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It was a busy time for the blockchain in the nation’s capital, with two weeks of back-to-back blockchain events: The Chamber of Digital Commerce’s DC Blockchain Summit and the (similarly named but unaffiliated) Healthcare Blockchain Summit.
Reaching the Summits
The DC Blockchain Summit featured two days of cross-industry updates with a particular focus on regulation and the public sector put on by the Chamber of Digital Commerce, a leading trade association representing the digital asset and blockchain industry. Unique among most blockchain technology events was the significant attendance by government officials (representing the U.S. as well as international countries). Topics ranged from healthcare to financial services, regulatory guidelines to intellectual property.
A particular highlight was the keynote by Robert Kahn, a foundational figure in the creation of the internet, who connected a range of specific underpinnings of blockchain technology to the early work done on the internet going back to the late 1960s. In particular, the long history of distributed data objects is a reminder that our current work on the blockchain is but the latest in a storied history of technical and communication innovation.
On the healthcare front, the key event was the Office of the National Coordinator’s (ONC) code-a-thon. Hashed Health was proud to be a sponsor of this event. Multiple coding teams were challenged to build working prototypes using blockchain technology to support the identity management requirements of the APIs that enable provider-to-provider and provider-to-patient exchanges, metadata tagging and policy expression for managing access to health information and data aggregation and linkage for sharing patient data. The resulting projects were impressive early works in integrating blockchain into these highly sensitive and complex areas of healthcare IT.
After the ONC code-a-thon and the Chamber of Digital Commerce events wrapped up, we had a weekend back in Nashville before returning to the capital for the Healthcare Blockchain Summit. This is one of two conferences (the other being Distributed:Health in Nashville) dedicated to healthcare and life sciences blockchains as they relate to the larger distributed ledger technology discussion.
Listening to the present chorus of thought-leading voices such as John Mattison of Kaiser, Mike Jacobs of Optum, Ted Tanner of Pokitdok, Brian Behlendorf of Hyperledger and John Bass of Hashed Health, certain themes seemed to emerge. Among them was the need for consortia, the future of chain interoperability, the spectrum of trust-based transactional networks and the emergence of specific healthcare use cases.
John Mattison of Kaiser has been a leading voice calling for strong leadership through consortia. Blockchain success in any market requires technical and business collaboration, so it’s natural that consortia are taking center stage.
Technical consortia such as Hyperledger are busy focusing on making sure the protocol-level open standards are strong and appropriate for the enterprise use-cases that will exist on top of them.
The business-level consortia such as Hashed Health are doing the hard work of bringing together corporates around solving shared problems, creating what Bass often referred to in his presentation as “ecosystems of shared value.”
Without the right protocol-level technology and without a business network that adopts a shared product, the whole idea of blockchain in healthcare is purely academic. In 2016, many companies stood up expensive blockchain proofs of concept (POCs) demonstrating this fact. Many expect that 2017 is the year that consortia will help healthcare demonstrate value, but success may depend on the resilience of consortia governance processes.
It may seem silly to some to worry about chain interoperability when there are so few real production systems. However, it’s clear that the world emerging will be a “chain of chains” in which interoperability will be key. If we don’t get this correct up front, we will need another “mulligan” (credit Tanner) down the road. Interoperability is made much easier by building atop open systems with public documentation.
The Spectrum of Trust-Based Transactional Networks
Bitcoin. Blockchains. Distributed Ledger. Proof of Work. Proof of Stake. Practical Byzantine Fault Tolerance. Tokens. Incentive Models.
There is a growing number of levers we can pull to solve problems and there is a spectrum of technologies that fall under what most people are calling “blockchains.” This drives some of our old-school Bitcoin philosopher friends crazy (note: in this case “old-school” is defined as maybe six years old).
In the commercial world of finance or healthcare, privacy and security are a reality and, at least in the short term, companies will want to use the best tools at their disposals to solve the problems related to trust and identity.
Most Mentioned Healthcare Use Cases at the Healthcare Summit
- Provider Data Management
- Track and Trace/Provenance/IoT
- Longitudinal Health Records
- Revenue Cycle