Client Background

Client name: Ministry of Health

Industry: Public health, disease prevention, health investment

Areas of operations: Middle East

Who are their customers: ~33 million nationals

Challenge

Medical codes record the story of a patient's interaction with a physician and provide accurate details of the services rendered. These records are used for calculating reimbursement. Additionally, healthcare revenue streams are based on the documentation of what was learned, decided, and performed by the physician. The challenge, however, is that there are thousands of conditions, diseases, injuries, and treatments.

Key challenges:

1. A huge volume of over 1 Million medical records needed to be processed for medical coding by the Wipro team.
2. Medical records from nearly 100 hospitals had to be standardized for language and presentation by reviewing scanned documents.
3. Thousands of descriptions, acronyms and names for each disease, procedure, and tool had to be identified from disarrayed medical records and coded.

Solution:

Wipro leveraged its in-house intellectual property and innovation ecosystem to streamline the medical coding process. The team took just three days to deliver a custom Proof-of-Concept (POC), demonstrating auto-redaction of personally identifiable information (PII) from medical records. The success of this POC was crucial in carrying out due diligence to extend the scope of the project. Improvement in key metrics such as time saved, volume covered, and file size reduction proved vital for the client.

Key solution highlights: 

1. Machine Learning (ML) enabled method to detect and mask barcodes and logos, and keywords in accordance with the International Classification of Diseases (IDC-10).
2. Enabled indexing of medical records to list headings as bookmarks within the same file, offering a clickable `table of contents’.
3. Advanced Optical Character Recognition (OCR) enabled systems to extract handwritten text and highlight keywords.
4. An artificial intelligence (AI) based Code Envisioning Tool extracted clinical data from charts and suggested possible code scenarios with logical rationale, to enable accurate coding

Business Impact

The automation of key activities in this client engagement created a significant impact on the approach to medical coding. With rich experience and deep insights in technology, Wipro was able to identify key opportunities in medical coding process transformation, while working in hyper-customized environments.

1. Over 100 minutes of time saved per resource, per day.
2. Productivity increase of over 40% for skilled medical coders.
3. Reduction in file size by 30%, saving storage space and data transfer charges annually.
4. Reduction in Missing Codes Error by 50%.
5. 15% increase in medical coding accuracy.