“Question: What are the eminent opportunities for blockchain in healthcare?
Aaron Symanski: Blockchain is proving its value every minute of every day. While it’s currently used in bitcoin and other cryptocurrencies, there are additional industries creating businesses utilizing blockchain, mainly around its audit capabilities. For example, logistics is an area where blockchain can be critical to healthcare. Think about pharmaceutical products that need to be maintained at a certain temperature, and to assure they’re not counterfeit and really were made by their manufacturer. Blockchain can assure both.
Those are the easy fits, but think about the next step in healthcare information. With bitcoin and auditing and logistics, it’s about the visibility of the information being stored and available on blockchain to everyone. With personal health information, it’s a different matter. We’re seeing information being stored away from the chain, but the chain is used to affirm that the information is correct. We’re seeing variations of blockchain where the information can be stored itself. A good deal of creative and innovative thinking is being done around this space.
There are other direct applications that aren’t as exciting because they don’t deal with protected information, but they’re very straightforward and that’s a lot of where our interest is: making that process of healthcare more effective and allowing clinicians to spend more time with patients instead of paperwork.
Q: What are some of the challenges associated with blockchain use in healthcare today?
AS: One of the biggest challenges for blockchain in healthcare is overcoming the hype. Those who utilize it are being really innovative and creative in coming up with ideas about what blockchain can do in healthcare if it had additional capabilities. We need to separate out where the real blockchain value-add opportunities are, and what pieces require more work and significant change to leverage the technology.
Q: Will blockchain have an impact on organizational workflows or healthcare reimbursement?
AS: I think the most direct change is that the chasing and reconciliation processes will begin to separate. About 80% of the work we do with chase deals with comeback, due to misspelling or typos in the record. With blockchain, that will be separated from the more challenging claims that need chasing—the ones that require human involvement. Are we doing bundling or unbundling? Do we have multiple providers? Are the cases more complicated with multi-year and multi-origin information? We see straightforward processes being peeled away from the organizations via blockchain, so they can use their existing resources for more challenging issues.
We’ve seen many of the standards around communication and reconciliation go away in other industries with blockchain. The organizations work their way down the value chain killing off the low value issues first, and leaning toward the high value where you need people involved to put all the puzzle pieces together. What you’ll see is a reduction in cost per case, cost per issue, and cost per event.
When you start moving your simple processes to automation, and know your counterparts are actually communicating and looking at everything the same way you are, it builds stronger partnerships. Whether you’re a hospital provider or payer, there is a lot of expertise for these processes that will be adding a good deal of value.
Q: Can blockchain move healthcare organizations closer to interoperability?
AS: There is a lot of hope in the aforementioned hype. One thing that blockchain doesn’t do for us, which needs to be done for interoperability, is defining the language of how information is stored and used. Are we referring to blood pressure and height in the same way? How do ICD-10 and other different languages come together? Once you and I know we are conversing in English, we can easily store that information in a record. If one of us was speaking French and the other Chinese and we were trying to put the questions and answers in the right place—that’s challenging.
Blockchain is a very effective storage mechanism; what it brings to interoperability is information about where things are stored. Blockchain can take interoperability and create a conversation about what information we actually want to exchange and store.”
The foregoing excerpt from an article by , “Blockchain in healthcare: Identifying the biggest and best opportunities with Change Healthcare CTO Aaron Symanski” in the August 21, 2017, edition of Becker’s Health IT & CIO Review (http://bit.ly/2vigoQb) includes important insights regarding the applicability of “blockchain” information technology (IT) technology for auditable and secure storage of transaction information, currently in vogue in the finance industry, to healthcare.
My opinion is that cloud-based block-chain technology is a sine qua non for secure storage that is as impermeable as can be created to defend against hackers and ransomware. In addition to this currently applicable tactic, the following proposition by Mr. Symanski’s proposition defines a transformative near-future opportunity: “When you start moving your simple processes to automation, and know your counterparts are actually communicating and looking at everything the same way you are, it builds stronger partnerships. Whether you’re a hospital provider or payer, there is a lot of expertise for these processes that will be adding a good deal of value.”
An IT solution compliant with the Cloud Healthcare Appliance Real-Time Solution as a Service reference architecture (CHARTSaaS RA) enables healthcare provider subject matter experts (SMEs) to automate processes with minimal cost and complexity, and little or no dependence on the provider’s IT staff or system resources. CHARTSaaS-built apps operate as systems of engagement with professional providers and their patients to leverage the on-premise legacy systems of record referred to as electronic health record (EHR) or hospital information systems (HIS) using secure intelligent interoperability. Furthermore, they can automate such problematic and error-prone use cases as differential diagnosis and treatment planning, and alarm/alert fatigue mitigation. Since such apps are easily modifiable, they can facilitate compliance with the accreditation standards of The Joint Commission that govern continuous process improvement.
Please validate these CHARTSaaS RA-related propositions to your own satisfaction by reading the white paper at http://bit.ly/2vmK1Rx, viewing the tutorials posted on YouTube (http://bit.ly/2sVajvS and https://www.youtube.com/watch?v=f5OtbCCDNLs) and also by reviewing the details of CHARTSaaS™ and the CHARTSaaS RA™ in these presentations:
https://mix.office.com/embed/19g5mpp3f6qkx
https://mix.office.com/embed/1bp3nuiwdjk86
https://mix.office.com/watch/o2y82frum3lt
Healthcare providers will benefit significantly from appreciating and then applying a CHARTSaaS RA-compliant IT solution. To do so will mitigate medical mistakes (currently the third leading cause of patient deaths. per Makaray and Daniel (http://bit.ly/1rtW6Sa); thereby minimizing patient adverse events and optimizing clinical case outcomes while maximizing the cost-effectiveness of care and treatment, and also accelerating the accrual and facilitating the application of medical knowledge.