INCORRUPTIBLE GOVERNANCE

What is Governance?

Governance encompasses the system by which an organisation is controlled and operates, and the mechanisms by which it, and its people, are held to account. Ethics, risk management, compliance and administration are all elements of governance. [1]

Why does Healthera.AI believe in the concept of self-governance? Healthcare professionals from all walks of life, countries, nationalities and no matter what colour or creed are bound by the Hippocratic oath.

This modern interpretation of the oath is as follows:

I swear to fulfill, to the best of my ability and judgment, this covenant:
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.
I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling, and may I long experience the joy of healing those who seek my help.

The essence of the Hippocratic oath is the first and deepest guiding principle, “do no harm”. The natural conclusion that should be drawn is that health practitioners are bound to always first and foremost, do the right thing by the patient. A financial benefit or result of this action, is and will always remain secondary. The influence of many intermediaries, seeking profits within the Healthcare sector has hampered the goodwill between clinician and patient.
The classical version of the oath can be found here. [Just a word of caution; this classical version should be read within the context of the era in which it was written. It has aspects which could be considered controversial in the current milieu.]

Why we believe that governance is particularly important within the Healthcare ecosystem?

The Healthcare ecosystem is highly complex, the management of which should not be left to any one individual or entity. As a result, we believe that the Healthcare system requires not just good governance, but incorruptible governance.

Although an obvious fact, when the patient’s health is at stake, the availability of finance should not be a factor. Currently however, this is not the case. Whether a patient receives ideal care should not be a function of the patient’s bank account or e-wallet. There is no good reason why today, funds for treatment cannot be easily and quickly accessible.

Whether individually or collectively, we as society are responsible for the ubiquitous delivery and access of healthcare to every person on the planet. It is neither up to one or a few individuals to determine if a patient lives or dies, or whether they receive care or they do not.


Why it is important to facilitate “incorruptible” governance on the Healthera.AI platform…

The management and distribution of financial resources at scale is not to be taken lightly. The responsibility of the allocation of financial resources to deliver care effectively and efficiently should be democratised.

Decision-making at any given time in life can be difficult, fraught with the potential of error. After all, we are all human, whether practitioner or patient. The decisions that we make as practitioners, have the power to either restore and heal or to damage and destroy.

It is important that the healthcare system is driven and dictated by the majority of practitioners who inherently and genuinely desire the ultimate good for the patient. By decentralisation of the decision-making processes for the Healthcare ecosystem, we can restore the originally intended patient-centric model of Healthcare, and hopefully start to reinstate the fundamental principles laid down by the Hippocratic oath.


What does incorruptible governance mean for patients?

Patients rely on healthcare practitioners to diagnose, plan, and treat them in the most appropriate way possible. Although they may have a better understanding of their health and health issues due to availability of ubiquitous information on the internet (and other sometimes unqualified sources), they may have an inherent lack of understanding of the nature of their problem because their “self-study” is made up of a case study of “1”. Because of this inherently unique bias, no individual can self-diagnose or interpret high quality qualitative and quantitative data in a manner which assists them in identifying a dental or medical problem they themselves, may have.

Thankfully however, healthcare professionals have the capabilities and experience to be able to diagnose, plan and treat with a separation of bias and good judgement. Multi-disciplinary care should be utilised where possible to reduce the risk of clinical error. As the Hippocratic oath itself refers to, the supplication of ego and the utilisation of multidisciplinary care has significant benefits for the patient.

A clinical example of the result of the inappropriate allocation of resources and time would be an x-ray for the wrong area of the body. This is wasted time and/or energy that could be otherwise utilised to focus on the correct cause of a problem. We could reasonably conclude that health practitioners already apply the principles of governance in a clinical manner.

We believe that incorruptible governance of the Healthcare sector will have significant downstream benefit to assist in more patients obtaining better quality healthcare.


What does incorruptible governance mean for decentralised finance (DeFi) within the healthcare sector?

The current Healthcare system lacks ubiquitous, up-to-date care because of the lack of utilisation of technology in the manner best suited to the quickest and most accurate diagnoses of medical problems.

One of the identifiable causes has been identified as the lack of abundant availability of capital for investment into Healthcare infrastructure (individual clinics, groups or conglomerates and large-scale hospitals). Decentralised finance and “frictionless” deployment of funding to the Healthcare industry will help facilitate the transformation of the industry by assisting practitioners to invest into and purchase equipment that can capture data in a digital format, rather than in traditional physical formats.

Healthera.AI strongly supports the idea that digital health transformation of the entire Healthcare industry to an 80% “completely-digital” environment is possible in the next few decades. With the availability and access to data in a digital form, artificial intelligence algorithms and machine learning can function to their full capacity. The eventual consequence of this will be a greater outreach of patient care than ever before and a quality of care far more superior compared to the current status-quo. The use of advanced software algorithms as an adjuvant to current clinical care regimes can reduce waiting times for treatment, and the diagnosis/treatment cycle itself.


What does incorruptible governance mean in relation to the Healthera.AI (HLTA) DAO?

A decentralised autonomous organisation (DAO) is our method to bring together Healthcare professionals globally to collectively decide the best allocation of resources, whether it be within a local jurisdiction or a geographically distant one. Blockchain or proof-of-work chain is at it's deepest level, the codification of truth.. [2]

New algorithms have developed such as “proof-of-stake” (POS), however Bitcoin is the first proof-of-work chain which to this day, remains secure and immutable. The technology underlying Bitcoin is also referred to as “blockchain technology” however the phrase has come to have a more diverse meaning with the development of new consensus algorithms and new use cases.

Why, who, what, when and how are critical questions to be asked when there is a misappropriation of resources (whether accidental or purposeful). The DAO we are creating does not purport to remove all injustice or malicious intent however it seeks to immutably record the evidence of all collective decisions, good or bad.

Thus, the DAO will be responsible for the incorruptible governance of the Healthcare sector. Decisions will be recorded and time-stamped, with the free availability of truthful, transparent reflection as to whether the appropriation of resources was good, bad, or otherwise. Most importantly, it will enable the forensic analysis of whether the decisionmaking involved had malignant intent or not.

The design of the HLTA DAO will ensure that bad actors will be unable to attack and permanently damage the network, in an irreversible manner.

Why are we utilising blockchain and artificial intelligence-based software?

“To err is forgivable but to not learn from the mistakes of the past, is a true sin.”

To ensure better decisions are made in the future, the DAO is given the chance to analyse prior decisions whilst in time, artificial intelligence algorithms can assist the DAO, so it can collectively make better decisions in the future for the Healthcare ecosystem it governs.

What could be the benefit of a combination of the principle of incorruptible governance and the application of the highest degree of privacy currently available to patient records and data?

We fundamentally believe in the right and principle that the patient is responsible for their own medical data. How they share that data is based on the decision of the individual with their implicit informed consent. The patient should be made aware that the contribution of their data helps the collective whole.

All patients should be allowed to provide their data for the collective good. That is, said another way, anonymised healthcare data from diagnosis all the way to treatment is a trove of valuable information that could help the health of another fellow patient.

Personal health information belongs to the individual. Community health data is beneficial for humanity.


References

[1] https://www.governanceinstitute.com.au/resources/what-is-governance/
[2] Nakamoto S., Bitcoin: A Peer-to-Peer Electronic Cash System, 2008, [https://bitcoin.org/bitcoin.pdf]