Beyond the EHR – Big Data Analytics in Healthcare

2 Jun

Background3

As the adoption of electronic health records (EHRs) reach critical mass, the healthcare industry is increasingly looking for ways to optimize on this now digital data. As we look beyond the implementation of the EHR, we have to ask ourselves, what’s next?  Digital health data, and the ability to mine that data, holds the promise of improved efficiency, lower costs, fewer errors, better health outcomes and greater accessibility.  Access to actionable and easy to understand personal health data could also be helpful in creating a more consumer focused health system.

While it is likely that most health entities have begun to collect some form of electronic health data, the challenge now is to figure out how to use big data to achieve the promise.  Healthcare entities should be planning their big data future. Entities should define their strategic objectives, and go about the work of developing a roadmap. Start with the end in mind. The big consideration is insourcing vs. outsourcing. Insourcing can be a high cost, high-risk proposition but it is an option that may pay out in the long run if done properly. Outsourcing offers a lower entry cost and lower risk option in that it allows you to push off the costs of implementation, development and maintenance. Regardless of which path an entity takes, a well-planned process will yield results by giving payers, providers, and patients access to the right data, at the right time for the right outcome.

How to Decide: Waterfall versus Agile Methodology

23 May

Often the success or failure of a software development project depends on deploying the appropriate methodology.  While Agile has many benefits, and appropriate for many projects, it has its limitations as well. Therefore, employing Agile Methodology does not guarantee success.  For example, Agile Methodology, when applied improperly, or without understanding structured software development techniques, can lead to an undisciplined and undocumented run-away project.  As developers go through iterations of refinements and unplanned complexities, Agile’s weaknesses become more pronounced, and the customer becomes unhappy.

On the other hand, a disciplined Waterfall Methodology is appropriate when requirements are well documented and straight-forward, the technology is familiar, and there are relatively few key users of the application.  In such cases, the Waterfall approach gets right to the point.  The designers know exactly what to do, and the developers are able to code to the design with relative ease.  There is no need to go through continuous iterations, except to address defects.  The overall mission is accomplished in relatively short order.

The important point is that each approach has its own unique challenges and advantages.  Deciding which one works best for your project is one of the most important decisions that will determine if the project can be completed on schedule and within budget.

Maintaining an Effective Quality Management System under ISO 9001:2008

10 May

This month, Ascellon passed our semi-annual ISO surveillance audit without any non-conformance citations.  It is our 18th straight semi-annual audit without any non-conformance citation.  Surveillance audits are conducted by independent certification auditors recognized by the ISO governing body. The purpose of the regularly scheduled surveillance audit is to assure the ISO certification body that the quality management system is put into practice for business operations.  The audit typically focuses on the results of internal audits which are conducted regularly, whether metrics are collected, and how the data collected are used to implement corrective or preventive actions and to improve business processes.  Our customers who require our ISO certification as a condition for doing business with us are further assured of our status as a certified organization based on the results of the surveillance audits.

As an organization, we have found that maintaining an effective ISO 9001:2008 certified quality management system requires continuous management, focus and energy.  The goal is to design a management system that is in line with the organization’s business, while satisfying the requirements of ISO.

Second, we maintain a rigorous internal audit schedule, such that all parts of the system are audited at least twice each year.  This is invaluable in preparing for external surveillance audits.  The organization hardly needs any additional preparation for surveillance audits if internal audits are well-conducted.

Finally, we get everyone involved.  The quality management system is not something for the Quality Assurance Department – it is a way of doing business across the entire organization.

In summary, management at the highest level must lead the quality management system effort, the organization must design a quality management system that fits its business processes while maintaining compliance with ISO, and the quality management system belongs to everyone, not just the QA Department.

ISO 9001-2008 Logo

Ascellon Introduces SAP Productivity Tool – XCODESEEKER

13 Mar

Through a partnership and reseller agreement with Coach-IT of Brazil, Ascellon is now able to support SAP installations with a suite of powerful productivity tools.

XCODESEEKER is engineered specifically for the SAP environment. It reduces Total Cost of Ownership (TCO) by increasing optimization of the hardware already deployed.  XCODESEEKER enhances Security and Quality, and guarantees best practice for ABAP Programs.

It is not unusual for an organization to incur high cost of rework in ABAP code due to inefficient programing or implementation of objects that are integrated with a database, other systems, or even objects that consume a lot of memory or which can crash the servers.

For a SAP installation, an organization depends on a number of skilled professionals, whose cost can be high and vary monthly. Assuming 2 or 3 technical consultants, with each consultant working on a maximum of 4 or 5 SAP objects a month.  The cost will be approximately $25, 000 per month to maintain approximately 10-15 objects.

With XCODESEEKER, there is predictable and level of investment per month for unlimited number of SAP objects.

For old and new objects the XCODESEEKER solution is able to add value in many ways.  For example, governance is maintained by analyzing software deliverables or the specific needs of an upgrade or implementation project or even guarantee the integrity of the production environment. The functions that the XCODESEEKER brings to an organization are in accordance with “IT Governance compliance” for new ABAP objects.

Ascellon in the Community

18 Aug

In keeping with its tradition of community service, Ascellon recently partnered with the Thomas Johnson Middle School in Prince George’s County, donating much needed office supplies and supporting educators in making the “Home of the Jaguars” a great place to learn.

Ascellon CEO Sheila Scott and President Ade Adebisi applaud Principal Rodney McBride and the dedicated school staff as they deal with the day-to-day challenges of meeting student needs.

“We believe in community,” Scott said, “and we believe that Ascellon can play a positive role in supporting our community and in helping its members to thrive.”

The company encourages employees to support community-based organizations and causes of their choice.

Did You Know

26 Nov

While salaries in the United States have increased 38% in the past 10 years, healthcare costs have increased a whopping 131% to more than $2 trillion per year. healthcare fraud plays a substantial role in the growing cost of care nationally. below are just a few of the facts that relate to healthcare fraud,waste and abuse and what is being done to fight it.

  • In many cases criminals hack into digital medical records and bill insurers for drugs, equipment and treatments that were never prescribed.
  • Criminals average more than $19,000 per fraudulent incident, that’s four times the amount realized through identity theft.
  • .To collect money, criminals set up fake companies that disappear after getting paid.
  • Money stolen through Medicare fraud is projected to exceed $1 trillion within the next decade.
  • The US Departments of Justice and Health and Human Services have brought extraordinary resources to bear in the fight against fraud waste and abuse in healthcare and ordinary citizens have joined the battle by reporting suspected fraud on their statements to insurers.

Ascellon Corporation offers the ANSWERS suite of tools to assist healthcare organizations in combating fraud, waste and abuse. This powerful suite of applications offers multidimensional views of every claim, cuts costs and saves time in data analysis and fraud prevention. To schedule a demo contact Ascellon today

What Does Healthcare Fraud Look Like?

22 Oct

Healthcare fraud has many faces as a recent Medicare Fraud Strike Force operation demonstrated.

In early October Medicare Fraud Strike Force operations in seven cities charged 91 individuals – including doctors, nurses and other licensed medical professionals – for their alleged participation in Medicare fraud schemes involving approximately $429.2 million in false billing.

The areas of fraud uncovered in the indictment included home healthcare services, mental healthcare services, ambulance transportation services, physical and occupational therapy services and more.  Investigators used sophisticated data analysis techniques to uncover the crimes.

As criminals become more creative in defrauding the government, so too are agencies finding more sophisticated tools for detecting fraud.  Ascellon Corporation is among the leading companies making sophisticated data analysis tools available to federal clients in the fight against healthcare fraud. 

The Answers suite of applications includes quality control mechanisms, intuitive analytics, and interactive reports that take data analysis to a new level, that not only uncovers fraud, waste and abuse but also gives investigators and analysts the tools to prevent, deter, identify and resolve high-risk situations.

Request a demo today.

Answers to Fighting Fraud Waste and Abuse in Healthcare

15 Oct

Ascellon’s JAmes BAker on fighting fraud, waste and abuse in healthcare

Ascellon Attending Premier Health Care Fraud Conference in OKC

17 Sep

The Ascellon team is attending the National Association for Medicaid Program Integrity (NAMPI) Conference, September 16th through the 18th, in Oklahoma City. NAMPI membership is comprised of state and federal officials whose primary task is to investigate instances of fraud & abuse in the Medicaid Medical Assistance Program. NAMPI’s membership currently consists of attorneys, nurses, contractors, investigators, managed cared staff, managers, pharmacists and others.

Ascellon is giving demos of its ANSWERS fraud solution. Government agencies across the nation are faced with the crisis of having to do more with less while maintaining health care coverage to a growing population. ANSWERS® by Ascellon is a highly integrated suite of applications designed to identify specific patterns of concerns associated with fraud, waste, and abuse within the health care system.
To set up a demo for your team at this year’s NAMPI conference, please contact James Baker or call 703.303.4233.

Watch the latest video on the Ascellon Answers solution to healthcare fraud.

Evolving From Fee for Service to Managed Care

6 Jul

As fee based Healthcare evolves into managed care, new methods of controlling costs will be a priority for government and businesses trying to avoid waste and fraud.  Fee for service and managed care present very different challenges for agencies and businesses concerned about healthcare fraud.

Added to the list of schemes like billing for services not rendered and using more lucrative clinical codes under fee for service, is the incentive to under service people who are enrolled, in order to maximize margins under managed care. Capitation fees (fixed fee for each person covered) offer different incentives for fraud. As our healthcare system transitions from fee for service to managed care, the workload will only increase for those charged with detecting fraud and the need for sophisticated detection tools will increase as well.   Ascellon is leading the way with innovative software packages designed to assist the healthcare community in saving money.