How Blockchain Can Streamline Healthcare and its Payments

[Music] we have freddie he is ceo of self-care and he's going to do now a keynote on how blockchain can streamline healthcare and its payments so freddie i'm very happy to have you on board and i'll give the word to you now thank you thank you victoria and hello everyone it is a pleasure to be here today and i certainly look forward to speaking to you all about healthcare and the application of blockchain and healthcare that can truly make an impact in our lives in our parents and our children's lives i have a short presentation that i will use as a backdrop but really the purpose here is to talk to you so and i welcome your questions as we run towards this towards the end of the presentation my name is pradeep gall i'm the ceo of solve care i started this company four years and about four weeks ago and it has been a great journey but i've spent my entire career 30 plus years in healthcare and primarily the insurance administration benefit administration employee benefits and government and but all of over these three decades i've had the opportunity to look at health care from many different angles and i had the fortune a good fortune of working with some of the top minds in health care over the last 25 30 years and this is my fifth company i've built four other health care it companies in the past but this is my proudest achievement because soft care is really trying to do something fundamental and long overdue which is to really improve the quality the access and the cost and the outcomes of care not just improve some administrative processes but realign the interests of all the key parties that make up the healthcare system starting with the patient so i'm going to share with you our thoughts on why we think that healthcare is long overdue for change which i think we all can agree to and how blockchain facilitates some of that long overdue change and then finally what is soft care doing to make that change possibility a reality so let's get into it uh the first thing i want to talk about is do we even know what good healthcare looks like have we even stopped and thought about what does healthcare look like and i can tell you and we all feel it that healthcare as it exists today whether it's in the u.s or in canada or in uk or in india does not look like good healthcare so let's imagine what healthcare actually should look like because let's start with that entity called the patient if you remember that entity the human being for whose health we are all concerned about it would be good wouldn't it if the patient could actually see the doctor when they needed as quickly as they need to and easily and they would be able to determine if the care they are getting is in line with the best health care practices not just what they are being told but what actually is the best care model for them and they had fewer barriers to managing their health care and if they actually had some intake power over their health care decisions and they could maintain their identity and sovereignty including their data today there is no health care system on the planet that actually empowers the patient the patient is a beneficiary of healthcare they are the recipient of healthcare they are the ones we need to take care of rather than somebody who can take care of themselves and that is a fundamental problem with healthcare around the world and then let's talk about the doctor remember the doctor without whom there is no health care well here's the thing every country every economy has bogged down the physician with administrative overhead you talk to a doctor in us they'll tell you one third of their time goes towards administrative stuff meaning one third of their time they're not practicing medicine they're practicing data entry you talk to the doctors in netherlands they tell you 40 of their time is spent in administrative stuff how are we going to have effective health care if you're not going to let the doctor practice health care i don't know of any physician regarding to the business of healthcare saying i'm going to be a wonderful data entry clerk into electronic medical record system that's my mission i'm going to be an amazing data entry clerk but that's what we're turning them into everywhere because it takes so much administrative overhead to protect themselves they are exposed in terms of liability risk they have to prove that they delivered the right service at the right time to get paid months later and they have hardly any time to grow their skill set which is necessary because medicine like every other field is evolving and you need to evolve with it but today we are finding that physicians can be up to 20 years behind in their therapeutic knowledge the time it takes to launch a new drug in the time it takes for physicians to feel comfortable prescribing it can be two decades why is that that's a real problem and this problem isn't isolated to any one country even though my experience has been primarily the us healthcare both government and private i've had the fortune of working in india and in china and in latin america and i can tell you the problems are the same and then there is a regulator because healthcare affects all of us there is always regulation involved and the thing is the regulators are much maligned and i used to be one but the issue here is that the regulator is trying to make sure that the patient and the doctor's interests are aligned that one is not profiting at the cost of the other that third-party influencers aren't influencing care for the for the in the manner that better that hurts the patient that cost and quality of care are balanced that there isn't fraud waste and abuse in every health in health care system which every health care system has it and that there is accountability if you're going to deliver health care you're accountable for the quality and the timeliness of health care that health care is available to all those who need it that's why regulations exist to make those things happen but they're very hard to enforce and industry works very hard to circumvent the regulation rather than live by it now what what do we do about all this this is like sort of repeating the doomsday scenario healthcare works barely can we live with the status quo no we shouldn't i have been the much hated insurance company cio who would walk into a restaurant and once they figured out that i was the cio of the the big insurance company they would refuse to serve me because they imagined that i'm denying claims and rejecting care for for the elderly far from the truth but that's the perception because the system is set up to be adversarial so what can we do about it there are things that we can today there are some fundamental changes and the heart of it is the pandemic it has caused us to rethink what an efficient healthcare delivery model looks like i don't think of any country on the planet that can say our healthcare system is doing fantastic in the face of covet everybody is recognizing in inequities in access in excessive imbalance and demand and supply inefficiency in incorrect information the misinformation pandemic which is almost as big as the pandemic itself the inefficiencies in the process the lack of technology availability there are a lot of things that make healthcare difficult to improve but there are some positives as well we are seeing a global adoption of digital technologies we are seeing a global recognition that patient rights and patient control matters ownership of data should not be automatically based on custody of data there are lots of things that we can do so the timing to improve healthcare is now and blockchain actually gives us some tools to do that a lot of people ask me pretty you were in this big government space and you were in the big insurance space what made you you know go from there to working in this crazy technology called blockchain and everybody thinks of blockchain as some kind of a cryptocurrency framework well look technology is a technology how we use it is how the value of technology to humanity is going to be and cryptocurrencies are a legitimate use case but so are many others in our mind blockchain gives us the properties that healthcare can benefit from transparency to begin with auditability of what happened and what didn't happen security over data and immutability so we don't have to continuously capture administrative consents and forms and documents just to prove that we did the right thing immutability blockchain is a great defense against accusations of impropriety which is one of the big problems in healthcare so what we are trying to do at softcare and we have done very successfully is to put the patient the center of the universe and to design a platform around them where the patient's autonomy and rights are fully enforceable auditable immutable and in violate where providers can effectively pursue medicine without having to do all the paperwork that they have to normally do and where we can achieve coordination between both known and semi-known parties in a manner that does not violate patients privacy and rights and we can actually restore the control of data to the party that needs control not the custody custody and control can be separated and the blockchain can give us control without having to have custody those are the reasons why we are excited about using blockchain in healthcare so what do we do as a company now a little bit about solve care we are effectively building and have built and launched in the market a decentralized network platform the idea is very simple let's build a salesforce.com type of a product using blockchain where every participant's autonomy and sovereignty is fully enforced in the architecture which means that every network participant has a role and that role is in violate their rights are in violate they have control over their data they can comfortably share the data with each other and they can give consent for the data to be used and they can revoke the consent if they don't like the use of their data and they can make real-time payments to each other on the abstract level basically what we're saying is every kind of coordination in health care that is needed be it clinical care or benefits or payment coordination you can essentially design a network quickly on our platform that helps you achieve a better outcome than today so in a nutshell we are allowing for patient-centric care networks to be designed and published with little to no coding requirement which inherit the properties of blockchain like immutability transparency auditability uh digital transactions and in cryptography or encryption where different participants doctor patient patients family members pharmacists specialists transportation home care radiology imaging whatever you whoever is in your team your health care team can participate in that network while maintaining a very clear sovereign role and identity and where they can protect their identity when they need to and they can still participate in the network on a semi on a role identified person de-identified manner and these networks essentially allows us to address all kinds of inefficiencies in healthcare i'll put it to you this way when i was responsible for a lot of backend systems for eligibility enrollment payment claims member management provider network management in a large group small group online exchanges the whole gamut of what a typical insurance company cio has to deal with i had a whole series of disparate systems that i desperately tried to connect and my budget variety was tens of millions hundreds of millions of dollars a year and i never could get those systems to talk to each other properly what we are doing is essentially using blockchain as an autonomous anonymous collaboration fabric where all the parties can participate in a specific role construct which allows them to do what they need to do without having to do any kind of a systematic interoperability so in effect we are replacing system to system transaction with a human to human transaction on the blockchain that being said there are these are the use cases so using our platform we have launched uh chronic disease management network so diabetes care network in participation with boringer engelheim or we are working on a suicide prevention and depression management network with another pharmaceutical company we have launched networks around provider payments based on outcomes not fee for service where providers actions and inactions determine the actual payment to them rather than how many times they saw the patient uh identifying care gaps and care opportunities one of our networks is focused on reducing fatality rate in adults the second type of networks that we have been able to configure and launch are around administrative how do i enroll in a health insurance plan how do i access make an appointment with a doctor in real time how do i submit a bill or pay a bill how do i get a verification that the service was indeed delivered how do i get a referral to a specialty care provider how do i get my pharmacy sent to the pharmacist and so i'm my prescription sent to the pharmacist so those are administrative networks again same model different use case and then there are healthcare incentives and reward networks where we can allow for delegated payment where the insurance company gives me a token rather than um then requiring the doctor to call them and when i go see a doctor i can give them the token which they can redeem from the insurance company and the token can assume the value of the service based on the service event that was generated on the blockchain in other words we can eliminate the need for claims we can eliminate the need for weight and pay serve and wait we can eliminate appeals we can eliminate adjudication and post payment chaos that typically happens and in fact we can pay the doctor in real time at the point of care rather than at the point of billing there are lots of use cases that our clients are finding in this model an inverted model of care that we have created and we believe that we are not the only ones as people understand this very innovative use of blockchain as a coordination fabric you're going to see others emulate what we are doing we just happen to be the first to market there is also a way to dramatically alter the payment flows and this is a big problem in healthcare healthcare is eight trillion dollars a year global sector four trillion in the u.s four trillion the rest of the world in the u.s we're anticipating and measuring and most studies say that we are wasting between 800 billion to 1 000 billion a year in administrative fraud and administrative costs fraud base and abuse in in we have these programs in the u.

s called medicaid and they typically give transportation assistance to the poor who need health care but can get to the hospital these transportation programs are extremely expensive and they are typically a fraught for waste and fraud you can many studies show that even up to 30 to 40 percent of transportation benefit that we put out each year as a country are actually black marketed for cigarettes and other things we designed a system a network where all the transportation benefits can be fully automated using digital tokens and in partnership with lyft and uber and this diagram just shows you how a very complex ecosystem of multiple parties of a healthcare insurance group client a a care sponsor a administrative entity a transportation provider a patient and a doctor can all collaborate on a blockchain based system which we actually implemented so this is not hypothetical my point in showing this to you is nothing to nothing more than to illustrate that healthcare is very complex it requires a lot of parties to collaborate when you think of encrypted digital tokens as tokens of authority and a blockchain as a coordination fabric you can streamline things that are unimaginably complex in real life and are very very expensive as a result our estimate is that proper application of this coordination platform that we have built in other platforms like ours we could trim off at least a trillion dollars a year in waste fraud abuse and administrative overhead and that money could go back into society or go back to actually taking care of the patient and that's just the united states in general our viewpoint is that help blockchain as a repository of data has some limitations but blockchain as a fabric on which you can coordinate can achieve better interoperability and we have proven that with our model of real time autonomous and anonymous interoperability as a as a real possibility and real achievement you can definitely reduce cost in terms of tr retention and storage and transference of data but most importantly you can reduce the risk as a physician i don't need to hold you know file folders of consents and forms in my back office and ensure that those are up to date for me to protect myself against claims of fraud or impropriety and if i am going to do something wrong it's equally easy for the other side to prove that i did or did not do my function properly so this lack of this lack of friction in terms of reducing risk is really important because that's where most of the physicians time and attention goes other than you know changing the payment that they are owed the auditability of the blockchain also lets you manage whether the utilization and quality of care is it per standard because in the end healthcare is always a triangle are we delivering the right care are we paying the right amount for the right care and are we delivering the right care to the right person at the right time that triangle is where you always have all the cost centered inside that triangle and having a fully auditable ledger of events between parties makes a triangle so much easier to optimize and to coordinate so the the nutshell of all this is that there is a way that you can deploy the emerging technologies and platforms like solve care to really address a different way of doing healthcare coordination since i've been in that space i can tell you that if i had the platform that softcare has built five years ago in my chair i would have implemented so many more patient-centric programs be it for my diabetics or my multi-chronic homebound population or my at-risk pregnancy population or at my or my palliative population there is so many things i would have wanted to have to i would have done that i wanted to do but i couldn't because the cost of doing a patient-centric program is very high you always have a small niche group of patients who need high-touch high-cost care and by the time you build an optimal system around them the needs of the patient or the protocols have changed and your systems never produced roi what solve care has done is made it possible to bring personalized care and personalized benefit to a wide array of people by essentially reducing the time cost effort and risk involved in launching launching patient-centric care and more importantly launching a way to pay those physicians in a both cost and value appropriate manner and to do so in real time and therein lies the opportunity to improve an eight trillion dollar a year industry which impacts us all and beyond the economics what we are really trying to do is to make the world a better place for our parents and of our children and as a father of a son who needs a lot of care i can tell you one of the reasons i left the the commercial insurance sector to start solve care is because despite my connections and access to the best care on the planet i found it incredibly difficult according to the care of my son and i realized that if i can get it done there's very very few people on the planet who can do it efficiently and therein lies the the mission and the purpose of solve care our ask of all of you who are listening or might hear this presentation later on you're all part of healthcare we were all born into it we're all gonna die in the arms of it our parents our children our friends our colleagues all live inside the healthcare umbrella because we all need it at one point in our life or the other so we don't need to accept the status quo we don't need to solve the problem at a macro level we can simply solve it for our society for our country for our city for our family for our friends and our mission here is to invite health care innovators and those who dare to think differently to come and speak with us and say we will give you access to our platform and you need to find the use cases for this platform that makes sense for you and your country and the place where you live and work and that's our vision that one day soon a physician will be able to launch a care network that serves their patients better and they don't need to become a blockchain engineer they don't need to become some i.t exec they simply can decide that they will deliver a better care model to their patients through a care network design it and launch it in a matter of days or weeks and actually see tangible value come out of that effort so that's what soft care is doing but more importantly that's what we think blockchain is capable of doing yes it can facilitate payments but equally importantly it can facilitate care and that's what we hope that you will take away from here and try to take advantage of i'll open it up for questions and see if anybody has any questions because victoria told me some of you may want to to um to do that and i see some questions here yes just if you take one question because we have the the next panel waiting but thank you so much for your presentation but please go ahead can you see the questions now in the checkbox i will just take the last one because and i'll try to answer these questions later in an email to you victoria so people can get these answers but as far as the question is if you have your phone is lost stolen battery is empty does a phone does not work abroad how do you provide coverage so the architecture of our platform allows for a digital twin of the phone exist on the chain what we call the evergreen node and even if your phone is off damaged lost or in or not in service your node always is green which means that in terms as a physician you can still accept and payments you can still accept appointments your node can essentially represent your pro your interface as an interface and the rest of the world and there is no break in service but whenever your phone is on and you finally connect it to the node you will sync with it but your digital avatar is always on on our platform uh i will let um the next panelist take from here but i'm seeing a lot of questions come through and i appreciate everyone taking the time to speak with me and i will get you these answers in writing and feel free to reach out to us at any point uh salt.care or info at salt.care thank you everyone thank thank you so much buddy yeah i think yeah you had quite a few questions you didn't have time to answer but um as you said they can reach out to you directly is through self.care but also i know some of your team members are umbrella platform so this is also a way to connect with your team if they want to know a bit more about your your project so thank you so much for the presentation thank you thank you thank you so much for being part of the european blockchain convention study and now i'll say to the audience please go to the schedule tab and then we will start with our next panel again thank you so much thanks everyone