ICD-11 Morbidity Pilot in Kuwait: Methodology and Lessons Learned for Future Implementation.

Islam Ibrahim,Fatima Al-Asoomi,Nenad Kostanjsek,Suhair Azam,Naela Al-Mazeedi,Mustafa Al-Salamin,Robert Jakob,Mohammad Alrashidi

doi:10.3390/ijerph19053057

Abstract

This paper reports on the first ICD-11 morbidity pilot for inpatient discharges in a public general hospital. We detail the pilot methodology, lessons learned in terms of facilitators and challenges, physician-reported opinion, and considerations for future implementation. The pilot included: engaging stakeholders; selecting the setting; building a common understanding of the discharge process; evaluating and preparing IT infrastructure; ICD-11 training; small-scale pre-pilot testing; implementing the pilot while providing on-site support and collecting data for analysis including a brief user-experience survey. Overall, physicians were satisfied with the experience. Facilitators for success included national health system influence, leadership commitment, a multidisciplinary team approach, physician-tailored training, using social media for training, and providing on-site support. Challenges included potential IT problems, and difficulties relating to training and engaging physicians. Issues to consider include DRG system requirements, and comparability of ICD-11 pilot results from different countries. In conclusion, ICD-11 can be successfully implemented for documenting diagnoses by physicians in a public hospital by installing the coding tool on the electronic hospital information system. Pilots can improve ICD-11 content by using the online proposal mechanism. Implementing ICD-11 requires effective change management, stakeholder-tailored communication, and innovative ideas for training to match the electronic nature of ICD-11 and its potential new users, physicians.

Highlights

The International Statistical Classification of Diseases and Related Health Problems (ICD) standardizes the way we report diagnoses and health conditions, enabling us to count, analyze, and present health data, producing health statistics for decision making at national and international levels [1]
This study aims to share the lessons learned in terms of facilitators and challenges from piloting the real-life implementation of ICD-11 for morbidity in a public general hospital in Kuwait so that other health systems, especially those that are similar to the one in Kuwait, can benefit as they start their own ICD-11 journeys
Due to the short duration of the training, we focused on using the ICD-11 coding tool and its main features, namely using the word list to narrow down search results, adding details to a diagnosis using postcoordination, using abbreviations, and we showcased the fact that ICD-11 can automatically postcoordinate detailed diagnoses on its own

Summary

Introduction

The International Statistical Classification of Diseases and Related Health Problems (ICD) standardizes the way we report diagnoses and health conditions, enabling us to count, analyze, and present health data, producing health statistics for decision making at national and international levels [1]. Since the release of ICD-10 in the early 1990s, computers have become more affordable and the internet widely accessible, bringing digital innovation to the heart of every aspect of healthcare services [2]. This has dramatically changed the way health data is managed, creating new opportunities and requirements for different health systems. The growing reliance on casemix/Diagnosis Related Group (DRG) systems for reimbursement, benchmarking, and health service planning means we

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