Salary-tracking website states that the national average salary for nursing recruiters in the US is $85,000 a year.  Nice job!  Placement fees (per nurse professional i.e. registered nurse) range from $3,000 to $20,000, depending on the type of position being filled. Wow! For doing what, exactly?  Spamming or cold calling nurses? Surfing LinkedIn? Emailing resumes? Verifying credentials? Are recruiters seriously adding that much value?

It is no secret that the demand for nurses is growing rapidly worldwide. In the US alone, demand for nursing is projected to grow at about 6% per annum across allied health, per diem nursing, travel nursing, and locum tenens. The US nursing and allied health staffing market size is around $12 billion per annum.

The increase for healthcare and nursing utilization is being driven by an aging population, government programs, and the implementation of readmission mitigation strategies. Sustained healthcare staffing shortages will continue to drive temporary staffing demand.

The US Nursing Staffing Market is Highly Fragmented

The US nursing staffing market remains substantially fragmented with the top 10 players holding approximately 40% of the market. No single firm maintains over 10% of the marketplace.

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Disintermediating Nursing Recruiters

The primary value that recruiters provide is credentialing, vetting, and access. This model is about to be disrupted by way of the Blockchain.

Here is how one might go about doing this: Create a decentralized, autonomous nursing organization (DANO), utilizing smart contracts and the Blockchain. Basically, a DAO is a self-governing organization similar to a collaborative, but without the overhead, costs, and politics that come with human-intensive organizations. Governance can be automated using electronic voting and advanced computerized rule-and-conditions encoded in smart contracts (Think Apps). DANO can be equally owned by all of its nurse-members. By virtual of belonging, nurses share in any and all profits derived from DANO. The beauty of utilizing the Blockchain is that the value each member brings to the DANO can be easily tracked and verified on a public ledger. Members can sign up and be assigned a unique ID or address on the Blockchain’s publicly verifying registration.   Monthly and annual activity requirements, agreed upon by DANO members, can be monitored via a smart contract with the terms and conditions of a membership quantified and approved by electronic vote. Nurse credentials can be automatically verified using “oracles” connected via APIs available to universities, nursing boards, criminal background services, exclusion lists, and social credibility services such as LinkedIn.

Smart Compliance Contracts fed by the oracle could be developed between the nurses and the DAO, ensuring credentials, criminal records, and social compliance are vetted and updated. This essentially eliminates the manual work required to validate an applicant’s resume and good standing. Nurse-members with expired credentials, criminal activity, etc., can be placed on suspension via the compliance contract (and cancellation of employment contract) depending on terms and conditions set forth in the Smart Employment Contract. Now, we just got rid of the back room of the recruiting company.

Nurse-members who decide to go on the market could give the DAO permission to give the paying public pseudonymous access to their resumes in return for a viewing fee paid by the viewer which perhaps can be a share in a pool of subscription revenue that hospitals, clinics, and employers pay to access these profiles based on Smart Viewing Contracts established on the DANO Blockchain, by and between DANO and participating employers.

A simple video room utilizing opt-in machine learning oracles to analyze interview content, scoring for future learning and improved match-making, could be added to enhance the interviewing process for both nurse-members and employers. Each and every step along the recruiting path could be a fee paid to the nurses’ public Blockchain account, perhaps in Bitcoin or some other prevailing digital currency in micro-payments. This model will disrupt the recruiting landscape where employers incrementally pay to find the proverbial ‘needle in a haystack.’ Nurses will be paid for their time and effort versus payment to the recruiter. Final employment offers, acceptances, and contract signing could be recorded on the Blockchain, too.

You clearly see where this is going: Namely, a shift away from commission-based recruiting and control to a nurse-controlled process utilizing a DAO model, Smart Contracts, and the Blockchain, to enforce and ensure credentialing and vetting, recording legal transactions between employee and employer, and the disinter-mediation of recruiters.

The savings can be significant to the employers and industry at large, perhaps reducing talent acquisition fees by as much as 60-80 percent and shifting control and value to DANO, away from the fragmented recruiting industry.

All industries must adapt as the Blockchain becomes a viable and efficient way to operate just as the brick and mortar retailers have since the inception of the internet and its inherent powerful online sales.

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Cyrus Maaghul is a lifelong entrepreneur currently exploring how blockchain, smart contract, and decentralized autonomous organization technology and constructs can be applied to solving healthcare industry problems. He is the founder of HealthCombix, a healthcare blockchain based population health platform and PointNurse, a Nurse Practitioner led telehealth collaborative.

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