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If there is better standard, I would be OK with it, but at some point, using the same standard, or normalizable to the same standard is needed, in order to better the interoperability. Using an ICD10 superset would indeed be interesting.
According to Dr. Boonchai’s interop book, Table 10; I think there needs to be more research on why some entries are not translatable.
In the end, either ICD10 needs to expand, or we needs an ICD10 compatible standard of our own.
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The International Classification of Diseases is the international from WHO standard of diagnosis, health management and clinical purposes but country do not use the ICD standard That are related with quality of treatment and epidemiology, knowledge of diseases treatment, research disease and standard of hospitals, Medical statistics, Medical Information System,Strategic planning, medical fee and HIE system to other organization.
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For me when we talk about the health system, we cannot deny the fact that the financing part of the system is most important. In UHC, the financing is being criticized, mostly by hospitals on inefficiency financial support. ICD has been using as a claim processing between NHSO and hospitals the same as the insurance billing process in the US. However, the UHC is heading to DRG to align with their move from “fee-for-service” to “fee-for-performance” which is the same as in many countries in Europe. Comparing to SNOMED-CT, ICD is rougher in terms of clinical terms needs, and when comparing to DRG there are too many details for payment processing. Then for me, ICD, apart from its function in disease diagnosis using internally in the hospital or epidemiological function as its origin, the hospital should get to know more on other standards following the national move.
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The disease data will be confused when we need to accumulate from different hospitals. Because many diseases and syndromes have several names and terms. And it will be very difficult to group or compare between hospitals.
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If the hospitals in the country do not use the ICD standard to classify the diagnosis. I think it will have confusion to collect the data for epidemiological study or reimbursement.
If we do not have any data standard at all, the diagnosis will be confusing and can’t proper categorize for further information. If we use another data standard such as SNOMED CT instead of ICD 10 I think it will be more user-friendly for clinical end-user to key the clinical input but it will make a lot of workloads for people in epidemiology and public health policymaker to grouping the diagnosis that related to each other by medical term.-
Hi Khun Tullaya…I agreed that workload is what may be a barrier standardization…I found that there are some tools to help reduce such workload grouping the data…kind of mapping tool or converter
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If hospital do not use the ICD standards, there might be pros and cons. If the country has their own standard/ well defined data sets, it will be ok not to use ICD standards. If the country does not have their own standard data sets, should use ICD standards. Without any standards, there would be difficult to collect and analysis. It will not favorable for interoperability. Currently there is no reimbursement system in hospital of our country. Not sure standard is needed for reimbursement process.
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ICD standard is the international standard for reporting diseases and health conditions. It is the diagnostic classification standard for all clinical and research purposes. ICD defines the universe of diseases, disorders, injuries and other related health conditions, listed in a comprehensive, hierarchical fashion. ICD is used for monitoring of the incidence and prevalence of diseases, observing reimbursements and resource allocation trends, and keeping track of safety and quality guidelines. They also include the counting of deaths as well as diseases, injuries, symptoms, reasons for encounter, factors that influence health status, and external causes of disease.
If the hospitals in the country do not use the ICD standard, it will be difficult
– To storage, retrieve and analyze health information for evidenced-based decision-making
– To share and compare health information between hospitals, regions, settings and countries
– To compare data in the same location across different time periods -
I agree with weerawan.hat that the reason why we use ICD-10 is we can share and compare health information between countries. Physician in each country or medical school would be trained in a different manner and give the diagnosis term differently even the patient have the same diagnosis. ICD-10 is the standard for diagnosis term which can be applied to all health care thus we can share and compare the prevalence of specific disease between hospitals or countries. Unless we cannot count specific disease correctly because there are different terms in the pool of superfluous data.
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In my point of view, I also agree with you all, in case of data analysis and data sharing. However, in the case of a user, my friend who is a clinician told me that the use of ICD10 makes her work waste time because the program to search ICD10 is not user-friendly at all. It is very difficult to search for ICD10 related to diseases or symptoms. Moreover, it is not help to treat patients. So if there are other better choices, she ready to use them instead.
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I also agree with Weerawan and others. ICD coding system is the international classification of diseases established by World Health Organization for reporting diseases and health conditions. It is the diagnostic classification aimed for local and national planning, public health policy, national resourcing assessment, and population research purposes. ICD defines the universe of diseases, disorders, injuries and other related health conditions, listed in a comprehensive, hierarchical fashion. ICD is used for monitoring of the incidence and prevalence of diseases, observing reimbursements and resource allocation trends, and keeping track of safety and quality guidelines. They also include the counting of deaths as well as diseases, injuries, symptoms, reasons for encounter, factors that influence health status, and external causes of disease.
If the hospitals in each country do not use the ICD standard, it will be difficult for health information exchange not only in one country but also international level in term of report and epidemiology eg.
– Storage, retrieval and analysis of health information for evidenced-based decision-making
– Sharing and comparing health information between hospitals, regions, settings and countries
– Comparing data set in the same location across different time periods -
I agree with Dr. Tullaya, K’Weeraphan and you all, as ICD is the diagnostic classification standard for all clinical and research purposes.
If the hospitals in the country do not use the ICD standard which is the international standard for reporting diseases and health conditions, it will be difficult to diagnose and then effect to data collection, including of information between hospital. For example, in case of the country do not use the ICD standard:
– hard to retrieve and analyze data due to difference format.
– hard to compare and exchange data between hospital.
– hard to utilize data to monitor, analyse and predict diseases
– etc.As Aj. Sananath said that ICD standard can also be mapped to other related standards, such as SNOMED-CT. I agree too, SNOMED and ICD can work together through mapping and integration. SNOMED-CT is linked with other terminologies or classifications so that:
– Healthcare data collected for one purpose can be used for another purpose
– Data can be more easily migrated to newer database formats and schemas
– Data can be entered once and reused, avoiding multiple data entry and reducing the risk of higher cost and errorsThe use of a map from SNOMED-CT to ICD-10-CM and ICD-10-PCS will allow clinical information captured at a very granular level to be aggregated for reporting and statistical analysis purposes. Mapping a reference terminology to modern classification systems:
– Decreases administrative costs
– Decreases time in revenue cycle
– Increases specificity and accuracy of data
– Maintains comparable data.
Mapping between SNOMED-CT and ICD is an imperfect science. It is very difficult to adequately represent some of the ICD coding conventions for a computer’s purposes. I hope that this will be perfect oneday in the future.
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