 Hello everybody. Welcome to the Hyperledger Healthcare special interest group meeting today. I'm the co-chair Ray Dogum of this group and today is April 26th. And before we get started with our agenda, I just wanted to go over a few housekeeping items as we always do. Number one, the Linux Foundation and their meetings involve participants and participation from industry competitors. So with that in mind, please be aware of what you're saying here. This is a recorded meeting and will be published on YouTube. So it's just extremely important that anything you say shouldn't violate any of these rules. So please make sure you follow any of your corporate and legal guidance. And all are actually welcome in the Hyperledger community. So everyone here is welcome. And this is an environment where it's important for you to feel safe and welcome. So just want that reminder here. And if you want to learn more about the Hyperledger code of conduct, you can find a link on the website as well. Just a reminder, these are the members of Hyperledger. You have premier members and general members. So thank you for all the sponsors and members here. If you haven't been involved in an open source project before it could be intimidating to start participating, but feel free to, you know, start poking around. Feel free to lurk don't wait for an invitation to reach out to people or use the tools and join meetings. And again, feel free to read our code of contact as well. So with that, I'm going to jump into our agenda here which we have for each meeting. And you can find that on the Hyperledger's wiki page. So you can see the link here. And I also send it out in emails as well. This is public anyone can access it. And you can also create an account to comment below. So to get started, are there any new people that would like to quickly introduce themselves to the group that might not have been before. Okay, not a problem. So I want to just also offer the opportunity for members to share any community announcements they have or anything they wanted to let the public know about what they're working on. This is the right time to do it. All right. Excellent. So I'm going to move into our, some of the upcoming industry events that I've listed here. And of course there's many more so if you are aware of one and you'd like to add it to this list. Feel free to let me know. And I'll be happy to include it here. So the first one which actually was last week and has concluded is the hymns event that was in Chicago so this is the health information. It was one of the largest events and conferences. So there was a lot of different types of sessions and panels and workshops and a lot of it had to do with how information technology is able to advance healthcare. So I know AI was a big topic. Blockchain was also a topic but I think AI was the bigger topic this year. We have consensus 2023 that's happening. This is more of a blockchain focused event. And it's happening in Austin so if you or anyone you know is going. Yeah, I'd love to learn about updates from that event. Feel free to share that in the YouTube comments or anywhere for the community to be aware of. And I think the eighth Boston is happening this weekend in Boston. I will actually be attending that and looking forward to hearing about updates from the industry. May 18 to the 20th Bitcoin 2023 conference is happening in Miami, Florida, which is always a huge event. Very splashy event as well. So if you're going to that should be a fun time. Well, but if you do, I hope you enjoy it. Next is symbio beta event, which is May 23 to the 25th, which I will be attending and that's going to be in Oakland, same California. So that should be a fun time. And later on this year in September, the Convy to X global blockchain health care event will be happening in New Orleans. So you should check that out as well. Very much focused on how blockchain will impact the health care industry. Can can I make some comments on that one or ask some questions about that one. So I'm, I'm in Louisiana. Casey and I have been talking about participating in that conference. And if anyone on this particular call has some insights is, is it a good one? Is it, you know, definitely one that we wouldn't want to miss? I've been in before those type things. I've loved some feedback. Yeah, James, thanks for asking that. And one thing I can share is I have been to this event in the past, and my podcast health unchained is actually immediate partner so you can see my name here. So I do recommend checking this event out. It's a rather intimate event so it's not like huge, and you're able to really, you know, spend time and learning from a lot of these speakers and talking to people and connecting so I do think it's a good event. It's a great place every year. So we'll see how it is in New Orleans but I think it'll be an exciting time. I agree. I can weigh into that too. So James I have attended in the past two. Actually, the very first time I attended a convict 2x meeting, I met Ray. And we met in a bar. And it's, I completely agree with what Ray said it's a more intimate setting. There is a good community. It's an opportunity to meet the people that you've been interacting with via zoom on many of these types of calls, people who have very shared interests and background. This is not a good environment for necessarily sales because we're all doing the same thing, but it's a great environment to find other people who are active and supportive of blockchain and healthcare. Exactly. And I'm strong here through the 2022 agenda. So last year's agenda. So feel free to take a look. I'm happy to connect you with Tori Sinage who's actually the organizer for this event. And that goes for anyone listening in as well. So hybrid is on there and hybrid means different things. Is it mostly in person? So there will be mostly how to answer mostly that but I think I'll say about 5050 at this point. I know that thank you. I think the live events will be recorded but I'll get more information on that to you later. Thank you. I appreciate it. Sure. Yes, and one more thing. I have been Tori Sinai reached out to me last week. We talked on the phone for a while and she asked me to speak, but I need my supervisor to grant permission. So hopefully I can come. Awesome. I'm going to continue here. So those are the events that are happening soon in the industry. And now I just wanted to share with you all an announcement from hyper ledger, where we have six new members joining the organization or the foundation. So I just quickly wanted to like mention the names of the companies here. You know, some of you recognize them. And here it is announced it's latest lineup of new members. So go ledger, Senofi Incorporated SpyDRA have joined as general members, while the digital Euro Association, digital pound foundation and the European Blockchain Association have also signed on as associate members. So just another indication of this growing community and feel free to check out the full announcement here in the link. Any questions or comments on that. All right, so the next article that I have here is actually about artificial intelligence, generating some buzz in the medical community as a way to reduce paperwork. So as I mentioned earlier, HIMS conference was last week in Chicago. And there was a lot of excitement about using AI to reduce paperwork and burn them some clerical tasks so healthcare workers can spend more time on patients. So I think everyone in here kind of understands that it's not a revolutionary idea, but the fact that more companies and people and, you know, organizations are trying to explain this to the healthcare practitioners and industry is a good sign it's a positive thing. And I think a lot of that has to do with, you know, now Microsoft backed open AI and chat GPT, which has sparked a lot of interest in the medical community. And I believe there are some huge companies including Epic, and I don't know if Epic has mentioned in this article specifically. Yes, they are. Yeah, on Monday of last week, I think Microsoft announced an expanded partnership with Epic. Specifically here, Epic's first application of the AI technology automatically generates draft responses to the messages that physicians receive from patients through my chart. So physicians don't have to use those suggested draft at all, but it saves them time if they choose to an editor send it. So this is just one way as could help doctors in the clinic. Yeah, any thoughts on this guys I think this is really interesting I'm glad this is happening and AI is becoming more of an accepted tool for for healthcare. And this is my name. I saw that news article come through and originally and it came through on April Fool's Day. And I thought it was an April Fool's joke. That's pretty funny. Yeah, but that's fascinating and it makes sense. I don't know, especially with Microsoft's effort. I don't know if any of you are using Microsoft copilot. I'm not using it yet, but a number of physicians are using it to help them generate emails and so it makes sense that they would integrate that capability to make it much more efficient to respond to patient information of course not necessarily involving a patient specific health or diagnostic material but there's so many things that we can automate a response to such as scheduling and questions about basic questions about medications so this is this is really interesting. Absolutely and I think like the goal is to allow these doctors to spend more time with patients. Yeah, I'm looking forward to hearing more about this and updates on this as technology gets better and people can use it more effectively. And on that another article related to this is epics. Again, more detailed announcement here of them using open AI through Microsoft. So I won't get into the details here I just wanted to leave the article in here. In case someone wanted to dive in. The next article here is from Coinbase talking about decentralized app called Sweat Economy or actually Sweat Tokens and I think the company is called Sweat Coin and I think we've talked about this in the past as well. So the main idea here is the project aims to introduce what it says as a fair system ahead of a vote to guide the protocol spending of 100 million sweat tokens. So what they're doing is in order to get more participation. Each community member will have one vote rather than wielding voting power proportional to the size of his or her governance token holdings, as is traditionally the case within decentralized autonomous organizations or DAOs. So that is actually a challenge that the industry blockchain industry faces where voting power voting rights is heavily weighed towards the people who have the most tokens. So what Sweat Coin is trying to do is develop a system where they verify individuals so each human individual person can only have one vote versus allowing wealthy or token rich people to vote more heavily. So that's the idea. Here the co-founder says we believe that everyone should have a say in the direction of our company regardless of the amount of tokens they hold their knowledge of Web 3 governance or wallet connection. So, yeah, and it says here the vote is likely to be one of the largest governance votes in the history of Web 3 with 15 million holders eligible to participate so this will be pretty big. And yeah, I think this is on the 18th of April, so I think this might have happened. So do a quick search on that update. If you guys are interested. So 1818. So maybe on a follow up meeting we can talk more about that I don't see any articles specifically after the 18th. So, I don't know how it went. If you do and you're listening in, feel free to comment and let us know what you, what you know. The next article here is from a 16 Z. And it's a state of crypto index that they released recently and I think it was pretty cool because it's sort of visually explains what's happening in the crypto space. Based on a bunch of different factors and indicators. So here, you know, you have a chart on innovation indicators and supply side. And you have an information of that in the tool tip, and then you have adoption indicators on the demand side. So it's not just the price of crypto that they're following they're looking at other metrics to measure how the crypto economies is going so I think that's pretty cool. And probably an important tool for our industry because a lot of times the prices like what everyone's following and that's not necessarily the best indicator. Thank you for pointing this out Ray. I read this with great interest as well. One of the things I found so interesting was in the deeper report was about the use of electricity for Ethereum now and how it's decreased by 99%. I thought there was a very interesting graph that showed the use of electricity by Ethereum versus YouTube and how YouTube has like uses now like 800 times more electricity than Ethereum does the Ethereum network. Wow, that's interesting. Yeah, I don't. I believe that and I think, you know, YouTube just having so much data and, you know, video especially requiring so much data. It makes sense I believe that. Yeah, well the critical distinction there was comparing the Ethereum network after the merge. So, Absolutely. Right when they went from proof of work to proof of stake. Exactly. Yeah, I think this is a great resource. We'll definitely be using this as we explore the next article I have here is actually about CVS, which files patent to sell goods and healthcare services in the metaverse. So there's a lot of talk about the metaverse course. And it's quite interesting to see how these large healthcare companies are actually trying to leverage the metaverse and are preparing for it really so that, you know, they're in a good position. Once adoption has as they see adoption, I guess, and I still think it's a, you know, gaining popularity but we haven't reached a critical mass. In terms of what's the impact here it says in the filing CVS health said it wants to trademark its logo establish an online store and create downloadable virtual goods raining from prescription drugs to beauty and personal care products. The first pharmacy to do so. Though trademark attorney Josh Gerben said there's been a blurry of metaverse filing since Facebook announced the name meta. And see where this goes. The company will create its downloadable virtual goods using blockchain technology it says digital assets and collectibles will be sold as NFTs. So pretty big deal for CVS. I haven't gotten an email from CVS yet telling telling me to join or, you know, find them on the metaverse yet but it's probably probably happening sometime soon. I am curious for the attendees in this group. Maybe directing this question to James. Do we know how organizations have decided to manage licensing and adherence with state statues in the metaverse. That's really not my research lane is that what you're asking where you're directing that towards me. Yeah, maybe I miss remembered your background so. Yeah, I was just curious if this group knew. Yeah, it's a good question, Monday. If someone does know listening here, feel free to comment. And we'd love to, you know, follow up with you. Thanks for the question. Just diving a little deeper here to understand what they're actually planning. The company will create three distinct store formats aimed at driving higher engagement with customers. Our consumers meant to serve as community health destination so that includes the traditional CVS pharmacy stores which will provide prescription services and health wellness and personal care sites specializing in primary care. And enhanced versions of health locations, which offer screenings monitoring counseling and treatment options. And also feature products as well. So, yeah, it looks like an interesting development for CVS and we'll be following that pretty closely. How's it going? Good. How are you? Good. I am just trying to understand how prescription services would work in the metaverse. That's a good question. I thought about that too. And I was reading it. I was thinking maybe if there's digital therapeutics that need to be prescribed that could be, you know, one explanation. Because obviously, you know, if they need physical tablets or capsules or something from a pharmacy, they're not going to be able to print that out. At least not yet, right? Right. So, yeah, that's a good question. And maybe they can get services that would set up, you know, like a mail order and that would, they could do that in the metaverse and then receive it at home or something. I don't know. Just kind of the services that they would receive in a pharmacy that could be done virtually, maybe could be done there. So maybe that's what they mean. Yeah. Another idea is maybe if they're in the metaverse, like a patient walking in there in like a virtual store and maybe there's like a virtual pharmacist they can talk to ask questions. So maybe like that experience could be enhanced with an avatar. So, and then I guess they would have to have the drug mailed to them, like you said, or, you know, drop by a local CVS or something. They could get like some kind of NFT they could show that would get them their, their, their drugs instead of a prescription. Right. Okay, you're bringing up said this is Wendy such great questions. I just really, I'm really struggling with understanding how this could comply with states. And I, because licensing is so critical. So I, I, I don't, I'm just. I just can't wrap my mind around how they could do this in the metaverse. Yeah, like location and all that is, is super critical for, for, yeah, the state requirements for a pharmacy. Yeah, I don't, I don't know either. Even like, you're licensed, you know, in a single state like in Colorado. Yeah, I am. So I mean, I have several different state licensures, but it makes no sense that it is interesting though, telehealth has a, I don't know if you've ever looked into like the way telehealth those licensing. Because I, I, yeah, I don't know a ton about it because I don't provide telehealth services, but I, there is some leeway around that where I do think people have to be in the state physically, like, maybe if they're in the state, you know, whatever. This, this metaverse pharmacy only serves like, you know, people physically in seven states. And so I don't know how they could verify that you're physically in that state when you enter the metaverse, but maybe it'll, that's kind of, I think how telehealth does it. Yeah, like you physically have to be, yeah, I don't, I don't know how they would like prove that or whatever. Yeah, exactly. We're establishing identity. Right. Yeah. One thing I just want to mention on telehealth is, so I did used to work at Amwell telehealth company and they would verify patients location based on their GPS on their phone. So that would be activate. And that's one way they were able to do it. So, yeah, I don't know how they would do it in the metaverse though, maybe something similar. Interesting questions. And we'll see, you know, this is still just like one of the first announcements. So I think there'll be some learnings from the in the metaverse. And yeah, it should be interesting. And if you want to actually read the patent that also available here. So, or this is not it, but you can see the link in the article. So maybe we can do a search for the actual patent number and find it. But I'm not going to dive into that right now. But if someone here's interested in doing that, I'd love to, you know, get your take on it. Thanks. All right. So the final article I have listed here in the section is in the software development times. And not super new, but you know, the idea of using electronic or of using blockchain for better electronic health records is another, you know, major application companies have been talking about and organization have been doing. So the one thing I wanted to point out here that I thought was like staggering was here this line. Unfortunately, over 11 billion 500 million medical records have been breached since 2005, according to privacy rights. So now more than ever, with advancing cyber tax and fraud, it's vital to begin implementing a secure system that can protect patient data. So I thought that's a huge number. So definitely, there's an obvious need for this, how companies go about doing it and how organizations adopt it is another matter, but yeah, you know, the article talks about increased efficiency improved data access enhanced security improved data integrity. And they also talk about some of the benefits for blockchain of blockchain for providers to which includes cost savings, reducing medical risks. And then it briefly discusses how you can start implementing blockchain in an EHR. So, you know, pretty high level article but it's good to know that you know this was published April 20 so relatively recently. Any thoughts on this guys and I think. Yeah, any thoughts. I have this is Wendy I haven't read the article is it mostly about theoretical benefit. So, yeah, I think it's more about, you know, how it could be used how could be used. There aren't examples of what is actually happening right now that I saw. You know, they talk about proof of authority. As a consensus algorithm. You know, the 1 thing that has struck me about some previous theoretical articles about blockchain for EHR is is that there is many times the authors who write those don't have awareness of the technology implementations of EHRs. There's a certified electronic health record technology that meets the requirements for the Office of the National Coordinator for Health Information Technology. Those are the authors of these theoretical items don't realize that EHRs already have a near immutable auditorial and capture significantly more information in their auditorial than blockchain would. And that the ONC is pushing so hard for patient transparency, visibility, increased patient sharing. So, it's just a little frustration sometimes that sometimes blockchain authors talk about the potential benefits of blockchain is if we did not already have many of the benefits. That are that people are entitled to per regulation and directives from our national government, or how EHRs are already designed. So, I was just curious as to whether there was any insight to this about what is the unique benefit that blockchain could bring. Certainly. Yeah, I think there are some like specific points they mentioned in the article. Yeah, like for this, the, the integrity that you were showing earlier, EHRs already do that. And there's nothing new. So, like some people, I have even seen some presentations where a technology provider will propose designing a blockchain for EHRs and they know nothing about the HIPAA security world. And does they just focus on potential features without awareness of the regulatory requirements or the ecosystem in which the technology actually exists. I've even heard speakers talk about how doctors apparently according to them run around willy nilly changing health records and of course no licensed physician would ever do that. So, I was just curious as to whether they took an informed position about blockchain integrations with the EHRs or if it was just an ignorant position based on lack of familiarity with the current ecosystem and technology. Yeah, good points, Wendy. I appreciate the challenge there and I'm not sure. I think the author does seem to have just a high level understanding of how EHRs may currently work with you there. I mean, I haven't read the article, so I'm not criticizing this author. I'm just asking and maybe sharing one of my pet peeves. It's hard for us for blockchain and healthcare to advance blockchain when there are others out there that don't communicate as effectively about the current that the technology that already exists and how blockchain is unique. Yes, I'm with you. And I think, you know, a lot of the information from this article, we've probably seen even three or four years ago, basically the same stuff. So I'm with you. The same claims, the same problems. So I do think they're, they may be missing some of like the. Yeah, because we regularly interact with EHRs. I'm actually serving as a project manager for a project right now where we are designing integrations with EHRs. And we're providing benefits that are different than what this article proposes. So I just was curious. Great points. I think, you know, I'm not able to speak to exactly what the author is thinking, but I do think, you know, there's a lot more room for additional information on explaining exactly how EHRs may actually benefit from this. Yeah, it's sort of like, you know, this is the theoretical applications that we think can work, but I don't see any specific examples or companies here indicating that they're using blockchain and doing this. I have a quick question for you, Wendy. So, you know how like in the Kaiser network patients have really good transparency for all their medical records and they can see everything. And then like people that have other types of, you know, that are going outside of that everything's like siloed and they, you know, if you want to get like, let's say you get a scan and then you go to a different hospital. In some cases, they can't even access that or whatever. Everything sort of separated out. I would think that like, I mean, I don't know, I know that there's a capability to get that all together and get patients access to that without blockchain. But people talk about that all the time as being the benefit, even though it sounds like or it seems like we could do that without it because everything's so siloed, we can't unless we're in like a Kaiser network. So, is is blockchain not the answer to that or is it, you know, I, in my opinion, it can facilitate that I don't know that blockchain is the answer by itself. So as we're seeing the office for the national coordinator health information technology pushing the concept of qualified health information networks called Q hands. And those are aggregations of health information exchanges. It's, we're seeing a considerable amount of progress in that regard, the Chinese already aggregate health information like for example, in the state of Colorado before we joined a Q hand in Arizona. Like Korea combined included records from 80% of the residents of Colorado that had electronic health record system. So, there are additional mechanisms. Oh, thank you Ray for showing Tefka. That's a really powerful standard that's enabling some of the exchange of health information and how best to integrate with these Q hands. So we're seeing movement on a federal level to increase the capabilities. I thought it was interesting that about two years ago, maybe three years ago now due to Faulkner herself was from Epic was fighting against the interoperability requirements but they really come on board and I don't know if that's a concern or pushing modernization of interoperability between their keep their EHRs. We're also seeing rapid growth in their app integrations so independent providers can design applications that integrate with those EHR systems app orchard, which is epics on a network of provider apps and patient oriented systems that are just exploding. So I, I, you know this is this it just goes back to the argument that I had earlier about, you know, how does this fit into the current ecosystem, and what organizations are currently working on, and federal mandates that we are not trying to invent something or find a problem for our solution but that we can better impact and facilitate the existing progress within that ecosystem. Thank you so much for the update. That helps a lot. And I, yeah, thank you for, thank you for all that. I'm glad this is happening. Yeah, this is wonderful news. And the timing is good for your question I'm actually teaching a course this quarter about EHRs. And so a lot of this information is very fresh in my mind. Sounds like it. Thank you. Wendy can you share where you're teaching that course for the. University of Denver, and it's foundations of digital health and the course is primarily about EHRs. But I also in real in real life that's so fun. I didn't really really say that unless that was like a Freudian slip. For my job, I'm working closely with EHRs right now too. And so I am really aware of the nature of API's that are being developed for EHRs. And the integration capabilities that are greatly expanding in order to allow better interoperability. So it's just, it's just valuable to keep in mind anytime we talk about awesome blockchain capabilities that we keep, we, we as a community keep in mind the ecosystem in which they exist. Awesome. Thanks Wendy. Thanks Erica as well. Yeah, thanks. Great questions Erica. The final educational nugget I put here actually this is a newsletter monthly newsletter that I wrote for company I'm working for now called by bio and this kind of details. The biotech industry is navigating the recent sort of changes in the in the economic outlook for VCs and the ability to raise money for, for, you know, biotech drug development programs. So I thought it was, you know, interesting to learn about how that you know industry is unfolding now that there's some issues with our banking system that we've seen in the last few months so this article from nature biotechnology was published actually quite recently called precision financing talks about how important it is for biotechs to be very specific and how much money they're using and raising at specific times. And so why I'm sharing this with you is I think that, you know, in the future as blockchain and crypto become more of a mainstream thing. I think it's possible that the way biotechs raise money could be through communities, and that's what we believe that by bio and just wanted to drop this in here in case anyone was interested in learning more about that. There's some interviews as well that I hosted a few guests in the drug development space so feel free to check that out. Yeah, that's all for today. Just wanted to thank you all for joining. Are there any other questions, comments or announcements or anything people want to share before we conclude today. Awesome discussion everyone. Thank you for your participation. Yes, thank you all appreciate it. Catch you in two weeks. Thanks. Bye.