Ian Hall is an Executive Software Architect at IBM specializing in the company’s U.S. Public Markets and Healthcare/Life Sciences accounts. Dr. Hall was also a Mentor for IBM’s Blockchain Hackathon in New York City, where he advises teams on business use cases in the public sector domains of government, healthcare, and education. Previously, Dr. Hall served for six years as a Senior Software Client Architect at IBM, working with all of the IBM Software Group products on behalf of a large global bank. Before then, Dr. Hall served for ten years as a Software Information Technology Architect at IBM, developing solutions that fully integrate and collaborate with existing IT systems in order to perform automated business functions. Among his other IBM professional certifications are Senior Certified Architect Level 3 Thought Leader, Foundations of IBM Cloud Reference Architecture V5 Solution Advisor, and Watson V3 Application Development. Outside of his work at IBM, Dr. Hall has been a volunteer chapel organist for nearly eighteen years at New York’s Coler Specialty Hospital and the Church of the Good Shepherd. He received a BA in Music from Yale, and an MM and Doctorate of Musical Arts in Composition from The Juilliard School.

The views and opinions expressed in this interview are those of Ian Hall and do not reflect the official policy or position of IBM.

The Politic: What’s your background at IBM?

Dr. Ian Hall: I moved into the healthcare and life sciences industries. We call that public markets. Really, I’ve been there for about three years now. We did some rebalancing of people like me to handle and strengthen more industries. We were pretty over-stacked in banking, financial markets, and insurance. I thought I might end up doing the rest of my career working on a large global bank. It was great. I got to travel the world and go to Europe, Singapore, Latin America for business. I had a lot of fun with that. 

However, I’m also enjoying the chance to work with governments and health care plans and providers and life sciences companies. I find that collection of industries and businesses quite fascinating, not that financial markets and banking are not fascinating. If you get to stay there, you might have to find out what’s going on in multiple industries. I’ve had a chance to do that, and I’m pretty pleased that I get to keep learning about new businesses well enough to use technology and figure out what’s valuable to them about things like blockchain.

What was your path from Yale to IBM?

Good question. I graduated with a BA in Music from Yale. I had a reasonably strong education in English, Russian, Music, and Math coming into Yale. I decided that among those four pursuits, I enjoyed Music the most. That’s chapter two.

Here’s chapter one. While at Yale, I got a BA in Music, and I took my senior year off to attend North Carolina School of the Arts as an organist and a composer. NCSA is more of a performing arts school. One of the reasons I picked Yale was because of its very strong music department. I did what I could at Yale, but I took my senior year to another school in Winston-Salem, North Carolina called Salem College. I was going back and forth between them. I finished the year, got some credits, and graduated from Yale in 1977 before heading to IBM, where I’ve been ever since.

However, I also decided to keep on with music, so I went to Julliard and earned a master’s and a doctorate in Musical Arts and Composition. I have a violin concerto, a string quartet, a symphony, and some choral music. It’s all kind of sitting in the closet of my apartment. I haven’t had time to perform but I’d like to someday. I was very fortunate that IBM was tolerant of those extracurricular activities, because I had quite a bit of fun finding musicians to play my pieces. It was a very good combination of things for me.

But, since 1991 when I got my doctorate, I’ve been working at IBM full-time. I started off in banking and financial markets. I had a chance around the year 2000 to move into other industries when I became a Software Architect for IBM, and I had a mix of other industries. I kind of moved out of Wall Street for a while and into retail, government, and some travel- and transportation-type industries. I had a good introduction to other industries. I’ve enjoyed getting to know a business not only from an IT perspective but in terms of what it actually does, because the job of an architect is to offer and apply the tech at our disposal to solve industry-specific business problems for particular companies.

When Bitcoin and blockchain came along, because of my varied background, I was interested in both of them for different reasons. The banks and financial markets were all scratching their heads and looking at what to do with these cryptocurrencies– with these suspicious characters mining these digital currencies on their computers and getting paid for creating them. The reason they call it Bitcoin “mining” is because these characters were kind of out there as pioneers, mining to get their next Bitcoin into the network. These cryptocurrency projects, starting with Bitcoin and a number of others, have evolved from that point where they were really a little bit illegitimate. 

They were being used for ransomware. Bitcoin had a rather unsavory reputation for a while because these sort of unscrupulous hacker types would go invade vulnerable home computers, making them unusable until the owner went outside, found a Bitcoin ATM, and sent them whatever amount of Bitcoin the ransom demanded. That was kind of an awful reputation for Bitcoin. It’s remembered that way by us more experienced, mature people. 

What’s interesting is that Bitcoin has gradually become more of a legitimate option for trading. It’s a digital currency. I don’t know that it’s been adopted as any country’s national currency, but it’s definitely out there, and it fluctuates wildly in the market, generating all kinds of excitement in the financial press.

I was asked once, “What do you think about Bitcoin? Should I buy it?” I said, “Well, there’s a good chance you lose everything you put into it, and also a chance it goes up wildly.” That was the best advice I could give at the time. Maybe things are stabilizing, but the way markets are working now, I don’t know. 

My wife works in anti-money laundering, and she occasionally works on cases that involve a Suspicious Activity Report (SAR). She can’t tar everything with the same brush. Financial activity involving Bitcoin, especially given that there are banks working with certain crypto exchanges now, might be completely legitimate. You can’t paint everything with the same brush because of an unsavory beginning.

How did you get involved in blockchain? What are your thoughts?

What’s really fascinating about blockchain is that it offers the promise of improving the working relationships of participants willing to become part of a trusted network. I’m making this as broad as possible. It really looks as though any industry that involves a partnership among peers, where there are costly operational for the consumer or end user of a product or service, could benefit from a blockchain consortium. These participant networks are forming as we speak. There are new ones every day across multiple industries. 

Again, with my banking background, I became aware that trade finance was a legitimate area for improvement through blockchain, assuming you could get participants to sign on to that kind of digital, distributed, general ledger network. We’re moving from the analog world to the digital world in a lot of these trade finance operations. As both big and small suppliers and supply chain networks evolve, it turns out that you don’t need a room full of computers to participate in a blockchain network. What you do need is a participant network where everyone agrees to trust the use of the blockchain to record their transactions or provide the provenance and movement of an object through the supply chain. 

For instance, you would record the movement of an object from Supplier A to Supplier B and then have an auditor role available so oversight and various forms of regulatory compliance could be observed. Blockchain takes what has often been a cumbersome, bureaucratic, and manual process, and it makes that into a digitally-efficient process. The promise there is very exciting. 

What does a consumer complain about today?

The middleman!

That’s right. In my early explorations, I found that big banks were trying to snoop out what was going on with blockchain; but, since they felt that they’d dominated their particular level of banking or bank-to-bank operations, they said, “We don’t need to do that. We’re already in charge of that.” Any big bank that’s involved in global trade already makes letters of credit, which they supply to intermediate banks. Sometimes, these letters turn into very smelly, fishy pieces of paper that are signed off on the loading dock. 

Then, there’s been a slow process of digitizing those letters into digital formats. But we’re not even talking about digital documents here. We’re talking about a network that records transactions for all of eternity in a very secure chain of blocks. The networks are permissioned, which means only the legitimate participants can put a block into or move a transaction through the blockchain network. The blocks are immutable. I’m using an awful analogy of slimy fish here, but I could substitute anything that can be marked and handled with a digital transaction: money, pharmaceuticals, books, and music. 

A few years ago, I had a great experience participating in IBM’s Blockchain Hackathon in lower Manhattan. It was fascinating to see the entrepreneurial spirit and innovation that showed up to learn more about blockchain’s potential for solving their particular business needs. In fact, musicians even showed up that were dissatisfied with their current digital rights management (DRM) system and their lack of alternatives. They were wondering if they could use blockchain for their own DRM network!

We heard presentations from a fascinating combination of people. There were some musicians who were dressed a little differently than the business people, but that’s because they already had their own brand as musicians. They talked passionately about the need for a better and more fair remunerative system: they wanted to be paid properly on their music releases. Some of them went through the trouble of putting their music on audio or video streaming platforms. It was actually easy for them to see who had downloaded and listened to their music, but not so easy to be compensated accordingly. Blockchain was there for consideration.

I joke that the partnerships always consisted of one creative person and one nerd. You would have the creative talent with the idea for a DRM, and then the techie, who knew how to use distributed ledger technology to put together the DRM. We were having a ball. 

People weren’t just presenting about music. Some of them were presenting on public safety and public health. For instance, I heard presentations by people working for their state and local governments on the clean water issue. In my own experience, I’ve worked with water resource operations. It’s a very fascinating and very analogy area. Think of vats, pipes, and reservoirs connected through metering pumps. That describes the vast majority of water resource operations today.

There have been some problems with properly administering chemicals, but imagine if the operations teams could use a general ledger to track the supply of reservoir water for pump pressure tanks. Imagine that these operators could see the right amount of detoxification chemicals to be added, too. The taxpayers bear the costs of water resource operations, and it’s possible that blockchain would not only allow them to be billed properly but also lead to a cleaner, safer, and more cost-effective water system.

When Uber came out with ride-sharing, entrepreneurs tried to apply the same method to everything: goods-sharing, home-sharing, accommodation-sharing, and so on. Now, it seems like people are doing the same with blockchain: find anywhere there’s a middleman, and remove him from the equation. Thoughts on the analogy?

I think I agree with that. The digitization of the car service business is always used as an example of a disruptive trend in digital transformation. People start with Uber when they’re describing a great new application in their business because of the way Uber disrupted taxi drivers in New York City. However, the taxi drivers fought back, and Uber’s having some problems right now. Would that be solved better through blockchain? I don’t know. I pose it as a question because the use of a blockchain is predicated on a consortium of willing participants who all feel they have something to gain from working together, rather than trying to eat someone else’s lunch. To me, that’s a very key point. 

In New York City, green taxis can’t pick people up in Manhattan; they have to be dropping people off, and they have to return to Queens, Staten Island, or wherever else. In Manhattan, we can take yellow taxis or we can walk onto the street and pick up Lyft or Uber through an app on our smartphones. If we use a ride-sharing app, we take our chances because there’s a lot of pushback in NYC from the unions. Why can’t the TLC agree to make all taxis in NYC co-participants in a blockchain network with Uber and Lyft, ultimately letting the chips fall where they may? Would that be better and more competitively appropriate than trying to freeze out a business that’s doing well?

To me, the idea of blockchain is to share alike in the benefits of a more efficient and cost-effective operation. That includes the middlemen. When you can’t see the pharmacy benefit managers (PBMs) as you can the pharmacy, the doctor, the hospital, or whatever is causing you to need a pharmaceutical product, there’s a tendency to blame them because they’re headless. I’m not saying that’s right or wrong. There’s probably quite a bit of inefficient and even corruption in some of the middlemen operations, but I can’t pick one and say, “If we just put that one out of business, we’ll fix everything.”

Pretty much all of the big companies in healthcare, in life sciences and pharmaceuticals, get invited by Congress to explain why drug prices are so high. The big companies blame the PBMs, and the PBMs blame the pharmaceutical companies. 

When pharma is pressed, they say, “Well, we need lots of funding for R&D because we’re developing better medications.” You could look at the whole process with great suspicion, but there could be a trusted and shared partnership between these partners. The government might have to force them to cooperate, or they might just figure it out before the government raises its heavy hand and makes them do it.

I actually see that happening right now. There are multiple interest areas in blockchain with hospitals, PBMs, and distributors– I’m not sure about the pharmaceutical companies. It’s the responsibility of providers to manage costs and make healthcare as affordable as possible. When they don’t take on that responsibility, people choose to move to different plan providers. So, because it’s in the best interest of the providers, maybe they’ll lead the way to integrating blockchain into this relationship. 

It’s actually the hospitals that buy most of the pharmaceuticals. They use most of the drugs. People do need to get prescriptions on an individual basis, the costliness of which causes people to complain about them, but the bigger cost-driving relationship is actually between the hospitals and the pharmaceutical companies or distributors and manufacturers that supply those medications.

It’s interesting you mention the middlemen in pharma. One of the key obstacles toward interoperability in healthcare is the fact of conflicting incentives. For instance, some hospitals might want exclusive access to a patient’s medical information because that’s better for business than sharing. It seems like those conflicting incentives make blockchain really difficult to implement.

You’ve described a very important concern pertaining to data ownership. Now, if you get to know blockchain from a technology perspective, you can see that it wasn’t originally designed to be a database. It wasn’t originally made to hold the whole electronic medical record of a patient. Blockchain networks run on the basis of a smart contract which describes the minimal amount of information to consummate a transaction, and you can’t put all of that patient data into a smart contract.

But, your point about whether it’s in the best interest of an individual participant to share the data with others is a very legitimate concern. If a hospital is considered to be the best hospital for a particular procedure in a particular area, why would they want to share? For one thing, they’re really not allowed to share because of health compliance regulators like HIPAA and HITRUST. They can’t share the data without a legitimate reason. Of course, that reason would be transferring a patient from one hospital to another which seems to have a better procedure for that given patient. Then, there’s a legitimate reason to share info from the electronic health record, and you do see that happening.

But, what you don’t see yet is a universal electronic health record for every individual. Given where we are with cyberattacks and security, I’d personally be very scared of that happening. On the other hand, there could be tremendous cost savings if the system permitted that with appropriate security and regulatory controls. So, I think it’s an open question. I think you raise a very interesting question: this area of electronic health records and how they could essentially become a social network. Imagine you broke your leg. Would you like all of your social media friends to see that?

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