HPEC-Humanitarian Physician Empowerment Community
Physician and patient data are very powerfulbut, unfortunately, they aretrapped in the current system.Physicians need to take control of their professional identity, so they will be able to shift the power dynamic back to doctors and patients, where the power belongsand stop sharing data with nefarious third parties. HPEC technology puts the individual physician in complete control, by providing the tools to store their credentialsand protect their patients’ medical data.
Q: “Why do physicians need a physician centric and physician controlled technology?”
A: At the crux of the crisis in medicine are middlemen who have inserted themselves between the doctor-patient relationship in order to profit from the pain and suffering of patients. The middlemen in healthcare are able to dictate terms and compel doctors and patients to comply with protocols that serve their interests and bottom line. This has led to widespread physician disempowerment, lack of autonomy, adverse consequences for physician reputation, and many other issues. The main prize middlemen are after is the physician’s professional identity, which correlates to their right to render services and bill for those services. When middlemen usurp your professional identity, they control the narrative, and collect the revenue. If physicians take control of their professional identity, they will be able to shift the power dynamic back to doctors and patients, where the power belongs.
Thankfully, technology has advanced to a level where the true identity of an individual can be digitally stored, verified, secured and exclusively owned by the user. This technology is called self-sovereign identity (SSI). Once physicians take possession and ownership of what makes up their identity they will be able to bypass predatory third parties at every level. The physician’s professional digital identity includes all of the documents required for hospital credentialing including state medical licenses, and unique identifiers like PTAN, NPI, and DEA number. These are the professional assets that give physicians the privilege to make life and death decisions on behalf of their patients. With an increasing number of physicians being employed, it has also made it more and more difficult for the physician community to connect with one another.
Once all physicians have their own self sovereign identity it will create a decentralized network of physicians that is not controlled by their employer, health systems or insurance companies. It will allow physicians to find each other based on specialty, location, type of practice and interests all self directed by the individual user, and free from 3rd party oversight or influence. This will make it easy for physicians to form interest groups and share information with their community. The only thing that makes this possible is SSI technology. By using their identity to cut out the middleman, physicians will also be able to capture dollars lost to third parties and extend more cost savings to patients. Physicians, we need to get off the menu, and help our patients do the same by building a new table. SSI gives us the tools to do that.
Q: “Why should we trust HPEC? How is it any different than the AMA, professional associations or specialty medical boards?”
A: Our current world is centralized, meaning there is a group of select people who hold power over others. As physicians this vertically integrated, top down way of doing things is demonstrated and amplified by increasing employment. There are now large vertically integrated health systems that dominate entire geographic areas, trapping both physicians and patients. Sutter Health is one example, and they have been hit with a second major lawsuit, this one amounting to over $3.7 billion lawsuit for their anti competitive and predatory behaviors. There are currently two major EHR companies that hold more than 50% of the contracts for electronic health information storage. Even our specialty boards have colluded to gain market share by compelling health systems and insurance companies to require physicians to purchase MOC®: their proprietary product, or be out of a job or out of network. When MOC® was initially proposed by specialty boards, many doctors referred to it as “extortion,” however because doctors did not have any way to powerfully organize around their opposition they were ignored. It is clear that doctors are kept in information silos and decisions are made for them by a select few who collude with politicians to keep physicians and patients trapped in the current system.
Decentralized systems are participatory, there is no central authority catering to a special interest agenda. Members of a decentralized system have an uncensored and digitally incorruptible platform to establish their position in an inclusive and self directed way. In the future, this powerful technology can allow doctors to form decentralized versions of their specialty boards and professional organizations and now doctors can ensure that organizations meant to represent them actually do so.
Q: “We already have the FSMB and CAQH, we don’t need another credentialing database. How is HPEC different?”
A: The Federation of State Medical Boards is a private entity that incentivises doctors to pay in order to store and maintain their credentials. Physicians have no control over what that organization does with their credentials. Currently the FSMB is proposing a Universal Medical License, which at first glance sounds great, but if you dig deeper you see potential flaws that could be detrimental to the patient-physician community. Not only will the FSMB now have control over what was originally a state lead issue, but there are no disincentives from tying the license to costly and time consuming administrative burdens, for example MOC®. This will further restrict the physicians right to work, and will likely further decrease access to care.
HPEC technology puts the individual physician in complete control, by providing the tools to store their credentials and be the primary source of truth regarding credential verification. HPEC will give you a private secure wallet to store your protected information so ONLY you and NOT even the founder of the company can see. Once you control your own credentials in your own wallet, nefarious parties can’t vote on your behalf or mine your data for their own predatory gain. Also your credentials have to be obtained by you only ONCE. After adding them to your wallet, any party that wants to look at your credential, such as a hospital you are onboarding with, would have to get your permission to see your credential. Having possession of your portable credentials also gives you leverage with an employer. If you felt mistreated at a job, it would be much easier and quicker to quit, and rapidly re-credential elsewhere.
Q: “We need a union. Why would HPEC be better than a union?”
A: Unions typically require uniform consensus from the employees they represent. The union may not be able to represent workers who have private practices. What physicians really want is to be able to organize and make a large impact. When you get your unique digital identifier from HPEC that only you control and execute, you can start a bid for an important issue and all the physicians who agree with you can digitally endorse this bid and digitally record the collective answers in a sealed, incorruptible ledger. If we had this ability during the California 2020 AB890 senate hearings for independent nurse practitioner scope of practice law, every doctor with an active California medical license could have registered their endorsement against this measure and the total number of No votes, potentially 142k of them, could have been sent to the media as well as the California legislature. We could also have had our patients register on the blockchain and use their unique identifier to endorse a NO vote as a patient. For specialty specific issues, there will be ways to reflect the endorsement from one specific specialty and the participation of all other specialties is not required. This ability to digitally represent uncensored and incorruptible physician opinions prevents other people, who don’t have our best interest in mind, from speaking on our behalf without our consent. We, the doctors, need to be speaking for our own selves! With this technology, there will be less confusion about what doctors really think.
Q: “How will HPEC deal with insurance providers?”
A: Right now physicians have to apply to be part of an insurance network. Once inside the network, they become trapped with little negotiating power and have to accept whatever terms the insurance company decides to set. The insurance companies know that doctors have no way to contest reimbursements and can’t organize and negotiate on a large scale. That’s why they can suddenly change their terms in a dreaded “Dear Provider” letter with far reaching consequences for patients without the consent of doctors and patients.
The insurance companies often do not keep their networks updated, and this leads to patients being left with surprise bills because their treatment was not covered. If physicians control their data on HPEC, they can reflect their network participation in real time. The physician community can easily find other physicians in the common insurance networks that will enable them to organize and collectively negotiate with the insurance companies. Right now the healthcare insurance industry operates by keeping all the doctors trapped inside narrow insurance networks that they control 100%. When we, the physicians, keep our own data and make our network on HPEC, it’s the insurance companies that will be asking us for permission to be in our network.
See how that flips the script? Now the doctors will have leverage to make the insurance companies compete for the most favorable terms on any issue that affects doctors and patients. For the first time, doctors will be able to organize and walk away en masse from an insurance provider with unfavorable terms.
Q:”How would patients benefit from HPEC?”
A: Patients are a vulnerable population and they expect their doctors to advocate on their behalf and make the best clinical decisions for them. The way healthcare works currently, the hospitals and insurance companies have too much influence over the physicians decision making power. Because of the HITECH act, all medical systems were mandated to use an Electronic Health Record system. The implementation of EHR was first sold to doctors citing doctor’s bad handwriting. The true intent was to consolidate billions of dollars worth of data that is used by third parties for their own gain, completely unbeknownst to the patient. Thanks to HIPAA, which is a data PORTABILITY act NOT a PRIVACY act, at any given time there may be dozens of people reading a patient’s chart, knowing their personal problems, denying treatments and selling their data to third parties. This data is de-identified, but extrapolated to look at like patients in order to make sweeping changes in entire patient populations without their knowledge or consent. For example, elderly patients with urinary incontinence may have their data sold to a catheter supplies company who will send their advertisements to patients who have similar profiles.
On the HPEC platform, the patients will also be given a digitally secure private wallet with their credentials (payment details, insurance information, Medicare card, and personal/portable medical records). Nobody will be able to view the contents of this wallet except for the user and whoever else they explicitly authorize by generating another digitally unique code. With an encrypted click of a button, the patient can send their medical record directly to their doctor’s tablet without the prying eyes of middlemen waiting to take their cut. Patients will be able to own and store their medical record data and only release their data to parties they trust and willingly interact with on their own terms. This is a gift that the physician community can give to their patients through the HPEC platform.
Q:”What does data have to do with physician autonomy?”
A: Our autonomy is being stripped, because middlemen are watching our every move, and recording our every click. We as physicians have to stop sharing data with nefarious third parties. The third parties have no interest in altruism and this has been demonstrated to us over and over again. Third parties become emboldened because we never put up any resistance. Many of us are afraid of speaking up in our institutions and these institutions know very well that our options are limited. Because of the legal mandate ordering use of EHRs, the HITECH act, data miners are able to copy the clinical decision making and practice behaviors of physicians in order to generate their own algorithms. The most obvious utility of these algorithms is to generate flow charts so that nurse practitioners can practice medicine independently. At this moment there are powerful parties backing companies that are creating artificial intelligence bots with the intent of eliminating the doctor completely and utilizing a lesser skilled individual to follow the orders of the algorithm. That person will not have the clinical experience of a physician to recognize that some recommendations may be wrong or dangerous. There is no doubt that these algorithms and bots will be designed to prioritize profit. The recommendations from the machine will be the most profitable course of clinical interventions for the hospital system that purchases them.
The HPEC platform provides a decentralized solution that gives digital wallets to MD/DO physicians so that their practice behaviors and data are secure and not being used to create profit algorithms for insurance companies. If there is an ethical use of artificial intelligence, it should be solely physicians and patients discussing and authorizing its use, not potentially predatory third parties. Physician and patient data are very powerful. In the modern technology world, it is our duty as physicians to protect our patients’ medical data from malicious intent.
See Dr. Megan Frost Babb’s article https://www.physicianoutlook.com/articles/hippocratic-oath-20.