Blockchain: The Missing Link in Healthcare

Flash Back to 2010.

Ah, 2010. Those halcyon days of innocence. Before the Harlem Shake.

Back then, I was full of what I believed were good ideas. I went to the then-CTO of SAIC’s Health group, Doug Barton, with my greatest yet.

“Those GPU servers the Law Enforcement and IC guys use for forensics analysis? They only run a couple hours a day. Yet the machines are powered 24-7. Why not use them to mine for this new blockchain-based cryptocurrency, Bitcoin? The power is a sunk cost, the machines are already running, it would basically be free money for SAIC. As more and more people mine Bitcoin, the value will go up.”

Doug asked me what the current cost of Bitcoin was, which at the time was around five cents per Bitcoin (BTC), and very politely laughed me out of the room. He was used to this sort of proposal from me, about twice a month on average.

In the interest of fairness, I will say that my twenties were filled with bad ideas. In that decade I learned how to run a nightclub, a marriage, and most of my hair follicles into the ground. But I was right about one thing: blockchain technology was going to have its day, even if that day wasn’t in 2010.

“Blockchain.” I’ve heard that word, but my Harlem Shake-addled brain can’t remember what it means. In concise terms, what is blockchain?

Before I get into that, let me point out that for the record, my idea was a moneymaker. After peaking at about $1250 per bitcoin (a 25,000x increase) and settling at around $650/BTC, the idea would have made SAIC boatloads of money. In fact, soon after the suggestion, consumer grade hardware such as mine was insufficient for mining bitcoin. After tendering over my first few, GPU-mined bitcoins in exchange for an application-specific integrated circuit (ASIC) miner, I soon was outpaced by the giant labs that corporations, shadowy underworld conglomerates and more were devoting to blockchain. My humble bitcoin miner now ekes out a meager existence providing a source of heat for germinating seeds.

But you don’t care about whole-grain sprouted bread. You want to know what a blockchain is.

In its simplest terms, a blockchain is a message with a history. “Here’s a note, Pass it on.” In the message, in its payload, is a history of every transaction or change ever made.  Conceptually, this article can be represented by a simple blockchain:

Figure 1 click to enlarge

You’ll note that Record 4, David’s update, is invalid and will be rolled back. This is because April removed the story about David and Zsa Zsa Gabor, and therefore there is nothing to update. More importantly, everyone with a copy of this blockchain is aware of three things:

  1. The current state of the blockchain
  2. Every change that’s been made to get it to that point
  3. Whether or not the update is correct; this validation is performed by a network quorum of acknowledgement

In short, the “network” approves whether something is valid or not based on timestamps and the change history to date. Now, that’s not to say that David can’t recreate his input, but there will be a record of that.

Figure 2 click to enlarge

So this is blockchain in its simplest form. It is:

  1. A series of data elements
  2. A change history of every change made, when, and by whom
  3. A system where everyone can see this change history equally visibly
  4. Governed by an automated and impartial mechanism, such as dates and timestamps, to deterministically resolve all conflicts the same way every time

Blockchain, in the real world, adds more bells and whistles to this. Bitcoin, for example, has a full record of every transaction ever made: but instead of using real names, it uses Public Key Infrastructure (PKI) encryption.

I know for an indisputable fact that on October 13th, 2016 at 8:34:25 PM Eastern, user 35iVepZkutiWtUeqRECjHac9eEsiFTWR5U transferred 0.05216 Bitcoins to user 1NDs66mcmsv4whPFNCmRW5mqDzWLHZv4Fi. [1] Yet who are these people? What did they exchange for those bitcoins? Was any of it legal? By design, the world will never know.

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