$TXT Created by at DEV.DEV.DOMAIN.EXT (KIDS) on Thursday, 03/29/18 at 12:36 ============================================================================= Run Date: APR 26, 2018 Designation: RA*5*135 Package : RA - RADIOLOGY/NUCLEAR MEDICINE Priority: Mandatory Version : 5 SEQ #127 Status: Released Compliance Date: MAY 28, 2018 ============================================================================= Associated patches: (v)RA*5*75 <<= must be installed BEFORE `RA*5*135' (v)RA*5*130 <<= must be installed BEFORE `RA*5*135' Subject: VISTA RADIOLOGY DISCONTINUE ORDERS (PENDING/HELD/SCHEDULED) Category: - Routine - Data Dictionary - Other Description: ============ *** RA*5.0*135 is a patch developed in response to the Deputy Under *** *** Secretary for Health for Operations and Management (10N) *** *** directive: '7806589 - SD Memo Radiology and Nuclear Medicine *** *** orders Management' dated September 11, 2017. *** Note: RA*5.0*135 (RA5P135) will discontinue older orders in the VistA Radiology/Nuclear Medicine and CPRS applications. Though every measure was taken to eliminate the burden on the host system by disabling radiology notifications, one CPRS notification, DC ORDER (#62), is beyond our control. Having the DC ORDER notification enabled has the potential to generate thousands of alerts. Since this particular CPRS notification was exported nationally as 'Disabled' we believe that the alert will only be generated to individual end users or teams who have selectively enabled the DC ORDER notification. Because of this, we strongly suggest that the installers or appropriate personnel inform your Radiology and CPRS Clinical Applications Coordinators for awareness. We are also providing the following fileman sort that can be run immediately to determine which end users actually have the CPRS DC ORDER notification enabled and therefore, could possibly receive a CPRS DC ORDER notification from this patch installation. We suggest you provide the fileman output beforehand to your sites CPRS Clinical Coordinators for their awareness. If, by chance, after patch installation an end user receives/complains of many DC ORDER notifications, Clinical Coordinators could offer to quickly erase just those notifications for the end user using the Erase Notifications [ORB3 ERASE NOTIFICATIONS] menu option. FILEMAN PRINT TO FIND END USERS WITH DC ORDER NOTIFICATION ENABLED ======================================================================== Notes: 1. Make sure to enter the following fields, including all alpha-numeric characters. 2. Be sure to use the proper Case because some of these values are case sensitive. 3. Some of these users may be inactive, based on their last sign on date/time. 4. Please give the fileman output to your sites clinical application coordinators. Print File Entries Output from what File: PARAMETERS// Sort by: NUMBER// INSTANCE Start with INSTANCE: FIRST// DC ORDER Go to INSTANCE: LAST// DC ORDER Within INSTANCE, Sort by: VALUE Start with VALUE: FIRST// Enabled Go to VALUE: LAST// Enabled Within VALUE, Sort by: STORE IN 'SORT' TEMPLATE: First Print FIELD: ENTITY Then Print FIELD: INSTANCE;L8// Then Print FIELD: VALUE;L8// Then Print FIELD: .01:200:LAST SIGN-ON DATE/TIME;"LAST SIGN ON" By '.01', do you mean PARAMETERS 'ENTITY'? Yes// Y (Yes) By 'LAST SIGN', do you mean NEW PERSON 'LAST SIGN-ON DATE/TIME'? Yes// Y (Yes) Then Print FIELD: Heading (S/C): PARAMETERS List// STORE PRINT LOGIC IN TEMPLATE: START at PAGE: 1// DEVICE: ;;900 PARAMETERS List MAR 29, 2018@08:05 PAGE 1 ENTITY INSTANCE VALUE LAST SIGN ON -------------------------------------------------------------------------- DEVPERSON,KERRY DC ORDER Enabled MAR 29,2018@07:24:10 LIFEISGOOD,RICK DC ORDER Enabled FEB 20,1994@14:22:13 SUNSHINE,LISA DC ORDER Enabled DEC 7,2017@07:05:25 DEVPERSON,GREG DC ORDER Enabled JUL 12,2017@15:15:02 If a user happened to get a lot of DC ORDER notifications after the Auto Discontinue task completes, your site's Clinical Coordinator could use the Erase Notifications [ORB3 ERASE NOTIFICATIONS] menu option to remove the DC ORDER notifications that the user received, otherwise the user would need to process the DC Order alert in CPRS like they do with any other alert. Here is an example using the Erase Notifications [ORB3 ERASE NOTIFICATIONS] menu option to remove all the DC ORDER notifications for a user: Erase Notifications 1. Erase all notifications for a User 2. Erase all notifications for a Patient 3. Erase all instances of a notification (regardless of Patient or User) 4. Erase specific notifications for a User <<<<<<<<<<<< THIS ITEM 5. Edit Erase All Notifications parameter for a User Select Erase option: 4 <<<<< This option purges an existing alert/notification for a recipient/user. *** USE WITH CAUTION *** Select NEW PERSON entry for deletion of alerts: DOCTOR,REBECCA J 1. MJBCPRSTE (M4537): [7A GEN MED] New DC order(s) placed. 2. ATEST,JOH (A9111): [7A GEN MED] New DC order(s) placed. 3. ATEST,JOH (A9111): Lab order canceled: CREATININE RED/GOLD SERUM SP LB 4. ATEST,JOH (A9111): Lab order canceled: poc-INR FINGERSTICK BLOOD SP ON 5. ATEST,JOH (A9111): UNSIGNED 21 DAY REBECCA Dated 08/10/17 OVERDUE for 6. ATEST,JOH (A9111): UNSIGNED 21 DAY REBECCA Dated 08/10/17 OVERDUE for 7. AAAHY,FHX (A0549): [7A GEN MED] New DC order(s) placed. 8. FXAHN,ZDJ (F1233): [7A GEN MED] New DC order(s) placed. 9. AAAHY,FHX (A0549): [7A GEN MED] New DC order(s) placed. 10. AAAHY,FHX (A0549): [7A GEN MED] New DC order(s) placed. 11. ZZOUTPATI (Z9898): [LIN] New order(s) placed. Select from 1 to 11 to DELETE or enter ?, A, or ^ to exit or RETURN to continue: 1,2,7-10 << YOU CAN ENTER A RANGE LIKE THIS. I SELECTED ALL THE New DC order(s) placed ALERTS The VistA Radiology/Nuclear Medicine application (RIS) will be automating the discontinuation of radiology orders that fall within a specific 'DATE DESIRED (Not guaranteed)' date/time range. All orders between the date of package inception through May 31st 2015 with request status values of 'Pending', 'Hold' & 'Scheduled' are in play regarding discontinuation. This work is based on a Central Office (CO) directive to the RIS ('ancillary') and the Computerized Patient Record System (CPRS). RA*5.0*135 will take the following approach: Three processes A, B & C will be scheduled to run. Process A consists of two parts. Process A: ---------- 1) Index the 'DATE DESIRED (Not guaranteed)' in the "BDD" index for all the records in the RAD/NUC MED ORDERS (#75.1) file. This part will be tasked to run in the background. 2) Process A, part two will re-compile all the impacted compiled input templates for file 75.1 including the 'DATE DESIRED (Not guaranteed)' field. This part will run in real time. Process B: ---------- Schedule the RA AUTO DISCONTINUE PROCESS option to run at different times depending on the type of account. If the account is a test account, the option is scheduled to run one hour in the future. If the account is a production account, the option is scheduled to run the next day at 21:00 hours. Starting at 21:00 hours will minimize user inconvenience. There are two parameters with the RA AUTO DISCONTINUE PROCESS. The first is that all radiology orders with a DATE DESIRED (not guaranteed) date between the date of package inception and midnight May 31st 2015 are orders identified as being discontinued. The second parameter is the REQUEST STATUS (#.05) of the order. This parameter is conditional depending on the REQUEST STATUS value. * All orders with REQUEST STATUS values of 'Pending' or 'Hold' those orders will be assigned a request status of 'Discontinued'. * If an order has a REQUEST STATUS value of 'Scheduled', the SCHEDULED DATE (TIME optional) (#23) field value must be midnight May 31st 2015 or earlier to have the order discontinued. The discontinuation process will be queued for the day after RA*5.0*135 is installed, at 21:00 hours. This will give the discontinuation (DC) process enough time to complete in quiet mode (CPRS notifications & RIS bulletins being disabled) before the next day begins. Note: while the discontinue task is being run the following RIS options will be set 'Out of Order': * Cancel a Request [RA ORDERCANCEL] * Hold a Request [RA ORDERHOLD] RA ORDERCANCEL & RA ORDERHOLD will be set back in order when the tasked option stops running. An email will be sent to the following recipients: POSTMASTER and members of the RA REQUEST CANCELLED mail group. This email will contain the date/time the DC process started, finished and the number of order records DC'd. Process C --------- This last tasked process will kill off the existing "AS" cross reference (xref) on the REQUEST STATUS (#5) field of the RAD/NUC MED ORDERS (#75.1) file. The "AS" xref was last updated in patch RA*5.0*130 but the xref was not rebuilt. As a result, bad data in the "AS" xref will cause a patient to appear in the 'Pending/Hold Rad/Nuc Med Request Log' [RA ORDERPENDING] option. Other actions taken by RA*5.0*135 --------------------------------- * Every order discontinued in the RIS will be discontinued in CPRS. * After the discontinuation process has successfully completed, RIS bulletins and CPRS notifications will be re-enabled. * For all the orders discontinued by RA*5.0*135 a generic cancel reason 'OBSOLETE ORDER-P135 (automated)' will be associated with the order. * POSTMASTER will be the "person" who discontinued (DC'd) the orders in both the RIS and CPRS. * The 'OBSOLETE ORDER-P135 (automated)' cancel reason will not be selectable by the user when exercising the 'Cancel a Request' [RA ORDERCANCEL] option. Participating Test Sites: ========================= West Los Angeles, CA VAMC Cleveland, OH VAMC Dallas, TX VAMC Heartland West (VISN 15) =================== Installation Instructions ==================== If installed during the normal workday, it is recommended that the Radiology users be off the system. Other VISTA users will not be affected. Install Time - less than two minutes 1. Load Transport Global: ---------------------- Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. Access the KIDS main menu: -------------------------- Start with the Kernel Installation and Distribution System Menu [XPD MAIN]: Edits and Distribution ... Utilities ... Installation ... Select Kernel Installation & Distribution System Option: INStallation Load a Distribution Print Transport Global Compare Transport Global to Current System Verify Checksums in Transport Global Install Package(s) Restart Install of Package(s) Unload a Distribution Backup a Transport Global Select Installation Option: 3. Select Installation Option: --------------------------- NOTE: The following are OPTIONAL - (When prompted for the INSTALL NAME, enter RA*5.0*135): a. Backup a Transport Global - This option will create a backup message of any routines exported with this patch. It will not backup any other changes such as DD's or templates. b. Compare Transport Global to Current System - This option will allow you to view all changes that will be made when this patch is installed. It compares all components of this patch (routines, DD's, templates, etc.). c. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. 4. Select Installation Option: Install Package(s): ----------------------------------------------- **This is the step to start the installation of this KIDS patch: a. Choose the Install Package(s) option to start the patch install. b. Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO// c. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//', answer NO. d. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', answer NO. Backout/Roll-back strategy ========================== Note: Back-out will be done only with the concurrence and participation of the development team and appropriate VA site/region personnel. The decision to back-out or rollback software will be a joint decision between development team, VA site/region personnel and other appropriate VA personnel. A national help desk ticket should be logged before attempting any backout procedure. If the discontinue process is not running use the Taskman Management menu to run the 'Schedule/Unschedule Options' option to unschedule 'RA AUTO DISCONTINUE PROCESS' If the discontinue process is running use the Taskman Management menu to run the 'Delete Tasks' option to unschedule 'RA AUTO DISCONTINUE PROCESS'. The task ID will be available by viewing the installation record for patch RA*5.0*135. Since three of the four routines are new, restore RABUL to its pre-RA*5.0*135 version and delete routines: RAIPR135, RAIPS135 and RAUTODC. Routine Information: ==================== The second line of each of these routines now looks like: ;;5.0;Radiology/Nuclear Medicine;**[Patch List]**;Mar 16, 1998;Build 7 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: RABUL Before: B5625174 After: B5711827 **2,15,75,135** Routine Name: RAIPR135 Before: n/a After: B1362436 **135** Routine Name: RAIPS135 Before: n/a After: B13391098 **135** Routine Name: RAUTODC Before: n/a After: B64769813 **135** Routine list of preceding patches: 75 ============================================================================= User Information: Entered By : Date Entered : JAN 26, 2017 Completed By: Date Completed: APR 26, 2018 Released By : Date Released : APR 26, 2018 ============================================================================= Packman Mail Message: ===================== $END TXT