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As a technology, the blockchain is still nascent, particularly when it comes to applications in the healthcare sector. However, potential uses are starting to emerge, and one aspect that could be ripe for the transformation by the blockchain is the revenue cycle, particularly in the area of claims denials.
A quick update: Blockchain is a distributed register technology to store data as a series of immutable and unalterable records. First came to the fore as a basis for the Bitcoin cryptocurrency, in which he transferred value without an intermediary, like a bank.
This is one of the main tricks of his repertoire. It also provides a distributed ledger, ensuring that no one can spend the same money twice. And instead of recording transactions in a central database – where funds are deducted from one account and added to another – blocks of digital blocks in blocks, which are then chained with cryptographic keys. The chain then traces the history of changes.
Each participant receives a copy and the content of each block is blocked. If someone agrees to alter the data, their copy of the chain will be broken, immediately and without subtlety.
Lynn Carroll, head of strategy and operations for HSBlox, said that waste management is probably the first part of the healthcare world to benefit from this emerging technology.
POTENTIAL BLOCKCHAIN APPLICATIONS
"When you think about using machine learning skills to evaluate historical claims, you now have the ability to verify, in the form of an intelligent contract on an intelligent complaint, the rules for judging that claim in real time," said Carroll. "He can tell you if he's likely to be denied, and can tell you multiple reasons, or I can automate those claims based on the results of machine learning: once a payer and a supplier have a contract, coding it into blockchain two things: allows you to follow the rules agreed by the two parties to finalize a transaction. "
If you move this process to the forefront of the claims award cycle, there is now the possibility of providing real-time transparency to the patient and the status provider. The claim can be finalized or the funding opportunities can be presented to the patient, and the payer could potentially take a further discount from the provider to take the risk.
Which means that if a complaint is finalized in real time, there is an opportunity for the patient, the provider and the payer to understand when the services are to be delivered and what the financial responsibility will be.
MOTIVATING STAKEHOLDERS
The success of Blockchain in the health sector, said Carroll, is measured by the participation of stakeholders. Those stakeholders must be motivated.
"By definition, an initiative or a blockchain program is a network in a bottle," he said, "with multiple participants having the ability to model information in real time. The motivation for people participating in a & # 39; blockchain initiative is the ability to have secure transactions, exchange value, it could be financial, or it could be a contractual relationship to participate, but often there could be a reason for information to participate ".
Carroll offered the following example: years ago, when a person had to reconcile his statement, there was a lack of transparency and visibility in real time when it came to determining the current balance. Then things started to move heavily in the direction of electronic transactions, but there were still scenarios where people had to reconcile their bank statements after the fact.
Then the mobile banking apps arrived. This gave people the opportunity to have transactions in real time, even if they were not finalized. A similar scenario can happen in the health sector, said Carroll.
"What you have is a whole series of transactions that typically occurred under the hood, where the patient was not able to see that information and make decisions in real time," he added. "When one thinks of the reasons why interested parties would participate, it is because it is in real time and on an authorized basis".
This is really what separates the blockchain from its cryptocurrency origins. Authorized access means that information will not be replicated publicly.
HIPAA establishes that information may be disclosed between covered entities and blockchain can help ensure that it is handled appropriately.
"This gives more control," said Carroll. "If they have the ability to aggregate this information alone and share it with stakeholders as a physician or in a case where they have more chronic conditions, they have a much greater visibility. All the information they share, they have full traceability of".
ADOZIONE BARRIERS
As with any technology that makes its way into the mainstream of health care, interoperability has continued to be a challenge in the industry. These challenges are set to come back as industry moves to adopt more standardized data formats.
The concept of ubiquitous data sharing along the welfare continuum poses a challenge for the pervasive adoption of the blockchain.
"How can you have motivated parts in a microcosm scenario that will share data and adopt standards with one another – on what would be a small-scale case to demonstrate the value of technology – ultimately I think showing the healthcare ecosystem would benefit from greater process automation, the reduced costs associated with that, "said Carroll. "And the biggest advantage is sharing information in real time."
Anticipate a significant increase in the use of blockchain in the health sector over the next three to five years, in particular the distributed registries. Pervasive adoption will probably come later, perhaps eight to ten years.
"Technology is ripe for disruptions," he said, "and as we continue to see more cases of use, it will become more apparent globally what the benefits of health care technology are, and probably more importantly. , for the full integration of patients in the ecosystem. "
Twitter: @JELagasse
Send an email to the writer: [email protected]
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