State of ICD 11 Robert Jakob, WHO
Overview Information and participation Activity to date Contribution Content Future 2
www.who.int/classifications/icd/revision/ Online information FAQ Video Working groups ICD-11 features Becoming involved 3
ICD-11 Tools apps.who.int/classifications/icd11/browse Coding tool: spelling-synonyms no problem icd11ct.cloudapp.net/ct#/ ICD-11 browser See foundation and linearization grid view Download versions frozen versions See differences Proposal tool Make suggestions and discuss them Notifications Review tool Translation tool Translate in your language Mapping tool See mapping at detailed level Comment mapping to and from ICD-10 4
Foundation - workload to date Proposal platform (start June 2014) 4743 proposals (78 authors, including WHO more added by WHO for tracking purposes) 3517(3025) proposals have been actioned (ranging from acceptance/implementation to direct rejection) 1250 (1710) to be addressed 480 (512) pending feedback from vertical TAGs Kind of proposals submitted: 65% content enhancement proposals, (definitions or terms); 21% complex hierarchical changes 14% delete or add individual entities 5
Major events Exteral ICD Process Review Activities of individual vertical TAGs JLMMS Task Force WHO working 6
ICD Contribution WHO icat Software Team JLMMS Task Force RSG SEG Morbidity TAG Mortality TAG RSG Internal Medicine TAG Paediatrics TAG Gastroenterology WG Cardiovascular WG Hepatology & Pancreatobiliary WG Functioning TAG Dentistry TAG Dermatology TAG Nephrology WG Endocrinology WG Quality & Safety TAG Primary care TF Rare Diseases TAG External Causes and Injuries TAG GURM Rheumatology WG Haematology WG Respiratory WG Mental Health TAG Musculoskeletal TAG Working Groups Neoplasms TAG Health Informatics and Modelling TAG (HIM TAG) Neurology TAG Ophthalmology TAG Traditional Medicine TAG Genito-Urinary, Reproductive and Maternal TAG 7
Main activities Restructure infectious diseases chapter Edit Dementia Structure postoperative complications Edit and design primary care Revisit shorelining Edit volume 2 Ordering Terminology Terms Parenting Exclusions Planning 8
Main activities Restructure infectious diseases chapter Edit Dementia Structure postoperative complications Edit and design primary care Revisit shorelining Edit volume 2 Ordering Terminology Terms Parenting Exclusions Planning 9
Is a category and has a code Shoreline Lumped into a category PC med-res 11 Joint lin111 Joint lin112 PC Low 1 PC med-res 12 Joint lin121 PC med-res 13 Joint lin131 Joint lin132 Joint lin133 PC Low 2 PC med-res 21 PC med-res 22 Joint lin211 Joint lin221 Joint lin222 e.g. Dentistry, ICD-11 GM PC Low 3 PC med-res 31 PC med-res 32 Joint lin311 Joint lin312 Joint lin321 PC med-res 33 PC med-res 34 Joint lin341 Joint lin342 PRIMARY CARE low PC med-res 35 PRIMARY CARE intermediate Joint lin351 Joint linearization International Extensions National Linearizations Specialty - Research
Above or below shoreline good classification (linearization) Content is still in foundation Content is used as index entry Content is codable with postcoordination Postcoordination= 2 or more codes describe one disease Criteria: relevance cover 95% of cases per country by age group, sex and use (mortality and morbidity) 11
Main activities Restructure infectious diseases chapter Edit Dementia Structure postoperative complications Edit and design primary care Revisit shorelining Edit volume 2 (Reference guide) Ordering Terminology Terms Parenting Exclusions Planning 12
Infectious Diseases Chapter Have groupings in JLMMS in way similar to ICD-10 Clinical Health prevention, Treatment or Monitoring tradition Useful for limited diagnostic capacity assist coders to understand and use the structure grouping of diseases with multiple agents meaningful tabulation categories. 13
New infectious diseases chapter Intestinal infectious diseases Tuberculosis Miliary tuberculosis Predominantly sexually transmitted infections HIV Opportunistic infections Arthropod-borne viral fevers Malaria Viral haemorrhagic fevers Viral infections of the central nervous system Prion diseases Viral infections characterized by skin and mucous membrane lesions Viral hepatitis Sepsis Predominantly airborne and direct contact Other viral diseases Other bacterial diseases Certain zoonotic diseases Protozoal diseases Mycoses Helminthiasis Pediculosis, ascariasis and other infestations 14
Differences to ICD-10 ICD-11 has five new chapters: Chapter 3 Chapter 4 Chapter 6 Chapter 8 Chapter 26 Chapter 27 Diseases of the Blood and Bloodforming Organs Disorders of the Immune System. Conditions related to Sexual Health. Sleep-Wake Disorders Extension codes Traditional Medicine 15
Differences to ICD-10 Term Foundation Entity Linearization Stem code Extension code Linearization parents Translation Everything in ICD Thing in foundation Classification Category (mostly dagger ) Additional information Classification hierarchy Chapter, Block, Category, 16
Differences to ICD-10- Coding scheme The chapter numbering: now arabic numbers not roman numerals The coding scheme for categories: now minimum 4 characters 2 levels of subcategories Coding scheme always has a letter in the second position to distinguish from the codes of ICD- 10. No l,i (L,i); 0,O (Zero, o) First character of the code always relates to the chapter number. 1-Z 17
Differences to ICD-10 - Terminology ICD-10 had a range of expressions to describe a causal relationship between conditions in a code title. In ICD 11, the preferred term is due to. ICD-10 had a range of expressions indicating the coincidence of two conditions in a code title (e.g. in or with ). In ICD-11, the preferred term is associated with. 18
Differences to ICD-10 Dagger-Asterisk and additional subclassifications Asterisk codes become Clinical forms Extension codes Additional sublassifications become Extension codes 19
Differences to ICD-10 Content model ICD-11 categories have a short and a long definition. All ICD-11 categories include separate information on anatomy, aetiology and other aspects Can be accessed for search purposes, or when browsing in the tabular list of the For morbidity, the definition of main diagnosis has changed: reason for admission after assessment at the end of the stay. 20
Focus on Joint Linearization for Mortality and Morbidity Statistics (JLMMS) Clean classification Shoreline Transition tables Test Inform World Health Assembly 2016 Decision by World Health Assembly 2018 21
JLMMS: Striving together to maximise utility of ICD-11 for monitoring mortality and morbidity trends