Brigitte Piniewski MD: Episode 1117

Transcript

[0:00:40] HA: As Web3 technology reshapes finance, supply chain, social media and other industries, my next guest’s book and message presents a clear case for including healthcare privacy and innovation within this new reality. Welcomed back to the Author Hour Podcast. I’m your host Hussein Al-Baiaty and I’m joined by Brigitte Piniewski, who is here to talk about her new book, Wealthcare: Demystifying Web3 and The Rise of Personal Data Economies. Let’s get into it. Hello everyone and welcome back to the show. I have a very special guest today, Brigitte Piniewski is here. I can’t tell you guys how easily I found myself getting into this book even though it was kind of techy and a little in my head-y but I’m super excited because Brigitte has got a unique message that I think really impacts a lot of us. Brigitte, thank you so much for joining me today on the show, I’m really excited to talk about your book and of course celebrate it as it hits the shelf in the world today. So talk to me Brigitte, how’s it going?

[0:01:50] BP: Well, thanks for having me, great to be here.

[0:01:51] HA: Yeah, absolutely, thank you for sharing your time with me. I really want to get into your book a little bit but before we do that, I love sharing with our audience, just a little bit of a background about you, where your upbringing was, you know? What kind of people influenced you? Perhaps your mom, your father, and uncle, someone distant to get into where you are today in this work around Web3 and this idea of wealth care.

[0:02:16] BP: Well, when I think of the early days, that phrase “it takes a village” really comes to mind. In my case, it took multiple villages. I grew up in a really small town and of course there were no smart phones back then, we didn’t even have a high school to graduate from. We had to bus ourselves over on school bus to the next town for an hour and the next town had to make sure that we graduated from high school. And what was interesting, I recall the teachers asking me, you know, which universities I had applied to and it struck me as strained. “I have to apply to a university? Don’t you just go the way you go to school?” and they would chuckle but they really picked up on the fact that a lot of kids don’t really have that background or the family situation that’s going to allow them to understand the opportunities that might be available to them. And so they made sure that you know, we apply to a university and eventually, I got in and I studied. I went through medicine and began delivering babies for a living and I got the impression that we would be doing really important work. You know, if we just get those nine months right and have a nice safe delivery, we could launch our babies off to a hundred years of good health but what I found in relatively short order was that that was very, very wrong.

[0:03:44] HA: Yeah, what a fascinating journey, and just to think, when you were young, you didn’t even understand the idea of how to apply for university and honestly, where I come from, in the Middle East like going to a university is a huge deal and of course, you got to apply in all those things but when we came here that’s like what my parents thought too, that you just kind of go to University like you sign up for high school, you know what I mean? But obviously, it’s not that and you know, kudos to those amazing teachers around you that supported you and aligned you to get into university, which obviously opened up doors and unique ones at that. So what inspired you to write this book specifically about this topic? Because obviously, we’re going to get into it a little bit more but who are you trying to reach with your message specifically?

[0:04:28] BP: With this tale telling in the topic, mostly what motivated me was as I said, I began thinking that these children would have a hundred years of good health and what happened relatively quickly over in just a few years, it started to become very apparent that we were working with incredibly faulty intelligence and intelligence that, you know, we recognize today in terms of our population health is not anything to be very proud of in terms of what could be achieved and so I thought we need to move beyond our current models of randomized control trials. We have the technology to know so much more today. How do we get this done? Because it was really the children that made it clear that within just four years of you know, the sensitive time such as puberty, you could unknowingly reduce your opportunities in the future through no fault of your own, in ways that were irreversible. And so that moved me away from seeing children one-on-one and I started acting as chief medical officer for one of the largest reference labs in the Pacific Northwest. We collaborated with Intel, Qualcomm, Academia, Technology companies to use technology to enable the smart household, the smart homes so that no one would be moving forward in their health not knowing those things that really mattered and that work moved me into advising for investors. As more and more technology companies were showing us solutions that involve blockchain and Web3, it made it clear that this is something I needed to learn about and even the investors around me, they needed an education because this was beyond what we had trained in or used during our time at work and so I setup investor education programs and that got me really excited about Web3. Realizing that this is finally an opportunity to transform health in ways we have been talking about for decades but have never really achieved. But of course, doing this, it’s going to take a village as well. A lot of diverse stakeholders have to come to the table, we need a common language and a common vision and that’s what made me motivated to write this book and get started with this conversation.

[0:06:58] HA: That’s so powerful, thank you for bringing that all the way home. Like I’m very interested in what all you have to say about Web3 but for those of us that don’t understand Web3 fully or even remotely, can you kind of talk a little bit about what Web3 is or that technology and then what issues in our current healthcare system do we believe Web3 can help address?

[0:07:24] BP: So I guess the easy way to think of Web3 is to walk us back to Web1. So Web1 is that first model of the Internet that allowed us to basically share information. So think of that as seeing an encyclopedia online or on a screen instead of in a book and Web1 model was provided to you know, flatten access to information. So that everybody anywhere, regardless of whether you have that encyclopedia at home or not could get access to what was on those pages and so the model at that time was really an opportunity for everyone to participate in the knowledge that was available but what happened with Web2 and we can think of Web2 as the time at which we started to transact. So buy things online, create web spaces and companies online, what happened there very quickly, it was large companies that could take advantage of Web2 technologies and commerce in ways that you and I, the average individual could not and so what we saw was a growing asymmetry, where large financial institutions and companies were able to harness most of the power of Web2. And what we’re looking at Web3 is an opportunity to take back that ethos of Web1 to say, “We would like as individuals to participate and manage our digital footprint and be able to decide ourselves where and when our individual data streams are being used for what purposes” and the beauty of what Web3 can do for healthcare is take us from where we are today. As I mentioned, our knowledge and our intelligence is incredibly faulty. We’ve made so many mistakes, we didn’t even get the basics right when it comes to things like calories, nutrition, you know, the war on fat should have been the war on trans fats and so fundamentally, there’s lots of opportunity in the current system to get things wrong. But what we’re talking about with a Web3 future is this opportunity to have individuals safely and effectively collaborate with their own true health experiences at scale and this is really important because as we talked about earlier, the children can have you know, their futures rearranged in the space of four years and every four years, we have another cohort of kids moving through puberty and we’re not able at all to understand how to protect them against this today. I think the other thing that’s important is, healthcare without Web3, we can only offer average. Today, every time we manage an individual, we’re actually managing a population. You walk into the clinic, we see a population, which means we can only give you average but at the end of the day, no one wants average. You know, if your wife was diagnosed with breast cancer tomorrow, she doesn’t want average. You don’t want her to have average, you would like her to have an optimal health outcome but in order for that to happen, we would need to have access to the plethora of individuals that have had breast cancer previously and what were the details and the co-occurrences that collaborated in ways that made it possible for some folks to have an outlier outcome versus those that did not. And so that is offering us an opportunity to finally get to the place where no health experience is wasted. It does evaporate, we have a place to carefully and effectively store it for the benefit of ourselves as well as the benefit of each other.

[0:11:11] HA: Yeah, it’s so powerful. I mean, you put it so eloquently, obviously, this is work you’re very passionate about and where you see the cross section between, you know, health, wellness, of course but also the future and what technology is able to do for us and how we can use these new tools or tools in general but this idea that we can own our sort of fingerprint back. Whatever decision we make going forward, it helps us all collectively and so powerful. So in the text, you mentioned the concept of accidental wellness and how it’s a thing of the past. Can you elaborate on what you mean by this and how Web3 technology can help prevent it?

[0:11:53] BP: Yeah and that relates back to this idea that I started with in medicine, thinking that we were launching our babies off to a hundred years of good health. Remember when we grew up, most of our parents didn’t have to know how to feed us. They didn’t have to know how to move us. They didn’t even manage our sleep because we didn’t have the access to screens and technology that’s available today. What has happened since that time is the defaults have all shifted such that items that don’t resemble real food are you know, cheaper, more convenient and easily consumed, such that passively, all of the future cohorts will never be accidentally well again. We would need to engineer in real food. We need to engineer in activity as we move away from you know, activity-based employment to knowledge-based employment. Now, it’s possible using a screen to keep the brain so busy that we can sit for hours at a time and employers will have a sit for eight or more hours at a time and this is something that our biology has no knowledge of. You know, our biology has no idea that we are carrying a smart phone, that has no idea that you know, we can control the photo period, we can make it light and day at any time according to our own choices. And so we’re working with a biology, which has an operating system that expects the defaults that were available when people used to be accidentally well. Those conditions no longer exist on the ground and therefore, we need to figure out how best to enable an environment that allows future generations to be actively well.

[0:13:40] HA: That is so powerful and just to think about you know, for me just sitting here listening to you, just think about how fast this has happened. Like I mean to me, I feel like, in 2004, maybe, 2003, 2004, when I had my little Nokia, little, you know, snake phone where I’m just playing games on it to where, you know, here I am talking to someone that’s quite literally like engineering the future and what that looks like for humanity. And the thing that we’re talking about is that same thing that’s evolved, of course, is consumed us in such a way is completely and utterly changed how we operate in the world and to think back to our biology, our humanity and the structures that make us, what we are and who we are, are now so intertwined with this screen. You know, I’m just thinking, I’m like, trying to take it all in. To be honest with you, like, I just kind of zoomed out and zoomed back in to our conversation because it is profound to me how fast this happened and what is that like for you as a person that’s heavily involved in this work? How do you feel about the speed? I feel like we went through a time warp, personally.

[0:14:56] BP: Totally but I think that what we’re left with is the vast majority of the population seems to feel as if healthcare is keeping up with the times and I think that that’s a thought you need to erase from your mind immediately. We have not kept up with the times. We offer the right drug for the right person at the right time, that’s going to give you average, that’s it. There is nothing beyond that that we can guarantee or achieve with the current model. We need to get to this place where we can, you know, safely and effectively pull our experiences and by the way, at the same time, create an inclusive business model that will actually make it happen. I mean, up until recently, we’ve been asking people to use technology to track their steps or monitor their nutrition because it was good for their health. That’s way too low a value proposition to have many people participate indefinitely. But with the use of Web3 and these novel technologies, we can tokenize behavior and your health data can become a digital asset that you manage and control that becomes an economic asset for you as well and so finally, we can solve some of the big problems in healthcare such as the quality and quantity of data as we purposefully put in our steps alongside or lab values, so that at the end of the day, our lab values will be worth more. So for instance, you know, an HDL, a lipid panel without understanding what type of activity was associated with that lipid panel is worth less on the open market than one that is and so I think there’s an opportunity here using Web3 and the book tried to make sure that we’re giving concrete examples about this. We offer a bit of a primer with new terms so that the novice reader doesn’t get lost. With these concrete examples go through and touch on things like blockchains, tokens, NFTs, DOWs, Metaverse, so they can begin to take shape and make some sort of sense and then we offer both current and future scenarios as well as a bit of a framework using a three-technology zone model that I think is very high level but that’s where we need to start so that we can have a diverse group of readers begin to be able to have these conversations, no longer shying away from them. Some people somehow feel like this is, blockchain is too hard and hopefully, this book will make it clear that it is definitely not too hard and we absolutely can all participate. At the end of the day actually it’s inevitable. I mean, which group wants to continue just accepting average? We all want optimal and more and more, there are so many intelligent folks on the planet that this will happen. It’s a matter of where will it happen first.

[0:17:57] HA: Yeah, that’s so powerful and you sort of wave in a flag amongst, I’m sure many others about the opportunities. It’s gratifying because you are focusing on energy instead of like fearing what all these potential new technologies can offer and filling them with positive possibilities, opportunities, things that can actually help us eliminate some challenges that we’ve had and that have held us back. Can you speak about the importance of something really big, the importance of privacy in healthcare and how Web3 technology can enhance it? Can you elaborate on that a little bit?

[0:18:32] BP: Yeah and so in healthcare, I think general population seems to feel that the HIPAA regulations are what protects our privacy, so every time we see a clinician we’re asked to sign a slip that says that we’re our visits is going to be HIPAA protected. The issue there though is that the health systems today are at liberty to remove identifiers from our visit and then use that data for research and other purposes at their discretion. So what Web3 offers however is an opportunity to insure that your health data on your own personal, you know, longitudinal record is managed in such a way that it has a built in audit control. You can authorize segments of your data to be used for specific purposes at specific times for specific reasons and all of that using the technology is easily auditable and this is something that hasn’t been possible prior to Web3 approaches. Before it would have been impossible to ask people to manage and control their own records. It is just too much of a technology ask but now with the use of a Web3 base technologies, I always think of them as kind of mathematically fortifying the Internet where the Internet can basically provide a longitudinal health record that is, you know, something that the individual now owns and manages without a lot of tech savviness required on their part at all.

[0:20:09] HA: Yeah, I love that. In a way, it is sort of like my health dashboard and I can kind of analyze and look at past, you know, where I am at today and by this idea and forgive me if I get it wrong but I am just kind of expressing what you are telling me in the sense of like tokenizing my health, those steps, those workouts, the boxing class, whatever it is that I am building better heath improves and adds value to this tokenized version of myself, if you will, or can you explain that a little bit further on the idea of tokenizing and kind of where, you know, transactions in this cross-section between those transactions and healthcare.

[0:20:49] BP: Sure. So I think what you’re describing has been kind of the typical model where we’ve been using technology to reflect back at you your own sleep for instance and you’ll have the pleasure of seeing your exact, you know, one-person sleep every day and it’s yours but in Web3 based phenomena, you don’t live in isolation. You kind of live with a crowd in your pocket, where you can have an opportunity to say, “Hey, I am not sleeping well.” “I can’t figure this out as an N of one, let me tap into my community to determine who’s sleeping well regardless of where they are in the planet and what are the combinations of co-occurrences they’re using that kind of match this sorts of things that I would be willing to do” and so we are launched right away into a high fidelity understanding of not only are you sleeping, you know, poorly or not but why it is that that’s the case. It’s informed not by, you know, years of the sleep lab and randomized control trials but it is informed by individuals that are part of the free living system providing you access to the ebb and flow of sleep as it happens on the planet.

[0:22:09] HA: Crazy because I just took the dashboard and made it literally three dimensional, right? Instead of just looking at it on a flat surface, now I get to see so many different variations. That is so powerful and thanks for contextualizing that for me.

[0:22:25] BP: Think of it as almost end dimensional. Right now, we don’t have the opportunity to query. We can’t even query really important things because we haven’t had a way of safely and effectively maintaining our health data. We don’t have the opportunity to say, you know, assume somebody suggested to you, you needed back surgery. You went, “Whoa, wait a minute, back surgery, what’s the outcome for me being in my mid-20s doing this now?” It would be ideal for you to tap into the hundreds of folks that have gone before have high definition understanding of what their outcomes were like and why and whether this is the option that you would like to pursue at this moment. We keep thinking of health as an isolated event or an individual event. It won’t be good, we’ll never get to our best health outcomes unless we do it together, unless it becomes a crowd-based event. But we need to have the technology to allow us to safely and effectively share our health experiences.

[0:23:27] HA: That’s so powerful and really reframing the way we think about our healthcare, just personal healthcare is actually connected to almost everyone and the more you know, not just from one specific doctor or a few doctors, really hundreds if not thousands helped if not millions of people around the world that are experiencing something similar that kind of match up to who you are, how you are and identifies a series of ways to look if there’s solutions perhaps. That’s so powerful and thank you for really, I guess, you took me from an iPhone screen to like a big television screen as to how to look at this, that’s so powerful. Thank you for clarifying that, yeah.

[0:24:10] BP: Yeah, I would just add that, you know, this sort of massive equalizer effect. So what we’re talking about is a fire hose access to the truth, you know, fire house access to on the ground truths and if you want to understand truth, you really need to have the expression of both good health and bad health and obscure health and you know, we all as individuals are remarkably unique and we approach the way we live our lives in very different ways. If there was a way to effectively digitize that, make it explorable and reap the benefits financially for doing so, we would have access to a level of truth that doesn’t exist today and a level of knowledge that we don’t have access to today. So I’m reminded always that more wealth or I guess the best way of putting this is new knowledge is the foundation of new wealth and so collectively together, we can build this fire hose of knowledge that would then be the basis for this next leap of wealth creation. Remember the Internet was a huge leap in wealth creation as more and more commerce went online. Now, we have an opportunity to you know, put the amount of transactions you and I engage in, put that on steroids.

[0:25:37] HA: That sounds so powerful, which leads us of course to such a great title to the book, Wealthcare. This idea of looking into the future and seeing all the possibilities that are for me, for others around me and how we can collectively really come out on top, get healthier, get a better perspective on who we are and how we operate and sort of like really lean into the fact that we are unique and that we are though we’re unique that is a huge sign of our unity, right? Is that we are unique individuals that go through things differently, however, understanding that vast world of knowledge, there are patterns and there are patterns and clues and ways where you can understand yourself that much better. I love not only books like that but people like you who crush all these wisdom together because this is years in the making and bring forth a book to kind of help us understand in the next wave of the world. I genuinely appreciated today, it’s been just an honor sitting with you and getting to know you and learn so much about your work. I’m really excited for this book. Before I let you go, I do want to know how do you want that reader to feel after putting down your book, having finished it, read it thoroughly, you know, enjoyed it, got through it, what do you want them to feel when they walk away from that book?

[0:27:01] BP: I really like them to come away with this strong conviction that Web3 is not just crypto, that it’s really an amazing collaboration highway that you know, we the people, we can coproduce the high fidelity intelligence that matters to us, to individuals as well as each other and that, you know, healthcare has not kept up with the times and that’s an idea we want to erase from our minds that we no business knowing as little as we know today. That average is not enough, it never was but now, we finally have an opportunity to offer optimal to ourselves and each other and that that’s something we’re all going to have to roll up our sleeves for and participate in and as you say, the world is changing quickly and we don’t want to be left behind. We want to have a world where we have agency over our digital footprint and be in a place where we have an opportunity not just to reach our full health but our full wealth potential by doing so. You know, just one last thought. I was thinking about I mentioned transactions and I’m thinking while we’re having this podcast, you know, today we might have had a handful of transactions. You might have bought some coffee, maybe some groceries, purchase something online but what we really see this Web3 model moving forward enabling for us is kind of a quiet hum in the background. Where a podcast like this you and I would have both had a few hundred transactions happen with our digital footprint in the background without us having to be involved but yet we could be absolutely convinced and confident that they’re happening according to our preferences and this will give us an opportunity to have that value tracked and perhaps overtime, be sufficient in terms of value creation that we can start to talk about. Even you know, audacious dreams like universal basic income because certainly the industry has proven to us that our health data is very valuable. There are billions in terms of financial transactions going on with health data today, they just don’t include any of us and so I think that is something that can comfort us to know that our health data is very valuable and at the same time, we now have the technology to participate in making that available safely and effectively to ourselves and each other.

[0:29:35] HA: Yeah and of course, take back some of the piece of the pie or get more of the piece of the pie because it feels like at this point, I have been putting into the piece of the pie, right? When I think about healthcare, it doesn’t seem like it wants me to do anything with not only data but just like the actual cost of physical healthcare. So again, just bringing all that idea, this idea of let’s bring – reign our powers back. Allow us to be in control, be educated in that way and know the power within how much our actions, our knowledge, our wisdom is collectively worth and how valuable it is to so many industries that earn money from it on a daily basis in the background without us even knowing. I am so thankful for your conversation today and your time because I hope that our audience learned a lot because I am still learning. I feel like I am still processing this conversation and things are hitting me slowly. So thank you so much for that. Again, I have learned so much, your stories and your experiences are obviously, you know, they are going to be challenging the world we see in it of itself and I commend your work and I am just honored today having learned from you today.

[0:30:52] BP: Great. Well, pleasure speaking with you Hussein. I think we think of this as expanding the workforce, you know, industries to operate in isolation and now we’re expanding the workforce to include all of us.

[0:31:03] HA: So powerful. The book is called, Wealthcare: Demystifying Web3 and The Rise of Personal Data Economies. Besides checking out the book, where can people find you?

[0:31:15] BP: So you can find me on LinkedIn at Brigitte Piniewski. I am also on Twitter there, the handle is Wealth Care Web3.

[0:31:23] HA: Beautiful. Well, thank you so much again Brigitte. I really appreciate your time today.

[0:31:27] BP: Thank you.

[0:31:29] HA: Thanks for joining us for this episode of Author Hour. You can find, Wealthcare: Demystifying Web3 and The Rise of Personal Data Economies, right now on Amazon. For more Author Hour episodes, subscribe to this podcast on your favorite subscription service. Thanks for joining us, we’ll see you next time. Same place, different author.