Presentation is loading. Please wait.

Presentation is loading. Please wait.

WHO-FIC The WHO Family of International Classifications WHO-FIC WHO-FIC UN Expert Group on International Economic and Social Classifications New York,

Similar presentations


Presentation on theme: "WHO-FIC The WHO Family of International Classifications WHO-FIC WHO-FIC UN Expert Group on International Economic and Social Classifications New York,"— Presentation transcript:

1 WHO-FIC The WHO Family of International Classifications WHO-FIC WHO-FIC UN Expert Group on International Economic and Social Classifications New York, 8-10 December 2003 Bedirhan Üstün M.D. Andre L’hours Nenad Kostanjsek Classification, Assessment, Surveys & Terminology Group Classification, Assessment, Surveys & Terminology Group World Health Organization

2 WHO-FIC Need for a Family of Health Classifications lack of common languagelack of common language –Death, disease, disability,… health need for health information systemsneed for health information systems –monitoring MDGs, Life expectancy –electronic health records –identifying needs, uses, cost and outcome monitoringcost and outcome monitoring –health care costs, major projects e.g. 3*5 lack of common languagelack of common language –Death, disease, disability,… health need for health information systemsneed for health information systems –monitoring MDGs, Life expectancy –electronic health records –identifying needs, uses, cost and outcome monitoringcost and outcome monitoring –health care costs, major projects e.g. 3*5

3 WHO-FIC Interventions procedures procedures Reasons for encounter ICD-10 ICD-10 International Statistical Classification of Diseases & Related Health Problems ICF International Classification of Functioning, Disability and Health Vobaularies,Terminologies.Nomenclature Speciality adaptation s Primary care adaptations WHO Family of International Classifications Associated Products Main Classifications Adaptations

4 WHO-FIC 150 years of the ICD 1853 International Statistical Congress William Farr (UK) and Marc d’Espine (Fr) prepared “an international classification of causes of death” International Statistical Congress William Farr (UK) and Marc d’Espine (Fr) prepared “an international classification of causes of death” first ICD adopted – –by Intl Statistical Institute (ISI) 1893 first ICD adopted – –by Intl Statistical Institute (ISI)

5 WHO-FIC ICD-10 international standard diagnostic classification for all general epidemiological and many health management purposes. –Mortality –Morbidity international standard diagnostic classification for all general epidemiological and many health management purposes. –Mortality –Morbidity

6 WHO-FIC Purpose of the ICD systematic recording analysis interpretation comparison systematic recording analysis interpretation comparison mortality data morbidity data –within countries –between countries –at a certain point in time –over time

7 WHO-FIC Main uses of the ICD MORTALITY: –Underlying and multiple cause Hospital discharge diagnostic data Primary care encounters Health surveys Disease registers Health insurance reimbursement Resource allocation in health services MORTALITY: –Underlying and multiple cause Hospital discharge diagnostic data Primary care encounters Health surveys Disease registers Health insurance reimbursement Resource allocation in health services

8 WHO-FIC Specialty-based adaptations psychiatry neurology dentistry oncology paediatrics dermatology psychiatry neurology dentistry oncology paediatrics dermatology

9 WHO-FIC The ICD-10 Browser Version 2003 Volumes I – III Publication in 2004 as CD-ROM (PDF format) & web-based version Adobe Acrobat Reader –Bookmarks –Hyperlinks –Text Search Simple Search Advanced Search (Boolean operators, proximity etc.) Version 2003 Volumes I – III Publication in 2004 as CD-ROM (PDF format) & web-based version Adobe Acrobat Reader –Bookmarks –Hyperlinks –Text Search Simple Search Advanced Search (Boolean operators, proximity etc.)

10 WHO-FIC WHO Statistical Information System Links to Health Statistics –External sources for health related statistical information –Statistics by disease or condition –Links to national health- related websites Regional and member state information –Comparison of indicators –All indicators for a member state Links to Health Statistics –External sources for health related statistical information –Statistics by disease or condition –Links to national health- related websites Regional and member state information –Comparison of indicators –All indicators for a member state

11 WHO-FIC Periodic updating of ICD-10 Since 1996 a mechanism has been established for the periodic updating of ICD-10 minor updates each year major updates every three years Since 1996 a mechanism has been established for the periodic updating of ICD-10 minor updates each year major updates every three years

12 WHO-FIC ICD Revisions

13 WHO-FIC Policy for Revision Continuous life cycle –Knowledge Management strategic vision - purpose - users - policy recognition of need & perspective: how & when –Software release methodology Beyond Prejudgement: conservatism vs novelty –undermining the ICD-10, ICF ? –New = better ?; Old = better ? –Marketing strategy –Credibility management –backward compatibility –real response to need systematic evaluation –impact, process serious planning for revision –needs, resources, timeplan, customers, partners Continuous life cycle –Knowledge Management strategic vision - purpose - users - policy recognition of need & perspective: how & when –Software release methodology Beyond Prejudgement: conservatism vs novelty –undermining the ICD-10, ICF ? –New = better ?; Old = better ? –Marketing strategy –Credibility management –backward compatibility –real response to need systematic evaluation –impact, process serious planning for revision –needs, resources, timeplan, customers, partners

14 WHO-FIC What difference does it make? ICF in Health & Disability Statistics

15 WHO-FIC Universal Model vs. Minority Model Everyone may have disability ContinuumMulti-dimensional Certain impairment groups CategoricalUni-dimensional

16 WHO-FIC Foundations of ICF Human Functioning - not merely disability Universal Model - not a minority model Integrative Model - not merely medical or social Interactive Model - not linear progressive Parity - not etiological causality Context - inclusive - not person alone Cultural applicability - not western concepts Operational - not theory driven alone Life span coverage - not adult driven Human Functioning - not merely disability Universal Model - not a minority model Integrative Model - not merely medical or social Interactive Model - not linear progressive Parity - not etiological causality Context - inclusive - not person alone Cultural applicability - not western concepts Operational - not theory driven alone Life span coverage - not adult driven

17 WHO-FIC Use of ICF framework BarriersFacilitators IMPAIRMENT of Functions & Structure CAPACITY/ PERFORMANCE PROBLEM Body Functions &StructuresActivities&Participation Environmental Factors Medical treatment Rehab, back to work programme, education Destigma. campaign Support informal care

18 WHO-FIC b1100 – b7809 b11420 – b54509 b54509 s1100 – s7609 s11000 – s76009 s76009 d1550 – d9309 e1100 – e5959 3rd level and 4th level: 1424 sub-categories 2nd level: 362 categories b110-b899s110-s899d110-d899e110-e599 4 Components 1st level: 34 Chapters ICF Functioning and Disability Activitiesand Participation (d) Environmental Factors (e) PersonalFactors Not classified yet b1– b8 Contextual Factors Body Functions (b) and Body Structures (s) 2 Parts s1– s8 d1– d9 e1– e5

19 WHO-FIC Common ‘language’ endorsed by 191 WHO Member States in the 54 th WHA l Endorse and publish ICF l Use the ICF in Member States in: Ü research Ü surveillance Ü reporting l Joint use with ICD l Operational subsets: Ü surveys Ü clinical encounters l Periodic revision

20 WHO-FIC WHO ICF framework for defining health & disability l l places disability as an issue of a threshold on a continuum of health l l clearly recognises the impact of the environment on levels of functioning l l destigmatises ‘ill-health’ and ‘disability’ by accepting it as a universal human experience

21 WHO-FIC The ICF Browser ICF Browser Multilingual ( languages)Multilingual ( languages) classification in its tree structureclassification in its tree structure display two languages at the same timedisplay two languages at the same time advanced search functionadvanced search function cross references via hyperlinkscross references via hyperlinks selects and work on subsetsselects and work on subsets internet based upgrading facilitiesinternet based upgrading facilities ICF Coding Tool (in development) Case specific recordingCase specific recording ICF Qualifier scaleICF Qualifier scale Customized Assessment scaleCustomized Assessment scale Assessment Instrument CrosswalkAssessment Instrument Crosswalk ICD Code & socio-demo. Info.ICD Code & socio-demo. Info. ICF Browser Multilingual ( languages)Multilingual ( languages) classification in its tree structureclassification in its tree structure display two languages at the same timedisplay two languages at the same time advanced search functionadvanced search function cross references via hyperlinkscross references via hyperlinks selects and work on subsetsselects and work on subsets internet based upgrading facilitiesinternet based upgrading facilities ICF Coding Tool (in development) Case specific recordingCase specific recording ICF Qualifier scaleICF Qualifier scale Customized Assessment scaleCustomized Assessment scale Assessment Instrument CrosswalkAssessment Instrument Crosswalk ICD Code & socio-demo. Info.ICD Code & socio-demo. Info.

22 WHO-FIC The World Health Survey ICF domains used 1. Vision 2. Hearing 3. Digestion 4. Bodily Excretions/ Continence 5. Fertility 6. Skin and Disfiguration 7. Breathing Difficulty 8. Pain and Discomfort 9. Affect 10. Sleep 11. Energy and Vitality 12. Understanding and Interacting 13. Communication 14. Mobility and Physical Activity 15. Dexterity and Fine Motor Activity 16. Self Care 17. Interpersonal Relationships 18. Usual Activities and Roles 19. Social Functioning

23 WHO-FIC 1. Population level –Census questions on health and disability –Health and Disability Surveys –Indicator development & reporting in Health Info. Systems –Health and Social Policy Legislation (UN Disability Convention, Right for Health 2. Specific Applications –Clinical Encounters –Specific populations ElderlyElderly Administrative RecordsAdministrative Records 3. Other uses –Insurance –Education 1. Population level –Census questions on health and disability –Health and Disability Surveys –Indicator development & reporting in Health Info. Systems –Health and Social Policy Legislation (UN Disability Convention, Right for Health 2. Specific Applications –Clinical Encounters –Specific populations ElderlyElderly Administrative RecordsAdministrative Records 3. Other uses –Insurance –Education ICF Implementation

24 WHO-FIC Information Paradox

25 WHO-FIC Drivers for change WHO as a Standards Development Organization –recognizing WHO FIC as “Knowledge Assets” –effectively “owning & managing” them Client needs & Information technology needs –Electronic Patient Records - billing- outcome evaluation –Clinical Terminology & Vocabulary SNOMED Int, NLM, HL7 … Clinical Currency –HIV-AIDS, SARS, … –Diabetes, Hypertension, Coronary disease… definitions, risk factors –Oncogenes –Single Gene Disorders Alzheimer’s; Narcolepsia, Huntington’s, Rye Syndrome... New and expected developments: –Human Genome Project, treatments... Compatibility within the Family –ICD - XM, updates of AM, CM, CA, DM. –ICF –ICHI –ICECI WHO as a Standards Development Organization –recognizing WHO FIC as “Knowledge Assets” –effectively “owning & managing” them Client needs & Information technology needs –Electronic Patient Records - billing- outcome evaluation –Clinical Terminology & Vocabulary SNOMED Int, NLM, HL7 … Clinical Currency –HIV-AIDS, SARS, … –Diabetes, Hypertension, Coronary disease… definitions, risk factors –Oncogenes –Single Gene Disorders Alzheimer’s; Narcolepsia, Huntington’s, Rye Syndrome... New and expected developments: –Human Genome Project, treatments... Compatibility within the Family –ICD - XM, updates of AM, CM, CA, DM. –ICF –ICHI –ICECI

26 WHO-FIC Further information: Visit the ICF website Contact us via Contact WHO Collaborating Centers for the Family of International Classifications Visit the ICF website Contact us via Contact WHO Collaborating Centers for the Family of International Classifications


Download ppt "WHO-FIC The WHO Family of International Classifications WHO-FIC WHO-FIC UN Expert Group on International Economic and Social Classifications New York,"

Similar presentations


Ads by Google