Background

Historically the ICD has been revised every 10 years to ensure its continued currency and utility. The current revision (ICD-10) was approved in 1990 by the World Health Assembly (WHA), the decision making body of the World Health Organization (WHO). Australian implementation occurred in 1997 with ICD-10 being used for reporting mortality data, and in 1998 an Australian modification was developed for morbidity coding.

The process to update the classification to the eleventh revision (ICD-11) was initiated by WHO in 2007. The design of ICD-11 has a Foundation component of clinical terms which can be expressed in tabular lists according to the expected use. The main tabular list for ICD-11 is made to collect data on disease and causes of death and is called ICD-11 for Mortality and Morbidity Statistics (ICD-11 MMS). Other tabular lists will be created for other uses such as those for Primary Care, Quality and Safety and special clinical groups.

Use cases

Two of the stated goals of the ICD revision process were to:

  1. establish a classification-terminology linkage from ICD-11 to the Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT), and
  2. minimise the need for country specific modifications by creating a structure within ICD-11 to accommodate such modifications.

It is envisaged the classification will serve the needs of multiple use cases, which include:

  • mortality (causes of death)
  • morbidity (diseases and related health problems), and
  • specialty adaptations and uses in different settings (for example primary care and clinical care) for different purposes (for example research, public health monitoring and safety and quality measures).

The objectives of the ICD revision process were to:

  • revise the ICD classification in line with scientific advances, to serve multiple purposes including mortality and morbidity statistics as well as clinical use in primary care, specialty care and research
  • continue to serve as an international standard in multiple languages and settings to allow for comparable data
  • link with computerised health information systems (directly use standard terminologies and other health informatics applications to be “electronic health application ready”).

ICD-11 activities in Australia

The AIHW has been leading implementation activities in Australia since the revision was announced in 2007.

Latest news

The AIHW is now publishing a stakeholder information update document on a six-monthly basis.

 ICD-11 stakeholder update - July 2022 (PDF, 723 kB )

ICD-11 revision launch

An alpha draft of ICD-11 was released to the public for review in July 2011. This was the first step in allowing wider participation of the global health community and multiple stakeholders in the development process of ICD-11.

In July 2011, the AIHW (as the ACC) hosted an Australian event to announce the ICD-11 revision process. This event, titled Think before you measure, was held in association with a symposium on classifications and hosted by the University of Sydney. The event announced the ICD-11 revision and the opportunity for public review to promote participation in the process.

ICD-11 field testing

In 2016-17, as part of the then ICD-11 Revision project plan, the AIHW lead the first phase of morbidity field testing of ICD-11 MMS in Australia, on behalf of WHO. The goals of this field testing were to:

  • inform whether ICD-11 was fit for purpose
  • identify any changes and enhancements that may be required, and
  • confirm any transitional and implementation issues.

The Australian Bureau of Statistics conducted ICD-11 MMS field testing for mortality purposes at the same time. Results from both tests showed more work was required.

Phase 2 morbidity field testing followed in 2017, with Phase 3 undertaken in 2018. These tests assessed the ease of use of the post-coordination functions of the classification and more complex scenarios for coding.

Stakeholder workshops

As part of socialising the classification in Australia, three workshops have been held in 2017, 2018 and in 2021 to update stakeholders on the progress of ICD-11 development by WHO and ascertain issues and considerations for its potential implementation in Australia.

The AIHW commissioned Shepheard Management Consultants to undertake in depth consultations with stakeholders during late 2018 and early 2019, resulting in a number of recommendations to assist the ICD-11 decision making process in Australia. The ICD-11 Review stakeholder consultation report was published in 2020.

The third stakeholder workshop in 2021 was held to validate the recommendations made in this report.

Further information 

If you would like further information on ICD-11 please contact the ACC at [email protected].