THE 4TH WHO FORUM
By Jiri Bilek
The 4th WHO Forum was one of the political meetings organized by ETCMA during the 48th TCM Congress in Rotheburg.
Unlike previous years, when we have welcomed WHO officials and collaborators in person, this time the meeting had a form of a teleconference. It was because at the same time as the TCM Congress the WHO organized the World Health Assembly in Geneva.
Thanks to the technologies, participants of the forum were able to receive the fresh update of the ICD-11 TM Chapter (11th revision of the International Classification of Diseases, Traditional Medicine) by Nenad Kostanjsek from WHO Collaborating Centre for Classification and Mental Health.
The official video promoting ICD-11 can be viewed at: https://www.youtube.com/watch?v=tZFcoYfnwiM
The TM Chapter has been presented a unique attempt to categorize diagnosis of TCM the same way that ones of modern Western Medicine. It has been built based of the national systems of China, Japan and South Korea and released as a part of the official release in 2016 for member states comments.
The progress on the ICD-11 including TM Chapter was supported my member states on the ICD Revision Conference in Tokyo, October 2016. The fully stable version of the ICD-11 for implementation is aimed to be released in 2018 after field-testing during this year.
WHO’s plan on use of TM chapter
• Use the TM Chapter as a tool to conduct projects in monitoring and assessing this part of TM morbidity and services at the global context;
• Facilitate the projects on safety, quality and effectiveness in T&CM services;
• Facilitate the projects on clinical research;
• Be included into relevant training and clinical documents. (e.g. the series of benchmarks for training and for practice documents in T&CM);
• Facilitate the integration of T&CM service with national healthcare systems;
• Monitoring how T&CM services contribute to health outcome and UHC.
The second guest of the WHO Forum was John Hughes from The Royal London Hospital for integrated Medicine. He presented a development and outcomes of the Europe-wide TM Chapter pilot field-testing that was comprised of three phases.
The Phase 1 was a survey among the acupuncturists. Data were collected via link that has been distributed by member organizations of ETCMA. For the final assessment were chosen answers of 127 practitioners.
The Phase 2 was testing a coding process on 5 case study vignettes selected from WHO database of case studies based on the findings from previus survey. Requirements for 15 participating practitioners from 4 countries (UK, Germany, Italy and Norway) was to be eligible for accreditation with a TM association within their country and have a minimum of 5 years clinical experience.
The Phase 3 included a survey among acupuncturists participating in the coding of case study vignettes.
Key conclusions and recommendations:
• European TM practitioners perceive the TM ICD-11 codes as valuable, conceptually accurate, and likely to be easy to learn. However, data from the study also identifies areas where the TM ICD-11 codes could be improved for European TM practitioners, including:
• Expanding the scope of the TM ICD-11 codes to incorporate additional traditional East Asian medical systems not currently included within the codes, to better reflect the practice of TM within Europe.
• Certain codes considered to be insufficiently detailed and should be amended to include further details.
• To better reflect the non-exclusive nature of TM diagnoses it is recommended that a multidimensional approach be adopted towards the TM ICD-11 codes, whereby more than one TM Pattern can be applied to a presenting patient.
• Further research is recommended. In particular the clinical utility of TM ICD-11 codes when utilised within routine clinical practice to explore European TM practitioners’ experiences of utilising the TM ICD-11 codes with actual presenting patients.
The 4th WHO Forum was moderated by Jiri Bilek, former ETCMA EC member and Maria Jekansen, the chair of the advocacy committee.
Both speakers and participants expressed an appreciation of the opportunity for the exchange of information and cooperation between WHO and ETCMA and agreed to organize the 5th Forum in 2018.