Hi rubbish Adrian Burke here as well.
Adrian
Through bubbles here.
Hi this is Jeff.
Hello, Jeff.
A few minutes
To join and then we can get started.
Sounds great.
I think guys we can get started.
We do have a hard stop at
330 today, unfortunately. But I think we can get started in, you know,
Someone can continue and take it to completion today.
So just to quickly summarize
We last we talked about the decision tree and you know framework for decision making on you know is blockchain the right solution for you or not. I know we've we talked about various things and decided on. Let's take
You know, what are the key considerations and we decided on each one of us is going to pick a topic and we kind of go through that and try to collate all that towards the end.
To, you know, kind of give it a framework shape and then obviously you know being pair focus. We will then kind of tweak it to what will be what will make sense from a PR standpoint.
You know whether the blockchain is a good solution for the use case that is being talked about. So that being said, I know Jeff.
Last time you presented kind of a
I would say high level thoughts on and we did you know take back some responsibility that each one of us is going to discuss one topic or one block of I would say
A key consideration so we can we can you know cover that today.
I know some Tony is not online today because he could not make it so I know he has a couple assignments. I know Steve had one, Jeff, you had to and
Rich, I believe there was one on your end as well. And I have to show what I'm thinking is, we'll go in sequence.
And let's see how far we go there and we will cover what we cannot cover today will try to cover next week. And the idea is going to be kind of
Summarizing that in these two meetings and then putting something on paper, so we can kind of start working through, you know, I would say framework or white paper that can actually, you know,
give anyone in idea about the framework that they're talking about. I know in the general meeting someone did raise a question about do we really have to do this and there were a bunch of frameworks out there in in in doing some research I found, like so many different kinds
That, again, it leaves it may have a question, how deep we want to go into this. I'll just take a pause there and you know have other share their thoughts and then we'll, we'll get into the
You know the each of the topic that we have to cover today.
Any, any suggestions questions doubts anyone has.
Well, this is Jacaranda couple others as
Well, but they all seem to be
Tailored around
particular use cases I
Haven't found the generalized framework.
Yeah, I personally saw a lot of lot of those were financial related I for some reason I stumbled upon lot of those. But you're right. I mean, it's not very general.
At this point in time.
Someone else I thought
So I think they're
The general ones end up being less useful. I've seen a lot of decision trees.
And I think there's there's so much subtlety involved in each
Use case the particulars.
You know when you're when you're trying to make these
Decisions that
You know having a very specific one.
Or a more specific. One is accepting more beneficial.
Yeah, I tend to agree with you on that because I think you can relate more to a specific one then to a general one
Just you because you're running a use case in your head while while you know kind of reviewing that eight. So I am Jeff, correct me if I'm wrong. I think the idea here was to start general and then make it specific to you know this peer group or NPR industry.
I'm just not sure
What that really means because
If you have a particular use case in mind, you can
tailor it to that, although the problem is
It's kind of circular and that you're looking at it through a
Very
Shaded lens to begin with because you have a particular use case in mind. It's kind of like what I saw in the
In the
Donor milk.
Case I didn't see
A justification for blockchain there but they went plowing ahead because they wanted to
Do it.
So they created a decision tree that said
It's the right thing to do.
But ultimately, it's, it has to be a value for particular use cases, a general one that's too general.
To be useful doesn't
Drive any value to anybody.
So, so I think for
What you are saying is
We are not talking about putting something very general we are talking about.
A decision tree that eventually will be catering to the pair.
In a community. I mean that's that's the focus of this group as well. Right. But just don't want to lose the, the, the focus. However, we have to have a starting point, which would be
You know, talking about all these fundamental pieces, like, you know, we have these many writers, you know that divergent in incentives.
Data, you know, so on and so forth. So I think we, we have to cover those topics and then we will kind of synthesize the information in terms of
And Jeff, to your point, yes. If you look at a particular use case and start thinking about that. Just use case.
I think that's one way to look at the other way to look at is going to be in, for example, in fair industry. We have some key constituent types. There is a member, there is a provider. There is a pair
You know, so on and so forth. So I think there are those key constituents in the industry and our, our page specific decision tree has to account for some of those key foundational constituent types. That's, that's how I see this
This isn't the Kyle here. I wanted to ask
I mean, who are you pitching this to, you know, is this going towards a sort of executives at health plan within the, you know, US healthcare market where you're trying to convince them to adopt.
This
Certain kind of
Infrastructure technology and
You know, I think the decision tree.
Has to basically be tailored, first of all, to, to a very specific set of decision makers. So we have to be clear about who they are.
And and also what what is the business value that is providing you know why should they take the, you know, take the trouble to to implement something like this, where were in their technology or wearing their business does it actually have an impact.
And and inevitably that's going to, you know, need to be driven down to more concrete details around whether you want to call it. Use cases are you want to call it service lines, you know, or or areas of business.
You know, without getting more concrete and being able to cite metrics, you know, to be able to say, you know, these are where you are spending X amount of dollars today.
And this is where you know adoption of a blockchain solution could have an impact and and, moreover, that you know we project that the impact, maybe you know why number of dollars per year and
It's going to cost to you know certain amount to
To put it in and a certain amount to operate it is that is it going to be operational savings is going to be
Reduction in fraud.
You know, and abuse. Is it is it you know where exactly is the tangible impact.
And it has to be put in terms of very concrete. Concrete redefined operating areas you know that our technology, technology related. So I just don't see how you can get away from getting getting more concrete in terms of the the calorie use case or service, whatever you want to
Call it
Yeah, so, so I think the question that you're referring to more of ROI and what is the business value. I think that varies based on the use case.
Right. The question that we are trying to answer here is, you know, considering the characteristics of blockchain technology.
What kind of problems are to be dealt with. And now relate those type of problems in their industry and kind of surface this this framework that can help you know FILTER, YOU KNOW, YOU'RE RIGHT AT A executive level that at a higher level, what will make sense in this technology.
You know we like Jeff talked about donor milk right, it can be done in a single you know simple database as well why blockchain.
And what is the value generates for that particular use case. I think that that will vary based on the use case type. It may be
The same type of implementation across various use cases can generate various you know different business value. So I don't think we can we can kind of hone on at this point in time, the euro dollars and the savings. The idea is going to be what
Technology problem. It solves or what problem. It solves with technology that may not be addressable in the in current scenarios using regular you know transactional engines that we have today, right.
Then comes the, the, now I can solve these three or four types of problems in our industry.
If I bring a particular business use case, it can use me you know savings from a VC perspective or XYZ dollars.
I think that varies based on the use case business use case. So I don't know how
Yeah.
Sorry. Yeah, so I mean if we were to take for example provider credentialing, you know,
That was something that that was an area that had been thrown
Around is one possible
Not only use case, but an
Area where PLC could be done.
You know, can we come up with a list of maybe a half dozen or a dozen similar you know at least high level use cases where we can actually
Put together a really short business case for each one.
And that way you know once you aggregate that then you you're providing a very comprehensive, you know, industry wide picture but and from there you can generalize, you know, commonalities.
across those different use cases.
Yeah, I think.
I don't know when you know
When you join, but this in the past. If you look at some of the previous meeting minutes we have been talking about, like,
Four or five different use cases, one was around the provider data management. The other one was around value based care. There was one around prior offs.
So we, we, the reason why we're here today is a discussion around those use cases and then challenging ourselves is this use case of valid use case for blockchain or not.
From which came the question, can we put together something that answer some of those, you know, fundamental questions before we get to a use case. So I think what you're describing is what we are trying to follow the journey.
And hence, we are here having the exact same discussion today.
I don't agenda for see your folks who have been know you know part of those discussions because I don't know whether you were part of those discussions were in we
Kind of went through in detail the business use cases that we felt might be a good idea about the blockchain. But we were not certain how to validate that. So I don't know if you were
Yeah, in those discussions. But yes, those discussion that happened earlier yeah I reviewed all the minutes of the
Meetings, I think it would be valuable to try to find some way to create a kind of a structure template to take all of the work that was done and try to frame it in a in a kind of a more structured model, you know, which could then turn into a decision tree.
Well, I think.
I think we are trying to create that model I
Mean, yeah.
We, we started out, I
This is Jeff, I kind of came up with this high level decision tree. But ultimately, we realized we had to break it down more and model.
Into smaller pieces.
Where we
Could actually come up with the tree, which is what the current assignment has
Been
I think i think i think we're actually in furious agreement, but, you know, yeah, I'm not certain.
I think because the issue is, you know, what is the starting point and what you are describing is exactly the thought process from groups that I mean this this group standpoint as well. It's just that, you know,
What is the starting thought
Is a model that we will convert into a framework with, you know, with the use cases or
We talked about the use cases. And now we are trying to figure out what model we put in place that becomes a framework for those use cases.
So is the exact same thought process and we are we are actually in complete agreement. I think one thing that you just mentioned would be very valuable in as we understand some of these parameters, trying to put together a, you know, kind of
As a just mentioned framework which in parallel validating that famous against the use cases that we discussed to see is it using the right, you know, are we getting the right outcome using the same book or not.
Just one.
Quick thought anyone who joined this meeting today that has not been there earlier just introduce yourself please
If not, no problem, we can proceed. So, so, any other thoughts before we start working through the list that we had
Okay.
So let's start with the list. I know Jeff in the in the picture that you had earlier. I don't know if you can do you want to throw that on the screen or let me
Yeah.
I can
So we can kind of
Excuse me.
See
Okay we sheet now. Well, yeah. Okay, so here was the
Here's the original kind of very high level beginning
And we, I didn't consider this an end.
And then these are the areas that we then broke
Into sections.
To look at them individually, because it doesn't really necessarily flow so smoothly as it would appear in this description.
And as long as I'm showing I'll, I'll then
I had, I took on two areas here.
One was a Gemini.
And I'm not
And so
I
Decided really. What you had is, it was really more like this than
Like that.
And I think the second one was the data. Yeah. Another one is
incoming data integrity was was here.
And I think, you know, we can eventually try to
Put all these building blocks together. But I think it's important to
Kind of model, the individual
Decisions first
Because they aren't necessarily simple yes noses. I had in that overview picture that I first showed
Yeah.
So I'm
Jeff, should we start from beginning like multiple writers and then we can kind of, that's fine. Just, I was showing. So I had what I could show
As long as I was up there because
The many writers with somebody
Else, but I'll keep this
Show, though. Yeah, so many writers me let me quickly cover that. You know what this is actually a simple why because
You know blockchain by nature requires multiple writers, right, so any of the dreamers that have visited or reviewed or had a chance to go through every single one of them had this question about, you know, multiple participants and and that
You know that that's a must, in order to, you know, talk about blockchain or distributed ledger solutions. So that's, that's kind of a prerequisite.
And, you know, was, you know, there was a there was a violent agreement across the board that I saw that that's something that is very clear. If you have multiple constituent types or multiple writers that's
A good one to look at. However, if you have, if you are the only one writing the data in blockchain. Then the question is going to be, do you really want blockchain because
The, the issues that it solved with multiple writers or writers was reconciliation of multiple data sources, because of multiple writers
And it tried to address the inconsistencies, you know, across multiple writers, by virtue of these distributed ledger and the consensus algorithms that have been implemented.
I did come across one question that is that something I wanted to discuss just to blow up this decision, you know, box a little more
Number one, are there multiple writers, and number two, there was a use case that was being talked about, like, if there is a certification authority issuing a certificate. That is, you know, publicly verifiable.
In those scenarios, it will be only that entity writing the information do we need blockchain for that.
And
I just wanted to bring this question to the table with, you know, to talk about if if you know just extending the thought process from, you know, payer perspective when we talk about the, you know, I would say eligibility or or verification of insurance policy.
Would be in that case if there will always be a single writer. The question is with the single writer you don't have inconsistency.
Of data sources, because the same writer writing the data. So in those scenarios, is this really a
viable solution, even if the writer is a single writer.
Any thoughts on that.
Well, I think one question that comes up is not
Whether you're talking about a single writer, but other different writers within the single organization that are acting independently and and therefore the consensus mechanism reflects
Maybe a division of responsibilities and decision making. So, for example,
If we're talking about
Pre authorization
You know, and obtaining advance approval.
For a certain procedure.
You know to what extent does the blockchain technology support the process of doing reviews of medical necessity.
For example, an application of guidelines to
A certain coverage decision. So it could be that
You know, there's different stakeholders potential within the same health plan or within the same organization.
That have different responsibilities in terms of reviewing and approval.
This does that kind of makes sense.
Yeah, I think that's, that's, that's a very good example to talk about a single writer from organization perspective, but there are multiple writers within the organization.
On the same you know data source, like for example pre op is a perfect example where in you know there is a
There is a business unit involved in, you know, the coverage from courage perspective and then the clinical, you know, or or the medical policy group involved in Medical Affairs group involved in
In deciding the medical necessity. So all have to work together. That's, that's a good consideration, I would say.
Yeah, I think the CA example.
That you gave the certificate authority.
Example, you don't really have a single rider, you might
Have a single certificate authority but multiple people are contributing the information that the certificate authority, then uses to approve.
And to revoke
I mean replication could be initiated by somebody outside their certificate authority, it just
So it's, I think you'd want
You aren't just looking at the
Process of
Of having a certificate on the blockchain. It's the process of validating the sort of
Certificate revoking it if necessary renewing it as necessary. I think there are multiple writers in that
Process.
I think Jeff, what you're describing them in the way I am.
Standing there might be a single certificate of authority but multiple contributors to the information that actually results in the certification right they may
Not be writing to the blockchain. But they are the contributors of the data.
Yes.
But it's beyond that. It's also a distributed decision making process.
Right. So, I mean, we're talking about
Something that is at a not not a data or transactional about level but but at a
At a at a higher level, kind of a business decision making or clinical decision making.
Process.
So I think so. I think that many writer, I think.
The point is that there are still many writers in
That example. So I'm not
Sure that we have a counter example that we have to deal with it, just a
Matter of interpreting
You know that use case of
It the good authority is recognizing that there are many writers
Because
It's like
The end result is a certificate
Or not.
It's kind of like a bitcoin, you know, bitcoin is a Bitcoin is a bitcoin, but you have many people
Involved in moving them around.
So you are seeing still that example as the multiple writers itself.
Yes. Is that how they're engaging with the with the overall process might be, you know, might be different but outcome is the synthesis of that information to result in in some outcome. Yes.
It's the same words to say think about it in in
In the
Author, you know, pay or authorization model.
You're either authorizing you don't authorize but
You
Need to get data from
Various
The process itself to come up with that decision involves many writers
Can I ask a
clarifying question. Sure.
You're talking about the writers are we also I'm assuming that the riders are responsible for reconciliation or the consensus of the information being written or are we
Assuming that there could be a different set of
nodes that are doing the consensus.
From the riders.
I don't
This is
Jeff, and it just my
Particular opinion is, it could be either or, I don't
Think that
The right many writers decision itself.
I think it's agnostic to whether or not they are the they are the people who also, you know, work on consensus.
Okay, yeah, that's, I just wanted to clarify that. So if you simply talking about
Multiple
Sources of information.
That could lead to
Multiple contributors to what
Actually gets
Posted on the blockchain.
Yeah.
Yeah, it's like a
It's a governance process to. I mean, you know, you really are talking about a decision making model.
Or a platform for
Supporting decision making and and ensuring
You know, appropriate levels of traceability and visibility into how decisions were made, so
You know, why was a certain coverage decision.
You know either approved or denied.
And was information.
Use to make that decision and who were the parties involved.
In the decision making. You know, so there's a there's kind of a governance.
Process and and a lot of value that can be
Brought to bear if you if you
Kind of raise the level of abstraction from simply, you know, writing blocks of data.
To ledger.
Hmm. We're your hard stop or vicious
I believe
It's three
Years already 30 time went by really fast. So Jeff, I will have to drop off. Can you continue the meeting and take it to completion. And let me quickly summarize, who has what and
Then hopefully it will have to continue the conversation next week to get kind of get to finish line. I'm in the on the list. I have
Just, just following your flow so incentives, I believe it was Tony and he is not here today. So it will have to skip that one for next week and then to Germany is just, it's you. Next one. Data integrity, it's you and then parties.
untrusted it's rich
Tampering was me. So I will take it up next week.
Attack an incentive was Steve and then again recourse was Tony so
I just take a quick
You know, check hopefully
If Jeff, you can quickly publish what where we stopped this week, so we can continue next week, or what is pending for next week we'll take it from this
Well, I'm happy to lead the discussion. I don't know if I'm going to have time
To document anything. I'm just buried right now but
No. Just, just what what we're covered. So I don't know what was to be covered next week. Okay.
Will do.
Okay.
All right. Thank you. Thank you, guys.
Alright, so since Tony's not here for an item number two will move on to item number three which is a Gemini.
And wrong direction.
So,
Let me actually
I've got a text here.
Is that text big enough to be visible if I
Do this.
Looks fine. I mean, I can read it. Okay.
I mean, the main thing is
A Gemini at is I think one of the really big issues that kind of gets
Kind of bundled into this idea of decentralization, which to me is, is not a single concept, it's multiple concepts, one of which is the Gemini.
And I think, but the reason to decentralize the architecture is often to avoid one party having contractions to decentralize the governance is to have to prevent one party from controlling
The system to his own benefit, and the disadvantage of the other parties.
And so if if if the solution provider is likely to exercise undesirable influence over the solution process integrity.
Then I think that would be a reason you'd want to consider blockchain.
Does that make sense.
Okay, yeah, it's lengthy tech so
I'll give you guys some time.
Is this document available for download. If it's not possible to read online during the meeting.
I can try to figure out a way to post it.
Yeah.
I'm not sure when I'm going to get to it, but I'd be happy to show. I'm not trying to keep it close held. That's the question.
Read too much of the text at the moment but um
Yeah, we can work out some way of getting some of this onto the wiki as well.
Yes, but
At the risk of some people still reading and not finishing the key thing was
If there's likelihood Gemini.
blockchains to be considered.
If there's not likely hegemony.
It doesn't mean you shouldn't consider blockchain. It just means that it's kind of not, it's not a consideration. It just kind of goes nowhere. It doesn't tell you anything.
So it isn't so no doesn't mean don't use blockchain no means don't use this as a decision criterion.
Know I'm even in a block chain solution. Say for example, the blockchain.
With its
Suppliers for the food.
From the farm to grocery store.
Right farm to table.
I'm there Walmart being such a big player, even though it's a blockchain solution. Can it be a powerful enough entity that controls.
I'm not sure what it would control that would be detrimental or that would make it a monopoly, but it is possible, right, that in a business blockchain that
Oh, absolutely. Absolutely. That's a, that's a problem and
I would say, in that case, they, the answer is yes. The solution provider is likely to under to exercise undue influence. So you'd want to consider a blockchain blockchain doesn't by itself, solve it.
You still need to end up then coming up with some governance rules that all the non Walmart in all Walmart's trading partners are willing to agree to
I mean, yes, so the governance in blockchain really
So considering it.
Considering considering blockchain isn't dispositive. You might if you can't, then come up with the right governance model.
Then blockchain doesn't necessarily buy you anything.
From the same. By the same token, whoever has a Geminis is not likely to to adopt blockchain. This is not a great argument for them to adopt unless there were some regular
Basis for that you know if
You know if CMS told all the health plans. They had to implement a blockchain for purposes of auditing their
Clinical you know their coverage decisions, for example, that would be kind of forcing the technical decision on them which they would otherwise perhaps not not want that level of, you know, visibility.
So, I mean, you know, it is a governance decision, but it may be one that is driven by the external regulatory environment.
Quite possibly. I mean all all all this limited model is saying is it's really not dispositive one way or the other. It says, consider blockchain. It doesn't say use blockchain. If you have a yes. And if you have a know it's you know don't even consider this as a decision criteria.
So if you consider a blockchain then along with somewhere else along the line, you have to consider. Does your governance model address this a Gemini problem because the alternative
Is that the
You know all the trading partners decide to
Not play
Now it turns out that's highly unlikely because somebody. It's kind of like stripe breaking. It's like if the other guys decide to boycott Walmart, they'll just find they'll just keep searching for suppliers till they find somebody or play along with the game.
But if they also come up with rules that are
That they don't really exercise their hegemony, the fact that they implement this, and demanded of their suppliers in and of itself isn't an unfair advantage.
They're doing it and their and their motivation for doing it isn't to take advantage of their suppliers. It's not like they're demanding.
Some kind of confidential pricing information or supply information. They just want to be able to do this so that it reduces their costs. So when the next lettuce scare comes up, they can find the right badge and not have to throw out all the letters in the network.
Well, I think that also depends a little bit on the use case that I want to discount. I've done a lot of putting around, you know, supply chain.
Now use cases. And I think that you're exactly right on the head Gemini issue.
Where the suppliers really do not necessarily want to be forced onto a platform that you know if they already have their own, you know, internal system that they've built up. Let's say you know they've been in SAP client for a long time.
They've already streamlined out their internal processes and they're not willing to maybe adopt something
That Walmart wants. So all of these different dynamics in terms of the business as well as the data ownership. We have seen instances where you know companies are trying to creep, you know, early into the value chain to get more data on the other suppliers.
Trying to cut out some of the middleman.
Mm hmm.
That is typically not gone, especially well. And that's why, again you don't hear a lot of success stories around
You know blockchain at this time.
Right. Well, as I say, nothing, nothing in this simplified model is dispositive. It's merely one is to consider it and one is don't even consider this as a decision criterion.
And so that was that's kind of the subtlety that we realized was missing in the net overall model that was showing before
But I think one of the points here that I'm not sure who is talking because I want him. I have to keep this up, I think, in order to
For you to be able to see it is
I'm lost. Losing my train of thought here.
Oh, that you still need to come somewhere along the line, if you have a yes here, then you need some other governance.
Decision to decide whether blockchains actually going to solve the hegemony problem.
Yeah, that that footnote would be good to have and that this is the truth about Jeff, if you click on participants, it will pull up a everything
To the right and i change if I change if I change my screen will it change what you're seeing, I guess, is my concern. Are you still seeing the same thing. Yes. Okay. I'm just not familiar with zoom and how it works.
Okay, so I can accept that I
Just see a blank screen.
So I can't see where participants.
On mine. It's at the bottom.
Yeah, bounce. I don't see. I don't see anything.
Once maybe I'm in the wrong place. Let me try this.
I can't actually get to the zoom page, I can either
Anyway, maybe it's my computer.
So, but your suggestions on a rope of adding a footnote, so maybe I'll, I'll add down at the bottom here.
If
The answer to the decision is yes.
We may need
Another
Decision.
To
Solve the problem.
Okay.
I'll bring this down for the moment. And then the next. Any more comments on this particular one.
I go to the next one, which is incoming data integrity.
So if there's not a problem with the integrity of the data coming in it.
This again was kind of a no op admins. They, the answer is no. Just don't use it as a decision criteria you still may want to use blockchain.
But if there is a problem with incoming data integrity then blockchain is something to be considered. And so then you move on to the second box will block chain help detect or resolve this problem. And if it doesn't, then you're going to have to fix the problem. Somehow,
If blockchain can do to help tech to resolve the problem, then you continue to want to consider blockchain.
But again, it's not dispositive. It's just one more element and these things may just all line up as separate decision elements.
That kind of really don't necessarily get linked
Does that make sense to people.
Could you give an example of
Be
Thinking of credentialing.
Oh, let's say somebody, somebody, somebody is a
Mocha be credentials easiest example is you have a counterfeiter, who says that he
You know, has 10 widgets.
And
You know that there are counterfeiters.
Out there who are trying to sell these things as authentic.
So,
There's a problem with the potential problem with the incoming data, you don't know if the if the supplier is actually giving you a legitimate or illegitimate items.
In that case blockchain could help detector resolve the problem because you could then find out where his upstream came from.
Using blockchain.
Or what ingredients. He used
Perhaps if he was the manufacturer if he was using parts that met spec or not.
Parts or elements.
I mean in healthcare. You've got a lot of problems with counterfeit drugs that seems like one
Right. One area, I wonder whether you could also
include things like revenue cycle, fraud, and abuse you know so filing false claims inappropriate. You know, there's a wide range between outright
Fraud and manipulation of for example claims data, you know, all the way into correct coding problems, you know, it can it can take on a very subtle flavor.
But, but, you know, arguably, you could see that all into the
Bucket as well.
Are very good agreed. Do you think this model will cover those different scenarios.
Well, again, it depends on what sort of tools you're using with the blockchain. You know, for example.
You know, if, for example, the, the mechanism of sort of consensus does involve some level of
Pre adjudication review, for example.
Then you could kick out in all of the the claims. If you stick a revenue cycle.
And you could apply a whole lot of value added logic. On top of that, including coverage policies and so forth.
You know, I'm not sure whether you know on the inbound side, you know, whether that's the best place to do that but
But certainly, you know that there are, you know, maybe not as much in the health system of the USA anymore, but in the rest of the world where health plans are, you know, in some ways, still in the nascent stage.
There, there's a huge temptation to to engage in fraudulent, you know, billing practices and and very weak controls over that.
So I think that the potential for an impact is is enormous, depending on who else you know has visibility into the into the data and who is part of the the governance of the consensus mechanism. So, you know, is the is the is the for example pair.
Obligated to share this information with the the the insurance provider, which might be the government in a public agency. So if you have a contractor, that is that is doing the you know the the health care plan, on behalf of the government.
And you're including let's say the patient, you know, just as an example, as as a party to the to the information flow and you're providing value out of tools.
That allow a patient or their family to to have, you know, access to to the billing information that's being submitted on their behalf, then
Then that level of transparency may actually go a long way towards reducing, you know, fraud, and abuse, which which in many systems, maybe, you know,
At a very high level because of poor, poor governance and poor controls. So this seems like it could be a very strong selling point for a lot of decision makers.
You know, depending on again on on the jurisdiction, you know, whether we're talking about the Indian health care system or we're talking about system in Latin America or or the UK or, you know,
I think
I think the context of the magnitude of the problem will be different, you know, each health system but but I think it's everyone struggles with this, you know, Tom's universal universal
Well,
If I, if I
Let me
See if I can summarize what you're saying. I think what you're saying is, again, we don't end up if we if we follow the yeses here. We don't have a dispositive conclusion.
It's merely we're still in the consider a blockchain. They're still many other. The idea is all these all these different criteria we're looking at get stacked up and if they all seem to point to a blockchain.
That's pretty you know maybe we will end up waiting them even decide the blockchain is the right solution.
But that might also then just go to what there might be a business case element also that we haven't even we're just looking at the technical side right now.
But we're not saying
You get two yeses.
It's definitely a block chain solution. So what block chain solution you then get to, once you're considering it is a different is a further down the pipe decision is that
Yeah.
Yeah, and I think we can also
In this situation, point to blockchain solving problems that may not be solvable using other technical
Design or
You know, this is a situation where
Potentially
The capacity of blockchain to to solve certain problems in more elegant ways, you know, maybe at a lower cost of acquisition and operation then other technical alternatives.
Maybe, you know, part of the, the decision making process or, you know, key differentiator, but but yeah you're right there. There's a lot of a, you know, use case specific value propositions, you know,
That especially in terms of quantifying the magnitude of some of the data integrity problems, fraud, and abuse problems compliance problems.
You know that that could could
only strengthen
The, the argument for for going in this direction.
Yeah, I have a, I have a comment. Jeff youngsters right you know being a data warehouse architect playing runner talk when I read them about data integrity. Okay. I think a tooth two different levels. What I'm hearing you guys talk about is, is the data truthful.
Right versus is the data.
It's more information assurance than then then
Just data integrity.
Because I think of referential integrity data type 01 of the text, you know, those kinds of things come to mind. And I don't want to get into the weeds here. But when I want to start here and how you talk in there it says sounds to me as if you talk about integrity. It means truthful.
No.
Data velocity
I'm happy to change that does that.
Is that something people think is a good idea.
I'm just saying.
My initial question.
Which is why I asked for an example is
What did integrity mean so
I think I think data veracity is an excellent suggestion. I think that is really what I was talking about here.
I'm just in the notes. But when we say about blockchain help detect resolve this problem, maybe
A little clarify explanation on which aspects of blockchain help detect or resolve this kind of problem like
Here's, here's some text that I have to go along with this as well, see if that addresses what you need.
I can't quite read it but you described it when you were explaining to me, which is the you know the provenance, the provenance tracking
Mm hmm.
Is really the aspect of blockchain. That would be helpful.
Okay, well, this one is short. So maybe I'll read it to everybody, so that everyone can
incoming data veracity addresses the quality of the data coming into the system that concerns that having an immutable blockchain data structure has a little value of the data being recorded as a poor quality garbage in equals garbage out.
Poor quality data has at least two sources. One source arises when the data writer intentionally attempts to game the system.
And that's probably enough another source arises from data that are difficult to characterize without ambiguity.
This need not be the result of a data writer trying to game the system. If a case of pharmaceuticals have swapped out in transit.
That have the same identity labels as the authentic originals, the recipient of that shipment may be unaware that the received goods are counterfeit at the time they are received.
And again, I don't think we have to have to go into the details, but
But I think the idea of
Changing this data veracity. Is this is actually an excellent suggestions are
Recognizing the input data integrity or data veracity problem is important because it cannot be solved.
The blockchain one merely serve to propagate bad information.
Until this problem is solved any attempted a solution may be flawed. So that's kind of why there was the fix the problem if you block chain can't fix it.
And at the bottom. In some cases blockchain may be an important part of solving this incoming data veracity problem.
For example, in the pharmaceutical solution described above the reporting of the sale. The original authentic case can be detected by the blockchain that tracks change of ownership.
A manual investigation would likely be needed to determine which cases authentic and which is cases fraudulent. But once the authentic cases determined correcting entries can be made in the blockchain.
What other comments, do we have on this and have I
Address everyone's concerns are. You said a robot or you that I address what you were trying to
Yes, this explains the example at the end explains
What blockchain can or cannot do.
I think, I think that is a very important consideration for blockchains understanding exactly where it can help with the velocity and where it cannot
Right, yeah.
Okay.
Alright.
Rich, are you rich on the line.
I'm still here.
Okay.
So let me just scroll up here.
Whoops.
bring this back down.
So parties untrusted
You have three minutes. Yeah, I know.
I can just start to screen share my participant. Can I take the screen.
Okay.
Let me figure out how to get rid of it. I'll stop share
That's pretty straightforward.
Is made a copy of that server, I see it. Yeah.
Well, this is kind of like a my attempt to try to understand what parties and trusted means
Where I talked about trust on a trust foundation and I did some research and stuff like that. And in what I came up with. It was a diagram that you don't see just yet, but I just wanted to start by saying
The guy back in the 1800s, forgive me on a little, a little history lesson in the United States.
His name was john Tatum.
And what he did was
He when the US Mint came out with a new Nicole was deemed the Liberty head, neck on the earth Fiat large Roman numeral five stamped on
The new nickel did not have the word sensor nickel stamp on it, and Josh didn't notice this. In fact, it was nearly the same size than the $5 copay so what he did was he decided to start. Go Go electrode plating the metal. So you could get five bucks.
With from a, from a nickel.
Okay so hence the if you ever heard the saying just Joshua. This is the the perceived
Source for that.
Cool in that are you fooling me
Kind of thing so so that's, I wanted to start off by saying that first
And actually come
Back to my
can all see my screen still
Yes.
Okay, so
I started this talking about Trump but and I ended up
talking more about risk.
And the reason why was because I had changed it to trusted party because untrusted party didn't make any sense to me. In other words, what you're saying. In the first diagram was that we were going to, if it's if its own trusted party use blockchain.
And I'm thinking, Well, I don't know if it's that simple or not. I think that you can have a trusted party, but there are degrees of risk involved in that.
And for those. It was ever done project management plans. There's a lot of things you can do when it comes to risk in a project.
Or you can mitigate the risks of can transfer or you can avoid it, or you can accept it. So what I was thinking was that that when you get to this particular decision.
Or can you trust the partner, not all right. I don't think it's, it's just that simple. Or is it don't trust the party move forward. It just doesn't make sense to me.
So I decided to say, Okay, what's the risk in in utilizing are working with a third party or or someone that he is absolutely no way you can trust. All right. Well, you can accept the risk and move forward tampering. Or you can determine the degree of risk. You want to take
In in doing the transaction. So mitigate means you can try to minimize the risks by doing depending on the the
Decision situation, you can transfer the risk. For example, you can take out insurance or whatever or you can avoid it all together and just not do it.
So that, that's pretty much what I was thinking. In this particular line item and I'm and I know we're at four o'clock, but Aaron, I guess. Something to think about till next week.
I think this is a very good
Thought process you're going through and just give you some other quick feedback. I think one of the other issues is
You know what recourses there are little Mike, do you want one of the other blocks decision blocks. I'm not sure.
All right.
But yeah, I think you're right, it is it is more of a risk decision because it's not like there's only zero or one. As far as trust.
Right.
And that was, that was actually the point of this exercise is to break those
blocks down into
Into the many components so
Right, so that that's what I can and I have
Some of the research and reading. I did. But this is just a about
A
It doesn't give us guidance as to if we want the next step is
There's a lot of outcomes here, but none of them that determine whether or not we should use blockchain. So we need to
link that to that final
For next week.
All right.
Okay.
Alright, well, we're out of time so I appreciate everyone's participation and we'll pick this up next week, I suppose.
Or someone will you post the
Documents, or you can read it.
Before next week's meeting.
I yeah. How do I do that.
I'm happy to do so.
Promptly on the wiki, there should be a place to just upload a file.
I'm not sure again.
Brains, not on
I can help with that. I mean, I've been kind of doing a lot of work on the wiki.
But, but it's it's pretty straightforward. You know,
I don't even know if I know where the wiki is just
If you, if you want, I can
If there's a file share or someplace you can make it available email it to me. I can post it on on your behalf, if you'd like. It's whatever you whatever is easiest for you.
Give me, give me, give me your email address.
I'll just, I'll put it on the chat.
Okay.
Yeah, I can do that this afternoon. I'll put it up in you know so you can find a link to it from the homepage, we've kind of got two different landing pages now but
I'll make it accessible to the to everyone from either. And then I'll just send another link to it via the the main chat, not, not the zoom chat.
There enough
Thanks very much. I appreciate it McHale
Alrighty.
Anybody else
Thank you all have a great day.
Thanks. Bye.