$TXT Created by WESTRA,HERLAN at KRN.FO-OAKLAND.MED.VA.GOV (KIDS) on Thursday, 02/23/12 at 06:29 ============================================================================= Run Date: APR 11, 2012 Designation: XU*8*513 Package : XU - KERNEL Priority: Mandatory Version : 8 SEQ #473 Status: Released Compliance Date: MAY 12, 2012 ============================================================================= Subject: Alert Fixes Category: - Routine - Data Dictionary - Enhancement (Mandatory) Description: ============ 1. This patch fixes problems where a user might be specified as a surrogate for someone who was currently or subsequently acting as surrogate for the same user. In some cases, the setting of the surrogate might be rejected. In other cases, the setting of the surrogate appeared to succeed, but it disappeared when checked, or if any other activity, such as an incoming alert, caused the relationship to be checked. This patch corrects this problem. The time period will be checked and the surrogate relationship added. [Remedy Ticket HD0000000332819 and duplicates. PSPO #1776 and #1865.] 2. This patch fixes instances where a surrogate relationship has ended, but unprocessed alerts are not returned to the user in a timely manner. A check will be made for expiring surrogacy the first time a user logs into VistA or a Graphical User Interface (GUI) application, and unprocessed alerts will be returned immediately. [Remedy Ticket HD0000000070184 and duplicates. PSPO #1862.] 3. This patch fixes instances where the ALERT TRACKING file is not updated to show the date/time an alert was viewed or processed. In some cases, when an alert is processed through a GUI, the ALERT TRACKING file shows that the alert was deleted, but never viewed or processed. The ALERT TRACKING file will now be updated when an alert is processed through a GUI. [Remedy Ticket HD0000000069554 and duplicates.] 4. Alerts which are indicated as critical are, at least in roll and scroll mode, moved to the beginning of the list of alerts presented to the user, and shown in reverse video [GUI applications determine how they show the alerts]. However, it has required that a new Kernel patch be released to add a new text to be identified as indicating a critical alert. There also was no checking for the word 'NOT' before the critical text. Patch XU*8*513 adds a new ALERT CRITICAL TEXT file (#8992.3) which can hold a string of text that will identify an alert that should be identified as critical. See file details below. [Remedy Ticket HD0000000254755.] Blood Bank Team Coordination: 7/26/2011 ============================= EFFECT ON BLOOD BANK FUNCTIONAL REQUIREMENTS: Patch XU*8*513 contains changes to a package referenced in VHA OI SEPG SOP 192-023 Review of VISTA Patches for Effects on VISTA Blood Bank Software. This patch does not alter or modify any VistA Blood Bank software design safeguards or safety critical elements functions. RISK ANALYSIS: Changes made by patch XU*8*513 have no effect on Blood Bank software functionality, therefore RISK is none. Patch Components ================ Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- ALERT CRITICAL CRITICAL TEXT (.01) New TEXT (#8992.3) PACKAGE-ID (.02) New CREATING New PACKAGE (.03) The ALERT CRITICAL TEXT file (#8992.3) was added to make it easier for packages or Medical Centers to specify text that should be used to indicate an alert to be marked as critical. This file contains those text strings that were previously identified as indicating a critical alert and adds "Possible Malig" as text as well. In addition, this checking is not case sensitive, and if the identified string is immediately preceeded by a NOT it will not be indicated as sensitive. Using this file means that the package or medical center can add desired text for identification without it having to be included in a Kernel patch. It is also possible to require a specific identifier as part of a the package ID for the alert in conjunction with the critical text to limit the identified text to a specific package. STANDARD DATA DICTIONARY #8992.3 -- ALERT CRITICAL TEXT FILE DATA NAME GLOBAL DATA ELEMENT TITLE LOCATION TYPE CROSS REFERENCED BY: CRITICAL TEXT(B) 8992.3,.01 CRITICAL TEXT 0;1 FREE TEXT (Required) INPUT TRANSFORM: K:$L(X)>30!($L(X)<3)!'(X'?1P.E) X LAST EDITED: JAN 11, 2011 HELP-PROMPT: Enter a string of text which, if present in the message text for an alert, indicates a critical alert. Answer must be 3-30 characters in length. This is not case-sensitive. DESCRIPTION: This is a string of text which if present in the message text for an alert should be identified as text identifying a critical alert and the alert emphasized in whatever manner available. A second field PACKAGE-ID (#.02) may contain the identifier used by a package in the ALERTID when creating an alert. If that field is non-null, an alert will only be marked critical if the PACKAGE-ID value is present in the ALERTID for the current alert. This may be used to make critical text package-specific. The comparison of the text entered with the text in the alert is NOT case sensitive. Also, if the critical text in the alert is preceded by the word 'NOT', it will not be identified as a critical alert. CROSS-REFERENCE: 8992.3^B 1)= S ^XTV(8992.3,"B",$E(X,1,30),DA)="" 2)= K ^XTV(8992.3,"B",$E(X,1,30),DA) 8992.3,.02 PACKAGE-ID 0;2 FREE TEXT INPUT TRANSFORM: K:$L(X)>30!($L(X)<1) X LAST EDITED: JAN 14, 2011 HELP-PROMPT: Optional. Enter the PACKAGE-ID used when creating alerts that the CRITICAL TEXT should be associated with. Enter 1-30 characters, it is not case-sensitive. DESCRIPTION: This field is used to specify, if desired, a specific package ID to be associated with the CRITICAL TEXT entered in field #.01. The value entered should be the textual part of the value used for XQAID when creating the alert(s) (e.g., OR for Order Entry or TIU for Text Integration Utility). If a non-null value is in this field, alerts containing the CRITICAL TEXT string will only be indicated as critical alerts if they also have text matching the PACKAGE-ID as a part of the ALERTID field. Matching of this value will not be case sensitive. 8992.3,.03 CREATING PACKAGE 0;3 POINTER TO PACKAGE FILE (#9.4) LAST EDITED: JAN 14, 2011 HELP-PROMPT: Answer with the PACKAGE NAME that is responsible for creating this CRITICAL TEXT entry. DESCRIPTION: This field provides a pointer to the PACKAGE file (#9.4) for the package which is responsible for creating this CRITICAL TEXT entry. Patient Safety Issues: ====================== PSPO #1776 Surrogates for patient alerts/notifications are not staying set. PSPO #1862 CBOC MD not getting the abnormal imaging alert after the surrogacy expired PSPO #1865 Surrogates for view alerts. (Duplicate of PSPO #1776.) Remedy Ticket(s) & Overview =========================== HD0000000069554 6 PAL-1101-69797 Data not displayed in notification HD0000000070147 MON-0603-50232 Alerts Tracking Problem HD0000000070184 6 PRE-0703-60448 Delay in Viewing Alert HD0000000070189 PAL-0703-60607 MEDICATION EXP ALERT PROBLEM HD0000000070558 6 LON-0204-61486 Alert display after 2 days from creation date HD0000000211528 Surrogate mysteriously disappears HD0000000254755 Kernel alert doesn't include POSSIBLE MALIG HD0000000287982 5 DNR expiring alert does not display as processed HD0000000306313 6 A check to return previous surrogate alerts is missing from a CPRS GUI call HD0000000332810 Unable to get user to stay as surrogate HD0000000365033 Once alerts are set they do not release HD0000000397123 Surrogates not staying set. Same as ticket 332810 I think. HD0000000407757 Surrogate Settings Not Staying HD0000000420820 alerts don't get forwarded until surrogate signs into system HD0000000436041 Surrogates falling off HD0000000462716 Notification/Alert received or not received? HD0000000515480 Why are notifications coming back HD0000000532704 Alerts issue in CPRS HD0000000588136 Tucson is not able to assign a view alert surrogate for a any user. HD0000000592062 Problems setting surrogates 1. HD0000000069554 6 PAL-1101-69797 Data not displayed in notification tracking (duplicates HD0000000070147, HD0000000070189, HD0000000287982, HD0000000462716) Problem: ------- GUI processing of alerts does not update the ALERT TRACKING (file #8992.1) RECIPIENT (20) fields ALERT FIRST DISPLAYED (.02) and FIRST SELECTED ALERT (.03). Resolution: ---------- Modified GETUSER1^XQALDATA to update the alert tracking file when viewing alerts in a RPC Broker call. 2. HD0000000070184 6 PRE-0703-60448 Delay in Viewing Alert (duplicates HD0000000070558, HD0000000532704) Problem: ------- Combination of problems. ALERT TRACKING (file #8992.1) information may be inaccurate (see #1 above). Also may be a problem with expiring surrogacy. A VistA user's alerts would only be returned if (a) the user manually checked for expired surrogates, or (b) a new alert is received and surrogate relationships are checked automatically. Resolution: ---------- Modified DISPLAY^XQALERT to check surrogacy relationships and return alerts from expired surrogates during a VistA user sign-on. [Partial resolution of PSPO #1862 for VistA sign-on.] 3. HD0000000306313 6 A check to return previous surrogate alerts is missing from a CPRS GUI call (duplicates HD0000000420820) Problem: ------- A check to return previous surrogate alerts is missing from a CPRS Graphical User Interface (GUI) Remote Procedure Call (RPC). [Partial resultion of PSPO #1862 for GUI sign-on.] Resolution: ---------- Modified GETUSER1^XQALDATA to check surrogacy relationships and return alerts from expired surrogates during a CPRS GUI user sign-on. 4. HD0000000332810 Unable to get user to stay as surrogate (duplicates HD0000000211528, HD0000000365033, HD0000000397123, HD0000000407757, HD0000000436041, HD0000000588136, HD0000000592062) Problem: ------- Surrogate settings are rejected or end prematurely. A user might be specified as a surrogate for someone who is currently or subsequently acting as a surrogate for the same user. [PSPO #1776 and #1865] Resolution: ---------- Alert routines are modified to properly check surrogate start and end date/times for surrogate loops. If a loop exists, the surrogate settings will not be permitted. If a loop does not exist, then the surrogacy will be set. 5. HD0000000515480 Why are notifications coming back Problem: ------- Notifications are being returned to the original recipient after a surrogacy expires, even though the surrogate has viewed and processed the alerts. Resolution: ---------- Patch XU*8*366 (RETURN ALERTS FROM SURROGATE) resolved a patient safety issue (PSI-04-036) by modifying the handling of alerts sent to surrogates to return unprocessed alerts to the originally intended recipient of the alert after a surrogacy period ends. As a side-effect of Remedy ticket HD0000000069554, the alerts are identified as deleted, but not processed, when a GUI user processes the alerts. Modified GETUSER1^XQALDATA to update the alert tracking file when viewing alerts in a RPC Broker call. 6. HD0000000254755 Kernel alert doesn't include POSSIBLE MALIG Problem: ------- Kernel alert doesn't include POSSIBLE MALIG in the routine XQALERT1 at DOIT1 to notify clinicians on urgent matters. Resolution: ---------- Patch XU*8*513 adds a new ALERT CRITICAL TEXT file (#8992.3) which can hold a string of text that will identify an alert that should be identified as critical. Routines XQALERT and XQALERT1 have been modified to use information from this file instead of hard-coded text within the routines. Test Sites: (Patch Tracking Message #56165411) ---------- Edward Hines Jr. VA Hospital, Hines, IL (L) Ralph H. Johnson VA Medical Center, Charleston, SC (L) Sioux Falls VA HCS, Sioux Falls, SD (M) VA Northwest Iowa HCS (Central Iowa HCS - Des Moines), IA (I) Installation Instructions ------------------------- WARNING: Since this patch involves routines which process alerts to users, it is recommended that the installation should be with users off the system or with a minimal number of users on the system to minimize the possible loss of data. It may be queued to install during non-peak hours. Installation takes less than a minute. You do NOT need to stop TaskMan or the HL7 background filers. You do NOT need to disable any menu options or protocols. 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 enter the patch #(ex. XU*8.0*513): 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. Install Package(s) 'XU*8.0*513' ========== 5. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//' answer "NO". There are no menu options included in this patch. 6. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//' answer "NO". 7. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//' answer "NO". 8. If prompted "Delay Install (Minutes): (0 - 60): 0// respond 0. Routine Information: ==================== The second line of each of these routines now looks like: ;;8.0;KERNEL;**[Patch List]**;Jul 10, 1995;Build 13 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: XQALDATA Before: B8047519 After: B11750303 **207,285,443,513** Routine Name: XQALERT Before: B16208814 After: B18400944 **1,65,125,173,285,366,513** Routine Name: XQALERT1 Before: B78786817 After: B79700717 **20,65,114,123,125,164,173, 285,366,443,513** Routine Name: XQALGUI Before: B18668830 After: B18911432 **207,513** Routine Name: XQALSET1 Before: B4576629 After: B4976921 **285,443,513** Routine Name: XQALSUR2 Before: B6279756 After: B3811185 **366,513** Routine Name: XQALSURO Before: B77946006 After: B90015726 **114,125,173,285,366,443,513** Routine list of preceding patches: 443 ============================================================================= User Information: Entered By : IVEY,JOEL Date Entered : OCT 08, 2008 Completed By: BEST,LISA Date Completed: MAR 21, 2012 Released By : TILLIS,LEWIS Date Released : APR 11, 2012 ============================================================================= Packman Mail Message: ===================== $END TXT