icd.who.int Dr Robert JAKOB, Team Leader, WHO, Geneva, Classifications, Terminologies and Standards (ICD, ICD, ICHI, Verbal Autopsy)

WHO Family of International health related Classifications (WHOFIC) World Health Organization 19 April, 2019 WHO Family of International health related Classifications (WHOFIC) REFERENCE Classifications Special versions Derived from reference clssifications 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, Third Edition (ICD-DA) Application of the International Classification of Diseases to Neurology (ICD-10-NA) RELATED Classifications Covering other relevant dimensions in health International Classification of Primary Care (ICPC) International Classification of External Causes of Injury (ICECI) The Anatomical, Therapeutic, Chemical (ATC) classification with Defined Daily Doses (DDD) ISO 9999 Technical aids for persons with disabilities – Classification and Terminology International Classification of Nursing Practice I nternational C lassification of D iseases F unctioning, Disability & Health H ealth I nterventions 19.04.2019 ICD-11 - Devices

ICD-11 International Classification of Diseases and related Health Problems The international standard for recording, reporting and measuring health & health services Mortality Statistics Morbidity Statistics Quality and Safety Primary care Health Care Costs Progress towards SDGs Clinical documentation 19.04.2019 ICD-11 - Devices

Why ICD-11? Improved usability (online and offline) Less training All clinical detail – code combinations Updated scientific content >>300 specialists, 99 countries Enable coding of all clinical detail Make eHealth* ready for use in electronic environments (API – software interface) Linkage to relevant other classifications and terminologies Full multilingual support on translation and in outputs (14 languages in progress; ICD10:42) Public proposal and updating mechanism *new preferred term: digital health 19.04.2019 ICD-11 - Devices

Timeline 2007 Start ICD-11 revision … 2018 June release of version for implementation 2019 January WHO Executive Board 2019 May World Health Assembly 19.04.2019 ICD-11 - Devices

Browser and Coding tool World Health Organization 19 April, 2019 Browser and Coding tool https://icd.who.int Official release The ICD-11 site has links to the ICD-11 Browser and the ICD-11 coding tool Reference Guide = Instruction Manual Maintenance browser - devices

Coding tool where humans talk with ICD World Health Organization 19 April, 2019 Coding tool where humans talk with ICD Type a diagnostic statement into the Coding Tool e.g. cancer of stomach Typing the whole statement into the search field, results in a match for this diagnostic statement . The coding tool has been enhanced to know that ‘cancer’ = ‘malignant neoplasm’ The Coding Tool will find the best match. Check the filters. In case of questions click on the question mark. Use the browser for browsing and searching, but not for coding. 19.04.2019 ICD-11 - Devices

Application Programming Interface (API – where software talks with ICD) Provides all detail you want Ways to use API URI (Unique Resource Identifier) Code Title Language Parents, siblings, synonyms External references Description Online Offline container version Updating online, as desired Use on single PC or local network 19.04.2019 ICD-11 - Devices

ICD-11 26 chapters – Diseases, Health conditions, Causes, reasons for contact with health system Special tabulation lists (statistics) Functioning section (functioning score – ICF/WHODAS/MDS) Traditional medicine (Diagnoses only. Module 1, ancient Chinese TM, as practiced in China, Japan and Korea – to be able to count, research and compare) Extension codes ICD consists of 3 components. This subdivision is derived from the traditional print format. In the electronic part all 3 components are interlinked to facilitate the correct use of the classification.

Examples of problems solved with ICD-11 Antimicrobial resistance - essentially missing in ICD-10 HIV subdivisions - outdated detail in ICD-10 Better representation of Immune diseases in own chapter Diabetes coding clinically more relevant and flexible External causes - Loosing detail in non-accidents; traffic accidents Patient safety reporting module Functioning assessment - ICF Medicaments – INN – ATC Tumour histopathology – ICD-O 19.04.2019 ICD-11 - Devices

Extension codes – add all the detail you need… if you need Type 1 Severity Temporality (course of the condition) Temporality (Time in life) Aetiology Anatomic detail Topology Anatomic location Histopathology (ICD-O) Biological Indicators Consciousness Substances External Causes detail Injury Specific detail . Type 2 Main Condition Reason for encounter Reason for admission Main Resource Condition Present on Admission Developed after admission Uncertain timing relative to admission Provisional diagnosis Diagnosis confirmed by… Lab Serology Histology Genetics Imaging – Unspecified means Differential Diagnosis Medicaments (WHO INN*) Chemicals Health Devices, Equipment and Supplies (WHO Nomenclature of medical devices) . *WHO International Nonproprietary Names: https://www.who.int/medicines/services/inn/en/ 19.04.2019 ICD-11 - Devices

Multiple parenting Individual devices are reused  building sets Individual identifier: (URI – Uniform resource identifier) Example: 130mm Backhaus Clamp primarily grouped to ‘Clamps and Clips’ under ‘Surgical Instruments’, ‘Medical Devices’ reused as part of Basic surgery set Code:XD2C79 URI: http://id.who.int/icd/entity/1699000479 19.04.2019 ICD-11 - Devices

Extension Codes Devices Health Devices, Equipment and Supplies Assistive Devices Medical Devices XD7QL5 Medical Equipment XD23H7 Surgical Instruments XD8JT7 Blades XD6MQ1 Scissors XD1BJ8 Dilators and probes XD7JB4 Speculum XD23W0 Basins/bowls XD0WK5 Clamps and Clips XD1CT5 Clamp, Allis, extra large ... XD2C79 Clips, Towel, Backhaus, 130 cm Health Devices, Equipment and Supplies Assistive Devices Medical Devices Sets, Kits, Systems Instrument Sets XD3JM0 Basic Surgery set / Minor tray XD2C79 Clamps, Towel, Backhaus, 130mm ... 19.04.2019 ICD-11 - Devices

Patient safety 19.04.2019 ICD-11 - Devices

A clinical example - device A respirator malfunction causes a barotrauma with air embolism in a patient Coding: PK9C.1& XD4M09 Cause of harm (medical devices associated with injury or harm & Ventilator, Adult) PL12.1 Mode/mechanism (Functional device failure) NF0A.0 Harm (Air embolism, traumatic) 19.04.2019 ICD-11 - Devices

A clinical example - medicament A patient presents with an intracranial hemorrhage arising while on warfarin anticoagulation. INR found to be 7.0 and careful history reveals patient to have accidentally taken double doses over several days. Coding: PH80 & XE9AC Code for the cause of harm (exposure to drug in therapeutic intent & warfarin) PH92.0 Code for mode/mechanism (overdose) 8B00.Z Code for actual harm (intracranial hemorrhage) 19.04.2019 ICD-11 - Devices

ICD-11 New content – up-to-date Modern technology Electronic data recording Software access Easy manual coding Established updating mechanism 19.04.2019 ICD-11 - Devices

ICD 11 for you – by you – for best possible health Thank you