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 Â € 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.
D. B. Hier and J. Pearson, "Two Algorithms for the Reorganisation of the Problem List by Organ System," BMJ Health and Care Informatics, vol. 26, no. 1, article no. e100024, BMJ Publishing Group; BCS, The Chartered Institute for IT, Dec 2019.
The definitive version is available at https://doi.org/10.1136/bmjhci-2019-100024
Keywords and Phrases
electronic health records; ICD-10-CM; problem list; problem-oriented medical record; SNOMED CT; usability
International Standard Serial Number (ISSN)
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16 Dec 2019