In-Depth: Cryptocurrency's digital health potential for data sharing, behavior incentives

By Laura Lovett
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As Bitcoin and other cryptocurrencies take off in a gold rush-like fashion, players in the digital health field have jumped on board the cryptocurrency wagon. Some companies, like Nobel Prize contender George Church’s brainchild Nebula, are finding ways for the consumer to monetize their personal genetic data. Still others are using the digital currency in more traditional ways, like incentivizing app users to workout by offering them coins.

Cryptocurrency is a general term for digital tokens backed by blockchain, a technology that makes the currency easy to verify and difficult to falsify. The most prominent among these is Bitcoin, which recently rose to a valuation of roughly $20,000 before plummeting to a third of that value within the month.
 
Cryptocurrency has both advocates and critics in the financial sector — Berkshire Hathaway CEO Warren Buffett, for instance, told CNBC during Bitcoin's rise and fall that he could "say with almost certainty that [cryptocurrency] will come to a bad ending." Concerns include the volatility of the market and the high volume of computing resources the technology tends to tie up.
 
In digital health, the use of cryptocurrency is equally undefined, but it has a lot of potential. While the use of cryptocurrency in digital health is still in its infancy, some experts say this is only the beginning of a growing field.
 
“I think we are very early on with all the applications that [can use] cryptocurrency technology, and there are a lot of things that are not quite solved yet,” Fred Schebesta, cofounder of finance publication , told MobihealthNews. “It’s going to be insane, and I am super excited in terms of healthcare.”
 
Data for digital dollars
 
Schebesta pointed out that digital money is a currency that never sleeps, as it can be traded 24-7 on the international market. It can also give users some anonymity and security — something particularly important in the healthcare space, where data is so personal.
 
In fact, that data is so personal it could include information about what makes a person who they are — their DNA.
 
Accessing DNA information has been a hot topic as companies like 23andMe and  continue to expand. The price tag is within reach of consumers — normally around the $100 mark — and was a popular holiday gift last year.
 
But instead of consumers paying for their genomes to be coded, one company is planning on letting consumers trade in their data for cryptocurrency.
 
, which was cofounded by Harvard geneticist George Church, plans to sequence participants’ genomes and then give users the agency to sell their personal data to researchers and pharmaceutical companies via a cryptocurrency. Cofounder Dennis Grishin said Nebula was developed after identifying several issues within the field of genomics, including high cost, privacy concerns, and the need for more data.
 
In part, the company hopes this will increase the number of people who sequence their genome.
 
“Right now we have a chicken-and-egg problem we would like to break out of, because if you want to learn more from your genome, researchers have to have many genomes to analyze and better understand genetics. But for them to have many genomes to analyze, more people need to be sequenced [and] there needs [to be] motivation,” Grishin said. “We need to break out of this dilemma, and we essentially are trying to do that by eliminating costs completely and removing the privacy issues.”
 
Genome sequencing still has a hefty price tag of around $1,000, which puts it out of reach for many, according to Grishin. While other companies like 23andMe and Helix can do genomic typing for less money, those services give consumers a much smaller amount of information, he said. Right now, only around 1 to 2 million people worldwide have their complete genomes sequenced.
 
Nebula will sequence the participants’ DNA for no out-of-pocket cost. People can then sell their data to researchers and receive Nebula tokens in exchange. They can then use these coins to purchase information about their genome sequencing and what it means in terms of their, and their future children's, health. This removes third-party vendors and lets people choose which researchers they would be willing to sell their data to.
 
“Data owners store their data in their computers or in the cloud storage of their choice and they control who gets access to their data,” Grishin said. “When they agree to share their data they are not selling it but lending it out.”
 
All of the seller-consumer transactions are stored on blockchain, which means if there was ever a leak — which Grishin stresses is highly unlikely — the team would be able to figure out what researcher or pharmaceutical company violated the contract.
 
Along a similar idea, health aggregation platform  is now providing channels for users to sell their health records to researchers and pharma companies — arguing that even if the consumer doesn’t sell their data a third party may — and probably already has.
 
“People should be able to trade these medical assets for incentives or for currency,” Raj Sharma, CEO of HealthWizz, told Babyforyou.net.ua. “If I want to participate in a clinical trial for, say, Type 2 diabetes, then I should be able to participate in that trial with my medical records, and from a rewards standpoint I should be able to get cryptocurrency or digital currency rewards for making my record deliverable and participating in the clinical trial.”
 
The HealthWizz app has the ability to aggregate data from multiple different sources including electronic health records, lab results, genetic data, and wearable data.
 
Both Grishin and Sharma stressed the value of eliminating a third-party vendor and allowing data buyers go directly to the individual whose data they are using.
 
Going through a third party vendor can take a lot of time and extra paperwork, Grishin said.
 
“What they really want is not access to static data but access to a person who is willing to collaborate and answer questions,” Grishin said. “If you have a middleman in between, that is really difficult.”
 
The direct-to-researcher approach can also give researchers a better snapshot of the patient.
 
“Even the data brokers today don’t have access to all the information,” Sharma said. “They don’t have clinical and genetic information in one place. Those research companies and pharma companies who could go directly to their patient could actually get a longitudinal view.”
 
Cryptocurrency as a behavioral incentive
 
But the use of cryptocurrency in the digital health space isn’t limited to selling health data. Recently, a number of apps have popped up using a digital currency to incentivize users to perform certain behaviors.
 
Several sobriety apps have integrated cryptocurrency into their model. Notably, Sobercoin and Hayver, which both use their own digital coin system to motivate app users to check in and remain sober.
 
Founder and CEO of  Harold Jonas said his original sobriety platform, called Sober Systems, struggled with adoption and retention, which led him to look to cryptocurrency as a solution.
 
“Then cryptocurrency came along and I always wanted to incentivize people to use the app to make it useful for them,” Jonas told Babyforyou.net.ua. “Now we can figure out a way to pay them or incentivize them to use the app or check-in reporting that they are drug free, and then get rewarded and incentivized for that methodology.”
 
Users could get a sobercoin after 30 days of self-reported sobriety. The coins can be traded in for coaching or training to be a health coach.
 
Hayver is another app aimed at helping people stay sober. This service uses a combination of daily check-ins and randomized urine tests as well as an accountability network, which includes friends and family. All users, including people in the accountability network, are eligible for the coins.
 
“Its foundation is taken from physicians and pilot treatment programs and proven research that [shows] people who submit to random drug and alcohol screens after they have left a treatment center have a much higher chance of being sober, even after five years,”  Dr. John M. Copenhaver, Hayver cofounder and chief medical officer, wrote to Babyforyou.net.ua in an email. “Hayver is the only app that provides a psychological deterrent through peer-to-peer accountability and random drug screen a psychological incentive with cryptocurrency rewards (The Duitcoin), not only for the member but to the accountability network as well.”
 
Developers are now using cryptocurrency in many apps that require self discipline.
 
Recently there has been much hype around Sweatcoin, a free app that tracks users’ outdoor steps using their phones’ accelerometer and GPS locator. The steps are then translated into the currency. Currently, the currency can be used for goods, services, and experiences that range from yoga classes to high-tech shoes, according to their webpage. Users can also donate the coins to a charity of their choice.
 
Its founders claim that it was the most downloaded app within the App Store's health and fitness category from September to January,and it appears investors have taken notice. The company recently landed $5.7 million in funding in January.  
 
“We are really pleased that our vision to build a ‘Movement Economy’ powered by the economic value of people’s physical activity is supported by such great visionaries,” Oleg Fomenko, cofounder of Sweatcoin, said in a statement in January. “This round will allow us to build out the product and technology team to improve our step-verification algorithm and develop an open-source blockchain [distributed ledger technology] to allow Sweatcoin to be traded like any other major crypto or fiat currency.”
 
Wellness app  offers its tokens as an activity and health reward system, and for participating in research studies.
 
“So many of the solutions we provide are around behavioral changes, and the psychology around cryptocurrencies is around gamification. [We] can create leaderboards and components,” Noel Chandler, CEO and cofounder of Clinicoin, told Babyforyou.net.ua.
 
The app was developed by Mosio, which is a two-way mobile messaging system for healthcare and clinical research. The Clinicoin app will send out alerts for users to take medication or perform certain activities, and reward them with the coins.
 
The app also allows providers to engage with patients, and gives providers the ability to solicit participants for surveys, similar to some of the companies aiming to give power to the data owners.
 
While the use of cryptocurrency in healthcare is expanding, the technology behind it is still very new and has many directions that it could take. Schebesta said that in the future he could see it growing in the genome field, health field, and possibly being used by insurance companies to incentivize clients. But only time will tell if cryptocurrency is here to stay, and to what extent it could impact the healthcare industry.  

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