| DESCRIPTION OF ENHANCEMENTS |
VISTA Laboratory Package patch LR*5.2*286 contains changes to software
found to have no impact on the VISTA BLOOD BANK SOFTWARE version 5.2
12. Enter/verify data (auto instrument) [LRVR] and Enter/verify/modify
data (manual) [LRENTER] options will display patient information from
PAT. INFO. field (#.091) in LAB DATA file (#63) during result verification.
(E3R #13408)
13. Alignment of test results during verification process has been adjusted
to avoid display of previous and current test results together. Results
will be displayed right-justified under the date/time of each specimen.
control functions.
14. NOIS ALB-0100-50284, FAV-1103-70892 reported a failure of UID creation
and storage when creating a non-daily accession that is in common with
another accession area. The failure occurs on the creation of the first
accession for a given accession area and date. After the first accession
for an accession date is created and stored in ACCESSION file (#68)
subsequent accessions have the UID stored properly. Failure was due to
missing subfile zeroth nodes for the ACCESSION DATE multiple (#68.01) and
ACCESSION NUMBER multiple (#68.02) of the ACCESSION file (#68) when calling
FileMan to store the UID. Routine LRWLST1 will now check and set the
subfile's zeroth nodes before calling FileMan.
FileMan calls have been converted from classic FileMan DIE calls to
FileMan Database Server calls (DBS). When an error condition is
encountered during a FileMan DBS call, the Laboratory package will
generate a mail message with the subject "FileMan DBS call failed during
accessioning in routine LRWLST1". This message will be sent to the local
mail group "LMI". It will contain debugging information to assist site
and National VistA Support in resolving the condition that produced the
error.
RISK ANALYSIS: Changes made by patch LR*5.2*286 have no effect on Blood
15. NOIS BON-0196-71728 reported a problem with storing the appropriate
treating specialty associated with an accession. A bad or incorrect
pointer to FACILITY TREATING SPECIALTY file (#45.7) could be stored in
the TREATING SPECIALTY (#6.6) field within the ACCESSION NUMBER field
(#68.02) multiple within the ACCESSION DATE field (#68.01) multiple of
the ACCESSION file (#68). When a specimen is accessioned for a
non-inpatient and the user selects an inpatient ordering location the
software would use the specialty from SPECIALITY file (#42.4) that
is associated with the WARD LOCATION file (#42) entry linked to the
HOSPITAL LOCATION file (#44).
Bank software functionality, therefore RISK is none.
Routine LRWLST1 will determine treating specialty based on the
associated TREATING SPECIALTY field (#9.5) in the HOSPITAL LOCATION file
(#44) when the patient is not an inpatient. When a patient is an inpatient
then treating specialty will be determined from the PATIENT file (#2),
TREATING SPECIALTY field (.103). Treating specialty will only be stored
in ACCESSION file (#68) when the patient is from PATIENT file (#2).
16. The following defects were identified during the software review as
part of patch development.
a. Ordering location and ordering provider will not be stored on
accessions that are related to LAB CONTROL NAME file (#62.3) entries.
b. During accessioning if accession area is locked by another process,
the message displayed to user was "Accession area is locked by another
user." Message will now include the name of the accession area that
the software is waiting on lock.
c. Interim report options and displays will display month portion of
EFFECT ON BLOOD BANK FUNCTIONAL REQUIREMENTS: Patch LR*5.2*286 does not
date/times using the three letter abbreviation instead of the two number
designation to eliminate potential confusion with day portion of dates.
Time is displayed using 24 hour time format.
d. Interim report could display the wrong ordering and collecting site
when the specimen was received from an integrated facility. Report will
display the correct ordering and collecting site.
e. Referral Patient Multi-purpose Accession option [LR LEDI] was
prompting the user for CPRS Nature of Order which is not used during
alter or modify any software design safeguards or safety critical elements
accessioning of non-PATIENT file (#2) patients. Routine LROW3 is
modified to only prompt the user for CPRS Nature of Order when
accessioning a patient from the PATIENT file (#2).
f. Previous test versions of previous LEDI versions may have installed
two versions of the "D" cross reference in LAB PENDING ORDERS ENTRY file
(#69.6). The post-install will delete and reindex the "D" cross reference
on file #69.6.
g. Entering of accession number during lab results verification will
functions.
check for invalid values or numbers out of range (1-999999).
17. Referral Patient Multi-purpose Accession option [LR LEDI] will check
for pending orders when performing accessioning without a bar code scanner.
It will display to the user and store order comments that accompanies
electronic orders with order in LAB ORDER ENTRY file (#69).
18. When using the Enter/verify/modify data (manual) option [LRENTER] to
amend previously released results user can now enter their verifying
initials in mixed case.
19. NOIS CHS-0303-40534 reported a defect which prevented results for
reflex tests added to a LEDI order at the host laboratory being returned
electronically to the collecting laboratory. Routine LRWLST11 was storing
the collecting site as both the collecting site and ordering site in the
order created in LAB ORDER ENTRY file (#69). When a collecting site is a
member of an integrated facility the collecting site is the site collecting
the specimen and the ordering site is the primary facility of the
integrated institution. Reflex test added by the host site would have the
incorrect ordering site assigned which prevents the LEDI software from
controlled by VHA DIRECTIVE 99-053, titled VISTA BLOOD BANK SOFTWARE
POTENTIAL IMPACT ON SITES: This patch contains changes to a Data
returning the results of the reflex test to the collecting facility. Defect
has been corrected to store the correct ordering and collecting sites on
LEDI accessions.
20. NOIS BRK-0499-10720, MAR-0603-21152 reported a defect during lab
result verification using option Enter/verify/modify data (manual)
[LRENTER] which caused the previous patient demographics to be displayed
when entering results on an accession. If the previous selected accession
was in an uncollected state, the option was skipping the uncollected
accession and incrementing the default accession number to the next
Dictionary identified in Veterans Health Administration (VHA) Directive
available accession. If the user selects this or another accession, the
patient demographics of the selected accession were not being displayed.
Instead, the patient demographics of the uncollected accession were
displayed. Routine LRVER will now display the patient demographics of the
currently selected accession.
21. NOIS SFC-1103-60132 reported a defect during display of lab results
in the CPRS GUI. When a critical flag becomes part of the data for a
patient in CPRS, the line of data containing the flag becomes split
after the * following the high or low flag, and the units along with
99-053. The changes have no effect in Blood Bank functionality or medical
the reference range gets bumped to the next line down. Routine LR7OGMP
increases the space allocated to display this information from 37 to 38
characters to display units/normals on same line.
22. When displaying results that are a Set of Codes data type, the result
will be displayed using the external value for the set of codes.
23. NOIS NYH-0700-11942 reported a defect with critical value flag not
being triggered when entering a value of 0. Value of 0 will be evaluated
when performing high/low/critical value checks.
device control functions. There is no adverse potential to sites.
24. When verifying results from a reference laboratory using Enter/verify
data (auto instrument) option [LRVR], any test results that have not
been verified will be displayed to the user after verification. The display
will list the test names, results, abnormal flags and units if available.
This display will list the test(s) as not reviewed. This may indicate that
additional or reflex testing has been added by the reference laboratory.
These additional tests may need to be added to the accession to process
these results.
25. During verification of laboratory results, comments for a previous
result are displayed along with the previous result when entering
results manually or by automated instrument for user selected tests
(E3R #18490). Users can indicate which tests should have previous
test comments displayed during verification by flagging the test using
General Lab User Parameters option [LR USER PARAM] located on the
Information-help menu [LRHELP].
26. NOIS SDC-0904-61304 Reported a defect with the display of text
results in CPRS when using the Laboratory Results-All Test By Date and
VALIDATION REQUIREMENTS BY OPTION: There are no required validation
Laboratory Results-Selected Tests By Date. When a text result was
displayed that exceeded 10 characters and the test has no units or
normals specified, the display of the result was corrupted with <spaces>
inserted into the text. Test results will be displayed without corruption.
Units, reference ranges, and site codes will be displayed on the following
line when test results print in area usually reserved for these parameters.
27. NOIS IND-0498-42538 reported a defect in display of test comments during
lab test result verification when encountering an 'end-of-page' condition.
All test comments will now be displayed.
scenarios to be completed by sites after installing LR*5.2*286.
PATIENT SAFETY ISSUES RESOLVED IN THIS PATCH:
============================================
PSI-040260/NOIS HVH-0604-10572 - "Not Performed test Resulted
- No Alert Generated"
This patch corrects defects in software used to set laboratory tests
to a Not-Performed (NP) state. The NP state was introduced by patch
LR*5.2*221 in 1999. The functionality introduced by this patch replaced
the "delete-a-test" functionality. Instead of deleting tests, tests are
now set to a not-performed state.
However, tests in the NP state could still be edited such that the NP
state is replaced with an actual result. Results entered into NP tests
were not treated in the same manner as results entered through the normal
results entry pathways. File updates to ACCESSION file (#68), LAB ORDER
ENTRY file (#69), and ORDER file (#100) as well as alerts were not
generated. This situation was documented in NOIS HVH-0604-10572
========================================
- "Not Performed test Resulted - No Alert Generated". This was identified
as a potential patient safety risk. With concurrence from the Pathology
& Laboratory Medicine Program Office, the appropriate mechanism for
handling the situation is to disable editing of NP tests. If the test is
designated as NP and the user wants to edit the test result, they will
now have to order the test(s) in a new accession.
ASSOCIATED E3R
--------------
E3R #13408, ADDING INFECTION WARNING TO PROCESS DATA OPTIONS
E3R #16060, CORRECT ALIGNMENT PROBLEM
E3R #17904, LEDI BETWEEN VA AND DOD SITES
E3R #18490, COMMENTS DISPLAY FORPRVIOUS RESULTS
ASSOCIATED NOIS
---------------
ALB-0100-50284
BRK-0499-10720
VERSION 5.2. Change includes:
Patch LR*5.2*286 VA/DOD LAB INTEROPERABILITY will be distributed and
BON-0196-71728
CHS-0303-40534
DAY-0303-40775
DEN-1299-52099
FAV-1103-70892
HVH-0604-10572
IND-0498-42538
MAR-0603-21152
NYH-0700-11942
PHI-0803-21507
installed with patch LA*5.2*64 VA/DOD LAB INTEROPERABILITY
SDC-0904-61304
SFC-1103-60132
TAM-0400-31033
WPB-0900-32221
TEST SITES
----------
Albuquerque VAMC - VMS/DSM and VMS/Cache
Boston HCS - VMS/DSM and VMS/Cache
El Paso HCS - NT/Cache and VMS/Cache
Hines VAMC - VMS/DSM and VMS/Cache
Honolulu VAMC - NT/Cache
Manchester VAMC - NT/Cache NT and VMS/Cache
Milwaukee VAMC - VMS/DSM
North Chicago VAMC - VMS/DSM
Salt Lake City VAMC - VMS/DSM
San Diego VAMC - VMS/DSM and VMS/Cache
Upstate New York HCS - VMS/DSM and VMS/Cache
This patch adds support for sending/receiving Laboratory Electronic
INSTALLATION FILES:
==================
The following software and documentation files are exported as part of
this patch:
File Name Contents Retrieval Format
--------- -------- ----------------
LAB_LEDI_III.KID LA*5.2*64 KIDS build ASCII
Data Interchange (LEDI) orders/results with Department of Defense (DoD)
LR*5.2*286 KIDS build
LAB_LEDI_III_IG.PDF LABORATORY ELECTRONIC DATA BINARY
INSTALLATION GUIDE
LAB_LEDI_III_IMP_UG.PDF LABORATORY ELECTRONIC DATA BINARY
IMPLEMENTATION AND USER GUIDE
The files listed above may be obtained via FTP. The preferred method is
facilities.
to FTP the files from:
download.vista.domain.ext
This transmits the files from the first available FTP server. Sites may
also elect to retrieve software directly from a specific server as
follows:
CIO FIELD OFFICE FTP ADDRESS DIRECTORY
---------------- ------------------------- --------------------
Albany ftp.fo-albany.domain.ext [anonymous.software]
Hines ftp.fo-hines.domain.ext [anonymous.software]
Salt Lake City ftp.fo-slc.domain.ext [anonymous.software]
ROUTINE SUMMARY
===============
The following routines are included in this patch. The second line
of each of these routines now looks like:
<tab> ;;5.2;LAB SERVICE;<patchlist>;Sep 27, 1994
Laboratory result verification has been enhanced to allow the designation
Checksum Checksum
Routine Name Before Patch After Patch Patch List
------------ ------------ ----------- ------------
LR286 N/A 5465218 **286** (Deleted by KIDS)
LR7OB63 9973912 9132350 **121,187,286**
LR7OGM 8016197 8279122 **187,220,312,286**
LR7OGMC 5100174 5463477 **187,230,312,286**
LR7OGMG 3593445 3973477 **187,230,286**
LR7OGMP 5548341 6065382 **187,246,282,286**
of a performing laboratory and the use of the performing laboratory's
LR7OR2 9125008 8919494 **121,187,219,285,286**
LR7OSUM1 12883059 12868699 **121,187,256,286**
LR7OSUM6 7911216 5450631 **121,201,187,286**
LRAFUNC 5202410 5809534 **286**
LRDIDLE0 5463932 6544739 **140,171,153,286**
LRDPAREF 5111405 7469302 **153,222,286**
LRDPAREX 7190033 6456580 **153,286**
LREVENT 3678954 2907416 **153,286**
LRFAST 19691126 18799737 **100,121,201,286**
LRFASTS 6423167 6524547 **30,95,121,271,286**
units, normals, and normalcy status in results reporting.
LRGP1 3988622 4165501 **112,269,286**
LROE 14550901 11534796 **100,121,201,221,263,286**
LRORD 12009917 12806626 **100,121,153,286**
LRORD1 9848796 9190513 **1,8,121,153,201,286**
LRORDB 3782224 7231598 **153,222,286**
LROW3 7497722 6459972 **33,121,286**
LRRP 11838355 9427993 **195,221,283,286**
LRRP1 8015031 6556852 **153,221,283,286**
LRRPU N/A 3220194 **286**
LRSTUF1 13209134 11668378 **153,286**
The addition of the "USE FOR REFERENCE TESTING" field (#13) to the
LRVER 17228890 15441873 **153,286**
LRVER1 8587449 7330679 **42,153,201,215,239,240,
263,232,286**
LRVER3 14311842 13055299 **42,100,121,140,171,153,
221,286**
LRVER4 19639169 14489554 **14,42,112,121,140,171,
153,188,279,283,286**
LRVER5 14564045 14854455 **42,153,283,286**
LRVERA 690805 5764794 **153,271,286**
LRVR 13316120 11130012 **42,153,263,286**
1. User during the verification process is able to specify the performing
LRVR1 11269859 11667912 **42,153,221,286**
LRVR3 10486080 11176919 **42,121,153,286**
LRVR4 8885642 9645653 **14,42,121,153,221,263,
279,283,287,286**
LRVR5 11950773 4666781 **1,42,153,263,283,286**
LRWLST1 18457202 12664045 **48,65,121,153,261,286**
LRWLST11 21393713 16883055 **121,128,153,202,286**
List of preceding patches: 187, 202, 222, 230, 232, 256, 261, 269, 271
282, 283, 285, 287, 312
laboratory. The performing laboratory is selected from the list of
Sites should use CHECK^XTSUMBLD to verify checksums.
INSTALLATION INSTRUCTIONS
=========================
See LABORATORY ELECTRONIC DATA INTERCHANGE III (LEDI III) INSTALLATION GUIDE
LA*5.2*64/LR*5.2*286
available entries in the site's INSTITUTION file (#4). The selection of
entries is screened as follows:
a. User can select the division they are logged on.
b. User can select an institution that is configured in the LAB
SHIPPING CONFIGURATION file (#62.9) as a host facility with their
division as the collecting facility.
"SITE/SPECIMEN SUB-FIELD" (#60.01) of the LABORATORY TEST file (#60).
2. During acceptance and verification of results received from a reference
laboratory via an HL7 interface (LEDI), the performing laboratory, results,
units, normals and normalcy status contained in the HL7 message are stored
"as is".
3. Receipt of amended reports from a reference laboratory will generate a
MailMan bulletin containing the particulars of the amended report. This
bulletin is sent to the members of the mail group specified for
"New Result" alerts in LA7 MESSAGE PARAMETER file (#62.48) for the interface.
The addition of the "USE FOR REFERENCE TESTING" field to the "LR ATOMIC
4. Amended reports received via a LEDI HL7 interface can be processed
via the Enter/verify/modify data (manual) option [LRENTER].
5. Users using the Enter/verify/modify data (manual) option [LRENTER] to
enter results manually from a reference laboratory can use the units and
normals specified in LABORATORY TEST file (#60) by configuring USE FOR
REFERENCE TESTING field (#13) within the SITE/SPECIMEN subfile (#100).
If this field is not enabled for reference laboratory result data entry,
then the user is prompted for units, normals, high and low reference ranges
to store with the results. The Edit atomic tests option [LRDIEATOMIC]
TESTS" Input Template.
allows Labortory Information Manager (LIM) to designate this functionality
for affected tests.
6. NOIS DEN-1299-52099, NYH-0700-11942, PHI-0803-21507, TAM-0400-31033, and
WPB-0900-32221 reported the defect of normalcy status (low/high/critical
low/critical high) being incorrectly evaluated when the test result is
zero (0). Evaluation of normalcy status will properly deal with test
results of zero (0).
7. Changing normalcy status and units will trigger the generation of audit
trail comments.
8. During verification, the ordering provider's phone and pager information
is displayed.
9. Display of lab results in the Computerized Patient Record System
Graphical User Interface (CPRS GUI) and Laboratory Interim Reports has
been modified to display units and normals associated with results at time
of verification. Results that are derived from a Set of Codes will be
reported using the external form of the code.
The above change has been reviewed by the VISTA Blood Bank Developer and
10. Display of performing laboratory has been added to CPRS GUI display of
results.
11. NOIS DAY-0303-40775 reported a defect in display of lab results with
embedded spaces. When lab results contained embedded spaces these spaces
were being removed prior to the display of the lab result. The removal of
theses spaces resulted in corruption of the result. Routines LR7OB63 and
LR7OR2 have been corrected to trim leading and trailing spaces but leave
embedded spaces.
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