============================================================================= Run Date: MAR 15, 2021 Designation: MAG*3*231 Package : MAG - IMAGING Priority: Mandatory Version : 3 SEQ #199 Status: Released Compliance Date: APR 15, 2021 ============================================================================= Associated patches: (v)MAG*3*161 <<= must be installed BEFORE `MAG*3*231' (v)MAG*3*208 <<= must be installed BEFORE `MAG*3*231' (v)MAG*3*218 <<= must be installed BEFORE `MAG*3*231' Subject: IMPROVE TRANSFER OF DICOM IMAGES FROM PACS TO VISTA Category: - Enhancement (Mandatory) - Data Dictionary - Routine - Other Description: ============ This document describes the MAG*3.0*231 changes to VistA and the Legacy DICOM Gateway (LDGW). The primary change is the addition of the Study Tracker. The VA requires all digital medical images for the patient to be stored in VistA Imaging. Study Tracker provides both an automatic and manual mechanism to identify missing images in VistA and retrieve them from a PACS. Study Tracker will be used for retrieving Radiology, Dental, Eye Care, and other clinical specialty images. The migration to Cerner expects all digital medical images (except Cardiology) to be in VistA Imaging. Cerner will be obtaining the VA images from VistA Imaging and not the site PACS The Study Tracker will typically be used by Radiology and Clinical Specialty Imaging Administrators as well as VistA Imaging site personnel. Included in the Study Tracker is: 1. Interactive check if images are stored on VistA 2. Report of Radiology studies lacking images 3. Report of Clinical specialty studies lacking images 4. Interactive DICOM Query/Retrieve client on VistA and LDGW 5. Automatic comparison of images on PACS to those stored on VistA 6. Automatic retrieval of missing images from PACS Additional enhancements addressed in this patch are: 1. Error handling for incorrectly formatted DICOM objects 2. Menu options to stop HL7 message processing and image processing 3. Upgrade LDGW to meet 2019d DICOM Standard 4. Support for new DICOM 64-bit binary value representations (VR) This patch also addresses the following LDGW additions and defects: 1. LDGW is not removing temporary files 2. Site is unable to send VistA Imaging ADT HL7 messages 3. Consults are not added to the Modality Worklist 4. LDGW does not completely install on new server 5. The LDGW is not showing as installed in the Windows Control Panel Associated Patches: ----------------- This patch must be installed after: MAG*3.0*161 MAG*3.0*208 MAG*3.0*218 Patch Components: ----------------- MAG3_0P231.KID - Kernel Installation and Distribution System (KIDS) build for Patch 231 - New MAG3_0P231_DICOM_Setup.exe - Legacy DICOM Gateway Installation File - New MAG3_0P231_DIBORG.PDF - Legacy DICOM Gateway Deployment, Installation, Back-Out, and Rollback Guide - New MAG3_0P231_Configuration_Guide.PDF - MAG*3.0*231 Study Tracker Planning and Configuration Instructions - New MAG_DICOMug.PDF - VistA Imaging DICOM Gateway User Manual - Updated VistA Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- IMAGING SITE PARAMETERS Q/R ACCESSION NUMBER New (#2006.1) PREFIX (#206) Q/R PATIENT IDENTIFIER New DASHES (#207) DICOM VISTA Q/R REQUEST New QUEUE (#2006.541) AUTOMATIC DICOM Q/R RUN New STATS (#2006.543) CLINICAL SPECIALTY QUERY/RETRIEVE New DICOM & HL7(#2006.5831) PROVIDER(#8) DICOM RETRIEVE REQUEST New QUEUE (#2006.542) LDGW Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Delete ------------------ ------------------- -------------------- DICOM RETRIEVE REQUEST New QUEUE (#2006.542) ELEMENT.DIC Modified TEMPLATE.DIC Modified SCU_LIST.SAMPLE Modified UID.DIC Modified WORKLIST.SAMPLE Modified HOSTS Modified Forms Associated: Form Name File Number New/Modified/Deleted --------- ----------- -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A New VistA Options Associated: Synonym Option Name Display Text ------- ----------- -------------------- QR MAGD STUDY TRACKER Study Tracker Menu ... (on MAGD DICOM MENU) CHK MAGD ACN CHECK Check a Radiology or Consult Study for Images Q MAGD QUERY DICOM Query Client QR MAGD QUERY/RETRIEVE DICOM Query/Retrieve Client CON MAGD CON STUDY TRACKER Consult Study Tracker Menu ... RAD MAGD RAD STUDY TRACKER Radiology Study Tracker Menu ... PARM MAGD SET QUERY PARAMETERS Set Query/Retrieve Site Parameters QDEL MAGD MAGDSTT QUEUE DELETE Delete the DICOM VISTA Q/R REQUEST QUEUE CON MAGD CON STUDY TRACKER Consult Study Tracker Menu ... CHK MAGD ACN CHECK Check a Radiology or Consult Study for Images RPT MAGD CON RANGE CHECK Report Consults without Images Q MAGD QUERY DICOM Query Client QR MAGD QUERY/RETRIEVE DICOM Query/Retrieve Client CMP MAGD CON COUNT COMPARE Compare Con/Proc Image Count on PACS with VistA RET MAGD CON AUTO RETRIEVE Retrieve Missing CPRS Consult/Procedure Images STAT MAGD Q/R CON RUN STATISTICS Display the statistics for consult batch Q/R SDEL MAGD CON STATISTICS DELETE Delete the stats for automatic consult Q/R runs STOP MAGD STOP AUTOMATIC PROCESSES Stop automatic Q/R processes RAD MAGD RAD STUDY TRACKER Radiology Study Tracker Menu ... CHK MAGD ACN CHECK Check a Radiology or Consult Study for Images RPT MAGD RAD RANGE CHECK Report Radiology Studies without Images Q MAGD QUERY DICOM Query Client QR MAGD QUERY/RETRIEVE DICOM Query/Retrieve Client CMP MAGD RAD COUNT COMPARE Compare Radiology Image Count on PACS with VistA RET MAGD RAD AUTO RETRIEVE Retrieve Missing Radiology Images from PACS STAT MAGD Q/R RAD RUN STATISTICS Display the statistics for radiology batch Q/R SDEL MAGD RAD STATISTICS DELETE Delete the stats for automatic consult Q/R runs STOP MAGD STOP AUTOMATIC PROCESSES Stop automatic Q/R processes Q/R MAGD DICOM MENU Study Tracker Menu..(on MAGD DICOM MENU) Q/R MAGD RAD STUDY TRACKER Radiology Study Tracker Menu..(on RA SUPERVISOR) LDGW Options Associated: Option Name ----------- 1-14 STOP Processing Text Messages from HIS 2-13 STOP Processing DICOM Images 2-14 Query/Retrieve User 2-14-1 Surrogate for VistA Q/R Client 2-14-2 Execute C-Move Request to Retrieve Images 2-14-3 STOP Surrogate for VistA Q/R Client 2-14-4 STOP Execute C-Move Request to Retrieve Images 2-14-5 Query Only 2-14-6 Query and Retrieve 2-14-7 Truncate the DICOM RETRIEVE REQUEST QUEUE Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name New/Modified/Deleted ----------------- -------------------- MAGD QR AUTO RETRIEVE New MAGD QR MANUAL RETRIEVE New MAGD QR REPORT New Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Remote Procedures Associated: Remote Procedure Name New/Modified/Deleted --------------------- -------------------- MAG DICOM FORMAT PATIENT NAME New MAG DICOM GET PT ID DASHES New MAG DICOM GET PT SENSITIVITY New MAG DICOM PATIENT HISTORY New MAG DICOM PATIENT LOOKUP New MAG DICOM Q/R CLIENT New MAG DICOM GET ACN PREFIX New Parameter Definitions Associated: Parameter Name New/Modified/Deleted -------------- -------------------- N/A Additional Information: ----------------------- Blood Bank Team Coordination: N/A New Service Requests (NSRs): N/A Patient Safety Issues (PSIs): N/A Defect Tracking System Ticket(s) & Overview: 1. Defect 951153 (Trouble Ticket INC1893027) - LDGW is not removing temporary files Problem: -------- The LDGW is sometimes leaving temporary files INCOMING.XXX AND OUTGOING.XXX in the C:\DICOM\Data1 folder when the .TXT files already exist. The system is unable to rename the files to the permanent name. Resolution: ----------- The LDGW was modified to allow the overwrite of the permanent file when renaming the temporary file. 2. Defect 967062 (Trouble Ticket INC4101382) - Site is unable to send VistA Imaging ADT HL7 messages Problem: -------- Site is unable to send ADT HL7 message because the Imaging Site Parameter entry is not the first record in the file. The LDGW is hardcoded to retrieve information from the Imaging Site Parameter file in the first node. Resolution: ----------- Modified the code retrieving information from the Imaging Site Parameter to do it based on site code. 3. Defect 978538 (Trouble Ticket INC4236237) - Consults are not added to the Modality Worklist Problem: -------- Some consults are not being added to the MWL. The OBR-17-Call Back Phone Number segment of the HL7 message is too long. It includes eight phone number fields from the New Person file and up to three phone numbers from VISITED FROM entries. When all these phone numbers are populated the segment is too long. Resolution: ----------- Adding the phone numbers from the VISITED FROM entries was not part of the original requirement. The code that adds these phone numbers was removed and this part of the segment is limited to 250 characters. 4. Defect 816488 (Trouble Ticket INC5137094) - The LDGW is not showing as installed in the Windows Control Panel Problem: -------- The LDGW only shows in the Windows Control Panel for the user that installed it. If another user is logged on the server it does not display, and that user cannot uninstall the LDGW. Resolution: ----------- Update the install of the LDGW so that the entry in the Windows Control Panel is available to anyone who logs into that server. Test Sites: ----------- R01 -Puget Sound R02 -St. Louis -Muskogee R03 -Richmond -Ann Arbor R04 -Boston -Philadelphia Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released using a host file. The host file is available at the following location: /srv/vista/patches/SOFTWARE/MAG3_0P231.KID Other Software Files: This release also includes other software files. These files can be obtained by accessing the URL: https://download.vista.domain.ext/index.html/SOFTWARE Patch Installation: ------------------- Supported Client Versions: When MAG*3.0*231 is released, the list of supported versions of Legacy DICOM Gateway (LDGW) will change: Client Versions Supported: 3.0.231 3.0.218 3.0.190 Client Versions No Longer Supported: 3.0.183 3.0.166 3.0.174 Pre/Post Installation Overview: Note: All released VistA Imaging patches must be installed on the VistA system before installing MAG*3.0*231. All sites running VistA Imaging 3.0 must install the KIDS portion of this patch on the VistA System. This patch can be loaded while the VistA Imaging System is active, and users are on the system. This patch must be installed by the compliance date to conform to VHA Directive 2001-023 Note: The MAG*3.0*231 KIDS should be installed on VistA first and then the DICOM Gateway updated. The VistA DICOM Gateway query/retrieve capabilities require DICOM Gateway services and will not be operational until MAG*3.0*231 is installed on the DICOM Gateways. The new Study Tracker will require additional configuration to be able to communicate and retrieve information from a PACS. See the Configuration section in the MAG*3.0*231 Study Tracker Planning and Configuration Guide for more information. Following the KIDS install, the DICOM Gateways can be updated. See Below. Installation Instructions: -------------------------- The actual KIDS installation will take less than 2 minutes. 1. On the VistA system, access the Kernel Installation and Distribution System Menu [XPD MAIN]. 2. Run the Installation option [XPD INSTALLATION MENU]. 3. Load the KIDS file by performing the following steps: a. Run the Load a Distribution option [XPD LOAD DISTRIBUTION] to load the KIDS distribution. b. When prompted, enter the path and file name (MAG3_0P231.KID) of the Patch 231 KIDS file. c. When prompted to continue with the load, enter "YES". A Distribution OK! message will be displayed when the load is complete. 4. After loading the KIDS file, use the following options to verify the contents of the patch and to back up any affected routines a. Verify Checksums in Transport Global [XPD PRINT CHECKSUM] - Run this option to ensure the integrity of the routines in the patch. b. Compare Transport Global to Current System [XPD COMPARE TO SYSTEM] - Run this option to view all changes that will be made when the patch is installed. All components (routines, options, and so on) in the patch will be compared. c. Backup a Transport Global [XPD BACKUP] - Run this option to create a backup message of any Routines and the Build for this patch. 5. After performing the load and any optional verification steps, install the KIDS file by performing the following steps: a. Run the Install Package(s) [XPD INSTALL BUILD] option. b. When prompted for the install name, enter "MAG*3.0*231". c. Answer "NO" to the following prompts: Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO// Want KIDS to INHIBIT LOGONs during the install? NO// Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO// 6. When installation is finished, an Install Complete message will be displayed. Post-Installation Instructions: ------------------------------- ALL DICOM Gateways, including Legacy, Text and Routing, as well as HDIGs, need to be upgraded with the installation of MAG3_0P231_DICOM_Setup.exe at your earliest convenience. Refer to the VistA Imaging DICOM Gateway Installation Guide for details. Note: Backup the DICOM dictionary directory. Typically, the DICOM Dictionaries are installed in the \DICOM\Dict directory on a network drive. IMPORTANT: The Caché Service must be stopped before upgrading the DICOM Gateway. Note: When Caché is installed, it will automatically install Adobe SVG Viewer 3.0 which is not approved for use and must therefore be uninstalled using Add/Remove programs. Note: If installing the LDGW on a new server, the latest 2008 C++ Redistributables must be downloaded and installed prior to running the install of the LDGW. The latest version can be downloaded at: https://www.microsoft.com/en-us/download/details.aspx?id=26368 Note: After the patch installation Telnet needs to be disabled. Refer to the VistA Imaging DICOM Gateway Installation Guide for details. (section 4.7.3) IMPORTANT: This patch requires a change in the in SCU_LIST.DIC on the DICOM Gateway for the Modality Worklist Query option to work. In addition to the SCU TYPE "STORE" added in Patch MAG*3.0*156, Patch MAG*3.0*231 adds two new values "WORKLIST" and "Q/R". The entries in the SCU_LIST.DIC for DICOM Modality Worklist need to have SCP TYPE changed from "STORE" to "WORKLIST". Example: Original Local Modality Worklist|VistA_Worklist|VistA Testing|LOCALHOST||||STORE Updated Local Modality Worklist|VistA_Worklist|VistA Testing|LOCALHOST|||WORKLIST Back-Out/Roll Back Plan: ------------------------ Uninstalling the Application: If it is necessary to uninstall the MAG*3.0*231, then the user would follow the following steps: 1. Stop Caché 2014 by selecting the blue Caché cube and select Stop Caché. 2. Copy the file Cache.key in the C:\CacheSys\mgr directory to a temporary location. 3. Go to the Control Panel, choose Uninstall a program, and remove the current version Caché instance. 4. Go to the Control Panel, choose Uninstall a program, and remove the VistA DICOM Gateway (Patch 231). 5. Delete the directory C:\CacheSys. 6. Restart the server. 7. Install Legacy DICOM Gateway patch MAG*3.0*218, refer to the VistA Imaging DICOM Gateway Installation Guide for instructions. 8. Copy the Cache.key file backed up earlier to C:\CacheSys\mgr. 9. Restore the DICOM dictionary directory from the backup made during installation. KIDS Uninstall: If it is necessary to uninstall the MAG*3.0*231 VistA KIDS, then select the "Kernel Installation & Distribution System" menu option, "Backup a Transport Global" (see Installation Steps section, step 4c must be done before installing the patch). Administrators will need to use the PackMan function INSTALL/CHECK MESSAGE. Check the MailMan messages for the backup message sent by the "Backup a Transport Global" function executed prior to the patch install. 1. Select the message shown below: - Backup of MAG*3.0*231 install on And/Or - Backup of MAG*3.0*231 install on Routines Only 2. Select the Xtract PackMan option. 3. Select the Install/Check Message option. 4. Enter "Yes" at the prompt. 5. Enter "No" at the backup prompt. There is no need to back up the backup. Enter message action (in IN basket): Ignore// Xtract PackMan Select PackMan function: ? Answer with PackMan function NUMBER, or NAME Choose from: 1 ROUTINE LOAD 2 GLOBAL LOAD 3 PACKAGE LOAD 4 SUMMARIZE MESSAGE 5 PRINT MESSAGE 6 INSTALL/CHECK MESSAGE 7 INSTALL SELECTED ROUTINE(S) 8 TEXT PRINT/DISPLAY 9 COMPARE MESSAGE Select PackMan function: Select PackMan function: 6 INSTALL/CHECK MESSAGE Warning: Installing this message will cause a permanent update of globals and routines. Do you really want to do this? NO// YES Shall I preserve the routines on disk in a separate back-up message? YES// NO No backup message built. Line 2 Message #42925 Unloading Routine MAGGGTU4C (PACKMAN_BACKUP) Select PackMan function: Routine Information: LDGW Checksums This section lists modified routines for the LDGW build. For each routine, the second line will contain the following information: ;;3.0;IMAGING;**[Patch List]**;Mar 19, 2002;Build 6056;November 27, 2019 Routine Checksums Routine Checksum Checksum Patch List Before After MAGDACU 9404510 9811459 **21,30,156,231** MAGDACU1 38544788 37609855 **30,51,54,231** MAGDDR0 57333954 72795860 **1,10,51,54,190,231** MAGDDR1 48401978 65150778 **10,11,30,51,54,231** MAGDDR2A 103732840 162741971 **1,10,51,54,99,110,190,218,231** MAGDDR3 55887980 74106591 **1,10,51,50,110,190,231** MAGDDW0 18480829 23723041 **1,10,51,54,231** MAGDDW3 37085878 38409719 **10,30,51,54,190,231** MAGDDW4 82471058 79469517 **1,10,51,54,190,231** MAGDHRC 86680704 96676069 **11,30,51,49,123,110,138,231** MAGDIR6 88850067 95113006 **11,30,51,54,53,49,138,166,231** MAGDIR6B 21857231 26476198 **11,30,51,54,53,99,123,190,231** MAGDM2MB 16447591 17835944 **11,51,54,231** MAGDMENO 39923631 47589798 **11,30,51,50,69,54,53,118,110,231** MAGDMENU 51445030 52618813 **9,21,11,30,51,69,54,53,118,110,231** MAGDMFB1 85395849 85811111 **9,21,11,30,51,69,54,53,123,118,110, 231** MAGDMFB2 49214267 47562046 **21,30,51,69,190,231** MAGDMFBB 53824931 54996922 **9,21,11,51,69,54,53,49,123,118,110, 231** MAGDMFBC 36412183 4383690 **9,21,11,138,231* MAGDMFBS 52098283 73024342 **9,10,11,30,51,50,69,54,156,231** MAGDMFBW 97895675 101552107 **9,10,11,30,69,110,138,174,166,231** MAGDQUE4 27764385 30626208 **30,51,54,231** MAGDRPC0 4954513 **11,51,50,49,123,110,231** MAGDSIU N/A 6643355 **231** MAGDSTQ N/A 149582639 **231** MAGDSTQ0 N/A 67817366 **231** MAGDSTQ1 N/A 145336060 **231** MAGDSTQ2 N/A 70069302 **231** MAGDSTQ3 N/A 14849170 **231** MAGDSTQ4 N/A 81682345 **231** MAGDSTQ5 N/A 78881204 **231** MAGDSTQ6 N/A 88368456 **231** MAGDSTQ7 N/A 13477232 **231** MAGDSTQ8 N/A 36279345 **231** MAGDSTQA N/A 117105808 **231** MAGDSTR1 N/A 36019368 **231** MAGDSTR2 N/A 162846793 **231** MAGDSTS1 N/A 34651556 **231** MAGDSTS2 N/A 22432182 **231** MAGDTCP1 6918159 6698523 **30,54,231** MAGDVR N/A 71634483 **231** MAGDVRSN 21494340 21494340 **1,7,9,26,21,10,36,3,11,30, 5,51,50,52,69,75,102,103,54, 53,66,49,99,123,118,87,110,138, 156,160,162,174,166,183,190,218,231** MAGDWLU 16460081 16445135 **21,11,30,51,53,49,156,231** MAGOSDIR 20477697 21221028 **10,51,69,162,166,231** VistA KIDS Checksums: This section lists modified routines for the VistA KIDS build. For each routine, the second line will contain the following information: ;;3.0;IMAGING;**[Patch List]**;5-May-2007;Build 1 CHECK1^XTSUMBLD is used to generate the checksums. Routine Checksums Routine Checksum Checksum Patch List Before After MAGDFCNV 13765242 20613077 **11,51,141,138.231** MAGDHLE 19989150 21479879 **54,49,183,231** MAGDHOW3 35060585 29067282 **138,180,203,208,231** MAGDHOWE 99382335 136169833 **138,231** MAGDIR8A 45934196 52547655 **11,51,49,123,138,231** MAGDQR73 7054630 7208274 **118,138,231** MAGDRPC0 N/A 4954513 **11,51,50,49,123,110,231** MAGDRPC8 64895858 67833755 **11,20,51,54,118,138,156,161,231** MAGDSTA N/A 71012132 **231** MAGDSTA1 N/A 165724732 **231** MAGDSTA2 N/A 85486784 **231** MAGDSTA3 N/A 29007274 **231** MAGDSTA4 N/A 22153576 **231** MAGDSTA5 N/A 22600618 **231** MAGDSTA6 N/A 26478026 **231** MAGDSTA7 N/A 44232225 **231** MAGDSTA8 N/A 94399552 **231** MAGDSTA9 N/A 26552534 **231** MAGDSTAA N/A 95449718 **231** MAGDSTAB N/A 20075272 **231** MAGDSTAC N/A 86667960 **231** MAGDSTAD N/A 6398633 **231** MAGDSTAE N/A 10806290 **231** MAGDSTAF N/A 56042539 **231** MAGDSTAS N/A 135860082 **231** MAGDSTD1 N/A 22643484 **231** MAGDSTD2 N/A 61061497 **231** MAGDSTD3 N/A 54201984 **231** MAGDSTQ N/A 149582639 **231** MAGDSTQ0 N/A 67817366 **231** MAGDSTQ1 N/A 145336060 **231** MAGDSTQ5 N/A 78881204 **231** MAGDSTQ6 N/A 88368456 **231** MAGDSTQ7 N/A 13477232 **231** MAGDSTQ8 N/A 36279345 **231** MAGDSTQ9 N/A 9459080 **231** MAGDSTQA N/A 117105808 **231** MAGDSTV1 N/A 38160188 **231** MAGDSTV2 N/A 25168899 **231** MAGDTRDX 38833590 42536577 **46,138,231** MAGIP231 N/A 4282469 **231** MAGVD001 17941768 18141931 **118,138,231** MAGVD010 13079258 13319555 **118,231** Routine MAGIP231 is an installation routine that is automatically deleted Routine Information: ==================== No routines included. ============================================================================= User Information: Entered By : Date Entered : DEC 10, 2018 Completed By: Date Completed: MAR 15, 2021 Released By : Date Released : MAR 15, 2021 ============================================================================= Packman Mail Message: ===================== No routines included