$TXT Created by RUSSELL,JOEL E at CPRS27.FO-SLC.MED.VA.GOV (KIDS) on Friday, 02/05/10 at 10:46 ============================================================================= Run Date: MAR 17, 2010 Designation: OR*3*307 Package : OR - ORDER ENTRY/RESULTS REPORTING Priority: Mandatory Version : 3 SEQ #278 Status: Released Compliance Date: APR 17, 2010 ============================================================================= Associated patches: (v)OR*3*243 <<= must be installed BEFORE `OR*3*307' Subject: ANTICOAGULATION MANAGEMENT Category: - Data Dictionary - Routine - Enhancement (Mandatory) - Other Description: ============ This tool was developed as Class 3 software at the Portland VA Medical Center to help simplify the complex, time consuming processes required to manage outpatients on anticoagulation medication. This patch brings the software up to Class 1 standards for national release. The tool enables the user to enter, review, and continuously update all information connected with patient anticoagulation management. With the Anticoagulation Tracking, one can order lab tests, enter outside lab results and graphically review lab data, enter notes, complete encounter data, complete the consults if consults are used to initiate entry into the Anticoagulation clinic, and print a variety of patient letters. Upon exiting the program all activities within the program are viewable on an Anticoagulation flow sheet located on the Computerized Patient Record System (CPRS) Reports tab. The Anticoagulation Tracking provides clinic staff a mechanism of ensuring continuous patient monitoring with a built-in mechanism that alerts staff when patients haven't been monitored in a timely period. A Lost to Follow-up list is maintained to insure that staff knows of patients who need attention. ATTENTION: This patch includes a new Graphical User Interface (GUI) executable file. Installation of this GUI is required immediately after the KIDS install for the Patch to function. The Anticoagulation Management Program (AMP) is a Joint Commission National Patient Safety Goal initiative to use standardized process for the management of their patients on extended anticoagulation therapy. It runs as a Windows Application from the CPRS Tools menu, and assists Clinicians with the expeditious documentation of visits to Anticoagulation Clinics. REMEDY TICKETS: =============== No open Remedy tickets are resolved by this patch. E3Rs: ===== No E3Rs are satisfied by this patch. Build Components: ================ UP SEND DATA USER DATE SEC. COMES SITE RSLV OVER FILE # FILE NAME DD CODE W/FILE DATA PTRS RIDE -------------------------------------------------------------------------- 101.24 OE/RR REPORT NO NO YES OVER YES NO DATA SCREEN: I Y=1604 103 ORAM FLOWSHEET YES YES NO PRINT TEMPLATE: ACTION: ORAM TEAM LIST FILE #100.21 SEND TO SITE ORAM TEAM LIST FILE #103 SEND TO SITE SORT TEMPLATE: ACTION: ORAM NEXT LAB SORT FILE #103 SEND TO SITE ORAM TEAM LIST FILE #100.21 SEND TO SITE ROUTINE: ACTION: ORAM SEND TO SITE ORAM1 SEND TO SITE ORAM2 SEND TO SITE ORAM3 SEND TO SITE ORAMSET SEND TO SITE ORAMTTR SEND TO SITE ORAMX SEND TO SITE ORWOR SEND TO SITE OPTION: ACTION: ORAM ANTICOAGULATION CONTEXT SEND TO SITE RPC Context for Anticoagulation Management. ORAM ANTICOAGULATION SETUP SEND TO SITE Supports entry and update of the parameters which determine the behavior of the Anticoagulation Management application. ORAM CLINIC PARAMETERS SEND TO SITE Supports entry and update of the Clinic parameters which determine the behavior of the Anticoagulation Management application. ORAM COMPLICATIONS REPORT SEND TO SITE Option to generate a report of complications to patients being tracked by Anticoagulation Management. ORAM DIVISION PARAMETERS SEND TO SITE Supports entry and update of the Division-wide parameters which determine the behavior of the Anticoagulation Management application. ORAM PATIENT LIST ALL SEND TO SITE This option prints the list of ALL patients for a selected Clinic. ORAM PATIENT LIST COMPLEX SEND TO SITE This option prints the list of Complex patients for a selected Clinic. ORAM PATIENT LIST MENU SEND TO SITE This menu allows printing/display of Patient Lists for Anticoagulation Management. ORAM PATIENT LIST NEXT LAB SEND TO SITE This option supports generation of a list of Anticoagulation patients for a selected Clinic, sorted by Next Lab Date for a user-specified date range. ORAM REPORTS MENU SEND TO SITE This option provides access to the Quality Assurance Reports for the Anticoagulation Management Program. ORAM ROSENDAAL SINGLE PT TTR SEND TO SITE Option to generate a report of the Time in Therapeutic range for a single patient in Anticoagulation Management. ORAM ROSENDAAL TTR REPORT SEND TO SITE Option to generate a report of the Time in Therapeutic range on both the facility-wide and clinic-by-clinic basis for Anticoagulation Management. ORAM SET TEAMS SEND TO SITE This non-interactive option is used to set the daily Team Lists for the Anticoagulation Management Teams. Works with the Anticoagulation Management software. It should be queued to run daily in the early morning, before the system is busy or the clinics start. ORW PARAM GUI USE AS LINK FOR MENU ITEMS PARAMETER DEFINITIONS: ACTION: ORAM ADDRESS LINE 1 SEND TO SITE This is the first line of the Anticoagulation Clinic address. ORAM ADDRESS LINE 2 SEND TO SITE This is the second line of the Anticoagulation Clinic address. ORAM ADDRESS LINE 3 SEND TO SITE This is the (optional) third line of the Anticoagulation Clinic address. ORAM APPT MATCH LOOK-AHEAD SEND TO SITE This is the whole number of days to look-ahead (into the future) when attempting to match the Anticoagulation Encounter to a scheduled appointment in the VistA Scheduling Package. Please enter a number between 0 and 3, no decimal digits. The default will be one (1) day (i.e., tomorrow). A value of zero (0) will restrict the search to end with today's appointments (i.e., T@23:59). ORAM APPT MATCH LOOK-BACK SEND TO SITE This is the whole number of days to look-back when attempting to match the Anticoagulation Encounter to a scheduled appointment in the VistA Scheduling Package. Please enter a number between 0 and 7, no decimal digits. The default will be one (1) day (i.e., yesterday). A value of zero (0) will restrict the search to begin with today's appointments (i.e., T@00:00). ORAM AUTO PRIMARY INDICATION SEND TO SITE This is an Indication for care which will automatically be filed as the Primary Indication for each visit to the applicable Clinic. (e.g., if all visits to a non-licensed provider should be filed with V58.83 ENCTR THERAP DRUG MONITOR as the primary indication, you can specify that with this parameter, and the user will still be able to select another indication from the list as the secondary indication). ORAM CBC QUICK ORDER SEND TO SITE This is the reference to the Quick Order Dialog for Complete Blood Count (CBC). ORAM CLINIC FAX NUMBER SEND TO SITE Telephone number, with extension if needed, for FAXes to be sent to the anticoagulation clinic. For patient letters. ORAM CLINIC NAME SEND TO SITE Specifies the name of the Clinic with which the user may associate the patient whose flowsheet is being viewed/entered (3 - 30 characters in length). ORAM CLINIC PHONE NUMBER SEND TO SITE Telephone number, with extension if needed, for patient to contact the anticoagulation clinic. For patient letters. ORAM CONSULT LINK ENABLED SEND TO SITE Indicates if Consult Linker will be used. If NO: prompt will not be seen to complete consult. ORAM CONSULT REQUEST SERVICE SEND TO SITE This is the reference to the Consult Request Service with which Consult data will be associated for the Anticoagulation clinic. It is used only if the linkage with the Consult Package is enabled. ORAM CPT FOR COMPLEX PHONE SEND TO SITE This is the CPT code for a Complex Telephone Visit (i.e., HC PRO PHONE CALL 21-30 MIN (CPT-4 98968), as of 10/2008). ORAM CPT FOR INITIAL VISIT SEND TO SITE This is the CPT code for the Initial Office Visit (i.e., ANTICOAG MGMT, INIT (CPT-4 99363), as of 10/2008). ORAM CPT FOR LETTER TO PT SEND TO SITE This is the CPT code for a Letter to the Patient (i.e., (CPT-4 98966), as of 10/2008). ORAM CPT FOR ORIENTATION SEND TO SITE This is the CPT code for the Orientation Class Visit (i.e., GROUP HEALTH EDUCATION (CPT-4 99078), as of 10/2008). ORAM CPT FOR SIMPLE PHONE SEND TO SITE This is the CPT code for a Simple Telephone Visit (i.e., HC PRO PHONE CALL 5-10 MIN (CPT-4 98966), as of 10/2008). ORAM CPT FOR SUBSEQUENT VISIT SEND TO SITE This is the CPT code for Subsequent Anticoagulation Management (i.e., ANTICOAG MGMT, SUBSEQ (CPT-4 99364), as of 10/2008). ORAM DEFAULT PILL STRENGTH SEND TO SITE This is the default Pill Strength in milligrams for the Clinic in question (e.g., 2.5, 5, or 10). If you do not specify a pill strength, the program will default to 5 mg. ORAM DISCHARGE NOTE SEND TO SITE This is the TIU Document Title that identifies the Anticoagulation Discharge Note, which is entered upon the patient's discharge from the Anticoagulation clinic. ORAM DSS ID SEND TO SITE This is the stop code for the Anticoagulation Clinic. ORAM DSS UNIT SEND TO SITE This is the reference to the DSS Unit to which the anticoagulation data will be associated. ORAM HCT/HGB REFERENCE SEND TO SITE This is the reference to the Lab Test for Hematocrit (HCT) or Hemoglobin (Hgb). It will determine whether the Demographics Tab will display the most recent Hematocrit or the last Hemoglobin. ORAM INCL TIME W/NEXT INR DATE SEND TO SITE Please indicate whether the user should be asked to include time of day when specifying the Return for INR Date. ORAM INDICATIONS FOR CARE SEND TO SITE These are the Indications for care and their associated ICD-9-CM codes. ORAM INITIAL NOTE SEND TO SITE This is the TIU Document Title that identifies the Anticoagulation Initial Assessment Note, which is entered for the patient's first visit upon enrollment in the Clinic. ORAM INR QUICK ORDER SEND TO SITE This is the reference to the Orderable Item for the INR (International Normalized Ratio) for Prothrombin Times. INR: International normalized ratio, a system established by the World Health Organization (WHO) and the International Committee on Thrombosis and Hemostasis for reporting the results of blood coagulation (clotting) tests. All results are standardized using the international sensitivity index for the particular thromboplastin reagent and instrument combination utilized to perform the test. For example, a person taking the anticoagulant ("blood thinner") warfarin (brand name: Coumadin) might optimally maintain a prothrombin time (a "pro time" or PT) of 2 to 3 INR. No matter what laboratory checks the prothrombin time, the result should be the same even if different thromboplastins and instruments are used. This international standardization permits the patient on warfarin to travel and still obtain comparable test results. ORAM INTERIM NOTE SEND TO SITE This is the TIU Document Title that identifies the Anticoagulation Interim Note, which is entered during the patient's ongoing treatment by the Anticoagulation clinic. ORAM MEDICAL CENTER NAME SEND TO SITE Name of medical facility for letter head. ORAM NON-COUNT LOCATION SEND TO SITE Clinic Locations Without PCE Functions: Clinic location you choose is the clinic the note will be associated with. This requires a number from the Hospital Location file. If you do NOT use the PCE function, then your site is responsible for encounters, etc. The program does NOT care if you use a count or a non-count clinic. With PCE Functions: If you DO use PCE functions, then you will be asked for three clinics, one for face contact (the one on the yellow sheet), one for phone contact, and one that is non count (these are on the PCE form). The "VISIT" location (the ANTICOAG VISIT Clinic Location) should be a Clinic for FACE to FACE visits. The program does not care if you use the same clinic for both the phone and face to face, but for PCE credit they must be COUNT CLINICS. The non-count clinic is used for notes only, when no PCE data is recorded. ORAM PCE LINK ENABLED SEND TO SITE Indicates if interface with PCE will be used. If NO: prompt will not be seen to enter PCE information, and the information will not be passed to the Event Capture system. ORAM PHONE CLINIC SEND TO SITE Clinic Locations Without PCE Functions: Clinic location you choose is the clinic the note will be associated with. This requires a number from the Hospital Location file. If you do NOT use the PCE function, then your site is responsible for encounters, etc. The program does NOT care if you use a count or a non-count clinic. With PCE Functions: If you DO use PCE functions, then you will be asked for three clinics, one for face contact (the one on the yellow sheet), one for phone contact, and one that is non count (these are on the PCE form). The "VISIT" location (the ANTICOAG VISIT Clinic Location) should be a Clinic for FACE to FACE visits. The program does not care if you use the same clinic for both the phone and face to face, but for PCE credit they must be COUNT CLINICS. The non-count clinic is used for notes only, when no PCE data is recorded. ORAM POINT OF CONTACT NAME SEND TO SITE Name of Contact Person (or Clinic) for the "CALL IF QUESTIONS" block on patient letters. ORAM RAV FILE PATH SEND TO SITE To use the letter programs the Anticoagulator needs to know where to find them. This path is where you put the 2 .rav files (cvisit.rav and mappt.rav). Usually placed in the same network file as the the .EXE file for the program for ease of updating, etc. This field contains the path up to the slash before the exe. Portland example: \\vhaporfpc11\ClinApps\DelphiExe\antiC\ ORAM SIGNATURE BLOCK NAME SEND TO SITE Signing name to be used in the letter signature blocks. ORAM SIGNATURE BLOCK TITLE SEND TO SITE Title used in letter signature blocks. ORAM TEAM LIST (ALL) SEND TO SITE The ALL Patient list, shows everyone scheduled for that team for that day AND any patients NOT completed on previous days. Patients drop off this list as they are completed in the Anticoagulator. ORAM TEAM LIST (COMPLEX) SEND TO SITE The complex patient list pulls out these patients so that they are not lost on the larger list (they appear on both lists). Patients drop off this list as they are completed in the Anticoagulator. ORAM TOLL FREE PHONE SEND TO SITE Toll free telephone number, for patient to contact the anticoagulation clinic. For patient letters. ORAM VISIT LOCATION SEND TO SITE Clinic Locations Without PCE Functions: Clinic location you choose is the clinic the note will be associated with. This requires a number from the Hospital Location file. If you do NOT use the PCE function, then your site is responsible for encounters, etc. The program does NOT care if you use a count or a non-count clinic. With PCE Functions: If you DO use PCE functions, then you will be asked for three clinics, one for face contact (the one on the yellow sheet), one for phone contact, and one that is non count (these are on the PCE form). The "VISIT" location (the ANTICOAG VISIT Clinic Location) should be a Clinic for FACE to FACE visits. The program does not care if you use the same clinic for both the phone and face to face, but for PCE credit they must be COUNT CLINICS. The non-count clinic is used for notes only, when no PCE data is recorded. PARAMETER TEMPLATE: ACTION: ORAM CLINIC PARAMETERS SEND TO SITE Supports entry and update of the Clinic parameters which determine the behavior of the Anticoagulation Management application. ORAM SITE PARAMETERS SEND TO SITE Supports entry and update of the Division-wide parameters which determine the behavior of the Anticoagulation Management application. REMOTE PROCEDURE: ORAM APPTMTCH SEND TO SITE This RPC supports revision of the appointment match when the user selects a new Clinic in Anticoagulator. ORAM CONCOMP SEND TO SITE Receives the Consult Number, the note number and the DUZ; completes the consult with the note. ORAM HCT SEND TO SITE Returns the patient's most recent Hematocrit (HCT). ORAM INR SEND TO SITE Returns last 6 months of INR values and dates. ORAM ORDER SEND TO SITE This RPC supports placing INR and CBC orders from the Anticoagulator application. ORAM PATIENT SEND TO SITE Returns the requested patient's Name, Gender, SSN, and Inpatient Status. ORAM PROVIDER SEND TO SITE Returns provider DUZ and name. ORAM SIGCHECK SEND TO SITE Validates the Electronic Signature Code entered by the user. ORAM1 ACDATA SEND TO SITE Retrieves record header information (e.g., indication for treatment, permissions, risks, goals, etc.) for the current patient. ORAM1 ADDTOP SEND TO SITE Files record header information for the current patient and care episode. ORAM1 COMPTEST SEND TO SITE Files complications for the current flowsheet entry. ORAM1 FLOWTT SEND TO SITE Retrieves flowsheet data for the current patient. ORAM1 GETPT SEND TO SITE Returns list of patients from Anticoagulation Flowsheet file (#103). ORAM1 LOCK SEND TO SITE Sets lock in Anticoagulation Flowsheet file (#103) so that only one person can edit a given patient's record at a time. ORAM1 LOG SEND TO SITE Updates Anticoagulation Flowsheet file (#103) and adds log entry. ORAM1 OUTINR SEND TO SITE Receives outside INR values and returns value^date (in $H format) for graphing. ORAM1 PCGOAL SEND TO SITE Calculates percent in goal from filed INR entries for Anticoagulation Management patients - can do either Stable or all patients (pass 1 as second parameter for stable). ORAM1 PTCHECK SEND TO SITE Boolean RPC. Checks to see if patient is in Anticoagulation Flowsheet file (#103). ORAM1 PTENTER SEND TO SITE Adds a new patient to the Anticoagulation Flowsheet file (#103). ORAM1 TERASE SEND TO SITE Removes a patient from the Anticoagulation Team List. ORAM1 UNLOCK SEND TO SITE Unlocks a patient's record in the Anticoagulation Flowsheet file (#103). ORAM2 ALLGOAL SEND TO SITE Returns the percentage of patients in the Anticoagulation Flowsheet file (#103) whose last INRs (within the specified number of days) were in-goal. ORAM2 NOACT SEND TO SITE Checks Anticoagulation Flowsheet file (#103) for patients not seen within the user-specified number of days. ORAM2 PTAPPT SEND TO SITE Returns the number of patients scheduled in the Anticoagulation clinic per day for the next 30 days. Only days with appointments are displayed. ORAM2 REMIND SEND TO SITE Sets date and text for ACM Reminder (can also be set as part of a complete visit entry). ORAM2 SHOWRATE SEND TO SITE Returns percentage of visits in which the patient was on time or within one day (before or after) scheduled draw date. ORAM2 TEAMCHK SEND TO SITE Checks list of teams to be sure they are in the OE/RR LIST file (#100.21), and returns the IEN and Clinic Name. ORAM3 COMPENT SEND TO SITE Enters complication note into the Anticoagulation Flowsheet file (#103). Can also be entered as part of a complete visit entry. ORAM3 PTADR SEND TO SITE Retrieves contact information. Will also check for active temporary information. ORAM3 PTFONE SEND TO SITE Gets home phone^work phone for the patient in question. ORAMSET GET SEND TO SITE Returns the Anticoagulation Manager parameters for the division which the user is logged into. ORAMSET GETCLINS SEND TO SITE This RPC fetches the list of Clinic Names from the configuration of the Anticoagulation Management Application. ORAMSET INDICS SEND TO SITE This call populates the list of selectable indications for Anticoagulation therapy. ORAMX CONSULT SEND TO SITE Send DFN and the name of the Consult Service (from the ORAM CONSULT REQUEST SERVICE parameter). Returns pending and active consults which meet those criteria. ORAMX PCESET SEND TO SITE This RPC accepts Diagnosis, Procedure, and service connection, etc., for PCE data call and calls DATA2PCE^PXAPI to file Encounter data. ORAM ANTICOAG REPORT This report implements an Anticoagulation Flowsheet for the CPRS Reports tab. The post-install routine for OR*3*307 automatically attaches the report to the ORRPW REPORT CATEGORIES group on the Reports tab, so that users of CPRS have immediate access to the Anticoagulation data for their patients. Documentation: ============== Documentation describing the functionality introduced by this patch is available. The preferred method is to FTP the files from download.vista.med.va.gov. This transmits the files from the first available FTP server. Sites may also elect to retrieve software directly from a specific server as follows: Albany ftp.fo-albany.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov The documentation will be in the form of Adobe Acrobat files and Microsoft Word Files. The documentation associated with this patch is: Installation/Implementation Guide: ORAMig.PDF and ORAMig.DOC User Manual: ORAMum.PDF and ORAMum.DOC Technical Manual: ORAMtm.PDF and ORAMtm.DOC Anticoagulation Management documentation can also be found in the VistA Documentation Library: http://www.va.gov/vdl. Installation Instructions: ========================= This patch may be installed with users on the system; however, it should be installed at a non-peak time to minimize disruption to the users. Installation of this patch should take less than 2 minutes. Complete installation instructions are in the Anticoagulation Management Installation/Implementation Guide. To obtain the current client software, use FTP to retrieve OR_30_307.zip from one of the following OI Field Offices' ANONYMOUS.SOFTWARE directories: OI Field Office FTP Address Directory Albany ftp.fo-albany.med.va.gov anonymous.software Hines ftp.fo-hines.med.va.gov anonymous.software Salt Lake City ftp.fo-slc.med.va.gov anonymous.software GUI Client installation instructions are in the Anticoagulation Management Installation/Implementation Guide. The software distribution includes these files, which are bundled in a .ZIP archive file, called OR_30_307.zip (3.39 MB): FILE NAME DESCRIPTION FILE VERSION Anticoag help file.cnt Client help TOC file Anticoag_help_file.hlp Client help file AntiCoagulate.exe Client 1.0.0.19 AntiCoagulate.map Client map file CVisit.rav Rave Reports Template MAppt.rav Rave Reports Template MAppt No FAX Labs.rav Rave Reports Template ORAMig.doc Install/Impl Guide ORAMig.pdf " " ORAMTM.doc Technical Manual ORAMTM.pdf " " ORAMUM.doc User Manual ORAMUM.pdf " " Post-Installation Instructions: ============================== Follow the instructions in the Anticoagulation Management Installation/ Implementation Guide to complete the implementation of this patch. Routine Information: ==================== The second line of each of these routines now looks like: ;;3.0;ORDER ENTRY/RESULTS REPORTING;**[Patch List]**;Dec 17, 1997;Build 60 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ORAM Before: n/a After: B73547514 **307** Routine Name: ORAM1 Before: n/a After:B159543113 **307** Routine Name: ORAM2 Before: n/a After:B120270114 **307** Routine Name: ORAM3 Before: n/a After: B38571379 **307** Routine Name: ORAMSET Before: n/a After: B40743224 **307** Routine Name: ORAMTTR Before: n/a After: B84948729 **307** Routine Name: ORAMX Before: n/a After:B147643525 **307** Routine Name: ORAMY Before: n/a After: B23662959 **307** Routine Name: ORWOR Before: B35518390 After: B36027702 **10,85,132,141,163,187,190, 215,243,307** Routine list of preceding patches: 243 ============================================================================= User Information: Entered By : RUSSELL,JOEL Date Entered : DEC 04, 2008 Completed By: SERVICE,JOHN Date Completed: MAR 15, 2010 Released By : STOKER,ELAINE Date Released : MAR 17, 2010 ============================================================================= Packman Mail Message: ===================== $END TXT