============================================================================= Run Date: MAY 08, 2006 Designation: MPIF*1*43 Package : MPIF - MASTER PATIENT INDEX VISTA Priority: Mandatory Version : 1 SEQ #41 Status: Released Compliance Date: JUN 08, 2006 ============================================================================= Associated patches: (v)MPIF*1*25 <<= must be installed BEFORE `MPIF*1*43' (v)MPIF*1*28 <<= must be installed BEFORE `MPIF*1*43' (v)MPIF*1*31 <<= must be installed BEFORE `MPIF*1*43' (v)MPIF*1*33 <<= must be installed BEFORE `MPIF*1*43' (v)MPIF*1*35 <<= must be installed BEFORE `MPIF*1*43' (v)MPIF*1*37 <<= must be installed BEFORE `MPIF*1*43' (v)MPIF*1*38 <<= must be installed BEFORE `MPIF*1*43' Subject: ICN ASSIGNMENT CHANGE/REMOVE SINGLE PATIENT INITIALIZATION OPTION Category: - Routine - Enhancement (Mandatory) - Other Description: ============ NOTE: The software for this patch, MPIF*1*43, and associated patch RG*1*43 is not being distributed through the National Patch Module. These patches are being distributed as a single KIDS software distribution (host file). This patch contains the informational portion of MPIF*1*43. Please refer to the 'Software Retrieval' and 'Installation Instructions' sections of this patch description for the instructions on how to acquire and install the patch software. NOTE: RG* and MPIF* patches should NOT be installed on legacy systems to avoid issues with the legacy systems ending up as Coordinating Master of Records (CMORs) or Treating Facilities. MPIF*1.0*25, MPIF*1.0*28, MPIF*1.0*31, MPIF*1.0*33, MPIF*1.0*35, MPIF*1.0*37, and MPIF*1.0*38 are required builds for patch MPIF*1*43. Issue #1 - Change in ICN Assignment Process In order to support the effort to get Integration Control Numbers (ICNs) for all patients in the Health Eligibility Center (HEC) database, when and how a patient gets an ICN is changing. If an exact match is not found on the Master Patient Index (MPI), then the patient will be added to the MPI. The only time a patient will get a local ICN is when communication with the MPI is unavailable or temporarily while the national ICN is being created. As a result of these changes, specific exceptions are no longer generated. These include the following three exception types: - Required field(s) missing for patient sent to MPI - SSN Match Failed - Name Doesn't Match All existing active exceptions in the CIRN HL7 EXCEPTION LOG (#991.1) file that have any of the above three exception types and the Potential Matches Returned exception type will be marked as PROCESSED by patch RG*1*43. A change has been made in the Display Only Query [MPIF DISPLAY ONLY QUERY TO MPI] option. It will now return potential matches, even if the patient being queried for is already known on the MPI. A change has been made in the Remote Single Patient Initialization [MPI DATA MGT REMOTE SPI] option used by the Identity Management Data Quality (IMDQ) staff on the Austin MPI. Previously, if the patient record being processed had a local ICN, the SPI process did not attempt to get a national ICN. This has been modified so that the remote SPI process can now send a VistA patient with a local ICN up to the MPI for national ICN assignment. Also, if the DFN passed is a merged record, it will find the primary record and use that DFN for the SPI query. The merge information will be included in the response. Issue #2 - If a patient is presented to the MPI and there is not an exact match but there is a potential match, the patient will be added to the MPI and a Potential Matches Returned exception will occur on the local VistA site. The user can use a new action, Potential Match Rev [PMR], to review the potential match exception in the MPI/PD Exception Handling option [RG EXCEPTION HANDLING]. This action is only available for Potential Matches Returned exceptions that are not marked as processed. The Potential Match Rev action will trigger a query to the MPI and present any potential matches to the user. The user can resolve a duplicate on the MPI if one exists for the patient being processed. The Potential Match Review process gives the user the same capability as the Single Patient Initialization action did, except for the ability to add. That is no longer needed as the patient has already been added to the MPI. The user will not see the ICN currently assigned to their patient in the list of potential matches. They will only see other potential matches. If there is not a match to be made, the user should quit and mark the exception as processed. If they are not sure if there is a match or not, the exception should remain in a NOT PROCESSED status. If the exception is marked as processed, it will be removed from the list of active exceptions. If the user is presented with more than one match that is the same patient, the IMDQ team should be contacted to assist in the resolution of more than one duplicate on the MPI. The user will only be able to match with one entry on the MPI. Since the patient has already been added to the MPI, there will not be a local ICN for this patient as there has been in the past. The only way to know that there is a potential match to be reviewed, at this point, is this exception. New Protocols to support this: CMORs Data View [MPIF POTENTIAL DUP (CMOR PDAT)] HELP [MPIF POTENTIAL DUP (HELP)] MPI Data View [MPIF POTENTIAL DUP (MPI PDAT)] Match With Existing Pt on List [MPIF POTENTIAL DUP (SELECT PATIENT)] Actions for Potential Duplication screen [MPIF POTENTIAL DUP MENU] New List Template to support this: MPIF POTENTIAL DUP Issue #3 - Menu Structure Changes Since all patients now receive a national ICN unless the MPI is unavailable, the Single Patient Initialization [MPIF IND MPI LOAD] option and the SPI action within the MPI/PD Exception Handling [RG EXCEPTION HANDLING] option are no longer needed in VistA. Because these options are in different namespaces, they will be deleted in the following separate patches: Patch MPIF*1*43 will remove the Single Patient Initialization [MPIF IND MPI LOAD] option. Patch RG*1*43 will remove the SPI action within the MPI/PD Exception Handling [RG EXCEPTION HANDLING] option. The Single Patient Initialization to MPI [MPIF IND MPI LOAD] option is being removed from the Master Patient Index Menu [MPIF VISTA MENU]. That change would have left only one item on the Master Patient Index Menu [MPIF VISTA MENU] structure. Therefore, the remaining option, Display Only Query [MPIF DISPLAY ONLY QUERY TO MPI], is moved from the Master Patient Index Menu [MPIF VISTA MENU] to the Message Exception Menu [RG EXCEPTION MENU]. The Master Patient Index Menu [MPIF VISTA MENU] is then deleted, as it no longer has sub-menu options. MENU STRUCTURE BEFORE: CORD MPI/PD Patient Admin Coordinator Menu ... [RG ADMIN COORD MENU] MPI Master Patient Index Menu ... [MPIF VISTA MENU] ;;1.0; MASTER PATIENT INDEX VISTA ;**[Patch List]**;30 Apr 99 Using old logic - CHECK^XTSUMBLD results: ----------------------------------------- Routine Before Patch After Patch Patch List -------- ------------ ------------ ---------- MPIF002 6171097 8690656 20,27,33,43 MPIFA24B 3269573 3566314 22,28,31,25,43 MPIFAPI 8167509 7469264 1,3,14,16,17,21,27, 28,33,35,37,43 MPIFBT2 20379145 21186224 1,3,10,17,21,31,43 MPIFBT3 16375512 9758315 1,3,10,17,21,24,28, 31,33,35,43 MPIFD1 N/A 18056105 43 MPIFDUP N/A 18537189 43 MPIFP43 N/A 722354 43 MPIFQ0 21421169 21454333 1,3,8,14,13,16,17, 21,20,24,26,28,31, 33,35,38,43 MPIFQ3 9905395 10945522 28,43 MPIFRES 5679691 7671130 1,7,10,15,17,21,26, 28,33,35,43 MPIFRPC2 5436926 9037932 20,24,33,43 MPIFSA2 20823700 20900133 28,29,35,38,43 MPIFSA3 17047641 17072124 28,31,35,43 Note: Routine MPIFP43 is deleted by the installation. Using new logic - CHECK1^XTSUMBLD results: ------------------------------------------ Routine Before Patch After Patch Patch List -------- ------------ ------------ ---------- MPIF002 21350253 28350773 20,27,33,43 MPIFA24B 6739707 7230667 22,28,31,25,43 MPIFAPI 31852226 28137088 1,3,14,16,17,21,27, 28,33,35,37,43 MPIFBT2 48374458 50661186 1,3,10,17,21,31,43 MPIFBT3 39361685 22745391 1,3,10,17,21,24,28, 31,33,35,43 MPIFD1 N/A 49972281 43 MPIFDUP N/A 52696250 43 MPIFP43 N/A 958116 43 MPIFQ0 66211325 70311672 1,3,8,14,13,16,17, 21,20,24,26,28,31, 33,35,38,43 MPIFQ3 16977860 19268712 28,43 MPIFRES 18642902 21931451 1,7,10,15,17,21,26, 28,33,35,43 MPIFRPC2 11239382 20174050 20,24,33,43 MPIFSA2 51929844 53121126 28,29,35,38,43 MPIFSA3 25608882 25833370 28,31,35,43 Note: Routine MPIFP43 is deleted by the installation. Post-Install Routine MPIFP43: ============================= The "AICNL" cross-reference is on the LOCALLY ASSIGNED ICN (#991.04) field in the PATIENT (#2) file. Post-init routine, MPIFP43, resets the "AICNL" cross-reference to null. The existing methodology prevented the resending of local ICNs to the MPI in the Local/Missing ICN Resolution [MPIF LOC/MIS ICN RES] job. This change will allow all of the existing local ICNs to be sent to the MPI for enumeration. Post-Install Routine RGP43PST: ============================== Some exceptions in the CIRN HL7 EXCEPTION LOG (#991.1) file will be marked as processed by post-init routine RGP43PST. The following existing active exception types will be retired. - Required field(s) missing for patient sent to MPI - SSN Match Failed - Name Doesn't Match - Potential Matches Returned A patient that in the past would have generated one of these exceptions, will now receive a national ICN as a result of the Master Patient Index - Health Eligibility Center (HEC) Enumeration project. Software Retrieval: =================== The software for this patch is not being distributed through the National Patch Module. The patch is being distributed as a host file. The host file contains the following two KIDS builds: Host file name: MPIF_1_P43.KID Builds: MPIF*1.0*43 RG*1.0*43 Sites may retrieve the software directly using FTP from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Albany: ftp.fo-albany.med.va.gov Hines: ftp.fo-hines.med.va.gov Salt Lake City: ftp.fo-slc.med.va.gov First Available Server: download.vista.med.va.gov Select the following file: File Name Description --------- ----------- MPIF_1_P43.KID Host file containing KIDS software distribution Note: Use ASCII mode when transferring the .KID file. Installation Instructions: ========================== This patch takes less than 5 minutes to install. This patch should be loaded during non-peak hours to minimize disruption to the users. 1. Users are allowed on the system during patch installation. 2. TaskMan does not need to be stopped or placed in a wait state. 3. These routines are not usually mapped, so you will not have to disable mapping. 4. Download the KIDS file, MPIF_1_P43.KID from the ANONYMOUS.SOFTWARE directory at the Albany, Hines, or Salt Lake CIOFO to the appropriate directory on your system. 5. From the Kernel Installation and Distribution System Menu, select the Installation menu. 6. Use the Load a Distribution option on the KIDS Installation menu, and enter: the directory onto which you have downloaded the host file, immediately followed by MPIF_1_P43.KID. 7. From the Installation menu, you may elect to use the following options. At the 'Select INSTALL NAME' prompt, enter MPIF*1.0*43. (a) Backup a Transport Global. (b) Compare Transport Global to Current System. (c) Verify Checksums in Transport Global. (d) Print Transport Global. 8. Use the Install Package(s) option. At the 'Select INSTALL NAME' prompt, enter MPIF*1.0*43. 9. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//' respond YES for both patches. 10. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//', respond NO. 11. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', respond YES. The following OPTIONS should be disabled during the installation. Single Patient Initialization to MPI [MPIF IND MPI LOAD] NOTE: If you install the patch more than once, ^ the above option will no longer be on your system, as it is being deleted. Display Only Query [MPIF DISPLAY ONLY QUERY TO MPI] Local/Missing ICN Resolution Background Job [MPIF LOC/MIS ICN RES] MPI/PD Exception Handling [RG EXCEPTION HANDLING] Register a Patient [DG REGISTER PATIENT] Load/Edit Patient Data [DG LOAD PATIENT DATA] Electronic 10-10EZ Processing [EAS EZ 1010EZ PROCESSING] 12. If you unmapped routines in step 3, remap them after installation has completed. 13. The MPIFP43 and RGP43PST routines are automatically deleted from your system after successful installation of the patch. The MPI HEC Enumeration Process (After Installation): ===================================================== In order to support the Health Eligibility Center (HEC) migration to the Administrative Data Repository (ADR), each record in the HEC must have a national Integration Control Number (ICN). To accomplish this, the Master Patient Index (MPI) development team and the HEC development /support staff have identified these patients by DFN at the respective site. They have created a new global on the MPI in Austin that contains this data. There are approximately 1.6 million records (across all facilities) that must be enumerated. After you have installed the MPIF*1*43 and RG*1*43 patches, you will be contacted to establish a timeframe for enumeration of the identified records. This is a remote process that takes place from the MPI to your facility and generates an ICN for each of the identified records. As additional messaging is involved, this will be coordinated with each facility to ensure adequate disk space is available for the extra HL messages and journal space for the HL7 globals. Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: MPIF002 Before: B21350253 After: B26919791 **20,27,33,43** Routine Name: MPIFA24B Before: B6739707 After: B7230667 **22,28,31,25,43** Routine Name: MPIFAPI Before: B31852226 After: B28137088 **1,3,14,16,17,21,27,28,33,35,37,43** Routine Name: MPIFBT2 Before: B48374458 After: B50661186 **1,3,10,17,21,31,43** Routine Name: MPIFBT3 Before: B39361685 After: B22745391 **1,3,10,17,21,24,28,31,33,35,43** Routine Name: MPIFD1 Before: n/a After: B47503592 **43** Routine Name: MPIFDUP Before: n/a After: B27969993 **43** Routine Name: MPIFP43 Before: n/a After: B958116 **43** Routine Name: MPIFQ0 Before: B66211325 After: B69367805 **1,3,8,14,13,16,17,21,20,24, 26,28,31,33,35,38,43** Routine Name: MPIFQ3 Before: B16977860 After: B18652216 **28,43** Routine Name: MPIFRES Before: B18642902 After: B20988611 **1,7,10,15,17,21,26,28,33,35,43** Routine Name: MPIFRPC2 Before: B11239382 After: B20174050 **20,24,33,43** Routine Name: MPIFSA2 Before: B51929844 After: B53121126 **28,29,35,38,43** Routine Name: MPIFSA3 ============================================================================= User Information: Entered By : CHESNEY,CHRISTINE M Date Entered : OCT 12, 2005 Completed By: ALDERMAN,MATT S Date Completed: MAY 04, 2006 Released By : FITCH,DONNA Date Released : MAY 08, 2006 ============================================================================= Packman Mail Message: ===================== No routines included