Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

davidgerard.co.uk

Post reply on HN
Print view View original

121–130 of 154 posts

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

#121

Post by AmericanChopper »

ramraj07 wrote: post #114
AmericanChopper wrote: post #81

Earlier quoted context omitted.

Consensus is certainly not a necessary element of a blockchain. A blockchain can just as easily exist under the control of a central authority, as it could under any other circumstances. Unless you mean that you’re still achieving consensus by simply trusting the central authority, which I guess is technically correct, but that’s not how ‘consensus’ is generally used in relation to blockchains, it’s generally used to…

How is this different from git?

What makes git different from a blockchain? A blockchain is a data structure, and a data structure doesn’t change based on who has permission to write to it.

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

#122

Post by binarnosp »

drcode wrote: post #97
marcus_holmes wrote: post #94

Earlier quoted context omitted.

That's interesting, and refreshing honesty :) thanks If you don't mind me being more nosy, are the long-term opportunities in this exact line of business? (i.e. do you think that one day medical records will be routinely stored on a blockchain?) or is it more than developing skills and capability with both blockchain and health tech will be valuable in the future?

Tracking employee identities in The medical space should be done in a much more rigorous fashion, there are significant benefits in doing this on a public blockchain. Medical records MAY someday end up on a blockchain, but the benefits of this are more hazy and may never outweigh the switching costs.

Maybe it could be used to track the certification process for pharmaceuticals or medical software?

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

#123

Post by tialaramex »

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.

Blockchain became a "new favourite toy".

When I bought my first screwdriver, a lot of problems seemed like they should be solved by tightening, loosening or adding screws to things. Because I had a screwdriver and damn it, I was going to use it. But often even when we have a fantastic idea, it isn't broadly applicable. Lots of problems I had couldn't be solved with a screwdriver, many more shouldn't be.

This came up for Certificate Transparency. CT uses Merkle hash trees to provide an immutable, cryptographically-verified Log of things it has been shown - in the original application those are X.509 certificates from the Web PKI ("SSL Certificates"). None of the component parts are even modern let alone unprecedented, although arguably it would be less practical without elliptic curve crypto, but nothing like CT itself had ever been done before, and its designers deserve significant praise.

And in the subsequent years as CT was successful we saw not only uptake of CT itself which was good, but also when there was some other problem people would propose solving it with this new magic toy - let's have Whatever Transparency. None of those went anywhere, because the unique recipe for CT is not a universal multi-tool, it solves one very specific problem very well indeed and that's fine.

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

#124

Post by davidgerard »

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.

The actual bit that catches the eye of enterprises seems to be solving one of these two problems:

* reconciling all the data in one place

* having a tamper-evident ledger of transactions

The second just puts logs in a 1979-style Merkle tree, and the first is 100% getting organisations working together and doing the hard tech-debt slog of cleaning up your data and formats.

If you have both problems, your problem is enough of a human/business mess that applying a blockchain won't fix any aspect, but may well make it worse.

Occasionally "blockchain" will be useful as a buzzword to get funding.

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

#125

Post by davidgerard »

smt88 wrote: post #83
AmericanChopper wrote: post #63

Earlier quoted context omitted.

But fault tolerance, consensus or mining are not a necessary part of blockchain either.

I put "true" in quotes because there are so many competing definitions for blockchain. I agree with other commenters that there is an original definition, but people rarely talk about blockchain these days without having the Bitcoin model in mind.

I had a good old rant about that previously: https://davidgerard.co.uk/blockchain/2018/06/28/ibm-the-gdpr...

You might come up with a reasonable definition, like "append-only ledger with a consensus mechanism" - but in marketing terms, "blockchain" literally only means "whatever I'm trying to sell you today."

And then there's weasel terms like "blockchain technology", which means "I can't even claim this thing is actually even a blockchain, but it's got a few of the same parts."

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

#126

Post by marcus_holmes »

pryelluw wrote: post #108
marcus_holmes wrote: post #28

Earlier quoted context omitted.

ahh, I see... so more like speculative R&D, developing a technology to the point where it's saleable to a larger organisation. So there's no need for a customer problem to solve, it's just about building enough capability with the tech to become acqui-hirable, is that right?

To a point. I cant comment on regards to this being the goal of the company above. We should consider the following: A startup can have a product offering and also be the product itself.

not sure that works in many places outside Silicon Valley. I've been working in the startup scene in Perth, Western Australia, for years now, and the opportunities for getting bought areslim. A startup there needs to have a global customer base to stand a chance of making revenue, let alone equity growth.

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

#127

Post by mhluongo »

tastroder wrote: post #110
mhluongo wrote: post #72

Earlier quoted context omitted.

Care to explain that hand-wavy downside?

The link you posted doesn't even aim for replacing DNS, by the abstract and landing page it seems to be an experimental setup to replace the root zone which has been signed for nearly 10 years now. DNSSEC is a thing. Don't really see what's hand-wavy about your parent comment tbh, the link you posted doesn't seem to address common scenarios like 51% attacks or even why our current system is flawed. The only tangible…

I didn't post the link. I'm just asking for details about an unspecified attack in your comment, or really any pointed criticism at all (:

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

#129

Post by acdha »

darawk wrote: post #117
acdha wrote: post #90

Earlier quoted context omitted.

> It allows you to store and transfer value in situations where you either cannot obtain, or do not trust your available banking relationships. This is already a small percentage of people but it’s smaller still when you realize that it requires full access to the blockchain network and a solid local network of people who accept it and/or convert into local currency at low rates, not to mention that since the model i…

> From whom? What are the actual rates? The rates are the cost of buying/selling bitcoin on both ends, let's call that 20 bps on each side, and then the cost of a single bitcoin network transaction, which is about 66 cents at the moment, if you're willing to wait 6 blocks [1]. So, to send $1000 it'll cost you 40 bps + 66 cents = $4.66. By comparison, international wires at your local bank will run you around $50 all…

> The rates are the cost of buying/selling bitcoin on both ends, let's call that 20 bps on each side, and then the cost of a single bitcoin network transaction, which is about 66 cents at the moment, if you're willing to wait 6 blocks [1]. So, to send $1000 it'll cost you 40 bps + 66 cents = $4.66.

Don’t forget to add in the currency conversion fees on either side since most people transfer money to use it.

Walmart charges $8 for the same service. There is some potential savings here but it seems unlikely to argue that Bitcoin’s enormous costs can be justified by the number of people who need to regularly do international transfers and, if everything is lucky, save a dollar or two on the transfers.

> Sure, and those are real challenges of using cryptocurrencies right now. However, they're also extremely solvable problems and people are working on them.

“Extremely solvable” but unsolved a decade later suggests that they are not in fact that easy and will end up making the cost even less competitive. People have been preaching that Bitcoin will take over for years but even most advocates don’t use it for a non-token percentage of their transactions because it’s simply not financially sensible to do so.

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

#130

Post by janekm »

darawk wrote: post #117
acdha wrote: post #90

Earlier quoted context omitted.

> It allows you to store and transfer value in situations where you either cannot obtain, or do not trust your available banking relationships. This is already a small percentage of people but it’s smaller still when you realize that it requires full access to the blockchain network and a solid local network of people who accept it and/or convert into local currency at low rates, not to mention that since the model i…

> From whom? What are the actual rates? The rates are the cost of buying/selling bitcoin on both ends, let's call that 20 bps on each side, and then the cost of a single bitcoin network transaction, which is about 66 cents at the moment, if you're willing to wait 6 blocks [1]. So, to send $1000 it'll cost you 40 bps + 66 cents = $4.66. By comparison, international wires at your local bank will run you around $50 all…

That's an overly rosy comparison of money transfer fees. To make it a little more fair, it makes sense to compare against a competitive money transfer service rather than typical bank fees... For example transferwise offer transferring $1000 to Euro for $6.86 total fees, at the mid-market rate, including the depositing fee. Depending on the bank networks on either end the transfer can be instant. In a way transferwise operate like an exchange only it's FIAT-FIAT rather than FIAT-BTC-FIAT. To compare you would have to take into consideration the bid/ask spread of the exchange on each end of the transaction for BTC, in addition to all charges on both ends. The bid/ask spread varies wildly from exchange to exchange. I'd be impressed if it were to cost less.
Post reply on HN