$TXT Created by WOLF,ED at MNTVBB.FO-ALBANY.MED.VA.GOV (KIDS) on Monday, 11/08/04 at 12:43 ============================================================================= Run Date: NOV 23, 2004 Designation: SD*5.3*376 Package : SD - SCHEDULING Priority: Mandatory Version : 5.3 SEQ #314 Status: Released Compliance Date: NOV 26, 2004 ============================================================================= Associated patches: (v)XU*8*284 <<= must be installed BEFORE `SD*5.3*376' (v)SD*5.3*349 <<= must be installed BEFORE `SD*5.3*376' Subject: COMBAT VETERAN AND OTHER INFORMATION ADDED TO PAIT Category: - Routine - Enhancement (Mandatory) - Data Dictionary Description: ============ This patch is a continuation of the Patient Appointment Information Transmission (PAIT) project. The previously released patches are: SD*5.3*290 SD*5.3*333 SD*5.3*349 The following enhancements, modifications and fixes are addressed: 1. COMBAT VETERAN (CV) The Chief Business Office (CBO) is requesting modifications to several Veterans Health Information Systems and Technology Architecture (VistA) packages to support implementation of VHA Directive 2002-049 - "Combat Veterans Are Eligible For Medical Services For 2-Years After Separation From Military Service Notwithstanding Lack Of Evidence For Service Connection", which iterates VA's policy to provide medical care and other medical services to combat veterans despite the absence of proof of service connection. A definition of the Combat Service taken from Attachment A of VHA DIRECTIVE 2004-017, April 2004 is: Combat Service - Veterans who served in combat during a period of war after the Gulf War, or against a hostile force during a period of hostilities after November 11, 1998, qualify, and are eligible for hospital care, medical services, and nursing home care for 2 years after discharge from the military for any illness. Software to support the Combat Veteran (CV) initiative has been developed and introduced in a phased implementation strategy. The Combat Veteran information included in PAIT is evaluated and transmitted based on the already released related patches. New HL7 message segments have been created and existing message segments have been changed to incorporate CV data. The additions are described below, summarized with the following format for each data item: Data item (source of data; assume Patient file if no other filename) - segment.sequence 1.1 Combat Veteran Eligibility field (calculated by a call to the ZEL segment) - ZEL.37 Identification/Notification of a CV Status veteran seeking medical care - CV eligibility will be calculated with the Appointment Creation Date passed as the treatment date. It indicates if the patient was eligible for CV status on the Appointment Creation Date. The result of the existing Registration API that creates the ZEL segment is modified by executing a separate call documented in DBIA # 4156 - NAME: COMBAT VETERAN STATUS. In the call to CVEDT^DGCV(DFN,DGDT), DGDT is now passed as the appointment creation date, to reflect the CV Status in reference to this date. ZEL-37: COMBAT VETERAN ELIGIBILITY is determined based on the Date Appointment Created, see SCH.11. The following values from table VA01 are used: 1 (Yes) is sent if the patient was/is considered a combat veteran; 0 (No) is sent if the patient wasn't/isn't considered a combat veteran. 1.2 Combat Veteran End Date field (.5295 of the Patient file) - ZEL.38 This field represents the last day for combat veteran eligibility. The calculated CV End Date indicates that a veteran has been CV eligible at some point in time. Even if the CV eligibility has expired, this date will be populated. 1.3 Combat Veteran Indication (COMBAT VETERAN field # 80007 of the Visit file # 9000010) - [ZCL].3[7] The Combat Veteran classification question is asked during the check out process or when updating the appointment's classifications. A seventh repetition of the ZCL (VA Specific Classification) segment was added that includes the answer to the Combat Veteran classification question, see table SD008: Table SD008 - Outpatient Classification Type VALUE DESCRIPTION -------------------- 1 AGENT ORANGE 2 IONIZING RADIATION 3 SERVICE CONNECTED 4 ENVIRONMENTAL CONTAMINANTS 5 MILITARY SEXUAL TRAUMA 6 HEAD AND/OR NECK CANCER 7 COMBAT VETERAN This will be included in the existing ZCL segment in the same way as other classifications are currently. 2. MILITARY HISTORY The Military History data is retrieved and transmitted so that the waiting time experienced by service members recently returning from the Iraq war can be calculated. A new ZMH segment is implemented - IE #: 4495. Table PAIT01 - Details of the field number for each field transmitted with PAIT: Type ------ SL Service Separation Date [Last] (.327) - ZMH4.2 COMB Combat Service Indicated (.5291) - ZMH3.1 Combat Service Location (.5292) - ZMH3.2 GULF Persian Gulf Service (.32201) - ZMH3.1 Table PAIT02 - Indicators identified and transmitted with PAIT: Type Indicator #1 Indicator #2 Indicator #3 To Date --------------------------------------------------------------- SL Not used Not used Not used Separated COMB Ind. 'Y', 'N' Service Location GULF Ind. 'Y', 'N' Not used Not used Not used 3. "Job Started" message on Forum server. A message will be generated from each site as soon as a new transmission starts and it will be sent to the Forum server. A tasked job on the Forum server will identify any site that has not started on the date following the PAIT scheduled date. A related reporting function will be available on Forum for the National Help Desk (NHD) and Enterprise VistA Support (EVS). 4. Post-installation updates: 4.1 Update sites that have not received HL7 acknowledgement (ACK) messages during the seeding process due to communication problems. Approximately 50% of seeding sites have not received acknowledgements and the expected process of flagging rejected appointments and removing the final, acknowledged ones, has not been performed. A post-init routine, working as a driver, will identify a particular sites where there is a need to execute the acknowledgement process, by retrieving rejected appointments from routines containing site-specific data only for sites with rejections. Appointments not rejected are processed as acknowledged. NOIS addressed: UNY-0404-12154 PAIT SEEDING 4.2 Clean up entries in the Patient Appointment Info file (#409.6) that report errors already resolved by later transmissions. Discrepancies have been identified between the error report that the site can generate using the Rejected Transmission [SD-PAIT REJECTED] option and the error report generated by the Austin Automation Center (AAC). The causes of the discrepancies are acknowledgements not coming to some sites after each run, and acknowledgements not coming on time for the previous transmissions. Currently it is the acknowledgement process that initiates cleaning the previously rejected entries. Patch SD*5.3*376 will perform a clean up of all entries except of those in the pending status. NOIS addressed: BIR-0604-30826 PAIT- Rejected appointments 5. Forum Server accepts and processes new completion messages from the VistA Interface Engine and Austin Automation Center. 6. HL7 subcomponent modifications to Provider AIP.3 segment: If a middle initial and/or a suffix were not identified and transmitted, the HL7 message did not include '~' as the end of AIP.3. The optional delimiters are now included as requested by AAC. 7. Interrupted Transmission Repair Process Fix: A separate option SD-PAIT Last Run Repair [SD-PAIT REPAIR] will be available to repair the interrupted PAIT transmission, while the follow-up finishing run may be scheduled independently. The SD-PAIT REPAIR option must be run before the additional transmission is started. If there is an attempt to start a new transmission but the previous one is not completed the task will abort, and a message will be sent to the SD-PAIT mail group: "The PAIT requested task has been terminated. The previous task #: 2784037 run #: 9 has not been completed. The previous run errored out, not repaired! Address a problem and use option SD-PAIT REPAIR to fix the run." Whenever an interrupted transmission is repaired a completion message to the National Help Desk will be generated asking them to initiate a NOIS to follow up with verification of the problem. An additional run must be started by the site to transmit the expected appointments for the current time period if the new transmission can be still processed by Austin Automation Center. NOIS's addressed: CTX-0604-71174 PAIT JOB CHA-0504-30364 MANUAL TRANSMISSION FOR SD-PAIT ERRORING OUT HIN-0504-40339 Cannot run patch SD*5.3*349 CTX-0704-70058 SD-PAIT TRANS ERROR NULL SUBSCRIPT ( ECH-0704-50049 SD-PAIT TRANS ERROR NULL SUBSCRIPT 8. Automated Verification on Forum server that requires elements from: - Vista Interface Engine messaging team - AAC team VistA IE is expected to report the number of batches received per site, and AAC is expected to report the number of batches received and a total of all received appointments. Any discrepancies with the VistA completion messages will generate messages to the National Help Desk. 9. Modification of completion messages More descriptive information is generated with different PAIT completion messages. The existing completion message format that is sent to the local SD-PAIT Mail Group and to the Forum server is as follows: Subj: 500 - PAIT BACKGROUND JOB [#1955306] 09/15/04@14:23 13 lines From: POSTMASTER In 'IN' basket. Page 1 *New* ------------------------------------------------------------------------------- The PAIT job has completed - TASK #: 2693498 Log #: 1 on 9/15/04@14:23 Started: 9/15/04 Last Scanned: 9/14/04 Pending appointments: 398 Final appointments: 622 ---------- Total appointments: 1020 Number of batches: 1 Fac Log Bch Appt # Date finished IP Address Gen Sent Com R Com P Status ----------------------------------------------------------------------- 500| 1| 1| 1020|9/15/04@14:23|10.6.208.19| 119| 118| 118 | 118 |Shutdown In addition to this existing completion message format the following informational messages may be generated: 9.1 If this is a clean run and totals of generated (Gen) and sent (Sent) batches are the same the only additional message is: "SUCCESS: Transmission completed." 9.2 If the number of (Gen-Sent) is less than the number of generated batches (Bch) that means that the transfer from the VistA site to the local Interface Engine (IE) is still in progress, and the following information will be sent: ex.: "WARNING: 2 out of 7 batches still have to be transmitted, please verify with the HL7 System Monitor." 9.3 If PAIT is stopped by a user it will finish cleanly but the below message will be sent additionally to the NHD. "WARNING: TASK STOPPED BY USER, NEEDS TO BE RESTARTED. INITIATE a NOIS to FOLLOW UP." 9.4 If the SD-PAIT HL Logical Link is "Shutdown", as shown in the above example of a completion message, it will be sent with the following note to the NHD: "SD-PAIT Logical Link has to be started!" 9.5 If (Gen)-(Sent) is not less than (Bch) and SD-PAIT Logical Link status is not "Shutdown", the problem is probably related to communication between VistA and the IE and the following message will complement the completion message sent additionally to the NHD: "Initiate a NOIS for VistA Interface Engine - communication problem." 9.6 When PAIT starts, it verifies that the prior transmission was completed. If it wasn't completed the following message is generated if SD-PAIT MANUAL TRANSMISSION is used: "The previous run errored out, not repaired! Please address a problem and then use option SD-PAIT REPAIR to fix the run." If PAIT is queued and the last run is not completed a message is sent to the SD-PAIT Mail Group: "The PAIT requested task has been terminated. The previous task #: 2784037 run #: 9 has not been completed. The previous run errored out, not repaired! Address a problem and use option SD-PAIT REPAIR to fix the run." 9.7 If the last PAIT run is repaired from the SD-PAIT Repair option the following note is added to the completion message: ex.: "WARNING!!!: Transmission of run#: 10 has been repaired. Please create a NOIS to verify if the problem has been addressed." Additionally if (Gen)-(Sent) is not less than (Bch) the problem is probably related to communication, and the following information will be added: "WARNING!!!: Transmission communication problem, please review." 10. Appointment Selection Logic. The following issue will be addressed: Appointments with a NULL creation date or a 'bogus' value not representing the VistA required date format for the DATE APPT. MADE field (# 20) of the APPOINTMENT SUBFILE (# 1900) in the Patient file (# 2), have been identified at some sites, and can be categorized as data corruption. The NULL creation date values were transmitted and the appointments were rejected. With this patch, the "ASADM" cross-reference in the Patient file will be checked for duplicates to eliminate resending null creation dates where the appointment has since been edited and a creation date exists. NOIS's addressed: DAY-0504-41282 PAIT Transmission Reject - 450 ATG-0504-31142 ERROR MESS #450 SD-PAIT TRANSMISSION REJECT SFC-0704-60302 How to process certain pait rejected transmissions 11. Patient Class evaluation. The current scheduling API returns only an OUTPATIENT/INPATIENT status in relation to the Appointment sub file (#2.98). It does not check the Patient Status In/Out field (#15002) in the Visit file (#9000010), therefore, returning under some conditions, a NULL value. This patch will change the process so that both the Visit(#9000010) and the Outpatient Encounter (#409.68) files will be evaluated to determine the proper Patient Class. 12. The cleaning process will be performed at the end of transmission instead of during the acknowledgement process. This change will make the cleaning process independent of acknowledgements, see 4.1 13. An informational message will be displayed to the user explaining why queuing of the manual option, Manual Startup PAIT Transmission [SD-PAIT MANUAL TRANSMISSION], is disallowed, when applicable. The following message will be displayed: You attempted to start PAIT outside the authorized transmission dates. Job has been terminated. NOIS addressed: ISB-0504-30390 Manual queue SD-PAIT MANUAL TRANSMISSION 14. This patch protects against errors due to a missing entry in the Patient Appointment Info Log file (#409.6) with a false "Y" cross reference, while scanning previously sent appointments. DAY-0704-41003 PAIT - transmitted 4 batches, no completion message 15. Currently, if an appointment is newly created and then cancelled, its status as a count or non-count clinic is not known. Additional verification is performed to determine the clinic type for canceled appointments, and if the clinic is 'NON-COUNT' it will receive 'NC' or 'RSN' as its appointment type. 'RSN' is a new Appointment Type value: RSN Re-schedule for Non Count The following canceled appointments will be anticipated for the Schedule Information Unsolicited (SIU) Message Type: SIU Event Mapping Table SIU SCH.25 Filler status SCH.6 Event Reason SCH.8 Appt Type S15 Final Cancelled Terminated (CT) S15 Final Cancelled Terminated (CT) Non Count (NC) S15 Final Cancelled by Clinic (CC) Re-schedule (RS) S15 Final Cancelled by Clinic (CC) Re-schedule for Non Count (RSN) S15 Final Cancelled by Clinic (CC) S15 Final Cancelled by Clinic (CC) Non Count (NC) S15 Final Cancelled by Patient (CP) Re-schedule (RS) S15 Final Cancelled by Patient (CP) Re-schedule for Non Count (RSN) S15 Final Cancelled by Patient (CP) S15 Final Cancelled by Patient (CP) Non Count (NC) If Appointment Type is not indicated or is 'RS' it will be interpreted as scheduled for a 'COUNT' clinic. 16 Field Name Change -------------------- The name of sub field #2 of Patient field #2 in file #409.6 was changed from HL7 BATCH # to HL7 MESSAGE ID. 17 Canceled Terminated Evaluation Modification ---------------------------------------------- If an appointment is canceled and another one is scheduled for the same Appointment Date/Time, then the previous one will get Canceled Terminated as the Event Reason, regardless of whether it was already canceled and transmitted in a previous run or if it was cancelled and transmitted in the current run with the new appointment that has the same Appointment Date/Time. This situation is automatically recognized when appointments have the same Appointment Date/Time, but different Creation Dates. The original Creation Date is retrieved from the Patient Appointment Info Log file #409.6, then overwritten in VistA by the Creation Date of the new appointment that has the same Appointment Date/Time. This patch addresses the following New Service Request (NSR): ------------------------------------------------------------ There was not a formal NSR associated with this patch. This patch addresses the following NOIS messages(s): --------------------------------------------------- UNY-0404-12154 PAIT SEEDING BIR-0604-30826 PAIT- Rejected appointments CTX-0604-71174 PAIT JOB CHA-0504-30364 MANUAL TRANSMISSION FOR SD-PAIT ERRORING OUT HIN-0504-40339 Cannot run patch SD*5.3*349 CTX-0704-70058 SD-PAIT TRANS ERROR NULL SUBSCRIPT DAY-0504-41282 PAIT Transmission Reject - 450 ATG-0504-31142 ERROR MESS #450 SD-PAIT TRANSMISSION REJECT SFC-0704-60302 How to process certain PAIT rejected transmissions ISB-0504-30390 Manual queue SD-PAIT MANUAL TRANSMISSION ECH-0704-50049 SD-PAIT TRANS ERROR NULL SUBSCRIPT The following documentation will be available: ============================================= File Name Description --------- ----------- SD_53_376_RN.PDF PAIT - Release Notes with SD*5.3*376 The preferred method is to FTP the file from: download.vista.med.va.gov Sites may retrieve the documentation directly using FTP from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Albany: ftp.fo-albany.med.va.gov Hines: ftp.fo-hines.med.va.gov Salt Lake City: ftp.fo-slc.med.va.gov Development Team: ----------------- Ed Wolf Steve Owen TESTING SITES: ============= 659 SALISBURY, NC 648 PORTLAND, OR 518 BEDFORD, MA 662 SAN FRANCISCO, CA 538 CHILLICOTHE, OH Additionally, the Patient Appointment Information Transmission repair process was tested in the COLUMBUS, OH (757) Production system where the regularly scheduled PAIT was interrupted because of the computer system going down. ============ INSTALLATION INSTRUCTIONS ================== NOTE: This patch installation requires previous installation of SD*5.3*349. Verify that the tasked PAIT Transmission [SD-PAIT TASKED TRANSMISSION] is not Scheduled to run at the time of installation. This patch may be installed with users staying on the system but because of the post-install process of updating outstanding acknowledgements it is advisable to run the installation when there is low activity. Install Time - less than 15 minutes 1. LOAD TRANSPORT GLOBAL --------------------- Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. DISABLE ROUTINE MAPPING (DSM for Open VMS sites only) ----------------------- Disable routine mapping on all systems for the routines listed in ROUTINE SUMMARY above. NOTE: If the routines included in this patch are not currently in your mapped routine set, please skip this step. 3. COMPONENTS SENT WITH PATCH -------------------------- 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: ;;5.3;Scheduling;**[patch list]**;Aug 13, 1993 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== SD376P N/A 2952283 376 SDRPA00 21030898 23456678 290,333,349,376 SDRPA02 3148669 4714175 349,376 SDRPA03 7922096 9714930 349,376 SDRPA04 N/A 11477406 376 SDRPA05 8714054 8808704 290,333,349,376 SDRPA06 12622184 12341805 290,333,349,376 SDRPA07 13059834 14643245 290,333,349,376 SDRPA08 14192786 14482919 290,333,349,376 SDRPA10 N/A 8202997 376 SDRPA11 N/A 6829874 376 SDRPA12 N/A 11762885 376 SDRPA13 N/A 20203817 376 SDRPA14 N/A 6822043 376 SDRPA15 N/A 7383061 376 SDRPA16 N/A 4035036 376 SDRPA17 N/A 14437021 376 SDRPA18 N/A 1098647 376 The following is a list of new option introduced with this patch: Option Name File New/Modified ------------------------------------------------------------------------------- SD-PAIT Last Run Repair [SD-PAIT REPAIR] #19 New Patient HL7 Location [SD-PAIT PATIENT HL7 LOCATION] #19 New The following is a list of files included in this patch: UP SEND DATA USER DATE SEC. COMES SITE RSLV OVER FILE # NAME DD CODE W/FILE DATA PTS RIDE ------------------------------------------------------------------------------- 409.6 PATIENT APPOINTMENT INFO LOG YES NO NO NO Partial DD: subDD: 409.69 fld: 2 fld: 8 DATA SCREEN: FIELD NAME: APPOINTMENT TYPE FLD NUMBER: 8 FLD TITLE: NODE;PIECE: 0;9 HELP FRAME: ACCESS: RD: DEL: WR: DATA TYPE: Set of Codes AR:Action Required NAT:No Action Taken F:Future NC:Non Count I:Inpatient NCF:Non Count Future ABK:Auto Rebook RS:Rescheduled O:Outpatient RSN:Rescheduled Non Count 4. START UP KIDS ------------- Start up the Kernel Installation and Distribution System Menu [XPD MAIN]: Edits and Distribution ... Utilities ... Installation ... Select Kernel Installation & Distribution System Option: INStallation Load a Distribution Verify Checksums in Transport Global Print Transport Global Compare Transport Global to Current System Backup a Transport Global Install Package(s) Restart Install of Package(s) Unload a Distribution 5. Select Installation Option: -------------------------- NOTE: When prompted for the INSTALL NAME, enter SD*5.3*376 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 DD's 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. c. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. 6. Select Installation Option: Install Package(s) ------------------- a. Choose the Install Package(s) option to start the patch install. b. When prompted 'Want KIDS to Rebuild Menu Trees Upon Competition of Install? YES//' answer NO. c. When prompted 'Want KIDS to INHIBIT LOGONs during the install ?YES//' answer NO. d. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', answer 'YES'. e. When prompted 'Enter options you wish to mark as 'Out of Order':' Enter the following options: SD-PAIT REPORTS PAIT Reports Menu SD-PAIT MANUAL TRANSMISSION Manual Startup PAIT Transmission f. When prompted 'Enter protocols you wish to mark as "Out Of Order':' press , NOTE: If installing on a test environment, an informational message, "NOT A PRODUCTION SYSTEM. POST INIT CANCELLED" will be displayed and the post-init will not be executed. 7. REBUILD MAPPED ROUTINE(S) (DSM for Open VMS sites only) ------------------------- NOTE: This step is only necessary if you performed step 2 or if you wish to include the routines in your mapped set. 8. Verify that SD-PAIT Logical Link is enabled, and if not start it. 9. Verify that you are a member of SD-PAIT Mail Group. 10. You must not install this patch on 1st, 2nd, 3rd, 15th, 16th or 17th of any month. NOTE: If you feel you have to install the patch on any of the above listed dates, please log a NOIS or call the National Help Desk. 11. Taskman PAIT Transmission [SD-PAIT TASKED TRANSMISSION] is scheduled to run the 1st and 15th of every month. Routine Information: ==================== Routine Name: - SDRPA00 Routine Checksum: Routine Name: - SDRPA06 Routine Checksum: Routine Name: - SDRPA03 Routine Checksum: Routine Name: - SDRPA02 Routine Checksum: Routine Name: - SDRPA05 Routine Checksum: Routine Name: - SDRPA07 Routine Checksum: Routine Name: - SDRPA08 Routine Checksum: Routine Name: - SDRPA10 Routine Checksum: Routine Name: - SDRPA11 Routine Checksum: Routine Name: - SDRPA12 Routine Checksum: Routine Name: - SDRPA13 Routine Checksum: Routine Name: - SDRPA14 Routine Checksum: Routine Name: - SDRPA15 Routine Checksum: Routine Name: - SDRPA16 Routine Checksum: Routine Name: - SDRPA17 Routine Checksum: Routine Name: - SDRPA18 Routine Checksum: Routine Name: - SD376P This post-install routine will initiate updating entries from the seeding run that have not received acknowledgements. Routine Checksum: Routine Name: - SDRPA04 This routine is called from the SD-PAIT Last Run Repair [SD-PAIT REPAIR] option if the repairing process is needed. Routine Checksum: ============================================================================= User Information: Entered By : WOLF,ED Date Entered : JUN 03, 2004 Completed By: LANIGAN,VASSER Date Completed: NOV 22, 2004 Released By : HEUER,CINDY Date Released : NOV 23, 2004 ============================================================================= Packman Mail Message: ===================== $END TXT