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Introducing Computational Trust to Healthcare
Episode

Jim Nasr, CEO at Acoer

Introducing Computational Trust to Healthcare

Today’s podcast features Jim Nasr, CEO at Acoer. Acoer is a software development company committed to building software that is usable, interoperable, and block-chained enabled to ensure trust, transparency, and security.
In this podcast, Jim talks about how his company focuses on building modern and usable real-time healthcare technologies. He speaks of improving health care by making data more accountable, delivering easier access to data for better efficiencies, and insights to understand blockchain technology.
We learned a lot from our conversation with Jim, and we hope you’ll find great value in it as well. Enjoy!

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Introducing Computational Trust to Healthcare

About Jim Nasr

Jim is an experienced technology executive and software architect building innovative software for health care. He is the CEO at Acoer since Jan 2015. Prior to Acoer, he has worked at several health tech companies, including IEEE, Synchrogenix, and CDC. He completed his Bachelor’s degree from Coventry University and earned his Masters from UConn.

Introducing Computational Trust to Healthcare with Jim Nasr, CEO at Acoer transcript powered by Sonix—easily convert your audio to text with Sonix.

Introducing Computational Trust to Healthcare with Jim Nasr, CEO at Acoer was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best audio automated transcription service in 2020. Our automated transcription algorithms works with many of the popular audio file formats.

Saul Marquez:
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Saul Marquez:
Welcome back to the Outcomes Rocket, Saul Marquez is here, thank you so much for tuning back in. Today I have the privilege of hosting Jim Nasr on the podcast. He is the CEO at Acoer. They’re developing usable, interoperable block chain enabled technologies for health care. Jim is an experienced technology executive and software architect building innovative software for health care. I’m really excited to talk to you today, Jim, about the work you guys are doing there and to share it with our listeners. And so before we go forward with some of the discussion, I love, if you could just finish up that intro with any anything that you may want to share beyond what I already have.

Jim Nasr:
Yes. Hi Saul. Thanks so much for the invitation and I appreciate your interest and really delighted to be part of the the the folks that you have spoken to. So thank you for the opportunity. So to kind of wrap up, if you like, your very kind introduction, really. I’m a technology professional, if you like, kind of an architect by profession. I have been an entrepreneur for a long time as well, like my own business for about 40 years or so, and then moved on from that. And this on my own. Thanks for a little while. I was at the Centers for Disease Control for a little while as well and helped to modernize some of the technology, particularly the scientific application portfolio technology at the agency. And really, as you kind of rounded it up over the last nine months or so, I’ve been really kind of full time Acoer running our software development business and really very much focused on health care. Very much. I guess we’re last six, seven years being in health care. I guess things that I would like to see differently done differently and perhaps value that I think we can add collectively that we don’t necessarily see. So that’s really the motivation. I think there’s like all of us, I think we have personal reasons and personal stories in there that maybe were the catalyst to get us motivated into health care is something that an industry would consider as easy to break into. So, you know, in my case, I had personal situations, particularly with my my family, where I’ve seen really how health care is just just really not delivered in an industry that, you know, that really for the amount of money that’s spent and the amount of of the percentage of of the gross domestic product that that is dedicated to, it really delivers and at the core lets individuals down. So all those things are kind of behind, I guess, my motivations to being the space that I’m in. I think there is an opportunity for technologists like myself to to get into this and really kind of make a difference. And that’s that’s what we’re trying to do.

Saul Marquez:
Well said, Jim. And yeah, there’s. A lot of money to really to get a product that is not the best that it could be, and I was just talking to a friend this morning and he said that he needed to get a stress test and that the test is eighteen thousand dollars. And I’m like, man, that’s like a couple hours, 18 grand man. And he had a copay of like eighteen hundred. He’s like, man, I don’t even think I’m going to do it. And this happens too often where where something is not probably priced the way that it should be. It’s overpriced and and people don’t get it because now employers are also offsetting their cost because it’s getting ridiculous. So I couldn’t agree with you more there, Jim, and appreciate you mentioning your very strong will and your strong purpose for being in the business.

Jim Nasr:
Thank you. Yes. And it’s funny you mention the eighteen thousand dollars. I think for many people the issue is they don’t even know what the price is. In fact, even after the event, when you come back and see the bill, you really cannot explain it. I’ve been there myself, but again, with my family, where there are bills that literally nobody can explain, they just went around from one place to another. But nobody can explain how the pricing was constructed or what the items really kind of map to. And this this kind of opaqueness of pricing is, you know, again, you look at almost any other industry. I think that industry even remotely in business, if in this day and age pricing is so kind of secretive and opaque, it’s like you have to be a member of the Illuminati to have any sense about it. But that’s that’s the reality of what we deal with. And I think most of us basically are exhausted into submission because we’re like it’s just not even worth the amount of effort because you just don’t get there and it consumes so many cycles. So you’re kind of like beaten up.

Saul Marquez:
So, yeah, I agree. And so tell me a little about Acoer and how the business is adding value to the health care ecosystem.

Jim Nasr:
Yeah, sure. I think you did a good job explaining really what our mission is and where we’re here to build modern, usable, essentially real time health care technologies. We have a focus on technologies that really, by and large, like in my mind, provide computational proof of transactions and hence the blocking enabling. But I think, you know, again, I think it’s important for us to to not get sidetracked by block chain or any other kind of exotic technology per say because they’re really just enablers and really block chain in many ways, infrastructure is what SMTP is to email as examples. So like 20 years ago, back in the early days of the Internet, we would have been talking about things like HTP and S.P. and these are underlying protocols. So that’s kind of, if you like, a kind of a corollary to where block chain is as an underlying protocol for trust or computational trust. So the oldest I think the real application and the real value is can you especially in a world where we all know and again, unfortunately, it’s very evident right now with this COVID-19 kind of pandemic that we’re all going through.

Jim Nasr:
We’re in a world where data and certainly health care data is we can’t necessarily trust. It can trust is origins. You can easily trust is not be manipulated. And not to mention as it gets relayed through various channels and social media, whatever, and all of that additional fake, you know, inputs and agendas that are kind of attached to these things. So our kind of thinking is we can do better and we can make health data much more accountable and we can prove it and prove it aside up like Jim or Acoer or any one entity. So so you could use a public ledger if you wanted to and just verify for yourself. You could have this global infrastructure that they can use in real time to prove provenance of information that the information that you’re looking at at least can be trusted in the sense that it wasn’t manipulated along the way. So that’s that’s fundamentally what we’re trying to do. Obviously, we have some applications that go one level higher from this and, for instance, provide real time visualization of data and analytics and things like this. But to me, really, the core concept is can you actually trust that data? Because if you can’t, then whatever inside some machine learning or whatever you get from it is going to be suspect.

Saul Marquez:
Yeah, no, I think that’s a good call out and put. What do we do when you got that bill and you didn’t know what it what it even meant. I’ve been there too. I’ve, I’ve gotten a bill from my son, got a little his chin. He fell and it opened up and then get stitches and this and that, and I get the bill, I’m like, what is right and what happens with this data? And these are just two points in a very large system. And how do you manage it? So. So tell us about how Acoer helps with that. And I’d love to hear some real applications here, Jim, because there’s a lot of talk about block chain. But to your point, how do you make it usable?

Jim Nasr:
Yeah, absolutely. And I think, by the way, I would actually kind of really echo what you said and in a way that I would say would be even kind of a little bit negative towards block chain, because I think it has become fodder for essentially perspective kind of perspective offerings. Right. offer offerings that are only on PowerPoint and people who pontificate about it without any proof that they’ve actually done it or it’s useful. So I’m and I certainly don’t want us to have another conversation like that. I think that’s not worth anybody’s time. So back to your question. What are we doing? Let me give you a specific example. There are several I can I can point you to, but here’s one. So we are working right now with a consortia, including Mayo Clinic, Safe Health Systems out of California and some some labs such as Labcore and other folks really building and have built a large scale, kind of a COVID-19 kind of essentially what we call diagnostics and triage platform. So there is a mobile app and we are white labeling that app for various entities. Just last week, you may have seen Delta Airlines had an announcement about the work they’re doing with the safe health systems and with Mayo specifically. That’s the application I’m referring to. And then a couple of weeks before that, Arizona State University had a similar press release or a blog entry. Again, this is kind of the underlying platform that myself, my team and a large cast of characters in this consortium are working on. But back to the block chain piece, there are two very important things we’re doing.

Jim Nasr:
One is that we have created what we call a national health ID, which is a unique idea, which obviously is not every system has unique ID. But what is unique about this is that we actually generated in real time using the Hedera distributed ledger technology as a public ledger entry. So for every number like my number, say one, two, three, four, that’s my ID. You can clearly see that it’s unique. You can clearly see it was recorded on the public block chain and you can interrogate that or just. No, not necessarily all the information about me, obviously that’s not on the screen. But the second thing related to this is that we are essentially working in this kind of group of of of the forward thinking outfits. We are sharing that national health idea and possibly associated or not possibly definitely associated barcode to essentially use that. And that alone to identify patients across different systems obviously is not at all practical, nor does it make sense to have one gigantic health care system. Right. There are all separate. However, it is practical to have a unique ID that you use to identify a user across different systems and in many ways use that to propel efficiencies. So then, Jim, there really is this number across many different systems, whether it is all built by EPIK or built by different companies. So that’s a big, big thing. And again, we can competition improve everything. We can also do what we have also done. And computation proof is this idea that using our mobile app, you’re essentially the first step before you get triage and essentially diagnose, if you like, online.

Jim Nasr:
Is this questionnaire that you take which you’ve seen Apple and other people do a typical kind of CDC guideline based questionnaire. You have a fever. If so, what temperature is it? How many days have you had? It is a protocol right now. But what is important, what is different to pretty much anybody else? I think I don’t think anybody else is doing this. Is that the those questions and the outcomes from them? Because the outcomes really are medical endpoints that lead to testing that lead to a telehealth provider’s speaking to you. We record every one of those as a as an encrypted reference on the public function. So, again, we can computationally prove that those transactions happen at the time to happen. And here’s a ledger entry to prove it. So if an auditor said, hey, Jim Acoer proof that this is real and is in effect the data because of your own agenda, we can prove it. We can prove the full data provenance for all of that. And again, it’s done in real time. They can report on it. So both of those are already in production, are being used actively again. Our clients use the application of the such as a trusted, if you like, transaction. The fact that we use block chain, make it. Provenance really is to me, is an abstraction, they don’t need to know about that, but if somebody says prove to me I have a manipulated data, we can prove that.

Saul Marquez:
That’s cool. And the health I.D. is an interesting concept that I think would be very useful for us to employ now. I mean, how that happens is a challenge, right? I mean, what do you think about that? I mean, are we any closer to getting there?

Jim Nasr:
Yeah, you know, it’s interesting, Right. this is obviously this is an issue that’s been around for a long time. I think if I recall correctly, sometime in the 50s, there was an initiative to create a national I.D. and various reasons, most of which was really political and territorial, did not happen. And of course, as time has gone on, like, again, you can easily imagine this right to a big charmander and you have your selection of two or three monopolistic ones, oligopolies. They want to have their own unique identity and not share Right. regardless of fact, that Jim Nasr could be on three of these systems, three different systems. So that has unfortunately kind of gone on in that time has gone on. There’s been real kind of financial incentives for them to keep it that way and disincentives for this kind of interoperability. However, I think what we have going for us is really two things right now at this moment. One is that because of covid in this pandemic and all of the repercussions, we largely have this ability through the emergency use authorization to push through ideas that perhaps in prior times may have taken years, if not decades, because of the many kind of contentious factions who have been involved and really fighting their own turf. So I think that’s that’s a positive if we can tap into the emergency centralization to really drive this. The other thing is that it’s becoming very evident that you and this is not just because it has been evident for a number of years and that the Cures Act kind of spells it out that that consumers need more control over their data.

Jim Nasr:
Consumers need to be able to get their data from wherever it happens to be anything. So it’s fine to say that. But but if consumers have 18 different identities on 18 different systems, that makes it difficult. And then the Cures Act allows us to essentially have an agent like a developer, like providing an app to to retrieve that data, but having some kind of a national health ID that simply allows you to identify Jim in 18 different systems. That really is the long term way of doing this without you providing all kinds of credentials and things like this and really making it difficult. And it’s one thing to say here is a law. It’s another thing to actually make it practicable. So I think that both of those things, I think at the very least, are kind of in our favor with this. But honestly, this is you know, this is an area where I think, technically speaking, it’s relatively straightforward. You take this as an example. You take this national health ID number that we’ve created. You add to it definitive biometrics, such as like your voice essentially with a very, very high degree of accuracy. You could have your voice be completely uniquely identified using machine learning, almost one hundred percent accuracy rate. So that number plus my voice could be essentially that if you like the private key for me to be able to tap into all kinds of different systems, the issue really is going to be the politicking around this, because that’s not going to at that culture is not going to change that quickly.

Saul Marquez:
And that’s some good call outs. And so I appreciate your insights there. I’ve always found that very interesting. And the promise and obviously to your point, there’s some some vested interest in not going there by some of the larger players. And so as you and Acoer work to operationalize and make these things usable, what’s one of the big things that you could point to as you’ve made business better or you’ve improved outcomes?

Jim Nasr:
I think it’d be foolish to say that where we have like really improved health care outcomes at a larger scale, because I think that’s one is as they say, it takes a village. Two I think a lot of things we’re doing are still really fledgling in the bigger scheme of things, including all of the real time and watching and able things. However, to me, what we’re really kind of trying to do, and I’m already seeing some outcomes and results and certainly good rhetoric and feedback from clients is really this idea of we do two things really well. Right? The first thing that we do while is is really abstract, real time blocking technologies into our software Right.. So so essentially you get software that like a software as a service cloud offering that you would get from any number of other vendors. But you basically get this real time auditability and computational trust and confidence score that’s built in. That’s that’s really just there. You don’t have to worry. I didn’t have manage keys and native tokens and things like this, we have to track all that for you. So I think that’s that’s one thing that that we kind of do. And we’ve seen people appreciate that. But then the other thing we do is really provide very rich analytics on the data that then we claim is is as trustworthy as we can make it. Right. And I think what we’ve seen is that there are uses for instance, we have some public health users who use our systems for really managing essentially that mortality data and particularly with with regards to the opioid crisis, which was a huge crisis before it became a crisis this year.

Jim Nasr:
But really what they do is, is that they use our analytics technology in a way that’s very, very simple to use and is oriented for end users and not for programmers or kind of experts, kind of visualization engineers and things like this, which I think is a differentiator, because end of day, what we really want to do is appeal to epidemiologists, forensic pathologist, chief medical examiner, as opposed to appeal to engineers like ourselves, because the real value that the actual medical value doesn’t sit with the technology people, it sits with those functional people. And I saw that when I was at the CDC, really, my clients were epidemiologists and public health experts, but they needed they were dependent on people like me who may have spent or would spend many weeks or months probably just manipulating data before they would even be able to really get their hands on the data and do anything with it. But that’s not right. I think in 2020 where you get this data to them in as absorbable and easy to use a way in a way that gives them control as quickly as possible. I think that’s what we’re trying to do. And I think that’s really kind of our you know, if there is an improving outcome, that’s what we’re trying to do. And that’s where we’ve seen some good results.

Saul Marquez:
Very cool. This is great. And it’s really it comes down to making it usable Right. and not having to wait forever and be a black box.

Jim Nasr:
Yeah. I mean, Saul imagine this. Imagine if we went to Wall Street and said, OK, this this financial transaction that you had, you’re going to get your settlement in six months. And by the way, you won’t really know why or how we settle. I mean, it’ll be ludicrous, but that’s kind of what we see in the world of healthcare.

Saul Marquez:
Yeah. Now, well said. That’s a great, great example. And so what’s been one of the biggest setbacks that you’ve seen and what was the key learning that came from it?

Jim Nasr:
Yeah, you know, I think, again, being an entrepreneur, I’m sure you can also understand this and empathize with this. I think there are times where, like, you know, I have one or two examples that come to mind where, you know, like I work that we have worked with entities and specific individual, so-called KOLs, key opinion leaders and particularly pharma, where really, honestly, their motivations and incentivization were completely misaligned to ours. They were motivated by essentially the bonus they would make at the end of the year and by very kind of reliable financials that effectively helped them but didn’t really have the bigger picture. And so I think essentially wasting time in you can’t please everyone all the time and you shouldn’t. And I think the lesson learned with that actually for me was the catalyst for us to really go all in with Acoer, which is what if you believe in it, if that’s a conviction, you know, you put your money where your mouth is and, you know, you don’t mess around with people who really have of a day that they’re daring to platitude, but they don’t really they don’t really care. At the core, they’re different.

Saul Marquez:
So it’s hard to search for that and to identify that. Right. How do you figure that out?

Jim Nasr:
You know, I wish I wish I had a perfect recipe. I think in order to be innovative and in order for to really make an impact, you need to have kind of a positive attitude and an attitude that allows you to take on challenges without kind of being jaded because you can easily talk yourself out of those things. And, of course, as an entrepreneur its almost always upway stream. And you have to get used to that and have a have skin to deal with that. But I think at some point you have to have that objective kind of if you like, the Mendoza line. I’m using baseball analogy here to know that this is you you’re below that line and you just got to drop it. If you’re batting below 200, it’s just to forget about it. Let’s move on now. I think that’s sometimes as entrepreneurs, we have unending enthusiasm and we think everybody kind of thinks that way. But the reality is that’s not the case. And people think differently. It doesn’t get good, bad or indifferent. But if if your objective is to make. Change and ultimately, that’s not everybody’s objective and that’s not a good place to be in a community. You need to have some degree of control over what you do. Otherwise, you just all you do is psych problems and not actually create any solutions.

Saul Marquez:
Right. That’s that’s awesome. And speaking of enthusiasm, what would you say you’re most excited about today?

Jim Nasr:
You know, it’s kind of sad, actually, because I’m most excited that because of COVID, we have the ability to actually make long, longer lasting changes. You know, it’s very sad. It’s a double edged sword. Obviously, nobody likes the situation we’re in and one hundred thirty thousand plus people have died. And, you know, and and all the numbers are just horrendous and they’re just, like, sickening. However, I think there is an awareness, as we’ve also seen, politically speaking, with Black Lives Matter, that there is there is an awakening for for a lot of us, some of these underlying kind of problems that really have been around for a long time, you know, and problems that impact all of us that we have for whatever reason, either ignored or just really haven’t paid that much attention to. So I kind of feel like there is I mean, just you ask that because of covid and because it’s that much greater awareness, all of us are kind of having that that we can actually push through some of these changes and push out some of these people who are really obstinate and have a day that they’re very singularly focused on their interests because, you know, we’re at 20 percent of our GDP going to health care. The results that we’re getting are just so poor, such a poor return that that, you know, we need to make a change. And people who are entrenched and have profited, you know, for really decades without really making too much of an innovation, we need to push them out.

Saul Marquez:
Yeah, I mean, you’re you’re calling it out. And I think it’s important to embrace truth, especially in a time of challenge. And I think that I mean, my thinking the same right now, we have an opportunity Right. there’s a lot of people experiencing pain. It’s difficult. We’re changing our lifestyle, how we do things. You know, the onus is on us. And if you’re listening to this today, it’s on you to do what we need to do to get more for our health care dollar and also to to do our part and pick up the trash from the ground. So really appreciate the insights you’ve shared with us on block chain It’s always an area of curiosity for all of us. So thank you for making it practical today for us. Before we conclude. I love if you could just share a closing thought and then the best place where the listeners could get in touch with you.

Jim Nasr:
Sure. Thank you. I think closing thought would be that there is an opportunity for entrepreneurs in health care. I think reality and perception, by and large, has been that health care is a very difficult space to break into for entrepreneurs. I don’t want to put on Pollyanna glasses and say that that has changed completely. That’s not really the case. Unfortunately, one year in many other industries is about a decade in health care. So things don’t move that quickly or those people and obstacles don’t kind of just go away that quickly. However, I think there is there’s definitely opportunity for entrepreneurs. I would strongly encourage, as a know, as kind of a more practical advice that, you know, look into ways where you can essentially make data accountable, Right.. It doesn’t have to be just functional. There are a number of ways of doing this. Obviously, I think block chain particularly real time next generation, actually not so much work type of Bitcoin because it’s too expensive to do so. I think, you know, end of a day, almost all of health care is about data Right. at one level, I’m not obviously referring to medical treatment and there’s tremendous efficiencies to be had by having data that that flows faster, that moves with less hops, that’s more interoperable, but also can be trusted. Right. I think there is an opportunity for a number of entrepreneurs in that space. And you could look at it from genomic data to public health data to clinical trials. I mean, you name it, there’s all kinds of data. It’s a very data rich space health care. And I strongly believe that there is opportunity for thinking forward looking entrepreneurs with technology background to marry that level of technology, skill and expertise with health care data. And I think, you know, I don’t think everybody’s doing that. I think there is a there’s a window.

Saul Marquez:
Well, let’s take advantage of that window. If that person is you. You’re listening to this. Take a look into that window. Take a step into that window. Right..

Jim Nasr:
Definitely, you know, you could be could be doing a lot less productive things.

Saul Marquez:
And if the interest is there, Jim, where can people reach out to you or connect with you to to learn?

Jim Nasr:
Oh, yes, sorry, I know.

Saul Marquez:
That’s OK.

Jim Nasr:
I guess the question I forgot to mention. Yeah. So our website is the best place in general. It is acoer.com. And you can contact me through the contact us over there. My email is Jim Nasr. I think I’m on LinkedIn, so I encourage you and your audience if you’re interested to reach out to me on LinkedIn. I’m quite approachable. So happy to connect with you.

Saul Marquez:
I love it. There you have it, folks. Jim Nassr and CEO of Acoer, our block chain expert for today’s episode. Jim, I’m really grateful that you gave us some insights here and helped us understand this critical technology better. And I’m really thankful for you.

Jim Nasr:
Oh, absolutely. And I appreciate the opportunity and thanks for your platform and what you do. I think it’s great that people like yourself take the time to invite people, like I said, to really talk about what we’re up to most real, what’s not real, and hopefully all of us can improve the space.

Saul Marquez:
Always a pleasure, my friend.

Jim Nasr:
Thanks so much.

Saul Marquez:
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Things You’ll Learn

  • To be innovative and really make an impact, you need to have kind of a positive attitude and an attitude that allows you to take on challenges without being jaded.
  • There are plenty of opportunities for entrepreneurs in healthcare. It’s on you to do what you need to do to get more from healthcare.
  • Look for ways to make data accountable.

Resources
https://www.acoer.com/