January 2019 report of WICC

WONCA International Classification Committee (WICC) chair, Prof Thomas Kühlein, writes:

Group membership
The current Chair of WICC is Thomas Kuehlein (Germany) and the deputy Chair is Kees van Boven (Netherlands)#

The executive committee consists of:
Thomas Kuehlein (Germany)
Kees van Boven (Netherlands)
Jean-Karl Soler (Malta)
Olawunmi Olagundoye (Nigeria)
Laurent Letrillart (France)

The governance committee consists of Diego Schrans (Belgium), Preben Larsen (Denmark), Julie Gordon (Australia).

The WICC is organised according to its policy document.

1. Achievements over the last biennium (between World Councils)
The main achievement is that mainly Kees van Boven managed to obtain money from different countries interested in the use of ICPC and willing to fund the development of ICPC-3 via a Consortium. At the moment the Consortium consists of WONCA World, WONCA Europe, Radboud University Nijmegen and an increasing number of participating countries. The ICPC-3 Project started January 2018 and runs for a period of three and half years. It has been the main topic of the WICC annual meetings in 2017 in Lyon (France) and in 2018 in Lviv (Ukraine).

The annual WONCA International Classification Committee (WICC) meeting in 2018 was held from 25 - 31 August in Lviv/Ukraine. There were 26 members and observers participating. The main topic was the development of ICPC-3 under organizational leadership of a Consortium under the lead of Kees van Boven at the University of Nijmegen/Netherlands. Another important topic was the development of a primary care version (linearization) of ICD-11 in collaboration with WHO.

The website informing about the work of WICC is the PH3C-website (link at bottom). This web-site was developed and maintained under the leadership of Marc Jamoulle (Belgium) who in Lviv handed it over to Heinz Bhend (Switzerland) who is going to reconstruct it technically and organizationally.

This year’s meeting of WICC will be held in Crete in Greece from 22 -26 September 2019. Again, the main topic will be the collaboration of WICC and the Consortium and common work on content of ICPC-3. Vivid discussions are to be expected. Anybody interested in the work of WICC will be welcome.

WICC was represented by its members at many WONCA Region Conferences and WONCA World Conference in Seoul /Korea) in 2018 presenting posters or holding workshops on classification topics like ICPC and the International Classification of Functioning, Disability and Health (ICF).

2. Activities planned and in progress
The core activity planned is ongoing work on ICPC-3.

3. Any activity in collaboration with WHO, either regionally or globally
At the meeting of the WHO-Family of International Classifications (WHO-FIC) Network in 2017 WICC was not represented for a number of reasons, one of them being that primary care was too little on the agenda. At the mid-year meeting and at the last annual meeting in Seoul/Korea (22 - 26 October 2018) there were discussions about the current state of the primary care version of ICD-11. The main change from ICD-10 to  ICD-11 will be a switch from the former big book to a software based version published as a searchable database to be incorporated in other software systems.

Another change will be that a so called foundation layer has been created, containing all concepts of the domain of medicine in a defined manner with semantic linkages (is part of…, relates to…) in all possible
directions (so called multi-parenting). Classifications are built on this foundation layer which is why they are called linearizations. One of these linearizations is the Joint Linearization for Morbidity and Mortality Statistics (JLMMS) which has been released as a version for preparing implementation in member states, including translations at 18 June 2018.

In the beginning an independent primary care linearization both for the high and a low resource setting in a telescopic structure, based directly on the foundation layer was planned (ICD-11 PC Linearization). Up to now only a simple pick-list from JLMMS as a short version for primary care has been achieved in a preliminary version. This is disappointing but was to be expected as nobody was willing or capable of investing into sufficient work force to achieve the original goal.

At the WHO-FIC annual conference Seoul/South-Korea Thomas Kühlein the current chair of WICC pointed at the deficiencies of the ICD-11 PC Linearization and the progress of ICPC-3. As a classification is a kind of standard and as the good thing about a standard is that there is one and not two of them, Thomas Kühlein proposed to finish the development of ICPC-3, include its concepts into the foundation layer retrospectively and make it the official primary care classification in the WHO-FIC. The proposal raised some discussions on technical feasibility which could not be solved. A subjective impression is that the problem is less technical feasibility than political will. Although the overarching topic of Seoul WHO-FIC Conference was the anniversary of the declaration of Alma-Ata, again the needs of primary health care played a minor role.

4. Other significant progress as per activity plans
The WICC executive committee and the WICC decided to now put all energy into the development of ICPC-3. As long as WHO doesn’t come forward with new initiatives to go on with ICD-11 PC Linearization development, WICC sees no priority in pushing it. Still, WICC is in principle ready and willing to cooperate with WHO in classification matters which has also been made explicit at the WHO-FIC Conference in Seoul.

5. Issues 
The annual WONCA International Classification Committee (WICC) meeting in 2018 was held from 25 - 31 August in Lviv/Ukraine. There were 26 members and observers participating. The main topic was the new version of the International Classification of Primary Care international (ICPC-3) which is currently developed under organizational leadership of a Consortium under the lead of Kees van Boven at the University of Nijmegen/Netherlands. Another important topic was the development of a primary care version (linearization) of ICD-11 in collaboration with WHO.

In the meantime the ICPC-3 Consortium took up its work which can be followed at the Consortium website Another website informing about the work of WICC is the PH3C-website. Links below.

This year’s meeting of WICC will be held in Crete in Greece from 22 -26 September 2019. Again, the main topic will be the collaboration of WICC and the Consortium and common work on content of ICPC-3. Vivid discussions are to be expected. Anybody interested in the work of WICC will be welcome. Joining link below.

Website: Primary Health Care Classification ConsortiumPH3C website Join our working party