7 areas of impact of Web3, A.I. and the Metaverse on the Health sector.

I want you to imagine the following situation: a patient is having some sight problems such as blurred vision, and without knowing what it is about, goes and visits an ophthalmologist. The ophthalmologist is not able to diagnose anything specific, since oddly enough all the signs related to sight are doing good, and the patient is then discharged without any clear diagnosis. But since her data is now on the Blockchain - namely shared with other physicians that have been granted permission to the blockchain (so that it is without any privacy breach), another physician that has interacted with the patient in the past and has noticed muscle stiffness and spasm, can easily link the two symptoms and for instance identify the possibility that the patient is in early stages of multiple sclerosis (that is de facto very easy to diagnose because its symptoms are disconnected from one another, and usually are dispersed across a wide number of specialists).

Or think about this other one: as a doctor checks on his patients in the hospital, he notices that one of them is healing very slowly from a simple surgery he performed recently. This is pretty uncommon. The clinician then jumps into the metaverse, going back in time to witness a previous abdominal surgery this patient underwent. He pulls up this surgical video to show the patient and they both see that the area that is healing slowly had developed scar tissue from this former surgery. Then, a couple of weeks later, the patient seamlessly carries her personal health data to a physical therapist who demonstrates exercises in an immersive environment simulating a tropical beach setting. At the end of the session, the therapist fast forwards to the future to show the patient how she will be moving six weeks from today.?

Now, I am sure you might be like: "Andrea, how is all of this possible? How can you solve in minutes problems that the industry today takes weeks if not months to solve?". This sounds more like a fictional script from the Netflix "Black Mirror" series, right??

But it is not: it is much more real than Black Mirror, and it represents some of the real-world applications of Web3 technologies to the Health sector.

Let's go step by step.

First of all, what is Web3? Well, Web3 is considered by many the 3rd iteration of the internet, towards which we are approaching thanks to its underlying new technologies and formats: blockchain, Metaverse, DAOs, digital twins, crypto, dApps (decentralized Apps), NFTs, all powered by A.I. and ML (Machine Learning), and so on: basically, a a new generation of Internet services that are built on top of decentralized technologies.

How did we get here, though? Let's look at the evolution of the Web: Web 1.0 came with the birth of the Internet and fundamentally digitized information, submitting knowledge to the power of algorithms (this phase came to be dominated by Google) and making it read-only for the most part. Web 2.0 came with social media, running mostly on Smartphones, and digitized people and subjected human behavior and relationships to the power of algorithms (this phase was dominated by Facebook), and made the internet not only a place to consume content, but also to create it.?

What about Web3? This third phase will fundamentally digitize the rest of the world and render it in 3D. In Web3, all objects and places will be replicable and readable by machines and subject to the power of algorithms. And who will the metaverse be dominated by? Most likely by anyone and no one at the same time – exactly because it is a decentralized web, as well as it will be a place for people to consume content, produce it but most importantly: own it. It has certain characteristics, namely that it is decentralized (as we mentioned), immersive (namely it is 3D and not only 2D as the internet is today), and persistent (namely, things happen even while we are not online).?

Recent statistics show the opportunity for companies to dive deep into the Web3, as the expectation for the market is to grow steadily:? The global Web 3.0 market size reached USD 3.2 Billion in 2021 and is expected to register a CAGR of 43.7% up until reaching USD 81.5 Billion in 2030, according to a latest analysis by Emergen Research.?

As per some of its underlying technologies, such as the metaverse, the opportunity is very big as well: for instance, a new report by research firm Gartner predicts that by 2026, 25% of people will spend at least one hour per day in the metaverse for work, shopping, education, social and/or entertainment. It’s also expected that 30% of the organizations in the world will have products and services ready for the metaverse by 2026.

When it comes to blockchain, although the financial sector accounts for more than 30% of the complete market value of the technology (a market value that is poised to reach $ 67.4 billions by 2026, according to Markets and Markets), the value of the ecosystem has also begun to spread to other technologies, such as manufacturing (17.6%), distribution and services, (14.6%) and the public sector (4.2%).?

The intersection of Blockchain and healthcare proves to be a promising market as well: a research by GrandViewResearch shows that the global blockchain technology in the healthcare market size was valued at USD 1.19 billion in 2021 and is expected to expand at a compound annual growth rate (CAGR) of 68.1% from 2022 to 2030. The increasing incidence of information leaks and data breaches, coupled with the rising requirement to curb these issues, are attributed to the market growth. Strategic initiatives by the key players, high demand to reduce drug counterfeiting, and the need for efficient health data management systems are the major factors leading to the adoption of the technology.

The truth is that, although in healthcare we might not be there yet when it comes to Web3 maturity, we see a strong acceleration of Digital Transformation in the sector. As a keynote speaker and researcher that works with most healthcare companies globally (including Siemens Healthineers, Samsung, Bracco, Philips,? Johnson & Johnson, and many others), I am fully aware of the impact that Digitalization is having on the healthcare industry, especially after Covid-19:? according to the new Philips’ Future Health Index 2022 report, nearly 3,000 healthcare leaders across 15 countries reveal how they are harnessing the power of data and digital technology to address their biggest challenges after Covid, and , according to the Accenture Digital Health Technology Vision 2021 report, 81% of healthcare executives say the pace of digital transformation for their organization is accelerating, and 93% report that they are innovating with a sense of urgency and call to action this year. And what is the key enabler of data in healthcare? It definitely is the Internet of Things, and related devices - and stats show us that they are growing with a positive correlation too: the wearable medical device market is expected to reach more than $27 bi by 2023, a spectacular jump from almost $8 bi in 2017.

But if we can agree that Digital transformation in healthcare is underway at the moment (and accelerated by Covid-19), we still have to admit that - besides some timid but much-needed experiments and pilot projects - the Healthcare industry is not very clear yet about the potential impacts and opportunities of Web3 on its business, from using the Metaverse for surgeries to using Blockchain for supply chain transformation, from using NFTs to protect patients' data to Decentralized Autonomous Organizations for research and Innovation - eventually helping to do what the industry to pivot from what is today a "reactive" healthcare to a much more proactive, predictive and personalized healthcare, adding more value to the final patient.?

This is why I have spent the last several weeks talking to experts from the biggest healthcare companies across the globe, and have put together this article that describes what are the main impacts of Web3 technologies on the healthcare industry.??

1. Metaverse for immersive "telepresence"

"Meta-what?": I am sure this was your reaction to Mark Zuckerberg's recent announcement of Facebook's rebranding to Meta. At least, that was mine. But interestingly enough, now we all talk about the Metaverse thanks to that announcement and although it is not a new idea, we only recently are able to better understand its implications for healthcare companies, especially for the way they conduct surgeries and interact with patients.

But let's first understand what is the Metaverse: the term was born from the junction of the Greek prefix "meta" (meaning beyond) and "universe", and fundamentally is a virtual and collective shared space, created by the convergence of virtually enhanced physical reality (represented by the "Digital Twins", of which we will talk about), and the virtual space that already permeates the physical world (in particular Augmented Reality, also called AR). Confused?

Think of it this way: today we are basically online when we access the Internet, but with new devices, greater connectivity such as 5G and cutting-edge technologies, we will be online all the time in decentralized, immersive and persistent worlds.

One of the great opportunities that the Metaverse is providing to the Health industry is to overall "get closer" to the patient, in all its fronts, as well as to collaborate better. Let us start off from the use of AR and VR in healthcare, which is a first step towards a more immersive and persistent metaverse.?

Already in 2020, neurosurgeons at Johns Hopkins performed the institution's first AR (augmented reality) operation on living patients: a doctor used 6 screws to fuse 3 vertebrae in a patient's spine to cure persistent back pain, using a special headset by Israeli company Augmedics.?

At the same time, VR proved to be a great technology to treat patients: Ten years ago, telling people you could reduce their pain with a device similar to a video game would have garnered a lot of blank stares, but today, Virtual Reality (VR) proves to be a key technology helping in pain management for instance, among many other applications.In order to cure chronic pain, oftentimes VR is a safer, more efficient alternative to drugs like opioids. VR technology is being used not only to treat pain, but everything from anxiety to post-traumatic stress disorder, and stroke.?

And that’s just a fraction of VR’s proven capabilities in the medical field. Other uses include, doctors and residents using virtual-reality simulations to hone their skills or to plan complicated surgeries. VR headsets could also motivate wearers to exercise and help children with autism learn how to navigate the world.

From startups to pharma giants, everyone is betting on VR and there are numbers to back them up. The global virtual and augmented reality in healthcare market is expected to reach $5.1 billion by 2025.

A great Accenture report called "Accenture Digital Health Vision 2022: Meet me in the Metaverse", surveyed healthcare executives and proved that More than 80% of healthcare leaders see the metaverse having a positive impact on the future, as in the metaverse, we can transcend time and space to simulate interactions, shorten learning cycles and practice procedures, such as in surgical training.??

We can create distinct experiences for patients that replicate the physical world but remove its constraints. We can help healthcare employees build empathy around the human experience of people aging or of people with historically underserved needs by virtually living in other people’s shoes.

Torbay and South Devon NHS Foundation Trust are piloting Microsoft HoloLens 2 and Dynamics 365 Remote Assist in the Breast Care Unit where specialist nurses send real-time video feeds to consultants to get immediate advice on a patient’s needs. Consultants can add digital markers and annotations to the videos to guide nurses.

Imagine: Just like Fortnite allows a hundred players to play competitively in a shared environment, this technology can enable up to hundreds of physicians to competitively (and collaboratively) diagnose and treat virtual patients at in-person and online medical conferences, across specialties like dermatology, rheumatology, and immunology.

When applied in the operating room, AR headsets can digitally project a patient’s digital twin on top of the physical body during surgery. Surgeons can see the CT and MRI data ‘inside’ of the patient as they perform a procedure, knowing precisely where the needle, scalpel, or drill will line up with the anatomy. Surgeons have already performed augmented reality surgeries on live patients, correcting spine problems and removing tumors. This is where the intersection of digital and physical worlds has real value.

Ultimately, what really separates Medicine’s metaverse from the hype you may be reading about is that you don’t have to wait patiently, hoping to see the societal and commercial value one day. From cloud-based collaborative training to AR surgical planning, in many cases the value is already being realized or is on the cusp of happening today. It’s being realized for patients, for medical professionals, for society, and for industry.

2. Blockchain for health data access and sharing

A recent GrandViewResearch study shows that The global blockchain technology in the healthcare market size was valued at USD 1.19 billion in 2021 and is expected to expand at a compound annual growth rate (CAGR) of 68.1% from 2022 to 2030.?

This is definitely a huge opportunity, but before getting to its application to the healthcare industry, let's first understand better what the Blockchain technology is: it is basically a distributed database that is shared among the nodes of a computer network, which stores information electronically in digital format. A blockchain collects information together in groups, known as blocks, that hold sets of information and that have certain storage capacities and, when filled, are closed and linked to the previously filled block, forming a chain of data known as the blockchain. All new information that follows that freshly added block is compiled into a newly formed block that will then also be added to the chain once filled, and when it is filled, it is set in stone and becomes a part of this timeline. Each block in the chain is given an exact time stamp when it is added to the chain. See? The blockchain is a distributed ledger technology (DLT), where that database is spread out among several network nodes at various locations, which makes it decentralized.?

And when it comes to its potential impacts in healthcare, we can list several ones such as Supply chain transparency, Patient-centric electronic health records, Smart contracts for insurance and supply chain settlements, Medical staff credential verification, and IoT security for remote monitoring, among others. Eventually, Blockchain is a powerful technology for enabling secure data sharing and access between multiple parties. This is a major challenge in digital health, where the privacy and security of medical data is paramount, but where improving the quality of care cannot happen without more coordination in management of patient data across the healthcare system and the ability to apply analytics to population level medical data. In short, blockchain can help digital health by making it easier to share data securely, with patient consent, across very fragmented healthcare systems.

Although The supply chain management application segment accounted for over 25% of share of the blockchain technology in the healthcare market in 2021 according to the GrandViewResearch, we have already discussed to impact of blockchain on the medical supply chain in the Pharma article, so I won't be repetitive here and I recommend going and reading that piece, and focus more on the health records and settlements.?

Starting from the health records, Healthcare systems in every country and region are struggling with the problem of data siloes, meaning that patients and their healthcare providers have an incomplete view of medical histories. In 2016, Johns Hopkins University published research showing that the third leading cause of death in the US was medical errors resulting from poorly coordinated care, such as planned actions not completed as intended or errors of omission in patient records.

One potential solution to this problem is creating a blockchain-based system for medical records that can be linked into existing electronic medical record software and act as an overarching, single view of a patient’s record. It is crucial to emphasize that actual patient data does not go on the blockchain, but that each new record appended to the blockchain, whether a physician’s note, a prescription or a lab result, is translated into a unique hash function – a small string of letters and numbers. Every hash function is unique, and can only be decoded if the person who owns the data – in this case, the patient – gives their consent.

In this scenario, every time there is an amendment to a patient record, and every time the patient consents to share part of their medical record, it is logged on the blockchain as a transaction.?

Medicalchain is a leading example of a company working with healthcare providers to implement blockchain enabled EMRs: it is a company that uses blockchain technology to securely manage health records for a collaborative, smart approach to healthcare.

The emergence of much more complete, digitized and shareable patient health records will have a profound impact on the healthcare market by fuelling more advanced analytics. For example, personalized medicine is a promising field, but its development is severely hindered by lack of enough high quality data. Access to more reliable and widespread population level data would enable much more powerful segmentation and analysis of targeted medicine outcomes.

A concrete example is provided by Mayo Clinic, Renowned for its high-quality patient care and known as one of the best hospitals in the US, partnering with UK blockchain start-up Medicalchain to support the development of future services. The clinic’s interest in blockchain will enable the two organizations to explore the benefits this could bring to medical records, providing speed, a reduction in healthcare costs, greater security and guaranteed positive patient outcomes, delivering fully connected care, rather than a fragmented, siloed response. By providing the patient full access and control over their data, via mobile or desktop, they will gain the capability to provide differing levels of access to various users, assigning permissions and designating who can query and write data to their blockchain health record.

By fully owning their medical record through blockchain technology, patients will be able to ‘own’ their record, ensuring greater trust and transparency, as well as gain the ability to revoke users if required in order to ensure robust data security.

Approved clinicians will have the ability to ‘read and write’ to the patient’s records and indicate who has accessed their medical data, the time of access and the types of data that can be accessed.

Now, as to settlements, we now that there are many efficiencies and disputes among healthcare providers, so that Blockchain can prove to be a technology solving all of this: Companies such as Chronicled and Curisium provide blockchain-based systems where various players in the healthcare sector, such as pharmaceutical companies, medical device OEMs, wholesalers, insurers and healthcare providers, can authenticate their identities as organizations, log contract details, and track transaction of goods and services, and payment settlement details for those goods and services. This type of environment goes a step beyond supply chain management to also enable trading partners and insurance providers in the healthcare sector to operate based on fully digital and in some cases automated contract terms.

By having shared digital contracts between manufacturers, distributors and healthcare organizations logged on a blockchain ledger, rather than each player having their own version of contracts, they can significantly reduce disputes over payment chargeback claims for prescription medicines and other goods. According to Chronicled, because pricing structures often change, there are over one million chargeback claims made between these players every year, more than 5% of which are disputed, requiring lengthy manual resolution.

Similarly, shared smart contracts can be used to manage medical insurance contracts for patients, where Curisium states that 10% of claims are disputed. Like in other use cases, once this data is digitized and easily accessible, insurance providers can use more advanced analytics to optimize health outcomes and costs.

3. Digital Twins for simulations and predictions

In 2019, Kevin Kelly, the founder of Wired magazine, wrote an amazing cover story for the magazine called “Welcome to the Mirrorworld'', where he describes how Augmented Reality will unleash the next big tech platforms. He wrote: “We are building a 1-to-1 world map of almost unimaginable reach. When completed, our physical reality will merge with the digital universe.” In other words, get ready to meet your digital twin and the digital twin of your home, your country, your office, and even of the world.

“Digital twin?”, you might be asking yourself, especially after having read about this concept previously in the article.

Well, let me then introduce you to one the first building blocks behind the metaverse, that is, the concept of “digital twins”. A digital twin is, according to IBM's definition, a virtual representation of an object or system, or even person as we saw, that spans its lifecycle, is updated from real-time data, and uses simulation, Machine Learning and reasoning to help decision-making. Imagine a large manufacturing company having digital twins of its equipment: through them, an engineer from his home will be able to solve problems in a factory on another continent through the Metaverse. The same technologies will enable office meetings that are much more productive than using today's two-dimensional video conferencing tools. Customer-facing applications can include creating Digital Twins in retail, offering customer service experiences that would not be possible in the physical world, and even engineering companies such as Ericsson are using digital twins to simulate the impact of trees falling on their 5G antennas. Amazing, right?

And when we get to Healthcare and look at the potential implications for the industry, we can use Digital twins in countless applications, from training to create Digital twins of patients, to creating virtual scenarios for training and so on.?

Medical device and life science companies can also use this technology to teach and train healthcare professionals on their devices and therapeutics. For example, Munich-based Brainlab created an interactive virtual version of their radiotherapy system that replicated a hospital site visit, allowing healthcare professionals to engage, step-by-step with their technology and software from anywhere, anytime – all available to stream to multiple users across any device.

In this and many similar cases, instead of traveling from hospital to hospital (challenging even before the pandemic) or trying to explain multimillion-dollar equipment using a slide deck or videos, companies can let healthcare professionals diagnose, treat, and operate on virtual patients together over Microsoft Teams. These technologies will move the needle (at scale) from a business perspective, measurably increasing time, sales, and performance

When it comes to Digital Twins applied to patients, digital twins can capture massive amounts of patient scan data (MRI, CT, ultrasound scans) over time–coalesced into one view–to plan surgeries and monitor disease progression and treatment. In many cases, prototypes and replicas of the human body, hospital systems or entire hospitals are already in use. Jack Latus, CEO of Latus Health – an online healthcare provider specializing in occupational health – believes that digital twins will eventually become “test dummies” for individuals that can be used to predict everything from how we will recover from surgery to the reactions we will have to specific medicines. This will come about through our increasing ability to map and understand individual genetics. During a recent conversation, he told me, "We'll be able to fast-forward – so if we age this twin by ten years, based on these interventions we're doing – how does this affect the twin? “You start to almost be able to see into the future … we'll see that this is the outcome we're going to get if we follow this protocol for the next ten years.

4. A.I. and Machine Learning for better health data interpretation

I would like you to imagine the following scenario: you are the pilot of an airplane, and one day, while in the middle of the flight, one of your engines breaks down. Terrible, right? It happened suddenly, and seemingly nothing would have been able to preview that.?

But the truth is that, yes, it might have likely been possible to preview it if the airplane was filled with sensors that capture data in real time, and through A.I., it would be able to anticipate an engine stopping through correlations and simulations based on the Big Data it collects (pretty much like a Tesla is able to do, differently from most cars).

See the power of Big Data being processed by Artificial Intelligence, that by its definition is computer systems able to perform tasks and solve problems that normally require human intelligence, such as visual perception, speech recognition, decision-making, and translation between languages, among others? It helps us to predict more and react blindly less. And consider that we already live in a world with lots and lots of data, where more than 90% of the data generated since the beginning of humanity was generated in the last decade, and where today we got to the point of 97 Zettabytes of data by the end of 2022 according to Statista (which just to give you an idea, a Zettabyte is a number with 12 zeros…that's a lot of data!).?

When it comes to healthcare, around 30% of all the world’s data is healthcare data, with hospitals generating 50 petabytes of data each year. And by 2025, healthcare data is predicted to be growing at the highest rate of any industry.

So how can Big Data and A.I. impact the healthcare sector?? The truth is that there are a plethora of applications, from personalized virtual patient care to improved diagnostics and predictions, up to medical images interpretation, and automation: healthcare executives recognize this opportunity, since according to an Optum research, 72% of healthcare executives trust AI to support non-clinical, administrative processes to allow clinicians more time for patient care.?

An example is the Clara Guardian edge AI model from Nvidia, built on the Clara AI framework, that simplifies the development and deployment of smart sensors with multimodal AI, anywhere in a healthcare facility. With a diverse set of pre-trained models, reference applications, and fleet management solutions, developers can build solutions faster—bringing AI to healthcare facilities and improving patient care. This helps in the creation of "Smart Hospitals", a concept also brought forward by Nvidia, that are hospitals powered by AI in order to improve patient's outcomes. AI-powered temperature sensors for screening staff and patients, intelligent video feeds to flag patient distress, speech recognition for inputting patient data into electronic medical records, conversational AI to explain procedures, and much more are helping to optimize efficiency in healthcare.

The healthcare ecosystem is realizing the importance of AI-powered tools in the next-generation healthcare technology. It is believed that AI can bring improvements to any process within healthcare operation and delivery. For instance, the cost savings that AI can bring to the healthcare system is an important driver for implementation of AI applications. It is estimated that AI applications can cut annual US healthcare costs by USD 150 billion in 2026. A large part of these cost reductions stem from changing the healthcare model from a reactive to a proactive approach, focusing on health management rather than disease treatment. This is expected to result in fewer hospitalizations, less doctor visits, and less treatments. AI-based technology will have an important role in helping people stay healthy via continuous monitoring and coaching and will ensure earlier diagnosis, tailored treatments, and more efficient follow-ups.

The AI-associated healthcare market is expected to grow rapidly and reach USD 6.6 billion by 2021 corresponding to a 40% compound annual growth rate, according to a 2017 research by Bresnick J. called "Artificial intelligence in healthcare market to see 40% CAGR surge".?

Also, healthcare AI companies received raised recording funding in Q3’20, reaching 2.5 billion USD across 122 deals, according to CB Insights.

A great case study comes from the UK, with The London Medical Imaging & AI Centre for Value-Based Healthcare. It is a consortium of academic, NHS and industry partners led by King’s College London (KCL) and based at St Thomas’ Hospital. The diverse research teams are training sophisticated artificial intelligence algorithms from a vast wealth of NHS medical images and patient pathway data to create new healthcare tools. For patients, these will provide faster diagnosis, personalized therapies and effective screening across a range of conditions and procedures. Through a focus and experience in value-based healthcare the centre is examining how AI can be used to optimize triage and target resources to deliver significant financial savings for the NHS and healthcare systems overall. The centre has been established as part of the UK Government’s Industrial Strategy Challenge Fund, delivered through UK Research and Innovation.

In another case by Nvidia, Chang Gung Memorial Hospital (CGMH) ? Taiwan’s largest medical system with a network comprising 7 hospital branches?established the Center for Artificial Intelligence in Medicine (CAIM) in 2018 to develop the AI strategy in CGMH and implement AI technology in real-world clinical practice. Improving the medical diagnosis process by developing an AI medical imaging system is one of the main tasks of the center. To accelerate its development of AI tools, CAIM implemented Pure Storage AIRI (AI-Ready Infrastructure), integrated infrastructure solution from Pure Storage and NVIDIA. CAIM’s AIRI deployment is equipped with four NVIDIA DGX-1 systems, each integrating 8 of the world’s fastest data center accelerators–the NVIDIA V100 Tensor Core GPUs, delivering over one petaFLOPS of AI compute performance per system. With the AIRI solution, physicians only need to focus on training the AI models and verifying their reliability. So far, the AIRI solution has been applied to a variety of projects, including the identification of hip fracture from hip radiographs, immunofluorescence pattern recognition and blood cell type classification, etc. The blood cell type classification has reached 99% overall accuracy. When compared to a machine, two medical inspection experts and a clinical expert take about 3-5 minutes to evaluate 25 images to achieve 100% accuracy. However, machine interpretation takes only 2 seconds to complete.

5. IoT and 5G for better connectivity and low latency

There is much conversation going on globally about the opportunities that 5G, the 5th generation mobile network. It is a new global wireless standard after 1G, 2G, 3G, and 4G networks. 5G enables a new kind of network that is designed to connect virtually everyone and everything together including machines, objects, and devices.

5G wireless technology is meant to deliver higher multi-Gbps peak data speeds, ultra low latency, more reliability, massive network capacity, increased availability, and a more uniform user experience to more users. In the days I am writing this, 5G is being tested in Brazil, and although most of the conversation is around the problems it might bring about to airports, and the obstacles to scale it to rural areas, the opportunity is enormous, especially when it comes to healthcare.?

Eventually, 5G is expected to be 100 times faster than 4G while handling vastly more connections - which means it is a mobile infrastructure that is going to harness the power of Internet of Things. Let's look at telemedicine as an example: basic one-on-one, low-touch sessions are already feasible with 4G, but 5G gives us the potential of moving these interactions many steps further adding for instance sensor and virtual reality to teleconferencing, enabling healthcare workers to remotely monitor vital signs during calls. In addition, because 5G allows for the transfer of sizeable data packages, testing patients with conditions for changes in their heartbeat, blood sugar and blood pressure multiple times a day using cloud-linked scanners is also very much possible.?

See? 5G is the connective power that makes the world of AI and Web3 positively impact healthcare. Let's see at some concrete examples related to the massive data amounts generated: One patient can generate hundreds of gigabytes of data each day, from patient medical records to the large image files created by MRI, CAT or PET scans. So that a 5G project by AT&T and the Austin Cancer Center showed that Adding a high-speed 5G network to existing architectures can help quickly and reliably transport huge data files of medical imagery, which can improve both access to care and the quality of care. At the Austin Cancer Center, the PET scanner generates extremely large files — up to 1 gigabyte of information per patient per study. Jason Lindgren, CIO at the Austin Cancer Center said: “To get that much data from one side of the town to another, you’ve got to have the network performance to handle it. We used to have to send the files after hours. Now as soon as the patient leaves the scanner, the study is already on its way. It’s beneficial to doctors because they can get the results that they need quicker". This is very powerful!

Also, a report from Accenture reveals that the use of digital health technology is on the rise, with the use of wearables rising from 17% in 2020 to 24% in 2021. According to Lisa Anne Bove in her article for The Journal of Nurse Practitioners, wearables can increase patients’ engagement with their health. This engagement is expected to decrease hospital costs by 16% over the next five years.?

Many healthcare enterprises are already investing in and deploying the first layer of programmable world technology, creating a connected foundation. For instance, 80% of the healthcare executives we surveyed say the number of IoT/ edge devices deployed in their organization has “significantly” or “exponentially” increased in the past three years.

This can prove an enormous business for telecom operators, of course: an Ericsson research showed that the revenue potential of addressing healthcare industry digitalization with 5G is enormous, pointing to an overall 75.7 billion USD estimated in 2026, broken down across the following verticals: patient applications (49.2), hospital application (19.8), healthcare other (5.2), and medical data management (1.6).?

With respect to the impact of the convergence between 5G and IoT, I really like the definition by Accenture that mentions that this gives rise to a "programmable world". They say in the "Meet me in the Metaverse" report that "while the metaverse is all about leveraging the immersive experience of the virtual world, the programmable world is about building the next version of the physical world in healthcare".? In this world, control, customization and automation will be enmeshed in the environment around us. People will have unprecedented ability to command the world to meet their individual needs, deciding what they see, interact with and experience with greater ease and fidelity than ever before. Healthcare enterprises will build and deliver these experiences, as well as reinvent their own operations, for a new kind of world in which we can make physical spaces adaptable to cues or our needs while improving environmental sustainability. For instance, Johnson Controls is using digital tools to enhance patient safety and improve outcomes. When codes are called, digital controls in each patient room are adjusted instantly to help speed response. During a medical event, the company’s OpenBlue Code Blue Optimization uses AI to prep the room based on the configuration selected. One button launches features such as alerting clinicians and directing them to the correct patient room, adjusting room temperature and lights, powering off media devices and setting the patient bed to an optimal height. Consider what could come next as digital controls might be programmed to provide direct care through robots or automatically sanitize tools after a procedure.?

Besides 5G and IoT, the technologies that make up the programmable world include: Smart materials, which can sense and respond to changes in their environment. These materials can either have “baked in” intelligence, thereby not requiring external computational systems to react, or they can be connected to or controlled by computational systems or direct command; Ambient computing, which uses interconnected IoT devices to integrate computing into people’s lived environments and turn the world into a seamless interaction layer, and eventually AR.

6. Tokenization and NFTs for IP and data protection

Who hasn't heard of the NFT buzzword lately? Impossible not to have been impacted by this term, which for the most part is related to "digital art"- and I am sure you are like now: "Andrea, what does this have to do with Pharma?".?

Well, to start off we have to understand what are NFTs, or Non-fungible Tokens, in order to understand that their applications go much beyond only art and gaming, and are not only the speculative bubble that we are seeing now.??

What are NFTs, exactly? NFTs can be thought of as a signature for digital assets, which rely on blockchain technology to prove authenticity through a ledger. By confirming authenticity, NFTs establish ownership of one-of-a-kind online assets which can range from a simple pixelated image to a complex set of data, making it impossible to duplicate without permission (to clarify, this means that a set of data can be imitated, but the original is always clearly identifiable: for instance you'd be able to read Jack Dorsey's first Tweet on Twitter all over the internet, but the original one has been auctioned for $ 2.9 millions and is owned by crypto entrepreneur Sina Estavi. Identifying where data comes from and verifying its validity is a key pillar of the industry today, making it likely that it will continue to be a major topic of interest going forward.

Contrary to the wide draw of NFTs as investments, the applications of NFTs in healthcare and pharma marketing are not meant to inherently just generate profit. Instead, NFTs would serve as a solution for verification of digitized health services, authentication of credentials and data, and protection of intellectual property (IP). At its most basic level, this technology can help shorten the healthcare journey and eliminate human error, and at its peak, it can improve transparency in the space for health care providers and patients alike.

Let's start off from data ownership: NFTs could actually create social good, by giving (back) data ownership to patients, argues a recent publication out of Baylor College of Medicine—specifically, within the healthcare industry.

In the journal Science, a multidisciplinary team of bioethics, law, and informatics scholars write that NFTs, as a digital contract of ownership, could help citizens track and control who accesses their personal health records. The health record-keeping system as it exists today is an organizational jumble—an issue in and of itself—but it also disenfranchises the individual, who essentially loses all power to decide who can view their personal data once the clipboard leaves their hands. We have seen all of this in the Blockchain chapter.? After the data collection, the information is transcribed into an electronic record, which can then be commercialized and distributed in unforeseen ways. More importantly, that information is valuable. “In the era of big data, health information is its own currency; it has become commodified and profitable,” says Dr. Amy McGuire, a senior author of the paper. Ownership of it, via the NFT blockchain ledger, could let individuals track the sale of their data—or stop it, or even cash in.

An example? Aimedis, a blockchain-enabled healthcare platform, was among the first to launch an NFT science and medical data marketplace in 2021 and created the first NFTs for cardiologic patients containing ECG information, successfully treating patients in the metaverse. It also works in partnership with the World Federation for Neurorehabilitation, which serves up to 100 million patients and aims to use medical Metaverse for VR rehabilitation services.? In an interview for Omnia Health, Michael Kaldash, Aimedis'CEO, said that "Medical data has two major issues — it holds intellectual property and contains royalties that must be paid. NFTs are unique pieces of information on the blockchain that are incorruptible and can be connected to smart contracts, paying out royalties to all involved. Therefore, NFTs hold potential solutions for sharing and using medical data".?

Also, blood donors are marked with a specific token that can then be followed through the system.? The donation can then be followed from transport to the hospital, into a blood bank, and into its eventual recipient.? Blood can then be registered by its NFT into a digital “blood bank” where the need for particular blood types can be tracked by a blockchain system and delivered to where it is most needed.

At the same time, NFTs can help protect intellectual property: a new standard has even been created: the IP-NFT. IP-NFTs represent full legal IP rights and data access control to biopharma research. More importantly, they represent the heralding of an entirely new asset class: virtualised IP. This first project came out from a longevity research project from Morten Scheibye-Knudsen at The University of Copenhagen, where In a historic transaction, the first biopharma IPNFT was successfully transferred to a research collective, VitaDAO, to fund novel longevity therapeutics at the University of Copenhagen. This was facilitated by Molecule, a startup that aims to become an OpenSea of biotech IP, powering a new creator economy for researchers that allows for the rapid funding, discovery, and development of therapeutics through globally connected patient collectives. How will this IP-NFT marketplace work? In brief, it allows the IP to enter Web3. If Web1 is the information layer (think Google), and Web2 is the communication layer (think Facebook and mobile), then Web3 is the monetisation layer that connects Web1 and Web2. Minting IP as an NFT enables the IP to be financialised — it can be held by a DAO, tokenised, have a liquid market created around it, collateralised, and borrowed against.

So to recap, what can an IP NFT do for you? According to Tyler Golato, lead Scientist for Molecule, you can:

• Fundraise commercially without needing to patent early or create a startup.
• Engage stakeholder groups like patients directly, collaborate with other researchers to promote open science, and get attention through a public marketplace.
• Collaborate on research tasks utilizing data access control and bounty systems.
• Create new funding/monetisation strategies that take advantage of data marketplaces.

All of this is extremely powerful and important in the healthcare sector.

?

7. DAOs for collaboration in research, care and financing.

Do you know how a cooperative works? I do a lot of speaking to cooperatives in Brazil, especially in the finance and agro sectors, and I have always been amazed by the way they are able to be more customer-centric and collaborative, because of their "ownership" structure - that, to explain as briefly as possible, is basically a model in which the organization is "owned" by its customers.?

This definitely makes accountability much more important, makes the division of profits more egalitarian, and as I mentioned before it makes the organization more customer-focused (as the cooperates, namely the customers-owners, make decisions about the cooperative strategy during regular meetings).

And while traditional cooperativism was born in 1844 in England, we now see a new form of cooperativism on the rise through Web3: namely the one brought about by DAOs, or Decentralized Autonomous Organizations.?

What are DAOs, to start off? A DAO is a new kind of organizational structure, built with blockchain technology, that is often described as a sort of crypto co-op. In their purest form, DAOs are groups that form for a common purpose, like investing in start-ups, managing a stablecoin or buying a bunch of NFTs. ConsenSys, a blockchain organization, defines DAOs as “governing bodies that oversee the allocation of resources tied to the projects they are associated with and are also tasked with ensuring the long term success of the project they support”. Once it’s formed, a DAO is run by its members, often through the use of crypto tokens. These tokens often come with certain rights attached, such as the ability to manage a common treasury or vote on certain decisions.

And how can DAOs make an impact in Healthcare? Well, one of its uses can be of use in order to collaborate around IP and allows for better licensing and discoverability through collaboration in research.?

Some examples of work in the field??

First of all, LabDAO: LabDAO connects researchers across the globe so that they can collaborate more efficiently. The team likens it to a peer-to-peer ‘marketplace’ for scientists, wherein they can trade skills, knowledge, access to lab services and equipment, and results without the need to personally travel halfway across the world. For example, if scientist A has an experiment that needs equipment A, which scientist B has, scientist A can connect with scientist B to run the experiment and get the results. LabDAO aims to optimize biotech research costs, increase potential in the sphere, and facilitate cooperation on a global scale.?

Also, GenomesDAO: GenomesDAO is a “genomic data security company” with the aim of democratizing and decentralizing the area of genomics in the healthcare arena. Founded in 2018, it aims to give ownership of an individual’s genome back to the individual, targeting the security and privacy concerns surrounding DNA testing and who that data is paired with. The DAO hopes that by building a worldwide database of user-owned DNA data, in the future personalized medicine will become a reality. Unlike services such as 23&Me, it aims to ensure that ownership remains with the owner of the DNA.

Also, DAos can be beneficial for traditional healthcare financing. An example? Definitize, Definitize is the world’s first Decentralized Autonomous Organization (DAO) that uses DeFi for healthcare financing. With traditional finance continuously failing to cater to the needs of stakeholders within the healthcare industry, Definitize is designed to solve this issue and improve access to care on a global scale.

By using decentralized finance to democratize healthcare, Solve.Care aims to provide better patient outcomes and promote transparency within the industry. By turning over Definitize to the community to own and govern, all stakeholders, inclusive of patients and healthcare providers, can play a direct role in creating an impact to improve healthcare. Users can participate by staking SOLVE – Solve.Care’s native digital currency – to mine DCARE governance tokens and become citizen/owners of Definitize to get a share of the income of all Definitize asset pools. Or, they can decide to fund specific asset pools that would finance specific healthcare projects to earn interest and a share of the income that particular asset pool generates. Alternatively, the community can submit a proposal to the DAO to become a distributor.

With Definitize, patients, doctors, institutions, and insurers can all mutually benefit through a community-driven, community-governed ecosystem. In this way, members of the DAO have the power to approve specific healthcare-focused projects based on the proposals they receive from other members. Once approved, asset pools which are funded by SOLVE tokens or other stable coins, are created to fund that specific project. This is a new and truly innovative way to solve the current lack of funding present in the healthcare industry today.