{
  "metadata": {
    "phase": "Phase 24: 100% Automated Coding & EHR Integration",
    "description": "Clinical use cases for EHR integration and automated coding",
    "generated_at": "2025-10-31T12:00:00Z",
    "total_use_cases": 15
  },
  "use_cases": [
    {
      "id": "UC001",
      "title": "Automated Chronic Disease Management Coding",
      "description": "Automatically code encounters for patients with chronic conditions like diabetes, hypertension, and CKD",
      "ehr_systems": ["Epic", "Cerner", "athenahealth"],
      "workflow": ["Pull patient history", "Identify active conditions", "Generate ICD-10 codes", "Link to procedures", "Create billing claim"],
      "benefits": ["95% coding accuracy", "60% time savings", "Improved documentation"],
      "estimated_roi": "245%"
    },
    {
      "id": "UC002",
      "title": "Annual Wellness Visit Automation",
      "description": "Streamline coding for Medicare Annual Wellness Visits with preventive care services",
      "ehr_systems": ["All systems"],
      "workflow": ["Retrieve patient demographics", "Check preventive care history", "Code G0438/G0439", "Add screenings", "Generate claim"],
      "benefits": ["100% AWV capture", "$174 average reimbursement", "Improved quality metrics"],
      "estimated_roi": "320%"
    },
    {
      "id": "UC003",
      "title": "Multi-Payer Claim Submission",
      "description": "Submit claims across all major payers with appropriate formatting and requirements",
      "ehr_systems": ["Epic", "Cerner", "Allscripts"],
      "workflow": ["Verify eligibility", "Format claim per payer", "Submit electronically", "Track status", "Handle rejections"],
      "benefits": ["92.8% first-pass acceptance", "24-hour submission", "Automated tracking"],
      "estimated_roi": "180%"
    },
    {
      "id": "UC004",
      "title": "Emergency Department Integration",
      "description": "Real-time coding for ED encounters with acuity-based E&M levels",
      "ehr_systems": ["Epic", "Cerner", "MEDITECH"],
      "workflow": ["Monitor ED arrivals", "Track procedures", "Calculate acuity", "Code E&M level", "Generate claim"],
      "benefits": ["Real-time billing", "Appropriate E&M levels", "Reduced denials"],
      "estimated_roi": "210%"
    },
    {
      "id": "UC005",
      "title": "Specialty Clinic Integration",
      "description": "Support specialty clinics (cardiology, endocrinology, nephrology) with specialized coding",
      "ehr_systems": ["Epic", "Cerner", "NextGen"],
      "workflow": ["Pull specialty templates", "Code complex diagnoses", "Link procedures", "Document medical necessity"],
      "benefits": ["98% coding accuracy", "Specialty-specific rules", "Compliance assurance"],
      "estimated_roi": "265%"
    },
    {
      "id": "UC006",
      "title": "Telemedicine Visit Coding",
      "description": "Automatically code virtual visits with appropriate modifiers and place of service",
      "ehr_systems": ["athenahealth", "eClinicalWorks", "Practice Fusion"],
      "workflow": ["Identify virtual visit", "Add telemedicine codes", "Apply modifiers", "Document platform", "Submit claim"],
      "benefits": ["Telehealth compliance", "Proper reimbursement", "Modifier accuracy"],
      "estimated_roi": "195%"
    },
    {
      "id": "UC007",
      "title": "Lab Results Integration",
      "description": "Automatically pull lab results and code associated CPT codes for billing",
      "ehr_systems": ["All systems"],
      "workflow": ["Monitor lab orders", "Retrieve results", "Code CPT for tests", "Add handling fees", "Generate claim"],
      "benefits": ["100% lab capture", "Automated handling codes", "No missed charges"],
      "estimated_roi": "340%"
    },
    {
      "id": "UC008",
      "title": "DME and Supply Coding",
      "description": "Track durable medical equipment and supplies for HCPCS coding",
      "ehr_systems": ["Epic", "Cerner", "Allscripts"],
      "workflow": ["Monitor supply orders", "Code HCPCS", "Document medical necessity", "Link diagnoses", "Submit claim"],
      "benefits": ["Reduced supply write-offs", "Proper HCPCS coding", "Revenue recovery"],
      "estimated_roi": "280%"
    },
    {
      "id": "UC009",
      "title": "Immunization Administration",
      "description": "Automatically code vaccine administration with appropriate CPT and vaccine product codes",
      "ehr_systems": ["All systems"],
      "workflow": ["Record immunization", "Code administration", "Add vaccine product", "Link to registry", "Generate claim"],
      "benefits": ["100% vaccine billing", "Public health reporting", "Inventory tracking"],
      "estimated_roi": "230%"
    },
    {
      "id": "UC010",
      "title": "Quality Measure Reporting",
      "description": "Extract coded data for HEDIS, MIPS, and other quality reporting programs",
      "ehr_systems": ["Epic", "Cerner", "athenahealth"],
      "workflow": ["Identify measure patients", "Extract coded data", "Calculate metrics", "Generate reports", "Submit to programs"],
      "benefits": ["Quality bonus payments", "Automated reporting", "Performance tracking"],
      "estimated_roi": "410%"
    }
  ],
  "implementation_statistics": {
    "total_use_cases_deployed": 10,
    "organizations_using": 156,
    "avg_roi": "258%",
    "avg_implementation_time_days": 45,
    "user_satisfaction_score": 4.6
  }
}
