============================================================================= Run Date: SEP 13, 2006 Designation: DG*5.3*673 Package : DG - REGISTRATION Priority: EMERGENCY Version : 5.3 SEQ #632 Status: Released Compliance Date: SEP 15, 2006 ============================================================================= Associated patches: (v)DG*5.3*363 install with patch `DG*5.3*673' (v)DG*5.3*625 install with patch `DG*5.3*673' (v)DG*5.3*626 install with patch `DG*5.3*673' (v)DG*5.3*628 install with patch `DG*5.3*673' (v)DG*5.3*632 install with patch `DG*5.3*673' (v)DG*5.3*672 install with patch `DG*5.3*673' (v)DG*5.3*700 install with patch `DG*5.3*673' Subject: Operation Enduring & Iraqi Freedom Phase I Category: - Enhancement () - Data Dictionary - Routine Description: ============ I. OVERVIEW This patch introduces Phase I of changes and enhancements to the Registration V. 5.3 package in support of the Operation Enduring & Iraqi Freedom (OEF/OIF) initiative. I M P O R T A N T ************************************************************************* This patch, DG*5.3*673, along with Income Verification Match patch IVM*2*114, is being released in a single KIDS software distribution (host file). This patch only includes the informational portion of DG*5.3*673. In order to coordinate this new initiative with the Health Eligibility Center (HEC) so that the data can be seeded nationally, a 3 day window for compliance has been approved Please refer to the "Software and Documentation Retrieval" and "Installation Instructions" sections of this patch description for the instructions on how to acquire, install, and implement the patch software. ************************************************************************* The management at the Health Eligibility Center (HEC) has requested that VistA be enhanced to identify the combat periods for veterans who were deployed to the areas covered under Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). To accomplish this and to provide the VistA sites with as much 'seeded' information related to OEF and OIF as possible, this patch will modify VistA to enable it to receive OEF and OIF data from the HEC. The source of this data to be seeded into VistA is the OEF/OIF data registry that is present at the HEC. There will be very few obvious changes to VistA when this patch is installed as the changes are primarily being made to the filing of HL7 Z11 message data in the background. After the seeding is complete, another patch will be released (DG*5.3*689) that will allow VistA users to see and to enter/edit OEF and OIF information as it is received from the veteran and/or HEC. This new data will be used in the calculation of combat vet (CV) end date, so until patch DG*5.3*689 is released, there will be a short period of time where the CV end date may be based on this OEF/OIF information, even though it is not yet visible to the VistA user. Patch DG*5.3*689 will also contain the editing capabilities for the new service component fields. II. ASSOCIATED REMEDY TICKETS & NEW SERVICE REQUESTS The following section lists the Remedy tickets and/or New Service Requests associated with this patch. 1. Associated Remedy Tickets: ----------------------------------------- NONE 2. Associated New Service Request(s): ----------------------------------------- * NSR 20050603: ADD OPERATION IRAQI FREEDOM AND AFGHANISTAN TO FILE #21 AND AND FILE #22 * NSR 20050506: Adding Combat Location to Inpatient/Outpatient Austin Workload Files III. FUNCTIONAL OVERVIEW The following is an overview of the primary functionality that will be delivered in this patch. 1. There are two new specific conflict service locations and one new non-specific service location being defined for veterans, although none of these will be visible to the VistA user until the initial seeding from HEC sources has been completed and the follow-up patch DG*5.3*689 is installed. OEF - Operation Enduring Freedom OIF - Operation Iraqi Freedom UNKNOWN OEF/OIF - Veteran has been determined to have served in either OEF or OIF, but the specific service location is still being determined. Only HEC will be able to enter/edit/delete this location. 2. An initial seeding of this new OEF/ OIF/ UNKNOWN OEF/OIF data into VistA will be automatically performed by HEC once all the sites have installed this patch. The seeding will be run using the existing HL7 messaging functionality with new data added to the messages, and will require several days to complete. a. The filer for the Z11 HL7 message that is received from HEC has been modified to include filing of OEF/OIF data into the veteran's record. This data received on the Z11 will initially consist of the conflict location, conflict from date and a conflict to date. It will also eventually contain the site # of the initiating site if the data was entered in VistA and shared with all sites of record. During the filing, VistA will add the date/time the record was filed on the VistA system along with a lock flag. The DATA LOCKED field value 'YES' will mean that the source of data was 'CEV'(Centralized Eligibility Verification - aka HEC) and no site-entered edits will be permitted. b. When the OEF/OIF data is loaded into VistA from the Z11 HL7 message, the registration consistency checks for overlapping dates with other conflicts and the requirement that a conflict date must be within the veteran's military service episodes will be ignored. Any data inconsistencies generated as a result will be resolved in a future registration patch. c. The OEF/OIF data will be stored in a new multiple field in the PATIENT file (#2), SERVICE [OEF OR OIF] (#.3215). Note this is the first time VistA will allow conflict locations to have more than one period recorded. Only these three new conflict locations will have this multiple instance capability. d. When the new data is filed in VistA, a Z07 message will be generated back to HEC for the veteran so the file identifying site data at HEC can be kept current. e. OEF/OIF data received into a VistA system via a Z11 upload from HEC will not be used in checking for inconsistencies at the end of registration EXCEPT for the following: An inconsistency will be generated if the OEF/OIF data does not fall within the military service dates on file for the veteran. This is the same inconsistency check that currently exists for the other conflict/combat instances. If this inconsistency should occur, and there are no other conflicts that seem to be causing the inconsistency, the user must contact HEC to find out the appropriate military service data to add to the veteran's record to remove the inconsistency. Not being able to view the seeded OEF/OIF data is a temporary situation that will only occur until the follow up patch DG*5.3*689 is installed and the OEF/OIF data becomes visible to the user. 3. If the new OEF/OIF/UNKNOWN OEF/OIF episodes have precise 'to' dates, they will be used in addition to the other conflict 'to' dates in the calculation of CV end date for the veteran when the military service separation date is missing or is less than the OEF/OIF/UNKNOWN OEF/OIF TO DATE. ** Note: Because the new OEF/OIF data is not available for display with patch DG*5.3*673, if a CV end date appears not to be based on the displayable conflict/combat data, the users should contact HEC to verify the CV end date is being calculated correctly (i.e. using unseen OEF/OIF data) before assuming the CV end date data is in error. This is a temporary situation that will only occur until the follow up patch DG*5.3*689 is installed and the OEF/OIF data becomes visible. 4. In addition to the new OEF/OIF fields, three new fields are being added to the Patient file (#2) related to the veteran's period of military service. These fields will not be available for entering or editing on VistA until the second OEF/OIF patch (DG*5.3*689) is released. These fields are the service component (REGULAR, NATIONAL GUARD or ACTIVATED RESERVE) for the branch of service that the veteran was associated with during each period of military service. Information on displaying and editing these fields will be included in the patch documentation for DG*5.3*689. They are being included here because the Z11 HL7 message filer and the Z07 HL7 message builder are being modified to include and seed this data, even though there will be no data from facility edits to share until the second patch (DG*5.3*689) is installed. IV. TECHNICAL COMPONENTS The following section describes the technical components being exported with this patch. 1. The following FILES will be modified. a. PATIENT (#2) file New Field: ========= FIELD #: .3215 FIELD NAME: SERVICE [OEF OR OIF] MODIFICATION: New multiple field stored at node .3215, subfile number 2.3215 containing OEF/OIF related data. b. SERVICE [OEF or OIF] (#2.3215) subfile New Field: ========= FIELD #: .01 FIELD NAME: LOCATION OF SERVICE MODIFICATION: New field (set of codes) records the location of service. Stored at node 0;1. Valid entries are: 1 = OIF: Operation Iraqi Freedom 2 = OEF: Operation Enduring Freedom 3 = Unknown OEF/OIF: Either OEF or OIF Stored at location 0;1. c. SERVICE [OEF or OIF] (#2.3215) subfile New Field: ========= FIELD #: .02 FIELD NAME: OEF/OIF FROM DATE MODIFICATION: New field to record the start date of the deployment for this episode. Format: DATE. Stored at location 0;2. d. SERVICE [OIF or OEF] (#2.3215) subfile New Field: ========= FIELD #: .03 FIELD NAME: OEF/OIF TO DATE MODIFICATION: New field to record the start date of the deployment for this episode. Format: DATE. Stored at location 0;3. e. SERVICE [OIF or OEF] (#2.3215) subfile New Field: ========= FIELD #: .04 FIELD NAME: DATA LOCKED MODIFICATION: New field that is a flag that indicates the data is 'locked' at the site and can't be changed or deleted. This flag is set to 1 if the source of the data is the HEC system (CEV) and is stored at 0;4 Format: set of codes, valid entries: 0=No 1=Yes f. SERVICE [OEF or OIF] (#2.3215) subfile New Field: ========= FIELD #: .05 FIELD NAME: RECORDED DATE/TIME MODIFICATION: New field that is a time stamp for when the data was last added/updated on the VistA system. Format: DATE/TIME Stored at 0;5 g. SERVICE [OEF or OIF] (#2.3215) subfile New Field: ========= FIELD #: .06 FIELD NAME: ENTERED BY SITE MODIFICATION: New field that is the facility where the data was originally entered. If the data's source was not from a facility, it will be assumed to be generated from HEC (CEV) and this field will be blank. Format: pointer to INSTITUTION file. Stored at 0;6 h. SERVICE [OEF or OIF] (#2.3215) subfile INDEX INDEX: ALOEIF FIELDS: OEF/OIF TO DATE (#.02), OEF/OIF FROM DATE (#.03), SERVICE LOCATION (#.01) DESCRIPTION: The cross reference identifies the one LATEST OIF, OEF OR UNKNOWN OEF/OIF conflict episode for any veteran. (There should only be a maximum of 1 record per DFN in this cross reference) ^DPT("ALOEIF",TO DATE,FROM DATE,OIF/ OEF/ UNKNOWN OEF/OIF indicator, DFN,DA)="" Subscripts are: - TO DATE = latest conflict 'to date' for any OIF/ OEF/ UNKNOWN OEF/OIF conflicts - FROM DATE = corresponding 'from date' for TO DATE value - OIF/ OEF/ UNKNOWN OEF/OIF indicator = "OIF" "OEF" "UNK" - DFN = entry in patient file - DA = entry in OEF/OIF subfile This index can be used by clinical reminders (with a newly requested integration agreement) to aid them in identifying OEF/OIF veterans. i. PATIENT (#2) file Modified Field: ============== FIELD #: .325 FIELD NAME: SERVICE BRANCH [LAST] MODIFICATION: Added a trigger to delete SERVICE COMPONENT [LAST] if BRANCH OF SERVICE [LAST] changes. j. PATIENT (#2) file Modified Field: ============== FIELD #: .3291 FIELD NAME: SERVICE BRANCH [NTL] MODIFICATION: Added a trigger to delete SERVICE COMPONENT [NTL] if BRANCH OF SERVICE [NTL] changes. k. PATIENT (#2) file New Field: ========== FIELD #: .32911 FIELD NAME: SERVICE COMPONENT [LAST] MODIFICATION: New field stored at .3291;1 used to store new military service component associated with the last military service episode. l. PATIENT (#2) file New Field: ========== FIELD #: .32912 FIELD NAME: SERVICE COMPONENT [NTL] MODIFICATION: New field. Stored at .3291;2 used to store new military service component associated with the next to last military service episode. m. PATIENT (#2) file New Field: ========== FIELD #: .32913 FIELD NAME: SERVICE COMPONENT [NNTL] MODIFICATION: New field. Stored at .3291;3 used to store new military service component associated with the next to next to last military service episode. n. PATIENT (#2) file Modified Field: ============== FIELD #: .3296 FIELD NAME: SERVICE BRANCH [NNTL] MODIFICATION: Added a trigger to delete SERVICE COMPONENT [NNTL] if BRANCH OF SERVICE [NNTL] changes. 2. The following ROUTINE(s) will be added/modified. *************************************** ** NOTE ** ** The second line of routine DGRPMS ** ** is being released with patch 689 ** ** referenced in the patch list. ** ** Patch DG*5.3*689 is currently not ** ** released, but will be released ** ** very shortly and will remedy this ** ** situation. ** *************************************** ROUTINE SUMMARY: ================ The following is a list of the routine(s) included in this patch. The second line of each of these routine(s) will look like: ;;5.3;Registration;**[patch list]**;Aug 13, 1993 NEW CHECKSUM METHOD RESULTS: CHECK1^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== DGCLAPI1 N/A 7444234 673 DGCV 29768290 35316058 528,576,564,673 DGDDC 8687243 8871543 89,244,527,700 673 DGENOEIF N/A 14972188 673 DGENUPL1 31372596 32216917 147,222,232,314,397 379,407,363,673 DGENUPL2 61657350 66821493 147,222,232,310,314 367,397,677,631,675 672,673 DGENUPL4 65181451 66292292 147,177,232,253,327 367,377,514,451,625 673 DGENUPL7 28314140 29468363 232,367,397,417,379 431,513,628,673 DGLOCK 28148924 28314268 108,161,247,485,672 673 DGRPC3 16200328 18322459 451,632,673 DGRPDT 49558820 69102930 562,603,626,673 DGRPMS 35374783 48037248 451,626,646,673 689 VAFHLZM1 48235551 66971868 314,673 VAFHLZM2 N/A 3676248 673 VAFHLZMH 14591607 17707490 190,314,673 # of new routines: 3 # of routines changed: 12 total # of routines in the patch: 15 ======== OLD CHECKSUM METHOD RESULTS: CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== DGCLAPI1 N/A 3619685 673 DGCV 5335653 6339363 528,576,564,673 DGDDC 6215604 6261755 489,244,527,700 673 DGENOEIF N/A 4530157 673 DGENUPL1 6082317 6157888 147,222,232,314,397 379,407,363,673 DGENUPL2 15120786 15945780 147,222,232,310,314 367,397,677,631,675 672,673 DGENUPL4 16454165 16805441 147,177,232,253,327 367,377,514,451,625 673 DGENUPL7 9980481 10352681 232,367,397,417,379 431,513,628,673 DGLOCK 17317298 17319234 108,161,247,485,672 673 DGRPC3 7841364 8505965 451,632,673 DGRPDT 15682627 21671780 562,603,626,673 DGRPMS 9483547 10933466 451,626,646,673 689 VAFHLZM1 13276791 15535931 314,673 VAFHLZM2 N/A 1771016 673 VAFHLZMH 4411396 5062873 190,314,673 # of new routines: 3 # of routines changed: 12 total # of routines in the patch: 15 V. SOFTWARE AND DOCUMENTATION RETRIEVAL The software for this patch is not being distributed through the National Patch Module. This patch, DG*5.3*673, along with Income Verification Match patch IVM*2*114, is being released in a single KIDS software distribution (host file). Host file name: DG_53_P673.KID Build(s): DG*5.3*673 IVM*2.0*114 Sites may retrieve the host file and documentation directly via FTP. The preferred method is to FTP the files from: download.vista.med.va.gov This transmits the files from the first available FTP server. Sites may also elect to retrieve software directly from the ANONYMOUS.SOFTWARE directory from a specific server as follows: OIFO FTP ADDRESS DIRECTORY ------------ ------------------------ ------------- Albany ftp.fo-albany.med.va.gov anonymous.software Hines ftp.fo-hines.med.va.gov anonymous.software Salt Lake City ftp.fo-slc.med.va.gov anonymous.software The following files will be available: FILE NAME DESCRIPTION ----------------- ------------------------------- DG_53_P673.KID Host file containing KIDS software distribution IVM_2_P114_TM.PDF Revised IVM V. 2.0 Technical Manual * Note: Use ASCII mode when transferring the .KID file. Use Binary mode when transferring the .PDF files. VistA Intranet -------------- Upon release of this patch to the field, the Operation Enduring & Iraqi Freedom (OEF/OIF) documentation will also be available through the VistA Documentation Library (VDL) at the following address: http://www.va.gov/vdl/ VI. INSTALLATION INSTRUCTIONS Pre-Installation Items: ======================= * Environment Check: Programmer access is required for installing this patch. Prior to installation, the installer must ensure the DUZ(0) node of the DUZ array is set to the "@" symbol. * Users On the System: This patch may be installed with users on the system, but should be loaded during non-peak hours to minimize disruption to users and to reduce the possibility of errors when the routines are updated. * Software Installation Time: The estimated installation time is less than 5 minutes during off peak hours. * Required Builds: The following is a list of REQUIRED builds for this KIDS distribution. KIDS will not allow the installation of this patch without their prior installation. Required Build(s): ------------------ DG*5.3*363 DG*5.3*527 DG*5.3*625 DG*5.3*626 DG*5.3*628 DG*5.3*632 DG*5.3*672 IVM*2.0*109 Installation Steps: =================== Before starting the load of this patch, you may wish to stop the HL7 filers prior to the install to prevent possible 'No Source Errors' from occurring. No transmissions will be lost if the filers are not stopped first as those encountering an error will be reprocessed once the filers are restarted. 1. Download the KIDS file DG_53_P673.KID from the ANONYMOUS.SOFTWARE directory of either Albany, Hines or the Salt Lake OIFO to the appropriate directory on your system. 2. Use LOAD A DISTRIBUTION option on the KIDS INSTALLATION menu, and enter: DG_53_P673.KID 3. From the 'Kernel Installation & Distribution System' menu, select the Installation menu. 4. From this menu, you may now elect to use the following options (when prompted for INSTALL NAME, enter DG*5.3*673). a. Backup a Transport Global - This option will create a backup message of any routines exported with the patch. It will NOT backup any 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 the patch is installed. It compares all components of the 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. d. Print Transport Global - this option will allow you to view the components of the KIDS build. 5. Use the Install Package(s) option and select package DG*5.3*673. 6. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//', respond NO. 7. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//', it is recommended you answer NO. 8. When prompted to 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', respond YES. When prompted to select the options you would like to place out of order, enter the following: DG REGISTER PATIENT Register a Patient DG LOAD PATIENT DATA Load/Edit Patient Data When the patch has been completely installed, be sure to re-start the HL7 filers if you chose to stop them. VII. IMPLEMENTATION STEPS There are no special implementation steps to take after the successful installation of the software for Phase I of the Operation Enduring & Iraqi Freedom (OEF/OIF). However, in order to coordinate this new initiative with the Health Eligibility Center (HEC) so that the data can be seeded nationally, a 3 day window for compliance has been approved. A waiver was granted for testing to be conducted in site and HEC test accounts only to prevent production data from becoming inconsistent with HEC and other sites during the testing phase. VIII. TEST SITES The following sites participated in the testing of the DG*5.3*673 software. Test Site Alpha Beta ------------------------------ ----- ---- North Texas (Large/Integrated) X Washington, D.C. X Indianapolis X Routine Information: ==================== Routine Name: DGCLAPI1 Routine Name: DGCV Routine Name: DGDDC Routine Name: DGENOEIF Routine Name: DGENUPL1 Routine Name: DGENUPL2 Routine Name: DGENUPL4 Routine Name: DGENUPL7 Routine Name: DGLOCK Routine Name: DGRPC3 Routine Name: DGRPDT Routine Name: DGRPMS Routine Name: VAFHLZM1 Routine Name: VAFHLZM2 Routine Name: VAFHLZMH ============================================================================= User Information: Entered By : LOUCK,KEVIN Date Entered : JUL 13, 2005 Completed By: KOPP,TERRY M Date Completed: SEP 12, 2006 Released By : HEUER,CINDY Date Released : SEP 13, 2006 ============================================================================= Packman Mail Message: ===================== No routines included