Classification systems in health services

-Automatic translation

Until 1911, there was no organised registration of causes of death in Iceland, except for reports of accidental deaths. Those reports were in the hands of priests and were recorded at the same time as other population reports as of 1850. Regular registration of epidemics and deaths began in Iceland in 1888.

• Registration of causes of death, according to an international classification system, was introduced in Iceland in 1911, cf. law no. 30, 22 July 1911. Death certificates were then issued for all those who died in urban areas, but priest's reports were recorded for deaths in rural areas. That year, the Medical Director of Health issued guidelines for writing death certificates and reports for the first time. From 1911 to 1940, causes of death were published according to Íslensk aðalskrá, a 155-category Icelandic disease classification index.

• On January 1, 1941, the Icelandic Causes of Death Register was established. It is a translation of the International Classification of Diseases, 5th revision (ICD-5) from the World Health Organization (WHO), which was revised in Paris in 1938 (with 200 diagnoses).

• The sixth revision of the International Classification of Diseases, ICD-6, was translated and published by the Directorate of Health and was valid in Iceland from January 1, 1951 to December 31, 1970. Vilmundur Jónsson is registered for Icelandic translations of ICD-6. By law, no. 42/1950, which entered into force on January 1, 1951, a death certificate was required for everyone who died in Iceland. However, if a body was not found, a casualty report was to be issued. Until 1951, part of the recorded causes of death was obtained from priests' reports but coded anyway.

• The seventh revision of the International Classification of Diseases, ICD-7, was never implemented in Iceland except by the Cancer Society of Iceland for the registration of cancers.

• The 8th revision of ICD-8 was valid in Iceland from the beginning of 1971. Benedikt Tómasson and Júlíus Sigurjónsson are registered for translations of ICD-8.

• The 9th revision of ICD-9 was valid in Iceland from the beginning of 1982 but for registration of causes of death the year before. When ICD-9 came into effect, translation was limited to three-digit codes, and the index was not published in Latin as before. Benedikt Tómasson was responsible for the translation, while Hrafn Tulinius and Guðjón Magnússon reviewed it.

• The latest revision, ICD-10, came into effect in Iceland on January 1, 1997, but for registration of causes of death on January 1, 1996. The classification system was then partially translated into Icelandic for the first time. The editor of the Icelandic edition was Magnús Snædal, a linguist, but in addition, the doctors Örn Bjarnason and Jóhann Heiðar Jóhannsson took care of the translation.

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At the beginning of 1982, The International Classification of Procedures in Medicine (ICPM) was put into use in Iceland. It was valid in Iceland until January 1, 1997, when The Nordic Classification of Surgical Procedures, NCSP, took over. Örn Bjarnason, MD, translated the NCSP in consultation with experts in various disciplines. The NCSP has been available on the Directorate of Health's website since 2001.

The Directorate of Health has now published a national version, NCSP-IS, which is based on the English version of NCSP+, which is published annually, previously by the Nordic Center for Classifications in Health Care, but now by the Nordic Casemix Center. NCSP-IS came into effect in Iceland on April 6, 2004, but has mainly been used at Landspítali.

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In 1975, the Egilsstaðir research started at the primary health care in Egilsstaðir, a study of medical records for primary health care and the processing of information from them. The study aimed to test a new form of medical records for primary health care and the usefulness and feasibility of using a computer for recording, storing, and processing information. This work attracted international attention and was supported by NOMESCO, among others.

The director of the study was Dr Guðmundur Sigurðsson, and the results were described and published in Heilbrigðisskýrslur 1980, supplement no. 1: "The Egilsstaðir research. Medical records for primary health cares and computer registration" and in Heilbrigðisskýrslur 1983, supplement no. 1: "Registration of communication in primary health care". Construction of a new registration system for primary health care began in 1993 and was first used in 1997 (Saga).

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Since 1986, the Directorate of Health's working group on nursing registration has been improving nursing registration and promoting more focused data collection. In addition, the group translated the classification systems NANDA nursing diagnoses and NIC nursing treatments and published them, among other things, in the Handbook of Nursing Registration. This work was first directed by Vilborg Ingólfsdóttir, later by Anna Björg Aradóttir, and finally by Ásta Thoroddsen, who was the editor of the publication. The translation and implementation of the International Classification of Nursing Practice, or ICNP, is currently in progress.

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The Directorate of Health's recommendations do not cover all needs for coded classification systems. In the fall of 2011, Iceland joined an international organisation called the International Health Terminology Standards Development Organization or IHTSDO. This includes authorisation to use SNOMED-CT within Iceland in cases where it is suitable. The aim is that the coded vocabularies in the health service meet such systems' professional and technical requirements. However, recent versions of electronic registration systems still contain custom-coded classification systems from older systems.