Abstract

Objective

This study investigated how well-suited the International Classification of Diseases, 11th Revision, for Mortality and Morbidity Statistics, (ICD-11 MMS) is for 2 morbidity use cases, patient safety and quality, examining the level of detail captured, and evaluating the necessity for the development of a US clinical modification (CM).

Materials and Methods

Utilizing the 5 NCVHS-specified perspectives plus the consumer perspective, a framework was created of International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) use cases. Analysis yielded candidate source criteria for use in case evaluation. Patient safety and quality were chosen because they are relevant across all perspectives.Granularity differences and content coverage of ICD-11 MMS entities were assessed pre- and post-coordination to determine suitability for the 2 use cases. Pressure ulcers, a common condition across 3 patient safety applications, became the focus for comparing ICD-10-CM codes to ICD-11 MMS codes. For 3 electronic clinical quality measures (eCQMs), the evaluation centered on specified value sets for ischemic stroke, hypertension, and diabetes.

Results

For pressure ulcers, the ICD-11 MMS was found to exceed ICD-10-CM capabilities via post-coordinated extension codes. For the 3 eCQM value sets explored, the ICD-11 MMS fully represented the disease concepts when post-coordinated code clusters were used.

Conclusions

The examples from the patient safety and quality use cases evaluated in this study are appropriate for ICD-11 MMS. It captures greater detail than ICD-10-CM, and ICD-11 MMS specificity would benefit both use cases. The authors believe this preliminary study indicates the US should invest resources to explore adopting the WHO ICD-11 MMS and tooling and guidelines to implement post-coordination.

中文翻译：

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ICD-11 MMS 患者安全和质量用例的初步研究

摘要

客观的

本研究调查了国际疾病分类第 11 版的死亡率和发病率统计 (ICD-11 MMS) 是否适合 2 个发病率用例、患者安全和质量，检查捕获的详细程度，并评估开发美国临床改良（CM）的必要性。

材料和方法

利用 NCVHS 指定的 5 个视角和消费者视角，创建了一个包含国际疾病分类、第 10 版、临床修改 (ICD-10-CM) 用例的框架。分析产生了用于案例评估的候选源标准。选择患者安全和质量是因为它们在所有方面都具有相关性。ICD-11 MMS 实体的粒度差异和内容覆盖范围在协调前后进行了评估，以确定对 2 个用例的适用性。压疮是 3 个患者安全应用程序中的常见情况，成为 ICD-10-CM 代码与 ICD-11 MMS 代码比较的焦点。对于 3 个电子临床质量测量 (eCQM)，评估集中在缺血性卒中、高血压和糖尿病的指定值集上。

结果

对于压疮，发现 ICD-11 MMS 通过后协调扩展代码超过了 ICD-10-CM 功能。对于探索的 3 个 eCQM 值集，ICD-11 MMS 完全代表了使用后协调代码簇时的疾病概念。

结论

本研究中评估的患者安全和质量用例中的示例适用于 ICD-11 MMS。它比 ICD-10-CM 捕获更多细节，并且 ICD-11 MMS 特异性将有利于这两个用例。作者认为，这项初步研究表明美国应该投入资源探索采用 WHO ICD-11 MMS 以及工具和指南来实施后期协调。