Abstract
Purpose :
The International Statistical Classification of Disease and Related Health Problems, tenth revision (ICD-10) coding in electronic health record (EHR) systems is unable to accurately characterize certain uveitis subtypes. We describe our experience with coding errors in our EHR system and using Google Forms to create a Health Insurance Portability and Accountability Act (HIPPA) compliant database to better characterize rare and poorly coded diseases in uveitis.
Methods :
This is a pilot single-center retrospective, consecutive case series including patients diagnosed with uveitis to assess the frequency of inaccurate coding in our MDI (MDIntelleSys, Nextech Systems LLC) EHR using ICD-10 codes and the feasibility of using Google Forms to create an accurate HIPAA compliant database. MDI electronic medical records were reviewed to collect patient demographics and uveitis characteristics.
Results :
The MDI charts of 100 consecutive patients beginning on September 7, 2015 and followed through March 24, 2023 were reviewed. Demographic information and uveitis characteristics were manually extracted to accurately classify various uveitis subtypes under the correct diagnosis using the organizational framework provided by Google Forms. The majority (64.0%) were female, aged 47.9 ± 18.1 years. Most patients were white (62.0%) and non-Hispanic (89.0%). The most common anatomic location of inflammation was anterior uveitis (52.0%), followed by panuveitis (15.0%), posterior uveitis (14.0%), scleritis (11.0%), intermediate uveitis (8.0%), and primary retinal vasculitis (1.0%). Most of the uveitis diagnoses in this study were non-infectious (94.0%). A majority of the uveitides were considered undifferentiated (52.0%), followed by HLA B27-associated (8.0%), sarcoidosis (8.0%), and birdshot chorioretinopathy (6.0%). Of the 22 total different etiologic diagnoses identified with extraction using Google Forms, 8 did not have an associated diagnosis or ICD-10 code in MDI (18 patients) and 2 etiologies (acute retinal necrosis and birdshot chorioretinopathy) were coded under the same diagnosis and ICD-10 code (disseminated chorioretinal inflammation, H30.13, 6 patients).
Conclusions :
This pilot study successfully showed that Google Forms is a useful tool in the creation of an accurate HIPAA compliant database for uveitis, which may be inaccurately coded using our current EHR and international disease classifications.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.