Original message: "RA5_0P157T2_3190724" [#94668066]
=============================================================================
Run Date: AUG 28, 2019                     Designation: RA*5*157
Package : RA - RADIOLOGY/NUCLEAR MEDICINE     Priority: Mandatory
Version : 5       SEQ #143                      Status: Released
                  Compliance Date: SEP 28, 2019
=============================================================================

Associated patches: (v)RA*5*77     <<= must be installed BEFORE `RA*5*157'
                    (v)RA*5*106    <<= must be installed BEFORE `RA*5*157'
                    (v)RA*5*154    <<= must be installed BEFORE `RA*5*157'

Subject: ABNORMAL REPORT FORMATTING & DX CODE PROCESSING

Category: 
  - Routine
  - Other

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

 Associated Ticket(s):
 =====================
 INC4644465
 INC4753897
 INC2890615
 INC6714227
  
 Associated NSR(s):
 ==================
 N/A
  
 Participating Test Sites:
 =========================
 White River Junction VAMC
 South Texas HCS (San Antonio)
  
 Problem A:
 ----------
 The Abnormal Exam Report [RA ABNORMAL] is formatted in a way that is 
 sometimes misleading as to which diagnostic codes go with which exams.
  
 Resolution A:
 ------------- 
 Routine RAPRINT1 is modified to adjust the report formatting so that 
 the diagnostic code header is clearly positioned above the exams it 
 represents.
  
 Problem B:
 ----------
 A subscript error was reported when attempting to process a "Procedure 
 Changed" alert [#67] in CPRS: 
  
 <SUBSCRIPT>SET1+25^RAO7PC4
  
 The 'changed from' procedure is missing from the 'DATA FOR PROCESSING' 
 field [#2] in the ALERT TRACKING [#8992.1] file.
  
 RESOLUTION B:
 -------------
 Routine RAO7PC4 is modified as follows:
  
 If the 'changed from' procedure is missing in the alert data, it will 
 first try to get the procedure information from the order, if available, 
 and if that fails it will display an 'UNKNOWN' on the alert when 
 processed.
  
 PROBLEM C:
 ----------
 Radiology identifies the primary and secondary diagnostic codes (DX) based
 on the order they are received in the OBX segments of the report message
 (HL7 version 2.4 only). A primary designation on Powerscribe does not
 dictate the order that they are sent, but instead they are sorted by the
 DX code's number (highest to lowest).  So, a secondary code number of 1200
 (AAA Not Present) will be above the primary code of 1000 (no alert
 required) and therefore be filed as Primary in Radiology.
  
 RESOLUTION C:
 -------------
 Voice Recognition sends the Primary designation along with the DX code. 
 VistA Radiology will check for that designation and assign the code as
 Primary regardless of its position in the HL7 message.  If no Primary
 designation is sent, the first code will still be identified as Primary.
  
 PROBLEM D:
 ----------
 The radiology registration menu enforces a location switch to the 
 modality of the ordered procedure. There are times when it is necessary 
 to register an exam under a different modality than what was ordered, as 
 decided by the radiologist at the time of the procedure. Currently, the 
 package prevents the modality from being changed and the order must be 
 discontinued and reordered.
  
 RESOLUTION D:
 -------------
 A new security key (RA SWITCHLOC) is distributed with this patch. Holders 
 of this key will be able to register an exam under a different modality 
 than the ordered procedure when appropriate. Routine RAREG3 is modified to
 check for this security key at the time of exam registration.
  
  
 DOCUMENTATION RETRIEVAL:
 ========================
 These are the documentation changes associated with this patch:
  
 Radiology/Nuclear Medicine Technical Manual 
  
 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 as follows:
  
     The preferred method is to SFTP the files from
     download.vista.domain.ext, which will transmit the files from the
     first available FTP server.
  
 The documentation distribution includes:
  
 File Name             Description                           Protocol
 ---------             -----------                           --------
 RA5_0TM.DOCX          Technical Manual                      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*157
  
       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:
       ----------------------------------------
       Abnormal Exam Report       [RA ABNORMAL]
       Register Patient for Exams [RA REG]
  
       When prompted, 'Enter protocols you wish to mark as 'Out Of
       order':',press <ENTER>.
  
 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

Routine Information:
====================
The second line of each of these routines now looks like:
 ;;5.0;Radiology/Nuclear Medicine;**[Patch List]**;Mar 16, 1998;Build 2

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

Routine Name: RAHLO1
    Before: B66582328   After: B66347162  **4,5,12,17,21,27,48,55,66,87,
                                           84,94,104,47,157**
Routine Name: RAHLO2
    Before: B23673505   After: B26410150  **55,80,84,144,157**
Routine Name: RAHLTCPB
    Before: B71900626   After: B76979466  **12,17,25,51,71,81,84,106,157**
Routine Name: RAHLTCPX
    Before:B103640512   After:B105636791  **47,114,129,141,144,157**
Routine Name: RAO7PC4
    Before: B40834055   After: B43547246  **28,32,31,45,77,157**
Routine Name: RAPRINT1
    Before: B29745884   After: B30536433  **34,97,47,157**
Routine Name: RAREG3
    Before: B30767634   After: B31537156  **8,137,144,154,157**
 
Routine list of preceding patches: 77, 106, 154

=============================================================================
User Information:
Entered By  :                               Date Entered  : MAR 14, 2019
Completed By:                               Date Completed: AUG 28, 2019
Released By :                               Date Released : AUG 28, 2019
=============================================================================


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

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