Who is Filling the Gap in the Clinical Terminology World?

The Mystery

I have worked in Healthcare Informatics long before it was called Healthcare Informatics, and this year was the first time I heard the term “IMO”.  While working on a data warehousing project the client asked if their Epic instance was storing Intelligent Medical Objects (IMO) codes.

In typical consultant fashion, I said I’d have to look into it.  Off to Google I went.

Naturally, the first hits were IMO’s website, Wikipedia plus an older news release about Epic integrating IMO with their EHR.  Curiously, IMO’s career posting page boasts that they need help to “continuously deliver our products and services to over 80% of US clinicians”.  MedAptus, one of IMO’s partners, says that “IMO’s terminology database is used by more than 2,500 hospitals and 350,000 physicians daily”. Why had I never heard of IMO?  Am I the only one?

Mission

So, who is IMO and what are their intentions?

Intelligent Medical Objects (IMO)’s website is very clear about what they do:

IMO is Clinical Interface Terminology

We bridge the gap between clinical language and complex coding systems.

Through a focus on the adoption and advancement of healthcare standards, accurate capture of clinical data at the point-of-contact, and timely management of semantic interoperability, IMO provides tools to healthcare organizations to support efficient billing, improved revenue cycle management, adoption of healthcare technology, and enhanced decision support, patient education and data analytics.  And in the end they aim to improve “global health”.

Definition

At the American Health Information Management Association (AHIMA) Clinical Vocabulary Mapping Methods Institute, Dr. Andrew Kanter, IMO’s Chief Medical Officer presented Vocabularies: Critical Software Infrastructure for Interoperability and Adoption Workshop, which focused on the keys to technology like IMO:  interoperability, ease-of-use and outsourced risk.

“In healthcare, interoperability is the ability of different information technology systems and software applications to communicate, to exchange data accurately, effectively, and consistently, and to use the information that has been exchanged.”

In healthcare we like to adopt a standard and then customize it to fit our providers, administrators and work flows.  There is a tug-of-war between understanding the wide-spread benefits of strict standards and the need to support the adoption of technology by end-users.

Even if we did agree to adopt a standard vocabulary, we still have too many to choose from.  In healthcare, there is no standard vocabulary for a specific use.  For example, we can use ICD or SNOMED for diagnosis codes; we use CPT, HCPCS, ICD or SNOMED for procedures; LOINCs and CPTs are used for labs; and medications may use NDC or RxNorm.

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Getting staff to adopt and adapt to the ever-changing landscape of healthcare terminology is a big challenge.  Doctors are more likely to adopt technology if they can continue to think like doctors, and not like the billing department.

On the other hand, when all front and back end users of technology see a benefit, the mere fact that they will use it is a tremendous benefit.  One organization integrated clinical and financial coding, so each part of the organization could get what they needed into and out of the data.  Physicians in particular had positive experiences and replied to the experiment with:

“I spend less time searching for and/or documenting diagnoses/problems in [the EHR].”

“I can enter more meaningful clinical documentation (more closely describe the true clinical situation, or capture more detailed information).”

The final reward for users of technology like IMO is “Managing the Madness”.  Dr. Kanter points out that managing the vocabularies is difficult, time consuming and can come with a high risk and cost, if done incorrectly or not in a timely manner.

Products

IMO’s products provide users with an interface between user-friend front end and complicated vocabulary management in the back end.

Three products, Problem IT™, Procedure IT ™, and Map IT™ lay the foundation for turning clinician and patient friendly terminology into billing, operational and administrative data, and vice versa.

Problem IT™ provides expressions that are more familiar to clinicians for choosing diagnosis codes for the encounter, problem list and past medical history.  Patients are also given information that they understand to better understand and manage their conditions.

Procedure IT™ also employs a user-friendly interface to allow clinicians to select relevant procedure codes using familiar terminology, and for patients to understand their patient health records while the tool translates the choices for billing and other code sets.

Map IT™ works behind the scenes to allow searches for key words or code sets, and link existing terminology maps to IMO content.

Partners

An article on crunchbase.com claims that Intelligent Medical Objects (IMO) is the “market leader in clinical interface terminology and a strategic partner with major content providers and EHR developers.”

IMO’s website list a wide range of partners.  They cover healthcare associations (eg. AHIMA, AMA), drug and clinical content providers (eg. Lexi-comp, Netsmart), healthcare revenue cycle, charge capture and management technologies (eg. MedAptus, CloudCare), and Electronic Health Record (EHR) software (eg. Epic, Cerner, AllScripts, Aprima, NextGen).

eClinicalWorks’s website states that “with IMO, eClinicalWorks users find the right terms quickly and easily, encouraging thorough and accurate documentation. Clinician terms are translated automatically into administrative codes for billing. Maps to reference vocabularies power intelligent searching, clinical decision support, and business intelligence tools.”

Lexi-Pro, a  leading provider of print and electronic medical references, formed the Lexi-Comp/IMO partnership.  It supports their main product, Medication Enhanced, by pulling “these two worlds together to enhance medical software with integrated prescription writing, automated drug-to-drug, drug-to-disease, drug-to-herb interaction checking and other computerized tools” to further advance patient safety practices utilizing data.

MedAptus, a software company specializing in charge capture and charge management, and patient assignment and care collaboration products, is also a partner with IMO.  MedAptus’s website lauds IMO: “IMO’s terminology database is used by more than 2,500 hospitals and 350,000 physicians daily, and this trusted terminology platform supports innovations by provider systems. IMO’s medical vocabulary and mapping products effectively capture clinical intent and help EHRs preserve and communicate this across the entire spectrum of care. This accelerates workflow and increases clinician utilization and satisfaction. “

Mystery Solved?

Many of us in Healthcare Informatics are all too familiar with standard vocabularies.  We also know the frustrations of converting one code set to another.  We have seen the challenges of EHR adoption and of forcing codes into disparate worlds.

Clinical interface terminology, like IMO, has applied a user-friendly, interoperable engine to encourage wider use of healthcare data and to add more power to its use across all areas in the industry.

In My Opinion Healthcare Informatics professionals would benefit from education on Intelligent Medical Objects (IMO) and similar technologies.  Understanding the connection between point-of-care clinical content and the stored values in the back end could help data analysts, business analysts, data modelers, as well as many other healthcare professionals, bridge the gap between the myriad of front and back end users of healthcare data.

What is your experience in this realm?  What other companies live in this space?  And where do analysts, developers, and consumers of healthcare data go to find out more?