Medical Doctors and PhDs Take on Blockchain: an Interview with the PeerAtlas Team

PeerAtlas is on a mission to make medical information free and create a sustainable and scalable incentive structure for medical doctors and medical professionals to contribute to and update information in the ad-free and peer-reviewed medical library.

The incumbent medical library collection comes with a relatively high subscription fee, which can be prohibitively expensive for doctors around the world. PeerAtlas is looking to democratize access to high-quality medical information for all.

A distinctive quality of PeerAtlas is that the founding team is a group of United States medical doctors and PhDs.

The following interview was conducted at the 2018 NEO DevCon by Alex Moskov, Colin Harper, and Jesus Najera with two of the project’s Co-Founders Colin Closser, M.D., and Ling Wu, Ph.D.

CoinCentral: How did Peer Atlas start?

Dr. Colin Closser: In 2011, it occurred to Dr. Brad Matteson, the founder, that as a third or fourth year student in medical school, he couldn’t necessarily access the important information for treating patients when he wasn’t at the hospital because their subscription to the Gold Standard Resource is a subscription with a paywall that’s through the facility.

The information wasn’t free, it was behind a paywall whereas the internet has opened up a lot of other areas, so we thought that was a little weird. He started learning to code and started building the first early alpha of the platform, Peer Atlas.

Dr. Ling Wu: It’s actually a big problem because thinking about when a patient needs care, they don’t pick a condition or a situation, like needing care only from the hospital at this particular time. A patient needs care any place, any time. There may not be a doctor around, but he still needs care. They don’t have the way to get equal care from people that can afford to pay, so how can we solve this problem?

If you think about it even further, even for doctors who treat patients, it’s not an equal chance. For patients that can get a doctor that paid the paywall, they get more resources that they can use. For other doctors, they have a choice, or they don’t have a choice to pay the subscription fee, so the resources they get is not the same.

Dr. Colin Closser: Across the world, many doctors cannot afford or do not pay the subscription and they might be winging it in a situation because there’s not a clear, high quality, free medical resource. They might be winging it based on their experience when it would be better for the patient if they had a resource available at their fingertips.

The patients are completely unaware that the doctor does not have access to that information?

Dr. Ling Wu: Exactly. You don’t even know what’s the deal behind the scenes.

That is very true. From my own interaction, I’ve seen how murky it is behind the scenes because you just wait and interact with the doctor for only five or ten minutes and they go away.

Dr. Colin Closser: They go back and work on your patient note, come up with a treatment plan if they haven’t already.

Peer Atlas is trying to break down these barriers and trying to increase transparency and access to knowledge. How does the system work? How will the program work? In practice, what can we expect?

Dr. Colin Closser: In practice, it’s two prongs.

First off, how does the encyclopedia work and second, how does the token work? The encyclopedia works without even logging in. All the information will be available. The reason that someone would log in would be two reasons as well. To tip creators of content that they found personally useful, as like a personal favor, and also, to earn credits for continuing medical education.

Continuing medical education credits are redeemed every year. It’s like a licensing board for your specialty, and you have a certain amount of education that you have to do every year to stay current in your field. You can accrue credits by using our platform and researching medical content. We will redeem those credits with your licensing authority in exchange for the token. It’s already an industry standard.

We’re not just promising to do something. Our competitor, up to date, is a subscription resource. They award you CME credits for using the site and they redeem them for free, but the subscription is expensive. We’ll have no subscription, the information is available, and then if you want to redeem CME through our site, we’re a pretty lean operation so we should be able to do it for well under the subscription cost of our competitor. It’s still a budget.

If you want, you can do your CME elsewhere, but if you do it through us, we should still be able to be cheaper than our competition.

How does a token play into everything here?

Dr. Colin Closser: The business model for the site is based on the token. It provides fundraising at first, in exchange for the NEO that we raised in the ICO, we can use that before the community is going, we can buy top quality content. Encourage prestigious doctors to create content for the site before the community reaches the critical mass of having a Steemit type situation where people are tipping.

[Editor’s note: The Steemit model isn’t exactly tipping, more so an inflationary creation of tokens distributed to users based on their activity and amount of Steem Power tokens, but that’s just a minor discrepancy and Dr. Closser’s example still makes sense.]

Dr. Ling Wu: If you’re thinking about this, people are doing this already. It doesn’t matter if it’s the medical field or the scientific field. I’m in the scientific field. I’m doing this every day. We publish a paper, we upload all our scientific experience for free that we don’t get anything for, and the system charges people to redeem all this information, this knowledge out.

The system uses you for free and charges people to use it. We want to break the system for the doctor who already provides all this authentic, high-quality medical information that gets to the patients directly.

Dr. Colin Closser: Let me actually give you why the token is necessary to the business model. It’s how they’re going to make one global standard for entering this medical encyclopedia content. Having the token allows globality. If someone puts on fake medical information, you’re going to know, or they’re not going to get paid.

Dr. Ling Wu: We have a peer review system building just like all the high-quality knowledge.

Dr. Colin Closser: We’ll need to pay our peer reviewers so that will be another function of the token.

When a doctor or a medical professional publish on your encyclopedia, other doctors or purveyors of the encyclopedia can tip those doctors in the tokens?

Dr. Colin Closser: Yes, people will be encouraged to tip the creators of content that you found useful in treating patients.

Like you said, this tipping system is the icing on the cake because doctors in this field already want to publish things because that helps their credibility.

Dr. Colin Closser: They’re already being asked all the time.

But now, with your system, they’re no longer doing it without some sort of financial incentive because they can be tipped if the content is good.

Dr. Ling Wu: They can, but I think, the reward for them is more for the reputation. They can feel even better because all the knowledge they’re providing gets to a better place that will benefit the whole society better. That’s the higher vision for doctors.

Dr. Colin Closser: Another use of the token that gives us an advantage over not having a token, which is the other way to run any business, the other use is that we have a long-term roadmap of 20 to 40 years involving artificial intelligence and getting involved in integration with electronic medical records to come up with individualized treatment recommendations based on our data.

Have a rolling clinical trial. Having a significant minority of tokens held by the foundation that they’ve held and then having the Atlas token be successful gives us a war chest to expand into beyond the medical encyclopedia and into new fields.

That makes complete sense, especially the longevity of the roadmap. An interesting question that always comes to my mind whenever I heard about any sort of blockchain solution in med or medtech is being HIPAA compliant and walking that very fine line between being encyclopedia and having access to people’s records. How is the censorship?

Dr. Colin Closser: HIPAA is very tough and there are many barriers which I wrote about in the whitepaper entering the electronic medical records field. We’re not a competitor to the patient or your medical team. We’re not trying to put patient EMRs on blockchain.

What we would be doing is trying to gain access to anonymized data to assess how well the treatments are working and assess which algorithm might be appropriate for a certain patient given their vital signs. Collect that feedback to bring machine learning to clinical treatment. This is a long-term goal, this currently does not exist.

Dr. Ling Wu: That’s very promising because that opens up a different market, different crowd because all the pharmaceutical companies, right now, are spending so much money on clinical trial costs. That’s one of the reasons driving up the costs of medical treatment and medicine.

Dr. Colin Closser: The drug companies are the ones paying for the research and then they take the research that’s favorable to them and publish it, which is why we have expensive drugs.

Between just absolutely exorbitant pharmaceutical fees and some pretty ridiculous overheads in some of the largest hospitals, you’re starting to see urgent care clinics come to the scene. Whether it be Peer Atlas or another medical industry blockchain, what kind of benefits do you see in blockchains for the healthcare industry moving forward? How do you see it benefiting and helping the space?

Dr. Ling Wu: I would say that if we used blockchain technology properly, we will take out a lot of buyers that were misleading in the medical and pharmaceutical field. That all depends on how you interface with this technology into the medical field, and also, into pharmaceutical marketing as well. That’s not a simple answer of how we’re doing that now, but we’ll see it down the road. How we can work together or how we work against the misleading advertising..

Dr. Colin Closser: The scope of your question is actually bigger than the scope of our project. Our competition is up to date, a product that does not have a blockchain. Competition is not the other medical tokens that are launching on or off the NEO platform. Because our main competitor does not use blockchain, we’re not trying to do something different than they are right now. We’re trying to do it with a different financial model using a blockchain model instead of a subscription model. I can’t tell you how blockchain is going to change medicine because even though I read the Patientory whitepaper, I don’t work in health administration and I don’t work with patient records and I can’t evaluate it.

Sorry for throwing you that.

Dr. Colin Closser: It’s fine because this is a good question. We’re an open source medical encyclopedia. I can tell you how blockchain will impact our project because I designed the token and I wrote the whitepaper, but I can’t tell you how blockchain will change the rest of medicine.

Dr. Ling Wu: If we’ll be the first one doing this on the road in the future, all the questions you raised today may become our project in the future. That’s the goal.

Having the source of the information accessible to everybody, you’re going after the WebMDs which you’re not really sure where the information comes from.

Dr. Colin Closser: WebMD has it accessible to everyone but it’s poor quality information and I can’t use to decide how to treat people. It’s not good enough for doctors.

They’re likely not trying to integrate with AI or machine learning technology.

Dr. Colin Closser: Probably not trying to change medicine in the future in that manner.

Dr. Ling Wu: We want to have a gold standard for ourselves first and then that will make all the questions you raise happen in the future.

You said you wrote the token. Why did you guys choose NEO?

Dr. Colin Closser: We have a Venn diagram. We have tokens that have large liquid markets and then we have tokens with good technology. The only one that has both is NEO. Maybe you can argue now that Stellar… I don’t know, I still think NEO market is better than Stellar. Stellar or Cardano, there’s no ICOs on Cardono yet. There probably will be eventually that we could do it on another platform. Stratis took a big step forward. Especially at the time that I wrote the whitepaper, the daily 24 volume for NEM was like 9 million. It’s a total joke. This is when NEO was 30-70 million a day.

Dr. Ling Wu: I also want to mention that another reason we chose NEO is that after we worked with NEO, we find out that they’re very easy to work with. They try to work with you and they try to include you in their community.

You’ve said every name except for Ethereum.

Dr. Colin Closser: The technology of Ethereum is well behind the cutting edge. The proof of work is a mess, it’s expensive, it’s slow. Smart contract platforms shouldn’t be running off proof of work.

Can you imagine if all these people, like doctors, are relying on the platform and it gets clogged up by Crypto Kitties? They can’t help the patients because of cats on the blockchain.

Dr. Colin Closser: First, we’ll be on NEO. Maybe, in the future, I have a dream to build out our own blockchain using NEO’s consensus technology, the dBFT. You have individual bookkeepers, so maybe they can be known doctors in 20 different countries. One doctor from each country is responsible for keeping the books. How are you going to corrupt 2/3rds of the doctors from different countries? For a token, that if it collapses, will damage an open source medical encyclopedia. Good luck.

Dr. Ling Wu: That’s also one of the reasons, we want to start with the US because this is the place. All the high-quality medical information and medical knowledge here. The next step, we want to get all other countries, even underserved countries having the equal chance to have access to this high-quality medical information that will help them in their countries with patients and people getting fair treatment.

Like the ability to cross-verify information. One country may have something completely different as a treatment for a very common condition.

Dr. Ling Wu: Yes. If we have this platform that will make it much easier than the current setup for how people are getting treated in the other countries.

Dr. Colin Closser: Also, Brad has published some things in medical journals that were peer-reviewed, and mistakes got through. The immutability of publishing is not an advantage. We can modify things if we see a mistake, catch a mistake, or want to change some small aspect of treatment, we can do it.

Dr. Ling Wu: With the current system, you cannot. Once it’s published, it’s all done. Then you have to do a correction and people don’t even see the correction. With our system, we make it all live.

I was looking at token allocation in the white paper and the team’s token allocation is very small. That’s not really something that you see with a lot of ICOs or startups. 10 to 15 has kind of become the new standard, even a lot of stuff is 20. You’ve got a team like Ripple that owns 60%.

Dr. Colin Closser: I don’t think that’s healthy for a digital currency to have a huge allocation to the team because that just seems like something that I personally would not want to use as a store of value if that were my angle.

Dr. Ling Wu: This is the reason we set up this way. We thought about that too.

Dr. Colin Closser: If Atlas is successful, there’s going to be enough for us. We have our personal finances, we have the NEO raised in the ICO, we have Gas generated by the NEO and we have the Atlas token at our disposal. We don’t need a huge allocation. We’re not starting from zero, financially. We’re backing ourselves. We’ve not taken a dime in fundraising yet.

When is the ICO going to launch?

Dr. Colin Closser: It depends on whether the SEC approves us as a utility token which we now have a communication channel through our hired law firm. They have a communication channel with the SEC.

I’m sure there’s not much in the realm of doubt here.

Dr. Colin Closser: This would be the first time the SEC had ever approved a project before an ICO. We’re trying to do that. If we can do that on a utility token, the ICO will be in March or April. If we can’t do that, then we’ll launch as a security. Securitization of Peer Atlas foundation and that would happen six months later in the fall.

Dr. Ling Wu: No matter what we decide, we will be 100% compliant with the SEC.

Dr. Colin Closser: We want to work with the SEC. We don’t want to avoid them.

Dr. Ling Wu: We want them to treat us like the first ever example for everyone after.

Dr. Colin Closser: A compliant ICO. How can America, a leading country, have one of the leading forms of technology, the ICO. How can we do this right? Is there a way to make this in the medical field?

Do you guys have a GitHub yet?

Dr. Colin Closser: Yes, but we don’t have anything on it because we haven’t open sourced the website yet. We will at the time of the ICO, so the platform is not open source yet. It will be. We own all the code because Brad wrote it all. Our smart contract developer already has experience with this. We can have him publish his code to the GitHub, but it would be more cosmetic.

If you guys have any issues open, I’d love to look into them.

Dr. Colin Closser: We appreciate that. We will need help auditing the smart contract so maybe we’ll open source it.

Dr. Ling Wu: Actually, I personally understand the community concept because if you’re one of the community, you try to help. You try to contribute because you make it better, you are better because you are part of it. After working with NEO for a long time, I feel like this is a great direction for our project. Working together on things and we grow together, we become more successful together. People don’t try to take people down, people try to boost people up.

Dr. Colin Closser: Yes. Telegram is really helpful because some of the core team members have joined through Telegram, and anyone can ask any questions so that is kind of an open source model where you can ask the team anything. As a result, we have a pretty high level of trust in the community because anyone can ask any question of the team. We don’t duck questions.

What was the inspiration to go into this and go into the blockchain world?

Dr. Colin Closser: Brad thought about that first and then I thought it was a good idea. Brad bought bitcoin more than a year ago and watched it go up.

Dr. Ling Wu: For $50! He put $50 in bitcoin and watched how it changed over a month.

Dr. Colin Closser: It caught his attention and we started learning about it.

Dr. Ling Wu: He started learning the field and he talked to us.

All three of you worked together? Obviously, you do now, but before this project, you were working together?

Dr. Colin Closser: Yes, we’ve known each other five years?

Dr. Ling Wu: No, more than that.

Dr. Colin Closser: Seven years? Eight years?

Dr. Ling Wu: Yeah, eight years. Brad and Colin are long-term friends.

Dr. Colin Closser: We sat at the same cafeteria table in middle school. We’ve been friends 20 years.

Dr. Ling Wu: I met them eight or nine years ago.

It’s great to see how tight-knit the crypto community is.

The need is there due to exorbitant healthcare costs and lack of access to information, especially around the world. It’s really a good cost champion and it’s not hard to get behind because it makes sense. How could someone who is reading this and wants to get involved help out?

Dr. Colin Closser: Join our Telegram. Join the community. The bigger the community is, the stronger the project is. We have almost 2,000 people on Telegram. Almost 3,000 on Twitter. If they want to follow the project, they can follow us on Twitter, and if they want to talk to the team, I’m on Telegram greeting people every single day.

Dr. Ling Wu: We keep very close.

Dr. Colin Closser: We’re very close. Anyone can ask us anything on the Telegram and it will be answered.

Dr. Ling Wu: We state everything on the Telegram. What’s our progress, what the changes are, what’s the positives, what are we working on, everything like that.

Dr. Colin Closser: Investor concerns, all this stuff.

To learn more about PeerAtlas, check out the PeerAtlas site, or join their Telegram group