About the talk
Fast, Secure, and Accurate Evaluation of Prescription Drug Reimbursement Claims using Hyperledger Fabric - Alevtina Dubovitskaya, Swisscom AG
For the reimbursement of some new medicines, health authorities authorize a pre-approval process based on clinical criteria by the health insurance provider. The traditional pre-approval process is paper-based, lacks interoperability and trust, and is often time-consuming, costly, and error-prone. A consortium consisting of a pharmaceutical company, insurance companies, two large teaching hospitals, and a technology provider, created a blockchain-based system using Hyperledger Fabric to optimise the pre-approval process and improve patient treatment. The system was tested with clinical patient data in the setting and compared with the traditional paper-based process regarding. Alevtina will present the system design and implementation, comparative results, and the advantages and barriers for the adoption of blockchain technology for medication cost approval and reimbursement management
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Dr. Alevtina Dubovitskaya is a lecturer in HSLU, where she is pursuing research work in the areas of blockchain technology, privacy, and distributed systems. She also works part-time as a consultant at Swisscom, where her work ranges from clients advisory to the design and implementation of blockchain-based solutions compliant with the laws and regulations. She is experienced in designing protocols for privacy-preserving data aggregation and sharing, developing systems using blockchain technologies with the focus on the accountable and trusted interactions. Her interests include distributed data management in the context of blockchain and cryptographic solutions for providing security and privacy.View the profile
I know my name is iJustine and I'm using. This work has been done by a very busy person, should consult some of that consist of what do insurance companies CSS. The Sanitas in your step at a time. Sulfodene imbursement, Soulfly different medications Vista, start a pre-approval process that is based on different clinical criteria. So this traditional pre-approval process is paper-based, the locksmith near Fairview Northland, time-consuming and costly and error-prone. So their
system for the past three or four to facilitate. Using a copper Legend fabric. Did you get your position of the process and there as well as its realization using a smart contracts on lock screen allows for optimization of this person and we have tested, our real-time patient data and also compared with their traditional paper-based. I don't expect I would just like to compare the traditional processes that currently exist to end to get answer with our blockchain-based. So
traditional on just a maybe to check is everything good. Okay? So that traditional caused immense process consists of the following steps. The first patient comes to that medical practitioner, and then medical practitioner has to submit refurbished form that is sent by post to their health insurance. Where are health insurance involves, a trusted position that has to evaluate inform and decide. Whether a patient is eligible for reimbursement of prescribed medication. The
problem that process takes about 2 to 8 weeks, because it can also involve back-and-forth exchanges between the medical practitioner health insurance. And those involved with drastic decision that can take time to evaluate the request. Oh, so this is the end of Thrones because the way you talkin about the paper best form and also a sharing of the patient data and does the same thing, the data over the past, which canosa scanning for some privacy in the digital manner. So basically the patients with cancer paint their medical practitioner and then I
am through its patient data and then the smart one to through a really great as a person is the patient is eligible for this treatment for the reimbursement. Because now, we both trusted tradition, it's also allowed to collect the data to collect the outcomes research process. And also, no additional visits is required for the prescription by the patients because Patients can receive from the medical practitioner answer immediately whether he is eligible for this treatment and or not.
So, as I already mentioned, this work has been done in collaboration with the pharmaceutical company with two different insurances and Suzanne Sands to a different University Hospital incident in Zurich and Geneva and in collaboration with the twist cone at that provided a technical Center. So, we started from those forms that exist in this usual, paper-based, paper-based processes, where the medical doctor with me to feeling and then standby, post, that's of Interest company for the issue. So what do we need, the visa from those forms? And the he
received part of the form and posted a description of, which was by the way happening in different languages. Because we have a sum of Is it in the French fashion season under a French language? And I'll send the German German you. So we had to basically as developed the interface self for two languages, and then those rules in order to, then Implement them in the form of a smart contract. To basically cut the form, we had the information on how to interpret the form filled in by the doctor. And so we created the rule, that then I become became a part of the smart
contract indications in the questionnaire. The doctor with the few on the paper. We created the truth, and the truth became the logic that was deployed lights on the older, peers of our blockchain Network, where we had stored Wednesday. She has one hospital. We have two hospitals are testing the system and those to do insurance. Company Center. We had some also created a front end for a space for each of the type of the user either, a hospital or Insurance Company.
So this event interface looks like this and I will demonstrate it to you in the demo. So I prepare the video in case of a dimmer fact. I will just drive through to demonstrate you in real life Halo system works. So, let me just another. Window. so, No receipt on the web interface. And I also, I would like to just show them. The logs of our system. So now we actually connected. 2 hour of looking at work, and we can see the giraffe ears from the hospital and appears from the ancient civilization. So now we're going
to enter the logs, the first one of the few years. And so basically we can see that this year's drawing to one channel and we will see. Let's retire to the height of the chain is like this. So now will you go back to all of them into face? Where? Receive an system works for the doctor and for the insurance company. So, for now and not liking as one of the doctors, so I will, again, as a doctor from our University Hospital. So here we can see a different request. It has already been created by the doctor
at the time of the equation of the request and two different companies that has received this request. We see that the song request was approved. And then also there is a reason right now is a friend request has been rejected. So no. Like I'm a doctor, I would create another request responsible for this medication and I first need to provide the information for the basic information about the patient, which is going to be with the last number. Leave the bagel spirits. Who found the dress information?
No, I can choose the weekend. When y'all would like to send this request and information is already prepared to automatically about this insurance company. Then I have to put the information about the patient's medical history, where I'm selecting the do Centrum Nation. Based on our information are examples where for example, patient-controlled smoke but she's cholesterol level is the Portuguese like high-end about this medication. So we can at least hear the information about some speakers me because I hear we are filling in
the form for the basic education and therefore their quest to be provided information about the previous two presentations because the patient has cholesterol level is pretty high. So now we can request And they're going through it. And now we see in the Lister of the request to receive that information from this doctor about the specification is sent and the state, then them, almost immediately receive that request was approved. And with the reason why this request was approved. So now we can
We can log in as an insurance company, this one and see where they received this request. So now I'm leaving. and basically, I can see this request that you just admitted that it is approved. And there's an insurance company. I can only without this data without and Malcolm Beckett. While still hot. I would like to get back to our logs on the pier and then he saw the previous high of 60 and now we're going to have their heart of the block increase by 2,
because there is sure we basically have two blocks and each block has one sins action. That is actually just date to send for the doctor. And then the second option is actually exist. so now just, I would like to representation with this. Las Vegas lights. Alexandra. So defeatist result is that we actually were able to test our framework with the real patient. Cases. Of course after the consensus was provided by everybody. So we test first our system reader about the cases from insurance company was created by insurance providers are based in summer list of
cases. Do they have before? And also with your patients are cases. We had six patients from two different hospital from two different insurance companies, and Teresa clear the results that instead of the average person takes about 11 days. In this specific situation. We had the results of it. So we received an answer basically. Also these approaches to identifying have to correct errors and the Give me the great potential for accusation of such their decision making process. So thank you very much. And I didn't know if you have time for any questions.
I'll be happy through. Oh, I see you there. The question from Brian, was the hardest part about making this all work. So actually, you took us quite a bit of time and I think it was really not in the blockchain side while first grade from the description and comes to paper-based the form because that's not even creating /, 35, with every stakeholder because this is what you had to do. We have to When when we created those business rules, we have to really make sure that they're correct before even implementing that. And then we had multiple
reviews with the people from insurance companies from the doctors and then read it to make sure that we captured any single every single possible case of four different. The patient that that's good, that could come and not the forest was actually in the face and those two really making this really makes you seem more easier that dog to Bow and really Implementing those forms that in in a situation that is easy for position so that it captures the the missing data but doesn't try to mess with the law doesn't propose. That
doesn't suggest to add something or to change something that would then influence the the give more data and influence the execution of his last contract. And yeah, we will try to yes. Exactly. We will but I try and make sure you writing a paper right now and we are also talking with the we are going to joke with the public house in order to in order to get their opinion. And then hopefully I'll bring the spoke to the next level and hopefully have it really used by by doctors in insurance companies.
Thanks a lot. I'm opening the grenade. Oh, yes, that's a great question about the mechanism for ensuring that no private data shared with a notarized party. So we actually so that is my second trip is running on the, on which compromises her with Cano's to be running. All the beers kudos to be right on the insurance, companies on the couch with those, which we have implemented. In order to ensure the privacy of the patient is that all the patient data is encrypted radecki shared between a doctor. That is the meeting the data and the insurance company.
So all the patients away old that are patient, identifiable information or information about their the patient's like a dress and age and date of birth. It's the encrypted And therefore, only the designated to insurance company can access can quiet can get the information from from The Ledger about the patients. The only about the patients from this insurance company and also as a as a service provider information, about a patient data, so like this, we have really going
to point encryption between the doctor and the insurance company have access to the and no other participants can or cannot see any information. So another question. I do have a process for deleting editing information. The doctors have him, put it in correctly. So, yes. So if this is supported by the web interface, so for example, if some important information is missing light indication, then I can actually share this real quick just to demonstrate.
Like if I will be there. Doctor. And I would try to create the form. So I will start getting their information and then I would try to submit the form that is completely not you. The first of all, I can say, is, I start using the form. I can stay some information. But if I try to submit the form, then the pacification, that'll save, please hold necessary necessary feuds, which there are few such as information about the private information about the patient insurance company. And the
golf course. The indication The basic need already of the stage of feeling the formation of. We can spot. If there any information. Is it? The medium steak and made you for both to add some information about then? The request is rejected while the doctor can see the reason of the reject and the see if there was maybe that was my mistake of English, maybe something. So, another question about the multiples of 10 have access to the data is encrypted. So we have just one looks change one channel.
We're different organizations in different users. Can either write or where do they sell? So first of all, the mechanisms that the the insurance company, can we run to music while I tune the blockchain? So only the They say that the reason for this, the insurance company can be accessed by this insurance company. This is, this is the mechanism in the, in the query of the of the, A Team chords, and the Beast theme in order to have the keys generated for each of the fair. So we have to doctor studies that
it's doctor. When sending information information balls to just want to information them, both to only one of the insurance companies. And then the older with no identifiable day that he's going to beat this would be. So it means that only designated insurance company can decrease information while the data set, Facts. Like whether this patient asks who have who have or not have to the day beaches away sound effects from the history. They stay on in the
bathroom because the personal identifiable information is encrypted. Then this is how we make sure. That even the technology provider note that even the entity that is writing the notes cannot really get or even get it. Cannot get any information about Thank you for your questions. So, I'm just going back to the chest. Yes. I think I'm a little overtime. So thanks a lot. Thank you very much.
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