Conversion from our old diagnosis schema to ICD10/CCI

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This article outlines how we will transition from the old diagnosis schema to ICD10 and CCI. Process has been in the works since at least 2016.

As of 18:59, 2017 September 16 (CDT), some of the discussion about this continues in Task Team Meeting - Rolling Agenda and Minutes.

Timeline

Current Timeline is this:

  • in progress now:
    • groupings for reports
    • Groupings for Charlson, Apache Dxs, Alert score, Overstay
  • 2018-03-01 implementation of cross-checks starts (incl TISS, CFE)
  • 2018-03-15 all initial cross-checks implemented
  • 2018-03-15 start full double-coding for all patients is expected
  • 2018-04-01 earliest possible date to only code ICD10; this might be later if double coding shows problems

Data

Diagnoses / ICD10

Diagnosis data will be stored in the L_ICD10 table. The codes will be provided by the s_ICD10 table.

Special consideration will need to be given to:

  • Code mapping Excel workbook from Allan Garland, used by Tina, can be found on X:ccmdb\!ICD10_Mapped

Procedures / CCI

See CCI Data Structure.

Special consideration will need to be given to:

Collection Interface

Patient viewer tab ICD10 will be added in Patient Viewer.

Need to address Facilitating diagnosis entries.

Documentation / wiki

Articles for each new DX are available on the wiki. Where possible the new article will contain a link to the related old article(s).

All will need to be reconciled with the old diagnoses articles.

The following link will take you to a Semantic Mediawiki table that lists articles for ICD10 diagnoses that have been added to the wiki, and the degree to which their article integration has been completed:

If the old article has no additional instructions Most of the conversions will be straightforward, just do a reality check and then change the status. Articles with explanations and links will take a little more time and effort. See Diagnoses that likely have criteria for a list.

Left to plan/set up

Template:Discussion The following still need to be set up

  • accommodate multiple alternate dxs as links drawn from Category: ICD10 Diagnosis
  • accommodate likely bug entries depending on how we code those...

Decisions made

Task Elements

  • What will we do with Category:Task Elements; they don't fit into ICD10/CCI (or do they)? emailed Dr. Allan Garland. Ttenbergen 20:17, 2017 September 18 (CDT)
    • Leave them in the L_Dxs table. Rename tab to "Tasks"
    • some tasks look like they would correspond to CCI codes but we use specific collection instructions for them so they would not be equivalent, so we can't change this to using CCI codes.

Future CCI/Procedure/Previous Location Cross Check

All we will have for xcheck is: if from OR or PACU, must have at least 1 CCI. Ttenbergen 16:26, 2017 September 19 (CDT)

optional dates for dx or px that isn't an acquired

  • Don't allow dates unless in acquired dx/px Ttenbergen 16:44, 2017 September 19 (CDT)

Charlson Comorbids

Allan has provided a table of which ICD10s contribute to which Charlson score. Tina has added a column for Charlson condition to s_ICD10 table and added S ICD10 Charlson Como conditions table to contain possible values and corresponding points. We will need a query to group conditions found per patient, and a query to give total Charlson score.

ICD10 / CCI Groupings for Reports

We need ways to group ICD10 codes for reports.

Allan has provided a listing.

Tina has set up structure so that any dx can be part of any number of groupings (like wiki categories):

need to populate

Decisions to be made

Flagging additional info available for dxs in CCMDB to look up on wiki

Dr. Allan Garland's table combines DX name and other information.

  • Take the extra info out of the dx name; add a column that says "important extra info", make wiki link more visible in ccmdb when that is the case.
    • Added a column to s_ICD10 table that would be set to true/checked if there is important wiki info.
      • Template:Discussion This approach will be misleading. There will be more additional info on the wiki from the start than just the extra info Allan added in the setup of ICD10. Using this tag will only lead people not to look things up. Should we really use this? Ttenbergen 18:07, 2017 October 14 (CDT)

CCI vs remaining manually collected labs

Category:Manually_collected_labs

  • Template:Discussion CCI - should we move the imaging labs collection in with this? Emailed Allan... Ttenbergen 19:51, 2017 September 18 (CDT)
    • Allan pointed out that the blood products etc also have procedures. Tina to send list. Ttenbergen 16:17, 2017 September 19 (CDT)
  • Template:Discussion It is much simpler and faster to count the number of CXR's, ABGs, and other tests in our lab counts than to put a CCI entry for each every day they are done. Also, anything that is currently on the tiss sheet should not have to be included in CCI at least for ICU. For example, CRRT and IHD is clearly marked on the tiss and which days are clearly shown. To have to enter in CCI all tests and procedures every single day they are done is not feasible within the time constraints of our EFT's in my opinion.--LKolesar 08:12, 2018 January 31 (CST)

significant complications

Related Articles

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