============================================================================= Run Date: SEP 11, 2003 Designation: DG*5.3*425 Package : DG - REGISTRATION Priority: Mandatory Version : 5.3 SEQ #469 Status: Released Compliance Date: SEP 25, 2003 ============================================================================= Associated patches: (v)DG*5.3*391 <<= must be installed BEFORE `DG*5.3*425' (v)DG*5.3*513 <<= must be installed BEFORE `DG*5.3*425' Subject: PATIENT RECORD FLAGS Category: - Enhancement (Mandatory) - Routine - Data Dictionary Description: ============ I. OVERVIEW This patch introduces changes and enhancements to the Registration V. 5.3 package in support of the Patient Record Flags (PRF) initiative. The VA Office of Inspector General (OIG) in its report "Evaluation of VHA's Policies and Practices for Managing Violent or Potentially Violent Psychiatric Patients" (6HI-A28-038, dated March 28, 1996) recommended that facilities communicate among themselves so that staff are aware of high risk patients regardless of where in the VHA system they may seek health care. The Patient Record Flags module of the Registration package provides the functionality needed to implement the OIG's recommendation. Patient Record Flags (aka Computerized Patient Advisories) will alert VHA employees of patients whose behavior or characteristics may pose a threat either to the safety of the employee, the safety of other patients, or compromise the delivery of quality health care. Patient Record Flags are separated into two categories, Category I National and Category II Local. Category I Patient Record Flags are nationally approved and will be nationally distributed via the patch module for implementation by all facilities. New Category I PRF assignments, and future modifications to Category I PRF assignments, are shared with all known treating facilities for the patient using VistA HL7 messaging. The registration of a new patient at a facility will generate a query to the patient's Coordinating Master of Record (CMOR) site to retrieve any existing Category I record flag assignments for the patient. Modification of existing Category I PRF assignments is limited to the site designated as the "owner" during the assignment process. A single Category I flag, named "BEHAVIORAL", is included in this patch for implementation by all facilities. The purpose of this patient record flag is to alert VHA medical staff and employees of patients whose behavior or characteristics may pose a threat either to their safety, the safety of other patients, or compromise the delivery of quality health care. Category II Patient Record Flags are locally established by individual VISNs or facilities. Category II PRF assignments are not shared between facilities. For additional information, refer to VHA Directive 2003-048 National Patient Record Flags. <<<<<<<<<<<<<<<<<<<< NOTE >>>>>>>>>>>>>>>>>>>> This patch, DG*5.3*425, is being released in a single KIDS software distribution (host file). This patch message contains the informational portion of DG*5.3*425 and provides field personnel with instructions on how to acquire, install, and implement the patch software. Two additional patches, USR*1*24 and TIU*1*165, are being released as a separate distribution (host file) in support of patch DG*5.3*425. II. FUNCTIONAL OVERVIEW The functionality delivered in this patch can be divided into six (6) main areas. 1. PATIENT RECORD FLAG MANAGEMENT There is a new Record Flag Management [DGPF RECORD FLAG MANAGEMENT] option. This option is a List Manager user interface and provides the following actions. a. Ability to create Category II (Local) flags. b. Ability to edit Category II (Local) flags. c. Ability to display a list of both Category I (National) and Category II (Local) flags. d. Ability to display details of both Category I (National) and Category II (Local) flags. 2. PATIENT RECORD FLAG ASSIGNMENT There is a new Record Flag Assignment [DGPF RECORD FLAG ASSIGNMENT] option. This option provides a List Manager user interface for assigning Patient Record Flags to patients. Additionally, this option provides the ability to review and manage Patient Record Flag assignments. The following actions are provided within the Record Flag Assignment option. a. Assign a patient record flag to a patient. b. Display the details of a patient's record flag assignments including the history of the assignment. c. Review/Edit a patient's record flag assignment. d. Change the site ownership of a patient's record flag assignment. 3. PATIENT RECORD FLAG REPORTS a. There is a new Flag Assignment Report [DGPF FLAG ASSIGNMENT REPORT] option. This option provides the ability to display/print a report of all record flag assignments associated with a specific patient record flag. b. There is a new Assignments Due For Review Report [DGPF ASSIGNMENT DUE REVIEW RPT] option. This option provides the ability to display/print a report of patients that require their record flag assignments to be reviewed based on an input date range. 4. DISPLAY ACTIVE PATIENT RECORD FLAG ASSIGNMENTS a. Patient Lookup in VistA has been modified and now will display all ACTIVE patient record flag assignments for a patient. The user will then have the ability to view the details of each of the patient's ACTIVE PRF assignments. b. The following Registration options have been modified to automatically generate a query for Category I patient record flag assignments when a new patient is registered at the facility. - Register a Patient [DG REGISTER PATIENT] - Load/Edit Patient Data [DG LOAD PATIENT DATA] - 10-10T Registration [DGRPT 10-10T REGISTRATION] The query will occur in real-time and will be sent to the patient's Coordinating Master of Record (CMOR) site. The query will search for and return all of the patient's ACTIVE and INACTIVE Category I (National) Patient Record Flag Assignments to be filed in the local site's Patient Record Flags database. If an ACTIVE Category I (National) record flag assignment is found for the patient, it will be displayed to the user. The user will then have the ability to view the details of each of the patient's ACTIVE PRF assignments. 5. SHARING CATEGORY I (NATIONAL) RECORD FLAG ASSIGNMENTS a. Automatic Sharing of Category I PRF Assignments. Category I PRF are nationally approved and will be nationally distributed for implementation by all facilities. New Category I patient assignments and future modifications to Category I PRF assignments will automatically be shared with all known treating facilities for the patient using VistA HL7 messaging. Modification of existing Category I patient assignments is limited to the site designated as the "owner" during the assignment process. b. Query for Category I (National) PRF Assignments. The registration of a new patient at a facility will generate a query to the patient's Coordinating Master of Record (CMOR) site to retrieve any existing Category I PRF assignments for the patient. Note: Category II flags are locally established by individual VISNs or facilities. Category II flag assignments are not shared between facilities. 6. SYSTEM CONFIGURATION There is a new PRF System Configuration [DGPF PRF SYSTEM CONFIGURATION] option. This option enables IRM staff to enable or disable the Patient Record Flag HL7 interfaces if the need arises. a. This option will provide the ability to enable or disable the Unsolicited Observation Update (ORU~R01) HL7 interface for the Patient Record Flags module. This interface is responsible for the transmission of unsolicited patient record flag (Category I) assignment data to a patient's sites of record. b. This option provides the ability to control the PRF HL7 query (QRY~R02) interface. The interface may be enabled or disabled. Additionally, the option allows the type of PRF HL7 query (QRY~R02) interface that may be used, either a VistA HL7 'direct' connection or a VistA HL7 'deferred' connection. III. TECHNICAL COMPONENTS The following section describes the technical components of this patch. 1. The following new OPTION(s) will be added. a. NAME: DGPF RECORD FLAG ASSIGNMENT MENU TEXT: Record Flag Assignment DESCRIPTION: This option provides a List Manager user interface for assigning Patient Record Flags to patients. Additionally, this option provides the ability to review and manage Patient Record Flag assignments. The following actions are provided within the patient Record Flag Assignment option. - Assign a Patient Record Flag to a patient. - Display the details of a patient's record flag assignments including the history of the assignment. - Review/Edit a patient's record flag assignment. - Change the site ownership of a patient's record flag assignment. b. NAME: DGPF RECORD FLAGS MAIN MENU MENU TEXT: Patient Record Flags Main Menu DESCRIPTION: This menu option contains all menus and options needed to assign, manage, and report patient record flag information. This is a new stand-alone menu option. c. NAME: DGPF RECORD FLAG MANAGEMENT MENU TEXT: Record Flag Management DESCRIPTION: This option will provide users with the ability to: - Create Category II (Local) Patient Record Flags - Edit Category II (Local) Patient Record Flags - List Category I (National) and Category II (Local) Patient Record Flags - Display details of Category I and Category II Patient Record Flags d. NAME: DGPF BACKGROUND PROCESSING MENU TEXT: Patient Record Flag Background DESCRIPTION: This option should be scheduled to run once a day. The following functions are processed by this background option: 1. Send review notification messages for pending Patient Record Flag Assignment reviews. 2. Auto retransmitting of rejected HL7 Patient Record Flag Assignment messages. e. NAME: DGPF RECORD FLAG REPORTS MENU MENU TEXT: Record Flag Reports Menu DESCRIPTION: This menu provides the user with functions to Display or Print Patient Record Flag Assignment Reports. f. NAME: DGPF FLAG ASSIGNMENT REPORT MENU TEXT: Flag Assignment Report DESCRIPTION: This option enables a user to display or print all of the patient assignments for Category I and/or Category II Patient Record Flags. g. NAME: DGPF ASSIGNMENT DUE REVIEW RPT MENU TEXT: Assignments Due For Review Report DESCRIPTION: This option will be used to display or print all Category I or Category II Patient Record Flag Assignments that are due for review within a given date range. h. NAME: DGPF PRF SYSTEM CONFIGURATION MENU TEXT: PRF System Configuration DESCRIPTION: This option enables IRM staff to enable or disable the Patient Record Flag HL7 interfaces. 2. The following new PROTOCOL(s) will be added. a. NAME: DGPF ADD FLAG ITEM TEXT: Add New Record Flag TYPE: action DESCRIPTION: This action protocol allows a user to add a new Category II (Local) flag within the Record Flag Management [DGPF RECORD FLAG MANAGEMENT] option. b. NAME: DGPF ASSIGN FLAG ITEM TEXT: Assign Flag TYPE: action DESCRIPTION: This action protocol permits the user to assign a flag to a patient within the Record Flag Assignment [DGPF RECORD FLAG ASSIGNMENT] option. c. NAME: DGPF CHANGE ASSIGNMENT OWNERSHIP ITEM TEXT: Change Assignment Ownership TYPE: action DESCRIPTION: This action protocol permits the user to change the site ownership of a patient's flag assignment within the Record Flag Assignment [DGPF RECORD FLAG ASSIGNMENT] option. d. NAME: DGPF CHANGE CATEGORY ITEM TEXT: Change Category TYPE: action DESCRIPTION: This action protocol allows the user to change the category of the flag list being viewed within the Record Flag Management [DGPF RECORD FLAG MANAGEMENT] option. The user may view either Category I (National) flags or Category II (Local) flags. e. NAME: DGPF DISPLAY ASSIGNMENT DETAIL ITEM TEXT: Display Assignment Details TYPE: action DESCRIPTION: This action protocol permits the user to view the details of a patient's flag assignment within the Record Flag Assignment [DGPF RECORD FLAG ASSIGNMENT] option. f. NAME: DGPF DISPLAY FLAG DETAIL ITEM TEXT: Display Flag Detail TYPE: action DESCRIPTION: This action protocol permits the user to view the details of a patient record flag within the Record Flag Management [DGPF RECORD FLAG MANAGEMENT] option. g. NAME: DGPF EDIT ASSIGNMENT ITEM TEXT: Edit Flag Assignment TYPE: action DESCRIPTION: This action protocol permits the user to edit a patient's flag assignment within the Record Flag Assignment [DGPF RECORD FLAG ASSIGNMENT] option. h. NAME: DGPF EDIT FLAG ITEM TEXT: Edit Record Flag TYPE: action DESCRIPTION: This action protocol allows a user to edit a Category II (Local) flag within the Record Flag Management [DGPF RECORD FLAG MANAGEMENT] option. i. NAME: DGPF PRF ORF/R04 SUBSC TYPE: subscriber DESCRIPTION: This protocol is the subscriber protocol for the Patient Record Flags query message (QRY~R02). The protocol will return an Observation results message (ORF~R04). j. NAME: DGPF PRF ORU/R01 EVENT TYPE: event driver DESCRIPTION: This protocol is the event protocol for Patient Record Flags assignment transmissions (ORU~R01). k. NAME: DGPF PRF ORU/R01 SUBSC TYPE: subscriber DESCRIPTION: This protocol is the subscriber protocol for Patient Record Flags assignment transmissions (ORU~R01). l. NAME: DGPF PRF QRY/R02 EVENT TYPE: event driver DESCRIPTION: This protocol is the event protocol for the Patient Record Flags query message (QRY~R02). m. NAME: DGPF RECORD FLAG ASSIGNMENT MENU TYPE: menu DESCRIPTION: This protocol menu contains all the activities for creating, editing, and displaying patient record flag assignments. n. NAME: DGPF RECORD FLAG MANAGEMENT MENU TYPE: menu DESCRIPTION: This protocol menu contains all the activities for creating, editing, and displaying patient record flags. o. NAME: DGPF SELECT PATIENT ITEM TEXT: Select Patient TYPE: action DESCRIPTION: This action protocol permits the user to select a patient within the Record Flag Assignment [DGPF RECORD FLAG ASSIGNMENT] option. p. NAME: DGPF SORT FLAG LIST ITEM TEXT: Change Sort TYPE: action DESCRIPTION: This action protocol allows the user to select a sort criteria for the flag list within the Record Flag Management [DGPF RECORD FLAG MANAGEMENT] option. The list may be sorted by flag name or flag type. 3. The following new MAIL GROUP(s) will be added. a. NAME: DGPF BEHAVIORAL FLAG REVIEW TYPE: public ALLOW SELF ENROLLMENT?: NO DESCRIPTION: This is the default mail group for receiving Patient Record Flag Assignment Review notifications. b. NAME: DGPF HL7 TRANSMISSION ERRORS TYPE: public ALLOW SELF ENROLLMENT?: NO DESCRIPTION: This mail group is used to notify Patient Record Flag administrators of transmission errors that occur during the processing of HL7. 4. The following new SECURITY KEY(s) will be added. a. NAME: DGPF PRF ACCESS DESC NAME: Patient Record Flag Access DESCRIPTION: This security key is used to control access to the Patient Record Flags module of the Registration package. Holders of this key will be able to display record flag detail, patient assignment detail and generate reports. b. NAME: DGPF RECORD FLAG ASSIGNMENT DESC NAME: Patient Record Flag Assignment DESCRIPTION: This security key will be used to control user access to the Record Flag Assignment [DGPF RECORD FLAG ASSIGNMENT] option. c. NAME: DGPF LOCAL FLAG EDIT DESC NAME: Local Patient Record Flag Edit DESCRIPTION: This security key will be used to control user access to the Record Flag Management [DGPF RECORD FLAG MANAGEMENT] option action items, AF Add New Record Flag and EF Edit Record Flag. d. NAME: DGPF PRF CONFIG DESC NAME: Patient Record Flag Config DESCRIPTION: This security key controls access to the PRF System Configuration [DGPF PRF SYSTEM CONFIGURATION] option. 5. The following new LIST TEMPLATE(s) will be added. a. NAME: DGPF ACTIVE ASSIGNMENTS TYPE OF LIST: DISPLAY b. NAME: DGPF ASSIGNMENT DETAIL TYPE OF LIST: DISPLAY c. NAME: DGPF FLAG DETAIL TYPE OF LIST: DISPLAY d. NAME: DGPF RECORD FLAG ASSIGNMENT TYPE OF LIST: PROTOCOL e. NAME: DGPF RECORD FLAG MANAGEMENT TYPE OF LIST: PROTOCOL 6. The following new HL7 APPLICATION PARAMETER(s) will be added. a. NAME: PRF-QRY b. NAME: PRF-QRYRESP c. NAME: PRF-RECV d. NAME: PRF-SEND 7. The following new FILES/FIELDS will be added. a. PRF LOCAL FLAG (#26.11) file This is a new file. The data for this file is stored in a new global, ^DGPF(. Description: This file contains Category II (Local) Patient Record Flags that can be assigned to a patient. Use the Record Flag Management [DGPF RECORD FLAG MANAGEMENT] option to create/edit entries in this file. Field # Field Name ------- ---------- .01 NAME .02 STATUS .03 TYPE .04 REVIEW FREQUENCY DAYS .05 NOTIFICATION DAYS .06 REVIEW MAIL GROUP 1 DESCRIPTION (Multiple) .01 DESCRIPTION 2 PRINCIPAL INVESTIGATOR(S) (Multiple) .01 PRINCIPAL INVESTIGATOR(S) b. PRF LOCAL FLAG HISTORY (#26.12) file This is a new file. The data for this file is stored in a new global, ^DGPF(. Description: This file contains the audit information associated with a record in the PRF LOCAL FLAG (#26.11) file. Entries in this file are created automatically by the Record Flag Management [DGPF RECORD FLAG MANAGEMENT] option for each creation/edit of a PRF LOCAL FLAG (#26.11) file entry. Field # Field Name ------- ---------- .001 NUMBER .01 FLAG NAME .02 FLAG EDIT DATE/TIME .03 ENTERED/EDITED BY .04 EDIT REASON (Multiple) .01 EDIT REASON c. PRF ASSIGNMENT (#26.13) file This is a new file. The data for this file is stored in a new global, ^DGPF(. Description: This file contains a list of Patient Record Flag assignments. Use the Record Flag Assignment [DGPF RECORD FLAG ASSIGNMENT] option to create/edit entries in this file. Field # Field Name ------- ---------- .001 NUMBER .01 PATIENT NAME .02 FLAG NAME .03 STATUS .04 OWNER SITE .05 ORIGINATING SITE .06 REVIEW DATE 1 ASSIGNMENT NARRATIVE (Multiple) .01 ASSIGNMENT NARRATIVE d. PRF ASSIGNMENT HISTORY (#26.14) file This is a new file. The data for this file is stored in a new global, ^DGPF(. Description: This file contains the audit information associated with a record in the PRF ASSIGNMENT (#26.13) file. Entries in this file are created automatically by the Record Flag Assignment [DGPF RECORD FLAG ASSIGNMENT] option for each creation/edit of a PRF ASSIGNMENT (#26.13) file entry. Field # Field Name ------- ---------- .001 NUMBER .01 PRF ASSIGNMENT .02 DATE/TIME .03 ACTION .04 ENTERED BY .05 APPROVED BY 1 HISTORY COMMENTS (Multiple) .01 HISTORY COMMENTS e. PRF NATIONAL FLAG (#26.15) file This is a new file. The data for this file is stored in a new global, ^DGPF(. Description: This file contains a list of the Category I (National) Patient Record Flags that can be assigned to a patient. Category I flags are established at a National level and any changes to this file or it's entries should only be done through a national patch release. Field # Field Name ------- ---------- .01 NAME .02 STATUS .03 TYPE .04 REVIEW FREQUENCY DAYS .05 NOTIFICATION DAYS .06 REVIEW MAIL GROUP 1 DESCRIPTION (Multiple) .01 DESCRIPTION 2 PRINCIPAL INVESTIGATOR(S) (Multiple) .01 PRINCIPAL INVESTIGATOR(S) f. PRF TYPE (#26.16) file This is a new file. The data for this file is stored in a new global, ^DGPF(. Description: This file contains a list of usage classifications that can be applied to a Patient Record Flag. Field # Field Name ------- ---------- .01 NAME g. PRF HL7 TRANSMISSION LOG (#26.17) file This is a new file. The data for this file is stored in a new global, ^DGPF(. Description: This file contains a list of all Unsolicited Observation Update (ORU~R01) HL7 transmissions that have been generated at the site by the Patient Record Flags software module. Entries in this file are created/edited automatically by the Patient Record Flags HL7 interface. Field # Field Name ------- ---------- .01 MESSAGE CONTROL ID .02 PRF ASSIGNMENT HISTORY .03 TRANSMISSION DATE/TIME .04 STATUS .05 SITE TRANSMITTED TO .06 ACK RECEIVED DATE/TIME h. PRF PARAMETERS (#26.18) file This is a new file. The data for this file is stored in a new global, ^DGPF(. Description: This file contains the configuration parameters for the Patient Record Flag module of the Registration package. The file should contain only one record numbered "1". Modifications to the file should only be done through the PRF System Configuration [DGPF PRF SYSTEM CONFIGURATION] option. Field # Field Name ------- ---------- .01 ONE 1 PRF SOFTWARE ACTIVATION DATE 2 PRF HL7 UPDATE STATUS 3 PRF HL7 QUERY STATUS 4 PRF HL7 RETRANSMIT DATE/TIME 5 PRF HL7 AUTO RETRANSMIT PERIOD 8. The following new DATABASE INTEGRATION AGREEMENT (DBIA) has been added. DBIA Reference: #3860-DGPF PATIENT RECORD FLAG Custodial Package: Registration Subscribing Package: ORDER ENTRY/RESULTS REPORTING Usage: Controlled Subscription Status: Active Type: Routine Description: A new Integration Agreement has been entered to allow the use of the $$GETACT^DGPFAPI API within the Patient Record Flags software module (DGPF*) through controlled subscription. The purpose of this API is to facilitate the retrieval of specific data that can be used for the displaying of or the reporting of only ACTIVE Patient Record Flags (PRF) Assignment information for a patient. See the FORUM Integration Agreement #3860 for detailed information. 9. The PATIENT LOOKUP module has been modified. Patient Lookup in VistA has been modified and will now display all ACTIVE patient record flag assignments for a patient. Specifically, a routine hook has been placed in the DGSEC routine within the Q tag. For those patient's having ACTIVE patient record flag assignments the following will be displayed to the user: Select PATIENT NAME: PATIENT,TEST >>> Active Patient Record Flag(s): CATEGORY I CATEGORY II Do you wish to view active patient record flag details? YES// 10. The following ROUTINE(s) will be added/modified. 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 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== DG10 6436217 6773589 32,109,139,149,182 326,513,425 DG53P425 N/A 8071507 425 DGPFAA N/A 6397630 425 DGPFAA1 N/A 752374 425 DGPFAA2 N/A 6366893 425 DGPFAA3 N/A 1122577 425 DGPFAAH N/A 5168790 425 DGPFAAH1 N/A 1001040 425 DGPFALF N/A 5994397 425 DGPFALF1 N/A 2629978 425 DGPFALH N/A 4287814 425 DGPFANF N/A 2660254 425 DGPFAPI N/A 4606964 425 DGPFBGR N/A 9316990 425 DGPFDD N/A 1789200 425 DGPFHLL N/A 2762690 425 DGPFHLQ N/A 7683472 425 DGPFHLQ1 N/A 2228151 425 DGPFHLQ2 N/A 1621509 425 DGPFHLQ3 N/A 3548528 425 DGPFHLR N/A 4582161 425 DGPFHLRT N/A 3125613 425 DGPFHLS N/A 5170135 425 DGPFHLU N/A 4741779 425 DGPFHLU1 N/A 4195205 425 DGPFHLU2 N/A 3796834 425 DGPFHLU3 N/A 7804885 425 DGPFHLU4 N/A 2912439 425 DGPFHLU5 N/A 6797283 425 DGPFHLU6 N/A 2099373 425 DGPFHLUT N/A 3589792 425 DGPFLF N/A 988060 425 DGPFLF1 N/A 7549865 425 DGPFLF2 N/A 2376602 425 DGPFLF3 N/A 13948860 425 DGPFLF4 N/A 9716810 425 DGPFLF5 N/A 13805445 425 DGPFLF6 N/A 6240533 425 DGPFLFD N/A 780194 425 DGPFLFD1 N/A 7319087 425 DGPFLMA N/A 577419 425 DGPFLMA1 N/A 1687222 425 DGPFLMA2 N/A 9128428 425 DGPFLMA3 N/A 13480202 425 DGPFLMA4 N/A 10481453 425 DGPFLMAD N/A 267764 425 DGPFLMD N/A 529986 425 DGPFLMD1 N/A 3836660 425 DGPFLMU N/A 3875301 425 DGPFLMU1 N/A 7068089 425 DGPFPARM N/A 796848 425 DGPFRFA N/A 5209879 425 DGPFRFA1 N/A 8183644 425 DGPFRFR N/A 5069773 425 DGPFRFR1 N/A 8876593 425 DGPFUT N/A 4153807 425 DGPFUT1 N/A 5456616 425 DGPFUT2 N/A 5672217 425 DGREG 17932097 18270435 1,32,108,147,149 182,245,250,513,425 DGRPT 366435 706092 108,149,425 DGSEC 9408298 9714367 32,46,197,214,249 281,352,391,425 Number of Routines = 61 IV. SOFTWARE AND DOCUMENTATION RETRIEVAL The software for this patch is not being distributed through the National Patch Module. This patch is being distributed as a host file. The host file will contain a single KIDS build. Host file name: DG_53_P425.KID Build: DG*5.3*425 Sites may retrieve the software and documentation directly using FTP from the following Office of Information Field Offices (OIFOs): 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_P425.KID Host file containing KIDS software distribution DG_53_425_HL7IS.PDF Patient Record Flags HL7 Interface Specification DG_53_425_TM.PDF Changes to the PIMS V. 5.3 Technical Manual DG_53_425_RN.PDF Release Notes on new features and functionality DG_53_425_UG.PDF User Guide for system access and use * 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 Patient Record Flags documentation will also be available through the VistA Documentation Library (VDL) at the following address: http://www.va.gov/vdl/Clinical.asp?appID=55 V. INSTALLATION INSTRUCTIONS Pre-Installation Items: ======================= * Environment Check: Programmer access is required for installing this patch. ** NOTE ** -- 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 modifies routines used by the Patient Lookup process and may affect many users. This patch also impacts the following Registration options: DG LOAD PATIENT DATA Load/Edit Patient Data DG REGISTER PATIENT Register a Patient DGRPT 10-10T REGISTRATION 10-10T Registration 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*391 DG*5.3*513 * File and Global Information: There is one new global, ^DGPF. The ^DGPF global contains the following (8) new files. Journaling File # File Name Global Root Recommended ------ ------------------------ ------------ ----------- 26.11 PRF LOCAL FLAG ^DGPF(26.11, YES 26.12 PRF LOCAL FLAG HISTORY ^DGPF(26.12, YES 26.13 PRF ASSIGNMENT ^DGPF(26.13, YES 26.14 PRF ASSIGNMENT HISTORY ^DGPF(26.14, YES 26.15 PRF NATIONAL FLAG ^DGPF(26.15, YES 26.16 PRF TYPE ^DGPF(26.16, YES 26.17 PRF HL7 TRANSMISSION LOG ^DGPF(26.17, YES 26.18 PRF PARAMETERS ^DGPF(26.18, YES The ^DGPF global must be placed with the appropriate Read/Write Global Access protection prior to installing this patch. Note: This should be done even if global translations are in effect. * Post-Install Routine (POST^DG53P425): Responsible for creating an initial entry in the PRF PARAMETERS (#26.18) file. This file entry will contain the configuration parameters for the Patient Record Flags module. Field Values: ------------- PRF SOFTWARE ACTIVATION DATE: SEP 25, 2003 PRF HL7 UPDATE STATUS: ACTIVE PRF HL7 QUERY STATUS: DIRECT PRF HL7 AUTO RETRANSMIT PERIOD: 7 Responsible for creating the BEHAVIORAL flag entry in the PRF NATIONAL FLAG (#26.15) file. Field Values: ------------- NAME: BEHAVIORAL STATUS: ACTIVE TYPE: BEHAVIORAL REVIEW MAIL GROUP: DGPF BEHAVIORAL FLAG NOTIFICATION DAYS: 60 REVIEW FREQUENCY: 730 DESCRIPTION: The purpose of this National Patient Record Flag is to alert VHA medical staff and employees of patients whose behavior or characteristics may pose a threat either to their safety, the safety of other patients, or compromise the delivery of quality health care. Application of National Patient Record Flags is coordinated through the Chief of Staff. This is a nationally distributed flag. Installation Steps: =================== 1. Download the KIDS file DG_53_P425.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_P425.KID 3. Review your mapped set. If any of the routines listed in the Routine Summary section of this guide are mapped, they should be removed from the mapped set at this time. 4. From the 'Kernel Installation & Distribution System' menu, select the Installation menu. 5. From this menu, you may now elect to use the following options (when prompted for INSTALL NAME, enter DG*5.3*425). 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. 6. Use the Install Package(s) option and select package DG*5.3*425. 7. When prompted for the name of the coordinator of the new mail group DGPF BEHAVIORAL FLAG REVIEW, please enter the name of the individual that will be responsible for maintaining this mail group. This mail group will receive notification messages regarding those patients that have patient record flag assignments that are due for review. 8. When prompted for the name of the coordinator of the new mail group DGPF HL7 TRANSMISSION ERRORS, please enter the name of the individual that will be responsible for maintaining this mail group. This mail group is used to notify Patient Record Flag administrators of transmission errors that occur during the processing of HL7 messages. 9. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//', respond NO. 10. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//', it is recommended you answer NO. 11. 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 LOAD PATIENT DATA Load/Edit Patient Data DG REGISTER PATIENT Register a Patient DGRPT 10-10T REGISTRATION 10-10T Registration 12. If routines were unmapped as part of Step 3, they should be returned to the mapped set once the installation has run to completion. 13. The ENV/PRE/POST Installation routine DG53P425 may be deleted from your system after successful patch installation. 14. Background Option (Scheduling): Schedule the new Patient Record Flag Background [DGPF BACKGROUND PROCESSING] option. Using the SCHEDULE/UNSCHEDULE OPTIONS [XUTM SCHEDULE] option, schedule the option to run daily (i.e. RESCHEDULING FREQUENCY: D@2AM). The following functions are processed by this background option: 1. Send review notification messages for pending Patient Record Flag Assignment reviews. 2. Auto retransmitting of rejected HL7 Patient Record Flag Assignment messages. VI. IMPLEMENTATION STEPS This section contains the final steps for implementing the Patient Record Flags software module after the successful patch installation of DG*5.3*425. 1. Menu Option assignment In order to use the Patient Record Flags software module, the new stand-alone Patient Record Flags Main Menu [DGPF RECORD FLAGS MAIN MENU] must be assigned as a secondary menu option to the appropriate personnel. 2. Security Keys allocation Using the Allocation of Security Keys [XUKEYALL] option of the Key Management [XUKEYMGMT] menu, allocate the following security keys to the appropriate personnel. a. DGPF PRF ACCESS These individuals should have the authority to access the new Patient Record Flags Main Menu [DGPF RECORD FLAGS MAIN MENU] option. b. DGPF RECORD FLAG ASSIGNMENT These individuals should have the authority to access the new Record Flag Assignment [DGPF RECORD FLAG ASSIGNMENT] option action items, 'AF Assign Flag', 'EF Edit Flag Assignment', and 'CO Change Assignment Ownership'. c. DGPF LOCAL FLAG EDIT These individuals should have the authority to access the new Record Flag Management [DGPF RECORD FLAG MANAGEMENT] option action items, 'AF Add New Record Flag' and the 'EF Edit Record Flag'. d. DGPF PRF CONFIG The purpose of this key is to restrict access to the PRF System Configuration [DGPF PRF SYSTEM CONFIGURATION] option for all users except IRM staff that may need to configure the Patient Record Flags system parameters. 3. Mail Group members The appropriate personnel should be added to the following mail groups. a. DGPF BEHAVIORAL FLAG REVIEW This mail group will receive notification messages regarding those patient's that have patient record flag assignments that are due for review. b. DGPF HL7 TRANSMISSION ERRORS This mail group is used to notify Patient Record Flag administrators of transmission errors that occur during the processing of HL7 messages. VII. TEST SITES The following sites participated in the testing of the DG*5.3*425 (Patient Record Flags) software. Test Site Alpha Beta ------------------------ ----- ---- Albuquerque, NM Yes Yes El Paso, TX Yes Yes Phoenix, AZ Yes Yes Atlanta, GA Yes Birmingham, AL Yes Central Alabama VHC, AL Yes Tuscaloosa, AL Yes Routine Information: ==================== Routine Name: - DGPFAA Routine Checksum: Routine Name: - DGPFAA1 Routine Checksum: Routine Name: - DGPFAAH Routine Checksum: Routine Name: - DGPFAAH1 Routine Checksum: Routine Name: - DGPFAPI Routine Checksum: Routine Name: - DGPFDD Routine Checksum: Routine Name: - DGPFLMA Routine Checksum: Routine Name: - DGPFLMA1 Routine Checksum: Routine Name: - DGPFLMA2 Routine Checksum: Routine Name: - DGPFUT Routine Checksum: Routine Name: - DGPFUT1 Routine Checksum: Routine Name: - DGREG Routine Checksum: Routine Name: - DG10 Routine Checksum: Routine Name: - DGRPT Routine Checksum: Routine Name: - DGSEC Routine Checksum: Routine Name: - DGPFAA2 Routine Checksum: Routine Name: - DGPFALF Routine Checksum: Routine Name: - DGPFALF1 Routine Checksum: Routine Name: - DGPFALH Routine Checksum: Routine Name: - DGPFANF Routine Checksum: Routine Name: - DGPFHLR Routine Checksum: Routine Name: - DGPFHLS Routine Checksum: Routine Name: - DGPFHLU Routine Checksum: Routine Name: - DGPFHLU1 Routine Checksum: Routine Name: - DGPFHLU2 Routine Checksum: Routine Name: - DGPFHLU3 Routine Checksum: Routine Name: - DGPFHLU4 Routine Checksum: Routine Name: - DGPFHLU5 Routine Checksum: Routine Name: - DGPFHLUT Routine Checksum: Routine Name: - DGPFLF Routine Checksum: Routine Name: - DGPFLF1 Routine Checksum: Routine Name: - DGPFLF2 Routine Checksum: Routine Name: - DGPFLF3 Routine Checksum: Routine Name: - DGPFLF4 Routine Checksum: Routine Name: - DGPFLFD Routine Checksum: Routine Name: - DGPFLFD1 Routine Checksum: Routine Name: - DGPFLMA3 Routine Checksum: Routine Name: - DGPFLMA4 Routine Checksum: Routine Name: - DGPFLMAD Routine Checksum: Routine Name: - DGPFLMU Routine Checksum: Routine Name: - DGPFLMU1 Routine Checksum: Routine Name: - DGPFUT2 Routine Checksum: Routine Name: - DGPFHLL Routine Checksum: Routine Name: - DGPFHLQ Routine Checksum: Routine Name: - DGPFHLQ1 Routine Checksum: Routine Name: - DGPFHLQ2 Routine Checksum: Routine Name: - DGPFHLQ3 Routine Checksum: Routine Name: - DGPFLF5 Routine Checksum: Routine Name: - DGPFRFA Routine Checksum: Routine Name: - DGPFRFA1 Routine Checksum: Routine Name: - DGPFRFR Routine Checksum: Routine Name: - DGPFRFR1 Routine Checksum: Routine Name: - DGPFLF6 Routine Checksum: Routine Name: - DGPFAA3 Routine Checksum: Routine Name: - DGPFBGR Routine Checksum: Routine Name: - DG53P425 Routine Checksum: Routine Name: - DGPFPARM Routine Checksum: Routine Name: - DGPFLMD Routine Checksum: Routine Name: - DGPFLMD1 Routine Checksum: Routine Name: - DGPFHLU6 Routine Checksum: Routine Name: - DGPFHLRT Routine Checksum: ============================================================================= User Information: Entered By : LOUCK,KEVIN Date Entered : OCT 31, 2001 Completed By: SHETLER,BOB Date Completed: SEP 04, 2003 Released By : NELSON,VICKI M Date Released : SEP 11, 2003 ============================================================================= Packman Mail Message: ===================== No routines included