Classification of diseases
The International Classification of Diseases is rather well suitable for the tasks of health care administration, but there is a definite shortcoming in terms of clinical requirements. The latest revision, the ICD-10, is a considerable progress, but it remains a statistical classification, not a scientific classification.
The change of ICD-9 to ICD-10 is executed worldwide only slowly. In Germany we did this in 2000, in Austria they changed 2001, in China last year. Each change of a classification causes great efforts and high costs, because all documentation and administration systems as well as reimbursement systems have to be adapted. For that our recommendation for Kenya is to start with ICD-10.
The new classification consists of 21 chapters and provides alphanumeric codes up to 5 digits. The chapters 1-18 cover all diseases ordered by anatomic site. Chapter 15 is used for obstetrics. Chapter 19 contains the classification for injuries and poisoning. The last two chapters are not used to encode diagnoses. Chapter 20 provides a classification for external causes of morbidity and mortality like accidents or injuries (for example traffic accidents). Chapter 21 is used for the encoding of "factors influencing health status and contact with health services", e.g. demands of the health care system by healthy persons, for example in order to get a prophylactic vaccination.
In certain specialised medical departments there is a need for a much more detailed documentation.
For example in oncology a special classification system has been developed and published by WHO either, called "International Classification of Diseases for Oncology (ICD-O)", meanwhile the second edition. Tumour location and histological type were encoded separately. The tumour stage can be stated by means of the TNM-classification provided by the International Union against Cancer (UICC).
Also the classification of bone fractures by means of ICD-10 is unsatisfactory. A very sophisticated classification system is provided by the Society of osteosynthesis (AO). Our company did a lot of work to make these systems compatible with the ICD-10.
For the acceptance in hospitals it is necessary to generate ICD-10 codes automatically from the workflow of clinical documentation.
Med-I-Class GmbH provides a graphical encoding system, fulfilling the needs of physicians as well as administration persons. The problem of the transformation of special classifications to the ICD-10 and migration from ICD-9 is solved.