$TXT Created by ACKERMAN,NIEN-CHIN at DEV.DEV.FO-HINES.MED.VA.GOV (KIDS) on Friday, 04/30/10 at 10:37 ============================================================================= Run Date: JUN 22, 2010 Designation: MD*1*21 Package : MD - CLINICAL PROCEDURES Priority: Mandatory Version : 1 SEQ #14 Status: Released Compliance Date: JUL 22, 2010 ============================================================================= Associated patches: (v)MD*1*11 <<= must be installed BEFORE `MD*1*21' (v)MD*1*13 <<= must be installed BEFORE `MD*1*21' Subject: HIGH VOLUME PROCEDURES Category: - Routine - Other - Enhancement (Mandatory) Description: ============ 508 Compliance -------------- There is no Graphical User Interface (GUI) application associated with this patch. ASSOCIATED NSR ============== NSR 20090106 20030304 20010604 ASSOCIATED E3R ============== #19631 #20257 Associated Remedy Ticket ------------------------ 305536 340824 342114 This patch contains the enhancement that will help streamline Clinical Procedures (CP) application processes for high volume procedures, such as electrocardiograms (EKG). It will accomplish the following: 1) Create an Application Proxy called CLINICAL,DEVICE PROXY SERVICE. (Reference DBIA #4677) A post-init routine MDPOST21 will be run during installation to create the Application Proxy. 2) Once the verified final result is transmitted from the medical device: a) The associated note of the study can be administratively closed using the Application Proxy. b) (For Muse device Only) The associated note can be administratively closed using the interpreter. NOTE: IF ONLY your site sets up the interpreter on the MUSE with the internal entry number in the New Person file (#200). 3) If the medical device sends text impression, it can be included in the note or entered as a significant finding on the procedure. 4) When the note is completed with the administrative closure, the procedure will be completed. If the text is entered as a significant finding, the note will remain in the "Undictated" status as the normal Clinical Procedure (CP) process. 5) If the text is entered as a significant finding, the detailed consult will be viewable on the Consults tab and Procedures (local Only) component on the Reports tab in the Computerized Patient Record System (CPRS). 6) Any current Procedural Terminology/Diagnosis codes transmitted from the device will be passed to Patient Care Encounter (PCE). NEW OPTIONS: NAME: MD HIGH VOLUME PROCEDURE SETUP Menu Text: High Volume Procedure Setup This option will let the user populate a list of CP procedures and set it up for high volume procedure process. This option will populate the XPAR Parameters MD GET HIGH VOLUME and MD NOT ADMN CLOSE MUSE NOTE. NAME: MD PROC W/INCOMPLETE WORKLOAD Menu Text: Print list of Procedure with incomplete workload This option will print a list of procedures within Clinical Procedures that have incomplete workload. This option is a tool for the users to find studies that do not have the workload completed. NAME: MD PROCESS RESULTS Menu Text: MD Process Results This option will need to be scheduled for every hour. This task will update Consult of the processed result. NEW PARAMETER DEFINITIONS: NAME: MD GET HIGH VOLUME DESCRIPTION: This parameter will contain a free text string that contains two pieces of data delimited by a semicolon ';'. The two pieces of data are: 1) 1/0 (Yes/No) to indicate whether or not the text of the result should be added to the note, 2) 1/0 (Yes/No) to enter the text of the result as the significant finding of the Consult. (If you enter a 0, the note will be auto closed with the text inside.) Example string: 1;0 NAME: MD NOT ADMN CLOSE MUSE NOTE DESCRIPTION: This parameter is used to indicate the note should not be administratively closed with the proxy user CLINICAL, DEVICE PROXY SERVICE but the interpreter of the procedure for the MUSE device. The default is "No". NAME: MD USE NOTE DESCRIPTION: This parameter indicates that Clinical Procedures will use the note for the text of the result instead of the Significant Finding field in Consult. HIGH VOLUME PROCEDURE SETUP: ================ BEGIN EXAMPLE 1 ================ Select OPTION NAME: MD HIGH VOLUME PROCEDURE SETUP High Volume Procedure S etup High Volume Procedure Setup Procedure: EKG 1 EKG, ROUTINE (12 LEADS) 2 EKG ECG CHOOSE 1-2: 1 EKG, ROUTINE (12 LEADS) Get Text? ? Indicate whether the text from the result should or should not be obtained. Enter either 'Y' or 'N'. Get Text? YES Use Interpreter to close note? ? If 'YES', the interpreter of the result will be used to close the note. If 'NO', the Proxy service will be used. Enter either 'Y' or 'N'. Use Interpreter to close note? YES Procedure: ============== END EXAMPLE 1 ============== ================ BEGIN EXAMPLE 2 ================ Select OPTION NAME: MD HIGH VOLUME PROCEDURE SETUP High Volume Procedure S etup High Volume Procedure Setup Procedure: COLON 1 COLONOSCOPY 2 COLONOSCOPY - HIST CHOOSE 1-2: 1 COLONOSCOPY Get Text? YES Do Not Auto Close Note? No// ? If 'YES', the text of the result will be in the significant finding of the procedure. If 'NO', the default auto closure will be used. Enter either 'Y' or 'N'. Do Not Auto Close Note? No// YES Procedure: ============== END EXAMPLE 2 ============== ====================================== BEGIN EXAMPLE OF SCHEDULING THE OPTION ====================================== Select Taskman Management Option: SCHEdule/Unschedule Options Select OPTION to schedule or reschedule: MD PROCESS RESULTS MD Process Res ults ...OK? Yes// (Yes) (R) Edit Option Schedule Option Name: MD PROCESS RESULTS Menu Text: MD Process Results TASK ID: 3659679 __________________________________________________________________________ QUEUED TO RUN AT WHAT TIME: APR 28,2009@08:00 DEVICE FOR QUEUED JOB OUTPUT: QUEUED TO RUN ON VOLUME SET: RESCHEDULING FREQUENCY: 1H TASK PARAMETERS: SPECIAL QUEUEING: Startup Persistent _______________________________________________________________________________ COMMAND: ======================================= END OF EXAMPLE OF SCHEDULING THE OPTION ======================================= MISCELLANEOUS FIXES =================== 1) Remedy Ticket: 305536 Wilmington reported that their encounters were checked out before all the workload information have been entered in CP-Hemodialysis. Routine MDPCE2 was modified to check if procedure, diagnosis codes, and provider was entered before checking out the encounter when the Treatment Summary is signed. 2) Remedy Ticket 340824 and 342114 Buffalo and Louisville reported that when the STATE field is blank, it generated an exception error in routine MDHL7BH. Routine MDHL7BH was modified to fix this issue. 3) Routines MDHL7U3,MDPCE2,MDRPCW, MDRPCW1, and MDRPCWU were modified to call Application Program Interface $$ICDDX^ICDCODE for the DIAGNOSIS field (#3) of the ICD DIAGNOSIS file (#80). Associated NSR 20010604 and 20030304 Code Set Versioning change. 4) Omaha reported that the text "\.br\" was not screened out from the result generated from KinetDx Echocardiogram device. Routine MDHL7K1 was modified to fix this. TEST SITES: =========== Ann Arbor (Large) Charleston (Large) Little Rock (Large) Montana (Integrated Medium) Omaha (Integrated Large) DOCUMENTATION RETRIEVAL: ======================= The documentation can be retrieved in the following steps: The following files can be retrieved in BINARY format by File Transfer Protocol (FTP): MD_1_P21_RN (Release Notes) MD_1_P21_IMPG (Implementation Guide - change pages) MD_1_P21_TM.PDF (Technical Manual - change pages) MD_1_P21_UM.PDF (User Manual - change pages) CLINPROC1_IMPG.PDF (Implementation Guide - whole manual) CLINPROC1_TM.PDF (Technical Manual- whole manual) CLINPROC1_UM.PDF (User Manual - whole manual) The preferred method is to FTP the files from download.vista.med.va.gov which will transmit the files from the first available FTP server. The files may also be downloaded directly from a particular FTP location at the following locations. Albany ftp.fo-albany.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov Files are available in the ANONYMOUS.SOFTWARE directory. PRE-INSTALLATION STEP: ===================== If both MD SCHEDULED STUDIES and MD STUDY CHECK-IN are scheduled at your site, stop both of the tasks before installation. INSTALLATION INSTRUCTIONS: ========================= Users may remain on the system but this patch should be installed at non-peak hours due to the high volume use of the routines included. Installation should take less than 3 minutes. 1. Use the INSTALL/CHECK MESSAGE option on the PackMan menu. 2. From the Kernel Installation and Distribution System Menu, select the Installation menu. 3. From this menu, you may elect to use the following options (when prompted for INSTALL NAME, enter MD*1.0*21): a. Backup a Transport Global b. Compare Transport Global to Current System c. Verify Checksums in Transport Global 4. Use the Install Package(s) option and select the patch MD*1.0*21. 5. When prompted "Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//", take the default. 6. When prompted "Want KIDS to INHIBIT LOGONs during the install? NO//", take the default. 7. When prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//", take the default. 8. When prompted 'DEVICE: HOME //', respond with or a device. POST-INSTALLATION STEPS: ======================= 1) Re-start the following tasks MD SCHEDULED STUDIES and MD STUDY CHECK-IN. 2) Schedule option MD PROCESS RESULTS to run for every hour. 3) Review Accessing Modules under General CP Package Information in the Clinical Procedures Implementation Guide to assign new options as SECONDARY MENU OPTIONS. 4) Review Chapter 7 on Application Proxy User in the Clinical Procedures Implementation Guide and add a signature block for the Application Proxy User, CLINICAL,DEVICE PROXY SERVICE. 5) Review Appendix E - High Volume Procedure Checklist in the Clinical Procedures Implementation Guide to setup a high volume procedure. 6) Once the Application Proxy User is created after the installation of the patch, the sites can delete the post-installation routine MDPOST21. The sites can re-run the post-init routine, if it is needed. Routine Information: ==================== The second line of each of these routines now looks like: ;;1.0;Clinical Procedures;**[Patch List]**;Apr 01, 2004;Build 30 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: MDAR7M Before: n/a After: B23544832 **21** Routine Name: MDARSET Before: n/a After: B19742072 **21** Routine Name: MDCLN Before: n/a After: B494118 **21** Routine Name: MDHL7A Before: B47975378 After: B49521176 **6,11,21** Routine Name: MDHL7BH Before: B17132013 After: B22756208 **11,21** Routine Name: MDHL7K1 Before: n/a After: B3829311 **21** Routine Name: MDHL7U3 Before: B59275593 After: B65415989 **6,21** Routine Name: MDHL7XXX Before: B4422982 After: B26957233 **21** Routine Name: MDNCHK Before: B2266513 After: B2544252 **11,21** Routine Name: MDPCE Before: B4577099 After: B4196998 **5,21** Routine Name: MDPCE2 Before: B23364191 After: B24598640 **6,21** Routine Name: MDPOST21 Before: n/a After: B3149541 **21** Routine Name: MDPS1 Before: B77051543 After: B81903471 **2,10,13,21** Routine Name: MDPSU Before: n/a After: B64018431 **21** Routine Name: MDPSUL Before: n/a After: B4032954 **21** Routine Name: MDRPCNT1 Before: B40746099 After: B42671785 **6,21** Routine Name: MDRPCOT Before: B79210353 After: B85701277 **5,6,11,21** Routine Name: MDRPCOT1 Before: B34134564 After: B41706537 **5,11,21** Routine Name: MDRPCOT2 Before: B41546824 After: B44563560 **6,21** Routine Name: MDRPCOTH Before: n/a After: B22669741 **21** Routine Name: MDRPCW Before: B62805042 After: B69393853 **6,21** Routine Name: MDRPCW1 Before: B47358389 After: B57107439 **6,21** Routine Name: MDRPCWU Before: n/a After: B2706250 **21** Routine Name: MDSTUDW Before: n/a After: B21880299 **21** Routine Name: MDWCAN Before: B16228241 After: B19425889 **11,21** Routine Name: MDWOR Before: B40687442 After: B40304234 **14,11,21** Routine Name: MDWORSR Before: B57396407 After: B57541495 **14,11,21** ============================================================================= User Information: Hold Date : JUN 17, 2010 Entered By : ACKERMAN,NIEN-CHIN Date Entered : MAR 11, 2009 Completed By: REZNIK,CHARMAINE Date Completed: MAY 27, 2010 Released By : COWNIE,KEVIN Date Released : JUN 22, 2010 ============================================================================= Packman Mail Message: ===================== $END TXT