Using An Allocation Model to Help Maintain Accurate Health Care Provider Directories
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Right-sized and effective governance for industry alliances
Operating model for a successful alliance
Building a blockchain utility in healthcare

Frequently asked questions

What is blockchain?

Blockchain is a shared, distributed digital ledger on which transactions are chronologically recorded in a cooperative and tamper-free manner. One of the best and simplest explanations compares it to a spreadsheet that gets duplicated multiple times across a network of computers designed to regularly update the spreadsheet. The technology is most useful when loosely coupled or independent organizations want to confidently share and audit information and automate mutually beneficial processes.

How could blockchain technology help healthcare?

The potential is substantial given the need to improve and streamline how health care data is managed and to ensure security, in addition to the opportunity the technology presents for collaboration across traditional industry and competitive boundaries. We have identified many potential uses for blockchain, including longitudinal health records, tracking assets, managing and exchanging data, and automating processes—all with the goal of improving member, provider, and payer experiences and removing cost from the healthcare system.

Synaptic has launched its first pilot project. What does it involve?

The first project, which was announced in April 2018, has demonstrated that collaborative use of blockchain technology can help improve the efficiency of updating directories people use to select health care providers. Through the “provider data exchange” enabled by blockchain technology, Alliance members were able to find and update certain demographic inaccuracies faster than they would on their own.

In the pilot, the Alliance used its blockchain functionality to identify up to 88% of necessary demographic data corrections across the Alliance members’ shared data for two of the most common errors in care provider directories:

  • Inactive locations, which refer to sites of service where care providers were once seeing patients but are no longer doing so; and
  • Address mismatches, which occur when health care organizations have differing addresses for the same care provider.

What problem do you hope to solve?

State and federal laws, regulations and guidance require health plans to regularly update provider directories, such as monthly with some requirements being even tighter. Additionally, many of those same laws require insurers to contact every provider in their directories, sometimes as often as every three months, and make updates to those directories much faster than has been done in the past. The present model encourages potentially duplicative outreach and maintenance costs while creating silos of data. This pilot shows how sharing data across health care organizations on blockchain technology can improve data accuracy, streamline administration, reduce costs and improve access to care.

Is the Alliance open to new members?

In forming this alliance, the group recognizes that to build an effective solution, the Synaptic Health Alliance and the blockchain network will need more participants from the health care industry.

In 2020, the Alliance added new members, helping bring key technical expertise, data expansion and patient/consumer insights to support the Alliance as it develops new use cases for blockchain technology. The new members include Centene, Cognizant, CorVel, and Prime Health Services.

The Alliance is currently accepting additional new members, especially health systems based in the United States.

How expansive is participation in the pilot project?

We believe this is the first blockchain initiative in health care to involve several national and international providers and payers, so the scale may be unprecedented.

Leveraging one of the health care industry’s first “multi-cloud” blockchain networks, the Alliance pilot focused on directories for health care providers in Texas with expansion into Colorado, Florida and New York underway. The Alliance plans later this year to begin a nationwide launch of the blockchain functionality.

What can we expect next from the Alliance?

We are developing new content and presenting at select virtual conferences throughout 2020.

The Alliance is also currently running another pilot phase centered on coordinating outreach efforts to avoid overlap. Each member calls certain care providers and shares resulting data updates with the other members. This has the potential to reduce the number of phone calls each Alliance member needs to make to providers in their networks and the number of times care providers are asked to confirm their information.

It is also testing a business model that involves delegating updates for certain records to third-party companies and an economic incentive model designed to fund and sustain the future infrastructure and operations of the blockchain functionality. These steps will help lay the foundation to ultimately support a nationwide rollout of a health care provider data exchange and future use cases for the Alliance.

Are there other uses for blockchain in healthcare?

As for other uses for blockchain in health care, we have identified several and will consider them for future exploration. That list includes:

  • Helping pharmaceutical and biotechnology companies monitor and track products and guard against counterfeit drugs
  • Creating longitudinal health records that allow patients access to all of their medical information regardless of which health plan or doctor was involved
  • Streamlining the pre-authorization process for medical procedures

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Solving health care’s toughest challenges with leading edge technology

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Improving Provider Data Accuracy:
A Collaborative Approach Using a Permissioned Blockchain