VegaLytics Platform

Solution for guiding future of
health systems

overview

VegaLytics

Accurate and reliable information is vital for decision-making. Having this information at your fingertips is a crucial aspect of running and growing your successful business. VegaLytics, a Digital Population Health Platform is designed for today’s Health plans and Health systems to improve member health outcomes. VegaLytics provides unique predictive insights to address population needs, emerging health risks, and opportunities for improvement.

We created a modern data warehouse, designed specifically for health systems. This warehouse brings together all your data sources – from customer enrollment to medical IoT – at any scale. Platform Ingests, Cleanses, Collates and Curates data and makes it ready for consumption. Our analytics dashboards then deliver high quality and reliable insights. All your users will have access to needed operational reports and advanced analytics.

Platform includes:

With these innovations, the platform infuses powerful capabilities that give access to an unparalleled depth of data, making it easier for you to make smarter health decisions for current and new members.

VegaLytics is built from the ground up to combine the low-cost storage of a data lake with the strong data structure of a traditional data warehouse. In addition to this ideal combination, it adds the capability to combine any form of data, from any source, and yield analytical insights, including streaming analytics. The plug-n-play platform is hosted in Microsoft Azure cloud and is secured with Microsoft’s HITRUST foundation.

Key Benefits of VegaLytics:

  1. End to End Digital Population health platform at about the same cost as 0.5 FTE
  2. Early identification of high-risk Health Plan members, allowing the development of a patient-centered care approach.
  3. Identify high cost claimants, claim leakages, episode costs, avoidable ER and many more insights to help manage cost and quality of care
  4. Compare Provider performance based on care costs
  5. Single source of truth enriched with metadata to serve varied health system business needs
  6. Compliance and performance reporting to Customers at the click of a button
  7. Eliminates the need to engage multiple vendors for Data Management, Reporting and Analytics
  8. Operates without organizations having their own source systems.
  9. Very powerful tool for small and medium ASOs, TPAs, Health Systems with limited IT staff and resources

VegaLytics with plug-N-play features

overview

Data Ingestion

Health Systems and Health Plans are experiencing a deluge of data. Rapid advancements in social media, data acquisition technologies, digital imaging devices, and wearables are all dumping massive amounts of diverse data into the hands of health plans. This adds to the already-complex network of multiple providers with different IT systems

VegaLytics is designed to ingest any type of Health or Social data. It has prebuilt adapters to ingest EDI, xls, csv, images, IoT, voice, video into a single system.

overview

Data Curation

Data Curation has five components:

1. Translation and Standardization
2. Data Quality Engine
3. Common Data Model
4. Reference Data Sets
5. Data Warehouse

Translation and Standardization:

A Healthcare eco system produces varied types and formats of data which can be challenging to translate and extract insights for the right context. Additionally, along with mergers and acquisitions, most Health Systems are challenged further wrangling additional sources and perform activities which includes, but is not limited to, data standardization and interoperability, across thousands of cases and providers.

VegaLytics has a UI based data translation engine to convert structured data into a common data model. The data translation engine comprises of a set of tools for EDI conversion, xls, csv, direct ingestion of SQL, IoT, Voice, Image and Video into the storage location. The platform requires no coding, only configuration. This greatly reduces the time needed to go live.

Data Quality Engine:

VegaLytics Data Quality Engine has prebuilt business rules covering Demographic, Claims, Eligibility information helping Health systems to jumpstart their Data Quality Management (DQM) initiative. It is designed to help run your growing business efficiently by onboarding new customers data smoothly. This ensures all your client’s data is processed and mapped correctly – thereby detecting any early claim leakages. Engine is designed to be scalable, flexible that can integrate with any of client’s partners and can work with any type of
data.

The pre-built rules are classified under three categories:

  • Data Cleansing Rules: Validates data structures and formats against definitions in the common data model. For example, Social Security Number or Zip codes having alphabets.
  • Data Domain Rules: Validates data rules for defined health data domains and values. Examples: Member is missing coverage dates, Date ranges for coverage are invalid, etc.
  • Business Logic Rules: Validates Business rules on Domains or cross-domains. For example: claim date outside benefit coverage, Payments matching issues with claims, etc.

The cleansed data is fed into the modern data warehouse or can be served back to the health system for further analysis.

Common Data Model:

VegaLytics includes a Common Data Model (CDM) which represent your organization’s logical entities. This acts as a base for information correlation. CDM relates information from all business areas and enables context creation, providing the backbone for an organization’s decision-support, analytical, and information environment. It is designed to accommodate new lines of business, new payment models, supporting evolving government mandates on compliance reporting and wide range of analytical applications.

Reference Data Sets:

VegaLytics has built in referential data sets: CPT, ICD9/10, RevCodes, HCPCS, etc. grouped as per industry standards to provide meaningful insights to the business. Building these relationships enables viewing information from multiple perspectives to gain stronger business insights.

Datawarehouse:

Health system specific Common Data Model based Datawarehouse for curated and collated data to build contexts such as Episodes, Categorizations, ICD/CPT matching, High cost claimants, low cost Providers and many more. Additionally, enriches information with industry reference data to support slicing and dicing for different perspectives. Datawarehouse represents a single source of truth and makes the information available on-demand for visualization or any of your other needs, internal or external. Datawarehouse is easily extensible to bring in other quality data sources to meet your enterprise information needs and leverage your existing investment in VegaLytics.

overview

Healthcare Analytics

VegaLytics provides out of the box descriptive reporting and analytics that help you identify opportunities to focus and reduce cost of care. The VegaLytics package comes with many insights at your fingertips, providing accurate analysis of your current customers and healthcare economics. This allows you to keep cost of care low by producing the following reports:

  • Utilization Metrics
  • High cost claimants
  • Avoidable ER
  • Episode and line level costs
  • Cost variance by provider
  • Claims Breakdown
  • Enrollment Guide
  • Provider Performance and many more

All relevant calculations are pre-built into the platform, allowing the business to deal with actionable insights at a click of a button. Look at some of our key visualizations below.

Executive Dashboards with Drill-Through

 

VegaLytics comes with Executive and Customer Dashboards with various breakdowns such as: Inpatient, outpatient, professional, pharmacy, total active members, total claims paid, total amount by state, Avoidable ER analysis, High Cost member view. Every view and dashboard provide an option to drill-through and gives a look at specific member view.

Utilization Dashboards

Utilization Metric provides you set of reports and dashboards that gives an organization all the information about your utilization. JBS also has algorithm to bifurcate your ER population into Avoidable ER and frequent ER visitors, Provides visibility into various inpatient admissions such as: NICU, Maternity, Surgery, SNF, etc. Provides information into top diagnostic for selected time. This allows the health systems to know about utilization, any population at risk and make better decisions.

Provider Performance Dashboards

VegaLytics Platform provides set of dashboards that can enlighten health plan, health systems about their provider performance, brings cost variance at the surface. Our out of the box dashboards gives you a bird’s eye view into cost variance and then lets you drill down to the variance per provider. This helps case management teams to manage patients effectively providing you the best quality of care at reduced cost.

overview

Risk Stratification

One of the key issues that most ASOs, Health Plans struggle with is

  1. Identifying high risk customers
  2. Predicting probability of hospitalization and
  3. Predicting future costs

VegaLytics has an integrated Risk Stratification model which predicts all the above and more. Jade’s out of the box Risk Stratification Engine leverages demographic data, diagnosis information and prior resource usage for your members. It also uses their pharmacy data to provide required indicators for population health management such as:

  1. Member risk score
  2. Hospitalization prediction scores
  3. Care coordination risk scores
  4. Pharmacy adherence risk scores
  5. Total healthcare cost
  6. Pharmacy cost

This serves as the guide for your case management team to focus on the high utilization, high risk members and improve the quality of care while reducing costs.