$TXT Created by T at CLE623.FO-BAYPINES.DOMAIN.EXT (KIDS) on Monday, 08/12/24 at 09:31 ============================================================================= Run Date: NOV 06, 2024 Designation: GMRC*3*189 Package : GMRC - CONSULT/REQUEST TRACKING Priority: Mandatory Version : 3 SEQ #169 Status: Released Compliance Date: DEC 06, 2024 ============================================================================= Associated patches: (v)GMRC*3*154 <<= must be installed BEFORE `GMRC*3*189' (v)GMRC*3*169 <<= must be installed BEFORE `GMRC*3*189' (v)GMRC*3*184 <<= must be installed BEFORE `GMRC*3*189' (v)GMRC*3*185 <<= must be installed BEFORE `GMRC*3*189' (v)GMRC*3*202 <<= must be installed BEFORE `GMRC*3*189' Subject: PROXY ADD AND ORDER RESUBMISSION Category: - Routine - Data Dictionary Description: ============ This patch is part of the IFC PROXY ADD/ORDER RESUBMISSION 1.0 build. Below is a list of all the applications involved in this multi-build host file along with their patch numbers: APPLICATION/VERSION PATCH -------------------------------------- ------------- REGISTRATION v5.3 DG*5.3*1096 ELECTRONIC HEALTH MODERNIZATION v1.0 EHM*1*10 CONSULT/REQUEST TRACKING v3.0 GMRC*3*189 REGISTRATION v5.3 DG*5.3*1091 1. An Inter-Facility Consult (IFC) requested by a non-converted VistA site and sent to a converted site is not processed by Cerner if the patient does not exist in Cerner and Rhapsody fails to create a patient entry. When VistA sends an IFC order to Cerner Millennium and the patient does not exist in Cerner's database, an HL7 acknowledgement is sent by Cerner but the order is not processed. The IFC order needs to be re-submitted by VistA to Cerner until processed. This patch modifies the proxy add process that updates Cerner to recognize when it fails and to create an entry in the IFC MESSAGE LOG (#123.6) with error code 203 (patient not in Cerner) so the order can be automatically re-submitted to Cerner the next day. 2. Prior to GMRC*3*189, when a non-converted VistA received an IFC from Cerner and the patient does not exist on VistA, IFC processing code generated a 201 (Unknown Patient) error. Once the patient was added to VistA, the order was re-processed by the GMRC background processor. GMRC*3*189 changes this processing to call the proxy add API (from DG*5.3*1096). The patient is added to the VistA database and processing of the IFC continues. If the proxy add fails, the order is treated as before with the generation of a 201 error. 3. This patch also introduces VistA code to recognize if the patient does not exist on the converted VistA associated with the Cerner ordering site. In this case, VistA IFC code calls the proxy add API to have the patient added remotely to the converted VistA site. 4. Resolution of errors and data discrepancies involving converted and non-converted sites is made difficult by the routine purging of HL7 messages in VistA. Problems with Inter-Facility Consults (IFC) and Patient Record Flags (PRF) regularly require greater time to resolve than is allowed by the current scheduled HL7 message purge. Since IFC and PRF HL7 message traffic that involves both a converted and a non-converted site are small relative to the overall HL7 message traffic in VistA, the solution is to save the few relevant messages separately rather than to extend the retention period of the greater whole. The companion patch EHM*1*10 creates a repository (EHM HL7 Message #1609) for HL7 messages and provides the software tools to save messages in the repository. GMRC*3*189 modifies the routines which process IFCs to use EHM*1*10's API to save in the repository HL7 messages that come from Cerner or which are sent to Cerner. 5. The REMOTE CONSULT FILE ENTRY field (#.06) of the REQUEST/CONSULTATION file (#123) stores either the order number on the remote system (in the case of Cerner) or the consult file number on the remote system (in the case of VistA). The field is defined as a number up to 12 digits long. Because the order number field in Cerner is expected to exceed 12 digits in the future, the REMOTE CONSULT FILE ENTRY field is redefined in GMRC*3*189 to be up to 20 digits long. The corresponding cross-reference is also changed to allow up to 20 digit order numbers. 6. When a comment is added to an IFC in VistA (CPRS or Prosthetics) that is COMPLETE, the HL7 message sent to Cerner includes a comment status of P (Preliminary). The status should be C (Changed). GMRC*3*189 populates OBX-11 with a status of C if a comment is added to a complete consult when sending an HL7 message to Cerner. 7. GMRC*3*154 introduced a mechanism for the IFC interface to proxy add a patient to Cerner before transmitting a new order. The proxy add API operates asynchronously in part with the update to the Treating Facility List being done after a return value is sent back to the calling routine. As a result, the new order messages cannot always be routed to Cerner after the API is called. GMRC*3*189 generates a 205 error (waiting for treating facility to update) and re-queues the new order for transmission the next time the Background Processor runs. 8. When the proxy add process fails, patch GMRC*3*189 generates a Mailman message to the IFC PATIENT ERROR MESSAGES mail group. 9. GMRC*3*154 introduced a mechanism for the IFC interface to proxy add a patient to Cerner before transmitting a new order. The code to determine if the proxy add API should be called included a check to see if the patient existed on the converted VistA that corresponded to the Cerner site. This check is unnecessary and results in unnecessary calls to the API and in returning occasional false negatives so the incoming order is not processed. The code has been simplified, and a call is made to the API if the patient is not in Cerner regardless of whether the patient is or is not in the converted VistA. Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- REQUEST/CONSULTATION REMOTE CONSULT FILE MODIFIED (#123) ENTRY (#.06) Forms Associated: Form Name File Number 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 Remote Procedures Associated: Remote Procedure Name New/Modified/Deleted --------------------- -------------------- N/A Parameter Definitions Associated: Parameter Name New/Modified/Deleted -------------- -------------------- N/A Additional Information: ----------------------- Blood Bank Team Coordination: N/A New Service Requests (NSRs): N/A Patient Safety Issues (PSIs): N/A Defect Tracking System Ticket(s) & Overview: INC25871481 Problem: Comments that are being placed on prosthetics orders in Vista are not transferring over to Cerner What was the user trying to do when the issue occurred? transfer Prosthetics orders from Vista to Cerner. Resolution: The comments referenced in the ticket are ones entered after the order is complete. These comments require that a status of "C" (Changed) be sent in the HL7 message. This patch does that. INC27818093 Problem: IFC number did not generate for TeleDermatology Image appointment after check-in/activation. Resolution: An order was sent from Cerner to VistA. The patient did not exist in VistA so a patient not found error (201) was generated. Manual procedures exist to add the patient to VistA. VDIF re-sends the order to VistA on a scheduled basis. Patch 189 replaces the manual procedure for adding patients to VistA and the need to re-send the orders with an automated proxy add process. This obviates the need to manually create patients and to re-send the orders. Test Sites: ----------- VA Portland Health Care System (Portland, Vancouver) Chalmers P. Wylie Ambulatory Care Center, Columbus SNOW Change Order #: -------------------- VA Portland Health Care System (Portland, Vancouver) - CHG0485482 Chalmers P. Wylie Ambulatory Care Center, Columbus - CHG0526853 Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released as part of the IFC PROXY ADD/ORDER RESUBMISSION 1.0 multi-build. The patches in this build are released in host file /srv/vista/patches/SOFTWARE/IFC_PROXY_ADD_ORDER_RESUBMISSION.KID Other Software Files: N/A File Title File Name Format --------------------------------------------------------------------- N/A Documentation describing the new functionality is included in this release. Documentation can be found on the VA Software Documentation Library at: https://www.domain.ext/vdl/. Documentation can also be obtained at https://download.vista.domain.ext/index.html/SOFTWARE. Documentation Title File Name --------------------------------------------------------------------- IFC PROXY ADD/ORDER RESUBMISSION Deployment, GMRC_3_189_DIBR.DOCX Installation, Back Out and Rollback Guide GMRC_3_189_DIBR.PDF Consult/Request Tracking Technical Manual CONSTM.DOCX CONSTM.PDF Patch Installation: ------------------- Pre/Post Installation Overview ------------------------------ N/A Pre-Installation Instructions: This build 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 build should take less than 30 minutes to install. This patch should not be queued. Installation Instructions: 1. Use the Load a Distribution option contained on the Kernel Installation and Distribution System Menu to load the Host file. When prompted to "Enter a Host File:" enter /srv/vista/patches/SOFTWARE/IFC_PROXY_ADD_ORDER_RESUBMISSION.KID. 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 build name IFC PROXY ADD/ORDER RESUBMISSION 1.0. 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 for each patch contained in the Host File. For each patch you can specify what to backup; the entire Build or just Routines. The backup message can be used to restore just the routines or everything that will restore your system to pre-patch condition. 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 NO. ii. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer NO. iii. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', answer NO. Post-Installation Instructions: Please refer to the "IFC PROXY ADD/ORDER RESUBMISSION Deployment, Installation, Back Out and Rollback Guide" for additional post-installation instructions. After patch installation has completed, restart the HL7 incoming filers. First, 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] to stop the filers. After the filers have 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] to start the filers. Back-Out/Roll Back Plan ----------------------- Please refer to the "IFC PROXY ADD/ORDER RESUBMISSION Deployment, Installation, Back Out and Rollback Guide". Routine Information: ==================== The second line of each of these routines now looks like: ;;3.0;CONSULT/REQUEST TRACKING;**[Patch List]**;DEC 27, 1997;Build 53 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: GMRCIACT Before:B105576202 After:B125284943 **22,47,58,66,73,121,154,176, 184,193,185,189** Routine Name: GMRCIBKG Before: B47729051 After: B55957269 **22,28,30,35,58,92,154,189** Routine Name: GMRCIEV1 Before:B162874990 After:B163839703 **22,28,31,154,184,185,189** Routine Name: GMRCIEVT Before:B211927861 After:B195790211 **22,28,31,121,154,184,189** Routine Name: GMRCIMSG Before: B60850283 After: B74644080 **22,28,51,44,154,184,189** Routine Name: GMRCISEG Before: B58591645 After: B62601175 **22,66,154,202,189** Routine Name: GMRCIUT1 Before: n/a After: B51075016 **189** Routine Name: GMRCIUTL Before: B90121709 After:B107796120 **22,58,184,185,189** Routine Name: GMRCXR Before: B57485850 After: B58389482 **83,86,169,189** Routine list of preceding patches: 169, 185, 202 ============================================================================= User Information: Entered By : Date Entered : MAR 09, 2022 Completed By: Date Completed: NOV 05, 2024 Released By : Date Released : NOV 06, 2024 ============================================================================= Packman Mail Message: ===================== $END TXT