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How well does ICD9 represent phrases used in the medical record problem list?
T H Payne1, G R Murphy, A A Salazar
1Group Health Cooperative of Puget Sound, Seattle, Washington.
Proceedings. Symposium on Computer Applications in Medical Care
|January 1, 1992
Summary
Physician satisfaction with International Classification of Diseases, Ninth Revision (ICD-9) for automated problem lists was low. Improvements are needed for better clinician user experience in clinical information systems.
Area of Science:
- Medical Informatics
- Health Information Systems
- Clinical Documentation
Background:
- Automated problem lists are crucial for clinical information systems.
- The International Classification of Diseases, Ninth Revision (ICD-9) is a potential basis for these lists.
- Physician satisfaction is key for the adoption and effectiveness of clinical tools.
Purpose of the Study:
- To assess physician satisfaction with ICD-9 representations of medical record problem list phrases.
- To identify areas for improvement in automated problem list generation.
Main Methods:
- Six physicians evaluated 332 phrases from medical record problem lists.
- ICD-9 codes were used to represent these phrases.
- A satisfaction scale (1-5) and intraclass correlation were employed.
Main Results:
- The mean physician satisfaction score was 3.0 out of 5.
- Physicians were dissatisfied with the ICD-9 representation in 45% of phrases.
- Intraclass correlation for phrase evaluation was 0.47.
Conclusions:
- Current ICD-9 representations yield suboptimal physician satisfaction for automated problem lists.
- Modifying ICD-9, using alternative vocabularies, or enhancing code assignment methods are potential solutions.
- Improving user satisfaction is essential for effective clinical information systems.