$TXT Created by CLN1S1.AAC.DOMAIN.EXT (KIDS) on Saturday, 11/14/20 at 05:50 ============================================================================= Run Date: DEC 03, 2020 Designation: YS*5.01*149 Package : YS - MENTAL HEALTH Priority: Mandatory Version : 5.01 SEQ #129 Status: Released Compliance Date: DEC 17, 2020 ============================================================================= Associated patches: (v)YS*5.01*166 <<= must be installed BEFORE `YS*5.01*149' Subject: CLOZAPINE MODERNIZATION PROJECT WITH HL7 MESSAGING (COVID EXEMPTION) Category: - Enhancement (Mandatory) - Routine Description: ============ The purpose of this software package is for the Department of Veterans Affairs (VA) to maintain compliance with federal mandates for tracking Clozapine prescriptions and dispensing. This patch will add enhancements to the Veterans Health Information Systems and Technology Architecture (VistA) Mental Health package for the National Clozapine Coordination (NCC) Phase 4 Project. The other components are web-based and will be installed on servers outside of VistA and in the VA cloud services. YS*5.01*149 will enhance the nightly Clozapine transmissions by sending Health Level 7 (HL7) messages to the National Clozapine Registry (NCR) database. The Veterans Data Integration and Federation (VDIF) Enterprise Platform is responsible for delivering the HL7 messages from each Vista facility to the NCR SQL database table HL7MessageDumps, which serves as an inbound HL7 queue. The NCR web application is responsible for parsing, validating, and processing the HL7 messages out of the HL7MessageDumps table and into permanent NCR tables. This patch adds new VistA options and a new file, CLOZAPINE HL7 TRANSMISSION (#603.05) to track the HL7 messages. This file can be read by users who have FileMan access and a "Y" in their FILE MANAGER ACCESS CODE, which is field #3 in the NEW PERSON file (#200). This patch also contains HL7 message components and their associated subscriptions, plus a logical link to VistA. Most of these components will not be visible to VistA users. The HL7 messages will be sent to track specific VistA activities such as registering a new clozapine patient for treatment. HL7 messages will be sent to an external system and VistA will receive HL7 acknowledgements, where needed. At some future date the sites will be instructed to disable the MailMan message transmission to the NCR. This will be accomplished by existing VistA options. It is expected that the instructions will be sent as an informational patch. A new HL LOGICAL LINK entry is named YSCL-NCCC and will connect to the National Clozapine Registry (NCR) servers. A complete list of the patch components can be generated using KIDS options. Except for routine YSCLTST5, the VistA components in this patch are all new and do not modify existing software. The types of HL7 messages to be transmitted: ADT^A05 (Pre-admit a Patient) RDE^O11 (Pharmacy/Treatment Encoded Order) Patch Components: ----------------- File #603.03 was already at sites; it has two new fields. Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- This is an existing file. CLOZAPINE PARAMETERS (#603.03) Modified (#603.03) HL7 TRANSMISSION START (#20.01) New (#603.03) HL7 TRANSMISSION END (#20.02) New This is a new file. CLOZAPINE HL7 TRANSMISSION (#603.05) New (#603.05) POINTER TO PATIENT FILE (#2) (#.01) New (#603.05) RX TRANSMISSION (#1, sub-file #603.51) New (#603.51) DATE/TIME OF TRANSMISSION (#.01) New (#603.51) HLO MESSAGE (#.02) New (#603.51) MESSAGE TYPE (#.03) New (#603.51) PRESCRIPTION # (#.04) New Forms Associated: Form Name File Number New/Modified/Deleted --------- ----------- -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- YSCLHL7 LOGS New Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- YSCL HL7 CLOZ RETRANSMIT run routine New YSCL HL7 CLOZ TRANSMISSION run routine New YSCL HL7 LIST CLOZAPINE RXS run routine New YSCL HL7 MAIN menu New YSCL HL7 QUEUE TRANSMISSION run routine New YSCL HL7 REPORT BY DATE run routine New YSCL HL7 STATUS REPORT run routine New HLO Application Registry ------------------------ YSCL-REG REC YSCL-REG SEND HL7 Logical Link ---------------- YSCL-NCCC Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Remote Procedures Associated: Remote Procedure Name New/Modified/Deleted --------------------- -------------------- N/A Parameter Definitions Associated: Parameter Name New/Modified/Deleted -------------- -------------------- N/A Additional Information: ----------------------- New Service Requests (NSRs): N/A Patient Safety Issues (PSIs): N/A Defect Tracking System Ticket(s) & Overview: 1. Rational ID Defect 1262531 Sites Not Able to Transmit Clozapine Prescription Data Problem: -------- Some sites were not transmitting data via the OPTION Daily Clozapine Transmission [YSCL DAILY TRANSMISSION]. The cause was a missing FileMan date in the log that is stored in the zero node of ^XTMP("YSCLTRN"). Resolution: ----------- The YSCLTST5 routine was modified to prevent this problem. The code now forces the initial loop value to zero and the logic proceeds. 2. Rational ID Defect 1273976 Inpatient Override Reason Codes Missing Problem: -------- In the HL7 message body for inpatient Clozapine orders the reason code for overrides was missing. Resolution: ----------- The YSCLHLGT routine was modified to add missing logic for retrieving the override code for inpatient orders. 3. Rational ID Defect 1273989 Override Approver Missing Problem: -------- In the HL7 message body the provider who was the Override Approver was missing. Resolution: ----------- The YSCLHLGT routine was modified to insert the Override Approver into the message. 4. Rational ID Defect 1273674 National Council for Prescription Drug Programs (NCPDP) Number Missing Leading Zeroes Problem: -------- In the HL7 message body the NCPDP NUMBER from the OUTPATIENT SITE file (#59) was stripping leading zeroes. Resolution: ----------- The YSCLHLGT routine was modified to not strip leading zeroes. It had forced the NCPDP number to be evaluated so that leading zeroes would be ignored. Test Sites: ----------- WEST LA VAMC (691) VA GREATER LOS ANGELES HEALTHCARE SYSTEM - WEST LOS ANGELES Los Angeles, CA CONNECTICUT HCS (689) CONNECTICUT HEALTH CARE SYSTEM - WEST HAVEN DIVISION West Haven, CT Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released in a PackMan message. Documentation describing the new functionality is included in this release. Documentation can be found at https://download.vista.domain.ext/index.html/SOFTWARE/ as well as on the VA Software Documentation Library at: https://www.domain.ext/vdl/ in the folder Clinical >> Mental Health Documentation Title File Name ---------------------------------------- ------------------------ Patch YS*5.01*149 Deployment, Installation YS_5_01_p149_dibrg.docx Backout, Rollback Guide YS_5_01_p149_dibrg.pdf Mental Health (YS) Technical Manual YS_MHA_TM.docx YS_MHA_TM.pdf Patch Installation: ------------------------------------------------ Installation Overview: Pre-Installation Instructions: The only pre-installation step is to decide who will be the coordinator for the new YSCLHL7 LOGS Mail Group; the installer will be prompted for that name during the installation. This patch may be installed with users on the system although it is recommended that it be installed during non-peak hours to minimize potential disruption to users. This patch should take less than 3 minutes to install. The menu rebuild may take a few minutes after the patch is installed. No options or protocols need to be disabled before installation. Installation Instructions: 1. Choose the PackMan message containing this build. Then select the INSTALL/CHECK MESSAGE PackMan option to load the build. 2. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, A. Select the Verify Checksums in Transport Global option to confirm the integrity of the routines that are in the transport global. When prompted for the INSTALL NAME enter YS*5.01*149. B. Select the Backup a Transport Global option to create a backup message of any routines exported with this patch. It will not backup any other changes such as DDs or templates. C. You may also elect to use the following options: i. Print Transport Global - This option will allow you to view the components of the KIDS build. ii. 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 of the components of this patch, such as routines, DDs, templates, etc. D. Select the Install Package(s) option and choose the patch to install. i. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//' answer . ii. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//' answer . iii. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//' answer . iv. When prompted 'Enter options you wish to mark as 'Out Of Order':' press . v. When prompted 'Enter protocols you wish to mark as 'Out Of Order':' press . vi. When prompted 'Delay Install (Minutes): (0 - 60): 0//', press for zero seconds. Post-Installation Instructions: Also, after installing the patch the coordinator for the YSCLHL7 LOGS Mail Group should be notified that the patch was installed and that users can be added to the Mail Group. MailMan messages with information about the HL7 message transmissions will be sent to that group. This is an example: Subj: Clozapine HL7 report ST ELIGIUS HOSPITAL (999) [#32221] 10/19/20@14:12 31 lines From: HRUBOVCAK,JC In 'IN' basket. Page 1 -------------------------------------------------------------------------- HL7 transmission report May 19, 2020@14:12:18 Site: ST ELIGIUS HOSPITAL (999) NOTE: This is a requested retransmission. Requested by: HRUBOVCAK,JC (#74) Total messages sent: 16 Message ID Type Prescription 1. 999 3120 ADT^A28 900265 2. 999 3121 RDE^O11 900265 3. 999 3122 ADT^A28 900436 4. 999 3123 RDE^O11 900436 5. 999 3124 ADT^A28 900054 6. 999 3125 RDE^O11 900054 7. 999 3126 ADT^A28 900435 8. 999 3127 RDE^O11 900435 Message ID Type Order Number 9. 999 3128 ADT^A28 407 10. 999 3129 RDE^O11 407 11. 999 3130 ADT^A28 412 12. 999 3131 RDE^O11 412 13. 999 3132 ADT^A28 413 14. 999 3133 RDE^O11 413 15. 999 3134 ADT^A28 414 16. 999 3135 RDE^O11 414 Sent to: G.YSCLHL7 LOGS *** END OF REPORT *** The new option Transmit Clozapine Rx HL7 Messages [YSCL HL7 CLOZ TRANSMISSION] should be scheduled in TaskMan to run daily in off-hours, typically between 10:00 PM and 2:00 AM. The option can be scheduled using the TaskMan option Schedule/Unschedule Options [XUTM SCHEDULE]. The option will not have a DEVICE FOR QUEUED JOB OUTPUT. That is, the device field should be null. This is an example: * * * * * * * * * * * * * * Edit Option Schedule Option Name: YSCL HL7 CLOZ TRANSMISSION Menu Text: Transmit Clozapine Rx HL7 Messages TASK ID: 8798880 ___________________________________________________________ QUEUED TO RUN AT WHAT TIME: DEC 5,2019@23:00 DEVICE FOR QUEUED JOB OUTPUT: QUEUED TO RUN ON VOLUME SET: RESCHEDULING FREQUENCY: 1D TASK PARAMETERS: SPECIAL QUEUEING: ______________________________________________________________ Exit Save Next Page Refresh Quit * * * * * * * * * * * * * * Back-Out/Roll Back Plan: ------------------------ The routines can be restored from the backup message created in installation step B above. The new options can be placed out-of-order or deleted. The new routines can be deleted manually without affecting other VistA packages. No data will need conversion to restore the system. The data dictionary components of this patch can be removed using standard VA FileMan options. See the patch YS*5.01*149 Deployment, Routine Information: ==================== The second line of each of these routines now looks like: ;;5.01;MENTAL HEALTH;**[Patch List]**;Dec 30, 1994;Build 72 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: YSCL149P Before: n/a After: B51331937 **149** Routine Name: YSCLHLAB Before: n/a After: B64118336 **149** Routine Name: YSCLHLAD Before: n/a After: B52470581 **149** Routine Name: YSCLHLFN Before: n/a After: B9733318 **149** Routine Name: YSCLHLGT Before: n/a After:B184903686 **149** Routine Name: YSCLHLMA Before: n/a After: B9856230 **149** Routine Name: YSCLHLOP Before: n/a After:B140610941 **149** Routine Name: YSCLHLPD Before: n/a After: B6374028 **149** Routine Name: YSCLHLPR Before: n/a After:B107701481 **149** Routine Name: YSCLHLRD Before: n/a After: B30294493 **149** Routine Name: YSCLTST5 Before:B143634815 After:B143804069 **122,154,149** ============================================================================= User Information: Hold Date : DEC 02, 2020 Entered By : Date Entered : APR 09, 2019 Completed By: Date Completed: DEC 02, 2020 Released By : Date Released : DEC 03, 2020 ============================================================================= Packman Mail Message: ===================== $END TXT