A Framework To Promote Health Data Quality and Best Practices For Hospital Clinical Coding

Hospital administrative datasets play a critical role in healthcare planning, financing, epidemiological surveillance, and health services research. In Portugal, diagnoses and procedures recorded during hospital stays are coded using ICD-10-CM/PCS, which form the basis of the National Hospital Morbidity Database. Despite their importance, substantial challenges per-sist throughout the national clinical coding lifecycle, including documenta-tion issues, inconsistencies in coding practices, inter-hospital variability, a lack of standard guidelines, and limitations in auditing processes. PROJECTX is a national research and development project that aims to de-sign a framework to evaluate and promote the quality of coded hospital da-ta, as well as support best practices in clinical coding. This paper presents the project’s motivation, objectives, methodological approach, and planned activities. The framework will include tools for systematic data quality as-sessment, a national set of Key Performance Indicators (KPIs) for monitor-ing clinical coding processes, and a module to support the reuse of hospital data for epidemiological research. The project, to be developed between 2026 and 2028, will be implemented in Portuguese public hospitals and is expected to yield actionable recommendations and a functional web-based prototype for national use.