============================================================================= Run Date: JAN 07, 2008 Designation: YS*5.01*85 Package : YS - MENTAL HEALTH Priority: Mandatory Version : 5.01 SEQ #77 Status: Released Compliance Date: FEB 07, 2008 ============================================================================= Associated patches: (v)YS*5.01*76 <<= must be installed BEFORE `YS*5.01*85' Subject: MENTAL HEALTH ASSISTANT VERSION 3 Category: - Enhancement (Mandatory) - Routine - Other - Data Dictionary Description: ============ DESCRIPTION: ***YS*5.01*85 needs to be installed prior to PXRM*2*6******* The Veterans Health Administration (VHA) Action Agenda for implementing the President's New Freedom Commission on Mental Health recommendations regarding the use of information technology to enhance the care of Mental Health patients states, "VHA should make the integration of MHA and HealtheVet Desktop (HeVD) an explicit goal and should provide the OI with sufficient resources to accomplish this goal in collaboration with the Mental Health Strategic Healthcare Group (MHSHG) Informatics Section. The integration should eliminate the need for Mental Health clinicians to change applications. Further, the integration should make appropriate Mental Health assessment tools available to clinicians outside Mental Health (e.g., depression and alcohol screening instruments should be made available to primary care clinicians)." This revision of MHA creates a closer integration with CPRS, by placing the MHA GUI on the CPRS Tools Menu. Additionally, functionality was created to allow a site to place an individual instrument on the Tools menu, allowing widespread access to that specific instrument without having to issue the menu for the MHP to all clinicians. Additional functionality that strengthens the tie to the patient's medical record is the creation of a progress note in CPRS when an instrument is completed through MHA. Furthermore, MHA maintains and strengthens its ties to the Clinical Reminders program, which allows for the presentation of specific instruments through reminder dialogs to all clinicians who resolve reminders. Clinical reminders has also developed a new patch, PXRM*2.0*6 that allows reminders to work with the new MHA file structure. YS*5.01*85 should be installed just before PXRM*2*6. If YS*5.01*85 is installed without PXRM*2*6, reminders will not be able to recognize MHA instruments administered after the file structure changes with YS*5.01*85. Additionally, the files of the MHP have been restructured to initiate the migration toward re-engineering and placing MHA as a component of HealtheVet Desktop when it is implemented. To better meet the needs of clinicians and patients in different programs, particularly non-traditional settings, MHA can now run in a standalone mode to administer instruments offline for later uploading to VistA. VistA Mental Health Assistant NEW features in MHA3: --------------------------------------------------- 1. Completely re-organized VistA Mental Health database files to simplify migration to HDR. 2. MHA3 must be invoked from the CPRS Tools menu, for interaction with VistA and patient selection. Patient-selection is done entirely by interaction with CPRS. 3. MHA3 can run in standalone mode, but only for administering offline tests-which later must be uploaded to VistA. 4. MHA3 allows the CPRS Tools menu to invoke any number of single types of instruments, without the need to go directly to the MHA3 Main form. For instance, a CAGE menu item can be added to the Tools menu, which would invoke only a CAGE data entry form. 5. Major functionality (GAF, ASI, Results, etc.) is now presented on individual forms, as opposed to as tabs on one main form. 6. MHA3 now provides a new Battery Wizard form to simplify creating batteries of instruments. 7. There is a new & improved SecureDesktop component that now uses stronger code to prevent hacking. 8. "Clerk entry" data-entry-mode form for psych tests has been removed. 9. All completed administrations now automatically generate a progress note for review in CPRS. 10. All test scores are now saved in VistA, instead of calculated on-the-fly. 11. There is now a Hospital Location associated with an administered instrument, for progress notes purposes. 12. The accompanying MHA3 help file is supplied only for describing the functions of the ASI Manager forms. All other tests and interview have built-in help that is retrieved directly from the MHP when using the "Description" pop-up menu function in the Instrument Manager. 13. MHA3 now recreates a debug log file named "c:\documents and settings\username\application data\mha3\mha3_debug.log" for each MHA3 session. This file can be emailed to developers to assist in remote debugging. No patient-identifying data is collected in this file. This patch contains 23 new Mental Health files, 58 new Mental Health Remote Procedures, 57 new Mental Health routines, 1 option, 2 Protocols, 1 HL7 application parameter and 1 HL logical link. 23 New Mental Health files to be released in this patch: -------------------------------------------------------- MH TESTS AND SURVEYS file (#601.71) ----------------------------------- This file defines the interviews, surveys and tests available in the Mental Health Assistant. 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. Entries may be made through the provided Mental Health Authoring software. Direct entry through Fileman or the programmer prompt is prohibited. MH QUESTIONS file (#601.72) --------------------------- This file contains a listing of all questions for all Psychological Interviews, Surveys and Tests. This allows usage of questions by multiple instruments. Each question can also linked to an entry in the MH INTRODUCTIONS file (#601.73), the MH CHOICES file (#601.75), the MH CHOICETYPES file (#601.751) and the Hint field (#8) in the MH QUESTIONS file (#601.72). MH INTRODUCTIONS file (#601.73) ------------------------------- This file contains the introductory information given at the beginning of each instrument or at the beginning of a new section of an instrument. The introduction text motivates, gives instructions and sets the frame for the task the patient must complete. The same introduction text can be used by multiple instruments. MH RESPONSE TYPES file (#601.74) -------------------------------- This file contains what type of response from the user is required for a question. Response types contained in the file include MCHOICE (multiple choice), Integers, Strings, Dates, Memos and Currency. These entries are pointed to the MH QUESTIONS file (#601.72). MH CHOICES file (#601.75) ------------------------- This file contains the individual selections possible in a multiple choice question. Examples are Yes or No, True or False, 1. Abraham Lincoln, 2. George Washington, 3. George W. Bush or 4. Richard Nixon. For instruments first defined in the legacy system MH INSTRUMENT file (#601), a single character is specified for a multiple choice answer. If George Washington was the choice selected the legacy value would be 2. Choices are pointed to by the MH CHOICETYPES file (#601.751) which is a collection of choices. Choices are referenced in the MH ANSWERS file (#601.85) as a pointer to the full response. MH CHOICETYPES file (#601.751) ------------------------------ This file contains a collection of choices from MH CHOICES file (#601.75) and their display sequence. This allows sets of choices to be specified by the MH QUESTIONS file (#601.72). An example of an entry would be: 1. True 2. False 3. Undecided Each multiple choice question must specify a ChoiceType. In this way a ChoiceType can be used by multiple instruments and multiple questions. MH INSTRUMENT CONTENT file (#601.76) ------------------------------------ This file specifies which entries from the MH QUESTIONS file (#601.72) are parts of which instrument in the MH TESTS AND SURVEYS file (#601.71). It is the "table of contents" for an interview, survey or test. Also specified are the sequence of questions and display attributes for the introductions, questions and choices. Display attributes can be bold, underlined and font size for the introductions, questions and choices. MH BATTERIES file (#601.77) --------------------------- This file contains a list of interview, survey and test order sets. MH BATTERY CONTENTS file (#601.78) ---------------------------------- Ties the entries in the MH BATTERY CONTENTS file (#601.78) to the instruments in the MH TESTS AND SURVEYS file (#601.71). MH BATTERY USERS file (#601.781) -------------------------------- This file contains a list of all interviews, surveys and tests associated with an entry in the MH BATTERIES file (#601.77). The order of presentation of the interviews, surveys and tests within a battery and which battery belongs to which user in the NEW PERSON file (#200) is also specified. MH SKIPPED QUESTIONS file (#601.79) ----------------------------------- This file specifies the questions to be skipped (by question IEN) if a rule is met for a given question in a given instrument. MH SECTIONS file (#601.81) -------------------------- This file specifies sections within an interview, survey and test. The first MH QUESTIONS file (#601.72) is specified along with captions (tab and overall). Display characteristics can also be set. MH RULES file (#601.82) ----------------------- This file contains the rules used in administering an interview, survey or test. A rule is an action that is performed when a specified question is answered in a specified manner. An example of a rule would be to enter 'Not applicable' to the Question, "Are you pregnant?" if the patient has had a hysterectomy. Rules are complex logic based entries that enables the user to create complex scripts. MH INSTRUMENTRULES file (#601.83) --------------------------------- This file ties together an instrument in the MH TESTS AND SURVEYS file (#601.71), a question in the MH QUESTIONS file (#601.72) and a rule in the MH RULES file (#601.82). This allows a rule to be used in multiple instruments and for different questions. MH ADMINISTRATIONS file (#601.84) --------------------------------- The MH ADMINISTRATIONS file (#601.84) contains the data collected during the administration of a specified instrument from the MH TESTS AND SURVEYS file (#601.71) given to a patient at a specific date and time. For each administration of a specified instrument from the MH TESTS AND SURVEYS file (#601.71) there will be an entry in this file. An entry in this file does not store the results of the instrument's administration but is an index to the instrument's administration. The entry indicates whether the instrument has been completed, who ordered the instrument, how many questions were answered and if the test has been electronically signed. MH ANSWERS file (#601.85) ------------------------- When a patient answers a question, the results are stored in this file. An entry for each question answered, in each administration is stored. Each entry has an MH ADMINISTRATON ID field(#.01) of the MH ADMINISTRATION file (#601.84), a Question NUMBER field (#.01) of the MH QUESTIONS file (601.72) and the response. MH SCALEGROUPS file (#601.86) ----------------------------- ScaleGroups are collections of MH SCALES file (#601.87) that are logically displayed together. Information needed to graph the scales are stored here. This includes the ordinate title, minimum and maximum values, graph increments and grid lines. All scales need to be associated with a MH SCALEGROUP to be displayed. MH SCALEGROUPS file (#601.86) and MH SCALES file (#601.87) allow multiple scoring possibilities within a single instrument. MH SCALES file (#601.87) ------------------------ A MH SCALE is one dimension of measurement in an instrument. An example may simply be a TOTAL as in a spelling test or multiple scales in a personality disorder instrument (depression, anxiety, thought disorder etc.). Each scale has at least one associated entry in the MH SCALEGROUP file (#601.86) and an entry in the MH SCORING KEYS file (#601.91). MH DISPLAY file (#601.88) ------------------------- This file contains the entries to set the Windows display attributes for the MH QUESTIONS file (#601.72), MH INTRODUCTIONS file (#601.73) and the MH RESPONSE TYPES file (#601.74). Windows display attributes include fonts, bolding, underline, colors and columns. MH CHOICEIDENTIFIERS file (#601.89) ----------------------------------- This file specifies the displayed numeric options that go along with a multiple choice item. Choice type identifiers can be numbered starting from one, from zero or remain unnumbered. MH SCORING KEYS file (#601.91) ------------------------------ This file contains the scoring keys. The scoring keys are the "answer sheet" for the specified scale entry in the MH SCALES file (#601.87). When an answer the matches the Target value (ie, is correct) a specified value is added to the score. An example would be: if the question is "How much is 5 plus 3", the target value would be 8 and 10 points would be added to the total score (grade) in a ten question test to make a possible score of 1 MH RESULTS file(#601.92) ______________________________ This file contains results of the scored output of completed instruments. MH REPORT file (#601.93) ------------------------------ This file contains the reporting format for a specified instrument. Input into this file must be entered only through the Mental Health Editor software . E3R#: None Associated NOIS: HD68109/BAC-0704-40498 ASI e-sign while editing HD68006/CLE-0504-40649 Interviewer cannot sign ASI in GUI HD67955/COA-0404-20702 Cannot sign ASI using MHA HD67709/BHS-0304-10794 Error - Null subscript at QTEP+6^YSASNAR HD67885/MAC-0204-61794 Mental Health Assistant - can't get to old tests HD67881/COA-0204-21407 MHA freezes during cross checks HD67870/TNV-0204-30263 Co-signer ignored within ASI HD67841/OKL-0104-71087 MH Assistant accessible w/o keys Test Site(s): Upstate New York HCS, NY VA Pacific Island HCS, HI Northern California HCS, CA Puget Sound HSC, WA Atlanta VAMC, GA Routine Summary Checksums shown are NEW Checksums The following routines are included in this patch. The second line of each of these routines now looks like: ;;5.01;MENTAL HEALTH;**[Patch List]**;Dec 30, 1994 Checksums Routine Old New Patch List YS85POST 2059692 2059560 **85** YS85PRE 813879 813879 **85** YTAPI5 n/a 12417658 **62,85** YTAUIRR n/a 14880327 **37,85** YTDOMR n/a 26438095 **31,85** YTKIL n/a 8970368 **37,85** YTPCL n/a 7363737 **66,85** YTQAPI 15475641 15475641 **85** YTQAPI1 27189337 27189337 **85** YTQAPI10 24613112 24613112 **85** YTQAPI11 22157825 22157825 **85** YTQAPI12 20141561 20141561 **85** YTQAPI13 19997427 19997427 **85** YTQAPI14 6830812 6830812 **85** YTQAPI15 25671527 25671527 **85** YTQAPI16 13185422 13185422 **85** YTQAPI2 21244483 21244483 **85** YTQAPI3 23768089 23768089 **85** YTQAPI4 28692651 28692651 **85** YTQAPI5 23263110 23263110 **85** YTQAPI6 5268725 5268725 **85** YTQAPI7 18902958 18902958 **85** YTQAPI8 32413314 32771511 **85** YTQAPI9 22741073 22741073 **85** YTQHL7 31149138 31149138 **85** YTQKIL n/a 5269849 **85** YTQLIB 8410129 8410129 **85** YTQPRT 25124936 25124936 **85** YTQPXRM 4498627 4498627 **85** YTQPXRM1 12743110 12743110 **85** YTQPXRM2 14658221 14658221 **85** YTQPXRM3 16585590 16585590 **85** YTQPXRM4 21974840 21974840 **85** YTQPXRM5 19969917 19969917 **85** YTQPXRM6 16689405 17034666 **85** YTQPXRM7 21919160 21919160 **85** YTQQI001 16371213 16371213 **85** YTQQI002 110963388 110963388 **85** YTQQI003 107420027 107420027 **85** YTQQI004 105189787 105189787 **85** YTQQI005 104556455 104556455 **85** YTQQI006 104012683 104012683 **85** YTQQI007 103468973 103468973 **85** YTQQI008 100582283 100582283 **85** YTQQI009 99865202 99888363 **85** YTQQI00A 99888363 99132958 **85** YTQQI00B 101279645 101279645 **85** YTQQI00C 102188832 102188832 **85** YTQQI00D 98549063 98549063 **85** YTQQI00E 96890307 96890307 **85** YTQQI00F 97231174 97231174 **85** YTQQI00G 96151494 96151494 **85** YTQQI00H 96468871 96468871 **85** YTQQI00I 100432284 100432284 **85** YTQQI00J 95575288 95575288 **85** YTQQI00K 25448044 25448044 **85** YTQTIU 11026585 11026585 **85** List of preceding patches: 31, 37, 62, 66 Sites should use CHECK1^XTSUMBLD to verify checksums. SOFTWARE RETRIEVAL: =================== The following software and documentation files are exported as part of this patch: File Name Contents Retrieval Format --------- -------- ---------------- YS_501_85.KID MHA Server Components ASCII YS50185_SETUP_1_0_3_36.exe Mental Health Assistant BINARY This file is the complete install for the Mental Health Assistant GUI Version 1.0.3.36. YS50185_SD_SETUP_1_0_2_77.exe Secure Desktop Install BINARY YS50185_MAH3_IG.PDF YS_MHA3 Installation Guide BINARY YS50185_MAH3_IG.DOC YS_MHA3 Installation Guide BINARY YS50185_MAH3_UM.PDF YS_MHA3 User Manual BINARY YS50185_MAH3_UM.DOC YS_MHA3 User Manual BINARY 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] Installation Instructions: ========================== 1. Use the 'LOAD A DISTRIBUTION' option on the PackMan menu. The Host File name is YS_501_85.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. During testing, it was noted that if a user had a reminder dialog open when the install took place, the reminder dialog would not load and work properly until CPRS was logged off. 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*85' and proceed with install. 6. 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 NO 7. Place the MENTAL HEALTH ASSISTANT VERSION 3 USER MANUAL in a location that can be accessed by MHA users. 8. Please refer to the INSTALL WINDOWS ILLUSTRATION section of the MENTAL HEALTH ASSISTANT VERSION 3 INSTALLATION GUIDE to install the MHA software. 9. The Secure Desktop feature in the MHA software is a security feature that locks down computers when patients are completing assessments directly in MHA. Because it locks down all other applications on the computer when activated, it must be loaded directly on the PC where it will be used. It should only be loaded on machines that will be used for patient administered assessments. It should not be pushed out to all machines on the network. More detailed information is found in the MHA VERSION 3 INSTALLATION GUIDE. 10. Place the option YS BROKER1 [YS BROKER1] on the Mental Health users secondary menu. Consider adding this option to all users that have the menu option OR CPRS GUI CHART in support of PXRM*2*6 11. Enter appropriate members into the Mail Group YS MHA-MHNDB to the system, but installation should be done at off peak hours. 12. Place the MHA application on the CPRS Tools menu. 13. Create progress note title of "Mental Health Diagnostic Study Note" in the progress note hierarchy. This is needed for MHA to automatically pass a note to CPRS from instrument administrations completed within MHA. 14. A new entry is created in File 771, the HL7 Application Parameter File: YS MHA. It is exported as Inactive and should be set to Active after install. 15. A new entry is also created in File 870, the HL Logical Link file. This entry is YS MHAT. The logical link named YS MHAT is used by the HL7 package to send VistA ADT HL7 messages containing patient demographics, patient administration and patient answers. secondary menu. Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: YS85POST Before: n/a After: B2059560 **85** Routine Name: YS85PRE Before: n/a After: B813879 **85** Routine Name: YTAPI5 Before: B9074622 After: B12417658 **62,85** Routine Name: YTAUIRR Before: B12780886 After: B14880327 **37,85** Routine Name: YTDOMR Before: B25756602 After: B26438095 **31,85** Routine Name: YTKIL Before: B8461736 After: B8970368 **37,85** Routine Name: YTPCL Before: B6068802 After: B7363737 **66,85** Routine Name: YTQAPI Before: n/a After: B15475641 **85** Routine Name: YTQAPI1 Before: n/a After: B27189337 **85** Routine Name: YTQAPI10 Before: n/a After: B24613112 **85** Routine Name: YTQAPI11 Before: n/a After: B22157825 **85** Routine Name: YTQAPI12 Before: n/a After: B20141561 **85** Routine Name: YTQAPI13 Before: n/a After: B19997427 **85** Routine Name: YTQAPI14 Before: n/a After: B6830812 **85** Routine Name: YTQAPI15 Before: n/a After: B25671527 **85** Routine Name: YTQAPI16 Before: n/a After: B13185422 **85** Routine Name: YTQAPI2 Before: n/a After: B21244483 **85** Routine Name: YTQAPI3 Before: n/a After: B23768089 **85** Routine Name: YTQAPI4 Before: n/a After: B28692651 **85** Routine Name: YTQAPI5 Before: n/a After: B23263110 **85** Routine Name: YTQAPI6 Before: n/a After: B5268725 **85** Routine Name: YTQAPI7 Before: n/a After: B18902958 **85** Routine Name: YTQAPI8 Before: n/a After: B32771511 **85** Routine Name: YTQAPI9 Before: n/a After: B22741073 **85** Routine Name: YTQHL7 Before: n/a After: B31149138 **85** Routine Name: YTQKIL Before: n/a After: B5269849 **85** Routine Name: YTQLIB Before: n/a After: B8410129 **85** Routine Name: YTQPRT Before: n/a After: B25124936 **85** Routine Name: YTQPXRM Before: n/a After: B4498627 **85** Routine Name: YTQPXRM1 Before: n/a After: B12743110 **85** Routine Name: YTQPXRM2 Before: n/a After: B14658221 **85** Routine Name: YTQPXRM3 Before: n/a After: B16585590 **85** Routine Name: YTQPXRM4 Before: n/a After: B21974840 **85** Routine Name: YTQPXRM5 Before: n/a After: B19969917 **85** Routine Name: YTQPXRM6 Before: n/a After: B17034666 **85** Routine Name: YTQPXRM7 Before: n/a After: B21919160 **85** Routine Name: YTQQI001 Before: n/a After: B16371213 **85** Routine Name: YTQQI002 Before: n/a After:B110963388 **85** Routine Name: YTQQI003 Before: n/a After:B107420027 **85** Routine Name: YTQQI004 Before: n/a After:B105189787 **85** Routine Name: YTQQI005 Before: n/a After:B104556455 **85** Routine Name: YTQQI006 Before: n/a After:B104012683 **85** Routine Name: YTQQI007 Before: n/a After:B103468973 **85** Routine Name: YTQQI008 Before: n/a After:B100582283 **85** Routine Name: YTQQI009 Before: n/a After: B99888363 **85** Routine Name: YTQQI00A Before: n/a After: B99132958 **85** Routine Name: YTQQI00B Before: n/a After:B101279645 **85** Routine Name: YTQQI00C Before: n/a After:B102188832 **85** Routine Name: YTQQI00D Before: n/a After: B98549063 **85** Routine Name: YTQQI00E Before: n/a After: B96890307 **85** Routine Name: YTQQI00F Before: n/a After: B97231174 **85** Routine Name: YTQQI00G Before: n/a After: B96151494 **85** Routine Name: YTQQI00H Before: n/a After: B96468871 **85** Routine Name: YTQQI00I Before: n/a After:B100432284 **85** Routine Name: YTQQI00J Before: n/a After: B95575288 **85** Routine Name: YTQQI00K Before: n/a After: B25448044 **85** Routine Name: YTQTIU Before: n/a After: B11026585 **85** Routine list of preceding patches: 31, 37, 62, 66 ============================================================================= User Information: Entered By : DEVLIN,MARK J Date Entered : MAY 17, 2004 Completed By: MORTON,RANDY Date Completed: JAN 07, 2008 Released By : MONTGOMERY,ALAN Date Released : JAN 07, 2008 ============================================================================= Packman Mail Message: ===================== No routines included