# Presentation: 312677

## 1.  Update on NACC ICF Activities:  ICF Overview, The Toronto NACC Meeting, DISTAB, Health Care Financing Review, and Dissemination

- Date: July 16, 2002
- Presenter: Paul J. Placek, PhD, Senior Statistician,
- Data Policy and Standards Staff, OCD/NCHS
- _[PJP2@](mailto:PJP2@cdc.gov)__[cdc](mailto:PJP2@cdc.gov)__[.](mailto:PJP2@cdc.gov)__[gov](mailto:PJP2@cdc.gov)_**      tel 301-458-4437**
**http://www.cdc.gov/nchs/about/otheract/icd9/icfhome.htm**

## ICF

**ICF**

-            2.  World Health Organization        Classification Assessment Surveys & Terminology Group

- as the
**New Member in the **
**WHO Family of **
**International Classifications**

**www.who.int/classification/icf**

##           3. ICF Launch

## 4.  ICF Part of WHO Family of Classifications (ICD & ICF)

**NACC hosted first joint ICD/ICF meeting of Heads of WHO Collaborating Centres for the Family of Inter- national Classifications in Bethesda, MD, October 2001**
**ICF sessions held on**
**coding guidelines**
**implementation issues**
**training, outreach and dissemination**
**adaptations**
**measurement**
**use of ICD and ICF together**
**maintenance and update process**
**NACC ICF papers:  Heads Mtg. Oct. 14-19, 2002 Brisbane**

## 5.  ICF Structure

***Classification***

***Parts***

***Components***

***Constructs/***
***qualifiers***

***Domains and categories***
*** ******at different levels ***

**ICF**

**Part 1:**
**Functioning and Disability**

**Part 2:**
**Contextual Factors**

**Body Functions **
**and Structures**

**Activities and**
**Participation**

**Environmental **
**Factors **

**Personal **
**Factors**

**Change in**
**Body**
** ****Structures**

**Capacity**

**Performance**

**Facilitator/**
**Barrier**

**Item levels:**
**1****st**** **
**2****nd**
**3****rd**
**4****th**

**Item levels:**
**1****st**** **
**2****nd**
**3****rd**
**4****th**

**Item levels:**
**1****st**** **
**2****nd**
**3****rd**
**4****th**

**Change in**
**Body**
** ****Functions**

**Item levels:**
**1****st**** **
**2****nd**
**3****rd**
**4****th**

**Item levels:**
**1****st**** **
**2****nd**
**3****rd**
**4****th**

## 6.  “There is a widely held misunderstanding that ICF is only about people with disabilities; in fact, it is about all people.  The health and health-related states associated with all health conditions can be described using ICF.  In other words, ICF has universal application." (p. 7, ICF) 

## 7.  Eighth NACC Conference on ICF:  June 2-4, 2002 in Toronto, Canada 

- Hosted by Canadian Institute for Health Information
- 74 Registrants; 32 presenters from USA, Canada, Germany, Netherlands, Switzerland, World Health Organization
*Ninth NACC Conference on ICF hosted by Wash. U. – David Gray:  June 17-19, 2003  - St. Louis, MO*

## 8.  Six Themes

- Strategies for ICF Implementation
- ICF Conceptual and Issue Areas
- ICF Applications in Surveys
- ICF for Clinical Practice
- Capturing & Coding Functional Status Info
- Basic ICF Research

## 9.  Toronto Papers on Web

**http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=home_e**
**Select "News and Events" from "About CIHI" box.**
**Scroll to "Events" Section.**
**Scroll to "Proceedings of Past Events"**
**Select "The 8th North American Collaborating Center Conference on ICF", view in PDF**
** ****If you need Adobe Acrobat free http://www.adobe.com/products/acrobat/readstep2.html**

## 10.  Spring 2003 issue of Health Care Financing Review

**Stimulus:  U.S. National Committee on Vital and Health Statistics Report on Classifying and Reporting Functional Status**
**Recommended ICF as *****the***** code set to capture functional status**
**http://www.ncvhs.hhs.gov/010617rp.pdf**
**Centers for Medicare & Medicaid Services invited NCHS to assemble issue:  Co-editors Placek & Hendershot**
**Articles by Ustun, Bickenbach, Swanson, Jette/Harris/Ruggieri, Iezzoni/Greenberg, Chute, Seltser/Hendershot, Carter, Buchanan, Clauser/Bierman/Clancy + Commentaries**

## 11.  DISTAB

**U.S., Canada, South Africa, Netherlands, & France**
**Since 1999; follow U.N. DISTA**_**T**_** guidelines**
**Monthly phone conference + annual meeting**
**Stimulated U.N. Seminar & Wash. City Group **
**Five national disability surveys, Q’s backcoded to ICF**
**Done:  Backcoding methods paper to be published**
**In draft:  Comparative tables report**
**Currently:  Code Environment and Participation survey items to ICF (Australia has just joined) **

## ICF Dissemination:               NCHS Takes the Lead

**Four ICF Videos:  ICF Use by Consumers, Applications in Clinical & Survey Areas, Historical Development, Conceptual/Issue Areas (Farmer interviews w/20 experts)**
**ICF Curricula in North American Colleges and Universities Fall 2002 Semester (U. of Michigan - Mulhorn)**
**NACC ICF Clearinghouse (in-house + contract)  **
**CODE ICF:  Web-based training on ICF **

## 13.  CODE ICF

**13.  CODE ICF**

**Monthly phone conferences 2 years**
**NCHS:  Placek**
**WHO:  Kostansjek, Bickenbach, Ustun**
**Western University (Swanson & Carrothers)**
**Much stakeholder input thru WHO & NACC meetings**

## 14.  CODE ICF

**Code ICF is a teaching tool designed to familiarize the learner with the**** ****ICF**
**Technology being used **
**	****Provides learner interactivity and integration **
**	****Applies learner algorithm **
**	****Easily translatable database driven platform**
**  ****WHO browser **
**Users will learn vocabulary and concepts, governing principles, how to code cases, the influence of environmental barriers and facilitators, current and potential uses**
**Fall 2002 completion**
**On WHO website**

## 15.  CODE ICF Screen on Body                                    Functions

**Mental Functions**
**Sensory Functions and pain**
**Voice and speech functions**
**Functions of the cardiovascular, haematological, immunological & respiratory systems**
**Functions of digestive, metabolic, endocrine systems**
**Genitourinary & reproductive functions**
**Neuromusculoskeletal & movement-related functions**
**Functions of the skin & related structures**
**EXAMPLE:  PRODUCTION OF VOICE**

## 16.  CODE ICF Screen on Barriers

***Barriers ***are environmental factors in a person’s environment that, through their absence or presence, limit functioning and create disability.
- EXAMPLE:  e235 **Human- caused events, disturbances in the natural environment that result in the disruption of people’s day-to-day lives, including conflict and wars...**

## 17.  CODE ICF Screen on Facilitators

** **

- Facilitators are environmental factors which improve functioning and reduce disability, or the absence of factors that are barriers.
- EXAMPLE:  e140 Assistive products for recreation and sport

## 18.  NACC Clearinghouse on ICF

- Need for regular information exchange, coordination and technical assistance
- Monthly e-mail summaries
- ID & Typology of ICF Users
- Marketing & Exhibits
- Training and Technical Assistance
- ICF Conference Support
- Specialized Document Preparation