AICES
Description
1. Reduce the backlog and processing times, minimize unnecessary in-person exams, and address workflow inefficiencies. 2. Reduce the burden of travel on veterans and expedite the time required for claims processing. During the period of performance, this effort will demonstrate the effectiveness of the proposed solution to develop Disability Benefits Questionnaire (DBQs) through Acceptable Clinical Evidence (ACE).
Detailed example
The system indexes structured, semi-structured, and unstructured Veteran health and service record data, including diagnosis, severity, and service connection evidence from eFolders, metadata, and lay evidence. It supports Disability Benefits Questionnaire (DBQ) processing to generate SMART Claims with recommendations. Objective 1: Reduce Unnecessary In-Person Examinations through Evidence-Driven Triage and Workflow Automation Goal: Demonstrate the accuracy of the solution to properly execute ACE exams. Metric: Demonstrate the ability to produce 5000 ACE exams during the period of performance within a 72-hour delivery window, through expert review. Objective 2: Enhance the accuracy of documentation for ACE-generated DBQs Goal: Validate the capability of advanced OCR and NLP tools to correctly extract and populate data. Metric: Achieve at least a 96% accuracy rating for all ACE DBQs.
AI / analytics pattern
Agentic AI: AI systems that perform tasks or make decisions autonomously with minimal human intervention.
Automation level / stage
a) Pre-deployment – The use case is in a development or acquisition status.
Expected benefit
This initiative aims to: 1. Reduce the backlog and processing times by more efficiently using Acceptable Clinical Evidence (ACE), minimizing unnecessary in-person exams and addressing workflow inefficiencies. 2. Reduce VA costs due to reduced in-person exams. 3. Improve the Veteran experience by reducing the burden of travel on veterans and expediting the time required for claims processing.
Controls / human review
ATO: Not reported; PIA: Not published