A really interesting breakout session was presented by Craig Wilkins of Webmedx. His topic, “Bridging the gap in clinical documentation by applying XML and CDA”, which was designed to help attendees understand three things:
- Everyone (patients, payors, physicians, public health organizations, etc.) all need better access to information
- Documents are the physicians preferred vehicle (60% of physician documents are dictated and transcribed)
- XML and Clinical Documentation Architecture (CDA) are the best paths toward adopting a better data accessibility and management approach
Wilkins shared some statistics to help the audience understand the problems impact in access to healthcare information. He also provided some context on the size of the problem by sharing these numbers:
- U.S. healthcare spend is $2.5 trillion per year
- Total U.S. healthcare spend is nearly 20% of GDP
- %75 of healthcare spend in U.S. is spent on chronic care
- 18,000 billing codes for procedures, but not one for cures
He provided a great overview of the history of physician-generated documentation. For instance, 60% of all clinical information is handwritten or dictated/transcribed, delaying access to the content because of unnecessary steps slowing the process down (scaning, OCR, QA, etc.)
Like other industries, the healthcare arena is adopting content standards. In this case, Wilkins said, “the standard that provides the most opportunity to help us overcome these challenges is an open XML standard known as Clinical Documentation Architecture (CDA).” The standard helps tackle challenges of importance to the providers of healthcare services as well as to the patients. Separating content from its formatting can making it discoverable means that everyone involved can have real-time access to content they need from portable devices.
He also discussed electronic personal health record management systems that allow patients to control their own healthcare data. These services provide patients wit the ability to record their own information, repurpose information (through syndication) from providers, and integrate with other healthcare-related services, some of which may become available in the future.
Wilkins showed a few very specific examples of recent projects on which his firm has worked that utilized the MarkLogic Server, one of which targets improvements in the transcription quality process.
Document accuracy - Data validation
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- Compared unstructured age data (narrative provided by the doctor) and the birthdate data collected on the patient data form to ensure they are in synch
- Medication section of documents includes dosage of medicine prescribed, so the system now compares the dosage prescribed against a database of information on typical dosage suggestions
- Lab value recommendations are compared from the care plan and laboratory results to ensure there are no discrepencies
Wilkins topic was a big one and he had so much content to cover but not really enough time to cover everything tin he way in which I belive he’d like to. Nevertheless, he did a good job showing the types of healthcare-specific solutions his firm has worked on. And, he made it clear that this is just the begining of a new rera in which patients and physicians alike will be empowered by fast access to healthcare content. And, by taking the MarkLogic approach, healthcare organizations can quickly and less expensively provide more meaningful results. Now you don’t need a herd of programmers or a CMS system that requires hundred of thousands of dollars in customizations and maintenance to start analyzing, sorting, comparing, and acting upon content of various types (both unstructured and structured) in myriad formats, quickly, safely, and innovatively.
Learn more about markLogic healthcare solutions.
