IBM Applications Use Analytics to Bolster Patient Care, Fight Fraud

IBM has unveiled Patient Care and Insights, new analytics software that allows health care organizations to determine the proper treatments for patients. The company also introduced Intelligent Investigation Manager, an application that helps companies conduct fraud and public-safety related investigations.

On Oct. 23 IBM announced the new products at its Information on Demand Conference in Las Vegas. The new software was developed at IBM Labs.

Patient Care and Insights uses natural language processing (NLP) technology similar to that which drives IBM’s Watson supercomputer. NLP allows medical professionals to analyze structured data in electronic health records and medical claims as well as unstructured data in doctors’ notes, consultation reports and faxes, IBM reported.

The software enables doctors to practice personalized medicine and make recommendations to improve an individual patient’s condition. It allows doctors to analyze similar clinical characteristics in other patients to make clinical decisions and spot complications.

Through Patient Care and Insights, doctors can analyze patient conditions as they move from one provider to another, according to Dr. Paul Grundy, global director of health care transformation at IBM. This federal care transition model is called the patient-centered medical home.

Multiple providers may include physicians, specialists, hospitals, clinics and home care environments.

“With the wide-scale adoption of the patient-centered medical home, the need for comprehensive care management and analysis of the patient as they transition across settings has become a national priority,” Grundy said in a statement. “Programs like those at the Center for Medicare and Medicaid Services, for instance, that focus on robust care management, are indicative of the significant returns on investment that these care models can deliver.”

IBM provides predictive modeling and algorithms in Patient Care and Insights to enable doctors to study demographic, social, clinical and financial data along with their notes to develop personalized treatment plans. The software can also match patients with the appropriate providers for certain conditions.

In addition, the analytics software can show “early identifiers” of a condition in a patient’s history that help doctors craft a treatment plan.

Patient Care and Analytics incorporates IBM’s Content and Predictive Analytics, which helps doctors spot patient trends and improve care.

Meanwhile, IBM’s new Intelligent Investigation Manager software will allow investigators to study relationships among perpetrators, providers or fraud rings and create simple visualizations of fraud cases from structured and unstructured data in silos.

Intelligent Investigation Manager will enable industries such as health care, banking, insurance, retail and law enforcement to analyze intelligence and develop fraud protection.

An organization can lose about 5 percent of annual revenue to fraud, according to the Association of Certified Fraud Examiners, an organization that provides training and education on fraud.

Intelligent Investigation Manager helps public safety officials by providing access to internal and external data. It incorporates IBM’s Case Manager software, which helps investigators prepare reports on cases for negotiation or prosecution. It also includes i2 Fraud Intelligence Analysis, an application that shows the connection among parties involved in a case.

The fraud-investigation platform also incorporates Content Analytics With Enterprise Search, a tool that searches, analyzes and extracts entities, as well as detects suspicious patterns of fraudulent activity while updating analytics data on cases.