Unlocking interoperability for digital transformation with a blockchain-powered network

Two of the biggest buzzwords in the healthcare industry these days are “digital transformation” – and for good reason. There is a lot of room for improvement! The patient experience must be improved, processes must be automated, and the costs of managing healthcare services must be lowered. Digital transformation is a path toward achieving these goals—just as it has been in other industries—but many hospitals, healthcare providers, payers, and provider organizations are struggling with where to begin on this journey.

Every organization has very specific needs, so evaluating different systems and vendors can be incredibly overwhelming, especially when it feels like the options are endless. And while there is certainly no one-size-fits-all approach to digital transformation, there is a solution that can help both develop the industry and be a springboard for digital transformation in organizations – a blockchain-enabled network of interoperability.

Blockchain basics

Blockchain technology can seem intimidating, but when you break it down in simple terms, blockchain is a digital collection of transactions that are tracked and recorded over a decentralized network. Think of it as a database or spreadsheet that multiple participants can access in real time. Each transaction is recorded and linked to the transaction that occurred before it and after it. They are then linked together in a chronological fashion, which creates the “block”. New blocks of data are connected to previous blocks of data, which eventually create the chain. Hence blockchain.

This allows for an unprecedented synchronization of data across participants and creates a single source of truth. The potential to enable cross-organizational workflows and the ability for participants to transact digitally over a network in real-time with higher levels of security and transparency is incredibly powerful.

Another key aspect of blockchain is permanence. Once a transaction is committed to the chain, it cannot be deleted. Users can only add to the chain via a new block, which ultimately creates a historical, linear and immutable record of events or transactions. Changes cannot be made unilaterally in the ledger – network participants must validate changes before a new block is created, reducing opportunities for fraudulent activities. Additionally, this decentralized approach allows for data parity, which is critical in a data-heavy, regulated industry like healthcare.

Working together is the way to achieve interoperability and transformation

One of the blockchain’s greatest characteristics is that it provides an unprecedented level of transparency and openness, allowing each participant to be held accountable and responsible for acting with integrity towards their community. But as we know, the notion of transparency, openness and trust is new to healthcare, and for blockchain to work in healthcare, a fundamental change in mindset is needed to build a community with common goals. Payers, providers, financial institutions and technology innovators – often known as “frenemies” – must put aside their old competitive spirit and come together as one team for the healthcare sector to be truly interoperable.

Cooperation can provide concrete, mutual benefits for both payers and suppliers. For example, there is a significant opportunity to simplify some of the core and repetitive administrative related tasks that occur through many touchpoints in the healthcare ecosystem, such as eligibility, pre-authorization, coordination of benefits, provider information and claim status, among others. A blockchain-based network of payers and providers creates the opportunity to reimagine many of these traditionally non-value-added activities. Furthermore, when payers and providers work together to create common processes and execute on a shared network, inefficiencies can be eliminated.

A use case that demonstrates how blockchain can streamline the administrative process includes sharing and updating provider demographic and banking information with payers in a secure environment. Often, the administrative processes behind managing supplier information are manual and disjointed so that when a change is made, significant effort is required to update the information across stakeholders. This can not only affect the timeliness of payments, but also increases the possibility of fraud. With a distributed network leveraging blockchain, when a validated change is made to a supplier’s data, all parties with appropriate permissions can automatically receive the updated information – resulting in faster and more accurate payments.

Let’s start working together

Blockchain technology can help lay the foundations for a newfound level of trust in the healthcare sector.

The next step is for all stakeholders—payers, providers, patients, financial institutions, and developers—to work together to build this network together to achieve efficiency and true healthcare interoperability. With a single network connecting the industry, healthcare will be better positioned to meet customer expectations and business goals.

Photo: Pixtum, Getty Images