GNU Health and the World Health Organization

The GNU Health project believes in coding standards, specially in those that can be widely used. In 2011, the United Nations University (UNU) adopted the GNU Health Hospital Management Information System (HMIS) component, in part because of its strong focus in social medicine and environmental health, but also because it complied with most of the World Health Organization standards.

Using WHO standards is key for global health. The GNU Health federation provides timely and accurate health information to citizens and health professionals globally. We are able to generate this large, distributed networks of information thanks to protocols and standards, that permit the aggregation of data from thousands and even millions of nodes.

GNU Health HMIS provides many WHO standards and UN models, such as:

• ICD-10, International Classification of Diseases, tenth revision
• ICD-9, Volume 3, for coding procedures
• ICF, International Classification of Functioning, Disability & Health
• ICPM, International Classification of Procedures in Medicine (to be replaced by ICHI)
• WHO List of Essential Medicines
• Pediatric growth charts
• Vaccination schedules
• MDG / SDG (Millennium Development Goals / Sustainable Development Goals, such as the MDG6 to tackle HIV, Malaria and Tuberculosis

Health professionals, institutions and governments around the world can trust GNU Health as the WHO compliant Hospital Management and Health information system.

Throughout these years, GNU Health and WHO have been cooperating in areas of Universal Health access, Mother and Child health or campaigns to fight HIV/AIDS, Malaria and Tuberculosis.

It has been nearly a decade of work, at the technical, functional and community level. The training of WHO regional officials, as well as to the health professionals have had a quite positive impact. Proper coding using WHO standards in GNU Health, both for health conditions and procedures / interventions result in good quality, epidemiological reports, better management of the internal resources and improved health promotion and disease prevention campaigns.

Moving forward: ICD-11 and ICHI

The current International Classification of Diseases, tenth revision (ICD10) has been of great help to standardize coding health conditions, but it has its limitations and it definitely needs a review in both the coding system itself as well as the need of specific health areas.

To overcome these limitations, the World Health Organization started ICD-11, the latest revision that includes many more health conditions, the much needed areas of mental health and sexual health, as well as a great method to combine conditions, called cluster coding or postcordination. Cluster coding allows the combination of two terms in for the condition. This concept brings much more flexibility and contextualization.

In terms of health procedures, the International Classification of Health Interventions (ICHI) is estimated to be released by the end of this month. ICHI will replace the International Classification of Procedures in Medicine (ICPM).

The International Classification of Health Interventions will become the standard coding system for reporting and analyzing health procedures. In words from WHO, “the classification provides Member States, service providers, managers, and researchers with a common tool for reporting and analyzing health interventions for statistical, quality and reimbursement purposes.“.

ICHI delivers a coding method based on three axes: Target, Action and Means. It is valid for all context of health (primary care, surgical, dental, nursing, community health). It contains over 7000 interventions that can deliver at an individual or population basis.

GNU Health leads the integration of WHO References

Depending on the individual and environment, a particular pathology can have different clinical representations of the disease. Diabetes mellitus (DM) can be controlled or can have devastating consequences for the individual. Most of the times the socioeconomic determinants play a key role on the epidemiology, clinical outcomes and disease progression, and assessing health as a whole – from the molecular basis to the socioeconomic determinants – is one of the areas where GNU Health excels.

GNU Health provides the WHO International Classification of Functioning, Disability and Health, that has been key in many context, to assess the impact of the environment in many patients. This was studied in the GNU Health implementation in Laos (see my post “GNU Health: Helping Laos Heal from UXO physical and emotional trauma.“).

GNU Health is ICD-11 ready, and waiting for you

The upcoming release 3.8 for the GNU Health HMIS component includes de ICD-11 Morbidity and Mortality Statistics (MMS) linearization, as well as the existing ICF package. We are waiting for WHO to release the stable version of ICHI.

The ICD-11 will officially come into effect on 1 January 2022, so we have a year to train and get used to it. The GNU Health HMIS community server can be your perfect training companion. It’s online 24×7 and you can test the new codings in this server.

At this point, you can already start testing the ICD-11 functionality, and how it interacts with the other references as the ICF. Of course, you can become part of the GNU Health team, either as an end-user of as a member of our development and research team, and provide feedback and improvements!

These new additions will be of great help to achieve our common mission towards Universal Health Coverage and Sustainable Development Goals. At the end of the day, GNU Health is a social project that uses really cool Libre technology. I am positive that the immense majority of our health related problems, both at individual and population level, can be solved by means of Social Medicine.

As Dr. Rudolf Virchow said, Medicine is a social science, and politics is nothing else but medicine at a larger scale.