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Implementation of ICD-11 in Bangladesh: Current Status and Future Plans
Introduction
The International Classification of Diseases (ICD) is a globally recognized standard for morbidity and mortality coding, essential for healthcare management, epidemiological studies, and policy formulation. Bangladesh has taken significant steps towards transitioning from ICD-10 to ICD-11, aligning with global health data interoperability and standardization efforts. The country is currently piloting ICD-11 implementation in six hospitals, with a roadmap for nationwide adoption.
Current Implementation of ICD-11 in Bangladesh
As part of the pilot phase, Bangladesh has deployed ICD-11 in six hospitals, using two different approaches:
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OpenMRS-Based Hospitals (WHO ICD-11 API):
- Cumilla District Hospital
- Nilphamari District Hospital
- Barguna District Hospital
These hospitals use OpenMRS, an open-source electronic medical record (EMR) system, integrated with the WHO ICD-11 API for morbidity and mortality coding.
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DHIS2-Based Hospitals (ICD-11 Codes in Dropdowns):
- Cox’s Bazar District Hospital
- Khulna Medical College Hospital
- Rajshahi Medical College Hospital
These hospitals use DHIS2, where ICD-11 codes are manually incorporated into dropdown menus for structured coding.
The pilot phase aims to assess the feasibility, usability, and integration of ICD-11 within existing healthcare information systems before broader deployment.
Future Plans for ICD-11 Implementation
Recognizing the importance of standardized medical coding, Bangladesh has formulated a comprehensive plan to fully integrate ICD-11 into its healthcare infrastructure. The key future initiatives include:
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Central Terminology Registry Adoption:
- Bangladesh is integrating ICD-11 into its Central Terminology Registry to standardize signs, symptoms, diagnoses, and medication classifications.
- This will ensure consistency across all public hospitals using OpenMRS and other health information systems.
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Expansion of ICD-11 in OpenMRS Deployments:
- Currently, over 100 public hospitals in Bangladesh use OpenMRS.
- ICD-11 will be adopted as the standard morbidity and mortality coding system across all these hospitals.
- Instead of relying on the WHO ICD-11 API, a dockerized ICD-11 API will be deployed for local usage, ensuring stability and reliability.
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Integration of ICD-11 in DHIS2:
- In DHIS2, ICD-11 will be introduced for mortality coding, replacing the previous ICD-10-based approach.
- For morbidity coding, ICD-10 will continue to be used, but a mapping system will be developed to transition the data to ICD-11 over time.
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Development of an ICD-11 Implementation Guide for Bangladesh:
- A national implementation guide will be formulated to streamline the adoption process.
- This guide will provide detailed technical and operational guidance for healthcare facilities and IT professionals.
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Training and Capacity Building:
- Training materials will be developed and hosted on an e-learning platform to facilitate nationwide training of healthcare professionals.
- This will ensure that doctors, coders, and health information officers are well-equipped to use ICD-11 effectively.
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Deployment and Maintenance Guidelines for IT Professionals:
- A comprehensive guide will be published to assist IT professionals in the deployment, maintenance, and troubleshooting of ICD-11 API and its integration with health information systems.
- This will support sustainable and scalable ICD-11 implementation.
Conclusion
Bangladesh's initiative to implement ICD-11 represents a major step toward modernizing health information management and aligning with international standards. The pilot program in six hospitals has provided critical insights, paving the way for nationwide adoption. With a structured approach encompassing policy formulation, system integration, training, and technical support, Bangladesh is well-positioned to achieve full-scale ICD-11 implementation in the coming years. This transition will significantly enhance healthcare reporting, disease surveillance, and evidence-based policy-making in the country.