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The Promise of Blockchain Technology and Clinic Operations Management

Bitcoin and other cryptocurrencies may still be unstable, but that doesn’t mean the technology that they are built is risky in and of itself. In fact, many businesses and healthcare practices have been exploring ways to put blockchains to work in improving operations management.

There are quite a few potential applications for blockchain technology in the healthcare sector — data sharing in clinic trials, for example. The Medical Futurist blog lays out a dozen companies bringing blockchain to the healthcare industry, including blockchain-based biological data management and more effective disaster relief.

But many mid-size and smaller medical clinics are wondering what the technology can do for their clinical operations management. The promise of blockchain is there, but what are its practical implications?

“Fundamentally, we think about blockchain as a technology that can support changes in human behavior, rather than a particular technology like a database or electronic health records,” says Dr. Noah Zimmerman, director of the Center for Biomedical Blockchain Research. 

The implication for medical clinics is that blockchains could change entire processes rather than working as a new piece of software to plug into legacy systems.

With this mindset, we dive into three specific ways blockchain technology is being used to improve revenue, referral and health record management in medical clinics.

Blockchain and Financial Management

While investing in blockchain technology could be a major endeavor, much of the benefit it brings to a clinic is related to long-term cost savings, financial efficiency and security. Here, we see blockchain improve financial management in two major ways: reduced friction for financial processes and increased security for these financial interactions.

John Moore of Chilmark Research says transactional processes within the healthcare sector makes up more than 20 percent of healthcare spend. “In healthcare, the combination of blockchain and smart contracts can greatly facilitate claims adjudication and processing, thereby removing significant friction in today’s transactional processes across the healthcare sector,” he concludes. Therefore, blockchains can make financial management a more efficient process for medical clinics.

Dr. David J. Fong at Wolters Kluwer writes that the technology can create time and cost savings for clinics, “considering there is less oversight, participants can interact directly, and it removes duplication of efforts, since all stakeholders have shared access to the network.” In other words, blockchains promise more cost-efficient clinical operations by creating more seamless processes and facilitating direct interactions.

Blockchain technology can also make transactions more secure. Some experts believe this to be the major benefit blockchains have to offer healthcare information technology. The immutable, linked transactions recorded on a blockchain “can help prevent fraud because what is put on the blockchain can never be changed or removed, which makes it very hard to falsify data,” says Dr. Simon Lin, chief research information officer at Nationwide Children’s Hospital in Ohio.

“As the name ‘blockchain’ suggests, this technology is very good at dealing with chain-of-custody problems,” Dr. Lin concludes. In other words, blockchain can make financial management more secure, reducing risk for medical clinics.

Blockchain and Automated Referral Management

Another, more technical, name for blockchains is “distributed ledger technology.” As a distributed ledger, instead of centralized record, blockchains could make the referral management process simpler for both physicians and clinic administrators.

“Think of DLT as an immutable ledger of referral transaction records,” writes Lynn Carroll, HSBlox chief of strategy and operations. “Each participant in the referral process has an exact copy of this ledger, creating a decentralized single point of truth, so as a result, all participants are aware of any changes to it.” In other words, the decentralized process makes referrals more transparent and easier to track.

Participants in this chain include patients, physicians and administrators. The physician is not left wondering whether the patient received the prescription or test, the patient is not left wondering where to go, and the administrator is not left wondering how to bill the whole thing.

As an example, Jasmine Pennic at HIT Consultant reports on the progress of Carroll’s company, HSBlox, which is using blockchains for a new automated referral management system. The system should result in “decreased network leakage, time and money savings for payers and providers, and enhanced patient care,” writes Pennic. 

Blockchain and EHR Management

Some think blockchains could ultimately replace EHRs altogether. “EHRs were never designed to manage multi-institutional, life time medical records,” write MIT researchers Ariel Ekblaw, Asaph Azaria and Andrew Lippman, along with John D. Halamka.”Patients leave data scattered across various organizations as life events take them away from one provider’s data silo and into another.”

Health records on a blockchain would be simultaneously more secure and shareable. “A blockchain-enabled health information exchange would alleviate security concerns related to data-sharing between different providers,” Jessica Kim Cohen writes at Becker’s Hospital Review. “A patient would be able to access and share their data from the blockchain and each provider would be able to update relevant information with an individual key.

Using blockchains could also help medical clinics maintain HIPAA compliance, overcoming data security concerns with a traditional EHR approach. “We will use blockchain for securing the qualification check data and reviews for medical specialists,” says Pavel Roytberg of Doctor Smart, a startup focused on delivering health care solutions on a blockchain-powered platform. 

“The results of regular checks and verifications will be protected using blockchain to guarantee that no changes can be made for any fraudulent or unlawful purpose.” Roytberg’s promise is to create a blockchain platform that fully complies with HIPAA security requirements. The more transparent, the better.

“It doesn’t have to be this complicated,” writes Dr. Robert Pearl of MedPage Today on current EHR systems. “All around the world, app developers take complex databases and build easy-to-use consumer tools for mobile devices that simplify nearly every aspect of our lives. Medicine can and must be next.”

Case Study: Mayo Clinic Moving Forward With Blockchain Technology 

Understanding how blockchains can fit into clinical operations management means looking to real-world implementations. By way of example, one of the largest teaching hospitals in the United States is betting big on blockchain.

Mike Miliard of Healthcare IT News reported in June 2018 that the Mayo Clinic has invested heavily in the technology in the hopes of improving operations management (and setting the stage for the rest of the healthcare sector).

According to Nathan Graham at ETH News, the investment takes the form of a partnership with British blockchain company Medicalchain. Graham’s report goes into detail regarding the goals of the partnership: “Medicalchain claims that hospitals and health systems will benefit from the technology’s ability to increase communication speed and reliability, increase security, and fix data fragmentation, as well as provide patients and clients with a way to access and share their medical records.” 

Fred Pennic at HIT Consultant goes into greater detail on that last point, writing that the partnership will give the Mayo Clinic the capability to set specific permissions and overwriting capabilities. This means patients will have direct control over access to their data, and be able to add data to their EHRs directly. This is just one of the benefits to using the technology for health record keeping.

These efforts from the Mayo Clinic highlight just how important of a development blockchain technology represents for the healthcare sector. Time will tell how the tech will improve clinical operations management for clinics of all sizes.

Blog: Healthcare Revenue Cycle

Images by: ChuttersnapMarkus Spiskerawpixel

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