Anyone who’s ever switched medical providers or struggled having claims approved knows how tedious and burdensome the process can be, for even the best healthcare systems are highly fragmented. This fragmentation leads to poor patient care, increased fraud, and slow claims processing. Could blockchain technology potentially solve for this? As the adoption of blockchain picks up speed in various industries, it’s only a matter of time before Healthcare also begins to see more blockchain innovation at the enterprise level.
Healthcare is fraught with many of the same inefficiencies and complexities that blockchain technology can solve for in other industries and markets. By facilitating the coordination of secure data amongst relevant parties in real time and based on pre-agreed parameters, blockchain could help solve healthcare’s data issues around collection, standardisation, reconciliation, and reporting.
This blogpost will walk through some of the top healthcare use cases and explain how Corda is best suited to solve for the industry’s pain points.
Health Records Exchange
The adoption of Electronic Health Records (EHR) software is a top priority for any health system CIO, yet it’s astronomically expensive and takes significant time and resources to implement. The biggest challenge is often the lack of interoperability not just between different organisations’ software platforms but even within a single health provider/system. Can you believe the average number of platforms a single hospital runs today is close to 16? One can only imagine how difficult it must be to reconcile the data that lives in these silos. Blockchain could enable these different systems to talk to one another and provide a complete holistic patient profile without the need for an intermediary to provide any particular validation. Records could be tracked in an auditable, time stamped, and immutable ledger so that no one party could ever fraudulently alter them.
Regarding compliance to the Health Insurance Portability and Accountability Act (HIPAA), PII data stored in internal enterprise systems would only be referenced in the blockchain by unique hashed identifiers. When corresponding data is deleted off chain, its reference on chain would effectively be de-identified.
Furthermore, blockchain could help foster one of the most important components of true value-based care — increased patient satisfaction. Through managed consent, patients would be able to authorise specific providers access to their unique data on a need to know basis. Significant initiatives around self- sovereign identity have already been built on Corda by prominent technology leaders — Gemalto, Luxoft, and Evernym.
Pharmaceutical Supply Chain
By 2023, U.S. companies in the pharmaceutical supply chain (manufacturers, repackagers, and distributors) will be required to meet all requirements in the Drug and Supply Chain Security Act (DSCSA). The DSCSA specifically puts forward regulation mandating increased pharmaceutical product traceability and transparency. Likewise, the EU will be mandating adherence to the Falsified Medicines Directive (FMD EU 2016/16) by 2019.
As a result, many pharmaceutical companies have begun to explore technologies that would enable the provenance of a drug (and its components) throughout its lifecycle. Blockchain technology could potentially reduce counterfeit production, assist in recalls, and verify compliance with industry guidelines (i.e. temperature, humidity, etc). By having all parties involved across the supply chain on the same ledger, one would be able to track the authenticity and integrity of any drug from manufacturing to distribution and sale.
Additionally, data from third parties such as sensors, beacons, and barcodes could easily be ingested into the blockchain (through oracles) to facilitate validation and the execution of smart contracts. This could potentially lead to improved inventory management to both assess shortages and patient safety.
Submitting a medical claim to an insurance provider can be one of the most arduous and annoying processes, often involving multiple different parties, redundant paperwork, and delayed claims payout. Currently, providers and payers utilize clearinghouses to check claims for errors and verify that they are compatible with any payer software. Moreover, insurance providers employ “claims specialists” whose sole job is to manually verify the authenticity of a claim and resolve billing issues. These processes are extremely antiquated and demonstrate the lack of innovation in a process that has not changed in more than 50 years.
Smart contract-based payments could improve customer satisfaction and reduce revenue cycle management costs. Updates to claims could be made in real time and shared across different parties. Self-executing smart contracts could facilitate auto payouts based on parameters set forth in original healthcare policies, without the need for an intermediately authority to validate the claim and slow the settlement process. The largest blockchain insurance consortiums in the world, Riskblock and B3i, are currently building claims centric solutions on Corda.
In conclusion, Healthcare solutions on blockchain are already a reality thanks to startups like HSBLOX . HSBlox’s Corda based solution seeks to use smart contracts to automate multi-party transactions, like bundled payments. This will improve the experience of payers, providers, and patients as well as reduce their corresponding costs.
Article written by Stephanie Perez, Associate Director at R3 in Medium