International Training and Certification Program: Work of the WHOFIC Education Committee and the Joi

1
International Training and Certification
ProgramWork of the WHO-FIC Education
Committeeand theJoint IFHRO and
WHO-FICCollaboration
2
WHO Family of International Classifications

• A suite of classifications for international use
  as meaningful information tools to capture the
  core health dimensions, such as deaths, disease,
  disability and health as well as related health
  system parameters such as health interventions

3
WHO-FIC Education Committee

• Purpose
• To assist and advise WHO and the WHO-FIC Network
  in improving the level and quality of use of the
  WHO Family of International Classifications
  (WHO-FIC) in Member States by developing an
  education, training and certification strategy
  for the WHO-FIC, identifying best training
  practices and providing a network for sharing
  expertise and experience on training. The first
  priority will be for the reference terminologies,
  ICD and ICF.

4
Functions of the Education Committee

• Assessment of the needs of users of the
  classifications, including those who provide
  source information, apply codes, conduct research
  or use the resulting data.
• 2. Identification of the learning objectives for
  educational approaches.
• 3. Inventory of existing educational materials
  and capacity.
• 4. Recommendations for learning content including
  development of core curricula
• 5. Recommendations for best practices for
  promotion and delivery of educational material.

5
International Training and Certification Program

• 1999 Collaborating Centres recognized the need
  to improve coding practice and the status and
  training of mortality and morbidity coders
  worldwide
• need to partner with an international
  organization in official relations with WHO to
  achieve this goal
• identified the International Federation of
  Health Records Organisations (IFHRO) - proposal
  for joint work made at 2000 Melbourne Congress

6
International Training and Certification Program

• Core curricula and business proposal presented to
  IFHRO Executive Committee at 2004 Congress and
  approved
• Approval also received from WHO-FIC Network in
  2004
• Joint WHO-FIC - IFHRO Collaboration established
  and holds bi-monthly conference calls and
  mid-year face to face meetings

7
Expected Outcomes

• Standard international ICD-10 curricula
• Approved training modules
• Process for recognizing practicing and new coders
• Trainer recognition process
• IFHRO Coder Special Interest Group
• Comparable high-quality coded data
• Improved status of coding professionals

8
Phases of Work to Date

• Establishment of a process to certify practicing
  underlying cause-of-death mortality coders
• Development of recognition for ICD
  trainers/educators
• Progress towards a process for testing and
  certifying newly-trained coders
• Early considerations re certification of
  morbidity coders

9
Accomplishments to Date

• Development of standard core curricula for
  morbidity and mortality coder education
• Soliciting training materials for assessment
• Quantitative and qualitative assessments of
  materials performed, with feedback to developers
• Conduct of pilot test for underlying
  cause-of-death coders in Korea and Canada (with
  another two pilots in Korea and Japan later in
  2007)

10
Additional Sub-Project

• Development of a process to recognize the skills
  and abilities of trainers and educators who teach
  ICD-10 coding
• Development of a roster of experienced and
  qualified trainers

11
Trainers

• Self assessment to be completed by those desiring
  formal recognition as trainers
• Assessment includes experience in providing
  training
• Trainers also sit for an exam, similar in nature
  to that of the coders, but more comprehensive
• Trainer must complete the exam with the required
  competency (80) to be awarded the certificate

12
Other Current Activities

• Web based training, under development by the JC
  and the WHO
• On line, CD Rom options
• Hard copy for countries where access to computers
  is difficult

13
Pilot tests in Canada and Korea

• Canada
• April 4 and 5
• Two mortality coders from Statistics Canada for
  coder exam
• Korea
• April 15
• Twenty three candidates including 6 mortality
  coders from Korea National Statistical Office
• coder exam 14 candidates
• both for coder and trainer exam 9 candidates

14
Process of the pilot test - Canada

• Sought Statistics Canada support of
  administration of pilot test
• Invited two Statistics Canada underlying cause of
  death coders to challenge the exam
• Held a brief (one day) refresher workshop on
  ICD-10 rules for selecting underlying cause of
  death
• Administration of the exam

15
Process of the pilot test - Korea

• Organized Task Force Committee
• Received exam questions and answer key
• Translated and verified the materials and exam
  questions by WHO translation protocol
• Held one-day workshop for underlying cause of
  death coding and rule(s) application
• Received and reviewed the application documents
• Administration of the exam

16
Marking Scheme

• Assistance of Mortality Reference Group
• Small working group for making marking scheme
• Cassia Buchalla (Brazil)
• Kathy Giannangelo (U.S.A.)
• Patricia Wood (Canada)
• Joon H. Hong (Korea)

17
Results of the pilot test

• Canada
• Both candidates were successful
• 93 and 96 for each
• Korea
• Successful candidates 10
• Coder exam 6 out of 14 (42.9)
• Both for coder and trainer exam 4 out of 9
  (44.4)
• Average passing rate 43.5
• The highest and the lowest marks 94.3 and 64.5

18
Advancing and Evaluating the International
Training and Certification Program for ICD

• Contract awarded to AHIMA FORE by the U.S.
  Centers for Disease Control and Prevention in
  August 2006
• Purpose of the Contract
• Document and implement processes to pilot
• Review and approval of ICD-10 training materials
• Testing and certification of practicing mortality
  coders
• Recognition of ICD trainers and educators
• Certification of newly trained coders

19
Advancing and Evaluating the International
Training and Certification Program for ICD

• Design and perform outreach program to coders and
  trainers
• Benefits of the program
• Methodology for participating

20
Advancing and Evaluating the International
Training and Certification Program for ICD

• Evaluation of the processes and methodologies
• Strengths and weaknesses
• Assessment of the effectiveness of outreach
  activities
• Development of recommendations for improvement

21
The future issues and challenges

• Taking the exam to the world coder population
  availability, translation, supervision,
  recognition
• Pre-exam education
• KMRA process as the model IFHRO member
  countries to take forward?
• Need to promote the program, seek further
  training materials, explain benefits, encourage
  participation

22
The future issues and challenges

• Need for standard rules and guidelines for
  multiple cause mortality coders and morbidity
  coders using WHO version of ICD-10
• Necessary to have these before we can assess
  coders
• Under development by Morbidity and Mortality
  Reference Groups of WHO-FIC Network

23
Core Curricula for international ICD training

• Outline of the subjects that should be covered in
  a comprehensive training course for
• Morbidity coders
• Mortality coders
• Certifiers of deaths
• See hand out of curricula

24
Core curriculum for morbidity coding

• Resource materials and references required by
  coders
• Full set of ICD-10 (Tabular List, Instructions,
  and Index) (current edition as updated by WHO)
• Periodic official WHO updates to ICD-10
• Medical dictionary
• Training materials relevant to core curriculum
• Drug references
• Abbreviation list
• Contact person to ask questions

25
Core curriculum for morbidity coders

• 1. Biomedical sciences
• Intent To develop an understanding of clinical
  knowledge through the study of the structure and
  function of the human body, pathophysiology,
  diagnostic and treatment modalities, and pharmacy
  therapy available for clinical management of
  patient care and to enhance professional
  communication in healthcare environments.

26
Core curriculum for morbidity coders

• 2. Legal/Ethical issues relevant to the country
  in which coding is being done
• Intent To introduce legal and ethical issues
  applicable to health information, its collection
  and release.

27
Core curriculum for morbidity coders

• 3. Healthcare Data Content and Structure
• Intent To introduce the generic components of
  the content, use and structure of healthcare data
  and data sets and how these components relate to
  primary and secondary record systems.

28
Core curriculum for morbidity coders

• 4. General uses of morbidity data
• Intent To explain the purposes for which
  morbidity data are collected and how they are
  used.

29
Core curriculum for morbidity coders

• 5. Specific uses of morbidity data
• Intent To introduce the specific uses of coded
  morbidity data and health information appropriate
  to healthcare settings.

30
Core curriculum for morbidity coders

• 6. Users of morbidity data
• Intent To explain the different groups and
  stakeholders who are users of morbidity data.

31
Core curriculum for morbidity coders

• 7. Healthcare Delivery Systems
• Intent To provide an awareness of the
  organization, financing and delivery of
  healthcare services

32
Core curriculum for morbidity coders

• 8. The International Classification of Diseases
  (ICD)
• Intent To develop an understanding of the ICD
  and to develop the knowledge and skills that are
  necessary to assign valid diagnostic codes.

33
Core curriculum for morbidity coders

• 9. How to code
• Intent To provide detailed instruction and
  experience on how to apply the coding rules and
  assign codes.

34
Core curriculum for morbidity coders

• 10. Quality Assurance
• Intent To raise awareness about the various
  factors that influence the quality of coded data
  and describe techniques for assuring the highest
  quality data possible.