To sum it up in one sentence, this book wasn’t very good but wasn’t completely without redeeming qualities. The writing was solid. A bit too much tell versus show at times but the narrative was engaging enough that it didn’t bother me. I liked the introductions to all the characters and felt that those early chapters gave me a really good handle on who everyone was. Except Toby, for the first few chapters I kept forgetting who he was and I am still not sure why I couldn’t remember him.

Jinx was a terrible main character. I could tell that she’s supposed to be smart but she really enjoyed acting like she wasn’t. Her father prepared her for the apocalypse for years, she knows what she should do in the situations presented in the book. She just decides not to do it. And then regrets it once everything goes horribly wrong. Just once I wanted her to follow the lessons of her father and go along with the disaster plan. But, alas, she did not. I tried really hard to like her as a character but I just couldn’t do it.

Charles was an absolutely delight as a character, which was completely unexpected for me. I did not expect to like him but he stole my heart. I wanted to protect him in his anxiety and fear. And to quite frank, he was a lot smarter than his older sister too.

My biggest problem with this book however was the political overtones. I don’t mind books that are commentaries on the current political climate. But, is it really so hard to disguise that a tiny bit? Somehow the current political parties have been replaced by The Spark and The Opposition. I have no idea how that happened because the author didn’t bother to tell me. The Spark is basically the Democrat party. Socialist, popular with “educated” folks who majored in political science, and the goal is take rich people’s money and spread it around so that everyone has a mediocre existence. They have been in power for about 10 years according to the book. Their leader is Rosenthal. Everyone in the book repeats the party catch phrase ad nauseum “Everyone’s for Rosenthal.” And if anyone in the book even hints that they might not be for Rosenthal they are immediately attacked with “so you just hate people? you just want to hoard your stuff instead of take care of people?!” Yawn. Boring. The Opposition is the Republicans, allegedly. Led by Ammon Carver, an enigmatic billionaire who owns the largest bank in the country and since “Everyone’s for Rosenthal” he obviously cheated in order to win. Is this sounding familiar at all? Oh yes, everyone in The Opposition wears red hats, carries shotguns, has a poor command of the English language, has a pickup truck, and obviously wants the world to descend into anarchy so they can keep all their stuff. Oh and every other character immediately labels them a Neo-Nazi seemingly without any evidence of that at all. Is this sounding familiar now?

I didn’t mind the political themes at first because after the first 20 pages or so they seemed to largely move on to other things. But then it comes back at the end in such a heavy handed way that I wanted to scream. It felt like the author was beating me over the head with a MAGA hat screaming “I’m talking about Trump and 2016!!!” I get it. Okay? Honestly. I get it. I am not so stupid that I didn’t see your glaringly obvious theme. I was so tired of it by the time we got to the big twist at the end that I mostly just wanted the book to end. I don’t mind politics in my books, but please refrain from beating me over the head with your own opinions. I don’t need the brain damage.

And then we come to the twist. It wasn’t that good either. I started figuring it out about halfway through the book. I was completely sure that I knew what was going on shortly after. It was so blatantly obvious that even another character basically says to Jinx, “Hey isn’t all this stuff weird and suspicious? Do you think there might be something odd going on here?” And Jinx just laughs and says “Of course not!”. Then she is oh so shocked when the traitor is revealed. Um, that other character literally told you all that stuff about 40 pages ago. Are you really that dense?

Overall, not a good book. I won’t be reading the next book but it gets some credit for the exciting middle portion and for Charles.

The transition to ICD-10 coding standards from ICD-9 in North America, the growing demand for CAC solutions, the growing need within the global healthcare system to curtail increasing healthcare costs, improve coding accuracy, and streamline the revenue cycle management procedures.

The computer assisted coding market is expanding with the emergence of new products and applications. These computer assisted coding solutions being used in many applications such as automated computer-assisted encoding, management reporting & analytics, and clinical coding auditing.

Implementation of ICD-10 Drive the Global Computer Assisted Coding Market

Many hospitals, especially in North America, are adopting CAC systems to manage the increasing load of coding resulting from the adoption of ICD-10 standards. Major health plans like Medicare have reported a smooth transition to ICD-10 due to rigorous testing for over six years. The ICD-10 coding system requires the use of 72,000 procedure codes and 68,000 CM codes, as opposed to the 4,000 and 14,000 codes, respectively, in the ICD-9 system. The requirement of managing a high volume of codes in the ICD-10 system is in turn driving the demand for automation.

The US is expected to dominate the global CAC market due to the mandated switchover to ICD-10 coding standards in October 2015. This transition may result in a decline in coders’ productivity, thereby resulting in lower profitability for hospitals. The implementation of CAC systems can resolve this issue as they enable healthcare organizations to work more efficiently while complying with procedural coding standards as per ICD-10 guidelines. This trend is expected to provide a strong stimulus to the growth of the CAC market in North America in the coming years.

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Geographical Region

The computer assisted coding market in APAC is expected to grow at the highest CAGR during the forecast period. The growth of this region is primarily driven by the escalating demand to reduce the burden of the healthcare systems, curtail healthcare delivery costs, increasing implementation of Healthcare IT solutions, and the various government initiatives for enabling efficient, affordable, and on-time delivery of quality care. As a result, APAC holds a significant share of the overall computer assisted coding market.

Leading Companies

3M Health Information Systems (US), Optum (US), McKesson Corporation (US), Nuance Communications (US), Cerner Corporation (US), Dolbey Systems (US), Precyse Solutions (nThrive) (US), Craneware (UK), Artificial Medical Intelligence (US), and TruCode (US). Other players include Quest Diagnostics (US), Streamline Health Solutions (US), M-scribe Technologies (US), eZDI Inc. (US), Alpha II LLC. (US), ID GmbH & Co. KGaA (Germany), ZyDoc (US), Coding Strategies (US), Patient Code Software (US), and Flash Code (US) among others.

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The growth of the market can be attributed to the transition to ICD-10 coding standards from ICD-9 in North America, the growing demand for CAC solutions, the growing need within the global healthcare system to curtail increasing healthcare costs, improve coding accuracy, and streamline the revenue cycle management procedures.

The computer-assisted coding market is expanding with the emergence of new products and applications. These computer assisted coding solutions being used in many applications such as automated computer-assisted encoding, management reporting & analytics, and clinical coding auditing. 

Market Growth Overview

The global computer assisted coding market is valued at USD 2.76 billion in 2017 and is expected to register a CAGR of 11.5% to reach to USD 4.75 billion by 2022. 

The computer assisted coding market in APAC is expected to grow at the highest CAGR during the forecast period. The growth of this region is primarily driven by the escalating demand to reduce the burden of the healthcare systems, curtail healthcare delivery costs, increasing implementation of Healthcare IT solutions, and the various government initiatives for enabling efficient, affordable, and on-time delivery of quality care. As a result, APAC holds a significant share of the overall computer assisted coding market.

Implementation of ICD-10 Drive the Global Computer Assisted Coding Market

Many hospitals, especially in North America, are adopting CAC systems to manage the increasing load of coding resulting from the adoption of ICD-10 standards. Major health plans like Medicare have reported a smooth transition to ICD-10 due to rigorous testing for over six years. The ICD-10 coding system requires the use of 72,000 procedure codes and 68,000 CM codes, as opposed to the 4,000 and 14,000 codes, respectively, in the ICD-9 system. The requirement of managing a high volume of codes in the ICD-10 system is in turn driving the demand for automation.

The US is expected to dominate the global CAC market due to the mandated switchover to ICD-10 coding standards in October 2015. This transition may result in a decline in coders’ productivity, thereby resulting in lower profitability for hospitals. The implementation of CAC systems can resolve this issue as they enable healthcare organizations to work more efficiently while complying with procedural coding standards as per ICD-10 guidelines. This trend is expected to provide a strong stimulus to the growth of the CAC market in North America in the coming years.

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Increasing Consolidations in the Market – Opening New Avenues for Growth in Computer-Assisted Coding Market

Over the last three years, leading players have focused on expanding their presence by acquiring small, regional/local players. For instance, in 2014, 3M HIS (US) acquired Treo Solutions (US) to expand its real-time data analytics and payment redesign businesses.

This acquisition helped 3M in broadening its end-user base for its 360 Encompass System. Product portfolio expansion, product integration, and geographic expansion are some of the key objectives behind such acquisitions. The acquisition of smaller players in the high-growth Asian and Central & Eastern European markets is also a key area of focus for market players. This is because having a direct presence in these countries will prove to be considerably beneficial once developed markets become saturated.

Apart from acquisitions, leading market players are pursuing the strategy of partnerships with small and medium-sized companies in order to offer innovative and comprehensive solutions to their customers. The growing focus on improving the interoperability of CAC solutions is a key factor driving partnerships in this market.

Applications such as automated computer-assisted encoding, management reporting & analytics, and clinical coding auditing drive the growth of computer assisted coding market

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Automated Computer-assisted Encoding

Automated computer-assisted encoding is one of those applications enables compliance with regulatory standards for clinical coding, thus ensuring that the information exchanged between different healthcare organizations is consistent, comparable, and meaningful.

Management Reporting & Analytics

The healthcare IT industry is facing challenges to make data accessible, sharable, and actionable. The management reporting and analytics modules of computer-assisted coding are designed to enable coding and revenue managers to monitor and track coding processes throughout the workflow. These tools help in tracking the various stages of coding procedures such as case assignment, recording the point and time of modifications to original coding, and the duration for which the chart was open. With analytics tools, coding data can be examined and used more efficiently in making critical decisions.

Clinical Coding Auditing

Clinical coding auditing reduces regulatory compliance risks by identifying potential patterns for fraud and enables healthcare organizations to maximize reimbursement by improving coding accuracy. Clinical coding audits include a statistical audit, subset audit, percentage audit, and a complete audit. They are aimed at providing a more comprehensive overview of the areas of concern using a more extensive data set. The complete clinical code audit uses all relevant data available to ensure a thorough audit. However, there are a number of solutions in the market that provide customizable auditing options, enabling users to define specific parameters for the information to be used. Such solutions help accelerate the auditing process.

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