How a Decentralized Network Accelerates the Business of Healthcare and Creates Better Care Experiences

Administrative expenses account for approximately 15% to 25% of our nation’s total healthcare expenditures, representing an estimated $600 billion to $1 trillion annually.

Billing and coding costs, physician administrative activities, and insurance administration costs are the some of the biggest drivers of these expenses. Data from the 2021 CAQH Index found that, of the $42 billion spent on conducting administrative transactions, the industry can save $20 billion, or 48 percent of existing annual spend, by transitioning to fully electronic transactions.

Though we’ve made significant progress in advancing clinical interoperability, it’s time to look for a new approach to achieving administrative interoperability and break down the barriers in healthcare. The most efficient model for interoperability is a decentralized network that connects all stakeholders safely and securely for seamless data exchange.

To better understand how such a network would work in healthcare, let’s first look at how Zelle® has transformed payments. Prior to Zelle, if an individual wanted to send money to another person, they had a number of options – all of which were manual. They could pay in cash, wire the money through a financial institution for a fee, or write a check and send it through the mail. Or they could go to their bank and get a money order and send it to the recipient. Once received, the recipient would have to sign the check or money order and take it to the bank, then wait. It could take days, sometimes more than a week, for the deposit to be validated and accepted. Even wired money can take days and be expensive to process.

Today, consumers can use Zelle to send money and it arrives in seconds. All they need to do is open their bank app, choose “Send money with Zelle” and enter the recipient’s phone or email.  With this limited information, funds move seamlessly between Zelle, the bank, and the recipient – it's a financial network with multiple parties interacting. No personal financial data is exchanged between parties except the amount to send.

The same level of interoperability can be available to healthcare stakeholders via a decentralized network:

  • A unique shared person identifier across the network
  • A secure environment for collaboration and data security
  • Distributed data, not aggregated data, which reduces issues with ownership and enables shared data for specific use cases
  • A set of coordination or collaboration services to direct transactions so participants can securely exchange the data needed

With an inclusive and neutral collaboration network, healthcare organizations can work together in a more collaborative way. This optimizes healthcare delivery and reduces the barriers that stand between consumers and their expectations of healthcare.

How it works:

  1. Payers and providers commit data to the network and allow it to be discoverable based on permissions and policies that are set by each participant.
  2. Participants connect to the network and use applications which facilitate data exchange based on specific use cases (for example, sharing of insurance coverage information).
  3. Applications leverage collaboration services to identify the person involved in the data exchange and to request the data available in that network for that person.
  4. The network provides security and validation of the requests to ensure that only the right data, with the right permissions, is shared.
  5. Data exchanges are secured, encrypted and recorded for auditability.

Avaneer Health is building such a decentralized network for healthcare and by healthcare, drawing upon the lessons learned from other industries. The Avaneer Network facilitates open collaboration and promotes trust among multiple stakeholders from different enterprises. Blockchain technology is used to enable participants to access information on a single network, alleviating redundancy and ensuring consistency of records while also providing secure, tamper-evident storage of transaction data. With this network, the payers and providers don’t need to build and maintain multiple connections with each others’ systems. Data can be exchanged faster. Fewer touchpoints mean fewer opportunities for security issues, not to mention lower IT costs and fewer resources needed to manage those connections.

As an industry, it is time to prioritize data fluidity in healthcare over competitive pressures and realize that all players in the healthcare ecosystem want to improve processes, productivity and ultimately, patient care. The first step to doing this is to become a participant in the Avaneer Network.

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