Overview of MedCredits
Healthcare decentralized and connected worldwide.
When we first began development on the MedCredits platform back in 2016, we had a simple vision: create a decentralized healthcare market allowing patients to see doctors faster and more affordably. The first step to realizing this vision was building a platform that would have immediate utility to its users — the patients and doctors. So we set out to develop a decentralized telemedicine app that allows patients to use smartphones to submit their ailments to doctors anywhere in the world. From this, the Hippocrates app was born. The outcome? See a doctor in minutes for under 10 USD.
This is impossible is the first response we usually hear. Or is it? What if we were able to connect patients and doctors anywhere in the world? We’d be distributing the global supply of doctors to meet the demands of patients everywhere. No longer would a New Yorker be required to pay premium prices to see a doctor in Manhattan. No longer would a patient in the countryside have to drive 2 hours to see a specialist. No longer would a patient be restricted to seeing the local doctor during daytime hours. Even if it’s 3:00 AM in New York City, it’s 8:00 AM in the United Kingdom and 6:30 PM in India. MedCredits connects patients anywhere in the world to a global network of doctors online.
The Hippocrates app
The first DApp on the MedCredits platform is Hippocrates, a user-friendly application that connects patients to dermatologists for fast diagnoses at a fraction of the cost. It’s as easy as snapping a photo of your skin ailment, providing a few details and submitting the case. It is immediately broadcasted to a global, decentralized registry of dermatologists who can reply to your case with a diagnosis and recommendation.
Teledermatology is just the beginning
We chose dermatology and skin ailments as the first application for the MedCredits platform because, well honestly, it’s the most popular use-case. Almost everyone, regardless of age, has seen a dermatologist before. At some point, you’ve probably had a rash, mole, burn, acne or something else and wished you could just send a picture to a doctor. But instead you got the referral from your primary care doctor, scheduled your appointment with the dermatologist, took the day off work and then sat in the waiting room for over an hour. (Or maybe you thought that all of this sounded like a lot of work, took a risk that it would go away on its own and your prayers were answered.)
Numerous studies have shown that teledermatology is safe, convenient and effective compared to traditional office visits. The same goes for many other medical specialties such as radiology, internal medicine, psychology, pediatrics, ophthalmology and others. MedCredits will serve as the single platform for all of these telemedicine services. It will be a place where patients can go for either first or second opinions on medical problems in just about any specialty.
A doctor’s perspective on MedCredits
MedCredits may be great for patients, but what about doctors? Of the fifteen members on the MedCredits team, five are US doctors striving to give patients access to the best possible care. Nevertheless, we realize that doctors have to be properly incentivized for the network to flourish. So let’s do some simple arithmetic: Our dermatologists estimate that a doctor will take about 5 minutes to evaluate each case. This means that a doctor can evaluate 12 patients an hour. Assuming a doctor receives 10 USD per patient evaluation, 12 patients per hour x 10 USD per patient = 120 USD per hour. This is the equivalent to a salary of 240,000 USD per year. This compensation is far greater than the current salaries of many doctors around the world, as shown in the figure below.
Aside from the reimbursement, MedCredits allows doctors to do what they do best: treat patients. On the MedCredits platform, there is no complicated billing system. There are no overhead building expenses. There is no burdensome electronic medical record (EMR) system filled with notifications and complex compliance requirements, which if completed incorrectly or left blank will result in a penalty in compensation. A physician on MedCredits does not have to pay an office of billing specialists to submit claims for reimbursement. Ethereum smart contracts automatically govern the entire patient encounter and payment. Besides the small fee for gas on the Ethereum network and a 1% fee to the verifiers in the physician registry (details below), the doctor receives nearly 100% of the payment. This allows doctors to spend more time diagnosing and treating patients (which is what the 8 years of medical training was for, right?) and less time in a backroom clicking through an EMR and calling up insurance companies.
The MedCredits platform
To have a truly decentralized ecosystem, there cannot be any central points of control. It has to be decentralized from the blockchain all the way to the user interface.
At the very foundation of our platform is the Ethereum blockchain. Unlike many other blockchain health applications, we are NOT using a permissioned or private blockchain. Using Ethereum as our public blockchain is critical for two reasons: 1) Payments are in native digital currency and are not under the control of any banks or financial intermediaries, and 2) smart contracts allow patients and doctors to engage in predictable encounters without any middlemen.
The next layer is the Physician Registry, or more specifically the Token Curated Registry of Physicians. This is a critical layer to the decentralization of the MedCredits platform. This is our solution to the problem of ensuring that only licensed and board certified physicians are on the network. Physicians worldwide will submit an application fee in MEDX and their public verification documents to the MedCredits token curated registry for review (think all those certificates on the walls of your doctor’s office such as medical school diploma, board certification and medical license). MEDX token holders will review these documents while cross referencing them with national databases such as the National Provider Identifier (NPI) Registry in the USA. In a smart contract reporting system, physicians will be enrolled into the registry based on majority vote. In turn, the MEDX token holders are rewarded with a network fee, physician application fee and any MEDX staked by the token holders who voted inaccurately or nefariously (see blog post https://medium.com/medcredits/the-first-decentralized-registry-of-physicians-ca88a7d5f252 for more details).
Our Token Curated Registry of Physicians is the first of its kind. With a growing network of providers, we suspect that many future blockchain healthcare apps will desire access to this registry…of course in exchange for a small network fee in MEDX.
Another layer of the MedCredits platform is data storage. It was imperative to integrate a decentralized way to store and secure patient records. The blockchain cannot be used directly for this. It is prohibitively expensive to store any substantial amount of data on the blockchain. However, there are decentralized data storage solutions that are integrated with blockchains. We chose the Swarm Protocol for data storage as it is native to the Ethereum blockchain, the base layer of our platform. Using Swarm, we can leverage the public-key cryptography already available on Ethereum to encrypt patient records and allow them to share their healthcare data with doctors (see blog post https://medium.com/medcredits/a-technical-overview-of-medcredits-decentralized-and-encrypted-emr-d94ca81533e2 for more details).
In summary, we have exercised great care and expended tremendous effort to create the foundation for a completely decentralized healthcare ecosystem. With the creation of a decentralized registry of physicians along with the implementation of decentralized payments and decentralized medical record storage, we have developed the first completely decentralized, smart contract guided patient-physician encounter. MedCredits will make history in decentralized healthcare upon the release of its first DApp on the Ethereum mainnet in May 2018. Welcome to the future of healthcare!
To find out more about the MedCredits healthcare ecosystem, please join the discussion on our Telegram! We also have a rapidly growing Whitelist. Be sure to register on the Whitelist if interested in participating in the MEDX Presale. Additional updates will be posted on Twitter and Facebook.
