Synaptic Health Alliance is Developing Blockchain Use Cases for Healthcare

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Bill Russell / Sean Lane

Michael Kim MultiPlan Blockchain Healthcare This Week in Health IT

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Michael Kim is the CIO for MultiPlan and its representative on the Synaptic Health Alliance.  Michael stopped by to discuss the use case, and the technology potential and challenges they have faced with blockchain.  Hope you enjoy.

Bill Russell: 00:00 Welcome to this week in health it events where we amplify great ideas with interviews from the floor. My name is bill Russell. recovering healthcare CIO and creative this week in health it, a set of podcasts and videos dedicated to developing the next generation of health leaders. We want to thank our founding channel sponsors who make this content possible, health lyrics and VMware. If you want to be a part of our mission to develop health leaders, go to the homepage this week, health.com 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, H L T, H, and we’re here with Michael Kim, the CIO for us. Are you for the synaptic health Alliance or for multiplan?

Michael Kim: 01:07 No, I’m the CIO for MultiPlan. MultiPlan I am multi plan’s board member on the synaptic health Alliance.

Bill Russell: 01:15 Got it. Thanks. And actually this guy I’m not familiar with either. I really want to 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’s your background? So you’re a CIO.

Michael Kim: 01:31 So I started my career as a consultant, uh, for about a dozen years more focused on the 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, it was the chief operating officer at a smaller insurance company out of Romita and then joined, um, multiplan and six years ago. So I’ve been in healthcare for about six years as a CIO.

Bill Russell: 02:03 Yeah. So we’re about, I came to healthcare after 20 years of consulting and other industries and, uh, there is a little bit of a learning curve, isn’t there? There’s a very steep learning curve, but it seems to continue to be a trend now. I mean, uh, Providence and, and now I’m a calm spirit of both hired CEOs from outside the industry. 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 going to go there. So, um, tell us a little bit about the synaptic health Alliance.

Michael Kim: 02:38 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 four founding members. The United slash Optum was one Humana quest and MultiPlan we were the original four founding members in, um, as we started the first pilot Aetna joined us as a now they’re officially designated as a founding member. So there are now five of us who are founding members,

Bill Russell: 03:12 family members, and what’s the, uh, what’s the direction, what’s the goal? What are you trying to do?

Michael Kim: 03:17 Yeah, so we’re trying to create a, um, utility for the industry in health care. So it’s not a for profit organization. It’s meant to be something that we create that really fundamentally provides value to the healthcare sector. Um, and leveraging blockchain technology. And so we started with one use case, but we’ll roll out to other use cases as well.

Bill Russell: 03:44 So use case is provider directory essentially.

Michael Kim: 03:47 Exactly right. So blockchain is a very powerful technology. Yeah. It’s effectively a distributed ledger. 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, significant, significant, um, and there it’s changing constantly.

Bill Russell: 04:37 Right. And that becomes the challenge. Right? And it doesn’t change it to the source that changes at all these districts.

Michael Kim: 04:42 Exactly. And what blockchain is about is basically crowd sourcing that. So if Aetna call someone and says, ah, dr Russell’s address changed, or they added a new doctor to 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 two point $1 billion on managing provider data 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, provide director information, right? And just think about the irritation that providers have, having to respond to all those different insurance companies, trying to provide them 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.

Bill Russell: 05:47 Interesting. So did, did, uh, the five partners, did they have to make any substantive changes to their tech stack in order to participate? No. No. Uh, so you set up your own, right?

Michael Kim: 05:58 Everyone saw blockchain technology basically has a node, each person, if we change that data on that note, then our provider data management system should have that data reflected in that. So we want to integrate that,

Bill Russell: 06:13 but that’s the work they have to do. Um, and are you running on any specific blockchain technology?

Michael Kim: 06:20 We are, it’s called Ethereum foundation that we’re going to be on. Yeah.

Bill Russell: 06:24 So you have the Etherium foundation distributed, uh, distributed ledger and then people have access to that. But, and so the, the payers will probably still pull that back into their core system

Michael Kim: 06:35 ultimately longterm. 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 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 update to the provider directory. Now, longer term, when we integrated into our systems that has implications on, we could continue to drive that productivity enhancement, 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.

Bill Russell: 07:37 So are you accepting other members or waiting to get through pilot before? Uh, we are

Michael Kim: 07:42 wrapping up our pilot. We’re now actively accepting other members because for blockchain 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 out of that. So we’re very actively, um, I’m trying to add new members to it. Initially as we’re 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 we’ve made some decisions.

Bill Russell: 08:16 Interesting. Uh, limitations of blockchain as you were experimenting with it, learning with it.

Michael Kim: 08:21 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 required 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.

Bill Russell: 08:59 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’s meant for these kinds of things. It’s a directory up to the minute, up to the second is not all that important.

Michael Kim: 09:16 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 current technology, with a level of business logic that needs to be embedded into those transactions.

Bill Russell: 09:43 Will it be truly distributed or where you have specific, do you have a specific node structure that you will absolutely be distributed?

Michael Kim: 09:51 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 set of servers or they can put it in the cloud, but it will be distributed.

Bill Russell: 10:05 Fantastic. Yeah, that was great. Anything else that I should know about synaptic health Alliance? Blockchain where you guys are going? No. No. can providers participate in this.

Michael Kim: 10:15 In fact, if providers participate, we’re better off because 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, we’ll accept that as a source of the truth. Right?

Bill Russell: 10:31 So, I know this is hard to believe, but that was uh, that was one of the hardest problems within a health system was keeping that roster current. 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 they don’t necessarily keep that, that roster current.

Michael Kim: 10:49 Yeah. So the beauty of this blockchain technologies, let’s say the health system goes up and modify a sign, but then we’ll know United or Aetna or whatever other blockchain parts have been, goes in and they accept that we’ll have validation from multiple parties.

Michael Kim: 11:07 And so we’ll see all of that transactions that are going on. That’s what I mean by distributed ledger database. It’s not just the data. And in fact we’re probably going to 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 base.

Bill Russell: 11:37 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 that. What has the most promise in the next handful of ideas?

Michael Kim: 11:47 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 going to be three parts. There’s rolling out this pilot nationally. All right, so we’ll 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 and so there’s a range of different things that are being conserved. What we want to do is I’ll add a bunch of health systems and provider representation into the blockchain so that they can define a use case that adds more value from a provider perspective.

Bill Russell: 12:39 What’s their commitment. Other than, I mean obviously participating with data and there’s good things. Is there a, is there an investment? Is there.

Michael Kim: 12:46 Yeah, there is a nominal participation fee to be part of the Alliance and this is just off offset some administrative costs. There’s 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?

Bill Russell: 13:08 The other people who came in.

Michael Kim: 13:10 Okay.

Bill Russell: 13:16 I hope you’ve enjoyed the conversation. If you’d like to recommend a guest or someone to be on the show, you can do that from our homepage recommended guesses about three quarters of the way down on the homepage. Please check that out. And don’t forget to please come back every Friday for more great interviews with influencers. And don’t forget every Tuesday we take a look at the news, which is impacting health. It, this show is a production of this week in health it for more great content. You check out our website this week, health.com or the YouTube channel, which you can get to from our homepage as well. Uh, if you get a chance to take a look at our newly redesigned guest page, I think you’ll find it a fantastic, I love the way you can navigate through the content. Special. Thanks again to our sponsors, VM-ware and health lyrics for choosing to invest in developing the next generation of health leaders. Thanks for listening. That’s all for now.