============================================================================= Run Date: SEP 01, 2017 Designation: ETS*1*1 Package : ETS - ENTERPRISE TERMINOLOGY SERVIC Priority: Mandatory Version : 1 SEQ #1 Status: Released Compliance Date: OCT 02, 2017 ============================================================================= Associated patches: (v)ETS*1*0 <<= must be installed BEFORE `ETS*1*1' Subject: RXNORM CODE SET AND LOINC UPDATES Category: - Routine - Data Dictionary - Enhancement (Mandatory) Description: ============ The Veterans Information Systems and Technology Architecture (VistA) Evolution program to modernize VistA includes modernizing Veterans Affairs (VA's) enterprise data management capabilities. Modernizing VA FileMan will functionally standardize VistA's database. This will enable structured data query and exchange across all VistA instances, creating an enterprise view of VistA data in standardized, computable form. This modernized VA FileMan is called VA FileMan Enterprise for its enterprise data management capabilities. This patch, ETS*1.0*1, introduces new and modified routines and data dictionaries to implement Enterprise Terminology Services (ETS) package. The Enterprise Terminology Services package exists to provide enterprise-wide access to common code sets that are needed in a health care system. It will contain VA FileMan files with the data and Application Program Interfaces (APIs) that can be used to provide access and process the data. The Integration Control Registrations will be supported and thus open to all VistA applications. Specifically, patch ETS*1.0*1 contains the following: --------------------------------------------------------- 1. The following new files have been created in ETS to support the RxNorm code set in VistA. a) The RXNORM CONCEPT NAMES AND SOURCES file (#129.2) b) The RXNORM SIMPLE CONCEPT AND ATOM ATTRIBUTES file (#129.21) c) The RXNORM RELATED CONCEPTS file (#129.22) d) The RXNORM SEMANTIC TYPES file (#129.23) e) The RXNORM SOURCE INFORMATION file (#129.24) 2. The data for the above files will be populated. This will require approximately 516 megabytes of disk space and 11.2 gigabytes of journal space. 3. The following new APIs were created to retrieve RxNorm data. a) $$CSDATA^ETSRXN: Get Detailed Information about a RxNorm Concept Unique Identifier (RXCUI) b) $$CSYS^ETSRXN: Retrieve the Coding System Information c) $$GETDATA^ETSRXN: Return all information for a RXCUI d) $$HIST^ETSRXN: Get Activation History for a RXCUI e) $$NDC2RXN^ETSRXN: Return RXCUI for a National Drug Code (NDC) f) $$PERIOD^ETSRXN: Get Activation/Inactivation Periods for a RXCUI g) $RXN2OUT^ETSRXN: Retrieve a VA Unique Identifier (VUID) and NDC for a RXCUI h) $$TAX^ETSRXN: Return list of VUIDs in same value set i) $$VUICLASS^ETSRXN: Return list of VUIDs with the same drug class j) $$VUI2RXN^ETSRXN: Retrieve RXCUI(s) for a valid VUID 4. The following Logical Observation Identifiers Names and Codes (LOINC) APIs were modified. a) $$CHKCODE^ETSLNC i) Change input value to be the full LOINC Code ii) Change return value from Yes/No (1 or 0) to Internal Entry Number (IEN) b) $$COMLST^ETSLNC: Allow Input of Component Name in addition to Component IEN c) $$CSDATA^ETSLNC: Change Return value to be the full LOINC Code d) $$GETCODE^ETSLNC: i) Add SHORT NAME (#81) field to the output ii) Change input value to be the full LOINC Code e) $$GETNAME^ETSLNC: Change input value to be the full LOINC Code f) $$GETREC^ETSLNC i) Change input value to be the full LOINC Code ii) Add EXTERNAL COPYRIGHT (#84) and COMPONENT (#1) fields to the output g) $$GETSTAT^ETSLNC: Change input value to be the full LOINC Code h) $$HIST^ETSLNC: Change input value to be the full LOINC Code i) $$PERIOD^ETSLNC: Change input value to be the full LOINC Code j) $$TAX^ETSLNC: Change input value to be the full LOINC Code 5. Modify the screens for the NON-PATIENT SPECIMEN (#1.7) and the TIME MODIFIER (#3.1) fields of the LOINC (#129.1) file. 6. Update sixteen records in the LOINC AXIS CODES (#129.22) so that NAME (#.01) field is unique. Detailed information on the APIs and the tasks they perform is included in the ETS 1.0 Technical Manual/Security Guide. Patch Components: ----------------- Files & Fields Associated: File Name (#) New/Modified/ Sub-file Name (#) Field Name (#) Deleted ------------------- -------------- ------------- LOINC (#129.1) NON-PATIENT SPECIMEN (#1.7) Modified LOINC (#129.1) TIME MODIFIER (#3.1) Modified RXNORM CONCEPT NAMES AND SOURCES (#129.2) New RXNORM SIMPLE CONCEPT AND ATOM ATTRIBUTES (#129.21) New RXNORM RELATED CONCEPTS (#129.22) New RXNORM SEMANTIC TYPES (#129.23) New RXNORM SOURCE INFORMATION (#129.24) New Forms Associated: Form Name File # 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 Additional Information: ----------------------- N/A New Service Requests (NSRs): ---------------------------- N/A Patient Safety Issues (PSIs): ----------------------------- N/A Defect Tracking System Ticket(s) & Overview: -------------------------------------------- N/A Blood Bank Clearance: --------------------- EFFECT ON BLOOD BANK FUNCTIONAL REQUIREMENTS: Patch ETS*1.0*1 contains changes to a package referenced in ProPath standard titled: BBM Team Review of VistA Patches. This patch does not alter or modify any VistA Blood Bank software design safeguards or safety critical elements functions. RISK ANALYSIS: Changes made by patch ETS*1.0*1 have no effect on Blood Bank software functionality, therefore RISK is none. Test Sites: ----------- VA Caribbean Healthcare System (San Juan) Ralph H. Johnson VA Medical Center (Charleston) Software and Documentation Retrieval Instructions: -------------------------------------------------- Documentation describing the new functionality introduced by this patch is available. The preferred method is to retrieve files from download.vista.domain.ext. This transmits the files from the first available server. Sites may also elect to retrieve files directly from a specific server. Sites may retrieve the software and/or documentation directly using Secure Transfer Protocol (SFTP) from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Albany: domain.ext 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/ under the Clinical folder. Title File Name SFTP Mode --------------------------------------------------------------- ETS 1.0 Technical/Security Guide ETS_1_TM.PDF Binary Software Installation Host file ETS_1_0_1.KID ASCII Backout and Rollback Procedure: ------------------------------- The rollback plan for VistA applications is complex and not able to be a 'one size fits all' solution. The development team recommends that sites log a CA Service Desk Manager (SDM) ticket for the Health Systems Platform group if this patch needs to be backed-out. The support team will determine the best approach to restore the system to its previous state. Rollback may be performed prior to response from the support team by first unloading the Kernel Installation and Distribution System (KIDS) distribution and then clearing all data from the new files contained in this patch: RXNORM CONCEPT NAMES AND SOURCES (#129.2) RXNORM SIMPLE CONCEPT AND ATOM ATTRIBUTES (#129.21) RXNORM RELATED CONCEPTS (#129.22) RXNORM SEMANTIC TYPES (#129.23) RXNORM SOURCE INFORMATION (#129.24) During the VistA Installation Procedure of the KIDS build, the installer should back up the modified routines by the use of the 'Backup a Transport Global' action (step 4a in the Installations Instructions below). The installer can restore the routines using the MailMan message that were saved prior to installing the patch. The backout procedure for data dictionary data loads is more complex and may require the issuance of a follow-on patch to ensure all components are properly removed. Note that a rollback of all software components, including routines must be restored to their previous state at the same time and in conjunction with restoration of the data. Patch Installation: Pre/Post Installation Overview: ------------------------------- There is a pre-install routine PRE^ETS1P1 that prepares the current process for the install. There is a post-install routine PST^ETS1P1 that will update the NAME (#.01) field of the LOINC AXIS CODES (#129.22) file for sixteen records. 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 approximately 90 minutes to install. Note: Due to the length of time for this installation, the installation process should be queued to avoid installation failure due to session timeout or a forced system reboot/restart. No options or protocols need to be disabled to install this patch. The installation of this patch can be queued. Note: Installation of this patch will require approximately 516 megabytes of disk space and 11.2 gigabytes of journal space. Ensure there is sufficient space allocated prior to installation. Installation Instructions: -------------------------- 1. OBTAIN PATCH ------------ Obtain the host file ETS_1_0_1.KID, which contains the following patch: ETS*1.0*1 Sites can retrieve VistA software directly using Secure File Transfer Protocol (sFTP) from the ANONYMOUS.SOFTWARE directory at the following sFTP address: download.vista.domain.ext This will transmit the files from the first available sFTP server. Sites may also elect to retrieve software directly from a specific server as follows: Albany ftp.domain.ext Hines ftp.domain.ext Salt Lake City ftp.domain.ext The ETS_1_0_1.KID host file is located in the directory. Use ASCII Mode when downloading the file. Due to the large size of this patch (approximately 516 megabytes), download may take 20+/- minutes depending upon bandwidth. 2. START UP KIDS ------------- Start up the Kernel Installation and Distribution System Menu option [XPD MAIN]: Edits and Distribution ... Utilities ... Installation ... Select Kernel Installation & Distribution System Option: INStallation --- Load a Distribution Print Transport Global Compare Transport Global to Current System Verify Checksums in Transport Global Install Package(s) Restart Install of Package(s) Unload a Distribution Backup a Transport Global Select Installation Option: 3. LOAD TRANSPORT GLOBAL --------------------- From the Installation menu, select the Load a Distribution option. When prompted for "Enter a Host File:", enter the full directory path where the host file ETS_1_0_1.KID was saved. For example: SYS$SYSDEVICE:[ANONYMOUS]ETS_1_0_1.KID When prompted for "OK to continue with Load? NO//", enter "YES." The following will display: Loading Distribution... ETS*1.0*1 Use INSTALL NAME: ETS*1.0*1 to install this Distribution. 4. RUN OPTIONAL INSTALLATION OPTIONS --------------------------------- From the Installation menu, you may select to use the following optional options (when prompted for the INSTALL NAME, enter ETS*1.0*1): 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 data dictionaries 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, data dictionaries, 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. 5. INSTALL THE BUILD ----------------- This is the step to start the installation of this KIDS patch. This will need to be run for the ETS*1.0*1 patch. a. Choose the Install Package(s) option to start the patch install. b. When prompted for the "Select INSTALL NAME:", enter ETS*1.0*1. c. When prompted "Want KIDS to INHIBIT LOGONs during the install? YES//", enter NO. d. When prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//", enter NO. e. When prompted "Device: HOME//", enter "Q" (without quotes) to queue the installation as a background task. f. When prompted "DEVICE: HOME//", enter HFS. g. When prompted "HOST FILE NAME:", enter the full path of the file where you want to direct the output of the installation. h. When prompted "ADDRESS/PARAMETERS: "NWS"//", enter NWS. i. When prompted for "Request Start Time: //", enter a valid FileMan Date/Time when you want the installation to begin, e.g., NOW+3' to start the installation 3 minutes from now. Post-Installation Instructions: ------------------------------- 1. In order to update the META DATA DICTIONARY File, run the UPDATE THE META DATA DICTIONARY [DDU UPDATE META DD] option, which is located on the DATA DICTIONARY UTILITIES [DI DDU] menu of VA FileMan [DIUSER]. When prompted "OK? No//" respond YES. Here is an abbreviated example of what to expect when you run this option. There will be approximately 100 rows of dots, and it should take less than one minute to complete. SINCE NO FILE IS IN APPLICATION GROUP 'DDD', the entire FileMan database will be scanned, and a Central Data Dictionary will now be compiled. OK? No// YES........................................................... ....................................................................... ....................................................................... 2. The ETS1P1 post install routine may be deleted after install. Routine Information: ==================== The second line of each of these routines now looks like: ;;1.0;Enterprise Terminology Service;**[Patch List]**;Mar 20, 2017;Build 7 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ETS10P0 Before: B1054269 After: Delete Routine Name: ETS1P1 Before: n/a After: B5937912 **1** Routine Name: ETSLNC Before: B84730591 After: B86929400 **1** Routine Name: ETSLNC1 Before: B11070106 After: B14161218 **1** Routine Name: ETSLNC2 Before: B6148545 After: B8966655 **1** Routine Name: ETSLNC3 Before: B49858538 After: B58309656 **1** Routine Name: ETSLNCIX Before: B9991707 After: B9991707 **1** Routine Name: ETSLNCTX Before: B27568889 After: B32085670 **1** Routine Name: ETSRXN Before: n/a After: B54861353 **1** Routine Name: ETSRXN1 Before: n/a After: B70502187 **1** Routine Name: ETSRXNTX Before: n/a After: B77757125 **1** ============================================================================= User Information: Entered By : Date Entered : APR 20, 2017 Completed By: Date Completed: AUG 29, 2017 Released By : Date Released : SEP 01, 2017 ============================================================================= Packman Mail Message: ===================== No routines included