4449. EPMO Open Source Coordination Office Redaction File Detail Report

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4449.1 Files compared

# Location File Last Modified
1 Fri Jun 9 19:51:38 2017 UTC
2 eHealth_Exch (eHealth Exchange Enhancements) Build 3 docs & code_May_2017.zip\VAP_CIF_CODE0502.zip\VAP_CIF_CODE0502\VAP_CIF_CODE0502\nvap-web\src\main\webapp\WEB-INF\web authorizeNwHIN.jsp Fri Apr 21 20:03:30 2017 UTC

4449.2 Comparison summary

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4449.5 Comparison detail

        1   <%@taglib  uri="http: //java.sun .com/jsp/j stl/core"  prefix="c" %>
        2   <%@taglib  uri="http: //java.sun .com/jsp/j stl/functi ons" prefi x="fn"%>
        3   <%@taglib  uri="http: //java.sun .com/jsp/j stl/fmt" p refix="fmt "%>
        4   <%@taglib  tagdir="/W EB-INF/tag s/cpp" pre fix="cpp"% >
        5   <%@taglib  tagdir="/W EB-INF/tag s/date" pr efix="date "%>
        6  
        7   <%--
        8           on Load="opt. init(docum ent.multiS electListF orm); setF ocus(multi SelectList Form.authe nticatingF acility);  --%>
        9   <div>
        10       <p cla ss="detail Text">
        11           Th e Departme nt of Vete rans Affai rs (VA) is
        12           on ly capable  of sharin g Veteran  electronic  health in formation  with
        13           no n-VA healt h care pro viders par ticipating  in <c:out  value="${ organizati onName}"/> . 
        14           So me health  care provi ders parti cipate in  <c:out val ue="${orga nizationNa me}"/> by 
        15           co ntracting  with a hea lth inform ation exch ange. By c ompleting  the 
        16           Au thorizatio n on VA Fo rm 10-0485 , the Vete ran is aut horizing V A to 
        17           sh are his/he r health i nformation  for treat ment purpo ses with a ll non-VA 
        18           he alth care  provider o rganizatio ns partici pating in  <c:out val ue="${orga nizationNa me}"/> 
        19           an d partneri ng with VA .
        20       </p>
        21       <p cla ss="detail Text">
        22           <s trong>DO N OT</strong > initiate  an author ize action  unless yo u have a v alid
        23           au thorizatio n on file  for the pa tient. NOT E: VA pati ent inform ation
        24           is  always sh ared with  the DoD. < strong>DO  NOT</stron g> authori ze DoD
        25           pa tients, on ly announc e the Vete ran.
        26       </p>
        27   </div>
        28  
        29   <div class ="form-con tainer">
        30       <field set>
        31           <l egend>Auth orize</leg end>
        32           <f orm name=" multiSelec tListForm"  id="multi SelectList Form" acti on="Patien tDetails.d o_sec" met hod="POST"  enctype=" multipart/ form-data"  onsubmit= "return do Submit(thi s)">
        33                <div>
        34                    <inp ut type="r adio" name ="consentG roup" id = "consentGr oup" value ="authoriz eAll" onCl ick="formH ide('multi SelectAuth orizeForm' )" checked >
        35                    <lab el for="co nsentGroup " style="t ext-align:  left; wid th: auto;  margin-rig ht: 0px; p adding-rig ht: 0px; f loat: none ; display:  inline;"> Authorized : </label>
        36                    The  Veteran au thorizes t he sharing  of his/he r electron ic health
        37                    info rmation wi th non-VA  health car e provider  organizat ions
        38                    part icipating  in <c:out  value="${o rganizatio nName}"/>  and partne ring with  VA for 
        39                    trea tment purp oses. The  VA will im mediately  share Vete ran 
        40                    elec tronic hea lth inform ation.
        41                </div>
        42                <br /> < br />
        43                <input t ype="text"  name="hid denText" s tyle="visi bility:hid den;displa y:none;" d isabled="d isabled" / >
        44                <input t ype="hidde n" name="i cn" value= "<c:out va lue="${pat ientDemogr aphics.icn }"/>" /> < input type ="hidden"  name="requ estId" val ue="<c:out  value="${ requestId} "/>" /> 
        45                <input t ype="hidde n" name="n ewLeft" va lue="" /> 
        46                <input t ype="hidde n" name="n ewRight" v alue="" />  
        47                <input t ype="hidde n" name="c onsentType " value="N wHIN Autho rization"  />
        48                <input t ype="hidde n" name="p urposeOfUs e" value=" TREATMENT"  />
        49                <input t ype="hidde n" name="e xpirationY ears" valu e="10" />
        50                <input t ype="hidde n" id="isD elayed" na me="isDela yed" value ="<c:out v alue="${de layedNwHIN Auth}"/>"  />
        51                
        52                <div id= "columndiv " style="m argin:0px  auto; widt h:100%">
        53                    <div  id="colum n1" style= "float:lef t; margin: 0; width:6 5%;">
        54                         <div>
        55                             <label  for="auth enticating Facility"> Authentica ting Facil ity<img al t="Require d field" s rc="res/st ar-icon_gr ey_bg.png"  /></label > 
        56                             <selec t id="auth enticating Facility"  name="user Facility"  style="wid th: 250px;  overflow:  auto;">
        57                                 <c :forEach v ar="f" ite ms="${allo wedFacilit ies}">
        58                                      <option  value="<c: out value= "${f.facil ityStation }"/>"
        59                                          <c:c hoose>
        60                                               <c:when te st="${f.fa cilityStat ion eq def aultUserFa cility.fac ilityStati on}">
        61                                                   select ed
        62                                               </c:when>
        63                                               <c:when te st="${cook ie.facilit y.value ==  f.facilit yStation}" >
        64                                                   select ed
        65                                               </c:when>
        66                                          </c: choose>>
        67                                          <c:c hoose>
        68                                               <c:when te st="${f.fa cilityName  != ''}">
        69                                               <c:out val ue="${f.fa cilityName }"/>
        70                                          </c: when>
        71                                               <c:otherwi se>
        72                                               ${fn:split (f.facilit yDns, '.') [0]}
        73                                          </c: otherwise>
        74                                          </c: choose>
        75                                          (<c: out value= "${f.facil ityStation }"/>)
        76                                      </option >
        77                                 </ c:forEach>
        78                             </sele ct> 
        79                             <br />  <br />
        80                         </div>
        81                         <div>
        82                             <label  for="opti on1">10-04 85 Form Va lidation<i mg alt="Re quired fie ld" src="r es/star-ic on_grey_bg .png" /></ label> 
        83                             <input  type="che ckbox" tit le="select  Form Vali dation che ckbox if A uthorizati on Form 10 -0485 was  received a nd validat ed. requir ed field"  onclick="e nableAutho rizeAfterV alidation( 'signature Date', 'op tion1', 'A uthorize') ;" name="o ption1" va lue="Autho rization F orm Receiv ed and Val idated" id ="option1" >
        84                             Author ization Fo rm Receive d and Vali dated
        85                             <br />  <br />
        86                         </div>
        87                         <div>
        88                             <label  for="sign atureDate" >Patient S ignature D ate<img al t="Require d field" s rc="res/st ar-icon_gr ey_bg.png"  /></label >
        89                             <date: date id="s ignatureDa te" name=" signatureD ate" onkey up="enable AuthorizeA fterValida tion('sign atureDate' , 'option1 ', 'Author ize');"/>  <i>mm/dd/y yyy</i>
        90                             <br /> <br />
        91                         </div>
        92                         <c:choose>
        93                             <c:whe n test="${ isFormUplo adAllowed} ">
        94                                 <d iv>
        95                                      <label f or="file"> Upload Con sent Form< br /> <i>< span style ="font-wei ght: norma l;">(Max f ile size:  <c:out val ue="${maxF ileUploadS ize/100000 0}"/> mega bytes)</sp an> </i> < /label>
        96                                      <input t itle="Brow se and Upl oad Consen t Form" na me="upload ed" type=" file" id=" file" acce pt="applic ation/pdf"  />
        97                                 </ div>
        98                             </c:wh en>
        99                         </c:choose >
        100                    </di v>
        101                    <div  id="delay edFields"  style="dis play:block ;">
        102                         <div id="c olumn2" st yle="float :left; mar gin:0; wid th:10%;">
        103                             <stron g>-OR-</st rong>
        104                         </div>
        105                         <div id="c olumn3" st yle="float :left; mar gin:0; wid th:25%;">
        106                             <input  type="che ckbox" tit le="Select  if author ization is  delayed"  onclick="e nableDelay edReasons( );" name=" delayedVal ue" value= "Delay thi s authoriz ation" id= "delayedVa lue" />
        107                             <label  for="dela yedValue"  style="flo at: none;  display: i nline;">
        108                                 De lay this a uthorizati on &nbsp;< /label> <b r /> <br / >
        109                            <div st yle="visib ility: hid den" id="d elayReason s">
        110                                <la bel for="r easonsForD elay" id=" reasonsLab el" style= "text-alig n: left">  <%-- name= "reasonsLa bel" --%>
        111                                     Reason fo r delay
        112                                     <img alt= "Required  field" src ="res/star -icon_grey _bg.png" / >
        113                                 </ label>
        114                                <in put type=" hidden" na me="collec tedReasons " id="coll ectedReaso ns" />
        115                                <in put type=" checkbox"  title="For m not sign ed" aria-l abelledby= "reasonsLa bel" name= "reasonsFo rDelay" id ="reasonsF orDelay1"  onclick="c ollectDela yedReasons (this); en ableAuthor izeAfterVa lidation(' delayedVal ue', 'reas onsForDela y', 'Autho rize');" v alue="1" / >
        116                                For m not sign ed<br/>
        117                                <in put type=" checkbox"  title="For m content  altered" a ria-labell edby="reas onsLabel"  name="reas onsForDela y" id="rea sonsForDel ay2" oncli ck="collec tDelayedRe asons(this ); enableA uthorizeAf terValidat ion('delay edValue',  'reasonsFo rDelay', ' Authorize' );" value= "2" />
        118                                For m content  altered<br />
        119                                <in put type=" checkbox"  title="Dem ographic c hanges" ar ia-labelle dby="reaso nsLabel" n ame="reaso nsForDelay " id="reas onsForDela y3" onclic k="collect DelayedRea sons(this) ; enableAu thorizeAft erValidati on('delaye dValue', ' reasonsFor Delay', 'A uthorize') ;" value=" 3" />
        120                                Dem ographic c hanges<br/ >
        121                                <in put type=" checkbox"  title="Pri vacy Offic er review"  aria-labe lledby="re asonsLabel " name="re asonsForDe lay" id="r easonsForD elay4" onc lick="coll ectDelayed Reasons(th is); enabl eAuthorize AfterValid ation('del ayedValue' , 'reasons ForDelay',  'Authoriz e');" valu e="4" />
        122                                Pri vacy Offic er review< br/>
        123                                <in put type=" checkbox"  title="Sig nature ver ification"  aria-labe lledby="re asonsLabel " name="re asonsForDe lay" id="r easonsForD elay5" onc lick="coll ectDelayed Reasons(th is); enabl eAuthorize AfterValid ation('del ayedValue' , 'reasons ForDelay',  'Authoriz e');" valu e="5" />
        124                                Sig nature ver ification< br/>
        125                                <in put type=" checkbox"  title="Pow er of Atto rney not o n file" ar ia-labelle dby="reaso nsLabel" n ame="reaso nsForDelay " id="reas onsForDela y6" onclic k="collect DelayedRea sons(this) ; enableAu thorizeAft erValidati on('delaye dValue', ' reasonsFor Delay', 'A uthorize') ;" value=" 6" />
        126                                Pow er of Atto rney not o n file
        127                            </div>
        128                         </div>
        129                    </di v>
        130                </div>
        131                <div cla ss="clearf ix"></div>
        132                <div>
        133                    <lab el for="co mments">Co mments</la bel>
        134                    <spa n style="d isplay: no ne;">Patie nt Comment s not a re quired fie ld</span>
        135                    <tex tarea id=" comments"  name="comm ents" styl e="width:  300px; hei ght: 60px; "></textar ea>
        136                    <br  />
        137                </div>
        138                <br />
        139                <div ali gn="center ">
        140                    <inp ut id="Aut horize" cl ass="butto n" type="s ubmit" dis abled="dis abled" val ue="Author ize" name= "optIn" ti tle="Autho rize" />
        141                </div>
        142           </ form>
        143       </fiel dset>
        144   </div>

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