It’s hard to have a conversation about technology innovations in 2018 without stumbling into the realm of blockchain. Since it first appeared on most people’s radars — thanks to the ever-turbulent bitcoin and other cryptocurrencies — financial organizations, major retailers and even governments have investigated whether or not the trendy technology has something to offer.

As such, it’s little surprise that a staggering number of startups and entrepreneurs have showcased their own blockchain tools aimed at improving consumer health, facilitating new research, securely transferring health data and solving other pressing healthcare challenges.

A blockchain primer

But first thing’s first — what is blockchain?

Speaking broadly, it’s a peer-to-peer series of locked digital data repositories (the blocks) that are linked together (the chain) and constantly checking each other for error. Changes to this chain are time-stamped and only able to be made with the appropriate cryptographic key, with any unauthorized alterations to a block detected and overwritten by the rest of the chain.

The result is a immutable, distributed ledger — an ideal framework for cryptocurrency ledgers looking to distance themselves from any kind of central database. But beyond the concept of exchanging online coins or digital kittens, its structure also promises key advantages for certain players in the healthcare industry.  

“What blockchain is good for is for sharing information and automating processes across enterprise boundaries, where those processes have a high cost of reconciling inconsistent data and it’s important in healthcare largely because we have so many islands of information in the healthcare world,” Mike Jacobs, senior distinguished engineer with Optum Health and the company’s blockchain spokesman, told MobiHealthNews. “One example is that a provider may submit a claim to a payer, and a payer has information on hand that needs to be compared against the claim, and if there’s any significant difference those claims can be rejected. It turns out that there needs to be a lot of reconciliation work between the two organizations as a result.”

Blockchain in the startup ecosystem

Optum’s claims processing approach isn’t the only application we’ve seen, though. And while major healthcare players have been steadily announcing pilots for clinical trial management, fraud prevention, revenue cycle management, supply chain monitoring and other use cases over the past couple of years, the startup space has seen a similar burst of activity as entrepreneurs look to strike while the iron is hot.

For some of these hopefuls, that means cashing in on the well-established blockchain-cryptocurrency concept. Sweatcoin, for instance, incentivizes users to log additional daily steps by offering its blockchain-backed digital currency, which can be redeemed for various goods. Others like Hayver and Sobercoin have a similar model for users who regularly check into an app to report that they are drug-free.

“Cryptocurrency came along, and I always wanted to incentivize people to use the app to make it useful for them,” Harold Jonas, founder and CEO of Sobercoin, told MobiHealthNews earlier this year. “Now we can figure out a way to pay them or incentivize them to use the app or check-in reporting that they are drug free, and then get rewarded and incentivized for that methodology.”

Digital coins aren’t just being employed to promote healthy behavior; they’re also serving as compensation for health data exchanges. Take genome sequencing startup Nebula Genomics: along with paying users a digital currency to sequence and sell their data to third parties, the company then uses blockchain to help store and protect testing results. These data are encrypted with multiple keys held by different parties to allow access, should the consumer allow it.  

“For example, you may choose to be informed every time a researcher requests access to your data, and you can deny any such request,” the company wrote on its website. “To protect the data that you decide to share, we will make sure that your data is anonymized and we will furthermore limit researchers’ access to it by implementing distributed, privacy-preserving computing.”

A number of startups like doc.ai and Embleema are also jumping on the chance to help consumers share their health data with life science researchers, but are pairing it with a personal health record platform.

“Our mission is to turn the bottle upside down and put patients first, restoring their sovereignty over their data,” Robert Chu, CEO and founder of Embleema, said in a statement earlier this year. “Blockchain removes the need for third parties to broker the sharing of data, while providing the most accurate data possible for precision medicine. This is the best way to guarantee that individual patient data will be used to their benefit.”

Adjacent to these is OncoPower. Built specifically for cancer patients, the blockchain-based personal health platform helps users track and share their medical data across various care providers, interact with a community of cancer survivors and — of course — receive cryptocurrency incentives for treatment adherence.

Still, not all of the startups eyeing blockchain are necessarily consumer-focused. For some time now, healthcare API startup PokitDok has been working on its own blockchain transaction network (DokChain) for a multitude of use cases, including EHR and identity verification, automatic adjucation, smart contracts and more. Akiri, a spinout of the AMA’s Health2047 innovation enterprise, is building a private network-as-a-service for healthcare organizations in which blockchain is used to allow changes from multiple authorized parties.

And with more startups still lining up to devise and sell their own blockchain healthcare solutions to health organizations in need, the space is certainly at no risk of slowing down.

“The promise of this is leading to hundreds of startup companies jumping on this trying to create this blockchain-enabled application,” Roger Smith, chief technology officer at Florida Hospital Nicholson Center, said earlier this year at the Digital Healthcare Innovations Congress in Boston. “Some of them are going to become very successful, and many of them we will never hear about again.”