Wiki the IMO search engine for EMRs

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myeo

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Hello All,
Our organization has purchased an add-on application to our EHR called IMO (Intelligent Medical Objects, Inc.). This application provides an extra search option for diagnosis codes within the electronic medical record. I believe the concept of providing a more sophisticated search tool for the providers is a very good idea, I am finding numerous errors of mapping the incorrect code to conditions. This has me extremely concerned.

Has anyone out there had the same experience with this application? If so, please let me know. I am having a very difficult time convincing the executive management that is could be a huge issue.

Thank you!
 
We've found a number of minor issues with regard to wording and an email from our IS department directly to IMO typically fixes the problem overnight. We've not found any "huge" issues, however, and their ICD-10 product is very good with numerous drop down menus to get to the most specific code.

What issues have you come across with regard to IMO?
 
Hi,
Thanks for responding. We are seeing the wrong descriptions mapped to codes. For example... CAD is being mapped to 410.90 (acute MI)

We have come across several instances of this.
 
I wonder if their IMO search engines vary by EHR? WE use ours in conjunction with NextGen, with few issues, and I also have a link on my desktop. In fact, I entered CAD into our IMO search engine, and came up with all appropriate codes from the 414.XX range. Interesting.
 
Really? Ours is with NextGen as well.

So, if you enter "Coronary artery disease", you see all the correct mapping? 414.XX?
 
Yes I do, with both searches, "Coronary Artery Disease" and CAD. With CAD, I got some other codes related to Cadmium lung disease and CADASIL (cerebral arteriopathy).

I'd check with IMO and NextGen. What version of KBM are you using? We're on 7.8, but upgrading to 8.1 next year.
 
IMO Errors in ICD-10

Hello - we are also equally concerned and are seeing a significant number of errors in the content mapping. What systems are you using?
 
Yes the IMO is very troubling. In fact I can't believe they haven't gotten in trouble. The system is rampant with errors. I'm not sure how the incorrect codes get in there. If users create them or if people that work at the IMO create them? In the last few days I've come across the ICD10 codes for
R11.2(nausea, vomiting and diarrhea) Z91.038 (Allergy to bee sting), F10.10 (history of alcohol abuse), I27.9 (cor pulmonale), Z12.4 (pap smear of vagina following gynecologic surgery) Z79.899 (long term prescription opiate use),
F99 (psychiatric symptoms associated with exposure to works of art), N40.0 (BPH with urinary retention). All incorrect and those are just some of the ones I've written down. My favorites though are the history of codes. We have some medical miracles happening here. In fact on Friday I found an ICD9 code for V12.09 history of AIDS with dementia.
Getting them removed from the system takes and act of G-d. Because the reps love to remind us that all the codes are "AHIMA approved". AHIMA should be a little worried. :eek:
 
We have IMO, and although I see the issues you've mentioned, there is frequently additional direction for providers to further clarify their codes through the selection of a link. For example, R11.2, NVD, there's a link in this code choice that further instructs the provider to select also R19.7 for the diarrhea.

Z91.038 is the status code for bee allergy. If you search on Bee sting allergy, there is a T code for the allergic reaction (injury code). We've explained to the providers...they have to think smart and read carefully when they use these search engines, because IMO loads any and all related code in case the provider is trying to be frugal with their search terminology. Maybe my docs are smarter and more conscientious, but I don't really see this as a problem in our recent testing.

Remember that the code descriptions may represent many codes, and I am reluctant to remove any of the code descriptions unless they are blatantly incorrect. Frankly, it's up to the provider to select the codes, and if they get sloppy, they'll hear about it in an audit. You won't be able to make this perfect, or you'll die trying...and I'm not even going to worry about ICD-9 codes any more. I've found that my time is better spent instructing providers on their documentation, instead of worrying that they'll misinterpret the code descriptions.
 
IMO in EMR's

All-

I have seen variations of descriptions in numerous EHR's.

Do you have access to the IMO Vocab portal?
It has been awhile since I've been on that site but previously several of the descriptions I found within the EHR's as being incorrect, didn't show up on the portal.
On the portal, you are able to submit "appeals" to have descriptions updated. When you submit the "appeals" or talk to IMO about the descriptions, make sure you have the guidelines and supporting documentation in front of you for submission and discussion.

I have seen it take awhile for descriptions to be updated within the EHR. The time is dependent on IMO as well as the EHR vendor (depending on how they may be set up).
I don't know if some EHR's receive an automatic feed of updated descriptions through IMO but numerous ones have to "accept" the updates in their system and then push it out.
Often times, the EHR vendors with assist the practices in working with IMO for corrections.

Currently, I am submitting cases with supporting documentation to our EHR vendor for several ICD-10 descriptions that are not mapped correctly.

I hope the above information is helpful.

Good Luck!!!!

Kim White
EHR Billing Specialist
Account Management & Training
 
I work IS and am the direct point of contact for our practice and IMO/Nextgen. Yes, there are some mapping issues. However, IMO has a tool where you submit a term request, and if the mapping is incorrect, they fix it quickly. These are just normal system kinks that will be worked out once we are further into ICD-10. I don't know about issues with them when we had ICD-9, because they were probably re-mapped or worked out before I joined the team. IMO really is a GREAT tool. But just like any electronic system, it has its issues. The good part is they are quick to fix them. :)
 
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