Knowledge Objects Marks 25 Years Driving AI Innovation in Healthcare Risk Management

Knowledge Objects Marks 25 Years of Innovation in Healthcare Risk Management

Knowledge Objects (KO) has reached a significant milestone, celebrating 25 years of delivering healthcare risk management software solutions. Starting as a rules engine for medical schemes, KO has grown into an AI-driven platform offering comprehensive administration and risk management services for health insurers across various markets.

“Our initial focus was embedding clinical and business rules into healthcare systems,” explained Chantal Viljoen, Chief Commercial Officer. “Today, we provide a full-service platform that integrates healthcare administration with advanced risk management.”

AI Integration Drives Smarter Healthcare Decisions

A key development in KO’s evolution was the integration of artificial intelligence. By incorporating predictive modeling, KO enables clients to make real-time, data-driven decisions that improve patient outcomes and reduce costs. This innovation earned KO the 2024 Global Excellence Award for AI-Powered Risk Management Solutions, following its 2021 AI in Healthcare Award in Singapore.

Viljoen highlighted, “These awards recognize our commitment to reducing waste, improving care, and supporting sustainable healthcare funding.”

JARVIS: Intelligent Risk Management Platform

At the core of KO’s offering is JARVIS, an AI-powered modular platform launched in Singapore in 2020 and 2021. JARVIS addresses the limitations of legacy systems by automating and integrating managed care, claims, member management, and predictive analytics into one unified solution.

“JARVIS combines modern technology with advanced risk management to deliver real-time insights at both individual and population levels,” Viljoen noted. The platform supports multi-region localization, cloud scalability, and includes embedded care modules like Digitised Managed Care (DMC) and Patient Driven Care (PDC). These modules help reduce hospital stays and readmissions while enhancing patient outcomes through holistic care management.

The system operates on more than 70,000 clinical and business rules, AI-driven predictive models, and insights from medical experts and provider efficiency data. This blend of machine intelligence and expert input ensures consistent, measurable benefits.

Provider Efficiency and Value-Based Networks

JARVIS also evaluates provider performance by analyzing outcomes, quality, and cost-effectiveness. This approach supports the creation of value-based networks centered on clinical excellence rather than just cost or disease management metrics. It helps insurers transition from fee-for-service to outcome-based contracting, rewarding both clinical results and financial sustainability.

Flexible Integration for Diverse Healthcare Systems

JARVIS offers seamless integration across different healthcare environments and regions. Its modular design allows clients to deploy the entire platform or select specific modules such as claims, risk management, authorizations, or finance. Integration is supported through:

• Adaptable rule sets aligned with local clinical protocols, coding systems (including ICD and CPT cross-walks), tariffs, and modifiers.
• REST APIs, SOAP services, batch files, and middleware compatibility with both legacy and modern IT systems.
• Collaborative configuration with clients to ensure smooth operations and minimal disruption.

“Our goal is to be a strategic partner, not just a software add-on,” Viljoen emphasized.

South Africa’s Healthcare Technology Outlook

South Africa is experiencing rapid changes in healthcare technology. AI is increasingly used in diagnostics and chronic disease management, while mobile health solutions extend access to underserved areas. With rising costs and growing rates of chronic diseases, platforms like JARVIS support more integrated and data-driven healthcare delivery.

Proven Results Delivering Value

KO’s data-centric approach has produced measurable improvements for clients, including:

• 13.2% reduction in claims related to fraud, waste, and abuse.
• 11% fewer readmissions for high-risk surgeries such as back and hip operations.
• 12%-20% drop in readmissions for chronic condition groups.
• 5%-11% savings in hospital costs due to reduced readmissions.
• Operational cost cuts exceeding 30%, driven by automation of 98% of claims and 80% of underwriting processes.
• Up to 15% reduction in specialist costs through intelligent provider profiling and network optimization.

KO’s consultative model ensures solutions align with each client’s business strategy rather than forcing process changes. Viljoen stated, “Our technology supports their strategy—not the other way around.”

Looking Ahead

As KO expands across Africa, Asia, and the UK, it remains focused on AI-powered healthcare innovation, offering scalable and adaptable solutions for insurers and medical schemes worldwide.

For managers seeking to understand how AI can optimize healthcare risk management, exploring platforms like JARVIS offers clear evidence of technology’s role in improving care quality and financial outcomes. To learn more about AI applications in healthcare and related fields, visit Complete AI Training's latest courses.