Original message: "RA*5.0*137T4" [#302281] ============================================================================= Run Date: MAR 02, 2018 Designation: RA*5*137 Package : RA - RADIOLOGY/NUCLEAR MEDICINE Priority: Mandatory Version : 5 SEQ #125 Status: Released Compliance Date: APR 02, 2018 ============================================================================= Associated patches: (v)RA*5*8 <<= must be installed BEFORE `RA*5*137' (v)RA*5*47 <<= must be installed BEFORE `RA*5*137' (v)RA*5*90 <<= must be installed BEFORE `RA*5*137' (v)RA*5*93 <<= must be installed BEFORE `RA*5*137' (v)RA*5*95 <<= must be installed BEFORE `RA*5*137' Subject: ADT MESSAGES & PREGNANCY SCREEN MODIFICATIONS Category: - Routine - Input Template - Data Dictionary - Print Template Description: ============ This patch addresses the following issues: Radiology historic patient demographic updates 'Mass Override to Complete' option removal Status Tracking of Exams addition of pregnancy screen prompt Status Tracking of printset exams with SSANs turned on Outside Report Entry/Edit bypass of pregnancy screen requirement Registered Request Printer Images Acquired indicator on radiology reports Associated Ticket(s): ===================== I9879245FY16 I16983173FY18 Associated NSR(s): ================== Waiver request 376790 Waiver request 382559 Participating Test Sites: ========================= Boston VAMC Richmond VAMC Southern Arizona VA Healthcare System (Tucson) Birmingham VAMC Problem A: ---------- Radiology historical demographic updates: If a name change occurs on VistA , it is not communicated to the departmental imaging system or Picture Archiving and Communication System (PACS), then order processing is delayed at the departmental imaging system because of the name mismatch. Subsequently, when the images with the old name sent are back to VistA, processing is delayed because of the name mismatch. Radiology PACS sites currently have a backlog of rejected radiology orders due to unmatched patient identifiers (patient name, date of birth, gender and social security number). Resolution A: ------------- Vista Imaging (VI) patch MAG*3.0*183 will add ADT patient demographic updates (A08) and patient identifier updates (A47) functionality for VI and PACS, allowing real time demographic updates. To address patient demographic updates that took place prior to the installation of MAG*3*183, this patch will provide a menu option to send HL7 ADT messages. A new option called 'Send ADT HL7 message to PACS' [RA ADT] will be created and reside on the 'Radiology HL7 Menu' [RA HL7 MENU]. This option will allow the application end user to select one or more radiology patients, and then it will call the VI Application Program Interface (API) to generate an ADT A08 and, if needed, an ADT A47 message to PACS. The user must hold the RA MGR key to access this new option. Problem B: ---------- Mass Override Exam Status retired: When the 'Mass Override Exam Status'[RA EXAMSTATUS MASS OVERRIDE] option is used, it does not result in any stop code or CPT crediting. With the release of RA*5.0*133, the default value for the fields TRACK REQUEST STATUS CHANGES (#.119) and TRACK EXAM STATUS CHANGES (.11) of our RAD/NUC MED DIVISION (#79) file will be set to 'YES' without out the ability to change from that value of 'YES'. It was discussed and put to a vote and the Radiology Informatics Committee (RIC) voted that the 'Mass Override Exam Status' [RA EXAMSTATUS MASS OVERRIDE] option be retired. Resolution B: ------------- The menu option 'Mass Override Exam Status'[RA EXAMSTATUS MASS OVERRIDE] will be removed from sites 'Supervisor Menu' [RA SUPERVISOR] and the related code in routine RAESO will also be removed. Note that the 'Override a Single Exam's Status to 'complete'' [RA OVERRIDE] will still be functional. Problem C: ---------- CA ticket #I9879245FY16 Since the pregnancy screen prompt was introduced with patch RA*5.0*99, there has been a discrepancy between the exam edit menu options('Case No. Exam Edit'[RA EDITCN] and 'Edit Exam by Patient'[RA EDITPT]) and the 'Status Tracking of Exams' [RA STATRACK] menu option. All of these options are used to input the required parameters for the modality allowing exams to advance through each status until complete. The requirement for female patients within the age bracket is that the pregnancy screen prompt be answered for the exam to reach a completed status. The pregnancy screen prompt was not added to the 'Status Tracking of Exams'[RA STATRACK] option, which if used will allow an exam to reach a completed status without the pregnancy screen being answered, thus not meeting the requirement to capture the patient's response in the patient's medical record. Resolution C: ------------- Add the pregnancy screen prompt to the 'Status Tracking of Exams option'. The input template [RA STATUS CHANGE] and routine RAUTL8 are modified to display the pregnancy screen prompt and comment for patients meeting gender and age requirements. In order to provide the same functionality as the exam edit options, the routine RASTREQ is modified to prevent a study from reaching a completed status if the pregnancy screen prompt is not answered. Both 'Status Tracking of Exams'[RA STATRACK] and the exam edit options [RA EDITCN, RA EDITPT] will now present the pregnancy screen to the user regardless of the report status. Problem D: ---------- It was reported that the pregnancy screen prompt is required to be answered for outside studies (entered through the radiology package) to reach a completed status. Since the patient is not examined at the facility, the person entering the outside report does not know the answer to the question: Enter the patient's response to the question of if she is pregnant at the time of the exam. Choose from: y Patient answered yes n Patient answered no u Patient is unable to answer or is unsure This causes delays in patient care, as the outside report has to be deleted, then the study cased for this question to be answered, and then the outside report entered again. Resolution D: ------------- Remove the requirement for the pregnancy prompt to be answered for an outside report, allowing the study to go to a completed status. Routine RASTREQ is modified to insert a 'u' (Patient is unable to answer or is unsure) in the PREGNANCY SCREEN [#32] field and "OUTSIDE STUDY" in the PREGNANCY SCREEN COMMENT [#80] field. This is the same functionality currently in place with outside reports created by the VistA Imaging Importer. Note that if these fields already contain data, the existing data values will not be changed. Problem E: ---------- The Print Registered Exams to Alternate Printer functionality comes from waiver request 376790 and is supported by the Radiology Informatics Committee and the VHA Radiology Program Office. When using the national Radiology software to 'Register Patient for Exams', unregistered and registered requests are printed to the general x-ray printer (Request Printer). This causes problems when the printer is not in close proximity to the radiology technician because they must walk long distances to obtain their printout, causing them to fall behind in processing patients. Resolution E: ------------- Add a new Registered Request Printer parameter [field #28)] to the Imaging Locations [#79.1] file. Modify routines RAREG1 and RAREG3 to check the new printer parameter and if it is defined, the request will print to that device when the exam registration is complete. If the Registered Request Printer is not defined for that location, the request will not print. The 'Device Specifications for Imaging Locations'[RA DEVICE] menu will be modified to allow printer assignment for the new Registered Request Printer. The help text for this menu was also modified to reflect the new printer. The 'Location Parameter List'[RA SYSLOCLIST] will be modified to display the new Register Request Printer. Problem F: ---------- Images captured indicator The Indicator of images associated with Exams on Radiology Reports comes from waiver request 382559 and is supported by the Radiology Informatics Committee and the VHA Radiology Program Office. When using the 'Delinquent Status Report'[RA DELINQUENT], or 'Incomplete Exam Report'[RA INCOMPLETE] options within the nationally released Radiology package, it is not possible to determine if the exam has an image associated with it. Therefore, it is difficult for technologists to ensure that their exams have transferred successfully to VistA Imaging. Resolution F: ------------- The VA Heartland Western Orbit facilities have modified the outputs to display a letter 'i' after the case number whenever the IMAGE field (#2005) is populated in the RAD/NUC MED REPORTS file (#74). This offers staff a quick reference point to assess image transfer to VistA Imaging. Append the images acquired indicator (i) to the case number in routine RADLQ1, used for the 'Delinquent Status Report' [RA DELINQUENT] and 'Incomplete Exam Report' [RA INCOMPLETE]. Problem G: ---------- I16983173FY18 - Status Tracking of printset exams with SSANs turned on. Birmingham reported that after turning on Site Specific Accession Numbers, printsets do not display correctly in the Exam Status Tracking menu. This is due to a defect in routine RASTEXT where the internal case number is not set correctly when doing the SSAN lookup. Resolution G: ------------- Modify routine RASTEXT to set RACNIXX (internal case number) correctly for lookup with SSANs. OPTIONS AFFECTED: ----------------- Send ADT HL7 message to PACS [RA ADT] Radiology HL7 Menu [RA HL7 MENU] Device Specifications for Imaging Locations [RA DEVICE] Mass Override Exam Status [RA EXAMSTATUS MASS OVERRIDE] Supervisor Menu [RA SUPERVISOR] Status Tracking of Exams [RA STATRACK] Outside Report Entry/Edit [RA OUTSIDE RPTENTRY] Delinquent Status Report [RA DELINQUENT] Incomplete Exam Report [RA INCOMPLETE] DOCUMENTATION RETRIEVAL: ======================== These are the documentation changes associated with this patch: User Manual Technical Manual ADPAC Guide These manuals are available on the ANONYMOUS.SOFTWARE directory at one of the following Office of Information (OI) Field Offices. These files should be retrieved in binary format. Sites may retrieve documentation in one of the following ways: (1) The preferred method is to SFTP the files from download.vista.domain.ext, which will transmit the files from the first available FTP server. (2) Sites may also elect to retrieve documentation directly from a specific server as follows: Hines ftp.domain.ext Salt Lake City ftp.domain.ext The documentation distribution includes: File Name Description Protocol --------- ----------- -------- RA5_0_UM_P137 RA Nuclear Medicine User Manual BINARY RA5_0_TM_P137 RA Nuclear Medicine Tech Manual BINARY RA5_0_AG_P137 RA Nuclear Medicine ADPAC Guide BINARY =================== Installation Instructions ==================== If installed during the normal workday, it is recommended that the Radiology users be off the system. Other VISTA users will not be affected. Install Time - less than 2 minutes 1. Load Transport Global: ---------------------- Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. Start Up KIDS: -------------- Start up the Kernel Installation and Distribution System Menu [XPD MAIN]: Edits and Distribution ... Utilities ... Installation ... Select Kernel Installation & Distribution System Option: INStallation Load a Distribution Print Transport Global Compare Transport Global to Current System Verify Checksums in Transport Global Install Package(s) Restart Install of Package(s) Unload a Distribution Backup a Transport Global Select Installation Option: 3. Select Installation Option: --------------------------- NOTE: The following are OPTIONAL - (When prompted for the INSTALL NAME, enter RA*5.0*137): 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 DD's 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, DD's, 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. Select Installation Option: Install Package(s): ----------------------------------------------- **This is the step to start the installation of this KIDS patch: a. Choose the Install Package(s) option to start the patch install. b. Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO// ,answer YES unless your site rebuilds menu trees nightly. c. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//', answer NO. d. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', answer YES. When prompted, 'Enter options you wish to mark as 'Out Of order':', enter the following options: Disable the following VistA RIS options: ---------------------------------------- Register Patient for Exams [RA REG] Status Tracking of Exams [RA STATRACK] Override a Single Exam's Status to 'complete' [RA OVERRIDE] Outside Report Entry/Edit [RA OUTSIDE RPTENTRY] Radiology HL7 Menu [RA HL7 MENU] Delinquent Status Report [RA DELINQUENT] Incomplete Exam Report [RA INCOMPLETE] When prompted, 'Enter protocols you wish to mark as 'Out Of order':',press . Backout/Roll-back Strategy: =========================== Back-out will be done only with the concurrence and participation of development team and appropriate VA site/region personnel. The decision to back-out or rollback software will be a joint decision between development team, VA site/region personnel and other appropriate VA personnel. A national help desk ticket should be logged before attempting any backout procedures. Prior to installing an updated KIDS package, the site/region should have saved a backup of the routines in a mail message using the Backup a Transport Global [XPD BACKUP] menu option (this is done at time of install). The message containing the backed up routines can be loaded with the "Xtract PackMan" function at the Message Action prompt. The Packman function "INSTALL/CHECK MESSAGE" is then used to install the backed up routines onto the VistA System. Routine Information: ==================== The second line of each of these routines now looks like: ;;5.0;Radiology/Nuclear Medicine;**[Patch List]**;Mar 16, 1998;Build 4 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: RADLQ1 Before: B33800278 After: B35197870 **15,97,47,137** Routine Name: RAESO Before: B27993971 After: B11039001 **47,137** Routine Name: RAHLRS Before: B12807617 After: B27750372 **25,54,60,71,82,95,137** Routine Name: RAREG1 Before: B30150241 After: B30837568 **7,21,93,137** Routine Name: RAREG3 Before: B17775791 After: B29955259 **8,137** Routine Name: RASITE Before: B12723351 After: B13056737 **137** Routine Name: RASTEXT Before: B34738271 After: B35874954 **48,47,137** Routine Name: RASTREQ Before: B56283063 After: B63019681 **1,10,23,40,56,99,90,137** Routine Name: RAUTL8 Before: B73540763 After: B71419275 **45,72,99,90,137** Routine list of preceding patches: 8, 47, 90, 93, 95 ============================================================================= User Information: Entered By : Date Entered : MAR 29, 2017 Completed By: Date Completed: MAR 02, 2018 Released By : Date Released : MAR 02, 2018 ============================================================================= Packman Mail Message: ===================== $END TXT