Block chain and digital innovation in healthcare

Do we want to innovate in a specific technology, like canals, or in an abstract industry like transport? Canals are obsolete, yet transport is still thriving.

In computer science terms, this question is about implementation bias. That is, canals implement transport. Implementation bias means being too concerned with what canals need (e.g. water, locks and boats) rather than focusing on what they are doing (transporting goods).

Consider block chain or bitcoin; both are implementations of money, but they don’t implement what coins do, they implement what money needs.

Money has always been used to make money, and new ways to make money attracts investors. This stimulates excitement in entrepreneurs who want funding to develop (and own and license) technologies that promise returns on investment.

In healthcare, the focus is patient benefit, not business or investor benefit. When a company is sold, what happens to the patients relying on its technology, who are relying on on-going bug fixes and upgrades to their heart implants?

Any technology as new as block chain potentially has problems of the sort that the millennia of conventional coinage long since learned to manage: the many ways that people use and abuse coinage is understood and countermeasures have matured. While there are many investors in cryptocurrencies, this does not mean that they are a good investment in healthcare (Green, 2018).

Most block chain investment is implementation biased: crypto is exciting, but excitement is not what’s needed in healthcare. For example, a key innovation in cryptocurrencies is relaxing the requirement for a trusted party; but anything in the NHS has the NHS as a trusted party. If you don’t trust the NHS, why offer it a technology that imposes high overheads? Why offer it a technology that undermines interoperability (Bates and Samal, 2018)? Of course, these criticisms do not mean that helping healthcare in war zones would not benefit from new techniques.

The lesson is not that block chain should be adopted in healthcare, but, rather, that mature digital thinking itself is the key. Block chain, distributed ledgers and so on are implementations, they should be inspiring more mature ideas about what can be achieved, not driving blind investment.

This is an excerpt from the white paper "Digital maturity in an age of digital excitement'. To download our other medical device white papers, please visit the Insight page on the Compliance Navigator website.