Health information in the digital age: UCalgary brings WHO conference to Banff

They came from 58 countries around the world — from Germany to Japan, Rwanda to Spain. Many of the health data classification experts attending the conference had never seen snow, and Banff did not disappoint.

Pristine views of the snow-capped Rocky Mountains served as the backdrop for the World Health Organization Family of International Classifications (WHO-FIC) annual meeting and conference, hosted by the Cumming School of Medicine’s (CSM) O’Brien Institute for Public Health earlier this month at the Banff Centre. The theme for 2019 was Health Information Meets Health Informatics, to coincide with the release of the International Classification of Diseases 11th revision (ICD-11). ICD is the global standard for classifying and reporting health conditions and diseases, and the 11th edition upgrades the classification system for use in digital environments. 

“In health care, we collect so much data, but collection is only one part,” says Dr. Hude Quan, PhD, director of the O’Brien Institute WHO Collaborating Centre for Classification, Terminology and Standards, at the CSM. “We need to turn this information into usable knowledge, and health informatics makes this possible.” In the photo above, Quan addresses the crowd at the conference. 

The WHO-FIC Network includes collaborating centres, NGOs, and selected experts who develop, update and promote the implementation of WHO health classification systems.

The O’Brien Institute was recently re-designated a WHO Collaborating Centre — in large part due to the central role its researchers have played in the development, testing and transition to ICD-11. It is far more comprehensive and digitalized than its predecessor, says Quan. ICD-11 also has potential to be integrated into electronic health records such as Connect Care in Alberta to code patients’ medical histories. This coded information could then be used for precision medicine and precision public health.

“Not only have we been working in partnership with the WHO on classification, particularly ICD-11, for the past decade, but eHealth and the integration of health information is an O’Brien Institute priority,” says Dr. William Ghali, MD, O’Brien Institute scientific director. “Hosting this meeting is a convergence of many of our initiatives and many of our people.”

ICD-11 was adopted at the WHO World Health Assembly this spring, giving the green light for countries around the world to begin planning its implementation. Given the work Cumming School of Medicine researchers have done on ICD-11, Dr. Nenad Kostanjsek, MD, technical officer, Classification, Terminology and Standards Unit, WHO, says this was a good year to bring the conference to Alberta.

“Our collaborating centre here in Calgary has a long tradition in analyzing and studying coded data and has been incredibly supportive in the development of WHO classifications and terminologies. It is an important knowledge hub in our WHO-FIC family,” says Kostanjsek.

Bringing together more than 250 delegates from around the world, WHO-FIC featured several days of strategic meetings, as well as a conference component with international keynote speakers, including Dr. Christopher Chute, MD, Bloomburg School of Public Health, Johns Hopkins University, who talked about harnessing data for use in precision medicine. Another presentation from the director of the Center for Quality Improvement and Patient Safety, Agency for Healthcare Research and Quality, USA, Dr. Jeffrey Brady, MD, focused on what all of this digital health information could mean for improving patient care.

Representatives from WHO sites around the world also gave updates on ICD-11 implementation, including Dr. Catherine Eastwood, PhD, who is the primary investigator on one of the largest ICD-11 trials to date — using full hospital records to test the new coding system.

“As the world moves towards implementation of ICD-11, there are some guidelines for success that we discovered from our study involving coding 3,000 hospital charts,” says Eastwood, operations manager, Centre for Health Informatics, CSM.

Allowing sufficient time to learn and practice using ICD-11 coding is one of the recommendations Eastwood and her team have for countries working to implement the new system, as it is much more complex than ICD-10. Eastwood also recommends face-to-face training, with the opportunity to practise the complex coding system with coding experts.

Currently, Eastwood and her colleagues at the O’Brien Institute’s WHO Collaborating Centre are building a framework and interactive tool for estimating the cost for the provinces implementing ICD-11. Once tested in Canada, this tool will be available for all countries to use for estimating the cost of moving to ICD-11, she says. This information could be used by governments or decision-makers to pave the way for ICD-11 in their country.

The next WHO-FIC meeting will take place in Thailand in 2020.

Dr. Hude Quan, PhD, is a professor in the Department of Community Health Sciences at the CSM, a member of the O’Brien Institute for Public Health and the Libin Cardiovascular Institute of Alberta, and director, Centre for Health Informatics, CSM.

Dr. William Ghali, MD, is a professor in the departments of Medicine and Community Health Sciences, scientific director of the O’Brien Institute for Public Health, and a member of the Libin Cardiovascular Institute of Alberta at the CSM.

Dr. Catherine Eastwood, PhD, is an adjunct assistant professor in the Department of Community Health Sciences at the Cumming School of Medicine and a member of the Libin Cardiovascular Institute of Alberta.