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Tokyo’s Kita City in trial to streamline use of AI in nursing care insurance processing

Tokyo’s Kita City in trial to streamline use of AI in nursing care insurance processing

As
part of the efforts to enhance social security benefits, especially against the
backdrop of aging population in Japan, Tokyo’s Kita City is partnering Fujitsu
to conduct a trial to evaluate
application of artificial intelligence (AI) to the municipality’s mission
critical systems in nursing care insurance processing.

According to the press release by Fujitsu, the field trial is
to evaluate how AI can be used to streamline tasks associated with guidance and
supervision of nursing care benefit claims from service providers, which Kita
City employees can customarily process by hand.

In
March 2015, the Tokyo Metropolitan Government announced the Improvement Plan
for Long-Term Care Benefits (3rd Phase) to make nursing care benefits fairer, by appropriately
identifying the beneficiaries of nursing care services, ascertaining the
services beneficiaries truly need through appropriate care management, and
promoting the delivery of appropriate services by providers in accordance with
the rules.

Under the Improvement Plan,
employees of Kita City will assess and analyse the appropriateness of
certification applications from nursing care service providers and nursing care
benefit claims. Based on its analysis, the Kita City is also responsible for
supervising and providing guidance associated with payments for nursing care
benefit claims to the nursing care service providers.

Although there are increase in both
the number of people certified as requiring care and in the number of care
facilities in Japan to cope with the aging population, there is also growing
volume of information and work related to guidance and the analysis of nursing care
benefit payment details.

As
the analysis of nursing care benefit claims must be conducted in great detail,
with reference to laws such as the Long-Term Care Insurance Act, it requires a
high level of skill and a great deal of time. The use of AI could potentially
reduce the burden on employees and improve the efficiency of the analysis
process.

Utilising
Fujitsu Human Centric AI Zinrai, the field trial in Kita City aims to improve the efficiency of nursing care
benefit payment operations and further enhance the services nursing care
service providers offer to residents. The trial has been launched in January
and will run until March 2018.

In this field trial, machine
learning technology is deployed by systems engineers to create a model to analyse
the appropriateness of claim details. Machine learning will be applied to
analyse data, such as past nursing care benefit claims from service providers
in Kita City's nursing care insurance system.

Kita City aims to use the insights
gained from this field trial not only to increase the efficiency of processing
nursing care benefit payments that employees previously had to spend time
handling, but also to further rationalize nursing care benefit claims.

Credit: Fujitsu

The technology Fujitsu Human
Centric AI Zinrai is developed
by Fujitsu Hokuriku Systems, combining both customer business expertise and
software development technology.

In this project, Fujitsu
trains machine learning algorithms on data, including appropriate nursing care
benefit claim data and claim data that required guidance and supervision, from
past claims by nursing care service providers stored in Kita City's nursing care
insurance system. Then, a model is built to automatically analysis nursing care
claim data.

The
newly built model will be used to analyse the appropriateness of nursing care
benefit claim data, and evaluate the results of those analyses against past
guidance and supervision records

Going forward, Fujitsu aims to offer the trained
model Zinrai as a service to local governments across Japan.

PARTNER

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