============================================================================= Run Date: AUG 23, 2011 Designation: MAG*3*49 Package : MAG - IMAGING Priority: Mandatory Version : 3 SEQ #76 Status: Released Compliance Date: SEP 23, 2011 ============================================================================= Associated patches: (v)RA*5*47 <<= must be installed BEFORE `MAG*3*49' (v)MAG*3*53 <<= must be installed BEFORE `MAG*3*49' (v)MAG*3*66 <<= must be installed BEFORE `MAG*3*49' (v)MAG*3*86 <<= must be installed BEFORE `MAG*3*49' Subject: HL7 ADT TRANSMISSION TO COMMERCIAL PACS Category: - Routine - Enhancement (Mandatory) - Data Dictionary - Other Description: ============ Commercial PACS have standardized on the use of HL7 for the transmission of patient demographics, patient movements, radiology orders, and radiology reports. Patch 49 defines HL7 standardized communications between VistA Imaging and a receiving PACS (Picture Archive and Communication System). The new HL7 interfaces implement the HL7 order and patient update transactions in the IHE Radiology Scheduled Workflow Profile. Use of the VistA Imaging Patch 49 (MAG*3.0*49) and the corresponding Radiology Patch 47 (RA*5.0*47) will provide improved quality of information over the current Class III HL7 interfaces that transfer data from the VistA System. It is expected that the use of Patches 49/47 will allow all sites to retire Class III software that is now used to obtain information via HL7. The new HL7 messages will also replace the now obsolete DICOM messages sent to the PACS by the VistA Imaging DICOM Gateway. Commercial vendors of HL7 interfaces (in particular, imaging, PACS, and voice recognition systems) are being requested to test and validate products currently sold to the VA with Patches 49/47. Testing will ensure that these products will continue to operate properly and that they make use of the new information available with the release of these patches. It is expected that the use of Patches 49/47 will be mandated to ensure better identification of patients and patient data, providing a significant improvement in safety, reliability, and interoperability. Vendors should be encouraged to participate in the testing and validation of HL7 interfaces with this software as soon as possible. Please direct any questions to the mail group: VHA VI DICOM Validation (VHA VI DICOM Validation@va.gov). Patch 49 defines HL7 standardized patient registration communications between VistA Imaging and a receiving PACS system. Each of these messages will be triggered by a patient event in the VistA PIMS (Patient Information Management Service) Package. The Patient Registration profile conveys the patient demographic and visit information that was captured at the point of encounter. This transaction is used both for inpatients and outpatients. The Patient Update profile conveys changes to patient information, including demographics, patient identification, patient location/class changes, and patient merges. These changes may occur at any time for a patient record. This transaction is used both for inpatients and outpatients. It is expected that the site be familiar with the operation of the VistA HL7 Package and with the options that it makes available for defining and inspecting message queues. All messaging will be handled through the VistA HL7 Package and will occur entirely in the background without active user intervention. The Accession Number has a new format, which includes a 3-digit site prefix (SSS). The old format was MMDDYY-NNNNN. It included only the date (MMDDYY) and the case number (NNNNN). The new format is: SSS-MMDDYY-NNNNN. The national Integration Control Number also is included in this interface. Additional patient information that describes the patient, for example, the Patient Height, Weight, and Confidentiality, is available to improve patient safety. To support of radiology coordination, technician comments, and a call back number is passed from VistA to PACS and Voice Recognition Systems. The Study Instance UID is the attribute that labels all of the DICOM objects that are created during the course of a study. In order to uniquely identify studies between the HIS, RIS, and PACS, the Integrating the Healthcare Enterprise Radiology Technical Framework have specified an HL7 ZDS segment to convey the Study Instance UID. This segment is inserted into the HL7 ORM order message after the OBR segment. All DICOM systems that receive these HL7 messages should use the Study Instance UID in the new HL7 ZDS segment. All sites running VistA Imaging 3.0 that have implemented DICOM Gateways must install both the KIDS portion on their VistA system and the client portions of this patch on all relevant client systems. NOTE: For details on the changes implemented in this patch and gateway installation instructions refer to the MAG3_0P49_Patch_Description.pdf document distributed with this patch. Distribution of Software: ======================== This patch can be downloaded from: ftp.imaging.med.va.gov/Software/Released_Software/Mag3_0P49 Installation instructions are included in this document. NOTE Any late-breaking news about this patch will be found in a readme file. If present, this file will also be located in the MAG3_0P49 directory. Patch Contents: ============== This patch includes the following files: Software: ======== MAG3_0P49_DICOM_Setup.exe Installation Program for DICOM Gateway MAG3_0P49.KID KIDS (Kernel Installation & Distribution System) package to be installed on the VistA hospital database Documentation: ============= MAG3_0P49_Patch_Description.pdf Detailed patch description with installation instructions VistA_PACS_HL7_Profile_1_2.pdf Profiles for HL7 Messages from VistA to Commercial PACS including Business and Functional Requirements, (available at http://www1.va.gov/imaging/page.cfm?pg=6) MAG3_0P49_DICOM_Install_Guide_Change.pdf Updates for the VistA DICOM Gateway Installation Guide MAG3_0P49_DICOM_User_Manual_Change.pdf Updates for the VistA DICOM Gateway User Manual MAG3_0P49_Security_Guide_Change.pdf Updates for the VistA Imaging Security Guide MAG3_0P49_Technical_Manual_Change.pdf Updates for the VistA Technical Manual Associated Patches: ================== This patch works in conjunction with RA*5.0*47 which must be loaded immediately before this patch. All released Vista Imaging patches are required, including MAG*3.0.53 and MAG*3.0*66, before MAG*3.0*49 can be installed. For a list of all released Imaging (MAG) patches, refer to the patch_list.txt file available on the Imaging FTP server (go to ftp://ftp.imaging.med.va.gov, then navigate to the \Docs\Imaging_Docs_Latest folder). Test Sites: ========== The following sites are test sites for this patch: Columbus, OH (Medium) Pittsburgh, PA (Integrated - Large) San Antonio, TX (Integrated - Large) Seattle, WA (Integrated - Large) White River Junction, VT (Medium) Remedy Calls: ============ The following Remedy help desk calls are addressed in this patch: 68131 Worklist to Provide Patient Location, Clinical History, and Callback Phone Numbers to Modalities. 89379 Commercial PACS as MWL provider. 116948 Worklist to Provide Patient Height and Weight to Modalities. 163841 HL7 Warning message in Text gateway for the1_1 process. 361589 Can Text Gateway send HL7 messages to commercial PACS? 411686 Study UID does not contain station number. 427608 Importer Menu option showing DICOM images that were already imported/completed 474108 Gateway creating extra abstracts that don't exist NSR Entries: =========== There are no NSR entries addressed in this patch. VistA Host Changes: ================== Data Dictionaries: ================= The following file in new in this patch: DICOM UID ROOT file (#2006.15) The following files are modified in this patch: IMAGING SITE PARAMETERS file (#2006.1) DICOM WORKLIST PATIENT file (#2006.55) DICOM WORKLIST STUDY file (#2006.56) DICOM GATEWAY PARAMETER file (2006.563) For details on the changes refer to the MAG3_0P49_Patch_Description.pdf document distributed with the patch. Security Keys: ============= There are no new or modified security keys included in this patch. Remote Procedures: ================= The following remote procedures are included in this patch: MAG DICOM GET PATIENT VITALS Menu Options: ============ The following new menu options are included in this patch. Imaging HL7 Messaging Maintenance [MAG HL7 MAINT] option. Maintain Subscriptions to Radiology HL7 Drivers [MAGD MAINT RAD HL7 SUBS] option. Configure IHE-Based HL7 Interface to PACS [MAG CONFIGURE IHE PACS HL7 I/F] option. These options are added to the existing menu: Imaging System Manager Menu [MAG SYS MENU] menu. Templates: ========= There are no new or modified templates included in this patch. Protocols: ========= The following new protocols are included in this patch. MAG CPACS A01 MAG CPACS A01 SUBS MAG CPACS A02 MAG CPACS A02 SUBS MAG CPACS A03 MAG CPACS A03 SUBS MAG CPACS A11 MAG CPACS A11 SUBS MAG CPACS A12 MAG CPACS A12 SUBS MAG CPACS A13 MAG CPACS A13 SUBS HL7 Application Parameters: ========================== The following new HL7 parameters are included in this patch. MAG COMRCL PACS MAG VISTA IMGNG HL Logical Link: =============== The following new HL logical link is included in this patch. MAG CPACS Installation Instructions: ========================= NOTE: Refer to the MAG3_0P49_Patch_Description.pdf document for detailed installation instructions. Before installing this patch, you will need to download the Patch 49 files from the Imaging FTP site to a local storage location. In general, it is a good idea to schedule the installation of a patch for a time when adequate support resources are available and when system load is expected to be low. Before installing the client portion of Patch 49 on a DICOM Gateway, all activity on that DICOM Gateway being updated must be stopped. Other DICOM Gateways present can remain active. Client installation should take about 10 to 30 minutes per gateway. It is required that all released VistA Imaging Patches be installed prior to the installation of VistA Imaging Patch 49. RA*5.0*47 is required to be installed on VistA before MAG*3.0*49. The following are a set of instructions to install Patch 49: =========================================================== Obtain the software from the Imaging FTP folder; the files to be downloaded are itemized in an earlier section. The time needed to download these files is dependent on the WAN activity; normally it will take a couple of minutes. The KIDS file can be installed with users on the system and will take less than 5 minutes. NOTE In general, it is a good idea to schedule the installation of a patch for a time when: * Adequate support resources are available * System load is expected to be low NOTE This section describes the basic steps you need to install this patch on an existing DICOM Gateway installation. The instructions in this section assume familiarity with the VistA DICOM Gateway Installation Guide, which contains complete details about installing the VistA System and the DICOM Gateway. NOTE The installation of the KIDS package typically takes less than a minute. The installation of the InstallShield package on the DICOM Gateways may vary, depending on the characteristics of the computer. During testing, "old and slow computers took almost half an hour, and "new and fast computers took less than five minutes. NOTE Install Patch 49 on the DICOM Text Gateway(s) immediately after the KIDS package is installed on VistA. The software can be installed on the other Gateways as is convenient. VistA System (KIDS) Installation: ================================ NOTE Please pay particular attention to the boxes labeled PACS CONFIGURATION NOTES in the following sections. They contain important information about values that you will need to make sure are configured within your commercial PACS product. Installing the KIDS Package: =========================== 1 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 [XPD LOAD DISTRIBUTION] option to load the KIDS distribution. b When prompted, enter the path and file name (MAG3_0P49.KID) of the Patch 49 KIDS file that you downloaded from the Imaging FTP server. c When prompted to continue with the load, enter YES. A Distribution OK! message will be displayed when the load is complete. 4 After you load the KIDS file, you may elect to use the following options: a Verify Checksums in Transport Global [XPD PRINT CHECKSUM] Run this option if you want to ensure the integrity of the routines in the patch. b Compare Transport Global to Current System [XPD COMPARE TO SYSTEM] Run this option if you want 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 if you want to create a backup message of any routines exported with the patch. It will NOT back up any of the other changes. 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*49. 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// When installation completes, a message that the patch is installed will be displayed. KIDS Installation Example: ========================= Select Installation Option: 6 Install Package(s) Select INSTALL NAME: MAG*3.0*49 Loaded from Distribution 4/7/11@13:40:06 => VistA Imaging V3.0 - Patch 49 - 04/07/2011 13:07PM ;Created o This Distribution was loaded on Apr 07, 2011@13:40:06 with header of VistA Imaging V3.0 - Patch 49 - 04/07/2011 13:07PM ;Created on Apr 0 7, 2011@13:07:06 It consisted of the following Install(s): MAG*3.0*49 Checking Install for Package MAG*3.0*49 Will first run the Environment Check Routine, MAGENV49 Install Questions for MAG*3.0*49 Incoming Files: 2006.1 IMAGING SITE PARAMETERS (Partial Definition) Note: You already have the 'IMAGING SITE PARAMETERS' File. 2006.15 DICOM UID ROOT Note: You already have the 'DICOM UID ROOT' File. 2006.55 DICOM WORKLIST PATIENT Note: You already have the 'DICOM WORKLIST PATIENT' File. 2006.56 DICOM WORKLIST STUDY Note: You already have the 'DICOM WORKLIST STUDY' File. 2006.563 DICOM GATEWAY PARAMETER Note: You already have the 'DICOM GATEWAY PARAMETER' File. 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// Enter the Device you want to print the Install messages. You can queue the install by enter a 'Q' at the device prompt. Enter a '^' to abort the install. DEVICE: HOME// HERE Install Started for MAG*3.0*49 : Apr 07, 2011@13:43:52 Build Distribution Date: Apr 07, 2011 Installing Routines:.............................. Apr 07, 2011@13:43:52 Installing Data Dictionaries: ....... Apr 07, 2011@13:43:53 Installing PACKAGE COMPONENTS: Installing HL LOGICAL LINK.. Installing HL7 APPLICATION PARAMETER... Installing PROTOCOL............. Installing REMOTE PROCEDURE.. Installing OPTION..... Apr 07, 2011@13:43:53 Running Post-Install Routine: POST^MAGIPS49. Updating Routine file...... Updating KIDS files....... MAG*3.0*49 Installed. Apr 07, 2011@13:43:54 DICOM Gateway Installation: ========================== For details on the DICOM Gateway Installation and Sample Modality Worklist Illustrating New Patch 49 Fields information refer to the MAG3_0P49_Patch_Description.pdf document. NOTE Install Patch 49 on the DICOM Text Gateway(s) immediately after the KIDS package is installed on VistA. The software can be installed on the other Gateways as is convenient. Pre-installation: ================ Before installing Patch 49 on a DICOM Gateway, perform the following steps: 1 Log into the DICOM Gateway as a local administrator. 2 Review the general setup of the DICOM Gateway (number of text data directories, mapped drives for components such as dictionary files, etc.). 3 Ensure all processing on the DICOM Gateway is stopped. 4 Stop Cachi from the blue cube. 5 Copy the MAG3_0P49_DICOM_SetUp.exe file to a location accessible to the gateway. DICOM Gateway Routines: ====================== New and modified routines for the Imaging DICOM Gateway are listed below. For each routine, the second line will contain the following information. ;;3.0;IMAGING;**[Patch List]**; Mar 19, 2002; Build 2030; Apr 04, 2011 Please note the before checksum may differ if an Imaging Field Unit Test has been installed. Routine Checksum Checksum Patch Name Before After List MAGDAIR1 173909266 174066539 **53,49** MAGDAIR3 110514648 110325747 **53,49** MAGDAIR5 177242390 176403451 **53,49** MAGDDW1 33149904 33395508 **10,49** MAGDFCNS 73892007 77913878 **9,10,11,30,50,49** MAGDFND2 82916429 84247727 **1,10,30,51,50,54,53,49** MAGDFND3 63710119 87561723 **10,30,51,54,53,49** MAGDFND4 23741315 31058834 **10,11,30,50,54,49** MAGDFND5 10032385 11262447 **10,30,54,49** MAGDHR9 7638917 7550129 **10,49** MAGDHRC 79419990 82233547 **11,30,51,49** MAGDHRC0 7715030 7768511 **11,51,54,49** MAGDHRC2 22449295 20185184 **11,49** MAGDHRC3 40850743 113328494 **11,30,102,49** MAGDHRC4 71401987 137481394 **11,51,102,49** MAGDHRC5 64340735 63082234 **11,30,51,49** MAGDHRC6 30040803 28767993 **11,51,49** MAGDHRC7 15893574 14399552 **11,51,49** MAGDHRCP 33544282 40374302 **11,54,49** MAGDIR6 68854843 87229193 **11,30,51,54,53,49** MAGDIR7C 70785160 70768786 ** 11,30,51,54,49** MAGDMFBB 51792993 52340245 **9,21,11,51,69,54,53,49** MAGDQRU0 5452504 5735145 **51,49** MAGDQUE2 21951411 21951411 **11,30,49** MAGDRPC0 4176279 4265561 **11,51,50,49** MAGDUID1 17581821 19789188 **21,10,11,50,54,49** MAGDVRSN 21494160 21494340 **1,7,9,26,21,10,36,3,11, 30,5,51,50,52,69,75,102, 103,54,53,66,49** MAGDWLPA 54804968 76434838 **11,51,49** MAGDWLPB 26022767 54570103 **11,30,51,102,49** MAGDWLPC 51913684 53817899 **11,51,102,49** MAGDWLU 16135727 16190289 **21,11,30,51,53,49** MAGDWLU0 4288023 4339594 **49** MAGDWLU3 73811680 96198773 **21,10,11,30,53,49** VistA Routines: ============== New and modified routines for the VistA System are listed below. For each routine, the second line will contain the following information. ;;3.0;IMAGING;**[Patch List]**; Mar 19, 2002; Build 2033; Apr 07, 2011 Please note that the "before" checksum may differ if any test software has been installed. Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: MAG7UCFG Before: n/a After: B21073435 **49** Routine Name: MAG7UD Before: n/a After: B4685901 **49** Routine Name: MAGDHLE Before: B9902651 After: B10197843 **54,49** Routine Name: MAGDHLI Before: n/a After: B5220582 **49** Routine Name: MAGDHLL Before: n/a After: B7511757 **49** Routine Name: MAGDHLS Before: n/a After: B67817009 **49** Routine Name: MAGDHLSO Before: n/a After: B9961335 **49** Routine Name: MAGDHLSV Before: n/a After: B49332835 **49** Routine Name: MAGDHLT Before: n/a After: B5153872 **49** Routine Name: MAGDHLTA Before: n/a After: B23848932 **49** Routine Name: MAGDHLTC Before: n/a After: B20360006 **49** Routine Name: MAGDHPS Before: n/a After: B35750729 **49** Routine Name: MAGDHRC0 Before: B7715030 After: B7768511 **46,54,49** Routine Name: MAGDHW0 Before: B9603861 After: B9185901 **10,86,49** Routine Name: MAGDHWA Before: B58838393 After: B45705303 **10,51,50,49** Routine Name: MAGDHWR Before: n/a After: B7473279 **49** Routine Name: MAGDIR8A Before: B36949369 After: B35665323 **11,51,49** Routine Name: MAGDIR8R Before: B53835298 After: B55950540 **53,49** Routine Name: MAGDIR9A Before: B52130794 After: B60148803 **11,30,51,46,54,53,49** Routine Name: MAGDRA2 Before: B25170126 After: B28718021 **10,11,51,54,49** Routine Name: MAGDRA3 Before: B6023529 After: B6846608 **49** Routine Name: MAGDRAHL Before: n/a After: B8520421 **49** Routine Name: MAGDRPC1 Before: B45275966 After: B46610398 **11,30,51,50,54,49** Routine Name: MAGDRPC3 Before: B64771366 After: B57242503 **11,30,51,50,85,54,49** Routine Name: MAGDRPC4 Before: B79966759 After: B61111180 **11,30,51,50,54,49** Routine Name: MAGDRPC9 Before: B56624389 After: B55355495 **50,54,53,49** Routine Name: MAGDRUID Before: B4073143 After: B4073143 **54,49** Routine Name: MAGENV49 Before: n/a After: B6706010 **49** Routine Name: MAGIPS49 Before: n/a After: B10146824 **49** Routine list of preceding patches: 53, 86 ============================================================================= User Information: Entered By : CASUGAY,ELSIE G Date Entered : DEC 21, 2004 Completed By: TROMBETTA,KATHY Date Completed: JUN 24, 2011 Released By : BLACK,KATHLEEN Date Released : AUG 23, 2011 ============================================================================= Packman Mail Message: ===================== No routines included