The document discusses the possibilities and implications of using the International Classification of Functioning (ICF) to power health information technology. It describes how incorporating standardized vocabularies like ICF and LOINC into electronic health records could allow for data reuse across settings, clinical decision support, and a more seamless exchange of health information. This would help realize the vision of a healthcare system with coordinated, consumer-centered care enabled by digital tools.
Report
Share
Report
Share
1 of 45
Download to read offline
More Related Content
2012 02 10 - Vreeman - Possibilities and Implications of ICF-powered Health Information Technology
17. EHR Decision Support
A computer-generated
suggestion about care for
an individual patient
me
18. The secret sauce of the
HIT chicken soup
photo via Robert Couse-Baker
19. photo via nosha
e rain forest canopy is a
seamless web through which
arboreal creatures efficiently
move to reach the edible
fruits without any attention
to the individual trees.
McDonald et al. Canopy Computing: using the Web in Clinical Practice. JAMA. 1998;280(15):1325-1329.
30. If an observation is a question
and the observation value is
an answer…
LOINC provides codes for
questions
Other vocabularies provide
codes for the answers
31. How fast does my
patient usually walk?
41959-8:Walking speed:Vel:1W^mean:^Patient:Qn:Calculated
photo via Ed Yourdon
32. Standardized Assessments in LOINC
Vreeman DJ, McDonald CJ, Huff SM. Representing patient assessments in LOINC®. AMIA Annu Symp Proc. 2010;832-836. PMID: 21347095.
Vreeman DJ, McDonald CJ, Huff SM. LOINC® - a universal catalog of individual clinical observations and uniform representation of enumerated collections. Int
J Funct Inform Personal Med. 2010;3(4):273-291.
36. An ICF-based Template
Escorpizo R et al. Creating an interface between the International Classification of Functioning, Disability and Health and physical therapist practice.
Phys Ther. 2010 Jul;90(7):1053-63. PMID: 20448104
could be coded
with LOINC
ICF Intervention
Targets
38. photo via Ed Yourdon
41957-2:Walking speed 24 hour mean
Walking speed: 1 m/s
64098-7:Distance walked in 6 minutes
6 min walk distance: 600m
Fall risk: Mod
NNN-N:More than 2 falls in last 1Y
ICF: walking short distances
d4500.1 “mild difficulty with walking short distances with the
use of assistive devices that are available to the person in
their current environment”
39. photo via Menage a Moi
b2804 “Radiating pain in a segment or region”
Classifying measures:
• Upper limb tension tests
• Spurling’s tests
• Distraction test
Imaging
24937-5:Cervical spine MRI W & WO Contrast IV
LOINC codes TBD
40. Now we have a powerful
set of coded data that
computers can operate on
and exchange between
independent systems in
an understandable way.
41. ICF-powered EHRs
Get patient reported
data before the clinical
encounter, with logic to
help drive evaluation
Rauch A et al. Using a case report of a patient with spinal cord injury to illustrate the application of the International Classification of Functioning, Disability
and Health during multidisciplinary patient management. Phys Ther. 2010 Jul;90(7):1039-52. PMID: 20508027
42. ICF-powered EHRs
Computerized
reminders to clinicians
for following ICF-based
intervention guidelines
Rauch A et al. Using a case report of a patient with spinal cord injury to illustrate the application of the International Classification of Functioning, Disability
and Health during multidisciplinary patient management. Phys Ther. 2010 Jul;90(7):1039-52. PMID: 20508027
43. ICF-powered EHRs
Rauch A et al. Using a case report of a patient with spinal cord injury to illustrate the application of the International Classification of Functioning, Disability
and Health during multidisciplinary patient management. Phys Ther. 2010 Jul;90(7):1039-52. PMID: 20508027
45. By incorporating vocabulary
standards into our clinical
information systems we can:
leverage the EHR’s potent
capabilities
and
move closer towards the
healthcare system we dream of