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

 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 Contents

Status of ICD

 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 Maintenance

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

 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 Mortality statistics

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

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

DiagnosisNo. 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 ……………. … … … 100 Necrosis of bone Total (83371) 9.3 (8.7) 73.3 (100) Hospital morbidity statistics by the main condition of patients in an university hospital

Use of ICD for Hospital management Average LOS of patients with cataract Average LOS of patients with tonsillectomy

 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 Healthcare system

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

 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 Obstacles

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

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

 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) Actions to be taken in Korea

Thank you