WICC report 2015-16

Thomas Kühlein of Germany is the new chair of WICC - the WONCA International Classification Committee. He is also this month's featured doctor.  In this article he outlines the past year's work of the WICC and also explains all those acronyms relating to classification. Above photo: WICC meeting in 2016.

WICC and classification explained

WICC is the WONCA International Classification Committee, the oldest working committee of WONCA. The WICC currently has 45 members from 29 countries.

A classification is much more than the annoying outflow of bureaucrats. Instead it is a tool to separate the fuzzy world into disjunctive categories in order to make it countable and statistically describable. The data which emerge can be used for many different purposes. The first and foremost use should be the practising physician’s wish and need to know about the quality of care provided. Furthermore the data can be used for research in primary care (PC). In terms of professionalism both are central issues.

The classification used most widely in the world is the International Classification of Diseases (ICD), provided by the WHO. The ICD is far too big and complicated on the one side and not specific enough on the other for use in PC. Therefore the major activity of WICC is the updating and further development of the International Classification of Primary Care (currently ICPC-2).

However, the WICC is not the ICPC-committee, but WONCA’s classification committee, which means that for example, work is also done concerning the development of a primary care linearization (classification) of ICD-11. There are also members of WICC involved in the special interest group of primary care in IHTSDO. IHTSDO is an international consortium having developed SNOMED-CT (Standardized Nomenclature Of Medicine – Clinical Terminology) another documentation standard. In a general practice special interest group (IHTSDO GP SIG) WICC members created a PC subset of SNOMED-CT within IHTSDO. Work on PC subsets of the International Classification of Functioning and Disability (ICF) is also done by some members of WICC.

This is all quite confusing in the beginning and it takes time to memorize all these abbreviations.

The WICC has an annual meeting hosted by one of its members. Work done between the 2015 meeting in Hyderabad, India and the 2016 meeting in Turku, Finland was:

- Revision of WICC Policy Document according to the discussions of the previous meetings

- Clearance of the member list of non-active people by insisting on member duties like voting, conflict of interest statements, country reports and meetings attendance

- Ongoing work of the IHTSDO GP SIG – Terminology Group

- Continuing problems with WHO concerning collaboration for ICD-11 PC work. Kees van Boven is leading the PC-group within WHO in order to develop a PC linearization. Work was started but then stopped due to a missing memorandum of understanding (MoU) between WHO and WONCA concerning property rights, licensing and control over content. Kees van Boven and Thomas Kühlein went to the WHO-FIC annual meeting in Tokyo, Japan in order solve the problems concerning this MoU.

- Development of ICPC-3: Progress in the development of ICPC-3 has been slow in the past. The main problem is the volunteer nature of the workforce of WICC. Anybody working on ICPC-3 has enough other tasks without this. Therefore the idea arose to set up a consortium as the basis for receiving grants to support this work and employ people – mainly Kees van Boven – to do the ground work of development to be decided upon by WICC. There have been major discussions on this consortium and the corresponding work-plan for ICPC-3 development. Should these problems be settled, the next steps will be to sufficiently raise funds to support the work. Nothing will strengthen the WONCA position in the negotiations concerning ICD-11 PC linearization more than ongoing work or best getting ready with the development of ICPC-3. If WONCA wants WICC to have a voice in world standards for classifications useful for primary care, we should urgently get ready with ICPC-3.

WICC meeting held in Turku, Finland from 10-15 September 2016

o Thomas Kühlein (Germany) was elected as the new chair of WICC
o Helena Britt (Australia), Jean-Karl Soler (Malta) and Kees van Boven (The Netherlands) were elected as new members of the executive committee together with the former member Shabir Moosa (South-Africa).
o Ongoing chapter work in the development of ICPC-3
o Agreement on major elements of the construction of a consortium to develop ICPC-3

The WICC action plan 2016/17

The action plan (reduced to the main targets) is to continue the ongoing work:
o to set up a consortium and raise funds to finish the development of ICPC-3
o of developing ICPC-3
o to achieve a MoU with WHO concerning collaboration for the development of ICD-11 PC linearization.

Thomas Kühlein
Chair WICC

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