$TXT Created by CHESNEY,CHRISTINE M at DEVCRN.FO-ALBANY.MED.VA.GOV (KIDS) on Wednesday, 10/28/09 at 08:59 ============================================================================= Run Date: NOV 30, 2009 Designation: MPIF*1*52 Package : MPIF - MASTER PATIENT INDEX VISTA Priority: EMERGENCY Version : 1 SEQ #48 Status: Released Compliance Date: DEC 03, 2009 ============================================================================= Associated patches: (v)MPIF*1*35 <<= must be installed BEFORE `MPIF*1*52' (v)MPIF*1*39 <<= must be installed BEFORE `MPIF*1*52' (v)MPIF*1*43 <<= must be installed BEFORE `MPIF*1*52' (v)MPIF*1*48 <<= must be installed BEFORE `MPIF*1*52' (v)XT*7.3*113 <<= must be installed BEFORE `MPIF*1*52' Subject: IDENTITY HUB CHANGES FOR MPI VISTA Category: - Enhancement () - Routine Description: ============ NOTE: RG* and MPIF* patches should NOT be installed on legacy systems to avoid issues with the legacy systems ending up as Treating Facilities. XT*7.3*113, MPIF*1.0*35, MPIF*1.0*39, MPIF*1.0*43, and MPIF*1.0*48 are required builds for patch MPIF*1*52. ************************************************************************* NOTE: The compliance date of this patch has been shortened due to dependencies which exist with the MPI Austin patch MPI*1.0*71, the Person Service Identity Management (PSIM) and Identity Management (IMDQ) Toolkit software releases. These releases support the switch to Initiate Identity Hub probabilistic algorithm during MPI searches. It is imperative that this patch be installed no later than the compliance date to ensure we are ready for the switch over. Your understanding and support is appreciated. ************************************************************************ This patch is related to KERNEL patch XT*7.3*113, Clinical Info Resource Network (CIRN) patch RG*1.0*54, and Master Patient Index Austin patches MPI*1.0*62 and MPI*1.0*71. This patch is in support of the Master Patient Index (MPI) Identity Hub Project for the Healthcare Identity Management (HC IdM) team. The project enables the change from the current MPI patient deterministic lookup to an Identity Hub based probabilistic patient lookup. The commercial Identity Management software vendor that was selected by the VHA to provide an Identity Management Probabilistic Algorithm is Initiate. Initiate probabilistic search algorithm was purchased to be integrated with the MPI and Person Service Identity Management (PSIM) for the purpose of improving the matching of patients and persons across VHA. PSIM will serve as the interface to the Initiate algorithm and the MPI will interact with PSIM. The Initiate centralized probabilistic search algorithm will replace the local VistA KERNEL DUPLICATE RECORD MERGE search process for identifying local potential duplicate PATIENT (#2) file records. When the patient is presented to the MPI for an Integration Control Number (ICN) and the search algorithm identifies potential duplicate in VistA, the patients are automatically added to the VistA DUPLICATE RECORD (#15) file. Please refer to VistA patch XT*7.3*113 for more information. Issue #1: A new routine, MPIFDNL, calls the Remote Procedure, MPIF DNL ADD UPD, at the Master Patient Index (MPI), to add, activate, or inactivate records in the MPI DO NOT LINK (#985.28) file (MPI Austin file). The purpose of this MPI file is to screen out records that have previously been identified as different patients, so that they do not continuously get logged as potential or automatic matches. If called from the Verify Potential Duplicates [XDR VERIFY ALL] option, and the user sets the STATUS field on a pair of patients to VERIFIED, NOT A DUPLICATE, then the MPIFDNL routine calls a Remote Procedure in the MPI system, to add (or activate) the patient pair to the MPI DO NOT LINK (#985.28) file (MPI Austin file) so that PSIM will not attempt to link the patients in the future. If called from the Edit the Status Field of a Duplicate Record [XDR EDIT DUP RECORD STATUS] option and the STATUS field of a patient pair is set from VERIFIED, NOT A DUPLICATE back to POTENTIAL DUPLICATE, UNVERIFIED, the Remote Procedure is called to inactivate the record that was previously added to the MPI DO NOT LINK (#985.28) file in Austin. The action taken by another site will not impact the status of your potential duplicate pair if two sites have the same potential duplicate. You will still be able to make your own determination if the patient is or is not a duplicate. Sites should not set the STATUS field of the potential duplicate via FileMan, this will not set an entry in the MPI DO NOT LINK (#985.28) file in Austin. Routine: MPIFDNL RPC: MPIF DNL ADD UPD Issue #2: All references to the logging of Potential Matches have been removed from the VistA HL7 message processor routines. That functionality is now handled on the MPI in Austin where the Healthcare Identity Management (HC IdM) team will process the Potential Match exceptions. For the VistA user, that means that there will no longer be any Potential Matches Returned exceptions added to the MPI/PD Exception Handling [RG EXCEPTION HANDLING] option. If there are any potential duplicates at the local site, they will be added directly to the VistA DUPLICATE RECORD (#15) file for processing as described above. Issue #3: Routine MPIFVTQ has been modified to send the following additional fields from the PATIENT file (#2) to the Master Patient Index (MPI) in a VistA HL7 message builder for use by the PSIM query for the search algorithm. STREET ADDRESS [LINE 1] (#.111), STREET ADDRESS [LINE 2] (#.112), STREET ADDRESS [LINE 3] (#.113), CITY (#.114), and PHONE NUMBER [RESIDENCE] (#.132). This data is not being updated, just potentially included in the query sent to the MPI for searching. Issue #4: The Display Only Query [MPIF DISPLAY ONLY QUERY TO MPI] display has been enhanced to assist in reducing the number of duplicate records added to the Master Patient Index (MPI) via the VAMC registration processes. Before registering a patient, the Display Only Query [MPIF DISPLAY ONLY QUERY TO MPI] option can be used to determine if the patient already exists on the MPI or if there is a duplicate (or duplicates) on the MPI. The user is asked if the patient is currently in the VistA PATIENT (#2) file. If so, the patient name is entered and all of the identity traits are collected from the PATIENT (#2) file record to send a HL7 query to the MPI. If the user selects No, at the prompt if the patient is currently in the VistA PATIENT (#2) file, the user is prompted for a set of identity traits. When entering the patient name, input can be either upper or lower case. Using the identity traits, the HL7 query is sent to the MPI where the new probabilistic search algorithm is used to get all matching records. Whether the records are an exact match or a potential match is determined by the match score in conjunction with established thresholds and are displayed in hierarchical order. After the user selects a record from the list, a Remote Procedure, MPIF EDAT REMOTE, extracts the patient information from the MPI. This is the same information that HC IdM has available on the MPI Extended Patient Data Inquiry (EDAT) [MPI DATA MGT PDAT EXT MPI] report. This will enable the VAMC user to register the patient with the correct information, thereby reducing duplication. This option can also be used for viewing potential matches after the registration process. Issue #5: When the Healthcare Identity Management (HC IdM) team used the Resolve MPI Duplicate [MPI DATA MGT DUP RES] option on the MPI for two records which are duplicates and should have the same Integration Control Number (ICN), a message was sent to the facilities associated with the ICN that was deprecated. The mail message, "MPI/PD Exception: Multiple ICNs", stated the following: "Multiple ICNs: Patient DFN=xxxxxxxxx is trying to be assigned ICN 123456786980 which is already in use for DFN=yyyyyyyyy". The logic has been changed in routine MPIF002 so that the previous e-mail message is no longer sent. Instead, the potential duplicate pair is added to the DUPLICATE RECORD (#15) file with a status of POTENTIAL DUPLICATE, UNVERIFIED. To let you know that potential duplicate(s) have occurred, a new message is generated so that the pair can be verified/merged as applicable. Information about the "Potential Duplicate PATIENT records found by MPI" message is available in VistA patch XT*7.3*113. Issue #6: VistA patch RG*1.0*52 removed code references to three obsolete Date of Death exceptions: 215 - Death Entry on MPI not VISTA, 216 - Death Entry on Vista not MPI, and 217 - Death Entries on MPI and Vista DON'T MATCH. Routine MPIFBT3 contained code that references these exception types. Since we did not want to delay the release of RG*1.0*52, code was put in place in EXC^RGHLLOG to quit if these three exception types were passed in as a parameter via routine MPIFBT3. Now that RG*1.0*52 has been released, the code in MPIFBT3 referencing these exception types is being removed. Issue #7: The following MPIF* options were distributed with patch MPIF*1.0*44 (released 2/6/07) as obsolete with an Out of Order message. These options are being distributed in this build as DELETE AT SITE in order to remove them from the OPTION (#19) file. There are other MPI/PD options in the VAFC* namespace that are also obsolete that will be removed in a future DG* patch. AUTO CHANGE CMOR NIGHT JOB [MPIF CMOR REQUEST AUTO JOB] Batch Review of CMOR Change Requests [MPIF BATCH REVIEW] Coordinating Master of Record (CMOR) Request [MPIF CMOR MGR] Create a New CMOR Change Request [MPIF NEW REQUEST] Display a CMOR Change Request [MPIF VIEW REQUEST] Edit Open CMOR Change Request [MPIF EDIT REQUEST] Push CMOR Request [MPIF PUSH CMOR] Report - CMOR Requests Approved [MPIF APPROVED REPORT] Report - CMOR Requests Disapproved [MPIF DISAPPROVE REPORT] Report - Pending Received Requests [MPIF RECEIVED REQUESTS] Report - Sent Requests Still Pending [MPIF SENT REQUESTS] Review Pending Change of CMOR Requests [MPIF REVIEW REQUEST] Site Parameters Edit for CMOR [MPIF SITE PARAMETER] Issue #8: During a code review, it was found that the unlock code in MAKE+28 in routine MPIFRES was not unlocking the same global that was being locked in MAKE+27. This could cause a number of locks to remain in the lock table until the Local/Missing ICN Resolution Background Job [MPIF LOC/MIS ICN RES] completes and releases all associated locks. Since this background job runs frequently, there are not too many entries to be processed; therefore, it has not caused an issue. The unlock code in MAKE+28 has been changed to unlock the same global as the one locked in MAKE+27. This was addressed in routine MPIFRES. Issue #9: If an ICN was trying to be assigned to a site's patient, but that ICN was already assigned to another patient and the MPIF LOC/MIS ICN RES background job was the process making the ICN update, then the A28 message to have the second patient added to the MPI was not being triggered. This was corrected in routine MPIFBT3. Issue #10: When processing a Health Level Seven A24 Link Patient Information message, if the ICN is already in use for another PATIENT (#2) file entry, the application level acknowledgement is being sent back with a status of AA with an error message. The status should be AE with an error message. This is corrected in routine MPIFA24. Options: ======== The following options are obsolete and are being distributed as DELETE AT SITE in order to remove them from the OPTION (#19) file. AUTO CHANGE CMOR NIGHT JOB [MPIF CMOR REQUEST AUTO JOB] Batch Review of CMOR Change Requests [MPIF BATCH REVIEW] Coordinating Master of Record (CMOR) Request [MPIF CMOR MGR] Create a New CMOR Change Request [MPIF NEW REQUEST] Display a CMOR Change Request [MPIF VIEW REQUEST] Edit Open CMOR Change Request [MPIF EDIT REQUEST] Push CMOR Request [MPIF PUSH CMOR] Report - CMOR Requests Approved [MPIF APPROVED REPORT] Report - CMOR Requests Disapproved [MPIF DISAPPROVE REPORT] Report - Pending Received Requests [MPIF RECEIVED REQUESTS] Report - Sent Requests Still Pending [MPIF SENT REQUESTS] Review Pending Change of CMOR Requests [MPIF REVIEW REQUEST] Site Parameters Edit for CMOR [MPIF SITE PARAMETER] Documentation Update: ===================== MASTER PATIENT INDEX/PATIENT DEMOGRAPHICS (MPI/PD) VISTA documentation is available, updated for patches RG*1.0*54 and MPIF*1.0*52. Facilities should download the revised documentation: (See patch description RG*1.0*54 for related documentation updates) The preferred retrieval method is to FTP from the ANONYMOUS.SOFTWARE directory at: DOWNLOAD.VISTA.MED.VA.GOV This transmits the file from the first available FTP server. Sites may also elect to retrieve software directly from one of the following servers. OI Field Office FTP Address Directory ------------------------------------------------------------------ Albany ftp.fo-albany.med.va.gov ANONYMOUS.SOFTWARE Hines ftp.fo-hines.med.va.gov ANONYMOUS.SOFTWARE Salt Lake City ftp.fo-slc.med.va.gov ANONYMOUS.SOFTWARE Note: These files must be transferred in binary or IMAGE, not ASCII, mode. The documents can also be downloaded from the VistA Documentation Library (VDL) Web page in both Acrobat PDF and MS-Word DOC formats: http://www.va.gov/vdl/application.asp?appid=16 Associated Remedy Ticket(s): ============================ There are no associated Remedy Tickets. Associated New Service Request (NSR): ===================================== There is no associated NSR with the patch. Test Sites: =========== Altoona North Texas Phoenix NOTE: If you run ^XINDEX on routine MPIFA24, a reference to OMGPIDMI is displayed as a routine that is not available on your system and that is correct. This relates only to the Federal Health Information Exchange (FHIE) Framework system. This reference was introduced in an earlier patch - MPIF*1.0*25. Installation Instructions: ========================== This patch takes less than 2 minutes to install. This patch should be loaded during non-peak hours to minimize disruption to the users since heavily-used Registration options will be out of order. 1. Users are allowed on the system during patch installation. 2. The HL7 incoming filers should be stopped. Use the Monitor, Start, Stop Filers [HL FILER MONITOR] option on the Filer and Link Management Options [HL MENU FILER LINK MGT] menu on the HL7 Main Menu [HL MAIN MENU]. 3. Use the INSTALL/CHECK MESSAGE option on the PackMan menu. Note: TEXT PRINT/DISPLAY option in the PackMan menu will display the patch text only. 4. From the Kernel Installation and Distribution System Menu, select the Installation menu. 5. From this menu, you may elect to use the following options: (when prompted for INSTALL NAME, enter MPIF*1.0*52): a. Compare Transport Global to Current System - this option will allow you to view all changes that will be made when the patch is installed. It compares all components of the patch (routines, DDs, templates, etc.). b. Verify Checksums in Transport Global - this option will allow you to ensure the integrity of the routines that are in the transport global. c. Print Transport Global - this option will allow you to view the components of the KIDS build. d. Backup a Transport Global - This option will create a backup message of any routines exported with this patch. It will not backup any other changes such as DD's or templates. 6. Use the Install Package(s) option and select the package MPIF*1.0*52. 7. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//', respond YES (this may disrupt CPRS users, so if your facility has the XQBUILDTREEQUE tasked to run nightly, you can say NO to this question.) 8. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', respond NO. 9. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', respond YES. The following OPTIONS should be disabled during the installation. Register a Patient [DG REGISTER PATIENT] Load/Edit Patient Data [DG LOAD PATIENT DATA] Electronic 10-10EZ Processing [EAS EZ 1010EZ PROCESSING] MPI/PD Exception Handling [RG EXCEPTION HANDLING] Display Only Query [MPIF DISPLAY ONLY QUERY TO MPI] Local/Missing ICN Resolution Background Job [MPIF LOC/MIS ICN RES] UPDATE BATCH JOB FOR HL7 v2.3 [VAFC BATCH UPDATE] 10. After patch installation has completed, restart the HL7 incoming filers. Use the Monitor, Start, Stop Filers [HL FILER MONITOR] option on the Filer and Link Management Options [HL MENU FILER LINK MGT] menu on the HL7 Main Menu [HL MAIN MENU]. Routine Information: ==================== The second line of each of these routines now looks like: ;;1.0; MASTER PATIENT INDEX VISTA ;**[Patch List]**;30 Apr 99;Build 7 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: MPIF002 Before: B28350773 After: B18349548 **20,27,33,43,52** Routine Name: MPIFA24 Before: B21971494 After: B22867722 **22,24,27,31,25,41,39,48,52** Routine Name: MPIFBT3 Before: B22745391 After: B15393291 **1,3,10,17,21,24,28,31,33,35,43,52** Routine Name: MPIFDNL Before: n/a After: B17887652 **52** Routine Name: MPIFQ0 Before: B70311672 After: B71703643 **1,3,8,14,13,16,17,21,20,24, 26,28,31,33,35,38,43,52** Routine Name: MPIFRES Before: B24792139 After: B25044617 **1,7,10,15,17,21,26,28,33,35, 43,39,52** Routine Name: MPIFSA2 Before: B53121126 After: B80384646 **28,29,35,38,43,52** Routine Name: MPIFSA3 Before: B25833370 After: B27819479 **28,31,35,43,52** Routine Name: MPIFSAQ Before: B13238010 After: B24115575 **1,3,8,13,17,21,23,28,35,52** Routine Name: MPIFVTQ Before: B29495992 After: B42786955 **1,9,17,21,23,28,33,35,52** Routine list of preceding patches: 48 ============================================================================= User Information: Hold Date : NOV 30, 2009 Entered By : DAVIS,PAULETTE Date Entered : MAY 08, 2008 Completed By: CHESNEY,CHRISTINE M Date Completed: NOV 30, 2009 Released By : HEUER,CINDY Date Released : NOV 30, 2009 ============================================================================= Packman Mail Message: ===================== $END TXT