Name	Value
NAME	SURGERY
PREFIX	SR
DEVELOPER (PERSON/SITE)	MICHAEL MONTALI/B'HAM ISC
*LOWEST FILE NUMBER	130
*HIGHEST FILE NUMBER	139.99
DEVELOPMENT ISC	Birmingham
CLASS	National
CURRENT VERSION	3.0
SHORT DESCRIPTION	SURGICAL DATA COLLECTION AND OPERATIONS SCHEDULING
VERSION	3.0 DATE DISTRIBUTED: 2005-11-19 00:00:00 PATCH APPLICATION HISTORY: 58 DATE APPLIED: 1996-10-22 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Surgery patch SR358, SURGERY INTERFACE TO PCE. 66 SEQ #63 DATE APPLIED: 1997-06-25 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Surgery patch SR366 includes modifications specifically for Imaging. 157 SEQ #153 DATE APPLIED: 2006-11-22 23:20:36 APPLIED BY: USER,ONE DESCRIPTION: 1. The Surgery-Tracking Prosthesis Items project enhances the Surgery 2. Unrelated to the Prosthesis features, the trigger event for discontinuing orders will be moved from the TIME PAT OUT OR field (#.232) of the SURGERY file (#130) to the TIME PAT IN OR field (#.205) of the SURGERY file (#130). This enhancement is required as part of the Documenting Preoperative Antibiotics (Gainesville Solution) project. 3. On the Nurse Intraoperative Report, replace references to CORRECT SURGERY COMMENTS to TIME OUT VERIFIED COMMENTS, IMAGING CONFIRMED software, adding new fields to the PROSTHESIS INSTALLED sub-file COMMENTS, and MARKED SITE COMMENTS, as appropriate. (#130.01) in the SURGERY file (#130). These new fields will function to mark the prosthesis item as sterile and record the expiration date of the sterile implant. The information entered into these fields will display on the Nurse Intraoperative Report. As an added safety/quality measure, the new fields will be mandatory for signing the Nurse Intraoperative Report. The report cannot be signed until all documentation is completed. 160 SEQ #154 DATE APPLIED: 2007-09-05 00:31:41 APPLIED BY: USER,ONE DESCRIPTION: This patch updates the Surgery Risk Assessment software of the Veterans Cardiac Risk Assessment Modifications ------------------------------------- - The software is modified to expand the answer options of the PREOP CIRCULATORY DEVICE field (#474) to include "ARTIFICIAL HEART" and to transmit "A" to CICSP for new raw value of this answer option. - This patch modifies all Lab fields under the Laboratory Test Results (Enter/Edit) [SROA LAB-CARDIAC] option to assume a past date if the user enters a date without a year. Non-Cardiac Assessment Modifications - Reinstitute the default functionality of the CARDIAC SURG PERFORMED NON-VA field (#472) in the SURGERY file (#130), so that it defaults to "NO". - The description is updated and/or other data dictionary changes are made for the following items: o CONGESTIVE HEART FAILURE field (#207) o ON VENTILATOR >48 HOURS field (#285) o PERIOPERATIVE MI field (#385) o PREOP CIRCULATORY DEVICE field (#474) ------------------------------------ o AORTIC STENOSIS field (#477) - Data Quality Queries The data entry that does not meet the criteria is permitted, but would cause a warning message to check the data for accuracy. o The D/T PATIENT EXTUBATED field (#470) should be later than the TIME PAT OUT OR field (#.232). o The D/T PATIENT EXTUBATED field (#470) should be earlier than the D/T PATIENT DISCH FROM ICU field (#471). o The D/T PATIENT DISCH FROM ICU field (#471) should be later than the * Note: All fields named below are in the SURGERY file (#130) unless D/T PATIENT EXTUBATED field (#470). o D/T PATIENT DISCH FROM ICU field (#471) be equal to or earlier than the HOSPITAL DISCHARGE DATE field (#419). o The SURGICAL PRIORITY, DATE field (#414.1) should be earlier than the TIME PAT IN OR field (#.205). o The ESTIMATE OF MORTALITY, DATE field (#364.1) should be earlier than the TIME PAT IN OR field (#.205). o If TOTAL CPB TIME field (#451) > 0, the CONVERT FROM OFF PUMP TO CPB field (#469) should not be answered "NO, began off/stayed off". otherwise indicated. General Surgery Items --------------------- - Remedy Ticket #HD0000000152814 This patch addresses two issues related to the Update Assessment Status to 'COMPLETE' [SROA COMPLETE ASSESSMENT] option missing items list: (1) For the NUM OF PRIOR HEART SURGERIES field (#352) in the SURGERY file (#130), the field is corrected to display "Number of Prior Heart Surgeries" instead of "Prior Heart Surgery (Y/N)". (2) For the field "PRIOR HEART SURGERIES" field (#485) in the SURGERY file (#130), the data input functionality is modified to use the same controlled data input functionality used by the Clinical Information (Enter/Edit) [SROA CLINICAL INFORMATION] option. - Remedy Ticket #HD0000000177807 After installing this patch, if procedure and diagnosis coding is not complete at the time the Update Assessment Status to 'COMPLETE' [SROA COMPLETE ASSESSMENT] option is run, the software will display "The coding for Procedure and Diagnosis is not complete" immediately before asking, "Are you sure you want to complete this assessment ?". - These updates include functionality for selecting cases for risk - Remedy Ticket #HD0000000185045 When using the Outcome Information (Enter/Edit) [SROA CARDIAC-OUTCOMES] option to edit the OPERATIVE DEATH field (#384), entering YES or NO causes the NEW MECHANICAL CIRCULATORY field (#467) to be changed to the same value. Editing the NEW MECHANICAL CIRCULATORY field (#467) field does not change the OPERATIVE DEATH field (#384). - Short LOCK Timeouts This patch updates the 1 second LOCK timeouts in the routine SROUTL to assessment based upon case Current Procedural Terminology (CPT) codes, use the VA FileMan variable DILOCKTM if it exists. replacing the use of the Major or Minor surgery definition. o When selecting a case to be assessed, the software will check the Health Information Systems and Technology Architecture (VistA) Surgery case CPT codes and display an informational statement if no CPT codes have been assigned to the case or if the case should be excluded from assessment. o A new report called "List of Eligible Cases" is added to the reports contained in the List of Surgery Risk Assessments [SROA ASSESSMENT LIST] option. o The MAJOR/MINOR field (#.03) is removed from NSQIP input options and from the Print a Surgery Risk Assessment [SROA PRINT ASSESSMENT] option. application as requested by the Executive Board of the National Surgical - A new field called INTRAOPERATIVE ASCITES (#446) is created: o Added to the Operation Information (Enter/Edit) [SROA OPERATION DATA] option o Added to the Print a Surgery Risk Assessment [SROA PRINT ASSESSMENT] option o Added to data set transmitted to the national database - A new field called CLOSTRIDIUM DIFFICILE COLITIS (#447) is created: o Added to the Print a Surgery Risk Assessment [SROA PRINT ASSESSMENT] option Quality Improvement Program (NSQIP) and by the Cardiac Surgery Consultants o Added to the PERIOPERATIVE OCCURRENCE CATEGORIES section of the Surgery Quarterly Report o CLOSTRIDIUM DIFFICILE COLITIS is added as a new occurrence category to the PERIOPERATIVE OCCURRENCE CATEGORY file (#136.5) - The description is updated and/or other data dictionary changes are made for the following items: o SURGERY SPECIALTY field (#.04) o WOUND CLASSIFICATION field (#1.09) o REASON FOR NO ASSESSMENT field (#102) Board of the Continuous Improvement in Cardiac Surgery Program (CICSP). o HISTORY OF COPD field (#203) o WEIGHT LOSS > 10% field (#215) o BLEEDING DISORDERS field (#216) o OPEN WOUND field (#218) o PREOPERATIVE SEPSIS field (#218.1) o PREVIOUS PCI field (#220) o SYSTEMIC SEPSIS field (#250) and the SYSTEMIC SEPSIS occurrence category in the PERIOPERATIVE OCCURRENCE CATEGORY file (#136.5) o PNEUMONIA field (#251) and the PNEUMONIA occurrence category in the PERIOPERATIVE OCCURRENCE CATEGORY file (#136.5) The updates include the addition of new data fields, changes to existing o PULMONARY EMBOLISM field (#252) and the PULMONARY EMBOLISM occurrence category in file (#136.5) o ACUTE RENAL FAILURE field (#254) and the ACUTE RENAL FAILURE occurrence category in file (#136.5) o PREGNANCY field (#269) o PERIPHERAL NERVE INJURY field (#287) and the PERIPHERAL NERVE INJURY occurrence category in the PERIOPERATIVE OCCURRENCE CATEGORY file (#136.5) o DYSPNEA field (#325) o CURRENT PNEUMONIA field (#326) data fields, changes to data entry screens, changes to reports used in o REST PAIN/GANGRENE (Y/N) field (#330) o CHEMOTHERAPY IN LAST 30 DAYS field (#338.1) o QUADRIPLEGIA (Y/N) field (#398) o TUMOR INVOLVING CNS (Y/N) field (#401) o INTRAOP DISSEMINATED CANCER field (#443) o DATE COMP NOTED field (#2, sub-file #130.22) o SEPSIS CATEGORY field (#7, sub-file #130.22) - Hemoglobin A1c is added to the set of preoperative lab test results. Surgery Risk Assessment management process and changes to the Surgery Risk - This patch modifies all Lab fields under the Laboratory Test Results (Enter/Edit) [SROA LAB] option to assume a past date if the user enters a date without a year. - The DATE OF DEATH field (#342) is modified to allow the entry of time as well as date and is added to the Patient Demographics (Enter/Edit) [SROA DEMOGRAPHICS] option. - Airway Trauma, Mallampati Scale and Airway Index are removed from the set of information collected and transmitted to NSQIP. Assessment transmissions. - The letter produced by the Print 30 Day Follow-up Letters [SROA REPRINT LETTERS] option is modified to display the date of operation and the local surgical specialty. - The Monthly Surgical Case Workload Report [SROA MONTHLY WORKLOAD REPORT] option is modified to replace references to major/minor with eligible or excluded. 161 SEQ #155 DATE APPLIED: 2007-09-05 01:09:12 APPLIED BY: USER,ONE DESCRIPTION: This patch addresses the following problems: a RESIDNET 2. HD175983 SROCON Error - <UNDEFINED>HELP+1^SROCON When entering Anesthesia data for a surgical case, ^SROCON routine errors at the "Do you want to store this information in the concurrent case ? YES//" prompt if a "?" is entered and concurrent cases exist. 3. HD177449 SROREQ4 UNDEF ERROR When running the : Operation Requests for a Day [SROP REQ] option the report generates an error <UNDEFINED>PRINT+2^SROREQ4 S S(0)=^SRF(SRTN,0),DFN=$P(S(0),"^"),CNT=CNT+1 4. HD153358 SROCDX1 Error - <UNDEFINED>PADD1+4^SROCDX1 An <UNDEFINDED> error was encountered when trying to verify some ICD-9 codes or Procedure codes. 1. HD136616 SROPCEP Primary and Secondary Provider incorrect from Surgery pkg The information passed from the surgical package to PCE when received in PCE the SURGEON is listed as the PRIAMRY PROVIDER and the ATTENDING is listed as the SECONDARY PROVIDER. Claims are being rejected if the PRIMARY PROVIDER is 159 SEQ #156 DATE APPLIED: 2007-12-12 20:17:01 APPLIED BY: USER,ONE DESCRIPTION: 1. This patch changes the Environmental Indicator ENVIRONMENTAL ENVIRONMENTAL CONTAMINANTS the mnemonic "SWAC:" will be displayed. The user dialog "Treatment related to Environmental Contaminants (Y/N)" will be changed to "Treatment related to SW Asia (Y/N)". 2. This patch modifies the Surgery software to always use a YES default when initially prompting for "Treatment related to Combat (Y/N)". 3. This patch modifies the Surgery software so that when entering or editing a waiting list entry, service connected and environmental indicator questions will be asked if appropriate for the patient CONTAMINANTS name to SOUTHWEST ASIA CONDITIONS. regardless of the patient's admission status. - The Surgery package data dictionaries for ENVIRONMENTAL CONTAMINANTS will be changed to SOUTHWEST ASIA CONDITIONS. The field help text will be updated with the new name. Other field cross references will be updated with the new name. - In user dialog where the mnemonic "EC:" is used to display the 163 SEQ #157 DATE APPLIED: 2007-12-12 21:00:43 APPLIED BY: USER,ONE DESCRIPTION: This patch makes changes to the Surgery software following the assessment information when entering or updating a surgery request if the ASK FOR RISK PREOP INFO field (#17) in the SURGERY SITE PARAMETERS file (#133) is set to YES is updated so that this functionality works correctly with the updated code for CARDIAC SURGERY in the SURGICAL SPECIALTY FILE (#45.3). 3. The logic executed when editing the CASE SCHEDULE TYPE field (#.035) in the SURGERY file (#130) is updated so that this logic works correctly with the updated code for CARDIAC SURGERY in the SURGICAL SPECIALTY file (#45.3) to populate the CARDIAC SURGICAL PRIORITY field (#414) in the installation of patch DG5.3757 (SURGICAL SPECIALTY FILE CHANGES) for SURGERY file (#130). the PTF Fields No Longer Needed Project: 1. The Quarterly Report - Surgical Service [SRO QUARTERLY REPORT] option is updated to correspond with the codes and specialties that exist in the updated SURGICAL SPECIALTY file (#45.3). 2. The functionality that allows the input of preoperative risk 164 SEQ #158 DATE APPLIED: 2007-12-12 22:20:20 APPLIED BY: USER,ONE DESCRIPTION: 1. This patch adds the SURGERY CONSULT DATE field (#513) to the SURGERY updated to display the SURGERY CONSULT DATE field (#513) when printing a cardiac risk assessment. 4. The missing information functionality for cardiac risk assessments is updated to include the SURGERY CONSULT DATE field (#513) for surgical cases after September 30, 2007. This functionality is used by the Update Assessment Status to 'COMPLETE' [SROA COMPLETE ASSESSMENT] option and the List of Surgery Risk Assessments [SROA ASSESSMENT LIST] option. 5. The SURGERY CONSULT DATE field (#513) is added to the cardiac risk file (#130) for use by the Cardiac Risk Assessment module to document the assessment transmission data set. 6. This patch adds the WAIT TIME START field (#21) to the SURGERY file (#130). This field will be auto-populated when the SURGERY CONSULT DATE field (#513) is entered. There are no plans to build additional functions for this field at this time. date that the patient was notified that Surgery was needed, effectively documenting the start of the patient's wait time. 2. The Resource Data [SROA CARDIAC RESOURCE] option is updated to include the SURGERY CONSULT DATE field (#513) for input. 3. The Print a Surgery Risk Assessment [SROA PRINT ASSESSMENT] option is 162 SEQ #159 DATE APPLIED: 2008-05-26 15:42:08 APPLIED BY: USER,ONE DESCRIPTION: Correct multiple Surgery tickets 166 SEQ #160 DATE APPLIED: 2008-05-26 16:02:11 APPLIED BY: USER,ONE DESCRIPTION: This patch updates the Surgery Risk Assessment software of the Veterans enhancement to this option shall list missing items in the same order as the standard assessment screens. - Cardiac Procedures Operative Data (Enter/Edit) [SROA CARDIAC PROCEDURES] The system is modified to initially prompts user to "Select Operative Information to Edit." A new entry of "N" shall allow the user to "Set All to No" for the 22 Cardiac Procedures fields. A verification prompt will follow to ensure that user understands entry. Fields that do not have YES/NO responses will be updated as follows: Non-Cardiac Assessment Modifications Items #1-#5 are numeric and their values will be set to 0. #9 Valve Repair will be set to NONE #13 Maze Procedure will be set to NO MAZE PERFORMED - Laboratory Test Results (Enter/Edit) [SROA LAB-CARDIAC] If the lab values entered into the screen are out of range, they will be flagged as high or low during data entry. - Resource Data [SROA CARDIAC RESOURCE] o When editing the D/T PATIENT DISCH FROM ICU field (#471), the software ------------------------------------ is modified to provide the user with a select option to allow user to pull date/time from existing list of possible entries or manually enter a date/time o Postop Extubation Hours If the extubation time is entered, the software will display the number of hours between the time the patient left the operating room and the time the patient was extubated. o PRIMARY CAUSE FOR DELAY field (#515) - List of Surgery Risk Assessment [SROA ASSESSMENT LIST] option If a Cardiac patient's surgery is greater than 30 days from initial VA Cardiothoracic Surgery Consultation (as calculated between the CT CONSULT DATE to DATE OF SURGERY), user is requested to enter cause as defined in the field. If date is less than or equal to 30 days, system shall automatically default entry to NONE. General Surgery Items --------------------- 1. The following fields in the SURGERY file (#130) are updated to utilize o When printing the List of Transmitted Assessments to screen or VistA Pharmacy supported API's in reference to the DRUG file (#50): - MEDICATIONS field (#.01, sub-file #130.33) - ANESTHESIA AGENTS field (#.01, sub-file #130.47 of sub-file #130.06) - TEST DOSE field (#.01, sub-file #130.48 of sub-file #130.06) 2. Remedy Ticket #HD0000000203815 When making an operation request, a site parameter controls whether preoperative risk assessment information can be entered. If set to YES, there are occasions within two screens delete variables causing an undefined error. This patch fixes this problem. printer, the user is prompted to view/print assessed cases only, 3. Remedy Ticket #HD0000000231157 The problem reported in this Remedy ticket is corrected by this patch. In the SURGERY file (#130), lookups on the DRUG file (#50) are modified to use only the GENERIC NAME field (#.01) and the SYNONYM field (#9). 4. The following date/time fields in the SURGERY file (#130) are modified to assume a past date if the user enters a date without a year: SURGICAL PRIORITY, DATE field (#414.1) HOSPITAL ADMISSION DATE field (#418) excluded cases only or both. Additionally, the user is prompted to HOSPITAL DISCHARGE DATE field (#419) ADMISSION/TRANSFER DATE field (#420) DISCHARGE/TRANSFER DATE field (#421) OBSERVATION ADMISSION DATE field (#452) OBSERVATION DISCHARGE DATE field (#453) view/print the list by date of operation or by date of transmission. o When printing the List of Eligible Cases to screen or printer, the user is prompted to view/print assessed cases only, excluded cases Health Information Systems and Technology Architecture (VistA) Surgery only, non-assessed cases only or all cases. o A new list, the List of Cases With No CPT Codes is added. This list displays all completed cases that have not been coded with CPT codes. o A new list, the Summary List of Assessed Cases is added. This report displays the total count of incomplete, complete and transmitted risk assessments and the count of excluded cases. This report may be printed for all or for selected surgical specialties and for all divisions or for a selected division. - M&M Verification Report [SRO M&M VERIFICATION REPORT] option application as requested by the Executive Board of the National Surgical This report is modified to display additional information as available, including the case number, final CPT codes and review of death comments. - Clostridium Difficile Colitis (C. difficile) definition updated o In the SURGERY file (#130), the description for the CLOSTRIDIUM DIFFICILE COLITIS field (#446) is updated. o In the PERIOPERATIVE OCCURRENCE CATEGORY file (#136.5), the description for the CLOSTRIDIUM DIFFICILE COLITIS (C-DIFFICILE) category is updated. Quality Improvement Program (NSQIP) and by the Cardiac Surgery Consultants - In the SURGERY file (#130), the description for the PREOP FUNCT. HEALTH STATUS field (#492) is updated. - Risk Model Lab Test (Enter/Edit) [SROA LAB TEST EDIT] option This new option is added to the Surgery Risk Assessment Menu [SROA RISK ASSESSMENT] to assist the nurse reviewers in mapping entries in the RISK MODEL LAB TEST file (#139.2) to the LAB DATA file (#63). - REGIONAL Anesthesia Technique added o REGIONAL is added to the list of choices when entering the ANESTHESIA Board of the Continuous Improvement in Cardiac Surgery Program (CICSP). TECHNIQUE field (#.37) in the SURGERY file (#130). o The Anesthesia AMIS [SROAMIS] option is inactivated and removed from the Anesthesia Menu [SROANES1] and from the Anesthesia Reports [SR ANESTH REPORTS] menu options. - Preoperative Information (Enter/Edit) [SROA PREOP DATA] option updated o The following items are no longer required and are removed from the input screens: > On Page 1, under GENERAL E. Pack/Years The updates include the addition of new data fields, changes to existing I. Pre-illness Funct Status > On Page 2, under CENTRAL NERVOUS SYSTEM H. Paraplegia I. Quadriplegia o The following changes are made relating to the capture of height from the Vitals software: > The 1 year date range limitation is removed from the height capture process so that the most recent height measurement is returned regardless of when it was taken. > If the height capture process returns a height measurement from the data fields, changes to data entry screens, changes to reports used in Vitals software, the date of the measurement will be stored and displayed on the data input screen. - Print a Surgery Risk Assessment [SROA PRINT ASSESSMENT] option If the user responds YES to batch printing for a specific date range, the user will be allowed to print for a single surgical specialty or for all surgical specialties. - Surgery Consult Dates added The Patient Demographics (Enter/Edit) [SROA DEMOGRAPHICS] option is Surgery Risk Assessment management process and changes to the Surgery Risk updated to include 2 additional date fields: o Surgery Consult Date o Date Surgery Consult Requested Cardiac Assessment Modifications ------------------------------------ - Clinical Information (Enter/Edit) [SROA CLINICAL INFORMATION] The HEIGHT field (#236) and the WEIGHT field (#237) will no longer accept an entry of NS for "No Study". System will only accept numeric values in the field. Assessment transmissions. - Operative Risk Summary Data (Enter/Edit) [SROA CARDIAC OPERATIVE RISK] This option is modified to allow users to enter a value of NS (No Study) into the Physician's Preoperative Estimate of Operative Mortality field. Upon entry of NS, the system will automatically populate the Date/Time of Estimate of Operative Mortality field with a value of NS (No Study). - Update Assessment Status to 'COMPLETE' [SROA COMPLETE ASSESSMENT] This option is modified to list items missing from the assessment based upon the order in the field number in SURGERY file (#130). An 169 SEQ #161 DATE APPLIED: 2009-04-21 13:54:27 APPLIED BY: USER,SEVENTEEN DESCRIPTION: The CPT EXCLUSIONS file (#137) stores CPT codes that have been identified by the National Surgical Quality Improvement Program (NSQIP) as procedures that should not be risk assessed. This patch updates this file with data for fiscal year 2008. 168 SEQ #162 DATE APPLIED: 2009-04-22 12:39:07 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch modifies the Blood Product Verification [SR BLOOD PRODUCT New Service Request (NSR): ========================== N/A Test Sites: =========== HEARTLAND-EAST HCS PHILADELPHIA, PA SAN DIEGO, CA VERIFICATION] option to accept the manually entered eye-readable code as Documentation Retrieval: ======================== No new documents or changes to existing documents are included in this patch. Installation Instructions: ========================== This patch can be installed at any time with users on the system. well as the scanned bar code for Codabar labels. Installation should take less than two minutes. 1. Use the INSTALL/CHECK MESSAGE option on the PackMan menu. 2. From the Kernel Installation & Distribution System menu, select the Installation menu. 3. From this menu, you may elect to use the following options (when prompted for the INSTALL NAME, enter SR3.0168): (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 DDs 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 (routines, DDs, templates, etc.). (c) Verify Checksums in Transport Global - this option will allow you to ensure the integrity of the routines that are in the transport global. (d) Print Transport Global - this option will allow you to view the components of the KIDS build. 4. Use the Install Package(s) option and select the package SR3.0168. 5. When prompted "Want KIDS to INHIBIT LOGONs during the install? NO//" respond NO. Associated Remedy Ticket(s): 6. When prompted "Want to DISABLE Scheduled options, Menu options, and Protocols? NO//" respond NO. Routine Summary: ================ 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: ============================ <TAB>;;3.0; Surgery ;[patch list];24 Jun 93;Build 2 Routine Name Before Patch After Patch Patch List ------------ ------------ ----------- ---------- SRBL 8388831 8708447 148,168 N/A 69 SEQ #64 DATE APPLIED: 1997-09-22 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Surgery patch SR369 - Surgery/PCE/NPCD Reporting 167 SEQ #163 DATE APPLIED: 2009-04-22 13:03:50 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch adds the Transplant Assessment module to the Surgery software. This option is used to enter and update the information required for the transplant assessments. This option also allows the assessment to be completed and transmitted. (2) Print Transplant Assessment [SRTP PRINT ASSESSMENT] This option is used to print a single Surgery Transplant Assessment. (3) List of Transplant Assessments [SRTP ASSESSMENT LIST] This option is used to print the List of Transplant Assessments. It provides summary information for assessments within the sort This enhancement provides the ability to create assessments for lung, parameters selected. (4) Transplant Assessment Parameters (Enter/Edit) [SR TRANSPLANT PARAMETER] This option is used to update local site parameters for the Surgery Transplants Assessment module. Sites that are transplant centers must designate the types of organ transplants performed or assessed in order to streamline the transplant selection process when entering data. liver, kidney and heart transplants. - The collected transplant assessments data will be stored in the SURGERY TRANSPLANT ASSESSMENTS file (#139.5). - Transplant Assessments Transmissions When editing an individual transplant assessment, upon leaving the final page, the software allows the user to transmit the assessment to the national database. o The data of the non-cardiac transplant assessments (lung, liver, and kidney) will be transmitted to national NSQIP database in Chicago, Illinois. o The data of the heart transplant assessments (cardiac) will be transmitted to national NSQIP database in Chicago, Illinois, as well as to national CICSP database in Denver, Colorado. - Followup to patch SR3169 This patch includes a pre-installation process that removes the following CPT codes from the CPT EXCLUSIONS file (#137) that were overlooked in the NSQIP - CPT EXCLUSION update patch for fiscal year A new menu, Transplant Assessment Menu [SR TRANSPLANT ASSESSMENT], is 2008 (SR3169). 33945 TRANSPLANTATION OF HEART 47135 TRANSPLANTATION OF LIVER 47136 TRANSPLANTATION OF LIVER added to the Surgery Menu [SROMENU] option. This new menu includes the following four options: (1) Enter/Edit Transplant Assessments [SR TRANSPLANT ENTER/EDIT] 170 SEQ #164 DATE APPLIED: 2009-10-07 11:00:19 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch addresses one minor issue, updates the CPT Exclusion List for In October 2003, under the Code Set Versioning Project, the code names, descriptions, inactive flags and dates were replaced by versioned data elements, each with an effective date of use. Additionally, VA software packages who utilize the ICD/CPT files were provided with Code Set Application Programmer Interfaces (APIs) to retrieve the new data and instructed to discontinue the use of the old un-versioned data elements. This patch modifies the routine SROCMPED to make use of one of the Code Set APIs to retrieve and display versioned data. NSQIP, and modifies a data element collected by NSQIP and CICSP. Each is 2. The CPT EXCLUSIONS file (#137) stores CPT codes that have been identified by the National Surgical Quality Improvement Program (NSQIP) as procedures that should not be risk assessed. This patch updates this file with data for fiscal year 2009. 3. The lower range for HEIGHT field (#236) in the SURGERY file (#130) collected by the National Surgical Quality Improvement Program (NSQIP) and Continuous Improvement in Cardiac Surgery Program (CICSP) has been lowered to account for post amputation height of patients with both legs amputated. explained in more detail. 1. The Health Insurance Portability and Accessibility Act (HIPAA) stipulated that diagnostic and procedure codes and terms used for billing purposes must be the codes and terms that were applicable at the time the service was provided. 171 SEQ #165 DATE APPLIED: 2010-05-10 14:44:58 APPLIED BY: USER,SEVENTEEN DESCRIPTION: There are two fixes in this patch: The first issue concerns an a PRINC. ANESTHESIA TECHNIQUE for their patients. UNDEFINED error occurring when trying to enter a DISCHARGE FROM PACU (DPACU) time that is earlier than the PATIENT IN ROOM (PIR) time even though the date is for the next day under the OPERATION INFORMATION option of the NON-CARDIAC ASSESSMENT INFORMATION. The second issue is under the same NON-CARDIAC ASSESSMENT INFORMATION option OPERATION INFORMATION and an UNDEFINED error is being generated due to an expected variable DA(1) not being set. This prevents users from being able to enter 174 SEQ #166 DATE APPLIED: 2010-11-15 10:45:02 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch provides the annual updates to the Veterans Health Information - The frequency of transmission of 1-liner cases is changed from the 45th o PREOP CIRCULATORY DEVICE field (#474) o ENDOVASCULAR REPAIR field (#505) o D/T PATIENT DISCH FROM ICU field (#471) - Corrections are made to the list of missing items functionality for the following fields in the SURGERY file (#130): o ANGINA field (#267) o CONVERT FROM OFF PUMP TO CPB field (#469) - TIME OPERATION BEGAN field (#.22) and TIME OPERATION ENDS field (#.23) day past the end of the quarter to the 45th day past the end of the are moved from the Operative Risk Summary Data (Enter/Edit) [SROA CARDIAC OPERATIVE RISK] option to the Resource Data [SROA CARDIAC RESOURCE] option. - The list of missing items functionality is updated to remove deleted variables and to include the new variables. - The SURGERY CONSULT DATE field (#513) and the PRIMARY CAUSE FOR DELAY field (#515) are removed from the Resource Data [SROA CARDIAC RESOURCE] option. month. - Patient gender is added to the information transmitted on 1-liner cases. - New fields added to SURGERY file (#130): o ASSESSMENT COMPLETED BY field (#272.1) When a non-cardiac assessment is completed, the user who completed the assessment will be identified in this field and the name of the user Systems and Technology Architecture (VistA) Surgery package in support of will be transmitted with the assessment. o PREOPERATIVE SLEEP APNEA field (#237.1) This field is added to the Preoperative Information (Enter/Edit) [SROA PREOP DATA] option, the assessment printout, assessment transmission and the list of missing items functionality. - The SURGERY CONSULT DATE field (#513) and the SURGERY CONSULT REQUESTED field (#516) are eliminated as non-cardiac assessment variables. - This patch updates the CPT EXCLUSIONS file (#137) with data for fiscal the VA Surgery Quality Improvement Program (VASQIP). The updates include year 2010. - Field descriptions are modified in the following fields in SURGERY file (#130): o HEIGHT field (#236) The description and the input transform are modified. o WEIGHT field (#237) The description and the input transform are modified. o HISTORY OF COPD field (#203) o ASCITES field (#212) the addition of new data fields, changes to existing fields, changes to o DISSEMINATED CANCER (Y/N) field (#338) o INTRAOP DISSEMINATED CANCER field (#443) o BLEEDING DISORDERS field (#216) o OTHER PROCEDURE field (#.01 of OTHER PROCEDURES multiple field #.42) o INTRAOPERATIVE ASCITES field (#446) o DVT/THROMBOPHLEBITIS field (#263) Note: The description of DVT/THROMBOPHLEBITIS in the PERIOPERATIVE OCCURRENCE CATEGORY file (#136.5) is updated as well. - On the Operation Information (Enter/Edit) [SROA OPERATION DATA] option: data entry screens, changes to reports, and changes to the Surgery Risk o When selecting item #3, CPT Codes (view only), the following note is added to the screen: CPT Codes should be verified. If need be, report discrepancies to the official CPT coder for surgery. o When selecting item #5, Concurrent Procedure, the following note is added to the screen: Concurrent Procedure: An additional operative procedure performed by different surgical team (i.e., a different specialty/service) under the same anesthetic which has a CPT code different from that of the Principal Operative Procedure (e.g., fixation of a femur Assessment transmissions. fracture in a patient undergoing a laparotomy for trauma). This field should be verified and, if need be, report discrepancies to the official CPT coder for surgery. - A new entry, N - NONE ASSIGNED, is added to the ASA CLASS file (#132.8). The output transform on ASA CLASS field (#1.13) in SURGERY file (#130) is modified to allow the display of the new entry. - The list of missing items functionality is updated to remove deleted variables and to include the new variables. Cardiac Assessment Modifications: --------------------------------- - The SURGERY CONSULT DATE field (#513) and the PRIMARY CAUSE FOR DELAY field (#515) are eliminated as cardiac assessment variables. - New fields added to SURGERY file (#130) as new cardiac variables: o PREOP ATRIAL FIBRILLATION field (#509) This field is added to the Clinical Information (Enter/Edit) [SROA CLINICAL INFORMATION] option. Non-Cardiac Assessment Modifications: o PULMONARY VALVE PROCEDURE field (#493) This field is added to the Cardiac Procedures Operative Data (Enter/Edit) [SROA CARDIAC PROCEDURES] option. o BNP field (#507) This field is added to the Laboratory Test Results (Enter/Edit) [SROA LAB-CARDIAC] option. o BNP DATE field (#507.1) This field is added to the Laboratory Test Results (Enter/Edit) [SROA LAB-CARDIAC] option. o POSTOP ATRIAL FIBRILLATION field (#448) ------------------------------------- This field is added to the Outcome Information (Enter/Edit) [SROA CARDIAC-OUTCOMES] option. Associated with this yes/no field is a new entry, POSTOPERATIVE ATRIAL FIBRILLATION, in the PERIOPERATIVE OCCURRENCE CATEGORY file (#136.5). - The following fields in SURGERY file (#130) are modified: o AORTIC VALVE PROCEDURE field (#367) o MITRAL VALVE PROCEDURE field (#368) o TRICUSPID VALVE PROCEDURE field (#369) o FUNCTIONAL HEALTH STATUS field (#240) 165 SEQ #167 DATE APPLIED: 2010-11-18 11:37:42 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch addresses the following problems: 2. HD238998 - FGH - service block issue on 5th week of month When a monthly service block is set for a day in the 4th week, users are unable to set a service block for that day in the 5th week of a month. 1. HD194156 - Input transform for CPT Modifier 51 in Surgery The Lexicon package has been working to update the CPT code ranges for the CPT Modifier 51. Part of this update is to include all Surgical Procedures with the exception of those listed in Appendix E of the CPT Manual. During the analysis phase for this project, it was discovered that this unique CPT Modifier carries with it the stipulation that it can not be used in conjunction with the principal procedure. 175 SEQ #168 DATE APPLIED: 2011-08-22 11:21:41 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch provides the VASQIP 2011 Increment 1 to the Veterans Health I. General Surgery Updates: ANESTHESIA AGENTS Multiple (#130.47) of the ANESTHESIA TECHNIQUE Multiple (#130.06) - DOSE field (#.1) of the TEST DOSE Multiple (#130.48) of the ANESTHESIA TECHNIQUE Multiple (#130.06) 9. The Clean Wound Infection Summary Report is updated to include the ORGAN/SPACE SSI field (#488) in the algorithm for calculating the clean wound infection rates. For cardiac assessed cases, ENDOCARDITIS field (#386) and MEDIASTINITIS field (#388) will be included in the algorithm for calculating the clean wound infection -------------------------- rates. 10. The Perioperative Occurrences Report, under the Morbidity & Mortality Reports [SROMM] option, will be modified to allow three selections as follows: 1-Intraoperative Occurrences 2-Postoperative Occurrences 3-Intraoperative and Postoperative Occurrences 1. All options under the Quarterly Report Menu [SROQ MENU] are retired II. Non-Cardiac Module Updates: -------------------------------- 1. A new 30 DAY DEATH field (#342.1) has been added to the SURGERY file (#130). This field is added to the Patient Demographics (Enter/Edit) [SROA DEMOGRAPHICS] option and it will indicate operative death has occurred within 30 days of surgery. This field will be auto populated based on an entry into the DATE OF DEATH field (#342). If Date of Death occurs within 30 days or less of the date in the DATE OF OPERATION field (#.09), then this field is automatically updated to "Yes" when the Date of Death is saved. If the except the Admissions Within 14 Days of Outpatient Surgery [SROQADM] Date of Death is greater than 30 days from the Date of Operation then this field is automatically updated to "No" when the Date of Death is saved. 2. The data dictionary of the PREOPERATIVE SLEEP APNEA field (#237.1) of the SURGERY file (#130) has been changed to allow for an entry of "N" for "NONE" on the Preoperative Information (Enter/Edit) [SROA PREOP DATA] option. 3. Update the printed Assessment to now include the field ASSESSMENT option, the Report of Missing Quarterly Report Data [SROQ MISSING DATA] COMPLETED BY field (#272.1) of the SURGERY file (#130). III. Cardiac Module Updates: --------------------------- 1. The field name "Myectomy for IHSS" is changed to "Myectomy" in the option for the Cardiac Procedures Operative Data (Enter/Edit) [SROA CARDIAC PROCEDURES] option and the the Print Assessment Report. 2. The data dictionary of the BRIDGE TO TRANSPLANT/DEVICE field option and Deaths Within 30 Days of Surgery [SROQD], which are (#481) is modified from the current values of "Yes" and "No" to "None", "Bridge to Transplant", and "Destination Therapy" 3. The existing field, WOUND CLASSIFICATION (#1.09), is added to the Operative Risk Summary Data (Enter/Edit) [SROA CARDIAC OPERATIVE RISK] option. This field has been added to the Cardiac Print Assessment Report. 4. The current WOUND DISRUPTION field (#404) of the Surgery file (#130) is added to the Outcome Information (Enter/Edit)[SROA CARDIAC-OUTCOMES] relocated under the Management Reports [SRO-CHIEF REPORTS] menu. option. This information will appear on the Printed Assessment Report and added to the Cardiac Transmission. 5. The Clinical Information (Enter/Edit)[SROA CLINICAL INFORMATION] option is updated to allow a response of "N" or "NO" at the prompt to update all the fields to a negative value except Height, Weight, FEV1, Functional Status, Angina, and CHF. IV. Transplant Module Updates: ------------------------------- 1. HLA Typing fields in the SURGERY TRANSPLANT ASSESSMENTS file (#139.5) across all four organ types are updated to allow entry of 4 digits (#,#,#,#). The Transplant Transmission is also updated. 2. The C-PEPTIDE AT TIME OF LISTING field (#136) of the SURGERY TRANSPLANT ASSESSMENTS file (#139.5) has been changed to allow for a value less than 1. When the value is less than 1, it will be displayed with a leading zero (i.e., 0.6). 2. Remove references to "NSQIP" and "CICSP" in field labels and field 3. The POST-TX PROPHYLAXIS - TB field (#92) of the SURGERY TRANSPLANT ASSESSMENTS file (#139.5) has been updated to allow a value to be entered of "N/A". This information is added to the Transmission. 4. The COLD ISCHEMIA TIME FOR ORGAN field (#87) and WARM ISCHEMIA TIME FOR ORGAN field (#85) of the SURGERY TRANSPLANT ASSESSMENTS file (#139.5) has been added to page #1 of the Enter/Edit Transplant Assessments [SR TRANSPLANT ENTER/EDIT] option and to the Print Transplant Assessment [SRTP PRINT ASSESSMENT] option for VA and Non-VA heart transplants. definitions. When the text is not in the header of a definition, the Information Systems and Technology Architecture (VistA) Surgery package in terms "NSQIP" and "CICSP" are replaced with "VASQIP". The complete list of these fields is listed in the Release Notes manual. 3. Addition of Scheduling Date fields The following new fields are added to the SURGERY file (#130): - ORIGINAL DESIRED PROCEDURE DATE field (#612) - D/T OF DESIRED PROCEDURE DATE ENTRY field (#613) - ORIGINAL SCHEDULED DATE field (#614) support of the VA Surgery Quality Improvement Program (VASQIP). The - D/T OF SCHEDULED DATE ENTRY field (#615) - DESIRED PROCEDURE DATE field (#616) - SCHEDULED DATE field (#617) 4. Add Time Out Verified Utilizing Checklist (a) The following new fields are added to the SURGERY file (#130): - CONFIRM PATIENT IDENTITY field (#600) - PROCEDURE TO BE PERFORMED field (#601) - SITE OF PROCEDURE field (#602) - VALID CONSENT FORM field (#603) updates include the addition of new data fields, changes to existing - CONFIRM PATIENT POSITION field (#604) - MARKED SITE CONFIRMED field (#605) - PREOPERATIVE IMAGES CONFIRMED field (#606) - CORRECT MEDICAL IMPLANTS field (#607) - ANTIBIOTIC PROPHYLAXIS field (#608) - APPROPRIATE DVT PROPHYLAXIS field (#609) - BLOOD AVAILABILITY field (#610) - AVAILABILITY OF SPECIAL EQUIP field (#611) - CHECKLIST COMMENT field (#85) fields, changes to data entry screens, changes to reports, changes to the (b) The VALID ID/CONSENT CONFIRMED BY field (#.69) has been renamed to CHECKLIST CONFIRMED BY. (c) All the above new fields are added to the new Time Out Verified Utilizing Checklist option [SROMEN-VERF], which has been added to the Operation Menu [SROPER]. (d) The existing ensuring correct surgery fields (MARKED SITE CONFIRMED field (#73), PREOPERATIVE IMAGING CONFIRMED field (#72), TIME OUT VERIFIED field (#71), MARKED SITE COMMENTS field (#84), IMAGING Surgery Risk Assessment transmissions, and changes to Transplant CONFIRMED COMMENTS field (#83), TIME OUT VERIFIED COMMENTS field (#82), and VALID ID/CONSENT CONFIRMED BY field (#.69)) will be removed from the following Operation Menu options: - Operation Startup [SROMEN-START] - Operation [SROMEN-OP] - Operation (Short Screen) [SROMEN-OUT] - Nurse Intraoperative Report [SRONRPT] (e) The existing ensuring correct surgery fields in the Nurse components of the VistA Surgery application. Intraoperative Report are replaced with the new Time Out Verified Utilizing Checklist fields (the fields listed in item "a" and "b" of this section are added). 5. OR Cancellation Report - The pre-existing reasons have been inactivated and will not be editable but can be viewed. - A new selection list for Cancellation Reasons has been added. - The SURGERY CANCELLATION REASON file (#135) will be locked with this patch so it will no longer be editable at sites. - The Update Site Configurable Files [SR UPDATE FILES] option has been updated to remove the Surgery Cancellation Reasons from the Site Configurable Files. 6. The CPT Code Exclusion list for 2011 has been updated so that the surgical package can accurately calculate the VASQIP eligible list (affecting the CPT EXCLUSIONS file (#137) and the Workload Report/List #9). 7. Two pre-existing fields for the SURGERY file (#130), PRINC ANESTHETIST field (#.31) and ANESTHESIOLOGIST SUPVR field (#.34), have been added to the Non-OR Procedure report. 8. This patch updates the Anesthesia Report and the Nurse Intraoperative Report to display values of less than 1 for the fields below with a leading zero in reports they are displayed. - DOSE field (#1) of the MEDICATIONS multiple (#130.33) - TIME ADM field (#1) of the TIME ADM multiple (#130.34) - DOSE field (#1) and the ANESTHESIA AGENTS field (#.01) of the 176 SEQ #169 DATE APPLIED: 2012-08-29 11:14:41 APPLIED BY: USER,SEVENTEEN DESCRIPTION: In support of the VA Surgery Quality Improvement Program (VASQIP), this a. Surgery cancellation functionality is modified so that any surgery References to ICD9 are replaced with ICD in the following menu options: - CPT/ICD9 Coding Menu [SRCODING MENU] - CPT/ICD9 Update/Verify Menu [SRCODING UPDATE/VERIFY MENU] - Update/verify Procedure/Diagnosis Codes [SRCODING EDIT] 9. Remove Quarterly Report References a. References to "Quarterly Report" are removed from the Deaths Within 30 Days of Surgery [SROQD] option. case that is placed on the surgery schedule and then cancelled will b. The routines that provided the Surgery Quarterly Report functionality are removed. Those routines are SROQ1, SROQ1A, SROQ2, SROQM, SROQM0, SROQM1 and SROQT. 10. Add Superficial Incisional SSI to Cardiac Outcomes The SUPERFICIAL INCISIONAL SSI field (#248) in the SURGERY file (#130) is added to the Outcome Information (Enter/Edit) [SROA CARDIAC-OUTCOMES] option, the cardiac assessment transmission and to the cardiac assessment printout. be retained in the SURGERY file (#130) as a cancelled case 11. The following routines associated with obsolete functionality are removed: SROAC, SROAC1, SROAC2, SROACCR, SROACRC, SROACS, SROASWAP, SROASWP, SROASWP0, SROASWP1, SROASWP2, SROAWSP3, SROASWPD, SRSLOOK, and SRSLOOK1. 12. This patch fixes the issue reported by Remedy ticket #528445, where the PREOPERATIVE IMAGES CONFIRMED field (#606) displays the same data as MARKED SITE CONFIRMED field (#605). 13. This patch updates the CPT EXCLUSIONS file (#137) with data for regardless of when the case is cancelled. Also, a cancellation fiscal year 2012. reason is required for every cancellation. Any scheduled case that is cancelled will be counted as a cancellation on the Report of Cancellations generated by the Report of Cancellations [SROCAN] option. b. The Report of Cancellations, generated by the Report of patch provides the VASQIP Increment 2 update to the Veterans Health Cancellations [SROCAN] option, is modified to group patient data together within specialty so that all cases for a single patient will be shown together. The report will also order based on operations so the same operation descriptions will show next to each other for the same patient. 2. Miscellaneous Additions to Risk Assessment Transmissions a. The name of the operating room as defined in the HOSPITAL LOCATION file (#44) is added to each cardiac and non-cardiac risk assessment transmission and to each 1-liner case transmission. Information Systems and Technology Architecture (VistA) Surgery package. b. The following four fields in the SURGERY file (#130) are added to each 1-liner case transmission and to the list of items checked for by the List of 1-Liner Cases Missing Information which is one of the reports generated by the List of Surgery Risk Assessments [SROA ASSESSMENT LIST] option: - TIME OPERATION BEGAN (#.22) - TIME OPERATION ENDS (#.23) - TIME PAT IN OR (#.205) - TIME PAT OUT OR (#.232) The updates include the addition of new data fields, changes to existing 3. Positive Drug Screening A new POSITIVE DRUG SCREENING field (#618) is added to the SURGERY file (#130). This field is added to the Preoperative Information (Enter/Edit)[SROA PREOP DATA] option, the Clinical Information (Enter/Edit)[SROA CLINICAL INFORMATION] option and the Print a Surgery Risk Assessment [SROA PRINT ASSESSMENT] option. This field is also added to the cardiac and non-cardiac risk assessment transmissions and is added to the list of missing items functionality. fields, changes to data entry screens, changes to reports, changes to the 4. Consolidation of Shared Cardiac, Non-Cardiac and Transplant Fields This patch updates various fields in the SURGERY file (#130) and in the SURGERY TRANSPLANT ASSESSMENTS file (#139.5) as well as various occurrence category descriptions in the PERIOPERATIVE OCCURRENCE CATEGORY file (#136.5) so that common items share common definitions. This patch also replaces various fields with new fields in order to enhance and refine certain data elements that are in common with cardiac and non-cardiac risk assessments and transplant assessments. All the associated data input options, assessment printouts and transmissions are updated accordingly. Surgery Risk Assessment transmissions, and changes to transplant The complete list of updated fields, new fields and replaced fields is in the patch release notes. 5. Add Serial Number for Prosthesis Items - Two new fields, LOT NUMBER (#11) and SERIAL NUMBER (#12) are added to the PROSTHESIS INSTALLED multiple field (#.47, sub-file #130.01) to replace the existing LOT/SERIAL NO field (#2.5). The Operation [SROMEN-OP] option and the Nurse Intraoperative Report [SRONRPT] option are updated to allow editing and display of these components of the VistA Surgery application. two new fields. - LOT NUMBER field (#8) and SERIAL NUMBER field (#9) are added to the PROSTHESIS file (#131.9). The Update Site Configurable Files [SR UPDATE FILES] option is modified to allow editing of these new fields and to disallow editing of the LOT/SERIAL NO field (#4) and the STERILE CODE field (#3). 6. Flash Sterilization Six new fields are added to the SURGERY file (#130) to document the number of episodes of each type of flash sterilization that happened for an operation: - FLASH-CONTAMINATION (#619) - FLASH-SPD/OR MGT ISSUE (#620) - FLASH-EMERGENCY CASE (#621) - FLASH-NO BETTER OPTION (#622) - FLASH-LOANER INSTRUMENT (#623) - FLASH-DECONTAMINATION (#624) The Post Operation [SROMEN-POST] option and the Nurse Intraoperative Report [SRONRPT] option are updated to allow editing and display of 1. Surgery Cancellation Modifications these two new fields. 7. 30-Day Readmission This patch creates a transmission report that lists inpatient surgery cases which were followed by the patient being readmitted within 30 days of discharge. This report is run by the Surgery Nightly Cleanup and Updates [SRTASK-NIGHT] option and will transmit to the VASQIP database automatically each quarter. 8. Update ICD9 to ICD 173 SEQ #170 DATE APPLIED: 2012-08-29 12:02:31 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch addresses the following issues: (1) Users are receiving an UNDEFINED error at SRHLXTMP+7^SRHLXTMP when their system runs the nightly task SRTASK-NIGHT option. (2) A user reported that addendums created in VistA are not always being transmitted to CPRS. The reason being it appears that TIU BUSINESS RULES for certain document types or user classes are being created which can cause unforeseen issues. 177 SEQ #172 DATE APPLIED: 2014-08-18 12:03:11 APPLIED BY: USER,SEVENTEEN DESCRIPTION: The International Classification of Diseases, Tenth Revision (ICD-10) characters. This value does not include the decimal point, which follows the third character for the ICD-10-CM code set. There is no decimal point in the ICD-10-PCS code set. These code sets have the potential to reveal more about quality of care, so that data can be used in a more meaningful way to better understand complications, better design clinically robust algorithms, and better track the outcomes of care. ICD-10-CM also incorporates greater specificity and clinical detail to provide information for clinical decision making and outcomes research. Class 1 Software Remediation project replaces the 30-year-old set of The only noticeable difference users may see will occur when a specific ICD diagnosis code descriptor changes based on the date of operation for the case. diagnosis and procedure codes (ICD-9-CM) that medical personnel use. Dates of service, or dates of discharge for inpatients, that occur on or after October 10, 2013 will use the ICD-10 code set. Clinical Modification (ICD-10-CM) diagnosis codes increase from about 13,000 ICD-9 codes to more than 68,000. Procedure Coding System (ICD-10-PCS) procedure codes increase from about 3,800 ICD-9 codes to nearly 87,000. Both systems also expand the number of characters allotted to seven alpha-numeric 178 SEQ #173 DATE APPLIED: 2014-10-31 15:56:19 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch will correct the following issues currently occurring in Next, the FIELD field (#2) for the ATTENDING CODE entry of the Surgery Interface Parameter file (#133.2) points to the ATTENDING CODE field (#.165) of the SURGERY file (#130) which is no longer used. It should point to ATTENDING CODE field (#.166) of the SURGERY file. Finally, when printing the 'LONG' form version of an operation request for a particular surgical specialty in the Operation Requests for a Day [SROP REQ] option in the Surgery Menu, a site noticed the Case Order number is not displaying correctly. the VistA Surgery application: In the Surgery option Exclusion Criteria (Enter/Edit) [SR NO ASSESSMENT REASON] when users try to enter exclusion criteria beginning with 'EXCEEDS' at the 'Reason an Assessment was not Created:' prompt, the response 'EXCEEDS MAX ASSMNTS' is always always displaying no matter what the user has entered/selected. 68 SEQ #65 DATE APPLIED: 1997-09-22 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Surgery patch SR368 - July 97 Fixes and Updates 182 SEQ #174 DATE APPLIED: 2015-01-06 11:49:15 APPLIED BY: USER,SEVENTEEN DESCRIPTION: The description of this build can be found in the National Patch Module under SR3182. 184 SEQ #175 DATE APPLIED: 2016-01-08 11:53:02 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: The description of this build can be found in the National Patch Module under SR3184. 185 SEQ #176 DATE APPLIED: 2016-03-23 11:53:57 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: The patch addresses two (2) issues: values have been added to the SET of allowable choices ("1" FOR SAME DAY, "2" FOR ADMISSION, "3" FOR HOSPITALIZED). 1. During transmission of Surgery Risk Assessments, an UNDEF error occurs when routine SROATMNO calls routine ADM1^SROAPIMS without initializing the needed local variable SRSOUT. 2. Routines that generate the Report of Non-O.R. Procedures [SRONOR] need to be modified to recognize recent modifications to the IN/OUT-PATIENT field (#.011) in the SURGERY FILE (#130): three (3) 186 SEQ #177 DATE APPLIED: 2016-05-04 12:53:30 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: The patch addresses two (2) issues: caret ("^") to escape the edit session prior to completion, the application erroneously adds a field delimiter to the selected category record in the SURGERY INTERFACE PARAMETER File (#133.2). 1. When a user edits the PROSTHESIS INSTALLED data for a completed surgery case using the Operation option [SROMEN-OP] of the Operation Menu option [SROPER] of the Surgery Menu option [SROMENU] and answers "NO" when prompted to create an addendum, an application error occurs. 2. When a user edits Surgery Flag Interface Fields and enters a 188 SEQ #178 DATE APPLIED: 2017-01-06 12:56:24 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: The patch addresses three (3) issues: 3. Users are unable to enter a D Code (Dental) in the PLANNED PRINCIPAL PROCEDURE field (#27) of the SURGERY file (#130) using the Non-O.R. Procedure option [SRONOP] in the Surgery package. 1. Cases aborted prior to the release of SR3.0184 are displayed as "CANCELLED" in the Operation Menu option [SROPER]. 2. Nurses are unable to sign their Nurse Intraoperative Report (NIR) in the Surgical Package when the case has been aborted using the Abort/Cancel Operation option [SROABRT]. 187 SEQ #179 DATE APPLIED: 2017-02-24 17:03:17 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: The patch addresses four (4) issues: 3. Surgery Post Operation and CPT/ICD Update/Verify options incorrectly allow CPT Modifier 51 to be entered on the Principle Procedure. 4. The Surgery Schedule of Operations report truncates the patient name inappropriately when its length is great than 23 characters. 1. When Surgery sends HL7 (Health Level-7) DG1 (Diagnosis) Segments to Ancillary systems, messages with other preoperative diagnoses have an incorrect value for the ICD diagnosis code. 2. When a Wound Classification Report is generated at an institution that has only one (1) Active surgery site and the Active site isn't the installation's default institution, the report displays no data regardless of the date range selected. 189 SEQ #180 DATE APPLIED: 2017-03-10 12:42:01 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: Patch SR3.0189 addresses the following Surgery issue: 1. The SURGERY file (#130) ADT and ARS cross references do not merge during a patient merge. 190 SEQ #181 DATE APPLIED: 2018-02-28 16:49:07 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: The patch addresses one (1) issues: 1. Under certain conditions, the transplant/donor section is not displayed on the Nurse Intraoperative Report (NIR) 193 SEQ #183 DATE APPLIED: 2019-04-02 17:16:30 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: Preoperative CVD data fields assigned invalid values 194 SEQ #182 DATE APPLIED: 2019-05-30 12:49:49 APPLIED BY: USER,SEVENTEEN DESCRIPTION: HOSPITAL ADMISSION STATUS field defaults to an inactive code 71 SEQ #66 DATE APPLIED: 1997-11-05 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: National Surgical Quality Improvement Program (NSQIP) enhancements patch. 195 SEQ #184 DATE APPLIED: 2019-08-19 12:04:46 APPLIED BY: USER,SIXTYFIVE DESCRIPTION: The description of this build can be found in the National Patch Module under SR3195. 196 SEQ #185 DATE APPLIED: 2020-01-15 12:27:30 APPLIED BY: USER,SIXTYFIVE DESCRIPTION: The patch addresses one (1) issue: 1. When the MAKE OPERATION REQUEST [SROOPREQ] option is used to delete an outstanding surgery request with a concurrent case request, the user is asked if they want to delete the concurrent case and defaults to "yes". If the user accepts the default the outstanding request AND concurrent cases are deleted regardless whether the concurrent case is completed case. 201 SEQ #186 DATE APPLIED: 2020-11-23 10:09:58 APPLIED BY: USER,SEVENTEEN DESCRIPTION: The patch addresses two (2) issue: schedule the same case for different times or rooms and block those resources from other users. 1. When a POSTOP OCCURRENCE for "OUT-OF-OR UNPLANNED INTUBATION W/IN 30 DAYS" is entered and then deleted, the printed risk assessment improperly displays "NO DATE" rather than "NO" for the occurrence. 2. When two (2) users accidently attempt to schedule or reschedule an operation for the same patient, they can inadvertently 202b DATE APPLIED: 2021-06-23 00:00:00 DESCRIPTION: Backup of SR3.0202 on Jun 23, 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. 202 SEQ #187 DATE APPLIED: 2021-06-23 11:33:47 APPLIED BY: USER,SEVENTEEN DESCRIPTION: The patch will address the following issue: The CPT EXCLUSIONS file (#137) needs to be updated for fiscal year 2021 (FY21). 200 SEQ #188 DATE APPLIED: 2021-11-29 09:58:37 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This enhancement to the VISTA Surgery package includes a new field (137.45). If defined for a local specialty, the software will automatically enter NO in the ROBOTIC ASSISTANCE (Y/N) field when a surgery case is created for the selected specialty. Update to transmission code to restrict date/time field 613 to 12 characters. Update to Nurse Intraoperative report to have Laser Duration notes as seconds (not minutes). Update to file #130.11, field #14 to reflect this change. ROBOTIC ASSISTANCE (Y/N) for tracking whether robotic assistance was used Update to include a search for any height for the patient, not just a height in the past year. when completing a surgery procedure. The new field is included on the Operation, Operation Short Screen, and Nurse Intraoperative Report options within the Operation Menu and is required to be entered prior to signing the Nurse Intraoperative Report. The field is also included on Non-Cardiac and Cardiac Risk Assessment data entry options. This indicator is transmitted to VASQIP for all cases. A new field, ROBOTIC DEFAULT (#12) has been added to the LOCAL SURGICAL SPECIALTY file 204 SEQ #189 DATE APPLIED: 2022-08-22 14:46:04 APPLIED BY: USER,EIGHTYSIX DESCRIPTION: The patch addresses two (2) issues: DELIVERED field (#9) in the LASER PERFORMED multiple (#135) in the SURGERY FILE (#130). Specifically: the request is to increase the largest allowable value to 99999.9. 1. One Liner (1-Liner) cases are not transmitting to the National Risk Assessment database because the SURGERY FILE (#130) AQ XREF is being killed and not reset when the TIME PAT OUT OR field (#.232) in the SURGERY FILE (#130) is edited for a surgery case with a signed Nurse Intraoperative Report with coding complete. 2. A request is to increase the numeric upper limit of the TOTAL JOULES 206 SEQ #190 DATE APPLIED: 2022-10-12 09:29:07 APPLIED BY: USER,NINETY DESCRIPTION: The patch addresses one (1) issue: The patch will address the following issue: the CPT EXCLUSIONS file (#137) needs to be updated for fiscal year 2022 (FY22). 203 SEQ #192 DATE APPLIED: 2023-01-18 16:12:57 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: The patch addresses three (3) issue: Abnormally terminated, the Operating Room schedule is blocked. If the VistA session times out at the same prompt, the Operating Room schedule is not blocked. 3. The Cardiac Assessment option only captures the height if entered into the Vitals package in the past year instead of capturing height regardless of when the measurement was taken like the Non-Cardiac Assessment option. 1. When using the "Scheduled Unrequested Operations" [SROSRES] option at the PRIMARY SURGEON prompt and the VistA session is terminated, the Operating Room schedule is blocked. If the VistA session times out at the same prompt, the Operating Room schedule is not blocked. 2. When using the "Schedule Unrequested Concurrent Cases" [SRSCHDC] Option at the PRIMARY SURGEON prompt and the VistA session is 207 SEQ #193 DATE APPLIED: 2023-04-14 11:30:13 APPLIED BY: USER,NINETY DESCRIPTION: The patch addresses one (1) issue: 1. Under certain circumstance, completed concurrent surgical cases (the TIME PAT OUT OR field {#.232} in the SURGERY FILE {#130} is entered) are allowed to be deleted from the VistA Surgery package. 70 SEQ #67 DATE APPLIED: 1997-11-18 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Surgery patch SR370 - September 97 Fixes 209 SEQ #194 DATE APPLIED: 2023-05-23 09:39:40 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: The patch addresses one (1) issue: 1. The National Surgery Office requests that the help text for wound classification information in VistA Surgery be updated so that 2018 CDC Wound Classification definitions are displayed rather than the current definitions (2007). 210 SEQ #195 DATE APPLIED: 2023-06-14 17:44:55 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: The patch addresses one (1) issue: The patch will address the following issue: the CPT EXCLUSIONS file (#137) needs to be updated for fiscal year 2023 (FY23). 211 SEQ #196 DATE APPLIED: 2023-09-01 14:11:14 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: The patch addresses one (1) issue: The CONCURRENT CASE field (#35) in the SURGERY FILE (#130) in a completed concurrent case is cleared however the CONCURRENT CASE field is not cleared in a cancelled concurrent case. 212 SEQ #197 DATE APPLIED: 2023-11-01 11:30:59 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: The patch addresses one (1) issue: Under certain circumstances, the CULTURES title/data does not display on the Nurse Intraoperative Report using the VistA Nurse Intraoperative Report display/print option or on the SURGERY tab in CPRS. This occurs when the NURSE INTRAOP REPORT field (#29) in the SURGERY SITE PARAMETERS FILE (#133) is set to "PRINT TITLES WITH INFO ONLY" and the CULTURES field (#64) in the SURGERY FILE (#130) contains data and the SPECIMENS field (#49) does not. 213 SEQ #198 DATE APPLIED: 2023-12-06 15:42:32 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: The patch addresses one (1) issue: Under certain circumstances, the CVD REPAIR/OBSTRUCT field (#521) value in the SURGERY File (#130) is not displaying/printing for a NON-CARDIAC RISK ASSESSMENT using the "Print a Surgery Risk Assessment" [SROA PRINT ASSESSMENT] option. 214 SEQ #199 DATE APPLIED: 2024-03-25 09:55:23 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: The patch addresses one (2) issues: erroneously instead of the field name/title when adding a new entry to several multiples in the SURGERY file (#130) when entering a new surgery case using the "Operation Menu". The multiples are: OTHER PROCEDURES (#.42), OTHER PREOP DIAGNOISIS (#.72) SURGERY POSITION (#65), REQ BLOOD KIND (#1.05), SPECIAL EQUIPMENT (#680), PLANNED IMPLANTS (#681), SPECIAL SUPPLIES (#682), SPECIAL INSTRUMENTS (#683), PHARMACY ITEMS (#684), and REFERRING PHYSICIAN (#23). 1. In certain circumstances if a value is entered in the REFERRING PHYSICIAN field (#23) of the SURGERY FILE (#130) in a surgery case the value is carried over and DISPLAYS in the SPECIAL EQUIPMENT (#680), PLANNED IMPLANTS (#681), SPECIAL SUPPLIES (#682), SPECIAL INSTRUMENTS (#683) or PHARMACY ITEMS (#684) fields. 2. In certain circumstances "Select Surgical Specialty:" displays 205 SEQ #200 DATE APPLIED: 2024-08-08 17:26:59 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: This enhancement to the VistA Surgery package includes: STORED IN ^SRF( (XX ENTRIES) SITE: XXXXXXX UCI: XXXXXXX (VERSION 3) DATA NAME GLOBAL DATA ELEMENT TITLE LOCATION TYPE ------------------------------------------------------------------------- 130,665 DONOR VESSEL DISPOSITION VER1;16 SET Donor Vessel Disposition if not used 'N' FOR NO DONOR VESSELS RECEIVED; 'D' FOR DISCARDED; 'R' FOR RETURNED TO OPO; 'S' FOR STORED; 'NA' FOR NOT APPLICABLE; <-- LAST EDITED: MAY 18, 2022 HELP-PROMPT: Enter disposition of donor vessels. DESCRIPTION: Document disposition of donor vessels. 1. An update to the SET OF CODES for the DONOR VESSEL DISPOSITION (#665) 2. Input template (order of menu options) realignment The SRONRPT, SRONRPT1, and SRONRPT2 input templates that are executed when the Nurse Intraoperative Report [SRONRPT] option is selected have been updated to follow the order of menu options requested by the National Surgery Office (NSO). 3. Deactivation of the POSSIBLE ITEM RETENTION (#630) field in the SURGERY (#130) file field in the SURGERY (#130) file The POSSIBLE ITEM RETENTION (#630) field has been marked as UNEDITABLE in the SURGERY (#130) file and will no longer be included in any VistA Surgery input templates for entry or editing. This field will also no longer be required to electronically sign the Nurse Intraoperative report. It will, however, continue to display in completed Nurse Intraoperative Reports for historical cases. 4. Correction of spelling for GLASSES/GOOGLES to GLASSES/GOGGLES in the PATIENT PRECAUTIONS (#15) subfield of the LASER PERFORMED (#130.11) multiple in the SURGERY (#130) file for display/print in the Nurse Intraoperative Report. 'NA - NOT APPLICABLE' has been added to the set of codes that can be selected for the DONOR VESSEL DISPOSITION (#665) field in the SURGERY (#130) file. Surgery Risk Assessment transmissions have been modified to accommodate the new 2 character code. 215 SEQ #201 DATE APPLIED: 2024-09-03 10:30:52 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: The patch addresses one (1) issue: The patch will address the following issue: the CPT EXCLUSIONS file (#137) needs to be updated for fiscal year 2024 (FY24). 217 SEQ #202 DATE APPLIED: 2024-10-30 12:50:09 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: Please review FORUM's Patch Module description and installation instructions before installing this patch. 76 SEQ #68 DATE APPLIED: 1998-01-12 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch removes the SURGEON'S OPERATION TIMES file (#131.2) from your system. This file has been obsolete since the release of Surgery V. 3.0 in 1993. 72 SEQ #69 DATE APPLIED: 1998-01-12 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch modifies the routine ^SROCODE used for flagging anesthesia enhanced to create a background task for performing this function. agents. With the release of Pharmacy Data Management V. 1.0, existing calls to the Inpatient Medications routine ^PSGIU will be replaced by the Pharmacy Data Management routine ^PSSGIU. This modification allows the function to work with or without the installation of Pharmacy Data Management V. 1.0. This patch also modifies the routine ^SROXR1 which is used for canceling IV orders upon start of a surgical procedure. This routine has been 73 SEQ #70 DATE APPLIED: 1998-01-12 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch contains modifications to routines used to file information to between Surgery and Order Entry/Results Reporting will be reestablished. A future patch will be necessary when that time comes. OE/RR. Changes will allow the software to function in it's current form when using Order Entry/Results Reporting V2.5, but will inactivate the interface for sites using CPRS and Order Entry/Results Reporting V3.0. The interface for Surgery used within Order Entry/Results Reporting V2.5 is not supported with CPRS and Order Entry/Results Reporting V3.0, causing errors when using the Surgery software. At the time of release of this patch, it is unclear when the interface 75 SEQ #71 DATE APPLIED: 1998-01-29 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Surgery patch SR375 - DELAYED OP REPORT COMMENTS ERROR 78 SEQ #72 DATE APPLIED: 1998-02-27 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch modifies the routines SROCON and SROCON1 used in creating the data to be stored in Concurrent Cases. A problem was discovered when a free text field contained a semi colon (;). The patch resolves this problem. 55 DATE APPLIED: 1997-01-22 00:00:00 APPLIED BY: USER,ONE 77 DATE APPLIED: 1998-03-30 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Patch SR377 provides software renovations related to Y2K (Year 2000) compliance. 74 DATE APPLIED: 1998-06-04 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch contains a new option [SR BLOOD PRODUCT VERIFICATION] within selected product is not associated with the patient identified, the warning message will be displayed. A new option called [SR BLOOD PRODUCT VERIFY AUDIT] is included to allow auditing of the option above. It has been placed on the "Chief of Surgery Menu" on the "Management Reports Menu". After installing this patch, IRM needs to turn on the KERNEL Audit Option by invoking the option, [XUAUDIT] for the new option exported with this patch [SR BLOOD PRODUCT VERIFICATION]. The expiration date for the audit the VistA Surgery package which will be used for transfusion error risk should be set to a date 100 years into the future. management. The new option is contained on the Surgery "Operations Menu". The option performs the following function; after scanning the blood unit ID, the software will check for an association with the patient identified. If there are multiple entries with the Unit ID scanned, these entries will be listed along with the Blood Component, Patient Associated, and Expiration Date. The user will then be prompted to select the one that matches the blood product about to be administered. If the 41 DATE APPLIED: 1998-07-12 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: The Surgery Interface is a generic interface that sends and receives Surgery and Patient information by way of the VistA HL7 package. The interface consists of QRY (Query), ORU (Observation Results Unsolicited), and ZIU (Scheduling Information Unsolicited) messages. Certain specified information is sent from the interface based on trigger events in the VistA Surgery package. 79 SEQ #76 DATE APPLIED: 1998-07-25 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch adds "ORAL" as a medications route to the set of codes within This patch modifies the routine SROXR1 to correct a problem at entry point IV with an undefined variable 'Y' and converts a read/write at entry point IV1 to a FileMan call. Surgery file (#130) and modifies the routine SROMED to reflect this addition. This patch also changes the definition of the field Major/Minor per Dr. Gerald McDonald, Acting Director, Surgical Service, VACO and the National Surgical Quality Improvement Program (NSQIP) Executive Committee. 83 SEQ #77 DATE APPLIED: 1998-08-31 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This is Surgery patch SR383. 82 SEQ #78 DATE APPLIED: 1998-10-07 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch modifies one Surgery routine, SROQM, which is used to transmit mail messages related to the Quarterly Report. Current code, while it works properly, needs to be updated based on guidance received from the MailMan development team. The changes included in this patch should be transparent. 80 SEQ #79 DATE APPLIED: 1998-10-07 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch corrects an undefined variable condition when the OERR Task Order Purge option [ORTASK PURGE] runs after installing patch SR341. This patch also reinstalls the protocols included in patch SR341. The install process for SR341 did not properly update HL7 related fields for these protocols in virgin installs. 50 DATE APPLIED: 1998-10-26 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This is Surgery patch SR350, REPORTS BY DIVISION & OTHER FIXES. 84 SEQ #81 DATE APPLIED: 1998-12-14 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Surgery Patch SR384 - XQUIT Processing 81 SEQ #82 DATE APPLIED: 1998-12-29 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Surgery patch SR381 - NSQIP/VHA Directive 98-025 61 SEQ #56 DATE APPLIED: 1997-01-22 00:00:00 APPLIED BY: USER,ONE 85 SEQ #83 DATE APPLIED: 1999-02-23 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch modifies one Surgery routine, SRBLOOD. This routine is used by the Blood Product Verification option [SR BLOOD PRODUCT VERIFICATION]. It is possible, but rare, that this routine could result in a software error when reading the Blood Unit ID. This patch eliminates the potential hole in the logic. 86 SEQ #84 DATE APPLIED: 1999-03-16 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This is Surgery patch SR386. 87 SEQ #85 DATE APPLIED: 1999-03-16 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: The changes included in this patch are described in the description of patch SR387 in the National Patch Module. 89 SEQ #86 DATE APPLIED: 1999-06-22 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch enhances the API written for the Imaging software. It updates the data to use a 4-digit year format when sending the DATE OF OPERATION field (#.09) from the SURGERY file (#130). Changes have also been made to provide the total number of images associated with the surgery case. 91 SEQ #87 DATE APPLIED: 1999-07-19 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Under some circumstances, incorrect nursing personnel were appearing on the Operation Report when using the option Batch Print Transcripted Operation Notes [SRSTRANS PRINT]. The problem occurs when a previous case in the batch has more entries for the fields OR SCRUB SUPPORT (#.112) or OR CIRC SUPPORT (#.111) of the SURGERY file (#130). 90 SEQ #88 DATE APPLIED: 1999-08-03 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. Information from the STROKE/CVA field (#256) of the SURGERY file (#130) $J. 3. The list of station numbers that identify medical centers that perform cardiac surgery is updated in the routine SROAUTLC, replacing 525 (Brockton/West Roxbury) with 523 (Boston). This routine is further modified updating several reads and writes with calls to ^DIR and EN^DDIOL. was not correctly extracted for cardiac risk assessments. This patch corrects the problem. The patch also provides a post-installation routine to retransmit missing information for all surgical cases in which the STROKE/CVA field (#256) was answered "YES". 2. This patch updates the cardiac assessment transmission routines (SROATCM, SROATCM1 and SROATCM2) so that in references to the global ^TMP the first two subscripts are a package namespaced subscript followed by 88 DATE APPLIED: 1999-12-10 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Surgery patch SR388 provides the ability to enter CPT modifiers and provides for displaying these CPT modifiers on screens and reports that display CPT codes within the Surgery package. The patch also includes several software updates related to NSQIP and multi-division facilities. 93 SEQ #90 DATE APPLIED: 2000-04-05 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. The cardiac risk assessment transmission routines SROATCM, SROATCM1 and This patch includes a post-install process that will transmit the added pieces of information for all cardiac assessments that have already transmitted. 2. For cardiac assessments, when using the Resource Data [SROA CARDIAC RESOURCE] option or the Update Assessment Status to 'COMPLETE' [SROA COMPLETE ASSESSMENT] option, if the admission date is later than the discharge date, the following message will be displayed on the screen: SROATCM2 are modified by this patch to do the following: NOTE: Discharge Date precedes Admission Date!! Please check. * Similarly, when using the Cardiac Procedures Requiring CPB (Enter/Edit) [SROA CARDIAC PROCEDURES] option or the Update Assessment Status to 'COMPLETE' [SROA COMPLETE ASSESSMENT] option, if the ischemic time is greater than the CPB (cardiopulmonary bypass) time, the following message will be displayed on the screen: * NOTE: Ischemic Time is greater than CPB Time!! Please check. * These changes require modifications to the routines SROACAR, SROACPM, SROACR1 and SROACOM. 3. The non-cardiac transmission routines SROATM1 and SROATMNO are modified by this patch to add to the transmissions the entry in the INTUBATED ? (Y/N) field (#42) for the principal anesthesia technique defined in the ANESTHESIA TECHNIQUE multiple field (#.37) in SURGERY file (#130). This patch includes a post-install process that will transmit this added piece of information for all FY2000 cases that have already transmitted. a. For both the admission and the discharge movements associated with 4. The routine SRSUP1 is modified to correct the problem described in NOIS DAY-0200-41350. the assessed operation, the entry in the TRANSFER FACILITY field (#.05) in the PATIENT MOVEMENT file (#405) is added to the transmission. b. The patient's address, including street address, city and state, and the patient's phone number are added to the transmission. 92 SEQ #91 DATE APPLIED: 2000-04-05 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. When using the option Print Surgery Waiting List [SRSWL2] to print the 3. The options Operation Requests for a Day [SROP REQ] and Report of Missing Quarterly Report Data [SROQ MISSING DATA] are updated to make the reports print by division. This change requires that the following routines be modified: SROPREQ, SROQN, SROREQ, SROREQ1, SROREQ2, SROREQ3 and SROREQ4. 4. When entering a request for an operation, if the normal request deadline falls on a holiday, the method used by the software to recalculate the deadline to allow for the holiday is problematic. (See NOIS BAY-0100-31625.) This patch modifies the routines SRSCAN2 and SRSREQ. After installing this brief form by tentative date of operation, entering "^" to quit may not work. patch, if the normal request deadline falls on a holiday, the software will use the deadline for the closest valid scheduling date prior to the operation request date. (See NOIS ALB-1199-52220.) This patch modifies the routines SRSWL12 and SRSWL14 to correct the problem. 2. The Monthly Surgical Case Workload Report [SROA MONTHLY WORKLOAD REPORT] option may generate an error if the report is run for a month prior to October 1995. (See NOIS TAM-1299-31004.) The routine SROAWL1 is modified to correct the problem. 94 SEQ #92 DATE APPLIED: 2000-06-26 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. This patch modifies the routine SROASSP adding the call to %ZISC to close 3. The routines SROREST and SROIRR are modified to correct the problem described in NOIS V02-0400-N0176. When using the option Enter Irrigation and Restraints [SROMEN-REST], if the number of active entries in the IRRIGATION file (#133.6) or in the RESTRAINTS AND POSITIONAL AIDS file (#132.05) is greater than 36, items will be displayed on multiple screen pages with no more than 36 items per page. 4. Before installing this patch, if the nurse reviewer used the option Non-Cardiac Assessment Information (Enter/Edit) [SROA ENTER/EDIT] or the option Cardiac Risk Assessment Information (Enter/Edit) [SROA CARDIAC the printer device. This change fixes the problem described by NOIS ENTER/EDIT] to update a risk assessment that was already transmitted, the software required the nurse reviewer to go to the option Update Assessment Completed/Transmitted in Error [SROA TRANSMITTED IN ERROR] to change the assessment status to incomplete before updating was allowed. After installing this patch, if the nurse reviewer attempts to update a risk assessment using the option Non-Cardiac Assessment Information (Enter/Edit) [SROA ENTER/EDIT] or the option Cardiac Risk Assessment Information (Enter/Edit) [SROA CARDIAC ENTER/EDIT], the option will allow the nurse reviewer to change the assessment status to incomplete without having to go to another option first. The routine SROASS is modified to provide this change. TAM-0300-32135 and NOIS ALB-0200-51214. 5. Obsolete code used originally to check for old Surgery Risk Assessment data was removed from the routine SROASS. This code was called by the entry action of 6 options whose entry actions are also updated by this patch. Those 6 options are listed below. Exclusion Criteria (Enter/Edit) [SR NO ASSESSMENT REASON] List of Surgery Risk Assessments [SROA ASSESSMENT LIST] Non-Cardiac Assessment Information (Enter/Edit) [SROA ENTER/EDIT] Print a Surgery Risk Assessment [SROA PRINT ASSESSMENT] Print 30 Day Follow-up Letters [SROA REPRINT LETTERS] Update Assessment Completed/Transmitted in Error [SROA TRANSMITTED IN ERROR] 6. This patch modifies the routines SRODLAY, SRODLA1, SRODLA2, SROREAS, SROREA1, SROREA2, SRODLT, SRODLT0, SROCAN, SROCAN0, SROCRAT, SRORAT1 and SRORAT2 allowing the following report options to print reports for all divisions or for a selected division: Report of Delayed Operations [SRODELA] Report of Delay Reasons [SROREAS] Report of Delay Time [SRO DELAY TIME] 2. The routine SRSDISP is modified to allow the display of the first 8 Report of Cancellations [SROCAN] Report of Cancellation Rates [SROCRAT] 7. This patch updates the data dictionary for the following fields in SURGERY file (#130) to require the inclusion of at least one space in every 31 characters of input. See NOIS HVH-0500-10303. OTHER PREOP DIAGNOSIS multiple field (#.72, sub-file #130.17) OTHER PREOP DIAGNOSIS field (#.01) OTHER POSTOP DIAGS multiple field (#.74, sub-file #130.18) characters of the name of the operating room on the operating room OTHER POSTOP DIAGS field (#.01) PRINCIPAL PRE-OP DIAGNOSIS field (#32) PRINCIPAL DIAGNOSIS field (#33) PRINCIPAL POST-OP DIAGNOSIS field (#34) availability display graph. This change is made in response to NOIS GNH-0300-42659 48 DATE APPLIED: 1997-01-22 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch installs the SURGERY DISPOSITION file (#131.6), converts the three disposition fields to point to this file and updates reports that access disposition data. 95 SEQ #93 DATE APPLIED: 2000-11-06 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch provides enhancements in support of the Continuous Improvement in Cardiac Surgery Program Expansion (CICSP-X). See Patch SR395 in the National Patch Module for description of the Build. 97 SEQ #94 DATE APPLIED: 2001-02-02 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: See Patch SR397 in the National Patch Module for description of the Build. 98 SEQ #95 DATE APPLIED: 2001-02-28 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: See patch SR398 in the National Patch Module for description of this build. 99 SEQ #96 DATE APPLIED: 2001-03-26 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. The input screen of the Cardiac Procedures Requiring CPB (Enter/Edit) expands to "RI-Remains in ICU at 30 days" when entered for D/T PATIENT EXTUBATED field (#470) in the SURGERY file (#130). Actually, it should expand to "RI-Remains intubated at 30 days". This patch fixes this problem. [SROA CARDIAC PROCEDURES] option, for the BATISTA PROCEDURE USED field (#439) the screen displays what is in the MISC. CARDIAC PROCEDURES field (#375) of the SURGERY file (#130). This patch fixes this problem. 2. The cardiac assessment transmission is modified to include the patient's date of birth. 3. On the Resource Data [SROA CARDIAC RESOURCE] option, the code "RI" 101 SEQ #97 DATE APPLIED: 2001-04-30 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. On the Print a Surgery Risk Assessment [SROA PRINT ASSESSMENT] option, this patch rewords the message to read "Today's date exceeds the blood product expiration date.". the code "RI" expands to "RI-Remains in ICU at 30 days" when entered for D/T PATIENT EXTUBATED field (#470) in the SURGERY file (#130). Actually, it should expand to "RI-Remains intubated at 30 days". This patch fixes this problem. 2. On the Blood Product Verification [SR BLOOD PRODUCT VERIFICATION] option, if the blood unit is expired the system displays the worning message "Blood Product Expiration Date is later than today's date.", 102 SEQ #98 DATE APPLIED: 2001-05-15 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. This patch modifies the RISK ASSESSMENT IN USE (Y/N) field (#15) in the controls access based upon the sites default institution station number. 2. This patch fixes the problem reported in NOIS SDC-0301-62902 to prevent the undefined variable error that may occur when completing a non-cardiac risk assessment. SURGERY SITE PARAMETERS file (#133), changing the name of the field to CARDIAC RISK ASSESSMENT IN USE(Y/N). After installing this patch, the entry action on the Cardiac Risk Assessment Information (Enter/Edit) [SROA CARDIAC ENTER/EDIT] menu will check this parameter field to determine if menu access is allowed. This parameter may be edited using the Surgery Site Parameters (Enter/Edit) [SROPARAM] option on the Surgery Package Management Menu [SRO PACKAGE MANAGEMENT]. This change enables local control of menu access and replaces the current function that 103 SEQ #99 DATE APPLIED: 2001-08-02 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. As reported in NOIS DUR-0501-32617, the value in the DATE/TIME OR 2. NOIS CPH-0601-41315 reported that the Surgery Quarterly Report is continuing to use inactive CPT codes in the Index Procedures section of the report. This patch modifies the routine SROQ0A, replacing the 3 inactive CPT codes (56340, 56341 and 56342) with the 3 replacement codes (47562, 47563 and 47564). The post-install process will task the Quarterly Reports for the past reporting periods of FY 2001 to transmit again. REQUEST MADE field (#1.098) in SURGERY file (#130) occasionally includes trailing zeros that cause the exclusion of such values when sorting by a date range. This patch modifies the routines SRSCAN0, SRSCAN2, SRSCHUN, SRSDT and SRSRQST so that trailing zeros will be removed before the value is stored. A post-install process will loop through SURGERY file (#130) and remove any trailing zeros in the DATE/TIME OR REQUEST MADE field (#1.098). 96 SEQ #100 DATE APPLIED: 2001-08-15 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. This patch modifies routine SROPRPT, adding the call to HOME^%ZIS to fix the error "DEVICE OR FILE NOT OPEN" that occurs occasionally due to the printer device not being closed prior to running the Operation Report [SROSRPT] option. 2. This patch fixes the problem reported in NOIS PUG-0701-50135, of an extrinsic function call in routine SROAUTLC which quits without a value. 104 SEQ #101 DATE APPLIED: 2001-11-06 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. This patch fixes the Undefined Error reported on NOIS LAH-0901-60445. The error is generated as a result of not killing variable DR before calling Surgery screen server routine SRCUSS. 2. When using the Delete Service Blockout [SRSBDEL] option at a multi-division facility, it was reported that this option displays all operations, where as it should display only those operations for the selected division. This patch fixes this problem. 105 SEQ #102 DATE APPLIED: 2002-01-02 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. This patch corrects the problem described in NOIS UNY-1101-11002 and NOIS This patch adds the following new fields to store responses to the MST and HNC classification questions that will be passed to PCE with the other surgical encounter information: - File: SURGERY (#130) Field: MILITARY SEXUAL TRAUMA (#.022) SET Description: This field will be used to indicate if this surgery or non-OR procedure is treating a VA patient for a problem that is related to Military Sexual Trauma. This information may be passed to the VISIT file (#9000010) for use by PCE. HAM-1101-21180. Field: HEAD AND/OR NECK CANCER (#.023) SET Description: This field will be used to indicate if this surgery or non-OR procedure is treating a VA patient for a problem that is related to Head and/or Neck Cancer. This information may be passed to the VISIT file (#9000010) for use by PCE. - File: SURGERY WAITING LIST (#133.8) Field: PATIENT (#1) (Multiple, sub-file #133.801) Sub-Field: MILITARY SEXUAL TRAUMA (#21) SET Description: This field will be used to indicate if this surgery is treating a VA patient for a problem related to military sexual trauma. This information may be passed to the VISIT file (#9000010) to be used by PCE. Sub-Field: HEAD AND/OR NECK CANCER (#22) SET Description: This field will be used to indicate if this surgery is treating a VA patient for a problem related to Head and/or Neck Cancer. This information may be passed to the VISIT file (#9000010) to be used by PCE. 2. This patch modifies the Surgery software to include the Military Sexual Trauma (MST) classification question and the Head and/or Neck Cancer (HNC) classification question on the list of potential classification questions that must be answered on ambulatory surgeries that are passed to PCE if the Surgery interface to PCE is turned on and the ASK CLASSIFICATION QUESTIONS field (#19) in SURGERY SITE PARAMETERS file (#133) is set to YES. 62 SEQ #58 DATE APPLIED: 1997-03-26 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Surgery Patch SR362. 106 SEQ #103 DATE APPLIED: 2002-03-15 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. It was reported that, when using the Report of Unscheduled Admissions characters, but no spaces in the next 80 or more characters after the last space, the software would loop, causing the job to hang. This patch fixes this problem. to ICU [SROICU] option, if the site is a multi-division facility, this report populates the data from all the divisions. This patch modifies the routines SROICU, SROICU1, and SROICU2 to enhance printing of this report to be a division specific. 2. When using the Nurse Intraoperative Reprot [SRONRPT] option, there is a problem which causes the job to hang. If the NURSING CARE COMMENTS field (#.29) of the SURGERY file (#130) contains spaces in the first 78 108 SEQ #104 DATE APPLIED: 2002-10-08 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. The calls to the Imaging (MAG) V 1.0 package software that are in the patch fixes this problem. 3. It was observed that when editing any multiple fields via the Surgery Screen Server Utility it's currently not allow editing of any multiple fields if those fields have only the top level field (.01) in the Input Template. This patch will ensure that such fields are editable. Surgery routines were added to those routines by patch SR366 to facilitate the use of the Imaging software. These calls are obsolete, any reference to those calls will cause the software to generate an error. This patch removes all of these references. 2. It was reported that the REQ FROZ SECT field (#1.02) in the SURGERY file (#130) is not printed when generating the Operating Room Schedule report using the Schedule of Operations [SROSCH] option. This 110 SEQ #105 DATE APPLIED: 2002-10-25 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch exports a new "AOE" cross-reference to the TIME PAT OUT OR field (#.232) in the SURGERY file (#130). The new cross-reference will allow the Computerized Patient Record System (CPRS) to automatically discontinue or release orders when patient leaves the Operating Room. 109 SEQ #106 DATE APPLIED: 2002-12-09 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: In preparation for the VistA Blood Establishment Computer Software post-install routine. A mail message will be sent to the person who started the installation to let them know the conversion is complete and any problems that were encountered. The subject of the message will be: SURGERY POINTER CONVERSION COMPLETED. Please note: if problems were encountered, the message will contain information on correcting the problems and re-running the conversion. However, it is not required to do this. Just be aware that these entries will now simply display as a number. (VBECS), changes are necessary in the Surgery V. 3.0 package. Any reference to the blood bank information needs to be modified to prepare for the VBECS release. This patch makes these modifications. As a part of these changes, it is necessary to convert the existing data. Pointers from the SURGERY SITE PARAMETERS file (#133) and the SURGERY file (#130) that reference the BLOOD PRODUCT file (#66) will be changed to actually contain the name of the product. This process will run as a 111 SEQ #107 DATE APPLIED: 2003-01-09 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch contains modifications to the Surgery package to include new Ethnicity and multiple Races display on the report. These fields are not editable through the Surgery package options. 3. Print a Surgery Risk Assessment [SROA PRINT ASSESSMENT]. Ethnicity and multiple races appear on the report. 4. Queue Assessment Transmissions [SROA TRANSMIT ASSESSMENTS]. a. Non-Cardiac Risk Assessment transmission. Old Race information is retained on node 7. New Ethnicity and multiple Races are transmitted on node 13. Ethnicity and multiple Race fields in four Surgery options as listed b. Cardiac Risk Assessment transmission. Old Race information is retained on node 24. New Ethnicity and multiple Races are transmitted on node 6. below. The new fields comply with the new Race and Ethnicity Standards as set forth by the Office of Management and Budget. 1. Tissue Examination Report [SROTRPT]. Ethnicity and multiple Races appear in the report footer. 2. Non-Cardiac Assessment Information (Enter/Edit) [SROA ENTER/EDIT]. 107 SEQ #108 DATE APPLIED: 2003-03-01 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This is an enhancement patch to the Surgery V. 3.0 software. It will 1. The new SPD COMMENTS field (#80) of the SURGERY file (#130) is added to the following options: - Make Operation Requests [SROOPREQ] - Delete or Update Operation Requests [SRSUPRQ] - Make a Request from the Waiting List [SRSWREQ] - Make a Request for Concurrent Cases [SRSREQCC] - Schedule Unrequested Operations [SROSRES] - Schedule Unrequested Concurrent Cases [SRSCHDC] replace the existing Surgery interface with the Integrated Funds - Reschedule or Update a Scheduled Operation [SRSCHUP] 2. The new AUTOMATED CASE CART ORDERING field (#37) will be added to the SURGERY SITE PARAMETERS file (#133) input template SRPARAM so that this field may be edited using the Surgery Site Parameters (Enter/Edit) [SROPARAM] option. This field will be checked to determine if the CoreFLS interface for Surgery is in use at the facility before sending the Surgery data to the CoreFLS package. 3. This patch modifies all options used to create or schedule a Surgery Distribution, Control Point Activity, Accounting, and Procurement (IFCAP) case so that information can be provided to SPD for the creation of Surgery case carts. 4. This patch modifies the Surgery software to send updates to SPD whenever any of the information provided on the messages has been modified using any data entry option. 5. This patch enhances the following options to initiate HL7 update messages if the Surgery Health Level 7 (HL7) interface is in use at the facility for the following options: with a new interface to the Core Financial and Logistics System (CoreFLS). - Enter PAC(U) Information [SROMEN-PACU] - Patient Demographics (Enter/Edit) [SROA DEMOGRAPHICS] - Operative Risk Summary Data (Enter/Edit) [SROA CARDIAC OPERATIVE RISK] - Exclusion Criteria (Enter/Edit) [SR NO ASSESSMENT REASON] - Update 1-Liner Case [SROA ONE-LINER UPDATE] Functionally, the new interface expands the features provided in the existing interface. The interface will provide Surgery case information to Supply Processing and Distribution (SPD) so that the specific Surgery case carts needed for the case can be created. The modifications include the following items: 113 SEQ #109 DATE APPLIED: 2003-03-29 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch provides the ability to display a new confidential communication address when using the Print 30 Day Follow-up Letters [SROA REPRINT LETTERS] option within VISTA Surgery if the Confidential Communication Types contain "All Others". 115 SEQ #110 DATE APPLIED: 2003-04-17 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch is created in support of directive 2002-070, ENSURING CORRECT SURGERY. The patch adds two new fields in the SURGERY file (#130). They are needed to document that the operating room team performed a "time out" to ensure that the correct surgery is being done. The new fields are: 1. TIME OUT VERIFIED (#71) 2. IMAGING CONFIRMED (#72) 112 SEQ #111 DATE APPLIED: 2003-05-20 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. This patch fixes the "NULLSUBSCR" error generated when using the PRINT 2. This patch adds the description to the Data Dictionary of the DEFAULT BLOOD COMPONENT field (#41) in the SURGERY SITE PARAMETERS file (#133). 3. When updating a Risk Assessment Status to "COMPLETE", the software checks for missing information and provides the ability to update it. This option was overlooked when doing the Race & Ethnicity changes (patch SR3111). This patch removes the current checking for the RACE field (#417) in the SURGERY file (#130). FILE ENTRIES FileMan option to print one or more of the following 4. When using the Print a Surgery Risk Assessment [SROA PRINT ASSESSMENT] option, there is a possibility of getting an undefined error if the length of the race data is found to be more than forty characters. This patch fixes this problem. fields in the SURGERY file (#130) if these fields contain no data: - OTHER RESPIRATORY OCCURRENCE field (#253) - OTHER URINARY TRACT OCCURRENCE field (#286) - OTHER CNS OCCURRENCE field (#343) - OTHER CARDIAC OCCURRENCE field (#344) 114 SEQ #112 DATE APPLIED: 2003-09-12 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. Surgery is using the Flag Drugs for Use as Anesthesia Agents [SROCODE] If the user quits using the up-arrow ("^"), the software does not respond correctly and subsequently errors out. This patch fixes this problem. 3. It was reported that if the Surgery case was in a requested state and if an entry is made in the TIME PAT IN OR field (#.205) of the SURGERY file (#130), it is found that the time gets appended to the DATE OF OPERATION field (#.09) of the SURGERY file (#130). This is causing the time to appear in the scheduling grid and prevents the case scheduling. This entry should be made only if the case is in a option to flag drugs in the DRUG file (#50) for use as anesthesia scheduled state or entered via the Operation Menu [SROPER] option. This patch provides the user the option to delete any of the following entered date fields as a pre-condition for scheduling such cases: - ANES CARE START TIME field (#.21), TIME OPERATION BEGAN field (#.22), TIME OPERATION ENDS field (#.23), ANES CARE END TIME field (#.24), TIME PAT IN OR field (#.205), and TIME PAT OUT OR field (#.232) This functionality is added to the following options: agents. This patch modifies this option to call Pharmacy Data - Delete or Update Operation Requests [SRSUPRQ] option - Schedule Requested Operations [SRSCHD1] option - Reschedule or Update a Scheduled Operation [SRSCHUP] option Management V. 1.0 (PDM) package so that PDM possibly generates an HL7 outgoing drug message. 2. When canceling a concurrent case using the Cancel Scheduled Operation [SRSCAN] option, the software prompts, "There is a concurrent case associated with this operation. Do you want to cancel it also? YES//". 63 SEQ #59 DATE APPLIED: 1997-04-14 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Surgery patch SR363, Fixes and Enhancements. 120 SEQ #113 DATE APPLIED: 2003-09-24 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: As a follow-up enhancement to Surgery patch SR3115, this patch adds a CONFIRMED field (#72). A surgical case is counted as compliant with the documentation process for ensuring correct surgery if the TIME OUT VERIFIED field (#71) is YES and if the IMAGING CONFIRMED field (#72) is either YES or NOT APPLICABLE. This report includes two parts, either of which may be printed separately or combined: 1. Compliance Summary - This part shows the number of cases with each of the possible data scenarios for the two fields in question and their percentage of the total cases performed. new report option to assist in reviewing compliance with the process 2. List of Non-Compliant Cases - This part provides a list of surgical cases that are not compliant (as defined above). defined by directive 2002-070, ENSURING CORRECT SURGERY. Ensuring Correct Surgery Compliance Report [SRO ECS COMPLIANCE] option is added to the Management Reports [SRO-CHIEF REPORTS] menu on the Chief of Surgery Menu [SROCHIEF] option. This report checks the two fields added to SURGERY file (#130) by Surgery patch SR3115, the TIME OUT VERIFIED field (#71) and the IMAGING 116 DATE APPLIED: 2003-09-24 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Please see the National Patch Module for details of the enhancements included in this patch. 123 SEQ #115 DATE APPLIED: 2003-10-02 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: As a follow-up enhancement to Surgery patch SR3115 (released April 8, after November 13, 2003, the Quarterly Report for the fourth quarter of Fiscal Year 2003 will also be automatically transmitted by a post-install process. 2003), this patch updates the Quarterly Report by adding the Compliance Summary portion of the Ensuring Correct Surgery Compliance Report (made available by patch SR3120) to the end of the existing Quarterly Report. This additional information will be transmitted as part of the Quarterly Report that goes to Surgical Service, Central Office. A post-install process will automatically transmit the Quarterly Report for the third quarter of Fiscal Year 2003. If this patch is installed 121 SEQ #116 DATE APPLIED: 2003-10-23 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This is an enhancement patch to the Surgery V. 3.0 software. It will - Print a Surgery Risk Assessment [SROA PRINT ASSESSMENT] - Update Assessment Completed/Transmitted in Error [SROA TRANSMITTED IN ERROR] - Print 30 Day Follow-up Letters [SROA REPRINT LETTERS] - Exclusion Criteria (Enter/Edit) [SR NO ASSESSMENT REASON] - Update 1-Liner Case [SROA ONE-LINER UPDATE] allow assessment lookups by assessment (case) number, in addition to the lookups by patient. The following options under the Surgery Risk Assessment Menu [SROA RISK ASSESSMENT] option has this functionality incorporated: - Non-Cardiac Assessment Information (Enter/Edit) [SROA ENTER/EDIT] - Cardiac Risk Assessment Information (Enter/Edit) [SROA CARDIAC ENTER/EDIT] 118 SEQ #117 DATE APPLIED: 2003-11-07 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch corrects two problems. It corrects the problem in the display when entering "Other Procedures" in the Operation [SROMEN-OP] Option. The display is limited to 15 entries, and sometimes more than 15 "Other Procedures" entries are needed. The patch also corrects a problem that occurs when printing the PCE Filing Status report. Long names should list the initial for the patient's first name. Currently, the report drops the first name completely. 124 SEQ #118 DATE APPLIED: 2003-11-07 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch corrects the null subscript error in SROPRPT routine. 122 SEQ #119 DATE APPLIED: 2004-03-30 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch updates the PROTOCOL file(#101) and HL LOGICAL LINK file(#870) for the Surgery interface. HL LOGICAL LINK file(#870) does not contain any site specific data. 126 SEQ #120 DATE APPLIED: 2004-03-30 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch is an enhancement to the Surgery software providing additional type field. This patch modifies the following four existing fields in the SURGERY file (#130): - A minor change is made to the description of the "NO" choice in the TIME OUT VERIFIED field (#71). - The PREOPERATIVE IMAGING CONFIRMED field (#72) will have three choices: "Y, YES", "I, IMAGING NOT REQUIRED FOR THIS PROCEDURE" and "N, NO - IMAGING REQUIRED BUT NOT VIEWED (see CORRECT SURGERY changes related to Ensuring Correct Surgery. This patch is Phase I of the COMMENTS)" - The description of the different choices of the ATTENDING CODE field (#.165) is modified. - The maximum number of years of surgical residency (post graduate) of the PGY OF PRIMARY SURGEON field (#214) is changed from 10 to 12. This patch also exports the following new date/time fields that will be used to time-stamp when the three correct Surgery fields (TIME OUT enhancement. VERIFIED (#71), PREOPERATIVE IMAGING CONFIRMED (#72), and MARKED SITE CONFIRMED (#73)) of the SURGERY file (#130) are entered or edited, and they are not editable fields: - TOV TIMESTAMP field (#75) - IMAG TIMESTAMP field (#76) - SITE MARK TIMESTAMP field (#77) These fields MARKED SITE CONFIRMED (#73), PREOPERATIVE IMAGING CONFIRMED (#72), and CORRECT SURGERY COMMENTS (#74) are found under the following menu options: - Operation [SROMEN-OP] option - Operation (Short Screen) [SROMEN-OUT] option - Operation Startup [SROMEN-START] option This patch will disable the Ensuring Correct Surgery Compliance Report [SRO ECS COMPLIANCE] option. Also, the compliance section of the Quarterly Report - Surgical Service [SRO QUARTERLY REPORT] option will be disabled until Correct Surgery Enhancements 2004 Phase II is released, targeted date is June 2004. This patch exports the following new fields in the SURGERY file (#130): - The MARKED SITE CONFIRMED field (#73) will have three choices: "Y, YES", "M, MARKING NOT REQUIRED FOR THIS PROCEDURE" and "N, NO - MARKING REQUIRED BUT NOT DONE (see CORRECT SURGERY COMMENTS)". - The CORRECT SURGERY COMMENTS field (#74) which is a word processing 100 DATE APPLIED: 2004-04-27 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch provides the ability to electronically sign operative reports Features provided by this patch are described in the Surgery Electronic Signature for Operative Reports Release Notes and in the Surgery Electronic Signature for Operative Reports Implementation Guide. contained within the VISTA Surgery V. 3.0 application. These reports include the Operation Report, the Nurse Intraoperative Report, the Anesthesia Report and the Procedure Report (Non-O.R.). This patch provides the ability to view these signed reports through the Computerized Patient Record System (CPRS) by storing them in the Text Integration Utilities (TIU) V. 1.0 application. Tools provided by the TIU software will be used to sign and manage the electronic documents. 128 SEQ #122 DATE APPLIED: 2004-05-07 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch addresses follow-up issues related to the Surgery Electronic DRAFT COPY - DRAFT COPY -- ABOVE NOTE IS UNSIGNED-- DRAFT COPY - DRAFT COPY This patch modifies the routine SROESPR1 to prevent the display of this line if the document has a status of COMPLETED. See NOIS FAR-0104-40622. 2. The input template SROARPT is used by the Anesthesia Report [SROARPT] option to edit fields that are part of the Anesthesia Report. This patch modifies this input template to remove the INTRAOPERATIVE OCCURRENCES field (#1.14) and the POSTOP OCCURRENCE field (#1.16) since Signature for Operative Reports patch (SR3100). these two fields do not appear on the Anesthesia Report. 1. Converted documents for historical surgical/non-OR cases are stored in the TIU DOCUMENT file (#8925) with a status of COMPLETED, but they have no signature date. Therefore, when one of these converted documents is printed, the following line is printed at the end of the document text: 64 SEQ #60 DATE APPLIED: 1997-04-14 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: The information contained in this KIDS Build relates to the Surgery patch SR364. 129 SEQ #123 DATE APPLIED: 2004-09-03 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: ***************************** N O T E ******************************** procedures. This patch implements the new levels of resident comment field. At the end of the conversion process, this patch will delete the data dictionary of the CORRECT SURGERY COMMENTS field (#74) in the SURGERY file (#130), which was exported in phase I of the Ensuring Correct Surgery patch SR3.0126. 3. SURGEON PRESENT TIME ON NURSE INTRAOPERATIVE REPORT Patch SR325 modified the Nurse Intraoperative Report so that it displayed the SURG PRESENT TIME field (#.206) only if data was entered. This functionality, omitted unintentionally by patch SR3100, is supervision in the Surgery software and includes the following restored by this patch. 4. DOCUMENTS PRINTED FROM TIU This patch modifies the routine SROESPR to correct a possible problem if no print group is defined when a document is printed. features: (a) A new file, ATTENDING CODES file (#132.9), is created to store all attending codes used by the Surgery software. These codes include both sets of Levels 0 to 3 (before and after patch SR3126, all flagged as inactive codes) and the latest codes for Levels A to F (active codes). There is no conflict between this patch and the CoreFLS software. (b) The name of the existing ATTENDING CODE field (#.165) in the SURGERY file (#130) is changed to ATTENDING CODE - NOT USED and a new ATTENDING CODE field (#.166) is created that points to the ATTENDING CODES file (#132.9). (c) The patch includes a post-install conversion that loops through all the cases in the SURGERY file (#130) and matches the attending code in the old field (#.165) with the equivalent code in the new ATTENDING CODE field (#.166), storing the equivalent code in the new field. The content of the old field is not changed by the conversion. Installation of this patch by the CoreFLS sites will not cause any (d) The following data entry options are updated to use the new ATTENDING CODE field (#.166): - Post Operation [SROMEN-POST] - Operation (Short Screen) [SROMEN-OUT] - Surgical Staff [SROMEN-STAFF] - Edit Non-O.R. Procedure [SRONOP-EDIT] - Update 1-Liner Case [SROA ONE-LINER UPDATE] (e) The following report and display options are updated to use the new problems. ATTENDING CODE field (#.166): - Attending Surgeon Reports [SROATT] - View Patient Perioperative Occurrences [SROMEN-M&M] - Operation Information [SROMEN-OPINFO] - Quarterly Report - Surgical Service [SRO QUARTERLY REPORT] Note: The Perioperative Occurrence Categories on this report are updated to reflect the categories used by the National Surgical Quality Improvement Program (NSQIP) and the Continuous Improvement in Cardiac Surgery Program (CICSP). Some of these categories may not be immediately available for selection, but will be included ************************************************************************* later in the NSQIP/CICSP ENHANCEMENTS 2004 patch (SR3125). - List of Operations Included on Quarterly Report [SROQ LIST OPS] - Report of Missing Quarterly Report Data [SROQ MISSING DATA] (f) The patch updates the transmission of Quarterly Report data to the national database to use the new ATTENDING CODE field (#.166). 2. ENSURING CORRECT SURGERY PHASE II Phase II of the Ensuring Correct Surgery Enhancement Project provides the following enhancements: (a) The following new fields are added to the SURGERY file (#130): - TIME OUT VERIFIED COMMENTS field (#82) - IMAGING CONFIRMED COMMENTS field (#83) - MARKED SITE COMMENTS field (#84) These fields are added to capture the comments corresponding to the following: - TIME OUT VERIFIED field (#71) - PREOPERATIVE IMAGING CONFIRMED field (#72) 1. RESIDENT SUPERVISION - MARKED SITE CONFIRMED field (#73) (b) The following data entry options will be modified to include the new comment fields noted in item (a): - Operation [SROMEN-OP] - Operation (Short Screen) [SROMEN-OUT] - Nurse Intraoperative Report [SRONRPT] Entry of "NO" in any of the three Correct Surgery fields will prompt the user to enter the associated comment field. Entry of "NO" in The Veterans Health Administration (VHA) Handbook 1400.1, dated May 3, any of the three Correct Surgery fields will not automatically force entry into the respective comment field. (c) Nurse Intraoperative Report Changes If any of the three Correct Surgery fields are not answered, the nurse will not be able to electronically sign the Nurse Intraoperative Report. If any of the three Correct Surgery fields is answered "NO" but does not have information in the corresponding comments field, the nurse will not be able to electronically sign the Nurse Intraoperative Report. The nurse will be able to update this 2004, changed the levels of resident supervision for operating room information at time of signature without leaving the option. (d) The compliance reports, which were disabled in phase I are reactivated and are modified to display the new formats for the three Correct Surgery fields. (e) Convert Existing Comments For each of the three Correct Surgery fields answered with a "NO" response, the information in the CORRECT SURGERY COMMENTS field (#27) of the SURGERY file (#130) will be replicated in the corresponding 132 SEQ #124 DATE APPLIED: 2004-09-03 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: ***************************** N O T E ******************************* dictated summary, if present. After patch SR3100, the Procedure Report (Non-OR) includes only the provider's dictated summary since only the provider's dictated summary is electronically signed. The only way to review the information entered into the data fields documenting the procedure in the SURGERY file (#130) is by way of the data entry options on the Non-O.R. Procedures (Enter/Edit) [SRONOP-ENTER] menu. This patch adds the Non-OR Procedure Information [SR NON-OR INFO] option, to the Non-O.R. Procedures (Enter/Edit) [SRONOP-ENTER] menu and to the CPT/ICD9 Update/Verify Menu [SRCODING UPDATE/VERIFY MENU]. This option There is no conflict between this patch and the CoreFLS software. will display the "op-top" information that formerly was part of the Procedure Report (Non-OR). The output from this option may be viewed on the user's screen or may be printed. A future enhancement is planned that will incorporate the "op-top" information into an electronically signed document and thus be viewable in the Computerized Patient Record System (CPRS). At this time, the details of this enhancement and schedule for release are not known. Installation of this patch by the CoreFLS sites will not cause any problems. ************************************************************************* Prior to patch SR3100, the Procedure Report (Non-OR) included an "op-top" section that included many of the data fields documenting the procedure in the SURGERY file (#130) in addition to the provider's 125 DATE APPLIED: 2004-09-03 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: ***************************** N O T E ******************************** VA's NSQIP module more in line with the data collected in the private sector. This patch also include updates to the Continuous Improvement in Cardiac Surgery Program (CICSP) module. Modifications to the Surgery V. 3.0 software include: - the addition of 22 new fields to SURGERY file (#130) - the update of approximately 120 field descriptions for NSQIP and CICSP data elements in the SURGERY file (#130) - the update of data input screens to allow the input of additional data elements as well as to delete some data elements no longer There is no conflict between this patch and the CoreFLS software. needed - the addition of two new data input options, Laboratory Test Results (Enter/Edit) [SROA LAB-CARDIAC] and Outcome Information (Enter/Edit) [SROA CARDIAC-OUTCOMES], on the Cardiac Risk Assessment Information (Enter/Edit) [SROA CARDIAC ENTER/EDIT] menu - the removal of the option Update Operations as Unrelated/Related to Death [SRO DEATH RELATED] from Surgery Risk Assessment Menu [SROA RISK ASSESSMENT] - the update of assessment transmissions to reflect the current set of NSQIP and CICSP data elements Installation of this patch by the CoreFLS sites will not cause any - the update of occurrence categories in the PERIOPERATIVE OCCURRENCE CATEGORY file (#136.5) 2. This patch will enhance the lookup by case/assessment number feature introduced in patch SR3121. Within the Surgery Risk Assessment Menu [SROA RISK ASSESSMENT] option, at the "Select Patient" prompt, lookup by case/assessment number is allowed by entering the case number preceded by #, e.g., enter #6785 to go to case #6785. problems. ************************************************************************** 1. This patch updates the Surgery Risk Assessment software of the VISTA Surgery V. 3.0 application as requested by the National Surgical Quality Improvement Program (NSQIP) Executive Committee to bring the 135 SEQ #126 DATE APPLIED: 2004-10-15 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. NON-CARDIAC PREOP INFORMATION SCREEN, PAGE 1 in the SURGERY file (#130), the word aneurysectomy is changed to aneurysmectomy. 3. REPEAT VENTILATOR W/IN 30 DAYS This patch modifies the cardiac assessment creation process to set the default value of the REPEAT VENTILATOR W/IN 30 DAYS field (#490) in the SURGERY file (#130) to NO if null. 4. CPB STATUS This patch updates how the cardiopulmonary bypass status associated When editing all the GENERAL items on the first page of the with a repeat cardiac surgical procedure outcome is updated and transmitted for cardiac assessments. Preoperative Information (Enter/Edit) [SROA PREOP DATA] option, the last two items are not presented for editing in the same order they appear on the main screen. This patch changes the order of presentation for editing to match the order on the main screen. 2. SPELLING CORRECTION In the field description of the PREVIOUS CARDIAC SURGERY field (#266) 127 SEQ #127 DATE APPLIED: 2004-10-15 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Office of Information Assurance, Office of Information, Veterans Health time service was provided. Four code sets, (ICD-9-CM, CPT, CPT modifiers, DRG) for this project were modified as required under HIPAA legislation to be date-sensitive under the first phase of the project. At the time that CSV was developed, a request was made to defer applicable text versioning to the next iteration. This deferment of the short and long-text versions from the CSV project makes up the scope of this Code Text Descriptor (CTD) project. This follow-up project, CTD, intends to add the functionality of date-sensitive versioning for all applicable code text descriptors for the four code sets, effective Administration (VHA), requested modifications to the VHA Information with all textual changes occurring since October 1, 2002. This patch addresses the changes done within the Surgery V. 3.0 software in compliance with the CTD project. The only noticeable difference users may see will occur when a specific CPT, CPT modifier or ICD9 code descriptor changes base on the date of operation for the case. Systems and Technical Architecture (VistA) Patient Information Management System (PIMS) package that would allow for the use of multiple versions of the code sets employed in financial transactions. This work was completed in 2003 in the Code Set Versioning (CSV) project that was deployed in October of 2003. CSV included the Health Information Portability and Accessibility Act (HIPAA) stipulation that diagnosis and procedure codes used for billing purposes must be the codes that were applicable at the 130 SEQ #128 DATE APPLIED: 2004-10-15 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: THIS PATCH WILL ALLOW SURGERY USERS TO ENTER MORE THEN 15 LINE ITEMS FOR ALL MULTIPLE FIELDS. 136 SEQ #129 DATE APPLIED: 2004-11-11 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch prevents the infinite loop condition described in NOIS ISW-0904-20140 when the Imaging software attempts to display an Operation Report that is not complete. 138 SEQ #130 DATE APPLIED: 2004-11-11 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch corrects the problem reported in NOIS WRJ-1004-10891 in which ORGAN/SPACE SSI occurrence categories were not appearing on the non-cardiac assessment printout. 131 SEQ #132 DATE APPLIED: 2004-12-28 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch will clean up old variables after the call to EN^DIQ1. It will also replace the Anesthesia Agent Dose that was removed during the install of SR3100. 134 SEQ #133 DATE APPLIED: 2004-12-28 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. LOCKING OF SURGICAL CASES FOR EDITING signed while the case or a concurrent case is open for editing. If a case is locked and another user attempts to open the same case for editing, a message will appear on the screen indicating the name of the user that has the case locked. Likewise, if a user attempts to sign the Nurse Intraoperative Report or the Anesthesia Report while the case is open for editing, a message will appear on the screen indicating the name of the user that has the case open for editing. 2. ALLOW CHART PRINT OUTSIDE MAS This patch modifies the software responsible for printing Patch SR3100 introduced locking of a surgical case when a user opens electronically signed surgery reports to honor the ALLOW CHART PRINT OUTSIDE MAS parameter defined in the TIU DOCUMENT PARAMETERS file (#8925.95). If this parameter is set to YES or is null, users will be allowed to choose between printing a work copy or a chart copy. If this parameter is set to NO, only users in MAS will be allowed to print a chart copy and all other users will be allowed to print a work copy only. 3. QUARTERLY REPORT ARRAY CLEANUP This patch updates the software that generates the Surgery Quarterly the case for editing, allowing only one user at a time to edit the same Report to kill a variable array that may cause problems when the Surgery Quarterly Report is transmitted from multidivisional facilities. 4. DATE/TIME OUTPUT TRANSFORM CORRECTION This patch corrects the output transform used to display the external format of several date/time fields modified by patch SR3125. Also, an update is made to the way admission, transfer and discharge date/times are retrieved and stored for Surgery Risk Assessment. case. This patch alters how surgical cases are locked and allows 5. DOCUMENTATION ERROR CORRECTION The patch SR3100 documentation problem described in NOIS PUG-0604-51225 is corrected in documentation distributed with this patch. 6. FIELD DESCRIPTION UPDATE In the SURGERY file (#130), the CONGESTIVE HEART FAILURE field (#207) field description is updated with the 2004 definition. 7. PATIENT NAME/ID ON CARDIAC ASSESSMENT PRINTOUT multiple users to open the same case for editing up until the time that This patch corrects a problem with the cardiac assessment printout in which the patient ID is truncated if the patient's name is more than 16 characters in length. 8. NOIS SHR-0904-71756 This patch corrects the problem described in NOIS SHR-0904-71756 so that the printer is closed after printing the assessment upon assessment completion. 9. CARDIAC TRANSMISSION UPDATE either the Nurse Intraoperative Report or the Anesthesia Report is The cardiac assessment transmission is modified by this patch to update the formatting of the date of death, if present. 10. NOIS SBY-0904-31547 Application of this patch prevents the problem described in NOIS SBY-0904-31547. 11. ATTENDING REQUIRED BEFORE COMPLETING CASE To prevent possible cosigner problems with the Operation Report and the Procedure Report (Non-OR), this patch will require the attending signed. When a user enters the function to sign either report and after surgeon/provider to be entered before the case can be completed. When a user enters the TIME PAT OUT OR field (#.232) in the SURGERY file (#130), to complete a surgical case, if the ATTEND SURGEON field (#.164) is blank, the software will prompt the user to enter the attending surgeon. For non-OR procedures, when a user enters the TIME PROCEDURE ENDED field (#122), if the ATTEND PROVIDER field (#124) is blank, the software will prompt the user to enter the attending provider. either report is signed, the software will again allow only one user at If the SURGICAL RESIDENTS (Y/N) field (#33) in the SURGERY SITE PARAMETERS file (#133) is set to NO, when a surgeon is entered in the SURGEON field (#.14) in the SURGERY file (#130), the software will enter the surgeon in the ATTEND SURGEON field (#.164). For non-OR procedures, when the provider is entered in the PROVIDER field (#123), the software will enter the provider in the ATTEND PROVIDER field (#124). a time to open the case for editing. Neither report for a case can be 65 SEQ #61 DATE APPLIED: 1997-05-01 00:00:00 APPLIED BY: USER,ONE 137 SEQ #131 DATE APPLIED: 2004-12-28 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Variables not printing correctly in Risk Assessment report 141 SEQ #134 DATE APPLIED: 2005-02-04 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. This patch fixes the problem reported in NOIS BAY-0105-30051. The PREOP DATA] on the menu Non-Cardiac Assessment Information (Enter/Edit) [SROA ENTER/EDIT] on the menu Surgery Risk Assessment Menu [SROA RISK ASSESSMENT] to edit items under GENERAL on page 1, entering a caret (^) to exit at one of the sub-item prompts does not work correctly. This patch corrects this problem. problem was introduced by patch SR3134. 2. This patch fixes the problem reported in NOIS CLA-0105-20215. This problem occurs only at facilities with multiple divisions defined in the SURGERY SITE PARAMETERS file (#133) with all but one division flagged as inactive. 3. When using the option Preoperative Information (Enter/Edit) [SROA 140 SEQ #135 DATE APPLIED: 2005-04-01 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch enables the user to delete surgery images. 143 SEQ #136 DATE APPLIED: 2005-04-26 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. In support of the Surgical Infection Project (SIP), this patch Medication Comments 2. The Morbidity & Mortality Reports [SROMM] option and the M&M Verification Report [SRO M&M VERIFICATION REPORT] option are modified to display the sepsis category for SYSTEMIC SEPSIS occurrences. 3. This patch modifies the DYSPNEA field (#325) in the SURGERY file (#130) changing MINIMAL EXERTION in the set of choices to MODERATE EXERTION. This change makes the set of codes agree with the field modifies the Nurse Intraoperative Report [SRONRPT] option to display description. and to allow editing of the following additional information related to medications: Time Administered Route Dosage Ordered By Administered By 119 DATE APPLIED: 2005-09-05 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: CLINICAL INDICATOR DATA CAPTURE - SURGERY 145 SEQ #138 DATE APPLIED: 2005-12-02 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: In Remedy HD 94190, when using the Patient Demographics (Enter/Edit) [SROA DEMOGRAPHICS] option, an undefined error occurs if the length of the race data is found to be more than 72 characters. 147 SEQ #139 DATE APPLIED: 2005-12-02 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. For CPRS-R (ReHosting), a cache of patient data will be maintained for (#.12) in the SURGERY file (#130). The field is renamed "PREOP HAIR CLIPPING BY" and the title and description of this field are updated. The field titles on the Nurse Intraoperative Report are changed as well. the duration of his/her inpatient stay (or outpatient visit) for ease of searching and sorting within the new Java client; rather than making frequent calls back to each application's database. To this end, this patch contains modifications that will allow the Surgery software to update the CPRS-R (ReHosting) cache of patient data when a case is created or edited. 2. This patch updates the data dictionary of the PREOP SHAVE BY field 149 SEQ #140 DATE APPLIED: 2005-12-21 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: THIS PATCH WILL INSERT "N SRX" TO THE BEGINNING OF SEVERAL SURGERY FILE (#130) INPUT TRANSFORMS. 150 SEQ #141 DATE APPLIED: 2006-01-12 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: THIS PATCH CORRECTS FOUR ISSUES RELATED TO CIDC. 148 SEQ #142 DATE APPLIED: 2006-01-12 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch modifies the Blood Product Verification [SR BLOOD PRODUCT VERIFICATION] option to reference the VistA Blood Establishment Computer Software (VBECS) if installed. This change allows the option to maintain its current functionality before and after VBECS is installed. 67 SEQ #62 DATE APPLIED: 1997-05-28 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This is Surgery patch SR367. 151 SEQ #143 DATE APPLIED: 2006-03-08 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: As existing pharmacy software modules are being re-engineered through 'behind-the-scenes' process to enable exchange of medication data. new development and the purchase of commercial off-the-shelf products (COTS). Transition to the new Pharmacy Re-Engineered system eliminates the VistA Pharmacy files currently referenced. Therefore, all Surgery existing references (direct global reads/writes, VA FileMan reads/writes) to all pharmacy application files must be replaced with Application Programmer Interfaces (APIs). This enhancement does not entail any user functionality change, only a 155 SEQ #144 DATE APPLIED: 2006-04-10 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch is a follow up patch for SR3151. It fixes the undefined error reported by Dublin when using the Anesthesia Provider Report [SROADOC] option. 142 SEQ #145 DATE APPLIED: 2006-05-04 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch is part of the Patient Financial Services System (PFSS) project. system. The project consists of the implementation of the billing o Quarterly Report - Surgical Service [SRO QUARTERLY REPORT] option o Report of Missing Quarterly Report Data [SROQ MISSING DATA] option Note: The Other CPT Codes no longer affect this report and references to Other CPT Codes are removed. The display of "I" in the footer of this report is removed. o Annual Report of Non-O.R. Procedures [SRONOP-ANNUAL] option o List of Invasive Diagnostic Procedures [SROQIDP] option - The following Surgery reports and options are modified to remove CPT and/or ICD codes from the display. o Update Status of Returns within 30 Days [SRO UPDATE RETURNS] option replacement system, business process improvements, and enhancements to o Update Operations as Unrelated/Related to Death [SRO DEATH RELATED] option o Non-OR Procedure Information [SR NON-OR INFO] option o Deaths Within 30 Days of Surgery [SROQD] option o Admissions Within 14 Days of Outpatient Surgery [SROQADM] option o List of Operations Included on Quarterly Report [SROQ LIST OPS] option 3. Modified Risk Assessment Options - Surgery case CPT and/or ICD codes used in the following options are VistA to support integration with the COTS billing replacement system. displayed from the SURGERY PROCEDURE/DIAGNOSIS CODES file (#136): o Print a Surgery Risk Assessment [SROA PRINT ASSESSMENT] option o List of Surgery Risk Assessments [SROA ASSESSMENT LIST] option o Exclusion Criteria (Enter/Edit) [SR NO ASSESSMENT REASON] option Note: The new CPT code fields will not be editable from this option. o Update 1-Liner Case [SROA ONE-LINER UPDATE] option Note: The new CPT code fields will not be editable from this option. o Queue Assessment Transmissions [SROA TRANSMIT ASSESSMENTS] option Significant changes to VistA legacy systems and ancillary packages are - In the following options CPT codes are removed from the screen headings: o Preoperative Information (Enter/Edit) [SROA PREOP DATA] option o Laboratory Test Results (Enter/Edit) [SROA LAB] option o Operation Information (Enter/Edit) [SROA OPERATION DATA] option Note: The CPT code and Postoperative Diagnosis fields will not be editable from this option. o Patient Demographics (Enter/Edit) [SROA DEMOGRAPHICS] option o Intraoperative Occurrences (Enter/Edit) [SRO INTRAOP COMP] option o Postoperative Occurrences (Enter/Edit) [SRO POSTOP COMP] option necessary. o Clinical Information (Enter/Edit) [SROA CLINICAL INFORMATION] option o Laboratory Test Results (Enter/Edit) [SROA LAB-CARDIAC] option o Enter Cardiac Catheterization & Angiographic Data [SROA CATHETERIZATION] option o Operative Risk Summary Data (Enter/Edit) [SROA CARDIAC OPERATIVE RISK] option Note: The CPT code fields will not be editable from this option. o Cardiac Procedures Operative Data (Enter/Edit) [SROA CARDIAC PROCEDURES] option o Outcome Information (Enter/Edit) [SROA CARDIAC-OUTCOMES] option o Resource Data [SROA CARDIAC RESOURCE] option - The Update Assessment Status to 'COMPLETE' [SROA COMPLETE ASSESSMENT] option is modified to remove the ability to edit CPT and ICD codes from this option. 4. Functions that are currently part of the Surgery Nightly Cleanup and Updates [SRTASK-NIGHT] option are modified as follows: - Store Operation Times function uses the CPT code fields in the SURGERY PROCEDURE/DIAGNOSIS CODES file (#136). Some of the PFSS software components are not operational until the PFSS - File Surgery Data in PCE function is removed. 5. The Surgery to PCE interface is modified to send coding data from the SURGERY PROCEDURE/DIAGNOSIS CODES file (#136). The interface now passes data to PCE in real time when the coder completes the coding process for a case. After a case is filed with PCE, if certain data passed to PCE is changed within the Surgery software, the Surgery to PCE interface sends an update to PCE immediately. ICD coding related data is updated through the Update/Verify Procedure/Diagnosis Codes [SRCODING EDIT] option. On/Off Switch, distributed with patch IB2260, is set to "ON". The ability for the local site to set the switch to "ON" will be provided at the appropriate time with the release of a subsequent Integrated Billing patch. PFSS patches are being released on various schedules. Some patch For more information about the PFSS project, review the documentation accompanying this patch and refer to the following website: http://vista.domain.ext/billreplace/ Features of patch SR3142 are listed below: 1. Modified Surgery Coding Option Coders currently use the Update/Verify Procedure/Diagnosis Codes [SRCODING EDIT] option, which updates coded data directly in the functionality will not be active until a new PFSS switch is activated SURGERY file (#130). However, the SURGERY file (#130) does not currently make a distinction between procedure and diagnosis data entered by clinicians and that entered by coders. Today, coding a surgical case impacts the clinical data for the patient and causes an addendum to be generated because each code is directly associated with a free-text procedure or diagnosis entry. This patch separates final coded procedures and diagnoses from the clinically captured procedures and diagnoses. A new file, the SURGERY PROCEDURE/DIAGNOSIS CODES file (#136), is during final implementation. PFSS will initially be implemented at select created to store coded procedure and coded diagnosis data for a Surgery case. Data entered into this file will be the new source coding data sent by the Surgery package to PCE. In the SURGERY file (#130), the existing PRINCIPAL CPT Code field (#27), PRIN DIAGNOSIS CODE field (#66), OTHER PROCEDURE CPT CODE field (#3 of sub-file #130.16) and ICD DIAGNOSIS CODE field (#3 of sub-file #130.18) are modified to include the word "PLANNED" in the field labels and titles. The Update/Verify Procedure/Diagnosis Codes [SRCODING EDIT] option is modified to allow entry of final billing Current Procedural pilot sites ONLY. Terminology (CPT) codes for surgical procedures and International Classification of Disease (ICD) diagnosis codes in the SURGERY PROCEDURE/DIAGNOSIS CODES file (#136). Modified features of the Update/Verify Procedure/Diagnosis Codes [SRCODING EDIT] option are listed below: - Upon record creation for a case in the SURGERY PROCEDURE/DIAGNOSIS CODES file (#136), the record will be auto-populated with clinician entered coding data, if any, from the SURGERY file (#130). - A principal ICD code and a principal CPT code are initial requirements for coding a surgical case. - An unlimited number of ICD codes may be entered for other diagnoses and an unlimited number of CPT codes may be entered for other procedures performed. - Each CPT code entered must be assigned the associated ICD code(s) related to the procedure performed. - An unlimited number of CPT modifiers may be entered for each CPT code entered. - For every ICD code entered, the following questions must be answered as appropriate for the patient based upon enrollment indicators: The purpose of the PFSS project is to prepare the Veterans Health o Treatment related to Service Connected condition? o Treatment related to Agent Orange Exposure? o Treatment related to Ionizing Radiation Exposure? o Treatment related to Environmental Contaminant Exposure? o Treatment related to Military Sexual Trauma? o Treatment related to Head and/or Neck Cancer? o Treatment related to Combat? - Upon completion of coding for a case, the coder is allowed to mark the record as complete and to send the record immediately to PCE. - Before allowing the record to be marked as complete, the option Information Systems and Technology Architecture (VistA) environment for the checks to see if a specific code, 065.0 CRIMEAN HEMORRHAGIC FEV, is entered as a diagnosis code. If it is entered, the software prompts the user to make sure that the code is correct for the case. This check is added to prevent the inadvertent assignment of code 065.0 when "CHF" is entered for the Principal or Other ICD Diagnosis codes. 2. Modified Surgery Reports and Other Options - The following Surgery reports and options as modified to use the coder entered CPT and/or ICD codes from the SURGERY implementation of a commercial off-the-shelf (COTS) billing replacement PROCEDURE/DIAGNOSIS CODES file (#136): o Cumulative Report of CPT Codes [SROACCT] option o Report of CPT Coding Accuracy [SR CPT ACCURACY] option o List Completed Cases Missing CPT Codes [SRSCPT] option Note: The option descriptions are updated to read "The List Completed Cases Missing CPT Codes option generates a report of completed cases that are missing the Principal CPT code for a specified date range." o Annual Report of Surgical Procedures [SROARSP] option o PCE Filing Status Report [SRO PCE STATUS] option 146 SEQ #146 DATE APPLIED: 2006-05-04 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. At many sites the Risk Assessment Nurse Reviewers are involved with the [SROA ENTER/EDIT] and Cardiac Risk Assessment Information (Enter/Edit) [SROA CARDIAC ENTER/EDIT] menus. o The Alert Coder Regarding Coding Issues [SROA CODE ISSUE] option will not check the PFSS On/Off switch. o The Alert Coder Regarding Coding Issues [SROA CODE ISSUE] option will display basic surgery case information including Patient, Case Number, Surgery Date, and Procedure. o The Alert Coder Regarding Coding Issues [SROA CODE ISSUE] option will display the following coded information: the PRINCIPAL CPT CODE, OTHER CPT CODE, and PRINCIPAL DIAGNOSIS CODE. Health Information Management Systems (HIMS) staff in determining the o The Alert Coder Regarding Coding Issues [SROA CODE ISSUE] option will allow the Reviewer to enter a free text comment field to send coding concerns to the coder, as well as to members of a predefined mail group identified in the CODE ISSUE MAIL GROUP parameter. o Values for the CODING COMPLETED BY field (#.01) of the CODING COMPLETED BY multiple (#136.011) of the SURGERY PROCEDURE/DIAGNOSIS CODES file (#136) or the CODE ISSUE MAIL GROUP will be present when the user selects the Alert Coder Regarding Coding Issues [SROA CODE ISSUE] option. If neither are valued, the user will be notified that the message cannot be sent without one of these two items defined. final codes for a Surgery case. An Alert Coder Option will allow the Risk o The CODE ISSUE MAIL GROUP field (#43) is added in the SURGERY SITE PARAMETERS file (#133) to allow the site to create a designated mail group for the Alert Coder Regarding Coding Issues [SROA CODE ISSUE] option. o The Surgery Site Parameters (Enter/Edit) [SROPARAM] option within the Surgery Package Management Menu [SRO PACKAGE MANAGEMENT] option is modified to allow entry and editing of the new CODE ISSUE MAIL GROUP. 2. When creating a request from a waiting list entry, the Surgery screen server incorrectly displays "SCHEDULING" in the screen header. This patch Assessment Nurse Reviewer to alert the coder if there is a question on the makes a modification to display "REQUEST" instead. 3. This patch corrects problems with the two trigger cross references that were added to the SITE field (#.01) of the SURGERY SITE PARAMETERS file (#133) by patch SR3150. Note: This patch includes a post-installation process that updates each entry in the SURGERY SITE PARAMETERS file (#133) as follows: - UPDATES TO PCE field (#18) is set to ALL CASES. - ASK CLASSIFICATION QUESTIONS field (#19) is set to YES. Current Procedural Terminology (CPT) or International Classification of Diseases (ICD) codes on a Surgery case. o The new Alert Coder Regarding Coding Issues [SROA CODE ISSUE] option will appear on both the Non-Cardiac Assessment Information (Enter/Edit) 152 SEQ #147 DATE APPLIED: 2006-06-08 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Project 112/SHAD (Shipboard Hazard and Defense) is a new environmental The Project 112/SHAD information will be forwarded to Patient Care Encounter (PCE) as part of the normal case coding activities. 2. This patch will prevent the PRIN PRE-OP ICD DIAGNOSIS CODE field (#32.5) of the SURGERY file (#130) from being sent to PCE. 3. This patch adds the Alert Coder Regarding Coding Issues [SROA CODE ISSUE] option to the Surgery Risk Assessment Menu [SROA RISK ASSESSMENT] option. indicator added to VistA as part of the Enrollment System Redesign (ESR) project. 1. This patch provides the ability to enter and edit Project 112/SHAD Environmental Indicator information in the Surgery package. The patient's Project 112/SHAD enrollment status is displayed when creating or editing a surgical case, and the user will be prompted to answer the Project 112/SHAD questions with "yes" or "no". 144 SEQ #148 DATE APPLIED: 2006-06-14 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch is part of the Patient Financial Services System (PFSS) replacement system. The project consists of the implementation of the billing replacement system, business process improvements, and enhancements to VistA to support integration with the COTS billing replacement system. Significant changes to VistA legacy systems and ancillary packages are necessary. Some of the PFSS software components are not operational until the PFSS On/Off Switch, distributed with patch IB2260, is set to "ON". The ability for the local site to set the switch to "ON" will be provided at the appropriate time with the release of a subsequent Integrated Billing project. PFSS patches are being released on various schedules. Some patch patch. For more information about the PFSS project, review the documentation accompanying this patch and refer to the following website: http://vista.domain.ext/billreplace/ Features of patch SR3144 are listed below: 1. The VistA Surgery software will be enhanced to request an account number for every Surgery Request Consult. This activity will support functionality will not be active until a new PFSS switch is activated the Revenue Office's need to pre-certify with insurance companies the requested Surgery. A national guideline will be issued defining the minimum format for creating a Surgery Request Consult within the VistA Consults package that will collect the data required by PFSS. The Surgery Request Consult will not create a Surgery case. This guideline does not require that sites use the Consults package for creating Surgery requests. Sites using VistA Surgery Request options can continue to use that approach. VistA Surgery will be enhanced to also request a PFSS ACCOUNT during final implementation. PFSS will initially be implemented at select REFERENCE, and it will be stored in the PFSS ACCOUNT REFERENCE field (#500) of the SURGERY file (#130). The association to a PFSS ACCOUNT REFERENCE is obtained when the Surgery case is created and is sent to the PATIENT CARE ENCOUNTER (PCE) application upon completion of coding. 2. This patch changes the List Completed Cases Missing CPT Codes [SRSCPT] option to list only those completed cases that do not have a final CPT code entered in the PRINCIPAL PROCEDURE CODE field (#.02) of the SURGERY PROCEDURE/DIAGNOSIS CODES file (#136). pilot sites ONLY. The purpose of the PFSS project is to prepare the Veterans Health Information Systems and Technology Architecture (VistA) environment for the implementation of a Commercial Off-The-Shelf (COTS) billing 156 SEQ #149 DATE APPLIED: 2006-07-11 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. The Print a Surgery Risk Assessment [SROA PRINT ASSESSMENT] option for Non-Cardiac assessments is corrected to display the PRIN POSTOP DIAGNOSIS CODE field (#.03) stored in the SURGERY PROCEDURE/DIAGNOSIS CODES file (#136). 2. The Print a Surgery Risk Assessment [SROA PRINT ASSESSMENT] option for Non-Cardiac assessments is corrected to display the PRINCIPAL PROCEDURE CODE field (#.02) stored in the SURGERY PROCEDURE/DIAGNOSIS CODES file (#136) when referencing CPT Codes for Returns within 30 Days. 154 SEQ #150 DATE APPLIED: 2006-08-07 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: An undefined error occurs when two users attempt to access the same record at the same time. One user is creating a surgery request and the other is attempting to delete that same user request. 158 SEQ #151 DATE APPLIED: 2006-08-07 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: After installing patch SR3144, if the SURGICAL RESIDENTS (Y/N) field correctly. This patch includes a post-installation process that will check each surgical case and correct any textual entries that may exist in the ATTEND SURG field (#.164) in the SURGERY file (#130). (#33) in the SURGERY SITE PARAMETERS file (#133) is NO, surgical cases for that division created using the Schedule Unrequested Operations [SROSRES] option will contain the textual name of the attending surgeon instead of the pointer value in the ATTEND SURG field (#.164) in the SURGERY file (#130). This patch modifies the Schedule Unrequested Operations [SROSRES] option so that the ATTEND SURG field (#.164) in the SURGERY file (#130) is set 153 SEQ #152 DATE APPLIED: 2006-08-24 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: his patch updates the Surgery Risk Assessment software of the Veterans o Modification to some of the user entries of fields that allow text to be entered to accept lower case or all CAPS - The NUM OF PRIOR HEART SURGERIES field (#352) is modified to allow the entry of lowercase letter "N" to represent "0 - NONE". Any existing N's will be converted to '0' for NONE by he post install routine. - The ESTIMATE OF MORTALITY field (#364) is modified to allow the entry of lowercase letter "ns" to represent "NO STUDY". o Modifications to the List of Surgery Risk Assessments [SROA ASSESSMENT LIST] option NOTE: All fields listed below are in the SURGERY file (#130) unless - Each report is modified to display the final CPT codes from the case coding record in the SURGERY PROCEDURE/DIAGNOSIS CODES file (#136). - List of 1-Liner Cases Missing Information (list #8) is added. General Surgery Items --------------------- o The PREOP HAIR CLIPPING BY field (#.12) is renamed HAIR REMOVAL BY. o The HAIR REMOVAL METHOD field (#506) and the HAIR REMOVAL COMMENTS field (#508) are added to the Operation Startup [SROMEN-START] option otherwise indicated. and the Operation (Short Screen) [SROMEN-OUT] option. Those two fields and the HAIR REMOVAL BY field (#.12) are added to the Nurse Intraoperative Report and became a mandatory documentation field to satisfy the record review process for quality measurement purposes. Cardiac Risk Assessment Modifications ------------------------------------- o Modifications to the Clinical Information (Enter/Edit) [SROA CLINICAL INFORMATION] option - The software is modified to auto-populate the HEIGHT field (#236) and the WEIGHT field (#237) as documented in the Vitals software. Health Information Systems and Technology Architecture (VistA) - The Current Smoker item under this option is modified to reference to the new CURRENT SMOKER (CARDIAC) field (#510) instead of the old field CURRENT SMOKER field (#202), which will be utilized by the NSQIP options. o Modifications to the Laboratory Test Results (Enter/Edit) [SROA LAB-CARDIAC] option - The HEMOGLOBIN A1C field (#504) and the HEMOGLOBIN A1C, DATE field (#504.1) are added to the list of preoperative lab results. - The software is modified to use a date range of 1000 days prior to the Surgery application as requested by the Executive Board of the National date of operation when searching for the most recent preoperative lab test result for the HDL (CARDIAC) field (#457), the LDL (CARDIAC) field (#461), the TOTAL CHOLESTEROL (CARDIAC) field (#462), the SERUM TRIGLYCERIDE (CARDIAC) field (#458), and the HEMOGLOBIN A1C field (#504). o The Enter Cardiac Catheterization & Angiographic Data [SROA CARDIAC PROCEDURES] option is modified to allow all fields to be auto-populated with 'NS' (NO STUDY) when 'NS' is entered in the PROCEDURE TYPE field (#476). Surgical Quality Improvement Program (NSQIP) and by the Cardiac Surgery o Modifications to the Cardiac Procedures Operative Data (Enter/Edit) [SROA CARDIAC PROCEDURES] option - The GREAT VESSEL REPAIR (Y/N) field (#372) is moved to screen #1 under this option as item #20. - The ENDOVASCULAR REPAIR field (#505) is added in screen #1 as item #21. - The OTHER CT PROCEDURE field (#484) in the first screen is now replaced by the OTHER CARDIAC PROCEDURES (Y/N) field (#502). If this field value is "YES" the software will prompt the user for the OTHER Consultants Board of the Continuous Improvement in Cardiac Surgery CARDIAC PROCEDURES-LIST field (#484). - The OTHER NON-CT PROCEDURES field (#491) is removed from the second screen and a blank line is added before "Other Operative Data details" header. - The software is modified so that entering "N" for the VALVE REPAIR field (#370) shall result in "5. None". The existing N's will be converted to '5' upon patch installation. - This option is updated to reference the new MAZE PROCEDURE field (#512) as item 13 in the first data entry screen. Program (CICSP). These updates include the addition of new data fields, o A new occurrence category REPEAT VENTILATOR SUPPORT W/IN 30 DAYS is created in the PERIOPERATIVE OCCURRENCE CATEGORY file (#136.5). This occurrence category will be selectable only for cardiac assessed cases. o The following fields on the Resource Data [SROA CARDIAC RESOURCE] option are modified to assume a default of "past date" when no year is specified: - ESTIMATE OF MORTALITY, DATE field (#364.1) - D/T PATIENT EXTUBATED field (#470) - D/T PATIENT DISCH FROM ICU field (#471) changes to existing data fields, changes to data entry screens, changes o This patch will allow the retransmission of a cardiac risk assessment. Non-Cardiac Assessment Modifications ------------------------------------ o Modifications to the Preoperative Information (Enter/Edit) [SROA PREOP DATA] option - The software is modified to auto-populate the HEIGHT field (#236) and the WEIGHT field (#237) as documented in the Vitals software. - The PREGNANCY field (#269) is added to the NUTRITIONAL/IMMUNE/OTHER to reports used in Surgery Risk Assessment management process and changes section. o Modifications to the Laboratory Test Results (Enter/Edit) [SROA LAB] option - The PREOPERATIVE ANION GAP field (#444) and the PREOP ANION GAP, DATE field (#444.1) are added to the list of preoperative lab results. - The HIGHEST ANION GAP field (#445) and the HIGH ANION GAP, DATE field (445.1) are added to the list of postoperative lab results. o The Operation Information (Enter/Edit) [SROA OPERATION DATA] option is to the Surgery Risk Assessment transmissions. modified to add the INTRAOP DISSEMINATED CANCER field (#443). Other Risk Assessment Modifications ----------------------------------- o The Print a Surgery Risk Assessment [SROA Print Assessment] option is modified to include the new data elements. o The transmissions to the national databases are modified to include the new fields. DATE INSTALLED AT THIS SITE: 1996-08-29 00:00:00
DESCRIPTION	The DHCP Surgery package is used to enter/edit and display information related to the Surgical Service. It will track surgical cases, provide useful management reports, and produce the necessary documentation for all surgical cases.
FILE	UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: NO MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: NO MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: YES MERGE OR OVERWRITE SITE'S DATA: MERGE MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: YES MERGE OR OVERWRITE SITE'S DATA: MERGE MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: YES MERGE OR OVERWRITE SITE'S DATA: MERGE MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: NO MERGE OR OVERWRITE SITE'S DATA: OVERWRITE MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: YES MERGE OR OVERWRITE SITE'S DATA: MERGE MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: YES MERGE OR OVERWRITE SITE'S DATA: MERGE MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: YES MERGE OR OVERWRITE SITE'S DATA: OVERWRITE MAY USER OVERRIDE DATA UPDATE: NO UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: YES MERGE OR OVERWRITE SITE'S DATA: MERGE MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: NO MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: NO MERGE OR OVERWRITE SITE'S DATA: OVERWRITE MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: YES MERGE OR OVERWRITE SITE'S DATA: OVERWRITE MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: YES MERGE OR OVERWRITE SITE'S DATA: MERGE MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: YES MERGE OR OVERWRITE SITE'S DATA: MERGE MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: YES MERGE OR OVERWRITE SITE'S DATA: MERGE MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: YES MERGE OR OVERWRITE SITE'S DATA: MERGE MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: YES MERGE OR OVERWRITE SITE'S DATA: MERGE MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: YES MERGE OR OVERWRITE SITE'S DATA: MERGE MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: NO MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: YES MERGE OR OVERWRITE SITE'S DATA: MERGE MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: NO MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: NO MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: YES DATA COMES WITH FILE: YES MERGE OR OVERWRITE SITE'S DATA: OVERWRITE MAY USER OVERRIDE DATA UPDATE: YES UPDATE THE DATA DICTIONARY: YES MAY USER OVERRIDE DD UPDATE: NO DATA COMES WITH FILE: YES MAY USER OVERRIDE DATA UPDATE: NO UPDATE THE DATA DICTIONARY: YES MAY USER OVERRIDE DD UPDATE: NO DATA COMES WITH FILE: YES MERGE OR OVERWRITE SITE'S DATA: MERGE MAY USER OVERRIDE DATA UPDATE: NO UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: NO MAY USER OVERRIDE DD UPDATE: NO DATA COMES WITH FILE: YES MERGE OR OVERWRITE SITE'S DATA: MERGE MAY USER OVERRIDE DATA UPDATE: NO SCREEN TO DETERMINE DD UPDATE: N UPDATE THE DATA DICTIONARY: YES ASSIGN A VERSION NUMBER: YES MAY USER OVERRIDE DD UPDATE: NO DATA COMES WITH FILE: NO MERGE OR OVERWRITE SITE'S DATA: OVERWRITE MAY USER OVERRIDE DATA UPDATE: NO
ENVIRONMENT CHECK ROUTINE	SROPRE
POST-INITIALIZATION ROUTINE	SROPOST
EXCLUDED NAME SPACE	SRCS SRA

SURGERY (127) PACKAGE (9.4)