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The Medical Characteristics of an Auto Injury Insurance Claim

DigitalOwl has recently reached a milestone of 30+ million pages of medical records processed by its proprietary Natural Language Processing (NLP) platform. The extracted medical data points from APSs and medical records allow us a unique view of the medical characteristics of these claims.


What have we learned from analyzing and summarizing millions of pages? In this article, we shed some light on the medical characteristics of the average auto injury claim.


Medical Extractions: The specific medical information contained in records


What is a medical extraction?


A medical extraction is a single data point of medical information—each appearance of a medical condition, procedure, or medication in the medical record is an extraction.


But, a medical data point is more than a plain medical term. One data point can have multiple meanings based on the surrounding text. For example, a condition can be a past condition, negated condition, or a family condition. A procedure can be a past procedure, referral, or something that has only been considered.


The average claim holds 1,299 medical condition extractions (like Fracture, Dizziness, Hearing Loss, etc.), 1,153 procedure extractions (X-ray, MRI, Spine Surgery), and 499 medication extractions. The average time range of medical information that has been summarized is 18 years and four months per claim.

The average claim holds almost 3,000 medical data points spread along more than 18 years of medical history! Reading and understanding this much data is very difficult without the assistance of technology.





Unique Medical Extractions: The medical story of a claimant

What is a unique medical extraction?


A unique medical extraction consolidates medical extractions with essentially the same meaning. A unique medical extraction can be a group of multiple dates/appearances of the same extraction, a group of various extractions that mean the same thing, or a combination of the two.


For example, a patient went to his physician three times. On the first visit, the physician mentioned a “limitation of movement,” on the second a “limited range of motion,” and on the third, a “problem moving freely” = three extractions (limitation of movement, limited range of motion, problem moving freely) = one unique medical extraction (movement limitation).


The average claim holds 139 unique condition extractions, 76 unique procedure extractions, and 50 unique medication extractions.


Of the unique conditions, on average, 10.25 are “high severity” risk factors, and of the unique procedures, 2.31 are “high severity.”





The Medical Categories: The high-level summary

What is a medical category?


A medical category is a higher-level summary than a unique medical extraction. A category holds a group of medically-related unique extractions. For example, Rib fracture, Knee sprain, and Arthritis would be grouped as “Musculoskeletal conditions.”


The average claim holds 48 categories, of which 7 are considered “high severity.”