Pre-Visit Diagnostic Engine Helps Prioritize Patients and Improve Efficiency

Since I graduated from medical school in 1977, I have noticed that patients have moved from passive, “whatever-you-think… doc” types to true consumer types. Driven by instantaneous access to information, health care consumers are demanding new conveniences and health care professionals are responding by embracing new technology to enable their practices to provide the level of care desired. 

But, some things have not changed. Such as virtually every patient visit begining with the question:  “why are you seeing the doctor?” This question creates a dialogue that eventually is supposed to satisfy the patient’s need. Most of the time, this question is followed by the patient explaining their history of illness and symptoms. And that part of the experience has not changed much in several centuries.

One company that is helping physicians fulfill the expectations of consumers by automating these first steps in their visit is Health Navigator, based in La Grange, Illinois and founded by Dr David A Thompson — who is both a physician and an engineer by training. Health Navigator is made up of several components or modules; a natural language processing (NLP) engine, a clinical documentation support engine and a diagnosis engine. 

His idea is to enable patients to use a technology-based system to create a virtual medical history, appropriate follow-up questions, and then create a list of possible diagnoses and recommend care options. Dr Thompson named his creation the Health Navigator symptom checker. Health Navigator is built on a database of clinical codes and analytic tools that help capture, organize, and present a better, faster diagnosis.

Health Navigator starts with the patient entering their symptoms or complaints into a web-based system in their own words. This information is then analyzed by the NLP engine in order to translate consumer-speak into medical terminology. Interestingly, a taxonomy of chief complaints did not exits before Health Navigator. While the current ICD-10 and previous ICD-9 coding systems existed, they are not presenting symptom or problem coding systems — meaning that there was no system to code the chief complaint, just the final diagnosis. 

Next, the information from the NLP is used to prompt patients to complete a rapid medical history related to their symptoms. The diagnostic engine then produces a list of possible causes, along with options for receiving care and evidence-based educational resources. Each step in the encounter is available through the patient’s preferred channels —be it telephone, video or online— which enables providers to deliver the right care suggestions at the right time.

Health Navigator also converts reasons for visits into a “coded chief complaint,” and color-codes complaint severity to prioritize the patients in order to help physicians decide who to see first. The bonus: this process also lends itself to a more standardized workflow, which leads to efficient care delivery.

Health Navigator aims to expand access to patient care and allows providers to do more with less, including connecting with patients outside the office setting, providing telephone triage, and delivering physician-led telemedicine to a patient’s home. All of these advancements make care more convenient and accessible for patients.

The Health Navigator platform is also designed to enable a more efficient use of both in office and telemedicine care, in that it helps to perform a “pre-visit” assessment to allow physicians to have significant information prior to the face-to-face time in the office or on the telemedicine screen. 

As our payment system moves from volume-based to value-based, we must find a way to handle the volume in a way that is not only satisfying to the patient but also results in care that is highly accurate, of high quality, and creates a satisfactory income and lifestyle for our over-worked physician workforce. Health Navigator seems to have created a novel technology-based platform that satisfies all of these needs.