| DESCRIPTION OF ENHANCEMENTS |
Description:
*************************************************************************
the AUTOPSY SUPPLEMENTARY REPORT for Autopsy. The field is a flag, when
set to '1', indicates a released supplementary report is being modified,
and has not yet been released.
63.207,.03 RELEASE SUPP REPORT MODIFIED 0;3 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: SEP 08, 2004
DESCRIPTION: This flag will be set to '1' when a
************************************
released supplementary report is modified. It is
removed when the modified supplementary report is
released.
63.817,.03 RELEASE SUPP REPORT MODIFIED 0;3 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: SEP 08, 2004
DESCRIPTION: This flag will be set to '1' when a
released supplementary report is modified. It is
removed when the modified supplementary report is
released.
63.907,.03 RELEASE SUPP REPORT MODIFIED 0;3 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: SEP 08, 2004
DESCRIPTION: This flag will be set to '1' when a
BLOOD BANK CLEARANCE
released supplementary report is modified. It is
removed when the modified supplementary report is
released.
63.324,.03 RELEASE SUPP REPORT MODIFIED 0;3 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: SEP 08, 2004
DESCRIPTION: This flag will be set to '1' when a
====================
released supplementary report is modified. It is
removed when the modified supplementary report is
released.
Modifications:
--------------
The following options have been modified. Please refer to the User
Guide distributed with this patch for detailed information and examples.
Supplementary Report, Anat Path [LRAPDSR] option
Supplementary report release, anat path [LRAPRS] option
Autopsy supplementary report [LRAPAUSR] option
Modify released pathology report [LRAPMRL] option
Print all reports on queue [LRAP PRINT ALL ON QUEUE] option
Print single report only [LRAP PRINT SINGLE] option
Print final path reports by accession # [LRAPFICH] option
This patch addresses the following E3R's:
========================================
VISTA Laboratory Package patch LR*5.2*317 contains changes to
N/A
This patch addresses the following NOIS / Remedy Ticket:
=======================================================
BRX-0704-11083 / HD0000000070862
CPH-0904-40215 / HD0000000070983
MIA-0604-31201 / HD0000000070788
PRO-0604-10213 / HD0000000070762
SLC-0604-50484 / HD0000000070766
software controlled by VHA DIRECTIVE 2004-053, titled VISTA BLOOD
SLC-0604-50594 / HD0000000070769
SLC-0604-51082 / H00000000070778
Overview of NOIS / Remedy Tickets:
=================================
BRX-0704-11083 / HD0000000070862
Problem: Pathologists are complaining about changes in procedure done
by the Electronic Signature patch. When a supplemental report is added
BANK SOFTWARE. Changes include:
the system un-verifies the parent report. This unverified report becomes
available for other Pathologists and transcriptionists to edit it. Before
once a report was verified it could not be changed. The Chief Pathologist
is very concerned with the legal and clinical ramifications of this change.
Resolution: The resolution of this issue is contained in the section
above that describes the resolution to patient safety issues #1 and #2.
CPH-0904-40215 / HD0000000070983 -
Problem: Our pathologists are concerned that post patch 259, addition of
File Sub-file Field Field Name Action
supplemental reports (additional information) must be added under MM Modify
option, thus un-releasing the original report, and necessitating the
re-release of both original and supplemental reports. They feel modified
reports should be reserved for edition/correction of previous released
reports. They feel this is a patient safety issue.
The post 259 options [LRAPDSR] and [LRAPDSS] are redundant when they are
operable only with un-released reports.
Resolution: The resolution of this issue is contained in the section
above that describes the resolution to patient safety issues #1 and #2.
===========
---- -------- ----- ---------- ------
MIA-0604-31201 / HD0000000070788 -
Problem: According to our lab folks in Anatomic path they used to go in to
an option called Supplementary Report, Anat Path to make a correction to
the original after it is released. They don't want to go under the edit
modify to reopen the report any ideas on how they can go into the
supplementary to attach to the original accession report or something like
that.
Resolution: The resolution of this issue is contained in the section
63 63.207 .03 RELEASE SUPP REPORT MODIFIED New Field
above that describes the resolution to patient safety issues #1 and #2.
PRO-0604-10213 / HD0000000070762 -
Problem: Our LAB Service Chief does not want IRM to install patch
LR*5.2*259 for the following Patient Safety, integrity, and additional
keystrokes reasons. For example the Surgical Pathology Reports, the new
patch, takes the Supplemental report feature away (ie. For a special
stain), it's replaced with a modified report feature, which allows you to
make changes to the original report in addition to adding. Also, while
using the modify report feature, while your in it, it makes the original
63 63.324 .03 RELEASE SUPP REPORT MODIFIED New Field
report unavailable for the Providers to view. He feels that this is a
Major Patient Safety issue, that if a Doctor is with the patient, he won't
be able to view the report.
Resolution: The resolution of this issue is contained in the section
above that describes the resolution to patient safety issues #1 and #2.
SLC-0604-50484 / HD0000000070766 -
Problem: I've just reviewed the NOIS MEM-0504-71296, and we are struggling
with the same issues of supplementary reports that they are. (Post install
63 63.817 .03 RELEASE SUPP REPORT MODIFIED New Field
of patch LR*5.2*259). We currently do not have the electronic signature
turned on. The concern is, that once a report is unreleased, the
previously released portion of the report is not viewable on CPRS, and the
way we operate here is that the secretaries transcribe the report, and the
pathologist signs them sometime later. We have only had the patch
installed for a couple of days, and the path lab has already received calls
that reports have "disappeared" on CPRS ... are there any suggestions for a
process change that could help with this?
Resolution: The resolution of this issue is contained in the section
63 63.907 .03 RELEASE SUPP REPORT MODIFIED New Field
above that describes the resolution to patient safety issues #1 and #2.
SLC-0604-50594 / HD0000000070769 -
Problem: Post installation of LA*5.2*259 we have encountered the usual
problems with any software install that changes the daily routine of
workflow, but there is a problem that we feel does affect patient care .
We now have to "unrelease" a report prior to adding a supplementary report,
the secretaries then transcribe the supplemental report, then the
pathologists must review/correct and sign it prior to the secretaries
re-releasing the report. This leaves a window of several hours during
which the original report is not viewable on the computer, we have already
received calls about "disappearing" path reports. Our pathologists feel
that a supplemental report should truly be regarded as an addendum to the
original report, and should not make the original report unviewable while
the supplemental report is being processed.
Resolution: The resolution of this issue is contained in the section
above that describes the resolution to patient safety issues #1 and #2.
SLC-0604-51082 / H00000000070778 -
All of the above changes have been reviewed by the VISTA Blood Bank
Problem: We have found a problem with the electronic signature patch. Our
transcriptionist mistakenly selected the field to add a date to the
supplementary report field (thru edit/modify), but didn't add text to the
free text field. He was unable to sign a supplementary report (the
computer says it doesn't exist), but when he tries to release the original
report, it says that the supplementary needs to be released first. The lab
figured out a way to release this, but it is an issue.
Resolution: The resolution of this issue is contained in the section
above that describes the resolution to patient safety issues #1 and #2.
Developer and found to have no impact on the VISTA BLOOD BANK
TEST SITES
==========
Ann Arbor VAMC - CACHE/VMS, large site
Boston HCS - CACHE/VMS, large integrated site
Long Beach VAMC - CACHE/VMS, large site
Providence VAMC - CACHE/VMS, medium site
Salem VAMC - CACHE/VMS, medium site
SOFTWARE control functions.
ROUTINE SUMMARY:
================
The following is a list of the routines included in this patch.
The second line of each of these routines look like:
<tab> ;;5.2;LAB SERVICE;**<patch list>;Sep 27, 1994
Using old logic:
CHECK^XTSUMBLD results
Routine Before After
Name Patch Patch Patch List
----------- -------- --------- ----------------------------
LR317 N/A 6221288 **317** (DELETED BY KIDS)
LR7OSAP 16576063 17166196 **121,187,230,256,259,317**
LR7OSAP1 8012437 8222916 **121,227,230,259,317**
LR7OSAP2 17315095 18146154 **230,256,259,317**
LRAPAUSR 7980343 8097532 **1,173,248,259,317**
LRAPBR1 8346961 8691424 **259,317**
LRAPBR4 5636439 5950657 **259,317**
RISK ANALYSIS: Changes made by patch LR*5.2*317 have no effect on
LRAPD1 5673315 5050395 **41,91,248,259,317**
LRAPDA 11977101 13331988 **72,73,91,121,248,259,295,317**
LRAPDSR 4820936 5708731 **248,259,295,317**
LRAPMRL 8314291 8358357 **259,295,317**
LRAPMRL1 4140484 5097223 **259,317**
LRAPR 12791716 12536700 **72,248,259,317**
LRAPR1 N/A 5253992 **317**
LRAPRES 10849835 10161024 **259,295,317**
LRAPV 3996189 4248185 **72,201,259,317**
LRSPRPT 12082607 12449414 **1,72,248,259,317**
Blood Bank software functionality, therefore RISK is none.
Using new logic:
CHECK1^XTSUMBLD results
Routine Before After
Name Patch Patch Patch List
----------- -------- --------- ----------------------------
LR317 N/A 18182916 **317** (DELETED BY KIDS)
LR7OSAP 34114559 37919526 **121,187,230,256,259,317**
LR7OSAP1 24974232 26109314 **121,227,230,259,317**
LR7OSAP2 52834321 59162352 **230,256,259,317**
LRAPAUSR 34065623 34793694 **1,173,248,259,317**
LRAPBR1 54673575 58834636 **259,317**
LRAPBR4 30127062 32957954 **259,317**
LRAPD1 24077474 22198195 **41,91,248,259,317**
LRAPDA 64317056 76606340 **72,73,91,121,248,259,295,317**
LRAPDSR 17788838 25438900 **248,259,295,317**
LRAPMRL 66524711 21952067 **259,295,317**
LRAPMRL1 15484610 21952067 **259,317**
LRAPR 89817361 84430863 **72,248,259,317**
EFFECT ON BLOOD BANK FUNCTIONAL REQUIREMENTS: Patch LR*5.2*317 does
LRAPR1 N/A 19317428 **317**
LRAPRES 103360947 94733481 **259,295,317**
LRAPV 13932043 15077938 **72,201,259,317**
LRSPRPT 88845330 92562557 **1,72,248,259,317**
NOTE: LR317 will be deleted after successful patch installation.
SOFTWARE RETRIEVAL:
===================
not alter or modify any software design safeguards or safety
Software Retrieval
------------------
VistA Laboratory Anatomic Pathology Modifications/Enhancements
to Address PSI-04-025 Patch LR*5.2*317 software is distributed by
Packman.
Documentation Retrieval
-----------------------
VistA Laboratory Anatomic Pathology (AP) Modifications/Enhancements
critical elements functions.
to Address PSI-04-025 Patch LR*5.2*317 User Guide is available at the
following Office of Information Field Offices (OIFOs) ANONYMOUS.SOFTWARE
directories:
OI 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]
Documentation Retrieval Formats
-------------------------------
VistA Laboratory Anatomic Pathology Supplementary Report Enhancements
Patch LR*5.2*317 User Guide files are exported in the following retrieval
formats:
File Name Contents Retrieval Formats
--------- -------- -----------------
LAB_52_317_UG.doc VistA Laboratory Anatomic Pathology
POTENTIAL IMPACT ON SITES: This patch contains changes to 0
(AP) Modifications/Enhancements
to Address PSI-04-025 Patch
LR*5.2*317 User Guide BINARY
LAB_52_317_UG.pdf VistA Laboratory Anatomic Pathology
(AP) Modifications/Enhancements
to Address PSI-04-025 Patch
LR*5.2*317 User Guide BINARY
VistA Website Locations:
routines and 1 file identified in Veterans Health Administration
-----------------------
VistA Laboratory Anatomic Pathology (AP) Modifications/Enhancements
to Address PSI-04-025 Patch LR*5.2*317 User Guide is accessible in
MS Word (.doc) and Portable Document Format (.pdf) at the following
VistA locations:
Laboratory Version 5.2 Home Page
--------------------------------
http://vista.domain.ext/ClinicalSpecialties/lab/
(VHA) Directive 2004-053, group B listing. The changes have no
VistA Documentation Library (VDL)
---------------------------------
www.domain.ext/vdl/
INSTALLATION INSTRUCTIONS
=========================
This patch can be installed with users on the system. However, it is
recommended that installation occur when there is no Anatomic Pathology
activity or activity is at a minimum. This will prevent 'Cannot return to
************************************
effect on Blood Bank functionality or medical device control
source routine' errors. The Anatomic Pathology menu will be disabled
automatically by this patch and re-enabled after installation.
Install Time - less than 5 minutes.
PRE-INSTALLATION INSTRUCTIONS
=============================
***************************************************************************
*** IT IS VERY IMPORTANT THAT YOU FOLLOW THE PRE-INSTALLATION ***
functions. There is no adverse potential to sites.
*** INSTRUCTIONS BEFORE INSTALLING THE PATCH. ***
*** ***
*** All outstanding (unreleased) supplementary reports from July 23, ***
*** 2003, the date LR*5.2*259 Anatomic Pathology Electronic Signature ***
*** patch was first installed in a production account, until the present***
*** MUST be released before installing this patch. If there are ***
*** unverified supplementary reports, THE PATCH WILL NOT INSTALL. ***
*** ***
*** The appropriate Laboratory personnel should check for unverified ***
*** supplementary reports and make sure all are reviewed and released ***
*** before proceeding with this installation. The following option ***
*** can be used to check for outstanding unreleased supplementary ***
*** reports: List of unverified pathology reports [LRAPV] option. ***
*** Selection #2 will create a listing of unverified supplementary ***
*** reports. ***
**************************************************************************
**************************************************************************
1. LOAD TRANSPORT GLOBAL
---------------------------------------
VALIDATION REQUIREMENTS BY OPTION:
Choose the PackMan message containing this patch and invoke the
INSTALL/CHECK MESSAGE PackMan option.
2. START UP KIDS
Start up the Kernel Installation and distribution System
Menu [XPD MAIN]:
Edits and Distribution ...
Utilities ...
Installation ...
Select Kernel Installation & Distribution System Option: INStallation
There are no validation requirements associated with this patch.
----
1 Load a Distribution
2 Verify Checksums in Transport Global
3 Print Transport Global
4 Compare Transport Global to Current System
5 Backup a Transport Global
6 Install Package(s)
Restart Install of Package(s)
Unload a Distribution
DD DD, 2nd Line Comparison
Select Installation Option:
3. Select Installation Option:
-------------------------------
NOTE: The following are OPTIONAL - (When prompted for the
INSTALL NAME, enter LR*5.2*317):
a. Backup a Transport Global - This option will create a
backup message of any routines exported with this patch.
MINIMAL TEST CASE SCENARIOS BY OPTION, INCLUSIVE OF ALL CONTROL FUNCTIONS:
It will not backup any other changes such as DD's or templates.
b. Compare Transport Global to Current System - This option
will allow you to view all changes that will be made when this
patch is installed. It compares all components of this patch
(routines, DD's, 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.
4. Select Installation Option: Install Package(s)
There are no test case scenarios associated with this patch.
------------------
**This is the step to start the installation of this KIDS patch:
a. Choose the Install Package(s) option to start the patch install.
(When prompted for the INSTALL NAME, enter LR*5.2*317.)
b. When prompted 'Want KIDS to INHIBIT LOGONs during the install?
YES//' answer NO (unless otherwise indicated)
c. When prompted 'Want to DISABLE Scheduled Options, Menu Options,
and Protocols? YES//' answer NO (unless otherwise indicated)
5. If you have any unreleased supplementary reports from July 23, 2003
until the present, the install will abort. To print the unreleased
supplementary reports, you can print the install file.
Here's an example:
Select Kernel Installation & Distribution System Option: utilities
Select Utilities Option: install File Print
Select INSTALL NAME: lr*5.2*317 Loaded from Distribution 8/25/06@14:37:36
=================
DEVICE: HOME// ;;1000 UCX/TELNET
PACKAGE: LR*5.2*317 Aug 25, 2006 2:39 pm PAGE 1
COMPLETED ELAPSED
---------------------------------------------------------------------------
INSTALLED BY: IRM,PERSON
NATIONAL PACKAGE: LAB SERVICE
INSTALL STARTED:
*************************************************************************
ROUTINES:
PRE-INIT CHECK POINTS:
XPD PREINSTALL STARTED
XPD PREINSTALL COMPLETED
FILES:
LAB DATA
VistA Laboratory Anatomic Pathology (AP) Modifications/Enhancements patch
POST-INIT CHECK POINTS:
XPD POSTINSTALL STARTED
XPD POSTINSTALL COMPLETED
MESSAGES:
Sending transport global loaded alert to mail group G.LMI
Unreleased supplemental report(s) from July 23,2003 until present- must
LR*5.2*317 addresses two patient safety issues (PSI) reported in PSI-04-025
be released before install.
Name: TEST,PATIENT Accession: NSP 04 2
--- Install Environment Check FAILED
---
LR*5.2*317 Build will not be installed
that arose from the release and implementation of the VistA Laboratory
Aug 25, 2006@14:38:55
Select Utilities Option:
**NOTE: Routine LR317 will be deleted after successful patch installation.
Anatomic Pathology Electronic Signature Patch LR*5.2*259.
The patient safety issues are described as follows:
1. Users that should not be allowed to modify an Anatomic Pathology SF515 or
Autopsy Protocol released report are given access to the Modify released report
SPECIAL NOTE:
[LRAPMRL] option in order to allow the user to add supplementary reports.
2. The original Anatomic Pathology SF515 or Autopsy Protocol report is not
viewable in the Computer Patient Records System (CPRS) during the time a
supplementary report is underway. Personnel are unable to view the report
during this time.
The VistA Laboratory Anatomic Pathology Electronic Signature Patch
LR*5.2*259 changed the location and the method by which supplementary
reports are added. The Modify released report [LRAPMRL] option is used to add
Installation of this patch MUST be coordinated with Laboratory personnel.
supplementary reports to the original report. Laboratory personnel allowed to
add supplementary reports to Anatomic Pathology released reports must have
access to the Modify released report [LRAPMRL] option. This access opened up
the potential for errors in which the report could be accidentally modified
when a supplementary report was added.
Patch LR*5.2*317 resolves this problem by removing the supplementary report
addition functionality from the Modify released reports [LRAPMRL] option and
placing the functionality back to the Supplementary Report, Anat Path
[LRAPDSR] option for Cytology, Electron Microscopy, and Surgical Pathology
The Pre-Installation instructions within the Installation Section below,
released reports and the Autopsy supplementary report [LRAPAUSR] option for
Autopsy released reports.
Another concern had to do with the addition of a supplementary report to a
released Anatomic Pathology report, which unreleased the original report and
made it unavailable for viewing in Computerized Patient Record System (CPRS).
The time span in which the original report remained unavailable for viewing by
the Providers could be crucial. It was considered a major patient safety issue
if a doctor, who was with a patient, was not able to view the report at that
time.
MUST be followed and completed before installation can begin.
Patch LR*5.2*317 resolves this problem by leaving the original report in
released status during the time a supplementary report is being added. The
original report remains available for viewing in CPRS during this time.
Enhancements to LAB DATA file (#63):
-------------
A new field, RELEASE SUPP REPORT MODIFIED (#.03), has been added to the
SUPPLEMENTARY REPORT SUB-FILE for the anatomic pathology sections
Cytopathology, Electron Microscopy, and Surgical Pathology; and to
|
