$TXT Created by PHELPS,TY at DAYT17.FO-BAYPINES.MED.VA.GOV (KIDS) on Wednesday, 11/04/09 at 12:45 ============================================================================= Run Date: FEB 23, 2010 Designation: GMRC*3*70 Package : GMRC - CONSULT/REQUEST TRACKING Priority: Mandatory Version : 3 SEQ #60 Status: Released Compliance Date: MAR 26, 2010 ============================================================================= Associated patches: (v)OR*3*304 <<= must be installed BEFORE `GMRC*3*70' Subject: CONSULT NOTE ON WRONG PATIENT Category: - Routine Description: ============ When a user was on the Consults tab of CPRS GUI v27 and the user timed out, when they resumed work on the Consults, there was the potential to attach the Consult Results to the wrong patient. Also, in the past, there have been Consult Results attached to the wrong patient due to a problem encountered during the upload process. This patch searches the entire REQUEST/CONSULTATION file for Consult Results that have the potential to be attached to the wrong patient record regardless of the source of the problem and creates a Mailman message containing a report of those records so they can be evaluated by the site and corrected, if needed. ***************************** IMPORTANT ******************************* * * * During the installation of this patch, the installer will be * * prompted to enter the names of persons who should receive the * * MailMan message containing the report. The report should go to * * the Clinical Application Coordinator, Chief of Health Information * * Management, and other pertinent facility staff. Do not install * * the patch until you have identified these persons. * * * *********************************************************************** ASSOCIATED NSR(S): ================== N/A ASSOCIATED REMEDY TICKETS: ========================== HD0000000281049 - Consults ending up on wrong patient PARTICIPATING TEST SITES: ========================= Manchester VAMC Palo Alto HCS Tampa VAMC REMEDY TICKET OVERVIEW: ======================= HD0000000281049 - Consults ending up on wrong patient Problem: -------- CPRS v27 could cause incorrect patient information to be displayed. On the Consults tab, when the incorrect patient information was displayed, the user could attach a result note to the wrong patient's record. Patch OR*3.0*304 corrected the incorrect patient display issue which caused the Consult Result records to be attached to the wrong patient. This patch identifies the consult records which have result records attached to a different patient. Resolution: ----------- Created post-installation routine GMRCYP70 to search through the REQUEST/CONSULTATION file (#123) looking for ASSOCIATED RESULTS. The patient IEN from the ASSOCIATED RESULTS file (8925, 691, 691.1, etc.) is compared to the patient IEN stored on the consult in the REQUEST/CONSULTATION file. If the patient IEN values are different, the results are determined to have the "potential" to be on the wrong patient and are written to the report contained in a MailMan message. During installation of this patch, the installer will be prompted to enter the names of the persons who should receive the MailMan message. The MailMan message will then be sent to those persons plus the installer of the patch. The message will include the CONSULT #, CONSULT NAME, CONSULT DATE/TIME, CONSULT PT IEN, RESULT PT IEN, RESULT TYPE, RESULT DOC #, and the RESULT DATE/TIME. The results will be sorted by division. The RESULT TYPE on the report represents the file number where the RESULT DOC # can be found. Sample MailMan Message: ======================= Subj: CONSULT NOTE ON WRONG PATIENT (MSG 1 of 1) [#534531] 04/20/09@11:19 215 lines From: WERNER,GARY In 'IN' basket. Page 1 -------------------------------------------------------------------------- This message (1 of 1) has been sent by routine GMRCYP70 at the completion of the Consult Result evaluation. In the report below, the patient IEN from the ASSOCIATED RESULTS file (8925, 691, 691.1, etc.) does not match the patient IEN stored on the consult in the REQUEST/CONSULTATION file. A team including a Clinical Application Coordinator, Chief, Health Information Management, and other pertinent facility staff should review the results of the report generated by this patch. This step is critical to ensuring the integrity and accuracy of the Consult data at your facility. See the description for patch GMRC*3.0*70 in the National Patch Module for further explanation of this report and for instructions on how to correct the listed entries. CONSULT # CONSULT NAME CONSULT DATE/TIME CONSULT PT IEN # RESULT PT IEN # RESULT TYPE RESULT DOC # RESULT DATE/TIME ========================================================================== -------------------------------------------------------------------------- Division: DAYTON -------------------------------------------------------------------------- 28206 UROLOGY JAN 06, 1997@17:10 1424 73075 8925 1696302 JAN 27, 1997@12:12:01 INSTALLATION INSTRUCTIONS: ========================== This patch can be loaded with users in the system. Installation time will be less than 2 minutes. The post-install routine may run for several minutes to 1 hour depending on the number of records it has to search through. 1. Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. Start up the Kernel Installation and Distribution System Menu [XPD MAIN]: Edits and Distribution ... Utilities ... Installation ... Select Kernel Installation & Distribution System Option: Installation 1 Load a Distribution 2 Verify Checksums in Transport Global 3 Print Transport Global 4 Compare Transport Global to Current System 5 Backup a Transport Global 6 Install Package(s) Restart Install of Package(s) Unload a Distribution 3. From this menu, you may elect to use the following options (When prompted for the INSTALL NAME, enter "GMRC*3.0*70"): 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. Use the Install Package(s) option and select the package. a. When prompted "Want KIDS to INHIBIT LOGONs during the install? NO//", answer NO. b. When prompted "Want to DISABLE Scheduled Options and Menu Options and Protocols? NO//", answer NO. POST-INSTALLATION ================= A team including a Clinical Application Coordinator, Chief, Health Information Management, and other pertinent facility staff shall be formed to review the results of the report generated by this patch. This step is critical to ensuring the integrity and accuracy of the Consult data at your facility. Because no automated functionality exists, each record on the report that potentially has a consult report for a wrong patient must be reviewed to determine that it actually does have an incorrect patient record. Once determined that it exists, the consult for the incorrect patient must be printed before the incorrect record is deleted from the file (via VA Filemanager). A copy of the incorrect report along with documentation of this process must be maintained at the facility. It is recommended that this action be reviewed and documented in your facility Medical Record Committee (or equivalent). Also, prior to deletion, each affected record specified on this report must be manually reviewed to determine if the incorrect consult attached to the record has been included in a release of information. If it has, the facility Chief, HIM and Privacy Act Officer must review and take appropriate actions. ----------- How to fix the mismatched consult/documents --------------- 1. Identify the correct document for the consult and determine the IEN of that document. 2. To remove the incorrect Document associated with the consult use Enter/Edit FileMan. Select the Consult and delete the incorrect document from its associated Results using the following example. Select VA FileMan Option: Enter or Edit File Entries INPUT TO WHAT FILE: REQUEST/CONSULTATION// EDIT WHICH FIELD: ALL// 50 ASSOCIATED RESULTS (multiple) EDIT WHICH ASSOCIATED RESULTS SUB-FIELD: ALL// THEN EDIT FIELD: Select REQUEST/CONSULTATION FILE ENTRY DATE: `3972191 (IEN of the consult) 10-6-2008@10:25:00 DJELHA WLSUDJB Select ASSOCIATED RESULTS: PROSTHETICS CONSULT NOTE // @ SURE YOU WANT TO DELETE? Y 3. To add the correct Document to the consult use Enter/Edit FileMan. Select the Consult and add the correct document to the Associated Result using the following example. Select REQUEST/CONSULTATION FILE ENTRY DATE: `3972191 (IEN of the consult) 10-6-2008@10:25:00 DJELHA WLSUDJB Select ASSOCIATED RESULTS: `28990050 (IEN of the correct note) Searching for a Note, (pointed-to by ASSOCIATED RESULTS) Searching for a Select ECHO report, (pointed-to by ASSOCIATED RESULTS) Searching for a Select CATH report, (pointed-to by ASSOCIATED RESULTS) Searching for a Select EKG report, (pointed-to by ASSOCIATED RESULTS) Searching for a Select HOLTER report, (pointed-to by ASSOCIATED RESULTS) Searching for a Select ETT report, (pointed-to by ASSOCIATED RESULTS) Searching for a Select EP report, (pointed-to by ASSOCIATED RESULTS) Searching for a Select HEM report, (pointed-to by ASSOCIATED RESULTS) Searching for a Select GEN IMP report, (pointed-to by ASSOCIATED RESULTS) Searching for a Select PACEMAKER report, (pointed-to by ASSOCIATED RESULTS) Searching for a Select ENDO report, (pointed-to by ASSOCIATED RESULTS) Searching for a Select PFT report, (pointed-to by ASSOCIATED RESULTS) Searching for a Note PROSTHETICS CONSULT NOTE HHJB,ELUXAI I 09-19-08 ...OK? Yes// (Yes) Select ASSOCIATED RESULTS: ------------------------ RERUNNING THE REPORT --------------------------- Sites which would like to rerun the post-install routine to verify their clean up efforts may do so by running the routine at the programmer's prompt: D EN1^GMRCYP70 Sites which no longer want to run the post-install routine may delete it at any time. Routine Information: ==================== The second line of each of these routines now looks like: ;;3.0;CONSULT/REQUEST TRACKING;**[Patch List]**;;Build 17 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: GMRCYP70 Before: n/a After:B155378691 **70** ============================================================================= User Information: Entered By : RANDALL,SHERRY Date Entered : JAN 15, 2009 Completed By: WERNER,GARY Date Completed: JAN 27, 2010 Released By : BOSE,MARY ELLEN Date Released : FEB 23, 2010 ============================================================================= Packman Mail Message: ===================== $END TXT