Who are the Miners in the Healthcare Blockchain?
Patient voices should be heard throughout every instance of Blockchain interoperability. The presentation of patient messages in the Blockchain and associated sidechains are important for documentation of 2-way communication with healthcare providers. The 6500+ miners on Bitcoin are anonymous individuals and entities that, for the most part, have nothing to do with healthcare. Patient messaging on the blockchain must be patient focused, and we do not know if 6500+ miners on Bitcoin will understand the specific situations that patients face on any given day.
In addition to patient messaging, each “flavor” of Blockchain should incorporate third party organizations representing patient constituents as part of any permissioned / private Blockchain group or consortium. To guarantee patient advocacy input, the Clinical Blockchain should include consideration of advocates such as Dave deBronkart (aka @epatientDave), Dana Lewis (creator of the first artificial pancreas @danamlewis) and Regina Holliday (@ReginaHolliday). There are many other groups and individuals that deserve consideration as being empathetic keepers of a patient focused blockchain.
There are many other voices that consistently advocate for patients including physicians, healthcare entities, and associations, most notably the Society for Participatory Medicine. In addition to patients organizations that have supported patients should be involved in any “federation” of groups implementing a Blockchain locally, regionally or nationally. CDC, NIH, American Diabetes Association, Doctors Without Borders should also be considered. As these systems, including the Clinical Blockchain, are put in place, we cannot underestimate their influence and importance, especially in this age of Social Media. Ideally, a clinical Blockchain dashboard will identify the voting patterns of permissioned participants to provide an audit trail on the effectiveness of the clinical Blockchain and the “voting patterns” of permissioned members.
The nature of healthcare forces the use of private / permissioned blockchains with the ability to have a “off ramp” to a public Blockchain such as Bitcoin or Ethereum. People who enter the healthcare system and provider healthcare services are not anonymous and must be treated with understanding and with dignity. In many cases, the Clinical Blockchain will have characteristics of a private intranet or virtual private network, with Blockchain features. Without a focus on patient experience, the blockchain will fail.
@ebukstel
September 12, 2016
