The document discusses plans for a collaboration between the American Medical Association (AMA) and the World Health Organization (WHO) to develop an integrated international classification of health interventions (ICHI). The goals are to improve interoperability of clinical data globally and enable cross-border data analysis. Key points discussed include establishing an expert group jointly appointed by AMA and WHO, developing ICHI using existing AMA and WHO source materials, and providing financial support for the project over 5 years.
Medical Records: Intro, importance, characteristics & issuesSrishti Bhardwaj
Unit 1 of MHA SEM- III's syllabus of Medical records Management
(Bharati Vidyapeeth- Center for Health Management Studies & Research, Pune)
Self made- study purpose- reference presentation
avoid hyperlinks on certain slides- inactive
sources shared on last slide as REFERENCES
Hope it helps :)
Medical Records: Intro, importance, characteristics & issuesSrishti Bhardwaj
Unit 1 of MHA SEM- III's syllabus of Medical records Management
(Bharati Vidyapeeth- Center for Health Management Studies & Research, Pune)
Self made- study purpose- reference presentation
avoid hyperlinks on certain slides- inactive
sources shared on last slide as REFERENCES
Hope it helps :)
Public Health informatics, Consumer health informatics, mHealth & PHRs (Novem...Nawanan Theera-Ampornpunt
Presented at the M.S. and Ph.D. Programs in Data Science for Health Care, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on November 11, 2019
What is plan and how to make your plan successful? A successful work is a reflection of a disciplined, delicate and strictly maintained plan. These discipline is discussed in above discussion. I know it never can satisfy you, but it is the summery. And I hope it will help you.
State of the WHO Family of International Classifications -2015Bedirhan Ustun
This is the last speech of Dr. Bedirhan Ustun on the WHO FIC. It is not a swan-song but a transition/handover speech to the WHO Community on the continuation of ICD and ICF work
The presentation multiple code sets ( aka linearizations) that are used in ICD11 and its different use cases: Primary Care, Mortality statistics, Morbidity Statistics. Use for Primary Care should be simple short and user friendly. It should have incentives for the providers and compatible with ICD11 Joint Linearizations.
Public Health informatics, Consumer health informatics, mHealth & PHRs (Novem...Nawanan Theera-Ampornpunt
Presented at the M.S. and Ph.D. Programs in Data Science for Health Care, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on November 11, 2019
What is plan and how to make your plan successful? A successful work is a reflection of a disciplined, delicate and strictly maintained plan. These discipline is discussed in above discussion. I know it never can satisfy you, but it is the summery. And I hope it will help you.
State of the WHO Family of International Classifications -2015Bedirhan Ustun
This is the last speech of Dr. Bedirhan Ustun on the WHO FIC. It is not a swan-song but a transition/handover speech to the WHO Community on the continuation of ICD and ICF work
The presentation multiple code sets ( aka linearizations) that are used in ICD11 and its different use cases: Primary Care, Mortality statistics, Morbidity Statistics. Use for Primary Care should be simple short and user friendly. It should have incentives for the providers and compatible with ICD11 Joint Linearizations.
USTUN_ Digital Health Assembly Open Innovation Conference: Sharing Global Da...Bedirhan Ustun
An inquiry about the use of Big Data in Health Information Systems as a new way of gathering new data. Inquiring ethical questions on ownership and orientation; analytic approaches and political implications for the society and decision making.
ICD Revision: Current Status Internal Medicine workgroupBedirhan Ustun
ICD Revision has entered into the final phase. It will be submitted to the World Health Organization's governing bodies in 2018. What is the current situation? Peer Review - Field Test. Do we need additional detail for Internal Medicine?
How can ICD-11 possibly help you enhancing your casemix ?
What Can ICD11 offer systematically?
A systematic meaningful integrated system of clinical conditions - (not only for DRGs … )
Better clinical description
Better severity grading
Better coding of co-morbidity
Inherent functional information (key ICF classes)
Integrated information system between ICD, ICF, ICHI
Deconstructing Diagnosis into subgroups
Computerized information processing
Making health data work for Patients and PopulationsBedirhan Ustun
This presentation contains the slide deck that Professor Iain Buchan - of Manchester University delivered in Koc University about what can be achieved if clinical health information were captured in a digital format.
ICF provides domains of functioning as body functions, personal activities and societal participation to classifiy what a person can do in a certain environment. It provides a common language for communication and meaningful exchange of data.
DSM5 has changed the requirements for describing the clinical significance of a DSM category. Now there it is required that "impairment" criteria is specified in accordance with the ICF ( International Classification of Functioning Disability and Health ) and operationally measured with the WHODAS 2.0;
World Health Organization on Health InformationBedirhan Ustun
THis presentation gives the background of WHO's work on health information including the compilation of data from different sources using ICD; as well as revision of ICD with modern ontological methods.
Çatışma ve Travma ne zaman yararlıdır ?: Psikiyatride travma sonrası ne yapab...Bedirhan Ustun
Bu sunu travma ile başa çıkma ve bu süreçle ilgili savunma mekanizmaları, adaptasyon ve büyüme kavramlarını ele almaktadır
'Fort-da' oyunu ele alınıp ayrılık kaygısı (separation anxiety) ndan kurtulma mekanizması üzerinden gidilerek, yitirilen nesnenin yerine bir başka nesne koyabilme ve bunun zihinsel representasyonu ve söze dökülmesi örnek alınarak bunun yaşam boyunca başka travmalarda kullanımı ve dayanıklılık (resilience) geliştirilmesine ilişkin etmenler tartışılmaktadır.
Description of Mind-Body dichotomy; error of Descartes, new paradigms of Mental Illness; RDOC; mind-body interaction; human evolution; evolutionary basis of human illness
intertnational council for harmonization The International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) is a project that brings together the regulatory authorities of Europe, Japan and the United States and experts from the pharmaceutical industry in the three regions to discuss scientific and technical aspects Details of the ICH guidelines for pharmaceutical quality from Q1 to Q12 including stability analysis, evaluation of impurities and quality risk management. ICH (Full form = International Conference on Harmonisation) is a committee that provides the pharmaceutical guidelines for industries.
Utility and Added Value of Classifications in Health Information SystemsBedirhan Ustun
Health Information Systems; ICD, ICD11, SNOMED-CT, Use Cases showing benefits of use of classification- terminology systems; avoid and e-tower of Babel; electronic health record, Enhance Patient Care, Decision Support, Safety & Quality
Better Health? Composite Evidence from Four Literature ReviewsHFG Project
The Marshaling the Evidence secretariat agreed that a cross-cutting synthesis paper was necessary to frame the work in the wider context of governance in health systems, drawing distinctions and consensus across all four TWG papers. Members of the secretariat, some of whom also were members of the TWGs, conducted the analysis across each TWG report and wrote the synthesis report. The report compiles results from the TWGs into a searchable database, contained in Annex 1. The report also lays the foundation for future action—from dissemination to further research agendas and policy plans.
Health technology assessment (HTA) is familiar as technique for gauging the value of specific medical technologies or approaches to care. As Adrian Towse points out, however, HTA has a much broader, ‘macro’ role in contributing to the efficiency of health care systems and supporting universal health coverage. This is particularly crucial in the face of increasing demands and limited budgets.
Explains about how to Enhance knowledge transfer among all of stakeholders including healthcare providers. For more information visit: http://www.transformhealth-it.org/
IX Reunion Relacsis 2019 ARG - Marcelo Dagostino - Information Systems for He...RELACSIS-OPS Red
IX Reunion Relacsis 2019 Argentina
Information Systems for Health (IS4H)
Marcelo Dagostino | OPS/EIH-IS
www.paho.org/relacsis
Comunidad académica y de práctica dedicada al Fortalecimiento de los Sistemas de Información de Salud (SIS)
#SaludParaTodos
Arastirmaci tarafindan Baslatilan Arastirmalarda larda ortak veri standartlar...Bedirhan Ustun
Araştırmacı tarafından Başlatılan Araştırma (ABA)lar bilimsel bir sistematik içerisinde bir tanı grubundaki deneklere yapılan girişimlerin etkinliklerini değerlendirmek için kullanılabilir: ‘Bu tedavi yöntemi başka yöntemlere göre daha mı iyi’, ‘yan etkileri var mı’ gibi soruları yanıtlamak; ve araştırmalar arasında karşılaştırma yapmak amacıyla yapılabilir. Bu bağlamda, ABAlarda tanı ve girişim etkinliğini ölçmek ve değerlendirmek için bilimsel standartların kullanılması zorunludur. Araştırmacılar genellikle kendi alanlarında daha önce belirlenmiş (1) tanı ve (2) çıktı (outcome) ölçeklerini kullanmaktadırlar.
(1)Bu tür tanı ölçekleri belirli bir tanı grubunu homojen olarak tanımlamak için yararlıdırlar. Ancak her araştırmacı kendi ölçeğini kullanırsa araştırmaların karşılaştırılması sorun yaratır. Örneğin bir araştırmacı depresif bozukluk tanısını DSMIV diğeri ICD10, bir diğeri başka bir klinik tanı sistemi ile koymuşsa bu çalışmaların aynı hastalık grubuna ait bulguları ortaya koyduğunu söyleyebilmek zordur. Yapılması gereken tıpkı EURO, Dolar vb para birimlerinin birbirine denk eşdeğerlik tablolarını çıkarmak; ya da her tanıyı tek bir sistem üzerinden ele almaktır.
(2) Bu alanda daha önemli olarak ikinci sorun tanıdan çok çıktı (outcome) karşılaştırmalarıdır. Çıktı olarak değişik tanı, belirti sayısı, hastalık şiddeti, yetiyitimi (disability) ve işlevsellik, yaşam kalitesi (quality of life) ve iyilik hali gibi veriler birbiri ile iç içe ve birbiri yerine kullanılmaktadır. Böyle durumlarda tedavi sonuçlarının karşılaştırılması olanaksız olmaktadır. Çözüm çıktı olarak neyin ölçüldüğünün net olarak belirlenmesi ve bunun belirli bir standart ölçek üzerinden derecelendirilmesidir.
Bu sunuda depresyon, alkol bağımlılığı, bel ağrısı, diz ve kalça protezleri üzerinden örnekleri üzerinden tanı ve çıktılar adına standart ölçümlerin nasıl karşılaştırılabileceği anlatılacaktır.
Elektronik Sağlık Kayıtlarında Hasta Mahremiyeti ve Etik SorunlarBedirhan Ustun
Issues about privacy, security and confidentiality of electronic health records in Turkey discussed in legal frameworks of Turkish Constitution and European Court of Human Rights
2017 Depression and Culture: Etic or Emic ? Can Memetics help?Bedirhan Ustun
This is a review of 40 years of research on Depression on how cultures may affect the manifestation of depression symptoms in different cultures. Key findings are: "depression is a brain disease" "its manifestations are shaped by culture" "new research opportunities on big data and Memetics can help us understand better gene-environment interaction"
Big Data: Impact on Global Health and Clinical Decision MakingBedirhan Ustun
A primer on Big Data and some warnings:
Big Data is not a FAD
YOU are already using it…
It is here to stay
Big Data has Minimal Structure
Big Data Is usually Raw Data
It is NOT like a typical Relational Database
Big Data is available - and Less Expensive
Big Data is not collected for a purpose - has no map
It is your business – your time and money is at work
Kisisel Saglik Verileri: Elektronik Saglik Kayitlarinda GuvenlikBedirhan Ustun
Kisisel Saglik Verileri; Electronic Health Records; Personal Health Records; EHR; PHR; Security; Privacy; Turkish Law; Turkish Constitution; European Court on Human Rights;
Personality and Personality Disorders: Medical Lecture on fundamentalsBedirhan Ustun
A lecture on personality and personality disorders for Medical Students ( Class III) . Explains "Big Five" Myers-Brigs; DSM5 and IPDE; TCI; temperament;
This is the slideset that summarizes the state of the WHO Family of International Classifications. ICD revision has created a joint linearization for mortality and morbidity statistics which can be extended for specialty or national modifications; it can also be used in Primary Care at two shorter versions; ICF proves to be useful to predict better the nees, service use and outcomes; ICHI will be developed using an ONTOLOGY approach merging and sorting ICHI alpha and AMA's CPT pending the agreement.
This is the current status of ICD Revision Process. A stable computer infrastructure is built; 24 Expert Advisory Groups in different segments have given their proposals. Crosswalks between ICD 10 and ICD 11 have been built using 5 different sources. Proposals can NOW be made by interested stakeholders and the PUBLIC. A scientific peer review for the current and future proposals is set up. YOU can comment, make proposals, review or translate the ICD11 BETA NOW...
Keynote lecture on ICD Revision; delivered 7 October 2014; Health Information Management, Coding, Digital ICD; ICD10, ICD11, Ontology, Content Model, Audio notes included.
Defining, classifying and measuring functioning and disability in DSM5Bedirhan Ustun
DSM5 has changed the requirements for describing the clinical significance of a DSM category. Now there it is required that "impairment" criteria is specified in accordance with the ICF ( International Classification of Functioning Disability and Health ) and operationally measured with the WHODAS 2.0;
How do we define Health? Is WHO definition sufficient to operationalize and measure health domains? How do we compare data across health domains? Can we set up a "stock exchange" type of conversion utility to make use of different sources of data?
AHIMA ICD-10 ICD-11 switch to ICD-10-CM in the USA; Bedirhan Ustun
Switching to ICD-10-CM and ICD revision in the USA. This presentation was made at AHIMA conference in 2011. Now ICD 11 is scheduled in 2017 and ICD-10-CM can be made as a National Linearization.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
2. Outline
• WHO perspective Ustun
• AMA perspective Musacchio
• ICHI work to date Madden
• Computable Classifications Musen
• Content Model Tu & Nyulas
• Conclusions All
• Question & Answers
3. Why do we need an
Interventions Classification?
• Clinical Documentation
• Monitoring and Evaluation
• Quality Indicators
• Safety Indicators
• Efficiency and Effectiveness research
• Reimbursement
• Resource Allocation Decisions
4. Global Landscape
WHO SURVEY 2006
Countries without an Intervention Classification: around 130
Countries with an Intervention Classification: 60
Countries using ICD-9-CM Vol 3: 12
Countries using Casemix: 20
OECD: sentinel interventions – Health Accounts 28
5. WHO Family of Classifications
REFERENCE
Classifications
I nternational
C lassification of
D iseases
I nternational
C lassification of
F unctioning,
Disability &
Health
I nternational
C lassification of
H ealth
I nterventions
(under development)
RELATED
Classifications
International Classification
of External Causes of
Injury (ICECI)
The Anatomical,
Therapeutic, Chemical
(ATC) classification system
with Defined Daily Doses
(DDD)
ISO 9999 Technical aids
for persons with disabilities
– Classification and
Terminology
International Classification
of Primary Care (ICPC)
DERIVED
Classifications
International Classification
of Diseases for Oncology,
Third Edition (ICD-O-3)
The ICD-10 Classification of
Mental and Behavioural
Disorders
Application of the
International Classification
of Diseases to Dentistry and
Stomatology
(ICD-DA)
Application of the
International Classification
of Diseases to Neurology
(ICD-10-NA)
5
9. ICHI Development Goals
1. Evolve a multi-purpose and coherent classification
– primary care, clinical care, research, public health…
– Consistency & interoperability across different uses
2. Serve as an international and multilingual reference
standard for scientific comparability and communication
purposes
3. Ensure that ICHI will function in an electronic health
records environment.
• Link ICHI logically to underpinning terminologies and
ontologies
10. Unpacking the Future Classification
1. Ontology
Structure
2018
2. Ontology
Content
a) CPT…
b) ICHI α, β, 2018…
11. What is
NOntology?
• Ontology (philosophy)
NOT meant as the Organization of Reality !!!
• Ontology (computer science)
– the explicit – operational description of the
conceptualization of a domain:
• Concepts: Entity
Properties
Value
• An ontology defines:
– a common vocabulary
a shared understanding/exchange:
• among software agents ( & people ?)
– to reuse data - information
– to introduce standards to allow interoperability
13. What is CPT®?
• CPT codes are an organized compilation of standardized descriptions and five
character alphanumeric codes that physicians, medical coders and billers use
to report healthcare services and procedures to payers for reimbursement
• CPT codes provide a uniform language accurately describing medical,
surgical and diagnostic services
• CPT codes serve as an effective means for reliable communications within the
U.S. healthcare industry
14. CPT Brief History
• First published as a 4 digit system in 1966
• Moved to its current 5 digit system in 1977
• Adopted for programs administered by the Centers for Medicare and Medicaid
Services in 1983
• Named as a Federal U.S. standard procedure code set for electronic
transactions for physician services and other healthcare services in August 2000
• Over 8000, surgical, diagnostic and cognitive procedures
15. The CPT Editorial Panel Process
• Panel Composition: Broad based and comprised of numerous sectors
o 11 physicians representing various medical specialties
o 3 physician payer representatives
o 1 hospital association physician representative
o 2 non-physician healthcare provider representatives
• Non-voting advisory participants from the health information management and
professional coding communities also participate
16. Collaboration Goal and Objectives
AMA and WHO are planning to collaborate in order to show global leadership in healthcare
information innovation through the development and distribution of integrated, ontology-based
terminologies to expand interoperability and analytical applications of clinical data.
Objectives:
Working together in the development of a next-generation ICHI code set that can be
linked to other classification systems, such as ICD and ICF, providing a fully integrated
international healthcare classification system
Enable cross-border data aggregation and analysis by deploying the next generation
ICHI as an augmenting code set for national health systems
Establish AMA as a credible international partner in the WHO-Family of International
Classifications
17. Why The Collaboration Between AMA and WHO
Makes Sense Today!
WHO and AMA have organizational missions that are closely aligned and focus on the overall
betterment of healthcare
WHO Mission
To provide leadership on global health
matters, shaping the health research
agenda, setting norms and standards,
articulating evidence-based policy options,
providing technical support to countries
and monitoring and assessing health
trends.
AMA Mission
To promote the art and science of
medicine and the betterment of public
health through the strategic focus areas of
improving health outcomes, accelerating
change in medical education, and
increasing professional satisfaction and
practice sustainability
18. Collaboration Group
– Expert Group ~ 12 members
– appointed by AMA and WHO in equal numbers and with joint agreement.
• Richard Madden and Mark Musen will be the co-chairs of the group
• 4 management members of current ICHI will be included on the board
– AMA and WHO will appoint one Staff Member each to represent them in
the Advisory Group as ex-officio members.
• Bob Musacchio and Bedirhan Ustun
– The group will be advisory to AMA and WHO and will oversee the
project work according to the Project Plan appended to this agreement.
19. Project Plan
• Objectives
• Streams of work
• Deliverables
• Timelines
• Budget
20. Financial Aspects
• AMA will provide the financial resources to WHO in support of
the development of the ICHI to cover Project costs:
• For five years
– Central project management: WHO Project Staff
– Meetings: Expert Group, other work groups
– Consultants
– Contracts – Development, Field Trials, Reports
– Other
21. ICHI Development Background
1978: WHO International Classification of Procedures in Medicine (ICPM)
1988: ICPM not maintained
Many national classifications developed:
US, UK, Australia, Germany, ...
Focus on medical/surgical interventions, hospital in-patients
Duplication, not comparable
Many countries with no classification
Use of U.S. and Australian classification in other countries
22. Broad scope for ICHI
ICHI planned to include
Medicine, surgery, diagnostics
Primary care
Allied health and provision of support
Mental health
Nursing interventions
Public health
alpha
23. Structure of ICHI
Finalised in 2010
Multi-dimensional, based on European standard for
classification of surgical interventions: France and Canada had
followed this approach
Definition
– A health intervention is an activity performed for, with or on behalf
of a person or a population whose purpose is to improve, assess or
modify health, functioning or health conditions.
24. ICHI Alpha-2 content - interventions
• 5648 interventions across medical and surgical, functioning and
other environmental and behaviour areas
– 4346 - Interventions on body systems and functions (incl ~ 1790
functioning interventions)
– 707 - Interventions on activities and participation domains
– 595 - Interventions to improve the environment and health
behaviour
• ncch/sydney.edu.au/health-sciences/ncch/resources.shtml
25. ICHI content - axes
• TARGET n = 633
• ACTION n = 131
• MEANS n = 59
• New hierarchical grouping of TARGET axis – with subchapters
for body parts and for types of activity.
26. New Target groups
provides the
tabular list with an
additional level of
hierarchy.
27. Extract from the Tabular list
illustrating the additional level of hierarchy.
28. ICD 9 CM Volume 3 and ICHI
• ICD-9-CM was included in the foundation (original base) for
ICHI
• Maps to ICD-9-CM were maintained
• An ICHI subset has been identified that can replace ICD-9-CM
29. Current ICHI Content Model
An Intervention in ICHI is represented by:
Title of Entity: Name of intervention
1. Textual definition
2. Hierarchy – Type – Use
3. Synonyms - Inclusion – Exclusion - Index terms- Notes
Descriptive characteristics
1 Target
A Body Part / Anatomical site D Environment
B Body Function E Behaviour
C Activities and Participation
30. Current ICHI Content Model (II)
2 Action
A Diagnostic C Managing
B Therapeutic D Preventing
3 Means
A Approach C Method
B Technique D Sample
Other relevant information
A Extension codes
B Device: Assistive Devices: ISO9999 (proprietary)
Implanted devices: GMDN (proprietary)
C Chemical substance: ATC
D Objective: ICD, ICF
36. Content Model development process:
• Analyze of ICHI Alpha and CPT sources
• Propose prototype Content Model
• Review by ICHI/CPT community
• Test with “exemplars”
• Implement in Protégé
• Demonstrate prototype iCAT-ICHI Plus
• Refine model
• …
42. Create Prototype Content Model
• Align CPT axes and ICHI axes, possibly creating new ones
• Determine sources of the value sets of axes
• Align CPT and ICHI intervention types
• For each intervention type, determine properties used to
describe the intervention
• Work out exemplars on paper
• Model Content Model in ontology authoring tool
10/15/14
43. Types of Content Model parameters
• WHO-FIC core parameters
– Shared among WHO-FIC classifications
• Descriptive/informational parameters
– Classification-specific information “about” a category
– Not inherited by derivative categories
• Structural parameters
– Axes along which a category can be abstracted or specialized
51. ICHI Meeting, Chicago June 2014
• Attended by ICHI Alpha developers and CPT experts
• Plenary as well as smaller groups using provisional CM to model
exemplars
– Dissected 3 exemplars together
– Two groups
• Dissected 2 common procedures
• Group 1: One additional procedure
• Group 2: Three additional procedures
– Remarkable consistency
52. Current Status
• 16 parameters derived or reformulated from ICHI Alpha or DTK
axes/parameters
• Value sets need to be defined
• Top-level interventions/procedures need to be finalized
• Prototype Content Model has been encoded in computable
representation language
54. Implication of our modeling approach to WHO-FIC
• We have created an shared core WHO-FIC content model
• We cross reference WHO-FIC classification terms
• We are using the same post-coordination paradigm across
WHO-FIC classifications (ICD-11 and ICHI)
• We will be experimenting with value sets shared across WHO-FIC
classifications (ICD-11 and ICHI)
• We use the same iCAT software infrastructure to support the
development of WHO-FIC classifications
Revised 55
56. Collaboration Timing
Drivers for Change: Interoperability to Manage Health Outcomes Globally
• The lack of interoperability in the healthcare system is holding back needed
innovations in quality of care and cost efficiencies
• Most countries have adopted their own standards for classifying procedural data,
making it difficult for cross-border integration and analysis
• In light of the growing global disease burden, especially concentrated in
developing nations, WHO has forged partnerships across the globe to combat
these challenges, enabling greater data exchange across countries would
support greater success of these initiatives
57. Collaboration Strengths
• In direct support of WHO’s and AMA’s missions
• Combines the power of the healthcare and terminology leaders
• Benefit from ICHI Alpha development and AMA’s CPT content
• Leverages WHO’s international prowess and structured classification experience
• Leverages AMA’s editorial and implementation prowess
• Delivers significant benefits to global healthcare
58. What does WHO want ?
• Meaningful exchange of health information
– Enable aggregation of health information from different sources
• One stop-shop for different users / developers
– In multiple languages
• Crystallization spiral for knowledge representation
– formalization conceptualization formalization
• Linkages between different domains of health information
• Translational research tool + semantic consistency
59. ICHI - 2018
• A reference classification-ontology set
– provision of semantics to enable users to use data in a consistent manner
– provision of possible services for:
• classification
• terminology
• linkages
• For use cases such as:
– Universal Health Coverage
– Billing & Reimbursement
– Casemix and Resource Allocation
– Quality and Safety monitoring
– Comparative Effectiveness Studies