Automated Control of Codes Accuracy in Case-Mix Databases by Evaluating Coherence with Available Information in the Electronic Health Record.

: Coding accuracy in case-mix databases enables efficient funding of health facilities and accurate epidemiological statistics based on patients' stays information. We assume that the data collected in the electronic health record, especially drug prescriptions and medical reports are relevant for checking the consistency of the coding of diagnoses. We evaluated a new coding control tool, "TOLBIAC control", embedded in the Web100T coding assistant. This tool interacts with the Vidal Application Programming Interface and the electronic health record of the University Hospital of Saint-Etienne. The micro-average F-measure was 0.76 for drug prescriptions and 0.55 for free text medical reports. This initial evaluation has revealed that drug prescriptions in EHRs can successfully be used to develop an automated ICD-10 code-control tool. Nevertheless the "TOLBIAC control" tool is not yet fully effective for widespread use because of its limited performance in text analysis, a feature that is currently undergoing improvements.