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For The Record
E-Newsletter    December 2022
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Editor's E-Note

Researchers need the public’s health to combat biases based on race and other disadvantaged groups in artificial intelligence (AI) algorithms for health care. A team led by the University of Birmingham and University Hospitals Birmingham wrote in Nature Medicine about the fact that biases in datasets used to create AI algorithms may lead to certain groups of people receiving inaccurate predictions, which can result in misdiagnoses and improper treatment.

In addition to reading our e-newsletter, be sure to visit For The Record’s website at www.fortherecordmag.com. We welcome your feedback at edit@gvpub.com. Follow For The Record on Facebook and Twitter, too.

Kate Jackson, editor
In This E-Newsletter
E-News Exclusive

Racial and Other Biases in Artificial Intelligence for Health Care

Members of the public are being asked to help remove biases based on race and other disadvantaged groups in artificial intelligence (AI) algorithms for health care.

Health researchers are calling for support to address how minoritized groups, who are actively disadvantaged by social constructs, would not see future benefits from the use of AI in health care. The team, led by the University of Birmingham and University Hospitals Birmingham, wrote in Nature Medicine on the launch of a consultation on a set of standards that they hope will reduce biases that are known to exist in AI algorithms.

There is growing evidence that some AI algorithms work less well for certain groups of people—particularly those in minoritized racial/ethnic groups. Some of this is caused by biases in the datasets used to develop AI algorithms. This means patients from Black and minoritized ethnic groups may receive inaccurate predictions, leading to misdiagnosis and the wrong treatments.

Other News

Charted: Just How Accurate Are Telehealth Diagnoses?
A Mayo Clinic study published in JAMA Network Open concluded that telehealth assessments are no less accurate than in-person consultations, with equivalent diagnoses in nearly 90% of cases.

Medical Coding Inhibiting Transgender Care
The reasons transgender patients are denied insurance coverage for gender-affirming care go beyond transphobia, according to Kaiser Health News, which reports on the ways in which medical coding contributes.

The Downside of Medicare Advantage Programs
According to The Indypendent, although Advantage programs offer expanded benefits, they can limit access to care and require prior authorizations and formulary restrictions.

The Benefits of Biometric Data for EHRs
There are patient security hurdles to overcome, but, according to a report in EHR Intelligence, the addition of biometric data to the EHR may enhance patient matching and result in cost savings.

Adding Glucose Measures to the EHR
Juan Espinoza, MD, of Children’s Hospital Los Angeles, University of Southern California, cochairs a project that aims to establish the first standard for integrating information from a wearable device into the EHR—specifically, continuous glucose monitoring data for people with diabetes. Medscape reports on the project.


Ask the Expert

Have a coding or documentation question? Get an expert answer by sending an email to edit@gvpub.com.

Do you have a National norm—how frequently is it billed? I understand it should not be billed frequently. I have not seen it billed frequently in the past.

It’s not common to find utilization information for codes other than outpatient office visit evaluation and management services, and there isn’t a good resource for what might be considered a “National norm.” Prolonged services have been a target of the Office of Inspector General (OIG) historically. In a previous posting, the OIG indicated, “the necessity of prolonged services is considered to be rare and unusual.” One of the best defenses against potential overbilling or inappropriate code use is to have a solid audit process in place for prolonged services. Current EHR and computer-assisted coding software technology are great tools for identifying unusual billing patterns for codes such as prolonged services. In addition, use the data tools within the coding and billing applications you have to track general usage of the code monthly, quarterly, and even yearly. Periodic auditing of documentation and coding for prolonged services is a good idea in general, but data review allows for easy identification of coding fluctuation, targeted review, and physician education if necessary. Also, review the OIG Work Plan on a regular basis for information around emerging issues with prolonged service codes.

— Karla VonEschen, CPC, CPMA, has worked in health care for more than 25 years in various roles ranging from health plan operations, consulting, auditing, and technology. She’s been a clinical development analyst for 3M HIS since 2015, working with The 3M℠ CodeAssist℠ System Products and most recently transitioned to a role as a clinical analyst with the 3M Content Team.
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