OrthoCarolina, Inc.

A new study from Mount Sinai suggests that using generative artificial intelligence to help with coding automation has some significant limitations. WHY IT MATTERS For the research , Mount Sinai's Icahn School of Medicine evaluated the potential application for large language models in healthcare to automate medical code assignments – based on clinical text – for reimbursement and research purposes. The study compared LLMs from OpenAI, Google and Meta to assess whether they could effectively match the right medical codes to their corresponding official text descriptions. To assess and benchmark the performance of GPT-3.5, GPT-4, Gemini Pro and Llama2-70b, researchers extracted more than 27,000 unique diagnosis and procedure codes from 12 months of routine care in the Mount Sinai Health System, excluding patient data. "Previous studies indicate that newer large language models struggle with numerical tasks," Dr. Eyal Klang, director of Icahn Mount Sinai's Data-Driven and Digital Medicine Generative AI Research Program and senior coauthor of the study, explained in an announcement last week. "However, the extent of their accuracy in assigning medical codes from clinical text had not been thoroughly investigated across different models." In assessing whether the four available models could effectively match medical codes through qualitative and quantitative methods, the researchers determined all LLMs scored below 50% accuracy in generating unique diagnosis and procedure codes. While GPT-4 performed the best in the study with the highest exact match rates for ICD-9-CM at 45.9%, ICD-10-CM at 33.9% and CPT codes at 49.8%, "unacceptably large" errors remained. The researchers said GPT-4 produced the most incorrectly generated codes, while GPT-3.5 had the greatest tendency to be vague, identifying more general rather than precise codes. The study results, which the New England Journal of Medicine AI published last week, led the researchers to caution that the performance of LLMs in real-world medical coding could have worse results. "LLMs are not appropriate for use on medical coding tasks without additional research," the researchers said in the report. "While AI holds great potential, it must be approached with caution and ongoing development to ensure its reliability and efficacy in healthcare," Dr. Ali Soroush, assistant professor of D3M and medicine, cautioned in a statement. Mount Sinai noted that the researchers will look to develop tailored LLM tools for accurate medical data extraction and billing code assignment. THE LARGER TREND Despite the findings of the Mount Sinai study, others see value in AI-enabled coding, and say AI systems can help physician groups avoid missing revenue opportunities and elevate their documentation compliance. Dr. Bruce Cohen, a surgeon and former CEO at OrthoCarolina in Charlotte, North Carolina. "As annual coding requirements are instituted, an AI-based system will integrate and implement those changes in real-time," Dr. Bruce Cohen, a surgeon and former CEO at OrthoCarolina in Charlotte, North Carolina, told Healthcare IT News . AI-based systems do not eliminate coders' jobs, he added: "It expands the oversight and accuracy of every charge going out based on evaluation and management coding." ON THE RECORD "Our findings underscore the critical need for rigorous evaluation and refinement before deploying AI technologies in sensitive operational areas like medical coding," Soroush asserted in a statement about the Mount Sinai research. "This study sheds light on the current capabilities and challenges of AI in healthcare, emphasizing the need for careful consideration and additional refinement prior to widespread adoption," added Dr. Girish Nadkarni, director of the Charles Bronfman Institute of Personalized Medicine and system chief of D3M. Andrea Fox is senior editor of Healthcare IT News. Email: afox@himss.org Healthcare IT News is a HIMSS Media publication.

MINNEAPOLIS, April 30, 2024 /PRNewswire/ -- Integrity Orthopaedics, Inc., a company pioneering next generation solutions for soft tissue repair, has successfully closed on a Series B financing of $20.6 million. The financing was co-led by Piper Sandler Merchant Banking and an undisclosed existing investor. The company intends to use the capital to expand the US commercial launch of its initial product in the rotator cuff repair market. This milestone advances the company's vision of revolutionizing soft tissue repair with its patented technology, aiming for stronger surgical repair and enhanced long-term healing. Integrity Orthopaedics was co-founded in 2020 by Thomas Westling, a veteran executive in medtech and previously Founder and CEO of Rotation Medical, David Crompton, Chief IP and General Counsel, and distinguished orthopaedic surgeons Dr. Patrick Connor, Dr. Howard Harris, and Dr. Marc Labbe. "We are pleased to co-lead the Series B financing," said Tom Schnettler, Managing Director, Piper Sandler Merchant Banking. "Tom Westling is a proven entrepreneur and outstanding biomedical engineer. We see significant opportunities for Integrity Orthopaedics to transform the rotator cuff repair space, with the potential for this system to become a platform technology with broad applicability for soft tissue repairs across the human body." "We are grateful for the support of our shareholders, who we view as a strategic asset," stated Thomas Westling, Co-Founder and Chief Executive Officer of Integrity Orthopaedics. "We have been blessed with an extraordinary set of investors, many with deep health care expertise and connections throughout the health care ecosystem, and they have consistently given us valuable counsel since our founding." The Integrity Orthopaedics system is designed to address the biggest unmet need in rotator cuff repairs, reducing the occurrence of cuff re-tears following surgical repair. Current surgical techniques have a structural failure rate that typically averages 20-40%, with rates ranging from 8-94% in specific studies (Young, et al., 2023). The Integrity Orthopaedics system was FDA cleared in early 2023 and initially utilized by a small group of surgeons in a limited launch. This system uses patented micro-anchors, a continuous, locking stitch, a patented instrument for anchor installation and unique operative techniques to enable physicians to dramatically improve the fixation and healing of torn tendons. The Company has begun a paced expansion of its field sales team, with the goal of working with innovative orthopedists in select markets throughout the country. This roll out is expected to broaden over time, as the Company ramps up its staffing, production volumes and physician education resources. "The keys to maximizing the environment for rotator cuff healing are a strong initial repair coupled with a technique that allows the tendon access to the patient's biology for long-term healing," said Dr. Patrick Connor, orthopaedic shoulder surgeon at OrthoCarolina in Charlotte, Chief of Sports Medicine and Shoulder & Elbow Surgery at Atrium Health, and Co-Founder of Integrity Orthopedics. "This technology achieves both goals with more fixation points than any other solution on the market. My experience using this device has shown that it not only creates a more consistent and efficient repair than other techniques, it also uniquely improves both the strength and the overall healing environment at the time of surgery. Based on the substantial increased strength of the repair and restoration of the entire rotator cuff footprint, surgeons may be more comfortable reducing postoperative sling immobilization for their patients which will lead to their faster and more complete recovery." About Integrity Orthopaedics Integrity Orthopaedics is committed to redefining the landscape of soft tissue repair. Its initial focus is on revolutionizing the approach to rotator cuff repair, overcoming limitations of traditional techniques by enabling robust initial repair strength while fostering an optimal environment for healing. The company was founded in 2020 and is headquartered in Maple Plain, MN. About Piper Sandler Merchant Banking Piper Sandler Merchant Banking (PSMB) is the growth equity investment arm of Piper Sandler Companies (NYSE: PIPR). The PSMB team strives to partner with founders and CEOs of growing, commercial stage businesses that can benefit by leveraging Piper Sandler's knowledge, experience, capital and relationships to build market leading enterprises. PSMB provides investment advisory services through the affiliated registered investment adviser, PSC Capital Partners LLC. Learn more about Piper Sandler Merchant Banking. References: Young BL, Bitzer A, Odum S, Hamid N, Shiffern S, Connor PM. Healthcare costs of failed rotator cuff repairs. JSES Rev Rep Tech. 2023 Apr 25;3(3):318-323. Contact: Michael Rodriguez Director of Marketing & Sales Operations [email protected] SOURCE Integrity Orthopaedics