Sri Lanka stands at a pivotal moment to become South Asia's first nation to fully adopt an international disease classification system (ICD-11) nationwide and implement a unified electronic health record system that integrates both modern and traditional Ayurveda medicine by 2030, according to Dr W Ajith Raveendra De Mel, Chairman of the Insurance Regulatory Commission of Sri Lanka (IRCSL)
ICD-11 stands for International Classification of Diseases, 11th Revision, which provides a comprehensive and globally comparable framework for classifying diseases and causes of death, bringing uniformity and accuracy to the recording and reporting of health conditions.
Implications for insurance industry
In a statement, Dr De Mel said that for insurers, the adoption of ICD-11 and the digitisation of Electronic Health Records (EHR) bring significant advantages to insurers. Standardized medical coding enhances risk assessment accuracy, enabling the creation of tiered and pre-underwritten health products that improve accessibility and affordability across all income segments. Digitized records also allow real-time verification, minimizing fraudulent and duplicate claims, reducing administrative costs, and ensuring faster claim settlements that enhance policyholder satisfaction.
For policyholders, this integration allows insurers to verify diagnoses and process claims seamlessly, reducing delays and disputes. Most importantly, it empowers individuals to take control of their own health data fostering trust, transparency, and accountability in both healthcare and insurance.
For the country
For citizens as a whole, a digitally transformed health ecosystem built around ICD-11 and EHRs means faster, safer, and more accurate care. Each citizen could have a secure digital health ID that contains their ICDcoded medical history and insurance entitlements accessible anywhere, anytime. This enables doctors to make informed decisions, minimises diagnostic errors, and ensures continuity of care across institutions.
For the economy, AI-driven analysis of anonymized health data can propel medical innovation, clinical research, and preventive-care initiatives. Accurate data enables better forecasting of health trends, smarter public spending, and early detection of disease outbreaks. By cutting down on inefficiencies, Sri Lanka could save billions of rupees annually in wasted healthcare expenditure.
Policy and regulatory priorities
Dr De Mel said that to transform the health information system, Sri Lanka must:
• Mandate ICD-11 coding across all healthcare providers and implement nationwide training for doctors, coders, and data managers. • Develop standardized pricing and billing guidelines for hospital and professional services to reduce cost disparities and overcharging.
• Expand affordable, inclusive health insurance products supported by accurate data and risk-based pricing models.
• Promote public–private partnerships to accelerate digital-health infrastructure development and innovation.
• Strengthen regulatory oversight to ensure that private hospitals and insurers adhere to digital-health and data-protection standards.
Dr De Mel added, “A phased national rollout, starting with tertiary hospitals and expanding to all healthcare levels by 2030 will allow for structured adoption, capacity-building, and integration with insurers. Equally important is the establishment of a multi-stakeholder coordination mechanism, led by all relevant parties. This collective governance framework will ensure consistency, accountability, and measurable progress.”