$TXT Created by HARRIS,DONNA H at MNTVBB.FO-ALBANY.MED.VA.GOV (KIDS) on Tuesday, 09/20/05 at 11:26 ============================================================================= Run Date: OCT 19, 2005 Designation: PX*1*170 Package : PX - PCE PATIENT CARE ENCOUNTER Priority: Mandatory Version : 1 SEQ #127 Status: Released Compliance Date: NOV 19, 2005 ============================================================================= Associated patches: (v)PX*1*121 <<= must be installed BEFORE `PX*1*170' (v)PX*1*124 <<= must be installed BEFORE `PX*1*170' (v)PX*1*149 <<= must be installed BEFORE `PX*1*170' Subject: CHANGE ICD CALLS TO LEXICON Category: - Routine - Data Dictionary Description: ============ PATIENT SAFETY ISSUE: PSI-05043 - ICD reported inappropriate lookup of diagnosis code when entering "CHF". Several applications are performing direct reads of the ICD DIAGNOSIS (#80) file which is used in the search for diagnosis. This file contains the long description for the ICD diagnosis codes as released by The Center for Medicare and Medicaid Services (CMS) which is the Standards Development Organization (SDO) for ICD codes. In the ICD DIAGNOSIS (#80) file, the long description for Crimean Hemorrhagic Fever contains a clause "CHF Congo Virus" and thus when the user enters "CHF", the only entry returned is code 065.0 for Crimean Hemorrhagic Fever. Most users entering "CHF" are actually seeking Congestive Heart Failure, code 428.0. If these searches were performed using Clinical Lexicon, the user would get a list of various congestive heart failure terms from which a selection can be made. Since the majority of the NOIS/Remedy tickets citing this problem reflect the Patient Care Encounter (PCE) and Patient Treatement File (PTF) packages, an interim solution has been put in place to change the direct reads from the ICD DIAGNOSIS (#80) file to Clinical Lexicon within these two packages. In addition, user education has been addressed to reduce these incorrect diagnosis selections. Additional review of other applications, also performing direct reads of the ICD DIAGNOSIS (#80) file, will follow and the long term solution will be addressed by rehosting, using the Enterprise Reference Terminology (ERT) solution. This patch (PX*1*170) will modify the PCE and Scheduling packages so that the diagnosis code lookup will utilize Clinical Lexicon. Therefore, when a user enters "CHF" for a diagnosis code, a list of various Congestive Heart Failure terms will be displayed for selection. This patch addresses the following New Service Request (NSR): ------------------------------------------------------------- None This patch addresses the following NOIS/Remedy Ticket(s): -------------------------------------------------------- 1. HD00000000106458 - CHF lookup in PCE retrieves Crimean Hemorrhagic Fever 2. HD00000000106455 - CHF lookup in Appt Mgr finds Crimean Hemorrhagic Fever Overview of NOIS/Remedy Ticket(s): ---------------------------------- Problem: When a user enters "CHF" for a diagnosis code within the PCE checkout process it retrieves Crimean Hemorrhagic Fever instead of Congestive Heart Failure Resolution: Modified the application PCE & Appt Mgr to lookup diagnosis codes using CLINICAL LEXICON. COMPONENTS SENT WITH PATCH -------------------------- The following is a list of the routines included in this patch. The second line of each of these routines now looks like: ;;1.0;PCE PATIENT ENCOUNTER;**[patch list]**;5/1/01 CHECK^XTSUMBLD results Routine Before Patch After Patch Patch List ------- ------------ ----------- ---------- PXBPPOV 9323903 8559280 11,28,92,121, 149,124,170 PXBPCPT2 3261534 3071753 124,170 PXCECPT 15066899 15033749 14,27,73,89 112,121,136 124,170 PXCECPT1 N/A 231526 170 PXCEPOV 10953989 11095458 27,121,124,170 PXCEPOV1 5834557 6185448 134,149,124,170 Total number of routines modified: 6 The following is a list of files included in this patch: UP SEND DATA USER DATE SEC. COMES SITE RSLV OVER FILE # NAME DD CODE W/FILE DATA PTS RIDE -------------------------------------------------------------------------- 9000010.18 V CPT YES YES NO NO The following is a list of fields included in this patch: Field Name (Number) DIAGNOSIS (.05) DIAGNOSIS 2 (.09) DIAGNOSIS 3 (.1) DIAGNOSIS 4 (.11) DIAGNOSIS 5 (.12) DIAGNOSIS 6 (.13) DIAGNOSIS 7 (.14) DIAGNOSIS 8 (.15) Test Sites: ----------- Cleveland El Paso Northport West LA ================INSTALLATION INSTRUCTIONS ================= If installed during the normal workday, it is recommended that the following selection(s) in the OPTION (#19) file, and all of their descendants be disabled to prevent possible conflicts while running the KIDS Install. Other VISTA users will not be affected. Appointment Management [SDAM APPT MGT] PCE Encounter Data Entry [PXCE ENCOUNTER DATA ENTRY] Install Time less than 5 minutes (unless otherwise indicated) 1. LOAD TRANSPORT GLOBAL --------------------- Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. DISABLE ROUTINE MAPPING (DSM for Open VMS sites only) ----------------------- Disable routine mapping on all systems for the routines listed in step 3 below. NOTE: If the routines included in this patch are not currently in your mapped routine set, please skip this step. 3. START UP KIDS ------------- Start up the Kernel Installation and Distribution System Menu [XPD MAIN]: Edits and Distribution ... Utilities ... Installation ... Select Kernel Installation & Distribution System Option: Installation --- Load a Distribution Print Transport Global Compare Transport Global to Current System Verify Checksums in Transport Global Install Package(s) Restart Install of Package(s) Unload a Distribution Backup a Transport Global Select Installation Option: 4. Select Installation Option: --------------------------- NOTE: The following are OPTIONAL - (When prompted for the INSTALL NAME, enter PX*1.0*170): 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. 5. Select Installation Option: Install Package(s) ---------------- a. Choose the Install Package(s) option to start the patch install. b. When prompted Want KIDS to INHIBIT LOGONs during the install? YES// answer NO c. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//' answer YES d. When prompted 'Enter options you wish to mark as 'Out Of Order':' Enter the following options: Appointment Management SDAM APPT MGT PCE Encounter Data Entry PXCE ENCOUNTER DATA ENTRY e. When prompted 'Enter protocols you wish to mark as 'Out Of Order': press . 6. REBUILD MAPPED ROUTINE(S) (DSM for Open VMS sites only) ------------------------- Optional - Include the routines distributed with this patch in the mapped routine set. NOTE: This step is only necessary if you performed step 2 or if you wish to include the routines in your mapped set. Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PXBPCPT2 Before: B6970858 After: B7116983 Routine Name: PXBPPOV Before: B21767905 After: B22000180 Routine Name: PXCECPT Before: B64389674 After: B64348056 Routine Name: PXCECPT1 Before: After: B373662 Routine Name: PXCEPOV Before: B16838649 After: B17000229 Routine Name: PXCEPOV1 Before: B23888557 After: B27429965 ============================================================================= User Information: Entered By : HARRIS,DONNA H Date Entered : JUN 06, 2005 Completed By: WOEHRLE,MARGARET Date Completed: OCT 11, 2005 Released By : CANNEDY,JOELLEN Date Released : OCT 19, 2005 ============================================================================= Packman Mail Message: ===================== $END TXT