Healthcare on the Blockchain: Big Changes Ahead

By Cara Sloman, executive vice president, Nadel Phelan, Inc.

One of the biggest challenges in the healthcare system pertains to the access and protection of sensitive medical information. Though blockchain technology was initially developed to support financial transactions, its decentralized, distributed ledger also holds great promise for the healthcare industry. For instance, a recent report by Deloitte notes that blockchain has significant potential to improve data interoperability, privacy and security.

Blockchain technology is poised to help the healthcare industry overcome multiple industry pain points, including the need for health information exchanges, varying data standards and inconsistent rules and permissions. The application of blockchain in healthcare is still in the early stages of development but is envisioned to solve the following challenges.

1. Medical Data Management:

Blockchain can be applied in healthcare to enhance the management of electronic health records (EHRs) because it would simplify the exchange of data across authorized parties. Current health information exchanges (HIEs) are hampered by a number of technology issues, including the need for an intermediary trust network, data interoperability issues and inconsistent rules and permissions. These issues prevent the safe transfer and sharing of data. However, it is now possible for healthcare organizations to build blockchains based on data pulled from existing databases, creating a complete data picture and single source of truth.

So then, HIEs would radically change from their current form to one that is patient-mediated. Patients would be the owners of their own data, accessible to each individual via the blockchain’s private key mechanisms. Patients could share this data with whomever they choose within their healthcare team. This would give patients and the caregivers of their choice a longitudinal history of their health.



2. Billing Management:

Intentional medical billing fraud is a serious and expensive issue. In July 2017, a Medicare fraud task force charged more than 400 people, including dozens of doctors, with defrauding the government of $1.3 billion. Current processes are incapable of detecting all instances of fraud. Therefore, blockchain’s security and auditability make it an ideal choice for claims adjudication and payments processing, as well.

3. Data Privacy:

HIPAA was implemented to protect the privacy and security of PII and PHI. The regulation limits how and under what circumstances this data may be used without patient authorization. A blockchain solution could assist with HIPAA compliance by segregating and encrypting patient identity, PII and PHI into discrete units, accessible at any time by those who have authorization to do so.

Another important benefit is that, because they establish a trusted audit trail that can be verified in real time, blockchains are an ideal platform for regulatory compliance, streamlining enforcement and discouraging fraudulent behavior from the beginning.

4. Medical Research:

Medical research stands to benefit from blockchain in the area of clinical trial data. The COMPare Trials Project found that out of 67 trials they examined, only nine were correctly reported; 354 outcomes were not reported, and 357 new outcomes were silently added. This casts doubt upon the accuracy of medical information derived from clinical trials and the resulting care that patients receive.

Researchers conducting clinical trials could create greater transparency and trust by using blockchain to record and time-stamp each event in the trial’s protocol. This would prevent selective reporting, ensuring that reporting of trials is correct and not “spun” to achieve a desired outcome.

The Future is Blockchain

The healthcare industry is at a pivot point that very well could determine organizations’ success or failure. The industry is just beginning to develop use cases for and implementations of blockchain technology, and its potential for disruption is huge. When secure and compliant access to medical data is possible, billing is more accurate, payments are faster and fraud is reduced, everyone wins.

About the author:

Ms. Sloman has helped shape Nadel Phelan’s brand, services and reputation for quality and results.

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