Strategy Plan of the Iris Institute for Iris with ICD-11

For the development and maintenance of Iris in light of preparing implementation of ICD-11 (International Classification of Diseases 11th Revision) the Iris Core Group compiled a strategy plan for the near, mid-term and long-term future. The strategy not only aligns to the main priorities that have driven the Iris development from the beginning but will consider current and foreseeable future requirements of health information management and enhanced use of mortality health data. The strategy is an evolving document which will be updated from time to time.

Additionally, the COVID-19 pandemic brings new demands for mortality statistics. It is a challenge to statisticians, health systems professionals, national governmental bodies, supranational organisations and policy makers worldwide. A timely and careful recording of mortality data will greatly benefit both real-time analysis to the pandemic and pre-planning to better equip health systems for the future. We have produced some early reflections on the lessons.

Transition Project on Iris from ICD-10 to ICD-11

Based on the “Evaluation Project” and “Strategy Plan”, the Iris Institute has set up a project plan that contains detailed steps and resources of the “Transition Project” for a new Iris version that will be capable to use ICD-11 codes.

BfArM, in framework of the Iris Institute, signed an agreement with the Data Science Campus of the Office for National Statistics (United Kingdom) in June 2021 to support the Iris Core Group in the transition of Iris from ICD-10 to ICD-11. The agreement has a term of 30 months.

Evaluation Project on Iris and ICD-11

In June 2018 WHO released a version of ICD-11 for starting programs for implementation. In mortality, the ICD coding is performed with the use of automated coding systems, mainly Iris. It is necessary to assess the needs for transitioning to ICD-11 before engaging in a full implementation project. This Evaluation Project will serve that need.

In order to revise Iris to work with ICD-11 codes and rules, it is necessary to change an integral part of Iris: the decision tables, which contain all codes and rules of the ICD. These tables will have to be completely adapted for the ICD-11 code structure and any changes in coding and selection rules.

According to the current beta draft of ICD-11, the ICD-11 rules for mortality coding will stay much the same as in ICD-10. This will hopefully enable the reuse of much of the current programming of Iris as well as the basic structure of the decision tables.

Major changes in medicine over the past two decades have greatly affected the content and structure of the ICD-11 codes. In addition, the ICD-11 structure will promote the use of multiple codes to represent a single disease description. This has the potential to impact the structure of decision tables as well.

In order to evaluate the impact of ICD-11 on Iris and the decision tables, the Iris Core Group agreed to initiate an Evaluation Project to assess the best way to adapt Iris for the use with ICD-11 and to estimate the resources needed to fully translate Iris to an ICD-11 based version. Within this project, possible enhancements to the Iris software due to the new IT-infrastructure of the ICD-11 will be addressed as well. Country specific needs in the realm of possible future implementation of ICD-11 and Iris are not subject of the project.

This Evaluation Project was financed by the Australian Bureau of Statistics (ABS), and in progress by the University of Udine (UNIUD) and the Italian National Institute of Statistics (Istat). Many thanks to our project partners who have enabled this project.

For more information concerning the project on Iris and ICD-11, please contact the Iris Institute.

E-mail: Iris Institute