In this series, we have been looking at health information exchanges, interfaces that allow medical information to follow a person between organisations and different clinical informatics systems. Along the way we have seen that the exchange of information is facilitated by using standardised frameworks for recording clinical information. This bifurcates into the classification of diseases on one hand (e.g the International Classification of Diseases) and a database driven clinical ontology on the other hand (e.g SNOMED-CT ®). We have seen that SNOMED began as SNOP in 1965 and then developed into SNOMED-RT before merging with the UK Read codes to form SNOMED-CT ®.
The development of SNOMED is a little complex but what about the World Health Organisation’s International Classification of Diseases (ICD)? Where did that begin? Well a brief and very helpful overview of the development of ICD can be found on the WHO website. Although there had been a number of classification systems developed in the 19th and 18th centuries, ICD began as a classification of deaths.
The International Statistical Institute established a committee to draw up a classification of the causes of death. Jacques Bertillon was the central figure in these efforts and was the chair of the committee drawing up the classification. Interestingly enough Bertillon’s brother Alphonse Bertillon worked in law enforcement in Paris and established the use of biometrics and the mugshot. Bertillon’s grandfather Achille Guillard was a statistician who had coined the term demographics and requested a resolution for a ‘uniform classification’ in the first Statistical Congress in 1853.
The Bertillon Classification of Causes of Death was in essence the first version of the International Classification of Disease but of course had a different meaning. ICD editions are referred to as revisions – they are revisions of this original classification of causes of deaths. Bertillon’s classification was presented and adopted at the meeting of the International Statistical Institute in 1893.
Appendix A – Other Posts in the Series on Health Information Exchanges
Appendix B – Definition of Health Information Exchange
This is the definition of the Health Information Exchange that I use (Hersh et al, 2015)
‘Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations‘
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