healthsim

What problem does it solve?

Healthcare data generation is complex, time-consuming, and often requires specialized coding or manual effort. This Skill automates the creation of realistic, clinically coherent synthetic healthcare data, eliminating manual data entry, reducing compliance risks associated with real PHI, and accelerating testing and development cycles for EMR systems, claims processing, and pharmacy benefits.

Core Features & Use Cases

• PatientSim: Generate detailed clinical/EMR data including patients, encounters, diagnoses, procedures, labs, vitals, and medications.
• MemberSim: Create realistic claims and payer data such as members, professional/facility claims, payments, and accumulator tracking.
• RxMemberSim: Produce comprehensive pharmacy benefits data, including prescriptions, formularies, drug utilization review (DUR) alerts, and prior authorizations.
• Multi-format Output: Export generated data in industry-standard formats like FHIR R4, HL7v2, X12 (837/835), and NCPDP D.0, as well as common formats like CSV and JSON.
• Use Case: Imagine you need to test a new claims adjudication system. Use HealthSim to generate 50 diverse professional claims, including some with prior authorization requirements and others with specific adjudication outcomes (e.g., denied for medical necessity), and export them as X12 837 transactions. This saves weeks of manual test data creation and ensures comprehensive test coverage.

Quick Start

Generate a 65-year-old diabetic patient with hypertension and recent labs.