Compliance Of ICD-10 In

Hospitals Of Pune A Case Study

Presented By

Dr P.M.Jenny

2ndYear Student(PGP-HS) Sancheti Healthcare Academy

•Introduction•Objective•Methodology•Findings•Challenges•Recommendation•Conclusion•Reference

Index

Introduction

International classification of diseases and related health problems 10 th version (ICD-10) is the international standard prescribed by WHO. Countries need to adopt and implement it so that the morbidity and mortality data are comparable within countries and inter countries.

 ICD is a medical classifications that provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease

Objective

To find out the compliance of ICD-10 codes in hospitals

Response of Clinicians & Paramedical staffs

Scope of improvements

Benefit analysis

Benefit of ICD-10

Mortality reporting

Morbidity reporting

Epidemiological reporting

Mediclaim reimbursements

Health planning

Resource allocations

Medical tourism

Data portability in different systems

Medical research

Methodology

Cross sectional study

Sample size- 20 hospitals

o 5 hospitals >200 bedso 2 hospitals =100 bedso 13 hospitals< 100 beds

Depth interview

o Statisticiano Professorso Doctors

Finding

1 20

2

4

6

8

10

12

14

16

No of Hospitals using ICD-10

ON

Yes

Bed wise hospitals

200-500 bedyes

100 bedYes

>100 bedNO

Clinicians’ Response

MRD department,46.46

%Death certificate,

33%

knows about

ICD-10, 20%

Doctor's response about ICD-10

Challenges

Diagnosis not written (OPD and IPD) properly, reason:

o Short forms

o Illegible

o Without secondary diagnosis

o Other morbid conditions

Less initiative by hospital authorities

Benefit analysis is not in place

Inadequate Electronic methods for data collections and software technologies

Strong government initiative

Less trained manpower

Recommendations

Cost, effort and benefit analysis

Adoptions of electronic methods

Customized soft ware technologies from various EMR Vendors

Capacity building initiatives, workshops, who facilitated ICD -10 soft wares and initiatives by private hospitals

Inclusion of ICD 10 in the UG and PG curriculum of medical courses

Department wise codes display

Hand outs and manuals in recording data in primary level having ICD codes and training for the same

Support from the medical fraternity in implementation

Present advancement

National Library of Medicine’s Unified Medical Language System (UMLS).

Mechanism for the distribution of clinical terminologies and classifications ,mappings between terminologies and between terminologies and classifications.

The maps will be distributed via the UMLS Met thesaurus.

The ICD-11 will be available in 2015

Scope for health care professionals

Training and orientation

Software having ICD-10 compliance

Format of prescriptions

Data capturing manuals

Medical record department

Examples

Apollo Hospital

ICD 10 implemented since 1993. MRD inter-linked through LAN with OPD emergency and IPD

Medical Records are scanned and stored in electronic format

PGI Rohtak

Booklet containing 20 pages of ICD 10 3 digit codes on

The basis of all the three volumes of ICD 10 book was framed.

Involvement of ICD 10 in UG, PG medical curriculum ,

Availability of Window based ICD 10 software,

Senior faculty members be made aware of ICD 10 and its utility

Conclusion

Information is used as technology & created from Data

Tool, collection methods, credibility, Uniformity and validity

Medical science itself has survived on data

ICD 10 will help in

o Health planningo Forecasting of disease patternso Resource allocationo Clinical decision support systemo Research o Compliance with MOCRA

Reference

SHIB(state health intelligence bureau)

BJ medical college

Ruby hall clinic

Jehangir hospital

Noble hospital

Sahyadri hospital

Sancheti orthopedic hospital

Poona research center

ABMH (Aditya Birla Memorial Hospital)

Columbia Asia