$TXT Created by DAVIS,PAULETTE T at DEVCRN.FO-ALBANY.MED.VA.GOV (KIDS) on Wednesday, 01/11/12 at 11:55 ============================================================================= Run Date: APR 20, 2012 Designation: RG*1*59 Package : RG - CLINICAL INFO RESOURCE NETWORK Priority: Mandatory Version : 1 SEQ #58 Status: Released Compliance Date: MAY 11, 2012 ============================================================================= Associated patches: (v)RG*1*47 <<= must be installed BEFORE `RG*1*59' (v)RG*1*48 <<= must be installed BEFORE `RG*1*59' (v)RG*1*57 <<= must be installed BEFORE `RG*1*59' (v)DG*5.3*837 <<= must be installed BEFORE `RG*1*59' (v)RG*1*58 <<= must be installed BEFORE `RG*1*59' Subject: MESSAGING ENHANCEMENTS FOR NEW FIELDS Category: - Routine Description: ============ NOTE: RG* and MPIF* patches should NOT be installed on legacy systems to avoid issues with the legacy systems ending up as Treating Facilities. RG*1.0*47, RG*1.0*48, RG*1.0*57, RG*1.0*58, and DG*5.3*837 are required builds for patch RG*1*59. The messaging enhancements for new fields are being distributed in three VistA namespaces. The patches should be installed in this order: DG*5.3*837, RG*1.0*59, and MPIF*1.0*54. After installing DG*5.3*837, it is not necessary to wait for the data conversion completion bulletin to move on with installing RG*1.0*59. It is recommended that these three patches be installed within a short time window. Issue #1: Duplicate Primary View Reject Exceptions It was recommended in VistA patch RG*1*48 that facilities schedule the MPI/PD Exception Purge [RG EXCEPTION PURGE] option to run hourly. In the event that the job is not scheduled, then whenever a user enters the MPI/PD Exception Handling [RG EXCEPTION HANDLING] option, the Exception Purge will run. That job removes duplicate exceptions for the same exception TYPE and PATIENT, keeping the most recent exception. However, once the Exception Purge has run, it does not run again for an hour. During that timeframe, if multiple Primary View Reject (234) exceptions occur for the same patient, an exception is created for each of these occurrences. HC IdM requested that duplicate Primary View Reject (234) exceptions not be created on VistA. A code change has been made to routine RGHLLOG to check if there is an existing exception with an EXCEPTION STATUS of NOT PROCESSED. If there is an active exception for the exception TYPE and PATIENT, then a new exception is not created. The user can review the history of rejected edits by using the "PVR View PV Rej Detail" action item within the MPI/PD Exception Handling [RG EXCEPTION HANDLING] option for a selected exception. Issue #2: Enhancement to the HL7 v2.4 PID Processor Using Health Level Seven (HL7) messaging, patient identification information is transmitted in the Patient Identification (PID) segment. The VistA HL7 v2.4 PID processor has been enhanced to extract the TEMPORARY ID NUMBER and the FOREIGN ID NUMBER from the PID segment. The values are placed in ARRAY("TIN") and ARRAY("FIN"), respectively. If the value is equal to two double quotes (""), then the corresponding ARRAY node is set to @. Issue #3: Enhancement to Patient Update Messaging Routines RGADTP2 and RGADTP3 have been modified to examine incoming data for TEMPORARY ID NUMBER and FOREIGN ID NUMBER and set the appropriate array values. Then the HL7 v2.4 patient update API is called in routine VAFCPTED to update the PATIENT (#2) file. (Note: The VAFCPTED routine is being updated in patch DG*5.3*837.) Issue #4: Prevent Non-Enumerated Record from Updating a More Recent Record during the Linking to the New Record When an "old" (non-enumerated) record was edited on VistA, it could potentially influence Primary View for that record on the MPI, and thus update a more recent patient record. Healthcare Identity Management (HC IdM) requests that this scenario be prevented. When facilities were originally enumerated and records in the PATIENT (#2) file were seeded with Integration Control Numbers (ICN), all records in the file were not enumerated - only records that were active during a three-year time span were enumerated. Patients added/edited after the original seeding also get ICNs. Therefore, there are old records in the PATIENT (#2) file without ICNs. To prevent an old non-enumerated record from updating a more recent record, two VistA patches (RG*1.0*59 and MPIF*1.0*54) and one Master Veteran Index patch (MPI*1.0*90) will be issued. These three patches make the following changes: RG*1.0*59 (this patch) ---------------------- - The A08 message builder has been enhanced to check whether ^XTMP("MPIF OLD RECORDS",dfn) is defined. If it is, the record is considered old, and the A08 message builder includes an OBX segment in the message: OBX^^CE^OLDER RECORD^^Y - The A08 application acknowledgment processor has been enhanced to kill the "old" record designator, ^XTMP("MPIF OLD RECORDS",dfn), since if the traits happen to be the same on the Primary View, no subsequent A31 synchronization message will be sent. Since the Primary View and the patient record are in sync, the "old" record designation can be removed, and subsequent updates to this record are allowed to update the Primary View. - The A31 message processor has been enhanced to kill the "old" record designator, ^XTMP("MPIF OLD RECORDS",dfn). If the MPI sends an update message, the VistA record and the Primary View are in sync, and the "old" record designation can be removed. MPIF*1.0*54 ----------- - The enumeration builder, remote procedure MPIF REMOTE LOCAL ICN ASSIGN, has been enhanced to set the ^XTMP("MPIF OLD RECORDS",dfn) global, if the record with that DFN has no ICN assigned and is not in the ^DPT("AMPIMIS",dfn) index indicating it is in the process of being assigned an ICN. - The A31 message builder has been enhanced to check whether ^XTMP("MPIF OLD RECORDS",dfn) is defined. If it is, the record is considered old, and the A31 message builder includes an OBX segment in the message: OBX^^CE^OLDER RECORD^^Y - The A31 application acknowledgment processor has been enhanced to kill the "old" record designator, ^XTMP("MPIF OLD RECORDS",dfn), since if the traits happen to be the same on the Primary View, no subsequent A31 synchronization message will be sent. Since the Primary View and the patient record are in sync, the "old" record designation can be removed, and subsequent updates to this record are allowed to update the Primary View. MPI*1.0*90 (patch is ONLY installed on the MPI) ----------------------------------------------- - The patch will check whether the incoming A31 or A08 message contains an OBX segment marking the record as "old". If it does, then the authority score for the patient will be considered -1, and thus not influence the Primary View. Associated Remedy Ticket(s): ============================ There are no associated Remedy Tickets. Associated New Service Request (NSR): ===================================== There is no associated NSR with the patch. Test Sites: =========== Alexandria VAMC Altoona VAMC New Mexico HCS (Albuquerque) South Texas HCS Installation Instructions: ========================== This patch takes less than 2 minutes to install. This patch should be loaded during non-peak hours to minimize disruption to the users. 1. Users are allowed on the system during patch installation. 2. The HL7 incoming filers should be stopped. Use the Monitor, Start, Stop Filers [HL FILER MONITOR] option on the Filer and Link Management Options [HL MENU FILER LINK MGT] menu on the HL7 Main Menu [HL MAIN MENU]. 3. Use the INSTALL/CHECK MESSAGE option on the PackMan menu. Note: TEXT PRINT/DISPLAY option in the PackMan menu will display the patch text only. 4. From the Kernel Installation and Distribution System Menu, select the Installation menu. 5. From this menu, you may elect to use the following options: (a) Backup a Transport Global. (b) Compare Transport Global to Current System. (c) Verify Checksums in Transport Global. (d) Print Transport Global. 6. Use the Install Package(s) option and select the package RG*1.0*59. 7. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//', respond NO. 8. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', respond YES. The following OPTIONS should be disabled during the installation. Register a Patient [DG REGISTER PATIENT] Load/Edit Patient Data [DG LOAD PATIENT DATA] Electronic 10-10EZ Processing [EAS EZ 1010EZ PROCESSING] Preregister a Patient [DGPRE PRE-REGISTER OPTION] UPDATE BATCH JOB FOR HL7 v2.3 [VAFC BATCH UPDATE] MPI/PD Exception Handling [RG EXCEPTION HANDLING] 9. After patch installation has completed, restart the HL7 incoming filers. Use the Monitor, Start, Stop Filers [HL FILER MONITOR] option on the Filer and Link Management Options [HL MENU FILER LINK MGT] menu on the HL7 Main Menu [HL MAIN MENU]. Routine Information: ==================== The second line of each of these routines now looks like: ;;1.0;CLINICAL INFO RESOURCE NETWORK;**[Patch List]**;30 Apr 99;Build 1 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: RGADTP Before: B77748334 After: B82380142 **26,27,20,34,35,40,45,44,47,59** Routine Name: RGADTP1 Before: B39482051 After: B41160023 **26,27,42,45,44,47,48,59** Routine Name: RGADTP2 Before: B54208943 After: B57266100 **27,20,45,44,47,48,49,52,54,58,59** Routine Name: RGADTP3 Before: B11058020 After: B13484715 **48,59** Routine Name: RGHLLOG Before: B24264633 After: B30413623 **1,3,11,13,18,19,25,45,52,57,59** Routine list of preceding patches: 57, 58 ============================================================================= User Information: Entered By : DAVIS,PAULETTE Date Entered : NOV 16, 2011 Completed By: ULRICH,CYNTHIA Date Completed: APR 04, 2012 Released By : HEUER,CINDY Date Released : APR 20, 2012 ============================================================================= Packman Mail Message: ===================== $END TXT