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Using data analytics to prevent fraud, corruption

Kirsten Doyle
By Kirsten Doyle, ITWeb contributor.
Johannesburg, 31 Jan 2018
Sonja Parsons, owner of Business Management Assignments.
Sonja Parsons, owner of Business Management Assignments.

Trillions of dollars are spent globally on health services. The stakes are high and the resources precious: money lost to corruption could be used to buy medicines, equip hospitals or hire badly needed medical staff.

Moreover, health-care systems worldwide are extremely diverse, with a multiplicity of parties involved. There's a dearth of good recordkeeping in many countries, and huge complexity in terms of distinguishing between corruption, inefficiency and honest mistakes, which makes it difficult to determine the overall costs of corruption in this sector around the globe.

So says Sonja Parsons, owner of Business Management Assignments, who will be presenting on 'Applying data analytics to detect, prevent and predict fraud', at the ITWeb BI & Analytics Summit 2018, to be held at the Forum in Bryanston on 13 and 14 March.

"Why are we not using the Petabytes of data we have stored to detect, prevent and detect corrupt activities which could mean the difference between life and death in the health sector?" she asks.

ITWeb BI & Analytics Summit 2018

Register now to attend the BI & Analytics Summit 2018 at The Forum, Bryanston on 13 - 15 March 2018. Sonja Parsons will join other industry leaders in discussing their experience of the best practices for business intelligence and analytics. For the most up-to-date agenda click here.

To find out more and register for the ITWeb Business Intelligence & Analytics Summit 2018, go to: http://v2.itweb.co.za/event/itweb/business-intelligence-summit-2018/?page=agendaday1

Speaking of how can data analytics help prevent fraud, not only in the healthcare sector, but in general, Parsons says analytics answers the questions of when, where, how, who and how often, and with this information, the organisation can put corrective measures in place where necessary.

Analysis will reveal trends in spending. Unusually high volumes of claims at specific times, among other behaviours, may have to be forensically investigated to recover losses. She says it also reveals areas and occasions of under-payments and over-payments made "in error".

Moreover, it identifies doctors and or suppliers claiming in voluminous batches, and errors identified in analysed data expose training needs as well as weaknesses in systems.

Parsons says in her view, companies collect data over the years and often do not even use it effectively for their core operations. They archive the data rather than analyse it to disrupt their "same old, same old" ways of doing things. "Besides using data for risk management, the data can identify stale markets and products; high and low sales periods and other factors they had not even considered previously."

In terms of the takeouts delegates can expect from her presentation, she says if the IT department wants representation in the boardroom, it needs to dramatise the value it can bring to the organisation. "Management Information is more than a "system" - it is integral to the success of the business."

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