July 2004
ICPC-2 PLUS
AN ENHANCED VERSION OF THE
INTERNATIONAL CLASSIFICATION OF PRIMARY CARE (ICPC-2)
Family Medicine Research Centre, University of Sydney
in co-operation with the
World Organisation of Family Doctors (Wonca)
FUNCTIONALITY
REQUIREMENTS FOR
DEVELOPERS
Use of ICPC-2 PLUS in clinical systems for Primary Care
ICPC-2 PLUS
This booklet has been designed to provide information needed to incorporate ICPC-2
PLUS into computerised clinical systems. All examples used in this document were
correct as at July 2004.
If you have any questions regarding the application of ICPC-2 PLUS in you software,
please contact us using the details provided below.
Associate Professor Helena Britt
Dr Graeme Miller
Family Medicine Research Centre
University of Sydney
Acacia House, Westmead Hospital
P. O. Box 533
WENTWORTHVILLE NSW 2145
Phone: +61 2 9845 8151
Fax: +61 2 9845 8155
Email: [email protected]
Website: www.fmrc.org.au
ICPC-2
© World Organisation of National Colleges, Academics and Academic Associations
of General Practitioners/Family Physicians
ICPC-2 PLUS
© University of Sydney, 1998 (Family Medicine Research Centre)
Contents
1) Introduction......................................................................................... 4
1.1) Classifications and coding systems .................................................................. 4
1.2) Structure of ICPC-2 .......................................................................................... 5
1.3) Explanation of ICPC-2 PLUS codes................................................................. 6
1.4) Structure of ICPC-2 PLUS terms ..................................................................... 6
1.5) Advantages of using ICPC-2 PLUS ................................................................. 7
1.6) Obligations regarding end users ....................................................................... 8
1.7) Updates of ICPC-2 PLUS................................................................................. 9
1.8) Demonstrator .................................................................................................... 9
1.9) Glossary .......................................................................................................... 10
1.10) Further information......................................................................................... 11
2) Data entry .......................................................................................... 12
2.1)
2.2)
2.3)
2.4)
2.5)
2.6)
Background..................................................................................................... 12
Table Description............................................................................................ 12
Field descriptions............................................................................................ 13
Entity Relationship Diagram .......................................................................... 14
Functionality requirements ............................................................................. 15
Temporary codes: ........................................................................................... 17
3) Supplementary information for data entry.................................... 18
3.1) Natural Language............................................................................................ 18
3.1.1) Background ................................................................................................ 18
3.1.2) Integrating the natural language functionality ........................................... 18
3.1.3) Field Description........................................................................................ 18
3.2) Inactive codes ................................................................................................. 19
3.2.1) Background ................................................................................................ 19
3.2.2) Table Description....................................................................................... 19
4) Additional reference material on ICPC-2 ...................................... 20
4.1)
4.2)
4.3)
4.4)
4.5)
4.6)
Background..................................................................................................... 20
Table Description............................................................................................ 20
Field descriptions............................................................................................ 21
Entity Relationship Diagram .......................................................................... 22
Use of ICPC-2 reference tables ...................................................................... 23
Functionality requirements ............................................................................. 23
5) Data reports....................................................................................... 24
5.1)
5.2)
5.3)
5.4)
Background..................................................................................................... 24
Table Description............................................................................................ 26
Entity Relationship Diagram .......................................................................... 27
Use of grouper files for data output................................................................ 28
Appendices............................................................................................... 34
Appendix A - DEVELOPERS LICENCE / CONTRACT
Appendix B - INFORMATION FOR USERS
1) Introduction
1.1) Classifications and coding systems
ICPC-2
Classifications organise information into logical groups and facilitate the timely and
accurate collection and analysis of grouped data. The International Classification of
Primary Care (ICPC-2) is a classification designed for primary care, or general
practice. It was developed by the World Organisation of Family Doctors (Wonca),
and classifies information in primary care relating to:
• reason(s) for encounter (why the patient has come for the consultation)
• problems managed
• diagnostic and therapeutic interventions, including:
o procedures
o referrals
o pathology tests
o imaging orders.
ICPC-2 is distributed exclusively in Australia and the Pacific Basin by the Family
Medicine Research Centre (FMRC), University of Sydney, Australia.
ICPC-2 is an excellent epidemiological tool. It logically groups conditions that are
commonly found in general practice, using body systems as the primary identifier.
This facilitates meaningful data analysis. However, ICPC-2 has only 1,380 codes, and
as such is too broad to accurately code specific individual conditions. For this reason,
the Family Medicine Research Centre at the University of Sydney extended the
classification for use in Australian general practice, into a coding system known as
ICPC-2 PLUS.
ICPC-2 PLUS
ICPC-2 PLUS is an extended terminology based on ICPC-2, developed using over
one million records of general practice encounters. ICPC-2 PLUS is a coding system.
It has been designed specifically for use in electronic health records, and includes
terms that are commonly used in Australian general practice. It is used in numerous
commercially available software packages, and in various research projects and coordinated care trials.
In your clinical system, ICPC-2 PLUS can be used to code data relating to reasons for
encounter, problems managed and treatments provided, in more specific terms than
ICPC-2. Data stored in medical records can then be extracted for data reports,
classified in ICPC-2.
For more information on classification and coding, refer to your User’s Guide. Copies
of
the
User’s
Guide
can
be
downloaded
from
our
website:
www.fmrc.org.au/classifi.htm.
ICPC-2 PLUS : Functionality requirements for developers
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1.2) Structure of ICPC-2
ICPC-2 has a bi-axial structure, with 17 chapters of one axis (each with an alphabetic
code) and seven components on the other (numeric codes) (see Figure 1). Chapters are
based on body systems, with additional chapters for psychological and social
problems. Component 1 includes symptoms and complaints, while Component 7
covers diagnoses. These are independent in each chapter and both can be used for
patient reasons for encounter and for problems managed.
Components 2 to 6 are common throughout all chapters. The processes of care,
including referrals, non-pharmacological treatments and orders for pathology and
imaging are classified in these process components of ICPC-2.
Component 2 (diagnostic screening and prevention) is also often applied in describing
the problem managed (e.g. check-up, immunisation).
Figure 1: The structure of the International Classification of Primary Care – Version 2
(ICPC-2)
A
Components
B
D
F
H
K
L
N
P
R
S
T
U
W X
Y
Z
1. Symptoms, complaints
2. Diagnostic, screening, prevention
3. Treatment, procedures, medication
4. Test results
5. Administrative
6. Other
7. Diagnoses, disease
A
B
D
F
H
K
General
Blood, blood-forming
Digestive
Eye
Ear
Circulatory
L
N
P
R
S
T
Musculoskeletal
Neurological
Psychological
Respiratory
Skin
Metabolic, endocrine, nutritional
U
W
X
Y
Z
Urinary
Pregnancy, family planning
Female genital
Male genital
Social
ICPC-2 PLUS code ranges for management
Within the ‘process’ components, ICPC-2 codes can be further broken down into
specific types of care for data entry. These can then be used to limit the ranges of
fields within your software. There are two ways this can be done:
1.
Generic management fields – if you have a single ‘management’ field in your
record. Within this field, any ICPC-2 PLUS code within the ranges of
-30 to -69 could be entered (see Table 1 for explanation).
2.
Specific management fields – multiple management fields may be available in
your software. If you wish you can limit the user to enter specific management
types only in the correct fields. For example, using this option, pathology
codes could only be entered in the pathology field in the record.
If you choose to implement Option 2, code ranges are provided below for the specific
types of management. Limit users to enter data only from the rubrics provided in the
table.
In the ‘reasons for encounter’ (RFEs) (i.e. the presenting problem) and ‘problems
managed’ fields, we recommend that all ICPC-2 PLUS codes are available for data
ICPC-2 PLUS : Functionality requirements for developers
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entry. This ensures that process codes, such as immunisations and medication requests
can be entered as either RFEs or problems.
Table 1: Ranges for ICPC-2 codes related to problem management
Updated April 2004
(a)
Code type
Data range
Management
-30 to –69
Check-ups
-30,-31
Pathology tests
-33, -34, -35, -36, -37, -38
Imaging tests
-41
Other tests and investigations
-39, -40, -43
Immunisation
-44
Non-pharmacological management
Advice/counselling
-45, -58
Therapeutic procedures
-51, -52, -53, -54, -55, -56, -57, -59
Referrals
-66, -67, -68
Other management
-32,-42,-46,-47,-48,-49,-50,-60,-61,-62,-63,-64,
-65,-69
(a)
a dash (-) in front of the numeric code indicates that the code is used consistently across all
chapters, with the exception of chapter Z. Alpha codes should replace the dashes across each
chapter, e.g. –41 would include all ICPC-2 PLUS codes beginning with A41, B41, D41, F41 etc.
1.3) Explanation of ICPC-2 PLUS codes
ICPC-2 PLUS codes are 6 digits long, and can be broken down into two parts, the
ICPC-2 code, and the ‘plus’ code.
A86 001
The first 3 characters are the ICPC-2
code. The alphabetic part (A)
indicates the chapter of the ICPC-2
code, while the numeric part (86)
identifies the location of the code
within the chapter.
The last three digits comprise the
‘plus’ part of the ICPC-2 PLUS code.
As each plus code is entered, it is
assigned the next available 3 digit
number in the rubric. As such, there is
no meaning to the order of these codes.
1.4) Structure of ICPC-2 PLUS terms
ICPC-2 PLUS terms appear in the files as one of two structures:
• Common usage expression – e.g. ‘Restless legs syndrome’
• Problem/Procedure;type;site – e.g. ‘Pain;musculoskeletal;leg’
‘Problems’ include terms such as lesion, inability, infection, disease, fracture etc.
‘Procedures’ include terms such as excision, destruction, test, etc.
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‘Type’ further specifies the nature of the problem, and may refer to the status of the
problem, e.g. acute, chronic. The ‘type’ section of the structure is not always present
in problem and procedure codes.
‘Site’ specifies the location of the problem. The ‘site’ section of the structure is not
always present in problem and procedure codes.
This structure is adhered to ensure the uniformity of codes in ICPC-2 PLUS and
minimises the risk of duplicating a term.
1.5) Advantages of using ICPC-2 PLUS
ICPC-2 has been endorsed as the Australian standard for classification in general
practice and patient self-reported data by the National Health and Information
Management Group (NHIMG) [a working group of the Australian Health Ministers
Advisory Council].
ICPC-2 PLUS is a dynamic coding system which is updated regularly. We aim to
provide users with a comprehensive set of terms used in Australian general practice.
As such, we encourage the participation of both ICPC-2 PLUS developers and users
in the further development of the coding system, so that it reflects the terms actually
used in general practice. We also appreciate the input of developers regarding both the
content and technical aspects of the system.
Through the use of logical links between keywords and terms, ICPC-2 PLUS aims to
be user-friendly. Users simply have to enter the first few letters of a keyword and
select the most appropriate term to record, rather than manually typing the name of
the condition they wish to enter. Users do not have to be aware of the codes saved, or
even know they are coding. Creating data reports is also easy using ICPC-2 PLUS, as
the codes are automatically saved, and can be quickly and accurately retrieved from
the system.
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1.6) Obligations regarding end users
ICPC-2 PLUS has been incorporated into commercially available medical software,
as well as being used exclusively for research. All sites using ICPC-2 PLUS within
commercially available software must be licensed through the Family Medicine
Research Centre.
Licence fees for the use of ICPC-2 PLUS are payable annually. Initial membership
includes a once only payment (for the life-long use of ICPC-2) which is passed on in
full to the World Organisation of Family Doctors (Wonca). This money is used for the
further development of classifications in general practice. An annual site licence fee is
also payable to the FMRC. In subsequent years, only the annual site licence fee is
payable. Licence fees for countries outside Australia are available by quotation. In
Australia, licence fees for general practices, are as follows:
INITIAL MEMBERSHIP
YEAR 1 ONLY
Single user site:
2-4 user site:
5-10 user site:
11-15 user site:
16-20 user site:
21+ user site:
*
$210*
$315*
$420*
$480*
$530*
$580*
ANNUAL SITE LICENCE FEE
FROM YEAR 2
Single user site:
$110*
2-4 user site:
$165*
5-10 user site:
$220*
11-15 user site:
$280*
16-20 user site:
$330*
21+ user site:
$380*
10% GST is calculated only on the annual site licence fee, and is included in this amount.
How to calculate the number of users
The number of users is calculated according to the clinical users of ICPC-2 PLUS
sharing medical records. The total number of users is then calculated by determining
the number of full-time equivalents (FTEs) in a practice, where 2 sessions or 1 day
equates to 0.2 FTEs, rounding this figure to the nearest whole number.
Licensing your end users:
When your software is nearing release, please contact the FMRC so we can discuss
the licensing arrangements for ICPC-2 PLUS. Large group licences can be negotiated,
or licensing can be arranged for each individual practice.
An information sheet for potential users of ICPC-2 PLUS is included as Appendix 2,
and is included electronically with each ICPC-2 PLUS release. Please print these out
and distribute to any practices considering using ICPC-2 PLUS in their medical
records. The information sheet outlines the purpose of ICPC-2 PLUS, gives an
example of how ICPC-2 PLUS should work in your software and tells the user where
they can find more information about ICPC-2 PLUS. A section at the bottom of the
sheet serves as a subscription form, which the user can then forward to the FMRC.
If a user does not pay their annual renewal fee, we will notify you that the practice is
no longer a licensed ICPC-2 PLUS user, and that access to ICPC-2 PLUS should be
removed.
Any practice that is not licensed to use ICPC-2 PLUS should not be able to
access the coding system for data entry.
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1.7) Updates of ICPC-2 PLUS
You will receive regular updates of the ICPC-2 PLUS data files. These are sent not
more often than three-monthly. Updates may take the form of updates to the terms
available for use in ICPC-2 PLUS, or updates to other aspects of the coding system,
such as structural revisions.
The Developer’s package you are sent every release will include information on the
content of the release. When ICPC-2 PLUS terms are updated, your end users will be
sent updated appendices for their User’s Guide. Appendix C of the user guide lists all
the new terms added to ICPC-2 PLUS in each update.
1.8) Demonstrator
The FMRC has developed an ICPC-2 PLUS Demonstrator package, which may help
you when you are incorporating ICPC-2 PLUS into your clinical system. The
Demonstrator outlines the uses of ICPC-2 PLUS from both the data entry and data
reporting perspectives. It adheres to the functionality specifications that are outlined
in this document, and can therefore be used to check how ICPC-2 PLUS is supposed
to work. It may also be used to demonstrate ICPC-2 PLUS to potential users of your
system.
The ICPC-2 PLUS Demonstrator is available on our website as a zipped Microsoft
Access database at: www.fmrc.org.au/classifi.htm.
The ICPC-2 PLUS Demonstrator is updated at the same time as each update is sent,
and can therefore be used to check that your search mechanisms give the correct
result.
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1.9) Glossary
TERM
ACTIVE
CHAPTER
COMPONENT
ICPC CODE
ICPC-2
ICPC-2 PLUS
ICPC-2 PLUS
CODE
INACTIVE
KEYWORD
NATURAL
LANGUAGE
PLUS CODE
RUBRIC
STATUS
TERM
TERM CODE
DESCRIPTION
codes marked as active (‘A’) are those available for data entry in ICPC-2 PLUS.
ICPC-2 has 17 chapters based mostly on body systems, e.g. circulatory system,
respiratory system. In the ICPC-2 diagram in Figure 1, the chapters run across
the horizontal axis. Chapters are identified through the use of a single alphabetic
letter
There are 7 components in ICPC-2. In the ICPC-2 diagram in Figure 1, the
components are situated on the vertical axis
also referred to as ICPC-2 codes. ICPC codes are 3 digit alpha-numeric codes.
Each represent a broad heading of a concept within the ICPC-2 classification.
an international classification designed for primary care, which facilitates the
timely and accurate collection of data in general practice.
an extended terminology classified in ICPC-2, designed for use in electronic
health records in Australian general practice.
the 6-digit alpha-numeric code, combining the 3-digit ICPC-2 code and the
3-digit plus code (or term code).
terms marked as inactive (‘I’) which are no longer valid for data entry, but must
be retained in the medical record for historical data reporting. For more
information, see Section 3.
words or abbreviations, of up to 10 characters long, which are linked to ICPC-2
PLUS terms, and used for searching.
ICPC-2 PLUS terms converted into the way terms are commonly spoken. For
more information, see Section 3
also called the ‘term code’. The three digit code that makes up the extension of
ICPC-2 for Australia. In combination with the ICPC code it provides a more
specific six digit code to record a concept in the classification.
descriptor of the concept that is represented by the ICPC code. The label of the
three digit alpha-numeric ICPC code which represents the broad heading of a
concept within the ICPC-2 classification.
indicates whether the code is valid for use in data entry (A= active; I= inactive).
For more information, see Section 3.
The description of an ICPC-2 PLUS term, attached to the 6 digit alphanumeric
code
also called the ‘plus code’. The three digit code that makes up the extension of
ICPC-2 for Australia. In combination with the ICPC code it provides a more
specific six digit code to record a concept in the classification.
ICPC-2 PLUS : Functionality requirements for developers
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1.10) Further information
Please refer to the following publications for further information on the development
of ICPC-2 PLUS and the ICPC-2 classification.
• ICPC-2 PLUS User’s Guide
• The Family Medicine Research Centre’s website: www.fmrc.org.au
• Britt H. A new coding system for computerised clinical systems in primary
care - ICPC PLUS. Aust Fam Physician.1997;26 (Suppl 2); S79-S82
• Britt H, Scahill S, Miller G. ICPC PLUS for community health? - a feasibility
study. Health Information Management 1997; 27: 4: 171-175.
• Britt H. Which code? Which classification? Informatics in Healthcare
Australia, 1996, 5:4; 140-44.
• Britt H, Beaton N, Miller G. Coding and classification in computerised general
practice medical records: Why code? Why classify? Aust Fam Physician 1995;
24: 612-615.
ICPC-2 PLUS : Functionality requirements for developers
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2) Data entry
2.1) Background
The purpose of data entry is to enter information into a clinical system to enable the
timely, accurate and consistent collection of data.
Entering data using ICPC-2 PLUS is done through the use of keywords. Keywords are
linked to ICPC-2 PLUS terms to provide the user with a picklist of all the connected
terms. Once the user selects the required term from the picklist the term and its ICPC2 PLUS code are saved. This saved code may then be retrieved at any time e.g. for
data reports.
2.2) Table Description
The tables needed for data entry are icpc2key.csv, icpc2lnk.csv and icpc2trm.csv. The
field contents and descriptions are listed below for these three CSV files. The order of
the fields in the CSV files from left to right corresponds with the field order from top to
bottom in the tables below. An Entity-Relationship diagram is also enclosed.
KEY TABLE (icpc2key.csv)
keyid
keyword
Integer
Char(10)
TERM KEY TABLE (icpc2lnk.csv)
keyid
Integer
termid
Integer
TERM TABLE (icpc2trm.csv)
termid
Integer
term30
Char(30)
nalan50
Char(50)
icpccode
Char(3)
termcode
Char(3)
status
Char(1)
replacement
Char(6) Updated April 2004
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2.3) Field descriptions
Field Name
Icpccode
Keyid
Keyword
Nalan50
Replacement
Status
Term30
Termcode
Termid
Note:
Field Description
The 3 digit alpha-numeric ICPC-2 code.
The unique identifier automatically generated when each keyword is entered
into the ICPC-2 PLUS database.
A word, or abbreviation of a word, of up to 10 characters.
The natural language term, up to 50 characters (for further information on
natural language, see Section 3).
The replacement code field is used when a term is made inactive, and states the
code that should be used in its place (for further information on inactive codes
see Section 3.2)
Indicates whether the code is active (A) or inactive (I) (for further information
on inactive codes, see Section 3).
The description of the ICPC-2 PLUS code, up to 30 characters
The 3 digit numeric ‘plus’ code
The unique identifier automatically generated when the term is added into the
ICPC-2 PLUS database.
Icpccode and Termcode combine to make the six character ICPC-2 PLUS code
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ICPC-2 PLUS : Functionality requirements for developers
keyid
1:m
keyid (FK)
icpc2lnk
•
•
termid (FK)
The Termid from the Term Table (icpc2trm.csv) has a one-tomany relationship with the Termid from the Term Key Table
(icpc2lnk.csv).
The Keyid from the Key Table (icpc2key.csv) has a one to
many relationship with the Keyid from the Term Key Table
(icpc2lnk.csv).
As shown in the Entity-Relationship diagram above;
keyword
icpc2key
Non-Key Attributes
Key Attributes
table_name
term30
nalan50
icpccode
termcode
status
replacement
termid
FK = Foreign Key
1:m = one-to-many relationship
eg. a one-to-many with the right hand
side with at least one.
Legend:
m:1
icpc2trm
Updated April 2004
2.4) Entity Relationship Diagram
Page 14 of 34
2.5) Functionality requirements
Keyword background
Keywords are essential when entering data using ICPC-2 PLUS. Keywords facilitate
data entry by linking to ICPC-2 PLUS terms, enabling a user to select the term they
want to record simply by entering a few letters rather than typing the whole
expression.
Keywords always have a logical connection with the ICPC2-PLUS term and can be
fragments of terms, whole words, abbreviations, synonyms or acronyms. They can be
up to 10 characters in length. Keywords tend to be plural rather than singular words
and are formatted without spaces, slashes (/) or dashes (-). Multiple keywords may be
linked to a single term. Similarly, multiple terms may be linked to a single keyword.
Data entry functionality
Keyword functionality
• For data entry, the user should enter the first few (approx 4) letters of a keyword
that is related to the desired term the user wants to record. Only keywords
supplied by the Family Medicine Research Centre in the icpc2key.csv file may be
used. Users must not be able to create their own keywords.
• The clinical system must be able to search on the first characters of a keyword.
The minimum number of keyword characters required to search on is one.
Therefore entering the letter ‘d’ as a keyword will give a picklist of terms that
have a linked keyword that starts with the letter ‘d’. The more keyword characters
that are entered the more specific the search results.
Picklist functionality
After entering a keyword:
• The resulting search must only be based on the keyword, not the keyword and
term.
• The keyword search must display a list of all terms (field name: term30) linked to
that keyword from which the user can select the one required.
• The list of displayed terms must be in alphabetical order.
• The terms shown in the picklist must only be those that are active (field name:
status = A).
• The keyword search must not display a picklist of natural language terms (field
name: nalan50) linked to that keyword.
• The picklist result of a search must be void of duplicate terms. If you have
duplicates in the picklist you may have included Inactive terms (field name: status
= I), or have run the search based on both the keyword and the term (see Section 3
for information on inactive codes).
• The picklist must only include ICPC-2 PLUS terms (i.e. those with six digit
codes) and not the ICPC-2 codes (three digit codes).
• When the user selects the term required from the picklist, its ICPC-2 PLUS code
must be stored in the medical record for future retrieval purposes.
• You can store the ICPC-2 PLUS code alone and use links to pull up either the
term (field name: term30) OR the natural language term (field name: nalan50) OR
you can store either of these in the record along with its ICPC-2 PLUS code.
ICPC-2 PLUS : Functionality requirements for developers
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•
Displaying the ICPC-2 PLUS code on the screen in both the picklists and the
medical record is optional.
Do not allow users to run searches for keyword fragments that are located
anywhere within an ICPC-2 PLUS term. For example, an incorrect search for ‘leg’
situated anywhere in an ICPC-2 PLUS keyword or term would result in a picklist
that would include terms such as ‘Paraplegia’ and ‘Pregnancy;illegitimate’,
neither of which are associated with the keyword ‘LEG’. Duplicates may also
result from a search of this kind.
Example
To record a diagnosis of leg ulcer, type in “leg” as your keyword because you are
looking for a term associated with leg(s). The correct search function will return a
picklist of terms that are linked to keywords beginning with leg (i.e. keywords ‘legs’,
‘legal’ and ‘legionnair’). The result is a picklist containing 38 terms in alphabetical
order (see Figure 2). Leg ulcer is listed under ‘U’ because ulcer is the problem and the
leg is the site (for information on the structure of ICPC-2 PLUS terms see Section
1.4). (Note–if you had entered ulcer as the keyword you would have got a smaller
picklist).
Figure 2: Results of ICPC-2 PLUS term search using keyword ‘LEG’
Ô
Term description
Keyword
Adjusting;brace;leg
LEGS
Admin;legal report
LEGAL
Advice/education;legal
LEGAL
Cellulitis;leg
LEGS
Corked leg
LEGS
Cramp(s);calf
LEGS
Cramp(s);leg
LEGS
Cramp(s);thigh
LEGS
CT scan;leg
LEGS
Deformity;limb;acquired
LEGS
Disease;Legionnaires
LEGIONNAIR
Fitting (of);brace;leg
LEGS
Footdrop
LEGS
Fracture;leg
LEGS
Inflammation;musculo
LEGS
Injury;leg
LEGS
Injury;limb
LEGS
Mononeuritis;legs
LEGS
Numbness;leg
LEGS
Oedema;leg
LEGS
Pain;leg
LEGS
Pain;musculoskeletal;leg
LEGS
Problem;legal
LEGAL
Referral;financial/legal serv
LEGAL
Restless legs syndrome
LEGS
Shin splints
LEGS
Swollen;leg
LEGS
Sympt/complaint;leg
LEGS
Test;Legionnaires antibodies
LEGIONNAIR
Ulcer;leg
LEGS
ICPC-2 PLUS : Functionality requirements for developers
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Ultrasound;leg
LEGS
Varicose veins;inflamed;leg
LEGS
Varicose veins;leg
LEGS
Weakness;leg
LEGS
X-ray;femur
LEGS
X-ray;leg
LEGS
X-ray;leg lower
LEGS
X-ray;tibia/fibula
LEGS
NB: the number of terms linked to the keyword search ‘leg’ was correct as at July 2004. To check
this example for releases dated after July 2004 refer to the Demonstrator (see Section 1).
2.6) Temporary codes:
There will be times where a user cannot find an appropriate ICPC-2 PLUS term (and
thus a code) when using ICPC-2 PLUS. The user can ring our Help Line on +61 2
9845 8151. However, he/she may not have the time to telephone, or our Help Line
may not be able to provide an immediate answer. Therefore, the system must provide
for the user to enter his/her own term until the correct term can be added to ICPC-2
PLUS. These "terms" will be allocated the code J99 (see below for functionality of J
codes).
These "J99" codes will be unique to each end user’s clinical system. A "Code
Confirmation" form is supplied to users (Appendix ‘J Codes’ in the users guide). It
can be faxed or posted to the FMRC indicating the medical concept for which a code
could not be found and noting the J99 code allocated by the clinical system. Upon
notification of a J99 code the FMRC will either determine the appropriate existing
code this concept should be allocated to and notify the user, or create a new code in
ICPC-2 PLUS for this concept. If a new code is created it will be included in the next
ICPC-2 PLUS release, making it available for all users.
Functionality of J codes
• A user must be able to create a J code to capture concepts for which he/she cannot
find a term in ICPC-2 PLUS. The user must give each J code a term.
• J codes must always be assigned to the ICPC-2 code J99. Each term must be
assigned a six digit ICPC-2 PLUS code. The first three digits of the code are J99
followed by a three digit plus code which is allocated consecutively, the first being
001, then 002 etc.
• The system should allow the user to select J99 as a legitimate ICPC code and display
its terms for selection.
• The users’ clinical system must be able to replace all instances of a selected J99 code
in his/her medical records with the correct ICPC-2 PLUS code as directed by the
FMRC. This may be most easily done through mapping the J code to an ICPC-2
PLUS code.
• After the medical record is corrected the J99 ICPC-2 PLUS code should be flagged
‘inactive’ so it cannot be selected again.
• The clinical system should never re-use a J99 term code after it has been allocated.
It is imperative that J codes are temporary. This is necessary because J codes are not
grouped within the ICPC-2 classification and hence will not be counted in data reports,
resulting in incorrect numbers. There is also the risk that a J code will duplicate an
existing ICPC-2 PLUS code leading to double ups in the picklist.
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3) Supplementary information for data entry
3.1) Natural Language
3.1.1) Background
‘Natural language’ terms are simplified descriptions of existing ICPC-2 PLUS terms.
ICPC-2 PLUS terms are structured with the generic ‘problem’ or ‘procedure’ entered
first, followed by terms that give greater specificity, such as the site of the problem.
Semicolons separate the terms. This ensures uniformity between the terms. However,
this is not the way the terms are commonly spoken.
When an ICPC-2 PLUS term is selected, the corresponding natural language term can
be stored instead of the original term description. The stored natural language term
allows easier understanding of the ICPC-2 PLUS concept, as it is in plain English.
3.1.2) Integrating the natural language functionality
Depending on the infrastructure of your clinical software, the natural language
function can be integrated in different ways.
Option 1:
When an ICPC-2 PLUS term is selected, your software can store the ICPC-2 PLUS
code alone – and not store either the original term or natural language term.
Depending on the type of term preferred, a query can be executed to extract the
desired term (original or natural language term).
Option 2:
Your software can be designed to store either or both the original and the natural
language term when an ICPC-2 PLUS term is selected (as well as the ICPC-2 PLUS
code).
This function can then be incorporated into automatic referral letters, patient reports
and medical certificates.
Example
If the user wants to code ‘leg pain’, the ICPC-2 PLUS term is ‘Pain;leg’ and its
corresponding natural language term is ‘leg pain’. Natural language terms are
basically the common terms that medical practitioners use.
If the keyword ‘leg’ is used to search for leg pain, the picklist generated from that
keyword must list all original ICPC-2 PLUS terms attached to the keyword ‘leg’ (as
demonstrated in Figure 2). It is important that natural language terms are not
substituted for the ICPC-2 PLUS terms in the picklist.
3.1.3) Field Description
All active ICPC-2 PLUS terms have an associated natural language term. The natural
language term of the corresponding ICPC-2 PLUS term is added into an extra field in
the ICPC-2 PLUS Term Table (icpc2trm.csv). This is one of the datafiles sent to
developers for each ICPC-2 PLUS release. The field name for natural language terms
is ‘nalan50’ and it has a field length of 50 characters.
For a full description of the ICPC-2 PLUS Term Table and the Entity-Relationship
diagram, see Section 2.
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3.2) Inactive codes
3.2.1) Background
Only active ICPC-2 PLUS codes are available for data entry. However if an ICPC-2
PLUS code becomes obsolete it must be removed from data entry, this is done by
making these codes inactive. ICPC-2 PLUS codes are never deleted. Instead, their
status is changed to “I” for inactive. Terms may be made inactive when:
• The term is no longer used in general practice
• The location of the code is incorrect
• The term has been incorrectly duplicated.
Terms that are marked as inactive should not be able to be entered into medical
records. An easy way of identifying inactive terms in your system is to check that you
don’t have duplicate terms available.
Inactive codes should, however, be available for data reporting purposes. Users may
have inactive terms saved in their records (entered previously when the term was
marked as active). These terms must still be accessible when the user runs a historical
data report. All terms that are made inactive are ‘mapped’ to an active term. This
means that, even though the term is no longer used, there is a similar term that can be
used to record and report the data.
3.2.2) Table Description
The status of terms within ICPC-2 PLUS is found as an extra field in the ICPC-2
PLUS Term Table (icpc2trm.csv). This is one of the datafiles sent to developers for
each ICPC-2 PLUS release. The field name is ‘status’ and it has a field length of 1.
There are two valid values entered in this field:
‘A’: indicates that the term is active, and can be used for data entry in ICPC-2
PLUS.
‘I’:
indicates that the term is inactive. These terms should only be used for data
reporting purposes. Any term with a status of ‘I’ should not be used for data
entry.
Updated April/July 2004
Replacement codes for inactive terms.
In the April 2004 release, the ICPC-2 PLUS term table (icpc2trm.csv) had a new field
added called ‘replacement’, which is 6 characters in length (Please see Sections 2.22.4 for more details about design). This field is used when terms are made inactive,
and states the active term to which the inactive term is mapped.
The replacement codes (where applicable) should be used for selection and groupings
to generate correct report output. This may require an extra step during the report
generation process. You may update the patient record with the new replacement code
only if the system keeps a history of changes.
When the term is active, this field will be null.
The inclusion of this field in the icpc2trm CSV file means that we will no longer
provide you with the ‘Replacement Code Status’ document.
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4) Additional reference material on ICPC-2
4.1) Background
There are four tables provided as part of each ICPC-2 PLUS update, these are
additional to the tables updated regularly. These tables usually remain unchanged
during each update, and are sent to you as CSV files. The purpose of these tables is to
apply different aspects of the ICPC-2 classification to the data coded in the clinical
system.
4.2) Table Description
There are four tables icpc2cha, icpc2com, icpc2res and icpc2cod included in this
section. An Entity-Relationship diagram is also enclosed.
CHAPTER TABLE (icpc2cha.csv)
chapter
chapname
Char(1)
Char(50)
Chapter table (icpc2cha.csv)
This table outlines the ICPC-2 chapters, as described in Section 1.
COMPONENT TABLE (icpc2com.csv)
component
compname
Char(2)
Char(50)
Component table (icpc2com.csv)
This table outlines the ICPC-2 components, described in Section 1.
Note that, when component is used elsewhere, the component Component '7'
(Diagnoses and diseases) has been replaced by Components 8, 9, 10, 11 and 12 and
that ICPC-2 Component 7 is made up of Components 8 – 12 inclusive.
ICPC-2 CODE TABLE (icpc2cod.csv)
icpccode
Char(3)
rubric
Char(50)
component
Char(2)
chapter
Char(1)
note
Char(5)
icd10
Char(15)
ICPC-2 code table (icpc2cod.csv)
This table summarises each ICPC-2 code (or rubric). It states the alpha-numeric code
and its rubric, along with the chapter and component each ICPC-2 code belongs to.
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The ‘note’ and ‘icd10’ fields are currently not used. Developers may also
ignore/delete the contents of the ‘note’ and ‘icd10’ columns from their systems
without impairing functionality of the coding system.
RESEARCH TABLE (icpc2res.csv)
chapter
Char(1)
component
Char(2)
rfrom
Char(6)
rto
Char(6)
grouping
Char(35)
Research table (icpc2res.csv)
This table has now been removed from use and does not need to be implemented. The
function of selecting records based on the ICPC-2 chapter and component is now
made using the ICPC-2 code table and the two related tables (chapter, component).
This is described in Section 4.5.
4.3) Field descriptions
Field Name
Chapname
Chapter
Compname
Component
Grouping
icd10
icpccode
Note
Rfrom
Rto
Rubric
Field Description
Label for ICPC-2 chapter code.
Single alphabetic character of chapter as defined by ICPC-2.
Label for ICPC-2 chapter code.
Numeric code of components as defined by ICPC-2 (1-7) and extended by
FMRC so that chapter 7 is further defined as components 8 to 12.
Currently not used and is blank.
ICPC-2 to ICD10 map. Currently not used and is blank.
The 3 digit alpha-numeric ICPC-2 code.
Currently not used and is blank.
Starting ICPC-2 code of range (inclusive).
Ending ICPC-2 code of range (inclusive).
Label of the ICPC-2 code.
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4.4) Entity Relationship Diagram
icpc2cod.csv
icpccode
icpc2com.csv
component
rubric
1:m
chapter (FK)
compname
icpc2cha.csv
component (FK)
m:1
note
chapter
chapname
icd10
Legend:
table_name
Key Attributes
Non-Key Attributes
FK = Foreign Key
1:m = one-to-many relationship
eg. a one-to-many with the right hand
side with at least one.
As shown in the Entity-Relationship diagram above;
• The component from the COMPONENT Table (icpc2com.csv)
has a one-to-many relationship with the component from the
ICPC-2 CODE Table (icpc2cod.csv).
• The chapter from the CHAPTER Table (icpc2cha.csv) has a
one-to-many relationship with the component from the ICPC-2
CODE Table (icpc2cod.csv).
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4.5) Use of ICPC-2 reference tables
These four tables provide greater detail about the information stored within the users’
clinical system by applying different aspects of the ICPC-2 classification to these
data. The different structures of ICPC-2 are outlined in Section 1 and are applied to
the data in clinical systems using these tables.
The chapter table and component tables are reference tables used by the research and
code tables. The research table is a summary table that allows users to search on
components or chapters of ICPC-2 for purposes of self-audit or research. The ICPC-2
code table is also a summary table however it also lists the ICPC-2 codes and rubrics
enabling selection on either the ICPC-2 code, component or chapter.
4.6) Functionality requirements
Users are encouraged to use the functionality of the output grouper files as
outlined in Section 5 entitled ‘Data Reports’.
There are three possible ways of searching for records using these data tables:
searching on chapter or component individually, or combining the two for a more
specific search. For example,
• A search for all skin related conditions (chapter S) would return all
records/encounters containing codes from the skin chapter.
• A search for all neoplasms (component 9) would return all records/encounters that
contain neoplasm codes.
• A search for all skin neoplasms would use a combination of chapter S and
component 9. The resulting search should return all records/encounters where a
skin neoplasm code was saved.
Note: At least one of the component or chapter fields must be specified to conduct a
valid search. If a chapter or component is not specified the search must find all
records/encounters in the unspecified field.
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5) Data reports
5.1) Background
ICPC-2 PLUS can also be used to create data reports, using the codes stored within medical
records during the data input phase. Users may wish to utilise this part of the system for a
variety of reasons, including:
• self audit
• to count the number of cases of a selected problem
• for patient recall or mail merge
• to report to Government for the Practice Incentive Program (PIP) payments, on the
number of cases of specific problems that they manage.
The FMRC has therefore developed files for data reports, based on ICPC-2 PLUS, which are
based on two levels within the coding system:
1.
ICPC-2 Classification
As described in Section 1, classifying data is about ordering data into meaningful groups.
The ICPC-2 classification groups concepts that can then be used to create data reports.
An example:
If the users want to find, or count, all their patients who have Insulin dependent diabetes—
IDDM is classified in ICPC-2 as Diabetes, insulin dependent – code T89.
It has many PLUS terms, each of which has its own code, allowing the user to select the
term they prefer when putting the data IN. These PLUS terms include:
§ T89 001 Diabetes;insulin dependent
§ T89 002 Diabete;Type 1
§ T89 003 Diabetes;complicated
§ T89 004 Diabetes;juvenile onset
§ T89 005 Coma;diabetic
§ T89 006 Hyperglycaemia (diabetic)
However, for data reports when they want to identify or count patients with IDDM,
they have to find all the records with ANY of these PLUS terms in them. They do this
by using the ICPC-2 classification code T89 (diabetes, insulin dependent) which is
common to all the above term codes.
2.
Higher level groupers
Sometimes, there are similar terms that fall into different ICPC-2 codes. This requires
grouping of multiple ICPC-2 codes (and sometimes, as in osteoarthritis, grouping of
multiple PLUS codes that cross over the ICPC-2 classification codes). We have created
standard groupers (G codes) to facilitate searches in such circumstances.
An example:
• What about if the users wanted to identify or count all the patients with ANY kind of
diabetes?
In that case they would need to find all the records that included ANY of three ICPC-2
classification codes- T89 (IDDM); T90 (NIDDM) and W85 (gestational diabetes). This is
time consuming and may be inaccurate. Instead, they could select a GROUPER code
rather than any of the ICPC-2 codes alone.
If you enter ‘DIAB’ or ‘IDDM’ or ‘NIDDM’ (etc) as a key word in the reporting
mechanism of your software, the system must offer the end-user a list of classification
ICPC-2 PLUS : Functionality requirements for developers
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codes and grouper codes that are linked to this key word. (Note there are two Grouper
codes included in the resulting list of possible concepts available for a search).
These would include:
• G40 Diabetes (all)
• G77 Diabetes (non-gestational)
• T89 IDDM
• T90 NIDDM
The end user can then select the concept at the level of specificity required. Your
program then needs to find all records that include any of the codes attached to this
concept (counting or identifying each record only once, irrespective of possible multiple
cases within an individual record).
The concepts provided for data reports are limited to:
• all individual ICPC-2 codes; AND (within the same file)
• an additional set of higher level grouper codes (the codes of which all start with the letter
‘G’)
The users should NOT be allowed (at this stage) to search on an individual ICPC-2 PLUS
term for diagnosis/symptom/disease. They must only be able to get data out in the
classified/grouped manner. Otherwise they find it difficult to retrieve reliable output.
Keywords in the output file
We have created a keyword list specifically for use with the files for data reports. Users can
then use this list to choose the level at which they would like to analyse their data. The
keyword list has been shortened for data reports, and only the most logical and likely
connections between keywords and concepts are retained.
• You MUST use the output keyword list when working with these files for reporting
output.
Do not use the much larger data input keyword file for data output.
Remember:
• PLUS terms are for getting the data IN to the record: The PLUS terms used in the
health record are provided so that the user has sufficient specificity in the record, for
quality and continuity of care – these are provided to ensure the user can record the
problem in their preferred form and that this will be retained in the record for continuity
of individual care.
• Getting the data OUT should rely on use of the ICPC-2 classification or grouped
ICPC-2 classification codes – not on the PLUS terms. The classification allows you to
group like with like in a logical manner. The first three digits of the ICPC-2 PLUS (6
digit) code, designate its place in the ICPC-2 CLASSIFICATION.
• Like the keyword search system used by data input (Section 2) the output Keyword
search system matches the start of the word. A 4-character word (e.g. diab) would
match all keywords with the matching first four characters (e.g. DIABETES,
DIABETIC).
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•
•
Spelling differences can cause a false negative result. If no groupers are found then the
users should be encouraged to type in the first 3 or 4 characters of the word being
searched. You can assist the user by providing a picklist of keywords, but users must
also be able to enter free text in this field (i.e. cannot allow keywords to be pick list
only).
If there is any problem with finding data or keyword connections then the user or
developer should contact us.
We believe it essential that we work together to ensure the users can get reliable and
meaningful data out of their records easily. Otherwise they will lose interest in using their
computerised medical records for data retrieval.
5.2) Table Description
Four grouper tables have been created. These are:1.
grp_Keyword
2.
grp_Keyword_Grouper
3.
grp_Grouper
4.
grp_Grouper_Icpc
A description of these is shown in the tables below.
An Entity-Relationship diagram is shown in Section 5.3. The column definitions for each of the
tables are provided below.
grp_Keyword (grp_keyword.csv)
keyword_id
keyword
Integer
Char(20)
grp_Keyword_Grouper (grp_kwd_grp.csv)
keyword_id
grouper_id
Integer
Integer
grp_Grouper (grp_grouper.csv)
grouper_id
grouper
grouper_description
Integer
Char(3)
Char(60)
grp_Grouper_Icpc (grp_grp_icpc.csv)
grouper_id
icpc_code
Integer
Char(6)
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Legend:
5.3) Entity Relationship Diagram
table_name
Key Attributes
grp_Keyword
Non-Key Attributes
keyword_id
FK = Foreign Key
1:m = one-to-many relationship
eg. a one-to-many with the right hand
side with at least one.
keyword
grp_Keyword_Grouper
1:m
keyword_id (FK)
grouper_id (FK)
1:m
grp_Grouper
grouper_id
Grouper
Grouper_Description
1:m
grp_Grouper_Icpc
grouper_id (FK)
ICPC_code (FK)
The ICPC_code is used to identify
matching ICPC codes in other data tables
The keyword_id from the grp_Keyword Table has a one-to-many relationship with the
keyword_id of the grp_Keyword_Grouper Table.
• The grouper_id of the grp_Keyword_Grouper Table has a many-to-one relationship to
the grouper_id of the grp_Grouper Table.
•
The grouper_id of the grp_Grouper Table has a one-to-many relationship with the
grouper_id of the grp_Grouper_Icpc Table.
•
The icpc_code of the grp_Grouper_Icpc Table will have a many-to-many relationship
with icpc_code fields of other data tables. This seems to be unavoidable but we will show
you later how to make use of it.
5.4) Use of grouper files for data output
This section details the use of these tables and functionality to include for the user. It includes
examples using Microsoft Access SQL queries. You will need to investigate different
techniques to develop the best method for implementation with your software.
It is recommended to save the 6 character combined ICPC-2 code and term code. You may
need to create search optimised tables by joining some tables together (denormalise) before
updating the client software. Also be aware that grouper files apply to the replacement code of
an inactive term and not the inactive term itself.
1. Keyword entry – list matching groupers
The User must be able to type in a keyword and given the choice of groupers which are linked
to the keywords. ‘ALCOHOL’ would be a ‘ALCOHOL*’ pattern match to any grouper linked
to ‘ALCOHOL’, ‘ALCOHOLIC’ or ‘ALCOHOLISM’ keywords.
The user will then select the grouper that they are interested in.
For example, when using MS Access a SQL query would use search criteria such as
SELECT DISTINCT grp_Grouper.Grouper, grp_Grouper.Grouper_Description
FROM grp_Keyword INNER JOIN (grp_Grouper INNER JOIN grp_Keyword_Grouper
ON
grp_Grouper.Grouper_id
=
grp_Keyword_Grouper.Grouper_id)
ON
grp_Keyword.Keyword_id = grp_Keyword_Grouper.Keyword_id
WHERE (((grp_Keyword.Keyword) Like "cancer*"))
ORDER BY grp_Grouper.Grouper;
For more generic searches build the query using a variable in the WHERE clause eg.
WHERE (((grp_Keyword.Keyword) Like [kwd] & "*"))
The groupers for the keyword ‘cancer’ are
Grouper
Grouper_Description
A26
FEAR, CANCER NOS
A79
MALIGNANCY NOS
B26
FEAR, CANCER BLOOD/LYMPH
D26
FEAR, CANCER DIGESTIVE SYSTEM
D77
MALIGNT NEOPLASM DIGEST OTHER
F74
NEOPLASM OF EYE/ADNEXA
G71
NEOPLASMS MALIGNANT (ALL)
G74
NEOPLASMS (ALL)
L26
FEAR, CANCER MUSCULOSKELETA
N26
FEAR OF CANCER OF NEUROLOGICAL SYSTEM
R26
FEAR, CANCER RESPIRATORY SYS
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S26
T26
U26
X25
X26
Y26
FEAR, CANCER SKIN
FEAR, CANCER ENDOCRINE SYSTE
FEAR OF CANCER OF URINARY SYSTEM
FEAR, CANCER GENITAL (F)
FEAR, CANCER BREAST(F)
FEAR, CANCER GENITAL (M)
2. Grouper selection – make temporary list of ICPC codes to match
The grouper selected by the user is used to filter the grp_Grouper_Icpc table. This list of
ICPC-2 codes and ICPC-2 PLUS codes is used as selection criteria for the ICPC-2 PLUS
codes stored in patient records.
For example, Selecting the group G74, NEOPLASMS (ALL)
SELECT grp_Grouper_Icpc.ICPC_code
FROM grp_Grouper INNER JOIN grp_Grouper_Icpc ON grp_Grouper.Grouper_id =
grp_Grouper_Icpc.Grouper_id
WHERE (((grp_Grouper.Grouper)="G74"))
ORDER BY grp_Grouper_Icpc.ICPC_code;
ICPC_code
A79
A99018
A99019
B72
B73
B74
B75
D74
D75
D76
D77
D78
F74
H75
K72
L71
…
L97
N74
N75
N76
R84
R85
R86
R92
S77
S78
S79
S80
S81
T71
T72
T73
U75
U76
U77
U78
U79
W72
W73
X75
X76
X77
X78
X79
X80
X81
Y77
Y78
Y79
…
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3. Search data file for records with matching ICPC-2 PLUS codes
Records are retrieved that have ICPC codes belonging to the selected group.
It is important to understand that if an ICPC–2 code is tied to the grouper (e.g.
A94), the query to be undertaken must pick up all the ICPC–2 PLUS codes of
A94 (i.e. A94001, A94002, A94003 etc.).
Remember that if the ICPC–code is a rubric (e.g. Y88) all the ICPC–2 PLUS codes
underneath Y88 (i.e. Y88001, Y88002 etc) should be included as part of the query.
There are many different ways to implement this step depending on the database
system, record structure, SQL features used, programming and user interface. Step 2
& 3 can be joined and executed in a single step.
You may have to search many patient related records to find patients who had a
condition that matches the selected grouper.
If the user is locating patients with a particular problem then the patient details (and
relevant conditions) should appear together in the output. If there is a count of patients
having had a particular condition then multiple occurrences for the same patient
should be counted as 1 patient.
For example,
a) Creating a list of ICPC-2 PLUS codes belonging to the grouper ‘G47’ using a table
of ICPC-2 PLUS codes named ‘tblicpccode’. Query is named “qry ICPC code
expansion”
SELECT tblicpccode.ICPCCODE
FROM
(grp_Grouper
INNER
JOIN
grp_Grouper_Icpc
ON
grp_Grouper.Grouper_id = grp_Grouper_Icpc.Grouper_id) INNER
JOIN
tblicpccode
ON
tblicpccode.ICPCCODE
like
(grp_Grouper_Icpc.ICPC_code & "*")
WHERE (((grp_Grouper.Grouper)="G74"));
b) Use above query as a sub-query to locate patient encounters with a condition in the
list.
SELECT EncID, patientid, Problem
FROM encounter
WHERE (((encounter.Problem) In (select icpccode as Problem from
[qry ICPC code expansion])));
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c) Use sub-query to search for patients using in-line statements
(This example a bit more complex)
SELECT
DISTINCT
patient.patientid,
patient.FirstName,
patient.LastName
FROM encounter INNER JOIN patient ON encounter.patientid =
patient.patientid
WHERE (encounter.Problem in
(SELECT tblicpccode.ICPCCODE as Problem
FROM
(grp_Grouper
INNER
JOIN
grp_Grouper_Icpc
ON
grp_Grouper.Grouper_id = grp_Grouper_Icpc.Grouper_id)
INNER
JOIN
tblicpccode
ON
tblicpccode.ICPCCODE
like
grp_Grouper_Icpc.ICPC_code + "*"
WHERE (((grp_Grouper.Grouper)='G74'))))
ORDER BY patient.LastName, patient.FirstName;
d) Use a join to select records that match either of two fields using the like operator.
SELECT encid, Problem1, Problem2
FROM
(grp_Grouper
INNER
JOIN
grp_Grouper_Icpc
ON
grp_Grouper.Grouper_id = grp_Grouper_Icpc.Grouper_id) INNER
JOIN
[tbl
problem]
ON
[tbl
problem].Problem1
like
(grp_Grouper_Icpc.ICPC_code & "*") or [tbl problem].Problem2
like (grp_Grouper_Icpc.ICPC_code & "*")
WHERE (((grp_Grouper.Grouper)="G74"));
4. Search optimisation.
You will likely have to create your own custom tables (denormalise) to speed up
grouper selection and record searches. These would be indexed and optimised for
runtime performance and improve useability.
For example:
1) Create a table for speed selection of grouper:
INSERT INTO SelectGrouper (Keyword, Grouper, Grouper_Description)
SELECT DISTINCT K.Keyword, G.Grouper, G.Grouper_Description
FROM grp_Grouper AS G INNER JOIN (grp_Keyword AS K INNER JOIN
grp_Keyword_Grouper AS KG ON K.Keyword_id = KG.Keyword_id) ON
G.Grouper_id = KG.Grouper_id;
2) Create a table to speed in the resolution of ICPC codes (3 or 6 character) to match
stored medical records.
INSERT INTO SearchGrouper (Grouper, ICPCCODE)
SELECT G.Grouper, ICPC.ICPCcode
FROM (grp_Grouper AS G INNER JOIN grp_Grouper_Icpc AS GI ON
G.Grouper_id = GI.Grouper_id) INNER JOIN icpc2trm AS ICPC ON GI.ICPC_code
= ICPC.ICPCcode
ORDER BY G.Grouper, ICPC.ICPCcode;
3) Use the "grp_Keyword" table if you have a keyword picklist.
4) The user enters a keyword or the start of a keyword.
E.g. "diab"
ICPC-2 PLUS : Functionality requirements for developers
Page 31 of 34
5) Search the groupers using the "SelectGrouper" custom table using the Keyword
like search_keyword*. Present the list of groupers and description for user to pick
from.
SELECT DISTINCT SG.Grouper_Description, SG.Grouper
FROM SelectGrouper as SG
WHERE (SG.Keyword Like [Grouperkw] & "*")
ORDER BY Left([Grouper],1)="G", SG.Grouper_Description;
Eg. for "diab"
users)
Keyword
DIABETES
DIABETES
DIABETES
DIABETES
DIABETES
DIABETES
DIABETIC
DIABETIC
(keyword shown for developer reference and would not be shown to
Grouper
G40
G77
T27
T89
T90
W85
F83
N94
Grouper_Description
DIABETES (ALL)
DIABETES (NON-GESTATIONAL)
FEAR, ENDOCRINE/METABOLIC DI
DIABETES, INSULIN DEPENDENT
DIABETES, NON-INSULIN DEPENDEN
GESTATIONAL DIABETES
RETINOPATHY
PERIPHERAL NEURITIS/NEUROPATHY
7) Search the medical records using the icpccodes returned from the "SearchGrouper"
custom table using the selected grouper code. eg. "T89" for insulin dependent
Diabetes which excludes gestational diabetes.
SELECT encdata.diag, encdata.patientid
FROM encdata INNER JOIN SearchGrouper ON
SearchGrouper.diag & "*"
WHERE grouper = [selectedgrouper];
eg. for "T89".
Grouper
icpccode
TermDescription
T89
T89001
Diabetes;insulin dependent
T89
T89002
Diabetes;Type 1
T89
T89003
Diabetes;juvenile onset
T89
T89004
Diabetes;complicated
T89
T89005
Coma;diabetic
T89
T89006
Hyperglycaemia (diabetic)
T89
T89007
Ulcer;diabetic
ICPC-2 PLUS : Functionality requirements for developers
encdata.diag
like
Page 32 of 34
8) Display listing of medical records found to match. Report summary would include
the description of the selected grouper. Each encounter listed in the result would show
the ICPC-2 PLUS term description or corresponding natural language term (see
Section 2).
Example for "T89"
Report
Page 1 of 1
All patients with a diagnosis of "DIABETES, INSULIN DEPENDENT (T89)".
Date
1/5/2003
12/6/2003
18/5/2003
Last Name
Dee
Doe
Nobody
First Name
Jenny
John
Jake
Age
12
8
14
ICPC-2 PLUS : Functionality requirements for developers
Gender
F
M
M
Diagnosis
Diabetes;juvenile
Diabetes;Type 1
Hyperglycaemia
Page 33 of 34
Appendices
Appendix A - DEVELOPERS LICENCE / CONTRACT
ICPC-2 PLUS : Functionality requirements for developers
Page 34 of 34
THE UNIVERSITY OF SYDNEY
International Classification of Primary Care - Version 2
and ICPC-2 PLUS
Services Agreement
Schedule
Principal
THE UNIVERSITY OF SYDNEY
Contact
Family Medicine Research Centre
Acacia House
Westmead Hospital
WESTMEAD NSW 2145
Tel:
Fax:
61 2 9845 8151
61 2 9845 8155
Contractor
Contact
Name:
Address:
Telephone:
Facsimile:
Appointment date
IMPORTANT
This agreement contains some important clauses which are set out in the following
pages. Please read them carefully.
ICPC-2 Plus : Developer contract - 2003
Page 1 of 10
Terms of agreement
1.
Dictionary
1.1
Definitions: In this agreement, the following words have these meanings when
appearing in the text with a capital letter.
Associated Documents
Any materials in hard copy or disk format that are
designed to assist a User or supplement a User's
understanding or application of the Database.
Database
One or both of these databases known as ICPC (the
International Classification of Primary Care) designed by
the Classification Committee of the World Organisation
of National Colleges, Academies, and Academic
Associations of General Practitioners/Family Physicians
or ICPC PLUS (an extended database of coded medical
terms and keywords classified according to ICPC).
Intellectual Property
Any Intellectual Property right including any patent,
copyright, rights in circuit layouts, registered design,
trademark or the right to have confidential information
kept confidential and any application or right to apply for
registration of any of these rights.
Licence
An agreement executed by the Principal and a User
authorising the User to operate the Database.
Services
Those Services to be performed by the Contractor as
described in Clause 3.1.
Site
One or more computers owned or operated by a User
onto which the database will be loaded.
Software
The medical systems software to be supplied by the
Contractor to a user on which the Database will be run.
Upgrade
Revision of an existing version of the Database supplied
to you with this licence.
User
A person who executes a Licence.
ICPC-2 Plus : Developer contract - 2003
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1.2
Interpretation:
In this agreement, unless the contrary intention appears:-
(a)
a reference to this agreement or another document includes a variation or
replacement of them.
(b)
a reference to a statute, ordinance, code, or other law includes a regulation or
other instrument made under it, and any consolidation, amendment, reenactment or replacement of any of them.
(c)
the singular includes the plural and vice versa.
(d)
the word person includes a firm, a partnership, body corporate, an
unincorporated association or an authority.
(e)
a reference to a person includes a reference to a person's executors,
administrators, successors, substitutes and assigns
(f)
an agreement, representation or warranty given by or given in favour of two or
more persons binds or is for the benefit of them jointly and severally
(g)
a reference to a clause or a schedule is a reference to a clause or a schedule
in this agreement and
(h)
a reference to any thing (including, without limitation, an amount) is a reference
to the whole of or any part of it, and a reference to a group of persons is a
reference to any one or more of them.
1.3
Headings Headings are inserted for convenience only and do not affect the
interpretation of this agreement.
2.
Term and termination
2.1
Term defined: This agreement begins on the appointment date described in the
schedule, and remains in force until it is terminated under clause 2.2 or 2.3.
2.2
Termination by either party: Either party may terminate this agreement at any time
by notifying the other party one (1) month in advance. A notice given under this clause
does not affect any Service to be performed by the Contractor that has been requested
by the Principal before the termination date specified in the notice.
2.3
Termination by Principal: The Principal may terminate this agreement at any time,
by notifying the Contractor seven (7) days in advance if:(a)
the Contractor, being a corporation, becomes insolvent in the circumstances
contemplated by section 459C of the Corporations Law
(b)
an application is made to a court for an order, or an order is made, that the
Contractor be wound up
ICPC-2 Plus : Developer contract - 2003
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2.4
(c)
the Contractor, being an individual, becomes insolvent under administration
defined under the Corporations Law, or action is taken which could result in
that event
(d)
the Contractor does not observe an obligation under clause 8 or 10, or
(e)
the Contractor does not observe any other obligation under this agreement
within fourteen (14) days of being notified to do so.
If this agreement is terminated for any reason, the
Obligations on termination:
Contractor must deliver to the Principal within seven (7) days of the termination date:(a)
all copies of the Database (including any items supplied under clause 5.1 and
then in the contractor's possession.
(b)
a report about the status of any Services commenced before, but not
completed by, the termination date and
(c)
a notice addressed to the Principal certifying that:(i) the Contractor has delivered to the Principal all copies of the database and
any associated documents in its possession and
(ii) the Contractor has not supplied any copies of the database or associated
documents to any person in breach of this agreement.
3.
Services
3.1
Defined: The Contractor agrees to provide the Services in a form and at those times
mutually agreed with the Principal, taking into account the individual requirements of
Users.
3.2
Non-exclusivity: This agreement does not confer on the Contractor any exclusive
right to perform the Services for the Principal.
3.3
Employees: The Contractor is fully responsible for ensuring that its employees or any
other persons otherwise engaged by the Contractor to perform the Services observe
the Contractor's obligations under this agreement at all times.
4.
Status of Contractor
4.1
Defined: The Contractor is not a partner, employee or agent of the Principal and has
no direct or indirect authority to bind the Principal to any agreement with another
person. The contractor is only authorised to perform services. This agreement also
does not confer on the Contractor any status or right as a licensee or distributor of the
Database.
ICPC-2 Plus : Developer contract - 2003
Page 4 of 10
4.2
Discretion: The Principal acknowledges that, provided the Contractor otherwise
observes its obligations under this agreement, the Contractor is entitled to exercise
independent discretion as to the most appropriate and effective manner of performing
services.
4.3
Promotion: The Principal has no obligation to promote or recommend the contractor
to any person, nor to identify suitable work opportunities for the Contractor.
4.4
Taxation: The Principal has no responsibility to pay any superannuation, worker's
compensation insurance tax incidental to employment in respect of the Services to the
Contractor, or any person employed or otherwise engaged by the Contractor to
perform services
5.
Principal's obligations
5.1
Database and Associated Documents: On or shortly after the execution of this
agreement, the Principal must supply the contractor with:-
5.2
(a)
one (1) master copy of the current version of the Database in general market
release
(b)
a description of the files in the Database
(c)
details of the software functionality requirements for use and operation of the
Database
(d)
one (1) hard copy and one (1) disk copy of the User's Guide for the Database
and
(e)
one (1) hard copy of any other Associated Documents available in connection
with the use or operation of the Database
Upgrades: The Principal must also supply the Contractor with the items described in
clause 5.1 in relation to any upgrades as and when these become available for general
release. Upgrades may occur by one of the following methods:*strike out whichever does not apply
*Automatic upgrade The Principal will supply the upgrade in disk directly to the User where
the software is able to automatically update the Database from the Upgrade disk supplied.
*Manual upgrade The Principal will supply the Contractor with one (1) copy of the Upgrade
in the format described in clause 5.1 and the Contractor will be responsible for integrating
that Upgrade into the Contractor's Software and integrating it at the relevant Site.
ICPC-2 Plus : Developer contract - 2003
Page 5 of 10
5.3
Execution of Licence: The Principal must notify the Contractor as soon as
practicable after a User executes a Licence:(a)
that the Contractor is authorised to proceed with performing the services and
(b)
which Database the User is authorised to operate under that licence
5.4
Failure to renew Licence: The Principal will notify the Contractor within one (1)
month after the due annual renewal date for that Licence if a User does not renew its
Licence with the Principal or if the Licence is otherwise terminated. If this occurs, the
Contractor must not supply the User with any further copies of the Database or
Associated Documents.
6.
Performing the Services
6.1
Warranties: The Contractor represents and warrants to the Principal that the
Contractor and its employees possess appropriate qualifications, training, expertise
and experience to enable the Contractor to perform its obligations under this
agreement.
6.2
Decompiling, copying and customising: The Contractor may decompile, copy or
customise a Database, but only to the extent necessary to integrate the Database into
the software and load it at a site.
6.3
Back up copies: The Contractor may make copies of any master copy of a Database
and Associated Documents supplied under this agreement for back up or archival
purposes only.
6.4
Licences: The Contractor must not install and load a Database at a Site unless the
Contractor first receives notification from the Principal under clause 5.3
7.
Training users
7.1
Responsibility: It is the responsibility of the Contractor, if requested by a User to do
so, to provide adequate and professional training on how to operate the Database
installed at that User's Site. The extent and cost of training shall be a matter
negotiated between the Contractor and the User directly. Under no circumstances will
the Principal be held responsible for:-
7.2
(a)
any claim by a User that training provided by the Contractor under this clause is
inadequate or inaccurate or
(b)
any costs payable to the Contractor for the provision of training under this
clause
Associated Documents: The Principal will supply to the contractor enough copies of
Associated Documents to enable each User to properly operate each Database no
later than fourteen (14) days after that user executes a licence.
ICPC-2 Plus : Developer contract - 2003
Page 6 of 10
8.
Intellectual Property
8.1
Ownership: Each Database, and any Associated Documents, are protected by
Australian laws and international treaties relating to Intellectual Property. The
Contractor must not do anything that prejudices or infringes Intellectual Property rights
in the Database or Associated Documents, or which has the potential to do so.
8.2
Copyright notices: The contractor must reproduce copyright notices on all copies of
the Database and Associated Documents made by the Contractor.
8.3
Defending third party claims: The Principal agrees to:(a)
defend at its cost any claim or legal action against the Contractor alleging the
Database or any Associated Document infringes Australian copyright and
(b)
to pay all costs and damages finally awarded against the Contractor,
on the conditions that
(i) the Contractor notifies the Principal promptly in writing about that claim or
action
(ii) the Principal has the right to decide whether to defend the claim or action
or to settle or reach a compromise of that claim or legal action
(iii) the Contractor gives the Principal all information and documents in its
possession relating to that claim or action, and other reasonable
assistance to enable the Principal to defend that action or claim properly
(iv) the Principal has the right to replace or modify the Database or Associated
Documents so that it becomes non-infringing or to procure for the
Contractor authority to continue the use and possession of the Database or
Associated Documents as contemplated by the agreement.
8.4
No liability: The Principal has no liability if the claim or action is based upon the use,
licence or sale of the Database or Associated Documents in:(a)
combination with other products (including Software) or
(b)
breach by the Contractor of its obligations under this agreement.
9.
Warranties
9.1
Defined: The Principal warrants to the Contractor that:(a)
to the best of its knowledge, information and belief, the supply of the Database
and Associated Documents under, and use of them as contemplated under this
agreement, does not infringe the Intellectual Property rights of another person
and
(b)
the version(s) of each Database, as supplied to the Contractor from time to
ICPC-2 Plus : Developer contract - 2003
Page 7 of 10
time during the term of this agreement, integrates(s) all current Upgrades in
general market release.
9.2
9.3
Exclusion of warranties: The Principal supplies the Database to the Contractor on
an "as is" basis only and without any knowledge or understanding of the Contractor's
Software or the Contractor's obligations to Users. To the extent that the Principal is
permitted to do so under state or federal laws, the Principal excludes from this
agreement any express or implied warranties that the Database and Associated
Documents:(a)
are of merchantable quality or can be used for a particular purpose
(b)
contain data or information that is accurate, up to date or reliable
(c)
are compatible for use with Software or
(d)
are suitable for the particular purpose for which the Contractor intends to use it.
Limitation: However, if the Principal does become liable for breach of a condition or
warranty implied in this agreement by the Trade Practice Act 1974 (Cth) and which
cannot be modified or excluded by that Act, then the Principal's liability is limited to it's
choice of one or more of these remedies:(a)
replacement of the Database or Associated Documents or
(b)
the cost of supplying the contractor with goods equivalent to the Database.
Under no circumstances does the Principal's liability extend to any other remedy for
any loss or damage the Contractor suffers arising from a breach of a condition or
warranty implied into this agreement or otherwise or any defect in the Database or
Associated Documents as the result of or connected with:(i)
defective storage, transportation, installation or maintenance by the Contractor
or any other person
(ii)
mismanagement by the Contractor
(iii)
modification, operation or use of either of them in a manner not contemplated
by this agreement or
(iv)
the Contractor's failure to comply with this agreement.
This exclusion of liability includes without limitation any direct or consequential loss or
damage, such as loss of data or loss of profits.
ICPC-2 Plus : Developer contract - 2003
Page 8 of 10
10.
Confidentiality
10.1
Security: The Contractor must ensure that any documents or information given to it
by the Principal for a purpose connected with the Services is kept confidential and
secure from unauthorised access at all times.
10.2
Disclosure to employees: The Contractor may disclose any documents or
information given to it by the principal to any employee or other person engaged to
perform the Services by the Contract, but only to the extent necessary to enable that
person to properly perform the Services.
11.
Consideration
11.1
Defined: The Principal agrees to pay the Contractor ten dollars ($10.00) as
consideration for the Services, when the parties sign this agreement. The Contractor
is not entitled to receive from the Principal any other fee for the services.
12.
Indemnity
12.1
Nature: The Contractor indemnifies the Principal against any claim, loss, damage or
cost (including legal costs) the Principal suffers, and arising from a breach of the
Contractor's obligations under this agreement, or the Contractor's performance of
Services while this agreement remains in force.
12.2
Scope: This indemnity is a separate obligation of the Contractor, survives termination
or expiry of this agreement, and includes legal costs in a full indemnity basis.
13.
Notices
13.1
A notice or other communication given under or about this
Requirements:
agreement must be:(a)
in writing
(b)
signed by the authorised officer of the party giving the notice or communication
described in the schedule and
(c)
delivered, or sent by ordinary pre-paid post, or transmitted to the addressee's
facsimile described in the schedule, or another address or facsimile number
notified by the addressee.
Unless a later time is specified in it, a notice given under or about this agreement takes
effect from the time it is received.
13.2
Receipt: A notice or communication given under or about this agreement is taken to
be received (as the case may be):(a)
on the date of delivery
ICPC-2 Plus : Developer contract - 2003
Page 9 of 10
(b)
three (3) days after posting or
(c)
when the sender receives a report that a facsimile has been transmitted in its
entirety to the addressee
14.
Assigning this agreement
14.1
By Contractor: The Contractor must not assign or otherwise deal with a right or
benefit given to it under this agreement, without first obtaining the written permission of
the Principal.
14.2
By Principal: If the Principal assigns or sub-licenses a right or a benefit given under
this agreement, the Principal's rights, benefits and obligations under this agreement
terminate immediately that assignment or sub-licence occurs. If the Principal assigns
or sub-licenses a right or a benefit given under this agreement, the Principal must
ensure that any right or obligation assigned or sub-licensed is in identical terms to the
relevant terms of this agreement.
15.
Governing law
15.1
Jurisdiction:
agreement
The laws in force in New South Wales govern the terms of this
Signatures
Principal
Date
Authorised signatory
Contractor
Date
Authorised signatory
ICPC-2 Plus : Developer contract - 2003
Page 10 of 10
Appendix B - INFORMATION FOR USERS
14/8/2003
ICPC-2 PLUS
INFORMATION FOR USERS
WHAT IS ICPC-2 PLUS?
The International Classification of Primary Care (ICPC-2) is a classification designed for primary care,
developed by the World Organisation of Family Doctors (Wonca). It classifies information relating to why
the patient has come for the consultation (the reasons for encounter), the problems managed during the
encounter, procedures, referrals, imaging and pathology tests. ICPC-2 has been endorsed as the Australian
standard for classification in general practice and patient self-reported data, and is distributed exclusively
in Australia by the Family Medicine Research Centre (FMRC) at the University of Sydney.
ICPC-2 PLUS is an extended terminology based on ICPC-2. It has been designed specifically for use in
electronic health records. It was developed using over one million encounter records and therefore uses
terms that are common in Australian general practice. ICPC-2 PLUS can be used in software available from a
number of software companies, including Medical Spectrum Solutions, Medtech Healthcare, Genie Solutions,
Intrahealth Systems and Synapse Medical Systems. At present approximately 1,500 GPs in Australia use
ICPC-2 PLUS, and it is also used in various research projects and co-ordinated care trials.
HOW DOES IT WORK?
ICPC-2 PLUS allows users to record information in electronic health records in a reliable and consistent way,
by attaching a ‘code’ to the term you choose. Using keywords that are common in everyday general practice,
ICPC-2 PLUS does all the work for you in the background. You won‘t even be aware that you are coding and
classifying the information! All you have to do is type in the first part of a keyword and select the term you
want to use – you don’t have to type whole words or phrases! When you subscribe to ICPC-2 PLUS we give
you a User Guide, which lists all the keywords available. ICPC-2 PLUS is updated regularly, and if there is a
term you use that isn’t included, we would love to hear from you!
Example
Mr Jones has come in for his regular diabetes check-up. In the reason for encounter section of your record
(if your software provider allows for this) you type in ‘CHECK’ (part of the keyword ‘CHECKUP’). You are then
presented with a list of terms. One of these terms is Check up;diabetes, which you select. The software
automatically assigns a code in the background, in this case T31 005, and stores the term you choose, and its
code in the record.
Mr Jones has non-insulin dependent diabetes. In ICPC-2 PLUS, you can use any of the synonyms for this type
of diabetes, such as Type 2 diabetes or adult onset diabetes. You can also use antonyms, such as NIDDM, as
keywords. Simply enter a keyword, such as ‘DIAB’, and you will be offered a picklist of terms. You select
your preferred term, non-insulin dependent diabetes, out of the picklist and again the term and its code are
stored in the record.
WHY DO I NEED ICPC-2 PLUS?
When you record data in medical records using ICPC-2 PLUS, retrieving your data for auditing, quality
assurance or continuity of care is easier and more reliable than manually counting patient records to find out
how many patients in your practice are being treated for a particular condition. Using ICPC-2 PLUS, it
doesn’t matter if other doctors in the practice don’t use the same terms as you, because each term is
grouped with similar terms (i.e. the terms are classified according to ICPC-2).
When you are ready to analyse your data, you can choose an output file, known as a grouper, which will
extract information from your records at a level of specificity that you choose.
Example
If you want to find or count all patients in your practice with:
• Any type of diabetes - you select the ‘Diabetes (all)’ grouper
•
•
•
All diabetes (except gestational) - you select the ‘Diabetes (non-gestational)’ grouper
insulin dependent diabetes only - you select ‘Diabetes, insulin dependent’
non-insulin dependent diabetes only - you select ‘Diabetes, non-insulin dependent’.
CAN I LOOK AT ICPC-2 PLUS BEFORE PURCHASING IT?
Yes! We have a demonstration package on our website (www.fmrc.org.au/classifi.htm) that allows you to
enter keywords and terms. You can also look at how you can analyse your data using ICPC-2 PLUS groupers.
Not all features of ICPC-2 PLUS are available in every software package. Your software provider may be
able to give you a demonstration of how ICPC-2 PLUS works in your system. Ask your contact person for
more details.
HOW MUCH DOES IT COST?
Initial membership includes a once only payment (for the life-long use of ICPC-2) which is passed on in full to
the World Organisation of Family Doctors (WONCA), and an annual site licence fee set by the Family
Medicine Research Centre (FMRC) for the ongoing development of ICPC-2 PLUS. In subsequent years, only
the annual fee is payable.
*
INITIAL MEMBERSHIP
ANNUAL SITE LICENCE FEE
YEAR 1 ONLY
Single user site:
2-4 user site:
5-10 user site:
11-15 user site:
16-20 user site:
21+ user site:
FROM YEAR 2
Single user site:
2-4 user site:
5-10 user site:
11-15 user site:
16-20 user site:
21+ user site:
$210*
$315*
$420*
$480*
$530*
$580*
10% GST is calculated only on the annual site licence fee, and is included in this amount.
$110*
$165*
$220*
$280*
$330*
$380*
WHERE CAN I GET MORE INFORMATION?
•
•
•
•
The FMRCs website: www.fmrc.org.au/classifi.htm where you can look at:
§ the structure of ICPC-2 PLUS
§ the background of ICPC-2 PLUS
§ the ICPC-2 PLUS Demonstrator
Phone: (02) 9845-8151
Email: [email protected]
Or ask your software provider for more information.
HOW CAN I PURCHASE ICPC-2 PLUS?
Complete the details on the subscription form below and either mail or fax it back to us at the FMRC. Your
software provider also has copies of the form, or go to our website and download a copy at www.fmrc.org.au.
------------"-----------------------------------------------"--------------------------------------------------"--------------------------------Name of software provider: _________________________________________________________________
Number of Users (FTE’s) who will be using ICPC-2 PLUS in my practice
MAIL ORDERS:
Complete and Mail
Family Medicine Research Centre
University of Sydney
PO Box 533
Wentworthville NSW 2145
ENQUIRIES:
FAX:
Contact Name _______________________________________________
__________________________
(02) 9845-8151
(02) 9845-8155
Signature_____________________________
Practice Name ________________________________________________________________________________________
Address______________________________________________________________________________________________
______________________________________ Phone_____________________ Fax________________________________
Email address _________________________________________________________________________________________