1. NES Implementation Update PSAAP 30 April 2015 Andrew Inder Andrew_Inder@moh.govt.nz Page 1

2. CBF Payment Current Process Uncleansed PHO Registers Register Merge Cleanse, enrich and validate Payments Input file CBF Calculator Payments File PHO Register Process Practice Register Extract E-SAM NHI Cleansed Register feedback loop Practice Register feedback loop

3. Why NES? improve health information management improve the ability of general practices to manage patient information sets and reduce national level duplication improve the information which general practices use for long-term business and patient care planning enable DHBs to manage their funding allocations more efficiently, and bring higher levels of accuracy and timeliness to aggregated data sets used by the Ministry of Health for funding allocation purposes support the reduction of the stand-down period for payment reduce the risk of claw-backs via audit due to incomplete or inaccurate enrolment forms reduce time burden on practices to validate eligibility and entitlement Page 3

4. NES Future Page 4 Uncleansed PHO/Practice Registers Uncleansed PHO/Practice Registers Validate & cleanse Payments Input file ETL* Enrolment Masterfile E-SAM HPI VLCA/U6/U13 CSC HUHC NHI E-SAM HPI NES enabled practice Real-time query and update New OPA based Payments Calculator Payments file Outcome Reports PHO Query and Reporting NHI ETL* = Extract, transform, load Bulk Load Exception process PMS

5. Key transition issues requiring assurance - each will require agreed process and accuracy milestones to be met before progression to next step 1.OPA calculator accuracy a)Ensure the OPA calculator produces the same result as the CBF calculation process b)Testing can be completed by running historical registers c)Current indications indicate 0.03% variance (due to rounding) d)Can be done pre “functional launch” 2.NES registry accuracy a)Ensure rules applied in NES produce the same result as current process b)Any NHI driven variance is explainable (ie PMS driven demographics vs NHI driven demographics c)Potential to do pre “functional launch”, most likely post-launch 3.PMS registry accuracy a)Ensure PMS to NES (and vice versa) changes relating to addresses, registration and other demographics are accurate. Clear business rules to establish which is the source of truth b)Must be done post “functional launch”, some pre-launch done in test environments 4. Abnormal Situation a)Changes to PMS and NES for one-off events such as buy and sell, exit, mergers, etc. b)Must be done post “functional launch” Page 5

6. NES Future Page 6 Uncleansed PHO/Practice Registers Uncleansed PHO/Practice Registers Validate & cleanse Payments Input file ETL* Enrolment Masterfile E-SAM HPI VLCA/U6/U13 CSC HUHC NHI E-SAM HPI NES enabled practice Real-time query and update New OPA based Payments Calculator Payments file Outcome Reports PHO Query and Reporting NHI ETL* = Extract, transform, load Bulk Load Exception process Key functional areas requiring testing PMS

7. Post functional launch: pre Go-Live Page 7 Uncleansed PHO Registers Register Merge Cleanse, enrich and validate Payments Input file Payments Input file Feedback loop Compare ETL Payments file OPA based Payments Calculator Bulk load or load Validate & cleanse Enrolment Masterfile “EEE” Payments Outcome Reports NHI E-SAM HPI VLCA/U6/U13 CSC HUHC NHI E-SAM HPI NES enabled practice Initial upload, including delta from register submission TEST OPA based Calculator Test Payments file Test Outcome Reports Compare Payment Processing Testing and Validation Track adoption Validate $% Variance and enrolment variance Abnormal Path (eg mergers/sales

8. Post Go-Live: ongoing parallel processes as failsafe fall back Page 8 Uncleansed PHO Registers Register Merge Cleanse, enrich and validate Payments Input file Payments Input file Feedback loop Compare ETL Backup Payments file OPA based Payments Calculator Bulk load Validate & cleanse Enrolment Masterfile “EEE” Backup Outcome Reports NHI E-SAM HPI VLCA/U6/U13 CSC HUHC NHI E-SAM HPI NES enabled practice Initial upload, including delta from register submission TEST OPA based Calculator Payments file Payments Outcome Reports Compare Backup/Fall-back Payment Processing If adoption >90% If variance <x% Pay from NES

9. NES Transition timeframes (proposed) Current state - Quarterly enrolment - 6+ week process from extract to load at MoH end Functional launch NES: 1 July 2015 - NES functionality launched at MoH and PMS - Payments process unchanged - Adoption period NES Go-Live: 1 Jan 2016 - Monthly enrolment - New business rules - Significant reduction in process time - Page 9

10. Final Go-Live position Uncleansed PHO/Practice Registers Uncleansed PHO/Practice Registers Validate & cleanse Payments Input file ETL* Enrolment Masterfile E-SAM HPI VLCA/U6/U13 CSC HUHC NHI E-SAM HPI NES enabled practice Real-time query and update New OPA based Payments Calculator Payments file Outcome Reports PHO Query and Reporting NHI ETL* = Extract, transform, load Bulk Load Exception process PMS