The MEDX Token
A protocol token to power the MedCredits ecosystem
At MedCredits, we believe that the future is peer-to-peer. In healthcare, that means connecting patients to physicians directly without the need for centralized middlemen. Currently, patients transact with physicians through financial intermediaries that create extraordinary friction. Moreover, legacy electronic medical record (EMR) vendors have a vested interest in retaining healthcare data. This forces healthcare institutions into housing medical records and creating silos of data that stifle data interoperability. Our team is committed to building an open peer-to-peer healthcare network. The question is, how do you create a trustworthy system without centralized authorities? The MEDX token is instrumental to this process as it ensures that only licensed physicians can access patient cases and data.
Token-curated registries
The primary purpose of the MEDX token is to power our token-curated registry (TCR) of physicians. Token-curated registries are an increasingly popular crypto-economic construct that incentivizes the output of a list. Instead of assigning a single authority the right to curate the list, a token provides intrinsic incentives in the decentralization of this process. The MEDX TCR is meant to be an open-source public utility that allows anyone to access a pool of licensed physicians and/or build decentralized healthcare applications. The basic incentive game involves three parties:
Doctors who seek entry into the registry. Before accessing any patient data, physicians must first verify their credentials by uploading images of their medical diploma, license and certification documents — the standard credentialing documents that most doctors have framed on the walls of their office. Doctors must stake MEDX to apply for the registry.
Physician verifiers who review physician credentials. Any verifier can challenge a physician applicant if he believes the applicant to be nefarious. To challenge the physician applicant, the verifier must match the physician’s staked MEDX deposit. Any challenged physician applicant then undergoes a voting round during which other verifiers vote either “Yea” or “Nay” on the applicant in a Partial Lock Commit Reveal (PLCR) contract. To incentivize honest voting, verifiers who vote in the majority will be rewarded with a portion of the tokens of verifiers who voted in the minority.
If the physician applicant loses the challenge, his staked tokens are distributed among the challenger and majority voters. Alternatively, if the physician wins the challenge, then the challenger’s staked tokens are distributed among the physician and the majority voters.
If no challenge is raised against the doctor, his public key will be added to the MedCredits physician-registry smart contract. Any public key in this registry is privileged with the ability to request and decrypt patient data on the MedCredits platform.
Finally, any active and honest verifiers are awarded with a 1% fee of all transactional activity powered by the MEDX TCR.
Patients who are consumers of the registry. Patients will only use a MEDX-powered application if the registry contains licensed doctors.
Crypto-economics of the MEDX TCR
The incentives of patients and physicians in the registry are fairly straightforward:
Patients want to be treated by licensed physicians
Physicians want to join the registry so they may treat patients on the platform in exchange for payment
Physician-verifiers are also key participants in the MedCredits ecosystem. Their motivation lies in earning transaction fees, which is accomplished in two key ways:
- Registry size. As new physicians are admitted to the registry, the total amount of staked tokens increases, thereby decreasing the circulating supply of MEDX. Thus, on the social layer, physician verifiers are incentivized to promote the registry to all their personal contacts so as to maximize the number of physicians in the registry. However, the registry is only valuable if it is pure — if non-physicians are admitted to the registry, the purity drops. Patients no longer trust applications built on the registry and therefore physicians see less value in applying to the registry. Rational physician-verifiers are therefore incentivized to both promote the registry but also curate the registry judiciously.
- Registry utility. Physician-verifiers have additional incentives to promote the MedCredits ecosystem to patients. Active and honest verifiers are awarded a fee of all transactions on the MedCredits network. The more patients who use applications built on the registry, the greater the fees physician-verifiers can earn. Note that only active and honest verifiers receive transaction fees. Passive token-holders who do not participate in the curation process do not receive any of the fees.
Medium-of-Exchange
We have been witnessing an increasingly common trend in which projects mint a new token to be used as currency for services on the platform instead of using already existing tokens (e.g. ETH). This is likely to hinder these platforms for several related reasons:
- Poor liquidity. Projects that hope to scale up the adoption of their platform services will be quickly limited by the liquidity of their proprietary token.
- Price volatility. Users are less likely to part with their tokens to use platform services, especially if they believe the platform will be highly successful. This is particularly true for longer-term financial contracts between two parties.
- Lower adoption. A new user who wishes to use the platform’s services is unlikely to already have a newly minted token in their wallet compared to a more widely adopted token. Note that a new patient in the MedCredits ecosystem will not need to own MEDX to access the platform services — this would be a barrier to adoption. Only physicians and physician-verifiers are required to own MEDX.
For these reasons, the MEDX token is not primarily a means-of-exchange token. While MEDX will initially be whitelisted for payment in our Hippocrates DApp, we will quickly whitelist other more suitable tokens for use as currency. Currently, ETH has the greatest liquidity and adoption but still does not deliver price stability. Newer stablecoins promise to deliver liquidity, stability and widespread adoption and will ultimately be the best choice as a platform currency.
Peer-to-Peer Arbitration
In a peer-to-peer system, it is necessary to have recourse should a particular actor misbehave. We have historically relied on powerful centralized middlemen to arbitrate the patient-physician interaction. In fact, many of the current care delivery models require pre-approval for services that physicians render. This has caused physicians to lose practice autonomy and for patients to be denied coverage for their care. This model of ‘guilty until proven innocent’ is designed to maximize profits for middlemen at the cost of patient care. At MedCredits, our care delivery model favors an ‘innocent until proven guilty’ approach. Physicians in the MEDX TCR are responsible for arbitration of any disputes that arise. If no disputes arise, care is frictionless, but patients always have recourse. This technique is demonstrated in the Hippocrates smart contract. (see the following blog post: https://medium.com/medcredits/the-smart-contract-that-guarantees-patient-satisfaction-8e0baf483256). This is hard-coded into all MedCredits protocols and ensures that patients have the ability to call in another physician for a second opinion if they believe they have not been provided with accurate, honest or fair evaluations.
In summary, MedCredits is a peer-to-peer healthcare ecosystem in which patients and physicians interact without centralized middlemen. The MEDX token is central to this care delivery model. It powers a token-curated registry that ensures that only licensed physicians will be able to treat patients. It also provides physician verifiers ongoing incentives to onboard patients and physicians onto the network. The MEDX token is not simply a means-of-exchange token as this would hinder the growth of the platform.
