$TXT Created by DAVIS,PAULETTE T at DEVCRN.FO-ALBANY.MED.VA.GOV (KIDS) on Tuesday, 09/24/02 at 12:10 ============================================================================= Run Date: OCT 08, 2002 Designation: RG*1*26 Package : RG - CLINICAL INFO NETWORKPriority: Mandatory Version : 1 SEQ #25 Status: Released ============================================================================= Associated patches: (v)RG*1*23 <<= must be installed BEFORE `RG*1*26' (v)DG*5.3*428 <<= must be installed BEFORE `RG*1*26' Subject: NEW MESSSAGE STRUCTURE - PHASE 1 Category: - Enhancement (Mandatory) - Routine Description: ============ IMPORTANT NOTE: Although this patch is NOT being sent out as an EMERGENCY patch, the Master Patient Index/Patient Demographics (MPI/PD) development team and the Master Patient Index Data Quality Management team request that you install the patch as soon as your schedule allows. Additional development in progress, described below, is dependent upon this patch being installed at all facilities. Also, the MPI/PD development team's facility access should remain active until all phases in this process are completed. DG*5.3*428 and RG*1.0*23 are required builds for patch RG*1*26. NOTE: RG* and MPIF* patches should NOT be installed on legacy systems to avoid issues with the legacy systems ending up as Coordinating Master of Records (CMORs), treating facilities, or subscribers. This patch includes enhancements that are proposed in the Master Patient Index/Patient Demographics, Phase III Enhancements, Software Design Document. A series of patches will be distributed to implement a new messaging structure for Master Patient Index/Patient Demographics (MPI/PD). Our current message scheme uses the Coordinating Master of Record (CMOR) as the origination point for a number of update messages to other treating facilities. Overall, our objective is to reduce the amount of facility to facility messaging. This will be done by using the Master Patient Index (MPI) as the source for update messages. For those message types that require CMOR action, the CMOR will update the MPI, and the MPI will distribute updates to the appropriate treating facilities. Changes to messaging will include using a new generic Health Level Seven (HL7) 2.4 message builder for the ENV, PD1, and PID segments. Additionally, HL7 application acknowledgements will be incorporated in all MPI/PD messages. These changes will take place in three phases. Patches DG*5.3*428, MPIF*1*22, and RG*1*26 constitute phase one. These patches contain the protocols and routines to execute those protocols for the new messaging. These patches must be installed at all facilities before the second step in the process can begin. The processing routines included in these patches will be dormant until then. The second phase will update the necessary routines to call the new trigger events using the updated messaging structure. The trigger events will include the following. - Add new patient to the MPI - Link to an existing patient on the MPI - Update to non-key fields on an existing MPI entry - Update to key fields on an existing MPI entry - Update to date last treated - Resolution of duplicates at the site where both entries exist on the MPI - Resolution of duplicates on the MPI - Identification and resolution of a mismatched patient - Inactivation of existing entry on the MPI Patches for the second phase must be installed at all facilities before the subsequent step can begin. Patches DG*5.3*474, MPIF*1*24, and RG*1*27 constitute phase two. The next step is a data synchronization process to populate new fields in the MPI FACILITY ASSOCIATION (#985.5) file on the MPI for each facility associated with a national integration control number. The third phase will contain additional messaging functionality that can not be implemented until the synchronization process has completed. A final group of patches will clean up obsolete routines, protocols, options, etc. that are no longer used. To summarize, patches DG*5.3*428, MPIF*1*22, and RG*1*26 contain the protocols and routines to execute those protocols for the new messaging. The processing routines are not invoked until the second phase in the process. New Protocols: ============== Ten new protocols are included to support the new messaging structure. (1) MPI/PD ADT-A01 2.4 Client Protocol [RG ADT-A01 2.4 CLIENT] This is the new MPI/PD ADT-A01 HL7 2.4 client protocol. This new version includes the new PID as well as the routing via the MPI. This will be used to send admission data to the MPI to support the synchronization of the patients date last treated and/or event reason. (2) MPI/PD ADT-A01 2.4 Server Protocol [RG ADT-A01 2.4 SERVER] This is the new MPI/PD ADT-A01 HL7 2.4 server protocol. This new version includes the new PID as well as the routing via the MPI. (3) MPI/PD ADT-A03 2.4 Client Protocol [RG ADT-A03 2.4 CLIENT] This is the new MPI/PD ADT-A03 HL7 2.4 client protocol. This new version includes the new PID as well as the routing via the MPI. This will be used to send discharge and clinic checkout data to the MPI to support the synchronization of the patients date last treated and/or event reason. (4) MPI/PD ADT-A03 2.4 Server Protocol [RG ADT-A03 2.4 SERVER] This is the new MPI/PD ADT-A03 HL7 2.4 server protocol. This new version includes the new PID as well as the routing via the MPI. (5) MPI/PD ADT-A04 2.4 Client Protocol [RG ADT-A04 2.4 CLIENT] This is the new MPI/PD ADT-A04 HL7 2.4 client protocol. This new version includes the new PID as well as the routing via the MPI. This will be used to send registration data to the MPI to support the synchronization of the patient demographic data. (6) MPI/PD ADT-A04 2.4 Server Protocol [RG ADT-A04 2.4 SERVER] This is the new MPI/PD ADT-A04 (Register a Patient) HL7 2.4 server protocol. This new version includes the new PID as well as the routing via the MPI. (7) MPI/PD ADT-A04 Trigger Protocol [RG ADT-A04 TRIGGER] This protocol is used as an internal process of the A04 messages. The protocol will read in the message and reformat to the HL7 v2.4 standard with Application and Commit acknowledgements turned on. (8) MPI/PD ADT-A08 2.4 Client Protocol [RG ADT-A08 2.4 CLIENT] This is the new MPI/PD ADT-A08 HL7 2.4 client protocol. This new version includes the new PID as well as the routing via the MPI. This will be used to send updated patient data to the MPI to support the synchronization of the patient demographic data. (9) MPI/PD ADT-A08 2.4 Server Protocol [RG ADT-A08 2.4 SERVER] This is the new MPI/PD ADT-A08 (Patient Update) HL7 2.4 server protocol. This new version includes the new PID as well as the routing via the MPI. (10) MPI/PD ADT-A08 Trigger Protocol [RG ADT-A08 TRIGGER] This is the new MPI/PD ADT-A08 HL7 2.4 trigger client protocol. This protocol is used to process in messages generated by the VAFC ADT-A08 SERVER protocol that is in 2.3 format and update the message to the 2.4 standard and include full enhanced mode acknowledgements at both the commit and application level. HL7 Application Parameter: ========================== RG ADT Device File Entry: ================== Entry RG QUEUE in the DEVICE (#3.5) file is created by the post- installation routine, RGP26PST. The device is used to limit the number of background jobs running on the system at any given time. The RG ADT-A08 TRIGGER and RG ADT-A04 TRIGGER HL7 client protocols hang off of the VAFC ADT-A04/A08 SERVER HL7 server protocols and are used to capture the patient event and queue up a subsequent HL7 message. This message contains the new Health Level Seven (HL7) Standard v2.4 message which also includes "commit" and "application" level acknowledgements. Since the potential exists for an unlimited number of patient edits to be queued off at any given time from a backlog in the ADT HL7 PIVOT (#391.71) file, the resource device prevents more than 10 jobs from running at any given time. Test Sites: =========== Battle Creek, MI Bay Pines, FL Manchester, NH Routine Summary: ================ The following is a list of the routine(s) included in this patch. The second line of each of these routine(s) will look like: ;;1.0;CLINICAL INFO RESOURCE NETWORK;**[Patch List]**;30 Apr 99 CHECK^XTSUMBLD results: Routine Before Patch After Patch Patch List -------- ------------ ------------ ---------- RGADTP N/A 17407790 26 RGADTP1 N/A 12905370 26 RGADTPC N/A 306945 26 RGP26PST N/A N/A 26 RGRSDYN 2371895 2287825 4,8,17,23,26 Note: Routine RGP26PST is deleted by the installation. The checksum prior to deletion is 649983. Post-Install Routine: ===================== The purpose of the post installation routine, RGP26PST, is to add the RG QUEUE entry to the DEVICE (#3.5) file. Installation Instructions: ========================== This patch may be loaded with users on the system. You may wish to install it during non-peak hours. Installation will take less than 5 minutes. 1. Using the TaskMan option Schedule/Unschedule Options [XUTM SCHEDULE], unschedule the following option: VAFC BATCH UPDATE UPDATE BATCH JOB FOR HL7 v2.3 2. 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.] 3. None of the routines in the MPI/PD Patient Demographics package have been recommended for routine mapping. 4. From the Kernel Installation and Distribution System Menu, select the Installation menu. 5. From this menu, you may elect to use the following options (when prompted for the INSTALL NAME, enter RG*1.0*26). (a) 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. (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. It compares all components of the patch (routines, DDs, templates, etc.). (c) Verify Checksums in Transport Global - this option will allow you to ensure the integrity of the routines that are in the transport global. (d) Print Transport Global - this option will allow you to view the components of the KIDS build. 6. Use the Install Package(s) option and select the package RG*1.0*26. 7. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//', respond NO. 8. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', respond NO. 9. Using the TaskMan option Schedule/Unschedule Options [XUTM SCHEDULE], schedule the option VAFC BATCH UPDATE [UPDATE BATCH JOB FOR HL7 v2.3] to run every 10 minutes. Routine Information: ==================== Routine Name: - RGADTP Routine Checksum: Routine Name: - RGADTP1 Routine Checksum: Routine Name: - RGP26PST Routine Checksum: Routine Name: - RGRSDYN Routine Checksum: Routine Name: - RGADTPC Routine Checksum: ============================================================================= User Information: Entered By : DAVIS,PAULETTE Date Entered : JUN 11, 2002 Completed By: HERREN,CATHRYN Date Completed: OCT 03, 2002 Released By : SCOTT,JEAN M Date Released : OCT 08, 2002 ============================================================================= Packman Mail Message: ===================== $END TXT