$TXT Created by PHELPS,TY at MNTVBB.FO-ALBANY.MED.VA.GOV (KIDS) on Tuesday, 11/21/06 at 22:21 ============================================================================= Run Date: FEB 07, 2007 Designation: GMRC*3*50 Package : GMRC - CONSULT/REQUEST TRACKING Priority: Mandatory Version : 3 SEQ #46 Status: Released Compliance Date: MAR 10, 2007 ============================================================================= Associated patches: (v)GMRC*3*21 <<= must be installed BEFORE `GMRC*3*50' (v)GMRC*3*22 <<= must be installed BEFORE `GMRC*3*50' (v)OR*3*215 <<= must be installed BEFORE `GMRC*3*50' Subject: GROUP UPDATE, SIGNIFICANT FINDINGS, WRONG TIME ZONE, AND RELATED SERVICES ISSUES Category: - Routine - Data Dictionary Description: ============ This patch corrects group updating to store the appropriate Last Action Taken and to update Inter-Facility Consults at the partnering facility. It also removes an inappropriate time zone stamp in the display of Consult activities and prevents Services set-up as Inter-Facility from being added as a Related Service to a Consult Procedure. Finally, this patch provides a list of consults which have the Significant Finding stored as an ampersand. ASSOCIATED NSR(s): ================== N/A ASSOCIATED REMEDY: ================ 1. HD0000000068007 MAD-0504-40687 Procedure IFC won't transmit 2. HD0000000068369 TUA-1004-32034 Update of IFC requests Duplicates: HD0000000068781 MAC-0205-60463 Remote site did mass complete - did not affect IFCs here HD0000000068800 BUT-0205-20604 IFC update not seen at Ordering Site HD0000000087042 Group update functionality for Interfacility Consults does not work. We cannot update consults sent to New Orleans and They can HD0000000088188 IFCs not updating with group update functionality 3. HD0000000112065 Group update doesn't update the last action taken field 4. HD0000000133729 Question on TIME ZONE notation on IFCs 5. HD0000000068574 ISL-1204-51593 Provide sites list of consults to edit Significant Findings PARTICIPATING TEST SITES: ========================= ALTOONA, PA NORTHERN CALIFORNIA HCS PUGET SOUND HCS UPSTATE NEW YORK HCS REMEDY OVERVIEW: ============== 1. HD0000000068007 MAD-0504-40687 Procedure IFC won't transmit Problem: -------- The problem reported by the site was an inability to transmit a Procedure Inter-Facility Consult. The Procedure Consult in question was not set-up as an Inter-Facility Consult, but a Related Service was. A Related Service should never be set-up as an Inter-Facility Consult. This can cause the Inter-Facility Consults to fail to transmit to the partnering site. Resolution: ----------- This patch adds a check for Service Inter-Facility Consults when selecting services at the "Select RELATED SERVICES: " prompt. The input transform for the RELATED SERVICES (#.01) field of the RELATED SERVICES (#123.32) sub-file was modified. The changes are the following: Before Patch ------------ 123.32,.01 INPUT TRANSFORM:I $P($G(^GMR(123.5,+X,0)),"^",2)=9!($P($G(^GMR( 123.5,+X,0)),"^",2)=1) D EN^DDIOL("This service is not orderable. Try again.") K X After Patch ----------- 123.32,.01 INPUT TRANSFORM:I $P($G(^GMR(123.5,+X,0)),"^",2)=9!($P($G(^GMR( 123.5,+X,0)),"^",2)=1)!(+$G(^GMR(123.5,+X,"IFC" )))!(+$O(^GMR(123.5,+X,"IFCS",0))) D EN^DDIOL(" This service is not orderable. Try again.") K X A post-init routine, GMRCYP50, has been included with this patch to provide a listing of all Consult Procedures containing a RELATED SERVICE set-up as an Inter-Facility Consult. If any are found, a mailman message will be generated and sent to the installer. The message will be similar to the following: Subj: RELATED SERVICES ARE INVALID [#2085249] 05/04/06@18:57 23 lines From: PATCH GMRC*3.0*50 POST-INIT In 'IN' basket. Page 1 *New* -------------------------------------------------------------------------- This message has been sent by patch GMRC*3.0*50 at the completion of the post-init routine. This message was sent because Consult Procedure records were found which contained one or more Related Services which are setup as Inter-Facility Consults. These related services should be removed and replaced with non-IFC services to prevent possible problems in the Consult/Request Tracking package. The following information is provided to assist you in your cleanup efforts. PROCEDURE RELATED SERVICE =========================================================================== EEG (#4) ELECTROENCEPHALOGRAM (#131) ELECTROENCEPHALOGRAM (#5) ELECTROENCEPHALOGRAM (#131) Total invalid Related Services: 2. Enter message action (in IN basket): Ignore// ++++++++++++++++++++++++++++++++++++++++++++++++++ NOTE: Due to questions coming out of testing this patch, A known limitation of the software was pointed out and will be noted here. This Note statement is located on page 11 of the INTER-FACILITY CONSULTS IMPLEMENTATION GUIDE. Note: Even though the RELATED SERVICE is a multiple, the consulting facility can only have one RELATED SERVICE entry for an inter- facility procedure. If sites need multiple services, they could set the procedure up with a related service that is a grouper. Then, the users of that service could forward it to the appropriate service. ++++++++++++++++++++++++++++++++++++++++++++++++++++ 2. HD0000000068369 TUA-1004-32034 Update of IFC requests Problem: -------- The issue reported was when a site used the Group update of consult/procedure requests [GMRCSTSU] option, Inter-Facility Consults were not being updated at the partnering site. This was because the before mentioned option did not check if the consults were Inter- Facility. Resolution: ----------- Routine GMRCSTS1 was modified to check if the Consult is an Inter- Facility Consult and update the partnering facililty with the appropriate information during the group update function. 3. HD0000000112065 Group update doesn't update the last action taken field Problem: -------- The problem reported is the Group update of consult/procedure requests [GMRCSTSU] option is not updating the LAST ACTION TAKEN (#9) field of the REQUEST/CONSULTATION (#123) file. Resolution: ----------- Routine GMRCSTS1 was modified to add the storing of the LAST ACTION TAKEN (#9) field of the REQUEST/CONSULTATION (#123) file during the group update function. 4. HD0000000133729 Question on TIME ZONE notation on IFCs Problem: -------- The problem reported is a time zone stamp for a remote site is being added to the (entered) date/time for remote activities when viewing the Consult Detailed Display. Since this date/time is the local date/time, the time zone stamp is inappropriate and should be removed. Resolution: ----------- Routine GMRCSLM4 was modified to remove the time zone stamp associated with the (entered) date/time for remote activities when viewing the Consult Detailed Display. 5. HD0000000068574 ISL-1204-51593 Provide sites list of consults to edit Significant Findings Problem: -------- Prior to CPRS GUI v26 (OR*3*215), when entering Consult "Significant Findings" via the CPRS GUI, the value stored was the ampersand ("&") character, which was subsequently treated as if "Unknown" had been selected. Significant Findings entered through OE/RR ListManager store and display correctly. This was fixed in CPRS GUI v26 (OR*3*215), so the correct value selected is being stored and displayed. Refer to Order Entry Result Reporting (OERR) Remedy tickets: HD0000000070231 and HD0000000070877 for additional information. As a result of this issue there may be consult "Significant Findings" entries which are set inappropriately and need to be corrected. Resolution: ----------- As it is not possible to automatically fix these bad consult "Significant Findings" entries, a software solution is needed to provide sites with a list of consults from which they can manually review and edit "Significant Findings" as appropriate. This patch uses a pre-init routine to search the SIGNIFICANT FINDINGS (#15) field of the REQUEST/CONSULTATION (#123) file for an ampersand ("&"). Any that are found are reported in Mailman Message(s) which are sent to the installer. There are two possible types of messages you might receive. One type will contain all locally correctable consults, while the second type of message will contain Inter-Facility Consults where the site is the requesting (sending) site. This second type of message is intended to list consults that can not be corrected locally. The pre-init reports can be generated with the patients' full name listed or with the patients' initials and last six of their Social Security Number. Following are examples of the two types of messages, with each demonstrating one of the two ways to display the patient identifier. The first type of message(s) will look like the following using the patients full names: Subj: SIGNIFICANT FINDINGS VALUES ARE INVALID (MSG 1 of 1) [#2104297] 10/17/06@09:37 40 lines From: PATCH GMRC*3.0*50 PRE-INIT In 'IN' basket. Page 1 *New* ---------------------------------------------------------------------------- This message (1 of 3) has been sent by patch GMRC*3.0*50 at the completion of the pre-init routine. This message was sent because Consult records were found which contained an Ampersand as the Significant Finding. Since these can not be corrected automatically, this message was created to assist in a manual correction of this data. We are hopeful that the following data will contain enough information to allow your site to make the corrections, or at least give you the information needed to research the specific consult and determine what the Significant Finding should have been. It is important to understand the comments from the Significant Finding are fine and the only problem needing correction is the Significant Finding value itself (Yes/No/Unknown). Per guidance from HIMSS, it is preferable that an audit trail exist for this fix. A disclaimer should be added, if possible. To correct the Significant Finding, you can use the Action, Consult Tracking menu on the Consults tab of CPRS GUI. The person making this change will need the appropriate update authority for the Consult Services involved. It should also be noted the significant finding will display as "Unknown" despite the ampersand ("&") stored in the data file. PATIENT IDENTIFIER CONSULT DATE(IEN) TO SERVICE STATUS ACTIVITY ACTIVITY DATE RESPONSIBLE PERSON ACTIVITY COMMENTS ============================================================================ TEST,GMRC 1 APR 02, 2004@11:31 (542938) WOMEN GYN SCREENING CLINIC (PRIME CARE) COMPLETE SIG FINDING UPDATE JUN 17, 2004@14:04:02 TEST,GMRC UPDATE1 SEE RADIOLOGIST REPORT. TEST,GMRC 2 MAY 03, 2004@14:21 (550819) CARDIOLOGY CLINIC DISCONTINUED SIG FINDING UPDATE MAY 21, 2004@10:22:21 TEST,GMRC UPDATE2 Please read fellow's note of 5/19/04 TEST,GMRC 3 FEB 09, 2004@15:15 (527834) COMMUNITY HEALTH NURSE COORDINATORS COMPLETE SIG FINDING UPDATE MAR 02, 2004@11:25:42 TEST,GMRC UPDATE3 TEST,GMRC 4 NOV 03, 2003@15:31 (503908) WOMEN GYN SCREENING CLINIC (PRIME CARE) COMPLETE SIG FINDING UPDATE DEC 19, 2003@12:44:13 TEST,GMRC ADMIN SEE RADIOLOGIST REPORT. FEB 03, 2004@08:24 (525904) WOMEN GYN SCREENING CLINIC (PRIME CARE) COMPLETE SIG FINDING UPDATE MAY 14, 2004@15:14:35 TEST,GMRC ADMIN SEE RADIOLOGIST REPORT. PLEASE ACKNOWLEDGE RECEIPT. TEST,GMRC 5 MAY 13, 2002@11:01 (375826) HOME OXYGEN REQUEST COMPLETE SIG FINDING UPDATE NOV 03, 2003@11:31:11 TEST,GMRC ADMIN Patient is being supplied home oxygen through the COLUMBUS VAMC. AUG 05, 2003@15:07 (481042) HOME OXYGEN REQUEST COMPLETE SIG FINDING UPDATE JAN 22, 2004@07:54:43 TEST,GMRC ADMIN THIS PATIENT RECEIVES HOME OXYGEN THROUGH COLUMBUS VAMC NOV 20, 2003@15:43 (508580) HOME OXYGEN REQUEST COMPLETE SIG FINDING UPDATE JAN 22, 2004@07:55:12 TEST,GMRC ADMIN THIS PATIENT RECEIVES HOME OXYGEN THROUGH COLUMBUS VAMC ... TEST,GMRC 6 MAR 18, 2004@10:07 (538353) RESIDENTIAL CARE HOME COMPLETE SIG FINDING UPDATE MAR 20, 2004@22:01 TEST,GMRC ADMIN Per 3/19/04 Social Work PN, the patient is not seen as stable enough for preparation for discharge to RCH. He appears preoccupied with his "guardianship status" and is not seen as stable on medications. VA approved CRC homes are unable to handle the patient's behaviors. He is not seen as appropriate for an assisted living facility as the ones affiliated with the VA CRC Program are not receptive to the placement of any patient with active behavioral symtoms. His physical functioning level of care is not seen as a predominant factor to be considered for placement in a VA CRC approved home. The guardian is free to arrange placement in a non-VA approved CRC home of his or the patient's choice, if desired. Total records in this message: 500 Total records containing a Significant Finding of an ampersand: 1023 Enter message action (in IN basket): Ignore// The second type of message(s) will look like the following using the patients initials and last six of their social security number: Subj: IFC SIGNIFICANT FINDINGS VALUES ARE INVALID (MSG 1 of 1) [#20373] 11/16/06@03:04 26 lines From: PATCH GMRC*3.0*50 PRE-INIT In 'IN' basket. Page 1 ---------------------------------------------------------------------------- This message (1 of 1) has been sent by patch GMRC*3.0*50 at the completion of the pre-init routine. This message was sent because Inter-Facility Consult records were found which contained an Ampersand as the Significant Finding. Since these can not be corrected by the requesting (sending) site, this message was created to alert you of these entries. The Consulting (receiving) site(s) will need to correct these entries and should receive a similar message when they install this patch. You can use this list as a record of Inter-Facility Consults needing to be corrected by the Consulting (receiving) site(s). PATIENT IDENTIFIER CONSULT DATE(IEN) TO SERVICE STATUS ACTIVITY ACTIVITY DATE RESPONSIBLE PERSON ACTIVITY COMMENTS ============================================================================ (JES486697) SEP 21, 2006@13:40 (146098) CARDIOLOGY IFC COMPLETE COMPLETE/UPDATE NOV 15, 2006@12:25:12 TEST,GMRC IFC TESTING SIGNIFICANT FROM ADMIN COMPLETE AND NEW CODE TO FIND IT. Total records in this message: 1 Total records containing a Significant Finding of an ampersand: 1 Enter message action (in IN basket): Ignore// ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NOTE: Only the historical data should be affected. It is up to each individual site to decide whether to correct these. ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ INSTALLATION INSTRUCTIONS ========================= This patch can be loaded with users in the system. But, it is recommended it be installed when user activity is low. Installation time will vary, depending on the length of time the pre/post init routines take to run. From site testing the install could be from 3 minutes to 30 minutes. 1. Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. Start up the Kernel Installation and Distribution System Menu [XPD MAIN]: Edits and Distribution ... Utilities ... Installation ... Select Kernel Installation & Distribution System Option: Installation --- 1 Load a Distribution 2 Verify Checksums in Transport Global 3 Print Transport Global 4 Compare Transport Global to Current System 5 Backup a Transport Global 6 Install Package(s) Restart Install of Package(s) Unload a Distribution 3. From this menu, you may elect to use the following options (When prompted for the INSTALL NAME, enter GMRC*3.0*50): 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. Use the Install Package(s) option and select the package GMRC*3.0*50. a. When prompted "Print Full Patient Names on pre-install report? YES//", select 'NO' to print only the patient's initials and last six of their SSN, or choose 'YES' to print the patient's full name. b. When prompted "Want KIDS to INHIBIT LOGONs during the install? YES//", answer NO. c. When prompted "Want to DISABLE Scheduled Options and Menu Options and Protocols? YES//", answer YES. d. When prompted "Enter options you wish to mark as 'Out Of Order':", enter the following options: Group update of consult/procedure requests [GMRCSTSU] Setup procedures [GMRC PROCEDURE SETUP] e. When prompted "Enter protocols you wish to mark as 'Out Of Order':", enter the following protocols: Detailed Display [GMRCACT DETAILED DISPLAY] Detailed Display [ORC DETAILED DISPLAY] f. When prompted "Delay Install (Minutes): (0-60): 0//", press . POST INSTALLATION INSTRUCTIONS: =============================== 1. If any invalid significant findings values of ampersand were found, a mailman message was sent to the installer. This message should be forwarded to the appropriate personnel, including the clinical application coordinator (CAC) so these entries may be corrected. 2. The pre-init routine, GMRCP50, may be used to search for consults which still contain an ampersand as the Significant Finding. Once all the entries have been corrected, the pre-init may be deleted. To run the pre-init from the programmers prompt type the following: D EN^GMRCP50 INSTALLATION EXAMPLE: ===================== Select Installation Option: 6 Install Package(s) Select INSTALL NAME: GMRC*3.0*50 Loaded from Distribution 10/17/06@09:27 :36 => GMRC*3*50 This Distribution was loaded on Oct 17, 2006@09:27:36 with header of GMRC*3*50 It consisted of the following Install(s): GMRC*3.0*50 Checking Install for Package GMRC*3.0*50 Install Questions for GMRC*3.0*50 Print Full Patient Names on pre-install report? YES// Incoming Files: 123.3 GMRC PROCEDURE (Partial Definition) Note: You already have the 'GMRC PROCEDURE' File. Want KIDS to INHIBIT LOGONs during the install? YES// NO Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES// Enter options you wish to mark as 'Out Of Order': GMRCSTSU Group updat e of consult/procedure requests Enter options you wish to mark as 'Out Of Order': GMRC PROCEDURE SETUP Setup procedures Enter options you wish to mark as 'Out Of Order': Enter protocols you wish to mark as 'Out Of Order': GMRCACT DETAILED DISPLAY Detailed Display Enter protocols you wish to mark as 'Out Of Order': ORC DETAILED DISPLAY Detailed Display Enter protocols you wish to mark as 'Out Of Order': Delay Install (Minutes): (0-60): 0// Enter the Device you want to print the Install messages. You can queue the install by enter a 'Q' at the device prompt. Enter a '^' to abort the install. DEVICE: HOME// ;;9999 UCX/TELNET Install Started for GMRC*3.0*50 : Oct 17, 2006@09:37:53 Build Distribution Date: Oct 16, 2006 Installing Routines: Oct 17, 2006@09:37:53 Running Pre-Install Routine: PRE^GMRCP50 Starting Pre-init... Searching for ampersand ("&") in the SIGNIFICANT FINDINGS (#15) field of the REQUEST/CONSULTATION (#123) file. Consult entry 62965 has an ampersand ("&") as the Significant Finding. Consult entry 326792 has an ampersand ("&") as the Significant Finding. Consult entry 375826 has an ampersand ("&") as the Significant Finding. Consult entry 382520 has an ampersand ("&") as the Significant Finding. Consult entry 392653 has an ampersand ("&") as the Significant Finding. Consult entry 392892 has an ampersand ("&") as the Significant Finding. Consult entry 407309 has an ampersand ("&") as the Significant Finding. Consult entry 451480 has an ampersand ("&") as the Significant Finding. Consult entry 457497 has an ampersand ("&") as the Significant Finding. Consult entry 461628 has an ampersand ("&") as the Significant Finding. Consult entry 461835 has an ampersand ("&") as the Significant Finding. Consult entry 471569 has an ampersand ("&") as the Significant Finding. Consult entry 477369 has an ampersand ("&") as the Significant Finding. Consult entry 478029 has an ampersand ("&") as the Significant Finding. Consult entry 481042 has an ampersand ("&") as the Significant Finding. ... Consult entry 608210 has an ampersand ("&") as the Significant Finding. 1023 total consults contain an ampersand as the Significant Finding. ***************************************************************************** ** Message (01 of 03) containing Consult records which have an ampersand as** ** the Significant Finding was sent to the user. Please forward this ** ** message to the appropriate staff, which includes the clinical ** ** coordinator, for further action. ** ***************************************************************************** ***************************************************************************** ** Message (02 of 03) containing Consult records which have an ampersand as** ** the Significant Finding was sent to the user. Please forward this ** ** message to the appropriate staff, which includes the clinical ** ** coordinator, for further action. ** ***************************************************************************** ***************************************************************************** ** Message (03 of 03) containing Consult records which have an ampersand as** ** the Significant Finding was sent to the user. Please forward this ** ** message to the appropriate staff, which includes the clinical ** ** coordinator, for further action. ** ***************************************************************************** ****************************************************************************** ** Message (01 of 01) containing Inter-Facility Consult records which have ** ** an ampersand as the Significant Finding was sent to the user. ** ** Please forward this message to the appropriate staff, which includes the ** ** clinical coordinator, for further action. ** ****************************************************************************** Pre-init complete. Installing Data Dictionaries: Oct 17, 2006@09:37:54 Running Post-Install Routine: POST^GMRCYP50 Starting Post-init... Searching for Procedure Consults which have an Inter-Facility Consult as a Related Service. Related Service, ELECTROENCEPHALOGRAM (IEN #131), associated with Consult Procedure, EEG (IEN #4), is an Inter-Facility Consult Service and must be removed or replaced with a service which is not an IFC! Related Service, ELECTROENCEPHALOGRAM (IEN #131), associated with Consult Procedure, ELECTROENCEPHALOGRAM (IEN #5), is an Inter-Facility Consult Service and must be removed or replaced with a service which is not an IFC! 2 total invalid Related Services. **************************************************************************** ** Message containing Procedure Consult records which have invalid ** ** Related Services was sent to the user. Please forward this ** ** message to the appropriate staff, which includes the clinical ** ** coordinator, for further action. ** **************************************************************************** Post-init complete. Updating Routine file... Updating KIDS files... GMRC*3.0*50 Installed. Oct 17, 2006@09:37:55 Install Message sent #2104300 ---------------------------------------------------------------------------- +------------------------------------------------------------+ 100% | 25 50 75 | Complete +------------------------------------------------------------+ Install Completed ROUTINE SUMMARY =============== The following is a list of the routines included in this patch. The second line of each of these routines now looks like: ;;3.0;CONSULT/REQUEST TRACKING;**[PATCH LIST]**;DEC 27, 1997 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== =========== GMRCP50 N/A 8361341 50 GMRCP50A N/A 29641928 50 GMRCSLM4 13908162 14037087 4,12,15,22,50 GMRCSTS1 7476561 8053047 8,18,21,50 GMRCYP50 N/A 14276393 50 Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: GMRCP50 Before: n/a After: B19728840 **50** Routine Name: GMRCP50A Before: n/a After: B63790900 **50** Routine Name: GMRCSLM4 Before: B35674872 After: B36237040 **4,12,15,22,50** Routine Name: GMRCSTS1 Before: B29194073 After: B31373636 **8,18,21,50** Routine Name: GMRCYP50 Before: n/a After: B31546211 **50** ============================================================================= User Information: Entered By : PHELPS,TY Date Entered : FEB 16, 2006 Completed By: BOWEN,MARY JANE Date Completed: FEB 07, 2007 Released By : STRONG,NICK Date Released : FEB 07, 2007 ============================================================================= Packman Mail Message: ===================== $END TXT