Overview

A mid-scale hospital network with operations in three cities was facing complexities in managing the insurance claims, treatment approvals, billing, and the consent of patients. They were following traditional and manual coordination systems between the patients, healthcare providers, insurers, and labs, which most of the time led to delays, disputes, and risks related to compliance. The hospital wanted a system that could bring automation to their complex workflows and help them build trust among all stakeholders, like regulators, insurance companies, and patients.

To solve these challenges, the hospital seeked blockchain for healthcare solutions and consulted the team of NetSet Software. We created a blockchain-based smart contracts which securely automated their ensure workflows with zero manual interference.

The Challenge

Insurance claims processes were facing delays due to back-and-forth paperwork between the insurers and providers.
Fragmented systems were causing emergencies to miss in the records creating a bad patient consent management ecosystem.
There were errors in billing, which was becoming a critical issue.
Medical records were unorganized and stored in silos which limited transparency and accessibility.
Regulation risks were becoming common due to inconsistent audit trails.

The hospital wanted a system that could bring automation to their complex workflows and help them build trust among all stakeholders, like regulators, insurance companies, and patients.

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The Solution: Smart Contracts for Medical Workflow Automation

Smart insurance claims were triggered automatically during the initiation of treatment once eligibility of the patient was validated removing the complete paperwork.
A digital consent contract was initiated as soon as the consent logic was met making recording in real time with best of traceability.
Smart billing contracts calculated complex distributable invoices with applied discounts and insurance.
Tokenized and interoperable medical records promoted better data organization and secured data sharing among the healthcare providers.
All healthcare events and transactions were logged on to the Blockchain with real-time treatment data integration giving audit ready records.

Real World Impact

A cancer patient, going through chemotherapy, got instant pre-approvals for each cycle using a smart contract. Every treatment initiated a new contract verifying diagnosis, dosage, and coverage, giving seamless care without any bill stress and interruptions.

Compliance and Data Privacy

The solution applied HIPAA and GDPR-based encryption protocols and also offers role-based access controls for the doctors, patients, and insurers. With that, on-chain logs were maintained as soon as a contract was executed with details about patient access events.

Key Takeaway

The above case is an excellent example of how smart contracts automated and simplified the most time-consuming aspect that has been going on in healthcare for a long time. NetSet Software introduced a complete blockchain infrastructure with smart contract functionality customized for the specific medical use cases. It created a shared and secure framework for all the healthcare events.

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No matter who we work with, Worth@Work is the business principle we follow to serve all our esteemed clients.

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Got a Blockchain based Project for Healthcare? Get an Estimation!

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Automating Healthcare Operations and Claims for a Hospital Using Smart Contract Technology

Case Studies

Got a Blockchain based Project for Healthcare? Get an Estimation!