============================================================================= Run Date: SEP 24, 2013 Designation: LA*5.2*80 Package : LA - AUTOMATED LAB INSTRUMENTS Priority: EMERGENCY Version : 5.2 SEQ #59 Status: Released Compliance Date: OCT 04, 2013 ============================================================================= Associated patches: (v)LA*5.2*74 <<= must be installed BEFORE `LA*5.2*80' Subject: LEDI IV UPDATES Category: - Routine - Data Dictionary Description: ============ The build for this patch is distributed as part of a multi-package build that contains LR*5.2*427 and LA*5.2*80. Blood Bank Clearance ==================== VISTA Laboratory Package patch LA*5.2*80 contains changes to software controlled by VHA DIRECTIVE 2004-058, titled VISTA BLOOD BANK SOFTWARE. Changes include: File Field ====------------------- ===== LAB CODE MAPPING (#62.47) SEQUENCE (#.001) CONCEPT (#.01) ALTERNATE CONCEPT (#.04) IDENTIFIER (#62.4701,.01) CODING SYSTEM (#62.4701,.02) NATIONAL STANDARD (#62.4701,.05) RELATED ENTRY (#62.4701,2.1) MESSAGE CONFIGURATION (#62.4701,2.2) LA7 MESSAGE PARAMETER (#62.48) SEQUENCE (#62.482,.001) VA FILE ENTRY (#62.482,.01) SNOMED CT ID (#62.482,.02) All of the above changes have been reviewed by the VISTA Blood Bank Developer and found to have no impact on the VISTA BLOOD BANK SOFTWARE control functions. RISK ANALYSIS: Changes made by patch LA*5.2*80 have no effect on Blood Bank software functionality, therefore RISK is none. EFFECT ON BLOOD BANK FUNCTIONAL REQUIREMENTS: Patch LA*5.2*80 does not alter or modify any software design safeguards or safety critical elements functions. POTENTIAL IMPACT ON SITES: This patch contains changes to 0 routines and 2 files identified in Veterans Health Administration (VHA) Directive 2004-058, group B listing. The changes have no effect on Blood Bank functionality or medical device control functions. There is no adverse potential to sites. VALIDATION REQUIREMENTS BY OPTION: There are no validation requirements by option MINIMAL TEST CASE SCENARIOS BY OPTION, INCLUSIVE OF ALL CONTROL FUNCTIONS: There are no test case scenarios by option -------------------------------------------------------------------------- This patch addresses the following items related to LEDI IV: o On the second line of routine LA7SMU2A, it is missing a star before the patch number. This will be added by the patch. o The routine LAMIAUT4 was modified to ask for performing lab and to send Computerized Patient Record System (CPRS) alerts when using the option Verify Micro Auto Data [LA MI VERIFY AUTO]. o This patch will make cosmetic changes to the Data Dictionary (e.g., update Help-Prompts, Descriptions, etc.) for files LAB CODE MAPPING (#62.47) and LA7 MESSAGE PARAMETER (#62.48). o The functionality to electronically transmit AP orders and AP/Micro results via the LEDI interface was previously disabled by default for LEDI IV. This patch will now enable the functionality to electronically transmit AP Orders and Micro Results via LEDI. (Note: The functionality to transmit AP results will still be disabled). o When a Systemized Nomenclature of Medicine Clinical Terms (SNOMED CT) mapping file is loaded, the system validates each SNOMED CT ID against the Lexicon. If there is an exception found (e.g., the code is inactive) the system sends an alert to Standards & Terminology Services (STS) so that STS can send an updated mapping for this entry. However, it is possible for a code to be active at the time of the load, but be deprecated when a Lexicon patch is installed that updates the SNOMED CT code set. To ensure the SCT mappings stay current, this patch creates a new option, 'Check SNOMED CT Mappings Against the Lexicon' [LA7TASK SCT MAPPINGS CHECK]. This option checks the SCT mappings against the Lexicon for exceptions, and should be scheduled to run on a recurring basis. If the option finds any exceptions: a. The SCT CODE STATUS field (#21) for the entry will be updated to 'Error' b. A HDI exception alert will be sent to STS c. A MailMan message will be sent to the G.LMI and G.LAB MESSAGING Mail Groups with a list of the exceptions found. (Note: When the members of the local mail groups receive the MailMan message with the list of exceptions found, they do not need to do anything. STS will review the exception alerts they receive, and if needed, will send an updated SCT mapping file to the site to load. Until STS notifies the site that there is an updated mapping file to load, there is nothing that the site needs to do) o This patch will fix an issue with how the system handles the following situation. When an order is received by a host site via the LEDI interface, the system tries to find a matching entry in the host's shipping configuration based off the test and specimen codes that were sent across in the HL7 message. In a scenario where it found a matching test/specimen entry setup, but the specimen at the host site was mapped to a different SNOMED CT ID than the ordering site, then when creating the order, the system was not using the specimen that was configured on the shipping configuration, but instead, would use a specimen that matched the SNOMED CT ID from the message. If the host site did not have an existing entry that matched the SNOMED CT ID from the message, the system automatically created a new entry based off the SNOMED CT information from the message and used that new specimen for the order. This patch changes this functionality, so that in this scenario, the host site rejects the order with an HL7 Application Error (AE). The collecting site would then need to change their test configuration to make sure that the specimen and collection samples they are using are mapped to the same SNOMED CT ID as the host site. NOTE ==== Due to this change, after a LEDI Host site installs this patch, they might start seeing Application Errors (AEs) being generated for incoming HL7 orders. If this occurs, notify the collecting site. The collecting site will need to ensure that the specimen and collection samples they are using are correctly mapped to the same SNOMED CT ID at the host site. o This patch will update the file #62.47 mapping to remove LOINC code 22638-1 from the SP COMMENT concept and add it to SP GROSS DESCRIPTION, CY GROSS DESCRIPTION, and EM GROSS DESCRIPTION. LOINC code 24419-4 will also be added to the CY GROSS DESCRIPTION and EM GROSS DESCRIPTION concepts. o When an HL7 ORU (Observational report - Unsolicited) message is generated for an AP result, the fourth component (body site) in OBR-15 (Specimen source) was not being populated. Similarly, for a mycobacteriology result, OBR-32 (Principal result interpreter) was not being populated. These issues have been fixed with this patch. o When an HL7 ORU (Observational report - Unsolicited) message is generated for a Micro result, an incorrect field number is being referenced so the PARASITOLOGY SMEAR/PREP field (#15.51) of the MICROBIOLOGY sub-file (#5) for the LAB DATA file (#63) is not populated and sent. This issue has been fixed with this patch. o This patch will hard code it so that Micro and AP results returned via the LEDI interface will never overlay previous results for this accession in the ^LAH global. o Microbiology sterility results being returned by a LEDI host site were not filing in the LAH global on the collecting site. This patch will add filing logic for sterility results. Patch Components ================ Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ----------------------- ----------------------- -------------------- LAB CODE MAPPING SEQUENCE (#.001) Modified (#62.47) CONCEPT (#.01) Modified ALTERNATE CONCEPT (#.04) Modified IDENTIFIER (#62.4701,.01) Modified CODING SYSTEM Modified (#62.4701,.02) NATIONAL STANDARD Modified (#62.4701,.05) RELATED ENTRY Modified (#62.4701,2.1) MESSAGE CONFIGURATION Modified (#62.4701,2.2) LA7 MESSAGE PARAMETER SEQUENCE (#62.482,.001) Modified (#62.48) VA FILE ENTRY Modified (#62.482,.01) SNOMED CT ID Modified (#62.482,.02) Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- LA7TASK SCT MAPPINGS CHECK routine New Parameter Definitions Associated: Parameter Definition Name: New/Modified/Deleted ------------------------- -------------------- LA LEDI ORM HL7 STATUS Modified LA LEDI ORU HL7 STATUS Modified Remedy Tickets Overview ======================= 1. INC000000852585 - Error with option LA DOWN Problem ------- Sometimes when a user runs option Download a load list to an Instrument [LA DOWN], the option generates an error in the VistA error trap and does not download the load list to the instrument. The issue is caused because patch LA*5.2*74 modified routine LA7ADL to change how variable LA761 was set. It moved this action from CHKTEST^LA7ADL to UID^LA7ADL. Routine LA7UIO is used by the option LA DOWN, and it calls CHKTEST^LA7ADL at CUP+20. Since it enters at CHKTEST, LA761 has not been set causing the undefined error. Solution -------- Modified CUP^LA7UIO to set variable LA761 before calling CHKTEST^LA7ADL. Routine: LA7UIO Test Sites ========== Bedford VAMC Biloxi VAMC Boston HCS Hines, IL VAMC Houston VAMC Madison, WI VAMC Milwaukee VAMC Minneapolis VA HCS Shreveport VAMC St. Cloud VA HCS Upstate New York HCS VA Heartland-West HCS We would also like to thank the following site who participated in the testing of this patch: Oklahoma City VAMC Software and Documentation Retrieval Information ================================================ VistA Laboratory patch LR*5.2*80 software is distributed by Host File, along with LR*5.2*427. Documentation is available on the ANONYMOUS.SOFTWARE directory at one of the following Office of Information (OI) Field Offices. The preferred method is to FTP the files from: download.vista.domain.ext This transmits files from the first available FTP server. Sites may also elect to retrieve documentation directly from a specific server as follows: Albany ftp.fo-albany.domain.ext Hines ftp.fo-hines.domain.ext Salt Lake City ftp.fo-slc.domain.ext File Name Contents Retrieval Format ------------------ -------------------- ---------------- LR_52_P427.KID Host File containing ascii KIDS software distribution LAB_LEDI_IV_UM_UPDATE.PDF LEDI IV User Manual binary Update LEDI_IV_AP_MICRO_CONFIGURATION_GUIDE.PDF binary LEDI IV Update AP/MICRO Configuration Guide Installation Instructions ========================= This patch, LA*5.2*80, is part of a combined build for LEDI IV Updates. Please refer to patch LR*5.2*427 for installation instructions. Routine Information: ==================== The second line of each of these routines now looks like: ;;5.2;AUTOMATED LAB INSTRUMENTS;**[Patch List]**;Sep 27, 1994;Build 19 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: LA7CHKF1 Before: n/a After: B91962013 **80** Routine Name: LA7SMU2 Before: B28488734 After: B27930322 **46,64,74,80** Routine Name: LA7SMU2A Before: B11988192 After: B11988192 **74,80** Routine Name: LA7UIO Before: B9066917 After: B9916746 **66,80** Routine Name: LA7VIN4A Before: B16212997 After: B19473776 **74,80** Routine Name: LA7VIN71 Before: B21329203 After: B21704396 **74,80** Routine Name: LA7VIN7C Before: B37686666 After: B42479147 **74,80** Routine Name: LA7VMSG Before: B31327904 After: B45543754 **27,50,56,46,64,74,80** Routine Name: LA7VORU2 Before: B30157126 After: B30167256 **46,64,68,74,80** Routine Name: LA7VORUB Before: B55030598 After: B55537548 **68,74,80** Routine Name: LA80 Before: n/a After: B5891361 **80** Routine Name: LAMIAUT4 Before: B18229439 After: B18820439 **153,80** Routine list of preceding patches: 66, 74, 153 ============================================================================= User Information: Entered By : ANZALDUA,CAROL Date Entered : OCT 11, 2012 Completed By: DERBES-MURPHY,ELISA Date Completed: SEP 17, 2013 Released By : BELSCHWINDER,MICHAEL Date Released : SEP 24, 2013 ============================================================================= Packman Mail Message: ===================== No routines included