When Distributed Ledgers and Trust Infrastructures Just Become As Natural As Ethernet and SQL…

When Distributed Ledgers and Trust Infrastructures Just Become As Natural As Ethernet and SQL Databases

I am the co-Chief Editor of the Blockchain in Healthcare Today journal [here], and was lucky to be part of an inspirational editorial/reviewer team discussion last week hosted by John Halamka [here] and Tory Cenaj [here]. Overall, I must admit, it was inspirational. Here were people who ‘just got on with, and built real systems that addressed fundamental problems in health care’. For many on the call, the usage of distributed ledgers was all just part of what they did. For them, these ledgers provided a core element, but it was their application areas that were their focus.

Doing good things for health care

I heard of one business that was using NFTs (Non-fungible Tokens) within clinical trials, and where it supported complete auditability and supported improved consent models. And, when you think about it, the use of NFTs within clinical trials is possibly a natural thing to implement, as it provides a verifiable and trusted source of identity for unique entities. A person, a drug batch, an experiment, and so on, can all be represented by NFTs, in the same way that we would have a bar code or a unique identifier.

And, when you think about it, where do we need trust the most? … in areas related to our health and looking after our money. To me, the use of cryptographic trust with prescriptions just seems a completely natural thing to do, as it is so important that we get things right, and have completely trusted audit and accounting trails [here]:

And then we need to improve the way that we authenticate all the entities involved in the supply chain of drugs [here]:

And in creating a trusted infrastructure for informed consent with a clinical trial [here]:

Let’s talk about resiliance and trust

One comment really struck me … “We don’t talk about blockchain anymore, we just get on with it”, and I realised that this is the way forward, and where we use our ledgers as a natural part of any trust infrastructure. Basically, whenever we need trust, we use a ledger to integrate records that are digitally signed. It’s a data source, which can be trusted for all its data elements. Another comment really struck me too, “We run our infrastructure across multiple clouds and distributed”, and I realised that our future must be towards never truly trusting our Cloud providers. For me, I’m hooked in with Amazon AWS for my site, but I’d love to run a data and service infrastructure that allowed by to jump from one to the other or use them all. In terms of costs, there’s a great benefit of using a small footprint in each Cloud, and then pooling them all together to create a distributed processing infrastructure.

But it was this comment that really struck me … “We use distributed ledgers as our core infrastructure, but we don’t need to say we do this anymore, we just get on with it”. And this is the comment that sticks with me, and it is one I strongly believe in. Basically, it’s a place to record transactions and implement digital signing, and a place that allows us to control our identity provision. It is part of the information system stack, and it does its work. Also, it plugs the core weaknesses of our main of our existing data infrastructures and will allow us to build a trusted foundation for the future. It is re-engineering the Internet, in the way it should have been created. Now, we have a multi-dimensional aspect of trust within services and entities, as opposed to the flawed TLS tunnel which only checks in one direction, and only does machine-to-machine. It overcomes that PKI weakness of defining top-level digital signers and trusted roots and move these to a more localised approach to the signing of transactions.

But, it was this comment that really struck home for me … “We did a test last week, and shut down parts a few of our cloud instances for a few hours, and then put them back on-line line, and it all fixed itself”, and it confirmed to me that we are building a new resilient digital world .. one which truly does not rely on any one provider, any one host, any one server or service, but can cope with attacks and outages on any one part of it, and come out of its undamaged. It is this part that we need to make sure that our future infrastructure can cope with outages, as our data infrastructure is now a critical part of our world.

And so …

To me, the ledger is a foundation layer, and it is the cryptography and software engineering binding that builds on this that allows the magic to happen, and build machines where every moving part works perfectly and where everything is synchronised. Without linkages from higher-level layers — for governance, rights, accounting, and so on — we will continue to build our digital world on sand.

And so my focus is renewed, and it is — as it has been for the past decade — a focus on building things for citizens and giving them the rights and the protections that they deserve in this digital world. We have created the most machine ever — The Internet — but it has hardly passed the Ford T stage. Now, we need to build it properly and build a Tesla.

I am really proud to play a small part in this journal. What I love about it, is that it does good things for real people. It doesn’t come at this from a ‘let’s just use Hyperledger approach’, it uses ledgers and cryptography for a reason. The papers focus on improving our health, the health of our families, and our societies. It has papers written by people who have identified real problems in our health care infrastructure, and who want to make improvements. It shares one of the most precious things we have in our world — knowledge — and allows people to learn from the triumphs and mistakes we have made and allows us to build on the shoulders of giants.

I don’t buy into hypes … call it what you want … Web 3 or whatever .. but this is just us moving towards getting things right, and plugging the gaps we have created in building our digital world. Our current digital world is based on wet signatures, and of us mimicing our paper forms, files and folders. Our future will properly integrate digital trust and look to not map our offices but to properly map our societies into digital spaces.

And, keep a watch our for our EU-funded GLASS project, we are building something special.