1. Standardization of Thailand healthcare codes Wansa Paoin MD.

2. Common agreement on 1. Health data definition or terminology 2. Classification and codes 3. Dataset and database 4. Data interchange protocol

3. 1. ACR-NEMA standard for Digital Imaging and Communications in Medicine (DICOM) 2. American Society for Testing and Materials (ASTM) Healthcare Informatics Standards 3. CEN CT251 Healthcare Informatics 4. CDISC Operational Data Model (ODM) 5. Electronic Common Technical Documents (eTCD) 6. Health Information Disclosure, Description and Evaluation Language (HIDDEL) 7. Health Level Seven (HL7) 8. Home Health Care Classification (HHCC) 9. IEEE Healthcare Standards 10. IFCC Online-English-Spanish Dictionary of Laboratory Terms 11. International Classification of Diseases (ICD-10) 12. ISO 5218 Information Interchange – Representation of Human Sexes 13. ISO TC215 : Health Informatics 14. International Union of Pure and Applied Chemistry (IUPAC) Recommendations 15. Medical Subject Headings (MeSH) 16. Multilingual glossary of popular technical and medical terms in nine European languages 17. Unified Medial Language System (UMLS) Medical Informatics Standards Source : Information Society Technologies, Information Society DG, European Commission

4. Problems with standards Few standards are worldwide accept ICD-10 DICOM HL-7 Most of standards are regional or country level created -> unable to use for health data set interchange

5. DIAGNOSIS CODING SYSTEM ICD-10 OR ICD-10 with Modification ICD-10-CMUSA2001 ICD-10-AMAustralia1998 ICD-10-CACanada2000 ICD-10-TMThailand2003 Additional/Optional System SNOMEDUSA READ CODESBritain

6. PROCEDURAL CODING SYSTEM OPCS-4BRITAIN1963 CPTUSA1966 ICPMWHO1978(Aborted 92) ICD-9-CMUSA1985 ICD-10-AMAUSTRALIA1998 HC-PCSUSA1998 CCICANADA2000 ICD-10-TMTHAILAND2003

7. RADIOLOGY CODE CPTUSA1966 ICPMWHO1978(Aborted 92) ICD-9-CMUSA1985 ICD-10-AMAUSTRALIA1998 ICD-10-PCSUSA1998 CCICANADA2000 ICD-10-TMTHAILAND2003

8. LABORATORY CODE CPTUSA1966 ICPMWHO1978(Aborted 92) ICD-9-CMUSA1985 ICD-10-PCSUSA1998 LOINCUSA1999 CCICANADA2000 ICD-10-TMTHAILAND2003

9. PMR CODE CPTUSA1966 ICPMWHO1978(Aborted 92) ICD-9-CMUSA1985 ICD-10-AMAUSTRALIA1998 ICD-10-PCSUSA1998 CCICANADA2000 ICD-10-TMTHAILAND2003

10. Dental Services Code CDTUSA1970 ICD-9-CMUSA1985 ICD-10-AMAUSTRALIA1998 ICD-10-PCSUSA1998 CCICANADA2000 ICD-10-TMTHAILAND2003

11. DRUGS CODE ASHPUSA1959 BNFBRITAIN1985 IOWAUSA? 1990 ATCWHO? 1990

12. Problem of different codes Unable to Share the data Communicate Combine data to analysis Do researches works Effectively

13. Standard code usage in Thailand, choices to be selected 1. Adoption With license fee – almost every codes Without license fee – ICD-10 2. Self development Researches Sharing

14. ICD-10-AM+AR DRG license fee Option 1 – Usage Fee(5 years contract) Annual payment 108,000 US$ Option 2 – Buy to modify One payment 364,000 US$ Free update for 4-5 years Source : Australian Department of Health and Aging

15. DEVELOPMENT METHODOLOGY LITERATURE REVIEW IDENTIFIED ACTIVE KEY PERSONS & DEVELOP WORKPLAN BRAIN STORMING ANALYSIS-1 SYNTHESIS-1 PUBLIC HEARING-1

16. DEVELOPMENT METHODOLOGY ANALYSIS-2 SYNTHESIS-2 PUBLIC HEARING-2 TESTING SYNTHESIS MAINTENANCE MECHANISMS CONCLUSION

17. CODING CENTERS IN THE WORLD Country Coding Centers AustraliaNCCH BritainNHS CanadaCIHI USANCHS ThailandTHCC

18. Thailand health coding center 1. Set common standard codes 2. Maintenance of standard codes 3. Training coders 4. User support 5. Research and development of new codes Establish March 1, 2006 in MOPH

19. Conclusion Standard health codes in the world rarely exist However each country must select which code to use in the country health information system and establish coding center to support standardization