In this exciting podcast we get to hear about how blockchain is used to track the coronavirus. We had the pleasure of having Jim Nasr, CEO of Acoer, developers of the blockchain coronavirus tracker, talk to us about the challenges the healthcare industry faces and opportunities for innovating it.
What is blockchain?
Jim looks at blockchain in terms of three pillars:
- Token economics
- Distributed computing
The first pillar is with technology of distributed ledgers themselves.
The second pillar is with regards to the value creation attribution specifically to public blockchains. This is where blockchain provides a reward in a public setting in a transparent manner for the creation of value. In the Bitcoin network for example miners are rewarded with 12.5 Bitcoins for completing a mathematical challenge for which they would have used electricity and processing power.
The third pillar is regarding distributed architecture and distributed computer. For Jim this is fundamentally a question of culture of distributing power instead of a few central figures or central servers and removing intermediaries.
The Coronavirus Tracker
On the 3rd of February Acoer announced the launched of its coronavirus tracker. Acoer is a software development company narrowly focused on modern, open and interoperable healthcare software.
Acoer has created a data visualization tool to track the deadly coronavirus. The tool, known as the HashLog data visualization engine, interacts in real-time with Hedera Hashgraph’s distributed ledger technology. This allows researchers, scientists and journalists to understand the spread of the coronavirus and its trends over time through visuals presented on Acoer’s HashLog dashboard.
In creating this tool Jim had looked at existing trackers, particularly the Johns Hopkins one and felt they could add a more global perspective on it, use the existing visualisation engine called HashLog to make it their tracker more usable, dynamic and filterable.
Jim has been a huge believer that when it comes to public health data surveillance, blockchain can be a source of truth and a source of accountability. If you tuned the token economics and the game theory correctly, you can incentivize good data collection and you can disincentivize bad players from gaming the system.
Acoer are constantly growing their data sources. Today they have clinical data from the CDC and other sources that show relevant clinical trials that are happening for treating coronavirus. Google Trends and social media provide in context data.
It was pointed out to Jim that as the Acoer coronavirus tracker the Johns Hopkins one is using the same data as theirs from the CDC and the WHO but it does it with APIs, Application Programming Interface, and not with a blockchain.
Jim points out that their tracker also uses APIs. APIs are the modern way for different systems that are unaware of each other to communicate with each other with standard protocols. For example the clinical trails data, Acoer gets is through APIs from https://clinicaltrials.gov/.
For Jim blockchain is supplementary to APIs. The blockchain ingests all this data from all kinds of sources via APIs. The blockchain can confirm whether or not the integrity of this data has been changed at any stage. Acoer can thus confirm that it hasn’t manipulated the CDC data for example as they can provide a real time audit trail of the data on a public Hedera DLT.
The reasons for using a public blockchain is to provide clear references to the data provenance.
Why Hedera Hashgraph?
Having experimented with numerous public blockchain, Jim wanted a near real time responsiveness for the coronavirus tracker, and Hedera’s consensus algorithm is mathematically proven to be the most optimal. In addition Hedera’s high number of transactions per seconds and the finale of transaction within a few seconds was very important to Jim.
Lack of innovation in the healthcare
Like many Western countries such as the NHS in the UK, western citizens have been conditioned to mediocrity and lack of innovation in the healthcare, Life Sciences space.
There are many reasons for it but the empirical evidence displayed in the Moore’s Law vs Eroom’s Law diagram above categorically shows that most industries have benefited from Moore’s Law of reducing costs and improving productivity due to technology getting faster and cheaper over the last 40 – 50 years. In life sciences we have seen an exact opposite trend in return on investment.
In Jim’s opinion there is a dearth of innovation in healthcare, largely because they are cash cow industries at play with no incentives to cooperate.
In the US you have the most expensive and by many statistics the least effective healthcare system with an annual waster of close to a trillion dollar a year.
Where can you start to change the status quo? In Jim’s opinion the underlying issue in healthcare, public health and life sciences is this idea of siloed data. This is one of the many reasons from a technical standpoint why things are not real time, not cost effective and why there is so much duplication of work. Once you have addressed this problem of siloed data, you can apply to the data machine learning, deep learning, predictive analytics and get real insights on the data.
Opportunities for blockchain in the healthcare industry
For Jim the biggest opportunity for blockchain in the healthcare industry is as a single source of truth for the data provenance. It shows the chain of custody of where data came from and where it was touched and by whom. It can show if consent was provided by the owner of the data. If they were incentivised through some kind of monetization benefit.
Blockchain, particularly in real time can shine and become proactive. For example blockchain can provide proactive compliance, auditing and data provenance in real time. With blockchain you can trust the algorithms and cryptography that goes behind it instead of trusting a big EMR / HER vendor’s word.
Jim recognises that there is room for improving supply chain in the healthcare industry. However not just supply chain in terms of physical supply but also in terms of information supply.
One of his ideas is for tracking public health data surveillance, particularly for infectious disease outbreaks. A public DLT that allows permissioned users or even in certain cases, permissionless users, so long as it has the token economic strength to collect information in a distributed way and have that information available to different parties, including authorities such as the CDC.
Jim recognises that this is a long-term play that will require a public health coin for the token economy and adoption from lots of different entities.
However, tracking the generic drug supply chain which is facing shortage issues in the US and others parts of the world is a simpler use case / implementation. It would require the FDA, pharmaceutical manufacturers, finishing shops, purchasing organisations and others to be compliant to all the rules and regulations in order to stipulate the usage of blockchain technology. The ultimate user is the FDA inspector and is something that is more practical in the near term.
Jim, however has reservations around private blockchain supply chain solutions due to their lack of market wide adoption. This is primarily a governance issue and one around transparency.
Bringing change in the healthcare industry
Jim points out that it requires a mixture of leadership at the right level with real influence and a grassroot group of people from developers to doers who have a lot of interest. This isn’t just about innovation but it represents a growth opportunity at the personal level. This allows individuals and organisations to remain relevant. In an era where things change very rapidly it is important to be able to stay relevant.
In December 2016 the FDA passed the 21st Century Cures Act. It’s been around for four years and it allows individuals to get to their electronic health care records. It also largely mandates electronic health record provider to provide open APIs for developer to allow that access. Based off this law, CMS the centres for Medicare and Medicaid have put some real meat to the bones of this act by adding on to it this idea of personal health care record and information blocking. It really incentivises or penalises organisations that do or don’t comply in providing APIs.
Globally Jim is encouraged by the increase in standards for data interoperability. He reminds us for example of the availability of an open API standard for the healthcare industry called FHIR (fast healthcare interoperability resource), here is a version of it with the NHS here in the; UK https://digital.nhs.uk/services/fhir-apis
Acoer’s plan for 2020
Acoer has two products right now, one under design and one called Hashlog which is their data visualisation engine behind the coronavirus tracker. They have multiple clients working with it for instance around substance abuse data and opioid abuse data. Acoer takes data from multiple data sources, aggregate them and present them in a visually compelling manner.
The new product is about securing blockchain enabled file data collaboration called HashLoad.