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WHO agenda: Classifications, Terminologies, Standards | RCP Conference on Digital Health & EMR, 15 July 2010, London, UK 1 |1 | WHO Agenda: Classifications.

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Presentation on theme: "WHO agenda: Classifications, Terminologies, Standards | RCP Conference on Digital Health & EMR, 15 July 2010, London, UK 1 |1 | WHO Agenda: Classifications."— Presentation transcript:

1 WHO agenda: Classifications, Terminologies, Standards | RCP Conference on Digital Health & EMR, 15 July 2010, London, UK 1 |1 | WHO Agenda: Classifications – Terminologies - Standards Nenad Kostanjsek World Health Organization Digital Health and Electronic Medical Records: Aligning the EU and UK Agendas 15th July 2010, RCP London, UK

2 WHO agenda: Classifications, Terminologies, Standards | RCP Conference on Digital Health & EMR, 15 July 2010, London, UK 2 |2 | Placing WHO Classifications in HIS & IT of the 21 st Century e-Health Record Systems ICD ICF ICHI Classifications KRs Mappings Terminologies Population Health Births Deaths Diseases Disability Risk factors Clinical Decision Support Integration of care Outcome Administration Scheduling Resources Billing Reporting Cost Needs Outcome ICPS ICTM

3 WHO agenda: Classifications, Terminologies, Standards | RCP Conference on Digital Health & EMR, 15 July 2010, London, UK 3 |3 | The desiderata for a WHO FIC in 21st Century Evolve a multi-purpose and coherent WHO classification which are –consistent yet adaptable and interoperable across different uses (public health, service management, research) the spectrum of health care (Primary, Secondary, Tertiary) in developing and developed countries –compatible with other WHO classifications Serve as an international and multilingual reference standard for scientific comparability and communication purposes Ensure that WHO classification will function in an electronic health records environment. –Link WHO FIC logically to underpinning terminologies and ontologies (e.g. SNOMED, GO, …) –WHO FIC categories “defined” by "logical operational rules" on their associations and details

4 WHO agenda: Classifications, Terminologies, Standards | RCP Conference on Digital Health & EMR, 15 July 2010, London, UK 4 |4 | Key workstreams & elements for developing WHO FIC Use cases Content model (parameter & value set) Population & peer review of content model Web based collaborative authoring tool (iCAT) Ontology development

5 WHO agenda: Classifications, Terminologies, Standards | RCP Conference on Digital Health & EMR, 15 July 2010, London, UK 5 |5 | ICD 11 is no longer just lists…it is based on a content model

6 WHO agenda: Classifications, Terminologies, Standards | RCP Conference on Digital Health & EMR, 15 July 2010, London, UK 6 |6 | THE CONTENT MODEL Any Category in ICD is represented by: Maintenance attributes A.Unique identifier B.Mapping relationships Linkages to other systems like SNOMED etc. C.Other rules 1.ICD Concept Title: Name of disease, disorder, or syndrome 2.Classification Properties : Parents, Type, Use 3.Textual Definition(s) : Fully Specified Name 4.Terms : synonyms, Index, inclusion, exclusion 5.Clinical Description: Body System(s), Body Part(s), [Anatomical Site(s), Histopathology 6.Manifestation Properties: Signs & Symptoms, Findings 7.Causal Properties: etiology type, agents, mechanisms, genomic characteristics; risk factors 8.Temporal Properties: age of occurrence & occurrence Frequency, development course 9.Severity Properties 10.Functioning Properties 11.Specific Condition Properties 12.Treatment Properties 13.Diagnostic Criteria 14.External Causes

7 WHO agenda: Classifications, Terminologies, Standards | RCP Conference on Digital Health & EMR, 15 July 2010, London, UK 7 |7 | ICD 11 Foundation Component and Linearizations ICD-11 content model parameters - Definitions, synonyms - Clinical descriptions - Manifestation properties - Causal properties - Functional properties Value Set SNOMED-CT, International Classification of Functioning, Disability and Health (ICF), International Classification of External Causes of Injury (ICECI)… Linearizations Morbidity Primary Care Mortality Specialty Adaptation

8 WHO agenda: Classifications, Terminologies, Standards | RCP Conference on Digital Health & EMR, 15 July 2010, London, UK 8 |8 | Web based collaborative authoring tool (iCAT) display & browse taxonomy with its content model rubrics allow user to comment on the content allow users editing the content and facilitate the use of value sets derived from other classifications and terminologies allow user restructuring the classification Incorporates multiple level of user access supports multilingual representation ontology tooling interface with description logic technology

9 WHO agenda: Classifications, Terminologies, Standards | RCP Conference on Digital Health & EMR, 15 July 2010, London, UK 9 |9 | Making WHO FIC ontology based Making WHO FIC ontology based Example: ICPS ontology development Incident HarmAction Patient outcome Org. outcome Injury Adverse Reaction Disease Disability Incident type has consequence is a Managing actionPreven. action is a Contextual Factors has circumstances has impact has type Hazard has cause

10 WHO agenda: Classifications, Terminologies, Standards | RCP Conference on Digital Health & EMR, 15 July 2010, London, UK 10 | WHO classification development in the 20 th Century Construction of ICD-10 & ICF: ICD: 8 Annual Revision Conferences ( ) ICF: 7 int. & 38 nat. Revision Conferences ( ) ICD: 17 – 58 Countries participated –1- 5 person delegations –mainly Health Statisticians ICF: 61 Countries participated –1- 5 person delegations –Multi-disciplinary Manual curation –List exchange –Index was done later "Decibel" ? Method of discussion ICF: Concept driven Output: Paper Copy Work in English only ICD: Limited testing in the field ICF: drafts translated into / tested in 27 languages post-coordinated development of linkages to related classification, terminologies and assessment instruments

11 WHO agenda: Classifications, Terminologies, Standards | RCP Conference on Digital Health & EMR, 15 July 2010, London, UK 11 | WHO classification development in the 21 th Century Internet-based permanent platform –All year round –Open to all people in a structured way –Linkages to related classification, terminologies and assessment instruments –Content experts & users are empowered Digital curation –Wiki enabled collaboration –Ontology Enhanced discussion & peer review Electronic copy  print version Work in multiple languages field tests –based on Use Cases

12 WHO agenda: Classifications, Terminologies, Standards | RCP Conference on Digital Health & EMR, 15 July 2010, London, UK 12 | What is the answer?... what is the question? Computers are useless. They can only give you answers. Pablo Picasso ( )


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