============================================================================= Run Date: SEP 04, 2014 Designation: OR*3*385 Package : OR - ORDER ENTRY/RESULTS REPORTING Priority: Mandatory Version : 3 SEQ #347 Status: Released Compliance Date: OCT 30, 2014 ============================================================================= Associated patches: (v)PXRM*2*26 <<= must be installed BEFORE `OR*3*385' (v)OR*3*361 <<= must be installed BEFORE `OR*3*385' Subject: CPRS GUI v30.A Category: - Routine - Enhancement (Mandatory) Description: ============ IMPORTANT INFORMATION: Please read the Overview Guide (ICD-10_PROD_OVERVIEW_GUIDE_GROUPS_5_6_7.pdf) posted on the Anonymous directory or specified FTP directory for installation order. This is critical for proper functionality of the ICD-10 Software. This patch contains the ICD-10 project enhancements for the Computerized Patient Records System CPRSv30.A project. This project will modify CPRS, TIU, GMRC, GMTS, GMPL, PXRM, and OERR to meet the requirements proposed by the Dept. of Health and Human Services to adopt ICD-10 code set standards. Please see the CPRS GUI v30.A Release Notes for a summary of the changes and enhancements. On January 16, 2009, the Centers for Medicare & Medicaid Services (CMS) released a final rule for replacing the 30-year-old ICD-9-CM code set with International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) and International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) with dates of service, or date of discharge for inpatients, that occur on or after the industry activation date. The classification system consists of more than 68,000 codes, compared to approximately 13,000 ICD-9-CM codes. There are nearly 87,000 ICD-10-PCS codes, while ICD-9-CM has nearly 3,800 procedure codes. Both systems also expand the number of characters allotted from five and four respectively to seven alpha-numeric characters. This value does not include the decimal point, which follows the third character for the ICD-10-CM code set. There is no decimal point in the ICD-10-PCS code set. These code sets have the potential to reveal more about quality of care, so that data can be used in a more meaningful way to better understand complications, better design clinically robust algorithms, and better track the outcomes of care. ICD-10-CM also incorporates greater specificity and clinical detail to provide information for clinical decision making and outcomes research. NOTE: Functionality specific to activation of the ICD-10 code set shall not be seen by end users until the code set has been activated. CPRS GUI v30.A consists of one host file, an updated CPRS GUI, and several Help files, too many to list (which will be located in a directory named HELP): 1. OR_30_385.KID 2. CPRSChart.exe 3. CPRS_30A_Help.zip (HELP Directory of files) To see the current status and target dates for Sites/VISN/Regions please refer to the following site: http://vaww.oed.portal.domain.ext/projects/CPRS/v30/30a/Public/Deployment/CPRS v30a Deployment Schedule.xlsx Patch Components ================ Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- N/A Forms Associated: Form Name File # New/Modified/Deleted --------- ------ -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- OR CPRS GUI CHART Broker Modified Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- ORC COMMENT PROBLEM Modified Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Additional Information: New Service Requests (NSRs) ---------------------------- NSR 20070902, ICD-10-CM Conversion Patient Safety Issues (PSIs) ----------------------------- N/A Remedy Ticket(s) & Overview --------------------------- N/A Problem: ------- 1. With ICD-10 activation, users were unable to annotate an existing problem with an inactive ICD-9 code without having to update/change the problem to a SNOMED CT equivalent term first on the Problems tab (whether date is before/after Oct 1, 2015). 2. Detroit reported a IS NOT A VALID FLOATING POINT VALUE error in IOC test of the Group Notes (GN) app. It appears that this error is due to some missing RPCs (ORWGN IDTVALID & ORWGN MAXFRQ) that failed to get registered on the OR CPRS GUI CHART option in patch OR*3*353 T8. 3. With ICD-9 active, when a user selects a SNOMED CT (SCT)/ICD-9 problem from their pick/selection list to add to the Problem list, the system saves and stores the SCT Designation code as the Concept code which is incorrect. This is displayed incorrectly as well on the Problem list. Problems are being incorrectly flagged ("#" indicator) with an inactive SCT code due to the incorrect designation code association. 4. When selecting the ICD-9 diagnosis code V65.49 from the TELEPHONE DIAGNOSES section of the National Telephone encounter form dialog, the selected diagnosis code does not appear under the Selected Diagnoses section for confirmation of selection. This issue only occurs when the user tries to select a diagnosis which has similar codes but different descriptions and are listed sequentially on the form. In the reported scenario, the user tried to select one or both of the V65.49 codes which were listed sequentially after one another with two different descriptions, COUNSELING W/OUT SICKNESS and HEALTH ADVICE INSTRUCTIONS. As a result the selected diagnoses did not appear under the Selected Diagnoses section of the dialog. Resolution: ---------- 1. The restriction has been removed so that users can now annotate any problem regardless of the current active coding system and without having to update the problem first. 2. CPRS will register and export the two GN RPC's on the GUI CHART option for GN. IOC GN sites will no longer have to manually register the RPC's with every CPRS GUI iteration install. 3. This has been resolved so that the correct SCT concept and designation codes are retrieved, saved, and stored appropriately when adding a SCT problem from a user selection list. 4. This bug has been resolved so that upon selection of an ICD-9 diagnosis (which has similar codes but different descriptions and are sequentially listed) on the encounter form dialog, it will appear under the Selected Diagnoses section of the dialog. Test Sites: =========== Denver, CO Detroit, MI Dublin, GA Orlando, FL Documentation and Software Retrieval: ===================================== The following documents can be downloaded from the FTP address as directed by the CPRS Implementation team. The updated documentation associated with this patch is: File Name Contents --------- -------- CPRSGUITM.DOC CPRS GUI Technical Manual (Word version) CPRSGUITM.PDF CPRS GUI Technical Manual CPRSGUIUM.DOC CPRS GUI User Manual (Word version) CPRSGUIUM.PDF CPRS GUI User Manual OR_30_385_IG.DOC CPRS GUI v30.A Installation Guide (Word Version) OR_30_385_IG.PDF CPRS GUI v30.A Installation Guide OR_30_385_RN.DOC CPRS GUI v30.A Release Notes (Word Version) OR_30_385_RN.PDF CPRS GUI v30.A Release Notes ICD-10_PROD_OVERVIEW ICD-10 Production Overview Guide Groups 5-7 _GUIDE_GROUPS_5_6_7.pdf CPRS documentation can also be found in the VA Software Document Library: http://www.domain.ext/vdl. Sites will retrieve VistA software from an FTP address as directed by the CPRS Implementation team. Installation instructions will be distributed when your site begins the implementation process. The software distribution includes: File Name Contents Retrieval Format --------- -------- ---------------- OR_30_385.ZIP CPRSCHART.EXE Binary CPRS_30A_Help.ZIP HELP Directory Binary CPRS_30A.MSP GUI Installer Binary (*This is the generic MSP filename. Specific filenames will differ depending on the site it is targeted for.) OR_30_385_SRC.ZIP CPRS v30.A Source Binary OR_30_385.KID KIDS Build Ascii Patch Installation: =================== Installation Overview --------------------- N/A Pre-installation Instructions ----------------------------- There are no pre-install steps for this patch. Installation Instructions ------------------------- This patch may be installed with users on the system although it is recommended that it be installed during non-peak hours to minimize potential disruption to users. This patch should take less than 5 minutes to install. 1. Download the OR_30_385.KID file from the appropriate FTP Server to a directory on your system. 2. Use the LOAD A DISTRIBUTION option on the KIDS INSTALLATION menu, and enter: [DIR:]OR_30_385.KID, where [DIR:] is the local directory where you have stored the host file. 3. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, you may elect to use the following option. When prompted for the INSTALL enter the patch #: OR*3.0*385. a. Print Transport Global - This option lets you print the contents of a Transport Global that is currently loaded in the ^XTMP global. b. 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 DDs or templates. c. Compare Transport Global to Current System - This option will allow you to view all changes that will be made when this patch is installed. It compares all components of this patch (routines, DDs, templates, etc.). d. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. 4. From the Installation Menu, select the Install Package(s) option and choose the patch to install: OR*3.0*385. 5. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//' Answer 'NO' 6. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//' Answer 'YES' 7. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//' Answer 'NO' 8. If prompted "Delay Install (Minutes): (0 - 60): 0//" Respond 0. Post-Installation Instructions ------------------------------ N/A Routine Information: ==================== The second line of each of these routines now looks like: ;;3.0;ORDER ENTRY/RESULTS REPORTING;**[Patch List]**;Dec 17, 1997;Build 13 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ORCPROB Before: B26200127 After: B24954470 **27,48,181,385** Routine Name: ORQQPL Before: B30115835 After: B32815951 **9,10,85,173,306,361,385** Routine Name: ORQQPL1 Before: B97265691 After: B93536539 **10,85,148,173,203,206,249, 243,280,306,361,385** Routine Name: ORQQPL3 Before: B68312739 After: B77595608 **10,148,173,243,280,306,361,385** Routine Name: ORWLEX Before: n/a After: B8576655 **385** Routine Name: ORWPCE Before: B60062605 After: B64200861 **10,85,116,173,190,195,215, 243,295,280,306,361,385** Routine Name: ORWPCE3 Before: B58956270 After: B60736821 **10,85,116,190,280,306,371,361,385** Routine list of preceding patches: 181, 361 ============================================================================= User Information: Hold Date : SEP 04, 2014 Entered By : Date Entered : NOV 19, 2013 Completed By: Date Completed: AUG 25, 2014 Released By : Date Released : SEP 04, 2014 ============================================================================= Packman Mail Message: ===================== No routines included