The case for Bearer Health Records

Bearer digital instrument is independent of the identity, the owner is always the one who controls it. Can we do the same with health records? Can we free the records from the chains of silos and regulations that lock them in those systems?

The main invention that Bitcoin and other cryptocurrencies bring, is the creation of digital bearer instruments, such as cash or bearer bonds, only in the digital realm. Instead of courtrooms, computer code (smart contracts) is used to determine the ownership of assets (coins/tokens).

In contrast, the stock and digital money in your bank account are allocated to your name, by an issuer. Bearer instruments and shares are banned/restricted in most countries. The excuse used for this restriction is their potential for abuse, tax evasion, movement of funds and money laundering.

The change between registered and unregistered ownership of the underlying asset might seem subtle, but it was necessary to invent digital bearer instruments before we can throw courtrooms out of the equation.

This is where the blockchain — unstoppable code comes in. It flips the power balance again from the goodwill of regulated issuer to the owner of the private key.

Once the control is back, permissionless of the system allows for experimentation and flourishing of the use-cases, especially those that regulated industries would never be able to find on their own.

So far the coins are mostly used to route value around regulation, avoid repressive regimes (political or regulatory) and now to offer startups a new global crowdfunding option for fundraising.

Can we do the same with health records? Can we free the records from the chains of silos and regulations that lock them in those systems? Can we ensue a new era in innovation around your priceless medical data?

The concept of BHR tries to imitate the physical access control that none-digital health records had, but with the efficiencies brought by the digital version of the record .

1.) Open standards
Making interoperability achievable in practice. An example is the OpenEHR standard.

2.) Open source app to store local copy of health record.
You have the ability to check app doesn’t have a kill switch, doesn’t lie about syncing, and doesn’t delete or rewrite anything the user did not authorise. The prerequisite is also the ability to export data.

3.) Local copy of your medical data.
Some patients might not care, but those who do matters here. Default (opt-out) patient phone storage. Only encrypted cloud/server backups are allowed.

4.) Real-time data writes
Doctor (or device in the future) that produces the data needs to write that in your record in real time. If there are delays and permissions need to be granted between the production of data and writing to your health records; two divergent copies might be in the production, and you can’t control the second one.

5.) Control enforcement through permissions and encryption

• Zero-knowledge: once you have the data, you can encrypt it with your key and back it up to the network/server.

• Giving doctor the ability to read the data means giving him either the private key or even better sharing just re-encryption key (public key cryptography).

• your access revocations should at least mean that the revocated parties can’t read the newer data.

6.) No ID and third-party controlled accounts

Things you really own won’t ask you for the government issued identification or ask you to sign in to your account which might be subject to deletion at the service discretion.

Part 2 explores the network effects that Bearer Health Record enables.

This article is part of the series on Bearer Health Records;

1.) How can Iryo help with advancing decentralization? Through the invention of Bearer Health Records.

2.) What previously unseen network effects do Bearer Health Records enable?

3.) How Iryo token captures the value of the Bearer Health Record

4.) Lastly, see why our competitors are unable to deliver on that promise.

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