============================================================================= Run Date: MAY 07, 2007 Designation: GMRA*4*29 Package : GMRA - ADVERSE REACTION TRACKING Priority: Mandatory Version : 4 SEQ #35 Status: Released Compliance Date: JUN 07, 2007 ============================================================================= Associated patches: (v)GMRA*4*36 <<= must be installed BEFORE `GMRA*4*29' Subject: Automated clean up of free text allergies Category: - Routine - Other Description: ============ NOTE: Patch 29 has an implementation plan. Please read the following section before installing this patch. IMPLEMENTATION PLAN =================== The installation of patch GMRA*4*29 will generate HL7 messages to update the allergy data stored in the Health Data Repository (HDR). Patch GMRA*4*36 was nationally released on March 20, 2007 with a post-install e-mail message that included the number of allergy HL7 messages that would be generated from the VistA site to the HDR. All sites installed the patch within the 30-day compliance date and the message counts were collected. It was determined that sites with greater than 20,000 messages could impact the HDR production system's ability to handle the message volume efficiently. The following seven sites have been identified with 20,000 or more allergy messages: VISN 2 - Upstate New York (Implementation Manager: Marianne Swift) VISN 8 - Bay Pines (Loren Behuniak) VISN 8 - Miami (Loren Behuniak) VISN 8 - N. Florida/S. Georgia (Loren Behuniak) VISN 9 - Tennessee Valley (Jane Lee) VISN 15 - Heartland West (Jane Lee) VISN 23 - Central Plains (Ed Ridley) These sites are asked to coordinate their installation of patch GMRA*4*29 with their Implementation Manager. The Implementation Manager is identified in parentheses above. The guidance from the Health Data Repository team is to recommend these sites install the patch on a weekday evening after 8:00 PM Eastern Time. The HDR is scheduled for a weekly cold restart between Saturday at 10:00 PM Eastern Time and Sunday at 10:00 AM Eastern Time. It is not recommended that the Allergy patch be installed during this time. Your Implementation Manager will be contacting you to discuss this patch and determine the date and approximate time you plan to complete its installation. Again, this is for only the seven sites listed above. All other sites do not require this coordination and may install the patch at their convenience. ************************************************************************* This patch will find all active free text allergies in the PATIENT ALLERGIES (120.8) file and will update the entry in one of three ways based on data in the conversion matrix. The conversion matrix is loaded into the ^XTMP global when the patch is installed and is used to determine how the free text entry should be updated. If the free text allergy reactant is found in the conversion matrix then the allergy entry will be updated to the associated reactant from the matrix. Please note that when an existing free text allergy is updated to a standardized allergy term, the patient's allergy record will be updated with ingredient and/or drug class information. The ingredient and/or drug class information will be used in future order checking but will not be used to perform any retrospective order checking on past or existing medication orders. If the free text allergy reactant is not found in the matrix or if updating the reactant would cause a duplicate entry then the free text reactant is updated to include the phrase ( FREE TEXT ) after the reactant. This will now serve as a visual cue that the allergy is a free text entry and will not be considered during order checking. Finally, if the matrix indicates that the reactant is an erroneous entry then the allergy will be marked as entered in error. If the entry was updated to a new entry or if the entry was marked as entered in error, a comment will be added to the entry that was updated indicating the action that the patch took. When the post-install has reviewed all active free text allergies a mailman message will be sent indicating the outcome of the conversion. The report will include the number of entries that were updated and will also report any entries that couldn't be updated and why that entry couldn't be updated. Upon completion of the update, the allergy free text utility can be used to review the remaining free text entries for manual updating. INSTALLATION FILE ================= The GMRA_4_29.KID host file may be obtained via FTP. The preferred method is to FTP the files from: download.vista.med.va.gov This transmits the file from the first available FTP server. Sites may also elect to retrieve software directly from a specific server as follows: CIO 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 City ftp.fo-slc.med.va.gov [anonymous.software] TEST SITES ========== Biloxi Baltimore Palo Alto Iron Mountain Tampa Puget Sound INSTALLATION ============ This patch may be installed with users on the system although it is recommended that users not be using the allergy free text clean up utility while this is running. The time to install this patch will vary depending on the number of allergy entries. **NOTE: Please be aware that the updating of allergy terms will likely produce heavy traffic to the HDR. If your site has a large number of allergies to be updated you can expect a correspondingly large amount of traffic to the HDR. Please keep this in mind when determining when to install this patch. **NOTE: DO NOT install this patch if you are on the list of controlled sites (see above) without first coordinating your install per the above listed instructions. 1. Obtain the file GMRA_4_29.KID. 2. From the Kernel Installation and Distribution System Menu, select the Installation menu. 3. Use Load a Distribution using GMRA_4_29.KID when prompted to Enter a host file name. You may need to prepend a directory name. 4. From this menu, you may elect to use the following options (when prompted for INSTALL NAME, enter GMRA*4.0*29): a. Backup a Transport Global b. Compare Transport Global to Current System c. Verify Checksums in Transport Global 5. Use the Install Package(s) option and select the package GMRA*4.0*29. 6. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//', you may respond NO. 7. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', respond NO. 8. If prompted 'Delay Install (Minutes): (0-60): 0//; respond '0'. 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: ;;4.0;Adverse Reaction Tracking;**[patch list]**;Mar 29, 1996 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== GMRAY29 N/A 21446461 29 Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: GMRAY29 Before: n/a After: B63595421 **29** ============================================================================= User Information: Entered By : NABER,DAVID A Date Entered : JUL 11, 2005 Completed By: SCHLEHUBER,PAM Date Completed: MAY 01, 2007 Released By : CAMPBELL,THOMAS Date Released : MAY 07, 2007 ============================================================================= Packman Mail Message: ===================== No routines included