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One of the biggest global challenges we face today is healthcare delivery. In terms of health-adjusted life expectancy, progress has slowed to a near stop despite increased spending globally; even more concerning, life expectancy has actually dropped for the second year in a row in the U.S., the first time in more than half a century. It is obvious that a new paradigm in healthcare is essential, and new ideas such as the Value Paradigm—which is the fundamental reworking of healthcare in which the shift towards outcomes puts the patient at the center of the healthcare navigation system—could be the new frame by which healthcare not only becomes less costly, but more efficient for healthcare providers, payers and most importantly, the patients. There are many areas in healthcare that must be improved upon. With $8 trillion projected to be spent on healthcare this year globally—and an astounding $18 trillion projected to be spent on healthcare by 2040—and little to no increase in desired outcomes, it is apparent that the healthcare industry is becoming conversely more expensive and less effective. In order to reverse this trend, there are several key areas that need to be overhauled, including:  Basic Research. While research within the healthcare industry today is seeing many new and exciting transformative discoveries, basic research is often overlooked and underfunded in favor of complex innovations. A vast majority of key proteins, for example, have yet to be discovered, and funding for basic research has continued to decline, seeing a 20% decline in real dollars from NIH over the last decade. Without a refocus on basic research, treatment for today’s biggest diseases such as diabetes and obesity will not receive enough research and healthcare costs will continue to rise. Physicians and best practices. With varying levels of knowledge and expertise, many physicians don’t have the means by which to acquire knowledge on new innovations and best practices. It is crucial, therefore, to create clinical pathways that can provide up-to-date education and disseminate new findings to physicians around the world, regardless of location or other factors. Cost of early intervention. With chronic conditions such as diabetes, obesity, and heart problems continuing to plague large populations, prevention and early intervention are key to reducing the severity of these diseases. However, with the high cost of healthcare, many people are forced to delay their care, preventing them from obtaining the proper drugs and screenings needed to treat their condition and ultimately leading to deterioration of health and even death. This inability to afford early intervention treatment is also costly for insurance companies. In the case of diabetes, for example, someone with a low case of diabetes costs about $1,000 per month; once the diabetes has progressed, however, cost expenditures increase to $4,000 to $5,000 per month for the company. Healthcare outcomes must be measured. Despite vast amounts of money being funneled into the healthcare industry, very little of it goes towards measuring outcomes. In order to move towards a more value-based paradigm, however, it is crucial for data to be collected and outcomes to be measured in various areas in order to understand whether we are seeing true success and where we can improve. Measuring outcomes in patients needs to be standardized. In order to define and measure outcomes, the process by which to measure the progress of patients needs to be standardized based on factors such as specific disease and sub-categorization of diseases, demographics of those involved in the study and comorbid conditions. While the outcomes will ultimately differ based on individual factors of the patient, it is crucial for the process to remain the same. Technology can be used to measure progress and outcomes. With technologies such as the Internet of Things and the Cloud, new models of engagement can be created to not only help lower cost and provide assistance for patients but also keep track of data on a consistent and standardized basis that payers and doctors can then use to measure patient outcomes. Measuring, standardizations and outcomes need to be measured based on different timelines. While populations of today have a high degree of chronic conditions that are already in full swing, as science advances, future generations will most likely be able to prevent against these chronic conditions. Therefore, the outcomes and standards we measure for treating already-existent conditions in patients will need to be different from the standards against which we measure future—and hopefully healthier—populations. Bioinformatics is key to the future of the healthcare industry. In order to arrive at a more precise diagnosis and generate better outcomes for all patients, focus on tearing down silos within healthcare and opening up the flow of information is crucial to eventually creating predictive care pathways where patients can receive accurate diagnoses and treatment plans even before being evaluated by physicians. Silos in healthcare need to be torn down. In order to optimize the flow of data to follow patients from primary care to hospital to nursing and everything in between, silos within hospitals need to be torn down and collaboration at all stages of healthcare needs to be achieved. Once you begin correlating information on patients from radiology, pathology and genomics and bring all factors that make up the health profile of an individual into one setting, many of the mistakes that are made in individual silos can begin to be reduced and healthcare delivery and best practice can be optimized due to the collaborative work of each healthcare professional. With focus on bioinformatics, predictive care pathways can be created. Once a substantial mass of data has been collected on patient pathways and outcomes, companies can begin developing deep algorithms that can read patient records and predict future treatment plans and prescriptions for future patients before they even see a doctor. Sharing patient data within healthcare leads to improved outcomes. In an academic hospital in Europe, studies found that 30% of cancer patients were either over or under diagnosed and/or over or under treated for their disease. By having various silos across the data share data with each other through the use of technology, however, they saw a massive improvement of cost for the outcome.

But it’s difficult to think about value when we have no buoy for understanding it outside our traditional lenses: for example, our time, our job, and what others tell us they are worth in cash. This, largely, is the world’s paradigm for value so far. But understanding what value really means changes everything—and will be at the center of the decentralized revolution in global coordination that will unfold over the next decade. So, where do we begin?

Let’s start with gold.

Gold is an inherent value. When backing a market, gold allows us to grow a balanced economy well into the trillions. But why does it allow for massive stable markets to form around it? It is gold's permanence that creates stability. We understand that gold will always have value, because it is inherent in all of us, not just in one part of the world, but everywhere, not just today, but tomorrow and for the long haul.

In the 1930s when the gold standard was removed, we learned that the U.S. dollar didn’t need gold to back its economy to flourish. We learned that it was just a symbol for U.S. citizens to decentralize their coordination around the United States economy.

It turns out, common agreement is a philosophy for building shared economy.



And so it seems inherent value is a marker for us to begin exploring what the future could look like—a future beyond gold and the existing realm of credit. And so what else has inherent value? Is education as valuable as gold? What about healthcare? What about a vote that can’t be tampered with? What about an ID that can’t be stolen or erased? What about access to nutrition or clean water? You will find value everywhere you look.



It turns out, we’ve already done the legwork necessary to uncover the most elemental inherent values: The Sustainable Development Goals are commitments grown out of the drive to bring to life basic tenets of the Universal Declaration of Human Rights—the closest possible social contract we have to a global, common agreement.

We’ve already agreed, as a global community, to ensure inclusive and equitable access to quality education. We’ve already agreed to empower all women and girls, to ensure pure and clean water access for all, to promote health at all stages of life, and to end hunger.

We’ve already agreed.

Our agreements are grounded in deep value centers that are globally shared, but undervalued and unfulfilled. The reason for this is our inability to quantify intangible value. All of these rich, inherent values are still nebulous and fragmented in implementation—largely existing as ideals and blueprints for deep, globally shared common agreement. That is, we all agree education, health, and equality have value, but we lack common units for understanding who and who is not contributing value—leaving us to fumble in our own, uncoordinated siloes as we chase the phantoms of impact. In essence, we lack common currencies for our common agreements.

Now we find ourselves at the nexus of the real paradigm of Blockchain, allowing us to fuse economics with inherent value by proving the participation of some great human effort, then quantifying the impact of that effort in unforgeable and decentralized ledgers. It allows us to build economic models for tomorrow, that create wholly new markets and economies for and around each of the richest of human endeavors.



In late 2017 at the height of the Bitcoin bubble, without individual coordination, planning, or the help of institutions, almost $1 trillion was infused into blockchain markets. This is remarkable, and the revolution has only just begun. When you realize that Blockchain is in a similar stage of development as the internet pre-AOL, you will see a glimpse of the global transformation to come.



Only twice in the information age have we had such a paradigm shift in global infrastructure reform—the computer and the internet. While the computer taught us how to store and process data, the Internet built off that ability and furthered the conversation by teaching us how to transfer that information. Blockchain takes another massive step forward—it builds off the internet, adding to the story of information storage and transfer—but, it teaches us a new, priceless and not yet understood skill: how to transfer value.



This third wave kicked off with a rough start—as happens with the birth of new technologies and their corresponding liberties. Blockchain has, thus far, been totally unregulated. Many, doubtless, have taken advantage. A young child, stretching their arms for the first couple times might knock over a cookie jar or two. Eventually, however, they learn to use their faculties—for evil or for good. As such, while it’s wise to be skeptical at this phase in blockchain’s evolution, it’s important not to be blind to its remarkable implications in a post-regulated world, so that we may wield its faculties like a surgeon’s scalpel—not for evil or snake-oil sales, but for the creation of more good, for the flourishing of commonwealth.

But what of the volatility in blockchain markets? People agree Bitcoin has value, but they don’t understand why they are in agreement, and so cryptomarkets fluctuate violently.  Stable blockchain economies will require new symbolic gold standards that clearly articulate why someone would agree to support each market, to anchor common agreement with stability. The more globally shared these new value standards, the better.

Is education more valuable than gold? What about healthcare or nutrition or clean water?


We set out in 2018 to prove a hypothesis—we believe that if you back a cryptocurrency economy with a globally agreed upon inherent value like education, you can solve for volatility and stabilize a mature long lasting cryptomarket that awards everyone who adds value to that market in a decentralized way without the friction of individual partnerships.

What if education was a new gold standard?

And what if this new Learning Economy had protocols to award everyone who is helping to steward the growth of global education?



Education is a mountain. Everyone takes a different path to the top. Blockchain allows us to measure all of those unique learning pathways, online and in classrooms, into immutable blockchain Learning Ledgers.

By quantifying the true value of education, a whole economy can be built around it to pay students to learn, educators to create substantive courses, and stewards to help the Learning Economy grow. It was designed to provide a decentralized way for everyone adding value to global education to coordinate around the commonwealth without the friction of individual partnerships. Imagine the same for healthcare, nutrition, and our environment?



Imagine a world where we can pay refugees to learn languages as they find themselves in foreign lands, a world where we can pay those laid off by the tide of automation to retrain themselves for the new economy, a world where we can pay the next generation to prepare themselves for the unsolved problems of tomorrow.



Imagine new commonwealth economies that alleviate the global burdens of poverty, disease, hunger, inequality, ignorance, toxic water, and joblessness. Commonwealths that orbit inherent values, upheld by immutable blockchain protocols that reward anyone in the ecosystem stewarding the economy—whether that means feeding the hungry, providing aid for the global poor, delivering mosquito nets in malaria-ridden areas, or developing transformative technologies that can provide a Harvard-class education to anyone in the world willing to learn.


These worlds are not out of reach—we are only now opening our eyes to the horizons of blockchain, decentralized coordination, and new gold standards. Even though coordination is the last of the seventeen sustainable development goals, when solved, its tide will lift for the rest—a much-needed rocket fuel for global prosperity.

“Let us raise a standard to which the wise and the honest can repair.”  —George Washington
About
Winona Roylance
:
Winona Roylance serves as a contributing editor and Diplomatic Courier's senior correspondent in Asia.
The views presented in this article are the author’s own and do not necessarily represent the views of any other organization.