============================================================================= Run Date: MAY 04, 2021 Designation: PXRM*2*42 Package : PXRM - CLINICAL REMINDERS Priority: Mandatory Version : 2 SEQ #59 Status: Released Compliance Date: JUN 04, 2021 ============================================================================= Associated patches: (v)PXRM*2*45 <<= must be installed BEFORE `PXRM*2*42' (v)PXRM*2*46 <<= must be installed BEFORE `PXRM*2*42' (v)PX*1*211 <<= must be installed BEFORE `PXRM*2*42' Subject: CLINICAL REMINDER CHANGES SUPPORTING PCE STANDARDIZATION Category: - Routine - Data Dictionary Description: ============ General Overview: ================= This patch is the Clinical Reminders portion of PCE STANDARDIZATION 1.0. To take full advantage of the PCE standardization work, changes to VistA applications that use PCE data are required. These applications include Clinical Reminders, Health Summary, and Problem List. To make it easier for sites, the builds for PCE (PX*1.0*211), Clinical Reminders (PXRM*2.0*42), Health Summary (GMTS*2.7*122), Problem List (GMPL*2.0*53), and Order Entry/Results Reporting (OR*3.0*501) are being distributed in a multi-package build named PCE STANDARDIZATION 1.0. For detailed information and installation instructions, please see the PCE Standardization 1.0 Installation Guide. In addition to the changes in support of PCE Standardization there were bug fixes and enhancements. A summary of all the changes follows. Clinical Reminders Index V Standard Codes was added to the Clinical Reminders Index build/rebuilding utility. Reminder Computed Findings A test site for PXRM*2.0*47 found they had several instances where the Computed Finding Parameter for CF.VA-REMINDER DEFINITION was the name of a definition that no longer existed. This could have been because the reminder definition was renamed or possibly deleted. To handle the case where it was renamed, a change was made so the Computed Finding Parameter can be either the Internal Entry Number or the Name of the Reminder Definition. Under certain circumstances evaluating the national computed finding VA-BSA would produce the following error: GHEIGHT+16^PXRMBMI *DIFFL("",0) While evaluating reminder VA-BODY SURFACE AREA For patient DFN=13 The time of the error was 11/13/2017@09:42:03 See the error trap for complete details. GHEIGHT tries to find the height measurement made closest to the patient's most recent weight measurement. The situation the generated the above error was the patient had a height measured before the weight measurement but none after. This corrected. Reminder Definitions: A site reported when running the integrity check on a local reminder definition they were getting a hard error: . I 'FIEVAL(LIST(IND)) Q ^ MRD+6^PXRMFF0 *FIEVAL("6") This was traced to two function findings in the definition that depend on finding 6 which does not exist. The function finding portion of the integrity checker was changed so it can handle non-existent findings. The integrity checker was only checking for a frequency if resolution logic was defined, in this case no frequency is a fatal error. A change was made so if there is no there is no resolution logic, a warning for no frequency is issued. If there is resolution logic a fatal error is issued. There was a request from Puget Sound to add the ability to edit the print name for national definitions. The Workgroup concurred with the stipulation that site changes are tracked so when content updates are made the site can determine what local changes were overwritten. Two new options were added to the REMINDER MANAGEMENT MENU: DEFINITION PRINT NAME EDIT and DEFINITION PRINT NAME REPORT. PXRM REMINDER MANAGEMENT Reminder Definition Management menu RL List Reminder Definitions RI Inquire about Reminder Definition RE Add/Edit Reminder Definition RC Copy Reminder Definition RA Activate/Inactivate Reminders HT Edit HT PERIODIC Reminder Definition Frequency RH Reminder Edit History ICS Integrity Check Selected ICA Integrity Check All PNE Definition Print Name Edit PNR Definition Print Name Report When the PNE option is selected the user will be prompted to select a Reminder Definition. After a definition is selected a ScreenMan form with Print Name the only editable field will be opened. The PNR option will run a report that finds all Reminder Definitions whose Print Name was edited using the PNE option. For each definition it lists who edited the print name, when it was edited, the original Print Name, and the new Print Name. The length of Print Name was increased from 35 to 64 characters. Reminder Evaluation The ability to use V Standard Codes in reminder evaluation and patient list building was added. Now, whenever Patient Data Source includes encounter data, V Standard Codes will be included in taxonomy evaluation. The Help text was updated to include V Standard Codes. A rebuild of the taxonomy "APDS" index was added to the post-init. The Clinical Maintenance output for Exams and Health Factors was changed to use the new Print Name field, if it is populated, otherwise the .01 will be used. Print Name was an existing field for Education Topics so Print Name was already being used in this manner for Education Topics. If there is no resolution logic, reminder frequency is not required, the following warning was added to the Clinical Maintenance output: "There is no reminder frequency!" If there is resolution logic and no frequency, then the reminder cannot be evaluated, this generates a status of ERROR. Text was added to the Clinical Maintenance output with the error message: "There is resolution logic but no reminder frequency!" Display of measurement data was added to the Clinical Maintenance output for Education Topics, Exams, Health Factors, and V Standard Codes. Reminder Exchange When PX*1.0*211 is installed, it adds the Class field to Education Topics, Exams, and Health Factors and it is a required field. Any Exchange prd files created in an account that does not have PX*1.0*211 will not have these fields and consequently will not install in PX*1.0*211 accounts. Reminder Exchange has been modified to eliminate this problem. If a Reminder Exchange entry, that does not contain the Class field, is being installed as part of KIDS install Reminder Exchange will set it automatically to National. If the entry is being installed by hand the Class fields will be set to local. In the future the Exchange prd file will contain information about the account where the prd file was created and this will also be used to determine how to set the Class field if it is missing. Another issue that Reminder Exchange must handle is the requirement that Health Factor Category names end in "[C]". Reminder Exchange tries to determine if an incoming category is new or if it is an existing category but is missing the "[C]". If it is new it will install it and append the "[C]" to the name. If already exists, any new incoming health factors in the category will have their category switched to the one with the appended "[C]". When multiple Reminder Dialogs are included in a single exchange file entry, for each dialog the Exchange dialog install software was restarting the install from the beginning of the dialog list. Because of this, dialog installation was slow and the display of the dialog was incorrect. This has been fixed, now only items associated with the dialog selected for installation will be included in the display and installation list; dialogs will install much faster. A Repack action was added to Reminder Exchange. This new action can be used to select an existing Reminder Exchange file entry and automatically repack it. If the Exchange file entry was originally packed in a different account the repack may fail because one or more of the components may not exist in the account where the repack is being done. During an install, if a component was already installed in the account and found to be identical to what is in the Exchange entry, Reminder Exchange was writing out the message: "FILE NAME entry named NAME already exists and the packed component is identical, skipping." For some Exchange installs there could be many of these messages and displaying them slowed down the install. Now, these messages will no longer be written out, instead a single '.' will be written to let the end user know Reminder Exchange is processing the entry. As part of the packing process, the Reminder Integrity Checker will now be run on every definition that is to be included in the Reminder Exchange file entry. If a definition has fatal errors the packing process will abort. In the past during an install, if a finding in a definition, term, or dialog did not exist, the user was prompted to input a replacement for every instance of the missing finding in the components being installed. Changes have been made to keep track of finding replacements, so now the user will only have to enter the replacement once. After the replacement has been entered the first time, every subsequent instance of the missing finding will be automatically replaced. The way dialogs are stored in an Exchange File entry was restructured so that they will install much faster. This means that dialogs packed before this restructuring need to have a conversion run on them. Having a way to determine if the conversion needs to be done necessitated creating a mechanism for storing and reading packing attributes. The attributes are stored in the Exchange File entry when it is created and read when it is installed. This is all done automatically and does not require any action by the Reminder Exchange user. Reminder Manager Menu Test site feedback reported: "the manager menu is one line too long - this needs to be shortened." Reminder Computed Finding Management ... Reminder Definition Management ... Reminder Sponsor Management ... Reminder Taxonomy Management Reminder Term Management ... Reminder Location List Management ... Reminder Exchange Reminder Test Other Supporting Menus ... Reminder Information Only Menu ... Reminder Dialog Management ... CPRS Reminder Configuration ... Reminder Reports ... Reminders MST Synchronization Management ... Reminder Patient List Menu ... Reminder Parameters ... NLM Value Set Menu Reminder Order Check Menu ... NLM Clinical Quality Measures Menu Reminder Extract Menu ... GEC Referral Report Add/Edit Reminder Categories The GEC Referral Report was already available in the Reminder Reports menu so it was removed from the Managers Menu. Reminder Patient Lists The Patient List building functionality using a CPT code from V Standard Codes was not working correctly, the list was coming up empty when it should have patients. When the change was made for V Standard Codes to store all codes created as a result of code mapping the list building code was not updated to handle the additional coding systems. The code was changed to handle all the coding systems that can now be stored in V Standard Codes. Reminder Reports When running a Reminders Due report Puget Sound got the following error: Reminders Due Report Select an existing REPORT TEMPLATE or return to continue: Select one of the following: I Individual Patient R Reminder Patient List L Location O OE/RR Team P PCMM Provider T PCMM Team PATIENT SAMPLE: L// o OE/RR Team Select TEAM: HCHV Case Mgmt Select another TEAM: Enter EFFECTIVE DUE DATE: Jan 07, 2018// (JAN 07, 2018) Select one of the following: D Detailed S Summary TYPE OF REPORT: S// d Detailed Display All Future Appointments: N// O Sort by Next Appointment date: N// O Print full SSN: N// O Print locations with no patients? YES// Print percentages with the report output? NO// Select individual REMINDER: ^ Print locations with no patients? YES// ^ RECORDING THAT AN ERROR OCCURRED --- This was occurring because the variable PXRMLCSC was not defined as a result of the "^" input. The code was changed to properly handle the "^" input. Reminder QUERI Extracts: The data from the IHD and MH QUERI extracts is no longer being used, therefore the monthly run of these extracts is being stopped and all the old QUERI patient lists are being deleted. The options: PXRM EXTRACT VA-IHD QUERI PXRM EXTRACT VA-MH QUERI are deleted and the scheduling of these options is removed. Reminder Taxonomies: A user reported that when using the Use In Dialog Edit (UIDE) action if you quit without saving and selected another taxonomy for UIDE, the codes from the original taxonomy were still displayed. This was corrected. When using the UIDE action, it was not clear if codes could be marked as Use In Dialog (UID). This display was changed to explicitly state if codes can be marked as UID. Reminder Terms A Reminder Term Test option was added to the Reminder Term Management menu. The user is prompted for a patient and a term. The term is evaluated and the True or False value and the FIEVAL (Finding Evaluation) array are written out. Reminder Test The reminder global variables and their values are now displayed in Reminder Test. Self-Identified Gender Self-identified gender has been added to the Patient file, consequently it has been added as a new reminder global variable named PXRMSIG. PXRMSIG can be used exactly like any of the already existing reminder global variables such as PXRMSEX or PXRMDOB. Test Sites: =========== Boise Fresno Northern California Puget Sound Tuscaloosa The documentation for this build is: Title File Name --------------------------------------------------------------- Deployment, Installation, Back-Out, px_1_0_211_dibr.docx and Rollback Guide px_1_0_211_dibr.pdf Release Notes px_1_0_211_rn.docx px_1_0_211_rn.pdf PCE Technical Manual pxtm.docx pxtm.pdf PCE User Manual pxum.docx pxum.pdf Clinical Reminders Index Technical Manual pxrm_index_tm.docx pxrm_index_tm.pdf Clinical Reminders Manager's Manual pxrm_mm.docx pxrm_mm.pdf Documentation can be found on the VistA Documentation Library (VDL) at: http://www.domain.ext/vdl/ Build Components: ================= FILE # NAME ------------------------------------------------------------------------------- 811.4 REMINDER COMPUTED FINDINGS 811.8 REMINDER EXCHANGE Partial DD: subDD: 811.805 811.9 REMINDER DEFINITION Partial DD: subDD: 811.9 fld: 1.2 FORM: ===== PXRM DEF PRINT NAME EDIT FILE #811.9 OPTION: ======= PXRM DEF PRINT NAME EDIT PXRM DEF PRINT NAME REPORT PXRM EXTRACT VA-IHD QUERI PXRM EXTRACT VA-MH QUERI PXRM REMINDER MANAGEMENT PXRM TERM MANAGEMENT PXRM TERM TESTER PXRMCS INACTIVE DIALOG CODES PROTOCOL: ========= PXRM EXCH MENU PXRM EXCH REPACK Installation: ============= Required builds: PXRM*2.0*45 (released) PXRM*2.0*46 (released) PX*1.0*211 The components sent with this patch: PXRM*2*42, are included in the multi-package build host file: PCE STANDARDIZATION 1.0.KID. Please follow the installation instructions in the patch description for patch PX*1*211. Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;CLINICAL REMINDERS;**[Patch List]**;Feb 04, 2005;Build 245 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PXRM Before: B47307370 After: B44585857 **4,11,12,16,18,24,26,47,42** Routine Name: PXRMART Before: B5789982 After: B5793538 **26,42** Routine Name: PXRMBMI Before: B15288671 After: B15273669 **12,18,42** Routine Name: PXRMCDEF Before: B6494294 After: B6688274 **4,18,24,26,47,45,42** Routine Name: PXRMCF Before: B63448106 After: B64545988 **6,12,18,26,42** Routine Name: PXRMCVRP Before: n/a After:B175521460 **42** Routine Name: PXRMCVTM Before: B16308038 After: B19003140 **45,42** Routine Name: PXRMDATA Before: B5674695 After: B5905920 **4,6,42** Routine Name: PXRMDATE Before: B72754452 After: B73452738 **4,6,12,17,18,24,26,47,42** Routine Name: PXRMDBL Before: B78666876 After: B78662365 **45,42** Routine Name: PXRMDEV Before: B90137524 After: B94601871 **4,6,11,16,18,24,26,47,45,46,42** Routine Name: PXRMEDU Before: B8112525 After: B13918373 **42** Routine Name: PXRMERRH Before: B37395390 After: B57078507 **4,17,18,47,45,42** Routine Name: PXRMEUT Before: B48589168 After: B48579737 **4,6,17,18,42** Routine Name: PXRMEVFI Before: B10519647 After: B11414696 **6,18,42** Routine Name: PXRMEXAM Before: B7684615 After: B13736448 **42** Routine Name: PXRMEXDB Before: B54744297 After: B57975072 **6,12,42** Routine Name: PXRMEXLC Before: B13059952 After: B12932001 **4,6,12,26,42** Routine Name: PXRMEXLI Before: B21897628 After: B61412209 **6,12,45,42** Routine Name: PXRMEXLR Before: B9879769 After: B10670039 **6,17,26,42** Routine Name: PXRMEXMH Before: B10558717 After: B13805661 **26,47,42** Routine Name: PXRMEXPD Before:B243937976 After:B243933810 **12,17,16,18,22,26,45,42** Routine Name: PXRMEXU1 Before: B49359858 After: B52468744 **6,12,16,26,45,42** Routine Name: PXRMEXU5 Before: B72466176 After: B72285914 **12,16,18,22,45,42** Routine Name: PXRMFF Before: B75070206 After: B76357476 **4,6,11,18,22,24,26,47,42** Routine Name: PXRMFF0 Before: B19175056 After: B18180135 **4,6,12,18,47,42** Routine Name: PXRMFMTO Before: B10636061 After: B11567960 **47,42** Routine Name: PXRMHF Before: B40695055 After: B53277538 **6,17,18,42** Routine Name: PXRMICHK Before:B262794291 After:B225635853 **18,24,26,47,45,42** Routine Name: PXRMICK1 Before: B2397232 After: B12234519 **45,42** Routine Name: PXRMIMM Before: B9661991 After: B11549713 **42** Routine Name: PXRMIOPT Before: n/a After: B11419394 **42** Routine Name: PXRMISF Before: B4736920 After: B4874044 **17,42** Routine Name: PXRMLDR Before: B18348692 After: B20234429 **18,26,47,42** Routine Name: PXRMLEXL Before:B190120643 After:B186454787 **26,47,42** Routine Name: PXRMLOG Before: B66402903 After: B67488337 **4,6,12,17,18,26,47,42** Routine Name: PXRMMSER Before:B106758017 After:B133664475 **11,12,21,24,26,42** Routine Name: PXRMOUTC Before: B39132077 After: B43713968 **4,6,17,26,47,46,42** Routine Name: PXRMOUTM Before: B30043679 After: B30066077 **4,6,17,47,46,42** Routine Name: PXRMOUTU Before: B18283584 After: B19206492 **17,18,26,47,42** Routine Name: PXRMP42I Before: n/a After: B19667470 **42** Routine Name: PXRMPDEM Before: B65842415 After: B65886599 **5,4,11,12,17,18,24,47,42** Routine Name: PXRMPDS Before: B38727338 After: B39667827 **12,26,42** Routine Name: PXRMPINF Before: B16498862 After: B16604052 **12,17,24,45,42** Routine Name: PXRMPLST Before: B53881985 After: B53881985 **4,6,18,42** Routine Name: PXRMPNRP Before: n/a After: B1983529 **42** Routine Name: PXRMPRF Before: B15497099 After: B15513795 **17,18,47,42** Routine Name: PXRMRCUR Before: B13247111 After: B13442684 **47,42** Routine Name: PXRMRULE Before: B60225083 After: B60162556 **4,6,42** Routine Name: PXRMSPED Before: B6621847 After: B6943031 **4,42** Routine Name: PXRMSXRM Before: B98450970 After:B100612241 **6,17,26,47,42** Routine Name: PXRMTAX Before: B60136875 After: B65755465 **4,6,12,18,24,26,42** Routine Name: PXRMTAXI Before: n/a After: B2022922 **42** Routine Name: PXRMTERM Before: B55250159 After: B64733107 **4,6,11,18,26,47,42** Routine Name: PXRMTMED Before: B13763388 After: B11727267 **1,4,6,12,26,45,42** Routine Name: PXRMTXLS Before:B150968479 After:B147613164 **26,47,42** Routine Name: PXRMTXSM Before: B56360268 After: B76721210 **26,47,42** Routine Name: PXRMUID Before: n/a After: B127583 **42** Routine Name: PXRMUIDE Before: B17671178 After: B18099598 **26,47,42** Routine Name: PXRMUTIL Before:B164856611 After:B150596029 **4,6,11,12,17,18,24,26,47,42** Routine Name: PXRMVCPT Before: B52602127 After: B53019296 **4,26,47,42** Routine Name: PXRMVITL Before: B14733842 After: B16703682 **6,12,17,18,42** Routine Name: PXRMVSC Before: n/a After: B34098955 **42** Routine Name: PXRMVSIT Before: B10650656 After: B10884562 **4,6,18,24,42** Routine Name: PXRMXD Before: B90635249 After: B90486802 **4,6,12,42** Routine Name: PXRMXEVL Before: B1513078 After: B1704230 **4,12,26,47,42** Routine Name: PXRMXSU Before: B67359624 After: B80002311 **4,42** Routine Name: PXRMXTA Before: B53931120 After: B54608368 **4,12,26,42** Routine list of preceding patches: 46 ============================================================================= User Information: Entered By : Date Entered : FEB 13, 2014 Completed By: Date Completed: APR 30, 2021 Released By : Date Released : MAY 04, 2021 ============================================================================= Packman Mail Message: ===================== No routines included