Systems and methods for extraction of clinical knowledge with reimbursement potential

Abstract

A computerized Medical Information Navigation Engine (“MINE”) extracts clinical knowledge, by identifying coded elements with reimbursement potential contributing to payoff based on clinical history, and subtracting coded elements documented in an encounter from the coded elements, based on business logic. The MINE sorts the remaining coded elements in accordance with one optimization criteria to payoff based on clinical history.

What is claimed is: 
     
         1 . In a Medical Information Navigation Engine (“MINE”), a computerized method for computing a metric for a medical system, the method comprising;
 construct a patient-encounter vector for every encounter within the medical system; 
 obtain a payoff for each constructed patient-encounter vector; 
 generate a linear system using the obtained payoffs and the constructed patient-encounter vectors, wherein the linear system is the obtained payoffs equaling an efficiency metric times the constructed patient-encounter vectors; and 
 optimizing the linear system to determine the efficiency metric.