Using Healthcare Blockchain to Solve Provider Data Issues

April 03, 2018 - Healthcare blockchain is expanding as more organizations make moves to implement the technology. Entities are looking toward blockchain to track provider information and reduce administrative costs.

Humana, MultiPlan, Quest Diagnostics, UnitedHealth Group’s Optum, and UnitedHealthcare announced a collaborative effort to launch a blockchain pilot program.

The program will use blockchain technology to improve data quality and reduce administrative costs arising from changes in provider data.

Companies can also use the program to test blockchain and potentially ensure that the most current healthcare provider information is available in health plan provider directories. Having accurate patient information will improve healthcare system functionality, helping patients easily find the information they’re looking for.

“Today, managed care organizations, health systems, physicians, diagnostic information service providers and other health care stakeholders typically maintain separate copies of health care provider data, which can result in time-intensive and expensive reconciliation processes when differences arise,” UnitedHealth Group said in a statement. “Industry estimates indicate that $2.1 billion is spent annually across the health care system chasing and maintaining provider data.”

Patients unable to find an in-network doctor is a large problem facing the healthcare industry. Many patients can’t afford going to a doctor outside of their network and may not have the tools available to locate a doctor in their health plan network.

UnitedHealth Group Senior Engineer Mike Jacobs told CNBC that keeping information like this private can cause problems for all providers.

"That information isn't competitive at all,” said Jacobs. “Why not share any work that you do? It's for the good of the system to insure that information is up-to-date."

All partners in this collaboration can potentially cut back administrative costs because they will all be contributing to the same blockchain, eliminating the need to maintain their own administrative data. Blockchain is a way these organizations can securely and accurately exchange data.

Blockchain exchanges information between nodes (e.g., users, organizations) via a shared database without the regulation of a third party controlling the data through a single silo and leads to the creation of a trusted history of transactions between organizations sharing data.

Each transaction between organizations consists of a block that holds the data from the current transaction, along with a hash linking back to the previous transaction, thus creating a chain. Every transaction is documented and users cannot go back and alter past data.

Organizations in the network all have a copy of the data shared via the blockchain and can see who is accessing the data and why. If the data is accessed by an unauthorized user, the network can instantly detect it and take action to protect the data.

Blockchain is currently being used in the healthcare industry by payer organizations to make claims processing and payment transactions secure and efficient. Leveraging the technology in other aspects of the healthcare industry can further improve data sharing and data exchange.

Each participant needs to accurately record data as it changes and updates for the benefit of all project partners. The blockchain will ensure that all participants and providers are getting the same accurate data. If one organization reports inaccurate data, the others can go back and reference where and why the mistake occurred and easily correct it.

The project also hopes to save organizations money by making it easier for them to avoid fines. CMS regulations may begin to fine organizations $25,000 a day for inaccurate provider lists.

The group explained it hopes to report the program results using the technology this coming fall.

Leveraging blockchain technology will make these fines easily avoidable and the information readily available to those who need it. Blockchain can potentially simplify the way healthcare organizations exchange information, making it easier for patients and providers to have access to the most accurate and up to date information.