Objective Long Problem Lists Can Be Challenging to Use. Reorganization of the Problem List by Organ System is a Strategy for Making Long Problem Lists More Manageable. Methods in a Small-Town Primary Care Setting, We Examined 4950 Unique Problem Lists over 5 Years (24 033 Total Problems and 2170 Unique Problems) from Our Electronic Health Record. All Problems Were Mapped to the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) and SNOMED CT Codes. We Developed Two Different Algorithms for Reorganizing the Problem List by Organ System based on Either the ICD-10-CM or the SNOMED CT Code. Results the Mean Problem List Length Was 4.9±4.6 Problems. the Two Reorganization Algorithms Allocated Problems to One of 15 Different Categories (12 Aligning with Organ Systems). 26.2% of Problems Were Assigned to a More General Category of  € Signs and Symptoms' that Did Not Correspond to a Single Organ System. the Two Algorithms Were Concordant in Allocation by Organ System for 90% of the Unique Problems. Since ICD-10-CM is a Monohierarchic Classification System, Problems Coded by ICD-10-CM Were Assigned to a Single Category. Since SNOMED CT is a Polyhierarchical Ontology, 19.4% of Problems Coded by SNOMED CT Were Assigned to Multiple Categories. Conclusion Reorganization of the Problem List by Organ System is Feasible using Algorithms based on Either ICD-10-CM or SNOMED CT Codes, and the Two Algorithms Are Highly Concordant.



Keywords and Phrases

electronic health records; ICD-10-CM; problem list; problem-oriented medical record; SNOMED CT; usability

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Article - Journal

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Publication Date

16 Dec 2019

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