A conversation with:
Dr. Leah Houston

The 5 Billion Dollar Doctor Identity Problem

While the world moves with the speed of emerging technologies, some sectors are yet to fully embrace this digital revolution. One such field is healthcare, where despite process advancements, there are still major difficulties when it comes to identity checks and credentialing doctors. 

The Complicated & Expensive Credentialing Process for Doctors 

Dr. Leah Houston revealed how tedious the credentialing process for doctors can be. The core problem lies within the lack of standardization across various medical schools which causes inefficient, time-consuming, and costly credentialing. 

Dr. Houston states, "Each medical school has its own way of displaying medical credentials. State licensing boards all have different licenses, different schemas that's why it’s so hard to check them all." 

The current process takes around four to six months with each credential being manually checked and verified. This results in a significant loss of time and often delays doctors from starting their work. Implicatively, this delay also affects the revenues of healthcare systems. 

Blockchain: A Solution to the Credentialing Problem

While the problem is multifaceted, the solution might lie in blockchain technology. Implementing decentralized digital identities in healthcare can lead to instantaneous verification of doctors' credentials, saving time, and in turn, money. 

Hyperledger and Polkadot are two major players considered by Dr. Houston for her platform. Blockchain-based platforms offer a chance for standardization and interoperability, thereby simplifying the process of verifying a doctor's credentials and expertise. 

The Humanitarian Physicians Empowerment Community (HPEC)

In addressing these issues, HPEC, backed by Dr. Leah Houston, will use a Decentralized Autonomous Organization (DAO) model to issue a blockchain-based decentralized digital identity to its physician members. 

The solution aims to empower doctors and emphasizes personal data ownership, privacy, and provides the freedom to work without being restrained by the cumbersome traditional identity verification process. 

According to Dr. Houston, the platform would help physicians own and control their data, unlike existing platforms where they are the default product, and their data is often subject to third-party monetization. 

Through the HPEC platform, physicians receive a digital identity they can use to demonstrate their credentials instantly. This drastically reduces the time taken to verify a doctor's credentials and can eventually result in substantial cost savings.

Building the Future

The intersection of healthcare and technology through blockchain is capable of revolutionizing the doctor credentialing process. Platforms like HPEC are pioneering this transformation, bringing significant benefits for both physicians and the healthcare system as a whole. But there's still a long road ahead for the complete adoption of this technology. 

As we advance into the digital age, this fusion of blockchain technology and healthcare presents a global, scalable vision of future healthcare, where patients and doctors can interact without unnecessary bureaucratic constraints. In the words of Dr. Houston, "We need to choose as doctors to create a privacy-preserving system of trust, where we have freedom to work, freedom to move, freedom to interact with our patients."

Episode Transcript

[00:00:00] Jared Gabaldon: Dr. Houston being one of the most unique people in crypto as a whole being a practicing emergency room physician and then also somebody that's actually leading her own blockchain companies.

It's absolutely incredible. I'm very curious as somebody that comes from an emergency room nurse, not physician. But my dad told me a whole bunch of stories and no day is ever the same.

It's keeps you on your toes constantly. And so I'm very curious in general, what interested you in emergency medicine in particular?

[00:00:26] Dr. Leah Houston: How are you? Thank you for that introduction. Yeah, so I wanted to learn the practice of medicine because I wanted to help people. I was like, I had an aptitude for mathematics and science, and a lot of the careers that you can go into are like working alone in your lab or on your problems that you solve.

And there's few opportunities for, interaction with people and being a physician was one of them. I decided to spend my youth with my nose in a book, learning how to prevent death and permanent disability and having, two childhood experiences one being that my father had epilepsy.

So we ended up in the emergency department a few times. And then the other thing was that, I was the daughter of a single mom. We moved around a lot, so it was many times I didn't have a doctor, so I also ended up getting some of my primary care from emergency doctors. And that, and combined with, my uncle was an emergency doc, so a lot of these, emergency experiences made me realize that this is where humanity is.

This is where people's, real problems are. This is where the car accidents, the gunshot wounds, the heart attacks, the strokes the life defining moments where healthcare really impacts the lives of people is and so by choosing emergency medicine, I get to take care of everyone and I get to take care of real problems, and I get to take care of the old, the young, the rich, the poor, and I get to actually make a really big impact.

That's what led me to choose emergency medicine.

[00:01:46] Jared Gabaldon: That's incredible. And you used the word that my father also likes to use, which is that's where the humanity is. Like You really get to see, humans at their worst day in a lot of cases, and you're the person that helps them out of that, so it's absolutely incredible.

But then also I am curious as well you've been in crypto since 2012. How did that happen? You're a very early adopter. How did that were you into conspiracy theories about inflation or something? Or I'm just very curious.

[00:02:07] Dr. Leah Houston: Despite what the public thinks, doctors do not make that much money and we are riddled with debt.

I was over $360,000 in debt when I graduated. And I was working with my other colleagues to like, think about alternative ways to make money. So we talked about our investments. I did some real estate investing and, one of my colleagues, we were sitting in the ER and it was a, quiet night and he said, check this out.

He sends me a video about Bitcoin and so I like watch it really quick. It was like a three minute video. I was like, there's something here. I watched it again when I got home, when I started like looking into it. He actually bought a Bitcoin then and, I was looking into it and I was like thinking about buying a raspberry pie and like I had to find some kind of computer person that knew how to do it.

And it just, it freaked me out and I actually didn't purchase any, but I started paying very close attention to the space. I started reading every single blockchain, healthcare white paper and all of them talked about patients owning their data. But I'm, a critical thinker. I have my undergrad in molecular biology, biochemistry, advanced mathematics.

Advanced organic chemistry. I'm a problem solver. I wanna really understand how things work. And when I tried to ask that question, there was a lot of hand waving. There was a lot of public private key pairs and bada bing bada boom, and so I was like wait a second. We create the data as doctors.

So it's really not possible for a peer to peer network of patient data unless we, the ones that create the data, have a mechanism to issue it to patients. Otherwise, we're forced to put it on siloed systems and then the patients are forced to pull it from those siloed systems. So all the current patient owned systems, they're interacting with siloed systems.

In order to build a truly peer to peer, decentralized privacy preserving network of, patients owning and controlling their right to understand their health information and to see the right doctor for them, we need to create a decentralized identity solution. And so that's what I did.

[00:04:09] Jared Gabaldon: Yeah. And so that's with your dual company ecosystem with the Humanitarian Physicians Empowerment Community, AKA Doctors DAO, with Evercred as well. And so maybe which one came first? Did the chicken before the egg or?

[00:04:21] Dr. Leah Houston: We're minting authentic data about patients. When you get admitted to the hospital, we write an admission summary. When you get discharged related, a discharge summary. When we deliver a baby, we signed the birth certificate.

When someone dies, we sign the death certificate. We, as physicians are minting authentic data about patients all day, every day. So we're like the miners of authentic data.

[00:04:46] Jared Gabaldon: Wow.

[00:04:46] Dr. Leah Houston: So in order for that data to be issued into the wallets of the patients, we need an electronic way to do that.

And we can issue with our decentralized identifiers into the wallet of the patients with decentralized identifiers. Now, with the Evercred system, they're also so medical licensing boards, medical schools, residency programs. The people that are educating me as a doctor are also minting authentic data about.

Evercred is an authentic data issuing system where it can issue me, my medical credentials, my medical degrees, my medical licenses into my wallet. So that I can prove that I should be able to deliver that baby, that I should be able to perform that surgery, and that I should be able to mint that information about the patient and issue it to them.

We're building an entire ecosystem and we need all the parts. We started with physician identity and credentialing because nobody had been thinking about that. It was the missing piece, in my opinion, to why these systems hadn't been working. And so because we're building a new marketplace, a new ecosystem that's, interacting and transacting in new ways, we had to build both sides to demonstrate that.

But there are, I think, over 30 global companies that are doing this kind of technology now, but we're the only one that's doing it for a physician credentialing in the United States.

[00:06:01] Ty Hagler: I was impressed that you had over what, 700 clinicians already in your system, it's almost like you have every doctor who's aware of crypto. It seems like it's a small overlap between healthcare and blockchain.

[00:06:12] Dr. Leah Houston: A lot of the physicians who understand crypto have paid attention to this. And then just a lot of physicians who feel the administrative burden and the friction of being data entry clerks for these siloed systems. The doctors that feel that their patients aren't being served, they're the ones that have chosen to pay attention to this cuz they're realizing, Hey, wait a second, technology has not been built for us. We need to pick this up and adopt it so that we can design the healthcare system of the future. Doctors are really busy, so it's hard for them to make the leap. But the ones that do get it very quickly.

[00:06:46] Jared Gabaldon: One of my questions is, so how inefficient is the past system of credentialing or the current system?

I still don't fully understand the problem to its depth.

[00:06:54] Dr. Leah Houston: Some of us have watched the movie Catch Me If You Can, where Leonard DiCaprio pretends to be a doctor and he's, wandering around hospitals making decisions. In order to prevent that kind of situation, we need to make sure that the doctor is who they say they are, that they haven't had their license revoked and that they actually graduated and have a license.

There is currently no standards around this stuff. Each medical school has its own way of displaying medical credentials, different sizes, different words that are on there, different signatures, different names. Same thing with state licensing boards. They all have different licenses, different schema, different things are included, different numbers, different lengths of numbers.

This is why it's so hard to check them all because there's no standardization. Decentralized identity brings us the opportunity for standardization and interoperability among, your credentials and identifying data. The process currently is a four to six month, sometimes more process where they have to go to every single credential, fax requests of proof, phone call to see if that fax was received.

If it wasn't received, fax it again. Then the person manually takes that fax and puts it onto a system, oftentimes a DOS system. Then they, manually check the credential. They call the medical state licensing board, or sometimes there's an online way to check, and then they take a screenshot and prove that they did it.

And they say who actually did it, because if somebody ever gets in trouble and is lying and said, that they did that work, but they didn't do the work and the doctor's not actually licensed. That person needs to be in charge. So that has to happen for every single one of our credentials. There's 30 to 70 on average number of credentials that are checked.

[00:08:31] Jared Gabaldon: Oh my gosh.

[00:08:31] Dr. Leah Houston: Then they have to check and make sure that I, wasn't fired from some hospital that I worked at or whatever for some, malicious thing. So that process takes a long time. And when we're talking about life and death, when we're talking. My privileges to transplant somebody's heart into your body.

You can understand why it's such a complex thing, because they wanna be sure.

[00:08:54] Jared Gabaldon: Absolutely and I see now the use case for blockchain being instantly verifiable on chain once you have it, done through, Evercred, right? In the beginning stage.

That, wow. So it saves you four to six months. So for a doctor caught up in this sort of credentialing issue, what are they doing in those four to six months? Is it just some downtime there or?

[00:09:12] Dr. Leah Houston: This is the autonomy piece that I'm trying to help physicians wrap their head around.

If you're working in a place that's not paying you well, that said, one thing, is doing another regarding the contract. If you wanna find another job, not only do you have to take the time to find the job, to interview, to get hired, but then there's this four to six month. Period where you're trapped wherever you are working or you're jobless.

So if we can shorten that time, make it instantaneous, doctors will have more freedom and autonomy to leave jobs that aren't treating them well and that aren't treating their patients well. It'll create a pressure on the systems that are currently really actually treating doctors pretty poorly. Some of them forcing us to work uncompensated, administrative burdens that are uncompensated.

They call it pajama time because they expect doctors to take the EHR home and finish them at home unpaid. And this is a huge source of stress for doctors. So if we can instantaneously verify ourselves, not only could we leave jobs that aren't treating us well, but we can provide automated workforce mobility where we can work part-time here for a little while and it's easy. You don't have to go through all this cumbersome stuff. A lot of doctors aren't working part-time or aren't working in an independent practice and this because it's just too much paperwork. Let's get rid of the paperwork, let's make it automated and trusted.

[00:10:38] Jared Gabaldon: As you're talking about this, Ty and I, we're working on this Gitcoin grant and, trying to help people from a web two background, get into web three and, donate to this grant.

We're finding it to be very difficult, to, onboard people to this. What you're talking about is actually making people's lives so much easier. To be able to tell any, practicing physician hey, you don't have to go through that process.

Let me walk you through, let's get this done. I don't know how long, maybe Evercred, would take to actually issue the credential. I'm sure far less time. But still despite that, right? Here's this method that's gonna be way quicker. All you have to do is, here's a guide on how to use a wallet and stuff like that.

[00:11:13] Dr. Leah Houston: Yeah, for sure. I just wanna remind everyone, we're not there yet. We have a beta version, we have the credential wallet where you can store your credentials.

You can also receive those credentials, but people are like are hospital's using it yet? I'm like, no. But in order for them to consider the possibility of using it, we have to choose to adopt it. And it's the same thing with crypto. Somebody said when I was talking about Bitcoin at one point, they said, oh, so you want me to take real money to buy fake money?

I'm like, no, you got it the other way around. Yeah's, you got it the other way around, and but the people, the early adopters of Bitcoin, the ones who bought it for $40 a coin or $240 a coin, they knew that nobody was accepting it yet, except for that one pizza guy who like, everybody hears about who like, sold a $3 million pizza, but they believed in the vision of the future of financial freedom. It's the same thing in this platform. We need to choose as doctors to create a privacy preserving system of trust, where we have freedom to work, freedom to move, freedom to interact with our patients. And we need to do that knowing that it's not happening today, but in order for it to be our tomorrow, we need to adopt it today.

[00:12:24] Jared Gabaldon: A hundred percent. And for HPEC or Doctor's DAO. From the end user perspective you chose to make it a DAO, for specific reason. For Doctor's DAO, when it launches, at a full level of adoption, what do you envision for, the various offerings that people or, physicians or even, regular people can engage with Doctor's DAO?

[00:12:43] Dr. Leah Houston: Yeah. So right now a patient's ability to see a doctor, Is controlled by whoever that doctor is paid by whether it's their employer, whether it's an insurance company and it's also controlled by their digital footprint online. So Google has their SEO and if you're a large vertically integrated health system and I'm a doctor that works at that system, maybe I'll be found, but if I'm a private practice doctor, how am I gonna compete with the SEO of these large health systems?

And if I, wanna take insurance, how am I gonna make sure that I'm gonna be paid for my services fairly, when hospitals are able to negotiate these, huge rates and add facilities fees where independent doctors are getting fractions on the dollar for the same exact care and the same exact procedure.

A DAO allows physicians to negotiate on par with large health systems, allows them to have independence and allows them to build their own referral networks so that they can get the best care for their patients. Everybody needs to remember we're the ones that took a Hippocratic oath. Hospitals do not provide healthcare, insurance does not provide healthcare, your doctor does, and we took an oath to serve you. And in order to serve you, we need to be free to make the right decisions for you. Un-influenced by third parties.

A concrete example, I'm a private practice doctor working in a remote area. And I have a patient who has a rare disease. Right now that patient has to decide to move to a large city or has to decide to spend lots of money on travel. But with a DAO of physicians, these doctors can ping each other and communicate directly about patient care without having all of this friction that currently exists in these health systems.

My mother was just admitted and discharged from the hospital. And they made medication changes. I checked in with her pharmacy. Did you get the changes? No, not yet. So then I had to call her doctor. Did you send the changes? Oh, yeah. We'll send them again. Did you get them yet? No. Okay. We'll send them again.

And I'm sitting here in the middle spending hours of my life on the phone to make sure the doctors and the pharmacists are talking to each other because the systems of communication are broken because they're not designed to serve the doctors and the patients. They're designed to serve the billing and coding of insurance companies.

[00:14:59] Jared Gabaldon: You're totally right. I think some of us, as the end user, we just accept how inefficient or inept the system is at some times as just it is what it is, right? And there's never gonna be anything that's gonna save us from it, but that's not true.

Obviously, with everything that you're working on that will change people's, everyone's lives. I was thinking about it just more in the sense of changing physician's lives. But yeah. Okay. So we do have some questions coming in the chat. Maybe we'll fire off a few of those. So Eric Higgins, Jr.

Is asking what benefits and potential risks do you think blockchain technology would have in disrupting the healthcare industry?

[00:15:32] Dr. Leah Houston: So with great responsibility also comes great risk. So currently in our current healthcare system, we have l ots of data breaches. There's ransomware being put on medical devices, so that pacemaker in your heart could be turned off by some hacker, and so people don't realize that this is happening. There's these big honey pots of data. If they're hacked into, they're asking for ransom from hospitals of millions of dollars. This is happening on a regular basis. So there's already tremendous risk, the thing is when you have control over your information, you also hold the keys to sharing it with others.

There's still that risk. There's always gonna be the human element of risk. The difference is it's a lot harder for a hacker to hack into the individual data wallets and the secure enclaves of individual doctors and patients than it is for them to hack into one large system.

And it's a lot more work for them. So it's a lot less of a reward cuz as I'm a private practice doctor, you hack into mine because somehow you convinced me to give you my private keys, which we would hope that people would learn that's not something you should do. Then you only have my data.

That's a lot of work for one person. And the risk is always with the individual, but it also has great benefit because of the decentralization of it.

[00:16:51] Jared Gabaldon: You rocked my world with that one. Being able to turn off the pacemakers. My just so happens, my mom works for Abbott and implants, pacemakers and so the fact that, she's never brought that up to me. I didn't even know that was a thing that somebody could hack into these devices. I guess it makes sense, right? Some of these are connected to Bluetooth technology.

That's how they get into your computers sometimes, oh my gosh.

[00:17:10] Dr. Leah Houston: Yeah. And they could send your doctor the wrong information. If you're, supposed to be monitoring your heart rate and stuff like that, it can cause all kinds of havoc if people are able to hack into these systems.

It's a whole new world.

[00:17:20] Ty Hagler: Yeah, we're seeing a lot of that security play out in the blockchain space, but fortunately that's happening with NFTs and, defi protocols and not with people's lives.

[00:17:30] Dr. Leah Houston: Right, for sure. And the node validators are the masters and the more, the better and if there's few, there's, they're not collusion resistant mm-hmm. So we have to consider that stuff.

[00:17:39] Jared Gabaldon: Yep. Let's see. We'll ask this last question from Sam Gonzales here, where they want to know how you actually came up with the 5 billion buzzword that we've seen as far as there's $5 billion being wasted.

[00:17:49] Dr. Leah Houston: So this is based on research on the cost of credentialing. And so it's extrapolated based on, each doctor, it costs an average of $1,600 per year per doctor. Sometimes it's more, sometimes less and that's just for the cost of credentialing. That doesn't count for my uncompensated time, paperwork, the time loss that I could be generating revenue because I'm not working, the lost revenue of the hospitals. It's an average of a million dollars per credentialing event. If I could work tomorrow instead of six months from now, I could be generating all that revenue for health systems. So the $5 billion cost of credentialing is an extrapolated number based on some research on that data.

But there's also research that shows that 30% of every healthcare dollar is wasted on administrative nonsense. And that should, that should really upset people like this is our healthcare dollars. Healthcare is expensive and the administrative burden is sucking 30% of it. Meanwhile, people are dying and going bankrupt because they can't afford their healthcare.

It's not necessary.

[00:18:48] Jared Gabaldon: Absolutely. So I guess I wanted to nerd out a little bit on the blockchain stuff. What chain are you interested in for hosting your DAO? Is it already on Ethereum, or are you thinking of a layer two? Just very curious about the tech.

[00:19:02] Dr. Leah Houston: There are so many different protocols. So decentralized identity is a protocol that's being developed by the Worldwide Web Consortium, the Decentralized Identity Foundation. So a bunch of really smart people have been building these protocols for several years now, and they're just now getting to the point that they're interropping with different chains. So I think the Hyperledger chain was one of the most recent ones. Polkadot is one that we looked close at, because we wanna be interoperable. In order to create a truly decentralized healthcare ecosystem, you need to be able to interop with whatever chain the patient decides to work with or that hospital decides to work with.

And if you don't interop, then it's useless to anyone. So interoperability is still a conversation that's happening. We wanna be blockchain agnostic and, whatever we do choose to use it needs to have a current did method that's actually in working order. There's also a did resolve.

Developed by a brilliant technologist called Matt Salia, who's made a way for the dids to interop and communicate with each other. And there's a lot of, really smart people working on this problem. We hope to be able to interop with many blockchains. Some might be public, some might be private.

We might not even use blockchains. There's a protocol called the carry protocol. And I forget what it stands for. It's like key event log recovery, which is something that's on internal systems that can still talk externally. You know a lot to unpack there.

[00:20:16] Jared Gabaldon: Yeah. When I think of interoperability, I think of like Cosmos, I think of Polkadot. But. At that same time, I see what you're saying. It's gonna be private, it's gonna be public to some degree. Maybe you need to be able to turn it off as well, on each end. That makes me think of Zcash.

There's so many things. Yeah, you're totally right. It's very complex. We do have another question in the chat. And I've never heard of this before, so I'm curious if you've heard of this. Have you ever heard of Doximity? Yes. Okay. So someone wants to know if your platform will compete with or create synergies with Doximity.

[00:20:47] Dr. Leah Houston: So Doximity is a web two platform for doctors to have a profile. I actually have a profile in Doximity. I think like I created one way back when I was a resident at some point. So I don't know if, I don't think they do credentialing, so I don't think that we would be competitor with them.

And yes, we can interop with 'em potentially. But the same way that you can use single sign-on where Doximity can be used to log in, you can also use HPEC as an identity system to log in. Web two versus web three. Big difference.

[00:21:19] Ty Hagler: So maybe for somebody who's skeptical about all of blockchain, like you compare a web two solution Doximity to like the web three version that you've built with HPEC.

Could you help somebody who's completely new to all of this and a lot of the terminology goes over their head. Like why does blockchain make more sense than something like a Doximity?

[00:21:38] Dr. Leah Houston: So with Doximity, I don't own my information. There's no wallet, there's no secure enclave, there's no way for me to own, store, keep, control any of my information.

If I connect with my colleagues there, I don't own that connection. There's no secure communication because it's all on the Doximity system, at least that I know of. So this is a new world where you own your data, you own your information, you own your right to work, to move, to interact. When it comes to the health of the nation and of the world, hopefully, if we become a global company, I believe that patients and doctors deserve privacy and that they shouldn't be keeping this information on centralized systems.

Doximity is like a LinkedIn for doctors. It's very useful for some people. But then they also sell my data and then I get ads and I get inbox messages. For pharma and devices that wanna try to sell things to me. And I have no way to turn that off cuz I don't own it.

[00:22:35] Jared Gabaldon: That's exactly what I was gonna say in the sense of, yeah, you don't own your data and the other part of owning it is you could in theory sell it if you wanted to, and then at that point you are actually are benefiting from it to some degree as well. Versus now you don't benefit from it at all. Centralized entities benefit from it.

[00:22:52] Dr. Leah Houston: It's a free platform. If it's a free platform, then you're the product people . And just to, expand on that a little bit.

HPEC is a free service for physicians. The way that we hope to generate revenue is when doctors sell their credentialing data they generate the revenue and we take a small transactional fee to kind of power the network. It is free until you use it for the thing it was used for.

[00:23:14] Jared Gabaldon: And at that point it's just a piece of, what they're earning anyway. So I think that's really great.

[00:23:18] Dr. Leah Houston: It's something they'd never earned before. They've been having, doctors have been having their data sell sold by many different entities and they've never even considered the possibility of owning their data.

[00:23:29] Jared Gabaldon: You really opened my eyes. I didn't know that doctors were being so mistreated across industry at, various levels. As far everyone thinks of doctors, generally am like, oh, they make so much money and, they never have to worry about anything other than their patients, and that's just totally not the case.

[00:23:42] Dr. Leah Houston: That's the lie they tell the public. And the truth is, is that many doctors are feeling extremely hurt and disempowered by the system. They're doing their best, but in order to do their best, they're working overtime, uncompensated, and they're struggling.

They're spending hours on the phone doing nonsense, doing data entry, doing follow ups and follow up and follow ups with these friction filled systems that weren't designed to serve patients or doctors. They were designed to make money.

[00:24:09] Ty Hagler: It seems like where we are in the progression of blockchain technologies.

It seems like for what you're building at HPEC, the time has come for identifiers. That seems to be where a lot of the investments flowing right now. Where a lot of the, I think momentum from developers is really pushing around decentralized identity. So for you personally, having been in this space, it seems like you're like your moment, like for your organization starting to arrive.

It's exciting to see where you are right now in this point and kind of the development of the story of blockchain.

[00:24:39] Dr. Leah Houston: Absolutely, and thank you for noticing that. What's really even more exciting is not only has the industry started paying attention to the fact that identity needs to be a part of the solution but the regulatory climate is also pointing the direction of personal data ownership and personal data privacy.

I'll bring up two things that have happened fairly recently. One is the 21st Century Cures Act, which item 4003 and 4004 state that: patients need to have immediate access to their health records. There needs to be interoperability between systems for their health records and if they don't, you're gonna get fined.

Did you help write that?

[00:25:16] Dr. Leah Houston: No but I think, and this was finalized in 2020 and so I think it's like by 2023 or 2025, they're gonna actually start putting pressure on systems to implement it. They're giving them a couple years to figure it out. The problem is the current systems have been designed to do the opposite.

They've been designed to be the opposite of interoperable. They've been designed to information block. We really have an opportunity now to build the systems that are in compliance with these privacy preserving regulations. So that's one. And then the other one is the no surprise billing act.

We're hearing a lot in the news about patients getting surprise medical bills. They think that they're covered, but then they go to the hospital and they find out that they're not, and they get a surprise bill and then they have to go bankrupt and lose their house and all this horrible stuff.

That's an identity and credentialing issue. From the day that you look at the list of doctors that accept your insurance until the day you actually have the surgery with that doctor can often be a cycle of 90 days, 60 days, however long, sometimes longer, six months sometimes. So between that moment and this moment, if your doctor stops taking your insurance, you get a surprise bill.

It's an identity and credentialing thing. Am I credentialed to take that insurance? Do I still accept that insurance? We're gonna start seeing them requiring this timeframe to be shortened, to be instantaneous, to be automated. And that's the kind of solution that we're building.

[00:26:39] Jared Gabaldon: So it begs the question what entities will be upset by the adoption of your technology?

Is it insurance companies, administrations, or does it help them to? Some agree. Maybe it doesn't. I'm curious.

[00:26:50] Dr. Leah Houston: So all systems are frustrated. The issue is, the same systems that are very frustrated also are benefiting a lot from keeping it friction filled. Because if you make it so complicated and so hard, then you have control because you're keeping it complicated and hard, but you also have a lot of control because of that.

If it's easy for a doctor that you're treating poorly to leave, then you lose that doctor and now you don't have anybody to take care of the patients in your hospital. I believe that the good guys, the guys who are for patient safety, patient privacy, patient rights the good guys who want to treat doctors well and compensate them fairly for their work will love this technology and the good guys will adopt it and they will lead the future of healthcare.

The incumbents who have purposely built these friction filled systems that make everybody's life hard and horrible are either gonna learn to adopt it and get on board, or they're gonna slowly fall away just like Blockbuster did when Netflix showed up.

[00:27:54] Jared Gabaldon: Yeah. Exactly.

You really hit the nail on the head. How long do you think it would take for this tech to be adopted? Is this like a five year path? Is it a 10 year path? It took us 10 years to get Bitcoin, some level of, public adoption.

And so it seems like this technology probably doesn't necessarily have to take as long as 10 years. It's already, hit a level of public acceptance. But how long do you think it would take for just the tech in general to be accepted by maybe the early adopters?

[00:28:18] Dr. Leah Houston: As I mentioned, there was like over 30 companies I think, that are working on this tech. So it's already being used in other industries. There's educational credentials basically. Everybody has to deal with this.

So you wanna know, does the person who's writing software actually know how to implement push notifications or is that something you're gonna be learning on the job? You can give a digital credential to somebody after they've completed XYZ software development cycle. Just like you can give a digital credential to a doctor after they've delivered 10 babies during their residency, which is something I had to do in order to graduate from emergency medicine residency. So I can capture these digital credentials for my procedures, for my experiences, not only my degrees, and that is coming, that's coming very soon because we need workforce intelligence, workforce mobility. We need authentication of who people are. The diligence process for onboarding people is friction filled everywhere. Other places, it takes a couple weeks.

For us, it takes four to six months. So I believe that this is coming sooner than people think. I think for 10 ish percent of the physician population to feel this new technology, it's gonna take a couple years. But then, for mass adoption, maybe closer to five to seven years.

[00:29:31] Jared Gabaldon: Who can I think of that would adopt this first? It's gonna be a bunch of the young folks, and maybe the young folks evangelizing it, to the people that are also facing the same issues. That's just not as open to blockchain.

[00:29:41] Dr. Leah Houston: There's two ways that this is going to start being mass adopted.

The way that I prefer it to happen is that the physician community chooses to onboard, to use it, to accept it, to build the future system. This is the concept of a DAO. This is why we want this to be a Physician's DAO. Build your own referral networks, make your connections, and then make it easy for patients to find you.

Patients wanna find the best doctor for them and the current systems aren't working for them. Their insurance lists, they're not even up to date as we discussed. Now, if Physicians choose not to adopt it first, we also have the opportunity for the Evercred system to be adopted in a large medical school or residency program or state licensing board where they start issuing these credentials and doctors can then pick up the wallet and receive the credentials and use it that way.

So either way it's gonna happen. And this is part of why the two interoperable systems need to exist in order to push this technology forward.

[00:30:35] Jared Gabaldon: We did get a very interesting question from an anonymous attendee, talking around this as well asking, do you think that this is gonna outcast an older adult population that's already struggling with tech, as it is or do you see that there could be a solution for their challenges within the current medical system already, or, maybe this needs to happen and they just have to, we have to figure out an easier way to onboard them.

[00:30:56] Dr. Leah Houston: So we have designed this to be very easy to onboard. The physicians who are approaching retirement, people who are over the age of 50 they remember the system before all of this nonsense and BS was implemented. They remember when doctors had private practices. They remember before there was EHRs and before there was all this, data surveillance, capitalism over their private relationships they have with their patients.

So they hear this message. Much more loudly and much more clearly than some of the younger doctors who have been taught to think that this is how it is. A lot of gen, gen z-ers, they're like we've given up on privacy. This is just how it is. We don't really have a say, when it comes to their work and when it comes to their hard work they did to become doctors. But I do believe that once they get into the actual practice and once they see and feel how bad it is, they'll start paying closer attention. It's just once you're in medical school and residency, you still are inside of it, not realizing how bad it is, in the real world.

[00:31:58] Jared Gabaldon: Yeah, totally. And even just regular folks like myself, I have also given up on the fact that it's so hard to control your data in this world that we live in now, and they basically know everything about us, from the time you get a cell phone, basically.

Like at that point it's over. They know everything about you.

[00:32:12] Dr. Leah Houston: And that's not necessary. It could have been created in privacy preserving ways, and, in the decentralized identity community, there's people that are in their fifties and sixties who tried to do this the right way the first time.

And the third party behemoths that we all know of now. Were able to raise the capital and build it faster in the ways that made them more powerful. And the voices of the people who are trying to do this in a truly user-centric privacy preserving way, their voices were drowned out, and they're still here, they're still banging the drum.

This is part of why decentralized identity is now a part of our ecosystem and an opportunity and a tool for us to pick up and use because those voices still are there.

[00:32:51] Ty Hagler: That's so surprising. That answer. I would, that was not what I was expecting. But this matters to the people who remember what privacy was like and yeah.

It's different from the older population's not gonna be able to adopt new technologies, but this is technology that matches the values of the older population. And we're trying to help preserve and remember what it was like to have self sovereignty over your own data.

[00:33:13] Dr. Leah Houston: Absolutely. Bringing it back to the concept of a DAO. A DAO is supposed to align incentives, so a lot of these people who built these third party systems that now own and control us they, from a principal standpoint, wanted to build it the right way, but there was no incentive for them and they had to feed their families and they had to get a job.

And so they chose the jobs at these places hoping maybe they could fix it from the inside. Same thing with the doctors who sometimes choose these jobs. They get the academic title hoping that they can change things from the inside, and they end up just getting burnt out like everybody else. So a DAO has an opportunity to align and to reward people who are doing the right thing. And so doctors who choose, for example, to work in more remote areas to increase access for people who previously didn't have access. We could create incentive structures where they maybe get tax breaks or, they maybe get, government funded office space or things like that, and so there's a lot of things that can be done with DAOs, that can't be done in traditional organizations or it can't be done easily in traditional organizations.

[00:34:11] Jared Gabaldon: Totally. And we're coming up, we're getting close here to, the hour and I did have a question about, the largest obstacles that you're facing, but somebody actually, Andrew here in the chat actually asked a more nuanced question that, expands that even more so I think.

Maybe we'll go into his question of just asking you, what makes your solution the best one? And what do you need right now to win? Do you need time? Do you need money? Do you need a bigger team? And how can the people that are listening, help you?

[00:34:38] Dr. Leah Houston: Awesome. What makes our solution the best one?

We are empowering the individuals who took an oath to put patients first. We are empowering the ones who spent their entire youth with their nose in a book, trying to learn how to best keep people healthy. That's why I believe we're the best option. We're very early, we're first movers. We've been very thoughtful in how we've designed this.

We have brilliant designers from the beginning and brilliant software developers still working on this today. So that's why I believe we're doing this right. And we're the ones that are gonna win in the end. The physicians are the ones that have their patient's best interests at heart.

Right now we are scaling. So if you know any physicians ask them to onboard, anybody can onboard onto the app now and become a part of this movement. Remind everybody that's in beta. It's early. A lot of the features that we wanna have aren't quite there yet. But being a part of this early gives you early opportunities to anything that we offer, whether it be a token launch or whether it be services or discounts and things like that. And then as an early startup, we need to grow our team. And so we need to pay them. So we are looking for funding. So we're opening up a fundraising around next month. And so if you're interested in investing, reach out.

[00:35:51] Jared Gabaldon: That's beautiful. I think that actually lines up perfectly with something we have going on as well. Our Gitcoin round 14 grant is live as well. It's actually through a quadratic funding model, which I think is very interesting. I think Ty's very eloquent to explain this.

I'll let him get into that Better than me.

[00:36:08] Ty Hagler: Yeah. And I'll post the link here but the, it's yeah Gitcoin, it's a decentralized funding model to where you've got a pool of money, in this case that's 1.5 million, and then if you compare say one person who votes for it with a thousand dollars, then there's a hundred percent match.

If you have a thousand people who vote with $1, then there's a 700% match. So it's a really interesting model for basically having the poor and the many outweigh the rich and the few, and so super interesting for just allocation. And then Leah and I have been talking a little bit about kind of applications for the Gitcoin model and doctor credentialing.

In terms of feedback mechanisms for, medical unmet needs. And so there's some super interesting potential here and I've just been excited, inspired by what Dr. Houston's been doing. So one of the teams that's in this, I think probably is gonna be a future collaborator with Doctors DAO because they're interested in Insurance access and there are a bunch of amazing, talented medical school students who absolutely should sign up for the platform.

I see Darius is on here. Darius, I'm glad you're on. And yeah, so it's something that we could, if you're new to crypto Jared and I are happy to jump on and help you figure out how to set a meta mask account and all of that and get going here. But you, that's something that we're excited and pushing forward.

There is a deadline of next week. And so that's something that we're excited about. Of course we're also excited to continue to support what Dr. Houston is doing here with also trying to help attract fundraising and also bring like you were saying, looking for other clinicians.

So I personally, I don't have a medical background or any medical credentials, so I can't join doctors DAO. So you have to be a licensed physician in order to be part of it. Is that correct?

[00:37:43] Dr. Leah Houston: Yeah, so currently you have to be a licensed physician, but we're actually working to allow residents in who graduated from medical school, they have a medical degree, but they don't have a license yet, most of them. So we're working on some of the onboarding, fixing some of the onboarding stuff to allow them in to.

[00:38:00] Jared Gabaldon: Okay, awesome. I know that we are, like I said, we are coming up on the hour and I know we have some very young doctors and future doctors actually, watching this as well.

Do you have any tips for a young up and coming physician that's just coming through school trying to navigate all this? Obviously you were in their shoes at some point, so I think they'd be, would love to hear a little advice from a practicing physician.

[00:38:21] Dr. Leah Houston: Start building your own professional brand. Get a Twitter account. Start building who you want to be as a physician because although you might take that first job out of residency and love it and live there for the rest of your life. Or you might start your own private practice. No matter what, being able to present yourself and to cultivate the doctor that you want to be, and the doctor that you want to be for your patients that's responsibilities on you.

So other than, studying hard and being diligent and critical thinking about your patients, that would be my advice.

[00:38:52] Jared Gabaldon: That's incredible. And then maybe any other, shameless plug about HPEC, anything coming up that you guys have or Evercred?

[00:38:58] Dr. Leah Houston: So we actually have a pilot project coming up with an academic residency program where there's gonna be eight resident graduates who are going to receive their residency certificate into their wallet.

That's at Norman Regional Medical Center in Oklahoma. So the graduates from this year and if that really goes well, I would love to expand to either the state of Oklahoma or to the rest of the Oklahoma State University system. And, we're also in conversations with, rush and Mass General and, others.

So we're really excited to actually see this be, used by actual people. Yeah.

[00:39:32] Jared Gabaldon: Wow. Dr. Houston, you're an incredible mind, incredible talent. We're very grateful to have had you here today. Thank you for taking time out of your, very busy schedule to be here with us.

You know everybody that's on the call. The humanitarian physicians empowerment community follow Dr. Houston on LinkedIn. You can go follow their pages there that she has live. But yeah, like I said, just thank you so much for joining us. It was very insightful.

And, good luck to you on your journey.

[00:39:55] Dr. Leah Houston: Thank you so much. Thanks for having me. And thanks for all the awesome questions.