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WHO agenda: Classifications, Terminologies, Standards |
RCP Conference on Digital Health & EMR, 15 July 2010, London, UK
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WHO Agenda: Classifications – Terminologies - Standards
WHO Agenda: Classifications – Terminologies - Standards
Nenad Kostanjsek World Health Organization
Digital Health and Electronic Medical Records: Digital Health and Electronic Medical Records: Aligning the EU and UK AgendasAligning the EU and UK Agendas
15th July 2010, RCP London, UK15th July 2010, RCP London, UK
WHO agenda: Classifications, Terminologies, Standards |
RCP Conference on Digital Health & EMR, 15 July 2010, London, UK
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Placing WHO Classifications in HIS & IT of the Placing WHO Classifications in HIS & IT of the 2121stst Century Century
e-Health RecordSystems
ICD ICD
ICFICF
ICHIICHI
Classifications
KRsMappings
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 ICPS
ICTMICTM
WHO agenda: Classifications, Terminologies, Standards |
RCP Conference on Digital Health & EMR, 15 July 2010, London, UK
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The desiderata for a WHO FIC in The desiderata for a WHO FIC in 21st Century21st CenturyThe desiderata for a WHO FIC in The desiderata for a WHO FIC in 21st Century21st 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
WHO agenda: Classifications, Terminologies, Standards |
RCP Conference on Digital Health & EMR, 15 July 2010, London, UK
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Key workstreams & elements for developing WHO FIC
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
WHO agenda: Classifications, Terminologies, Standards |
RCP Conference on Digital Health & EMR, 15 July 2010, London, UK
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ICD 11 is no longer just lists…it is based on a content model
ICD 11 is no longer just lists…it is based on a content model
WHO agenda: Classifications, Terminologies, Standards |
RCP Conference on Digital Health & EMR, 15 July 2010, London, UK
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THE CONTENT MODELAny Category in ICD is represented by:
THE CONTENT MODELAny Category in ICD is represented by:
Maintenance attributes
A. Unique identifier
B. Mapping relationshipsLinkages 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
WHO agenda: Classifications, Terminologies, Standards |
RCP Conference on Digital Health & EMR, 15 July 2010, London, UK
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ICD 11 Foundation Component and Linearizations
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
SpecialtyAdaptation
WHO agenda: Classifications, Terminologies, Standards |
RCP Conference on Digital Health & EMR, 15 July 2010, London, UK
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Web based collaborative authoring tool (iCAT)
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
WHO agenda: Classifications, Terminologies, Standards |
RCP Conference on Digital Health & EMR, 15 July 2010, London, UK
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Making WHO FICMaking WHO FIC ontology ontology based based Example: ICPS ontology development
Making WHO FICMaking WHO FIC ontology ontology based based Example: ICPS ontology development
Incident
Harm Action
Patient outcome Org. outcome
InjuryAdverse Reaction
Disease
Disability
Incident type
has consequence
is a
is a
Managing action Preven. action
is a
Contextual Factors
has circumstances
has impact
has type
Hazardhas cause
WHO agenda: Classifications, Terminologies, Standards |
RCP Conference on Digital Health & EMR, 15 July 2010, London, UK
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WHO classification development in the 20th Century Construction of ICD-10 & ICF:
WHO classification development in the 20th Century Construction of ICD-10 & ICF:
ICD: 8 Annual Revision Conferences (1982 - 89) ICF: 7 int. & 38 nat. Revision Conferences (1994 - 2001)
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
WHO agenda: Classifications, Terminologies, Standards |
RCP Conference on Digital Health & EMR, 15 July 2010, London, UK
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WHO classification development in the 21th Century WHO classification development in the 21th 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