Jim Nasr on cryptographic trust, decentralized science, and the future of patient-owned data
In Episode 9 of Exponential, Jim Nasr, CEO of Acoer, joins us to tackle one of the most broken but vital systems in modern life: healthcare data. His story starts where many do — with a personal experience that revealed just how fragmented and opaque medical data really is. But unlike most, he decided to build something better.
Acoer is a software company rethinking health infrastructure from the ground up, using cryptography, blockchain, and user-centric design to make data more connected, more trustworthy, and more usable.
“We’re trying to bring connectivity, usability, and authenticity to health data. It sounds simple — but structurally, it’s incredibly hard.”
The problem beneath the problem
The Acoer team is focused on two fundamental blockers: siloed data and lack of trust. Without consistent standards or shared infrastructure, patient data gets trapped in incompatible systems. Meanwhile, providers and patients alike often don’t know whether the data they do see is up to date, complete, or accurate.
“You can’t make critical decisions with incomplete or unverifiable data. And yet — that’s still the norm in healthcare today.”
Drawing a contrast with open banking APIs, Jim points out that while finance has had a clear path toward interoperability, healthcare continues to lag behind. And when data drives life-or-death decisions, the consequences are profound.
Building trust, not hype
Rather than leading with web3 terminology, Acoer takes a pragmatic, behind-the-scenes approach to blockchain. The technology functions like SMTP for email —critical infrastructure, but invisible to most users. “Blockchain is just part of the tech stack,” Nasr explained. “We use it to record consent, establish provenance, and build computational trust. But it’s plumbing, not branding.”
One real-world example: Acoer works with families of children undergoing treatment for neuroblastoma. When parents log into a patient portal and provide consent, every action — login, data sync, re-consent — is hashed and written to a layer-one blockchain. The system maintains full data lineage while preserving privacy.
“We’re not putting patient names onchain. But we are cryptographically proving every step. That’s how you get trust without compromising privacy.”
Verifiability at scale
Acoer’s work dovetails closely with Nexus’s mission around verifiable computation. As AI systems become more integrated into decision-making workflows, the need for trustworthy, proof-carrying data increases exponentially.
“Once you’re creating insights that feed other insights, the pyramid of trust becomes critical. Without verifiability, bias and hallucinations can spiral out of control.”
Jim is particularly focused on ethical AI: private, verifiable, and accountable from the start. “We can’t afford to wait,” he said. “And we definitely can’t just take billionaires at their word. Open-sourcing the code isn’t the same as building real transparency into the system.”
Decentralized science — with a dose of realism
While Jim sees value in the decentralized science (DeSci) movement, he also approaches it with nuance. “We’ve been doing DeSci-type work for five years,” he said, pointing to Acoer’s focus on transparency, interoperability, and ethical governance. But he’s wary of token-first narratives that over-index on IP and speculation.
“There’s an overindulgence in turning IP into NFTs. That shouldn’t be the opening move. We need to start with trust, community, and accountability.”
Instead, he advocates for use cases like privacy-preserving open data for public health, where verifiability and shared access can actually save lives.
Acoer’s flagship product, Health Data Explorer, is already deployed across counties and states in the U.S., helping medical examiners and public health officials understand and respond to opioid-related deaths.
Working with jurisdictions like Jefferson County (AL) and DeKalb County (GA), Acoer ingests data from multiple incompatible systems — including PDFs and legacy software — makes it interoperable and machine-readable, and then layers analytics, AI, and real-time dashboards on top.
“It’s about making high-quality data more usable, more shareable, and more trustworthy — so we can actually respond to public health crises in real time.”
Patient-owned data and long-term focus
Jim's vision for the future is grounded in realism — but also optimism. He believes the next major shift will be patient-owned health data, driven by wearables, personalized AI, and a growing sense of urgency.
“We’ll overestimate what can happen in one year and underestimate what can happen in ten. But long-term, the shift to self-sovereign health data feels inevitable.”
