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ICF Clinical Data Collection
Tool: What to Report
Stucki G, Gutenbrunner C, Giustini A,
on behalf of the international eff...
• WHO´s paradigm shift and the ICF
– A unique opportunity to strengthen
Rehabilitation and PRM
• ICF  the reference syste...
WHO’s Mandate
Normative, aspirational
“…health is a state of complete
physical, mental and social well-being
and not merel...
WHO’s Paradigm Shift
• Traditional focus
–compression of morbidity
• “absence of disease or infirmity”
• New focus
–optima...
With the new ICF-lens we can now study
how to describe, understand and influence
1. the lived experience of health and its...
Declaration of Alma-Ata
Expresses the need for urgent action
by all governments, all health and
development workers, and t...
Rethinking the Health Strategies
in light of ICF
Strategy Health Goal Indicator Classification
Preventive Disease preventi...
21th Century - the Rehabilitative Strategy
The goal  Optimal functioning
Health Strategies
 a historical perspective
2001
World Health
Assembly endorses
the International
Classification of
Functioning,
Disability and Health
(ICF)
2011
Worl...
PRM
The Medicine of Functioning
Functioning Properties
A first step to introduce ICD users
to functioning  as an essential
component of health
Functionin...
Rehabilitation has the aim of
supporting peoples’
independent living and their
autonomy and takes a holistic
approach to f...
Objective 2
To strengthen and extend rehabilitation,
habilitation, assistive technology,
assistance and support services, ...
WHO-ISPRM Collaboration Plan
for 2015-2017
World Health Organization (WHO) & International Society of Physical and Rehabil...
ICF the reference system
for describing, understanding and influencing functioning
15
Functioning Diagnosis
1. What to document, for Whom and When
– Clinical Assessment Schedule
2. How to assess
– ICF-based D...
Clinical Assessment Schedule
• Option 1 – “From the shelf”
– Select a Model Rehabilitation Service
• developed by the UEMS...
Clinical Assessment Schedule
• Option 2 – “Custom-made”
– Describe your Rehabilitation Service
• Characterize your Patient...
4 Steps for the Standardized Description of
Functioning based on the ICF
1. What ICF domains to document
• ICF Generic Set...
German Italian Spanish
ICF Core Sets
Chinese Japanese Korean
English
WHO
http://www.who.int/classifications/icf/en/
ICF Re...
“The ICF serves as practical lens through which we can observe the lived
experience of health in a way that is meaningful ...
ICF Rehabilitation Set
9 categories from Body Functions
b130 Energy and drive functions (G)
b134 Sleep functions
b152 Emot...
Simple, Intuitive Description
Selb M, Gimigliano F, Prodinger B, Stucki G, Pestelli G, Iocco M, Boldrini B. Toward an Inte...
Simple, intuitive descriptions can be used
together with a Numeric Rating Scale (NRS)
in routine clinical practice
Assessi...
ICF-based reporting of data
collected with various instruments
on a common metric
Mobility items
No problem Complete probl...
“Having functioning information available in a systematic
way will ensure that this information is available to all
stakeh...
System-wide Implementation of the ICF
Call to all National societies
to join the efforts of ISPRM and WHO
1. Section of Physical and Rehabilitation Medicine Union Européenne des Médecins Spécialistes (UEMS); European Board of
Ph...
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RIWC_PARA_A185 icf, rehabilitation, health system, health policy and outcome measurement

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RIWC_PARA_A185 icf, rehabilitation, health system, health policy and outcome measurement

  1. 1. ICF Clinical Data Collection Tool: What to Report Stucki G, Gutenbrunner C, Giustini A, on behalf of the international effort under an activity in the ISPRM-WHO’s Collaboration Plan, spearheaded by the Chinese Association of Rehabilitation Medicine (CARM), the Italian Society of Physical Medicine and Rehabilitation (SIMFER), and the UEMS-PRM Section, and coordinated by the ICF Research Branch at Swiss Paraplegic Research
  2. 2. • WHO´s paradigm shift and the ICF – A unique opportunity to strengthen Rehabilitation and PRM • ICF  the reference system for describing, understanding and influencing health – Thanks to tools that have been developed, the ICF is now ready for implementation • System-wide implementation of the ICF – A call for action to all national societies!
  3. 3. WHO’s Mandate Normative, aspirational “…health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity…” Preamble to the Constitution of the World Health Organization April 1948. The Definition has not been amended since 1948
  4. 4. WHO’s Paradigm Shift • Traditional focus –compression of morbidity • “absence of disease or infirmity” • New focus –optimal functioning • “complete physical, mental and social well-being”
  5. 5. With the new ICF-lens we can now study how to describe, understand and influence 1. the lived experience of health and its determinants 2. the social translation of biological health into lived health 3. The response by the society to functioning needs
  6. 6. Declaration of Alma-Ata Expresses the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world by year 2000. By ‘…address[ing] the main health problems in the community, providing promotive, preventive, curative and rehabilitative services accordingly…’ http://www.who.int/publications/almaata_declaration_en.pdf Rethinking the Health Strategies in light of the ICF
  7. 7. Rethinking the Health Strategies in light of ICF Strategy Health Goal Indicator Classification Preventive Disease prevention Morbidity ICD Promotive Opt. biological health ICF-Capacity ICF Curative Disease control Mortality ICD ICF Capacity ICF Rehabilitative Optimal functioning ICF Capacity & Performance ICF Supportive Optimal lived health ICF Performance ICF Palliative Well-being Quality of Life ? Stucki G. The Olle Höök Lectureship 2015: WHO’s Paradigm Shift and the Implementation of the ICF in Rehabilitation. J Rehab Med 2016; 48:486-493.
  8. 8. 21th Century - the Rehabilitative Strategy The goal  Optimal functioning Health Strategies  a historical perspective
  9. 9. 2001 World Health Assembly endorses the International Classification of Functioning, Disability and Health (ICF) 2011 World Report on Disability (WRD) 2013 International Perspectives on Spinal Cord Injury (IPSCI) 2014 Global Disability Action Plan 2014–2021: Better health for all people with disability (GDAP) 2015 Learning Health System for Spinal Cord Injury and International SCI Survey (INSCI) 2006, Convention on the Rights of Persons with Disabilities (CRPD) WHO Taking Action
  10. 10. PRM The Medicine of Functioning
  11. 11. Functioning Properties A first step to introduce ICD users to functioning  as an essential component of health Functioning Properties can inform the diagnosis and trigger a more comprehensive assessment of functioning  assessment __________ __________ __________ Physician‘s diagnosis PT assessment __________ __________ __________ Additional Tests
  12. 12. Rehabilitation has the aim of supporting peoples’ independent living and their autonomy and takes a holistic approach to facilitate this.” (White Book – UEMS-PRM) Section of Physical and Rehabilitation Medicine Union Européenne des Médecins Spécialistes (UEMS); European Board of Physical and Rehabilitation Medicine; Académie Européenne de Médecine de Réadaptation; European Society for Physical and Rehabilitation Medicine. White book on physical and rehabilitation medicine in Europe. Eura Medicophys. 2006; 42(4): 292-332.
  13. 13. Objective 2 To strengthen and extend rehabilitation, habilitation, assistive technology, assistance and support services, and community-based rehabilitation Objective 3 To strengthen collection of relevant and internationally comparable data on disability and support research on disability and related services2 World Health Organization. WHO Global Disability Action Plan 2014-2021: Better health for all people with disability. Sixty-seventh World Health Assembly 4 April 2014: World Health Organization; 2014 Available from: http://www.who.int/disabilities/actionplan/en/
  14. 14. WHO-ISPRM Collaboration Plan for 2015-2017 World Health Organization (WHO) & International Society of Physical and Rehabilitation Medicine (ISPRM). WHO- ISPM Collaboration Plan 2015-2017. Unpublished document. 2015.
  15. 15. ICF the reference system for describing, understanding and influencing functioning 15
  16. 16. Functioning Diagnosis 1. What to document, for Whom and When – Clinical Assessment Schedule 2. How to assess – ICF-based Data Collection Tools 3. How to report – Raw Data – Interval Scale Metric
  17. 17. Clinical Assessment Schedule • Option 1 – “From the shelf” – Select a Model Rehabilitation Service • developed by the UEMS PRM Section and Board • includes a Model Clinical Assessment Schedule
  18. 18. Clinical Assessment Schedule • Option 2 – “Custom-made” – Describe your Rehabilitation Service • Characterize your Patient Population(s) • Specify the Time Point(s) for assessment • Select relevant Brief ICF Core Sets – for each Time Point and Patient Population – recommend including the ICF Generic Set (7 Categories) – add ICF Categories from Comprehensive ICF Core Sets
  19. 19. 4 Steps for the Standardized Description of Functioning based on the ICF 1. What ICF domains to document • ICF Generic Set and ICF Rehabilitation Set • ICF Core Sets for specific health conditions 2. What perspective to choose? • Capacity or Performance 3. What data collection tools to apply • Current health status instruments • ICF-based data collection tools 4. What approach to use for reporting • Transformation into a common metric • Specific approach for a data collection tool
  20. 20. German Italian Spanish ICF Core Sets Chinese Japanese Korean English WHO http://www.who.int/classifications/icf/en/ ICF Research Branch http://www.icf-research-branch.org/ Endorsed by ISPRM 2009
  21. 21. “The ICF serves as practical lens through which we can observe the lived experience of health in a way that is meaningful and useful to practitioners who aim to optimize functioning of individual patients, policy-makers who aim to shape the health system in response to persons’ functioning needs, and researchers who aim to explain and influence functioning.” Minimum standard for collecting data on functioning Stucki G. Olle Höök lectureship 2015: The World Health Organization's paradigm shift and implementation of the ICF in rehabilitation. J Rehabil Med. 2016; 48: 486-493. Cieza A, Oberhauser C, Bickenbach J, Chatterji S, Stucki G. Towards a minimal generic set of domains of functioning and health. BMC Public Health. 2014;14(1):218.
  22. 22. ICF Rehabilitation Set 9 categories from Body Functions b130 Energy and drive functions (G) b134 Sleep functions b152 Emotional functions (G) b280 Sensation of pain (G) b455 Exercise tolerance functions b620 Urination functions b640 Sexual functions b710 Mobility of joint functions b730 Muscle power functions 21 categories from Activities & Participation d230 Carrying out daily routine (G) d240 Handling stress and other psychological demands d410 Changing basic body position d415 Maintaining a body position d420 Transferring oneself d450 Walking (G) d455 Moving around (G) d465 Moving around using equipment d470 Using transportation d510 Washing oneself d520 Caring for body parts d530 Toileting d540 Dressing d550 Eating d570 Looking after one's health d640 Doing housework d660 Assisting others d710 Basic interpersonal interactions d770 Intimate relationships d850 Remunerative employment (G) d920 Recreation and leisure Minimal Set of Environmental Factors Can be used to complement the ICF Generic and Rehabilitation Sets Prodinger B, Cieza A, Oberhauser C, Bickenbach J, TB Üstün, Chatterji S, Stucki G: Toward the ICF Rehabilitation Set: A minimal generic set of domains for rehabilitation as a health strategy. Archives of Physical Medicine and Rehabilitation 2016; 97(6): 875-884.
  23. 23. Simple, Intuitive Description Selb M, Gimigliano F, Prodinger B, Stucki G, Pestelli G, Iocco M, Boldrini B. Toward an International Classification of Functioning, Disability and Health clinical data collection tool: The Italian experience of developing simple, intuitive descriptions of the Rehabilitation Set categories. Manuscript submitted for publication. ICF Research Branch, Chinese Association of Rehabilitation Medicine, Nanjing Medical University, First Affiliated Hospital of Nanjing of Nanjing Medical University. Assessing functioning in routine clinical practice. Manual on applying the ICF Generic Set in practical assessments. Manual in development; 2016.
  24. 24. Simple, intuitive descriptions can be used together with a Numeric Rating Scale (NRS) in routine clinical practice Assessing Functioning in Routine Clinical Practice
  25. 25. ICF-based reporting of data collected with various instruments on a common metric Mobility items No problem Complete problem No problem Complete problem Self-Care items
  26. 26. “Having functioning information available in a systematic way will ensure that this information is available to all stakeholders in the health system, who can, in turn, use it to inform their decision-making at the clinical as well as management level, and ultimately contribute to optimizing the quality of care.” National Rehabilitation Quality Management (NRQM) Systems Prodinger B, Reinhardt J, Selb M, Stucki G, Yan T, Zhang X, Li J. Toward the system-wide implementation of the ICF in routine practice: Developing simple, intuitive descriptions of ICF categories in the ICF Generic and Rehabilitation Set. J Rehabil Med. 2016; 48(6): 508-514.
  27. 27. System-wide Implementation of the ICF Call to all National societies to join the efforts of ISPRM and WHO
  28. 28. 1. Section of Physical and Rehabilitation Medicine Union Européenne des Médecins Spécialistes (UEMS); European Board of Physical and Rehabilitation Medicine; Académie Européenne de Médecine de Réadaptation; European Society for Physical and Rehabilitation Medicine. White book on physical and rehabilitation medicine in Europe. Eura Medicophys. 2006; 42(4): 292-332. 2. World Health Organization. WHO Global Disability Action Plan 2014-2021: Better health for all people with disability. Sixty- seventh World Health Assembly 4 April 2014: World Health Organization; 2014; Available from: http://www.who.int/disabilities/actionplan/en/ 3. World Health Organization (WHO) & International Society of Physical and Rehabilitation Medicine (ISPRM). WHO-ISPM Collaboration Plan 2015-2017. Unpublished document. 2015. 4. Stucki G. Olle Höök lectureship 2015: The World Health Organization's paradigm shift and implementation of the ICF in rehabilitation. J Rehabil Med. 2016; 48: 486-493. 5. Cieza A, Oberhauser C, Bickenbach J, Chatterji S, Stucki G. Towards a minimal generic set of domains of functioning and health. BMC Public Health. 2014;14(1):218. 6. Prodinger B, Cieza A, Oberhauser C, Bickenbach J, TB Üstün, Chatterji S, Stucki G: Toward the ICF Rehabilitation Set: A minimal generic set of domains for rehabilitation as a health strategy. Archives of Physical Medicine and Rehabilitation 2016; 97(6): 875-884. 7. Prodinger B, Reinhardt J, Selb M, Stucki G, Yan T, Zhang X, Li J. Toward the system-wide implementation of the ICF in routine practice: Developing simple, intuitive descriptions of ICF categories in the ICF Generic and Rehabilitation Set. J Rehabil Med. 2016; 48(6): 508-514. 8. Selb M, Gimigliano F, Prodinger B, Stucki G, Pestelli G, Iocco M, Boldrini B. Toward an International Classification of Functioning, Disability and Health clinical data collection tool: The Italian experience of developing simple, intuitive descriptions of the Rehabilitation Set categories. Manuscript submitted for publication. 9. ICF Research Branch, Chinese Association of Rehabilitation Medicine, Nanjing Medical University, First Affiliated Hospital of Nanjing of Nanjing Medical University. Assessing functioning in routine clinical practice. Manual on applying the ICF Generic Set in practical assessments. Manual in development; 2016.

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