In the InstaMed Innovation Lab, we built a blockchain prototype focused on healthcare payments among providers, payers and patients. One of the prototype’s purposes is to evaluate the value of blockchain in driving a better healthcare payments experience for all stakeholders.
Healthcare payments among providers, payers, and patients is often slow, paper-based and error prone. Often, all stakeholders feel like they are missing some of the information they want:
- Patients are often confused by the statements from their providers and payers. They also have to juggle logins to different provider portals.
- Payers have members who need to pay patient responsibility. Payers want to make it easy for them to pay the provider through their member portal, but they often cannot see if the patient has already paid the provider.
- Providers would like to avoid sending multiple paper statements to collect patient responsibility. They also want their patients to have a simple and frictionless payment experience.
In the Innovation Lab we’ve been exploring how to address this problem using private blockchain technology. We built a prototype blockchain to track healthcare claims and payments.
We created the prototype using HyperLedger Fabric 1.4, an open-source enterprise-ready permissioned blockchain managed by the Linux Foundation. We built smart contracts that utilize the HL7 FHIR v4 specifications.
You can test out our prototype blockchain using our demo app:
We have released our prototype source code with a flexible open-source license for commercial or public projects. We have detailed instructions on installing the blockchain on Linux. Check out the Github repo:
How It Works
While our demo is publicly viewable, a private blockchain is only accessible to participating organizations. Permissions limit what each participant can see, ensuring data privacy and HIPAA compliance. Participants can be members and host a node or go through another member to connect to the blockchain. Blockchain participants can easily and securely share data.
There are a number of potential benefits from using a blockchain, such as:
- Eliminating duplicate posting and reconciliation efforts
- Ensuring transparency through the entire claim and payment process
- Avoiding and identifying the source of mistakes or fraud
The prototype currently supports:
- Creating patients, providers, payers, and other participating organizations
- Creating an encounter for a patient visit
- Submitting a claim for a patient encounter
- Adjudicating a claim
- Generate provider claim response and patient invoice
- Record a patient payment (payment is processed outside of the blockchain and recorded)
Join the Conversation
InstaMed will be assembling a team of industry stakeholders to discuss blockchain in healthcare payments and evaluate the benefits to the entire healthcare economy.