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Health Insurance verified Verified Outcome TRL 9

Interoperability & Longitudinal Records

domain Client: A major health insurance company handshake Provider: Google Cloud Healthcare API schedule Deploy: 2023
85 Impact
Enterprise Ready
Evidence Score: A/10
Strength: High

Executive Summary

ANALYST: COI RESEARCH

Ingestion of 2.5 petabytes of data into a cloud-native platform to create a real-time longitudinal patient record.

rate_review Analyst Verdict

"Low Risk (Strategic). Payer-provider data convergence is the primary trend in the sector. Cloud APIs (FHIR) are the only viable mechanism for this scale."

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Full Audit Report Available Includes Risk Register, Technical Specs & Compliance Data.

warning The Challenge

Member health history was fragmented across claims, EHRs, and HIEs. The payer lacked a timely view of member health, leading to delayed authorizations and gaps in care.

psychology The Solution

Built a data foundation on Google Cloud. Uses the Healthcare API to ingest and normalize data to FHIR standards, creating a longitudinal record accessible to both payers and providers.

settings_suggest Technical & Deployment Specs

Integrations
Legacy Mainframes / HIEs
Deployment Model
PaaS
Data Classification
PHI / Claims
Estimated TCO / ROI
High
POC Summary ( to )

"N/A"

shield Risk Register & Mitigation

Risk Factor Severity Mitigation Strategy
Privacy Regulations High De-identification services

trending_up Impact Trajectory

Audited value realization curve

Ingested 2.5 PB of data Verified Outcome
Primary KPIImproved prior authorization speed (directional)
Audit CycleEnhanced fraud detection capabilities

policy Compliance & Gov

  • Standards: HIPAA / CMS Interoperability Rule
  • Maturity (TRL): 9
  • Evidence Score: A/10
  • Data Class: PHI / Claims

folder_shared Verified Assets

description
Verified Case Study
PDF • Version 1
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Technical Audit
PDF • Audited
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The "Blind Verification" Protocol

How we verified these outcomes for A major health insurance company without exposing sensitive IP or identities.

Private
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1. Raw Evidence

Audit ID: #PRIV-509
Evidence: Direct SQL Logs
Public
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2. Verified Asset

Outcome: Verified
Ref ID: #COI-509

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