============================================================================= Run Date: AUG 31, 2005 Designation: RA*5*41 Package : RA - RADIOLOGY/NUCLEAR MEDICINE Priority: Mandatory Version : 5 SEQ #52 Status: Released Compliance Date: OCT 01, 2005 ============================================================================= Associated patches: (v)RA*5*2 <<= must be installed BEFORE `RA*5*41' (v)RA*5*26 <<= must be installed BEFORE `RA*5*41' (v)RA*5*27 <<= must be installed BEFORE `RA*5*41' (v)RA*5*34 <<= must be installed BEFORE `RA*5*41' (v)PX*1*124 <<= must be installed BEFORE `RA*5*41' (v)RA*5*45 <<= must be installed BEFORE `RA*5*41' Subject: Clinical Indicator Data Capture - Radiology Category: - Informational - Data Dictionary - Routine - Input Template - Enhancement (Mandatory) Description: ============ This patch is the Radiology/Nuclear Medicine part of the Clinical Indicator Data Capture (CIDC) project. There are no E3Rs associated with this patch; however, there is a NOIS associated with this patch, due to identical concern in validating the provider who requested the order. The NOIS is HAM-1104-20122, which is Remedy ticket HD0000000068382. The problem occurred in the 'Request an Exam' [RA ORDEREXAM] option, when a person, having a termination date in the NEW PERSON file (#200), was selectable at the "Person Requesting Order:" prompt. This patch corrects the data screening at this prompt, so that only non-terminated users with the PROVIDER key would be selectable. The software for this patch is being distributed in host file PX_CLINICAL_INDICATOR_DATA_CAPTURE.KID. The host file will contain six KIDS builds. The builds contained in the CIDC multi-package distribution are: Package Patch ------- --------- PCE PATIENT CARE ENCOUNTER PX*1.0*124 INTEGRATED BILLING IB*2.0*260 RADIOLOGY/NUCLEAR MEDICINE RA*5.0*41 SURGERY SR*3.0*119 PROSTHETICS RMPR*3.0*78 OUTPATIENT PHARMACY PSO*7.0*143 Please refer to the 'Software and Documentation Retrieval' section of the PX*1.0*124 patch description for instructions on how to acquire the patch software and install instructions. Overview ======== This enhancement will allow the Radiology package to capture Clinical Indicator information related to care provided to a patient. This patch includes changes and additions to the Radiology package as required by the Clinical Indicator Data Capture Project. Functional Description ====================== Modifications to the 'Request an Exam' [RA ORDEREXAM] and 'ADD Exams to Last Visit' [RA ADDEXAM] options were made to provide for the capture of CIDC related data. These data will be included in transmission of Orders between Radiology and CPRS GUI, where orders can be entered from either application. Technical Description ====================== There is a pre-installation routine, RA41PRE, which will run prior to the patch installation to temporarily delete the description for the CREDIT METHOD sub-field (#26) within the EXAMINATIONS multiple (#50) within the REGISTERED EXAMS multiple (#2) in the RAD/NUC MED PATIENT file (#70) and for the CREDIT METHOD field (#21) in the IMAGING LOCATIONS file (#79.1). Also, a post-installation routine RA41PST will recompile the following three input templates: RA REGISTER from the RAD/NUC MED PATIENT file (#70) RA ORDER EXAM from the RAD/NUC MED ORDERS file (#75.1) RA QUICK EXAM ORDER from the RAD/NUC MED ORDERS file (#75.1) 1. The 'Purge Data Function' [RA PURGE] option will no longer allow purging of orders from the Radiology Package. Routine RAPURGE was modified. 2. The 'Request An Exam' [RA ORDEREXAM] option will display new prompts for ICD diagnosis codes and any associated SC/EI (Service Connected / Environmental Indicators) if the user is a provider and the CIDC switch and the patient's insurance permit these prompts. The 'ADD Exams to Last Visit' [RA ADDEXAM] option may also display these new prompts, if the above conditions are met and if the added exam comes from a new order that was made within this option. The new prompts are: Copy a previous order's ICD codes and SC/EI values Primary Ordering ICD Diagnosis and Clinical Indicators related to this ICD Diagnosis Secondary Ordering ICD Diagnosis and Clinical Indicators related to this ICD Diagnosis If the conditions for user PROVIDER key, CIDC switch, and patient's insurance are satisfied, then this option will prompt the users to indicate if they want to copy the ICD Diagnosis and SC/EI values from an order previously submitted for the current patient. If the user answers "Yes", then the option will display a list of the patient's previously submitted orders and asks the user to select one of them. The selected order's ICD Diagnoses and ICD/SC/EI values, if any, will be used as default values to the new order's ICD Diagnoses and SC/EI prompts, which will be displayed later in the ordering process. The user may change, delete, and/or add to these default values. Data from the new prompts will be transmitted between Radiology and CPRS GUI, so both applications would be storing ordering ICD diagnoses and associated SC/EI values. Radiology initiated orders (backdoor orders) normally do not require electronic signatures from CPRS GUI, unless their NATURE OF ORDER is VERBAL or TELEPHONED. In these two instances, the ordering physician would receive an alert in CPRS GUI to sign off those orders. Because the CPRS sign-off process includes the updating of ICD diagnoses and SC/EI values, and there's no time limit to when a sign-off can be done, the ordering physician may update these values after the exam has already been completed. If this should happen, the transmission of this completed exam to PCE will be repeated to include the updated ICD diagnoses and SC/EI values. To accomplish the above, routines RAO7NEW, RAO7RON, RAORD1, and RAORDU1 were modified, and routines RABWORD, RABWORD1, RABWORD2 were added. 3. The following options will display the new Ordering ICD Diagnosis fields and their related data: Detailed Request Display [RA ORDERDISPLAY] Print Rad/Nuc Med Requests by Date [RA ORDERPRINTS] Print Selected Requests by Patient [RA ORDERPRINTPAT] The modified routines are: RABWUTL, RAORD3, and RAORD6 4. The screen, DIC("S"), for the REQUESTING PHYSICIAN field (#14) in the RAD NUC/MED ORDERS file (#75.1) and the REQUESTING PHYSICIAN sub-field (#14) within the EXAMINATIONS multiple (#50) within the REGISTERED EXAMS multiple (#2) in the RAD/NUC MED PATIENT file (#70) has been changed to "I $$PROV^RABWORD" which calls a Kernel API to make sure the user is an active user and checks that the user has the PROVIDER key. 5. The CREDIT METHOD sub-field (#26) within the EXAMINATIONS multiple (#50) within the REGISTERED EXAMS multiple (#2) in the RAD/NUC MED PATIENT file (#70) and the CREDIT METHOD field (#21) in the IMAGING LOCATIONS file (#79.1) will also accept partial crediting. The screen, DIC("S"), for both fields has been removed from both files. 6. The following options will display a new prompt, INTERPRETING IMAGING LOCATION : Report Entry/Edit [RA RPTENTRY] Resident On-Line Pre-Verification [RA RESIDENT PRE-VERIFY] Routines RARTE4 and RARTRPV1 were modified and routine RABWRTE was added. 7. At the time of exam completion, the Ordering ICD Diagnoses and associated SC/EI data would be included in the data transmitted to PCE. Routine RAPCE has been modified and routine RABWPCE was added. 8. When an exam is completed, both inpatient and outpatient data would be sent to PCE. (Previously, only outpatient completed data would be sent to PCE.) The new ICD Diagnoses and SC/EI data are included in the data sent to PCE. Routine RAORDU was modified to include inpatients. DATA DICTIONARY SUMMARY ======================== This patch adds the following new fields: --------------------------------- RAD/NUC MED ORDERS file (#75.1) --------------------------------- Field Name and Number Field Type ------------------------------------ ----------------------------------- PRIMARY ORDERING ICD DIAGNOSIS (#91) Pointer to ICD DIAGNOSIS file (#80) PRIMARY DX RELATED TO SC (#92) Set of Codes PRIMARY DX RELATED TO AO (#93) Set of Codes PRIMARY DX RELATED TO IR (#94) Set of Codes PRIMARY DX RELATED TO EC (#95) Set of Codes PRIMARY DX RELATED TO MST (#96) Set of Codes PRIMARY DX RELATED TO HNC (#97) Set of Codes PRIMARY DX RELATED TO CV (#99) Set of Codes Subfields within the SECONDARY ORDERING ICD DIAG. multiple (#98) in the RAD/NUC MED ORDERS file (#75.1): Sub field Name and Number Field Type ----------------------------------- ----------------------------------- SECONDARY ORDERING ICD DIAG. (#.01) Pointer to ICD DIAGNOSIS file (#80) SECONDARY DX RELATED TO SC (#2) Set of Codes SECONDARY DX RELATED TO AO (#3) Set of Codes SECONDARY DX RELATED TO IR (#4) Set of Codes SECONDARY DX RELATED TO EC (#5) Set of Codes SECONDARY DX RELATED TO MST (#6) Set of Codes SECONDARY DX RELATED TO HNC (#7) Set of Codes SECONDARY DX RELATED TO CV (#8) Set of Codes ------------------------------- RAD/NUC MED REPORTS file (#74) ------------------------------- Field Name Field Type ----------------------------------- ------------------------------- INTERPRETING IMAGING LOCATION (#86) Pointer to the IMAGING LOCATION file (#79.1) This patch modifies the following fields: --------------------------------- RAD/NUC MED ORDERS file (#75.1) --------------------------------- Field Name Field Type -------------------------- -------------------------------- REQUESTING PHYSICIAN (#14) Pointer to NEW PERSON file (#200) Modification: REQUESTING PHYSICIAN (#14) -- the DIC("S") will use an API from Kernel and also check if the user has the PROVIDER key. ------------------------------------------------- Sub-fields within the EXAMINATIONS multiple (#50) within the REGISTERED EXAMS multiple (#2) in the RAD/NUC MED PATIENT file (#70) : ------------------------------------------------- Sub-field Name and Number Field Type -------------------------- --------------------------------- REQUESTING PHYSICIAN (#14) Pointer to New Person file (#200) CREDIT METHOD (#26) Set of Codes IMAGING ORDER (#11) Pointer to RAD/NUC MED ORDERS file (#75.1) Modifications: REQUESTING PHYSICIAN (#14) -- the DIC("S") will use an API from Kernel and also check if the user has the PROVIDER key. CREDIT METHOD (#26) -- the DIC("S") will be removed so that partial crediting can also be selected: 1:Interpretation Only 3:Technical Component Only. IMAGING ORDER (#11) -- the Technical Description will state that Patch RA*5*41 will disallow purging of orders from the Radiology/Nuclear Medicine application. ---------------------------------- RAD/NUC MED REPORTS file (#79.1) ---------------------------------- Field Name and Number Field Type --------------------- ---------- CREDIT METHOD (#21) Set of codes Modification: CREDIT METHOD (#21) -- the DIC("S") will be removed so that partial crediting can also be selected: 1:Interpretation Only 3:Technical Component Only. DOCUMENTATION SUMMARY ===================== The documentation for this Radiology patch can be found in the following [ANONYMOUS.SOFTWARE] directories: Preferred Address ------------------------- First available FTP server download.vista.med.va.gov Specific Field Office FTP Address --------------------- ------------------------ Albany ftp.fo-albany.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov File Name Description Format -------------- ------------- -------- Updated manuals: RA5_0UM.PDF Radiology V. 5.0 User Manual BINARY RA5_0TM.PDF Radiology V. 5.0 Technical Manual BINARY RA5_0AG.PDF Radiology V. 5.0 ADPAC Guide BINARY RA5_0RN.PDF Radiology V. 5.0 Release Notes BINARY TEST STIES ============== Loma Linda, CA Cleveland, OH Dayton, OH Boston, MA Memphis, TN Charleston, SC ROUTINE SUMMARY =============== The second line of each of these routines now looks like: ;;5.0;Radiology/Nuclear Medicine;**41**;Mar 16, 1998 Routine name Before Patch After Patch Patch List ============ ============ =========== ========== RA41PRE N/A 1763526 41 RA41PST N/A 2431832 41 RABWORD N/A 8574365 41 RABWORD1 N/A 6076103 41 RABWORD2 N/A 8169752 41 RABWPCE N/A 1512846 41 RABWRTE N/A 5309305 41 RABWUTL N/A 858015 41 RAO7NEW 16705781 16988951 5,10,18,41 RAO7RON 4506084 5154108 41 RAORD1 19206033 17530701 10,45,41 RAORD3 14044719 14271828 5,15,21,27,45,41 RAORD6 16690655 16834702 5,10,15,18,27,45,41 RAORDU 13962818 14094086 18,41 RAORDU1 24059996 23931023 10,41 RAPCE 14330808 15492591 10,17,21,26,41 RAPURGE 13590622 12532693 34,41 RARTE4 13683329 13799009 15,27,41 RARTRPV1 3373903 2927916 5,41 Total number of routines : 19 INSTALLATION INSTRUCTIONS ========================= Please refer to the 'Software and Documentation Retrieval' section of the PX*1.0*124 patch description for instructions on how to acquire the patch software and install instructions. Routine Information: ==================== Routine Name: - RABWORD Routine Checksum: Routine Name: - RABWORD1 Routine Checksum: Routine Name: - RABWPCE Routine Checksum: Routine Name: - RABWRTE Routine Checksum: Routine Name: - RABWUTL Routine Checksum: Routine Name: - RAO7NEW Routine Checksum: Routine Name: - RAO7RON Routine Checksum: Routine Name: - RAORD1 Routine Checksum: Routine Name: - RAORD3 Routine Checksum: Routine Name: - RAORD6 Routine Checksum: Routine Name: - RAORDU Routine Checksum: Routine Name: - RAORDU1 Routine Checksum: Routine Name: - RAPCE Routine Checksum: Routine Name: - RAPURGE Routine Checksum: Routine Name: - RARTE4 Routine Checksum: Routine Name: - RARTRPV1 Routine Checksum: Routine Name: - RABWORD2 Routine Checksum: Routine Name: - RA41PRE Routine Checksum: Routine Name: - RA41PST Routine Checksum: ============================================================================= User Information: Entered By : RECTOR,KEN Date Entered : MAY 13, 2003 Completed By: LYNCH,MARY F. Date Completed: AUG 18, 2005 Released By : THORNTON,NANCY Date Released : AUG 31, 2005 ============================================================================= Packman Mail Message: ===================== No routines included