$TXT Created by WOLF,ED at MNTVBB.FO-ALBANY.MED.VA.GOV (KIDS) on Wednesday, 11/20/02 at 17:27 ============================================================================= Run Date: JUL 03, 2003 Designation: PX*1*96 Package : PX - PCE PATIENT CARE ENCOUNTER Priority: Mandatory Version : 1 SEQ #96 Status: Released Compliance Date: AUG 03, 2003 ============================================================================= Associated patches: (c)SD*5.3*257 install with patch `PX*1*96' (v)PX*1*95 <<= must be installed BEFORE `PX*1*96' (v)PX*1*111 <<= must be installed BEFORE `PX*1*96' Subject: CHANGE TO DATA2PCE- OUTSIDE LOCATION/DELETE ENCOUNTER/ACCEPT INSTITUTION Category: - Routine Description: ============ I. FUNCTIONAL OVERVIEW ======================== 1. Development Team for the Clinical Reminders Package requested modification of DATA2PCE^PXAPI API to support the entry of historical encounter location or outside location. The TYPE field (#.03) of the VISIT file (#9000010) will be determined depending on whether the OUTSIDE LOCATION field (#2101) or the pointer to the INSTITUTION file is passed to PCE. Additionally, a free text response will now be accepted for the OUTSIDE LOCATION when entered from CPRS/GUI. The TYPE field (#.03) will be set to O (Other) when the OUTSIDE LOCATION is passed. Currently its value is equal to the default DUZ("AG") that corresponds to the AGENCY CODE field of the KERNEL SYSTEM PARAMETERS file (#8989.3) of the system that processes the data via DATA2PCE^PXAPI. If the OUTSIDE LOCATION is entered from CPRS/GUI as a free text then it will be accepted due to the processing of a new subscript passed to DATA2PCE^PXAPI. This part of the patch addresses the following NOIS messages: --------------------------------------------------------------- ISL-0799-50548 Mandated Clinical Reminders requires change to DATA2PCE PAL-0802-62589 ADD OUTSIDE LOCATION 2. There was not a complete deletion of a visit and its outpatient encounter when a stand alone visit/encounter was created and a HOSPITAL LOCATION had both the STOP CODE NUMBER (#8) and the CREDIT STOP CODE (#2503) fields defined. This problem has been addressed by deleting a credit stop visit and its outpatient encounter when a request is sent to delete the credit stop. NOTE: This part of the patch has to be implemented with SD*5.3*257, which ---- addresses a similar problem in the Scheduling package. --------------------------- The patches have modified the routines in such a way that users can now accomplish edits/deletions that were not possible before, even if there were no entries pointing to a visit. This provides a mechanism for cleaning up so called 'duplicate' visits/encounters and prevents from keeping 'duplicates' from deletion in the future. Users should be fully aware of what can and cannot be deleted with the patch. If a site does have verified 'duplicates' with entries from outside the PCE, i.e. TIU DOCUMENT, CLAIMS TRACKING, A&SP CLINIC VISIT etc., is unable to reassign them, and needs assistance with deleting the visit/encounter, then a NOIS call should be logged. If while trying to delete a visit/encounter you see a message: 'Could not delete the encounter. There are still users of it.' it may indicate that the entries like (DX, CPT, etc) are deleted but the encounter date/time is still there because of entries pointing to the visit from packages outside of PCE. This is how it works. If an outpatient encounter is created, it points to the previously created visit and all entry information (DX, CPT, Progress Notes etc) point to the visit as well. If you want to delete the encounter all entries to that visit must be deleted. Some of those entries are from PCE and some from other packages as TIU etc. The patches address a problem of properly deleting entries related to PCE but no action is taken regarding other entries. Another words, you may still expect that the system does not allow you to delete encounters that have at least one entry and, it cannot be deleted from PCE. Before those patches were implemented it was not possible to delete a visit/encounter with the outpatient encounter being the only entry pointing to the visit and/or its credit/stop visit. That problem has been corrected and this is what the patches address. If a site does have verified 'duplicates' with entries from outside the PCE, i.e. TIU DOCUMENT, CLAIMS TRACKING, A&SP CLINIC VISIT etc., is unable to reassign them, and needs assistance with deleting the visit/encounter, then a NOIS call should be logged. ------------------------------ This part of the patch addresses the following NOIS messages: --------------------------------------------------------- SDC-0801-62236 deleting encounters-still users of it UNY-0802-11825 Action Required Duplicate Encounter UNY-0802-10110 Need Option to Delete Duplicate Visit SLC-0798-51246 DUPLICATE VISITS VIA TIU/PCE/APPT MANAGEMENT 3. If the INSTITUTION is passed to PCE a new visit/encounter should be created with the corresponding entries. Currently a visit without any entries is created and all entries are filed on the visit with the default INSTITUTION pointed to from the DIVISION field of the HOSPITAL LOCATION file. This situation happens frequently when procedures with the same Hospital Location, Patient Name and Date/Time but different Institution are passed to PCE. The passed Institutions were expected to be credited with the corresponding entries. This problem originally was addressed as generation of duplicate providers on one visit: NOIS: LIT-0602-71276 DUPLICATE PROVIDERS However, it came out during the investigation that the situation described above contributed to the issue that was addressed in this NOIS. The determination of how to implement the described functionality was made on Nov 1st, 2002 during a teleconference with Gail Graham - Director - HIMP, Frank Stalling - Lab developer, Mary Marks - Registration developer and Ed Wolf - PCE developer. NOTE: This part of patch PX*1.0*96 has to be implemented with SD*5.3*257, ---- which addresses related problem in the Scheduling package. II. Technical Components: ======================== 1. The Integration Agreement DBIA1889-A has been modified to include as an optional subscript: "ENCOUNTER",1,"OUTSIDE LOCATION") This is an outside location of an encounter, not included in the INSTITUTION file. Format: Free text The OUTSIDE LOCATION should exclude the INSTITUTION: "ENCOUNTER",1,"INSTITUTION") and the INSTITUTION should exclude the OUTSIDE LOCATION. 2. Routine PXAIVST, which creates ^TMP("PXK" global, used for filing an encounter, has been modified to include a logic to setup the TYPE and to accept the OUTSIDE LOCATION if passed to DATA2PCE^PXAPI. Another modification to the PXAIVST routine includes passing the Institution, as the LOC. OF ENCOUNTER field (#.06) of the VISIT file, to the $$LOOKVSIT^PXUTLVST call. 3. Routine PXUTLSTP has been modified to identify an outpatient encounter pointing to a visit with already deleted entries, and to delete the outpatient encounter as well. That action allows the software to delete the visit completely as there will no longer be an entry pointing to it. 4. Routine PXKCO has been modified to accept the passed Institution, filed in the VISIT entry. ============ INSTALLATION INSTRUCTIONS ================== NOTE: This patch installation should follow installation of SD*5.3*257 to address fully the visit/encounter deletion problem. This patch should be loaded with a very low activity in the system, outside of the regular working hours, when transferring data from other packages to PCE does not take place. It is recommended that the following menu options (File #19) and all of their descendants be disabled to prevent possible conflicts while running the KIDS Install. Other VISTA users will not be affected. SDAM APPT CHECK IN/OUT Appointment Check-in/Check-out SDAM APPT MGT Appointment Management SDAM APPT UPDATE Appointment Status Update SDAM APPT UPDATE MENU Appointment Status Update Menu PXCE ENCOUNTER DATA ENTRY PCE Encounter Data Entry PXCE ENCOUNTER ENTRY & DELETE PCE Encounter Data Entry and Delete PXCE ENCOUNTER ENTRY SUPER PCE Encounter Data Entry - Supervisor Install Time - 1 minute 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. COMPONENTS SENT WITH PATCH -------------------------- 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: ;;1.0;PCE PATIENT CARE ENCOUNTER;**[patch list]**;Aug 12, 1996 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== PXAIVST 4475034 5345807 5,9,15,74,111 96 PXCEVFI2 9289770 9333893 22,73,95,96 PXKCO 3403563 4137094 28,41,96 PXUTLSTP 4878652 6159240 1,96 Total number of routines - 4 4. 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 Verify Checksums in Transport Global Print Transport Global Compare Transport Global to Current System Backup a Transport Global Install Package(s) Restart Install of Package(s) Unload a Distribution Select Installation Option: 5. Select Installation Option: --------------------------- NOTE: When prompted for the INSTALL NAME, enter PX*1.0*96. 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 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 the patch is installed. It compares all components of the patch. c. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. 6. 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: SDAM APPT CHECK IN/OUT [Appointment Check-in/Check-out] SDAM APPT MGT [Appointment Management] SDAM APPT UPDATE [Appointment Status Update] SDAM APPT UPDATE MENU [Appointment Status Update Menu] PXCE ENCOUNTER DATA ENTRY [PCE Encounter Data Entry] PXCE ENCOUNTER ENTRY & DELETE [PCE Encounter Data Entry and Delete] PXCE ENCOUNTER ENTRY SUPER [PCE Encounter Data Entry-Supervisor] e. When prompted 'Enter protocols you wish to mark as "Out Of Order':' press , 7. REBUILD MAPPED ROUTINE(S) (DSM for Open VMS sites only) ========================== 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: ==================== Routine Name: - PXAIVST Routine Checksum: Routine Name: - PXCEVFI2 Routine Checksum: Routine Name: - PXKCO Routine Checksum: Routine Name: - PXUTLSTP Routine Checksum: ============================================================================= User Information: Entered By : HARDING,PETER Date Entered : JUN 28, 2000 Completed By: RUDINGER,NANCY L Date Completed: JUL 03, 2003 Released By : NELSON,VICKI M Date Released : JUL 03, 2003 ============================================================================= Packman Mail Message: ===================== $END TXT