============================================================================= Run Date: MAR 06, 2014 Designation: PXRM*2*36 Package : PXRM - CLINICAL REMINDERS Priority: Mandatory Version : 2 SEQ #25 Status: Released Compliance Date: APR 06, 2014 ============================================================================= Associated patches: (v)PXRM*2*24 <<= must be installed BEFORE `PXRM*2*36' Subject: PNEUMOCOCCAL REMINDERS AND WOMEN'S HEALTH TAXONOMY UPDATE Category: - Routine Description: ============ PCV13 (Pneumococcal Conjugate) Vaccine Recommendations ====================================================== For Adults with no Previous Pneumococcal Vaccinations: ------------------------------------------------------ The Advisory Committee on Immunization Practices (ACIP) recommends that adults 19 years of age or older with immunocompromising conditions, functional or anatomic asplenia, CSF leaks, or cochlear implants, and who have not previously received PCV13 or PPSV23, should receive a dose of PCV13 first followed by a dose of PPSV23 at least 8 weeks later. Subsequent doses of PPSV23 should follow current PPSV23 recommendations for high risk adults. Specifically, a second PPSV23 dose is recommended 5 years after the first PPSV23 dose for persons aged 19 through 64 years with functional or anatomic asplenia and for persons with immunocompromising conditions. A second dose of PPSV23 is not recommended for persons 19 through 64 years of age with cochlear implants or CSF leaks. Additionally, those who received one or more doses of PPSV23 before age 65 years for any indication should receive another dose of the vaccine at age 65 years or older if at least 5 years have elapsed since their previous PPSV23 dose. If a dose of PPSV23 was received at age 65 years or later, no additional doses of PPSV23 are recommended. For Adults with Previous Pneumococcal Polysaccharide Vaccinations: ------------------------------------------------------------------ Adults 19 years of age or older with the aforementioned conditions (functional or anatomic asplenia, immunocompromising conditions, or those with CSF leaks or cochlear implants) who have previously received one or more doses of PPSV23 should be given a dose of PCV13 one or more years after the last PPSV23 dose was received. For those who require additional doses of PPSV23, the first such dose should be given no sooner than 8 weeks after PCV13 and at least 5 years since the most recent dose of PPSV23. Associated Remedy Ticket(s): ============================ 1. INC000000894115 - PCV13 (Pneumococcal Conjugate) Vaccine Recommendations 2. INC000000355037 - Missing CPT code in a taxonomy Associated NSR(s): ================== N/A Participating Test Site(s) ========================== VA Northern California HCS VA Northern Indiana HCS VA New York Harbor HCS VA Longbeach HCS REMEDY OVERVIEW: ================ 1. INC000000894115 - PCV13 (Pneumococcal Conjugate) Vaccine Recommendations Problem 1: ---------- The Centers for Disease Control and Prevention Centers for Disease Control and Prevention (CDC) have issued recommendations for PCV13 (Pneumococcal Conjugate) Vaccine. Resolution 1: ------------- This patch, PXRM*2*36, contains two routines, PXRMP36E and PXRMP36I. They are init tasks that add new entries to the REMINDER EXCHANGE (#811.8) file and the contents of these entries are installed during the post-init. These routines can be deleted after the install. They perform the following during installation: 1. Installation Routine: Rename PNEUMOVAX to PNEUMOVAX POLYSACCHARIDE PPSV23 (does not change the short name that displays in CPRS or on Health Summary). Rename the reminder term VA-HIGH RISK FOR PNEUMOCOCCAL DZ to VA-PNEUMOC DZ RISK - HIGH 2. Reminders: LONG TERM STEROID USE (LOCAL) VA-BL PNEUMOC RISK IMMUNOCOMPROMISED VA-PNEUMOCOCCAL IMMUNIZATION PPSV23 VA-PNEUMOCOCCAL IMMUNIZATION PCV13 VA-MHV PNEUMOVAX VA-BL PNEUMOC RECENT CHEMO/IMMUNOSUPPRESSION VA-OB PNEUMOCOCCAL PRIOR VACCINATIONS VA-OB PNEUMOCOCCAL PPSV23 INDICATIONS VA-OB ZOSTER VACCINE DATE VA-OB PNEUMOCOCCAL PCV13 INDICATIONS 3. Dialogs VA-PNEUMOCOCCAL IMMUNIZATION PPSV23 PNEUMOVAX VA-PNEUMOCOCCAL IMMUNIZATION PCV13 PREVNAR 4. Taxonomies VA-PNEUMOC DZ RISK - HIGHEST/NOT IMMUNO COMP VA-PNEUMOC DZ RISK - IMMUNOCOMPROMISED VA-PNEUMOC DZ RISK - HIGH VA-PNEUMOC DZ RISK - CHEMOTHERAPY (includes drug classes and drugs) VA-CERVICAL CA/ABNORMAL PAP VA-MASTECTOMY VA-CERVICAL CANCER SCREEN VA-WH HYSTERECTOMY W/CERVIX REMOVED VA-WH PAP SMEAR SCREEN CODES 5. Immunization: PNEUMOCOCCAL CONJUGATE PCV13 No mnemonic is being sent out 6. Terms STEROIDS - PNEUMOCOCCAL DZ RISK ( LOCAL) VA-PNEUMOC DZ RISK - CHEMO/IMMUNOSUPP DRUGS VA-PNEUMOC DZ RISK - CHEMOTHERAPY VA-PNEUMOC DZ RISK - HIGH VA-PNEUMOC DZ RISK - HIGHEST/NOT IMMUNO COMP VA-PNEUMOC DZ RISK - IMMUNOCOMPROMISED VA-PNEUMOC DZ RISK - LONG TERM STEROIDS VA-PNEUMOC PCV13 CONTRAINDICATION VA-PNEUMOC PCV13 DEFERRALS VA-PNEUMOC PCV13 DX INCORRECT VA-PNEUMOC PCV13 IMMUNIZATION VA-PNEUMOC PCV13 ORDER SUPPRESSION VA-PNEUMOC PCV13 ORDERS VA-PNEUMOC PPSV23 CONTRAINDICATIONS VA-PNEUMOC PPSV23 DEFERRALS VA-PNEUMOC PPSV23 IMMUNIZATION VA-PNEUMOC PPSV23 INCORRECT DIAGNOSIS VA-PNEUMOC PPSV23 ORDER SUPPRESSION VA-PNEUMOC PPSV23 ORDERS 2. INC000000355037 - Missing CPT code in a taxonomy Problem 2: ---------- The VA-WH PAP SMEAR SCREENING reminder has a taxonomy named "VA-WH PAP SMEAR SCREEN CODES". This taxonomy does not have a 88175 CPT code in it. From the CPT manual: 88175: Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thinlayer preparation; screening by automated system, under physician supervision n/a as on clinical lab. Resolution 2: ------------- The 88175 CPT code was added to the taxonomy by the routines PXRMP36E and PXRMP36I. They are init tasks that add new entries to the REMINDER EXCHANGE (#811.8) file and the contents of these entries are installed during the post-init. Build Components: ================= N/A Data Dictionary: ================ N/A Software & Documentation Retrieval Instructions: ================================================ This patch is being distributed as a host file. The name of the host file is PXRM_2_0_36.KID. This file should be downloaded in ASCII format. The preferred method for obtaining these files is to use File Transfer Protocol (FTP) to download them from: ftp://download.vista.domain.ext/. This transmits the files from the first available FTP server. Sites may also elect to retrieve the files directly from a specific server as follows: Albany ftp.domain.ext Hines ftp.domain.ext Salt Lake City ftp.domain.ext The Install and Setup Guide is also available on the above servers. It is available as .pdf format. This file should be downloaded in BINARY format. File Name: Description: Protocol: ========== ============ ========= PXRM_2_0_36_IG.PDF PXRM*2.0*36 Install BINARY and Setup Guide PXRM_2_0_36.KID PXRM*2.0*36 Host File ASCII Documentation can also be found on the VistA Documentation Library (VDL) at: http://www.domain.ext/vdl/ Installation: ============= This patch can be loaded with users on the system. Installation will take ten to fifteen minutes. Refer to the Install and Setup Guide, PXRM_2_0_36_IG.PDF, for complete details. NOTE: DO NOT QUEUE THE INSTALLATION, because this installation asks questions requiring responses and queuing will stop the installation. 1. Use the "Load a Distribution" option on the KIDS installation menu. When prompted to enter a host file type in PXRM_2_0_36.KID 2. On the KIDS menu under the 'INSTALLATION' menu, use the following options, as desired: Print Transport Global Compare Transport Global to Current System Verify checksums in Transport Global Backup a Transport Global 3. On the KIDS menu under the 'INSTALLATION' menu, use the following option to install the patch: Install Package(s) When prompted for INSTALL NAME, use PXRM*2.0*36 4. When prompted "Want KIDS to INHIBIT LOGONs during the install? NO//," respond 'NO'. 5. When prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO// respond 'NO'. 6. After successful installation, the following init routines may be deleted PXRMP36E PXRMP36I Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;CLINICAL REMINDERS;**[Patch List]**;Feb 04, 2005;Build 207 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PXRMP36E Before: n/a After: B1366156 **36** Routine Name: PXRMP36I Before: n/a After: B9403859 **36** ============================================================================= User Information: Entered By : Date Entered : SEP 03, 2013 Completed By: Date Completed: MAR 05, 2014 Released By : Date Released : MAR 06, 2014 ============================================================================= Packman Mail Message: ===================== No routines included