– Progress on ICPC-3 will be reported here as soon as this has been discussed and decided within the Consortium. –

 

Shifting the Health Paradigm in Primary Care and Public Health:

Person-Centeredness at the core of ICPC-3!

The leading principles are:

Covering every kind of contact in Primary and Community Care for all disciplines involved.

Relevant Regional Extensions on content within ICPC-3 to suit National Primary Care needs.

The rational for additions to ICPC-3 is: frequency and evidence based.

Simplicity of the new ICPC-3, no excessive subclasses like most classifications and clinical terminologies. For present users of ICPC-2 and ICPC-1 it will be familiar.

The content of ICPC-3 will be ‘linked’ to relevant classifications, such as ICD-10, ICD-11, ICF, ICHI, DSM-V, clinical terminologies such as Snomed-CT, but also to previous versions of ICPC-1 , ICPC2.7 and to the goals of WHO, such as Universal Health Coverage (UHC) and the Global Burden of Disease (GBD).

The ICPC-3 also contributes to several SDG’s (United Nations’ Sustainable Development Goals – 2030), specifically to Goal 3 and its Targets:

 
Goal 3. Ensure healthy lives and promote well-being for all at all ages.

WHAT IS NEW IN ICPC-3 ?

The focus of the classification is Primary Care and not only General Practice.

The ICPC-3 includes all those classes / concepts in primary care that can lead to better decisions by the providers and policy makers. It includes the new approach to health, person-centeredness, providing a medical language that is used in daily practice.

The functioning and functioning related aspects of the patient (activities and participation, environmental factors and personality functions) are added as fourth important element of the health encounter to the RFE, diagnoses or problems, and processes of care.

The bi-axial structure of ICPC-2 is replaced by the structure within the Content Model, which describes the properties for the content and the maintenance attributes of the ICPC-3.

The content is based on the ICPC-2.7 and on the proposals of WICC and the Consortium partners. There was a strong need for more classes, especially for prevention, regionally important classes and non-disease related information. In the present version of ICPC-2 these proposals could not be classified within the existing structure.

THE PERSON-CENTERED ENCOUNTER

Any encounter starts with a RFE.

RFE’s are the agreed statement of the reason(s) why a patient meets the health care provider, representing the demand for care by that person. These reasons are usually related to one or more underlying problems, diseases, symptoms and complaints, functioning and functioning related issues (environmental factors and personality functions). By adding a Chapter of Functioning and Functioning related issues to the other elements of the encounter, the ICPC-3 will become a more person-centered than disease- or provider-oriented classification. This new ICPC-3 meets the need to record the reason for encounter (RFE), functioning (activities and participation) and personal preferences linked to morbidity.

Present progress from the ICPC-3 Taskforce Zoom meetings held on July 8th, 2020:

  • The Field testing is being discussed and prepared for the pre-testing Phase in July 2020 and the Field Testing starting thereafter.
  • Participants focussed on are all PC providers that could benefit from the ICPC-3.
  • All members of the ICPC-3 Consortium Taskforce will invite and select a test-panel.
FOUR STREAMS OF FIELD TESTING:
  • FT 1 – Coding Fun 1: coding in ICPC-3, based on real case descriptions, phrases and expressions coming from records.
    • For Coding Fun a coding tool is being developed, as a Progressive Web Application (PWA), which can be opened on a smartphone, tablet or PC.  FT 1 is open for testing!
  • FT 2 – Coding Fun 2: coding UseCases – quiz style, including Functioning UsesCases.
    • For this FT a dedicated website is under development.
  • FT 3 – testing the Index Terms for Regional Use.
    • Existing indexes from countries that use ICPC already, and have additional search terms are explored for missing terms. These terms need at least to be frequently used search terms, and require corresponding linkages to ICD-10, ICD11, ICHI, ICF or Snomed-CT, to be candidates for the ICPC-3 Index.
  • FT 4 – testing Usefulness of ICPC-3 for implementation.
    • Examples of UseCases are: recoding ICD-9 CM, using ICPC-3 (if possible with Canada).
    • WHO-Service Packages for Developing Countries as a UseCase for ICPC-3. This testing started a few months ago and proved the Usefulness of ICPC-3 already as explained below.
  • Please go to the Field Testing page for further information on the new content of ICPC-3.
Other businesses:
  • Contacts have been made between the newly formed WHO PHCPI group, the Consortium and WONCA CEO, resulting in cooperation between all parties.
  • WHO PHCPI has been studying on usefulness of ICPC-3 – structure and classes from Signs, symptoms and abnormal findings te be used within the Frame for Service Packages for developing Countries as part of Universal Health Coverage (UHC) and the Sustainable Development Goals (SDG’s).  The International Classification of Primary Care (ICPC-3) provided  structure and nomenclature for common presentations found in frontline care including symptoms and syndromes.
  • Publication of the new version of ICPC-3. Contacts with the Publisher have been made. The work will be planned after finalization of the present project, but needs preparation by the ICPC-3 Consortium.
  • The Steering Group advocated for visibility of ICPC-3 on WONCA website, being an important landmark for Primary Health Care.
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Suggested ICPC-3 Framework, including Functioning:

Working method:

To achieve the new content, present content of the ICPC 2.7, has been reviewed and revised from an International and National perspective.

International:

This work has been done within the Consortium Core-Group and WICC. The input from WICC is through membership of the ICPC-3 Consortium Taskforce. As a dedicated body represented within the Consortium by one of the Taskforce-members, the WICC members have been reviewing all chapters of ICPC 2.7, based on a set of criteria. The result of the review is provided as proposals for the ICPC-3 and processed by the ICPC-3 Consortium Secretariat, in view of the criteria.

National:

The Country Members of the Taskforce have been reviewing the ICPC 2.7 on content that is of relevance, and is not present, or cannot be registered as a separate entity for the Countries own needs. Frequently used National classes are added to the ICPC-3 “Regional Extensions”.

All results of the reviews are processed within the ICPC-3 Comment site.

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