Challenge Overview
The Healthcare Fraud Prevention Partnership (HFPP) is building a network to exchange data between health insurers to detect and prevent fraud. An essential requirement is that data must be stored individually on each partner's premises, not centralized in a warehouse. The data exchange network must be decentralized and secure, and it must encourage reciprocity in sharing data.
The process of collecting and analyzing data is encapsulated in a concept called the study. Each study is a plan to answer certain questions about healthcare reimbursement claims that have been submitted to health insurers who are partners in the HFPP.
The front end of the HFPP system has a study management interface that is currently under development. In the initial version of the HFPP system, studies are designed by an external committee and delivered to a trusted third party (TTP) for execution. The TTP user enters a study in the form of business rules that express the following constraints:
- which partners are being asked to contribute data to the study
- what data is requested from each partner's database
Upon receiving the data requests, partners who agree to contribute to the study retrieve the requested claims and transform them into a standard XML format using a conversion module that is currently under development. The data exchange network will take the output of the conversion module and transmit it to the TTP for aggregation and analysis.
This contest will design the module architecture for Data Exchange Network Hub.
Final Submission Guidelines
Please see the wiki for the full requirements: