2021年11月10日星期三

ICD-10, why is it so late?

Why is the implementation of ICD-10 opposed?

As the most advanced disease and health problem coding system in the world, ICD-10 has greater progress, better classification and more powerful functions than ICD-9 40 years ago. However, the American Medical Association (AMA), the largest doctor organization in the United States headquartered in Chicago, has always played an opponent role in the promotion of ICD-10 in the United States. Recently, AMA also supported the proposal of extending ICD-10 again put forward by Texas Republican representative Ted Poe. In fact, it is not difficult to understand the attitude of AMA, because as a group representing the political interests of American doctors, AMA must strive to protect the interests of doctors. Because the United States is one of the only countries in the world that uses ICD-9 code as the basis for charging, doctors need to rely on this code for bargaining charges when settling accounts with insurance companies. ICD-10 has five times more codes than ICD-9, expanding from 13000 codes to 68000 codes, which requires doctors to record and analyze diseases, diagnosis and treatment more carefully, The workload has increased greatly; At the same time, clinics and hospitals must upgrade their health information systems to meet the coding needs of ICD-10, which requires a lot of time and money to hire IT personnel, more managers to complete this conversion, the cost is very high, and this upgrade is not supported by government funds. It is estimated that the use of ICD-10 will reduce the productivity of doctors and hospitals by 10% - 50%. Under such circumstances, it is not difficult to understand why AMA continues to support the postponement of the use of ICD-10, and even calls for the direct skipping of ICD-10 and the emergence of ICD-11 in 2017.

Although the wave of opposition is very large, why is the implementation of ICD-10 still on the agenda? This is because ICD-10 is very beneficial to the long-term development of medicine in all aspects.

Medical quality evaluation

ICD-10 can provide more accurate and perfect classification and records for new medical technology and surgery, bring higher quality data for the evaluation and progress of medical quality, better analyze the complications in the medical process, build a more perfect clinical path and track more detailed medical results.

Medical research

ICD-10 will provide higher quality data support for medical research. In the long run, more logical ICD-10 coding will continue to reduce coding errors and improve the accuracy of medical research. It can be predicted that higher coding precision can enable people to find medical phenomena that have not been noticed before, such as discovering latent epidemics, such as studying under which conditions laparotomy and laparoscopic surgery are more beneficial to the prognosis of patients. These studies may save more lives and greatly improve the quality of medical treatment, Even save billions of dollars for the U.S. health care system.

Public Health

The United States is the only developed country in the world that does not use ICD-10 to record diseases, which has created a barrier for the international sharing and exchange of disease information. Therefore, the ability of the United States as a superpower in disease tracking and response is limited. ICD-10 codes public health diseases far better than ICD-9. It is more precise and can capture diseases that need to be reported at the national level. The use of ICD-10 can promote the comparison and exchange of international medical quality, and is also very helpful for the prevention of pandemic and terrorism related diseases.

Quality control and charges of medical institutions

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