Grant: Project Grant

The International Classification of Disease (ICD) is a global system for coding health conditions and diseases. This creates standardized, comparable information that is used by different countries worldwide for research, understanding disease trends, and making policy decisions. In Canada, the 9th version of ICD (ICD-9) is used by healthcare providers to submit billing claims to governments for payment for their clinical services. The ICD-9 system is over 40 years old and is in need of updating. ICD-9 does not fully capture the broad scope of primary care activities, types of conditions seen, and workflow. There are two new systems that may be more useful and relevant for primary care: ICD version 11 (ICD-11) and the International Classification for Primary Care version 3 (ICPC-3). Both have been recently made available with updated clinical and scientific content. In project 1, we will use pan-Canadian primary care data to explore the gaps and overlap between the old (ICD-9) and new systems (ICD-11, ICPC-3) in their coverage of common patient visits/activities in primary care. In project 2, we will ask family doctors from across Canada to test the ICD-9, ICD-11 and ICPC-3 systems by using these codes to describe a series of example patients. Next, the family doctors will be asked to complete a survey to determine what features of a new system would be preferred for use in primary care and to report their feedback, satisfaction, and preference between ICD-11 and ICPC-3, as well as any concerns with bringing in a new system. Lastly, we will hold focus group discussions with family doctors in Canada and conduct interviews with policymakers who have experience with ICD-9. These conversations will help us understand different perspectives about ICD-11 and ICPC-3 in more detail, including readiness to replace ICD-9, challenges with implementing a new system, and possible solutions.