$TXT Created by DAVIS,PAULETTE T at DEVCRN.ISC-ALBANY.VA.GOV (KIDS) on TUESDAY, 10/12/99 at 13:43 ============================================================================= Run Date: JAN 20, 2000 Designation: RG*1*1 Package : RG - CLINICAL INFO NETWORKPriority: Mandatory Version : 1 SEQ #2 Status: Released ============================================================================= Subject: EXCEPTION MESSAGE ENHANCEMENTS Category: - Routine - Data Dictionary - Enhancement (Mandatory) Description: ============ Y2K Waiver Request ID#: Y2KW0001 Y2K Waiver Status: Approved This patch may be installed during the Y2K Moratorium, after 1/15/2000. 1.) RESOLVING POTENTIAL MATCHES DURING DIRECT CONNECT & POTENTIAL MATCH EXCEPTION MESSAGE ENHANCEMENT This patch addresses the related issues of resolving potential matches during a direct connect and potential match exception messages that are generated each night during the Local/Missing ICN Resolution Background Job [MPIF LOC/MIS ICN RES]. Potential Matches During a Direct Connect: ------------------------------------------ Originally, the software functioned in the following fashion. While using Registration for a new patient or accessing a patient who doesn't have a national Integration Control Number (ICN) through Load/Edit, a direct connect is made to the Master Patient Index (MPI) to get the patient an ICN. A check is made to see if the patient already exists on the MPI. During that check, the user may be presented with a list of potential matches to review. The user can decide that one of the potential matches looks like an exact match and make that selection, reject everyone on the list and create a new ICN, or elect to QUIT the List Manager screen and a local ICN is assigned. This patch brings in the following functionality. During Registration or Load/Edit, if a direct connect to the MPI would result in a list of potential matches, the patient is instead given a local ICN and an exception is logged in the CIRN HL7 EXCEPTION LOG file (#991.1). A new option, View Potential Match Patient [RG EXCEPTION POTENTIAL MATCH], is used to list patients that must be manually resolved to the MPI. The person(s) designated to resolve these patients is notified of pending resolutions when he/she logs on to the system. The Single Patient Initialization to MPI option [MPIF IND MPI LOAD] is used to match the patient to the MPI, thus taking this responsibility off of the registration clerk. Potential Match Exception Messages: ----------------------------------- Originally, the software functioned in the following fashion. During the initialization to the MPI, any patient who cannot be resolved automatically is placed in the CIRN HL7 EXCEPTION LOG file (#991.1). A local E-Mail message is sent to all members of the MPIF EXCEPTIONS mail group stating that the patient needs to be resolved manually through the Single Patient Initialization to MPI option [MPIF IND MPI LOAD]. A message is sent for each patient who needs to be resolved, resulting in a large number of messages. Also, the nightly Local/Missing ICN Resolution Background JOB attempts an automatic resolution for all patients with local ICNs or who are missing an ICN. Any failed attempts result in more exception messages. This is repeated each night until the patient is resolved manually. This produced hundreds of individual messages (many duplicates) that are cumbersome to review. This patch brings in the following functionality. The E-Mail messages have been eliminated for the potential match exceptions. A new option, View Potential Match Patient [RG EXCEPTION POTENTIAL MATCH], prints patients in the CIRN HL7 EXCEPTION LOG file (#991.1) who currently need a national ICN. Members of the RG CIRN DEMOGRAPHIC ISSUES mail group are notified when they sign on to the system if there are any patients in the CIRN HL7 EXCEPTION LOG file (#991.1) who have an exception type of 'Potential Matches Returned' that do not have a national ICN. 2.) BULLETIN GENERATED IF REMOTE PATIENT MARKED AS DECEASED If a shared patient is flagged as deceased at one treating facility, a bulletin is generated to the RG CIRN DEMOGRAPHIC ISSUES mail group at the subscribing sites. The bulletin is generated when the remote site has a date of death and the subscribing site does not and also when the remote site has a date of death which is different from the subscribing site's date of death (excluding time). Each subscriber can then review whether the patient should be marked as deceased at their site. The following message is displayed when the remote site has a date of death and the subscribing site does not. Subj: Remote Date of Death Indicated From: CIRN PACKAGE in 'IN' basket ----------------------------------------------------------- The CIRN Package has received a message from: MIAMI --> Site Number: 546 This message indicates that patient DOE,JOHN has a date of death at the other facility but not at your facility. Date of Death from other facility: Jun 11, 1999 The following message is displayed when the remote site has a date of death that is different from the subscribing site's date of death. Subj: Remote Date of Death Indicated From: CIRN PACKAGE in 'IN' basket ----------------------------------------------------------- The CIRN Package has received a message from: BAY PINES, FL --> Site Number: 516 This message indicates that patient DOE,JOHN has a different date of death at the other facility than at your facility. Date of Death from other facility: Jun 04, 1999 Date of Death at your facility: Jun 11, 1999 3.) EXCEPTION MESSAGE GENERATED IF SCN IS NULL During the initial load to the Master Patient Index (MPI) or during an individual direct connect to the MPI, a facility makes it's first contact to the MPI for a patient. If the patient already exists on the MPI, the patient's Integration Control Number (ICN) and CIRN Master of Record (CMOR) are returned. Using this information, the site sends a request to the CMOR to be added as a treating facility for the patient and as a subscriber to data updates for the patient (Subscription Request). After processing these requests, the CMOR broadcasts messages to all subscriber sites to add the new facility as well. If the CMOR has a site erroneously listed as subscriber, this patch allows the CIRN software to detect that fact and generates an exception message to the RG CIRN DEMOGRAPHIC ISSUES mail group. A copy of the message follows. Subj: CIRN Exception: Patient Does Not Exist From: HL7 Msg#716449 in 'IN' basket ----------------------------------------------------------- Patient Does Not Exist: Msg#716449 DOE,JOHN Does not exist in patient database. See Appendix F of the Clinical Information Resource Network Patient Demographics (CIRN-PD) and Master Patient Index (MPI) Installation and Implementation Guide. 4.) A minor change was made to routine RGRSDYN1 to correct the DO dot structure. 5.) The code to generate the sensitive patient bulletin in RGRSPT was inadvertently "commented out" during testing. That code has now been activated. 6.) Checks were added to insure that subscription messages do not go to "Non-CIRN" sites. The node is checked in the HL LOGICAL LINK file (#870) to insure that it is a VA* node. An exception message, with the text "Missing/Unable to get Logical Link", goes out to the MPIF EXCEPTIONS mail group. This indicates that the institution is linked to a node that it should not be linked to in the HL LOGICAL LINK file (#870). This modification was made to address NOIS message MIA-0899-30007. The MPIF EXCEPTIONS mail group should contain only the remote mail group, CIRN EXCEPTION MGT on FORUM. This mail group, composed of Technical Services and National VistA Support members, will process the technical exceptions from the CIRN sites. 7.) In routine RGJCSUB, code was added to handle situations where the site has duplicate station numbers in the Institution (#4) file. 8.) Code was modified in RGJCREC, RGJCTS01 and RGJCSUB to pass the DFN for CIRN HL7 Exceptions so that the "ADFN" cross-reference in the CIRN HL7 EXCEPTION LOG file (#991.1) will be populated. 9.) A NOIS was reported by Atlanta regarding a "CIRN - MISSING DATA" exception message. This synchronization problem created a bulletin because the incoming HL7 message was attempting to process a non-ADT message. The message contained no data for all fields. CIRN should only process the message if it is an "ADT" type message. Code was added to routine RGRSPT to check for message type (ADT) to resolve NOIS message ISP-1099-N0294. Data Dictionary Changes: ======================== The "Patient Does Not Exist" entry, Internal Entry Number (IEN) 228 and "Duplicate Station Number in Institution File (#4)" entry, IEN 229 were added to the CIRN HL7 EXCEPTION TYPE file (#991.11). A new field was added to the CIRN HL7 EXCEPTION LOG file (#991.1). The PATIENT (#3) field was added to the EXCEPTION multiple. A MUMPS type cross-reference for quick identification of patient specific exceptions is used to eliminate duplicate exceptions as well as group exceptions by type and patient. New Options: ============ Message Exception Menu [RG EXCEPTION MENU] This menu is used to view CIRN Health Level Seven (HL7) message exceptions logged in the CIRN HL7 EXCEPTION LOG file (#991.1). IRM can assign the Message Exception Menu [RG EXCEPTION MENU] to selected users as needed for exception review. CIRN HL7 Exception Notifier [RG EXCEPTION NOTIFIER] This option is used to notify members of the RG CIRN DEMOGRAPHIC ISSUES Mail Group that there are exceptions to review. IRM: The CIRN HL7 Exception Notifier [RG EXCEPTION NOTIFIER] option is NOT a user option and should not be added to user's menus. View Potential Match Patient [RG EXCEPTION POTENTIAL MATCH] This option produces a list of patients from the CIRN HL7 EXCEPTION LOG file (#991.1) who have been identified as having more than one potential match on the Master Patient Index (MPI). These patients have not been resolved using the Single Patient Initialization to MPI option [MPIF IND MPI LOAD]. Before producing the report, this option purges DUPLICATE potential match entries from the CIRN HL7 EXCEPTION LOG file (#991.1). Test Sites: =========== Atlanta, GA Alexandria, LA Augusta, GA Battle Creek, MI Bay Pines, FL Big Spring, TX Central Alabama HCS Charleston, SC Connecticut HCS Danville, IL El Paso, Tx Fayetteville, AR Houston, TX Indianapolis, IN Manchester, NH Miami, FL Mountain Home, TN Nashville, TN Prescott, AZ Saginaw, MI Salt Lake City, UT San Francisco, CA Southern Colorado HCS West Palm Beach, FL Associated NOIS: ================ MIA-0899-30007 ISP-1099-N0294 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 -------- ------------ ------------ ---------- RGEVPM N/A 7338460 1 RGHLLOG 2524310 3763356 1 RGJCREC 14023460 22405882 1 RGJCSUB 10701198 15191772 1 RGJCTS01 1115126 4119447 1 RGP1ENV N/A 510763 1 RGRSBUL1 5146413 7407808 1 RGRSDYN1 8571379 8460215 1 RGRSPT 6105474 6205472 1 RGRSUTIL 2734373 3871163 1 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. Note: Version 1.0 of the CLINICAL INFO RESOURCE NETWORK must be installed prior to installing this patch. The environment check routine fails without version 1.0 of CIRN PD/MPI. This patch should be installed immediately before MPIF*1*1. 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 CIRN 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*1). (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*1. 7. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', respond NO. 8. 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. 9. Routine RGP1ENV can be deleted from your system after successful installation. Sample Installation: ===================== Select Kernel Installation & Distribution System Option: Installation Select Installation Option: Install Package(s) Select INSTALL NAME: RG*1.0*1 Loaded from Distribution 7/9/99@10:39:25 => RG*1*1 This Distribution was loaded on Jul 09, 1999@10:39:25 with header of RG*1*1 It consisted of the following Install(s): RG*1.0*1 RG*1.0*1 Will first run the Environment Check Routine, RGP1ENV Environment check is ok. Install Questions for RG*1.0*1 Incoming Files: 991.1 CIRN HL7 EXCEPTION LOG (Partial Definition) Note: You already have the 'CIRN HL7 EXCEPTION LOG' File. 991.11 CIRN HL7 EXCEPTION TYPE (including data) Note: You already have the 'CIRN HL7 EXCEPTION TYPE' File. I will MERGE your data with mine. Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES// NO Enter the Device you want to print the Install messages. You can queue the install by enter a 'Q' at the device prompt. Enter a '^' to abort the install. DEVICE: HOME// Install Started for RG*1.0*1 : Jul 09, 1999@10:42:40 Installing Routines:.......... Jul 09, 1999@10:42:40 Installing Data Dictionaries: ... Jul 09, 1999@10:42:42 Installing Data: Jul 09, 1999@10:42:42 Installing PACKAGE COMPONENTS: Installing OPTION...... Jul 09, 1999@10:42:43 Updating Routine file...... Updating KIDS files....... RG*1.0*1 Installed. Jul 09, 1999@10:42:44 Install Message sent #11197855 Routine Information: ==================== Routine Name: - RGJCREC Routine Checksum: Routine Name: - RGRSDYN1 Routine Checksum: Routine Name: - RGRSBUL1 Routine Checksum: Routine Name: - RGRSPT Routine Checksum: Routine Name: - RGP1ENV Routine Checksum: Routine Name: - RGEVPM Routine Checksum: Routine Name: - RGHLLOG Routine Checksum: Routine Name: - RGRSUTIL Routine Checksum: Routine Name: - RGJCSUB Routine Checksum: Routine Name: - RGJCTS01 Routine Checksum: ============================================================================= User Information: Entered By : LAZABARA,CINDY F Date Entered : JUN 07, 1999 Completed By: DAVIS,PAULETTE Date Completed: JAN 20, 2000 Released By : CARLSON-GOTTS,NANCY Date Released : JAN 20, 2000 ============================================================================= Packman Mail Message: ===================== $END TXT