Synaptic Health Alliance is Developing Blockchain Use Cases for Healthcare
Episode 1455th November 2019 • This Week Health: Conference • This Week Health
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 Welcome to this Week in Health IT events where we amplify great ideas with interviews from the floor. My name is Bill Russell. We're recovering healthcare, CIO, and creator of this week in health. It a set of podcasts and videos dedicated to developing the next generation of health leaders. We wanna thank our founding channel sponsors who make this content possible, health lyrics and VMware.

If you wanna be a part of our mission to develop health leaders, go to the homepage this week, and click on sponsorship information. This week we're at the health conference in Las Vegas and I was looking for use cases in blockchain and ai. And this conversation I caught up with Michael Kim, the CIO for MultiPlan, which is a member of the Synaptic Health Alliance, which is building out common directories on blockchain for payer provider, uh, applications.

Uh, have a listen. Hope you enjoy. Okay. Another, uh, another interview from the Health Conference, HLTH. And we're here with Michael Kim, the CIO for, uh, are you for the Synaptic Health Alliance or for multi-plan? No, uh, I'm the CIO for multi-plan, multi-plan. I am multi-plan board member on the Synaptic Health Alliance.

Got it. Thanks. And, and actually this, I'm not familiar with either. I really wanna talk about blockchain, which is the underlying technology, but. Um, so for not only the listeners, but for me, give us an idea of, uh, of, well, let's start with you. What, what's your background? So you're ACIO. So I started my career as a consultant, uh, for about a dozen years.

More focused on the, uh, financial services industry. Um, then I did a startup for three years. Then I was in, um, the Chief Technology Officer at The Hartford, which is a big insurance company. And, uh, um, I was a Chief operating officer at, uh, smaller insurance company out of Bermuda, and then joined, um, MultiPlan six years ago.

So I've been in healthcare for about six years as ACIO. Yeah, so we're about, I, I came to healthcare after 20 years of consulting in other industries and, uh, . There is a little bit of a learning curve, isn't there? There's a very steep learning curve. see that? But it, it seems to continue to be a trend though.

I mean, uh, Providence and, and now, um, uh, common Spirit have both hired CIOs from outside the industry. Yeah. And uh, I think it's, it's recognizing that the technologies that are in use in other . Industries have a lot of potential within, within healthcare, and we're gonna, we're gonna go there. So, um, tell us a little bit about the, uh, synaptic Health Alliance.

So, synaptic Health Alliance, uh, the brainchild of that started a little over a year ago, and there were discussions about that. There were initially. Uh, uh, four founding members. United slash Optum was one, Humana, quest and MultiPlan. We were the original four founding members, and, um, as we started the first pilot, Aetna joined us as a, um, um, now they're officially designated as a founding member, so there are now five of us who are founding members.

Family members. And what's the, uh, what's the direction, what's the goal? What are you trying to address? Yeah, we're, so we're trying to create a, um, utility for the industry in healthcare. So it's not a for-profit organization. It's meant to be something that we create that really fundamentally provides value to the um, uh, the healthcare sector.

Um, and, um, leveraging blockchain technology. And so we started with one use case, but we'll roll out to other use cases as well. So the use use case is provider directory essentially? Exactly. Right. So blockchain's a very powerful technology. Yeah. Um, it's effectively a distributed ledger, right? So you have data.

We have data, and as someone changes their data, you could see what changes were made to the data and why. Um, so that's the metadata around the data. What we're doing around that is starting with provider directories, 'cause that's all publicly available information. Um, and, um, there's no PHI associated with that.

And so effectively it's a much easier data set to start with, right? And so every single payer out there, . Has provider directory data, right? Yeah. Significant. It's significant. Um, and they're, it's changing constantly. Right? So and that becomes the challenge, right? And it doesn't change it to the source. It changes at all these distributed points.

Exactly. And what blockchain is about is basically crowdsourcing that. So if Aetna calls someone and says, ah, Dr. Russell's address changed, or they added a new doctor to the, the roster. Well, why couldn't we get access to that information? There's no competitive advantage associated with that. And in the industry today, we spend about $2.1 billion on managing provider data Really, and think of, yes, yes, about 2.1 billion.

We have hundreds of people whose sole job is to call and reach out and update the provider directory information. , um, provider directory information. Yeah. Right. And just think about the irritation that providers have, having to respond to all those different insurance companies trying to, providing that same information over and over again.

Right. And so that's why we thought this was a great use case, starting to target some of the, the waste out there and redundancy. And so, and there's no competitive advantage associated with that, and it's all publicly available information. Interesting. So did, did, uh, the five partners, did they have to make any substantive

Changes to their tech stack in order to participate? Uh, no. No. Uh, so you set up longer term, you set up your own Right. Everyone. So blockchain technology basically has a node. Each person. If we change that data on that node, then our provider data management system should. Have that data reflected in that.

Absolutely. And so we want to integrate that. But right now it's, so that's the work they have to do. Yeah. You're gonna have in the future. Um, and are you running on any specific blockchain technology? We are. It's called Ethereum Foundation that we're gonna be on. Yeah. So you have the Ethereum Foundation distributed, uh, distributed ledger.

And then people have access to that. Mm-Hmm. . But, and so the, the payers will probably still pull that back into their core systems ultimately long term. But because we're in a pilot, we're just trying to figure out how good is that data? If Aetna makes a change, do we want to accept that on an automated basis?

So we're doing the analytics around that. And what we're actually finding is today our folks that are reaching out directly to providers. 16% of the phone calls are resulting in a change. Oh, wow. With blockchain, that number is four or five times that it's over 60%. So think about the improvement in the data quality, where the same number of people are making the same number of outbound calls, but now 60% of that's resulting in a change or updates to the provider directory.

Now, longer term, when we integrate it into our systems. That has implications are we could continue to drive that to productivity enhancement, uh, uh, that um, effectiveness or quality of the data or we can opt to just accept that on an automated basis. And you don't need as big of a provider data management group.

So are you accepting other members or waiting to get through pilot before we, uh, we are wrapping up our pilot. We're now actively accepting other members 'cause . For blockchain to add value, it's crowdsourcing. So the more members, the better. The more people participating, the more people updating, the better and the more value that's coming outta that.

So we're very actively, um, um, trying to add new members to it. Initially as we were in pilot, you know, it's hard to, from a governance perspective, agreeing on definitions, et cetera, to have too many people. But now we've got to the point where we're mature enough and, and we've made some decisions.

Interesting, uh, limitations of blockchain as you were. Experimenting with it. Learning with it. Yeah. It's a new technology. Right. And so, you know, to be frank with you, we're now on our third technology platform, but the folks who have been developing this have done a great job kind of, um, abstracting the layer so that we can change the technology platform without changing the services too much.

Uh, or require too much rework. So we're now on our third iteration. We're finding that it's an immature technology, great for cryptocurrency, but for enterprise scalability for our whole industry, it's probably not quite mature enough, and so we're learning as we're going. Interesting. So. It's, I've heard some people say, well, it could be used for this and this, but it's not a, it's not a very fast transactional system.

No, it is really it. It's meant for these kinds of things. Yeah. It's a directory up to the minute, up to the second is not, yeah. All that important. Yeah. I mean, we're trying to get it to. Um, where the transactions are within seconds, not, you know, minutes or hours. And so we, we do need to have that type of performance perspective on that.

And that's where we're finding there are some scalability, performance issues with the, the current technology, with a level of business logic that needs to be embedded into those transactions. Will it be truly distributed or will you have . A specific, do you have a specific node structure that you've just defined?

It will absolutely be distributed. It's a permission-based distributed system, so it will be distributed. Every single member who participates will have their own node. They can pick their own on-prem, um, set of servers, or they can put it in the cloud, but it will be distributed. Fantastic. Yeah. That's great.

Anything else that, that I should know about Synaptic Health Alliance blockchain where you guys are going, no, no. Can can providers participate in this? In fact, if providers participate, we're better off because Oh yeah, they will be the source of truth. Right? If they, if we find. Like, let's say a company like HCA goes up and updates its roster or updates will accept that as a source of truth, right?

So I know, I, I know this is hard to believe, but that was, uh, that was one of the harder problems within a health system Yeah. Was keeping that roster current. Yes. And you would think that, you know, all these people are within one health system, but. You have splitters, you have people in different health systems and, and they don't necessarily keep that, that roster current.

Yeah, so the beauty of this blockchain technology is, let's say the health system goes up and modifies that, but then we'll know United or . Aetna or whatever other blockchain participant goes in and they accept that we'll have validation from multiple parties. Right? And so we'll see all of that transactions that are going on.

That's what I mean by distributed, um, database. It's not just the data. And in fact, we're probably gonna store the data off blockchain. It's the transactions that are going on saying, ah. Provider X came in and updated it, and Aetna came in and accepted that and validated that information as did Quest. And so if I see that happening, I can then take that on an automated basis.

So you've been pretty disciplined state to the one pilot, I'm sure. Like there's 55 other things that people have come forward with. Uh, what, what has the most promise, the next handful of ideas? Well, so, um, there are a range of ideas. That are being considered. We're wrapping up this particular pilot, which happens to be in Texas On that Synaptics growth is gonna be three parts.

There's rolling out this pilot nationally, right? So we will do a multi-state rollout. Adding new members. And then the third is new use cases. And so we are actively considering new use cases, everything from credentialing to prior authorization to coordination of benefits. Wow. And so there's a range of different things that are being considered.

What we want to do is they'll add a bunch of health systems and provide a representation into the blockchain so that they can . Define a use case that adds more value from a provider perspective, what's their commitment? Other than, I mean, obviously participating with data Yep. And those kind of things.

Is there a, is there an investment? Is there, yeah, there is, um, nominal participation fee to be part of the alliance, and it's just to off offset some administrative costs. There is no for-profit. Motivation on. Right. It's fascinating. Yeah. Well, Michael, thanks so much. Thank you. Appreciate it. All right. That work?

Is that good? Yeah. The other people who came in . Yeah. You, uh, there's a couple people just walking through.

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