Use of the Delphi Method to Generate a Gold Standard for the Medical Coding Industry

The Delphi Method was developed in the 1950’s at the RAND Corporation. The original process is still in use today. In this article the authors proposed a modified version of the process with the intent of providing a “gold standard” for medical coding for records that eliminates coder variability. They called their new process, The Delphi Method of Medical Coding, which is a patent pending process.

This proposed new method of the Delphi process was created in hopes of eliminating some of the biases that can be presented in the original method. It also eliminates some of the cumbersome written communication required in the old method.

The Delphi Method of Medical Coding

1. Multiple coders are given identical sets of medical records and asked to code them as they would normally. These results show the different possible ways of coding. Each different possible code is shown on consolidated list.

2. The consolidated list from step 1 are presented to a second set of coders. The coders then make a simple yes/no determination about whether they should be applied to the associated record or not.

3. For each of the codes on the listing, a percentage is calculated of coders who decided the code should be applied. From this percentage, determined by either a fixed percentage or some derived statistic, one of three decisions is made. These possible decisions are the code should be applied to the record, the code should not be applied, or the code is indeterminate.

Conclusion

Although this study only showed only one use of this method, it’s possible it could be applied to other areas, similarly to the versatility of the original Delphi Method. However, it would be a good idea to conduct research comparing this method with the original to see if it truly eliminates biases while arriving at a similar outcome. This new method may provide a better way of gaining active participation due to smaller amount of steps and less time spent on the overall process. The article talks about possibly even implementing this method as a game, which may provide an even easier interaction for the people involved it the process.