Blockchain: Revolutionizing Healthcare Management Technology

Blockchain technology in healthcare has the potential to transform healthcare, placing the patient at the center. Organizations have started to invest in research and POCs as Blockchain has the potential to connect fragmented systems to generate insights and to better assess the value of care. According to Gartner, about 20% of healthcare providers and payers will have use cases for healthcare settings; the business value addition of this emerging Blockchain technology will exceed $176 billion by 2025, and $3.1 trillion by 2030.

A Blockchain-powered system can dramatically simplify the data acquisition process. It allow the user to upload data directly to the system and give an individual permission to use his data if it was bought through the system using a transparent price formula determined by data value model. In addition, it guarantees fair tracking of all data usage activity.

Let us look at some use cases where Blockchain has been making an impact in healthcare:

  • Health Records: The problem with the health system is that the patient record is scattered across various health systems during the patient’s journey. Blockchain is interesting and reliable as it is easy to track the health record scattered across multiple systems with its data integration ability between proprietary systems. Additionally, it has an innate quality of holding the fragmented health records. Blockchain could very well become a standard in healthcare interoperability.
  • Data Security: Since the crux of Blockchain is that the information is distributed at various locations, it guarantees that a large number of providers can behold the trust of data safeguard without exposing any private patient/consumer data.
  • Revenue Cycle, Reconciliation & Fraud: The complex nature of today’s health system means that millions of dollars are spent annually trying to figure out which patient received what service from which service provider. Blockchain could potentially form the foundation of a high-integrity tracking capability that is updated in a near instantaneous manner. This would lead to much fewer errors (with both financial and patient care upsides), substantially reduce fraud, and save on administrative costs.
  • Network Contract and Performance Management cross Partner System: Blockchain’s architecture helps in optimization of the network across partner systems, thus helping healthcare organizations scale.

 Healthcare CIOs need to realize that Blockchain technology is new and yet to develop fully. Early adopters will, however, reap benefits by operationalizing Blockchain in the organization, as it will create unique opportunities to reduce complexities.

There are a few things which CIOs must consider while adopting Blockchain into their organization such as reviewing their business model, processes and regulatory requirements, suitability with their business need, up to what extent they require to use Blockchain and so on. The diagram below (Source: Gartner) depicts the decision tree to be adopted for Organizations.

Diagram – Decision tree logic for adopting Blockchain (Source and Copyright: Gartner)

Most common questions faced by Healthcare CIO while thinking of adopting blockchain are:

  • To what extent do I rely on Blockchain?
  • Healthcare data is distributed so how easy will it be for me to implement Blockchain?
  • How to adopt Blockchain in the organization?
  • What is the relevant use case for my organization?
  • To what level will I need architectural changes if I were to implement the Blockchain?
  • How could I use it for interoperability?
  • What should be my strategy to ensure data security?

Keeping the above challenges in mind, some of the mitigation strategies that we adopted for data security and interoperability were using consortium Blockchain ICO and Exchanges – wherein a special access layer protocol was used taking care of data security providing more control with whom information should be shared. Taking into consideration all the capabilities of Blockchain and our expertise in the healthcare industry, we believe that it has capability to become a pivotal innovation.


Let us know if your organization faces any of the above challenges! For more information, reach out to us at

GitHub Acquisition: Reconciling GitHub with Microsoft

Microsoft’s most recent business move has shrouded the developer community in a state of wariness. GitHub, a popular open source code collaboration platform for developers and scientists (basically anyone working with data), was acquired by the tech behemoth for $7.5 billion. This figure represents an amount thirty times (!) GitHub’s annual recurring revenue.

Before the acquisition, GitHub suffered from multiple issues. These included serious monetary and leadership problems. GitHub narrowed solutions down to two options: the first was to hire a new CEO to streamline the company’s business direction and thus gain invaluable funding opportunities. The second option was to be acquired. GitHub chose this easier, faster path.

The optimal candidates to be acquired by were companies with access to large enterprise customers/subscriptions. This insight is derived from GitHub’s revenue model; GitHub is free for individuals but requires enterprise users to pay. Google, Amazon and Microsoft were among the

companies enticing GitHub with offers of acquisition. In the end, GitHub decided to go with Microsoft because of the tech titan’s more generous value offering. GitHub was also fully aware of Microsoft’s increased appreciation of open source (especially with Satya Nadella as CEO) and of its desire to show this to the world.

In this situation, Microsoft had an excellent opportunity to advance their own interests. First was the opportunity to show the world their transition from a propriety/monopoly based business to an open source model. Next was the all-important target of grabbing networking opportunities. Microsoft acquired LinkedIn in 2016, which enabled access to a network of professionals. With the acquisition of GitHub, Microsoft now has access to a network of developers. With this access to the largest pool of developer mindshare, they can compete with the likes of Facebook. With GitHub being the one of the largest code repositories, Microsoft can easily monitor new projects, interests, technologies, and market trends to stay ahead of the competition. Microsoft can also capitalize on an opportunity to woo developers more effectively by creating more offers and generating value, for example by creating attractive Microsoft based tool chains in open source to gain traction towards Microsoft technology. Lastly, the acquisition may have been an exercise in building strategic value. The strategic value – which pertains to how a certain company’s offerings help a different company (usually larger) to be successful – of GitHub, is essentially in the 85 million repositories and 28 million developers it hosts worldwide. It is not difficult to imagine the value of access to these developers, who regularly use GitHub’s code repository products, especially when the developers can be installed in Microsoft’s immensely profitable developer environment.

Microsoft’s long history of generally running counter to open source software, however, has led to lukewarm reactions from the developer community. Many developers feel that despite Microsoft’s attempts to foster acceptance toward an open source culture, Microsoft is not good for GitHub. This comes from GitHub’s initial premise of hosting distributed version control for remote coding for a flexible coding experience that could boost a developer’s community presence. Behind the developers’ tepid reactions are fears that Microsoft might leverage or co-opt their code for future products, or that the developers will be muscled into using only Microsoft products. Additionally, there are some direct conflicts between Microsoft and GitHub. For example, there are certain GitHub projects that are Xbox simulators. It is quite likely that Microsoft will kill these projects. There are even rumors that Microsoft may add tracking or advertisements to GitHub’s sites. There has thus been an upsurge in developers shifting their code to GitLab, one of GitHub’s prime competitors. In all fairness, however, this might be a reaction to a temporary fear.

So what is the future for GitHub? Looks like only time will tell.

AI and ML: The Next big leap towards innovative patient pro-active participation

In the year 1955, the computer scientist ‘John McCarthy’ coined the term ‘Artificial Intelligence’. From 1955 to 2005 computer scientist mostly used ‘Artificial Intelligence’ for research purpose. Additionally, they also checked if AI could be implemented across different industries.

In the year 2011, Apple introduced ‘Siri’ into the market and quickly the whole world started thinking about AI to solve the day-to-day activities. The recent example of this is ‘Google Duplex’, which can help to book an appointment by using AI and Machine learning technologies.

Similar to other industries, many companies in the healthcare market are investing a lot on AI and Machine Learning to enhance the quality of care, operations and engagement. Many healthcare IT companies are investing a lot in tech space for getting more data insights, enhance the virtual care and move patient’s risk zone from ‘At Risk’ to ‘Healthy’. For Healthcare community enhancing patient engagement has become the topmost priority. Artificial intelligence can certainly play an important role in achieving those outcomes.

Why AI is required in Patient Engagement

As healthcare industry is moving from FFS (fee For Service) to value-based system, the patient should be aligned to the centre position to get a better quality of service at minimum healthcare cost. To achieve this alignment, patient engagement tool is vital, which helps patients, providers and payers. In last 8 to 10 years, we have observed remarkable progress in patient engagement technology, which has been helpful to solve multiple challenges like access to patients about their patient info, web/ mobile based scheduling, communication with caregivers and many more. On the other hand, patient engagement still faces many challenges that need to be addressed. Some of the challenges are below:

  • More patient information to capture (habits, behaviour trend, emotional quotient, etc.)
  • Capture patient info before appointment though HRA (Health Risk Assessment)
  • Not having personalized healthcare education
  • Not having personalized care plan and tracking of the care plan

Current patient engagement processes are allowing patient to participate in care delivery. But this participation is only restricted when system/app informs them to participate (feed the questionnaire, upload reports etc.). Moreover, the patient should participate more ‘Pro-Actively’ in care delivery process. In an ideal scenario, patient should participate in care delivery process in form of suggestions, sharing their thoughts/emotions/ feelings/symptoms, feedback about physicians, etc.

Patient Engagement: Access-> participation-> Pro-Active participation

For last 5-6 years, the penetration of web and mobile patient portals has increased at the moderate pace. However, the patient data these systems are generating is humongous and we are not utilizing it for ‘Pro-Active Patient participation’. Let us look at how patient engagement has evolved over a period of time, and how is going to look like in the near future.


Tomorrow’s Patient Engagement

While implementing ‘Pro-Active patient Participation’, technologies like AI and ML will be used for data aggregation, data analysis and extracting deeper insights.

Most of the providers have started online appointment scheduling for their patients. In upcoming months, we can use AI and ML to automate the scheduling part, which could be helpful to reduce the admin cost of providers. At the time of scheduling, one can extract detailed patient information through personalized health risk assessment by using AI technologies. In the current patient world, nearly 74% patients forget their care plan after leaving doctor’s appointment. To reduce the percentages health systems should suggest personalize care plan to physicians based on aggregated data from multiple data sources.

Technology acts as a bridge between caregivers and patients to connect patients at the personal level and improve their health. ‘Pro-active patient engagement’ is the way forward to achieve the goal. It is quite evident how advanced technologies are helpful for building powerful patient engagement solutions.

In the future, during care plan tracking, personalized AI based patient education will be the key to boost ‘Pro-Active patient Participation’. These advance patient engagement activities will be helpful for better ‘Patient – Physician’ relationship.

Now that it is established that AI and ML will be a win-win for every healthcare entity, when are you planning to implement AI-ML techniques to enhance your quality of care? If you would like to find out more, feel free to write to us at

The Health Pivot Framework – The Next-gen Paradigm of Rule Engine

In our previous blogs, we discussed the industry challenges and how rule engines help overcome those challenges; we also elaborated upon the characteristics of  an ideal rule engine and factors that any CIO should consider when choosing a rule engine.

We had a quick introduction to  Health Pivot – a new age ideal rule engine that could very well be a solution for the most pertinent healthcare industry challenges. Health Pivot helps users define business rules, an operational environment that can apply and execute those rules in software to enable automated decisions, and tools to help teams monitor and maintain the effectiveness of sets of rules in response to changing healthcare situations or requirements.

Additionally, Health Pivot comes with the ability to collate data from multiple sources in  multiple formats. At the same time, it allows the maintenance of data quality while educating the user about data consistency and missing fields in the data, therefore making Health Pivot a topmost choice for any healthcare CIO. Health Pivot plays a major role in improving health outcomes. It delivers the efficiency and agility needed for better health care, lower costs, and rapid response to change.

In addition to the usual Rule Engine qualities you can find anywhere, there are features specific to Health Pivot.  Let us look at the features Health Pivot offers making it a standout Healthcare Rule Engine:

  Maintain Patient Information

Set the rules for comprehensive patient profiles including demographic data, claims records, and authorization data as well as a full clinical profile.

Develop Case Management

Create and deliver the most effective, personalized treatment plan for the patient condition while setting flexible rules.

Set Emergency Alerts

Streamline patient tasks and interactions, including authorizations and pre-authorizations, notifications, alerts, interventions and correspondence.

View Real-time Information

 Identify, evaluate and engage customers to take action to close gaps in care. Get detailed insights and compliance tools, including population stratification, predictive modelling integration, program assessment and audit.

Choose Flexible Visualization

Choose any visualization layer according to the  business needs for displaying real-time dashboard and ad-hoc reports. Get tailored reports, providing insights on performance and regulatory compliances.

So where is Health Pivot’s sweet spot? The framework is particularly applicable to operational, financial & clinical decision-making.

Following are some of the Health Pivot benefits, which ensure Healthcare transformation.

 Health Pivot Sweet Spot: Financial, Clinical and Operational

 Ease of Operation

The most important part of  Health Pivot is ease of use. It comes with a simple drag and drop functionality to choose fields for the rule and arithmetic operations that can be performed swiftly. Health Pivot drastically reduces operation time by informing the user if the chosen fields carry data. This means that the user is not compelled to wait until rule execution to find that the field is empty.

Ease of Finance

 Using Health Pivot, you can easily set financial rules relating to accounts receivable, accounts payable, patient receivable and run various financial reports based on business needs.

Ease of Patient Management

 Health Pivot gives you the flexibility of various clinical rules such as alerts on patients’ vitals going beyond the certain range, allergy alerts, CDSS alerts, vaccination alerts, etc.

Here is How Health Pivot Works

Benefits of Health Pivot Across the Healthcare Industry

Now that you have seen how and where Health Pivot can deliver business value, let us explore how exactly it is going to benefit the healthcare industry.

Rule Engine is the  necessity of the hour in the US healthcare IT world, and Health Pivot is an ideal solution to deal with the industry challenges.

Applying Health Pivot to businesses will be beneficial in more than one respect, as it will solve multiple business cases. In case of providers, it will take care of regulatory reporting such as MACRA-MIPS. Smartness of Health Pivot will recommend provider’s rules, which will be best suited viewing  the data sets, helping focus more on the patient.

It does not stop here as providers can also set custom rules, such as alerts, according to  business needs . Additionally, some of the most popular use cases used in daily operations include patients’ vitals going beyond a certain range, accounts receivable reminder, account payable reminder, patient’s collection reminder and many more.

For payers, it is not any different when it comes to HEDIS regulatory reporting, as it could easily take care of custom rules set for members, providers, financials etc.

As you can clearly see, Health pivot is very smart and healthy proposition for entire healthcare industry. Health Pivot as a framework fares better than any other Rule Engine because of its capability to be flexible and scalable as per any organizational requirement. While Rule Engines as packaged solutions lack customization capabilities, our Health Pivot framework can blend into any solution that your organization requires.

 However, what happens when it is compared with other Rule Engines available in the market?

Let us see how Health Pivot shapes up when compared to other Rule Engines:

Health Pivot Vs Other Rule Engines

To begin building an intelligent Rule Engine to solve your business needs, shoot an email to

Rule Engine: The next leap towards healthcare transformation

We clearly discussed in our last blog that the healthcare industry is experiencing a period of unprecedented change. Rising above all the chaos, Rule Engine is trying to bring lasting improvements in healthcare while minimizing expenditure. It might not be immediate, but a Rule Engine can play a pivotal part in improving operational flexibility for organizations. So what exactly is an ideal Rule Engine?

The Ideal Rule Engine

The term Rule Engine may sometimes sound confusing, as it can be any system that uses rules, in any form that can be applied to data to produce outcomes. This includes simple systems like form validation and dynamic expression engines. Many tools and technologies are used when it comes to engineering a rule engine such as Drools, JBoss, jBPM. They use expressions and delegates in its decision nodes, which control the transitions in a Workflow. It becomes confusing as to which rule engine suffices the need of the business.

An ideal Rule Engine should collate data from multiple sources, ensure data quality and allow the user to create a rule as per business needs. Business rule management gives an additional advantage over a general-purpose Rule Engine, as it provides an advantage for the custom rule creation, analysis, data collaboration, multi-facet collaboration, management, visualization of charts and graphs. For instance, what if a rule engine suggests to the user which rules can be created when multiple data sets have collaborated. Does this scenario sound helpful when it comes to regulatory reporting such as MACRA-MIPS and HEDIS reporting?

While a lot of Engines in market claim to be an ideal Rule Engine, following are some important factors that need to be taken into contention by CIO’s.

Factors to consider when selecting a rule-engine

Some of the very popular Rule Engines in the healthcare IT world does not provide flexibility to create own rules easily, and visualization has its own limitations as it is not in the user’s control. It also lacks the recommendation or suggestion part wherein a user can know which of the rules are feasible at the time of creation.

Important factors influencing CIO’s decision to choose a rule engine depends on how fast a rule engine can adopt to the existing workflow. An ideal Rule Engine allows to collate data from multiple sources, provides flexibility to create own customized rules.

You should explore the following capabilities in particular:

  • Is it easy for non-technical users to author rules?
  • Can authors use tools in collaboration with each other, or do they each have to work separately using their own individual tools?
  • Does it suggest what rules can be applied and does it provide visualization as per the choice of the user?
  • Can the engine quickly determine which rules or rulesets to apply based on the nature of the data?
  • How well the Rule Engine works when it comes to the data security?

The most important point to keep in mind – no single rule engine allows regulatory reporting and helps create rules of choice as per business need. It means that organization must have more than one Rule Engine and should keep different workflows in mind. Performance is also a big issue in some of the popular rule engine since it does not foresee that data could become so large.

What if we told you that there is an ideal rule engine that can take care of regulatory reporting and custom rule creation. In addition, it can take care of data collaboration from multiple sources, data security and ensure that performance is not hampered at any given time.

In future, technologies such as machine learning, artificial intelligence (AI) & robotic process automation will play an important role in Rule Engine – as it evolves from the current state. Furthermore, workflows will become more automated with minimum manual intervention. Nitor’s futuristic Rule Engine known as Health Pivot is one of the forerunners in applying AI-ML & RPA based concepts.

Health Pivot is a new generation ideal rule engine framework – which gives flexibility even for a non-technical person to create own rules and has the pre-defined rule to choose from a list of for regulatory reporting. It can easily collate data from multiple sources and ensure data quality as well.

In our next blog, we will discuss Health Pivot in detail, till the time stay tuned.

Health Pivot – Mitigating US Healthcare Challenges to Create Better Patient Care

Note: This is the first part of a three-part blog series detailing how Nitor has created a futuristic framework that aims to nullify the challenges of the US Healthcare industry.

 Healthcare is experiencing a radical change around the U.S market. A dramatic overhaul of guidelines fused with disruptive digital technologies, has caused major changes in payer-provider model.

Payers and Providers mostly work in silos with restricted patient data sharing – limited to claims and financials. While both of them aim to reduce cost and provide quality care, they face the challenges of having restricted access to patient information. What is needed here is a collaboration in leveraging payer and provider data to assess gaps in care. This could be achieved easily if the data is used meaningfully, for instance if the providers combine EHR and payer data, they would be able to infuse meaningful insights into patient health. It is only possible if the providers start thinking beyond processing the financial information available in the payers data.

Payers are increasingly feeling the need for payer-provider collaboration and are willing to invest and take the initiative to assess the gaps in care, which will lead to improved patient management and lowered claim value.

Nevertheless, there is still plenty of work, which needs accomplishment; healthcare industry conflicts are nothing new. Legislation and technology will continue to modify its landscape. Doctors, and their medical teams must evolve their focus & approach to meet those challenges. Let us have a look at some of the challenges in the current industry workflow.

Ever Changing Compliance

 The US healthcare industry is monitored rigorously against stringent regulatory norms. As many of these regulations undergo routine changes, the healthcare industry is under constant pressure to keep up with the changes.

Recent study shows that healthcare executives are additionally burdened to comply with an assortment of freshly revised standards including the Health Insurance Portability and Accountability Act (HIPAA) and many more. On the top of standalone reporting requirements that each of these standards bring in, healthcare providers need to take care of interdependencies as well.

For instance, the healthcare reform legislation increases the number of people covered under Medicaid by more than 25 million. Consequently, the healthcare industry is faced with the prospect of creating, storing, encrypting and protecting 25 million more EHRs. Combine this with the need to report on the actions taken in a regular manner, HITECH compliance will increase volumes in CMS reporting needs.

Data Aggregation & Breaches

 The problem in healthcare lies with the aggregation of the data. To derive insights from data, it is critical that they be accurate and relatively complete. When data is divided and systematically biased through either errors or omissions, the correlations that give rise to new insights will be missed or turn spurious, and could result in misguided confidence or scarce resources dedicated to chasing down dead ends.

Additionally, patient privacy issues, including worries about data breaches, continue to be a challenge for providers & payers.

Providers and payers are constantly looking for the best practices for data security to avoid the type of HIPAA violations that can negatively affect an organization.

Assessing Gaps in Care 

 Health systems are trying to put together integrated techniques to delivering care, which enhance the overall quality for the patient.

The problem that still remains- what level within the provider healthcare system should be held responsible for quality, and how can this be achieved most effectively. One of the major problem is that providers do not have sufficient time to look at the complete health record of a patient and subsequently write a care plan for the patient.

Other most common and prominent difficulties are: data transfer and data merging across different information systems with secure protection of sensitive patient data.

Technology Framework: The Saviour of the Hour

Despite the challenges, many clinicians and health care organizations are making progress by using right technology to provide better care for their patients.

As we charge headlong into the future, those of us in the healthcare industry are striving to create a better system overcoming challenges. Some of the recent use cases are helping to achieve the ultimate goal of quality care and improved patient engagement. Is there a one-size-fits-all solution that can tackle some of the major challenges discussed above?

The answer is Rule Engine – A smart, customizable healthcare data aggregator framework for enhancing patient care journey. Rule Engines help healthcare organizations around the world make better, more informed decisions that increase outcomes, grow revenues, cut costs and liability. Additionally, Rule Engines integrate data from multiple sources providing meaningful insights. This means smarter decisions about products, claims and care in challenging environment.

Let us look at some of the Rule engine use cases, which proves it is a boon.

1) MACRA MIPS Solution:

With CMS introducing MACRA-MIPS program to replace PQRS and other quality programs, providers have turned skeptics. An ideal rule engine allows you to implement MACRA MIPS solution by looking at the available provider data and suggest which rules could be reported to the CMS.

2) Alert Engine:

Prevention is better than cure is a dictum suited to all but what is important is to treat it in time for a higher survival rate. A Rule Engine is capable of setting alerts when patient parameter goes beyond normal range, with the user able to set custom alerts as per standard practices.

3) Financial Reports:

One of the major advantage of the Rule Engine is that it allows setting financial reports as per business needs with custom visualization for the report.

4) Payer-Provider Collaboration:

US healthcare is moving towards patient quality care rather than quantity, complete picture of the patient health; using payer and provider data becomes an important aspect in assessing gaps in care. A rule engine is capable of combining payer and provider data to get complete health record of the patient. It ultimately helps to derive gaps in care, which is the need of the hour.

Importance of Rule Engines and how it changes the dynamics in healthcare

 It is quite clear that a Rule Engine is the solution for the challenges above. Not only does it combine data from multiple sources but also works in real time as per the business needs. It makes it easy for the users to configure rules and set the notifications, alerts, automation, predictive maintenance and much more. An advanced Rule Engine can fulfil that role by ingesting real-time data, reasoning on those data and invoking automated actions based on the result of that reasoning process.

Check out our next blog where we discuss in detail about how an ideal rule engine should look like!

How to Skyrocket Your Venture’s Funding with ICOs

ICOs (Initial Coin Offering) have gained tremendous traction in today’s world of digital currency. Built upon the security, trust and transparency of the Blockchain paradigm, ICOs have helped companies raise 7 billion USD as of May 1, 2018. This is a rise from 5 billion USD in 2017.These facts, coupled with the recent favorable economic climate, indicate that this the optimal time to capitalize upon the rising tide of cryptocurrency.

Read on to discover how and why you should raise maximum funds with this innovative business model.

Why ICO?

ICOs merge the power of crowdfunding with the allure of cryptocurrency.

In an ICO, internet users view your value proposition and invest in your vision by buying tokens. Note that this happens before the actual token-based marketplace is released to the world. The next step is a full exchange in which the issued tokens can be traded for other currencies. This structure motivates the public to participate in the ICO and own as many tokens as possible to gain on future enrollment into cryptocurrency exchanges. Because Blockchain technology underlies ICOs, users can be assured of security, transparency, and trust.

Building an ICO Platform

Nitor’s ICO platform follows certain best practices to ensure that your ICO is a success. First, all necessary ICO information is presented on an intuitive website. This includes token information, ICO duration, the beneficiary wallet address, and interfaces to popular cryptocurrency wallets. After this critical step, it is advisable to ask white-listed users to register and share their information so you are sure that every payment is legitimate.

During the ICO, it is useful to display the token status. This is usually shown as Total Tokens Sold vs. Total Tokens Allocated (known as a hard cap). It is also a good idea to have a token calculator, which shows the relationship between one token and a cryptocurrency such as Ether, Bitcoin etc. You will also need to display a transaction history. This is a list or record of transactions showing wallet addresses, amount invested, transaction costs and transaction signatures. This also helps in maintaining accurate records.

If issues arise, architectural modularity helps quickly identify and fix problems so that token sale can progress. An AML (Anti-Money Laundering) feature ensures that if, based on data analysis, you see an issue with a particular transaction post-payment, you can reclaim the issued token. Finally, remember that it is important to market your ICO. A strong integrated email notification engine automatically feeds ICO highlights to subscribed users. This has the potential to be used as a powerful marketing tool.

Ethereum-based Engineering Guidelines

Some helpful guidelines for Ethereum-based engineering include:

  1. Choose Modular HTML5 frameworks for front-end development as you may be looking to integrate an existing website instead of developing from scratch.
  2. Leverage the Truffle framework. This is useful for the creation of Smart Contracts.
  3. Follow the best practices in writing solidity files.
  4. Use a sandbox/test network such as Ropsten for integrated tests.
  5. Ensure 100% code coverage for all development.
  6. Modularize Smart Contracts for maintainability.
  7. Ensure that a third-party auditor, instead of the developers involved in writing code, conducts the security audit of Smart Contracts.
  8. Deploy your Smart Contracts to the Ethereum public network.

Nitor implements all these and more so that you can hold a profitable ICO.

Key Considerations

Before running your ICO, decide on a minimum funding goal (known as a soft cap). Complete the requisite research beforehand to understand what this number should be. Next, remember to avoid issuing tokens before the sale ends. This is important as record keeping becomes easier. Issue tokens only after the minimum funding goal is achieved and the token sale officially ends. If the minimum funding goal is not achieved, however, it is best to refund the money and modify your approach. With the guidance of Nitor’s dedicated experts, you can avail the benefits of a secure sandbox ICO platform to pre-test token sales.

Nitor’s services can help you at every stage of the ICO process. Nitor can get to the heart of the complicated code of Smart Contracts, leaving you free to strategize and innovate. We also help you drive innovation with 70% of ICO contract features already in place. With our knowledgeable teams, you can set the stage with your ICO website within two short weeks.

ICOs are one of the most useful, secure, and transparent tools for fundraising today. Nitor can help you leverage the brilliant power of Blockchain technology with the application of the aforementioned tips. With our experts, you can craft a brilliant strategy to generate the funding that your revolutionary product deserves.

If you would like to benefit from our world-leading Blockchain arsenal to raise funds for your venture, reach out to us at

Nitor at HIMSS18

Nitor is presenting at HIMSS 18 Conference. HIMSS brings together 45,000+ professionals from around the world for five full days of education, innovation and collaboration to help uncover the promise of health information and technology. No other conference brings you world-class healthcare education, cutting-edge products and solutions, and the unique networking opportunities you need to solve your biggest health information and technology challenges –  all in one place.

Nitor will be exhibiting at HIMSS18 in Las Vegas, from March 5th  to March 9th , 2018, at booth #11013. We are excited to highlight the transformation that Nitor has brought to the healthcare industry. Our modern frameworks and technology approach enables care teams to deliver innovative, patient-centric programs across case, disease, utilization and wellness management.

Come meet us to discuss  everything related to Care Management, check out our live demos, and win exciting raffle prizes!

Top 3 reasons to visit Nitor at HIMSS 18:

Care Management

Learn how Nitor helps unlock and integrate the full breadth of information for care providers, automates care management workflows, and scales to meet the ever-changing demands of population health .

Understand how Nitor’s Modern Care Management accelerators are improving risk stratification, deploying machine algorithms for effective care plans & offering advanced analytics for with top-notch data quality for deeper insights.

Live Demo

Come watch live demos highlighting our cutting-edge accelerators that enable effective care management, increasing patient engagement, improved wellness applications, and superior payer-provider collaboration. The following is a  list of demos we will showcase at HIMSS 2018:

  • Patient portal & App Framework
  • Out-of-pocket calculation framework
  • Bundle payments framework
  • Payer-provider collaboration framework
  • Emergency care (IOT) Framework
  • Wellness (Wearable Device Integration) Framework
  • Interoperability (HL7 2 * FHIR), rule engine

Additionally, check out the live demos of Nitor’s smart accelerator, Health Pivot. Discover how Health Pivot allows users to create  customized rules, generate reports, set alerts, and much more for better health outcomes, lower costs and a rapid response to change.

Furthermore, learn about our machine learning capabilities in Health Pivot that enable you to set flexible rules to create and deliver the most effective, personalized treatment plan for the patient’s condition.

Raffle Prize

Last but not  least, don’t miss out on an amazing chance to win an all-new  Amazon Echo Spot. Drop your business card at our booth to try your luck!.

We would love to meet you!For more information, please visit

About Nitor’s Healthcare Offerings:

With innovation in both healthcare  and technology, Nitor provides accelerator frameworks that significantly improve product time-to-market. This helps  ISVs to stay ahead of the curve and deliver quality healthcare applications, better engagement and flexibility. With our accelerator frameworks, we enable healthcare ISVs to build innovative solutions which improve consumer engagement, payer and provider operations, and payer-provider collaboration.

Visit to discover more.

Top Healthcare technology advances for 2018

In  2017, the new U.S. Presidency pushed industries to follow the ‘wait-and-watch’ approach. Unlike other factors, a change in the government always brings new compliances and strategies, which could impact business plans and product roadmaps. During the presidential campaign, President Trump’s vocal contempt for Obamacare was evident. Due to this, the healthcare industry was a little skeptical about the health IT systems investments.

We experienced that healthcare IT  transformed a lot since 2010, i.e. from the early days of Obamacare. Since the last two years, healthcare professionals have started talking about various new technologies such as AI, machine learning, blockchain for healthcare, etc. This is an obvious reaction from the healthcare industry, as it is usually the last one to adapt. Though everybody refers  to advanced technologies for business, in our conversation, we found  that the real penetration of such technology is still in the nascent stage..

Because of all these lows and a few other factors, the industry  slowed down. It has now just started to open up with new product plans, new technology adoption plans, business expansion roadmaps and many other plans for growth. Let us look at the Healthcare technologies you should keep an eye on this year:

1. Artificial Intelligent (AI) and Machine Learning

AI and machine learning require enormous amounts of  data to be functional. Professionals have spent a decade  building such data repositories that can be fed into the algorithm.  Until the end of 2017, professionals we spoke to mentioned that they felt comfortable with the tech after verifying a few use cases on basic modules to check feasibility. This year, they want to focus on taking this further by moving from  pilot to real projects.

From 2000 to 2017, the majority of paper-based systems  transformed into  paperless electronic systems. In this timeframe, a majority of  healthcare professionals were busy converting these paper-based systems to different web technologies.

In 2013, the industry sensed that  the enormous amount of healthcare data could be leveraged through web technologies and utilized  for better insights.

This year, we predict that the following functional areas will be in focus to implement AI and machine learning.

Care management –  improve patient insights for better care management

Wellness platforms –  plot patient’s health roadmap and work on disease prevention through wellness

Provider/ payer operations – to reduce the operation cost, improve relationship (satisfaction score) and time for provider and payers

2.  Internet of Things (IoT), Internet of Medical Things (IoMT) and Wearables

According to Gartner, “By 2020 more than 95% of new product designs featuring electronics will incorporate connected sensor component”.

Last year, various IoT, IoMT, and major tech companies launched their wearable device collections into the market. Apple has made a huge investment in the advancing carekit and research kit to track  vital health stats.

‘Prevention’ is the big reason behind the soaring popularity of wearable healthcare devices. Features such as tracking patient data and identifying the patient’s risk score, and suggesting wellness activities through which a patient could lead a healthy life, are very popular

This year, we expect more hospital devices to turn into BLE devices to gather more data. One more functional area in which we can expect massive changes through IoT technologies is in homecare and hospice. IoT devices become very handy when it comes to virtually tracking a patient’s statistics.

3. Voice and chatbots

In the current healthcare market, penetration of voice bots and chatbots is low compared to other technologies. Google and Amazon are trying to grab the maximum market share through their voice bots, Google Home and Alexa respectively. This year, many tech companies will incorporate chatbots and voice bots into their existing applications. Consider the use of voice bots in the homecare and hospice setup. We saw an increased request from our customers to add a chatbot and voice bot feature in the patient portal for extra comfort and better engagement. It also does not hurt, if in the process we can gather better data for insights.

 Bots are crucial because they act as a supplement to machine learning and AI algorithms. We spoke earlier about how these AI algorithms hog  data. Bots leverage focused conversations to easily gather patient data . Bots not only help to capture patient vital stats but can also gather behavioral data.

4. Augmented reality and Virtual reality 

At the last HIMSS conference, Microsoft showcased how ‘Microsoft Hololense’ could be useful in healthcare. Google also re-launched the ‘Google glass’. Augmented reality and virtual reality will be very useful for physicians to view a patient’s data  in a completely different manner.

This year, we can assume that various tech companies will evaluate feasibility by implementing basic functional modules. Although the technology penetration will remain low for the year, we see the tremendous potential.

In  2018, the Blockchain technologies will evolve to the next level. We are sure of one thing – by the end of 2018, we might have taken a few more steps towards matured data engineering market in healthcare industry.

Lets us know what you think of it!


Nitor Healthcare Team


Best Practices for Fixed Price Proposals

Fixed Price proposals are tricky to deal with. Any fixed price and fixed schedule proposal has the chances of budget and/or schedule overrun. This can affect the profitability of the project.

Best practices on writing the fixed price proposal to cover the risks are as below.

  1. Proposing a Discovery Phase where the clarity is around 70%. This helps in:

a. Locking the scope of the entire project, in the interests of predictability. A Flexiblity Matrix, for example, will help guide initial scope and planning discussions. A WBS (Work Breakdown Structure) can organize the work to be completed by the entire team.

b. Finalizing the technology stack

c. Finalizing the UI/UX

d. Finalizing the business rules

e. Finalizing the hardware/devices etc. to be supported

f. Creating a technical rapport with the customer team

g. The deliverables of the discovery phase should be as follows:

  • Architectural recommendations
  • Detailed user stories documented for the project along with acceptance criteria
  • UI/UX defined along with wireframes/mock-ups
  • Detailed release plan created along with sprints defined in all releases
  • Commercials & milestones defined as per the defined scope

2. Proposing an MVP-Minimum Viable Productwhere clarity is low

a. This helps the customer to gain confidence

b. A customer can approach the market and get market feedback

c. Customer can define the next plan of action

3. Proposing creation of a Proof of Concept (POC) for technical items for  the clarity of requirements if the  technical approach is unclear

a. This helps in finalizing the approach, which can be estimated

b. Customer gains confidence about the approach

4. Proposing multiple approaches:

a. Multiple technologies approach

b. Multiple timelines and budget approaches

c. This helps in gauging the customer’s budget and technology preference. In turn, the understanding evolves.

5. During estimation, appropriate padding/buffer needs to be added:

a. The padding or buffer should be over and above base development efforts. The development efforts should include the infrastructure setup, design, architecture and user interface efforts.

b. The Rough Order of Magnitude (ROM) estimate should be also be calculated. A ROM is a cost estimate provided for budgeting purposes. Seventy-five percent accuracy of a ROM is considered acceptable.

c. If the number of resources allocated to the modules of project is more than 5 per module, redundancy has to be considered

6. Mapping of customer’s objectives to our approach plan

a. List all customer’s objectives –technical, strategic, operational, go-to-market, process, etc.

b. Map these objectives and provide action plan with periodic reviews


7. Documenting the assumptions in detail

a. Assumptions are the basis of estimates. Therfore they must be documented in detail

b. Assumptions should be classified as :

  • Scope related – This are assumptions about the overall scope of project/engagement
  • Technical assumptions – These can involve the technology stack, integration with existing software, globalization, devices/browsers etc. supported, user interface, interfaces exposed etc.
  • Non-functional requirements related – These can involve security, performance, scalability, hosting etc.
  • Project Execution – Execution methodology, execution and documentation tools, collaboration techniques, points of contact etc.
  • Expectations from customer – Customer specific requirements such as infrastructure, VPN/network, software/hosting licenses etc. should be documented

8. Attaching appropriate case studies in the proposal – technical, domain, process-related

9. Having sync-ups with customers before the proposal due date to get as many details as needed

10. Change requests  are important for any fixed price proposal as scope creeps can affect the cost and/or schedule, leading to situations in which it may become necessary to re-baseline immediately.

a. Change request process should be documented. This includes:

b. Change management process for scope and schedule changes

c. Change request logs – documentation of change requests

d. Change request steering committee definition – this is for approval of CRs and escalation handling

f. Change request approval process

g. Procedure for change request addendum for cost and/or schedule changes

h. The proposal should also define the upper limit of the cost of a change request as a percentage of the overall cost of the project.

11. Providing an appropriate governance structure as per customer characterization

a. Strategic customers should have a fortnightly review with the steering committee, including the leadership team and a weekly sync up with the management team

b. Mid-size customers should have a monthly sync-up with the steering committee, including the leadership team and a weekly sync up with management team

c. Start-ups should have a heightened sync-up – twice a week reviews with the management team

12. Define payment milestones as below:

a. Kick-off should have a major chunk of payment – 30-40%

b. Milestones until QA should be defined as per actual resource loading

c. UAT and defect fixes milestones should be for 2-3 weeks and should have 10% final payments

d. Documenting all payment details – travel, payment realization etc. and appraising customers