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Medical records on the blockchain – the history of a bad idea
- tanseydavid 8y agoI really appreciate being made aware of this author, so that I know in the future to avoid his writing. He desperately needs an editor (an editor other than his spouse).
- sctb 8y agoCould you please try to be less rude and also tell us something we can learn from? https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
- pvaldes 8y agoVisually looks a little messed up. Could be improved IMHO paying attention to some standard typographic rules. Do not use a mix of several fonts and sizes in the same article Choose good fonts. I wonder why is so trendy nowadays to use the thinnest font available and put it in an low contrast gray tone. It puts a innecessary strain in the eye of your public Cheap fonts have a badly designed character spacing. The same problem happens here. Some letters look more closer than other and this is plain wrong in typography. All characters must create an uniform word and all words must have clear boundaries. Fix your line spacing. Needs more height here for the same reason. Plan your design and take care of the flow of your text. Do not randomly displace the beginning of some paragraphs over the other paragraphs without a good reason. Split your page using some strong vertical lines. Not a vertical zigzag pattern.
- EnFinlay 8y agoI am personally grateful for every blog which does not go out of it's way to follow "standard typographic rules" because so many of them end up looking identical.
- pvaldes 8y agoEditors have extensively tested what works and what not for thousands of years. You might notice that I didn't talk about the ideas expressed in the text. Is because the chosen format is too cluttered and distracting. I was expelled in the first two paragraphs and personally couldn't care less about what was written here. I'm not probably the only one. The lack of knowledge (or care) about basic typography is particularly surprising among web page creators (one of the groups of people that produce more written texts currently). This hurts everybody in many unexpected ways. We enjoy gray text over white background for some reason, jumpscare videos playing suddenly when you enter a web page, diminutive fontsizes by default guaranteeing to damage your eyes, and too long lines of text that are just the incorrect way to do it (but nobody cares).
- perl4ever 8y ago"I wonder why is so trendy nowadays to use the thinnest font available" I am pretty much an amateur at making web pages, and after I used Garamond for something, I read an article about how terrible it is for the WWW because it's so thin and you should only use it for print. But I thought, hey, my phone has more resolution than early laser printers, so is this advice really still relevant?
- 9HZZRfNlpR 8y agoReally sad seeing people bashing people who still run websites and blogs. No wonder everyone's using the spyware funded centralizes sites. Editor for personal blog? Are you serious? It was a great read, we need it instead of tweeting 90 char snarky tweets.
- godzillabrennus 8y agoI recently worked on a yellow paper that outlines a data exchange with no centralized authority that puts ownership and encryption responsibility of that data back onto the users of the network. It's a data exchange not a blockchain because all data should be mutable and nullifiable. Blockchain is the wrong technology for so many things that it's been hyped for.
- 80x25 8y agoPerhaps your comment was meant to be tongue in cheek, but it sounds like this data exchange is a replacement for the World Wide Web? It's not IPFS is it?
- perl4ever 8y agoI had to look up IPFS, because I confused it with IPoAC.
- godzillabrennus 8y agoIPFS was a technology we evaluated but decided it was not appropriate given specific requirements of all parties that will be using it.
- djyaz1200 8y agoTo be generous to those proposing blockchain for health records I think their intent to suggest that it be used for the access/authentication layer of a more conventional secure database, but that's just a guess.
- thatoneuser 8y agoHow would it actually solve a problem that couldn't be solved more conveniently with current standards?
- everfree 8y agoIt would provide an auditable, tamper-proof database with an immutable history, accessible by all health companies and not controlled by any one health company.
- dekhn 8y agoI believe there were technologies before blockchain that enabled that.
- pavlov 8y agoSince the actual data in this scenario would still be hosted by the individual companies, what guarantee is there that they’d correctly log all access into this shared ledger?
- JohnFen 8y agoOk... but a database of what? If it's the access/authentication layer activity, I don't see what blockchain really brings to the table.
- tracker1 8y agoCool.. what about the attached records, are they also accessible by all health companies? And if not, how do you know the ledger is really tied to the records, and if so, isn't this a breach waiting to happen?
- buhrmi 8y agoGosh I love David Gerard....
- oooshha 8y agoHard not to imagine a pompous Brit spraying saliva everywhere while reading this. To the content - there is only one way to place data on the cloud that is impervious to all global state, corporate and nefarious actors. That is with a robust blockchain. Whether or not you think that is useful in medical records is another story. I've been a medical doctor for 10 years and think that it is.
- adrianpike 8y ago> nefarious actors hey, it's me, your blockchain developer
- JohnFen 8y ago> I've been a medical doctor for 10 years and think that it is. Can you explain how blockchain is useful for this in a more nuts-and-bolts way?
- killjoywashere 8y ago"I'm a medical doctor" is, in most cases outside of hospitals and clinics, entirely superfluous to the issue at hand. And it's frequently less relevant than you might think inside a hospital or clinic. If you hear someone saying this in any situation outside a medical emergency, I hereby give you permission to deduct 1 point from their debate score. I say this having also been a medical doctor for 10 years.
- JohnFen 8y ago> I hereby give you permission to deduct 1 point from their debate score. I already did, because it looked like a clear invocation of the "appeal to authority" fallacy. While being an MD can provide insight (depending on the nature of the doctor's practice) in terms of how things impact the practice of medicine, being an expert in a field only really matters when discussing topics that are in that field. Outside of their field, an expert's evaluation carries no more weight than anybody else's.
- tracker1 8y ago
- Uptrenda 8y agoI feel its become very fashionable to dismiss the simpler applications of the tech because of how unrealistically its been applied. It's so easy to do too. Look at the insane valuations, the fraud, and hype cooked up by marketers, and the whole thing looks very stupid. But its a mistake to let this get in the way of critical thinking. There is a reason why the topic is brought up so often and its because among all that garbage there is genuine potential. It requires education, and R & D to unlock most of it. But at some point we'll have straight-forward tools that can be applied to solve a variety of common problems. I predict the end result won't look any where near as exciting as it is today. It's likely going to end up being a flexible and boring set of auditing tools. But that's still going to improve the transparency and efficiency of many organizations. And give how archaic some of the processes around businesses are today -- those changes are still going to look revolutionary in their context.
- davidgerard 8y agoThe obviously convincing argument would be - after ten years - "something to show for it all." That is, something that blockchain is clearly and obviously the use case for. "Potential" goes only so far. Eventually you need kinetic.
- drcode 8y agoAs someone who is a CEO of a medical blockchain startup which is trying to find actual meaningful use cases, I agree 100% with the conclusions of this post. (finding actual convincing use cases in the medical space for this tech is hard)
- marcus_holmes 8y agoso...why are you still the CEO of a medical blockchain startup? Surely you escorted yourself off the premises by now? ;) But seriously, isn't this putting the cart before the horse? The usual order is "find a problem, build a solution", not "find a technology, build a solution, work out who has a problem it can solve". How's that working out for you?
- pryelluw 8y agoThere might be potential uses for distributed ledgers in an industry that is required by law to share your care history. This specific company not having arrived at a concrete product does not negate the potential upside. All it takes for them to do is develop a technology that can be of interest to an industry giant and become acquired. Im not saying this is the case here, but it is a real option.
- marcus_holmes 8y agoahh, I see... so more like speculative R&D, developing a technology to the point where it's saleable to a larger organisation. So there's no need for a customer problem to solve, it's just about building enough capability with the tech to become acqui-hirable, is that right?
- pryelluw 8y agoTo a point. I cant comment on regards to this being the goal of the company above. We should consider the following: A startup can have a product offering and also be the product itself.
- JohnFen 8y agoOf all the crazy applications that I've heard for the blockchain, medical records are easily the craziest.
- M2Ys4U 8y agoElections on a blockchain are probably in the same ballpark
- deleted 8y ago[deleted]
- tracker1 8y agoI cringe every single time someone suggests blockchain in our space. Either it's easier with other tech (even public/private key tech doesn't require blockchain), or open to potential leaks/abuse in the future (tracking how everyone voted). There are a lot of use cases, most even, where it's not a great fit, and there are other, better, approaches. Disclosure, I work for an election services company...
- encloser 8y agoI like to provide people the NIST Blockchain Overview pdf. Particularly the decision flowchart. https://nvlpubs.nist.gov/nistpubs/ir/2018/NIST.IR.8202.pdf https://nvlpubs.nist.gov/nistpubs/ir/2018/NIST.IR.8202.pdf
- airstrike 8y agoThanks for sharing this. Really insightful
- dredmorbius 8y agoP. 42 for the chart. (But of course.)
- _fizz_buzz_ 8y agoI prefer this decision flowchart ;) https://twitter.com/MalwareTechBlog/status/932649133256597505 https://twitter.com/MalwareTechBlog/status/93264913325659750...
- tracker1 8y agoI've actually forwarded a lot of that to the higher ups... There are places that it could be useful, I just feel that most cases it creates more problems than it really solves.
- smt88 8y agoI've discovered that some people say "blockchain" when they mean "immutable, distributed, cryptographically-verified database" -- which is actually a useful thing for many people. The Byzantine fault tolerance, public consensus, and mining aspects that we associate with "true" blockchains are the parts that people can't find a way to justify and can typically be ignored.
- woah 8y agoNever have I seen someone so angry that a college student gave a vague talk, a startup made some exaggerated claims, and a university research project wasn’t completed. I hope he doesn’t read hacker news. The vague talks, exaggerated claims, and unfinished research projects here would give him an aneurism!
- monkeydreams 8y agoI work in this space and I am hard pressed to see where blockchain could improve patient control of data. The real problem that I have is that health data rules and workflows are completely unlike any other type of data I have worked with. Ownership of data, attribution of information, interoperability, all of these elements are context dependent. Centralised, independent storage of information so that all healthcare providers (with the patient's permission) can access critical records is a much simpler solution. It is still complex, but at least you don't have the byzantine bullshit of the blockchain sitting beneath it.
- nwhatt 8y agoMay be of interest to some: In recent years healthcare has adopted centralized PKI in the Direct project. https://www.directtrust.org/ https://www.directtrust.org/
- zby 8y agoWhen a technology does an unexpected thing, something you'd never thought would be possible, it is tempting to think that it is magic and it can do all the other impossible things.