A four-month old licensing agreement between Epic Systems and Intelligent Medical Objects has already begun to bear fruit, but officials from both partners are predicting even more benefits – both individually and collaboratively – in the coming year.

Speaking on behalf of IMO, John Ennis said the company anticipates closing contracts with four to eight vendors in the coming months.In September, Epic and IMO agreed to a 15-year deal in which existing and future Epic clients would be able to integrate IMO's controlled medical vocabularies into the Epic suite of products. The agreement gives Epic users access to IMO Personal Health Terminology, Procedures/CPT and Medical Necessity data sets.

According to Christopher Alban of Epic, the IMO vocabularies bridge the wide gap between the language and descriptions clinicians and the billing or specialty codes many enterprise systems are still based on.

"Historically customers used ICD-9 based terminology because they needed codes from their EMR to flow directly into their billing system," Alban said. "That worked well for the billing staff, but not as well for clinicians. ICD-9 is at its core a classification system. Doctors needed a way to describe the nuances of a clinical condition in ways that could not be found in ICD-9."

"There wasn't a problem until doctors started using these systems," agrees IMO president and CMO Andrew S. Kanter, MD.

As hospitals and other large provider organizations increasingly rely on the IT connections between clinicians, orders and documentation of care to generate accurate billing, millions and perhaps billions of dollars are at stake. It's essential, Kanter said, that clinical software not erect barriers to physician use. Medical vocabularies mapped to diagnoses and billing codes can knock down those barriers and encourage physician uptake.

"IMO provided a solid middle ground. They have the terms in a doctor friendly and findable terminology and they have the mapping between SNOMED and ICD-9 that helps makes sure the doctors will get the bills out correctly," Alban said, explaining the value of the IMO relationship. "In addition to providing vocabularies mapped to ICD-9, SNOMED CT, Mesh/ UMLA and others, IMO also takes on the job of updating and maintaining those vocabularies."

Kanter adds, "The requirement to maintain dictionaries by clients themselves have outstripped providers' capacity to do so. Requirements for full-time employees, coders and the cost of miscoding, means that outsourcing is well worth the price."

While Alban agrees that hard ROI numbers can be assigned to this function, "there's no way to attach a price tag to the happiness of the end-users."

One benefit in particular that attracted Epic's attention was IMO's dictionary of patient-friendly terms, which has been incorporated into MyChart, a shared electronic medical record used by patients and physicians. For example, ICD-9 has a term called "Lumbago." IMO translates this for patients to "low back pain." These translations make a big difference for patients using MyChart.

"Patient demand for access to data, particularly over a secure Internet connection, is really, really booming," Alban said. "We feel that this is one market differentiator for us."