Browsing by Author "Khair, Shahreen"

Now showing 1 - 4 of 4
  • Thumbnail Image
    ItemOpen Access
    Decision algorithm for when to use the ICD-11 3-part model for healthcare harms
    (2022-06-07) Eastwood, Cathy A.; Khair, Shahreen; Southern, Danielle A.
    Abstract Accurate data collection of healthcare-related adverse events provides a foundation for quality and health system improvement. The International Classification of Diseases for Mortality and Morbidity Statistics, 11th revision (ICD-11 MMS) includes new codes to identify harm or injury and the events or actions leading to the adverse events. However, it is difficult to choose the correct codes without in-depth understanding of which event may be classified as an injury or harm. A 3-part model will be available in the ICD-11 MMS to cluster the codes for the harm or injury that occurred, the causal factors, and the mode (mechanism) involved. While field testing coding of adverse events, our team developed a decision tree (algorithm), which guides when to use the 3-part model. The decision tree now resides in the ICD-11 Reference Guide. This paper is part of a special ICD-11 paper series and outlines the steps used in the decision-tree (algorithm) and provides examples to help understand the process. While it may take coders some time to gain experience to use the 3-part model and decision-tree, the ICD-11 Reference Guide and this paper can be helpful resources to help clarify the process.
  • Thumbnail Image
    ItemOpen Access
    Field testing a new ICD coding system: methods and early experiences with ICD-11 Beta Version 2018
    (2022-11-08) Eastwood, Cathy A.; Southern, Danielle A.; Khair, Shahreen; Doktorchik, Chelsea; Cullen, Denise; Ghali, William A.; Quan, Hude
    Abstract Objective A beta version (2018) of International Classification of Diseases, 11th Revision for MMS (ICD-11), needed testing. Field-testing involves real-world application of the new codes to examine usability. We describe creating a dataset and characterizing the usability of ICD-11 code set by coders. We compare ICD-11 against ICD-10-CA (Canadian modification) and a reference standard dataset of diagnoses. Real-world usability encompasses code selection and time to code a complete inpatient chart using ICD-11 compared with ICD-10-CA. Methods and results A random sample of inpatient records previously coded using ICD-10-CA was selected from hospitals in Calgary, Alberta (N = 2896). Nurses examined these charts for conditions and healthcare-related harms. Clinical coders re-coded the same charts using ICD-11 codes. Inter-rater reliability (IRR) and coding time improved with ICD-11 coding experience (23.6 to 9.9 min average per chart). Code structure comparisons and challenges encountered are described. Overall, 86.3% of main condition codes matched. Coder comments regarding duplicate codes, missing codes, code finding issues enabled improvements to the ICD-11 Browser, Coding Tool, and Reference Guide. Training is essential for solid IRR with 17,000 diagnostic categories in the new ICD-11. As countries transition to ICD-11, our coding experiences and methods can inform users for implementation or field testing.
  • Thumbnail Image
    ItemOpen Access
    Supervised consumption site enables cost savings by avoiding emergency services: a cost analysis study
    (2022-03-28) Khair, Shahreen; Eastwood, Cathy A.; Lu, Mingshan; Jackson, Jennifer
    Abstract Background and aims We report on a cost analysis study, using population level data to determine the emergency service costs avoided from emergency overdose management at supervised consumption services (SCS). Design We completed a cost analysis from a payer’s perspective. In this setting, there is a single-payer model of service delivery. Setting In Calgary, Canada, ‘Safeworks Harm Reduction Program’ was established in late 2017 and offers 24/7 access to SCS. The facility is a nurse-led service, available for client drop-in. We conducted a cost analysis for the entire duration of the program from November 2017 to January 2020, a period of 2 years and 3 months. Methods We assessed costs using the following factors from government health databases: monthly operational costs of providing services for drug consumption, cost of providing ambulance pre-hospital care for clients with overdoses who could not be revived at the facility, cost of initial treatment in an emergency department, and benefit of costs averted from overdoses that were successfully managed at the SCS. Results The proportion of clients who have overdosed at the SCS has decreased steadily for the duration of the program. The number of overdoses that can be managed on site at the SCS has trended upward, currently 98%. Each overdose that is managed at the SCS produces approximately $1600 CAD in cost savings, with a savings of over $2.3 million for the lifetime of the program. Conclusion Overdose management at an SCS creates cost savings by offsetting costs required for managing overdoses using emergency department and pre-hospital ambulance services.
  • Thumbnail Image
    ItemOpen Access
    The Economics of Big Data in Healthcare: A Case Study of the ICD-9 to ICD-10 Transition
    (2018-10-23) Khair, Shahreen; Lu, Mingshan; Yuan, Lasheng; Quan, Hude
    This thesis attempts to provide a methodological and qualitative analysis of the trend in data usage in the healthcare industry and highlight the importance of economic evaluation in big data for healthcare. The paper explores the need for economic evaluation of the current data usage scenario in Canada via a case study on the ICD-9 to ICD-10 transition and illustrates the gaps in data availability. Detailed formulae for calculating the costs and benefits of the transition is provided, while a comprehensive guideline illustrates how the cost calculations would differ between the different provinces of Alberta, Manitoba, Saskatchewan and British Columbia. The paper also presents an overview of the upcoming ICD-11 transition and provides a framework for conducting an economic evaluation of the ICD-10 to ICD-11 transition. In conclusion, the thesis finds that although considerable progress has been made, significant improvements in data utilization is required to reap the full benefits of health data available and enable efficient economic evaluation.