Using National Health Index (NHI) and National Enrolment Services (NES)

what is the national enrolment service (nes)? the national enrolment service (previously known as e enrolment) provides the capability to support practices by assisting in patient identification and eligibility assessments, using a single, nationally standard electronic process that will integrate directly within the pmss this will allow for greater accuracy in the information collected, reducing the need for data re work nationally consistent approach to confirming and tracking a patient’s eligibility capability for funding to be provided closer to the date of patient enrolment this service will implement a secure web based solution that provides real time demographic and enrolment data nes will eventually replace quarterly capitation based funding (cbf) register submissions, and will provide automated system data aggregation reports eligibility look up (eligibility to receive publicly funded health services) authorised users at the point of patient enrolment can search to determine whether an identified patient is a verified nz citizen by birth before 2006 patient identity information nhi search and get users can search and view the national health index (nhi) records for a patient from within profile, and update it with the most recent demographic data for the patient nhi create and update authorised users can create a new nhi using the patient identity service within profile, update systems, and synchronise both profile and nes with the most recent demographic data for the patient certification for this service is required national enrolment service masterfile this allows for extraction of a national enrolment masterfile that contains the “single national source of truth” for all enrolment data the purpose of nes is to capture enrolment register changes on a daily basis, which makes it possible to take a snapshot of enrolment registers on a monthly basis this will allow for payment processing at monthly intervals reporting will then go back to the primary health organisations (phos) and/or management service organisations electronically on enrolment registers profile updates when a new patient is created, a window will appear allowing the user to search the nhi and autopopulate the new patient record with the relevant patient details for existing patients, there is an ability to first synchronise or validate existing information in the patient record with the nhi and to check their current enrolment status, details and history this document provides instructions for users on how to use these features new patients when creating a new patient, you can check the nhi to find existing patient demographic information and auto populate the new patient record in profile where the patient does not have an nhi record, you can create a profile record and then sync it with the nhi new patient creation with existing nhi record search for the patient to ensure they do not already exist in profile if they do not have an existing record, you can create a new patient in profile click new patient in the main toolbar menu this opens the select patient from nhi system window enter demographic information to search for the patient in the nhi database and press search you must enter either a last name or first name, in full, as part of the search criteria, if nhi is not present if you search by nhi, this will override any other demographic criteria entered and return the single record matching the specified nhi select a name from the list of results to view more demographic information on the patient the score column denotes a weighted result showing the likeliness of the match, based on search criteria higher scores indicate close matches to search criteria entered if a patient uses more than one name, a warning icon is displayed in the multiple names column when the \[ ] at the end of the patient’s row is pressed, the nhi system patient details for \[patient] window will open press ok to select the patient to create a new patient in profile this opens the alter patient window and it is populated with the demographic information pulled from the nhi, which includes nhi number and ethnicity at the bottom of the general view, the last nhi system update date and time will display, if available note if the patient selected already has a record in profile, the following warning appears to prevent duplicate patients being created additional information can be now be entered manually and saved by pressing apply or ok to save and close the window the nhi sync window appears changes to data appear in red press add local only to save the details in profile only or sync to update the nhi when the details are synced, the connection information field will populate with the message connected successfully press ok to save and close new patient creation without existing nhi record before creating a new patient locally in profile, it is important to search profile to make sure the patient does not already have an existing local record in profile and to search the nhi database to make sure the patient does not already have an nhi record if the patient does not have a record in profile or in the nhi database, complete the following steps to create a new patient in the select patient from nhi system window, press add local to create a new record in profile this opens the new patient window hot tip in the new patient window, you can now enter the primary address dates in the from and to fields accessed via the dropdown arrow next to the street address panel title enter the new patient demographic details including name, date of birth, address and ethnicity press to apply to save or ok to save and close a notification dialog box appears to confirm that you are adding a new patient to the nhi system check the confirmation checkbox and press ok to complete the process the nhi add patient window displays with the information which will be added to the new nhi record enter the source that was used to corroborate patient details for name, date of birth, and citizenship by clicking in the source row and nhi lookup column for each property and selecting the item from the dropdown list note if you have not sighted any corroborating documentation, select the proof not sighted option press add local only to save the details in profile only or sync to update the nhi note when syncing the record with the nhi, if there are mandatory fields which have not been completed, you will be prompted to enter the required details a message confirming successful connection to the nhi is displayed when the details are synced, the data not currently stored in profile is displayed in red press ok this returns you to the new patient window press ok to save and close the new patient window existing patients existing patient records in profile are not automatically synced with the nhi register this process needs to be completed manually and can be done as part of your normal process of checking patient demographic details on arrival at the clinic priority should be given to enrolled patients as this will enable you to update their enrolment status online once you have activated the national enrolment service existing patient records linking with nhi click alter patient on the main toolbar menu this opens the alter patient window press link to nhi this opens the select patient from nhi system window basic demographic data is prepopulated from the patient record press search if the patient has a record in the nhi database, it is displayed press ok to close the window this returns you to the alter patient window the last nhi system update field still displays never press apply or ok to save this opens the nhi sync window, showing the data from each record any differences will be displayed in red press sync to update the profile record with the nhi data note if the ministry of health has granted your practice with read only access to the nhi database, this window may be used as a reference only and syncing cannot be completed when the details are synced, the connection information field will populate with the message connected successfully press ok this returns you to the alter patient window the last nhi system update field displays the date and time of the update press ok to save and close the alter patient window patient demographics update and sync with nhi whenever you make changes to a patient’s demographic details, profile will attempt to synchronise these changes with the nhi system click alter patient on the main toolbar men this opens the alter patient window update information as applicable and press apply or ok to save this opens the nhi sync window, showing the current data stored in profile and the nhi any differences will be displayed in red press add local only to save the details in profile only or sync to update the nhi when the details are synced, the connection information field will populate with the message connected successfully press ok to save and close this returns you to the alter patient window the last nhi system update field displays the date and time of the update press ok to save and close the alter patient window nhi push the nhi push allows you to update a patient’s record in the nhi with additional information not held in profile or not automatically updated from profile for example, in the nhi, you can record “baby name” and “anglicised name”, which are not recorded in profile alternative addresses can also be added to the nhi go to clinical/nhi push this opens the select patient window search for the desired patient and press ok this opens the maintain nhi system patient details window for the patient use the icons in the toolbar to manipulate the information icon description add a new name add a new address nhi allows up to 3 addresses to be specified for a patient modify the highlighted line set preferred/primary (name, address, etc ) inactivate property an add or modify window will appear for each icon hot tip if the patient has more than one name you can check the preferred checkbox in the modify name window to ensure their preferred name is used in profile modify the desired fields and press ok the changes appear in the maintain nhi system patient details window press sync to save and close enrolment check alert you can set up enrolment alerts whenever a booked patient is arrived for an appointment at your practice if the patient’s last confirmed date is older than the practice defined threshold, an enrolment check alert is displayed when there is a mismatch between profile and the nes database note your system administrator can enable the enrolment check alert through organisation/preferences/patient select patient arrives and then check the enrolment check checkbox below the alerts panel, check the last confirmed is older than checkbox, enter the number of months to set the threshold, and check the not capitated checkbox nhi details verification profile will also verify if the version of your patient record matches the nhi’s version of the same patient whenever you arrive the patient for a booked appointment the versions will be different if, for example, your patient has made a casual visit to another gp who updated their address details a task will be generated automatically in the task list of the user/user group set up by your system administrator, prompting an update to the patient record (please refer to the patient demographics update and sync with nhi section of this manual) nes enrolment enrolment of patient provided a patient has been validated by the nhi system (refer to previous section), you can enrol thepatient using nes on line enrolment click alter patient on the main toolbar men this opens the alter patient window in the general view/ enrolment panel, the patient’s enrolment status is displayed patients who have not previously been enrolled using nes will have a status of unknown to enrol the patient, press enrol this opens the enrol patient window the processed on field displays the date on which the patient completed formal enrolment enter the date, if different from today’s date where the practice processes enrolment by provider, the appropriate provider should be selected from the dropdown list in the provider field the default will be the patient’s usual doctor note your system administrator can enable this enrol patients at provider level preference through organisation/preferences/financial/other tab check the patient declarations and your declaration checkboxes once the checkboxes are checked, press the enabled ok an enrolment request is sent to nes, and if accepted, the enrolment status and validity period are updated note your system administrator can enable enrolled patients must specify a pos owner preference through organisation/preferences/financial/other in this case, thepatient must have an organisation specified in their record re enrolment of patient for patients who are already enrolled with nes, you can re enrol them using the maintain button click alter patient on the main toolbar menu this opens the alter patient window in the enrolment panel, the patient’s enrolment status and enrolment period are displayed press maintain this opens the maintain enrolment for \[patient] window select the re enrol radio button enter the date in the re enrol date field, if different from today’s date press ok a maintain enrolment request is sent to nes, and if accepted, the validity period is extended patient enrolment termination for patients who have un enrolled, died or transferred to another practice, you can terminate their enrolment using the maintain button click alter patient on the main toolbar menu this opens the alter patient window in the enrolment panel, the patient’s enrolment status and enrolment period are displayed press maintain this opens the maintain enrolment for \[patient] window select the terminate radio button enter the date in the terminate on field, if different from today’s date in the reason field, select one of the items from the dropdown list press ok a maintain enrolment request is sent to nes to terminate the patient’s enrolment, and if accepted, the enrolment status and validity period are updated usual provider modifcation for enrolled patient each enrolled patient may be assigned to a specific provider in your practice you can update nes with changes to a patient’s assigned provider using the maintain request click alter patient on the main toolbar menu this opens the alter patient window in the enrolment panel, the patient’s enrolment status and enrolment period are displayed press maintain this opens the maintain enrolment for \[patient] window select the change provider radio button in the provider field, enter a provider from the practice or remove an assigned provider press ok a maintain enrolment request is sent to nes to update the provider information pre enrolment for babies pre enrolment is available for babies who are younger than 90 days old the pre enrolment process allows the baby to be enrolled with your practice without having to complete the formal declarations once a baby is pre enrolled, the baby needs to be fully enrolled with the practice within 90 days click alter patient on the main toolbar men this opens the alter patient window in the enrolment panel, the baby’s enrolment status is set to unknown press pre enrol this opens the pre enrol window for the patient note you can enrol a baby without pre enrolling them by checking the enrol now checkbox you will need to complete the standard enrolment declarations as for a regular enrolment enter the date in the processed on field, if different from today’s date in the provider field, enter the provider, if necessary depending on your organisation’s settings, this might be a required field press ok an enrolment request is sent to nes, and if accepted, the enrolment status and validity period are updated enrolment for pre enrolled babies to continue their enrolment at the practice, enrolment for a pre enrolled baby must be renewed before the pre enrolment expiry date click alter patient on the main toolbar menu this opens the alter patient window in the enrolment panel, the baby’s pre enrolment status and pre enrolment period are displayed press maintain this opens the maintain enrolment for \[patient] window select the enrol radio button enter the date in the processed on field, if different from today’s date check the patient declarations and your declaration checkboxes once the checkboxes are checked, press the enabled ok an enrolment request is sent to nes, and if accepted, the enrolment status and validity period are updated patient enrolment details update profile runs a scheduled task to send nes updates for patient’s whose enrolment details have changed since the last update nes updates are sent every hour but can be changed by modifying the scheduled task for nes enrolment web service it sends updates for every patient where their enrolment status is explicitly updated using enrol , pre enrol or maintain their date of last contact is updated enrolment notifications receipt nes sends notifications to profile about changes to the practice’s enrolled population for example, notifications are sent to a practice when a patient dies, enrols at another practice, or is linked to a different nhi notification messages appear in the enrolments manager view in the control centre notification requests are generated every 4 hours but can be changed by modifying the scheduled task for nes notification web service note depending on network load and data volumes, the nes webservices may have an impact on system performance so the frequency can be modified to suit your practice’s business operations for more details, refer to the nes enrolment schedule configuration section in the user manual – national enrolment services configuration document the enrolments manager view the enrolments manager view in the control centre provides details of new nes enrolment transactions it does not provide information about patients enrolled in the legacy system the practice will need to use the traditional process for these patients for more details, refer to the enrolment preferences section in the user manual – national enrolment services configuration document to make this view available to users at your practice select a patient from the list to enable the buttons in the enrolments manager view toolbar icon description displays the enrolment detail window for the selected patient allows you to enrol , terminate , or change provider for the selected patient displays the enrolment history window for the selected patient this window can also be accessed from alter patient/enrolment panel default filters are provided to display different information on enrolment transactions category description enrolled this month list of patients who were enrolled in the current calendar month funded/elsewhere list of patients who are currently funded at this practice but are now enrolled elsewhere terminated this qtr list of patients who terminated their enrolment in the current quarter expiring this quarter list of patients whose enrolment ends in the current quarter transfers this month list of patients who have transferred to other practices in the current calendar month pre enrolments list of patients who were pre enrolled in the current calendar month note users can create additional filters by clicking edit as with filters in other windows, the presentation tab allows changes to column display supporting documents/resources user manual – national enrolment services configuration intrahealth also provides a configuration manual to assist with initial set up of patient identity within profile this has been prepared for system administrators health identity online training module web address learnonline health nz http //learnonline health nz/ this moh course takes authorised users of the nhi through the key things they need to know when interacting with the nhi through profile the learning is interactive and focuses on the user behaviours required in two main areas maintaining optimal data quality with accurate and current identity data minimising errors in identifying patients thus increasing patient safety and reducing risk the course is suitable for all nhi users, but on implementation, is targeted at gp receptionists and administrators who will start to interact with the nhi with the introduction of the national enrolment service national health index information for consumers web address http //www health govt nz/our work/health identity/national health index/nhiinformation health consumers http //www health govt nz/our work/health identity/national health index/nhiinformation health consumers this page contains links to a statement of use covering the nhi and medical health warnings system and how they are used an nhi faq which included background information, data management, benefits, security and privacy information on how a patient can obtain information held against their nhi number moh user support all issues should be logged following standard practices with which phos and practices will be mostly familiar profile software issues first, log the issue with intrahealth helpdesk on 0508 300 900 to establish whether it is something that can be resolved within the application if it is not, then log the issue by phoning the online support team on 0800 505 125 and follow the prompts note you will be asked some questions when logging the issue, so please be prepared by having information available (including date and time of issue, what you were doing, any error or warning messages, screenshots, etc ) identity data issues log the issue with moh by phoning the online support team on 0800 855 151 and follow the prompts your pho will have a nominated person responsible for identity nhi data quality they will also be able to assist you with training, knowledge, data quality monitoring requirements and feedback pho enrolment data issues log the issue by phoning the primary care support team on 0800 458 448 and follow the prompts attachments