3 Healthcare Industry Pains Solved With Blockchain

By Ivan Kot, Itransition

Trusting is difficult, but it is an integral part of life. Yet different activities require different levels of trust. You may easily buy something on Amazon relying on user reviews only but taking care of your health is a whole different level of reliance.

Every part of the care cycle requires the patient’s trust. Patients need to believe their diagnosis is accurate, the treatment relevant, and the health outcomes positive. Providers, in their turn, have to justify their patients’ trust.

The blockchain technology is gaining momentum, promising to introduce more transparency to healthcare software development and strengthen the trust between patients and caregivers without compromising security.

Blockchain In A Nutshell

Gartner predicts blockchain to yield more than $3.1 trillion in business value by 2030. With this estimation, blockchain bids to become one of the top technologies in the next two decades. The reasons are rooted in its unique approach to data processing.

Blockchain is a distributed and decentralized ledger that stores transaction records and shares them across a peer-to-peer network of computers, so-called nodes. Each set of transactions (block) gets a unique identifier (hash) and becomes cryptographically linked to the hash of the previous block, creating an unbreakable chain.

Blockchain allows each network user to access, view, exchange, add and store the information. Any interaction is visible to the entire network and requires verification from the majority of nodes according to the implemented consensus algorithm before new information can be added to the chain. This process keeps data secure from breaches.

However, to maintain the privacy required by healthcare organizations, a permissioned (private) blockchain can be adopted. Data encapsulated in such a blockchain is only visible to authorized parties involved in each transaction directly.

3 Healthcare Areas Ripe For Blockchain Transformation

Blockchain introduces fault tolerance and data encryption to the healthcare ecosystem.

The distributed ledger and the authentication process reduce the risk of security breach and fraud. Moreover, automatic transaction verification allows eliminating third parties from operational processes (such as claim management and procurement), cutting administrative costs and accelerating decision making.

Now, let’s review the areas that can benefit from blockchain the most.

Chronic care management

Chronic patients are the major focus of value-based care. They require continuous attention and carry higher morbidity risks in case of ill-timed medical assistance, incorrect treatment plan or poor care team collaboration.

Used for chronic care management, blockchain is at its most when used across an ecosystem of multiple healthcare providers.

Longitudinal Patient Records

Blockchain can transform chronic care management by introducing longitudinal patient records. These records represent the strict timeline of a patient’s history with appointments, lab results, diagnoses, and treatments. Ambulatory and patient-generated health data (PGHD) from wearables and IoMT devices can contribute to the records as well, allowing providers to evaluate the patient’s progress.

With blockchain, the entire dataset collected from different sources gets hashed to the ledger automatically and attributed to the patient’s identity. All data bits are verified against previously created blocks, which helps to avoid possible duplication and mismatch in the EHR system.

Care Coordination

When a care coordinator identifies therapy, activity and nutrition goals for a patient with a chronic condition, all recommendations comprise a thorough milestone-based treatment plan. For this plan to be successful, a patient and their care team need to have access to all relevant health data and recent status updates — the requirements that blockchain can easily satisfy.

Once added to the ledger, the care plan will show chronological care delivery information and the patient’s results connected to it. Each new entry gets authenticated and becomes available to all network peers.

The care coordinator can then access patient data on demand, which allows them to:

• Evaluate the patient’s current health status relying on the most recent updates
• Detect possible side-effects
• Initiate informed changes to the treatment plan, and more

Since all the care delivery and patient progress details are available for the team in real time, the health specialists can stay informed about significant changes in the patient’s status and gain more control over health outcomes.

Claims And Billing Management

Apart from improving chronic care delivery, a shared data ecosystem allows providers to tap into a more stable, predictable and streamlined billing environment.

Claims Processing

In healthcare, time delays are the worst enemy. It takes a ridiculous amount of time to settle a claim, determine and track co-payments and deductibles. Processing an electronic claim takes anywhere between 7 to 14 days, while banks need only a few seconds to receive a transaction request and execute it.

Blockchain can help to speed claim processing with smart contracts. A smart contract is a protocol that represents and executes the payer-provider contractual terms. Upon claim submission, it is processed and verified automatically in real time with the subsequent billing and payment transfer to the provider. All needed verification processes happen in the background, automatically and without additional effort.

Billing Management

Blockchain’s authentication mechanism and its ability to accurately record transactions can help reduce transaction-related fraud in healthcare. With blockchain-powered data transparency and security, payers will be able to access a patient’s record and view approved providers to analyze for suspect claims or payment requests that mismatch this patient’s conditions, diagnoses or current care plans.

Supply Chain Management

Asset management is another area prone to time delays and fraud. It is critical to gain more control over consumable supplies, including high-value medications and addictive opioids. Healthcare organizations can’t enter the value-based care realm and become accountable for patient health outcomes to the full unless they know where the medication comes from.

With blockchain, providers can benefit from a decentralized asset management system to access a transparent and traceable path of their supplies. Healthcare organizations will be able to see the entire supply chain stages, from manufacturing to distribution and delivery across facilities.

Launching The Transformation Process

Ensuring transparency and security, blockchain can become the standard for data management, accumulation, storage and exchange in healthcare.

Not many technologies out there are capable of accelerating the arrival of the value-based care era the way blockchain can. It promises to:

• Enable secure access to medical records
• Improve care coordination and information exchange
• Streamline claim and billing management, among other aspects

This digital-ledger technology can disrupt many healthcare aspects. However, it is manageable. The transformation can take place step by step, touching on each aspect mentioned above independently or all the aspects at once yet in parallel. We can’t wait to see its potential unfolded to the maximum.

About The Author

Ivan Kot is a Senior Manager at Itransition, focusing on business development in verticals such as eCommerce, Business Automation, and cutting-edge tools such as Blockchain of Business. He began his career as a developer, taking different positions in both web and mobile development projects, and eventually shifted focus to project management and team coordination. Ivan’s everyday motto is: if something has to be done, it has to be done right.