Medical researchers cheer release of new global standard for disease reporting

With this week’s release of the 11th edition of the International Classification of Diseases (ICD) comes a powerful tool to track epidemics, spot trends before they become emergencies, and better allot health-care resources locally and globally.

The ICD is the World Health Organization’s (WHO) international standard for reporting, monitoring and measuring disease and morbidity. The system provides a precise, unified language that is critical for the effective sharing and communicating of disease data across borders and around the world. A group of dedicated O’Brien Institute for Public Health researchers at the Cumming School of Medicine have spent the last five years making sure ICD-11 is the most accurate, most versatile, and complete ICD to date.

These scientists were central to the creation of the latest iteration of an international standard that is essential to all aspects of health — from how a diagnosis is acted upon and how many health services a community requires, to identifying trends in chronic diseases and understanding the true scale of the next pandemic. Leading the charge on behalf of the University of Calgary were the O’Brien Institute’s WHO Collaborating Centre for Classification, Terminology and Standards, led by Dr. Hude Quan, PhD, and institute scientific director Dr. William Ghali, MD, who serves as chair of the quality and safety committee.

“ICD-11 will create better health-care information, better health-care information creates better tools, and better health information systems in hospitals leads to better care and better health,” says Ghali of the potential for ICD-11.

When a new disease arises, such as an Ebola outbreak, it is coded and classified within the ICD to allow for accessibility of information to effectively diagnose and treat patients, and to track the extent and the speed of the spread.

But much more than just a reporting system, the ICD serves a critical role in the health-care system, explains Ghali. ICD’s core functions include tracking causes of death, monitoring the health of populations, and providing financial insight into health systems.  

The ICD is foundational to health in a global context and helps answer questions and track key information such as the number of patient deaths due to heart attacks or how many patients were seen with symptoms of pneumonia within the past six months within a specific region.

“The ICD creates the building blocks for health information and serves as the backbone of our health-care system,” says Ghali.

Since the release of ICD-10 in 1990, the system has outgrown the one-code model approach to disease classification. Diseases are complex, complicated and can range in severity, and there is a need to specify areas of impact. The new ICD-11 reflects this demand by creating a user-friendly coding tool with more combinations, code mapping and clinical detail. The new system will also have the capability to translate codes to free text automatically, which will facilitate patient communication between health-care professionals. 

“This outstanding leadership by Drs. Quan, Ghali and the other members of the O’Brien team will help the global health community to capitalize on the benefits that ICD-11 will unlock,” says Dr. Marcello Tonelli, MD, associate vice-president (health research) at the University of Calgary. “The University of Calgary is very proud of this collaboration between the O’Brien Institute and the World Health Organization.”

Changing to the ICD-11 system will not happen overnight. Adapting information to a new system requires extensive preparation and when faced with the magnitude of change that comes along with ICD-11, careful attention needs to be at the forefront.

“Going forward there will be consultation with the Canadian Institute for Health Information (CIHI) to develop the Canadian strategy for implementing ICD-11. The preparation will be similar to the Y2K phenomenon; everything needs to be ready for the switch. Previously, the switches to the ICD have been updates to the system, but this time it is a big change and it is an exciting change because it is very powerful,” says Ghali.

Significant contributions to ICD-11 were also made by institute members Danielle Southern, senior statistician, and Cathy Eastwood with the O’Brien Institute’s Methods Hub. 

William Ghali is a professor in the departments of Medicine and Community Health Sciences and scientific director of the O’Brien Institute for Public Health and a member of the Libin Cardiovascular Institute of Alberta.

Hude Quan is a professor in the Department Community Health Sciences and member of O’Brien Institute for Public Health and the Libin Cardiovascular Institute of Alberta.