Opportunities and challenges in the implementation of the 11th revision of the International Classification of Diseases in Bulgaria
General Medicine, 2025, 27(3), 28-36.
A. Neeva1, E. Grigorov2, P. Salchev1,3
1 National Center for Public Health and Analyses ‒ Sofia
2 Faculty of Pharmacy, Medical University – Varna (3)Bulgarian Academy of Sciences
Abstract. The implementation of the 11th revision of the International Classification of Diseases requires a comprehensive approach, involving the adaptation of regulatory frameworks, updates to health information systems, and the allocation of necessary resources for a smooth transition. One of the key steps in this process is the precise translation and adaptation of terminology to ensure clarity and alignment with Bulgarian medical practice. This will benefit not only physicians but also health economists, programmers, and administrators working with medical data. Another major challenge is the training of medical personnel. A structured training process and practical guidelines for using the new classification must be developed. This includes both foundational knowledge and specialized courses for different groups of professionals involved in the coding process. Ensuring continuous training will help minimize errors and facilitate the transition to the new system. Beyond training, there is a need to analyze and update all medical documents that use diagnostic codes ‒ including medical records, outpatient forms, death certificates, prescriptions, and other administrative forms. Adapting these documents will prevent inconsistencies and ensure the correct application of the new codes. Despite the challenges, the implementation of the latest classification presents an opportunity for more accurate medical statistics, more efficient healthcare resource management, and better integration of Bulgaria into the global health information system. Successful adoption of the new classification will require a well-coordinated process involving all stakeholders, with a clear strategy and a long-term vision for development.
Key words: ICD-11, implementation, health information, digitalization, health policies, adoption, update, training
Address for correspondence: Chief Expert Anita Neeva, MD, e-mail: