WHO/Europe helps Central Asian countries transition to an improved International Classification of Diseases

WHO/Europe is supporting 5 Central Asian countries to make the transition to the new and improved 11th Revision of the International Classification of Diseases (ICD-11), an essential health information tool for the classification of medical conditions and disease that allows health professionals across the globe to make and record accurate and swift diagnoses.

From 10–12 March 2021, WHO conducted a workshop for approximately 30 representatives from the ministries of health from 5 Central Asian republics as part of the Central Asian Republics Information Network (CARINFONET), which includes Kazakhstan, Kyrgyz Republic, Tajikistan, Turkmenistan and Uzbekistan. The workshop focused on:

• the content, structure and maintenance of, and changes to, the ICD-11;
• ICD coding skills, namely, the transformation of every diagnosis, description of symptoms and cause of death into universal medical designations; and
• identifying technical requirements needed at the country level to ensure an efficient transition to the new system.

To assist the CARINFONET countries in their efforts towards effective transition, WHO/Europe will also be assessing and providing valuable feedback to the national roadmaps and strategies for implementation that participants from each of the countries are developing.

Designed for the global digital age

Preparing countries to implement the fully electronic ICD-11 and to have health statistics reported through it, by the designated time target of January 2022, is a massive undertaking. The workshop helped strengthen the capacity of countries to reach this goal.

Participants included health care professionals, medical coding specialists, e-health and IT experts, and government officials. Interconnecting the multipurpose, multilingual, user-friendly ICD-11 database with electronic hospital information systems will require multisectoral involvement. The fully digital nature of ICD-11 will assist implementation, reduce errors in diagnosis, and make it more adaptable for local contexts.

Steps toward full implementation include:

• mapping the existing country ICD-10 classifications to support translation and statistical continuity during the transition;
• introducing the new system in all health care facilities across the country;
• developing and implementing training for health care workers on coding; and
• translating the entire ICD into local languages.

The translation task alone is an arduous one as it needs to involve medical associations and local coordinators and must undergo final government approval.

New system will help patients, health care professionals and researchers

The ICD-11, with its 55 000 unique codes of injuries, diseases and causes of death, is a substantial improvement to its previous version that counted only 14 400 entries. The overall improvements to coding also allow for more precise and detailed data recording and collection. It will play an influential role in informing policy-making, clinical practice and research that affects end-users.

Some of the changes address mental health, such as the entry on post-traumatic stress disorder, where simpler diagnostic descriptions and a reduction in criteria are expected to facilitate diagnoses, thereby making treatment more accessible to patients in need. Addictive conditions, such as gaming and hoarding disorders, have also been added to the classification.

These and other revisions will help clinicians by providing more accurate clinical information, and it will contribute to developing a fuller picture of a patient’s health over time. The degree of detail and amount of data gathered on a specific disease or condition will also support global health researchers, data collection specialists and epidemiologists.

WHO to continue its support

While it may take years for the system to be fully operational in all regions of a country, it will eventually contribute to help answer some of the most pressing questions about a variety of health concerns for patients.

For this change to come about as efficiently and effectively as possible, WHO/Europe will continue to offer assistance to the CARINFONET countries beyond the workshop, by providing technical support and sharing valuable information that other Member States, which have already moved towards ICD-11 and have started on its implementation, have gathered to date.

WHO/Europe’s commitment to helping countries move towards ICD-11 implementation is part of larger efforts geared towards strengthening national health information systems, which is a priority area of focus identified in the European Programme of Work. To this end, WHO/Europe is also working to establish the European Network of the WHO Family of International Classifications (European WHO-FIC), a network of WHO Collaborating Centres, NGOs and experts that promotes the implementation, use, maintenance and updating of the WHO reference health classifications, which includes the ICD-11.