The University of Southampton
University of Southampton Institutional Repository

Usage of allergy codes in primary care electronic health records: a national evaluation in Scotland

Usage of allergy codes in primary care electronic health records: a national evaluation in Scotland
Usage of allergy codes in primary care electronic health records: a national evaluation in Scotland
Background: The UK's NHS intends to move from the current Read code system to the international, detailed Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT) to facilitate more clinically appropriate coding of conditions and associated risk factors and outcomes. Given concerns about coding behaviour of general practitioners, we sought to study the current coding patterns in allergies and identify lessons for the future migration to SNOMED-CT.

Methods: Data from 2 014 551 primary care consultations in over 100 000 patients with one or more of 11 potentially allergic diseases (anaphylaxis, angioedema, asthma, conjunctivitis, drug allergies, eczema, food allergy, rhinitis, urticaria, venom allergy and other probable allergic disorders) from the Scottish Primary Care Clinical Informatics Unit Research (PCCIU-R) database were descriptively analysed and visualized to understand Read code usage patterns.

Results: We identified 352 Read codes for these allergic diseases, but only 36 codes (10%) were used in 95% of consultations; 73 codes (21%) were never used. Half of all usage was for Quality and Outcomes Framework codes for asthma. Despite 149 detailed codes (42%) being available for allergic triggers, these were infrequently used.

Conclusions: This analysis of Read codes use suggests that introduction of the more detailed SNOMED-CT, in isolation, will not improve the quality of allergy coding in Scottish primary care. The introduction of SNOMED-CT should be accompanied by initiatives aimed at improving coding quality, such as the definition of terms/codes, the availability of terminology browsers, a recommended list of codes and mechanisms to incentivize detailed coding of the condition and the underlying allergic trigger.
0105-4538
1594-1602
Mukherjee, Mome
b4383a34-269e-4d5d-a2f1-073dd8dd9766
Wyatt, Jeremy
8361be5a-fca9-4acf-b3d2-7ce04126f468
Simpson, Colin R.
661322de-3227-484b-8145-a527a5fbb6fc
Sheikh, Aziz
48655796-f608-4bb4-b4d9-6f58f0a6b1cd
Mukherjee, Mome
b4383a34-269e-4d5d-a2f1-073dd8dd9766
Wyatt, Jeremy
8361be5a-fca9-4acf-b3d2-7ce04126f468
Simpson, Colin R.
661322de-3227-484b-8145-a527a5fbb6fc
Sheikh, Aziz
48655796-f608-4bb4-b4d9-6f58f0a6b1cd

Mukherjee, Mome, Wyatt, Jeremy, Simpson, Colin R. and Sheikh, Aziz (2016) Usage of allergy codes in primary care electronic health records: a national evaluation in Scotland. Allergy, 71 (11), 1594-1602. (doi:10.1111/all.12928). (PMID:27146325)

Record type: Article

Abstract

Background: The UK's NHS intends to move from the current Read code system to the international, detailed Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT) to facilitate more clinically appropriate coding of conditions and associated risk factors and outcomes. Given concerns about coding behaviour of general practitioners, we sought to study the current coding patterns in allergies and identify lessons for the future migration to SNOMED-CT.

Methods: Data from 2 014 551 primary care consultations in over 100 000 patients with one or more of 11 potentially allergic diseases (anaphylaxis, angioedema, asthma, conjunctivitis, drug allergies, eczema, food allergy, rhinitis, urticaria, venom allergy and other probable allergic disorders) from the Scottish Primary Care Clinical Informatics Unit Research (PCCIU-R) database were descriptively analysed and visualized to understand Read code usage patterns.

Results: We identified 352 Read codes for these allergic diseases, but only 36 codes (10%) were used in 95% of consultations; 73 codes (21%) were never used. Half of all usage was for Quality and Outcomes Framework codes for asthma. Despite 149 detailed codes (42%) being available for allergic triggers, these were infrequently used.

Conclusions: This analysis of Read codes use suggests that introduction of the more detailed SNOMED-CT, in isolation, will not improve the quality of allergy coding in Scottish primary care. The introduction of SNOMED-CT should be accompanied by initiatives aimed at improving coding quality, such as the definition of terms/codes, the availability of terminology browsers, a recommended list of codes and mechanisms to incentivize detailed coding of the condition and the underlying allergic trigger.

Text
Mukherjee_et_al-2016-Allergy.pdf - Accepted Manuscript
Download (343kB)

More information

Accepted/In Press date: 30 April 2016
e-pub ahead of print date: 3 June 2016
Published date: November 2016
Organisations: Faculty of Medicine, Wessex Institute

Identifiers

Local EPrints ID: 396597
URI: http://eprints.soton.ac.uk/id/eprint/396597
ISSN: 0105-4538
PURE UUID: 81905764-18ab-4998-a20d-1e1fae14a7dd
ORCID for Jeremy Wyatt: ORCID iD orcid.org/0000-0001-7008-1473

Catalogue record

Date deposited: 08 Jun 2016 12:38
Last modified: 07 Oct 2020 04:38

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×