A case for the introduction of the ICD-11 in Germany

Since its adoption by the World Health Assembly in 2019, the 11^th Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11) has been set to replace ICD-10. The old revision is no longer maintained by World Health Organization (WHO). In Germany, a national advisory board (Kuratorium für Fragen der Kodiersysteme im Gesundheitswesen (KKG)) of the Ministry of Health is concerned with ICD-11 since 2013. Members of the KKG Working Group ICD-11 from the Association of the Scientific Medical Societies in Germany (AWMF) describe in this paper the need for a careful, well planned and timely transition from ICD-10 to ICD-11. The transition to ICD-11 ensures a valid representation of medical progress with the coded diagnoses and seizes opportunities of digitization for health care and science. Combining a unique documentation of medical facts with their multiple use for daily health care and research as well as for reimbursement and health policy should be the ultimate goal. This goal demands a one-time coding covering different coding systems in order to bridge a transitional period with parallel support of ICD-10 and ICD-11 on the one hand and to support further policy areas, e.g. with SNOMED CT, on the other hand. In particular, the use of generative artificial intelligence offers a high potential to achieve this goal. Even though estimating the time required is always subject to a high degree of uncertainty given the nature of the German health care system, the transition from ICD-10 to ICD-11 can be carried out in the next 5 years. Then, 13 years without content maintenance through the WHO, the ICD-10 would have lost the connection to the medical State of the Art at the latest.