============================================================================= Run Date: JAN 26, 2004 Designation: PXRM*1.5*21 Package : PXRM - CLINICAL REMINDERS Priority: Mandatory Version : 1.5 SEQ #20 Status: Released Compliance Date: FEB 26, 2004 ============================================================================= Associated patches: (v)PXRM*1.5*18 <<= must be installed BEFORE `PXRM*1.5*21' Subject: Iraq,Afghan Deployment Reminder Category: - Other - Routine Description: ============ This patch releases a new NATIONAL reminder and dialog required for the Iraq &Afghan Post-Deployment Reminder project. It is placed into the REMINDER EXCHANGE file (#811.8). VA-IRAQ &AFGHAN POST-DEPLOY SCREEN This clinical reminder patch has been developed by the Office of Quality & Performance and the Office of Information (OI) System Design & Development (SDD) Health Data systems group. PRINT NAME: Iraq&Afghan Post-Deployment Screen REMINDER DESCRIPTION: Patients who served in combat in either Iraq (Operation Iraqi Freedom) or in Afghanistan (Operation Enduring Freedom) should be screened for illnesses related to their service. Screening for PTSD, depression, problem alcohol use, infectious diseases, and chronic symptoms should be part of the initial evaluation of these Veterans. COHORT: veterans with separation date after 9/11/01. This finding is part of the reminder term: IRAQ/AFGHAN PERIOD OF SERVICE and is determined by a computed finding. RESOLUTION: entry of a health factor for NO IRAQ/AFGHAN SERVICE which is found in the reminder term IRAQ/AFGHAN SERVICE NO will resolve the reminder. If the veteran served in Iraq or Afghanistan (IRAQ/AFGHAN SERVICE) then all the other items are required to resolve the reminder: 1) screen for PTSD, 2) screen for depression, 3) screen for alcohol use, 4) all 4 screening questions related to infectious diseases and other symptoms. An entry of IRAQ/AFGHAN SERVICE on the reminder dialog then requires all of the screening questions to be answered. All of the individual elements of the screening tool are exported with attached health factors and reminder terms. The national health factors and reminder terms for the 2 question depression screen are used for the depression screening. The reminder dialog for alcohol screening allows the use of the standard AUDIT-C tool from the Mental Health package or entry of a refusal or entry of a health factor for no alcohol in the past year. The reminder term for ALCOHOL USE SCREEN contains the AUDIT-C and CAGE from the Mental Health package, the health factor for no alcohol use in the past year and the health factor for refusal. Additional health factors are included for PTSD screening and for the Infectious Diseases/Chronic symptoms screening. If your site does PTSD screening, then you will need to map your local health factors to the national PTSD reminder term (PTSD SCREEN) that is exported with this reminder. The Health Factors for all of these screens should be entered in the site parameters as ones that cannot be added outside of a reminder dialog. Use the parameter ORWPCE EXCLUDE HEALTH FACTORS to exclude these from the electronic encounter forms. Entry of these health factors should ONLY occur during reminder dialog use. REMINDER FREQUENCY: 99Y FINDING ITEM: IRAQ/AFGHAN SERVICE NO USE IN RESOLUTION LOGIC: OR FINDING ITEM: IRAQ/AFGHAN PERIOD OF SERVICE USE IN PATIENT COHORT LOGIC: AND EFFECTIVE DATE: SEP 11, 2001 During the Alcohol Screen, if the patient answers yes to consuming alcohol in the past year and the user clicks on that response in the dialog, a button for completing the Audit-C will appear which consists of asking the patient 3 Audit-C questions. If the user does NOT do the Audit-C at that point, the reminder will not be resolved since the reminder requires completion of all of the elements. The reminder will continue to show as DUE on the cover sheet and the details will indicate that no alcohol screen has been done. The reminder requires the entry of something that represents an alcohol use screen in order to be satisfied. The reminder term for alcohol use screen contains the HF for 'no alcohol use in the past year' and the CAGE and the AUDIT-C. Functionality to require completion of AUDIT-C mandatory if the patient answers 'Yes' to alcohol consumption in the past year will be included in the release of CPRS GUIv24 in February 2004. Documentation: ============== Updated documentation describing the new functionality introduced by this patch is available in a new Iraq & Afghan Post Deployment Screen Reminder Setup Guide. The preferred method is to FTP the files from download.vista.med.va.gov. This transmits the files from the first available FTP server. Sites may also elect to retrieve software directly from a specific server as follows: Albany ftp.fo-albany.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov This documentation will be in the form of an Adobe Acrobat file: PXRM_1_5_21_SETUP.PDF (Iraq & Afghan Post Deployment Reminder Setup Guide). The documentation can also be found on the Health System Design and Development web page:(http://vista.med.va.gov/vdl/). Build Components: ================= Data: ===== REMINDER EXCHANGE FILE FILE #811.8 IRAQ &AFGHAN POST DEPLOY SCREEN Host File: ========== This patch will be available only as a host file. The name of the file is PXRM_1_5_21.KID. Sites will retrieve VistA software via FTP. The preferred method is to FTP the file from download.vista.med.va.gov. This transmits the file from the first available FTP server. Sites may also elect to retrieve software directly from a specific server as follows: Albany ftp.fo-albany.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov ROUTINES: ========= The following routines are included in this patch. The second line looks like: ;;1.5;CLINICAL REMINDERS;**[Patch List]**;Jun 19, 2000 Routine: Old Checksum New Checksum Patch List ======== ============ ============ ========== PXRMP21I NEW 632086 21 PXRMP21E NEW 348881 21 PXRMPDEM 921874 1617143 2,7,14,21 Sites should use CHECK^XTSUMBLD to verify checksums. NOTE: The routine PXRMPDEM is installed with the Computed Finding, VA-IRAQ & AFGHAN SEP DATE, through the Exchange Utility. Install Instructions: ===================== **DON'T QUEUE THIS PATCH FOR INSTALLATION** It may ask questions during the reminder installation of the patch. This patch should be loaded during non-peak hours to minimize disruption to users, who can remain on the system during installation. Installation will take approximately 3 minutes. The environment routine will check to see if the site is running version 1.5 of Clinical Reminder and abort if it is running another version. 1. Use the 'Load a Distribution' option on the KIDS installation menu. When prompted to enter a host file, type in PXRM_1_5_21.KID. 2. Review your mapped set. If any of the routines are mapped, they should be removed from the mapped set at this time. 3. On the KIDS menu under the 'INSTALLATION' menu, use the following options as desired: Print Transport Global Compare Transport Global to Current System Verify checksums in Transport Global Backup a Transport Global 4. On the KIDS menu under the 'INSTALLATION' menu, use the following options to install the patch: Install Packages(s) (PXRM*1.5*21) 5. When prompted "Want KIDS to INHIBIT LOGON's during the install? YES//", respond "NO". 6. When prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//" respond "NO". 7. If any routines were unmapped as part of step 2, they should be returned to the mapped set once the installation has run to completion. 8. The init routine PXRMP21I may be deleted once the installation has completed successfully. 9.The init routine PXRMP21E may be deleted once the installation has completed successfully. 10. Please refer to the Setup Guide to continue the implementation of the reminder. Routine Information: ==================== Routine Name: - PXRMP21I Routine Checksum: Routine Name: - PXRMP21E Routine Checksum: Routine Name: - PXRMPDEM Routine Checksum: ============================================================================= User Information: Entered By : SMITH,VAUGHN Date Entered : OCT 21, 2003 Completed By: STERNHAGEN,SHERRIL Date Completed: JAN 23, 2004 Released By : BELSCHWINDER,MICHAEL Date Released : JAN 26, 2004 ============================================================================= Packman Mail Message: ===================== No routines included