$TXT Created by F at CLN1G1.AAC.DOMAIN.EXT (KIDS) on Monday, 05/03/21 at 16:36 ============================================================================= Run Date: JUN 30, 2021 Designation: GMRA*4*66 Package : GMRA - ADVERSE REACTION TRACKING Priority: Mandatory Version : 4 SEQ #60 Status: Released Compliance Date: JUL 31, 2021 ============================================================================= Associated patches: (v)GMRA*4*43 <<= must be installed BEFORE `GMRA*4*66' Subject: ISSUES WITH 120.86 AFTER PATIENT MERGE Category: - Routine Description: ============ This patch will resolve the following issue: 1) INC17497887 - UNABLE TO MODIFY AN ALLERGY ASSESSMENT USING THE VISTA (HITPS-7808) ASSESSMENT CLEANUP UTILITY ECN 74075 Duplicate: ----------- INC16946767 - allergy info being displayed differently (incorrectly) in different areas of Vista/CPRS INC17041102 - Adverse Reaction Tracking-Allergy Assessment; 3 Discrepancies that cannot be resolved with the Modify Assessment tool. INC17041569 - CPRS ERROR_unable to update allergies for ONE patient INC17069709 - Adverse Reaction Tracking - Allergy Assessment INC17072229 - Adverse Reaction Tracking - Allergy Assessment Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 1) INC17497887 - UNABLE TO MODIFY AN ALLERGY ASSESSMENT USING THE VISTA (HITPS-7808) ASSESSMENT CLEANUP UTILITY ECN 74075 Problem: ------- The Captain James A. Lovell Federal Health Care Center reported that they were unable to modify an allergy assessment for a specific patient using the Assessment clean up utility option [GMRA ASSESSMENT UTILITY]. After some research it was discovered that when two patients were merged and the 'TO' patient (remaining patient after them merge) did not have an Allergy assessment while the 'FROM' patient (deleted after the merge) did have one, then a corrupt record was being created for the 'TO' patient. These records could not be fixed using the Assessment clean utility option [GMRA ASSESSMENT UTILITY]. This issue is being tracked by the Patient Safety team via HITPS-7808. Resolution: ---------- The root of the problem is within the Kernel Patient Merge module. However we were able to address the problem by modifying GMR code specifically designed to run right before two patients are merged. The solution applied consisted of copying the 'FROM' Allergy assessment information to the 'TO' assessment before the patient merge was performed by the Kernel Patient Merge utility. In addition to fixing this problem so that no new entries are affected this patch also fixes the existing entries with the problem through a post-install routine that is described below. Technical Resolution: -------------------- Modified the routine GMRAMRG by adding right at the beginning of the ASSESS tag code to identify whether the 'FROM' patient had an allergy assessment in the ADVERSE REACTION ASSESSMENT file (#120.86) and the 'TO' patient did not. If that's the case for the patient pair being merged the new code will copy the 'FROM' patient allergy assessment and create an identical assessment for the 'TO' patient in the ADVERSE REACTION ASSESSMENT file (#120.86). This will effectively prevent the Kernel Patient Merge Utility from creating a corrupt entry for the 'TO' patient. Patient Safety Issues (PSIs): ----------------------------- HITPS-7808 Test Sites: ----------- North Chicago VAMC North Chicago, IL Indianapolis VAMC Indianapolis, IN Patch Installation: Pre/Post Installation Overview: ------------------------------- It is not necessary to disable any options. Pre-Installation Instructions: ------------------------------ This patch should be installed during non-peak hours to minimize potential disruption to users. This patch should take less than 2 minutes to install. Installation Instructions: -------------------------- 1. Choose the PackMan message containing this build. Then select the INSTALL/CHECK MESSAGE PackMan option to load the build. 2. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, A. Select the Verify Checksums in Transport Global option to confirm the integrity of the routines that are in the transport global. When prompted for the INSTALL NAME enter the patch or build name. (ex. GMRA*4.0*66) NOTE: Using will not bring up a Multi-Package build even if it was loaded immediately before this step. It will only bring up the last patch in the build. B. Select the Backup a Transport Global option to create a backup message. You must use this option and specify what to backup; the entire Build or just Routines. The backup message can be used to restore the routines and components of the build to the pre-patch condition. i. At the Installation option menu, select Backup a Transport Global ii. At the Select INSTALL NAME prompt, enter your build GMRA*4.0*66 iii. When prompted for the following, enter "R" for Routines or "B" for Build. Select one of the following: B Build R Routines Enter response: Build iv. When prompted "Do you wish to secure your build? NO//", press and take the default response of "NO". v. When prompted with, "Send mail to: Last name, First Name", press to take default recipient. Add any additional recipients. vi. When prompted with "Select basket to send to: IN//", press and take the default IN mailbox or select a different mailbox. C. You may also elect to use the following options: i. Print Transport Global - This option will allow you to view the components of the KIDS build. ii. 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 of the components of this patch, such as routines, DDs, templates, etc. D. Select the Install Package(s) option and choose the patch to install. i. If prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//', answer . ii. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer . iii. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', answer . Post Installation Instructions: ------------------------------- A post-install routine will run and check for existing corrupt entries in the ADVERSE REACTION ASSESSMENT file (#120.86) caused by the patient merge and will fix them automatically. A Mailman message (see example below) will be sent to the holders of the PSNMGR security key with the list of entries that have been fixed if any are found or it will indicate that no problems were found. Subj: GMRA*4*66 - ADVERSE REACTION ASSESSMENT file (#120.86) Clean-up [#167] From: POSTMASTER In 'IN' basket. Page 1 *New* ----------------------------------------------------------------------------- When two patients are merged there is a possibility that the ADVERSE REACTION ASSESSMENT file (#120.86) entry for the 'TO' patient (patient that remains after the merge is complete) is corrupt. The patch GMRA*4*66 addressed the problem caused by the Kernel Patient Merge Utility and also fixed all the patients on file that currently have this problem at your site (if any). See list below: ---------------------------------------------------------------------------- PATIENT WRONG DFN VALUE CORRECT DFN VALUE ---------------------------------------------------------------------------- TEST,PATIENT TWENTY (1865) 7209295 7209296 TEST,PATIENT ELEVEN (5577) 7209358 7209359 End of report. Please, run the Assessment clean up utility option [GMRA ASSESSMENT UTILITY] and address any remaining entries on the list. Enter message action (in IN basket): Ignore// Back-out Procedures: -------------------- Back-out will be done only with the concurrence and participation of development team and appropriate VA site/region personnel. The decision to back-out or rollback software will be a joint decision between development team, VA site/region personnel and other appropriate VA personnel. Prior to installing an updated KIDS package, the site/region should have saved a backup of the routines in a mail message using the Backup a Transport Global [XPD BACKUP] menu option (this is done at time of install). The message containing the backed up routines can be loaded with the "Xtract PackMan" function at the Message Action prompt. The Packman function "INSTALL/CHECK MESSAGE" is then used to install the backed up routines onto the VistA System. The back-out plan is to restore the routines from the backup created. No data was modified by this patch installation and, therefore, no rollback strategy is required. Validation of Back-out Procedure: --------------------------------- The Back-out Procedure can be verified by printing the first 2 lines of the routines contained in this patch using the option First Line Routine Print [XU FIRST LINE PRINT]. Once the routines contained in GMRA*4.0*66 patch have been backed out, the first two lines of the routines will no longer contain the designation of this patch in the patch list section on line 2. Routine Information: ==================== The second line of each of these routines now looks like: ;;4.0;Adverse Reaction Tracking;**[Patch List]**;Mar 29, 1996;Build 1 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: GMRA66PI Before: n/a After: B10017016 **66** Routine Name: GMRAMRG Before: B2162163 After: B3715071 **43,66** Routine list of preceding patches: 43 ============================================================================= User Information: Entered By : Date Entered : MAY 03, 2021 Completed By: Date Completed: JUN 30, 2021 Released By : Date Released : JUN 30, 2021 ============================================================================= Packman Mail Message: ===================== $END TXT