The current healthcare systems of the world have many major challenges.
Moving from sickcare to wellcare is a challenge that most national healthcare systems are struggling with. One critical bottleneck is the difficulty most political systems have to make proactive investments into the health of a population, rather than investing merely in cures and infrastructure.
Health care is stuck in crisis management mode. Most medical measures are reactive and respond to an acute health crisis, rather than acting preventively.
To justify the use of funds, medical science must prove causality between measures and outcomes which takes long and can be difficult or impossible. There is no working market mechanism to reward correlation instead.
Known schemes such as social impact bonds have proven to be too bureaucratic and lack investors' appeal. Many governments do not have a sufficiently long-term investment horizon and are too busy dealing with rising costs.
There are attempts to establish value-based medicine, but no agreement by stakeholders or realistic implementation opportunities are in sight. Many healthcare systems afford undue profits to rent-seeking parties with no transparency or hope to break the gridlock.
There are some key insights that need to be kept in mind when approaching preventive health. The Health Impact Transfer approach to preventive medicine is firmly grounded on accepted research and scientific findings.
Sufficiently large populations. When recruiting the cohorts for a preventive scheme it is important to recognize that the certainty assiated with the desired outcome grows with the size of the population involved. Cohort access is one of the biggest challenges in this scheme. While selection bias, a major problem in clinical trials, is not a problem per se because it does not affect the economic model, it is still desirable to recruit a cohort as large as possible.
Disease Management. Due to the above problem of cohort identification and recruitment we would also consider disease management as a valid preventive scheme. For example, stroke prevention for patients with past stroke history, or drug abuse relapse control are good candidates for projects with both huge health benefits and good economics incentives.
The Health Impact Transfer Token (HIT) will enable the funding of preventive health measures
to make healthcare sustainable and save lives.
Using blockchain technology, HIT solves a fundamental and systemic problem in healthcare: the lack of trust between producers of preventive medical programs and the payors who would benefit most based on the outcomes of these measures. The intermediary is the investor as one critical stakeholder in this ecosystem. Blockchain creates the transparency to enable a viable financial market in preventive medicine futures.
Investors finance concrete projects directly and receive Health Impact Transfer Tokens.
Health care institutions or project teams implement the preventive or diagnostic measure. Compliance information and verification is logged to the blockchain.
The health outcome is measured and verified across a predefined population over an agreed period of time. This enables the precise quantification of the savings generated by cost reduction.
Payors will compensate investors by paying a dividend consisting of a part of the achieved savings as contracted prior to the project start.
Investors will receive HIT tokens that entitle them to a future payout in case the measures are followed by the desired outcomes. Both compliance with the measures and the verification of the outcomes will be verified by one or more independent third parties which will be authorized to certify these items via the blockchain. Importantly, there needs to be no proof of any causal relationship between measures and outcomes, only the proof that both occurred as contracted. The investors bear the risk of the measure not showing the desired effect, regardless of the causal relationship. The original payer, on the other hand, will reduce risk exposure and only pay for measues that actually correlate with the desired health outcomes (ideally with actual cash savings).
Many blockchain experiments and participation in healthcare projects based on Hyperledger and Ethereum.
Idea validation with experts from Harvard School of Pulic Health and Harvard Medical School.
Exploring the feasibility of preventive projects by interviewing experts and reviewing studies.
Development start of the first alpha version of the necessary smart contracts based on Ethereum.
First HIT issuance, launching the first preventive health project.
FAS, Harvard University
Founder, Commercial & Technical Lead
KSG, Harvard University
Founder, Financial Architect & Marketing
KSG, Harvard University
Research & Government Relations
LL.M., Harvard University
Legal & Non-Profit
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FAS, Harvard University
Public Health, Economics
Medical School, Public Health