Meta-analysis of fraud, waste and abuse detection methods in healthcare

Fraud, waste and abuse have been a concern in healthcare system due to the exponential increase in the loss of revenue, loss of reputation and goodwill, and a rapid decline in the relationship between healthcare providers and patients. Consequently, fraud, waste and abuse result in a high cost of healthcare services, decreased quality of care, and threat to patients’ lives. Its enormous side effects in healthcare have attracted diverse efforts in the healthcare industry, data analytics industry and research communities towards the development of fraud detection methods. Hence, this study examines and analyzes fraud, waste and abuse detection methods used in healthcare, to reveal the strengths and limitations of each approach. Eighty eight literatures obtained from journal articles, conference proceedings and books based on their relevance to the research problem were reviewed. The result of this review revealed that fraud detection methods are difficult to implement in the healthcare system because new fraud patterns are constantly developed to circumvent fraud detection methods. Research in medical fraud assessment is limited due to data limitations as well as privacy and confidentiality concerns.Keywords: abuse, fraud, healthcare, waste, fraud detection method

Information Technology and Computer Science

Abstract- The healthcare system is a knowledge driven industry which consists of vast and growing volumes of narrative information obtained from discharge summaries/reports, physicians case notes, pathologists as well as radiologists reports. This information is usually stored in unstructured and non-standardized formats in electronic healthcare systems which make it difficult for the systems to understand the information contents of the narrative information. Thus, the access to valuable and meaningful healthcare information for decision making is a challenge. Nevertheless, Natural Language Processing (NLP) techniques have been used to structure narrative information in healthcare. Thus, NLP techniques have the capability to capture unstructured healthcare information, analyze its grammatical structure, determine the meaning of the information and translate the information so that it can be easily understood by the electronic healthcare systems. Consequently, NLP techniques reduce cost as well as improve the quality of healthcare. It is therefore against this background that this paper reviews the NLP techniques used in healthcare, their applications as well as their limitations

Social robots as psychometric tools for cognitive assessment: a pilot test

Recent research demonstrated the benefits of employing robots as therapeutic assistants and caregivers, but very little is known on the use of robots as a tool for psychological assessment. Socially capable robots can provide many advantages to diagnostic practice: engage people, guarantee standardized administration and assessor neutrality, perform automatic recording of subject behaviors for further analysis by practitioners. In this paper, we present a pilot study on testing people’s cognitive functioning via social interaction with a humanoid robot. To this end, we programmed a social robot to administer a psychometric tool for detecting Mild Cognitive Impairment, a risk factor for dementia, implementing the first prototype of robotic assistant for mass screening of elderly population. Finally, we present a pilot test of the robotic procedure with healthy adults that show promising results of the robotic test, also compared to its traditional paper version

An Appraisal of Content-Based Image Retrieval (CBIR) Methods

Background: Content Based Image Retrieval (CBIR) is an aspect of computer vision and image processing that finds images that are similar to a given query image in a large scale database using the visual contents of images such as colour, texture, shape, and spatial arrangement of regions of interest (ROIs) rather than manually annotated textual keywords. A CBIR system represents an image as a feature vector and measures the similarity between the image and other images in the database for the purpose of retrieving similar images with minimal human intervention. The CBIR system has been deployed in several fields such as fingerprint identification, biodiversity information systems, digital libraries, Architectural and Engineering design, crime prevention, historical research and medicine. There are several steps involved in the development of CBIR systems. Typical examples of these steps include feature extraction and selection, indexing and similarity measurement. Problem: However, each of these steps has its own method. Nevertheless, there is no universally acceptable method for retrieving similar images in CBIR. Aim: Hence, this study examines the diverse methods used in CBIR systems. This is with the aim of revealing the strengths and weakness of each of these methods. Methodology: Literatures that are related to the subject matter were sought in three scientific electronic databases namely CiteseerX, Science Direct and Google scholar. The Google search engine was used to search for documents and WebPages that are appropriate to the study. Results: The result of the study revealed that three main features are usually extracted during CBIR. These features include colour, shape and text. The study also revealed that diverse methods that can be used for extracting each of the features in CBIR. For instance, colour space, colour histogram, colour moments, geometric moment as well as colour correlogram can be used for extracting colour features. The commonly used methods for texture feature extraction include statistical, model-based, and transform-based methods while the edge method, Fourier transform and Zernike methods can be used for extracting shape features. Contributions: The paper highlights the benefits and challenges of diverse methods used in CBIR. This is with the aim of revealing the methods that are more efficient for CBIR. Conclusion: Each of the CBIR methods has their own advantages and disadvantages. However, there is a need for a further work that will validate the reliability and efficiency of each of the method