Transforming Healthcare Data Management with Sumex AG

Modernizing Data Platform for Enhanced Security and Scalability 

Some of Sumex AG’s customers using the ERP system Siddhartha work with a data warehouse (DWH) that could benefit from technological updates and expanded functionality. To support data-driven transformation and enhance the decision-making processes of these companies, it is crucial for Sumex AG to replace this DWH with a modern analytics platform leveraging innovative AI and GenAI capabilities.

Security is a paramount concern, as Sumex AG’s customers in the insurance industry handle vast amounts of highly sensitive data, including individual health information that requires stringent protection. To accommodate potential large customers from the healthcare sector, Sumex AG needs a highly scalable analytics platform capable of leveraging AI capabilities.

Transforming Data to Insights with ELCA's Secure Analytics Solutions 

Thanks to ELCA's comprehensive and secure analytics solutions, Sumex AG created an analytics platform, which allows to transform data into actionable insights, optimizing operations, and uncovering new revenue opportunities.

• Data Security and Data Privacy: The solution fully complies with Swiss data privacy regulations, providing top-tier protection. A multi-layer encryption is implemented for data at rest, in transit, and at the column level for PII. Furthermore, the use of private networks and stringent access controls assured the security of data.
• State-of-the-Art Data Architecture: State-of-the-art data architecture is ready to scale and designed with the Data Mesh concept in mind. This modern architecture supports robust, decentralized data management, ensuring data infrastructure to grow with business needs.
• End-to-End Implementation in the Cloud: The end-to-end implementation in Databricks on Azure is a game-changer. Utilizing the open-source SmartDataLakeBuilder as a data pipeline orchestrator, provides for a flexible, efficient data processing environment. 
• User-Empowerment with Privacy-Preserving AI:  ELCA’s privacy filters for Generative AI enable Sumex AG to integrate advanced AI model services while protecting sensitive data and PII. This is the foundation for developing exciting functionality like copilots, chatbots, and process automation solutions using leading AI models, ensuring that all data and user interactions remain secure and confidential.

Empowering Efficiency, Security, Insights and AI based functionality in Health Insurance

Sumex AG has made significant strides in enhancing efficiency, security, and reporting capabilities with the implementation of the new Secure Cloud Data Platform, based on a Smart Data Lake. This platform offers a robust solution for efficiently managing vast amounts of structured and unstructured data, specifically designed to meet the critical needs of their customers in the health insurance sector.

• Efficiency and Productivity: The Data Platform empowers Sumex AG to seamlessly import and process both structured and unstructured data of any size. With its well-designed data architecture and prepared data products, Sumex AG and their customers' data scientists experience enhanced productivity. Additionally, compared to the on-premises data warehouse solution, the Smart Data Lake significantly reduces operating and maintenance costs.
• Security and data privacy: Adhering to ISO27k best practices ensures the highest level of data protection. All data is encrypted both in transit and at rest, with personal data receiving additional encryption. Role-based access control mechanisms are implemented to restrict access to data objects. To comply with GDPR, data is strictly located within Switzerland and processed exclusively within "private" networks.
• Enhanced Reporting: Databricks enables secure connections to external reporting tools, such as PowerBI, for accessing data in the Smart Data Lake. This capability facilitates insightful analysis and reporting for Sumex AG and their customers, thereby enhancing decision-making capabilities.
• AI based functionality: Sumex AG is adding new capabilities, including an AI assistant to improve claims processing. This assistant will cross-reference claims with a comprehensive knowledge base that includes product documentation, laws, regulations, and medical information about drugs. It will explain why claims are flagged as conspicuous, connect relevant background information, and offer multilingual translation capabilities. In short, it will assist users by providing more transparency and increasing productivity.
   

From Quickstart to Full-Scale Production

ELCA’s approach started with a Quickstart phase and a Proof of Concept (PoC) that quickly demonstrated the value of the solution, smoothly transitioning to full-scale production, handling the entire concept development, and delivering comprehensive documentation. 

We provided training and support to staff of Sumex AG, ensuring they could maintain and further develop the solution ourselves, fostering long-term success.

The solution is highly versatile and applicable to various industries and use cases due to its robust, scalable, and secure design. The multi-layer encryption and stringent data privacy measures ensure compliance with diverse regulatory environments, making it suitable for sectors like finance, healthcare, and retail. The scalable architecture supports different data products and complex analytical needs, enabling industries to harness the power of data for decision-making, operational efficiency, and innovation. The end-to-end implementation using Databricks on Azure, coupled with the flexible Smart Data Lake Builder and our framework for Privacy Preserving GenAI, allows for easy adaptation to industry-specific requirements, whether it’s for real-time analytics, predictive modeling, or comprehensive data management.

About Sumex 

Sumex AG was founded in 2019 and emerged from the long-standing collaboration between ELCA Informatik AG and Suva. Sumex AG is a leading technology provider that aims to make an important contribution to the automation and cost stabilization of the Swiss healthcare system. The company offers open platforms for insurance companies with a focus on process automation, cost reduction and innovative solutions. In 2022, Sumex AG merged with Secon AG to become a leading provider of ERP and claims management software for the Swiss healthcare sector. The goal is to reduce complexity, ensure compliance and increase efficiency by automating standard insurance processes. Based in Zurich, the privately owned company employs more than 50 experts who serve customers throughout Switzerland. With the Sumex Suite, Sumex AG offers a flexible workflow solution for the automated processing of claim documents in the Swiss healthcare system. Sumex AG also offers other services such as the preparation and provision of current tariff and reference data or a service for digitizing scanned medical cost invoices.

www.sumex.ch