Data definitions for the faster cancer treatment indicators
3386455-31877000Faster Cancer Treatment Indicators: Business Rules and Data Definitions Date:March 2014Version:3.1Owner:Ministry of HealthCancer ServicesStatusFinalContents TOC \o "1-3" Purpose of this document PAGEREF _Toc381964320 \h 4Intended audience PAGEREF _Toc381964321 \h 4Authority for collection of health information PAGEREF _Toc381964322 \h 4Faster cancer treatment indicators PAGEREF _Toc381964323 \h 5Rationale PAGEREF _Toc381964324 \h 5Reporting against the FCT indicators PAGEREF _Toc381964325 \h 6Retrospective reporting PAGEREF _Toc381964326 \h 6Data collection responsibility PAGEREF _Toc381964327 \h 6Data reporting process PAGEREF _Toc381964328 \h 7Inclusions and exclusions for the 62 day indicator PAGEREF _Toc381964329 \h 8Inclusions and exclusions for the 31 day indicator PAGEREF _Toc381964330 \h 9FCT cancer pathway entry points PAGEREF _Toc381964331 \h 10Reportable data items for the FCT indicators PAGEREF _Toc381964332 \h 11Mandatory data items PAGEREF _Toc381964333 \h 11Primary key PAGEREF _Toc381964334 \h 12Data definitions PAGEREF _Toc381964335 \h 13Record type definition PAGEREF _Toc381964336 \h 13National Health Index (NHI) number definition PAGEREF _Toc381964337 \h 13First name definition PAGEREF _Toc381964338 \h 14Family name definition PAGEREF _Toc381964339 \h 14Date of birth definition PAGEREF _Toc381964340 \h 14Sex definition PAGEREF _Toc381964341 \h 14DHB of domicile definition PAGEREF _Toc381964342 \h 15Date of diagnosis definition PAGEREF _Toc381964343 \h 16Primary site International Classification of Diseases (ICD) definition PAGEREF _Toc381964344 \h 16Date of receipt of referral definition PAGEREF _Toc381964345 \h 17DHB of receipt of referral definition PAGEREF _Toc381964346 \h 18Date patient informed of diagnosis PAGEREF _Toc381964347 \h 18First multidisciplinary meeting (MDM) date definition PAGEREF _Toc381964348 \h 18Date of Decision-to-treat definition PAGEREF _Toc381964349 \h 19Date of first treatment definition PAGEREF _Toc381964350 \h 20Type of first treatment definition PAGEREF _Toc381964351 \h 21DHB of service for first treatment definition PAGEREF _Toc381964352 \h 23Source of referral definition PAGEREF _Toc381964353 \h 23SCAN definition PAGEREF _Toc381964354 \h 242W definition PAGEREF _Toc381964355 \h 24Delay code definition PAGEREF _Toc381964356 \h 25Extract file requirements PAGEREF _Toc381964357 \h 26Batch file name PAGEREF _Toc381964358 \h 26Batch file format PAGEREF _Toc381964359 \h 26Null fields PAGEREF _Toc381964360 \h 26Dates, partial dates and date times PAGEREF _Toc381964361 \h 26Batch processing PAGEREF _Toc381964362 \h 26Batch process overview PAGEREF _Toc381964363 \h 26Batch send process PAGEREF _Toc381964364 \h 26Creating the FCT batch (input) file PAGEREF _Toc381964365 \h 27Header record PAGEREF _Toc381964366 \h 27FCT event record PAGEREF _Toc381964367 \h 27Sending the batch to the Ministry PAGEREF _Toc381964368 \h 28Ministry batch pre-processing PAGEREF _Toc381964369 \h 28Pre-processing PAGEREF _Toc381964370 \h 28Batch passes pre-processing PAGEREF _Toc381964371 \h 29Batch fails pre-processing PAGEREF _Toc381964372 \h 29Load into the FCT database and validate (pre-processing passed) PAGEREF _Toc381964373 \h 29Automated return files PAGEREF _Toc381964374 \h 29Data quality checks PAGEREF _Toc381964375 \h 29Appendix A: DHB acronyms for file naming PAGEREF _Toc381964376 \h 30Appendix B: Primary site ICD codes PAGEREF _Toc381964377 \h 31Purpose of this documentThis document outlines the requirements for reporting the ‘faster cancer treatment’ indicators (the FCT indicators). DHBs began collecting baseline data on the FCT indicators during 2012/13. During the 2014/15 financial year the 62 day indicator will replace the current Shorter waits for cancer health target. Reporting is required on both the 62 day indicator and the 31 day indicator.This document provides the updated Business Rules and Data Definitions for the FCT indicators. This sits alongside the Ministry of Health’s (the Ministry) faster cancer treatment initiatives supporting quality care, including the development of tumour standards and pathways.The definitions for the FCT indicators are based on:National Cancer Core Data Definitions Interim Standard HISO 10038.3 (2011)National Health Service (Scotland) New Cancer Waiting Times Targets Data and Definitions Manual (2010)National Health Service (Wales) Definitions to support the Cancer Waiting Times Service and Financial Framework (SaFF) Target (2004).National Health Index Data Dictionary v5.3 (July 2009).This document also describes the business rules required to ensure that:data from DHBs can be loaded into the Ministry of Health’s (the Ministry’s) FCT databasedata in the Ministry’s FCT database can be analysed.Intended audience The intended audience for this document are: anyone working in a DHB who is responsible for collecting and submitting FCT indicator data to the MinistrySoftware developers designing, implementing and altering provider systems to ensure they export information in a format suitable for loading into the FCT databaseBusiness Analysts verifying that all required data elements are present and specified correctly. Authority for collection of health informationThe Ministry may collect health information where this is necessary to carry out lawful purposes connected with the Ministry’s functions and activities. These purposes, functions and activities may be set out in legislation, such as the Health Act 1956, or may be derived from lawful instructions from the Minister of Health. The collection, storage and use of health information is also governed by the Privacy Act 1993 and the Health Information Privacy Code 1994.Faster cancer treatment indicatorsThere are two indicators collectively referred to as the FCT indicators. Collection of data to calculate the indicators is mandatory and will be used to measure the timeliness of key points in a patient’s cancer pathway. The FCT indicators are: The 62 day indicator: The maximum target length of time taken for a patient referred with a high-suspicion of cancer (without a confirmed pathological diagnosis of cancer at referral)where the triaging clinician believes the patient needs to be seen within two weeksto receive their first treatment (or other management) for cancer.The 31 day indicator: The maximum target length of time a patient should have to wait from date of decision-to-treat to receive their first treatment (or other management) for cancer.The 31 day indicator includes all patients who receive their first cancer treatment, irrespective of how they were initially referred. Rationale The Government is committed to Better, Sooner, More Convenient Health Care. For the National Cancer Programme this means improving access to, and shorter waiting times for cancer treatment. Streamlined pathways of care that are based on well-coordinated services are crucial to timely diagnosis and management of cancer. This programme takes a patient pathway approach that covers surgical and non-surgical cancer treatment. The programme aims to improve services so that over time, all patients will have access to the same quality care within the same timeframes, no matter where they live. Reporting against the FCT indicatorsReporting against the FCT indicators will be based on three data points. Figure 1 shows the data points that make up the start and stop points of the FCT indicators. Figure 1: Data points for the two FCT indicatorsRetrospective reportingThe reporting to the Ministry on the FCT indicators data is retrospective. For both indicators, reporting to the Ministry occurs at the time of first treatment (or other management) for cancer.DHBs should establish their data collection and reporting systems to collect information on patients as they track through the care pathway (ie, prospectively). This information is then reported retrospectively to the Ministry.Any changes to the nature of the retrospective reporting will be on an annual basis. Data collection responsibilityThe DHB of domicile is responsible for collecting and collating information on the data items for their patients and submitting this information via submission of a text file to the Ministry, see Data reporting process below.The DHB of domicile is responsible for collecting and reporting information on their domiciled population even if it is not the DHB of:receipt of referralservice.Data reporting processData is reported retrospectively, by the DHB of domicile, via a pipe delimited text file and must be submitted to the Ministry via secure File Transfer Protocol (FTP).All data is reported monthly and must reach the Ministry within 20 days of the end of the month in which the patient’s first treatment took place. Inclusions and exclusions for the 62 day indicatorThe following inclusions and exclusions are detailed for the FCT 62 day indicator. GroupingPatients are included in the 62 day indicator if they Patients are excluded from the 62 day indicator if theyEligibilityAre eligible for treatment in New ZealandAre not eligible for treatment in New ZealandCancer pathway start pointHave a pathway that begins inside the NZ health systemHave a cancer that was diagnosed publiclyHave entered the cancer pathway through an acute presentation, as long as there is a subsequent referral to an outpatient clinicHave received treatment for metastatic cancer where the primary site is unknownHave a pathway that begins outside the New Zealand health systemHave a cancer that has been diagnosed through a screening programmeHave a cancer that was diagnosed privatelyHave entered the cancer pathway through an acute presentation, which does not subsequently result in a referral to an outpatient clinicHave a recurrent cancer (irrespective of the time frame of recurrence)Have metastatic cancer, but the patient’s primary cancer has already been included in FCT reportingAge of patientAre under the care of adult services and are 16 or older at the date of first cancer treatmentAre not under the care of adult services and/or are not 16 or older at the date of first cancer treatmentTreatmentHave received a first treatment (or other management) for cancer that is publicly funded, in the reporting periodHave not received a first treatment (or other management) for cancer that is publicly funded, in the reporting periodHave a first treatment for cancer that was undertaken privatelyTriageHave been triaged as having a high suspicion of cancer and as having a need to be seen within two weeksHave been triaged as not having a high suspicion of cancerHave a confirmed diagnosis of cancer at triage of referralHave been triaged as not needing to be seen within two weeksPrimary diagnosisHave a primary diagnosis of cancer that is included in Appendix B of this documentHave a primary diagnosis that is not included in Appendix B of this documentInclusions and exclusions for the 31 day indicatorThe following inclusions and exclusions are detailed for the FCT 31 day indicator. GroupingPatients are included in the 31 day indicator if they Patients are excluded from the 31 day indicator if theyEligibilityAre eligible for treatment in New ZealandAre not eligible for treatment in New Zealand.Cancer pathway start pointHave a treatment pathway that begins inside the New Zealand health systemHave a cancer that has been diagnosed through a screening programmeHave entered the cancer pathway through an acute presentationHave a cancer that was treated following it being detected incidentallyHave received treatment for metastatic cancer where the primary site is unknownHave a treatment pathway that begins outside the New Zealand health systemHave a recurrent cancer (irrespective of the time frame of recurrence)Have metastatic cancer and the patient’s primary cancer has already been included in FCT reportingAge of patientAre under the care of adult services and are 16 or older at the date of first cancer treatmentAre not under the care of adult services and/or are not 16 or older at the date of first cancer treatmentTreatmentHave received a first treatment (or other management) for cancer that is publicly funded, in the reporting periodHave not received a first treatment (or other management) for cancer that is publicly funded, in the reporting periodHave a first treatment for cancer that was undertaken privatelyPrimary diagnosisHave a primary diagnosis of cancer that is included in Appendix B of this documentHave a primary diagnosis that is not included in Appendix B of this documentFCT cancer pathway entry pointsPatients enter their cancer pathway through a variety of different entry points. Figure 2 shows how some of the different pathway entry points should be related to the two FCT indicators.Figure 2: Cancer pathway entry points and the FCT indicatorsNB - All records submitted for the 62 day indicator, should, by definition, also contain data that enables the 31 day indicator to be calculated.Reportable data items for the FCT indicators Mandatory data itemsThe mandatory (M) data items to be reported to the Ministry for the two FCT indicators are identified as follows:Mandatory fields required for processing and calculation of the 62 day indicatorRecord typeMNational Health Index (NHI) numberMFirst nameFamily nameDate of birthMSexMDHB of domicileMDate of diagnosisPrimary site ICD10MDate of receipt of referralMDHB of receipt of referralMDate patient informed of diagnosisDate of first multidisciplinary meeting (MDM)Date of decision-to-treatMDate of first treatment MType of first treatmentMDHB of service for first treatmentMSource of referralClinician defined suspicion of cancerM 2 Week flagM Delay code 62 Delay code 31 Mandatory fields required for processing and calculation of the 31 day indicatorRecord typeMNational Health Index (NHI) numberMFirst nameFamily nameDate of birthMSexMDHB of domicileMDate of diagnosisPrimary site ICD10MDate of receipt of referral?DHB of receipt of referral?Date patient informed of diagnosisDate of first multidisciplinary meeting (MDM)Date of decision-to-treatMDate of first treatment MType of first treatmentMDHB of service for first treatmentMSource of referral?Clinician defined suspicion of cancer2 Week flagDelay code 62 Delay code 31 Primary keyEach record has a unique primary key consisting of:NHI_NumberPrimary_site_ID.The primary key is used to check for duplicates on insert, or check for existence of a record for update or delete. During the load process, the FCT database checks that the data key is unique for the records with an A (add) record type. It is possible that a record may legitimately have the same primary key as a record already stored within the FCT database, due to a patient developing a second primary cancer with the same ICD10 code. This is a rare occurrence, however if it occurs, please speak to your Ministry FCT contact who can ensure the legitimate duplicate record is not rejected from the FCT database.Data definitionsRecord type definitionDefinition: Each FCT event record in an input file must have a record type in order to be loaded correctlySource standards: N/AObligation: Mandatory for any submitted recordData domain:ValueMeaning AAddUUpdateDDeleteField Name:Record_typeFormat:A(1)Guide for use: This field denotes whether a record is to be added to, updated within, or deleted from the FCT database Add: Creates a new event if no existing record with the same primary key is found on the FCT database.Update: Replaces any event with the same primary key.Delete: Deletes the record from the FCT database based on the primary key.National Health Index (NHI) number definitionDefinition: The NHI is a unique 7-character identification number assigned to a healthcare user by the NHI database. Source standards: National Health Index Data Dictionary v5.3 (July 2009). Obligation: Mandatory for any submitted recordField Name:NHI_NumberFormat:AAANNNNGuide for use: The NHI number forms part of the primary key for the faster cancer treatment record. First name definitionDefinition:The first given name of a healthcare user. Source standards:National Health Index Data Dictionary v5.3 (July 2009).Obligation:Non-mandatoryData domain:N/AField Name:First_NameFormat:A(50)Family name definitionDefinition: The family name (surname) of a healthcare user. Source standards: National Health Index Data Dictionary v5.3 (July 2009). Obligation: Non-mandatory Field Name:Family_NameFormat:A(50)Date of birth definitionDefinition: The date on which the healthcare user was born. Source standards: HL7 v2.4 DT – date. Obligation: Mandatory for any submitted recordData domain:Valid dateField Name: Date_of_BirthFormat:DDMMCCYYSex definitionDefinition: The person’s biological sex Source standards: National Health Index Data Dictionary v5.3 (July 2009).Obligation: Mandatory for any submitted recordData domain: ValueMeaning FFemaleIIndeterminateMMaleUUnknownField Name: SexFormat:A(1)DHB of domicile definitionDefinition: The DHB of domicile is the code of the DHB responsible for the patient.Source standards: National Health Index Data Dictionary v5.3 (July 2009).Obligation: Mandatory for any submitted recordData domain: ValueMeaning 011Northland021Waitemata022Auckland023Counties Manukau031Waikato042Lakes047Bay of Plenty051Tairawhiti061Hawkes Bay071Taranaki081MidCentral082Whanganui091Capital and Coast092Hutt Valley093Wairarapa101Nelson Marlborough111West Coast121Canterbury123South Canterbury160SouthernField Name: DHB_of_ domicile Format:NNNDate of diagnosis definitionDefinition:The date on which the patient was definitively diagnosed with a particular condition or disease.Source standards:National Cancer Core Data Definitions Interim Standard HISO 10038.3 October (2011).Obligation:Non-mandatoryData domain:Valid dateField Name:Date_of_diagnosisFormat:DDMMCCYYGuide for use:The date of diagnosis is the date of the pathology report, if any, that first confirmed the diagnosis of cancer. This date may be found attached to a letter of referral or a patient's medical record from another institution or hospital. If this date is unavailable, or if no pathological test was done, then the date may be determined from one of the sources listed in the following sequence:1. Date of the consultation at, or admission to, the hospital, clinic or institution when the cancer was first diagnosed. Note: do not use the admission date of the current admission if the patient had a prior diagnosis of this cancer.2. Date of first diagnosis as stated by a recognised medical practitioner or dentist. Note: This date may be found attached to a letter of referral or a patient's medical record from an institution or hospital.3. Date the patient states they were first diagnosed with cancer. Note: This may be the only date available in a few cases (for example, patient was first diagnosed in a foreign country).If a patient is admitted for another condition (for example a broken leg or pregnancy), and a cancer is diagnosed incidentally then the date of diagnosis is the date that the decision-to-treat as cancer was made.Primary site International Classification of Diseases (ICD) definition Definition: The Primary site ICD is the code that describes the primary site of the cancer for which the patient is being seen.Source standards: National Health Index Data Dictionary v5.3 (July 2009).Obligation: Mandatory for any submitted recordData domain: Valid ICD (10th edition) codes recorded to the third digit (see appendix B). Field Name:Primary_SiteFormat:ANNGuide for use:The 3 digit ICD10 code forms part of the primary key for the faster cancer treatment record.See appendix B of this document for the list of the ICD10 codes included in the FCT initiative.Date of receipt of referral definitionDefinition:The date of receipt of referral is the date the referral is initially received into secondary care. If the referral is transferred to another district health board (DHB) the date of referral remains the date that the referral was received by the first DHB.Source standards:National Cancer Core Data Definitions Interim Standard HISO 10038.3 October (2011).HL7 v2.4 DT – date.Obligation:Mandatory for the 62 day indicator.Non-mandatory for the 31 day indicator (as the patient may not have been referred with a high suspicion of cancer with a need to be seen within two weeks).Data domain:Valid dateField Name:Date_of_receipt_of_referralFormat:DDMMCCYYGuide for use:As referrals are received in different formats the following provides a guide for consistency purposesElectronic referralsBest practice is for referrals to be submitted electronically. Where referrals are submitted electronically the date of receipt of referral is the date that initiates the handling / processing of the electronic referral.Letter or faxed referralsWhen referrals are made by letter or fax the date of receipt of referral is the date with which the referral is stamped as having first being received in secondary care.Telephone or verbal referralsWhen referrals are made by telephone or a face to face conversation there is a need for information to be recorded or documented so that the booking process can be initiated. The date of receipt of referral is the date recorded on that documentation of the conversation with secondary care.On occasion, there will be multiple referrals for an individual patient. Where a patient has been accepted into another care pathway a clinical decision will need to be made as to whether the newer referral overrides the current pathway or not. The clinical decision needs to be documented and will determine the date of receipt of referral. Electronic referrals must consider the Referrals, Status and Discharge Referrals (RSD) suite of standards. These provide guidance for electronic information exchange when all or part of patient care is transferred from one health care provider to another as based on HL7 V2.4.DHB of receipt of referral definitionDefinition: The DHB of receipt of referral is the code of the DHB that received the initial referral. Source standards: National Health Index Data Dictionary v5.3 (July 2009).Obligation: Mandatory for the 62 day indicator.Non-mandatory for the 31 day indicator (as the patient may not have been referred with a high suspicion of cancer with a need to be seen within two weeks).Data domain:Valid 3-digit DHB code (refer to DHB of domicile definition).Field Name:DHB_of_receipt_of_referralFormat:NNNGuide for use:On occasion, an individual patient will have multiple referrals. Where a patient has been referred from one DHB to another DHB use the code for the DHB that first received the referral that initiated the treatment for cancer.Date patient informed of diagnosisDefinition: The date the patient was informed of their diagnosisSource standards: HL7 v2.4 DT – date.Obligation: Non-mandatory for all recordsData domain:Valid dateField Name:Date_patient_informed_of_diagnosisFormat:DDMMCCYYGuide for use: N/AFirst multidisciplinary meeting (MDM) date definitionDefinition:Date on which the patient was first discussed at a MDM. Source standards:National Cancer Core Data Definitions Interim Standard HISO 10038.3 October (2011).Obligation:Non-mandatory for all recordsData domain:Valid dateField Name:Date_of_First_MDMFormat:DDMMCCYYGuide for use:N/ADate of Decision-to-treat definitionDefinition:The decision-to-treat is the date when the decision was made for the patient’s treatment plan or other management plan, following discussion between the patient and the clinician responsible for treatment. Source standards:National Health Service Scotland New Cancer Waiting Times Targets Data and Definitions Manual (2010).National Patient Flow File SpecificationObligation:Mandatory for all submitted recordsData domain:Valid dateField Name:Date_of_Decision_to_treatFormat:DDMMCCYYGuide for use:Where there are two possible dates, the earliest date applies. When a patient has been discussed in a MDM, it is in the best interests of the patient that the decision-to-treat discussion with the patient takes place as soon as possible after the MDM.Where decision-to-treat is not routinely collected, the date that a booking request for treatment is made can be used as a surrogate for decision-to-treat. The National Patient Flow collection requires outpatient attendance outcome decision to be reported. The date that this is recorded is to be used in the first instance. Where there is no outpatient attendance outcome decision recorded then the following dates can be used as date of decision-to-treat (for the associated treatment type)Surgery - Date booking for surgery was requestedChemotherapy / Radiotherapy (or concurrent) - Date chemotherapy or radiotherapy booking was requestedTargeted therapy - Date prescription was writtenNon – intervention management – date the decision of non-intervention management was recorded in the patient’s recordBest supportive care – date referral was writtenPatient declined treatment – date of outpatient visit Patient died – date of deathDate of first treatment definitionDefinition: The date for first treatment is the date that the first treatment was provided for that patient for that cancer. Source standards: HL7 v2.4 DT – date.Obligation: Mandatory for all submitted recordsData domain:Valid dateField Name:Date-of_First_TreatmentFormat:DDMMCCYYGuide for use:The date of first treatment is the date the first treatment was provided or attempted but not carried out or completed for clinical reasons. For example ‘open and shut surgery’ would be coded under 01 surgery.Where a patient’s diagnostic biopsy is included as first treatment, because the whole tumour has been removed and the margins are clear, the date of the biopsy is the date of first treatment.Where first treatment is targeted therapy – hormone therapy, the date of first treatment is considered to be the date the prescription is written for the treatment.Where the treatment is ‘best supportive care’ and there is a referral to a palliative or supportive care service outside the DHB, the date the referral was written can be used as date of first treatment.If a patient dies before treatment occurs, the date of death is used as the date of first treatment.Where first treatment is an ethically approved clinical trial, the date of first treatment is considered to be the date the patient consents to be put forward for the clinical trial.Note that the following treatments could have the same date as the date of decision-to-treat:Non-intervention managementBest supportive carePatient declined treatmentTargeted therapy.Type of first treatment definitionDefinition:The type of first treatment is defined as the treatment or other management that attempts to begin the patient’s first treatment, including palliative care or non-intervention management.Source standards:Based on the: National Cancer Core Data Definitions Interim Standard HISO 10038.3 October (2011).National Health Service Scotland New Cancer Waiting Times Targets Data and Definitions Manual (2010).Obligation:Mandatory for all submitted recordsData domain:ValueMeaning00Other01Surgery: exclude diagnostic procedures such as punch, incisional, needle or core biopsy02Radiation therapy03Chemotherapy04Targeted therapy: refers to a medication / drug that targets a specific pathway in the growth and development of a tumour05Non-intervention management: an expectant or observational approach pending change in the patient’s circumstances. It is a period of active management not unmanaged non-treatment06Palliative care (including best supportive care): covers the essential services provided to patients that are not surgical, chemotherapy or radiotherapy based. These are likely to be delivered by staff trained in delivering palliative and/or supportive care. The care maybe delivered in the patient’s home or in a palliative care setting.07Patient declined treatment08Patient died before treatment09Concurrent radiation therapy and chemotherapy10Clinical trial: where a patient is being treated as part of a clinical trial, irrespective of modality of treatment99Not recordedField Name:Type_of_First_TreatmentFormat:NNGuide for use:Patients should be included if first treatment is attempted but not carried out or completed for clinical reasons. For example ‘open and shut surgery’ would be coded under 01 surgery.A diagnostic biopsy should only be included as first treatment when the whole tumour has been removed and the margins are clear.Where the treatment is a ‘decision not to treat’ the record should be allocated the most appropriate of either the ‘best supportive care’ or ‘non-intervention management’ codes.Concurrent radiation therapy and chemotherapy refers to where both radiation and chemotherapy are given simultaneously. This is distinct to when both are given in sequence where a course of chemotherapy is followed by a course of radiotherapy (or vice versa).DHB of service for first treatment definitionDefinition: The DHB of service for first treatment is the code of the DHB that provided the patient’s first cancer treatment.Source standards: National Health Index Data Dictionary v5.3 (July 2009).Obligation: Mandatory for all submitted recordsData domain:Valid 3-digit DHB code (refer to DHB of domicile definition).Field Name:DHB_of_First_TreatmentFormat:NNNGuide for use:This is the DHB that provided the first treatment recorded in the type of first treatment field. Where first treatment is a clinical trial, the DHB of first treatment is considered to the DHB where the patient was enrolled in the clinical trial.Where first treatment is targeted therapy – hormone therapy, the DHB of first treatment is considered to be the DHB where the prescription is written for the treatment.Source of referral definitionDefinition:The source of the referral is defined by the facility / health professional that made the referral.Source standards:National Health Service Scotland New Cancer Waiting Times Targets Data and Definitions Manual (2010).Obligation:Non-mandatory for all recordsData domain:ValueMeaning00Other 01Primary care clinician / practice02Primary dental clinician / practice03Accident and medical / after-hours04Emergency department05Other hospital department06Other hospital07Private specialist / hospital08National screening programme09UnknownField Name:Source_of_ReferralFormat:NNSCAN definitionDefinition:Clinician defined suspicion of cancerSource standards:National Patient Flow documentation as at 28 February 2014Obligation:Mandatory for the 62 day indicator. Non-mandatory for the 31 day indicator (as the patient may not have been referred with a high suspicion of cancer).Data domain:ValueMeaning10The patient had a confirmed diagnosis of cancer at triage20There is not a high suspicion of cancer30There is a high suspicion of cancerField Name:SCANFormat:NNGuide for use:If set to ‘10’ this indicates that the patient already had a confirmed pathological diagnosis of cancer at the point of triage. If set to ‘20’ this indicates that the patient was triaged as not having a high suspicion of cancer. If set to ‘30’ this indicates that the patient was triaged as having a high suspicion of cancer. These decisions are at the discretion of the triaging clinician.If not captured by the DHB, then set ‘30’ as default for all records where you wish the 62 day indicator to be calculated.2W definitionDefinition:The triaging clinician has assessed that the patient needs to be seen within two weeks of the initial referral.Source standards:Obligation:Mandatory for the 62 day indicator Non-mandatory for the 31 day indicator (as the patient may not need to be seen within two weeks).Data domain:ValueMeaning0No1YesField Name:2W_flagFormat:NGuide for use:If set to ‘1’ this indicates that the patient was triaged as needing to be seen within two weeks. This decision is at the discretion of the triaging clinician.A DHB may be able to derive this flag from the optimal date of assessment field described in the draft National Patient Flow file specification document (as at February 2014).Otherwise if not captured by the DHB, then set ‘1’ as default for all records where you wish the 62 day indicator to be calculated.Delay code definitionDefinition:When the time taken for a patient to track through the patient pathway is outside the time identified for the indicator the main reason for the delay must be reported. There is a separate delay code for each indicator, stored in two individual fields representing the two indicators, as required.Source standards:Obligation:Non-mandatory for all records.Only include where there was a delay for that particular indicator.Data domain:ValueMeaning1Patient reason (chosen to delay)2Clinical consideration (co-morbidities)3Capacity constraint (resulting from lack of resources (theatre, equipment, facilities or workforce) or process constraint including administrative errors)Field Names:Delay_code_62Delay_code_31Format:NGuide for use:This field should be used to indicate the reason why the timeframe was not met. The main reason for delay is the reason that contributed to the longest delay, or if there are two delays of equal length, use the first delay that occurred.Although this field is currently non-mandatory, DHBs are encouraged to report this information for all records that exceed the indicator timeframes. It is intended that reporting of this field becomes mandatory in the future. The situation will be reviewed in early 2015. If a record contains the fields to enable both the 62 day indicator and the 31 day indicator to be calculated, and both of the indicator timeframes have been exceeded, both the delay_code_62 and delay_code 31 fields should be completed for that record.Extract file requirementsBatch file name The file naming convention used to supply batches to the FCT database must consist of the following elements:three-letter acronym allocated to each sending agency by the Ministry (see Appendix A for a list of the acronyms)sequential number to uniquely identify each batchfile extension allocated by the Ministry (‘.fct’ for FCT database upload files).For example, a typical file name for Capital Coast District Health Board would be ‘CCH00001.fct’.Batch file format The file is in ASCII format, where:only ASCII characters 32 through 127 (except for 34) are permittedrecords are delimited by carriage return and line feed (ASCII 13 and ASCII 10)fields are variable in length and delimited by the pipe “|” character.Null fields If a field is not mandatory and no data is being sent, a field delimiter must be present. Dates, partial dates and date timesDates are DDMMCCYY unless otherwise specified Partial dates are not permittedDates are sent as charDates must be formatted with leading zeros.Batch processingBatch process overviewThe FCT data collection is the responsibility of the provider (submitting DHB). The provider is to set up and maintain batch processes to supply the data to the Ministry via secure FTP. The Ministry will send an acknowledgement of the data processing via an e-mail. The Ministry validates and loads data, and reports from the database.Batch send processThis section describes batch reporting, which will be carried out on a monthly basis. The data should reach the Ministry within 20 days after the end of the month in which the patient’s first treatment took place.Creating the FCT batch (input) fileThe provider extracts data from their local FCT repository into a batch file (also known as the input file) to send to the Ministry. Each input file must contain a header record and an unlimited number of event details records. All fields should be pipe mas, carriage returns or other formatting must not appear in any field. (however, commas are allowed in text fields but not carriage returns or other formatting).Text fields should not be in quotes.No leading or trailing spaces are permitted unless otherwise stated. Header recordFieldTypeFormatMNotesrecord typeChar 6A (6)M‘HEADER’file nameChar 12A (12)MIncluding .fct extensionnumber of recordsIntegerMThe number of records, including the header, in the file eg, 23456date sentDate 8DDMMCCYYMMust be a valid date and must be on or before the current datefile versionChar 5ANN.NMMust be ‘V02.0’ if using the specifications set out in this document. All files must be V02.0 for patients who are treated on or after 1 July 2014, as V01.0 files will not be accepted after this time.Records for patients with a date of first treatment prior to 1 July 2014 can be sent using either of the V01.0 or VO2.0 formats – both will be loaded into the FCT database.FCT event record FieldTypeFormatNotesRecord_TypeTextA(6)‘ADD’,’UPDATE’ or ‘DELETE’ (‘A’, ‘U’ or ‘D’ also accepted)NHI_NumberTextAAANNNNFirst_NameTextA(50)Optional – DHB choice to includeFamily_NameTextA(50)Optional – DHB choice to includeDate_of_BirthDate/TimeDDMMCCYYSexTextA(1)DHB_of_DomicileIntegerNNNDate_of_DiagnosisDate/TimeDDMMCCYYPrimary_SiteTextANNDate_of_Receipt_of_ReferralDate/TimeDDMMCCYYDHB_of_Receipt_of_ReferralLong IntegerNNNDate_Patient_Informed_of_DxDate/TimeDDMMCCYYDate_of_First_MDMDate/TimeDDMMCCYYDate_of_Decision_to_TreatDate/TimeDDMMCCYYDate_of_First_TreatmentDate/TimeDDMMCCYYType_of_First_TreatmentIntegerNNDHB_of_First_TreatmentIntegerNNNSource_of_ReferralIntegerNNSCANIntegerNNClinician defined suspicion of cancer2W_flagIntegerN2 week flag Delay_Code_62IntegerNDelay_Code_31IntegerNAn example of the format of the file is shown below. In this example, Nelson Marlborough DHB (NMH) has submitted four records using the new format (version V02.0). HEADER|NMH00007.fct|5|14032014|V02.0A|ABC1234|Bob|Brown|20011950|M|101|20112013|C21|12112013|101|15112013|2|15112013|20112013|20112013|25022014|2|101|1|1|30|3||D|HIJ1234|Ruth|Red|16101974|F|101|30112013|C50|14112013|121|24112013|4|24112013|30112013|30112013|30112013|3|101|3|1|30|||U|KLM5678|Gary|Green|17042001|M|101|20112013|C61|15112013|111|16112013|5|16112013|20112013|20112013|30112013|4|121|4|1|30|||A|XYZ7890|Betty|Black|24121963|F|101|20112013|C50||||||20112013|20112013|30122013|5|101|5|0|20|||3Sending the batch to the Ministry The batch file is sent to the Ministry via secure FTP.Quarterly or monthly files are placed on the Ministry’s FTP server following the same mechanisms and software currently used when providing files for similar collection processes (eg, National Minimum Data Set (NMDS) or National Booking Reporting System (NBRS)). For FCT data, a separate directory structure called FCT has been created:\\[dhb]\FCT\ Ministry batch pre-processingPre-processingThe input file is initially pre-processed. This checks that the:batch is in sequencethe count of records in the header equals the actual number of records in the file (including the header record)number of fields per record complies with FCT database requirements.Batch passes pre-processingIf the batch passes pre-processing the data is loaded into the FCT database and an email is generated to indicate how many records have been inserted, updated and deleted.Batch fails pre-processingIf the batch fails pre-processing, an e-mail is generated containing error messages indicating the cause of failure. Load into the FCT database and validate (pre-processing passed)When pre-processing is passed, the batch is loaded into the FCT database.The records are processed as follows:each delete (D) record is applied, removing it from the databaseeach new (A) record is added to the databaseeach update (U) record is processed by first deleting the existing record with the same primary key, and then adding the new “update” record.During the load process, if any record in a batch is found to contain an error, that record will not be loaded.Records with the following errors will not be loaded:if the NHI number is validated against the NHI repository and is not able to be matched, the record will not be loadedif the record is deemed to be a duplicate (based on the primary key of NHI and primary site) the record will not be loadedif the record does not have a date of first treatment, or the date of first treatment is prior to 01 January 2012, or is greater than the load date the record will not be loadedif there is a missing primary site, or the primary site is out of range then the record will not be loaded.Automated return filesDetails to follow.Data quality checksOnce each batch of data is successfully loaded into the FCT database, a series of routine data quality checks are performed, and the results are reported back to the submitting DHB. Examples include checking that:mandatory fields have been completedcodes supplied for each field are within the expected code rangedates are sensible and are in chronological ordera range of tumour groups have been supplieda range of treatment types have been supplieda range of source of referral and delay codes have been supplied.Appendix A: DHB acronyms for file namingDHB 3 letter acronymDHB_DescriptionNHLNorthlandYTMWaitemataAHCAucklandSAHCounties ManukauHYKWaikatoLLHLakesBOPBay of PlentyTRWTairawhitiHBHHawkes BayTHLTaranakiPNHMidCentralGHWWhanganuiCCHCapital and CoastHVHHutt ValleyYRRWairarapaNMHNelson MarlboroughWCOWest CoastCHCCanterburyHSCSouth CanterburySRNSouthernAppendix B: Primary site ICD codesThe ICD codes should be recorded to the third digit for all cancers. The ICD codes to be reported are provided in the following table. Note that D codes are excluded from the FCT indicators because they relate to cancers that are low-risk, or non-invasive, or non-malignant, or low-grade, asymptomatic or indolent.ICD codes to third digitDescriptionCancer site groupEffective dateC00Malignant neoplasm of lipHead and neck01/01/2012C01Malignant neoplasm of base of tongueHead and neck01/01/2012C02Malignant neoplasm of other and unspecified parts of tongueHead and neck01/01/2012C03Malignant neoplasm of gumHead and neck01/01/2012C04Malignant neoplasm floor of mouthHead and neck01/01/2012C05Malignant neoplasm of palateHead and neck01/01/2012C06Malignant neoplasm other and unspecified parts of the mouthHead and neck01/01/2012C07Malignant neoplasms of parotid glandHead and neck01/01/2012C08Malignant neoplasm other and unspecific part of salivary glandHead and neck01/01/2012C09Malignant neoplasm of tonsilHead and neck01/01/2012C10Malignant neoplasm of oropharynxHead and neck01/01/2012C11Malignant neoplasm of nasopharynxHead and neck01/01/2012C12Malignant neoplasm of pyriform sinusHead and neck01/01/2012C13Malignant neoplasm of hypopharynxHead and neck01/01/2012C14Malignant neoplasm of other and ill-defined sites in the lip, oral cavity and pharynxHead and neck01/01/2012C15Malignant neoplasm of oesophagusUpper gastrointestinal01/01/2012C16Malignant neoplasm of stomachUpper gastrointestinal01/01/2012C17Malignant neoplasm of small intestineUpper gastrointestinal01/01/2012C18Malignant neoplasm of colonLower gastrointestinal01/01/2012C19Malignant neoplasm of rectosigmoid junctionLower gastrointestinal01/01/2012C20 Malignant neoplasm of rectumLower gastrointestinal01/01/2012C21Malignant neoplasm of anus and anal canalLower gastrointestinal01/01/2012C22Malignant neoplasm of liver and intrahepatic bile ductsUpper gastrointestinal01/01/2012C23Malignant neoplasm of gallbladderUpper gastrointestinal01/01/2012C24Malignant neoplasm of other and unspecific parts of biliary tractUpper gastrointestinal01/01/2012C25Malignant neoplasm of pancreasUpper gastrointestinal01/01/2012C26Malignant neoplasm of other and ill-defined digestive organsLower gastrointestinal01/01/2012C30Malignant neoplasm of nasal cavity and middle earHead and neck01/01/2012C31Malignant neoplasm of accessory sinusesHead and neck01/01/2012C32Malignant neoplasm of larynxHead and neck01/01/2012C33Malignant neoplasm of tracheaLung01/01/2012C34 Malignant neoplasm of bronchus and lungLung01/01/2012C37 Malignant neoplasm of thymusOther01/01/2012C38Malignant neoplasm of heart, mediastinum and pleura, heartLung01/01/2012C39Malignant neoplasm of other and ill-defined sites in the respiratory system and intrathoracic organsLung01/01/2012C40Malignant neoplasm of bone and articular cartilage of limbsSarcoma01/01/2012C41Malignant neoplasm of bone and articular cartilage of other and unspecific sitesSarcoma01/01/2012C43Malignant melanoma of skinSkin01/01/2012C45MesotheliomaLung01/01/2012C46Kaposi’s sarcomaSarcoma01/01/2012C47Malignant neoplasm of peripheral nervous and autonomic nervous systemBrain/CNS01/01/2012C48Malignant neoplasm of retroperiotneum or peritoneumSarcoma01/01/2012C49Malignant neoplasm of other connective or soft tissueSarcoma01/01/2012C50Malignant neoplasm of breastBreast01/01/2012C51Malignant neoplasm of vulvaGynaecological01/01/2012C52Malignant neoplasm of vaginaGynaecological01/01/2012C53 Malignant neoplasm of cervix uteriGynaecological01/01/2012C54Malignant neoplasm of corpus uteriGynaecological01/01/2012C55Malignant neoplasm of uterus, part unspecifiedGynaecological01/01/2012C56Malignant neoplasm of ovaryGynaecological01/01/2012C57Malignant neoplasm of other and unspecified female genital organsGynaecological01/01/2012C58Malignant neoplasm of placentaGynaecological01/01/2012C60Malignant neoplasm of penisUrological01/01/2012C61Malignant neoplasm of prostateUrological01/01/2012C62Malignant neoplasm of testisUrological01/01/2012C63Malignant neoplasm of other and unspecified male genital organsUrological01/01/2012C64Malignant neoplasm of kidney, except renal pelvisUrological01/01/2012C65Malignant neoplasm of renal pelvisUrological01/01/2012C66Malignant neoplasm of ureterUrological01/01/2012C67Malignant neoplasm of bladderUrological01/01/2012C68Malignant neoplasm of other and unspecified urinary organsUrological01/01/2012C69Malignant neoplasm of eye and adnexaBrain/CNS01/01/2012C70Malignant neoplasm of meningesBrain/CNS01/01/2012C71Malignant neoplasm of brainBrain/CNS01/01/2012C72Malignant neoplasm of spinal cord, cranial nerves and other parts of central nervous systemBrain/CNS01/01/2012C73Malignant neoplasm of thyroid glandHead and neck01/01/2012C74Malignant neoplasm of adrenal glandOther01/01/2012C75Malignant neoplasm of other endocrine glands and related structuresOther01/01/2012C76Malignant neoplasm of other and ill-defined sitesOther01/01/2012C80Malignant neoplasm without specification of siteOther01/01/2012C81Hodgkin’s diseaseHaematological01/01/2012C82Follicular lymphomaHaematological01/04/2014C83 Diffuse non-Hodgkin’s lymphomaHaematological01/01/2012C84Peripheral and cutaneous T-cell lymphomasHaematological01/01/2012C85Other and unspecified types of non-Hodgkin’s lymphomaHaematological01/01/2012C86Other specified types of T/NK-cell lymphomaHaematological01/04/2014C88Malignant immunoproliferative diseasesHaematological01/01/2012C90Multiple myeloma and malignant plasma cell neoplasmsHaematological01/01/2012C91Lymphoid leukaemiaHaematological01/01/2012C92Myeloid leukaemiaHaematological01/01/2012C93Monocytic leukaemiaHaematological01/01/2012C94Other leukaemia of specified cell typeHaematological01/01/2012C95Leukaemia of unspecified cell typeHaematological01/01/2012C96Other and unspecified malignant neoplasms of lymphoid, haematopoietic and related tissueHaematological01/01/2012 ................
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