Removing Health Care Inefficiencies One Link at a Time

AHA Market Scan Removing Health Care Inefficiencies One Link at a Time. Blue background with line pattern in which some areas have ed crosses highlighted.

Blockchain is a term that describes a system in which data are maintained and shared across a peer-to-peer network, rather than by a single authority. It’s most known as the technology underpinning cryptocurrencies like Bitcoin, but it’s beginning to be used to improve significant inefficiencies in health care.

“[Blockchain] is all about co-opetition,” said Radhika Iyengar-Emens, founding partner at StarChain Ventures, who moderated a panel discussion at the recent HLTH conference on the technology. Traditional competitors can improve efficiency and drive data insights through blockchain, but they first must determine what specific data they will share, or decentralize, she explained.

So, how are competitors coming together to share data via blockchain? Here are some of the more common use cases for the technology, as discussed by the panel:

  • Provider directories and credentialing. Provider credentialing costs an estimated $2.1 billion annually and is highly inefficient. Each payer has hundreds if not thousands of staff calling providers to confirm license information, office address and hours, etc. And on the provider side, staff answer the same questions by multiple payers. Synaptic Health Alliance — a consortium of partners including Optum, UnitedHealthcare, Aetna, Humana and others — is collaborating to create a provider data exchange using blockchain technology. Although the alliance comprises payers, it soon plans to welcome provider organizations, said a panelist representing the alliance.
  • Drug distribution tracking. In July, the Food and Drug Administration launched pilots — including a collaboration among IBM, KPMG, Merck and Walmart — to explore the use of blockchain to help track pharmaceutical distribution and ensure safety and security across the supply chain.
  • Revenue-cycle management. A number of newer companies are exploring the use of blockchain for real-time exchange of information on claim submissions, insurer payment, patient responsibility and patient billing and payment status. In February, Providence St. Joseph Health acquired one such company, Lumedic, which aims to drive interoperability as it relates to claims processing between providers and payers.
  • Clinical trial data management. Blockchain is well positioned today to manage the administrative end of clinical trials, such as consent management, said the panelists. In the future, many believe blockchain technology could revolutionize how patients are identified and recruited for trials. In theory, patients could share their data, opting in to be contacted by clinical trial recruiters if they qualify for new trials. Last year, drugmakers Pfizer, Amgen, and Sanofi entered ”frenemy” territory, announcing they’d partner to explore ways to work together on blockchain solutions to improve the efficiency of clinical trials, while continuing to compete in many other ways.

While most near-term use cases for blockchain in health care do not involve protected health information, efforts to use blockchain to store and manage PHI are certainly underway. Various consortia of partners are exploring how blockchain can be used to exchange individual medical records; health data from wearables and other devices; medical claims data; and genomic data.

So, what’s the big takeaway? These are early days for blockchain in health care, but it certainly holds promise for helping organizations across the health care ecosystem share large volumes of diverse data that today may be locked within individual organizations. Many opportunities for new discoveries and improved outcomes are contained within these data, but partners first must overcome the governance challenges that surround shared data networks.

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