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.  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

3. Status of ICD

4.  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-10 2008version Maintenance

5.  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

6.  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

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

8. 1980 1990 20002010 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

9. DiagnosisNo. of pt. LOS % 1 Liver & Bile duct cancer 6760 11.3 8.4 2 Chronic ischemic heart disease 3689 5.7 4.6 3 Stomach cancer 3337 9.3 4.1 4 Lung cancer 2035 4.5 2.5 5 Chronic renal failure 1885 9.3 2.3 6 Cholelithiasis 1820 9.7 2.3 7 Cataract 1590 2.1 2.0 8 Liver cirrhosis 1481 12.6 1.8 9 Leukemia 1096 21.0 1.4 10 Breast cancer 1063 12.3 1.3 ……………. … … … 100 Necrosis of bone 148 17.2 0.2 Total 59128 (83371) 9.3 (8.7) 73.3 (100) Hospital morbidity statistics by the main condition of patients in an university hospital

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

11.  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

12. 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

19.  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

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

21. 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

22.  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

23. Thank you