Novartis talks blockchain on CNN & Google's aggregation of health data comes under scrutiny
|Robert Miller||Nov 17, 2019|| 2|
Blockchain in healthcare updates
Believes that near-time value in use cases closer to supply chain, and but there is long-term value in patient data use cases
Stressing their desire to go live with production use cases in 2020
Highlighting the IMI blockchain and healthcare consortium, which has 11 pharma partners and 28 companies participating in total. It is set to launch in the coming months and I’m keen to see what they tackle
When asked about how they compare to their peers they didn’t directly answer the question but talked about their work on digital identity and verifiable credentials
Emphasized the need for an ecosystem in blockchain solutions
Cool to see blockchain and healthcare getting the spotlight like this!
Oasis is building tools to let people control their data by leveraging blockchains and special hardware called trusted execution environments (“TEEs”). In short, TEEs provide an isolated area to store sensitive data and run software on it, and this area is both private and resistant to tampering even if you have access to the physical hardware. Your mobile phone likely uses a TEE to store your biometrics or financial data.
Oasis hopes to marry the confidentiality and integrity of TEEs with smart contracts to give people real “control” over their data. The article highlights a pilot being done with Nebula Genomics, a blockchain and genomics company, where users will retain control over their genomic data while still enabling Nebula to run specific analysis on their data without revealing it to Nebula. Another collaboration is Kara, where patients have the option to share retina scans and other medical data with researchers to train machine-learning models to recognize disease, and they hope to test what kind of incentives patients respond to.
There are several projects taking the approach of using TEEs to give users more autonomy and privacy. Enigma, is another project and just last weekend I was working on a use case fairly similar to Kara using Engima’s tech instead of Oasis’. Hyperledger Avalon, is a “framework” and does not specify the implementation of particular technologies like its peers, but has similar goals, though Avalon’s scope goes beyond TEEs.
Overall my personal assessment is that these technologies are nascent, and have work to be done to make them production grade, but have great potential.
MediBloc is one of the 2017 healthcare ICOs that is still around and occasionally putting out headlines. They tout this as their 12th MOU, which is nice, but it occurred to me that I’ve never heard anything more about what has happened with the past 11 MOUs that they have signed. Take that as you will.
What I’m reading this weekend
The initiative moves tens of millions of personal health records to Google’s cloud, where they will have the ability, indeed the explicit aim, of analyzing huge amounts of identified personal health information. The WSJ, citing anonymous employees, reported that as many as 150 Google employees have access to this patient data, and reported that patients and physicians were not informed of this work. A day after the WSJ’s report broke they also reported that the HHS has opened a probe into this arrangement, though it’s not immediate clear to me when that probe was started.
Google defended this work as in line with industry standards, HIPAA compliant, and subject to a Business Associates Agreement they have with Ascension. But given Google’s history, which a charitable reading would characterize as misleading the public on their practices with our data, it is hard not suspect there is more going on here than Google lets on. Moreover, without seeing the contents of their BAA we won’t know the limits of Google’s work. For example BAAs often times include a provision allowing the business associate (Google) to deidentify data, which in turn means that data would no longer be governed by HIPAA and provided HIPAA’s protections.
Google has built their brand on an image of relentless curiosity and built their business on a relentless march to gather more and more data about us in the face of growing privacy concerns. This history, along with other notable tech mishaps, has led to a huge trust deficit where only 10% of consumers are willing to share their health data with tech companies. Against this backdrop it is no surprise that people are turning to technologies like blockchain and trusted execution environments to fill that gap.
A new study in Health Affairs found the following, bolding mine:
On average, hospitals gave 95 percent of discharged patients access to view, download, and transmit their information, but only about 10 percent of those with access used it—levels that were stagnant during the study period.
More telling statistics
81% of the public say that the potential risks they face because of data collection by companies outweigh the benefits
81% say they have very little/no control over data companies collect
79% say they are very/somewhat concerned about how companies use(s) the data collected
59% say they very little/no understanding about what companies do/does with the data collected
These questions were also run with the government being the focus, not just companies.
There’s a lot here, and I’m not through the whole report yet, but it’s a great read.
After this podcast with Balaji Srinivasan I was interested by Glen Weyl’s ideas on identity and how current market mechanisms fail to account for the robustness of social relations, so I’ve been digging into that idea this weekend. I read this paper when it came out and didn’t have much of a reaction to it, but it became much more interesting after hearing Glen speak to the concepts using examples on the aforementioned podcast. I’ll try to write something about how this is relevant to healthcare after I digest it a bit more.
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