Many healthcare systems around the world are failing. From high fees to confusing record systems, these roadblocks are making it hard for people to access the care they need. Solve.Care is attempting to use the blockchain to fix this.
BeInCrypto interviewed Pradeep Goel, the CEO of Solve.Care, a healthcare IT company that builds blockchain platforms, about how the company plans to address these issues and what opportunities blockchain and DeFi offer this space.
Using blockchain to make healthcare accessible
BeInCrypto (BIC): How can Solve.Care bring quality healthcare into your living room?
Pradeep Goel (PG): Solve.Care is putting healthcare at the fingertips of everyone wherever they are, whenever they are, not just their living rooms.
Our mission is to give patients choice and immediate availability of healthcare. We also bring transparency to healthcare while putting patients and doctors in absolute control of their journeys by empowering patients while upholding the sovereignty of physicians.
Information asymmetry is one of the root causes of issues in healthcare. Solve.Care is making healthcare intuitive through our Care.Wallet and Care Networks, and removing barriers caused by this asymmetry.
The resulting impact is that all this combined leads to a much more democratized, accessible, and equitable system of healthcare available to all. The significant adaptability built into our model allows us to customize Care Networks to serve local healthcare needs in different demographics and geographies.
Making patient and doctor information shareable, securely
BIC: How can blockchain check credentials, and what is the advantage over traditional licensing systems? Or how can this technology be used to access data from state boards, for example?
PG: The auditability, transparency, and encryption of blockchain allows for more an efficient, effective, and transparent credential management processes.
Smart contracts — self-executing programs — and automation can be introduced. The terms of these smart contracts can be preset to execute access only if those terms are fulfilled. Credentials can be checked using the specified terms.
BIC: How can blockchain help to share patient information across health systems, software — if not everyone uses EPIC — in a secure way?
PG: Blockchain, by its very nature, is secure, immutable, and easily auditable. Blockchain allows patients to maintain full ownership and autonomy over their data rather than an organization or specific healthcare facility. This allows them total control over their data sharing. Data is decentralized, making unauthorized access to the patients’ data a near impossibility.
BIC: What do you think will happen with the big data that healthcare companies and EMRs are collecting? How will the public be able to access it?
PG: Healthcare suffers from massive information asymmetry. Certain organizations control all the data that other stakeholders need to deliver healthcare effectively. They make large profits from this data but rarely yield better outcomes for patients or delivery for doctors.
Solve.Care removes this asymmetry by putting the information into the hands of data owners, not intermediaries.
We achieve this by focusing on improving costs and access to healthcare and aligning the interest of the triangle of stakeholders comprising patients, providers, and payers.
By decentralizing and creating data autonomy we redefine how data is aggregated and used, and to whose benefit. Solve.Care’s Global Telehealth Exchange solution is one such example where patients can utilize their nodes to store their data at no cost at all.
Public access to that data can only happen with the explicit consent of the data owner. When such consent is given, the data can be tracked by the owner to ensure it is aggregated only for the purpose it was shared. This is the new model of equitable transparent healthcare.
Streamlining the healthcare and insurance process
BIC:Doctors and nurses are always complaining they have too much to do, especially when it comes to charting. How do you think blockchain can streamline healthcare processes for providers?
PG: The majority of healthcare providers’ efforts, costs, disputes, and frustrations are caused by different factors like consent management, data management, and compliance with various administrative and clinical protocols.
A platform like Solve.Care is designed to address these issues in a fully automated fashion.
All three things, consent management, data management, and compliance, become largely or fully automated and auditable when on the blockchain. This principle of transparency/automation in data ownership, digital consents, and payments will change how healthcare is administered.
I am fully confident that this will become the de facto standard in the management of healthcare.
BIC: How can blockchain challenge and work with the U.S.’s complex private insurance system?
PG: The United States healthcare system is complex, as is its accompanying insurance system because it is fragmented along state lines. Even so, it shares some similarities in benefits administration, payment administration, and managing and improving clinical care outcomes.
The Solve.Care platform is designed to allow any insurer in the U.S. or worldwide to easily configure and launch Care Networks that automate benefits administration, improve their payment administration dramatically, and improve clinical care outcomes while achieving total compliance with all applicable state and federal laws.
The platform was built with insurers in mind. The architecture of the platform gives insurers a ready-to-use and dramatically accelerated time to market solution in launching a simple or complex Care Network.
BIC: What are some of the new ways to handle billing with or without insurance?
PG: We need to rethink the billing and payment processes that have evolved over the last three decades into the current complex workflows that exist today.
Our ideal model of payment is based on a programmable currency model. This model allows for the easier implementation of simpler payment flows, including delegated payment authority to the patient. The insurer can issue a digital token to the patient which can be redeemed by the patient for approved services.
The tokens value will adjust to the fair value of the service, thereby eliminating billing altogether. In other words, the individual service is paid for at the point of the service being concluded with a digital token that can compute the value of the service in real-time and can be redeemed for that value.
This will then simplify the payment process and eliminate the need for adjudication, delayed payments, appeals, re-adjudication, or payment recovery. The payment cycle, instead of being a complex multiparty business process, flow becomes highly streamlined by delegating the authority to the patient.
Addressing healthcare costs with blockchain
BIC: How can blockchain keep healthcare costs down? How can it improve on-demand telemedicine?
PG: Blockchain can reduce healthcare costs in a number of ways.
First of all, it makes the administrative, care delivery, and payment processes transparent. We can reduce fraud, we can reduce administrative burdens on the doctor to bill and on the insurer to adjudicate, and for the patient to do a co-payment. By utilizing blockchain technology, we can eliminate all these time-consuming and wasteful processes.
Another benefit of blockchain is that it improves access to care. This can eliminate the avoidable cost which is typically related to delayed care. We all know that with timely intervention, we can save lives. Hospital admissions and re-admission rates would be reduced if we provided care locally instead of centrally.
Proactive care can be planned and delivered in a more cost-effective manner compared to reactive care. Using blockchain, we can also do a better job at acute and chronic management, to prevent these cases from ending up in the Emergency Room (ER).
Chronic issues should be handled by being diligent, compliant, judicious, and having better communication with your doctor. Telemedicine is just one element that can improve access, but it is by itself, a small piece of the solution. The real game-changer is better care coordination and protocols.
For on-demand telemedicine, most people presume it is a simple remote teleconsultation with a doctor. But in fact, there are big fundamental enabling capabilities that are needed for telemedicine to reach its full potential, and this is where blockchain really shines.
One is in tracking and auditing which session took place, consents that need to be given before, during, and after the session, for billing, for insurance, for care quality, and for record management.
All these data management, consent management, administrative management need to be done. Blockchain addresses these overheads in an automated fashion. It is also a strong vehicle to measure the quality of care.
Privacy protected through personal control
BIC: How can blockchain address issues of HIPAA and privacy between systems?
PG: Blockchain addresses these issues by giving control to the data owner (the patient), by implementing real-time consent management and consent revocation.
It gives the patient the ability to track how the data is being used by whom when it is used, or for what purpose, and if needs be, revoke access to that data. It brings a whole new level of capabilities that are not available today.
Blockchain will enable patients to enforce the way their data is used according to the parameters of their consent. It will also ensure that the data shared stays in the sole control of whom it was shared within the duration that it is shared.
This fundamental philosophy is in-built in Solve.Care’s platform, covering consent management, revocation, and auditability of data using blockchain. This will replace many of the manual processes used to enforce HIPAA.
In terms of privacy, the patient or data owner becomes the hub of the data exchange so there will be no instances where they do not know where their data is, and what it is used for.
DeFi and affordable healthcare
BIC: Previously, you have talked about DeFi creating a market for healthcare. Do you think that decentralized healthcare platforms can really bring affordable healthcare on their own, or do they need regulation?
If so how? Likewise, insurance reimbursement in the U.S. is usually based on Medicare rates as the “basement.” How can DLT, DeFi, and blockchain disrupt this system for the better?
PG: Healthcare has a lot of unmet needs. A lot of people are disadvantaged geographically or economically. They are unable to access quality care, devices, procedures, labs, or specialty care.
DeFi represents a way for a community to fulfill these needs by funding worthy causes in a manner that is in the best interest of people, communities, and humanity. At the same time, generating very healthy and sustainable returns.
Currently, there are many intermediaries between the patient and healthcare services. These intermediaries take up a lot of the $3.8 trillion spent on healthcare in the U.S. Eliminating those intermediaries is one of the key opportunities to lowering healthcare costs and generating significant returns for the DeFi community.
Our goal is also to align the DeFi community towards streamlining the business processes, care, and improving outcomes while removing fraud and abuse. That will create massive savings worldwide. The savings, just for implementing the basic efficiencies enabled by platforms like Solve.Care will potentially be in the trillions of dollars.
Healthcare, in general, will always be regulated because of its importance and how it affects all of us. The purpose of decentralized platforms is not to buck regulation but make the intent of regulation happen. If regulation is made for the best interests of the patient, then blockchain platforms like Solve.Care and regulations are fully aligned.
If there are old or archaic regulations that do not serve the interests of the patient, then of course those will have to be challenged. By and large, most healthcare regulations are written to protect the patient.