Changes to National Collection 3

NEW ZEALAND HEALTH INFORMATION SERVICE

Changes to National Collections effective from 1 July 2006
Contents

Introduction

In line with our obligations under the National Health Information System (NHIS) Access Agreement, the New Zealand Health Information Service (NZHIS) is providing six months notice of changes to the following systems, which will be effective from 1 July 2006.

The changes to the national systems effective from 1 July 2006 include:

changes to the National Minimum Dataset (NMDS)
changes to the Mental Health Information National Collection (MHINC)
changes to the National Booking Reporting System (NBRS).

Changes to the above systems have been considered through a number of forums with joint DHB and Ministry of Health participation. These include the Information Liaison Group (ILG), the Analyst Coordination Group (ACG), the Mental Health Working Group (for MHINC) and the Elective Services Forum (for NBRS).

A high-level summary of these changes is listed below, along with information on the timeline, compliance testing requirements, communications and questions and answers. Please take the time to review the information available.

Detailed requirements have now been completed and published in the National Minimum Dataset (NMDS) document list and the National Booking Reporting System (NBRS) document list below. These include updated file specifications and data dictionary information.

We also invite your questions and will publish a Questions and Answers section that will be updated weekly.

Changes to the National Minimum Dataset (NMDS)

Some of the changes to the NMDS will result in updates to the file specification, data dictionary and compliance tests for the NMDS load file. Updated file specifications and data dictionaries will be published within the Technical Documentation section of this web site once the changes have gone live. Details of the implementation of these changes will be published via the e-mail usergroup and on this web site.

The requirement changes effective from 1 July 2006 are:

1. ‘WIES Code Table’ Update (WR2005-364)

Sector change required: YES. Note: Waikato is the only DHB affected by this change.
The Ministry has identified that NMDS events should be allocated to the Purchase Unit S05.01 (Anaethesia Services (inpatient)). The NMDS does not currently store this purchase unit within the WIES code.
Adjustments will need to be made to the Health Specialty Code (HS) maps in the Casemix Framework document to enable it to produce this new purchase unit.

2. Store ‘NZ_DRG’ (WR2005-370)

Sector change required: NO. This is an internal NZHIS change only but should be noted.
The NMDS will be updated to store the NZ_DRG code. The NMDS datamart will be updated to retrieve and store the NZ_DRG code. The NMDS business objects universe will be updated to store the NZ_DRG code enabling information analysts access to such data.
Storing the NZ_DRG code will aid analysis of data from the Inpatient Discharges datamart.

3. Adding Categories to ‘DRG Codes’ (WR2005-398)

Sector change required: NO. This is an internal NZHIS change only but should be noted.
Information Analysts have requests that the DRG codes be mapped into Surgical, Medical and Other categories – including AN-DRG 3.1, AR-DRG 4.0, AR-DRG 4.1, AR-DRG 4.2, AR-DRG 5.0 – for ease of analysis.

4. Ethnic Code Table Descriptions (WR2004-096)

Sector change required: NO. This is an internal NZHIS change only but should be noted.
Currently there a number of inconsistencies that have been identified between MHINC and NMDS ethnicity descriptions. From 1 July 2006, these inconsistencies will be corrected so that both collections are aligned.

National Minimum Dataset (NMDS) documents

File
Description
Date last
updated

National Minimum Dataset (NMDS) requirement changes
[download as a 1.2 MB PDF file or a 344 kB Word file] Detailed requirement changes to be applied to the national system. 31 March 2006

Changes to the National Booking Reporting System (NBRS)

Some of the changes to NBRS will result in updates to the file specifications, data dictionary and compliance tests for the NBRS load file. Updated file specifications and data dictionaries will be published within the Technical Documentation section of the web site once the changes have gone live. Details of the implementation of these changes will be published via the e-mail usergroup and on this web site.

The requirement changes effective from 1 July 2006 are:

5. Add ‘Calendar_month_dim’ (WR2005-399)

Sector change required: NO. This is an internal NZHIS change only but should be noted.
Sector Analysts have requested that the ‘last_day_of_month’ be added to the Calendar_Month dimension and be made available within the NBRS Business Objects Universe for ease of analysis.

6. Reject ‘03’ Residual Status (WR2005-215)

Sector change required: YES.
The MOH Electives Programme has requested the discontinuation of use for the booking status code ‘03’ – Residual Waiting Lists from within the NBRS system. From 1 July 2006, the system will reject any records with this applicable code.

7. NAH Reconciliation Return File (WR2005-422)

Sector change required: YES.
There has been a request to add an additional field, the latest ‘certainty given date’, into the Reconciliation Return file.

8. Deactivation of support for v01.0 file load type (WR2005-496)

Sector change required: YES.
Issues around the backout and reloading of NBRS data required v01.0 to be supported; however, these issues have now been rectified. Files can be reversed out of NBRS, negating the need to reload all files (including v01.0 files) when a data or processing issue occurs. The continuing support for file format v01.0 is no longer needed and will be discontinued.

9. New ‘Health Speciality & CPAC’ Validation (WR2005-272)

Sector change required: YES.
The NBRS does not currently perform checks against what CPAC scoring tool is supplied and the Health Specialty that the record comes in under. To help with data quality, Elective Services have requested that the NBRS perform a validation ensuring that the tool submitted is consistent with the Health Specialty (HS) and Booked Procedure (BP) the Episode of Care is sitting under.

10. Change Record Type ‘C’ New Warning (WR2005-380)

Sector change required: YES.
When a change record with an action code of ‘C’ is sent whose accepted field values are the same as that held on the national system (ie, no logical change is made to the episode of care data), or when a ‘C’ record is being used to update ‘STATUS’ information, a warning or error message will be generated.

11. Outpatient Template (WR2005-475)

Sector change required: YES.
The Outpatients database is a Microsoft Access database that generates a DHB-specific template, for DHBs to populate and return. This information is collated into the Outpatients database, then extracted monthly via text file to be loaded into the NBRS datamart. Elective Services have requested that a number of existing fields will be dropped from the NBRS Outpatient Data Spreadsheet.

12. Agency Open_Close Validation (WR2005-241)

Sector change required: YES. (Note: This change is still subject to ACG/ILG approval. Further information will be supplied upon this change moving through the approval process).
Note: This Work Request (WR) has been de-scoped and is no longer included in the 1 July 2006 changes.

13. Pre-processing rules (WR2005-421)

Sector change required: YES.
Currently the NBRS is checking the following fields for valid values within the pre-processing section of the NBRS processing cycle:

facility_code
treatment_facility_code
contract_agency_code
deferred_by_code
exit_category_code
staged/planned_procedure_flag
professional_group_code.

This change moves the validation of the above fields from the pre-processing stage to the processing stage of the NBRS data processing cycle.

National Booking Reporting System (NBRS) documents

File
Description
Date last
updated

National Booking Reporting System (NBRS) requirement changes
[download as a 5.9 MB PDF file or a 764 kB Word file] Detailed requirement changes to be applied to the national system. 15 May 2006

Changes to the Mental Health Information National Collection (MHINC)

The change to MHINC will result in updates to the file specification and data dictionary. Updated file specifications and data dictionaries will be published within the Technical Documentation section of the web site once the changes have gone live. Details of the implementation of these changes will be published via the e-mail usergroup and on this web site.

The requirement changes effective from 1 July 2005 are:

14. MHINC Documentation Inconsistencies (WR2004-096)

Sector change required: NO. This is an internal NZHIS change only but should be noted.
A number of inconsistencies have been identified between MHINC and NMDS ethnicity descriptions, these will be corrected, so that collections are aligned.

Mental Health Information National Collection (MHINC) documents

File
Description
Date last
updated

Mental Health Information National Collection (MHINC) requirement changes
[download as a 1.5 MB PDF file or a 208 kB Word file] Detailed requirement changes to be applied to the national system. 31 March 2006

Timeline

Deliverable	Approximate timeframe
High-level changes advised	December 2005
Detailed NBRS change requirements (excluding data dictionary and file specification updates)	21 February 2006
Detailed NMDS change requirements (excluding data dictionary and file specification updates)	13 March 2006
Detailed NBRS change requirements (including data dictionary and file specification updates)	31 March 2006
Detailed NMDS change requirements (including data dictionary and file specification updates)	31 March 2006
Changes go live	1 July 2006

Compliance testing requirements

Note: There is no requirement to complete compliance testing this year; however, we are happy to load files and provide acknowledgement in response for your 1July testing if needed.

Communication

The main changes this year that affect the sector are related to the NBRS. The changes to the other collections are mainly fixes to help increase the integrity of the data held within each of the collections.

NZHIS expects there will not be a need for a joint DHB, Vendor, and Ministry Forum this year, because of the nature of the changes, and instead a teleconference has been organised with nominated DHB and software vendor representatives

We will, as we have done previously, establish an e-mail usergroup for the duration of the project, as well as publish information on this web site. These communication channels will be used to provide monthly updates on progress and further information on the changes. We will also invite questions from the e-mail usergroup, and will include a Questions and Answers page on this web site that will be updated regularly.

If you have any queries regarding these changes, please contact the project manager by e-mail on datamanagementservices@moh.govt.nz with ‘July 2006 Changes’ in the subject line.

Questions and Answers

In order to provide all stakeholders in the July 2006 changes a view of the questions being raised, a list of all the questions received will be collated and published (anonymously) on this web site on a regular basis, and an e-mail sent to the e-mail usergroup to advise when this is done.

Question: Are we only required to do compliance testing where a change has been made to a system (eg, after quickly reading through the requirements, it occurs to me that there should be no need for any of the DHBs to do compliance testing for MHINC since there are no changes that affect them)?

Answer:

Yes, compliance scripts will only be provided to DHBs where changes have an impact on current systems and processes.

Question: Given that reporting of booked procedure using NBRS procedure codes were discontinued from 1 July 2005 (use of clinical code/system and type became mandatory) why is MoH using the NBRS procedure codes for validating CPAC tool and the corresponding procedure code?

Answer:

The Booked Procedure (BP) code is a system-generated code and is for NZHIS internal use only. DHBs are not required to do validation on Booked Procedure codes. This is noted in the NBRS Detailed Requirement Changes as shown below.

NB The Booked Procedure Code is a system generated code and is for NZHIS internal use only. DHBs should concentrate on ensuring that the relevant health_specialty_code and cpac_scoring_system_codes are a valid combination.

Question: Is it expected that the DHB should include the validation of CPAC tool, procedure code (and health specialty) combinations even though NBRS procedure codes are no longer used? If so, is NZHIS able to provide a mapping from ICD-10 3rd edition codes to NBRS procedure codes?

Answer:

Question: My understanding is that this year MHINC changes are all internal NZHIS changes and that providing DHB systems are compliant with current MHINC file specifications and data dictionaries then no action by DHBs is required. Is this correct?

Answer:

Yes that is correct – the one change to MHINC is an internal NZHIS change and there is no action required by DHBs.

Note: Please refer to 14. MHINC Documentation Inconsistencies (WR2004-096) above.

Sector Feedback

Collection of lessons learnt from projects is a crucial aspect of building up knowledge associated with projects within MOH.

Feedback from the Sector was requested to ensure that lessons could be learnt to enable improving the management of future 1 July projects with the Sector. Below is a summary of the five feedback responses received from the Sector, with their suggestions on how the project can do it better next time.

1 July 2006 Change Feedback

Aspect
What worked well
What didn't work well
Suggestions for
improvement

The Project

From our perspective the process overall went well and smoothly and the changes required were minor in nature.
Overall I think NZHIS should be pleased with the way in which this project was managed and the communication paths.
Generally I felt the management of and communication about the project was very good.
The Management of the project was good, clear lines of contact and requirements.

The only issue that occurred for us was due to a reasonably unlikely set of circumstances where a new extract ‘middleware’ application (NMDS) was being readied in conjunction with a DHB PMS Upgrade and tested at about the same time as the NZHIS update changes occurred.
Not being able to send NMDS files at the beginning of the month especially at the beginning of a new year affects organisations reporting processes.

None

Communication
– Email User Group

Your communication regarding the status of the changes to the Ministry’s applications this year have been excellent. The hospitals certainly cannot complain about the lack of information regarding the status, even though there were issues with some of the applications.
From our point of view, the process worked better than in previous years due to better communication and co-ordination. The fact that the changes were less significant then in previous years may have assisted in making the process easier.
Project communication was very clear with regular updates and information on deadlines and changed requirements.

It would be really good if NNPAC changes could be incorporated into this communication process as I think it was a little disjointed to have it running as a separate project however I understand the reasoning of it being a new (MoH driven) initiative, but for future years it would be better (more effective) within the 1 July changes project.

Provide six months notice of changes.
Combine NNPAC changes in future 1 July communications.

Communication
– Vendors Forum

As you did this year, if there are not many changes, there is no need for a User Group meeting in Wellington to go through the specifications, a teleconference is quite sufficient.
I was surprised that the very large telephone conference was so successful. However the actual changes involved for most Boards appear fairly minor on this occasion.

None

None

Communication
– Website

The website with all the docs is very easy to navigate through – well done.
Project documentation was available on the Web Site and was at the level required to implement the changes.
The website and project documentation, although having understandable minor glitches, I have always found to be of a very high standard which has been well maintained.

I do still believe that a six month notification is necessary and it would be beneficial if ALL the documentation could be updated and available on the website within a month of the initial notification going out as opposed to the end of the project. As a developer, it is most frustrating to issue a quote to the customers with requirement changes and then a month or 2 later, find that there are further changes which alter the requirements.

None

Compliance

The assistance and feedback provided by NZHIS has, however been of an exceptionally high quality and responsiveness through the compliance testing process.

Better validation of data during the test phase would also save issues later on.
It would be helpful if new compliance scripts could be published on the NZHIS website at or very soon after any 1 July changes.

Do compliance testing even if new file formats are not changing (i.e. validate data).

Top Back

File	Description	Date last updated
National Minimum Dataset (NMDS) requirement changes [download as a 1.2 MB PDF file or a 344 kB Word file]	Detailed requirement changes to be applied to the national system.	31 March 2006

Aspect	What worked well	What didn't work well	Suggestions for improvement
The Project	From our perspective the process overall went well and smoothly and the changes required were minor in nature. Overall I think NZHIS should be pleased with the way in which this project was managed and the communication paths. Generally I felt the management of and communication about the project was very good. The Management of the project was good, clear lines of contact and requirements.	The only issue that occurred for us was due to a reasonably unlikely set of circumstances where a new extract ‘middleware’ application (NMDS) was being readied in conjunction with a DHB PMS Upgrade and tested at about the same time as the NZHIS update changes occurred. Not being able to send NMDS files at the beginning of the month especially at the beginning of a new year affects organisations reporting processes.	None
Communication – Email User Group	Your communication regarding the status of the changes to the Ministry’s applications this year have been excellent. The hospitals certainly cannot complain about the lack of information regarding the status, even though there were issues with some of the applications. From our point of view, the process worked better than in previous years due to better communication and co-ordination. The fact that the changes were less significant then in previous years may have assisted in making the process easier. Project communication was very clear with regular updates and information on deadlines and changed requirements.	It would be really good if NNPAC changes could be incorporated into this communication process as I think it was a little disjointed to have it running as a separate project however I understand the reasoning of it being a new (MoH driven) initiative, but for future years it would be better (more effective) within the 1 July changes project.	Provide six months notice of changes. Combine NNPAC changes in future 1 July communications.
Communication – Vendors Forum	As you did this year, if there are not many changes, there is no need for a User Group meeting in Wellington to go through the specifications, a teleconference is quite sufficient. I was surprised that the very large telephone conference was so successful. However the actual changes involved for most Boards appear fairly minor on this occasion.	None	None
Communication – Website	The website with all the docs is very easy to navigate through – well done. Project documentation was available on the Web Site and was at the level required to implement the changes. The website and project documentation, although having understandable minor glitches, I have always found to be of a very high standard which has been well maintained.	I do still believe that a six month notification is necessary and it would be beneficial if ALL the documentation could be updated and available on the website within a month of the initial notification going out as opposed to the end of the project. As a developer, it is most frustrating to issue a quote to the customers with requirement changes and then a month or 2 later, find that there are further changes which alter the requirements.	None
Compliance	The assistance and feedback provided by NZHIS has, however been of an exceptionally high quality and responsiveness through the compliance testing process.	Better validation of data during the test phase would also save issues later on. It would be helpful if new compliance scripts could be published on the NZHIS website at or very soon after any 1 July changes.	Do compliance testing even if new file formats are not changing (i.e. validate data).