One Intelligent Platform for Benefits and Care Coordination
DOI:
https://doi.org/10.5281/ypkf1x41Keywords:
Systems engineering, smart cities. Digital economy. Digital Innovation. Digital Infrastructure. Health Systems. Health Operations, Operations Research, Business Analytics, Data Science, Intelligent Operations.Abstract
An Intelligent Health Operations Fabric (IHOF) unifies benefit administration and population-centered care coordination, much as a data fabric streamlines access to and use of data for analysis. Governance ensures data are complete, accurate, timely, protected, and provisioned at scale for analytic engines. Interoperability bridges, built on industry-standard components, give internal and external users controlled access to the fabric's data and capabilities. Workflow orchestration links supply and demand, integrates software systems, and coordinates business processes on behalf of and in support of individuals, while decision-support modules enable fact-driven decision making.
By bringing together these disparate functions, the IHOF addresses two questions that research and practice have largely treated separately: how to coordinate service delivery for a defined population, and how to improve the operational decisions that support that coordination. In doing so, it enables population health management and a better beneficiary experience across an ecosystem of health-related partners. Specifically, managed data access and use drive intelligent decision making that advances population health; enables equitable access to services; supports risk stratification, personalized care planning, and quality-focused functional outcomes; connects service delivery across geographic and institutional boundaries; engages patients and beneficiaries in their own care; enables systematic, continuous outcome measurement; and closes feedback loops for ongoing improvement.
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Data Availability Statement
No new datasets were generated or analyzed in this study. Illustrative figures and tables are conceptual and presented for explanatory purposes only.
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