============================================================================= Run Date: MAR 10, 2011 Designation: YS*5.01*96 Package : YS - MENTAL HEALTH Priority: Mandatory Version : 5.01 SEQ #84 Status: Released Compliance Date: APR 10, 2011 ============================================================================= Associated patches: (v)YS*5.01*10 install with patch `YS*5.01*96' (v)YS*5.01*37 install with patch `YS*5.01*96' (v)YS*5.01*76 install with patch `YS*5.01*96' (v)YS*5.01*85 <<= must be installed BEFORE `YS*5.01*96' (v)YS*5.01*97 <<= must be installed BEFORE `YS*5.01*96' Subject: FIXES TO PATCH YS*5.01*85 AND UPDATE TO NEW ICD/CPT API Category: - Data Dictionary - Routine - Print Template - Sort Template - Other Description: ============ DISCLAIMER: =========== In the "Associated patches" section above, three patches are listed as "install with patch". It should read "<<= must be installed BEFORE". The text in this section is generated by the Patch Module and cannot be changed. Summary of problems in Patch YS*5.01*85 corrected in this patch: ---------------------------------------------------------------- This patch fixes errors and defects in the Mental Health Assistant version 3 (MHA3). 1) Changes are made in displaying, scoring, reporting or printing of the following instruments: Morse Fall Scale - Morse Fall Scale SCL90R - Symptom Checklist 90 Revised BDI2 - Beck Depression Inventory Second Edition MMPI2 - Minnesota Multiphasic Personality Inventory 2 AUD-C - Alcohol Use Disorders Identification Test Consumption AUDIT - Alcohol Use Disorders Identification Test 2) The results from the BOMC (Blessed Orientation Memory Concentration) test will be sent to the national database. 3) The two instruments, TBI (Traumatic Brain Injury) Second Level Evaluation and TBI Follow-up are removed from MHA3. 4) The ASI-MV (Addiction Severity Index, Multi-Media Version) cannot be edited in MHA3 which corrects the problem of the ASI-MV results being converted to ASI Follow-up data. 5) A new GUI (Graphical User Interface) has slightly revised data-entry screens and dialogs to correct usability defects and 508 compliance. The number of tests entered in error is reduced by a true "Cancel" option in data entry. 6) Progress notes generated by MHA3 and the reports displayed in MHA3 concerning instrument results are now identical in terms of question and scoring summaries. 7) Progress notes can be signed by a co-signer when the person who orders an instrument is a student (or a person who requires a co-signer). The GUI now asks those who need co-signatures to select a co-signer. 8) The National Psychology Advisory Committee expressed concern regarding aspects of the progress note generated from MHA3 in some instances. The nature of the concern was that the content of the note may be viewed as being definitive and used diagnostically by itself, rather than in conjunction with other clinical information. They requested that a disclaimer be added to the note to indicate that the information contained in the note alone is not sufficient for diagnostic purposes. 9) This patch also changes Mental Health routines and templates to use new APIs (Application Programming Interfaces) to avoid using unsupported fields in files 81, 81.3, 80, and 80.1. The supported calls in the ICDCODE API (ICR #3990) are now used. Changes to the ICD9 file (#80) necessitated calls to the new API's as opposed to the older direct calls to the ICD9 global. This patch contains 2 modified Mental Health fields, 2 new Mental Health fields, 19 Mental Health routines, 1 new Print Template, 1 new Sort Template, 2 new Remote Procedure Calls and 1 modified Option. MH TESTS AND SURVEYS file (#601.71): --------------------------------------------------------- This file defines the interviews, surveys and tests available in MHA3. Attributes of the instruments include authoring credits, target populations, normative samples and copyright information. Actions available including privileging, reporting of full item content and transmission to the Mental Health National Database are also specified. This file is updated with the appropriate information for each of these instruments: Morse Fall Scale, SCL9R, BDI2, MMPI2, AUD-C, AUDIT and BOMC. The following fields were changed to support administration and reporting privileging. 601.71,8 A PRIVILEGE 1;6 POINTER TO SECURITY KEY FILE (#19.1) LAST EDITED: JUN 28, 2010 HELP-PROMPT: Select a security key. DESCRIPTION: If not null, only those users holding the specified key can administer the instrument. 601.71,27 DAYS TO RESTART 8;7 NUMBER INPUT TRANSFORM: K:+X'=X!(X>999)!(X<-1)!(X?.E1"."1N.N) X LAST EDITED: OCT 08, 2008 HELP-PROMPT: Type a Number between -1 and 999, 0 Decimal Digits DESCRIPTION: This field sets a limit on finishing a previously started instrument. Set to zero if re-start is not allowed. Set to minus 1 if instrument can be completed at any time. The following fields were added. 601.71,28 GENERATE PNOTE 8;8 SET 'Y' FOR Yes; 'N' FOR No; LAST EDITED: JUN 28, 2010 HELP-PROMPT: Should the TIU note be created? DESCRIPTION: Select No (or leave null) to stop MHA3 from generating a TIU note. Clinical Reminders do not read this flag. TIU notes are never generated for a test that has an R_Privilege set. 601.71,29 TIU TITLE 8;9 POINTER TO TIU DOCUMENT DEFINITION FILE (#8925.1) LAST EDITED: JUN 28, 2010 HELP-PROMPT: Select the progress note title. DESCRIPTION: Title of the TIU note used to identify the progress note for this instrument. Mental Health Diagnostic Study is the currently approved title for additional instruments. Other titles need approval by the Standards Group. Direct entry through FileMan or the programmer prompt is prohibited. MH REPORT file (#601.93) --------------------------------------------------------- This file contains the reporting format for a specified instrument. This file is updated with the report format for each of these instruments: Morse Fall Scale, SCL9R, BDI2, MMPI2, AUD-C, AUDIT and BOMC. Input into this file must be entered only through the Mental Health Editor (Instrument Authoring Tool) software. PRINT TEMPLATE: --------------------------------------------------------- YS TEST RESULTS file (#601.92) SORT TEMPLATE: --------------------------------------------------------- YS TEST SORT file (#601.92) REMOTE PROCEDURE CALLS: --------------------------------------------------------- NAME: YTQ ADMIN DELETE TAG: DELADMIN ROUTINE: YTQAPI5 RETURN VALUE TYPE: ARRAY AVAILABILITY: SUBSCRIPTION DESCRIPTION: Users who have the MHS Manager menu can delete a specified MH Administration and its MH Answers and MH Results. Please use caution as deletions cannot be restored. Only ADPACs should use this feature and in consultation with medical records policy. Input: YS("AD") as internal entry number of MH ADMINISTRATIONS (#601.84) file. Output: Data vs ERROR NOTE: The MHS MANAGER menu referred to in the above RPC description is YSMANAGER. Also, deleting an administration does not delete or change any progress notes or consults associated with that administration. NAME: YTQ SET ANSWER ALL TAG: SAVEALL ROUTINE: YTQAPI17 RETURN VALUE TYPE: ARRAY AVAILABILITY: SUBSCRIPTION DESCRIPTION: Saves all answers for an administration. Input: YS("AD") as internal entry number of MH ADMINISTRATIONS (#601.84) file. Output: Data vs ERROR OPTION: --------------------------------------------------------- YS BROKER1 The two new RPCs listed above are added to the RPC multiple. The MENU TEXT (#1) field is changed to include the latest version value. Before: YS BROKER1 version 1.0.2.20~1.0.0.1~1.0.0.1 After: YS BROKER1 version 1.0.3.45~1.0.3.45~1.0.3.45 DATA ENTRIES: --------------------------------------------------------- For the MH TESTS AND SURVEYS (#601.71) file all entries are exported with an internal entry number under 100000 (i.e., national entries) and an OPERATIONAL (#10) value of "Yes", "No", "Clinical Reminder" or "Dropped". National entries that have an OPERATIONAL (#10) value of "Under Development" are not exported. For the MH REPORT (#601.93) file all entries are exported with an internal entry number under 100000 (i.e., national entries) and which point to an entry in FILE 601.71 that has an OPERATIONAL value of "Yes", "No", "Clinical Reminder" or "Dropped" Associated Remedy Tickets: 1) 230389 (duplicates: 233188, 237642, 243942, 248954, 261653, 272313, 283303, 285908, 294024, 302911, 315604, 313776, 334117, 334883, 354883, 375511, 406335, 432017, 449220, 455597, 459943). These Remedy Tickets address problems with the SCL9R and the two missing lines; SCOR1+8^YTQAPI14. 2) 241181 and 242543 (duplicates: 247303, 272392, 410792, 441767). These tickets refer to a problem with the printing of MMPI2 reports; graphs are split between pages. 3) 244328 (duplicates: 269185, 302124, 305015, 306386, 249641, 279078, 297163, 302207, 305069, 308420, 345812, 363119, 366994, 394371, 395084, 412421, 446091, 454495). RD+1^YTREPT; Last Global Ref: ^YTD(601.2, ..) 4) 238664 and 272385 (duplicate: 276143, 340330, 375367). BDI2+1^YTBI; Last Global Ref:^YTD(601.2, ..) 5) 231173 (duplicate 288154) TBI 2nd level Evaluation errors. 6) 234141 (duplicates: 262796, 272784, 336196, 336426). Co-signer issues with mental health diagnostic study note. 7) 283809 (duplicate 378085) Morse Fall Scale has incorrect scoring on one item. 8) 304299 Mental Health Assistant times out while user is active in ASI. 9) 235709 Data from ASI-MV does not display properly and changes designation to ASI Follow-up. 10) 248645 Instrument entered in error. 11) 228898 When the clinician goes to select a new patient they are not prompted to sign the note and a view alert is generated. 12) 232470 (duplicate: 271310). Patients with a period in their DFN produce error UNDEFINED>GETDATA+9^PXRMMH. Associated NSR(s): ================== N/A Associated E3R(s): ================== N/A Participating Test Sites: =========================== North Texas HCS, TX Upstate New York, NY Oklahoma City, OK Atlanta VAMC, GA Remedy Overview: ================ 1) 230389 (duplicates: 233188, 237642, 243942, 248954, 261653, 272313, 283303, 285908, 294024, 302911, 315604, 313776, 334117, 334883, 354883, 375511, 406335, 432017, 449220, 455597, 459943). Problem: --------------------------------------------------------- When MHA3 tries to score the instrument SCL-9R, according to Don Donati, "The problem occurs when the program attempts to execute the EXECUTABLE SCORING CODE: D MULT^YTSCL9R, but line label "MULT" does not exist in this routine. This produces errors In the trap, e.g., "SCOR1+8^YTQAPI14. Resolution: --------------------------------------------------------- M code changes were made to avoid this error. 2) 241181 and 242543 (duplicates: 247303, 272392, 410792, 441767). Problem: --------------------------------------------------------- When printing MMPI2 reports, the graph is not displayed on one page and the T-score will wrap. Resolution: --------------------------------------------------------- The report template has end-of-page markers (**eop**) to signal the start of a new page for the printer. The width of the printer page is set to avoid unnecessary wrapping. 3) 244328 (duplicates: 269185, 302124, 305015, 306386, 249641, 279078, 297163, 302207, 305069, 308420, 345812, 363119, 366994, 394371, 395084, 412421, 446091, 454495). Problem: --------------------------------------------------------- RD+1^YTREPT; Last Global Ref: ^YTD(601.2, ..) Resolution: --------------------------------------------------------- Lookups are now made on file 601.84 instead of 601.2. 4) 238664, 272385 (duplicate: 276143, 340330, 375367). Problem: --------------------------------------------------------- BDI2+1^YTBI; Last Global Ref:^YTD(601.2, ..) Resolution: --------------------------------------------------------- Lookups are now made on file 601.84 instead of 601.2. 5) 231173 (duplicate 288154) Problem: --------------------------------------------------------- TBI 2nd level Evaluation errors. Resolution: --------------------------------------------------------- The TBI 2nd Level Evaluation has been removed from the list of active instruments. 6) 234141 (duplicates: 262796, 272784, 336196, 336426). Problem: --------------------------------------------------------- The MENTAL HEALTH DIAGNOSTIC STUDY NOTE does not allow the user to have a co-signer for the note. Resolution: --------------------------------------------------------- Co-signer is included with appropriate business rules. 7) 283809 (duplicate 378085) Problem: --------------------------------------------------------- Morse Fall Scale has incorrect scoring on the question concerning Ambulatory aid: the third alternative (answer) should have a score-value of 15 but is scored as a 10 instead. Resolution: --------------------------------------------------------- The correct value of 15 is now in place. 8) 304299 Problem: --------------------------------------------------------- Mental Health Assistant times out while user is active in ASI. This is based on the inactivity of CPRS. If CPRS times out, MHA3 will also time-out, even if the user is actively entering data in the ASI. (This was only a concern with the ASI, other instruments were not closed when CPRS timed out.) Resolution: --------------------------------------------------------- The ASI data-entry screen will remain active, even if CPRS times-out. Once the ASI is completed, MHA3 will close. 9) 235709 Problem: --------------------------------------------------------- The Addiction Severity Index, Multi-Media Version (ASI-MV) is a COTS product in use at a few sites. The ASI Manager Menu in MHA3 displays the status and results of ASI-MV (as it does the other three types of ASIs Full, Lite and Follow-up). If an ASI is not signed, it can still be edited by the user. The problem was that the ASI-MV should not be edited. It is completed only by the patient. When the user attempted to sign the ASI-MV, MHA3 incorrectly treated it as a Follow-up and required the user to answer more questions. Resolution: --------------------------------------------------------- The ASI-MV cannot be edited, only signed (if it is complete). 10) 248645 Problem: --------------------------------------------------------- Instrument entered in error. Even the most conscientious clinicians can start an instrument on a patient and then realize while entering the data, or some time later, that the data was entered on the wrong patient. MHA3 did not have a way to ignore a faulty administration that was in process. Resolution: --------------------------------------------------------- To provide a way for clinicians to back out of data-entry, this patch for MHA3 has a "Cancel" button on the data-entry screen. When pressed, no information about that administration is saved to VistA. If the error was not caught before the data were saved, there are now two ways to remove data entered-in-error. A) The person who has the MHS Manager [YSMANAGER] menu can use the re-designed MHS Manager menu in VistA to remove the incorrect administration. B) The MH Manager can use MHA3; from the Instruments Results Review screen, the incorrect administration can be deleted by pressing the "DEL" key. The advantage to the GUI method is that the entire report is visible so the MH Manager has more information as to which instrument is to be removed. 11) 228898 Problem: --------------------------------------------------------- After completing a test in the Mental Health Assistant the MENTAL HEALTH DIAGNOSTIC STUDY NOTE is created in CPRS. When the clinician goes to select a new patient they are not prompted to sign the note and a view alert is generated. Resolution: --------------------------------------------------------- CPRS will show unsigned notes on the patient selection screen. However CPRS is unable to prompt for signatures elsewhere for TIUs created outside CPRS. This request has been sent to the CPRS team. 12) 232470 (duplicate: 271310). Problem: --------------------------------------------------------- Patients with a period in their DFN produce error UNDEFINED>GETDATA+9^PXRMMH. Resolution: --------------------------------------------------------- Patients with a period in their DFN will no longer produce an error code. Presumably patient DFNs should not have periods. SOFTWARE AND DOCUMENT DISTRIBUTION: =================================== The following software and documentation files are exported as part of this patch: File Name Contents Retrieval Format --------- -------- ---------------- YS_501_96.KID KIDS Build ASCII YS_501_96_Setup.EXE YS_MHA.EXE Binary YS50196_MHA3_UM.pdf User Manual Binary YS50196_MHA3_UM.doc User Manual Binary YS_501_96_IG.pdf Installation Guide Binary YS_501_96_IG.doc Installation Guide Binary The YS_501_96_Setup.EXE file will create the following two files: YS_MHA_A.dll - used to resolve Clinical Reminders. YS_MHA_AUX.dll - used for scoring instruments. The software files are available on the following OI Field Offices' ANONYMOUS.SOFTWARE directories. All sites are encouraged to use their FTP capability to obtain these files. Use the FTP address "download.vista.med.va.gov" (without the quotes) to connect to the first available FTP server where the files are located. OI FIELD OFFICE FTP ADDRESS DIRECTORY =============== =========== ========= ALBANY ftp.fo-albany.med.va.gov [ANONYMOUS.SOFTWARE] HINES ftp.fo-hines.med.va.gov [ANONYMOUS.SOFTWARE] SALT LAKE ftp.fo-slc.med.va.gov [ANONYMOUS.SOFTWARE] The updated User Manual will be posted to the VistA Document Library (VDL) immediately after the release of the patch. PRE-INSTALLATION INSTRUCTIONS: ============================== 1. If it does not already exist, create the progress note title "MENTAL HEALTH DIAGNOSTIC STUDY NOTE" (without quotes) in the progress note hierarchy. Sites should have this note title, though. It's creation was part of the YS*5.01*85 instructions (January 2008). This new patch, YS*5.01*96, adds a new field, TIU TITLE (#29), to the MH TESTS AND SURVEYS (#601.71) file. This field is a pointer to the TIU DOCUMENT DEFINITION (#8925.1) file. This patch exports the entries in FILE 601.71 with the TIU TITLE field filled in with this note title. If this note title is not defined or not recognized by the installation process, you will see an error message for each FILE 601.71 entry. Example of error message: ** ERROR IN POINTER RESOLUTION OF DATA ** Unable to find exact match and resolve pointer (^TIU(8925.1, Entry:MENTAL HEALTH DIAGNOSTIC STUDY NOTE). You can correct the entries after installation by using the following menu path and option: MHS MANAGER [YSMANAGER] MHA3 Utilities [YTQ MHA3 MENU] Stop/Re-Start Progress Notes for an Instrument [YTQ PNOTE FLAG] Example of linking note title to a FILE 601.71 entry: Select MH TESTS AND SURVEYS NAME: MORSE FALL SCALE <-select test name GENERATE PNOTE: Yes// <-answer Yes TIU TITLE: MENTAL HEALTH DIAGNOSTIC STUDY NOTE// <-fill in note title Some tests require the user to have the YSP security key. INSTALLATION INSTRUCTIONS: ========================== 1. Use the 'LOAD A DISTRIBUTION' option on the PackMan menu. The Host File name is YS_501_96.KID. Answer YES to the question: "Want to Continue with Load? YES//" 2. The patch has now been loaded into a Transport global on your system. You now need to install the Transport global. On the KIDS menu, under the 'Installation' menu, use the following options: Print Transport Global Compare Transport Global to Current System Verify Checksums in Transport Global Backup a Transport Global 3. Users may remain on the system, but installation should be done at off-peak hours when use of CPRS, Mental Health and Clinical Reminders is low. 4. Installation will take less than five minutes. 5. From the 'Installation Menu' of the KIDS menu, run the option 'Install Package(s)' Select the package 'YS*5.01*96' and proceed with install. 6. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//' answer according to your facility's policy concerning the rebuilding of menu trees. When prompted 'Want KIDS to INHIBIT LOGONs during the install//', respond NO. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', respond YES. Place the following options out of order: YS BROKER1 7. Ensure that the option YS BROKER1 [YS BROKER1] is on the Mental Health users secondary menu, if it is not already there. 8. Place the MHA3 application on the CPRS Tools menu, if it is not already there. For instructions on how to add the MHA3 application to the CPRS Tools menu, see the "Setting up VistA MHA3 on CPRS GUI Tolls Menu" section in the Installation Guide. 9. You can delete the YS96POST routine when the installation is complete. 10. Please follow the instructions in the "Client: GUI Software" section of the Installation Guide to setup and distribute the GUIs for this patch. The new GUIs must be installed for the MHA3 functionality to work. NOTE: If you run the XINDEX utility for this patch you will see the following informational message: YTBI * * 84 Lines, 4552 Bytes, Checksum: B26357240 R *X:900 S:'$T X=42 G:X<32 RD S X=$C(X) Q RD+1 I - Star or pound READ used. You can ignore this message. The Mental Health package has an exemption to use the Star/Pound READ functionality. DISCLAIMER: =========== The text below this point is generated by the Patch Module and cannot be changed. The last line states "Routine list of preceding patches: 10, 37, 76, 97, 102". The Patch Module has omitted "85" from the listing. It should read "Routine list of preceding patches: 10, 37, 76, 85, 97, 102" Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: YS96POST Before: n/a After: B58388339 **96** Routine Name: YSCEN53 Before: B20118879 After: B21873679 **96** Routine Name: YSDX3UA Before: B15418176 After: B18903332 **96** Routine Name: YSPDR1 Before: B4439889 After: B5138382 **96** Routine Name: YSPDXR Before: B4042829 After: B4817026 **37,96** Routine Name: YSPRBR2 Before: B11960913 After: B13034877 **37,96** Routine Name: YSPROBR Before: B24876751 After: B27507572 **37,96** Routine Name: YTBI Before: B26105949 After: B26357240 **76,96** Routine Name: YTQAPI11 Before: B22157825 After: B25396570 **85,96** Routine Name: YTQAPI14 Before: B29200951 After: B30095919 **85,97,96** Routine Name: YTQAPI17 Before: n/a After: B4160285 **96** Routine Name: YTQAPI2 Before: B21244483 After: B23049934 **85,96** Routine Name: YTQAPI5 Before: B24361726 After: B31633912 **85,102,96** Routine Name: YTQAPI9 Before: B22741073 After: B29518632 **85,96** Routine Name: YTQPXRM1 Before: B12743110 After: B12928367 **85,96** Routine Name: YTQPXRM7 Before: B21919160 After: B22901061 **85,96** Routine Name: YTQTIU Before: B11026585 After: B22339305 **85,96** Routine Name: YTRPWRP Before: B7734449 After: B8620690 **71,76,96** Routine Name: YTSCL9R Before: B17426077 After: B19518546 **10,96** Routine list of preceding patches: 10, 37, 76, 97, 102 ============================================================================= User Information: Entered By : FINKELSTEIN,ALLAN Date Entered : MAY 23, 2008 Completed By: ELIJAH,VICKEY Date Completed: MAR 09, 2011 Released By : MONTGOMERY,ALAN Date Released : MAR 10, 2011 ============================================================================= Packman Mail Message: ===================== No routines included