============================================================================= Run Date: APR 17, 2001 Designation: PXRM*1.5*2 Package : PXRM - CLINICAL REMINDERS Priority: Mandatory Version : 1.5 SEQ #3 Status: Released ============================================================================= Associated patches: (v)PSO*7*54 <<= must be installed BEFORE `PXRM*1.5*2' (v)DI*22*67 <<= must be installed BEFORE `PXRM*1.5*2' (v)PXRM*1.5*3 <<= must be installed BEFORE `PXRM*1.5*2' Subject: Clinical Reminders Fixes and Enhancements Category: - Data Dictionary - Routine - Print Template - Input Template - Enhancement (Mandatory) Description: ============ General Overview: ================= This patch provides a number of NOIS fixes as well as minor enhancements. Detailed descriptions of the changes follow: 1. Inquiry Option changes: 1.1 All inquiry functions were consolidated into a standard set of print templates and routines. Previously all fields in the FINDINGS multiple of the REMINDER DEFINITION (#811.9) and REMINDER TERM (#811.5) files were printed, even if they were null. Now only non-null fields will be printed. This should provide considerably shorter output. 1.2 There was a bug in the taxonomy inquiry that caused the ICD Operation/Procedure to be displayed incorrectly. This problem is corrected. NOIS: CIN-0900-42457, FAR-0800-40686, HUN-1000-20744, LAH-0101-60194, PHI-0101-20893, V01-0201-N0005. 1.3 If display of the FINDINGS multiple required more than one page, there was no page breaking. Proper page breaking is now done. 2. Data dictionary changes: 2.1 A number of fields in the REMINDER TAXONOMY (#811.2) and REMINDER DEFINITION (#811.9) files were made obsolete when Clinical Reminders version 1.5 was released. These fields are deleted by this patch, as well as the associated AC and C cross references in file 811.9. 2.2 Due to the way KIDS works, security codes were not properly set on the previously existing Clinical Reminders' files when Clinical Reminders version 1.5 was installed. The security codes are set to their proper values during the post-install. 2.3 A VERSION field was added to CLINICAL REMINDER PARAMETERS file (#800) to store the current version number of the package. This patch will initially set the VERSION field to "1.5". 2.4 Moved the CONDITION field in the REMINDER TERM (#811.5) and REMINDER DEFINITION (#811.9) files to a separate node. It now has a maximum length of 225 characters instead of 52. Also added the new field CONDITION CASE SENSITIVE to the FINDINGS multiple in the same two files. When this has a value of "NO" the condition evaluation will not be case sensitive. The default is "YES". 2.5 Added the new field EFFECTIVE DATE to the FINDINGS multiple in the REMINDER TERM (#811.5) and REMINDER DEFINITION (#811.9) files. A finding with a date older than the EFFECTIVE DATE will be treated as false. An updated version of the VA-HEP C RISK ASSESSMENT reminder definition is included. In this definition the EFFECTIVE PERIOD of 2Y is replaced by an EFFECTIVE DATE of October 1, 1998. If your site has created a dialog for this reminder you will need to relink it to the dialog after the install has finished. 3. Reminder Evaluation/Clinical Maintenance changes: 3.1 The Computed Finding VA-RACE was not returning the patient's race correctly. This was fixed. NOIS: CTX-0900-70341, WPB-0700-30774. 3.2 Inpatient medications were not being found for drug findings. This was fixed. Drug finding evaluations were made more efficient. This also requires Outpatient Pharmacy patch PSO*7*54. NOIS: BRX-0900-12529. 3.3 The code that calls the TIU object expansion was passing a pointer to the INSTITUTION file (#4) instead of the required HOSPITAL LOCATION file (#44). It was fixed. NOIS: FGH-0700-32788. 3.4 When there was no match between any of the baseline age ranges and the patient's age, making the reminder N/A due to age, the output was still appearing in the Clinical Maintenance component even, if IGNORE ON N/A was set. This was fixed. 3.5 Locking of expanded taxonomies was made more robust. It no longer generates an error when it fails to get a lock. It now produces a "no lock" message. NOIS: CHA-0900-30869. 3.6 Added display of Problem List priorities (acute or chronic) in the Clinical Maintenance output. NOIS: UNY-0900-12325 3.7 The wildcard form of IGNORE ON N/A was not working correctly when the reminder was N/A because the PATIENT COHORT LOGIC evaluated to false. This was fixed. NOIS: HOU-1100-72053 3.8 A term with more than one drug finding was not always working correctly. This was fixed. NOIS: SAG-1200-40405 3.9 A change was made in the calculation of the resolution date for complex resolutions. Previously, the most recent date was used. Now, if two findings are ANDed, the oldest date is used. If two findings are ORed, the most recent date is used. If the logic is complex, then the date is determined by using the above rules. NOIS: HIN-0900-40246, WRJ-0101-11399. 3.10 Previously, when a health factor without a category - which is a required field - was encountered during the reminder evaluation, it caused a null subscript error. Now, when a health factor without a category is encountered, a warning message will be sent to the user and the reminders mailgroup (if the mailgroup is defined). The health factor will be ignored in the reminder evaluation and the null subscript errors will be eliminated. NOIS: UNY-0900-10369 3.11 When set, the IGNORE ON N/A field was suppressing the Summary component output in addition to the Maintenance component. It should suppress only the Maintenance component output. It now works correctly. 3.12 The CONDITION field can now be used with all finding types. Previously, all drug findings, radiology procedures, and taxonomies would not allow the use of CONDITION because there is no value for these findings. These findings still do not return a value to test against, but there is now a standard set of variables that can be used in all CONDITIONS. These variables are: PXRMAGE - patient's age PXRMDOB - patient's date of birth in FileMan format PXRMRACE - patient's race (this is the text from the RACE file) PXRMSEX - patient's sex, in the format M^MALE or F^FEMALE 3.13 When there was no reminder frequency the error message "Patient does not meet any age criteria" was being displayed instead of "There is no reminder frequency". NOIS: MAC-0201-61450 3.14 For a historical encounter the internal entry number of the Institution file was being displayed instead of the station number. A change was made to display the station number. NOIS: BUT-0201-22423 4. Reminder List Option changes: 4.1 When doing a Reminder List, typing a ^ at a prompt caused an undefined error instead of taking the user to the previous prompt. This was fixed. NOIS: HUN-0700-21914, HUN-1100-22185, SFC-1100-60475. 5. Reminder Dialog changes: 5.1 Dialog elements with sequence numbers >100 created by generating dialogs for reminders with >20 findings could not be edited unless the sequence number was first changed to <100. This is corrected and additional validation is also included to prevent duplicate sequence numbers being entered. NOIS: MIA-1100-32057, WPB-0800-30571. 5.2 A dialog group could be entered as a dialog element within itself. The result was that stack errors were generated when running the reminder dialog containing the group multiple. The REMINDER DIALOG file (#801.41) is corrected so that a dialog group may no longer be entered as a dialog element within itself. NOIS: SLC-0800-52045 and WAS-0700-21656 5.3 Auto generated dialog elements for contraindicated immunizations included an additional prompt - PXRM VISIT DATE - that was not displayed in the reminder dialog. This is corrected so that the PXRM VISIT DATE prompt displays in the reminder dialog. NOIS: HUN-1000-21282 5.4 Dialog elements for exams occasionally displayed a code value instead of the exam name in the encounter window of the reminder dialog. This is corrected to show the exam name. NOIS: SPO-1000-52529 5.5 Editing dialog groups within the CV option of reminder dialogs now uses the same editor as is used for reminder dialogs. Dialog group elements may be edited, copied/renamed or deleted. It is no longer necessary to build component dialog elements before building the dialog group. Elements may be created from within the dialog group screen. NOIS: WIC-1000-42229 5.6 A problem was reported by San Diego where the reminder categories in CPRS GUI display the wrong reminders. This is corrected. NOIS: SDC-1000-61815 5.7 If a reminder taxonomy was created after the installation of the Clinical Reminders package, selectable codes were not generated for the taxonomy dialog. This is changed so that taxonomy dialog edit will auto-create the selectable codes if none exist. NOIS: CHA-1100-30888 5.8 If multiple web sites were entered for a reminder and the first 30 characters of the URLs were the same, only the first of the web sites would display in the 'reference information' section of the GUI. This is corrected. NOIS: MAC-1100-60409 5.9 The GROUP ENTRY field of the REMINDER DIALOG file (#801.41) used for dialog groups is extended to allow a new code: 3 None or One Selection 5.10 The forced value 'PXRM REPEAT CONTRAINDICATED' released with the reminder package had the default value incorrectly set to 'YES'. As a result, the contraindicted field in PCE was not being updated because it expects a 1 or 0. This is corrected by patch 2 which sets the default value from YES to 1. 5.11 Dialog copy of additional prompts now allows the prompt to be changed into a forced value if the prompt updates PCE or Vitals data. NOIS HVH-1200-11111. 5.12 Dialog edit screens now return to the selection screen from which the edit was initiated. NOIS: PUG-1200-52077 5.13 CPRS Lookup Categories now display sub-categories in display order and show the display sequence number. NOIS: PUG-0101-50004 5.14 Edit template for dialog groups (PXRM EDIT GROUP) now allows additional prompts for a group level finding to be excluded from progress note text. NOIS: WAS-0700-21999 6. Reminder Reports: 6.1 Reminders Due Report displays 'See below' if future appointments exist outside of the selected location and the 'Display All Future Appointments' option is being used. NOIS: FAR-1000-42813 NOIS Messages: ============== BRX-0900-12529 BUT-0201-22423 CHA-0900-30869 CHA-1100-30888 CIN-0900-42457 CTX-0900-70341 EKH-1000-42980 FAR-0800-40686 FAR-1000-42813 FGH-0700-32788 HIN-0900-40246 HOU-1100-72053 HUN-0700-21914 HUN-1000-20744 HUN-1000-21282 HUN-1000-22185 HVH-1200-11111 LAH-0101-60194 MAC-1100-60338 MAC-1100-60409 MAC-0201-61450 MIA-1100-32057 PHI-0101-20893 PUG-1200-52077 PUG-0101-50004 SAG-1200-40405 SDC-1000-61815 SFC-1100-60475 SLC-0800-52045 SPO-1000-52529 UNY-0900-10369 UNY-0900-12325 V01-0201-N0005 WAS-0700-21656 WAS-0700-21999 WIC-1000-42229 WPB-0700-30744 WPB-0800-30571 WRJ-0101-11399 Documentation: ============== Updated documentation describing the new functionality introduced by this patch is available. 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 Adobe Acrobat files. The complete Clinical Reminders Manager Manual is PXRM.PDF The documentation can also be found on the System Design and Development Web page: (http://vista.med.va.gov/vdl/). Build Components: ================= Data Dictionary: ================ 800 CLINICAL REMINDER PARAMETERS 801.41 REMINDER DIALOG 811.2 REMINDER TAXONOMY 811.5 REMINDER TERM 811.9 REMINDER DEFINITION Input Templates: ================ PXRM EDIT NATIONAL TERM FILE #811.5 PXRM EDIT REMINDER TERM FILE #811.5 PXRM EDIT GROUP FILE #801.41 Options: ======== PXRM TAXONOMY EDIT Print Templates: ================ PXRM DEFINITION INQUIRY FILE #811.9 PXRM DEFINITION LIST FILE #811.9 PXRM TAXONOMY INQUIRY FILE #811.2 PXRM TAXONOMY LIST FILE #811.2 PXRM TERM INQUIRY FILE #811.5 Protocols ========= PXRM DIALOG GROUP MENU PXRM DIALOG COPY, PXRM DIALOG DETAILS PXRM DIALOG EDIT PXRM DIALOG EXIT PXRM DIALOG P/N TEXT PXRM DIALOG TEXT Routines: ========= The following is a list of the routines included in this patch. The routines listed as "N/A" under the New Checksum column are deleted with this build. Routine PXRMP2I is deleted after the post-install. The second line of each routine looks like: ;;1.5;CLINICAL REMINDERS;**[Patch List]**;Jun 19, 2000 Routine Old Checksum New Checksum Patch List ======== ============ ============ ========== PXRM 3816281 4276601 2 PXRMAGE 3398678 3397400 2 PXRMBXTL 3201909 3438802 2 PXRMCAT 3145185 3330747 2 PXRMCF 3397035 3801455 2 PXRMCFED 543812 798554 2 PXRMDATE 4435925 4517542 2 PXRMDCPY 5408718 6126482 2 PXRMDD41 1091179 1140872 2 PXRMDEDT 9206221 10300729 2 PXRMDGEN 3699225 4225676 2 PXRMDGPT 10492083 10626355 2 PXRMDHLP 13385107 13568838 2 PXRMDLG 6508726 7537029 2 PXRMDLG1 8128481 9632990 2 PXRMDLG2 3543072 5420627 2 PXRMDLGH 4498235 4519609 2 PXRMDLGZ 5844728 5872662 2 PXRMDLL 9778396 10147371 2 PXRMDLLA 9800444 10050318 2 PXRMDRCL 3842208 4371963 2 PXRMDRUG 5864311 8714771 2 PXRMEDU 3849331 4278237 2 PXRMERRH 3620664 3648519 2 PXRMEXAM 3831349 4270459 2 PXRMFOUT 2872675 3100525 2 PXRMGEDT 3304615 6058517 2 PXRMHF 8880190 9700858 2 PXRMHL7 688053 686776 2 PXRMHOST NEW 1336573 2 PXRMIMM 4398662 4834048 2 PXRMINQ 1592893 2902345 2 PXRMLAB 3865324 4273456 2 PXRMLOG 6824235 7572721 2 PXRMMEAS 3614991 4013021 2 PXRMMH 5534594 5944952 2 PXRMMSG NEW 449608 2 PXRMOPT 9291744 10078727 2 PXRMORDR 3743577 4144019 2 PXRMP2I NEW 5005097 2 PXRMPDEM 221119 210698 2 PXRMPINF 2111744 2175542 2 PXRMPROB 4254831 4416909 2 PXRMPTDF NEW 5394581 2 PXRMPT 4472285 N/A 2 PXRMPTL 4286810 4213780 2 PXRMPTTR NEW 2725320 2 PXRMPTTX NEW 2069535 2 PXRMRAD 5221163 5833093 2 PXRMRCPT 2466387 2533523 2 PXRMREDF 2453701 2417599 2 PXRMRIN2 7477789 N/A 2 PXRMRIN3 4062919 N/A 2 PXRMRLST 2961893 3039774 2 PXRMRPCA 9792377 9804337 2 PXRMRPCC 2283217 2283809 2 PXRMRUTL 2008056 2010864 2 PXRMSEL 9370492 9364011 2 PXRMSKIN 4154373 4594812 2 PXRMTAX 6312205 7229778 2 PXRMTDLG 2691148 2854658 2 PXRMTDUP NEW 3660612 2 PXRMTEDT 746070 812846 2 PXRMUTIL 2780351 4126777 2 PXRMV1I 5530187 N/A 2 PXRMV1IA 7961867 N/A 2 PXRMV1ID 3591902 N/A 2 PXRMV1IE 1518945 N/A 2 PXRMV1IG 2452372 N/A 2 PXRMV1IH 2517295 N/A 2 PXRMV1X 571258 N/A 2 PXRMV1X1 273779 N/A 2 PXRMVCPT 2077093 2144229 2 PXRMVPOV 3475533 3542669 2 PXRMVPTR 218074 672795 2 PXRMVSIT 1013124 1086391 2 PXRMXAP 2600970 2562625 2 PXRMXPR 5961989 6077381 2 Host File: ========== Due to its size this patch will be available only as a host file. The name of the file is PXRM_1_5_2.KID. Sites will retrieve VistA software from the following FTP addresses. 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 Installation: ============= This patch can be loaded with users on the system; however, we recommend installtion during non-peak hours. The installation time will vary depending on the size of your patient cache. Test sites have experienced installation times between 1 and 35 minutes. During this time your users may experience slow system response. 1. Download the KIDS file PXRM_1_5_2.KID via FTP. Move the file to the appropriate directory on your system. 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 option: Load a Distribution When prompted for the file name, type in the directory where you have stored the KIDS build, followed by PXRM_1_5_2.KID. An example for a VMS system is [ANON]:PXRM_1_5_2.KID. 4. 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 5. On the KIDS menu under the 'INSTALLATION' menu, use the following option to install the patch: Install Package(s) (PXRM*1.5*2) 6. When prompted "Want KIDS to INHIBIT LOGONs during the install? YES//", respond 'NO'. 7. 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: GMTS* PXRM* IBDF PRINT* IBDF PRINT FORM OR CPRS GUI CHART ORS HEALTH SUMMARY **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. When prompted to select the protocols you would like to place out of order, enter the following: ORS AD HOC HEALTH SUMMARY ORS HEALTH SUMMARY PXRM PATIENT DATA CHANGE 8. 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. Routine Information: ==================== Routine Name: - PXRM Routine Checksum: Routine Name: - PXRMAGE Routine Checksum: Routine Name: - PXRMBXTL Routine Checksum: Routine Name: - PXRMCF Routine Checksum: Routine Name: - PXRMDATE Routine Checksum: Routine Name: - PXRMDD41 Routine Checksum: Routine Name: - PXRMDGEN Routine Checksum: Routine Name: - PXRMDGPT Routine Checksum: Routine Name: - PXRMDLG Routine Checksum: Routine Name: - PXRMDLL Routine Checksum: Routine Name: - PXRMDLLA Routine Checksum: Routine Name: - PXRMDRCL Routine Checksum: Routine Name: - PXRMDRUG Routine Checksum: Routine Name: - PXRMEDU Routine Checksum: Routine Name: - PXRMERRH Routine Checksum: Routine Name: - PXRMEXAM Routine Checksum: Routine Name: - PXRMHF Routine Checksum: Routine Name: - PXRMHOST Routine Checksum: Routine Name: - PXRMIMM Routine Checksum: Routine Name: - PXRMINQ Routine Checksum: Routine Name: - PXRMLAB Routine Checksum: Routine Name: - PXRMMEAS Routine Checksum: Routine Name: - PXRMMH Routine Checksum: Routine Name: - PXRMOPT Routine Checksum: Routine Name: - PXRMORDR Routine Checksum: Routine Name: - PXRMP2I Routine Checksum: Routine Name: - PXRMPDEM Routine Checksum: Routine Name: - PXRMPINF Routine Checksum: Routine Name: - PXRMPROB Routine Checksum: Routine Name: - PXRMPTDF Routine Checksum: Routine Name: - PXRMPTL Routine Checksum: Routine Name: - PXRMPTTR Routine Checksum: Routine Name: - PXRMPTTX Routine Checksum: Routine Name: - PXRMRCPT Routine Checksum: Routine Name: - PXRMREDF Routine Checksum: Routine Name: - PXRMRLST Routine Checksum: Routine Name: - PXRMRPCC Routine Checksum: Routine Name: - PXRMSKIN Routine Checksum: Routine Name: - PXRMTAX Routine Checksum: Routine Name: - PXRMTEDT Routine Checksum: Routine Name: - PXRMUTIL Routine Checksum: Routine Name: - PXRMVCPT Routine Checksum: Routine Name: - PXRMVPOV Routine Checksum: Routine Name: - PXRMXAP Routine Checksum: Routine Name: - PXRMDEDT Routine Checksum: Routine Name: - PXRMDLG1 Routine Checksum: Routine Name: - PXRMDLG2 Routine Checksum: Routine Name: - PXRMRPCA Routine Checksum: Routine Name: - PXRMGEDT Routine Checksum: Routine Name: - PXRMTDLG Routine Checksum: Routine Name: - PXRMTDUP Routine Checksum: Routine Name: - PXRMLOG Routine Checksum: Routine Name: - PXRMDCPY Routine Checksum: Routine Name: - PXRMDLGZ Routine Checksum: Routine Name: - PXRMDHLP Routine Checksum: Routine Name: - PXRMDLGH Routine Checksum: Routine Name: - PXRMSEL Routine Checksum: Routine Name: - PXRMCAT Routine Checksum: Routine Name: - PXRMXPR Routine Checksum: Routine Name: - PXRMMSG Routine Checksum: Routine Name: - PXRMFOUT Routine Checksum: Routine Name: - PXRMHL7 Routine Checksum: Routine Name: - PXRMRAD Routine Checksum: Routine Name: - PXRMRUTL Routine Checksum: Routine Name: - PXRMVPTR Routine Checksum: Routine Name: - PXRMCFED Routine Checksum: Routine Name: - PXRMVSIT Routine Checksum: ============================================================================= User Information: Entered By : REDINGTON,PATRICK Date Entered : OCT 26, 2000 Completed By: MERRILL,DAVID P Date Completed: APR 17, 2001 Released By : CARLSON-GOTTS,NANCY Date Released : APR 17, 2001 ============================================================================= Packman Mail Message: ===================== No routines included