ABNORMAL BEHAVIOUR AND FRAUD DETECTION BASED ON ELECTRONIC MEDICAL RECORDS
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United States of America Patent
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app pub date -
Dec 18, 2014
filing date -
Dec 18, 2014
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Abstract
Methods and systems for detecting and mitigating fraud by proactively analyzing and correlating Electronic Medical Record (EMR) audit log information in real-time are provided. According to one embodiment, activity information is received and queued in real-time as it is posted to audit logs of an EMR system onto a message queue of an EMR fraud and risk mitigation system. The activity information includes information regarding timing of an access to a database of multiple databases of the EMR system, a type of the access and a user initiating the access. The activity information is correlated and analyzed in real-time by one or more analysis models by dequeuing the activity information from the message queue and applying configurable rules maintained by a rules engine. The existence of one or more related events potentially indicative of fraud are detected based the results of the real-time correlation and analysis.
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