Is ICD-10 The Path To Big Data Success?

From injuries by turkey (or squirrel) to handwringing over the enormous increase in code number and complexity, much of the discussion around ICD-10 has centered on the problematic and the comical. This article from HIT Consultant though, takes the position that the new coding system may actually be an integral key to productive use of Big Data in the healthcare space.   

The article by William Rusnak, MD focuses on the potential that ICD-10 has in improving the provision of healthcare in the U.S.

How 10 Beats 9

Dr. Rusnak compares the data being filtered through ICD-9 to poor-quality recording musical recording equipment. He describes 9 as “inflexible, and far from comprehensive” — traits that he holds responsible for its garbage in, garbage out nature. The expansion in 10, he argues, only seems excessive on its face, and if you don’t consider the fact that the number of actions a provider or patient can perform or experience, is actually limited.

ICD-9 falls woefully short in meeting the needs of modern healthcare (no code for Ebola exists, for example), while ICD-10, with its 68,000 diagnosis codes and 72,000 procedural, is admittedly full of inane and comical examples. However, the doctor argues that this is what happens when comprehensiveness is the goal: “As an example, look at nutrition. From my experience, when asked, many people will tell you that they ‘eat a pretty normal diet.’ Now, make a decision with that data. Not very helpful, is it? Sure, a quick glance at the person can provide you with an answer like “it looks like it’s working,” but what advice can a physician or nutritionist possibly give without having the necessary details of the person’s diet? The same holds true for the rest of medical practice. Without measuring everything that we are doing in healthcare, improvement of our systems is going to be excessively difficult. A bird’s-eye view will be achieved when every medical organization in the country — eventually the world — is tracking events and outcomes with ICD-10. Only then will we have enough information to begin making the impactful changes needed to mend today’s broken system.”

Dr. Rusnak still acknowledges that the coding system was largely redesigned with better billing in mind, and that the cost of conversion can be prohibitively high.

Another Perspective

This article from InformationWeek takes a deeper look at the cost-benefit dynamic around ICD-10, and offers some interesting insight into the specific strengths of the system.

It specifically calls out ICD-9’s shortcomings, like not coding for laterality, and its significant lack of clinical specificity. This additional level of granularity is especially important to any entity interested in the secondary use of health data for public health, research, or any other analytics.