Chronic Care Coordination Network

A shared, permissioned ledger provides a single source of truth for patient data across providers, labs, and payers. This eliminates redundant tests and administrative reconciliation, directly cutting costs.

• Example: A patient with diabetes sees a PCP, endocrinologist, and nephrologist. Blockchain ensures lab results are instantly available to all, preventing duplicate A1c tests and manual record requests.
• ROI Impact: Reduces administrative costs by 15-25% and cuts duplicate testing, a major source of waste in chronic care.

Smart contracts automatically execute payments and track outcomes against predefined clinical benchmarks, removing manual claims adjudication and disputes.

• Example: A contract pays a bonus if a cohort of heart failure patients maintains medication adherence >90% and avoids hospital readmissions. Sensor data and pharmacy fills recorded on-chain trigger automatic, auditable payments.
• ROI Impact: Accelerates reimbursement cycles from months to days and reduces administrative overhead for pay-for-performance programs by over 30%.

Immutable, patient-controlled health records allow for instant verification of treatment history and plan eligibility, bypassing lengthy fax/phone-based prior auth processes.

• Example: A provider requests a high-cost biologic for a rheumatoid arthritis patient. The patient's consent and treatment history on the blockchain provide instant proof of failed conventional therapies, auto-approving the request.
• ROI Impact: Reduces prior authorization processing time by 70-80%, improving patient access to care and freeing clinical staff for higher-value tasks.

A patient-centric data ledger enables precision recruitment for trials by matching anonymized profiles to criteria, while providing an immutable audit trail for all clinical data points.

• Example: A pharma company seeks patients with specific genetic markers and treatment history for an oncology trial. With patient consent, the network identifies matches in hours, not months, using verifiable on-chain data.
• ROI Impact: Cuts patient recruitment timelines by up to 50% and reduces data reconciliation costs, accelerating time-to-market for new therapies.

Every data access, consent grant, and transaction is immutably recorded, creating a granular audit trail for compliance (HIPAA, GDPR), billing audits, and quality reporting.

• Example: During a HIPAA audit, a health system can instantly prove who accessed a patient record, when, and for what purpose, without manual log aggregation.
• ROI Impact: Reduces audit preparation costs by 40-60% and mitigates risk of compliance penalties, which can exceed $1.5 million per violation.

Patients can securely monetize their anonymized data through tokenized consent, creating a new, compliant revenue stream for health systems that facilitate these data marketplaces.

• Example: A research institute purchases access to a de-identified dataset of 10,000 diabetic patients for a longitudinal study. Patients receive tokens for their contribution, and the health system earns a facilitation fee.
• ROI Impact: Creates a new high-margin revenue line while aligning with patient-centric care models, turning data from a cost center into an asset.

Patient health records are trapped in disparate EHR systems across providers, payers, and labs. Coordinating care for a diabetic patient requires manual faxes, phone calls, and data re-entry, leading to:

• Medication errors from outdated information.
• Delayed treatment while waiting for records.
• High administrative costs for data reconciliation.

A permissioned blockchain creates a single source of truth for patient data. Authorized providers append encrypted updates (e.g., lab results, medication changes) to an immutable audit trail. Key benefits:

• Real-time data sync across the care network.
• Patient-controlled access via private keys, enhancing privacy compliance (HIPAA).
• Elimination of duplicate tests, saving an estimated $1,000+ per patient annually in redundant imaging and labs.

The most burdensome administrative process. Today, it involves weeks of back-and-forth between providers and insurers. With smart contracts, rules are encoded and auto-executed.

• Example: A prior auth for a new insulin pump is submitted with clinical data. The smart contract verifies criteria against the insurer's policy and approves in minutes, not days.
• Result: 80% reduction in processing time and ~$15 in administrative cost savings per transaction.

Meeting HIPAA and value-based care reporting requirements is manual and error-prone. Blockchain's immutable audit trail provides a verifiable record of every data access and update.

• Automated compliance reporting for audits.
• Proof of data provenance for every lab result or diagnosis.
• Significant reduction in audit preparation time and liability.

Start with a focused consortium (e.g., 1 health system + 2 payer partners) on a low-risk, high-friction process like specialty drug referrals. Phased approach:

1. Phase 1: Establish patient identity and consent layer.
2. Phase 2: Automate a single workflow (e.g., lab result sharing).
3. Phase 3: Scale to complex pathways (e.g., oncology care). Key success factor: Business process redesign, not just technology lift-and-shift.

The Pain Point: Up to 20% of medical tests are repeated due to inaccessible records, costing billions annually and delaying care.

The Blockchain Fix: A permissioned ledger creates an immutable, patient-centric record accessible to all authorized providers. This enables:

• Instant verification of prior test results and imaging studies.
• Automated consent management for data sharing across networks.
• Reduced administrative overhead from manual record requests.

Real-World Impact: Pilot programs show a 15-25% reduction in redundant diagnostic procedures, directly improving the bottom line and patient experience.

The Pain Point: Pharmaceutical trials suffer from data manipulation, slow patient recruitment, and opaque supply chains, increasing costs and regulatory risk.

The Blockchain Fix: An end-to-end immutable ledger tracks every data point and asset. This delivers:

• Unchangeable audit trail for all trial data, ensuring regulatory compliance (FDA 21 CFR Part 11).
• Faster patient onboarding via secure, consent-based record matching.
• Real-time monitoring of drug supply chain from manufacturer to patient.

Quantified Benefit: Companies like Boehringer Ingelheim report blockchain pilots reducing clinical trial data reconciliation time by up to 90%, accelerating time-to-market.