Who Family of International Classifications Network

WHO FAMILY OF INTERNATIONAL CLASSIFICATIONS WHOFIC/04.XXX NETWORK MEETING Reykjavik, Iceland 24-30 October, 2004 Title: WHO-FIC Education Committee: A Status Report, 2003-2004 Authors: Marjorie S. Greenberg, Chair National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA Purpose: for information and discussion Recommendations: • Post Acronyms and Abbreviations document on WHO-FIC Network website with hyperlinks • Endorse Guiding Principles for Disseminating Materials • Other recommendations will be presented in separate reports Abstract: The WHO-FIC Education Committee was established at the 2003 WHO-FIC Network meeting in Cologne, Germany, as a successor to the Subgroup on Training and Credentialing of the WHO-FIC Implementation Committee. The Subgroup held meetings at the 1999 - 2002 Collaborating Centres meetings, as well as a three-day meeting in Washington, D.C., in 2003, to make progress on an international training and credentialing program for ICD-10 mortality and morbidity coders. A proposal for such a program had been developed by the Subgroup in 2000 and endorsed in principle by the International Federation of Health Records Organizations (IFHRO). During the Cologne meeting, the participants developed new terms of reference to reflect generic tasks for education and training on the International Statistical Classification of Diseases and Related Health Problems (ICD) and the International Classification of Functioning, Disability and Health (ICF). Specific tasks were agreed for ICD, based on the Subgroup’s previous terms of reference. Specific tasks for ICF were developed and agreed through e-mail exchange during 2004. The WHO-FIC Education Committee Chair has prepared a discussion paper on the ICF tasks for consideration at a joint session of the WHO-FIC Implementation and Education Committees in Reykjavik. Following the Cologne meeting, the needs assessment questionnaires for ICD-10 mortality and morbidity coders were finalized and circulated to WHO Regional Offices and Collaborating Centers for distribution to the member states. The WHO-FIC Education Committee held a second three-day meeting in Prague, Czech Republic, on May 26-28, 2004 to review the responses received to the questionnaires and advance work on the international program proposal. Substantial progress was made on defining core curricula for underlying cause-of-death coders and morbidity coders and on developing a business plan for standardized ICD-10 training and international certification. The participants also discussed plans for presenting the international proposal at the 14th Congress of IFHRO on October 9-14, 2004 in Washington, D.C. Introduction The WHO-FIC Education Committee was established at the 2003 WHO-FIC Network meeting in Cologne, Germany, as a successor to the Subgroup on Training and Credentialing of the WHO-FIC Implementation Committee. The new name and status as a Committee was in recognition of the broader educational focus required for the WHO-FIC and the fact that education and training are important beyond the implementation phase of a classification. The Subgroup had held meetings at the 1999 - 2002 Collaborating Centres meetings, as well as a three-day meeting in Washington, D.C., in 2003, to make progress on an international training and credentialing program for ICD-10 mortality and morbidity coders. The purpose of this program is improve the quality of mortality and morbidity data and the status of ICD coders. During the Cologne meeting, the participants developed new terms of reference to reflect generic tasks for education and training on the International Statistical Classification of Diseases and Related Health Problems (ICD) and the International Classification of Functioning, Disability and Health (ICF). Specific tasks were agreed for ICD, based on the Subgroup’s previous terms of reference. Specific tasks for ICF were developed and agreed through e-mail exchange during 2004. The new terms of reference for the Committee are included as Attachment 1. The WHO-FIC Education Committee held a second three-day meeting in Prague, Czech Republic, on May 26-28, 2004 to review the responses received to its needs assessment questionnaires for mortality and morbidity coders and to advance work on the international program for ICD-10 coders. Twenty-two persons from ten countries, the World Health Organization (WHO) and the International Federation of Health Records Organizations (IFHRO) participated in the meeting. The full meeting summary is available on the North American Collaborating Center (NACC) website at http://www.cdc.gov/nchs/about/otheract/icd9/nacc_education.htm. Substantial progress was made during the Prague meeting on defining core curricula for underlying cause-of- death coders and morbidity coders and on developing a business plan for standardized ICD-10 training and international certification. The participants also discussed plans for presenting the international proposal at the 14th Congress of IFHRO on October 9-14, 2004. The outcome of the discussions at IFHRO will be presented at the 2004 WHO FIC Network meeting in Reykjavik. In regard to addressing the specific ICF tasks for the Education Committee, the Committee Chair has prepared a discussion paper for consideration at a joint session of the WHO-FIC Implementation and Education Committees in Reykjavik. Several members of the Committee also have prepared papers about ICF educational activities in their respective countries. This paper provides a summary report of the Committee’s activities and progress since the 2003 Cologne meeting. Separate papers by the Chair and several Committee members will provide greater detail and recommendations on key aspects of the Committee’s work plan. ICD-10 Mortality and Morbidity Training 2 Needs Assessment Questionnaires Needs assessment questionnaires for ICD-10 mortality and morbidity medical coders were developed, translated and circulated to regional offices and collaborating centres in 2002; preliminary results were reported at the 2002 annual meeting of collaborating centres. The response rate was quite low, and it was clear that several respondents misinterpreted a few of the questions. During the April 2003 Subgroup meeting in Washington, D.C., it was agreed that the questionnaires should be revised to clarify questions and facilitate data analysis and then re-fielded to all countries, regardless of whether they had implemented ICD-10. The revised questionnaires were reviewed during the Cologne meeting in October 2003, and it was decided that several questions should be added about the status of ICD-10 implementation to assist in the “stocktaking” of the WHO-FIC Implementation Committee. The Education Committee Chair circulated the new questionnaires to regional offices and collaborating centers in February 2004. As with the earlier questionnaires, the Pan American Health Organization had translated the questionnaires into French, Portuguese and Spanish. The Australian Collaborating Centre entered the responses into a data base and provided a preliminary report at the May 2004 meeting in Prague. At that time, nearly 100 responses had been received from all of the WHO Regions. A separate paper by Walker and McKenzie reports on the findings from the surveys received as of August 2004. Participants in the Prague meeting had agreed that the preliminary results were extremely interesting and should guide future work of the WHO-FIC Education and Implementation Committees. International Training and Credentialing Proposal The Subgroup had developed a proposal for an International Training and Credentialing Program for ICD-10 mortality and morbidity coders, which was endorsed in principle by the IFHRO Executive Committee in 2000. There was strong agreement that WHO and the collaborating centres should partner with a non-governmental organization, such as IFHRO, to accomplish these objectives. This initial approach had been discussed with IFHRO representatives and subsequently in 2003 with the IFHRO Executive Committee in Rochdale, England and with Willem Hogeboom, President of IFHRO, who attended a session of the Education Committee in Cologne. While the IFHRO Executive Committee was agreeable in principle, the members requested a business plan from the WHO-FIC Network to see how the proposal could be progressed. It was recognized that both WHO and IFHRO had limited financial resources, and a key concern was how the international credential could be supported. Development of a business plan was one of the motivating factors for holding the 2004 meeting in Prague, in anticipation of the upcoming IFHRO Congress. A major focus of the Prague meeting was to make progress on core curricula for mortality and morbidity coders and to develop the business plan. The core curricula, which were initiated at the 2002 Subgroup meeting in Brisbane and further developed in the Washington, D.C. 2003 meeting, were considerably expanded in Prague and refined for review and approval by the WHO-FIC Network and the IFHRO General Assembly in October 2004. 3 The group also tentatively agreed on a strategic approach for implementing the International Training and Credentialing Program, with an initial focus on awarding an international certificate. This would include review and approval of existing training materials for ICD-10 mortality and morbidity coders, using the core curricula as the benchmark; development of “gold standard” core training packages, which would be based on a modular

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