National Collections Annual Maintenance Project
Version 1.0 ● Final
Date: / 10/10/2017
Author: / Tracy Worsley
CREATED WITH /
Table of Contents
National Collections Annual Maintenance Project
1Introduction
2Remove reporting of country codes from NMDS
3Common code tables - new Health Speciality Codes (HSCs)
4NMDS – WIESNZ18 and Cost Weights (Provisional)
5NNPAC - Review of Mode of Delivery code
6PRIMHD - Miscellaneous HISO changes
7PRIMHD - Review of ADOM & SCR codes
NCAMP 2018 - HL Requirements - NCR 100210 October, 2017
National Collections Annual Maintenance Project
1Introduction
1.1Purpose
This document provides a vehicle for the discussion of the requests for changes to the national collections and documents the requirements that are within the proposed scope of the 2018 National Collections Annual Maintenance Project (NCAMP).
1.2Background
NCAMP is an annual project to perform maintenance onthe Ministry’s national collections. Part of this project is to ensure the on-going statutory obligations are met. The NCAMP 2018 project will potentially deliver changes to the following national collections/systems:
National Non-admitted Patient Collection (NNPAC)
National Minimum Data Set (NMDS)
Programme for the Integration of Mental Health Data (PRIMHD)
the Ministry Common Code tables
those collections/systems that hold country code data.
Some NCAMP changes require District Health Boards (DHBs), Non-Governmental Organisations (NGOs) and those private hospitals reporting directly to the National Collections to implement changes to their Patient Administration Systems (PAS) sometimes also referred to as Patient Management Systems (PMS). The annual process for making these changes is outlined in the Operational Policy Framework (OPF).
1.3Project goals and objectives
The goal of this work is to:
improve data quality to enable DHBs to accurately report on the provision and funding of services or treatment, particularly in relation to inter-district flows
ensure data quality and integrity is maintained to avoid substantial rework by both the Ministry and DHBs
improve DHBs’ ability to provide timely, accurate and comparative information. This will assist them to complete functions and meet objectives set out in the New Zealand Public Health and Disability Act 2000
enable the Ministry to meet its obligations of providing high quality data to the DHBs and other providers, particularly in relation to data processing and reporting, manual data entry, and application of data collection business rules
Upgrade the national collections to meet Ministerial requirements.
1.4Business Context
1.4.1Exclusions
BA1. Producing the cost weights framework document as specified in this document is outside the scope of the NCAMP 2018 project.
1.4.2Relevant facts
Relevant Facts
The cut-off date for requests for NCAMP 2018 was 1 June 2017
The deadline for the final scope for NCAMP 2018 is 5 September 2017.
These business requirements are intended to advise Ministry and sector representatives of the planned work to be undertaken as part of NCAMP 2018. The sector change notices are the official formal notices of change initiation and requirements for sector systems.
1.4.3Business Scope
The following items are proposed for NCAMP 2018, subject to sector consultation. Of these changes, some are Sector facing, some are Ministry-only changes and some affect both parties (as noted in the table, below).
NCAMP Ref # / Collection(s)/ System(s) Impacted / Description / Sector and/or Ministry132 / Multiple / Remove/Update requirement forcountry code / Sector / Ministry
147 / PRIMHD / Review of ADOM & Supplementary Consumer Records code sets to ensure they reflect the way the sector is using them / Sector / Ministry
152# / PRIMHD / Substance Addiction (Compulsory Assessment and Treatment) Bill implementation / Sector / Ministry
161 / PRIMHD / Review of Legal Status codes / Sector / Ministry
166 / NNPAC / Mode of Delivery clarification / Sector / Ministry
167 / Common code tables / Add a new Health Speciality Code for 'Maternal Fetal Medicine Services' / Advisory
168 / PRIMHD / Misc HISO changes / TBA
171 / NMDS / WIES NZ 2018/19 / Sector / Ministry
173 / Common code tables / Add a new Health Speciality Code for 'Hyperbaric Services' / Advisory
Please note that the items listed above are the full list of items that are to be included as candidates for NCAMP 2018. Some are Ministry only and some affect both Ministry and the Sector.
# Due to the earlier required delivery of the requirements around the Substance Addiction (Compulsory Assessment & Treatment) Act, the SACAT documentation is being handled separately from the NCAMP 2018 requirements contained in this document.
2Removereporting of country codes from NMDS
Currently the Ministry of Health uses three character country values which does not comply with the naming conventions provided by the International Standards Organisation (ISO). The Health Information Standards Organisation (HISO) requires country codes to be assigned using the HISO 10046 Consumer Health Identity Standard which mandates ISO 3166-1 2 Alpha.
After evaluation of the use of country codes it has been decided to remove the requirement to report country of birthcodes from the NMDS.
2.1BR-CTY Remove reporting country of birthfrom the NMDS collection
Rationale
The country of birth field in the NMDS is optional and after analysis of the population of this field it has been decided that the cost and effort required to bring the code up to the required standards as defined by Statistics New Zealand and HISO is not warranted.
Requirement
Retire the validation of the country of birth in the load file to the common code set
Create warning validation if country of birth field is populated after 1 July 2018
Historical records with an event end date prior to 1 July 2018 must still be accepted if provided in the input file
Notate in the NMDS file specification that the country of birth field is no longer populated (Not used NN)
Notate the data dictionary that the field is no longer required
The country of birth field is to remain in the input file
Applicable from
The country of birth codes will cease to be reported to the NMDS for events with an end date on or after 1 July 2018.
Future state
When the NHI country of birth field is fully populated consideration will be given to deriving the country of birth for NMDS events from the NHI.
3Common code tables - new Health Speciality Codes (HSCs)
The clinical code tables are accessed by some national collections and are available to the general public on the Ministry of Health website here: Health Speciality common code table.
3.1BR-HSC-01 New HSC for 'Maternal Fetal Medicine Services'
The following requirement was sourced from the Health Identity Program Sector Advisory Group (Fetal Identity) and Client Insights and Analytics.
Update the Ministry of Health 'Health Speciality' code table to add:
P39 - Maternal Fetal Medicine Services
This new code P39 will be assigned on the mother's record when her baby receives outpatient treatment from the Maternal Fetal Medicine service (rather than creating a record for the baby). This approach is in line with the guidance from the NHI team about not assigning an NHI to an unborn child
This code is applicable to NNPAC reporting only.
Code to have a start date of 1 July 2018 with no end date.
3.2BR-HSC-02 New HSC for 'Hyperbaric Services'
The following requirement was sourced from the Service Commissioning group.
Update the Ministry of Health 'Health Speciality' code table to add:
H01 - Hyperbaric Services
Code to have a start date 1 July 2018 with no end date
To be available to be used for NNPAC activity records with a datetime of service on or after 1 July 2018
To be available to be used for NMDS records with anevent end date on or after 1 July 2018
The Health Speciality table is found here: Health Speciality common code table.
Details relating to volumes and purchase units can be found in the usual location on the Nationwide Services Framework Library
3.3BR-HSC-03 Update Web Page Common Codes Tables
Update the common code tables located at
4NMDS – WIESNZ18 and Cost Weights (Provisional)
4.1BR-WIES NMDS WIESNZ and Cost Weight changes for 2018/19
BACKGROUND
The requirements for the Weighted Inlier Equivalent Separation (WIES) NZ and Cost Weight changes are sourced from the Cost Weights Working Group. These requirements are provisional only as final approval is yet to be obtained.
WIESNZ is the methodology used to calculate the cost weight value based on the assigned Australian Refined Diagnosis Related Groups (AR-DRGs) and New Zealand costs. Revisions and implementation of WIESNZ are performed annually as part of the National Costing Collection Programme (NCCP) and NCAMP.
The 2018/19 New Zealand Casemix Framework for Publicly Funded Hospitals document (WIESNZ18) will be available on the NCAMP website here (
As the Ministry are the official calculators of the Diagnosis Related Groups (DRGs) and cost weights the NMDS will be updated to calculate cost weights, NZ DRGs and excluded purchase units for event records with an event end date on or after 1 July 2018 in accordance with the 2018/19 Casemix Framework.
THE CHANGES
STILL TO BE RATIFIED
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The review of the Casemix Framework Document, from the standpoints of translation into the coding and DRG classifications and stakeholder issues, lead to the need for some changes to existing definitions. These are summarised below with reference to the Costweights Framework Document:
- New co-payment developed for Ventricular Assist Devices (VADs) for adults
- New co-payment developed for Complex Traumatic Limb cases
- New co-payment developed for Bilateral Mastectomy or Combined Mastectomy and Reconstruction
- Revised Abdominal Aortic Aneurysm (AAA) co-payment value from 4.3219 to 4.2336
- Revised Atrial Septal Defect (ASD) co-payment value from 1.0000 to 1.1135
- Revised Scoliosis co-payment values from 5.5011 to 5.5546
- Revised Electrophysiology Studies (EPS) co-payment value from 2.2266 to 1.7266
- Revised Live Donor Nephrectomy (LDN) co-payment value from 1.4357 to 1.4133
- Revised Endovascular Treatment of Cerebral Aneurysms and Clot Retrieval for Treatment of Strokes co-payment values for DRGs:
- B02A from 4.5199 to 6.0430
- B02B from 3.3551 to 2.2658
- B02C from 3.9556 to 2.4683
- Revised Isolated Limb Infusion (ILI) co-payment value from 2.6486 to 2.9784
- Revised weights for NZ DRGs C03W and J11W, see 5.2.38 and 5.2.39
- High outlier per diem weights for high ALOS DRGs have been set more generously to account for the higher proportions of high outlier events in these DRGs
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PRIORITY
Please note that the WIESNZ changes are mandatory for the Ministry, but are optional for DHBs, however where DHBs have their own WIESNZ and DRG calculation systems these should be updated.
IMPACTS
The impacts of not completing this Ministry mandatory change are:
Outdated reporting, financial and data analysis carried out by the Ministry of Health and the wider Health Sector
Impacts on:
* casemix purchasing by DHBs
* calculation of cost weighted discharge values
* identification of casemix purchased Purchase Units
* case complexity (for future costing work)
* cost weight version used.
STAKEHOLDERS
Ministry of Health, District Health Boards, 3M HIS, Software vendors, Cost Weights Project group and the Technical Reference group.
4.2BR-WIES-01 Effective from
NMDS will be updated to calculate cost weights, NZ DRGs and excluded purchase units for records with an event end date on or after 1 July 2018, in accordance with the 2018/19 Casemix Framework.
4.3BR-WIES-02 3M Codefinder update
The Ministry will provide 3M HIS with the 2018/19 Casemix Framework document so the methodology and weight schedule for WIESNZ18 can be developed into the 3M Codefinder application.
4.4BR-WIES-03 Casemix framework document
DHBs that have their own grouping/costweight systems/applications will need to update these to reflect the changes in the 2018/19 Casemix Framework document (WIESNZ18). Otherwise there are no expected changes for the sector.
5NNPAC - Review of Mode of Delivery code
The Mode of Delivery in NNPAC is a way to identify how the activity was delivered (the relationship between the patient and the clinician). Reporting the Mode of Delivery does not change what activity providers are already reporting in NNPAC, the purpose is to identify how services are currently being delivered.
5.1BR-MODE. Modify the Mode of delivery descriptions for Face toFace
The Mode of Delivery field in NNPAC enables the DHBs to be able to identify how healthcare is delivered to patients to enable trends and costs to be evaluated.
There are three Mode of Delivery description changes that have been requested on behalf of the Telehealth Leadership Group (TLG) Forum. The intention of these changes is to be a bit clearer on the delivery mechanism as 'Face to Face' can be ambiguous.
The remaining codes in the NNPAC Mode of Delivery table are unchanged.
5.2BR-MODE-01 Option 1
It is a description only change request for the following:
Option 1 is being amended FROM
Face to Face (1 patient to 1 clinician) TO
In person (1 patient to 1 clinician)
Guidance text to be "Individual face to face at the same location. Where tests are performed the mode of delivery is 'In person (1 patient to 1 clinician)'."
5.3BR-MODE-02 Option 2
It is a description only change request for the following:
Option 2 is being amended FROM
Face to Face (1 patient to many clinicians) TO
In person (1 patient to many clinicians)
Guidance text to be "Multi disciplinary meeting with patient present at the same location and time"
5.4BR-MODE-03 Option 3
It is a description only change request for the following:
Option 3 is being amended FROM
Face to Face (1 clinician to many patients) TO
In person (1 clinician to many patients)
Guidance text to be "Group of patients being seen by one clinician at the same location and time"
5.5BR-MODE-04 Update NNPAC documentation
NNPAC Data Dictionary:
The NNPAC Data dictionary (Appendix E) will need to be updated to reflect these three new Mode descriptions for options 1, 2 and 3. The remaining codes and descriptions in the NNPAC Mode of Delivery table are unchanged.
NNPAC File Specification:
The NNPAC File specification (section 12.14) will need to be updated to reflect these three new Mode descriptions for options 1, 2 and 3. The remaining codes and descriptions in the NNPAC Mode of Delivery table are unchanged:
NNPAC File Specification:
The NNPAC File Specification (section 8.1.2 Event record, page 25) will need to be updated to reflect these three new Mode descriptions for options 1, 2 and 3. The remaining codes and descriptions in the NNPAC Event record table for Mode of Delivery remain unchanged).
The following changes apply to both the Data Dictionary (Appendix E) and the File Specification (Section 12.14):
Code (Option) / Description / Guidance text1 / In person (1 patient to 1 clinician) / Individual face to face at the same location. Where tests are performed the mode of delivery is 'In person (1 patient to 1 clinician)'
2 / In person (1 patient to many clinicians) / Multi disciplinary meeting with patient present at the same location and time
3 / In person (1 clinician to many patients) / Group of patients being seen by one or many clinicians at the same location and time
* Where tests are performed the mode of delivery is option 1, In person (1 patient to 1 clinician) - because at some point the patient was there - eg bloods were taken etc.
6PRIMHD - Miscellaneous HISO changes
6.1BR-HISO Various updates to HISO documentation
The Health Information Standards Organisation (HISO) documents define the common set of codes to be used for each data element of the Integrated Mental Health Collection (PRIMHD) data set that requires coding.
The adoption of a common code set for the health sector will reduce the need for complex interface programmes to translate or manipulate data being exchanged. It will also contribute towards creating a common understanding of data, thus allowing better analysis and interpretation.
Various minor changes to HISO documentation for NCAMP 2018 are:
6.1.1BR-HISO-02 LS code description text
PRIMHD Code Set document - one of the Legal Status code descriptions needs amending.
Section 2.2.1.2 - the Used for/comment for code RF needs to be updated as follows:
Incorrect Used for/comment:
Convicted and sentenced to a term of imprisonment and ordered to be detained in hospital as a special tangata whaiora/consumer under the Mental Health (Compulsory Care and Rehabilitation Assessment and Treatment) Act 1992.
Amended Used for/comment:
Convicted and sentenced to a term of imprisonment and ordered to be detained in hospital as a special tangata whaiora/consumer under the Mental Health (Compulsory Assessment and Treatment) Act 1992.
No other changes to this Legal Status are required.
Documentation change only.
6.1.2BR-HISO-03 T code end date change
The HISO Code set has incorrect 'code valid from' dates for codes T47 and T49.
Currently both T47 and T49 codes have a 'code valid from' date in the HISO documentation of 01-07-2016.
This 'valid from' date differs from the PRIMHD database, which has a 'code valid from' date for both codes of 01-07-2014.
Please amend the 'code valid from' date for both T47 and T49 to 01-07-2014 in section 2.4.1.1 of the HISO Code Set 10023.3:2015.
The 'Guide to PRIMHD Activity Collection and Use' document will need to be amended as well:
Reference to T47 - Support for family/whanau - from 1 July 2016 = amend to 'from 1 July 2014'
Reference to T49 - Support for Children of Parents with Mental Illness and Addictions (COPMIA) - from 1 July 2016 = amend to 'from 1 July 2014'
The entire document will need to be checked to make sure all cases where codes T47 and T49 are mentioned the date recorded is from 1 July 2014 (instead of from 1 July 2016).
Documentation changes only
6.1.3BR-HISO-04 Referral To and From amendments
PRIMHD HISO Referral To and From amendments
Documentation changes only.Changes are shown in red.
ReferralTo and From (HISO PRIMHD Code Set Sections 2.3.1.1 and 2.3.1.2)
Code / Description / Code Valid From / Code Valid To / Used for/CommentAD / Alcohol and drug / 01-01-1900 / 30-06-2020 / Alcohol and drug provider or facility. Includes both medical and social Detox
AE / Accident and emergency / 01-01-1900 / 30-06-2020 / Accident and emergency department or service.
CA / Child adolescent and family/whānau mental health services / 01-01-1900 / 30-06-2020 / Child, adolescent and family/whānau service.
CM / Adult community mental health services / 01-01-1900 / 30-06-2020 / Adult community service, including mobile community teams.
CS / Community Support Service / 01-07-2008 / 30-06-2020 / Example: NGOs supporting non-clinically.
DH / Day hospital / 01-01-1900 / 30-06-2020 / Day hospital.
ES / Education sector / 01-01-1900 / 30-06-2020 / Educational institution including schools, pre-school, kindergarten, school guidance counsellor, special education services, tertiary institutions.
NOTE: Until 30-06-2014 this element was coded as ‘ED’. It has been changed to avoid confusion with Emergency Department.
GP / General practitioner / 01-01-1900 / 30-06-2020 / General practitioner or medical centre, including private after hours emergency services.
JU / Justice / 01-01-1900 / 30-06-2020 / Justice,Courts, Prison, Corrections or Youth Justice.
KM / Kaupapa Māori Service / 01-01-1900 / 30-06-2020 / Kaupapa Māori provider or facility.
KP / Pacific peoples / 01-01-1900 / 30-06-2020 / Pacific peoples provider or facility.
NA / Needs assessment and co-ordination service / 01-01-1900 / 30-06-2020 / Needs assessment and co-ordination service.
NP / Hospital referral (non-psychiatric) / 01-01-1900 / 30-06-2020 / Hospital facility which is not psychiatric inpatient, paediatrics, public health or emergency services.
NR / No further referral / 01-01-1900 / 30-06-2020
OP / Psychiatric outpatients / 01-01-1900 / 30-06-2020 / Mental Health outpatient service
OT / Other / 01-01-1900 / 30-06-2020 / Other service or agency not specified elsewhere.
PD / Paediatrics / 01-01-1900 / 30-06-2020 / Paediatric setting or a paediatrician.
PH / Public health / 01-01-1900 / 30-06-2020 / Tangata whaiora/consumer referred from or to a non mental health and addiction community provider, eg public health nurse, Plunket.
PI / Psychiatric inpatient / 01-01-1900 / 30-06-2020 / Psychiatric inpatient service.
PO / Police / 01-01-1900 / 30-06-2020 / Police.
PP / Private practitioner / 01-01-1900 / 30-06-2020 / Private practitioner, eg psychologist, psychiatrist, medical specialist in private practice excluding private after hours emergency services.
RE / Mental health residential / 01-01-1900 / 30-06-2020 / Mental health residential service providing bednight activity.
SE / Mental health community skills enhancement programme / 01-01-1900 / 30-06-2020 / Mental health community skills enhancement programme, e.g. functional gain.
SR / Self- or relative referral / 01-01-1900 / 30-06-2020 / Self, relatives, family/whānau or significant other person.
SW / Social Welfare / 01-01-1900 / 30-06-2020 / Government social welfare, eg CYPFA (Children, Young Persons and their Families Agency), WINZ (Work and Income New Zealand).
UN / Unknown / 01-01-1900 / 30-06-2020 / Not known.
VS / Vocational Service / 01-07-2008 / 30-06-2020 / A service focussing on employment skills.
6.1.4BR-HISO-05 Referral End code amendments