EXL Health believes in the power of Human Ingenuity – our innate ability to work alongside our clients to create solutions for their most complex problems.

Across the company, our team members leverage Human Ingenuity as the catalyst to look and go deeper to solve the challenges that are standing in the way of what payers, providers, pharmacy benefit managers, and life sciences companies need to do to accomplish their goals.

Human Ingenuity is a mindset that propels us to adapt and adopt quickly as market forces change. We don’t back down just because the problem is difficult. Instead we apply a combination of domain expertise, data and analytics, and cutting-edge technology to find answers. At EXL Health, we embrace challenges to solve real-world problems for our clients.

Human Ingenuity in Action

Here are just a few examples of how EXL Health went above and beyond to help solve our clients’ challenges:

  • Enabling self-service investigation capabilities

    A large U.S. health insurer has a team that specializes in identifying fraud and abuse. They were manually running reports in multiple data sources to find outliers that required further review. We knew there had to be a simpler way.

    We created a view that pulls all the required summarizations from claims, member, and provider data to evaluate potential issues. The report can be easily shared with other parties assisting with the investigation. By automating the process, we eliminated the need for four full-time employees to manually create reports.

    More importantly, the investigators are now able to investigate more providers and identify potential fraud much more quickly than before with an estimated savings of $2 million.
     
  • Real time, natural language processing (NLP) framework in weeks

    A provider needed to extract medical referral requests from free form text and fully automate the end-to-end process. Our team had one month to figure out how to accept as many as 20,000 documents per day, run them through our NLP algorithm, and return structured data into our care management system for scheduling.

    We saw that the project’s requirements weren’t much different than the needs of the systems that are at the core of our Care Management application. So, we developed a scaled-down implementation that effectively applied well understood design principles in that domain to this project.

    The resulting back-end application successfully routed requests as required. We also developed real-time monitoring so that if any request was slow, or if extracted data was not of sufficient quality, or if any request failed, the system stopped processing and notified operators to fix the problem.
     
  • Hospital Operations Dashboard

    The COVID-19 pandemic has and continues to cause significant operational and administrative challenges for hospital and healthcare systems across the United States. Addressing these challenges translates into delivering the much-needed support for the front-line healthcare providers and the care that patients desperately need.

    A health system in the Midwest was looking for a way to leverage its hospital data to measure its operational efficiencies during the pandemic, as well as plan for various circumstances.

    Based on the health system’s requirements and hospital data assets, EXL Health designed and co-developed a dashboard that allows the hospital’s administrators to quantify and illustrate patient flows through various channels of admission, measure occupancy rates on staffed beds vs. available beds, and determine supply levels and needs based on current burn rates of inventory. The dashboard also allows the client to conduct “What if” analyses, enabling the client to measure the impact on its key resource metrics for different scenarios.
     
  • Multiple Sclerosis patient analytics

    A life sciences client wanted to identity the attributes of Multiple Sclerosis patients who were dropping out of treatment vs. those patients who adhere to care plans.

    Our team deployed several statistical regression/machine learning algorithms that helped identify these patients. As part of the approach, we created a decision tree that visually displayed what patient attributes were correlated to staying on therapy. This enabled our client to understand the complex nature of the underlying analysis in an easy-to-understand design.

Human Ingenuity delivers real results

EXL Health relentlessly innovates to help our customers transform their businesses. It’s part of our DNA to always look deeper to find a better way and be a trustworthy partner in our clients’ pursuit of healthcare excellence.

Together, we will do this.

Author:

Sue Willman
SVP and General Manager of EXL Health Pharmacy and Data & Analytics

Contact US