============================================================================= Run Date: NOV 03, 2011 Designation: MAG*3*104 Package : MAG - IMAGING Priority: Mandatory Version : 3 SEQ #79 Status: Released Compliance Date: DEC 05, 2011 ============================================================================= Associated patches: (v)MAG*3*83 <<= must be installed BEFORE `MAG*3*104' (v)MAG*3*93 <<= must be installed BEFORE `MAG*3*104' (v)MAG*3*115 <<= must be installed BEFORE `MAG*3*104' Subject: Dept. of Defense (DoD) - Central Vista Imaging Exchange (CVIX) Category: - Enhancement (Mandatory) - Routine - Other Description: ============ Patch 104 Overview: =================== This document describes Imaging Patch MAG*3.0*104, which updates the Central VistA Imaging Exchange (CVIX) and VistA Image Exchange (VIX) servers. MAG*3.0*104 is part of the image sharing initiative to fulfill the congressionally mandated exchange of medical images between the Department of Veterans Affairs (VA) and the Department of Defense (DoD). Implementing this patch will: * Expand VA/DoD image sharing to provide VA access to DoD medical artifacts such as non-radiology medical images, scanned documents, and Neurocognitive Assessment Tool (NCAT) reports. * Expand VA/DoD image sharing to provide DoD access to VA non-radiology images. * Allow a site VIX to make a single query for DoD artifacts and radiology images through the CVIX. The CVIX handles retrieving the needed data from the various DoD servers, and return a single combined response to a VA site's VIX. * Insulate the VIX from changes in the DoD information sharing architecture as it continues to evolve from its original conception (National Defense Authorization Act (NDAA)), near-term solution (Health Artifact and Image Management Solution (HAIMS)), and final form (HAIMS II). * Correct an issue that prevented VIX installation at integrated sites using 4 character station numbers, and allow full use of VIXes at consolidated VA sites (that is, non-primary divisions with local image storage). * Improve the performance and credentialing mechanisms for the existing VA/DoD radiology image sharing established in MAG*3.0*83. * Resolve certain issues by updating to a newer version of the Laurel Bridge DCF (DICOM Connectivity Framework) toolkit. These changes are described in detail on the Patch 104 Changes Section. For installation information, refer to the Installation Section. Note All sites running Imaging 3.0 must install the Kernel Installation & Distribution System (KIDS) portion of this patch. Note Sites that have implemented the MAG*3.0*83 VIX must install the updated VIX software included with this patch. Distribution of Software: ========================= Imaging Patch 104 can be downloaded from: ftp.imaging.med.va.gov/Software/Released_Software/Mag3_0P104 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_0P104 directory. Patch Contents: =============== This patch includes the following files: Software: ========= MAG3_0P104.KID - KIDS package to be installed on the VistA System. MAG3_0P104_VIX_Setup.msi - Installation file for the VIX software. Note The CVIX software is not distributed with this patch; it is installed in VA data centers co-resident with the Bidirectional Health Information Exchange (BHIE) framework. The CVIX software is centrally updated on release of this patch; pre-existing MAG*3.0*83 VIXes are compatible with the MAG*3.0*104 CVIX. Documentation: ============== MAG3_0P104_Patch_Description.pdf - Patch Description. MAG_VIX_admin_guide.pdf - Revised VIX Administrator's Guide. MAG_VIX_installation_guide.pdf - New VIX Installation Guide. MAG3_0P104_Technical_Manual_changes.pdf - Technical Manual change pages for this patch. MAG3_0P104_Install_Guide_changes.pdf - Installation Guide change pages for this patch. MAG3_0P104_Security_Guide_changes.pdf - Security Guide change pages for this patch. Associated Patches: =================== Before the MAG*3.0*104 KIDS file is installed, the following patches must be installed: MAG*3.0*93 MAG*3.0*83 MAG*3.0*115 Note Certain capabilities of Patch MAG*3.0*104 are not available unless MAG*3.0*117 is installed as well. 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, and then navigate to the \Docs\Imaging_Docs_Latest folder). Test Sites: =========== This patch has been tested at the following sites: Fayetteville VA Medical Center (large) North Chicago VA Medical Center (medium) Ralph H. Johnson VA Medical Center - Charleston (large) VA Heartland - East (integrated) VA Heartland - West (integrated) VA Gulf Coast Veterans Health Care System - Biloxi (large) VA Montana HCS -Ft. Harrison (integrated) Washington DC VA Medical Center (large) Remedy Calls: ============= The following Remedy tickets are addressed in this patch: Ticket 479857 Problem: Increase in Jukebox pulls after VIX Solution: Add new parameter to MAGJ RADCASEIMAGES RPC to prevent unneeded retrieves. Ticket 479913 Problem: VIX not starting after installation Solution: Modify installer to allocate sufficient memory on servers with more than 4 GB RAM. NSRs: ===== The following New Service Request (NSR) is associated with this patch: 20091208 - NCAT Data from DoD to VA: grant authorized VA users access to DoD NCAT data for shared VA/DoD patients. Patch 104 Changes: ================== CVIX Changes: ============= The CVIX (Centralized VIX), introduced in MAG*3.0*105, is a special implementation of the VIX (VistA Imaging Exchange service). The CVIX is deployed in the VA annex of the Philadelphia Sungard Spring Garden data center. In MAG*3.0*104, the role of the CVIX is being expanded as described below. The changes described in this section do not require any VA site action or configuration changes. Expanded VA/DoD Image Exchange: =============================== When this patch is implemented, the CVIX will serve as the gateway for all VA/DoD image and document exchanges. * The CVIX extends VA/DoD image exchange to include non-radiology medical images, scanned documents, and PDF files such as DoD NCAT reports. Use of this functionality requires the Patch 117 clinical display client. * The CVIX extends VA/DoD image exchange to include more types of radiology images. See the Appendix on page 15 for details. * VA clinicians at sites that have implemented a MAG*3.0*104 VIX will be able to retrieve the types of images described above from DoD facilities that are part of the El Paso/NDAA data sharing program as well as the pending DoD HAIMS system. * If not all of a DoD patient's data can be retrieved from applicable DoD servers because of network or connection issues, the CVIX will indicate that the data is incomplete when passing the data to a local site VIX. * DoD clinicians will be able to receive the new documents and images described above from all VA sites. Image requests are logged in the IMAGE ACCESS LOG file (#2006.95) at the VA site where the images reside. Credentialing and CVIX Performance Improvements: ================================================ * When a DoD provider requests a VA radiology image, the request will now be sent to the CVIX before being passed to a VA site VIX. This allows provider credentialing to be handled by the Station 200 VistA system, and eliminates the need for VA sites to create a service account for DoD clinician access, as was done for MAG*3.0*83. * The CVIX will be reconfigured as a load-balanced cluster to achieve the scalability and reliability required by an enterprise gateway. * The CVIX will provide an additional layer of caching to reduce unnecessary network traffic. Note Because NCAT report identifiers are set dynamically at their source, retrieval of previously requested NCAT reports from the VIX or CVIX cache is not possible. NCAT reports are always retrieved from their source as needed. This only applies to NCAT reports, and not to other types of data from the DoD. Host VistA Site Service on CVIX: ================================ The VistA Site Service (used by the VIX and other Imaging components to connect to other sites) has been integrated with the CVIX for improved availability. This change is transparent to the VIX and other Imaging components, and no local configuration changes are needed for this. VIX Changes: ============ The following changes have been made to the VIX service. Sites must implement the MAG*3.0*104 VIX to take advantage of these changes. Provide DoD Artifacts to Clinical Display Users: ================================================ Implementing a MAG*3.0*104 VIX and MAG.3.0*117 Clinical Display gives VA clinicians access to DoD artifacts and NCAT reports. This process is triggered when a clinician uses Clinical Display's Remote Image Views capability to connect to the DoD. Connecting to the DoD triggers a single query for both radiology images and artifacts to the local VIX. The VIX will forward the request to the CVIX for processing, and will pass the results returned by the CVIX back to Clinical Display. Improved VA/DoD Radiology Image Sharing: ======================================== The VIX will no longer communicate directly with the BIA to retrieve DoD radiology images. Instead, when a VA clinician requests a DoD radiology image, the VIX will forward the requests to the CVIX for processing and will pass the results returned by the CVIX back to Clinical Display or VistARad. Likewise, all DoD requests for VA radiology images will be sent to the CVIX, and the CVIX will query VA sites as needed. This change will: * Reduce the timeouts some VA sites experience when attempting to retrieve DoD radiology images. * Eliminate the need to have a manually configured VA service account for VA/DoD image sharing. Improved Integrated/Consolidated Site Support: ============================================== * The MAG*3.0*104 VIX can now be installed at sites that use station numbers (as defined in the INSTITUTION file (#4)) with four or more characters. Previously the VIX presumed the use of 3-digit station numbers. * When Clinical Display and VistARad are used for remote image retrieves at a consolidated site, the VIX at the local division will now be used, rather than routing image retrieves though the VIX at the primary site. Note This capability presumes MAG*3.0*117 Clinical Display (or later) and/or MAG*3.0*90 VistARad (or later). Updated Laurel Bridge DCF Toolkit: ================================== The MAG*3.0*104 VIX uses an updated version (3.3.22c) of the Laurel Bridge DICOM Connectivity Framework (DCF) Toolkit. * Laurel Bridge has implemented a new licensing method for this toolkit. For information about updating the licenses of an existing VIX or about getting new licenses for a first-time VIX implementation refer to the VIX Installation Guide distributed with this patch. Note The new licensing method requires that the VIX has access to the Laurel Bridge site at https://192.131.14.9. If this site is blocked, you can submit a Remedy ticket to have your facility's ACL (access control lists) modified. * The updated toolkit also addresses an issue that triggered questionable integrity warnings in remote images retrieved through a VIX. This issue was limited to images that are stored originally as DICOM encapsulated JPEG, that had patient information changes, and that were sent to remote sites by a VIX. New VIX Transaction Log Archiving Service: ========================================== MAG*3.0*104 introduces a new VIX Log Collector service that backs up site VIX transaction logs. The log collector service is deployed on and stores the backed-up logs on a VA data center server. The log collector service uses VistA site service to identify the VIXes (and any CVIXes) that logs need to be collected from. Each day, one day's worth of entries that are more than 48 hours old are collected. For example, on Monday, the Log Collector service will collect all VIX log entries from the previous Saturday. The VIX Log Collector service does not require any site-level or local VIX configuration. Improved Exception Handling: ============================ * If the VIX cannot retrieve data from all locations where a patient has been seen, the VIX will pass a "partial results flag back to the requesting system (such as Clinical Display). For details about how Clinical Display handles this information, see the MAG*3.0*117 Patch Description. * The VIX transaction logs have been modified to include additional information for improved troubleshooting. Additional Changes: =================== * In addition to Windows Server 2003 x32, the VIX now supports Windows Server 2008 R2 x64. * The VIX now requires the Microsoft Visual C++ 2005 SP1 Redistributable Package (x86) to support the updated Laurel Bridge Toolkit included in MAG*3.0*104. Information about downloading this package is covered in the installation section. * The VIX dependency for J# has been removed from the VIX installer; J# no longer needs to be pre-installed on servers where the VIX will be installed. * An issue that prevented the VIX installer from properly allocating memory for the bundled Java Runtime Environment has been corrected. This issue was limited to servers that had more than 4 GB of memory (Remedy #479913). * The VIX now provides DoD data used by VistARad to populate the "Site column in VistARad's patient exams list. Previously, this data was not provided by the VIX even if it was available from the DoD. This change does not require any VistARad software or configuration changes to implement. VistA Changes: ============== MAG*3.0*104 includes a KIDS package to be installed on the VistA System. This KIDS must be installed by all sites, even those that have not deployed a VIX. Data Dictionaries: ================== There are no new or modified data dictionaries in this patch. Security Keys: ============== There are no new or modified security keys in this patch. Remote Procedures: ================== There are no new or modified Remote Procedures. Menu Options: ============= There are no new or modified menu options in this patch. Templates: ========== There are no new or modified templates in this patch. Installation: ============= All sites must install the KIDS portion of this patch. The MAG*3.0*104 KIDS can be loaded while VistA Imaging System is active. Installing the KIDS will take less than one minute. Before installing this patch: * Download the MAG*3.0*104 files from the Imaging FTP site to a local storage location. * Verify that required patches and any optional patches that support desired or needed features have been installed. For a summary of associated patches, see page 2. After the KIDS portion of this patch is installed, sites with an existing VIX will need to update their VIX and request updated Laurel Bridge licenses. For detailed information, refer to the VIX Installation Guide. Note The MAG*3.0*83 VIX can be used after the KIDS for MAG*3.0*104 is installed, but most changes described in this document will not take effect until after the VIX is updated to MAG*3.0*104. Note After a MAG*3.0*83 VIX has been updated to MAG*3.0*104, the VistA service account established for the MAG*3.0*83 VIX can be removed. It is recommended to wait until the MAG*3.0*104 VIX has been in place with no issues before removing this account. KIDS Installation: ================== All sites must install the KIDS portion of this patch. 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 option [XPD LOAD DISTRIBUTION] to load the KIDS distribution. b) When prompted, enter the path and file name (MAG3_0P104.KID) of the Patch 104 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 loading the KIDS file, use the following options if you need to verify the contents of the patch and to back up any affected routines. Verify Checksums in Transport Global [XPD PRINT CHECKSUM] run this option to ensure the integrity of the routines in the patch. 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. Backup a Transport Global [XPD BACKUP] run this option 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, perform the following steps to install the KIDS file: a) Run the Install Package(s) option [XPD INSTALL BUILD]. b) When prompted for the install name, enter MAG*3.0*104. c) Answer NO to the following prompts: Want KIDS to INHIBIT LOGONs during the install? No//NO Want to DISABLE Scheduled Options, Menu Options, and Protocols? //NO 6. When installation has finished, an Install Complete message will be displayed. Sample KIDS Installation: ========================= The sample installation below illustrates the installation of the MAG*3.0*104 KIDS. Select OPTION NAME: XPD MAIN Kernel Installation & Distribution System Edits and Distribution ... Utilities ... Installation ... Patch Monitor Main Menu ... Select Kernel Installation & Distribution System Option: Installation 1 Load a Distribution 2 Verify Checksums in Transport Global 3 Print Transport Global 4 Compare Transport Global to Current System 5 Backup a Transport Global 6 Install Package(s) Restart Install of Package(s) Unload a Distribution Select Installation Option: 6 Install Package(s) Select INSTALL NAME: MAG*3.0*104 7/12/11@14:56:44 => VistA Imaging V3.0 - Patch 104 - 07/12/2011 10:38AM ;Created o This Distribution was loaded on Jul 12, 2011@14:56:44 with header of VistA Imaging V3.0 - Patch 104 - 07/12/2011 10:38AM ;Created on Jul 1 2, 2011@10:38:15 It consisted of the following Install(s): MAG*3.0*104 Checking Install for Package MAG*3.0*104 Install Questions for MAG*3.0*104 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// TELNET Install Started for MAG*3.0*104 : Jul 12, 2011@14:56:49 Build Distribution Date: Jul 12, 2011 Installing Routines: Jul 12, 2011@14:56:49 Running Pre-Install Routine: PRE^MAGIP104 Running Post-Install Routine: POS^MAGIP104 Updating Routine file... Updating KIDS files... MAG*3.0*104 Installed. Jul 12, 2011@14:56:49 Install Completed Install Message sent #32579 Appendix-DICOM Image Support: ============================= MAG*3.0*83 supported VA/DoD radiology image exchange for a subset of radiology images based on DICOM modality type. In MAG*3.0*104, the types of radiology images that can be exchanged has been significantly expanded. VA DICOM Provided to DoD: ========================= DoD clinicians can request the following types of radiology exams from the VA through the CVIX (the asterisks indicate identifiers supported in the previous VIX patch): VA DICOM Objects Provided to DoD: (For more information on the DICOM objects please refer to Patch Description in the Appendix Section). DoD DICOM Provided to VA: ========================= Study information (including reports) for studies associated with all DICOM modality types can be retrieved from the DoD through the CVIX. However, for certain DICOM object types, the associated objects are not actually images and Clinical Display and VistARad cannot display them.. For these types of DICOM studies, the VIX will provide the metadata (including reports) but will not provide the image counts and/or image locations. The VIX only does this for following DICOM modality types, and only if the data originates from the DoD: DoD objects not displayable at the VA (metadata and reports remain accessible): (For more information on DoD Objects please refer to the Patch Description in ithe Appendix Section) Routines: ========= For each routine, the second line contains the following information: ;;3.0;IMAGING;**[Patch List]**;MAR 19, 2002;;Build 2225;Jul 12, 2011 New and modified routines for the VistA System are listed below. CHECK1^XTSUMBLD is used to generate the checksums. Note that the "before checksum may differ if any test software has been installed. MAGIP104 is a post-installation routine and is deleted after the is KIDS installed. Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: MAGDQR21 Before:B147169782 After:B159758067 **83,104** Routine Name: MAGIP104 Before: n/a After: B4514377 **104** Routine Name: MAGJEX1 Before: B78821225 After: B67789912 **16,22,18,65,101,115,104** Routine Name: MAGJEX1B Before: B30045444 After: B25186309 **16,22,18,65,76,104** Routine Name: MAGJUTL2 Before: B48913977 After: B45983614 **18,65,76,104** Routine Name: MAGJUTL5 Before: B33147179 After: B38131193 **65,76,101,90,115,104** Routine list of preceding patches: 83, 115 ============================================================================= User Information: Entered By : TROMBETTA,KATHY Date Entered : MAR 10, 2009 Completed By: CASUGAY,ELSIE G Date Completed: NOV 03, 2011 Released By : FUGETT,BRENT Date Released : NOV 03, 2011 ============================================================================= Packman Mail Message: ===================== No routines included