National Health Information Platform nHIP

@darren.douglass from the Ministry of Health recently spoke at SDHB to our Coummunity Health Council and shared the following presentation on nHIP. Darren was happy for me to post it on Discourse.

11. nHIP overview Jan20.pdf (2.1 MB)

I thought it would be useful to share on Discourse as there’s not a lot of info about it on MOH sites yet since it is still a work in progress and not fully signed off by government.

As the nHIP will influence the future direction of Health IT in NZ, I thought this would be a good place to share what we know about it so far. My understanding is the MOH have a clinical advisory group which has contributed to this but they are also keen for feedback from the wider CILN network as well as Community Health Councils.

I’ve pasted below some links that also mention nHIP

https://www.hinz.org.nz/news/452553/National-Health-Information-Platform-replaces-Electronic-Health-Record.htm

https://ehealthforum.nz/t/orion-problems-list/9470/25

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Allergies vs Adverse Reactions

Here is draft data requirements from the MOH website (Sep 2019)

https://www.health.govt.nz/system/files/documents/pages/personal_health_information_a3_poster.pdf

I’m interested if anyone who has been involved knows the thinking behind having a data-field to be “allergies” rather than “adverse medication reactions”. I see that the “allergies” field is to include food and other allergies, which is important information. But does anyone know how then we would record adverse drug reactions that are not allergies?

Thanks for sharing @damon, useful posts to have for discussion.

@david.hay, you helped develop an Adverse reaction standard with @John_Fountain based on FHIR and SNOMED CT/NZULM. Has this progressed any further?

I think that John has published that as an information model thru HISO, but don’t think it has progressed beyond that…

cheers…

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To my eye these look like categories of data, rather than fields per se. There will need to be many fields in each.

And yes, that type of granularity (and more) is absolutely vital for the data to be useful, and that MUST be standardised or we perpetuate the mess. Hence data models.

Interesting pdf, thanks. Who/what MoH group compiled this, do you know? Can’t find link in MoH web page and it has no reference on whether this is expected to eventually cover all data requirements which the MoH currently requires of services.

Hi @karen.vince

My understanding is @darren.douglass from the MoH has a lead role in this. Input has been received from a clinical advisory group, many of whom (or possibly ?all) are also members of CiLN so on Discourse as well.

I believe the reason there is not much on the MoH website about it yet is that it is still a proposal in development and not yet fully signed off by government.

The intention is for an evolutionary approach starting with well defined sets of data that can lead to achievable outcomes. It is recognised that it’s not possible to define all future data sets that may be included before the start of the project.

I’d welcome any posts from anyone on the clinical advisory group for the MoH who have worked on this as well as they will be more in touch with these details than me.

@karenblake is on that group, but I’m not sure who else. Apparently it was/is managed via a Yammer forum.
Can anyone tell us more?

Hi team,

we have a few CiLN members on the nHIP sector advisory panel:
@BeckyGeorge @emily.gill @robyn.whittaker @searnshaw @Ruth_Large @nigelmillarnz @rebecca.grainger @KarenDay @michael.hosking @MValentine and myself.

nHIP is undergoing the business case phase for cabinet, and we will know more in the coming months once this has been through cabinet and treasury.

@John_Fountain has been working on data standards for allergies/adverse reactions. Suggest reaching out to him.

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Hi All,

There is indeed a solid information model under development in conjunction with HISO and Medsafe.

Further work is required (e.g. messaging) and discussion is necessary in regard to how this data will be stored managed at a national level.

Overall progress has been delayed due to unforeseen issues, but there should be an outcome this year.

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Thank you @John_Fountain; it is really good to know that you are on the case and are making progress with this.

Can you tell us any more? I’m pretty sure that all of @nz-ciln would like to know more about our approach to solving the massive real world problem we all have of not having reliable information about allergies and alerts for our patients.

Indeed it is a sizable issue and it seems that a simple implementation will simply not work… A major issue is balancing the twin issues of easy collection of local data (Ms X has X intolerance to substance Z) as is currently found in many systems, with national level reporting similar to that reported to Medsafe via CARM.

The approach cannot be adequately described in this forum, but is designed to cover both (immunological) allergies and (non-immunological) intolerances. Two workshops have been run via Medsafe and HISO with various experts and a data model is largely complete. Messaging and data storage / analytics require attention.

Discussions were to be held this month to progress the project (various resourcing and other issues have arisen) but have been pushed out. There will be some (I hope) discussion at an upcoming HISO meeting this month.

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The PSSS looks good. I note that (for MOH page) “PSSS does not address the scope of requirements related to care plan, transfer of care and consumer-generated data. Subjective personal information that shapes the whole patient journey across multiple services and providers, including the influential social factors of ‘who I am’ as a patient and consumer, is also not within scope for PSSS. These requirements need different reference points and it will be essential to consider all their aspects when developing standards.” Is there a group who is considering standards/requirements for the ‘subjective’ (e.g., free text) component that should be central to all patient records (portals and EHRs)? An approach is to focus the ‘who I am’ around their overarching goal to help focus all care direction. Determining that goal is, in itself, an important process that likely needs professional resources and input . . . this ties into the work around advanced care planning, but should not be limited to end-of-life situations.

Hi Damon - when I clicked on the link for the nHIP overview it went to a blank page - can you plz repost - thanks

An update on the programme from eHealthNews https://www.hinz.org.nz/news/489775/nHIP-heads-back-to-Cabinet.htm

I hear a rumour that nHIP may have a name change on the cards. Can’t name my source however.