| DESCRIPTION OF ENHANCEMENTS |
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
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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
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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
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- 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
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