I’m a healthcare provider and am trying to think how the medical insurance reimbursement system could be improved with blockchain. Certainly the vast amount of paperwork could be eliminated, and many expenses related to the number of employees the insurance companies employ could be reduced. Personally, I have seen many a disappointed patient when their insurance company paid less or none of what was described as a covered expense in their booklet. Certainly, insurance companies are in the business of making a profit, which means taking in more in premiums than they pay out in expenses. However, the overhead of these companies should be able to be cut drastically with a blockchain business model. AND, with complete transparency, the many grey areas of deciding what is or is not covered should become very specific. Does anyone see this as a potential use of blockchain?
Interesting, I agree that insurance could be revolutionized through the blockchain technology. I haven’t worked with insurance but one can for example make a smart contract that holds the funds to be paid in case of sickness and this amount can be sent if and only if a certified doctor uses his/her private key and basically verifies that the patient is indeed sick. Just some ideas
This way the patient know for sure that they will receive the entire amount agreed upon because the smart contract holds that amount already
I really don’t know if all insurance companies will use the blockchain for “transparency” and “many grey areas of deciding what is or is not covered”.
My opinion is that the implementation of blockchain in every records / decision procedures should be mandatory by Governments and Healthcare Regulators on behalf of transparency in grey areas of deciding what is or is not covered.
Yes, I agree. I think if this could work a brand new insurance company would need to be formed that would be must less expensive for the patient combined with predictable payouts. If it took off the “normal” insurance companies could not compete. It’s a HUGE project but I’m just looking to play with the idea here.
Please excuse me if I am off track on this response, but has anyone evaluated the Dentacoin Assurance model?
The dentist gets paid a set number of Dentacoin a month and provides all the dental care the patient needs for that payment. The patient contracts to visit the dentist 3 times a year, practice good oral hygiene, etc.
The smart contract seems custom tailored to this transaction. Both parties have to do what they are contracted to do to get the payment.
This seems to put everyone on the same side of the health table, so to speak. It might really change the way medical insurance is purchased.
This type of payment modality it similar to a Capitation insurance policy. The dentist is paid a fixed amount of money each month or three times a year in the DentCoin example per assigned patient and the dentist is expected to take care of all dental needs. This does not work. The dentist makes more money by not delivering treatment. A patient with a lot of work needed can actually cost the dentist more in time and supplies than the payment that is received. Patients under this type of plan tend to have treatment delayed or dragged out over time as the dentist waits for the next fixed payment from the plan.
As I mentioned before the entire business plan of DentCoin is too vast to be effective IMHO. The only portion of the plan that has a chance is the insurance plan and as it seems to model a Capitation plan, I don’t see any long term success with the platform.
Doc, you are a true capitalist after my own heart! Of course a dentist (or anyone) getting paid the same amount regardless of the amount of work they do will do the absolute least amount of work possible. This is why Socialism (or a guaranteed income, as some countries are currently discussion) will never work!
HIPAA is a prime “confounding” rule set that effects any records release, but there is a way to obfuscate individual ID’s…
It seems to me that there are a couple of issues getting conflated here.
What is covered by an insurance contact is pretty easy to spell out in the contract. Blockchain has a role to play in the administration of fulfilling those terms through smart contracts. For anyone unfamiliar with this, it’s an element of the Ethereum blockchain. I think of it as a “poised payment” that sends cryptocurrency to someone when they perform a service. There’s more to it than that, but it basically gives both parties to a transaction that services will be performed and payment will be made.
Storing medical records on blockchain is a distinct issue from the smart contract. It’s here that blockchain’s basic function of providing very low cost and secure storage of information can really shine.
My private key to my Ether wallet gives me access to the information there while it denies access to anyone else. Instead of cryptocurrency balances, a similar wallet can hold my medical information. I gave someone the address of my Ether wallet and they put some coins in it. My doctor could have my health wallet address and put medical results and records in it.
It seems to me that both of these applications have value.
Very well said Mr. Kos
Great idea. It would be fantastic if the suppliers (Insurance Companies) would incorporate blockchain. But in reality I do not think that they wil do so in the near future. In each country the market is controlled by a handful of very large companies. They enjoy having control of data and do not make it readily available to their users (clients=subscribers=claimants) . The terms and conditions carry elements of ambiguity, and puts most people off making claims.
Insurance companies will probably move to blockchain eventually simply because their databases are getting hacked and the incredibly valuable data is being sold on the black market.
There is at least one idea floating around out there for a blockchain medical records coin, and the emergence of that approach will financially threaten the large companies to look into blockchain.
But that raises a question I do not understand completely. I get the incorruptible nature of blockchain, and how no one can hack the system to create coins for themselves. HOWEVER, I am unclear about the secrecy and security surrounding the information.
Simply put, all the medical records on one centralized database are protected by protocols and firewalls and passwords. What protects all the copies of a de-centralized blockchain. Isn’t the information only as secure as the least protected hard drive on the system?
So, a medical blockchain will prevent me from going in and changing data so I look healthier (an interesting movie plot), but how does a medical blockchain protect a drug company from learning I have high blood pressure so they can target me in their marketing?
Any insight on this question would be greatly appreciated.
There are protocols such as the ones used in Zcash and Monero that prevent any user from knowing another persons balance, even if the ‘person’ is only identified by the wallet, thus providing true anonymity in your transfers.
I don’t know the particulars but i know it requires a series of Zero Knowledge Proofs, a cryptographic concept in where you can prove to someone else you know a piece of information without revealing anything about the information itself. The Z in Zcash comes from this.
I’m not sure about how you could implement this in a medical history perspective, but i suspect you could arrange a blockchain in which the fact that someone has this particular condition is public, but it’s impossible to link this information to any particular person or address in the network.
However it’s worth remembering that full transparency is much easier to achieve in a blockchain than full anonymity.
The issue is critical to protecting the confidentiality of the medical information. The problem I see is that every piece of information - not just an account balance - has to be separated from the identity of the person.
I saw a prototype of a medical information blockchain that included a picture of the patient. Given the developments in face recognition software, this seems like a very dangerous feature.
I just joint yesterday. I work for a Dutch company as product manager, we develop and sell Electronic Health Record software.
I agree that this topic consists of two chapters, that are however related:
- a transaction chapter about paying for healthcare,
- a chapter about data storage of medical data.
The connection between the two parts, is in my opinion the moment the doctor/hospital adds treatment data to my record. I want to authorize that I have been to this doctor and I agree with what he added. That authorization should be the trigger for the transaction system to start working and make sure that the doctor gets paid (by my insurance or by myself).
About transaction blockchains we have seen many examples. The only one I want to mention is raiblocks, because of their smart solution of just storing the result in the chain, which will highly increase the number of transactions.
About data storage blockchain solutions I read an interesting item over here http://www.dataversity.net/blockchain-can-used-secure-sensitive-data-storage/
Read the item if you like, an interesting part is this:
“There are a few ways that a Blockchain can be used in distributed storage software. One of the most common is to:
- Break up data into chunks.
- Encrypt the data so that you are the only one with access to it.
- Distribute files across a network in a way that means all your files are available, even if part of the network is down.
Essentially, instead of handing your files to a company like Amazon or Microsoft, you distribute it across a network of people all over the world. The cloud is shared by the community, and nobody can read or tamper with anyone else’s sensitive data. In other words, you stay in control. This could also be useful in public services to keep public records safe, available, and decentralized.”
In my opinion this sounds like a solid solution for storing my medical data. Some interesting examples are mentioned as well. I will start diving in there right now .
And meanwhile found some initiatives:
all of them have interesting parts, but none of them really convinced me up to now. I couldn’t find anything about open source yet e.g. Curious about your opinions!
Just to be clear I do not have any connections to any of those.
I don’t know much about health insurance, but I believe healthcare in general can be improved by the power of the blockchain. For example, storing patient data electronically will greatly improve medical data access and overall patient care. Our Trufield project for example is aiming to create free electronic medical record systems in developing countries. This will replace paper-based records still in use today. This will greatly improve information access and help healthcare professionals deliver better care in poor communities. Learn more about the project here at http://Trufield.com