Introduction:
World Health Organization (WHO) identified the novel coronavirus disease
2019 (COVID-19) as a pandemic in March 2020 1. The
pandemic has impacted the world economy negatively, as well as social
and personal health across the globe. A thorough analysis of the current
state of the pandemic and the appropriate associated solutions such as
allocation of resources to medical centres and launch of new field
hospitals requires an accurate evaluation of the number of confirmed and
suspected cases and their state of health. Moreover, a true assessment
of disease symptoms and the ongoing therapeutic interventions and
associated outcomes can facilitate future informed therapeutic
decisions.
Medical record codes are considered to be one of the most important
pieces of administrative data 2 . The
International
Statistical Classification of Diseases and Related Health Problems
(ICD) is a
medical
classification list of codified standard diagnoses introduced by the
WHO. This standard is updated regularly and has so far reached its
10th revision (ICD-10). Different countries have
developed their native variations of these standards, tailored to meet
their specific healthcare requirements. For instance, a variant of
ICD-10 named ICD-10-CM has been developed and adopted in the United
States 3.
These kinds of codes are useful for the processing of reimbursement
claims, clinical and epidemiological studies, quality of care and also
used for reporting disease surveillance and monitoring4. ICD-10 standards have preserved levels of coding
for new types of disease (U codes). For the case of COVID-19 pandemic,
there is a preserved ”U” character assigned for this disease.
Reports of surveillance and monitoring of the COVID-19 pandemic is
directly linked to the accuracy of clinical coding in accordance with
the WHO coding guidelines 5-7. However, due to the
unprecedented and unknown nature of this novel disease, future
modifications of the introduced codes might be needed, which, in turn,
may require changes of the codes used for medical records. Moreover,
changing diagnostic methods, e.g., computerized tomography (CT) reports
have created some problems for the accurate coding of medical records.
In particular, during the first month of the COVID-19 outbreak in many
countries, coding practices were inconsistent. Patients were discharged
before guidelines had been made available and different codes were also
released in succession 8,9.
The process of notifying and training coders is an important step in
maintaining the accuracy of data. Despite the heavy financial burden of
the current pandemic on healthcare systems, careful attention should be
paid to meet coding standards10. Documented guidelines
alone do not seem to be adequate to address the questions and problems
raised by coders.
More recently, social networks have attracted a lot of attention for
online consultations. There are systematic reviews that highlight the
value of social media for healthcare communication and interventions11-13. Some studies emphasise the effectiveness of
social media in different areas of healthcare consultation such as
plastic surgery 1, emergencies 14,
orthopaedics 15, and oral or maxillofacial surgery16. Also, over the course of COVID-19 pandemic,
governmental organizations have attempted to use internet-based
technologies and telehealth (defined as the use of telecommunication
technologies to support long-distance clinical health care and patient
data 17,18) to overcome problems arising from the
pandemic through online monitoring and follow-up of patients with
chronic disease and people with initial symptoms of COVID-1919-21. For example, in China, an online mental
counselling application has been implemented in an attempt to overcome
the psychological stress exerted by the COVID-19 situation22. Baptista Silva et al. mentioned that health
managers need to use remote consultations to improve services and
provide care from a human rights perspective 23.
Sabrir et al investigated the effects of WhatsApp video consultation on
patient admission and discharge times in comparison to bedside
consultation during the pandemic. Consultation via WhatsApp reduced
both contact time with patients with COVID-19 and the number of medical
staff contacting the patients, which contributes greatly to reducing the
risk of COVID-19 transmission 24.
Xu
et al. evaluate a telemedicine model that was developed to address the
challenges of treating patients with progressive COVID-19 based on a
popular social media smartphone app called WeChat. The telemedicine
system was useful for medical staff to identify disease progression and,
hence, make appropriate and timely treatment decisions25. Abbas et al. mentioned positive effects of
educating people through social media platforms to reduce the mental
health consequences of the COVID-19 26.
The ability of smartphones to transmit voice, text, images, videos and
other multimedia messages has made them an effective and popular
messaging tool. Today, smartphones are ubiquitous and almost everybody,
including health professionals, in different countries make use of them27.
In this study, we assessed the
efficiency of using
tele-consultations between clinical coders based on the social network
to solve COVID-19 clinical coding problems and reduce coding time.
Consultations were gathered over a 10-month period since the onset of
the pandemic in Iran. Also, we evaluated the expediency of code setting
and use by investigating the categories of consultations in coding
groups.