Medicalchain Whitepaper en

Whitepaper 2.
0
Contents
1.0 Abstract 4
2.0 Letter from the CEO

Dr Abdullah Albeyatti 5
3.0 Executive Summary 6
4.0 Introduction to the Healthcare of Today 7
5.0 Medicalchain Solutions: 12

The Healthcare of Tomorrow
6.0 Technical Explanation 13
7.0 A Better System for Care 20
8.0 Token Utilities 26
9.0 Cost Impact Analysis 29
10.0 Token Sale 31
11.0 Timelines 32
Copyright © 2018 Medicalchain. All rights reserved

Disclaimer
PLEASE READ THIS DISCLAIMER SECTION CAREFULLY.

IF YOU ARE IN ANY DOUBT AS TO THE ACTION YOU
SHOULD TAKE, YOU SHOULD CONSULT YOUR LEGAL,
FINANCIAL, TAX, OR OTHER PROFESSIONAL ADVISOR(S).
The information set forth below may not be exhaustive and does
not imply any elements of a contractual relationship. While we
make every effort to ensure that any material in this whitepaper
is accurate and up to date, such as products, services, technical
architecture, token distribution, company timelines - such
material could be subject to change without notice and in no way
constitutes a binding agreement or the provision of professional
advice.
Medicalchain does not guarantee, and accepts no legal liability

whatsoever arising from or connected to, the accuracy, reliability,
currency, or completeness of any material contained in this
whitepaper. Potential MedToken holders should seek appropriate
independent professional advice prior to relying on, or entering
into any commitment or transaction based on, material published
in this whitepaper, which material is purely published for reference
purposes alone. MedTokens will not be intended to constitute
securities in any jurisdiction.
This whitepaper does not constitute a prospectus or offer

document of any sort and is not intended to constitute an offer
of securities or a solicitation for investment in securities in any
jurisdiction. Medicalchain does not provide any opinion on any
advice to purchase, sell, or otherwise transact with MedTokens
and the fact of presentation of this whitepaper shall not form
the basis of, or be relied upon in connection with, any contract
or investment decision. No person is bound to enter into any
contract or binding legal commitment in relation to the sale and
purchase of MedTokens, and no cryptocurrency or other form of
payment is to be accepted on the basis of this whitepaper.
Copyright © 2018 Medicalchain. All rights reserved 3

1.0 Abstract
Thank you for taking the time to read the Medicalchain Whitepaper.
This paper is the result of collaboration between doctors, allied
health professionals, blockchain specialists, academics and
business advisors.
Medicalchain uses blockchain technology to create a

user-focused electronic health record and maintain
a single true version of the user’s data.
Medicalchain enables users to give healthcare professionals

access to their health data and records interactions with
this data in an auditable, transparent and secure way on
Medicalchain’s distributed ledger.
Moreover, Medicalchain is a platform for others to build

applications on top of to complement and improve the user
experience. Users will be able to leverage their medical data to
power a plethora of applications and services.
Medicalchain White Paper 2.0 will outline the vision of

Medicalchain, the current issues in healthcare, as well as give
a brief summary of the blockchain technology used and how
Medicalchain is utilising it to address specific issues to make
healthcare better for users.

2.0 Letter from the CEO
Dear Reader,
Thank you for taking the time to research Medicalchain and read our Whitepaper.
This has been a culmination of hard work and dedication from all of the team here
at Medicalchain and we would like to proudly share our vision with you all.
As a medical doctor I have worked long hours while managing expectations and
multitasking to satisfy tight deadlines. Despite such experiences nothing had
prepared me for the challenge of growing Medicalchain from the ground up. I could
not have done this without the support of my Co-Founder and COO, Mo Tayeb.
Working side by side, we have selected the finest individuals to join our team to
become, what we now know as Medicalchain.
Our team is a unique one: a perfect blend of clinicians, engineers, developers and
visionaries from the world over. We have nine different nationalities representing us,
each bringing with them their own personal views and experiences of healthcare in
their respective countries.
The Medicalchain team have the drive and commitment to improve healthcare for
those who need it most: the patients.
Our mission is to improve care for people by placing

the patient at the center of the digital transformation
of healthcare.
We enact this mission by empowering patients with the tools to engage in a more
comprehensive healthcare experience, such as accessing their own records on their
mobile device, or conducting a consultation via webcam with a doctor anywhere in
the world, we can improve people’s lives.
It has been an amazing journey so far and we are fortunate to have such strong
support from the community who has helped to drive us onwards in developing this
platform. We are only at the beginning and I truly believe the most exciting times lie
ahead. Please continue to follow and support us here at Medicalchain so that we
can truly make a difference in the healthcare industry.
Best wishes,
Dr. Abdullah Albeyatti

Medicalchain CEO and Co-Founder

3.0 Executive summary
Medicalchain is a decentralized
platform that enables secure, fast
and transparent exchange and
usage of medical data. We use
blockchain technology to create
a user-focused electronic health
record and maintain a single true
version of the user’s data.
Medicalchain will enable users to give conditional
access to different healthcare agents such as
doctors, hospitals, laboratories, pharmacists and
The telemedicine application will enable users to
insurers to interact as they see fit.
consult a real doctor remotely (for example, on their
phone) for a small fee payable directly to the doctor.
Each interaction with their medical data is auditable,
transparent and secure, and will be recorded as a
With the marketplace, Medicalchain will enable users
transaction on Medicalchain’s distributed ledger.
entirely at their will, to negotiate commercial terms
We protect patients’ privacy in the process and at
with third parties for alternative uses or applications
all times. Medicalchain is built on the permission-
of their health data as for instance would be the case
based Hyperledger Fabric architecture which allows
with sharing this with researchers. It is intended that
varying access levels; users control who can view
Medicalchain and others will contribute many more
their records, how much they see and for what length
applications to the platform - helping bring value to
of time.
all stakeholders.
By empowering users we can build the future of
Medicalchain’s platform will be powered by
healthcare together. Medicalchain will be a platform
“MedTokens”. We are issuing 500 million tokens,
for other digital health applications to develop on;
which will be distributed at a rate up to 1 token to
users will be able to sign for these applications and
$0.25 USD in ETH and/or BTC. These will be offered
services which are powered by their health data and
in a crowd selling process commonly known as an
secured by smart contracts. Medicalchain is currently
“ICO” or “Initial Coin Offering.”
developing two applications to work alongside
the platform: a doctor-to-patient telemedicine
The contribution period will follow our presale and
application and a health data marketplace.
begin on February 1st 2018. More details on our ICO
can be found below on page 31.

4.0 Introduction to the
Healthcare of Today
4.1 Expectations of Healthcare Users
In today’s world, users expect an instantaneous and seamless

flow of data. Many industries have adopted, or are beginning
to adopt necessary technologies to guarantee their users’
expectation for instant information. Unfortunately, the healthcare
industry has lagged behind. Legacy systems are burdensome,
slow, oftentimes vulnerable and have little role for the patient.
4.2 Fragmented Health Services
Health data contained in legacy systems is siloed and difficult to

share with others because of varying formats and standards. In
short, the current healthcare data landscape is fragmented and
ill-suited to the instantaneous needs of modern users. As a result
of this, stakeholders are incentivized to keep their own records,
and no singular version of the truth exists.
4.3 Lack of patient centricity (passive user)
The relationship between healthcare professionals and patients

has long been a paternalistic one. In recent times however, there
has been a significant shift of authority.
Medicine is being democratised and

patients are more empowered.
It is now considered reasonable to seek a second opinion and
patients are expected to contribute to decisions made about
their treatment choices.
Even in single-payer system like the UK’s National Health Service

(NHS), patients have the right to choose where and when they
receive their care. Thus, with patient mobility comes the need for
information mobility. In order to provide the best care patients
not only can, but must have control over their own data.

4.0 Introduction to the Healthcare of Today
4.4 Ill-informed Clinical Decision Making

(data driven decision making
risk of fatalities)
Clinicians rely upon investigations and tests to make

informed decisions about a patient’s diagnosis
and possible treatment plan.
Traditionally, an investigation or Death in the United States
test should only be requested Johns Hopkins University researches estimate that medical
and arranged if this is going error is now the third leading cuase of death. Here’s a ranking
to lead to a different possible by yearly deaths.
diagnosis or alternative treatment Heart Disease 614.348
plan. Unfortunately, even when
the results of an investigation Cancer 591,699
or test have returned, these are Medical Error 251,454
rarely shared widely with all of
the health professionals involved Respiratory Disease 147,101
in the patient’s care and are
Accidents 136,053
normally isolated, or siloed, at the
institution which requested them Stroke 133,103
originally.
Alzheimer's 93,541
The patient’s quality of care Diabetes 76,488
suffers as a result of this. Other
institutions are not aware of a Flu/pneumonia 55,227
patient’s complete history and in
Kidney Disease 48,146
turn this could lead to incorrect
decision making, delays, and Suicide 42,773
unnecessary costs for the patient
Source: National Center for Health Statistics, BMJ
or health institution. In the worst
case, these medical errors can be fatal. Research at Figure 1: Table showing yearly death rate as per
the American John Hopkins Hospital by Makary et John Hopkins University research in 2016
al, 2016 concluded that medical errors are the third
leading cause of death in the United States and that
“most errors represent systemic problems, including
poorly coordinated care.”

4.5 Security Risks to Patient Data In spring of 2017, over a dozen NHS Hospitals
and GP surgeries in the United Kingdom and over
At present, electronic health records (EHR) are 300,000 machines in 150 countries were the target
stored on centralized databases in which medical of the WannaCry attack. This attack led to days of
data remains largely non-portable. Centralization in- uncertainty for millions of patients, cancelled ap-
creases the security risk footprint, and requires trust pointments and caused the NHS to come to a grind-
in a single authority. Moreover, centralized data- ing halt. WannaCry was ransomware with shadowy
bases cannot ensure security and data integrity, re- origins which highlighted the vulnerability of our
gardless of de-identification and controlled access healthcare systems to potential threats and a sober
requirements. Centralized health databases are le- warning about the inadequacies of the current infra-
gally a requirement and necessity in most countries structure. WannaCry is just the latest in a long list of
worldwide and therefore require an added layer of countless accounts of cybercrime.
technology to improve their portability and security.
Privacy is often compromised from within organi-
As cybercrime around the world is on the rise, health- zations. The medical records of 26 million patients
care systems also become targets and are no excep- were exposed because the systems being used by
tion as shown by recent ransomware hacking. The thousands of GPs were not secure. Hundreds of
technology that powers these systems is under at- thousands of strangers could access the records
tack on an unprecedented scale. In fact, the health- held at 2,700 practices and patients would have no
care industry has more data breaches than any oth- knowledge of their privacy being breached.
er sector and medical records are being stolen and
sold on darknet markets where they are 10 times Many have tried to overcome this issue, and it is high
more valuable than credit card data. on the agenda of many governments and a source of
frustration for both doctors and patients. A signifi-
cant component of the challenge centers on data se-
“Your medical information is worth curity. Security is paramount because medical data
10 times more than your credit card is incredibly sensitive.
number on the black market.”
Figure 2: Technology News, Reuters, September 24th 2014

4.6 Lack of Transparency 4.62 Insurance Fraud
4.61 Increasing Costs Whether you have employer-sponsored health

insurance or you purchase your own insurance
For patients and professionals, the present system policy, health care fraud inevitably translates into
is incredibly slow, inflexible and woefully opaque. higher premiums and out-of-pocket expenses
These problems are equally visible throughout the for consumers, as well as reduced benefits and
claims process. When a patient needs services coverage. For employers this increases the cost of
(from a provider such as a general practice, a providing insurance benefits to employees, which
pharmacy or nursing home), health plans are used then increases the overall cost of doing business.
to determine how much of the cost they will pay. Moreover, the reality for many patients is that the
In order to determine this cost, the health plan increased expense as a result of fraud, could mean
must validate services received from the provider the difference between affording health insurance
against the agreement the patient and health or not.
plan have, and then share their findings with the
provider. This only occurs if the provider is “in- Fraud by design dictates that false information
network” with a health plan. For a provider to be be represented as fact. A common healthcare
considered in-network, a complex agreement needs fraud involves perpetrators who take advantage of
to be negotiated which adds a significant expense patients, by entering into their EHR false diagnoses
to the provider’s administration costs. One part of of conditions they do not have, or of exaggerating
these costs are Billing and Insurance Related (BIR) conditions they actually do have. This is done so
costs which include activities such as maintaining that fraudulent insurance claims can be submitted
benefits databases and keeping records of services for payment.
delivered. BIR costs are projected to reach $315
billion dollars by 2018 and take up to 3.8 hours for “The total cost of insurance fraud is
the average physician to navigate.
estimated to be more than $40 billion
On average, this whole process takes between one per year.”
to two weeks if done electronically and takes three
to five weeks by paper. Moreover, this process
is rife with places for miscommunication and FBI.gov
misunderstanding to occur. For care to actually
take place, multiple people need to check multiple Unless this discovery is made early on, these false or
archaic agreements against multiple records. The exaggerated diagnoses become part of the patient’s
result is an inefficient and opaque process that documented medical history within the health
leaves stakeholders and ultimately patients feeling insurer’s records if not in other databases as well.
confused and skeptical.

4.63 Record Tampering Examples include Telecardiology, Teleradiology,

Telepathology, Telepsychiatry, Teledermatology and
others. Clearly there is a large market, and benefits
Medical records are to be considered not only as
include:
medical documents, but also as legal documents.
To pass off a rewritten record as contemporaneous
is a criminal offence and any retrospective changes
• Improved quality of care
have to be clearly marked, dated and signed, and the
• More time for doctor-patient interactions
reason for such changes clearly documented.
• Improved access to consultation
• Reduced costs
Altering existing medical records, removing
The market is currently dominated by North America
records, or adding false records puts a healthcare
and Europe though highest growth is expected in
professional at risk of medicolegal repercussions.
India, China, and Japan in the next few years.
Disclosure of authentic and original clinical notes is
essential when a claim is brought up, and failure to
do so can make a claim indefensible. In 2017, the global telemedicine
market was estimated to be worth
4.7 Telemedicine Market $23.8 Billion and is projected to
Healthcare costs are on the rise around the globe exceed $55 Billion by 2021.
as societies struggle to deal with aging populations
and rising chronic disease burden. Current models There are several challenges to full implementation:
of care delivery, particularly in places like the US
and UK, are unsustainable. One trend combating Unfortunately, most modern Telehealth systems are
increased costs has been the rise in digital health not integrated with the core financial and clinical
services. The value of the global digital health systems used by healthcare organizations. Data
market was valued at $80 billion U.S dollars in 2015 remains within the Telehealth application and
and is expected to increase to over $200 billion by requires manual entry later into health records.
2020 with a CAGR of 21%.
Digitisation promises much potential, but adding an
Digital health solutions such as Telemedicine will additional silo without incorporating the information
be critical for driving efficiency and reducing costs. does not add value. In order to succeed, systems,
The scope of Telemedicine covers referrals, second devices, and data need to be seamlessly integrated.
opinions, education, follow-up care, monitoring, Privacy and security law issues must consider the
diagnostics and treatments across numerous management of data in non-traditional formats (for
specialities. example, audio and/or video) and the sharing of
data responsibilities encountered.
To minimize the privacy/security risk of Telehealth

encounters, providers require reliable methods for
verifying and authenticating the identities of the
patient and practitioners. Blockchain solutions are a
great tool to overcome these issues.

5.0 Medicalchain Solutions:
The Healthcare of Tomorrow
5.1 Medicalchain Dual 5.3 Ethereum and Smart 5.4 Medicalchain as a

Blockchain Contracts Healthcare Platform
Medicalchain is built using a Ethereum is a digital platform Using blockchain technology,

dual blockchain structure. The where thousands of powerful smart contracts, and our crypto-
first blockchain controls access computers around the world work currency, Medicalchain provides
to health records and is built us- in harmony to host the Ethereum the infrastructure for digital health
ing Hyperledger Fabric. The sec- network. Ethereum’s blockchain applications and services to be
ond blockchain is powered by an represents all accounts and built. These applications and ser-
ERC20 token on Ethereum and transactions made by its users. vices will be seamlessly powered
underlies all the applications and Every time you send an Ether, the by user’s health data. Anyone
services for our platform. currency of Ethereum, to anoth- will be able to develop on Medi-
er user, those computers act as calchain’s platform and we hope
5.2 Hyperledger Fabric accountants by verifying the va- to foster a thriving ecosystem to
lidity of the transaction. Once the provide value, reduce costs, and
verification is approved by those ultimately improve people’s lives.
The Hyperledger blockchain net-
“accountants” the money is then
work is permission based and
transferred to the other user, mak- 5.5 Identity management
requires users to sign up to use
ing transfers secure, transparent
it. Permissioning on the network
and conflict-free.
using Civic
is controlled using Hyperledg-
er modeling and access control Identity fraud is a
Smart Contracts are code held
languages. Hyperledger Fabric is
a platform for distributed ledger
and executed on the Ethereum massive problem in
blockchain. Anything that can
solutions underpinned by a mod-
be programmed normally can be the world.
ular architecture delivering high
programmed within the Ethereum
degrees of confidentiality, resil- Hackers steal identities and im-
network.
ience, flexibility and scalability. personate users to incur huge
Processes that normally require a costs on both users and busi-
Medical information is often high- nesses. To combat this, Medical-
professional or notary can be au-
ly sensitive, in both a social and chain has partnered with Civic
tomated and validated by smart
legal sense, so a closed block- and will use Civic’s Secure Identi-
contracts in a wholly transparent
chain such as Hyperledger Fabric ty Platform to easily and securely
and secure way. For example, the
helps to retain the necessary pri- manage the identities of users in
average physician spends 3.8
vacy required for such an applica- a decentralized way. Civic’s de-
hours weekly on billing and insur-
tion. centralized architecture with the
ance related activity. Imagine the
cost savings if these processes blockchain and biometrics on the
Hyperledger Fabric is a better mobile device provides multi-fac-
were conducted on smart con-
solution for managing access to tor authentication without a user-
tracts and validated by the Ethe-
health records, as it accommo- name, password, third-party au-
reum network.
dates for multiple layers of per- thenticator, or physical hardware
mission, meaning the owner of token, ensuring user’s privacy in
a set of data can control which a simple and safe way.
parts of their data is accessed.

6.0 Technical Explanation
6.1 Participants Definitions and Permissions
With a plethora of different actors, identity management and access to data is key
to Medicalchain’s solution. A dynamic system has been developed that identifies
actors and gives them the appropriate scope over a health record, contingent on the
patient’s permission. Below are some examples of read/write permission:
6.2 Table: Read / Write Permission
Participant Permission
Practitioner • Read/Write on permissioned EHRs.
• Request permission for other Practitioner/Insti-
tutions to gain Read/Write access.
Patient • Read their EHR.

• Permission a Practitioner/Institution to Read/
Write EHR or a portion of their EHR.
• Revoke permission from Practitioners/Institu-
tions.
• Permission next of kin / emergency contact to
Read/Grant permission
• Write certain attributes to EHR
◊ Amount of tobacco consumed daily
◊ Alcohol consumed weekly
◊ Weekly exercise
• Ability to integrate IoT data into EHR
Research institution • Read permissioned EHRs

6.3 Encryption Cryptography
To ensure privacy, health records are encrypted In the case that a participant’s access is removed
using symmetric key cryptography. The record from a health record:
will be encrypted and stored on a data store with-
in the appropriate regulatory jurisdiction. The sym- 1. The symmetric key is decrypted with the private
metric key will be encrypted with the public key of a key of the owner of the EHR
2048-bit RSA key pair. Each time an entity is given 2. The EHR is decrypted using the symmetric key
permission to access the patient’s record: 3. The record is re-encrypted with a new
symmetric key
1. The record is decrypted with the owner’s private 4. The symmetric key is encrypted with all the
key remaining authorized users public keys
2. The symmetric key is encrypted with the public
key of the authorized user
If a user is authorized to access a health

record and requests access then the following
process takes place:
1. The private key of the requesting user is used to

decrypt the symmetric key for the EHR
2. The decrypted symmetric key is used to decrypt
the patient’s EHR

6.4 Transactions
Any interactions with health records are recorded as transactions on the network.
Transactions are viewable only to the participants associated with the transaction.
Here are examples of how transactions take place on Medicalchain.
Patient Granting Access
• Patient A grants access to EHR to Practitioner A

• Practitioner A’s ID is added to Patient A’s authorized asset on the ledger
• Patient A’s ID is added to Practitioner A’s authorized asset on the ledger
• The Symmetric key for the EHR is decrypted with Patient A’s private key
• Symmetric key is then encrypted with Practitioner A’s public key
Patient Revoking Access
• Patient A revokes access from Practitioner A

• Practitioner A’s ID is removed from Patient A’s authorized asset
• Patient A’s ID is removed from Practitioner A’s authorized asset
• Patient A’s private key is used to decrypt Symmetric key for EHR which is
used to decrypt the EHR
• The EHR is encrypted with a new Symmetric key
• The new Symmetric key is encrypted with Patient A’s public key and the
public keys of all the remaining ID’s that have permission
Practitioner Referring Patient
• Practitioner A updates the permissions to allow Practitioner B to access

the Patient’s EHR.
• Chaincode will check that the Practitioner A has permission on the EHR.
• Practitioner A uses its private key to decrypt the EHR’s symmetric key
• Practitioner B’s public key is used to encrypt the Symmetric key
• Practitioner B’s ID is added to Patient A’s authorized asset
• Patient A’s ID is added to Practitioner B’s authorized asset

6.5 Data Structure
Hyperledger’s modeling language will be used to define the domain model for the
network. Below are some examples from the .CTO file of how models will be defined
and stored on the chain. These are subject to change depending upon different
regulations and requirements in order to make the Medicalchain platform HIPPA
and GDPR compliant.
Participants
Patient
Variable Type Variable Description
String ID A unique string (128-bit UUID)
Asset PersonalDetails Structure defined in asset
String (Array) authorized Array of all participants ID’s that have been
authorized to read EHR
Asset MedicalRecord Structure defined in asset
Practitioner
Asset PublicProfile Structure defined in asset
String (Array) Patient Array of all participants ID’s that have been
authorized to read EHR
Asset MedicalRecord Structure defined in asset

Assets
Personal Details
Relationship: Patient (Participant)

String ID Unique ID for asset
String FirstName User’s given name
String LastName User’s last name
String EmailAddress User’s email used to sign up
Int Dob Unix timestamp of DOB
concept Address Defined in Concepts section
Super-Type Owner Extends Patient (Participant) asset
Practitioners public profile

Relationship: Practitioner (Participant)

String ID Unique ID for asset
String FirstName User’s given name
String LastName User’s last name
String EmailAddress User’s email used to sign up
Int Dob Unix timestamp of DOB
concept Address Defined in Concepts section
String Identification ID The assigned number the practitioner was
given when registered with practice
Array Qualification Qualifications practitioner holds
String Image Url Pointer to practitioners image
Super-Type Owner Extends Practictioner (Participant) asset

Medical Record

Super-Type Owner Extends Patient (Participant) asset
Super-Type Author Extends practitioner (Participant) asset
Array Permissions Array of participant IDS
String File Hash SHA-256 hash of the latest version of the file
Float Version Int increments every time a file is updated
String Pointer This points to where the file is in storage out-
side of the blockchain
Concepts
Address
String Numer Numer/name of building
String Street A unique string (128-it UUID)
String City Extends Patient (Participant) asset
String Country Extends practitioner (Participant) asset
String Postal/zip code Area code

6.6 Permission Definitions

Hyperledger fabric includes an access control language (ACL), which defines ac-
cess over the elements of the CTO domain model above. By defining ACL rules we
are able to control which resources participants have access to on the network’s
domain model. Some examples of these access rules are shown below:
6.7 Medicalchain API Platform

Medicalchain will offer an API that will permit third parties to obtain and interact
with EHRs with the user’s permission. All endpoints available in the UI will be avail-
able to developers. We hope to cultivate a robust ecosystem of applications and
services.

7.0 A Better System for Care
7.1 User Control able to fully control who accesses

their data and which information
In the current healthcare system, they access. The patient would
patients have their health infor- have the ability to grant access
mation spread over multiple sys- to their EHR to other users and re-
tems, hospitals, networks and voke access by setting up a time
potentially countries. limited gateway, thereby improv-
ing data security.
There are multiple fragmented
records from the same patient, Approved clinicians on the Med-
held at different institutions all icalchain platform will have the
with their own snapshot of the ability to ‘read and write’ to the
patient’s health at the point of patient’s records. Moreover, the
their interaction with them, such Medicalchain platform will pro-
as blood tests, imaging and clinic vide the users with a full log of
letters. Medicalchain will chrono- who has access to their medical
logically arrange all of these re- data, the time of access and the
cords and filter them into the spe- particular types of data that can
cific categories above to aid data be accessed.
handling. Such a categorization
would make the records more ac- 7.2 Data Security
cessible and understandable for
patients and it will also facilitate The Medicalchain system uses
researchers in searching for the a double encryption mechanism
on a closed, permissioned based
Medicalchain provides the blockchain. The security of health
records is secured beyond any
user full access and control centralised data system currently
in use. Patient data is not acces-
over their data. sible directly on the blockchain.
information relevant to them. The blockchain acts as a pointer

The user will have the capability to where patient data is held in an
to provide differing levels of ac- encrypted format, meaning that
cess to various users, by assign- anyone attempting to intercept
ing a set of access permissions patient data will be unable to with
and designating who can query the ease that is required to ac-
and write data to their blockchain. cess data existing in any central
location.
The patient, being the owner of
their own medical records, will be

7.3 User Centric Model
In the current healthcare system, patients have their health in-

formation spread over multiple systems, hospitals, networks
and potentially countries. There are multiple fragmented records
of the same patient, held at different institutions with their own
snapshot of the patient’s health during their interaction with them
such as blood tests, imaging, and clinic letters. Medicalchain will
order and filter all of these records into a chronological order and
the specific categories above to aid data handling. Such a cate-
gorization would make the records more accessible and under-
standable for patients, and it will also facilitate researchers in
seeking out the information important to them.
7.4 Health Data Revolution
Bold companies like 23 and Me, Fitbit, Apple, Nest, and Qardio
are rapidly innovating to expand the frontier of the data that is
collectable. We already have remarkable access to anatomic,
biological, environmental, genomic, phenomic and physiologi-
cal data. New ideas and technologies will only move this fron-
tier further. If we can connect these disparate data sources, then
caregivers and researchers will have unprecedented insight into
patient’s lives. Ultimately this will lead to lowered costs, better
patient outcomes and better research.
Medicalchain wants to be at the forefront

of this revolution and will seek to integrate
as many sources of health data to its
platform as possible.
Medicalchain will start with integrating Apple HealthKit and com-
mon wearables, before moving to add support for diagnostic
tests, IoT, and other digital health. Patients and their doctors will
have the ability to view this data along with their electronic health
record.

7.5 Patient Safety
Medicalchain has also developed a backup access

system for emergency situations, ensuring patient
safety at all times.
A patient can generally grant or decline healthcare professionals

access to their records. However, in the event of an emergency
and with the patient incapacitated, there must be an ability to
view certain information in order to provide the best possible
care.
The most vital information needed in an emergency would be

the patient’s name, their next of kin, medications, allergies and
any advanced decisions they may have made. Patients using the
Medicalchain platform will have the ability to select in advance
which areas of their records can be viewed in an emergency
situation. Clinicians would not need to know any more than this
in an emergency situation.
In the case that the patient is incapacitated or unconscious

and unable to grant access to their records, the emergency
bracelet the patient is wearing would be scanned to unlock
this information. Two clinicians would have to agree that given
the situation, access to this information without the patient’s
explicit consent was clinically in the patient’s best interest. To
be clear, a patient’s entire record would not be unlocked, but only
information that would be vital in an emergency situation and the
patient had prior agreed to sharing in such a situation.
To unlock this information, two doctors would need to scan the

emergency bracelet the patient is wearing, or their wearable
device which would unlock access to these key parts of their
medical records.
This would enable clinicians to provide the best care possible to

a patient in an emergency situation and would avoid mistakes
such as giving the patient medications they are allergic to or
treatments which are contraindicated based on their known
medical history.
7.6 Clinical Application
7.61 Clinical Communication
Along with increased access to

emergency information, Medicalchain
allows clinicians to communicate with
each other with ease. As an authorised
healthcare professional updates a
patient health record, the system will
update that record on Medicalchain. Any
clinician with authorised access to that
users records will see the updates within
seconds.
As health records are updated via

Medicalchain for all access authorized
parties, there is no need for patient data
to be manually transferred from system
to system.
Medicalchain will be usable in any browser on any computer. As

a result, any doctor with a browser and an internet connection
will be able to access the documents that were shared with them.
Issues currently associated with interoperability are resolved this
way and costs are associated with the transportation of notes
currently undertaken by junior clinicians or administrative staff
are cut down on.
7.62 Borderless Health and Social Care

With the utilisation of data compliant storage nodes alongside
borderless blockchain technology the user will be able to
transport their records with them as they travel. Healthcare
services become borderless as telemedicine services allow
users to interact with clinicians in other countries. This will be
particularly beneficial for travelling business men and women,
alongside those moving abroad that do not wish to have the
inconvenience of getting their records sent over to their new
healthcare provider.

7.7 Transparency
7.71 Patients / Users
In present day healthcare, there is a lack of transparency between

all actors involved. Patients have no immediate access to health
records written by medical professionals. Medical professionals
are only able to share data quickly within their own organisation
or with other health professionals using the same EHR system.
Insurance companies are kept in the dark, unless they request
patient data which is required for a claim. Researchers who
could benefit society are forced to seek anonymised data from
multiple intermediaries, which is both costly and timely. The lack
of transparency on how patient data is handled also leaves the
user unaware of how their data is currently being used.
7.72 Health Insurance

Patients are unknowingly and in some instances, knowingly not
disclosing their health conditions to insurance companies. As
a result of this incorrect information, patients can pay incorrect
premiums for years, only to discover that their claims are declined
in the instance they need to make one.

7.7 Transparency
7.73 Transparency Cost Benefits
The verifiability and immutability of health records on Medical-

chain’s platform allows insurance companies to make a more ac-
curate assessment of an individual’s health and health premiums
should reflect this.
By allowing health insurers access to their

health records, patients could be rewarded
for their transparency in the form of lower
premiums.
Moreover, patients could pledge to a set of health goals with their
insurer and be rewarded as they reach milestones associated
with those goals.
In the same way ‘black box’ GPS devices are installed in cars by
insurance companies to monitor driving habits, with those driv-
ing sensibly being rewarded with lower insurance costs.
The same can be applied with health insurance with regular en-
gagement, measurement uploads, proof of therapy compliance
and attendance at a gym might incentivise rewards from health
insurers.

8.0 Token Utilites
8.1 MedToken 8.21 Patient Benefits
Once the patient has access to their own EHR this From the patient’s perspective, the time for seeking
will enable the following key features to be used in a consultation is massively reduced by removing the
conjunction with the Medicalchain platform. need to physically attend the doctor’s practice. There
are many simple ailments that are currently managed
8.2 Telemedicine Consultations over the telephone, but by providing a telemedicine
component we can improve the patient’s experience
by facilitating a visual consultation which would be
Telemedicine, an online consultation with a doctor
more in-depth and beneficial to both the doctor and
and patient using a webcam interface, is set to
the patient.
be the future of consultations. Medicalchain not
only provides this established and successful
format of consultation, but will accommodate the 8.22 Clinician Benefits
doctor by enabling them to interact live with the
patient’s records during the consultation. Patients To attend a doctor’s appointment requires a patient
would grant access to their records during the to cancel their work in advance or a take their child
telemedicine consultations, allowing for a more in- out of school for the appointment. There is then the
depth, informative, and valuable experience for both waiting time at the clinic in order to see the doctor,
the patient and doctor. often times for a simple request. Telemedicine
Patient controls access of records to doctors when

conducting telemedicine consultation and pays the
doctor for the consultation with MedTokens.
There are also further benefits from the telemedicine provides the patient with the opportunity to select
experience which Medicalchain delivers. Telemed- a specific time to conduct the consultation at their
icine platforms available today offer online visual convenience , encouraging patient choice and
consultations but do not have access to longitudinal freedom. Further, patients are able to choose which
health records. Medicalchain offers this unique val- doctor they would like to conduct their consultation
ue and provides patients with privacy controls. Pa- with offering greater choice and building a
tients will be able to choose the level of detail visible relationship between that
and allocate viewing rights to their chosen doctor for
as long as they feel necessary.

8.0 Token Utilities
8.3 Health Data Marketplace Control There would be a few broad categories of data leas-
ing agreements though more are likely to evolve over
time. Here are a few we envision:
As with the founding principal of Medicalchain, pa-
tients should have control over their health records,
• One time leasing. Institutions will use APIs
and they should also benefit from the potential value
provided by Medicalchain to pull relevant data
that they possess.
from participants from our servers.
Medicalchain will connect research institutions with
• Longitudinal studies. Institutions that need to
users who are willing to have their health data used
see data over a period of time will be able to ask
in studies in a health data marketplace. Users will be
users to stream their data. Ex: how many steps
given clear information as to how their data is being
users have walked per day or what their heart
used and what data will be required. In many cases
rate looked like today.
anonymised data will be permissible, ensuring the • Collated data. Medicalchain would combine
privacy of everyone involved. In return, participants normally disparate data sources and provide
will be compensated in MedTokens. Patients will be easy access to these data sources with user
given the ability to unlock the monetary value that consent.
their health data holds, they will be more engaged
with their health conditions and the next generation • Ongoing anonymized data offerings. Users could
of cutting edge medicine will be powered. opt in to have their data anonymized and labelled
as accessible to research institutions interested
Pharmaceutical and research companies will also in it. Institutions would have the ability to filter by
benefit from the changes brought in by Medical- broad categories (e.g 40-50 year old, 25+ BMI,
chain. They will be able to seek out patients who male) and users would be paid every time their
have opted in to being contacted by researches so data is accessed.
that these institutions can interact directly with the
patient. By doing so, companies will no longer need
to approach a hospital or clinic and can go straight
Patient grants access of personal health data to

researchers in return for incentivisation with MedTokens
to the people whose information will be used. Not

only will this increase efficiency, but it is a more
transparent process that strikes a relationship which
is symbiotic and sustainable.

8.0 Token Utilities
8.4 Potential Insurance Integration
Users could allow health insurers access to their health records.

In turn, insurers could rest assured that the information they are
making decisions upon is trusted, verifiable and patients could be
rewarded for their transparency in the form of lower premiums.
Moreover, patients could pledge to a set of health goals with their
Patient grants access of personal health data to insurance

companies in return for incentivisation with MedTokens
insurer and be rewarded as they hit milestones associated with

those goals. Regular weight and blood pressure measurement
uploads, proof of therapy compliance and attendance at a
gym might incentivise rewards from health insurers with lower
premiums or rewarding users with MedTokens.
8.5 Powering Medicalchain’s Platform
Users will be able to pay for a variety of other applications and

services that have been developed on Medicalchain’s platform.
Integrations with a plethora of different healthcare sectors are
possible and the above is only the beginning of the revolution
that is coming.

9.0 Cost Impact Analysis
9.1 Users 9.2 Clinicians
Whereas typically for a patient to gain access to their For Clinicians on-boarded onto the Medicalchain
medical records, they would need to apply to their platform, they would have immediate access to con-
service provider and pay all associated administra- duct tele-consultations with any users also on the
tive fees to have these released to them, with Med- platform. This will provide them with an additional
icalchain, the user would provide consent to have revenue stream, meaning they could practice with-
their data retrieved on their behalf, and stored free of out any overheads other than a computer with inter-
charge on Medicalchain’s nodes. Once this has been net connection.
carried out, the patient would then use the Medi-
calchain application to have a standardized, single This availability would decrease the chance of can-
point of access to those records at their discretion, cellations due to patients being unable to physically
eliminating the need for additional administration attend a consultation. Cutting this variable out saves
fees should they lose this data, or need to send orig- on facility expenses, administration costs and the
inal, physical copies at any time, instead they would need for additional staff to be present.
grant access to this data to any requesting parties.
Having permanent access to their own data, should

patients attend a consultation or need to seek medi-
cal assistance away from their usual healthcare pro-
vider, they become the means of transferring those
records, mitigating the risk of lack of patient data
during the consultation.
Utilising Medicalchain’s tele-consultation platform,

users would have dramatically decreased wait times,
which would save money considering the reduced
need for time off work. Further, without the need to
physically attend an appointment or consultation,
a patient would remove entirely the need for travel
expenses to and from any physical location, with all
associated parking charges included.

9.0 Cost Impact Analysis
9.3 Healthcare Providers
There are a plethora of benefits to healthcare providers. First of

all, these will benefit from having a more complete picture of a
patient’s health condition. Medicalchain’s single true record will
be the sole place providers would need to look for patient data,
providing peace of mind and reducing time spent on gathering re-
cords. Moreover, providers would benefit from not having to con-
stantly invest to upgrade or upkeep their health record systems.
9.4 Researchers
Researchers would have the ability to reach a global audience

of patients through Medicalchain’s health data marketplace. This
would increase the potential sample size used in research and
improve the accuracy of the results. Costs would be reduced by
simply pulling the relevant information from a participant’s health
record, with their consent, instead of the burdensome process of
forming research groups and going through health providers for
access to health data.
9.5 Insurers
Verifiable, immutable data, means that insurance companies will

need to spend less man hours checking data, that they can trust
the data presented to them, both from the patient granting them
access and likewise from the medical professional’s notation.
Similarly, if an insurance company wanted the patient to be com-

pletely transparent with them, in order to offer them an accurate
premium based on their medical records. They would offer the
patient MedTokens and/or offer a cheaper premium as an incen-
tive for their transparency.

10.0 Token Sale
Medicalchain’s ICO will be a capped sale raising $24 Of these 500 million tokens...
million (24,000,000) equivalent of ETH and/or BTC
with whitelisted contribution caps. Medicalchain • 35% will be offered in the pre-sale and crowdsale
will be issuing 500 million (500,000,000) ERC20 to-
kens, called MedTokens, to create a new blockchain • 34% will be retained by the company, team, advi-
based healthcare ecosystem. sors, founders and future employees. Within this
34%...
These tokens will be offered in a crowdsale to allow
participants to purchase MedTokens early as well as • 10% will have already vested.
contribute and support the further development of
Medicalchain. Starting on February 1st 2018, partic- • 12% vests over 2 years.
ipants will have the ability to contribute and receive
MedTokens in exchange for their ETH by sending • 12% over 4 years.
Ether to a designated address.
• Founders: 15%
During the ICO MedTokens will be distributed at an
exchange rate of 1 token = $0.25 equivalent in ETH • Company development: 8%
and/or BTC and offered before this date at a dis-
count in a pre-sale. • Team, advisors, early backers: 11%
• 31% will be retained for community development.
500 million tokens issued Medicalchain will use these tokens to help grow an
ecosystem on it’s blockchain by educating others,
supporting node holders, bringing partners onto
its platform, conducting pilots, and sponsoring in-
dustry leading events. This will vest over 4 years.
31%
35%
34%
community development
crowdsale
retained by the company

11.0 Timelines
11.1 The Story so far Together, the team has developed Medicalchain–
complementing Discharge Summary and helping to
build Dr. Albeyatti’s vision.
Work on Medicalchain started in early 2016 when
founder Dr. Albeyatti identified an issue with writing
Over the past few months a flurry of work has been
clinical notes on patients being discharged out of
completed and Medicalchain has been featured
the hospital and having their care transferred back
at world renowned forums such as the Financial
to their family doctor (general practitioner). These
Times Digital Health Summit, Blockchain Labo, and
notes, known as “Discharge Summaries” contain a
the Technology Innovation. The work to date has
substantial volume of mandatory information that
resulted in a public Beta, which will be released in
is often written in freeform text by the doctors. The
February, as well as several key partnerships. One
notes are subject to errors. For example, doctors
thing is for sure: Medicalchain is leading the way
may forget to include vital medical information, such
in blockchain applications in healthcare and digital
as the correct dosage or course of drug prescription.
health’s role in our daily lives.
These errors put the patients’ wellbeing at risk, incur
raised costs, and represent a liability for the hospital.
To address this, Dr. Albeyatti co-founded Discharge 11.2 Current Developments
Summary with Bara Mustafa.
The proof of concept is in its final phase and
First employed in Leeds Teaching Hospital Trust, the development is now focused on design and
UK, the tool was designed to generate accurate and UX/UI experience. The core of the application,
timely notes when patients are sent home. Discharge Medicalchain’s secure API and blockchain, is ready
summary received a positive welcome and was for the release of the Beta. The nodes setup and
adopted by junior doctors as well as consultants and operated during the Beta are run by Medicalchain,
other healthcare practitioners. but over time Medicalchain will include other nodes
onto it’s network. Several of these conversations are
Discharge Summary, by improving communication underway already with hospitals, universities and
and standardizing data, demonstrated to Dr. Albeyatti non-profit organisations.
the power of digital health to lower costs and improve
outcomes. He sought to apply this insight to a 11.3 Collaborative Design
broader problem: disparate health systems. In short,
documents are transferred, often on paper, to other
organisations where the exchange of data results in To enhance the user experience of Medicalchain
no single version of the truth. Moreover, oftentimes a range of global advisors have been selected to
IT systems are not interoperable; they cannot talk to work on specific use cases. Expert patients, doctors,
each other let alone use each other’s vital data. Dr. health professionals, health providers, insurance and
Albeyatti expanded the team by bringing Mo Tayeb, pharmaceutical companies will take part in system
Jay Povey, Robert Miller as well as a combination design consultation with blockchain developers. The
of medical doctors, allied health professionals, and Beta release with enable testing of each use case,
experts from the blockchain community. with the trialing community providing feedback via
the platform.

11.4 Roadmap
jan
feb
Conceptualization of ideas.
Development started on Discharge Summary
dec
Cardialogy department identified as good
starting point to cultivate idea
jan
feb
mar
apr
Discharge Summary website launched
may
DS launched with Leeds Teaching Hospital trust
jun
First release of Medicalchain prototype
jul
aug
sep
Medichalchain joins Hyperledger and Linux Foundation DS launched with Queen Elizabeth Hospital
oct
DS launched with University Hospital Lewisham
Medichalchain showcased at
FT Digital Health Summit NYC nov Medichalchain is nominated top 10 in Europe for
Accenture healthtech Challenge
dec
Medichalchain is nominated top 20 in the world
for H-Farm Health Accelerator Competition

11.4 Roadmap
jan
DS launched with Princess Royal hospital

feb
Closed beta platform launch
mar Medicalchain set to present at

Doctor and patient enrollment for
European Parliament
Telemedicine application
apr Medicalchain establishing links with
world class universities
may
jun
jul Medicalchain Emergency

bracelet introduced into the pilots
aug
US and UK pilot completed and collected

sep
data and feedack analysed with improvements
made to the platform
oct Pilot to be launched in China,
Japan and South Korea
Wearable devices integrated nov
into the Medicalchain platform
dec
2019 jan
China, Japan and South Korea feb

Medicalchain pilots all completed and platform
ready for worldwide launch
mar Phased roll out of fully
functioning Medicalchain platform

11.5 Route to market
The identified actors that will require initial Communication to users is focused on safety and
onboarding include: security of patient data. Education on blockchain
technology is seen as a priority, to raise awareness,
• Patients / Service Users gain trust and influence adoption of Medicalchain.
• Clinicians Innovators and early adopters will be the prima-
• Non Profit Node Services ry target market for system trials. Influential users
• Research Institutes / Pharma that witness the benefits of Medicalchain will be the
main catalysts for further patient onboarding.
Expert patients have expressed great interest in the
benefits to owning and managing their own health As we continue with awareness and onboarding
records. We are working with several disease specif- campaigns, Medicalchain will offer a service where it
ic organisations to onboard experienced healthcare will request healthcare records for consenting users.
users to test the collation of data processes, along- Our legal team are working with system developers
side the user interface. to build API integration compliant with various in-
ternational regulations. We acknowledge that some
countries may have barriers to the decentralization
Medicalchain has several of data and we are working with others to negotiate
community campaigns running, these barriers.
on a variety of platforms to raise The data migration process would require a user to
awareness of the project and complete a short form of consent, highlighting the
providers they wish to obtain records from who they
the benefits of blockchain for had previously visited.
healthcare users.
Physical documents will be scanned and mined for
Communication platforms include: information which will then be encrypted and up-
loaded to data lakes. Electronic records will be stan-
• Global Events dardized, encrypted and uploaded.
• International Press Releases
• Sponsored Meetups Medicalchain is approaching clinicians individually
• Telegram and at an organisational level. This multilevel ap-
• Email Campaigns proach will allow for forward thinking health provid-
• Linkedin ers to test the Medicalchain platform throughout
• Reddit their service but does not exclude innovative au-
• Twitter tonomous healthcare professionals. We will work
• Bitcoin Chat alongside clinicians to test the pilot with consenting
• LINE patients and assist providers with patient targeted
• WeChat marketing material to improve user adoption.
• Kakao Talk

11.5 Route to market
The key incentives for clinical onboarding include:
Cost savings: Decreased need for repeat diagnostics,

decreased administrative costs for record retrieval/
transportation, decreased risk of errors associated
with inaccurate or unobtainable medical records.
Increased revenue: Access to global patients when

completing chargeable telemedicine consultations
complete with simultaneous up-to-date healthcare
records.
Non profit organisations with the required

compliance documents and experience in handling
sensitive, will have the opportunity to partner with
Medicalchain. Organisations will be incentives to act
a secure nodes for holding encrypted health data.
The key incentives for node onboarding include:
Financial incentivisation: MedTokens will be used

to support the maintenance of the node as well as
incentivise the hospital, university and/or non-profit
organisation to continue acting as a node.
Public relations opportunity: To be a node for

Medicalchain and part of an international community
of healthcare providers. An opportunity to be a leader
in the future of healthcare and become involved in
blockchain technology.
Research Institutes / Pharma

Medicalchain is currently in discussion with
several large pharmaceutical and health research
organisations, who have expressed interest in . The
organisations will have the ability to request data
from any Medicalchain user.

11.6 Looking forward
Medicalchain has ambitious goals for

the future.
We want to improve people’s lives by

building the digital infrastructure for
the healthcare of the future.
We’re looking for driven people or organizations
to help us realize that vision. If you’re interested in
working with Medicalchain, please send an e-mail to
[email protected].
Copyright © 2018 Medicalchain. All rights reserved

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Whitepaper 2.

2.0 Letter from the CEO

3.0 Executive Summary 6

4.0 Introduction to the Healthcare of Today 7

5.0 Medicalchain Solutions: 12

6.0 Technical Explanation 13

7.0 A Better System for Care 20

8.0 Token Utilities 26

9.0 Cost Impact Analysis 29

10.0 Token Sale 31

Copyright © 2018 Medicalchain. All rights reserved

PLEASE READ THIS DISCLAIMER SECTION CAREFULLY.

Medicalchain does not guarantee, and accepts no legal liability

This whitepaper does not constitute a prospectus or offer

Copyright © 2018 Medicalchain. All rights reserved 3

Medicalchain uses blockchain technology to create a

Medicalchain enables users to give healthcare professionals

Moreover, Medicalchain is a platform for others to build

Medicalchain White Paper 2.0 will outline the vision of

Copyright © 2018 Medicalchain. All rights reserved 4

Our mission is to improve care for people by placing

Dr. Abdullah Albeyatti

Copyright © 2018 Medicalchain. All rights reserved 5

Copyright © 2018 Medicalchain. All rights reserved 6

4.1 Expectations of Healthcare Users

In today’s world, users expect an instantaneous and seamless

4.2 Fragmented Health Services

Health data contained in legacy systems is siloed and difficult to

4.3 Lack of patient centricity (passive user)

The relationship between healthcare professionals and patients

Medicine is being democratised and

Even in single-payer system like the UK’s National Health Service

Copyright © 2018 Medicalchain. All rights reserved 7

4.4 Ill-informed Clinical Decision Making

Clinicians rely upon investigations and tests to make

Copyright © 2018 Medicalchain. All rights reserved 8

number on the black market.”

Figure 2: Technology News, Reuters, September 24th 2014

Copyright © 2018 Medicalchain. All rights reserved 9

4.6 Lack of Transparency 4.62 Insurance Fraud

4.61 Increasing Costs Whether you have employer-sponsored health

Copyright © 2018 Medicalchain. All rights reserved 10

4.63 Record Tampering Examples include Telecardiology, Teleradiology,

To minimize the privacy/security risk of Telehealth

Copyright © 2018 Medicalchain. All rights reserved 11

5.1 Medicalchain Dual 5.3 Ethereum and Smart 5.4 Medicalchain as a

Medicalchain is built using a Ethereum is a digital platform Using blockchain technology,

Copyright © 2018 Medicalchain. All rights reserved 12

6.1 Participants Definitions and Permissions

6.2 Table: Read / Write Permission

Patient • Read their EHR.

Research institution • Read permissioned EHRs

Copyright © 2018 Medicalchain. All rights reserved 13

If a user is authorized to access a health

1. The private key of the requesting user is used to

Copyright © 2018 Medicalchain. All rights reserved 14

Here are examples of how transactions take place on Medicalchain.

Patient Granting Access

• Patient A grants access to EHR to Practitioner A