Identifying Missing Medical Codes for Re-Coding in Patient Registry Records

• US 20170235883A1
• Filed: 02/17/2016
• Published: 08/17/2017
• Est. Priority Date: 02/17/2016
• Status: Abandoned Application

• Current Assignee: International Business Machines Corporation
• Original Assignee: International Business Machines Corporation
• Inventors: Westfall, Matt T., Harmon, Jonathan M., Kumar, Atul, Olsen, Russell G.
• Application Number:
  US15/045,475
• Publication Number:
  US 20170235883A1
• Time in Patent Office: Days
• CPC Class Codes: G06Q 10/1095 Meeting or appointment
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms

Abstract

Mechanisms are provided to implement a medical code re-coding system. The mechanisms analyze a patient medical record corresponding to a patient, to identify at least one previous occurrence of a medical code in the patient medical record. At least one medical code re-coding rule corresponding to the at least one previous occurrence of the medical code is applied to the patient medical record. Based on results of the application of the at least one medical code re-coding rule, a determination is made as to whether the medical code is a candidate for re-coding. A notification of the medical code being a candidate for re-coding is output in response to the determination indicating that the medical code is a candidate for re-coding.

Claims

1. A method, in a data processing system comprising at least one processor and a memory comprising instructions which, when executed by the at least one processor, causes the at least one processor to implement a medical code re-coding system, the method comprising:

analyzing, by the medical code re-coding system, a patient medical record corresponding to a patient, to identify at least one previous occurrence of a medical code in the patient medical record;

applying, by the medical code re-coding system, at least one medical code re-coding rule corresponding to the at least one previous occurrence of the medical code to the patient medical record;

determining, by the medical code re-coding system, based on results of the application of the at least one medical code re-coding rule, whether the medical code is a candidate for re-coding; and

outputting, by the medical code re-coding system, a notification of the medical code being a candidate for re-coding in response to the determination indicating that the medical code is a candidate for re-coding.

2. The method of claim 1, wherein analyzing the patient medical record comprises:

analyzing a patient registry record in a patient registry to identify a historical set of medical codes present in the patient registry record, wherein the patient registry record is associated with a corresponding patient and comprising personal and medical information about the corresponding patient; and

evaluating the historical set of medical codes to identify at least one medical code in the set of medical codes that has not been re-coded in a subsequent time frame.

3. The method of claim 1, wherein the method is performed in response to detecting the occurrence of a triggering event, and wherein the triggering event is one of the patient scheduling an appointment with a medical practitioner, an elapse of a time period corresponding to a medical incentive program, or a user initiated request to perform the method.

4. The method of claim 3, further comprising:

outputting, by an appointment scheduling system, a reminder output identifying a scheduled appointment of the patient with a medical practitioner, wherein the notification of the medical code is a notification added to the reminder output.

5. The method of claim 1, wherein each medical code re-coding rule in the at least one medical code re-coding rule defines a pattern of one or more medical codes corresponding to medical maladies that are likely to persist in a patient.

6. The method of claim 1, wherein applying at least one medical code re-coding rule corresponding to the at least one previous occurrence of the medical code to the patient medical record comprises:

identifying occurrences of other medical codes within a predetermined time period of a current time in the patient medical record; and

determining if the occurrences of the other medical codes match a pattern of medical codes specified by the at least one medical code re-coding rule.

7. The method of claim 1, wherein applying at least one medical code re-coding rule corresponding to the at least one previous occurrence of the medical code to the patient medical record comprises:

determining if the medical code is present in one or more entries in the patient medical record within a specified time period prior to a current time; and

determining that the medical code is a candidate for re-coding in response to the medical code not being present in any of the entries in the patient medical record within the specified time period.

8. The method of claim 7, wherein the specified time period prior to the current time is a specified time period associated with the medical code, and wherein different medical codes have different associated specified time periods.

9. The method of claim 1, further comprising:

automatically re-coding the medical code in response to the determination indicating that the medical code is a candidate for re-coding.

10. The method of claim 1, wherein the notification comprises user selectable features for confirming or rejecting re-coding of the medical code, and wherein, in response to a user selecting a feature confirming re-coding of the medical code, the medical code is re-coded in the patient medical record.

11. A computer program product comprising a computer readable storage medium having a computer readable program stored therein, wherein the computer readable program, when executed on a computing device, causes the computing device to implement a medical code re-coding system which operates to:

analyze a patient medical record corresponding to a patient, to identify at least one previous occurrence of a medical code in the patient medical record;

apply at least one medical code re-coding rule corresponding to the at least one previous occurrence of the medical code to the patient medical record;

determine, based on results of the application of the at least one medical code re-coding rule, whether the medical code is a candidate for re-coding; and

output a notification of the medical code being a candidate for re-coding in response to the determination indicating that the medical code is a candidate for re-coding.

12. The computer program product of claim 11, wherein analyzing the patient medical record comprises:

analyzing a patient registry record in a patient registry to identify a historical set of medical codes present in the patient registry record, wherein the patient registry record is associated with a corresponding patient and comprising personal and medical information about the corresponding patient; and

evaluating the historical set of medical codes to identify at least one medical code in the set of medical codes that has not been re-coded in a subsequent time frame.

13. The computer program product of claim 11, wherein the computer program product is executed in response to detecting the occurrence of a triggering event, and wherein the triggering event is one of the patient scheduling an appointment with a medical practitioner, an elapse of a time period corresponding to a medical incentive program, or a user initiated request to perform the method.

14. The computer program product of claim 13, wherein the medical code re-coding system further operates to:

output, by an appointment scheduling system, a reminder output identifying a scheduled appointment of the patient with a medical practitioner, wherein the notification of the medical code is a notification added to the reminder output.

15. The computer program product of claim 11, wherein each medical code re-coding rule in the at least one medical code re-coding rule defines a pattern of one or more medical codes corresponding to medical maladies that are likely to persist in a patient.

16. The computer program product of claim 11, wherein applying at least one medical code re-coding rule corresponding to the at least one previous occurrence of the medical code to the patient medical record comprises:

identifying occurrences of other medical codes within a predetermined time period of a current time in the patient medical record; and

determining if the occurrences of the other medical codes match a pattern of medical codes specified by the at least one medical code re-coding rule.

17. The computer program product of claim 11, wherein applying at least one medical code re-coding rule corresponding to the at least one previous occurrence of the medical code to the patient medical record comprises:

determining if the medical code is present in one or more entries in the patient medical record within a specified time period prior to a current time; and

determining that the medical code is a candidate for re-coding in response to the medical code not being present in any of the entries in the patient medical record within the specified time period.

18. The computer program product of claim 17, wherein the specified time period prior to the current time is a specified time period associated with the medical code, and wherein different medical codes have different associated specified time periods.

19. The computer program product of claim 11, wherein the medical code re-coding system further operates to:

automatically re-code the medical code in response to the determination indicating that the medical code is a candidate for re-coding.

20. An apparatus comprising:

a processor; and

a memory coupled to the processor, wherein the memory comprises instructions which, when executed by the processor, cause the processor to implement a medical code re-coding system which operates to;

analyze a patient medical record corresponding to a patient, to identify at least one previous occurrence of a medical code in the patient medical record;

apply at least one medical code re-coding rule corresponding to the at least one previous occurrence of the medical code to the patient medical record;

determine, based on results of the application of the at least one medical code re-coding rule, whether the medical code is a candidate for re-coding; and

output a notification of the medical code being a candidate for re-coding in response to the determination indicating that the medical code is a candidate for re-coding.