Healthcare in Blockchain - An Evolution?
Crynet.io (project manager), EU structural funds, ICO/STO/IEO, NGO & venture, marketing projects
The economic costs of COVID-19 are devastating, on a scale perhaps never seen in modern times. At this stage, the human costs are vital. This is one of those rare points in history. The COVID-19 pandemic will profoundly change our economy, our behavior, and society. Some leaders who failed the test will lose their jobs. Some governments that failed their people will lose their power. Many institutions will come under scrutiny. Blockchain’s mission is to help “realize the new promise of the digital economy now.” It’s a new promise because we’re in a new second era of the digital age, where technologies like artificial intelligence (AI), the Internet of Things (IoT), augmented and virtual reality (AR/VR), biotech, and above all, blockchain is providing leaders with an unprecedented set of opportunities. These technologies are now relevant as never before, not just to business and the economy but the future of public health and the safety of global populations. Traditional systems have failed, and it’s time for a new paradigm. To build on Victor Hugo, “Nothing is more powerful than an idea that has become a necessity.” We have to understand the challenges of COVID-19 and the possibilities of using blockchain technologies in areas of need. We have to identify use cases where innovators are already deploying blockchain in Public Health and other sectors. Nodaway, we can detail five main areas for action:
1. Personal identity, health records, and shared data
Data is the most important asset in fighting pandemics. Without it, we can’t answer critical questions: Who are infected? Where have they traveled? If any useful data exists now, it sits in institutional silos, inaccessible to individuals and other stakeholders. We need better access to the data of entire populations and a consent-based data sharing system. The trade-off between privacy and public safety need not be clear. Through personal identities where individuals own their health records and can freely volunteer it to governments, clinicians, drug companies, and others, blockchain achieve both.
2. Just-in-time logistic and supply chain solutions
Supply chains are critical infrastructure for our globally connected economy, and COVID-19 has put them under tremendous strain, exposing potential weaknesses in their design. We must build supply chains that are transparent, where information can be accessed quickly, and where participants can trust that information about goods are accurate. Here blockchain is devoted to these targets. Blockchain serves as a “state machine” that allows us to know the state of not only our suppliers but also the assets themselves.
3. Sustaining the economy
If supply chains are the machinery of global commerce, then money is its blood. Yet, money itself has been a source of confusion and strain during this crisis. First, cash has been criticized as a carrier of the disease, and the drumbeat to abolish it altogether is growing louder. This use case highlights the what, why, and how of global digital cash. Second, the health crisis has become a financial crisis, destroying supply chains, closing off access to credit, and raising the alarm of counterparty risk. Third, insurance and risk management have been mishandled at business and personal levels. We must rethink ways to protect people and businesses from catastrophic risks. Fourth, decentralized models of governance, organization, and problem-solving can not only cut the costs of healthcare delivery but also transform how nongovernmental organizations (NGOs), governments, and individual donors contribute money and other resources to the fight against COVID-19 as an example.
4. HR database
Front-line medical professionals are the heroes and our last line of defense. Yet hospitals can’t onboard people fast enough. This is not for lack of talent; it’s the inability to find them. That’s what one calls the “talent management paradox,” where organizations continuously struggle to tap into the pool of skilled people looking for work. How does blockchain solve this? By streamlining coordination among different geographies, departments, and certification bodies so that process becomes more efficient and transparent. Convoluted criteria checks, redundancies in the certification process, and the processing of documents all slow down (re)licensing. If, as part of personal identity, every professional had verifiable and trusted professional information, then we could resolve this talent management paradox and get people to where we needed them, saving lives and starting jobs in the process.
5. Models to reward responsible behavior
People respond to incentives. That’s the consensus among behavioral economists and a theme of much public policy: How do we improve individual and business accountability during a crisis? What kinds of incentives do we need to manifest behaviors that will prevent viral outbreaks from rocketing into health problems or mitigate the damage that pandemics cause — without compromising privacy or liberty? Government must be aligned, too. How do we encourage policymakers, governments, businesses, and other institutions to prepare for the inevitable by keeping supplies on hand, designing a strategy for handling public health crises, or reserving funds for swift response? Cryptoeconomics can help with alignment: blockchain serves as a mechanism to synch up the incentives of stakeholder groups around issues and activities, changing patterns of behavior in the process.
Governments and public authorities
Governments must wake up to the blockchain opportunity. Every national government should create an emergency task force on medical data first to start planning and implementing blockchain initiatives. They can stimulate the development of technology firms working on the solutions described here. They can act as a model user of these important platforms and applications. They must focus on the supply side of the market for data, not just the demand side. That means passing legislation to mobilize stakeholders around creating personal identities and citizen-owned health records as a starter. They should pilot blockchain incentive systems for motivating people to behave responsibly. They should partner with medical professional associations and other players to implement blockchain credential systems. Governments have the world’s largest supply chains, many involved in producing critical medical provisions. They should rapidly pilot asset chains as described herein. Central banks should move swiftly to create a digital currency in their country and the International Monetary Fund should provide leadership in rolling these into a global, hegemonic, synthetic digital currency as an option. Data is perhaps the most powerful asset in fighting pandemics. If governments, clinicians, and citizens had access to data about a virus, they could take effective steps against it. We need data about what, where, when, how, who — how many people are infected, where are they located, when were they infected (and when did they recover), how were they infected, and who else did they contact? The countries with good access to such data — China, South Korea, and Singapore, for example — have had some measure of control over this coronavirus. Since they had experienced SARS or MERS, they were much faster to ban travel, impose quarantine, and enforce social distancing. Now Hubei province in China has lifted travel bans, and shopping malls in Wuhan are reopening under banners, “Wuhan is back!”. Countries with poor data — Italy, Spain, and now the United States — have fared much worse.
Nevertheless, getting good data these days comes at a high cost to privacy and individual rights. Chinese authorities impeded the spread of the virus through mass surveillance and big data analytics combined with propaganda. Let’s start with the surveillance. There are an estimated 170 million television cameras in China. These continually stream video into a centralized system that applies facial recognition software and other AI to identify people within their database and check their whereabouts against their identities — which is all the easier because it’s a real-name system, meaning that citizens must use their government-issued IDs to buy mobile SIM cards, open social media accounts and travel by air or rail. No pseudonyms. So if the Chinese lawfully buy SIM cards, the government can track citizens by their mobile devices. In Hangzhou, authorities deployed security staff wearing Rokid smart glasses with augmented reality. As they roamed the streets, security officers could check the temperatures of several hundred people in only a few minutes. During the total lockdown, people needed special permission to travel outside their immediate neighborhood. If they were caught on camera but didn’t have permission to be where they happened to be, then the police showed up. If they ventured beyond the nearest grocery store, they got a phone call from the police. Combined with a campaign of collective action and personal sacrifice, China managed to save countless lives and instill pride in its citizens for their unified response, compared to the seemingly impotent efforts of the West. Blockchain opens a new world of possibilities that shift control to individuals. In the city of Hangzhou in Zhejiang Province, VestChain Technology — a tech firm that develops open-source blockchain solutions on Ethereum in support of smart contracts and machine learning — has launched a decentralized application for identity management called Access Pass, the app integrates with WeChat to generate QR codes that enable residents only to enter their gated communities. According to VestChain, the app collects, encrypts, and stores users’ personal data in VestChain’s blockchain-based cloud servers; not even VestChain can access these data, and it has committed to deleting the data when the pandemic has run its course. This is important for the future of health, prosperity, and freedom because your medical information is a subset of your digital identity — the “virtual you.” The digital crumbs that you leave in daily life create a mirror image that knows more about you than you do. You probably can’t remember dozens of your personal identifiers: the numbers and other details of your driver’s license, passport, credit cards, marriage license, university, or corporate ID. Unless our brain works differently from ours, you definitely don’t recall your exact location a year ago, what you bought or how much money you spent and received that day, what you said online, and maybe which medications you took. Blockchain ledgers can remember for you. That’s just the beginning. In the future, the virtual you will contain detailed medical information like your heart rate, blood pressure, temperature, and myriad other real-time measures of what you do, how you function, where you are, and perhaps even how you feel. The trouble is that the virtual you are not owned by you. We can create the asset, but powerful companies and governments expropriate it for sure and without a doubt.
The crisis has shown to everyone that governments, strong and effective, are, in fact, critical to our society. So much for Ronald Reagan/Margaret Thatcher’s theory that “government is not the solution to our problem; government is the problem.” Libertarianism as an ideology is in deep trouble. In the United States, for example, people are looking to the Centers for Disease Control and Prevention (CDC) for up-to-date and accurate information and guidance, to the Food and Drug Administration for a vaccine, to the Army Corps of Engineers to set up hospital facilities, to Congress for financial relief, and to the Federal Reserve to lessen the inevitable recession. In some countries like China or Dubai, there is strong leadership to use this technology in transforming government and building an innovation economy. Governments should act now to help manage the crisis and create the conditions for controlling pandemics more effectively in the future:
· First, every national government should create an emergency task force on medical data to start planning and implementing blockchain initiatives. To implement this, we need new laws in many areas: our current legislative parameters use outdated frameworks that limit the ability to access and use data while protecting citizens’ rights. Governments must set the policies to ensure that the second era of the digital age actually serves people. By creating sensible legislation around privacy, security, and identity, policymakers can open up opportunities for blockchain innovation in.
· Second, governments can stimulate the development of technology companies working on the solutions outlined above. Many of these are early-stage companies that are critical but most vulnerable. This can be achieved not just through financial investments, but there are numerous other tax changes that can encourage investment in these companies. Securities legislation in most countries hampers the development of blockchain fundraising activities like token generation events, and entrepreneurs must deal with regulatory unclarity or outright regulatory hostility toward this technology and its leaders.
· Third, governments must pass legislation to mobilize stakeholders to create a sovereign health record and personal citizen identity. We need dedicated, speedy work on consent frameworks and legislation that confers ownership of data on the individual. Consent and data governance are key to unlocking this potential of blockchain and how the technology can better serve society’s needs.
· Fourth, governments have the biggest supply chains in the world, many of which are now involved in producing critical medical supplies and delivering services. The opportunities presented here for more proactive and flexible supply chains should be thought for officials who must manage not only shortages but the public’s faith in their systems
· Fifth, governments should move rapidly to implement national digital currencies. The International Monetary Fund can take important leadership in rolling this global basket of currencies into a synthetic hegemonic digital currency.
Private sector and business
Blockchain is already beginning to change many industries, including parts of the financial services industry, shipping, and global transportation logistics, upstream oil and gas, natural resource tracking and consumption, manufacturing, and segments of our global supply chain including food and electronics — many of which have been drastically hit by this crisis. That said, we are still in the very early days of this second era of the Internet, and deployment is still immature. Companies can act now, and benefit in the long term through understanding how blockchain can transform their businesses:
· First, large players in these industries affected by COVID-19 must still lead the way, starting today, by incorporating blockchain into their infrastructures. Building systems using blockchain will create a wider, more thorough data environment to mitigate future crises like this one.
· Second, firms must build blockchain consortia in the industries affected by the crisis. Businesses can provide useful solutions to help mitigate the crisis, as well as demonstrate the value of blockchain in the face of distorted supply chains and data opacity, planning an important role. We need coopetition among even the biggest competitors — especially in this time of crisis, as we all fight a common enemy. We need to challenge ourselves to move beyond our corporate boxes. We need to think about how we stitch together our solutions. We need to set aside our egos.
· Third, the private sector needs to continue its work to create pilots framed around all these opportunities: startups on medical records, credentialing systems, incentive structures, and other sovereign identity solutions. Implementing a sovereign digital personal identity that includes these aspects of identity will require cooperation with government.
· Fourth, when designing these test pilots, companies would do well to consider embedding incentive systems to mobilize their consumers to behave in a socially responsible way — whether that be sharing their data for health research and infection tracking or following government pandemic protocols. To achieve effective incentive systems, they will have to collaborate with the government.
Much of the innovation on public health will come from entrepreneurs; it is our hope that this initiative will wake up entrepreneurs around the world to seize the day.
NGO and civil society
Experts recommend that privacy advocates turn away from focusing purely on laws and governmental regulation to protect privacy. Rather, it is time to advocate for a personal medical record and citizen identity to protect data privacy while also making it more easily accessible. As we have seen throughout this situation, this crisis stems from a crisis in data accessibility. Without transparent data records, politicians, healthcare providers, researchers, and citizens are not prepared to build proactive solutions. Citizens — the creators of this data — have a vital role to play in moving this dial forward. Professional associations like the American Medical Association, nurses’ associations, and others would benefit from exploring the personal patient record and becoming its strongest advocates. Blockchain can enable patients to provide rights easily to their medical data to scientists and clinicians for critical research and planning. These associations, along with schools, colleges, and universities should consider blockchain for medical licensing and accreditation. Everybody needs the right clinicians and practitioners at the right places in the right times and blockchain is the new platform for credentials and trust.
This pandemic has shown us the extent to which our current systems are not ready for the next age of our global economy and society. What makes anyone think we’re prepared for the next global crisis, the next transformation to our economy, or the next test in our life? A new era of transformative digital technologies is arriving. According to expert opinion, we haven’t realized the promise of the first era — the promise of a P2P empowered world. Instead, the economic and political benefits have accrued asymmetrically, with power and prosperity funneled to those who already have it. In pandemics, those hardest hit are the most vulnerable among us, in the poorest neighborhoods with the worst sanitation systems. Technology doesn’t create prosperity and the quality of healthcare — any more than it destroys privacy, property rights, and peace of mind. However, in this digital age, technology is at the heart of just about everything — good and bad. Let’s go to working toward the good within our operations and through our relationships with customers, employees, and supply chain partners. The opportunities described above ought not to be taken as one-time initiatives. Rather, they are integral to ongoing business and governmental concerns, opportunities that should pull us out of this crisis and prepare us for the next.
It appears that once again the technological genie has been unleashed from its bottle. Now at our service for another kick to transform the economic power and the old order of human affairs. You already can see all these transformations. Laws that would have taken months, if not years, to clear congress are passed in days. Businesses like Zoom, once used mostly by technology companies, have become important tools of daily life for community and business. Meanwhile, former titans of the Industrial Age like Boeing are asking for bailouts. Add to this mix the exponential properties of technologies like blockchain, and we’re setting ourselves up for a cataclysm of some kind.
One can anticipate a real crisis of leadership as the new digital only models of this next era conflict with the old industrial examples. Maybe this awful crisis will call forth a new generation of leaders who can help us finally get the digital age on track for a promise fulfilled? I hope so.
Sergey Golubev (Сергей Голубев)
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