Healthcare primer on NFTs

I have stayed up-to-date and on the cutting edge of new technology, ideas, and investments. However, NFTs or non-fungible tokens have alluded me. I have asked my children and their contemporaries, and no one has been able to 'splain it to me. When it comes to NFTs or the emerging form of digital certificate that certifies an asset as one-of-a-kind, the medical community is in pro-and anti-NFT camps. Those belonging to the former camp tout it as a novel approach to finance and ownership of digital data. At the same time, those against NFTs point to the devastating impact on global climate or the use of large amounts of energy to compute the blockchain transfer of the billions of dollars that occur regularly in the metaverse.

NFT's untapped potential in healthcare is uncharted, let alone what NFTs are and how they work. This blog will provide the basics of NFTs and how they can further empower patients in the digital health age.

What is an NFT?

A non-fungible token is "a unique digital certificate, registered in a blockchain, to record the ownership of an asset such as an artwork or a collectible." For those of us, like myself, who are neophytes to the world of NFTs, they are a permanent tracking device that proves ownership of a digital file. The best comparison is like inserting a microchip under a pet's skin to claim animal ownership. An NFT is a token connected to a digital asset such as music, artwork, or even a patient's medical data that preserves the right of ownership in the metaverse. Non-fungible means "not exchangeable." Most things in the real world are non-fungible because most physical objects are unique and are not exchanged.

On the other hand, money is one of the few fungible items, meaning one dollar is equivalent to another dollar, and one Bitcoin is equal to another. The underlying decentralized technology that enables the digital transfer of funds is blockchain. Blockchain prevents digital money from being duplicated or hacked. It removes the need for a centralized authority, such as a bank, to validate transactions. The advantage of these transactions is that no intermediaries are involved.

Creating or mining NFT transactions leverages blockchain technology, akin to what cryptocurrencies like Bitcoin use.

In short, the technology relies on a decentralized network of computers employing advanced cryptography to verify the validity of a transaction. I have previously explored the relevance of blockchain in healthcare and pharma, highlighting its ability to secure sensitive medical data and curb counterfeit drugs. (Baum NH, Blockchain for healthcare. J Med Prac Mgmt, July\August 2019)

NFTs have disrupted the art world and could positively change the digital health landscape by giving patients control over their medical information. NFTs allow everyone to own their data.

As we dive into the digital health era, personal health sensors and apps equip patients with personalized data to become more proactive in managing their health. But what is still mostly the norm to control sensitive data is governed by the companies providing these services. They often profit from using this data, which is oblivious to patients. For example, a pregnancy-tracking app sells aggregated data to employers. Similarly, 23andMe.com intends to develop drugs based on the genetic database it amassed from customers who used its genetic testing kits. Customers providing this data might have yet to be explicitly aware of their potential use.

My take-home message is that it is not appropriate or legal for private companies and institutions to make money from patient data without compensating the patients.

NFTs' potential in healthcare

For example, a patient orders a direct-to-consumer DNA testing kit with a nutrition plan from a for-profit company tailored to the patient's genetic makeup and biome. You also know that the company might sell your genetic data to third parties for research purposes, unbeknownst to you. But you agree to the service because it's the most accurate way to obtain a personalized diet that is unique to you.

However, by selling your genetic data, the company could make enormous profits that they will not share with you. Moreover, as such sensitive data gets passed along the transaction chain, the risk of mishandling the information increases.

Let's look at the scenario if your genetic data is mined as NFTs. The information will come with an inherent feature for tracking. You could see where your data appears and hold those who use it without your permission accountable since you are the sole owner of the data, as certified by the NFT authentication. Moreover, the NFT owner enables a feature to earn money whenever a transaction or sharing of your data takes place.

In the previous examples of pregnancy-tracking and 23andMe apps, patients whose data is used by those companies are not receiving any compensation. But with an NFT approach, companies offering digital health services could encourage patients to participate in studies by contributing their data and earning from it. Other third parties interested in utilizing the data for research or developing new products could reach out directly to patients in a digital marketplace. Compared to the traditional approach, the main difference is that patients can share their data in a more informed manner.

Patients gain control over their health records with the underlying blockchain technology and an NFT certification.

Bottom Line: Unlike cryptocurrencies, a form of money or digital asset, NFT's purpose is to be the equivalent of a certificate of authenticity. NFTs have revolutionized the entertainment industry and the art world. Everything from digital art and music to bits of video and healthcare data can be monetized with NFTs. Very soon, NFTs will help reform data transfer in healthcare.

Neil Baum, MD, a Professor of Clinical Urology at Tulane University in New Orleans, LA. Dr. Baum is the author of several books, including the best-selling book, Marketing Your Medical Practice-Ethically, Effectively, and Economically, which has sold over 225,000 copies and has been translated into Spanish.