Today, we present an interview with Conrad Barski, founder and CEO of Chicago-based Forward Blockchain. Conrad’s company came to our attention late in 2017 as we began researching our latest e-book, “The Healthcare Professional’s Guide to Blockchain.” Forward Blockchain is one of the few companies building tangible solutions on a public blockchain today. We reached out to Conrad to get his take on blockchain in healthcare.
Hi Conrad! I understand you are not only a software developer, but a medical doctor as well? Can you give me a summary of your professional background?
When I was in undergrad, I did some contract work for Atari, working on video games. I’m one of those guys that was into computer programming as a kid, but ended up going to medical school. When I completed medical school, it was at the height of the dot-com era, and I decided to go into medical informatics, as opposed to practicing as a doctor. I finished up medical school and started working for Wolters Kluwer, a large enterprise medical software company. I was there for 14 years and doing low-level development of various medical projects.
When were you first exposed to blockchain technology?
Around 2011, I first heard about Bitcoin and was immediately excited about the concept of decentralized systems.
It wasn’t until 2013 I started thinking about all the different ways you could apply this Bitcoin technology.
I always came back to the same problem, which is this – to do anything interesting as a software developer I’m going to have to write software and that software is going to have to live on some computer. The moment you have software running on a computer somewhere, you have a centralized point of failure. This was a disappointment for me with Bitcoin — it wasn’t very programmable, you still had to rely on outside software systems to leverage Bitcoin technology. The more you did that, the more you lost the benefit of blockchain, because you’re back to a centralized failure point.
I got excited when I heard about the Ethereum white paper in 2014. I’ve been basically sold on Ethereum ever since and I’ve been running the Ethereum Users Group here in Chicago.
I also started realizing that technology could have applications in medicine, so I approached my employer, outlined how a blockchain medical system could work and, pretty much, people just thought I was nuts. But remember, that was 2014, and nobody had heard of blockchain — it was a couple years before the concept had become more popularized.
I left Wolters Kluwer and spent a year and a half working at a large company in the financial field on a private blockchain project. In 2017, I decided things were finally ready where it might be worth starting to do a blockchain startup with a medical focus, and so that’s why we started Forward Blockchain.
One thing that struck me about Forward Blockchain is that you are doing something that is tangible and real. You have a product for medical device inspection tracking and a product for license tracking. Why did you start with these solutions?
Yes, we have a fully-functional licensing system that uses the public blockchain. Our goal with Forward Blockchain was to go after the low hanging fruit first.
It’s sort of a paradox – there’s obviously big value in applying the technology, to taking patients structured patient data, putting it in a blockchain data structure, and then running algorithms against it. I think clearly that’s the most valuable thing you could do with blockchain right now. However, the technology today is not mature enough to allow you to do that.
So, right now you have to build something that is less valuable. That’s the paradox. I think the place where it makes sense right now to use blockchain tech is for applications that revolve around quality.
So, you know you want to make sure that your employees are properly licensed. You want to make sure that when a piece of equipment in your hospital is inspected, there’s an unalterable record documenting that inspection. You want to make sure the supply chain for pharmaceuticals is well-documented.
What do all these things have in common? They don’t fall under HIPAA guidelines, so you can leverage the fantastic security properties of blockchains.
In my opinion, the most secure digital signing mechanisms that have ever been developed are the ones being used by Ethereum and Bitcoin. It would be great if a medical license needed to be updated or renewed for a provider because, you could use those exact same digital signing algorithms.
So, I know the application data is stored on the Ethereum blockchain. Are your applications *themselves* distributed & running off the blockchain?
That’s really the goal – to have all of the application logic that is usually run on a server, in a smart contract. The logic that runs these contracts is fairly simple, but you do need a sophisticated way of tracking roles and responsibilities. You need to know that this person is an employee of the inspection company, and they are allowed to make attestations on behalf of that company. Employees need to be tracked and linked to digital signatures when they create transactions.
There are other things to understand too. For licensing, you need to know who is allowed to renew a particular license for a particular doctor. All kinds of roles can be written as smart contracts. Basically, what you have is little systems without a server where all of the actual business logic is encoded in smart contracts that live on the blockchain.
But, I think the future is going to be a little more complicated – some logic will be in public smart contracts, some will be in a semi-private or limited blockchain system, and then some of the data may also be in a traditional relational database.
I think as this field matures, you’re going to see blockchain applications in medicine where a client application will aggregate data from different sources and present it to the user in a coherent view. Some of the data that needs high integrity will be stored on public blockchains, some of the data will be stored in traditional databases, and some of the data will be in some sort of in-between form.
How is the market for blockchain solutions right now? Are companies jumping in or are they taking a wait-and-see approach? Are companies willing to invest in pilot programs?
I think right now it’s very early — everybody is willing to talk with us and we are having conversations with a lot of people and large medical companies. But for the most part, medical software is a very low-margin and low-risk business. It’s a conservative business that involves taking existing products and making small incremental changes. There’s not much spirit for doing things in a completely different way.
We started this company because we wanted to start establishing a track record, with the understanding that it will probably be a couple of years before we can really make a good ROI case to companies.
The bottom line is there’s lots of interest, but it’s a lot harder to get to the next step – a signed contract.
Do you have any projects on the horizon?
We are still working on fundamental technology right now.
A week ago we released a system called QL Kit, which is open-source software — it’s a web development framework that will allow you to link up applications seamlessly to a blockchain. In the near future, we’re going to release a module that ties the QL Kit to one or more different types of blockchains.
Another challenge we are working on is around data structure. The way the data is structured on the blockchain is all about optimizing performance for node validation, which is a very different requirement than most traditional client-server software.
In the next few months, we will be releasing some proof-of-concept applications that people can play around with online. We realize it’s early on with blockchain technology and that our company has an educational role to play.
We are also interested in helping medical companies get exposure to this technology – we are willing to work with companies on different concepts and pilots, finding opportunities to move things forward.
One last hypothetical question: It’s February 2018 and I’m still sitting on a few Bitcoins, what do I do to – buy, hold, or sell?
I don’t think that you will find anyone that would want commit to any of those options! [pauses] I would say basically that the technology behind Bitcoin has proven to be successful, but you just never know whether Bitcoin ends up being ‘MySpace’ and something else ends up being ‘Facebook’. So I don’t know if it’s a good investment opportunity or not. [chuckles]
If you enjoyed this interview, you might enjoy our e-book, “The Healthcare Professional’s Guide to Blockchain.” The complete e-book is available now, for free. Get up to speed on blockchain technology for healthcare in 15 minutes or less.