$TXT Created by TRAXLER,FRANK at DEV.DEV.FO-HINES.MED.VA.GOV (KIDS) on Tuesday, 08/18/09 at 12:10 ============================================================================= Run Date: NOV 10, 2009 Designation: GMRV*5*23 Package : GMRV - GEN. MED. REC. - VITALS Priority: Mandatory Version : 5 SEQ #17 Status: Released Compliance Date: DEC 11, 2009 ============================================================================= Associated patches: (v)GMRV*5*1 <<= must be installed BEFORE `GMRV*5*23' (v)GMRV*5*3 <<= must be installed BEFORE `GMRV*5*23' (v)GMRV*5*6 <<= must be installed BEFORE `GMRV*5*23' (v)GMRV*5*22 <<= must be installed BEFORE `GMRV*5*23' (v)GMRV*5*25 <<= must be installed BEFORE `GMRV*5*23' Subject: SWITCHING TO PXRMINDX INDEX Category: - Routine - Enhancement (Mandatory) - Other Description: ============ ASSOCIATED E3R(s) ================= 20191 - API ENCHANCEMENTS FOR CLIO 19259 - CASMED INTERFACE ASSOCIATED REMEDY TICKETS ========================= 116911 - Pain Scores 0 Display as Critical Red Buttons in the Nursing Dashboard 174395 - Problem with nationally released objects 277170 - Date/Time pulled from PC rather than VistA 277330 - ARCHIVING 301139 - 1 Incorrect vital 508 COMPLIANCE ============== Section 508 testing was conducted on the software by two test engineers from the VA Section 508 Program Office. The software was modified to meet their recommendations and re-tested. The software is now 508 compliant. Many of the changes are not noticeable since they involve use of screen reading software. One new report, Graph Report, was added. It summarizes in text format the values on the graph display. E3R 20191 - API ENCHANCEMENTS FOR CLIO CHANGES ============================================== 1) This patch modifies the existing Vitals package routines so they use the "PXRMINDX(120.5" index to find patient vital sign records. Before this patch, these routines used the AA cross-reference in the GMRV VITAL MEASUREMENT file (#120.5). This new approach is being used because a new software package called Clinical Observations will also collect patient vitals data, but will store data in a different file. The Clinical Observations package (CliO) will update the "PXRMINDX(120.5" index just as the Vitals package currently does. The "PXRMINDX(120.5" index belongs to the Clinical Reminders package and is used to resolve reminders related to patient vital signs. These routine changes will allow the Vitals package to retrieve patient vital signs data from both the GMRV VITAL MEASUREMENT file (#120.5) and the Clinical Observations package. The programming calls will continue to function as before with the same input parameters and output with two exceptions. The GMV LATEST VM and GMV V/M ALLDATA Remote Procedure Calls (RPCs) will return an extra piece of data that identifies the package where the record is stored (e.g., Vitals or CliO). These RPCs are used by the Vitals Graphical User Interface (GUIs). VistA applications and locally developed routines that use these existing APIs should not see any change with invoking the APIs or the format of the results. VistA applications that use the AA cross-reference or get data directly from the Vitals package globals will modify their existing code to use the "PXRMINDX(120.5" index and the APIs provided in this patch. Facilities that have local development that does direct global reads of the AA cross-reference are encouraged to change their code to use the "PXRMINDX(120.5" index and one of the existing APIs (e.g., GMRVUTL or GMVPXRM) to get the record data. Several new APIs are added to the GMVUTL routine to retrieve patient records. Three new routines (GMVGETVT, GMVGETQL and GMVGETC) are added to retrieve information about vital types (GMRV VITAL TYPE file (#120.51)), qualifiers (GMRV VITAL QUALIFIER file (#120.52)) and categories (GMRV VITAL CATEGORY file (#120.53)). The Remote Procedure Calls (and corresponding ICR #, if any) using the modified routines: GMV CUMULATIVE REPORT GMV PT GRAPH GMV LATEST VM (4358) GMV V/M ALLDATA (4654) GMV EXTRACT REC (4416) GMV LATEST VITALS FOR PATIENT GMV LATEST VITALS BY LOCATION GMV ENTERED IN ERROR-PATIENT Application Programming Interfaces (and corresponding ICR #, if any) using the modified routines: EN^GMVPXRM (3647) VITALS^GMVPXRM (3647) EN6^GMRVUTL (1120) EN1^GMRVUT0 (1446) EN1^GMVHS (4791) EN3^GMRVSC0 (1444) EN1^GMVDCEXT (4251) EN1^GMVDCSAV (3996) CALBMI^GMRVBMI CALBMI^GMVBMI GMVUTL (5046) new GMVGETVT (5047) new GMVGETQL (5048) new GMVGETC (5050) new The GMRVUT0 and GMVHS Application Programming Interfaces (APIs) each return an array. Before this patch the right most subscript in each array was the internal entry number of the record in GMRV VITAL MEASUREMENT file (#120.5). Once a facility starts to use the Clinical Observations package, a record in the array may come from the new OBS file (#704.117) instead of the GMRV VITAL MEASUREMENT file (#120.5). If the record comes from the OBS file (# 704.117) this subscript will be a phony number. It will not be the internal entry number of the record because the OBS file (#704.117) uses a Global Unique ID (GUID) which is a string of unique characters to identify its records instead of a purely canonic number. Assigning a phony canonic number to the subscript allows the existing applications that call these APIs to continue to $ORDER through the array. The existing applications that have permission to use these APIs do not use this subscript to actually look up the record in the GMRV VITAL MEASUREMENT file (#120.5) so the change should not cause a problem. 2) The following five options under the Reports menu of the Vitals User interface will no longer be available. Vital Signs Record B/P Plotting Chart Weight Chart POx/Respiration Chart Pain Chart Similar graphic reports can be printed by right-clicking in the data grid display and selecting the Print Graph option or using the Print Graph option under the File menu. E3R 19259 - CASMED INTERFACE CHANGES ==================================== A "Read Monitor" button is added to the "Enter Vitals" screen. When this button is invoked, the software will attempt to retrieve vital sign readings from a vital sign monitor (VSM) connected to the workstation. The vital sign readings that appear on the VSM screen will be sent to the "Enter Vitals" screen and pasted into the input template. This saves the user from having to type in the values. There are two types of interfaces between the "Read Monitor" button and the vital signs monitor: 1) direct link to a CASMED VSM and 2) a Dynamic Link Library (DLL) link to all other VSMs. When the Vitals software starts up, the VSM connected to the workstation should be turned on. The Vitals software checks all of the DLLs in the "Program Files\VistA\Vitals\Plugins" directory to determine if any of the DLLs respond to the VSM. The first DLL that confirms it can "talk" to the VSM is recognized. If none of the DLLs respond, the VSM is considered to be a CASMED VSM and that interface is used. Vendor supplied DLLs should be placed in the "Program Files\VistA\Vitals\Plugins" directory of the workstation where the VSM will be connected. If this directory does not exist, it should be created. Other files supplied by a VSM vendor should be placed in the "Program Files\vendor name\" directory (e.g., "Program Files\ACME Medical Co\". REMEDY TICKET FIXES =================== 116911 - Pain Scores 0 Display as Critical Red Buttons in the Nursing Dashboard ICR 1446 sometimes returned an abnormal flag (i.e., an asterisk) with a Pain score. Some of the vital types have normal ranges defined, but Pain does not. Pain should never return an abnormal flag. After this patch is installed, it will not. Routine(s): GMRVUT2 174395 - Problem with nationally released objects ICR 1446 did not return a Blood Pressure or Pulse reading if it was not numeric (e.g., Refused, On Pass or Unavailable). After this patch it will. Routine(s): GMRVUT2 277170 - Date/Time pulled from PC rather than VistA Prior to GMRV*5*22 the Vitals.exe and GMV_VitalsViewEnter.dll had a bug that used the date/time from the workstation clock as the default for when the observation was made. The default date/time should be taken from the server clock. The GMRV*5*22 patch fixed the problem in the Vitals.exe only. This patch will fix the problem in the GMV_VitalsViewEnter.dll file. 277330 - ARCHIVING The package does not export any archive/purge functionality. However, Section 6 of the Technical Manual provides instructions for using FileMan functionality to do so. Archiving/purging vitals records is discouraged. Therefore, these instructions will be removed from the Technical Manual. 301139 - 1 Incorrect vital This ticket was elevated to a Patient Safety Issue (PSPO 1258). The wrong weight was entered for a patient. The mistake was discovered a few days later. The record was changed to "Entered-in-Error". A new record was entered with the correct weight. Before that happened, a medication was given to the patient with the dosage based on the incorrect weight. No harm came to the patient and the dosage was corrected based on the correct weight. To prevent future occurrences, the software will do an additional check on any new weight and height values entered. If the new weight value is different by 20% or more from the previous value, a warning message will be displayed. If the new height value is different by 10% or more from the previous value, a warning message will be displayed. Software Retrieval: ------------------- The KIDS build is attached to this message. The other files in this patch are bundled into the VITL5_P23.ZIP file. Use Binary to download the file. Sites may retrieve the ZIP file in one of the following ways: 1. The preferred method is to FTP the files from: download.vista.med.va.gov This will transmit the files from the first available FTP Server. 2. Sites may also elect to retrieve the software directly from a specific Server as follows: CIO FIELD OFFICE FTP ADDRESS DIRECTORY --------------- ----------- --------- Albany ftp.fo-albany.med.va.gov [anonymous.software] Hines ftp.fo-hines.med.va.gov [anonymous.software] Salt Lake City ftp.fo-slc.med.va.gov [anonymous.software] The ZIP file contains: FILE NAME DESCRIPTION RETRIEVAL FORMAT ---------- ----------- ---------------- VITL5_P23.EXE GUI executable Binary VITL5_P23_SRC.ZIP GUI source code Binary GMV_VitalsViewEnter.DLL DLL file Binary GMV_VitalsViewEnter.HLP Help file for DLL Binary GMV_VitalsViewEnter.CNT Table of Contents for Binary the DLL Help file VITL5_TM.PDF Technical Manual (all pages) Binary VITL_5_P23_TM_CHANGE Technical Manual (change pages) Binary _PAGES.PDF VITL5_UM.PDF User Manual (all pages) Binary VITL_5_P23_UM_CHANGE User Manual (change pages) Binary _PAGES.PDF VITL5_P23_IG.PDF Installation Guide Binary VITL5_P23_RN.PDF Release Notes Binary The User Manual (all pages) can also be retrieved from the VistA Documentation Library (VDL) on the VA Intranet at the following address: http://www.va.gov/vdl Test Sites: ----------- Central Plains HCS Charleston Eastern Colorado HCS Fayetteville, AR Heartland-East HCS Hines Minneapolis Installation Instructions: ========================== 1) This patch can be installed with users on the system. However, it should be installed when use of the software is low. Installation should take less than 5 minutes. Please see the Installation Guide (VITL5_P23_IG.PDF) for an example. 2) Load the Transport Global. 3) (Optional) Run the following KIDS options before installing the patch: Compare Transport Global to Current System Verify Checksums in Transport Global Backup a Transport Global 4) Install the KIDS Build GMRV*5.0*23. At the "Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//" prompt answer according to your facility's policy concerning the rebuilding of menu trees. At the 'Want KIDS to INHIBIT LOGONs during the install' prompt answer NO. At the 'Want to DISABLE Scheduled Options, Menu Options, and Protocols?' prompt answer YES. Place the following options out of service: Vitals/Measurements GUI Application [GMV V/M GUI] 5. The post-installation routine, GMV23PST, is automatically deleted. 6. Unzip the VITL5_P23.zip file and move the VITL5_P23.exe file to an appropriate directory and/or workstations. 7. Install the new Vitals executable files. a) Double-click on the VITL5_P23.EXE file to start the InstallShield Wizard. b) Follow the Wizard instructions. When prompted to "Modify, repair, or remove the program." select "Repair". c) Follow the wizard instructions to completion. 8. The installation wizard creates the following files: C:\Program Files\vista\Vitals\Vitals.exe C:\Program Files\vista\Vitals\VitalsManager.exe C:\Program Files\vista\Vitals\Help\Vitals.hlp C:\Program Files\vista\Vitals\Help\Vitals.cnt C:\Program Files\vista\Vitals\Help\VitalsManager.hlp C:\Program Files\vista\Vitals\Help\VitalsManager.cnt C:\Program Files\vista\Vitals\Help\Roboex32.dll The exe files are placed in the "Program Files\vista\Vitals" directory on the workstation. The other files are placed in the "Program Files\vista\Vitals\Help" directory. If you are running the software from a server, you should move these files to the server. If you are running the software from individual workstations and want to push these files, you should include them in your script. 9. Push the GMV_VitalsViewEnter.dll, GMV_VitalsViewEnter.hlp, and GMV_VitalsViewEnter.cnt files to the "Program Files\vista\Common Files directory of the workstation where CPRS is located. For example, if CPRS is installed on the C:\ drive, the three DLL related files must be copied into the C:\Program Files\vista\Common Files directory. If this directory path does not exist, you must create it. IMPORTANT: These files must not be installed in the same folder as CPRS. CPRS looks for these three files in the specified directory path. If CPRS cannot find the DLL and its supporting files, the users will not be able to enter patient vitals/measurements data. 10. The GMVPXRM and GMVUTL routines call new routines (MDCLIO1 and MDTERM) that will be released with MD*1.0*16. These GMV* routines will not call these MD* routines if they do not exist on the system. If you run the XINDEX utility for the GMRV*5.0*23 patch before MD*1.0*16 is installed, you will see these error messages which can be ignored. F - Reference to routine '^MDCLIO1'. That isn't in this UCI. F - Reference to routine '^MDTERM'. That isn't in this UCI. Routine Information: ==================== The second line of each of these routines now looks like: ;;5.0;GEN. MED. REC. - VITALS;**[Patch List]**;Oct 31, 2002;Build 25 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: GMRVBMI Before: B5009163 After: B312331 **23** Routine Name: GMRVSC0 Before: B24203413 After: B14042810 **23** Routine Name: GMRVSC1 Before: B9241892 After: B14206536 **23** Routine Name: GMRVSC2 Before: B15866640 After: B17609755 **23** Routine Name: GMRVUT0 Before: B12655515 After: B14673210 **23** Routine Name: GMRVUT2 Before: B18552169 After: B17965647 **23** Routine Name: GMRVUTL Before: B6225466 After: B4909510 **23** Routine Name: GMV23PST Before: n/a After: B9487682 **23** Routine Name: GMVBMI Before: B5347673 After: B6498219 **3,23** Routine Name: GMVDCEXT Before: B43745459 After: B58279686 **23** Routine Name: GMVDCSAV Before: B19948030 After: B10117160 **9,3,25,23** Routine Name: GMVDS0 Before: B20439902 After: B23299046 **23** Routine Name: GMVDS1 Before: B17212354 After: B17287007 **23** Routine Name: GMVDS2 Before: B3421820 After: B1905 **23** Routine Name: GMVER0 Before: B9040069 After: B9089403 **23** Routine Name: GMVGETC Before: n/a After: B3544134 **23** Routine Name: GMVGETD Before: B12427237 After: B46740490 **3,22,23** Routine Name: GMVGETD1 Before: B3929660 After: B4725749 **23** Routine Name: GMVGETD2 Before: B21008972 After: B21667822 **1,23** Routine Name: GMVGETQL Before: n/a After: B4569446 **23** Routine Name: GMVGETVT Before: n/a After: B7880375 **23** Routine Name: GMVGGR1 Before: B19172168 After: B21349900 **3,23** Routine Name: GMVGGR2 Before: B16803927 After: B17252274 **3,23** Routine Name: GMVHS Before: B58476565 After: B32961922 **3,23** Routine Name: GMVHS1 Before: B8049761 After: B22061645 **3,23** Routine Name: GMVLAT0 Before: B31312749 After: B31803306 **1,3,23** Routine Name: GMVPXRM Before: B36506457 After: B46095157 **6,23** Routine Name: GMVSC0 Before: B17816371 After: B17931365 **23** Routine Name: GMVSC1 Before: B8913074 After: B14142553 **23** Routine Name: GMVSC2 Before: B15927181 After: B16556193 **23** Routine Name: GMVSR0 Before: B30880367 After: B32180686 **23** Routine Name: GMVUTL Before: B84410 After: B41699178 **23** Routine list of preceding patches: 6, 22, 25 ============================================================================= User Information: Hold Date : NOV 10, 2009 Entered By : TRAXLER,FRANK Date Entered : FEB 13, 2008 Completed By: CHIPMAN,HONEY Date Completed: NOV 10, 2009 Released By : MURCH,CLAUDETTE Date Released : NOV 10, 2009 ============================================================================= Packman Mail Message: ===================== $END TXT