What is The Blockchain?
This is a tricky question that I have spent time attempting to understand and will attempt to explain. It is basically a data repository of trusted exchanges (in the case of Bitcoin, money). It acts as a ledger of exchanges between multiple parties over time. One the best explanations from a social work/care management point of view is to start with the idea that it is just a basic ledger record and work your way up to the tech. Chris Berg, Sinclair Davidson and Jason Potts are from the RMIT Blockchain Innovation Hub, offer this explanation that does just that..
What I find fascinating is this ability to quickly perform all the tasks in a ledger, quickly such as confirming ownership, status, and authority just by joining a group of peers on a Blockchain. From the social work perspective I found this sentence most intriguing… “At their most fundamental level, ledgers map economic and social relationships.”
So still confused.. probably…The next best explanation I found is a deeper dive into how it is built and how it keeps information secure. For a deep dive into this you can read this article, aptly titled “WTF is a Blockchain?”. But trust me they are built in a cool way where networks can agree upon contracts, they get locked into the network, and their value gets added over time.
Also this Ted Talk via Bettina Warburgh explains this and I like her illustrations to wrap my head around how it works…
Alright so the Blockchain offers a quick, efficient way to exchange assets and information…my hope is that left you with some good resources if you want to dig deeper. On to Health Information Technology’s application of the Blockchain.
Health Information Technology and The Blockchain
This year I am heading to the Health Information and Management Systems Society Conference where Blockchain is sure to come up. If you are into healthcare you may have heard about a Health Information Exchange (or HIE). This a trusted group of providers willing to share information in a centralized way with patient consent. So in reading the above information and my knowledge about HIE’s I asked the following question via twitter…
Alright call me naive but serious question prior to #HIMSS18…
What is the difference between #Blockchain for health & a well designed #HIE ? #EmpowerHIT #interoperability #HITsm pic.twitter.com/dSuXnLKQZl
— Sean Erreger, LCSW (@StuckonSW) February 15, 2018
The ensuing thread on twitter lead to a great conversation about what Blockchain is and is not..
Actually that a blockchain can ensure the provenance of data is quite important. The purpose of something like @youbaseio, or @blockstack, etc. is that they enable dApps w/ data relevant to the dev's interests, & data that the individual can consent to share via different methods
— Nate DiNiro (@unclenate) February 15, 2018
You can make an HIE out of lots of things, using lots of techniques; blockchain is an ingredient @ReasObBob @haroldsmith3rd @jeffbrandt @leonardkish @unclenate
— Chuck Webster MD See you at #HIMSS19 in Orlando🍊! (@wareFLO) February 15, 2018
Prior to understanding this as a trusted/private exchange ..
…So is a Blockchain medical record provider facing or patient facing? As a care manager if someone said to me can you forward this to my blockchain, I would be awfully suspicious?
— Sean Erreger, LCSW (@StuckonSW) February 15, 2018
This was my take away.. that prior to engaging in this conversation I thought the Blockchain was a place but it can be cooked into health information exchanges…
Hi Sean, IMO we must conduct thorough planning, requirements gathering, capabilities assessment, feasibility studies & ROI projections to determine how to best deploy #Blockchain. Tech can't be solution looking for a problem. Need functional adaptation to healthcare.#HIMSS18
— Michael Joseph, PMP (@HealthData4All) February 17, 2018
Once Was Lost But Now Am Found
As the title alludes I set out on a course to understand the Blockchain a little more. I thought it was a place and I didn’t quite understood what it did. Not only that but how it could solve problems. Similar to my recent post about API’s, I feel like this is a place social workers should be hanging out. It’s still in it’s infancy but exchanging information in an efficient, trusted way is something social work should be invested in.
With the use of trusted contracts, Blockchain could have an impact on poverty. This article via Data Floq argues...
“Blockchain enables irreversible records of ownership, because once data is on the blockchain, it can no longer be tampered with. In addition, the usage of smart contracts will enable automatic transfer of ownership if the right conditions have been met, protecting the seller as well as the buyer from fraudulent actions. Therefore, Blockchain ensures easy and safe registration of property ownership. When property ownership can be proven easily, the person has a better chance to prosper in a capitalist society.”
It was also noted in many articles I read that Blockchain may assist in reducing costs for complex transactions like buying a home and insurance. The easy exchange of information and contracts could ultimately lower costs for non-profits trying to solve complex social problems like poverty. Again, Blockchain applications for things beyond finance are in their infancy. As I understand this technology, it could have tremendous implications on Health and Human Services. Contracts, financial transactions, and referral’s between agencies could be more efficient. I would argue again that those building these innovations, should do this in partnership with social workers. That don’t let our profession sit on the sideline and be lost on the Blockchain.
That Blockchain is not just this “sexy” piece of technology. There was recently an article about how putting the words “blockchain” in your titled increased it’s value on the stock market. We have to be careful not underestimate the power of this technology but also be cautious about it’s limitations. That right now it appears to be a “shiny thing” powering Bitcoin. The Blockchain has potential to make an impact on human services and healthcare. So I hope I have given my social work colleagues enough information not to feel lost on the Blockchain but also to feel empowered to get involved in this technology. As always I would argue social work should be an integral part of building technology like Blockchain solving complex social problems.
More Info
Thanks to @Textrahealth on twitter for providing this list of useful cryptocurrency articles
Also for more information about Blockchain in the healthcare space check out this post by Edward Bukstel