My wife has been studying to become a medical doctor for the last eight years. She is now at the stage where she works almost exclusively in hospitals getting hands-on experience with patients and healthcare providers. One of the most baffling things — both for her and for me — is how dated the healthcare system is when it comes to record keeping. The hospitals she has worked with — even some brand new establishments — still use pens and papers to record all medical notes. Everything is stored in binders and file cabinets. Important information is transmitted over the phone and stored in spreadsheets. At one hospital the most advanced piece of communications technology she came into contact with was a pager!
The cost of monitoring and facilitating health insurance payments in the US has risen to $59 billion, and it is climbing. Much of this cost is attributable to poor record keeping, communication errors and outdated technology being relied upon for what is called the ‘claims process’ — which is process healthcare providers like general practitioners, specialists or hospitals must go through to have a patient’s medical insurer pay for a prescribed treatment. Currently, this is a cumbersome process, laden with errors largely due to this problem of outdated record keeping.
In the latest episode of ICO101, host Aaron Paul spoke with Chris Plance, CEO and founder of the Veris Foundation. Veris is a US-based non-profit initiative who are proposing a blockchain solution to this problem. According to their whitepaper: “The Veris Foundation solves the problem of bringing healthcare service providers, insurers, and banks together to authorize the provisioning and payment for healthcare services.”
They will attempt to do this by placing the current claims process onto the blockchain, executable by smart contracts. Chris offers the warning that the term “smart contracts” may be deceiving as they aren’t very smart, nor are they technically contracts. But they are incredibly useful. Decryptionary defines them as: “A smart contract is a promise made between two or more people and recorded in the permanent, transparent digital record known as the blockchain.”
First, the Veris Foundation will operate a governance layer via the Proof of Stake mechanism. Meaning, in order to participate in their solution, providers, payers (insurers), or financial institutions would hold “VeriStakes” and serve as disinterested third party governance over individual smart contracts as well as having the ability to create new contracts. Secondly, there are “VeriCoins” which are given as a reward for holding VeriStakes and can be used to execute smart contracts but not create new ones. This is a similar set up to the NEO blockchain whereby NEO coins are staked and their GAS tokens are rewarded.
The smart contracts involved would embody the current claims made by the healthcare providers to the payers. These typically involved many stages including eligibility, pre-authorization, claim submission, claim to process, claim payment and post-payment review. All of which takes time, money and are wide open to clerical error and miscommunication. The entire process can be shifted to the Veris network and have the process streamlined by executing the claims efficiently and economically via smart contracts.
These smart contracts would be a series of integrated contracts — responsible for different stages of the claims process — in communication with one another and would trigger each other once they have been executed. For example, in order for a payment to be finalised, the patient’s ID would need to be verified and the contract between the patient and the payer would also need to be verified etc.
Overall, the Veris Foundation is proposing a unique and sorely-needed use case of blockchain technology to an industry crying out for innovation. Some of the challenges will include familiar themes like convincing stakeholders to adopt the platform. We will have to see how a system who in 2018 relies on pens, paper, phone calls and Excel spreadsheets will react to a proposed blockchain solution to the expensive claims process. Veris might be the project to do it. The core team has over 30 years of experience in the sector and a solid proposition.
What do you think?
ICO101 Podcast on the Veris Foundation — https://apple.co/2pma0qQ
The Veris Foundation — http://www.verisfoundation.com
Information on the crowdsale — http://www.verisfoundation.com/presale