The German refined diagnosis-related-groups (G-DRG) system was introduced on 1st January 2003, initially on a voluntary basis and on I st January 2004 the use of a G-DRG costing for stationary hospital treatment becam...
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The German refined diagnosis-related-groups (G-DRG) system was introduced on 1st January 2003, initially on a voluntary basis and on I st January 2004 the use of a G-DRG costing for stationary hospital treatment became obligatory. The possibility of a description of acute and chronic pain therapy in the G-DRG system was initially rudimentary and not logically planned and also a fair allotment of proceeds according to resources was not possible. By further development of the G-DRG system, pain therapeutic treatment could be improved in some areas, but in others it still remains unsatisfactory. This article offers a summary of the underlying systematics of the G-DRG system and consideration of chronic and current pain therapy in the GDRG system 2006. In addition to information on currently available possibilities of a pain therapeutical coding in conformation with the G-DRG system, the tasks which are still outstanding will be outlined.
For a project on development of an Electronic Health Record (EHR) for stroke patients, medical information was organised in care information models (templates). All (medical) concepts in these templates need a unique ...
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ISBN:
(纸本)9781586036478
For a project on development of an Electronic Health Record (EHR) for stroke patients, medical information was organised in care information models (templates). All (medical) concepts in these templates need a unique code to make electronic information exchange between different EHR systems possible. When no unique code could be found in an existing coding system, a code was made up. In the study presented in this article we describe our search for unique codes in SNOMED CT to replace the self made codes. This to enhance interoperability by using standardized codes. We wanted to know for how many of the (self made) codes we could find a SNOMED CT code. Next to that we were interested in a possible difference between templates with individual concepts and concepts being part of (scientific) scales. Results of this study were that we could find a SNOMED CT code for 58% of the concepts. When we look at the concepts with a self made code, 54,9% of these codes could be replaced with a SNOMED CT code. A difference could be detected between templates with individual concepts and templates that represent a scientific scale or measurement instrument. For 68% of the individual concepts a SNOMED CT could be found. However, for the scientific scales only 26% of the concepts could get a SNOMED CT code. Although the percentage of SNOMED CT codes found is lower than expected, we still think SNOMED CT could be a useful coding system for the concepts necessary for the continuity of care for stroke patients, and the inclusion in Electronic Health Records. Partly this is due to the fact that SNOMED CT has the option to request unique codes for new concepts, and is currently working on scale representation.
Objective: To develop a 'quality use of medicines' coding system for the assessment of pharmacists' medication reviews and to apply it to an appropriate cohort. Method: A 'quality use of medicines'...
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Objective: To develop a 'quality use of medicines' coding system for the assessment of pharmacists' medication reviews and to apply it to an appropriate cohort. Method: A 'quality use of medicines' coding system was developed based on findings in the literature. These codes were then applied to 216 (111 intervention, 105 control) veterans' medication profiles by an independent clinical pharmacist who was supported by a clinical pharmacologist with the aim to assess the appropriateness of pharmacy interventions. The profiles were provided for veterans participating in a randomised, controlled trial in private hospitals evaluating the effect of medication review and discharge counselling. The reliability of the coding was tested by two independent clinical pharmacists in a random sample of 23 veterans from the study population. Main outcome measure: Interrater reliability was assessed by applying Cohen's kappa score on aggregated codes. Results: The coding system based on the literature consisted of 19 codes. The results from the three clinical pharmacists suggested that the original coding system had two major problems: (a) a lack of discrimination for certain recommendations e. g. adverse drug reactions, toxicity and mortality may be seen as variations in degree of a single effect and (b) certain codes e. g. essential therapy were in low prevalence. The interrater reliability for an aggregation of all codes into positive, negative and clinically non-significant codes ranged from 0.49-0.58 (good to fair). The interrater reliability increased to 0.72-0.79 (excellent) when all negative codes were excluded. Analysis of the sample of 216 profiles showed that the most prevalent recommendations from the clinical pharmacists were a positive impact in reducing adverse responses (31.9%), an improvement in good clinical pharmacy practice (25.5%) and a positive impact in reducing drug toxicity (11.1%). Most medications were assigned the clinically non-significant code (96.6%).
There are many variables within crisis situations that contribute to the outcome of the event. This research focused on the communication process during crisis situations. Verbal communication is one of the key behavi...
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A new French coding system of clinical procedures, the Classification Commune Des Actes Medicaux (CCAM), has been developed at the turn of the millennium (between 1996 and 2001). Two methodologies were used: a traditi...
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A new French coding system of clinical procedures, the Classification Commune Des Actes Medicaux (CCAM), has been developed at the turn of the millennium (between 1996 and 2001). Two methodologies were used: a traditional domain-experts consensus method, and an artificial-intelligence-based semantic representation. An economic evaluation of clinical procedures was also undertaken for the rating for fee-for-service payment. We present the methodologies used and stress how the European Union research project, 'European Consortium, Generalised Architecture for Languages, Encyclopaedias and Nomenclatures in Medicine' (GALEN), facilitated the sharing and maintaining of consistent medical knowledge. This country case study highlights the significant cost to individual countries in developing their own classifications in isolation. It also demonstrates the benefits of contributing to international efforts such as GALEN that enable harmonisation, yet still allow for diversity.
The presentation assess the usability of the ontology platform protege integrated with the terminology reasoning tool PACER to represent different terminology, systems as the CEN European standard EN 1828 which is a c...
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ISBN:
(纸本)9781586035495
The presentation assess the usability of the ontology platform protege integrated with the terminology reasoning tool PACER to represent different terminology, systems as the CEN European standard EN 1828 which is a categorical structure and the extensive French coding system CCAM supported by a GALEN representation. We present the 2 systems and some results showing the easiness to test the consistence of the ontology or of instances of terminology systems. This type of software tool which is accessible as open source could support a convergent "reference terminology representation" approach. Based on a formal representation development and allowing diversity in linguistic expressiveness of end users this approach can associate shared knowledge acquisition in the public domain and competing systems, software developers and researchers.
A three-dimensional (3D) chip design strategy will be of increasing significance in association with miniaturization of VLSI circuits. In the design of 3D VLSI and 3D MCM, the placement which is to locate given 3D obj...
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ISBN:
(纸本)0780393635
A three-dimensional (3D) chip design strategy will be of increasing significance in association with miniaturization of VLSI circuits. In the design of 3D VLSI and 3D MCM, the placement which is to locate given 3D objects without overlapping each other in the 3D space, becomes an important issue. The 3D placement under the nonoverlapping constraint is called the 3D packing in which minimizing the volume of the package is required. This paper introduces a new coding system to encode the topology of 3D packing as an extension of BSG(Bounded-Sliceline Grid) for 2D packing. The novel coding system is referred to as three dimensional Bounded-Sliceplane Grid(3DBSG). The topology is a set of relative relations assigned to pairs of 3D modules in such a way that one module shall be either "right-of", "rear-of" or "above" the other. Furthermore, we propose an idea to handle L-shaped 3D modules on the 3DBSG. The simulation results in which a standard simulated annealing is utilized as an optimization algorithm, are demonstrated in order to test the validity of our 3D packing method based on the 3DBSG.
The Motivational Interviewing Skill Code (MISC) is a coding system developed to measure adherence to motivational interviewing (MI). MI is an effective clinical style used in different treatment situations. Counsellor...
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The Motivational Interviewing Skill Code (MISC) is a coding system developed to measure adherence to motivational interviewing (MI). MI is an effective clinical style used in different treatment situations. Counsellors practising MI have to follow general principles and avoid certain traps. In the present study, the content of the MISC is compared with the general principles of MI and the traps to avoid in MI. Investigation of the content validity raises some questions. All general principles are represented but the traps to avoid in MI are not fully covered. The consequences of this under-representation are shown in transcripts of a selection of well-conducted MI training sessions. The reliability of the MISC was investigated by having five independent coders code 39 MI training sessions of different counsellors. The reliability of the MISC is reasonable. The five coders agreed to a large extent on the absolute ratings but the intraclass correlations were low. Although the MISC can be a useful research tool for process research of MI, it remains a labour-intensive instrument and for teaching and practice audit development of a more simple coding system is recommended.
coding systems are important tools for the documentation of drug-related problems and following interventions. They should be suitable not only for scientific studies but for the broader implementation of Pharmaceutic...
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coding systems are important tools for the documentation of drug-related problems and following interventions. They should be suitable not only for scientific studies but for the broader implementation of Pharmaceutical Care in the pharmacy. A suitable coding system must be easy to use in daily routine. To facilitate later computer aided use, it should be preferably structured like a decision tree and consist of three parts: 1. the classification of drug-related problems 2. the intervention taken to solve to problem 3. the degree to which the problem was solved PI-Doc(R) considers other classification systems used by Hepler and Strand the PAS(R)-coding system and draws empirical experience from a study in 1995 and 1998 in Germany. The main groups comprise the following: - unsuitable drug choice - unsuitable use by the patient, incl. compliance - unsuitable dosage - drug-drug interactions - adverse drug reactions - other drug-related problems - patient-related - communication-related - technical and logistic problems The article discusses basic principles of the development of a coding system and the prerequisites for its application. In addition, it tries to give guidance for the classification process itself. It is also recommended to collect further information while documenting drug-related problems, in order to allow additional statistical evaluation.
This article describes some preliminary work done by the National Centre for Classification in Health (NCCH) in response to the recommendations of the General Practice coding Jury. Terms derived from two Australian ge...
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This article describes some preliminary work done by the National Centre for Classification in Health (NCCH) in response to the recommendations of the General Practice coding Jury. Terms derived from two Australian general practices, two coordinated care trials and the General Practice coding Jury were matched to the index of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM) to gauge the content coverage provided by the existing index. Results showed the percentage of good general practice (GP) term/ICD-10-AM Index term matches was 58%. The percentage of acceptable concept matches was 88%. It is concluded that this work provides a useful methodology, and that the ICD-10-AM index may support a level of concept matches, while it will require augmentation to support term matching.
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