It was no big surprise that HIMSS was the polar opposite of SXSW in terms of the debates, conversations on stage, and the audience. It was evident at HIMSS that the post ICO world has tilted towards the enterprise. At HIMSS, permissioned consortium blockchains are a given. Instead of debating private versus open blockchains, conversations focused primarily on the three big consortia coming to life and which business-to-business use cases might mature at the fastest rate. Moreover, brand name companies are starting to place their bets. Enterprise-focused solutions dominated the week which means that DLT solutions and enterprise-focused Ethereum plans were on display. Decentralization was definitely not the center of attention at HIMSS.
At HIMSS19 there were over 90 blockchain-related events and booths. The centerpiece was an all-day blockchain symposium that featured prominent speakers such as Microsoft’s David Houlding, ConsenSys’ Heather Flannery, Steve Posnack of the ONC, and Anthony Begando of ProCredEx. The sold-out symposium was a mix of large enterprise organizations, traditional technology vendors, academics, startups and even a few ICOs (see Robert Miller’s excellent recent ICO research here).
The Hardest Part about Blockchain
Microsoft’s David Houlding did an excellent job kicking off the week with a thoughtful introduction to blockchain in healthcare. His slides can be found here and they are a good primer for anyone new to the technology. Towards the end of his presentation, David commented that “The hardest thing about blockchain in healthcare is forming the consortium.” I found his words resonating throughout the week.
I agree that forming the network is often a limiting factor. Failure to bring a network together is a killer for many projects. Only a few have publicly announced that they have pulled it off. These include ProCredEx (provider credentialing), Synaptic (provider directory), and IBM (use case undefined at this time). We know there are a few other projects on the path at Hashed Health and in stealth mode elsewhere.
Throughout the rest of the week’s presentations and meetings, I also heard speakers conversely comment that “the hardest part about blockchain in healthcare is making the technology / product work.”
It’s true that many people are making poor use of the ledger from a technical perspective. Some companies leverage blockchain as an innovation brand or as “transparency-washing.” Others use the technology to prove a thesis around a jointly operated network. Version one of the technology may be rightly criticized as something that could have been managed with a centralized system, but the plan is to prove a technical solution and evolve in to a multi-party / multi-system version.
Still others cried “the hardest part is the business model!” It’s certainly true that many use cases successfully employ the ledger from a technical perspective, but there’s no real value creation. The use of the technology does not unlock any new advantages or improvements to the current business model. It’s decentralization for the sake of decentralization, or the decentralized solution has no real business model advantages over doing it the old way.
Those invested in some use cases commented that “the hardest part is the successful navigation of regulatory considerations.” For certain use cases this is true as well. Certain use cases will remain out of reach because of important regulatory considerations. Some use cases are advancing more quickly overseas for this reason. I always consider it wise to not bet your future on an unanswered regulatory question. There’s plenty we can do that stays clear of regulatory questions.
The hard truth is that the hardest part about blockchain in healthcare it that it’s all of these at once. It’s the network + the technical model + the new business model + staying clear of regulatory hurdles and it’s trying to do all of this at the same time. Coordinating all these “hardest part” statements at the same time is the biggest challenge. Very few use cases check all the boxes right now.