PokitDok has discussed a lot of interesting technology that would be integrated into the DokChain Network. Although these innovations may seem to have inherent production risk, DokChain Alliance Members can be assured that the newer elements will be enterprise and go-to-market ready.
This is possible because the Founding Members of the DokChain Alliance will be expected to contribute to the iterative testing and optimization of the DokChain Protocol during the initial closed period of operation. That being said, in anticipation of the testing and optimization phase, PokitDok has already implemented development and test networks in which all software development of DokChain smart contracts and other system components take place, including a robust suite of unit and integration tests. These tests are executed as part of automated continuous integration builds, and any test failures prevent code changes from being deployed to the development network. Similarly, builds are promoted from the development network to the test network, which is a mirror of the production network. In addition to the unit and integration tests performed on the dev network, the test network includes load testing for ensuring the performance characteristics of the system. Results of these tests will be available to DokChain Alliance members.
Technology Platform features include security, PoET and cryptographic concepts.
Proof of Elapsed Time (PoET) – most have only just begun to become familiar with this approach. Here is a high-level explanation of how it functions in a practical example.
“PoET essentially works as follows… Every validator requests a wait time from an enclave (a trusted function). The validator with the shortest wait time for a particular transaction block is elected the leader. One function, say “CreateTimer,” creates a timer for a transaction block that is guaranteed to have been created by the enclave. Another function, say “CheckTimer,” verifies that the timer was created by the enclave and, if it has expired, creates an attestation that can be used to verify that the validator did, in fact, wait the allotted time before claiming the leadership role.”
The enclave is a hardware based Intel SGX feature of the CPU. Thus, the code as well as the execution environment are protected at the hardware level. See also the Intel Sawtooth documentation on github.
The Role of Cryptocurrency and ICOs
Cryptocurrency remains part of the DokChain approach, as described in the DokChain white paper that was distributed following the June 2017 DokChain Alliance meeting in New York. Further, we have created a crypto-asset framework on HyperLedger Sawtooth that facilitates pluggable models for currency minting and management.
The initial role of the currency is to function as a B2B token used as a means of “paying” for transactions and rewarding Founding Members for their efforts during the initial, closed-period of Network optimization. Once the Network is open to a larger group of participants, however, the cryptocurrency accrued by Founders may be sold as part of the onboarding process for new network participants or traded for other currencies on a public exchange.
On an ongoing basis, the in-network currency will be used for ensuring equanimity of transaction processing, and may be used in special case contracts as desired by DokChain Alliance members. For example, a possible use by providers is to incentivize patients to stay in the provider’s healthcare network. Also, potentially, the currency can be used as a reimbursement mechanism for network service providers such as identity providers, doctor directory data providers, etc. Any transaction allowed by the Network will include as a requirement some payment in the form of the internal currency.
The starting amount of currency will be generated through a pre-sale and distributed to Founding Members. Subsequent currency will be obtained by users based on per-transaction processing fees (for DokChain Alliance members operating a node which processes transactions), and through minting (all operating nodes receive even distribution according to a network monetary policy). See the DokChain white paper for additional crypto-currency details.
Running and Hosting a Node
|Computation (operating system, disk space, RAM)||8 core CPU with Intel SGX, 32gb ram, and 3tb RAID5 managed disk|
|Internet connection speed (upload and download)||100mb/s|
|Connection usage (gigabytes per month)||Dependent upon network usage and growth (estimated at 500gb for 2 million average healthcare transactions)|
|Minimum number of hours to run per day||24|
|Physical security requirements that must be met (regarding location and access to the server)||SOC II Compliance|
|Required Software||DokChain Node Software (provided by PokitDok) includes proprietary and open-source software packages|
|DokChain node legal requirements (HIPPA, PHI, etc.)||HIPAA compliance, BAA with PokitDok, access controls provided by DokChain smart contracts (with full access auditable on the blockchain), option to host PHI all sensitive information on an encrypted node|
|DokChain node technical requirements (hosting location/cloud storage)||DokChain Node Software comes with automated provisioning methods to deploy a node in multiple cloud environments|
PokitDok provides a machine image and scripted deployment to make the provisioning of the environment as simple as possible for all DokChain Alliance members. The DokChain dev/test network is a cloud hosted environment in Microsoft Azure and Amazon AWS.
Running a node means to host an instance of the above infrastructure. All interfaces are secured through private networking interfaces or secured public interfaces, and the DokChain Alliance will license a complete security profile from PokitDok Information Security. Given the distributed and decentralized nature of the DokChain Network, combined with the fact that all data is encrypted using “sharded” keys that are not held by any individual node, any single node is not a point of failure and, under normal circumstances, can not be used to compromise the network or even specific private data elements. The node’s main activity is transaction processing and validation, and the node can be limited to only perform validation and/or processing of specific transaction families as appropriate. Further, due to the design of the protocol, processed transactions must be validated by nodes other than the PoET-selected leader, and therefore the risk is also distributed across the network.
Deployment, Implementation, Testing
The initial dev/test network is deployed and being used to provide the basis for a production network deployment in Q4 2017. All efforts are being made to ensure security and consistency while automating the provisioning of nodes by DokChain Alliance members. The production network rollout will coincide with the completion of these production testing efforts: security, compliance, load, performance, availability, backup, re-deployment, component upgrades, contract deployment, patching, administrative SOPs.
The initial release of the production network is targeted for Q4 2017. Once DokChain Alliance Members join the test network, the initial use cases for identity, autonomous auto-adjudication, prior authorizations, and supply-chain management will be executed as coordinated tests across Founding Members. Any necessary changes to smart contract code must be voted on an approved, using the on-chain governance contracts, by each of the Alliance Members. PokitDok will be primarily responsible for maintaining all test resources and communicating with node operators on any necessary actions.
Value of Investing in the DokChain Alliance
The efficiency gains as well as new market opportunities are discussed in the DokChain white paper, although some details remain to be determined. It is our position that working with other Founding Members to clearly define this and to contribute to the development of use cases that are lucrative to all parties is a large part of the opportunity at this stage. Becoming an early DokChain Alliance Member and hosting a node will allow greatest access to implementing and shaping the network behavior going forward.
Use Case Prioritization and Governance Definition
Founding members of the DokChain Alliance will have a unique role in defining the specifics of initial use cases, and will work together to determine the optimal governance structure for overseeing the development and operation of the Network. Because the Network will only be open to Founders during the initial period of testing and optimization, the ability to have a large-scale impact directly on the outcome of the system will be the sole privilege of these first adopters. While provisions for modifying the Network have been incorporated into the protocol, such modifications will be minor once the initial, closed-period of optimization has lapsed.
Information Asset Monetization
As is often described in other blockchain implementations, one of the most intriguing opportunities to be explored is the different ways information assets can be defined and monetized. One example of this – in which an individual user’s identity provides monetization opportunities both for the individual as well as the participating entities who provide identifying information from their respective domains – is described in the Use Case section of the white paper. There will also be significant value creation in the eventual emergence of smart contract markets, wherein users will bid on the right to use different contracts to conduct their transactions, relying on full transparency around the relevant attributes of the various contracts being used to set a fair price. Other information-asset classes and mechanisms for monetization are left as an exercise for the reader.
An obvious feature of an integrated health information network, as described here, is that the potential for outcomes-based optimization may finally be realized. Not only will all the relevant data to conduct such optimizations be available at a population level, but true personalized medicine approaches at an individual level can be approached with confidence, knowing that the user identities and the data surrounding their episodes of care have been verified and reliably logged in the system via distributed consensus. The industry-horizontal nature of the DokChain network will enable outcomes-based optimization in a much broader business context as well.
Consumer-Driven Healthcare Markets
As consumers take charge of their personal health information and begin to understand the value of that information as an asset, having access to a platform where that value can be exchanged for goods and services provides tremendous opportunity for the emergence of true markets for health services. As discussed elsewhere, rising plan deductibles and a growing consumer awareness of varying levels of quality of care are already providing massive incentives to drive these markets. The DokChain Network provides the information access and transparency required to capitalize on those existing incentives. We see these markets evolving in such a way that the very nature of healthcare service payment will change dramatically, shifting from the existing model based on premiums and deductibles to one where “payers” make real-time bids to pay for services on behalf of consumers in exchange for interest payments over time.