PATENT CLASSIFICATION INDEX
CONTENTS INTRODUCTION BASIC PRINCIPLES: HOW THE ICPC-?3 WAS BUILT THE PRIMARY CARE USE CASE DESCRIPTION, INCLUSION, EXCLUSION, CODING HINT, NOTE, INDEX TERMS AND CROSS REFERENCES EPISODES OF CARE: A CENTRAL CONCEPT IN PRIMARY HEALTH CARE STANDARD FOR USE OF REASON FOR ENCOUNTER STANDARD FOR USE OF HEALTH PROBLEMS AND NON-?DISEASE-?RELATED CARE EPISODES STANDARD FOR USE OF FUNCTIONING AND FUNCTIONING RELATED STANDARD FOR USE OF PROCESSES OF CARE (INTERVENTIONS) 10 STANDARD FOR USE OF REGIONAL EXTENSIONS, EMERGENCY CODES AND EXTENSION CODES 11 DESK VERSION, UPDATE PLATFORM AND UPDATES, LICENCING OF ICPC-?3, TRANSLATIONS 12 TABULAR LIST OF ICPC-?3 CLASSES CHAPTER THE CONTENT OF THE CLASSIFICATION HAS CHANGED, AND IT NOW HAS A FRAMEWORK AND CONTAINS NEW CHAPTERS THE CLASSIFICATION HAS A FRAMEWORK THAT UNDERLINES THE IMPORTANCE OF INTERRELATIONS BETWEEN ALL CHAPTERS OF THE ICPC FROM A PERSON-?CENTRED PERSPECTIVE THE CLASSIFICATION HAS A SYSTEMATIC LIST WITH A NEW STRUCTURE FOR THE SEQUENCE OF CHAPTERS: A NEW CHAPTER ENTITLED VISITS FOR GENERAL EXAMINATION, ROUTINE EXAMINATION, FAMILY PLANNING, PREVENTION AND OTHER VISITS, FOR NON-?PROBLEM-?RELATED REASONS FOR ENCOUNTER AND EPISODES CHAPTERS ON BODY/?ORGAN SYSTEMS HAVE NEW COMPONENTS RELATING TO SYMPTOMS, COMPLAINTS AND ABNORMAL FINDINGS, AND DIAGNOSES AND DISEASES A NEW CHAPTER ON SOCIAL PROBLEMS, COVERING SOCIAL AND ENVIRONMENTAL FACTORS A CHAPTER HEADED INTERVENTIONS AND PROCESSES, SUBDIVIDED INTO DIAGNOSTIC AND MONITORING INTERVENTIONS, THERAPEUTIC AND PREVENTIVE INTERVENTIONS, PROGRAMMES RELATED TO REPORTED CONDITIONS (A NEW COMPONENT), RESULTS, CONSULTATION, REFERRAL AND OTHER REASONS FOR ENCOUNTER, AND ADMINISTRATIVE A NEW CHAPTER ENTITLED FUNCTIONING, CONSISTING OF ACTIVITIES AND PARTICIPATION, AND FUNCTIONS A NEW CHAPTER CALLED FUNCTIONING RELATED, COVERING ENVIRONMENTAL FACTORS AND PERSONALITY FUNCTIONS A NEW CHAPTER ENTITLED REGIONAL EXTENSIONS, WITH NATIONAL OR REGIONAL CLASSES THE EXECUTIVE RESPONSE IS AS FOLLOWS: AFTER CONSIDERATION OF THE PROPOSALS PREPARED BY THE ICPC-?3 CONSORTIUM MEMBERS AND BROUGHT FORWARD BY THE ICPC-?3 STEERING GROUP ON THE INTERNATIONAL CLASSIFICATION FOR PRIMARY CARE –? THIRD EDITION, WONCA EXECUTIVES ACCEPTED AND ENDORSED THE ICPC-?3 ON 16 APRIL, 2021 THE EXECUTIVE RECOMMENDS THE USE AND IMPLEMENTATION OF THE FULL ICPC-?3 FOR ALL PRIMARY HEALTH CARE PROFESSIONALS ON A GLOBAL SCALE THE EXECUTIVE REQUESTS THE ICPC-?3 CONSORTIUM PUBLISHES THE ICPC-?3 MANUAL HISTORY OF THE ICPCI UNTIL THE MID-?1970S, MOST MORBIDITY DATA COLLECTED IN PRIMARY CARE RESEARCH WERE CLASSIFIED USING THE INTERNATIONAL CLASSIFICATION OF DISEASES (ICD) [1,2] THIS HAD THE IMPORTANT ADVANTAGE OF INTERNATIONAL RECOGNITION, AIDING COMPAR- ABILITY OF DATA FROM DIFFERENT COUNTRIES HOWEVER, THERE WAS THE DISADVANTAGE THAT THE MANY SYMPTOMS AND NON-?DISEASE CONDITIONS THAT WERE PRESENT IN PRIMARY CARE WERE DIFFICULT TO CODE WITH THE ICD, ORIGINALLY DESIGNED FOR APPLICATION TO MORTALITY STATISTICS AND WITH A DISEASE-?BASED STRUCTURE RECOGNISING THE PROBLEMS OF THE ICD AND THE NEED FOR AN INTERNATIONALLY RECOGNISED CLASSIFICATION FOR GENERAL PRACTICE, THE WONCA CLASSIFICATION COMMITTEE DESIGNED THE INTERNATIONAL CLASSIFICATION OF HEALTH PROBLEMS IN PRIMARY CARE (ICHPPC), FIRST PUBLISHED IN 1975[3] AND WITH A SECOND EDITION IN 1979[4] RELATED TO THE NINTH REVISION OF THE ICD ALTHOUGH THIS PROVIDED A SECTION FOR THE CLASSIFICATION OF SOME UNDIAG- NOSED SYMPTOMS, IT WAS STILL BASED ON THE ICD STRUCTURE AND REMAINED INADEQUATE A THIRD EDITION IN 1983 ADDED TO ITS CRITERIA FOR THE USE OF MOST OF THE CLASSES,[5] GREATLY ADDING TO THE RELIABILITY WITH WHICH IT COULD BE USED BUT NOT OVERCOMING ITS DEFICIEN- CIES FOR PRIMARY CARE A NEW CLASSIFICATION WAS NEEDED FOR BOTH THE PATIENT’S REASON FOR ENCOUNTER (RFE) AND THE PROVIDER’S RECORD OF THE PATIENT’S PROBLEMS AT THE 1978 WORLD HEALTH ORGANIZATION (WHO) INTERNATIONAL CONFERENCE ON PRIMARY HEALTH CARE IN ALMA ATA,[6] ADEQUATE PRIMARY HEALTH CARE WAS RECOGNISED AS THE KEY TO THE GOAL OF ‘HEALTH FOR ALL BY THE YEAR 2000’ SUBSEQUENTLY, BOTH WHO AND WONCA RECOGNISED THAT THE BUILDING OF APPROPRIATE PRIMARY CARE SYSTEMS TO CLASSIFIED INDEX OF SUBJECTS OF INVENTION ADOPTED IN THE U S PATENT OFFICE ALLOW THE ASSESSMENT AND IMPLEMENTATION OF HEALTH CARE PRIORITIES WAS ONLY POS- SIBLE IF THE RIGHT INFORMATION WAS AVAILABLE TO HEALTH CARE PLANNERS THIS LED TO THE DEVELOPMENT OF NEW CLASSIFICATION SYSTEMS LATER IN 1978, WHO APPOINTED WHAT BECAME THE WHO WORKING PARTY FOR DEVELOPMENT OF AN INTERNATIONAL CLASSIFICATION OF REASONS FOR ENCOUNTER IN PRIMARY CARE [7] THIS GROUP, MOST OF WHOSE MEMBERS WERE ALSO MEMBERS OF THE WONCA CLASSIFICATION COMMITTEE, DEVELOPED THE REASON FOR ENCOUNTER CLASSIFICATION (RFEC),[7,8,9] WHICH LATER BECAME THE ICPC AN RFE IS THE AGREED STATEMENT OF THE REASON(S) WHY A PATIENT ENTERS THE HEALTH CARE SYSTEM, REPRESENTING THE DEMAND FOR CARE BY THAT PERSON THIS MAY BE SYMPTOMS OR COMPLAINTS (E G HEADACHE OR FEAR OF CANCER), A KNOWN DISEASE (E G FLU OR DIABETES), A REQUEST FOR PREVENTIVE OR DIAGNOSTIC SERVICES (E G A BLOOD PRESSURE CHECK OR AN ECG), A REQUEST FOR TREATMENT (E G A REPEAT PRESCRIPTION), TO GET TEST RESULTS, OR AN ADMINISTRA- TIVE PURPOSE (E G TO GET A MEDICAL CERTIFICATE) THESE REASONS ARE USUALLY RELATED TO ONE OR MORE UNDERLYING PROBLEMS THAT THE DOCTOR FORMULATES AT THE END OF THE ENCOUNTER AS THE CONDITIONS THAT HAVE BEEN TREATED, WHICH MAY OR MAY NOT BE THE SAME AS THE RFE DISEASE CLASSIFICATIONS ARE DESIGNED TO ALLOW THE HEALTH CARE PROVIDER’S INTERPRET- ATION OF A PATIENT’S HEALTH CARE PROBLEM TO BE CODED IN THE FORM OF AN ILLNESS, DISEASE OR INJURY IN CONTRAST, THE RFEC FOCUSES ON DATA ELEMENTS FROM THE PATIENT’S PERSPEC- TIVE [7,10,11,12] IN THIS RESPECT, IT IS PATIENT ORIENTED RATHER THAN DISEASE ORIENTED OR PRO- VIDER ORIENTED THE RFE, OR DEMAND FOR CARE, GIVEN BY THE PATIENT HAS TO BE CLARIFIED BY THE PHYSICIAN OR OTHER PRIMARY CARE HEALTH WORKER BEFORE THERE IS AN ATTEMPT TO INTERPRET AND ASSESS THE PATIENT’S HEALTH PROBLEM IN TERMS OF A DIAGNOSIS OR TO MAKE ANY DECISION ABOUT THE PROCESS OF MANAGEMENT AND CARE THE WORKING GROUP DEVELOPING THE RFEC TESTED SEVERAL VERSIONS IN FIELD TRIALS IN THE COURSE OF THIS FEASIBILITY TESTING, IT WAS NOTED THAT THE RFEC COULD EASILY BE USED TO CLASSIFY SIMULTANEOUSLY THE RFES AND TWO OTHER ELEMENTS OF PROBLEM-?ORIENTED CARE: THE PROCESS OF CARE AND THE HEALTH PROBLEMS DIAGNOSED THUS, THIS CONCEPTUAL FRAMEWORK ALLOWED FOR THE EVOLUTION OF THE RFEC INTO THE ICPC PROBLEMS IN RELATION TO THE CONCURRENT DEVELOPMENT OF THE ICD-?10 PREVENTED WHO FROM PUBLISHING THE RFEC HOWEVER, WONCA WAS ABLE TO USE IT TO DEVELOP THE ICPC AND PUBLISHED THE FIRST EDITION IN 1987 [13] WHILE THE ICPC-?1 WAS MUCH MORE APPROPRIATE FOR PRIMARY CARE THAN PREVIOUS CLASSIFICATIONS BASED ON THE ICD FRAME- WORK, IT DID NOT PROVIDE INCLUSION CRITERIA FOR THE CLASSES OR ANY CROSS-?REFERENCING IT WAS, IN THIS RESPECT, LESS USEFUL THAN THE PREVIOUS PUBLICATION, ICHPPC-?2-?DEFINED, THOUGH IT REFERRED TO THE LATTER AS A SOURCE OF INCLUSION CRITERIA IN 1980 WONCA BECAME A NON-?GOVERNMENT ORGANISATION IN OFFICIAL RELATIONS WITH WHO, AND JOINT WORK SINCE THEN HAS LED TO A BETTER UNDERSTANDING OF THE REQUIREMENTS OF PRIMARY CARE FOR ITS OWN INFORMATION SYSTEMS AND CLASSIFICATIONS WITHIN AN OVERALL FRAMEWORK ENCOMPASSING ALL HEALTH SERVICES IN 1985 A PROJECT BEGAN IN SEVERAL EUROPEAN COUNTRIES TO USE THE NEW CLASSIFICATION SYSTEM TO PRODUCE MORBIDITY DATA FROM GENERAL PRACTICE FOR NATIONAL HEALTH INFORMA- TION SYSTEMS THIS INVOLVED TRANSLATIONS OF THE CLASSIFICATION AND COMPARATIVE STUDIES ACROSS COUNTRIES THE RESULTS WERE PUBLISHED IN 1993 IN A BOOK INCLUDING AN UPDATE OF THE ICPC [14] NEEDED TO BE ADJUSTED OR CHANGED EXPANDING THE ICPC WITH CLASSES ON FUNCTIONING, IN THE PAST 10 TO 15 YEARS, THE DESIRE TO DEVELOP THE ICPC-?3 DOMINATED THE AGENDA FOR WONCA INTERNATIONAL CLASSIFICATION COMMITTEE (WICC) MEETINGS A MAJOR STEP FORWARD IN 2017 WAS THE CREATION OF A CONSORTIUM OF COLLEGES OF FAMILY MEDICINE AND INTERESTED NATIONAL ORGANISATIONS, IN COLLABORATION WITH WONCA AND LED BY THE UNIVERSITY OF NIJMEGEN, TO FUND THE WORK INVOLVED IN JANUARY 2018 THE DEVELOPMENT PROJECT STARTED IN THE FIRST INSTANCE BY SETTING THE FRAMEWORK FOR THE NEW ICPC-?3, BASED ON THE MOST RECENT PRINCIPLES OF CLASSIFICATION DEVELOPMENT AND TAKING INTO ACCOUNT A VARIETY OF USER NEEDS THE PROJECT WAS COMPLETED WITHIN A TIME FRAME OF 3 YEARS, RESULTING IN THE LAUNCH OF THE ICPC-?3 BY WONCA PRESIDENT DONALD LI ON 15 DECEMBER, 2020 ICPC AND ICD THE ICPC HAS ALWAYS BEEN LINKED WITH THE WELL-?KNOWN AND WIDELY USED ICD, PUBLISHED BY WHO [18] THE FIRST EDITION OF THE ICPC CONTAINED A LIST OF CONVERSION CODES TO LINK TO THE ICD-?9 SINCE THEN, THE ICD-?10 WAS INTRODUCED, AND THE ICPC-?2 WAS CAREFULLY MAPPED TO THE ICD-?10 SO THAT CONVERSION SYSTEMS COULD BE USED EXTENSIVE EMPIRICAL RESEARCH HAS CONFIRMED THAT THE ICPC AND THE ICD ARE COMPLEMENTARY RATHER THAN IN COMPETITION THE ICPC DEALS WITH THE COMPLEXITY OF PRIMARY HEALTH CARE IN ALL RELE- VANT SETTINGS IN A COMPREHENSIVE MANNER THE ICD MAINLY SERVES FOR INTERNATIONAL COMPARABILITY OF MORTALITY DATA AND FOR NATIONAL MORBIDITY DATA, MAINLY IN HOSPITAL SETTINGS THE ICPC-?3 IS THE CEMENT OR GLUE BETWEEN THE DIFFERENT HEALTH CARE SETTINGS AND VERSIONS OF CLASSIFICATIONS USED IN THE ICPC-?3, IMPORTANT CONCEPTS FOR PRIMARY HEALTH CARE HAVE THEREFORE BEEN LINKED TO THE ICD-?10 AND THE ICD-?11 FROM ABOUT 9,000 MEANINGFUL TERMS (IN THE THESAURUS), 2,900 ARE LINKED TO THE ICD-?10 AND THE ICD-?11 AND 4,560 TO TERMS IN THE SYSTEMATIC NOMENCLATURE FOR MEDICINE –? CLINICAL TERMS (SNOMED CT) THE LINKAGES ARE BASED ON WHAT ARE IMPORTANT, FREQUENTLY USED AND MEANINGFUL CONCEPTS THESE RELATIONS ARE FURTHER EXPLAINED IN CHAPTER 4 NOTE I PART OF THE HISTORY OF THE ICPC GIVEN HERE IS IDENTICAL TO THE HISTORY IN THE ICPC-?2-?R REFERENCES 1 INTERNATIONAL CLASSIFICATION OF DISEASES, NINTH REVISION (ICD-?9) GENEVA, WORLD HEALTH ORGANIZATION, 1977 2 INTERNATIONAL STATISTICAL CLASSIFICATION OF DISEASES AND RELATED HEALTH PROBLEMS, TENTH REVISION (ICD-? 10) GENEVA, WORLD HEALTH ORGANIZATION, 1992 3 INTERNATIONAL CLASSIFICATION OF HEALTH PROBLEMS IN PRIMARY CARE (ICHPPC) CHICAGO, WORLD ORGANIZATION NATIONAL COLLEGES, ACADEMIES AND ACADEMIC ASSOCIATIONS OF GENERAL PRACTITIONERS/? FAMILY PHYSICIANS (WONCA)/?AMERICAN HOSPITAL ASSOCIATION (AHA), 1975 4 ICHPPC-?2 (INTERNATIONAL CLASSIFICATION OF HEALTH PROBLEMS IN PRIMARY CARE) OXFORD, OXFORD UNIVERSITY PRESS, 1979 5 ICHPPC-?2-?DEFINED: INTERNATIONAL CLASSIFICATION OF HEALTH PROBLEMS IN PRIMARY CARE 3RD ED OXFORD, OXFORD UNIVERSITY PRESS, 1983 6 REPORT OF THE INTERNATIONAL CONFERENCE ON PRIMARY HEALTH CARE, ALMA ATA, USSR, 6–?12 SEPTEMBER 1978 GENEVA, WORLD HEALTH ORGANIZATION 7 MEADS S THE WHO REASON FOR ENCOUNTER CLASSIFICATION WHO CHRONICLE 1983; 37 (5): 159–?162 8 LAMBERTS H, MEADS S, WOOD M CLASSIFICATION OF REASONS WHY PERSONS SEEK PRIMARY CARE: PILOT STUDY OF A NEW SYSTEM PUBLIC HEALTH REP 1984; 99: 597–?605 9 LAMBERTS H, MEADS S, WOOD M RESULTS OF THE INTERNATIONAL FIELD TRIAL WITH THE REASON FOR ENCOUNTER CLASSIFICATION (RFEC) MED SOCIALE PREVENTIVE 1985; 30: 80–?87 10 WORKING PARTY TO DEVELOP A CLASSIFICATION OF THE ‘REASONS FOR CONTACT WITH PRIMARY HEALTH CARE SERVICES’ REPORT TO THE WORLD HEALTH ORGANIZATION, GENEVA, SWITZERLAND, 1981 11 WOOD M FAMILY MEDICINE CLASSIFICATION SYSTEMS IN EVOLUTION J FAM PRACT 1981; 12: 199–?200 12 OLDE HARTMAN T, VAN RAVESTEIJN H, VAN BOVEN K, VAN WEEL-?BAUMGARTEN E, VAN WEEL C WHY THE ‘REASON FOR ENCOUNTER’ SHOULD BE INCORPORATED IN THE ANALYSIS OF OUTCOME OF CARE BR J GEN PRACT 2011; 61 (593): E839–?E841 13 LAMBERTS H, WOOD M (EDS ) ICPC: INTERNATIONAL CLASSIFICATION OF PRIMARY CARE OXFORD, OXFORD UNIVERSITY PRESS, 1987 14 LAMBERTS H, WOOD M, HOFMANS-?OKKES I (EDS ) THE INTERNATIONAL CLASSIFICATION OF PRIMARY CARE IN THE EUROPEAN COMMUNITY: WITH MULTI-?LANGUAGE LAYER OXFORD, OXFORD UNIVERSITY PRESS, 1993 15 BRIDGES-?WEBB C, BRITT H, MILES DA, NEARY S, CHARLES J, TRAYNOR V MORBIDITY AND TREATMENT IN GENERAL PRACTICE IN AUSTRALIA 1990–?1991 MED J AUST 1992; 157, SUPPL 19 OCT: S1–?S56 16 ICPC-?2, INTERNATIONAL CLASSIFICATION OF PRIMARY CARE PREPARED BY THE CLASSIFICATION COMMITTEE OF WONCA OXFORD, OXFORD UNIVERSITY PRESS, 1998 17 INTERNATIONAL CLASSIFICATION OF PRIMARY CARE ICPC-?2-?R OXFORD, OXFORD UNIVERSITY PRESS, 2005 18 WOOD M, LAMBERTS H, MEIJER JS, HOFMANS-?OKKES IM THE CONVERSION BETWEEN ICPC AND ICD-? 10: REQUIREMENTS FOR A FAMILY OF CLASSIFICATION SYSTEMS IN THE NEXT DECADE IN: LAMBERTS H, WOOD M, HOFMAN-?OKKES I (EDS ), THE INTERNATIONAL CLASSIFICATION OF PRIMARY CARE IN THE EUROPEAN COMMUNITY: WITH MULTI-?LANGUAGE LAYER OXFORD, OXFORD UNIVERSITY PRESS, 1993: 18–?24