National Health Index training presentation

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National Health Index training presentation
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This presentation has six sections
Session 1 Introduction to the NHI for people who
are new to the NHI
Session 2 Collecting and updating information
for people who use the NHI
Session 3 Searching for people who want to
improve their searching techniques
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This presentation has six sections
Session 4 Linking for people who find duplicate
records
Session 5 Medical Warnings System for people who
use the MWS
Session 6 Privacy and security for people
interested in protecting privacy and security
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Session 1 Introduction to the NHI
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Topic 1 - What is the NHI?

• The National Health Index (NHI) is a database
• Demographic data uniquely identifies individuals
  (ie. name, address, date of birth, gender and
  ethnicity)
• It assigns a unique NHI number (eg. ABC1234) to
  every individual
• The NHI can enable a persons medical events to
  be linked and helps to protect their electronic
  health and disability information

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Topic 2 What organisations use the NHI?

• All New Zealand Health Information System (NZHIS)
  information systems
• Public and some private hospital Patient
  Management Systems
• Primary Care Practice Management Systems
• Laboratories
• HealthPAC payment processing systems
• Pharmacies

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Topic 3 Why use the NHI?

• Health and disability support services use the
  NHI
• To accurately link health data to individuals
• To submit or access information on the Medical
  Warnings System (adverse drug warnings and other
  alerts)
• To improve patient privacy when transferring data
• To generate statistics and assist the Ministry of
  Health to develop, co-ordinate and provide better
  health and disability support services

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Topic 4 Importance of registration

• Most people need an NHI number when accessing
  publicly funded health care
• Commonly, new registrations would include new
  borns, new immigrants, refugees or overseas
  visitors, or those that have not had contact with
  a Health Care Provider since about 1997
• Most other New Zealanders are already registered
  (98 percent

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Topic 5 NZHIS systems that use the NHI number

• Medical Warnings System
• National Minimum Dataset
• Mental Health Information National Collection
• Cancer Register
• Mortality Collection
• National Booking Reporting System
• National Immunisation Register

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Topic 6 Access agreement

• All DHBs have a global access agreement and are
  responsible for making sure their staff adhere to
  the conditions
• Others must sign individual access agreements
• Administered by NZHIS

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Topic 7 Data quality

• NHI has a history of problems with data quality
• rubbish in - rubbish out
• Data quality is everyones responsibility
• Essential to provide accurate information for all
• Duplicate records

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Topic 8 Benefits for users

• A safety net for patients
• Correct information about patient location (for
  deprivation index and capitation)
• Transferring data between locations
• Richness of data (understand who our patients are
  and what they need)

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Topic 9 Who to contact with questions
The NHI is managed by the New Zealand Health
Information Service (NZHIS) of the Ministry of
Health. The contact is NZHIS NHI Data Quality
TeamPhone [phone] Fax [phone]
Email NHI_DataQuality_at_nzhis.govt.nz More info
http//www.nzhis.govt.nz/nhi/index.html
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Key points of the introduction section

• The NHI is a database that identifies all health
  care users in New Zealand. Each heath care user
  has a unique NHI number
• The NHI number is used by all NZHIS systems
  including the National Immunisation Register, PMS
  systems, Laboratories, Pharmacies, Rest Homes,
  and HealthPAC
• Anyone using the NHI must have an access
  agreement with NZHIS
• Data quality is very important to the NHI. Data
  quality brings benefits to NHI users

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Session 2 Collecting and updating information
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Topic 1 - Importance of collecting good
information

• Helps to improve the value of the NHI for
• Patients who will be correctly identified and
  have vital health information made available
• Staff who deal with patients
• Analysts who generate statistics on the state of
  health amongst New Zealanders
• Policy analysts, developers of programmes and
  services

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Topic 2 - Collecting data

• General standards
• Hyphens, apostrophes
• UPPER CASE
• Non-standard residences (eg. boats, rural
  addresses and flats or units)
• Local road names (eg. State Highway 2 known as
  Main Road locally)
• Spelling

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Topic 2 - Collecting data

• Name Fields
• Family Name is a surname and is a mandatory field
  (if only one name use it in both the Family
  Name and First Name fields)
• First Name is a persons given name and is a
  mandatory field
• Second and Third Name are for given additional
  names and can be left empty if not appropriate
• Preferred Name is on optional field, not used by
  the search engine, indicates which of the three
  given names the person uses

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Topic 2 - Collecting data
Gender Gender is a is a mandatory field F
female M male U unknown
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Topic 2 - Collecting data

• Residency
• A permanent resident is a person who
• Resides in New Zealand, and who complies with
  the Immigration Act 1987
• Health service providers are responsible for
  checking patients/clients eligibility for
  treatment. Payment for care is dependent on a
  patients residency
• Guide to classifying potential problem situations

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Topic 2 - Collecting data

• Domiciles
• Domicile code is a Geographic Information System
  (GIS) code for the physical location of the
  person's registered address
• Rural addresses without a locality (eg. RD 9
  Wanganui) will not result in an accurate domicile
  code
• If a domicile code cannot be assigned
  automatically, you have the ability to manually
  assign a domicile code

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Topic 2 - Collecting data

• Addresses
• Address Line 1 - The first line of the address at
  which the person has been, or plans to be, living
  at for three months or more and is a mandatory
  field
• Address Line 2 - The second line of the address
  at which the person has been, or plans to be,
  living at for three months or more
• Suburb - The suburb enables the generation of an
  accurate domicile code
• Town /City - The city, town or region enables the
  generation of an accurate domicile code
• Country - The external region or country is
  normally only required for overseas residents

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Topic 2 - Collecting data
Date of Birth The date on which the person was
born is required with full four-digit years and
should be input in English date
format dd/mm/yyyy
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Topic 2 - Collecting data

• Date of Death
• The date on which the person died. This field
  can only be entered or edited by NZHIS
• If you think a date of death has been incorrectly
  assigned call NZHIS (Mortality Team) with the NHI
  number to get it investigated/removed

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Topic 2 - Collecting data

• Ethnicity
• Ethnicity data collection is guided by the
  Ethnicity Data Protocols for the Health and
  Disability Sector, Ministry of Health 2004
• There are three ethnicity fields but only the
  first is mandatory. Once an ethnicity code is
  used it should not be used in either of the other
  two fields

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Topic 3 - Checking details with patients

• Respect the patient
• Alternative names (peoples names can change)
• Spelling (Catherine, Katherine, Kathryn)
• Address (postal addresses are not physical
  addresses)
• Date of death (contact NZHIS)
• Donor details (no legal standing)

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Key points of the collection section

• Collecting comprehensive information protects the
  value and reputation of the NHI
• Every time you use the NHI you can check and
  update an individuals demographic data
• Standards for entering data in the NHI must be
  maintained and all mandatory fields must be
  complete
• Confirm names, spelling, address and other data
  with patients

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Session 3 Searching
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Topic 1 - Duplicate records

• Occur when an individual has been registered more
  than once on the NHI
• Where there are duplicate records for one person,
  the records are linked

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Topic 2 - Important things to know about
searching

• Approximately 98 of New Zealanders have an NHI
  number
• The new registration will most likely be new
  borns, new immigrants, refugees, overseas visitor
• Or someone who has not used a health service
  since 1997

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Topic 3 - Search types

• Default - designed to give a wide range of
  results, including name variations this should
  be the default search type
• Wildcard - takes the characters you type for each
  of the name fields and uses this with a wildcard
  suffix to perform the search use when a normal
  search does not return the expected result

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Key points of the searching section

• Duplicate records occur when an individual has
  been registered more than once on the NHI
• Where there are found to be duplicate records for
  one person, the records are linked
• Dont give up try more than one search before
  creating a new NHI
• There are two search types normal and wildcard
• Search results will be different locally

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Session 4 Linking
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Topic 1 - What linking (merging) and unlinking is

• When more than one NHI is found to be assigned to
  a single person (ie. duplicates), the records are
  linked
• The different details are preserved to allow for
  possible unlinking in the future
• Of the two NHI records, one record is the master
  and will be the one returned by a subsequent
  search

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Topic 2 - Getting patients to verify link
requests

• Important to verify that two or more records
  belong to the same person
• If you have the person with you, ask them to
  check the details, or
• Verify the information from the documentation

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Topic 3 - The Do Not Link table

• Where it is confirmed that two NHIs are not
  related (ie. they do not relate to the same
  person) you can request that the NZHIS note this
  on the NHI system
• Prevents the NHIs from being linked in the
  future
• Twins and other multiple births
• People with very similar details

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Topic 4 - Pre-allocated numbers
Hospitals are allocated NHI numbers in case the
NHI is not available (off line) or for use in
emergency departments when no details can be given
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Key points of the linking section

• Linking is done when there are duplicate records
  to merge records (linking is also known as
  merging)
• Unlinking is done when two NHI records have been
  incorrectly linked
• Get patients to verify link requests
• Pre-allocated numbers are NHI numbers which are
  issued in blocks for emergencies. They must be
  registered

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Session 5 Medical Warnings System
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Topic 1 - What information is available

• Description of adverse reactions
• Onset date
• CARM approval date
• Facility code
• Severity (W or D or R)
• Doctor number and more

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Topic 2 - How do you access the information

• Medical Warning information is available via a
  standard transaction which uses the NHI number to
  retrieve the data
• Not all users of the NHI have access to view or
  update Medical Warnings

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Topic 3 - The role of CARM

• Centre for Adverse Reactions Monitoring (CARM)
• Assesses events to establish whether they are
  drug or vaccine linked
• Is able to update the Medical Warnings System

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Key points of the MWS section

• The MWS contains information on Adverse Medicines
  Reactions (AMR) and Significant Medical
  Conditions (SMC)
• Access to the MWS depends on the level of access
  you have been given under your access agreement
  or by your organisations internal policy
• The Centre for Adverse Reactions Monitoring
  (CARM) assesses events to establish whether they
  are vaccine or drug linked

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Session 6 Privacy and security
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Topic 1 - Your requirements

• NHI number on its own does not directly identify
  an individual but can be used to link to
  identifiable data
• Disclosure and Verification of Information
• Privacy Act, Health Act, Official Information Act
• Health Information privacy Code (HIPC) is a guide

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Topic 2 - Audit

• Access and use of the NHI is monitored for
  auditing purposes
• Helps to ensure the system is being used
  appropriately

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Key points of the privacy section

• Do not disclose inappropriate information
• The Privacy Act 1993 and Health Information
  Privacy Code 1994 (HIPC) are the controls for
  managing identifiable information you have
  signed an agreement to adhere to those Acts
• The access and use of the NHI is monitored and
  audited

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Thank you