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Blockchain - a pathway to better administration of healthcare

An interview with Pradeep Goel, Chief Executive Officer, Solve.Care

Original source:

John Drachman What’s the concept behind your idea for applying blockchain to improving healthcare?

Pradeep Goel The concept is profound, yet simple… Blockchain (or distributed ledger technology for the purists) offers a way to decentralize data, processes and ultimately relationships in a way that will change the way many industries work.

The concept is profound and yet elegantly simply — data can be published on a chain and can be reliably replicated and localized to the user who needs it to make decisions. And since the local copy of data is reliable, it can be queried, instead of a centralized system or entity.

Of course, there are the usual nuances of security, privacy and audit of data, but these are procedural and technical issues that need to be resolved in the appropriate context.

The fact remains, we can now design processes and interactions around a trusted, highly replicated, up-to-date local ledger.

Solve.Care Foundation has announced the start of the pre-sale of its platform tokens.CAN is the native token of the Solve.Care platform and will be available via the public pre-sale beginning on January 15, 2018

John Drachman How and why will Blockchain be applied to Healthcare?

Pradeep Goel Already, there has been tremendous focus on projects attempting to use Blockchain to manage clinical records better. It is an obvious and understandable use case.

However, as a healthcare administrator, I witnessed many problems that are not rooted in the ability to share clinical data.

The biggest growth in healthcare costs (other than cost of medical services themselves) has been in administration of healthcare. All the stuff that happens behind the scene between insurance companies, doctors’ offices, hospitals, pharmacies and government agencies.

A tremendous contributor to cost and inefficiency in healthcare is due to processes such as eligibility, enrollment, pre-authorization, adjudication, medical review, provider credentialing, contract provider management, appeals, utilization review, case management and of course payments.

So, uses of Blockchain that address the friction and cost built into the current administrative processes will have a strong appeal to those who bear the cost of healthcare — insurers, employers and consumers.

John Drachman Tell me a use case and ROI I can understand.

Pradeep Goel It is fairly easy to calculate the ROI from issuing insurance ID cards on the chain to replace, print and mail these cards to millions of consumers every year. And the additional value to the consumer is accurate and instantly verifiable information about their insurance — allowing doctors, hospitals and pharmacies to avoid the time-consuming administrative step of having to call the insurance company to verify.

This simple use case represents a win-win-win for patient-doctor-insurer in terms of user experience, administrative burden and call center/web-portal costs respectively.

Same is true for pre-authorizations that can and will be redesigned and automated using a distributed ledger. Same is true for provider credentialing which is the recurring administrative process to verify physician’s skills and certifications to practice medicine.

And last but not the least, there is a huge opportunity to decentralize and streamline healthcare payment cycles, which are notoriously long, complex, expensive, error-prone and susceptible to fraud and abuse. Blockchain gives us a unique opportunity to deploy a programmable healthcare currency to verify and pay healthcare bills accurately and in real time.

John Drachman It sounds like Solve.Care aspires to the administrative redesign of healthcare. Is that about right?

Pradeep Goel We have compiled a list of dozens of use cases for administrative simplification of healthcare with measurable ROI that is compelling to insurers, physicians, hospitals, employers and consumers. These identified and documented use cases of Blockchain are focused on administrative simplification for all parties involved and will save lives and billions in annual costs.

That is the mission and purpose of Solve.Care platform and why we are so furiously working to deliver to the market, a robust healthcare administration platform, built from the ground up, on Blockchain.

About Pradeep Goel As the founder and Chief Executive Officer of Solve.Care Foundation, Mr. Goel has been in the CEO, COO, CIO and CTO roles at various innovative healthcare technology companies for more than 25 years. He has unparalleled experience, deep healthcare expertise and a unique combination of skills that combine health and human services, finance and technology.

Also posted on Medium.

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