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ISH_IT_HCM_SSN_CUST - IT: SDO Customizing

ISH_IT_HCM_SSN_CUST - IT: SDO Customizing

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This Customizing activity is relevant for the country version Italy only.

Procedure for Implementing Customizing for Data Exchange with the National Healthcare System (SSN) in Italy, especially the Hospital Discharge Report (SDO)

The 'Hospital Discharge Report' is made of a set of files that can be different from Region to Region, due to the Italian Regional Healthcare System.

SAP only provides fields for the file formats valid on a national basis for the 'Hospital Discharge Report'. They can be reused as examples for region-specific implementations. Since the file content can vary over time due to legal changes, the version concept is used.

In particular SAP pre-delivers:

  • A specific EDI Procedure with the name 'SDO'. An EDI procedure specifies a communication procedure which is supported by electronic data interchange in the Patient Management System. You can display available EDI procedures with the transaction ONG1.
  • A communication standard named 'SDO' with version '0.1' as an example, containing all fields relevant for all of Italy. The communication standard represents the set of external communication files. The version number starts with '0.1' and allows for future versions that might be released due to legal changes relevant for all of Italy. Please note that the EDI procedure 'SDO' and communication standard 'SDO' have the same name, but are different entities.
  • A transaction 'NSDO', available from the SAP Easy Access Menu path Hospital -> Communications -> EDI -> Hospital Discharge Report (SDO) that produces the communication files for a set of cases.

What else can you do?

  • Define your own communication standard with the name 'Z*' (for example: 'ZSDO') which must be assigned to the SAP-provided EDI procedure 'SDO' in order to be used for the 'Hospital Discharge Report'.
  • Check how the delivered communication standard 'SDO' is defined, by using the transaction ONCEDI8 (Report RNCEDIC1) or via the IS-H: Communication Menu (Transaction NM44 -> Communication -> Message -> Structure Tree). All Message Types with assigned Message Segments are listed. Two kinds of message segments are available: header segments and item segments. To each segment one or more Segment Fields are assigned. Each segment field has specific attributes, such as a technical name, a length and a comment (description).
  • An elaboration of the above step is as follows: The communication standard represents the set of external communication files. One single message type represents a single external communication file like SDO1 or SDO2. A message segment represents one line type inside the external file. The header segment represents the header line of every external SDO file, which contains, for example, the number of how many item lines are in the file. The item segment represents a line for every SDO record. Every segment field represents a single value in line of the external file, for example, the birth date of a patient or the main diagnosis code.

In order to represent the regional file format (specific to regions in Italy), the following steps must be followed:

  1. Create your customer specific communication standard, including a version

Definition:In Italy different regions have different file formats; therefore specific communication standards are expected to be created for each region. Here you can define each one needed in the system. For example, if you have two institutions, one belonging to the Lombardia region and another belonging to the Puglia region, you must create two communication standards, one for each region.
How to:Via the IS-H: Communication Menu (Transaction NM44 -> EDI -> EDI Procedure -> Basics -> Maintain Communication Standard) or directly via the transaction ONG0 (Maintain Communication Standard). For example, you create the communication standard with the name 'ZSDO' and the version '0.1'.
Hints:A good starting point for this is to look at how the SAP-delivered communication standard 'SDO' is defined. Other attributes of the communication standard definition such as 'Comment' and 'Standard body' are respectively optional or unused.

  1. Create a Data Collection Point (DCP)

Definition: In CV Italy, a data collection point is needed to define a name for the Authority collecting files such as the SDO. For example, one hospital needs to report to its ASL of reference, so one DCP needs to be created.
How to: Via the IS-H: Communication Menu (Transaction NM44 -> EDI -> Data Collection Point -> Master Data) or directly via the transaction ONCZ (Data Collection Point Master Data). Only the technical key and optional description text is used. For example, your Data Collection Point can be 'ASL301' and the description 'ASL Bergamo'. The Data Collection Point is required in the Customizing activity Validity of the version (communication standard).
  1. Assign your Data Collection Point to an Insurance Provider

Definition: Here you can assign an insurance provider to the data collection point. For example, you assign the ASL of the institution which receives the files and is created in the system as an Insurance Provider to the data collection point. The hospital reports the SDO files to the ASL that is responsible for the hospital, and pays for the cases sent in the file.
How to:Via the IS-H: Communication Menu (Transaction NM44 -> EDI -> Data Collection Point -> Insurance Provider Assigment) or directly via the transaction ONCEDI5 (Assign Data Collection Point to an Insurance Provider). The insurance provider must be the same insurance provider which represents the ASL of the institution in the Customizing activity Create an institution. With this assignment the Data Collection Point in the Customizing activity Specify Validity of Version (P301 and Other Communication Procedures) is identified.

  1. Assign Communication Standard and Version validity

Definition:Here you can assign the valid file format for a given period to an institution. The reference date is the discharge date of a case. For example: institution 1 is assigned to the Lombardia region file (communication standard ZSDO) and to the correct ASL of the institution itself (DCP). You must also enter an owner code that represents the owner of a message type. SAP standard message types start with the owner code 'S', while customer-specific owner codes start with, for example, 'Z'.
How to:Using the Customizing activity for SAP Healthcare - Industry-Specific Components for Hospitals -> Communication -> Electronic Data Interchange -> Set Up Data Collection Points -> Specify Validity of Version (P301 and Other Communication Procedures).
Hints: In this step you can assign:
  • Different versions of a communication standard to a time period. This maps the different file format for a given region at a specific time, as the file format can vary over time due to legal changes in Italy. To support this step, you can use the SAP standard report RNCTT_STANDVERSION_COPY which copies customizing from an existing version of a communication standard to a new version (having additional fields for the different file format).

  • Different communication standards for different institutions. This supports the customizing of different file formats for different regions.

  • A new Data Collection Point (ASL), if it changes in time, for the EDI procedure 'SDO'.

You must enter values for all of the following fields:
  • Institution: 0001

  • Data collection point: ASL301

  • Valid from: 01.01.2007

  • Valid to: 31.12.2007

  • Communication standard: ZSDO

  • Communication version: 0.1

  • Message Type Owner Code: ZI

  1. Message Type definition
Definition: Here you can assign the set of SDO files (for example 'SDO1', 'SDO2', and 'SDO3') to the communication standard and version. In the 'Hospital Discharge Report', all customized message types inside a used communication standard which begin with the name "SDO" (Type attribute: Message Type) are created as separate files.
How to: You can create or change message types with the transaction ONC1 (Maintain Message Types)
Hints:
  • The owner code must be the same as previously used.
  • You can also define message types for answer messages from the ASL. The only restriction is that the name should not begin with 'SDO'.

  1. Message Segment definition

Definition: Here you can define the segments (header/item) for each SDO file. For instance, for the Lombardia region, items are required but headers are not. Hence, only three entries are needed: one for each file (SDO1 item, SDO2 item, SDO3 item).
How to: You can create or change message segments with the transaction ONC3 (Maintain Message Segments).
You can assign message segments to message types with the transaction ONCA (Message Type-Segment-Assignment).
Hints:
  • The owner code must be the same as previously used.

  • A header segment with the checkbox Indicator for Header Segment marked is used as a summary line in the external SDO files.

  • An item segment with the checkbox Indicator for Header Segment unmarked is used for the specific SDO records in the external SDO files.

  1. Message Field definition

Definition: Here you can define the association between each file and the related sequence of fields.
How to: You can create or change message fields with the transaction ONC8 (Maintain Message Fields).
You can assign message fields to message segments with the transaction ONCC (Message Segment-Field-Assignment).
Hints:
  • Important attributes to enter are: field Field Name (with FDNAM as technical identifier)) with the field name to be used for the SDO files, field Field Name (with FDBEM as technical identifier) with a description of the attribute in the User Interface, and field Field Name in Database Reference section (with FDDBF as technical identifier) with a reference to the structure RNSDO_HEADER (for header fields) or structure RNSDO_ITEM (for item fields).

  • If not changed later, during the assignment of a field to a segment, the original length of a field is used for file creation.

  • Enter the field description texts only in the logon language. Follow the menu 'Goto -> translation' to provide a translation in different languages.

  1. Append new fields to RNSDO_HEADER or RNDSO_ITEM for region (customer) specific fields

Definition:You can add regional (customer) specific fields to the structures RNSDO_HEADER or RNSDO_ITEM. This is essential to add fields that are required for a specific region in Italy. For example, you can add the field 'Healthcare identifier of the mother' (which is not in the SAP Standard) here.
How to: You can create an append structure with customer-defined fields with the transaction SE11 (ABAP Dictionary).
Hints:
  • The values for the SAP Standard field in RNSDO_HEADER and RNSDO_ITEM are filled by SAP.

  • The region (customer) specific fields can be filled by the BAdI ISH_SDODATA_FILL.

  1. Implement the Business Add-Ins provided by SAP

  • Implement BAdI ISH_SDODATA_FILL to fill in values for region (customer) specific fields

Definition: You can implement the logic to fill region (customer) specific fields.
How to: with the Customizing activity for SAP Healthcare - Industry-Specific Components for Hospitals -> Communication -> Electronic Data Interchange -> Country Specifics -> Country-Specifics for Italy -> SDO Report -> Business Add-Ins for SDO Report -> IS-H: Fill SDO Data for Customer Specific Fields.
Hints:
  • To optimize the access to database (in case you need additional data which is not available in the BAdI interface) you can try to use the same function modules (normally buffered) which are used within the function module 'ISH_SDOITEM_GETDETAIL'. For example, ISH_NBEWTAB_READ for selection of movements.

  • If a regional (customer) field in IS-HCM customizing is created with database reference field (see step 8) as the RNSDO_ITEM structure field, the value of the RNSDO_ITEM field filled by the system or the user in the ISH_SDODATA_FILL BAdI is copied automatically in the file by the system and passed to ISH_SDODATA_FORMAT BAdI.

  • Implement BAdI ISH_SDODATA_CHECK to check plausibility of values

Definition:You can run checks for the availability and plausibility of values in the structures RNSDO_HEADER and RNSDO_ITEM.
How to: With the Customizing activity for SAP Healthcare - Industry-Specific Components for Hospitals -> Communication ->Electronic Data Interchange -> Country Specifics -> Country-Specifics for Italy -> SDO Report -> Business Add-Ins for SDO Report -> IS-H: Perform Checks on SDO Data.

  • Implement BAdI ISH_SDODATA_FORMAT to format values

Definition:You can implement region (customer) specific conversions of fields in SAP format in the structures RNSDO_HEADER and RNSDO_ITEM to a legally needed SDO file format.
How to: With the Customizing activity SAP Healthcare - Industry-Specific Components for Hospitals -> Communication -> Electronic Data Interchange -> Country Specifics -> Country-Specifics for Italy -> SDO Report -> Business Add-Ins for SDO Report -> IS-H: Change SDO Record Data for a File Format.
Hints:
  • SAP standard fields and region (customer) specific fields are already converted into SDO file format. However, you can still change the standard conversion to a region (customer) specific conversion format here.

  • If a regional (customer) field in IS-HCM customizing is created without a database reference field, the field value is empty and must be filled by the user in the ISH_SDODATA_FORMAT BAdI. Note that the check for these fields cannot be carried out in ISH_SDODATA_CHECK BAdI.

  1. Define customizing for status management in 'Hospital Discharge Report'
  • External communication status
Definition:You can define the values of the external communication status (that means the status for the receiver) of a record to be sent. It represents whether or not the record is sent for the first time to the receiver, or if it is to be updated or cancelled from the archive of the receiver.
How to: Via the IS-H: Communication Menu (Transaction NM44-> EDI -> EDI Procedure -> Define Status -> Communication Status) or directly via transaction ONCEDI3.
Hints:
  • Example:

External: I Assigned to Internal: F (First submision)
External: C Assigned to Internal: A (Amendment)
External: A Assigned to Internal: C (Cancellation)

  • Internal (User) status
Definition:You can define the internal (user) status (the status for the hospital) of an SDO record. You can set up the system in such a way that only some cases are considered ready for SDO reporting, or that only some users can modify data of a case after discharge.
How to: Via the path "Define Status Profiles" or directly via transaction BS02.
Hints:
  • Example:

NOTS Not Sent
NOTP Not to be Processed
RERR Record with Error
CONF Confirmed (for Transmission)
SENT Sent, to be Authorized
SENA Sent and Authorized
SENN Sent and Not Authorized
CON2 Confirmed Again Errors Corr.

  • There are many points (transactions) in the systems where you can assign a status to a case depending on the customizing settings in"> Maintain Status Profiles Used for Medical Documentation". For example, when you maintain the "Diagnoses" via transactions NP61 or NV2000, the system shows the internal code (for example, "E0004" Confirmed for transmission) in the sub-screen for maintaining status. You can change the status for the case here and this is assigned as the internal status.

  • The internal (user) status is used as selection criteria in the 'Hospital Discharge Report', and is updated according to the Customizing activity for SAP Healthcare - Industry-Specific Components for Hospitals under Medical/Nursing Documentation -> Basic Medical Documentation Status Management -> Define Status Profiles, or directly via transaction BS02, after it is run in effective mode.

  • To avoid error messages in case revision (reassignment of outpatient visit to inpatient case), the customizing of the status for the status profile 'ISHCVIT0' should be carried out via " Define Case Revision Settings". In order to enable case revision, the status for case revision should be compatible with the one for inpatient cases.

  1. Define External codes for Organizational Units

Definition:If you follow the steps below, the 'Hospital Discharge Report' handles the external representation (4 digit code) of the nursing units in which a patient has been during his stay. External codes for units are used in the SAP communication standard 'SDO' for the fields Admission Unit, Discharge Unit, Transfer Unit 1, Transfer Unit 2 and Transfer Unit 3.
How to:
  • Define Specialty Categories
Use the Customizing for SAP Healthcare - Industry-Specific Components for Hospitals -> Hospital Basic Data -> Hospital Structure -> Organizational Structure -> Define Specialty Categories or transaction ON74. The field Category of Specialty Key must be filled with the value "A" (Free for user). "A" is used as the identifier in the communication with the SSN. The description and the keyword can be anything you choose (for example, SDO). The position is used for later maintenance of the specialty code values via transaction NB20 (Create Org. Unit).
  • Code Specialties
Use the Customizing for SAP Healthcare - Industry-Specific Components for Hospitals -> Hospital Basic Data -> Hospital Structure -> Organizational Structure -> Code Specialities or transaction ON54. You must define the specialties values for the specialty category "A". The speciality values are the F4 help values for the specialty field in transaction NB20 ( Create Org. Unit).
  • Transaction NB20 (Create Org. Unit)
For every nursing Organizational Unit, the new specialty code must be assigned with this transaction.

CON2

Reading the history of SDO records

In order to view the complete history of a SDO record, you can execute the function module ISH_NCSSN_GETLIST for a case or SSNID (SDOID), which is designed for the internal reading of data from the database in the first run. In future releases, an output as a structured table according to the version and communication standard at the time of the record creation will be delivered.

Retrieving SAP values to be used in SDO record

A function module ISH_SDOITEM_GETDETAIL is available which can be used to retrieve the SAP values of the fields to be used in the SDO record for a list of cases. It is also used to retrieve the communication standard, version and the header details to be used in the process of SDO file creation.

EDI Utility Report

There is a utility program in the IS-HCM framework, RNCTT_STANDVERSION_COPY, which you can use to copy a communication standard with version "X" to a new version "Y". It is currently not possible to copy a whole communication standard.

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