I first came across the concept of Blockchain one and a half years ago when I heard about the cryptocurrency Bitcoin. At the time there were talks about regulating big bank notes in India, and China was increasing restrictions on getting money out of the country. Bitcoin is a decentralized currency, where transactions bypassed banks. All you need is a smartphone, access to the Internet, and an email address. The advantages of Bitcoin were made possible because it was built on a Blockchain. A Blockchain-based currency? It was a no brainier. I sunk thousands into the currency when it was £250 a Bitcoin. Within just over a year it was over £2,000 a Bitcoin. It now flitters around that mark. However, it’s worth noting that it wasn’t Bitcoin that swayed me, it was the fact that it was built on Blockchain. Other Blockchain currencies like Etherium good long-term returns at the time of writing this. The blockchain is a revolutionary advancement, like the internet or the invention of the telephone. As a clinician, here are 4 things you should know about blockchain.
How Blockchain works
The main attribute of Blockchain is that it’s a decentralized database as opposed to a centralized one. Instead of the database being on one server, the database is distributed amongst multiple computers. If you wanted to hack in and alter something, you would have to hack all the computers as opposed to one server. So if you buy Bitcoin, you own a part of the database on that Blockchain. Transparency is also an attribute of the Blockchain. It acts as a ledger. Entries can be added, but previous entries cannot be altered and new entries, known as blocks get added. Each block has a time stamp and a link to the previous block. Because of this, the paradigm of trust as we know it is shifted. Right now with the centralized database model, you give your data over to a bank or Facebook etc, and you trust them. With the decentralized database, you don’t have to trust them, there’s now a technical reason why they can’t do whatever they want with your data, as opposed to just a legal reason.
Because of the nature of blocks, initial uses mainly consist of ledger like applications. Production is a straightforward application. If a product is produced, blocks can be added when the product goes through each checkpoint, making it easy to trace. Quality control, in general, seems like a clear application for Blockchain. Outside of manufacturing, businesses are starting to use Blockchain to hold electronic contracts known as smart contracts. A smart contract can be held between multiple parties and cannot be altered. Due to it’s fast, secure nature, Blockchain technology has already disrupted financial transactions, with the rocketing value of nearly all cryptocurrencies being a testament to this. Blockchain financial transactions do not need to go through banks making it a hot topic in the financial tech world. The implications of this don’t stop in financial tech but can have huge humanitarian ramifications on a global scale. The decentralized nature makes it hard for governments and large organizations to have complete control over people and seize assets or block their transactions. However, this is where the debate arises as criminals and terrorists have used Blockchain tech like Bitcoin to finance their operations. Blockchain also has the opportunity to hold corrupt government officials to account.
It’s not hard to understand the financial incentive a trader has at buying produce from one supplier/location and lying about it to charge more money or hide fraud. Here the Blockchain is poised to disrupt whole markets the moment people wake up and adopt it. But is there really a burning need in healthcare? People who know me know I roll my eyes when people make out that the NHS is staffed by superbeings who also have to morals of saints, don’t do it for the money and are the smartest people in the world. However, in this case, I do have to hand it to us, there isn’t really a trust issue in the documentation of patients. The advantage in Blockchain tech being used in healthcare records is security, as the blockchain will have multiple checkpoints instead of one single gateway for sending sensitive data. Scaling is also easier. When a patient goes to another hospital or department, the department can simply be added to the patients’ Blockchain. In my opinion, the biggest need is for blockchains in medical trials, especially where pharmaceutical companies are involved. But don’t expect this tomorrow. I suspect politics will slow down this adoption. For small groups of clinicians, auditing and quality control are the easiest ones to break into. As Blockchain is still new there is first mover advantage. Build a blockchain database on defib quality checks that users input into everytime they do a defib check. Do this and I don’t see why it won’t grow into a national database, as none Blockchain rivals would be no match. The opportunities are numerous ranging from surgery logging to vaccine administration. Your app/database will scale quickly with little competition.
Ease of implementation
All this sounds exciting but the thing to remember is that it’s all fairly new. The chances of you bumping into a developer who is happy to create a blockchain app are unlikely. This doesn’t mean that it’s impossible. There are some tutorials out there depending on the language that you want to code in, and there seem to be some early libraries emerging. However, there doesn’t seem to be much at all when it comes to running blockchain applications in web frameworks. This is generally the case. The most lucrative areas where you truly first mover advantage and a chance to change the world have high barriers to entry. If you’re a clinician who finds this exciting then I recommend watching this space if you don’t have access to super smart developers right now. There will be a sweet spot for you, where the tech support has progressed enough for you to code a Blockchain app fairly easily and cheaply, but the areas that require clinical insight are still untapped. At the time of this sweet spot, the super smart developers who understand the tech will be unaware of the clinical nuances of applying Blockchain, and the majority of clinicians won’t know what Blockchain is. Don’t worry too much, the moment I come across comprehensive tech support for Blockchain you will hear me raving about it.