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Leveraging Technology For Better Interoperability: Harnessing The Power Of FHIR & BlockchainODH, Inc. | November 2017
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AGENDA
Welcoming Remarks
Industry Overview
FHIR & Blockchain
Panel Discussion
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Monica E. Oss
Chief Executive OfficerOPEN MINDS
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Michael Jarjour
President and Chief Executive OfficerODH, Inc.
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Data Sharing
Payer Push For “Integration” & “Pay For Value”
New “Business Model” For Providers Requiring
A Complete View Of Consumers
Changing Health Care Landscape
Reimbursement Based On A
Fee-For-Service Model
Provider Business Model Limited To Transactional Encounters
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Fee-For-Service (FFS)
Case Rates & Bundled
Payments
Capitation & Population Payments
Pay-For-Performance
(P4P)
Transition From Pay-For-Volume To Pay-For-Value Across All Payers
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7%
12%
18%
27%
28%
29%
30%
46%
60%
62%
0% 10% 20% 30% 40% 50% 60% 70%
Hospital Does Not Typically Share Patient Data
Hospital Cannot Electronically Send Patient Health…
Hospital Cannot Electronically Receive Patient Health…
Difficult To Match Or Identify Patients Between Systems
Extra Cost Incurred To Send/Retrieve Data
Cumbersome Work Flow To Send Information From EHR…
Those Receiving Summary Of Care Records Do Not Find…
Difficult To Find Provider's Electronic Address
Other Providers Have An EHR, But Are Not Capable Of…
Intended Recipient Does Not Have An EHR Or Other…
Provider Perspective: Barriers To Accessing & Sharing Data
Percent Of Hospitals Reporting Issues When Trying To Electronically Send, Retrieve, Or Find Patient Health Information With Other Care Settings, 2014
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68%
74%
74%
74%
79%
79%
89%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Inadequate Funding For Substance Abuse
Patient Engagement
Inadequate Funding For Public Health Programs
Health Record Interoperability
Difficulty In Coordinating Care Across Organizations
Inadequate Funding For Social Service Programs
Inadequate Funding For Behavioral Health
Top Responses
ACO Perspective: Barriers to Addressing Social Needs
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Lack of Care Coordination = Poor Outcomes & Higher Costs
SOCIAL
MEDICAL
BEHAVIORAL
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Integrated Care Coordination is required
NEEDED: coordinated care model across medical, behavioral, and social systems
SOCIAL
MEDICAL
BEHAVIORAL
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Data Supplies The 360° View Which Drives Insights To Action
Physical Health Data
Pharmacy Data
Behavioral Health Data
Claims Data
Social Determinant
Data
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INTEROPERABILITY: The Key To Better Outcomes
Payer
ProviderPatient
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ADAM JOHNSON
Executive, Technology and Product Development
ODH, Inc.
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What Are FHIR & Blockchain?
Fast Healthcare Interoperability Resources
• Created by HL7 International
• A standard for exchanging healthcare information electronically
• Comprised of modular building blocks (“resources”) which can be easily assembled, and are suitable for use in a variety of contexts
Blockchain
• Digital ledger technology, originally created for Bitcoin and finance
• Transactions are logged publically and in chronological order
• Each is time-stamped and connected to the one before it
• Transactions cannot be deleted, changed, or otherwise modified – but can be distributed and shared via encryption and network verification
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This issue…
Created overly complex value chains
Middlemen created to address the lack of trust
More and more added over time, each building their own systems
The blockchain…
Moves this issue of assurance to the network
Shifts solutioning to the network, collaborators build together
Eliminates unnecessary steps in the value chain
Tackling the lack of assurance
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Patient Care Value Chain
– 1 MPI per party
– Typical value chain = 5 to 6 parties involved
– Conservative cost for each: $4 million
1 MPI per network
Parties maintain the ledger
Solutions developed on the marketplace leveraging a single MPI
Significant savings
For Example
Today Marketplace (on the blockchain)
Envision a day when we have a shared MPI ledger across networks!
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>75% of payers and ~20% of hospitals are in process of or thinking about deploying blockchain
61% of healthcare organizations are identifying use cases for blockchain
60% of healthcare companies identified an inability to collaborate and create a network as an impediment to blockchainintroduction
57% of healthcare survey respondents believe blockchain will be transformative in healthcare industry
76% of healthcare survey respondents said their top leadership is committed to blockchain adoption
98% of healthcare professionals expect >2.5% of healthcare jobs to be automated as a result of blockchaintechnology
Increased Relevance of Blockchain in Healthcare
CURRENT STATE FUTURE OUTLOOK
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Cryptocurrency is just data…
There is a lot of hype, but the fundamentals of the Blockchain are real
– Technology is proven, its scaled
– Bitcoin price has surpassed $7,400
– 300k plus transactions per day
– Market Cap closing in on 120B
Blockchain for HealthCare – Hype or Real?
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Two Pieces Of The Puzzle
DATA INTEGRITY
&SECURITY
INTEROPERABILITYFHIR Blockchain
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Two Pieces Of The Puzzle
Provides the assurance that
a record is complete,
up-to-date, and accurate.
Unified language to place and consume
health information in a modular format,
on and off chain.
FHIR Blockchain
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Transparency, patient data portability
Security
– Indelible record
Health care data at this scale would be invaluable to health care
– Implications for improving delivery of care
– Implications for improving creation of new medications, services
No one “owns” the data
– Removes the need to request data from one user in order to access it
Great Opportunity, Great Potential, Great Benefits
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Requires adoption of the technology
– Some are still having trouble with adoption of HL7
– Raises questions as to how to get everyone to adopt FHIR standards
No one “owns” the data
– Raises questions about patients having control over their health data
Record is unchangeable
– Patients seek second opinions, and not all who deliver care agree on how to do so
– Once information (for example, a diagnosis) is on the chain, it doesn’t come off
Challenges
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Blockchain + FHIR
Supporting value-based care (established working group with Hashed Health consortium)
Care gaps ledger (Negative changes in SDoH, Insights to take action on)
Critical diagnosis ledger
FHIR-based resource key ledger
Examples In Practice
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The best time to plant a tree was 20 years ago.The second best time is now. – Chinese Proverb
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PANEL DISCUSSION
John Falsetti, Director of IT, Maryville Academy
Daniel Paolini, Chief Information Officer, DBHIDS
Rakesh Mathew, MS, MBA, CPHIMS, Program Manager, HSX
Moderator:
Monica E. Oss, Chief Executive Officer, OPEN MINDS
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Questions?