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Integrated Web Services Platform for the facilitation of fraud detection in health care e-government services

Obiettivo

Public healthcare is a basic service provided by governments to citizens expected to come under rising pressure as the European population ages and the ratio of working to elderly persons falls. A way to make public spending on healthcare more efficient is to ensure that the money is spent on legitimate causes. The project aims to design and develop a flexible fraud detection web services platform, which will be able to serve e-government processes of fraud detection and prevention, in order to ensure quality and accuracy and minimise loss of health care funds.

The platform will be accessible via Internet from actors involved in the heath care business. They will be able to detect erroneous or suspicious records in submitted health care data sets, ensuring homogeneity and consistency and promoting awareness and harmonization of fraud detection practices among health care systems in the EU. Critical project objectives include, development of an ontology of health care data associated with semantic rules, implementation and initial population of an ontology and rules repository, development of a fraud detection engine and implementation of a self-learning module, which will be able to learn new rules from suitable data and properly update the central rules repository.

iWebCare impact can be substantial. More money on healthcare mean better healthcare. Living conditions, and the trust of citizens in public healthcare will be improved. This may lead to reduction of private expenditure on healthcare and money saved can be invested on other activities. Finally, iWebCare will also improve working conditions and performance in the administrations financing public healthcare. The development of the platform offers large exploitation potential, as fraud detection is needed in all forms of government-citizen interaction where some form of financial claim is involved. The commercial target of the platform initially, will be public and private providers of healthcare insurance.

Coordinatore

INSTITUTE OF COMMUNICATION AND COMPUTER SYSTEMS
Indirizzo
Patission Street 42
10682 Athens
Greece

Partecipanti (7)

AGILIS ANONYMI ETAIREIA STATISTIKIS KAI PLIROFORIKIS
Greece
Indirizzo
Akademias 77
10678 Athina
FRAUNHOFER IAF
Germania
Indirizzo
Tullastr. 72
79108 München
INTRASOFT INTERNATIONAL SA
Belgio
Indirizzo
Rue Montoyer 40
1000 Bruxelles
ROYAL BROMPTON & HAREFIELD NHS TRUST
United Kingdom
Indirizzo
Sydney Street
SW3 6NP London
SOCIAL SECURITY BODY OF HEALTH PROFESSIONALS
Greece
Indirizzo
Aharnon 27
10439 Athens
UNIVERSITA DEGLI STUDI DI NAPOLI FEDERICO II
Italia
Indirizzo
Corso Umberto 1
80138 Napoli
UNIVERZITA KOMENSKEHO V BRATISLAVE
Slovacchia
Indirizzo
Safarikovo Nam 6
Bratislava 16