$TXT Created by BRODNIANSKY,PAVEL at DEV.DEV.FO-HINES.MED.VA.GOV (KIDS) on Wednesday, 04/25/07 at 11:14 ============================================================================= Run Date: JUN 13, 2007 Designation: RA*5*81 Package : RA - RADIOLOGY/NUCLEAR MEDICINE Priority: Mandatory Version : 5 SEQ #70 Status: Released Compliance Date: JUL 14, 2007 ============================================================================= Subject: MULTIPLE ACCESSIONS BOUND TO ONE REPORT Category: - Routine - Enhancement (Mandatory) - Data Dictionary Description: ============ Associated patches: (v)RA*5*82 <<= must be installed BEFORE `RA*5*81' (v)HL*1.6*132 <<= must be installed BEFORE `RA*5*81' The Radiology 5.0 application has business rules established for a report being shared by multiple cases and for registering multiple cases at the same exam date/time: - cases from different orders should have their own separate reports (single orders) - cases from a parent procedure order should share the same report (printset) - cases from a parent procedure cannot be registered at the same time with cases from other orders - cases from more than one parent procedure cannot be registered at the same time These business rules are not always followed by radiology departments when using voice recognition (VR) systems. The VR system, contrary to legacy VistA Radiology business rules, may allow the user to group two or more cases from separate orders (printset on the fly) and dictate one report for these cases, even though these cases were not defined to share the same report. VR would send the data from this one dictated report as separate OBR segments within one HL7 message, one OBR segment for each case, to the Vista Radiology application. In the past, the Radiology application only accepted the first of this group of OBR segments and ignored the remaining OBR segments without sending back reject HL7 messages to notify the sending VR system that some of their OBR segments were not accepted by Radiology. This patch will modify the Radiology application's processing of an incoming HL7 message with multiple OBR segments from VR, to account for deviation from business rules: - If VR sends an HL7 message with multiple OBR segments for one dictated report based upon cases from separate orders, the Radiology application will make a separate record in the RAD/NUC MED REPORTS file (#74) for each case. The report text and impression would be identical in these separate records in file #74. - If VR sends an HL7 message with multiple OBR segments for one dictated report based upon cases from separate orders AND a parent procedure (printset), the Radiology application will make a separate record in the RAD/NUC MED REPORTS file (#74) for each of the cases from separate orders, but only one report record in file #74 for all the cases within the parent procedure (printset). The report text and impression would be identical in these separate records in file #74. - If VR sends an HL7 message with multiple OBR segments for one dictated report based upon cases from 2 or more parent procedures, the Radiology application will make a separate record in the RAD/NUC MED REPORTS file (#74) for each printset, but not for each case (printsets). The report text and impression would be identical in these separate records in file #74. - If VR sends an HL7 message with multiple OBR segments for the same addendum based upon cases from separate orders, the Radiology application will put the addendum into each of the existing report records for each case that is expected to have a separate report. - If VR sends an HL7 message with multiple OBR segments for the same addendum based upon cases from separate orders and a parent procedure, the Radiology application will put the addendum into each of the existing report records for the cases that are expected to have separate reports, and the same addendum into the shared report record for the cases that are expected to share a report (printset). - If VR sends an addendum that is identical to the existing verified report in the VistA database, the Radiology application will reject this message. - When a HL7 report is received by the Radiology application, the Radiology application files the report and broadcasts out the HL7 report message to all known subscribers. This allows all subscribers (including the original VR sender) to be updated with the same report This patch will prevent the Radiology application from broadcasting the HL7 report message back to the original sender. This functionality will be conditional. If site for whatever reason wants the report to be returned back to the Sender , there is the flag which may be set as the indication to do so. The flag is field: 79.7211 Return HL7 to Sender. The file is:79.7 RAD/NUC MED HL7 APPLICATION EXCEPTION The Sender is represented as Entry from Application Parameter file #771. Example of setting the flag to indicate desire to return Report to sender: D Q^DI Select OPTION: 1 ENTER OR EDIT FILE ENTRIES INPUT TO WHAT FILE: // 79.7 RAD/NUC MED HL7 APPLICATION EXCEPTION EDIT WHICH FIELD: ALL// Select RAD/NUC MED HL7 APPLICATION EXCEPTION HL7 APPLICATION NAME: ?? You may enter a new RAD/NUC MED HL7 APPLICATION EXCEPTION, if you wish RAD HL7 Application name, the exceptions are set. Choose from: RA-CLIENT-IMG ACTIVE RA-CLIENT-TCP INACTIVE RA-PSCRIBE-TCP ACTIVE RA-SEND-TCP ACTIVE RA-SERVER-IMG ACTIVE RA-TALK2 ACTIVE RA-TALKLINK-TCP ACTIVE RA-VOICE-SERVER ACTIVE RADIOLOGY ACTIVE Select RAD/NUC MED HL7 APPLICATION EXCEPTION HL7 APPLICATION NAME: RA-TALKLINK-TCP Are you adding 'RA-TALKLINK-TCP' as a new RAD/NUC MED HL7 APPLICATION EXCEPTION (the 1ST)? No// Y (Yes) Select Message Type: ORU Observ result/unsolicited Are you adding 'ORU' as a new Message Type (the 1ST for this RAD/NUC MED HL7 A PPLICATION EXCEPTION)? No// Y (Yes) Select Event Type: R01 ORU/ACK-Unsolicited transmission of an observation message Are you adding 'R01' as a new Event Type (the 1ST for this Message Type)? No// Y (Yes) Select HL7 Version: 2.3 1 2.3 HEALTH LEVEL SEVEN 2 2.3.1 HEALTH LEVEL SEVEN CHOOSE 1-2: 1 2.3 HEALTH LEVEL SEVEN Are you adding '2.3' as a new HL7 Version (the 1ST for this Event Type)? No// Y (Yes) Return HL7 to Sender: YES Yes Inbound Segment coding.: Outbound Segment coding.: Select HL7 Field Exceptions name: Select Message Type: REMEDY TICKETS ============== 136139 172606 DISTRIBUTION ============= The KIDS build is linked to this message. DOCUMENTATION ============= Documentation updates for this patch can be downloaded from 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 The documentation updates include: File Name Description ========= =========== RA5_0RN_P81.PDF Release Notes in Adobe PDF RA5_0RN_P81.DOC Release Notes in Word format RA5_0TM.PDF Technical Manual in Adobe PDF RA5_0TM.DOC Technical Manual in Word format Once released, documentation may also be retrieved from the VistA Documentation Library (VDL) on the Internet at the following address: http://www.va.gov/vdl Test Sites ========== 1.San Antonio 2.Charleston 3.Atlanta The second line of the routine now looks like: ;;5.0;Radiology/Nuclear Medicine;**[Patch List]**;Mar 16, 1998 Integrity checking tools: CHECK^XTSUMBLD Name Before Patch After Patch Patch List ------------------------------------------------------------------ RAHLO3 4224512 7334907 4,81 RAHLO4 10319255 10578445 4,8,81 RAHLRPC 6544423 5885283 12,25,54,71,82,81 RAHLRPT 23604842 23788116 2,12,10,25,81 RAHLRU 5677635 8608876 10,25,81 RAHLTCPB 15533156 18840568 12,17,25,51,71,81 INSTALLATION INSTRUCTIONS ========================= This patch must be installed when all Radiology users are off the system and the Radiology HL Logical Links have been shutdown. Install time will be less than 2 minutes. 1. Use the INSTALL/CHECK MESSAGE option on the PackMan menu. [Note: TEXT PRINT/DISPLAY option in the PackMan menu will display the patch text only]. 2. From the Kernel Installation and Distribution System (KIDS) menu, select the Installation menu. 3. From this menu, you should use the following options. And you must use the 'Backup a Transport Global' to save the routines that are affected by this patch. (When prompted for INSTALL NAME, enter RA*5.0*81). a. 'Print Transport Global' - this option will allow you to view the components of the KIDS build. b. 'Verify Checksums in Transport Global' - this option will allow you to ensure the integrity of the routines that are in the transport global. c. 'Compare Transport Global to Current System' - this option will allow you to view all changes that will be made when the patch is installed. It compares all components of the patch (routines, DDs, templates, etc.). d. 'Backup a Transport Global' - this option will create a backup message of any routines exported with the patch. It will NOT backup any other changes such as DDs or templates. 4. Shut down all Radiology HL logical links 'Start/Stop Links [HL START]'. 5. Use the 'Install Package(s)' option and select the package RA*5.0*81. 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 NO. 8. 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*81). 9. Start up the Radiology HL logical links that were shutdown in step four 'Start/Stop Links [HL START]'. Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: RAHLO3 Before: B8588948 After: B20660605 **4,81** Routine Name: RAHLO4 Before: B39683908 After: B41347235 **4,8,81** Routine Name: RAHLRPC Before: B16016942 After: B13841696 **12,25,54,71,82,81** Routine Name: RAHLRPT Before: B65391180 After: B70016688 **2,12,10,25,81** Routine Name: RAHLRU Before: B11355538 After: B28042615 **10,25,81** Routine Name: RAHLTCPB Before: B57781715 After: B61371898 **12,17,25,51,71,81** ============================================================================= User Information: Entered By : BRODNIANSKY,PAVEL Date Entered : OCT 17, 2006 Completed By: MARTINI,SUE Date Completed: JUN 12, 2007 Released By : BLACK,KATHLEEN Date Released : JUN 13, 2007 ============================================================================= Packman Mail Message: ===================== $END TXT