[ICD-11, ICHI and SNOMED CT-What do the standards mean for eHealth applications?]

BACKGROUND: Medical documentation is no longer used primarily for administrative processes or healthcare billing, but for the entire electronic health record with accompanying eHealth use cases.

OBJECTIVES: It shall be examined to what extent classifications such as the International Statistical Classification of Diseases and Related Health Problems (ICD-11) and the International Classification of Health Interventions (ICHI), in comparison to the international reference terminology SNOMED CT, meet the requirements of current eHealth applications and ensure interoperability.

MATERIALS AND METHODS: The strengths and weaknesses of ICD-11 and ICHI are highlighted in terms of literature, contextual mapping within the international patient summary, telemedicine applications and the use in IT standards, such as HL7 in comparison to SNOMED CT.

RESULTS: The whole range of medical terminology is not covered by ICHI and ICD-10, but with SNOMED CT, because ICD-11 and ICHI may be used in strict limitations to annotate procedures and diagnosis. A sample value set (n = 30) shows high mapping equivalence in SNOMED CT. In the literature, ICD-11 to SNOMED CT mappings are described as complex and error-prone.

CONCLUSIONS: In terms of content expressivity and international usability, the potential of SNOMED CT in eHealth applications can be considered more favorable than ICD-11 or ICHI, even considering the original scope of these classifications, diagnoses and procedures. ICHI may even be recommended for specific use cases (e. g. statistics).