Blockchain has emerged as one of the most promising technologies to address the fragmentation and inefficiencies afflicting current health care systems. Its distributed real-time architecture promises a process and regulation of faster requests, lower transaction costs, easier management and greater security for electronic medical records (EHRs) and better patient outcomes.
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Getting all of this is obviously a daunting task, but blockchain could be one of those rare technologies that is at the height of its hype. Here is a look at how.
Complaint management: elimination of fragmentation costs
Smart contracts, sometimes referred to as "decentralized applications", consist of code that can trigger an action once a certain set of conditions have been met.
One of the central problems in managing health today is the lack of interoperability between IT systems. For example, in a typical medium-sized city, patients may have relationships with primary care physicians, a regional hospital, more laboratories, clinics and pharmacies, each of which could use different and incompatible IT systems. When payers enter the scene with their proprietary IT systems, the situation becomes even more complex and difficult to manage.
With blockchain, all members of these different groups can be on the same system with the same data in the same formats, effectively eliminating duplication of effort, manual matching and reconciliation which is now an unfortunate fact of life in the processing of complaints.
In addition, blockchain has a "smart contracts" function that can automate virtually any type of transaction. Smart contracts, sometimes referred to as "decentralized applications", consist of code that can trigger an action once a certain set of conditions have been met. An obvious example would be the activation of payments to suppliers once the correct documentation is in the blockchain.
The net result of these features is faster and more efficient processing at a lower cost.
[ Can you explain blockchain to non-techies? Read our related story, How to explain blockchain in plain English. ]
EHR: a new approach to access and security
The average patient in the United States accumulates medical records of 19 different providers throughout his life.
Blockchain also benefits the management of EHRs, where fragmentation is also a significant problem. The average patient in the United States accumulates medical records of 19 different providers throughout his life. Often, not all of these records are available to providers at the time of treatment due to incompatibility issues. In a blockchain network, where records for each patient reside on each participant's node and are updated in real time, providers can base clinical decisions on complete data they know they can trust.
In addition to increasing doctors' access to EHRs, blockchain strengthens EHR security. Each block of data in the chain can be encrypted using public-key cryptography. In a model proposed to ensure HIPPA compliance, the patient holds the private key that unlocks the data and grants access (sharing the key) with various providers as required.
Accuracy of the provider directory
Another area in which blockchain can contribute to health care is in the directory of health plan providers. Insured persons regularly turn to these directories to select participating physicians, but directory accuracy has been a problem for years. Recent regulatory changes have made the problem more acute. More than a dozen states have passed laws requiring monthly catalog updates, and the Medicare and Medicaid Service Centers can now impose fines of up to $ 25,000 for inaccuracies. A blockchain involving payers, suppliers and certification bodies could quickly solve accuracy problems.
Too good to be true?
For many, the benefits of blockchain seem too good to be true, and indeed, there are several non-trivial challenges facing blockchain before it can gain broad acceptance in the health community.
The first is scalability. The first instantiation of blockchain, Bitcoin, averages about seven transactions per second (tps). In comparison, PayPal reaches 193 tps and Visa claims 24,000 tps. While the accuracy of these numbers is a topic of discussion, it is fair to say that blockchain technology in its current state lacks adequate throughput for many applications. Its speed will certainly increase over time, but the rate of progress can not be predicted.
The second challenge is financial. Blockchain clearly has the ability to reduce operating costs, but requires a substantial front-end investment that could be an obstacle for many classes of participants.
The third challenge is to convince the various stakeholder groups to participate by establishing effective governance and sharing the system costs fairly once it is installed.
Despite these challenges, Blockchain clearly has an impulse. Five major healthcare organizations – United Healthcare, Humana, Optum, Quest Diagnostics and MultiPlan – have launched a pilot program that will use blockchain technology to meet government requirements for accurate provider directories. AWS has released blockchain models specifically targeting developers in the healthcare sector. The FDA has launched a blockchain-based pilot program for secure data sharing with healthcare professionals and hospitals. A survey of 2017 on 200 health organizations revealed that 16% of participants expected to have a commercial blockchain solution in place by the end of the year.
[ Read also: How to tell when moving to blockchain is a bad idea. ]
What should IT health managers know?
While the blockchain continues to permeate traditional business activities, healthcare IT managers must prepare their teams to make the most of this new technology. When considering how to introduce the blockchain in your business, it is important to keep in mind that:
- Blockchain is a broad technology that stands out from bitcoins and cryptocurrencies. Its capabilities extend beyond payment systems and can be applied to almost all transactional business processes, making it essential to adopt healthcare systems.
- By eliminating the need for third-party authenticators, blockchain will speed up processes and reduce costs for both suppliers and payers. With integrated blockchain technology in healthcare systems, suppliers can reduce costs and increase real service spending, all while increasing business efficiency.
- Amid the growing threat of data theft of patients, the unique architecture of the blockchain promotes a highly secure and reliable relationship between patients and providers. With a distributed accounting system, all information exchanges are kept up-to-date and universally authenticated.
- Blockchain is the answer to data inaccuracies, particularly in suppliers' catalogs. I look forward to using blockchain as an authenticator that mitigates information discrepancies.
- Early adoption of blockchain is critical to your organization's future success. Technology already has a big push in the market, as big players like Amazon Web Services and FDA have publicized their interest in its potential.
Blockchain is ready to make a big impact in the health sector over time. Its ability to simplify processes by increasing security is particularly interesting for an industry where complexity and privacy are central. The support he received from large companies and the government made him credible. It has the mystique of attracting brilliant programmers, which will surely exceed its technical limits. Finally, ensuring the availability of up-to-date clinical data, it serves the people for whom the entire health system has been created: the patients.
[ Where else is blockchain making tangible progress? See our related story: Blockchain in action: 5 interesting examples. ]