 Hello, everybody. Welcome to the Hyperledger Foundation July 6 General Meeting for the Healthcare Special Interest Group. My name is Ray Dogum, chair of this group. And, you know, thank you all for joining. This is a bi-weekly meeting. And where we talk about different topics related to the healthcare blockchain Web 3 Hyperledger DLT. So, your participation is always welcome. Again, this meeting is recorded. We have a YouTube playlist now where you can watch the recordings of these meetings as well. As you can see here, there's a link to it in the agenda. All the agenda meeting notes are on this Hyperledger Confluence Space. So, feel free to check it out. It is public. You can log in as well and even add comments if you'd like. So, this is just a little bit of housekeeping. Are there any new members who would like to introduce themselves today? Oh, I'm new. Can you guys hear me? Yeah, we can hear you. Hey, Filiberto. How are you doing? Good, good. Thank you. How about you? Doing well. Thanks for joining. Oh, my name is Filiberto Quintero. I'm here in San Diego, California for the summer. And I'm a student in biomedical engineering. Biomedical engineering, is it? Yes. Well, welcome. I hope you find this to be valuable. And so it's good to have students as well. So thanks for joining. Thank you. Anyone else? Okay, well, I'll go ahead and get started here. Just as a reminder, there are various groups online, communities that you can join, including the Hyperledger Discord channel. You can find a link to those here. There's also other ones listed. If there's one that you would like to be listed here, let me know. I can add it most likely. I think it's important to kind of, you know, maintain participation in these communities, even as we enter a crypto winter. I think we need to make sure that, you know, we keep building and keep thinking about how these technologies can be applied to actual use cases, not just a speculation. All right. Next is upcoming events. I just wanted to highlight a few here. There's an event at MIT in Cambridge, Massachusetts, July 13. It's called the platform revolution comes to healthcare. It's a deep dive during the 2022 MIT platform strategy summit, which is on the 14th as well. So the 13th and the 14th. There's an event in San Diego, the AHA leadership summit. This is the American Hospital Association. It's in San Diego also mid July. It's in Stanford, August 29 to 31. The science of blockchain event will be held September 12 to the 14th. The 2022 Hyperledger Global Forum will take place and there's a coupon promo code here you can use to save 20% on those tickets. September 15. There's the converge to X symposium in Austin, Texas. It's usually a very focused event on blockchain and healthcare. On September 23 and 24 in Boston, there's a decide Boston event that's being planned as well. Interesting. If you guys are into the decide space, this is a trending area, and you have sponsors like molecule Vita Dow lab, Dow. So that should be interesting. And of course, in Las Vegas, November 13 to the 16th is the health conference, which is a major healthcare digital health conference that many of you probably are aware of. Huge event. Any other events people have in mind or you want to share any comments on this. Okay. So here, jumping into some of the articles. This is Jim real quick. I'm sorry I just got to mention I threw this in the chat but the hyperledger global forum is one of a number of for that are all coinciding with the open source summit in the EU so the Linux Foundation open source summit goes from the 12 to the 14th and we have hyperledger global open source summit, Kuvicon open source security summit, etc. It's all it's all co located which you'll see when you go to the to the to the registration page. Awesome. Thanks Jim. Appreciate that. All right so jumping in here now we have a bunch of articles, a lot of it actually related to privacy issues, especially given the recent Supreme Court judgment that was made decision to overturn row view. So we'll get into those conversations I'm sure there's a lot of opinions and considerations there so first one is from stat news healthcare companies are scrambling to close data privacy gaps after abortion really looks like I don't have access to this anymore here but basically the article was talking about how different telehealth apps as well as apps that track menstrual periods for women are reporting, you know, some of the data is not really secure. So it's also possible that government agencies could request data from the companies about specific users, which is obviously could pose a danger to that person. So, can't open it here but anyone see this or take a look at this, have any thoughts on this. When I was looking at it I was like, wait a minute. I know there's to an extent your health care data is private like if I don't know you're diagnosed with HIV or something along those lines can the government subpoena that information. I know there's certain things that have to be reported perhaps if it's if you show up the emergency room with a gunshot wound, or, or something similar that maybe those have to be reported but I mean is this fear mongering or is this truly a thing and I don't know if we have any attorneys on. It is truly a thing and I'm not an attorney James more than happy to comment and I haven't I don't have a stat plus subscription. But what I'll tell you is the challenges around health care data, so you may not have seen the article yesterday and I can find the link to it but there's been an analysis of the fact that meta is putting a pixel on EHR portals, even if they're behind an SSL and sending data back to meta to Facebook about patients appointments. And you know that's clearly a breach and a whole other topic but that's a brew haha. In addition, the rules for HIPAA de identification of data are decades old. And so it is common practice now quite frankly that HIPAA de identified data is legally released by a health care entity and the data aggregators just and data brokers just match it with the data that they can buy lists and records for and re aggregate all that information. You know in the US I think that that has been sort of because we don't really care about privacy. That has just been kind of oh you know that's the problem out there we should do something about it. Now we're at a point of of talking about doing that sort of re aggregation and re identification and having criminal prosecution implications you know civil rights and and and human privacy issues. And yet it's, it's still a thing. I didn't even think of that when you know when, when they, you know when it was first becoming, you know, really release the judgment, the ruling. And then I and I saw that I'm like wait a minute. Can this be, can this be a thing. And so, that's concerning. I think it also matters what state the individuals in as well so there's going to be a lot of like gray area I would say in terms of like how some of this data is handled shared just taking a quote from this article here from the professor of bioethics and law at University of Michigan, Katie specter bag daddy she said, people think HIPAA protects a lot more health information than it actually does. So she said the federal privacy rule contains exceptions that could allow prosecutors to compel businesses to relinquish information relevant to criminal cases, and the same is true for other kinds of legal action to. In other words, in a state that has outlawed abortion HIPAA wouldn't necessarily keep records of the procedure from being used as evidence. So, a big concern for many. Yeah, we tend to think of privacy culturally conceptually is my stuff is private and you can't get it unless you ask me first. But the HIPAA administrative safeguards around privacy or organizational construct and really aimed at how does the health care organization protect their records and as the article says there are legal exceptions. You can be compelled by subpoena and depending on the hospital in question, if the sheriff shows up at your door with a subpoena, how much you're going to argue about federal regulations versus dealing with a subpoena right in your own backyard are two different plus how they may be able to get the data that they need to substantiate a case if they're trying to prosecute under state law and and where they get that information so again they could, they could aggregate information collectively that provides you know reasonable suspicion or probable cause without necessarily getting information directly from the HR. And one thing here she mentioned certain states, higher standards for release of mental health records and HIV status for instance of that. She's saying that you know mental health records and HIV status is slightly more protected, but those standards aren't currently in place for reproductive health care and would remain permeable so yeah. So I have a question, what's going to happen to when actually, in the case of abortion, when people travel to other states where it's legal and they come back to their state where it's legal. Because that like for example in the state of Washington, I just heard that they're going to have, I guess, past part of the budget from the state is going to go to support people, women to come here and have abortions here. So what I'm wondering is, there's going to be a digital trail and all of that. So I'm wondering how that's going to work. And what I've read there's no legal precedent yet that says if you travel to another state to do something that's legal in another state. But illegal in the state that you live, how do you get prosecuted for that and they're to my to my knowledge and understanding, you know, not being a lawyer there is no precedent yet for figuring that out. Yeah, I also didn't say anything that was super clear on those situations either. But one thing that also is concerning are that providers who have been practicing abortion in these states that now made it illegal. Like, what are they going to do, you know, what's their situation going to be like. There's a section about crossing state lines for an abortion. One question that remains is what might happen if states try to ban their residents from going elsewhere to seek abortion. Well, I'm sure that the practitioners and the OB YNs that do this, you know, practice is not just based on abortion. So they're probably continue practicing without doing that. Sure, yeah. Yeah, well, see what else is happening here in the news but I think that this is going to be a topic we're going to be talking about for some time. Next here is an article is published July 1 how much health insurers pay for almost everything is about to go public. So, I would say this is a positive announcement or positive legislation that is being, you know, put on to the industry. So health insurers and self insured employers must post on websites just about every price they've negotiated with providers for health care services item by item. So typically this has always been something that has, you know, these prices were negotiated behind closed doors, and it gave specific parties an advantage competitive advantage. Now that they're public it's going to create a lot of transparency between these different parties so prices, you would expect to hopefully drop but then I also read that prices could increase because some of the, you know, health systems or health insurance companies might want a better deal as well. Great I'll just add I know we have a bit of a mixed audience so just elaborate on this so everybody understands if I walk in the door to Mayo Clinic for an appointment. And I've got Blue Cross Blue Shield. Well, let me be more specific. I've got it. When you receive services from a hospital or provider with your insurance they have negotiated rates for their laundry list of things that they do individually with each health care insurance company. And then of course there's a separate prescribed rate structure for Medicare and for Medicaid. So, so just to describe this article more than what they're saying is that all of those rates that have been negotiated on an individual basis contract for contract network for contract network are now supposed to be publicized, because I could walk in the door to have to get a prescription for allergy medication and see a doctor. And what I get charged under it is different than if I had Blue Cross Blue Shield that if I had Medicare that if I had Medicaid, and in some cases they can vary as much as 30 40 150%. So one procedure might be $7000 under one plan it might be 1500 under another plan up until now that's been completely obfuscated for commercial interests about the provider and the insurance company insurance company because they have a commercial interest, the provider because they really don't understand how they pay for things in the first place and don't know how to do budget, but that's a different story. So, so that's what this, that's what this law is now requiring is to shine daylight into all of those contract structures. Is there a website that this is going to be under that you can actually look because sometimes they say this is going to be published and all of these people don't know what to look. Wonderful question and I don't know Alicia I know of some folks that I'm connected with on LinkedIn that run small businesses, their own consulting firms around around benefits, and they have been compiling their own databases which they will sell and provide as a service that is based on the existing price transparency law, which is, which is pretty, pretty weak, both in terms of the penalties as well as what must be disclosed. But it is a model that they've been using. And so I think there will probably be some third party service providers and others that will that will work with us. And I think the idea of you and companies, what which you hope is that your benefits advisor your HR departments, your third party administrator go to this to help negotiate better rates and structures for things and ultimately come up with cash payment formulas because a lot of providers don't aren't even equipped to take cash you can offer them 500 bucks on the spot for being there. And they don't know how to take it. They've got to build somebody because of just administrative procedure so hopefully this will rectify that too. So one of the issues with that, and I'm pretty sure you're familiar with is that the fact that, you know, you will have that. But when people actually sign the release. You know, for treatment, you're agreeing to pay everything that the insurance doesn't pay for. So, you know the cost like you were saying $7,000 in one place $1,500 in another place. And one of the issues with that is that patients are still paying for part of it. Because it's in the release for care. Oh yeah that's exactly right and that's a function of your co insurance your co pay. Correct balance billing difference that's over. And one thing to add here as well in the article I do mention company turquoise health. It's an online company that's been posting price information. So you can take a look here. This is just one company I'm sure there's others that are doing this. But basically you can see. See back to Turquoise health that was their blog so if I wanted to put in a service. Surgery, let's just say, and a zip code. You can see the cash prices here and all rates. And I guess you know, there's an option to verify it here so not 100% sure if this is 100% true but this is something we're going to be seeing more and more of as a result of this regulation. So I think good news overall for the industry and makes it better for makes blockchain sort of. If you think about how you know, blockchain can get involved here now that it's transparent services can be offered and people can pay for it more directly. With cash for example. But again, a lot of work that needs to be done behind the scenes here to make this sort of make it work with the other existing insurance companies so. Yeah, any comments on this. I'm sure when they were going to have the ability to Google a procedure and view all the prices in our area cash prices. Next article on Forbes year I found was titled Web three in the future of medicine. So talks about how, you know, the web has evolved from Web one to a more decentralized Web three here, you know, as more competition and corporate influence grew. So to would the web's capabilities bring forth an evolution of data tracking tools and ways for users to interact with website owners. That would prove to be a double edged sword however a centralized services would become the norm and web based capitalism would rain. You can even think of this as web based surveillance capitalism would rain. While we may have to keep our guard up for a while longer web three is being bringing in, bringing with it a tide of technologies innovations that will take power and priority back to the individual user. There's optimism in this article. Whereas the first two iterations of the web evolved, almost as testing grounds, pushing the web to test its capabilities and limits and connecting the word socially and economically. Heavy emphasis is now being placed on establishing privacy trust and security. Be a catalyst for greater interaction and dependency on the web, laying the groundwork for further forms of complex interaction that we're only just beginning to unravel. So more definitions of web three in this article I know that's something that we've talked about in the past defining web three is not a simple thing so a lot of good content in here. For example, tidy, tidy, T, Y, D, E, I, for example where the next level of medical device management is beginning. The founder sold medical device for 15 years, observing firsthand how cluttered unorganized and inefficient hospital management systems were. Not only was the process of clearing paperwork for purchases abysmal but Hatchell also likely witnessed how long it would take for medical personnel to learn how to use or submit requests for new equipment. So here it goes into how web three can make this better. Okay, thanks for, thanks for bringing it to my attention right I didn't even know we were quoted in that article so. Oh, I'm glad you're on that's awesome yeah. Any would you like to say any few words or any, anything you, how do you see the web three, john. Well, you know, I would say what we offer today is probably not web three in its truest form but you know what we're working on right now certainly is and so in the early stages of bringing that together. But really our company utilize smart contracts really to really handle a lot of transactional and efficiency that goes on between healthcare facilities and third party suppliers. But, you know, we are, we're looking at at doing, doing some other things like it's kind of kind of in stealth right now but you know, certainly, like I said, I, my biggest belief right now, I think around, you know, the concept of web three is certainly with Dallas I think I think Dallas truly, you know, provide the biggest opportunity for healthcare transformation right now and so, you know, I'm incredibly bullish on that and I think, you know, I think the healthcare community at large needs of me so really start putting some weight behind it as well and organizing and, you know, it's great great to see announcements like we saw last week with molecule. But that's great that North Pond stepped up and led that round the way that they did for them and, you know, and I appreciate bring up the kind of the centralized the decide, you know, movement which is growing and I and again it's much needed and I know you know you all do do some great work and equidrium on that as well and so. Yeah, I guess I would say staying tuned on the web three stuff but in terms in terms of what we offer right now I mean it's strictly, you know, strictly more of a ledger tech approach for, you know, for healthcare given given some of the other challenges that come when you're working with healthcare facilities so. Yeah, I appreciate that john thanks for sharing and the decide space is quite interesting I feel like it did gain much more traction than the individual patient owning their own data. In terms of location, I feel like that was talked about since 2017, you know how can we allow patients to own their own data and take it to different hospitals and make it work incentivize them through some sort of tokenization systems. And a lot of experiments, trying to do that. But nothing really got much traction as far as I can tell the decide movement, however, doesn't require any patient data per se. So I think because of that, it made it a little more easier to to make it work really. But we'll see I mean definitely a lot of excitement around decide. Awesome. Next article here from Med City news about real world data and how it could eliminate the need for placebos and clinical trials. So, and this was from a Google cloud executive. It talked about the speed at which the vaccines for COVID-19 were developed. And, you know, the dire circumstances of the pandemic drove this rapid timeline as well as the drug makers pioneering of mRNA technology. So here real world data refers to information on the health outcomes of a diverse population in a real world setting, as opposed to a controlled clinical trial setting. And this is often derived from a variety of sources such as EMRs, patient surveys and claims submitted to payers. Since the collection of this heterogeneous data campaign to picture of the health outcomes across a wide population, it may be able to replace the placebo arm and clinical trials one day. So the trick is or the problem. I guess I should say the challenge now is how do we get this information like the EMR patient surveys all aggregated into one, not one place but in a way where the exchange of that data can flow to researchers with the consent of the individuals as data data. That's the trick and I think a lot of DLT blockchain web three solutions out there are trying to figure out a way to effectively do this. And we have a lot of real world data I mean more and more devices, fitness devices, monitoring things that we're eating. I think all these things can contribute to this type of research. A November PWC study showed that 67% of Americans said they were less likely to join a clinical trial if they were required to travel outside their local area to get to the research site. Anyone here in this meeting who's been involved with clinical research or clinical trials knows how difficult really it is to find subjects human subjects and recruit them and then maintain and retain them throughout the entire trial life cycle. Yeah right just to emphasize that for a second let's say I come into my oncologist with a certain cancer diagnosis, and he says oh hey good news there's a clinical trial going on. If I have to travel to Boston to do it I have to travel to Boston to do it and that is completely out of my control, and the primary investigators control that's conducting the clinical trial these all reflect. bureaucratic guidelines that are built into all of these clinical trial requirements and a lot of clinical trials that go through the phase one. It's something absurd something like I just got to throw a number out 67% or something like that of clinical trials that start in phase one. They'll make it through phase two or phase three, and largely because as you go through the other phases and you get the subsequent new testing and requirements, trying to find a population to work with and and conducting a randomized clinical trial gets very difficult and expensive. Indeed, any other comments or questions around this topic is article. All right, another article from the Washington Post here related to the recent ruling here. I thought it was funny because the title, not even gonna say it because my device will go up but to protect women collect less data about everyone. So, this article is mainly about how much data Google is collecting and talking about as well that there is something they could do right so Google could do something about this which is stop collecting and start deleting data that could be used to prosecute abortions. It's so far Google and big tech companies have committed a few product changes that might endanger their ability to profit off of our personal lives. I see a blog post from Google about this as well. They are, I think, planning to delete some of the location history data where a person is navigating or taking directions to a abortion clinic. So they would be deleting that data. I'm not sure about the details exactly or what mechanism, they're going to be using to do that. But it is a topic, a huge topic of discussion here. Earlier this week, even the Department of Health and Human Services decided it needed to publish an advisory unlocking down health information. Yes, and I did see that as well. This is from, you know, HHS talks about how to protect yourself. How protect your data really after using your cell phone or tablets and being able to remove your location history activity on your smartphone and instructing people on how to do that. And this is on the HHS website. So this is like a tutorial step by step guide on your Apple and your device on how to stay safe. I think one of the interesting things is going to be in this, you know, in all of these that is going on is that teenage pregnancy is what you're going to, is what you see a lot of this. So it's going to be interesting how they're thinking of prosecuting as well as managing all of this. Because teenage pregnancy is going to is one of the biggest things when when it comes to abortion. That's a really good point. I agree. Yeah, that's, I don't know how they're going to handle that either. I think there's probably more, you know, confusion, frustration, fear that these teenagers might be experiencing and you know, I can't tell you the situation, especially if you're in one of those states that had trigger laws, which enacted the outlawing of abortions now really. So, and they might not also have, you know, the access to a car or travel to a different state either so. Yeah, it could be a real, I mean it's going to be a problem, I think. With that mentioned, I'm digging up the link for the article in the American Association of Pediatrics that I just got yesterday, which was a analysis of adolescent privacy laws and the TLDR is that there are no two states with similar laws concerning adolescent privacy on on any issue that was analyzed. Oh, wow. Thanks for sharing that, Jim. Yeah, any other comments on that article, Washington Post, there was a few other specific quotes I wanted to share. It does talk about ways to build civil rights into Google products. You know, we talked about Google in this article but I think this applies to other, you know, major organizations as well, Facebook, Amazon to some degree. So here, here's an action planner for Google to build civil rights into their products. Step by step by delete search queries and web browsing history. Stop saving individual location information. Make chromes incognito mode actually incognito. And then better product, better protect texts and messages. Stop using Chrome altogether. Yeah. As we speak I'm using Chrome but yeah. Firefox is a good alternative. Right. Another related privacy article, a lot of privacy issues in this meeting, or in the last couple weeks I should say. So this one was quite interesting because it goes really back into our history starting in like, I think, before. 1875 and 1800s 1900s. And it talks about the different perspectives people had on privacy and how this idea of right to privacy came up. It's a fairly long article, but it was quite interesting it talks about the origins of Roe v Wade, and some of the kind of politics that were involved in the drama I should say as well so it's pretty good read. I'll just take a snippet here the shifting terrain here invites the question of whether when we talk about the right to privacy. We're talking as interchangeable two terms that are merely homonyms. Roughly privacy as non disclosure, right, and then privacy as non interference, two different things. So in his leaked draft opinion overturning Roe v Wade asserted that the, that the court in holding that privacy covered abortion have previously conflated two very different meanings of the term, the right to shield information from disclosure, and the right to make and implement important important personal decisions without governmental interference. I think it's important to highlight because it kind of you know a lot of you are wondering, you know, why did the Supreme Court overturn this. They have their reasoning, not saying I agree with it but this is sort of helpful article to give you a, I guess a wide view of what's going on. Yeah, a lot of history in this very interesting. The way to tie it all together why it's important I think is because there are many countries that culturally and philosophically with a privacy different than what we do in the US. And that hyper ledger technologies are in many cases the technology of choice for not only just digital identity but constructing digital identity in a way that enforces privacy and consent and a right to be anonymous. There's a lot of optimization that that factors more into their thinking, and, and the sense of data ownership than we have as a culture here in the US. Thank you. And one, I just want to read this year privacy in its various forms, ultimately about control, the ethic of non disclosure involves our ability to control access to information about ourselves, whether the information is favorable or unflattering. Non interference involves our ability to control decisions about our own lives for good or ill. When we disaggregate these meetings, it becomes easier to understand how their connection through mutual reinforcement is basic to personal liberty. So I have here from tech Republic from the Pentagon which says they found concerning vulnerabilities on blockchain. So this was interesting because especially now with, you know, the market the crypto market not looking too hot. So there are many concerns about blockchain in general not being secure and things like that so this article discusses some of the recent issues like the Luna crypto crash talks about security issues, challenges and blockchain. Here the safety of the blockchain depends on the security of the software and protocols of its off chain governance or consensus mechanisms. And I actually put the trail of bits report here in the educational nuggets it's a PDF document, rather lengthy very informative. I recommend if you have a chance to read it you should see if I can open this. If I could for the sake of discussion, I'll just offer a group I'm going to blast the report and I'm not going to blast it in the context to be their health care of blockchain. But having spent a lot of years in security audits and vulnerability assessments. You're but you're supposed to be very specific as to what you're assessing for vulnerabilities, what the source of the information is the environment you're assessing and the controls around it. And this has got a bunch of hubbub and headlines around is blockchain secure. When they say explicitly in the first two paragraphs that they concentrated on Ethereum and Bitcoin, and then derive their analysis from published literature, not from their own technical evaluation and testing. So, there's nothing inherently wrong with what they did is you dig through the report but it's been mischaracterized and, and for me, if I was paying for that as an enterprise assessment. I throw it back and say it doesn't actually tell me from a risk management perspective from a controls and and vulnerability standpoint what should I be concerned about from blockchain or distributed ledger in general I just want to throw that out there. Yeah, absolutely. I appreciate that. And you're referring to this article or report here, the folks on Ethereum. Darpa say that, if you could scroll for a second, DARPA engaged us to investigate the extent to which block chains are truly decentralized sentence. Now all of us know there's like what 7452 blockchain protocols out there not to mention what we're representing within the hyperledger community. We focus primarily on two of them. So, you know, tell me, tell me about the safety of cars to drive. Okay, I picked a Camry and a Ford F 150. And based on those two I'm telling you what the whole world is like of automotive, automotive is out there and, you know, or worse yet I picked an F one car and a NASCAR vehicle and compare those two to tell you how safe it was to drive your Ford and I just think that that is that that's that for me, technically and professionally is not the way to do an assessment. Yeah, I appreciate that. And I hope, you know, there will be some feedback to this report, like the one, like what you mentioned Jim from there, they can maybe revise or, you know, respond to it I think there's a lot of interesting points here but again like there's many different blockchain systems or different ways to do it. You mentioned hyperledger you can have hybrid systems as well which kind of create a more secure potentially system. It really depends on what you're trying to build. But yeah a lot of good reading in here. So I'll leave that the link is in the educational nuggets here on finally the last thing that I would like to share with you all is this economic report from the bank for international settlements, which is talking about the future monetary system also recently published. And it just goes into, you know, blockchain Bitcoin and all it talks about how they can be used the promise and pitfalls of crypto. A lot of good material in here, very dense as well but just wanted to make it available to you also feel for sure that I would talk about stable coins as well. This has been really an important conversation this year. So it's an interesting graphs to display here bridges across blockchains are rising and have been at the center of many hacks. Fair enough. Retail investors are chasing past price increases in a risky strategy. Retail investors play a growing role in crypto. We've seen them. I think there was a recent announcement that there's a btf or a Bitcoin short ETF recently approved. So we'll see I think that was two weeks ago. So yeah just wanted to make this available to you all. All I had for today's meeting but if there's anything else you would like to share anything you've seen the last few weeks you want to discuss or happening in the next couple weeks you want to share with the group here. Now's a great time to do so. Take a look at the messages in here. Thanks for sharing those Jim. Okay. Well, just to let you know on the last one there. I'm involved with a couple groups around consent and what can not only consent architecture looks like but consent governance and consent policy. This link came through another group that I haven't gotten involved in yet but they're going to be going over this paper, and it talks about the inadvertent ethical issues of ethical consent and data collection from underrepresented communities. So you could take a look through that and from a hyper ledger standpoint I'd ask everybody to check out cardiac CRDA.org that's been a project sponsored by in DCO as a member of hyper ledger and LFPH. And when you read it you'll read all about travel credentials and vaccination credentials. One of the mechanisms that that cardiac uses for machine readable governance is something we're looking at for automated consent mechanisms as part of using credentials and information sharing. Thanks Jim. And with that, like to end thank you all for joining today really appreciate it. See you here in two weeks. Thank you. Thanks right. Thank you. Bye everybody. Have a good week. Thank you.