============================================================================= Run Date: NOV 26, 2014 Designation: PX*1*201 Package : PX - PCE PATIENT CARE ENCOUNTER Priority: Mandatory Version : 1 SEQ #155 Status: Released Compliance Date: DEC 26, 2014 ============================================================================= Associated patches: (v)PX*1*199 <<= must be installed BEFORE `PX*1*201' Subject: VISTA IMMUNIZATION ENHANCEMENTS 1.0 Category: - Enhancement (Mandatory) - Data Dictionary - Routine - Other Description: ============ ********************************************************************** NOTE: This patch contains updates to the Data Dictionary for several files that are also used by Indian Health Service. In order to maintain compatibility with the Indian Health Service version of these files, fields used by Indian Health Service that will not be used by the Department of Veterans Affairs have been included. In some cases, these fields reference files and/or routines that will not be deployed by the Department of Veterans Affairs. These fields are included with the VA's Database Administrator's approval. ********************************************************************** The Veterans Health Information Systems and Technology Architecture (VistA) Immunizations Enhancements (VIMM) 1.0 project modifies existing immunization files and adds additional files to enable VA to quickly and reliably document and exchange standardized immunization information on beneficiaries across services and departments. Additionally, modifications support Certification for Meaningful Use as well as VistA Evolution requirements. This provides a Veteran patient-centric vaccine record exchangeable with the external community. Clinicians will have access to a more complete medical history in the VistA electronic medical record resulting in improved health status as well as public health monitoring. The goals for the VIMM 1.0 project are to deliver an Initial Operating Capability comprised of standard, interoperable immunization data for exchange with external trading partners based on the modernization of the VistA Patient Care Encounter (PCE) package. This patch provides the following new features: 1) The vaccines in the IMMUNIZATION (#9999999.14) file are standardized to match the Center for Disease Control (CDC)'s table of administered vaccines at http://www2a.cdc.gov/vaccines/iis/iisstandards/vaccines.asp?rpt=cvx. During the post installation, records in the IMMUNIZATION file are modified and new immunization records are added to mirror entries from the CDC table. Existing records are assigned a Vaccine Administered (CVX) code. CVX codes are developed and maintained by the CDC. They identify the type of vaccine product used. A new field (CLASS) has been added to identify each record as NATIONAL or LOCAL. Only records with a CLASS of NATIONAL are selectable. The NAME and INACTIVE FLAG of NATIONAL records will be updated to match the CDC Standard. Other CDC information has been added to the record for future use. There may be more than one record with the same CVX code. A record is selected as the standard based on the following selection rules: o An entry that does not have the INACTIVE FLAG marked will be given precedence over an entry that is marked INACTIVE. o An entry that was distributed nationally with the immunization package will be given precedence over an entry that was created locally. o An entry that was created in the VistA instance where this patch is being installed will be given precedence over an entry imported from another VAMC. o ACTION/RECOMMENDATION: In order to guide the program to selecting a facility's choice on which of two conflicting entries for the same CVX code will be marked as NATIONAL, for any entries in the IMMUNIZATION file that represent the same concept, mark all except one of them as INACTIVE. If a record is not the standard, the CLASS will be set to LOCAL and (HISTORICAL) will be appended to the name. The INACTIVE FLAG will be set to INACTIVE. 2) Data stored in the DIAGNOSIS (#.08) field in the V IMMUNIZATION (#9000010.11) file are moved to a new field, PRIMARY DIAGNOSIS (#1304). This field is blank in most records. Values stored in DIAGNOSIS 2 (#.09), DIAGNOSIS 3 (#.1), DIAGNOSIS 4 (#.11), DIAGNOSIS 5 (#.12), DIAGNOSIS 6 (#.13), DIAGNOSIS 7 (#.14) and DIAGNOSIS 8 (#.15) are moved to the multiple OTHER DIAGNOSES (#3). 3) The options, PXTT EDIT IMMUNIZATIONS and PXTT IN/ACTIVATE IMMUNIZATION have been placed out of order. Future updates to the IMMUNIZATION file will be provided in the short term by patches. In the long term the IMMUNIZATION file will be maintained by the Master File Server. 4) Indian Health Service (IHS) fields have been included in the files for this patch for purposes of code convergence, even though the VA does not use them. Of those fields, the following point to files or call routines that are included in the IHS Resource and Patient Management System (RPMS) but not in VistA: File Name (Number) Field Name (Number) IHS File/Routine ------------------ ------------------- ---------------- V IMMUNIZATION (#9000010.11) VAC ELIGIBILITY (#.14) BI TABLE ELIGIBILITY CODES (#9002084.83) NDC (#.16) BI TABLE NDC CODES (#9002084.95) IMMUNIZATION (#9999999.14) VACCINE GROUP (SERIES BI TABLE VACCINE GROUP TYPE) (#.09) (SERIES TYPE) (#9002084.93) BRAND #1 (#1.01) BIUTL5 BRAND #2 (#1.03) BIUTL5 BRAND #3 (#1.05) BIUTL5 BRAND #4 (#1.07) BIUTL5 BRAND #5 (#1.09) BIUTL5 IMMUNIZATION LOT (#9999999.41) NDC CODE (#.17) BI TABLE NDC CODES (#9002084.95) Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- VACCINE INFORMATION STATEMENT (#920) NAME (#.01) New EDITION DATE (#.02) New EDITION STATUS (#.03) New LANGUAGE (#.04) New VIS TEXT (#2) New REPLACED BY VHA STANDARD TERM (#99.97) New MASTER ENTRY FOR VUID (#99.98) New VUID (#99.99) New EFFECTIVE DATE/TIME (multiple field #99.991, sub-file #920.99) New EFFECTIVE DATE/TIME (#.01) of the EFFECTIVE DATE/TIME sub-file (#920.99) New STATUS (#.02) of the EFFECTIVE DATE/TIME sub-file (#920.99) New VIS URL (#101) New IMMUNIZATION INFO SOURCE (#920.1) SOURCE (#.01) New HL7 CODE (#.02) New STATUS (#.03) New IMM ADMINISTRATION ROUTE (#920.2) ROUTE (#.01) New HL7 CODE (#.02) New NCIT (#.03) New IMM ADMINISTRATION SITE (BODY) (#920.3) SITE (#.01) New HL7 CODE (#.02) New V IMMUNIZATION (#9000010.11) IMMUNIZATION (#.01) Modified PATIENT NAME (#.02) Modified VISIT (#.03) Modified SERIES (#.04) Modified LOT (#.05) ) New REACTION (#.06) New CONTRAINDICATED (#.07) Modified DIAGNOSIS (#.08) Deleted DIAGNOSIS 2 (#.09) Deleted DIAGNOSIS 3 (#.1) Deleted DIAGNOSIS 4 (#.11) Deleted DIAGNOSIS 5 (#.12) Deleted DIAGNOSIS 6 (#.13) Deleted DIAGNOSIS 7 (#.14) Deleted DIAGNOSIS 8 (#.15) Deleted DOSE OVERRIDE (#.08) New INJECTION SITE (#.09) New VOLUME (#.11) New DATE OF VAC INFO STATEMENT (#.12) New CREATED BY V CPT ENTRY (#.13) New VAC ELIGIBILITY (#.14) New IMPORT FROM OUTSIDE REGISTRY (#.15) New NDC (#.16) New ADMINISTRATIVE NOTES (#1) New VIS OFFERED/GIVEN TO PATIENT (multiple field #2, sub-file #9000010.112) New VIS OFFERED/GIVEN TO PATIENT (#.01) of the VIS OFFERED/GIVEN TO PATIENT sub-file (#9000010.112) New DATE VIS OFFERED/GIVEN (#.02) of the VIS OFFERED/GIVEN TO PATIENT sub-file (#9000010.112) New OTHER DIAGNOSIS (multiple field #3, sub-file #9000010.113) New OTHER DIAGNOSIS (#.01) of the OTHER DIAGNOSIS sub-file (#9000010.113) New REMARKS (#1101) New EVENT DATE AND TIME (#1201) Modified ORDERING PROVIDER (#1202) Modified CLINIC (#1203) New ENCOUNTER PROVIDER (#1204) Modified DATE/TIME RECORDED (#1205) New IMMUNIZATION DOCUMENTER (#1206) New LOT NUMBER (#1207) New PARENT (#1208) New EXTERNAL KEY (#1209) New OUTSIDE PROVIDER NAME (#1210) New ANCILLARY POV (#1213) New USER LAST UPDATE (#1214) New ORDERING LOCATION (#1215) New DATE/TIME ENTERED (#1216) New ENTERED BY (#1217) New DATE/TIME LAST MODIFIED (#1218) New LAST MODIFIED BY (#1219) New EVENT INFORMATION SOURCE (#1301) New ROUTE OF ADMINISTRATION (#1302) New SITE OF ADMINISTRATION (BODY) (#1303) New PRIMARY DIAGNOSIS (#1304) New DOSAGE (#1305) New SNOMED CT (multiple field #2601, sub-file #9000010.1126) New SNOMED CT (#.01) of the SNOMED CT sub-file (#9000010.1126) New SNOMED PREFERRED TERM (#.019) of the SNOMED CT sub-file (#9000010.1126) New LOINC CODES (multiple field #2701, sub-file #9000010.1127) New LOINC CODES (#.01) of the LOINC CODES sub-file (#9000010.1127) New LOINC TEXT (#.019) of the LOINC CODES sub-file (#9000010.1127) New EDITED FLAG (#80101) Modified AUDIT TRAIL (#80102) Modified COMMENTS (#81101) Modified VERIFIED (#81201) Modified PACKAGE (#81202) Modified DATA SOURCE (#81203) Modified IMM MANUFACTURER (#9999999.04) NAME (#.01) New MVX CODE (#.02) New STATUS (#.03) New FULL NAME (#.04) New SYNONYM #1 (#.05) New REPLACED BY VHA STANDARD TERM (#99.97) New MASTER ENTRY FOR VUID (#99.98) New VUID (#99.99) New EFFECTIVE DATE/TIME (multiple field #99.991, sub-file #9999999.0499) New EFFECTIVE DATE/TIME (#.01) of the EFFECTIVE DATE/TIME sub-file (#9999999.0499) New STATUS (#.02) of the EFFECTIVE DATE/TIME sub-file (#9999999.0499) New CDC NOTES (#201) New VACCINE (multiple field #1101, sub-file #9999999.0411) New VACCINE (#.01) of the VACCINE sub-file (#9999999.0411) New MNEMONIC (#8801) New IMMUNIZATION (#9999999.14) NAME (#.01) Modified SHORT NAME (.02) Modified CVX (#.03) New DEFAULT LOT # (.04) New MAX # IN SERIES (#.05) Modified CHILDHOOD IMMUNIZATION (#.06) New INACTIVE FLAG (#.07) Modified SKIN TEST (#.08) New VACCINE GROUP (SERIES TYPE) (#.09) New ALTERNATE SHORT NAME (#.1) New CPT CODE (#.11) New RELATED CONTRAIND HL7 CODES (#.12) New VIS DEFAULT DATE (#.13) New ICD DIAGNOSIS CODE (#.14) New ICD PROCEDURE CODE (#.15) New INCLUDE IN FORECAST (#.16) New INCLUDE IN VAC ACCOUNT REPORT (#.17) New DEFAULT VOLUME (#.18) New COMBINATION IMMUNIZATION (Y/N) (#.2) New COMPONENT #1 (#.21) New COMPONENT #2 (#.22) New COMPONENT #3 (#.23) New COMPONENT #4 (#.24) New COMPONENT #5 (#.25) New COMPONENT #6 (#.26) New BRAND #1 (#1.01) New BRAND #2 (#1.03) New BRAND #3 (#1.05) New BRAND #4 (#1.07) New BRAND #5 (#1.09) New FULL NAME (#1.14) New CPT CODE 2ND (#1.15) New CDC FULL VACCINE NAME (#.01) of the CDC FULL VACCINE NAME sub-file (#9999999.142) New CODING SYSTEM (#.01) of the CODING SYSTEM sub-file (#9999999.143) New CODE (#.01) of the CODE sub-file (#9999999.1431) of the CODING SYSTEM sub-file (#9999999.143) New VACCINE INFORMATION STATEMENT (#4) New CDC PRODUCT NAM (#5) New SYNONYM (#.01) of the SYNONYM sub-file (#9999999.141) New REPLACED BY VHA STANDARD TERM (#99.97) New MASTER ENTRY FOR VUID (#99.98) New VUID (#99.99) New EFFECTIVE DATE/TIME (multiple field #99.991, sub-file #9999999.1499) New EFFECTIVE DATE/TIME (#.01) of the EFFECTIVE DATE/TIME sub-file (#9999999.1499) New STATUS (#.02) of the EFFECTIVE DATE/TIME sub-file (#9999999.1499) New CLASS (#100) New MNEMONIC (#8801) Modified ACRONYM (#8802) New SELECTABLE FOR HISTORIC (#8803) New IMMUNIZATION LOT (#9999999.41) LOT NUMBER (#.01) New MANUFACTURER (#.02) New STATUS (#.03) New VACCINE (#.04) New VACCINE #2 (#.05) New VACCINE #3 (#.06) New VACCINE #4 (#.07) New VACCINE #5 (#.08) New EXPIRATION DATE (#.09) New STARTING COUNT (#.11) New DOSES UNUSED (#.12) New VACCINE SOURCE (#.13) New HEALTH CARE FACILITY (#.14) New LOW SUPPLY ALERT (#.15) New LOT NUMBER FOR EXPORT (#.16) New NDC CODE (#.17) New NDC CODE (VA) (#.18) New 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 ----------- ---- -------------------- PXTT EDIT IMMUNIZATIONS Edit Modified PXTT IN/ACTIVATE IMMUNIZATION Edit Modified Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Additional Information: N/A New Service Requests (NSRs): ---------------------------- N/A Patient Safety Issues (PSIs): ----------------------------- N/A Blood Bank Clearance: --------------------- N/A Remedy Ticket(s) & Overview: ---------------------------- N/A Test Sites: ---------- Cleveland, OH Hampton, VA Heartland-East HCS, MO San Antonio, TX Documentation Retrieval Instructions: ------------------------------------- Updated documentation describing the new functionality introduced by this patch is available. The preferred method is to FTP the files from ftp://download.vista.domain.ext/. This transmits the files from the first available FTP server. Sites may also elect to retrieve software directly from a specific server as follows: Albany ftp.domain.ext Hines ftp.domain.ext Salt Lake City ftp.domain.ext Documentation can also be found on the VA Software Documentation Library at: http://www4.domain.ext/vdl/ Title File Name FTP Mode ------------------------------------------------------------- Patient Care Encounter (PCE) PXUM.PDF (binary) V. 1.0 User Manual Patient Care Encounter (PCE) PXTM.PDF (binary) V.1.0 Technical Manual Patch Installation: Pre/Post Installation Overview: ------------------------------- This patch will run a brief pre-installation process that will check for invalid entries in the IMMUNIZATION file (#9999999.14) and will delete field definitions for replaced fields in the V IMMUNIZATION file (#9000010.11). A post-installation process will standardize data in the IMMUNIZATION file (#9999999.14) and will move data from exiting diagnosis fields in the V IMMUNIZATION file (#9000010.11) to new fields. The routine, PXVP201, may be deleted after the patch is successfully installed. Pre-Installation Instructions: ------------------------------ N/A Installation Instructions: -------------------------- This patch should be installed during a period of minimal system activity, preferably with users off the system. Installation time is expected to be approximately 10 minutes. This patch is available via FTP as a KIDS distribution file. The Host File is named PX_1_201.KID and should be downloaded in ASCII format. The file is located in the [ANONYMOUS.SOFTWARE] directory of the following OI Field Offices. PREFERRED ADDRESS ----------------- First available ftp server download.vista.domain.ext SPECIFIC FIELD OFFICE FTP ADDRESS --------------------- ----------- Albany ftp.domain.ext Hines ftp.domain.ext SLC ftp.domain.ext 1. Load the KIDS distribution file via the 'Load a Distribution' option on the KIDS Installation menu. 2. Prior to installing the patch use the following installation options located on the KIDS Installation menu: a. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. b. 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, DD's, templates, etc.). c. 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. 3. Install the KIDS distribution via the 'Install Package(s)' option on the KIDS Installation menu. For the Install Name enter PX*1.0*201. a. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//' Answer NO. b. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO// Answer NO. c. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//' Answer NO. 4. Verify the status of the installation. An email message is sent to the installer at the end of the installation indicating whether the installation was successful. Please enter a Remedy ticket if the installation failed. Post-Installation Instructions: ------------------------------- N/A Routine Information: ==================== The second line of each of these routines now looks like: ;;1.0;PCE PATIENT CARE ENCOUNTER;**[Patch List]**;Aug 12, 1996;Build 41 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PXCEAE1 Before: B16220510 After: B23079983 **22,73,199,201** Routine Name: PXCEVFI4 Before: B26873797 After: B28425692 **124,203,199,201** Routine Name: PXCEVIMM Before: B31390321 After: B56314311 **27,124,199,201** Routine Name: PXKFIMM Before: B2638532 After: B2843857 **22,124,201** Routine Name: PXVP201 Before: n/a After: B70774804 **201** Routine Name: PXVPST01 Before: n/a After: B4321227 **201** Routine Name: PXVUTIL Before: n/a After: B3032993 **201** ============================================================================= User Information: Entered By : Date Entered : APR 14, 2014 Completed By: Date Completed: NOV 26, 2014 Released By : Date Released : NOV 26, 2014 ============================================================================= Packman Mail Message: ===================== No routines included