[rdiddly]

This is a political problem, not technical. If my doctor were willing to store my info however I want them to, the problem is solved. And if they were willing to store it on a block chain, then presumably they'd also be willing to just put it on a thumb drive for me? Or a piece of paper? A centralized solution, centered on me.

[langitbiru]

I think one of the values that blockchain can bring on the table in this context is convenience.

Passing data to a thumb drive or a piece of paper is a decentralized strategy but inconvenient one.

I imagine in the future, the doctor in Brazil writes your medical data into his/her local computer. You ask the data and show the QR code or public address in your mobile phone. The doctor sends your data to this QR code or public address. You store this data into the blockchain.

Next year, you go to Singapore and do some medical operation. You pass the data from the blockchain via your mobile phone to the doctor in Singapore.

I guess that is the selling point.

Can this be done with centralized approach? Of course. We can build a Paypal company but for medical records. The problem with that is some countries are reluctant to share the medical data with American company. They, I assume, will trust the algorithm which does not have the bias compared to an American company.

Paypal right now is not supported in Iran. I imagine this is one of the reasons doctors around the world would trust the blockchain compared to an American startup company.

[Edited] If we want to build a platform where Chinese and Americans can collaborate on sensitive data, blockchain could be the answer. You don't expect Chinese to trust an American startup company or vice versa. [/Edited]

This is my hypothesis.

[marcus_holmes]

You might want to do some actual research on non-US medical systems before investing your cash into this.

There are already several international standards on the interchange of medical records. There are some limits on requesting your own medical records (for apparently good reasons) but basically the system you describe already exists, minus the need for blockchain (which apparently is more "convenient" than a thumb drive... how?) outside the USA.

Also, the problem with Chinese-Americans collaborating on sensitive data is that they don't want to, not that they don't have a suitable format for data interchange.

Again, solution chasing problem... as always with blockchain...

[icebraining]

Why is the doctor sending your data to some public address shown on your phone, and not to your phone directly?

[slfnflctd]

My phone has zero reception at my doctor's office. It also runs out of space regularly, since manufacturers decided to screw consumers over by taking out SD card slots. There could be plenty of other reasons.

[icebraining]

Why do you need reception to transmit something from a computer to a phone in the same room?

As for out of space, that's a valid concern. But the blockchain itself can store almost nothing - a few bytes per transaction at most. So you'll have to store the data somewhere else anyway, and only point to it using the blockain. And therefore, the question returns: why not store that pointer in the phone itself?

[dnomad]

Yeah, it's like Americans have this massive blindspot when it comes to government. The "problem" of standardized medical record storage and distribution has been thoroughly solved in France. There you have a nationwide system of healthcare and there are largely no issues with medical record access. (Which is not to say it's perfect but what you're dealing with are largely internal organizational issues not the massive coordination issues that make American healthcare so unpredictable and expensive.)

There's this very naieve view that blockchains are somehow going to replace governments. I think a lot of people are in for a very rude awakening. The government, as they say, are the guys with the guns. It highly unlikely that they will surrender enormous power and privilege to decentralized networks. When it comes to currency, capital formation, medicine, energy, defense and transportation the governments will step in to ensure they remain firmly in control. These are political "core competencies" that no government in their right mind will abrogate.

This is what makes all these blockchain delusions about a blockchain of medical records so stupid and pointless. If there were such a blockchain it would be controlled by the government in which case you wouldn't need a blockchain at all as everything could be done much faster, cheaper and more securely using a centralized, government-controlled database. I mean, really? Do people not see this?

And the idea of "forking" Google or Amazon is so hilariously dumb all I can do cringe that somebody seriously wrote that and put their name behind it.

It's clear now that many of these blockchain advocates don't really understand where the blockchain is actually useful. There actually is a class of problems that require global, decentralized, democratic consensus and are not susceptible to economies of scale but are susceptible to network effects. (I say democratic consensus here because this idea that blockchains are "trustless" is nonsense. Every blockchain is a democracy and democracy requires enormous trust. As we've seen again and again if the majority of nodes vote one way you have no choice but to follow or lose all your assets. Blockchains do not fulfill this libertarian fantasy of freedom from democracy.) This class of problems does not overlap with what governments at all. But it does overlap almost 100% with those problems that the internet has already solved so successfully. Particularly investors like USV should be looking at their previous tech investments -- Twitter, blogging, open source companies, digital collaboration, content generation, messaging -- and thinking about how blockchains could help these problems. TLDR: the blockchains aren't anything new. They're global, decentralized networks that let millions of people communicate and coordinate in real-time. Just like the internet itself.

[icebraining]

The "problem" of standardized medical record storage and distribution has been thoroughly solved in France. There you have a nationwide system of healthcare and there are largely no issues with medical record access.

What happens when a French citizens moves to another country? Some people even live a few months every year on different countries, what happens then?

[PeterisP]

Whatever solution you'd propose for ensuring global adoption and interoperability of hypothetical blockchain-based medical records would also work just as well (or better) for any other type digital healthcare records. That's mostly a political problem, and not one where blockchain provides any advantage.

[icebraining]

I don't disagree, I don't think the blockchain makes any sense here (or mostly anywhere). I just disagree that France has "solved" the problem.

[PeterisP]

One could argue that France is one of multiple examples that demonstrate that the technical parts of the problem are already solved. If we actually wanted to (IMHO we don't), had the political decision to implement global interchange of health data, and had solved the political problems required to get the resources and will to implement it, then we could just copy and deploy the solution of France or Estonia or whatever, knowing that the technical and organizational structures are reasonably appropriate, and there's no need to suppose that something fundamentally technically different is needed, there are no obvious technical problems that need solving.

[icebraining]

I don't know who "we" are. But the solution proposed with the blockchains and stuff - misguided as I may think it is - had the goal of allowing general interoperability / portability of data among any providers, potentially across the world.

That France has some software that works well for their small corner of the world with their specific centralized model of healthcare is great for them, but doesn't solve the same problem. And it certainly doesn't mean you could necessarily apply it to the US, even if there was political will to do so.

[dboreham]

Except almost nobody does that.

[icebraining]

Perhaps. I know at least three retirees doing that (spending winters with their family abroad), and apparently there's a term for it in the UK ("mouseholing"), but I can't find any statistics.

[dboreham]

That's seasonal living between two places (e.g. Snow Birds). Presumably there is already a workable solution for those folks. Parent was talking about people who randomly move country to country.

[icebraining]

I am Parent, and I wasn't, even if I didn't explain myself clearly :)

Is there a workable solution? I don't have any experience with the French system, but between the two EU countries I know, there's no good solution, or at least none was offered by doctors on either side.

[snarf21]

Okay, but the US doesn't have a nationwide health system and probably never will. So how do we fix the medical record access issue?

Saying "solve it with regulation" is no more helpful than saying "solve it with blockchain". A working solution is better than something "better" that is theoretical.