Healthcare Is Aching for Solutions: Is Blockchain The Answer?

Few are aware that prior to my work as a journalist, I was part of three different senior management teams in healthcare. As a young administrator in my twenties, I found the inner workings of healthcare organizations equally interesting and frustrating.

To this day the opportunity to visit a hospital or medical center engenders generally fond memories. In fact when my significant other recently asked whether I would go with her for a diagnostic procedure, I was excited. That is until we witnessed a support team member struggling mightily with some type of administrative issue with a patient ahead of us in line. Resolution took nearly minutes, to the exasperation of others waiting to check in.

Sadly, at that moment this conjured up memories for me of how many of the issues that were present during my healthcare years still persist today. These include:

• Increased disintermediation and disempowerment of patients and physicians.
• Access barriers to patients’ seeking to visit a doctor or specialist
• Growing administrative burdens on physicians, eating away valuable time needed to focus on the patients.
• High administrative costs and inefficiencies such as enrollment, benefit verification, scheduling, referrals, billing, payments and reconciliation.
• The over-utilization and waste of healthcare programs, contributing to ever higher costs.
• Complex payment authorization processes, including payment delays payments to the physician.

These prevailing issues are why I’m intrigued with the work of a new project known as Solve.Care. Their core belief is that the innovative use of Blockchain can and will truly create a more decentralized and robust system of healthcare transactions — all in a manner that saves lives while cutting out billions in annual healthcare costs around the world.

Known primarily for its experimental use cases in the financial industry, Blockchain technology — a distributed ledger tool that’s being applied to real-time transactions — holds great promise for streamlined healthcare solutions. The Solve.Care approach delivers a highly efficient tool for organizations to create, store, and share administrative and financial records via a ecosystem of personal devices without reliance on third party intermediaries to control the data.

The platform provides real time updates on all parties to the “chain,”allowing physician offices to check patient eligibility and benefits details, coordinate care, and eliminate payer reimbursement bottlenecks.

Says CEO Pradeep Goel: “Our aim is to redefine care coordination, benefit administration and the accuracy of payments in healthcare, through proper use of Blockchain based distributed ledger technologies. Our deep domain knowledge in healthcare will fuel our efforts around building a platform that links, syncs and empowers all stakeholders in healthcare delivery and administration. We see this as the first step in expanding our community of publishers, developers, integrators, clients and partners.”

Arizona Care Network Use Case

In a first-of-its-kind partnership in the healthcare industry, Arizona Care Network, a leading care organization, will pilot a game-changing Blockchain technology platform developed by Solve.Care with the aim of boosting clinical outcomes, mitigating healthcare’s administrative burdens, and reducing costly waste within the system. This proprietary platform will facilitate the deployment of smart applications throughout its network of 5,500 physicians and 250,000 patient members.

Says David Hanekom, MD, CEO of Arizona Care Network in a press release announcing the collaboration: “There are so many inefficiencies in today’s healthcare system. We want to help patients get the information and care they need more quickly while easing the considerable administrative burden on our providers.”

This intent rang true during my days in healthcare and perhaps even more so today. The demand for better accountability from today’s healthcare systems has never been greater. As a result Solve.Care seeks to deliver the following elements in support of a new era of care delivery:

• Provide patients with a tool that simplifies the process of finding a physician that can offer timely access to care.
• Provide insurance benefit transparency so that patients can access the type of care that’s best for them. This will allow them to confirm eligibility and know the costs ahead of time.
• Provide access to patient care event information across all providers so that care teams can communicate, coordinate, and eliminate costly duplication of services.
• Reduce the confusing and often duplicate paperwork associated with health insurance billing and payments.

New efficiencies are also needed for physicians as well: Says Dr. Ed Clarke, chief medical officer for the Arizona Care Network: “Technology was supposed to streamline administrative systems to make healthcare safer and more efficient. But one of the biggest headaches for physicians is the use of so many different technology solutions. Unfortunately, none of them talk to each other, which delays updates, or misses them altogether. This can adversely affect patients and their health.”

The Arizona Care Network created by Solve.Care has its sights on alleviating many of these problems associated with the administrative aspect of health benefits creating greater system and cost efficiencies. This comports with ACN’s intention to become the leading technology-enabled care organization in the United States.

ACN is expected to go live with the Solve.Care platform this summer. In phase one providers will use the Care.Wallet application to receive payments from ACN. Additional features such as reimbursement for healthcare delivery will be added for providers. The Care.Wallet will also be expanded to patients.

Emerging Trends and Forward Advancement

Dovetailing off of Solve.Care’s pioneering work, I asked Pradeep Goel, the company’s CEO about what sort of general trends he seeing on the horizon in terms of the intersection between Blockchain and Healthcare. He had this to say: “The initial focus of many projects involving the Blockchain of healthcare have targeted the clinical records space, specifically record aggregation, portability and sharing. While this represents a popular use case, I believe we’re going to see an increased focus on the administrative, financial and quality measurement of healthcare. While we can expect to see legacy system companies begin integrating Blockchain into their system architecture, the truly utility of that approach remains to be seen.”

Goel also believes that the healthcare industry will move towards standards and certifications tied to transactions and interactions on Blockchain, requiring proper participation and engagement from the industry.

In terms of Solve Care’s development in the next 12–18 months. Goel says he expects to be deployed in healthcare delivery systems in multiple regions around the world including but not limited to the U.S., Canada, Middle East and Asia. “We anticipate having partnerships with insurance, hospital and government clients with clear use cases around improved access to care, reduced administrative costs and demonstrable improvement in improved outcome for patients.”

Concludes Goel: “At the end of the day, our platform is designed to be configurable and extensible for any healthcare delivery model in the world, including but not limited to commercial insurance, employer sponsored benefits, managed care delivery and government paid programs. We expect to be part of major industry standards bodies and thought leadership forums tasked with shaping the adoption and sustainability of Blockchain solutions in healthcare, all to the benefit of patients, providers payers and employers worldwide.”