$TXT Created by DAVIS,PAULETTE T at DEVCRN.FO-ALBANY.MED.VA.GOV (KIDS) on Tuesday, 09/07/10 at 20:44 ============================================================================= Run Date: JAN 25, 2011 Designation: DG*5.3*825 Package : DG - REGISTRATION Priority: Mandatory Version : 5.3 SEQ #736 Status: Released Compliance Date: FEB 08, 2011 ============================================================================= Associated patches: (v)DG*5.3*479 <<= must be installed BEFORE `DG*5.3*825' (v)DG*5.3*756 <<= must be installed BEFORE `DG*5.3*825' Subject: SUPPORT FOR NATIONAL HEALTH INFORMATION EXCHANGE Category: - Enhancement (Mandatory) - Data Dictionary - Routine Description: ============ Patch DG*5.3*825 contains elements to support and enhance VA IdM (Identity Management) service communication with the National Health Information Network (NHIN). The NHIN can be thought of as the 'parent' gateway that communicates with the Master Patient Index (MPI) on behalf of its National Health Information Exchange (NHIE) 'children'. The NHIN project has systems that interact with the VA NHIN adapter to search for patients. On behalf of these systems, NHIN will communicate with the MPI and serve as an interpreter for the NHIE. Some of NHINS facilities include Kaiser Permanente, the Department of Defense, MedVirginia, and the Consumer Preference and Policy System (CPP). Patch DG*5.3*825 will enhance the capability of VA IdM to support the HL7v3.0 formatted Fully Qualified IDs. This effort will align the data perspective to support all four elements of the HL7 v2.4 standard PID-3 Identifier sequence as well as the larger HL7 v3.0 formatted unique Source IDs. Extensive information for the PID-3 Identifier sequence can be found in the Master Patient Index/Patient Demographics (MPI/PD), HL7 Interface Specifications document, available on the VistA Documentation Library (VDL). DG*5.3*479 and DG*5.3*756 are required builds for patch DG*5.3*825. Issue #1 When patient data is edited in VistA, an A04 or A08 Health Level Seven (HL7) message is generated to the Master Patient Index (MPI). When that record has an entry in the PATIENT MOVEMENT (#405) file and the TRANSACTION (#.02) field equals 1 (ADMISSION) the data is passed in the PV2-14 field of the PV2 segment. This data was incorrectly transmitted in the wrong piece of the PV2 segment. Routine VAFCSB has been modified to send the data in the 15th piece of the PV2 segment. Issue #2 A new file is created by patch DG*5.3*825. The VAFC ASSIGNING AUTHORITY (#391.92) file stores information used to assemble fully qualified identifiers used for either the Health Level Seven v2.4 or v3.0 standard. This data will support future initiatives, (i.e., National Health Information Network (NHIN) and non-Patient Identity Management). The VAFC ASSIGNING AUTHORITY (#391.92) file is exported with five entries and new data will be added as needed for HL7 messaging. The length of the SOURCE ID (#.01) field in the SOURCE ID (#20) multiple of the TREATING FACILITY LIST (#391.91) file has been changed from 40 to 150 characters. This will accommodate identifiers for National Health Information Network (NHIN) facilities. Two new fields have also been added. SOURCE ID TYPE (#.09) defines the data source and comes from the HL7 Table 0203, Identifier Type. The ASSIGNING AUTHORITY (#1) field is a pointer to the VAFC ASSIGNING AUTHORITY (#391.92) file. It identifies the entity that established the identification number for the patient. Cross-references have also been added for these new fields. Issue #3 Routine VAFCAAUT contains two new Application Programmer Interfaces (APIs). These APIs will be used for the upcoming NATIONAL HEALTH INFORMATION EXCHANGE project. The first API will retrieve data from the VAFC ASSIGNING AUTHORITY (#391.92) file. When either the HL7V2_4 or HL7V3_0 value is passed in, the Internal Entry Number (IEN) for that entry in the file is returned. The second API will create a new entry in the VAFC ASSIGNING AUTHORITY (#391.92) file. The data fields that make up the new entry, most likely the HL7V3_0 (#.03) and DEFAULT SOURCE ID TYPE (#.04) fields, are passed into the API. If the entry is successfully created, the API returns the IEN. If the entry cannot be created, an error message is returned. Issue #4 DG Field Monitor [DG FIELD MONITOR] is a PROTOCOL (#101) that observes the editing of fields during the Register a Patient [DG REGISTER PATIENT] option. Under specific conditions, an update could be unsuccessful in creating an entry in the ADT/HL7 PIVOT (#391.71) file, and thus fail to broadcast an update message to the MPI. This scenario occurs when a field that uses the DG Field Monitor PROTOCOL is edited via the Register a Patient [DG REGISTER PATIENT] option. No other fields are edited and the user exits without completing the registration process. Under these conditions, an entry is not created in the ADT/HL7 PIVOT (#391.71) file. Routine DGFCPROT has been changed to correct this. Issue #5 When a new entry is added to the MPI ASSIGNING AUTHORITY (#985.55) file on the MPI, the VAFC AA UPDATE REMOTE PROCEDURE is called. The RPC triggers an update message to those Treating Facilities where the patient's Integration Control Number (ICN) is known and creates an identical entry in the VistA VAFC ASSIGNING AUTHORITY (#391.92) file. The VAFCRPC routine is called to make this update. Data Dictionary Changes: ======================== - The VAFC ASSIGNING AUTHORITY (#391.92) file is a new file that contains the following fields. (#.01) IDENTIFIER (#.02) HL7V2_4 (#.03) HL7V3_0 (#.04) DEFAULT SOURCE ID TYPE The file is exported with data and will receive updates from the MPI. - The following changes have been made to the TREATING FACILITY LIST (#391.91) file. - The length of the SOURCE ID (#.01) field in the SOURCE ID (#20) multiple has been expanded. - Two new fields have been added. (#.09) SOURCE ID TYPE (#1) ASSIGNING AUTHORITY Documentation Update: ===================== The following MASTER PATIENT INDEX/PATIENT DEMOGRAPHICS (MPI/PD) VISTA documentation is available, updated for patch DG*5.3*825. Facilities should download the revised documentation listed as follows: Technical Manual DG5_3_P825RG_TM.PDF User Manual DG5_3_P825RG_UM.PDF The preferred retrieval method is to FTP from the ANONYMOUS.SOFTWARE directory at: DOWNLOAD.VISTA.MED.VA.GOV This transmits the file from the first available FTP server. Sites may also elect to retrieve software directly from one of the following servers. 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 Note: These files must be transferred in binary or IMAGE, not ASCII, mode. The documents can also be downloaded from the VistA Documentation Library (VDL) Web page in both Acrobat PDF and MS-Word DOC formats: http://www.va.gov/vdl/application.asp?appid=16 Associated Remedy Ticket(s): ============================ There are no associated Remedy Tickets. Associated New Service Request (NSR): ===================================== There is no associated NSR with the patch. Test Sites: =========== Bay Pines VA HCS Huntington VAMC VA Montana HCS PLEASE NOTE: ============ Routine VAFCSB, distributed in this patch, references routines LRPXAPI, PSO52API, and RAO7UTL1. In the event that DG*5.3*825 is installed in an account where those routines are not present, XINDEX may display either of these messages: "Reference to routine (one of the above). That isn't in this UCI." "Call to this MISSING LABEL (one of the above)" VAFCSB contains conditional $$PATCH^XPDUTL checks for the existence of the routine and quits if it is not there. So, the code will work with or without the routine being present. Installation Instructions: ========================== This patch takes less than 2 minutes to install. This patch should be loaded during non-peak hours to minimize disruption to the users. 1. Users are allowed on the system during patch installation. 2. The HL7 incoming filers should be stopped. Use the Monitor, Start, Stop Filers [HL FILER MONITOR] option on the Filer and Link Management Options [HL MENU FILER LINK MGT] menu on the HL7 Main Menu [HL MAIN MENU]. 3. Use the INSTALL/CHECK MESSAGE option on the PackMan menu. Note: TEXT PRINT/DISPLAY option in the PackMan menu will display the patch text only. 4. From the Kernel Installation and Distribution System Menu, select the Installation menu. 5. From this menu, you may elect to use the following options: (a) Backup a Transport Global. (b) Compare Transport Global to Current System. (c) Verify Checksums in Transport Global. (d) Print Transport Global. 6. Use the Install Package(s) option and select the package DG*5.3*825. 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? YES//', respond YES. The following OPTIONS should be disabled during the installation. Register a Patient [DG REGISTER PATIENT] Load/Edit Patient Data [DG LOAD PATIENT DATA] Electronic 10-10EZ Processing [EAS EZ 1010EZ PROCESSING] Preregister a Patient [DGPRE PRE-REGISTER OPTION] UPDATE BATCH JOB FOR HL7 v2.3 [VAFC BATCH UPDATE] 9. After patch installation has completed, restart the HL7 incoming filers. Use the Monitor, Start, Stop Filers [HL FILER MONITOR] option on the Filer and Link Management Options [HL MENU FILER LINK MGT] menu on the HL7 Main Menu [HL MAIN MENU]. Routine Information: ==================== The second line of each of these routines now looks like: ;;5.3;Registration;**[Patch List]**;AUG 13, 1993;Build 1 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: DGFCPROT Before: B4864093 After: B7131954 **273,526,707,825** Routine Name: VAFCAAUT Before: n/a After: B27332848 **825** Routine Name: VAFCRPC Before: B7443211 After: B7679300 **414,440,474,477,479,825** Routine Name: VAFCSB Before: B8457410 After: B8780845 **707,756,825** Routine list of preceding patches: 479, 756 ============================================================================= User Information: Hold Date : JAN 01, 2011 Entered By : DAVIS,PAULETTE Date Entered : FEB 22, 2010 Completed By: CHESNEY,CHRISTINE M Date Completed: DEC 22, 2010 Released By : HEUER,CINDY Date Released : JAN 25, 2011 ============================================================================= Packman Mail Message: ===================== $END TXT