The integration of WHO classifications and reference terminologies to improve information exchange and quality of electronic health records: the SNOMED–CT ICF harmonization within the ICD-11 revision process

Introduction The Family of International Classifications (WHO-FIC) is a suite of integrated classification products of the World Health Organization (WHO) that can be used to provide information on different aspects of health and the health-care system. These tools and their national modifications allow, together with the related classifications of health interventions, full representation of the volumes of health services provided in the various countries that adopt case mix systems. The use of standardized terminologies in classifications, for the definition of the descriptive characteristics of the disease, is a necessary step to allow full integration between different information systems, making available information about the diagnosed diseases, the performed health procedures and the level of functioning of the person, for very different uses such as, for example, public health, safety of care and quality control. Materials and methods Within the WHO and International Health Terminology Standards Development Organization (IHTSDO) collaboration agreement, a work of independent review was carried out on all the Activities and Participation categories (A&P) of the WHO International Classification of Functioning, Disability and Health (ICF), in order to identify equivalence and gaps to the Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT) concepts in terms of lexical, semantic (content) and hierarchical matching, to harmonize WHO classifications and SNOMED CT. Results and conclusions The performed mapping suggests that the ICF A&P categories are semantically and hierarchically different from the terms of SNOMED CT thus confirming the high value of the WHO-IHTSDO synergy aiming to frame together, in a joint effort, their respective unique contribution. Recommendations were formulated to WHO and IHTSDO in order to better frame together, in a joint effort, their respective unique contribution ensuring that SNOMED CT and ICF can interoperate in electronic health records.