$TXT Created by YORTY,M ROBERT at DEVVOO.FO-ALBANY.MED.VA.GOV (KIDS) on Monday, 04/11/05 at 13:09 ============================================================================= Run Date: APR 25, 2005 Designation: DG*5.3*638 Package : DG - REGISTRATION Priority: Mandatory Version : 5.3 SEQ #567 Status: Released Compliance Date: MAY 26, 2005 ============================================================================= Associated patches: (v)DG*5.3*545 <<= must be installed BEFORE `DG*5.3*638' (v)DG*5.3*570 <<= must be installed BEFORE `DG*5.3*638' (v)DG*5.3*626 <<= must be installed BEFORE `DG*5.3*638' (v)DG*5.3*629 <<= must be installed BEFORE `DG*5.3*638' Subject: PREVENTING CATASTROPHIC EDITS TO IDENTITY Category: - Enhancement (Mandatory) - Routine - Other Description: ============ This patch is made in support of patient safety issues identified by the Health Data and Informatics Program Office and the National Center for Patient Safety (NCPS) when catastrophic edits result in altering patient identity fields within electronic health records. Patient Identity Fields: Patient Name (First and/or Last Name Components) Social Security Number Date of Birth Sex Patch MPIF*1.0*37 will be released separately to address the display of Patient identity fields that are blank or requiring editing at the beginning of the registration process. This patch DG*5.3*638 will place all of the patient identity fields within one screen. It will also provide additional prompts and alerts within the Registration Intake process that will ensure that users are fully aware of the impact of modifications to more than one patient identity fields which can impact patient care throughout the entire Department of Veterans Affairs (VA). The alerts will provide local staff with sufficient information for follow-up with users who repeatedly modify two or more of the four key patient identity fields within one edit session. 1). The PATIENT DEMOGRAPHIC DATA, SCREEN <1> will display the SEX field. 2). At the time of the Registration Intake process, when two or more edits are made to the patient identity fields a warning message will be displayed to the user making modifications to the patient: **WARNING!!** The edits you are about to make, may potentially change the identity of this patient. Please verify that you have selected the correct patient and ensure that supporting documentation exists for these changes. If you continue with these edits, an alert will be generated and sent to your Supervisor and ADPAC, notifying them of the changes. Do you wish to continue and save your edits:? NO// 2A). Answering 'NO' will not save the edits being made and you will return to the PATIENT DEMOGRAPHIC DATA, SCREEN <1> with the original patient information intact. 2B). Answering 'YES' will save the edits and the user will return to the PATIENT DEMOGRAPHIC DATA, SCREEN <1>. An alert with the potential patient catastrophic edits will be forwarded to your site's ADPAC and appropriate supervisor for review and action. 3). This patch creates a new Security key (DG CATASTROPHIC EDIT) that will need to be distributed to the appropriate supervisor and ADPAC in order for them to receive and review the alerts. If the Security key (DG CATASTROPHIC EDIT) is not assigned, the alert (with review) and a mail message will be forwarded to those users holding the Security key (DG SUPERVISOR). In addition a mail message will be sent to the MPIF Exceptions Mail Group notifying them the DG Catastrophic Edit key has not been assigned. 3A). Alerts forwarded to your site's ADPAC and appropriate supervisor will highlight before and after edits of the patient identification fields. Mother's Maiden name, Place of Birth for both city and state are included to assist with patient identity. 3B). In addition, the after edits of the patient identification fields will display an asterisk to highlight the edited fields that have been modified when the alert was generated. 3C). The alert will prompt the supervisor if the patient information has been reviewed. 3D). An alert will remain on the user's active alert screens until the alert is reviewed ('YES' response). 3E). The supervisor who has reviewed the alert will be prompted with a follow up prompt, asking if the patient alert was determined to be a catastrophic edit ('YES' or 'NO'). 3F). Only, after the alert has been reviewed, will it allow the supervisor the option to remove the alert, or, keep it under their active screen alerts. 3G). Alerts will remain for retention in the ALERT TRACKING (#8992.1) File for 365 days. 4). This patch installs a new report in the 'Registration Menu' [DG REGISTRATION MENU]. This report, 'Report - Patient Catastrophic Edits' [DG PATIENT CE REPORT], will provide the viewer a listing (up to one year) of posted potential catastrophic alerts, alerts reviewed, and alerts determined to be catastrophic edits. It will list as a summary of totals, or display a detailed listing of all the information contained in the alert. ========================================================================= Upon release of this patch to the field, the updated Registration documentation will be available through the VistA Documentation Library (VDL) at the following address: http://www.va.gov/vdl/Clinical.asp?appID=55 ========================================================================= This patch addresses the following New Service Request (NSR): ------------------------------------------------------------- 20041009 - Preventing Catastrophic Edits to Identity This patch addresses the following NOIS/Remedy ticket(s): --------------------------------------------------------- BAC-0204-41147 PATIENT RECORDS SWITCHED Overview of NOIS/Remedy Ticket(s): ---------------------------------- BAC-0204-41147 PATIENT RECORDS SWITCHED Problem: Clerk mistakenly changed existing patient data to another patient's information. Resolution: Patch MPIF*1*37 will decrease the possibility of mistakenly editing patient data, by displaying for edit only those fields that are blank or requiring editing changes. This patch, DG*5.3*638, will increase the awareness of potential catastrophic edits to patient identity to the appropriate supervisors. COMPONENTS SENT WITH PATCH -------------------------- The following is a list of the routines included in this patch. The second line of each of these routines now looks like: ;;5.3;Registration;**[patch list]**;Aug 13,1993 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== DG53P638 N/A 609510 638 DGRP1 14865698 15348933 109,161,506,244,546, 570,269,638 DGRP2 7763122 7262238 415,545,638 DGRPE 26743702 26577675 32,114,139,169,175, 247,190,343,397,342, 454,415,489,506,244, 547,522,528,555,508, 451,626,638 DGRPECE N/A 6632236 638 DGRPECE1 N/A 12600826 638 DGRPECE2 N/A 14903016 638 DGRPH 21341979 21362264 114,343,397,415,489, 545,638 Total number of routines modified: 4 Total number of new routines: 4 Total number of deleted routines: 1 The following is a list of options included in this patch: Option Name Type New/Modified ----------- ---- ------------ [DG PATIENT CE REPORT] run routine new The following is a list of security keys included in this patch: SECURITY KEY ------------ DG CATASTROPHIC EDIT SEND TO SITE Test Sites: ----------- Clarksburg VAMC Milwaukee VAMC West LA VAMC =======================INSTALLATION INSTRUCTIONS========================== Because the Registration process is being modified, it is recommended that this patch be installed during non-peak hours to limit interruptions and that the following selection(s) in the OPTION (#19) file, and all of their descendants be disabled to prevent possible conflicts while running the KIDS Install. Other VISTA users will not be affected. Load/Edit Patient Data [DG LOAD PATIENT DATA] Register a Patient [DG REGISTER PATIENT] Enter a Request/Notification [FBCH ENTER REQUEST] View Registration [DG REGISTRATION VIEW] Installation will take less than 2 minutes. 1. LOAD TRANSPORT GLOBAL --------------------- Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. START UP KIDS ------------- Start up the Kernel Installation and Distribution System Menu [XPD MAIN]: Edits and Distribution ... Utilities ... Installation ... Select Kernel Installation & Distribution System Option: Installation --- Load a Distribution Print Transport Global Compare Transport Global to Current System Verify Checksums in Transport Global Install Package(s) Restart Install of Package(s) Unload a Distribution Backup a Transport Global Select Installation Option: 3. Select Installation Option: -------------------------- NOTE: The following are OPTIONAL - (When prompted for the INSTALL NAME, enter DG*5.3*638): 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 DD's 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, DD's, 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. Select Installation Option: Install Package(s) ------------------ a. Choose the Install Package(s) option to start the patch install. b. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//', answer YES. c. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//', answer NO. d. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', answer YES. e. When prompted 'Enter options you wish to mark as 'Out Of Order':' Enter the following options: Load/Edit Patient Data [DG LOAD PATIENT DATA] Register a Patient [DG REGISTER PATIENT] Enter a Request/Notification [FBCH ENTER REQUEST] View Registration [DG REGISTRATION VIEW] f. When prompted 'Enter protocols you wish to mark as 'Out Of Order':' press . ****************** POST-INSTALLATION INSTRUCTIONS ************************ 1. Assign the Security key, DG CATASTROPHIC EDIT, to your HAS ADPAC and designated supervisor selected to review catastrophic edits. 2. Delete routine DG53P638 after a successful installation. ************************************************************************** Routine Information: ==================== Routine Name: - DG53P638 Routine Checksum: Routine Name: - DGRP1 Routine Checksum: Routine Name: - DGRP2 Routine Checksum: Routine Name: - DGRPE Routine Checksum: Routine Name: - DGRPECE Routine Checksum: Routine Name: - DGRPECE1 Routine Checksum: Routine Name: - DGRPECE2 Routine Checksum: Routine Name: - DGRPH Routine Checksum: ============================================================================= User Information: Entered By : YORTY,M ROBERT Date Entered : DEC 01, 2004 Completed By: WOEHRLE,MARGARET Date Completed: APR 25, 2005 Released By : CANNEDY,JOELLEN Date Released : APR 25, 2005 ============================================================================= Packman Mail Message: ===================== $END TXT