Helix3 is a next-gen healthcare platform that rewards members for consolidating data and achieving
health and wellness goals. We bring meaningful use to the members data through various modules
designed to improve patient value, security and access control. By bringing together secure and
connected data, a goal achievement system, and a marketplace for healthcare products and services,
we are creating the foundation of a new and improved healthcare ecosystem.
Our secure platform, built on blockchain technology, ensures data breaches are a thing of the past
by using advanced encryption, cryptography, and de-identifying techniques. This enables the consolidation
of health data (patient partials, fit devices, medical devices) that will be leveraged for support
AI, deep learning, and other innovations. It also shrinks the scope of an attack to a single
record, significantly lowering the target value.
The goal achievement system is powered by FitFlows, which have a defined goal, activities to
achieve the goal, and different milestones to measure goal progress. The achievement of each milestone
is rewarded with tokens that can be spent in the the Helix3 healthcare marketplace, or at the
healthcare provider much like a loyalty rewards program.
Members can get support building their FitFlows from healthcare providers that can help support the
successful achievement of the goals by defining activities, milestones, and funding rewards. Members
can view FitFlow provider ratings, reviews, and an automatically calculated goal achievement
rating, and eventually be guided to better health through personal recommendations and FitFlows.
In the Helix app, users can use their health and activity data to earn rewards from goal sponsors and
FitFlow providers. Rewards are provided in Helix Tokens (HLX) and can be spent on health related
products and services in our marketplace.
At the center of the platform is the ever growing Helix Twin. The Helix Twin consolidates health information
including EMR data, activity records and 3rd party verified measurement into a single pane
of glass that is used to create optimal FitFlows, personalized for our members. Helix Twin organizes
and automatically updates its record through our integration framework. This enables seamless interoperability
between all parties interested in lowering the risk and cost of poor health.
Our mission is to bring the healthcare industry together in a meaningful way, creating more patient
value across the healthcare ecosystem which provides better care to billions of people around the
world. By improving overall health and bringing automation and improved controls to health management,
Helix3 aims to reduce the trillions of dollars in healthcare waste globally and improve quality
of life.
This white paper will explore some of the problems with the current healthcare system and our proposed
solution.
The healthcare industry is in a state of disarray where data is silo’d, information exchange is paralyzed
by regulations and security, and the desired outcomes are not being achieved.
It’s hard to believe all the inefficiencies and security vulnerabilities in the current healthcare system of
fragmented data. However, when you look at the current situation, the healthcare system is designed
in a centralized way, which creates vulnerabilities and single points of failure.
The US spends 17.1% of GDP on healthcare, that’s over $3 trillion per year and growing. For comparison,
the global mobile advertising market (that’s the market that gives companies like Facebook
or Google pretty much all their valuation) is about $100+ billion per year, the global handset market
is $400+ billion per year.(1) There doesn’t seem to be a lack of funding. So, why haven’t things
changed?
Germany spends 11.3% of GDP on its healthcare system (and everyone is insured throughout his or
her whole life), Switzerland spends 11.7% of GDP, France 11.5%, Japan 10.2%. In fact, you won’t find
another developed country that spends more than 11-12% of GDP on healthcare.
If you plot this against life expectancy, people in the US die earlier than in all those countries I just
listed, and we somehow manage to spend 50-100% more on healthcare per GDP than any other developed
nation, and still leave 10% of our population uninsured. Right now, you see the incredible
inefficiencies of our healthcare system today. (1)
Issues with the way health data is managed and how transactions are orchestrated in the healthcare
industry is a problem that leads to even bigger problems - (Fraud, security vulnerabilities, and inaccessibility).
While patients are looking for increased value, there is pressure to spend more quality time (lower readmittance)
and follow rigorous process to document the details. These goals are polar opposite in
the constructs of the current system of transactions.
The end result is an inordinately high level of administration behind every physician. It’s estimated
that there are 16 full-time employees for each physician in the system many of which are manually
processing claims, entering data, and ensuring regulatory compliance.
The healthcare ecosystem needs to transition to a decentralized and secure system that focuses on
seamless interoperability and better patient care, while reducing administration, security and compliance
burdens.
Vulnerable healthcare systems are major targets for malicious actors. The healthcare networks of the
world are established as silos in centralized data centers. This creates single points of failure across
the industry.
A visit to a new provider typically requires a patient to complete a paper questionnaire that is manually
entered into a computer to be stored electronically, and then filed away at a later time.
If a person sees 20 different doctors, specialist, hospitals in their lifetime, there are now 40 copies of
a patient’s health records and often some financial information (co-pay and insurance), none of which
are under the control of the patient.
The repetition of duplicate records at every different provider creates an enormous attack surface (ie.
points of entry) for hackers. The security of a person’s data is limited to that of the weakest link in the
chain of records, either physical or digital. In one instance, a single stolen hard drive containing over
1 Million records was stolen 2017[47], a reminder of the scale of the problem. Each one of these
records can contain enough information to impersonate the patient for financial gain.
This is why HIPAA in the US provides strict guidelines for in-scope providers and payers to create
layers of security around their information. Some examples are:
• Data at rest (storage) is expected to be encrypted
• Network based access control is expected to prevent unauthorized devices
• Data transfers (data in motion) is expected to be encrypted
• Changes that are applicable to protecting data at rest and motion are expected to be documented.
Fines for non compliance have been as high as $4.8M dollars in the case of New York-Presbyterian
Hospital and Columbia University Medical Center in 2010[48]
. Costs to test for and remediate compliance
violations can cost upwards of $40,000, and need to be repeated yearly to ensure continuous
compliance. In addition to fines, some companies are paying identify theft protection[49]
for all members
who’s records have been breached to help protect their reputation in the marketplace.
By creating financial pressure to keep networks protected, the networks are forced into silos limiting
the ability for providers to exchange information as needed. It is a cycle that can only be rectified
with an underlying architectural change.
A popular solution to this problem, is to move towards centralized or cloud storage. Cloud providers
deploy complex security solutions, have redundant data centers to protect the data and make it
highly available, and have generator backup, fire suppression, redundant power and UPS battery
backup among other resiliency capabilities. This allows state of the art technology to be applied to
larger sets of data, mitigating most of the physical security risks.
The problem with centralized storage was brought to light with the recent Equifax data breach[49]
.
The centralized storage contained names, Social Security numbers, birth dates, addresses, and in
some instances, driver’s license numbers for 145.5 Million people affected by the breach. In 209,000
cases, credit card numbers were also exposed.
Applying this to healthcare, Epic Systems Corporation says its softwares holds the medical records of
54% of patients in the United States (190 Million worldwide). As more and more of these records
move to centralized cloud storage, the attack target becomes more attractive to cyber attackers. Access
to a single administrator account grants access to a very profitable data repository.
Meaningful Use Stage 3, which is a CMS requirement for Medicare and Medicaid reimbursement,
will also contribute to duplication of records by requiring providers to allow their patients to access
their EHR data through the patient’s app of choice. While this is meant to facilitate sharing and innovation,
the result will be more duplicate copies of patient health information stored by each new application
a patient uses, increasing the attack surface.
According to Donald M. Berwick and Andrew D. Hackbarth[92], the following categories of waste exceeds
20% of total health care expenditures.
• Over-treatment
• Failures of care coordination
• Failures in execution of
care processes
• Administrative complexity
• Pricing failures
• Fraud and abuse
Helix believes the root of this
problem is in the process of how
patients, providers, and payers
exchange and validate information.
In today’s system, the patient
is not the owner of their information.
Providers and payers
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transact with each other, using the patient’s information, without real-time approval. To combat potential
consumer risks, regulations and checks and balances are implemented which are slowing the
pace of innovation.
To illustrate the scale of the problem just in administrative complexity in the system, in 2013, the ratio
of doctors to non-doctor staff was 1:16[50]. Of the 16, only 6 were nurses or general practitioners.
The remaining 10 were administrators spending time on manual activities like submitting and resolving
claims, gaining prior approvals, transcribing data, and faxing records. Administrative costs in the
U.S. healthcare system consume well over $300 billion annually[51]
, or nearly 15 percent of all healthcare
expenditures by some estimates.
Fraud estimates range from $68-320B of healthcare spending, most of it undetected. Just this year,
the US government accused 400 health care providers of healthcare fraud in the order of $1.3
Billion[51].
The first line of detection is placed on patients requiring them to review their bills for correctness,
when they could be dealing with serious health issues. Even a patient in good health would never
understand which ICD-10 codes are acceptable for the services delivered, or how many units of
which medications they received.
Closing Thoughts
Decisions are only as good as the information you have to make them on. The current healthcare
system is not equipped to securely store patient data and allow transactions using the information to
be controlled properly leading to poor overall outcomes.
The focus needs to be shifted towards achieving better patient outcomes, increasing participation in
preventative measures, and leveraging secure data storage and controls to reduce waste.
