Customer Stories

Trusted Healthcare Communication with Diagnotes on Kaleido

Apr 30, 2020
by 
Trent Shupe

Healthcare is not provided in isolation.  It requires coordination and collaboration between teams of doctors, clinicians, nurses, administrative staff, and patients.  

It is estimated that administrative waste in healthcare exceeds $200B* annually in the US. In fact, recent studies show that up to 34%** of total healthcare costs are administrative.  A lot of that can be attributed to the lack of proper coordination and collaboration between the various participants in the healthcare ecosystem.  The costs are even higher when you consider the real health consequences of a delayed or improper diagnosis of patients due to misinformation.  

That’s why Diagnotes, a Kaleido customer, developed a healthcare-focused team and communication platform that streamlines workflows, increases communication efficiencies and reduces medical errors.  

Built for providers and their patients, Diagnotes connects every member of the care team via secure text, voice and video.  The solution also provides integration with any EHR system, giving everybody real-time access care team members and patient information.  

“Our focus has always been first and foremost on care teams and their organizations. We have worked tirelessly to develop a healthcare-specific solution that simplifies how care teams interact and communicate,” said Jamie Kurtz, Chief Technology Officer of Diagnotes. “While we are certainly concerned about protecting data, that’s only one component. The people using Diagnotes have stressful jobs, and we help alleviate some of the burdens by streamlining the technology they use into one unified system that’s intuitive. When we help make the job of a healthcare professional easier, we know we have done our jobs well.”

Consider a seemingly simple task of a healthcare professional trying to track down a cardiologist.  Without an integrated collaboration platform, team members would need to page the cardiologist and wait for a response.  Not an ideal solution when a quick answer is required.

With Diagnotes, there are direct connections to phones and messaging for everybody on the care team.  The platform automates and gives team members access to on-call schedules and directories, connecting them with the best contact at any given moment.  It enables everyone involved in patient care to communicate instantly, even remotely or after-hours, from their preferred device: smartphone, tablet, laptop or PC.

Diagnotes is aligning technology with what healthcare professionals do best - collaborate in teams and take care of patients.

Trusted Collaboration

Having an integrated, easy-to-use platform for collaboration provides immense benefits.  But how can the data be secured and trusted?   Healthcare data includes Personally Identifiable Information (PII) that can’t be shared outside of the immediate network.  To collaborate effectively, healthcare workers need to have confidence in the data.  And when it comes to legal discoveries for patient data, healthcare organizations need to ensure data integrity and know that the data was not tampered with.  

Diagnotes is solving this challenge with blockchain.  Partnering with Kaleido, Diagnotes is setting themselves apart from other communication platforms by integrating with blockchain.  Clinicians can keep their focus on patients across the care continuum by bringing together treatment teams, providing everything they need in one, easy-to-use integrated experience for the desktop and/or mobile device.

When a client request comes in about a specific communication, Diangotes can provide the details of the communication, with proof of tamper-free, non-altered messages.  Providing proof of data integrity simplifies the audit process and saves healthcare workers a lot of time because they don’t need to look back through communications to verify data requests.  

The Solution

The Diagnotes platform harnesses the power of blockchain to provide data integrity for healthcare workers and their patients.   The solution supports 10’s of thousands of users per month, generating over 1M messages and images.  It stores the signatures, or hashes, of every message and communication on a private, permissioned blockchain running on Kaleido.  

Hashing, an algorithmic computation that delivers a deterministic output of a given payload, allows for immediate resolution in the case of litigation.  Diagnotes, or an auditor, can use the stored message payload along with the on-chain proof and transaction details (block number, tx hash, timestamp) to prove that the written transaction has not been retroactively altered (i.e. recreate the hash).  

Hashing algorithms, by nature, are one-way operations, meaning that the input cannot be derived even with knowledge of the output. This offers important protections around patient privacy should an unwarranted third party or malicious actor achieve access to the chain.  Moreover, there is no PII or PHI metadata stored alongside the on-chain transaction, further ensuring the privacy of patient data.  

Diagnotes Solution Architecture

When a communication occurs, a SHA-256 hash is created for the stored payload of that communication.  Using Kaleido’s REST API submission layer, the hash is submitted asynchronously through a Kafka messaging tier and is eventually executed as a transaction on-chain.  When the block containing the transaction is mined, Kaleido’s Event Stream calls back to a Diagnotes server function that can consume the event payload.  The JSON data (proof of the transaction) is sent to a queue, and the event record is updated in their database.  

“Facilitating critical healthcare communication and collaboration in an efficient manner while maintaining data integrity is extremely complex,” said Kurtz. “As a result, many solutions are cumbersome for care team members to use and involve logging into several systems. However, our goal at Diagnotes has always been to deliver a platform that can provide trustworthy communication in an intuitive, easy-to-use package. With Kaleido, we are now providing a level of assurance and trust that no other healthcare communication solution can provide without compromising ease of use.”

Clients using the platform can easily access information through an intuitive interface available on desktops, tablets or smartphones.  

Diagnotes team room of urgent messages for a Covid-19 response team, linked to an on-call schedule for accurate notifications


Diagnotes team room for messages submitted by the general public using Diagnotes Extend


Diagnotes mobile view of a set of Covid-19 response team rooms


Hear Jamie explain Diagnotes solution on Kaleido’s “Digitally Transforming Healthcare Webinar” below:

(To watch the full webinar recording, click here)

Getting to Production

Working with Kaleido, Diagnotes was able to get from concept to production in less than a month.  

“We started looking into options for a blockchain network about a year ago. Until a trusted colleague recommended Kaleido, we were at a standstill” said Kurtz. “Being a small company, we couldn't just go out and hire a team of blockchain gurus. Instead, we needed to leverage our existing capabilities around SaaS, microservices, and REST/JSON communication, while not compromising our objectives around increased data integrity and helping our clients with legal challenges.”

Using Kaleido’s integrated services and easy-to-use platform, Diagnotes saved months and millions from having to develop the solution in house.  It’s a big part of the reason why they were able to get to production faster than many solutions are able to make it from PoC to Pilot.  

“Kaleido checked all the boxes, and did so with a phenomenal team willing to sit down with us and walk through the basics,” said Kurtz. “We were able to limit the required blockchain knowledge while at the same time leveraging existing services capabilities to quickly stand up what we needed.”

“So after nearly a year of exploration, we went from initial call with Kaleido to working proof of concept in a matter of days, and then deployed to production shortly thereafter. The key here is that we haven't compromised the blockchain architectural advantages and data integrity assurances in order to leverage a service, like most of the other solutions we found along the way.”

Looking Forward

The initial Diagnotes application provides a simple solution to a common customer pain point. Integrating blockchain into their platform provides trust and confidence in the data for Diagnotes’ clients.  Now that the value of blockchain has been proven out for the initial use case, the team at Diagnotes is exploring other applications and use cases.  

Their long-term vision is to provide a patient channel that would be connected to every healthcare provider and organization in the patient’s network.  Patients would actually own their healthcare channel and could invite any member of their healthcare team to join, giving the patients more control over their healthcare data.  

Learn more about Diagnotes here.  

Start building your own blockchain-enabled solution by getting started on Kaleido for free!

Sources:
*https://www.modernhealthcare.com/opinion-editorial/reduce-total-cost-care-6-reasons-why-providers-and-payers-should-tackle-challenge
** https://time.com/5759972/health-care-administrative-costs/

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