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.