US2020202986A1PendingUtilityA1

Systems and methods for parallel execution of program analytics utilizing a common data object

Assignee: OPTUM INCPriority: Dec 19, 2018Filed: Dec 19, 2018Published: Jun 25, 2020
Est. expiryDec 19, 2038(~12.4 yrs left)· nominal 20-yr term from priority
G16H 10/60G06Q 40/08G06F 16/1744
46
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Claims

Abstract

An analytics platform for analyzing medical claims with low latency is configured to compress medical claims records into common data input objects that may be usable by a plurality of independent and parallel program analytics. The common data input objects are then passed as input to all of those program analytics, which are then configured to retrieve at least one compressed parameter file for use in processing data elements of the common data input object in accordance with a framework of a respective program analytic. The program analytics generate respective outputs based at least in part on data elements of the common data input objects, and the analytics platform combines those outputs into a single combined common output object.

Claims

exact text as granted — not AI-modified
1 . An analytic platform for processing a claims record, the analytic platform comprising one or more memory storage areas and one or more processors configured to:
 receive a record data file;   compress the record data file to generate a common data input object comprising a plurality of data elements, wherein each of the plurality of data elements represents one or more attributes of the record data file;   pass the common data input object as input to a plurality of analytics executing independently and in parallel, and wherein:
 each of the plurality of analytics retrieves at least one compressed parameter file for use in processing data elements of the common data input object; and 
 each of the plurality of analytics is configured to generate respective outputs based at least in part on one or more of the plurality of data elements of the common data input object; and 
   combine the respective outputs from each of the plurality of analytics into a common output object.   
     
     
         2 . The analytic platform of  claim 1 , wherein the one or more processors are further configured to:
 receive historical data files relating to an actor identified within at least one record data file;   compress the one or more historical data files to generate a historical summary data file relating to the actor; and   wherein the at least one compressed parameter file retrieved by at least one of the plurality of analytics is embodied as the historical summary data file relating to the actor.   
     
     
         3 . (canceled) 
     
     
         4 . The analytic platform of  claim 3 , wherein the plurality of analytics comprises the FWAE scoring analytic, and wherein the FWAE scoring analytic is configured to:
 parse the common data input object to identify one or more contexts relating to an underlying claim record;   retrieve at least one compressed parameter file relating to each of the identified one or more contexts; and   generate a respective output comprising a score value for the common data input object.   
     
     
         5 . The analytic platform of  claim 4 , wherein the FWAE scoring analytic is further configured to generate a human-readable narrative corresponding to the score value. 
     
     
         6 . The analytic platform of  claim 4 , wherein the one or more contexts relating to the underlying claims record comprise one or more of: a patient identity, a provider identity, an entity identity, or a medical claim. 
     
     
         7 . The analytic platform of  claim 4 , wherein the at least one compressed parameter file generated periodically based at least in part on historical data relating to a respective context of the one or more contexts. 
     
     
         8 . The analytic platform of  claim 7 , wherein the historical data is embodied as historical data generated during a moving time period having a defined length. 
     
     
         9 . The analytic platform of  claim 3 , wherein the plurality of analytics comprises the provider signature analytic, and wherein the provider signature analytic is configured to:
 parse the common data input object to identify a provider relating to an underlying claim record;   retrieve a compressed parameter file comprising historical data relating to the provider; and   generate a respective output identifying whether data elements within the common data input object are consistent with the compressed parameter file.   
     
     
         10 . A method for processing a claims record, the method comprising:
 receiving a record data file;   compressing the record data file to generate a common data input object comprising a plurality of data elements, wherein each of the plurality of data elements represents one or more attributes of the record data file;   passing the common data input object as input to a plurality of analytics executing independently and in parallel, and wherein:
 each of the plurality of analytics retrieves at least one compressed parameter file for use in processing data elements of the common data input object; and 
 each of the plurality of analytics is configured to generate respective outputs based at least in part on one or more of the plurality of data elements of the common data input object; and 
   combining the respective outputs from each of the plurality of analytics into a common output object.   
     
     
         11 . The method for processing a claims record of  claim 10 , further comprising:
 receiving historical data files relating to an actor identified within at least one record data file;   compressing the one or more historical data files to generate a historical summary data file relating to the actor; and   wherein the at least one compressed parameter file retrieved by at least one of the plurality of analytics is embodied as the historical summary data file relating to the actor.   
     
     
         12 . (canceled) 
     
     
         13 . The method for processing a claims record of  claim 12 , wherein the plurality of analytics comprises the FWAE scoring analytic, and wherein the FWAE scoring analytic is configured to:
 parse the common data input object to identify one or more contexts relating to an underlying claim record;   retrieve at least one compressed parameter file relating to each of the identified one or more contexts; and   generate a respective output comprising a score value for the common data input object.   
     
     
         14 . The method for processing a claims record of  claim 13 , wherein the one or more contexts relating to the underlying claims record comprise one or more of: a patient identity, a provider identity, an entity identity, or a medical claim. 
     
     
         15 . The method for processing a claims record of  claim 12 , wherein the plurality of analytics comprises the provider signature analytic, and wherein the provider signature analytic is configured to:
 parse the common data input object to identify a provider relating to an underlying claim record;   retrieve a compressed parameter file comprising historical data relating to the provider; and   generate a respective output identifying whether data elements within the common data input object are consistent with the compressed parameter file.   
     
     
         16 . A computer program product comprising a non-transitory computer readable medium having computer program instructions stored therein, the computer program instructions when executed by a processor, cause the processor to:
 receive a record data file;   compress the record data file to generate a common data input object comprising a plurality of data elements, wherein each of the plurality of data elements represents one or more attributes of the record data file;   pass the common data input object as input to a plurality of analytics executing independently and in parallel, and wherein:
 each of the plurality of analytics retrieves at least one compressed parameter file for use in processing data elements of the common data input object; and 
 each of the plurality of analytics is configured to generate respective outputs based at least in part on one or more of the plurality of data elements of the common data input object; and 
   combine the respective outputs from each of the plurality of analytics into a combined common output object.   
     
     
         17 . The computer program product of  claim 16 , wherein the computer program instructions when executed by a processor, cause the processor to:
 receive historical data files relating to an actor identified within at least one record data file;   compress the one or more historical data files to generate a historical summary data file relating to the actor; and   wherein the at least one compressed parameter file retrieved by at least one of the plurality of analytics is embodied as the historical summary data file relating to the actor.   
     
     
         18 . (canceled) 
     
     
         19 . The computer program product of  claim 18 , wherein the plurality of analytics comprises the FWAE scoring analytic, and wherein the FWAE scoring analytic is configured to:
 parse the common data input object to identify one or more contexts relating to an underlying claim record;   retrieve at least one compressed parameter file relating to each of the identified one or more contexts; and   generate a respective output comprising a score value for the common data input object.   
     
     
         20 . The computer program product of  claim 18 , wherein the plurality of analytics comprises the provider signature analytic, and wherein the provider signature analytic is configured to:
 parse the common data input object to identify a provider relating to an underlying claim record;   retrieve a compressed parameter file comprising historical data relating to the provider; and   generate a respective output identifying whether data elements within the common data input object are consistent with the compressed parameter file.

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