Drs Huib Ten Napel WHO FIC CC & MI University Medical Centre Nijmegen The Netherlands

1. Applicability of Dutch ICD-10 Electronic tool for publication of ICD-10 updatesand control of derived classifications Drs Huib Ten Napel WHO FIC CC & MI University Medical Centre Nijmegen The Netherlands Meeting of Heads of WHO FIC CC

2. Presentation overview • Purpose of presentation • Ist & Soll situation • What ClaM can do • What we wish ClaM to do • Update massages • Derived classification schemes • Mapping • Discussion Meeting of Heads of WHO FIC CC

3. Purpose • Presuppostion that electronic versions of classification schemes will prevail • Main purpose of presentation • exploration of the possibilities of Dutch Centres electronic tool for: • Update messages in ClaML • Deriving Classification schemes from source files • Mapping related Classifications schemes • From a National point of view Meeting of Heads of WHO FIC CC

4. Ist & Soll • Ist • Primarily focus on Presentation = production of book: • Text editing and lay-out • Alphabetical indexing • Secondary • Updates • ´Electronic versions´(hyperlinks in textfiles) • Involving • Decentralised working: • A high number of persons working separate & independent • Various text processing tools • Various versions of these tools • Laborious and time consuming • No standard for structure elements of classification Meeting of Heads of WHO FIC CC

5. Ist & Soll • External quest for: • Classifications in database format • Guidance in classifications to be derived • How ICD-9 CM maps to ICD-10 (crosswalks) • How ICD maps to ICF (and ICF to former ICIDH) • How ICD maps to DBC´s Meeting of Heads of WHO FIC CC

6. Ist & Soll • Soll • Primarily focus on Representation = production of a central source file: • Using a standard, CEN/TS 14463 (ClaML) • Using a software tool for support of requirements, the Classification Manager (ClaM) • Involving • Centralised working: • A number of persons working separate but dependent • One standard editing tool • One version of the tool • Less laborious and time consuming • A standard for the structure elements of classifications Meeting of Heads of WHO FIC CC

7. What ClaM can do 1 • To explore the possiblities of the electronic tool, first to explain what it can do: • Store classification schemes in electronic form • Preserving the internal structure • Explicitly representing rubrics, codes and the hierarchy that makes up the structure • Offers several classification manipulation functions: • Edit functions such as: replace, move up move down, etc. • Standard operations that allow to add, edit, find, delete or move a class • More complex operations to collect, sort or shift children classes • Add modifiers and assign these modifiers to classes • Summarize existing classes under a new parent class Meeting of Heads of WHO FIC CC

8. What ClaM can do 2 • Offers several views: • Centre, expand, collaps, show from top, show class in structure and spawn the classification scheme • Index the classification scheme as disered: • Class and rubric structure allows in- or exclusion of terms on every level • Import function of other indexes and theasauri • Referencing: • Referral tool checks the text for references and places tags • Reference tags are shown as hyperlinks Meeting of Heads of WHO FIC CC

9. What ClaM can do 3 • Comparator tool: • Checks classification schemes • Reports absence, reports differences • Summary report • Accountability: • Keeps complete history of changes made • Export function: • Exports in several formats, such as old ClaM, ClaML, comma & tab separated, RTF • rtf already has a classification type style • Exports in selected levels Meeting of Heads of WHO FIC CC

10. What we wish ClaM to do • Presupposition repeated: electronic versions will prevail • We want ClaM to support our work on: • Update messages • Derived classification schemes • Mapping between classification schemes Meeting of Heads of WHO FIC CC

11. Update messages • After translation of list of changes, Classification schemes are easily adjusted in ClaM: • New version of the Classification scheme • Based on the former version • Complete history of changes is in archive • The Comparator tool: • Check´s the two versions and makes a summary of the differences • This summary could be used as an update • Required: • Import and update mechanisme • A standard for the update message (CEN ´prEN 13609-1, Updating of coding schemes´, is a candidate) Meeting of Heads of WHO FIC CC

12. Derived classification schemes • Present situation is • Derived classification schemes are: • Developed in unstructured environment • Paper based • Commited, but compatible? • Univocal? • With ClaM • Working directly in the source file: • Extension within branches (most cases) • Structured and controlled working • History makes changes traceable and controllable • Comparator makes additions visible for comment • Required: • Structuring of editorial process • Central editing or is parallel editing possible? Meeting of Heads of WHO FIC CC

13. Mapping classification schemes 1 • This is a very complicated item • Questions to be put here are: • Are crosswalks sensible? • What do these crosswalks formally represent? • Same term or nearly same term? • Same meaning, but referring to what? • What does a map mean in this context? • With ClaM: • Classification schemes can be compared • Only on the level of codes and text strings • Not on semantics, referential meaning Meeting of Heads of WHO FIC CC

14. Mapping classification schemes 2 ClaM does not support this function, the Classification Workbench (ClaW) does! • It offers the possibility to explore formal relations between (categories of) terms • To map classes to a reference model (RM) and • To expand similar classes to the RM (which is a kind of mapping) • First we have to make explicit: • what is meant by mapping (or crosswalking) and • why it is needed (eg continuity of information?) Meeting of Heads of WHO FIC CC

15. Discussion • Questions? • Discussion points? Meeting of Heads of WHO FIC CC

16. Thank you for your attention Meeting of Heads of WHO FIC CC