Fdrg bcn-014 - m icf progress report (stefanus snyman & olaf kraus de camargo)

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FDRGmICF Collaborative

13 October 2014

Barcelona, Spain

@MatiesIPE

#mICF

The ICF Spring

Community-based, person-centred healthcare strategies are central to realising the vision to reach health equity in the 21st

century.1

These strategies are designed to identify ill-health, the determinants of health, and to facilitate improvements in persons’ health and their participation in all areas of life.2

The relevance of the ICF has been demonstrated in community-oriented primary care (COPC) and community-based rehabilitation (CBR), strategies fundamental to health equity.1,2

1 Frenk J, Chen L, Bhutta Z et al. Health Professionals for a new century: transforming education

to strengthen health systems in an interdependent world. Lancet 2010;376:1923-1958.2 Madden R, Dune T, Lukersmith S et al. The relevance of the International Classification of

Functioning, Disability and Health (ICF) in monitoring and evaluating Community-based

Rehabilitation (CBR). Disability and Rehabilitation 2013; Early online: 1-12.

ICF Spring

2nd decade

Integrate ICF into clinical practice:

interprofessional bio-psycho-social-spiritual

approach to person-centred management

ICF as catalyst for clinical practice and health

systems reform from community care level up,

e.g.

Community care level: 1 million community health

workers in Sub-Saharan Africa by 20151

Increasingly mobile phone applications are being

used to collect health information to support

continuity of care.2

1 Singh P, Sachs, J. 1 million community health workers in Sub-Saharan Africa by 2015. Lancet 2013;

382:363-365.2 Labrique A, Vasudevan K, Kochi E, et al. mHealth innovations as health system strengthening tools: 12

common applications as a visual framework. Global health: Science and Practice 2013;1(2):160-171.

mHealth applications: no ICF

ICF not widely implemented e.g. not leveraging

mobile applications yet

Inconsistent & inefficient capturing of

contextualized data

Data management complexity: volume, variety,

velocity & veracity

FDRG: Beijing 2013 & London 2014

Aims of mICF

1. assist providers and users of health

services in the front line

to identify a person's problems in terms

of the ICF (functional status and

contextual information), and

2. To investigate the development of a

user-friendly mobile application to

amalgamate ICF-related data centrally.

It is envisaged that the mICF

will

ensure accurate and efficient capture of

functional status and contextual information,

convey information securely between service

providers in different service settings,

facilitate clinical decision-making by making

person-centred data readily available,

facilitate administration and reporting

through the aggregation of the data and

minimise the need for repeat data collection.

The envisaged benefits of the

mICF would be to:

Empower providers and users of health and

related services

Enable continuity of care

Capture the interactions between ICF

components to facilitate

Understanding of the complexity of interactions

between health and contextual factors

Person-centred decision-making and goal

setting

Interprofessional and transprofessional

collaborative practice

Amalgamate data to help strengthen systems.

Aim 1: Objective 1

1. Develop the specifications for the mICF

to enable programmers to develop the

application.

Activities

Requirement survey

Partnership development

Workshops: Barcelona

Literature review

mICF Survey resultsOlaf Kraus de Camargo, Judy Zhuxi Gong

Translations in 11 Languages

Template available from Stefanus

ssnyman@sun.ac.za

In the process:

Hindi

Spanish

Catalan

Danish

Take the survey: http://tiny.cc/icfmobile

Responses (on 2014-10-13)

Languages ResponsesAfrikaans (South Africa) 14Dutch 10English 1111Finnish 186French 84German 60Korean 21Mandarin 2Mongolian 0Portuguese (Brazil) 11Portuguese (Portugal) 1Thai 0TOTAL 1500

Respondents and Technology

55% health service providers

100% have access to a computer at work

58% use a smart phone for work

33% use a tablet for work

39% use sms for work on a daily basis

89% use email for work on a daily basis

4% – 8% use mobile health applications

As a potential user of the ICF mobile application

(mICF), which option(s) would you prefer to enter

ICF-related data on your device?

34%41%

80%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Type own words select items select items &qualifiers

Data entry

What information would you like to obtain

through the mobile application after

having submitted the data?

74%

55%

84%

39% 36%

4%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

reportavailable

immediatelyfor end-user

reportavailable

immediatelyfor multiple

users

updatable,show change

over time

provideautomaticsuggestions(algorithm)

report onaggregated

data

Other

Output

Free Text -philosophyI am less enthusiastic about an app that is for clinicians and

clinical services. I think it will take too long for the services

to adopt it, and then it will mean all the info will be held by

the service (data protection blah bla blah).

I think an app like this would be a real opportunity to move

the power to the patients' hands - they hold the record and

they control who can access the info. They are the master

user owner of their information.

If a clinician requests a report the patient may then provide

it if they so wish. And because it is the ICF it gives the

patient the legitimacy that what they are doing is WHO

sanctioned - clinicians cannot just ignore the app and the

info in it.

So: 1) develop the app to patients 2) promote and train

clinicians in asking for the app info from patients (NOT the

old way: develop the app for clinicians, persuade patients to

complete info)

Collaborators – 199 from 36

countries

65

49

58

25

15

10

10

20

30

40

50

60

70

Researchprotocol

Lit. Rev. Needsassessment

Grant writing Admin Funding

Responses

Collaborators

18

10

14

0

5

10

15

20

Systems architecture Algorithm Development Coding (Android)

Responses

Collaborators

120

57

0

20

40

60

80

100

120

140

Usability testing Patient/client researcher

Responses

Software expertise

12

58

43

0

10

20

30

40

50

Android Data Synch Systems/Database Usability

Responses

Software expertise

13 12

21

0

5

10

15

20

25

ICF Applications mHealth Apps Health Informatics

Responses

Successful consensus-based partnerships

develop solid trust relationships:

31 from 17 countries met in Barcelona

Aim 1: Objective 2

2. Provide a means for providers and users of

health services to collect and transfer ICF-

related information to facilitate the

continuity of care

Activities

Agile and iterative developing of mICF

application

Develop and test Minimum Viable Product

(MVP)

to develop a first product/service with

the minimum effort and minimum cost

that is still really useful

Work groups and convenors

Finalising specification for MVP

[Stefanus Snyman]

Research facilitation team

[Olaf Kraus de Camargo]

Literature review and ‘environmental scan’

[Trish Saleeby]

Pilot testing team (Round 1)

[Brazil, Canada, Australia, South Africa]

Technical team

[Stefanus Snyman & Olaf Kraus de Camargo]

Facilitation Team [Stefanus Snyman]

Want to join our collaborative?

http://tiny.cc/micfpartners

First steps first: licencing and IP

Most probable scenario to develop

sustainable mICF:

mICF partnership outsource development

to private company

Private company develops application for

free and free licence to partners as well

as data for research

For profit: big data analysis for industry /

governments

Portion to mICF partnership: sustainability

Acknowledgement

This work is based on the research

supported by the National Research

Foundation of South Africa, Stellenbosch

University (South Africa), McMaster

University (Canada) and AQuAS (Catalonia).

DISCUSSION