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Computer Assisted Coding Of Medical Information Market Shares Strategies, and Forecasts 2008 to 2014

August 2008 | 327 pages | ID: C6265C479B2EN
WinterGreen Research

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Systems are implemented with natural language pattern recognition in order to assign appropriate billing codes based on the language and the context in which those patterns of language occur. Properly designed natural language processing (NLP) solutions do not require physicians to change the way they work. They can dictate in a free-flowing fashion, consistent with the way they think, and are not limited to structured inputs that may or may not fully capture the unique circumstances of each patient encounter.

Matching codes generated from physician notes to standard treatment protocols promises to improve health care delivery. Accompanying that type of physician patient management against best practice promises to revolutionize health care delivery. The ability ot further check as to whether the recommendations for follow up made by radiologists and matching the commendations with the actual follow up heralds’ significant promise of vastly improved health care delivery.

Computer assisted coding applications depend on the development of production quality natural language processing (NLP)-based computer assisted coding applications. This requires a process-driven approach to software development and quality assurance.

A well-defined software engineering process consists of requirements analysis, preliminary design, detailed design, implementation, unit testing, system testing and deployment. NLP complex technology defines the key features of a computer assisted coding (CAC) application.

Automation of process will revolutionize health care delivery. In addition to automating the insurance, billing, and transaction systems, streamlined care delivery is an added benefit. The ability to look at workflow and compare actual care to best practice is fundamental to automated business process.

The ability to link diagnostic patient information to treatment regimes and drug prescriptions is central to improving medical care delivery. Once a physician can see what conditions need to be followed, and see that appropriate care has been prescribed 100% of the time, care delivery improves dramatically. Diagnosis of conditions using radiology frequently results in detection of events that need followup.

Emergency department visits rose 20 percent in 2008, while the number of available emergency centers fell by 15 percent. A study from the American Hospital Association indicated that 62 percent of hospitals feel they are at or over operating capacity. That number jumps to 90 percent when considering Level 1 Trauma Centers and larger (300+ beds) hospitals. According to a report from the General Accounting Office, two-thirds of EDs diverted ambulances.

Worldwide, the computer assisted coding markets are anticipated to grow from $50.9 million in 2007 to $2.7 billion in 2014. The markets are primarily U.S. markets because of the primary role that insurance plays in the health care delivery system. Worldwide markets start to grow as more hospitals and physician offices seek to get control of systems costs and introduce automated process systems.
COMPUTER ASSISTED CODING OF MEDICAL INFORMATION EXECUTIVE SUMMARY

Medical Best Practice Linking
  Best Practice Using NLP Computer Assisted Coding
  Hybrid Technology
  Computer Assisted Coding Engine
Computer Assisted Coding of Medical Information Market
Driving Forces
  Natural Language Computer Assisted Coding Medical
  Information Solutions
  Natural Language Coding Solutions
Natural Language Computer Assisted Coding Market Shares
Worldwide, Computer Assisted Coding Market Forecasts
  Natural Language Computer Assisted Coding Of Medical
  Procedures Forecasts
Number Of Procedures
  Focus On Reducing Overpayments

1. COMPUTER ASSISTED CODING OF MEDICAL INFORMATION MARKET DESCRIPTION AND MARKET DYNAMICS

1.1 Coding Challenge
  1.1.1 Computer Assisted Coding (CAC)
  1.1.2 Advances In Natural Language Processing And Informatics
1.2 Computer-assisted Coding Technology
1.3 Computer-assisted Coding
  1.3.1 Industry Forces Affecting Development of CAC
1.4 Development of a CAC Tool For Hospital Inpatient Use
  1.4.1 CAC Impact on the Coding Workflow
  1.4.2 Computers Replace Human Coders
1.5 Healthcare Industry Largest Industry In The United States
  1.5.1 Building a Safer Health System
  1.5.2 Facilitating the Use of Technology in the Healthcare Industry
  1.5.3 Medicare Prescription Drug Improvement and Modernization Act
1.6 Medical Necessity and Medical Necessity Errors
1.7 Electronic Coding Technologies
  1.7.1 Electronic Coding Integrated Database
1.8 Natural Language Solutions
  1.8.1 State Of Language Technology Evaluation
1.9 Computerized Workflow System
  1.9.1 Confidence Assessment Module
  1.9.2 Researching Electronic Coding Products:

2. NATURAL LANGUAGE COMPUTER ASSISTED MEDICAL CODING MARKET SHARES AND MARKET FORECASTS

2.1 Computer Assisted Coding of Medical Information Market Driving Forces
  2.1.1 Medical Best Practice Linking
  2.1.2 Best Practice Using NLP Computer Assisted Coding
  2.1.3 Natural Language Computer Assisted Coding Medical Information Solutions
  2.1.4 Natural Language Coding Solutions
2.2 Natural Language Computer Assisted Coding Market Shares
  2.2.1 A Life Medical
  2.2.2 A-Life Medical Fusion3 Advanced Practice Management System
  2.2.3 CodeRyte
  2.2.4 LingoLogix
  2.2.5 3M
  2.2.6 3M Merging Quality With Reimbursement
  2.2.7 Artificial Medical Intelligence
  2.2.8 Platocode Benefits
2.3 Natural Language Computer Assisted Coding of Medical Procedures Forecasts
  2.3.1 Electronic Coding for Physician Practices Advantages
2.4 Worldwide, Number of Patients and Procedures
  2.4.1 Number of Medical Procedures and Codes Forecasts
2.5 Number of U.S. Community Hospitals
  2.5.1 Physician Coding Analysis
2.6 Claims Scrubbers
  2.6.1 3M APR DRG Software
  2.6.2 CodeCorrect Capture Revenue and Maintain Compliance
  2.6.3 Ingenix Rules Creation Manager
2.7 DRG/APC Groupers
2.8 Medical Necessity/Correct Coding Tools
  2.8.1 3M Health Data Management System
2.9 Physician Electronic Medical Record (EMR) Systems
  2.9.1 Physician Electronic Medical Record (EMR) Markets
  2.9.2 Inpatient Procedures
2.10 Computer Assisted Coding Regional Analysis

3. COMPUTER ASSISTED CODING OF MEDICAL INFORMATION PRODUCTS

3.1 A Life Medical
  3.1.1 A-Life Medical ICODE™ Tool to Automate Hospital Coding
  3.1.2 A-Life Medical Actus(TM) Application Suite
  3.1.3 A-Life Medical Fusion³ Advanced Practice Management System Combining NLP Coding, Billing, and Document Management
  3.1.4 A-Life Medical Products
  3.1.5 A-Life Medical Advanced Practice Management System
3.2 CodeRyte
  3.2.1 CodeRyte Computer-Assisted Coding Solutions
  3.2.2 CodeRyte Medical Coding Tools Streamline Processes
  3.2.3 CodeAssist Automating the Medical Coding Process
  3.2.4 CodeRyte CodeComplete Outsource Solution for Medical Coding
  3.2.5 CodeRyte DataScout Clinical Data Extraction and Identification
  3.2.6 CodeRyte and American Academy of Professional Coders (AAPC)
  3.2.7 CodeRyte Data Mining Technology
  3.2.8 CodeRyte Systems for Overcoming Documentation Shortfalls
  3.2.9 CodeRyte Web-Based Coding Software Return on Investment
  3.2.10 CodeRyte Coding Software Functions
  3.2.11 CodeRyte Computer-Assisted Coding Solutions Targeted to Specialty Areas
  3.2.12 CodeRyte CodeAssist Functions
  3.2.13 CodeRyte CodeComplete Business Process Management
3.3 LingoLogix GoCode
  3.3.1 LingoLogox Automated Coding
  3.3.2 LingoLogox GoCode Computer Assisted Coding Products for the Healthcare Industry
3.4 Platocode® Solution
  3.4.1 Platocode® Solution For Ambulatory Surgery
  3.4.2 Platocode® API
  3.4.3 Communication Between 3rd-Party Applications And A Platocode Server
3.5 Language and Computing: Ontology Assisted Solutions
  3.5.1 Language and Computing Ontoloy Assisted Coding and its Benefit
  3.5.2 Language and Computing Ontoloy Automated Coding
  3.5.3 Language and Computing -- Ontology assisted Natural Language Processing
  3.5.4 Language and Computing Natural Language Understanding
  3.5.5 Language and Computing Mapping and Modeling Disparate Controlled Medical Vocabularies (CMVs);
3.6 Artificial Medical Intelligence
  3.6.1 Artificial Medical Intelligence (AMI) EMscribe Dx
3.7 3M
  3.7.1 3M Merging Quality With Reimbursement
  3.7.2 3M™ APR DRG Software
  3.7.3 3 M Classification System For Patients
  3.7.4 3M APR DRG Software
  3.7.5 3M APR DRG Software Features: Versions 20 And 24
  3.7.6 CodeCorrrect
  3.7.7 CodeCorrrect Capture Revenue and Maintain Compliance
  3.7.8 CodeCorrect knowledge
  3.7.9 CodeCorrect Medical Necessity Verification and APC Performance Tools
  3.7.10 Ingenix
  3.7.11 Ingenix CPT® codes
  3.7.12 Ingenix Medicare fee schedule
  3.7.13 QuadraMed
3.8 Claims Scrubbers
  3.8.1 Ingenix
  3.8.2 Ingenix Claims Editing System
  3.8.3 Ingenix Rules Creation Manager
  3.8.4 3M™ Claim Scrubber
  3.8.5 3M™ Edit Engine
  3.8.6 3M APCfinder Software
  3.8.7 3M Health Information Systems Adds Medical Necessity Validation To Your Coding Workflow
  3.8.8 GE (TES – Transaction Editing System)
  3.8.9 McKesson Horizon Practice Plus
  3.8.10 McKesson HorizonWP Physician Portal
3.9 Craneware
  3.9.1 Craneware Software Automated Tool
  3.9.2 Craneware Chargemaster Corporate Toolkit®
3.10 Athenahealth Medical Group Office Automation Subscription Services
  3.10.1 athenaEnterpriseSM
3.11 DRG/APC Groupers
3.12 3M
  3.12.1 3M Ambulatory Revenue Management Software
  3.12.2 3M Health Data Management System (Info-X)
3.13 GE Centricity Physician Office PM
3.14 EpicCare MobileMeds
3.15 Cerner Physician Large Group / Enterprise
3.16 Siemens Unity® Financials Registration And Billing Applications
3.17 QuadraMed Physician Solutions
3.18 Medical Necessity/Correct Coding Tools
  3.18.1 McKesson
  3.18.2 McKesson Horizon Practice Imaging
3.19 High-Performance Search & Match Software
  3.19.1 WCC

4. COMPUTER ASSISTED CODING OF MEDICAL INFORMATION TECHNOLOGY

4.1 Hybrid Technology
  4.1.1 Computer Assisted Coding Engine
4.2 Preventable Medical Conditions
4.3 Natural Language Processing (NLP) Medical Coding
  4.3.1 Rules Based Approaches
  4.3.2 Reports Based On Statistics
  4.3.3 Normalize the Data
4.4 Reports Must Be In Some Kind Of Electronic Format
  4.4.1 NLP Software Statistical Analysis
  4.4.2 Workflow
  4.4.3 Feedback for Machine Learning
  4.4.4 Coding
  4.4.5 Accuracy And Specificity Of Retrieval
  4.4.6 Natural Language Programming (NLP) Vocabulary Processor
  4.4.7 Robust Underlying Terminological Model And A Component Architecture
4.5 TeSSI® (Terminology Supported Semantic Indexing)
  4.5.1 L&C’s LinkBase® Medical Ontology
  4.5.2 Semantic Indexing With The TeSSI® Indexing Engine
  4.5.3 Semantic Indexing Solution Automates The Indexing Process
  4.5.4 Information Extraction with TeSSI® Extraction Engine
  4.5.5 Semantic Search with TeSSI® Search Engine
4.6 Technology Requirements

5 COMPUTER ASSISTED CODING OF MEDICAL INFORMATION COMPANY PROFILES

5.1 3M Health Information Systems
  5.1.1 3M Health Information Systems
5.2 Accuro / CodeCorrect
  5.2.1 CodeCorrect
  5.2.2 Revenue Cycle Management Tools Including Medical Coding Software Solutions
5.3 Advocate Radiology Billing and Reimbursement Specialists
5.4 A-Life Medical
  5.4.1 Emory Healthcare / A-Life Medical Actus
  5.4.2 A-Life Medical LifeCode
5.5 AHIMA Computer-Assisted Coding Software Standards Workshop
  5.5.1 Collaborative Effort to Establish Standards For Computer-Assisted Coding Applications
  5.5.2 American Health Information Management Association (AHIMA)
5.6 American Academy of Professional Coders (AAPC)
5.7 Artificial Medical Intelligence AMI
  5.7.1 Artificial Medical Intelligence Computer Assisted Coding
  5.7.2 Artificial Medical Intelligence (AMI) Fusion CAC
5.8 athenahealth
5.9 Cerner
  5.9.1 Automate the Care Process
  5.9.2 Connect the Person
  5.9.3 Structure the Knowledge
  5.9.4 Close the Loop
  5.9.5 Cerner Positioning
5.10 CodeRyte
  5.10.1 CodeRyte Web-Enabled Workflow
  5.10.2 CodeRyte Technologies And Services
  5.10.3 CodeRyte Customers
5.11 Craneware
5.12 Dolbey
5.13 Language and Computing
  5.13.1 L&C Customers
  5.13.2 L&C European Clients
  5.13.3 L&C and Eclipsys
  5.13.4 L&C First DataBank (UK)
  5.13.5 L&C IDEWE (Belgium)
5.14 LingoLogix
  5.14.1 University of Texas Medical Branch Electronic Health Network
  5.14.2 Johns Hopkins University Signs Agreement for Production Use of GoCode
  5.14.3 LingoLogox GoCode Mayo Clinic
  5.14.4 University of Texas Medical Branch Electronic Health Network Pilots GoCode to Automate Coding Of Free Text Encounter Notes
5.15 MDS Medical
  5.15.1 Medical Software and Services for the Medical Industry
5.16 Meditech
5.17 Plato
5.18 QuadraMed
5.19 Radiology Business Management Professionals (RBMA)
5.20 RMI Physician Services Corporation
5.21 WCC

LIST OF TABLES AND FIGURES

Table ES-1
Electronic Coding Solution Market Driving Forces
Table ES-2
Electronic Coding Product Issues
Table ES-3
Worldwide Natural Language Computer Assisted Coding Software License, Maintenance, and Services (SaaS) Market Shares, Dollars, First Half 2008
Figure ES-4
Worldwide, Computer Assisted Coding Software License / Maintenance and Software as a Service (SaaS), Market Forecasts, 2008-2014
Figure ES-5
Worldwide, Number of Procedures with Computer Assisted Coding, Market Forecasts, Number, 2008-2014

Table 1-1
Advantages of CAC
Table 1-2
Barriers to CAC
Table 1-3
Electronic Coding Integrated Database Issues
Table 1-4
3M Medical Necessity Online
Table 1-5
Natural Language Solutions System For Coding
Table 1-6
Computerized Workflow System Systems Features
Table 1-7
Confidence Assessment Module System
Table 2-1
Electronic Coding Solution Market Driving Forces
Table 2-2
Electronic Coding Product Issues
Figure 2-3
Worldwide Natural Language Computer Assisted Coding Software License, Maintenance, And Services (SAAS) Market Shares, Dollars, First Half 2008
Figure 2-4
Worldwide Natural Language Computer Assisted Coding Software License, Maintenance, And Services (SAAS) Market Shares, Dollars, 2007
Table 2-5
Worldwide Natural Language Computer Assisted Coding Software License, Maintenance, and Services (SaaS) Market Shares, Dollars, 2007 and First Half 2008
Table 2-6
Platocode® Computer Assisted Coding Solution Benefits
Figure 2-7
Worldwide, Computer Assisted Coding Software License / Maintenance and Software as a Service (SaaS), Market Forecasts, 2008-2014
Figure 2-8
Worldwide, Computer Assisted Coding Software License / Maintenance and Software as a Service (SaaS), Market Forecasts, 2008-2014
Figure 2-9
Worldwide Medical Procedure Coding Market Forecasts, # CAC Procedures, 2008-2014
Figure 2-10
Worldwide Medical Procedure Coding Market Forecasts, # CAC Procedures, 2008-2014
Figure 2-11
U.S. Computer Assisted Coding Software License / Maintenance and Software as a Service (SaaS) Market Forecasts, Dollars, 2008-2014
Table 2-12
U.S. Computer Assisted Coding (CAC) Outpatient and Inpatient Software License / Maintenance and Software as a Service (SaaS), Market Forecasts, 2008-2014
Figure 2-13
U.S. Computer Assisted Coding Software and Software as a Service (SaaS) Outpatient Market Forecasts, 2008-2014
Figure 2-14
U.S. Computer Assisted Coding Software License / Maintenance Outpatient Market Forecasts, Dollars, 2008-2014
Table 2-15
Advanced Practice Management System Benefits
Figure 2-16
Worldwide, Number of Patients, Market Forecasts, 2007-2013
Figure 2-17
Worldwide, Number of Patients With Digital Records, Market Forecasts, Dollars, 2007-2013
Table 2-18
U.S. Computer Assisted Coding Outpatient Procedure Market Penetration Forecasts, % Penetration, 2008-2014 ff
Table 2-19
U.S. Computer Assisted Coding Outpatient Procedures Forecasts, Number of Procedures, 2008-2014
Table 2-20
U.S. Computer Assisted Coding Outpatient Procedure Market Penetration Forecasts, % Penetration, 2008-2014 ff
Table 2-21
U.S. Computer Assisted Coding Software as a Service (SaaS) Outpatient Market Forecasts, Dollars, 2008-2014
Table 2-22
U.S. Computer Hospital Procedures Performed Market Analysis, Dollars, 2008-2014
Table 2-23
U.S. Inpatient Procedure Forecasts, Major and Minor Procedures, % Penetration of CAC, 2008-2014
Table 2-24
U.S. Computer Assisted Coding Inpatient Market Forecasts, Dollars, 2008-2014
Table 2-25
Worldwide Number of Physicians and Number of Physician Visits Market Forecasts, 2008-2014
Table 2-26
Total Number of U.S. Hospitals
Table 2-26 (Continued)
Total Number of U.S. Hospitals
Table 2-27
Total Staffed Beds in U.S. Registered Hospitals
Table 2-28
Physician Admissions Coding Price Variation Analysis
Table 2-29
Physician Coding Price Variation Analysis
Table 2-30
US Number Procedures, 2003-2004
Table 2-31
Computer Assisted Coding Regional Market Segments, 2007
Table 2-32
Computer Assisted Coding Regional Market Segments, 2007

Table 3-1
A-Life Medical Natural Language Processing (NLP) Solutions
Table 3-2
A-Life Medical Actus(TM) Application Suite Functions
Table 3-3
A-Life Medical Fusion³ Advanced Practice Management System Benefits
Table 3-4
A-Life Medical Solutions
Table 3-4 (Continued)
A-Life Medical Solutions
Table 3-5
A-Life Medical Services
Table 3-6
A-Life Medical Actus® Application Suite
Table 3-7
A-Life Medical CoAudit™
Table 3-8
A-Life Medical Active Natural Language NLP-Based Solutions Development Program
Table 3-9
A-Life Medical Advanced Practice Management System Functions
Table 3-10
CodeRyte Medical Coding Tools
Table 3-11
CodeRyte DataScout Functions
Table 3-12
CodeRyte Clinical Information Extraction Functions
Table 3-13
CodeRyte Systems for Overcoming Documentation Shortfalls Focus
Table 3-14
CodeRyte Systems Topics
Table 3-15
CodeRyte Systems Metrics Included For Computerized Coding
Table 3-16
CodeRyte Web-Based Coding Software Return on Investment Metrics
Table 3-17
CodeRyte Web-Based Coding Software Key Benefits
Table 3-18
CodeRyte Coding Software Functions
Table 3-19
CodeRyte Coding Software Features
Table 3-20
CodeRyte Internet-Based Computer-Assisted Medical
Coding Target Markets
Table 3-21
CodeRyte CodeAssist Functions
Table 3-21 (Continued)
CodeRyte CodeAssist Functions
Table 3-22
CodeRyte CodeComplete Functions
Table 3-22 (Continued)
CodeRyte CodeComplete Functions
Table 3-23
LingoLogox GoCode - Benefits of Automated E&M Coding
Table 3-23 (Continued)
LingoLogox GoCode - Benefits of Automated E&M Coding
Table 3-24
LingoLogox GoCode Coding Benefits
Figure 3-25
LingoLogix GoCode Benefits
Table 3-26
LingoLogix GoCode Accuracy
Table 3-27
Language and Computing Ontoloy Advantages Of Automating E/M Coding With LinkCode
Table 3-27 (Continued)
Language and Computing Ontoloy Advantages Of Automating E/M Coding With LinkCode
Table 3-28
Language and Computing Ontoloy OAIE Coding
Algorithms
Table 3-29
Language and Computing Mapping And Modeling Disparate Controlled Medical Vocabulary Functions
Table 3-30
Artificial Medical Intelligence (AMI) Emscribe™ DX Benefits
Table 3-31
3M APR DRG Solutions Aspects
Table 3-32
3M Applications For Severity- And Risk-Adjusted Data
Table 3-33
3M Classification System
Table 3-34
3M APR DRG Software Features
Table 3-34 (Continued)
3M APR DRG Software Features
Table 3-35
Ingenix Medicare fee schedule
Table 3-35 (Continued)
Ingenix Medicare fee schedule
Table 3-36
Benefits of 3M Claim Scrubber
Figure 3-37
How 3M Claim Scrubber Works
Table 3-38
3M Claim Scrubber Claim Flow
Table 3-39
3M Claim Scrubber Features
Table 3-40
GE 2007 Medicare Reimbursement Information by Product
Table 3-41
McKesson Horizon Physician Portal Benefits
Table 3-42
McKesson Horizon Hospital Portal Benefits
Table 3-43
McKesson Horizon Portal Benefits
Table 3-44
athenaEnterprise Services Functionality
Table 3-45
athenaEnterprise Services Functionality
Table 3-45 (Continued)
athenaEnterprise Services Functionality
Table 3-46
3M Ambulatory Revenue Management Software Functions
Table 3-46 (Continued)
3M Ambulatory Revenue Management Software Functions
Table 3-47
GE Centricity PM Features
Table 3-48
Cerner physician enterprise application suite functions
Table 3-49
Siemens Unity® Financials Registration And Billing
Applications Key Features
Table 3-50
Siemens Unity® Financials Transactions
Within Workflows Functions
Table 3-51
Siemens Unity support for organizational business goals
Table 3-52
McKesson Horizon Practice Compliance Modules
Table 3-53
McKesson Horizon Practice Compliance Module Benefits
Table 3-54
McKesson Horizon Practice Imaging Module Benefits
Table 3-55
McKesson Horizon Practice Imaging Module Benefits

Table 4-1
Semantic Indexing Benefits L&C’s LinkBase® Medical Ontology
Figure 4-2
L&C’s LinkBase® Semantic Process Flow Index Component
Medical Ontology
Table 4-3
Information Extraction with TeSSI® Extraction Engine Functions
Figure 4-4
L&C TeSSi Indexing L&C TeSSi Search
Table 4-5
Resulting Template With Extracted Information
Figure 4-6
Semantic Extraction by TeSSi Semantic Indexing by TeSSi

Table 5-1
AHIMA Computer-Assisted Coding Software
Standards Directions
Table 5-2
Artificial Medical Intelligence Computer Assisted
Coding Solution Benefits
Table 5-2(Continued)
Artificial Medical Intelligence Computer Assisted
Coding Solution Benefits
Table 5-3
CodeRyte Overview
Table 5-3 (Continued)
CodeRyte Overview
Table 5-3 (Continued)
CodeRyte Overview
Table 5-3 (Continued)
CodeRyte Overview
Table 5-4
LingoLogix Automated Coding With GoCode Benefits

COMPANIES PROFILED

A-Life Medical
CodeRyte
3M Health Information Systems
CraneWare
MDS Medical
QuadraMed
Meditech
LingoLogix
Cerner
Artifical Medical Intelligence AMI
Accuro / CodeCorrect
Language and Computing
PLATO
WCC
Professionals (RBMP)
AHIMA Computer-Assisted Coding Software
Standards Workshop
Radiology Business Management


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