January 23, 2025 | Michelle Badore
The World Health Organization (WHO) completely restructured the ICD-11 classification to take advantage of today’s digital capabilities – to improve coordination with other classifications and terminologies, to provide flexibility to reduce the need for national clinical modifications, and to improve the comparability of translations and support online services to reduce the cost of implementation.
Let’s think of this in terms of a global universal language, like music. Think of a song that the Coca-Cola company used in the 1970s to marry the idea of happiness with a universal love of their product. Much like WHO is promoting for its new classification. So, starting with “I’d Like to Teach the World to Sing” – this is a song that WHO wants to record. They set the key and scale – with ICD-11-MMS.
Each country has global and localized reasons for listening to music, as they do for reasons to use the ICD classification – funding, reimbursement, clinical outcomes, government reporting, health policy, patient care, etc.
For this reason, each country has localized its own set of requirements into specialties – each having a certain balance of voice types. We have the U.S. singing soprano taking ICD-10-WHO and developing ICD-10-CM, Australia singing baritone with -AM, Canada singing tenor with -CA, Germany singing bass with -GM, etc. These countries that have created their clinical modifications need to determine if ICD-11-MMS will meet their needs, or if they will have to modify again.
There are many things to consider when harmonizing:
The WHO has created many committees, reference groups and task forces to help pleasingly combine multiple pitches, often by using a particular key’s structure and using chord progressions, to create movement and resolution. The WHO is the orchestral conductor holding the baton, with each instrument section (or region/country) having its own principal in charge. For the U.S., our principal is the National Committee on Vital and Health Statistics (NCVHS), which will advise on implementation timing, processes and impacts. For Australia, it’s the Australian Institute of Health and Welfare (AIHW); for Canada, the Canadian Institute for Health Information (CIHI); for Germany, the Federal Institute for Drugs & Medical Devices (BfArM), and so on. Each principal frequently works with their conductor, and each of these regions meets regularly with WHO to identify implementation issues and potential solutions with members sitting in WHO-FIC Collaborating Centres, committees and resource groups.
It's the goal of WHO to create a round, which is a musical composition where multiple performers sing the same melody but start at different times. WHO will introduce the melody, like they did in 2019 with the transition to ICD-10, and each following performer or region will start when the time is right.
Let’s warm our collective vocal cords and start. I'd like to teach the world to sing, in perfect harmony…
Michelle Badore is an international content development manager at Solventum.