Decentralized networks, such as those built on blockchain technology, without a doubt hold the potential to improve outdated, manual processes in healthcare, but physicians should be careful not to get blinded by the hype.
From an easy-to-understand point of view, think of blockchain as a database (ledger) that is shared among a network of participants, with each participant seeing only the data that it has received permission to access. Since the database is shared, changes made are visible in real time and any business rules for processing the data are handled through computer code to which the participants agreed to ahead of time.
Such business rules are implemented using “smart contracts,” which are called “smart” because they include terms of the agreement between parties directly written into lines of computer code. By implementing an agreement’s business and legal rules into code via a shared, decentralized distributed ledger, smart contracts enable transactions among disparate, anonymous parties without the need for a central authority or external enforcement.
The result is that processes that were once tedious, manual, error-prone and redundant now can happen in real time, accurately and in a secure fashion. In general, blockchain’s greatest benefit may revolve around data integrity and the confidence boost created from sharing a single source of truth.
Before we go any further, an important caveat: Physicians are experts at patient care; not technology. In that respect, think of blockchain as similar to a laptop. Few who use laptops understand exactly what happens behind the scenes after they press the power button, but they still use and benefit from the technology.
In that context, following are three common medical practice business processes that blockchain can simplify and enhance, enabling practices to boost efficiency while saving time and money.
Claims processing: The billing process begins when a physician treats a patient and sends a bill of services provided to the appropriate party (i.e., payers) and ends once the physician practice is paid for those services. Unfortunately, because the process can involve numerous manual steps and third parties, it may take weeks or even months to settle. Because blockchain can reconcile transactions in near real-time, it can help physician practices collect payment much more quickly.
Sharing patient records: Healthcare organizations have experienced well-documented challenges with IT interoperability that prevent them for exchanging patient data. As a result, few providers have information systems capable of allowing multiple providers to share patient data while simultaneously maintaining a complete record of all patient care. With blockchain, users can manage their own IT systems but also share patient records on a permissioned basis while tracking the process from end-to-end. This enables users to view a time-stamped audit of all edits to a patient record.
Referrals: Typically, medical practices handle referrals through an inefficient and time-consuming process of paper, phone and unencrypted email-based communications that create time burdens for staff and financial costs for practices. Blockchain has the ability to automate the process, streamlining data exchange among payers, removing the need for many manual steps and freeing staff to focus on patient care.
One important caveat: Even to a true believer, blockchain is not the solution to every healthcare problem in existence. Blockchain works best for solving problems that involve sharing data among multiple, disparate entities -- a use case that will only grow in importance as the healthcare system continues its transition to value-based care, which places greater emphasis on care coordination and population health management.
Blockchain is not a replacement for EHR systems; however, it is very useful for proof of work, data integrity, audits, real-time claims adjudication and scenarios that require numerous manual steps and data reconciliation among multiple entities.
Deepti Sharma is the Director of Product Management at HSBlox, a technology company that is bringing innovation and transparent economics to the healthcare ecosystem. She is an experienced professional in the Medical Industry with many years of experience in Product Management, Account Management and Medical Billing/Coding.