$TXT Created by T at CLE623.FO-BAYPINES.DOMAIN.EXT (KIDS) on Thursday, 01/09/25 at 10:38 ============================================================================= Run Date: MAY 22, 2025 Designation: GMRC*3*201 Package : GMRC - CONSULT/REQUEST TRACKING Priority: Mandatory Version : 3 SEQ #170 Status: Released Compliance Date: JUN 22, 2025 ============================================================================= Associated patches: (v)GMRC*3*189 <<= must be installed BEFORE `GMRC*3*201' (v)GMRC*3*193 <<= must be installed BEFORE `GMRC*3*201' Subject: URGENCY CODE FIX, REASON FOR REQUEST RESEQUENCING, PROXY ADD FIX, ETC. Category: - Routine - Data Dictionary - Other - Enhancement (Mandatory) Description: ============ 1. The reasons for request for some Prosthetics orders sent by Cerner are not displayed in the desired sequence in CPRS. GMRC*3*201 introduces a table-driven tool to re-sequence the reasons for request for incoming orders before they are filed in VistA in the REQUEST/CONSULTATION file (#123). The tool also supports the option to not store selected data fields. The orders eligible for re-sequencing are stored in the IFC REASON FOR REQUEST MAPPING file (#123.7). 344 of them are distributed with the patch. 2. In GMRC*3*176, code was inserted in GMRCIACT so that when Cerner sends an urgency of "STAT" on an Inter-Facility Consult (IFC) order, it is converted to "NEXT AVAILABLE" before being stored in VistA. For certain Prosthetics orders, this causes the order to have a low priority in PSAS and Veterans are not timely serviced. GMRC*3*201 changes this translation. For Cerner-initiated orders, urgency is set to STAT in VistA if Cerner sends either STAT or URGENT and to ROUTINE if Cerner sends ROUTINE. 3. When a local consult in VistA is forwarded to another site as an IFC and that site is a Cerner site, the forwarded IFC is not processed properly by Cerner. Forwarding a consult as an IFC, triggers generation of a series of HL7 messages from the placer site to the filler site. These messages are: a) new order message, b) message for each consult action performed and c) forward message. The problem with processing this series of HL7 messages occurs because Cerner must acknowledge new orders twice: the first is a generic acknowledgment of the order and the second returns Cerner's order number and patient account number. The HL7 messages following the order (a and b above) do not include Cerner's order number and cannot be processed by Cerner. The solution provided here is to: 1) not send the HL7 messages for the consult actions performed and 2) delay sending the forward message until the 2nd order acknowledgement is received for the new order. The HL7 messages for follow-on actions are not required for IFCs sent to Cerner because the forward message includes cumulative comments. The forward message is delayed for an hour by assigning it an error code (204 - IFC NOT YET IN CERNER) and posting it to the IFC Message Log (#123.6). The background processor sends the forward message an hour later after checking that the 2nd order acknowledgement has been received from Cerner. The forward solution described above is conditioned on completion of the proxy add process. A 204 error code will not be generated if the IFC is subject to either an error code 203 (proxy add failed) or error code 205 (proxy add not complete yet). Once either of those errors is cleared by the proxy add process, a 204 error code is generated if the Cerner order number is not received. 4. When VistA responds to a Cerner-initiated IFC, unless a comment was entered in CPRS at the time the IFC was received, the message automatically posted in PowerChart - "Action Taken on Consult in VistA" - is too brief to be meaningful and requires the EHR user to take additional steps to determine its meaning. This patch adds the comment "Referral received by CPRS" to VistA's response to Cerner so that it along with standard comments showing the activity type, entering location and person entering are generated. 5. Prosthetics needs the Cerner FIN number to appear in the reason for request. GMRC*3*201 adds it along with "FIN:" at the end of the reason for request before the reason is filed in the REQUEST/CONSULTATION file (#123). 6. Orders are sometimes sent from Cerner with an EDIPI but not ICN (i.e., a DoD patient only). They are not to be accepted until properly registered as VA patients. GMRC*3*201 identifies such orders and generates a 206 error (ICN Missing from Incoming Order) into the IFC Message Log (file #123.6). A mail message is sent to members of the GMRC Enrollment Errors mail group. The affected order is re-processed by the GMRC IFC Background Processor for up to 5 days. If an ICN is assigned to the patient during those days, the patch inserts the ICN into the HL7 message and then re-processes it. 7. GMRC*3*184 added a new field - #508 Cerner Placer Field 1 - to the REQUEST/CONSULTATION file (#123). The name of the field has been corrected in GMRC*3*201 to be "Cerner Placer Field 2." 8. Actions taken in CPRS or VistA on IFCs that go to converted VistA sites generate HL7 messages that are sent to Cerner for processing. If the messages do not contain the Cerner order number, they will not be processed by Cerner and the update lost. GMRC*3*201 holds outgoing HL7 messages destined for Cerner until the REMOTE CONSULT FILE ENTRY field (#.06) in the REQUEST/CONSULTATION file (#123) is populated with the Cerner order number. The activities that generate these HL7 messages are stored in the IFC MESSAGE LOG (#123.6) tagged with error code 204 (Waiting for IFC order to be processed in Cerner) and re-processed an hour later or until the Cerner order number is received. Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- REQUEST/CONSULTATION (#123) Cerner Placer Field 1 (#508) MODIFIED IFC REASON FOR REQUEST NAME (#.01) NEW MAPPING (#123.7) DATA FIELD NAME (#1) NEW DATA FIELD NAME (#.01) NEW SEQUENCE (#1) NEW DO NOT STORE (#2) NEW Forms Associated: Form Name File Number New/Modified/Deleted --------- ----------- -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- N/A 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 ------------- ---- ------------------ -------------------- N/A Remote Procedures Associated: Remote Procedure Name New/Modified/Deleted --------------------- -------------------- N/A Parameter Definitions Associated: Parameter Name New/Modified/Deleted -------------- -------------------- N/A Additional Information: ----------------------- Blood Bank Team Coordination: N/A New Service Requests (NSRs): N/A Patient Safety Issues (PSIs): N/A Defect Tracking System Ticket(s) & Overview: INC25635371 - Data being transferred from Millennium to VistA is inaccurate INC25886707 - Stat issue with HL7 Message to Vista Prosthetics INC26306110 - SUX - (Orders sent by Cerner to Prosthetics Vista are showing as "next Available" **** Issue since GMRC*3.0*176 patch install MAR 14, 2022@10:51:25***** RITM9854166 - Enhance message in Power Chart for IFC receipt acknowledgement from VistA. Test Sites: ----------- VA Roseburg Healthcare, (Roseburg, Oregon) VA Puget Sound Healthcare System (Seattle) VA Portland Health Care System (Portland, Vancouver) SNOW Change Order #: -------------------- VA Roseburg Healthcare, (Roseburg, Oregon) #CHG0598462 VA Puget Sound Healthcare System (Seattle) #CHG0598504 VA Portland Health Care System (Portland, Vancouver) #CHG05098410 Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released in a PackMan message. Other Software Files: This release also includes other software files. They can be obtained at location: /srv/vista/patches/SOFTWARE Other software files can also be obtained by accessing the URL: https://download.vista.domain.ext/index.html/SOFTWARE File Title File Name Format --------------------------------------------------------------------- N/A Documentation describing the new functionality is included in this release. Documentation can be found on the VA Software Documentation Library at: https://www.domain.ext/vdl/. Documentation can also be obtained at https://download.vista.domain.ext/index.html/SOFTWARE. Documentation Title File Name --------------------------------------------------------------------- URGENCY CODE FIX, PULSE DOSE REASONS RESEQUENCING, PROXY ADD FIX Deployment, Installation, Backout and Rollback Guide GMRC_3_201_DIBR.DOCX GMRC_3_201_DIBR.PDF Consult/Request Tracking Technical Manual CONSTM.DOCX CONSTM.PDF Patch Installation: ------------------- 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. Installation Instructions: 1. Choose the PackMan message containing this build. Then select the INSTALL/CHECK MESSAGE PackMan option to load the build. 2. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, A. Select the Verify Checksums in Transport Global option to confirm the integrity of the routines that are in the transport global. When prompted for the INSTALL NAME enter the patch or build name GMRC*3.0*201. B. Select the Backup a Transport Global option to create a backup message. You must use this option for each patch contained in the Host File. For each patch you can specify what to backup; the entire Build or just Routines. The backup message can be used to restore just the routines or everything that will restore your system to pre-patch condition. C. You may also elect to use the following options: i. Print Transport Global - This option will allow you to view the components of the KIDS build. ii. 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 of the components of this patch, such as routines, DDs, templates, etc. D. Select the Install Package(s) option and choose the patch to install. i. If prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//', answer NO. ii. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer NO. iii. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', answer NO. Post-Installation Instructions: None Routine Information: ==================== The second line of each of these routines now looks like: ;;3.0;CONSULT/REQUEST TRACKING;**[Patch List]**;DEC 27, 1997;Build 7 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: GMRCIAC1 Before:B102707508 After:B107832884 **22,66,73,154,193,201** Routine Name: GMRCIAC2 Before: B69304351 After: B69346008 **22,28,35,66,154,184,193,201** Routine Name: GMRCIAC3 Before: n/a After: B3595694 **201** Routine Name: GMRCIACT Before:B125284943 After:B146586294 **22,47,58,66,73,121,154,176, 184,193,185,189,201** Routine Name: GMRCIBKG Before: B55957269 After: B88082759 **22,28,30,35,58,92,154,189,201** Routine Name: GMRCIEV1 Before:B163839703 After:B210233245 **22,28,31,154,184,185,189,201** Routine Name: GMRCIEVT Before:B195790211 After:B194851647 **22,28,31,121,154,184,189,201** Routine Name: GMRCIRSN Before: n/a After: B32491242 **201** Routine Name: GMRCIUTL Before:B107796120 After:B109894088 **22,58,184,185,189,201** ============================================================================= User Information: Entered By : Date Entered : OCT 31, 2023 Completed By: Date Completed: MAY 21, 2025 Released By : Date Released : MAY 22, 2025 ============================================================================= Packman Mail Message: ===================== $END TXT