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This is a Great Place for Blockchain to Enter Healthcare...

Updated: Apr 26, 2020

Credentialing and Enrollment of providers, as an analogy for Blockchain in healthcare being the core of an onion, makes this the best place for Blockchain to enter the Healthcare industry.

If Blockchain technology can focus first on proof of concepts related to the credentialing and enrollment of providers among the state and federal agencies along with commercial and government payors it will open up many layers of options for further #Blockchain#implementation. Developing these further, which several are doing, will be a key to the long-term adoption of Blockchain in #healthcare. Here are a couple examples of efforts already underway focused on #provider#credentialing:

From Hashed Health - "Decentralized Provider Identity"

State of Illinois - Interstate Medical Licensure Compact (IMLC)

It will be equally important for anyone working on Blockchain prospects in healthcare to start with a very isolated challenge. Once this focal point has been identified, those that are working on this, likely very technical folks, will need to describe the pain that is currently being experienced by the stakeholders in general terms most would understand.

Once that pain has been described and acknowledged by all participating in the conversation, the discussion should move to a couple very tactical, and most importantly non-technical, actions that are feasible for the novice participant to understand as well and see as realistic.

Essentially, the novice participant, who is likely unaware of #DistributedLedger or blockchain technology, will need to see how a path is laid out one stepping stone at a time. If they can acknowledge the pain or the fear as the focal point of the proof of concept, and they can see a feasible first, second, or even third step along the path, then the Blockchain-proficient participant in the conversation can supplement the stepping stones with more blockchain-specific concepts which may help the novice begin to see how Blockchain could make sense in addressing the agreed upon challenge.

Only then will Blockchain be able to evolve into new areas of opportunity. Considering #credentialing and #enrollment is a foundational concept, while also a point of incredible throughput inefficiency, many other challenges in healthcare can be incrementally addressed. Just like the layers of an onion are reliant on the core being solidly structured, Blockchain's implementation will also need to focus on wide-spread and thoughtful integration into a messy core of healthcare systems and workflows.

Several areas of healthcare that are ripe for improvement that Blockchain could support after starting with credentialing and enrollment include:

  • Authorization management with provider credentials or specialty

  • Denial management related to provider credentials

  • Enrollment of electronic remittance advice (ERA)

  • Enrollment of electronic funds transfer (EFT)

These are just a few items that come to mind and I'm sure others will agree that this is the best place to start and will pave the way for easier adoption of more challenging approaches.

If you need further proof of the issues of credentialing, especially when providers transfer across state lines, consider my sister who chronicled her journey as a Nurse Practitioner moving from Georgia to Colorado.

Do you feel credentialing and enrollment are worthy contenders for starting points? If not what would be the better place? What proofs of concept do you see?

Share your thoughts in our forums of proof of concepts in our GAME CHAiNGER Forum.

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