$TXT Created by at MNTVBB.DOMAIN.EXT (KIDS) on Tuesday, 09/20/22 at 16:23 ============================================================================= Run Date: MAY 22, 2023 Designation: LA*5.2*101 Package : LA - AUTOMATED LAB INSTRUMENTS Priority: Mandatory Version : 5.2 SEQ #74 Status: Released Compliance Date: JUN 22, 2023 ============================================================================= Associated patches: (v)LA*5.2*88 <<= must be installed BEFORE `LA*5.2*101' Subject: LEDI RESULTS AVAILABLE STATUS ISSUE Category: - Routine Description: ============ This patch addresses one issue: The Incomplete Test Status Report (LRWRKINC) sometimes does not display a status of "Results Available" for Laboratory Electronic Data Interchange (LEDI) tests when results are available for review from a host site. Defect Tracking System Ticket(s) & Overview: =========================================== NOTE 1: LR*5.2*562 is a companion patch to LA*5.2*101. NOTE 2: LA*5.2*103 will address this issue for non-VistA LEDI interfaces, such as Quest. INC22082550: LEDI Results Available Status Issue Problem: -------- LEDI collecting site Laboratory workflow might include relying on the Incomplete Test Status Report (LRWRKINC) to determine when results have been received from a LEDI host site and are ready for review. Several sites utilizing this workflow have discovered that there are times when results have been received, but the ordered test status on the Incomplete Test Status Report remains at "Test shipped" instead of updating to "Results received". Research showed that when the issue occurs, the entry filed into the LAB TEST (#.08) field of the LAB SHIPPING EVENT (#62.85) file is 0 (zero) for the EVENT CODE (#.05) field status of "Results received". LEDI HL7 transaction processing logic at the collecting site relies on three pieces of information to determine the ordered test IEN (internal entry number) in the LABORATORY TEST (#60) file: (1) the shipping manifest identifier sent by the host site in the ORC-4 field; (2) the collecting site UID (universal identifier) sent in the OBR segment; and (3) other ordered test related information from the OBR segment. If any of the three pieces of information is missing or does not pertain to the ordered test on the UID, this issue will occur. One of three root causes might be responsible: 1. An incorrect shipping manifest identifier was received for the ordered test. If a UID has two tests ordered which are on different manifests, the LEDI logic at the VistA host site assumes each UID was present on a single manifest. Only the first manifest identifier received by the host site is filed into the ORC-4 field when sending results back. This issue will then occur for any tests that were sent on subsequent manifests. 2. A profile is not completely verified on the LEDI host site (i.e. some results are pending). 3. The collecting site sends one HL7 OBR segment for a profile when transmitting an order transaction to the host site, but the host site sends individual HL7 OBR segments for each panel component when transmitting a result transaction. All root causes do not impact the ability to review and verify results. Only the Incomplete Test Status Report is impacted. Resolution: ----------- Solutions for each root cause: 1. The host site LEDI logic will loop through all shipping manifest identifiers received for a UID and determine the correct one for the test which has results being transmitted. This will ensure that the correct shipping manifest identifier is transmitted in the ORC-4 field. Routine LA7VORU was modified. 2. If no shipping manifest identifier is received or if the shipping manifest identifier received in the ORC-4 field is incorrect for the UID and ordered test, an attempt is made to determine the LABORATORY TEST (#60) file IEN of the ordered test based on only the UID and OBR segment information. Routines LA7VIN4, LA7VIN4A and LA7SMU1 were modified. 3. If no match is found after invoking the logic described above, the tests on the accession are evaluated to determine whether any profile components are a match. Routine LA7SMU1 was further modified. Test Sites: ----------- Columbia VA Health Care System(Columbia,SC) Augusta VAMC (Augusta, GA) San Diego VAMC (San Diego, CA) VA Long Beach Heathcare System (Long Beach, CA) Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released in a PackMan message. Patch Installation: ------------------- Pre-Installation Instructions: This patch 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 patch should take less than 5 minutes to install. NOTE: LR*5.2*562 is a companion patch to LA*5.2*101. The two patches should be installed together. One is not dependent on the other. The patches may be installed in any order. Installation Instructions: 1. Choose the PackMan message containing this build. Then select the INSTALL/CHECK MESSAGE PackMan option to load the build. 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 patch name. (ex. LA*5.2*101). 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 and specify what to backup; the entire Build or just Routines. The backup message can be used to restore the routines and components of the build to the pre-patch condition. i. At the Installation option menu, select Backup a Transport Global. ii. At the Select INSTALL NAME prompt, enter your build LA*5.2*101. iii. When prompted for the following, enter "R" for Routines or "B" for Build. Select one of the following: B Build R Routines Enter response: Build iv. When prompted "Do you wish to secure your build? NO//", press and take the default response of "NO". v. When prompted with, "Send mail to: Last name, First Name", press to take default recipient. Add any additional recipients. vi. When prompted with "Select basket to send to: IN//", press and take the default IN mailbox or select a different mailbox. 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. Back-out/Roll Back Plan: ------------------------ Back-out will be done only with the concurrence and participation of development team and appropriate VA site/region personnel. The decision to back-out or rollback software will be a joint decision between development team, VA site/region personnel and other appropriate VA personnel. Prior to installing an updated KIDS package, the site/region should have saved a backup of the routines in a mail message using the Backup a Transport Global [XPD BACKUP] menu option (this is done at time of install). The message containing the backed-up routines can be loaded with the "Xtract PackMan" function at the Message Action prompt. The Packman function "INSTALL/CHECK MESSAGE" is then used to install the backed up routines onto the VistA System. The back-out plan is to restore the routines from the backup created. No data was modified by this patch. Validation of Back-out Procedure: --------------------------------- The Back-out Procedure can be verified by printing the first two line of the routines contained in this patch using the option First Line Routine Print [XU FIRST LINE PRINT]. After the routines contained in the patch have been backed out, the first two lines of the routines will no longer contain the designation of this patch in the patch list section. Routine Information: ==================== The second line of each of these routines now looks like: ;;5.2;AUTOMATED LAB INSTRUMENTS;**[Patch List]**;Sep 27, 1994;Build 6 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: LA7SMU1 Before: B47133373 After: B80235547 **27,46,65,64,74,101** Routine Name: LA7VIN4 Before: B81803911 After: B81605769 **46,64,67,66,74,85,88,101** Routine Name: LA7VIN4A Before: B23154184 After: B23417905 **74,80,88,101** Routine Name: LA7VORU Before: B21144150 After: B23822315 **27,46,61,64,71,68,74,101** Routine list of preceding patches: 88 ============================================================================= User Information: Entered By : Date Entered : JUN 09, 2022 Completed By: Date Completed: MAY 18, 2023 Released By : Date Released : MAY 22, 2023 ============================================================================= Packman Mail Message: ===================== $END TXT