$TXT Created by DEVA.DOMAIN.EXT (KIDS) on Tuesday, 02/05/19 at 18:46 ============================================================================= Run Date: MAR 04, 2019 Designation: DG*5.3*951 Package : DG - REGISTRATION Priority: EMERGENCY Version : 5.3 SEQ #854 Status: Released Compliance Date: MAR 07, 2019 ============================================================================= Associated patches: (v)DG*5.3*864 <<= must be installed BEFORE `DG*5.3*951' (v)DG*5.3*911 <<= must be installed BEFORE `DG*5.3*951' (v)DG*5.3*921 <<= must be installed BEFORE `DG*5.3*951' Subject: SHRPE ENHANCEMENTS FOR PATIENT RECORD FLAGS Category: - Enhancement () - Data Dictionary - Routine - Other Description: ============ NOTE: This patch is requested to be installed prior to or on the compliance date, which is 3 days after its release. Patient Record Flags (PRF) data can get out of sync when some sites have installed the patch and some have not and this can potentially cause patient safety issues. The patch description provides instructions on how to fix the issues if they arise. While the shorter period of installation cannot guarantee there will be no issues, this approach can minimize the risk by reducing the chance of out-of-sync occurrences and in the case it does happen, there will be fewer sites that will need to fix issues manually. This patch addresses enhancements to Patient Record Flags (PRF) to improve the delivery of targeted Mental Health care for individuals at high risk for suicide. Enhancements to PRF reports were made to improve effective management of coordination of care for high risk individuals and to include new data elements introduced with this patch. 1. The Disruptive Behavior Reporting System (DBRS) record numbers are now recorded in the PRF FileMan files to enable a convenient reference between VistA and DBRS. The patch contains the following modifications to support DBRS functionality: a) Ability to enter/edit multiple DBRS data sets on National Category 1 Behavioral PRF flags in VistA. b) Enforced format of DBRS Number field to be consistent with DBRS case numbers in DBRS system. c) HL7 updates to pertinent messages to include DBRS data set information. d) Implemented business rules around editing DBRS data sets and tracking the author for enforcement of editing rules. e) New DBRS Historical Report to display historical edits made to a single National Category 1 Behavioral PRF flag in VistA. f) New Application Programming Interface (API) GETDBRS^DGPFDBRS was added to the Registration (DG) application to provide access to DBRS data to external applications like Computerized Patient Record System (CPRS) for displaying DBRS data on the screen. The Integration Control Registration (ICR)# 6874 was introduced for this new interface. 2. Modification to support Text Integration Utility (TIU)/CPRS Progress Note Properties' flag action list functionality. The new array element "ORIG FAC" was added to the output of the pre-existing API $$GETHTIU^DGPFAPI1. The new data element contains the facility that created the Assignment History record. This will allow the TIU application to retrieve the data via RPC TIU GET PRF ACTIONS and display the originating facility on the Progress Note Properties' flag action list and sort entries by these values. Note: The respective TIU modification is required to make this functionality available for users and it will be included in the future version of CPRS. The ICR# 4383, that covers $$GETHTIU^DGPFAPI1, was updated accordingly. 3. Enhancements to PRF flags ownership transfers. The patch implements new functionality and makes modifications to existing code to improve the process of ownership transfer and eliminate issues reported by PRF users: a) The new ListMan action "PRF Owner Transfer Request" (FT) in the Record Flag Assignment [DGPF RECORD FLAG ASSIGNMENT] menu option was created to request ownership transfer of PRF assignments. - When a user requests ownership transfer, the division that was used to sign into VistA will be the new owner. Note: This modification addresses PRF transfer issues experienced by integrated sites. - If the assignment is active, a MailMan message will be sent to the current owner's mail group requesting approval. - If the assignment is inactive, the transfer will be done immediately and a MailMan message will be sent notifying the current owner of the change of ownership action. - The functionality prevents duplicate requests. b) The corresponding new menu option Record Flag Transfer Requests (TR) was created to manage ownership transfer requests: The new menu option allows users to: - list requests and their statuses - review request details - approve or reject requests - enter a reason for transfer request and a reason for approval/rejection c) The MailMan modification is sent to PRF mail group 'DGPF PRF TRANSFER REQUESTS' when PRF ownership request is - sent - received - approved - rejected d) Both the Change Assignment Ownership (CO) and the PRF Owner Transfer Request (FT) actions will set the Review Date on the new owner's system to the default value for that flag. e) Change Assignment Ownership (CO) action is blocked from transferring an Active PRF assignment if an existing request created in PRF Owner Transfer Request (FT) action is pending. f) New option, DGPF RECORD REFRESH is sent out as a stand alone OPTION not attached to any menu. It is locked with the SECURITY KEY "DGPF TRANSMISSIONS". This option was designed to be used by VA Tier II Support or at their direction. This action allows the user to retransmit the entire PRF record to other sites to enforce PRF flag synchronization across the sites where the patient is registered. 4. Various enhancements and fixes related to PRF flag HL7 transmissions: a) In the Assign Flag (AF) and the Edit Flag Assignment (EF) actions, the two word processing fields for Assignment Narrative and Edit Reason will require a minimum of three consecutive alpha characters. b) HL7 messages for PRF related transmission and their processing were updated to use external names of PRF flag instead of internal entry numbers (IENs). c) PRF HL7 message processing code was updated to properly handle HL7 delimiters entered by users in free text fields. Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name(Number) New/Modified/Deleted ---------------------------- -------------------- ------------------- PRF ASSIGNMENT FILE (#26.13) DBRS NUMBER (#2) New Multiple DBRS NUMBER (#26.131) DBRS NUMBER (#.01) New OTHER DBRS DATA (#.02) New DATE (#.03) New CREATE SITE (#.04) New PRF ASSIGNMENT HISTORY (#26.14) PRF ASSIGNMENT (#.01) Modified ACTION (#.03) Modified CREATED BY SITE (#.09) New DBRS NUMBER (#2) New Multiple DBRS NUMBER (#26.142) DBRS NUMBER (#.01) New DBRS OTHER (#.02) New DATE (#.03) New STATUS (#.04) New CREATE SITE (#.05) New PRF HL7 REQUEST LOG (#26.22) New Bulletins Associated: New/Modified/ Bulletin Name Deleted ------------- ------------- N/A Dialogs Associated: New/Modified/ Dialog Name Deleted ----------- ------------- N/A Forms Associated: New/Modified/ Form Name File Name (Number) Deleted --------- ------------------ ------------- N/A Functions Associated: New/Modified/ Function Name Deleted ------------- ------------- N/A HL Logical Link: New/Modified/ HL Logical Name Deleted --------------- ------------- N/A HL7 Application Parameters: New/Modified/ HL7 Parameter Name Deleted ------------------ ------------- PRF-TRANS-REQ New PRF-TRANS-RESP New HLO Application Registry: New/Modified/ HLO Registry Name Deleted ----------------- ------------- N/A Help Frames Associated: New/Modified/ Help Frame Name Deleted --------------- ------------- N/A Mail Groups Associated: New/Modified/ Mail Group Name Deleted --------------- ------------- DGPF PRF TRANSFER REQUESTS New Options Associated: New/Modified/ Option Name Type Deleted ----------- ----------- ------------- DGPF DISRUPT BEHAVIOR REPORT Run Routine New DGPF PRF TRANSFER REQUESTS Run Routine New DGPF RECORD FLAG REPORTS MENU Menu Modified DGPF RECORD FLAGS MAIN MENU Menu Modified DGPF RECORD REFRESH Run Routine New Parameter Definitions: New/Modified/ Parameter Name Deleted -------------- ------------- N/A Parameter Template: New/Modified/ Template Name Deleted ------------- ------------- N/A Protocols Associated: New/Modified/ Protocol Name Deleted ------------- ------------- DGPF PRF QBP/Q11 EVENT New DGPF PRF QBP/Q11 SUBSC New DGPF PRF RSP/K11 EVENT New DGPF PRF RSP/K11 SUBSC New DGPF PRF TR REQ CHANGE VIEW New DGPF PRF TR REQ DETAILS New DGPF PRF TR REQ MENU New DGPF PRF TR REQ REVIEW New DGPF RECORD FLAG ASSIGNMENT MENU New DGPF TRANSFER FLAG New VALM QUIT Unchanged Remote Procedures Associated: New/Modified/ Remote Procedure Name Deleted --------------------- ------------- N/A Security Keys Associated: New/Modified/ Security Key Name Deleted ----------------- ------------- N/A Templates, Input Associated: New/Modified/ Template Name Type File Name (Number) Deleted ------------- ---- ------------------ ------------- N/A Templates, List Associated: New/Modified/ Template Name Type Deleted ------------- ---- ------------- DGPF PRF TRANSFER REQUESTS List New Templates, Print Associated: New/Modified/ Template Name Type File Name (Number) Deleted ------------- ---- ------------------ ------------- N/A Templates, Sort Associated: New/Modified/ Template Name Type File Name (Number) Deleted ------------- ---- ------------------ ------------- N/A Additional Information: N/A New Service Requests (NSRs) ---------------------------- N/A Patient Safety Issues (PSIs) ----------------------------- N/A Remedy Ticket(s) & Overview --------------------------- 1. I17222368FY18 - No Category I Patient Record Flag Assignments found Problem: ------- "No Category I Patient Record Flag Assignments found" is the response for queries made concerning existing Patient Record Flag (PRF) data and no PRF data is transmitted. It has been determined a PRF file entry having a lone associated comment consisting solely of a punctuation/ control character is treated by PRF-HL7 processing as not-valid; and is treated as if there is no flag history. Resolution: ---------- Modify routine DGPFHLUT to transmit an HL7 message when entering a punctuation as a comment and store it with quotes so that it does not interfere with HL7 message format or integrity. Test Sites: ---------- Syracuse West Palm Beach Iowa City Des Moines Omaha Documentation Retrieval Instructions ------------------------------------ The software is released as a PackMan patch message and is distributed via FORUM. Software documentation describing the new functionality introduced by this patch is available for downloading from the ANONYMOUS.SOFTWARE directories or from the VA Software Documentation Library. The preferred method is to retrieve the files from the ANONYMOUS.SOFTWARE directories is from download.vista.domain.ext. This transmits the files from the first available server. Sites may elect to retrieve the software and/or documentation directly using Secure File Transfer Protocol (SFTP) from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Hines: domain.ext Salt Lake City: domain.ext Documentation can also be found on the VA Software Documentation Library at: http://www.domain.ext/vdl/ Title File Name SFTP Mode ----------------------------------------------------------------------- PIMS Technical Manual pimstm.pdf Binary Patient Record Flags prfhl7is.pdf Binary HL7 Interface Specification Patient Record Flags patient_record_flags_user_guide.pdf Binary User Guide Patch Installation: Pre/Post Installation Overview ------------------------------ Post-installation routine DG53P951 creates a non-human user "DGPRF,INTERFACE", if one does not already exist. This user account is used for sending various MailMan notifications and ownership transfers of inactive PRF flags. The installer needs to contact the site's Suicide Prevention Coordinators (National Category 1 High Risk for Suicide flags) and Disruptive Behavior Committee Chair (National Category 1 Behavioral flags) to identify the person who will be coordinating transfer requests notifications for PRF flags. That person's name should be entered at the following prompt for the newly created mailgroup: Enter the Coordinator for Mail Group 'DGPF PRF TRANSFER REQUESTS': During installation of the patch, the "HL7 CHECK POST-INSTALLATION" report will be generated and sent to: - the installer, - POSTMASTER, - DGPF BEHAVIORAL FLAG REVIEW mail group, - IRM mail group to identify potential DBRS data synchronization issues. Pre-Installation Instructions ----------------------------- N/A 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. However, the "HL7 CHECK POST-INSTALLATION" report generation portion of the patch might take up to several hours. Therefore it is designed to be run in the background (see details in the paragraph below). The patch installation can be queued if necessary. - If the patch installation is queued, no questions will be asked and the installer will receive a separate MailMan message with the "HL7 CHECK POST-INSTALLATION" report if something was found to report. A "NO REPORT GENERATED" message will be emailed and displayed if nothing was found to report. - If the patch installation is not queued then the installer will be prompted to schedule a specific time when the background jobs should be started. The user can also press the Enter key to accept NOW and start it immediately: Requested Start Time: NOW// Later, the user (and other recipients) will receive the report as a MailMan message or "NO REPORT GENERATED" message if nothing was found to report. Note: please see more details about this report in the post-install section. Options to disable during the install: Patient Record Flag Background [DGPF BACKGROUND PROCESSING] 1. Choose the PackMan message containing this patch. 2. Choose the INSTALL/CHECK MESSAGE PackMan option. 3. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, you may elect to use the following options. When prompted for the INSTALL enter the patch #: DG*5.3*951. 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. From the Installation Menu, select the Install Package(s) option and choose the patch to install. Enter DG*5.3*951 5. Enter the Coordinator for Mail Group 'DGPF PRF TRANSFER REQUESTS': 6. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//', answer with YES. 7. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer with NO. 8. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', answer with YES, Enter options you wish to mark as 'Out Of Order': DGPF BACKGROUND PROCESSING Patient Record Flag Background Enter options you wish to mark as 'Out Of Order': Enter protocols you wish to mark as 'Out Of Order': 9. If prompted 'Delay Install (Minutes): (0 - 60): 0//', respond 0. 10. Enter the Device you want to print the Install messages. You can queue the install by enter a 'Q' at the device prompt. Enter a '^' to abort the install. DEVICE: HOME// 11. You will now be prompted for Requested Start Time to generate the HL7 CHECK POST INSTALLATION REPORT If you do not enter a time, then this report will be queued to run NOW. Requested Start Time: NOW// Post-Installation Instructions ------------------------------ During National Release period all VA sites will generate the "HL7 CHECK POST-INSTALLATION" report that will be used to address DBRS data synchronization issues across the VA that can be occur during the deployment period when some sites will have DG*5.3*951 installed and some will not have it yet. During this period, DBRS data sent in HL7 messages to the sites without the patch will not be able to store DBRS data in the database. The report will be generated at the end of the DG*5.3*951 installation process. The installer and other recipients of the report will receive it in the form of a MailMan message. The process of generating the report might take up to several hours; therefore, the MailMan message with the report can be received several hours after the time scheduled to generate the report. The report will identify patients for whom DBRS data was sent from other sites during the National Release period (for simplicity the report will be checking for the last 4 days in the past and this will cover the National Release period). The report text will list patients and sending sites that need to run the "Refresh" option for their patients listed in the report. The report will be sent to the following recipients: the installer, POSTMASTER, local Information Resources Management (IRM) "IRM" mail group, local "DGPF BEHAVIORAL FLAG REVIEW" mail group. Routine Information: ==================== The second line of each of these routines now looks like: ;;5.3;Registration;**[Patch List]**;Aug 13, 1993;Build 135 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: DG53P951 Before: n/a After:B177935300 **951** Routine Name: DGPFAA Before: B41515033 After: B81848262 **425,921,951** Routine Name: DGPFAA1 Before: B954394 After: B1552435 **425,951** Routine Name: DGPFAA2 Before: B31192734 After: B33264279 **425,554,650,951** Routine Name: DGPFAA3 Before: B36294863 After: B37090841 **425,650,911,951** Routine Name: DGPFAAH Before: B32554418 After: B57134079 **425,554,951** Routine Name: DGPFAAH1 Before: B1218620 After: B1497249 **425,951** Routine Name: DGPFAPI1 Before: B24558175 After: B27698774 **554,650,951** Routine Name: DGPFDBRS Before: n/a After: B1824667 **951** Routine Name: DGPFHLF Before: n/a After: B68443058 **951** Routine Name: DGPFHLQ Before: B44511391 After: B53156618 **425,650,951** Routine Name: DGPFHLQ4 Before: B17883143 After: B34191835 **425,650,951** Routine Name: DGPFHLR Before: B69390340 After:B124847191 **425,650,951** Routine Name: DGPFHLT Before: n/a After: B17377719 **951** Routine Name: DGPFHLT1 Before: n/a After: B83307291 **951** Routine Name: DGPFHLT2 Before: n/a After: B13087829 **951** Routine Name: DGPFHLT3 Before: n/a After: B17764072 **951** Routine Name: DGPFHLT4 Before: n/a After: B1707116 **951** Routine Name: DGPFHLTM Before: n/a After: B17001676 **951** Routine Name: DGPFHLU Before: B34815804 After: B54583242 **425,718,650,951** Routine Name: DGPFHLU1 Before: B28767858 After: B6628832 **425,951** Routine Name: DGPFHLU2 Before: B22238545 After: B25225629 **425,951** Routine Name: DGPFHLU3 Before: B31915353 After: B31602328 **425,650,951** Routine Name: DGPFHLU4 Before: B16669354 After: B17533287 **425,951** Routine Name: DGPFHLUT Before: B36458354 After: B64018223 **425,650,951** Routine Name: DGPFLMA2 Before: B58607996 After: B95827931 **425,623,554,650,864,951** Routine Name: DGPFLMA3 Before: B74777125 After:B115226280 **425,623,554,650,864,951** Routine Name: DGPFLMA4 Before: B39834723 After: B45697880 **425,554,650,951** Routine Name: DGPFLMA5 Before: n/a After: B26946927 **951** Routine Name: DGPFLMU1 Before: B45355090 After: B57734763 **425,554,650,951** Routine Name: DGPFRDB Before: n/a After: B2814866 **951** Routine Name: DGPFRDB1 Before: n/a After: B36629736 **951** Routine Name: DGPFTR Before: n/a After: B25361396 **951** Routine Name: DGPFTR1 Before: n/a After: B75593234 **951** Routine Name: DGPFUT Before: B38902808 After: B65688898 **425,554,650,951** Routine Name: DGPFUT3 Before: B35131526 After: B43190610 **554,951** Routine Name: DGPFUT4 Before: B36954590 After: B49462470 **554,951** Routine Name: DGPFUT6 Before: n/a After: B4892495 **951** Routine Name: DGPFUT61 Before: n/a After:B148565711 **951** Routine Name: DGPFUT62 Before: n/a After: B53001893 **951** Routine Name: DGPFUT64 Before: n/a After: B9605992 **951** Routine list of preceding patches: 864, 911, 921 ============================================================================= User Information: Entered By : Date Entered : NOV 22, 2017 Completed By: Date Completed: MAR 04, 2019 Released By : Date Released : MAR 04, 2019 ============================================================================= Packman Mail Message: ===================== $END TXT