#Disease Classification

Parajuli SB, 2026
www.suryaparajuli.com.np

For
Community Medicine (Kathmandu University) | MBBS 1st Semester | Batch 2026
Birat Medical College Teaching Hospital

April 21, 2026 | 12:00 PM – 1:00 PM NST

#Specific Learning Outcomes (SLOs)

At the end of the session, the learner will be able to

• describe the classification of diseases and explain its importance

• explain the International Classification of Diseases — ICD-11

• describe the Integrated Health Information Management System — IHIMS

• apply disease classification and health information systems

#Disease Classification

#Definition

Systematic grouping of diseases and health conditions into categories based on:

• Cause (etiology)

• Symptoms and clinical features

• Body systems affected

• Severity and course

Helps in standardizing diagnosis, recording, and reporting of diseases

#Importance

• Standardization of disease recording

• Improves communication among health professionals

• Supports data collection & reporting (IHIMS)

• Useful in epidemiology (disease patterns & trends)

• Guides planning and policy-making for resource allocation

#Major Classification Systems

• ICD-11

• DSM-5

• SNOMED CT

• ICPC-2

• ICF

• ATC/DDD

• LOINC

• CPT

• MeSH

• IHIMS Nepal

https://icd.who.int/en/
https://www.youtube.com/watch?v=jPW0sahWWg0

#ICD-11

#Overview

ICD-11 is the 11th revision of the International Classification of Diseases

Replaces ICD-10 as the global standard for:

• Recording health information

• Causes of death

#Development & Adoption

Developed by World Health Organization

Development started: 2007

Endorsed: 72nd World Health Assembly (25 May 2019)

Implementation date: 1 January 2022

#Structure

Large ontology with ~85,000 entities (classes/nodes)

Each entity represents:

• Diseases

• Pathogens

• Symptoms

• Developmental anomalies

• External causes of injury/death

• Social circumstances

• Reasons for health service contact

#ICD-11 Family

Part of the WHO Family of International Classifications (WHO-FIC)

Main derivative:

ICD-11 MMS (Mortality and Morbidity Statistics)

Commonly referred to as “ICD-11”

#ICD-11 Chapters (All Chapters in One Table)

Unlike the ICD-10 codes, the ICD-11 MMS codes never contain the letters I or O, to prevent confusion with the numbers 1 and 0

#Purpose of ICD-11

• Standardizes diagnosis and disease reporting globally

• Supports monitoring of disease trends and outbreaks

• Helps in national and international health policy formulation

• Facilitates uniform data for research studies

• Improves clinical documentation and reimbursement systems

#Key Features of ICD-11

#1. Fully Digital System

• First ICD version designed for electronic use

• Available online with coding tools

• Easy search, update, and real-time use

#2. Updated & Expanded Content

• ~17,000 diagnostic categories

• Over 100,000 possible codes with combinations

• Includes new diseases and conditions (e.g., Gaming disorder)

#3. User-Friendly Coding

• Uses alphanumeric codes

• Improved structure for easy searching

• Faster and more intuitive coding system

#4. Clinical Detail

• More detailed than ICD-10

• Better classification of modern diseases

• Includes emerging conditions

#5. International Standard

• Used globally for mortality & morbidity data

• Ensures uniform health statistics worldwide

#6. Coding System

• Alphanumeric format (e.g., 1A00)

• Each code represents a specific disease/condition

• Supports combination (post-coordination) coding for higher detail

#IHIMS

(Integrated Health Information Management System)

Nepal’s national digital health platform integrating multiple health information systems into one unified framework.

Implemented by: Ministry of Health and Population, Nepal

Managed by: Department of Health Services

Purpose: Strengthen evidence-based decision-making at all levels of healthcare

Established: 1994/95 AD (2051/52 BS)

Roadmap Approved: IHIMS Roadmap 2022–2030 approved in 2021 AD (2078 BS)

#HMIS

(Health Management Information System)

Core component of IHIMS

Collects routine health service data

Covers:

• OPD (Outpatient Department)

• IPD (Inpatient Department)

• Maternal and Child Health

• Family Planning

• Immunization

• Nutrition Services

#Indicators Collected

• Maternal Health – ANC visits, institutional delivery

• Child Health – Immunization, malnutrition

• Communicable Diseases – TB, malaria, HIV

• Non-Communicable Diseases – Hypertension, diabetes

• Service Utilization – OPD/IPD attendance

#Data Analysis and Use

Data analyzed at:

• Facility level

• Local government level

• Provincial and central levels

#Used For

• Planning health programs

• Monitoring performance

• Resource allocation

• Policy formulation

#Advantages of IHIMS

• Integration – Combines multiple systems into one unified platform

• Real-Time Data – Faster reporting and quick decision-making

• Improved Data Quality – Standardized formats and validation checks

• Better Monitoring – Tracks national health programs effectively

• Transparency – Accessible dashboards and reports

#MASTER LIST — HMIS Tool Groups 1 to 9

#Detailed Compilation

#GROUP 1 — Common Tools

Purpose: Core patient registration and service documentation.

Major Forms:

• HMIS 1.1 — Master Register

• HMIS 1.2 — Health Service Card

• HMIS 1.3 — OPD Register

• HMIS 1.4 — Referral/Transfer Slip

• HMIS 1.5 — Loss to Follow-Up

• HMIS 1.6 — Open Tally Sheet

• HMIS 1.7 — Basic Health Facility Monitoring Sheet

• HMIS 1.8 — Hospital Monitoring Sheet

Key Role:
Foundation of all routine data collection.

#GROUP 2 — Infant and Child Health

Purpose: Child health monitoring.

Major Forms:

• HMIS 2.1 — Child Health Card

• HMIS 2.2 — Immunization Register

• HMIS 2.3 — Nutrition Register

• HMIS 2.4 — IMNCI Register

• HMIS 2.5 — IMAM Child Health Card

• HMIS 2.6 — IMAM Register

• HMIS 2.7 — IMAM Hospital Register

• HMIS 2.8 — NRH Register

Key Role:
Supports child survival indicators.

#GROUP 3 — Family Health

Purpose: Reproductive and maternal health services.

Major Areas:

• Family Planning

• Maternal Health

• Newborn Health

• Safe Abortion

• RH Morbidity

Key Role:
Essential for maternal mortality reduction programs.

#GROUP 4 — Community Services

Purpose: Community outreach recording.

Major Forms:

• Outreach Clinic Register

• FCHV Register

• Vitamin A Register

• Health Promotion Register

Key Role:
Tracks preventive services at community level.

#GROUP 5 — Disease Programs

Purpose: Disease-specific services.

Major Programs Covered:

• Malaria

• Leprosy

• Kala-azar

• NCD

• Mental Health

Key Role:
Supports disease elimination programs.

#GROUP 6 — Tuberculosis

Purpose: TB program management.

Major Forms:

• Presumptive TB Register

• Laboratory Register

• Treatment Register

• Contact Investigation Register

Key Role:
Essential for DOTS strategy monitoring.

#GROUP 7 — HIV/AIDS & STI

Purpose: HIV program documentation.

Major Forms:

• HIV Testing Register

• ART Register

• PMTCT Register

• STI Register

Key Role:
Supports national HIV surveillance.

#GROUP 8 — Hospital Services

Purpose: Hospital-level services.

Major Forms:

• Admission Register

• Discharge Register

• Emergency Register

• ICU/NICU Register

Key Role:
Provides hospital utilization statistics.

#GROUP 9 — Monthly Reporting Forms

This is the missing group you asked to compile.

Purpose: Monthly reporting and data submission.

Major Forms:

These tools are used to submit monthly service data from facilities to higher administrative levels.

#HMIS Workflow Integration )

This is how all 9 groups function together:

Group 1–8 → Data Recording
Group 9 → Monthly Reporting

So the system works as:

Service → Recording → Reporting → Analysis → Planning

This is the core RHIS cycle.

#Integrated Functional Mapping

#References

World Health Organization. International classification of diseases for mortality and morbidity statistics (11th Revision) (ICD-11) [Internet]. Geneva: WHO; 2019 [cited 2026 Apr 6]. Available from: https://icd.who.int

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5). 5th ed. Washington, DC: American Psychiatric Publishing; 2013.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5-TR). 5th ed., text rev. Washington, DC: American Psychiatric Publishing; 2022.

World Health Organization. Health information systems: toolkit on monitoring health systems strengthening [Internet]. Geneva: WHO; 2008 [cited 2026 Apr 6]. Available from: https://www.who.int

Ministry of Health and Population (Nepal). Integrated Health Information Management System (IHIMS) guidelines [Internet]. Kathmandu: MOHP; [cited 2026 Apr 6]. Available from: https://mohp.gov.np

Ministry of Health and Population (Nepal). Annual Report, Department of Health Services (DoHS) [Internet]. Kathmandu: DoHS; [cited 2026 Apr 6]. Available from: https://dohs.gov.np

Park K. Park’s textbook of preventive and social medicine. 27th ed. Jabalpur: Banarsidas Bhanot; 2023.

World Health Organization. Classification of diseases (ICD) [Internet]. Geneva: WHO; [cited 2026 Apr 6]. Available from: https://www.who.int/standards/classifications