• Ruth Amos RN JD

Blockchain, Digital Health and Baltic Anti-Hype

What a fantastic time I had in Washington DC at the US Baltic Business Summit!

The April 3 events were filled with dignitaries from around the world, and it was easy to feel overwhelmed in such a large crowd. Even Saturday Night Live posted a humorous jab at one of the meetings, where President Trump appears to be falling asleep at the droning speeches of the Baltic leaders. Fortunately, they were smart enough to leave Estonia out of the fray- Latvia and Lithuania were not so lucky. Contrary to SNL’s attempt at political Trumpian banter (not having anything to do with the subject at hand), the Baltic Summit was actually a very productive week, with much progress happening behind the scenes of most popular media outlets.

I’ll be the first to admit as an Estonian-American myself, the Baltic people in general are not the most flamboyant folks on the planet. However, they tend to be more creative, loyal, and much smarter than the average bear. It’s not an exaggeration to say that those qualities are in short supply these days. Historically, the Baltics are known as an “anti-hype” culture- that is, they will make sure to analyze and point out all of the faults and shortcomings of a situation before shouting any praises. Kind of boring in our current world of super-hyped up sales messaging that glosses over major obstacles, but I like it that way. When plans are ultimately implemented, they actually work, and they work well.

One of the main speakers at the Summit was Renate Strazdina (she is on the left- I am on the right), a fellow EY alum from Latvia, now Microsoft country manager in the Baltics. EY is such a familiar global brand that being an alumnus of the firm has proven to be a valuable conversation starter for me no matter where I go. Renate is also a connection of mine on LinkedIn, another global platform that is invaluable in connecting people with similar backgrounds and interests. 

Renate and I know a fellow EY colleague from Lithuania, Linas Sneideris, a brilliant physicist who has contributed strong thought leadership in robotics and similar areas for EY. Linas, Renate and I were all able to message each other on LinkedIn regarding the Summit where we exchanged photos and videos of the events. 

On April 4, I attended a private cybersecurity interview between CNN and Estonian President Kersti Kaljulaid, hosted by the Atlantic Council. It was a very candid conversation that outlined some major cybersecurity topics across international borders, and within healthcare (note: the healthcare portion is mentioned at minutes 38:30-46:00). 

Estonia’s digital health system has been a passion of mine for the past several years and I have traveled to Tallinn and Tartu many times to explore the country’s path in this area. I’ve had the pleasure to personally meet with the CEO of Cybernetica (creator of the “X-road” platform that allows free exchange of data in Estonia) for several hours where he explained in great detail for me how the system works. I’ve also had private tours of Estonian hospitals and live demonstrations of their ehealth records. Equally important, I have seen the types of policy and legal agreements that must be made for it to run safely and retain data privacy. 

In the past year, Estonia has implemented blockchain on their digital health records as an extra layer of security; however, this action was preceded by a system of carefully crafted government agreements that utilizes a unique digital identifier via a national ID card (I have one…)- critical first steps to lay the foundation. 

These opportunities in Estonia, combined with my experience at Kaiser Permanente during EHR build and as a regional lead for deployment of 18 hospitals, have given me some specific insights into the pitfalls and opportunities with our digital healthcare journey here in the US. 

In recent days, there has been tremendous hype surrounding the potential of blockchain use in US healthcare. The vast majority of articles I’ve read proudly tout the benefits far more than the risks. This perspective runs in direct contrast to my Estonian cultural roots and I must stay true to my roots; that approach has served me well so far. 

I’m definitely not anti-blockchain in US healthcare.  The potential is great, provided several elements are established first to set the proper foundation. In true Baltic fashion, I firmly believe that we must thoroughly assess, analyze and work to mitigate the issues and risks before buying into any of the hype. Estonia is setting the bar high, and I’m following its progress closely. I plan to speak and write more about this topic in coming days- stay tuned!

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