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By Jennifer Bresnick
– As the volume of big data continues to increase exponentially and the pressure to reduce wasteful spending is escalating, healthcare organizations are expanding their search for secure and uninterrupted data management strategies.
Increasingly, organizations are finding that blockchain has the potential to solve many of the most challenging issues involved in managing administrative, financial, and even clinical data.
The methodology of the distributed ledger, which has its roots in the world of cryptocurrency, offers health workers an innovative option to deal with trivial but vital tasks, such as keeping the provider directories up-to-date.
Vendor lists are needed to ensure that the right staff members are trained and authorized to provide specific services at support sites for which they have current credentials.
In addition to being crucial to the reimbursement process, supplier directories protect patients by preventing unqualified individuals from practicing incorrectly.
READ MORE: Provider data management offers payers a Blockchain use case
But keeping the credentials and affiliations of millions of health professionals up-to-date is a daunting prospect for payers and providers.
Most of the credentials and confirmation processes are still conducted manually, using good old-fashioned telephone calls and faxes to verify the use or verify the suitability to provide repayable services. As a result, the phone tag and human error constantly add time, frustration and expense to an already complex procedure.
Most states require monthly updates to the provider directories and many regulations state that payers should regularly contact each and every supplier of the list to update their information.
As a result, providers may be forced to field an endless series of calls from a dozen different payers, each of whom asks the same questions and tries to replicate the same information.
Every year, the healthcare system spends more than $ 2 billion to acquire and maintain supplier data, as recent estimates show.
READ MORE: 55% of executives say that Blockchain is ready to interrupt health care
Blockchain could drastically reduce confusion by creating a single source of truth for provider data and a shared, standardized framework for exchanging such data when needed, theorizing the Synaptic Health Alliance.
The collaboration, launched in April 2018, is exploring how to implement a blockchain-based approach to managing directory data of the provider that will promote trust and provide accurate and timely data to all entities that need it.
The founding members of Synaptic, Humana, MultiPlan, Quest Diagnostics, Optum and UnitedHealthcare believe the blockchain has significant potential to overcome the confusion created by existing data management strategies.
"The Alliance considers blockchain technology as a means for a fundamental purpose: to ensure that data are accurate and shareable for reliable use throughout the health care ecosystem," the Alliance said in a recent white paper.
"Thanks to the large volume of collective data and the members' national footprint, this collaboration could demonstrate the business value of cross-company data sharing in the healthcare sector and ultimately help to facilitate a positive impact significant in the space of the health market ".
READ MORE: How artificial intelligence and blockchain combine to feed the great analysis of health data
The big footprint of Alliance data is further expanding, the group announced at the beginning of December, when two new market leaders will join the coalition as founding members.
Aetna, recently acquired by CVS Health and Ascension, the largest non-profit national healthcare system, is adding its resources and expertise to the project.
Source: Xtelligent Media
"We are participating in the Alliance because the opportunity to share information securely and appropriately across the healthcare continuum is extremely important," said Gerry Lewis, Senior Vice President and Chief Information Officer at Ascension.
"If we can exploit the blockchain to help effectively exchange this information between suppliers, payers and consumers, then we will be able to make significant progress with our ability to improve the experience of anyone who interacts with that data."
Solving the enigma of the provider directory is an ideal test case for blockchain, Lewis said HealthITAnalytics.com.
"We have tried to solve this problem with well-established technologies for a while, but there are many points of friction," he noted. "There are so many different stakeholders, each with their own semantic ontologies, and this is a very complex landscape to explore."
"Right now, both suppliers and taxpayers are wasting a lot of time and money on lost phone calls and correcting mistakes, and it is in everyone's interest to see if there is a better way to achieve alignment. and get the correct information at the time of assistance ".
Lewis believes that probably Blockchain will constitute at least part of this solution.
"I do not know if blockchain will be the right technology to completely solve this problem – that's why we're exploring and experimenting with it – but I think it will help bring about more efficient and effective processes," he added. He said.
And multi-stakeholder organizations such as the Synaptic Alliance will be crucial to identify how the blockchain can contribute to better experiences and streamlined and simplified workflows.
"The timeliness of these data is very important," stressed Lewis. "Would not it be nice if a patient showed up on an appointment and you could immediately withdraw the payment information contracted by the supplier on the blockchain and the service confirmation was immediately validated? Would not it be nice if we could provide that kind of consumer-focused experience? for the patient and for the administrative staff? "
"Blockchain has the potential to support it.At the end of the day, blockchain could change the way we do business.This should be a very exciting thought for health care."
The Alliance is planning to pilot an authorized blockchain, or a closed and invitation-only blockchain community, which will allow members to view, validate and update data from non-proprietary providers within the network, he explained the group's white paper. The pilot project will initially focus on a geographic market, to maintain the scope of the manageable initiative.
"The pilot is examining whether sharing administrative efforts related to supplier data management reduces the individual share of that burden for health plans and care providers," the report continues.
"It is also testing the possibility of incorporating incentives to motivate data sharing with all users of the blockchain network, improving data quality and reducing data maintenance costs."
The Alliance hopes to make significant progress towards a viable solution in 2019, said Lewis.
"We are working on several cases of use that we want to validate in the next year, and then use those results to evaluate where we need to move forward," he said. "It is important to be able to rotate quickly towards the next possibility, and we believe that the Alliance will play an important role in identifying those new opportunities with blockchain."
For Ascension, participating in the pilot project is a way for the healthcare system to keep abreast of trends in rapid evolution in the health IT area that could improve operations and reduce costs.
"Things are changing so fast that healthcare organizations must learn to be agile and adapt quickly to new technologies," said Lewis. "They have to focus on creating positive experiences for their consumers: the goal is to first think about the experience, and then choose the tools and strategies that will enhance the journey of the consumer through the entire continuum" .
"Clearly, spending is a challenge in the United States and we think there are opportunities to reduce some of the administrative waste resulting from having incomplete or inaccurate data." We believe that blockchain will help us do that while we run the economy as well. ".
