Strengthening National Morbidity Statistics in the Pacific: ICD-10 -AM/ACHI/ACS Training for Coders under the COVID-19 Pandemic

BACKGROUND

Pacific countries are at various stages of implementing information systems in the health sector for managing information and service delivery, including adopting the standards like ICD-10. Despite some challenges with ICD-10 coding, countries and healthcare organizations have had general success with coding disease burden and deaths.

The biggest challenge has been having qualified well-trained personnel and ensuring data quality. Also, license fees have presented another barrier to several countries’ ability to access critical health information tools. Although the WHO version of the ICD-10 classification is freely available, it does not include the ability to code interventions and procedures.

Prior commitments from Australia in 2005 to wave the license fees for ICD-10-AM and ACHI (4th Edition) for Fiji, Samoa, Tonga and Solomon Islands remain highly valued because of this added functionality. Currently, Tonga and Fiji continue to code all hospital admissions using the 4th Edition and use this coding structure for everyday reporting, e.g. safety and quality metrics and public health analysis.  In 2020, Australia, through the Independent Hospital Pricing Authority (IHPA) waived the license fee for the current Australian Modification of the classifications (11th version), which allows Pacific Island countries to code diagnoses to a greater level of specificity, but also code procedure and interventions using the Australian Classification of Health Interventions (ACHI).

Information systems, including appropriately coded data, have played a critical role in responding to the outbreak of COVID-19. In this era of the pandemic, data are essential to understand where the disease is occurring and its severity to craft national policy. This information is needed to undertake appropriate responses to the pandemic, including how to allocate resources to provide medical care.

Since the beginning of the pandemic and in response to member state requests, WHO has been progressively activating emergency codes for COVID-19 in ICD-10 and ICD-11 after consultation with the relevant committees and reference groups of the WHO Family of International Classifications (WHO-FIC) Network. A set of additional new codes upon request by member states were activated to be able to document or flag conditions that occur in the context of COVID-19. In particular the need for disambiguation between acute disease, late effects or lengthy course led to the neutral formulation “post-COVID”.

PURPOSE/SPECIFIC OBJECTIVE OF THE ACTIVITY

Working closely with the Ministries of Health and Medical Services and the WHO Pacific Health Systems and Policy team, the contractor will contribute to strengthening the national morbidity statistics in 3 countries in the Pacific. The primary objective is to develop and conduct a virtual morbidity training course for those directly involved in coding including potential new coders.

The contractor will be responsible for assisting the WHO to conduct the training course jointly with the respective Ministries, including but not limited to:

• • Initial meeting with the WHO Pacific Health Systems and Policy team and preparations
• • Development of methodology, content and schedule for ICD10-AM and ACHI training
• • Deliver Training course on medical terminology and morbidity coding remotely
• • Final report with training outcomes, recommendations for future training needs

DESCRIPTION OF ACTIVITIES TO BE CARRIED OUT

In collaboration with the WHO Pacific Health Systems and Policy team and WHO country offices, the contractor will assess countries training needs, guide countries to prepare for the course (direct them to acquire correct training materials) and develop a modular training course.

• •  Develop a methodology for the ICD 10-AM training. Two separate courses should be tailored:
  • Medical terminology/medical science education: The course should include at minimum but not limited to introduction to common medical terms for all body systems and strategies for interpreting complex medical terms, some information about common diseases and treatments. (20 participants)
• •  Morbidity coding: The course should include the use of the five volumes of the ICD-10-Australian Modification/Australian Classification of Health Interventions/Australian Coding Standards and have some practical exercises with real hospital data records (preferably using hospital records from the Pacific). (20 participants)
  • Training need to address potential updates in relation to COVID-19 coding in ICD-10-AM (Multisystem inflammatory syndrome associated with COVID-19, Post COVID-19 condition, Personal history of COVID-19, Immunization to prevent COVID-19 and Adverse reaction to a COVID-19 vaccine)
• •  Pre-test and post-test should be administered during the first and last days of the training course,
• •  Develop approximately 7 months long training schedule and conduct training for 20 people for medical terminology and morbidity coding virtually across the several Pacific Island countries.

• Planned timelines:
• Start date: June 2021
• End date: Up to 7 months
•  
• Technical Supervision:
• Responsible Officer: Katri Kontio Technical Officer
• Manager: Dr Akeem Ali Acting Representative/Director, PSC

METHODS TO CARRY OUT THE ACTIVITY

• •  Conduct a training course for morbidity coding for those directly involved in coding including potential new coders. The course should cover at minimum the introduction, medical terminology, conventions, basic and advance coding guidelines, morbidity rules and guidelines and all the chapters of the ICD-10-AM and ACHI (and potentially also including ICD10).
• • Access some example medical records from each country for the purposes of the training courses.
• •  The methods to carry out the work will include remote support and training to PICs virtually due to travel restrictions; meetings with health partners including Ministries of Health, WPRO, universities, as appropriate.

QUALIFICATIONS & EXPERIENCE

Essential:  

• •  At least 10 years of medical terminology and morbidity coding education experience and conduct of training courses for ICD10-AM and ACHI.
• •  Evidence of ability to conduct remote training in low and middle-income countries

Desirable:

• •  Previous experience in resource poor settings and conduct of online/virtual training
• •  Experience working in one or more Pacific islands to strengthen health information would be a strong asset.

TECHNICAL SKILLS & KNOWLEDGE:

• •  Excellent communication skills;
• •  Excellent analytical, planning and organizational skills;
• •  Ability to work in a team with limited supervision; and
• •  Ability to work under pressure.

LANGUAGES

• •  Written and spoken fluency in English is essential;

COMPETENCIES

• •  Building and promoting partnerships across the organization and beyond;
• •  Moving forward in a changing environment;
• •  Ensuring the effective use of resources;
• •  Fostering Integration and teamwork; and
• •  Communication in a credible and effective way.

ADDITIONAL INFORMATION:

Place of Assignment

Remote, home station

Travel (travel dates to be determined)

No travel required

APPLICATIONS

Qualified and interested specialists should submit their CV {for individual contractors} or Company Profile {for institutional applications} and Expression of Interest {cover letter} to the Supply Officer through WP RO UNGM at < wproungm@who.int > by 14 May 2021

The cover letter should outline how their experience and qualifications make them a suitable candidate for this position, demonstrates how the selection criteria are met and should include their proposed daily consultancy fee, total contract cost and availability.

Please use Tender Notice No. 126921 as subject to all submission. Only successful candidates will be contacted.