Blockchain in healthcare updates
IBM is collaborating with VetBloom, the digital learning ecosystem from Ethos Veterinary Health, to create a “group” for using a blockchain for credentialing in the veterinary industry. Critically this credentialing solution is focused on “micro-credentials,” like learning a particular new skill, instead of “macro-credentials,” like a degree.
In short each time someone is issued a micro-credential then a verifiable and permanent record will be created on a blockchain that corresponds to that credential. The idea is that individuals will be able to point to these records on a blockchain to prove their qualification to employers, making it easier to apply for jobs for the applicant, and reducing the costs to verify credentials for the employer.
An interesting contrast to note here is with other credentialing solutions, which have enabled the reuse of one parties’ verification of a set of credentials. The workflow, at a 10,000 ft level, is something like this:
Institution issues credential —> intermediary requests relevant documents about this credential to verify it —> record(s) of this verification process are posted to a blockchain —> others can leverage these record(s) instead of repeating the same verification process themselves
The solution proposed by this veterinarian group goes directly to the source and has the relevant institutions issue credentials directly on a blockchain:
Institution issues credential —> a record of this is posted to a blockchain —> others can leverage this record to verify credentials
Both are more efficient than the status quo. But all other things being equal if you are given the choice of two solutions to verify a credential, where one is directly from the source, and the other is through an intermediary, you’ll default to going directly to the source. One has to wonder which (macro) credentialing authority in healthcare will start to issue credentials on a blockchain first and which solution they’ll partner with.
Details here are sparse, but it seems this is a blockchain solution for making payments in a pharma supply chain more efficient. They partnered with Zheshang Bank, which had previously securitized loans using accounts receivables, perhaps signalling a future direction.
“It is very hard to get companies that compete with each other to work together,” he said, adding: “And then, if we get them to work together on a single problem, and ultimately we are proven wrong on the efficiency or effectiveness of the solution, that’s a lot of work for nothing.”
This echos the sentiment expressed by industry leaders as well that governance problems are more difficult than technical problems.
What I’m reading this weekend
The article speaks from a crypto-first, blockchain-second perspective and they highlight four larger consequence we can expect to play out in China after Xi’s speech endorsing blockchain:
Crypto-native companies in China will face less regulatory pressure
There is more room for entrepeneurs to experiment in legal “gray zones”
Blockchain initiatives, policies, and funding will come top-down from the government and corporate boardrooms.
Enterprise blockchain providers emerging and selling “blockchain as a service” to businesses and governments.
More global blockchain support:
I hope to see the same top-level support for blockchain initiatives in the US.
Specifically, they looked at it previously and came to the conclusion that the benefits of such a project were less appealing for the US, where cash is prominent, the “payments landscape is highly innovative and competitive,” and a digital currency would pose many important policy questions. It’s a good read on the various issues and detailing how the Fed is thinking about this at a high level.
While reviewing this, and the above stories of other global activities, I was struck by how much the overton window had been moved, particularly by the announcement of Libra. These proposals and headlines above would have been unthinkable not too long ago.
Using a public blockchain you incur transaction fees that are necessary to get your transactions included in the next block. These aren’t that costly (especially if you’re willing to wait awhile) but it is rather expensive if you want to post private transactions on a public blockchain today because doing so uses advanced cryptography that generally requires a lot of extra computation.
In contrast running a private blockchain means you’ll incur the one-time costs of setting it up and on-boarding members as well as the relatively low on-going costs of running nodes and validating transactions. EY’s paper looked at the tradeoffs and economics involved to determine when each solution was more prudent. Some takeaways:
Posting private transactions to a blockchain today is very expensive but the next iteration of EY’s zero-knowledge proofs, supposedly launching soon, will drive this cost down by ~90%.
Even with the more expensive private transactions today if your blockchain solution has relatively low transaction volume it is less expensive to use private transactions on a public blockchain due to the high one-time costs associated with setting up a private network.
There’s a point that EY identifies close to ~2,000 transactions a day where it becomes more efficient to use a private network over their future state (cheaper) ZKPs.
The model EY creates make a series of assumptions around costs that may or may not be true in any given situation. But the general heuristic of “public blockchains are more efficient for low transaction volume and private are better for high transaction volume” seems reasonable.
In a paper published by Visa’s research and development arm, researchers describe a system called LucidiTEE. It outlines a system for sharing sensitive personal data on a blockchain, crunching that data within a trusted execution environment (TEE) and using history-based policies to ensure that each of the parties receive an output of the computation. (The system’s name is a combination of TEE and the word lucidity).
Easy to see how this could be applied to healthcare as well.
Podcast: Vitalik Buterin on The Portal
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