In Blockchain, Health Informatics

Blockchain technology came into its own with the advent of the crypto-currency Bitcoin, but other industries took notice, and blockchain started growing exponentially. Decentralized consensus has been achieved with blockchains because they’re secure by design and exemplify a distributed computing system. Outside of finance, nowhere has this technology’s potential been more warmly received than in healthcare.

Note: You can download a transcript of the full SXSW blockchain Q&A to read now or later, or share.

To that end, Change Healthcare Chief Technical Officer Aaron Symanski spoke at this year’s South by Southwest (SXSW) conference in Austin, Texas, to a crowd of 400 attendees eager to learn more about blockchain’s potential to transform the healthcare system. Symanski shared the stage with panelists Dominique Hurley of HealthVerity; Elizabeth Breeden of Lipscomb University; and John Bass, founder and CEO of Hashed Health, who moderated the discussion titled, “Blockchain and the Crisis in Healthcare.”

Speaking at SXSW 2018 were (L. to R.) Elizabeth Breeden of Lipscomb University; Aaron Symanski of Change Healthcare; Dominique Hurley of HealthVerity; and moderator John Bass of Hashed Health.

Bass jumped right to such crises in his opening remarks. “There’s a crisis in cost. There’s a crisis in transparency. There’s a crisis in value,” he said. But it’s not because the healthcare system is broken. “Healthcare in the U.S. is working exactly as it has been designed,” Bass said. The implication: The design is flawed. “For healthcare in the U.S. to change, fundamental changes need to occur in the industry … blockchain can be a technology that lets us address business models that are not currently available today,” he said.

The panelists focused much of their discussion on the possibilities blockchain holds for managing consent; verifying identity; scaling up claims management; and improving patient care by enabling safer, simpler, and more comprehensive sharing of patient information.

Symanski said that for blockchain to be effective, “You need a network of participants. And the way to find a network of participants is to use a network that’s already existing.” Under Symanski’s leadership, Change Healthcare has enabled its Intelligent Healthcare Network (used by over 800,000 providers and more than 2,100 payers) by adding blockchain capability to it. Symanski acknowledged the company’s early adopter status, saying partners are now exploring development of applications that can work with this blockchain network at scale.

The panelists agreed that developers will come up with blockchain-enabled applications to solve problems such as:

• Addressing the opioid epidemic by tracking pharmaceuticals
• Developing a chain of consent
• Managing and scaling up insurance claims processes
• Creating a chain of identity
• Providing patients with digital-rights management
• Enhancing clinical workflow
• Reducing the time and operational burden of patient care
• Providing needed information to providers and patients alike at optimal moments in the healthcare delivery process.

Audience members asked a number of challenging questions at the conclusion of the presentation. One international emergency room physician who works across the globe said the U.S. is the only country in which he cannot readily access his emergency department patients’ comprehensive, longitudinal medical records. Would blockchain make a difference? “That’s a problem blockchain can help with,” Symanski said. “It can help with identity. It can help with, ‘What part of my medical record do I want to share with you?’”

Another audience member asked whether blockchain will be “the” technology that will make possible a single-payer healthcare system. Not necessarily, Symanski answered. Rather, the technology itself will bring transparency to payments, providing the ability to “follow the money,” no matter what the payment system. “If blockchain was fully utilized everywhere, you could trace the money you’re spending on taxes, insurance, employers, out-of-pocket, and know where that dollar ends up,” he said. “That’s your nirvana.”

Nirvana aside, panelists cautioned there’s still a great deal of work to be done. “It is still very early in the game,” said Elizabeth Breeden of Lipscomb University. “However, blockchain in healthcare holds great potential, as evidenced by innovative solutions which are currently being released, as well as those under development.”

HealthVerity’s Dominique Hurley called on the industry to step up action on blockchain. “Companies need to commit to working together in the name of improved operations … We need to move beyond proof of concept,” she said. “Every player in the industry should put an ops team in place with the intent to improve business operations.”

Note: You can download a transcript of the full SXSW blockchain Q&A to read now or later, or share.

A study commissioned by Change Healthcare found that 72% of consumers say their engagement experience with both providers and health plans hasn’t improved—or has worsened—over the last two years. Yet at the same time, investment in consumer engagement is a top priority for 80% of payers, who invest up to one-...

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