Changing the world of medicine using market forces
Health Impact Transfer
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Healthcare Challenges

The current healthcare systems of the world have many major challenges.

Moving from sickcare to wellcare is a challenge that most national healthcare systems are struggling with. One critical bottleneck is the difficulty most political systems have to make proactive investments into the health of a population, rather than investing merely in cures and infrastructure.

Stuck in Repair

Health care is stuck in crisis management mode. Most medical measures are reactive and respond to an acute health crisis, rather than acting preventively.

Causality Trap

To justify the use of funds, medical science must prove causality between measures and outcomes which takes long and can be difficult or impossible. There is no working market mechanism to reward correlation instead.

Inadequate Finance

Known schemes such as social impact bonds have proven to be too bureaucratic and lack investors' appeal. Many governments do not have a sufficiently long-term investment horizon and are too busy dealing with rising costs.


There are attempts to establish value-based medicine, but no agreement by stakeholders or realistic implementation opportunities are in sight. Many healthcare systems afford undue profits to rent-seeking parties with no transparency or hope to break the gridlock.

About Prevention

There are some key insights that need to be kept in mind when approaching preventive health. The Health Impact Transfer approach to preventive medicine is firmly grounded on accepted research and scientific findings.

Sufficiently large populations. When recruiting the cohorts for a preventive scheme it is important to recognize that the certainty assiated with the desired outcome grows with the size of the population involved. Cohort access is one of the biggest challenges in this scheme. While selection bias, a major problem in clinical trials, is not a problem per se because it does not affect the economic model, it is still desirable to recruit a cohort as large as possible.

Disease Management. Due to the above problem of cohort identification and recruitment we would also consider disease management as a valid preventive scheme. For example, stroke prevention for patients with past stroke history, or drug abuse relapse control are good candidates for projects with both huge health benefits and good economics incentives.

How it works

The Health Impact Transfer Token (HIT) will enable the funding of preventive health measures to make healthcare sustainable and save lives.

Using blockchain technology, HIT solves a fundamental and systemic problem in healthcare: the lack of trust between producers of preventive medical programs and the payors who would benefit most based on the outcomes of these measures. The intermediary is the investor as one critical stakeholder in this ecosystem. Blockchain creates the transparency to enable a viable financial market in preventive medicine futures.

Project Funding Investment

Investors finance concrete projects directly and receive Health Impact Transfer Tokens.

Project Implementation

Health care institutions or project teams implement the preventive or diagnostic measure. Compliance information and verification is logged to the blockchain.

Outcome measurement

The health outcome is measured and verified across a predefined population over an agreed period of time. This enables the precise quantification of the savings generated by cost reduction.

Success-Based Payout

Payors will compensate investors by paying a dividend consisting of a part of the achieved savings as contracted prior to the project start.

Investors will receive HIT tokens that entitle them to a future payout in case the measures are followed by the desired outcomes. Both compliance with the measures and the verification of the outcomes will be verified by one or more independent third parties which will be authorized to certify these items via the blockchain. Importantly, there needs to be no proof of any causal relationship between measures and outcomes, only the proof that both occurred as contracted. The investors bear the risk of the measure not showing the desired effect, regardless of the causal relationship. The original payer, on the other hand, will reduce risk exposure and only pay for measues that actually correlate with the desired health outcomes (ideally with actual cash savings).

Architecture Overview

  1. When the project plan is finalized, a token generation event issues new HITs (Health Impact Transfer Tokens) and collects the necessary cash. The received cryptocurrency such as BTC or ETH is converted into fiat cash to finance the real world project.
  2. If necessary in case of international projects, the cash is transferred to local subsidiaries that act as contractual partnres for projects and underwriters.
  3. Cash is dispensed to the institutions in preventive care or an otherwise constituted project team.
  4. The project starts and the affected population is treated with the proposed measures.
  5. The reduction in patients in acute care is measured throughout the period of the project duration and across the designated population.
  6. An independent auditor reports the findings concerning the population effects that were contracted.
  7. Upon expiry of the project time limit, the payor or other entity fulfills the pre-agreed contract and dispenses a percentage of their savings to the HIT Ecosystem, realising net cost savings without own investments.
  8. These disbursements are passed on as dividends to all token holders, and used to help maintain the ecosystem and to be reinvested in follow-up projects.


The Health Impact Transfer Token can be applied in many use cases, ranging from awareness campaigns, screening programs and diagnostic adoption promotion to intensive preventive care.

The following are examples of possible applications.

Diabetes Treatment

Comprehensive program to reduce the number of diabetes patients.

Pre-Term Birth

Targeted prenatal screen-and-treat program in Austria.

Cardio-Vascular Prevention

Intensive programs for high-risk patients in Germany

Smoking Cessation

Reducing the number of smokers in the population of an Austrian city.

Opioid Relapse Control

90% of patients will restart drug abuse after a successful detox therapy. Intensive monitoring program in the Eastern USA.

Women's Health

Improving women's health in Tanzania through pre- and post-natal care.


Our Journey and Roadmap.

  • 2016-2017

    Early Blockchain Research

    Many blockchain experiments and participation in healthcare projects based on Hyperledger and Ethereum.

  • Summer 2018

    Building an Advisory Board

    Idea validation with experts from Harvard School of Pulic Health and Harvard Medical School.

  • Winter 2018

    Field Studies

    Exploring the feasibility of preventive projects by interviewing experts and reviewing studies.

  • December 2018

    Starting development of MVP

    Development start of the first alpha version of the necessary smart contracts based on Ethereum.

  • Late 2019 / Early 2020

    Going Live

    Launching the first preventive health project (pre-term birth prevention).

  • February 2020

    CoVID19 Disruption

    Unfortunately, the global pandemic has put our projects on temporary hold. Summer and Fall 2020: Renegotiating pending projects.

  • Continued

    HIT token to be released for the next project.

Health Impact Team

All team members are volunteers having contributed their work pro bono.

Sascha Mundstein

FAS, Harvard University
Founder, Commercial & Technical Lead

Mark Schmitt

KSG, Harvard University
Founder, Financial Architect & Marketing

Kay Kim

KSG, Harvard University
Research & Government Relations

Paul Schörghofer

LL.M., Harvard University
Legal & Non-Profit

We need more experts in various health care fields, financial markets and blockchain engineering. If you can contribute to this important project, please contact us.

Contact Us

Advisory Board

We are humbled by the great wisdom and generous support we receive from our experienced mentors who are all impactful leaders in their respective fields. We are also welcomeing advisors in a more formal role in our advisory board to build a solid governance structure for the Health Impact Organization.

Dr. Alexander Schwartz

FAS, Harvard University

St. O., PH.D.

Harvard Medical School
Medical, Health Economics


Medical School