ICPC PLUS for community health? A feasibility study.

BACKGROUND: The development of information systems in community health is being led by the Community Health Information Management Enterprise, a multi state consortium of State Health Departments. To ensure reliable and valid data collection, client problems (issues) presented to community health providers and the activities they undertook will require coding and classification. The suitability of existing classification systems for issues and activities in the community health setting therefore warranted investigation. AIMS: To assess the extent to which the extended version of the International Classification of Primary Care (ICPC PLUS) is a feasible tool with which to code issues and activities in community health settings.
METHOD: 62 providers representing 22 service groups recorded, in their own words, details about issues and activities at all client contacts for a period of two weeks. These were secondarily coded with ICPC PLUS and subjective judgment made about the "goodness" of fit between the recorded term and the term available in ICPC PLUS.
RESULTS: Of the 2146 issues recorded, 90.5% could be coded with ICPC PLUS. Codes with a "good fit" were available for 71.2%. ICPC PLUS had suitable codes for 67.5% of the 2470 recorded activities, but only half of these were a "good fit". Some ICPC PLUS terms required greater specificity and some of the terms recorded needed to be further defined before a code could be allocated.
CONCLUSION: It is feasible to use ICPC PLUS to classify issues with only minor additions and alterations. Activities could also be classified with ICPC PLUS but far more development would be required.