...
- Create Reports DB datamart with all the required data about doctors, MSP, declarations, etc. that should be used as a source for the fraud detection reports.
- Configure the real-time data streaming from the PRM DB, OPS DB, MPI DB, etc. to the Reports DB datamart. There should be no personal data in the Reports DB.
- Use BI tool to analyze data in the Reports DB and create reports to detect fraud suspicious activities.
- Responsible persons should analyze reports, do the investigation and perform some follow-up actions.
- Use the NHS admin to perform the follow-up actions in case if fraud has been confirmed. For example, block/unblock MIS, block/unblock MSP, block/unblock user, etc.
| Scope Item | Description | Status |
|---|---|---|
| Report 1: Number of patients per doctor | M | |
| Report 2: Number of patients registered for the same phone number | M | |
| Report 3: Number and percentage of patients per doctor that have set offline authorization method | M | |
| Report 4: Number and percentage of patients per legal entity that have set offline authorization method | M | |
| Report 5: Frequency of declarations changes per patient |
| Descoped | ||
| Fraud Data Mart | Provide datasource for MoH analysts | M |
| Fraud Data Mart ETL procedures development | M | |
| Deploy and configure BI System of choice | M | |
| Action 1: Block/Unblock User and related entities | M | |
| Action 2: Block/Unblock MSP | M | |
| Action 3: Block/Unblock MIS | M | |
| NHS Admin portal update | Provide ability to ban/block/unblock core entities that defined as fraudsters | M |
Open questions:
BI tool to be used - Yevhen - 9/10/17
Fraud DB vs. Reporting DB - Katerina - 9/10/17
| Milestones | PIC | Date |
|---|---|---|
| Decide on architecture | ||
| Chose BI Tool | Yevhen | |
| Provide report templates | ||
| Actions Defined | ||
| Design Fraud Data Mart | ||
| Design Approved | ||
| Actions Specifications finished | ||
| ETL Specifications finished | ||
| NHS Portal Specifications finished | ||
| Data Mart Dev Finished | Alex Troush | |
| Test Scenarios and Data prepared | ||
| Data Mart Tested | ||
| BI Tool deployed and connected | Valery Litvinov | |
| Reports Configured | ||
| Actions developed | ||
| NHS Admin developed | ||
| NHS Admin tested |