Purpose of the Consultancy

The purpose of the short-term consultant (STC) is to provide technical assistance to the Ministry of Health in developing guidelines, tools, training materials, and standard operating procedures for the simplified International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) for Department of Planning and Health Information (DPHI), Ministry of Health, Cambodia.

ICD-10 is recognized globally as the international standard for reporting diseases and health related conditions. It is used officially in over a hundred countries to track and record the incidence and prevalence of disease and mortality statistics. Since 2017, the simplified ICD-10 coding system has been introduced to support implementation in low-resource countries. All procedures and processes should follow well-written guidelines, tools, training materials and standard operating procedures in line with the global simplified ICD-10 standards.

In order to achieve the objectives of the assignment, the consultant will be asked to work with relevant staff from Department of Planning and Health Information (DPHI) which is a department under the Ministry of Health (MOH). The consultant will also be asked to consult with the Department of Hospital Services Department, another department under MOH, that works on service delivery including hospital management. 

Terms of references for a WHO Short-term consultant include

In close collaboration with Department of Planning and Health Information (DPHI), Ministry of Health and WHO Country office in Cambodia, the consultant will undertake following tasks from June-November 2018:

1. develop a complete package of guidelines, tools, and standard operating procedures (SOP) for all steps of the simplified ICD-10 coding. This should be completed in the month of June to be translated in July.

Guidelines and SOPs  include, but not to limited, good medical recording practices for doctors on quality diagnosis and cause of death, good data and medical record management for hospitals, guidance for coding, data analysis and reporting data etc.

1. design training course on simplified ICD-10 for doctors on good medical recording practice and determining cause of death. This should be completed in the month of June to be translated in July;
2. design training course on the simplified ICD-10 cording for inpatient and cause of death. This should be completed in the month of June to be translated in July;

1. design training on data analysis of simplified ICD-10 coding for morbidity and mortality coding. This should be completed in the month of June to be translated in July;
2. train staff of Department of Planning and Health Information on the newly developed guidelines, tools and standard operating procedures to ensure that staff are confident with processes for coding ICD-10 and data management (end of June);
3. develop plan for building-up ICD-10 institutional capacity in country. To be completed in July. This should include:
   1. Designing terms of reference for ICD-10 technical officer at central level and at the provincial health department
   2. Estimating financial and human resources needed to maintain simplified ICD-10 coding in Cambodia
   3. Recommendations on institutional arrangements and capacity building for ICD-10
4. conduct four three-day trainings to train all hospitals on the ICD-10 coding practices and procedures (between August and November);
5. write a final report, including next steps and recommendations, with a debriefing to MOH and WHO.

Background

In the last year, Cambodia has piloted successfully the use of simplified ICD-10 coding across 10 hospitals[1] for inpatient diagnosis and mortality coding (August 2017-December 2018). The following approach was used to build capacity at the hospitals to be able to code inpatient and cause of death at the hospital level:

1. “Introduction workshop on ICD-10 mortality and morbidity data” reviewed key foundational materials for hospitals and doctors to introduce ICD-10 coding practices. Attended by hospital directors and other stakeholders. (21 Aug, Phnom Penh)
2. “Training of trainers workshop on ICD-10” where doctors learned how to write good medical recording practices and fill-in the death certificates. Hospital staff - the ‘coders’ learned how to code inpatient and cause of death data using simplified ICD-10 (11-13 Sept, Kampong Cham)
3. “Training on data analysis of the ICD-10 mortality and morbidity statistics” taught hospital staff how to analyze the ICD-10 data. (4-5 Dec, Phnom Penh)
4. Workshop on pilot results and next steps. (19 Dec, Phnom Penh)
5. On-site coaching for hospitals who needed additional support (Aug-Dec 2017)

It’s been requested from the Ministry of Health, DPHI to expand the scale-up of simplified ICD-10 nation-wide to all hospitals between August to November 2018. Using the lessons learned from previous 10 pilot hospitals, a similar approach will be introduced to the remaining 17 provincial hospitals and 84 operational district hospitals. In order to institutionalize the process, the development of SOPs, guidelines, tools, training materials and standard operating guidelines are needed. The application of simplified ICD-10 will improve the country’s health data on burden of disease and cause of death information. This will generate more accurate and timely information that can be used to inform evidence-based policy making.

The objective of this consultancy is to assist the Department of Planning and Health Information, Ministry of Health to introduce protocols and practices for systematic ICD-10 coding for morbidity and mortality data at all hospitals in Cambodia.

Planned timelines (subject to confirmation)

Start date:           16 July 2018
End date:             30 November 2018

30 working days over 5 months

Work to be performed

In close coordination with Department of Planning and Health Information, Ministry of Health and WHO:

1. Review of key documents
2. Development of guidelines for ICD-10 data and medical record management for hospitals
3. Development of guidelines for doctors on quality diagnosis and cause of death medical recording practices 
4. Development of guidelines on guidance for ICD-10 coding practices for morbidity and mortality data
5. Development of guidelines on reporting and data analysis
6. Development of training materials for doctors on quality diagnosis and cause of death
7. Development of training materials for coders on ICD-10 coding for morbidity and mortality data
8. Development of training materials for data analysis of ICD-10 morbidity and mortality data
9. Development of terms of reference for ICD-10 officer at central and provincial level
10. Estimation of human and financial resources needed to maintain ICD-10 system
11. Development of plan for building institutional capacity for ICD-10
12. Training of department of planning and health information  staff on a complete package of guidelines, SOPs etc 
13. Training of hospital staff from remaining hospitals on ICD-10 morbidity and mortality coding and data analysis and training for PHD/OD health information officer on basics of ICD-10
14. Develop a final report including next steps and recommendations for implementation

Method(s) to carry out the activity

Review key documents and reports regarding simplified ICD-10; development of documents, meeting all relevant stakeholders (MOH, DPHI staff, HSD staff); trainings coaching of health staff and consultation with stakeholders. 

Output/s 
16 July-16 August 2018

Output 1:  The consultant is expected to develop guidelines, tools and standard operating procedures to improve the country’s health data on burden of disease and cause of death information. This will generate more accurate and timely information that can be used to inform evidence-based policy making in Cambodia.

Deliverable 1.1: ICD-10 guidelines for medical and recording management for hospitals

Deliverable 1.2: ICD-10 guidelines for coding practices for morbidity and mortality data 

Deliverable 1.3: guideline for doctor on quality diagnosis and cause of death medical recording practice

Deliverable 1.4: ICD-10 guidelines for reporting and data analysis

Deliverable: 1.5: tools and standard operating procedures to implement the newly developed ICD-10 guidelines 

Output 2:  Training and coaching of department of planning and health information staff on completed package of guidelines, tools, training materials, SOPs

Deliverable 2.1: Training materials (power point presentations and exercises) on ICD-10 medical recording practices, ICD-10 coding practices, and reporting and data analysis linked to deliverable 1.1-1.4.

Deliverable 2.2: Training of department of planning and health information staff on the completed package and consultation with stakeholders

Deliverable 2.3: One day training for PHD/OD health information officer on basics of ICD-10

August to November, 2018 

Output 3: Capacity building in country on ICD-10 morbidity and mortality coding protocols and practices for all hospitals in Cambodia.

Deliverable 3.1: Conduct 4 trainings in Cambodia to all hospital staff selected for the training.

Deliverable 3.2: Recommendations for building in-country capacity on ICD-10, estimation of resources needed for ICD-10, and terms of reference for ICD-10 technical officers.

November 2018

Output 4:  Submission of a final report at the end of the consultancy including following deliverables

Deliverable 4.1: developed guidelines, tools, training materials and SOPs. 

Deliverable 4.2: technical report with next steps and recommendations for implementation of ICD-10 for outpatient cases.

Technical Supervision

The selected Consultant will work on the supervision of:

Responsible Officer:
Dr Kumanan Rasanathan, Coordinator Health Systems
Email:  [email protected]

Manager:  Dr Liu Yunguo
WHO Representative
Email:  [email protected]

Specific requirements

Qualifications required:   

• Post graduated university’s degree in Health Management, Health Informatics. Preferred Medical Doctor with training on disease classification and coding

- Experience :

• At least 7 years working on health system information, disease classification and coding, working experience on ICD-10 application is an asset.
• International and regional experience working on ICD-10 coding application is preferable
• Research on ICD-10 including publications in relevant field: health information systems, especially using ICD10; heath systems.

- Skills / Technical skills and knowledge:

• An asset to have understanding of the social-political context of Cambodia; familiar with national, government economic reform process and issues; understanding of health issues in the country.
• Knowledge of ICD-10 coding for mortality [(Start-Up Mortality List (SMoL)],and morbidity (APN Simplified Version for morbidity)
• Clear communication and skill in facilitation – desirable ICD-10 Training for trainer (WHO Collaborating course)

- Language requirements:

• Essential: Fluent in English (Reading and writing)

Competencies

• Proven research and training skills in health information systems or relevant field
• The Consultant needs to be committed to maintain utmost confidentiality at all times, and any information obtained during the review process is not to be disseminated without prior approval from MOH and WHO.

Place of assignment

• For outputs one and two, the work can be done remotely. For output 3, this work will be done in Cambodia, select provinces to be determined.

Medical clearance

The selected Consultant will be expected to provide a medical certificate of fitness for work.

Travel

The selected Consultant is expected to travel with government counterparts during the consultancy to provinces for a total of 12 days maximum. The Consultant will receive subsistence allowance when he/she go on mission to Cambodia as indicated in output 2 and 3. 

The dates will be confirmed by MOH once the consultant is selected.

Travel dates                         Location

From  16/7/2018  To 30/11/2018

During the consultancy, the selected Consultant will be required to  provinces (schedule TBC by government counterpart)

Purpose:   Travel to conduct trainings (output 2 and 3)

All travel arrangements will be made by WHO – WHO will not be responsible for tickets purchased by the Consultant without the express, prior authorization of WHO. While on mission under the terms of this consultancy, the Consultant will receive subsistence allowance.

Visas requirements: it is the consultant’s responsibility to fulfil  visa requirements and ask for visa support letter(s) if needed.

Medical clearance

The selected Consultant will be expected to provide a medical certificate of fitness for work.

Application

Interested should submit the following documents to [email protected] by 25 June 2018. Please use Tender Notice No. 73229 as subject to all submissions.

• Expression of Interest
• WHO personal history form or CV
• Proposed charging rate

Please note that the application may be closed before the indicated closing date if a sufficient number of applications are received. Only the successful candidates will be contacted