Is Your Workflow Working? Finding Facts in Healthcare Litigation and Investigations

Are you a healthcare provider or payor with any of these concerns?

• Your company is trying to manage its budget for litigation and investigations but can’t find the most effective approach
• You’re concerned that you may be missing critical insights because you can only review a small subset of your document population to stay within your budget
• You’re subject to an investigation and you want to quickly understand if the government or opposing party has any “gotcha” information
• You want to proactively perform a risk assessment to monitor for fraudulent activities

If so, you’re not alone. These are challenges that depend on finding pertinent facts, many of which are buried in the volumes of electronic information most companies now have, quickly and efficiently. In the healthcare industry especially, where litigation and investigation risks are common, complex data environments can pose confounding obstacles to finding key information quickly.

In the case of any litigation or investigation, it pays to be able to hit the ground running.  Early and effective fact-finding can provide valuable insights for both company and counsel, enabling cost-effective resource alignment based on the strength of the case and faster development of the narrative.

Since most insight comes from an assessment of facts that lie within electronically-stored information (ESI), advance preparation for data preservation and collection is critical. So is having the right methodology, tools and expertise in place to find key information once you’ve identified the most important data to explore. Here’s how to optimize those efforts.

It's all about data. Plan accordingly.

In today’s complex healthcare data landscape, knowing (and finding) the key documents and other information located within massive data collections is no mean feat. Although many data repositories in an enterprise are contained and accessible, today’s myriad data sources, from mobile devices to billing systems to sensor data, are growing in size and complexity every day. Advance planning can speed up the process and enable straightforward and beneficial negotiations with the opposing counsel or regulatory agency.

What to do? In advance of litigation or investigation, make sure the enterprise maintains an inventory of data systems that includes descriptions of business owners, users, locations, functionality, backups, data types, possible PII/PHI, and a potential preservation/collection approach. Counsel and in-house legal teams should work with IT to organize this information in a format that can be useful for eDiscovery to enable an expeditious and organized response to a matter.

Then make sure that you have the right experts to preserve/collect data from the implicated sources. You may need forensic collections or different ways to extract relevant information from certain data stores. Databases and other structured data sources may require reporting rather than collection techniques, for example, and it’s best to know that early, when you can inform and negotiate with the requesting agency or other side, setting expectations and mitigating potential conflict.

Finding key documents quickly is essential. Scrap an out-of-date workflow and explore new methods and tools.

There are complex needs involved in a litigation or investigation response and a dizzying array of service providers, tools and technologies to choose from, with new ones being offered every day. The traditional workflow of finding key documents—developing keyword search terms to cull the documents then performing a manual review—is just not efficient. New data analytics and machine learning tools (not to mention the experts that provide them) have opened up a whole new fact-finding horizon. Imagine a team of linguists and search experts with experience in the healthcare domain attacking a complex data population with advanced search and analytics tools going after key documents right from the very start. Actually experiencing how experts leverage such tools to accelerate time to critical insights may be eye-opening for any legal teams who have had to spend weeks and months trying to piece the facts together.

What to do? If you haven’t explored new ways to find key documents, you’re probably bogged down with an out-of-date workflow. Pairing advanced analytics tools with the right expertise can accelerate fact-finding and document review, but you may have to try it to believe it. You could discover that having the right expertise on hand in advance of the need will expedite response efforts, reduce cost and risk, and lead to the best possible outcome.

Learn more about finding facts fast with Key Document Identification.