Death of the Middleman: Healthcare & Blockchain

by | Feb 7, 2018 | Blockchain | 11 comments

I’ve seen it twice before. Some new technology drops out of the sky and within a few years we are living in a different world. First, we witnessed the rise of the personal computer. In the early days it was only the nerds who saw it coming and naysayers were everywhere saying, “Who needs a computer?”. Next came the birth of the internet. What can be said about that? Talk about a game changer, that was it. I can remember many smart people telling us, “I don’t see what the big deal is”. Now comes the earthquake number three, blockchain technology. Blockchain is a way to store information that doesn’t rely on a single computer or server. Information is verified, distributed, and with permission, viewable.

Blockchain is not evolutionary. It is a revolutionary concept that fell out of the clear blue sky during the collapse of the global economy in 2008. We can see the first white paper that spawned it all. We can see the first block ever created, the Genesis Block. One day it wasn’t there and the next day it was. I kinda like that. That is the way many breakthroughs occur. Now don’t confuse this as being just the Next Big Thing. That phrase is reserved for inventions like 3-D printing, Artificial Intelligence, and The Cloud. Pretty cool stuff but not going to massively disrupt numerous industries on a global scale.

Blockchain is an innovation that will both create and kill business models across the full spectrum. Want to use your credit card? Somebody will be paying the card company up to 3.5% to be the middleman. With blockchain that charge can shrink by 90% or more. No wonder Visa has pilot programs underway to use blockchain for transactions. They can see their future survival as a middleman is dependent on the new reality of blockchain.

In healthcare, we see the failure of interoperability when data is forced through intermediaries. Who needs a Health Information Exchange (HIE) when a blockchain will do? Sure, there are problems to be worked out such as scalability and privacy, but you can bet these are being worked on by development communities. The range of blockchain’s influence on healthcare has yet to be fully imagined. There is a birth taking place here that I encourage you to keep an eye on.

For a quick high-level view of blockchain basics check out this Ted Talk. In less than 20 minutes you will see there is an arc here that stretches beyond the horizon. For healthcare anyone involved with infrastructure must keep up with blockchain developments. The HIMSS 2018 conference next month is loaded with blockchain forums, exhibitions, and education focused on blockchain. He who has ears, let him hear.


  1. Dr K. Lovick

    I may have lost the point here, What is Blockchain if not just another middleman, it adds no value, it has no product it claims to remove third party costs is some mythical way like huge multi ton dragons can fly on tiny wings and breath fire from their nostrils. Evidence is missing, statements are easy to make (there in another way of putting this involvine Bovine excrement)

  2. Jim Tate

    Dr. Lovick, thank you for taking the time to read my opinion and replying with your own. Time will tell which is the most accurate.

  3. Michael Gagnon

    Blockchain is a very interesting technology that will not replace our HIE but may become a technology that I use to run my HIE. You greatly underestimate the role of an an HIE. It is not to absorb a bunch of transactions from providers and link them in a central repository. It is to make sense of the data collected by individual providers for use by many other organizations. In other words Blockchain does nothing to fix the quality of the data collected by providers. That is what we do in our HIE. It’s the old adage “garbage in, garbage out.” In Blockchain it may be really secure and accessible garbage but it is garbage nonetheless. Blockchain is only useful if the organizations or individuals contributing to the chain adopt rigorous standards. Healthcare is not close to this today.

  4. Jim Tate

    I agree with you. Just dumping data into a HIE is not the solution. To your point, many of the CCDAs created by EHRs contain inaccurate info. Finding best use cases for blockchain is paramount for success. Thanks for adding to the discussion.

  5. Erin Ressler

    Jim, I think you’re absolutely right. This will prove to be a revolution (initial roadbumps aside). In fact, I love your example, because when I read my first in-depth article about how it works and the purpose(s) it was created to serve, my first thought was, literally, “Hey – I won’t need Visa!” I don’t think many of us can even begin to grasp the implications here, for healthcare and so many other industries. Thanks for this!

  6. Jim Tate

    I like your phrase “I don’t think many of us can even begin to grasp the implication”. Some have expressed the opinion that blockchain is meaningless. I think something big is coming.

  7. Nick

    I’m a bit confused as to the concept of storing the data in a blockchsin. Most assuredly you can validate the existence of the document with a block chain but I don’t think we will be storing actual full data sets in block chain. Perhaps I’m wrong but there are huge issues with that. We also must consider what impact does GDPR have on the idea of immutable data in a blockchain. I’m sure greater minds then mine may figure it out. I will say this though, no one has found the holy grail or eldorado.

  8. Phil McSweeney

    Can you give the link to the TED talk you mention please?

    Phil McSweeney

  9. Al Hegab

    Thanks for the heads up, I agree, the third earthquake is coming, might take time, but definitely is a game changer

  10. Rick W. Finch

    Jim: You are spot on! In fact, I will go on record and say that Insurance Carriers/Payers/TPA’s as we know them today, will become a thing of the past in the not so distant future. I was at a workshop last week discussing CAPTIVES and this very topic quickly took over the discussion.

  11. Jim Tate

    You are correct that a blockchain is not a good way to store data. It is more of a ledger than a data base. Most solutions will incorporate a mix of public/private blockchains and data bases.

Submit a Comment

Your email address will not be published. Required fields are marked *