$TXT Created by GAVRILOV,SERGEY at DEV.DEV.FO-HINES.MED.VA.GOV (KIDS) on Wednesday, 02/23/05 at 10:37 ============================================================================= Run Date: APR 29, 2005 Designation: ROR*1*8 Package : ROR - CLINICAL CASE REGISTRIES Priority: Mandatory Version : 1 SEQ #8 Status: Released Compliance Date: MAY 23, 2005 ============================================================================= Associated patches: (v)ROR*1*6 <<= must be installed BEFORE `ROR*1*8' (v)ROR*1*7 <<= must be installed BEFORE `ROR*1*8' Subject: Historical Data Extraction and Context Management (CCOW) Category: - Routine - Enhancement (Mandatory) Description: ============ This patch prepares the Immunology Case (ICR) and Hepatitis C (Hep C) registries for the historical data extraction, and instructs the users how to perform it. Please read the instructions (ROR1_0P8IG) completely and then follow them step by step. A new version of the Clinical Case Registries (CCR) GUI is also exported as a part of this patch. The new GUI includes the HL7 context management (CCOW) functionality (both patient and user subjects). The fixes and enhancements can be separated into two groups: M code and GUI changes. M Code ------ [01] ICR and Hep C historical data extraction ---------------------------------------- Post-install routine of this patch prepares the ICR and Hep C registries for the historical data extraction (AKA backpull) that will extract the clinical data for the registry patients starting from January 1, 1985. Code of the RORHDT02, RORHDT04, and RORHDTUT routines has been amended to simplify simultaneous historical data extraction for several registries (format of the output file names has been changed to include the registry name). Description of the FILE NAME field (1.01) of the ROR HDT TASK file (#798.5) has been updated to reflect the new file name format. [02] Too aggressive error checks --------------------------- The data extraction code of the nightly task performed too aggressive error checks on the AUTOMATED INSTRUMENT DATA ? (21) field of the ELECTROCARDIOGRAM (EKG) file (#691.5). If this field was empty, an error was recorded in the log and processing of the patient data was aborted despite the fact that there was no "required" indicator for this field in the data dictionary. The RORHL13 routine has been amended (the aforementioned error check has been removed). The NOIS references for this problem are FGH-0804-30388, LOU-0804-41178, MAR-0804-20334, and SFC-0704-60158. [03] Inpatient and Outpatient Utilization report in loop --------------------------------------------------- When running the 'Inpatient and Outpatient Utilization' report, it went into an infinite loop in routine RORX005A. The problem was caused by a Fee Basis record of the PTF file (#45) that overlapped another inpatient admission. The RORX005A routine has been amended to prevent the infinite loop in case of incorrect data. The NOIS reference for this problem is LON-0904-61196. [04] Inactivation reason and date are not sent ----------------------------------------- 30 days after a date of death is entered for a registry patient, the nightly task automatically inactivates the registry record. If it is determined later that the patient was erroneously added to the registry in the first place, the CCR GUI allows the user to manually inactivate the patient again, which should exclude them from the registry reports. Despite the fact that the manual inactivation of deceased patients was enabled in the GUI, the code of the ROR PATIENT (IN)ACTIVATE remote procedure ignored such requests. The RORRP030 routine has been amended. The NOIS reference for this problem is PAL-0804-60772. [05] ICR data is not extracted in some cases --------------------------------------- The ICR data extraction task stopped transmitting the data for some patients despite having on-going clinical events. The investigation showed that the data was not sent because of the problem [02] mentioned earlier. The software flagged valid EKG data as erroneous. Moreover, the error was considered a severe one. As a result, no data was sent for the patients in question since those EKG procedures had been performed. The NOIS reference for this problem is PAL-0904-60103. [06] Updated ICR search criteria --------------------------- According to the NOIS PAL-0804-60107 the registry update task was missing some patients with positive HIV antibody tests because patients with positive Elisa tests automatically went on to Western Blot tests with the results reported under the Western Blot. The CCR search engine did not look for positive tests with LOINC codes for HIV Western Blots. Two LOINC codes for HIV 1 Western Blot (13499-9 and 21009-6) have been added to the ICR lab search criteria. [07] CCR alerts and CPRS GUI ----------------------- If a local coordinator inactivated a patient in the CCR GUI, this generated an alert. These alerts appeared in the CPRS GUI under notifications. However, they could be processed only by the old "roll and scroll" interface, not by the CPRS GUI. These alerts used M routines to display expanded explanations of the corresponding events. Since the CPRS GUI does not process these alerts, the inactivation/reactivation and task completion alerts have been modified so that they are considered by the CPRS GUI as informational and can be processed. Detailed explanations have been moved to the user manual and the reference guide. The RORERR20, RORRP030, RORTSK01, and RORUTL18 routines have been amended. The VistA dialogs 7980000.013, 7980000.014, and 7980000.019 are deleted by this patch from the DIALOG file (#.84). The NOIS reference for this problem is PAL-0604-61001. [08] List of Hep C NDC codes ----------------------- The National Drug Code (NDC) 0004-0350-99 has been added to the DRUG THERAPY LIST multiple (17) of the Hepatitis C (Hep C) registry parameters record in the ROR REGISTRY PARAMETERS file (#798.1). The NOIS reference for this problem is PRO-0404-11958. [09] Reports missing some ARV drugs ------------------------------ The code for some reports, which was selecting the drug prescriptions, examined order dates of original prescriptions instead of fill dates. This caused discrepancies between pharmacy related reports. The RORX009A and RORX011 routines have been amended. The NOIS reference for this problem is PAL-0804-61825. [10] Missing HL7 encoding -------------------- It was discovered that text in some fields of the Microbiology, Surgical Pathology, and Cytopathology HL7 segments was not properly encoded. Since that text contained |TAB|, |INDENT|, and other word-processing "windows", it broke the structure of the segments. The RORHL10, RORHL11, RORHL12 and RORHL121 routines have been amended to apply proper HL7 encoding to the text fields. The NOIS reference for this problem is PAL-1004-60805. [11] New HIV Drugs ------------- As per request from Center of Quality Management (CQM), two HIV drugs have been added to the ROR GENERIC DRUG file (#799.51) and associated with the ICR: EPZICOM (ABACAVIR/LAMIVUDINE) and TRUVADA (EMTRICITABINE/TENOFOVIR). [12] Temporary fix for Vitals API bug -------------------------------- Vitals API EN1^GMRVUT0, which is used by the CCR to extract the vital signs, erroneously appends zero to the dates without a time part. As a result, those dates were considered invalid during conversion into HL7 format and were replaced by empty strings. The RORHL16 routine has been ammended to provide a temporary fix for this problem (remove the zero) until the Vitals API is fixed. The NOIS reference for this problem is PAL-0105-60940. [13] Fix for invalid output transforms in the LAB DATA file (#63) ------------------------------------------------------------ The following fields of the LAB DATA file (#63) have invalid output transforms (direct WRITE): DATE/TIME SPECIMEN TAKEN (.01) of the multiple EM (2) DATE/TIME SPECIMEN TAKEN (.01) of the multiple SURGICAL PATHOLOGY (8) DATE/TIME SPECIMEN TAKEN (.01) of the multiple CYTOPATHOLOGY (9) Those output transforms look like this: D D^LRU W ?0,"---------------------------------" This caused a problem for the historical data extraction. The CCR package used constructions like this: D GETS^DIQ(63.08,IENS,".01;.03;.06;.07;.08","IE","ROROUT","RORMSG") As a result, those lines of dashes ended up in the output files (HL7 batches) and made the HL7 parser at AAC crazy. Since the external value of the .01 field was not actually needed, the RORHL06 and RORHL10 routines have been modified to extract only its internal value (separately from other fields). The NOIS reference for this problem is ISH-0105-41112. CCR GUI ------- [01] HL7 context management ---------------------- The code of the CCR GUI has been modified to implement the HL7 Context Management Standard developed by the Clinical Context Object Workgroup (CCOW). In order to use these enhancements, the Sentillion Vergence desktop components should be installed on the user workstation and the required Kernel (XU*8*337) and RPC Broker (XWB*1.1*35) patches should be installed on the M server. If the desktop components are not installed or not configured properly, the GUI will still be functional but all context management functionality will be disabled. If the required Kernel and/or RPC Broker patches are not installed, then the Single Sign-On/User Context (SSO/UC) functionality will be disabled. [02] Incorrect number of patients in the list ---------------------------------------- If the number of patients conforming to the search criteria was greater than the maximum value defined by the CCR GUI options, then up to 20 patient records more than the value of the parameter were added to the list on the Registry tab. The code of the GUI has been modified to load the correct number of patient records. The NOIS reference for this problem is PHI-0704-20569. [03] Incorrect ethnicity check-boxes on the CDC form ----------------------------------------------- While a patient was shown by the CPRS GUI with race and ethnicity 'Unknown', the 'Ethnicity' check-boxes of the CDC form indicated 'Not Hispanic or Latino'. The code of the GUI has been modified to check the correct 'Ethnicity' check-box. The NOIS reference for this problem is DET-0704-41561. [04] Interface enhancements ---------------------- Since the implementation of the context management involved significant changes to the GUI code, it had some "side effects" in the form of user interface enhancements (see the User Manual for more details): * When search for patient(s) is performed from the Registry tab, the "Patients found" field indicates the status of the search process. * A long patient search can be aborted by pressing the key. * Sort order indicators have been added to the task and patient lists. * Location and appearance of common buttons (Ok, Cancel, Save, etc.) have been uniformly modified for all dialog boxes. * Activate and Inactivate buttons have been removed from the ICR Patient Data Editor dialog box (because this functionality is available from the main toolbar). * Lists shown in most dialog boxes can now be sorted by different columns. * Appearance and functionality of the double-pane lists in the Site Parameters dialog box have been improved (e.g. Remove All buttons and 'drag and drop' functionality have been added). See the updated User Manual for more details. * Due to non-conformance with GUI design standards for VA applications, the Reconnect menu option has been removed from the File menu. Associated NOIS and Remedy Tickets: ================================== DET-0704-41561 HD0000000068139 FGH-0804-30388 HD0000000068167 ISH-0105-41112 HD0000000071188 LON-0904-61196 HD0000000068266 LOU-0804-41178 HD0000000068202 MAR-0804-20334 HD0000000068163 PAL-0604-61001 HD0000000068058 PAL-0804-60107 HD0000000068155 PAL-0804-60772 HD0000000068183 PAL-0804-61825 HD0000000068221 PAL-0904-60103 HD0000000068235 PAL-1004-60805 HD0000000068335 PAL-0105-60940 HD0000000068666 PHI-0704-20569 HD0000000067112 PRO-0404-11958 HD0000000067986 SFC-0704-60158 HD0000000068097 Thanks to Test Sites: ==================== Bronx Coatesville Long Beach NY Harbor Palo Alto San Antonio Routine Summary: =============== The following routines are included in this patch. The second line of each of these routines now looks like: ;;1.0;CLINICAL CASE REGISTRIES;**[patchlist]**;May 14, 2002 Checksum Routine Before After Patch List -------- -------- -------- --------------------------- ROR 2393807 2393819 2,3,5,6,8 ROR01 1117 1117 5,8 RORERR20 13404338 13500365 2,3,5,8 ROREXT 4234009 4259663 2,5,8 ROREXTUT 6225863 5466521 2,5,8 RORHDT02 1374405 2424530 2,5,8 RORHDT04 8306528 8399917 2,3,4,5,8 RORHDTUT 4563799 4590218 5,8 RORHL06 4487923 4688456 2,5,8 RORHL08 4376658 6190681 5,8 RORHL10 6706945 6840817 5,8 RORHL11 5142087 5507013 5,8 RORHL12 2274629 2446424 5,8 RORHL121 9997256 10798141 5,8 RORHL13 3432675 3406802 5,8 RORHL16 2973634 3293867 5,8 RORHL17 6039977 5969995 5,6,8 RORHL7 5115013 5463554 2,5,8 RORNTEG 4224648 4216987 3,4,5,6,8 RORNTEG0 3103265 3102911 3,4,5,6,8 RORP006 4399886 n/a 6 RORP008 n/a 3623044 8 RORRP024 3769315 3821351 5,8 RORRP030 6154417 4942418 5,6,8 RORRP035 1615892 1615985 5,8 RORSETU2 2901879 3134457 5,8 RORTSK01 7060222 6875571 5,8 RORUPD52 2548867 2583157 3,8 RORUTL18 285281 927178 6,8 RORX005A 7139090 7242281 5,8 RORX009A 6814376 7103569 5,8 RORX011 6937846 7479478 5,8 Data Dictionary Summary: ======================= File Field Comments -------- ------- --------------------------------------------- 798.1 21.06 New field (HDT PATIENTS PER BATCH). 798.5 1.01 Description of the FILE NAME field has been updated to reflect the changes in the code. INSTALLATION FILES: ================== The following software and documentation files are exported as part of this patch: File Name Contents Transfer Mode Size ---------------- ----------------------- ------------- --------- ROR1_OP8GUI.ZIP Zipped GUI distributive BINARY 3,764,007 ROR1_0P8DOC.ZIP Patch Documentation BINARY 255,752 ROR1_0P8IG.DOC Installation and 201,728 ROR1_0P8IG.PDF Implementation Guide 258,386 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: CIO 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 documentation will be in the form of an Adobe Acrobat file, and can also be found on the Health System Design and Development website: http://www.va.gov/vdl/ Installation Instructions: ========================= Please follow the instructions provided in the Clinical Case Registries Patch ROR*1*8 Installation/Implementation Guide (ROR1_0P8IG). Routine Information: ==================== Routine Name: - RORHDT04 Routine Checksum: Routine Name: - RORHL13 Routine Checksum: Routine Name: - ROR Routine Checksum: Routine Name: - RORHL17 Routine Checksum: Routine Name: - RORRP030 Routine Checksum: Routine Name: - RORTSK01 Routine Checksum: Routine Name: - RORUTL18 Routine Checksum: Routine Name: - RORX005A Routine Checksum: Routine Name: - RORP008 Routine Checksum: Routine Name: - RORNTEG Routine Checksum: Routine Name: - RORNTEG0 Routine Checksum: Routine Name: - RORX009A Routine Checksum: Routine Name: - RORX011 Routine Checksum: Routine Name: - RORERR20 Routine Checksum: Routine Name: - RORHL10 Routine Checksum: Routine Name: - RORHL11 Routine Checksum: Routine Name: - RORHL12 Routine Checksum: Routine Name: - RORHL121 Routine Checksum: Routine Name: - RORSETU2 Routine Checksum: Routine Name: - RORUPD52 Routine Checksum: Routine Name: - RORP006 Routine Checksum: Routine Name: - RORRP024 Routine Checksum: Routine Name: - ROREXT Routine Checksum: Routine Name: - RORHL08 Routine Checksum: Routine Name: - ROR01 Routine Checksum: Routine Name: - RORHDT02 Routine Checksum: Routine Name: - RORHDTUT Routine Checksum: Routine Name: - ROREXTUT Routine Checksum: Routine Name: - RORHL7 Routine Checksum: Routine Name: - RORHL16 Routine Checksum: Routine Name: - RORHL06 Routine Checksum: Routine Name: - RORRP035 Routine Checksum: ============================================================================= User Information: Entered By : GAVRILOV,SERGUEI Date Entered : AUG 11, 2004 Completed By: PATRICK,PAT Date Completed: APR 29, 2005 Released By : BELSCHWINDER,MICHAEL Date Released : APR 29, 2005 ============================================================================= Packman Mail Message: ===================== $END TXT