============================================================================= Run Date: JAN 08, 2003 Designation: DG*5.3*415 Package : DG - REGISTRATION Priority: Mandatory Version : 5.3 SEQ #428 Status: Released Compliance Date: JAN 31, 2003 ============================================================================= Associated patches: (v)DG*5.3*169 <<= must be installed BEFORE `DG*5.3*415' (v)DG*5.3*251 <<= must be installed BEFORE `DG*5.3*415' (v)DG*5.3*298 <<= must be installed BEFORE `DG*5.3*415' (v)DG*5.3*389 <<= must be installed BEFORE `DG*5.3*415' (v)DG*5.3*423 <<= must be installed BEFORE `DG*5.3*415' (v)DG*5.3*454 <<= must be installed BEFORE `DG*5.3*415' (v)DG*5.3*466 <<= must be installed BEFORE `DG*5.3*415' Subject: RACE AND ETHNICITY, 1997 STANDARDS Category: - Routine - Data Dictionary - Input Template Description: ============ NOTE: Patches DG*5.3*415 and SD*5.3*254 are being released in a single distribution. Because of this, patch descriptions for DG*5.3*415 and SD*5.3*254 are identical and contain routine summaries for both sets of routines. This patch distributes the changes required to the Registration, Scheduling, PTF, and Ambulatory Care Reporting software for the collection and distribution of new Race and Ethnicity categories. These new categories will be collected and stored in the PATIENT file (#2) and sent to the Austin Automation Center for storage in the National Patient Care Database and National Patient Treatment File. The standards have been developed by the Office of Management and Budget to provide a common language for uniformity and comparability in the collection and use of data on race and ethnicity by Federal agencies. This patch is not being distributed through the National Patch Module. The distribution file DG_53_P415.KID (which contains DG*5.3*415 and SD*5.3*254) may be obtained using FTP from the ANONYMOUS.SOFTWARE directory at DOWNLOAD.VISTA.MED.VA.GOV or from specific servers at the Albany (ftp.fo-albany.med.va.gov), Hines (ftp.fo-hines.med.va.gov), or Salt Lake City (ftp.fo-slc.med.va.gov) OI Field Office. Nationally Approved/Supported Races ----------------------------------- * AMERICAN INDIAN OR ALASKA NATIVE * ASIAN * BLACK OR AFRICAN AMERICAN * NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER * WHITE * DECLINED TO ANSWER * UNKNOWN BY PATIENT All other race values will be flagged as inactive Nationally Approved/Supported Ethnicities ----------------------------------------- * HISPANIC OR LATINO * NOT HISPANIC OR LATINO * DECLINED TO ANSWER * UNKNOWN BY PATIENT Nationally Approved/Supported Collection Methods ------------------------------------------------ * SELF-IDENTIFICATION * OBSERVER * PROXY * UNKNOWN Although 4 collection methods are possible, the PIMS software will only collect Self Identified races and ethnicities. This is in line with a decision by HIMS to only collect self identified values when registering the patient for care or when encoding the patient's inpatient/outpatient record [via PTF/PCE]. Changes to PATIENT file (#2) ---------------------------- * The existing RACE field (#.06) is made uneditable * The existing RACE field (#.06) is removed as an identifier * The multiple RACE INFORMATION (sub-file #2.02) is created * The multiple ETHNICITY INFORMATION (sub-file #2.06) is created Changes to RACE file (#10) -------------------------- * The field HL7 VALUE (#3) is created with regular cross reference AHL7 * The field CDC VALUE (#4) is created * The field PTF VALUE (#5) is created * The field INACTIVE (#200) is created * The field INACTIVATION DATE (#202) is created New file - ETHNICITY (#10.2) ---------------------------- FLD FIELD NAME X-REF ~~~ ~~~~~~~~~~~~~~~~~~ ~~~~~ .01 NAME B 2 ABBREVIATION C 3 HL7 VALUE AHL7 4 CDC VALUE 5 PTF VALUE 100 SYNONYM (Mult 10.21) .01 -SYNONYM -B 200 INACTIVE 202 INACTIVATION DATE New file - RACE AND ETHNICITY COLLECTION METHOD (#10.3) ------------------------------------------------------- FLD FIELD NAME X-REF ~~~ ~~~~~~~~~~~~~~~~~~ ~~~~~ .01 NAME B .02 ABBREVIATION C .03 HL7 VALUE AHL7 .05 PTF VALUE Changes to Registration ----------------------- The Registration package does not currently prompt for race information during the registration process. The software will be modified to collect race and ethnicity data elements as well as their collection methods within the frame of the Patient Data screen (#2) as item number 3. When adding a new race and/or ethnicity value, the collection method SELF-IDENTIFICATION will automatically be used. Prompting for the collection method will only be done if the currently stored value is not SELF-IDENTIFICATION. Changes to Scheduling --------------------- Since the race field is not currently displayed on any of the Scheduling screens, race and ethnicity information will not be added to them. The options MAKE APPOINTMENT [SDM] and MAKE CONSULT APPOINTMENT [SC MAKE CONSULT APPT] currently prompt for race if the value is not already on file. These options will be adjusted to prompt for entry of the new race and ethnicity values if a value is not already on file. When adding a new race and/or ethnicity value, the collection method SELF-IDENTIFICATION will automatically be used. Prompting for the collection method will only be done if the currently stored value is not SELF-IDENTIFICATION. The option APPOINTMENT MANAGEMENT [SDAM APPT MGT] currently prompts for race if the action 'Patient Demographics' is selected. Prompting for race will occur at all times and will be adjusted to prompt for entry of the new race and ethnicity values. When adding a new race and/or ethnicity value, the collection method SELF-IDENTIFICATION will automatically be used. Prompting for the collection method will only be done if the currently stored value is not SELF-IDENTIFICATION. Changes to PTF -------------- The options LOAD/EDIT PTF DATA [DG PTF SCREEN] and QUICK LOAD/EDIT PTF DATA [DG PTF QUICK LOAD] currently collect race using input templates. These templates will be modified to collect race, ethnicity, and their collection methods. When adding a new race and/or ethnicity value, the collection method SELF-IDENTIFICATION will automatically be used. Prompting for the collection method will only be done if the currently stored value is not SELF-IDENTIFICATION. Note that the equivalent Census options and the options SET UP NON-VA PTF RECORD [DG PTF FEE BASIS ADD] and INQUIRE PTF RECORD [DG PTF COMPREHENSIVE INQUIRY] are also covered by these changes. Race is currently displayed on the 101 screen of LOAD/EDIT PTF DATA. In order to fit all race and ethnicity values on this screen, the transmission values will be used. Race is transmitted to the AAC in the PTF transmission and is located at position 56 of the 701 segment. Transmission of released PTF records is done through the option PTF TRANSMISSION [DG PTF TRANSMISSION VADATS]. The EAL Listing, which contains validation errors, currently displays the transmission value for race. An "X" will be placed in position 56 of the 701 segment. This is being done to denote that the historical value for race is no longer being used in the transmission. Ethnicity will be placed in positions 94 and 95 of the 701 segment, with ethnicity in position 94 and it's collection method in position 95. Race will also be added to the 701 segment in the same pairing methodology using positions 96 through 107 (ex: 96 is race #1, 97 is collection method #1, 98 is race #2, 99 is collection #2). The following tables list the transmission values for race, ethnicity, and collection method: PTF Race Values Value Description ~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3 American Indian or Alaska Native 8 Asian 9 Black or African American A Native Hawaiian or Other Pacific Islander B White C Declined to Answer D Unknown by Patient PTF Ethnicity Values Value Description ~~~~~ ~~~~~~~~~~~~~~~~~~~~~~ D Declined to Answer H Hispanic or Latino N Not Hispanic or Latino U Unknown by Patient PTF Race & Ethnicity Collection Method Values Value Description ~~~~~ ~~~~~~~~~~~~~~~~~~~ O Observer P Proxy S Self-identification U Unknown Changes to Ambulatory Care Reporting (ACRP) ------------------------------------------- Race is currently included in several reports and the HL7 transmission to Austin. The HL7 transmission will be modified to use the newly formatted PID segment. The following reports will be modified so that multiple race values are printed and the patient's ethnicity is selectable for output: ACRP AD HOC REPORT [SCRPW AD HOC REPORT], MEANS TEST/ELIGIBILITY/ENROLLMENT REPORT [SCRPW MT/ELIG/ENROLLMENT RPT], OUTPATIENT DIAGNOSIS/PROCEDURE CODE SEARCH [SCRPW DX/PROCEDURE CODE SEARCH], and VETERANS WITHOUT ACTIVITY SINCE A SPECIFIED DATE [SCRPW VETS W/OUT ACTIVITY]. New APIs -------- The following APIs are nationally supported. Refer to DBIA #3799 for details concerning input parameters and output of the calls. $$PTR2TEXT^DGUTL4 Function call converts a pointer to the RACE, ETHNICITY, or RACE AND ETHNICITY COLLECTION METHOD file (numbers 10, 10.2, and 10.3 respectively) into it's displayable name (i.e. .01 field). $$INACTIVE^DGUTL4 Function call returns whether or not a given entry in the RACE or ETHNICITY file (numbers 10 and 10.2 respectively) is marked as inactive. $$PTR2CODE^DGUTL4 Function call converts a pointer to the RACE, ETHNICITY, or RACE AND ETHNICITY COLLECTION METHOD file (numbers 10, 10.2, and 10.3 respectively) into it's abbreviation, HL7, CDC, or PTF code. $$CODE2PTR^DGUTL4 Function call converts an abbreviation, HL7, CDC, or PTF code into a pointer to it's entry in the RACE, ETHNICITY, or RACE AND ETHNICITY COLLECTION METHOD file (numbers 10, 10.2, and 10.3 respectively). Modifications to DEM^VADPT -------------------------- The new array element VADM(11) will contain the new ethnicity value. VADM(11) will be set to 1, VADM(11,1) will contain ethnicity in internal^external format (e.g. 1^HISPANIC OR LATINO) and VADM(11,1,1) will contain the collection method in internal^external format (e.g. 2^PROXY). The new array element VADM(12) will contain the new race values. VADM(12) will contain the number of race values being returned, VADM(12,x) will contain each race value in internal^external format (e.g. 11^WHITE), and VADM(12,x,1) will contain the collection method of each race value in internal^external format (e.g. 2^PROXY). Modifications to $$EN^VAFHLPID and $$EN^VAFCPID ----------------------------------------------- The current definition of the PID segment lists Race as sequence 10 and Ethnicity as sequence 22. Both fields have a data type of composite element (CE), which is defined as a field broken down by 6 components. Because this data type does not allow for the ability to encode the collection method, the values sent will be encoded with the collection method. These values will be placed into the first triplet (components 1 to 3). The HL7 standard states that the second triplet (components 4 to 6) is reserved for governmentally assigned codes. For our purposes, we will use the CDC values in the second triplet. Note that the collection method is not carried/implied within the second triplet. When calling the API, a parameter containing the list of sequences desired is used. An example of this parameter, VAFSTR, would be "1,2,3,4,5" when the calling program wishing to have sequences 1 to 5 returned. To provide flexibility, the text (components 2 & 5) and second triplet (components 4 to 6) for race and ethnicity will be optional. Applications wishing to have the second triplet included in the output PID will append "B" to the sequence number (ex: "10B" and "22B"). Applications wishing to have the text included will append "T" to the sequence number (ex: "10T" and "22T"). Applications wishing to have the text and second triplet will append "B" and "T" to the sequence number (ex: "10BT" and "22BT"). To maintain backwards compatibility, the existing PID API will continue to return the historical value for race in sequence 10. Applications wishing to have the new race values returned can either use the "B" and/or "T" qualifier or can use "N" as a qualifier. Use of the "N" qualifier will return the race values but not include the text or second triplet in the output. Modified PTF AUSTIN ERROR CODES ------------------------------- * Error code 713 is marked as no longer used New TRANSMITTED OUTPATIENT ENCOUNTER ERROR CODE ----------------------------------------------- * Austin error code 238 = Ethnicity code missing or invalid * VistA error code 2380 = Ethnicity code missing or invalid New/Modified ACRP REPORT TEMPLATE PARAMETER ------------------------------------------- * 0703 (PATIENT RACE) modified to accomodate multiple race values * 0706 (PATIENT ETHNICITY) created Modified Input Templates ------------------------ NAME USED FOR ~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DG101 Load/Edit PTF Data - 101 Screen DG101F Load/Edit PTF Data (Fee Basis patient) - 101 Screen DGQWK Quick Load/Edit PTF Data DGQWKF Quick Load/Edit PTF Data (Fee Basis patient) ROUTINE SUMMARY - REGISTRATION: =============================== 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 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== DG53415 N/A 7332051 415 DGPT101 5863619 5816091 8,164,180,247,415 DGPT701 5773024 5646278 64,164,251,415 DGPT701P 2698106 2598214 164,415 DGPTAE 7140217 7057535 58,415 DGPTAEE2 8619653 9053107 8,338,415 DGPTF1 14834587 14591632 69,114,195,397,342 415 DGPTFTR 9405205 9571338 37,415 DGPTFVC1 15246957 15619820 52,58,79,114,164 400,342,466,415 DGPTR1 16196119 16330674 58,247,338,342,423 415 DGPTR4 4592148 5121100 338,423,415 DGRP2 5687059 6896051 415 DGRPE 20568255 21982861 32,114,139,169,175 247,190,343,397,342 454,415 DGRPH 22085843 22220138 114,343,397,415 DGRPU1 1411324 2702386 139,169,415 DGRPV 9054980 9086115 109,114,247,190,327 365,343,397,415 DGUTL4 N/A 2109591 415 VADPT 6944450 6944486 193,343,389,415 VADPT0 3122632 3139984 343,342,415 VADPT1 9482819 10364665 415 VAFCA04 4391209 4832043 91,209,149,261,298 415 VAFCADT2 3877798 4194411 91,179,209,415 VAFCMSG4 3543724 3893163 91,209,149,415 VAFCPID 9237084 3564275 91,149,190,415 VAFHBGJ 1942843 1977309 91,415 VAFHLPI1 N/A 3602800 415 VAFHLPID 6542186 3153380 68,94,415 VAFHLU N/A 872343 415 VAFHQRY 1561975 1585072 91,415 Note: The VADPT routines must be moved to the Imaging DICOM gateways. Refer to installation step 9 for further details. ROUTINE SUMMARY - SCHEDULING: ============================= 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;Scheduling;**[patch list]**;Aug 13, 1993 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== SCDXMSG1 9697913 9645949 44,55,70,77,85 66,143,142,162,172 180,239,245,254 SCMSVPID 5148825 3522345 44,66,162,254 SCMSVUT0 6549627 6602857 44,55,66,132,245 254 SCMSVUT2 3158470 3255774 66,180,254 SCMSVUT5 N/A 1130452 254 SCRPW24 27654973 27453254 144,163,180,254 SCRPW241 1240533 2787665 180,254 SDM 15139012 15212475 15,32,38,41,44 79,94,167,168,218 223,250,254 INSTALLATION INSTRUCTIONS: ========================== This patch can be installed with users on the system, however it should be installed during off hours to minimize disruption to users. This patch affects Registration, PTF, the check-out process and must be installed when the SCDX AMBCAR NIGHTLY XMIT background job is not running. Installation will take less than 5 minutes. Note: The new race and ethnicity data is stored in multiples of the PATIENT file (#2). The sub-file numbers used for these multiples (#2.02 & #2.06) were used by other multiples in the past. During field testing it was found that these sub-files were still defined at some sites. To ensure that the obsolete sub-files do not exist, the pre-init of this patch checks for their existence and deletes them if they are found. This deletion can take a long time to run since deletion of the sub-files also requires deletion of any data still on file. Sites wishing to decrease the installation time of this patch should check for their existence and manually delete them. The following sample code can be used to accomplish this: MUMPS> F DIU=2.02,2.06 I $D(^DD(DIU)) S DIU(0)="DEST" D EN^DIU2 Note: The following is a list of REQUIRED builds for this KIDS distribution. KIDS will not allow the installation of this patch without the prior installation of them. DG*5.3*169 DG*5.3*251 DG*5.3*298 DG*5.3*389 DG*5.3*423 DG*5.3*454 DG*5.3*466 SD*5.3*250 SD*5.3*245 1. Use the LOAD A DISTRIBUTION option on the KIDS INSTALLATION Menu, and enter DG_53_P415.KID. 2. Review your mapped set. If any of the routines listed in the ROUTINE SUMMARY section are mapped, they should be removed from the mapped set at this time. 3. From the Kernel Installation and Distribution System Menu, select the Installation menu. 4. From this menu, you may elect to use the following options (when prompted for INSTALL NAME, enter DG*5.3*415): a. Backup a Transport Global - this option will create a backup message of any routines exported with the patch. It will NOT backup any other 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 the package DG*5.3*415. 6. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//',respond NO. 7. When prompted '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: SCDX AMBCAR NIGHTLY XMIT Ambulatory Care Nightly Transmission to NPCDB SDAM APPT MGT Appointment Management SDAM APPT CHECK IN/OUT Appointment Check-in/Check-out SDADDEDIT Add/Edit Stop Codes SDAPP Appointment Menu SDI Check-in/Unsched. Visit SDM Make Appointment PXCE ENCOUNTER DATA ENTRY PCE Encounter Data Entry PXCE ENCOUNTER ENTRY & DELETE PCE Encounter Data Entry & Delete PXCE ENCOUNTER ENTRY NO DELETE PCE Encounter Entry Without Delete PXCE ENCOUNTER ENTRY SUPER PCE Encounter Data Entry - Supervisor DG PTF MENU PTF Menu DG PTF SCREEN Load/Edit PTF Data DG PTF TRANSMISSION VADATS PTF Transmission DG PTF QUICK LOAD Quick Load/Edit PTF Data DG PTF MESSAGE ENTER Enter PTF Message DG PTF FEE BASIS ADD Set Up Non-VA PTF Record DG REGISTRATION MENU Registration Menu DG CONSISTENCY PATIENT Edit Inconsistent Data for a Patient DG LOAD PATIENT DATA Load/Edit Patient Data DG PATIENT INQUIRY Patient Inquiry When prompted to select the protocols you would like to place out of order, enter the following: SDAM PCE EVENT Process PCE Event Data 8. If routines were unmapped as part of step 2, they should be returned to the mapped set once the installation has run to completion. 9. If you are running Vista Imaging, use the menu option to copy the routines to the Imaging DICOM gateways as follows: "On the Vista server (hospital database), use menu option 'Copy Routines to DICOM Gateway' located under the 'Imaging System Manager' Menu. Then on all Text and Image gateways use the 'System Maintenance' menu to select Gateway Configuration and DICOM Master File and then select 'Download Current Radiology and MAS Routines'. This will cause the up-to-date versions of all radiology and MAS routines to be copied to the gateway systems." Routine Information: ==================== Routine Name: - DG53415 Routine Checksum: Routine Name: - DGPT101 Routine Checksum: Routine Name: - DGPT701 Routine Checksum: Routine Name: - DGPT701P Routine Checksum: Routine Name: - DGPTAE Routine Checksum: Routine Name: - DGPTAEE2 Routine Checksum: Routine Name: - DGPTF1 Routine Checksum: Routine Name: - DGPTFTR Routine Checksum: Routine Name: - DGPTFVC1 Routine Checksum: Routine Name: - DGPTR1 Routine Checksum: Routine Name: - DGRP2 Routine Checksum: Routine Name: - DGRPE Routine Checksum: Routine Name: - DGRPH Routine Checksum: Routine Name: - DGRPU1 Routine Checksum: Routine Name: - DGUTL4 Routine Checksum: Routine Name: - DGRPV Routine Checksum: Routine Name: - VADPT Routine Checksum: Routine Name: - VADPT0 Routine Checksum: Routine Name: - VADPT1 Routine Checksum: Routine Name: - VAFCA04 Routine Checksum: Routine Name: - VAFCADT2 Routine Checksum: Routine Name: - VAFCMSG4 Routine Checksum: Routine Name: - VAFCPID Routine Checksum: Routine Name: - VAFHBGJ Routine Checksum: Routine Name: - VAFHLPI1 Routine Checksum: Routine Name: - VAFHLPID Routine Checksum: Routine Name: - VAFHLU Routine Checksum: Routine Name: - VAFHQRY Routine Checksum: Routine Name: - DGPTR4 Routine Checksum: ============================================================================= User Information: Entered By : SAUNDERS,ANGELA C Date Entered : SEP 19, 2001 Completed By: GUTHRIE,MARY H Date Completed: JAN 06, 2003 Released By : SIVLEY,JIMMIE SUE Date Released : JAN 08, 2003 ============================================================================= Packman Mail Message: ===================== No routines included