Podcast Episode 27 | Blockchain Technology and Physician Credentialing

Leah Houston: [00:00:00] A hospital actually stole my identity.

Intro: [00:00:04] From Spaugh Dameron Tenny, it's the Prosperous Doc Podcast, real stories, real inspiration, real growth, a show for doctors who are ready to improve their overall wellness in every aspect of life. Now here's your host, Shane Tenny.

Shane Tenny: [00:00:22] Welcome back to another episode of the Prosperous Doc podcast, I am Shane Tenny and glad to have you with us today. Whether you're working out or driving or, uh, just sitting around looking for some good information and a supportive community, which of course is what we try to breed here. You know, if you've been listening last couple of weeks, we've been talking about some of the topics that are the most common founding for practitioners, for our constituents for you. Last week, if you didn't hear the episode, we were talking about one of the most confusing aspects of the medical or the dental profession, and that is the proverbial employment contract. There are a few things that create quite as much, just confusion when you're coming out of training and starting a job or trying to switch to a new hospital or trying to join a new group or become a partner.

And we had a really great candid conversation with dr. Jason Goble talking about a couple of successes and failures through his career in dealing with contracts and contract attorneys and things like that. If you haven't listened to it, I definitely encourage you to go back and listen to that episode. Today, though, we wanted to tackle one of the most complicated aspect of life as a doc.

And one of the most frustrating things that we hear about from folks across the country, and that is the credentialing process. You know the, that annoying process that takes a month or two, and impairs your ability to practice or see patients or bill makes it a challenge when you're trying to get started, or when you want to move to a new state or even just move across town to a different hospital.

For those of you who are interested in working in locums, often it's like a cold dose of reality to realize that every different hospital that you want to help out requires their own process and the person whose life impacts the most, yours is completely out of control, even though you've put in the time and you've got the diploma and that sort of thing.

It's in the hands of third parties. And so, like a lot of things in life, credentialing is one of those things that is subject to and ripe for disruption. And there have been a lot smart people thinking about ways to make this go better. And we were lucky enough to find Dr. Leah Houston who's with us today.

And, the story that she's been on, the journey she's been on and the innovation that she's bringing to this topic of credentialing and just a variety of things to bring autonomy to physicians. Dr. Houston is trained in emergency medicine and worked clinically for over a decade before couple of years ago when she either had a brilliant genius restrike or, or maybe just a lot of frustration and decided to do something different.

So, Leah, thanks so much for joining us today.

Leah Houston: [00:03:08] Thank you so much for that lovely introduction and an introduction to this problem. Credentialing is outrageous, you know, you said one or two months, it's really two to six months for practicing physicians.

Shane Tenny: [00:03:20] Yeah, the key is that nobody knows how long it's going to take and you just have to wait until you get through thumbs up. Don't ya?

Leah Houston: [00:03:25] Absolutely.

Shane Tenny: [00:03:27] Yeah. We're going to spend the time talking about kind of the, the innovation, the ideas that you've been putting together and are kind of trying to build momentum around. Can we back up first, they'll give us a little bit of your background, how you started, maybe we'll kind of what lead us up to the point where you started to realize you want to do something about this?

Leah Houston: [00:03:45] Well, I'm a Locum Tenens Doc, meaning I, you know, had to credential for multiple places because I was doing, you know, quick stints here and there and higher areas of need. So I had to go through this process many, many, many times, and in some health systems, yeah it took a long time, but they had somebody handholding me and making it easy for me. Other health systems, I felt like I was spending hours filling out redundant forms, but it wasn't just experiencing that process that made me decide that it needs to be fixed.

A hospital actually stole my identity.

Shane Tenny: [00:04:16] One of the hospitals that you were working at or a hospital that you had no affiliation with?

Leah Houston: [00:04:20] One that I was working at that I had left and no longer was affiliated with. At least so I thought.

Shane Tenny: [00:04:26] Alright, well that sounds like a story worth going down. So how did they steal your identity and how did you find out?

Leah Houston: [00:04:32] Well, you know, in these contracts that we signed, that you guys talked about last week, you have to fill out all of these, you know, agreements and you often agree to do X, do Y, do Z, supervise sometimes mid level providers. And that's something that I had signed at this place. And basically I gave them permission to use my professional identity in order to bill for services that I was either rendering or supervising.

Now, what I thought was that supervising means the person's there with me. I get to see the patients I get to actually supervise the care. But what was happening was this hospital was claiming that I was supervising patients that I never saw. A mid level provider was seeing the cases I never knew about.

And then when I left the hospital, they continued that process.

Shane Tenny: [00:05:23] How'd you find this out? This sounds like the sort of thing that it would be easy to never know about.

Leah Houston: [00:05:27] Well, I left the hospital, I left the state and I stopped, you know, renewing my license in that state. And so the federal government said "you're practicing medicine without a license", and I said, no what are you talking about? They're like, yes, you are. Here's the proof. And they sent me a bunch of patients that I had supposedly built for on dates that I wasn't even there anymore.

Shane Tenny: [00:05:51] And what'd you do?

Leah Houston: [00:05:52] Well, I ended up having to, you know, essentially take them to court, you know, and reach a settlement agreement and things like that, but it was very disruptive to my career.

It was very, and then I found about it, this fraud, this waste, and this abuse that's happening under our noses at, you know. How many people is this happening to every day who haven't left the state? How many people is this happening to who are just working in a hospital, not even knowing that their professional brand and their, their credentials are being used on patients that they don't even know about, or maybe they they're aware that they're supposed to be in a supervisory role, but they're not actually supervising, which is also dangerous.

And so, this is part of why when I found this solution, and this is a solution I found it's not something that I'm just making up out of thin air, self sovereign identity is a solution to this problem.

Shane Tenny: [00:06:42] Yeah. So I think you just put together three words there that confused most everyone who heard him, what his self sovereign identity, and how'd you come across that as part of a solution to this issue?

Leah Houston: [00:06:55] So we all have our identity and the definition of identity is as nuanced, but some of it has to do with where you were born, what your birth certificate says, the date of your birth, your identity is your age. Whether you identify as male or female.

As a physician, part of your identity are your credentials. Whether you got that MD or the DO at the end of your name. Whether or not you, you had completed a residency or a board certification, whether or not you have a license to practice medicine. That's also part of our identity.

In the digital world, now that everything's on the internet, you know, 1991, the internet was essentially available to the masses. It wasn't until 2001 that, you know, 50% of U.S. households had access to the internet. So this is a very new thing still that we're talking about. But when you think about it, little pieces of our identity are now digitized and are out there.

You know, we have our email or Gmail address, for example. That is part of our electronic identity. We have our social media identities. Now, when you log into these systems digitally, these third parties, the systems, whether they be an email platform or a social media platform, or even your bank that you're logging into, they own and control your rights to your own information and your rights to your identifying information.

Whether it be, financial information, whether it be, rights to communicating with others. Right now, in this current world that we live in third party ownership and control over that communication is the only way that's accessible to us, until we consider the fact that decentralizing technologies are now available and being deployed.

And when I say decentralizing, I mean not owned or controlled by a single entity. And self sovereign identity is one of those applications of a decentralizing technology. And it is exactly what it says it is: self, it's yours, sovereign, owned and controlled by you, identity. It identifies who you are digitally.

Unlike the current way that we communicate digital information over the internet, where we have to go through a third party. Self sovereign identity allows us to connect directly without the need for a third party.

Shane Tenny: [00:09:13] And is this being, as you said, you didn't invent this, your background is in medicine, not programming or coding or things like that, but you discovered it.

Where else has this been used or where else is self sovereign identity or similar concepts kind of being brought to some sort of application.

Leah Houston: [00:09:31] Well, it's still very new. There are many applications currently being designed, built and deployed. You know, last week I was interviewed by Trinsic, which is a web development essentially tool center.

So if there's any coders out there who want to learn how to build these tools, Trinsic is one space for you to do that, where essentially you can build self sovereign identity tools for any type of credential. There, you know, during coronavirus there's been a coronavirus credential application built, called Med Creds. It's an app that you can download today. It's still early in that process, but when you download it, you can go to your doctor, they can put that credential into your wallet, and then you can prove it that you had your recent negative test. And eventually when we have a vaccine, you can prove that you were vaccinated and things of that nature, which might start to be, you know, required.

And rather than this totalitarian, fear-based thing that a lot of us think, "Oh, the government's going to spy on us and it's going to restrict our movement", well, because this is self sovereign, only you will be in control over who gets to see that information. And that's the difference. And that's the power of this technology.

Shane Tenny: [00:10:42] And so talk a little bit, then help connect the dots on actually... let me back up. So you've started a company, that is working to build a community people to participate in this. Go through that, that step of the equation a little bit there.

Leah Houston: [00:10:56] So right now, as a physician, what I want to document something about my patient I have to go through these third party EHR. And what do they do with that information? Unless it's my company or my private practice that I own and control, and unless I have read the fine print on my EHR contract, they essentially have the rights to share that with whoever they want, as long as they do identify it, which doesn't really mean very much.

This tool provides an opportunity for me to no longer distribute that information to the centralized system, that allows me to connect directly and securely and privately with my patients, so that I can share that information directly with them without any third parties, self, you know, eyes, you know, glaring at their private health information or to share it with other physicians.

So when you're talking about referring a patient, you know, right now, if you're in a hospital and the specialist is in some private practice office, it's a huge cumbersome pain in the butt for one doctor to just get the information from the other doctor, they have to do faxes and the full fax isn't there and they fax 80 pages and there's only five that are actually necessary.

That friction can be eliminated with a system like this, because I know what I need to send the specialist. I know what he wants. You know, he knows what to ask me for, but when there's all these other entities dictating what can and can happen in the middle of wedging themselves, between doctors and doctors, and doctors and patients, then that's what causes the friction and the confusion.

Shane Tenny: [00:12:32] And so does, so your organization is, is HPEC. Right. Which stands for what?

Leah Houston: [00:12:40] Humanitarian Physicians Empowerment Community.

Shane Tenny: [00:12:44] Okay. And you have the ability for people to sign up with you and participate in this type of SSI technology?

Leah Houston: [00:12:54] Well, we are in the process of building our MVP, so we are not ready yet for people to sign up, but we do have an investment opportunity, so, yeah.

Shane Tenny: [00:13:03] Yeah. And so, so for people that are listening that are interested in this, I mean, now is the time to reach out and connect with you. Does the technology require that both parties, in the example you gave, you know, the practitioner or the specialist, do both parties have to be participating or members of HPEC, or does it work if only one, one of the parties is on that system?

Leah Houston: [00:13:29] Well, if you think about it, I mean, look at any of the recent technologies. Uber, Airbnb... you require more than one person, right? Nobody's an Island. You know, you need drivers, you need writers, you need people willing to rent out their houses. You need people willing to live, you know, stay in another person's house instead of a hotel.

So we're creating a similar type marketplace. We're creating a decentralized network of physician services, where all of the physicians specialists can come together, can own their identity, own their right to work, kick out the third parties who are not only not providing value, but essentially are surveilling and capitalizing off of not only our practice, but off of the suffering of our patients really is what's going on. And we can restore autonomy and trust and privacy to the doctor, patient relationship again, that's what this is about.

Shane Tenny: [00:14:18] And so you're in the process of building your, your MVP. I think you threw out there. I'm pretty sure it was Minimum Viable Product. Is that, is that what we mean in this case? Correct?

Leah Houston: [00:14:27] Yeah.

Shane Tenny: [00:14:28] That's okay. That's a good, just provide translation service on the spot. So you're in the process with your team of building out a Minimum Viable Product and then ultimately from there, or I guess what's the timeline that you're hearing and that you're expecting there. And then what kind of critical mass did need to get. To launch an Airbnb or to launch HPEC and have enough people who are giving and sharing and using and believing.

Leah Houston: [00:14:52] Well, according to our economist, who's crunched the numbers for us, we need 5,000 physicians to utilize this platform in order to be revenue positive.

And then in order to really have a huge effect and shake up the entire system, we would need probably 60 to 70 thousand practicing doctors on the network, which is about the same number of physicians and non-physician providers that Doc Doc had last I checked, which it might be more now, but you know, whoever knows Doc Doc it's, you know, it's well, it's a well known platform for finding care if you need it.

Shane Tenny: [00:15:29] Yeah. Yeah. So how much time, or what's the runway in terms of the MVP?

Leah Houston: [00:15:35] Some people's houses are burning down in Silicon Valley right now. So, there was a little bit of a delay with that. And, you know, I I'd rather get it right than rush it. And, you know, I'm kind of stepping back and allowing them to take their time to manage that.

So there's been a little bit of a delay, but we, you know, I don't like to make promises on the air. You know, originally I said, I'd like to have it done by the time our crowdfunding round is complete, which is November 5th. But it probably is not going to be done by then at this point, you know, a couple months later, hopefully we'll see.

Shane Tenny: [00:16:04] Yeah, yeah, absolutely. Well, I think anybody that has any experience in the angel space or being a crowdfunding investor, understands that you lay out your plans and then you'll see what real life folds. So, alright, so. You have done something that's really remarkable, which is make a transition from clinical medicine, into business, entrepreneurship and innovation.

And I want to run down that road just a little bit. When we come back from this quick break.

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Shane Tenny: [00:18:22] All right. So Dr. Leah Houston, we're talking about your efforts. To decentralize the stranglehold of information that third parties have on a doctor's identity to streamline credentialing, you started a business a couple of years ago. You've undertaken a pretty big undertaking around programming, coding, crowdfund, things that I know you weren't taught in medical school.

How'd you learn all this?

Leah Houston: [00:18:53] It's one of those things where I got a little taste of blockchain back in 2012, you know, I've always been an investor. And I used to chat with my fellow physician colleagues about the stock market and about our real estate investments. And one of my physician colleagues who is actually now an investor in this company said, "Hey, have you heard about this Bitcoin thing?"

I'm like, what's that. And so I'm like, you know, learning about Bitcoin and watching some YouTube videos about it in 2012. And then I happened to move to Silicon Valley in 2015, and I actually got to meet some of the people who made a lot of wealth in this industry and in the cryptocurrency world. And then, you know, of course we learned about the ICO scams and all the blockchain scams that happened and the 2016 jobs act and so I had read and learned about the technology slowly since, you know, back in 2012. And I had just, I had learned about identity and I'm, you know, I'm a humanitarian physician. This is why my company name is Humanitarian Physicians, Empowerment Community. So I really do care about humanity. And so I read about how these emerging economies are going to change lives.

And I read specifically about how in totalitarian governments and in, you know, dictatorships around the world, where the individual people don't have a say where the internet is controlled by the government self sovereign identity is a solution for the people there where they can own a sense of selves.

You know, people who don't have a birth certificate, can now have an identity can buy and trade with cryptocurrency, can vote in a decentralized way without worrying about the vote being not counted. You know, this is something that we're talking about here in the States right now, people are worried about mailing ballots.

Well, if every single US citizen had a self sovereign digital identity, then they would be able to vote and it would be counted based on the cryptography without risk for, you know, misbalance or over counting ballots, you know, and a human error that we are all worried about. And this is just a very powerful thing.

And so when I saw that, I learned about it. And when I was going through this credentialing experience that I went through this, you know, stolen credential experience, I kind of put two and two together and said, wow, well, this can fix voter fraud at this can fix, you know, allocation of resources, fraud in developing countries. This could certainly fix insurance and Medicare and Medicaid fraud. So there you go.

Shane Tenny: [00:21:31] Yeah. And to be clear, cause you you've brought into the conversation terms that maybe some folks don't see the connection. Yeah. But, but cryptocurrency and blockchain, the emerging method of financial transaction of the last decade, you mentioned Bitcoin that I'm sure folks have heard the name of is a method of financial transaction where there's a permanent and perpetual record of where the money is going. And so while in some ways, your effort around self sovereign identity, isn't a financial one per se. It's an identity one there's a perpetual and consistent updating of the identifying information, taking the editorial liberties as we go along here to try to translate the concept that you are passionate about and seeing the vision for, with folks that may not be as familiar. How'd I do it with that leaflet explanation.

Leah Houston: [00:22:20] Perfect. Perfect. You know, this is about transferring digital assets, whether they be in the form of digital money or cryptocurrency, or whether they be in the form of my professional credentials.

When you think about it, just like you have $1 and you can create $1, you can create one Bitcoin and then that's there permanently, unless of course you burned the money or something like that. Same thing with the doctor, when I'm graduated from medical school, that's a permanent record about me. That's a permanent piece of my identity now.

And so we can now document that permanence on a blockchain rather than have to do this redundant credentialing.

Shane Tenny: [00:23:01] And so, you know, the healthcare system is, is massive and has so many systemic issues and interested parties. I mean, I'm thinking back just a decade ago with the enormous undertaking, it was just to get Obamacare passed.

And not making a judgment on whether the merits or the cost of Obamacare, but just between health insurance, and patients, and physicians, and government advocacy groups. How do you go about getting started to with a vision to overhaul the system, which I think is an understatement for what your vision really is. It's an overhaul.

Leah Houston: [00:23:37] I love that you see it. I'm definitely thinking big like that, for sure. And I hope everybody listens is also thinking big because this system is broken. Okay. I think everybody can agree with that. You know, this is a real opportunity to create a paradigm shift in how we interact with the system, or just build a new system for ourselves.

Shane Tenny: [00:23:58] Yeah. So, it's a big undertaking. You've got to have a lot of smart people, a lot of visionaries involved people to do coding, people to do fundraising. How do you go about starting a fundraising project for something like this?

Leah Houston: [00:24:09] In my opinion, the first and most important thing you have to do is attract a brilliant securities attorney because I'm selling securities in a privately held company.

So it's regulated by the federal government and you know, it's not something that you want to mess with or mess up. You know, in general, you have to attract for all the things you mentioned, the coding, the fundraising, you have to attract the right people. People who believe in the vision, the mission, and people who want to get on this crazy train to a different future for all of us, understanding that it is high risk, that we are going to be pushing up against the medical, industrial complex and all of these things that are making our lives hard.

But they with you, agree that it's worth it.

Shane Tenny: [00:24:55] Great step, which is you gotta get your critical advisors seated first. And then from there, you've got to attract people that buy into the vision.

Leah Houston: [00:25:03] Yes, absolutely. We're very lucky. You know, I was actually pitching this idea to investors in New York city and somebody in the audience said, "Hey, you know, tell me a little more about this" and "Hey, I think I want to help you", and that was Paul Goodman, who is my securities attorney still to this day.

Shane Tenny: [00:25:20] That's awesome. Now your vision, for this is that the technology to be used by providers, and I guess even the hospitals and other participating entities would be free. Is that right?

Leah Houston: [00:25:36] Yes. So it would be free to sign up, free to upload your own credentials, free to utilize the platform.

The only time it would cost anything is if, if you make money, we take a small transactional fee. So if you are selling access to your credentials, as a physician, then we take a small 2% transactional fee for the services that we provide about helping you store and control your credentials.

Shane Tenny: [00:26:01] Sure. And so what, what's an example of where a physician would be selling access to their credentials.

Leah Houston: [00:26:06] Also, for example, with, with what happened to me, you know, rather than having to sign away the stack of paperwork, agreeing that they can just use my professional identity, I can build a smart contract for that health system digitally, and give them permission to use my credentials from this date, to that date only.

And then I can see every day if I want to, who's using my credentials, who is, and who has access, who doesn't. Versus the past where I had to just kind of give all my information away, like your social security number, your date of birth, everything. Your medical license number and everything. And then you just hope that they take good care of your identity...it's not right.

So this system would put more control into the hands of the doctor directly. And so for that access, they would have to pay us, you know, they're paying us a salary or whatever. They're paying us hourly. They're going to have to also pay a certain amount of money for access to our credentials as well.

Shane Tenny: [00:27:05] Gotcha. Yeah. So it's a foreign concept in today's world where I'm not selling access to my credentials, I'm hoping you're going to verify my credentials. In this case, if a hospital needs your credentials to license you or to employ you, or things like that, then they needed to pay a fee for that access and that's where there'd be a transaction fee to just to grease the wheels and keep the machine moving.

Leah Houston: [00:27:27] Right. And so people say, well, why would they pay for those credentials? Well, first of all, they need doctors, they can't function without us, they can try and pretend that they can, but they can't. The second, you know, the amount of money and time and energy that they're currently paying for the credentialing process is about an average $3,000 a year per physician.

So, and that's, you know, not really taking into account the potential waste, the human error, what happened to me, the lawsuits that they lose over, things like that, clawbacks from insurance companies for inappropriately billing things. So now they won't have to do that anymore because this will be a streamlined credentialing in perpetuity.

They won't have it to ever call a hospital, never have to call your medical school again, to see if your medical degree is real, which is something that happens every two years for people or every. They will be verified, validated on this ledger and for that service, they will pay because it's a way better experience than what they're currently experiencing.

Shane Tenny: [00:28:25] Yeah. As you've begun to get out and tell the story and build interest and build momentum, are you finding more interest among individual providers who see the opportunity to better protect themselves? And use it for their personal production or, or are you seeing more interest from hospital systems or other parties who, who get bogged down themselves or end up suffering from their own errors and things like that.

Leah Houston: [00:28:52] So, health systems are very, very, very interested in this type of technology. In fact, the Cleveland clinic has an agreement with a company called Axual A-X-U-A-L, which is a self sovereign identity platform for physician, um, in order to provide a similar type of solution. So this is a very real, very present and big health systems like Cleveland clinic are paying attention to this.

Now, as far as the physician community and what we're trying to offer them, we're trying to, rather than go to a health system and try to incentivize the doctors to adopt this, we're going to individual, independent docs. Whether they're employed or not, whether they have their own private practice or not, and asking them to adopt this technology in a sovereign way so that they don't have to interact with any system, but their own.

And in my opinion, the physician community is really in a really rough space right now, you know, especially with what happened with coronavirus and telling people not to wear masks and not providing protective equipment and for allowing and firing physicians and all of this horrible stuff that's been going on.

I think that a huge number of my fellow colleagues have a Stockholm syndrome, Stockholm like syndrome with this medical industrial complex, where they really don't think there's any other way. And the idea and the possibility of anything new or anything changing or shaking things up, is just something they don't even think about, they think it's not possible.

And that is the major barrier and roadblocks that I'm seeing is that people are, or so hurt, so disempowered, and so harmed by the system that they don't even think it's possible to fix it. That they're just leaving. They're quitting their, you know, you mentioned physician suicide at one point, you know, I think privately before this was recorded, they're dying by suicide, they're leaving the practice of medicine, they don't realize that there's some hope in this technology.

Shane Tenny: [00:30:43] Well Leah, I'm really grateful for your time to talk about something innovative, something that can help the community, help the system and ultimately help the patients be able to get care from a physician who doesn't have to waste as much time and put as much at risk.

For folks that are listening that are, that want to learn more or want to connect with, you want to understand better? Where do they go? How can they find you?

Leah Houston: [00:31:09] There are two places. That you can always find our information is of course on our website HPEC.io H-P-E-C dot IO. We're on social media, and when I say we, I mean, me personally at Leah Houston MD [inaudible], across all platforms. I'm on Twitter, I do respond to direct messages when I can, as long as there's not millions of them, and our company handle is HPEC H-P-E-C.id across all platforms as well.

Shane Tenny: [00:31:41] Awesome. Yeah. And we'll put links to all those in the show notes so you can find those, if you don't have anything to write with while you're driving down the road right now.

Leah, thanks so much for your time today. And thank you for listening. If you weren't here, we wouldn't be here. And so thanks for your interest in our topic.

As I said, contact information for Leah and her project will be in the show notes. Speaking of social media, we're on social media too. So you can track down the Prosperous Doc Podcast through Facebook, Insta, and Twitter. And if you have any suggestions, ideas, questions, or comments, you're welcome to just email me directly, it's shaneatwhitecoatwell.com. Thanks for being with us and we'll see you back here next time. Take care.

Outro: [00:32:24] This episode of the Prosperous Doc Podcast is over, but you're not alone on your journey. Spaugh Dameron Tenny has been helping physicians and dentists prosper through financial planning for over 60 years. To connect with us, visit sdtplanning.com today and take your financial wellness to new levels. Join us on the next episode of the Prosperous Doc Podcast.