MedPayRx’s Marguerite Arnold discusses the opportunities and pitfalls of using blockchain in personalised (cannabinoid) healthcare delivery.
As the planet prepares to enter the third decade of the 21st century, the basic presumptions of ‘normality’ left over from the late 20th century are falling faster behind us. Formally announced or not, the hunt for transitional if not transformational paradigms is underway in almost every aspect of human life. Issues of sustainability, from the economic to environmental kind, are also complicating the conversation in a way that, historically, is unprecedented.
What does this mean in specifics? Population demographics, international migration (for any reason), as well as socioeconomic reorganisation of societies is all a part of this. So is the way that governments administer basic services, as well as fund them. Starting with, of course, healthcare.
This is not new in and of itself. Revolutions in science and technology often lead the way in changing how societies function and progress (or fail). The combustion engine and the assembly line had vast impacts on economies and countries far beyond the actual adoption of steam-driven piston technology or mass production. Not to mention, of course, healthcare delivery.
In other words, cutting edge science and technology fuelled solutions to regulated, mass healthcare solutions have certainly always been one of the most potentially impactful places where governments and policymakers can turn for answers. As a result, calls for adoption of the same and on an unprecedented scale is also increasingly, particularly in places like the UK and Germany right now, at the forefront of this discussion.
In best case scenarios, advancements in both can better human life. See the adoption of public healthcare infrastructure across Europe after WWII combined with ‘new drugs’ like penicillin.
Further, expenditures on even ‘public’ infrastructure that have a very ‘private’ if not personalised face and impact are also a part of the debate. Affordable housing, indoor plumbing and public transport are certainly part of healthcare delivery and efficacy. If you live in dangerous conditions, or cannot get to a doctor, or cannot afford what is prescribed, the most high-tech medical services delivery system on the planet or the drugs they dispense are not effective because they are not widely accessible. The United States is perhaps the best example of the same.
How such technology and science (and which ones) are applied in healthcare today, in other words, particularly in a European model, including personalised delivery of cutting edge and life-saving medical services, medical equipment and drugs, is still very much an open debate. This has to do as much with an understanding of how to apply and administer cutting edge tech and new drugs in sustainable, compliant, inclusive if not ‘public’ healthcare models, as the pace of development and mainstream introduction of cutting-edge medication and medical devices developments and delivery models themselves.
One of the more interesting places this discussion is developing now is in the application of blockchain to healthcare ecosystems and, in particular, the delivery of a certain class of drugs and medical devices. It is also increasingly in the room as new privacy regulation called GDPR begins to shape designs for the compliant personal delivery of affordable healthcare, particularly in Europe.
Further, because of a number of factors, including regulation if not acceptance of new delivery models beyond that, it is a particularly salient discussion right now. Especially when combined with one of the most revolutionary drugs on the planet loosely grouped under the heading ‘cannabinoids’.
Why blockchain is so intriguing for regulated healthcare delivery services
Blockchain as a technology got its start in the banking sector. It has subsequently permeated into mainstream awareness for just one of its features – namely as the underlying technology of ‘cryptocurrency’, or digital ‘tokens’ that are (today at least) utilised as alternative investments.
However, blockchain is far more than this. At its most fundamental level, it is a protocol technology, much like http is for digital data and TCP/IP is for voice. Stripped of ‘commoditised tokens’, it is the basis of most forward-looking automation processes that allows a sender (either a person or a machine) to forward commands to another machine with the idea of then doing something. And further, this process can be recorded in a permanent, untamperable ‘ledger’ or database of transactions that prove that this event occurred, and between which parties. For example, non-crypto uses of blockchain are increasingly showing up in Internet of Things (IoT) models (like supply chain ordering and tracking). In a healthcare environment, blockchain could certainly be used to facilitate and automate some of the most complicated and cumbersome aspects of healthcare delivery.
That includes the dispensation and tracking of medications to drug compliance itself.
However, here is the wrinkle: any blockchain that relies on crypto economics to function, (including Bitcoin, Ethereum and so-called ‘utility tokens’ based on these tokens and technology) is completely unsuitable for a healthcare system where inclusivity is the first mandated feature, and compliance to strict regulations beyond that, a mandated requirement.
Why? Will patients (if not governments and policy makers beyond them) really want to adopt technology that delivers services that can also be speculated upon, globally, by individuals or groups of investors whose only interest is making money?
Blockchain and cannabinoids – beyond potcoin and paragon
The meeting of blockchain as medical or industry service delivery provider with the cannabis space (itself not exactly ‘new’ but certainly a ‘revolutionary’ medicine at the table right now) has already occurred, although so far with ineffective if not explosive results. As a result, the entire ‘hybrid’ combination has caused a great deal of examination of how and why such combinations could work. Not to mention extrapolations of what this could mean for much wider application in healthcare (and for drugs far beyond cannabinoids and medical devices to deliver the same).
There is a logical reason for this. Commoditised, token-based blockchain concepts, particularly in places like Canada and the USA were, until last year at least, seen as a great way to try to raise capital for launching a cannabis business (whatever that was). Or running one. This had everything to do with the difficulty of cannabis entrepreneurs (in both medical and recreational cannabis markets) to raise money, use the regulated banking system, and further for commercial applications involving a still highly stigmatised and widely misunderstood plant. Even today, there are similar models now in the market, including in Europe and Canada that attempt to use such ideas in various ways, from creating a commercial ‘ecosystem’ of providers and users to protecting the ‘IP’ of cannabis plant strains.
The popularity of such combinations so far, particularly in the United States, but also now seen in Canada and even Europe, also have everything to do with a fundamental distrust and dislike of government regulation in general. And for a variety of reasons. These include widespread (usually mischaracterised as ‘populist’) reactions to the long-term toxicity of the ‘Global Financial Meltdown’ circa 2008 plus subsequent ‘austerity’ policies, to Central Bank policies that regulate capital, to the right to grow, sell and consume cannabis including as an IP-protected product.
In truth, this discussion is actually wider than even one specific technology or even one kind of drug, cannabinoid based or not. Talk to any chronically ill person whose condition is not effectively managed, treated or cured by ‘conventional’ healthcare or medications (no matter what they are), and you find the same anger and frustration as seen by the so-called ‘Yellow Vests’ on the streets of Paris, France. However, because cannabis can potentially positively affect so many of those marginalised because of a wide range of illness or disability, such discussions today have, inevitably, a strongly cannabinoid influenced (if not shaped) face and voice. The ‘Green Vest’ movement, in other words, has absolutely hit healthcare in Europe.
This is also occurring at a time when, at a governmental and policy level, new forms of healthcare delivery must be developed quickly and inexpensively to sustain the ‘public’ system if not survivabiliy of the concept itself. And further, must occur at a time when forty years of a progressively ‘lower tax’ mantra have decimated public budgets (beyond the last decade of austerity).
However, many ‘popular’ ideas on how to combine blockchain and cannabinoids are fundamentally also antithetical (in direct applications created so far) to the concept of inclusive healthcare, which by definition must operate within rules and regulation to protect people and set standards. Starting with patients’ right to afford medications they also need to have access to them in the first place in a safe, regulated environment. Brexit, let’s remember, had as one of its most popular justifications the idea of pumping millions of pounds per day back into the NHS (however disingenuous this argument was from the start).
Occupy digital-if not cannabinoid-infused healthcare
In some ways, this discussion, at the grassroots, certainly has all the overtones of a popular movement to reform not only accessibility to effective and affordable medical care but what is included in the same. This movement is far greater and more fundamental than just cannabinoids. Or even blockchain. Although, as Exhibit A, see frustrated potential cannabis patients who are still widely marginalised from such access just about everywhere because of issues that include lack of access at all points, including doctors to prescribe it, insurers to approve it, and the money to pay for it.
This in itself is just as revolutionary as new ideas of delivering all new forms of medical care, new drugs and even medical device driven solutions via digital solutions. In the USA, there is no such thing as inclusive healthcare coverage in general, much less for cannabis patients. In Europe and Canada, there is the possibility of the survival of the same, but this requires not only better approaches, but faster rollouts and within managed care models. And further, that does so via the application of science and research that accepts that cannabis itself as a revolutionary if not exactly ‘new’ drug that works, for the vast majority of patients, in an unprocessed if not lightly processed form. And further still, as a substance that patients must be given control over (in other words the antithesis of a formal ‘dosing’ model) that takes the form of governmental, policymaker and even doctor fondness for ‘pills’.
The right blockchained applications, in other words, that use cannabis as the basis of their ‘first’ entry into a wider healthcare delivery may well be the key to saving and reforming mass healthcare itself. The wrong ones absolutely have the potential to destroy it.
About the author
Marguerite Arnold is the founder of MedPayRx, a blockchain-based digital prescription and automated claims ecosystem platform now going to pilot in Europe, which uses medical cannabis as a strategic market entry point. She is also an American expat author and journalist who has covered the cannabis industry for the last five years from Germany. Her second book, Green II: Spreading Like Kudzu will be published in 2020. Her first book on the cannabis industry, Green: The First Year of Modern American Marijuana Reform about the cannabis industry in the USA in 2014, has recently been republished.