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Medical Causation Analysis (MCA) software - An introduction:

Medical Causation Analysis (MCA) software can comprehensively organize and tabulate each medical event in a EHR medical chart of any client to support or contend current legal claims. This is accomplished in fractions of a minute per file so that every approach to every file can be identified and refined quickly to produce informed analysis.  MCA automates the same medical legal discovery process that is used by Medicare with the knowledge base of 135+ AAMC[1] medical specialties.  

Conventional medical analysis of a patient chart is traditionally limited to specialists that review approximately 10% of the chart entries; A single MCA query can review all chart entries and tabulate over 300 indices that summarize healthcare delivery processes (i.e. acute, ambulatory) and specialties. The result determines the optimal range of analysis in the quickest time, at the lowest cost, to achieve the most favorable outcomes for litigation and mediation.

 MCA provides: 

1. A thorough tabulation provided in summary reports of all health related events found in a EHR patient chart/CCDA[2], including 300+ CMS healthcare quality indicators required of providers in acute or ambulatory settings.

2. A statistically complete analysis of each EHR patient chart with a summary of statistics relevant to your tort: i.e. Severity of illness index, Rx Summary, DRG/MDC[2] indices, length and frequency of tiered levels of care.

3. A comprehensive categorization of medical events in a EHR patient chart by Incorporating all relevant National Library of Medicine code and value systems including:
•ICD - International Classification of Diseases
•CPT - Current Procedural Terminology
•SNOMED CT - Systemized Nomenclature of Medicine – Clinical Terms
•RxNorm - Medication Value Sets
•LOINC - Logical Observation Identifier Names and Codes
•CDT – Code on Dental Procedures and Nomenclature
•CVX - Vaccine codeset CDC National Center of Immunization and Respiratory Diseases (NCIRD)
•HL7 - Health Level Seven International® - Administrative patient and quality chart standards
•ICF—International Classification of Functioning, Disability, and Health
•NHSN Healthcare Facility Patient Care Location
•VSAC - Value Set Authority Center 
•NUCC – National Uniform Claim Committee•Source of Payment Typology (National Association of Health Data Organizations [NAHDO])
•UCUM – The Unified Code for Units of Measure

4. Established secure Medicare/CMS patient data acquisition processes that minimize impact on provider workflows while simultaneously acquiring complete patient datasets while strictly complying with HIPAA regulations.

5. Mass tort and Class action analysis tools that provide the following benefits:

Population summary analysis option which proposes specialist categories for expert witnesses appropriate for target clients.

Locale specific analysis option with designated proximity zones to ground zero.

Claims AI correlator that sorts according to economic and medical parameters with Cull Summary Standards set by your administrative and medical staff to segregate illegitimate and low value claims from high value claims

Integration with public, industry and patient specific datasets to assist you in evaluating and predicting risk and enhancing operational efficiency, and compare them to national trends and averages.

 

MCA: A comparison of Time, Quality, and Cost

Technical Considerations: 

• MCA utilizes the same automated medical discovery process  used by Medicare in legal proceedings, utilizing the knowledge base of 135+ AAMC specialty profiles.
   
• MCA will unearth dozens of red flag conditions per chart otherwise missed by conventional methods. 
   
• The MCA review process covers 98% of a mass tort medical record ; Conventional methods review a fraction of available medical records. 
   
• The MCA process has been in daily use by Consortium for Universal Health System Metrics (CUHSM), a Medicare approved registry, since 2014.

         MCA provides a HIPAA secure environment to enhance expert witnesses with expedited delivery of concise documentation to the litigation team on demand. 

Cost Benefits:

• Lower cost per file
• Dependable fixed rates
• No retainer or upfront costs
• Tiered pricing

◦     Stage 1 Preliminary report

◦     Stage 2 Claim evaluation and sorting

◦     Stage 3 Full documentation w/motions

• Quicker turn-around time for greater file data
• Added case value for experts ($100k+ per expert)
• HIPAA secure delivery of supporting documentation

The Medical Causation Analysis staff will deliver a test case for review upon request.

The following patient chart summary reports were generated within 30 seconds
   1. MCA Individual report - Rx Metrics
   2. MCA Individual report - Levels of Care
 

CUHSM QCDR Measures approved by CMS - Non QPP Program - Patient Adherence Measures
• 2014 • 2015 • 2016 • 2017 • 2018 • 2019 • 2017_07_Non_Compliance_letter • 2017_QCDRbenchmarks •

For more information, contact us via email at clientservices@cuhsm.org

Phone:  (888) 979-2499 x2

Universal Health System Metric Tools referenced on this site:
CMS Submission Toolkit, CST-CMS Submission Template, PQRS Audit Tool, PQRS Validator, GPRO Aggregator,
    QCDR-HISP, QRDASolutions, and NwHIN Sleuth are trademarks of CMS Gateways, LLC
All other products mentioned are registered trademarks or trademarks of their respective companies.

QCDR-HISP = Qualified Clinical Data Registry - Health Information Service Provider

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Last modified: Tuesday November 10, 2020.