What is ICD and why is it important?

By Rohan Gupta

Published on 25, June, 2018

On June 18th, 2018 WHO released a version of ICD-11 for the countries to ready themselves for implementation and translation of ICD in their own languages. The final ICD-11 will be submitted to 144th Executive Board meeting on January 2019 and it is expected that the Member states will start reporting using ICD by January 2022. 

What is ICD?
International Classification of Diseases (ICD) is tool for recording, classifying, reporting and grouping conditions and factors affecting health.  The objective of ICD is to have a systematic and uniform methodology for the categorization, comparison and interpretation of morbidity and mortality data reported from different countries at different times. 
ICD uses alpha-numeric codes to classify diseases. But ICD is not limited to just disease; it contains information on  disorders, syndromes, signs, symptoms, findings, injuries, external causes of morbidity and mortality, factors influencing health status, reasons for encounter of the health system, and traditional medicine. Standardized classification and reporting of Mortality and Morbidity data are the main uses of ICD. 
Mortality coding - Systematically coded Mortality data can be effectively used for monitoring public health, health research, evaluating health interventions and so on. If ICD is to be implemented, there needs to be proper infrastructure for reporting and storage of data, designed information flows, quality assurance and feedback. Mortality coding is done from Death certificates. 
Morbidity coding – The health care practitioner treating the patient should be responsible for recording the patient’s health conditions. The records need to be systematically maintained for coding purposes. ICD coding for morbidity can be done when sound written records of the patient’s health conditions are available.
ICD in India
ICD-10 was introduced in 1993 while India adopted it in 2000. ICD compliance has been made mandatory by the Indian Medical Council for research, but the implementation has, at best, been partial. A major fraction of Hospitals in India are not ICD compliant. According to a 2015 study published in the Indian Journal of Public Health, few Hospitals in Delhi were using ICD while fewer had any knowledge about it. Awareness seems to be a major but not the only barrier in the implementation. Lack of computers and ICD-10 software in some hospitals means that coding had to be done manually which is a cumbersome job. Also, the lack of professional health experts puts the onus of coding on the doctors which was an additional and detested burden for them. 
Adoption of ICD in India can help streamline mortality and morbidity data across the regions, states and time periods, which will help in identifying patterns of diseases and better reporting of prevalence and incidence.