Innovative Risk and Quality Solutions for Value-Based Care. Company Overview

Transcription

1 Innovative Risk and Quality Solutions for Value-Based Care Company Overview

2 Meet Talix Talix provides risk and quality solutions to help providers, payers and accountable care organizations address the growing challenges of value-based healthcare. Our leading-edge SaaS applications leverage machine learning and advanced patient data analytics to transform complex data into actionable intelligence that drives improved coding efficiency and accuracy leading to better patient outcomes, more accurate reimbursements and reduced costs. To learn more about Talix, visit or contact us at

3 InSight Suite Applications for Value-Based Care Coding InSight: Integrated Risk Adjustment Coding Solution Our Coding InSight application is the first in a suite of applications designed to address the risk adjustment coding challenges that healthcare organizations face as they transition from fee-for-service to value-based care. The application leverages the power of machine learning, combined with proprietary natural language processing (NLP) technology, a sophisticated clinical rules engine and a rich medical taxonomy, to analyze the valuable patient information in claims files, structured clinical data and unstructured data such as free-text physician notes, patient historical charts and hospital admission and discharge notes and transforms that information into actionable intelligence. Fully automated and embedded within physician and coder workflows, Coding InSight enables clinicians and coders to easily identify missed and inaccurately coded conditions prospectively (to plan patient visits), at the point of care (for more accurate coding in real time) and retrospectively (during sweeps and audits). The application then makes code recommendations based on evidence found in the records. The result? More efficient and accurate coding, increased productivity, more accurate risk scores and associated reimbursements, and improved patient outcomes. Coding InSight for Providers Improve coding and documentation accuracy to deliver better care planning, ensure accurate risk scoring and successfully manage valuebased reimbursements Coding InSight for Payers Streamline time-consuming, error-prone manual chart reviews to increase coder accuracy and productivity, and improve financial performance Coming Soon in the InSight Suite! Claims InSight Validate submitted codes, reduce coding errors and close documentation gaps for increased RADV audit confidence Quality InSight Identify care gaps and track performance for improved quality reporting under HEDIS, STARS and ACO benchmark measurements Coding InSight has transformed the coding and risk adjustment processes for Village Family Practice. It has improved not only coding efficiency, but more importantly, the level of care we re able to provide to our patients. As a practice, we are now coding for care rather than for dollars. Clive Fields, MD, President of Village Family Practice

4 Talix Platform The Core Technology that Powers Talix Our innovative Talix Platform is the foundation of Talix s technology. Built from the ground up using data mining and aggregation capabilities, the platform leverages three core technologies each designed to work together with specific frameworks for scalability, maximum efficiency and optimum results. We built the Talix Platform with one goal in mind: to provide powerful, high-quality, analytics-driven solutions that enable risk-bearing organizations to gain greater insight and succeed in the age of value-based care. InSight Suite: SaaS Applications for Value-Based Care Coding InSight Claims InSight Quality InSight InSight Framework (Data Connectors, Administrative Interfaces, OCR) Talix Platform Taxonomy NLP Clinical Rules Search / BI Framework Search/BI Initiatives Clinical Decision Analytics Clinical NLP with Curation Machine Learning Search and Tagging Talix Taxonomy Incrementally developed and meticulously curated over more than 15 years by a team of skilled medical informaticists and data scientists, the Talix Taxonomy maps out more than 1 million health concepts and the more than 2 million relationships that connect them. It is constantly updated, expanded and refined making it the most comprehensive map of healthcare today. Symptoms Breast Lump Nipple Discharge Flaxseed Meditation Inflammatory Carcinoma of Breast Vitamin E Acupuncture Ductal Breast Carcinoma Nutritional Supplements Alternative Therapies Types Medical Name Malignant Neoplasm of Breast Concept Relationships Concept Attributes Semantic Type Neoplastic Process Concept BREAST CANCER Diagnostic Procedures Medical Codes NCI: C4872 ICD9: ICD10: C79.8 Treatments Medications Biopsy of Breast NCI: C51698 ICD9: Mastectomy NCI: C15277 Doxorubicin NCI: C456 RxNorm: Mammography NCI: C16818 ICD9: V76.12 ICD10: Z12.31 Chemotherapy NCI: C63358 ICD9: V58.11 ICD10: Z51.11 CPT-4: Tamoxifen Cancer of Thorax Metastatic Cancer Complications Synonyms Malignant Breast Tumor Cancer of Breast Tumor of Breast Risk Factors BRCA1 Mutation Family History of Breast Cancer Early Menstruation No Known Cause Causes Preventions Physician Specialties Surgeon Oncologist Breast Feeding Low Fat Diet

5 Talix NLP and Clinical Rules Talix NLP (natural language processing) is the result of more than 15 years of search, content and data analytics solutions development for some of healthcare s best-known enterprise brands. Today, the Talix NLP, combined with clinical rules and the Talix Taxonomy, is capable of clinical inference from unstructured data at scale going beyond simple NLP to deliver true natural language understanding. Condition/Finding The patient came in today with ongoing issues with diabetic control. We have been fairly aggressively adjusting her insulin. The patient has been on insulin for a long time. Despite frequent increases in her insulin regimen, she continues to have somewhat high blood glucose, most notably in the evening. The patient underwent an ultrasound-guided core needle biopsy with clip placement of the 2.3cm mass in the upper outer quadrant of the right breast. Diabetes Labs High blood glucose Medications Insulin, Long term (current) use of Insulin Diagnostic Procedure Ultrasound-guided core needle biopsy: clip placement of 2.3cm mass in the upper outer quadrant of the right breast ICD-9: ICD-10: E11.65 HCC: 19 ICD-9: V58.67 ICD-10: Z79.4 HCC: 19 Therefore, the patient was found to have T2N2MX, stage IIIA breast cancer. Condition/Finding Stage IIIA Breast Cancer ICD-9: ICD-10: C HCC: 12 Talix Machine Learning Module The Talix Machine Learning Module enables automated entity pattern recognition based on a training set of entity values. Using a recurrent neural network (RNN) model, it can take a set of curated entity patterns for individual entities and use that for extracting entities out of unstructured text. Search/BI Initiatives Analytics-Driven Programs The Talix Platform s capabilities extend beyond risk and quality analytics. For 15 years, our platform has powered complex clinical search and analytics applications of many leading Fortune 500 healthcare companies. Clinical Decision Analytics Support better clinical decisionmaking by using advanced data analytics to automatically identify the valuable health information found in both structured and unstructured patient data. Clinical NLP with Curation Easily complete patient records with relevant clinical concepts that are extracted from unstructured, freetext databases to improve clinical decision-making, facilitate research initiatives and better determine clinical trial eligibility. Search and Tagging Go beyond simple keyword analysis for smarter, highly accurate search results that facilitate clinical research, improve knowledge management, optimize care planning and streamline operational efficiency.

6 Our Partners and Customers Our team of passionate software engineers, medical informaticists and product leaders are dedicated to making a real difference in healthcare. We work hard every day to bring measurable outcomes to our partners and customers across the U.S. We work to make your life easier, your team better and your documentation more accurate. VILLAGE FAMILY PRACTICE To learn more about Talix, visit or contact us at info@talix.com.

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