CLINICAL REMINDERS (180)    PACKAGE (9.4)

  This patch adds:
      print data from the REMINDER EXTRACT SUMMARY file (810.3)
 REQUIRED BUILDS:
 ================
  CLINICAL REMINDERS 1.5
 
 INSTALLATION INSTRUCTIONS:
 ==========================
  
 This patch should be loaded during non-peak hours to minimize disruption
 to users.  Installation will take less than 15 minutes.
  
    * 2 new sort templates, one to identify terms to distribute and one
                           **Warning** 
 When an option is included in the patch build, the question REBUILD MENUS
 is asked as a PRE-INSTALL question.  If you choose to have KIDs rebuild
 the menus it will happen at the end of the build installation and may
 take several hours.
  
  1.  Download the KIDS file HEP_C_EXTRACT_1_0.KID via FTP from any
      of the anonymous.software directories listed above.  Move the file
      to the appropriate directory on your system.
 
      for the REMINDER EXTRACT SUMMARY file
  2.  Review your mapped set.  If any of the routines listed in the
      Routines section are mapped, they should be removed from the mapped
      set at this time. 
 
  3.  From the Kernel Installation and Distribution System (KIDS) menu,
      select the Installation menu.
 
  4.  Use Load a Distribution option on the KIDS Installation menu, and
      enter: HEP_C_EXTRACT_1_0.KID
  
    * 3 new print templates, all related to reporting the EPI findings
  5.  From this menu, you may elect to use the following options
      (when prompted for INSTALL NAME, enter HEPATITIS_C_EXTRACT).
    
      Note - Option (a.), Backup a Transport Global, can and must be
      referenced exclusively by the primary build name of
      HEPATITIS_C_EXTRACT. Option (b.) can be run by either using the
      primary build name of HEPATITIS_C_EXTRACT or the individual patch
      names (e.g., PXRM*1.5*1, etc.). Options (c.) and (d.) must be run
      for each individual build (using the patch names) included in
      this transport.
 
  
      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
  This patch modifies the:
          the transport global.
      d.  Print Transport Global - this option will allow you to view the
          components of the KIDS build.
  
  6.  Use the Install Package(s) option and select the package
      HEPATITIS_C_EXTRACT.
  
  7.  When prompted 'Want to DISABLE Scheduled Options, Menu Options, and
      Protocols? YES//', respond NO.
  
    * description in the VA-HEP C RISK ASSESSMENT reminder definition
  8.  If routines were unmapped as part of step 2, they should be returned
      to the mapped set once the installation has run to completion.
 
 POST INSTALLATION INSTRUCTIONS
 ============================== 
 The details of the setup to be completed is available in the
 documentation. Generally, these steps need to be done by the REMINDERS
 MANAGER or the CLINICAL REMINDERS APPLICATION COORDINATOR. The success of
 the Hepatitis C updates to the EPI database will depend on a Hepatitis
 Team at your site addressing all of the issues in the documentation.
    * description for 3 previously distributed Reminder Terms
 
  1. See the descriptions for the reminder definitions and 
     the descriptions in the REMINDER TERMS file to determine what
     additional setup is required for the terms. You will need to review
     the reminder terms with laboratory and pharmacy coordinators.
 
  2. You can use the Detailed Reminders Due report to determine if all
     the correct patients are being identified to send to the EPI
     database.
 
    * name and description for the Reminder Term PREV POSITIVE TEST FOR
  3. You may need to check that all dispensed drugs are mapped to the
     national drug file entries represented by the Hepatitis C Medication
     terms. If you have local dispensed drugs that cannot be mapped to the
     national drug file (VA GENERIC, #50.6), you will need to enter the
     dispensed drugs as findings for the appropriate national reminder
     term.
 
  4. Add local laboratory tests with appropriate CONDITIONS in the
     REMINDER TERM file for the laboratory terms.
 
      HEP C, which is renamed PREVIOUSLY ASSESSED HEP C RISK
  5. The VA-NATIONAL EPI LAB EXTRACT and VA-NATIONAL EPI RX EXTRACT
     reminders should NOT be added to the "Clinical Reminders for Search"
     parameter for clinicians.  The Reminders Manager may want to create a
     National EPI Update reminder category and add these reminders to it,
     along with the VA-HEP C RISK ASSESSMENT REMINDER. The category could
     be added to the CPRS Reminder Categories parameter option for testing
     the setup of the reminder terms and reviewing the results.
 
DETAILED DESCRIPTION:
=====================
    * 2 new reminder definitions to the REMINDER DEFINITION file (811.9)
 
Data Dictionary:
 
  1. REMINDER DEFINITION file (811.9)
     The reminder for VA-NATIONAL EPI DB UPDATE may be used at sites to
     determine whether a patient has data that is sent to the Austin
     Automation Center to update the national EPI database.
 
  2. REMINDER TERM file (811.5)
     There are twenty reminder terms used by the lab and pharmacy extract
     reminders. Eighteen of these terms are newly distributed in this
  This patch will work with the LR*5.2*260 patch and two pharmacy
     file. These new terms represent Hepatitis A, Hepatitis B and
     Hepatitis C lab and medication information. The reminder terms may be
     used at sites in locally defined reminders for clinicians providing
     clinical care for Hepatitis patients.
 
     Hepatitis A laboratory reminder terms:
         HAV Ab positive         Hepatitis A virus antibody total positive
         HAV IgM Ab positive     Hepatitis A virus antibody immunoglobulin
                                         M positive 
         HAV IgG positive        Hepatitis A virus antibody immunoglobulin
  patches (PSO*7*45 and PSJ*5*48) to extract Hepatitis C risk
                                         G positive
         Bilirubin
 
     Hepatitis B laboratory reminder terms:
         HBs Ag positive         Hepatitis B surface antigen positive 
         HBc Ab IgM positive     Hepatitis B core antibody immunoglobulin
                                         M positive 
         HBs Ab positive         Hepatitis B surface antibody positive
         HBe Ag positive         Hepatitis B e antigen positive 
 
  assessment, laboratory and medication data. The extracted data will be
     Hepatitis C laboratory reminder terms: 
         HEP C VIRUS ANTIBODY NEGATIVE    
         HEP C VIRUS ANTIBODY POSITIVE    
         TRANSFERASE (AST) (SGOT)
         ALANINE AMINO (ALT) (SGPT)
 
     Hepatitis Medications (based on VA GENERIC file): 
         INTERFERON ALFA-2A 
         INTERFERON ALFA-2B     
         INTERFERON ALFA-2B/RIBAVIRIN 
  used to update the EPI database at the AAC.
         INTERFERON ALFA-3N     
         INTERFERON ALFACON-1 
         INTERFERON BETA-1A 
         INTERFERON BETA-1B 
         RIBAVIRIN           
 
Sort Template:
 
   PXRM EPI LAB AND MED TERMS contains reminder term entries defined above
   to distribute with the REMINDER TERM (811.5) data dictionary.
 
 
   PXRM EXTRACT EPI BY FIND_PT sorts an extract by Finding Item and SSN.
   This sort template may be useful when looking up an SSN to compare
   findings to an error message returned to the site from the AAC.  When
   the AAC has problems processing a sites extracted data, the original
   extract message and SSN are returned to the site in an error message
   for review and correction.
 General Overview:
 =================
  This patch is released in response to Congressional reporting
  requirements and a policy letter distributed by the Under Secretary
    * 18 new national terms to the REMINDER TERM file (811.5)
  of Health addressing treatment of Hepatitis patients.
 
  The data extracted for Risk Assessment is based on the VA-HEP C RISK
  ASSESSMENT reminder definition.  The data extracted from laboratory is
  based on the VA-NATIONAL EPI LAB EXTRACT reminder, previously
  distributed as VA-NATIONAL EPI DB UPDATE.  Both of these reminders were
  first released in the Clinical Reminders V.1.5 package. A new reminder
  definition, VA-NATIONAL EPI RX EXTRACT, is distributed in this patch for
  extracting medications. These three reminder definitions provide the
  criteria for extracting the risk assessment, lab, and medication data.
    * 1 new file, REMINDER EXTRACT SUMMARY (810.3), that temporarily
 
  The reminder evaluation and update to the EPI database occurs on the
  15th of the month following the reporting month. The option that manages
  this update is the LREPI NIGHTLY TASK.  This task currently runs nightly
  at each site. Note: The monthly task on the 15th occurs because the LAG
  DAYS field in the LAB SEARCH/EXTRACT file (69.5) is set to "15" for each
  pathogen. The LR*5.2*260 patch contains new processing logic that sends
  data extracted from reminder extract results to the EPI database.
 
  This patch also fixes a problem where CUSTOMIZED PATIENT COHORT LOGIC
      stores data extracted from reminder evaluation processing when
was 
  not being used in the reminder evaluation. (NOIS SLC-0600-52703).
 
 NOIS Messages:
 ==============
 SLC-0600-52703
 MON-0800-50154
 
  
 Build Components:
      updating the EPI database. This temporary data can be used to
 =================
  Data Dictionary for three files:
      REMINDER EXTRACT SUMMARY (810.3) (new) 
      REMINDER DEFINITION (811.9)
      REMINDER TERM (811.5)
 
  Option:
      PXRM REMINDER REPORTS menu (description change; lists new options)
      PXRM REMINDERS DUE (no change, just attach to menu)
      PXRM EXTRACT EPI TOTALS (new)
      compare to data in HL7 messages sent to the EPI database, and
      PXRM EXTRACT EPI FINDING LIST (new)
 
  Print Templates to print data from the REMINDER EXTRACT SUMMARY:
      PXRM EXTRACT EPI FINDING LIST (new)
      PXRM EXTRACT EPI FINDING HDR (new)
      PXRM EXTRACT EPI FINDING TOT (new) 
 
  Sort Templates:
      PXRM EPI LAB AND MED TERMS (new)(identifies reminder terms to
        include in this patch)
      validate that the appropriate data is extracted.
      PXRM EXTRACT EPI BY FIND_PT (new)(sorts the extract data in the
        REMINDER EXTRACT SUMMARY file)
 
  Routines:
 
   The second line of each routine looks like:
 
   <tab>;;1.5;CLINICAL REMINDERS;**1**;June 19, 2000
 
   Routine         Old Checksum    New Checksum    Patch List
    * 2 new options added to the PXRM REMINDER REPORTS option menu to
   =======         ============    ============    ==========
   PXRMLOGX          3009219          3005995        **1**
   PXRMP1I               n/a          2412825        **1** 
   PXRMP1IE              n/a           349212        **1**
   PXRMTERM          6249864          6249864        **1**
   PXRMXX            2465756          9832947        **1**
   PXRMXX1               n/a          8675493        **1**
   PXRMXX2               n/a          8200381        **1**
   PXRMXXT               n/a           573203        **1**
 

This patch makes changes to MST synchronization and dialog so that
dates passed to the MST API will not be rejected by the API.

NOIS fixes, see the National Patch Module for a complete description.

NOIS fixes, see the National Patch Module for a complete description.

NOIS fixes, see the National Patch Module for a complete description.

The description of this patch is found in the National Patch Module under 
the name PXRM*1.5*15. It contains 3 National Mental Health Reminders.

SEE NATIONAL PATCH MODULE

The description of this patch is found in the National Patch Module under 
the name PXRM*1.5*18. Clinical Reminders - Code Set Versioning

This patch creates a utility that provides an estimate of size of the
Clinical Reminders index. See the National Patch Module entry for full
details.

See description in the National Patch Module under the patch number 
PXRM*1.5*21

This patch creates the Clinical Reminder index global. See the National
Patch module for a complete description.

Clinical Reminders version 1.5 patch 2. This patch includes a number of
bug fixes and enhancements. Please see the National Patch module for a
complete description.

Reminder Dialogs for TIU.

This patch update the Exchange Utility so it is compatible with version
1.5 of Clinical Reminders.

This patch includes fixes and minor changes to the Reminders Due report.

This patch provides tools for Clinical Reminders to support MST
functionality. See the National Patch Module for a complete
description.

This patch distributes the VA-MST SCREENING reminder that was missing
from patch PXRM*1.5*7.

This patch contains national reminders for the IHD QUERI project:
 
VA-IHD ELEVATED LDL
VA-IHD LIPID PROFILE
 
See national patch module for details.

Clinical Reminders

Release National VA-TBI/POLYTRAUMA REHAB/REINTEGRATION PLAN OF 
CARE Dialog.

Polytrauma marker.

ARCH

High Risk Mental Health.

DG API Updates.

National Teratogneric Medications Order Checks

See description in the national patch module under patch PXRM*2*2.

National Clinical Reminders content updates.

High Risk Mental Health phase 2.

National Clinical Reminders content updates.

National Clinical Reminders content updates.

National Clinical Reminders content updates: VA-TETRATOGENIC MEDICATIONS
ORDER CHECKS, Update #1.

National Clinical Reminders content updates: Pneumoccocal vaccine.

National Clinical Reminders content updates.

Clinical Reminders ICD-10 changes.

National Clinical Reminders content updates, Mental Health dialogs,
increments 1 and 2.

National Clinical Reminders content update Ebola screening.

MyHealtheVet National Clinical Reminders

This patch corrects a problem with the "AB" index of file #100.21 not
being populated when copying a reminder patient list to an OE/RR team
list. In the post-init it checks all existing lists in file #100.21 and
ensures the "AB" index is populated for all of them.

National Clinical Reminders content updates: Airborne hazard templates.

National Clinical Reminders content updates, Mental Health dialogs
increment 3.

National Clinical Reminders content update Veteran's Choice Note.

National Clinical Reminders content updates: Lung oncology templates.

National Clinical Reminders content update of national taxonomies.

National Clinical Reminders content update Pneumococcal reminders.

National Clinical Reminders content update Advance Directive.

National Clinical Reminders content updates: VA-TERATOGENIC MEDICATIONS
ORDER CHECKS (UPDATE #2 PXRM*2*51)

National Clinical Reminders content update: Hepatitis C.

MyHealtheVet National Clinical Reminders

National Clinical Reminders content updates: MST screening.

National Clinical Reminders taxonomy update, increment 2.

Clinical Reminders Dialog Search Report.

National Clinical Reminders content updates: Caregiver templates.

National Clinical Reminders Telederm templates.

Selectable Immunizations

TDAP/Zoster/PNEUMO Reminder Updates

This patch is in support of the Mental Health PCL-5 instrument patch.  It 
The following clinical reminder items are updated to use PCL-5 as a
finding instead of PCLC:
 
  VA-PTSD REASSESSMENT (PCL)      reminder definition
 
  VA-MH CPT ASSESSMENT GROUP      dialog group
  VA-MH PEI ASSESSMENT GP         dialog group
 
  VA-PTSD EVALUATION (PCL)        reminder dialog
  VA-PTSD SCREENING               reminder dialog
will modify nationally released clinical reminders and reminder dialogs 
 
The effects of updating the dialog groups will be seen in the VA-MH CPT* 
and the VA-MH PEI* reminder dialogs.  They will open the PCL-5 instrument 
now instead of the PCLC instrument.
 
 
Patch Components:
-----------------
 
Files & Fields Associated:  N/A
to use the PCL-5 instrument instead of the previously used PCLC 
 
Forms Associated:           N/A
 
Mail Groups Associated:     N/A
 
Options Associated:         N/A
 
Protocols Associated:       N/A
 
Security Keys Associated:   N/A
instrument.  The PCLC and PCLM instruments are inactivated with the 
 
Templates Associated:       N/A
 
 
New Service Requests (NSRs):
----------------------------
NSR #20150509: Posttraumatic Stress Disorder (PTSD) Checklist 5 (PCL-5) 
and Mental Health Assistant Stabilization (MHAS) 
 
Patient Safety Issues (PSIs):
associated mental health patch.
-----------------------------
N/A
 
Remedy Ticket(s) & Overview:
----------------------------
N/A
 
Test Sites:
----------
TBD
 
 
 
Documentation Retrieval Instructions:
------------------------------------- 
Documentation can also be found on the VA Software Documentation Library 
at:
http://www4.domain.ext/vdl/
 
 
Patch Installation:
  Please refer to the information contained in the Mental Health patch
------------------
 
  Instructions for installation of the software are included in the 
  Mental Health PCL-5 patch YS*5.01*119.
 
Post-Installation Instructions:
-------------------------------
 
  See Mental Health PCL-5 patch YS*5.01*119 for post-installation 
  instructions.
  for installation instructions.
 

National Clinical Reminders content updates: VA-LIFE-SUSTAINING TREATEMENT.

Contains the Reminder Definitions, Dialogs, and associated components to 
create the standardized national template set for Home Telehealth (HT).

Removal of old-style MRD and bug fixes.

Clinical Reminders ICD-10 follow-up build.

This patch will:
 - Inactivate MyHealtheVet (MHV) Reminders.

This patch modifies the Clinical Reminders package to improve monitoring 
of teratogens prescribed or administered to women of childbearing age.  
Specifically, the software now prompts providers to document a woman's 
pregnancy and lacation status when appropriate using reminder dialogs.
 
Please see the accompanying patch description for details and the 
Computerized Patient Record System (CPRS) version 31 installation manual 
for installation instructions.

Updates for COVID-19 status banner.

Previous diagnosis API.

Backup of PXRM*2.0*75 on Apr 29, 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.

This patch address a problem with male radiology reports merging across a 
patients.

This patch supports PCE standardization.
 
For detailed information and installation instructions, please see the PCE
Standardization 1.0 Installation Guide.


To take full advantage of the PCE standardization work, changes to VistA
applications that use PCE data are required. These applications include
Clinical Reminders, Health Summary, Problem List, and Order Entry/Results
Reporting. To make it easier for sites, the builds for PCE (PX*1.0*211),
Clinical Reminders (PXRM*2.0*42), Health Summary (GMTS*2.7*122), Problem List
(GMPL*2.0*53), and Order Entry/Results Reporting (OR*3.0*501) are being
distributed in a multi-package build named PCE STANDARDIZATION 1.0.

Release National VA-TBI SCREENING Reminder and Dialog.

Backup of PXRM*2.0*77 on Aug 18, 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.

This patch addresses the following issue:
 
Reminder dialogs which are elements and have a class of "NATIONAL"
should not be edited.

Addresses INC21025485,INC21350480

Clinical Reminders VIMM changes

This patch addresses some issue with deleting notes that had a sexual 
orientation entered on. See the Patch Description for more details

Please see the National Patch Module for details of the enhancements
included in this patch.

National Skin Risk Assessment Dialogs

Integration of Clinical Reminders with the new version of the Mental
Health package.