============================================================================= Run Date: JUL 24, 2014 Designation: PXRM*2*26 Package : PXRM - CLINICAL REMINDERS Priority: Mandatory Version : 2 SEQ #27 Status: Released Compliance Date: AUG 24, 2014 ============================================================================= Associated patches: (v)LEX*2*80 <<= must be installed BEFORE `PXRM*2*26' (v)PXRM*2*24 <<= must be installed BEFORE `PXRM*2*26' (v)DG*5.3*862 <<= must be installed BEFORE `PXRM*2*26' (v)GMPL*2*44 <<= must be installed BEFORE `PXRM*2*26' Subject: CLINICAL REMINDERS ICD-10 CHANGES Category: - Enhancement (Mandatory) - Data Dictionary - Routine - Other Description: ============ General Overview: ================= This patch is part of the Computerized Patient Record System CPRSv30 project. This project will modify the Computerized Patient Record System, Text Integration Utilities, Consults, Health Summary, Problem List, Clinical Reminders, and Order Entry/Results Reporting domains to meet the requirements proposed by the Dept. of Health and Human Services to replace the ICD-9 code set with the ICD-10 code set. The Clinical Reminders changes are implemented in a multi-package build that contains DG*5.3*862, GMPL*2.0*44, and PXRM*2.0*26. Detailed information about each of these builds and installation instructions can be found in the Installation Guide: PXRM_2_0_26_IG.PDF. This document can be obtained from one of the anonymous ftp directories or from the VistA Documentation Library: www.domain.ext/vdl. Because this is a multi-package build, it can only be distributed as a host file; no builds are included in the patch messages. The name of the host file is: CR_ICD-10_UPDATE.KID; it can be obtained from one of the anonymous ftp directories. 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. Remedy Tickets: ============== 623745 718406 761925 783078 810582 823815 862866 867073 868728 896951 916079 946668 Test Sites: =========== Miami VA Healthcare System VA Northern California Health Care System Orlando VA Medical Center Software & Documentation Retrieval Instructions: ================================================ The software for this set of patches is not being distributed through the National Patch Module. There is a multi-package build named CLINICAL REMINDERS ICD-10 UPDATE 1.0 which contains the following KIDS builds: DG*5.3*862, GMPL*2.0*44, and PXRM*2.0*26. The associated host file is named CR_ICD-10_UPDATE.KID. 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 CR_ICD-10-UPDATE.ZIP contains the following files: PXRM_2_0_26_IG.PDF PXRM_2_0_26_RN.PDF PXRM_2_0_26_UM.PDF PXRM_2_0_MM.PDF PXRM_2_0_TM.PDF PXRM_INDEX_TM.PDF Documentation can also be found on the VistA Documentation Library (VDL) at: http://www.domain.ext/vdl/ Title File Name FTP Mode ----------------------------------------------------------------------- CLINICAL REMINDERS ICD-10 UPDATE 1.0 CR_ICD-10-UPDATE.KID ASCII Clinical Reminders Patch 26 Installation Guide PXRM_2_0_26_IG.PDF Binary Clinical Reminders Patch 26 Release Notes PXRM_2_0_26_RN.PDF Binary Clinical Reminders User Manual PXRM_2_0_26_UM.PDF Binary Clinical Reminders Manager's Manual PXRM_2_0_MM.PDF Binary Clinical Reminders Technical Manual PXRM_2_0_TM.PDF Binary Clinical Reminders Index Technical Manual PXRM_INDEX_TM.PDF Binary Build Components: ================= Data Dictionary: ================ FILE # NAME ------------------------------------------------------------------------------- 801.41 REMINDER DIALOG 801.45 REMINDER FINDING TYPE PARAMETER 802.4 REMINDER FUNCTION FINDING FUNCTIONS 811.2 REMINDER TAXONOMY 811.4 REMINDER COMPUTED FINDINGS 811.8 REMINDER EXCHANGE Print Template: =============== PXRM COMPUTED FINDING INQUIRY FILE #811.4 SEND TO SITE Input Template: =============== PXRM EDIT ELEMENT FILE #801.41 SEND TO SITE PXRM EDIT GROUP FILE #801.41 SEND TO SITE PXRM EDIT NATIONAL DIALOG FILE #801.41 SEND TO SITE Form: ===== PXRM DIALOG TAXONOMY EDIT FILE #811.2 SEND TO SITE PXRM TAXONOMY CHANGE LOG FILE #811.2 SEND TO SITE PXRM TAXONOMY EDIT FILE #811.2 SEND TO SITE Installation: ============= This patch can be loaded with users on the system, but it should be done during off-hours. The installation time can vary greatly depending on a number of factors, it will take anywhere from ten minutes to three hours. Before carrying out the installation please read the Clinical Reminders Patch 26 Installation Guide. There are a number of steps that must be performed before doing the install. 1. Use the 'Load a Distribution' option on the KIDS installation menu. When prompted to enter a host file type in CR_ICD-10-UPDATE.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) (CLINICAL REMINDERS ICD-10 UPDATE 1.0) 4. When prompted "Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO// respond 'NO'. 5. When prompted "Want KIDS to INHIBIT LOGONs during the install? NO//," respond 'NO'. 6. When prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO// respond 'NO'. 7. The init routines PXRMP26D, PXRMP26E, PXRMP26I, PXRMP26T, and PXRMP26X may be deleted once the installation has successfully completed. Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;CLINICAL REMINDERS;**[Patch List]**;Feb 04, 2005;Build 404 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PXRM Before: B37992293 After: B54398070 **4,11,12,16,18,24,26** Routine Name: PXRMART Before: B4884352 After: B5789982 **26** Routine Name: PXRMBXTL Before: B29578553 After: B28912703 **12,26** Routine Name: PXRMCDEF Before: B2284758 After: B2371303 **4,18,24,26** Routine Name: PXRMCF Before: B54030816 After: B63448106 **6,12,18,26** Routine Name: PXRMCOPY Before: B21177715 After: B21259633 **6,12,26** Routine Name: PXRMCPLS Before: n/a After: B12687369 **26** Routine Name: PXRMCSPE Before: B1686038 After: B1560002 **26** Routine Name: PXRMCSTX Before: B33730668 After: B2261498 **9,12,17,18,26** Routine Name: PXRMDATE Before: B69746461 After: B70140007 **4,6,12,17,18,24,26** Routine Name: PXRMDEDI Before: B22823576 After: B25523952 **4,26** Routine Name: PXRMDEDT Before: B86390747 After: B86565471 **4,6,12,17,16,24,26** Routine Name: PXRMDEV Before: B78211075 After: B78755601 **4,6,11,16,18,24,26** Routine Name: PXRMDGPT Before: B43220720 After: B33156979 **4,26** Routine Name: PXRMDIEV Before: n/a After: B68563179 **26** Routine Name: PXRMDLG1 Before: B23307326 After: B7385364 **12,26** Routine Name: PXRMDLG4 Before: B92764011 After: B91752060 **4,6,12,16,26** Routine Name: PXRMDLG6 Before: B19778801 After: B20894000 **12,26** Routine Name: PXRMDLL Before:B110071468 After:B137187250 **10,6,12,17,18,26** Routine Name: PXRMDLLA Before: B80062265 After: B84693327 **6,12,18,26** Routine Name: PXRMDLLB Before: B39413514 After: B33584430 **6,12,16,26** Routine Name: PXRMDLRP Before: B90356438 After: B96040502 **12,18,26** Routine Name: PXRMDTAX Before: n/a After:B200174205 **26** Routine Name: PXRMDUTL Before: B9494253 After: B11502615 **24,26** Routine Name: PXRMEFED Before: B10643956 After: B10725830 **4,26** Routine Name: PXRMEGED Before: B10382097 After: B10459294 **4,26** Routine Name: PXRMENOD Before: B20293476 After: B24879383 **4,6,18,26** Routine Name: PXRMEPED Before: B10077314 After: B10154511 **4,26** Routine Name: PXRMETH Before: B98230476 After:B101071654 **4,6,26** Routine Name: PXRMETX Before: B62331260 After: B62476117 **4,6,26** Routine Name: PXRMETXR Before: B76063275 After: B76497570 **4,6,26** Routine Name: PXRMEXCS Before: B15766398 After: B15773333 **6,12,26** Routine Name: PXRMEXFI Before: B53496841 After: B55982418 **6,12,18,24,26** Routine Name: PXRMEXHF Before: B46895809 After: B49479695 **12,17,18,26** Routine Name: PXRMEXIC Before: B80167234 After: B84313734 **6,12,17,16,18,22,24,26** Routine Name: PXRMEXID Before: B65987316 After: B66152122 **6,12,24,26** Routine Name: PXRMEXIH Before: B48815644 After: B48820476 **6,12,26** Routine Name: PXRMEXIU Before: B66069083 After: B68841657 **4,6,12,17,18,24,26** Routine Name: PXRMEXLB Before: B64707312 After: B63445674 **6,12,26** Routine Name: PXRMEXLC Before: B13031715 After: B13059952 **4,6,12,26** Routine Name: PXRMEXLM Before: B46743705 After: B52621060 **6,12,17,24,26** Routine Name: PXRMEXLR Before: B10532497 After: B9879769 **6,17,26** Routine Name: PXRMEXMH Before: B9663752 After: B10764722 **26** Routine Name: PXRMEXMM Before: B32394409 After: B32677866 **12,26** Routine Name: PXRMEXPD Before:B195546503 After:B200143562 **12,17,16,18,22,26** Routine Name: PXRMEXPS Before:B192149462 After:B188507722 **12,16,18,22,24,26** Routine Name: PXRMEXU0 Before: B6669231 After: B23209797 **4,12,18,26** Routine Name: PXRMEXU1 Before: B36300309 After: B36996811 **6,12,16,26** Routine Name: PXRMEXU2 Before: B57725277 After: B74659923 **6,12,26** Routine Name: PXRMEXU4 Before: B80777182 After:B182800125 **6,12,22,26** Routine Name: PXRMEXWB Before: n/a After: B1609378 **26** Routine Name: PXRMFF Before: B65126590 After: B72420410 **4,6,11,18,22,24,26** Routine Name: PXRMFFDB Before: B67646936 After: B67684724 **4,6,12,18,26** Routine Name: PXRMFFH Before: B8850687 After: B11369552 **12,18,26** Routine Name: PXRMFRPT Before:B123701570 After:B184393482 **12,17,16,18,22,26** Routine Name: PXRMGEDT Before: B45680272 After: B45920622 **26** Routine Name: PXRMGEN Before: B4714370 After: B4344668 **26** Routine Name: PXRMICHK Before:B132138736 After:B191422911 **18,24,26** Routine Name: PXRMINDC Before: B64870601 After: B76451646 **4,6,17,26** Routine Name: PXRMINDD Before: B63358470 After: B76803119 **4,6,17,26** Routine Name: PXRMINDL Before: B24445330 After: B24651910 **4,6,12,26** Routine Name: PXRMINDX Before: B36208748 After: B36378752 **4,6,12,17,18,26** Routine Name: PXRMINTR Before: B38456694 After: B45347072 **4,12,16,18,26** Routine Name: PXRMLCR Before: B37880789 After: B39948429 **4,6,12,26** Routine Name: PXRMLDR Before: B20371554 After: B15240412 **18,26** Routine Name: PXRMLEX Before: B13035630 After: B35438125 **17,18,26** Routine Name: PXRMLEXL Before: n/a After:B240921269 **26** Routine Name: PXRMLIST Before: B9382525 After: B9607187 **6,26** Routine Name: PXRMLOG Before: B61916340 After: B65785719 **4,6,12,17,18,26** Routine Name: PXRMLPOE Before: B14864405 After: B15191347 **4,24,26** Routine Name: PXRMMSER Before:B106782052 After:B106758017 **11,12,21,24,26** Routine Name: PXRMORCH Before: B29035983 After: B34974913 **16,22,26** Routine Name: PXRMOUTC Before: B31296456 After: B38949930 **4,6,17,26** Routine Name: PXRMOUTU Before: B15123879 After: B17168118 **17,18,26** Routine Name: PXRMP26D Before: n/a After:B226626413 **26** Routine Name: PXRMP26E Before: n/a After: B1814747 **26** Routine Name: PXRMP26I Before: n/a After: B28610158 **26** Routine Name: PXRMP26X Before: n/a After: B39898924 **26** Routine Name: PXRMPARS Before: B3493881 After: B3546283 **4,6,26** Routine Name: PXRMPDS Before: B79435180 After: B38727338 **12,26** Routine Name: PXRMPROB Before: B44715259 After: B47060633 **4,26** Routine Name: PXRMPTTX Before: B39235224 After: B39642269 **12,26** Routine Name: PXRMRCPT Before: B20816421 After: B24259553 **4,12,26** Routine Name: PXRMRDI Before: B38535019 After: B37867827 **4,17,18,24,26** Routine Name: PXRMREDF Before: B87890130 After: B84708461 **4,6,12,26** Routine Name: PXRMREDT Before: B70692621 After: B70699612 **4,6,12,18,26** Routine Name: PXRMRUL1 Before: B49843481 After: B49947013 **4,6,26** Routine Name: PXRMSCR Before: B88295 After: B126404 **24,26** Routine Name: PXRMSEL Before: B75458515 After: B75136649 **26** Routine Name: PXRMSINQ Before: n/a After: B22958302 **26** Routine Name: PXRMSTA1 Before: B72929755 After: B67419179 **4,6,26** Routine Name: PXRMSTA2 Before: B24851406 After: B22367612 **4,6,26** Routine Name: PXRMSTAC Before: B10361634 After: B10577788 **18,26** Routine Name: PXRMSTS Before:B177106484 After:B178092687 **12,17,18,26** Routine Name: PXRMSXRM Before: B45463918 After: B51532846 **6,17,26** Routine Name: PXRMTAX Before: B65791721 After: B60136875 **4,6,12,18,24,26** Routine Name: PXRMTAXD Before: B831541 After: B68009180 **26** Routine Name: PXRMTAXL Before: n/a After: B59845028 **26** Routine Name: PXRMTDLG Before: B19639441 After: B19639441 **26** Routine Name: PXRMTERM Before: B55250159 After: B55315672 **4,6,11,18,26** Routine Name: PXRMTIU Before: B6286331 After: B7669051 **4,12,26** Routine Name: PXRMTMED Before: B13077287 After: B13031751 **1,4,6,12,26** Routine Name: PXRMTXCE Before: n/a After: B21765274 **26** Routine Name: PXRMTXCR Before: n/a After: B74745189 **26** Routine Name: PXRMTXCS Before: n/a After: B3010053 **26** Routine Name: PXRMTXDL Before: n/a After: B1299916 **26** Routine Name: PXRMTXIC Before: n/a After: B8164040 **26** Routine Name: PXRMTXIH Before: n/a After: B25527600 **26** Routine Name: PXRMTXIM Before: n/a After:B193866629 **26** Routine Name: PXRMTXIN Before: n/a After: B68427938 **26** Routine Name: PXRMTXSM Before: n/a After: B41443129 **26** Routine Name: PXRMUIDR Before: n/a After: B9563816 **26** Routine Name: PXRMUTIL Before:B113964494 After:B128848927 **4,6,11,12,17,18,24,26** Routine Name: PXRMVCPT Before: B26000582 After: B51805382 **4,26** Routine Name: PXRMVPOV Before: B26252424 After: B51874901 **4,26** Routine Name: PXRMXEVL Before: B1729475 After: B1989772 **4,12,26** Routine Name: PXRMXSE1 Before: B30585167 After: B30616308 **4,6,12,26** Routine Name: PXRMXT Before: B32803390 After: B32837496 **4,26** Routine Name: PXRMXTA Before: B53827588 After: B53931120 **4,12,26** Routine Name: PXRMXTB Before: B7862686 After: B7902302 **6,12,26** Routine list of preceding patches: 24 ============================================================================= User Information: Entered By : Date Entered : MAR 02, 2012 Completed By: Date Completed: JUL 24, 2014 Released By : Date Released : JUL 24, 2014 ============================================================================= Packman Mail Message: ===================== No routines included