This patch will modify PCE so that it will create a visit with the progress
note associated with a disposition location in the same way like with
other locations.
Currently if a CPT code is part of a subset of E & M codes the user is
allowed to enter that CPT code only once per encounter and with a
quantity of only 1. There are 2 problems being addressed with this logic.
1) If a CPT code begins with a letter it is being identified as an E & M
code whether or not it truly is.
2) Certain E & M codes need to allow a quantity of more than 1 to be
ordered.
PROBLEM 1:
In the Check Out function of PCE the user is asked to enter an ICD9
code. If the user enters a partial CPT code then the Check Out procedure
will generate a list of codes that match. However, if one of the matching
ICD9 codes has a blank Description field the program will error.
In PCE, while running the CP (CPT Procedure) Protocol, the code does
not check to see if the CPT code is an E&M code in file 357.69 (Type of
Visit). An E&M code may only be placed on an encounter once with the
"Quantity" field only allowing a "1" unless the "Type of Visit" file is
set up to allow more than one. This business rule is, therefore, not
being enforced.
PROBLEM 2:
Fixing a problem where the checkout process errors when bad data is
passed to a fileman call while looking up and displaying ICD9 codes
already on the encounter.
Fix three problems. 1) Editing provider information for an encounter is
not triggering a re-transmission to the NPCDB. 2) The prompts under the CP
protocol work incorrectly when editing a CPT code that begins with a
letter. 3) Editing the Provider does not update the User Class when
changing an existing provider to a different provider.
This will address the CASELOAD PROFILE BY CLINIC [PXRR CASELOAD
PROFILE BY CL] option of the PATIENT CARE ENCOUNTER (PCE) package.
The report did not correctly display unscheduled encounters.
Date of death display warning. Addresses the selecting of deceased
patients, within PCE, that currently does not check and display for date
of death.
Also, addresses [PXRR PROVIDER ENCOUNTER COUNTS] where the prompt for
selection by Person Class was limited to 30 characters.
Patch 4 for PCE Patient Care Encounter 1.0
PCE/SD Debugging Utilities
See National Patch Module for a description of the changes incorporated in
this patch.
1. Text editing/alignment in PXTT EDIT EDUCATION TOPICS not displaying
correctly when using PXTT INQUIRE EDUC TOPIC
2.Screen editor for GOALS and STANDARDS not displaying properly during
[PXTT INQUIRE EDUC TOPIC].
Default DX during Appt Check Out. Also, invalid code when entering
diagnosis for PCE procedures. Also, if no procedure, only option is to
delete encounter.
This patch addresses four issues related to the Patient Care Encounter
PXCE Data entry functionality
(PCE) module that were reported on the Remedy tickets listed below:
1) HD123432 - IBDF UTIL MAINT UTILITY PROBLEM
2) HD135534 - IB MT NIGHT COMP erroring out with
<SUBSCRIPT>ENCEVENT+10~PXKENC
3) HD136528 - Warning on Patient Death - warning displayed with not
a related patient
4) HD173398 - Event Capture Issue - update to the User Manual regarding
This patch will fix an undefined variable error which occurs when the
enough to fill up about a screen, then hit <ENTER> key.
FileMan ENTER OR EDIT FILE ENTRIES option is used to edit a POV (Problem
of Visit used by VA or Purpose of Visit used by IHS) code.
This patch will also fix a subscript error which occurs when the CPT Code
contains very lengthy ASCII control characters. User was in Appointment
Management [SDAM APPT MGT] going through the checkout process and was
being prompted for a CPT code. At the 'Enter PROCEDURE (CPT CODE): '
prompt, the user input 99456 but then pressed and hold the <TAB> key long
Change field #.08 in the Health Factors file (9999999.64) to a required
field. Also, add a warning message for PCE Health Factors to let users
know when a Health Factor is not set up to display on a Health Summary
report.
This patch fixes the sequence numbers of the Education Subtopic out of
order and word wrapping problems for the Goals and Standards of the
Education Topics.
This patch addresses the problem where a date and time is missing when
validates the status of the Diagnosis Code.
This patch will also update the CREATED BY USER (#.23) field description
of the Visit (#9000010) file to reflect the current functionality.
This patch will change the existing code for the Caseload Profile by
Encounters occurred at Non-VA sites will be included in the report as
well.
The last item this patch will fix is an 'O' displayed after accepting the
default value N from a prompt when running the Provider Encounter Counts
report.
Clinic [PXRR CASELOAD PROFILE BY CL] report to remove the existing direct
global read, so data is now pulled from the PXRMINDX index.
The second item this patch will modify is the report logic to display
historical encounters that with no Loc. of Encounter (#.06) field
populated in the Visit (#9000010) file when running the report Provider
Encounter Counts [PXRR PROVIDER ENCOUNTER COUNTS] and selecting Service
Category "EVENT (HISTORICAL)", it returns very few or no encounters.
This patch addresses the upcoming deletion of unsupported fields in the
ICD Diagnosis File, #80, and the CPT File, #81. Modifications are being
made to affected Patient Care Encounter routines to replace unsupported
calls to the deleted data fields with the appropriate supported API.
This patch will prevent the credit stop visit entry from being
deleted when the primary visit receives a request to delete "ALL"
entries while the visit is associated with an appointment.
The Veterans Health Information Systems and Technology Architecture
resulting in improved health status as well as public health monitoring.
The goals for the VIMM 1.0 project are to deliver an Initial Operating
Capability comprised of standard, interoperable immunization data for
exchange with external trading partners based on the modernization of
the VistA Patient Care Encounter (PCE) package.
(VistA) Immunizations Enhancements (VIMM) 1.0 project modifies existing
immunization files and adds additional files to enable VA to quickly and
reliably document and exchange standardized immunization information on
beneficiaries across services and departments. Additionally, modifications
support Certification for Meaningful Use as well as VistA Evolution
requirements. This provides a Veteran patient-centric vaccine record
exchangeable with the external community. Clinicians will have access to a
more complete medical history in the VistA electronic medical record
Patch PX*1*205 addresses the following Patient Care Encounter issues:
1. AUDIT+9^PXQFV errors
2. OCC+40^PXBGPRV errors
3. No CHECK for non-unique names on editing Health Factors
The Veterans Health Information Systems and Technology Architecture
health status as well as public health monitoring.
The goals for the VIMM 2.0 project are to deliver an Initial Operating
Capability comprised of standard, interoperable skin test and immunization
data for exchange with external trading partners based on the
modernization of the VistA Patient Care Encounter (PCE) package.
(VistA) Immunizations Enhancements (VIMM) 2.0 project modifies existing
Skin Test files and adds additional files to enable VA to quickly and
reliably document and exchange standardized skin test and immunization
information on beneficiaries across services and departments.
Additionally, modifications support VistA Evolution requirements. This
provides a Veteran patient-centric vaccine record exchangeable with the
external community. Clinicians will have access to a more complete medical
history in the VistA electronic medical record resulting in improved
The Veterans Health Information Systems and Technology Architecture
(VistA) Immunizations Enhancements (VIMM) 2.0 project, Increment 2,
builds upon the file structures and standardized data introduced by
Increment 1 by adding functional enhancements to the existing VistA
Patient Care Encounter (PCE) package.
See the National Patch Module for a more detailed description.
Patch PX*1.0*212 addresses the following issues:
- Data Dictionary technical description misspells classification in
the VISIT file [#9000010]
- References to SHORT NAME field [#2] of the CPT file [#81] need to be
removed.
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.
The Veterans Health Information Systems and Technology Architecture
(VistA) Immunizations Enhancements (VIMM) 2.0 project, Increment 4, builds
upon the file structures and standardized data introduced in Increments 1,
2 and 3 by adding functional enhancements to the existing VistA Patient
Care Encounter (PCE) package.
This patch will fix 2 issues:
and the application will switch the dates to make logical sense but gives
no indication to the user.
2. User requests to have the user manual updated for the Patient Care
Encounter (PCE) VistA application to add the option PCE\SD Debugging
Utilities [PXQ PCE/SD DEBUGGING UTILITIES] back into the document.
1. A user can select an end date prior to a start date within the PXCE
Options:
PCE Encounter Data Entry [PXCE ENCOUNTER DATA ENTRY]
PCE Encounter Data Entry and Delete [PXCE ENCOUNTER ENTRY & DELETE]
PCE Encounter Data Entry without Delete [PXCE ENCOUNTER ENTRY NO DELETE]
PCE Encounter Data Entry - Supervisor [PXCE ENCOUNTER ENTRY SUPER]
PCE Encounter Viewer [PXCE ENCOUNTER VIEWER]
PCE data standardization, for detailed information and installation
distributed in a multi-package build named PCE STANDARDIZATION 1.0.
instructions, please see the PCE Standardization 1.0 Installation Guide.
To take full advantage of the PCE standardization work, changes to VistA
applications that use PCE data are required. These applications include
Clinical Reminders, Health Summary, Problem List, and Order Entry/Results
Reporting. To make it easier for sites, the builds for PCE (PX*1.0*211),
Clinical Reminders (PXRM*2.0*42), Health Summary (GMTS*2.7*122), Problem List
(GMPL*2.0*53), and Order Entry/Results Reporting (OR*3.0*501) are being
227b
DATE APPLIED: 2021-05-12 00:00:00
DESCRIPTION:
Backup of SD*5.3*777, PX*1.0*227 on May 12, 2021
Warning: Installing this backup patch message will install older versions
of routines and Build Components (options, protocols, templates, etc.).
Please verify with the Development Team that it is safe to install.
The documentation for DATA2PCE describes two ways to mark a diagnosis as
"P"::=Primary
"S"::=Secondary
Alternatively
1::=Primary
0::=Secondary
There was a bug that prevented the "P" from working, patch PX*1*228 fixes
that bug.
primary:
("DX/PL",i,"PRIMARY")
Code that specifies that the diagnosis is the "primary" diagnosis for
this encounter. Only one "primary" diagnosis is
recorded for each encounter
Patch PX*1.0*232 addresses an issue where the CPT code is being displayed
in internal format and causing an error message to display making it
unselectable.
The purpose of this patch is to repair corrupted V HEALTH FACTORS
measurements. A complete description can be found in the Forum patch
module entry of this patch.
PCE patch 40, PX*1.0*40, clinical reminders. This patch changes the
behavior of the INACTIVE FLAG so it inactivates the reminder. See the
National Patch Module for a complete description.
This build contains a change to two routines. It will cause the
execution of a Scheduling entry point to run the workload validator. The
patch is being distributed as part of Scheduling patch SD*5.3*66.
PCE patch 42, PX*1.0*42, clinical reminders. This patch adds a new
Health Summary component PCE CLINICAL REMINDERS SUMMARY, CRS. See the
National Patch Module for a full description.
This build contains the PCE APIs required by the ACRP Interface Toolkit
(Build SD*5.3*131).
This build provides ACRP access to procedure, diagnosis and provider
information for an outpatient encounter.
Refer to National Patch Module for more details on patch SD*5.3*131.
Patch 20 for PCE Patient Care Encounter 1.0
This is a new PCE report called PCE Encounter Summary. It replaces the
PCE Workload Report.
See National Patch Module for a description of the changes incorporated in
this patch.
Patch 31 for PCE Patient Care Encounter 1.0
PCE Reports, improvements to the Frequency of Diagnosis Report.
See National Patch Module for a complete description of the changes
incorporated in this patch.
Patch 49, PX*1.0*49 for PCE Patient Care Encounter 1.0.
See the National Patch Module for a complete description of the changes
incorporated in this patch.
Patch 48 for PCE Patient Care Encounter 1.0
PCE Reports, print facility on detailed provider report.
See National Patch Module for a complete description of the changes
incorporated in this patch.
PCE patch 50, PX*1.0*50, clinical reminders. This patch allows information
about deceased patients to be displayed in the Clinical Maintenance and
Clinical Reminders Summary components. See the National Patch Module for a
complete description.
PCE patch 51, PX*1.0*51, clinical reminders. This patch adds a screen
to the APPLY LOGIC field to check for valid entries.
See the National Patch Module for a complete description.
This build is part of the overall patch SD*5.3*149, and provides the
capability to display and capture Global Assessment of Function (GAF)
scores and related data during appointment check out.
A single VISIT (#9000010) is pointed to by two main OUTPATIENT
ENCOUNTERs (#409.68), when there should only be one. This is now
addressed using LOCK. This problem was noted in NOIS message
HUN-0598-22218. Some of the most important discussions of this
problem occurred in FORUM mail message #27819009 : "Huntington
problem with dup. Outpatient Encounters". The routine PXKMAIN has
been modified to fix this defect.
PCE patch 55, PX*1.0*55, clinical reminders. This patch adds a wildcard
to the IGNORE ON N/A field. See the National Patch Module for a complete
description.
PCE Help Text says "Provider" when it should say "Diagnosis" or
"Procedure". This problem was noted in NOIS message PUG-1098-51770.
It affects the protocols Check Out Interview [PXCE ADD/EDIT
INTERVIEW], Check Out Interview [PXCE INTERVIEW] and Check Out
Interview [PXCE SDAM INTERVIEW]. The routines PXBHLP3 and PXBHLP4
have been modified to fix this defect.
1. PCE sometimes crashes when editing cancelled appointments for
2. It has been pointed out that PCE should not allow the user to
edit an encounter that has been cancelled, in cases where the
visit no longer exists. This problem was noted in NOIS message
TAM-0397-32584. It affects the options PCE Encounter Data Entry
[PXCE ENCOUNTER DATA ENTRY], PCE Encounter Data Entry and Delete
[PXCE ENCOUNTER ENTRY & DELETE], PCE Encounter Data Entry
without Delete [PXCE ENCOUNTER ENTRY NO DELETE] and PCE
Encounter Data Entry - Supervisor [PXCE ENCOUNTER ENTRY SUPER].
It also affects the protocols MCCR SITE PARAMETER EDIT [MAF MCCR
which a visit still exists. This problem was noted in NOIS
SITE PARM PROTOCOL], Group 1 Edit [MAF IB SITE PARM GROUP 1] and
Group 2 Edit [MAF IB SITE PARM GROUP 2]. The routine PXCESDAM
has been modified to fix this defect.
messages BOS-0397-11896, PRO-0397-10568, HOU-0998-71834 and
DAY-0898-41893. It affects the options PCE Encounter Data Entry
- Supervisor [PXCE ENCOUNTER ENTRY SUPER], PCE Encounter Data
Entry and Delete [PXCE ENCOUNTER ENTRY & DELETE], PCE Encounter
Data Entry [PXCE ENCOUNTER DATA ENTRY] and PCE Encounter Data
Entry without Delete [PXCE ENCOUNTER ENTRY NO DELETE]. The
routine PXCESDAM has been modified to fix this defect.
PCE patch 46, PX*1.0*46, clinical reminders. This patch adds a new
option that lets sites share reminder definitions. See the National
Patch Module for a complete description.
VHA Directive 98-058, "Sexual Trauma Counseling Care and Services"
requires that VHA provide care and counseling to veterans determined to
have been a victim of sexual trauma while the veteran was serving on
active duty. This patch will focus on the data collection for this
directive.
This is the PCE portion of the overall patch. See DG*5.3*195
1. Some sites have reported 'subscript too long' errors when
PROVIDER ENCOUNTER COUNTS]. The routines PXRRFDD, PXRRLCD,
PXRRPRD, PXRRWLD and PXRRPAD have been modified to fix this
defect.
2. The PCE Encounter Summary report does not properly handle
encounters having multiple providers. This problem was noted in
NOIS messages PRO-0898-10847 and MIN-1198-41070. It affects the
option PCE Encounter Summary [PXRR PCE ENCOUNTER SUMMARY]. The
routines PXRRWLD, PXRRWLPR, PXRRWLS2, PXRRWLSA and PXRRWLSE have
been modified to fix this defect.
running PCE reports, even though the reports meet standards.
The subscripts have been shortened to make this less likely.
This problem was noted in NOIS messages BYN-0998-10088 and
ISA-1098-11607. It affects the options PCE Encounter Summary
[PXRR PCE ENCOUNTER SUMMARY], Diagnosis Ranked by Frequency
[PXRR MOST FREQUENT DIAGNOSES], Location Encounter Counts [PXRR
LOCATION ENCOUNTER COUNTS], Patient Activity by Location [PXRR
PATIENT ACTIVITY BY LOC] and Provider Encounter Counts [PXRR
PCE patch 53, PX*1.0*53, clinical reminders. This patch adds data caching
to improve performance. See the National Patch Module for a complete
description.
PCE patch 63, PX*1.0*63, clinical reminders. This patch adds a new report
function REMINDERS DUE REPORT.
See the National Patch Module for a complete description.
While Visit Tracking, namespace VSIT, went out as a distinct package, it is
now consolidated with PX and should have as its Parent Package, PCE
PATIENT CARE ENCOUNTER. That means future patches to routines in the
VSIT namespace should be sent out under PX* and the second line for any
patched VSIT routines will now reflect the new ownership.
PCE Report does not recognize events which occurred at non-VA sites.
Also, this patch addresses the issue of when a user sends a PCE Report
to the printer queue, the user's default editor type reverts to a
line editor.
Patch 2 for PCE Patient Care Encounter 1.0
See National Patch Module for a description of the changes incorporated in
this patch.
Efficiency improvments in PCE's Clinical Reminders.
Changes to the logic to allow taxonomy findings be used in the date due
calculation. The logic for computed findings, health factors, and taxonomies
was changed so that a frequency must be specified in order to use anyone of
these findings to change minimum age and maximum age.
This patch addresses the PCE provider selection and lookup issue, as
-DSM-I-ECODE, MUMPS error code: M7
%DSM-I-ATLABEL, RELOOK+7^PXBGPRV2:1 S
TOTAL=$P(^TMP("PXBTOTAL",$J,"DILIST",0
),"^",1)
The second subscript of the global-variable ^TMP would contain a "$J"
value. The problem seems to have been caused by errant data in a
"person/provider's record" .
follows:
During a lookup, LIST^DIC (by default) retrieves a record's "WRITE"
fields; the "TITLE" field of a person's record is such a field. The WRITE
fields may vary per source file. The TITLE field is a non-
required ("null" is not invalid), pointer field. When LIST^DIC
encounters a "broken pointer"/invalid data in any person's TITLE
field while attempting to create a PCE provider selection list,
LIST^DIC immediately generates an error, discontinues the lookup
process, and does not return any list of provider choices [i.e.
^TMP(..."DILIST")]. The standard LIST^DIC call does not account
for errant data in fields that should have been validated early
during person record processing. The errant data in a person
record's TITLE field and the standard LIST^DIC call in the PCE
routine PXBGPRV2 caused provider lookups to fail when processing
in PCE.
Addressing the "RELOOK+7^PXBGPRV2" error, patch PX*1*105 redesigns the
LIST^DIC call in PXBGPRV2 suppressing LIST^DIC 's need of valid TITLE
data. The standard PCE LIST^DIC call explicitly requests "NAME" as a
result of a lookup and implicitly requests default WRITE fields such as
the TITLE field. The redesigned call in PXBGPRV2 will force LIST^DIC to
Several NOIS calls have reported an error while processing provider data
"ignore" WRITE fields and return only NAME data, therefore complete
provider lookup processing within PCE and avoid fields unneeded by PCE
that may contain errant data. PX*1*105 will resolve this issue in PCE.
specifically provider lookups in different PCE modules. The error
presented itself at the RELOOK+7 label in routine
PXBGPRV2. The exact error displayed as follows:
%DSM-E-UNDEF, undefined variable ^TMP("PXBTOTAL",557880418,"DILIST",0)
PRACTICE PROFILING/PCE PHASE II
The Under Secretary for Health chartered a Steering Committee to develop
a national strategy and plan for implementing Practice Profiling
nationwide.
This patch implements the PCE requirements for Practice Profiling
Patch PX*1.0*92 has been created in response to several NOIS's -
BAY-1100-31050 and its duplicates. The error <SUBSCRIPT>LI1+19^PXBPPOV
re-occurred and was caused by a ^DIC Lookup that, in some cases, is
unable to return a selected, listed value. ^DIC is not able to
choose between values that are interpreted as "identical." As an example
^DIC considers "94.0" and "94." identical; so if the user selected
"94." , ^DIC needs to know the user means exactly "94." PX*1*92
resolves this issue by redesigning the ^DIC Lookup and allows the
retrieval of "exact" user selections.
The changes included in this patch are described in the description of
patch PX*1*111 (Mill Bill - LTC/Visit/Medication Co-Pay) in the National
Patch Module.
This patch corrects the following problems related to the PXTT EDIT HEALTH
setting/editing a national package.
FACTORS option:
- users could exit before filling in all required fields and that could have
contributed to the further syntax errors.
- validation of a duplicate name was not working correctly when an originally
entered factor, displayed as default, was changed into an already existing
one.
Additionally the patch introduced PXNAT varable to be set to 1 for
This patch adresses multiple NOIS, related to missing fields in V CPT records,
starting from PROVIDER NARRATIVE. That missing field was causing errors that
originated the NOIS(es).
This patch is in response to Item #22 in the Rossio Report. In the area
of Means Test (MT) Deficiencies, Item #22 required that the Veterans
Health Administration (VHA) identify best practices for means testing and
acquiring veterans' signatures at the local level and explore the
promulgation of these best practices throughout the system. This patch
incorporates into the Patient Care Encounter software an Enrollment
Application Systems (EAS) API which will inidcate whether to block the
checkout of an existing appointment through the PCE menu or not. This
blocking is based on the veterans current means test status.
This is a clean up patch of V CPT records, following already released
PX*1.0*117 that prevents future occurrences of filing incomplete V CPT records.
Additionally a correction is made to VSIT routine to return a correct
information, related to entered either Visit IEN or Visit's ID.
Correctly evaluate and display different formats of CPT codes when entered
separately or as multiple. Additionally prompts for the provider and other
entries, related to the selected procedure, when procedures are entered as
multiple.
Calls for a list of providers for an encounter were redesigned to return
the correct list without duplicates, if any. Also, the PCE will not change
the primary provider if not requested.
In response to Policy Board (NLB) comment on the VHA Veterans Equitable
updating.
Current policy establishes a requirement to block transmission of
outpatient encounters (ACRP) to the National Patient Care Database if the
patient's current Means Test status equals "Required." This leads to
under-reported workload and inaccurate information in national
databases.
Software has been implemented which blocks the ability to schedule future
appointments for veterans whose financial assessment needs updating. VHA
Resource Allocation (VERA) process, the CBO requests the removal of:
Directive 2002-019, dated April 4, 2002, provided guidance to facilities
on the implementation of the appointment blocking software. If a
veteran's financial assessment needs updating, the software prevents the
ability to make future appointments for the veteran. This restriction
shall also be removed at the request of the CBO.
(1) the current restriction that blocks transmission of outpatient
encounters (ACRP) to the National Patient Care Database (NPCD) if a
veteran's updated financial assessment (Means Test) information is not
complete, and
(2) the restriction that blocks the ability to schedule
future appointments for veterans whose financial assessments need
This patch addresses the following issues:
- modifies DATA2PCE^PXAPI to support the entry of the Outside Location and
properly determines the TYPE of the encounter.
- the problem to delete completely a visit and its corresponding outpatient
encounter, as well a credit stop visit if applicable.
- acceptance and a proper filing of the INSITUTION if passed to PCE and it
is different than a pointer from the Division filed of the Hospital Location.
This patch addresses the following issues:
- allows to enter only one primary diagnosis and not allows for duplicates
- only one E&M procedure code may be accepted and with quantity=1 only
- fix a misspelling in a called label to address MIW-0503-41153.
