Enabling value based care

Enabling value based care


NashTech executed a series of evaluations of tech stack and solutions, later building basic components in one sprint in which various technical decisions were made. 

A new generation startup that aligns clinical coding, Clinical documentation integrity and Care coordination best practices to deliver accurate patient risk and better HEDIS compliance to value based organisation. Various insurance companies and providers, work with them to help uncover issues in patient risk, streamline documentation and provide concrete data and documentation on missed factors and improve risk accuracy. Their unique platform allows clinicians to rapidly analyse the data and provide feedback to customers and automate the entire end to end process

The challenge

As a rapidly growing startup, their management needed a business intelligence system that helped them understand the productivity and business value delivered on a daily and sometimes hourly basis. On one end, this analysis required intricate analysis of activity performed by clinicians real time which help identify issues early on and ensure promised dates to customers are met. While On the other end, provide accurate, explainable reports to customers that have a huge financial impact.

The company needs performance data ‘as of a date in the past.’ i.e. a point-in-time report is one which allows executives to go back in time, look at the statistics as of a particular date and be able to compare with what it was a year ago or now. This requires, not just the current state of data but every mutation to the data along with time.

The solution

Upon onboarding NashTech, the team spent the first few days getting familiar with Health Care industry terminology and acquired the domain knowledge required to start the architecture process. The engineers read the report published by CMS (Medicare services) to Congress, that illustrates the evolution of measuring patient risk. The knowledge is documented in confluence and an onboarding document was prepared.

NashTech team then spent a couple of days understanding the customer processes, agreeing on development methodology, CICD standards, Infrastructure standards, documentation standards, Approval processes etc.

With basic knowledge required and understanding of process burden, NashTech kick started the ‘Fusion’ exercise, in which NashTech had a series of workshops with key stakeholders to define goals, success criteria, vision, approach, communication standards and Agile processes. A high level road map is prepared for the next few sprints and a backlog is generated.

The next step was architecture release, in which NashTech executed a series of evaluations of tech stack and solutions to determine the best approach. NashTech built basic components in 1 sprint (2 weeks) in which various technical decisions were made. 

The outcome 

The solution was a great success and the business started using the system within 6 weeks of the start. Today business relies heavily on Looker to understand the business, generate compliance reports in minutes and provide reporting for customers on demand. Due to streaming, the data is always fresh to seconds. The scalability of big query and pubsub, provides elasticity and speed required.
The solution is HIPAA and SOC2 Compliant, which is a basic necessity in the healthcare industry.

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