Healthcare Data Analytics

faster.  easier.  smarter.

COVID-19 UPDATE: Pulselight is using healthcare data NOW to help Public Health organizations fight the Coronavirus. For Fraud Waste and Abuse. To track virus Penetration, Impact Analysis and Contact Tracing. For Oversight of Elderly, Disabled and Disadvantaged.

2019 NASCIO Recognition Award

NEWS: Pulselight’s technology finalist in NASCIO’s 2019 State IT Recognition Awards for Data Management, Analytics & Visualization: “Cross-Agency Data Sharing to Drive Value and Save Money"

power to solve your challenges

The Power to Solve Your Most Difficult Healthcare Challenges

At the heart of Pulselight is our Torch® Analytic Platform – a one-of-a-kind analytics framework that allows you to:

  • Easily get the right data ready for analysis
  • Surface interactions, relationships and affiliations between people and events
  • Leverage automated analytics, including statistical models, AI algorithms and link graphs
  • See and explore critical information, regardless of technical skill
  • Log in from wherever you are through HIPAA-approved, web-based software

In short, Pulselight’s Torch Platform is the key to transforming your data into simple, actionable intelligence – to tackle any healthcare challenge.  Below are examples of where Pulselight is making an impact today.

COVID-19 Task Force

Payment Integrity

Fraud, Waste, and Abuse

Opioid Utilization

Critical Incidents

COVID-19 Task Force

Pulselight’s COVID-19 Task Force is doing the following:

  • Finding fraud, waste, and abuse in public healthcare programs, where resources are scarce, and populations are most at risk. It’s a sad truth that amidst tragedy, bad actors will create new schemes to abuse emergency policies and relaxed billing rules. Pulselight is helping to stop them in their tracks. Measure and understand the way your program or plan pays for services from multiple dimensions: procedure code, provider type, specialty, claim types
  • Using healthcare data to monitor the safety and wellbeing of those most in need in our public system, including the elderly, disabled and developmentally disadvantaged. To do this, Pulselight is detecting adverse incidents, diagnosis spikes, penetration clusters and the impact of isolation.
  • Highlighting clusters of high-risk patients and penetration. Once new program bulletins or laws are enacted, we can track impact on public health, cost and resources. We can trace contact spread by location and individuals.
  • Using AI techniques to prioritize findings and build explainable, predictive models to measure risk at the patient, provider or program level.

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Payment Integrity

Through a simple web browser-based interface, our suite of Payment Integrity tools allows you to:

  • Measure and understand the way your program or plan pays for services from multiple dimensions: procedure code, provider type, specialty, claim types
  • Find efficiencies or deficits in your provider network or reimbursement structure
  • Make informed decisions regarding reimbursement or policy changes, and then track the effects over time
  • Uncover geographic hotspots or areas with service deficiencies

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Fraud, Waste and Abuse

Root out bad providers and identify improper payments with Pulselight’s Fraud, Waste & Abuse Solution:

  • Take advantage of pre-built analysis tools such as Impossible Days, Inpatient Overlap and Shared Patients
  • Construct and analyze suspicious provider billing behaviors in real time
  • Easy-to-understand, interactive charts that visualize the situation and clearly point to bad actors
  • Discover provider networks and hidden connections using the Pulselight Graph
  • Gain instant insight with provider and member Profile Pages

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Opioid Utilization

With the Pulselight Opioid Utilization Solution you get:

  • The right measures to illuminate and act on opioid addiction, overdose, over-prescribing and improper filling
  • Clear understanding of dangerous overlapping drug combinations
  • Easy-to-understand, interactive charts that visualize situations and trends
  • Seamless blending of pharmacy claims and patient medical history
  • The intelligence you need to take the right actions and track their progress

Shining a Light on Opioid Abuse

Download the MME Calculator

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Critical Incidents

Use the claims/encounter data you already have to protect those most vulnerable:

  • Proactively identify incidents of injury, illness or death for at-risk populations in various settings:
    • Developmentally disabled in group homes
    • Elderly or disabled in nursing homes
    • Foster children in group homes
    • At-risk members in home care settings
  • Quickly identify those in need of help, and facilities with evidence of abuse or neglect
  • Make use of diagnosis-based incident categories to better understand patterns
  • End the reliance on voluntary incident reports as your only means of detecting danger