This week, I’ve been invited to participate in a roundtable, hosted by Microsoft at its Annual Worldwide Partner Conference in Toronto. The topic is Blockchain. So I thought now would be a good time to elaborate on a prediction my co-founder Lisa Maki made back in January.
As Lisa speculated, Blockchain, otherwise known as the Distributed Ledger, is making its way into healthcare. Last month, I showed some production ready running code on the Blockchain to a group of two dozen financial institutions, health systems, and technology providers. I cannot say who was in the room but can tell you the meeting was held in a place called Redmond, Washington.
It was a few days after we announced our induction into the Microsoft Azure Marketplace. As I mentioned in my last post, we recognize that healthcare worldwide predominantly runs on Microsoft products and nearly 85 percent of clinical tools are Windows-based systems.
So, in Redmond, we showed a full production-ready eligibility check running on the blockchain on Microsoft Azure services utilizing a live payer, Cigna, as well as our platform services with a multi-signature wallet for both the provider and consumer.
I want the above to sink in as to the magnitude of what this means for the #HealthIT industry.
There’s too much buzzword bingo going on and it is time we unveil what a working prototype looks like. It’s called DokChain(™).
Some people often conflate blockchain with all their true desires. Others think it is abstract and are still trying to wrap their head around it. Some skeptics are so hung up with how long this will take and question if it is really necessary. Was introducing the airplane necessary when horses, trains and ships could get us there?
Blockchain won’t make unicorns cough up hundred dollar bills. But it will make healthcare work better and save the trillion dollar industry billions. While I’m in physical pain and I want it to stop right now - I don’t want to fill out another form.
We have a business process problem that can be saved by blockchain. We should not be focused on creating business models that continue to support legacy systems and processes. We should focus on new ways to transform the healthcare experience for consumer and providers.
Underlying Market Forces
We’re at a point in time where the architectural foundation is taking real shape, comprised of several native blockchains with cryptographically provable off-chain inputs and side-chaining from API systems, such as PokitDok’s Platform. Built on those rails, consider this:
Identity Management lives at the intersection of health and finance. And it just so happens that the finance industry is the first to successfully adopt blockchain. So we can reasonably conclude that identity management connected to eligibility and benefit verification will be one of the first applications as blockchain makes its way into healthcare.
For example, when running an eligibility check on one patient, there are a spectrum of dimensions available to identify that person in need of medical services. Couple this with scheduling and the ability to precisely geo-locate the healthcare provider and we have a complete distributed Amazon-like shopping experience that will, by definition of the architecture, operate in seamless fashion.
Our 23 APIs were designed to enable consumers to “Shop, Schedule, and Pay” for medical services. This facilitates the consumer, provider, and payer interaction model, including validating the consumer’s identity. The connection of the Eligibility API, the Identity Management API and the Scheduling API allows us to fully resolve Jane Doe for that particular service at that particular instance or across the life time value of the consumer.
Imagination to Reality
Imagine if you only had to fill out registration once. And you owned your medical data, like you manage your bank accounts and private email. Every time it is accessed or updated, it creates a reference hash. These requests generate a series of events, recorded on the secure distributed ledger. The sequence in a chain is implicitly encoded. It is about protecting your data instead of worrying about EMR systems getting hacked or locking up information that belongs to you. It also means that the aspect of what an EMR is or accomplishes post Meaningful Use changes drastically even if needed for management of information for the consumer.
Provenance and Control
Multi-signature has been used for thousands of years to protect the security of crypts holding the most precious relics of saints. The superior of a monastery would give monks only partial keys for gaining access to the precious relics. Thus, no single monk could gain access to and possibly steal the relics.
In the cyber realm, the concepts for digital identity management are not new in the least. Layers such as SSL and kerberos have been around for decades. Kim Cameron’s seminal paper on the 7 Laws of Digital Identity lays out the fundamental concepts. One in particular is an outlier:
“Digital identity systems must be designed so the disclosure of identifying information is limited to parties having a necessary and justifiable place in a given identity relationship.”
As I see it, the fundamental tenet of how the blockchain system is designed and will evolve in the future is based upon this law. The provenance of the initiating transaction can be granted or revoked with respect to the parties involved. Transactions that occur are a function of hashed values that are reliant on the previous transactions. Thus the entire provenance or identity of that transaction is fulfilled.
Why This? Why Now?
At the core, blockchain drives efficiency, protects rights through immutable records and establishes a system of accountability. With the support of key industry partners, we are building a healthcare blockchain to fundamentally change the way consumers, providers, and payers interact. This system inherently improves the security of sensitive healthcare information while simultaneously making data more readily accessible to authorized parties in real time. With an elastic front end, data is encrypted on the blockchain and lives in the cloud.
Healthcare has largely skipped the internet and has been slow to embrace the cloud. High operational costs, inefficiencies, and legislation are forcing the industry to re-think their technology strategy. Watch APIs serve as a bridge to legacy systems with distributed ledger technologies, that make up the blockchain, layered in.
We need to remove perceived technical barriers to how we think about and execute the business of health. I wrote this piece to conjure a mutual understanding of the technical and business opportunities presented with blockchain, using identity management as the starting point.
In the next link in the chain (ahem blog) I will discuss the technical aspects of the implementation.
Once again: We have something running in production, ready for commercial engagement.
Now let’s get the DokChain going....
- Full Consensus and Distributed Ledger Hardware Acceleration - May 10, 2017
- Blockchain Virtual Machines with Consensus in Silicon - October 11, 2016
- Snake_Bytes #3: Statistics! - September 23, 2016
- DokChain Technical Deep Dive - Part One - September 13, 2016
- Welcome To Snake_Bytes - September 9, 2016
- The DokChain is Now - July 13, 2016
- PokitDok Now in the Microsoft Azure Marketplace - June 8, 2016
- ClearingHouses Are Oxymorons - May 4, 2016
- Social Capital Within Social Health Networks (part 2) - August 22, 2012
- Social Capital Within Social Health Networks - August 3, 2012