Ontology based medical system for automatically generating healthcare billing codes from a patient encounter

• US 20060020492A1
• Filed: 07/22/2005
• Published: 01/26/2006
• Est. Priority Date: 07/26/2004
• Status: Abandoned Application

• Current Assignee: Wisper Technologies LLC
• Original Assignee: Wisper Technologies LLC
• Inventors: Brewster, Ravindra R., Cousineau, Leo E., Young, Harry, Cherpes, Peter L.
• Application Number:
  US11/186,761
• Publication Number:
  US 20060020492A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06F 40/295 Named entity recognition
• CPC Class Codes: G06N 5/02 Knowledge representation; Symbolic representation
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G16H 20/00 ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A healthcare related system is disclosed in which non-standard input data is corrected in a syntax processing block with reference to one or more healthcare lexicons, and a resulting corrected data file is thereafter used by an ontology processing block to reference an ontology and generate a standardized output including one or more healthcare billing codes.

Claims

1. A system for generating healthcare billing codes, comprising:

a syntax processing block associated with a healthcare lexicon adapted to receive non-standard input data generated during a patient encounter and to generate a corrected data file including components from the healthcare lexicon; and

,

an ontology processing block adapted to receive the corrected data file and to generate, in response to the corrected data file, standardized output data including one or more healthcare billing codes associated with the patient encounter.

2. The system of claim 1, where the healthcare billing codes include at least one of a medical diagnosis code and a healthcare procedure code.

3. The system of claim 2, where the healthcare billing codes include at least one healthcare procedure code belonging to a set of healthcare procedure codes of Current Procedure Terminology, Yth edition, where Y≧

4.

4. The system of claim 3, where the healthcare procedure code is an Evaluation &

Management (E&

M) code.

5. The system of claim 2, where the healthcare billing codes include a medical diagnosis code belonging to a set of diagnosis codes of the International Classification of Diseases, Xth edition, Clinical Modification, where X≧

9.

6. The system of claim 1, where the standardized output data is formatted in accordance with a healthcare services claim form.

7. The system of claim 6, where the healthcare services claim form is one of a CMS-1450 and a HCFA-1500 claim form.

8. The system of claim 1, wherein the non-standard input data comprises voice data, and the syntax processing block comprises a speech recognition application associated with the healthcare lexicon.

9. The system of claim 1, wherein the non-standard input data comprises handwriting, and the syntax processing block comprises a handwriting recognition application associated with the healthcare lexicon.

10. The system of claim 1, wherein the non-standard input data comprises text data, and the syntax processing block comprises a forms recognition application.

11. The system of claim 1, wherein the non-standard input data comprises an electronic file, and the syntax processing block comprises a file parsing application.

12. The system of claim 1, wherein the non-standard input data comprises at least one of voice, handwriting, text, image data, and an electronic file, and wherein the syntax processing block comprises at least one of a voice recognition application, a forms recognition application, an image recognition application, and a file parsing application associated with the healthcare lexicon.

13. The system of claim 1, wherein the syntax processing block comprises a capture block wirelessly connected to a staging block.

14. The system of claim 13, wherein the capture block comprises a wireless microphone generating a voice transcript signal, and wherein the staging block comprises a digital logic platform receiving the voice transcript signal and generating the corrected data file in response to the voice transcript signal and with reference to the healthcare lexicon.

15. The system of claim 14, wherein the digital logic platform comprises;

a Personal Computer (PC), a tablet PC, a laptop PC, or Personal Digital Assistant (PDA), or other transportable computing hardware.

16. The system of claim 14, wherein the digital logic platform comprises computational logic and memory adapted to run:

a capture application enabling receipt of the voice transcript signal and generation of a voice data file from the voice transcript signal;

a syntax application generating the corrected data file from the voice data file; and

with reference to the healthcare lexicon,

an interface application enabling a data communication link between the syntax processing block and the ontology processing block.

17. The system of claim 16, wherein the data communication link between the syntax processing block and the ontology processing block comprises a Wireless Local Area Network (WLAN), a Wireless Metropolitan Area Network (WMAN), an ad-hoc wireless network, a hardwired Local Area Network (LAN), or an Ethernet connected network.

18. The system of claim 16, wherein the syntax application comprises a subroutine correcting components in the voice data file with reference to the healthcare lexicon.

19. The system of claim 16, wherein the syntax application comprises a subroutine correcting the voice data file in accordance with a criteria.

20. The system of claim 16, wherein the syntax application comprises one subroutine correcting components in the voice data file with reference to the healthcare lexicon and another subroutine correcting the voice data file in accordance with a criteria.

21. The system of claim 20, wherein the ontology processing block comprises a database or other persistent data storage mechanism adapted to store the corrected data file received from the syntax processing block, and a server.

24. The system of claim 1, wherein the standardized output is standardized in relation to at least one of:

Health Insurance Portability &

Accountability Act (HIPAA) standard;

a Health Care Procedures Coding System (HCPCS) standard;

Systematized Nomenclature of Medicine—

Clinical Terms (SNOMED CT);

International Classification of Diseases;

X^th revision, Clinical Modification (ICD-X-CM) standard, where X≧

9;

Current Procedural Terminology (CPT-Y) standard, where Y≧

4;

Health Level 7 (HL7);

a Digital Imaging and Communications in Medicine (DICOM) standard;

a Food &

Drug Administration (FDA) standard;

a Veterans Affairs (VA) standard;

a National Library of Medicine (NLM) standard;

a Health and Human Services (HHS) standard;

a Centers of Medicare and Medicaid Services (CMS) standard, or a World Health Organization (WHO) standard.

22. The system of claim 22, wherein the server comprises computational logic and memory adapted to run an ontology application adapted to reference the ontology in relation to the corrected data file and generate the standardized output.

23. The system of claim 22, wherein the computational logic and memory are adapted to run an interface application enabling access to the standardized output by an external system.

25. A system, comprising:

a syntax processing block comprising;

a wireless microphone system adapted to receive from a user non-standard voice input data relating to a patient encounter from a user and to generate a voice transcript signal in response to the non-standard voice input data;

a digital logic platform adapted to wirelessly receive the voice transcript signal and to generate a corrected data file with reference to a healthcare lexicon; and

,

an ontology processing block adapted to receive the corrected data file from the syntax processing block via a data communication link and to generate in response to the corrected data file a standardized output including one or more billing codes.

26. The system of claim 25, where the healthcare billing codes include at least one of a medical diagnosis code and a healthcare procedure code.

27. The system of claim 26, where the healthcare billing codes include at least one healthcare procedure code belonging to a set of healthcare procedure codes of Current Procedure Terminology, Yth edition, where Y≧

4.

28. The system of claim 27, where the healthcare procedure code is an Evaluation &

Management (E&

M) code.

29. The system of claim 26, where the healthcare billing codes include a medical diagnosis code belonging to a set of diagnosis codes of the International Classification of Diseases, Xth edition, Clinical Modification, where X≧

9.

30. The system of claim 25, where the server is adapted to communicate the healthcare billing code to the digital logic platform for review.

31. A system allowing hands-free entry of non-standard input data during a patient encounter and generating a corresponding standardized output, comprising:

an ontology application running on a server, referencing an ontology in relation to a corrected data file stored in a database associated with the server, and generating a standardized output including at least one healthcare billing code; and

a digital logic platform connected to the server and generating the corrected data file in relation to the non-standard input data and with reference to a healthcare lexicon.

32. The system of claim 31, wherein the non-standard input data is component corrected in the digital logic platform with reference to the healthcare lexicon.

33. The system of claim 32, wherein the non-standard input data is further corrected in the digital logic platform in relation to a criteria.

34. The system of claim 33, wherein the non-standard input data is further corrected in the digital logic platform in relation to user input resulting from a set of grouped data elements visually communicated to the user on a display associated with the digital logic platform.

35. The system of claim 31, where the server communicates the healthcare billing code to the digital logic platform for review.

36. The system of claim 31, where the server generates an output in a standard format for a healthcare services claim form.

37. The system of claim 36, where the healthcare services claim form is one of a CMS-1450 and a HCFA-1500 claim form.