2014.ISDS.Abstracts.Final.pdf


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ISDS 2014 Conference Abstracts

Preparing Disease Surveillance Systems for ICD10
Alimelu Jonnagadla*2, Wayne Loschen2, Julia Gunn1 and Jennifer Evans1

1Boston Public Health Commission, Boston, MA, USA; 2Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA

Objective
To help users seamlessly query and analyze data in disease 

surveillance systems using both ICD9 and ICD10 codes during the 
transition period. Additionally, the mappings between ICD9 and 
ICD10 codes must be flexible enough to support locally required 
changes based upon a user’s needs.

Introduction
The compliance date for the ICD9-ICD10 transition is October 1, 

2015. The hospitals have started the ICD9-ICD10 transition. However, 
not all data providers will transition the data at the same time. In 
order to facilitate some coherence to the data during this transition 
period, user interface and data processing functionalities have been 
developed in ESSENCE to allow usage of both classification systems 
simultaneously. This capability will allow users to perform ICD10-
based queries across all the hospitals in their system, irrespective 
of the exact number of hospitals that have completed the ICD10 
transition.

Methods
The Boston Public Health Commission utilizes an ESSENCE 

system to perform disease surveillance in their community. This 
project enhanced their existing ESSENCE system to support ICD10-
based queries. Using the Centers for Medicare & Medicaid Services 
(CMS) and the Centers for Disease Control and Prevention’s (CDC) 
General Equivalence Mappings (GEMs) as a starting point, processes 
were built to convert the ICD9 codes in both existing and incoming 
data to the equivalent ICD10 codes. This newly derived information 
is stored in a new field to allow the system to query against it, while 
keeping the original information for users to view as well. The user 
interface to perform queries in ESSENCE was updated to support 
ICD10-based filtering. Additionally, the interface provides an ICD10 
lookup mechanism using codes and keywords to help users learn or 
remember the ICD10 codes they may need for a query. Also, a user 
interface and a backend process were built to provide administrators 
the ability to modify the ICD9-ICD10 mappings as needed. This gives 
the administrators the mechanism to adjust the mappings based upon 
their needs or to respond to coding patterns of their specific hospitals. 
Finally, the system provides a mechanism to reprocess the entire 
historical dataset using the modified mappings when required.

Results
The above described ESSENCE functionality has been implemented 

and deployed to the Boston Public Health Commission system. The 
described features have enabled the public health professionals to 
query the data using ICD10 codes without any concern of which code 
classification the data source originally included. This new capability 
also provides users with the ability to perform yearly reporting even 
during a transition year. This has allowed a hospital that has 9 months 
of ICD-9-CM data and three months of ICD-10-CM/PCS data in same 
year to still be queried on and provide usable results.

Conclusions
Public health entities will face many challenges due to the transition 

of the ICD code set. Adding the ability to convert to ICD10 codes and 
provide a single query function to ESSENCE well in advance of the 

compliance date will ease the transition and allow users to still utilize 
the hospital’s data during the change. Providing the flexibility for 
a system to modify the mappings will allow for local behaviors in 
coding practices to be accounted for that otherwise may be lost by 
using a single mapping system.

Keywords
ICD10; Disease Surveillance; ESSENCE; ICD9-ICD10 transition

Acknowledgments

This work was funded by Boston Public Health Commission

*Alimelu Jonnagadla
E-mail: jonnaas1@jhuapl.edu    

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * (1):e85, 201