Health Unchained Podcast

This episode is with Philip Parker, Chief Operating Officer, from Coral Health. Coral Health is based in Vancouver Canada and has been building their app with user experience and data interoperability as their focus. They want to bring personalized medicine to the patient via blockchain and SMART on FHIR protocols. •SMART (Substitutable Medical Apps, Reusable Technology) on FHIR (Fast Healthcare Interoperability Resources) protocols •Blockchain benefits •Working with Patient Advocacy groups •Prior Authorization process is wasteful and can be improved with data interoperability between payers and providers. •CoverMyMeds streamlines the medication PA process, electronically connecting providers, pharmacists and plan/PBMs. CoverMyMeds was acquired by McKesson Corporation in 2017 •$1.3 trillion annual healthare spending in US may be categorized as wasteful or of no value to patients- admin complexity, fraud, abuse, poor coordination. •Adverse effects from drug to drug interactions is a major cause of hospital admissions •As a company using a permissioned blockchain, what do you think are some advantages of using a public blockchain? •What does personalized medicine mean to you? •Importance of Longitudinal health data •Many clinical trial recruitment is still being done with train station advertisements- very inefficient/ineffective/expensive •Observational/Longitudinal studies can be drastically improved with a platform like Coral Health Links: Homepage: https://mycoralhealth.com/ Access to the app: https://medium.com/@mycoralhealth/introducing-coral-health-records-the-easiest-way-to-access-control-your-health-records-on-apple-5335127f2fbe For early access to test app, email: info@mycoralhealth.com FHIR Index: https://www.hl7.org/fhir

In this episode, I speak with Dr. James Todaro – co-founder and CEO of MedCredits about Decentralization and his experience in the healthcare and blockchain community. Show Notes: • Medcredits Origins • Advantages and disadvantages of decentralization in healthcare • Hippocrates app - Tele-dermatology as the first available service in beta • Token Curated Registry(TCR) used to create a decentralized global physician registry • Investor speculation and competitive token sale environment • Permissioned blockchains • How has your medical school training helped you in your endeavor with MedCredits? • Artificial Intelligence • Shortage of healthcare providers • Can you share some of the competitive pressures you are feeling in this space right now? What other blockchain companies are trying to do what you are doing? • Technology adoption takes time especially in healthcare MedCredits beta application: https://medium.com/medcredits/get-paid-to-test-the-hippocrates-physician-ui-dfffacaa29c0 Learn about TCR: https://medium.com/medcredits/a-token-curated-registry-for-occupational-licensing-6ada7c43df4e New Corner: Mount Sinai Health System is looking to take a lead role in finding ways that healthcare can use emerging blockchain solutions. The New York-based integrated delivery system has launched the Center for Biomedical Blockchain Research to solve healthcare challenges using technology that underlies the Bitcoin cryptocurrency and provides a data structure that can be timed-stamped and signed using a private key. https://www.healthdatamanagement.com/news/mount-sinai-creates-center-for-biomedical-blockchain-research

In this episode, we talk about genomic data ownership and privacy ethics with David Koepsell, lawyer, author, and philosopher. http://davidkoepsell.com/ Check out the Encrypgen Market Demo - https://marketdemo.encrypgen.info/ Show Notes • Introduction of David’s background • Brief journey into blockchain • Patenting genes and ownership of personal data • Origins of Encrypgen - value proposition to upload individual genetic information securely on a research marketplace • Multichain, used by Encypgen, is built specifically for permissioned blockchain and satisfies the requirements of GDPR • Importance of Individual Metadata to make Genetic information valuable • Search capability of the genetic data and metadata • Value of genotyping and sequencing • The cost of sequencing one human genome has gone down from over $100M in 2001 to under $1000 today. • Challenging ICO Offering experience • How will Encypgen generate revenue? • Genomic Data Markeplace • How will the value and price of a person’s genetic change over time? • 23andme surveys and the collection of phenotypic data • Research Impact of the study of Epigenetics • Data Validation and accuracy • We will need multiple generations of genetic data to bring us tons of new insights about humans and health. • Genes are not your destiny • Ethical considerations • Breaking Bad and Philosophy - the book • Community building and importance of community support • David’s Upcoming event dates and locations- (https://www.healthfurther.com/ Nashvile, TN Aug 28-29), (https://www.eventbrite.com/e/the-exponential-healthcare-conference-tickets-47599097181 Newport, CA Oct 10) GINA Act - https://www.eeoc.gov/laws/statutes/gina.cfm News Corner - A subsidiary of Pornhub called Tube8 has entered into a partnership with Vice Industry Token. https://thenextweb.com/hardfork/2018/08/17/pornhub-tube8-blockchain-cryptocurrency/

George Church, professor at Harvard & MIT, co-author of 480 papers, 130 patent publications & one book "Regenesis", originally published in 2012. His contributions have enabled nearly all advancements in “next generation” DNA sequencing methods, he’s cofounded over 20 companies and he was listed as one of TIME’s 100 most influential people of 2017. Also considered the father of synthetic biology. George M. Church - http://arep.med.harvard.edu/gmc/ Nebula Genomics - https://www.nebulagenomics.io/ Veritas Genetics - https://www.veritasgenetics.com/ Show Notes • Nebula Genomics origins and Veritas Genetics traction • Genotyping vs. Medical grade whole genome sequencing – prices, value, and utility • Data ownership of personal genomes • Personal Genome Project is an open source/open access collaboration to share genomic and phenotypic information with researchers • 3 Axes: How close to useful medical genome (technically); who controls it (self or corporate); how useful on a day-to-day basis (understandability and interactivity). • Genome sequencing technology adoption and Seat-belts • What scientific and social problems are you most concerned or obsessed with today? • Aging Reversal • Human life extension limitations and perceptions • How Genome sequencing is like the internet back in the late 1980s. • Genome editing risks and biohacking ethics • Equitable distribution of gene editing technology among all the people require lower cost • What’s more important- Information Systems R&D or microbiology wet-lab experiments? How dependent are they on each other? • How did you first hear about blockchain technology? • Personal Genetics Education Project - PGed.org • Cambrian explosion of blockchains • Exploring possibilities of genomic research • What is the basis of consciousness? • George’s favorite scientists Quick Quote: Decoding the human genome sequence is the most significant undertaking that we have mounted so far in an organized way in all of science. I believe that reading our blueprints, cataloguing our own instruction book, will be judged by history as more significant than even splitting the atom or going to the moon. -Francis S. Collins [Director of the National Institute of Health (NIH)] News Corner 23andMe announces $300M deal for your DNA with giant drug company GSK - https://www.digitaltrends.com/cool-tech/23andme-gsk-drugs/

In this episode, I had the chance to speak with Vasja Bocko, founder and CEO of Iryo, an early stage healthcare IT company from Slovenia. We discuss the IRYO’s journey so far and the importance of permissioning private health data using blockchain technology. IRYO runs on the EOS network and is focused on creating an open-sourced EHR platform with zero-knowledge encryption. I apologize in advance for the sound quality of parts of this recording, there were periods of technical difficulty but we made it through and I think there’s plenty to take away in this episode. Show Notes Introduction of Vasja Bocko and origins of Iryo. Iryo is focusing on interoperability, data toxicity, data ownership. Data toxicity refers to companies and organizations holding health data as toxic assets because they risk data breaches. Personal health records and Iryo Research Portal. How is the data stored on the mobile device and the cloud? Using ZeroPass to ensure recoverability of your private keys (https://www.zeropass.io/). Choosing EOS as Iryo’s foundational blockchain network. Risks of moving healthcare data from centralized systems to distributed networks? What kind of devices will be used to store private keys in the future? Clinical institutions stake tokens– spam protection, institutions would include organizations such as hospitals, clinics and research institutes. In case of emergency escrow mechanism. How does is fit into clinician workflow? Iryo is working to be compliant with OpenEHR standards. Lack of incentives for existing Health IT to adopt open standards because their clients get locked-in to using their platform. OpenEHR (UK based - https://www.openehr.org/) vs. HL7/FHIR standards (primarily US based - https://www.hl7.org/fhir/) SNOMED - Systematized Nomenclature of Medicine (Clinical Terms) – is a standardized, multilingual vocabulary of clinical terminology that is used by physicians and other health care providers for the electronic exchange of clinical health information. (https://www.snomed.org/) AI and Machine learning methods – analyzing in place. Integrating with Medical/Health devices. Preserving anonymity and privacy of healthcare data. ICO decisions and crypto market sentiment. Iryo platform traction in the market. Iryo partners with NGO called Walk With Me organization to provide IT infrastructure to refugee camps in the Middle East (https://medium.com/iryo-network/announcing-the-first-deployment-of-the-iryo-system-improving-healthcare-for-refugees-bee8c441e7e6) News Corner: On July 5, 2018 - The International Journal of Health Geographics published an editorial titled Geospatial blockchain: promises, challenges, and scenarios in health and healthcare. Article: https://ij-healthgeographics.biomedcentral.com/articles/10.1186/s12942-018-0144-x Links Website: Iryo.io ICO: Iryo.network Vasja’s email address: vasja@iryo.io Iryo Telegram Group: https://t.me/IRYOnetwork Iryo Medium: https://medium.com/iryo-network

We discuss the origins of SV Health and the challenges she faces bringing new technology into the slow-moving healthcare industry. Their featured platform HealthNexus is a globally HIPAA compatible protocol and forked from the ethereum blockchain. Kat is Health Unchained’s first female guest and I would certainly encourage other women entrepreneurs to get involved with building these new types of distributed business models in healthcare. SimplyVital Health is hiring. Check out the show notes for more details about the episode and a few cool links related to the show. Show Notes Teach for America experience at the Texas/Mexico border Teaching nutrition and diabetes management as a 7th grade teacher Changing career paths Incorporating SimplyVital Health in Delaware SV Health is equity backed by multiple Venture Capitalists Receipt hash function creates an audit trail to track the interaction of the providers with the each other and the patient to prove care coordination. Creating a healthcare safe blockchain protocol Open-source key pair system foundation Why did you fork the ethereum blockchain? Two reasons: Proof-of-traction is needed in healthcare and there are more developers with ethereum based coding skills Creating the permissioned blockchain to comply with HIPAA and attract healthcare institutions Opportunity in Clinical trials research needs better data access just like the rest of healthcare Regulatory challenges in the blockchain space and difficulty understanding the value of tokens Blockchain bad actors and maintaining your integrity What has your experience been like as a woman CEO and do you think there have been any disadvantages or advantages being a woman in this field? What advice would you give to women who may be interested in this new field of architecting trust with technology? Existing products and traction with users/developers Patient data is super valuable, case in point, Henrietta Lacks cell lines (https://www.scientificamerican.com/article/5-ways-henrietta-lacks-changed-medical-science/New Hampshire). Dangers of selling data as your business model (https://hbr.org/2017/06/to-survive-health-care-data-providers-need-to-stop-selling-data) Ontario experimenting with open access to residents’ healthcare data (https://qz.com/1246042/ontario-is-releasing-its-residents-personal-health-data-to-eager-tech-companies/) Data producers, analyzers, and quality control. Creating a marketplace for patients to share data with pharmaceutical companies. Entrepreneurship fundamentals are still critical to be successful with blockchain technology. Decision to use telegram only as an announcement channel. If it’s not too personal, what would you consider to be your biggest mistake? Embracing failure to grow stronger with experience. Lack of good healthcare data access is a business issue not a technology issue. Health Information Exchanges don’t work because of lack of trust and business. News Corner: SimplyVital Health, the Boston-based blockchain healthcare company has joined with The Cool Kids to bring SimplyVital's open source Key Pair System to identify the highest healthcare impact opportunity in the Philippines. https://www.prnewswire.com/news-releases/filipino-company-picks-health-nexus-blockchain-protocol-to-fix-healthcare-nationwide-300666767.html Links: https://www.simplyvitalhealth.com/ https://www.linkedin.com/in/katherinekuzmeskas/ https://gitter.im/ https://github.com/Health-Nexus

This week’s guest is Dr. Michael Kaldasch, CEO of Aimedis, in Germany. I want to quickly thank my previous guest Girisha Fernando from DIGIPHARM for connecting me with Dr. Kaldasch. Aimedis is a startup trying to build a comprehensive healthcare ecosystem that can store your health records, interact with providers using video chat, and a social media community. They are using blockchain technology to facilitate better health data access and establish trust for patients and providers. I think they have large goals to accomplish and it certainly won’t be easy but as you’ll hear in the episode, health care institutions prefer an all-in-one product for them to actually want to adopt them in their workflow. Towards the end, we also got into a bit of a philosophical conversation about fiat money, greed, and the perception of value. Although it is still early for Aimedis, it sounds like they are making good strides in the German and Asian marketplace with their 5 hospital chain partners using version 1. Show Notes: How did you get the idea to start with Aimedis? Previous experience for Dr. Michael Kaldasch included TheHealthNet which was built in 2013 and had over 10,000 patients. Aimedis Proposed Use cases: Social Media Interaction, Patient Record access, Medical Service Provider Action History, Lab and specialized procedure records, Medical service provider credentials, Telemedicine delivery support. Aimedis has been rolled out to 5 hospital chains in Europe and Asia. There are about 25,000 patients that are in version 1 of Aimedis platform already. Competition - Medicalchain and Mediblock Breaking down data silos and the importance of collaboration for blockchain projects. Aidmedis has raised $2.5 million during their pre-sale round. ICOs and Financing the project to attract high quality talent. Innovation in the United States vs. Europe. Stress in the Emergency Room as a doctor. What makes your life happy and fulfilled? What was your biggest mistake? Philosophical considerations regarding the value of money and basic human needs. AimedisTelegram group: https://t.me/aimedistoken Website: https://aimedis.com/ Quote reference: https://www.quora.com/What-do-you-think-Henry-Ford-was-referring-to-when-he-said-It-is-well-enough-that-people-of-the-nation-do-not-understand-our-banking-and-monetary-system-for-if-they-did-I-believe-there-would-be-a-revolution-before-tomorrow-morning

In this episode, I spoke with the Swiss-based DigiPharm team who are trying to tackle some of healthcare’s most challenging problems, specifically in the pharmaceutical pricing and clinical trial space. Both the CEO, Ahmed Abdulla, and the COO, Girisha Fernando are co-founders of DigiPharm and have spent parts of their careers working at the 2nd largest global pharmaceutical company by revenue, Roche. Ahmed recently joined the Centre for Trade Facilitation and Electronic Business, part of the United Nations Economic Commission for Europe as an blockchain expert in healthcare. Zach Daniels, DigiPharm’s CTO, also joins us from Denver, CO and he spoke about the specifics of DigiPharm’s anticipated technology. I apologize in advance for the sound quality of parts of this recording, there were periods of technical difficulty but we made it through and gets better as the conversation unfolds. Introduction of the DigiPharm team and company. History at Roche Pharmaceuticals. DigiPharm was one of the Pfizer Healthcare Hub top 10 finalists. Trying to frame the problem being solved in one sentence. Using smart contracts to deliver outcome-based agreement. Importance and increased use of real world evidence. ICO landscape. Swisscom partnership provides Digipharm with the necessary development resources. Offering patients better access to life-saving drugs that are still in clinical trials. Using dynamic pricing to let patients pay for the value they actually receive from a drug. Project Timeline. DigiPharm Website: www.digipharm.ch/ Telegram group: t.me/digipharm News Corner https://www.forbes.com/sites/forbestechcouncil/2018/06/08/how-blockchain-and-ai-can-help-pharma-focus-on-innovation-rather-than-advertising/2/

In this episode, we dove really deep into medical records. I know our guests from episode 1 and 3 were also involved with medical records but this guest is truly an expert on how medical records have evolved ever since the mandatory transition for providers to move medical records from paper to digital. Show Notes: What does Health Record Banking Alliance do? Why is it us taking so long to easily access useful medical records? Richard explains how family caregivers can benefit directly from the access to loved one’s health records. Health Record Banking Alliance Principles Self-diagnosis on the internet and its dangers. Apple health – consumers and developers. General Data Protection Regulation (GDPR) and privacy concerns. User interface ease of use and consumer demand. How can blockchain create a trusted environment to share medical and health information? Health outcomes depend on our behavior and the potential for using micropayments to incentivize patients to choose healthy options. Working with federal regulators to encourage data sharing among patients. Providers and payers manage data according to HIPAA. Giving advice using medical records is something the FDA monitors carefully. Access to the vital health information is difficult in some populations, especially in developing countries. Who are the stakeholders in the health record marketplace? Self-diagnosis and treatment using the internet can be valuable but possibly dangerous. Micropayments using blockchain technology offer a way to incentivize data sharing and promote active and healthy lifestyle. Permission based data sharing can help solve transparency concerns. Provider fear of misdiagnosis still exists. Unstructured data- The patient story is more than the data collected in medical records. Complete medical record on one 5x7 Index card in 1984. Europeans spend more on social care than healthcare than America but the total amount of money spent on both social and health care are about the same in each country. The result is that Europeans actually have better health outcomes. End of life care and special directives. Trusting blockchain vs trusting a brand. http://www.healthbanking.org/executivedirector.html https://www.linkedin.com/in/richardgibsonmdphd/ News Corner: https://www.apple.com/newsroom/2018/06/apple-opens-health-records-api-to-developers/ On June 4th, Apple announced that it opened up its Health Record API (application programming interface) to developers so that they can build 3rd party apps that can easily and securely pull health record data directly from Apple users (with their permission of course).

UK based electronic health records Pilot with Groves Medical Group Benefits of international medical consultations using cryptocurrencies Telemedicine technology Hospitals, non-profit, universities as Guardians of data The importance of having access to medical records for a surgeon Working at the NHS as a clinical doctor Why healthcare industry is a laggard in technology adoption? Touch Surgery using augmented reality to train surgeons and improve patient results Prevention is better than treatment Who will be primary users? MyClinic.com is Medicalchain’s new telemedicine service that is being piloted with the Grove Medical Group in London, offering over 30,000 patients the ability to connect with their provider on a video platform. https://medicalchain.com/en/ https://myclinic.com/ News Corner: https://medium.com/medicalchain/medicalchain-announces-a-partnership-with-the-groves-medical-group-london-98c30372998b