- LifeCode is the industry’s first NLP engine to accurately interpret meaning and context of medical terminology in electronic health records
- Breakthrough technology mines data within EHRs for accurate computer-assisted coding and quality reporting, supports ICD-10 readiness and health reform compliance
EDEN PRAIRIE, Minn.--(BUSINESS WIRE)-- OptumInsight’s LifeCode® Natural Language Processing technology, which powers its computer-assisted coding software, has received a 2011 U.S. Patent as the coding industry’s first natural language processing (NLP) engine to accurately interpret the meaning and context of medical terminology in electronic health records (EHR).
LifeCode bridges the natural way physicians communicate about patient care and the data required in hospital information systems to help provide consistent and accurate diagnoses and procedure codes for proper reimbursement and metrics for quality reporting.
The newest LifeCode NLP engine patent recognizes OptumInsight’s innovative “mere-parsing” methodology, which not only identifies and interprets words and phrases, but enables the technology to understand their contextual use to make coding decisions and track clinical documentation practices.
For example, a patient record may include the phrase “breast cancer.” Other computer-assisted coding (CAC) tools are often unable to determine whether this is a current or past diagnosis, or whether it pertains to the patient or the patient’s family history.
Because LifeCode understands the words around such phrases, the software can make these distinctions, which results in more accurate coding recommendations and clinical analytics. These capabilities help increase the accuracy of the information to the insurer, increase the productivity of medical claims coding staff, decrease claims rejected by health plans or missed charges and speed time to payment. NLP can also be used to improve the meaningful use of EHRs by identifying holes in current documentation practices and specific clinicians who may need additional support with regards to best practices.
“OptumInsight’s patented NLP technology is helping hospitals increase coder accuracy and productivity today. It will help support the transition to the more complex ICD-10 code system, and information used for measuring quality, best practice adherence and documentation improvement,” said Mark Morsch, vice president of technology, OptumInsight.
Ohio Health, a network of not-for-profit hospitals in Central Ohio, made significant gains in coding efficiency when five of its hospitals implemented OptumInsight’s CAC solution. OptumInsight’s CAC solution helped Ohio Health realize a 106-percent increase in productivity among diagnostic coders and a 60-percent increase in emergency department coding within months of using the technology. Ohio Health hopes to realize an improved case mix for inpatient services over the longer term, a critical measurement for ensuring accurate Medicare and Medicaid reimbursement rates.
Implementing OptumInsight’s CAC is also foundational to Ohio Health’s ICD-10 readiness efforts. By October 2013, the Centers for Medicare & Medicaid Services requires all health care providers to code medical claims using the ICD-10 classification system, a 155,000-line index of medical diagnoses and procedures that replaces the 17,000-line ICD-9 system. As a result, hospitals and physicians offices face an increased demand for coding resources and are at greater risk of lost revenue and productivity from bottlenecks, inaccuracies, denials and delays in the coding process.
“ICD-10 requires a lot more data knowledge and will take more time to code correctly,” Diane Setty, Ohio Health’s corporate director for health information management. “We wanted to make sure that we had sufficient resources to accommodate the additional time required to use ICD-10 accurately. We knew OptumInsight’s CAC solution had the capability to do what we needed today, and will enable us to work more rapidly within the coming ICD-10 environment.”
OptumInsight’s NLP system received its first patent in 2005 for its architecture and sophisticated method of interpreting the context of words used in clinical documentation and assigning meaning. It has continually been refined for more than a decade, reading more than 300,000,000 medical documents since its creation and over 5.5 million medical documents per month.
- Visit Optum’s CAC resource page online
- Request AHIMA’s CAC Report featuring Measuring the Performance of CAC
- Read more about Ohio Health’s success with CAC
OptumInsight provides health information, technology and consulting services. Commercial health plans, physicians, hospitals, life sciences companies, government agencies and other organizations that comprise the health care system depend on OptumInsight solutions and insights to improve their performance. OptumInsight is part of Optum, a leading information and technology-enabled health services company dedicated to making the health system work better for everyone. Visit www.optum.com or www.optuminsight.com for more information.
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