Blockchain: Catalyst for New Healthcare EcosystemBy Guest Author
Blockchain: Catalyst for New Healthcare Ecosystem
By Florian Quarre and Adam Israel
With billions spent on unnecessary services, excessive administrative costs, fraud and other issues, the healthcare industry is also continually hit by cyber-attacks. Recently, a massive ransomware attack hit the United Kingdom’s National Health Service, and it's among many other industries across the globe. Breaches alone can cost healthcare organizations billions of dollars, and recovery from such hits can take years to unwind.
Beyond the security challenge, the healthcare industry is under pressure to find a way to share information, uncover patterns that lead to better patient outcomes, and discover new models for care that can work for everyone in a more secure and cost-effective way. The healthcare blockchain could be the game changer that makes all this possible.
While blockchain is a fairly new concept, a recent Deloitte survey found that 35 percent of healthcare and life sciences respondents plan to deploy blockchain in production within the next calendar year.
At its core, a healthcare blockchain is a data repository of patient-related events. Transactions—everything from diagnoses and surgeries, to prescribed drugs and claim history—are permanently recorded, linked and augmented to continuously generate patient-specific insights. A blockchain system has no central authority, which is critical to its success.
Here are three ways blockchain promises to deliver value across the healthcare ecosystem: It’s shared and complete. Because the system is decentralized, it offers transparency. It’s also highly secure. Once a transaction is contained within a block and chained to other blocks, it is everlasting, creating an exhaustive healthcare events trail that can be resistant to changes.
1. Medical records can be shared without sacrificing privacy, bringing significant cost savings.
Participants exchange data and transaction records that are stored and distributed across all ecosystem participants connected to the network: doctors, insurers, pharmas and the patient. Whoever rightfully owns the keys can access the information, and that access can be repudiated instantly. Rules verify that the data is true, so it’s trusted.
This integrated care ecosystem means care providers are exchanging the most accurate and up-to-date medical information and analytics about each patient, enabling the proper type of care at the right time. Faster action could lead to dollars saved. Thorough information could lead to predictive diagnoses, fewer costly procedures and the prevention of duplicating tests.
In addition, patients can see and access their own records and decide who (family members, select providers, pharmas or caretakers) gets access to what. With patients in control, privacy can be achieved. And, maybe most importantly, existing electronic medical records (EMRs) and health information exchanges (HIEs) are empowered, not disrupted.
Providers integrating their systems into a blockchain can continue to store information from each patient interaction in their EMR and select which information should make its way to the blockchain. Medical interoperability extends to both internal and external systems, and that can save big on integration and record-keeping costs.
2. Researchers will work with much richer datasets.
More complete and transparent sets of patient information provide the entire healthcare ecosystem with opportunities to perform advanced analyses to push the definition of accurate diagnoses, effective care plans and high-performing drugs. Blockchain is a critical piece to enabling these opportunities.
For example, it promises to give a longitudinal view of the patient. Patient transactions and care outcomes are fed around-the-clock to the open blockchain ledger. By creating an identity-protected repository of data that different ecosystem players can leverage for cognitive analytics and machine learning, blockchain has the potential to uncover previously unknown insights at scale.
Providers can instantly compare the symptoms of their immediate patients with others to determine the optimal care plan, while continuously monitoring and analyzing their patient outcomes as they interact with other care providers. In addition, precision medicine is redefined. The holistic patient data set provides pharmas with the tools to help pinpoint demographic groups with similar characteristics in order to design new drugs and perform clinical trials on the patients that have the right symptoms.
Blockchain: Catalyst for New Healthcare Ecosystem
3. Smart contracts can enable near-real-time claims processing.
In the integrated care ecosystem, every patient interaction—whether it is seeing a primary care physician for an annual checkup, getting surgery or picking up a prescription from the pharmacy—will eventually lead to the submission of a claim for a payer to process. Breakdowns in any piece of the process can lead to significant issues for patients and providers: incorrect application of benefits, delays in payments and even delays in care. Blockchain can address these issues.
Smart contracts can automate processing. Pricing terms between the provider and payer, which are captured in a smart contract that stipulates the terms of service, can significantly accelerate the time from negotiation to contract setup. Smart contracts then execute the terms of the contract, run checks (e.g. pre-authorization, age limits, etc.), and display the adjudication results in near real time, significantly reducing administration costs.
In addition, adjudication results can be demystified. Instead of waiting for letters in the mail, patients and providers connected to the blockchain can view the results and understand how the claim was either approved/denied or if it was triggered for manual review.
Still in Its Infancy, but Adoption Is Exponential
While Blockchain in healthcare is still being formalized, contrary to most traditional technologies, its adoption is exponential, and it will not be long until scaled implementations surface. A variety of blockchain platforms exist to support these implementations, and choosing the right combination of platforms will determine the range of applications—and will lead to either swift success or years of trials, errors and failures.
Currently, many of the large healthcare players are organizing to coordinate the definition of an industry-specific blockchain protocol.
While examples of production blockchain applications in healthcare are still sparse, one large independent biotechnology company is using blockchain to maintain a consistent temperature for temperature-sensitive drugs. The blockchain application tracks, monitors and logs product temperature from the point of manufacture to the point of prescription.
As blockchain unfolds, expect industry associations and governments to take notice and help set standards. The power of the blockchain is in numbers. Consortiums have been established in other industries and are slowly beginning to take shape among healthcare organizations.
A number of healthcare organizations and government agencies are publicly exploring the potential of blockchain. These include Humana, Kaiser Permanente, the National Institutes of Health (NIH) and the Office of the National Coordinator for Health Information Technology (ONC). Even so, a continued push for leadership and collaboration among ecosystem players is needed.
So engage with blockchain technology by piloting targeted, small-scale proof-of-concept projects to prove the ability and value of deploying the technology. Work with your business partners and other industry leaders to create a protocol that will be used across all actors.
Remember that blockchain, like all exponential technologies, is not for the faint of heart. To truly take advantage of its capabilities, CIOs and other executive supporters must be convinced of blockchain's potential and have a vision for its future.
Florian Quarre is the life sciences and healthcare blockchain lead and Adam Israel is the blockchain envisionier and strategist at Deloitte Consulting LLP.