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27 Nov 18 14:32

As I said in my last post on Blockchain, I love reading things that broaden my horizons, teach me something and make me better in the process, and one of my favorite books in this arena is Tom Friedman's "The World is Flat." So naturally, as I look back over the last few months and think about this fast-moving topic, another of Tom Friedman's book titles seemed appropriate – "Hot, Flat and Crowded." Let me explain:

Hot – The topic definitely is that. Over the past several months, I have been contacted by various people to talk about or otherwise engage on this topic. Most look at it – unsurprisingly – from the cryptocurrency angle but a few have thought about its implications for healthcare. Overall, it definitely seems to have struck a chord and piqued people's curiosity, if not actual meaningful interest. I expect even more curiosity over the coming months and I am happy to engage with that in any sensible way.

Flat – as a distributed digital ledger, it is, and the technology itself, is lesser understood. In my view, Blockchain's potential to disrupt paper and process-heavy transactional industries like insurance (including health insurance as well as others) is quite significant. Some exploratory work seems to have been done in this regard but I have yet to see and hear of real tangible successful progress.

Crowded – It does seem to be getting more so. Interest seems to be rising, though it still appears fragmented, at least from where I sit. I have seen some surveys etc. that claim almost 50% of industry executives are developing, piloting or implementing Blockchain projects within their healthcare organizations in some shape or form, but I remain unconvinced that the number is that high. Nevertheless, perhaps they are doing so quietly. Time will tell.In any case, in the interest of moving the topic forward, let me articulate some specific areas that may be impacted by this. Transactions will undoubtedly be an area that will be affected – and quickly. Here are some others:

• Supply chain and general inventory management
• Enrollment/Disenrollment
• Data collection, data exchange and data management (especially Provider Data/Information Management – the perennial issue that really needs to be solved)
• Accounting, premium payments and other back-office functions, especially simpler ones, at first.
• Risk, reporting and other regulatory processes could also be impacted, especially the simpler more straightforward ones, at first.
• Fraud, waste, and abuse among others

Part of the reason this is still plodding along is that there are still significant issues that need addressing. These include:

• Cost
• Trust and security across the entities involved
• Data assurance and quality
• The lack of a regulatory framework to date
• Unity
• Interoperability
• Scale

Although there is obviously still a lot of work to be done, we need to recognize Blockchain's disruptive potential, especially in industries like healthcare, where it could be really attractive. Large scale implementation still seems some time away, but if any of this is even remotely true, it is soon going to get much more crowded.Where do you stand on Blockchain?


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Location: USA


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