Health Unchained Podcast

Brennen Hodge, founder of Citizen Health. I first saw Brennen’s pitch at the Distributed Health conference in 2018. His passion to fix healthcare has driven him to build a fair healthcare marketplace and PHR that will enable patients to seek services that they need with prices clearly displayed. Citizen Health wants to rebuild healthcare for the next generation. Website: citizenhealth.io Community: https://hq.citizenhealth.io Email: brennen@citizenhealth.io Udemy Blockchain/Healthcare Course ($125 off with HEALTHUNCHAINED coupon): https://www.udemy.com/blockchain-and-healthcare/?couponCode=HEALTHUNCHAINED Show Notes •Introduction of Brennen's background •Brennen’s previous startup, Pharmedio, inadvertently enabled fraud among pharmacy benefit managers and pharma sales reps. •Origins of Citizen Health •On Jan 1, 2019, hospitals across the United States became responsible for providing the prices of services that they offer to the public in a “machine-readable format”. This mandate is part of the CMS’s Inpatient and long-term care hospital prospective payment system rules. This is a step in the right direction but doesn’t necessarily help the patient make decisions about their healthcare •Price Transparency •Citizen Health is a Public Benefits Corporation •Cost of healthcare •Humantiv – Consumer Personal Health Record Platform •Medoplex – Healthcare services marketplace •Health Service Token HST – ERC-721 tokenized services •Private practices and direct primary care providers accepting cash-based payments will be initial users of Medoplex •Smart contracts and insurance claims processing •Medit MDT (ERC20) token launched June 2018 •Medex MDX (ERC20) - listed security token •OpenFinance security token listing for MDX •Personal Health Asset PHA ERC-998 health investment account – each human is gifted one PHA (can store MDT and MDX) – part of future 2020 roadmap •Asynchronous telemedicine can provide uber-style clinical services •Proof of Health Algorithm – How is good health determined? Is this health score number personalized to the individual? •People with pre-existing conditions are encouraged to use Humantiv •Open Source/Access and crowdsourcing is essential for fixing healthcare •Bioelectric pharmaceuticals •Artificial Intelligence will drastically augment the clinician’s work to improve patient care •Favorite business person – Elon Musk •Roadmap News Corner: In 2019, hospitals are mandated to publicly post their prices for their services online. This mandate is part of the CMS’s Inpatient and long-term care hospital prospective payment system rules. However, many in the industry say that hospitals are posting the bare minimum to comply with the mandate. This includes chargemaster medical codes, some abbreviations, and prices in a way that’s not easy to understand for most people. Additionally, most people don’t actually pay the chargemaster prices and insurance companies negotiate prices with hospitals to get better deals for the members. Some argue that it would be more helpful to post average prices they accept from insurers but this could reveal hospital negotiated secret prices. CMS has requested information from the public to improve the new rules so that patients have a more clear idea on what they are required to pay. They will consider information in future rulemaking. https://www.cms.gov/newsroom/fact-sheets/fiscal-year-fy-2019-medicare-hospital-inpatient-prospective-payment-system-ipps-and-long-term-acute-0 https://khn.org/news/as-hospitals-post-sticker-prices-online-most-patients-will-remain-befuddled/

Chrissa McFarlane experience as a laboratory research assistant 2007-2009 at the US dept of Agriculture and Albert Einstein College of Medicine 2005-2007 helped shape her perspective in the healthcare system. She studied Business and Africana studies, Spanish, Latin American studies/ global health at Cornell University. Wake forest university MA- business. Bronx High school She's an active leader at HIMSS and is part of their Blockchain in healthcare task force. She's also a mentor of Boomtown accelerators Patientory was founded by Chrissa in 2015 and raised $7.2 Million in 2017 via an initial coin offering. We talked about what it means to empower patients to own and manage their own medical records using blockchain technology. Admittedly, Chrissa doesn’t emphasize the word blockchain when speaking to healthcare executives because it tends to dissuade them. Patientory Association Website: Ptoy.org Patientory Corporation Site: Patientory.com Udemy Blockchain/Healthcare Course ($125 off with HEALTHUNCHAINED coupon): www.udemy.com/blockchain-and-hea…de=HEALTHUNCHAINED Topics Overview Chrissa McFarlane, Founder and CEO of Patientory- A peer-to-peer EMR Storage network. • Introduction of Chrissa's background and experience • Origins of Patientory and experience with startup incubators • How important is the peer-to-peer aspect of your company? • How does the app interact with hospital systems to get provider produced patient records? • What happens if Patientory no longer exists? Where does my data go? • Private key management- maybe body embedded RFID chips • Permissioned blockchains and cryptocurrency market • How can various stakeholders (Patients, providers, payers, pharma, and research) benefit in the Patientory ecosystem? • Smart contracts and insurance claims processing • Patientory Enterprise is still in development and will be released in 2019 • How much has the crypto bear market affected your company operations or goals? • How are blockchain companies changing traditional Business strategies? • Patientory is one of the first healthcare/blockchain companies having started in 2015. Did the early start help you stay ahead of other competitors doing similar projects? • HIPAA compliance and regulatory environment • PTOY token utility is to allow access to the network and allocate data storage • Patientory Association is currently run by Patientory ambassadors • Patientory sponsored the 2nd issue of the Journal of the British Blockchain Association • Adoption challenges • Patientory team and community culture • Roadmap News Corner The biggest story in the past couple weeks is McKesson’s Change Healthcare acquisition of Pokitdok. Pokitdok was founded in 2011 and provides its customers with a platform-as-a-service solutions including Identity, benefits, and claims management. Pokitdok’s solution run on a blockchain called Dokchain and is governed by the Dokchain Health Alliance. Change healthcare plans to integrate key PokitDok APIs into the Change healthcare intelligent healthcare network which will add new capabilities for digital health, telemedicine, and other new disruptive car models that support value-based, patient-centric healthcare. The Change Healthcare Intelligent Healthcare Network reaches approximately 2,200 government and commercial payer connections, 5,500 hospitals, 900,000 physicians, and 33,000 pharmacies. In the company’s fiscal year ended March 31, 2018, it facilitated nearly 14 billion healthcare transactions and $1.0 trillion in annual healthcare expenditures. Press Release: https://www.changehealthcare.com/press-room/press-releases/detail/change-healthcare-acquires-pokitdok-assets

Juhan Sonin, designer, researcher, and MIT lecturer. Juhan specialized in software design and system engineering. He has worked at Apple, National Center for Supercomputing Applications, Massachusetts Institute of Technology (MIT), and MITRE. I had the opportunity to record this episode in Juhan’s GoInvo studio office, where he is the company’s Creative Director. Website: https://www.goinvo.com/ WE MUST SET HEALTHCARE FREE: Opensourcehealthcare.org Udemy Blockchain/Healthcare Course ($125 off with HEALTHUNCHAINED coupon): https://www.udemy.com/blockchain-and-healthcare/?couponCOde=HEALTHUNCHAINED Show Notes •Software Design and System Engineering •Asynchronous telemedicine •People don’t really care about their health until we are unwell •Blockchain use case to access medical records and proxy it from anywhere with internet •Location of conception will be part of your life (health) data •Ownership and co-ownership models for health data •Data Use Agreements •Open Genome Project •You’ve put your data out on the internet and your genetic data is open-sourced. Have you had any unexpected consequences from that decision? •Health Data Standards •Open-source Standard Health Record: http://standardhealthrecord.org/ •Data exchange problems are not only business and technology issues but generally human issues •Determinants of Health •Robot doctors and the future of healthcare •Black-box healthcare algorithms should be •Open source is the only way for Medicine https://medium.com/@marcus_baw/open-source-is-the-only-way-for-medicine-9e698de0447e •Primary Care Manifesto •Patients’ interests in owning their own health •Favorite books: The Elements of Style by William Strunk Jr; Automating Inequality by Virginia Eubanks; Democracy in Chains by Nancy MacLean; The Color of Law by Richard Rothstein News Corner: https://hitinfrastructure.com/news/aetna-ascension-sign-on-to-healthcare-blockchain-alliance On Dec 3rd, two new organizations announced that they will be joining the Alliance to be part of it’s first pilot project which seeks to determine if applying blockchain technology can help ensure the most current information about healthcare providers is available in the provider directories maintained by health insurers. The two organizations are Aetna, one of the top 3 health insurance companies in the US with $60 billion in revenue in 2017 AND Ascension, the largest Catholic health system in the world and the largest non-profit health system in the US. To me this is really exciting news because Aetna recently merged with CVS Health making the combined provider directory information from these organizations huge.

In this episode, I speak with Dennis Zhang, co-founder and CEO of Boston based VitaData. He’s their token economics architect and talked to us about how vitals data, like heart rate and movement can be shared for monetary compensation. He has a PhD in Economics and worked as a Vice president State Street Bank. Graduated from Boston University with a Ph.D. in Economics. With 10 years of experience in quantitative data analysis and risk management, he served as a Vice President of State Street Bank. He won the first place in the JD Artificial Intelligence FinTech Competition. Website: https://vitadata.io/ Show Notes • How did you get into Healthcare from finance and economics? • Clinical Research patient recruitment problems • 1/3 of clinical trials budget is dedicated to finding patients • Recruiting patients with a licensed clinical trials operator in order for multi-site research settings generate data from a diverse population • Tracking data from wearable devices on the blockchain • Starting the company at the MIT Bitcoin Club Hackathon • Better sensors allow people to collect more precise heart rate, oxygen levels, movements, etc. • VitaData wants to be datasharing platform that can give permissions to others to access the data • Data owners and Data users • Data privacy & Encryption security • Identity verification and devices can only be bound to a single user by design • Symmetric and asymmetric data encryption • Payment to data owners for sharing their information • Blockstack - Data owners can choose different data storage methods for their own data, such as Dropbox, Google Drive, and more. • Proof of Diligence, Proof of Neutrality, Proof of Efficiency • Nebulas vs. Ethereum (NRC20 and ERC20 tokens) • VDT function and utility – measures the value of the data you generate in the network • Technical Challenges • Economics - how do you make money? Earn VDT token by sharing your data • Smart Contracts for trials • Dynamic Tokenomics • Customers - adoption challenges and traction • Token Sale / ICO • Roadmap • Usefulness of Big Data • Recap of VitaData Blockchain and Healthcare – Udemy Online course https://www.udemy.com/blockchain-and-healthcare/?couponCode=HEALTHUNCHAINED

Emily Vaughn Bailey - Product Development Director at Change Healthcare • Business impact of blockchain infrastructure in claims and revenue cycle management • Manages $3 trillion in transactions per year • Connecting Change Healthcare clearinghouse services to the blockchain • Path of adoption for Blockchain technology • Partnership with Tibco to develop better tools for payment processing • Visualizing smart contracts to bring together business architects and product teams

Distributed Health 2018 mini interviews 1. Kamal Obbad – CEO of Nebula Genomics (https://www.nebula.org/) 2. Tyler Penrod – CTO at Recovery Unplugged (https://www.recoveryunplugged.com/) 3. Jason O’Meara - Senior Director of Architecture at Quest Diagnostics discussing the Synaptic Alliance (https://www.synaptichealthalliance.com/) 4. Teresa J. Walker – Law Firm Management Guru and COO of Waller Lansden Dortch & Davis, LLP (http://www.wallerlaw.com/) 5. Cory Pitt – Personal Digital Spaces 6. David Boswell – Developer/Director of Ecosystem at Hyperledger Linux Foundation 7. Himanshu Verma – CEO of Consilx (http://www.consilx.com/) 8. Jason Bierly, CPA - Senior Tax Manager at Aprio (https://www.aprio.com/) 9. Najib Ben Brahim – CEO Telehealth Management LLC (https://www.telehealthmgt.com/) 10. JC Crawford – Networking Sales Specialist (Tennessee) Citrix (https://www.citrix.com/) 11. Khrys Hatch - Capital Formation Research Coordinator at Launch Tennessee (https://launchtn.org/) 12. Dominique Hurley – VP, Strategic Partnerships and Innovation at HealthVerity (https://healthverity.com/) 13. Dr. Tal Rapke – Founder and CEO of ScalaMed (Winner of Distributed Health 2018 Investor Pitch Competition) (https://www.scalamed.com/)

Phil Baker (PharmD) – Founder, Good Shepherd Health | Founder, CEO at Remedichain. https://www.linkedin.com/in/philbakerpharmacist/ Stuart Lackey - Co-Founder, CEO at Solaster. Medical Device commercialization expert. https://www.linkedin.com/in/stuart-lackey-34105a13/ Links: goodsheprx.com remedichain.com solaster.io •Pharmacy drugs (primarily oral chemotherapies) can be donated to Good Shepherd Health who will give them to low-income people •Solaster using Go-chain – GO-70 interoperability standard •Working successfully with government to change drug donation laws •1st day - $40,000 worth of medicine were donated. 1st week - $100,000 of medicine were donated. •Focusing on building a strong network of drug supply and demand on the Remedichain platform •New partnerships opportunities are welcome

Announcement: I will be in downtown Nashville, TN Nov 4-6 for the Distributed Health conference- https://health.distributed.com/ Helen Disney is the CEO and Founder of Unblocked, a hub for Blockchain events, education and information. She was listed in Innovate Finance’s 2016 Women in Fintech Powerlist and referred to by Barclays as a “Blockchain guru”. Unblocked Events Homepage - https://unblockedevents.com Healthcare Unblocked London - Nov 9, 2018 - https://unblockedevents.com/events/healthcare-unblocked-2018/ Conference Topics include: o Can Blockchain help save costs and reform the NHS? o Building a Decentralised Healthcare Identity o Digital service records, analytics and actionable insights for medical devices and equipment o The Disrupting Convergence of Blockchain, AI & Healthcare o Preventive medicine and longevity - what role can blockchain play? o What are the new business models being enabled by the rise of tokenisation? Show Notes • What is Unblocked Events and why did you start it? • Different verticals in the blockchain including healthcare, energy, creative content sharing • Helen co-authored two books on healthcare: IMPATIENT FOR CHANGE: European Attitudes To Healthcare Reform, 2004 | POLES APART: Eastern European Attitudes To Healthcare Reform, 2005 • Lack of patient agency in the existing healthcare system • Actionable data insights and patient centered experience is still not on par with the consumer experiences with other industries • Bi-lateral relationship with stakeholders in the healthcare ecosystem • Obstacles and challenges faced in setting up conference events • Bitcoin and blockchain adoption trends • Decentralized jurisdictions and governance system like the Decenturion State can change the way we interact with our government - https://decenturion.com/ • How will the government and healthcare will work together to drive public policy in a decentralized world? • Security using blockchain to enable provenance of data used in artificial intelligence systems • Blockchain as a substrate for our future global economy • Skepticism around individually owned patient records • What would you consider to be your biggest mistake and what did you learn from it? News Corner: Upcoming Health IT events 1. Beverly Hills Health IT Summit November 8 - 9, 2018 Beverly Hills, CA This is the final event for the Health IT summit series which is partnership between Renowned Healthcare Informatics and KLAS Enterprises (KLAS) where they offer exclusive education sessions to educators, providers, government officials, vendors, and consultants. https://vendome.swoogo.com/2018-BeverlyHills 2. Playing with FHIR – An ONC Developer Workshop November 27 - November 28 Washington, DC The Workshop seeks to catalyze new ideas and approaches to using FHIR to solve interoperability issues. The workshop event is free and open to anyone who’s interested in playing with FHIR https://www.healthit.gov/news/events/playing-fhir-onc-developer-workshop 3. BLOCKCHAIN HEALTH IT SUMMIT December 5-6, 2018 San Diego, California "Utilizing Blockchain to Transform Healthcare Systems and Business Practice" The Blockchain Health IT Summit will offer key insight on the future of blockchain business models in healthcare, and how this disruptive technology will go on to innovate healthcare delivery for years to come. http://rscouncil.org/blockchainhealthit/ • Guest episodes mentioned about decentralized government from Ray’s other podcast PFL with Stephanie and Luis: https://pflpodcast.com/2018/03/10/ep-51-decentralized-voting-with-sandra-miller-from-democracy-earth/ • https://pflpodcast.com/2018/03/20/ep-52-borderless-nation-states-with-bitnation-founder-susanne-tarkowski-tempelhof/

On September 22 and 23rd 2018, high school students- Kevin Liu (CTO), Kunal Sharda (CEO), Will Hemond (COO)won first place in a DoraHacks hackathon with Delphus which is a decentralized clinical trial management platform. This episode features the 3 inspiring co-founders of the Scintilating team. Remember to follow me on Twitter to stay up-to-date on all things healthcare/blockchain and follow me on Instagram where you can find pictures of the hackathon and the winning team. • Introduction of the team • Experience with Hackathons • How did you get interested in the research process and clinical trials? • Audit trails in clinical trials is becoming more important • Improving the clinical research documentation process • Brief mention of Scintillating’s other ideas for projects- QueCoin, LitCoin, AddictCoin • Delphus is on Ethereum Testnet • ERC721 (DELPH) is used as reputation tokens to provide proof of identity • ERC20 (COM) holders will serve as committee verifiers • Delphus governance structure is modeled off of MakerDAO and Dai • StableCoin Collateralization Ratio explained • Team’s first programming language • User experience and Internet browser compatibility • Blockchain encryption methods • Using Protonmail’s encryption library • Complying with HIPAA regulations • Team dynamics explored and the “get it done” mentality • Team Favorites – Elon Musk, Mozilla, Jeff Bezos • Scintillating company homepage: https://scintillating.us/ • Delphus platform homepage: https://delph.us • Discord channel: https://discordapp.com/invite/Xst7TR3 • Email: head@scintillating.me Blackberry has announced that it will begin to tackle one of the biggest challenges in the healthcare industry: leveraging healthcare endpoints to improve paitent outcomes while ensuring security and data privacy. And how does it expect to do that? The company will use it’s network operation center to power a decentralized digital ledger provided by ONEBIO, OneBio is Swiss based blockchain company which aims to build a peer-to-peer marketplace for biodata. Additionally, it will leverage it’s blackberry Spark communications platform to connect, protect, and manage smart devices in hospitals and clinics. For more info on this partnership, check out the episode show notes. https://www.techrepublic.com/article/blackberrys-new-blockchain-tools-could-boost-security-for-medical-iot https://www.ecnmag.com/news/2018/10/blackberry-offers-secure-sharing-data-all-healthcare-things https://www.onebio.io/

Universal Health Coin was one of the books that actually inspired me to start this podcast. So it was a great pleasure to have the author of the book as a guest on the show. Dr. Gordon Jones (President and COO) – Universal Health Coin (UHX) Gordon's LinkedIn: https://www.linkedin.com/in/drgordonjones/ • Apache adventures and the US Army Airborne Division, and SC National Guard | Co-author of universal health Coin with Courtney Jones • Entrepreneur in Residence at Startup life incubator - StartupLife Incubator in Augusta, GA: https://startuplife.theclubhou.se/ (Register your startup before October 8, 2018) • What’s the most frustrating problem in healthcare? • Inception of Universal Health Coin with Courtney Jones • BUCAH: Blue Cross, United, Cigna, Aetna, Humana are the largest healthcare insurance companies which control much of the healthcare industry, along with the government. • Health Cost Sharing Organizations (HCSO) is a semi-unregulated health coverage plan that individuals and families can join as community members (commonly faith-based organizations) • UHX blockchain technology pivots from ETH to NEO to Stellar • Positive experiences with IBM collaborations and the Think Conference • Using IdentityMind for KYC/AML processes and soon to use Sovrin (identity management) • Partnership with Teledoc to provide telehealth services to UHX users • How do you protect patient privacy? • Nancy Kassebaum co-sponsored HIPAA- meant initially for health data portability not privacy. • Which healthcare industry stakeholders will benefit the most from blockchain technology? • Tokenomics of healthcare and how users will interact with UHX. • Future marketing plans for UHX will not boast blockchain or cryptocurrencies, advertising will be focused on health cost sharing and more affordable healthcare. • Healthcare provider shortage due to wasted time performing data entry work. • Philosophy about end of life care • Roadmap – design and build the platform, build the decentralized health exchange and decentralized token exchange Universal Health Coin Homepage: https://uhx.io/ Universal Health Coin book: https://medium.com/@uhctoken/universal-health-coin-9518ca3769cf Decision to use Stellar: https://www.linkedin.com/pulse/comparative-assessment-neo-eth-stellar-dr-gordon-jones/ “Blockchain Movement”: https://choon.co/artists/gordonjones