Issue #1
Beyond Blocks
Bridging the gap between blockchain and healthcare
Thank you for your support for my content thus far. I have felt there was a huge gap between the crypto-world and the blockchain in healthcare communities. Some of the most interesting ideas and trends in both communities never make it to the other. This newsletter is my attempt to bridge that gap.

I’ll be curating select content, providing light commentary, and sending them out weekly. In the beginning I’ll be experimenting with the format of the newsletter a bit, so please bear with me and feel free to submit feedback.
Crypto news
Ethereum Classic has been 51% attacked
The mechanics of this are fairly technical, but practically this means that a single party has gained enough hashpower to rewrite a chain's history, thereby rendering the core benefits of decentralization and immutability null. In the case of Ethereum Classic, this attack meant swindling a lot of centralized exchanges by making it look like they were sent coins only to rewrite the blocks later.

Ethereum Classic has a market cap of half a billion dollars and is listed on Coinbase. This isn't a random coin someone spun up out of a dorm room. It's a well known network with a non-trivial community. And it was successfully 51% attacked, cheating several exchanges out of millions of dollars. It's amazing that the hashpower to 51% attack Ethereum Classic for an hour only cost $4,000 but potentially yields millions of dollars!

Ethereum Classic's attack is a reminder to all of us that blockchains are vulnerable to attacks and we need to be thinking about the security of our implementations.

Private blockchains are popular in healthcare and entail different security risks, but it's striking to me that in all of the conferences I've been to in the past two years I can't remember a single conversation about blockchain security.  This absolutely needs to be a bigger part of our conversations.

Right now the stakes are pretty low. No private blockchain in healthcare is critical infrastructure or has serious economic activity on top of it. But when hundreds of thousands of patients manage access to their health data with a blockchain and billions of dollars in claims payments through a blockchain then there are huge incentives to attack a chain. And people will try.

If we want blockchain in healthcare to succeed then we need to be more thoughtful about security. I expect this to be a more prominent narrative in 2019 as more public blockchains are attacked.

Blockchain Can Wrest the Internet From Corporations' Grasp
Chris Dixon argues that blockchains can provide an alternative to the highly centralized Internet dominated by tech giants we have today. The core idea here is that blockchains are open and maintained by the community, allowing them to stay neutral over time and for governance decisions to be made by the community as well.

The idea of community governed, neutral, and open networks resonates with me a lot, and I think is a winning message within healthcare. Look for a blog post about this from me soon.

Strong and weak technologies
Another thought provoking post from Chrix Dixon. In this he defined strong and weak technologies.

Strong technologies adapt the world to themselves. Examples are the iPhone, the Internet, and public permissionless blockchains.

Weak technologies adapt to the world as it currently exists. Examples are Blackberry, private Intranets, and private permissioned blockchains.

Chris argues that while weak technologies can be successful, it is strong technologies that end up "defining eras." The task for us then, is to identify strong technologies early on and stick with them through their adoption curve. 
Blockchain in healthcare updates
Blockchain Tokens Are Dead in Healthcare
Edward Bukstel has a sobering take on tokens within healthcare, and the common flaw in how we think of the value of patient data. He concludes "We have to stop trying to force these round tokens into the square hole of healthcare."

I found similar data in my Status Report on Healthcare ICOs published with Vince Kuraitis.

I agree tokens are indeed dead, not just in healthcare, but in all verticals for the time being. The fact of the matter is no one knows how to create long term sustainable value with these things yet, but we have ample evidence that the current model of payment tokens do not work. It is also apparent that there is too much friction for even sophisticated users to use tokens today. 

Some day someone will figure it out. But it will look like nothing we've seen to date. The token mechanics will be novel and I suspect the governance will be more open source, a la Ethereum or Linux Foundation, than issued by a central company. 

Out Of 126 Healthcare White Papers We Analyzed, One Stood Out
A two piece article by Dr. Alex Cahana (part 2 here). I won't spoil the whitepaper that stood out for him and his team, but his multidisciplinary approach to the space stands out.
Feb 11th - HIMSS Blockchain Symposium (I'll be speaking at the first Pilot to Process session)

Feb 26th - Blockchain in Healthcare Global & Chainhaus NYC Meetup
Have an article, event, or content you want featured? Send me an email at or get in contact with me on a platform below.
Robert Miller · Queens Street · Long Island City NY 11101 · USA
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