$TXT Created by at MNTVBB.DOMAIN.EXT (KIDS) on Friday, 07/06/18 at 08:05 ============================================================================= Run Date: NOV 19, 2018 Designation: LR*5.2*509 Package : LR - LAB SERVICE Priority: Mandatory Version : 5.2 SEQ #415 Status: Released Compliance Date: DEC 20, 2018 ============================================================================= Associated patches: (v)LR*5.2*421 <<= must be installed BEFORE `LR*5.2*509' (v)LR*5.2*483 <<= must be installed BEFORE `LR*5.2*509' Subject: EPI EXTRACT W23 WARNING MESSAGES; AP ISSUES RELATED TO CPRS ORDER ENTRY Category: - Routine Description: ============ The patch addresses four (4) issues: 1. Emerging Pathogen Initiative (EPI) data is collected in VistA and forwarded to the Austin Information Technology Center (AITC) for national roll-up monthly. Part of the collected data has to do with Clinical Reminders related to Hepatitis C. The Clinical Reminder data is formatted into the DSP segment of a HL7 record for delivery to the AITC. The data is currently being formatted improperly. 2. When USING AP Log-in, anat path [option LRAPLG], an error occurs in the NEXT subroutine of routine LRAPKOE when logging in a case for a deceased veteran ordered in CPRS. 3. In AP Log-in, anat path [option LRAPLG], the PATHOLOGIST prompt is a required entry. The pathologist who will read the case is usually not known at the time the case is logged into the laboratory. The process should be modified to make entry of PATHOLOGIST optional. 4. The routine (LRAPKOE) that processes Anatomic Pathology orders entered in CPRS needs to be modified to call VistA Imaging to add the case to the MAG PATH CASELIST file (#2005.42) to support Telepathology and to generate the HL7 message that is sent to digital pathology systems. Associated NSR(s): ================== This patch addresses the following New Service Request (NSR): 20090511 - VistA Imaging Enhancements: Store and Forward Telehealth and Telepathology The previous patch LR*5.2*433 made changes to the legacy Anatomic Pathology case login routines to support this NSR. This patch makes the same changes for the CPRS Anatomic Pathology ordered case login routines. Associated ticket(s): ========================== 1. I18968586FY18 - EPI Extract W23 Warning Messages 2. RTC WI 756192 - UNDEF Error when Logging Deceased Veteran 3. RTC WI 756196 - PATHOLOGIST Prompt Should be Optional 4. RTC WI 756202 - LRAPKOE Modification for VistA Imaging Blood Bank Review: ================== EFFECT ON BLOOD BANK FUNCTIONAL REQUIREMENTS: Patch LR*5.2*509 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*509 does not alter or modify any software design safeguards or safety critical elements functions. RISK ANALYSIS: Changes made by patch LR*5.2*509 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. Participating Test Sites: ========================= Northport VA Medical Center Philadelphia - VA Medical Center Remedy Overview: ================ 1. I18968586FY18 - EPI Extract W23 Warning Messages Problem: -------- The Clinical Reminders code called by the EPI search option properly returns the reminder text but not the number (1 - 7) sometimes referred to as the Resolve Term (ALTTRM). As a result, the EPI code sets the number equal to "00" in the HL7 DSP segment to be sent to Austin. This works for two (2) of the reminders (5 and 6) but not the others. The AITC performs validations on the data that expect that if the value in the Resolve Term is 1, 2, 3, 4 or 7; then the lab result data value must be null. If it is 0, 5 or 6; the lab result value must not be null. When there is an inconsistency between the value of the Resolve Term and whether the result field is null, a W23 warning message is generated. Resolution: ----------- Per the business owners, the data is no longer used by EPI and the HIV, Hepatitis, and Related Conditions (HHRC) program is not using it. Consequently, there is no point for the LREPI routine to continue to call the Clinical Reminders API and send the data to Austin. As a result, the routine LREPI is modified to not call the routine (^PXRMXX) that extracts the Clinical Reminders. That will eliminate the W23 warnings. Routines: LREPI 2. RTC WI 756192 - UNDEF Error when Logging Deceased Veteran Problem: -------- An error occurs in the NEXT subroutine in ^LRAPKOE when performing AP Log-In in VistA for an Anatomic study ordered in CPRS v32 for a deceased veteran. Resolution: ----------- Modify routine LRAPKOE in subroutine NEXT to assure that variable LRVIDO is defined. Routines: LRAPKOE 3. RTC WI 756196 - PATHOLOGIST Prompt Should be Optional Problem: -------- When an Anatomic Pathology order is entered via CPRS V32 Order and logged in in VistA, entry of a pathologist is required. However, the pathologist who will ultimately read the case is usually not known at the time that the case is logged into the laboratory. The log in pathway for V32 orders should be consistent with the legacy roll and scroll anatomic pathology login process which has the PATHOLOGIST prompt as optional. Resolution: ----------- Routine LRAPKOE is modified to change the PATHOLOGIST prompt from "required" to "optional". Routines: LRPAKOE 4. RTC WI 756202 - LRAPKOE Modification for VistA Imaging Problem: -------- CPRS v32 provided a new Anatomic Pathology Order Entry capability. LRAPKOE is the new routine that takes an order entered via CPRS and logs it into the legacy anatomic pathology application (LRAP*). LRAPKOE was created in patch LR*5.2*462 and updated in patch LR*5.2*479 and again in LR*5.2*483. The current programming does not call VistA Imaging to add a case to the MAG PATH CASELIST file (#2005.42). Resolution: ----------- LRAPKOE is modified to call VistA Imaging to add the case study to the MAG PATH CASELIST file (#2005.42) to support a Telepathology Worklist and to generate the HL7 message that is sent to digital pathology systems. Routines: LRPAKOE Components: =========== N/A Patch Installation: =================== Pre-Installation Instructions: ------------------------------ This patch can be installed when Laboratory users are on the system. The install time for this patch is less than 2 minutes. NOTE: Kernel patches must be current on the target system to avoid problems loading and/or installing this patch. Installation Instructions: -------------------------- 1. Choose the PackMan message containing this patch. 2. Choose the INSTALL/CHECK MESSAGE PackMan option to load the KIDS patch into a Transport Global on your system. 3. From the Kernel Installation & Distribution System Menu (KIDS), select the Installation Menu. 4. From the Installation Menu, select the Backup a Transport Global option and when prompted for the INSTALL NAME enter the patch LR*5.2*509. 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. 5. From the Installation Menu, you may elect to use the following options. When prompted for the INSTALL NAME enter the patch LR*5.2*509. a. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. b. Print Transport Global - This option will allow you to print only a summary of the patch, to print a summary of the patch and the routines in the transport global, or to print only the routines in the transport global. c. 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's routines, DDs, templates, etc.). 6. From the Installation Menu, select the Install Package(s) option and enter the patch LR*5.2*509. 7. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', respond 'NO'. 8. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', respond 'NO'. Back-out/Rollback Strategy: --------------------------- In the event of a catastrophic failure, the Facility Chief Information Officer may make the decision to back-out the patch. The back-out plan is to restore the routine from the backup created. No data was modified by this patch installation and, therefore, no rollback strategy is required. 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. To verify the back-out completed successfully, ensure the checksum matches the pre-patch checksum from the patch descriptions. Routine Information: ==================== The second line of each of these routines now looks like: ;;5.2;LAB SERVICE;**[Patch List]**;Sep 27, 1994;Build 4 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: LRAPKOE Before:B175040482 After:B184170357 **462,479,483,509** Routine Name: LREPI Before: B66094816 After: B66831950 **132,175,260,281,421,509** Routine list of preceding patches: 421, 483 ============================================================================= User Information: Entered By : Date Entered : MAY 29, 2018 Completed By: Date Completed: NOV 16, 2018 Released By : Date Released : NOV 19, 2018 ============================================================================= Packman Mail Message: ===================== $END TXT