Blockchain in Healthcare Panel Discussion at the EU Parliament

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Daniel Benjamens (Associate Director, APCO Worldwide): (00:00)

My name is Daniel Benjamens. I am a healthcare director working at APCO Worldwide and I'm moderating this next session on digital health. We've been hearing about blockchain for quite a while, but still not very well understood by everybody and more of course, what the implications or possibilities are for, for healthcare.

Today you want to talk a bit more about the concrete opportunities and challenges and, as we are in the European parliament, also would be good to explore a little bit about what are the required policy actions to further develop this in the near future.

We are fortunate to have with us today, a group of international leading policy makers and thought leaders on this matter. I'm about to ask them to introduce themselves. But first I want to hand it over to MEP Boni. I don't know if you require an introduction to this crowd, but I guess it's safe to say that you are one of the most digital savvy members of the European parliament.

You've been focusing a lot on digital health and I would like to ask if you have a few opening statements as the host of this panel.

Michael Boni (MEP- Justice & Home Affairrs & Technology, EU Parliament): (01:20)

First of all, thank you very much for the invitation and thank you very much for this concept. You said here to organize the whole day on blockchain because as I know there are many discussions, there are many debates today and it is very important to understand what kind of solutions blockchain can bring to us. When we are talking about ICT development, when we are talking about digital revolution, it's obvious that when we are talking about the digital health venue paradigm in the area of healthcare.

We get two possibilities open the by digital technologies. We need to focus on some issues. Firstly, it's how to process the data and how to use the data. Secondly, how to change the model and prepare the diagnosis much more oriented on real problems which is important for patients.

Michael Boni (MEP- Justice & Home Affairrs & Technology, EU Parliament): (02:05)

I think it's important to understand that when we know more about the patient, when we know more due to real time monitoring the state of health, some analysis of genetic conditions and so on and so on, we can prepare better therapies, better therapies in the health RR means personalized therapies, personalized medicine, personalized medical services. And I think it's very, very important. It's a changing the relations between patient and physician and doctor. It's changing the healthcare paradigm because now, in the tradition it's clear that we are reacting from some diseases and symptoms of diseases, but it should be much more focused on prevention. What is the role of the blockchain when we want to exchange health information and make it much more secure and make the situation much more complex?

We can use blockchain networks and blockchain solutions because this technology can develop the potential to connect fragmented systems to generate insights and give the better assets of values and curves. So, it's creating efficiency. On the other hand, we need to understand that this is the, if I can say the starting point for blockchain, so it means that we need to work on adoption and implementation of blockchains and it will be the evolution rather than revolution. But I'm ready to put the question yes. Because probably it could be also on the one hand, this is very disruptive, on the other hand, it could be much faster and go in the way, which will be much more of a revolution there. It's very important to understand how important the new understanding of the role of cloud will be when we will use the blockchain because it will allow us to analyze aggregated records.

Michael Boni (MEP- Justice & Home Affairrs & Technology, EU Parliament): (05:01)

And on the other hand, it's the new possibility to organize the streamline data flows across stakeholders, which is very important because it’s now opening the possibility for remote consultations and also using for some advisors, not by human doctors, but also artificial intelligence. This will be much more open for machine learning for a new model of conversation between patient and machine learning, with all the requirements, ethical and so on and so on. Patients should know with whom he's talking about his medical conditions with. On the other hand, I think that this is also the important to understand that blockchain probably will combine in a much more proper way. Some efforts that are important for monitoring of the state of health and the combination of the monitoring and analysis by using artificial intelligence and machine learning.

Michael Boni (MEP- Justice & Home Affairrs & Technology, EU Parliament): (06:19)

At the end, it's clear that we need to combine technological achievements and some requirements and the fitting of patients which are important for that feeling of security and privacy protection. And I think we need to focus on both. There is no one area so we can say, okay, we need to protect privacy, we need to protect security, but we need to be cautious with the development of technologies. They need to go hand in hand, shoulder in shoulder. But when we want to achieve some new goals, we have GDPR, general data protection regulation in the European union. We need to put some new questions related to GDPR and in the future to the privacy because IE privacy will describe in the future the, uh, model of transferring of data. And I think it would be very important not to kill the model, the possibilities of processing the data.

Michael Boni (MEP- Justice & Home Affairrs & Technology, EU Parliament): (07:31)

So, the legislation should be much more open than we have discussed in the first version is the European parliament. And I hope that we will come back into the next term to this debate and it will be much more open for data and data processing. It is important for creating the trust because each one requires the new model of trust between patient and physicians. The new technologies require us to build the trust between all users and the technologies. With blockchain, we can organize it in the complex way. And on the other hand, we can make it small and oriented for digital trust and built by a design. We also need to remember that a blockchain means that in discussions, it's clear the decentralization and also it is decentralization of data.

Michael Boni (MEP- Justice & Home Affairrs & Technology, EU Parliament): (08:38)

And some people are saying that now medical data belongs to patients.But forcing transparency with blockchain technologies may be helpful to create a new model where patients are ready to use the data because they feel that it will be secure and protected. And of course, I think that blockchain will create a stronger interoperability, not on a national level, but, generally, and when we are talking about adaptation of electronic medical records in last to 10 years, it's clear that every hospital seems to have its own vendor. But sharing and distributing patient's medical data from one provider to the another is now inefficient. Blockchain network can create the new possibilities and make it a much more possibility.

Michael Boni (MEP- Justice & Home Affairrs & Technology, EU Parliament): (09:47)

So finally, we need to solve interoperability problems and blockchain because it's ready to help us. I think that it would be much easier to create a better interoperable solution by using blockchain models. It's also very important that blockchain will create the special value chain and relationships between all stakeholders, researchers, patients, healthcare practitioners. And then the access to data, stored in database, stored in this cloud, stored in networks will be much more open and useable for patients. And also, I think it is important that data sautéing in platforms so it can be quickly distributed into servers in different arrives without single failure or disaster. The more transactions we will have. And it's clear that the more transactions that happened with the data, the higher the value of the network will be.

Michael Boni (MEP- Justice & Home Affairrs & Technology, EU Parliament): (11:01)

So, I think that we need to discuss what is needed when we are talking about the framework. And when I'm talking about the framework, it doesn't mean strong legislation because I have a little distance, but there's strong legislation before because technologies are developing much quicker than our legislation. So, I think that we need to be much more open for light models of legislation for code of conduct, self-legislation, self-regulation and so on and so on. And I think that today just the discussion opens an IRR of the blockchain technologies for e-health. We are working on the communication done by the commission and we are working on the framework for the future of the European parliament, how to use and how to build a strong background for e-health also using blockchain. Thank you.

Daniel Benjamens (Associate Director, APCO Worldwide): (12:06)

Thank you, Mr. Boni. It's clear that you give it a lot of thought. And let's hear from the panelists if they agree with everything you said and maybe they have some additional questions for you about what is required from the members of European parliament.Now I would like to move over to the panelists and ask them quickly to introduce themselves and share a few initial thoughts about the topic from their specific perspective. I wanted to keep it very short, so about five minutes. But we actually lost one of the panelists on the Belgium highway this morning - Mike Hennessey couldn't join in the end.That means that you have a little bit of extra time. So, one more minute. So that’s maybe a positive effect of that. I want to start with an invite, Mr. Rys, to share his views on the potential future of blockchain driven healthcare systems. Maybe from the perspective of your current position as director responsible for health systems, medical products and innovation at the European Commission, but perhaps also from your personal perspective as a medical doctor specialized in radiology, in public health.

Andrzej Ryz (Director Medical Products & Innovation, European Commission): (13:20)

I think you're right, Daniel. So, you introduced me already. So yes, my job in the European commission is working in the department of health systems, but also medical products like authorization of medicines. I can also have a few words about the data and R and D pipeline. I think it's clean on paper. You know, when you read this, the blockchain technology has potential to bring to the table the changes in the healthcare sector. I am happy that I am putting this in this meeting because it's maybe the next step to open the eyes of the potential users of this technology. My colonists know that we have to avoid the, the shooting of black box, you know, the people you, you bring this technology to, to physicians or hospital managers or reimbursement and you say, ‘okay, it's going to work.’

Andrzej Ryz (Director Medical Products & Innovation, European Commission): (14:29)

If it’s my son, you know, who is one of my three children in the business, he said, try to explain, how this is working. You know, I said, well, it's working, but what is in it, you know, if all the terms he used it was completely foreign to me. I am new in the digital world, you know so, I think it's the first step to explain this is not magic solution, it’s not black books. Because what I think health professionals haze that you bring the solution and you don't explain what this is. So, I think this would be my first remark before I go to other important things. When you see this again from the concept of healthcare today, you know, there are lots of ideas.

Andrzej Ryz (Director Medical Products & Innovation, European Commission): (15:15)

They're very close to the heart of the policy makers. You know, you just mentioned transparency. It's almost in every policy paper we develop around the globe, there's centralization again and those in nature of the health system accountability, it's addressed basically the same. It just mentioned the main three challenges in the health sector. But what can bring this magic solution and interesting solution to the citizens? I think, what was mentioned by Michael, this is fragmented health data. This is what we hear. You know, when you go to the GP offices, I don't have access to the hospital, the records. And I would like to help you, but I didn't see your like ECG exam or spirometric exam or your blood tests, you go again to, to get the blood test because I don't trust this data even there on the paper.

Andrzej Ryz (Director Medical Products & Innovation, European Commission): (16:22)

So, they're related to the individuals in the system, but they are competitive, fragmented. So, they say stitching this data together that this can help build this, as we call the health profile. The other problem is a lack of citizens secure access to their own health data. You know, when we did a study last year before we publish our, where our communication on digital healthcare, we understood the citizen so basically, they don't have problem to share data. We see kind of rather positive outcome. But of course, then the things that are coming, you know, trust and security, and of course, you know this is what individuals are happy to grant, but they also like to make sure that the access is easy for them.

Andrzej Ryz (Director Medical Products & Innovation, European Commission): (17:26)

But the data is also secured, so citing this is what we see as a commission, as a prerequisite of this game change, of lack of interoperability. There's this other problem in the health system, so we know this. It's the currency transfer of data between clinicians and the related actors is very difficult.Blockchain may help, but also, we cannot bring the solution without work done by the healthcare professionals themselves. You know, this is not that we employ technology for example. It's not that great in the professional cycle that there is a standard of communication. And I give you example, we try to, to see for example, how you see how many transactions you can see in the radiology field. So, in one country, the way they pay for a radiology services are generating almost 3,000 codes, transaction codes in other country when the block approach you have 14.

Andrzej Ryz (Director Medical Products & Innovation, European Commission): (18:37)

So, you know especially when you start to do this transaction and know between different providers and payers and always going a create nightmare. So, security, dynamic consent, I think this is the for the transfer of health data, it's blockchain again, you know, seems like a solution. So of course, it's attracting our interest and if this transfer can be granted by eBay, by patients and the concept could be modified. This again is giving the potential of this technology to the health and other things with work. I think the patients we spoke to, health care professionals, but I think patients, citizens, you know, he or she is the supporter because if the trust is the issue of that access issue, if they're my rights, our issue of course I can support the last point of the benefit of this technology, which we really feel that our study all kinds of documents with multi-team is the, is the management and we just recently, last week published an ECG report about helping classes as a part of our communication around the state to help you.

Andrzej Ryz (Director Medical Products & Innovation, European Commission): (20:00)

And one of the ways we try are two topics. One was mental health, but the other one that was about the waste in healthcare. And of course, you know, those of you working in the health system, you know that sometimes in the hospital, a manager is surprised when you do study that.According to different articles, I have seen the up to 20% of medical devices there are not authorized to be in the hospital. That's not there, you cannot use them, but simply that are coming to different routes or they are not used or the ratios and so on. So, even the supply chain, is a show. I have seen the study in the hospital at mass general one day when they showed that you can increase and reduce the cost of operation and to Arthur basically better management.

Andrzej Ryz (Director Medical Products & Innovation, European Commission): (20:53)

So, you don't need to spend more money. You can also reduce or relocate, you know, some savings. So, saving money is a big issue. Or why relocation is an issue. So, this may be something, you know, we can also, put on the number of payers were also see this technology as a, as a way to reduce the frauds, you know in the system. Because there is also clearly the way to make money, not the correct way. So, this technology, combining medical and, and transcendent, fascia transaction can help. But it's a bit about the kind of difficulties we are facing when we study this approach. The first, I think that the cautious is that I already said to understand, you know how this makes with the transformation because this is I think critical.

Andrzej Ryz (Director Medical Products & Innovation, European Commission): (21:51)

A second is how we address the privacy concerns, you know, and how this canhelp because you know the wrong direction when people will say, ‘okay, this technology is going opposite way than promised, you know, so this is what comes across.’ We have to avoid already just mentioned about the GDPR and the right to erase, you know, how this will work. You know, this should be also explained, because we know now access is possible. Transparency is possible, but so for example, right to arrays is working in this system or not, this was unclear to me. Trying to understand better a decentralization frame ago. So under GDPR is also a quite dynamic issue. Because you know, who is the controller and who is a processor in this system.

Andrzej Ryz (Director Medical Products & Innovation, European Commission): (22:44)

You know, I think we'd be very, very interesting for me to understand because, you know, it's very difficult and for finally the privacy sensitive that needs to be preserve on old calls because the trust lost reveal will be very difficult. What is the next step creativity of the policy frameworks of the regulations? You know, the experiments pilots, we see them already going on in show countries. They’re still the very small scale that I think is good because if they will work, you know, I hear from one government, they're ready to cut up at the fairs. They would like to try with the small transactions and medical evidence, which they hope would not harm if something goes wrong, clever approach. And then finally we should explain in a what we'll drink, what kind of efficacy in the system this will bring, you know and I don't like to kind of balance between the money efficacy, cost saving waste management in the healthcare sector against this transparency accountability and sits on the rights because they are both important on the same level. But I think it's good to discuss this, you know, because I think the trick, which way blockchain takes us. Thank you.

Daniel Benjamens (Associate Director, APCO Worldwide): (24:14)

Thank you, Andrzej.
I think we heard a lot already about the potential and the concerns of this technology. So, I think it's time to listen to the people that are, are working on the solutions. And I wanted to start with Frank ricotta. He's the CEO of BurstIQ, a company providing end to end enablement of blockchain based health application services. So I would like to ask if you can explain briefly what this exactly means and how you believe a blockchain from your perspective will impact, um, the health sector and maybe also confirm or deny whether or not addresses some of the concerns that

Frank Ricotta (CEO/Co-founder, BurstIQ): (25:02)

Well, thanks for having me on the panel and excited to be here. So, and thank you for the introduction. So, let's take a step back in terms of what, what is the, what is the broader impact potential of blockchain? Because you know, I started burst IQ three and a half years ago. Blockchain was a fundamental building block of what we set out to do. Um, and why, why was that? Well, we, we think there's a broader need, um, and that is providing more of a university health, uh, universal health equity and access. You know, it's just not about taking medical records and putting them on a blockchain. It's, it's providing a whole new kind of access economy for health and health services by empowering the individual. And really at the core of that is data, you know, allowing individual own and control their data and to gain value from their data in terms of how they interact with their care providers, how they, how they can use that data to live a better and more healthier life and even potentially monetizing it.

Frank Ricotta (CEO/Co-founder, BurstIQ): (25:59)

Because at the end of the day, data really is the currency of digital health. Know everybody wants to own it because they know it's extremely valuable. New companies are generated every day, every day to generate more of it. Researchers are, are hungry, hungry for data to produce a new and innovative health, healthcare and treatments. But we're still at this fundamental root cause at individuals. Have a hard time accessing it and let alone understanding it to use it in a productive way. And that's the problem we set out to solve. There's no, no other industry within health and health really isn't one industry. There's a lot of verticals within the healthcare space and on one end you have large hospitals and systems and doctors and physicians and other care providers. On the other end, you have pharmaceuticals and biotech companies. And in between you have this whole plethora of digital health service providers, uh, addressing individual needs at different levels from dealing with chronic conditions, which by the way, 80% of all our doll, 80% of all money spent in health is really associated with chronic conditions, diabetes, heart, a heart disease, um, blood pressure, et.

Frank Ricotta (CEO/Co-founder, BurstIQ): (27:13)

So, where what's missing is this unification across is this notion of connectivity, of connecting all these, all these little data islands in a way, way that makes sense. And that's, that's really where blockchain fits in that is in providing the roads and bridges between all these various dimensions within, within the healthcare community. Um, so some of, some of the things I want to address as you know, I really, I really do strongly believe in this notion, in the, in the transition to personalize our person centric person centric medicine. I think that is really the true hell, uh, the true tipping point in this whole conversation. And in my view, really a health singularity. And that's a convergence of all these precision men, these new and emerging precision medicine tests that address really the primary determinants of health. How, how I, how I'm built as a person, my genetics, our genomes, how my body is functioning as phenom and cellular type tests as well as kind of the second, second tier of data is all these, all these next generation of IOT devices.

Frank Ricotta (CEO/Co-founder, BurstIQ): (28:20)

You know, I'm not talking just about a Fitbit that can't count your steps. I'm talking about things that really provide quantitative measurements of how, how your body's working or how you're living in a certain way. Because let's face it, 99.999% of our lives are lived outside of a clinical environment. You know, we go see a doctor, a physician when something's wrong and the systems are all set up to deal with, you know, a patient encounter, not a person health, a person's health journey and health profile. Yes sir. There are really good doctors out there that, that really strive to do that. But the system itself in terms of how it works, how people get paid within the systems are all dealt with sick care, not helping somebody live a nice healthy, healthy journey or building a journey map with their, with their health profile. And I think that's where blockchain comes in.

Frank Ricotta (CEO/Co-founder, BurstIQ): (29:13)

You know, blockchain provides this, this, this amazing longitudinal view of you, of a person. You know, it makes the quantify itself, uh, become a reality. Um, and in, in that, you know, it enables us to again, interact with our, our care providers in new and meaningful ways, in virtualized access because I have a better view of who we are as a person, you know, without me having to sit in, in front of them and poking me with a needle. It allows me to, to really move across different types of care providers. You know, we're going to see 16 doctors over the course of our lifetime as an example. The need for really being able to present ourselves as a person is become, is becoming more of a necessity to deal with these. Costs within the health systems and I don't care where you are in the world, there is still some fundamental problems.

Frank Ricotta (CEO/Co-founder, BurstIQ): (30:11)

You know, I hear, well the U S is different than Europe, which is, you know, different than Asia, you know, it to some degrees. I believe. I believe that's true from a health delivery system.In other ways I don't, I mean I still hear the same stories in single-payer systems about the ability to share data across care boundaries are across the entire care continuum. They're still here. The same stories about people have horror stories about people getting the type of care they really need are really, you know, dealing with the right kind of medication that suited for, for themselves. You know, let's realize half the half the population, half the population of those that are 60 years or older are on, on the wrong medication or the wrong kind of drug cocktail. Uh, why? Because they'll see doc, one doctor and then another doctor. Then the third doctor all prescribed them something different.

Frank Ricotta (CEO/Co-founder, BurstIQ): (31:04)

And then when you get in emerging growth areas of the world that are ha have access to the same kind of care or the same kind of opportunities. Um, and I'm going to throw this out just from a clinical trial perspective. You know, 90 plus percent of all clinical trials are in North American, Western European. I don't think we have 90% of the population. You know, there's quite a diversity that we're just not touching at this point in time that a system like this would enable the next generation and the next type of clinical trials. You know, more virtual trials. They don't have to be specific where experts truly can collaborate without the fear of compromising underlying intellectual property. Our ownership of their research, which I think can be very, very powerful. So, from a burst IQ perspective, you know, this is where we come in when we say we're a blockchain enablement platform.

Frank Ricotta (CEO/Co-founder, BurstIQ): (31:58)

Really what we are is we're a network of care providers, businesses, small and large, uh, connected with each other. And you know, all those focus in the health space and with the people they serve. That's what our intent is. That's what our broader, our broader mission is. Um, and unlike most blockchain companies, we were well beyond talking about a lot of use cases. We've been actively in production with large hospital systems now for almost a year. Um, one of our cornerstone clients has driven 20% other costs of surgical operations, um, uh, out of their system. That's a lot considering most hospitals, half the cost of most hospitals is centered around surgical operations. So that's either reduction of costs or an increase in capacity. That's amazing. Right? And on the other side, we have biotech and pharma companies dealing with um, concept, uh, you know, improving supply chain and dealing with fraud and eliminating fraud, you know, but from our perspective, you know, we're not, we're not all those applications. Burst IQ is not all those Apple applications. We focus on making data usable for those applications and transportable across those applications, which is really one of the wicked problems in health data is, is probably the number one problem in health and health systems, regardless of where you live. Um, and if we make a small dance in that and we change the whole access economy and how access method for health and health services, you know, I think we've done a great benefit for society.

Daniel Benjamens (Associate Director, APCO Worldwide): (33:33)

Thank you. That was a lot of information. I think you're trying to get in the black box with Andrzej spoke about and make, make that usable. That's right?

Frank Ricotta (CEO/Co-founder, BurstIQ): (33:44)

You know, I think it's important to nail down, is that, you know, we talk about blockchain is one thing. You know, blockchain is not one thing. Yes, it's a, it's a technology and there's lots of different ways to implement the technology. And I'm sure the technologists in this room each have their own view of which one's the best. But really blockchain is more of a way of doing things. And, and that's really more of a way that's talking about democratization or enabling individuals and individual liberties and in a way that's productive for society. You know, and government and legislation and regulatory bodies all have a role, a role to play in all of this. Not from the standpoint of directing how the technology itself evolves, but in what they're supposed to do, which is, which is to protect us as citizens and provide safe environments for us to live our lives.

Daniel Benjamens (Associate Director, APCO Worldwide): (34:37)

Thank you. That brings us to our last panelists. I think in the beginning we spoke about the need for health care professionals where people have a medical background to understand better the technology. I think that it's a good way to go through you, Alex Cahana, to share with us your journey and how you ended up working on blockchain.

Alex Cahana (Head of MedTech, Crypto Oracle): (35:02)

Thank you. And, uh, thank you for APCO for, having this important discussion. If blockchain in general is a sideline discussion, then blockchain and healthcare is even less than the, and the interest becomes even more pointed.I do want to say a few words about my unusual journey because that will explain also my focus is on blockchain and a lot of problems were brought up in the last half an hour. I'll just try and in on four main messages because for people who don't live block chain on a daily basis, this could be dizzying. I ride in my medium moniker that I lived four lives in one, which means not all the, and I'm old, but also, I know the dirty little secrets of each life. And so, the first life was in the military saying not only that we're mission-driven and data driven and situation aware, but really, we understand that none of us is as good as all of us.

Alex Cahana (Head of MedTech, Crypto Oracle): (36:05)

So, this whole concept of decentralization is natural. This whole idea of community building, this whole idea of interdependence is something that is second to none. I've been since medical school, 30 years, so I did not graduate thinking that I'll be a leader in the crypto health field. I built four pain departments in my career, so it's safe to say that I'm familiar. It was in three different countries that I'm familiar with. Global health systems, both as a provider, as a patient advocate, as someone who's done laboratory research, bed research, familiar with working with insurance companies, with vendors, with the industry. I was sucked in in the United States until the opioid epidemic, which is a total failure of healthcare delivery. And so, as we speak here, I want to remind you that every seven minutes someone dies from an overdose.

Alex Cahana (Head of MedTech, Crypto Oracle): (37:03)

So, we need to move a little bit more gingerly on solutions. That exposed me to the regulatory and legal aspects of it. And I became a subject matter expert for the department of defense and the veteran’s administration. So, systems thinking and systems design. And in the last 10 years I've been, uh, consulting investment firms on digital cuticles or digital solutions. In 2014, I was frustrated, like everyone not understanding what blockchain was, then spent a couple of thousand hours diving into it and, uh, became people, said a, a crypto influencer. I like to think myself more as a crypto Sherpa, you know, helping people get down from the mountain and not, you know, killing themselves on the way down. Um, I am currently a head of the crypto health advisory, uh, at crypto Oracle, which is a VC, crypto fund. And I see dozens if not hundreds of, different healthcare and healthcare related projects that come to me for advice.

Alex Cahana (Head of MedTech, Crypto Oracle): (38:10)

So, I'm paid to tell them that what they're doing is nonsense and it gives me a great grasp and I invite you to read my posts on medium. Uh, that'll give you an insight into these Scott's. There are four things that I would like kind of to focus on because the panelist mentioned a lot of important things. The reason for the first is description and people don't explain, well blockchain the number one reason that I think we don't explain what blockchain is because we don't, we describe it. So, so when you say someone, what is water? And they say water is h20 if you don't know what H is and you don't know what O is, it's like say waters w a T. E. R. so we don't explain blockchains here. There's a public ledger or we use words that were invented in the last two years.

Alex Cahana (Head of MedTech, Crypto Oracle): (39:01)

It's meaningless. And so, we need to go into the beginnings of blockchain to understand the intention behind it. And so, when we go to Satoshi Nakamoto Genesis block, and we read the VAX version a of it in it, he, between the numbers of that protocol he put in the chancellor baled again RBC. So, in his mind, the whole idea of digital money is to overcome or to decrease the predatory practices of centralized organizations. So, this is really what it's all about. It's all about, uh, us today living in a world that we are surrounded by centralized institutions that are using our data, our money or information without our explicit, uh, consent in a way that is not beneficial to us. And, and, and, uh, um, so that's, that's one thing. The second thing is that because data is the, the, the currency that we talk about in healthcare, we about a lot of things.

Alex Cahana (Head of MedTech, Crypto Oracle): (40:16)

We talk about security; we talk about privacy. What we don't talk about enough is ownership. And so, when 23 and me goes and sells my information for $300 million and I don't get anything from it, that is not okay. When Facebook does what it does, that is not OK. So, so, so it's about the ownership. Yes. A military grade encryption is really excited. Zero knowledge proof is excited. There's a whole host of your technologists. You can get really aroused by all the things that are happening, but, but it's really about empowerment, about ownership and, and, and, and, and is rooted in elements of dignity, human dignity and empathy. The third thing that I would want to say, and I've said this a couple of times in Congress and in different testimonials that I gave, when people ask what is the problem of healthcare? There are, we can spend a whole day of what the problems are anywhere from saying that we don't care about health.

Alex Cahana (Head of MedTech, Crypto Oracle): (41:20)

And that's the problem of healthcare. The fundamental problem in my opinion is, we are brought up in a system where we are health service consumers instead of health producers. So, we just do stuff. We go and we do tests and we take pills and we do a whole bunch of things okay. And we consume more and more of it. And their mortality actually or, or life expectancy in the United States has been decreasing the third year in a row. So, this is a low value proposition business. And so, we need to transform patients from health consumers, from passive health consumers to, to, uh, health producers. Now, what blockchain brings is not just the quantified self and what Frank was talking about knowing our own data. And actually, engaging in preventative, healthy behaviors. But it's also creating wealth that suddenly through different reward mechanisms, be it on utility tokens or security tokens. I can actually make money from being healthy. And so, data and health data are like money. It's mine. I can access it whenever I want for whatever reason I need to keep it in a safe wallet. And if my expectation is that it's valuable accrue with time, then also I can donate it and I can hear it.

Alex Cahana (Head of MedTech, Crypto Oracle): (43:05)

And this brings me to my last point and that is that it is mine.
And this David brought up in his historical review and the previous panel, where were all, some of us are old enough to remember that we grew up in an environment that we wouldn't speak unless spoken to his kids. We did not have expectations to any participatory a reality. Okay. We lived in a, in a democracy may be or, but we live in an authoritative, uh, mindset where someone who was older than you would speak, and you would not. And then somewhere, I don't know, it was the 80s, uh, Reagan Thatcher deregulation, internet democratization of knowledge. Suddenly it became human centric, patient centric, citizen centric, student centric. It was not nice to tell to people what to do, but it's not patient-centric anymore because 2008 happened and this representative democracy where our representatives did not represent us but represented their own needs and their own interests have created a movement of Holacracy, of self-assembling teams that we are doing stuff. I didn't fit the job description. David didn't fill the jobs that we went and had an urge. Woke up ask, do you want to help me? Do you want to help me do? And he said fine. And this is the world that's now human, right driven. Its student driven, its citizen driven.
And this is what blockchain does, this technology that works together of course with other technologies and it's not on its own, but it allows us, it gives us the tool to drive.

Daniel Benjamens (Associate Director, APCO Worldwide): (44:55)

I think now that we know who you are and where you're coming from and what you, what you're working on, it's good to start with having a panel discussion. I would like to invite everybody to participate. So, if you have a question or a comment, please indicate that by raising your hand.

David Siegel: (45:15)

My name's David Siegel. I'm a regulatory refugee from the United States living in London. And I want to ask Frank, I imagine that data in healthcare is doubling every 18 months or something like that, just like it is everywhere else roughly. Right. And you mentioned Fitbit and a bunch of another sort of, you know, quantitative quantify itself. I am concerned about rigorous nonsense. I am concerned that there is lousy data everywhere and it's getting more and more, and people are just generating data for data's sake. And your Fitbit doesn't tell have anything to do with your personal health at all. What the outcomes can, can you address a little bit about like how do we know what data is any good or use?

Frank Ricotta (CEO/Co-founder, BurstIQ): (46:03)

Well, I mean, that's a great question because you know, when you get an over plethora of data than what's meaningful and what's not meaning, you know, and this is where the next component comes in and some of it you guys addressed in the previous panel, which is some aspect of machine learning and intelligence and make it relevant. So, I think a lot of the existing IOT space is irrelevant personally because, you know, as I said, most people that have the Fitbit stop using it after six months. Why, I don't know, maybe they don't want to hit their 10,000 steps and it gets frustrated or is it that meaningful? But I do think the next round, uh, the next round of things, uh, are going to be very meaningful. You know, take, take genomic genomic tests and, and reading some of some, uh, some of the markers from genomic tests on my metabolic rate for certain medications.

Frank Ricotta (CEO/Co-founder, BurstIQ): (46:55)

I think that's meaningful. You know, I think reading some of the pro denomix, type tests in terms of how my body is functioning, I think that becomes very meaningful. But that needs an interpretation. You know, me as an individual, you know, I'm not a doctor, I'm not a scientist from that perspective. So, it needs a level of an interpretation and understanding. But the quantity of those kinds of data, you know, just one protein read, proteomics read is really the equivalent inside to doing a high-fidelity genome scan, genome sequence. And I'm going to do those pretty regular now. And then with the, you know, with the advent new techniques to draw blood, you know, these little micro draws, that make it a little easier to do that. So, I don't have to go onto the dock and get poked with a needle.

Frank Ricotta (CEO/Co-founder, BurstIQ): (47:40)

So, you're going to see more quantitative, true quantitative measures. And I think some of the IOT devices are going to are going to be true, true quantitative measures. We’ve seen some of this, although it's not been pro productized on a broad scale, a continuous measurement of blood sugar, you know, with contacts. That's very valuable. You know, things that IOT devices you may swallow and provide some internal measurements become very valuable. So, I just think we're just seeing the start of what's valuable, but it's, it's more than doubling every year, by the way on data. It's, it's almost like a 10 X on the, on the healthcare side of life. And I will contend that most data in current health records are meaningless for you going forward. So rather than trying to pull it all out and stick it in a blockchain, I say we take a starting point with this next generation of health and use that as a basis to move forward. And then yeah, if we can get some of that old stuff in. Awesome. That's great. Let's do that. You know? Yeah. Let me see my cluster. I'll read for the last 20 years I would be prayed. I'm not sure how relevant it is for me tomorrow just yet.

Alex Cahana (Head of MedTech, Crypto Oracle): (48:45)

I would like to add also, I'll be even more provocative in, in saying yes, you know, obviously machine learning, we'll, we'll refine our understandings. But even as we speak now, we, we quite understand what are the questions that need to be asked. And if we look at the bulk of the burden of diseases that are out there in at least in the OACD countries, uh, and now also permeating into developing countries, we're talking about heart disease, hypertension, heart disease, uh, obesity, diabetes, all these lifestyle modifiable diseases. And then we included to that mental health and pain and alcohol and smoking and so on. And for those, for the bulk of chronic lifestyle modifiable diseases, there are only two questions that have been found to be correlators to your, your, your life. And that is one, your zip code and your second is the presence or absence of adverse childhood events. So, I'm not saying that, uh, Genomix and phenomics and proteomics or whatever, or mics are not a thing and that we don't need to do it because we'll do it for more emotional reasons. Cause we have this fetish towards numbers that we feel more secure if we know all this and then we'll figure out some optimization technology to, you know, S uh, sift away the stuff that is noise. But the real question, okay. It's not really complicated that it's the social determinants of health. People have clean water, clean air, uh, green, uh, green parks is the only vegetable in our neighborhood. Catch up. All these kinds of things actually will determine life expectancy.

Andrzej Ryz (Director Medical Products & Innovation, European Commission): (50:38)

I like it. You know, I love the concept of moving from a service consumer to the health producers as you rightly said, but, following your question and discussion around the data. Yeah, it’s one hand, you know, how to manage this, this capital of Kalief, you know, with all this information, location, you know, our quality water and so on, uh, against the situation that, uh, still, you know, the small percentage of citizens are chronic patients. So, they are in the constant interaction with the, with the healthcare sector, you know, because of the, one of other diagnosis. So I think that we always will deal with, uh, with, uh, with one concept, which is try to get the data which help us to maintain the health capital, which Alex explained this a is a, is a good to have and maintain even to be paid for this.

Andrzej Ryz (Director Medical Products & Innovation, European Commission): (51:43)

It's a very interesting concept as well, which were explored by the way, by Singapore some years ago when the concept, you know, it's something we have seen and then we go to the, to the situation that, that the interaction with data montane we see now the, in the kind of quite big network of clinic in the European reference network, we have thousands of clinics connected that age. Patients coming with the rare diseases case. It's just a mountain of data. And of course, you know, there's data should exist and should be this cause and then, assess to get the right diagnosis. Because even if you have great capital health capital, you still may have very serious, this is what you have to manage with a huge number of data. But of course, the next problem is coming with all the sensors, data, all the nice monitors we can then we can register, you know, everyday our heartbeat, our osteoporosis, glucose is whatever. But how data can be analyzed and what did it make sense? This is something goes so maybe we should not forget about medical professionals and the standards and guidelines. I don't, so far, I don't believe that there is a complete change in the world that machines will tell us, you know, what to do with some medical problems because we still need human touch. Maybe not in the next 10 years, but, but so now I don't believe that machines will, will answer all questions.

Michael Boni (MEP- Justice & Home Affairrs & Technology, EU Parliament): (53:26)

What we need to remember about the quality of data because we are living at the time in which we are collecting all kinds of data. But I think it should be, it shouldn't be related to the type of the disease. It should be, uh, related to the possibility to compare the data. So, some standards are, are, are very important. And the quality of data is also related to the complexity of data in some diseases as it was mentioned when we are talking about some mental diseases themselves, the lifestyle information, lifestyle data are very important in some, much more important are the data, all different types. Yes. So, so we need to, to separate the, the, the ways and to differentiate. But on the other hand, when we are talking about this, about this quote, quality of the data, we need to remember about the message from the general data protection regulation, which, uh, which means, uh, when we are starting to process the data legitimacy, it should be, it should be based on legitimacy.

Michael Boni (MEP- Justice & Home Affairrs & Technology, EU Parliament): (54:36)

And of course, I think if we will have much more precise described the, the needs and expectations related to data, we can start to not only to go this way, uh, of a patient centric S and as you have sent, it's very inspiring, patient driven, as with participation of, uh, of patient. But also, I think, uh, uh, it would be much more, much clearer, uh, what does it mean not only my control over my data, but also my openness for donating data in addition. So, I think it's also related to the knowledge of what kind of data are qualified and are needed for very early research and after that real diagnosis and after that support and help to [inaudible].

Daniel Benjamens (Associate Director, APCO Worldwide): (55:26)

Would you like to respond to this question? Okay. Well that, let's be just to then finalize this question. I think very interesting to hear that, you know, we're looking at data as the fuel what we put in blockchain. We talked about the importance of having the data from nurture in nature. I think it's a legit question. I think we're agreed at the current generation of tools, may not be everything we need, but it's in development of the next generation of tools will probably give us a more reliable source of input for blockchain. Just go ahead.

Speaker 7: (56:02)

Thank you. So, my name is Maria I'm from fetch AI. We're an AI blockchain and digital economics company based in Cambridge. And I actually have a question because I've been to a healthcare unblocked in London. I listened to you there. We met there. I'm here and I'm just going to read, I'm not from Estonia, I'm from Slovakia originally. I live in the UK, but I just want to read about Estonia and it says I'm on the website here. Each person in Estonia has a, that has visited a doctor. It has an online e-health record that can be tracked, identified by the electronic ID card. The health information is kept completely secure and at the same time accessible to authorized individuals. K S I blockchain technologies being tested for the system and it will be implemented in the near future to ensure they tie integrity and mitigate internal threats to the daytime. And I have three statistics here. Out of four, 95% of a health data is digitized. 99% of Perce decryptions are digital and 100% of electronic billing in healthcare is there. So how come they're not here? Why are we not having them here in this panel discussing what they have done, their far events? I think they're probably the, the, the most advanced country in Europe that has digitized almost everything, pretty much. Um, they're, you know, using a certain kind of blockchain.
Uh, it's not public as far as I know, but, but still, you know, they have so much more experience. Why don't, why don't we have them here?

Daniel Benjamens (Associate Director, APCO Worldwide): (57:28)

Oh, they're not here because they couldn't come. We definitely invite them and talking with them. On the other hand, I can say that, we spoke to them about this and, and they also admitted that, you know, yes, they may be over the leading country in that sense, but they are also a relatively smaller countries, so it's a, they have a different starting point than other countries, but yes, it would've been great to have them here and I know that they're leading the discussions here in the institutions as well. So, they're already kind of, um, very, very much involved in the existing, uh, policy efforts. Uh, but yes, but also, I think that yes, they advanced a great bit, but they also have still a lot of, um, barriers they need to overcome as well in terms of, um, uh, ownership and access, uh, of the blockchains out there. Yes. It sounds very good, but they're also not there yet.

Speaker 8 (Maria): (58:23)

Yeah, I agree with that. So, I'm sure they're not 100% yet, but I think there are farther than we are. All of us in this room probably, we're wanting to be an, I understand they're a smaller country, but you started with a pilot, always you started with something small and then you scale up. So I think it would be really helpful to all of us to understand what they have done, what kind of issues they have encountered, how they have overcome them, and then learn from that and together build something that's uh, that's going to work and scale up.

Daniel Benjamens (Associate Director, APCO Worldwide): (58:48)

Yeah. I think it's also a very important point you make in terms of you know, we spoke about there may be difference between Europe and the us and elsewhere, uh, across the globe. I think yes, we deal with the same challenges, but I think in Europe we have additional challenges in terms of here we have so many different health systems and yes, we may have a, a case study or a, a pilot country, but then, yeah, whatever they come up with may not be applicable in other countries. So, it's an additional challenge. Um, but

Speaker 8(Maria): (59:22)

That's true. And just for your information, you may be aware of that. But I think at the moment they're starting a new pilot. They will be testing, uh, the digitize, uh, exchanging prescriptions between Estonia and Finland. So, they are already involving other countries in this pilot and scaling up. So, I think we should probably, you know, um, thank you that it's great that you've tried, but I think perhaps in the future we should really make sure that we have somebody, uh,

Speaker 9: (59:46)

Yes, we need to be stricter. I think his Sonia is certainly irrelevant, but this is a centralizer pros and we are now trying to see what can be a decentralized approach within a different ecosystem and a different LA racial nail for having incentives aligned. And so, coming back to blockchain, it is a design element. I think we live here in the combined world. We have a great technology, which is blockchain. We have a great regulation, notwithstanding what, David Seigel, will say about GDPR, which has to be implemented, which doesn't foresee, explicitly the blockchain, which needs to be worked upon on this something which is possibly combining the GDPR. And blockchain is the fact that in blockchain we can use smart contracts, smart contracts can handle consent.

Speaker 9: (01:00:59)

The blocks, the GDPR is very much about consent. And so, this will be possibly a higher way of dealing with all this. And I think this is important. I am representing here a little, a European project, which is called my health my data. We are working on this. But on the other hand, the is the big question that until we find a way for really making data sharable and tradable exchangeable, there will not be an incentive for doing anything. Even the passage from data consumer to data producer means implies that something like this is in place. And this is a connected with another type of technology that is the privacy preserving technologies, which go with it because blockchain need these with transections. But, this implies in using, so there are two aspects of the privacy preserving issue, that one is the fact that you need to be, uh, allowing for data publishing in some way or another beat, pseudo revise, beat, anonymize bit as synthetic data.

Speaker 9: (01:02:16)

There must be some way there which is GDPR compliant and very straightforward. And the other thing is that you can have data computation, which is another horizon now through secure, multi-party computation through a homomorphic encryption, which is a way of getting output results, something which gives you an answer to questions where you want to test an algorithm on a large number of data and then you can have on this basis. So, these are the things which I think should go together. There is the, it is a game with three players. There is the GDPR, there is the blockchain with its capacity or is privacy preserving technology with must come together and give solutions.

Alex Cahana (Head of MedTech, Crypto Oracle): (01:03:07)

I just want to say briefly, in both of the questions, you know, just want to make everybody attentive that the discussion here is very nuanced and there are very sophisticated considerations that are put into the fray that explain the possible barriers to adoption right now or speak about the next steps we should wait for, uh, for it to become more mainstream. I would just, because I'm a doctor at the end of the day and I see patients and I look at people and I tried to understand why they behave and why they say the things they say that most of the considerations of lack of, uh, adoption pertain to the normal human reaction to change. I'm sure you're all familiar with Kubo, Ross's five stages of bereavement. So, if anybody you hear thinking the room that blockchain is not a thing, you're in stage one, it's denial, right?

Alex Cahana (Head of MedTech, Crypto Oracle): (01:04:06)

If you're all upset because of all the scams and you think that 99% is just scams, you're in stage two, which is anger. If you're starting to say, well, you know, maybe it's a small country, it's a big country. It's us, it's this, it's the widow and morphic without all the, we are now ICLs STOs all this is now stage three the bargaining phase. Stage four is depression. Oh my God. You know, we lost 97% let's look back to the Amazon bubble. Let's try to calm ourselves down. I think this morning we were on the greed and fear index. I don't know if you don't look at that, but we were at like nine, which is extreme panic. But again, you know, United States, we have reasons why it'd be an extreme panic and only five stage five is the acceptance. So, all, what I'm trying to say is that we will continue this very sophisticated conversation because it is important because we are the specialists.

Alex Cahana (Head of MedTech, Crypto Oracle): (01:05:07)

And with the Estonians we'll be even better. But, at the end of the day, the drivers for policy, when I work with four star generals, when I work with the, the, the, the, the, the representatives both in the house and the Senate, it re it, it resorts or, or, or falls on much more basic human behavior instincts that have to do with the change and understanding the non-sustainability of our current behavior. Because when my wife explains to her friends what I do, I look at her and I say, sweetheart, that is not at all what I do. But when my 12-year-old explains, I say that's exactly what we're doing. So, we are designing a world for our children where obviously they're going to have their electronic healthcare record residing on their mobile, three-way distributed, um, cloud because it is attack resistant and sensor resistance and collusion resistance.

Alex Cahana (Head of MedTech, Crypto Oracle): (01:06:07)

Of course they will receive different types of rewards, monetary or nonmonetary in order to preserve their health are actually also when they're injured, do secondary and tertiary care because even when you are addicted and you are into drugs and you are in recovery, there are ways to gamify it. In a sense that you can maintain and resort back to life. So all what I'm saying is that this is a great conversation, but at the end, you know, what we really need to do is not only block Chenise healthcare but also Healthify if that's a word, the crypto space and the whole community of technologists, that lawyer.

Daniel Benjamens (Associate Director, APCO Worldwide):

So, first and thank you for that. Andrzej, do you agree with what he said, and this is also, does it apply you think, on this side of the maybe I can reflect on this depression change?

Andrzej Ryz (Director Medical Products & Innovation, European Commission): (01:07:05)

I think the be a doctor as well. You know, I really feel that okay. Patients roles is important. I know. And then they really feel that informed patients’ consumer as well. We'll play the game according to the rules, the he or she likes and so on. But now we cannot live without the health professionals as we know. It's a, I know we are the, I am defending over professional beds, but, uh, I have seen this in many, many situation that doctors are usually the, uh, most innovative, uh, guys, they really even know if the new technology coming to the doctor's office.

Andrzej Ryz (Director Medical Products & Innovation, European Commission): (01:07:47)

Usually we grab these, we like to use, sometimes we have all these, you know, five stages thinking. But most of doctors I met in my life, they are really kind of entrepreneur at ready for change. But the same time we are, doctors are very conservative and you, you, you always have this feeling, you know, and I ask time to time in the room, you know, who like to be operated by innovative or by conservative Sargent, you know, and usually people, the concept of active Sergeant who is the one who knows what he's doing, he isn’t here. This is, you know, a thousand times and he doesn't try on me. And this is the, I think the complex problem in the, in the change in the, in the health system, because in one hand that we run full technologies, uh, in other hand we are really, uh, skeptical and conservative to, to use it.

Andrzej Ryz (Director Medical Products & Innovation, European Commission): (01:08:37)

But at the same time, I strongly believe if we don't go next step, we will not get there. So, so in any full agreement, you know, the, that we are designing future and they still remember, you know, many years ago when a big corporation, when it was still my university shoes, you know, ask me to join the global debate about the future. And this time it was a question, you know, what will happen with the mobile phones, you know, we have them not smartphone this time they remember we conclude that it will be the day like this that will have smartphones for everything. But this time, you know, believe it or not, even this big corporation, the CEO's, you know, the, they're quite skeptical about this. So, so, you know, we are so in the technology maneuver when, when even the big bosses, they, they still don't believe so, but I, I strongly believe in Alexis, right? It will happen. And us smart phones happen today. It will happen and we have to just scalp.

Alex Cahana (Head of MedTech, Crypto Oracle): (01:09:37)

I would just briefly add that, it's interesting that at least, I don't know if it's the same in Europe, but in the US there is a movement, actually, it's called direct primary care, where doctors do not want to participate in the current marketplace where they have all this friction with insurance companies and where they are, uh, creating these peer-to-peer medical and monetary transactions. Some of them using cryptocurrencies now less so, but they very much embrace this disintermediated approach that reminds them the way they think medicine should be. And there's actually a couple of projects that are like Dao, decentralized autonomous organizations for doctors where the governance is determined by smart contracts to represent them. Because currently doctors, at least in the US do not have representative unions and their savant societies don't actually help them out. So, you're absolutely right that if your name is dr hammer, everything looks like a nail and you would want to be that kind of in that way.

Alex Cahana (Head of MedTech, Crypto Oracle): (01:10:42)

But I think that doctors more than I would say hospitals or payers or the government have that sense of urgency that this is not sustainable because their patients are not doing better and their life is miserable. I don't know, again, the numbers in Europe, but burnout from, for your suicide, from burnout among physicians in the US has become a real problem every day one to two doctors commit suicide. So, think about that. They would prefer to die than to rather log into their electronic health record. That's very extreme. And so, and so to the point that the IHI, the Institute for health improvement had added to better care, lower costs, better experience. The fourth point, which is to reduce doctor burnout. So, they are the adopters of digital therapies and digital ceuticals and uh, in blockchain. But again, we need to explain it in a more, I would say, a relevant way to them.

Frank Ricotta (CEO/Co-founder, BurstIQ): (01:12:00)

Yeah. I think at the end of the day we want to make health personal again. It's not about data. It's not about the technology. It's really about living, not living our lives. And we've tried so many things to, to force electronic health records that, uh, actually introduced, uh, more overhead and more burdens. You knowing we increased the diagnostic and talk about in the US diagnostic codes and all the other things that add administrative overhead that make it extremely frustrating for professionals to do their jobs. And for me as a patient to it 10 or interact, because I'm not talking to you on, you're talking to a screen and I'm there for three minutes and then I'm out talking to somebody to pay my bill or something out. That's not the way it's supposed to be, you know. And when we talk about blockchain, I don't know if it's five years, I don't know if it's 10 years from now.

Frank Ricotta (CEO/Co-founder, BurstIQ): (01:12:51)

We're not going to even mention the word. Maybe we go back to the start of the internet. There was a big fight over all the underlying protocols. This thing called a, and I'm not talking about money machines where all the telcos were saying, Hey, this is the technology of the future. And then this little startup technology called ethernet and TCP IP just overcame why, because there was this broad skill, community adoption and that's what I think you see with blockchain. Yeah. Is there a problems in health, particularly with data, you know, blockchain's not suited for large complex datasets as, as is in terms of how it was invented and applied for cryptocurrencies. And those types of digital assets and digital asset transfers, it's not suited for that. So there has to be augmented protocols. It's not suited for complex consent models when more than one person may own or have rights to a piece of data.

Frank Ricotta (CEO/Co-founder, BurstIQ): (01:13:39)

Because you know, doctors would still like to maintain some of your information in a, in the health record within their files as well as let you take some with you along the way. We still have needs for broader population health. We still have needs to do deal with. Um, applying that and combine that with social economic determinants. We still have needs on a personalized basis, um, to, to how that data is used and consumed in a, in a much more efficient, meaningful way. And I'm just going to echo, echo one thing. Technology never anything. It doesn't solve many, you know, the application of technology to a useful solution. That's what solves problems. So, it's like technology doesn't solve management problems and management can solve and work around technology issues. And that's really where we are. And it's got to be a combination of a ground of, of grass grassroots support.

Frank Ricotta (CEO/Co-founder, BurstIQ): (01:14:32)

I'll just use demographics in the United States, right? So, we have 5,000 hospitals. We have roughly one to 1.2 million health professionals. Um, and there's 300 million people, 350 million people, depending on what your accounting, where can you, where can you effectuate most change? Nope. I get 50 million people driving down the road and something I guarantee you the system is going to adopt. But the current system with all his existing immune systems in place between how things get paid. And how services deliver, what can I deliver are, Hey, you got to do this first before I can go to there. Even though I know I'm smart enough to know as a physician, I should just take you right to that treatment. So that's the thing. That's the thing that some of this really allows us to begin to address and overcome in a way that's provided solutions that's different and unique and innovative that enable the creativity of the primary participants, um, in this whole eco system, which is you as a person and your care providers. And that's really the ultimate objective in my opinion. And that's the goal and what blockchain can actually facilitate.

Michael Boni (MEP- Justice & Home Affairrs & Technology, EU Parliament): (01:15:44)

So, I'm not sure if you can, if we, if we can avoid, uh, uh, all of those five stages and go directly to the stage five for acceptances, probably we need to go through all those. But on the other hand, I think it's very important when you have asked about a, the relations between the European union and the United States, for example, to start a stronger corporation, uh, in Glover dimension, it's very important. It's related not only to healthcare era because there are many different systems. Not only say it's related to the model, how we are using the data. And this is a privacy shield agreement between European union and United States. This is our Alliance with Japan now and South Korea on the principle of adequacy, uh, to have also agreement related to, uh, flows of data. And I think it would be very, very important. So, we need to have some global solutions when we are talking about data.

Michael Boni (MEP- Justice & Home Affairrs & Technology, EU Parliament): (01:16:52)

It will cost probably better standardization and so on. And so, but on the other hand, what is, what is especially important to treat and to understand that decentralization, which is the, the substance of all of blockchain, uh, is the great opportunity because this decentralization is starting with participation of us as individuals. You have mentioned the consent. Yes. And, uh, uh, when you have, uh, uh, managing these, uh, uh, those, uh, agreements and, uh, corporate smart, a smart contract. And so, I think it's very important to create the RAR, to create the field for, for this decentralization and involve all partners, how to involve individuals, how to, how to involve the professionals, uh, medical professionals, how to evolve the, uh, technologies, uh, uh, and understand that the technology is not solving the problem, but we need to solve some problems.

Michael Boni (MEP- Justice & Home Affairrs & Technology, EU Parliament): (01:18:06)

And what are the, what are the very important part of this new issue where the future is, if I can say digital health literacy, because we need to understand now I think there are many problems also among visit physicians, doctors also among patients. Yes. So, so I think we need to, to focus also on, uh, in addition on, on that issue. And I think it's not, uh, it's not, uh, uh, create a situation over the five stage suddenly as their acceptance. Yes. But I think it will be, uh, one of the stimulative factor to go in this direction.

Daniel Benjamens (Associate Director, APCO Worldwide): (01:18:45)

Thank you. I think these are kind of nice closing remarks. We are also ending our time. I think we can all agree that a blockchain or whatever it's going to be called in the future, um, is here to stay. Um, but we need to find a way to better explain it to all the stakeholders and more what it means exactly. So not just talk about technology, but what, uh, the outcome of that technology, uh, will be. Um, it's also, we spoke about the need to ensure that blockchain is kind of dealt with, um, or integrated in current and future regulation. Uh, GDPR was mentioned as a possibly a nice starting point to pick up, um, after a next year elections. Um, maybe, um, with that, uh, one final question to end the session to each of you. Um, if you could change one thing with immediate effect to advance the potential for technology, what would it be?

Michael Boni (MEP- Justice & Home Affairrs & Technology, EU Parliament): (01:19:54)

Discuss, develop creative partnerships, but not kill the development of those technologies, but redundancy legislators.

Frank Ricotta (CEO/Co-founder, BurstIQ): (01:20:09)

And that's a, that's an awesome question. What one thing would I, what I do? Um, uh, well I'm just going to I'm an echo. Let's go to stage five of acceptance, you know, which is little, little incremental little incremental movements. Make big changes over time. So, you know, let's, let's, let's get some things going right now. Let's not wait for it all to evolve. You know, let's go trial and learn and iterate and do it again and do it again and do it again.

Andrzej Ryz (Director Medical Products & Innovation, European Commission): (01:20:37)

So not a one size fits all model. I follow Frank. Basically, it was my [inaudible] as well. I mean we have to experiment, you know, the stick would not happen without, without trial. Uh, but at the same time, I think we should share this. There's no ledge, uh, I run was probably not just here in Brussels. And finally, uh, acceptance will come with the time, you know, we, we should not kind of go against the time, you know, cause we're not to contend tomorrow, but hopefully, you know, it will come in time.

Alex Cahana (Head of MedTech, Crypto Oracle): (01:21:11)

Yeah. I'm actually used to these types of questions. The military, I remember once my Sergeant asked me for one thing to bring to the desert. I said, I would bring a door of a car. And he said, why said, because if it's hot I can open the window. But, but, but, but, but it really just one thing if there's one takeaway is everybody could understand that the opposite of health is not disease because we think that the opposite of health is disease. That's how we have a disease management system. The opposite of health is isolation. That as we get sicker, our world contracts that becomes smaller and smaller until one day it's so small. We say this is not worth it. And so, if we believe that the opposite of health is D is isolation than the journey back to wellness is connectedness to our family, to our friends, to our data, to our faith.

Alex Cahana (Head of MedTech, Crypto Oracle): (01:22:07)

We used to say Facebook, now I don't say that anymore, but you know, choose your F. but it's, it's, it's uh, it's connectedness. It's community, it's community building. And the way I explain it to my 12-year-old is I say to her, if you take the “I” out of illness and you replace it with “we”, you get the word “wellness”. And so, this is really what it's all about. This whole effort today is about creating a community that is interdependent. Just like I said at the beginning of the talk is because none of us is as good as all this.

Daniel Benjamens (Associate Director, APCO Worldwide): (01:22:42)

Thank you very much.I encourage everybody to take forward to discussion over lunch. Thank you very much for your attention.

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World Economic Forum at Davos 2019 - Ben Yablon Executive VP Salt Lending

Matt Bird sits down with Ben Yablon - Executive VP of Salt Lending - at the World Economic Forum in Davos January 2019