============================================================================= Run Date: JUL 15, 2004 Designation: PX*1*130 Package : PX - PCE PATIENT CARE ENCOUNTER Priority: Mandatory Version : 1 SEQ #108 Status: Released Compliance Date: AUG 15, 2004 ============================================================================= Associated patches: (v)PX*1*96 <<= must be installed BEFORE `PX*1*130' (v)PX*1*113 <<= must be installed BEFORE `PX*1*130' (v)PX*1*115 <<= must be installed BEFORE `PX*1*130' (v)PX*1*116 <<= must be installed BEFORE `PX*1*130' (v)PX*1*117 <<= must be installed BEFORE `PX*1*130' (v)PX*1*121 <<= must be installed BEFORE `PX*1*130' (v)PX*1*122 <<= must be installed BEFORE `PX*1*130' Subject: COMBAT VETERAN PHASE II - PCE Category: - Routine - Data Dictionary Description: ============ The Chief Business Office (CBO) is requesting modifications to several Veterans Health Information Systems and Technology Architecture (VistA) packages to support implementation of VHA Directive 2002-049 - "Combat Veterans Are Eligible For Medical Services For 2-Years After Separation From Military Service Notwithstanding Lack Of Evidence For Service Connection", which iterates VA's policy to provide medical care and other medical services to combat veterans despite the absence of proof of service connection. Software to support the Combat Veteran (CV) initiative is being developed and introduced in a phased implementation strategy. The reason for this type of deployment is due to the complexity of the functionality and the number of product line dependencies. Phase I: Combat Veteran Interim Solution (CVIS) was a VistA only solution that involved development in the Integrated Billing (IB) and Registration/Enrollment product lines. It provided the logic to identify those veterans who met the criteria for the combat veteran eligibility and provided billing reports cross-referenced against this identifier to aid in the copayment billing process. Phase II of this initiative will involve multiple product lines and additional VistA only development. The main goals of Phase II will be to fully automate the copayment billing processing of combat vets based on episode of care by providing the appropriate questions at check-out as supplied by CPRS. Product lines that have a stake in Phase II development include Enrollment/Registration (VistA), IB, Outpatient Pharmacy, Consolidated Mail Outpatient Pharmacy (CMOP), CPRS/TIU, Patient Care Encounter (PCE), Ambulatory Care, Event Capture, Scheduling and PTF. The National Patient Care Database (NPCD) will also require modifications to capture workload reporting. The patches are listed below in the order that they must be installed. It should be noted all patches with the exception of the PIMS host file have been previously released and the installation status of those patches should be validated at your site prior to installation the PIMS build: Outpatient Pharmacy: PSO*7*157 - Release Date, May 13, 2004 PSX*2*50 - Release Date, May 13, 2004 CPRS: OR*3.0*190 - Release Date, July 12, 2004 Integrated Billing: IB*2.0*247 - Release Date, June 9, 2004 PCE/PTF/Event Capture/Scheduling PIMS Host file PX*1.0*130 SD*5.3*325 DG*5.3*565 EC*2.0*54 Product Features There are three main areas addressed by this enhancement: a. Identification/Notification of a CV Status veteran seeking medical care o The clinical applications shall obtain the CV Status for those veterans who qualify as such per the directive o The CV Status identification shall be displayed to the appropriate audience (pharmacist, clinician providing care, intake personnel, schedulers, etc.) o Provider shall be able to identify whether care provided CV veteran was for a condition potentially related to combat service in the same manner as identification of exposure related care; care for SC conditions, etc. b. Assistance in the communication of a treatment being determined as Combat Related o Provide a means for the billing and pharmacy software package to identify these patients and services provided care for a combat related condition c. Automatically precludes inpatient and outpatient medical care, prescription and Long-term care copayments for CV Status veterans whose treatment/service has been deemed combat related by provider or unless changed by pharmacist. This patch distributes the changes to PCE in support of the Combat Veteran initiative. Functional Changes ------------------ 1. A new prompt, 'Was treatment related to Combat?' has been added to the current classification prompts within the PCE Encounter Data Entry options and the ADD STANDALONE ENC and the UPDATE ENCOUNTER actions on the Encounter List screen. --- Classification --- [Required] Was treatment for SC Condition? Was treatment related to Combat? Was treatment related to Agent Orange Exposure? Was treatment related to Ionizing Radiation Exposure? Was treatment related to Environmental Contaminant Exposure? Was treatment related to Military Sexual Trauma? Was treatment related to Head and/or Neck Cancer? 2. The List By Encounter [PXCE ENCOUNTER LIST] action on the PCE Encounter Viewer [PXCE ENCOUNTER VIEWER] option has been modified to display the Combat Veteran values. 3. The protocol PXCE ADD/EDIT DISPLAY DETAIL (Display Detail) will now display the Combat Veteran title and value. 1 Encounter Date and Time: NOV 02, 2003@09:00 Patient Name: BIRD,ROBIN Hospital Location: GENERAL MEDICINE AT ALBANY Clinic Stop: 301 GENERAL INTERNAL MEDICINE Service Connected: NO Combat Veteran: YES Agent Orange Exposure: NO Ionizing Radiation Exposure: NO Environmental Contaminant Exposure: NO Military Sexual Trauma: NO Head and/or Neck Cancer: NO 4. When editting an existing visit/encounter, PCE will delete previously answered classification questions if it is no longer applicable (ex: changing Service Connected from NO to YES will automatically delete the values for Agent Orange, Ionizing Radiation, and Environmental Contaminants). When doing the deletion, PCE would delete the value from the OUTPATIENT CLASSIFICATION file (#409.42) but not the VISIT file (#9000010). This has been corrected to delete the value from both files. 5. When fixing PCE to correctly delete classification questions that were no longer applicable (see #4), the API $$DATA2PCE^PXAPI began to delete previously stored values for classification questions when the nodes for this information were not included in the input array. Since the documentation for this API was vague on how not setting these nodes would be handled, it was decided to maintain backwards compatibility and adjust the API so that it only deletes classification questions if explicitely told to [by setting the array node equal to '@']. 6. Added 'Head/Neck Cancer' and 'Combat Veteran' to DIALOG number 8390001.003 (Warning message for service connectedness). API Changes ----------- 1. The following Database Integration Agreements were affected by the changes made to introduce the new Combat Veteran classification and were updated accordingly. 2.1 DATA2PCE - DBIA 1889-A 1889 2.2 PXCA - DBIA 1889-A 1899 2.3 PXUTLSCC - SERVICE CONNECTED CONDITIONS 2348 2.6 VSIT LOOKUP - DBIA 1900-G 1906 2.7 VSIT UPD - DBIA 1900-B 1901 2.8 VSIT TRACKING - DBIA 489 489 File Changes ------------ 1. VISIT file (#9000010) FIELD: (#80007) COMBAT VETERAN DATA TYPE: SET OF CODES - 1 will stand for Yes 0 will stand for No DESCRIPTION: This field is used to indicate that the visit represents treatment of a VA patient for a problem that is related to Combat Veteran. 2. V POV file (#9000010.07) FIELD: (#80005) MILITARY SEXUAL TRAUMA DATA TYPE: SET OF CODES - 1 will stand for Yes 0 will stand for No DESCRIPTION: This field will be used to indicate if this Diagnosis code was related to a Military Sexual Trauma problem. FIELD: (#80006) HEAD AND/OR NECK CANCER DATA TYPE: SET OF CODES - 1 will stand for Yes 0 will stand for No DESCRIPTION: This field will be used to indicate if this Diagnosis code was related to Head and/or Neck Cancer. FIELD: (#80007) COMBAT VETERAN DATA TYPE: SET OF CODES - 1 will stand for Yes 0 will stand for No DESCRIPTION: This field is used to indicate that the visit represents treatment of a VA patient for a problem that is related to Combat Veteran. ROUTINE SUMMARY: ================ The following is a list of the routines included in this patch. The second line of each of these routines will look like: ;;1.0;PCE PATIENT CARE ENCOUNTER;**[patch list]**;Aug 12, 1996 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== PXAI 6706979 6706979 15,74,69,102,111 112,130 PXAICPTV 5803989 5953784 15,73,74,111,121 130 PXAIPOV 6121994 6162167 28,73,69,108,112 130 PXAIVST 5345807 5382765 5,9,15,74,111 96,130 PXAIVSTV 26840870 29044768 9,15,19,74,111 116,130 PXAPIDEL 9931203 9931254 1,9,22,130 PXBAPI1 8539757 8671561 1,9,23,56,104 111,113,122,116,130 PXBAPI21 4799017 4799017 130 PXBPL 6176999 6193998 11,94,115,130 PXCADXP2 13416693 13977169 115,130 PXCAPL 16453215 16956420 24,27,115,130 PXCAPL1 2908993 2953008 33,115,130 PXCAPL2 4089605 4133867 33,115,130 PXCAPOV 13370975 14955427 24,27,33,121,130 PXCAVST 19256683 20209379 14,33,74,111,116 130 PXCAVST1 5891356 6004913 73,74,111,121,130 PXCEAPPM 4309094 4521435 22,74,111,130 PXCEE800 1195024 1268146 74,111,130 PXCESIT 5841021 6053362 22,74,111,130 PXCEVST 4309379 4521720 22,74,111,130 PXKFPOV 598703 631277 22,130 PXKFVST 2825465 1810564 22,56,111,130 PXKMAIN 10724796 10854965 22,59,73,88,69 117,130 PXKVST 7817620 7898662 56,111,130 PXUTLSCC 8958561 12450381 74,107,111,130 VSITDEF 9943631 10118922 76,111,130 VSITFLD 4105975 4330103 76,81,111,130 VSITHLP 6982136 7040067 76,111,130 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 is a multi-package build containing four (4) KIDS builds. Host file name: COMBAT_VET_PHASE_II_PIMS.KID Multi-Package Build: COMBAT VET PHASE II PIMS 1.0 Builds: PX*1.0*130 : SD*5.3*325 : DG*5.3*565 : EC*2.0*54 Sites may retrieve the software and documentation 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 The following files will be available: File Name Description --------- ----------- COMBAT_VET_PHASE_II_PIMS.KID Host file containing KIDS software distribution EC2_0P54.EXE Event Capture GUI Change Pages to the following documentations are included in the files below. DG_53_P565_UM.PDF PIMS V5.3 User Manual EC_2_P54_CB.PDF Event Capture V2.0 Cook Book EC_2_P54_UM.PDF Event Capture V2.0 User Manual PX_1_P130_TM.PDF PCE V1.0 Technical Manual PX_1_P130_UM.PDF PCE V1.0 User Manual SD_53_P325_TM.PDF PIMS V5.3 Technical Manual SD_53_P325_UM.PDF PIMS V5.3 User Manual * Note: Use ASCII mode when transferring the .KID file. Use Binary mode when transferring the .EXE and .PDF files. The .PDF files can be read on a PC using the Adobe Acrobat Reader program. INSTALLATION INSTRUCTIONS: ========================== ** It is recommended that this patch NOT be installed less ** ** than seven days before AmbCare's monthly close-out ** 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 the check-out process and must be installed when the SCDX AMBCAR NIGHTLY XMIT background job is not running. Installation will take less than 10 minutes. Note: The following is a list of REQUIRED builds for this multi-package distribution. KIDS will not allow the installation of this patch without the prior installation of them. DG*5.3*497 DG*5.3*510 DG*5.3*524 DG*5.3*576 DG*5.3*590 DG*5.3*602 EC*2.0*49 EC*2.0*50 SD*5.3*244 SD*5.3*254 SD*5.3*258 SD*5.3*293 PX*1.0*96 PX*1.0*112 PX*1.0*115 PX*1.0*116 PX*1.0*121 PX*1.0*122 PX*1.0*117 1. Download the KIDS file COMBAT_VET_PHASE_II_PIMS.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: COMBAT_VET_PHASE_II_PIMS.KID 3. 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. 4. From the Kernel Installation and Distribution System Menu, select the Installation menu. 5. From this menu, you may elect to use the following options (when prompted for INSTALL NAME, enter the appropriate patch designation - PX*1.0*130, SD*5.3*325, DG*5.3*565, EC*2.0*54): 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. 6. Use the Install Package(s) option and select the package COMBAT VET PHASE II PIMS 1.0. 7. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//',respond NO. 8. 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 ECENTER Event Capture Data Entry EC NIGHT Nightly Data Feed to PCE When prompted to select the protocols you would like to place out of order, enter the following: SDAM PCE EVENT Process PCE Event Data PXK VISIT DATA EVENT VISIT RELATED DATA PXCA DATA EVENT PCE Device Interface Module's Data Event 9. If routines were unmapped as part of step 3, they should be returned to the mapped set once the installation has run to completion. 10. The pre and post install routines SD53325 and SD53325A can be deleted after receiving the message that the SD*5.3*325 post init has run to completion. Routine Information: ==================== Routine Name: - PXAI Routine Checksum: Routine Name: - PXAICPTV Routine Checksum: Routine Name: - PXAIPOV Routine Checksum: Routine Name: - PXAIVST Routine Checksum: Routine Name: - PXAIVSTV Routine Checksum: Routine Name: - PXBAPI1 Routine Checksum: Routine Name: - PXBPL Routine Checksum: Routine Name: - PXCAPOV Routine Checksum: Routine Name: - PXCADXP2 Routine Checksum: Routine Name: - PXCAPL Routine Checksum: Routine Name: - PXCAPL1 Routine Checksum: Routine Name: - PXCAPL2 Routine Checksum: Routine Name: - PXCAVST Routine Checksum: Routine Name: - PXCEAPPM Routine Checksum: Routine Name: - PXCEE800 Routine Checksum: Routine Name: - PXCESIT Routine Checksum: Routine Name: - PXCEVST Routine Checksum: Routine Name: - PXKFVST Routine Checksum: Routine Name: - PXKVST Routine Checksum: Routine Name: - PXUTLSCC Routine Checksum: Routine Name: - VSITDEF Routine Checksum: Routine Name: - VSITFLD Routine Checksum: Routine Name: - VSITHLP Routine Checksum: Routine Name: - PXCAVST1 Routine Checksum: Routine Name: - PXBAPI21 Routine Checksum: Routine Name: - PXKMAIN Routine Checksum: Routine Name: - PXAPIDEL Routine Checksum: Routine Name: - PXKFPOV Routine Checksum: ============================================================================= User Information: Entered By : BRICKER,DENNIS Date Entered : NOV 04, 2003 Completed By: OLINGER,BRIAN Date Completed: JUL 14, 2004 Released By : GROOMS,ANTHONY E Date Released : JUL 15, 2004 ============================================================================= Packman Mail Message: ===================== No routines included