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Lack of interoperability has been the bane of healthcare for decades. That’s not to say there hasn’t been progress. But when will providers and payers achieve the same interoperability, transparency, and access to real-time data to help reduce administrative burdens, lower costs, and improve outcomes? While initiatives such as FHIR (Fast Healthcare Interoperability Resources) are making substantial headway, there are still barriers standing in the way. Concerns about security and trust combined with interoperability and operational challenges between payers and providers continue despite immense progress. But there is new hope that an answer may be at hand and it’s coming out of the private, non-healthcare sector.
This is where Avaneer Health is poised to make an impact. Avaneer Health grew out of the Health Utility Network, a consortium leader organizations: Aetna, Anthem, Cleveland Clinic, Health Care Service Corporation (HCSC), IBM, The PNC Financial Services Group, Inc. and Sentara Healthcare. Their participation and commitment to the venture gives Avaneer Health the overlapping patient populations necessary to make a meaningful difference from its start.
If we want to create real transformation in healthcare, we need a new infrastructure – a nationwide healthcare network that leverages blockchain, FHIR, and other technologies to enable healthcare organizations, patients, and other key stakeholders can access accurate, timely information in real time—an Internet for healthcare.
How it Works
First, payers and providers commit data to the cloud and allow it to be discoverable based on permissions that are set by each party. Users can connect to the network via the cloud, where the ID keychain and master index locates the information requested and matches it to the data available, then delivers it to the requestor. The intermediary—Avaneer Health—provides certification, end-point validation, an immutable audit trail, cybersecurity, and compliance. Use cases include eligibility verification, prior authorization, and real-time access to accurate, complete medical records.
The network also connects with rich solution providers like revenue cycle management companies, telehealth platforms and others that are involved in care coordination or the business of healthcare. This eliminates the need for payers and providers to build and maintain connections with multiple systems. Fewer touchpoints means fewer opportunities for security issues, not to mention reduced IT costs and resources needed to manage those gateways. Patients can benefit from a reduction in paperwork and timely access to better coordinated care.
The Bottom Line
If we think of healthcare as an orchestra, payers and providers have their own sections but must play together to create the best outcome. And patients? They’re in the audience, watching what we do next.
The bottom line is that we all need to play together well with a focus on delivery of quality care for patients. But we can’t do that without trust and transparency. With blockchain technology, we now have the ability to make this long-sought-after dream a reality. According to Deloitte, “A blockchain-powered health information exchange could unlock the true value of interoperability.” Patients are waiting- the time to act is now.
