Reviewing my 2020 blockchain and healthcare predictions

Hi everyone and happy holidays,

At the beginning of the year I made some predictions for blockchain and healthcare in 2020 and I thought it would be good practice to review them as the year comes to an end. A little bit of a preview: I will publish reflections on blockchain and healthcare in 2020 next week, and hope to publish some predictions for 2021 in early January.

You can connect with me on TwitterLinkedIn, or join the Telegram chat room I run. Anyway, here are my 2020 predictions in the same order as I listed them before:

1. Enterprises will drive activity

Notable activity from startups dropped sharply this year, and almost all significant developments were driven from enterprises. I was right on the mark here.

Rating: 10/10 🎯

2. We won’t see a blockchain based electronic health record in 2020

As always there were a few stray announcements of an odd health data focused project here or there, but a blockchain-based EHR remains the ever elusive holy grail of this industry.

This said, I am cautiously optimistic for 2021 and beyond with the ONC’s information blocking regulations coming into place, web3 technologies maturing, and some signals of interest from big enterprises. A fully fledged blockchain based EHR won’t be realized next year, but some big steps towards that might be taken.

Rating: 10/10 🎯

3. Two new healthcare specific credentialing networks will be launched

Coming into 2020 I was super excited by credentialing as a use case: the tech was ready, there was a clear business model, and I liked the entrepreneurs in that space. I still believe all of that, but my timing was off. ProCredEx did have some big announcements this year, but their network was forming and they were around in the scene generally in 2019, so it feels off to call them a “new” launch. Further, there were some proof-of-concepts and a brief flare up from Rapid Supplier Connect (which retired this year too), but this doesn’t amount to the 2 launches that I had expected (and hoped for).

Rating: 3/10 👎

4. Hyperledger Fabric and Ethereum will retain their positions of dominance in the enterprise space

This is still true, although compared to this time last year I think Corda is in a stronger position today than it was because of the strong advocate they have in ProCredEx.

The dark horse candidate to watch in the coming years will be Polkadot, who has differentiated technology, a stellar team, a massive war chest, the beginnings of a public ledger ecosystem that could rival Ethereum’s, and an unannounced (I think?) but prominent blockchain and healthcare company building on PolkaDot. Still, the network effects of the incumbents are strong so don’t expect PolkaDot to vault into first or second place anytime soon.

Rating: 8/10 👍

5. A healthcare focused decentralized autonomous organization (“DAO”) will be started

I thought that we would see a DAO focused on investing in biotech or giving out grants, but that did not come true. I personally thought of starting this (that’s one way to be right in a prediction!) and circulated a whitepaper to close colleagues early this year. But in the midst of the pandemic I judged that I shouldn’t take attention and money away from other things that were more important. I wonder how many others followed the same thought process.

There is Definitize.Finance, a DAO by Solve.Care that supposedly loans out money to borrowers buying medical devices. I am very skeptical of this. The whole idea of a DAO is, well, that it is decentralized and autonomous. Making loans to consumers to buy expensive medical devices today necessarily requires centralization and humans. So I do not think this can be used to validate my prediction.

Rating: 2/10 👎

6. Healthcare ICOs that are still around today will rework their tokens completely, return capital, or perish

I followed this on with these specific numbers:

Without any pivots I’d speculate 3 - 6 more tokens will be dead by this time next year.

Further, here is what I wrote at the end of 2019 about “dead tokens”:

Several tokens are, for all practical purposes, dead. The teams behind these tokens may continue shipping updates, but make no mistake, their tokens have bleak futures with little to no volume and no way for consumers to reach them, as they have been delisted from major exchanges. If tokens are a “breakthrough in network design” then these tokens have failed to create the networks necessary to sustain them. A few tokens on this list were like zombies: dangerously close to death themselves or difficult to tell if they were really alive.

My definition for a dead token is: 1. there is little to no trading volume (no one is buying or selling it) and 2. it is not available on major exchanges (consumers cannot easily get access). And to be clear this does not mean the company behind a token shuts down, but simply that the token itself is functionally dead.

Now, this is what the healthcare ICO landscape looked like at the end of 2020:

Four new tokens have died and from that perspective I was right that “3 - 6” tokens would die. But I was wrong that all of the remainders would rework their tokens or return capital. A few - notably the ones that performed relatively better - continued to innovate around their token, but no one returned capital. Altogether a mixed bag, but big picture I think I was right even if some details were off.

Rating: 7/10 👍


Summing it all up I would give myself 40 out of 60 possible points, roughly translating to four correct predictions and two wrong predictions. Not too bad considering the volatility of the year!

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