$TXT Created by CARPENTER,TERRY at DAYT17.FO-BAYPINES.MED.VA.GOV (KIDS) on Tuesday, 09/07/10 at 11:33 ============================================================================= Run Date: MAY 10, 2011 Designation: LR*5.2*406 Package : LR - LAB SERVICE Priority: Mandatory Version : 5.2 SEQ #322 Status: Released Compliance Date: JUN 10, 2011 ============================================================================= Associated patches: (v)LR*5.2*291 <<= must be installed BEFORE `LR*5.2*406' (v)LR*5.2*372 <<= must be installed BEFORE `LR*5.2*406' Subject: SOME ALERTS FOR LAB TEST RESULTS ARE NOT SENT Category: - Routine Description: ============ This patch addresses Patient Safety Issue PSPO #1384 which involves critical lab test result alerts. When a lab test result is verified and that result lies outside the normal boundaries defined for the test, alerts are generated that are sent to the physicians who are responsible for the patient's care. In some cases these alerts are not being generated. ASSOCIATED NSR(S): ================== N/A ASSOCIATED REMEDY TICKET: ======================== HD0000000311272 - Critical lab alert not being sent PARTICIPATING TEST SITES: ======================== Boston HCS Nebraska Western Iowa HCS Montana HCS Oklahoma City VAMC REMEDY TICKET OVERVIEW: ======================= HD0000000311272 - Critical lab alert not being sent Patient Safety Issue PSPO #1384 Problem: -------- Sometimes a group of lab tests are ordered for a patient and the test results for these tests are not all entered and verified at the same time. When this happens, a test result of "pending" is sometimes stored in the LAB DATA file (#63). If "pending" is stored as a result for a test in file 63 and then an abnormal/critical result is entered and verified, the code does not generate an OBX segment (results segment) in the HL7 message and therefore the alerts are not sent out to the appropriate physicians and/or caregivers. Solution: --------- Modify routine LRVER3 to set a new node in the LRSA array to indicate this condition (a result of "pending" stored in file 63). This node will be LRSA(test#,3). Also modify routine LR7OB63 to look for this node when creating the ^TMP("LRX") global. This ^TMP("LRX") global is subsequently used to generate the HL7 message which in turn triggers the alerts and notifications when appropriate (results outside of reference range). Routines: LRVER3 LR7OB63 BLOOD BANK CLEARANCE: ===================== EFFECT ON BLOOD BANK FUNCTIONAL REQUIREMENTS: Patch LR*5.2*406 does not contain any changes to the VISTA BLOOD BANK Software as defined by VHA DIRECTIVE 2004-058 titled VISTA BLOOD BANK SOFTWARE VERSION 5.2. EFFECT ON BLOOD BANK FUNCTIONAL REQUIREMENTS: Patch LR*5.2*406 does not alter or modify any software design safeguards or safety critical elements functions. RISK ANALYSIS: Changes made by patch LR*5.2*406 have no effect on Blood Bank software functionality, therefore RISK is none. VALIDATION REQUIREMENTS BY OPTION: Because of the nature of the changes made, no specific validation requirements exist as a result of installation of this patch. INSTALLATION INSTRUCTIONS: ========================= The install time for this patch is less than 2 minutes. This patch may be installed when Laboratory users are on the system. NOTE: Kernel patches must be current on the target system to avoid problems loading and/or installing this patch. 1. Use the 'INSTALL/CHECK MESSAGE' option of the PackMan menu. This option will load the KIDS patch onto your system. 2. The patch has now been loaded into a Transport global on your system. You now need to use KIDS to install the transport global. 3. On the 'Kernel Installation & Distribution System' Menu (KIDS), select the 'Installation' menu. 4. Use the 'Verify Checksum in Transport Global' option and verify that all routines have the correct checksums. 5. On the KIDS menu, under the 'Installation' menu, use the following options: Print Transport Global Compare Transport Global to Current System Backup a Transport Global If you wish to preserve a copy of the routines exported in this patch prior to installation, you should use the 'Backup a Transport Global' option at this time. You may also compare the routines in your production account to the routines in the patch by using the 'Compare a Transport Global to Current System' option. 6. Use the 'Install Package(s)' option under the 'Installation' menu and select the package 'LR*5.2*406. If prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//, choose 'NO'. If prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', choose 'NO'. Routine Information: ==================== The second line of each of these routines now looks like: ;;5.2;LAB SERVICE;**[Patch List]**;Sep 27, 1994;Build 1 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: LR7OB63 Before: B23763803 After: B23908890 **121,187,286,372,406** Routine Name: LRVER3 Before: B49207018 After: B49397241 **42,100,121,140,171,153,221, 286,291,406** Routine list of preceding patches: 291, 372 ============================================================================= User Information: Entered By : CARPENTER,TERRY Date Entered : AUG 04, 2010 Completed By: WERNER,GARY Date Completed: APR 19, 2011 Released By : BARKOOZIS,GREGORY Date Released : MAY 10, 2011 ============================================================================= Packman Mail Message: ===================== $END TXT