RX Podcast_Leah Houston: Audio automatically transcribed by Sonix

RX Podcast_Leah Houston: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

John Shufeldt:
Hello everybody and welcome to another edition of Entrepreneur Rx, where we help health care professionals own their future.

John Shufeldt:
Hello everybody and welcome back to another episode of Entrepreneur Rx. I have the pleasure and honor to have someone I've been following for a few years. Her name is Leah Houston. She's an emergency medicine trained physician, so she's one of us, one of us emergency physicians, and she is the founder of a company called HPEC. That's where I got to know her from. And it was funny because when I first learned about HPEC and everything else that she was doing, it was so far outside of my knowledge base, which of course doesn't take much, I thought she is so far ahead of her time, what a badass. And now talking to her, she has a new business that's kind of a pivot from HPEC, although HPEC is still up and running, which we're going to learn about. Leah, welcome to the podcast.

Leah Houston:
Thanks so much for having me again.

John Shufeldt:
So people the first time they meet you, give us, give people a little bit about your background.

Leah Houston:
So as you said, I'm an emergency doctor like you. I practiced across the U.S. for nearly 10 years and I experienced what we all experience. The administrative burden, you know the burnout, like, some people don't like that word, but that's what people call it. And I actually experienced identity theft, where one of my, you know, hospitals use my professional identity to bill under my name. And that's where I got this idea for HPEC. I had already learned about blockchain technology and its ability to be leveraged for decentralized identity to prevent things like that from happening, to allow people to own their data and control their data. And I realized that this could be a solution for us as doctors.

John Shufeldt:
Now, how did you learn? I mean, everybody knows about bitcoin, and I know incredibly little about it. But how did you learn about blockchain prior to HPEC?

Leah Houston:
So in the emergency department, we all have our other interests, and so I was sitting there and it was a slower shift, and one of my colleagues, who is now also an investor, it was 2012, he said, hey, check out this bitcoin thing and he sends me a YouTube video. And I'm like watching, like wow, this is really something big. I can tell this is something big, and I tried to find a way to invest, but I was like wait, I have to find a computer programmer, how am I going to know I'm not going to get scammed? And, you know, long story short, I didn't invest till much later, but that's when I started learning about it and reading about it, and that's how I learned about decentralized identity so early.

John Shufeldt:
Can you give everyone kind of a thumbnail overview of how blockchain works and what it means to health care?

Leah Houston:
So I can give a very quick overview of how blockchain works and then how pertains to health care. Sure. So go back to the days where we had merchants and taking their goods from the Middle East into Europe and think about the fact that they had to have ledgers, where they said, OK, we have 10 sacks of potatoes, x ounces of gold or pieces of silver, and people were getting swindled. So they realize if they take two copies of the ledger and they give the merchants on each end one copy and force them to compare those two copies, then it's much harder for them to cook the books because if one person stole then the other person has the copy to find out who stole. So Satoshi Nakamoto, who we don't really know who this entity is, is it a boy, is it a girl? He developed this protocol that took that concept of a duplicative ledger and created a, distributed ledger technology, which instead of making one copy that two people look at, the bitcoin protocol makes thousands of copies of every transaction on what's called a distributed ledger so that there's people all over the world that gets copies of this and get to compare it. And so it creates trust with any transaction. And the other piece that makes it important is that that ledger is immutable, so you can't cross anything off and each block is attached to the block before. So in order to add one block, you need to compare all of these ledgers, make sure they're all the same. And so that creates essentially digital trust, and it prevents the need for third parties to own and control these centralized databases. And so when you think about all the data that we have, it's really a more secure protocol to store things that are permanent, like our credentials that should be owned by the individual and that you don't want to have the risk of it being deleted or breached by hackers.

John Shufeldt:
No. So that actually makes total sense. One of the best explanations I heard. But, but it's also we identified, unless you have access, unless you are given permission to compare the person's name and assign that name to that amount of data, is that correct?

Leah Houston:
Well, so this is where decentralized identity comes in, because a lot of the bitcoin maximalist and the crypto enthusiasts out there like the fact that it's anonymous, that's the thing that they love the most about cryptocurrency. But there are some things where you don't want anonymity. You want to know who the doctor is that's rolling you in the O.R. You want to know who the doctor is that's writing you the prescription. You want to know that you can trust them and that they are who they say they are. And so just like some use cases, you need to have identity layers, in some use cases, you don't. In cryptocurrency you don't. You don't care who's giving you money, it's a fundable asset, you can get it from wherever. But when it comes to who's making a healthcare decision about you, you want to know who that person is.

John Shufeldt:
Right. So for example, the patient's medical records at some point being placed on a blockchain, so they're immutable and manageable and distributable to wherever health system they're walking into.

Leah Houston:
I don't recommend that, and I also think it's too much data to put on a blockchain. I mean, think about like the size of one MRI. It's expensive and it takes up a lot of energy and space to hash or document any data to a blockchain. So you really want to reserve it for things that really are important, like your one time that you graduated from medical school or the, you know, every year that you renew your medical license, those are few enough transactions that they make sense. However, I do think that patients will eventually have their decentralized identity wallets. And if you think about a workflow, if I have a decentralized identity wallet as a doctor and you have a decentralized identity wallet as a patient and I document something about you in a decentralized EHR, I can keep a copy, transmit a copy to you, hash proof that that relationship existed and that that interaction happened with a timestamp so that if you as a patient ever want to share that record, people know that it's authentic and they know that I'm the one that created it. And so that's actually the real value of decentralized identity and distributed ledger technology in health care.

John Shufeldt:
Perfect. Ok, so now I get it. So when you get your identity borrowed/stolen/illegally misused, was that the genesis for HPEC?

Leah Houston:
It was, it was. You know, it was really devastating. I thought it was potentially career compromising. I know that there are some doctors out there listening who have either come close to having a lawsuit or a legal issue or have had some kind of fiasco because we're all in these like really entrenched, you know, very essentially corrupt, administratively burdened systems that don't really serve us as doctors. So it took me a month to find an attorney that would even take my case, I called over 30 people. So I really, I was starting to lose hope. But once I actually started getting that legal issue figured out, I started really thinking, OK, how did this happen? How can I prevent this from happening again? You know, I'm a problem solver. We all are, right?

John Shufeldt:
Ok, so take it, in exactment, all physicians are ultimately problem solvers, so give everybody the leap of faith, you got your identity stolen, what was the leap of faith HPEC? The impossibility of stealing someone's data if it's on a blockchain because they just they simply can't go and grab it without your permission?

Leah Houston:
Yeah, I mean, HPEC is really a mission-driven company. You know, I had the vision of making this a physician-owned, physician-run company, raising money from doctors, giving them their identity, giving them their data on place so that they can own and control their right to work, their way to move, the right to their data, and we did that. In 2020, we raised six hundred and fifty thousand dollars from over three hundred and sixty doctors who wanted this to be built, and now it's deployed on the App Store. The vision is for us to.

John Shufeldt:
Congratulations.

Leah Houston:
Oh, thank you, thank you. It's really exciting, actually. I mean, it's a very soft launch because there are still lots of features that we want to build out to make it accessible for all physicians immediately. There are some manual processes involved now. Technology development is expensive and you want to be very careful and design it properly. But yeah, I'm really excited about it.

John Shufeldt:
Ok, so HPEC has been around for about two and a half years, but recently you said you, you made a little bit of a pivot, and I described the pivot to you as going from B2C business to customer to B2B. Can you kind of give us a background on the pivot and where the new company is going now and what people can do to help you because it's, you know, once you set up, you know, it's like bingo, I think you've got it.

Leah Houston:
Amazing. Thank you. So I don't know if I really would call it a pivot rather than like a feature add or acknowledging a need. So the real purpose of HPEC is to have credential issuing bodies issue you your credentials, and they're going to hash or document-proof that your credential is issued on the day that you graduated from medical school or residency. And once it goes into your wallet and you can show that credential and show the provenance data that that credential is actually issued, they'll never have to do primary source verification again. And you, as the doctor, get to be the primary source. But in order for that to happen, we need to build a system that allows them to issue the credentials. And so there are some credential issuing companies out there. And I looked into a bunch of them back in January-February of 2021 and I realized that they weren't really fitting the specific use case of physician credentials and so we decided to develop our own that was, that was specific to our need.

John Shufeldt:
I mean, it seems like such a, once you explain it, like everything, it seemed like such an obvious no-brainer. Like, yeah. I mean, I was looking at, literally just today I was pulling out my medical school diploma and putting it in a file because like I know I'm going to get asked to send some of this damned diploma that's now a zillion years old, you know, it's on some parchment paper, so it seems like this is an obvious solution for that.

Leah Houston:
Absolutely. You know, the technology's new. It's still, the standards around this technology are still close to being finished, but they're still in development, they're still in discussion. But essentially, if you use these decentralized identity protocols in order to communicate this data in a secure way, then you can have an interoperable system so everyone can interact with any decentralized identity protocol as can HPEC.

John Shufeldt:
Is this going to be a race to the first one wins sort of race like the first one who gets widespread acceptance across state medical boards or across X. Is it going to across health plans? Is that what's going to determine the winner?

Leah Houston:
I don't think so. I don't think there's going to be a winner. You know, I think that that's the magic and the beauty of decentralized technologies is that it's the winners are the ones who attract the most individuals. It's a community-driven product and a community-driven effort. It's a different way of looking at things, you know? So.

John Shufeldt:
So OK someday, so I'm going to apply to get a medical license in Florida and we'll, it'll Florida then say to me, well the Florida State medical boards say, find share with us your evercred credentials or share with us your x y z credentials, is that how will work? Like they'll be able to review a couple of different versions of my credentials based upon who I use?

Leah Houston:
No, I think that the state will realize that they need to adopt decentralized methods of communicating because that's what the standards bodies are requiring. I actually listened in on Medbiquitous webinar a couple of weeks ago, and they said that this particular type of technology will be the standard. And for those of you don't know, Medbiquitous is building standards around the American Association of Medical Colleges, Student Data and Information System. So this is, number one, we have the California Data Protection and Privacy Act and GDPR that are pushing us in the direction of data privacy and more secure storage of individual personal identifying information. And then we have our own medical associations adopting this very particular type of technology to solve this very real problem of secure and authentic data. And so I think that the state is going to potentially adopt the evercred system and use it to issue credentials not only to doctors, but maybe even to other people who have state licenses as well. And so that's also part of it. Yes, evercred talks to HPEC, but it also could talk to any other decentralized system just as HPEC, yes, it talks to every cred, but it can talk to any other decentralized system.

John Shufeldt:
Will this be kind of installed on, ok, if I'm a physician and I want to have different states and different licensing bodies, and access to my records, it'll be like, all right, John, we're going to charge you x per year basically for access to the system, will it be physicians who pay for this ultimately, do you think?

Leah Houston:
No. I mean, I don't think physicians, we already paid enough. I mean, I paid three hundred and sixty thousand for my degrees, so, and I pay licensing fees to renew them, I don't think I should have to pay to store them and share them. Currently, the people who are paying to have these credentials verified are the ones who are verifying. The employers, the insurance companies. And so I believe that they'll likely be the ones that are going to continue to pay. And the people who are issuing credentials are also paying quite a bit of money for these software, student information systems, and these, you know HR departments are spending a lot of money on workforce software and workforce data analytics. And so we have the potential to kind of build out a lot of the features that people would want in a system like this, but with a more secure and more authentic data provenance structure.

John Shufeldt:
Yes, I agree with you. And so the health plans that should be paying for access. But as a physician to spend, you know, fifty bucks a year on an app that I can store all my stuff on so I'm not doing what I did today, which like, oh for God's sakes, where I put my transcripts from medical school so I can upload them and send them into some credentialing body. That alone like 50 bucks today, slam dunk. So at least it makes sense that way but I get what you are saying.

Leah Houston:
I mean, I have physicians who say that they would pay thousands of dollars for this app, but I really want to keep it free for doctors. And I'm not saying that we might not have features that cost extra. We have so many different opportunities within the app, but I think there's also going to be ways for doctors to make money on the app. And we could also do like a transactional V model and build essentially the future decentralized health care marketplace where independent doctors can go, can do telemedicine, can do side gigs and consults, and transact with patients directly and get paid at the time of service if they're independent. There's so much upside to this. I don't think I need to charge the doctors., I think that keeping it free and keeping it accessible is really the solution for them.

John Shufeldt:
That's awesome. Now, are you out raising money for evercred?

Leah Houston:
Yes, we just opened a fundraising round for evercred. And so yeah, it's a really exciting opportunity, I wasn't really planning on doing this other additional thing, but we were very surprised to get approved for, IRB approval for a pilot project with an academic residency program. And so when we got approval for the pilot project earlier than I expected, we kind of had to make a decision. Do we spend a lot of development resources integrating to one of these already previously existing credentialing systems that doesn't really solve our problem in the way we want it to be solved? Or do we spend a little bit of extra time and resources designing and building the one that works for us? And so we decided to take step two, and that's what evercred is.

John Shufeldt:
So prior to this, you are using a CRM sort of program and trying to integrate it with HPEC and then finally decided basically we'll build it ourselves.

Leah Houston:
Well, no, I wasn't using CRM. We were always going to do DIP com, decentralized identity protocol. So we were always going to need a new a completely new system and we may we talk a lot, the decentralized identity community is a pretty tight knit community, and I talk a lot to these other founders about interoperability projects that we can do together, there are a couple of other systems that are talking about educational credentials. So those conversations are being had.

John Shufeldt:
Yeah, yeah, absolutely. And there's a lot of us out there. How can people find out about how to invest in evercred business like we talked about earlier? And this, to me, seems like a one of those aha moments where it's like, well, of course, we need this at some point, at some point soon will be the standard. So how can people invest?

Leah Houston:
So, yeah, I mean, if you're interested in investing in evercred, you can go onto the website and put in your information and click that I'm an accredited investor and I'm interested, I will be following up on all those. I mean, this is very, very early, where we just opened this round and we are seeking a lead investor. So if you are a big picture thinker, very big picture, want to understand or you already understand the potential of creating the future decentralized health care marketplace, I mean, this technology has the ability to touch and potentially usurp huge sectors of this three point nine trillion dollar health care system. And that's our vision, and we think that it's possible through these systems.

John Shufeldt:
That's got to be really exciting. I mean, how much, how much sleep are you getting these days?

Leah Houston:
Funny, you ask. I only got three last night, but you know, that's the life of a solopreneur, an entrepreneur, you know? But I love every day, I love what I do, and I'm very grateful to be able to do this. You know, I'm grateful for the trust that the physician community gave me. I mean, like, you know, like you said in the beginning, this is kind of an abstract concept, it's very new, it's a greenfield space, new tech. And so to trust some other random colleague, it just shows how much we, as, as physicians believe in the ability of our colleagues and want a better life for ourselves and for our patients.

John Shufeldt:
Totally, I mean, so I, you probably know, I speak in a lot of these conferences, and your name comes up a lot as somebody who is a visionary and who was way ahead of the curve in this area, so congratulations, you've made a real name for yourself as a health care leader and visionary, which is very cool.

Leah Houston:
Wow. I appreciate that. That's surprising to hear, but thank you. I'm trapped in my home office all day, working every day, so I don't get to hear that stuff very often. It's very nice to hear.

John Shufeldt:
Well, you know, you can never be a prophet in your own land. So, you know, of course you don't realize that, but there's people, there's people talking about you. Well, Leah, where can people go to learn more about you? How can they get a hold of you?

Leah Houston:
So I'm on Twitter, I'm on LinkedIn. LeahHoustonMD across all social channels, but Twitter and LinkedIn is where I kind of hang out the most. You're welcome to send an email to me, leah@hpec.io, and if you want to know about HPEC, go to the HPEC website. Click the get your early access pass because this is an invite only application, the HPEC app is currently invite only, and we are also going to give doctors ability to invite each other eventually, too. And so we're in the very, very early stages. And if you are a residency program director, if you are a GME director, if you are a chancellor of research at an academic medical school or a GME or academic residency program, and you want to do a pilot project with us, also reach out on the website and we have a bunch of people who really want to give this a try. So we're building out processes for getting this deployed rapidly throughout systems.

John Shufeldt:
Very good. I really appreciate the time. It's always great to see you and hear from you. And this seems like a over the horizon visionary moves. So strong work on that.

Leah Houston:
Thank you. Thank you so much for having me to let me share and thanks for what you do.

John Shufeldt:
Of course, on my pleasure, I'm honored. Well, thanks everybody. Another episode of Entrepreneur Rx. I will catch you soon.

John Shufeldt:
Thanks for listening to another great edition of Entrepreneur Rx. To find out how to start a business and help secure your future, Go to JohnShufeldtMD.com. Thanks for listening.

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