The proposed blockchain-based health care platform aims to address several challenges in the current health care system. These challenges include the lack of a single database or social network for reliable information about health issues, the difficulty in navigating the vast amount of available health knowledge, the potential for patients to be mistreated or wrongly diagnosed, the differences in diagnosis and treatment recommendations among different health practitioners, and the lack of a platform for sharing and profiting from personalized health knowledge. The platform would use blockchain technology to verify the reputation of those sharing their knowledge and to incentivize experts and patients with valuable experience to share their knowledge. It would also strive to be neutral in terms of providing equal information about the effectiveness of different approaches, such as acupuncture and prescribed drugs, and would allow users to connect with others with expertise about their specific disease or similar experiences. The platform could also potentially reduce the burden on public health services and improve the overall efficiency and effectiveness of the health care system.
MedBook
Blockchain technology allows for building a social platform where the reputation of those sharing their knowledge can be verified. This could complement the current health care system in a profound way. Let us take a closer look at what such a platform could do, and also try to understand why the introduction of blockchain is such a potential game changer for health care.
This would allow individuals to connect to others with expertise about their specific disease, and/or similar experiences, and being able to trust their recommendations due to the platform's native reputation system.
Most of us have asked Google for guidance when feeling sick. General practitioners (GP) report that both those seeking clarity about their condition, and those already having a diagnosis spend considerable time researching their illness online before coming to see them. However, validating the presented information is a considerable challenge, and there is no single database or social network where users can search for reliable information about their health issues. Further, patients suffering from complex diseases are typically overwhelmed and/or lost in the amount of information. Hence, the role of the GP is often to help the patients to sort this input, and even medical doctors have a hard time navigating the ocean of available knowledge (to the degree they keep themselves up to date). Public health services are currently doing their best to handle an increasingly complex reality, where patients/clients often know more about their own specific diagnosis/condition/problem than do many professionals. However, in many cases, users of such services are maltreated, wrongly diagnosed, and/or health professionals are unable to provide an adequate explanation and/or treatment for their symptoms. In many cases different health practitioners will also differ significantly in their diagnosis and/or treatment recommendations, making chance a considerable factor in whether individuals will receive optimal treatment or not – especially in more rare and/or complex conditions. Most people will typically have experienced that a friend or relative had to “fight”, sometimes for years, to receive, or perhaps find an adequate treatment for their condition. Importantly, those who have managed to find, and implement, solutions to their health problems are valuable sources of knowledge, but they often lack a platform where they can share, and/or profit from sharing their experience(s) with others who are currently in a similar situation they have once been in themselves. Sometimes people are fortunate in terms of knowing, finding or meeting others who have had similar symptoms and/or conditions, and can receive valuable information directly from these sources. The lack of such personalized help is one likely reason why alternative medicine has been rapidly growing in the Western world the last couple of decades. Hence, there is a pressing need to build a platform that would allow such knowledge to be exchanged in a way that allows the users to trust the sources. Blockchain technology allows for such a platform where the reputation of those sharing their knowledge can be verified. Further, such a blockchain-based medical platform could incentivize people with expertise, e.g., experienced experts, or patients who have already been on long journeys within, and/or outside, the health care system searching for, and finding, a solution to their health concerns, to share their knowledge. Further, within the current healthcare system, different paradigms compete, and such a platform would need to be neutral in terms of providing equal information about the effect of different approaches, e.g., for instance providing experts reports on both acupuncture and prescribed drugs for certain conditions.
Problem statement
Google provides vast amounts of information about our symptoms and diagnoses, but as the sources typically have economic or egocentric motives influencing their answers, the normal user has a hard time verifying the trustworthiness and/or relevance of what s/he reads. Further, many medical patients don’t fit within the framework of the current healthcare system, for diverse reasons. Firstly, in most countries the medical profession is dominated by a system where general practitioners (GP) are responsible for referrals to specialist health services, e.g., hospitals. Since the 1950s, GP has become a specialty in its own right, with specific training requirements tailored to each country. Most GPs have a broad base of knowledge within the medical field, which allows them to treat patients of any age and sex to levels of typically low to moderate complexity. Consequently, in many cases, a GP may know less than the patient about their specific disease, and be unable to refer, or treat, the patient in an optimal way. Secondly, this may also be true when the patient is being referred to specialist health services as well, e.g., due to a lack of necessary expertise, rigid regulations, and/or being referred to the wrong (kind of) specialist. Hence, in an increasingly complex and cost oriented society, there is a need for disrupting an old, and partially dysfunctional, monopoly of medical knowledge/expertise. Introducing a blockchain-based platform could incentivize experts to share their unique expertise, and also ensure the integrity of their reputation. This would allow individuals to connect to others with expertise about their specific disease, and/or similar experiences, and being able to trust their recommendations due to the platform's native reputation system.
MedBook: Outline of vision
MedBook is a blockchain-based solution that aims to monetize reputation in a medical network. By establishing a token-based economy, with a tamper-proof reputation system, individuals would be directly connected to others who have expertise and/or experience with the same, or similar, conditions. Hence the MedBook platform will allow for high quality health advice to be exchanged between users. This would allow each individual to match themselves to a database containing for instance similar symptoms, demographics, test results, genetic data, and anamnesis (case history). The platform will allow for psychiatric as well as somatic narratives, and contain recommended treatments, and detailed stories of people in similar situations. The MedBook platform will have its own native currency, the MedBook Token, which will capture the value of exchanging useful health information between users and contributors in the network. Hence, the MedBook token will incentivize people who have gathered expertise from education and/or experience to share high quality health recommendations and narratives. Researchers could also utilize the network, by paying users for their data. Application of a blockchain-based system would allow users to control what information they wish to share, and hence be able to benefit from research results without compromising their own privacy. There could be endless examples of how MedBook could solve the current issues in the health industry, but let us entertain one concrete example, and assume that you notice red circles on the skin after a tick bite. You go to the doctor, and s/he sets you up for a standard treatment of 500 mg Apocillin (first line of treatment in many countries) daily for 14 days. As a user of MedBook, you ask for a range of tests. Hence, after the consultation, you enter your results, symptoms and your health narrative into the network, and search for similar cases. You soon discover that within the field of people having had Lyme borreliosis, many report that the standard treatment with Apocillin did not help them much, and that some have been severely ill for as much as 10 years after this initial, standard treatment. One prominent medical professor, who has a reputation score of 97 out of 100 on MedBook, reports that she underestimated the importance of the initial treatment after having had a tick bite herself, something that likely cost her several years of illness. You find several similar profiles that also recommend not taking Apocillin, but rather 100 mg Doxycyclin 3 times daily for 30 days, followed by 100 mg Azitromax daily for 2 days. We see here how MedBook may change the current process for better or worse. This information would allow the user in our example to choose whether s/he wanted to adhere to the treatment prescribed by the first doctor, or to find some way to follow the recommendation from MedBook, e.g., seeing a private practitioner who could prescribe the recommended medication. The platform could potentially provide life-changing information. However, the platform would not in itself be a medical authority (at this point), or official medical institution, such that the user would still depend on finding a health professional willing to adhere to the clinical advice provided by MedBook.
Blockchain technology solution
The MedBook platform will allow for costless verification of the reputation of users, the content, and the content providers, once a user, or content provider, is registered on the blockchain. The MedBook token will be transferable and tradable on crypto exchanges. The token will primarily be rewarded content providers for sharing useful information with other users. The network will reward outstanding quality by allowing a user with high reputation, but few contributions, to earn more tokens than a user with a lower reputation and more content. Up to a certain level, more tokens will allow users more weight in upvoting other users’ content, but to prevent the possibility of misuse, this increase in voting power will have a ceiling effect. Users will be able to earn tokens by providing data to research projects. When the platform has attracted enough initial users, the project will allow researchers to apply for tokens. Collaboration with clinicians, e.g., GPs, could be established by allowing them to advertise on the platform. Users would earn tokens by watching these ads. Tokens will be of a fixed number, such that it will increase in value as the system gains more users. Early contributors will be invited, and will be rewarded more tokens if they receive a high quality score. This will ensure that early contributors provide high quality content, such making the platform attractive at an early stage.
The so-called «last mile problem» is probably the major challenge for this project. The last mile problem is the disconnect between online and offline activities. Solving this problem involves building a bridge between the offline events and the online recordings of those events during the verification of a transaction in a way that ensures an accurate accounting in the blockchain. In this Harvard Business Review article, Professor Christian Catalini and Professor Catherine Tucker further unpack the last mile problem and illustrate how the usefulness of technology still relies on trusted intermediaries to bridge this “last mile”. One solution os applying a secure mechanism of "know your customer" (KYC). If the MedBook network grows beyond a certain point, then Dan Larimer’s KYC solution (No-KYC ID Solution) could be gradually implemented, and the game theory will disincentivise users from providing fraudulent information. However, the challenge is how to transpose medical records over to the blockchain, and also validate contributors’ expertise, at an early stage of the project. In order to succeed, this project needs to cooperate both with the government, who keeps track of certified health practitioners, and established experts in the field, e.g., clinicians. For many users and content providers, being allowed to share their unique medical story will be valuable in itself, as people typically wish to share their stories, even without being highly rewarded in the beginning. This would allow for the platform to grow beyond a critical point, were mass adaptation can occur. In order for the masses to move over to the platform, it needs to contain a considerable amount of information. Hence, the platform needs to be made publicly available from the very start, allowing users to describe their stories from the very beginning. The government should be interested in allowing their citizens to find the best treatments available, and could be further rewarded in terms of having access to statistics and user feedback.
The MedBook platform should probably be built on the Cardano or Ethereum blockchain, allowing for both fast, and reasonably safe transactions. All (parts of the) project(s) involving users providing sensitive information would be based on the Ethereum blockchain, such that security is maximized. In the beginning, normal KYC procedures should be put in place, and would be absolutely in order to verify expertise. Gradually the MedBook token will allow other users to upvote and reward good content providers, and a process in line with Larimer’s recent KYC patent could evolve over time. Game theory should ensure that content providers act ethically. There would be a machine-learning algorithm added to the system, such that the process of matching users with relevant recommendations would evolve over time. Hence, as the platform eventually gained mass adoption, users would be guided to relevant information in an optimized way.
Quiz
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What is the main purpose of the proposed blockchain-based health care platform?
a) To provide a single database for reliable health information
b) To verify the reputation of those sharing health knowledge
c) To incentivize the sharing of health knowledge by experts and patients
d) To reduce the burden on public health services -
Which of the following is NOT a challenge addressed by the proposed platform?
a) The lack of a platform for sharing personalized health knowledge
b) The difficulty in navigating the vast amount of available health knowledge
c) The potential for patients to be mistreated or wrongly diagnosed
d) The lack of competition among different health care approaches -
Which of the following is NOT a potential benefit of the proposed platform?
a) Improved efficiency and effectiveness of the health care system
b) Reduced burden on public health services
c) Greater trust in the sources of health information
d) Increased profit for health professionals -
How does the proposed platform plan to provide equal information about the effectiveness of different health care approaches?
a) By using blockchain technology to verify the reputation of those sharing knowledge
b) By providing reports from experts on both acupuncture and prescribed drugs
c) By incentivizing the sharing of knowledge by experts and patients
d) By reducing the burden on public health services -
How does the proposed platform plan to reduce the burden on public health services?
a) By providing a single database for reliable health information
b) By verifying the reputation of those sharing health knowledge
c) By incentivizing the sharing of health knowledge by experts and patients
d) By increasing the profit of health professionals -
Which of the following is NOT a potential use of the proposed platform?
a) Connecting with others with expertise about a specific disease or similar experiences
b) Validating the information presented by Google
c) Sorting through vast amounts of health information
d) Providing a single database for reliable health information -
How does the proposed platform plan to incentivize the sharing of health knowledge?
a) By using blockchain technology to verify the reputation of those sharing knowledge
b) By providing reports from experts on both acupuncture and prescribed drugs
c) By connecting users with others with expertise about their specific disease or similar experiences
d) By increasing the profit of health professionals -
How does the proposed platform plan to improve the efficiency and effectiveness of the health care system? a) By providing a single database for reliable health information
b) By verifying the reputation of those sharing health knowledge
c) By incentivizing the sharing of health knowledge by experts and patients
d) By reducing the burden on public health services -
Which of the following is NOT a reason why the role of the general practitioner is challenging?
a) Patients often spend considerable time researching their illness online before coming to see them
b) Validating the presented information is a considerable challenge
c) Patients suffering from complex diseases are typically overwhelmed by the amount of information
d) Medical doctors have an easy time navigating the ocean of available knowledge - How does the proposed platform plan to connect individuals with others with expertise about their specific disease or similar experiences?
a) By using blockchain technology to verify the reputation of those sharing knowledge
b) By providing reports from experts on both acupuncture and prescribed drugs
c) By incentivizing the sharing of knowledge by experts and patients
d) By increasing the profit of health professionals
Correct answers
- b) To verify the reputation of those sharing health knowledge
- d) The lack of competition among different health care approaches
- d) Increased profit for health professionals
- b) By providing reports from experts on both acupuncture and prescribed drugs
- a) By connecting individuals with others with expertise about their specific disease or similar experiences
- a) Verification of the reputation of those sharing knowledge
- c) To allow individuals to connect with others with expertise about their specific disease or similar experiences
- a) To provide a social platform where the reputation of those sharing their knowledge can be verified
- c) Greater trust in the sources of health information
- a) By using blockchain technology to verify the reputation of those sharing knowledge
