1. Terminology and ICPC in EPR The Belgian challenge: a link between analogue doctors and digital machines in a bilingual country M.Verbeke M.D. Ghent University

2. November 8, 2006Brussels Workshop on Health Terminologies Why a national terminology? Language Terminologies reflect local Politics Ethics Tradition Religion Social organization Standardization of qualifiers Different national use of data

3. Terminology without classification Like paint without painting or color without picture

4. November 8, 2006Brussels Workshop on Health Terminologies Classifications in health care Grouping of concepts and analysis of data Primary care ICPC-2-R: covers 80% of the morbidity Specialist care ICD-10: more granularity ICF: description of functioning ICHI: procedures under re-construction General plan of classifications needed

5. November 8, 2006Brussels Workshop on Health Terminologies Compounds of Belgian bilingual thesaurus Vocabulary Bilingual Clinical labels Classifications

6. November 8, 2006Brussels Workshop on Health Terminologies Vocabulary Keywords Independent content for each language (Fr/Nl) Patient oriented terms Doctor oriented terms (jargon) Synonyms or equivalent terms Link between thoughts and clinical label Flexible adaptation

7. November 8, 2006Brussels Workshop on Health Terminologies Clinical labels Concepts: “units of thought” Fixed meaning Bilingual: 100% reciprocity Including procedures Linked by IBUI to vocabulary Long term: all diagnostic and clinical procedures

8. November 8, 2006Brussels Workshop on Health Terminologies Vocabulary FrenchVocabulary Dutch IBUI Clinical label French = Clinical label Dutch ICPC ICD RIZIV/INAMI procedures ICF (ICHI) n 1 n 1 n n Under construction Double encoded ICPC/ICD 1n 1 1 47037 686+39 11363 1510

9. November 8, 2006Brussels Workshop on Health Terminologies Why Encoded information? classifications with accurate granularity Structured information? EPR structure: enables exchangeable data

10. November 8, 2006Brussels Workshop on Health Terminologies Encoded information (1) Codes linked to ICPC indexed “EBM Guidelines” and other expert systems Online available During patient contact Appropriate guideline Very accurate information as decision support Language independent link

11. November 8, 2006Brussels Workshop on Health Terminologies Encoded information (2) Use of ICPC codes in EPR Prevention module Risk calculator Workflow and automating processes Creation of alerts and warnings Creating views in the EPR with appropriate information in function of doctors’ need Billing systems

12. November 8, 2006Brussels Workshop on Health Terminologies Encoded information (3) Enables Retrieving tool for epidemiological studies Sharing information with other primary health care providers or specialists (ICPC-ICD-ICF link) Retrieving tool for social security and insurance Evaluating and improving quality of care

13. November 8, 2006Brussels Workshop on Health Terminologies Structured information Necessary for exchangeable data Belgian Government provided structural model Guaranteed for all “labeled” software systems Episode based information with ICPC philosophy RFE Procedures Assessment Guarantee for correct data use by software system.

14. November 8, 2006Brussels Workshop on Health Terminologies Topics for discussion National or European terminology Challenge of multilingual systems in Europe Importance of appropriate classifications

15. November 8, 2006Brussels Workshop on Health Terminologies Developing team Ghent University Jan De Maeseneer Diëgo Schrans Sven Deroose Marc Verbeke Paul Van Hove Brussels University Michel Roland Michel Dejonghe Nadine Kacenelenbogen Bernard Dendeau Federal Government Marc Bangels Luc Nicolas