Matt Weiss is a portfolio director and business designer at IDEO Boston, where he blends his experience in strategic design for large corporations with his roots in the startup world. Alongside Dan Elitzer and Joe Gerber, he runs the Bits + Blocks Lab, a pop-up blockchain startup creation lab hosted at the Harvard Innovation Lab.
This post, which examines how bitcoin's blockchain could reshape our medical experiences, is part of the Humans + Bits + Blocks series. Read the previous post in the series here.
Blockchains and health could be a happy marriage across a multitude of applications. From robust interoperable health records to proof of medication adherence, opportunities abound to create new value and enhance health-related experiences.
For the purposes of making this exploration tangible (as is our goal with this entire series), let’s follow the journey of a person with a chronic condition we’ll call Screenoritis* in a future with blockchains.
First, it’s important to know that Screenoritis is a troublesome condition. The prognosis isn’t fatal, but the symptoms of it are debilitating, ranging from sleeplessness to short-term memory loss. The good news? It is both treatable and reversible, though the path to recovery is not easy.
Jane is 34. She loves her job as an animator and works way more than the average person. It’s Thursday afternoon, she’s totally worn out from a super challenging scene she just finished, and she decides to take a break. It’s beautiful outside, so she heads out for a run by the river. About two miles in, Jane starts to feel a bit nauseous and then lightheaded. She slows to a walk, but even so collapses 100 yards down the trail. A runner coming from the other direction finds Jane unresponsive on the ground and calls 911.
When the ambulance arrives, the EMTs scan the fitness band on Jane’s wrist to retrieve her HealthChain ID, a unique public identifier used for health information. When Jane signed up for HealthChain, she created rules and named individuals who could verify access to her medical records. The EMT’s combine Jane’s ID with their own, which proves that they’re accredited emergency health responders.
They then issue a broadcast on the HealthChain network, which automatically generates alerts to Jane’s four emergency contacts asking them to validate that the EMTs can access Jane’s records. Ten seconds later, after two of her contacts grant access, the EMTs are able to access her emergency health info.
A few hours later, Jane wakes up in the hospital. She’s OK, but she’s shaken up and wants to understand what’s going on. The doctor on call sits down with her to explain her encounter with Screenoritis.
After reviewing some of the facts, the doctor asks if she’s willing to share her anonymized information in the public research repository – this has become standard practice, and she has no problem with it. She’s willing to share her medical history, pertinent data about the event she just experienced, and results from the tests they’re currently running.
Jane wants to learn what people like her have experienced and how she can get better. She and others have opted into share their information in order to participate in a private network. Compared to today’s self-guided searching, the doctor does a criteria match for her profile and finds an entire set of people who share many important characteristics with Jane, ranging from age to location to type of job.
Although Screenoritis is fairly widespread and medications have been developed to treat symptoms, recovery is still difficult and treatment of the underlying conditions have gotten little attention from the medical community.
As part of her initial research about the condition, Jane quickly discovers that there is a publicly crowdfunded bounty for the release of a treatment regimen that will treat the underlying causes of Screenoritis.
Her contribution is governed by a series of smart contracts that provide conditional access to treatments once they’re released. Unlike traditional crowdfunding, her contributions are held in escrow by the contracts until the treatment is ready for her.
Now that Jane has a solid understanding of her condition, she’s begun to see a specialist who has prescribed a daily physical routine for her in addition to well-known Screenoritis medications. Adherence to both is critical for recovery and also rewarded by her insurer. With a watch that can track her location and movements and pills that are instrumented to collect data, the information that the insurer and doctor needs is readily available. So long as Jane sticks to her agreed-upon treatment, the entirety of her bills are covered automatically — no paperwork needed.
Health and blockchains turn out to be a great match. Together, they can usher in a patient-centric revolution in how we take care of ourselves and others. In our most vulnerable moments, we’ll seamlessly share permissions to access important information attached to our identity. We’ll make advance promises of payment in return for new treatments that we desire. Rather than opaque risk models and quotas, insurance payments will be triggered by our verified healthy behaviors.
It’s time for health to get an upgrade. Far from state-of-the-art, our health is tracked, diagnosed and treated without the full benefit of technologies that we take for granted in other aspects of our everyday lives. The addition of blockchains could change that substantially, and we’re excited about these future opportunities becoming real.
* Screenoritis is not an actual disease.
Written by Matt Weiss, Dan Elitzer and Joe Gerber. Visual designs by Kim Miller & Nick Dupey.