636 MEP083 – The power of data. Developing simple and accurate clinical codes to support preventative measures for mental health concerns in elite sport

AbstractBackground An accurate diagnosis directs care and advises on prognosis whilst aggregated data can be used to develop services for primary and secondary prevention. Ascribing an accurate mental health diagnosis is sometimes challenging for the busy sports physician.Objectives Review mental health disorder coding in the electronic medical records system.Recommend improvements to coding accuracy whilst retaining simplicity.Design Phase 1: Monthly meetings between sports physicians and psychiatrists to review codes, related data and advise on incremental improvements. Phase 2: Consultation with data team to implement new coding system.Setting High-performance multi-sport in the UK (Olympic and Paralympic).Participants Collaborative project between sport and exercise medicine, psychiatry, operational leadership and technical experts in data management and user interface.Intervention Discussions identified the importance of retaining diagnostic codes covering the spectrum of mental disorders. Simplifications and additions were required. Outcome Some codes were dropped for simplicity and ease of use. New codes for complex conditions were added. Diagnoses were operationalised using standard diagnostic systems.Results Combine some disordered eating categories. Add categories for trauma disorders, emotionally unstable and other personality disorders, alcohol and substance use disorders, other addictive disorders.Each code accompanied by a short definition of the disorder (based on DSMV) to improve diagnostic accuracy and confidence. Diagnoses now colour coded. 13 Green codes entered directly by the sports physician (with option for advice from a mental health expert). 5 Amber codes prompt physician to consider and 2 red codes strongly suggest consulting a mental health clinician before entering diagnosis.Conclusions Experience of having mental health experts in the high-performance system has identified more complex disorders. Data on these are desirable to develop preventative measures (e.g., mental health awareness, literacy and other educational programmes). Secondary prevention also demands early, accurate diagnosis and allocation to an appropriate clinical pathway.