A couple of weeks ago in Washington, DC, Blockchain and Life Science executives / luminaries gathered from across the county to discuss the future of Blockchain in healthcare. The speakers and attendees at the Healthcare Blockchain Summit were a “who’s who” of Blockchain, Crypto, Pharma, and Healthcare Experts with a shared interest in “somehow” integrating health data onto a Blockchain.

John Mattison on Surfing and the Healhcare Blockchain

Vince Kuratis, Jody Ranck, and Ted Tanner were featured in keynotes identifying subjects ranging from platforms and “cautionary flags,” to an actual implementation of a B2B Financial Blockchain for healthcare insurance transactions created by PokitDok. John Mattison also spoke, and I gotta say, John’s one of the smartest people out there talking about Blockchain and healthcare technology in general. The Hype Cycle (popularized by Gartner) as well as the Bullshit Factors (general knowledge) were kept in check at this meeting. This was a group of very serious people gathered to discuss the intricacies of moving health data onto a Blockchain (or being referenced on the Blockchain via a sidechain, because everyone knows that Blockchain is horrible at storing data).

As I walked around and talked to a variety of people that were thinking about the details involved in various Blockchain use cases, I realized I’d seen this before. I remember going to Comdex in Atlanta, (yes, Comdex was small enough to fit in Atlanta) when Hayes Communications introduced the 9600 Baud Modem. I thought about a long ago discussion that I had with a HIMSS attendee about how the conference was too big at 2000 attendees. I thought about another Washington, DC convention called SCAMC, where a couple hundred people gathered in 1987 to discuss standards for communication of patient data between hospitals, laboratories and doctors.

Nobody at the conference really cared about Merkle Trees or the specific cryptographic equations associated with mining. The focus was on the business, logistical, and realistic challenges / opportunities of utilizing Blockchain in healthcare settings. The presentations focused on internal (corporate) blockchains, and external (patient facing) blockchains. It became abundantly clear that the use cases and actual implementations for the corporate blockchains were much further along than any of the patient facing efforts.

In fact, no company at the Healthcare Blockchain Summit could point to a single instance where a patient utilized a Blockchain to successfully access their actual clinical data.

While there are certainly some luddites that will point to this lack of adoption by patients as a failing of the Blockchain, these people do not see that the community is growing, maturing, and trying to not make the same mistakes found in previous technology rollouts in the life science arena. Blockchain as an immutable ledger technology actually presents a situation that forces serious thought and understanding to the technology, implementation, and actual clinical workflow, not found in other tech platforms. If you work with an immutable ledger, it’s probably not a good idea to do too much “iterating” with patient data.

After day one was over, free beer and wine was enjoyed by attendees and some groups headed into the DC night for Afghan and Thai food, and of course, more Blockchain discussions.

Shereese Maynard, Joe Guagliardo, and Edward Bukstel Discuss SDoH and Rare Disease

Shereese Maynard and Joe Guagliardo joined me on stage for a Panel Discussion on Day Two of the Summit to discuss Social Determinants of Health (SDoH) and Rare Disease Use Cases for blockchain. The fact that SDoH has been placed as a use case for Blockchain demonstrates a focus on the need to provide solutions to vulnerable people. Following this panel, a group of attendees asked questions, shared ideas, and exchanged business cards. (we are still doing that) The panel discussion generated numerous side conversations from government and private sector representatives on the specific applications of Blockchain tech for people with rare disease and Complex Medical and Social Needs.

David Schweikert (R. Arizona) discussed the recent efforts of the Congressional Blockchain Caucus and reasons for implementing Blockchain in healthcare. I have to say, my favorite comment from Schweikert, was when he stated, “I’m an old SQL programmer.” It was also fairly impressive to see a member of congress actually understand how a blockchain could benefit patients in the US healthcare system.

Rep. David Schweikert leads the Congressional Blockchain Caucus

Immediately after the Summit, there was a workshop organized as a 3 hour, deeper dive into utilizing Blockchain in healthcare. The workshop was organized by Neil Wasserman who did an excellent job setting the stage for workshop as well as guiding the attendees through a tight schedule. Initially, I advocated for an actual “hands on” session that would introduce actual programming of smart contracts on an Ethereum Blockchain for a specific use case. (ie: Pharmaceuticals). One of the amazing facts surrounding the DC Healthcare Blockchain Summit is the nearly 30% level of sign-ups for the Workshop out of the total number of Summit attendees. I have not seen this level of attendee interest in a workshop of any kind in over 25 years of healthcare conferences of any kind.

Susan Ramonat led off the Workgroup Session with a Davos, Switzerland Quality Analysis of blockchain which began with healthcare and moved onto the other aspects of an individual’s life, which may be impacted by the technology.

Blockchain will impact all areas of a persons life and identity

Mike Jacobs is a “Distinguished” Engineer at Optum, and the bulk of the workshop, specifically the Blockchain application use cases, was his responsibility. The attendees divided into (4) groups based on a specific healthcare blockchain use case that was to be discussed and debated. The use cases that the attendees selected were:

Value Based Care

Identity Management

Logistics (Supply Chain)

EMR focused on Medication Compliance

Over the course of the next 2 hours, flipcharts, iPads, debates and constructive arguments were deployed in an attempt to get to the heart of implementing Blockchain in healthcare. Mike Jacob’s continued to demonstrate why he is “distinguished” as he helped guide workshop attendees through the use case discussion. The Workshop Attendees did a phenomenal job at going into a “deep dive” into their use cases and also making the “elevator pitch” at the end.

Blockchain Use Case Design Requires Focus

Kyle Culver (Humana), Philip Clothiaux (Hashed Health), and I rounded out the technology / architecture discussion of the workshop. The resulting presentations and “work product” of the attendees was truly incredible. Flip charts and white boards were filled with info and gotta give a shout out to Kat Kuzmeskas who will probably be the next Elon Musk in healthcare for an incredibly concise description of how Blockchain could work in a value based care environment.

A lot of hard work remains to be done for the healthcare Blockchain. It would have been nice to see the individual use case groups agree to a set of information (Blockchain interoperability) that they would share amongst their applications on the Blockchain. Only the Logistics Use Case group identified incentives for participants, which will be critical for the success of any healthcare Blockchain. There probably wasn’t enough time to focus on the “the miners,” participants, or nodes on a permissioned Blockchain could become very interesting when deciding to allow medical malpractice law firms into Value Based Care Blockchain.

Comdex, CES, and HIMSS all started off pretty small with some very dedicated and passionate people. People used to joke about the “hype,” they don’t anymore. I wondered a bit about what will be next for the Blockchain in healthcare.

@ebukstel

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