$TXT Created by PHELPS,TY at DAYT17.FO-BAYPINES.MED.VA.GOV (KIDS) on Tuesday, 07/27/10 at 12:58 ============================================================================= Run Date: OCT 28, 2010 Designation: GMRC*3*68 Package : GMRC - CONSULT/REQUEST TRACKING Priority: Mandatory Version : 3 SEQ #61 Status: Released Compliance Date: NOV 28, 2010 ============================================================================= Associated patches: (v)GMRC*3*33 <<= must be installed BEFORE `GMRC*3*68' Subject: INTER-FACILITY CONSULTS NOT TRANSMITTING Category: - Routine Description: ============ This patch addresses Patient Safety Issue PSPO #1619, an issue which causes an Inter-Facility Consult (IFC) to appear as a local consult and not transmit correctly to the consulting site. ASSOCIATED NSR(s): ================== N/A ASSOCIATED REMEDY: ================== HD0000000342037 - IFC consult not showing in system as IFC Duplicates: ----------- HD0000000263849 - Some IFC consults are not being transmitted HD0000000344315 - IFC Consults Not Showing as IFC HD0000000369576 - IFC transaction did not occur HD0000000389915 - IFC not showing as IFC PARTICIPATING TEST SITES: ========================= VA Illiana HCS - Danville Orlando VAMC VA Pittsburgh HCS VA Southern Oregon Rehabilitation Center & Clinics - White City REMEDY OVERVIEW: ================ HD0000000342037 - IFC consult not showing in system as IFC Problem: -------- When entering an Interfacility Consult request, if a user copies data into the Provisional Diagnosis field by utilizing the cut, copy and paste functions (CNTL-X, CNTL-C, CNTL-V, or through menu options), unseen control characters may be introduced in the data. When the data is stored to a file, the control characters captured from the cut & paste cause an error during the save which leaves the file incomplete. The missing data just happens to be needed to determine if the Consult Request is an Inter-Facility Consult. Since the consult is not recognized as an IFC, it is never transmitted to the consulting site. Since the consulting site does not receive the consult order, the consult is not performed, possibly causing harm to the patient. This has resulted in Patient Safety Issue PSPO #1619. Resolution: ----------- The resolution will be in 2 parts: 1. Routine GMRCHL7A was modified to remove any control characters from the Provisional Diagnosis field before saving the data. 2. A post-init routine, GMRCYP68, will examine the system and determine when the IFC functionality was installed and then will search the REQUEST/CONSULTATION (#123) file for any entries back to that date, in a "ACTIVE", "PARTIAL RESULTS", "PENDING", or "SCHEDULED" status and appearing as local consults but should have been IFCs. When the patch installation is completed and some bad IFCs were found, a MailMan message will be sent to the installer. This message should be forwarded to the appropriate Clinical Application Coordinator or others responsible for the Consult/Request package at your site for their review. The patch does not make any changes to existing consults - they can only be changed by following the instructions in the MailMan message. If no bad IFCs were found, no Mailman message will be sent but the following message will be displayed during the install. Starting Post-init... Searching for Consult Request which should be Inter-Facility Consults, but are displaying as local Consults. 0 Total Invalid IFC Consult Request Records Found. No invalid entries found. Post-init complete. Sample MailMan Message: ----------------------- Subj: GMRC*3*68 - IFC CONSULTS NOT SENT [#588209] 07/28/10@09:38 From: PATCH GMRC*3.0*68 POST-INIT In 'IN' basket. Page 1 -------------------------------------------------------------------------- This message has been sent by patch GMRC*3.0*68 at the completion of the post-init routine. This message was sent because Inter-Facility Consult records were found which were not sent as Inter-Facility Consults and appear as local Consults. These IFC Consults are listed in this Mailman message so the proper action may be taken to correct the erroneous IFC Consult Request Records. We have identified two different ways in which sites may correct these incorrect IFC entries: Option 1: After identifying and verifying the problem entry, forward the problem entry to a different consult service/procedure and then forward the entry back to the original service/procedure. This action will correct the problem and allow the consult to transmit properly to the consulting facility. If this option is used, it is suggested the forwarding to service be made aware of these pending actions and a standard message be devised to be included as a comment for the effected consult entries. Option 2: After identifying and verifying the problem entry, contact the ordering provider to determine if the order is still needed. Have the provider Discontinue the order. If the order was no longer needed, then this is all that is needed. If the order is needed, then the provider should re-order it. Sites may want to create a standardized message for the discontinued orders and new orders if appropriate. Submit a Remedy ticket if you need additional instructions or help. The following information is provided to assist you in your cleanup efforts. PATIENT NAME (L4 SSN) DATE IEN NUMBER STATUS CONSULT REQUEST (SERVICE/PROCEDURE) IFC ROUTING SITE IFC REMOTE NAME ========================================================================== AAADTXY,CLZHT HIPLUI (####) JUN 02, 2010@15:45 609155 PENDING MENTAL HEALTH CLINIC (SERVICE) TEST VAMC MENTAL HEALTH CLINIC JUN 02, 2010@15:47 609156 PENDING MENTAL HEALTH CLINIC (SERVICE) TEST VAMC MENTAL HEALTH CLINIC AAAHY,CXEY J (####) JUL 05, 2002@11:06 387732 ACTIVE MENTAL HEALTH CLINIC (SERVICE) TEST VAMC MENTAL HEALTH CLINIC AAAHY,FAHYY U (####) JUN 27, 2008@15:42 471741 ACTIVE MENTAL HEALTH CLINIC (SERVICE) TEST VAMC MENTAL HEALTH CLINIC INSTALLATION INSTRUCTIONS ========================= This patch can be loaded with users in the system. Installation time will vary by site depending on the number of records in the REQUEST/ CONSULTATION (#123) file and should not take more than 10 minutes. 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*68"): 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-INSTALL INSTRUCTIONS: ========================== Check the messages displayed during the install. If you get the message that no records were found, you may delete the routine GMRCYP68. If you get the message that records were found, check your mail for the message 'GMRC*3*68 - IFC CONSULTS NOT SENT' and forward it to the appropriate staff. If you need to rerun the post-init routine, you may do so at the programmer's prompt: >D POST^GMRCYP68 This will generate a new MailMan message if records are found or will display the message that no records were found if the clean up efforts were successful. NOTE: ===== There is an existing 'Lock missing Timeout' error displayed when utilizing XINDEX. This error is not being addressed by this patch but is being rectified in patch GMRC*3.0*66. Compiled list of Errors and Warnings Jul 27, 2010@10:43:12 page 1 GMRCHL7A * * 121 Lines, 6234 Bytes, Checksum: B28033116 L +^GMR(123,DA) D ^DIE L -^GMR(123,DA) RTN+2 S - Lock missing Timeout. Routine Information: ==================== The second line of each of these routines now looks like: ;;3.0;CONSULT/REQUEST TRACKING;**[Patch List]**;DEC 27, 1997;Build 21 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: GMRCHL7A Before: B27421740 After: B28033116 **1,5,12,15,21,22,33,68** Routine Name: GMRCYP68 Before: n/a After: B76565979 **68** Routine list of preceding patches: 33 ============================================================================= User Information: Entered By : RANDALL,SHERRY Date Entered : OCT 24, 2008 Completed By: WERNER,GARY Date Completed: OCT 08, 2010 Released By : KREUZ,SHERI B Date Released : OCT 28, 2010 ============================================================================= Packman Mail Message: ===================== $END TXT