It’s becoming more evident by the day that healthcare is on the cusp of disruption. Everything from the explosion of health hackathons seeking innovative ideas to giant companies like Apple, Google, and Amazon making bold announcements to enter the arena, the signs are overwhelmingly clear that a major transformation is swiftly in motion. However, as a consumer and participant of health, we must collectively make a decision on the technology that will set the stage for this new health system. If we all agree that personalized medicine with a patient-centric design is the way forward, we must consider the implications of security, privacy, health outcome, and costs. In this post, I will make the case for blockchain and related technologies to address all the challenges that is better than whatever we have now.

If you were to poll health stakeholders today, most would agree that patient engagement plays a key crucial part in realizing the future of health. Gather as much data as possible about the person. Evidence-based medicine should collect, well, more evidence. Lots of it, and I mean everything from sleep, food, sex, exercise, work, shopping, gait, bathroom habits, emails, SMS, to creepier and creepier. This is on top of biometrics data like facial, fingerprints, and DNA, which are intrinsic to you and cannot be changed ever. Believe it or not, all of this data give insights that can be used to maximize your well-being at any given time. With advancements in AI, we can even predict health events given abundant amount of data. The intimacy of ourselves and our health is the trade-off most people have yet to understand.

If you’re thinking that personal health information (PHI) is highly sensitive and private information, you are absolutely correct. It can’t get more private than this. It’s why we cannot rely on anyone storing and sharing this data except you. Any companies with central cloud databases and file systems can and will be hacked. Honeypots will always provide enough incentives for hackers to break it regardless of the technology. The bigger the honeypots, the larger the attacks, the bigger the damages. This is a truism of security. On top of server breaches, social hacking to compromise username/password to infiltrate systems poses another vulnerability of centralized design. Hackers don’t have to brute force the database but instead gain developer and admin credentials to access the system. Since it’s centralized, a single point of failure puts the mass at risk. With blockchain, the entire stack leverages the best in cryptography to decentralize storage and access to be controlled by you. Only you have the cryptographic keys to your data. Hackers would have to breach many many users to gain any meaningful value from the data. There is no single point of failure. Things are distributed and so are the incentives to attack it.

Now that you are in control of your PHI, blockchain also makes sharing simpler and widely available to more health services anywhere in the world. All the permissions and access are recorded on the blockchain. Full traceability and accountability are ensured by the decentralized ledger. Full utilization of asymmetric cryptography to seamlessly encrypt and decrypt data. New applications of homomorphic cryptography enable more services to run more analysis on sensitive data. Third party developers can freely build on top layers to add more value to unlock health insights. All of this is only possible once each person owns their data and distribute access to it. As a result, health outcomes will improve two-folds. First, by keeping the person informed about their health, they will be more incentivized to make better health choices. At the end of the day, You are solely responsible for your health. Second, by removing centralized barriers, innovations are unfettered leading to more health tools and more choices available. Combined with more data, health services becomes more refined overtime to maximize health outcomes.

Perhaps the most convincing argument for blockchain is cost reduction during the time of inflated and out-of-control rise in healthcare spendings. Blockchain can improve efficiency and reduce costs in three ways. First, by removing intermediary and toll-booth data relays middle men, all health transactions will see lower costs. Second, the peer-to-peer nature of file storage and micro-payments of blockchain will leverage new algorithm and innovations in information technology to efficiently move data around. Lastly, business processes and workflows will restructure around blockchain to be much more efficient in staff management and delivery of care. All three effects will reinforce each other that will dramatically cut health costs.

As a consumer of health, I’m excited for the fantastic future of health but at the same time concern about how it will be organized. As a technologist, I see the power of blockchain and its promise to improve healthcare. It’s why I’m working on Emrify to decentralize the Personal Health Record. I want my kid’s health records on blockchain. I want to live longer and healthier. I don’t want to have to make the hard decision to choose health expectancy in exchange for my privacy and security. Blockchain is a bold and radical transformation of healthcare that will take real efforts, but it is the only path forward given all the pros and cons. Blockchain is as close as we can get to the true meaning of patient-centric healthcare. Decentralization is the foundation of the future. I hope that this post was able to shine some light and nudge you in the right direction. I hope you join me in making this a reality.