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The AI input model is represented by a matrix having on each row one Medical Item/Service from a Claim. If the FHIR Claim Bundle contains multiple Claims then the AI input model will contain all Items/Services from all Claims. Each row contains the following informations (either FHIR Medical OR ActivityDefinition, representing an Item in FHIR Claim):
identifier (ItemUUID) | identifier (ServiceUUID) | identifier (ClaimUUID) | identifier (InsureeUUID, CHFID) | identifier (HfUUID) |
extension.unitPrice | unitPrice | billablePeriod (start, end) | birthDate (to calculate age) | location (HFLocationUUID) |
frequency | frequency | created | gender | category |
extension.useContext (ItemPatCat) | useContext (ServicePatCat) | type | extension.isHead | type |
type (always “Medication”) | type (always “ActivityDefinition”) | item.quantity | extension.povertyStatus | |
item.unitPrice | extension.locationCode (LocationUUID) | |||
diagnosis.diagnosisReference (for icd_0 get ICDID) | extension.group (FamilyUUID) | |||
diagnosis.diagnosisReference (for icd_1 get ICDID) | ||||
enterer (ClaimAdminUUID) |
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The following module configuration is defined:
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{
'authentication': [string], // Authentication key list. Default: [] String
'claim_response_url': 'http://localhost:8000/claim_ai/ClaimResponse', // URL set in the ClaimResponse. String
'ai_model_file': string"joblib_Voting_Model.pkl", // AI Model file name, relative location withto fullmodule pathfolder. String
Default: ./ai_model.pkl claim'ai_responsescaler_organizationfile': string"scaler.pkl", // ValueAI toScaler buildfile thename, insurerrelative referencelocation into themodule ClaimResponse. Default: folder. String
'ai_encoder_file': "Encoder.obj", // AI Encoder file name, relative location to module folder. String
'claim_response_organization': 'openIMIS-Claim-AI', // Organisation name in ClaimResponse. String
'date_format': '%Y-%m-%d', // Date format to use. String
'first_date': '2016-01-01' // First date for date transformation. String
}
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| Note |
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The default AI Model filename will be defined after finalizing the AI Algorithm development. |
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FHIR Contained Resources feature allows to integrate the referred resourced. Because AI-model is requiring information from other resources referenced by the Claim, these resources must to be accessible from the Claim sent by Claim-AI Quality module. In case of FHIR Claim, these are Patient, Condition, Medication, HealthcareService, Practitioner, ActivityDefinition. The mechanism to build Claim resource with Contained Resources is developed in the openIMIS FHIR R4 module. In FHIR R4 module, the inclusion of Contained Resources should be possible based on the query variable contained=true/false (default false).
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