It is perhaps the most exciting tokenization solution our Chief Editor has come across so far. California-based ikioo provides healthcare solutions of the future already now. AI on blockchain is employed in remote health monitoring. Dr Ayman Salem, MD, FAANS, Founder of ikioo explains it all in the exclusive interview:
Q) Some describe ikioo as a corporation, while others refer to you as a global community of health care professionals, other call you a technology provider. What is ikioo?
We are a California corporation that has the vision to transition over the next few years to a permission-less global healthcare community. We see the future of global healthcare in developing self-governed open global healthcare communities that can set and achieve healthcare goals by incentivizing providers and users alike, better allocate and spend their healthcare dollars in a productive way.
Dr Ayman Salem, MD, FAANS, IKIOO Founder
The role of ikioo as a corporation would be a permissionless “utility” provider to these healthcare communities relevant to healthcare technology. We would like to be in the background and provide logistical technological support to our global healthcare community and other communities in the future, pertaining to low level disease care and health management.
The nucleus of any community is a set of simple values or a “constitution” if you will, that the community can rely on and re-visit to rectify course. Our platform is currently “permissioned” for that reason, and there are two or three steps that need to happen before we transition to a fully “permissionless” healthcare community.
Q) AI is a word used by many but understood by few. Can you describe your five step AI proprietary algorithms in detailed, yet popular way?
AI has a lot of hype around it and used in different ways in healthcare. We utilize general purpose AI in different ways on our ikioo/ikioor platform for example speech recognition for voice entries in the interactive diary, “ikioo vision” to recognize basic items just by taking a photo then correlate this photo with different outcomes, for example you take a photo of a sofa then AI correlates an activity like “sitting on a sofa watching TV” hence estimating calorie expenditure based on time lapsed, or a single food item like a bag of chips and how many calories consumed. This general-purpose AI is not user specific.
We are developing a more focused user specific AI that is provider supervised. This user specific AI is starting at a very basic, ground level starting point. Our ikioo/ikioor AI platform gives the ability to healthcare providers to build “provider supervised” AI tools to use in their clinical practice. Healthcare providers can build an AI algorithm on our ikioor AI Hub in 15 to 30 minutes in five easy online steps using an online image classifier (as a start), then publish their AI algorithms worldwide on our ikioo App AI hub for people to use it worldwide.
These are not stand-alone AI algorithms; the results of the algorithm are saved in the patient’s chart for the provider to review and give final opinion. An example would be a surgical incision classifier – that we give for free on the ikioo App – that qualifies a surgical incision whether it is “infected” or “clean”. There are around 50 million inpatient surgeries annually in the USA with an overall estimated cost of Surgical Site Infection “SSI” of $3.5 to $10 billion annually.
This is only one example of low-level disease care management that can potentially save millions of dollars. Another example is Jaundice or yellow discoloration of the eye or macular degeneration of the retina or cataract, the examples are endless. Our goal is to inspire healthcare providers to innovate and come up with new ways to follow and manage patients using AI, as part of their clinical armamentarium. An average US doctor sees 30 -70 patients a day at his or her office, you can easily leverage that number to 300 -700 patients a day using AI as a screening tool.
The 5 steps for Healthcare providers to train and publish their single function AI algorithm using our online image classifier is as follows:
A brilliant simple health or disease related idea: It’s simple, Providers come up with ideas for different body organs or body functions. An example for single function AI algorithm would be “Cataract or no Cataract? “ or “Good Spine posture or not? “. It’s the providers’ brilliant ideas and the sky is the limit.
Positive & Negative Data Sets: We are starting with an image classifier, so you need around 200 images of the disease or condition you are specifying and around 200 images of control or “no disease” images.
Upload the images: The images are uploaded online to train a deep machine learning convoluted network. The provider will see the online training happening on ikioor AI Hub Dashboard.
Overfitting vs. Underfitting: Once training is completed in 15 – 30 min, we might need to guide the provider to fine tune the accuracy of their AI algorithm.
Publish the AI algorithm on ikioo App AI Hub: The AI algorithm will be available for the whole world to use and benefit from, either for free or for a small fee. The healthcare provider will receive stats and notifications on their ikioor AI Hub dashboard.
For healthcare providers to train an AI algorithm and publish it, they need an AI utility coin called neuron that represents AI compute credits on the ikioor AI Hub. They need ten thousand neurons (equivalent to one thousand US dollars) to train and deploy their AI algorithms. Monthly maintenance fees are at one hundred neurons (equivalent to ten US dollars). These AI compute credits (neurons) can be bought and sold only among ikioor healthcare providers.
Q) Can we step away from Ikioo to place things into a wider context for a brief moment, how do you think AI will help us to improve our life quality. Many believe AI is here to replace human doctors. What can you tell people who share this point of view?
In my view, AI is only a tool and as the saying goes “if all you have is a hammer, everything looks like a nail”. In healthcare we utilize different tools to perform specific functions, like using a stethoscope to listen to the lungs or a pin to test for sensation. AI is no different. Currently, AI as a tool has its own limitations and equivocations, I have no doubt that it will continue to improve and become more integrated in everyday healthcare “point of care” interactions. Our starting point is low level disease care which we feel is more appropriate for where AI technology is today. We see it having greater impact in medical subspecialties like radiology and pathology but to a lesser extent in medical subspecialties that require nuanced care. I do not think that AI will replace doctors, but it will allow doctors to do the heavy lifting necessary to interact with more patient in different locations of the world, and in different languages.
Q) In this global context, where does Ikioo fit in?
We pride ourselves here at the US as having the best healthcare system in terms of cutting-edge technologies, research … etc. Alas, we are spending 18% of our GDP to deliver it to our fellow citizens. At ikioo, we want to hit two birds with one stone by allowing US healthcare providers to share their knowledge and healthcare “know how” globally, as well as deflating some of the healthcare delivery costs pertaining to low level disease care and health management.
Out of the $3.5 trillion spent annually to deliver US healthcare ($10,739 per person in 2017), $1.1 trillion is spent on acute hospital care and that is for the big boys (Microsoft, Apple, Google and Amazon) to figure out. We are focused on low level disease care and how to make a difference at the very basic health decisions made every day by an average individual, whether this individual is here at the US or in the middle of the Sahara or the jungle in Africa. For relevant statistics and analysis of traditional trends, please look here.
Q) Your business model, what is it?
Our business model is to make the world a “better place” when it comes to healthcare. Financial sustainability and profitability are also important.
We identified 10 guiding principles for our business model:
1)Increase transparency to overcome information asymmetry in healthcare,
2) Improve information sharing,
3) Adopt sound remote screening healthcare models,
4)Encourage healthcare providers to innovate,
5)Facilitate Macro and Micro efficiencies at “point of care” interactions,
6) Use Gamification and Game theory to create new sustainable self-propelling healthcare market equilibriums,
7)Reduce negative healthcare market pressures on the average user,
8)Foster patient accountability,
9)Use synergies among different technologies like AI and Blockchain to reduce healthcare costs,
10) Global outreach.
Based on these ten guiding principles we can adapt our financial model to judiciously and effortlessly build a successful global decentralized healthcare community with ikioo Technologies, Inc. as the healthcare “utilities” provider for both the users and healthcare providers.
Q) Why do you need security tokens in your business model? What functions do they perform?
ikiooTech security tokens represent equity shares in our company and are an integral part of the ikioo blockchain platform. In keeping with ikioo’s commitment as a global “on-ledger” healthcare operating ecosystem, we have internalized the equity issuance and future exchange related processes. By issuing the ikiooTech security tokens as fully programable “on-ledger” shares, we believe that we can exercise more control over our destiny and provide more protection for our shareholders. ikiooTech tokens are issued following the InPortal INPR protocol which by design requires the ikiooTech tokens to be deposited into a digital wallet issued by ikioo. The ikiooTech tokens can be traded within ikioo’s ecosystem venues, or externally in any exchange that deals in digital securities. One of the most important aspects of the ikiooTechs is the transparency provided in determining the pricing of the ikiooTech tokens.
We strongly believe that all shareholders should have access to the company’s financial and operating information to be able to make an informed decision on the relative value of their ikiooTechs. Our ikioor investor wallet is the receptacle for a variety of different corporate documents including quarterly financial reports, corporate news, independent analysts’ reports, Board of directors’ resolutions, Board of trustees’ agendas, and most importantly, distributions to token holders.
We believe that providing transparency on ikioo’s operations will be a driver to grow our decentralized health-care community. ikiooTech holders will feel connected to the company in a way not previously experienced by private equity investors. ikiooTech token holders will no longer be trapped and bound by traditional investment pitfalls. The adoption of security tokens truly has changed the way private companies can raise capital and provides the potential for shareholder liquidity through the standardization of smart security contracts and ongoing dissemination of pricing information.
Q) Which platform do employ and why?
We employ an open source blockchain platform that gives us the ability to have around 1000 transactions per second (TPS). We are always looking to improve TPS on the ikioo/ikioor blockchain platform.
Q) How do you use blockchain outside digital securities?
We have different utility coins on the platform. The first two that we released are the “ikioo” and “neuron” coins. We use the ikioo coin to gamify and incentivize ikioo App users to take better care of their health by getting discounts on goods and services on the platform. The “neuron” is our AI compute credit coin and it is restricted to healthcare providers. These are permissioned coins that can be bought and sold on exchanges as utility coins. We take strict measures to discourage speculators and maintain a stable sustainable ecosystem.
Q) What function do you believe blockchain may have in health care, now and in the foreseeable future?
Blockchain platform utility coins in general can function as an “enhancer” of value for purchased goods and services. Classically, the costs of goods and services are among the most important determinants of a currency’s purchasing power. When the price level rises, purchasing power decreases, and when the price level falls, purchasing power increases, if all other factors are held equal. The US dollar, healthcare purchasing power varies year over year. For 2021-2026, average US national health spending growth is projected to increase by an average of 5.7 percent, or 0.2 percentage point faster compared to average growth in 2019-2020.
During this timeframe, Medicare spending growth is projected to continue to outpace growth in private health insurance spending, mostly due to enrollment growth (as baby boomers continue to age out of private insurance and into the Medicare program).
Medicare pays physicians based on services provided. As of 2010 about 7,000 distinct physician services were listed in the physician fee schedule. For each service, a payment formula contains three relative value units “RVU” s, one for physician work, one for practice expense, and one for malpractice expense.
On average, the proportion of costs for Medicare are 52%, 44% and 4%, respectively. The three RVUs for a given service are each multiplied by a unique geographic practice cost index, referred to as the GPCI adjustment.
The sum of the three geographically weighted RVU values is then multiplied by the Medicare conversion factor to obtain a final price in US dollar equivalent. This “quasi” cryptocurrency system adopted by the US government since 1992 has been a very successful payment system to enhance the value of healthcare dollars being spent on purchasing of healthcare services.
The goal is to maximize purchasing power of healthcare services.
Now you have an added functional dimension for a currency like the US dollar for a specific purpose, namely healthcare. So, as the RVU is the US government mandated coin for “disease care”, we created the ikioo coin for “health care”. Both are not a replacement of legal tender, but they serve special purpose adjunct to legal tender.
So, Blockchain utility coins can serve different functions in an ecosystem, e.g. to tailor incentives, adjust purchasing power or serve as an enhancer to legal tender.