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ICPC : recent advances,

research & teaching

• Marc Jamoulle, Gilly, Belgium.

• Jean Karl Soler, La Valette, Malta.

• Laurent Letrilliart, Lyon, France .

• Jan De Maeseneer, Ghent, Belgium

• Dimitris Kounalakis, Heraklion, Greece

WICC members

Wonca Europe, KOS, Sep.7, 2005

WICC, Heidelberg, Sep. 6, 2006

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Wonca InternationalClassification 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

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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.

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Main fields of research:

• ICPC

• Wonca Dictionary of General Practice

• Coop Wonca charts

• Dusoi-Wonca

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17 chapters

15somatic

1Psychologic

1 Social

3 components coming from 3 gathered classifications

Symptoms and complaints

Process Diagnoses

R F E CReason for Encounter Classification

IC-Proces-PCInternational Classificationof Process in Primary Care

ICHPPC

ICHPPC-2-dInternational Classification

of Health Problem inPrimary Care

1& 2 edition, defined &

ICPC

ICPC 2

Revision and inclusion of criteria and definitions

ICPC 2 RRevised transcoding to ICD-10

Towards ICPC 3

1974

1981

1983

1985

1987

1998

2005

1974

1979

ICPC story

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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

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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)

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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

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Comparison of chapter P diagnosis of two family doctors each in solo practice

Courtesy of Dr Joseph Huberty, Ciney, Belgium

A new insight in GP practice allowing quality assessment and

alternative teaching process

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200 Primary care practitionners in 5 years

Courtesy of Dr Alejandro Lopez, Buenos aires

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ICPC & Information needs in the health system

• Implies opening of the rubrics of ICPC

• Implies use of classified terminologies

» ICPC Plus / Encode FM / SNOMED/ 3BT

• Implies transcoding with main other tools

• ICPC/ICD carefully followed since the beginning

• ICPC admitted in the WHO family of Classification

• Implies ethical background

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• Z25       ASSAULT & HARMFUL EVENT•           bewitchment•           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•       

Cridland JS,.Koonin S. Use of traditional medicinestowards a classification. S.Afr.Med J 2001;91:489-91

Example of opening of an ICPC rubric

• Implies opening of the rubrics of ICPC

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October 2003• First WICC & WHO-FIC working meeting

• Implies transcoding with main other tools

ICPC accepted as a member of the

Word Health Organisation

Family of International Classification

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WHO-FIC

• WHO Family of International Classification

»ICD diseases

»ATC drugs

»ICF functions

»ICPC health problems

»ICHI Interventions

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Advances in terminology• Dutch Thesaurus ICPC / ICD

• ENCODE – FM (Canada)

• ICPC – PLUS (Australia)

• 3BT Biclassified Belgian Bilingual Thésaurus ICD / ICPC

• ICPC linked to UMLS metathesaurus

• SNOMED / ICPC working group

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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

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Availability

ICPC 2 R From Oxford University Press

ICPC 2 pager

From KITH web siteICPC 2 E

From Wonca / WICC web site

www.globalfamilydoctor.com/wicc

www.kith.no

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Thank you

marc@jamoulle.com