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Developing an ICF mobile application (mICF) to improve

continuity of care and strengthen health systems:

A CALL FOR INTERNATIONAL COLLABORATION

Poster: C539WHO-FIC meeting Beijing 2013Stefanus Snyman, Catherine Sykes, Navreet Bhattal,

Ros Madden, Charlyn Goliath, Coen van Gool, Olaf Kraus de Camargo

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Health Condition (disorder/disease)

ICF: WHO world standardFunctioning and disability multidimensional,

interactive

Environmental Factors

Personal Factors

Body functions & structures (Impairment)

Activities(Limitation

)

Participation(Restriction)

2

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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.

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The ICF Spring

• ICF as catalyst for health systems reform on grass root level

• Integrated into clinical practice: patient-centred bio-psycho-social-spiritual approach

• 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.21 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.

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The ICF Spring

• 50% of people own a mobile phone in the developing world

• 70% have access to mobile phones• 1000 new mobile broadband connections

are made every minute in the developing world

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The ICF Spring

• However, the pivotal role of data on functioning and context is often overlooked in mobile applications designed to capture patient information.

• Currently, no mobile applications incorporate the ICF.

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Goal of mICF

• Providing a means for healthcare workers to collect and transfer ICF-related information to support continuity of care• Ensure accurate and efficient capture of

functional status and contextual information• Convey information securely between service

providers in different service settings consistent with ethical and privacy principles in relation to data sharing, e.g. among clinicians

• Facilitate shared decision-making by making person-centred data readily available

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Goal of mICF

• Patient-centred • Patient / carer empowerment

• Facilitate administration and reporting through data aggregation• Gather statistics• Data analysis• Developing algorithms

• Not to re-invent the wheel

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What is out there already?

• University of Sydney:eFRHOM (electronic Functioning and Related Health Outcomes Module)

• McMaster UniversityICanFunction App Development - The App for the ICF! 

• Stellenbosch University: Android apps that can integrate with OpenMRS (circulating cell phone)

• The Netherlands: “Revalidatie EPD”• Italy: Faber; ICF Machine• Switzerland

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Practical Implications The mICF should be:

• User friendly, including built-in decision support, to assist community care workers in recording data

• Low cost, ideally open source, to enable broad accessibility and user configuration

• Able to provide a holistic overview of the individual and information flows, including assessment data, progress reports and interprofessional treatment plans

• Capable of real-time reporting and provision of aggregated datasets to health service and system managers

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Practical Implications The mICF should be:

• An integrated single source of functional status information, which is accessible to patients

• Able to ‘plug in’ and be interoperable with existing information record systems (e.g. OpenMRS)

• Suitable for use in various languages

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Social ImplicationsThe mICF could:

• Provide a means to collect and transfer ICF-related information

• Add value to interprofessional collaborative practice

• Improve continuity of care

• Contribute to more efficient and cost effective health systems

• Statistics and algorithms

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Approach to research/develop mICF

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Goal of 25 interested partners from FDRG

Clinical encounter

Data analysis

Feedba

ck to

mICF

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Next steps

• Needs requirement study• Questionnaire: potential end users and

administrators• Identify pilot groups for requirement

assessment (currently: AU, ZA, IT, TH, CA, DE, BR, DK, KR) WHO else?

• Evaluate current electronic ICF products

• Define project• Consult with knowledge users (e.g. patients,

health practitioners)• Develop partnership

• Clarify potential intellectual property issues• Identify potential project manager(s)

(e.g. postdoc)

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Would you like to contribute?

Complete online questionnaire NOWhttp://tiny.cc/mICF (case sensitive)

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Thank you

More information• Dr Stefanus Snyman:

ssnyman@sun.ac.za Centre for Health Professions Education, Stellenbosch UniversityMember: WHO Collaborating Centre: South Africa

• Ros Madden: ros.madden@sydney.edu.au

Centre for Disability Research and PolicyUniversity of SydneyMember: WHO Collaborating Centre Australia

• Catherine Sykes: csykes@wcpt.orgWorld Council of Physical Therapists