Ten Going on Eleven: Part I

EDITOR’S NOTE: Ten Going on Eleven is a month-long series on ICD10monitor and Talk Ten Tuesdays that examines the importance of data mining, as it pertains to the looming transition to ICD-11. World Health Organization (WHO) Classifications and Terminologies Team Leader Dr. Robert Jakob appeared as a special guest on a recent edition of Talk Ten Tuesdays focused on this topic, and this article is a summary of his remarks.

As the team leader of the Classifications and Terminologies group with the World Health Organization (WHO), Dr. Robert Jakob is uniquely positioned to enjoy a bird’s-eye view of the looming global transition to the ICD-11 coding system.

And the early reports aren’t just encouraging – they’re tantalizing.

“We are now receiving input from countries that, as you (may have) heard, are starting implementation these days. So far, the organization (WHO) has provided systematic information about ICD-11 to some 90 countries, (with) training provided to core staff,” Jakob said. “And (there) was a comment that for one hour of training, sometimes even half an hour of instruction, on how to use this smart coding engine that ICD-11 has, and people were able to get 88 percent, 90 percent correct coding out of the samples. So this is a real step forward.”

The U.S. was among the last developed nations in the world to implement ICD-10, just four years ago, after some countries had already been using it for decades. It might want to elbow its way up toward the front of the line this time around.

“Also, this (ICD-11) coding engine, the smart thing there is the code combinations. You have heard, in the early parts of this conversation, that there are a lot of things that can be added to codes that sound scary – that if you use the coding engine, it can do some natural language processing, and it just gives you the code sequence so you have the detail that you were targeting, without any additional effort,” Jakob said. “As countries told us, they like it really because coding is so simple, so they (can) make big savings … and reduce the number of errors and loss of detail, because … ICD-11 has all these kinds of clinical details that clinicians like.”

Jakob noted that when the WHO began developing ICD-11, it took a look at the clinical modifications to ICD-10 that were made in nations such as Canada, Australia, and the United States, in order to inform improvements. What resulted was a coding set that can be nearly seamlessly integrated into existing frameworks worldwide – meaning a clinical modification may not even be necessary.

“Some countries have said they won’t need a clinical modification; others said, well, they may need them for political reasons. We will see how this evolves,” Jakob said. “However … at the core of ICD-10, (it) worked off an index and a lot of rules do to a proper coding job. Well, here (with ICD-11), you don’t need to know much. This whole thing can really be plugged in any kind of electronic coding environment.”

Preparations for ICD-11 are already underway in a litany of countries, including China, Egypt, Germany, Jamaica, India, Japan, Tunisia, Russia, and much of Central and South America, Jakob added.

You can add the U.S. to that list as well, soon enough.