ICD-11 and ICHI: Terminology, Overview, and Purpose
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I
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H
I
I
C
D
•
International Classification of Diseases
•
International
Statistical
Classification
of
Diseases
and
related
health
problems
I
C
H
I
•
International
Classification
of Health
I
n
t
e
r
v
e
n
t
io
n
s
•
Interventions for
treatment,
prevention
and
diagnostics: medical,
nursing,
rehabilitation,
laboratory,
imaging,
ultrasound,
public
health.
T
e
r
m
i
n
o
l
o
g
y
WHO
-
FIC
W
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C
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s
W
H
O
T
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r
m
i
n
o
l
o
g
i
e
s
-
WHO INN (non
proprietary
names
-
medicaments)
-
WHO
Devices
-
ICD-O
-
Histopathology
(tumours)
-
Anatomy
-
Details
of
external
causes
-
Severity
-
Infectious
agents
I
CD
I
CF
I
CHI
R
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l
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C
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,
S
t
a
n
d
a
r
d
s
-
ICNP
Nursing
-
ICPC
Family med.
Aspects
-
ATC
Medicament
dosage
use
-
Orphanet
Rare
diseases
-
LOINC/NPU
Laboratory
O
t
h
e
r
s
y
s
t
e
m
s
(
O
B
O
,
H
P
O
,
S
N
O
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E
D
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D
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m
o
n
F
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d
a
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o
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C
D
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1
1
•
Legally mandated health data standard (WHO Constitution and Nomenclature
Regulations)
•
In effect from January 2022
•
Conceptual framework independent of language and culture
•
Integration of terminology and classification
•
End-to-end digital solution (API, tools, online and offline)
•
Up-to-date scientific knowledge
•
Comparable statistics and semantic interoperability - for 150 years
•
Distributed under Creative Commons Attribution-NoDerivs 3.0 IGO license
July 20, 2024
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•
Allows the systematic recording, analysis, interpretation and comparison of mortality and
morbidity data collected in different countries or regions and at different times;
•
Ensures semantic interoperability and reusability of recorded data for the different use
cases beyond mere health statistics, including decision support, resource allocation,
reimbursement, guidelines and more.
July 20, 2024
7/20/2024
D
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s
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g
n
e
d
f
o
r
M
u
l
t
i
p
l
e
U
s
e
s
ICD-10
Statistical
system
imposed
for
clinical
use
Primitive
structure
with
focus
on
statistics.
Missing
a
lot
of
clinical
detail
product
Codes
and
URI
Combinations:
1
4
000
stat.
categories
(codes)
Separate
text
index
Separate
rule
base
Need
terminology
link
30
years
outdated
content
WO
-
FIC
8
Codes
and
URI
C
o
mbin
a
t
ion
s
:
1
7
000
stat.
categories
(codes)
8
0
000
entities
12
0
000
terms
>
1
6
0
0
000
terms
with
formalized
post-
coordination
Searchable in
“Google style”
without
training
ICD-11
Clinical
systems
for
statistical
use
•
Ontology with
multiple
parenting
from
which
statistical
information
is
derived.
•
All
desired
clinical
detail
•
codable,
eventually
with
code
combinations
•
More detail
beyond
statistical
categories (foundation
in
yellow)
•
Input
from clinical
modifications
of
ICD-10
U
p
d
a
t
i
o
n
i
n
V
e
r
s
i
o
n
-
1
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•
N
e
w
c
h
a
p
t
e
r
s
a
n
d
s
e
c
t
i
o
n
s
•
Diseases
of
the
immune
system
•
Sleep
wake
disorders
•
Conditions
related
to
sexual
health
•
Optional
section
Traditional
Medicine
Conditions
•
Disability
assessment
Scheme
(WHO-
DAS)
•
Redesigned Diseases of Skin
•
Improved functioning of External causes
I
n
l
i
n
e
w
i
t
h
m
a
j
o
r
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t
e
r
n
a
t
i
o
n
a
l
i
n
i
t
i
a
t
i
v
e
s
,
a
s
•
Patient
safety
reporting
•
Antimicrobial
resistance
documentation
•
Detail
for
DRG
(integration
of
clinical
modifications
of
ICD)
•
Detail
for
primary
care
U
p
d
a
t
i
o
n
i
n
V
e
r
s
i
o
n
-
1
1
•
C
o
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s
f
o
r
C
O
V
I
D
-
1
9
•
N
e
o
p
l
a
s
m
s
New
hierarchy
Inclusion
of
histopathology,
basalioma,
melanoma
types
Coding
for
Grade
and
Stage
•
N
e
r
v
o
u
s
s
y
s
t
e
m
More
clinical
detail
Moved
cerebrovascular
diseases
here
•
C
a
r
d
i
o
v
a
s
c
u
l
a
r
s
y
s
t
e
m
Myocardial
infarction
STEMI-
non-STEMI
updated
arrhythmias
and
pulmonary
hypertension
I
C
D
-
1
1
-
s
t
a
t
i
s
t
i
c
a
l
c
o
r
e
(
2
6
c
h
a
p
t
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r
s
)
Need
for
Health
se
r
v
i
c
es
Cond
i
t
i
on
s
F
a
c
t
o
r
s
influencing
Maternal
Neonate
General
population
Tr
a
u
m
a
I
n
f
e
c
t
i
o
n
Congenital
O
t
h
e
r
Tu
m
o
u
r
B
l
oo
d
Endocrine
Psychiatry
Ne
u
r
o
Ey
e
Ea
r
Cardiovascular
Respiratory
Digestive
S
k
i
n
M
u
s
c
ul
o
s
k
el
e
t
a
l
Urogenital
S
i
g
n
s
S
y
m
p
t
o
m
s
Ex
t
e
r
n
a
l
ca
u
se
I
mm
un
e
sy
st
e
m
S
e
x
u
a
l
Health
Sl
e
e
p
-
W
a
k
e
T
r
a
d
i
t
i
o
n
a
l
m
e
d
i
c
i
n
e
c
o
n
d
i
t
i
o
n
s
(optional
dual
coding)
An
c
ie
n
t
C
h
i
n
e
s
e
r
oot
s
Ancient
India
roots
Functioning
a
s
sess
m
e
n
t
(WHO
DAS2)
Need
for
treatment
of
illnesses
Conditions
need
specific
treatment
Conditions
-
Classification
Diagnoses
Injuries
Signs
S
y
m
p
t
oms
Findings
Reasons
for
encounter
or
health
status
External
causes
of
illness
&
death
Infectious agents
and
AMR
Histopathology
(ICD-O)
Chemicals and Medicaments (INN)
Devices
Mechanisms
of harm
(Safety)
Activities
Places
O
b
j
ec
t
s
Severity
Temporality
Anatomy
Laterality
Con
s
c
i
ou
s
ne
s
s
Traditional
medicine
conditions
Functioning
assessment
–
WHO-DAS2
Extension codes
-
Terminology
C
o
d
i
n
g
P
a
t
t
e
r
n
E
a
s
y
t
o
u
s
e
m
u
l
t
i
p
l
e
t
o
o
l
s
Guide
for
implementation
of
ICD-11
*
timelines
–
steps
–
questions
Mappings
ICD-11
self
learning
training
online
Field
implementation
and
testing
platform
Webinars
and
online
class
for
coding
DRG
system
(under
development)
API
and
coding
tool
that
can
be
embedded
LOCALLY
or
ONLINE
Type
a
diagnostic
statement
into
the
Coding
Tool
e.g.
cancer
of
stomach
The
Coding
Tool
will
find
the
best
match
E
a
s
y
t
o
u
s
e
e.g.
Osteoarthritis
of
right
knee
The Coding
Tool
will find the
best
match
including
the
code
combination
(postcoordination) information
for
left or right
(laterality)
E
a
s
y
t
o
u
s
e
Type
a
diagnostic
statement
into
the
Coding
Tool
I
C
D
-
1
1
B
e
n
e
f
i
t
s
•
I
m
p
r
o
v
e
d
u
s
a
b
i
l
i
t
y
o
Less
training
o
Easily
add
all clinical
detail
Add
terms
•
I
m
p
r
o
v
e
d
u
s
a
b
i
l
i
t
y
o
Less
training
o
Easily
add
all clinical
detail
Add
terms
•
U
p
-
t
o
-
d
a
t
e
s
c
i
e
n
t
i
f
i
c
k
n
o
w
l
e
d
g
e
•
B
e
t
t
e
r
u
s
e
o
f
h
e
a
l
t
h
r
e
s
o
u
r
c
e
s
o
DRG
o
Patient
Safety
•
I
m
p
r
o
v
e
d
i
n
c
o
r
p
o
r
a
t
i
o
n
i
n
e
l
e
c
t
r
o
n
i
c
e
n
v
i
r
o
n
m
e
n
t
s
•
C
l
i
n
i
c
a
l
t
e
r
m
s
•
L
i
n
k
a
g
e
t
o
r
e
l
e
v
a
n
t
o
t
h
e
r
c
l
a
s
s
i
f
i
c
a
t
i
o
n
s
a
n
d
t
e
r
m
i
n
o
l
o
g
i
e
s
O
n
l
i
n
e
a
n
d
o
f
f
l
i
n
e
–
d
i
g
i
t
a
l
–
p
a
p
e
r
•
C
r
e
a
t
i
v
e
c
o
m
m
o
n
s
l
i
c
e
n
s
e
=
f
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e
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f
o
r
c
o
m
m
e
r
c
i
a
l
a
n
d
n
o
n
-
c
o
m
m
e
r
c
i
a
l
u
s
e
•
The International Classification of Health Interventions (ICHI) is a common tool for
reporting and analysing health interventions for clinical and statistical purposes.
•
ICHI covers interventions carried out by a broad range of providers across the full scope of
health systems and includes interventions on: diagnostic, medical, surgical, mental health,
primary care, allied health, functioning support, rehabilitation, traditional medicine and
public health.
•
The classification is built around three axes: Target (the entity on which the Action is
carried out), Action (a deed done by an actor to a target) and Means (the processes and
methods by which the Action is carried out).
I
C
H
I
I
C
H
I
m
u
l
t
i
p
l
e
u
s
e
s
•
Extension codes are shared with ICD and ICF in the common foundation and allow
users to describe additional detail about the intervention in addition to the relevant
ICHI code. A simple, logical syntax links ICHI stem codes and extension codes,
interventions performed together, and packages of interventions.
•
The number of categories in ICHI, is determined with regard to the use cases for ICHI
and the need for stability of the classification over time. The terminological core
allows for a high level of detail (granularity) for all kinds of clinical documentation and
data usage.
•
The Beta-3 version of ICHI was released in October 2020. The component relating to
clinical interventions has been finalized. The components on functioning interventions
and public health interventions are under final review and are finalized 2021
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THANK YOU
International Classification of Diseases (ICD-11) and International Classification of Health Interventions (ICHI) provide a comprehensive framework for recording and analyzing health data globally. The system ensures semantic interoperability, integrates terminology and classification, and supports various use cases beyond basic health statistics. Designed for multiple applications, including decision support, resource allocation, reimbursement, and guideline development. Explore the terminology, overview, and key uses of ICD-11 and ICHI for effective health data management and analysis.
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Presentation Transcript
Overview of ICD-11/ICHI
Terminology ICD International Classification of Diseases International Statistical Classification of Diseases and related health problems ICHI International Classification of Health Interventions Interventions for treatment, prevention and diagnostics: medical, nursing, rehabilitation, laboratory, imaging, ultrasound, public health.
Common Foundation Extension Codes WHO Terminologies ICD WHO INN (non proprietary names - medicaments) WHO Devices ICD-O - Histopathology (tumours) Anatomy Details of external causes Severity Infectious agents - ICHI - - WHO WHO core c classifi lassific ca at tio ion ns s core Related Classifications, Terminologies, Standards - - ICF ICNP Nursing ICPC Family med.Aspects ATC Medicament dosage use Orphanet Rare diseases LOINC/NPU Laboratory - - - - - - - Other systems (OBO, HPO, SNOMED, MedDRA) WHO-FIC
ICD-11 Legally mandated health data standard (WHO Constitution and Nomenclature Regulations) In effect from January 2022 Conceptual framework independent of language and culture Integration of terminology and classification End-to-end digital solution (API, tools, online and offline) Up-to-date scientific knowledge Comparable statistics and semantic interoperability - for 150 years Distributed under Creative Commons Attribution-NoDerivs 3.0 IGO license July 20, 2024
ICD Purpose and Uses As a classification and terminology ICD-11: Allows the systematic recording, analysis, interpretation and comparison of mortality and morbidity data collected in different countries or regions and at different times; Ensures semantic interoperability and reusability of recorded data for the different use cases beyond mere health statistics, including decision support, resource allocation, reimbursement, guidelines and more. July 20, 2024
Designed for Multiple Uses 7/20/2024
Codes and URI Combinations: 14000 stat.categories (codes) ICD-10 Statistical system imposed for clinical use Separatetextindex Separaterulebase Primitive structure with focus on statistics. Missing a lot of clinical detail Print product Need terminologylink 30 yearsoutdated content 8 WO-FIC
ICD-11 CodesandURI Combinations: 17000 stat.categories (codes) Clinical systems for statistical use 80000 entities Ontology with multiple parenting from which statistical information is derived. All desired clinical detail codable, eventually with code combinations More detail beyond statistical categories (foundation in yellow) 120000 terms >1600000 terms with formalized post- coordination Input from clinical modifications of ICD-10 Searchable in Google style without training
Updation in Version-11 New chapters and sections Diseases of the immune system Sleep wake disorders Conditions related to sexual health Optional section Traditional Medicine Conditions Disability assessment Scheme (WHO- DAS) Redesigned Diseases of Skin Improved functioning of External causes In line with major international initiatives, as Patient safety reporting Antimicrobial resistance documentation Detail for DRG (integration of clinical modifications of ICD) Detail for primary care
Updation in Version-11 Codes for COVID-19 Neoplasms New hierarchy Inclusion of histopathology, basalioma, melanoma types Coding for Grade and Stage Nervous system More clinical detail Moved cerebrovascular diseases here Cardiovascular system Myocardial infarction STEMI- non-STEMI updated arrhythmias and pulmonary hypertension
ICD-11 -statistical core (26 chapters) Traditional medicine conditions (optional dual coding) Ancient Chinese roots Need for treatment of illnesses Conditions need specific treatment Need for Health services Conditions Factors influencing Ancient India roots External cause Maternal Neonate General population Functioning assessment (WHO DAS2) Trauma Infection Congenital Tumour Other Eye Ear Sexual Health Immune system Psychiatry Respiratory Skin Urogenital Blood Cardiovascular Digestive Musculoskeletal Endocrine Neuro Signs Symptoms Sleep- Wake
Coding Pattern Extension codes- Terminology Conditions - Classification Severity Temporality Anatomy Laterality Consciousness Diagnoses Injuries Signs Symptoms Infectious agents and AMR Histopathology (ICD-O) Findings Chemicals and Medicaments (INN) Reasons for encounter or health status Devices External causes of illness & death Mechanisms of harm (Safety) Activities Places Objects Traditional medicine conditions Functioning assessment WHO-DAS2
Easy to use multiple tools Guide for implementation of ICD-11* timelines steps questions Mappings ICD-11 self learning training online Field implementation and testing platform Webinars and online class for coding DRG system (under development) API and coding tool that can be embedded LOCALLY or ONLINE
Easy to use Type a diagnostic statement into the Coding Tool e.g. cancer of stomach The Coding Toolwill find the best match
Easy to use Type a diagnostic statement into the Coding Tool e.g. Osteoarthritis of right knee The Coding Tool will find the best match including the code combination (postcoordination) information for left or right (laterality)
ICD-11 Benefits Improved usability o Less training o Easily add all clinical detail Add terms Improved usability o Less training o Easily add all clinical detail Add terms Up-to-date scientific knowledge Better use of health resources o DRG o Patient Safety Improved incorporation in electronic environments Clinical terms Linkage to relevant other classifications and terminologies Online and offline digital paper Creative commons license = free for commercial and non- commercial use
ICHI multiple uses The International Classification of Health Interventions (ICHI) is a common tool for reporting and analysing health interventions for clinical and statistical purposes. ICHI covers interventions carried out by a broad range of providers across the full scope of health systems and includes interventions on: diagnostic, medical, surgical, mental health, primary care, allied health, functioning support, rehabilitation, traditional medicine and public health. The classification is built around three axes: Target (the entity on which the Action is carried out), Action (a deed done by an actor to a target) and Means (the processes and methods by which the Action is carried out). ICHI
ICHI multiple uses Extension codes are shared with ICD and ICF in the common foundation and allow users to describe additional detail about the intervention in addition to the relevant ICHI code. A simple, logical syntax links ICHI stem codes and extension codes, interventions performed together, and packages of interventions. The number of categories in ICHI, is determined with regard to the use cases for ICHI and the need for stability of the classification over time. The terminological core allows for a high level of detail (granularity) for all kinds of clinical documentation and data usage. The Beta-3 version of ICHI was released in October 2020. The component relating to clinical interventions has been finalized. The components on functioning interventions and public health interventions are under final review and are finalized 2021
ICHI multiple uses National use of ICHI Patient safety and quality HealthSystemPerformance FrameworkforWHOinterventions Internationalcomparison SustainableDevelopmentindicators UniversalHealthindicators essentialinterventions
