HXR 2017: Denise Gosnell, Pokitdok: Blockchain: The Now and The Future:

Denise K. Gosnell, Ph.D. @DeniseKGosnell

Computing the Contract: Why Smart Contracts are the Asset

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“Controls allow a quarrelsome species ill-suited to organizations larger than tribes to work together on vast projects like manufacturing jumbo jets and running hospitals.”! - Nick Szabo on Smart Contracts, 1997

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History of Blockchain

1985: ECC first suggested

1989: Paxos Consensus

1991: Initial descriptions of cryptographically secured chains of blocks

2008: Satoshi Nakamoto Paper

2014: The first “programmable” blockchain and monetization models beyond bitcoin

2016: DokChain Alliance

1994: Nick Szabo coins “smart contracts”

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Traditional Blockchains

Records Ungoverned Immutable

Consensus Centralized Decentralized

Visibility Closed door Transparent and Auditable

Security Highly Evolved Cryptographically Verifiable

Traditional Systems vs. Blockchains

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Smart Contract a digitally signed, computable agreement (software code) between two or more parties, that relies on a consensus system

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Law Software

Reasoning Contractual + Subjective Boolean Logic

Governance Imprisonment Replication + Cryptography

Predictability Flexible Rigid

Maturity Highly Evolved Few Experiences

Traditional vs. Smart Contracts

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Why smart contracts? Consensus reduces vulnerabilities centralized systems and 3rd party oracles

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The PokitDok Platform

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Health Tech Business Goal

The entirety of medical and pharma business services are encompassed:

PrPayment = Pr( $ | ICD,CPT,NPI )

($) Asset Under Consideration

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The Rules

80% of operational rule and rule sets are locked within Store Procedures in SQL databases

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Multiple Chains with consensus systems

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Smart Contracts: Eligibility Request

1979: X12

HL*1**20*1~NM1*PR*2*Premium Gold Insurance Co.*****PI*0123456~HL*2*1*21*1~NM1*1P*1*Back*Has*Your***XX*9876543210~HL*3*2*22*0~TRN*2*89368DC6A14E4E529AA876ED416E8A9F*1453915417NM1*IL*1*A-lot*Lifts****MI*MEM10001~N3*2150 Pleasant Drive~N4*Sunny*CA*900010001~DMG*D8*19820315*M~DTP*291*D8*20141001~EB*B**98****10~EB*A**33*****.20~

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APIs: JSON

{ "member": { "birth_date": "1982-03-15", "first_name": "Lifts", "last_name": "A-Lot", "id": "MEM10001"}, "provider": { "first_name": "Has-Your", "last_name": "Back", "npi": "9876543210"}, "service_types": [ "professional_physician_visit_office", "chiropractic"], "trading_partner_id": "premium_gold_insurance"}

Smart Contracts: Eligibility Request

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function response(address providerWalletAddress, ! address consumerWalletAddress, !

bytes32 activityId) onlyOwner { !

EligibilityResponseEvent(providerWalletAddress, consumerWalletAddress); ! ConsumerWallet consumerWallet = ConsumerWallet(consumerWalletAddress); ! ProviderWallet providerWallet = ProviderWallet(providerWalletAddress); ! consumerWallet.eligibilityUpdate(activityId); !

providerWallet.eligibilityUpdate(consumerWallet); ! } !

} !

Smart Contracts: Solidity Code

Smart Contracts: Eligibility Request

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Next: Patient-Centered Transactions Smart contracts are a centerpiece

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The Complete Multi-Party Identity

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Reasoning

Governance

Predictability

Maturity

Smart Contract Considerations

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Reasoning Expressing business logic as computer programs that self-amend

Governance Representing the events which trigger that logic as messages to the respective programs

Predictability We must separate policy from mechanism design

Maturity

Smart Contract Considerations

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Reasoning

Governance Using digital signatures to prove who sent/received

the messages

Predictability Connecting and placing the programs, messages and signatures on a blockchain

Maturity Permission system can be used to restrict the right to create assets

Smart Contract Considerations

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Reasoning

Governance

Predictability The asset(s) function via rule sets based on context

Maturity Rule sets can be greatly simplified if based on behaviors and expected outcomes

Smart Contract Considerations

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Reasoning

Governance

Predictability

Maturity Though early in development, smart contracts will be the most valuable asset of the future systems

Smart Contract Considerations

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Digital Health Record Assembled from Consensus of ID

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Near Term and Future Considerations

•  EMRs will be a node on the chain(s)

•  Dynamic Underwriting offerings will be created

•  Clearinghouses will be disintermediated

•  Complete systems will be on chip and fabless

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Blockchain + Healthcare is here

Denise K. Gosnell, Ph.D. @DeniseKGosnell

Computing the Contract: Why Smart Contracts are the Asset