International Classification of Diseases 11th revision

Background

Historically the ICD has been revised every 10 years to ensure its continued currency and utility. The current revision (ICD-10) was approved in 1990 by the World Health Assembly (WHA), the decision-making body of the World Health Organization (WHO).

Australian implementation occurred in 1997 with ICD-10 being used for reporting mortality data, and in 1998 using an Australian modification for morbidity coding.

The process to update the classification to the eleventh revision (ICD-11) was commenced by the WHO in 2007. The design of ICD-11 includes a Foundation component of clinical terms which can be utilised in Tabular Lists according to the expected use case. The  Tabular List for ICD-11 which is most like the ICD-10 was designed to collect data on diseases and causes of death and is the ICD-11 for Mortality and Morbidity Statistics (known as the ICD-11 MMS). Other Tabular Lists will be created for other use cases such as Primary Care, Quality and Safety and special clinical groups such as Dermatological Diseases, Neurology and Ophthalmology.

There are anticipated to be substantial benefits from ICD-11’s shift to a digital platform that supports greater integration with digital health applications and technologies (such as the use of APIs) as well as efficiencies through better support of auto-coding of data. There is also potential for better and increased data with the ICD-11 with more granular coding of many areas within health care, such as injuries, self-harm and suicide, and family, sexual and domestic violence, as well as addressing ICD-10 known data gaps.

ICD-11 activities in Australia

The AIHW has been leading implementation activities in Australia since the revision was announced in 2007.

ICD-11 newsletters

The ICD-11 newsletters give you the latest information about national and international health classification activities. These updates are intended to be produced twice a year and will have a focus on activities related to the WHO-FIC reference classifications with a primary focus on ICD-11, with some ICF and ICHI content as well. This is part of the developing communications and education strategies to keep people informed as we work toward a decision on Australia’s approach to ICD-11.

Australian ICD-11 Task Force (AITF)

The establishment of the Australian ICD-11 Task Force (AITF) was a recommendation from the ICD-11 stakeholder consultation report published in 2020. The main objective the AITF is to develop (and undertake) a broad multi-year Roadmap of activities required to make a decision on implementation of ICD-11 in a range of context.

An invitation was sent to the Health Data and Digital Transformation Collaboration (HDDTC) jurisdictional members in March 2022 seeking members for this Task Force. Currently, the AITF has representation from all states and territories except for Northern Territory and South Australia.

The AITF was originally set up as a time limited group for 12 months but in July 2023, the AHCAC endorsed its extension to the end of 2025, aligning its term with the mid-point of the Roadmap where a decision regarding ICD-11 in Australia is expected to be made. It is the AITF’s aim that the activities on the Roadmap be completed (as much as possible) by the end of 2025.

The Roadmap outlines activities that will need to be undertaken to assess the ICD-11 for a particular use case, from jurisdictional to national level, or from a mortality, admitted care, primary care, and other healthcare sector perspectives. This is to ensure that all potential evidence that can be collected in order to make an informed decision across all use cases.  

The achievements of the AITF in its first 12 months include the creation of an ICD-11 vision statement and development of Roadmap activities to the decision date of the end of 2025 and to a potential implementation date of 2031.

Stakeholder workshops

As part of socialising the ICD-11 in Australia, three workshops have been held in 2017, 2018 and in 2021 to provide an update on the progress of ICD-11 development by WHO and ascertain issues and considerations for its potential implementation in Australia.

The AIHW commissioned Shepheard Management Consultants to undertake in depth consultations with stakeholders during late 2018 and early 2019, resulting in a number of recommendations to assist the ICD-11 decision making process in Australia. The ICD-11 Review stakeholder consultation report was published in 2020.

The third stakeholder workshop in 2021 was held to validate the recommendations made in this report.

ICD-11 field testing

In 2016-17, as part of the then ICD-11 Revision project plan, the AIHW lead the first phase of morbidity field testing of ICD-11 MMS in Australia, on behalf of WHO. The goals of this field testing were to:

• inform whether ICD-11 was fit for purpose
• identify any changes and enhancements that may be required, and
• confirm any transitional and implementation issues.

The Australian Bureau of Statistics conducted ICD-11 MMS field testing for mortality purposes at the same time. Results from both tests showed more work was required.

Phase 2 morbidity field testing followed in 2017, with Phase 3 undertaken in 2018. These tests assessed the ease of use of the post-coordination functions of the classification and more complex scenarios for coding.

Further information 

If you would like further information on ICD-11 please contact the ACC at the following details and refer to our other resources.