Blockchain In Healthcaresocal.himsschapter.org/sites/himsschapter/files...•Hybrid database...

• Built & developed a number of successful healthcare software companies and tech-enabled service businesses

• Spent last 17 years developing solutions to simplify and automate practitioner credentialing, privileging, & administration

• Pioneered the use of data science, AI, and blockchain to address complex practitioner identity & credentialing use cases

• Native Southern Californian and graduate of the University of Redlands

Anthony BegandoCEO & Founder

Professional Credentials Exchange

Blockchain In Healthcare DEVELOPING ENTERPRISE-LEVEL SOLUTIONS

Hashed Health Overview

• We Are: Global leader in healthcare blockchain innovation; expertise in healthcare, blockchain, venture capital.

• Why Blockchain: Trust, transparency, incentives, network effects

• Our Focus: Product creation, Market development & Networkorchestration

• Our Goal: An ecosystem of digital health businesses that use blockchain as digital infrastructure:

1. ProCredEx (PCX): A Credentialing Exchange

2. Bramble: Decentralized Exchange for Digital Health Assets

3. Contracting Engine: Payment Relationships

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Objective / Agenda• Objectives

• Provide a Non-Technical Introduction to Blockchain

• Explain How Blockchain Helps Solve Old Problems in New Ways

• Examine utilizing Blockchain to resolve delays in practitioner identity and credentialing

• Agenda

• Introduction / Context

• Blockchain Concepts

• Blockchain Landscape in Healthcare

• Use Cases

• How Blockchain Might Change the Industry

• Q&A

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Immutable, Chronological, Shared Ledger

• Moves trust from a third party to the software

• Becomes a market-level source of truth

• Moves application development from the relational database to the market

• Allows for the re-design of value chains

• Allows for a spectrum of trust-based transactional systems

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The world’s first Blockchain is called

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Bitcoin proved that by moving

trustto the software we change how

digital assets are transacted across value chains.

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Blockchain removes the need for a middle man

to track the

movement of value.

The software does the job of the intermediary.

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The world’s second Blockchain is called

Ethereum opened the door to digital assets & a new wave of innovation.

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Gartner: $3T by 2030

www www 2.0 www 3.0

Primary focus information reputation value

Primary unit search / links likes assets

Dominant Platform

Google Facebook ?

Blockchain: The Internet of Value

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1. Market-level, multi-constituent process2. Trust3. Transparency4. Alignment of incentives

When Do You Need A Blockchain?

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1. Immutable Shared Ledger

• Move trust to the protocol

• Overcome limitations of current infrastructure (ex. claims built for volume, fiat currency not programmable)

2. Smart Contracts: Programmable Value Transfer / Tokenization

• Reduce administrative burden

• Connect payments and benefits / incentives

• Create new applications on top of shared, market-level data structures

Two Levels of Value / Complexity

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What Success Looks Like: The Challenge & The Opportunity

Business Model

Technical Model

Network Governance

StructureFinding this is hard(but your future may depend on it)

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14

Healthcare: Working As Designed

18% of GDP in 2018 >$5.7T by 2023 1/3 Administrative Waste

Transaction FocusedLacks Consumer Choice

Irrational PricingLess Competition

Massive InfrastructureMassive Administrative BurdenDevelopment on Siloed Systems

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Medical RecordsClaimsProducts/SuppliesHealth ServicesPatientsDataIdentityClinical Trials

digital health assets+

enterprise businesses+

decentralized health infrastructure

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New Business ModelsExample: Decentralized Exchange / Marketplace

• “Tokenized” digital assets are created• List asset on the Exchange for consumers• Creates a rational, decentralized market for trading• Allows for innovation on the buy & sell side• Creates a foundation for smart value-exchange innovation &

automation

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CAT SCANS

MRI

BUNDLE

PAYMENTS

SECONDARY

MARKETS

PROCEDUR

E

SITUATION SOLUTION

Can only receive MRI/CAT

scan after PCP referral – that

referral restricts scan within

provider affiliate network

Bundle payment

reimbursements can be

dependent on post-operative

quality of care which is not

necessarily in their control

Currently there is no

secondary market for

healthcare services so

utilization can remain low for

specialists

Allow consumers and providers to engage

with external vendors and out of network

service providers to lower costs, open

access, and increase utilization

The creation of smart contracts introduce an

incentivization structure for patients to adhere

to post-operative care plans and thus, also

incentivize physicans to provide the highest

quality of care

With the introduction of tokenized health

services, employers can purchase services in

bulk and distribute amongst employees. When

these services are unused, they can be resold

for lowered prices

Use Case Examples

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New Pricing & Contracting Models

Programmable Value Transfer: Creating a relationship between payments & real-world activities “fundamentally reorient how Medicare and Medicaid

pay for care, and create a true competitive playing field where value is rewarded handsomely.”

Alex Azar, HHS Secretary 3/6/18

Examples:• Proof of Threshold for Contracting• Proof of Service for Payments• Proof of Outcome for Settlements• Dynamic Pricing for Pharma• Episodic Value-Based Contracting

/ Value-Based Payments for Bundles

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• Infrastructure for identity & credentialing• Goal: Reduce effort, cost, complexity• How?

- Distributed Exchange Model- Allow counterparties to supply /

acquire data according to their requirements/rules/validation checks

- Not a credentialing company

Why Blockchain? Why Now?• Complex, multi-constituent process• Trust & transparency concerns• No PHI• Centralized business models are not

working

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Board Certifications

Background Checks

Adverse EventsMalpractice Insurance

Education & Training

Professional Licenses

Practice Information

Professional References

Employment Gap Reports

Scope of PracticePrivilege History

Occupational Training

Immunization History

Identification

EmploymentHistory

Facility Affiliations

DEA / CDS Certifications

Continuing Education

Curriculum Vitae

Clinical Certifications

• Inherently Unstructured

• Non-standard

• Unique Attributes

• Unlimited Types

• Vary By Occupation

Physician

Complex Data

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Hospital Systems

✅ Rules

🔃 Processes

📝 Requirements

📑 Forms

💾 Data

Payers

✅ Rules

🔃 Processes

📝 Requirements

📑 Forms

💾 Data

Outpatient Clinics

✅ Rules

🔃 Processes

📝 Requirements

📑 Forms

💾 Data

Provider Networks

✅ Rules

🔃 Processes

📝 Requirements

📑 Forms

💾 Data

Widespread Redundancy, Failure in Trust & Transparency

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Solution Framework • Platform & rules engine residing in MS Azure and

developed in C#

• Hybrid database incorporating both MongoDB and

MS SQLServer addresses complex data model

• High performance enterprise Blockchain protocol

• All apps built in HTML-5 incorporating responsive

design

• RESTful APIs

• Current

• Relevant

• Massively Scalable

• Compliant & Secure

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• Data Market• Multi-center trials administration & provenance• Master data management• Tracking supplies / supply chain• Outcomes data collection• Patient recruitment & retention• Funding• Reimbursement models for orphan drugs

A Few Other Use Cases of Interest:

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The Healthcare Innovator’s Dream Come True!

• Create new infrastructure designed for trust, transparency & incentive alignment in healthcare

• Create new methods of building applications.• Create new business models designed for adoption • Create new economies / markets / value chains.• Create new actors & jobs in markets.

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QUESTIONS?

Anthony D. Begando

Founder & CEO

Professional Credentials Exchange LLC

Email: abegando@hashedhealth.com

LinkedIn: https://www.linkedin.com/in/adbegando/

Find Resources & Join the Conversation at https://chat.hashedhealth.com

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