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Medical records on the blockchain – the history of a bad idea

davidgerard.co.uk

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Re: Medical records on the blockchain – the history of a bad idea

#41

Post by airstrike »

encloser wrote: post #39
tracker1 wrote: post #36

I cringe every single time someone suggests blockchain in our space. Either it's easier with other tech (even public/private key tech doesn't require blockchain), or open to potential leaks/abuse in the future (tracking how everyone voted). There are a lot of use cases, most even, where it's not a great fit, and there are other, better, approaches. Disclosure, I work for an election services company...

I like to provide people the NIST Blockchain Overview pdf. Particularly the decision flowchart. https://nvlpubs.nist.gov/nistpubs/ir/2018/NIST.IR.8202.pdf

Thanks for sharing this. Really insightful

Re: Medical records on the blockchain – the history of a bad idea

#42

Post by smt88 »

wefarrell wrote: post #29
davidgerard wrote: post #22

Earlier quoted context omitted.

The obviously convincing argument would be - after ten years - "something to show for it all." That is, something that blockchain is clearly and obviously the use case for. "Potential" goes only so far. Eventually you need kinetic.

Buying and selling illicit products on the internet.

Or in-person. Any criminal transactions, really (drugs, weapons, people, etc.)

Re: Medical records on the blockchain – the history of a bad idea

#43

Post by smt88 »

tracker1 wrote: post #36

I cringe every single time someone suggests blockchain in our space. Either it's easier with other tech (even public/private key tech doesn't require blockchain), or open to potential leaks/abuse in the future (tracking how everyone voted). There are a lot of use cases, most even, where it's not a great fit, and there are other, better, approaches. Disclosure, I work for an election services company...

I've discovered that some people say "blockchain" when they mean "immutable, distributed, cryptographically-verified database" -- which is actually a useful thing for many people.

The Byzantine fault tolerance, public consensus, and mining aspects that we associate with "true" blockchains are the parts that people can't find a way to justify and can typically be ignored.

Re: Medical records on the blockchain – the history of a bad idea

#44

Post by chris_wot »

Uptrenda wrote: post #15

I feel its become very fashionable to dismiss the simpler applications of the tech because of how unrealistically its been applied. It's so easy to do too. Look at the insane valuations, the fraud, and hype cooked up by marketers, and the whole thing looks very stupid. But its a mistake to let this get in the way of critical thinking. There is a reason why the topic is brought up so often and its because among all th…

If you could tell me even one application of this technology outside of cryptocurrency, I'd genuinely be interested.

Re: Medical records on the blockchain – the history of a bad idea

#45

Post by bigiain »

smt88 wrote: post #42
wefarrell wrote: post #29

Earlier quoted context omitted.

Buying and selling illicit products on the internet.

Or in-person. Any criminal transactions, really (drugs, weapons, people, etc.)

> Where cash is still a better alternative.

I suspect not too many drug dealers or gun runners want to wait around 20 mins staring at their phone (with a traceable internet connection) for 2 confirmations before declaring the deal "done"...

Re: Medical records on the blockchain – the history of a bad idea

#46

Post by chapium »

tracker1 wrote: post #36

I cringe every single time someone suggests blockchain in our space. Either it's easier with other tech (even public/private key tech doesn't require blockchain), or open to potential leaks/abuse in the future (tracking how everyone voted). There are a lot of use cases, most even, where it's not a great fit, and there are other, better, approaches. Disclosure, I work for an election services company...

Blockchain in general is way too broadly prescribed. The "how" blockchain solves a particular medical system problem is very important to consider. Many sources are selling the idea but not discussing tradeoffs.

Re: Medical records on the blockchain – the history of a bad idea

#47

Post by hschoenburg »

chris_wot wrote: post #44
Uptrenda wrote: post #15

I feel its become very fashionable to dismiss the simpler applications of the tech because of how unrealistically its been applied. It's so easy to do too. Look at the insane valuations, the fraud, and hype cooked up by marketers, and the whole thing looks very stupid. But its a mistake to let this get in the way of critical thinking. There is a reason why the topic is brought up so often and its because among all th…

If you could tell me even one application of this technology outside of cryptocurrency, I'd genuinely be interested.

DNS -> https://handshake.org

Re: Medical records on the blockchain – the history of a bad idea

#48

Post by erulabs »

tracker1 wrote: post #38
oooshha wrote: post #12

Hard not to imagine a pompous Brit spraying saliva everywhere while reading this. To the content - there is only one way to place data on the cloud that is impervious to all global state, corporate and nefarious actors. That is with a robust blockchain. Whether or not you think that is useful in medical records is another story. I've been a medical doctor for 10 years and think that it is.

How do you use this and not allow for anyone with access to the block chain to also have access to all medical records? How do you secure this data without also securing the block chain access itself? How do you provide this security without effectively losing the usefulness of the block chain in general? How do you do this in a way that is effective in terms of performance/speed?

I don't have a side in this fight, and in general I absolutely agree with "solution in search of a problem", etc, but, if I had to think of an application:

All medical records are encoded as transactions between doctors and patients - that is, if person A is diagnosed with medical issue A by Doctor A, a public transaction is sent from a patient, via anonymized address, with a few bits of information:

- Amount (public due to nature of transaction on blockchain)

- Doctor (public due to complexity of anonymized destination addresses on blockchain, lets not solve impossible problems)

- Encrypted with the public key of the Doctor, the medical record

- Encrypted with the public key of the Patient, the medical record again

- Public, well-known "code" for some medical transaction, for example "code 1" could be a checkup, "code 2" could be a heart-transplant - I'm completely unfamiliar with the medical world so I suspect this system most likely already exists

- Encrypted with the public key of the Doctor, a random UUID identification code

This would allow Doctors offices to collect all their records by reading thru all transactions. Offices could validate that the patient correctly filed the transaction before accepting the transaction, and one can imagine software such that patients could easily file the transaction without having to copy the medical records, etc.

Additionally, using the public key of a doctor, one could verify that similar medical procedures were priced fairly compared to their own (ie: you could see the average cost of checkups, etc). This is most likely a naive assumption about pricing in healthcare, but maybe a good feature thanks to blockchain?

It would be particularly neat if it was powered by a contract, via something like Ethereum - You'd still need a bit of government help, but:

- Retrieval of medical data by the Doctors office is signed by a secret key contained in a contract oracle. When data is retrieved, it's signed with a timestamp indicating when the data was obtained.

- Laws requiring that valid signatures for valid timestamps from the contract oracle accompany _any and all_ use of medical records.

- Assuming the fines were steep and enforced, medical records could not be used for longer than a certain date, could be invalidated, and could be "observed being observed" by the patient.

In other words, assuming minor changes in the legal/medical system, the blockchain could actually be used to create immutable records of medical transactions, protect patient privacy, etc.

But if to accomplish this blockchain _also needs_ a trusted 3rd party and law enforcement... Then i'm not sure how it's better than any other application, except that it comes with a free globally available API, which is not actually a bad feature. Just not world-changing is all.

Re: Medical records on the blockchain – the history of a bad idea

#49

Post by bigiain »

smt88 wrote: post #43
tracker1 wrote: post #36

I cringe every single time someone suggests blockchain in our space. Either it's easier with other tech (even public/private key tech doesn't require blockchain), or open to potential leaks/abuse in the future (tracking how everyone voted). There are a lot of use cases, most even, where it's not a great fit, and there are other, better, approaches. Disclosure, I work for an election services company...

I've discovered that some people say "blockchain" when they mean "immutable, distributed, cryptographically-verified database" -- which is actually a useful thing for many people. The Byzantine fault tolerance, public consensus, and mining aspects that we associate with "true" blockchains are the parts that people can't find a way to justify and can typically be ignored.

So they _really_ mean git.

Re: Medical records on the blockchain – the history of a bad idea

#50

Post by DennisP »

chris_wot wrote: post #44
Uptrenda wrote: post #15

I feel its become very fashionable to dismiss the simpler applications of the tech because of how unrealistically its been applied. It's so easy to do too. Look at the insane valuations, the fraud, and hype cooked up by marketers, and the whole thing looks very stupid. But its a mistake to let this get in the way of critical thinking. There is a reason why the topic is brought up so often and its because among all th…

If you could tell me even one application of this technology outside of cryptocurrency, I'd genuinely be interested.

Do you mean outside of any involvement with currency, or just outside of simple transfers of currency? Because a lot of things are applications of programmable money, like derivatives, exchanges, and gambling.

Beyond that, some games are using public blockchains to track ownership of game items.

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