Why Map Congenital?

With EMR we are now able to analyze about anything the medical data present to us.

We are currently struggling, it seems, to get our systems operating such that we can perform according to the standards we are being evaluated, as part of the new Obamacare plan.

However, if we continue to move at the rate this “meaningful use” plan intends for us to show performance, we will never reach the point where we evaluate our systems and document their fullest extent of use.  By relying upon a few dozen elements to define our system, we are focusing only upon the grade we receive for our work, and not the meaningfulness it is mean to provide its most important beneficiaries–the patient population.

I have identified about a dozen to dozen or so “real uses” for EMR data.  These dozen or so “uses” include meaningful use as on of its components.  It also includes a number of evaluations that are obviously meaningful, which many of us performed in the past, but never see the light of in today’s desire to meet mostly the requirements.  It also includes some very unique but essential uses of the EMR data.

One of these socially important uses is the identification of local congenital, development and pregnancy-birth related problems that might strike a given area.  This is one of the more important uses for an EMR, with the help of applying spatial analysis techniques to the data and its processing steps.

The following is a listing of congenital diseases I like to run regularly, derived from ICD9 data (those interested in ICD10 will have to translate).  These are the conditions that are usually rare, or scarce, and which we pay heavily for due to the lack of much effort to monitor and attempt to better understand why these events are happening.  Until we know the cause for  these problems, we are left treating them, their patients, in a reactive manner instead of a preventive proactive manner.

The following list can be cut and past into a surveillance system using ICD9 data for the identification of diagnoses and diseases.

*******************************************************
CASE
WHEN ICD IN (‘271.0′,’271.1′,’271.2′,’271.3′,’271.4′,’271.8′,’271.9′,’272.0′,’272.1′,’272.2′,’272.3’,
‘272.4’,’272.5′,’272.6′,’272.7′,’272.8′,’272.9′,’273.0′,’273.1′,’273.2′,’273.3′,’273.4′,
‘273.8’,’273.9′,’274.0′,’274.1′,’274.2′,’274.3′,’274.10′,’274.11′,’274.19′,’274.81′,
‘274.82’,’274.89′,’274.9′,’275.0′,’275.1′,’275.2′,’275.3′,’275.9′,’275.1′,’275.2′,’275.3′,
‘275.40’,’275.41′,’275.42′,’275.49′) THEN ‘Endocrine’

WHEN ICD IN (‘277.0′,’277.1′,’277.2′,’277.3′,’277.9′,’277.1′,’277.2′,’277.30′,’277.31′,’277.39′,’277.4’,
‘277.5’,’277.6′,’277.7′,’277.81′,’277.82′,’277.83′,’277.84′,’277.85′,’277.86′,’277.87′,’277.88′,’277.89′) THEN ‘Metabolic’

WHEN ICD IN (‘279.4′,’279.9′,’279.10′,’279.11′,’279.12′,’279.13′,’279.19′,’279.2′,’279.3′,’279.41′,’279.49’) THEN ‘Immunological’

WHEN ICD IN (‘282.0′,’282.1′,’282.2′,’282.3′,’282.40′,’282.41′,’282.42′,’282.43′,’282.44′,’282.45′,’282.46′,’282.47′,’282.49’,
‘282.5’,’282.60′,’282.61′,’282.62′,’282.63′,’282.64′,’282.68′,’282.69′,’282.7′,’282.8′,’282.9′) THEN ‘Hematic’

WHEN ICD IN (‘286.0′,’286.1′,’286.2′,’286.3′,’286.4′,’286.52′,’286.53′,’286.59′,’286.6’) THEN ‘Hematic’

WHEN ICD IN (‘287.33′,’288.1′,’288.1′,’288.2’) THEN ‘Hematic’

WHEN ICD IN (‘330.0′,’330.1′,’330.2′,’330.3′,’330.8′,’330.9′,’331.0′,’331.11′,’331.19′,’331.2′,’331.3′,’331.4′,’331.5′,’331.6′,’331.7′,’331.81′,’331.82′,’331.83′,’331.89′,’331.9′,’332.0′,’332.1′,’333.0′,’333.1′,’333.2′,’333.3′,’333.4′,’333.5′,’333.6′,’333.71′,’333.72′,’333.79′,’333.81′,’333.82′,’333.83’) THEN ‘Neuro-developmental’

WHEN ICD IN (‘334.0′,’334.1′,’334.2′,’334.3′,’334.4′,’334.8′,’334.9′,’335.0′,’335.10′,’335.11′,’335.19′,’335.20′,’335.21′,’335.22′,’335.23′,’335.24′,’335.29′,’335.8′,’335.9′,’336.0′,’336.1’) THEN
‘Neurofunctional’

WHEN ICD IN (‘340.’,’341.0′,’341.1′,’341.8′,’341.9′,’342.0′,’342.1′,’342.2′,’342.10′,’342.11′,’342.12′,’342.80′,’342.81′,’342.82′,’342.90′,’342.91′,’342.92′,’343.0′,’343.1′,’343.2′,’343.3′,’343.4′,’343.8′,’343.9′) THEN ‘Neurological’

WHEN ICD IN (‘356.0′,’356.1′,’356.2′,’356.3′,’356.4′,’356.8′,’356.9’) THEN ‘Neurological’

WHEN ICD IN (‘359.0′,’359.1′,’359.21′,’359.22′,’359.23’) THEN ‘Neurological’

WHEN ICD IN (‘362.70′,’362.71′,’362.72′,’362.73′,’362.74′,’362.75′,’362.76′,’362.77’) THEN ‘Ocular’

WHEN ICD IN (‘371.50′,’371.51′,’371.52′,’371.53′,’371.54′,’371.55′,’371.56′,’371.57′,’371.58’) THEN ‘Ocular’

WHEN ICD IN (‘377.16′,’377.17’) THEN ‘Ocular’

WHEN ICD IN (‘378.0′,’378.1’) THEN ‘Ocular’

WHEN ICD IN (‘378.30′,’378.31′,’378.32′,’378.33′,’378.34′,’378.35′,’378.50’) THEN ‘Optic’

WHEN ICD IN (‘425.11′,’425.2’) THEN ‘Cardiac’

WHEN ICD IN (‘429.83’) THEN ‘Cardiac’

WHEN ICD IN (‘437.5’) THEN ‘Cardiac’

WHEN ICD IN (‘446.7’) THEN ‘Cardiac’

WHEN ICD IN (‘516.61′,’516.62′,’516.63’) THEN ‘Pulmonary’

WHEN ICD IN (‘520.0′,’520.1′,’520.2′,’520.3′,’520.4′,’520.5′,’520.6′,’520.7′,’520.8’) THEN ‘Dental’

WHEN ICD IN (‘524.0′,’524.1′,’524.2′,’524.3′,’524.4′,’524.5′,’524.6′,’524.7′,’524.9′,’524.10′,’524.11’,
‘524.12’,’524.19′,’524.20′,’524.21′,’524.22′,’524.23′,’524.24′,’524.25′,’524.26′,’524.27′,
‘524.28’,’524.29′,’524.30′,’524.31′,’524.32′,’524.33′,’524.34′,’524.35′,’524.36′,’524.37′,
‘524.39’,’524.4′,’524.50′,’524.51′,’524.52′,’524.53′,’524.54′,’524.55′,’524.56′,’524.57′,
‘524.59’,’524.60′,’524.61′,’524.62′,’524.63′,’524.64′,’524.69′,’524.70′,’524.71′,’524.72′,
‘524.73’,’524.74′,’524.75′,’524.76′,’524.79′,’524.81′,’524.82′,’524.89′) THEN ‘Dental’

ELSE ‘Non-Congenital’

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