$TXT Created by                    at DEV.DEV.DOMAIN.EXT  (KIDS) on Tuesday, 08/09/16 at 14:38
=============================================================================
Run Date: DEC 13, 2016                     Designation: RA*5*129
Package : RA - RADIOLOGY/NUCLEAR MEDICINE     Priority: EMERGENCY
Version : 5       SEQ #114                      Status: Released
                  Compliance Date: DEC 16, 2016
=============================================================================

Associated patches: (v)RA*5*98     <<= must be installed BEFORE `RA*5*129'
                    (v)RA*5*114    <<= must be installed BEFORE `RA*5*129'
                    (v)RA*5*125    <<= must be installed BEFORE `RA*5*129'

Subject: HL7: UNPRINTABLE CONTROL CHARS, RESEND WHEN STUDIES SPAN HL7 VERSIONS & MISC

Category: 
  - Routine

Description:
============

 RA*5.0*129 will cover 3 issues:
  
 1. Embedded unprintable control characters (ASCII 0 - 31) in the VistA 
    Radiology/Nuclear Medicine ('RIS') database is creating unexpected 
    results with VistA HL7. Note: This patch addresses front door ordering.
  
 2. The HL7 Resend options have issues broadcasting studies created
    before the existence of the site specific accession number (SSAN) in 
    accounts now broadcasting radiology studies with the SSAN. The M Server
    side has been updated to accept a SSAN and determine correctly if the 
    SSAN cross reference ("ADC1") or the legacy accession number cross 
    reference ("ADC") should be used to break down the radiology
    examinations multiple in order to determine the correct study and/or
    report for this VistA study.
  
 3. The undefined variable PAR(26) in Routine RAHLTCPX causes a hard error.
  
 Associated Ticket(s):
 =====================
 1. I9349322FY16 - Control Characters embedded in CPRS and RIS orders
                   I9624888FY16 (d)
                   I9853791FY16 (d)
                   I9913750FY16 (d)
                   I9954772FY16 (d)
  
 2. I9335483FY16 - Resend (by case or date) use the legacy accession 
                   when the SSAN should be used.
  
 3. R9397618FY16 - HL7 failing daily <UNDEFINED>OBR+29^RAHLTCPX *PAR(26)
  
 Associated NSR(s):
 ==================
 N/A
  
 Participating Test Sites:
 =========================
 Boston, MA
 North Chicago
 Orlando, FL
  
 Ticket Overview:
 ================
 1. I9349322FY16 - Control Characters embedded in CPRS and RIS orders
  
    Problem:
    --------
    Control characters (ASCII table the first 32 characters from 0 - 31)
    are introduced into the REASON FOR STUDY and CLINICAL HISTORY fields 
    of a radiology order when the order is entered through CPRS. A subset
    of these control characters are used as 'reserve characters' and have
    special meaning when building HL7 messages. The inclusion of these
    reserve characters in our REASON FOR STUDY and/or CLINICAL HISTORY data
    causes the HL7 broadcast to fail.
  
    Resolution:
    -----------
    REASON FOR STUDY and CLINICAL HISTORY data is checked for control 
    characters. All control characters are stripped from the data string 
    when found and replaced by the null string ("").
  
    Routine: RAO7RON1
  
 2. I9335483FY16 - Resend (by case or date) use the legacy accession 
                   when the SSAN should be used.
  
    Problem A:
    ----------
    A bug in Routine RAHLR1 sets the accession number value to the value
    stored in the SITE ACCESSION NUMBER field (file #70.03; field #31).
    This logic is in error because an older study created before the RIS
    used v2.4 of the VistA Health Level Seven (HL7) application will not
    have a value in the SITE ACCESSION NUMBER. When in a v2.4 HL7
    environment these older studies pass the legacy accession number. Voice
    Recognition systems are looking for the Site Specific Accession Number
    ('SSAN') and reject the inbound RIS HL7 message.
  
    Resolution A:
    -------------
    Routine RAHLR1 has been updated to check the RIS specific HL7
    environment the production account is running under. If the environment
    is pre v2.4 the legacy accession number is used. If the environment is
    v2.4 the SSAN is used.
  
    Problem B:
    ----------
    Routine RAHLTCPX determined the type of accession number, legacy or
    SSAN, based on the number of dash ('-') delimited pieces. If the number
    of pieces was two the software used the "ADC" cross reference. If the
    number of pieces was three the software used the "ADC1" cross
    reference. Note: Both the "ADC" and the "ADC1" cross references are
    file-wide cross references on the  RAD/NUC MED PATIENT (#70) file.
  
    Resolution B:
    -------------
    Routine RAHLTCPX has been updated to check the number of pieces of the
    accession number delimited by a dash. If the number of pieces is two,
    the "ADC" cross reference is used. If the number of pieces is three and
    the "ADC1" cross reference exists the "ADC1" cross reference is used.
    If the number of pieces is three and the "ADC1" cross reference does
    not exist the "ADC" cross reference is used.
  
    Routines: RAHLTCPX, RAHLR1
  
 3. R9397618FY16 - HL7 failing daily <UNDEFINED>OBR+29^RAHLTCPX *PAR(26)
  
    Problem:
    --------
    When a v2.4 HL7 report is broadcast to the VistA M server, the segments
    and fields from that message are de-constructed and processed. It is 
    assumed that the RESULT STATUS (OBR-25) will have a value. A value
    may not always be assigned. Before this patch, the software lapsed into
    an error condition because it does not have a result status. After this
    patch the software will identify the missing Result Status value and
    exit without error.
  
    Resolution:
    -----------
    RAHLTCPX will be updated to check for the array element PAR(26) and if
    it is undefined, the software will negatively acknowledge ('NAK') the
    inbound HL7 v2.4 ORU message.
  
    Routine: RAHLTCPX
  
       ==================== Installation Instructions ====================
  This patch cannot be installed with Radiology/Nuclear Medicine users on
  the system. This patch should take less than five minutes to install.
   
  All VistA Radiology users are to be off the system. Voice Recognition 
  and Radiology based PACS activities are to be paused while RA*5.0*129 is
  installed.
   
  1. Stop entering radiology orders through CPRS and the Radiology/Nuclear 
     Medicine application.
  
  2. Shutdown HL7 messaging between the VistA RIS and non-VistA RIS 
     applications, by using the "Filer and Link Management Options [menu]".
  
  3. Use the 'INSTALL/CHECK MESSAGE' option of the PackMan menu. This
     option will load the KIDS patch onto your system.
   
  4. The patch has now been loaded into a Transport global on your
     system. You now need to use KIDS to install the transport global.
   
  5. On the 'Kernel Installation & Distribution System' Menu (KIDS),
     select the 'Installation' menu.
   
  6. Use the 'Verify Checksum in Transport Global' option and verify
     that all routines have the correct checksums.
   
  7. On the KIDS menu, under the 'Installation' menu, use the following
     options:
             Print Transport Global
             Compare Transport Global to Current System
             Backup a Transport Global
   
        Preserve a copy of the routines exported in this patch prior to
        installation, you should use the 'Backup a Transport Global' option
        at this time. You may also compare the routines in your production
        account to the routines in the patch by using the 'Compare a
        Transport Global to Current System' option.
  
  8. Use the 'Install Package(s)' option under the 'Installation' menu 
     and select the package 'RA*5.0*129.
   
     When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//, 
     choose 'NO'.
   
     When prompted 'Want to DISABLE Scheduled Options, Menu Options, and 
     Protocols? NO//', choose YES.
      
     When prompted, 'Enter options you wish to mark as 'Out Of order':', 
     enter the following options:
      
     Disable the following VistA RIS options:
     ----------------------------------------
     Request an Exam                             [RA ORDEREXAM]
     Resend Radiology HL7 Message                [RA HL7 MESSAGE RESEND]
     Resend Radiology HL7 Messages By Date Range [RA HL7 RESEND BY 
                                                 DATE RANGE]
      
  9. If prompted 'Delay Install (Minutes):  (0 - 60): 0//', respond 0.
  
   ==================== Post-Installation Instructions ====================
     Restart HL7 messaging between the VistA RIS and non-VistA RIS
     applications, by using the "Filer and Link Management Options [menu]".
     
     Resume entering radiology order through CPRS and the 
     Radiology/Nuclear Medicine application.
  
     The installation of RA*5.0*129 is complete.

Routine Information:
====================
The second line of each of these routines now looks like:
 ;;5.0;Radiology/Nuclear Medicine;**[Patch List]**;Mar 16, 1998;Build 1

The checksums below are new checksums, and
 can be checked with CHECK1^XTSUMBLD.

Routine Name: RAHLR1
    Before: B25001746   After: B26243078  **47,125,129**
 Description of Changes:
  Some sites may rebroadcast old studies built around the legacy accession 
  number format while running under v2.4 of HL7 messaging for the VistA 
  RIS. Commercial off the Shelf (COTS) products are expecting a site 
  specific accession number (SSAN). We build the SSAN in this case and 
  broadcast the order to COTS. 
   
  This new logic resides in INIT^RAHLR1.

Routine Name: RAHLTCPX
    Before: B94012646   After:B100969954  **47,114,129**
 Description of Changes:
  Some sites may rebroadcast old studies built around the legacy accession 
  number format while running under v2.4 of HL7 messaging for the VistA 
  RIS. Commercial off the Shelf (COTS) products are expecting a site 
  specific accession number (SSAN). We build the SSAN in this case and 
  broadcast the order to COTS. COTS results the report and broadcasts the 
  report back to VistA with the SSAN. Our server side software has to check 
  for the possibility that the SSAN in the report was for a pre-v2.4 
  Radiology placed order.
   
  In this case if the SSAN cannot be found having a specific cross 
  reference ("ADC1") the software looks for a match on the "ADC" cross
  reference.
   
  RAHLTCPX will be updated to check for the array element PAR(26) and if
  it is undefined the software will negatively acknowledge ('NAK') the
  inbound HL7 v2.4 ORU message.

Routine Name: RAO7RON1
    Before: B29535548   After: B30720358  **69,75,98,129**
 Description of Changes:
  RAO7RON1 has added code to strip all unprintable ASCII characters (ASCII 
  0 - 31) from the CLINICAL HISTORY and REASON FOR STUDY data associated 
  with a radiology order.
   
  Some control characters are 'reserve' characters used with the Minimal
  Lower-Layer Protocol (MLLP). The MLLP defines how a HL7 message is 
  structured to ensure you know where a message starts, where a message
  stops, and where the next message starts.

 
Routine list of preceding patches: 98, 114, 125

=============================================================================
User Information:
Entered By  :                               Date Entered  : JUL 21, 2016
Completed By:                               Date Completed: DEC 12, 2016
Released By :                               Date Released : DEC 13, 2016
=============================================================================


Packman Mail Message:
=====================

$END TXT