Entity cohort discovery and entity profiling

Abstract

Disclosed are systems and techniques for providing a master health entity index and a data analysis mechanism designed for entity cohort discovery and entity profiling. The entity can be a health care facility that diagnosis or treats health conditions and diseases (e.g., hospital, clinic), individuals (e.g., providers, patients, care givers), healthcare data (e.g., medical conditions, treatments, diagnostic studies, health outcomes), etc. For example, a data analysis mechanism may identify distinctive patient cohorts based on what happened to patients in a hospital and why the occurrence happened, reconstruct timelines of healthcare events from fragmented medical data, and leverage the existing electronic health data to generate comprehensive profiles of healthcare entities.

What is claimed is: 
     
         1 . A method for processing healthcare data to discover cohorts and profile healthcare entities, the method comprising:
 receiving a first set of healthcare data from a source;   performing analytics on the first set of healthcare data based on an event that occurred in a healthcare facility;   identifying a cohort based on the analytics;   generating a second set of healthcare data associated with the cohort based on the analytics;   identifying a cost based on the second set of data associated with the cohort;   determining a fraudulent charge based on the cost and the analytics; and   generating a report based on the fraudulent charge, the cost, the second set of data and the cohort.   
     
     
         2 . The method recited above in  claim 1 , wherein the source includes one or more of:
 an insurance claim;   an electronic health record;   a digitized paper health record;   a wearable device;   a piece of feedback collected through a survey;   a third party dataset;   an accounts receivable;   an invoice;   a pharmacy benefits manager; and   a medical supply provider.   
     
     
         3 . A method for processing healthcare data to discover cohorts and profile healthcare entities, the method comprising:
 receiving a first set of healthcare data associated with an event that occurred to a user in a healthcare facility;   receiving a second set of healthcare data associated with the user;   identifying an cohort associated with the event and the user;   performing analytics on the first set of healthcare data, the second set of healthcare data and the cohort;   generating a healthcare timeline of the user based on the analytics;   identifying a path based on the healthcare timeline of the user;   identifying a result associated with the path; and   generating a report based on the result associated with the path.   
     
     
         4 . A method for generating descriptive statistics, narrative reports, and quality measurements about healthcare providers and payers, the method comprising:
 receiving a first set of data from a source;   identifying an interaction between healthcare entities;   identifying a relationship between the healthcare entities;   performing analytics on the first set of data based on the interaction and the relationship; and   generating a second set of data based on the analytics;   identifying a cost associated with the interaction between healthcare entities and the relationship between healthcare entities based on the second set of data; and   generating a report based on the cost associated with the entities.   
     
     
         5 . The method recited above in  claim 4 , wherein the source includes one or more of:
 an insurance claim;   an electronic health record;   a digitized paper health record;   a wearable device;   a piece of feedback collected through a survey;   a third party dataset;   an accounts receivable;   an invoice;   a pharmacy benefits manager; and   a medical supply provider.   
     
     
         6 . The method recited above in  claim 4 , wherein the second set of data includes one or more of:
 a cost;   a treatment;   an outcome prediction;   a descriptive statistic; and   a narrative report.   
     
     
         7 . A method for processing healthcare data to generate a heath entity index, the method comprising:
 receiving a first set of healthcare data associated with a healthcare entity;   assigning an identifier to the healthcare entity; and   generating the heath entity index based on the identifier associated with the entity.   
     
     
         8 . An apparatus for processing healthcare data to discover cohorts and profile healthcare entities, the apparatus comprising:
 at least one processor; and   at least one memory including computer program code for one or more programs, the at least one memory and the computer program code configured to, with the at least one processor, cause the apparatus to perform at least the following,
 receive a first set of healthcare data from a source; 
 performing analytics on the first set of healthcare data based on an event that occurred in a healthcare facility; 
 identify a cohort based on the analytics; and 
 generate a second set of healthcare data associated with the cohort based on the analytics. 
   
     
     
         9 . The apparatus of  claim 8 , wherein the source includes one or more of:
 an insurance claim;   an electronic health record;   a digitized paper health record;   a wearable device;   a piece of feedback collected through a survey;   a third party dataset;   an accounts receivable;   an invoice;   a pharmacy benefits manager; and   a medical supply provider.   
     
     
         10 . The apparatus recited above in  claim 8 , wherein the apparatus is further caused to:
 identify a cost based on the second set of data associated with the cohort;   determine a fraudulent charge based on the cost and the analytics; and   generate a report based on the fraudulent charge, the cost, the second set of data and the cohort.   
     
     
         11 . An apparatus for processing healthcare data to discover cohorts and profile healthcare entities, the apparatus comprising:
 at least one processor; and   at least one memory including computer program code for one or more programs, the at least one memory and the computer program code configured to, with the at least one processor, cause the apparatus to perform at least the following,
 receive a first set of healthcare data associated with an event that occurred to a user in a healthcare facility; 
 receive a second set of healthcare data associated with the user; 
 identify an cohort associated with the event and the user; 
 perform analytics on the first set of healthcare data, the second set of healthcare data and the cohort; and 
 generate a healthcare timeline of the user based on the analytics. 
   
     
     
         12 . The apparatus recited above in  claim 11 , wherein the apparatus is further caused to:
 identify a path based on the healthcare timeline of the user;   identify a result associated with the path; and   generate a report based on the result associated with the path.   
     
     
         13 . An apparatus comprising:
 at least one processor; and   at least one memory including computer program code for one or more programs, the at least one memory and the computer program code configured to, with the at least one processor, cause the apparatus to perform at least the following,
 receive a first set of data from a source; 
 identify an interaction between healthcare entities; 
 identify a relationship between the healthcare entities; 
 perform analytics on the first set of data based on the interaction and the relationship; and 
 generate a second set of data based on the analytics. 
   
     
     
         14 . The apparatus recited above in  claim 13 , wherein the apparatus is further caused to:
 identify a cost associated with the interaction between healthcare entities and the relationship between healthcare entities based on the second set of data; and   generate a report based on the cost associated with the entities.   
     
     
         15 . The apparatus of  claim 13 , wherein the source includes one or more of:
 an insurance claim;   an electronic health record;   a digitized paper health record;   a wearable device;   a piece of feedback collected through a survey;   a third party dataset;   an accounts receivable;   an invoice;   a pharmacy benefits manager; and   a medical supply provider.   
     
     
         16 . The apparatus recited above in  claim 13 , wherein the second set of data includes one or more of:
 a cost;   a treatment;   an outcome prediction;   a descriptive statistic; and   a narrative report.   
     
     
         17 . An apparatus for processing healthcare data to generate a heath entity index, the apparatus comprising:
 at least one processor; and   at least one memory including computer program code for one or more programs, the at least one memory and the computer program code configured to, with the at least one processor, cause the apparatus to perform at least the following,
 receive a first set of healthcare data associated with a healthcare entity; 
 assign an identifier to the healthcare entity; and 
 generate the heath entity index based on the identifier associated with the entity. 
   
     
     
         18 . A computer-readable storage medium carrying one or more sequences of one or more instructions which, when executed by one or more processors, cause an apparatus to at least perform the following steps:
 receiving a first set of healthcare data from a source;   performing analytics on the first set of healthcare data based on an event that occurred in a healthcare facility;   identifying a cohort based on the analytics;   generating a second set of healthcare data associated with the cohort based on the analytics;   identifying a cost based on the second set of data associated with the cohort;   determining a fraudulent charge based on the cost and the analytics; and   generating a report based on the fraudulent charge, the cost, the second set of data and the cohort.   
     
     
         19 . The computer-readable storage medium recited above in  claim 18 , wherein the source includes one or more of:
 an insurance claim;   an electronic health record;   a digitized paper health record;   a wearable device;   a piece of feedback collected through a survey;   a third party dataset;   an accounts receivable;   an invoice;   a pharmacy benefits manager; and   a medical supply provider.   
     
     
         20 . A computer-readable storage medium carrying one or more sequences of one or more instructions which, when executed by one or more processors, cause an apparatus to at least perform the following steps:
 receiving a first set of healthcare data associated with an event that occurred to a user in a healthcare facility;   receiving a second set of healthcare data associated with the user;   identifying an cohort associated with the event and the user;   performing analytics on the first set of healthcare data, the second set of healthcare data and the cohort;   generating a healthcare timeline of the user based on the analytics;   identifying a path based on the healthcare timeline of the user;   identifying a result associated with the path; and   generating a report based on the result associated with the path.   
     
     
         21 . A computer-readable storage medium carrying one or more sequences of one or more instructions which, when executed by one or more processors, cause an apparatus to at least perform the following steps:
 receiving a first set of data from a source;   identifying an interaction between healthcare entities;   identifying a relationship between the healthcare entities;   performing analytics on the first set of data based on the interaction and the relationship; and   generating a second set of data based on the analytics;   identifying a cost associated with the interaction between healthcare entities and the relationship between healthcare entities based on the second set of data; and   generating a report based on the cost associated with the entities.   
     
     
         22 . The computer-readable storage medium recited above in  claim 21 , wherein the source includes one or more of:
 an insurance claim;   an electronic health record;   a digitized paper health record;   a wearable device;   a piece of feedback collected through a survey;   a third party dataset;   an accounts receivable;   an invoice;   a pharmacy benefits manager; and   a medical supply provider.   
     
     
         23 . The computer-readable storage medium recited above in  claim 21 , wherein the second set of data includes one or more of:
 a cost;   a treatment;   an outcome prediction;   a descriptive statistic; and   a narrative report.   
     
     
         24 . A computer-readable storage medium carrying one or more sequences of one or more instructions which, when executed by one or more processors, cause an apparatus to at least perform the following steps:
 receiving a first set of healthcare data associated with a healthcare entity;   assigning an identifier to the healthcare entity; and   generating a heath entity index based on the identifier associated with the entity.