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Quæfacta Data Natives, Paris, May 15th, 2019


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Quæfacta’s presentation at Data Natives, Big Data Paris v8.0, on Blockchain in Healthcare

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Quæfacta Data Natives, Paris, May 15th, 2019

  1. 1. Blockchain in Healthcare May 15th, 2019 Quæfacta Lea Dias, CEO & Co-founder David Andrianavalontsalama, CPO & Co-founder
  2. 2. !3 France Australia Average Length Of Stay (Acute Care) 5.7 days 4.2 days Hospital admissions/year 12.7 M (2017) 11 M (2016/2017) Hospital discharge rate/100 000 inhabitants 18,783 17,760 Doctors consultations per capita 6.1 7.7 Total nurses/1000 inhabitants 10.5 11.6 Number of CT scans in hospital/1000 inhabitants 124 13 Number of CT scans ambulatory/1000 inhabitants 81 114 Number of MRI exams in hospitals/1000 inhabitants 48.7 1.9 Number of MRI exams ambulatory/1000 inhabitants 65 43 Medical devices: Data production x times a day xxx xxx Average number of medications prescribed on discharge xxx xxx Average number of procedures in hospital xxx xxx
  3. 3. !4 Patient
  4. 4. !5 Case study Patient : • Mr J Doe • 57yo male, morbidly obese, smoker • PMHx: hypertension, hypercholesterolaemia, NIDDM • Presents: Stroke like symptoms, dizziness, confusion, weakness in limbs, speech difficulty, facial drooping
  5. 5. !6 1. Examinations 2. Diagnosis 3. Emergency treatment with medications 4. Procedure 5. Treatment team may include: 6. Medications post stroke Ischaemic stroke J Doe Intravenous injection of tissue plasminogen activator (tPA) Angioplasty and carotid artery stent • Doctor trained in brain conditions (neurologist) • Rehabilitation doctor (physiatrist) • Nurse • Dietitian • Physical therapist • Occupational therapist • Recreational therapist • Speech pathologist • Social worker • Case manager • Psychologist or psychiatrist High blood pressure medication Blood thinners Anti - coagulants Diuretics Cholesterol medication Anti-fibrillation drug Diabetic medication Antidepressants Physical examination Blood tests CT scan MRI scan Carotid ultrasound Cerebral angiogram Echocardiogram
  6. 6. Fragmentation and gaps in the transfer of information between hospital care and community care Patient Hospital Providers Hospital HealthcareCommunity Healthcare Outpatient clinicsGP Clinic / Community Health Home Health Pharmacy Wearable devices Laboratory Rehabilitation Screening & diagnosis Ambulatory care !7
  7. 7. 1. Observable gaps in the transfer of information 2. Lack of interoperability — Many devices and practitioners interact and do not share the full data 3. Procedures that should be implemented are not, or not followed, or incomplete !8
  8. 8. Medicines information, inpatient records, admission and discharge information are often missing or poorly communicated by health professionals within hospitals and to community health providers. This may lead to: ‣ hospital readmissions; ‣ adverse drugs events; ‣ compromised patient care; ‣ serious or fatal outcomes. !9 Consequences of siloed and missing information
  9. 9. !10 Patient Role of blockchain Securely sharing information Interoperability Traceability Accountability Fraud detection Incentives Data privacy Analytics & AI
  10. 10. Multi-vendor + smart contracts Vendor A Vendor B Vendor C Auditing system hash data data data hash hash The data and results are accurate certification! command + hash data Anchoring system using blockchain + smart contracts !11 Interoperability
  11. 11. Patient Hospital Providers Hospital HealthcareCommunity Healthcare Outpatient clinicsGP Clinic / Community Health Home Health Pharmacy Wearable devices Laboratory Rehabilitation Screening & diagnosis Ambulatory care !12 Securely sharing information
  12. 12. !13 Pharma Pharma Pharma / Med device Product Development Innovation Active Pharmaceutical Ingredient Manufacturing Secondary Manufacturing ERP ERP ERP Logistics Logistics Distribution Supplier ERP ERP Logistics Pharmacist Customer Wholesaler Reseller (Pharmacist dispenses Rx
 2D scan - WF1) Patient ERP ERP PIS Smart device Direct to patient Retail Pharmacy (Pharmacist dispenses Rx
 2D scan - WF1) Hospital Pharmacy (Pharmacist dispenses Rx
 2D scan - WF1) Supply chain logistics workflowTraceability
  13. 13. !14 TR TR TR TR TR TR TR TR TR TR TR TR Acquiring traces
  14. 14. !15 Traceability content: Who? What? Where? When? Why? Traceability actor: Any known user + key Acquisition tools Anchoring: Any known blockchain Metrics: How many traces per device? How often? How long? What a trace holds
  15. 15. !16 How we acquire a trace Tool suite: • API • Mobile & desktop apps • Dashboards
  16. 16. !17 TR TR TR TR-1 TR-2 TR-3
  17. 17. !18 TR TR TR TR-1 TR-2 TR-3 TR TR-4smart contract
  18. 18. !19 TR TR-XXX = 2000 lines
  19. 19. !20 TR TR-XXX = 2000 lines smart contract TR TR-XXX-1 TR TR-XXX-2 TR TR-XXX-2000 TR TR-XXX-3 …
  20. 20. !21 Chain reconstitution Whole chain Partial view #1 analysis
  21. 21. !22 Chain anchoring Whole chain Partial view #1 etc. + supervisor validation + supervisor validation smart contract smart contract TR TR-x TR TR-y
  22. 22. !23 Trace composition Supply chain model Diversity of actors Incremental level of trust What a chain holds
  23. 23. Data
 Lake !24 TR TR TR BLOCKCHAINS Analysis TR-SPEC TR-SPEC Trace reports Traceability chains Traces validated data Data retrieval Analytics dashboard BUSINESS RULES event anchoring
  24. 24. + 1 level
 of trust Data
 Lake !25 TR BLOCKCHAINS Analysis + supervisor validation BUSINESS RULES TR TR-SPEC TR-SPEC
  25. 25. !26 Analytics & AI Weighting the trust Feedback loops Pattern matching from theoretical chains Statistical inference from actual chains
  26. 26. !27 Fraud detection Pharma companies • Detection of counterfeit medications. Governments/healthcare • Detection of opioid/medication misuse, abuse and theft; • Detection of inappropriate use of medications (including high cost medication). Insurance companies • false claims/information by patients and providers to receive payable benefits.
  27. 27. !28 Incentives • Insurance companies may incentivise patient’s (data) for good behaviour via a reward mechanism.
 e.g. tokens for following a care plan or staying healthy. • Pharma companies/medical institutions may incentivise patients who provide data for research and clinical trials.
  28. 28. !29 4,567 steps 2 coins cash in
  29. 29. Quæfacta !30 We do: • Blockchain traceability solutions in healthcare • AI, data acquisition and analytics Thank you! May 15th, 2019