The following is a guest article by Michael Kim, Senior Vice President/CIO at MultiPlan.
In recent years, blockchain has been one of the most-hyped technologies: A public ledger that lives on a network of computers, each validating any changes in real-time. Unlike traditional distributed databases with centralized management, blockchain offers a shared database, providing security, transparency, traceability, and speed. While the shared ledger idea can be traced back to the 80s, blockchain technology emerged in 2008 as the foundation for decentralized currency, namely Bitcoin.
While it is true the cryptocurrency markets have crashed, that does not mean it is wise to dismiss the underlying technology. There are companies actively using blockchain to improve data-sharing and storage, and it has shown great promise in solving complex challenges in many industries, most notably healthcare. In fact, this living ledger could bring significant efficiency and savings to healthcare and is expected to save more than $2 billion each year by revolutionizing record keeping, according to a large pilot study conducted by the Synaptic Health Alliance.
Going Beyond Crypto
The Synaptic Health Alliance, a coalition founded by Humana, MultiPlan, Quest Diagnostics, and United Health Group – some of which are competitors – studies the potential of blockchain technology to ease inefficient administrative burdens. Because provider information is publicly available, there’s no competitive advantage for anyone to keep their own proprietary database. A shared ledger improves productivity and reduces costs for every Alliance member. Thus far, Alliance participation has resulted in a 500% ROI annually for Multiplan. All Alliance members believe blockchain technology will create a colossal transformation in healthcare.
Blockchain is already reducing healthcare expenditures, and its potential uses in healthcare could include:
- Updating and maintaining highly accurate provider directories,
- Shrinking the administrative burden of matching claims with providers,
- Decreasing the expense of updating patient records; and
- Expanding IT interoperability to improve patient outcomes.
In addition, it is being shown that blockchain can offer value in many diverse business scenarios: smart contracts, supply chain optimization, energy trading, gaming, domain name management, music distribution, academia, the insurance industry, and more.
Addressing Costly Database Errors in Healthcare
Billions of dollars are spent collecting and updating health provider demographics – publicly available information, such as name, address, telephone, accepting new patients, languages spoken, etc.
Nearly every insurer, health care system, physician network, and hospital keep their own proprietary database of providers. Together, they employ tens of thousands of people to contact each provider to update information. In addition, providers employ more staff to respond to these inquiries. If a physician accepts 10 different insurance plans, he/she is contacted by 10 different insurers asking for the same information.
These activities, by those seeking information and those providing information, make up a large part of healthcare budgets in our country.
Healthcare payors also have a massive administrative task to process and pay claims quickly and correctly. To reduce waste, payors must be sure that the claim is matched with the correct provider. Is the physician Dr. A. Jones or Dr. Abigail Jones or Dr. A. Rose Jones? Is Dr. Jones at 123 Main Street or 456 Tenth Street? Does she bill out of the Main Street address? What happens when a claim is submitted using the Tenth Street address?
Matching claims with providers is essential, but not always easy. Physician offices hunting payments that weren’t received and resubmitting claims wastes time and money. Payors spend more on unresolved claims when a name, address, contract number, etc. aren’t updated. A blockchain distributed database keeps track of any changes made. When one organization updates a file, the change is seen immediately by all others in the group. It eliminates waste from outdated, inaccurate providers and claims information.
A Shared Future
Future applications of blockchain in healthcare could be in coordinating benefits, patient consent management, scheduling or patient records. However, before it is used with sensitive patient information, secure protections must be in place to reduce cyber risk and ensure patient privacy. Then, blockchain could decrease high outlays for patient record keeping across providers.
Blockchain would expand IT interoperability, moving healthcare organizations away from expensive proprietary databases, and knitting fragments of information together to result in more accurate shared medical records. If providers in different practices, different hospitals, and even different states shared the same medical record for each individual, with symptoms, diagnoses, treatments, surgeries, medications, etc., patient outcomes could improve.
Blockchain has moved well beyond cryptocurrency, creating meaningful efficiencies and cost-savings in healthcare. These benefits in the healthcare system touch everyone’s life. Healthcare technology leaders from all across the industry should not be overlooking or ignoring its potential to dramatically improve efficiency.
