The IT health sector today faces a number of challenges, including silos within hospitals that limit information sharing, the integration of artificial intelligence into clinical practice, resolution of opioid crisis. While generalized accounting technologies such as blockchain do not all mitigate them, this technology can solve a number of significant painful points associated with routine business processes.
Blockchain is the best solution to solve the health problems that arise from the following conditions: the need to share data in real time among multiple participants, the lack of transparency, the obligation to verify the integrity data and the need for a high standard of security.
Much of the value of blockchain in the health sector comes from "smart contracts", which effectively organize the terms of an agreement between two or more parties in lines of computer code. Because smart contracts implement corporate and legal code rules through a shared, decentralized shared registry, they facilitate transactions between various entities without the need for an external enforcement mechanism or central authority source.
As a result, blockchain enables the tedious, manual, error-prone and redundant business processes that occur in real time, accurately and securely.
Here are four cases of use for daily health business processes that can be improved using blockchain.
Sharing of payment provider data. In an increasingly value-based ecosystem, interoperability issues between separate medical information systems have long frustrated payers and providers – and virtually all stakeholders in the health care system – creating difficulties in exchanging clinical and patient data. claims. As a result, it is very difficult for many payers and providers to view and share patient data while maintaining a complete and up-to-date record of the diagnoses, medications and treatments of a given patient.
With blockchain, all authorized participants in the care delivery process can continue to use their information systems while sharing patient records. Blockchain provides a unique source of truth (a shared ledger) that can not be altered. This single source serves as the main record of all transactions, specifying who, what, when and where of the information associated with each transaction. In this context, it considers each transaction as any update of a patient record, for which multiple parties need to share data in real time.
Revenue cycle management (RCM). In health care, RCM differs from other industries in an important way: the billing and payment processes move slowly and take longer to solve. In the claims settlement process, payers and providers face problems resulting from the inability to address information in real time at the point of service, such as questions about patient eligibility or patient financial responsibility.
For suppliers, this back-and sometimes leads to the costly problem of denying claims, 90 percent of which is estimated to be preventable. Using smart contracts, blockchain offers a way to alleviate problems related to slow payments, denied requests and sharing of patient data.
By using blockchain technology, key patient and payer information as eligibility and benefits, as well as the contractual tariffs applicable by rate programs, smart contracts can reach the service point that often takes months in the traditional RCM process.
Referral management. Vendor groups often manage referrals through laborious manual operations that involve a combination of paper, telephone, and email communications that cost time and money. This jumble of communications can lead to errors and other negative effects such as delayed care, unplanned appointments, repetitive and expensive tests, and frustrated doctors and staff.
Many of the challenges related to referrals can be traced to poor communication and can largely be addressed through the automation of the referral process. Blockchain provides an excellent way to automate referrals because it allows secure exchange of data in real time between different parts, reducing the likelihood of errors, discrepancies and lost connections.
Under a blockchain scenario, each key player in the referral process (suppliers, staff, payers and service team members) has access to real-time information. All participants are advised of events along the continuum of care, which means that referring physicians remain informed if patients have or have not received prescribed treatments, medications and tests. In addition, because provider groups have more detailed information on real-time referrals, they are able to reduce network losses.
Supply chain management. Blockchain's ability to connect multiple parts around shared data that is updated in real time makes it the "killer app" for supply chain management, providing a deep insight into the origin and chain of custody.
Complete traceability along the supply chain is essential for successful clinical trials, for example. In many clinical studies, thousands of biological samples are collected from different sites sometimes over a long period of time, which often causes complications such as excessive manual data entry, frequent opportunities for error and difficult end-of-school reconciliation  The current supply chain management industry standards lack technology that provides real-time and unambiguous registration of all transactions to all relevant participants – producers, intermediaries and customers – according to an Accenture 2018 report. Through blockchain, it is possible to create a "master ledger" that reduces processing costs by offering a unique authoritarian view in real time to all participants in the clinical trial and increases confidence and trust.
It is important for blockchain evangelists to recognize that while technology offers great potential for increasing efficiency in many areas of health care, it is not the complete solution. For example, blockchain works well to facilitate the transfer of electronic medical records but is not a substitute for EHR systems.
While a number of compelling use cases, such as those discussed above, exist for the application of blockchain to health care, we are still in the early days of the discovery of how we can exploit this promising technology for the ultimate goal of reducing costs and improving patient outcomes.