============================================================================= Run Date: AUG 31, 2000 Designation: PXRM*1.5*1 Package : PXRM - CLINICAL REMINDERS Priority: Mandatory Version : 1.5 SEQ #1 Status: Released ============================================================================= Subject: Hepatitis C Extract Category: - Informational - Data Dictionary - Routine - Print Template - Sort Template Description: ============ The Hepatitis C Extract project was created to meet Hepatitis C Initiative requirements. The House Veterans Affairs Committee requires periodic reporting by Veterans Health Administration (VHA) on progress toward screening all veterans for Hepatitis C Virus (HCV). The VHA Headquarters Infectious Disease Program Office will provide the periodic reports. These reports will be based on HCV information extracted from VHA facilities and stored in the Emerging Pathogens Initiative (EPI) database located at the Austin Automation Center (AAC). The HCV information includes Hepatitis C risk assessment, laboratory tests, and medications provided to the veteran population. Tracking this information will allow the Infectious Disease Program Office to respond to Congressional queries about HCV veteran care. This project consists of four patches that work together to accomplish EPI search, extraction, and reporting requirements for Hepatitis A, B, and C: PXRM*1.5*1 Hepatitis C Extract LR*5.2*260 Hepatitis C Extract PSJ*5*48 Hepatitis C Extract PSO*7*45 Hepatitis C Extract These patches are combined into a single build for ease of installation at VHA facilities: HEP_C_EXTRACT_1_0.KID Documentation is available in Portable Document Format (PDF): Hepatitis C Extract Installation and Setup Guide PXRMP1.PDF Laboratory Search/Extract Technical and User Guide LR_260TUG.PDF The build and documentation are available at the following locations: Albany 152.127.1.5 anonymous.software Hines 152.129.1.110 anonymous.software Salt Lake City 152.131.2.1 anonymous.software Patch Description specific to PXRM*1.5*1 ======================================== This patch adds: * 2 new reminder definitions to the REMINDER DEFINITION file (811.9) * 18 new national terms to the REMINDER TERM file (811.5) * 1 new file, REMINDER EXTRACT SUMMARY (810.3), that temporarily stores data extracted from reminder evaluation processing when updating the EPI database. This temporary data can be used to compare to data in HL7 messages sent to the EPI database, and validate that the appropriate data is extracted. * 2 new options added to the PXRM REMINDER REPORTS option menu to print data from the REMINDER EXTRACT SUMMARY file (810.3) * 2 new sort templates, one to identify terms to distribute and one for the REMINDER EXTRACT SUMMARY file * 3 new print templates, all related to reporting the EPI findings This patch modifies the: * description in the VA-HEP C RISK ASSESSMENT reminder definition * description for 3 previously distributed Reminder Terms * name and description for the Reminder Term PREV POSITIVE TEST FOR HEP C, which is renamed PREVIOUSLY ASSESSED HEP C RISK This patch will work with the LR*5.2*260 patch and two pharmacy patches (PSO*7*45 and PSJ*5*48) to extract Hepatitis C risk assessment, laboratory and medication data. The extracted data will be used to update the EPI database at the AAC. General Overview: ================= This patch is released in response to Congressional reporting requirements and a policy letter distributed by the Under Secretary of Health addressing treatment of Hepatitis patients. The data extracted for Risk Assessment is based on the VA-HEP C RISK ASSESSMENT reminder definition. The data extracted from laboratory is based on the VA-NATIONAL EPI LAB EXTRACT reminder, previously distributed as VA-NATIONAL EPI DB UPDATE. Both of these reminders were first released in the Clinical Reminders V.1.5 package. A new reminder definition, VA-NATIONAL EPI RX EXTRACT, is distributed in this patch for extracting medications. These three reminder definitions provide the criteria for extracting the risk assessment, lab, and medication data. The reminder evaluation and update to the EPI database occurs on the 15th of the month following the reporting month. The option that manages this update is the LREPI NIGHTLY TASK. This task currently runs nightly at each site. Note: The monthly task on the 15th occurs because the LAG DAYS field in the LAB SEARCH/EXTRACT file (69.5) is set to "15" for each pathogen. The LR*5.2*260 patch contains new processing logic that sends data extracted from reminder extract results to the EPI database. This patch also fixes a problem where CUSTOMIZED PATIENT COHORT LOGIC was not being used in the reminder evaluation. (NOIS SLC-0600-52703). NOIS Messages: ============== SLC-0600-52703 MON-0800-50154 Build Components: ================= Data Dictionary for three files: REMINDER EXTRACT SUMMARY (810.3) (new) REMINDER DEFINITION (811.9) REMINDER TERM (811.5) Options: PXRM REMINDER REPORTS menu (description change; lists new options) PXRM REMINDERS DUE (no change, just attach to menu) PXRM EXTRACT EPI TOTALS (new) PXRM EXTRACT EPI FINDING LIST (new) Print Templates to print data from the REMINDER EXTRACT SUMMARY: PXRM EXTRACT EPI FINDING LIST (new) PXRM EXTRACT EPI FINDING HDR (new) PXRM EXTRACT EPI FINDING TOT (new) Sort Templates: PXRM EPI LAB AND MED TERMS (new) (identifies reminder terms to include in this patch) PXRM EXTRACT EPI BY FIND_PT (new) (sorts the extract data in the REMINDER EXTRACT SUMMARY file) Routines: The second line of each routine looks like: ;;1.5;CLINICAL REMINDERS;**1**;June 19, 2000 Routine Old Checksum New Checksum Patch List ======= ============ ============ ========== PXRMLOGX 3009219 3005995 **1** PXRMP1I n/a 2412825 **1** PXRMP1IE n/a 349212 **1** PXRMTERM 6249864 6249864 **1** PXRMXX 2465756 9832947 **1** PXRMXX1 n/a 8675493 **1** PXRMXX2 n/a 8200381 **1** PXRMXXT n/a 573203 **1** REQUIRED BUILDS: ================ CLINICAL REMINDERS 1.5 INSTALLATION INSTRUCTIONS: ========================== The instructions for installation and implementation of the HEP_C_EXTRACT_1_0.KID build are included in the PXRMP1.PDF file. This patch should be loaded during non-peak hours to minimize disruption to users. Installation will take less than 15 minutes. **Warning** When an option is included in the patch build, the question REBUILD MENUS is asked as a PRE-INSTALL question. If you choose to have KIDs rebuild the menus it will happen at the end of the build installation and may take several hours. POST INSTALLATION INSTRUCTIONS ============================== The details of the setup to be completed is available in the documentation. Generally, these steps need to be done by the REMINDERS MANAGER or the CLINICAL REMINDERS APPLICATION COORDINATOR. The success of the Hepatitis C updates to the EPI database will depend on a Hepatitis Team at your site addressing all of the issues in the documentation. DETAILED DESCRIPTION: ===================== Data Dictionary: 1. REMINDER DEFINITION file (811.9) The reminder for VA-NATIONAL EPI DB UPDATE may be used at sites to determine whether a patient has data that is sent to the Austin Automation Center to update the national EPI database. 2. REMINDER TERM file (811.5) There are twenty reminder terms used by the lab and pharmacy extract reminders. Eighteen of these terms are newly distributed in this file. These new terms represent Hepatitis A, Hepatitis B and Hepatitis C lab and medication information. The reminder terms may be used at sites in locally defined reminders for clinicians providing clinical care for Hepatitis patients. Hepatitis A laboratory reminder terms: HAV Ab positive Hepatitis A virus antibody total positive HAV IgM Ab positive Hepatitis A virus antibody immunoglobulin M positive HAV IgG positive Hepatitis A virus antibody immunoglobulin G positive Bilirubin Hepatitis B laboratory reminder terms: HBs Ag positive Hepatitis B surface antigen positive HBc Ab IgM positive Hepatitis B core antibody immunoglobulin M positive HBs Ab positive Hepatitis B surface antibody positive HBe Ag positive Hepatitis B e antigen positive Hepatitis C laboratory reminder terms: HEP C VIRUS ANTIBODY NEGATIVE HEP C VIRUS ANTIBODY POSITIVE TRANSFERASE (AST) (SGOT) ALANINE AMINO (ALT) (SGPT) Hepatitis Medications (based on VA GENERIC file): INTERFERON ALFA-2A INTERFERON ALFA-2B INTERFERON ALFA-2B/RIBAVIRIN INTERFERON ALFA-3N INTERFERON ALFACON-1 INTERFERON BETA-1A INTERFERON BETA-1B RIBAVIRIN Sort Template: PXRM EPI LAB AND MED TERMS contains reminder term entries defined above to distribute with the REMINDER TERM (811.5) data dictionary. PXRM EXTRACT EPI BY FIND_PT sorts an extract by Finding Item and SSN. This sort template may be useful when looking up an SSN to compare findings to an error message returned to the site from the AAC. When the AAC has problems processing a sites extracted data, the original extract message and SSN are returned to the site in an error message for review and correction. Routine Information: ==================== Routine Name: - PXRMLOGX Routine Checksum: Routine Name: - PXRMXX Routine Checksum: Routine Name: - PXRMXX1 Routine Checksum: Routine Name: - PXRMXX2 Routine Checksum: Routine Name: - PXRMXXT Routine Checksum: Routine Name: - PXRMP1I Routine Checksum: Routine Name: - PXRMTERM Routine Checksum: ============================================================================= User Information: Entered By : TROST,DEBBIE Date Entered : JUN 21, 2000 Completed By: ANTRY,MIKE Date Completed: AUG 31, 2000 Released By : CARLSON-GOTTS,NANCY Date Released : AUG 31, 2000 ============================================================================= Packman Mail Message: ===================== No routines included