Optum360, LLC

Optum360, Llcq

Michelle Wieczorek

Mark L Morsch

Ronald Sheffer

Computer-based, natural language processing systems and methods are provided for review of clinical documentation and other medical records, and for clinical documentation improvement. The systems and methods are configured to analyze received diagnoses and/or procedures in view of documents in the record using a natural language processor and a tiered information model to identify clinical indicators, and optionally markers. The identified information is compared with the received data for use in generating queries requesting evidence in support of the received diagnosis or procedure, or for use in validating the received information.

Automated clinical indicator recognition with natural language processing

Computer-based, natural language processing systems and methods are provided for review of clinical documentation and other medical records, and for clinical documentation improvement. The systems and methods are configured to review documents in the record using a natural language processor and to identify clinical indicators with associated contextual information. The clinical indicators are compared to scenarios to generate markers based on an information model. The markers used to generate physician queries and other informational requests with supporting evidence for each query based on indicators identified in the record. In additional examples, pragmatic guidelines including business-based rules can also be utilized, either in combination with, or as part of, the scenarios in the information model.

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Waterford, PA, United States of America

Michelle Wieczorek