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Why Can’t We Fix This Already? The Workgroup for External Cause Coding Improvement (WECCI)

Why Can’t We Fix This Already? The Workgroup for External Cause Coding Improvement (WECCI). Mel Kohn, MD MPH State Epidemiologist Public Health Division, Oregon Department of Human Services CSTE 2007 Annual Meeting Atlantic City, NJ, June 26, 2007. Background.

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Why Can’t We Fix This Already? The Workgroup for External Cause Coding Improvement (WECCI)

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  1. Why Can’t We Fix This Already? The Workgroup for External Cause Coding Improvement (WECCI) Mel Kohn, MD MPH State Epidemiologist Public Health Division, Oregon Department of Human Services CSTE 2007 Annual Meeting Atlantic City, NJ, June 26, 2007

  2. Background • Injury data used to design, implement and evaluate injury prevention activities • Need data on both fatal and non-fatal injuries • Statewide hospital discharge data and emergency room data important for injury surveillance • Variability in data collection processes • External cause of injury codes (E-codes) identify causes of injuries

  3. 1997 Report on E-coding • APHA’s Injury Control and Emergency Health Services Section surveys states about E-coding in statewide hospital discharge and emergency department data systems • Documented serious gaps and variability in E-coding

  4. Repeat of Study in 2004 • To assess the current status of E-coding in statewide morbidity data systems • Compare with 1997 results • Are we making progress in improving the data infrastructure for state-level injury surveillance?

  5. Hospital Discharge Data Systems Number of states

  6. Completeness of E-coding in Hospital Discharge Data Systems, 2004

  7. Little Progress Has Been Made • In 2004 Only 22 states knew the completeness of E-coding • Only 14 had >90% E-coded • Issues of non-specific codes • E.g., Fall NOS • No systematic evaluation of validity of E-codes

  8. WECCI is born… • Current organizations represented: CSTE, APHA, STIPDA, PHDSC, ASTHO • Goal: Spur improvements in external cause coding • Monthly conference calls

  9. Getting E-coding on the Radar • Revise policy statements • Collected existing statements • Submitted updated CSTE and APHA statements • Publications • MMWR on CSTE study • Journal editorial(s) • Possible summit?

  10. Tools • Training and feedback for reporters • Assessment of e-coding by states • Policy options to be explored • Tie to reimbursement • Mandates • Monitor and respond to legislative threats • Politics of ICD10-CM implementation

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