$TXT Created by JR at CHEY59.FO-BAYPINES.DOMAIN.EXT (KIDS) on Monday, 12/19/16 at 12:28 ============================================================================= Run Date: MAR 07, 2017 Designation: LR*5.2*468 Package : LR - LAB SERVICE Priority: Mandatory Version : 5.2 SEQ #383 Status: Released Compliance Date: APR 07, 2017 ============================================================================= Associated patches: (v)HDI*1*15 <<= must be installed BEFORE `LR*5.2*468' (v)XU*8*665 <<= must be installed BEFORE `LR*5.2*468' Subject: NATIVE DOMAIN SERVICE Category: - Enhancement (Mandatory) - Routine - Data Dictionary - Input Template Description: ============ The Department of Veterans Affairs (VA) Interagency Program Office (IPO) and the Department of Defense (DoD) is tasked by its charter with leading the Departments efforts "to implement national health data standards for interoperability and be responsible for establishing, monitoring, and approving the clinical and technical standards profile and processes to ensure a seamless exchange of health data." This task of Native Domain standardization is aligned with achieving the goals outlined in the 2014 National Defense Authorization Act (NDAA) requiring that the Departments' "healthcare data are computable in real-time and comply with existing national data standards" and that the "data are standardized as national standards continue to evolve." VA clinicians historically used non-standardized clinical terminologies which are inconsistent within the VA user community as well as within the currently accepted data standards as established by Office of the National Coordinator for Health Information Technology (ONC). Implementation of Native Standardization will allow a streamlined method for data sharing, performing clinical decision support and engaging in national data reporting and analysis. The VA has recently established a process for implementing standard terminology/terminologies within individual clinical domains for the exchange of data. The intent of this effort is to provide the detailed groundwork necessary for industry-wide interoperability. By providing a detailed analysis of the current state of the applicable domains and recommendations regarding the path forward, the Native Domain Standardization supports VA's efforts to remain at the forefront of healthcare data exchange. The system will include the addition of new fields to the LABORATORY TEST file (#60) and creation of the MASTER LABORATORY TEST file (#66.3) (MLTF). The local facility Laboratory Information Manager(LIM) will need to associate the local tests/specimen in LABORATORY TEST file (#60) to Gold Names in MASTER LABORATORY TEST file (#66.3). It will be necessary to develop a national standard of Laboratory Tests and map them to their respective Logical Observation Identifiers Names and Codes (LOINC Code). The MASTER LABORATORY TEST file will be populated under the direction of the VHA Laboratory Program Office prior to implementation of any of the data within these files. The objective of this process is to enable the most user friendly interface possible in the implementation of the native standardization along with the activities required to operationalize the change within the VistA environment and the associated terminology consuming applications. The Laboratory LIM will match each active test/specimen entry in the LABORATORY TEST file (#60) to an entry in the MASTER LABORATORY TEST file (#66.3) (MLTF). This is all that is required outside the normal day-to-day operations. When a specimen is processed the Laboratory system does a LOINC Code lookup. This enhancement has added logic to the lookup, that if the (#60) file specimen and test is identified and if the (#60) file test/specimen are associated to the MLTF (#66.3) then the MLTF LOINC Code is used. If the (#60) file specimen and test are not identified or if the (#60) file test/specimen is not associated to the MLTF, then the LOINC Code determining logic that is currently in place will be used. The impact of this enhancement will be on the LIM, who has to associate LABORATORY TEST (#60) test/specimens to the MLTF. When a new Test/Specimen is entered into the LABORATORY TEST file (#60) an email is automatically sent to the NEW TERMINOLOGY RAPID TURNAROUND (NTRT) team for the creation of a new entry in the MLTF. The results of the NTRT process will be one of three possible results. 1) A new entry will be created in the MLTF and will be included in the next file release. 2) A match was found in the MLTF and the facility should use that entry for a match. 3) There is no LOINC Code that matches this test/specimen and a request for a new LOINC Code has been submitted. An On Demand report is available to the VHA Laboratory Program Office that will allow them to monitor new Tests/Specimens creation activity. The report request subject line will be 'MLTF'. ******************************************** After installing this patch and after the MASTER LABORATORY TEST file (#66.3) is deployed to your facility there is an associated follow on informational patch (LR*5.2*481) that should be installed. The informational patch LR*5.2*481 provides instructions for turning on the sending of NTRT messages to the NTRT group. Related Patches --------------- XU*8*665, HDI*1.0*15, LR*5.2*468, LA*5.2*82, LR*5.2*481 Until all of the patches listed in the Related Patches section are installed and the MASTER LABORATORY TEST file (#66.3) (MLTF) content has been deployed to your facility the LIM will not have the ability to interact with the MLTF. The MASTER LABORATORY TEST file (#66.3), distributed with the patch is not populated. Therefore, the options in the LIM NDS MENU should not be used at this time. In the future, the NTRT team will populate and deploy the MLTF file for all sites. Prior to the population of the MLTF file, creation of a new test in the LABORATORY TEST file(#60) will generate a mailman message to the LIM entering the new site/specimen and members of the facilities G.LMI mail group. Because the functionality to forward that message on to the NTRT team has not yet been turned on, sites should ignore these messages. When the content of the MASTER LABORATORY TEST file (#66.3) has been deployed the NTRT group sends a message to the NTRT_NOTIFICATION-L listserv. The LIM for the facility shall subscribe to this list using the following web site: http://vaww.listserv.domain.ext/scripts/wa.exe. The NTRT group does not own the List Serve application. The List Serve is a VA service. The user will need to create an account using a username and password that does NOT synchronize with the user's VA network account. ******************************************** Blood Bank Review: ================== EFFECT ON BLOOD BANK FUNCTIONAL REQUIREMENTS: Patch LR*5.2*468 does not contain any changes to the VISTA BLOOD BANK Software as defined by ProPath standard titled: BBM Team Review of VistA Patches. EFFECT ON BLOOD BANK FUNCTIONAL REQUIREMENTS: Patch LR*5.2*468 does not alter or modify any software design safeguards or safety critical elements functions. RISK ANALYSIS: Changes made by patch LR*5.2*468 have no effect on Blood Bank software functionality, therefore RISK is none. VALIDATION REQUIREMENTS BY OPTION: Because of the nature of the changes made, no specific validation requirements exist as a result of installation of this patch. Patch Components: Bulletins Files and Fields Input Templates Mailman Group Options Routines Backout Plan Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- LABORATORY TEST (#60) Modified TYPE (# 3) Modified CREATION DATE (# 131) New TEST INACTIVE (# 132) New TEST INACTIVE DATE (# 133) New MLTF NUMBER (# 60.01,30) New MLTF NAME (# 60.01,31) New RESULT/SPECIMEN INACTIVE (# 60.01,32) New RESULT/SPECIMEN INACTIVE DATE (# 60.01,33) New EXCEPTION FLAG (# 60.01,34) New SPECIMEN CREATE DATE (# 60.01,35) New AUDIT DATE/TIME multiple (# 140) New AUDIT DATE/TIME (# 60.28,.01) New EDIT USER (# 60.28,.02) New EDIT FIELD (# 60.28,.03) New EDIT OLD VALUE (# 60.28,.04) New EDIT NEW VALUE (# 60.28,.05) New SPECIMEN NUMBER (# 60.28,.06) New LAB MLTF MANAGED ITEMS (#66.4) New INSTITUTION POINTER (# .01) New NTRT SEND METHOD (# .02) New AUTO REMINDERS PARAMETER (# .03) New AUDIT PURGE DAYS (# .04) New ISAAC ACTIVE (# .05) New LAB IEN (# .06) New SUBSCRIPT FOR NTRT (# .07) New LAST AUTO TEST ID (# .08) New SEND NTRT MESSAGES (# .1) New DEFAULT NTRT MAIL GROUP (# 1) New DEFAULT SITE LAB MAIL GROUP (# 2) New SITE LAB SERVER (# 3) New ISAAC WEB ADDRESS (# 4) New ISAAC PORT NUMBER (# 5) New ISAAC NTRT PATH (# 6) New ISAAC SCHEMA NAME (# 7) New ISAAC SCHEMA PATH (# 8) New MASTER LABORATORY TEST (#66.3) New LAB TEST NAME (#.01) New ALTERNATE TEST NAME (#.02) New LOINC CODE (# .04) New COMPONENT (# .05) New PROPERTY (# .06) New TIME ASPECT (# .07) New SPECIMEN (# .08) New SCALE (# .09) New METHOD (# 1) New REPLACED BY VHA STANDARD TERM (# 99.97) New MASTER ENTRY FOR VUID (# 99.98) New VUID (9# 99.99) New EFFECTIVE DATE/TIME multiple (# 99.991) New EFFECTIVE DATE/TIME (# 66.399,.01) New STATUS (# 66.399,.02) New Forms Associated: Form Name File # New/Modified/Deleted --------- ------ -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- LMI Modified Options Associated: Option Name Type N/M/D ----------- ---- --- Managed Items Edit[LR NDS MANAGED ITEMS EDIT] INPUT New Associate Test to NDS MLTF[LR NDS ASSOCIATE TEST TO MLTF] INPUT New Walk Associate Test to MLTF[LR NDS WALK ASSOCIATE] INPUT New Lab to MLTF Extract[LR NDS MLTF EXTRACT] OUTPUT New Purge NDS File 60 Audits[LR NDS AUDIT PURGE] MAINTENANCE New Print NDS Audits in File 60[LR NDS FILE 60 AUDIT PRINT] OUTPUT New Print Specimens Without VUIDS[LR NDS SPECIMENS W/O VUIDS] OUTPUT New LIM NDS MENU[LR NDS LIM MENU] MENU New Print Specimens with Inactive VUIDS[LR NDS TESTS W/INACTIVE VUIDS]OUTPUT New Lab liaison menu[LRLIAISON] MENU Modified Routines Associated: Routine Name: -------------- LR664L New LRLNCV Modified LRMLACM New LRMLED New LRMLEDA New LRMLPRG New LRMLRCP New LRMLREI New LRMLRIV New LRMLWT New LRSRVR Modified LRSRVR9 New LRSRVR9A New LRVER1 Modified LRVRPOC Modified Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted -------------- ----- ----------------- -------------------- MANAGED ITEMS EDIT EDIT LAB MLTF MANAGED ITEMS (#66.4) New LAB ENTRY NTRT EDIT LABORATORY TEST (#60) New LAB NTRT ASSOCIATE EDIT LABORATORY TEST (#60) New Additional Information: None New Service Requests (NSRs): ---------------------------- N/A Patient Safety Issues (PSIs): ----------------------------- None Defect Tracking System Ticket(s) & Overview: -------------------------------------------- N/A Test Sites: ---------- Upstate NY (Station 640) Boston (Station 523) Tampa (Station 673) Software and Documentation Retrieval Instructions: ---------------------------------------------------- Software being released as a host file and/or documentation describing the new functionality introduced by this patch are available. The preferred method is to retrieve files from download.vista.domain.ext. This transmits the files from the first available server. Sites may also elect to retrieve files directly from a specific server. Sites may retrieve the software and/or documentation directly using Secure File Transfer Protocol (SFTP) from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Albany: domain.ext Hines: domain.ext Salt Lake City: domain.ext Documentation can also be found on the VA Software Documentation Library at: http://www4.domain.ext/vdl/ Title File Name FTP Mode ----------------------------------------------------------------------- LAB_NDS_VERSION_1_1_DOCS.zip BINARY Patch Installation: Pre/Post Installation Overview: Pre Installation Actions: ========================= It is recommended that the Facility perform a VistA system backup prior to installing the patch. It is recommended that a 'Scratch Patch'(SP) be created containing the following items: Data Definition for the LABORATORY TEST (#60) 'No Data' OPTION: LRLIAISON, and ROUTINES: LRSRVR, LRVER1, LRLNCV, LRVRPOC, and routine from patch LA*5.2*92 LA7VHLU5. This last is for consistency of usage. It is recommended that the LAB Backout Plan (further down in this document)be reviewed. It is recommended that the LIM's Name be recorded for inclusion with the LMI lab group. Pre-Installation Instructions: ============================== This patch may be installed with users on the system although it is recommended that it be installed during non-peak hours to minimize potential disruption to users. This patch should take less than 5 minutes to install. It is not necessary to disable any options. Prior to the Patch being installed follow steps 1 - 52 in the Backout Plan section titled: Pre-Implementation work that will be required for the Backout Plan. Installation Instructions: -------------------------- 1. Choose the PackMan message containing this patch. 2. Choose the INSTALL/CHECK MESSAGE PackMan option. 3. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, you may elect to use the following options. When prompted for the INSTALL NAME enter the patch Build (ex. LR*5.2*468): a. Backup a Transport Global - This option will create a backup message of any routines exported with this patch. It will not backup any other changes such as DDs or templates. b. Compare Transport Global to Current System - This option will (allow you to view all changes that will be made when this patch is installed. It compares all components of this patch routines, DDs, templates, etc.). c. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. 4. From the Installation Menu, select the Install Package(s) option and choose the patch to install. 5. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//' 6. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//' 7. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//' 8. If prompted 'Delay Install (Minutes): (0 - 60): 0//' respond 0. Post-Installation Instructions: =============================== Routine EN^LR664L will be executed to seed the LAB MANAGED ITEMS file (#66.4). Backout Plan: ===================== Pre-Implementation work that will be required for the Backout Plan ------------------------------------------------------------------ ------------------------------------------------------------------ Perform the following procedure to create a Saved Local Patch File. 1. Create a local KIDS patch. 2. From the KIDS (Kernel Installation & Distribution System) menu. 3. Select 'Edits and Distribution'. 4. Select 'Create a Build Using Namespace'. 5. Enter a local patch name and identifier; (for example: ZZZ*1.0*004). 6. At 'BUILD PACKAGE FILE LINK:' press . 7. At 'BUILD TYPE: SINGLE PACKAGE//' press . 8. At 'BUILD TRACK PACKAGE NATIONALLY: YES//' enter NO. 9. At 'Namespace:' press . 10. At the menu select 'Edit a Build'. 11. Enter the 'local package name and identifier' that was created in Step 5. 12. For the 'Description:' enter the following: "this is a local patch save for DD file (#60), routines: LA7VHLU5, LRSRVR, LRVER1, LRLNCV. This patch is only to be re-loaded in the event that the LR*5.2*468 and LA*5.2*92 patches need to be backed- out. 13. Select 'Next Page'. 14. For 'file List' enter 60 for LABORATORY TEST File. 15. Send Full or Partial DD...: FULL. 16. Update the Data Dictionary: YES. 17. Send Security Code: YES. 18. Data Comes With File...: NO 19. At 'COMMAND:' enter 'Close' 20. Up arrow to the 'COMMAND:' prompt 21. Enter 'Next Page'. 22. Down arrow to 'ROUTINE' and press . 23. Enter LA7VHLU5 'Send To Site'. 24. Enter LRSRVR 'Send To Site'. 25. Enter LRLNCV 'Send To Site'. 26. Enter LRVER1 'Send To Site'. 27. Enter LRVRPOC 'Send To Site' 28. Down arrow to 'OPTION' and press . 29. Enter LRLIAISON and 'Send to Site'. 30. Down arrow to the 'COMMAND:' prompt. 31. Enter 'Close'. 32. Down arrow to the 'COMMAND:' prompt. 33. Enter 'Save'. 43. Enter 'Exit' . 35. On the menu select 'Transport a Distribution'. 36. Enter the 'local package name and identifier' that was created in Step 5. 37. At the 'Another Package Name:' press . 38. At the 'OK to continue? YES//' press . THESE NEXT STEPS ARE FOR A 'HF' TRANSPORT. ------------------------------------------ 39. At the 'Transport through (HF)Host File or (PM)PackMan:' enter HF 40. At the 'Enter a Host File:' enter the system file name that will hold the scratch patch. (ex: ZZZ_1-0_004.KID) 41. At the 'Header Comment:' enter Scratch patch for Lab 42. At the menu press 43. At the KIDS menu press THESE NEXT STEPS ARE FOR CREATING A 'PM' TRANSPORT. --------------------------------------------------- 44. At the 'Transport through (HF)Host File or (PM)PackMan:' enter PM 54. At the 'Header Comment:' enter Scratch patch for Lab 46. For the description of Packman Message enter: 'This is a saved backup for the lab patch install for LR*5.2*468 and LA*5.2*92. This scratch build will be used in the event that the above mentioned installs need to be backed off.' 47. At 'EDIT Option:' press 48. At the 'Do you wish to secure this message? NO//' enter 'NO' 49. At the 'Send mail to:' enter your name 50. At the 'Select basket to send to: IN//' press 51. At the 'And Send to:' enter any additional persons that may need to have the scratch patch. 52. At The 'Select Edits and Distribution Option:' press Backout Plan guidance to restore service to the pre-change state ---------------------------------------------------------------- ---------------------------------------------------------------- Authority for Back-Out ---------------------- The local facility management in concurrence with the VHA Pathology and Laboratory Medicine Program Office. Back-Out Risks -------------- By backing out LR*5.2*468 and LA*5.2*92, the local facility will have to maintain the local test to LOINC Code mappings. Back-Out Instructions --------------------- Please contact the product development team for assistance if the installed LR*5.2*468 and LA*5.2*92 patches that needs to be backed out contains anything at all besides routines before trying backout the patch. This concludes the Backout Plan =============================== Routine Information: ==================== The second line of each of these routines now looks like: ;;5.2;LAB SERVICE;**[Patch List]**;FEB 10 2016;Build 64 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: LR664L Before: n/a After: B96398079 **468** Routine Name: LRLNCV Before: B8183772 After: B8729767 **232,278,468** Routine Name: LRMLACM Before: n/a After: B18901427 **468** Routine Name: LRMLED Before: n/a After:B152483182 **468** Routine Name: LRMLEDA Before: n/a After:B133294860 **468** Routine Name: LRMLPRG Before: n/a After: B3125134 **468** Routine Name: LRMLRCP Before: n/a After: B20138748 **468** Routine Name: LRMLREI Before: n/a After: B21744522 **468** Routine Name: LRMLRIV Before: n/a After: B17383350 **468** Routine Name: LRMLWT Before: n/a After: B37343726 **468** Routine Name: LRSRVR Before: B18215977 After: B19202402 **232,303,346,350,468** Routine Name: LRSRVR9 Before: n/a After:B122473152 **468** Routine Name: LRSRVR9A Before: n/a After: B42448804 **468** Routine Name: LRVER1 Before: B33061562 After: B40561385 **42,153,201,215,239,240,263, 232,286,291,350,468** Routine Name: LRVRPOC Before: B82812080 After: B85608617 **290,350,468** Routine list of preceding patches: 278, 350 ============================================================================= User Information: Entered By : Date Entered : FEB 08, 2016 Completed By: Date Completed: MAR 06, 2017 Released By : Date Released : MAR 07, 2017 ============================================================================= Packman Mail Message: ===================== $END TXT