ICPC recent advances research teaching Wonca Europe KOS

ICPC : recent advances, research & teaching Wonca Europe, KOS, Sep. 7, 2005 WICC, Heidelberg, Sep. 6, 2006 • Marc Jamoulle, Gilly, Belgium. • Jean Karl Soler, La Valette, Malta. • Laurent Letrilliart, Lyon, France. WICC members • Jan De Maeseneer, Ghent, Belgium • Dimitris Kounalakis, Heraklion, Greece MJ/2005 1

Wonca International Classification Committee • WICC has 40 members from 23 countries. • Membership is voluntary and based on personal involvement in the classification field. • Members, mainly GPs, communicate through web log and mailing list. They meet once a year MJ/2005 2

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The aim of WICC is to: Develop, update and distribute systems which enable international communication about the work with patients in general/family practice. MJ/2005 4

Main fields of research: • ICPC • Wonca Dictionary of General Practice • Coop Wonca charts • Dusoi-Wonca MJ/2005 5

y or t s PC IC 17 chapters 15 somatic 3 components coming from 3 gathered classifications Symptoms and complaints Process RFEC Reason for Encounter Classification IC-Proces-PC International Classification of Process in Primary Care 1981 1985 1 Psychologic Diagnoses ICHPPC 1974 ICHPPC-2 -d International Classification of Health Problem in Primary Care 1& 2 edition, defined & 1979 1 Social 1987 1998 1983 ICPC 2 Revision and inclusion of criteria and definitions 2005 ICPC 2 R Revised transcoding to ICD-10 MJ/2005 Towards ICPC 3 6

ICPC is an ordering principle • For nosography of health problems • Conceptual grid of problem allowing comprehensiveness • About high prevalence problems • Patient centered » Based on body system • For structure of health information • SOAP & Episode based allowing continuity • Linked to other classifications for information exchange MJ/2005 7

ICPC • 1974 Designed by GPs for paper and pencil research in GP/FM & PHC to be used in statistical & epidemiological studies • 1990 Fit perfectly with the need of ordering information in EMR (to be used with controlled terminologies) MJ/2005 8

ICPC as a quality assurance tool Medicine can be harmful to your patients' health. Analyse what you do using ICPC, and protect your patient from harm MJ/2005 9

Comparison of chapter P diagnosis of two family doctors each in solo practice A new insight in GP practice allowing quality assessment and alternative teaching process MJ/2005 Courtesy of Dr Joseph Huberty, Ciney, Belgium 10

200 Primary care practitionners in 5 years MJ/2005 Courtesy of Dr Alejandro Lopez, Buenos aires 11

ICPC & Information needs in the health system • Implies opening of the rubrics of ICPC • Implies use of classified terminologies » ICPC Plus / Encode FM / SNOMED/ 3 BT • Implies transcoding with main other tools • ICPC/ICD carefully followed since the beginning • ICPC admitted in the WHO family of Classification • Implies ethical background MJ/2005 12

• Implies opening of the rubrics of ICPC • • • • • Z 25 ASSAULT & HARMFUL EVENT bewitchment with pig's liver damage from malediction desecration of grave by witches dupa spells evil influence ns harm from fighting harm from troublesome spirits harm from war harm from witchcraft harm from witches' familiars makgoba bewitchment negative condition ns possession by spirits possession by bad spirits possession by evil spirits • MJ/2005 Example of opening of an ICPC rubric Cridland JS, . Koonin S. Use of traditional medicines towards a classification. S. Afr. Med J 2001; 91: 489 -91 13

• Implies transcoding with main other tools October 2003 • First WICC & WHO-FIC working meeting ICPC accepted as a member of the Word Health Organisation Family of International Classification MJ/2005 14

WHO-FIC • WHO Family of International Classification » ICD » ATC » ICF » ICPC » ICHI MJ/2005 diseases drugs functions health problems Interventions 15

Advances in terminology • Dutch Thesaurus ICPC / ICD • ENCODE – FM (Canada) • ICPC – PLUS (Australia) • 3 BT Biclassified Belgian Bilingual Thésaurus ICD / ICPC • ICPC linked to UMLS metathesaurus • SNOMED / ICPC working group MJ/2005 16

Ethical aspects • Developing tools for health information system is not an innocent game Ongoing discussion in WICC Charter of medical information published by the CISP Club (French speaking ICPC fan club) http: //www. wbcispclub. be/chart. htm MJ/2005 17

Availability ICPC 2 R ICPC 2 pager From Oxford University Press From Wonca / WICC web site www. globalfamilydoctor. com/wicc ICPC 2 E From KITH web site www. kith. no MJ/2005 18

Thank you marc@jamoulle. com MJ/2005 19