There’s a worldwide shortage of nurses that’s hit crisis levels. NurseToken tackles this problem head on with a de-centralized credential & payment system that increases nurse portability enables hospitals to fill much needed positions on-demand, and offers more uniform and universalized payments to nurses worldwide.
NurseToken is a 21st century solution to a persistent yet growing 20th century problem: a global nursing shortage of epic and crisis proportions. We address in this whitepaper the general healthcare supply and demand of human resources as we transition globally towards ubiquitous shared-economy scenarios with a more prevalent real-time allocation or matching of supply vs. demand. Currently a large majority of the business processes pertaining to the onboarding or registration of nurses is largely manual or consisting of a collection of mixed manual and automated processes, the healthcare industry is faced with a challenge of moving data across disparate, isolated silos and the related burdens of security, privacy, legal, compliance, locality, and in many cases the lack of automation, which introduces the potential for human errors or bias. NurseToken will power a credentialing, incentive, and payment ecosystem that overcomes the problems of recognizing national and state credentials, cross-border payments, misaligned incentives, data accessibility, and payment risk. In doing so, NurseToken will align healthcare needs with available healthcare resources around the globe. Participating nurses will gain increased control over their schedules and enhanced reliability in providing their services to the numerous member facilities throughout the world. Many different nursing verticals will benefit from NurseToken’s capabilities: Global Nurse Agencies, Hospitals, Clinics, and Home Health Care Businesses, among others (combined $344B annual market worldwide). These capabilities will support NurseToken’s mission to combat the global nursing shortage crisis by making it easier for nurses to get hired by the hospitals and clinics who need them most.
Critical factors contributing to the nursing shortage include:
Difficulty in Credentialing. Difficulty in Credentialing. At present a nurse’s credentialing details are not owned or controlled by the nurse. The nurse must work to assemble a ‘credentialing packet’ every time she goes to work for a new institution, and the resulting materials are owned by that institution. A nurse cannot take their credentials that were previously certified by a given hospital or clinic with them. Nor can health care facilities access or benefit from the highly duplicative efforts undertaken by other similar employers. As a result, many available nursing resources are inaccessible to healthcare institutions with acute and time-sensitive needs. Credentialing processes include mounds of paperwork, in addition to re-taking tests, and checking references. Placing these verifications and tests on the blockchain ensures immutability and portability, while decreasing the need for repeating a trusted transaction.
Declining workforce. Declining workforce. Nursing is a very challenging profession and fewer qualified candidates are pursuing careers in the field. In response to cost pressures, hospitals have been forced to reduce staffing and have implemented mandatory overtime policies to ensure that RNs will be available to work when the number of patients admitted increased unexpectedly. Heavy workloads are a factor affecting the decision to enter or remain in the nursing profession. In addition, a substantial segment of the nursing population is nearing retirement age. According to a 2013 survey conducted by the National Council of State Boards of Nursing and The Forum of State Nursing Workforce Centers, 55 percent of the RN workforce in the US is age 50 or older. Also, the Health Resources and Services Administration projects that more than one million registered nurses will reach retirement age within the next 10 to 15 years. Greater incentives are needed to encourage bright, talented, and caring individuals to enter this field of vital consequence.
Misalignment of available resources. Misalignment of available resources. Travel nursing volumes have nearly doubled over three years to $4.8 billion in 2017, according to Staffing Industry Analysts, a global advisor on workforce issues. Total spend for the US in 2017 for contract agency nurses (PRN, Per Diem, and Travel nurses combined) was $13B in the US alone. Hospitals are spending $2-3M a month in Agency Nurse expenses. Yet, even with the increased spend, significant shortages still remain in many areas. And while some nations have nursing personnel that are willing and able to travel to meet these needs, the cost of traveling, meeting credentialing requirements, and moving currency back to the nation of origin combine to leave substantial available resources stranded. A credentialing, incentive, and payment system that addresses these obstacles is critical to allowing supply to meet demand.
The NurseToken Solution
It is NurseToken’s vision to solve a number of critical security, privacy and data-ownership challenges with blockchain technology. We intend to create an ecosystem that facilitates the efficient matching of healthcare skilled resources with medical care facilities in desperate need. The overall blockchain functionality can be split in two large categories of use-cases, one pertaining to credentialing and one to the operative aspects related to incentives, payments, and other cryptocurrency transactions. NurseToken is a decentralized global nurse staffing utility built on blockchain. NurseToken allows hospitals to greatly reduce the cost and hassle of dealing with the administrative overhead and paperwork typically associated with staffing agencies. Increased staffing efficiency and utilization, powered in part by NurseToken, will have a massive impact on quality of care and increase the roster of nurses available to participating institutions. Patient engagement, driven by nurses who are not over-extended and can provide more time and attention to each patient, translates to better outcomes and reduces overall care costs. Portable credentials and better, more accessible incentives are an integral part of this shift. Using blockchain is the perfect solution to an array of problems faced by nurses and hospitals today. It affords both parties to a transaction a decentralized ecosystem on which to access an essential breakthrough in the antiquated existing regime. Nurses want a portable credentialing system, a loyalty-rewards program, and a better way of being paid for their work. Hospitals want to make sure that nurses have verified credentials, can come to work without undue delay, and are properly motivated to provide high-quality, consistent care over time. In a generic sense we view smart contracts as the vehicle that controls all interactions within the ecosystem. We envision creating a smart contract as a “governing workflow” service that supervises all transactions within the NurseToken ecosystem. Acting as a “listener” that watches over all transactions arriving into the NurseToken blockchain and upon processing any certain NurseToken makes it possible for a nurse to carry their own portable credentialing passport. Once a nurse has their credentials in a blockchain wallet, those credentials can move freely through participating facilities in the healthcare system. This increased mobility makes it possible for hospitals and clinics to retain nurses much more easily and in a more flexible manner. For example, if there is an oversupply of nurses in one market, a hospital in a nurse constricted market can hire them immediately without waiting the two to three months it takes in some circumstances to re-credential nurses. The decentralized nature of blockchain technology makes this revolutionary shift possible. The price of trust is expensive. With blockchain technology, the steps in the verification process
can be greatly reduced and the need for repeating expensive tests such as background checks, urine drug tests, workplace and license verifications, and health screens, is greatly reduced or eliminated, saving time and money for hospitals and nurses. Nurses can start caring for patients instantly! Blockchain Credentialing of Nurses transaction, such as an onboarding and credentialing of a nurse, it would “know” what actions
are to be “triggered” that pertain to a given transaction and its state. Similarly, for any transaction that handles the movement of cryptocurrency or payments a different smart contract would be identified for such transactions governing the right set of actions to be taken in such case. The extra-mile that we go with our system by contrast to other smart contract platforms is that each action associated with a smart contract is a microservice and a set of rules enabling a much more powerful integration vehicle as actions would not be limited to a proprietary smart contract language but open up to the whole world of integration tools, and fostering a more rapid expansion of the ecosystem.