By Sean Manion. This post has been reprinted with permission from the author.
I worked for 18 years in Federal brain research for the Department of Defense (DoD) as both researcher and research administrator. I understand the opportunities and challenges in ways few others do. I’ve previously explored the return on investment (ROI) for research when it aligned with my job, though I put this on the back burner when my assignment changed. In 2016, following the Health & Human Services blockchain and Healthcare white paper contest, I began looking at blockchain/distributed ledger technology (DLT) as a way to enhance research quality and value. I tried to advance this in the DoD, but I may have been a little ahead of the curve.
On 25 Apr 2017 I wrote the following email to several senior DoD leaders and Federal TBI research colleagues from the programs mentioned:
“All, I’m developing a proposal for better coordination of TBI research across the DoD, in light of the OMB request for both agency and public recommendations for alignment and reform (see the OMB website and memo 17-22 for details). I think we can all envision DVBIC’s successful network combining with NICoE/ISC’s innovative IOP nodes, connecting to USU/CNRM’s central research and research admin power, integrating with the VA via CENC, cross-communicating with HHS and civilian partners along with TBIMS, and fueled by MRMC’s broad RFP reach with DHA‘s guidance on gaps and translation.”
“This can all be brought together much more efficiently with a streamlined governance. A practice-based evidence approach will provide a great shared outcomes platform. Blockchain technology will allow for an effective way to combine health data beyond the EHR for research (plus OMB Director Mulvaney is the former co-chair of the congressional blockchain caucus and a huge fan of this emerging technology’s security and efficiency). The current call even allows for recommendations for identifying laws that may need to be adjusted to achieve these reforms (i.e. NDAA 2006 moving DVBIC out of USU).”
This email was not well received.
Within 24hrs a senior official notified the people on the email, and some added senior executives, that they should ignore me and that I had no authority to suggest any reform or innovation.
A few comical meetings with my leadership later, I received an email directing me to cease work on “block gain,” because technology innovation had no place in research or the clinical/research contract I’d been asked to draft. This hangs in my “Catch-22” Hall of Fame next to the email I got a few months earlier directing me to stop using email entirely (How do you even respond to that?). But that’s a story for another time.
I departed the federal government a few weeks later. I immediately began work on what would become Science Distributed. To their credit, a number of forward looking individuals and groups in the Military Health System saw the value in looking at Blockchain/DLT. I was invited to present on the subject to the DoD’s Precision Care Advisory Program along with a USU colleague just prior to my departure. We were also invited to present to MRMC’s Military Health System Research Symposium in Aug. Later I was invited to present at the DHA Industry Day in Nov and the Air Force Medical Service Digital Biobank Forum last month. Thankfully there are enough smart people in the DoD to usually overcome the bureaucratic dead-enders.
I have advanced in the world of blockchain and healthcare since then. I have a deeper understanding of how money could be saved and research advanced by the application of blockchain/DLT. The world has caught on as well.
I decided to revisit the subject of research ROI with an eye toward the application of blockchain/DLT in a series of articles. I’ll focus on the various DoD and other federal TBI research programs as a case study. As a private citizen now, I’ll be using only my bare wits and publicly available information. I welcome any federal partners that would like to dive deeper, either as part of this series or privately.
This work is meant to: explore the value of blockchain/DLT for research as part of the Science Distributed model, offer to my 27,000+ (mostly scientist) followers an explanation of this same value, and proffer to the federal government a roadmap to better science, cheaper research, and faster miracles.
If they can keep the bureaucrats in check.