Supply chain & logistics
The need for transparency A no-brainer, then, as Screen says. Yet, for a technology that brands itself explicitly in terms of transparency, trust, openness and communication, it’s surprisingly difficult to pin down its key figures, both at Hedera and beyond. While requests to speak the CEO of Hedera were bounced on to partner companies, blockchain strategists at other global enterprises agreed to interviews, only to pull out at the last minute due to a ‘conflict’ (whether of interest or time is unclear). Even when you do get someone on the phone, descriptions of the technology tend to remain abstracted, couched as analogies and what-ifs, rather than practical, on- the-ground case studies, because NDAs and privacy policies keep the facts sealed away – on ledgers that are supposed to be transparent.
Of course, when it comes to healthcare, there’s a big question about how transparent we really want our information to be – so it’s reassuring to know that the companies who the government outsources its databases to aren’t quick to dish the data. As Screen reveals, there’s also an implicit question mark over who in the hospital setting is even afforded access to that data. “It’s all managed on the system,” he explains, “so ward staff have access to the data, pharmacists have access to the data, but it’s very strictly controlled […] there are all kinds of security policies and privacy policies around that, which I would hope goes without saying.”
This raises another question about the use of DLTs in a medical context: the issue of immutability. As every exponent of blockchain will tell you, the greatest virtue of this technology is its immutability. Yet, as a recent IBM Institute for Business Value paper notes, the “issue of how immutability squares with regulatory rules requiring the easy deletion of consumer data is [an] area of interest” – and one that doesn’t align with the EU General Data Protection Regulation (GDPR), which grants consumers the right to have their data deleted. As the IBM paper explains, “development of viable responses to these challenges are underway, including not placing highly sensitive data, such as medical records, directly on the blockchain. Instead, the information is saved in a database and only stored as a hash on the blockchain”.
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Revolution on the way? All of this is simply a reminder that DLTs are in their infancy, working out the teething problems that come with the development of any new technology. But it’s also a reminder that the technical revolution promised by the disciples of DLT comes with an attendant set of risks and fears. Do we want our data to be immutable? Do we trust the silent companies in which DLT, by its very nature, necessitates that we place trust? And what about jobs? Do these ledgers present just another instance of automation, of replacing human labour with machine power? “Yes,” Screen admits, “that may well be [the case]. But on a multigenerational timescale, it really doesn’t matter if you’re made redundant in the grand scheme of things, because it’s about that bigger trajectory. And having more information available means that you can do more things. It’s not about replacing you, it’s about giving you more information to be able to make better decisions.”
Although invoking the multigenerational timescale in the face of possible redundancy might seem like an echo of ‘let them eat cake’, in fact, Screen comes back, again and again, to the very real potential of DLT to “empower the people further down the chain.” Often, he says, “these people […] don’t necessarily feel as though they’re in a position to raise a hand and say, ‘excuse me, I think there’s something wrong here’, because they don’t want to disrupt the process, [and] because the manager will usually say ‘you’re creating a problem for me’. This is very much an endemic cultural issue. So having some automated processes in there, is empowering because […] it becomes objective.” If Screen is right, there’s more to DLTs than blockchain, bitcoin and the buzz of cryptocurrency. His techno-utopian vision feels genuinely revolutionary – both within healthcare and beyond, both on a longer time scale and for right now, both for society and for the individual. But we can only hope that those who hold the keys feel the same. For a technology that’s rooted in trust to work, we need be sure that the people at the top are worth trusting. Transparency, by definition, must cut both ways – because nobody wants their data immutably etched onto one-way glass. ●
World Pharmaceutical Frontiers /
www.worldpharmaceuticals.net
Isaac Zakar/
www.shutterstock.com
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