This document discusses plans for developing a mobile application called mICF to capture patient health data using the International Classification of Functioning, Disability and Health (ICF) framework. A survey found support from health professionals for an app allowing selection of ICF items and qualifiers to enter data. The app aims to facilitate continuity of care by allowing sharing of reports between providers. Developers will focus first on a minimum viable product, with plans for pilot testing and developing partnerships for ongoing collaboration.

1. FDRG
mICF Collaborative
13 October 2014
Barcelona, Spain
@MatiesIPE
#mICF

5. The ICF Spring
 Community-based, person-centred
healthcare strategies are central to realising
the vision to reach health equity in the 21st
century.1
 These strategies are designed to identify ill-health,
the determinants of health, and to
facilitate improvements in persons’ health
and their participation in all areas of life.2
 The relevance of the ICF has been
demonstrated in community-oriented primary
care (COPC) and community-based
rehabilitation (CBR), strategies fundamental
to health equity.1,2
1 Frenk J, Chen L, Bhutta Z et al. Health Professionals for a new century: transforming education
to strengthen health systems in an interdependent world. Lancet 2010;376:1923-1958.
2 Madden R, Dune T, Lukersmith S et al. The relevance of the International Classification of
Functioning, Disability and Health (ICF) in monitoring and evaluating Community-based
Rehabilitation (CBR). Disability and Rehabilitation 2013; Early online: 1-12.

6. ICF Spring
 2nd decade
 Integrate ICF into clinical practice:
interprofessional bio-psycho-social-spiritual
approach to person-centred management
 ICF as catalyst for clinical practice and health
systems reform from community care level up,
e.g.
 Community care level: 1 million community health
workers in Sub-Saharan Africa by 20151
 Increasingly mobile phone applications are being
used to collect health information to support
continuity of care.2
1 Singh P, Sachs, J. 1 million community health workers in Sub-Saharan Africa by 2015. Lancet 2013;
382:363-365.
2 Labrique A, Vasudevan K, Kochi E, et al. mHealth innovations as health system strengthening tools: 12
common applications as a visual framework. Global health: Science and Practice 2013;1(2):160-171.

7. mHealth applications: no ICF
 ICF not widely implemented e.g. not leveraging
mobile applications yet
 Inconsistent & inefficient capturing of
contextualized data
 Data management complexity: volume, variety,
velocity & veracity

8. FDRG: Beijing 2013 & London 2014
Aims of mICF
1. assist providers and users of health
services in the front line
to identify a person's problems in terms
of the ICF (functional status and
contextual information), and
2. To investigate the development of a
user-friendly mobile application to
amalgamate ICF-related data centrally.

9. It is envisaged that the mICF
will
 ensure accurate and efficient capture of
functional status and contextual information,
 convey information securely between service
providers in different service settings,
 facilitate clinical decision-making by making
person-centred data readily available,
 facilitate administration and reporting
through the aggregation of the data and
 minimise the need for repeat data collection.

10. The envisaged benefits of the
mICF would be to:
 Empower providers and users of health and
related services
 Enable continuity of care
 Capture the interactions between ICF
components to facilitate
 Understanding of the complexity of interactions
between health and contextual factors
 Person-centred decision-making and goal
setting
 Interprofessional and transprofessional
collaborative practice
 Amalgamate data to help strengthen systems.

11. Aim 1: Objective 1
1. Develop the specifications for the mICF
to enable programmers to develop the
application.
Activities
 Requirement survey 
 Partnership development 
 Workshops: Barcelona 
 Literature review 

12. mICF Survey results
Olaf Kraus de Camargo, Judy Zhuxi Gong

13. Translations in 11 Languages
 Template available from Stefanus
 ssnyman@sun.ac.za
 In the process:
 Hindi
 Spanish
 Catalan
 Danish
 Take the survey: http://tiny.cc/icfmobile

14. Responses (on 2014-10-13)
Languages Responses
Afrikaans (South Africa) 14
Dutch 10
English 1111
Finnish 186
French 84
German 60
Korean 21
Mandarin 2
Mongolian 0
Portuguese (Brazil) 11
Portuguese (Portugal) 1
Thai 0
TOTAL 1500

15. Respondents and Technology
 55% health service providers
 100% have access to a computer at work
 58% use a smart phone for work
 33% use a tablet for work
 39% use sms for work on a daily basis
 89% use email for work on a daily basis
 4% – 8% use mobile health applications

16. As a potential user of the ICF mobile application
(mICF), which option(s) would you prefer to enter
ICF-related data on your device?
34%
41%
80%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Type own words select items select items &
qualifiers
Data entry

17. What information would you like to obtain
through the mobile application after
having submitted the data?
74%
55%
84%
39% 36%
4%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
report
available
immediately
for end-user
report
available
immediately
for multiple
users
updatable,
show change
over time
provide
automatic
suggestions
(algorithm)
report on
aggregated
data
Other
Output

18. Free Text -philosophy
I am less enthusiastic about an app that is for clinicians and
clinical services. I think it will take too long for the services
to adopt it, and then it will mean all the info will be held by
the service (data protection blah bla blah).
I think an app like this would be a real opportunity to move
the power to the patients' hands - they hold the record and
they control who can access the info. They are the master
user owner of their information.
If a clinician requests a report the patient may then provide
it if they so wish. And because it is the ICF it gives the
patient the legitimacy that what they are doing is WHO
sanctioned - clinicians cannot just ignore the app and the
info in it.
So: 1) develop the app to patients 2) promote and train
clinicians in asking for the app info from patients (NOT the
old way: develop the app for clinicians, persuade patients to
complete info)

19. Collaborators – 199 from 36
countries
65
49
Responses
58
25
15
1
70
60
50
40
30
20
10
0
Research
protocol
Lit. Rev. Needs
assessment
Grant writing Admin Funding

20. Collaborators
18
Responses
10
14
20
15
10
5
0
Systems architecture Algorithm Development Coding (Android)

21. Collaborators
120
57
140
120
100
80
60
40
20
0
Responses
Usability testing Patient/client researcher

22. Software expertise
12
5
8
43
50
40
30
20
10
0
Responses
Android Data Synch Systems/Database Usability

23. Software expertise
Responses
13 12
21
25
20
15
10
5
0
ICF Applications mHealth Apps Health Informatics

24. Successful consensus-based partnerships
develop solid trust relationships:
31 from 17 countries met in Barcelona

25. Aim 1: Objective 2
2. Provide a means for providers and users of
health services to collect and transfer ICF-related
information to facilitate the
continuity of care
Activities
 Agile and iterative developing of mICF
application
 Develop and test Minimum Viable Product
(MVP)
to develop a first product/service with
the minimum effort and minimum cost
that is still really useful

26. Work groups and convenors
 Finalising specification for MVP
[Stefanus Snyman]
 Research facilitation team
[Olaf Kraus de Camargo]
 Literature review and ‘environmental scan’
[Trish Saleeby]
 Pilot testing team (Round 1)
[Brazil, Canada, Australia, South Africa]
 Technical team
[Stefanus Snyman & Olaf Kraus de Camargo]
 Facilitation Team [Stefanus Snyman]

27. Want to join our collaborative?
http://tiny.cc/micfpartners

28. First steps first: licencing and IP
Most probable scenario to develop
sustainable mICF:
 mICF partnership outsource development
to private company
 Private company develops application for
free and free licence to partners as well
as data for research
 For profit: big data analysis for industry /
governments
 Portion to mICF partnership: sustainability

31. Acknowledgement
This work is based on the research
supported by the National Research
Foundation of South Africa, Stellenbosch
University (South Africa), McMaster
University (Canada) and AQuAS (Catalonia).

32. DISCUSSION