Blockchain Spotlight on WELL

The health care as an industry and medical records in particular, is an environment that is ripe for disruption via blockchain technologies. I’ve seen a lot of initiatives started, but I think this WELL project is the furthest along and it is far beyond just storing medical records, it is enabling an entire Telemedicine platform and payment system.

WELL has had a working platform for almost three years now and is the largest therapist network in California and has conducted 22,916 consults, comprised of Post Acute, Wellness Visits, Clinics and Pilots. WELL is a HIPAA compliant virtual care platform that combines telemedicine, biometric devices and telemonitoring. Their integrated secure messaging system, integrates a clinical network comprised of over 1,600 providers in 49 of the US states and a variety countries around the world. WELL also has their trademark approved in the US and a Medicare license. All of this is to say that they are a real and established company that already has their ducks in a row for working in this space.

The purpose of the crowdsale is to fund the development of their own blockchain to enable more advanced features and easier global deployment. WELL provides the ability to get access to quality diagnosis from around the world, regardless of where a patient is located, also making second and third opinions easier as travel is not required and all the doctors notes and patient history is on the blockchain. Direct and immediate payment for services rendered at the time of service; in the case of insurance billing, WELL says they will facilitate escrow accounts to managed fund transfers via smart contract conditions being met. This can ensure the right paperwork is processed and customers can’t arbitrarily put ‘stop payments’ on a transaction after the fact.

The WELL platform already interfaces with common medical devices that have been adapted for the digital transmission of information for telehealth. Current devices include items such as Stethoscopes, Thermometer, Blood glucose meters, Blood coagulation meters, Pulse oximeters, weight scales, and blood pressure monitors, with more added as they become available. As to providers, WELL currently works with many providers including: Medicare, myMatrixx, Optum, Century Pacific Medical Inc, Medi-Cal, Veteran Affairs, Tricare, Medicare Advantage, several HMO/PPO plans, and self-pay/private pay, as well as dozens of hospitals, elder care/assisted living facilities, hospices, and over 200 home healthcare agencies. They say they are in process of adding even more providers. When I asked, they said the providers are all very receptive to using the WELL token.

Patient records stored in the blockchain, are encrypted and immediately available, which makes seeing different doctors much faster and simpler as there is no lengthy process to transfer records. The doctors/clinics are now freed from keeping their own copies on site as well. The distributed nature of the records makes for better resilience of storage and security. The system also records reputation, rather like Uber/Lyft, with ratings, but those ratings are based on factual instead of subjective data, such as time-stamped compliance and performance to name just two, but many metrics will be stored and utilized. Something WELL says they can help with, which would be fantastic, is fighting fraud. In 2016 in the US there was nearly $1 billion in false billing. Anything that can help mitigate that corruption is going to be a welcome relief.

I really appreciate that they have a Live demo (use the email addresses patient@demo.com or provider@demo.com along with the password: password) to try out the system. I went through the intake system to try it out, and it is pretty thorough and easy to use, it even was able to tell I had no camera on my computer for the video chat (it worked on my laptop that had a camera). Their messaging platform is using 256 bit encryption and the video portion was developed by their partner Digital Noema.

How does the process work? It’s pretty simple, you login to the site, fill in free form symptoms, use checklists to identify various issues, fill in any relevant information that you might have like your current blood pressure, temperature, etc., and any medications you are on (this should be saved on your profile once you’ve done it the first time) and eventually you get to video chat with a doctor.

You can skip any section that isn’t relevant, but it only took me a few minutes to walk through it. At this stage you are talking with a human being on video chat just like you would when you go in an office. They can loop in another person to do a group consult, the idea is that you can eventually get to a rough diagnosis and advice. Prescriptions can be issued in a digital format and used with a WELL partner pharmacy. WELL does claim however that because of the reduced costs in the business model, that they can generate an average priced reduction of 30% for patients.

I asked the team at WELL what the full utility of the token was, and it was described to me this way:

-The WELL token provides for multiple features within the WELL platform:

  1. Form of payment. WELL tokens will serve as the main means of payment within the system, although they will accept and use other types of fiat or cryptocurrencies.
  2. Currency exchange. It will also support price determination for WELL services. The system will take a fee in WELL tokens, and some premium features will be available only in WELL tokens.
  3. Gamification of healthcare. The WELL platform will award WELL tokens for behaviors that lead to desirable outcomes. Patients will earn WELL tokens for achieving markers, such as improved blood pressure, cholesterol, and other health measurements, or ratings and timeliness. Clinicians will earn WELL tokens for patient achievements, lower hospital readmission rates, ratings, timeliness, and more. Corporate partners will receive bigger discounts for higher satisfaction ratings from their patients and clinicians or better adherence to smart-contract governance. Programmers will earn WELL tokens for their contributions to WELL source code based on measurable metrics, such as Github references, library usage in the WELL code base, and hackathon wins.
  4. Social and gaming functions. The WELL token also acts as an “in-game” token, and participants in the WELL ecosystem earn tokens for certain actions. Also, network members can use the token to unlock network resources such as wellness resources for patients, clinical education resources for clinicians, and data and analytics resources for enterprise clients and partners. They want to create strong community connections between the different parties in healthcare.
  5. Encouragement and rewards. WELL patients, doctors, and other users earn WELL tokens for being on time to appointments, thus reducing costs associated with schedule disruption.
  6. Partnership access. WELL ownership will give access to advanced platform features, and special partnership programs will help in integrating big companies and institutional players into the WELL network.
  7. Data share. Every time WELL receives a payment for de-identified and anonymous patient and clinician data, the corresponding patient and clinician will earn WELL tokens. WELL respects the personal details of all clients and will never disclose any information to third parties without consent from the client.
  8. Payable access to de-identified health histories. Insurance companies and other enterprises will pay tokens to access de-identified WELL health data.

I spent a number of years designing and writing medical billing software, so I really appreciate what WELL is doing here, the systems currently in place are a nightmare of complexity and problems. My concern goes back to my opening paragraph, basically there are a lot of companies going after this space and if even a moderate number of them succeed, then it leaves open the possibility of competing systems that don’t talk to each other, but that will shake itself out as we watch these technologies become available.

The WELL token sale begins on April 16, 2018, at 5:00 p.m. PST and will continue until it reaches the hard cap of $28M Ether or Bitcoin or until May 15, 2018, at 5:00 p.m. PST. There will be 600 million WELL tokens available during the crowdsale, priced at $.10 each.

Technology and blockchain developer and enthusiast as well as prolific musician.