- This topic has 16 replies, 12 voices, and was last updated 1 year, 6 months ago by Tanatorn Tilkanont.
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2022-09-23 at 1:05 pm #38257SaranathKeymaster
Currently, most hospitals use the ICD standard to classify disease diagnosis. What would happen if the hospitals in the country do not use the ICD standard?
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2022-09-26 at 6:12 pm #38363Zarni Lynn KyawParticipant
I would like to argue that most hospital in Myanmar don’t use ICD or SNOMED CT standards as we don’t have a widespread insurance program in Myanmar. According to data nearly 75% of our health care cost is out-of-pocket payment, it is in my opinion, one of the areas the country have to invest heavily in the future.
So, instead of being hypothetical, let me share what is happening in Myanmar because the hospitals in the country do not use the ICD standard.
1) each private hospital use there own EMR systems and data can’t be share with other hospital
2) after each discharge from the hospital patients have to ask all the medical records on paper (some hospital as an anti-competitive measure wont’ release those data as well)
3) patients have to save all of those paper at their homes and if needed they have to take all of those paper to another hospital if needed
4) Since the hospital EMR systems can’t talk to each other, if a patient loss those papers, all of the medical history will be lost, especially if the patient decided to go to another hospital.
5) The private hospital have little incentive to standardize because there is no widespread insurance system in Myanmar and the public understanding of their right to their own health record is very lowAlthough, I have to add that in 2016, Myanmar Ministry of Health mandated that the whole country will use DHIS2 system and all public and private hospital must participate, there is no enforcement and very little incentive to use the same standard across the country. After 2021 military coup, the health agenda is put on near last and most of the health budget was cut.
In the future, we are hoping that Myanmar government can pass laws to mandate interoperable standards like HL7/FHIR to be used by health facilities across the country and move towards a more efficient health systems.
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2022-09-27 at 9:54 pm #38377Siriphak PongthaiParticipant
Definition defined by CDC, the International Classification of Diseases (ICD) is designed to promote international comparability in the collection, processing, classification, and presentation of mortality statistics.
If the hospital don’t use ICD standard, this would effect many organization as consequences. Since ICD provides standard in common language for reporting and monitoring of diseases. This standard allows us to compare and share data across not only organizations (e.g. hospitals, government sectors, health insurance companies) but the world. If ICD is not implemented, the health information data cannot be transferred and shared. Then data cannot be further collected, analyzed, and helped in decision making.
In addition, ICD could help us seeing, predicting, and managing trends of diseases. Thus leads to evidence based, policy development, and decision making in a national level.
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2022-09-28 at 3:23 pm #38392Boonyarat KanjanapongpornParticipant
Data wouldn’t be easy to tranfer without ICD standard and I agree that data-based decision making will be harder especially with the demand of real-time usage.
Thank you.
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2022-09-28 at 9:37 pm #38400PREUT ASSAWAWORRARITParticipant
What will happen if we do not use ICD?
1. Some diseases have several names with the same meaning, for instance, common cold or acute nasopharyngitis. Without ICD, there will be numerous names with the same disease which cause difficult to group them.
2. Data surveillance or other epidemiologic studies would be done with difficulty.
3. Insurance company will find it is hard to make the correct reimbursement.
4. Since the ICD-10 TM is modified from the international version, the disease grouping and classification can be used to compare the information between countries. Without ICD, it is a hard work to do so. -
2022-09-28 at 10:52 pm #38403ABDILLAH FARKHANParticipant
ICD is important to be operated at the level of hospital/health care because the codes are used for indexing disease records and reporting disease morbidity and mortality. ICD codes mean the code of problem/diagnosis/health conditions. ICD combined with CPT (Current Procedural Terminology) can be useful to process treatment billing and inform the payors or insurance companies about what treatment is being given to cure the diagnosis.
So, in case the hospital could not perform a coding system according to the ICD standard, this will be difficult to determine the diagnosis and link to the treatment, as well as vulnerable to inappropriate data reporting that reduces the quality of surveillance data. In addition, hospitals that are not implementing ICD coding yet will challenge CPT codes to determine an accurate billing payment.
Correct me if I am wrong.
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2022-09-30 at 11:13 am #38471Boonyarat KanjanapongpornParticipant
ICD (International Classification of Diseases) is the healthcare data standard which creates interoperability in healthcare stakeholders. ICD coding system would classify disease and health problem. ICD is mainly utilized in epidemiological proposals and administrative reimbursement.
It might be harder and slower the process of exchange and use of data without ICD especially with social health protection schemes such as Social Security scheme. Reimbursement, Financial plan, Public Health Policy and Population research could be affected without exchange standard, making it hard to do any real-time updates for issues.
Moreover, Sending and aggregating data would have to be done manually. These would increase the costs for staff to manually re-input data each time from the health service provider to insurers. More than just the process being slower compared to automatically sharing by data standards, the chances of inconsistency of reporting or human error increase because of the instability of human capability.-
2022-10-08 at 9:32 pm #38589Kansiri ApinantanakulParticipant
Thank you for sharing.
You comment is comprehensive. I agree with you that it would not only affect at the hospital level but also country level including public health policy.I think that the better and organized health data we get, the more we could add the value to them.
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2022-10-01 at 6:27 am #38479Hazem AbouelfetouhParticipant
Hospitals that use the ICD to categorize patient data can drive quality improvement and have an opportunity to make a training ground for the management of big data and can provide researchers with detailed information for population management purposes. Without ICD, exchanging health data would be difficult and will cause many problems with disease classification and make it impossible to analyze it for research purposes.
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2022-10-03 at 12:53 am #38503Kawin WongthamarinParticipant
I think without interoperability standards, each hospital would have a hard time transmitting information to each other. Data must be converted to suit each organization and hospital, which would waste a lot of human resources and time to convert the data. Due to a large amount of data preparation time required, a fast response to the rapid rise in incidence is difficult. Consequently, the surveillance system would work inefficiently.
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2022-10-05 at 9:35 pm #38550SIPPAPAS WANGSRIParticipant
I agree. Without standards, there would be prone to error that affects patient care. There are many HIS system on the market these days and all of them are just creating their own databases and schemas! From what I know, a FHIR HL7 standard is being implemented by tech companies to comply.
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2022-10-05 at 7:03 pm #38546SIPPAPAS WANGSRIParticipant
Well, to my knowledge, ICD standard was originally used for reimbursement purpose because ICD itself does not contain a specific detail about a disease. For example, in patient diagnosed with bacterial pneumonia, if we use ICD-10 for reimbursement, we will have to enter J159: Bacterial pneumonia, unspecified. As you can see, it tells us no more than what was this patient actually had, it does not tell us which lung was affected. In contrast, SNOMED-CT can tell us using a “concept”, that would be Pneumonia + Left/Right lung structure + gram positive bacteria
So, to answer the question, what if some hospitals in the country do not use ICD standard. Well, that would lead to reimbursement problem if the hospital were to pay a bill to the payee (Social security, insurance company or a government in CSMBS scheme) and they wouldn’t get paid. Even an ICD standard does not clarify the disease in detail, but at least, when sending a patient information about his/her diagnosis, it can still tell us what are the patients diagnosis.
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2022-10-08 at 9:29 pm #38588Kansiri ApinantanakulParticipant
I agree with you that the ICD-10 did not contain specific details about disease.
Hospital may provided other equivalent information to the payee for reimbursement but I’m not quite sure that it would delay the payment process or not.
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2022-10-05 at 8:09 pm #38547Tanyawat SaisongcrohParticipant
As we known, the goals of standardization include achieving comparability, compatibility and interoperability between independent systems, ensure data compatibility and reduce duplication of effort and redundancies.
Without standard (ICD), health information communication between different systems will need a large number of interfaces. It will waste of time, resources and effort that we have to spend in terms of health care service in different department of the hospital and also in referral system, reimbursement system, disease surveillance system, and also for further research purpose.-
2022-10-12 at 10:30 pm #38682Tanatorn TilkanontParticipant
I agree that redundancy process leads to consuming of time, resources and efforts. Those are the problems that we need to concern when sharing or exchanging data. Therefore, the standardized data is very crucial for interoperability.
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2022-10-08 at 9:26 pm #38587Kansiri ApinantanakulParticipant
My opinion towards the ICD use is quite the same with other classmates.
I agree that if the hospitals do not use the ICD10 as a standard for disease diagnosis.
This would cause a major problem involving many healthcare stakeholders including
1) Insurance and reimbursement party: Since Thailand mostly rely on ICD-10 for reimbursement, the reimbursement process would be more complicated if the hospital do not use ICD-10 and do not use other interoperability standards for diagnosis and in long term would affects healthcare system. People may tend to have self-pay more and more.
2) Epidemiological research would be more difficult to conduct resulted in less real world evidence generated in country
3) Less organized and less interoperable system for data sharing among healthcare systems -
2022-10-12 at 9:44 pm #38680Tanatorn TilkanontParticipant
According to WHO, “ICD serves a broad range of uses globally and provides critical knowledge on the extent, causes and consequences of human disease and death worldwide via data that is reported and coded with the ICD”. Without using ICD standard, health data collected for statistical research might not impact worldwide as we did not use standard code. It might be difficult for data sharing between different organizations as well.
However, from my understanding, there are other standards that can be used instead of ICD in terms of terminology, such as SNOMED-CT, which is also a global standard for health terms and more specific details the diseases, signs and symptoms.
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