The Workflow

From data to insights.
Fully automated.

Our AI-powered platform transforms raw healthcare data into actionable population health intelligence—combining geographic data, environmental factors, and predictive analytics to optimize outcomes at scale.

1

Secure Data Ingestion

RxOracle ingests member data via bulk CSV upload, API integration, or direct connections to your data warehouse. Upload patient demographics, pharmacy claims, diagnoses, and lab results. Our platform processes millions of records with intelligent batch processing and real-time enrichment queues. All data transmission uses 256-bit encryption with HIPAA-compliant security protocols.

Bulk CSV Upload

Patient rosters, claims files, member lists

API Integration

Real-time data feeds, continuous sync

Data Warehouse

Direct ETL connections, scheduled pulls

2

Geographic Enrichment

Every patient is automatically enriched with comprehensive SDOH data from 5 US Census sources (ACS, SAHIE, SAIPE, CRE, ZBP). We derive 50+ social determinant metrics including income, poverty rates, healthcare access, pharmacy density, and transportation barriers—all from ZIP code alone.

Real-Time Census Integration
3

AI Disease Prediction

Machine learning models analyze comorbidities, demographics, SDOH risk factors, and environmental conditions to predict disease progression with 99.3% accuracy. The system identifies members at high risk for hospitalizations, ER visits, or chronic disease complications before events occur.

99.3% prediction accuracy
6-12mo forecast horizon
4

Environmental Health Intelligence

Real-time integration of environmental health risk factors including air quality monitoring, water pollution data, climate conditions, and disease outbreak tracking. The platform identifies populations at elevated risk due to environmental exposures and generates targeted alerts for care teams.

Air Quality Index

Real-time AQI monitoring by location

Water Quality

Contamination tracking & alerts

Climate Data

Temperature extremes & weather risk

Disease Outbreaks

Real-time outbreak monitoring

5

Population Analytics Dashboard

Real-time executive dashboards display population health metrics, risk stratification, geographic heatmaps, and care gap identification. Drill down from population-level trends to individual member details. Export board-ready reports and CMS submissions with one click.

Interactive Intelligence Dashboards
6

HEDIS/Stars Optimization

Automated tracking against national HEDIS benchmarks and Stars rating thresholds. The platform identifies which members are impacting quality measures and prioritizes interventions by expected Stars impact. Generate CMS-ready reports instantly.

Stars Rating Optimization
7

Continuous Intelligence & Alerts

The platform continuously monitors your population for care gaps, risk changes, environmental alerts, and quality measure opportunities. Intelligent alert systems notify care teams of critical events requiring intervention. All insights are prioritized by potential cost savings and Stars impact.

50+

SDOH Metrics Per Patient

99.3%

Disease Prediction Accuracy

Real-Time

Environmental Monitoring

Technical Architecture

Built on enterprise-grade infrastructure for reliability and scale.

Cloud Infrastructure

Hosted on AWS with 99.99% uptime SLA. Auto-scaling architecture handles millions of daily interactions.

Data Pipeline

Real-time ETL processes with sub-second latency. Handles 10M+ records per day with zero data loss.

Security

End-to-end encryption, enterprise security controls, HIPAA compliant with comprehensive audit logging.

From Data to Intelligence

See how RxOracle transforms raw data into actionable insights

Patient Data
STEP 1-2

Enriched Patient Profiles

Every patient record enhanced with 50+ SDOH metrics, risk scores, and predictive insights—automatically.

STEP 3-5

Real-Time Intelligence

Turn data into decisions with population health dashboards, risk stratification, and care gap identification.

Command Center
CMS Stars Dashboard
STEP 6-7

Quality Optimization

Track HEDIS measures, optimize CMS Star Ratings, and identify opportunities for quality improvement.

See the platform in action

Schedule a personalized demo to see how RxOracle can optimize your population health strategy.

Schedule Demo