A typical organization licenses 5 to 15 different administrative and medical terminology content sets. These are obtained from different standards organizations, content or web services vendors. These content sets are then updated on a regular schedule throughout the year, requiring the organization to incorporate these code set updates with existing processing applications containing specific business rules. These updates change the codes sets from 3% to over 400%.
The technical and clinical time to handle these updates can run from 30 to 90 days per year, depending on the number of content sets and frequency of each update.
HLI streamlines this process by providing all of the content in a standard format on a scheduled basis after completing an analysis to resolve any conflicts. This file is then placed in the customer’s LE Solution to resolve any conflicts with local codes and terms before being released to a processing environment. This update can be an exported reference file or through an API.
Streamline the updating of all content in use today and be positioned for SNOMED and ICD-10-CMSNOMED terminology, distributed by the International Health Terminology Standards Development Organization (IHSTDO), has been adopted by nine countries including the United States. With over 360,000 terms and concepts, SNOMED is a scientifically-validated clinical healthcare terminology. When used, this terminology enhances billing and administration of claims by enhancing structured data entry, data analysis, research and the framework to incorporate multiple languages.
Although ICD-10 is in use in most other countries, the U.S. government is just now encouraging the adoption of ICD-10-CM. ICD-9 has over 12,000 codes and terms while ICD-10 has over 100,000 codes and terms.
Moving to these new code sets will require organizations to map from one to another, in addition to handling the updates. Estimates suggest that the amount of time to handle these updates could significantly impact an organization.
HLI solutions can minimize this impact by updating content today and managing the transition to SNOMED and ICD-10-CM tomorrow.
Search and Index unstructured text to translate concepts into meaningful resultsNot all healthcare documentation is completed in a structured, codified format. Much of the relevant clinical data remains in unstructured, narrative text-based documents. The documents are generated from multiple sources in multiple formats. Assembling and managing these documents for each patient episode is challenging. Aggregating the documents across multiple providers and service lines to enable analysis of relevant clinical information is a labor-intensive task.
Natural language processing capabilities in the LExIndex module in LE are used to automatically interpret free text documents and to identify and index clinical concepts and terms. HLI has developed proprietary algorithms to support negations to rule inconsequential findings.
For example, an organization needs to search text documents for Present on Admission conditions in current or historical medical records databases. LExIndex can be run against a set of documents such as transcribed progress notes, post-surgical summaries, discharge summaries, radiology reports, pathology reports, etc. The tools in LExIndex will dramatically improve the accuracy and productivity of utilization and chart review.
Increase staff productivity and data accuracy with timely content updatesContent updates absorb technical and clinical time. The time ranges from 60 to 90 days of work, depending on the number of content sets and the amount of changes within each update. When these updates are delayed, the processing accuracy and timeliness could be impacted.
HLI solutions reduce the amount of technical and staff time required to handle updates. Additionally, they provide the ability to audit the documentation of each change in the updated code or term set.
Integrate disparate systems and consolidate databases into meaningful informationMost healthcare organizations, both provider and payer, operate in an environment comprised of multiple facilities, locations and departments, all supporting multiple systems for the collection of clinical and administrative data to support the administration of patient care.
With multiple systems comes the challenge of maintaining a synchronized version of clinical and administrative code sets. Code sets such as ICD-9, ICD-10, CPT, SNOMED CT, LOINC, etc., all come from different standards bodies, have different release dates, different effective dates, and different formats for delivery (paper, CD, online, etc.).
The challenge faced by any healthcare organization is keeping these code sets current and synchronized. Failure to keep all the code sets updated and synchronized will cause deviations in code set accuracy and will jeopardize an organization’s ability to accurately perform retrospective clinical analysis on services rendered, outcomes achieved and true financial performance.
This update and content management process is streamlined with the use of the LE solution. Content sets are updated, versioned and stored in the Language Engine. Customers receive access to not only the current terms and concepts, but also to the original versions from each standards body, dating back to 2001.
Convert medical terms into consumer-friendly languageToday, the explanation of benefits and the clinical discharge report is presented in administrative and clinical terms, which often causes confusion for patients and members. Communicating administrative codes and clinical terminology in consumer-friendly terms improves patient understanding, thereby reducing the number of support calls while improving patient compliance.
HLI offers consumer-friendly terminology mapped to ICD-9-CM diagnosis and procedure codes, allowing for easy translation on an Explanation of Benefits (EOB) or care management plan.
Easy client-specific implementations with APIs and software development kitMost healthcare organizations, both provider and payer, operate in an environment comprised of multiple facilities, locations and departments, all supporting multiple systems for the collection of clinical and administrative data to support the administration of patient care.
With multiple systems comes the challenge of maintaining a synchronized version of clinical and administrative code sets. Code sets such as ICD-9, ICD-10, CPT, SNOMED CT, LOINC, etc., all come from different standards bodies, have different release dates, different effective dates, and different formats for delivery (paper, CD, online, etc.).
The challenge faced by any healthcare organization is keeping these code sets current and synchronized. Failure to keep all the code sets updated and synchronized will cause deviations in code set accuracy and will jeopardize an organization’s ability to accurately perform retrospective clinical analysis on services rendered, outcomes achieved and true financial performance. This update and content management process is streamlined with the use of the LE Solution.