Aetna, Anthem pilot seeks blockchain potential in healthcare

By | January 27, 2019

Dive Brief:

  • Aetna, Anthem, Health Care Service Corporation, IBM and PNC Bank are teaming up to design and develop a blockchain network aimed at improving transparency and interoperability in healthcare. 
  • The goal is an inclusive blockchain network that members of multiple organizations across the healthcare ecosystem can use to securely share personal health information.
  • Potential use cases include claims and payment processing, health information exchange and ensuring and maintaining the accuracy of provider directories, according to a Thursday release announcing the collaboration.

Dive Insight:

Given the wealth of data and customers these companies have, the collaboration could spell real potential to overcome some of the interoperability and information-blocking hurdles facing the healthcare industry. 

What makes blockchain intriguing is its people-centered focus. But for blockchain networks to be robust and effective, lots of people need to join. One of the key challenges for the technology in healthcare is getting participants, because incentives are often misaligned between different groups of users. 

“What blockchain has to be able to do is create markets where a market didn’t previously exist,” Noah Zimmerman, director of Mount Sinai’s Health Data and Design Center and its recently launched Center for Biomedical Blockchain Research, told Healthcare Dive in an interview last summer. The technology is still largely in the infrastructure-building stage, he said.

Still, there is a lot of hope hinging on blockchain as an answer to data security and interoperability, which Aetna, Anthem and their partners appear ready to plumb. 

“Blockchain’s unique attributes make it suitable for large networks of members to quickly exchange sensitive data in a permissioned, controlled, and transparent way,” Lori Steele, general manager for healthcare and life sciences at IBM, said in a statement. “The fact that these major healthcare players have come together to collaborate indicates the value they see in working together to explore new models that we think could drive more efficiency in the healthcare system and ultimately improve the patient experience.”

While still nascent and largely unproven, organizations are starting to invest in blockchain and explore potential use cases. In a 2017 Black Book Market Research survey, nearly 20% of hospital leaders and 76% of health insurance executives said they were thinking of deploying blockchain technology or were already implementing it.

A more recent Deloitte global survey found three-fourths of healthcare leaders see a “compelling business case” for blockchain in their organizations.

Last year, Humana, UnitedHealthcare, Optum, MultiPlan and Quest Diagnostics announced a blockchain-enabled initiative to boost the accuracy of health plan network provider directories. The pilot program, announced in April, aims to study how blockchain can ensure directories have the latest provider information. It will also look at how the technology impacts data accuracy, administrative efficiencies, access to care and costs when information is shared across organizations.

In July, Mount Sinai unveiled the Center for Biomedical Blockchain Research aimed at applying the technology to advance healthcare and medical science. Among other initiatives, the center will partner with companies seeking to develop biomedical blockchain technologies for clinical or research applications.

More recently, Mountain View, California-based Open Health Network launched a blockchain-enabled feature that lets users earn cash or rewards for uploading personal health data.

Still, understanding blockchain’s potential in healthcare is still in the early stages. Potential use cases include urging patients to share personal data and improving administrative data quality and management and supply chain efficiency. Blockchain might also be used to incentivize patients with rare diseases to collect data in conjunction with drug companies to develop new therapies, or to promote healthy behaviors, but such use cases are more hope than reality. 

The key to blockchain is getting people to jump on board the network. If Anthem and its partners can overcome that barrier, they could be onto something big.

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