$TXT Created by at CTST.FO-BIRM.DOMAIN.EXT (KIDS) on Monday, 05/22/17 at 16:19 ============================================================================= Run Date: JUL 20, 2017 Designation: TIU*1*297 Package : TIU - TEXT INTEGRATION UTILITIES Priority: Mandatory Version : 1 SEQ #278 Status: Released Compliance Date: AUG 19, 2017 ============================================================================= Associated patches: (v)TIU*1*218 <<= must be installed BEFORE `TIU*1*297' (v)TIU*1*225 <<= must be installed BEFORE `TIU*1*297' (v)TIU*1*256 <<= must be installed BEFORE `TIU*1*297' (v)TIU*1*296 <<= must be installed BEFORE `TIU*1*297' Subject: TIU UNAUTHORIZED ABBREVIATION AND DICTATION CONTROL Category: - Data Dictionary - Routine - Other - Enhancement (Mandatory) - Input Template Description: ============ TIU*1.0*297 modifies the Text Integration Utilities (TIU) application. This patch addresses NSR # 20140809 (Prevention of Unauthorized Abbreviations in the TIU Screen) and NSR # 20141003 (TIU Dictation Control). Detailed descriptions for each of these NSRs are listed below. This patch also addresses a minor issue identified with Patch TIU*1.0*296 in which the new TIU Event Edit [TIU TEXT EVENT EDIT] option only allows users with at-sign (@)-Programmer access in VistA to add/update/delete entries in the TIU TEXT EVENTS File (#8925.71). ***** Please Note the Following ******* Per management guidelines, the functionality in NSR #20140809 and #20141003 is optional and upon release of the patch, it should be in an inactive or disabled state. This allows facilities that choose not to use this functionality, to only be required to install the patch. In other words the corresponding functionality will continue to act the same as it did prior to the installation of this patch with no changes. Any facility that wants to use the functionality of the NSRs must activate the functionality as defined in the post installation instructions. ************************************** NSR #20140809 - Prevention of Unauthorized Abbreviations in the TIU Screen -------------------------------------------------------------------------- Problem: -------- Currently Unauthorized Abbreviations, such as those on The Joint Commission "Do Not Use" list, can be used in the progress note within the TIU application without any alert to the note author. Solution: --------- Once the new "TIU Unauthorized Abbreviation" application is activated, it will prevent a NOTE from being signed unless each unauthorized abbreviation has been removed or spelled out. USE OF THIS FUNCTIONALITY IS OPTIONAL. Work with your facility Chief, Health Information Management (HIM) and Chief of Staff to determine whether this functionality should be turned on. A newly created "TIU Unauthorized Abbreviation" File (#8927.9) contains a standard set of fourteen unauthorized abbreviations from The Joint Commission. Staff may add additional abbreviation(s) to match any unauthorized abbreviations that they have identified in local policy. A newly created menu option "Unauthorized Abbreviations (Enter/Edit)" [TIU ABBV ENTER EDIT] maintains unauthorized abbreviation data in the "TIU Unauthorized Abbreviation" File (#8927.9). Another newly created menu option "List Unauthorized Abbreviations" [TIU ABBV LIST] lists all the abbreviations in File (#8927.9). These two new options are located under the existing "TIU Maintenance Menu" [TIU IRM MAINTENANCE MENU]. This patch will deploy all fourteen abbreviations with STATUS field set to "Inactive." This application can be activated by updating an abbreviation to a STATUS of "Active." If any identified abbreviation is found and listed in the File (#8927.9) with ACTIVE STATUS, the abbreviation will be listed in the CPRS "Insufficient Authorization" box. The Note cannot be signed by the staff unless each identified unauthorized abbreviation has been removed or spelled out. Select OPTION NAME: TIU MAINTENANCE MENU TIU IRM MAINTENANCE MENU 10 Unauthorized Abbreviations (Enter/Edit) 11 List Unauthorized Abbreviations The Unauthorized Abbreviations (Enter/Edit) option allows facility staff to enter/edit their own unauthorized abbreviation(s) into the "TIU UNAUTHORIZED ABBREVIATION" File (#8927.9). When facility staff creates a new entry, the field default settings will be as follows: * The CLASS Field (#.02) is defaulted to "LOCAL". * The ABBREVIATION EXACT MATCH Field (#.03) is defaulted to "YES". * The STATUS Field (#.04) is defaulted to "ACTIVE". * The NOTE Field (#.05) is optional. Staff can only edit the entries for ABBREVIATION EXACT MATCH, STATUS and NOTE if the CLASS field is set to "LOCAL." If the CLASS field is set to "NATIONAL", then no entry can be edited at the facility level. The List Unauthorized Abbreviations option displays a list of existing unauthorized abbreviations in the Unauthorized Abbreviations File (#8927.9), either active abbreviations only or active and inactive abbreviations. Requirements for the "Unauthorized Abbreviations (Enter/Edit)" are: 1) Fourteen Unauthorized Abbreviations from the Joint Commission listing are released in the "TIU UNAUTHORIZED ABBREVIATION" File (#8927.9) with CLASS Field (#.02) set to "LOCAL", "ABBREVIATION EXACT MATCH" Field (#.03) set to "YES", and the STATUS Field (#.04) set to "INACTIVE". The fourteen Unauthorized Abbreviations are: "IU, MgSO4, MS, MSO4, QD, Q.D., qd, q.d., QOD, Q.O.D., qod, q.o.d., U, u". 2) Any Unauthorized Abbreviation(s) entry with CLASS Field (#.02) set to "NATIONAL" cannot be added or modified by facility staff. In this release, no entry is released with "NATIONAL" CLASS. 3) No Unauthorized Abbreviation entry can be deleted once it is created. 4) The UNAUTHORIZED ABBREVIATION at field (#.01) cannot be changed or deleted once it is created, but STATUS Field (#.04) can be change to either ACTIVE or INACTIVE. 5) The UNAUTHORIZED ABBREVIATION Field (#.01) is prohibited from including the following punctuations: |^&~\:;,!? 6) The UNAUTHORIZED ABBREVIATION Field (#.01) is not case sensitive. 7) The requirement for case sensitivity check for an Unauthorized Abbreviation entry is determined by the "ABBREVIATION EXACT MATCH" Field (#.03). 8) Once a new Unauthorized Abbreviation entry is created, "ABBREVIATION EXACT MATCH" Field (#.03) is defaulted to "YES". Staff can change the value in this field. 9) The CLASS (#.02), ABBREVIATION EXACT MATCH (#.03), STATUS (#.04), and NOTE (#.05) fields are audited using FileMan options. 10) If CLASS Field (#.02) is set to "NATIONAL", Facility staff cannot change any Unauthorized Abbreviation entry. On the other hand, if CLASS Field (#.02) set to "LCOAL", the Facility staff can add/modify/activate/inactivate the Unauthorized Abbreviation entry from field (#.03) to field (#.05) regardless of the STATUS value. 11) An Unauthorized Abbreviation entry with CLASS field set to "LOCAL" can be managed by facility staff to serve any general medical and business practice need. Facility staff can inactivate these entries when an unauthorized abbreviation is no longer needed. (For example, MS may be an abbreviation for Multiple Sclerosis or Mitral Stenosis, or an abbreviation for Mississippi to obtain discount mailing bulk rate. U may be an abbreviation for U Street Corridor which is a commercial and residential district in Northwest Washington DC.) CAUTION: Any Abbreviation which is listed with ACTIVE STATUS in the "TIU UNAUTHORIZED ABBREVIATION" File (#8927.9) will be checked against an entire progress note including any credentials and street address. Thus, if a progress note contains any abbreviation which is listed with ACTIVE STATUS in the File (#8927.9), the NOTE cannot be signed unless each identified abbreviation is either removed or spelled out. NSR #20141003 - TIU Dictation Control ------------------------------------- Problem ------- Many medical centers have been having problems with students, residents, and other providers dictating progress notes and failing to supply all of the necessary information such as note title, associated visit, etc. This patch addresses this issue by introducing functionality which will allow a facility to control TIU dictation privileges for TIU documents of any type (Op reports, DC Summaries, Consults, etc.). Dictating authors should initiate a note stub and dictate a unique ID number with dictation instructions. The unique ID number is generated by the system. It is normally not disclosed to the user. However, in this case, it is disclosed as part of the dictation instructions, for easy identification. USE OF THIS FUNCTIONALITY IS OPTIONAL. Work with your facility Chief, and Health Information Management (HIM) to discuss the functionality this patch provides and whether it should be turned on. Dictation privileges are controlled by two new fields in the "TIU PARAMETERS" File (#8925.99). The fields are: 1) ENABLE DICTATION CONTROL Field (#.23) can be answered YES to enable the patch functionality. Entry of NO or nothing will disable the functionality. 2) DICTATION INSTRUCTIONS Field (#6) is a word processing field. It allows sites to enter site-specific dictation instructions. Within this field, sites may reference the variables TIUDA, TIUL5, and TIUINST by placing them between vertical bars, Example |TIUDA|. TIUDA is the internal entry number of the current document, TIUL5 is the last 5 digits of TIUDA, and TIUINST is the internal entry number of the INSTITUTION of the current logged-in user. Kernel's software-wide variables which are defined in the Kernel technical manual, and FileMan's package-wide variables which are defined in the FileMan technical manual, may be used as well. The security key, TIUDCT, must be assigned to the CPRS users who are authorized to dictate TIU Documents, and transcription personnel such as the Facility Chief HIM and the Transcription Supervisor/Staff. These two new fields (#.23 and #6) in the "TIU PARAMETERS" File (#8925.99) can be modified by using the "TIU BASIC PARAMETERS EDIT" option. Since the "TIU PARAMETERS" File (#8925.99) is based on the INSTITUTION File (#4), the "Enable Dictation Control" Field (#.23) can either enabled or disabled this "Dictation Control" functionality at the site's division level. By entering "BEGIN-DICTATION" on the first line of the progress note then "Save Without Signature", the text of the note will be immediately replaced with the text in the "DICTATION INSTRUCTIONS" Field (#6) in the "TIU PARAMETERS" File (#8925.99). Issue identified with Patch TIU*1.0*296: ------------------------------------------ Patch TIU*1*296 modified the Text Integration Utilities (TIU) application to send a TIU alert to the appropriate service provider(s) immediately after a staff member screens a patient and signs the associated note. The patch added the TIU TEXT EVENTS File (#8925.71) to allow the facility to define the words or phrase that will be searched for in a TIU document (progress note, consult, etc.). If the words or phrase are found in the TIU document, an alert is sent to the team specified in the TIU TEXT EVENTS File (#8925.71). Problem: -------- Patch TIU*1.0*296 exported the new TIU Event Edit [TIU TEXT EVENT EDIT] option which allows file add/update/delete functionality for the TIU TEXT EVENTS File (#8925.71). This option only allowed a user with at-sign (@)-Programmer access in VistA to add/update/delete entries in this file. Sites require Informatics staff who do not have the at-sign (@)-Programmer access, have this option for file updates. Solution: --------- The TIU Event Edit [TIU TEXT EVENT EDIT] option has been updated and is being deployed to allow Informatics staff, who do not have the at-sign (@)-Programmer access, to add/update/delete entries in the TIU TEXT EVENTS File (#8925.71). Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Mod/Del ----------------------- ------------------------------- ----------- TIU UNAUTHORIZED UNAUTHORIZED ABBREVIATION (#.01) NEW ABBREVIATION (#8927.9) CLASS (#.02) NEW ABBREVIATION EXACT MATCH (#.03) NEW STATUS (#.04) NEW NOTE (#.05) NEW TIU PARAMETERS (#8925.99) ENABLE DICTATION CONTROL (#.23) NEW TIU PARAMETERS (#8925.99) DICTATION INSTRUCTIONS (#6) NEW Forms Associated: Form Name File # New/Modified/Deleted --------- ------ -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ------------------------ ----------- -------------------- TIU IRM MAINTENANCE MENU MENU Modified TIU ABBV ENTER EDIT RUN ROUTINE NEW TIU ABBV LIST RUN ROUTINE NEW TIU ACTIVE TITLE CLEANUP RUN ROUTINE Modified TIU MAP TITLES MENU MENU Modified TIU TEXT EVENT EDIT EDIT Modified Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- TIUDCT Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- TIU TEXT EVENT EDIT INPUT TIU TEXT EVENTS Deleted (#8925.71) TIU BASIC PARAMETER EDIT INPUT TIU PARAMETERS Modified (#8925.99) Additional Information: New Service Requests (NSRs): ---------------------------- 20140809 - Prevention of Unauthorized Abbreviations in the TIU Screen 20141003 - TIU Dictation Control Patient Safety Issues (PSIs): ----------------------------- N/A Remedy Ticket(s) & Overview: ---------------------------- N/A Test Sites: ---------- Albany Upstate NY (528) Cleveland (541) Hines (578) Milwaukee (695) Omaha Nebraska (636) Software and Documentation Retrieval Instructions: ---------------------------------------------------- Software being released as a PackMan file and/or documentation describing the new functionality introduced by this patch are available. The preferred method is to retrieve files from download.vista.domain.ext. This transmits the files from the first available server. Sites may also elect to retrieve files directly from a specific server. Sites may retrieve the software and/or documentation directly using Secure File Transfer Protocol (SFTP) from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Albany: domain.ext Hines: domain.ext Salt Lake City: domain.ext Documentation can also be found on the VA Software Documentation Library at: http://www4.domain.ext/vdl/ Title File Name FTP Mode ---------------------------------------- --------- -------- TIU Clinical Coordinator and User Manual tiuum.pdf Binary TIU Technical Manual tiutm.pdf Binary Deployment, Installation, Back-Out, and Rollback Guide tiu_1_0_297_ig.pdf Binary TIU Dictation Control Training Guide tiu_1_0_297_tg.pdf Binary Patch Installation: Pre/Post Installation Overview: ------------------------------- Pre-Installation Instructions: ------------------------------ Do not install this patch while CPRS users are on the Computerized Patient Record System using "CPRS - Progress Note / Sign Note Now". It is recommended to install this patch during non-peak hours to minimize potential disruption to users. The installation of this patch should not take more than 5 minutes. The following options should be disabled before installing this patch: TIU Maintenance Menu [TIU IRM MAINTENANCE MENU] Active Title Cleanup Report [TIU ACTIVE TITLE CLEANUP] Title Mapping Utilities [TIU MAP TITLES MENU] TIU Parameters [TIU BASIC PARAMETER EDIT] Text Event Edit [TIU TEXT EVENT EDIT] Installation Instructions: -------------------------- 1. Choose the PackMan message containing this patch. 2. Choose the INSTALL/CHECK MESSAGE PackMan option. 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 NAME enter the patch # (ex. TIU*1.0*297): 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 DDs 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, DDs, 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. From the Installation Menu, select the Install Package(s) option and choose the patch to install. => Choose TIU*1.0*297 5. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO// => respond NO 6. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO// => respond NO 7. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO// => respond YES. Select the following options to disable: Option Name Menu Text ------------------------ ------------------------------ TIU IRM MAINTENANCE MENU TIU Maintenance Menu TIU ACTIVE TITLE CLEANUP Active Title Cleanup Report TIU MAP TITLES MENU Title Mapping Utilities TIU TEXT EVENT EDIT TIU Event Edit TIU BASIC PARAMETER EDIT Basic TIU Parameters 8. If prompted 'Delay Install (Minutes): (0 - 60): 0// => respond 0 Post-Installation Instructions: ------------------------------- 1. After this TIU*1*297 patch is installed successfully, please make sure that the Post-Installation routine, TIUPS297, is removed. 2. If your site wants to use the new functionality implemented for NSR # 20140809 (Prevention of Unauthorized Abbreviations in the TIU Screen), the following should be done for any abbreviations decided upon by the site: a. Determine which of the following provided fourteen Unauthorized Abbreviations from The Joint Commission listing are to be required at your site: IU, MgSO4, MS, MSO4, QD, Q.D., qd, q.d., QOD, Q.O.D., qod, q.o.d., U, u b. Determine if your site has any additional abbreviation that it would like to be included to prevent usage by users. c. Utilize the Unauthorized Abbreviations (Enter/Edit) [TIU ABBV ENTER EDIT] option found on the TIU Maintenance Menu [TIU IRM MAINTENANCE MENU] to do the following: 1. Set the STATUS field to "Active" for each of the Unauthorized Abbreviations, from The Joint Commission listing, that you prefer to prevent from being used at your site. 2. Enter any new Unauthorized Abbreviation that you prefer to prevent at your site. 3. If your site wants to use the new functionality implemented for NSR #20141003 (TIU Dictation Control), the following should be done: a. User can use the "Basic TIU Parameters" option [TIU BASIC PARAMETER EDIT] to enable/disable the "Dictation Control" functionality, and create "Dictation Instruction" as appropriate for your site. Please note that the "TIU PARAMETERS" File (#8925.99) is defined to have one entry for each division. It will require this step to be done for each division using this functionality. This facilitates usage and/or dictation instructions to be defined by division as needed at multi-divisional facilities. b. Assign the TIUDCT security key to anyone who will need to dictate TIU documents using CPRS. If your site does not want to use this functionality, no action is required. Back Out Instructions for Patch TIU*1.0*297 ------------------------------------------- In the event a site determines that this patch should be backed out, the site should submit a CA SDM ticket with the NSD for assistance with the procedure. Refer to the Deployment, Installation, Back-Out, and Rollback Guide (DIBORG), tiu_1_0_297_ig.pdf, information regarding back out of the software. Routine Information: ==================== The second line of each of these routines now looks like: ;;1.0;TEXT INTEGRATION UTILITIES;**[Patch List]**;JUN 20, 1997;Build 40 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: TIUABBV Before: n/a After: B7597487 **297** Routine Name: TIUABBV1 Before: n/a After: B58892280 **297** Routine Name: TIUABBVC Before: n/a After: B5804430 **297** Routine Name: TIUABBVP Before: n/a After: B9842666 **297** Routine Name: TIUDCT Before: n/a After: B8195446 **297** Routine Name: TIULP Before: B55451451 After: B61391624 **98,100,116,109,138,152,175, 157,182,184,217,236,234,232, 241,256,297** Routine Name: TIUPS297 Before: n/a After: B1090642 **297** ============================================================================= User Information: Entered By : Date Entered : JUN 25, 2015 Completed By: Date Completed: JUL 13, 2017 Released By : Date Released : JUL 20, 2017 ============================================================================= Packman Mail Message: ===================== $END TXT