Healthcare

IT at the Heart of Real-Time, Personalized Healthcare #PBLS

October 29, 2009

Last session at the SAS/BetterManagement.com event this week on IT and personalized healthcare. Yan Chow of Kaiser Permanente presented on their vision for IT-enabled healthcare. Kaiser is an integrated system with 8.6M patients and 180,000 employees and physicians. Integrated means that insurance/delivery are all aligned and Kaiser is very focused on prevention. It is also [...]

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First Look – FICO Insurance Fraud Manager

October 20, 2009

I got a chance to catch up with Andrea Allmon of FICO to hear about their new Insurance Fraud Manager release (3.0 in July). This is a timely topic because of the debates around healthcare at the moment. In all the discussions about healthcare costs you never hear about the amount of fraud involved, yet [...]

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Survive, thrive and capitalize with BPM

October 5, 2009

Jim Sinur introduced the session by describing how Gartner saw BPM being used to turn a cost reduction axe into a cost reduction scalpel during the recent recession – cutting more precisely. The current economic climate he says is “nirvana” for BPM and BPM is not perceived as a luxury but a necessity. The session’s [...]

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Rules-based innovation

August 27, 2009

An old friend of mine, Anders Björlin, has just won a 2009 Humanitarian Impact award from The Itanium Solutions Alliance. The press release says:
Judges selected Kiwok of Sweden for its BodyKom(TM) Series remote ECG monitor. Deployed in conjunction with caregivers and health systems, BodyKom allows heart patients to live independently while their heart is monitored [...]

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Using decision management for meaningful EMR

July 20, 2009

I saw this comment last week in The US stimulus program Taking medical records online – McKinsey Quarterly – Health Care – Strategy & Analysis and it struck a chord with me:
health care providers to upgrade their IT systems rapidly to reach the act’s standards for “meaningful use” of EMR (Electronic Medical Record)
This phrase – [...]

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Decision Management Event Calendar for July 3

July 3, 2009

This week’s event calendar is below. The intent of this weekly post is to focus on web events coming in the next few weeks and conferences in the coming months. If you know about web or physical events around business rules, analytics, optimization or decision management, please let me know – james@decisionmanagementsolutions.com.
Web Events:

Silverlink: Applying Analytics [...]

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Building Agile Processes with SOA and Business Rules

May 4, 2009

Vision Service Plan, VSP, presented on their use of business rules to build agile business processes in healthcare. VSP has some 55M customers in their plans and have been an IBM/ILOG customer since 2002. Every process in healthcare is governed by policies, regulations – every process has decisions that must be made following the rules [...]

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High-Performance Scoring of Healthcare Data

February 19, 2009

Syndicated from Smart Data Collective
Natasha Balac from UC San Diego and Michael Zeller from Zementis (their product was blogged here and their support for the amazon.com compute cloud was discussed here) presented on the use of Medicare and Medicaid data to detect and prevent fraud. The high computing center at UC San Diego (San Diego [...]

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The High ROI of Data Mining for Innovative Organizations

February 19, 2009

Syndicated from Smart Data Collective
John Elder presented a collection of case studies to showcase the ROI of data mining. John started by making the point that many of his case studies had technical success but not business success – an interesting statistic. John sees three major ways that predictive analytics can help – streamlining, eliminating [...]

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Mr Obama, smarten these systems!

January 20, 2009

Like millions of my fellow Americans I listened to our new President today. As I did I was struck by the opportunities for decision management to deliver the smarter systems that will be critical with some of the priorities President Obama laid out in his speech. There were four commitments he made that struck me [...]

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Decision Sciences in Healthcare – Academic Research Request

January 13, 2009

A client of mine is looking to align themselves with a university and get some published research on using decision science in healthcare communications. Anyone know people or universities that might be interested? Let me know – james at jtonedm.com

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Decision management is critical for successful e-prescription

December 19, 2008

MSNBC had an interesting article on Docs to get bonus pay for e-prescriptions. The article had a great comment:
The biggest reason for the paperless push is to improve safety. More than 1.5 million Americans are injured every year by medication mistakes. Deciphering doctors’ chicken-scratch — was that 100 milligrams or 100 micrograms? — does play [...]

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Decision Management and fixing healthcare

November 14, 2008

I think alot about how decision management can be used to improve healthcare. Neil Versel is one of the bloggers I read in this space and he had a post this week called “A modest proposal” in which he repeated some comments about the failure of the medical profession to use Clinical Decision Support systems [...]

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First Look – Savvion 7.5

November 11, 2008

I got a quick overview of Savvion 7.5 this week. Savvion is one of the pure-play BPM vendors with customers in Telecommunications, Media, Financial Services and Manufacturing (along with some retail and healthcare). They released version 7.5 at the end of September.
Savvion has recently been investing in domain-specific vertical solutions built on their horizontal [...]

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On the importance of holistic decision making

November 6, 2008

I was chatting with someone the other day who shared a story of a European health insurer.   Their decision-making in claims looked only at the validity of the claim and nothing else. This of course created a situation where good (and very profitable customers) could be treated correctly but ineffectively – such as one [...]

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Integrating Predictive Analytics and BRM to Improve Health Plan Member Experience

October 30, 2008

Two gentlemen from Deloitte presented Integrating Predictive Analytics and BRM to Improve Health Plan Member Experience. 80% of healthcare costs are incurred by 20% of members and traditionally the 20% get all the focus. Analytics and data mining get applied to claims, authorization, costs as a result. Segmentation focuses on the unprofitable and unhealthy. Increasingly [...]

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Credit Scoring in Healthcare. In Healthcare!

July 24, 2008

I saw a post today on medical credit scoring that made me think I should post something about how credit scoring can be used in healthcare. Now saying that, of course, makes everyone nervous – are we talking about refusing people treatment because of their credit score? Why should financial questions like credit worthiness have [...]

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Using Decision Management to improve healthcare communication

June 10, 2008

I have just finished presenting on the last of a series of roadshows for Silverlink. I was one of a series of presenters for their Think Different seminars. I presented with Kinney Zalesne (author of Microtrends: The Small Forces Behind Tomorrow’s Big Changes), Liz Boehm (Healthcare analyst at Forrester) and Fred Jubitz (recently of American [...]

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Old Way, EDM way returns

May 27, 2008

One of the most fun things we did in the book was write about real success stories. We used an “Old Way” v “EDM Way” model for these. In the past I have written some blog posts using a similar style and today I have a new one.
Old Way
An online pharmacy (that the country trusts, [...]

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Here’s how one company is using EDM to improve healthcare

March 4, 2008

Silverlink is an interesting company whose approach is to apply science to drive healthcare behaviors in a scalable manner. They made some announcements today at the Health 2.0 conference. I recently got a chance to speak with the CEO (Stan Nowak) and his team. Silverlink has 50 healthcare clients representing 150 million lives (including 9 [...]

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