A Proposed Agreement for a Blockchain-Enabled Medical Staff Credentialing Process
J. Mark Waxman and Jennifer Rathburn of Foley & Lardner discuss the possibility of using blockchain technology in the medical staff credentialing process and propose a form of agreement to be used for that purpose.
The medical credentialing process, whether for a hospital, a hospital system or a health plan, has emerged as a potential early target for the application of blockchain technology and administration. It is a process that allows a secure database to be established over time and on a cumulative basis.
Medical credentialing involves verifying whether a candidate meets the applicable educational and training prerequisites for the position sought — appointment to a hospital’s medical staff or the ability to participate as a member of a health care delivery network, such as an independent practice association — and subsequent updating and verification throughout a career.
This process takes time and can be frustrating to complete, but it can be made more efficient by using simple storage techniques and avoiding duplication.
Because blockchains are a form of database that can be verified and updated incrementally, they may be well suited for this credentialing process. Information in the form of “blocks” of credentialing information can be linked together to create the credentialing information “chain,” with links to prior blocks and information about when that block was created or contributed into the chain.
Blockchain encryption applications and access limitations can provide security for the database. Thus, blockchain can create secure access across all those participating in the chain.
Each data contributor, or user, may be granted access to the entire ledger, or chain of information. Alternatively, access can be restricted. For example, educational institutions providing information need not have access to the entire chain.
The initial effort to engage blockchain for these purposes was initiated in Illinois in 2017 with a pilot program involving the Hashed Health consortium. The goal of this early effort is to create a blockchain-based registry containing a reliable
record of certifications and credentials.
This article proposes a template for an agreement for a credentialing database specifically designed to use blockchain technology as its infrastructure. Because inputs from several states may be required, before parties can embrace a “smart contract,” i.e., one fully adopting the blockchain technology, the relevant states may need to enact an enabling statute for such contracts. Hence, a standard contract format is needed pending such a development.
