============================================================================= Run Date: AUG 29, 2014 Designation: TIU*1*263 Package : TIU - TEXT INTEGRATION UTILITIES Priority: Mandatory Version : 1 SEQ #260 Status: Released Compliance Date: SEP 12, 2014 ============================================================================= Associated patches: (v)TIU*1*250 <<= must be installed BEFORE `TIU*1*263' (v)LEX*2*80 <<= must be installed BEFORE `TIU*1*263' (v)ICD*18*57 <<= must be installed BEFORE `TIU*1*263' (v)TIU*1*267 <<= must be installed BEFORE `TIU*1*263' Subject: CHANGES FOR ICD-10 Category: - Routine - Other - Informational Description: ============ IMPORTANT INFORMATION Please read the Overview Guide (ICD-10_PROD_OVERVIEW_GUIDE_GROUPS_5_6_7.pdf) posted on the Anonymous directory for installation order. This is critical for proper functionality of the ICD-10 Software. This patch is part of the Computerized Patient Records System CPRSv30 project. This project will modify the Computerized Patient Record System, Text Integration Utilities, Consults, Health Summary, Problem List, Clinical Reminders, and Order Entry/Results Reporting to meet the requirements proposed by the Dept. of Health and Human Services to adopt ICD-10 code set standards for Clinic Orders. On January 16, 2009, the Centers for Medicare & Medicaid Services (CMS) released a final rule for replacing the 30-year-old ICD-9-CM code set with International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) and International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) with dates of service, or date of discharge for inpatients, that occur on or after the industry activation date. The classification system consists of more than 68,000 codes, compared to approximately 13,000 ICD-9-CM codes. There are nearly 87,000 ICD-10-PCS codes, while ICD-9-CM has nearly 3,800 procedure codes. Both systems also expand the number of characters allotted from five and four respectively to seven alpha-numeric characters. This value does not include the decimal point, which follows the third character for the ICD-10-CM code set. There is no decimal point in the ICD-10-PCS code set. These code sets have the potential to reveal more about quality of care, so that data can be used in a more meaningful way to better understand complications, better design clinically robust algorithms, and better track the outcomes of care. ICD-10-CM also incorporates greater specificity and clinical detail to provide information for clinical decision making and outcomes research. NOTE: Functionality specific to activation of the ICD-10 code set shall not be seen by end users until the code set has been activated. Patch Components ================ Files & Fields Associated: N/A Forms Associated: N/A Mail Groups Associated: N/A Options Associated: N/A Protocols Associated: N/A Security Keys Associated: N/A Templates Associated: N/A Additional Information: Changes Made to Accommodate ICD-10: ----------------------------------- Problem 1: ---------- In the past, a TIU Progress Note could be linked to particular problems from the patient's Problem List using TIU VISTA. These problems are displayed in the "Associated Problems" section of the Detailed Display of the note. This has generated the following needs for changes from TIU. Need: The List Manager actions that permit users to link problems directly to a TIU Progress Note must be either updated to allow the selection of ICD-9 or ICD-10 problems or the link action must be discontinued. Resolution: TIU VISTA protocols permitting users to link problems directly to a TIU Progress Note have been disabled. Disabled Protocols: TIU ACTION LINK TO PROBLEMS TIU ACTION MENU LINK TO PROBLEM TIU ACTION SELECT PROBLEM TIU BROWSE ACTION LINK TO PROBLEM Note: This means that all problems linked directly to Progress Notes will predate this patch and will therefore be ICD-9 problems. Need: The "Associated Problems" section of the Detailed Display of the note must indicate the coding system of the linked problems since there are now 2 possible coding systems. Resolution: The Detailed Display of the note has been altered to indicate the code version of the linked problems. The Detailed Display has been changed for TIU VISTA and for the CPRS GUI. Need: PRINTING from the CPRS GUI of the Detailed Display of notes must indicate the coding system of the linked problems. Resolution: Such prints now indicate the coding system of the linked problems. Need: Health Summaries from the CPRS GUI whose type includes the detailed display of a note must indicate the coding system of the linked problems. Resolution: Such Health Summaries now indicate the coding system of the linked problems. Problem 2: ---------- Need: TIU List Manager (LM) Action Reassign is a manager action that is still in use. It creates a new TIU document, prompts the user for a visit, and then prompts the user for diagnoses for the visit. In some circumstances TIU code is invoked to prompt for diagnoses. This TIU code must be updated to use the appropriate coding version, ICD-9 or ICD-10. Resolution: The TIU process of prompting the user for diagnoses and storing them has been updated to use the correct code version. Problem 3: ---------- Need: TIU Object VA-WRIISC ACTIVE PROBLEMS must be updated to fetch and display problems in their own coding system, ICD-9 or ICD-10. Resolution: The object now displays problems in their own code version. NOTE: TIU Object VA-WRIISC ACTIVE PROBLEMS is the only nationally distributed TIU Object which includes Diagnoses/Problems. New Service Requests (NSRs) ---------------------------- N/A Patient Safety Issues (PSIs) N/A Remedy Ticket(s) & Overview --------------------------- ClearQuest Ticket: 1. HDS000021548 TIU Associated Problems on a PN contains lower case icd-9-cm instead of caps Problem: ------- This ClearQuest ticket is related to Problem 1 above, but concerns the text of the Provider Narrative which in some cases may contain coding system information as part of the Narrative itself. This information was indicated in lower case. Resolution: ---------- The coding system shown as part of the Provider Narrative is now indicated in upper case. 2. HDS000021870 ICD10 IOC TIU reassign notes, no ICD-10 encounter form in VistA Problem: ------- In the ICD-10 Code System, when users reassigned a note and edited the encounter data for the destination visit, they were not presented with a list of diagnoses from the encounter form to choose from as they should have been. Resolution: ---------- The encounter form initially used to test with was faulty. When using a correct form, testers were presented with the list of diagnoses. Test Sites: ---------- Denver Madison Northampton Coatesville Orlando Documentation Retrieval Instructions ------------------------------------ Updated documentation describing the new functionality introduced by this patch is available. The preferred method is to FTP the files from ftp://download.vista.domain.ext/. This transmits the files from the first available FTP server. Sites may also elect to retrieve software directly from a specific server as follows: Albany ftp.domain.ext Hines ftp.domain.ext Salt Lake City ftp.domain.ext Documentation can also be found on the VA Software Documentation Library at: http://www.domain.ext/vdl/ Title File Name FTP Mode ------------------------------------------------------------------------- Clinical Coordinator and User Manual tiuum.pdf (binary) tiuum.doc (ascii) Technical Manual tiutm.pdf (binary) tiutm.doc (ascii) ICD-10 Production Overview Guide Groups 5, 6, and 7 ICD-10_PROD_OVERVIEW_GUIDE_GROUPS_5_6_7.pdf (binary) Patch Installation: Pre/Post Installation Overview ------------------------------ This patch has a post-install routine, TIUPS263, which disables the 4 protocols listed above. This routine can be deleted once the patch is installed successfully. Installation Instructions ------------------------- This patch may be installed at any time with no disruption to users. This patch should take less than 5 minutes to install. There are no options to disable during the installation. 1. Download the TIU_10_263.KID file from the appropriate FTP Server to a directory on your system. 2. Use the LOAD A DISTRIBUTION option on the KIDS INSTALLATION menu, and enter: [DIR:]TIU_10_263.KID, where [DIR:] is the local directory where you have stored the host file. 3. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, you may elect to use the following options. When prompted for the INSTALL enter the patch: TIU*1.0*263 a. Print Transport Global - This option lets you print the contents of a Transport Global that is currently loaded in the ^XTMP global. b. 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. c. 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.). d. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. 4. From the Installation Menu, select the Install Package(s) option and choose the patch to install: TIU*1.0*263 5. When Prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//' answer 'NO' 6. When Prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//' answer 'NO' Post-Installation Instructions ------------------------------ Post-install routine TIUPS263 may be deleted after the patch installs successfully. Routine Information: ==================== The second line of each of these routines now looks like: ;;1.0;TEXT INTEGRATION UTILITIES;**[Patch List]**;Jun 20, 1997;Build 16 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: TIULQ Before: B15422187 After: B16402401 **19,100,157,211,263** Routine Name: TIUPS263 Before: n/a After: B2355409 **263** Routine Name: TIUPXAPI Before: B76270559 After: B85709375 **15,24,29,82,107,126,161,267,263** Routine Name: TIUSRV Before: B53540919 After: B56568642 **1,19,28,87,61,100,109,113, 112,184,211,250,263** Routine list of preceding patches: 250, 267 ============================================================================= User Information: Entered By : Date Entered : AUG 22, 2011 Completed By: Date Completed: AUG 27, 2014 Released By : Date Released : AUG 29, 2014 ============================================================================= Packman Mail Message: ===================== No routines included