Healthcare needs a way to share data, uncover patterns leading to better patient outcomes, and discover models for care that work securely and cost-effectively.
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.
This article was originally published on 08-16-2017