A short overview of the developmental process and the goals for the mICF platform, using big data analytics based on patient-driven data.

1. Improving Health and Functioning Using
Mobile ICF (mICF) Technology
- the mobile ICanFunction App
Patricia WELCH SALEEBY1, Olaf KRAUS de CAMARGO2,
Stefanus SNYMAN3, Jaana PALTAMAA4, Joanne VALERIUS5, Kaija
SARANTO6, Petteri WECKSTRÖM4, Thomas MARIBO7, Heidi ANTTILA8
Pacific Rim International Conference on Disability and Diversity
May 19, 2015
1Southern Illinois University, United States of America, 2 McMaster University, Canada, 3 University of
Stellenbosch, South Africa, 4 Jyväskylä University of Applied Sciences, Finland, 5 Oregon Health &
Science University, United States of America, 6 University of Eastern Finland, Finland, 7 Rehabilitation
Center Marselisborg, Aarhus University, Denmark, 8 National Institute for Health and Welfare, Finland
mICF International Partnership 1

2. Introduction
• An estimated 15% of population experience
limitations in activities and participation with 2-
4% severe limitations
(World Bank & WHO, 2001)
• These needs are not easily transferred from
patients to services nor interprofessionally
• Potential consumers include all people as well as
all social and health care organizations in the
Americas, Europe, Africa, Asia and Australia
mICF International PartnershipTwitter: @ICFmobile 2

3. WHO and ICF
• World Health Organization (WHO) aims at re-
engineering primary health care with emphasis
on community-based, person-centered care
• The International Classification of Functioning,
Disability and Health (ICF), provides
standardized information structure and
common language across professionals, to
describe the lived experience of a person’s real
life situation
mICF International PartnershipTwitter: @ICFmobile 3

4. Current use of the ICF
• Major use has been in research on ICF
• Despite many initiatives to train clinicians
worldwide, the ICF has not been used in clinical
practice (across professions) for multiple reasons
• Several groups have started to investigate the
feasibility of an electronic or a mobile version of
the ICF in order to facilitate the clinical use
• While it is not too difficult to transfer the
classification into an electronic and searchable
document, this would only be part of the overall
process of using the ICF clinically
mICF International PartnershipTwitter: @ICFmobile 4

5. A global online survey for social
and health care specialists (n=1,198)
• Purpose was to assess needs requirements to
develop a mICF to collect patient-centered data
for clinical decision-making
• Conducted June-December 2014 in 40 countries,
via a “snowball” system
• English, Afrikaans, Chinese, Danish, Dutch,
Finnish, French, German, Japanese, Korean,
Mongolian, Portuguese (Brazil), Portuguese
(Portugal), Spanish and Thai
mICF International PartnershipTwitter: @ICFmobile 5

6. Results from the global
online survey
• Many people do not have experience in using the
ICF neither in research nor in clinical practice
• Even among those who are familiar with the ICF:
only 30-50% would always ask about personal or
environmental factors
• Nearly all wanted to use electronic devices for
collecting and reporting health data
• Most benefits were seen in improved patient care
with better supported clinical reasoning, decision-
making about interventions, and in monitoring
functional health over time
mICF International PartnershipTwitter: @ICFmobile 6

7. International mICF Partnership
• An international collaborative of the Functioning
and Disability Reference Group of the WHO’s
Family of International Classifications Network was
established to investigate the development for a
mobile application for the ICF (mICF)
• Included in the WHO-FIC FDRG strategic work plan
• 248 collaborators from 48 countries to develop
• User-friendly ICanFunction (mICF) health service
platform to conceptualise health and wellbeing as a
dynamic interaction between a person’s health
condition, functioning and contextual factors
mICF International PartnershipTwitter: @ICFmobile 7

8. When “taking a history”
• Clinicians focus on pieces of information from
various sources (patient, family, professionals) that
help them to understand what is going on
• Putting many pieces together can help to make a
more accurate diagnosis
• One of the challenges for clinicians is to find the
balance between collecting all the right pieces
of information to make a diagnosis and paying
attention to the unique stories of individual
patients’ daily lives
• Good patient care takes them both into account!
mICF International PartnershipTwitter: @ICFmobile 8

9. Linda and her son Erik
• Linda struggled with all the deprecating comments
her family members made about her son Erik during
the celebrations on the long weekend
• He did not eat as other kids his age, did not behave
like them or play like them. Tired of all the “well-
meant” advice of how to educate and raise her child
and not having a diagnosis to explain easily to others
Erik’s differences, …
• She started describing his strengths and struggles in
the “mICF PROFILE BUILDER” to share a description
of her son that might help others to better
understand, accept and include him in future family
gatherings
mICF International PartnershipTwitter: @ICFmobile 9

10. I am Erik.
What works for me?
• Give me time to talk – I may
take longer but I have lots to say
• Let me eat what I can, when I
can … I know what foods are safe
for me, and forcing me to eat
won’t help
• If I am acting poorly, let my
mom deal with it.
• If I get overwhelmed by
sensory input (noise, sight,
touch), my behaviour may look
inappropriate, but it is my
reaction to an overwhelming
situation. Please give me time
alone.
mICF International PartnershipTwitter: @ICFmobile 10
Things I am learning:
• Learning to chew and swallow food;
Learning to talk clearly; Learning to
play well with my friends
What I like doing:
• Playing with my sister; Staying close
to mom; Running around; Pretend
play with my toys; Helping mom
vacuum and clean.
What is important for me?
• Good sensory regulation; Proper
nutrition with PediaSure®; People
who are patient with me.
What people say about me?
• Busy; Adorable; Smart; Funny;
Hyper; Small; Doesn’t eat; Hard to
Understand

11. Short profile captures Erik’s
difficulties and strengths
09-05-2015 mICF International Partnership 11
Erik’s profile ICF items ICF codes
Give me time to talk – I
may take longer but I have
lots to say
Articulation functions b320
Let me eat what I can,
when I can … I know what
foods are safe for me, and
forcing me to eat won’t
help
Ingestion functions
Swallowing
Individual attitudes of extended
family members
b510
b5105
e415
If I am acting poorly, let
my mom deal with it.
Managing one's own behaviour
Individual attitudes of immediate
family members
d250
e410
If I get overwhelmed by
sensory input (noise, sight,
touch), my behaviour may
look inappropriate, but it is
my reaction to an
overwhelming situation.
Please give me time alone.
Handling stress and other
psychological demands
Sound quality
Light
Tactile perception
Auditory perception
Visual perception
Individual attitudes of extended
family members
d240
e2501
e240
b1564
b1560
b1561
e415

12. mICF International Partnership09-05-2015 12
Erik’s profile ICF items ICF codes
Learning to chew and
swallow food
Chewing
Swallowing
b5102
b5105
Learning to talk clearly Articulation functions b320
Learning to play well with
my friends
Shared co-operative play d8803
Playing with my sister Shared co-operative play d8803
Staying close to mom Physical contact in relationships d7105
Running around Running d4552
Helping mom vacuum and
clean
Helping to do housework d6406
Good sensory regulation Perceptual functions b156
Proper nutrition with
PediaSure®
Food e1100
People who are patient
with me
Attitudes e4
Busy Energy and drive functions b130
Adorable Personal factor Personal strength
Smart Personal factor Personal strength
Funny Personal factor Personal strength
Hyper Energy and drive functions b130
Small Height percentile
Doesn’t eat Appetite b1302
Hard to Understand Articulation functions b320

13. Based on the underlying
coding with ICF
• Linda was able to get a nice printout to be shared with
her relatives
• Sharing the anonymised profile on the “mICF
WEBSPACE” revealed that there was another boy with
similar issues living in the same town
• His parents had uploaded his profile on the
protected webspace and also indicated that he
benefitted significantly from using text-to-speech
software that not only helped him learn to read but
through the voice recognition software was also able to
provide feedback to their son on his articulation, helping
him to improve his intelligibility in a playful and non-
judgmental way
Twitter: @ICFmobile mICF International Partnership 13

14. Connection with others
• She decided to connect with this family over the
secure chat to obtain more information
• By using the App this mother was able to better
articulate her son’s needs and strengths and
also obtain automatic recommendations based on
the functional profile of her son
• If parents try to find help for their children on
Webpages or in chat rooms they usually feel
overwhelmed by the deluge of information and
the need to filter out what is applicable to their
own child and their specific family needs
mICF International PartnershipTwitter: @ICFmobile 14

15. Approach – mobile
ICanFunction App (mICF)
• Easy to use, safe mobile solution for all people
• A person can share his/her own functional needs
(problems and strengths) and thus ease the conversation
with professionals
• The professionals get easy and quick summary for the
rehabilitation or service plan, and can follow-up changes
• Minimize need for repeat data collection: time-savings
• A solution that bases on international standard to
describe each person’s functioning as a dynamic
interaction between the person’s health condition,
functioning, and environmental and personal factors
 comprehensiveness, transferability
mICF International PartnershipTwitter: @ICFmobile 15

16. How will mICF be developed?
• Data will be patient-driven, facilitating shared
decision-making and well-coordinated, holistic,
continuity of care across various service settings
• Personal health data will be processed securely,
informing a patient-empowering bio-psycho-social
approach
• Big data analytics will enable personalised,
predictive care
• Proof-of-concept validation across the globe
include low-and middle income countries
mICF International PartnershipTwitter: @ICFmobile 16

17. mICF International PartnershipTwitter: @ICFmobile 17
• Clinical studies will focus on older people, as
well as children and adults with chronic diseases
• State-of-the-art service design will entail
iterative in-market experimentation, and impact
and economic evaluation
• An extensive dissemination strategy, in close
collaboration with the International mICF
Partnership, will focus on change management,
allowing new patient pathways and
interprofessional collaboration
• Lean, agile commercialization will ensure
sustainability and the development of new
business and service solutions adhering to
ethical and legal regulations

18. mICF International PartnershipTwitter: @ICFmobile 18
Funding Initiatives
mHealth solution based on
International Classification of
Functioning, Disability and
Health
The mobile ICanFunction App
(mICF)
Horizon 2020 PHC-25 Call
Coordinator: THL
3,5 years: 1.1.2016-30.6.2019
Twitter @ICFmobile
Facebook ICanFunction