$TXT Created by CEBELINSKI,GREGORY J at DEV.DEV.FO-HINES.MED.VA.GOV (KIDS) on Wednesday, 04/04/07 at 06:36 ============================================================================= Run Date: JUN 04, 2007 Designation: RA*5*75 Package : RA - RADIOLOGY/NUCLEAR MEDICINE Priority: Mandatory Version : 5 SEQ #69 Status: Released Compliance Date: JUL 05, 2007 ============================================================================= Associated patches: (v)RA*5*31 <<= must be installed BEFORE `RA*5*75' (v)RA*5*35 <<= must be installed BEFORE `RA*5*75' (v)RA*5*36 <<= must be installed BEFORE `RA*5*75' (v)RA*5*41 <<= must be installed BEFORE `RA*5*75' (v)RA*5*51 <<= must be installed BEFORE `RA*5*75' (v)RA*5*55 <<= must be installed BEFORE `RA*5*75' (v)RA*5*69 <<= must be installed BEFORE `RA*5*75' (v)RA*5*82 <<= must be installed BEFORE `RA*5*75' Subject: REASON FOR STUDY, PATIENT AGE ALGORITHM/DISPLAY, & DATE DESIRED DEFAULT ISSUE Category: - Data Dictionary - Input Template - Routine - Enhancement (Mandatory) Description: ============ This patch addresses three issues within the VistA Radiology/Nuclear Medicine application. + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ATTENTION : Sites using Nuance PowerScribe + + + + + + PowerScribe cannot handle certain characters that may be entered + + into the new REASON FOR STUDY field (Issue One.) Inclusion of any + + of these characters would cause the entire order to disappear from + + the PowerScribe display screen. + + + + These characters are reserve characters in XML : ampersand (&), + + apostrophe ('), quote ("), greater than (>), and less than (<). + + + + PowerScribe has a software fix planned, but has not announced a + + release date for this fix. Therefore, the person responsible for + + your site's PowerScribe interface should contact the PowerScribe + + National Support Center at 800.833.7776 and request a Dictaphone + + work order to correct this issue before patch RA*5.0*75 is + + installed. + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ISSUE ONE --------- When VistA Radiology exam data are sent to the Nuance PowerScribe voice recognition system, this system cannot accept CLINICAL HISTORY data of indefinite length. It can only accept the REASON FOR STUDY data of a limited length, 64 characters maximum, meeting DICOM standards. Because the physician using PowerScribe cannot view the REASON FOR STUDY that is embedded in the CLINICAL HISTORY, s/he has to go back to the VistA Radiology system to get the data. This patch will obviate the need for PowerScribe users to access REASON FOR STUDY from the VistA Radiology system. This issue was reported in Remedy ticket #175929. To correct this issue, this patch will require the user entering the request to input the reason for the request into a new field, 'REASON FOR STUDY', which will be stored in the RAD/NUC MED ORDERS (#75.1) file. This patch will change the 'CLINICAL HISTORY FOR EXAM' prompt from being required to optional. VistA Radiology/Nuclear Medicine reports, orders, and patient profile options will be enhanced to display both the REASON FOR STUDY and CLINICAL HISTORY data. Operation when ordering through the front door ---------------------------------------------- CPRS GUI v27 (OR*3.0*243) will have separate boxes for REASON FOR STUDY and for CLINICAL HISTORY. CPRS GUI v26 currently has one box for both HISTORY & REASON FOR EXAM. This patch will, in the background, auto-populate the REASON FOR STUDY field with "See Clinical History:". This will be displayed in various reports, orders, and patient profile where CLINICAL HISTORY is displayed. Operation when ordering through the backdoor -------------------------------------------- VistA Radiology/Nuclear Medicine will collect the REASON FOR STUDY (required) and CLINICAL HISTORY (optional). CPRS GUI v27 (OR*3.0*243) will display REASON FOR STUDY and CLINICAL HISTORY in separate boxes. CPRS GUI v26 with this patch, RA*5*75, will display both the REASON FOR STUDY and the CLINICAL HISTORY inside the HISTORY & REASON FOR EXAM box as follows: The REASON FOR STUDY will be displayed first and flagged by "REASON FOR STUDY:", then a line of hyphens, then the CLINICAL HISTORY. For example: "REASON FOR STUDY: This is an example only ------------------------------------------ The Clinical History starts here.........." ISSUE TWO --------- When displaying a Radiology Requisition, the patient's age is calculated against the date the request is displayed instead of calculating the patient's age against the date the request was entered. The incorrect patient age is currently displayed when either of the following options is executed: * Print Rad/Nuc Med Requests by Date [RA ORDERPRINTS] * Print Selected Requests by Patient [RA ORDERPRINTPAT] This issue was reported in Remedy ticket #162508. To correct this issue, a modification will be made in the routine RAORD5 to calculate the patient's age based on the following: * The patient's Date of Birth * The date the request was entered In addition, routine RAORD6 will be modified to change the request report header as follows: * The label "Age" will be changed to "Age at req" * The first line will now contain the word "Printed:" to indicate that the date is the date of printing, not the date of the request. ISSUE THREE ----------- Whether an order is entered through CPRS or through the VistA Radiology/Nuclear Medicine application, an erroneously entered "Date Desired" value impacts a radiology department's ability to comply with the thirty day out-patient appointment wait times mandate. Physicians sometimes use the default date of "Today" as a matter of convenience, rather than inputting the actual date in which they want the examination. This issue was reported in E3R #19834 (Change DESIRED DATE default) The solution is to remove the automatic default date of "Today" and require the physicians to enter a date they actually desire to have the examination. This patch only addresses the backdoor (VistA Radiology/Nuclear Medicine application) order entry. CPRS GUI v27 will address the front door removal of "Today" as the default to "Date Desired." ASSOCIATED REMEDY/NOIS TICKETS ============================== Issue One: HD0000000175929 Issue Two: HD0000000162508 Issue Three: E3R #19834 Integration Agreements 2265 and 2266 have been updated to pass the REASON FOR STUDY to subscribing applications. Please refer to these specific IAs for further information. INSTALLATION FILES: ================== The following software files are exported as part of this patch: File Name Contents Retrieval Format --------- -------- ---------------- RA5_0RN_P75.pdf Release Notes (Adobe Acrobat version) ASCII RA5_0RN_P75.doc Release Notes (Word version) ASCII RA5_0UM.pdf User Manual (Adobe Acrobat version) ASCII RA5_0UM.doc User Manual (Word version) ASCII The files listed above may be obtained via FTP. 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: OI FIELD OFFICE FTP ADDRESS DIRECTORY ---------------- ------------------------- -------------------- Albany ftp.fo-albany.med.va.gov [anonymous.software] Hines ftp.fo-hines.med.va.gov [anonymous.software] Salt Lake City ftp.fo-slc.med.va.gov [anonymous.software] The following are the routines included in this patch. The second line of of these routines now looks like: ;;5.0;Radiology/Nuclear Medicine;**[patch list]**;Mar 16, 1998 CHECK^XTSUMBLD results Routine Before Patch After Patch Patch List ------- ------------ ----------- ---------- RA75PST New 2463278 **75** RABUL 1960113 2263220 **2,15,75** RAHLR 23409852 23171365 **2,12,10,25,71,82,75** RAO7NEW 16988951 19108244 **5,10,18,41,75** RAO7PC1 4988201 4988201 **1,16,18,26,36,45,75** RAO7PC2 13303812 13670400 **1,11,14,16,22,27,45,75** RAO7RO 10952365 11405279 **1,2,13,15,75** RAO7RO1 3611894 3720896 **2,75** RAO7RON 5154108 5160294 **41,75** RAO7RON1 5720758 8329024 **69,75** RAO7VLD 740114 754304 **75** RAORD1 17530701 17915862 **10,45,41,75** RAORD2 16592047 16672293 **5,10,51,45,75** RAORD3 14271828 14497398 **5,15,21,27,45,41,75** RAORD5 14010598 13867889 **8,10,15,31,45,75** RAORD6 16834702 17240800 **5,10,15,18,27,45,41,75** RAORDU1 23931023 24194569 **10,41,75** RART3 9929650 10353508 **8,10,18,27,35,45,75** RARTR 16252459 16269683 **5,13,16,27,43,55,75** RARTR3 8374182 10360544 **8,10,19,27,35,45,75** RAUTL12 3677659 3850814 **75** RAUTL5 9589104 11916425 **8,26,75** TEST SITES ========== Puget Sound Health Care System Northern California Health Care System Asheville VAMC Bay Pines VAMC Maryland Health Care System INSTALLATION INSTRUCTIONS ========================= Since input templates are being re-compiled, it is best if this patch is installed outside of normal working hours. Radiology users should be off the system and users should not place radiology orders through CPRS while this patch is being installed. The install time for this patch should be under five minutes. NOTE: MailMan and Kernel patches must be current on the target system to avoid problems loading and installing this patch. 1. Use the 'Delete Routines' [XTRDEL] option to delete the following compiled routines for the RAD/NUC MED ORDERS file (#75.1)'s input templates RA ORDER EXAM and RA QUICK EXAM ORDER: RACTOE* RACTQE* We suggest that this step be taken so that re-compilation of the RA ORDER EXAM and RA QUICK EXAM ORDER input templates guarantee a new set of compiled input template routines. Failure to delete the compiled input template routines for the RA ORDER EXAM and RA QUICK EXAM ORDER input templates will not prevent installation of this patch. Please note that the RA ORDER EXAM and RA QUICK EXAM ORDER input templates can be recompiled by accessing the the 'IRM Menu' [RA SITEMANAGER] and executing the option: 'Template Compilation' [RA COMPILE TEMPLATES]. 2. Use the 'INSTALL/CHECK MESSAGE' option of your PackMan menu to load the KIDS distribution onto your system. 3. From the Kernel Installation & Distribution System menu, select the 'Installation' menu. From this menu you may select the following options prior to installing the patch: a. Backup a Transport Global - this option will create a backup message of any routines exported with the patch. 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. c. Verify Checksums in Transport Global - this option will ensure the integrity of the routines that are in the transport global. 4. Use the 'Install Package(s)' option under the 'Installation' menu. When prompted for INSTALL NAME, enter: RA*5.0*75 When prompted "Want KIDS to INHIBIT LOGONs during the install? YES//", respond NO. When prompted "Want to DISABLE Scheduled Options and Menu Options? YES//", respond YES When prompted "Enter options you wish to mark as 'Out of Order':", enter the following to disable all Rad/Nuc Med options: RA* When prompted "Enter protocols you wish to mark as 'Out of Order':", enter the following to disable all Rad/Nuc Med protocols: RA* 5. Verify that the patch installation completed correctly by using the KIDS 'Utilities...' [XPD UTILITY] option 'Install File Print' [XPD PRINT INSTALL FILE] and selecting this patch (RA*5.0*75). 6. The post-installation routine, RA75PST, can be deleted. 7. All radiology, and those users utilizing CPRS to place radiology orders, can resume their normal activities. Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: RA75PST Before: n/a After: B5639049 **75** Routine Name: RABUL Before: B4837424 After: B5625174 **2,15,75** Routine Name: RAHLR Before: B49413163 After: B47516973 **2,12,10,25,71,82,75** Routine Name: RAO7NEW Before: B34874778 After: B43134846 **5,10,18,41,75** Routine Name: RAO7PC1 Before: B25997110 After: B26248522 **1,16,18,26,36,45,75** Routine Name: RAO7PC2 Before: B43565991 After: B44787869 **1,11,14,16,22,27,45,75** Routine Name: RAO7RO Before: B37491814 After: B38944723 **1,2,13,15,75** Routine Name: RAO7RO1 Before: B7615493 After: B7990676 **2,75** Routine Name: RAO7RON Before: B14133845 After: B14011011 **41,75** Routine Name: RAO7RON1 Before: B16218705 After: B28343551 **69,75** Routine Name: RAO7VLD Before: B2349255 After: B2388912 **75** Routine Name: RAORD1 Before: B47171265 After: B48840656 **10,45,41,75** Routine Name: RAORD2 Before: B43792586 After: B44295727 **5,10,51,45,75** Routine Name: RAORD3 Before: B24179273 After: B24685743 **5,15,21,27,45,41,75** Routine Name: RAORD5 Before: B27398038 After: B27804066 **8,10,15,31,45,75** Routine Name: RAORD6 Before: B44913351 After: B47839640 **5,10,15,18,27,45,41,75** Routine Name: RAORDU1 Before: B30958799 After: B32546485 **10,41,75** Routine Name: RART3 Before: B21497929 After: B23818641 **8,10,18,27,35,45,75** Routine Name: RARTR Before: B56272140 After: B56338116 **5,13,16,27,43,55,75** Routine Name: RARTR3 Before: B17132620 After: B24116267 **8,10,19,27,35,45,75** Routine Name: RAUTL12 Before: B13350139 After: B13921156 **75** Routine Name: RAUTL5 Before: B25572659 After: B39178869 **8,26,75** ============================================================================= User Information: Entered By : CEBELINSKI,GREGORY Date Entered : MAY 25, 2006 Completed By: MARTINI,SUE Date Completed: MAY 31, 2007 Released By : COWNIE,KEVIN Date Released : JUN 04, 2007 ============================================================================= Packman Mail Message: ===================== $END TXT