Life after dsNavigator, Moving to a New Coding System

May 9, 2016

Watch Recording

Eclipse hosted Coding Webinar: Life after dsNavigator, Moving to a New Coding System, featured panelist, Jeffrey Linstad on February 25th, 2015 at 2:00PM EST. The webinar provides an instructive webinar on coding and valuable information on transferring data and insight into factors to consider that should be made for selecting a new coding system. The “coming off of support” of dsNavigator has left many organizations in search of a new coding system.  The webinar discussed the challenges of moving to a new system and some of the advantages you should be looking for.  Further discussed includes the importance of system configurability and the process of data migration.  Additionally, the video will discuss how to transfer data from one system to another including a demonstration of our own coding system. View this webinar on coding to learn about transferring data from one Coding system to another and learn how Eclipse coding system can integrate your current system to ours and cut costs.

Jeff Linstad: Mr. Linstad’s Clinical Technology career includes executive roles in the development and execution of global Clinical and Healthcare initiatives. With a Bachelor’s of Science Degree in Electrical and Computer Engineering from Merrimack College, Mr. Linstad leads, develops and directs the strategic clinical and healthcare technology operations for the clients of Eclipse Clinical Technology. Prior to joining Eclipse Clinical Technology, Mr. Linstad was employed by Phase Forward where he designed clinical solutions based on Phase Forward software (now Oracle Healthcare) to integrate with customers’ existing technical and non-technical processes.

Life after dsNavigator, moving to a New Coding System Transcription

Jeffrey Linstad: Today we are going to discuss medical coding and some of the various things you need to look for when looking for a new coding system. In my experience coding is one of the most overlooked clinical technologies, coders are often subjected to using simplistic tools that were built in house many years ago or medical coding tools built into an off the shelf software designed for another purpose like EDC or safety data or sometimes as a lot of people are facing right now, your favorite software actually retires before you do and that is a situation a lot of you are facing right now being with a system that they really like, but the system itself is retiring. This can result in a fragmented or non-existent coding environment where medical coders must learn many different software tools and manage multiple installation of dictionaries or a need to go out and find new software when you are happy with your current software. Today we are going to consider some of the factors when choosing a new system, we are going to be looking at workflow or considerations around workflow, dictionary management functionality, customization and functionality, rights and roles, data migration and we are also going to be doing a brief demonstration. Workflow is really very crucial when it comes to safety safety coding, it is important to think about your current workflow when choosing a new system. Some of the questions that you may want to ask yourself is the workflow I am using right now one you would chose or is it something that was dictated by your current system are there things that you would change or do you need a new system that is really flexible enough to match your current processes and current workflow? This is also a great time to look at your processes and SOPs and integration to see what you can gain for efficiencies, free up resources and improve your quality. For example you may be tired of manually loading in your terms and maybe you want to add in some integrations or you could be a CRO that requires multiple workflows for different clients and you need a system that could really help you with that. Often you will see that your safety group has a different workflow than your clinical group. These are all things that you will want to take into consideration when it comes to workflow and choosing a new system. If any of these cases are true you want to carefully look at configurability of the coding systems you are considering. Does the software that you are using have a robust workflow capability? For example when you start looking everyone in your coding software should be considered when you switch to a new system and it’s a good time to consider any of the current issues you have with your current process. At eclipse we not only work with our own coding system but other coding systems as well. We really recommend choosing a standalone system and a company that understands the importance of process to help you implement it. Of course dictionaries are at the heart of any medical coding system and this makes dictionary management one of the most crucial functionalities of the medical coding system you will want to look for a coding system that is flexible enough to support all of your dictionaries whether they are standard or custom. The system should offer easy and intuitive dictionary loading that could be performed by your dictionary administrator. In the event that you do not have a dictionary administrator you will want to ensure that the system vendor can support this activity or that they can provide a SaS offering that will meet your needs. The system should also support multiple active versions and languages this is especially important for CROs or if you have long running studies that you want to keep on a certain dictionary version. When it comes time to move your study over to a new dictionary version the medical coding system should provide tools that will help you determine the impact on your medical coded terms ahead of the move and provide recommendations for any items that are impacted. Configurability and functionality are also key factors in a medical coding system. The most popular features we rely on everyday help us perform our job efficiently and accurately. Things like robust safety coding algorithm, custom synonym lists and custom software word lists are a must to maximize the effectiveness of your auto encoder. An easy to use web interface and custom workflow and medical coding propagation all enhance the coding experience and solid administration tools and interfaces dictionary management be the configuration along with a robust integration layer will help you drive down costs of maintenance to free up IT resources. All of the above are important things to look at in any medical coding system, it is also important to choose a vendor that will listen to your needs and work with you to grow the software. Having a single medical coding system to handle all of your safety coding needs helps reduce cost by simplifying dictionary management, reducing training and reducing IT resources. When all of your medical coding is performed in central software it becomes important that the software has the proper permission and access rights. In a complex environment it is necessary to ensure that users are only able to access the medical coding terms and features that they should have access to. You may need to go ahead and restrict access to certain verbatim based on the data source. For example a safety system versus an EDC system or trial A versus trial B. You may also need to limit access based on a variety of steps; you may wish to have a coder and an approver set up or a coder and a confirmer and an approver if you are outsourcing your safety coding. You also need to be able to restrict based on feature only some users may be able to create and manage synonyms, propagate codes or run the auto encoder. It is important to have the ability to set up manager roles so that you can code so that the coding manager can distribute the terms to various medical coders. Medical coding systems often serve as a location where you house all of your coded data, they hold key information such as which verbatim terms have been loaded into the coding system, which terms have been coded and identification keys to determine if the source system has multiple modified the verbatim or if it is supporting data. All of this is important to ensure duplicate data is not loaded or not loaded and medical coded and modified data gets recoded as needed. In certain circumstances you may want and you may be able to keep your existing data in your current coding system until your study ends. But for long running studies this can add costs such as dictionary maintenance, hardware and software costs and also have a toll on your IT resources and your coders as they have to maintain and use multiple systems. So it becomes very important to examine what data that you are currently safety coding and how long that you will need to support this data. Once you determine this you will want to choose a vendor that is able to help you to decide which data to migrate and is able to migrate the data in an efficient and cost friendly manner. We are now going to watch a brief demonstration by Moe of the loading of coded and uncoded terms into the eclipse coding systems. The eclipse safety coding system can easily be configured to match your data fields in your current existing safety coding systems and it can additionally be configured to display certain fields while storing others in their database and not displaying them. We are then able to quickly customize the built in data migration tools, take all of the data extracted from your current system and load it into our system. Once it is loaded into our system we will be able to merge the data which will automatically sync it with our system so that it can be tracked, coded and recoded as needed. So we will now see a brief demo.

Coding Demonstration

Moses Lam:  For todays demo I will be migrating pharmacovigilance coded data into the eclipse pharmacovigilance coding system. When you login to the eclipse coding browser you are presented with a set of pharmacovigilance coding set definitions here on the left. The coding sets are a collection of work flows that allows the coder to interact with their safety coding terms. Here we see the con med drug c format coding set definition, the code items workflow allows me to code my conmed terms, the confirm coding workflow allows me to confirm the codes that have been selected. The approval workflow allows me to approve all codes that have been confirmed and the clear approved items workflow allows me to clear codes that have been approved. Once a code is cleared it will reappear in the code item workflow so that the user can recode. These coding sets as well as the workflows within are configurable, only the users who belong to the specific groups and roles can have access. For example, only users assigned to the specific group can see their coding set and users assigned to specific roles can see that specific workflow. For this migration demo I have created two pharmacovigilance coding sets, the MedDra and the web WHO-DD, I will be loading external data into the web medDra coding set and after the load and merge of data these terms will appear in the code item workflow so that I can begin to code and interact with those terms. Here are the spreadsheets of the adverse events terms that I will be loading into the web MedDra coding definition. So this first list contains just raw data that has not yet been coded similarly her is the MD web WHO-DD coding set, I will be loading a second spreadsheet of drug names and its associating codes. These will appear in these clear approved items coding set. Here is the WHO-DD spreadsheet that I will be loading into this WHO-DD coding set definition, so as you can see the drug names along with codes that are applicable to these drug names will all be loaded into the eclipse safety coding system and they will be displayed in the browser as coded items. Once the drug names are loaded into the WHO-DD coding set I will have the opportunity to clear the codes and then recode them within the eclipse coding browser. TO load this data I will be using the loader utility this loading utility allows me to perform various administration tasks for example I can create and load new coding dictionaries. I can load both WHO-DD dictionary’s as well as medDra as well as custom dictionaries. The utility also allows me to load synonym lists or stop words into a specific coding definition. The utility will also allow me to load uncoded terms as well as codes that have already been coded from a third party system. I am going to start loading into our WHO-DD coding definition and I will be selecting the pharmacovigilance  coding spreadsheet that I displayed earlier with all of our drug names and their associated codes so we have got 99 records loaded and in order for me to display them in the coding browser I also need to perform a merge so again I select the web WHO-DD coding definition and I am prompted to confirm the 99 records and once the records have been loaded and merged I can view them in the pharmacovigilance  coding browser. So here are the 99 drug names as well as their associated codes from the external system all loaded into the eclipse safety coding system. I can clear one of these codes so let me clear Advil, so Advil no longer displays in the list and instead in now displays in the code items workflow, so I am going to go ahead and code Advil and I can expand this view to see the additional information such as the ATC codes so I will select this code and once Advil has been coded it will appear in the confirmed safety coding workflow, I will go ahead and confirm this and finally I will approve the confirm code and so once again Advil appears in my clear approved workflow. Next I am going to load data into the web medDra coding set so I return to my loader utility and this time I select the web medDra coding set definition and I will select the medDra terms, the adverse events medDra spreadsheet. I am going to select a few records have them loaded and now I am going to merge these records confirm the 163 records I am going through the loading and the merging steps one at a time for the purpose of this demonstration but the eclipse pharmacovigilance coding system has a very strong integration suites so I could have easily performed all of these tasks seamlessly through an automated integration. So once the terms have been loaded into the web medDra coding definition they appear under the code items workflow so these are the raw terms that have not yet been coded these is why they appear in the code items workflow. I will go ahead and code one of these terms and I am going to select this once since we have multiples of this term so because we have multiples of this term I am prompted to propagate this particular code. So once the code has been propagated I can come here to confirm the code and I also have the option to create a synonym for this particular term and once the code is confirmed I can approve and once the code is approved it will now show up in my clear approval workflow. This concludes the demonstration of the loading the uncoded terms as well as coded terms from an external source into the eclipse coding system.

Jeffrey Linstad: Great thank you Moe! I hope today’s webinar helped you start to work through the process of selecting a new coding system. There are many factors to consider when you are choose a new coding system and it can often be overwhelming and even overlook things if you have been working with your current system for years we saw a brief demonstration of data migration with the eclipse coding system today but we would be happy to give you a full in depth demo of our product if you would like to schedule a demo please reach out to us by phone or via our website. There are really many factors to consider when choosing a new pharmacovigilance coding system, but there are really quite a few of them and it is also important to select a vendor that will be a good partner in additional to providing a modern, clean pharmacovigilance coding system they should be able to support you when it comes to business process, maintenance and services you should really look for a vendor that is actively supporting adding features to their coding system as well, so this concludes the presentation and I would now like to ask Morgan our moderator to come on and to open it up for any questions anyone may have.

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