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Changes to National Collections effective from 1 July 2008
Contents
Introduction
In line with the obligations under the National Health Information System Access Agreement, the New Zealand Health Information Services (NZHIS) has provided six months notice of changes to the following systems, which will be effective from 1 July 2008 as part of the 2008 National Collections Annual Maintenance Project (NCAMP).
The changes to the national systems effective from 1 July 2008 include:
- Changes to the National Minimum Dataset (NMDS)
- Changes to the National Booking Reporting System (NBRS)
- Changes to the National Non Admitted Patient Collection (NNPAC)
Full details of these changes are available in the Requirement Changes documents which are included in this page in PDF format under the Documents section.
We also invite your questions and have published a Questions and Answers section that will be updated on a regular basis.
Note:
There will be no changes to MHINC at 1 July 2008 due to the Project for the Integration of Mental Health Data in New Zealand (PRIMHD) which is creating a new Mental Health Collection and is also scheduled for implementation on 1 July 2008. More details on PRIMHD can be found at http://www2.nzhis.govt.nz/primhd/primhd.html| September 2007 | Approval of scope given by Analyst Coordination group (ACG ) |
| October 2007 | Approval of scope given by Information Liaison Group (ILG) |
| 14 December 2007 | 6 month notification of changes sent to DHB CEOs along with the detailed change requirements |
| January – March 2008 | NZHIS System Development. |
| 11 March 2008 | Vendor and Developer Workshop Copthorne Hotel Oriental Bay Wellington |
| 8 April 2008 | NHI Reference tables updated to use new post codes |
| 14, 16, 17 April 2008 | Regional Compliance workshops held in Dunedin, Palmerston North, Hamilton |
| April 2008 | NZHIS System Testing |
| May 2008 | NZHIS User Acceptance Testing |
| End May 2008 | Compliance test scripts available |
| June 2008 | Compliance testing |
| 1 July 2008 | Publication of file specifications and data dictionaries |
Maternity Health Specialty Codes
From 1 July 2008, maternity Health Specialty Codes P00, P10, P11, P20, P30 and P35 will be retired.
From 1 July 2008, new maternity Health Specialty Codes P60, P61, P70, and P71 will be introduced.
Table One: New Maternity Health Specialty Codes
| Health Specialty Code | Health Specialty Description |
| P60 | Maternity services - mother [no community LMC] |
| P61 | Maternity services - well newborn [no community LMC] |
| P70 | Maternity services - mother [with community LMC] |
| P71 | Maternity services - well newborn [with community LMC] |
The following neonatal health specialty codes are still applicable for neonatal specialist services.
Table Two: Neonatal Health Specialty Codes
| Health Specialty Codes Description |
| Paediatric neonatal special care [Level I] |
| Paediatric neonatal special / intensive care [Level II] |
| Paediatric neonatal special / intensive care [Level III] |
| Postnatal early intervention |
The following questions were received from the DHBs.
What is the point of distinction between “No Community LMC” and “Community LMC”? What does this data signify?
The data signifies that some workforce cost is being paid for by another mechanism. The point of distinction is costing. To clarify, a “Community LMC” is NOT employed or paid by the DHB provider arm, typically an independent midwife or private obstetrician being funded under the section 88 notice for primary maternity services.
How do we record a patient who was initially registered with a Community LMC but has been referred to a specialist for ongoing management?
The health specialty code is to be allocated according to who is responsible for the ongoing maternity care.
The event should be coded as P70 (Mother) and P71 (baby) when the DHB has not assumed LMC status (eg formal handover), this would also apply to, for example:
· labour and delivery at a DHB facility lead by a community LMC
· episodic secondary care (ie obstetrician FSAs and subsequent assessments)
· emergency caesarean sections.
When should P60 and P61 codes be used?
P60 and P61 health specialty codes should be used when there has been formal hand over of the mother from primary care to secondary care, or when the primary care midwife is employed by the DHB provider arm (ie, mother has not been able to obtain a community LMC). These codes are for use where all maternity care is provided by the DHB.
P60 and P61 should also be used for medically indicated non-emergency caesareans.
What is happening to the 20 week rule (patients who end up on the Gynaecology Ward with complications related to pregnancy)?
The 20 week rule does not apply as the split between S30 and P health specialty codes is a clinical decision.
In our DHB we formally hand over the care of a woman who goes for an emergency LSCS to the obstetrician from the primary LMC. She will stay under their care for at least 24 hours (currently it is in fact 48 hours). Sometimes they will not be handed back to the primary LMC at all. I would have thought that perhaps the P codes would change for these women?
Under the S88 Notice it is acknowledged that with an emergency LSCS there is normally not time to formally transfer care, therefore, the LMC can claim a full labour and birth fee. As the purpose of the P60/P70 split is costing and tracking those cases where the woman has a community LMC (who will normally attend the emergency LSCS), it was decided that an emergency LSCS for a woman with a community LMC would be P70.
Women who have an elective LSCS and are handed back to the primary LMC during admission what would the Health Specialty Code be?
The Health Specialty Code would be P60. Again the purpose is for costing, so given that an elective LSCS is not something that community LMCs are paid for (they cannot claim a labour and birth fee, although sometimes are paid a lesser accompanying the woman fee) the idea is that this is a service where the cost is primarily borne the DHBs.
Please confirm the assumption that we will not be required to change the P codes whilst the woman is in hospital to reflect the type of carer (DHB vs Community) along the path of the admission?
No. The Health Specialty Code should be the one that best fits the woman’s circumstances at admission, even if there is a change part way through.
If a woman is admitted for an elective LSCS she will be admitted with a P60 code (under the care of an obstetrician) but in fact may be handed back to the original LMC so her status at discharge has changed. Should we be changing her to P70?
No. The Health Specialty Code would be P60 when the woman is admitted and it would be expected to stay that way.
Can you please provide some information around the use of the P50 code?
The P50 Health Specialty Code is used for post natal early intervention. This service involves multidisciplinary teams from maternity, neonatal, psychology, psychiatry and allied health services, especially where there is a complex care requirement resulting in a perceived risk of failure to thrive in the baby or post natal depression in the mother. This care is specialised and is performed in a specialist care unit. Some DHBs provide this service in an outpatient setting but Waikato DHB has always admitted their patients during the week and they will often go home during the weekend.
This service is excluded from Casemix and purchased as a service. The P50 health specialty code was developed to enable these events to be excluded from casemix funding. There is no national price.
If you require further information please contact Tina Stacey on email STACEYT@waikatodhb.govt.nz
When a woman visits an obstetrician as an outpatient and she is less than 20 weeks I am making the assumption she will be a P70?
If a woman has a community LMC then the Health Specialty Code will be P70 (if this is an obstetric consult and not a gynecology one). If the woman does not have a community LMC (ie she is a secondary patient or the DHB is being her primary maternity caregiver) then the Health Specialty Code will be P60.
We have women less than 20 weeks admitted to the maternity ward for induction of labour – will we use the P60 code for these women?
A woman being induced at less than 20 weeks would undoubtedly be under secondary or tertiary care (and not primary care). So, yes, the health specialty should be P60 if this is being treated as an obstetric case or S30 if it is a gynecological case.
How are we to distinguish between Antenatal, Delivery and Postnatal Services?
There is no longer a distinction between Antenatal, Delivery and Postnatal Services using the Health Specialty Codes. We have used the Health Specialty Codes internally in the past to separate out these patients and also to collate all the relevant data for the Ministry of Health Maternity Performance Monitoring in Dunedin which we are required to submit a report to. They do request a split between Antenatal, Delivery and Postnatal Services and we're currently trying to work out a possible way to extract this information without using Health Specialty Codes but as yet haven't come up with anything.
The splits will be done in the NMDS using the clinical coding data (mixture of ICD-10-AM and DRGs) in order to allocate patients to the correct purchase units that fall within an antenatal, delivery and post natal services.
If a patient is admitted on 30th June and at that time allocated a Health Specialty Code, and they are discharged on or after 1st July, does this mean we need to change the Health Specialty Code?
Yes, the changes to the Health Specialty Code and all other NCAMP changes are effective for all discharges from 1 July 2008.
Postcode and domicile code changesThe NHI will be updated to include the new post codes required by NZ Post (refer to NZ Post website for more details on the postcodes: http://www.nzpost.co.nz/Cultures/en-NZ/Business/AddressingForBusinesses/PostcodesandAddressStandards/ ). This update will be done in two stages:
- On 8 April 2008 the NHI reference tables were updated with the new post codes; this means that all new and updated addresses return the new post code.
- All current NHI addresses will be updated with the new post code. It is planned to have this completed by July 2008.Domicile code changes arising from Census 2006 will be applied to all relevant addresses. This will be completed by 1 July 2008.
The excel spreadsheet LOCATIONS file, which is extracted from one of the NHI reference files used in domicile and postcode assignment, can be downloaded using the link below. This can be used to help find a suburb if you need to enter both suburb and city into your PMS to get the correct postcode.
You can download the LOCATIONS file here: Locations20080520 (Excel, 416 KB)
Postcode Frequently Asked Questions
Why has there been an increase in default domicile codes recently?
On 8 April, NZHIS updated the NHI to use the new postcodes from NZ Post and because of the way the NHI address scrubbing software works, this has impacted the allocation of some domicile codes.
Initial investigations into problems encountered have highlighted the fact that in many areas the number of postcodes has increased. The NHI scrubbing software must be able to allocate a default post code to an address in order to access the appropriate part of the streets file which holds domicile codes. A reference file is used for this purpose. As this reference file can only hold one postcode per location/town/city, a choice has had to be made from multiple postcodes for many towns and cities.
How can I get the right postcode and domicile for Christchurch addresses?
In most instances we have found that supplying a suburb as well as city will obtain the right results. Alternatively, because of the way the reference file is structured, if a suburb has a unique entry in the reference file it can be used without the city field.
The reference file of locations/suburbs/towns and their domicile codes and postcodes is available and can be sorted by your DHB area.
My suburb called Western Heights in Rotorua is getting the postcode for central Rotorua – why is this?
The old postcodes tended to cover larger areas and in some cases there was only one postcode covering most of an urban area. The Rotorua urban area has now been split into two postcodes. The reference file used by the NHI to obtain a default postcode can only hold one postcode per location/town/city and 3010 has been chosen as the default postcode for Rotorua. A further complication is that Western Heights is a duplicate location (there is also a suburb of the same name in Auckland). Both these areas have separate entries in the reference file and should generate the correct codes, but NADIS/ADC is not handling these instances properly. We will be attempting to change the way NADIS/ADC works in these cases, but we have to hire an external contractor to do this as such changes were not part of the postcode project.
If your suburb has a unique entry in the reference file it can be used without the city field.
We are getting an error message in our PMS when we add a note verifying the patient’s address. How can we get the new postcode?
To generate a new postcode the NHI must get an update message for your patient from your system.
The easiest and most consistent way of doing this seems to be to remove the postcode from your address and save the record. This should send an update transaction to the NHI and the new postcode will be returned to you.
I am not getting the correct postcode for a rural address.
176 Parton Road, R D 7, Te Puke is returning the postcode for Te Puke township.
The NHI reference file has entries for many specific rural locations, however, if the area is also an urban area like Te Puke our software can’t distinguish that, and will currently return the urban postcode. This is an area we will be exploring for improvement shortly.
In the meantime, if your address can be found close to a rural location, substituting this for the urban area should give the correct postcode if that location is in the reference file. Eg, if R D 7 Te Puke becomes R D 7 Papamoa, it should get the correct result.
Another useful website to try for looking up addresses is: http://www.smaps.co.nz
We are getting incorrect postcodes for Devonport Road in Tauranga. This probably applies to Edgecumbe Road and Cameron Road as well.
These roads now run through several postcodes. 3110 has been selected as the default code for our reference file. The only way to get postcode 3112 is to supply a suburb as well as the city. However, Tauranga South or South Tauranga will still return postcode 3110. Please use the examples below as a guide.
Numbers 1 to 353 Devonport Road will work with just Tauranga or Tauranga Central.
Numbers 355 to 542 require Parkvale as the suburb to get postcode 3112.
Numbers 1 to 101 Edgecumbe Road will work with just Tauranga or Tauranga Central.
Numbers 104 to 209 require Parkvale as the suburb to get postcode 3112.
Numbers 1 to 554 Cameron Road will work with just Tauranga or Tauranga Central.
Numbers 556 to 882 require Parkvale as the suburb to get postcode 3112.
Numbers 893 to 1356 require Gate Pa as the suburb to get postcode 3112.
Numbers 1382 to 1480 require Greerton as the suburb to get postcode 3112.
Will the incorrect post code prevent delivery?
NZ Post advise that incorrect postcodes will not prevent delivery of mail. The postcode is only one component of the address, delivery is more likely to be prevented if the street, suburb and town information is incorrect. Please refer to NZ Post's website for more details on their address accuracy programme: http://www.nzpost.co.nz/Cultures/en-NZ/BusinessSolutions/AddressingForBusinesses/
What happens next ?
We are currently considering the options for phase 2 of the post code change which involves updating all current addresses in the NHI to have the new post code. It is intended that all addresses will be updated by 1 July 2008.
We are continuing to investigate how to improve the allocation of postcodes and domicile codes so would appreciate any specific examples you have to help us focus our analysis. Due to the legacy nature of the NHI we have limited ability to change how the address scrubbing functionality works but will continue to make improvements where we can.
Please direct any enquiries or examples regarding the post code update to datamanagementservices@nzhis.govt.nz
Please address the email to Liz Mooney, who is coordinating the investigative work.
Question:
Does collecting the mother’s NHI on the NMDS birth event compromise the confidentiality required for adoptions?Answer:
The submitted Mother’s NHI will be held in encrypted form in the NMDS. No other identifying information is held about the Mother within the birth record. Birth data including the Mother’s Encrypted NHI will be extracted and held in the Maternity and Newborn Information System (MNIS). Mother’s Encrypted NHI will not be published to the Business Objects Universes.Question:
When will the 2008 file specifications and data dictionaries be ready?Answer:
These are usually released on 1 July; the Requirements Change documents contain the details of the changes that will be made to the existing specifications and dictionaries.Draft versions of the file specifications have put on this page on 29 May 2008, these have still to complete the internal review process and will be updated when this is complete.
Question:
Clarification of formatting required for new ICU hours field.Answer:
Data Domain has been updated to be 00001-99999 or NULLEg: A value of 12 should be sent as 00012.
Question:
NZHIS definition of ICU against HDU.Answer:
The essential difference is that an intensive care unit must be capable of providing invasive ventilation for more than 24 hours.Question:
Will the new and updated addresses return the new post code in a separate field i.e. a separate Post Code field instead of the current City field where we noted the post code is being placed?Answer:
No change is being made to the formatting or location of the post code field. The new post codes will be returned in exactly the same manner as the existing ones are now.Requests for data held by NZHIS are processed by NZHIS Information Analysts in conjunction with the Chief Analyst and Privacy Officer. Any datasets released from either NMDS or MNIS would not include the Mother’s
Documents
| File | Description | Date last updated |
| NMDS Change Requirements v1.2 (sector version) (Word, 3 MB) | Outlines changes to be made to NMDS | 22 April 2008 |
| NBRS Change Requirements v1.2 (sector version) (Word, 1 MB) | Outlines changes to be made to NBRS | 22 April 2008 |
| NNPAC Change Requirements v1.2 (sector version) (Word, 3 MB) | Outlines changes to be made to NNPAC | 22 April 2008 |
| 2008 NCAMP and ICD presentation for DHB_Vendor day 11 Mar 08 (PDF, 100 KB) | Presentation given at vendor workshop | 11 March 2008 |
| NMDS FIle Specification v12 (Word, 2 MB) | DRAFT file specification including the NCAMP 2008 changes | 29 May 2008 |
| NBRS File Specification v4.0 (Word, 1 MB) | DRAFT file specification including the NCAMP 2008 changes | 29 May 2008 |
| NNPAC File Specification v2.0 (Word, 430 KB) | DRAFT file specification including the NCAMP 2008 changes | 29 May 2008 |
Compliance Testing
NCAMP Compliance testing for 1 July 2008 is made up of the following phases:
- Pre-Compliance - The pre-compliance test script is for NBRS only and includes creating test patients and booking records to be extracted from the DHB system before the NCAMP changes are applied.
- Compliance Testing– Once the DHB test system has been updated to include the NCAMP changes, the DHB will follow the test scenarios provided by NZHIS and extract the data created.
- Check of first production file – After successfully completing the NZHIS testing the DHB will have provisional compliance. The first file created in the DHBs production environment will be loaded into the NZHIS compliance environment as a final check before loading into the NZHIS production environment. If this load is successful, the DHB will have full compliance.
- Check of first production file containing ICD-10-AM 6th Edition codes - If a DHB achieves full compliance using the ICD-10-AM 3rd Edition codes, please inform NZHIS when the first production file containing ICD-10-AM 6th Edition codes is sent. This will be loaded into the NZHIS compliance environment as a final check before loading into the NZHIS production environment.
Compliance Documents
| File | Description | Date last updated |
| NCAMP 2008 DHB Compliance Requirements (Word, 188 KB) | Compliance Procedures for DHBs | 22 May 2008 |
| NCAMP 2008 Compliance - NBRS Pre-Compliance Test Script v1 (Word, 275 KB) | NBRS Pre-compliance test script | 15 May 2008 |
| NCAMP 2008 Compliance - NBRS Compliance Test Script v1 (Word, 561 KB) | NBRS Compliance test script | 26 May 2008 |
| NCAMP 2008 Compliance - NMDS Compliance Test Script v2 (Word, 777 KB) | NMDS Compliance test script | 9 June 2008 |
| NCAMP 2008 Compliance - NNPAC Compliance Test Script v1 (Word, 243 KB) | NNPAC Compliance test script | 9 June 2008 |
If you have any queries regarding this project or if you wish to be included in the email group, please contact the NCAMP Project Manager, Lynda Kamstra, by email to Lynda_Kamstra@nzhis.govt.nz.
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