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
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]
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
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