Marguerite Arnold introduces MedPayRx, a digital healthcare solution utilising blockchain technology to address a core challenge in health systems today.
I conceptualised MedPayRx with a very focused mission: to solve a problem. The problem at the table? The healthcare system, wherever you are reading this, is old, cranky and still mostly paper-based. Where it is not, it is bound by IT infrastructure and processes that just perpetuate the huge waste (of time, money and resources) currently built into just about every transaction. The crisis itself is also not a single problem facing just patients or doctors – or, in fact, any one industry that currently touches or serves the ‘healthcare’ space.
However, if you understand that European doctors are paid a pittance for engaging in approvals for certain kinds of prescription drugs and medical equipment that has not been raised – at least in Germany – since 1982, you begin to understand the scope of the problem from the medical infrastructure point of view. And that is just one of them.
Yet, even as those who are now calling for telemedicine ‘by Skype’ understand well, the new face of digital healthcare – while coming and absolutely convenient for budgetary if not healthcare system saving reasons – is fraught with issues that are also complicated in their own right. IT and tech ‘solutions’ therefore must be implemented in a way that is applicable to healthcare itself, with all its strange variables and considerable quirks. ‘Accessibility’ is, in other words, a matter of concern for those who must navigate a world not made for them beyond unfamiliar interfaces.
That is true of all ecosystem participants, but if patients cannot use healthcare services, there are no customers. If the technology, whatever that is, does not solve the problem at hand, to paraphrase my late uncle, Peter Drucker, don’t use it. And he was the guy, after all, who coined the term the ‘information worker’ – if not a few other phrases beyond that.
From a policy if not business perspective, these were the challenges I sought to address when I came up with the drivers behind my blockchain start-up, MedPayRx, four years ago as my EMBA thesis, and they are certainly still in the room as we manoeuvre to bring MedPayRx to market this year.
After all, to paraphrase Drucker again, the best way to predict the future is to change the present yourself.
What MedPayRx is engineered to do
MedPayRx is not designed to ‘fix’ healthcare, anywhere, systemically, as much as it is designed to help address a single big problem at a strategic ‘tipping point’.
To do that, we start from the perspective of the chronically ill patient. They are also generally the poorest.
These people are, by logic, also the largest ‘consumers’ of healthcare. No matter who pays for it. That is why this is also tricky. They are not, in other words, directly thought of as ‘customers’ by just about anyone, including us (although they are most certainly one group of our users and the driver of everything else we do). No patients, no prescriptions – very easy to understand.
However, for that very reason it also means that this group is systematically put into situations where the kind of healthcare they need – and the system must shift to deliver better – is very, very difficult to access at present – far less to ‘reform’ – and for a range of interconnected reasons.
A business case born of crisis
MedPayRx is a digital prescription, claims and payment processing platform rolled into one. We connect an ecosystem of very different users and customers – which in our case include patients, doctors, pharmacies, insurance companies, distributors, producers and the government.
We also use a technology called blockchain to help facilitate the same. We do not use ‘tokens’ with any kind of economic worth other than authorising the medicines or medical equipment they are issued to track and dispense. Further, we use blockchain elements in new ways – some of which we have borrowed from FinTech (financial technology) – and combine this with regulatory and cybersecurity engineering that comes from banking but is designed for the additional rigors of healthcare. Data privacy and access – by whom and for what purpose, and for what period of time – is the magic behind the mix.
We are also looking at service entry strategies quickly. Thus, one of our adoption use cases that has gotten a lot of attention so far is our intention to work with medical cannabis prescriptions and approvals. That is of course not our only focus (we are designed to work with all prescription drugs and medical equipment). In Germany, what we are focused on is commonly called Betäübungsmittel (narcotic drugs) and Zubehör (medical devices) (resources). Ultimately, of course, we have no control over who uses our platform for what medicines or medical equipment. That will be determined by the users.
However, the trials and tribulations faced by all those who work to get or provide care in this space are illustrative of larger problems throughout the entire ecosystem of healthcare, far beyond cannabinoids. See diabetics as another great example.
This is not your healthcare on cybercurrency, in other words.
What exactly does MedPayRx do?
We are designed to digitalise and automate three related functions involved in the issuance of prescriptions.
The first is automating insurance approval for drugs and medical devices that are dispensed by prescription, must be approved by either insurance or regional healthcare decision makers, and are generally both expensive and highly controlled.
This constitutes, by euro value, the vast majority of the prescription drug and medical device market annually (approximately €100bn of an annual €120bn annual spend in Germany, for example). We also streamline payment (by the multiple parties necessary). Finally, we eliminate claims at the back-end. Our system settles all automatically when the patient receives their prescription.
In doing so, we also shift the risks of this process for all participants and guarantee that people are paid, processed and authorised to do what they should be doing along the way.
We also drop costs, dramatically, for everyone, while creating more transparency throughout the process for all involved. That includes a highly efficient seed-to-sale tracking system that allows ‘demand’ to be accurately judged from the patient end first (not industry or government estimate), plus a first-of-its-kind anonymous drug interaction database of users – in addition to a few other cool things like, for the first time, the ability to track anonymously and in real time every prescription drug (including cannabinoids) from time of prescription through dispensation.
Validation of the concept
The concept was born as my formal EMBA at the Frankfurt School of Finance and Management. Last summer we were accepted into the prestigious Werk1 incubator in Munich, sponsored by the government and insurance companies. Last autumn we were included in the Deutsch Telekom ‘Boost’ programme for high-tech start-ups. As this article is going to print, we are also applying to InsurLab Germany, another top insurance-backed accelerator in Cologne.
As of early 2019, we are also going to pilot. What does this mean specifically? By the end of Q1, we hope to have our first end-to-end proof of concept (POC) tying all the ecosystem partners together. We also just held our first ‘pilot workshop’ in Cologne where we brought all members of the ecosystem we touch together in a unique workshop designed to validate and test critical elements of the platform.
The feedback we received from ecosystem participants was significant and validating at every single point.
As we move to release hopefully later this year, the bridges we are connecting, the stakeholders we are starting to find, and the agreement between vastly disparate users of the ecosystem we are now launching are the best validation that we need to ensure that we not only stay true to my original vision but are pivoting, where necessary, to ensure market launch upon a successful and profitable path.
We are in the room, in other words, and on a path to continue this discussion as we push forward to market. There is not another, easier, way in, for anyone (even the bigger tech companies and players). And so far, we have not seen a single approach that does not duplicate the problems we solve, one way or another.
That alone is the inspiration we need to continue to push forward.
Please note, this article will appear in issue 9 of Health Europa Quarterly, which is available to read now.