2. IMO as Clinical Foundation Terminology in your MEDITECH System

3. Subjects to touch IMO and MEDITECH partnership
IMO as Clinical Foundation Terminology
IMO supports Clinicians
IMO in the Centre: stable IMO term / ID
IMO is ready for SNOMED CT, ICD – 10 and OPCS4
IMO implementation: joint project
IMO Terminology Maintenance 3

4. Clinical Terminology as a Foundation
Capture Diagnosis for Problem List
Capture Diagnosis for Billing
Order Entry & Charge Capture
Clinical Decision Support
Quality Measures
Capture Clinical Intent
Groupers
Structured Clinical Data from EHRs
Multiple, distinct data sources
Clinician Entry
Structured Data From Unstructured Text
Retrospective Claims Data
New Code Sets
Term Requests
Lab, Rx, & Dx testing Data
IMO Terminology Foundation 4

5. Clinician Adoption- Key Factors
Clinically friendly Terms- DO NOT TRY TO TURN DOCTORS INTO CODERS
Clinicians do not express themselves as a coder would
IMO’s Clinical team “translates” standard code sets in a clinical fashion
Desired term must be found quickly - “Do not slow me down”
Smart Search - “Google-Like”, “Did you mean…”, “Type ahead”, etc.
Term Synonymy - Multiple ways to express same concept
Capture and Preserve Clinical Intent
Terms are not limited to standard code sets, however all terms are still mapped to appropriate code sets
Terms must have appropriate granularity - Can be more or less specific than ICD or SNOMED
Rapid Term Request Process

6. What does IMO support?
Capture complete clinical content at the point of care
Multiple codes per clinical term
Use of ED Subsets: easy transfer of multiple coded information
Secondary use of data
Conversions to SNOMED
Co-morbid conditions
Maintenance of descriptions and administrative code sets

7. IMO’s Clinical Interface Terminology- Problem
275,000 + Clinically-friendly descriptions
75% of which are more granular than SNOMED CT®
All terms map to SNOMED CT® UK Version
Pragmatic coverage of SNOMED CT® clinical terms
All terms map to ICD-10 UK 5th Edition
Full “same as” coverage of ICD-10-UK 5th Edition
IMO assumes maintenance of all terms and codes including new descriptions and code set updates

8. Clinical Interface Terminology
IMO Clinician-Friendly Terms
Synonymous
Administrative Mappings
ST elevation myocardial infarction (STEMI)
ST elevation MI (STEMI)
Heart attack with ST elevation
STEMI (ST elevation myocardial infarction)
Heart attack STEMI
SNOMED CT®
ICD-10 5th
I21.3
IMO Lexical Title & ID
Read v2
G30X0
…and MORE
Future Support
Read CTv3
XaIwM
MedDRA
ICD-11
CA11.1
Each of these descriptions carries its own unique IMO Lexical ID

9. Accurate and Efficient SNOMED CT Code Capture
IMO Solution
Quickly and easily capture ALL SNOMED CT codes with ONE IMO term selection
Clinician Selects
IMO Lexical includes mapping to all three SNOMED CT codes
SNOMED CT Carcinoma of breast (disorder)- preferred primary
SNOMED CT Clinical stage I (finding)- non-preferred primary
SNOMED CT Estrogen receptor positive tumor (disorder)- non-preferred primary
“carcinoma of breast, stage 1, estrogen receptor positive”
IMO Lexical ID:
Without IMO
Clinician needs to search for and select THREE distinct SNOMED CT terms
Without complete SNOMED CT coding on the problem list Quality Measures may fail
SNOMED CT Carcinoma of breast (disorder)- preferred primary
SNOMED CT Clinical stage I (finding)- non-preferred primary
AND
SNOMED CT Estrogen receptor positive tumor (disorder)- non-preferred primary

10. Clinical Terms with >1 SNOMED CT Code Map
IMO Lexical ID
IMO Lexical
# SNOMED CT Codes
Colon cancer metastasized to bone 3
Severe binge-eating disorder, in full remission
Hypophosphatemic nephrolithiasis osteoporosis syndrome type 1 4
Pregnancy with nephrolithiasis in first trimester
Malignant melanoma metastatic to lymph node
Type 1 diabetes mellitus with moderate nonproliferative retinopathy of both eyes and macular edema 5

11. Outcome based healthcare REQUIRES good data
Secondary Use of Data
Interoperability is Key
Population Health
Quality Reporting
Data Analytics
Value Based Care
Healthcare is requiring more and more data,
Outcome based healthcare REQUIRES good data

12. International Support
Support of International Code Sets
ProblemIT- ICD-10-AM, CA, AU, UK, WHO
ProcedureIT- OPCS 4.8, CCI
Support Region Specific Use Cases
Emergency Department Subsets- Australia (VEMD), United Kingdom (ECDS)
Local Codes Set Conversion to SNOMED CT
Support of Regional Spelling Variations
Anemia vs. Anaemia
Esophageal vs. Oesophageal

13. ECDS – IMO Solution
ECDS
Type 1 diabetes mellitus
Type 2 diabetes mellitus
Breast cancer
+757 MORE …
275K IMO terms in UK Release-
160K are children of ECDS terms
IMO allows for the ACCURATE documentation of the patient’s condition AND adherence to the ECDS reporting standards

14. IMO Search
SNOMED CT not designed as a clinical documentation terminology
IMO allows for:
Synonymy
Co-morbid conditions
Staging
Laterality
Spelling variations
Hyper specific terms beyond standard code sets

15. Content Size and Granularity
IMO
800,000
SNOMED CT
Genetic defect
100,000
IMO supports clinically friendly terms that are both more and less granular than either ICD or SNOMED CT supporting multiple use cases
Degree of Granularity
ICD-10-UK
5th Ed.
Chromosomal Abnormality
18,000
Chromosomal alterations of group C and X

16. IMO Search IMO Term Distinction
Carcinoma of breast, stage 1, estrogen receptor positive
Staging & specificity
Type 2 diabetes mellitus with ophthalmic complication
Co-morbid condition
Renal Calculi
Spelling variation
Bladder cancer metastasized to bone
Specificity
Abnormal ultrasound of gallbladder
Definition of anatomy beyond SNOMED
Recurrent otitis media
Modifier
Bilateral knee pain
Laterality

17. IMO in MEDITECH (Expanse)
IMO ProblemIT is fully integrated in MEDITECH
IMO ProblemIT will be delivered and configured by IMO in cooperation with MEDITECH
IMO will work with you and MEDITECH to normalize you existing MEDITECH Dictionaries
IMO will add any term to the delivery
IMO will make sure your Terminology is accurate
You will get updates through the VM

18. MEDITECH Dictionaries impacted

19. Coding at the Source – Fully integrated in the EMR
The IMO Clinical Terminology
Natural Physician Language
IMO Package: use case based/localized
IMO Lexicals: “terms”: structured search
Coders – Administration
DRG’s
Billing Codes
Clinical Statistics
Clinical Documentation
Validation
Reporting
Communication
Data Analysis
………..
Using the IMO Code gives highly specific and valued clinical documentation
ICD-9
IMO Clinical Concept
ICD-10
SNOMED CT
IMO Lexical ID’s
CPT
...ETC....
OPCS4
LOINC
External Standard Codes ID
Clinical Vocabulary – Clinical Concepts – Maps
Coding at the Source – Fully integrated in the EMR
ProblemIT and/or ProcedureIT

20. IMO Mapping (ProblemIT)

21. IMO Mapping (ProcedureIT)

22. Terminology Request Process
Provider can’t
find term or Challenge a term
Doctor is
able to use
new term
Coordinator /Provider
sends request
to VMWC
Term is available**
VMWC submits
term to
web site*
If approved,
term added to
next release
IMO reviews
and approves
or rejects;
IMO created the Terminology Request Website to provide clinicians the ability to interact with the IMO Knowledge Team
Users are able to expand the terminology breadth by requesting IMO to add terms that are desired and not yet in our terminology dictionary.
Users are also able to send editorial questions regarding any term or term-related issues
With ten updates/year, terms are added quickly once they are reviewed by our Knowledge Team
We use a WIKI model so that we can leverage new terms that are added across our customer base – in this way, each customer benefits from all terminology requests
All term requests are funneled to your organization’s designated Terminology Maintenance Website Coordinator in order to manage the process seamlessly.
**All Products reflect term in subsequent release as well as providing all applicable standard mapping
*VMWC (Vocabulary Maintenance Website Coordinator) coordinates between clinician and Term Request web site

24. Phases of implementation
Agreement
Effective Date
Kickoff (1 – 4 weeks): Client & IMO call outlining timeline of on-boarding and integration.
Content Deployment (3 – 4 weeks): IMO server and content installation.
EHR Connectivity (3 – 4 weeks): MEDITECH MIS Team configures EHR parameters to connect to IMO.
Dictionary Reports (4 – 6 weeks):
a. IMO excutes a Health Check on the existing dictionaries
b. Client runs dictionary reports in scope for IMO migration and sends to IMO
Product Training (5 – 7 weeks): IMO trains clients on IMO tools used for dictionary migration.
MapIT/CQM (7 – 12 weeks): Client approves IMO’s curation and mappings in client dictionaries.
Export (12 – 14 weeks): IMO exports client’s dictionaries and sends back to client.
Reconciliation (14 – 16 weeks): Client loads dictionaries back into MEDITECH to complete reconciliation.
Debriefing (16 weeks)

25. Some Wins for Customer using IMO
Full Clinical Alignment with the 2020 SNOMED initiative
No burden for Clinicians to find a diagnosis and a related code
Includes maps to ICD-10-NHS
Terminology Management (maintenance, updates)
Better Clinical Data (clinical documentation, interoperability, reporting, research)
Less communication errors (wrong codes, less coding efforts)
Coders can focus on reporting and management of data (better and more precise data)
Ever stable IMO ID for downstream use

26. IMO is THE Terminology Foundation for effective and efficient working with MEDITECH
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SNOMED and SNOMED CT are registered trademarks of the SNOMED International.
CPT is a registered trademark of the American Medical Association. All rights reserved.