Medicalchain Whitepaper

Tuesday, June 19, 2018
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Whitepaper 2.1

Contents 1.0 Abstract 4 2.0 Letter from the CEO Dr Abdullah Albeyatti 5 3.0 Executive Summary 6 4.0 Introduction - 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 25 9.0 Cost Impact Analysis 28 10.0 Token Sale 30 11.0 Timelines 31 12.0 MedToken and Legal Crowdsale 36 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, re- liability, currency, or completeness of any material contained in this whitepaper. Potential MedToken holders should seek ap- propriate 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 in- vestment 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. KPMG KPMG has been one of our earliest advisors who helped Medicalchain to navigate Switzerland’s legal framework. They helped Medicalchain to draft the legal structure for the launch of the Medicalchain token, coordinated contacts with the regulatory authority, obtained the tax ruling before the launch of the token sale and supported Medicalchain in drafting the legal opinion (both legal and regulatory) and in finalizing the legal aspects re- lated to the whitepaper. Finally, they are managing the tax ruling before the authority. 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 whilst maintaining a single true version of the user’s data. Medicalchain enables the user to give healthcare professionals access to their personal health data. Medicalchain then records interactions with this data in an auditable, transparent and secure way on Medicalchain’s distributed ledger. Lastly, Medicalchain is a platform for others to use to build applications that complement and improve the user experience. Users will be able to leverage their medical data to power a plethora of applications and services. Medicalchain Whitepaper 2.1 will outline the vision of Medicalchain and 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. Copyright © 2018 Medicalchain. All rights reserved 4

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 whilst managing expectations and multitasking in order 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 centre 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, and by doing so, 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 Copyright © 2018 Medicalchain. All rights reserved 5

3.0 Executive summary Medicalchain is a decentralised 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 insurers to interact as they see fit. The Marketplace enables Medicalchain users to negotiate commercial terms with third parties for Each interaction with their medical data is auditable, alternative uses or applications of their personal transparent and secure, and will be recorded health data. For example, putting forward their data as a transaction on Medicalchain’s distributed to be used in medical research. It is intended that ledger. During this process, the patient’s privacy is Medicalchain and others will contribute many more protected at all times. Medicalchain is built on the applications to the platform - helping bring value to permission-based Hyperledger Fabric architecture all stakeholders. which allows varying access levels; users control who can view their records, how much they see and Medicalchain’s platform will be powered by for what length of time. “MedTokens”. We are issuing 500 million tokens, which will be distributed at a rate up to 1 token to By empowering users, we can build the future of $0.25 USD in ETH and/or BTC. These will be offered healthcare together. Medicalchain will be a platform in a crowd selling process commonly known as for other digital health applications to develop on; an “ICO” or “Initial Coin Offering.” users will be able to sign for these applications and services which are powered by their health data and The contribution period will follow our pre-sale and secured by smart contracts. Medicalchain is currently begin on February 1st 2018. More details on our ICO developing two applications to work alongside can be found below on page 31. the platform: a doctor-to-patient telemedicine application and a health data marketplace. The telemedicine application will enable users to consult a real doctor remotely (for example, on their phone) for a small fee payable directly to the doctor. Copyright © 2018 Medicalchain. All rights reserved 6

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, often 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 incentivised to keep their own records, and no single 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 be provided with the best care patients not only can, but must have control over their own data. Copyright © 2018 Medicalchain. All rights reserved 7

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 researchers estimate and arranged if this is going that medical error is now the third leading cause to lead to a different possible of death. Here’s a ranking 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 Figure 1: Table showing yearly death rate as per fatal. Johns Hopkins University research in 2016 Research at the American Johns Hopkins Hospital by Makary et 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.” Copyright © 2018 Medicalchain. All rights reserved 8

4.0 Introduction to the Healthcare of Today 4.5 Security Risks to Patient Data At present, electronic health records (EHR) are stored on cen- tralised databases in which medical data remains largely non- portable. Centralization increases the security risk footprint, and requires trust in a single authority. Moreover, centralised databases cannot ensure security and data integrity, regardless of de-identification and controlled access requirements. Cen- tralised health databases are legally a requirement and necessity in most countries worldwide and therefore require an added layer of technology to improve their portability and security. As cybercrime around the world is on the rise, healthcare systems are no exception as shown by recent high profile ransomware hacking. In fact, the healthcare industry has more data breaches than any other sector and medical records are being stolen and passed on. “Your medical information is worth 10 times more than your credit card number on the black market.” Figure 2: Technology News, Reuters, September 24th 2014 Data security is paramount due to the increased sensitivity of medical data. This was highlighted in early 2017 when a cyber attack struck healthcare institutions around the globe. This highlighted to the public the vulnerability of our healthcare systems to potential threats and a sober warning regarding the inadequacies of the current infrastructure. Many have tried to overcome this issue, and it is high on the agenda of governments and a source of frustration for both doctors and patients. A significant component of the challenge focuses on data security. Copyright © 2018 Medicalchain. All rights reserved 9

4.0 Introduction to the Healthcare of Today 4.6 Lack of Transparency 4.62 Insurance Fraud 4.61 Increasing Costs Whether you have employer-sponsored health For patients and professionals, the present system insurance or you purchase your own insurance is incredibly slow, inflexible and woefully opaque. policy, health care fraud inevitably translates into These problems are equally visible throughout the higher premiums and out-of-pocket expenses claims process. When a patient needs services for consumers, as well as reduced benefits and (from a provider such as a general practice, coverage. For employers, this increases the cost of a pharmacy or nursing home), health plans are providing insurance benefits to employees, which used to determine how much of the cost they will then increases the overall cost of doing business. pay. In order to determine this cost, the health plan Moreover, the reality for many patients is that the must validate services received from the provider increased expense as a result of fraud, could mean against the agreement the patient and health plan the difference between affording health insurance have, and then share their findings with the provider. or not. This only occurs if the provider is “in-network” with a health plan. For a provider to be considered Fraud by design dictates that false information in-network, a complex agreement needs to be be represented as fact. A common healthcare negotiated which adds a significant expense to fraud involves perpetrators who take advantage of the provider’s administration costs. One part of patients, by entering into their health record false these costs are Billing and Insurance Related (BIR) diagnoses of conditions they do not have, or of costs which include activities such as maintaining exaggerating conditions they actually do have. This benefits databases and keeping records of services is done so that fraudulent insurance claims can be delivered. BIR costs are projected to reach $315 submitted for payment. billion dollars by 2018 and take up to 3.8 hours for the average physician to navigate. “The total cost of insurance fraud is On average, this whole process takes between one estimated to be more than $40 billion to two weeks if done electronically and takes three to five weeks by paper. Moreover, this process per year.” is rife with places for miscommunication and misunderstanding to occur. For care to actually take place, multiple people need to check multiple archaic agreements against multiple records. The Unless this discovery is made early on, these false or result is an inefficient and opaque process that exaggerated diagnoses become part of the patient’s leaves stakeholders and, ultimately patients feeling documented medical history within the health confused and sceptical. insurer’s records if not in other databases as well. Copyright © 2018 Medicalchain. All rights reserved 10

4.0 Introduction to the Healthcare of Today 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 records, The market is currently dominated by North America or adding false records puts a healthcare pro- and Europe though highest growth is expected in fessional at risk of medicolegal repercussions. India, China, and Japan in the next few years. Disclosure of authentic and original clinical notes is There are several challenges to full implementation: essential when a claim is brought up, and failure to do so can make a claim indefensible. In 2017, the global telemedicine 4.7 Telemedicine Market market was estimated to be worth Healthcare costs are on the rise around the globe $23.8 Billion and is projected to as societies struggle to deal with ageing pop- exceed $55 Billion by 2021. ulations and the rising chronic disease burden. Current models of care delivery, particularly in places like the US and UK, are unsustainable. One Unfortunately, most modern Telehealth systems are trend combating increased costs has been the rise not integrated with the core financial and clinical in digital health services. The value of the global systems used by healthcare organisations. Data digital health market was valued at $80 billion US remains within the Telehealth application and dollars in 2015 and is expected to increase to over requires manual entry later into health records. $200 billion by 2020 with a CAGR of 21%. Digitisation promises much potential, but adding Digital health solutions such as Telemedicine will an additional silo without incorporating the in- be critical for driving efficiency and reducing costs. formation does not add value. In order to succeed, The scope of Telemedicine covers referrals, second systems, devices, and data need to be seamlessly opinions, education, follow-up care, monitoring, di- integrated. agnostics and treatments across numerous spe- cialities. Privacy and security law issues must consider the management of data in non-traditional formats (for 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. Copyright © 2018 Medicalchain. All rights reserved 11

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 dual Ethereum is a digital platform Using blockchain technology, blockchain structure. The first where thousands of powerful Smart Contracts, and our cryp- blockchain controls access to computers around the world work tocurrency, Medicalchain pro- health records and is built using in harmony to host the Ethereum vides the infrastructure for digital Hyperledger Fabric. The second network. Ethereum’s blockchain health applications and services blockchain is powered by an represents all accounts and to be built. These applications ERC20 token on Ethereum and transactions made by its users. and services will be seamlessly underlies all the applications and Every time you send an Ether, the powered by user’s health data. services for our platform. currency of Ethereum, to anoth- Anyone will be able to develop on er user, those computers act as Medicalchain’s platform and we 5.2 Hyperledger Fabric accountants by verifying the va- hope to foster a thriving eco- lidity of the transaction. Once the system to provide value, reduce verification is approved by those costs, and ultimately improve The Hyperledger blockchain net- “accountants” the money is then people’s lives. work is permission-based and transferred to the other user, mak- requires users to sign up to use ing transfers secure, transparent 5.5 Identity management it. Permissioning on the network and conflict-free. is controlled using Hyperledger using Civic modelling and access control Smart Contracts are code held languages. Hyperledger Fabric is Identity fraud is a and executed on the Ethereum a platform for distributed ledger blockchain. Anything that can massive problem in solutions underpinned by a mod- be programmed normally can be ular architecture delivering high programmed within the Ethereum the world. degrees of confidentiality, resil- network. ience, flexibility and scalability. Hackers steal identities and im- Processes that normally require personate users to incur huge Medical information is often high- costs on both users and business- a professional or notary can ly sensitive, in both a social and es. To combat this, Medicalchain be automated and validated by legal sense, so a closed block- has partnered with Civic and will Smart Contracts in a wholly trans- chain such as Hyperledger Fabric use Civic’s user authentication parent and secure way. For exam- helps to retain the necessary pri- services to easily and securely ple, the average physician spends vacy required for such an applica- manage the identities of users in 3.8 hours weekly on billing and tion. a decentralised way. Civic identi- insurance related activity. Imag- ine the cost savings if these pro- fies and verifies users using bio- Hyperledger Fabric is a better metrics, which provides a simple cesses were conducted on Smart solution for managing access to and safe way of ensuring user’s Contracts and validated by the health records, as it accommo- privacy. Ethereum network. dates for multiple layers of per- mission, meaning the owner of a set of data can control which parts of their data is accessed. Copyright © 2018 Medicalchain. All rights reserved 12

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/ Institutions 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/Institutions • 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 Copyright © 2018 Medicalchain. All rights reserved 13

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 in a data store within 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 key of the owner of the EHR a 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 authorised users’ public keys 2. The symmetric key is encrypted with the public key of the authorised user If a user is authorised to access a health record and requests access then the following process takes place: Input Data Object Hash of object stored Data Object encrypted Hashing Algorithm on ledger and stored in secure data store Original Data Secure Data Storage 0x e3b0c4 Object Stored Ledger Object Hash on ledger and hash of stored object compared Stored Object Hash Comparison Data Object called from storage and unencrypted Flagged if compromised If hashes match data is served to user Verified Data Sent To Requester 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 Copyright © 2018 Medicalchain. All rights reserved 14

6.0 Technical Explanation 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 authorised asset on the ledger • Patient A’s ID is added to Practitioner A’s authorised 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 authorised asset • Patient A’s ID is removed from Practitioner A’s authorised 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 IDs that have permission Practitioner Referring Patient • Practitioner A updates the permissions to allow Prac- titioner B to access the Patient’s EHR. • Chaincode will check that 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 authorised asset • Patient A’s ID is added to Practitioner B’s authorised asset Copyright © 2018 Medicalchain. All rights reserved 15

6.0 Technical Explanation 6.5 Data Structure Hyperledger’s modelling 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) authorised Array of all participants ID’s that have been authorised to read EHR Asset MedicalRecord Structure defined in asset Practitioner Variable Type Variable Description String ID A unique string (128-bit UUID) Asset PublicProfile Structure defined in asset String (Array) Patient Array of all participants ID’s that have been authorised to read EHR Asset MedicalRecord Structure defined in asset Copyright © 2018 Medicalchain. All rights reserved 16

6.0 Technical Explanation Assets Personal Details Relationship: Patient (Participant) Variable Type Variable Description String ID Unique ID for asset String FirstName User’s given name String Last Name 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 Practitioner’s public profile Relationship: Practitioner (Participant) Variable Type Variable Description String ID Unique ID for asset String FirstName User’s given name String Last Name 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 Practitioner (Participant) asset Copyright © 2018 Medicalchain. All rights reserved 17

6.0 Technical Explanation Medical Record Variable Type Variable Description String ID A unique string (128-bit UUID) 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 outside of the blockchain Concepts Address Variable Type Variable Description String Number Number/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 Copyright © 2018 Medicalchain. All rights reserved 18

6.0 Technical Explanation 6.6 Permission Definitions Hyperledger Fabric includes an access control language (ACL), which defines access 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 available to developers. We hope to cultivate a robust ecosystem of applications and services. Copyright © 2018 Medicalchain. All rights reserved 19

7.0 A Better System for Care 7.1 User Control Approved clinicians on the Medicalchain platform will have In the current healthcare system, the ability to ‘read and write’ on patients have their health in- the patient’s records. Moreover, formation spread over multiple the Medicalchain platform will systems, hospitals, networks and provide the users with a full log of potentially countries. who has access to their medical data, the time of access and the There are multiple fragmented particular types of data that can records from the same patient, be accessed. held at different institutions all with their own snapshot of 7.2 Data Security the patient’s health at the point of their interaction with them, The Medicalchain system uses such as blood tests, imaging a double encryption mechanism and clinic letters. Medicalchain on a closed, permission-based will chronologically arrange all blockchain. of these records and filter them into the specific categories The security of health records is above to aid data handling. Such secured beyond any centralised a categorisation would make the data system currently in use. records more accessible and un- Patient data is not accessible derstandable for patients and it directly on the blockchain. will also facilitate researchers in searching for the information The blockchain acts as a pointer relevant to them. to where patient data is held in an encrypted format, meaning that Medicalchain provides the anyone attempting to intercept patient data will be unable to user, being the owner of their with the ease that is required own medical records, full to access data existing in any central location. access and control over their data. The user will have the capability to provide differing levels of access to various users, by assigning a set of access permissions and designating who can query and write data to their blockchain, and for how long. Copyright © 2018 Medicalchain. All rights reserved 20

7.0 A Better System for Care 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 cate- gorisation would make the records more accessible and under- standable for patients, and 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 by integrating with Apple HealthKit and common 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. Copyright © 2018 Medicalchain. All rights reserved 21

7.0 A Better System for Care 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 incapacitat- ed, 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, medica- tions, 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. In the case that the patient is incapacitated or uncon- scious and unable to grant access to their records, the emergen- cy 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 ex- plicit 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 de- vice which would unlock access to these key parts of their med- ical records. This would enable clinicians to provide the best care possible to a patient in an emergency situation based on their pre-authorised sample of relevant data. Copyright © 2018 Medicalchain. All rights reserved 22

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. When an authorised healthcare professional updates a patient health record, the system will update that record on Medicalchain. Any clinician with authorised access to that record will see the update in real time. As health records are updated via Medicalchain for all authorised 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 users’ documents shared with them. Issues currently associated with interoperability are resolved this way and costs that 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 frequent travellers and those moving abroad who want to avoid the inconvenience of transferring their health records to their new provider. Medicalchain has the vision of one day bringing its platform to developing nations around the world where there is less access to quality care. We believe the ability to carry your health in- formation with you on a mobile phone is powerful. Copyright © 2018 Medicalchain. All rights reserved 23

7.7 Transparency 7.71 Patients / Users In present-day healthcare, there is a lack of transparency between all parties 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 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 & Transparency Cost Benefits 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 scenario they need to make one. The verifiability and immutability of health records on Medicalchain’s platform allows insurance companies to make a more accurate 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. As in turn, a healthier lifestyle works in favour of both the insurer and the patient. Copyright © 2018 Medicalchain. All rights reserved 24

8.0 Token Utilities 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 conjunction with the Medicalchain platform: the need to physically attend the doctor’s practice. There are many simple ailments that are currently 8.2 Telemedicine Consultations managed over the telephone, but by providing a Telemedicine component we can improve the Telemedicine, an online consultation with a doctor patient’s experience by facilitating a visual con- and patient using a webcam interface, is set to be sultation which would be more in-depth and the future of consultations. beneficial to both the doctor and the patient. Patient controls access of records to doctors when conducting telemedicine consultation and pays the doctor for the consultation with MedTokens. Medicalchain not only provides this established and successful format of consultation, but will ac- 8.22 Clinician Benefits commodate the doctor by enabling them to interact live with the patient’s records during the consultation. To attend a doctor’s appointment requires a patient Patients would grant access to their records during to cancel their work in advance or take their child the Telemedicine consultations, allowing for a more out of school for the appointment. There is then the in-depth, informative, and valuable experience for waiting time at the clinic in order to see the doctor, both the patient and doctor. often times for a simple request. Telemedicine There are also further benefits from the telemedicine provides the patient with the opportunity to select experience which Medicalchain delivers. a specific time to conduct the consultation at their convenience, encouraging patient choice and Telemedicine platforms available today offer online freedom. Further, patients are able to choose which visual consultations but do not have access to lon- doctor they would like to conduct their consultation gitudinal health records. Medicalchain offers this with offering greater choice and building a rela- unique value and provides patients with privacy tionship between that doctor and patient, whereas controls. Patients will be able to choose the level perhaps logistically it would not have been possible of detail visible and allocate viewing rights to their beforehand if they were based in different cities. chosen doctor for as long as they feel necessary. Copyright © 2018 Medicalchain. All rights reserved 25

8.0 Token Utilities The doctor also reaps many benefits from utilising Pharmaceutical and research companies will telemedicine by providing the clinician with also benefit from the changes brought in by a flexible working pattern allowing them to conduct Medicalchain. They will be able to seek out patients consultations from any location with adequate who have opted into being contacted by researchers internet connectivity. Medicalchain will provide the so that these institutions can interact directly with doctor access to the patient’s health record (with the patient. By doing so, companies will no longer the patient’s permission) during the telemedicine need to approach a hospital or clinic and can go consultation. This will also give the clinician the straight to the people whose information will be added confidence during the consultation that they used. Not only will this increase efficiency, but it is are being provided with all of the information they a more transparent process that strikes a rela- require to suggest appropriate investigations and tionship which is symbiotic and sustainable. organise a treatment plan. There would be a few broad categories of data leasing agreements though more are likely to evolve 8.3 Health Data Marketplace Control over time. Here are a few we envision: As with the founding principal of Medicalchain, • One time leasing. Institutions will use APIs patients should have control over their health records, provided by Medicalchain to pull relevant data and they should also benefit from the potential from participants from our servers. value that they possess. Medicalchain will connect research institutions with users who are willing to • Longitudinal studies. Institutions that need to have their health data used in studies in a health data see data over a period of time will be able to ask marketplace. Users will be given clear information as users to stream their data. Example: how many to how their data is being used and what data will be steps users have walked per day or what their required. In many cases anonymised data will be per- heart rate looked like today. missible, ensuring the privacy of everyone involved. • Collated data. Medicalchain would combine normally disparate data sources and provide easy access to these data sources with user consent. • Ongoing anonymised data offerings. Users could opt in to have their data anonymised and Patient grants access of personal labelled as accessible to research institutions health data to researchers in return for interested in it. Institutions would have incentivisation with MedTokens the ability to filter by broad categories (e.g. 40-50 year old, 25+ BMI, male) and users In return, participants will be compensated in would be paid every time their data is accessed. MedTokens. Patients will be given the ability to unlock the monetary value that their health data holds, they will be more engaged with their health conditions and the next generation of cutting-edge medicine will be empowered. Copyright © 2018 Medicalchain. All rights reserved 26

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 to 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. Copyright © 2018 Medicalchain. All rights reserved 27

9.0 Cost Impact Analysis 9.1 Users 9.2 Clinicians Whereas typically for a patient to gain access to Clinicians using the Medicalchain platform would their medical records, they would need to apply to have immediate access to conduct Telecon- their service provider and pay all associated admin- sultations. This will provide an additional revenue istrative fees to have these released to them, with stream, meaning they could practice without any Medicalchain, the user would provide consent to overheads other than a computer with internet have their data retrieved on their behalf, and stored connection. free of charge on Medicalchain’s nodes. Once this has been carried out, the patient would then use the This availability would decrease the chance of Medicalchain application to have a standardised, cancellations due to patients being unable to single point of access to those records at their physically attend a consultation. Cutting this variable discretion, eliminating the need for additional ad- out saves on facility expenses, administration costs ministration fees. Should they lose this data, or need and the need for additional staff. to send original, physical copies at any time, they would grant access to any requesting parties. With transportable personal data, the risk is sig- nificantly reduced if medical assistance is required away from a users healthcare provider. Utilising Medicalchain’s Teleconsultation platform, users would have dramatically decreased waiting times and costs associated with travel. Copyright © 2018 Medicalchain. All rights reserved 28

9.0 Cost Impact Analysis 9.3 Healthcare Providers There are a plethora of benefits to healthcare providers. First of all, they 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 pro- cess of forming research groups and going through health pro- viders for access to health data. 9.5 Insurers Verifiable, immutable data, means that insurance companies will need to spend fewer 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. Copyright © 2018 Medicalchain. All rights reserved 29

10.0 Token Sale Medicalchain’s ICO will be a capped sale raising Of these 500 million tokens... $24 million (24,000,000) equivalent of ETH and/ or BTC with whitelisted contribution caps. Medi- • 35% will be offered in the pre-sale and crowdsale. calchain will be issuing 500 million (500,000,000) ERC20 tokens, called MedTokens, to create a new • 34% will be retained by the company, team, blockchain based healthcare ecosystem. advisors, founders and future employees. Within this 34%... These tokens will be offered in a Crowdsale to allow participants to purchase MedTokens early as well • 10% will have already vested. as contribute and support the further development of Medicalchain. Starting on 1st February, 2018, • 12% vests over 2 years. participants will have the ability to contribute and receive MedTokens in exchange for their ETH and/ • 12% vests over 4 years. or BTC by sending 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 • Company development: 8% ETH and offered before this date at a discount 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 its blockchain by educating others, supporting node holders, bringing partners onto its platform, conducting pilots, and sponsoring industry leading events. This will vest over 4 years. 31% 35% 34% community development crowdsale retained by the company Copyright © 2018 Medicalchain. All rights reserved 30

11.0 Timelines 11.1 Medicalchain to date Dr. Albeyatti expanded the team by bringing Mo Tayeb, Jay Povey, Robert Miller as well as a combination of medical doctors, allied health The Story So Far professionals, and experts from the blockchain community. Together, the team has developed Medi- Work on Medicalchain started in 2016 when founder calchain – complementing Discharge Summary and Dr. Albeyatti identified an issue with writing clinical helping to build Dr. Albeyatti’s vision. notes on patients being discharged out of the hospital and having their care transferred back to Over the past few months, a flurry of work has been their family doctor (general practitioner). These completed and Medicalchain has been featured notes, known as “Discharge Summaries” contain at world-renowned forums such as the Financial a substantial volume of mandatory information Times Digital Health Summit, Blockchain Labo, and that is often written in freeform text by the doctors. the Technology Innovation. The work to date has The notes are subject to errors. For example, doctors resulted in a public Beta, which will be released in may forget to include vital medical information, such February, as well as several key partnerships. One as the correct dosage or course of drug prescription. thing is for sure: Medicalchain is leading the way These errors put the patients’ wellbeing at risk, incur in blockchain applications in healthcare and digital raised costs, and represent a liability for the hospital. health’s role in our daily lives. To address this, Dr. Albeyatti co-founded Discharge Summary with Bara Mustafa. 11.2 Current Developments First deployed in Leeds Teaching Hospital Trust, UK, the tool was designed to generate accurate The proof of concept is in its final phase and and timely notes when patients are sent home. the development is now focused on design and Discharge Summary received a positive welcome UX/UI experience.The core of the application, and was adopted by junior doctors as well as con- Medicalchain’s secure API and blockchain, is ready for sultants and other healthcare practitioners. the release of the Beta. The nodes setup and operated during the Beta are run by Medicalchain, but over time Discharge Summary, by improving communication Medicalchain will include other nodes onto its and standardising data, demonstrated to Dr. Albeyatti network. Several of these conversations are the power of digital health to lower costs and underway already with hospitals, universities and improve outcomes. He sought to apply this insight to non-profit organisations. a broader problem: disparate health systems. In short, documents are transferred, often on paper, 11.3 Collaborative Design to other organisations where the exchange of data results in no single version of the truth. Moreover, To enhance the user experience of Medicalchain oftentimes IT systems are not interoperable; they a range of global advisors have been selected to cannot talk to each other let alone use each other’s work on specific use cases. Expert patients, doctors, vital data. health professionals, health providers, insurance and pharmaceutical companies will take part in system design consultation with blockchain developers. The Beta release will enable testing of each use case, with the trialling community providing feedback via the platform. Copyright © 2018 Medicalchain. All rights reserved 31

11.4 Roadmap jan feb Conceptualisation of ideas. Development started on Discharge Summary dec Cardiology 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 First release of jun Medicalchain prototype jul aug Medicalchain joins Hyperledger sep DS launched with Queen and Linux Foundation Elizabeth Hospital oct DS launched with University Hospital Lewisham Medicalchain showcased at nov FT Digital Health Summit NYC Medicalchain is nominated top 10 in Europe for Accenture healthtech Challenge dec Medicalchain is nominated top 20 in the world for H-Farm Health Accelerator Competition Copyright © 2018 Medicalchain. All rights reserved 32

11.4 Roadmap jan DS launched with Princess Closed beta feb Royal hospital platform launch mar Medicalchain set to present Doctor and patient enrollment at European Parliament for 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 sep collected data and feedback 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 Copyright © 2018 Medicalchain. All rights reserved 33

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 primary • Non-Profit Node Services target market for system trials. Influential users that • Research Institutes / Pharma witness the benefits of Medicalchain will be the main catalysts for further patient onboarding. Expert patients have expressed great interest in As we continue with awareness and onboarding the benefits of owning and managing their own campaigns, Medicalchain will offer a service where it health records. We are working with several dis- will request healthcare records for consenting users. ease-specific organisations to onboard experienced Our legal team are working with system developers healthcare users to test the collation of data to build API integration compliant with various in- processes, alongside the user interface. ternational regulations. We acknowledge that some countries may have barriers to the decentralization of data and we are working with others to negotiate Medicalchain has several these barriers. community campaigns running, The data migration process would require a user to on a variety of platforms to complete a short form of consent, highlighting the raise awareness of the project providers they wish to obtain records from who they had previously visited. and the benefits of blockchain for healthcare users. Physical documents will be scanned and mined for information which will then be encrypted and Communication platforms include: uploaded to data lakes. Electronic records will be standardised, encrypted and uploaded. • Global Events • International Press Releases Medicalchain is approaching clinicians individually • Sponsored Meetups and at an organisational level. This multilevel • Telegram approach will allow for forward-thinking health • Email Campaigns providers to test the Medicalchain platform • LinkedIn throughout their service but does not exclude in- • Reddit novative autonomous healthcare professionals. We • Twitter will work alongside clinicians to test the pilot with • Bitcoin Chat consenting patients and assist providers with pa- • LINE tient-targeted marketing material to improve user • WeChat adoption. • Kakao Talk Copyright © 2018 Medicalchain. All rights reserved 34

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 data, will have the opportunity to partner with Medicalchain. Organisations will be incentivised to act as 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. These organisations will have the ability to request data from cohorts of users on Medicalchain’s platform, and with their consent, use their health records for research. Copyright © 2018 Medicalchain. All rights reserved 35

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 joining our team or in building on our platform then please reach out to [email protected] Copyright © 2018 Medicalchain. All rights reserved 36

12.0 MedToken Legal and Crowdsale 12.1 General Information 12.3 Risks The MedToken does not have the legal qualification Acquiring MedToken and storing them involves of a security, since it does not give any rights to various risks, in particular the risk that Medicalchain dividends or interests. The sale of MedTokens is SA may not be able to launch its operations and develop final and non-refundable. MedTokens are not shares its blockchain and provide the services promised. and do not give any right to participate to the general Therefore, and prior to acquiring MedTokens, any meeting of Medicalchain SA. MedToken cannot user should carefully consider the risks, costs and have a performance or a particular value outside the benefits of acquiring MedToken in the context of the Medicalchain SA network. MedToken shall therefore crowdsale and, if necessary, obtain any independent not be used or purchased for speculative or in- advice in this regard. vestment purposes. The purchaser of MedToken is aware that national securities laws, which ensure Any interested person who is not in the position to that investors are sold investments that include all accept or to understand the risks associated with the proper disclosures and are subject to regulatory the activity (incl. the risks related to the non-de- scrutiny for the investors’ protection, are not ap- velopment of the Medicalchain SA platform) or any plicable. other risks as indicated in the Terms & Conditions of the crowdsale should not acquire MedTokens. Anyone purchasing MedToken expressly ac- knowledges and represents that she/he has carefully 12.4 Disclaimer reviewed this whitepaper and fully understands the risks, costs and benefits associated with the This whitepaper shall not and cannot be considered purchase of MedToken. as an invitation to enter into an investment. It does not constitute or relate in any way nor should be 12.2 General Knowledge considered as an offering of securities in any ju- risdiction. The whitepaper does not include nor The purchaser of MedToken undertakes that she/he contain any information or indication that might understands and has significant experience of cryp- be considered as a recommendation or that tocurrencies, blockchain systems and services, and might be used to base any investment decision. that she/he fully understands the risks associated This document does not constitute an offer or an in- with the crowdsale as well as the mechanism related vitation to sell shares, securities or rights belonging to the use of cryptocurrencies (incl. storage). to Medicalchain SA or any related or associated company. The MedToken is just a utility token which Medicalchain SA shall not be responsible for any can be used only on the Medicalchain SA platform loss of MedToken or situations making it impossible and is not intended to be used as an investment. to access MedTokens, which may result from any actions or omissions of the user or any person un- The offering of MedToken on a trading platform is dertaking to acquire MedTokens, as well as in case done in order to allow the use of the Medicalchain of hacker attacks. SA platform and not for speculative purposes. The offering of MedToken on a trading platform is not Copyright © 2018 Medicalchain. All rights reserved 37

12.0 MedToken Legal and Crowdsale changing the legal qualification of the token, which remains a simple means for the use of the Medicalchain SA platform and is not a security. Medicalchain SA is not to be considered as advisor in any legal, tax or financial matters. Any information in the whitepaper is given for general information purpose only and Medicalchain SA does not provide with any warranty as to the accuracy and completeness of this information. Given the lack of crypto-token qualifications in most countries, each buyer is strongly advised to carry out a legal and tax analysis concerning the purchase and ownership of Medicalchain’s Tokens according to their nationality and place of residence. Medicalchain SA today is not a financial intermediary according to Swiss Law and is not required to obtain any authorization for Anti-Money Laundering purpose. This qualification may change in case Medicalchain SA will offer services which are to be considered as qualifying a financial intermediation activity. In this case, the use of Medicalchain SA services may require the positive conclusion of an AML/KYC identification process. MedTokens confer no direct or indirect right to Medicalchain SA’s capital or income, nor does it confer any governance right within Medicalchain SA; a MedToken is not proof of ownership or a right of control over Medicalchain SA and does not grant the con- trolling individual any asset or share in Medicalchain SA, or in the Medicalchain SA network. A MedToken does not grant any right to participate in control over Medicalchain SA’s management or decision-making set-up, or over the Medicalchain SA network and governance to the purchasers. Regulatory authorities are carefully scrutinizing businesses and operations associated with cryptocurrencies in the world. In that respect, regulatory measures, investigations or actions may impact Medicalchain SA’s business and even limit or prevent it from de- veloping its operations in the future. Any person undertaking to acquire MedToken must be aware of the Medicalchain SA business model, the whitepaper or Terms & Conditions may change or need to be modified because of new regulatory and compliance re- quirements from any applicable laws in any jurisdictions. Copyright © 2018 Medicalchain. All rights reserved 38

12.0 MedToken Legal and Crowdsale In such a case, purchasers and anyone undertaking to acquire MedToken acknowledge and understand that neither Medicalchain SA nor any of its affiliates shall be held liable for any direct or indirect loss or damage caused by such changes. Medicalchain SA will do its utmost to launch its operations and develop the Medicalchain SA platform. Anyone undertaking to acquire MedToken acknowledges and understands that Medicalchain SA does not provide any guarantee that it will manage to achieve it. On concluding the Commercial Operation, these tokens will be issued by a technical process referred to as a «Blockchain». This is an open source IT protocol over which the Company has no rights or liability in terms of its development and operation. The token distribution mechanism will be controlled by a Smart Contract; this involves a computer program that can be executed on the Ethereum network or on a blockchain network that is compatible with Smart Contract programming language. They acknowledge and understand therefore that Medicalchain SA (incl. its bodies and employees) assumes no liability or respon- sibility for any loss or damage that would result from or relate to the incapacity to use MedTokens, except in case of intentional misconduct or gross negligence. MedTokens is based on the Ethereum protocol. Therefore, any malfunction, unplanned function or unexpected operation of the Ethereum protocol may cause the Medicalchain SA network or Medicalchain SAs to malfunction or operate in a way that is not expected. Ether, the native Ethereum Protocol account unit may itself lose value in a similar way to MedTokens, and also in other ways. Copyright © 2018 Medicalchain. All rights reserved 39

12.0 MedToken Legal and Crowdsale 12.5 Representation and warranties By participating in the crowdsale, the purchaser agrees to the above and in particular, they represent and warrant that they: • have read carefully the Terms & Conditions attached to the whitepaper; agree to their full contents and accept to be legally bound by them; • are authorised and have full power to purchase MedToken according to the laws that apply in their jurisdiction of domicile; • are not a U.S. citizen, resident or entity (a “U.S. Person”) nor are they purchasing Medicalchain SA or signing on behalf of a U.S. Person; • are not resident in China or South Korea and nor are they purchasing MedToken or signing on behalf of a Chinese or South Korean resident; • live in a jurisdiction which allows Medicalchain SA to sell MedToken through a crowdsale without requiring any local authorization and are in compliance with the local, state, and national laws and regulations when purchasing, selling and/or using Medicalchain; • are familiar with all related regulations in the specific jurisdiction in which they are based and that purchasing cryptographic tokens in that jurisdiction is not prohibited, restricted or subject to additional conditions of any kind; • will not use the crowdsale for any illegal activity, including but not limited to money laundering and the financing of terrorism; • have sufficient knowledge about the nature of the cryptographic tokens and have significant experience with, and functional understanding of, the usage and intricacies of dealing with cryptographic tokens and currencies and blockchain-based systems and services; • purchase MedToken because they wish to have access to the Medicalchain SA platform; • are not purchasing MedToken for the purpose of speculative investment or usage. Copyright © 2018 Medicalchain. All rights reserved 40

12.0 MedToken Legal and Crowdsale 12.6 Governing law – Arbitration The Client acknowledges and accepts that the Medicalchain SA ICO operation is taking place within a Swiss legal environment that is still under development. The Parties agree to seek an amicable settlement prior to bringing any legal action. All disputes arising with the with papers provided, shall be resolved by arbitration in accordance with the Swiss Rules of International Arbitration of the Swiss Chambers of Commerce in force on the date when the Notice of Arbitration is submitted in accordance with these Rules. The arbitration panel shall consist of one arbitrator only. The seat of the arbitration shall be Lugano, Switzerland. The arbitral proceedings shall be conducted in English. MedTokens will not be listed on any regulated stock exchange, such as SIX Swiss Exchange, or SIX. These Terms have been prepared without regard to the legal standards for prospectuses under art. 1156 or art. 652a of the Swiss Code of Obligations or the legal standards for facilitated prospectuses under art. 5 of the Collective Investment Schemes Act (“CISA”) or art. 27 ff. of the SIX Listing Rules or the listing rules of any other stock exchange in Switzerland. Neither these Terms nor any other material relating to the Offer, Medicalchain SA or MedTokens will be or have been filed with or approved by any Swiss regulatory authority. Specifically, these Terms will not be filed with, and the Offer of MedTokens will not be supervised by, the Swiss Financial Market Supervisory Authority FINMA (FINMA). Furthermore, the Offer of MedTokens has not been and will not be authorised under the CISA. Thus, the protection which is given to purchasers of interests or units in collective in- vestment schemes under the CISA does not extend to purchasers of MedTokens. Copyright © 2018 Medicalchain. All rights reserved 41

Copyright © 2018 Medicalchain. All rights reserved