NDIS Commission to have a new intelligent risk engine by August

The NDIS Quality and Safeguards Commission is expecting to have the “essential” capabilities of a new risk engine to support its work regulating the $50 billion-a-year insurance scheme in place by August. 

The risk engine, which is officially described as a “decision-support capability”, will enable the Commission to identify “providers, workers, participants and networks that present the greatest risk of harm, unacceptable quality and safety, fraud or non‑compliance.”

It is a key technical mechanism to bring an intelligence‑led approach to the Commission’s work, and comes under the four-year, $160 million Data and Regulatory Transformation (DART) program.

“The NDIS Quality and Safeguards Commission is modernising its ICT systems through the DART program,” deputy commissioner and chief operating officer for DART and enabling services Laura Sham said.

“The DART program is advancing the NDIS Commission’s use of analytics and intelligence to target systemic risks and improve risk-based regulation of the NDIS market.

“With the new systems developed under DART, the NDIS Commission will be better placed to make more informed, efficient, and effective decisions based on risk, harm, trends and patterns.”

Regulation of the NDIS - the National Disability Insurance Scheme - is emerging as a key issue for this year’s federal budget, with the scheme predicted to cost more than $50 billion a year, and to continue rising.

A long-term concern with the scheme is whether funding is reaching the people that need it, and the extent to which fraud or misuse exists.

The forthcoming “risk engine” could help the Commission perform its regulatory functions and oversight work.

It noted in procurement documents that the engine would not act as an “automated enforcement system” against providers and participants.

It will, however, calculate “automated, explainable risk scores and risk tiers” for the various stakeholders involved in the scheme, the documents state.

Additionally, the risk engine is anticipated to produce “improved visibility of the NDIS market”, enable “earlier identification of risk before harm escalates” and drive “more consistent and defensible decision‑making across the Commission”.

The result is likely to be “faster and more targeted” complaint handling, incident triage and investigations, as well as broader “identification of systemic and network‑level risks across the sector.”

iTnews understands that the risk engine does not require new software to be purchased.

Rather, what the Commission is seeking is outside assistance to bring together multiple risk-indicators - existing and new - alongside relevant visualisations and data pipelines into a single analytics capability.

A production-ready version of the risk engine could be ready within a matter of months, according to an indicative timeline for the work.

The Commission wants “all essential requirements” for the risk engine to be delivered between May and August of this year.

Improvements are anticipated to be made over nine months, with final handover by May 2027.

“Phases will overlap where appropriate, with the system becoming operational early and progressively enhanced rather than delivered as a single ‘big bang’,” the Commission wrote.

EDRMS replacement

Simultaneously under the DART program, the Commission is set to replace its electronic document and records management system (EDRMS).

Its current EDRMS, based on OpenText, has configuration issues and will not play nicely with a Salesforce-based customer relationship management (CRM) system that is being deployed, according to a procurement notice.

“The current indexing is poorly configured and returning unexpected results, which is a significant concern in an EDRMS and is resulting in a lack of trust in the system with some users,” the notice states.

It is also not operated by the Commission, instead consumed via a shared services arrangement. The Commission consumes shared services from the Department of Social Services (DSS) and Services Australia.

The target EDRMS needs to be cloud-based, highly available and able to host about 8TB of existing records.

Sham told iTnews that a modern EDRMS “will enhance our information management capabilities, provide more oversight on compliance, security, unified approach to document management, and assist with providing a platform that can adapt to new standards and changes as the Commission continues to mature its data, systems and processes.”

The Commission does not rule out running its own OpenText-based system, if a fit-for-purpose option is proposed.