Code Encapsulation Reasoning for Single Medical Code Selection
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Solution Overview
Problem
Existing machine learning and AI models for natural language processing struggle to accurately analyze unstructured text, particularly in nuanced contexts like medical coding, leading to multiple code selections where only one is valid, and are prone to high error rates and labor-intensive processes.
Innovation Solution
A holistic logical inference model using a knowledge graph and human-based reasoning framework applies contextual analysis, tokenization, archetype association, and logics operations to determine a single valid code selection by querying encapsulation data and excluding others, mimicking human comprehension.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Extent of automation
If existing machine learning models are used for natural language processing, then automation is achieved, but accuracy deteriorates due to multiple code selections and high error rates
Solution Approach 1:
The patent introduces an intermediary verification mechanism that mediates between the automated ML model outputs and the final code selection. The system uses multiple verification steps including confidence threshold checking, alternative model validation, and expert rule-based verification to ensure accuracy while maintaining automation. This intermediary layer filters out erroneous predictions before they become final results.
Solution Approach 2:
The patent implements feedback loops where the system continuously monitors its own performance and adjusts its processing accordingly. When the ML model produces low-confidence predictions or conflicting results, the feedback mechanism triggers re-analysis using different models or methods. The system also incorporates feedback from validation datasets to refine its selection criteria and improve overall accuracy over time.
2Productivity
If existing machine learning models are used for code selection, then processing speed is improved, but reliability deteriorates due to multiple invalid code selections
Solution Approach 1:
The patent performs preliminary filtering and validation actions before final code selection to prevent unreliable results. The system pre-processes ML model outputs by checking confidence thresholds, validating against known code patterns, and eliminating obviously incorrect selections before committing to a final result. This preliminary action ensures that only high-reliability predictions proceed to the selection stage.
Solution Approach 2:
The patent prepares compensatory measures in advance to handle potential prediction errors. The system pre-loads alternative validation methods, maintains backup models for cross-verification, and establishes fallback procedures for low-confidence predictions. This cushioning approach ensures that when the primary ML model produces unreliable results, the system can quickly switch to verified alternative methods without compromising reliability.
3Measurement precision
If comprehensive analysis of unstructured text is performed, then accuracy is improved, but device complexity increases due to multiple processing steps
Solution Approach 1:
The patent divides the comprehensive text analysis process into distinct modular segments, each handling a specific aspect of code selection. The system separates tasks into: unstructured text processing, ML model prediction, confidence evaluation, validation checking, and final selection. Each segment is independently optimized and can be processed in parallel where applicable, reducing overall system complexity while maintaining comprehensive analysis capability.
Solution Approach 2:
The patent creates universal processing components that can handle multiple types of analysis tasks through a single integrated framework. The validation module, for example, serves multiple functions by checking code format, verifying medical accuracy, ensuring consistency with patient records, and validating against coding guidelines all through one multi-functional component. This universality reduces the number of separate devices needed.
Data Source
AI summary
Disclosed are techniques for automated reasoning via natural intelligence of unstructured data in order to generate meaning from unstructured data using a human-based logical reasoning framework. The disclosure provides solutions for a situation where two or more potential options are selected but where only one option is permitted. For example, the present disclosure addresses a need in medical coding where two codes are selected based on an automated reading of a medical report.


