In the InstaMed Innovation Lab, we built a blockchain prototype focused on healthcare payments among providers, payers and consumers. One of the prototype’s purposes is to evaluate the value of blockchain in driving a better healthcare payments experience for all stakeholders.
What Is Blockchain?
Blockchain software allows multiple parties to transact information on a decentralized network. Blockchain technology has a unique structure that allows a database and software to run across multiple computers owned by different entities.
The blockchain data model is simple. Data is stored into discrete records called blocks. Each block contains a hash of its data and the hash of the last block. A hash is a cryptographic signature that is derived from the data, so if any data in the block is changed its hash will not match. Also, if any block is added or removed, the chain of blocks will not match. Taken together, this creates an immutable audit log. Because of this self-auditing structure and the fact that the data has copies on many different computers, it is impossible to change the data without leaving a trace.
If Bitcoin was the first generation of blockchain, we’re now seeing the fourth generation. Blockchains are now focusing on “smart contracts,” executable code inside the blockchain. Smart contracts are one of the most powerful features of blockchain, enabling automated financial transactions and business rules within the blockchain.
What Is the InstaMed Blockchain Prototype?
The InstaMed blockchain prototype essentially creates a shared patient account ledger accessible by the provider, payer and consumer. Patient accounts are tracked through the entire claim payment cycle. Payments and adjustments are posted once. The blockchain holds the shared patient account ledger including patient account, encounters, claims and payments. Providers, payers and patients are able to view and write to the record’s blockchain based on HIPAA and business process rules.
What Are the Potential Benefits?
- Eliminate duplicate posting and reconciliation processes across providers, payers and consumers caused by having multiple ledgers
- Enable all stakeholders to see a patient encounter through all phases: claim submission, claim adjudication, claim payment, patient billing and patient payment
- Avoid and identify the source of mistakes or fraud
What Technology Is Being Utilized For the Prototype?
- The underlying network for this application is the Hyperledger Fabric, a Linux Foundation project
- The workflows implemented and the record formats used are built on HL7 FHIR
- Learn more about the InstaMed blockchain prototype on the Developer Portal
Join the Conversation!
Let’s discuss blockchain in healthcare payments. We encourage all industry stakeholders to participate.