Blockchain in health records: utopia, dystopia and grey areas

As Plato used to say, necessity is the mother of invention. When it comes to storing patients’ health records through the blockchain, MetLife and UnitedHealthcare are far into the game.

How come? Is this a contribution to the lofty, long-term vision of a world where patients are the masters of their own data? Or maybe it’s about training AI with more complex, complete data sets? The answer is much simpler. It helps with improving insurance filings.

Try not to be underwhelmed by how down-to-earth I sometimes get, but I currently find simple applications way more exciting than grandiose ones. The reason is even simpler. Currently, there’s just too much hype about what the blockchain can actually do. When it comes to healthcare, that gets particularly irritating. From curing all illnesses to training Artificial Superintelligence into the health overlord it ought to be, there’s nothing the blockchains can’t do. Really?

Dystopia meets utopia: I’ll catch you in the grey areas

Blockchains and non-blockchain DLTs are still incredibly unscalable, clunky and slow. Basically, they’re the worst database decision your company can make. Unless… (and here comes the juicy bit) you might be a criminal in need of censorship resistance. Or perhaps, you’re a patient looking for a new, highly promising drug that isn’t yet approved in your country. You’d love to be able to purchase it at your own risk and peril. Hell, you’d love to even just know if such a drug is in any pipeline at all.

Censorship resistance is a killer application of decentralised blockchains. Can it facilitate the job of criminals? Yes. Can it save the life of patients? Yes.

Let’s go a step further and think of a world in which health records are fully on the blockchain, shareable and accessible just like your personal data, buying habits and secret daydreams are to Facebook marketers (sigh). Now, a third party could leverage them to find the possessor of a rare type of genetic profile that is most suitable for a specific organ transplant. A compliant third party will approach the possessor with an offer. A corrupt third party might not be that kind… just like the barrier between Jack’s free will and Trump actively urging Jack to vote for Trump can be quite thin.

Creating the right future

Don’t get me wrong – I’d truly love to see health records being managed on the (right) decentralised ledger. Yet, I like to bring up dystopia too. Why? Mainly because we need to think of all these scenarios when designing our governance systems. For instance, being aware of perils such as criminals abusing transparency properties of health records highlights the need for a system optimised towards privacy, partial shareability and selective anonymity. Patients ought to be able to choose with whom, for how long and what to share from their records.

In my series of articles, I’ll explore blockchain and non-blockchain DLT applications across a wide range of industries and use cases. Having been in this sector for over six years, I’m excited about what the future holds. I just happen to believe that more realistic, pragmatic approaches to leveraging blockchain-like systems will benefit every stakeholder in this brave new world.

When I’m not curbing your enthusiasm for stretched use cases, you can also find me on Instagram and Twitter.

Alessandra