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 marketing@nitorinfotech.com.

About Ravi Agrawal

Senior Lead Business Analyst

  • Healthcare
  • FHIR
  • Blockchain
A self-confessed healthcare warrior, an expert in Medicare, Medicaid, ACO, and Integration projects, Ravi speaks HL7 as a language. A doctor, doubling up as a Healthcare consultant, he is always a ‘patient’ person (pun intended) with a business mind. He says that technology never ceases to amaze him, and he is a student forever.