Classification 1
16
| Thursday, October 26, 2023 |
| 2:05 PM - 3:40 PM |
| Meeting Room C4.9 |
Speaker
Dr Preben Larsen
Danish College Family Medicine
International Classification of Primary Care - 3 (ICPC - 3) Workshop
2:05 PM - 3:40 PMSummary
Backgound: The third version of International Classification of Primary Care (ICPC-3) was released in 2021 The structure changed from one letter and two digit alphanumeric codes to two letters and two digits, but the mnemonic rules of the chapters remained, with chapter B for “Blood” and Chapter D for “Digestive” conditions and symptoms. There are 19 chapters, including 14 organ/system, one general and one for social problems. Each chapter is organized into two components, namely S - Symptoms and D - Diseases. Among the key innovations are chapters for Prevention, Functioning and Regional extension.
Objective: The workshop aims to present ICPC 3 in a practical way and discuss the future of clinical documentation.
Methods: There will be four parts:
1st part (15 minutes): presentation on the history and structure of ICPC-3
2nd part: (20 minutes):
• Concepts around the interaction of ICPC and Electronic Health Record
• Discussion on how ICPC 3 could better be implemented in Electronic Health Records?
3rd part (30 minutes): ICPC-3 exercises on the RSOAP structure
Example:
Reason for encounter: fever (AS03), headache (NS01), pain in the joints (LS20)
Subjective: In the neighborhood people with Dengue (AD14.01), unable to work (2F58 PSV.3)
Objective: Partial examination (A102), well hydrated, blood pressure 120 x 80 and no other abnormal findings.The tourniquet test is negative (A199)Assessment: Almost certain Dengue infection (AD14.01)
Plan: Prescription (A201), paracetamol and advice (A203) to come back if she notices any signs of worsening
4th part (25 minutes): Discussions around the future of clinical documentation process by Primary Care providers:
• What are the tools (classifications, terminologies, thesaurus, browsers, dashboards, natural language process tools) currently used?
• What will be the main tools in the near future?
• What are the providers expectations with the tools?
• What is the future of clinical documentation?
Objective: The workshop aims to present ICPC 3 in a practical way and discuss the future of clinical documentation.
Methods: There will be four parts:
1st part (15 minutes): presentation on the history and structure of ICPC-3
2nd part: (20 minutes):
• Concepts around the interaction of ICPC and Electronic Health Record
• Discussion on how ICPC 3 could better be implemented in Electronic Health Records?
3rd part (30 minutes): ICPC-3 exercises on the RSOAP structure
Example:
Reason for encounter: fever (AS03), headache (NS01), pain in the joints (LS20)
Subjective: In the neighborhood people with Dengue (AD14.01), unable to work (2F58 PSV.3)
Objective: Partial examination (A102), well hydrated, blood pressure 120 x 80 and no other abnormal findings.The tourniquet test is negative (A199)Assessment: Almost certain Dengue infection (AD14.01)
Plan: Prescription (A201), paracetamol and advice (A203) to come back if she notices any signs of worsening
4th part (25 minutes): Discussions around the future of clinical documentation process by Primary Care providers:
• What are the tools (classifications, terminologies, thesaurus, browsers, dashboards, natural language process tools) currently used?
• What will be the main tools in the near future?
• What are the providers expectations with the tools?
• What is the future of clinical documentation?
Takeaways
1. Structure of ICPC-3
2. Practical use of ICPC - 3
3. Insights around the future of clinical documentation
2. Practical use of ICPC - 3
3. Insights around the future of clinical documentation
Biography
Gustavo Gusso is professor of General Practice at Universidade de São Paulo and former president of Brazilian Society of Family and Community Medicine
