$TXT Created by at DEVRAD.DOMAIN.EXT (KIDS) on Wednesday, 12/04/19 at 12:53 ============================================================================= Run Date: FEB 13, 2020 Designation: RA*5*161 Package : RA - RADIOLOGY/NUCLEAR MEDICINE Priority: Mandatory Version : 5 SEQ #146 Status: Released Compliance Date: MAR 16, 2020 ============================================================================= Associated patches: (v)RA*5*148 <<= must be installed BEFORE `RA*5*161' Subject: COMMUNITY CARE CONSULTS REVISITED Category: - Routine - PATCH FOR A PATCH - Data Dictionary Description: ============ Associated Ticket(s): ===================== INC6250998 INC6000785 Associated NSR(s): ================== N/A Participating Test Sites: ========================= Salisbury VAMC VA Heartland - West, VISN 15 Problem A: ---------- Patch RA*5.0*148 created the ability to refer radiology orders to Community Care. The option will automatically create a consult for the radiology order and place the radiology order on hold. The request services must be entered exactly as indicated in the post-install instructions for that patch. The issue comes in with integrated sites who must enter each one multiple times with a site identifier that designates which division the service belongs to. The software as written did not accommodate this workflow. Additionally, only six of the nine imaging types (modalities) were activated for community care referral. Cardiology Studies, Angio/Neuro/Interventional, and Vascular Lab cannot be referred to CC using the new option. Resolution A: ------------- A new field called COMMUNITY CARE REQUEST SERVICE (#120) has been added to the Imaging Location file (#79.1). This new field is a pointer to the Request Services file (#123.5) which will link the request service for that site/division with the corresponding imaging location for that site/division. The naming convention of the request service is the same as indicated in RA*5*148, however the site will be able to append a site identifier to the end of the name. Prepending the site identifier will not work. For example: COMMUNITY CARE-IMAGING CT-AUTO SYR <-- SY for Syracuse The imaging location from the radiology request is used to look up the CC Consult that will be used for the referral. A new menu called 'Radiology Community Care Consult Entry/Edit' [RA COMCARE] allows the community care consult service to be associated with the appropriate imaging location. This new menu is located on the 'Utility Files Maintenance Menu' [RA MAINTENANCE]. The user will select the imaging location and then enter the Community Care service which matches that location's division. A screen is in place to enforce the naming convention and the imaging type are a match. You cannot add a CT request service to an MRI Imaging Location. The 'Location Parameter List' [RA SYSLOCLIST] option has been modified to display the CC Consult service that is on file for the selected imaging location. For mammography studies, there are two CC request services that can be entered on the mammography locations. Once for SCREENING and one for DIAGNOSTIC. This is the only time you should have more than one request service on an imaging location. Community Care Request Services can be created for Angio/Neuro /Interventional, Vascular Lab and Cardiology Studies following the naming convention. Once created, they can be added to the appropriate imaging locations for those modalities. COMMUNITY CARE-IMAGING ANGIO/NEURO/INTERVENTIONAL-AUTO COMMUNITY CARE-IMAGING CARDIOLOGY STUDIES (NUC MED)-AUTO COMMUNITY CARE-IMAGING VASCULAR LAB-AUTO (site identifier may be appended) Problem B: ---------- HSRM does not receive the provisional diagnosis from radiology orders forwarded to Community Care using the RA*5.0*148 menu option 'Refer Selected Requests to COMMUNITY CARE Provider' [RA ORDERREF]. Resolution B: ------------- Routine RAORDR1 is modified to set the OR GTX CODE dialog for the provisional diagnosis (Z01.89). DOCUMENTATION RETRIEVAL: ======================== These are the documentation changes associated with this patch: Radiology/Nuclear Medicine Technical Manual Radiology/Nuclear Medicine ADPAC Guide 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 RA5_OAG.DOCX ADPAC Guide BINARY =================== 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 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*161 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? NO// 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: ---------------------------------------- Refer Selected Requests to COMMUNITY CARE Provider [RA ORDERREF] Location Parameter List [RA SYSLOCLIST] When prompted, 'Enter protocols you wish to mark as 'Out Of order':',press . POST-INSTALL INSTRUCTIONS: ========================== 1. INTEGRATED/MULTIDIVISIONAL SITES: This step should be executed by CAC/HIS. Create new services for each division and each imaging type by using the following menu option: Consult Management [GMRC MGR] - SS Set up Consult Services [GMRC SETUP REQUEST SERVICES] The new services should match the naming convention below exactly, but a site identifier should be added to the END of the service name (for example KC for Kansas City: COMMUNITY CARE-IMAGING CT-AUTO KC) COMMUNITY CARE-IMAGING ANGIO/NEURO/INTERVENTIONAL-AUTO COMMUNITY CARE-IMAGING CARDIOLOGY STUDIES (NUC MED)-AUTO COMMUNITY CARE-IMAGING CT-AUTO COMMUNITY CARE-IMAGING GENERAL RADIOLOGY-AUTO COMMUNITY CARE-IMAGING MAGNETIC RESONANCE IMAGING-AUTO COMMUNITY CARE-IMAGING MAMMOGRAPHY DIAGNOSTIC-AUTO COMMUNITY CARE-IMAGING MAMMOGRAPHY SCREEN-AUTO COMMUNITY CARE-IMAGING NUCLEAR MEDICINE-AUTO COMMUNITY CARE-IMAGING ULTRASOUND-AUTO COMMUNITY CARE-IMAGING VASCULAR LAB-AUTO All newly created services should have ADMINISTRATIVE = YES and be added to the existing COMMUNITY CARE-GROUPER. 2. ALL SITES: ********************************************************************** * All sites must complete the following for the Community Care * * Referral option to function! * ********************************************************************** This step should be performed by the Radiology ADPAC or AO or designee. Use the following menu option to edit each active imaging location and add the appropriate Community Care Consult Service. It will be a ONE to ONE relationship. Only mammography locations will have more than one CCC service assigned (Screening and Diagnostic). From the 'Utility Files Maintenance Menu' [RA MAINTENANCE], select the new menu Radiology Community Care Consult Entry/Edit [RA COMCARE]. RA MAINTENANCE Utility Files Maintenance Menu Complication Type Entry/Edit Diagnostic Code Enter/Edit Examination Status Entry/Edit Film Type Entry/Edit Label/Header/Footer Formatter Major AMIS Code Entry/Edit Nuclear Medicine Setup Menu ... Order Entry Procedure Display Menu ... Procedure Edit Menu ... Radiology Community Care Consult Entry/Edit <-- new menu Reports Distribution Edit Sharing Agreement/Contract Entry/Edit Standard Reports Entry/Edit Valid Imaging Stop Codes Edit Select Utility Files Maintenance Menu Option: radiology Community Care Consult Entry/Edit Select IMAGING LOCATIONS: X-RAY CLINIC (GENERAL RADIOLOGY-500) ALBANY Select COMMUNITY CARE REQUEST SERVICE: commUNITY CARE-IMAGING GENERAL RADIOLOGY- AUTO ALB Select IMAGING LOCATIONS: CT SCAN CAT SCAN (CT SCAN-500) ALBANY Select COMMUNITY CARE REQUEST SERVICE: COMMUNITY CARE-IMAGING CT-AUTO ALB 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: RAORDR Before: B93349955 After:B102292069 **148,161** Routine Name: RAORDR1 Before: B40134897 After: B48879943 **148,161** Routine Name: RAORDR2 Before: B22971178 After: B27720200 **148,161** Routine list of preceding patches: 148 ============================================================================= User Information: Entered By : Date Entered : JUN 26, 2019 Completed By: Date Completed: FEB 13, 2020 Released By : Date Released : FEB 13, 2020 ============================================================================= Packman Mail Message: ===================== $END TXT