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 Referral ID
- Previous Related Referral ID
- Previous Related Referral Date
- Presenting Problem
- Presenting Problem Code Type
- Health Specialty responsible
- Health Specialty transferred to
- Health Specialty referred from
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2016_NSUP_National Patient Flow_Phase 3
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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
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2016_NSUP_National Patient Flow_Phase 3
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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
4500
Botulinum toxin therapy
5200
X-ray (plain)
New service sub-type – for
collection in referrals, bookings
and encounters
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 Referral 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 Referral 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
DataElement
Activity
Accident Flag
Activity: Booking
Responsible Organisation ID
Activity: Booking
Service Sub-Type
Activity: Encounter
Lead Clinician Code
Activity: Encounter
Lead Clinician Professional Group Code
Activity: Encounter
Responsible Organisation ID
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2016_NSUP_National Patient Flow_Phase 3
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Activity: Exception
Responsible Organisation ID
Activity: Notification
Responsible Organisation ID
Activity: Prioritisation
Prioritising Clinician Code
Activity: Prioritisation
Prioritising Clinician Professional Group Code
Activity: Prioritisation
Clinical Exclusion Code
Activity: Prioritisation
Responsible Organisation ID
Clinical Priority
Clinical Override
Clinical Priority
Clinical Priority Score Date
Referral
Date Referral Sent
Referral
Referral
Defined Suspicion of Cancer (SCAN)
Referral
Presenting Problem Code Type
Referral
Presenting Problem Coding System Code
Referral
Presenting Referral ID
Referral
Receiving Responsible Organisation ID
Presenting Problem Classification
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
Activity: Encounter
NMDS Client System ID
For inpatient and day patient encounters
Activity: Encounter
NMDS PMS Unique ID
For inpatient and day patient encounters
Activity: Encounter
NNPAC PMS Unique ID
Activity: Notification
Date Referrer Notified
For outpatient encounters (including remote)
If Referrer is not the GP
Encounter Outcome
Date of Decision to Treat
Prioritisation Outcome
Transferred Date
For cancer and waitlisted Electives patients
If Transferred
Referral
Previous Related Referral Date
If not the Presenting Referral
Referral
Previous Related Referral ID
If not the Presenting Referral
Referral
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 Referral 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 Referral 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 Referral ID
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2016_NSUP_National Patient Flow_Phase 3
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-
Previous Related Referral ID
Previous Related Referral 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
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