Use of classifications in Korea

Transcription

1 Use of classifications in Korea The 6th Meeting of the Asia Pacific Network of the WHO Family of International Classifications Bangkok July 18, 2013 Korean Collaborating Center Sukil Kim

2 Contents Current status of ICD in Korea Maintenance Usage Changing health information environment Change of hospital information system New roles of health information manager Action to be taken for the future

3 Status of ICD

4 Maintenance By the Statistics Korea under the law Practically by Korean Medical Record Association (KMRA) Local extension by large scale hospitals KCD-6 since 2011 Modification of ICD version

5 Use of mortality and morbidity Vital statistics data Administration, clinical care and research Health insurance claims (Fee For Service) Hospital administration Electronic Medical (Health) Record OECD reports

6 Mortality statistics National death registration system Operation Ministry of Security and Public Administration Submission of death certificates signed by doctors to regional district office No funeral without the document Ministry of Health and Welfare Annual report By Statistics Korea since 1980

7 Mortality statistics Status of mortality data in Korea by Colin D. Mathers, et al. Mar. 2005, WHO Bulletin Coverage: 88% ill-defined code: 14%

8 Trend of health information system in Korea Health insurance program for public officers and private school employees Health insurance reform Separation of prescribing and dispensing of drug Health insurance program for private companies Health insurance for all Korean Partial approval of electronic prescription, Electronic health record, Telehealth by revision of the law Software for medical claims CPOE EDI for insurance clams EMR market for private clinics Hospital EMR e-prescription Concept of EHR

9 Hospital morbidity statistics by the main condition of patients in an university hospital Diagnosis No. of pt. LOS % 1 Liver & Bile duct cancer Chronic ischemic heart disease Stomach cancer Lung cancer Chronic renal failure Cholelithiasis Cataract Liver cirrhosis Leukemia Breast cancer Necrosis of bone Total (83371) 9.3 (8.7) 73.3 (100)

10 Use of ICD for Hospital management 2.5 Average LOS of patients with cataract 2.5 Average LOS of patients with tonsillectomy 전체 2001 전체 월화수목금토일공휴일 전체 2001 전체 월화수목금토일공휴일

11 Healthcare system 90% of private sector One and only one national health insurer Legal submission of medical claims to reviewer (Health Insurance review and assessment service) Fee For Service system for both outpatient and inpatient services

12 Reimbursement of health insurance and claims review HIS (Hospital Information System) - EMR, OCS(CPOE), CRM, FACS, ERP Disk (CD, DAT) EDI Web Multiple Bar Coded Paper HIRA

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19 Obstacles Reimbursement purposes Code shift main condition Too many additional codes Health Information Manager Involved in the valid data for research and internal management of hospitals

20 Clinical coders in Korea Coding education included in HIM program University College National license since 1985 Continuing education By Korean Medical Record Association

21 Role of HIM professional Health Information Manager Clinical Data Specialist HIM Professional Patient Information Coordinator Data Quality Manager Research & Decision Support Analyst Document & Repository Manager Security Officer Documentation improvement specialist (Vision 2013, AHIMA)

22 Actions to be taken in Korea Activation of collaborating center for WHO-FIC and Terminology Activities based on terms of reference Development of standard terminology for EMR/EHR Training for the coding specialist in mortality and morbidity International certificate from WHO-FIC- IFHO joint collaboration (JC)

23 Thank you