The authors of the “ISPRM Discussion Paper: Proposing Dimensions for an International Classification System for Service Organisation in Health-related Rehabilitation (ICSO-R)” are grateful to Dominique Van de Velde and Guy Vanderstraeten for commenting on their paper (1, 2). The authors agree that within the dimension “service provider”, the category “human resources” is important for the delivery of rehabilitation services. However, it must be stressed that classifications cannot refer to the importance of specific items.

The ICSO-R working group has started a number of projects to test the feasibility and suitability of the proposed dimensions, e.g. by applying the ICSO-R to cases around the world. Another recent project, within the PRM Section and Board of the European Union of Medical Specialists (UEMS), includes narrative and systematic descriptions of rehabilitation services.

The authors of the discussion paper are aware that discussion of the dimensions and experiences from the ongoing application of the classification system will lead to a refined version of the ICSO-R (1). As proposed in the original paper this must also include a third level, consisting of value sets and more detailed descriptions of the categories (inclusions and exclusions). For human resources this may include “competencies of rehabilitation professionals”.

Regarding the revision process of the ICSO-R, the authors will consider the proposal of Dominique Van de Velde and Guy Vanderstraeten with care. From experience in using the ICSO-R for the development of National Disability, Health and Rehabilitation Plans in several countries, the authors are aware that, in addition to dimensions, categories and value sets, prototype services may be needed and, in particular, that the competencies of rehabilitation professionals are of great importance.

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