hApp for increasing the 'receptivity' of the Healthcare System

I’ve had this idea on my mind for months and thought I would speak it in to existence so others can join the conversation and we all learn something more together.

The problem:

According to some estimates, the healthcare spending in the USA will reach $4 trillion. Around 75% of these healthcare dollars are spent on managing and treating of chronic diseases (obesity, diabetes, heart disease, kidney disease, cancer, osteoporosis, sarcopenia, etc.).

The cause:

The fact is that most of these diseases stem from people not having healthy habits such as bad eating (drinking) habits and no physical activity (the result being altered body composition). There are other bad habits (like smoking) but the effect of smoking on the overall personal health is lower than being obese.

The majority of the effort is put towards treating and managing of these diseases instead of prevention. The system is therefore battling and trying to fix the ‘downward spiral’ that in most cases starts with obesity. Obesity (lack of healthy eating habits and physical activity) is the major cause for diabetes, which is a major cause for heart disease, which is a major cause for kidney disease, etc. The further you go, the more debilitating is the disease effects are, which in turn result in less physical activity, and here we go again.

What if:

Suppose any Agent would be able to create accurate body composition data. Body composition data is the result of both eating (drinking) habits and the amount of physical activity. It can be categorized in to three parameters: fat mass, fat free mass, and water. The water in our bodies fills 2 compartments, the intracellular (ICW) and extracellular (ECW) water, which is water inside and outside of our cells.

All of the above mentioned parameters are the holy grail of human health. Most of the chronic diseases (and their associated costs) stem from these parameters not being in their ‘healthy state’. Therefore they can be used as direct predictors of ‘general’ human health and therefore healthcare costs.

Interesting Fact: In Heart Failure, Kidney Failure, Lymph-edema, ECW significantly increases before any of the symptoms occur (swollen legs, arms, fatigue, breathing problems, etc.). The same parameter change can be seen in Corona Virus patients where ECW in their lungs increases and breathing problems begin.

The hurdles associated with current solutions:

We can see that the current healthcare insurance companies (payers) are already conscious of the problem. They realize that prevention is far more important and is the key to prevent the ‘downward spiral’ of comorbidity that contributes to most of the costs, and some payers are already pushing ‘incentive programs’ to increase physical activity of their customers for instance.

United Healthcare is using FitBit watches to track behavior and financially reward participants for achieving desired goals (such as walking 10000 steps each day). Such approaches (and similar) seem to have a hard time taking off in the healthcare sector because of the lack of data (anyone can eat 5 hamburgers after they achieve 10000 steps) and the fact that the initiatives are risky, meaning that they require the companies to financially reward people in advance and not knowing if the calculations for the expected costs are accurate. This involves very high initial investments in long studies.

To me, it seems that accurate body composition data is just what the Healthcare Insurance Company needs to increase its ‘receptivity’; sense the behavior patterns of its customers on the edges, predict costs, use different incentive mechanisms to steer toward healthy behavioral patterns. This would result in lower healthcare costs (insurance premiums), higher productivity rates (regular employers), customer satisfaction, etc.

(My theory is that just due to the fact that payers aren’t able to have proper data inputs on the edges, this ‘pathology’ of the system alone results in higher Healthcare Insurance premiums. With incentives to achieve better body composition parameters, the change would be tremendous.)

Neutralize the beginning risk with a ‘self organizing (healing)’ system?

The tech capable of measuring accurate body composition data (fat free mass, fat mass, and hydration ICWECW) is currently confined only to hospitals and different medical centers. I am aware that many companies are trying to make this tech accessible, so the question is when not if this tech will ever be at the palms of our hands.

My question :grimacing:; do you think it would it be possible to create a hApp that would incentivize people people to stay healthy with good diet and enough physical activity ? The first thing that came to mind when thinking about this was Steemit (I still don’t understand where the money comes from and started reading the whitepaper). Maybe something similar, where people would be incentivized to keep body composition parameters intact, be rewarded for helping others achieve goals, different peer pressures instead of writing ‘quality’ posts (like on Steemit). Maybe the financial reward would be an agent-centric NON FIAT currency that would be able to handle the complexity of the changing environment. From what I think I understand about agent-centricity so far is that it enables you to manage complexity far more easily (like increasing/decreasing supply based on certain parameters, like in Holo for instance).

Do you think it’s possible to create a system that when for instance, with proper incentive mechanisms (game theory), a hundred people join, their average body composition data improves for lets say (10%). When the next 100 join, the same average can be drawn, and so on, and so on. With a ‘self healing’ system like this (if possible to construct) Insurance Companies would automatically ‘eat up’ the ‘self healing’ system because there would be zero risk in in getting involved. The data proves that the average body composition of the participants always improves, and would therefore know that the costs will be lowered, without them spending a single dime on trying to themselves financially incentivize individuals. Once in one payer would reap the benefits, others would have to do the same thing and try to compete, or else they will be no more.

My thinking is that this would open the doors for payers to slowly increase incentives from their own pockets and significantly change the relationships between the participants of the whole healthcare sector. With prevention standing before curing and management of diseases, USA’s $4 trillion healthcare bill would be significantly lowered (not counting the increased productivity).

So the hApp idea is basically a ‘self-healing’ hApp that would get ‘engulfed’ by the Insurance Industry.

There is much to explore on this topic and would invite others on this forum to join the conversation and share your thoughts. Please feel free to criticize my written thoughts, it is only the wind that makes the pine stronger :grin:.


Boy, do I (does @artbrock) have a resource for you…



YES! Much appreciated.

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The story of Buurtzorg is also an interesting approach:

“Potential cost savings of up to 40% have been calculated.”

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Very interesting…thanks for sharing ! Interesting concepts and profound implications. I will research more about these…

List of some companies in the business of health as an indirect service (namely - access to network of gym) to offer you some inspiration or to come up with business models.

In regards to specifics around your idea - how do we currently do following:

Accurately measure Body Composition Data

Please elaborate on tools currently used, process of how this service is availed basically the process flow - with pictures and descriptions. Such that people with technical background lacking domain knowledge can visualize it. This will help stimulate further discussions.

Also check out this github repository with description stated below:

Empowered (person-centric) health marketplace on holochain

If time permits skim through National Prevention Strategy released in year 2011 can give you some more guidance on Services that can be offered in Preventive Health space.

@burrr please find my brief Introduction and Skills on offer.

FunFact: I did my short training under Preventive and Social Medicine department in Mumbai (2009) and spent a year at Johns Hopkins University (2011 - 2012).


I’m brand new here, trying to get my head around Holochain tech.
We seem to love games and competing more that we fear lingering ill health or an early death.
I’d expect that as soon as we’re more able to measure health in real time, it will become almost gamified and we’ll even compete with each other for say 'slowest biological aging". Expectations of what is possible will rise.
Here in the UK, the COVID19 healthcare motto was basically saying our behaviour can “save the NHS”. i.e. our behaviour has the largest impact on the capacity and costs within the health service. Hopefully the penny will drop… another way to ‘fund’ the NHS is more preventive care…at a personal level. However, it is quite event (to me at least) that preventive care isn’t necessarily what large pharma would encourage. Who wants to encourage cheap vitamin D to lower risks associated with COVID19 or seasonal flu… not pharma.

**I’m interested in self-sovereign identity (SSI)… and self-sovereign clinical data. **
Normally, I’d expect SSI data to be kept at the edges (in the owners device), but with an hApp it would be possible to keep the data distributed and still just as self-sovereign?

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I’m not sure I understand the question well enough to give you a satisfying answer. What do you think is the difference between non-Holochain- and Holochain-based SSI data?

I guess I’m trying to understand who has control and visibility of that data. Normally I’d expect SSI data to be held on a device which is controlled by the owner of the data, but really what is most important is that access to the data itself is controlled by the owner.
The disadvantage of the data being on a single device is it can be lost. So, I thinking that if the data is kept on a distributed store, then it must be safer; if it is also still as private. How do I make it private? Must it be encrypted or is it just not visible to others?
Another point I’m not clear on: In other systems I’d store the SSI data on the phone, but a hash of that data on a BFT distributed ledger. Can I do that on a Holochain based system?

Maybe if I could see that this is similar to some other system x but with some other difference, it would help me visualise what to expect. e.g. “A Holochain app is a distributed app and database that is guaranteed to execute when triggered by certain conditions. The cost of execution is x. Holochain apps are scalable because…”

Have you read any articles or documentation so far? Just trying to get a good sense of your current level of awareness of concepts and general knowledge, not only on Holochain but other distributed systems.

Apart from following ETH over several years (but not very closely as I’m not convinced about scalability) , I’ve seen a Holochain intro video about two years ago (and purchased some tokens on a hunch it might scale), I’ve also been looking at Siacoin and IPFS; I’m most familiar with Obyte and their autonomous agents.

Firstly @luc Luc welome to the forum, consider introducing yourself in our WelcomeThread, being a HOT investor if you need guidance on how you could engage with or support Holo ecosystem then reach out to DaYa @Daya.

It is very interesting to see your first interaction in this forum is under this post. Would it be safe for me to assume Healthcare / Wellness space is where your passion is, in lines with @burrr creator of this post?

That is great - how can we help you in your journey translate interest into action.


For Example:

  1. Create a thread under #projects:100happs section of the forum using Project Template
  2. Take a deep dive into Personalized Health and Care 2020 policy paper to get some inspiration.
  3. Do your own research by documenting current process of Clincal Data Storage in NHS and related challenges. Ethonography is a good technique to search and document your findings - not to mention powerful means for StoryTelling.

Practical Project related Advice:

  • Deep dive into National Prevention Strategy one can come up with many ideas on Health Promotion / Preventive Care services.
  • Consider service model - leveraging country with large demography of English speaking healthcare professionals. (India has 446 search result in WDoMS vs 56 in UK)
  • Focus on movement towards clinical-data sovereignty - going forward - rather than prioritizing mining of legacy health information in disjointed systems.
  • Consider alternative currency such as Health and Wellness Token to offer personal preventive health care.
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I don’t know whether it’s some kind of Privacy Preserving Computation, the data can be used but invisible.

BTW , about how to “Accurately measure Body Composition Data”, I am living Type 1 Diabetes for about 12 years ,now I use some wearable devices like CGM , insulin pump to manage my glucose ,I have lots of data ,but the data all locked by the device manufacturer in their own server or device.

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Out of interest have you investigated any of the open source cgm projects? There’s a few around.

Of course , that’s the foundation of what I rely on .

I have good knowledge of CGMs and pumps protocol

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Oh - perhaps I misunderstood because you said the data was locked by the device manufacturer but maybe that was a comment on the general marketplace as previous to that you said “I have lots of data”.


I have an idea about building some hApps on Holochain, which can store my diabetes management data, like CGM ,insulin ,activities etc……then deploy a web app for visualization(maybe I am wrong for there is no C/S architecture on holo-chain? )

I am looking some help from this community,

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If I’m understanding your question correctly that’s the point of holo.host and any other future services which provide similar C/S connectivity where you’re taking C as “the web/webapps” and S as “the Holochain Free/Libre Open Source scripting language for distributed, decentralised applications”.

IMHO as a long-time avid fan and observer of this project, you have to become very clear as to why building what you want to build can only be built with an hApp. The clearest reason at the moment for this is because it’s still very much in development so if you just want to store cgm data and deploy it on a web app I’m sure there’s ways you could do that and be up and running pretty quickly with other existing technologies.

It’s also about the why - is this just for yourself? To change the world for everyone? Just a subset of everyone? And so on, because something as general and widespread as this will have other people as well as very well funded groups of people with various agendas also building this functionality now or in the future - mostly I find when either someone else with less funding has figured out a lot especially how to profit from it and/or solved some big problem and given it away for free.

My feeling has always been you find the core why and reason then gather together others who are similarly as driven as it will no doubt take a lot to get out of bed every morning to build and maintain something that may seem like a simple vision in your mind right now but until you begin to actualise/execute it you don’t encounter the issues you don’t know about like a few I’ve mentioned above from my own experience in the world of technology and entrepreneurship!

There’s a few groups/topics on the forums you could post to if you want to start something like app ideas etc. plus there’s a discord server you could try posting to, or perhaps someone reads your posts and connects to help.

For me, I’m all about being in complete control so I would be thinking about things like well what happens if network connection is cut to where I’m living - things like creating local networks so in case of any emergency situation local medical people would still have access to the residents medical details. I’m not sure off-hand how that would work if there weren’t any local holo.host hosters or even if there were whether all the data were there (perhaps that would be up to the app itself to define, then there’d be storage issues etc. but maybe not as it’s not movies etc.) anyway I feel I’ve rambled enough… hope that hasn’t confused too much.

Thanks for your replying .

Of course it’s not only for myself , we all know the value from such medical data ,it was discussed deeply in this thread. What we want to do is capture the value .

Autonomy of data is the first step, nobody knows how it will go when users can control the flow of their own data ,of course we can imagine some scenarios, like personal EMR, insurances, DeSci……For an unenclosable holo world ,we need to think more about incentives, but the reality is we cannot completely access our own data so far.

To be honest , I am a beginner in the cryptography world, I invested IOTA, IPFS, and even, Ethereum for my idea, there is no out of box solutions. I have built an app which now have about 20K users who use it to capture their own CGM, insulin data(the app can capture CGM and insulin data from hardwares), then store it in Amazon . The cost is increasing ,and I take all risks about storing the data ,that’s my original intention why I want to look for other solutions. I just want to learn to how to build a demo on such solutions ,this is my way to learn new techs.

Really appreciate your kind suggestions.

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Ah ok, well sounds like perhaps start over at the Holochain Gym to familiarise yourself with building stuff in Holochain?

As for the other stuff, personally whenever I read about incentivising people to do stuff I think that’s a result of the current systems (“current… current see… currency!”) - many are unhealthy because of mental health issues due to the “work” that’s involved in living in the current setup. And then because of what foods are available, and a host of other things. Let’s instead build from a viewpoint of a world where that isn’t the case because people have adopted things like Holochain, hREA, permaculture, and so on because otherwise we are potentially building systems that only go to prop up the current bad systems as opposed to fostering growth of the new systems, i.e. getting to the root of the problems instead of focusing on the outcomes because then you’re just doing never-ending fire-fighting which is what happens in most IT departments and things like healthcare where I see my mother’s leg ulcers being bandaged up weekly instead of when I was round there and they almost disappeared after a diet change but that’s another story…

So for me when designing for the future (in my mind of course ‘currently’!) I like the idea of worrying about the core functionality required, the model itself, then worry about and wrap around any “fashionable functionality” required, so incentive to do X etc. I wrote an article a while back about this when I ended up subcontracting for a digital agency who were totally focused on the user journeys with their post-it-notes on the wall and so on which only go to restrict people to certain paths and I am one of those who always seems to be the “outlier” with a slightly different requirement than they catered for so usually I break their web system within a few minutes. It’s a daily occurrence :wink:

So instead of focusing on the incentivising to do X, building a core resilient base (unenclosable carrier) where we can store data then have default sets of privacy filters in order to share with various other communities (neighbourhoods perhaps?) could provide a good foundation for evolution, and sounds like the core of what you’re working on.

My particular interest in this as I ask myself why I’m sitting here writing another lengthy reply and the words are coming out like I’m channeling some kind of benevolent being sent back from the future to give retrospective bug-fixing advice; or just some crazed newly discovered that I’m autistic & adhd person getting distracted again lol is from my experience navigating a severe Vitamin B12 deficiency, going from bedridden five years ago to climbing mountains, along with my two decades of the deeper discovery of Free/Libre Open Source Software and the rabbit holes of that.

I think there’s an entirely different way we can view all this, and Holochain provides one possible way of actualising this; the fediverse is another and as per the duality of this world, they both have their benefits and disadvantages. If we fracture functionality like we have at the moment then we end up with more issues in the long-run, hence my questioning around your vision of scope and discussions around other agendas.

Where I still have belief and hope is the incentivising should be focused not on the end user of the software but the software creator because they hold the power of ultimate control - see anything by Richard Stallman for further clarification on this! We need to incentivise writing less code for the same requirements which is why I liked my time in the world of Drupal, because you’re using tried-and-tested code instead which people wrote for the purpose of the functionality not some business model like selling the next version because the goals are not aligned, especially when tied to ever-changing monetary systems. However because the current business world profits from selling employee time the incentive to share is not there, so although a decade ago I was part of founding a Drupal distribution for local councils so they could share functionality, it’s taken a decade for it to grow and only recently pick up when the economy had a downturn. Still saves taxpayers millions but could save much more if they weren’t constantly sold the same functionality by different companies and thus creating more costs, inconsistencies and problems.

As humans we previously recognised opportunities to standardise on things would create paradigm shifts - for example train tracks, time zones… I wrote an article on this subject too a while back The End Of The Web CMS Brass Era?. What I liked about Holochain is sharing code is a core requirement of the architecture and hopefully that means the thinking about how to make it sustainable will shift into new and more interesting ways.

As for cryptography, remember that Holochain is just a language where you can if you want create a cryptocurrency, it is not a requirement in order for it to be used. This opens up a much wider range of possibilities which is why I still hang around waffling on like nobody’s got anything else better to do in the world lol.

ATEOTD it’s not necessarily the best technology that wins but the one that markets the best (as in meets the market, the market always decides etc.). The best way I’ve seen of winning that is by providing it for free and that just works because it’s hard to get someone to buy out of that position. It’s currently happening in the ‘Open Source’ world because of fear around support, however this is inherently the problem the Open Source people created themselves when they decided to remove the humanity out of Free Software and label it Open Source in the name of it being a supposedly core requirement in order for adoption by corporations, so it’s kinda fun watching them try a million-and-one ways to change that from within the system which of course will never work but it’s fun watching them try.

Anyway I woke up this morning thinking I needed a therapist but can’t afford one so thanks for unintentionally holding space for me, I’ll leave you with a post I made a while back on my thoughts for the healthcare side of things and how I believe we could evolve that: