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VA Code in Flight Submission - Existing Product Intake Program (EPIP) Patches.
Revision: 1
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Patch LR*5.2*508 corrects references to one obsolete field and one specimen found in the EXECUTE CODE file (#62.07) for Mycology and Bacteriology. The obsolete references were discovered after the release of LR*5.2*476.
For Mycology, field #19.2 listed in the EXECUTE CODE field (#1) is not defined in the LAB DATA file (#63) and is deleted. For Bacteriology, specimen #68 from the TOPOGRAPHY FIELD file (#61) was previously referenced in the EXECUTE CODE field (#1) with the expression LRSPEC=68. This reference is changed to LRSPEC=360 to reflect specimen #360 from the TOPOGRAPHY FIELD file (#61).
This patch also updates the DESCRIPTION field (#6) in the EXECUTE CODE file (#62.07) with new national definitions for Bacteriology, Mycology, and TB Bacteriology entries. The national definitions are updated to include the sub-fields PRELIMINARY BACT COMMENT (#1), PRELIMINARY MYCOLOGY COMMENT (#20.5), and PRELIMINARY TB COMMENT (#26.5). These sub-fields originate from the MICROBIOLOGY multiple field (#5) defined in the LAB DATA file (#63).
Post-installation routine LR52P508 makes the edits to the EXECUTE CODE field (#1) for Bacteriology and Mycology records. This routine also updates the DESCRIPTION field (#6) with new national definitions for Bacteriology, Mycology, and TB Bacteriology entries. Upon completion of patch installation, the routine is deleted automatically.
Routine LRMISTF is modified to reference the preliminary comment fields for Bacteriology, Mycology, and TB Bacteriology, along with corresponding expansion codes. This enables predefined messages from the LAB DESCRIPTIONS file (#62.5) to appear when the user runs the Results Entry (Batch) option.
Note to sites: Office of Information and Technology (OIT) personnel can retrieve the installation log for this patch by using the Install File Print [XPD PRINT INSTALL FILE] option in the UTILITIES submenu of KIDS. If any local changes were saved when this patch was installed, they must be restored manually after installation of the patch.

BLOOD BANK Clearance:
EFFECT ON BLOOD BANK FUNCTIONAL REQUIREMENTS: Patch LR*5.2*508 does not contain any changes to the VISTA BLOOD BANK Software as defined by ProPath standard titled: BBM Team Review of VistA Patches.

EFFECT ON BLOOD BANK FUNCTIONAL REQUIREMENTS: Patch LR*5.2*508 does not alter or modify any software design safeguards or safety critical elements functions.

RISK ANALYSIS: Changes made by patch LR*5.2*508 have no effect on Blood
Bank software functionality, therefore RISK is none.

VALIDATION REQUIREMENTS BY OPTION: Because of the nature of the changes made, no specific validation requirements exist as a result of installation of this patch.

Patch PSB*3.0*111 corrects an issue with the 'Missing Dose Followup' report as reported by a single VA site in a multidivisional setting. The issue states that after a record is selected for completion and then saved, it is not dropping off the list of available records. The expected behavior is that after a record in the report is completed and saved, it should be removed from the report selection list.

The routine PSBMD is modified to correct this issue by refreshing the report selection list when any record is completed and saved.

Patch DGJ*1.0*5 modifies the Incomplete Records Tracking (IRT) package to enable an existing IRT nightly scheduled job to automatically review the Computerized Patient Record System (CPRS) Text Integration Utility (TIU) Note system to search for tracked IRT deficiencies. A deficiency occurs when a note cannot be marked as Complete (Reviewed) because one or more providers need to sign the note. The tracked IRT deficiencies are DISCHARGE SUMMARY, H&P ADMISSION (formerly H&P SUMMARY), and OP REPORT. Deficiencies are tracked for Inpatient records only.

If a TIU document is found that satisfies the deficiency, then IRT marks the note as Complete. If no TIU document satisfying the deficiency is found, then IRT generates a new deficiency for tracking purposes and sends an alert to the provider that must take action to complete the note.

A new IRT Print menu [DGJ IRT PRINT2] provides two new reports that can be used to identify deficiencies requiring resolution. The IRT Print menu is accessed from the existing DGJ IRT PRINT menu. The new reports are:

- PIA – Print Incomplete Records (by Attending) [DGJ IRT INCOMPLETE3], prints tracked IRT deficiencies by attending physician. This allows the report to be easily distributed to providers that have deficiencies to resolve.

- PIH – Print Incomplete Records by Discharge (Hosp wide) [DGJ IRT INCOMPLETE2] reports IRT deficiency totals by Service/Section for management tracking purposes.

After IRT deficiencies have been resolved and marked as Complete through the TIU signature process, they display on the IRT reports with a status of "COMPLETED." To remove completed deficiencies from the reports, delete the IRT record from the INCOMPLETE RECORDS file (#393) using the existing Delete an IRT [DELETE AN IRT] option on the Incomplete Records Tracking menu.

Three new alert options are added to the OPTION SCHEDULING file (#19.2). An alert is sent if no TIU document satisfying a deficiency is found. Each alert is associated with one of the tracked deficiencies: Discharge Summary Alerts [DGJ DISCHARGE SUMMARY ALERTS] is associated with the DISCHARGE SUMMARY deficiency; H&P Due Alert [DGJ H&P DUE ALERT] is associated with the H&P ADMISSION deficiency; OP Report Due [DGJ OP REPORT DUE] is associated with the OP REPORT deficiency.

The post-installation routine DGJP005 modifies the MEDICAL CENTER DIVISION file (#40.8) by adding three new fields that are used to adjust the frequency of the new alerts. The values stored in these fields specify the number of hours elapsed between when a qualifying event occurs and when the resulting alert is sent. The qualifying events are discharge from a ward, admission to a ward, or completion of an operation. The DISCHARGE ALERT HRS field (#100.4) determines the Discharge Summary Alerts hours elapsed (the number of hours elapsed after discharge and before an alert is sent); the H&P ALERT HOURS field (#100.5) determines the H&P Due Alert hours elapsed (the number of hours elapsed after admission to a ward and before an alert is sent); the OPERATION ALERT HOURS field (#100.6) determines the OP Report Due alert hours elapsed (the number of hours elapsed after an operation is completed and before an alert is sent). These values can be customized for each VA Medical Center Division.

Note: The new fields in the MEDICAL CENTER DIVISION file may be set to a value of 0 – 720 hours, with each day defined as an increment of 24 hours. The post-installation routine sets these values to a default of 24 hours for each Medical Center Division having the TRACK INCOMPLETE SUMMARIES (#100.01) field set to "Y" (Yes). If the TRACK INCOMPLETE SUMMARIES field is set to “N” (No), then signature tracking and alert functionality are not available.

The post-installation routine also sets the new IRT TRACKING field (#999) in the FACILITY TREATING SPECIALTY file (#45.7) to the default value TRACKING AND REPORTS, enabling any active Treating Specialty to be included in IRT tracking and subsequent reports. To exclude a Treating Specialty from IRT tracking or reporting, use the new IRT Tracking [IRT PARAMETERS] option to change the value of the IRT TRACKING field to either TRACKING ONLY or NO TRACKING. The IRT DEFICIENCY EXCLUDED field (#999.1) in the FACILITY TREATING SPECIALTIES EXCLUDED file (#45.703) stores information necessary to exclude certain IRT deficiencies from being tracked for a certain Treating Specialty. The FACILITY TREATING SPECIALTIES EXCLUDED file is a sub-file within the FACILITY TREATING SPECIALTY file.

Finally, the post-installation routine re-schedules the nightly IRT job (IRT Update Std. Def. Background Job [DGJ IRT UPDATE] option), which performs a nightly review of the CPRS TIU Note system, to run before the alert options.

These changes enable the IRT, Surgery, TIU, and CPRS applications to function together to track and complete IRT deficiencies.

Patch SR*3.0*192 adds the new IRT RECORD field (#1010) and modifies the existing TIME PAT OUT OR field (#.232) in the SURGERY file (#130). These fields are used to track the signature status and related IRT deficiencies for Operative Reports. When the TIME PAT OUT OR field is entered during completion of the Nurse’s Interoperability Report (NIR), a trigger cross-reference is executed to create an entry for the OP REPORT deficiency in the DEFICIENCY file (#393). A stub (placeholder) for the Operative Report is created in the TIU application.

TIU*1.0*317 Modifies the IRT RECORD field (#1403) and the ENTRY DATE/TIME field (#1201) in the TIU DOCUMENT file (#8925) to track TIU signature status and update IRT deficiencies. These fields are modified to enable tracking of a TIU Note that is linked to a specific IRT deficiency, using pointers and cross-references. The IRT RECORD field is used to link a TIU note to either the H&P ADMISSION deficiency or the DISCHARGE SUMMARY deficiency. The ENTRY DATE/TIME field is used to create the new deficiency.

Revision Version
Submitted By
Submission Date
2OIT EPMO Open Source Coordination Office08-15-2018This revision provides additional patches that are currently under development.
1OIT EPMO Open Source Coordination Office07-31-2018

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