$TXT Created by                L at DEV.DEV.DOMAIN.EXT  (KIDS) on Tuesday, 05/29/18 at 07:00
=============================================================================
Run Date: SEP 06, 2018                     Designation: RA*5*144
Package : RA - RADIOLOGY/NUCLEAR MEDICINE     Priority: Mandatory
Version : 5       SEQ #131                      Status: Released
                  Compliance Date: OCT 07, 2018
=============================================================================

Associated patches: (v)RA*5*103    <<= must be installed BEFORE `RA*5*144'
                    (v)RA*5*132    <<= must be installed BEFORE `RA*5*144'
                    (v)RA*5*137    <<= must be installed BEFORE `RA*5*144'
                    (v)RA*5*141    <<= must be installed BEFORE `RA*5*144'

Subject: HL7 VAQ RELEASE STUDY & HLO QUERY CLEAN-UP

Category: 
  - Routine
  - Other

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

 This patch addresses the following issues:
  
 1) National Teleradiology Program (NTP) 'Release' study (VAQ) HL7 message
 2) HLO Query Logic Cleanup
 3) Erroneous reports with 'Add Exam to Last Visit' option
 4) Inactive DX codes from Voice Recognition, NTP, and/or other reporting 
    interface.
 5) Redundant call to GENERATE^HLMA
 6) Registered request printer location and exam information display
 7) <SUBSCRIPT>STUFF+1^RASTREQ1 - Strip site prefix if SSANs are disabled
  
 Associated Ticket(s):
 =====================
 I9842171FY16
 R18449004FY18
 R17033449FY18
 I18877890FY18
 INC0052650
  
 Associated NSR(s):
 ==================
 N/A
  
 Participating Test Sites:
 =========================
 Martinsburg VAMC
 Huntington VAMC
 North Texas HCS (Dallas)
  
 Problem A:
 ----------
 When NTP releases a study back to the facility for local dication, they
 send a 'VAQ' message to VistA Radiology. The radiology package will update
 the report to a deleted status if it has no images attached, or the report
 status will be NULL if there are images attached. The report's activity
 log is also updated with a QUIT action.   However, radiology does not pass
 the information on to the Picture Archiving and Communication System
 (PACS) so PACS is not aware that the study was released and now needs to
 be read by a local radiologist. This potentially causes delays in patient
 care as the released study may be overlooked.  Manual steps are needed to
 resend the study to PACS or update it so that it will be picked up by
 local staff to read/dictate.
  
 Resolution A:
 -------------
 When VistA Radiology receives a 'VAQ' release study message from NTP, it 
 will process it and then broadcast the 'VAQ' message out to subscribers 
 of the new radiology event driver protocol RA RELEASE 2.4.  The ORU 
 message will contain a 'VAQ' in the OBR 25 - Result Status field and the 
 OBX 11 - Observation Result Status fields. The message will not be 
 returned to the sender if they are a subscriber of the RA RELEASE 2.4 
 event driver. 
  
 Problem B:
 ----------
 Previous NTP vendor (ScImage) used HLO queries to retrieve historical 
 radiology reports.  The current vendor uses the radiology option 'Resend
 Radiology HL7 Messages By Date Range' [RA HL7 RESEND BY DATE RANGE]. The
 HLO query logic is no longer in use and will be removed from all VistA
 systems.  This includes five routines and four HLO Application Registries.
  
 Resolution B:
 -------------
 This patch will DELETE the following routines:
  
  RAHL23Q
  RAHL23Q1
  RAHL23QU
  RAHL24Q
  RAHL24U
  
 This patch will DELETE the following HLO Application Registries:
  
  RA-NTP-QRY-CLIENT
  RA-NTP-QRY-SERVER
  RA-NTP-QUERY
  RA-NTP-RSP
  
 Problem C:
 ----------
 R18449004FY18
 R17033449FY18
 Using the 'Add Exam to Last Visit' [RA ADDEXAM] option in Radiology to add
 a descendant printset exam will intermittently result in an erroneous 
 report being attached to the added exam(s). 
  
 Resolution C:
 -------------
 Variable RA17 is set in routine RAREG and used in RAREG2 to set the 
 report pointer  on the printset studies.  PS1 will set RA17 again in
 RAREG1 just before calling SET17^RAREG2 to set the 'REPORT TEXT' [#17]
 field on the descendant exam.  A check is also performed in RAREG and
 RAREG1 to see if the RA17 variable is not correct, and if so the
 application will log it.
  
 Problem D:
 ----------
 I18877890FY18
 Inactive Radiology Diagnostic Codes (Dx Code) from the DIAGNOSTIC CODES 
 file [#78.3] are selectable with Voice Recognition (VR) HL7 interface with
 VistA Radiology package. A VistA Radiology patch is needed to
 monitor/check the status of the Dx Code and prevent an inactive Dx Code
 from being sent from VR software via HL7 interface to VistA Radiology. The
 patch will need to send information back to VR why the message was not
 transmitted and necessary follow-up actions to communicate the correct
 Radiologic Dx Code. The use of inactive DX Codes has been reported as a 
 patient safety issue (PSPO 3637); a National Patient Safety Alert is
 pending. 
  
 Resolution D:
 -------------
 Modify DIAG^RAHLO2 to reject the HL7 report (ORU) message if the 
 diagnostic code passed has the inactive flag set.  A negative
 acknowledgement (NAK) will be returned to the sending application
 indicating the reason for the rejection. If the site has a mail group 
 populated on the sending application parameter, a mail bulletin will be
 generated to that mail group.  An exception will be logged in file HL7
 MESSAGE EXCEPTIONS [#79.3]. RAHLO has also been modified to clean up some
 variables.
  
 Problem E:
 ----------
 A redundant call to GENERATE^HLMA was discovered in RAHLRPT where the
 routine branches off to v2.4 logic.
  
 Resolution E:
 -------------
 Remove superfluous 'EXIT' call in routine RAHLRPT where v2.4 logic 
 branches off.
  
 Problem F:
 ----------
 Radiology exams may be registered to a different location that the one 
 specified on the order and if the registered request printer is defined,
 the request will print to the order's submitted to location instead of the
 registered location. Also, unless a procedure is changed, the exam
 information is not displayed on the printed registered request.
  
 Resolution F:
 -------------
 Routine RAREG3 is modified to look at the registered exam's imaging 
 location's printer instead of the order's (submitted to) location 
 printer. Routines RAORD6 and RAUTL15 are modified to save and print the 
 exam data regardless if the procedure changed or which option is used.
  
 Problem G:
 ----------
 If radiology receives a report HL7 message with a site prefix on the 
 accession number, but site specific accession numbers (SSAN) are
 not enabled, radiology will error with <SUBSCRIPT>STUFF+1^RASTREQ1 and the
 exam will not complete.
  
 Resolution G:
 -------------
 Modify routine RAHLTCPX to strip off the site prefix if SSANs are not 
 enabled. 
  
  
 DOCUMENTATION RETRIEVAL:
 ========================
 These are the documentation changes associated with this patch:
  
 HL7 Setup/Implementation Manual
 HL7 Interface Specification
 HL7 Interface Specifications for Voice Recognition Dictation Systems 
  
  
 These manuals are available on the ANONYMOUS.SOFTWARE directory at one of
 the following Office of Information (OI) Field Offices. These files
 should be retrieved in binary format.
  
 Sites may retrieve documentation in one of the following ways:
  
 (1) The preferred method is to SFTP the files from
     download.vista.domain.ext, which will transmit the files from the
     first available FTP server.
  
 (2) Sites may also elect to retrieve documentation directly from a
     specific server as follows:
  
     Hines                 ftp.domain.ext
     Salt Lake City        ftp.domain.ext
  
 The documentation distribution includes:
  
 File Name             Description                           Protocol
 ---------             -----------                           --------
 RA5_0HL7              HL7 Setup/Implementation Manual       BINARY
 RA5_0HL7IS            HL7 Interface Specification           BINARY
 RA5_5HL7IS_VR         HL7 Interface Specifications for VR   BINARY 
  
  
    ===================  Installation Instructions ====================
   If installed during the normal workday, it is recommended that the
   Radiology users be off the system. **Voice Recognition activity 
   should be stopped.**  Other VISTA users will not be affected.
  
   Install Time - less than 2 minutes
  
   1. Load Transport Global:
      ----------------------
    Choose the PackMan message containing this patch and invoke the
    INSTALL/CHECK MESSAGE PackMan option.
  
   2. Start Up KIDS:
      --------------
    Start up 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:
      ---------------------------
       When prompted for the INSTALL NAME, enter RA*5.0*144
  
       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//
       ,answer YES unless your site rebuilds menu trees nightly.
  
    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
       Options, and Protocols? YES//', answer YES.
  
       When prompted, 'Enter options you wish to mark as 'Out Of order':',
       enter the following options:
  
       Disable the following VistA RIS options:
       ----------------------------------------
       Register Patient for Exams                    [RA REG]
  
  
  
       When prompted, 'Enter protocols you wish to mark as 'Out Of
       order':',press <ENTER>.
  
  
 Post-Install:
 =============
  
 At the time of this patch release, there are three vendors who can accept
 a 'VAQ' report status:
  
         McKesson PACS
         Carestream PACS
         Nuance (Powerscribe)
  
 Please coordinate with your PACS/VR vendor before enabling this event 
 driver.
  
 To activate the 'Release Study' messages, add your existing RA XXXPACS 
 ORU subsciber to the new RA RELEASE 2.4 Event Driver using the HL7 
 menu options:
  
  HL MAIN MENU       HL7 Main Menu
  
  
           Event monitoring menu ...
           Systems Link Monitor
           Filer and Link Management Options ...
           Message Management Options ...
           Interface Developer Options ...
           Site Parameter Edit
    HLO    HL7 (Optimized) MAIN MENU ...
  
  
  
  Select HL7 Main Menu Option: interface Developer Options
  
  
    EA     Application Edit
    EP     Protocol Edit
    EL     Link Edit
    VI     Validate Interfaces
           Reports ...
  
 Select Interface Developer Options Option: ep  Protocol Edit
  
  
 Select PROTOCOL NAME: RA RELEASE 2.4       Rad/Nuc Med release report 
 (v2.4 HL7)
                       HL7 INTERFACE SETUP               PAGE 1 OF 2
 --------------------------------------------------------------------------
  
             NAME: RA RELEASE 2.4
  
 DESCRIPTION (wp): + [This protocol is triggered whenever a Radiology]
  
  
 ENTRY ACTION:
  
  EXIT ACTION:
  
  
         TYPE: event driver  <ENTER>
  
  
  
 __________________________________________________________________________
  
 Exit    Save    Refresh    Quit
  
  
                         HL7 EVENT DRIVER               PAGE 2 OF 2
                          RA RELEASE 2.4
 --------------------------------------------------------------------------
       SENDING APPLICATION: RA-VOICE-SERVER
  TRANSACTION MESSAGE TYPE: ORU                        EVENT TYPE: R01
         MESSAGE STRUCTURE:
             PROCESSING ID:                            VERSION ID: 2.4
           ACCEPT ACK CODE:                 APPLICATION ACK TYPE:
  
  RESPONSE PROCESSING RTN: 
                            SUBSCRIBERS
  
   RA MCKESS ORU  <-- Input PACS ORU subscriber
  
  
  
  
 __________________________________________________________________________
  
 Exit    Save    Previous Page    Refresh    Quit
  
  
 Backout/Roll-back Strategy:
 ===========================
  
  Back-out will be done only with the concurrence and participation of
  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 procedures.
  
  Prior to installing an updated KIDS package, the site/region should have
  saved a backup of the routines in a mail message using the Backup a
  Transport Global [XPD BACKUP] menu option (this is done at time of
  install). The message containing the backed up routines can be loaded
  with the "Xtract PackMan" function at the Message Action prompt. The
  Packman function "INSTALL/CHECK MESSAGE" is then used to install the
  backed up routines onto the VistA System.

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: RAHL23Q
    Before:B135675772   After:    Delete  
Routine Name: RAHL23Q1
    Before:B125594612   After:    Delete  
Routine Name: RAHL23QU
    Before: B19520551   After:    Delete  
Routine Name: RAHL24Q
    Before: B17508754   After:    Delete  
Routine Name: RAHL24U
    Before:B179243251   After:    Delete  
Routine Name: RAHLO
    Before: B50036551   After: B51371724  **4,8,27,55,66,84,94,106,144**
Routine Name: RAHLO2
    Before: B22560890   After: B23673505  **55,80,84,144**
Routine Name: RAHLRPC
    Before: B16908988   After: B19608797  **12,25,54,71,82,81,84,144**
Routine Name: RAHLRPT
    Before: B66664791   After: B66920112  **2,12,10,25,81,80,84,103,144**
Routine Name: RAHLRPT1
    Before: B48303444   After: B50118132  **47,144**
Routine Name: RAHLRPT2
    Before:  B7037276   After:  B8297921  **47,144**
Routine Name: RAHLTCPX
    Before:B100993150   After:B103640512  **47,114,129,141,144**
Routine Name: RAIPS144
    Before:       n/a   After:  B1579964  **144**
Routine Name: RAORD6
    Before: B62955625   After: B63274201  **5,10,15,18,27,45,41,75,85,
                                           99,123,132,144**
Routine Name: RAREG
    Before: B43601921   After: B45671169  **23,85,47,144**
Routine Name: RAREG1
    Before: B30837568   After: B33386427  **7,21,93,137,144**
Routine Name: RAREG3
    Before: B29955259   After: B30473392  **8,137,144**
Routine Name: RARPTUT
    Before:B110702869   After:B111429659  **106,114,144**
Routine Name: RAUTL15
    Before: B20281413   After: B18349381  **5,10,47,144**
 
Routine list of preceding patches: 103, 132, 137, 141

=============================================================================
User Information:
Entered By  :                               Date Entered  : NOV 02, 2017
Completed By:                               Date Completed: SEP 06, 2018
Released By :                               Date Released : SEP 06, 2018
=============================================================================


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

$END TXT