CASE STUDY

Data-driven Preventive
Healthcare – Payers

An insurance agency offering health, dental, and vision coverage to individuals, families, seniors, and small businesses was looking at ways to leverage data for delivering better patient health outcomes.

Sparity with its extensive experience in solving complex business problems came up with data driven strategies to help our client leverage the true potential of big data and AI.

Key Challenges

  • With day to day rise in hospital readmission rates, payers are looking at ways to use the available medical, pharmacy, and clinical encounter data to improve member engagement and reduce costs
  • Our client has data coming from disparate systems that too are in different data formats which makes harnessing the data a challenge 
  • They wanted to analyze the data from all the sources and stage them for advanced integration and analytics to gain a deeper insight into their member population
  • They wanted to have a FHIR enabled data activation platform to streamline patient data

Technologies used

Data-driven Preventive Healthcare – Payers
Data-driven Preventive Healthcare – Payers
Data-driven Preventive Healthcare – Payers
Data-driven Preventive Healthcare – Payers

Solution:

  • Collected patient profiles from various data sources such as claims data, EMR/EHR systems, and wearable and medical devices
  • Processed the data into required formats for enhanced data analysis using state of the art data mining techniques
  • Generated dashboards to illustrate the data analysis results for better visualization
  • Built AI models to predict health events of members using big data
  • Developed FHIR compliant application which cleans, aggregates healthcare data from electronic health records, pharmacies, hospitals, labs
  • Using prediction models, client was able to identify individuals with lifestyle diseases and helped them with personalized preventive care through m-health apps, IoT devices thereby reducing overall costs

Benefits:

  • Improved risk assessments assisted client in optimizing health plans/offerings
  • Generated real time alerts via wearables to help patients analyze their health stats
  • Enhanced patient diagnosis through early detection, resulting in improved health outcomes

Let’s get started

Find out how Sparity uses data for
sorting payer information

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