Bjork, Blockchain -- and Healthcare

Healthcare should pay more attention to Bjork.

To be fair, I think everyone should pay more attention to Bjork.  I've loved her since she was in the Sugarcubes.  Her voice is astonishing, her music is always interesting and often magical, and when she sings she commits more fully than any other singer.  If her fashion sense is sometimes out there, well, we expect some eccentricities from our geniuses (and, oh-by-the-way, that infamous swan dress is now honored in a museum). 

But all that aside, health care should be paying attention to how Bjork embraces new technology.  That now includes blockchain.

With her latest album, Utopia, due to be released later this month, Bjork is teaming with blockchain company Blackpool to use blockchain and, more specifically, crypocurrency to try some new things.  As reported by Musically, fans can:

• Pre-order the album using several different kinds of cryptocurrencies, such as Bitcoin or Audiocoin, along with more conventional forms of payment.
• Earn 100 Audiocoins -- worth $0.19 currently -- just for pre-ordering.  The digital coins will be deposited into a e-wallet, and can be exchanged for other cryptocurrencies, converted into "fiat currencies (like dollars), or kept for future use.
• Receive additional Audiocoins by interacting with Bjork and her music, such as attendance at concerts or perhaps promotion on social media.  
• Use their Audiocoins to buy additional Bjork music or related materials.  

It wasn't explicitly spelled out but presumably the fan participation will be tracked using blockchain.

Bjork and Blackpool will develop more details about how fans can earn and use their cryptocurrency over the next couple years, but it certainly is a unique approach.  As The Next Web put it, "at the moment it just kinda sounds like a hybrid between a CVS pharmacy rewards card and a fan club. That’s not necessarily a bad thing."

Blackpool CEO Kevin Bacon told Musically:  

You could create blockchain-enabled digital treasure hunts, although what we don’t want to do is turn this into Pokémon Go! But why not reward your fans for engaging with what you do, and reward them in a meaningful way?

Keep in mind this isn't the first time Bjork has creatively used technology in conjunction with her music:

• She made a critically acclaimed video ("All Is Full of Love") featuring robots -- in 1998.  
• In 2011, Biophilia came as a standard audio version but also featured a collection of apps that transformed the audio experience.  MoMA included the app as the first downloadable app in their permanent collection, noting: "With Biophilia however, Björk truly innovated the way people experience music by letting them participate in performing and making the music and visuals, rather than just listening passively."  There is now also a Biophilia Education Project to help inspire creativity in children.
• A subsequent album, Vulnicura, led to a virtual reality (VR)-based exhibit also expanded the musical experience.  It has appeared in major museums around the world.

Bjork may be not just a genius with her music but also in using technology to change how we experience it.

I have previously written on why and how bitcoin, blockchain, and even smart contracts might be used in health care, but to pretend that I actually understand any of them would be overstating the case, to say the least.  Fortunately, more knowledgeable people in the field are increasingly coming up with applications for it, as a recent synopsis in HealthIT Analytics illustrated.

Let's think, though, about how Bjork's latest experiment could be translated into health care.  Imagine, for example, a direct primary care practice (DPC) that:

• Allows/encourages patients to pay for their services using crypocurrency;
• Uses a smart contract to establish the mutual obligations, the agreed-upon measurements for "success," and the mechanisms for performance-based rewards/penalties;
• Tracks patients' behaviors (preventive visits, exercise, etc.), readings (vitals, labs, etc.), and records (diagnoses, treatments, etc.) using blockchain (a blockchain EHR!);
• Allows patients to earn additional cryptocurrency for meeting desired health goals and/or activities.    

I used DPC as the example because the fixed monthly fees may be easier to work with than fee-for-service, but there is no reason a similar approach couldn't be used for health plans, health clubs, or even fee-for-service providers.  

Bjork's blockchain-based :"CVS rewards card/fan club" that rewards fans for a variety of desired types of involvement is particularly intriguing.  Applying the concept to health care would help recognize that most things impacting patients' health happen outside of health care settings, and could create ongoing, visible, positive incentives for patients. 

Not just DPC; Fitbit and Apple Watch: are you paying attention?

We're not going to transform the entire health care system into blockchain immediately, nor should we.  There are still too many unknowns.  However, experimenting with it within a moderately closed environment like a DPC practice might be a great place to start. 

Blackpool's Kevin Bacon has a great perspective on blockchain:

There’s a lot of talk about whether crypto and blockchain is a bubble. I don’t see it as a bubble: I see it as a burst of energy. I think you’ll see a lot of activity, a lot of things will disappear or get left to rot, but the important things will stay and grow. 

I think blockchain and crypto will be like the dotcom boom and bust in the late 1990s. We’ll see enormous adoption over the next couple of years, then some kind of bubble burst, but then a long-term change.

Blockchain won't solve the health care mess we find ourselves in, especially in the U.S.  There are too many fundamental issues that we need to address.  What it may do, though, is give us a new set of tools to help solve it.  We need to see that boom and bust that Mr. Bacon refers to, and see what uses are left standing.

I'm looking forward to hearing more about what Bjork does with her new initiative, and I hope some health care organization takes note.

Meanwhile, I can't wait to see how Bjork will use what Fast Company says may be the next iteration of the Internet itself -- Dispersed Computing.   But that's a topic for another post...