“Even if EHRs reduce the risk of errors overall, they may produce entirely new ones, Edward Fotsch, CEO of PDR Network, which will provide network operations for the new reporting system, tells the Health Blog. For example, EHRs may cut the risk of failing to alert a patient to an abnormal test result, but confusing user interfaces may produce their own mistakes and need tinkering.”
“Even with these differences, a human can rapidly determine that they refer to the same individual for two reasons. The first is that the values that differ across the pair of records are not too different from each other, and the second is that there seems to be enough support from across each pair of attributes to assert some degree of similarity.”
“According to the Centers for Medicare and Medicaid Services, the program made nearly $24 billion in improper payments in 2009, almost doubling the previous years’ rate. The price of fraud, however, runs even higher. A CBS report notes that Medicare fraud costs taxpayers an estimated $60 billion a year, and some estimates put the figure at nearly $100 billion.”
“For the last two years, respondents to our survey have cited several information management-related problems among the top barriers to adopting BI tools company-wide. Data quality problems are cited most often, by 55% in both 2009 and this year, followed by ease-of-use challenges, and integration and compatibility with existing platforms. Among the people directly responsible for information management, the biggest impediments to success are accessing relevant, timely, reliable data (59%); cleansing, deduping, and ensuring consistent data (51%); and integrating data (49%).”
“Billions of your tax dollars are lost every year to healthcare fraud. In fact, the tab is $36Million a day for Medicare fraud alone. U.S. Congressman Michael Burgess of Lewisville watched FOX 4’s undercover investigation in to the practices of a home health care recruiter. Today, FOX 4’s Becky Oliver spoke with Congressman Burgess.”
“McCassell gave the ticket to a clerk — but when the clerk scanned it, he ‘told him that it wasn’t a big winner,’ New York Lottery Director Gordon Medenica said. When McCassell asked for the ticket back, the clerk told him ‘he had lost the ticket,’ Medenica said. ‘The clerk said, ‘I already threw it away.””
“‘State government cannot afford redundant and disconnected investment — even in the best of times. And right now, we’re in the worst of times,’ he said in a statement. According to the INPUT report, released earlier this year, the market for state and local BI / audit and recovery (A&R) technologies will increase at an annual growth rate of 7.6 percent, topping out at over a billion dollars in 2014. Cumulatively, INPUT believes states will invest $600 million in A&R solutions, and $225 million in BI and prevention solutions in 2010 for the five biggest federal benefits programs.”
“‘We will continue to work with our state and federal partners to police abuse of the program that so many people depend on,’ Coakley said in prepared remarks. Over the last three years, Coakley’s Medicaid fraud division has recovered approximately $125 million for the state Medicaid program, according to the AG’s office.”
“This is the third in a series of four posts that discuss four methods for linking references. These methods are:
Direct matching
Transitive linking
Linking by association
Asserted Linking
In the last post I discussed transitive linking, and why it is essential for producing a unique and deterministic outcome of an ER process. In this post I will discuss the third method, linking by association.”
“There are many types of relationships that are discovered as a by-product of entity resolution, such as households or families. These terms take on different meaning depending on the subject area and the business situation. For example, we can examine parent-child and sibling relationships associated with individuals, we can look at components such as paper clips or screws that are in the same ‘family,’ or we can look at corporate ownership relationships that reflect families of companies. Alternatively, we can look at other types of relationships – individuals belonging to the same health club, components manufactured from the same type of metal, or companies that share the same board members.”
“In an 80-page civil complaint, the United States Attorney’s Office claims 51-year-old Doctor Robert Ritchea, a physician, not only allowed an unlicensed medical assistant to inject patients with pain medications, but also improperly billed Medicare for the treatments. The complaint also alleges Ritchea over-billed Medicare by more than $2.2 million in over 4,300 separate claims over a period of four years.”
“If you know that 123 Main Street in Anytown is a single family house there is a high probability that this is the same real world individual. But if you know that 123 Main Street in Anytown is a building used as a nursing home, a campus or that this entrance has many apartments or other kind of units, then it is not so certain that these records represents the same real world individual (not at least if the name is John Smith). So this example highlights the importance of using external reference data in data matching.”
“The Association of Certified Fraud Examiners (ACFE) held its annual conference and exhibition in Washington, DC this week. Through the keynote address and the plethora of wonderful speakers, one message became loud and clear - fraudsters are becoming more and more creative in finding ways to circumvent your policies…”
“A confluence of changing business requirements and on-going vendor consolidation leads many organizations to rethink their business intelligence (BI) strategies… Ensure the systems supports multi-channel heterogeneous data sources. Do not stay dependent on ERP systems for primary sources of data. Expect a rapidly changing business environment that rewards flexibility.”
“The idea is for police in your area to better share essential information about possible criminal and terrorist threats with their federal counterparts, poor communication being one of the reasons why the terrorist hijackings were allowed to occur in the first place. Civil libertarians have repeatedly expressed concern that the centers are stockpiling too much personal data about Americans who haven’t committed a crime in the hope that some piece of it can be ‘fused’ with another to unravel a terrorist plot. Serrao and his colleagues counter that organizations like the ACLU ‘have no clue’ what’s actually being collected and analyzed at fusion centers.”
“The EHRs are designed to be digital replications of the hard-copy, paper health records commonly in use today. They are also engineered to be easily transferable among different doctors and hospitals so as to eliminate the creation of duplicate or disparate records among different health care providers, thus allowing any health care office to access a patient’s complete medical record at each visit.”
“‘There’s an awful lot of talk about it and there is consumption of cloud,’ said Al Gillen, an analyst at IDC. But ‘organizations don’t simply make change because they can. There has to be good justification.’ Harry Weller, a general partner at New Enterprise Associates, said start-ups and new businesses will likely be among the first to move to the cloud. A need to hold down costs is often an overriding factor in their decision, he said.”
“There are still options, Karel writes, including S3 Matching Technologies, Syslore or identity resolution/matching vendor Infoglide Software. But if Oracle plans to just use its own matching engine from the Oracle Customer Hub in Oracle Universal Content Management – ‘that would be a step backwards in my opinion,’ he writes.”
“But both FBI Agent Royce Curtain and the DPS’ Tom Ruocco said that communication among law enforcement agencies in the area is good – and, said Ruocco, the addition of a local Austin Regional Intelligence Center (a.k.a. a ‘fusion center‘) would be an asset to getting information needed to detect if there is an increase in local drug trafficking activity. Getting involved in the fusion center is ‘proactive on the city’s part,’ said Ruocco. When there are trends ‘coming forward’ the city will be in a ‘better position to react.’”
“The indictment alleged that between May 2004 and May 2005, Allen underreported monthly payroll and the number of miners working for her to Kentucky Employers Mutual Insurance. She did this by creating a sham trucking company and placing many of her mining employees on that payroll.”
“Why are some people always reminding us that this and that must be seen in a business context? Of course everything we do in our professional life within data quality, master data management, business intelligence and so on must be seen in a business context.”
“Confusion about medical records can lead to chaos. We’ve all heard horror stories about hospital tragedies caused by misidentification of a patient, such as applying an unnecessary surgery. It’s hard to overemphasize the importance of correct, unambiguous information in the practice of medicine. Knowing as much as possible about a patient enables a practitioner to reach a correct diagnosis and the proper treatment regimen in the least amount of time.”
“Tom Campbell, a consultant on terrorist issues who has worked with Sandy in the past, has been in the field of counter-terrorism for 14 years. We do not profile based on ethnicity and race, what we do is profile behavior,” said Campbell. “Terrorism is evolutionary. Terrorists are always changing their behavior, appearances and tactics. What we try to do to prevent terrorism is focus on the behavior. That’s how we disrupt it before it happens. The emphasis is on prevention.”
“Cloud computing and SaaS will become less niche as both BI heavy weights and vertically-focused vendors recognize that the infrastructure side of BI offers little competitive advantage; instead, it’s the time-to-value and agility. IT owners who don’t want to give up any control are in for a bruising.”
“DHS uses TSDB data, managed by the Terrorist Screening Center that is administered by the FBI, to determine who may board, who requires further screening and investigation, who should not be admitted, or who should be referred to appropriate law enforcement personnel. Specifically, to help make these determinations, DHS uses the No-Fly List and the Selectee List, two important subsets within the TSDB. Individuals on the No-Fly List should not receive a boarding pass for a flight to, from, over, or within the United States.”
“Four years ago this week, a small aircraft lifted off from Watson Island in Miami. It was the plane’s 39,743rd flight. And as the tiny craft first vented white smoke and then lost its right wing in an explosion, it became clear that this was its last. All twenty people in the Grumman G73-T, including three infants, perished. The National Transportation Safety Board later determined that the culprit was metal fatigue.”
“For the mid-market and those new to BI, open source and BI software as a service (SaaS) will offer attractive alternatives. In the case of BI SaaS, increasing deployments of enterprise applications in the cloud by SMEs will act as a further driver for take-up of this option.”
“Hildreth references a 2009 New England Journal of Medicine survey indicating that close to 4 percent of physicians have a fully functional EHR system. About 13 percent of physicians’ offices have a basic EHR system in the works. Many organizations, Hildreth says, currently have bits and pieces of EHR, but not the full thing.”
“While prosecution of various forms of insurance fraud is affected by budget constraints, the prosecution of underreporting of workers comp premiums by unscrupulous employers, or their outright failure to purchase the mandated coverage, may take the biggest hit, depending on each state’s priorities, Mr. Jay said.”
“Specifically, the 2009 survey found that 29% of BI deployments were slightly successful and 47% were moderately successful. Only 21% of the respondents rated their deployments very successful.’A number of technical factors continue to contribute to — or hinder — stronger BI impact,’ the report said. ‘Data quality, reliability of the BI system and access to relevant data are the most important technical factors.’”
“Identity resolution is a vital technology for law enforcement fusion centers, and we’ve often followed developments with links to stories in this area. When overlapping and adjacent jurisdictions share data with each other, uncovering hidden identities and linkages greatly accelerates the detection of criminal activity. This map shows current and planned deployments of state and local fusion centers.”
“These three posts formed an excellent blogging debate between Jim Harris, Henrik Liliendahl Sørensen and Charles Blyth on the subject of Single Version of the Truth, a common term in our profession - but what exactly does it mean?”
“Initially, the Secure Flight program was part of a larger debate about how to identify terrorists consistently while maintaining the privacy of fliers in the post-9/11 world. Once watch list matching was determined to be the correct mechanism, TSA designed the program with privacy and security embedded into its foundation. Secure Flight now uses advanced watch list matching technology and has taken the time to get it right.”
“In addition, with some EMR/EHR providers offering as Software As A Service solution (SaaS), the initial fears of implementation costs and backup/disaster recovery planning can be significantly decreased. These SaaS providers have already worked through those issues, and through a web interface, can offer full functionality.”
“Complexity occurs when the subject details being mastered have more variables, and variables that can be vague—such as a person. In the instances of complex subject areas, mastering the reference value requires more sophisticated analysis [i.e. identity resolution] of the numerous attributes associated with the individual reference value such as their name or address.”
Infoglide Software provides entity resolution and analysis solutions for retail, banking, insurance, government, and law enforcement. Without the need for data cleansing or warehousing, Infoglide Software's Identity Resolution Engine™ (IRE) analyzes all of the information relating to individuals and/or entities from multiple sources of data and then applies...
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