A convergence of digital health and decentralization is just what the doctor ordered, writes Pradeep Goel, Founder & CEO of Solve.Care

Healthcare is very clearly going digital, both in terms of access to services and how those services are delivered to patients. The global pandemic has only served to accelerate this trend over the last 12 months. Left with little choice, people have quickly become used to the concept of virtual appointments with their GP. This is supported by a recent report from Deloitte which estimates that virtual video visits are predicted to account for 5% of all visits to doctors globally this year. This is in stark contrast to pre-COVID times of only 1% in 2019. The CDC recorded a staggering 154% increase in telehealth visits during the last week of March 2020, compared with the same period the previous year.

But will this last?

COVID has highlighted the inequalities and inefficiencies in the healthcare system and, as a result, we are going to see a very different model of healthcare post-COVID. The world is moving away from a healthcare model that was driven by centralization and constrained to geography, and towards a digital health model where people will have access to the best of care, regardless of where they live. All of this is set to have a huge impact when it comes to benefit coordination, care coordination, and delivery.

Chart: Growth in Healthcare Spending by Region (via IHS Markit)

Healthcare spending by region

In short, a digital health model will remove a lot of friction from the process, giving people more choices and better access to care, as well as improving how doctors practice medicine. There is no doubt that digital health is not only here to stay but will play a much more dominant role in how we take care of each other.

Of course, the shift towards this digital care model will prompt questions about how we measure the quality of care or how we manage consent, as well as raising challenges around authorizations, privacy, and payments. Solving these problems will require technologies that are decentralized, globally accessible, and less bound to an entity-based technology stack. In a simple sense, digital health will also pave the way for the decentralization of healthcare. A global model of digital health will need decentralized systems where people can join and elect to share information freely, while also maintaining control over how that information is seen and shared.

When it comes to the development of a global digital health model, one key question that arises is how to incorporate digital value transfer i.e. how do we facilitate the use of digital currencies as a mechanism of payment? This is an essential consideration because if digital health is going to achieve one thing, it will be connecting doctors and patients from far-flung areas with one another. And, of course, this means that we’re going to have to rethink how we pay one another. Given this scenario, we can fully expect that along with a decentralization fabric, such as blockchain, we are going to see a significant shift in the payment model towards digital currencies.

A successful healthcare currency and healthcare payment system will need to serve billions of people around the world. Rather than being a pure store of value, like bitcoin, any global healthcare currency will have to become more like a utility. Like air and water, food and education, health is a necessity. Ultimately, this means that we will see a much greater and more organic linkage of the value of this token to its actual utility in the market. With total global healthcare expenditure expected to reach a staggering $8.8 trillion USD in 2021, the market cap of any token that captures a share of this market will be an order of magnitude larger than the market caps of those tokens that are solely used for trading or to represent stores of value.

Now, for this global healthcare currency to make sense and succeed, it has to meet certain criteria that make it different and more powerful than the current payment mechanisms that are in place today. To this end, there are a number of core components that are fundamental to any healthcare-focused digital currency. Firstly, it must facilitate delegated payments. Patients need access to a token that can be spent on approved services with an approved set of vendors or healthcare service providers, such as doctors or chiropractors. This token needs to be transferable not only between the patients and the approved healthcare providers in the network but also between all of the patients on the network. This ability to conduct peer-to-peer transfers within the network and with third-party healthcare providers is fundamental to ensuring successful global digital health adoption.

The second essential component of a digital currency for healthcare is that it must be auditable. Fortunately, the nature of blockchain lends itself to this already, in that one can easily view transactions on the ledger. Qualities that we see in blockchain already such as transparency and decentralization will need to be adapted to payments. This will give rise to purposeful blockchains that enable specific parties to provide care and receive payments. These blockchains will primarily take the form of permissioned networks linked to digital currencies.

Thirdly, a healthcare-centric digital currency needs to be able to maintain a stable value at certain points in its existence. It is essential that service providers can be rest assured that they are receiving the correct value for the service that they have performed and that this value isn’t going to diminish. It is possible that this requirement will lead to the development of tokens whose value fluctuates while in the open market only to stabilize at the point of payment. However, this stability is an essential component of any system exchange, and must be addressed.

The next essential factor in enabling a healthcare digital currency to gain global adoption is ease of accessibility. Acquisition should not require users to have specific accounts with specific trading platforms, or specific tokens to trade on a certain platform, and so on. It needs to be much, much easier to access than that, and it must completely circumvent the need to learn or participate in specific crypto entry and exit points. This is an issue that needs to be assessed from the application layer — how can we make it simpler for anyone to access the digital currency market to make use of their purchase for healthcare payments on an ongoing basis? This is a question that applies to the entire cryptocurrency space more generally.

Last but not least, from a business perspective, it’s essential that the cost of accepting this currency as a means of payment is a set fee, insofar as is possible. For example, if you have a scenario where businesses don’t know what the cost overhead is when they accept payment via this digital currency they are simply not going to accept it. Instead, they’ll revert to traditional payment mechanisms like credit cards based on fiat currencies where they already know what the overhead will be. From a service provider perspective, the cost of handling this currency has to become considerably more predictable. Fortunately, companies like Solve.Care and others in the sector are making significant strides towards achieving these ends.

Once all of these problems are solved, I believe we will see rapid adoption of a global healthcare digital currency. There is a real business need for one and those of us in the blockchain and digital currency space are working hard to deliver the solution that the market needs.

Change is inevitable. Right now, healthcare is undergoing a demographic shift — the aging population, the globalization of the workforce, the impact of the coronavirus — all of these things are driving the need to rebalance demand and supply of healthcare. These forces are aligned towards healthcare becoming digital, decentralized, and moving to a more peer-to-peer payment model, where the control of price, privacy, and consent is clearly shifting from the enterprise to the consumer. Blockchain has a major role to play in this shift. But even more important still is the role that digital currency will fulfill at the very center of the new decentralized healthcare ecosystem.

Chart: Top 10 Digital healthcare currencies by Market cap (via Cryptoslate.com)

Healthcare currencies

The views and opinions expressed herein are the views and opinions of the author and do not necessarily reflect those of Nasdaq, Inc.