Covid-19 Impact on Standard Coding Systems Update

The outbreak of Covid-19 pandemic has sped up many healthcare processes and practices. Both stakeholders and standard organizations and authorities had to quickly implement new guidelines and codes to uniquely identify the disease and all the related healthcare data. The object of this work is to study the impact of the Covid-19 pandemic on clinical coding systems, in terms of updates and introduction of new specific codes for the identification of the SARS-CoV-2 virus, with the aim of allowing a better description of the disease and interoperability of the clinical data. The analysis is focused on ICD, SNOMED CT, LOINC, ATC as coding systems either included into the Italian EHR regulation or widely used internationally. Results show that coding systems that created a plenty of new codes for Covid-19 have: i) a flexible structure; ii) a speed process for updates; iii) a large user community for inputs. Others instead demonstrated in this circumstance that they are limited by hierarchical structures or excessively cumbersome updating processes, which conflict with the flexibility required to standards to represent the evolution of clinical knowledge. This is especially true in exceptional situation like the pandemic one.