Embed Size (px)
Citation preview
Written by:
Date:
Read Codes are dead, long live SNOMED!Casualties & Consequences
Fire & IceAuckland
24 July 2015
Zeeman van der Merwe
Read CodesUK History
• READ version 1 (4-Byte READ) (1980’s – 2009)Developed in 1980’s by Dr James Read, Loughborough GP
• READ version 2 (5-Byte READ) (1991 – 2016/20)NHS required a cross map to ICD-9-CM needed an additional hierarchical levelCode structure was extended to 5-Bytes - READ2Oct 2010 release: 82,967 codes (82,593 clinical concepts)
• READ version 3 (Clinical Terms Version 3 - CTV3) (Late 1990’s – 2018/20)Hierarchical relationship separate from coding; separate concept & term codes Compound expressions with more detailed semanticsOct 2010 release: 298,102 codes (55,829 inactive, 58,130 pharmaceutical products/devices
• READ and SNOMED CT (2001 – 2018/20)Technical, editorial, content merger of CTV3 and SNOMED RT (from the USA)Significant part of SNOMED CT derives directly from CTV3UK health system moving to SNOMED by April 2020
2
Copyright (c) ACC
Read CodesNZ History
• Used in NZ since mid 1990’s
• Primary care use to code medical conditions
• ACCCoding medical conditions in personal injury claims (and ICD10)ACC list contains 33,880 codes
• Ministry of Social Development (MSD)Medical certificates connected with sickness benefits and supported living paymentsMSD list contains 903 codes
3
Copyright (c) ACC
CLAIMS % of
TOTAL # of
READ % READ INJURIES
1,746,374 20.39% 3 0.03% Ankle sprain Open wound finger(s) or thumb Sacroiliac ligament sprain (Area: back)
2,183,239 25.49% 5 0.04% Contusion wrist or hand Abrasion, knee
4,319,075 50.42% 23 0.20%
6,429,143 75.05% 72 0.62%
6,853,879 80.01% 94 0.81%
7,711,307 90.02% 187 1.61%
8,137,774 95.00% 342 2.94%
8,479,886 99.00% 1,365 11.73%
8,565,965 100.00% 11,633 100.00%
YEAR # READ CLAIMS %
READ % CLAIMS 2010 6,961 1,679,892 59.8% 19.6%
2011 6,978 1,687,746 60.0% 19.7%
2012 6,083 1,688,597 52.3% 19.7%
2013 5,731 1,736,073 49.3% 20.3%
2014 5,881 1,773,657 50.6% 20.7%
TOTAL 11,633 8,565,965 100.0% 100.0%
Read CodesACC Actual Use
Year # READ Claims % READ1974-98 122,162 14,123,059 0.9%
1999 599,506 1,351,885 44.3%2000 1,332,444 1,377,275 96.7%2001 1,503,579 1,530,861 98.2%2002 1,554,518 1,579,118 98.4%2003 1,593,433 1,616,959 98.5%2004 1,618,498 1,642,590 98.5%2005 1,691,439 1,718,823 98.4%2006 1,733,668 1,776,027 97.6%2007 1,795,463 1,854,891 96.8%2008 1,800,273 1,863,314 96.6%2009 1,737,375 1,803,948 96.3%2010 1,679,925 1,765,138 95.2%2011 1,687,778 1,776,184 95.0%2012 1,688,662 1,813,510 93.1%2013 1,736,155 1,867,945 92.9%2014 1,774,616 1,912,047 92.8%2015 972,741 1,048,682 92.8%
TOTAL 26,622,235 42,422,256 92.8%
# Claims with Read codes
# Read codes used in claims
ACC list contains 33,880 codes
Only one exceptionto map READV2
to SNOMED
5
“I tend to fall back on the patient and the possibility of harm … at ACC the coding is for internal consumption and for billing,not as part of a clinical record, where care errors could cause things to run amok” “I do not allow codes from ACC forms to be copied to my classification list. If I did my classifications would be potentially overwhelmed by trivia. E.g. minor laceration finger. Long “problem lists” full of trivial injuries are not helpful across the system”
“with reference to SNOMED as a Clinical Terminology System (the preferred name – clinicians dislike ‘coding’) that …there is a ‘need to move’; i.e. it is an ‘if’ not a ‘when’.”
“acknowledge … that SNOMED is the future – it seems pretty obvious. … the challenge is that, for a national organisation that represents perhaps 15% of the health system, taking the lead on SNOMED would be ambitious”
Read CodesWhat are the problems?
“To enable the level of detail we need to make use of advanced analytical capabilities to model current state and automate decisions we need the level of detail possible with SNOMED: current levels of coding are not detailed enough to support this.”
Moving forward
Who benefits?• Everyone in the health sector• Particularly for the benefit of patients
Who needs to be involved?• Everyone in the health sector
Who needs to take the lead?• ACC (and MSD) dependent on READ• A sector led approach is best
When do we start?• We already have …
6
Copyright (c) ACC Author/Unit
7
Inform
Learn
Innovate
