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VA Code in Flight Submission - VIMM v2 Patch PX*1*215 v1 (code only)
Please use this identifier to cite or link to this publication: http://hdl.handle.net/10909/11193
Submitted by OI&T EPMO Lean Systems Engineering Open Source Coordination Office on 03-23-2016.
The Veterans Health Information Systems and Technology Architecture
(VistA) Immunizations Enhancements (VIMM) 2.0 project, Increment 3, builds
upon the file structures and standardized data introduced in Increments 1
and 2 by adding functional enhancements to the existing VistA Patient Care
Encounter (PCE) package.

This patch provides the following new features:

1) This patch creates Remote Procedure Calls (RPCs) for use by the
Enterprise Health Management Platform (eHMP) project, the
Computerized Patient Record System (CPRS) software, Data Access Service
(DAS) and others. These RPCs retrieve immunization information from the
following files:
- VACCINE INFORMATION STATEMENT (#920)
- IMMUNIZATION INFO SOURCE (#920.1)
- IMM ADMINISTRATION ROUTE (#920.2)
- IMM ADMINISTRATION SITE (BODY) (#920.3)
- IMM CONTRAINDICATION REASONS (#920.4)
- IMM REFUSAL REASONS (#920.5)
- V IMM CONTRA/REFUSAL EVENTS (#9000010.707)
- IMM MANUFACTURER (#9999999.04)
- IMMUNIZATION (#9999999.14)
- IMMUNIZATION LOT (#9999999.41)

2) This patch introduces functionality for capturing the reason(s) an
immunization was not given by documenting immunization
contraindications and/or refusal events. This functionality includes
the following:
- Creation of the V IMM CONTRA/REFUSAL EVENTS file (#9000010.707)
- A WARNING UNTIL DATE may be stored for temporary
contraindications/refusals. This is the date until which the
contraindication/refusal is valid.
- When an immunization for a patient is associated with valid
contraindications/refusals (WARNING UNTIL DATE is not a past date),
the software will display a warning and the user will be required to
acknowledge the warning and enter a justification reason before
continuing with administration.

3) This patch inactivates the PCE CODE MAPPING file (#811.1). The file
will still exist, but the mappings in the file will no longer be used
to determine which related entries in the V IMMUNIZATION (#9000010.11),
V SKIN TEST (#9000010.12), and V CPT (#9000010.18) files need to
reflexively be recorded. From now on, the mappings in the CODING SYSTEM
multiple of the IMMUNIZATION (#9999999.14) and SKIN TEST (#9999999.28)
files will be used for this purpose. There are a few differences with
this new approach:
a) The PCE CODE MAPPING file was managed locally, while the CODING
SYSTEM multiple of the IMMUNIZATION and SKIN TEST files are
standardized and managed nationally.
b) We will now support mappings to ICD-10 codes. If an immunization
or skin test is mapped to an ICD-10 code, when that immunization
or skin test is documented, we will reflexively file the mapped
ICD-10 code to the V POV file (#9000010.07).
c) We will stop the practice of reflexively recording an immunization
or skin test when a corresponding CPT code is filed. The mappings
will only be used to reflexively file the corresponding codes (CPT
and ICD-10) when an immunization or skin test is documented.
However, in the reverse scenario, when a CPT code is documented,
we will not reflexively record the corresponding immunization or
skin test.
d) Codes will only reflexively be filed when a VA-administered
(non-historical) immunization or skin test is documented.

4) This patch includes functionality to enable a documenting provider to
view some immunization prompts with default values to accept and to
edit the responses if need be. This functionality includes:
- Creation of the IMM DEFAULT RESPONSES file (#920.05) to store
facility specific default values by immunization type for ROUTE OF
ADMINISTRATION, SITE OF ADMINISTRATION, DOSE, DOSE UNITS, and COMMENTS.
- Creation of the Immunization Default Responses Enter/Edit menu option
[PXV EDIT DEFAULT RESPONSES] to allow authorized users to enter or
update information in the IMM DEFAULT RESPONSES file (#920.05).

5) This patch updates the NDC CODE (VA) field (#.18) in the IMMUNIZATION
LOT file (#9999999.41) so that access to information in the NDC/UPN
file (#50.67) is controlled by application programmer interfaces
(APIs).

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