The Path to Transforming Healthcare

How a dual token model will improve patient outcomes at lower costs

Written by the Chief Technology Officer of MintHealth, Tyson McDowell

This is the first in a series of discussions on the technology behind MintHealth. This post sets the stage, and subsequent posts will dive into the technical details of each component within. Enjoy!

We understand that US Healthcare is a complex system with many players and silos. Each stakeholder has its own entrenched interest and agenda and there isn’t true transparency to the cause-and-effect relationship of individual behaviors to the spiraling health cost overall. Furthermore, the inclusion of insurance in the whole system reduces the direct incentive an individual has to truly care about his or her health today, which affects cost a year or more into the future.

In our view, the equation for moving to an improved, high-value healthcare system has four components. Action Incentives, Clinically-validated Results, Aggregated Data at the Patient Level, and Reliable User Engagement.

Action Incentives: An Incentive-based Model Using a Utility token [Vidamints (VIDA)]

The first component of the solution is to create a direct financial incentive to reward individuals for behaviors which benefit his or her health. These behaviors powered by a smart contract, plus provable improvements in health, correlate to the medium and long-term cost implications for those paying for their healthcare (such as insurance companies).

From the perspective of the healthcare payer, they need not be concerned with the concept of spending money on something that won’t work because unlike generalized population handling, the tokens are held in escrow and only earned by the patients when they complete an action known to connect to improved health, and when improved health is actually attained.

The assumption is that an improved quality of life for the patient provides a greater ability for healthcare to be more effective at lower cost.

Clinically-validated Results: Unlocking the Value of Healthful Actions

The second component is validating that the changed behavior(s) of a patient has led to improved outcomes through tangible results like blood pressure, weight, blood tests, urinalysis etc.

To accomplish this, we have designed our early token campaigns at patients suffering from one or more chronic conditions such as hypertension, diabetes, metabolic syndrome and obesity.

Access to data streams are permissioned and measured via a token-incented “link to data” offered to patients. Connecting movement data (via Validic, FitBit, and others) or self-reporting a weigh-in results in earning tokens. Connecting to the patient’s health system’s portal to automatically link lab results and annual physical metrics are rewarded the same way.

Based upon the confirmation of healthful action per these data streams, MintHealth awards vidamints with the majority released to be redeemed once the clinically-validated results play through. In this way, a patient can earn many tokens, but a large portion will be in a “hold for clinically-validated results” state until clinically-validated results are delivered. This ensures a data-driven behavior modification ecosystem.

Aggregated Data at the Patient Level: The Self-Sovereign Personal Health Record

This tokenized Patient Health Records (PHR) provides data security and sharing through a personal cloud storage offered by a third party (such as Microsoft Azure). The private key to their data are held by the patient and data liquidity is enforced by permission (self-authorization).

In this way, patients can be confident that only they see their data and nobody else does. And when someone comes tries to access their data, they can see who it is, why they are trying to access it, and how much tokens they can earn for releasing specific data components to them. They can accept or reject the offer; their data is perfectly secure.

All of this is a perfect setup for a truly self-sovereign patient health record. A record that can serve the digital needs of patients but also the help patients contribute their data to health innovation by being incentivized to opt in. The patients themselves are active and are aware of the opportunities ahead.

In order to significantly improve health and health delivery, we must make patient self-sovereignty the cornerstone of a re-engineered system to improve care quality at lower costs. The key to accomplishing this transformation is an aggregation of valid, meaningful and valuable healthcare data with the patient at the patient’s perspective.

Reliable User Engagement: Driving Patient Action

What is all this worth if people don’t use it?

So many good solutions never make a difference due to low adoption and low retention driven by systems that are not easily engaged. Our approach is to gamify the interaction with the right message, for the right person, at the right moment.

Our system of multichannel, context-aware contact management is key to user adoption of healthy habits. Facebook messenger, in-app messaging, location-based alerts, user status knowledge such as “at home” or “traveling,” SMS, Alexa… the list goes on. Simple messages like “Earn more!” prompted by the complex-in-reality rules of the healthcare system we live in, reduced to an easy to understand value proposition, gives us the best chance to make real changes in people at scale.

The number of and types of things patients can do to be healthy that earn tokens will expand over time, allowing the outcomes associated with those actions to promote the most healthful protocols and feedback to the providers of those protocols for continuous improvement. This structure drives continuous improvement to the core of the spiraling health cost problem. Many solutions push a health agenda that is good but don’t attack the critical problem of financial sustainability related to healthful action.

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