[Gnumed-devel] GNUmed support for coding systems

[Sebastian Hilbert]

Hi all,

This is to elicit input on a future feature of GNUmed - namely support of 
coding systems.

I would like to see support of of coding systems in GNUmed.

Here is my use case:
When treating atrial fibrillation (which makes a nice use case for documenting 
health issues, episodes, procedures, hospital stays) one needs to make sure 
the patient is on the right kind of anticoagulation.

One score to decide this ist the CHA²DS²-VASC-Score and the HASBLED-Score:

Both these scores are highly computable by looking at the patients diagnoses.

I would like GNUmed to automatically calculate the score by looking at

diagnoses:

congestive heart failure
hypertension
age
diabetes
stroke

CAD/PAVD
gender

By having e.g. ICD coding available this should be manageable. It could then 
check for the ATC code of aspirin, or vitamin k antagonists or the newer 
anticoagulant substances and make the user aware of a potential problem.

Furthermore upon detection of Aspirin it might check for gstric ulcer, reflux 
esophagitis and friends and recommend PPI treatment :-)

While at it it could look for renal insufficiency and recommend a dose 
reduction of e.g. dabigatran.

I am not talking about a decision support systems here which could do all 
kinds of nifty things.

ICD data is available in many formats at

http://www.dimdi.de/dynamic/de/klassi/downloadcenter/icd-10-
who/version2006/systematik/

and

http://www.dimdi.de/dynamic/de/klassi/downloadcenter/icd-10-
gm/version2010/systematik/ 

Is there anything I can do (research etc.) to get this into GNUmed ?

Sebastian