Occupational Health in the 11 th Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD11)

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1 Occupational Health in the 11 th Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD11) Dr Ivan D. Ivanov Department of Public Health, Environmental and Social Determinants World Health Organization, Headquarters, Geneva

2 Content ICD11 process Including occupational health items ICD11 Beta Version

3 ICD-11 Revision Goals 1. Multi-purpose and coherent classification Mortality, morbidity, primary care, clinical care, research, public health Consistency & interoperability across different uses 2. International multilingual reference standard for scientific comparability and communication purposes 3. Fit for electronic health record environments Link terminologies and ontologies (e.g. SNOMED, GO, ) ICD Categories defined by "logical operational rules" on their associations and details

Placing WHO Classifications in HIS & IT ICD

ICF ICHI Classifications Population Health Births

Decision Support Integration of care Outcome

4 Placing WHO Classifications in HIS & IT ICD e-health Record Systems Terminologies Linkages KRs ICF ICHI Classifications Population Health Births Deaths Diseases Disability Risk factors Clinical Decision Support Integration of care Outcome Administration Scheduling Resources Billing Reporting Cost Needs Outcome

Construction of ICD-11: Revision Process in the 21 st Century Internet-based permanent platform All year round Open to all people in a structured way Content experts focus Digital curation Wiki

5 Construction of ICD-11: Revision Process in the 21 st Century Internet-based permanent platform All year round Open to all people in a structured way Content experts focus Digital curation Wiki enabled collaboration Ontology based Enhanced discussion & peer review TAGs serve as the editorial group Electronic copy print version Work in multiple languages Planned field tests Based on Use Cases

6 Definition of Disease a set of dysfunction(s) in any of the body systems including: with a known pattern of signs, symptoms & findings symptomatology - manifestations probably with an underlying explanatory mechanism a distinct pattern of development over time a known pattern of response to interventions etiology course and outcome treatment response with linkage to underlying genetic factors genotypes, phenotypes and endophenotypes with linkage to interacting environmental factors

7 THE CONTENT MODEL Any Category in ICD is represented by: 1. ICD Concept Title 1.1. Fully Specified Name 2. Classification Properties 2.1. Parents 2.2 Type 2.3. Use and Linearization(s) 3. Textual Definition(s) 4. Terms 4.1. Base Index Terms 4.2. Inclusion Terms 4.3. Exclusions 5. Body Structure Description 5.1. Body System(s) 5.2. Body Part(s) [Anatomical Site(s)] 5.3. Morphological Properties 6. Manifestation Properties 6.1. Signs & Symptoms 6.2. Investigation findings 7. Causal Properties 7.1. Etiology Type 7.2. Causal Properties - Agents 7.3. Causal Properties - Causal Mechanisms 7.4. Genomic Linkages 7.5. Risk Factors 8. Temporal Properties 8.1. Age of Occurrence & Occurrence Frequency 8.2. Development Course/Stage 9. Severity of Subtypes Properties 10. Functioning Properties Impact on Activities and Participation Contextual factors Body functions 11. Specific Condition Properties 11.1 Biological Sex Life-Cycle Properties 12.Treatment Properties 13. Diagnostic Criteria

Version 100 words Detailed definitions ONLINE Definitions will be compatible with:

8 Definitions All ICD entities will have definitions: key descriptions of the meaning of the category in human readable terms to guide users Limited definition in Print Version 100 words Detailed definitions ONLINE Definitions will be compatible with: the Content Model Diagnostic Criteria across the whole classification and the versions

CONTENT MODEL Parameters Value sets Ontology Component Refers to ICD Concepts Definitions structured according to the CONTENT MODEL Generates ICD Presentations Mortality Lists Morbidity Lists Primary

9 CONTENT MODEL Parameters Value sets Ontology Component Refers to ICD Concepts Definitions structured according to the CONTENT MODEL Generates ICD Presentations Mortality Lists Morbidity Lists Primary Care Specialty Adaptations Linearization Component 3 1 Value Sets from established terminologies SNOMED CT Gene Ontology ICF other Foundation Component 2 icat software platform PUBLICATIONS Print Copies Electronic publications

10 ICD Revision Organizational Structure WHO Health Informatics and Modelling TAG (HIM TAG) icat Software Team Revision Steering Group Internal Medicine TAG Paediatrics TAG Dentistry TAG Dermatology TAG Gastroenterology WG Cardiovascular WG Hepatology & Pancreatobiliary WG Nephrology WG Endocrinology WG Morbidity TAG Mortality TAG Functioning TAG Quality & Safety TAG Cross-Sectional TAGs Occupational Health WG Rare Diseases TAG External Causes and Injuries TAG GURM Mental Health TAG Musculoskeletal TAG Neoplasms TAG Neurology TAG Ophthalmology TAG Traditional Medicine TAG Rheumatology WG Haematology WG Respiratory WG Working Groups Genito-Urinary, Reproductive and Maternal TAG

11 WHA Resolution Workers Health: Global Plan of Action

12 WHO report on OH in ICD10 To have information on both diagnosis and exposure A guideline on how to use ICD-10 codes for coding the medical diagnosis of notified occupational diseases Non-exhaustive lists of exposures relevant for each of the diseases To help in making international comparisons and in building OD reporting systems in countries not having a well-established system

13 ILO List of Occupational Diseases Diseases by exposure to agents Chemical Physical Biological Diseases by target organ and systems Respiratory Skin Musculoskeletal Mental and behavioral Cancer Other

14 Towards ICD Comparative analysis ICD11 and ILO list 2011 Global working group on occupational health in ICD11 Members: USA, Colombia, UK, South Africa, UAE, Italy, India, China, South Korea, Australia, WHO, ILO 2012 WHO Collaborating Centres for Occupational Health Surveys of the use of ICD in OH Field testing Review and comments ILO exposure and diagnostic criteria for occupational diseases

Clinical terms and ICD 11

Clinical terms and ICD 11 Family of Classifications Robert Jakob, WHO Detail of health information -> Classification Reality (individual detail) Free Text (medical information) Terminologies / ICD-11 URI