The Blockbuster Opportunity to Mitigate $1T in Waste, Fraud, and Abuse in the US Health System

The U.S. spends an astonishing $4.9 trillion annually on healthcare—yet consistently ranks poorly among high-income nations in health outcomes, access, and equity. A shocking $1 trillion of this spending is considered wasteful. Could blockchain, Web3, and decentralized technologies help solve this trillion-dollar problem?

Join us for this insightful livestream as part of the monthly Emerging GovTech series, sponsored by the Government Blockchain Association and the National DigiFoundry. Hosts Gerard Dache and Kevin L. Jackson, CISSP?,CCSP? will be joined by special guests Heather Leigh Flannery (Chair, GBA Healthcare & Life Sciences Working Group; CEO, AI MINDSystems Foundation) and Pradeep Goel (CEO, Solve.Care Foundation & TuumIO) for this February Healthcare & Life Sciences focused session.

Listen in as these visionary health tech leaders discuss:

The scale, causes, and impact of waste, fraud, and abuse in U.S. healthcare

How blockchain, Web3, and decentralized technologies can enhance data security, governance, and compliance

Innovative solutions like the National HERO Initiative and 340B Transparency & Accountability Program, and the role of the Blockchain Maturity Model

How AI MINDSystems Foundation, Solve.Care Foundation, and Tuumio are driving change in healthcare

Actionable insights and expert engagement on the future of GovTech in healthcare

Transcript

Kevin Jackson(00:01:40):

Well, good morning. Hey Gerard. Hey buddy. How are you today? Oh, I'm doing good. Trying to get these butterflies out in my stomach for this premier show. How about you?

Gerard Dache ?(00:01:53):

Oh, I'm really looking forward to this. This is going to be a great episode. There's so much going on in the world in the country with regard to this topic. It's going to be a phenomenal time and our guests are just out of the park, so it's going to be awesome.

Kevin Jackson(00:02:08):

Yeah, see there's a lot of people coming in the room. Looks like it's pretty, it's filling up fast. This is the top ticket in the world.

Gerard Dache ?(00:02:22):

So do you want to tell 'em maybe a little bit about what we've got in store for today?

Kevin Jackson(00:02:29):

Yeah, sure. So thanks everyone. My name is Kevin Jackson. I am the operations executive for the National Digit Foundry, and I'm so excited about the opportunity to co-sponsor the emerging Govtech series with the Government Blockchain Association. And with me is Gerard Dash, the executive director of the GBA. This will be a series a monthly series highlighting how these emerging technologies like blockchain are being used in just about every industry vertical. This show is about the healthcare industry vertical, and we have some two great guests that are going to talk more about this topic. Gerard,

Gerard Dache ?(00:03:28):

Lemme just take a minute. So my name is Gerard Dashay, I'm the Executive director of the Government Blockchain Association. Lemme just take a minute or two to talk a little bit about the organisations involved, national Digi Foundry and the GBA. So the GBA, the Government Blockchain Association. We're a nonprofit. We're essentially a membership organisation like a business league. And our goal is to help the public and private sector connect, communicate, and collaborate to use blockchain and Web3 technologies to solve public sector problems. And what we are really all about is really three things. It's creating the communities where people come together and it's also about creating the standards and just enabling a lot of that. And I'm super excited to work with Kevin Jackson of the National Digi Foundry because their expertise really is in really supporting the infrastructure. So Kevin, you want to tell me just a little bit about the National Digi Foundry and how this partnership, this relationship between the GBA and the National Digi Foundry works so well together?

Kevin Jackson(00:04:33):

Yeah, absolutely. So the National News Foundry Allo Genesis actually was an executive order from the president where he wanted to leverage a whole of government approach to the use of digital assets, blockchain and other Web3 and Industry 4.0 technologies across not just the financial industry but across all industries. So the White House Office of Technology policy put out a grant to create a incubator, a safe space where companies, public, private academia could work together to innovate in this space. And that was the genesis of the National Digit Foundry. This it was a two year grant to create an infrastructure, to build a community about innovation with these technologies we've started, we built, and about a year ago it's been, we started collaborating closely with the government Blockchain Association because of their large, global, and really industry leading position.

(00:05:56):

I guess over 4,000 members seem to be very interested in actually building solutions and bringing them to the market. So our environment is just that. It's a place where you could create proof of concepts, where you can do minimal viable products, where you can demonstrate your expertise in leveraging blockchain, for instance, to address the critical needs of government, global government. To that end, we've also partnered with the Dynamic Coalition on Blockchain Assurance and Standardisation with the Internet Governance Forum. So this is not a local thing, this is a global thing to help all governments everywhere leverage this advanced technology. And since then I think we've found out that our work is very synergistic and they have been accelerated quite rapidly. Rapidly.

Gerard Dache ?(00:07:16):

Yeah, that's absolutely right. And so together we've worked very, very closely to really create an environment in the GBA. We have about half of our members are government. And one of the things that makes us different than a lot of other associations is they're work focusing on policy lawsuits, really trying to change the public dynamic. And we are working primarily with programme managers, with people sort of in middle level that have budgets and requirements. And we're trying to get those people that have budgets and requirements connected with vendors and people that have solutions and get them together so that down the road when the policymakers ask their administrators and they say, Hey, what do you think of this blockchain thing? They can say, oh yeah, well we've been doing it for the last two years and yeah, there are some bumps and we've worked out the kinks, but it's working great now.

(00:08:08):

So we really are focused with people that want to get stuff done as opposed to working at the very top changing policies and things like that. So if you're interested in actually getting stuff done, the GBA and then in partnership with the NDF is just a great way to connect with the right people and to develop the infrastructure necessary in order to experiment with, to pilot, to commercialise solutions that can then be moved to government. And that's why I think that this relationship is so great. So towards that end, we've decided to hold this a series of webinars every month on the second Tuesday at this time to talk about different topics. Today the topic is healthcare and because there's so much going on with the new administration and trying to be more, and you hear all kinds of people talking about where can we cut expenses and be more efficient without cutting services, blockchain and healthcare, it's a perfect connection, especially in light of one of the presidential candidates in the United States, RFK.

(00:09:12):

He made a commitment that if he won the White House, that he would put the US federal government on the blockchain. Well, he didn't win the White House, but he did win HHS. So now a lot of people are talking about, huh, can we use blockchain to be more efficient in healthcare? Which essentially lines us up exactly for this webinar. So let me turn it over. Back to you, Kevin. There's a couple of things happening in the news you want to share, any thoughts or insights in terms of the topic and then we will turn it over to our speakers.

Kevin Jackson(00:09:45):

Well, before we do that, I'd also like to make everyone aware that at the end of this show, at the end of the live stream, we're actually going to have a round table where people will be able to discuss topics around healthcare with our guests and with Gerald and I, so don't go away at the end of the first hour. So with respect to news, one of the things that was recently published, we were talking about the why or how blockchain actually can be used in healthcare. This was done within what's known as the NAS community, and it was saying that the healthcare industry is really undergoing a digital transformation, but there are many challenges in this security breaches, fragmented databases and inefficiencies when it comes to administrative work. Blockchain as a technology really presents a groundbreaking solution because of its decentralised, tamper-proof and transparent approach to managing data, and in this case, patient data.

(00:11:22):

So it really plays important roles as we digitise all of our medical records. It actually fortifies data security and privacy by providing cryptographic encryption and immutable records, records that can't be changed. The decentralised storage eliminate single point of failure among other things. It also enhances interoperability amongst all of the medical providers and seamless data exchange. This provides really a universal standardised ledger and it provides accessibility to patients as well. Empowering these patients with full data ownership, patients can control their own health records with blockchain, and this in turn reduces fraud and it can prevent medical errors. The digital timestamps and audit trails allow providers and insurers to verify the authenticity of medical procedures and you can get real time fraud detection. And finally, it simplifies regulatory compliance and the ability to audit this data. Blockchain has transparent audit trails, so regulators can easily verify data security compliance and healthcare institutions can reduced paperwork. So when you look at all these things together, blockchain can really deliver a lot of value to the healthcare industry.

Gerard Dache ?(00:13:22):

Yeah, I had to just share just a couple things with regards to just some of the other articles and I want to make sure I give as much time to our panellists as possible. Can you guys hear me okay?

Kevin Jackson(00:13:36):

Yeah.

Gerard Dache ?(00:13:37):

Excellent. So one of the things that we see, blockchain really, and really the blockchain and ai, Heather's going to talk a lot about this and I'm sure PRADE will too. This intersection between how what blockchain can help us do is with all of this data coming out of the healthcare system, tonnes and tonnes of data, AI now gives us an opportunity to use that data in a way that we was never imaginable before. Precision medicine as an example. But then the problem with all of that data getting used is essentially the privacy, the security. And one of the things I love in talking you'll hear from the guests is how this rich data that's coming out can be used in a whole new data economy.

(00:14:26):

And one of the things that I've learned from Pradeep over the years is how it doesn't have to be siloed anymore. So when you look at all of the different ways that blockchain and AI can help us in terms of reducing costs from a healthcare perspective, you got all the administrative costs, how many times we hear about fraud, waste, and abuse. And that's one of the topics that we'll talk about clinical trials. So being able to match patients, participants in clinical trials and the laboratories, that's an incredible, incredible thing for us to do. There's so many precision medicine, being able to take this data and provide people with exactly the processes and treatments that they need. The administrative part of it, there's so much in this space. There's a great article that talks about it, but honestly, the greatest wealth of information is really going to come from Pradeep and Heather. So is it okay if I introduce them because I know we've been talking about them and I'd love to get 'em on stage and let them share some of their magic.

Kevin Jackson(00:15:34):

Well, before you do that, I want to actually highlight the fact that we have a global audience here on this live stream. Let's talk about, for instance, Alba who's joining from San Diego, California. And so we got the West Coast covered. If you also check out me, Nova from downtown Arlington, Virginia, right down the street from me in Manassas Ard, who's in Fairfax. And we also have from Argentina, Franco Garcia, Franco Garcia. So I guess they are getting ready to go into their winter. We're still in, they're down there in summer going into their winter. We are in winter getting ready to go to summer, about to get eight inches here where we are. And NFTE from the District of Columbia, everybody's jumping in. We got Nic Kumar from Seattle. So my son lives just south of Seattle, so where my grandkids are. But we really, really appreciate you joining us today. So Gerard, it's probably a good time for you to introduce our two guests.

Gerard Dache ?(00:17:18):

Well, thank you Kevin. So we've got two of the most incredible people on the topic that we could hear from. So lemme tell you about Pradeep first. And there are some people that are experts in their field. There are some people are just incredible people in general. So Pradeep, just to give you an example, he was at the very top of different healthcare companies, right? And I don't remember if it was Blue Cross Blue Shield, but one of the big health insurance companies, he had a career in that space. When the US government launched healthcare.gov, for those of you who remember, it was a train wreck and they had to find people to basically untangle this spaghetti code and they reached out to Pradeep and a small number of other peoples. And Pradeep was one of the people that basically saved healthcare.gov from total calamity.

(00:18:12):

So he's used to working at the highest levels at the White House with folks in the different states, public sector insurance companies. So he understands this. One of the things that he recognised early on was that the healthcare system just couldn't change, right? They were so big, so they were so bureaucratic. And he realised that he had to find a way to basically solve problems smaller, faster that can grow. So he came up with this entire concept that eventually became solve care. He had a company to do that, doing some incredible things with the diabetes community, just all sorts of different aspects of healthcare. But then this really talks about who he is. When the Russian soldiers were lining up on the border Ukraine and started pouring over the border, he went over there and he basically made sure that his people were safe. He moved them out of harm's way, he got houses for them and their families.

(00:19:11):

And then when he saw the faeces made contact with a rotary oscillator, he then went on to get shelter for people who had lost their homes to feed them, created a supply chain, saw that the kids were losing access to their education. So he contacted people globally to set up remote educational facilities. This man, he's a true leader, he's inspirational, he's, he's somebody who solves big problems. He's got a big heart, he works hard, which is why he won the GBA Annual Achievement award. I don't remember if it was just last year or the year before. But not only is he brilliant, not only is he capable of solving big problems, but he is indicative of the character of the leadership that I'm so excited that you get a chance to hear from him. He's very humble, so you won't hear it in his voice, but he's an incredible human being. Heather Flannery. And she's embarrassed when I tell people this. She is the smartest person in healthcare technology that I've ever met. And she also has an incredible story of overcoming. And again, it is her story to tell, but she has tackled big, big problems. And she also recognised that healthcare can't be changed incrementally. It's got to be changed in a big way. So she's worked diligently with folks in the economic aspects of healthcare, the technology aspects, the political aspects, all different areas to tie all these pieces together. And so with Heather and Pradeep, you've got big thinkers, incredibly smart, inspirational folks. And I don't want to take any more time, but give you an opportunity to hear from these two amazingly bodacious human beings

Heather Flannery (00:21:18):

There. They're ard, you're too much. Too much. Thank you.

Kevin Jackson(00:21:28):

Welcome to the show.

Pradeep Goel (00:21:31):

Thank you Gerard. Thank you Kevin. Hello Heather. It's honour and a privilege to be here. Thank you for having us.

Gerard Dache ?(00:21:41):

So the floor is yours. I can't wait to hear, I can't wait to hear. I know you guys are going to have a fireside chat and I'd love to hear a little bit from both of you in terms of what got you into this space. You can elaborate on that and the whole concept of saving from this fraud, waste and abuse. I can't wait to hear what you have to say. So guys, the floor is yours,

Heather Flannery (00:22:05):

Pradeep. Would you like to open up with some of your associations with hard work mitigating waste, fraud and abuse? And then I'll continue forward facilitating our discussion here.

Pradeep Goel (00:22:18):

Thank you. So that's very kind and please feel free to jump in. I'll be brief. We all have heard the big numbers around healthcare fraud, waste and abuse. A trillion dollars is the number you hear most often. One would argue that's understatement and that's just the us. It's important to understand the root cause. The root cause isn't one person sitting in some secret power conniving to steal a trillion dollars from people. It's not that way. The system is set up that way. And that system evolved over the last 75, 80 years, not in a day. So it is a systemic issue as we all know, but it is very intractable issue as well because every time you talk about reducing something, somebody's chequebook is going to be impacted. If you want to talk about drug price control, pharmas going to be impacted. We talk about telemedicine, hospital revenue goes down.

(00:23:10):

If you talk about making access to care more easy, insurance companies balance sheet suffers. So everybody's got a skin in the game and everybody's struggles. Nobody disagrees that our system is broken in the US in particular. But really common analysis is the issue worldwide. We are the most egregious example of it. Now, my personal experience is three dimensions. One is as a insurance executive, we always worry about cost of healthcare, but we also worry about over utilisation abuse of the system because ultimately you are custodians of a group pool of money. And as insurance company you operate on super thin margins. So while they have big buildings and a lot of overhead, ultimately the margins are very small. So room for error is very low. So as an insurer you're always worrying about utilisation, exploitation of the system, inappropriate benefits and whatnot. The flip side, you're worrying about and denying people care that they deserve a need.

(00:24:03):

So it's a very delicate balance as a healthcare policy and as a government executive, I always worry about budget, what Congress gave me and also how many people I have to care for and typically think about millions of people. If you're a Medicaid director, you're not thinking 2000 people talking, 2 million, 3 million people needing care and you only get 90% from the Fed and 10% the state budget and states don't have the money. So there's always that issue. And the third dimension, which is the most important one, is the parent. When you're trying to get care for your sick kid, you are not particularly interested in this bureaucracy. You just want the best care possible and every possible care delivery to your kid regardless of the system's limitations. And that becomes really frustrating even for people who have deep knowledge of healthcare like Heather does, like I do. So where does the answer lie? The answer lies ultimately in both technology and policy, but also in consumer awareness. And I think we should talk about that, that either we can build better tech, which will definitely help. Maybe half the waste is tech related, the other half is policy related, but none of them will work unless we get a consumer more engaged in understanding how to use the system properly. So that's my take on things. I'm looking forward to the conversation with Heather

Heather Flannery (00:25:23):

Pradeep, thank you so much. And I absolutely loved the insight that you described about how a reduction in expenditure in any part of our system is impacting the balance sheets of one stakeholder group or another, that those reductions in budget do represent trade-offs. And you highlight the fundamental issue that I would put top of the list is that we have misaligned incentives between stakeholder groups and that's a summarization of the wonderful point that you were making something intrinsic to blockchain technology. And the movement that is Web3 for those of you familiar with that, is that it represents not only a system of operating and governing entirely new trust and security and compliance models, but it allows the possibility of the discovery of dynamic incentives that can be optimised potentially so, so much faster than the pace of contractual changes or legislative changes that could occur.

(00:26:32):

So by combining blockchain technologies with the extraordinary potential of ai, we have an opportunity now we have an opportunity to make a non-linear exponential impact. And I think Pradeep, you and I share those values and Kevin and Gerard embody them as well looking for outsized outsized potentials that have alluded our society to date. So thank you so much for that. And in terms of gbas good work, I am honoured to chair the healthcare and life sciences working group at the GBA where we are looking at how to deepen and widen the adoption of Gbas standard for blockchain assurance called the blockchain maturity model. And that is a trust system for trust technologies and itself introduces an important way of overcoming a key barrier to adoption of this family of technologies, which is human beings aren't cryptographers and human beings need systems of trust that allow decision support in a preponderance of so many examples of possible uses of this tech. So go ahead.

Gerard Dache ?(00:28:00):

I'd like to ask both of you guys a question, and that is for the folks that are in government now, we know that the healthcare system is big and huge and it's all interconnected. Pdi, I want to throw this over to you first, right? How do folks in government, do you have any idea suggestions about if I'm a government bureaucrat, let's say at the state level, our topic next month is going to be specifically about putting budgets on the blockchain. We're talking to one of the state health departments about that or talking to folks connected with that. But if they wanted to move forward, what are your thoughts in terms of those steps? What are the first couple of things that folks in government could do? And I know that there's many, but if you could maybe just pick what some of those first steps would be about how do we move the ball in this space? So Pradeep, why don't you go first and then Heather, I'd love to hear your thought.

Pradeep Goel (00:29:04):

As you said, there are many opportunities, but I would look at the low hanging fruit. Every public programme is taxpayer funded and it has a fiduciary responsibility to make sure that benefits are consumed by those who are eligible for it and deserve it economically or demographically or geographically. There's always a requirement for you to participate in a public health programme or public programme of any kind. So first thing you focus on is making sure that the right people and only the right people have access to the right care, which is the second part of the problem, which is that you don't want to deny care and you don't want to at the same time also make care too permissible where wrong people get the wrong amount of care for the wrong reasons. So eligibility systems being tokenized is a very clear pathway to reducing tremendous amount of fraud, waste and abuse.

(00:29:54):

Very simply put every public health programme, every public agency for any programme has to do eligibility verification and it's a very complex and time consuming process and is centralised and inefficient and frankly, the root cause of most fraud waste number use. The second equal, the opposite side of the coin is pricing. So one is eligibility, the other is cost. Now the pricing side, you have narrow networks which are run by companies like Centene or by entities like my old Blue Cross Blue Shield or the Blue Network and so on and so on. These are provider rate contracts and these are provider rate networks, which are supposedly designed to give you right value for the money, but they rarely work as advertised. So if we can move to a tokenized payment cost and payment model, which basically says that when I go to get an x-ray done as a Medicaid recipient, I show my Medicare token and I receive a token from the government that lets the doctor charge me $72.

(00:30:53):

You don't need to bill this, you don't need to do anything. You just need to show them the token, which is equivalent to the rate sheet that is already known to the government. So we can eliminate tremendous amount of waste and opportunity for fraud by tokenizing costs, which is well-known fixed price, well-defined parameter. Why don't you put it on the chain, tokenize it and give it to everybody. That's your second opportunity. The third opportunity is in advanced care, which is the referral system. So whenever you get outside the bounds of normal care, cost is incurred, 80% of healthcare costs goes to 20% of the healthcare beneficiaries, right? Most of us aren't big consumers of healthcare till we are. The amount of money government will spend upon any citizen last three weeks is when 85% of their lifelong cost is spent because that's when healthcare becomes very complex. Average healthcare isn't the expensive part, it's a complex care. That's the hard part. So why don't we focus on making sure that the referral system in government is tokenized? So I'll give you basically three extremely clear, low hanging fruit for public health, tokenized eligibility, tokenized rate sheet and payments, tokenize your referral system and will that solve every problem? No, but can you get rid of half a trillion dollars out of a trillion? I submit You can.

Kevin Jackson(00:32:13):

Wow,

Gerard Dache ?(00:32:14):

That's

Kevin Jackson(00:32:15):

Fascinating. That's really amazing. One thing I'd like your comments on both, and Heather, at least here in the United States, we have this new organisation called Doge, which is actually dismantling the government. Is this a good thing for healthcare or a thing or healthcare or how should we actually address the government's roles? This is a comment from AVI 1, 1 2.

Gerard Dache ?(00:32:54):

Actually, before you answer that real Heather, do me a favour answer the last question, where do they start? And then maybe if both of you could answer Kevin's question, that would be awesome, but I'd like to hear your response to where can governments start low hanging fruit for them?

Heather Flannery (00:33:11):

Sure, absolutely. And I think it's important to note that of our nation's $4.9 trillion of total spend, 34% of that is coming out of the public sector. And because the payments volume and the economic volume moving through that channel is so enormous that the points that PDI make are absolutely spot on. I'd like to build on that by talking about some critical path elements to make that go. For example, each of the areas that Pradeep mentioned presuppose that you actually know that the patient who is submitting a bill or accessing a resource is alive, is the actual patient that is the intended patient and is not a duplicate of the same human receiving other or duplicative resources or services. That's three different vectors of fraud and some of it is waste through inadvertent accidental challenges that live within this domain called the patient matching problem. All of that is presupposed in the solution using identity primitives from or technological components from the field of blockchain and Web3 technologies and creating a system of identification that not only provides higher level, but makes it possible to also offer privacy and anonymity in areas that are particularly sensitive and that block access to care, imagine suicidality, substance use disorder, our deaths of despair that plague our country.

(00:35:03):

So that ability through the same set of technologies to enable the programmatic efficiency and the fraud mitigation and provide dignified and safe and emotionally accessible care in some of our nation's most challenging areas, including one that heavily impacts the population that I focus on very closely, which is United States veterans and their families and caregivers where we have a tragic number of veterans take their life every day in the United States despite ever escalating expenditure seeking to resolve that. So this fundamental principle of identity as the cornerstone of a foundation of a new system is incredibly important and is accessible. There's a bunch of policy details that I could dig into there, but it's a very high priority. The other that I would build on from P'S comment is something in our industry that has talked about the transition from volume to value for those outside of healthcare that aren't familiar with that parlance the giant system we're talking about literally 4.9 trillion in the US alone runs like a giant time and materials contract, but it's not one contract, it's millions of contracts and they run on a time and materials basis.

(00:36:30):

What that means is you're paying for time, you're paying for materials, you are paying for fees connected to that, but you aren't paying for a specific clinical or pop health endpoint or outcome. And the industry has had a consensus for many years that this is where we need to get to, but it is blocked, blocked by so many different barriers to that transition. Now only about 5% of total expenditure is subject to any kind of risk bearing relationship. When you think about what is the problem with moving from volume to value, the heart of it is data. The heart of it is trust. It is how do you know what outcomes are actually achieved by whom and when and how could you move that into something more like real-time settlement systems that make that feasible because the truing up on the backend of what happened. Aftercare is an enormous public health challenge and it's an enormous contract administration challenge that today eludes our ability to use those techniques. But that's a fundamental thing that needs incentives across the stakeholder groups.

Gerard Dache ?(00:37:48):

Got it. There's so much there that I love to unpack, but I want to get to Kevin's question, but gosh, there's so much there I want to unpack. So Kevin Prade and Heather, why don't you address Kevin's question, but then let's bounce back to this if you don't mind that after that?

Kevin Jackson(00:38:07):

Yeah, just to sort of revise that, review that question. I mean, government is important in healthcare and there's movement to reduce fraud and waste in the government by dismantling some of these regulatory organisations. So what is your viewpoint from your expertise? Is this a good thing, a bad thing? How do we do we eliminate fraud by dismantling government's roles?

Pradeep Goel (00:38:40):

So I will take a quick shot at that, but it's a very complex question, but I'll break it down. Government in the United States is a payer, not a provider, meaning the government writes the check but doesn't deliver healthcare and when it tries to do so, it fails miserably at it. So it normally doesn't get in the business of delivering healthcare. It's primarily in the business of paying for healthcare, Medicare, medicaid, ACOs, they're all government funded programmes. They're not government administered programmes in sense of you rely upon a completely different machinery to talk to the patient to deliver drugs and admit them in the hospital, and that's typically private. So what government can do, what Doge can do is to certainly align the interests of the patient with government policy, but that's a long road that's not going to happen. Walk in and grab the IT systems

(00:39:32):

Approach. So where I see the opportunity lying today is in all the stalled initiatives that, like Heather mentioned, the accountable care initiatives that were blocked because of misappropriate funding was not allocated. I think what government can do and seize the opportunity to do one hopes is to actually invest the vast amount of available dollars in things that actually drive better outcomes for the patient. And we haven't always prioritised the patient. In fact, rarely is the patient in the room, right? And in put things lightly, but not too lightly. I wish that every government policy meeting had an empty chair with a consumer refugee in it like Amazon does. There's an empty chair representing the consumer. We need that mindset in government, particularly in healthcare. But that's one is essentially to i'll reallocate funds to projects that actually are impactful in terms of quality of care, access to care and cost of care, which is typically not where money goes.

(00:40:34):

The second area where I see government absolutely do something is to make the data the right of the consumer. This is absolutely fundamental to all our broken healthcare system. The fact that hospital systems who are custodians of patient data claim that data is theirs. The president can with one exact order can mandate that the patient has unfettered right to their data. Whether you're a lab or a pharmacy or a hospital or insurance company or an employer or a doctor or a chiropractor, thou sh not do anything or through inaction, prevent access to patient data. The moment you open up the patient data and remove it from the clutches of people like Optum and Blue Crosses and the big epic run systems through Mandate Healthcare will change because people will have access to data they have never had. None of you have probably ever seen your lifelong claim history.

(00:41:26):

It exists. You don't remember the last time you went and saw a specialist unless it was recent. You don't know all the drugs you've taken all in your whole life. You don't know anything about your healthcare other than what you remember for the last episode. Nobody remembers that the government does. And government has every reason and right to say, you know what, Gerard, you have now unfettered access to your data. You will see within weeks a completely different healthcare system because people will suddenly go, oh my God, are you kidding me? And that, oh my god reaction comes once you actually see your health journey laid out in front of you. So those are the two things that come to my mind. Stop investing in, start investing in where all the stall initiatives are, which we have plenty of money to go around. We just don't prioritise them and open up the data to the consumer. You do that, you'll have better impact than seizing any other IT system because the current approach I don't agree with just grabbing IT systems and shutting them down or putting them under the control of some kid is not going to fix that healthcare because you don't deliver help, you only pay for it and you can stop paying people, but that won't help anything either. So focus on the data access to the patient and focus on reallocation of the four, $5.9 trillion that we spend each year.

Gerard Dache ?(00:42:44):

Heather, would you expand on that? I know you've done a lot of work with the health data economy, right? So maybe talk a little bit about that and then I just want to address some things in the chat. There have been a number of comments and questions about the blockchain maturity model. You should just be able to google GBA blockchain maturity model. You'll see a page with the model, the D, healthcare standard, all sorts of different stuff. So you can certainly take a look at that. But Heather, would you please talk two things, the health data economy and then also what role AI mine systems is playing in helping with standardisation and the BMM and stuff like that.

Heather Flannery (00:43:24):

Sure. Thank you Pradeep. Once again, very insightful. I'd like to highlight for the audience a couple of background principles that apply to do's thinking first of all, regardless what is or isn't actually happening, the intent is to replace broken systems with ancient to somewhat less ancient technology infrastructures with net new. And it's like applying at the zero based budgeting kind of practise that you would see to tech. And that's the intent there. And I believe that is a laudable intent and one that when we have seen recent very large scale government modernization programmes, they've been modernised to the point where I would say is about a K 15 years ago roughly not modern to the best that technology can achieve right now today. They're modernised from systems from the sixties and seventies to the systems from the nineties.

(00:44:36):

So I think that the ethic of being more open to embracing the actual current state of the art the right now best that exists in the world from a technology perspective is a wonderful opportunity, but IT systems aren't budgets and shutting them down overnight, absent planning for a more effective replacement is something that can break the fundamental principle of health across the board, which is to first do no harm and it is irresponsible to completely suspend operations without having a fulsome view of the implications to the risk of human life and wellbeing. Setting aside anything beyond that which could live in the realm of political will, but protecting human life is always the first priority. And when we talk about our industry being conservative, that's appropriate. That's because we all live and die in our most human and deep experiences being affected and existing within that system.

(00:45:47):

So with the potentials for extraordinary efficiency, all of these systems and all of that economic value creates oceans of data. Right now, that data economy, I rigorously sized at $66.56 billion annually as of 2023 today, 0% of that literally zero accrues to the individual producers of that data. The actual data subjects prize may have originated or custody that information. None of that economic value accrues to the person. And therefore if you believe in the rational actor theory of economics as well as behavioural economics, you recognise that individual people lack incentives themselves to help overcome the blockers that might affect their ability to engage in health promoting behaviours and overcome the obstacles in their life that we might refer to as social, environmental or occupational determinants of health. So the ability to do what Pradeep was saying, ensure that there are no further blockers to the realisation of the anti information blocking provisions set forth in the 21st Century Cures Act and making that absolute and immediate, I couldn't agree more.

(00:47:24):

Then what happens with that data when it is under the custody, when it can be brought under the custody copied into the custody of an individual becomes endless. And when it converges with AI that can become self-sovereign, trustworthy, and absent any conflict of interest with the individual. That's when the incredible potential both economic growth for the individual because that is clearly a very valuable financial asset and the attainment of health and wellbeing goals for the person it comes at hand because they have now the ability to make fullest use of that information using the absolute latest, most bleeding edge tools implemented and operated in a way that assures that they are not being unduly influenced by parties who have an agenda that is at best a Venn diagram with the person's own agenda.

Gerard Dache ?(00:48:25):

I wish we had.

Pradeep Goel (00:48:27):

I can add, if I may add very briefly some very statistical thing that I ran into when I was working on the Obamacare healthcare.gov and other things. There are 5,000 or less entities in the United States that have all the consumer health data, about 1500 insurance companies, about the same number of major hospital systems and the remaining of pharmacy networks and lab networks and so on. But there's less than 5,000 entities that have all the data. Now, one entity has all the data. Optum, they carry everything, which is why when change health got hacked, all of us got hacked, right? More than pretty much every single American's data was leaked out to the dark web when change, health lost control over their IT system. So you know that the data is highly concentrated. You want to talk about immediate and short-term impact. You mandate those companies put that data in the hands of the consumer, but they're economically disinclined to do so.

(00:49:24):

There is no technical challenge. We all have EDI and we all have HL seven and we all have the same EMRs, but at the end of the day, none of them are inclined economically to share your data with you. So if you want to talk about, and Heather is right, once that data is in your hands, you become the interoperability hub trying to connect these 5,000 entities to each other. Forget it. Never going to happen, never going to happen. But if you give me the data and everybody comes to me for my data as a single source of truth where I have the records, you don't need to go to the pharmacy to ask for my past prescriptions. You don't need to go to the insurance company to ask for my past claims. You don't need to go to the doctor to ask my past medical records. It's with me. It's that simple. So we have already this thing called Blue API, where you can download all your Medicare and Medicaid data from government mandate, the blue API works for every one of these 5,000 organisations and penalise them if you don't. And you will have a completely different model for patient centred healthcare.

Kevin Jackson(00:50:25):

Yeah, this is clearly very emotional area for us all, but we're quickly coming to the end of our time. So I want to highlight a couple of questions before we go to the round table.

Heather Flannery (00:50:47):

Oh, go ahead. Sorry, I had a touch of latency there. Apologies. I would love to make the point that if we as a country, as a nation across all the stakeholder groups wish to see this future manifest, it means human beings have to make smart decisions. Human beings that are not going to individually become domain experts in a new family of very intricate technology. There must be systems of assurance that can provide, that can shine the light on a way to go forward with elevated trust or at least a third party attestation of various circumstances being met. GBA is leading the way on creating that system which interjects a vital piece into how human beings have to make decisions, especially for rapid and efficient action. I just wanted to follow through with what Gerard you had mentioned a moment ago. Back to you Kevin.

Kevin Jackson(00:51:53):

Yeah, no, that is great. And the question that came from Parlour 12, no Nola Dilio the goal, I guess her goal for being here today is to identify for her clients the ability to transition from legacy systems to modernise application. And he mentioned that I think the maturity model mentioned here is a pillar, maybe Rod you had mentioned and talked a little bit about the maturity model. Will that help organisation the transition from these legacy systems to modernise applications?

Gerard Dache ?(00:52:43):

Well, I think one of the biggest problems that folks in government have with regards to implementing blockchain and especially in healthcare because as Heather said, it is conservative and you've got to be very careful about the introduction of new technology, which is why it's been a challenge for so long,

(00:52:59):

Is that people in government don't know. They don't trust blockchain. They've heard about sandbag man free and FTX. They heard about Terra Luna and Celsius maybe all the way back to Mount Gox. And they know that blockchain is for terrorists and drug dealers and human traffickers. So somebody walks in with this new technology and says, Hey, trust me, the stakes are too big. And the problem is, in these acquisition officials, they don't have a box to check. In almost every other industry, there's is O 9,000, ISO 27,000, there's cybersecurity standards, there's certifications, there's nothing like that in blockchain. So the GBA endeavour to create this project called the Blockchain maturity model. We studied successful blockchain projects over the last two years and we identified the characteristics of a successful blockchain project. We built that into a model. And there's not enough time for me to get into a detail, but if you Google GBA blockchain maturity model, you'll find the information.

(00:54:02):

But this is a way that companies, they can download the model for free, they can use it. It's a roadmap. It's a guidelines to help them figure out how to develop trusted blockchain solutions. And this assessment criteria and framework to allow acquisition officials to be able to evaluate and investors to do due diligence. So that when you go to an investor, when you go to an acquisition official, you can say, don't just take my word for it because everybody else is totally hyping their system. Our system has been independently evaluated by a group of professionals that are showcased by the United Nations Internet Governance Form Dynamic Coalition on Blockchain Assurance and Standardisation. And what this does is it builds trust between the solution provider and the investor or the acquisition official. And this we believe is critical towards really maturing and developing the industry. So sorry to be kind of long-winded on that. And Heather and her company is involved in performing assessments. So if somebody would like to have their solution evaluated, they could contact GBA or AI mine systems and say, Hey, I'm interested in having our solution vetted in order to make sure that we can be trusted by investors and acquisition officials. So Kevin, hopefully that answers it.

Kevin Jackson(00:55:25):

No, no, that sounds good. And it's a great thing that we're going to have a round table immediately following this event. And I want to really thank Heather and Prade for their inspiring and insightful comments as we try to bring this first part of the event to a close. But don't go away. We'll give you the link for round table where you can actually talk in an interactive way and we will answer many of these other questions that everyone has. I want to say one other thing, we have a few closing and formative.

Gerard Dache ?(00:56:25):

Yeah, I also want to say one other thing. If you're interested in finding healthcare solutions, Web3, healthcare Solutions, if you go to the gba a website,

Kevin Jackson(00:56:34):

We have that.

Gerard Dache ?(00:56:36):

Yeah, if you go to the gba, a website underneath resources, there's a dropdown. One of them is Web3 Solutions, and we've put together a list of, I don't know, 10 20 Web3 Blockchain Healthcare Solutions that you can find there. So that directory is one that we are in the process of developing for investors and acquisition officials that want to, so there's some websites for the organisations. I got two minutes to get through the next five slides, so let's jump to the next one. Alright, there's a QR code for the blockchain maturity model. There's also links in the chat. Let's go ahead and hit the next one.

(00:57:22):

Healthcare resources. So this is what I talked about. If you go to GBA global.org/wg-resources-healthcare, or you go to the main menu underneath resources, go to Healthcare. Now this is a site that the healthcare working group owns and controls. So I do understand that they're working on some updates to the site as well. I think we still have Solve Care listed there, so we've got to make some updates, but we'll do that. Alright, next slide. This is a link to the next slide is a link to just the different QR codes, right? So if you'd like to stay informed about the future events that we're doing, all the different projects that we're doing, there's a mailing list. You can certainly join the GBA. Please consider joining the National Digi Foundry Foundry, especially if you're looking for infrastructure. And that bottom one is basically a list of all of our public events.

(00:58:19):

So Heather's got another event coming up in a week or two. Another healthcare event, we've got one on cryptocurrency. The GBA has got over 50 working groups. So we do a lot of events on a lot of different topics. And with that, we're at the end of our time. Do we have a link to the, there we go. There's a discussion. So if you'd like to join us there, we'll just have an open floor and people can ask their questions, talk to each other. It's just a place where people can talk in the lobby. So Kevin, thank you so much. This has been a great session. Thank you. It was Kevin's idea to do this. And Heather,

Kevin Jackson(00:58:55):

You just blamed me. All right,

Gerard Dache ?(00:58:59):

Heather. But

Kevin Jackson(00:59:01):

Before we go though, I'd like to just thank again, Pradeep and Heather Pradeep, how can audience reach out to you if they have some specific questions they want to address to you?

Pradeep Goel (00:59:17):

Thank you for the opportunity. It really was a privilege in terms of reaching out us. If you are looking to build a government solution, a commercial solution for healthcare or public sector at large, reach out to [email protected]. You can also find me on LinkedIn, you can find us on Telegram. There are a number of people building very exciting and impactful solutions on the two Myo platform. And it lets you have the optionality to do it fast, cheap, and prototype, because government loves to see prototype. And as a former in that chair of a buyer, I didn't want to see just a proposal. I wanted to see you put in some sweat button equity to come in and show me something that may or may not be fully relevant, but that you've actually built for me. That's always a great thing in government to see something brought to them that is functioning. So we encourage you, and I think similarly, AI mind systems that Heather will talk about has similar tools and capabilities coming up. But on the to IO side, we are a platform to incubate your ideas, take it to your favourite target audience, and show them what decentralised blockchain based transactional capability looks like. So reach out to us on info to io.com, find me on LinkedIn, reach to us in Telegram, or just call Gerard or Kevin.

Kevin Jackson(01:00:40):

Okay, great. Thank you Pip and Heather, how can somebody best reach out to you?

Heather Flannery (01:00:45):

Thanks, Kevin. I'm a heavy LinkedIn user and I use my middle name on LinkedIn, Heather Lee Flannery, L-E-I-G-H. And I am just incredibly honoured to have the opportunity to do this event with Pradeep and to be collaborating with Pradeep. Generally, there are two major initiatives that if you want to get involved and you want to show support, there are ways to do that on ai mind systems.org. And that includes our national Hero initiative, supporting our veterans first responders, active duty service members and their families. Along the themes we've discussed today and something called the three 40 B Transparency and Accountability Initiative where we are working on new approaches to ensure that social safety net programmes that intend to get patients who can't afford their medications, those medications can actually be made to work as originally intended, which they do not today. So those are areas of collaboration. And thank you very much.

Kevin Jackson(01:01:51):

No, thank you. Thank you. And in closing, I'd like to really thank our audience. This is what this is for, and especially those in India, which is up in the middle of the night to join us. And Gerard, any final words before we shift over to the round table?

Gerard Dache ?(01:02:13):

No thanks. If you can just put the round table QR code back up. We'll hang out there for as long as people want to talk.

Kevin Jackson(01:02:21):

Alright, so thank you everyone. See you in the round table.

Gerard Dache ?(01:02:26):

Alrighty. Looks

Speaker 5 (01:02:26):

Good.