For planned elective surgical procedures, what national data reporting requirements are there for names of operations?
For those hospitals who have an electronic elective surgical booking form for the surgeon to fill out when there is a Decision to Treat, do you get the surgeons to select from a structured data list of operation titles so it can be directly saved with these in the Patient Administration System to track the waiting list?
In Southern we are using ICD10 codes when the procedure is entered on our waiting list in SIPICS, and I believe this is the case for the South Island as a whole. Is anyone using SNOMED codes for this instead?
Northern - still using ACHI here. Also v keen to see if anyone is using SNOMED for this in the country at the point of where the surgeon enters the booking. Even if just one spec (and even if then translating to ACHI for external reporting). I seem to recall there was a program of curating SNOMED terminology lists for different surgical specs. Have not looked into this for some years, so readily confess near-total ignorance re progress if any.
@damon and @eras it may not be widespread but the only right answer here is to use a SNOMED code for the procedure at booking and all points downstream in the person’s health record. ACHI comes in later as part of clinical coding by a clinical coder at the end of the event. Using SNOMED to code surgical bookings might well be entirely new here in NZ, but it’s still the right choice. NZ Core Data for Interoperability (NZCDI) 2026 - approved by our clinical reference group and close to being published - states the requirement. USCDI and AUCDI say the same (to be fair, USCDI also allows a code system called CPT) and the International Patient Summary (IPS) FHIR IG has SNOMED as the preferred binding for procedures. Our radiology procedure codes are moving to SNOMED. Our SNOMED NZ edition, NZ health terminology service, FHIR forms and whatever NLP/AI you have to throw at it, all make using SNOMED in your application easy to do. Bin the forms you have today and start with new ones. Best person to contact is @dmeiklejohn if you’d like support from the HISO team.
Respectfully, I disagree that ACHI is assigned by coders after the booking - this is not the reality of my centre. I have personally spent some hours as recently as last year(!) trying to marry up the ACHI code book with anaesthesia procedures, so that they could be entered in our OR booking platform (TrakCare that replaced PIMS). The ACHI list is sorely lacking in granularity , which is why I am heartened by your statement below @alastairk :
However, where are my and @damon’s resources to implement this? Where is our institutional awareness that this is what we should be doing? Where is the approved terminology directory to enable us to throw out the forms today?
Stirring the pot here, but let’s be realistic: I have exactly zero organisational support to make the right choice and the moral injury of having to constantly invest (often my own) time to do the suboptimal just because that is the only thing available to me (and suboptimal is still better than nothing) is significant. I can reach out to HISO all I like but the powers much higher than me decided to align Trak with ACHI and not SNOMED as late as 5 years ago, so I am still stuck dealing with an organisational fait accompli .