Select PATCH: PX*1*201    VISTA IMMUNIZATION ENHANCEMENTS 1.0           VER AM

DEVICE: HOME// ;80;9999  SSH VIRTUAL TERMINAL

VistA Patch Display                                                   Page: 1
=============================================================================
Run Date: JAN 21, 2015                      Designation: PX*1*201
Package : PCE PATIENT CARE ENCOUNTER        Priority   : MANDATORY
Version : 1 SEQ #155                        Status     : RELEASED
                         Compliance Date: DEC 26, 2014
=============================================================================

Associated patches: (v)PX*1*199    <<= must be installed BEFORE `PX*1*201'
                    

Subject:  VISTA IMMUNIZATION ENHANCEMENTS 1.0

Category:  ENHANCEMENT
           DATA DICTIONARY
           ROUTINE
           OTHER

Description:
===========
 
 
**********************************************************************
NOTE:  This patch contains updates to the Data Dictionary for several 
files that are also used by Indian Health Service.  In order to 
maintain compatibility with the Indian Health Service version of these 
files, fields used by Indian Health Service that will not be used by 
the Department of Veterans Affairs have been included.  In some cases, 
these fields reference files and/or routines that will not be deployed 
by the Department of Veterans Affairs.  These fields are included with 
the VA's Database Administrator's approval.
**********************************************************************
 
The Veterans Health Information Systems and Technology Architecture
(VistA) Immunizations Enhancements (VIMM) 1.0 project modifies existing
immunization files and adds additional files to enable VA to quickly and
reliably document and exchange standardized immunization information on
beneficiaries across services and departments. Additionally, modifications
support Certification for Meaningful Use as well as VistA Evolution
requirements. This provides a Veteran patient-centric vaccine record
exchangeable with the external community. Clinicians will have access to a
more complete medical history in the VistA electronic medical record
resulting in improved health status as well as public health monitoring.
 
The goals for the VIMM 1.0 project are to deliver an Initial Operating
Capability comprised of standard, interoperable immunization data for
exchange with external trading partners based on the modernization of
the VistA Patient Care Encounter (PCE) package.
 
This patch provides the following new features:
 
1) The vaccines in the IMMUNIZATION (#9999999.14) file are standardized to
   match the Center for Disease Control (CDC)'s table of administered
   vaccines at 
   http://www2a.cdc.gov/vaccines/iis/iisstandards/vaccines.asp?rpt=cvx. 
 
   During the post installation, records in the IMMUNIZATION file are
   modified and new immunization records are added to mirror entries 
   from the CDC table. Existing records are assigned a Vaccine
   Administered (CVX) code. CVX codes are developed and maintained by the
   CDC. They identify the type of vaccine product used.
 
   A new field (CLASS) has been added to identify each record as NATIONAL
   or LOCAL. Only records with a CLASS of NATIONAL are selectable. The
   NAME and INACTIVE FLAG of NATIONAL records will be updated to match the
   CDC Standard. Other CDC information has been added to the record for
   future use.
 
   There may be more than one record with the same CVX code. A record is 
   selected as the standard based on the following selection rules:
   o An entry that does not have the INACTIVE FLAG marked will be given 
     precedence over an entry that is marked INACTIVE.
   o An entry that was distributed nationally with the immunization
     package will be given precedence over an entry that was created
     locally.
   o An entry that was created in the VistA instance where this patch
     is being installed will be given precedence over an entry imported
     from another VAMC. 
   o ACTION/RECOMMENDATION: In order to guide the program to selecting a
     facility's choice on which of two conflicting entries for the same
     CVX code will be marked as NATIONAL, for any entries in the
     IMMUNIZATION file that represent the same concept, mark all except
     one of them as INACTIVE.
 
   If a record is not the standard, the CLASS will be set to LOCAL and 
   (HISTORICAL) will be appended to the name. The INACTIVE FLAG will be
   set to INACTIVE.
 
2) Data stored in the DIAGNOSIS (#.08) field in the V IMMUNIZATION 
   (#9000010.11) file are moved to a new field, PRIMARY DIAGNOSIS (#1304).
   This field is blank in most records. Values stored in DIAGNOSIS 2
   (#.09), DIAGNOSIS 3 (#.1), DIAGNOSIS 4 (#.11), DIAGNOSIS 5 (#.12),
   DIAGNOSIS 6 (#.13), DIAGNOSIS 7 (#.14) and DIAGNOSIS 8 (#.15) are moved
   to the multiple OTHER DIAGNOSES (#3).
 
3) The options, PXTT EDIT IMMUNIZATIONS and PXTT IN/ACTIVATE IMMUNIZATION 
   have been placed out of order. Future updates to the IMMUNIZATION file
   will be provided in the short term by patches. In the long term the
   IMMUNIZATION file will be maintained by the Master File Server.
 
4) Indian Health Service (IHS) fields have been included in the files for 
   this patch for purposes of code convergence, even though the VA does
   not use them. Of those fields, the following point to files or call
   routines that are included in the IHS Resource and Patient Management
   System (RPMS) but not in VistA:
  
   File Name (Number)   Field Name (Number)        IHS File/Routine
   ------------------   -------------------        ----------------
   V IMMUNIZATION  
      (#9000010.11)     VAC ELIGIBILITY (#.14)     BI TABLE ELIGIBILITY
                                                      CODES (#9002084.83)
                        NDC (#.16)                 BI TABLE NDC CODES 
                                                        (#9002084.95)
   IMMUNIZATION             
      (#9999999.14)     VACCINE GROUP (SERIES      BI TABLE VACCINE GROUP
                           TYPE) (#.09)               (SERIES TYPE)
                                                      (#9002084.93)
                        BRAND #1 (#1.01)           BIUTL5
                        BRAND #2 (#1.03)           BIUTL5
                        BRAND #3 (#1.05)           BIUTL5
                        BRAND #4 (#1.07)           BIUTL5
                        BRAND #5 (#1.09)           BIUTL5
 
   IMMUNIZATION LOT 
      (#9999999.41)     NDC CODE (#.17)            BI TABLE NDC CODES 
                                                      (#9002084.95)
 
Patch Components: 
----------------- 
 
Files & Fields Associated:
 
File Name (Number)     Field Name (Number)           New/Modified/Deleted
------------------     -------------------           --------------------
VACCINE INFORMATION
   STATEMENT (#920)    NAME (#.01)                          New
                       EDITION DATE (#.02)                  New
                       EDITION STATUS (#.03)                New
                       LANGUAGE (#.04)                      New
                       VIS TEXT (#2)                        New
                       REPLACED BY VHA STANDARD TERM 
                          (#99.97)                          New
                       MASTER ENTRY FOR VUID (#99.98)       New
                       VUID (#99.99)                        New
                       EFFECTIVE DATE/TIME (multiple field
                          #99.991, sub-file #920.99)        New
                         EFFECTIVE DATE/TIME (#.01) of
                           the EFFECTIVE DATE/TIME 
                           sub-file (#920.99)               New
                         STATUS (#.02) of the EFFECTIVE
                           DATE/TIME sub-file (#920.99)     New
                       VIS URL (#101)                       New
 
IMMUNIZATION INFO 
   SOURCE (#920.1)     SOURCE (#.01)                        New
                       HL7 CODE (#.02)                      New
                       STATUS (#.03)                        New
 
IMM ADMINISTRATION 
   ROUTE (#920.2)      ROUTE (#.01)                         New
                       HL7 CODE (#.02)                      New
                       NCIT (#.03)                          New
 
IMM ADMINISTRATION SITE 
   (BODY) (#920.3)     SITE (#.01)                          New
                       HL7 CODE (#.02)                      New
 
V IMMUNIZATION  
   (#9000010.11)       IMMUNIZATION (#.01)                Modified
                       PATIENT NAME (#.02)                Modified
                       VISIT (#.03)                       Modified
                       SERIES (#.04)                      Modified
                       LOT (#.05) )                         New
                       REACTION (#.06)                      New
                       CONTRAINDICATED (#.07)             Modified
                       DIAGNOSIS (#.08)                   Deleted
                       DIAGNOSIS 2 (#.09)                 Deleted
                       DIAGNOSIS 3 (#.1)                  Deleted
                       DIAGNOSIS 4 (#.11)                 Deleted
                       DIAGNOSIS 5 (#.12)                 Deleted
                       DIAGNOSIS 6 (#.13)                 Deleted
                       DIAGNOSIS 7 (#.14)                 Deleted
                       DIAGNOSIS 8 (#.15)                 Deleted
                       DOSE OVERRIDE (#.08)                 New
                       INJECTION SITE (#.09)                New
                       VOLUME (#.11)                        New
                       DATE OF VAC INFO STATEMENT (#.12)    New
                       CREATED BY V CPT ENTRY (#.13)        New
                       VAC ELIGIBILITY (#.14)               New
                       IMPORT FROM OUTSIDE REGISTRY (#.15)  New
                       NDC (#.16)                           New
                       ADMINISTRATIVE NOTES (#1)            New
                       VIS OFFERED/GIVEN TO PATIENT
                          (multiple field #2, sub-file 
                          #9000010.112)                     New
                         VIS OFFERED/GIVEN TO PATIENT 
                           (#.01) of the VIS OFFERED/GIVEN 
                           TO PATIENT sub-file 
                           (#9000010.112)                   New
                         DATE VIS OFFERED/GIVEN (#.02) of 
                           the VIS OFFERED/GIVEN TO PATIENT
                           sub-file (#9000010.112)          New
                       OTHER DIAGNOSIS (multiple field #3,
                          sub-file #9000010.113)            New
                         OTHER DIAGNOSIS (#.01) of the
                           OTHER DIAGNOSIS sub-file 
                           (#9000010.113)                   New
                       REMARKS (#1101)                      New
                       EVENT DATE AND TIME (#1201)        Modified
                       ORDERING PROVIDER (#1202)          Modified
                       CLINIC (#1203)                       New
                       ENCOUNTER PROVIDER (#1204)         Modified
                       DATE/TIME RECORDED (#1205)           New
                       IMMUNIZATION DOCUMENTER (#1206)      New
                       LOT NUMBER (#1207)                   New
                       PARENT (#1208)                       New
                       EXTERNAL KEY (#1209)                 New
                       OUTSIDE PROVIDER NAME (#1210)        New
                       ANCILLARY POV (#1213)                New
                       USER LAST UPDATE (#1214)             New
                       ORDERING LOCATION (#1215)            New
                       DATE/TIME ENTERED (#1216)            New
                       ENTERED BY (#1217)                   New
                       DATE/TIME LAST MODIFIED (#1218)      New
                       LAST MODIFIED BY (#1219)             New
                       EVENT INFORMATION SOURCE (#1301)     New
                       ROUTE OF ADMINISTRATION (#1302)      New
                       SITE OF ADMINISTRATION (BODY) 
                          (#1303)                           New
                       PRIMARY DIAGNOSIS (#1304)            New
                       DOSAGE (#1305)                       New
                       SNOMED CT (multiple field #2601,
                          sub-file #9000010.1126)           New
                       SNOMED CT (#.01) of the SNOMED CT
                          sub-file (#9000010.1126)          New
                       SNOMED PREFERRED TERM (#.019) of
                          the SNOMED CT sub-file 
                          (#9000010.1126)                   New
                       LOINC CODES (multiple field #2701,
                          sub-file #9000010.1127)           New
                       LOINC CODES (#.01) of the LOINC
                          CODES sub-file (#9000010.1127)    New
                       LOINC TEXT (#.019) of the LOINC 
                          CODES sub-file (#9000010.1127)    New 
                       EDITED FLAG (#80101)               Modified
                       AUDIT TRAIL (#80102)               Modified
                       COMMENTS (#81101)                  Modified
                       VERIFIED (#81201)                  Modified
                       PACKAGE (#81202)                   Modified
                       DATA SOURCE (#81203)               Modified
 
IMM MANUFACTURER  
   (#9999999.04)       NAME (#.01)                          New
                       MVX CODE (#.02)                      New
                       STATUS (#.03)                        New
                       FULL NAME (#.04)                     New
                       SYNONYM #1 (#.05)                    New
                       REPLACED BY VHA STANDARD TERM    
                          (#99.97)                          New
                       MASTER ENTRY FOR VUID (#99.98)       New
                       VUID (#99.99)                        New
                       EFFECTIVE DATE/TIME (multiple field
                          #99.991, sub-file #9999999.0499)  New
                         EFFECTIVE DATE/TIME (#.01) of
                           the EFFECTIVE DATE/TIME 
                           sub-file (#9999999.0499)         New
                         STATUS (#.02) of the EFFECTIVE
                           DATE/TIME sub-file 
                           (#9999999.0499)                  New
                       CDC NOTES (#201)                     New
                       VACCINE (multiple field #1101,
                          sub-file #9999999.0411)           New
                         VACCINE (#.01) of the VACCINE
                           sub-file (#9999999.0411)         New
                       MNEMONIC (#8801)                     New
 
IMMUNIZATION             
   (#9999999.14)       NAME (#.01)                        Modified
                       SHORT NAME (.02)                   Modified
                       CVX (#.03)                           New
                       DEFAULT LOT # (.04)                  New
                       MAX # IN SERIES (#.05)             Modified
                       CHILDHOOD IMMUNIZATION (#.06)        New
                       INACTIVE FLAG (#.07)               Modified
                       SKIN TEST (#.08)                     New
                       VACCINE GROUP (SERIES TYPE) (#.09)   New
                       ALTERNATE SHORT NAME (#.1)           New
                       CPT CODE (#.11)                      New
                       RELATED CONTRAIND HL7 CODES (#.12)   New
                       VIS DEFAULT DATE (#.13)              New
                       ICD DIAGNOSIS CODE (#.14)            New
                       ICD PROCEDURE CODE (#.15)            New
                       INCLUDE IN FORECAST (#.16)           New
                       INCLUDE IN VAC ACCOUNT REPORT (#.17) New
                       DEFAULT VOLUME (#.18)                New
                       COMBINATION IMMUNIZATION (Y/N) (#.2) New 
                       COMPONENT #1 (#.21)                  New
                       COMPONENT #2 (#.22)                  New
                       COMPONENT #3 (#.23)                  New
                       COMPONENT #4 (#.24)                  New
                       COMPONENT #5 (#.25)                  New
                       COMPONENT #6 (#.26)                  New
                       BRAND #1 (#1.01)                     New
                       BRAND #2 (#1.03)                     New
                       BRAND #3 (#1.05)                     New
                       BRAND #4 (#1.07)                     New
                       BRAND #5 (#1.09)                     New
                       FULL NAME (#1.14)                    New
                       CPT CODE 2ND (#1.15)                 New
                       CDC FULL VACCINE NAME (#.01) 
                          of the CDC FULL VACCINE 
                          NAME sub-file (#9999999.142)      New
                       CODING SYSTEM (#.01) of the
                          CODING SYSTEM sub-file 
                          (#9999999.143)                    New
                       CODE (#.01) of the CODE 
                          sub-file (#9999999.1431)
                          of the CODING SYSTEM 
                          sub-file (#9999999.143)           New
                       VACCINE INFORMATION STATEMENT
                          (#4)                              New
                       CDC PRODUCT NAM (#5)                 New
                       SYNONYM (#.01) of the SYNONYM
                          sub-file (#9999999.141)           New
                       REPLACED BY VHA STANDARD TERM 
                          (#99.97)                          New
                       MASTER ENTRY FOR VUID (#99.98)       New
                       VUID (#99.99)                        New
                       EFFECTIVE DATE/TIME (multiple field
                          #99.991, sub-file #9999999.1499)  New
                         EFFECTIVE DATE/TIME (#.01) of
                           the EFFECTIVE DATE/TIME 
                           sub-file (#9999999.1499)         New
                         STATUS (#.02) of the EFFECTIVE
                           DATE/TIME sub-file 
                           (#9999999.1499)                  New
                       CLASS (#100)                         New
                       MNEMONIC (#8801)                   Modified
                       ACRONYM (#8802)                      New
                       SELECTABLE FOR HISTORIC (#8803)      New
 
IMMUNIZATION LOT 
   (#9999999.41)       LOT NUMBER (#.01)                    New
                       MANUFACTURER (#.02)                  New
                       STATUS (#.03)                        New
                       VACCINE (#.04)                       New
                       VACCINE #2 (#.05)                    New
                       VACCINE #3 (#.06)                    New
                       VACCINE #4 (#.07)                    New
                       VACCINE #5 (#.08)                    New
                       EXPIRATION DATE (#.09)               New
                       STARTING COUNT (#.11)                New
                       DOSES UNUSED (#.12)                  New
                       VACCINE SOURCE (#.13)                New
                       HEALTH CARE FACILITY (#.14)          New
                       LOW SUPPLY ALERT (#.15)              New
                       LOT NUMBER FOR EXPORT (#.16)         New
                       NDC CODE (#.17)                      New
                       NDC CODE (VA) (#.18)                 New
 
Forms Associated:
 
Form Name                    File #               New/Modified/Deleted
---------                    ------               --------------------
N/A 
 
Mail Groups Associated:
 
Mail Group Name          New/Modified/Deleted
---------------          --------------------
N/A 
 
Options Associated:
 
Option Name                     Type             New/Modified/Deleted
-----------                     ----             -------------------- 
PXTT EDIT IMMUNIZATIONS         Edit                  Modified
PXTT IN/ACTIVATE IMMUNIZATION   Edit                  Modified
 
Protocols Associated:
 
Protocol Name       New/Modified/Deleted
-------------       -------------------- 
N/A 
 
Security Keys Associated:
 
Security Key Name
-----------------
 
Templates Associated:
 
Template Name      Type      File Name (Number)  New/Modified/Deleted 
-------------      ----      ------------------  --------------------
N/A 
 
Additional Information:
N/A 
 
New Service Requests (NSRs):
----------------------------  
N/A 
 
Patient Safety Issues (PSIs):
-----------------------------
N/A 
 
Blood Bank Clearance:
---------------------
N/A
 
Remedy Ticket(s) & Overview:
----------------------------
N/A 
 
Test Sites:
----------
Cleveland, OH
Hampton, VA
Heartland-East HCS, MO
San Antonio, TX
 
 
Documentation Retrieval Instructions:
------------------------------------- 
Updated documentation describing the new functionality introduced by this 
patch is available.
 
The preferred method is to FTP the files from 
ftp://download.DNS      .DNS/.
This transmits the files from the first available FTP server. Sites may 
also elect to retrieve software directly from a specific server as 
follows:
 
 Albany         DNS.URL         <DNS.URL       >
 Hines          .DNS     .URL          /DNS     .URL       >
 Salt Lake City DNS.URL            <DNS.URL       >
 
Documentation can also be found on the VA Software Documentation Library 
at:
http://URL            /
 
Title                           File Name           FTP Mode
-------------------------------------------------------------
Patient Care Encounter (PCE)    PXUM.PDF            (binary)
   V. 1.0 User Manual
Patient Care Encounter (PCE)    PXTM.PDF            (binary)
   V.1.0 Technical Manual
 
 
Patch Installation:
 
Pre/Post Installation Overview:
-------------------------------
This patch will run a brief pre-installation process that will check for 
invalid entries in the IMMUNIZATION file (#9999999.14) and will delete 
field definitions for replaced fields in the V IMMUNIZATION file 
(#9000010.11). A post-installation process will standardize data in the 
IMMUNIZATION file (#9999999.14) and will move data from exiting diagnosis 
fields in the V IMMUNIZATION file (#9000010.11) to new fields. The 
routine, PXVP201, may be deleted after the patch is successfully
installed.
 
Pre-Installation Instructions:
------------------------------
N/A
 
Installation Instructions:
--------------------------
This patch should be installed during a period of minimal system 
activity, preferably with users off the system. Installation time is 
expected to be approximately 10 minutes.
 
This patch is available via FTP as a KIDS distribution file. The Host
File is named PX_1_201.KID and should be downloaded in ASCII format. 
The file is located in the [ANONYMOUS.SOFTWARE] directory of the following
OI Field Offices.
    
                               PREFERRED ADDRESS
                               -----------------
 First available ftp server    download.DNS      .URL
 
 SPECIFIC FIELD OFFICE         FTP ADDRESS
 ---------------------         -----------
 Albany                        DNS.URL       
 Hines                         DNS     .URL       
 SLC                           DNS.URL       
 
1. Load the KIDS distribution file via the 'Load a Distribution' option 
   on the KIDS Installation menu.
 
2. Prior to installing the patch use the following installation options 
   located on the KIDS Installation menu:
 
   a.  Verify Checksums in Transport Global - This option will allow
       you to ensure the integrity of the routines that are in the
       transport global.
 
   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.  Backup a Transport Global - This option will create a backup
       message of any routines exported with this patch. It will not
       backup any other changes such as DD's or templates.
 
3. Install the KIDS distribution via the 'Install Package(s)' option on 
   the KIDS Installation menu. For the Install Name enter PX*1.0*201.
 
   a.  When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of 
       Install? NO//'
       Answer NO.
 
   b.  When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//
       Answer NO.
 
   c.  When prompted 'Want to DISABLE Scheduled Options, Menu Options, and
       Protocols? NO//'
       Answer NO. 
 
4.  Verify the status of the installation.  An email message is sent to 
    the installer at the end of the installation indicating whether the
    installation was successful. Please enter a Remedy ticket if the 
    installation failed.
   
 
Post-Installation Instructions:
-------------------------------
N/A


Routine Information:
====================


The second line of each of these routines now looks like:
 ;;1.0;PCE PATIENT CARE ENCOUNTER;**[Patch List]**;Aug 12, 1996;Build 41

The checksums below are new checksums, and
 can be checked with CHECK1^XTSUMBLD.

Routine Name: PXCEAE1
    Before: B16220510   After: B23079983  **22,73,199,201**
Routine Name: PXCEVFI4
    Before: B26873797   After: B28425692  **124,203,199,201**
Routine Name: PXCEVIMM
    Before: B31390321   After: B56314311  **27,124,199,201**
Routine Name: PXKFIMM
    Before:  B2638532   After:  B2843857  **22,124,201**
Routine Name: PXVP201
    Before:       n/a   After: B70774804  **201**
Routine Name: PXVPST01
    Before:       n/a   After:  B4321227  **201**
Routine Name: PXVUTIL
    Before:       n/a   After:  B3032993  **201**


=============================================================================
User Information:  
  Entered By  :   MONOSKY,ALAN         Date Entered  :   APR 14,2014
  Completed By:   DANE,SIDNEY          Date Completed:   NOV 26,2014
  Released By :   BARFIELD,RICHARD     Date Released :   NOV 26,2014
=============================================================================


