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In order to provide all stakeholders in the NNPAC project a view of the questions being raised, a list of all the questions received will be collated and published (anonymously) on this web site on a regular basis, and an e-mail sent to the e-mail usergroup to advise when this is done.

Question: Point 6.1 has a paragraph mentioning “the source system”. What is this? It is not mentioned in the file specification Header or Event Record.

Answer: ‘Source system’ should say ‘extract system’.

Question: What format will the "extract system ID" be? Will each DHB have one for production and one for compliance? For example, WCDHBPROD and WCDHBCMPL?

Answer: The extract system ID can be any string of upper-case alphabetic characters. It needs to be agreed between the DHB and NZHIS, but it would be useful if it started with an acronym for the DHB, eg, AKDHB. Please refer to the NNPAC File Specification for more information.

Question: Will there be one “client system ID” per DHB? Or will there be one per hospital per DHB?

Answer: The number of ‘client system ID’ depends on the number of sets of PMS unique identifiers, as the combination of client system ID and PMS unique identifier has to be guaranteed to be unique. Therefore each system that creates PMS unique identifiers should have its own client system ID. Please refer to the NNPAC File Specification for more information.

Question: The document says that NNPAC will store “non-admitted face-to-face secondary care events, such as outpatient and emergency department visits.” Does this include visits such as Physiotherapy and Occupational Therapy visits in the hospital? Or District Nursing and Home Help visits? Really, should any Community or Allied Health visits be included?

Answer: The definition of a non-admitted patient for the purposes of NNPAC is outlined below.
A non-admitted patient service is:

• a publicly funded service (defined as paid for from Vote Health or under the Injury, Prevention, Rehabilitation and Compensation Act 2001) that is provided by a health practitioner (as defined by the Health Practitioners Competence Assurance Act 2003 and including allied health professionals)
• a service based on acceptance of a referral (generally by a health practitioner) or provided in an Emergency Department or other self-referral accepting department
• a service provided by, on behalf of, or contracted by, the provider arm of a DHB where information about that service is collected at an individualised level.

The following services are excluded from the definition:

• primary care
• rest home or other long-term residential care
• Mental Health services and inpatient care (as defined by NMDS).

For Phase 1A (ie, the elements requested by 1 July 2006), only Medical, Surgical and Emergency Department service information (purchase units) are requested. The mandatory elements for latter phases have not yet been confirmed.

Question: The other NZHIS reporting requirements (MHINC, NMDS and NBRS) have details in the Header Record such as “Date Sent/Extracted” and “File Version Number”. Will these be included in NNPAC now or in the future?

Answer: It is not intended to include those fields.

Question: In the file specification the field “facility code” is mandatory, but only allowed if “location type” is ‘Hospital Facility’. What happens if the “location type” is not a ‘Hospital Facility’? How do we send a mandatory field for this scenario?

Answer: Where the location type is 1, 2 or 3, then this must contain a valid facility code. Where the location type is not 1, 2 or 3, then if a facility code exists for the location then it may be included. Where the location type is not 1, 2 or 3 and no facility code exists for the location, then this will be null.

Question: Can you please explain what the “volume” field is to be used for? It says “not the number of events but the number of purchase units”; what does this mean? Is this explained in the NNPAC Data Dictionary?

Answer: The volume field relates to the unit of measure of the Purchase Units. This information is found in the Nationwide Service Framework (NSF) Data Dictionary. As an example, the unit of measure for some Purchase Units is ‘Procedures’. For others (eg, M30008 Haemophilia – Factor IX) the measure is international units. These volumes may be greater than one. Please refer to the NNPAC File Specification for more information.

Question: In the other NZHIS extracts (NMDS, NBRS) the fields such as ‘number of records’, ‘batch number’, ‘PMS unique identifier’ are all fixed length and zero-filled. From how I read the file specification this is not the case for NNPAC. Please confirm.

Answer: These fields are not fixed length and are not zero-filled, but as they are all mandatory they must have something in them. Do not add leading or trailing spaces to pad out the field to fixed length. Please refer to the NNPAC File Specification for more information.

Question: In the other NZHIS extracts (NMDS, NBRS and MHINC) the fields are comma delimited, but in this extract they are bar [pipe] delimited. Is there a reason for this?

Answer: Many other NZHIS extracts, such as those from Healthpac, are pipe (“|”) delimited;. Generally this is safer, as commas are permitted in some fields such as addresses or names, although these do not occur is this system.

Question: What is the “equivalent purchase unit code”? This says “as described in the NSF data dictionary”, can you tell me what the NSF data dictionary is also. And point me in the direction as to where this in on the MOH or NZHIS web sites.

Answer: The NSF Data Dictionary lists all valid purchase units (including inpatient, etc).

Question: Please could you confirm the following definition: Our definition of a pre-admission clinic is a separately booked appointment for a patient with a consultant in a clinic room where the purpose is to medically/anaesthetic assess prior to an elective procedure.

Answer: The definition of PREADM as defined in the NNPAC File Specification is “attendance at a clinic where the purpose is to medically/anaesthetic assess prior to an elective procedure.”

Question: The specs say that you have to submit a facility code where it is a hospital facility (location type Public, Private or Psychiatric). What facility code do we submit where an outpatient clinic occurs at a different DHB facility? We manage the booking and record the attendance but it didn’t occur at our facility (eg, we run clinics at Capital Coast and Hawke’s Bay Hospitals).

Answer: The facility code of the facility where the visit takes place should be used (eg, Hawke’s Bay DHB or Capital and Coast DHB)

Question: What is the zipping format required by NZHIS when transferring NNPAC data files from DHB to NZHIS?

Answer: NZHIS prefer that you don’t zip up the data file. An ‘NNPAC’ folder has been created for each DHB on the FTP server so all NNPAC files should be placed in this directory. Send us an ASCII text file with bar/pipe delimiters and no spaces.

Question: What encryption algorithm should be used for the NHIs in the NNPAC data files?

Answer: The encryption algorithm isn’t required if the data file is sent via the Health Intranet (secure VPN), ie, by using the FTP server. This is secure and is the usual method of data file transfer to NZHIS.

Question: Should an NZHIS resource be notified via e-mail when a NNPAC data file has been sent to NZHIS from a DHB? If so, please provide the name and the e-mail address for this resource.

Answer: When a data file has been sent to NZHIS, please e-mail a notification to operations@moh.govt.nz.

Question: What are the NNPAC validation stages?

Answer: It is a two-stage process – the first checks the file validity and the header record; if these fail the file is rejected. The second check is at the transaction event level. Acknowledgements are sent for accepted records, record identification details and an error message for any rejected records.
For more detailed information on this refer to page 9 of the File Specification.

Question: What is the format of the Error Message file that will be created in the NNPAC directory for DHB to pick up when a file fails pre-processing?

Answer: Instead of an error message being sent on file failure, an e-mail will be generated to the NZHIS Operations team. Before sending anything out to the DHBs, the first step is for our Operations team to check to see if the error was caused by the way we processed the file. If it isn’t, then the second step is to forward the e-mail and error details on to the DHB concerned. Depending on the time constraints an Operations Analyst may call the DHB to go through the error, but it is the DHB’s responsibility to correct the errors and resubmit the file.

Question: What would happen if DHB sends a DELETE record that does not have a matching record previously sent to NZHIS? Would the DELETE record be ignored or sent back as an ERROR?

Answer: If you send a DELETE record with no corresponding record previously sent then this will be returned as an error transaction.

Question: Does the definition of “non-admit” for ED data mean the patient’s status when they are discharged from ED. For example we have Disposition codes that define what happens to a patient when they leave ED. We have one called Treated & Referred where a child will be referred on Departure from ED to say PAU, and from PAU they will then be admitted. Is that a non-ED admit?

Answer: Existing Common Counting rules should be applied to determine when events should be recorded as non-admitted events (in NNPAC) and when they should be inpatient events (NMDS). In general, an admission resulting from an ED attendance should be recorded only in NMDS (ie, is not a non-admitted patient event). The Common Counting group is responsible for confirming the specific rules – refer to your Common Counting representative for clarification on the rules.

Question: Date of Service / Time of Service – Your definition states ‘start of event’ – this is not correct, as an event can be started and can last over a period of time and have many attendances.

Answer: For this phase of the project a non-admitted event is a single event and cannot include multiple events. Note distinction between episode of care and event.

Question: Domicile Code – If you are using the NHI to look up the domicile at time of attendance, why does it need to be sent?

Answer: The file spec explains that this will be used as a data quality test to compare with the NHI domicile code.

Question: Our system will require an upgrade to include 4 or 5 fields you request that we do no collect. Why are they necessary?
a) Service Type – The purchase unit determines whether it is an FSA or follow up, attendance procedure etc.
b) Event Type – The purchase unit determines whether it is Emergency department or outpatient, why then is this required?

Answer: a) It is considered easier to have this field mandatory, rather than by default for (current or future) purchase units that do not reflect this information. The field can also be used for ease of data management (separating out particular types) and for checking purposes.
b) Checking and data management, as above.

Question: Cases coded in NMDS – Please confirm that events that have been sent to NMDS and are in the mandatory purchase unit list are not required in the NNPAC Extract as you already have this data.

Answer: Correct – the scope of NNPAC excludes inpatient (NMDS) events – these should continue to be collected in NMDS.

Question: Why is the ‘Did Not Attend’ being collected for NNPAC?

Answer: DHB feedback was that this information would be useful to capture resource cost that isn’t shown currently.

Question: The preadmission clinic purchase units are not in the mandatory list. Does this mean it is no longer required?

Answer: Correct – the pre-admit PUs are not mandatory for the first phase (we wanted to give sufficient notice as capturing this information is a change from current practice). They will be mandatory for the next phase (commencing July 2007).

Question: Is HSC_HPS ok as the client system identifier?

Answer: Yes.

Question: For appointments that are cancelled, do we treat them as for DNAs, or not include them?

Answer: If the appointment is cancelled prior do not include them. If the patient did not arrive for their appointment, they need to be counted as Did Not Attend (DNA).

Question: If a patient is admitted but is then seen in the clinic do we need to include them in NNPAC?

Answer: If the outpatient clinic visit is for an unrelated condition then the NSF Data Dictionary states that it should be included as an outpatient event.
If it is for the same inpatient condition they should not be included.

Question: Your mandatory list of purchase units includes some that we already send to NMDS (eg, M25004 Gastroenterology – ERCP). Do we need to send these to both NNPAC and NMDS?

Answer: No. These purchase units are only mandatory for NNPAC if you don’t already supply them through to NMDS. So if they are supplied through NMDS then you must not include them in NNPAC as it will lead to double counting. This was mentioned at the workshops, but we may need to highlight it again.

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