Blockchain technologies has been in the forefront of innovation and is maturing at a fast pace with fintech leading the way. Though the innovation in the permissionless space is high, the enterprise adoption has still not caught up. The reasons include a variety of reasons including inadequate understanding of the technology, full awareness even in enterprises, unclear regulations, and lack of exploration and evangelism to really understand the reimagination of shared enterprise business processes. Most enterprise blockchain efforts are run from a small exploratory group in large companies and has NOT moved beyond pilots or limited production tryouts in to mainstream adoption at scale. This is because there is not much knowledge about what is possible for reimagining current business processes which are mostly unilateral.  This is more obvious in healthcare. A horizontal transformation enabler like the blockchain technology can effect collaborative business processes in a networked world. This paper explores the root causes for the challengesand suggests a methodology for discovery of the key inflection points for potential collaborative business processes and  the re-engineering that would be needed. Blockchain in enterprise are not an isolated piece of technology, and has to interact with the enterprise assets, and there has to be mechanisms for aggregating the data that is meaningful to the counter parties for shared collaboration. Equally important is solid and a stair-stepping change management plan for the blockchain efforts to meet operations mainstream and gradually move the operations to the end state. Possibilities and results of the collaborative processes have to be shown in meticulous economic rigor for any possibilities of blockchain efforts getting the enterprise portfolio dollars against many enterprise systems that are already overloading budgets. The paper will cite the journey in a reference implementation with results, findings at the technical, functional, operational and change management levels for healthcare administration executives and portfolio managers.

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