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Background/AimsThe United State currently uses version nine (ICD-9) for diagnosis and procedure coding. Federal regulations require that the US adopt the next version (ICD-10) by 10/1/2014. The new version expands the number of diagnosis codes from about 13,000 to 68,000, providing more granularity to classify diseases. Challenges in moving to ICD-10 include: (a) the crosswalk between versions is a many-to-many match; (b) the relationship between the old and the new codes will sometimes be complex; and (c) it will encompass system-level changes such as expanded field sizes and support for alphanumeric characters. Our challenge is to implement the transition across three research centers at Kaiser Permanente Northwest, Southeast and Hawaii.MethodsThe three research centers need to account for the new ICD-10 code set and any new data structures introduced by either the EMR or Research Data Warehouse. A smooth transition between coding systems requires working with researchers across the three regions. This includes identifying corresponding ICD-10 codes that correctly identify the research cohort members and remediating the existing programing logic. Kaiser Permanente’s Center for Health Research (CHR) has developed a detailed plan to accomplish these two goals. CHR staff are partnering with the Kaiser Health Plan ICD-10 implementation team in the development of our project plans. The standard source to be used for mapping at the three Kaiser Research centers is the General Equivalence Mappings based Crosswalk Query Tool, which Kaiser is implementing to support transition mapping needs.ResultsThe CHR ICD-10 remediation team has completed the Framing and Planning phases including identifying programs/tables affected, sharing remediation solutions across the Kaiser regional research teams, and meeting with the Health Plan to coordinate efforts. We have developed a project remediation checklist and will report on the development of validation testing plans and the refinement of vanguard project code mappings.ConclusionsIn the transition to ICD-10, it is essential to have a well-formed plan and to identify and include all stakeholders in the process. It is also beneficial to share tools and ideas between research centers to improve the overall methods. |
