Automatic analysis of process and/or operations data related to a benefit manager organization

Patent metadata

Field	Value
Publication number	US-11257012-B1
Application number	US-201715685784-A
Country	US
Kind code	B1
Filing date	Aug 24, 2017
Priority date	Jun 9, 2017
Publication date	Feb 22, 2022
Grant date	Feb 22, 2022

Abstract

A device may receive data associated with a benefit manager organization. The data may relate to a performance of the benefit manager organization and hardware resources associated with the benefit manager organization. The device may process the data using a technique after receiving the data. The device may map the data to a benefit manager operating model based on processing the data. The benefit manager operating model may identify a functional area or a sub-area of another benefit manager organization. The device may perform an analysis of the data based on mapping the data to the benefit manager operating model. The device may identify a deficiency related to the performance of the benefit manager organization. The device may perform an action to positively impact the performance of the benefit manager organization based on identifying the deficiency. The action may reduce the deficiency.

First claim

What is claimed is:

1. A device, comprising:
one or more processors to:
receive data associated with an organization,
the data relating to a performance of a process or operations of the organization,
the data relating to hardware resources of the organization used to implement the process or the operations;

identify, based on processing the data, metadata associated with the data,
the metadata being used to identify a type of the organization with which the data is associated,
the type including at least one of:
 a pharmacy benefit manger (PBM) organization, or
 a specialty PBM organization;

determine, based on identifying the metadata associated with the data, the type of the organization;
select, based on determining the type of the organization, an operating model to use to perform an analysis of the data,
the operating model including at least one of:
a PBM operating model associated with the PBM organization, or
a specialty PBM operating model associated with the specialty PBM organization;

map the data to the operating model based on processing the data,
the operating model to be used to compare the organization to one or more other organizations;

perform the analysis of the data based on mapping the data to the operating model;
identify an infrastructure of the organization based on performing the analysis of the data;
identify a deficiency related to at least one of the performance of the organization or the infrastructure of the organization based on identifying the infrastructure; and
configure, in real-time and based on the identified deficiency, at least one of:
another device associated with the organization, or
software to be online or offline.

2. The device of claim 1 , where the one or more processors, when identifying the infrastructure, are to:
identify the infrastructure of the organization based on performing the analysis,
the infrastructure of the organization including at least one of:
a quantity of call centers associated with the organization,
a quantity of departments of the organization, or
a quantity of claims processing centers of the organization.

3. The device of claim 1 , where the one or more processors, when receiving the data, are to:
receive cross-domain data associated with multiple types of organizations,
the cross-domain data including data elements related to other organizations associated with one or more other industries different than an industry associated with the organization; and

where the one or more processors are further to:
generate the operating model based on the cross-domain data.

4. The device of claim 1 , where the one or more processors are further to:
identify a metric or a rule associated with the organization based on mapping the data to the operating model,
the metric or the rule to be used when performing the analysis; and

where the one or more processors, when performing the analysis, are to:
perform the analysis based on identifying the metric or the rule.

5. The device of claim 1 , where the one or more processors, when mapping the data, are to:
map the data to the operating model to identify a manner in which an individual interacts with the organization; and
where the one or more processors, when performing the analysis, are to:
perform the analysis to identify the deficiency related to the manner in which the individual interacts with the organization based on mapping the data to the operating model.

6. The device of claim 1 , where the one or more processors are further to:
receive other data associated with a manufacturing organization in association with receiving the data; and
where the one or more processors, when mapping the data, are to:
map the data to a manufacturing operating model based on receiving the other data.

7. A method, comprising:
receiving, by a device, data associated with a benefit manager organization,
the data relating to at least one of:
a process implemented by the benefit manager organization, or
operations of the benefit manager organization;

processing, by the device, the data using a technique to permit an analysis of the data after receiving the data,
the technique to be used to format the data to permit mapping or analysis of the data;

identifying, by the device and based on processing the data, metadata associated with the data,
the metadata being used to identify a type of the benefit manager organization with which the data is associated,
the type including at least one of:
a pharmacy benefit manger (PBM) organization, or
a specialty PBM organization;

determining, by the device and based on identifying the metadata associated with the data, the type of the benefit manager organization;
selecting, by the device and based on determining the type of the organization, a benefit manager operating model to use to perform the analysis of the data,
the benefit manager operating model including at least one of:
a PBM operating model associated with the PBM organization, or
a specialty PBM operating model associated with the specialty PBM organization;

mapping, by the device, the data to the benefit manager operating model based on processing the data,
the benefit manager operating model to be used to perform the analysis of the benefit manager organization,
the benefit manager operating model being associated with one or more other benefit manager organizations;

performing, by the device, the analysis of the data based on mapping the data to the benefit manager operating model;
identifying, by the device, an infrastructure of the organization based on performing the analysis;
identifying, by the device, a deficiency related to at least one of the performance of the organization or the infrastructure of the organization based on identifying the infrastructure; and
configuring, by the device, in real-time, and based on the identified deficiency, at least one of a device associated with the organization or software to be online or offline.

8. The method of claim 7 , where processing the data comprises:
processing the data to identify a manner in which the benefit manager organization implements the process or the operations after receiving the data; and
where performing the analysis further comprises:
performing the analysis of the manner in which the benefit manager organization implements the process or the operations based on processing the data.

9. The method of claim 7 , further comprising:
receiving other data associated with the one or more other benefit manager organizations prior to receiving the data associated with the benefit manager organization;
identifying one or more functional areas or one or more sub-areas with which the other data is associated after receiving the other data;
generating, after receiving the other data and based on identifying the one or more functional areas or the one or more sub-areas, the benefit manager operating model; and
where receiving the data comprises:
receiving the data after generating the benefit manager operating model.

10. The method of claim 7 , where identifying the deficiency is based on identifying a functional area or a sub-area that the benefit manager organization is missing based on mapping the data to the benefit manager operating model.

11. The method of claim 7 , further comprising:
monitoring, based on configuring the other device or the software, the process or the operations.

12. A non-transitory computer-readable medium storing instructions, the instructions comprising:
one or more instructions that, when executed by one or more processors, cause the one or more processors

Assignees

• Accenture Global Solutions Ltd

Inventors

• Malhotra Dinesh
• Pawar Milind
• Westcott Peter
• Slagg Barbara

Classifications

• G16H40/20

  for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms · CPC title

• G06Q10/0639

  Performance analysis of employees; Performance analysis of enterprise or organisation operations · CPC title

• G10L15/18

  using natural language modelling · CPC title

• G06Q10/06395 Primary

  Quality analysis or management · CPC title

• G06Q10/067

  Enterprise or organisation modelling · CPC title