$TXT Created by LOUCK,KEVIN C at DEVFEX.FO-ALBANY.MED.VA.GOV (KIDS) on Monday, 04/19/10 at 13:14 ============================================================================= Run Date: MAY 25, 2010 Designation: DVBA*2.7*151 Package : DVBA - AUTOMATED MED INFO EXCHANGE Priority: Mandatory Version : 2.7 SEQ #135 Status: Released Compliance Date: JUN 25, 2010 ============================================================================= Associated patches: (v)DVBA*2.7*142<<= must be installed BEFORE `DVBA*2.7*151' Subject: CAPRI TEMPLATES - STANDARD OBJECTS, PHASE II Category: - Enhancement (Mandatory) Description: ============ I. OVERVIEW 1. Standardized Panels, comprised of standardized components known collectively as Standard Objects, have been developed for Compensation & Pension Record Interchange (CAPRI) to standardize the exam questions being asked across Compensation & Pension Worksheet Module (CPWM) templates as they relate to certain body systems. 2. A major benefit of Standardized Panels, and Standard Objects in general, is the elimination of duplicate data entry for CAPRI CPWM templates that are merged and contain the same set of questions on individual templates. Once data has been entered on one of the merged templates, it will appear on all other merged templates which share its Standard Objects. 3. Revised report coding for the Standard Objects has also been developed so that the report format for each Standardized Panel or other Standard Object is consistent across templates. 4. These new Standard Objects will be incorporated into the set of CPWM templates in a three-phase approach. The first phase of this initiative, Patch DVBA*2.7*142, CAPRI TEMPLATES - STANDARD OBJECTS, PHASE I, was released on December 2, 2009. Patch DVBA*2.7*151, CAPRI TEMPLATES - STANDARD OBJECTS, PHASE II is the second step of the initiative. 5. Several modifications have been made to templates to correct both functional and textual defects. The affected templates include: - AID AND ATTENDANCE OR HOUSEBOUND EXAMINATION - BLANK TEMPLATE - EPILEPSY AND NARCOLEPSY - EYE EXAMINATION - GENERAL MEDICAL EXAMINATION - GULF WAR GUIDELINES - HYPERTENSION - PRISONER OF WAR PROTOCOL EXAMINATION - TRAUMATIC BRAIN INJURY II. ASSOCIATED REMEDY TICKETS & NEW SERVICE REQUESTS The following section lists the Remedy tickets and/or New Service Requests associated with this patch. 1. Associated Remedy Ticket(s): ---------------------------------- NONE 2. Associated New Service Request(s): ---------------------------------- NONE III. FUNCTIONAL OVERVIEW The following is an overview of the changes and primary functionality that will be delivered in this patch. 1. Content for a number of Standardized Panels has been approved by the Veterans Benefits Administration Veterans Affairs Central Office (VBAVACO). They are listed here, grouped by the template tab page to which each is related: HISTORY - Trauma, Neoplasm PHYSICAL EXAM - Residuals of Neoplasm, Motor Function, Sensory Function, Reflexes DIAGNOSIS - Employment History, Financial Affairs, Diagnosis 2. This patch adds the Standard Objects listed above to the following templates, if they apply: AID AND ATTENDANCE OR HOUSEBOUND EXAMINATION BRAIN AND SPINAL CORD COLD INJURY PROTOCOL EXAMINATION CUSHINGS SYNDROME DIABETES MELLITUS GENERAL MEDICAL EXAMINATION GULF WAR GUIDELINES NEUROLOGICAL DISORDERS, MISCELLANEOUS PERIPHERAL NERVES PRISONER OF WAR PROTOCOL EXAMINATION SOCIAL AND INDUSTRIAL SURVEY SPINE TRAUMATIC BRAIN INJURY 3. The following defects that were reported directly to the CAPRI development team are being addressed: a. Defect - Inconsistent report format for non-specific weight changes Problem ------- On several templates, weight changes without a specified quantity appear on reports with inconsistent formats. Solution -------- On the following templates: AID AND ATTENDANCE OR HOUSEBOUND EXAMINATION; COLD INJURY PROTOCOL EXAMINATION; DIABETES MELLITUS; GENERAL MEDICAL EXAMINATION; GULF WAR GUIDELINES; HYPERTENSION; NEUROLOGICAL DISORDERS, MISCELLANEOUS; PRISONER OF WAR PROTOCOL EXAMINATION; TRAUMATIC BRAIN INJURY, weight changes without a specified quantity will appear on reports as: "WEIGHT CHANGE: Gain - baseline percentage change not provided." or "WEIGHT CHANGE: Loss - baseline percentage change not provided." b. Defect - Missing data on Cardiac Exam report Problem ------- On the DIABETES MELLITUS, GENERAL MEDICAL EXAMINATION, GULF WAR GUIDELINES, HYPERTENSION, and PRISONER OF WAR PROTOCOL EXAMINATION templates, Physical Exam tab, the Cardiac Exam section of the report does not display information entered into the "Describe and state significance of extra heart sounds noted:" memo box unless "Other" is selected in the "Extra heart sounds:" list box. Solution -------- The Cardiac Exam report on these templates has been altered so that information entered into the "Describe and state significance of extra heart sounds noted:" memo box is included in the report, whether or not "Other" is selected in the "Extra heart sounds:" list box. c. Defect - Inconvenient tabbing order on Vital Signs panel Problem ------- On the GENERAL MEDICAL EXAMINATION, GULF WAR GUIDELINES, and PRISONER OF WAR PROTOCOL EXAMINATION templates, the tabbing order on the Vital Signs panel is inconvenient for clinicians. This issue was raised by Dr. Sven Ljaamo of the VA Healthcare Network Upstate New York. Solution -------- On these templates, the tabbing order on the Physical Exam tab, Vital Signs panel has been changed to facilitate data entry during exams. d. Defect - GENERAL MEDICAL EXAMINATION template is missing the Mental Competency panel on the Diagnosis tab Problem ------- On the GENERAL MEDICAL EXAMINATION template, the Mental Competency panel (Capacity to Handle Financial Affairs button) is missing from the Diagnosis tab. Solution -------- The Mental Competency panel has been restored to the Diagnosis tab of the GENERAL MEDICAL EXAMINATION template. e. Defect - Single digit Tonometry reading not appearing on reports Problem ------- On the EYE EXAMINATION Template, Physical Exam tab, Tonometry section, a single digit pressure reading entered into the Right or Left Eye Pressure input box does not appear on reports. Solution -------- The EYE EXAMINATION Template, Physical Exam tab, Tonometry section, has been changed so that single digit entries in the Right or Left Eye Pressure input box will appear on reports. f. Defect - Incorrect terms on the EPILEPSY AND NARCOLEPSY template Problem ------- On the EPILEPSY AND NARCOLEPSY template, the terms "conclusive" and "non-conclusive" appear where "convulsive" and "non-convulsive" are the correct terms. Solution -------- The EPILEPSY AND NARCOLEPSY template has been edited. The term "non-conclusive" has been replaced with "non-convulsive". The term "conclusive" has been replaced with "convulsive". g. Defect - When a BLANK TEMPLATE and a MEDICAL OPINION template are merged, unintended data sharing occurs Problem ------- When a BLANK TEMPLATE and MEDICAL OPINION template are merged, data entered in the BLANK TEMPLATE, Free Text area appears in the MEDICAL OPINION template, Medical Opinion Summary text area (and vice versa). Solution -------- This patch eliminates the overlap. Data entered in either the BLANK TEMPLATE, Free Text area or the MEDICAL OPINION template, Summary text area no longer appears in the other. h. Defect - HYPERTENSION template not clear on METS assessment requirement Problem ------- The METS information on the HYPERTENSION template was confusing to some providers as to whether or not METS assessment is needed for hypertension due to the Note to Examiners instructions located on the Physical Exam tab. Solution -------- On the HYPERTENSION template the following two changes were made: - Test tab, the " Stress test results: METS" section has been removed from the template. - Physical Exam tab, Cardiac Exam panel, the Examiners Note has been modified to remove METS exercise testing from the note. i. Defect - TRAUMATIC BRAIN INJURY template not prompting for behavioral signs due to co-morbidity or TBI Problem ------- The TRAUMATIC BRAIN INJURY template is not adequately prompting examiners to indicate whether behavioral signs and symptoms are due to a co-morbid mental disorder or to TBI. Solution -------- On the TRAUMATIC BRAIN INJURY template, Physical Exam tab, when the examiner answers "Yes" to the question "Psychiatric Manifestations Present?", a pop-up message is presented: "When a mental disorder is present, state, or ask the mental disorders examiner to state, to the extent possible, which emotional/behavioral signs and symptoms are part of a co-morbid mental disorder and which represent residuals of TBI. If it is not possible to make such a determination without speculation, so state." j. Defect - AID AND ATTENDANCE OR HOUSEBOUND EXAMINATION template contains repetitious questions about lower extremity functional limitations Problem ------- The AID AND ATTENDANCE OR HOUSEBOUND EXAMINATION template, Physical Exam tab, Lower Extremities Functional Limitations form, contains repetitious questions. Input options provided by selecting "Other" from either the Right or Left lower extremity functional limitations list box and associated "Describe functional restrictions..." memo box are already available using the "Are there other functional limitations of the lower extremity" buttons and "Describe other functional limitations" memo box. Solution -------- Remove "Other" as an option under Right and Left lower extremities functional limitations. Remove "Describe functional restrictions..." memo boxes under the Right and Left lower extremities functional limitations list boxes. IV. TECHNICAL COMPONENTS The following section describes the technical components being exported with this patch. 1. The following FILE will be included. UP SEND DATA USER DATE SEC. COMES SITE RSLV OVER FILE# NAME DD CODE W/FILE DATA PTS RIDE ------------------------------------------------------------------------ 396.18 CAPRI TEMPLATE DEFINITIONS NO YES YES OVER NO NO 2. The following Template Definition updates will be added to the CAPRI TEMPLATE DEFINITIONS (#396.18) file: AID AND ATTENDANCE OR HOUSEBOUND EXAMINATION ~151 BLANK TEMPLATE~151 BRAIN AND SPINAL CORD~151 COLD INJURY PROTOCOL EXAMINATION~151 CUSHINGS SYNDROME~151 DIABETES MELLITUS~151 EPILEPSY AND NARCOLEPSY~151 EYE EXAMINATION~151 GENERAL MEDICAL EXAMINATION~151 GULF WAR GUIDELINES~151 HYPERTENSION~151 NEUROLOGICAL DISORDERS, MISCELLANEOUS~151 PERIPHERAL NERVES~151 PRISONER OF WAR PROTOCOL EXAMINATION~151 SOCIAL AND INDUSTRIAL SURVEY~151 SPINE~151 TRAUMATIC BRAIN INJURY~151 V. SOFTWARE AND DOCUMENTATION RETRIEVAL 1. VistA Patch DVBA*2.7*151 a. The VistA software is being distributed as a PackMan patch message through the National Patch Module (NPM). The KIDS build for this patch is DVBA*2.7*151. 2. User Documentation a. The user documentation for this patch may be retrieved directly using FTP. 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: OI&T 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] The following files will be available: File Name Format Description --------- ------ ----------- DVBA_27_P151_RN.PDF Binary Release Notes DVBA_27_P151_TBI_WF.PDF Binary TRAUMATIC BRAIN INJURY Workflow DVBA_27_P151_A_AND_A_WF.PDF Binary AID AND ATTENDANCE OR HOUSEBOUND EXAMINATION Workflow b. Documentation may also be retrieved from the VistA Documentation Library (VDL) on the Internet at the following address. This web site is usually updated within 1-3 days of the patch release date. http://www4.va.gov/vdl/application.asp?appid=133 VI. INSTALLATION INSTRUCTIONS * CAPRI GUI Users: This patch may be installed while users are running the CAPRI GUI. * Users on the VistA system: This patch may be installed with users on the system, but should be loaded during non-peak hours to minimize disruption to users and to reduce the possibility of errors when the routines and file entries are updated. There are no VistA options to disable while installing this patch. * Software Installation Time: The estimated installation time is less than 5 minutes during off peak hours. * Required Builds: The following is a list of REQUIRED builds for this KIDS distribution. KIDS will not allow the installation of this patch without their prior installation. Required Build(s): ------------------ DVBA*2.7*142 * Installation Steps: 1. Use the INSTALL/CHECK MESSAGE option on the PackMan menu to unload the KIDS distribution included with this message. 2. From the 'Kernel Installation & Distribution System' menu, select the Installation menu. 3. From this menu, you may now elect to use the following options (when prompted for INSTALL NAME, enter DVBA*2.7*151). a. Backup a Transport Global - This option will create a backup message of any routines exported with the patch. It will NOT backup any changes such as DDs or templates. b. Compare Transport Global to Current System - This option will allow you to view all changes that will be made when the patch is installed. It compares all components of the patch (routines, DDs, 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. d. Print Transport Global - this option will allow you to view the components of the KIDS build. 4. Use the Install Package(s) option and select package DVBA*2.7*151. 5. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer NO. 6. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', answer NO. 7. NOTE: Pre/Post-init routine DVBA151P is a temporary routine used as part of the pre/post-install process and will be automatically deleted by KIDS after patch installation. However, in some cases Cache doesn't always delete the routine. You may delete it manually if you discover this at your site. VII. TEST SITES The following sites participated in the testing of the DVBA*2.7*151 software. Test Sites ---------- * Eastern Colorado HCS * Miami * Upstate New York HCS Routine Information: ==================== The second line of each of these routines now looks like: ;;2.7;AMIE;**[Patch List]**;Apr 10, 1995;Build 14 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: DVBA151P Before: n/a After: B43672952 **151** ============================================================================= User Information: Entered By : FAIRBROTHER,EILEEN Date Entered : NOV 19, 2009 Completed By: DELACRUZ,KRISTINA Date Completed: MAY 21, 2010 Released By : FRANCE,KATHI Date Released : MAY 25, 2010 ============================================================================= Packman Mail Message: ===================== $END TXT