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Media

KYC for Healthcare

Matthew Warner | May 2020

Frequently for those that are interacting with the healthcare system, whether it be in a hospital, being visited by a doctor, attending a clinic or any other instance, it is at an awkward or stressful time of their lives. Whilst the healthcare industry is full of amazing people, it is an unavoidable fact that most of us will be going through that particular system because of illness or injury.

As is often the case, one of the biggest issues that raises its head when it comes to a lack of secure identity verification is that of fraud. Both sides of the system are open to exploitation in this – healthcare providers and patients alike. Providers may charge for unnecessary or fake services, misrepresenting treatments, falsifying credentials, and generally manipulating the system to their advantage. On the patient side, people may use other people’s identity to take advantage of their healthcare insurance, avoid payment, claim prescriptions under false pretenses or provide fake sick notes. In all of these cases, fraudsters are using the lack of transparency, interoperability and identity checks to their benefit. This has obvious financial consequences, with billions of dollars estimated to be lost each year to medical fraud, but it also has significant impacts on legitimate healthcare providers and patients, increasing wait times, stress levels and causing unnecessary suffering at some of the worst possible times in people’s lives. Beyond this, a general lack of efficiency in both time and cost is engendered through a lack of suitable identification. 

There are a huge number of instances in which effective identity verification and KYC provision could be implemented to improve the situation. One of the most obvious is by ensuring that the healthcare providers and patients are who they say they are. A secure solution to do this would not only cut out the danger of people stealing others’ identity and healthcare insurance or coverage, but would also enable the possibility of providing remote consultations and prescriptions. Doing this could save time for medical professionals and patients. It would also reduce the need for people (although not all) to visit clinics or walk-in centers which can increase the risk of catching germs and illness – a particularly relevant issue with the current coronavirus pandemic. A good solution would also facilitate ongoing communication and follow-up testing and monitoring between patient and professionals, improving the level of care provided to the patient and information available to the professional. This has particularly strong uses for people with specific needs who may need to be checked up on or reminded of steps they need to take on a regular basis. 

Connecting a patient’s identity to their wearable technology that monitors various health parameters would strengthen the possible provision of healthcare even further. The linking of medical technology to identity management systems would enable a level of healthcare monitoring and reporting which have not been possible before and could even be linked to remote medical tests whereby the individual or their carers or family members could play a greater part in their own healthcare process should they be able.    

With the right transparent, auditable system, particularly one that could have automated systems put in place to monitor interactions and outcomes, the danger of fraudulent actions from the minority of medical professionals and patients that commit them would also be reduced. Checking the medical records of patients to the treatments and prescriptions that professionals assign would highlight anyone obviously using or claiming unnecessary measures for financial gain. By having a method which recorded consultation times and documentation automatically, cases of professionals fraudulently claiming to have seen patients would also be removed, as both patient and professional identities could be required to be associated with the event with measures such as video or signatures to prove it took place. Not only would this reduce fraud, but it would provide a quick and easy way for patients and professionals to review the steps and developments of the patient’s case history even when going to a multitude of medical professionals. 

Another instance which would benefit from a solution with a secure identity management system is the documentation and record keeping across medical service providers. Hospitals and other medical establishments are somewhat notorious for being a mix of disparate departments and services which all need to communicate effectively to convey important information about the patients as they go through the system. A system could be implemented which had all of a patient’s healthcare records and previous consultations etc., allowing the data to be shared easily between hospitals and other healthcare providers. 

Last but not least, with these provisions put in place on a secure platform, it would be possible to put patients in charge of their own data, enabling them to share relevant records and information to verified medical professionals in seconds, rather than having to go through often-overburdened healthcare systems to access test results or diagnosis that they may need to share between a multitude of professionals in various locations.

Blockpass’ products are tailored exactly to these kinds of needs. With a user-centric, reusable digital KYC solution, Blockpass is quick and easy to integrate. The Blockpass Mobile App is able to prove a user’s identity instantly whilst their data remains under their control – allowing them to share their information with any they choose. In the healthcare industry this could be medical records, proofs of consultation, test results or simply their verified identity. Certificates are able to be created and assigned to the individual and communication channels exist which would allow the medical professionals to keep in contact with their patients through the app, providing reminders or follow-up consultations and healthcare tracking. 

Some of the developments being worked on include reputation systems which would allow those involved to build up a trust profile which could be comforting to those seeking medical advice or attention. Additionally, Blockpass is working with Edinburgh Napier University to develop groundbreaking data privacy models, which will allow people to prove or verify information without exposing it at all should they wish to keep it private. This might be particularly beneficial in the healthcare industry where people may hide symptoms or illness due to embarrassment or fear of judgement. 

Ultimately, providing this kind of platform through Blockpass makes sharing and proving the veracity of medical documentation faster, simpler and more efficient whilst opening up additional avenues to the healthcare industry in terms of monitoring patients, accessing data and conducting remote consultations securely. Reducing the risk of fraud whilst making the healthcare industry more efficient, flexible and enabling remote solutions should be high on most people’s list of priorities as we experience the devastating impact of the coronavirus pandemic and try to avoid future catastrophes. At Blockpass, we hope we can be part of the solution.

 

Useful articles:

https://www.nhcaa.org/resources/health-care-anti-fraud-resources/the-challenge-of-health-care-fraud/

https://chpi.org.uk/wp-content/uploads/2012/06/CHPI-Healthcare-Fraud-a-threat-to-patient-care1.pdf

https://www.fraud-magazine.com/article.aspx?id=4294976280

https://www.ncjrs.gov/pdffiles1/172841.pdf

https://www.pacificprime.com/blog/health-care-system-fraud-impacts.html

https://www.healthcareitnews.com/news/europe/digital-health-and-oncology-growing-world-personalisation-diagnosis-and-prognosis

https://bmjopen.bmj.com/content/9/12/e031637

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2965886/

https://www.healthcareitnews.com/news/reasons-why-hies-are-slow-take-root