Publications

HISO 10003 ISO/IEC 11179 Information technology – Metadata registries

International standard ISO/IEC 11179 Information technology - Metadata registries is endorsed by HISO as the standard for creating and presenting data element definitions. The standard provides rules for the naming, definition and representation of data elements, value domains and associated data constructs. By following the standard in our data set specifications and database designs, we support an interoperable and data-driven health and disability system.

The standard has these parts:

The key parts of the standard are freely available on the ISO web page for publicly available standards.

For more information, contact standards@health.govt.nz

HISO 10013:2015 HL7 Standards Endorsement

The statement of endorsement covers the continued use in the New Zealand health and disability sector of HL7 standards for interoperable electronic health records.

HL7 standards for interoperability are implemented in electronic health record systems around the world. The purpose of the statement of endorsement – first published in 2005 – is to provide clear direction on the use of HL7 standards in the New Zealand health and disability sector. The 2015 revision reflects advances in health information technology and the emergence of new standards for interoperability.

Next revision

In 2020, HISO will update this statement of endorsement to reflect the growing importance of HL7 FHIR(R) and our commitment to it.

As one of the first steps, HISO has accepted the following recommendation from HL7 New Zealand on adoption of the HL7 FHIR R4 International Patient Summary Implementation Guide.

The HL7 FHIR R4 International Patient Summary Implementation Guide is recommended for the exchange of core personal health information in trans-national settings, and also as a starting point or building block for consumer health applications in general. This recommendation is likely to be upgraded to a full endorsement once the Implementation Guide (currently subject to the HL7 International balloting process) reaches normative status.

HISO 10019 ICD-10-AM and ICD-O endorsement

Standard classification systems

The standard classification systems used in the health and disability system are:

  • The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM)
  • Australian Classification of Health Interventions (ACHI)
  • Australian Coding Standards (ACS)
  • ICD-O – International Classification of Diseases for Oncology.
  • New Zealand upgraded concurrently with Australia to ICD-10-AM/ACHI/ACS Eleventh Edition on 1 July 2019.

ICD-11 is in development and will replace ICD-10-AM when it is introduced within the next few years.

Background

A National Cancer Information Work Programme was established in 2003 by the then New Zealand Health Information Service (NZHIS) to improve the completeness, quality, accuracy and currency of data held on the New Zealand Cancer Registry and associated feeder sources such as the Mortality Collection.

As a component of this programme, HISO endorsed ICD-10 AM and ICD-O as national coding standards, allowing for consistent coding of clinical and cancer data. ICD classifications were already de facto standards, used by the health and disability sector for more than 30 years.

These standards are an essential building block for any national data set coding clinical and cancer data in New Zealand and used for statistical and administrative purposes.

The benefits of having standardised coding include an enhanced ability of sector and health researchers to more quickly identify trends in the incidence of disease, mortality and survival.

The ICD standards complement SNOMED CT, the international terminology standard for the descriptive and interoperable health and disability information used in patient care.

Maintenance

The World Health Organization (WHO) produces new editions of ICD approximately every ten years and the National Centre for Classification in Health (NCCH) has produced an Australian Modified (AM) version about every two years.

The ongoing maintenance of these classifications is performed by WHO and NCCH and monitored by the Ministry of Health.

HISO 10033 SNOMED CT Endorsement

SNOMED CT is the comprehensive multilingual clinical terminology used around the world. Internationally, SNOMED CT is a key standard for interoperability in health care and we require its use in New Zealand by all health providers and their industry partners.

When implemented in software applications, SNOMED CT enables the capture and reuse of clinical information on a consistent and reliable basis, enabling this information to be stored and shared without ambiguity.

SNOMED adoption is key to our interoperability roadmap as we accelerate the shift to a fully interoperable digital health ecosystem.

See the SNOMED CT five-step briefing for an introduction to what SNOMED CT is, how it works and the benefits to users.

SNOMED International – a not-for-profit organisation based in London – owns, develops and promotes the use of SNOMED CT worldwide. New Zealand is a charter member of SNOMED International and our annual membership fee covers unlimited use of SNOMED CT in New Zealand.

The Ministry of Health represents the New Zealand Government as a member of SNOMED International, operates the SNOMED National Release Centre and distributes the SNOMED New Zealand Edition to registered users.

SNOMED International’s latest annual report looks back over five years of improvements to SNOMED CT product and services, and points the way forward under the 2020-25 strategy.

In 2021, we introduced a SNOMED CT terminology service as a free public good to New Zealand health providers and their software industry partners. The terminology service is available via a standard application programming interface (API) for use by clinical information systems and consumer health platforms.

HISO 10040.4:2015 Clinical Document Metadata Standard

This interim standard defines the metadata elements captured about every clinical document stored in a clinical data repository and accessed via clinical workstation or patient portal systems.

The purpose of this standard is to ensure that clinical assessments, test results, transfer of care summaries, operation notes and other common clinical document types can be identified, classified and indexed in a common way, enabling secure document sharing. While the standard is primarily about clinical documents, it can be extended to other models of information sharing too.

Metadata elements identify the patient, practitioner, facility, health specialty, document type and confidentiality level associated with each clinical document, as well as giving the document's repository location.

HISO 10049.1:2014 Videoconferencing Interoperability Standard

This standard provides guidance in the procurement of videoconferencing and telepresence equipment that has the required interoperability.

Videoconferencing and telepresence are important technologies in establishing telehealth in New Zealand. Telehealth is the term for the use of information and communication technologies to deliver health care across a wide range of health settings and physical locations, such as between DHBs, integrated family health centres and long term care facilities.

The Ministry of Health and the Health Information Standards Organisation recognised the need to specify standards to make sure the technologies and systems work well, are secure and talk to each other.

See also HISO 10049.2:2019 Videoconferencing Endpoint Naming Scheme

 

HISO 10049.2:2019 Videoconferencing Endpoint Naming Scheme

This standard defines a naming and addressing scheme for videoconferencing endpoints.

HISO 10049 is the published standard for videoconferencing interoperability, supporting telehealth services and interoffice communication. This second part of the standard, developed by the New Zealand Telehealth Forum’s videoconferencing working group, provides a naming and addressing scheme for videoconferencing endpoints. The standard defines how display names and web addresses are constructed, supporting the National Health Videoconference Directory for videoconferencing endpoints.

 

HISO 10083:2020 Interoperability Roadmap

Digital health can transform the outcomes and experience of consumers if information is shared seamlessly. When digital products, services and information systems work together in this way, we call it being interoperable.

Interoperability is a key enabler of the digital health ecosystem we are building. Interoperability will ensure that health information can be accessed by consumers, health professionals, carers and whānau anywhere, anytime and anyhow.

Our interoperability roadmap is about accelerating the shift to a fully interoperable digital health ecosystem. In the document, we outline the need for change and set out practical steps over the next two years on our collective journey.

The roadmap has four interwoven themes:

  • connecting and identifying
  • using the same languages
  • unblocking access to data
  • enabling joined-up services.

Under each of these headings, we describe the current situation, what we’ll look to shift to, how we’ll do this, and what great looks like.

Tracking your progress

We are tracking progress against the interoperability roadmap and posted our first report in July 2021 – see attached. The report covers each item on the two-year plan to note the work completed and the work still to come.

While some milestones are taking longer to achieve, there is a good progress overall. Highlights include the following:

  • New application programming interfaces (APIs) for the National Health Index (NHI) and Health Provider Index (HPI) have reached user acceptance testing. The new APIs implement the web friendly HL7® FHIR® standard for data exchange.
  • Scheduled releases of the SNOMED New Zealand Edition and New Zealand Pathology Observations Code Sets (NZPOCS) were delivered in October 2020 and April 2021.
  • Our SNOMED CT affiliates now have real-time access to the SNOMED NZ Edition via a FHIR API: https://snomednz.digital.health.nz/fhir. Integrating health software with the API removes the need to load the six-monthly release files, improves the user experience and contributes to data quality. Users can easily select the terms they need to record relevant clinical information and share it with patients, whānau and other health professionals. The new service is backed by a cloud-hosted instance of the free and open source SNOMED CT terminology server called Snowstorm from SNOMED International. We have provided free developer education in the use of Snowstorm and the FHIR API.
  • Building on our existing SNOMED CT authoring platform, we have a project underway to extend the New Zealand Health Terminology Service (NZHTS) to create an operational platform providing API access to all our standard terminologies and code sets
  • We have subscribed to the Simplifier.net platform to establish a New Zealand FHIR Registry, where the FHIR design artefacts created by national programmes will be published.