Two of the most popular buzzwords in the healthcare industry today are “digital transformation” — and for good reason. There is a lot of room for improvement! The patient experience needs to be improved, processes need to be automated, and the cost of managing healthcare needs to be reduced. Digital transformation is the way to achieve these goals—just like any other industry—but many hospitals, healthcare systems, payer and provider organizations struggle with where to start.
Every organization has very specific needs, so evaluating a variety of systems and vendors can be mind-boggling, especially when it feels like the options are endless. While there is certainly no one-size-fits-all approach to digital transformation, there is one solution that can both help industries grow and serve as a springboard for digital transformation within an organization—a blockchain-enabled network of interoperability.
Blockchain Basics
Blockchain technology may seem intimidating, but in simple terms, a blockchain is a digital collection of transactions, tracked and recorded over a decentralized network. Think of it as a database or spreadsheet that multiple participants can access in real time. Every transaction is recorded and linked to the transactions that happened before and after. They are then connected in chronological order, creating “chunks”. The new data block is connected to the previous data block, finally creating the chain. Hence, blockchain.
This allows for unprecedented data synchronization between participants creating a single source of truth. The potential to enable cross-organizational workflows and the ability for participants to conduct digital transactions in real-time over the network with a higher level of security and transparency is enormous.
Another key aspect of blockchain is permanence. Once a transaction is committed on-chain, it cannot be deleted. Users can only be added to the chain through new blocks, ultimately creating a historical, linear and immutable record of events or transactions. Changes to the ledger cannot be made unilaterally – network participants need to validate changes before creating new blocks, reducing the chance of fraudulent activity. What’s more, this decentralized approach allows for data parity, which is critical in data-intensive and regulated industries such as healthcare.
Working together is the path to interoperability and transformation
One of the greatest features of blockchain is that it offers unprecedented transparency and openness, so every participant can be held accountable and act with integrity to their community. But as we know, the concepts of transparency, openness, and trust are new to healthcare, and for blockchain to work in healthcare, it will require a fundamental shift in mindset to build a shared purpose community. Payers, providers, financial institutions, and technology innovators—often referred to as “friends and foes”—need to ditch the old competitive spirit and come together to make the healthcare industry truly interoperable.
Collaboration can lead to tangible mutual benefits for payers and providers. For example, there is a significant opportunity to simplify some core and repetitive administrative-related tasks such as eligibility, prior authorization, benefit coordination, provider information, and claims status that arise across many touchpoints in the healthcare industry ecosystem. Blockchain-based networks of payers and providers create the opportunity to reimagine many of these traditionally non-value-added activities. Additionally, inefficiencies can be eliminated when payers and providers work together to create joint processes and execute on shared networks.
A use case that demonstrates how blockchain can simplify administrative processes includes sharing and updating provider demographics and banking information with payers in a secure environment. Often, the administrative processes behind supplier information management are manual and incoherent, so when changes are made, significant effort is required to update stakeholder information. This not only affects the timeliness of payments, but also increases the chance of fraud. With a distributed network that leverages blockchain, when validating changes are made to a provider’s data, all parties with the proper permissions can automatically receive the updated information – enabling faster, more accurate payments.
Let’s start with cooperation
Blockchain technology can help lay the foundation for a new level of trust in the healthcare industry.
The next step is for all stakeholders – payers, providers, patients, financial institutions and developers – to collaborate to build this network for efficiency and true interoperability in healthcare. With a single network connecting the industry, healthcare will be better able to meet customer expectations and business goals.
Photo: Pixtum, Getty Images
