Data Analytics and Insights (DAISI) is a data warehouse and analytics tool for health claims and related data administered by IBM Watson Health. All the organizations that supply health and wellness products and services as part of the Group Health Insurance Program put data into DAISI through a secure file transfer process. DAISI organizes and protects this data and has tools to help make sense of the data.
- ETF uses DAISI to analyze Group Health Insurance Program data. Staff can see trends in health, quality and costs.
- ETF uses this data to make cost effective decisions and recommendations for the Group Health Insurance Program.
- The data helps staff identify where education and information is needed.
- ETF and the Group Insurance Board (GIB) use information from DAISI to better understand members’ health needs and identify opportunities to improve their health and quality of care.
- ETF and the GIB will also gain a better understanding of how many people have chronic conditions, such as diabetes or heart disease and can use that understanding to work with the health plans to develop or improve care management and other programs.
Data in DAISI
DAISI securely collects and stores enrollment, claims, and wellness data for all participants of the State Group Health Insurance Program. This data flow graphic shows how this works.
A claim supplies data on a service (e.g., health care visit, prescription) you received covered by the Group Health Insurance Program. The claim has codes for each service that gives information used as data, such as:
- Date of the service
- Service provider name and location (e.g., doctor, place)
- Payment information
- Amount billed
- Copay or coinsurance amount
- Amount insurer paid to the provider
ETF can use this data to monitor and improve the Group Health Insurance Program. For example, ETF will be able to closely monitor health plan and provider performance and compare it to a variety of standard cost and quality measures. ETF could then develop incentives to improve that performance. This will ensure members receive high quality, valuable and cost-effective care.
ETF does not have access to information that shows personally identifiable information about an individual receiving the service. Only your doctor, other health care providers, and your benefits administrators for medical, pharmacy, dental and wellness have access. Under HIPAA privacy and security rules they have access to give you care and to properly process claims.
IBM Watson Health had to prove to ETF that it could keep our member ’s data secure to become our data warehouse vendor. They had to meet federal standards for data security and multiple reviews of security standards, testing, processes, and resources.
ETF and the Group Insurance Board holds IBM Watson Health to strict privacy and security requirements. ETF consulted with data security experts to make sure the requirements met the highest standards. All data sent to the data warehouse is encrypted in a way that cannot be read by unauthorized parties.
ETF treats privacy breaches very seriously. There are protections in place to prevent a breach. However, if there ever were a breach, ETF and IBM Watson Health have detailed processes in place for handling such a breach, as required under HIPAA privacy and security rules. In the event your data would ever be compromised, you will be notified in writing.