Evaluation of the International Classification of Health Interventions (ICHI) in the coding of common surgical procedures

Abstract

Objective : To evaluate the International Classification of Health Interventions (ICHI) in the clinical and statistical use cases. Materials and Methods : We identified 300 most-performed surgical procedures as represented by their display names in an electronic health record. For comparison with existing coding systems, we coded the procedures in ICHI, SNOMED CT, International Classification of Diseases (ICD)-10-PCS, and CCI (Canadian Classification of Health Interventions), using postcoordination (modification of existing codes by adding other codes), when applicable. Failure analysis was done for cases where full representation was not achieved. The ICHI encoding was further evaluated for adequacy to support statistical reporting by the Organisation for Economic Co-operation and Development (OECD) and European Union (EU) categories of surgical procedures. Results : After deduplication, 229 distinct procedures remained. Without postcoordination, ICHI achieved full representation in 52.8%. A further 19.2% could be fully represented with postcoordination. SNOMED CT was the best performing overall, with 94.3% full representation without postcoordination, and 99.6% with postcoordination. Failure analysis showed that “method” and “target” constituted most of the missing information for ICHI encoding. For all OECD/EU surgical categories, ICHI coding was adequate to support statistical reporting. One OECD/EU category (“Hip replacement, secondary”) required postcoordination for correct assignment. Conclusion : In the clinical use case of capturing information in the electronic health record, ICHI was outperformed by the clinically oriented procedure coding systems (SNOMED CT and CCI), but was comparable to ICD-10-PCS. Postcoordination could be an effective and efficient means of improving coverage. ICHI is generally adequate for the collection of international statistics.

Designing a minimum data set for the information management system (registry) of spinal canal stenosis: An applied‐descriptive study

“…In the class on surgery and invasive interventions, it was proposed to use ICHI for the coding of interventions. Some studies have shown that ICHI, in comparison to other intervention classification systems, has a better performance in registering the patient's information in the electronic health record 48 …”

“…Some studies have shown that ICHI, in comparison to other intervention classification systems, has a better performance in registering the patient's information in the electronic health record. 48 For a complete registry of the surgical intervention data, in addition to the surgical/invasive procedures class, a separate class had also been considered for registering the complication surgical procedure. In the international registry of vertebral column Spine Tango, 11 the postoperative complications data elements had been propounded.…”

“…Some studies have shown that ICHI, in comparison to other intervention classification systems, has a better performance in registering the patient's information in the electronic health record. 48 …”

Methodological challenges in the evidence synthesis of health outcomes of digital health technologies

“…The World Health Organization (WHO) has chosen to incorporate all health treatments in a new categorization known as the International Classification of Health Interventions (ICHI) (Paviot et al, 2011;Aljunid et al, 2015). ICHI covers diagnostics, medicine, surgery, mental health, primary care, medical aids, functional support, rehabilitation, traditional medicine, and public health (Fung et al, 2021).…”

“…As suggested in the literature review, the World Health Organization family of international classifications (WHO) is an integrated set of classifications that serve as a global language for health information and consists of three reference classifications: the International Classification of Diseases (ICD), the International Classification of Functioning, Disability and Health (ICF), and the International Classification of Health Interventions (ICHI) (Fung et al, 2021). The use of ICD to classify illnesses has expanded dramatically in recent years (Harrison et al, 2021).…”