============================================================================= Run Date: MAY 05, 2006 Designation: TIU*1*184 Package : TIU - TEXT INTEGRATION UTILITIES Priority: Mandatory Version : 1 SEQ #196 Status: Released Compliance Date: JUN 19, 2006 ============================================================================= Associated patches: (v)TIU*1*43 <<= must be installed BEFORE `TIU*1*184' (v)TIU*1*64 <<= must be installed BEFORE `TIU*1*184' (v)TIU*1*77 <<= must be installed BEFORE `TIU*1*184' (v)TIU*1*112 <<= must be installed BEFORE `TIU*1*184' (v)TIU*1*144 <<= must be installed BEFORE `TIU*1*184' (v)TIU*1*155 <<= must be installed BEFORE `TIU*1*184' (v)TIU*1*156 <<= must be installed BEFORE `TIU*1*184' (v)TIU*1*157 <<= must be installed BEFORE `TIU*1*184' (v)TIU*1*173 <<= must be installed BEFORE `TIU*1*184' (v)TIU*1*180 <<= must be installed BEFORE `TIU*1*184' (v)TIU*1*182 <<= must be installed BEFORE `TIU*1*184' Subject: PATIENT RECORD FLAGS PHASE II Category: - Routine - Other - Input Template - Data Dictionary Description: ============ Patch TIU*1*184 is the TIU portion of the Patient Record Flags (PRF) Project Phase II. Two other portions of the project, patch DG*5.3*554 and patch USR*1*27, are being released along with Patch TIU*1*184 in a single KIDS software distribution. This patch includes the informational portion of Patch TIU*1*184, along with installation instructions for the combined software distribution. ************ Warning ************ Since TIU*1*184 has not been tested against CPRS GUI V25, please do not install TIU*1*184 until you are ready to install CPRS GUI V26 immediately after installing TIU*1*184. ****************** I. DESCRIPTION - Patch TIU*1*184 ================================ PRF notes are required by policy whenever a PRF flag is assigned (or continued, etc.), to document the reasons for the action. The Flag Assignment Action must be entered first; then a new note is written and linked to the assignment action. Patch TIU*1*184 together with DG*5.3*554 provides functionality to link notes to assignment actions, and TIU*1*184 ensures that every NEW PRF note is linked to a corresponding PRF Flag assignment action. Note that neither Registration nor TIU software enforces the reverse, that every PRF Flag assignment action be linked to a new PRF note. Instead, flag assignment actions lacking linked notes appear in PRF Registration reports so that they can be followed up manually. In addition to ensuring that every NEW PRF note is linked to a corresponding PRF Flag assignment action, TIU also provides an action to link existing, unlinked PRF notes (those created before the implementation of PRF II) to flag assignment actions. This action is also used to correct existing miss-linked notes. Authorization for this TIU List Manager action is granted using USR Action LINK TO FLAG, exported in USR*1*27. For linking EXISTING PRF notes, List Manager (LM) action LINK TO REQUEST has been changed to read: LINK TO OTHER APPLIC. Action LINK TO OTHER APPLIC appears on menus wherever action LINK TO REQUEST appeared before. The action is context-sensitive: it links a Consult Result to a Request, but links a PRF note to a flag. The LINK TO OTHER APPLIC action is available either directly or under submenu action 'Link' on the following menus: Text Integration Utilities (MRT) ... [TIU MAIN MENU MRT] Progress Notes/Discharge Summary [TIU] ... [TIU MAIN MENU CLINICIAN] Text Integration Utilities (MIS Manager) ... [TIU MAIN MENU MGR] Here is an example from the Manager menu: Clinical Documents Jan 20, 2005@13:55:16 Page: 1 of 1 by ALL CATEGORIES from 10/12/04 to 01/20/05 3 documents Patient Document Ref Date Status 1 XXXXXX PATIENT RECORD FLAG CATEGORY II- INF 01/10/05 completed 2 XXXXXX PATIENT RECORD FLAG CATEGORY I 01/10/05 completed 3 XXXXXX PATIENT RECORD FLAG CATEGORY I 12/10/04 completed + Next Screen - Prev Screen ?? More Actions >>> Find Delete Document Browse On Chart Reassign Interdiscipl'ry Note Edit Link to Other Applic Change View Verify/Unverify Send Back Print Amend Document Display... Quit Select Action: Quit// Besides these new linking capabilities, this patch updates existing note actions such as Change Title, Reassign, TIU Upload, etc., to ensure that any NEW PRF notes are linked to Flag assignment actions. Note that addenda are NOT linked to Flag assignment actions. The Detailed Display of PRF notes has been changed to include PRF link information. The change applies to both the GUI and the LM versions. The Detailed Display of PRF Titles has been changed to include computed field PRF Flag (#.15). If no flag is associated with a PRF title, the field has value '?'. PRF Titles cannot be used for Interdisciplinary Notes or for Group Notes. The use of PRF Titles for Group Notes would result in PRF notes which are not linked to flag actions. As of Phase II, new PRF notes must ALWAYS be linked to flags. Pre-patch Setup: Titles In preparation for Phase II, in which every title used to document clinical reasons for flag assignment is associated with ONE flag and every flag is associated with ONE PRF title, sites should examine their PRF titles to make sure they have a separate title for each flag, and are not using more than one title for any particular flag. Some sites may find it best to create NEW titles for Phase II and inactivate the old titles. Sites should also make sure that titles used to document clinical reasons for flag assignment are in the appropriate PRF Document Class. If sites wish to use action COPY/MOVE from the Document Definition Utility to move PRF titles or documents, they must do so BEFORE installing this patch. **** The following actions are no longer permitted *** *** once TIU*1*184 is installed *** - Moving titles into or out of PRF document classes - Moving documents en masse from one title to another if one or both titles are PRF titles, Also, you are reminded that Category II titles should be named according to the following pattern from the PRF Directive: PATIENT RECORD FLAG CATEGORY II - [ ] where the bracketed part is determined by the site when it creates its own Category II titles. It is best if this part matches the flag name. ONCE THIS PATCH IS INSTALLED, NEW ASSIGNMENTS CANNOT BE MADE FOR PRF CATEGORY II FLAGS AND EXISTING CATEGORY II ASSIGNMENTS CANNOT BE EDITED UNTIL A PRF PROGRESS NOTE TITLE IS ASSOCIATED WITH THE FLAG. Pre-patch Setup: Business Rules *** IMPORTANT *** ** SITES SHOULD REVIEW THEIR BUSINESS RULES PERMITTING PRF NOTES TO BE VIEWED BEFORE INSTALLING V26 OF THE CPRS GUI ** The flag display in CPRS GUI has been modified in v26 to list Progress Notes that have been linked to the selected flag. If the user then selects a listed note, the note is displayed if the user has permission to view it. Although permission to view these notes here is identical to permission for viewing them from the notes tab, this list is accessible upon patient selection, making the list more prominent. With this in mind, ** SITES SHOULD REVIEW THEIR BUSINESS RULES PERMITTING PRF NOTES TO BE VIEWED BEFORE INSTALLING V26 OF THE CPRS GUI ** Note: The list of notes is available upon patient selection in the CPRS GUI ONLY, NOT from List Manager. For Linking rules, see the Post-Installation Setup section. Remedy/NOIS: ============ HD0000000069156 FAR-0799-40998 Unable to remove Entered In Error notes from completed consults HD0000000071109 MIN-1204-40058 Consult Note Titles Changed- HD0000000070045 RIC-0303-20597 UNLINK note from consult HD0000000070565 HWH-0204-41760 User wishes to disassociate a result from a consult HD0000000069271 BEC-0500-21732 have wrong note tied to consult HD0000000069283 CIH-0600-41855 Need to Disassociate Note HD0000000069370 NJH-0101-22886 INCORRECT NOTE LINKED TO CONSULT HD0000000069386 NOL-0301-70356 Break link to consult w/o assigning note to new consult HD0000000069439 RIC-0601-20548 Disassociate Result Not Working? HD0000000069922 MEM-1102-71490 TITLES DISASSOCIATION FROM CONSULT HD0000000070008 WAS-0203-20287 REASSIGN REQUIRING LINK TO CONSULT HD0000000070045 RIC-0303-20597 UNLINK note from consult II. TECHNICAL COMPONENTS - Patch TIU*1*184 ========================================== ROUTINE SUMMARY: **Old Checksums** ================================== The following is a list of the routine(s) included in Patch TIU*1*184. The second line of each of these routine(s) will look like: ;;1.0;TEXT INTEGRATION UTILITIES;**[patch list]**;Jun 20, 1997 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== TIUCNSLT 6031905 7680970 4,31,109,131, 142,144,184 TIUEDI3 7643974 7702924 100,113,184 TIUFD 13598967 13638982 14,184 TIUFHA1 16281189 16299871 2,13,43,184 TIUFHA7 28416472 29111623 11,27,184 TIUFHA8 22552337 19530681 11,27,64,184 TIUFHLP1 7600836 7667058 14,184 TIUHELP 6454973 7638562 100,184 TIUFL 8588136 8588216 14,184 TIUFLD 13320947 13416565 14,77,184 TIUFLF7 11169628 12404691 2,17,90,184 TIULP 12967495 14818023 98,100,116,109,138, 152,175,157,182,184 TIUPEVNT 12180351 12148923 3,21,81, 131,113,184 TIUPFFIX NA 3684395 184 TIUPNAPI 5881794 7781371 57,140,175,180,184 TIUPRF NA 1869304 184 TIUPRF1 NA 11387713 184 TIUPRF2 NA 6445914 184 TIUPRF3 NA 1227681 184 TIUPRFL NA 5759293 184 TIUPS184 NA 1649522 184 TIUPUTC 10381246 10429781 3,21,81,100,113, 112,173,184 TIUPUTPF NA 8593572 184 TIURB 10277423 11313361 4,32,52,78, 58,100,109,155,184 TIURB2 10551884 11023872 100,109,154, 112,184 TIURC1 13203672 13165195 100,113,184 TIURD 11887994 11792326 4,58,61,100, 109,173,184 TIURE 10529314 10848831 3,21,81, 131,113,184 TIURS1 17599097 18256027 7,36,58,100, 109,142,156,184 TIUSRV 14983008 12499047 1,19,28,87,61, 100,109,113,112,184 TIUSRVP 14589099 10211280 1,7,19,28,47,89,104, 100,115,109,167,113, 112,175,157,184 TIUSRVP2 NA 5492322 184 PROTOCOLS: TIU ACTION LINK TO PROBLEMS SEND TO SITE TIU ACTION LINK TO VISIT SEND TO SITE TIU ACTION LINK WITH CLIENT RECORD SEND TO SITE TIU ACTION MENU LINK SEND TO SITE TIU BROWSE ACTION LINK TO PROBLEM SEND TO SITE TIU BROWSE ACTION LINK WITH CLIENT APP SEND TO SITE TIU BROWSE ACTION REASSIGN SEND TO SITE TIU BROWSE MENU LINK SEND TO SITE REMOTE PROCEDURE: TIU GET DOCUMENT STATUS SEND TO SITE TIU GET PRF ACTIONS SEND TO SITE TIU ISPRF SEND TO SITE TIU LINK TO FLAG SEND TO SITE TIU GET PRF TITLE SEND TO SITE TIU GET LINKED PRF NOTES SEND TO SITE POST-INSTALL ROUTINE: POST^TIUPS184 The Post-Install routine populates the following fields for Document Classes PATIENT RECORD FLAG CAT I and PATIENT RECORD FLAG CAT II: #4 UPLOAD LOOK-UP METHOD #4.4 DELETE ACTION #4.45 PACKAGE REASSIGNMENT ACTION #4.5 UPLOAD POST-FILING CODE #4.8 UPLOAD FILING ERROR CODE #5 EDIT TEMPLATE #6.51 ON RETRACT EVENT Note: Document Classes PATIENT RECORD FLAG CAT I and PATIENT RECORD FLAG CAT II were created in PRF Phase I by running an option sent out with patch TIU*1*165. Patches TIU*1.0*184 and DG*5.3*554 assume the existence of these Document Classes, along with Title PATIENT RECORD FLAG CATEGORY I. INPUT TEMPLATE: TIU ENTER/EDIT PRF Edit template TIU ENTER/EDIT PRF is new. It is similar to the Progress Notes Edit Template but includes code to link newly created PRF notes to flag actions. The post-install routine TIUPS184 assigns this new template as the EDIT TEMPLATE for document classes PATIENT RECORD FLAG CAT I and PATIENT RECORD FLAG CAT II. TIU DOCUMENT DEFINITION FILE (#8925.1) ====================================== New Computed Field PRF FLAG DATA NAME GLOBAL DATA ELEMENT TITLE LOCATION TYPE -------------------------------------------------------------------------- 8925.1,.15 PRF FLAG ; COMPUTED TITLE: ASSOCIATED PATIENT RECORD FLAG DESCRIPTION: PRF FLAG applies only to PRF titles. The PRF FLAG of a PRF title is the name of the Patient Record Flag associated with the title. (Notes cannot be written using a PRF title unless the title is associated with a flag and that flag is assigned to the given patient.) If the title is not associated with a flag or the associated flag cannot be found, the field has value "?". If the Document Definition is not a title under Document Class PATIENT RECORD FLAG CAT I or PATIENT RECORD FLAG CAT II, the field has value NA for non-applicable. TIU DOCUMENT FILE (#8925) ========================= New Computed Field PRF FLAG ACTION DATA NAME GLOBAL DATA ELEMENT TITLE LOCATION TYPE -------------------------------------------------------------------------- 8925,1407 PRF FLAG ACTION ; COMPUTED TITLE: LINKED PATIENT RECORD FLAG ACTION DESCRIPTION: PRF FLAG ACTION applies only to PATIENT RECORD FLAG (PRF) notes. When a new flag is assigned to a given patient, or, after review, another action such as CONTINUE is taken on an existing flag assignment, a note must be written to document the clinical reasons for the action. Upon entry of the note, it is linked to the action it documents. Field PRF FLAG ACTION refers to this linked action. The field contains the Date of the Action followed by the Name of the Action. Example: 3/3/05 CONTINUE If the PRF note is not linked to a flag action or the linked action date or name cannot be found, the field has value "?". If the note is not a PRF note (a note with a title under Document Class PATIENT RECORD FLAG CAT I or PATIENT RECORD FLAG CAT II), the field has value NA for non-applicable. III. COMBINED SOFTWARE AND DOCUMENTATION RETRIEVAL ================================================== The software for this patch is included in a combined KIDS build along with patches USR*1*27 and DG*5.3*554. The combined build is being distributed as a host file. Host file name: PRF_PhaseII.KID Build 1: TIU*1.0*184 Build 2: USR*1.0*27 Build 3: DG*5.3*554 Documentation is distributed in a zip file and includes the following documents: - Updated TIU Implementation Manual (Appendix F covers TIU aspects of PRF Phase II, including set-up information. It is similar to the PRF Handbook that was created for test sites.) - Updated ASU User Manual - Updated ASU Technical Manual - Combined TIU/USR/DG Release Notes - Patient Record Flags Phase II User Guide (Registration's User Guide) INSTALLATION FILES: =================== The following software and documentation files are exported as part of this patch: File Name Contents Retrieval Format --------- -------- ---------------- PRF_PHASEII.KID KIDS Build ASCII PRFII.ZIP File(s) indented below BINARY - TIUIM.DOC Implementation Manual (Word Version) - TIUIM.PDF Implementation Manual - ASUUM.DOC User Manual (Word Version) - ASUUM.PDF User Manual - ASUTM.DOC Technical Manual (Word Version) - ASUTM.PDF Technical Manual - PRFII_RN.DOC Release Notes (Word Version) - PRFII_RN.PDF Release Notes - DG_53_554_UG.DOC User Guide (Word Version) - DG_53_554_UG.PDF User Guide 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 may also be found on the VistA Documentation Library [VDL] web site. This web site is usually updated within 1-3 days of the patch release date. The VDL address is http://www.va.gov/vdl/Clinical.asp?appID=156. IV. COMBINED INSTALLATION INSTRUCTIONS ====================================== Pre-Installation Notes on USR*1*27: * Environment Check: The environment check makes sure the current USR ACTION file 8930.8 has the correct actions with the correct IENS. The last record in the file should be ATTACH ID ENTRY, IEN #25. If the check finds incorrect actions or IENS, it will abort. If the file already has action LINK TO FLAG, IEN #26, the action is overwritten. If the file is correct and does not yet have action LINK TO FLAG, the patch will install it as IEN 26. Pre-Installation Notes on DG*5.3*554: * Environment Check: Programmer access is required for installing this patch. ** NOTE ** -- Prior to installation, the installer must ensure the DUZ(0) node of the DUZ array is set to the "@" symbol. * Users On the System: This patch modifies routines used by the Patient Lookup process and may affect many users. It also impacts the following Registration options: DGPF* DG LOAD PATIENT DATA Load/Edit Patient Data DG REGISTER PATIENT Register a Patient Therefore, this patch may be installed with users on the system, but should be loaded during non-peak hours to minimize disruption to users and to reduce the possibility of errors when the routines are updated. * Post-Install Routine (POST^DG53P554) associates the PRF National Flag with Progress Note Title PATIENT RECORD FLAG CATEGORY I. Document Definitions: ===================== Patches TIU*1.0*184 and DG*5.3*554 assume the existence of Document Classes PATIENT RECORD FLAG CAT I and PATIENT RECORD FLAG CAT II, and Title PATIENT RECORD FLAG CATEGORY I. These Document Definitions were created in PRF Phase I by running an option sent out with patch TIU*1*165. COMBINED Required Builds: ========================= The following is a list of REQUIRED builds which must be installed prior to installing the distribution: Prior Required Build(s): ------------------------ TIU*1.0*43 TIU*1.0*64 TIU*1.0*77 TIU*1.0*90 TIU*1.0*112 TIU*1.0*144 TIU*1.0*155 TIU*1.0*156 TIU*1.0*157 TIU*1.0*173 TIU*1.0*180 TIU*1.0*182 DG*5.3*425 DG*5.3*555 DG*5.3*623 In addition, patch DG*5.3*554 requires both TIU*1.0*184 and USR*1.0*27. Patch DG*5.3*554 must therefore be installed last, after the other two patches. COMBINED Installation Instructions: =================================== This distribution may be installed with users on the system; however, it should be installed at a non-peak time to minimize disruption to the users. Installation of this distribution should take less than 15 minutes total for all three patches Installation Steps: =================== 1. Download file PRF_PhaseII.KID to the appropriate directory on your system. See section COMBINED SOFTWARE AND DOCUMENTATION RETRIEVAL, above. 2. Use LOAD A DISTRIBUTION option on the KIDS INSTALLATION menu, and enter: PRF_PhaseII.KID 3. If given the option to run any Environment Check Routine(s), answer "YES." 4. From the 'Kernel Installation & Distribution System' menu, select the Installation menu. 5. From this menu, you may now elect to use the following options if you wish. (When prompted for INSTALL NAME, enter TIU*1.0*184.) a. Backup a Transport Global b. Compare Transport Global to Current System c. Verify Checksums in Transport Global d. Print Transport Global 6. Use the Install Package(s) option and select package TIU*1.0*184. 7. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//', respond NO. 8. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//', it is recommended you answer NO. 9. When prompted to 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', respond YES. When prompted to select the options you would like to place out of order, enter the following: TIU* USR* DGPF* DG LOAD PATIENT DATA Load/Edit Patient Data DG REGISTER PATIENT Register a Patient 10. Environment check/Pre-install/Post-install routines TIUPS184, USR27 and DG53P554 should be deleted from your system after successful patch installation. V. COMBINED POST-INSTALLATION SETUP: ===================================== ONCE THIS PATCH IS INSTALLED, A NEW CATEGORY II FLAG ASSIGNMENT CANNOT BE CREATED UNTIL THE FLAG HAS A PRF TITLE ASSOCIATED WITH IT. Record Flag Management options are used to associate flags with titles. See Patch Description for DG*5.3*554 or Release Notes. Authorization for Linking/Re-linking Existing Notes in TIU LM: In setting up, sites will need to write business rules for action LINK TO FLAG before users can link existing notes created before Phase II of PRF, or re-link Patient Record Flag (PRF) notes that have been improperly linked. Your rules will probably bear some resemblance to the rules for linking Consults: for Unsigned notes, authors should be permitted to re-link their own notes. For signed notes, re-linking should be reserved for a small group of users who are familiar with both TIU and Patient Record Flags and are qualified to correct chart documents. Retracted notes are automatically unlinked upon retraction and must never be re-linked. Rules will need to be set for both PRF Document Classes: PATIENT RECORD FLAG CAT I and PATIENT RECORD FLAG CAT II. Note that this authorization is required to link/re-link existing notes. It is NOT required to link new notes during NOTE CREATION. Uploading PRF Notes: Sites intending to upload PRF notes MUST set up new Upload parameters for Document Classes PATIENT RECORD FLAG CAT I and PATIENT RECORD FLAG CAT II. They should also designate as filing error recipients persons familiar with linking notes to actions, for those rare cases where the software is not able to link uploaded notes automatically. ********************* IMPORTANT UPLOAD WARNING Do not upload PRF notes as Progress Notes, using the existing upload setup for Progress Notes. If your site plans to upload PRF notes, upload parameters MUST be set explicitly for Document Classes PATIENT RECORD FLAG CAT I and PATIENT RECORD FLAG CAT II. Failure to do so will result in new PRF notes which ARE NOT LINKED TO FLAGS, and the creation of new unlinked PRF Notes is not permitted in PRF Phase II! *********************** See details in section UPLOADING PRF NOTES of the Release Notes. Note: PRF notes, like Consults, are always uploaded as original notes, never as addenda to existing notes. Routine Information: ==================== Routine Name: TIUCNSLT Routine Name: TIUEDI3 Routine Name: TIUFD Routine Name: TIUFHA1 Routine Name: TIUFHA7 Routine Name: TIUFHA8 Routine Name: TIUFHLP1 Routine Name: TIUFL Routine Name: TIUFLD Routine Name: TIUFLF7 Routine Name: TIUHELP Routine Name: TIULP Routine Name: TIUPEVNT Routine Name: TIUPFFIX Routine Name: TIUPNAPI Routine Name: TIUPRF Routine Name: TIUPRF1 Routine Name: TIUPRF2 Routine Name: TIUPRF3 Routine Name: TIUPRFL Routine Name: TIUPS184 Routine Name: TIUPUTC Routine Name: TIUPUTPF Routine Name: TIURB Routine Name: TIURB2 Routine Name: TIURC1 Routine Name: TIURD Routine Name: TIURE Routine Name: TIURS1 Routine Name: TIUSRV Routine Name: TIUSRVP Routine Name: TIUSRVP2 ============================================================================= User Information: Entered By : HAWSEY,JASON Date Entered : MAR 17, 2004 Completed By: SERVICE,JOHN Date Completed: MAY 05, 2006 Released By : STRONG,NICK Date Released : MAY 05, 2006 ============================================================================= Packman Mail Message: ===================== No routines included