1. 1. Update on NACC ICF Activities: ICF Overview, The Toronto NACC Meeting, DISTAB, Health Care Financing Review, and Dissemination Date: July 16, 2002 Presenter: Paul J. Placek, PhD, Senior Statistician, Data Policy and Standards Staff, OCD/NCHS PJP2@cdc.govPJP2@cdc.gov tel 301-458-4437 http://www.cdc.gov/nchs/about/otheract/icd9/icfhome.htm

2. ICF 2. World Health Organization Classification Assessment Surveys & Terminology Group 2. World Health Organization Classification Assessment Surveys & Terminology Group as the New Member in the WHO Family of International Classifications www.who.int/classification/icf

3. 3. ICF Launch 3. ICF Launch D eveloped over a decade with the active participation of 65 countries D eveloped over a decade with the active participation of 65 countries Approved by the 191 Member States of the World Health Assembly May 2001 Approved by the 191 Member States of the World Health Assembly May 2001 Published simultaneously in 6 WHO Official Languages: English, French, Arabic, Russian, Chinese, Spanish Published simultaneously in 6 WHO Official Languages: English, French, Arabic, Russian, Chinese, Spanish New Dutch and Italian translations New Dutch and Italian translations CD ROM#0990011 $135 USD CD ROM#0990011 $135 USD Full 4 digit volume #1152088 $45 USD Full 4 digit volume #1152088 $45 USD Two digit Pocketbook#1153088 $12.60 USD Two digit Pocketbook#1153088 $12.60 USD FREE Public access on INTERNET FREE Public access on INTERNET www.who.int/classification/icf www.who.int/classification/icf FREE single copies for teachers and researchers: call Paul FREE single copies for teachers and researchers: call Paul

4. 4. ICF Part of WHO Family of Classifications (ICD & ICF) NACC hosted first joint ICD/ICF meeting of Heads of WHO Collaborating Centres for the Family of Inter- national Classifications in Bethesda, MD, October 2001 ICF sessions held on coding guidelines implementation issues training, outreach and dissemination adaptations measurement use of ICD and ICF together maintenance and update process NACC ICF papers: Heads Mtg. Oct. 14-19, 2002 Brisbane

5. 5. ICF Structure Classification Parts Components Constructs/qualifiers Domains and categories at different levels at different levels ICF Part 1: Functioning and Disability Part 2: Contextual Factors Body Functions and Structures Activities and Participation EnvironmentalFactorsPersonalFactors Change in Body Structures StructuresCapacityPerformanceFacilitator/Barrier Item levels: 1 st 2 nd 3 rd 4 th Item levels: 1 st 2 nd 3 rd 4 th Item levels: 1 st 2 nd 3 rd 4 th Change in Body Functions Functions Item levels: 1 st 2 nd 3 rd 4 th Item levels: 1 st 2 nd 3 rd 4 th

6. 6. “There is a widely held misunderstanding that ICF is only about people with disabilities; in fact, it is about all people. The health and health-related states associated with all health conditions can be described using ICF. In other words, ICF has universal application." (p. 7, ICF)

7. 7. Eighth NACC Conference on ICF: June 2-4, 2002 in Toronto, Canada Hosted by Canadian Institute for Health Information 74 Registrants; 32 presenters from USA, Canada, Germany, Netherlands, Switzerland, World Health Organization Ninth NACC Conference on ICF hosted by Wash. U. – David Gray: June 17-19, 2003 - St. Louis, MO

8. 8. Six Themes Strategies for ICF Implementation ICF Conceptual and Issue Areas ICF Applications in Surveys ICF for Clinical Practice Capturing & Coding Functional Status Info Basic ICF Research

9. 9. Toronto Papers on Web http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=home_e Select "News and Events" from "About CIHI" box. Scroll to "Events" Section. Scroll to "Proceedings of Past Events" Select "The 8th North American Collaborating Center Conference on ICF", view in PDF If you need Adobe Acrobat free http://www.adobe.com/products/acrobat/readstep2.html

10. 10. Spring 2003 issue of Health Care Financing Review Stimulus: U.S. National Committee on Vital and Health Statistics Report on Classifying and Reporting Functional Status Recommended ICF as the code set to capture functional status http://www.ncvhs.hhs.gov/010617rp.pdf Centers for Medicare & Medicaid Services invited NCHS to assemble issue: Co-editors Placek & Hendershot Articles by Ustun, Bickenbach, Swanson, Jette/Harris/Ruggieri, Iezzoni/Greenberg, Chute, Seltser/Hendershot, Carter, Buchanan, Clauser/Bierman/Clancy + Commentaries

11. 11. DISTAB U.S., Canada, South Africa, Netherlands, & France Since 1999; follow U.N. DISTAT guidelines Monthly phone conference + annual meeting Stimulated U.N. Seminar & Wash. City Group Five national disability surveys, Q’s backcoded to ICF Done: Backcoding methods paper to be published In draft: Comparative tables report Currently: Code Environment and Participation survey items to ICF (Australia has just joined)

12. 12.ICF Dissemination: NCHS Takes the Lead Four ICF Videos: ICF Use by Consumers, Applications in Clinical & Survey Areas, Historical Development, Conceptual/Issue Areas (Farmer interviews w/20 experts) ICF Curricula in North American Colleges and Universities Fall 2002 Semester (U. of Michigan - Mulhorn) NACC ICF Clearinghouse (in-house + contract) CODE ICF: Web-based training on ICF

13. 13. CODE ICF Monthly phone conferences 2 years NCHS: Placek WHO: Kostansjek, Bickenbach, Ustun Western University (Swanson & Carrothers) Much stakeholder input thru WHO & NACC meetings

14. 14. CODE ICF Code ICF is a teaching tool designed to familiarize the learner with the ICF Technology being used Provides learner interactivity and integration Applies learner algorithm Easily translatable database driven platform WHO browser Users will learn vocabulary and concepts, governing principles, how to code cases, the influence of environmental barriers and facilitators, current and potential uses Fall 2002 completion On WHO website

15. 15. CODE ICF Screen on Body Functions Mental Functions Sensory Functions and pain Voice and speech functions Functions of the cardiovascular, haematological, immunological & respiratory systems Functions of digestive, metabolic, endocrine systems Genitourinary & reproductive functions Neuromusculoskeletal & movement-related functions Functions of the skin & related structures EXAMPLE: PRODUCTION OF VOICE Example: Production of voice

16. 16. CODE ICF Screen on Barriers Barriers are environmental factors in a person’s environment that, through their absence or presence, limit functioning and create disability. EXAMPLE: e235 Human- caused events, disturbances in the natural environment that result in the disruption of people’s day-to-day lives, including conflict and wars…

17. 17. CODE ICF Screen on Facilitators Facilitators are environmental factors which improve functioning and reduce disability, or the absence of factors that are barriers. EXAMPLE: e140 Assistive products for recreation and sport

18. 18. NACC Clearinghouse on ICF Need for regular information exchange, coordination and technical assistance Monthly e-mail summaries ID & Typology of ICF Users Marketing & Exhibits Training and Technical Assistance ICF Conference Support Specialized Document Preparation