Plans by a group of leading healthcare industry firms to create a joint database of doctors and other healthcare providers using Quorum’s Ethereum-based enterprise blockchain technology got a boost this past week when two industry giants—insurer Aetna, which was just purchased by CVS Health, and Ascension, the largest non-profit health system in the country with more than 150 hospitals—joined the project.
The Synaptic Health Alliance’s overarching goal is see if blockchain’s distributed ledger technology can be used to share the burden of managing healthcare provider data while improving its accuracy, without adding another intermediary to the process. The other members are health insurers Humana and UnitedHealthcare, healthcare cost management provider MultiPlan, medical testing firm Quest Diagnostics, and UnitedHealth Group’s Optum, whose offerings range from pharmacy benefit management to data analytics and IT services to medical practice management.
“Blockchain is the trigger that brought us together,” said Mike Jacobs, senior distinguished engineer for Optum, in a Synaptic white paper outlining the project. “But the collaboration to solve widespread healthcare problems is our real goal. We envision the possibility of effecting change at scale — helping to make the health system work better for everyone.”
With each company maintaining its own healthcare provider database, there is a huge amount of work needlessly duplicated, according to the Synaptic white paper, which noted that $2.1 billion is spent annually maintaining them. It’s also a huge time-sink for medical offices, as the average provider is affiliated with 20 insurance plans, it says.
The current system is not only “inefficient and reliant on manual processes,” but it is also widely inaccurate, with the U.S. Centers for Medicare & Medicaid Services (CMS) reporting that more than half of the provider office locations listed in these directories contained at least one error, the white paper notes. The error-rate in these databases, which state and federal regulations mandate be confirmed and updated frequently, can bring fines and other penalties. And then, of course, there’s the fact that these errors upset insurance customers in an industry that J.D. Power in May called “one of the lowest-rated industries” it evaluates for customer satisfaction.
Synaptic’s pilot project, launched in April, is to build an industry-wide database of healthcare providers for patients to use when seeking out doctors and making healthcare decisions. This is, intentionally, low-hanging fruit, as these databases are one of the few types of records that do not have strong security and privacy requirements, and do not contain any proprietary information.
That said, this is a pilot project, and if successful could lead to blockchain databases containing confidential information. For example, the white paper says, “a node on the blockchain with sufficient privacy protections and protocols could query a personal health record to find out (verify) whether a patient is prediabetic (yes/no) without revealing or exposing any of the information that health record contains (including prediabetes risk factors).”
In turning to JPMorgan’s Quorum blockchain technology, the Synaptic Health Alliance’s members have chosen a type of enterprise distributed ledger technology designed with the financial industry’s privacy needs in mind. Permissioned blockchain flips the technology on head as it creates a private network only accessible by in-network computers, in which private transactions are made between known participants, rather than the typical public transactions between anonymous participants. Distributed block validation, creation, and single-chain architecture are not affected.
A key for Synaptic is a Quorum security feature called a zero-knowledge security layer, which allows the system “to authenticate a single data element in an encrypted file without revealing any of the other data in that file,” with a simple yes/no answer, the white paper explains. “Even the system doing the check does not decrypt the data. This entirely automated authentication process also minimizes the possibility of human error and can allow sensitive information to be distributed across the network without being viewable by potential bad actors. And if human error does occur, the system can identify the source of the breach and remedy it.”
The pilot project will also experiment with incentives to motivate participants to share data and update the shared database. For it to be successful, the widest possible adoption by the industry is vital.
“Everyone in this industry has been dreaming of interoperability for a long time,” said Lidia Fonseca, chief information officer of Quest Diagnostics, in the white paper. “Blockchain is a key to that. Better quality data leads to better decision-making, better patient care and experiences — that’s the promise of what this alliance hopes to deliver.”