“All in all, even though NFTs are still in their infancy, the technology might evolve in the future to become more compelling for patients to favor the agency it provides over their data.”Dr. Bertalan Meskó & Dr. Pranavsingh Dhunnoo, The Medical Futurist.com, January 13, 2022
Yesterday, Dr. Bertalan Meskó & Dr. Pranavsingh Dhunnoo published a thought-provoking article on The Medical Futurist website speculating whether NFTs might play a role in health care by allowing patients to monetize their health data. Here’s a link to their article.
I’ve long admired the work being done by Dr. Mesko and his team at The Medical Futurist Institute. This article had my head spinning. We’ve all heard the hype about NFTs for some time now, usually associated with some artwork or other collectible. But until this article, I had not given much thought to whether NFTs would be used in health care. I’ve written about the underlying technology of blockchain before. I understand the point the authors are trying to make here, and I agree with the potential to empower patients to control the use of their health data. However, I’m conflicted trying to balance the potential of the technology with the impact that NFT-mining has on the environment.
First, some basics for those unfamiliar with NFTs. NFTs (Non-Fungible Tokens) are defined as “unique, digital items with blockchain-managed ownership,” per NFT marketplace OpenSea. In short, NFTs represent digital assets — which can range from images to songs to videos to tweets to patient data — that are verified through blockchain technology. Owning NFTs allows individuals to claim exclusive ownership over these digital assets. Crucially, NFTs offer a way to monetize digital goods by authenticating their scarcity and provenance.
A debate has arisen over what ownership means in the context of NFTs. In many transactions, NFTs don’t represent the actual asset itself (nor IP nor reproduction nor copyright) but are solely a record of ownership. Despite the ballooning hype, the tech isn’t new. In 2017, people spent millions buying and selling “CryptoKitties,” digital collectible cats created by Dapper Labs, some of which sold for more than $100K.
As reported by CB Insights, several NFT marketplaces have emerged to capitalize on the soaring demand. OpenSea, for example, recently raised $23M led by VC firm Andreessen Horowitz. Other names in the space include Sorare, SuperRare, Nifty Gateway (which was acquired by Gemini), MakersPlace, Decentraland, Rarible, and more.
In health care, as Dr. Mesko points out, NFTs could be used to allow patients’ genetic data to be minted as NFTs, so the information will come with an inherent feature to be tracked. You would be able to see where it ends up and hold those who used it without your permission accountable since you are the sole owner of the data, as certified by the NFT authentication. Moreover, the NFT owner can enable a feature to earn money whenever a transaction occurs with the data. Think of companies like 23 and Me who are using the tremendous amount of genetic data they have amassed by selling their kits to conduct drug discovery for which they might make billions – while you get nothing, even though it’s your information.
A non-digital example in the news recently was the case of Henrietta Lacks. In 1951, Henrietta Lacks, a Black mother of five who was dying of cervical cancer, went to Johns Hopkins Hospital in Baltimore for treatment. Without her knowledge or consent, doctors removed a sample of cells from the tumor in her cervix. They gave the sample to a researcher at Johns Hopkins University who was trying to find cells that would survive indefinitely so researchers could experiment on them. They were reproduced billions of times, contributed to nearly 75,000 studies, and helped pave the way for the HPV vaccine, medications used to help patients with H.I.V. and AIDS, and, recently, the development of Covid-19 vaccines.
Last October, 70 years after Ms. Lacks died at Johns Hopkins Hospital and was buried in an unmarked grave, the World Health Organization honored the contribution she unknowingly made to science and medicine. During a ceremony in Geneva, Dr. Tedros Adhanom Ghebreyesus, the director-general of the W.H.O., presented the Director-General Award to Ms. Lacks’s son Lawrence Lacks. He was 16 when his mother died on Oct. 4, 1951. On Oct. 4, 2021, her descendants sued Thermo Fisher Scientific, a biotechnology company they accused “of making a conscious choice to sell and mass-produce the living tissue of Henrietta Lacks,” according to the federal lawsuit. The family said it demanded that Thermo Fisher pay $9.9 million and “disgorge the full amount of its net profits obtained by commercializing the HeLa cell line” to Ms. Lacks’s estate.
Proponents of NFTs argue that their use would prevent what happened to Henrietta Lacks to anyone else, especially in today’s world of genomic data and CRISPR technology.
Here’s my dilemma – I’m having trouble reconciling the potential benefits versus the immense environmental impact of proof-of-work (PoW) blockchains. The annualized carbon footprint of the Ethereum network alone is estimated to be almost 16 megatons of CO2 — comparable to the carbon footprint of Lithuania — while it consumes 34 terawatt-hours of electricity, similar to the power consumption of Denmark, per Digiconomist. As such, NFTs might not be outright commercially viable soon. But alternatives for NFT minting are in the works that could use a fraction of the computing power currently involved in their transactions. Then there is the issue of whether companies offering digital health services will want to adopt the technology. They might not be particularly excited by the idea of sharing their profits with patients. I admit that I’m not a big fan of cryptocurrency, so that’s probably coloring my opinion on this topic. I don’t think that NFTs will dramatically impact health care any time in the near future. Lots of hype. Lots of challenges. And sharing potential revenues with patients isn’t in the corporate DNA of life sciences companies – and won’t be any time soon.