Adapting international classifiers

In order to structure information, manage and analyze data in the Electronic Health Record system, work is underway to adapt the international classifiers ICD-10 PCS, LOINC, and work is also planned on the acquisition and implementation of ICPC-2.

Classifiers are systematized lists of named objects, each of which is assigned a unique code. This is the standard code language of documents in automated systems, such as the EHR.

ICPC-2 (International Classification of Primary Care) is a method used to classify primary health care. It classifies patient’s reason for encounter and health problems, diagnoses, primary or general procedures and appointments, and orders data of the primary care session in an episode of care structure. It was developed by the WONCA International Classification Committee (WICC), and first published in 1987 by Oxford University Press (OUP). The revision with inclusion of criteria and definitions was published in 1998. The second revision was accepted within International Classifications of the World Health Organization (WHO).

ICPC-2 will be translated into Russian and Kazakh by the end of 2017. It will be then sent to an expertise consisting of practicing physicians, social workers and pediatricians. Coding methods for classifiers will be developed by primary care physicians after the classifier is adaptated into Kazakhstan’s healthcare system.  After appropriate training of the medical community the classifier will be implemented into the system of the Electronic Health Record.

Learn more about ICPC-2 on the World Health Organization’s official website.

ICD-10-PCS (International Classification of Disease Procedure Coding System) is a specific clinical modification of the original ICD-10. Each symbol forms a procedure classification axis that defines information about the procedure or the manipulation performed. The updated ICD-10-PCS code set has more codes than the ICD-9 version, which was the basis in creating Kazakhstan’s own classifier of medical procedures and manipulations. More detailed and structurally flexible ICD-10-PCS codes will help to assign clinical procedures and manipulations with higher precision and accuracy by medical personnel when using local or the national information systems. ICD-10-PCS was developed by the Centers for Medicare and Medicaid Services (CMS) in collaboration with 3M Health Information Management to track international morbidity and mortality statistics in a comparable way.

ICD-10-PCS is set as the international standard to be used for coding medical procedures and manipulations, as the standard for management of electronic processes of diagnostic and medical procedures and was approved by the Order of the Minister of Health and Social Development of the Republic of Kazakhstan from July 20, 2015 № 600.

This classifier has been translated into Kazakh and Russian languages. Today it is undergoing the process of mapping with the classifiers used in the Kazakhstan’s healthcare system, namely with the classifier of medical procedures and manipulations (based on ICD-9) and the Tarifficator of medical services. After the completion of mapping process and the expertise, the classifier will be uploaded into the EHR system for coding medical procedures and manipulations, which will allow for structuring larger quantities of data.

Official guidelines for coding using ICD-10-PCS can be found by following this link

LOINC (Logical Observation Identifiers Names and Codes) is a database and a universal standard for identifying medical and laboratory observations. After gaining access to LOINC codes health professionals will be able to use them to assign laboratory investigations in the Electronic Health Record system. Adaption of LOINC will ensure HER’s compliance with the universal standard in medical information. Each of the 80,000+ code identifier of LOINC database is unique for each laboratory investigation and corresponds to the name of observation or the result. Medical standards such as the IHE and HL7 use LOINC to transfer data electronically between different information systems. The HL7 Standard Developers Organization adopted LOINC as the preferred set of codes for laboratory test names for transactions between medical facilities, laboratories, laboratory equipment and health authorities.

To date, the LOINC database has been fully analyzed. The codes of the section for laboratory investigations of the Tarifficator of medical services are being mapped to LOINC codes (using the classifier of laboratory services). The e-health Standardization unit has also begun collaborating with the LOINC developer, the Regenstrief Institute, USA, to get consultative support from the institute. It is planned to conduct the final stages of mapping and validation of the mapped codes in cooperation with the experts of Regentrief and laboratory specialists from Kazakhstan. After the expertise the codes will be sent to the developers of the EHR system for the implementation in the Platform.