Blog

Author: Matthew Flores MS, RRT, CHCA  

Before we assess whether Natural Language Processing (NLP) could benefit HEDIS® reporting, it is important to look at the history of HEDIS as well as some of the information surrounding trends in quality reporting from a regulatory and operational standpoint to put the question into perspective.

The Setting

The Healthcare Effectiveness Data Information Set (HEDIS) is an important set of healthcare quality indicators developed and administered by the National Committee for Quality Assurance (NCQA) with the goal of improving the triple aim in healthcare. This is accomplished by measuring care provision at the payer level which has historically relied heavily on claims and other administrative data as the primary means for measuring clinical activities.

When HEDIS started, administrative (e.g. claims) data was the primary type of clinical information most health plans received for their patients. Over time, Hybrid measures were added using Medical Record Review (MRR) to bridge the gap of information not received in administrative data for some measures. HEDIS evolved to incorporate supplemental data from various other data sources such as immunization registries and eventually EHRs.


How the Medical University of South Carolina (MUSC) is using Natural Language Processing to improve clinical care

Social determinants of Health (SDoH) are a top priority of agencies globally such as the World Health Organization (WHO), as well as back here in the U.S. where the Center for Disease Control (CDC) has its own variation of goals per Healthy People 2020. The exact definition of what is included in SDoHs varies - but what remains clear is that they are social factors which impact the health of individuals. These may include a myriad of components, such as: stress, social isolation, employment (or lack of), social support, addiction, food insecurity, transportation issues, etc. SDoHs are primarily found within the clinician narrative in electronic health records (EHR), and are difficult to find when trying to identify individuals to ensure proper care.

Sometimes physicians focus excessively on the ‘medical’ problems and don’t pay enough attention to the context that people live in and the social aspects that influence their health. Our study [utilizing Linguamatics NLP] once again highlights the importance of knowing this information in order to provide patients our very best care.

- Leslie Lenert, M.D., MS, Chief Research Information Officer for MUSC and director of MUSC’s Biomedical Informatics Center (BMIC) 1


Spring is a lovely time to be in Cambridge – winter is finally moving on, the spring bulbs are out and the trees are in blossom. Time for Linguamatics Spring Text Mining Conference, which again this year was blessed with lovely sunshine. And of course, the opportunity to hear the latest about Linguamatics products and some new and fascinating use cases from our customers.

In March 2019, attendees from across pharma and healthcare came to our Spring Text Mining Conference, for hands-on workshops, a Healthcare Hackathon, networking and great presentations. The presentations covered innovations in using Natural Language Processing (NLP) to get more value from a range of unstructured text, covering electronic medical records, regulatory documents and patient social media verbatims.


Throughout my journey of becoming a physician, I have been privy to lots of varying medical opinions/practices. One thing I have noticed is a lack of taking the entire patient, that is all the information available about a patient, into consideration. Now, working for a company specializing in Natural Language Processing (NLP), I find myself wondering how could NLP have helped in these situations?

One stop shopping

I once came across a chain-smoking cardiologist, who would eat fast food everyday. He found it pretty humorous when I cracked a joke about his office proximity to the chain restaurant. I suggested that he put in a revolving door connected to the restaurant and start a campaign of “One Stop Shopping! Get your arteries filled and roto-rootered all within walking distance!” That is if you can walk about 100 feet with a lifestyle such as that. His response? Something about not being a nutritional expert: “my expertise is the heart!” At least, he did always tell his patients not to do what he did.


Hot Topics at HIMSS19

The 2019 Annual HIMSS Conference & Exhibition in Orlando proved to be another spectacular event. HIMSS continues to grow, with an estimated 45,000+ individuals from over 90 countries attending (a 5K population increase in projections from last year).  This was Linguamatics 5th consecutive year exhibiting at HIMSS, and each time it seems the more information we ingest from the event, the more eager we are to attend the subsequent year. This 5-day event offers endless opportunities to educate oneself on ‘what’s new’ and ‘hot topics’ within the industry, and to engage in robust networking sessions.

Trying to find the “signal in the noise” can be difficult at HIMSS. It is both exciting and overwhelming. Two topics of particular interest come to the forefront of my mind: Artificial Intelligence and Interoperability is the one and physician burnout is the other. Burnout ‘studies’ seem to be wildly inconsistent but when you look at the frustrated, sometimes defeated physician faces (and hear the tone of the conversations) my expertise says there is only one obvious conclusion!