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Aetna and Ascension join blockchain pilot project for better provider directories

Major insurer Aetna and multi-state health system Ascension are the two latest partners in Synaptic Health Alliance, a collaboration between a range of organizations looking to apply blockchain technology to healthcare.

Initially launched in April by Humana, MultiPlan, Quest Diagnostics and UnitedHealth Group’s Optum and UnitedHealthcare, the first pilot project from the group is directing the technology toward the problem of inaccurate health plan physician directories.

Keeping health plan provider directories current is a major administrative and cost burden for the industry, with an estimated $2.1 billion spent annually across the healthcare system to acquire and maintain accurate provider data.

Even with that cost, a CMS review found that 52 percent of provider directory locations listed had at least one inaccuracy, potentially harming a patient’s ability to access care. Data inaccuracies can also harm providers who have incorrect contact information or are falsely listed as being out of network.

Besides the labor costs associated with largely manual process of updating and confirming provider directories, the system creates information silos between companies with the same general goal.

The hope is that by using blockchain – which is distributed across many systems and can easily tracks provider data changes – accuracy can be greatly improved at a fraction of the cost. Synaptic is planning to build a permissioned blockchain that would let members view, input, validate, update and audit non-proprietary provider data within the network.

The alliance, which laid out its plans and ambitions in a research paper entitled “Improving Provider Data Accuracy,” also pointed to blockchain’s ability to cut through traditional barriers to collaboration because of its decentralized nature.

“Blockchain is a logical choice for technological disruption because it features built-in transparency and verifiability of transactions without an intermediary,
so control will be decentralized and all participating organizations will be peers,” the paper states.

Synaptic’s pilot project, which ranks as one of the most ambitious single blockchain initiatives in healthcare, will initially focus on one major geographic market and on a common set of providers.

Moving forward, the group plans to expand the footprint of the blockchain database and build a technology infrastructure for sharing provider data for other use cases like sharing clinical data between plans and providers.

Other blockchain applications in healthcare Synaptic said it is exploring include helping life sciences companies track drugs, creating longitudinal health records that can be easily accessed by patients and streamlining pre-authorization for medical procedures.

“Everyone in this industry has been dreaming of interoperability for a long time. 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,” Quest Diagnostics CIO  Lidia Fonseca said in a statement.

Picture: Getty Images, ismagilov


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