AI-powered clinical coding software ‘live and in the lab’

“It’s amazing! It’s taking us just five minutes to code a case instead of 20 minutes…”

On Wednesday 19 March, AI developer HeartAI and AusHealth launched a live version of CODEXA, the AI-powered software set to revolutionise the way Australian hospitals are reimbursed for patient care.

“CODEXA has gone live in the lab,” says Adam Phillips, General Manager of HeartAI.

“Basically, we’ve loaded the software with an artificial data set to emulate the end user experience and handed it over to the clinical coders in AusHealth.”

As Adam describes it, the coders are ‘taking a prototype racing car around the track’. While they’re behind the wheel, the software development team is assessing how the coders are using the software and measuring the value that’s being offered by the system.

“We can see whether there’s a natural or optimal flow in the way it’s being used and how it performs. From the information we gather, we can optimise the software to ensure the AI adds real value to the process.”

Julie Stojanovski, Manager of AusHealth’s Clinical Coding division says she and her team have been using CODEXA at every opportunity since it was released on Wednesday.

“It’s amazing!” she says. “For simple cases, it’s taking us just five minutes to code instead of 20 minutes.

“A complex, 100-page coding case could be reduced from two hours to a fraction of the time.”

Julie says CODEXA is a ‘world away’ from the software being used at present by most clinical coders. “The existing software is 20 years old, and it’s a spreadsheet by comparison.

“CODEXA can scan a patient’s clinical notes and use AI to suggest standardised codes for diagnoses and procedures. The coder can then choose the code that’s most relevant.”

The software also includes rules for validation to ensure accuracy and compliance – both critical for completed coded episodes to be approved for payment by Medicare.

“At present, clinical coding is a real brake on hospitals being paid – it slows their revenue cycle dramatically.

“But if we can code four times faster and with a greater degree of accuracy, we’ll unlock huge revenues for cash-strapped healthcare providers.”

AusHealth CEO Justin Coombs says CODEXA is already generating tremendous interest among the health care industry. “There’s nothing like it in Australia,” he says. “Effectively, we’re overcoming the very real challenge of coordinating the development of the AI-enabled software with the realities and complexities of the clinical space.

“To say we’re excited about it is a bit of an understatement…”

The next step for the CODEXA project is to replace the artificial lab data with real but anonymous – or ‘de-identified’ – data to further enhance the development process.

Adam Phillips says this phase of the project is commencing now, along with an application to integrate CODEXA into a live clinical setting within the next two months.

Visit: www.aushealth.com.au/clinical-coding

(L to R) HeartAI’s James Malycha, Lukah Dykes, Adam Phillips and Lukasz Wiklendt. Photo: James Field