What Does Blockchain Mean For HealthCare?

There are many people who cringe when they think about what is going to happen to healthcare under a Trump administration. Healthcare is a subject which has wormed its way into everyday conversation since Ronald Reagan was in office. Back then “entitlements”, specifically social security, were a supposed “third rail” that could not be touched, whittled down or even frozen.

Fast forward to the present.

Regardless of what you think about immigrants, poor people, old people, sick people or children, there is one fact that is inescapable. The basic notion of the “welfare state” is being re-examined. It is not just the United States where this is a hotly contested issue.

The drivers? Exploding costs and aging demographics along with creaky infrastructure and outdated service models.

The scandal facing the NHS in mid May over a massive hack made possible by outdated software is just one example of how fragile established western healthcare systems currently are.

That the system needs to be fixed is not controversial. How to fix it is another issue.

In the United States, there is huge pressure on Republicans to overhaul Obamacare. And it is fair to say that there are no easy fixes to a system in the United States that is unbelievably complex, expensive, and which has gaping holes in it. Out of desperation, one proposal to cut costs in the United States is to incorporate blockchain technology. In Europe, where the social state as a concept has not died, blockchain has already begun to be examined as a cost-saver in both the public and private insurance industry.

Blockchain could help to reduce healthcare costs. One of the biggest drivers of healthcare costs in the United States and other places is the administrative time, cost and paperwork necessary to run a regulated industry. A key benefit of using blockchain will be lower costs of healthcare administration due to economies of scale that will provide much needed relief to state and national budgets. This means that the forecast explosion of costs might be better contained.

Rising healthcare costs are further complicated by privacy laws that aim to protect health related information. In the United States, this falls under HIPAA. Otherwise known as the Health Insurance Portability and Accountability Act, this Clinton-era legislation has very strict rules about how health records can be shared. Blockchain in this environment provides a secure way for databases to talk to each other, and offers a solution to the privacy conundrum laid out for IT professionals in this space since 1996.

For this reason, introducing blockchain represents one of the first true opportunities to “fix” a horribly broken system – in the U.S. and elsewhere.

In Europe, where the concept of inclusive healthcare is akin to a sovereign right, this conversation has already started.

Implementing blockchain will not simply be a matter of sending “bitcoins” to doctors for payment. It will be about the widespread use of “smart contracts”. The earliest use cases across the industry are mostly related to health record management and access, as well as insurance claims.

Blockchain may be a secure technology, but creating a fully digitised healthcare system raises serious privacy concerns. If people are enrolled in systems where they can be tracked for life, what happens to that information and who has the right to access it? How will such interactions be designed to protect the individual in a world where nothing, suddenly, is truly private. How can people with pre-existing medical conditions be sure that their information won’t fall into the hands of insurance companies who will use the information to charge higher insurance premiums or to deny coverage?

These new healthcare systems will need to be designed with privacy issues kept firmly in mind. An old and crumbling system is about to be replaced with a technology whose impact is as yet largely unfelt. And for the most part, it will be Generation X and Y who will be tasked with building these systems. The privacy rights of young people and many voiceless individuals on the fringes of the system will be affected. This could serve as a clarion call to those who have long been left out of the healthcare debate, but more likely it underlines the importance of safeguarding the privacy rights of groups who are presently unaware that their fundamental rights are hanging in the balance.

In sum, blockchain will absolutely play a defining role in healthcare reform. How and where it will be applied is still unclear. However, it is likely to play a central role in redesigning healthcare systems for the 21st century in America and beyond.

Marguerite Arnold is the founder of MedPayRx, a blockchain healthcare startup in Frankfurt. She is also an author, journalist and has just obtained her EMBA from the Frankfurt School of Finance and Management.

Image: Flickr

Wearable Technology: Implications for Entrepreneurs and Organizations

Imagine a world where one can rate the popularity of any individual from 1 to 5 using a mobile device. And in this imaginary world, these ratings are important for determining one’s employability, social status, and where one can live. Furthermore, each person’s name and rating is visible to everyone else through the use of a wearable contact lens. This world already exists in the Black Mirror episode, Nosedive, but is slowly becoming a reality in our world. It is not uncommon to run across people who are staring at their Apple Watch or Fitbit as you walk through the city. In fact, wearable technology is becoming an increasingly popular trend with 50 million wearable devices shipped in 2015 and an expected shipment of 125 million devices in 2019. These statistics suggest that many people are already incorporating wearable technology into their daily lives. So, in this article, we will investigate the implications of wearable technology on businesses and entrepreneurs.

Every business is looking for ways to continually improve the productivity of its employees. One research study found that the productivity of workers using wearable technology increased by 8.5%. This is a striking statistic. How are wearables doing this? Well, for example, companies like Boeing and Tesco use wearables to gather data about the time it takes to complete certain tasks. They can then perform analytics on these data in order to train their workers to be more efficient and productive in the workplace. Ultimately, wearables allow businesses to gather information on employee activities that have not been easily accessible in the past.

Productivity of employees is also connected to their health. This is particularly relevant in America, where improved employee health can allow businesses to cut costs associated with healthcare premiums. Many consumers of wearables use their devices with the intent of improving their health. In fact, 56% of consumers believe [pdf] that their wearable device will improve their fitness. However, even though wearable devices claim that they can improve health, there is no empirical evidence that demonstrates that they can. Studies show that almost a third of users will stop using their device after 6 months [pdf]. Until more studies come out proving that wearables improve consumer health or further improvements are made in wearable technologies, businesses should be wary of using these devices as a way to improve the overall health of their organizations. In essence, an investment into current wearables to improve employee overall health may not pay off.

Another challenge for wearable technologies is privacy. Even though wearables will allow organizations to gather data that was not easily obtained before, employees may object to having their data used for analytics by their organization. It will be important for organizations to prepare themselves to navigate these privacy hurdles before implementing wearable applications to gather data analytics. For example, organizations should be open and honest with their employees about which datasets they are gathering from their wearable devices. This will prevent employee dissatisfaction and potentially costly lawsuits.

Entrepreneurs should not only think about using analytics collected by wearables to improve their startups, but also be on the lookout for opportunities in the wearable technology market. Because of the potential for businesses to use wearables as a way to improve employee productivity and health, wearable technology is an emerging market that is rapidly growing to meet the needs of organizations. As of now, the wearables market is predicted to grow by 35% by 2019. These statistics suggest that there is a lot of potential in the wearables market for startups to develop new devices and applications. Ultimately, entrepreneurs that are looking for a growing market should consider investing in wearable technology and applications.

Thomas Beck is a postdoctoral fellow in the Department of Molecular Physiology and Biophysics at Vanderbilt University and co-founder of a digital mental health startup, and runner-up in the 2016 TechVenture Challenge for a novel therapeutic. Dr. beck serves as the president of the Vanderbilt University Advanced Degree Consulting Club.

Free Services vs Privacy Online

Big data (combined with data analytics and machine learning) offers exciting opportunities to decipher patterns and solve complex problems more quickly and cheaply than ever before, but it also has the potential to infringe the privacy of individual users.

Looking at a company like Evernote, which uses a freemium business model to help tens of millions of people be more productive at work, it would be easy to think that there is an inherent trade off between providing a free service and dealing with issues like surveillance and data oversight.

CEO Phil Libin rejects the idea that there has to be a trade off between free services and privacy online.

“We don’t have a big data problem”, he told Stephen Chambers in 2013, “we have millions of small data problems … Everything that people put into Evernote is yours, is private and it should be completely up to you what you want to do with it.”

A few years ago, Evernote published three principles of data protection:

  1. Your data is yours,
  2. Your data is protected (that is, it is not data mined or used for affiliate marketing), and
  3. Your data is portable (that is, you can easily take your data and leave).

Libin’s principles for data protection are admirable, and they certainly provide a level of comfort for Evernote users that doesn’t exist everywhere elsewhere.

Facebook, for instance, has been pretty cavalier with user data over the years. Whether it be adding features that share a user’s location, preventing users from easily downloading their own data, or it’s recent and widely criticised Internet.org initiative to provide a limited number of free internet services in developing markets which digital rights groups have argued undermines net neutrality, freedom of expression and the privacy of users.

While Evernote actively favours data protection, there are strong indications that Facebook definitely doesn’t.

Why do Evernote and Facebook have such a different approach to data protection?

The answer appears to lie in the different business models that the two companies have chosen to adopt. Facebook is a free service and apparently always will be. It makes money through ads, and exploits user data in order to serve those ads more effectively. On the other hand, Evernote has adopted a freemium model. It offers a free product to all users and offers a more premium version of the product to paying customers. Happy customers can upgrade if they want to, and this is where Evernote makes all of its money.

There is money to be made online through targeted ads, and this is how Google and Facebook make money. There is also money to be made by providing products that people are willing to pay for, and this is how Netflix, Audible and Evernote make money.

The issue with the targeted ad approach is not that it lacks profitability, but that it requires the companies involved to harvest and analyse user data, and these companies are often elusive about exactly what data they are collecting and how they are using it.

Transparency would restore a lot of trust.