Change Notification: 2016_NSUP_National Patient Flow_Phase 3 Date of Issue: 30 Sep 2015 (8) Proposed Implementation Date: 01 July 2016 Subject: Phase 3 National Patient Flow CHANGE NOTIFICATION Summary: This change notification informs DHBs that they will be required to execute change management, and fund and work with the vendors of their PAS, related systems and National Patient Flow extracts to implement the requirements of the Phase 3 National Patient Flow data capture and extract development. This change has been publicised through National Patient Flow (NPF) communications, presentations, workshops and activity with DHB representatives since June 2013. The majority of informational scope of this change notification was included as Optional in the Phase 2 File Specification, released in February 2015. In general this Change Notice advises that, previously optional information has become mandatory or conditionally mandatory. National Collections Impacted by Change: National Patient Flow Context of the Change: The High Level Requirements Statement (All Phases) v1.1 was published to the sector 18 December 2014. This document describes the extent of the collection (Phases 1-3) for the full programme through to 1 July 2016, including objectives, purpose, description and definitional material. Phase 1 of the National Patient Flow Collection (NPF) is underway and DHBs have been collecting data from 1 July 2014. Phase 2 will be effective from 1 October 2015. The National Patient Flow Phase 2 File Specification has been published detailing the structure of the collection and the Phase 2 Scope and DHBs are executing change in their organisations to achieve this by 1 October 2015. Phase 3 seeks additional information for National Patient Flow by Extending through the collection of additional services (service sub-types) that were optional in Phase 2, as well as a small number of new service sub-types. Expanding through a greater expression of the patient journey including o the source of referrals o the Health Specialty context of each referral activity o the destination of referrals Enriching through a stronger mandate for some previously optional data elements of the collection Further, sufficient linking information is mandated including: - Presenting ID - Previous Related ID - Previous Related Date - Presenting Problem - Presenting Problem Code Type - Health Specialty responsible - Health Specialty transferred to - Health Specialty referred from Date of Issue: 30 Sep 2015 (8) 2016_NSUP_National Patient Flow_Phase 3 Page 1 of 5
Details of the Change: A Extend Informational Scope A (i) The additional services (service sub-types) for which information must be provided in Phase 3 of the Collection are the following. 2001 Follow up re-referral 2002 Follow up subsequent to FSA 2003 Follow up subsequent to procedure/treatment 4050 Colonoscopy/gastroscopy 4010 Gastroscopy 4020 ERCP 4060 Colposcopy 4070 Hysteroscopy 4250 Interventional radiology 4300 Minor eye procedure 4320 Eye laser 4400 Bronchoscopy 4600 Cystoscopy 4610 Urodynamics 4620 Lithotripsy 4850 Dental treatment 4900 Minor operation 5000 CT scan 5001 CT angiography 5002 CT colonography 5010 MRI scan 5011 MRI angiography 5020 PET scan 5030 Ultrasound 5040 Mammogram 5050 Nuclear medicine 5060 Audiology 5100 ECG 5110 Echo cardiogram - transoesophogeal 5111 Echo cardiogram - transthoracic 5120 ETT 5130 Holter monitoring 5400 Lung function Date of Issue: 30 Sep 2015 (8) 2016_NSUP_National Patient Flow_Phase 3 Page 2 of 5
5410 Sleep study 5500 EEG 5510 Nerve study 5999 Other A (ii) The services (service sub- types) for which information should be provided in Phase 3 of the Collection are: 2010 Nurse / midwife assessment 2011 Transplant/donor liaison coordinator assessment New service sub-type 2012 Dialysis education New service sub-type 2020 Anaesthetic assessment 2050 Multi-Disciplinary Meeting New service sub-type for collection in referrals, bookings and encounters 4500 Botulinum toxin therapy 5200 X-ray (plain) Services provided in Emergency and Acute situations (including Acute Admissions) remain outside of scope. B Expand Informational Scope NEW Data elements (i) Add Health Specialty Responsible to Prioritisation, Booking and Encounter Activity data segments (ii) Add Referring Health Specialty to data segment. This will be conditionally mandatory when the Referred from Professional Group Type is a Specialist Medical Officer. (iii) Add Clinical Code Type to Diagnosis and Diagnosis, using the current Ministry of Health list with the addition of S for SNOMED CT. (iv) Add additional code to SCAN Suspicion of Cancer 99 Not stated. To be applied to the Defined Suspicion of Cancer within a referral. Not available for Prioritisation or other data segments. C Enrich Informational Scope C (i) The obligation of the supply of the following information will be raised from an optional to a mandatory requirement: Data Segment Activity Activity: Booking Activity: Booking DataElement Accident Flag Service Sub-Type Lead Clinician Code Lead Clinician Professional Group Code Date of Issue: 30 Sep 2015 (8) 2016_NSUP_National Patient Flow_Phase 3 Page 3 of 5
Activity: Exception Activity: Notification Clinical Priority Clinical Priority Prioritising Clinician Code Prioritising Clinician Professional Group Code Clinical Exclusion Code Clinical Override Clinical Priority Score Date Date Sent Defined Suspicion of Cancer (SCAN) Presenting Problem Classification Presenting Problem Code Type Presenting Problem Coding System Code Presenting ID Receiving C (ii) The obligation of the supply of the following information will be raised from an optional to a conditionally mandatory requirement: Data Segment DataElement Conditional Mandate Activity: Booking Reason Rebooked If Rebooked NMDS Client System ID For inpatient and day patient encounters NMDS PMS Unique ID For inpatient and day patient encounters NNPAC PMS Unique ID For outpatient encounters (including remote) Activity: Notification Date Referrer Notified If Referrer is not the GP Encounter Outcome Date of Decision to Treat For cancer and waitlisted Electives patients Prioritisation Outcome Transferred Date If Transferred Previous Related Date If not the Presenting Previous Related ID If not the Presenting Referrer Defined Priority Category If priority stated C (iii) The obligation of the supply of the Diagnosis data segment will be raised to a mandatory requirement for cancer patients. C (iv) The obligation for the supply of Diagnosis data segment is mandatory for cancer patients where the Referred from Professional Group Type is a Specialist Medical Officer from own or other DHB. C (v) The obligation of the supply of the Date of Diagnosis within the Diagnosis following information will be changed from Mandatory to Optional within the referral diagnosis data segment, however is to be supplied if known. Note 1 - While the Ministry of Health acknowledges definitive codesets for SNOMED are under development for Presenting Problem Classification, these are targeted for completion for 31 July 2017 and expected to form a part of the collection from that point on. Note 2 - As the method through which the linking of referrals to form the patient journey has yet to be mandated, the expectation is that DHBs will provide sufficient information for - Presenting ID Date of Issue: 30 Sep 2015 (8) 2016_NSUP_National Patient Flow_Phase 3 Page 4 of 5
- Previous Related ID - Previous Related Date - Presenting Problem - Presenting Problem Code Type - Health Specialty responsible - Health Specialty transferred to - Health Specialty referred from Note 3 - The application of the above information will be expressed in the File Specification to be published 16 December 2015 What is Expected of the Sector: DHBs will need to advise which of the key linking elements are able to be provided at Phase 3 start date by 15 November 2015. DHBs will need to supply a Readiness update by 25 February 2016 DHBs will need to have an agreed Phase 3 implementation plan by 1 April 2016 DHBs will need to capture the required Phase 3 information from 1 July 2016 onwards Submission of the load file to the Ministry of Health from 1 July 2016 onwards DHBs will work towards providing the full extent of the collection including optional data elements Relevant Documentation and support information The National Patient Flow File Specification (Phase 3) is under development and planned for December 2015 release. The National Patient Flow documentation will be published on the existing Ministry of Health data reference pages http://www.health.govt.nz/nz-health-statistics/data-references/file-specifications and http://www.health.govt.nz/nz-health-statistics/data-references/data-dictionaries and will be available to download from these link as published Comments: Contact: Contact: If you have any questions regarding this change notice, please email npfadmin@moh.govt.nz or contact Libby Antoun (Engagement Manager) on 04 816 4355 Date of Issue: 30 Sep 2015 (8) 2016_NSUP_National Patient Flow_Phase 3 Page 5 of 5