============================================================================= Run Date: SEP 29, 2022 Designation: PX*1*217 Package : PX - PCE PATIENT CARE ENCOUNTER Priority: Mandatory Version : 1 SEQ #175 Status: Released Compliance Date: DEC 16, 2022 ============================================================================= Associated patches: (c)OR*3*405 install with patch `PX*1*217' (v)PX*1*199 <<= must be installed BEFORE `PX*1*217' (v)XU*8*657 <<= must be installed BEFORE `PX*1*217' (v)PX*1*211 <<= must be installed BEFORE `PX*1*217' Subject: CPRS V32B - PCE IMMUNIZATION AND SKIN TEST ENHANCEMENTS Category: - Data Dictionary - Routine - Enhancement (Mandatory) - Other Description: ============ This patch is part of the Computerized Patient Record System (CPRS) v32B updates. Below is a list of all the applications involved in this project along with their patch numbers: APPLICATION/VERSION PATCH --------------------------------------------------------------- TEXT INTEGRATION UTILITIES v1.0 TIU*1.0*289 OUTPATIENT PHARMACY v7.0 PSO*7.0*441 CLINICAL REMINDERS v2.0 PXRM*2.0*65 ADVERSE REACTION TRACKING v4.0 GMRA*4.0*51 HEALTH SUMMARY v2.7 GMTS*2.7*115 PCE PATIENT CARE ENCOUNTER v1.0 PX*1.0*217 BAR CODE MEDICATION ADMINISTRATION v3.0 PSB*3.0*93 ORDER ENTRY/RESULTS REPORTING v3.0 OR*3.0*405 INPATIENT MEDICATIONS v5.0 PSJ*5.0*399 MENTAL HEALTH v5.01 YS*5.01*211 PHARMACY DATA MANAGEMENT v1.0 PSS*1.0*187 KERNEL v8.0 XU*8.0*662 PSS*1.0*187 and XU*8.0*662 are being released as host files, but they will not be included in the multi-package build. The remaining patches are being released in the KIDS multi-package build CPRS V32B COMBINED BUILD 1.0. This patch adds the following features: - Adds and updates Remote Procedure Calls (RPCs) to support the Computerized Patient Record System (CPRS) Veterans Health Information Systems and Technology Architecture (VistA) Immunizations Enhancements (VIMM). - Adds support for recording immunization readings (for smallpox) via the DATA2PCE^PXAPI Application Programming Interface (API). - Adds support to record skin tests in two linked records. When the patient first comes in to get tested, it will record a "placement" V Skin Test entry. A few days later, when the patient comes in again for the reading, a "reading" V Skin Test entry will get created that will be linked to the "placement" entry. Health Summaries and Clinical Reminders will treat the placement and reading entries as one record. - When recording a skin test reading, the system will auto file the CPT code configured in the PXV SKIN TEST READING CPT parameter. - When deleting a V Immunization record for a patient, don't delete the linked ICD-10 code (V POV entry) unless there are no more immunizations for the Visit. - Update the option, Immunization Lot Add/Edit/Display [PXTT EDIT IMMUNIZATION LOT], to support transferring immunization inventory between divisions on the same system. Also, when printing the immunization inventory report, include the initials of the user who first set the lot to active. - Add an option, PCE File Inquiry [PXTT FILE INQUIRY], to allow a user to lookup an entry from one of the PCE source files. - Add an option, Edit Sequence for Immunization Forms [PXV EDIT SEQUENCE], to allow a user to configure the following parameters: PXV INFO SOURCE SEQUENCE, PXV CONTRA SEQUENCE, PXV REFUSAL SEQUENCE. These parameters control the order that these entries will display in forms. - Create ability for individual immunizations to be mapped to their own CPT administration codes (to support COVID). - Pre-populate the IMM DEFAULT RESPONSES file (920.05) with immunization defaults for route, dose, and dose units. - Add the capability to define defaults for when an immunization contraindication/precaution/refusal reason should expire. The initial defaults will be pre-populated by this patch. - Enable the "low stock" immunization inventory alerts. When documenting a VA-administered immunization, if that administration causes the total active doses remaining for that immunization to fall below the threshold, send out an email to the PXV IMM INVENTORY MGR key holders and the PXV IMM INVENTORY ALERTS mail group. The parameter PXV IMM INVENTORY ALERTS can be set to disable the sending of the "low stock" message. - This patch creates RPCs to support Clinical Decision Support (CDS) by making web service calls to the Immunization Calculation Engine (ICE) server. This new ICE functionality will be dormant and not enabled. The new ICE options, PX ICE WEB ENABLE/DISABLE and PX ICE WEB UPDATE CACHE will be marked as out of order. - Replaced the API ENCEVENT^PXAPI, with a faster version, it runs in approximately 0.6 the time of the original version. - The ScreenMan forms for Education Topics, Exams, and Health Factors were modified so that only national data elements can be mapped to standard codes. - Several changes were made to how a measurement is defined. The fields PROMPT CAPTION and UCUM DISPLAY were added. PROMPT CAPTION is displayed when the data element is used in a Reminder Dialog. UCUM DISPLAY is a set of codes that controls how the units are displayed in CPRS, Clinical Reminders Maintenance output, and Health Summary. The ScreenMan forms were modified to include these fields. Also, all of the fields defining a measurement must be defined or none of them defined. This applies to Education Topics, Exams, and Health Factors. - The API DATA2PCE was enhanced for measurements. When measurement data is passed, it is validated to make sure it is within the defined range, if problems are found, error messages describing the problem are returned. - The PCE encounter List Manager interface was modified improve editing and entry of measurements. - A problem was discovered where third party software was saving a Visit with a Service Category of "HF". This value is incorrect and causing problems in PCE. While this issue has stopped back in 2020, the patch post-install will kick off a background task that will update those past incorrect entries. Those entries that have a incorrect Service Category of "HF" will be changed to "H". Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- IMM DEFAULT RESPONSES (920.05) IMMUNIZATION Multiple NON-STANDARD DOSE UNITS New (920.051) (1314) CONTRA/REFUSAL CONTRA/REFUSAL (.01) New Multiple (920.052) WARN UNTIL DAYS (.02) New PX ICE WEB SERVER NAME (.01) New (920.75) PROTOCOL (1) New SERVER (2) New PORT (3) New SERVICE NAME (4) New VERSION (5) New SUFFIX (6) New METHOD (7) New URL (8) New PX ICE SERVER STATUS STATUS (.01) New (920.76) ACTIVITY Multiple DATE/TIME (.01) New (920.761) USER (.02) New STATUS (.03) New PX ICE MESSAGE ELEMENT (.01) New (920.77) PARENT ELEMENT (.02) New SORT ORDER (.03) New MODIFIER (.04) New BUILD LOGIC (1) New PRE-CONTENT (2) New CONTENT (3) New POST-CONTENT (4) New V IMMUNIZATION LOT NUMBER (1207) Modified (9000010.11) ORDERED BY POLICY (1222) New V SKIN TEST PLACEMENT SKIN TEST New (9000010.12) (1208) V EXAM MAGNITUDE (200) Modified (9000010.13) V PATIENT ED MAGNITUDE (200) Modified (9000010.16) V HEALTH FACTORS MAGNITUDE (200) Modified (9000010.23) V IMM CONTRA/REFUSAL REFUSED VACCINE GROUP New EVENTS (9000010.707) (1205) EDUCATION TOPICS PROMPT CAPTION New (9999999.09) UCUM DISPLAY New EXAM PROMPT CAPTION New (9999999.15) UCUM DISPLAY New IMMUNIZATION LOT STATUS (.03) Modified (9999999.41) EFFECTIVE DATE/TIME EFFECTIVE DATE/TIME (.01) New Multiple (9999999.411) USER (.02) New STATUS (.03) New HEALTH FACTORS PROMPT CAPTION New (9999999.64) UCUM DISPLAY New Forms Associated: Form Name File Number New/Modified/Deleted --------- ----------- ------------------- PX EDUCATION TOPIC EDIT 9999999.09 Modified PX EDUCATION TOPIC EDIT NCM 9999999.09 Modified PX EXAM EDIT 9999999.15 Modified PX EXAM EDIT NCM 9999999.15 Modified PX HEALTH FACTOR EDIT 9999999.64 Modified PX HEALTH FACTOR EDIT NCM 9999999.64 Modified Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- PXV IMM INVENTORY ALERTS New Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- PX EDU MEASUREMENT CHECK/FIX Routine New PX EXAM MEASUREMENT CHECK/FIX Routine New PX HF MEASUREMENT CHECK/FIX Routine New PX MEASUREMENT CHECK/FIX MENU Menu New PX ICE WEB ENABLE/DISABLE Routine New PX ICE WEB UPDATE CACHE Routine New PXTT FILE INQUIRY Routine New PXTT PCE INFORMATION ONLY Menu Modified PXTT TABLE MAINTENANCE Menu Modified PXV EDIT SEQUENCE Routine New PXV SKIN TEST READING CPT Action New Parameter Definitions Associated: Parameter Name New/Modified/Deleted -------------- -------------------- PX ICE WEB DEFAULT SERVER New PX ICE WEB PREFETCH STOP CODES New PXV CONTRA SEQUENCE New PXV IMM INVENTORY ALERTS New PXV INFO SOURCE SEQUENCE New PXV REFUSAL SEQUENCE New PXV SKIN TEST READING CPT New Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Remote Procedures Associated: Remote Procedure Name New/Modified/Deleted --------------------- -------------------- PX ICE WEB New PX SAVE DATA Modified PXRPC SAVE2 New PXVIMM ADMIN CODES Modified PXVIMM ICR LIST Modified PXVIMM IMM DETAILED Modified PXVIMM IMM SHORT LIST Modified PXVIMM VICR EVENTS Modified PXVSK SKIN SHORT LIST Modified PXVSK V SKIN TEST LIST Modified Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Additional Information: ----------------------- The following Bulletins will be sent out: PX ICE INTERFACE DOWN PX ICE INTERFACE RESTORED New Service Requests (NSRs): NSR 20130903 - VistA Immunization Enhancements This request is to support the delivery of standard, interoperable immunization data for exchange with DoD. As of July 2013, in response to strategic decisions made by the Interagency Program Office (IPO), VA and DoD, the direction of the Joint Immunization Capability was altered to allow the VA to move ahead with a development effort to ensure readiness to meet Federated Data Accelerator goals by September 30, 2014. The requirements documented in this request include VA Short Term needs to support VistA Evolution as well as VA Long term needs for complete standardized, interoperable immunization data. Patient Safety Issues (PSIs): N/A Defect Tracking System Ticket(s) & Overview: N/A Test Sites: ----------- Fresno, CA Northern California HCS North Florida / South Georgia HCS Software and Documentation Retrieval Instructions: -------------------------------------------------- Sites may retrieve the software and documentation directly using the deployment download server provided by the CPRS Implementation team. Instructions will be distributed when your site begins the implementation process. After the wave deployment has been completed, the host file will be available at the following location: /srv/vista/patches/SOFTWARE/CPRS_V32B_COMBINED_BUILD.KID Other Software Files: This release also includes other software files. Other software files can be obtained by accessing the URL: https://download.vista.domain.ext/index.html/SOFTWARE after the deployment has been completed. File Name Contents Retrieval Format --------- -------- ---------------- OR_30_405.ZIP CPRSChart.exe BINARY RoboEx32.dll borlndmm.dll CPRSChart.map CRC.TXT YS_MHA_A_XE10.dll HELP Directory OR_30_405_SRC.ZIP CPRS v32B Source BINARY CPRS_V32B_COMBINED_BUILD.KID CPRS V32B COMBINED BUILD ASCII XU_8_662.KID Kernel Changes ASCII PSS_1_187.KID PDM Changes ASCII Documentation describing the new functionality is included in this release. Documentation can be found on the VA Software Documentation Library at: https://www.domain.ext/vdl/. Documentation can also be obtained at https://download.vista.domain.ext/index.html/SOFTWARE. Both the VDL and the SOFTWARE folder will be updated after deployment has been completed. Documentation Title File Name ------------------------------------------------------------- Patient Care Encounter User Manual PXUM.DOCX PXUM.PDF Patient Care Encounter Technical Manual PXTM.DOCX PXTM.PDF Patch Installation: ------------------- Installation Instructions: -------------------------- ***NOTE: Installation of this build MUST NOT be queued.*** Please refer to the "CPRS v32b (OR*3.0*405) Deployment, Installation, Back Out, and Rollback Guide" for installation and set-up information. This document is exported as OR_3_0_405_DIBR.PDF and OR_3_0_405_DIBR.DOCX. Post-Installation Instructions: ------------------------------- Please refer to the "CPRS v32b (OR*3.0*405) Deployment, Installation, Back Out, and Rollback Guide" for installation and partial set-up information. For the remaining setup instructions, please refer to the "Computerized Patient Record System (CPRS) Version 32b Build (OR*3.0*405) Setup and Configuration Guide". This document is exported as OR_3_0_405_SETUP.PDF and OR_3_0_405_SETUP.DOCX. Back-Out/Roll Back Plan: ------------------------ Please refer to the "CPRS v32b (OR*3.0*405) Deployment, Installation, Back Out, and Rollback Guide" for back-out and rollback information, along with risks and criteria for back-out. 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 133 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PXAIHF Before: B9054925 After: B9530251 **45,211,217** Routine Name: PXAIHFV Before: B2220137 After: B3566225 **211,217** Routine Name: PXAIICR Before: B6645954 After: B7472991 **215,211,217** Routine Name: PXAIIMM Before: B17502496 After: B22402329 **45,124,209,210,215,211,217** Routine Name: PXAIPED Before: B8938808 After: B9394551 **45,211,217** Routine Name: PXAIPEDV Before: B1678279 After: B2879942 **211,217** Routine Name: PXAIPRVV Before: B15796718 After: B16757457 **27,186,211,217** Routine Name: PXAISK Before: B11766988 After: B14101699 **45,124,210,211,217** Routine Name: PXAISKV Before: B1477924 After: B5131080 **199,211,217** Routine Name: PXAIVAL Before: B16639730 After: B39771610 **211,217** Routine Name: PXAIXAM Before: B8796529 After: B9321014 **45,211,217** Routine Name: PXAIXAMV Before: B1260682 After: B2461474 **211,217** Routine Name: PXAPI Before: B47756429 After: B48285109 **15,14,27,28,124,164,210,211,217** Routine Name: PXAPIDEL Before: B62219131 After: B88819123 **1,9,22,130,168,197,216,211,217** Routine Name: PXAPIIM Before: B80558091 After:B206158162 **210,215,217** Routine Name: PXAPIIM2 Before: n/a After: B4819770 **217** Routine Name: PXCEHF Before: B15706424 After: B19779487 **27,22,211,217** Routine Name: PXCEICR Before: B18593217 After: B35160143 **215,217** Routine Name: PXCEPED Before: B15287972 After: B19211507 **27,211,217** Routine Name: PXCEPRV Before: B36686640 After: B36348510 **7,27,124,211,217** Routine Name: PXCESK Before: B36345474 After: B82833116 **27,124,162,210,211,217** Routine Name: PXCEVFI1 Before: B82681322 After: B93651409 **23,73,112,136,143,124,184, 185,210,215,216,211,217** Routine Name: PXCEVFI2 Before: B40463216 After: B41595582 **22,73,95,96,124,158,184,215, 211,217** Routine Name: PXCEVIMM Before:B111978919 After:B113524563 **27,124,199,201,210,215,211,217** Routine Name: PXCEXAM Before: B14623291 After: B18674953 **27,211,217** Routine Name: PXDATE Before: B6790282 After: B6911810 **211,217** Routine Name: PXEDUINQ Before: B22377538 After: B23857611 **211,217** Routine Name: PXEDUSM Before: B34287130 After: B36443739 **211,217** Routine Name: PXEXINQ Before: B13752981 After: B14970049 **211,217** Routine Name: PXEXSM Before: B34648427 After: B34026547 **211,217** Routine Name: PXHFINQ Before: B16231400 After: B17520074 **211,217** Routine Name: PXHFSM Before: B38219209 After: B40566783 **211,217** Routine Name: PXINPTR Before: B6202218 After: B6927876 **211,217** Routine Name: PXKENC Before: B30511135 After: B30571715 **15,22,73,108,143,183,210,215, 211,217** Routine Name: PXKENCOUNTER Before: n/a After:B137908547 **217** Routine Name: PXKFICR Before: B1725753 After: B1805450 **215,217** Routine Name: PXKFIMM Before: B5574555 After: B5703900 **22,124,201,209,210,215,216,217** Routine Name: PXKFSK Before: B3471699 After: B3537764 **22,124,210,217** Routine Name: PXKMAIN1 Before: B58789612 After: B57903729 **22,73,124,178,210,216,211,217** Routine Name: PXKMAIN2 Before: B25829818 After: B32558179 **69,186,215,217** Routine Name: PXMEASCF Before: n/a After: B58284529 **217** Routine Name: PXMEASUREMENT Before: n/a After: B15630151 **217** Routine Name: PXPXRM Before:B261436336 After:B205148021 **119,199,210,215,216,211,217** Routine Name: PXPXRM1 Before: B13393609 After: B64573332 **211,217** Routine Name: PXPXRMI2 Before:B138986698 After:B142799893 **119,194,199,211,217** Routine Name: PXRHS03 Before: B59630785 After: B61510472 **13,210,216,217** Routine Name: PXRHS04 Before: B8043318 After: B15131679 **13,206,217** Routine Name: PXRHS05 Before: B11668556 After: B12094016 **13,211,217** Routine Name: PXRHS07 Before: B19973501 After: B20925035 **13,123,211,217** Routine Name: PXRHS08 Before: B10776728 After: B11223796 **13,16,211,217** Routine Name: PXRPC Before:B165397212 After: B58597505 **200,209,210,215,216,211,217** Routine Name: PXRPC1 Before: n/a After:B145942298 **217** Routine Name: PXRRMDR Before: B38033243 After: B38067947 **124,174,168,199,217** Routine Name: PXTTINQ Before: n/a After: B7714542 **217** Routine Name: PXUCUM Before: n/a After: B958221 **217** Routine Name: PXUTIL Before: B20118889 After: B23428822 **211,217** Routine Name: PXVEDIT Before: B16872011 After: B19537877 **210,216,217** Routine Name: PXVINV Before: B28479638 After: B32235861 **210,216,217** Routine Name: PXVP217 Before: n/a After:B209369150 **217** Routine Name: PXVPARS Before: n/a After: B1482480 **217** Routine Name: PXVRESP Before: B3810590 After: B6828533 **215,217** Routine Name: PXVRPC2 Before: B29476719 After: B37054889 **215,217** Routine Name: PXVRPC4 Before:B138502412 After:B172045370 **215,216,217** Routine Name: PXVRPC4A Before: n/a After: B89015051 **217** Routine Name: PXVRPC5 Before: B35949423 After: B78179470 **215,216,217** Routine Name: PXVRPC8 Before: B30970984 After: B68598322 **216,217** Routine Name: PXVTRAN Before: n/a After: B31392917 **217** Routine Name: PXVUTL Before: B4415955 After: B5865943 **210,217** Routine Name: PXVWCCH Before: n/a After: B52699812 **217** Routine Name: PXVWICE Before: n/a After:B101118232 **217** Routine Name: PXVWMSG Before: n/a After: B19283368 **217** Routine Name: PXVWPXML Before: n/a After: B91911086 **217** Routine Name: PXVWSOAP Before: n/a After: B44694318 **217** Routine Name: PXVWSTAT Before: n/a After: B43918458 **217** Routine Name: PXVWVMR Before: n/a After: B8772256 **217** Routine Name: PXVXR Before: B25897576 After: B63935307 **210,216,211,217** Routine Name: PXVZRT Before: B84727294 After: B84774709 **206,215,216,217** Routine list of preceding patches: 211 ============================================================================= User Information: Entered By : Date Entered : AUG 04, 2016 Completed By: Date Completed: SEP 28, 2022 Released By : Date Released : SEP 29, 2022 ============================================================================= Packman Mail Message: ===================== No routines included