Ron Ribitzky, CEO of R&D Ribitzky, John Bass, CEO of Hashed Health, and Lucas Hendren, Co-Founder of SimplyVital at Converge2Xcelerate Conference (Boston, MA)
- 55% of healthcare applications will have adopted blockchain for commercial deployment by 2025
- SimplyVital believes access to better data decreases healthcare costs
- Adoption of blockchain technology can save healthcare industry $100-150 billion per year by 2025
INTERVIEW TRANSCRIPTS: Ron Ribitzky, CEO of R&D Ribitzky, John Bass, CEO of Hashed Health, and Lucas Hendren, Co-Founder of SimplyVital
Ron Ribitzky – CEO, R&D Ribitzky: 00:00
Good afternoon. Welcome to the panel on real world value of blockchain. So what does it take to produce real world value? We asked John & Lucas to share with us their experience and their experience because there are early adopters, they are considered pioneers and they work around the world. So it’s not just a US exercise, the clickers here. So to learn more about pragmatic consideration, interdisciplinary considerations of blockchain healthcare, you may really want to read this article that we published on phdy in March, 2018 we are nine fellow members of HIMSS blockchain task force. Thank you Marie for orchestrating that effort. I was very happy and privileged to lead that effort. One of the significant element in addition to being a HIMSS position paper thought leadership on the subject is that my fellow coauthors are from Intel, Accenture, blue cross, Aetna and others.
Ron Ribitzky – CEO, R&D Ribitzky: 01:07
So this represents really a microcosm of the ecosystem that really has to work together to collaborate, you know, to be successful in generating real world market value of blockchain in healthcare. Numbers speak for themselves to this date, this article was downloaded over 4,800 times from 70 countries and 16 citations, right? So if you have not read that highly recommend that we, that you do and we will drive this conversation in part based on certain kind of assumption hypothesis that we expressed as ecosystem statement in this article. My take is the 2017 was the year of the shiny object. Blockchain was a shiny object in healthcare, right? One way to look at that from my standpoint is like is the ideation expedition. Thought leaders went out to the field to Greenfield or even field and tried to figure out what can we do, what should we do with blockchain in healthcare?
Ron Ribitzky – CEO, R&D Ribitzky: 02:08
2018, 10 out to be something that feels like to me feels like a drug race fanfare. Why is that? Because it was the year of the ICO. If you did, blockchain healthcare and you did not do ICO. You were not considered very serious player. And too often I came across interested in your perspective came across notions that I felt that my audience, people I’m interacting with, they believe that blockchain and crypto are interchangeable. They have to be one, just two different synonymous words and that turns into two very quickly, I think 2019 as far as I’m concerned, we’re still in it. Still working on, it’s evolving into okay. Look. So let’s see what the bottom line is, what reality is, what the real market value of blockchain in healthcare. So what I asked the panelists is to look back and you’ll see in this map this all the geopolitical areas are working on. And I asked them to answer. We’ll begin the conversation with three quick questions. I’ve asked the panelists to share their thought about looking back on what they could or could not do. So let’s start with two of the families. Let’s go to the next slide was the videos with start with and the video is coming up. Two of our panelists, we’re stuck on the way in their airport, UAE yesterday LD in the morning and Carissa was stuck on route to Boston earlier today. So let’s go to the next slide and we’ll, let’s click on the Fest video. Mazin is a yet another pioneer. And at that point she lost connection on this remote zoom video. So we’ll go back through the map slide. We turned down the volume. And how about, I’ll start with Lucas and then we’ll wrap it up. Lucas, are you where you want it to be?
Lucas Hendren – Co-Founder, SimplyVital: 08:31
Some cases we’re ahead of the cases are behind, excuse me. For example. In cases where ahead we, from a business development standpoint, we’re pretty far ahead. Right now we’re working with about 1,750 physicians now and we’re actually ahead of some of the competitors in the care coordination, BPCI place. Tech wise, we’re kind of, we’re on track, we’re not ahead but we’re not behind doing some work with the UNICEF on that for behind we found general adoption for blockchain to be further behind. The reason for that, there are probably multiple reasons for that for regulatory use problems to general enterprise business case issues and also for UI, UX. And that’s would be the one I’d highlight there for. The reason I think that’s behind we recently conducted about 30 interviews with customers and users to try to figure out pain points and that when you, a UX is a big pain point for the blockchain healthcare space.
Ron Ribitzky – CEO, R&D Ribitzky: 09:29
What more specifically in the user experience situation that you guys encountered that you did not factor in the begin with?
Lucas Hendren – Co-Founder, SimplyVital: 09:40
We, we started off thinking people would be probably a bit more ready to adopt de-centralized technologies and use things. I won’t say like they are intended but you know, keep track of maybe their own wallet, that sort of thing. And they don’t really want to do that for the most part is that we’d gathered.
Ron Ribitzky – CEO, R&D Ribitzky: 09:57
I’ll let you fill in it’s a little bit to what you guys do. Perhaps not everybody knows what the company does in few sentences, what problem is space you try and solve.
Lucas Hendren – Co-Founder, SimplyVital: 10:05
Sure. So we’re driving to try to bring more trust in value to healthcare. Specifically. Right now we’re doing that with kind of two primary use cases. The first one is care coordination tools. Right now through the BPCI program. And then once people are on our platform and systems through that, we are helping them monetize their data through a data marketplace.
Ron Ribitzky – CEO, R&D Ribitzky: 10:27
Thank you. Imagine that we are now in an advisory board meeting your advisor to a new company. Right? You have investors who have done the news and then they’re preparing to for conversation with enterprise clients, what would be your advice to them to do or not to do or do it differently?
Lucas Hendren – Co-Founder, SimplyVital: 10:50
So I would advise to focus on the use case first and blockchain second. And can you kind of come in to your company, decided you’re going to use blockchain without actually identifying a problem, you’re probably not going to build the right product. So I would say focus on the use case.
Ron Ribitzky – CEO, R&D Ribitzky: 11:05
All right. Thank you very much John. And I think that now we can just leave the state and leave the state to the scope and the scale of your activities. So just in case not everybody really knows what Hashed Health is doing. What it was the few statement about this problem, space strategies, solution to go after this. And then those three questions are you where you want it to be.
John Bass – CEO, Hashed Health: 11:33
Oh, thank you. So Hashed Health is a healthcare innovation firm focused on access and cost of care challenges. I think we think the biggest challenge especially in the US is the cost and kind of the irrationality around how healthcare is accessed and paid for. And so being early in the space we took a protocol agnostic use case agnostic approach because there’s lots of cost challenges in healthcare. There’s supply chain and revenue cycle and identity and all the things that we’ve been talking about throughout the day today. And when we started the company, we very much took the approach if we’re going to work on a lot of different use cases with a lot of different partners, not knowing which ones are going to accelerate the quickest and realizing that it’s all about networks and we weren’t sure which networks were going to come together the fastest.
John Bass – CEO, Hashed Health: 12:28
And we also realized that the protocols, the technologies, the underlying tools that we would use are going to mature a lot over the years. And so we weren’t sure if Etherium or Corda or any of this stuff Tendermint all this stuff that was around back in 2016 when we started the company, we weren’t sure which of those were going to be appropriate for those different use cases. And so for the past three years, we’ve kind of had a front row seat in terms of doing a lot of different projects and a lot of different protocols with a lot of our customers in the US and Europe and around pharma use cases, insurance use cases, care delivery use cases. And so we’ve kind of seen how the technology has matured, seeing how certain use cases fit nicely on top of certain technologies. We’ve experimented with business models and we’ve watched the formation of these networks that are now coming together.
John Bass – CEO, Hashed Health: 13:18
And so we are a little different in that regard a lot. Most people are kind of aiming at one thing. We’re kind of doing a lot of projects. And our goal is to get a lot of experience and product market fit information back from the marketplace so that we can build the right tools to enable the use of these things. And so we’ve seen a couple of different design patterns emerging one Israel in these asset exchange. So a data marketplace is an example of an app, what we call an asset exchange. It’s a data market. And then the other one is what we call multi-party business process automation, where counter parties or people in a workflow are using a shared source of truth that in healthcare basically collects and services clinical and business information in order to efficiently manage a contract or a workflow process.
John Bass – CEO, Hashed Health: 14:07
And so we’ve seen these design patterns emerge and we are starting to get a picture of kind of where the, where the real work is happening and what tooling is necessary to bring that to life. So our, we were we thought we would be. I feel like the sort of answer is a cop out, but I got to say it because in my world we think of we think of things in these three dimensions in blockchain, right? You think of technical models, you think of innovative business models that are enabled by the use of the technology and you think about networks and if you’re missing any of that, or if you run into a regulatory issue or something, then the whole thing falls down and you’ve spent a lot of money and you wasted a lot of time and your customers probably aren’t going to come back to you.
John Bass – CEO, Hashed Health: 14:55
And so you know, I think from a technical model standpoint, we’re, where are we thought like there’s much more many more options, technical options to solve problems than there were in 2016. You’ve seen the spectrum of technologies really evolved. You know, where in 2016, it was really just a Etherium in Bitcoin that you could anchor to now there’s a whole spectrum of things that you can anchor to, including a lot of people who are really aiming at the HIPAA compliant space. And there’s also these kinds of hybrid cloud systems. Now we’re, it’s basically a serverless architecture with cryptographic security around it. It’s not a blockchain, it’s not at all a blockchain it’s very much just using cryptography to protect data. But it’s a lot less expensive than running a bunch of nodes.
John Bass – CEO, Hashed Health: 15:49
And for certain use cases, that’s really all you need. But so now you’ve got like, it really depends on the business problem and the business problem directs you to a certain protocol or tooling. If you’re truly trying to solve a problem, you need to consider the problem first before you choose the technologies to solve the problem. And I think all of these protocols and the last thing on the technical models, like now these protocols are so many of them, they’re starting to commoditize from a business model standpoint. We’ve seen the evolution of things like data markets that are innovative in terms of how we solve problems in healthcare. So credentialing is a great example. Professional credentials exchange solves the credentialing problem through a data market process where people who have credentials can offer them to people who need them.
John Bass – CEO, Hashed Health: 16:39
And so instead of having a bunch of people in your basement who are doing that work over and over, you basically can acquire those verified credentials for someone who’s already done that work, curated that dataset. And so that is a version of vision of an asset exchange for Bitcoin except the crypto, the asset that’s being traded on that ledger is a verified credential. And so we’ve seen as we hoped we would in 2016 we’ve seen the maturation of certain business models that are bringing new answers to old problems in healthcare. So, and then the third area is the, the network piece. So are we where we thought we’d be from the network perspective? Yes. I mean the professional conditionals exchange has almost 15 different corporate members. And we’re seeing the a lot of different alliances coming together to do something that’s very new and interesting, which is to come together, even competitive companies coming together to solve common problems if they cannot solve by themselves.
John Bass – CEO, Hashed Health: 17:38
And so whether it’s a procratax or the hunt Alliance or the synaptic Alliance, you know, there are all of these large competitive companies that are realizing that this technology enables them to solve an old problem in a new way by collaborating with people in your network, even if they’re competitive organizations. It’s the only way you can solve this problem is by using a shared piece of infrastructure. So I think that’s why the kind of answer is fitting because it’s a multidimensional answer to a simple question.
Ron Ribitzky – CEO, R&D Ribitzky: 18:18
Thank you. Thank you very much. I really appreciate the month. The dimensionality is we had also the user experience in adoption exercise and seeing when you look back at the role of crypto and relationship Wes’ mining any sorts today, like going forward, how should we address the combination of utility token CSMO or maybe most of you as well as what’s the role of minors today? How do we understand minors part of the entire complex?
Lucas Hendren – Co-Founder, SimplyVital: 18:55
I’ll start with the minors questions. So I kind of view that when you’re looking at the minors, you’re really just looking at the people running the network. So those would be more akin to nightclub perspective. Your AWS I guess. That’s kind of how I view their role would continue to be. You do still, they do. Minors still need a way to incentivize who actually run the network. But that can vary. And more permission networks, you can have minors or nodes who incentive is more Kendra, they actually have to use the network versus more public networks where you need some type of crypto usually to award them to want to continue to use, utilize their resources to secure that work.
John Bass – CEO, Hashed Health: 19:33
Yeah, I think in terms of so the, the, the definition of mining is it has evolved a lot since Satoshi, right. And there’s some of these derivatives of Satoshi’s vision and some of these DLT and hybrid cloud infrastructures don’t have, may not even have nodes, much less minors that running a proof of work consensus algorithm on those nodes. And so again, you’ve got a lot of tools and a lot of different kinds of techniques to solve problems now and then there’s blockchain and there are these new derivatives. And you know, in terms of tokens, the exciting thing about 2017 and we did not do an ICO and we’re glad we didn’t do an ICO. And the reason we did an ice, you’d know, do an ICO, is because we had these large fortune 500 US and European companies that we’re working with.
John Bass – CEO, Hashed Health: 20:27
And if you brought up doing an ICO, it was toxic to the conversation. I mean, and, and they don’t just don’t work. I mean the friction, it’s like friction as a service. You know, you’re introducing friction to something that doesn’t need it right now. Now I’ll will say the exciting thing about ICOs, the promise of IC as it was never delivered, was network effects. And having a user of a system have a small piece of ownership and an incentive to see the adoption and growth of that system is a remarkable concept that healthcare has never had before. And so I love that vision because that’s true disruption. Having millions of consumers who are adopting a healthcare application has the potential to change things dramatically. I just think it’s not the right time. 2017 was not the right time. I think that will probably resurface in some fashion. But it’s not the work that’s going on right now.
Ron Ribitzky – CEO, R&D Ribitzky: 21:21
And there’s no simple answer to that. It’s felt that dementia. So folks in the room are, who may be interested in that. Vince, if I may call on you for example, you hear that conversation. If this gentleman, we’re now members on your board, the new guys who are meeting, would that change any, anything from what you do already now you and your team already and I’m talking to about direct trust a project or this fits what you already figured out and newly I will come to you afterwards.
Speaker 1: 22:07
And evolutionary process and the tactical taking industry consortium in the Alliance forces we do, we’ve been focused on not recreating the deployment of our nodes and those types of things to be done on top of already is already I trust. So one of the questions for you two might be for the deployment. There’s a lot of experimentation. So some of our clients are even trying to see a blockchain works very early stage and when it gets, there’s also some fear, I believe in posting your own notes. You seen that in the marketplace?
John Bass – CEO, Hashed Health: 23:01
Yeah, we certainly are seeing a lot of that and a lot of use cases fall down because you can’t bring the network together. And there’s a lot of reasons why the network can’t come together. One is you can’t get through legal and procurement because you’re talking about them doing something that their lawyers are totally uncomfortable with and bringing a cryptocurrency conversation makes it even worse. And so there are options where like Corda for example, you’re not running, no, well, sorry, Corda you’re running nodes, but they’re not global broadcasting. And when, unless I, I’m not pushing Corda, but for certain use cases, that concept of peer-to-peer broadcasting if the data is super, it makes sense. And if you’ve got a network that you’re trying to stand up and that, you know, these people are physician’s offices and they just don’t want to, I mean, like they don’t want to run the node, and so you’re left with like one or two people running nodes, then why do you have a blockchain? And so there’s just, you know, there’s these often times you’ve got either technical or non-technical reasons why those conversations don’t go well. And as an early stage company we’re, you know, we’re trying to find the sweet spot between those different pieces and deploy things that can be deployed. And I think that’s what has taken so long. Right. It’s finding that sweet spot between the architecture and the business model and the network.
Lucas Hendren – Co-Founder, SimplyVital: 24:28
Yeah. And I would agree with that. And I’m to expand slightly, one issue we had in addition to that, it was just a lack of general education because people don’t even know what spinning up a node means. They, we’ve found that they can think it means a wide variety of things. And all of the news from all the way back in 2017 typically mean that’s a bad spin. So we also have found we had to spend a lot of time educating people to try to understand what they’re actually trying to do and what their actual use cases. Cause there’s just so much misinformation out there. I’d give it to you, the scale of the issue. At one point we had a person we were talking to ask us to actually show them the blockchain because they thought there was an actual chain of blocks somewhere. So there’s so a lot of education in this space that has to happen.
Ron Ribitzky – CEO, R&D Ribitzky: 25:16
Okay. Would you mind introduce yourself, who you are.
Speaker 2: 25:19
Chief Medical doctor at NASCO. I used to be the CIO product provider topic. I want to say that I was going to ask the same questions. That was great. Great point. So when you get down and sort of as you move down the scale and you get to those small niche entities that need to have something on a note. So provider needs to be to prove that that doctor went to a certain school, that doctor had was credentialed. All of those, those attributes that a provider has that isn’t part of a hospital network less and less, but there still are plenty of how, how do you, where, where is the tipping point for that? Because the biggest problem with healthcare is one of the biggest problems that black people saw is the idea that we could solve this provider demographics issue, right? You’ve heard about it probably a thousand times and you get very good use case and it’s a challenging one thing I know about tackling. You want to think about it, I just wonder how you get to the point where that individual, let’s just call my mom and pop provider. How do you get those folks? When, when do we reach over? That’s what’s feasible.
John Bass – CEO, Hashed Health: 26:31
So a little bit so we’re talking about provider identity and there’s basically three different approaches to this use case. There’s one approach which is the synaptic approach, which is a data synchronization project. So the blockchain is being used as a data layer where anyone can kind of pay their way and contribute data to a shared a master dataset. And then in contributing your data, you learn about how your data is different from everyone else’s and then you go resolve your discrepancies. So that’s one. Then you got professional credentials exchange, which is a different business model in a different technical structure. It’s a data market. So where people who’ve gone out and curated that data can offer it for sale to people who need to do that same piece of work. And it’s better, faster, cheaper to acquire that from someone who’s already got it.
John Bass – CEO, Hashed Health: 27:19
That is a different design pattern, a different business model and a different technical solution that looks like an asset exchange. And then the third area is what we call self-sovereign identity. This is the true blockchain ideal for any kind of identity solution. And it’s basically sovereign, ever known. These companies that basically will allow you to stand up a blockchain where you’ve got lots and lots of nodes who are all sharing information and you’re selectively exposing that information. And it’s the, it’s the individual that it’s self-sovereign and it’s the physician who opens and closes the door to that information as they go through their lives, which is a beautiful dream, but it’s not really the way the US healthcare works today. So that’s an example of something that will probably move faster somewhere outside the US and perhaps with an HS in London or in the US we have a directory problem and a credentialing problem.
John Bass – CEO, Hashed Health: 28:16
And so I lean towards the more practical solutions that don’t look like true blockchain, that have elements of centralization where it’s still starting a beat as a B2B solution. And then over time it has the credential potential. If the world moves in that direction, it has the potential to go to the consumer with the physician being the consumer, in which case you would basically layer a wall of application on top of one of those two solutions that would expose that physician’s information to them and allow them to start controlling it. So from my perspective, having done a lot of different versions of this directory project in the last three years on different protocols and using different business models, my perspective is solve today’s problem in a B2B space where it’s comfortable and you’ve got a good kind of, it’s as simple as possible and then iterate and expand and kind of build a bridge to that self-sovereign future if we go to that direction.
Lucas Hendren – Co-Founder, SimplyVital: 29:16
I would agree with that, especially on the ideal dream Sandpoint but having to focus on more realistic B2B method right now. I might also want to say our approach has also been to try to approach them with the most basic feature or need we can address and try to work up to that. Trying to get any, especially a mom and pop physician to try to just immediately jump into a and having a self-sovereign identity, but just any of those blockchain solutions will be very difficult. So we’ve tried to really narrow down and to feel pain points and kind of like start by bridging that large gap by just targeting one small pain point after the other. In our case we’re a specific target and care coordination and BPCIA with the hope that we can start there. And then once they get kind of comfortable utilizing blockchain technology and they’re on board, we can then start upgrading them and like we end up in that B2B solution. That’s kind of also where I see things
John Bass – CEO, Hashed Health: 30:11
And that’s the way a lot of these consortia are working is they start with kind of something Hung’s a little different. They’re kind of a governance first use case second, but most of the other ones on the list that we’re tracking that are kind of real, are starting with a very specific use case and it’s trying to solve that problem and then iterating on top of that.
Ron Ribitzky – CEO, R&D Ribitzky: 30:32
So I would enter that the extent on John’s point. My team at times Ribitzky our take is all those considerations are critical, but there are means to yet another thing that I see we heard here before about user experience and adoption. When they come into a situation to sound like shops we need to figure out what is the total cost of getting there, getting to the plate, what will be the operating, the total operating costs of continuing display and how will it impact the economics of this mom and pop shop. And then only then we are ready to have the conversation recognizing, Oh yeah, if they figure out the economics work. Now we have players that can deliver that, but the economics is the gatekeeper and we tell on adoption, how do we drive adoption over time, generate those returns that go beyond just simple retail investment. Other questions from the forum. All right. Thank you so much for being here. Thank you guys.
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