Managing Managed Care

Our inequitable, inefficient, oftentimes uncaring health care "system," revealed. -- Jeffrey G. Kaplan, M.D., M.S.

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Diagnostic Coding, the Key to What Ails Ya'

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Coding systems that support clinical decision-making and 'measurement and management,' the modus operandi of Managed Care.

Dr. Andrew Wiesenthal* recommends that we take a hard look at the ICD-10 coding system and consider moving towards Convergent Medical Terminology (CMT), which is mapped to the Systematized Nomenclature of Medicine–Clinical Terms (SNOMED CT©).  It is more transferable or sharable than the ICD alternative and it is an internationally-accepted standard vocabulary and classification system.  Most importantly, it supports clinical decision-making because it is hierarchical (rather than simply an ICD-like list).  Wiesenthal says it is "a lot closer to doctor- and nurse-speak," [For instance,] "If you want to identify a diabetic person with kidney disease, there is a unique naming in Snomed for diabetic neuropathy. It's in the diabetes and the kidney hierarchy."

* Dr. Wiesenthal directs the Deloitte Consulting firm's healthcare practice and previously, he had been the Assoc. Executive Director for Information Support, the Permanente Federation.

ICD-10 delay prompts talk of alternatives - IT Everything, the healthcare IT blog by Modern Healthcare's Joe Conn

For more information, see "Kaiser Permanente's Convergent Medical Terminology" [pdf] frp [failed access 4/3/13] 

If you are a Medscape participant [free to enroll if you have the proper credentials], the following are excellent reviews (CME/CE) on the subject of ICD-10:

ICD-10 and Clinical DocumentationICD-10: Getting From Here to There -- Navigating the Road AheadPreparing for ICD-10: Now Is the Time [Sept. 18, 2014]