VistApedia - User contributions [en]

CPRS Installation

2016-07-09T14:29:52Z

Anthracite:

__TOC__

This page [[record~|Record]]s the process of installation of the [[CPRSComputerized Patient Record System]] Graphical User Interface client program on the [[Microsoft Windows OS]].

=== [[CPRS~|CPRS]] Versions ===

This table will list links for the various [[CPRS~|CPRS]] versions. (The most current version is at the top)

{| class="grey" border="1" cellpadding="2"
|+ [[CPRS~|CPRS]] Versions
|-
! Version Number
! Distribution File
! Availability
! Date
|-
| version 1.0.27.90
| OR-3_SEQ-273_PAT-296.ZIP
| http://foia-vista.osehra.org/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/OR-3_SEQ-273_PAT-296.ZIP Download folder on the OSEHRA site]
| 8/2009
|-
| version 1.0.27.83
| OR_30_304.ZIP
| [http://foia-vista.osehra.org/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/or_30_304.zip Download folder on OSEHRA site]
| 11/2008 Emergency Correction of Patient Safety Issues
|-
| version 1.0.27.77
| OR_30_243.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer/OR_30_243.ZIP or Download folder OSEHRA site http://foia-vista.osehra.org/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/OR_30_243.ZIP]
| 08/2008
|-
| version 1.0.26.69
| OR_30_270.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server] or
[https://downloads.va.gov/files/FOIA/Software/VistA_FOIA_Historical_Files/VISTA_FOIA_RELEASES_BEFORE_2008/OR-Order%20Entry-Results%20Reporting/ Download folder on VA site]
|-
| version 1.0.26.69
| for WorldVistA EHR
| on the Sourceforge WorldVistA EHR site and http://opensourcevista.net:8888/NancysVistAServer
| (dated June 2007)

|-
| version 1.0.26.68
| OR_30_258.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| Note Below (NB):(dated July 17, 2006)
|-
| version 1.0.25.42
| OR_30_235.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated July 09, 2005) Note: Replace .25.40 with .25.42 for patient safety
|-
| version 1.0.25.40
| OR_30_231.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated May 06, 2005)
|-
| version 1.0.25.28
| OR_30_195.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Feb 09, 2005)
|-
| version 1.0.24.27
| OR_30_224.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Sep 03, 2004)
|-
| version 1.0.24.26
| OR_30_190.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Aug 02, 2004)
|-
| version 1.0.23.15
| OR_30_187.ZIP
| *Sourceforge WorldVistA and [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 02/04)
|-
| version 1.0.22.16
| OR_30_206.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 01/04)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 11/02)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
|(dated about 11/02)
|-
| version 1.0.19.7
| OR_30_132.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 05/02)
|-
| version 1.0.18.2
| OR_30_125.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 12/01)
|}

----

=== version change trick ===
NB: There is a trick to making version 1.0.26.68. It is done for you in CPRSDir.zip which can be found along with the instructions for creating it at:

http://downloads.opensourcevista.net/VADemo9-26-06

To find out which version to use, look next to the option [[OPTION OR CPRS GUI CHART|named "OR CPRS GUI CHART"]] like this example where [[~|CPRS~|CPRS]] version 1.0.23.15 was needed:

D Q^DI

VA FileMan 22.0
Select OPTION: 5 INQUIRE TO FILE ENTRIES

OUTPUT FROM WHAT FILE: DEVICE// OPTION
1 OPTION (10126 entries)
2 OPTION SCHEDULING (116 entries)
CHOOSE 1-2: 1 OPTION (10126 entries)
Select OPTION NAME: OR CPRS GUI CHART CPRSChart version 1.0.23.15
ANOTHER ONE:

To use a particular version of [[CPRS~|CPRS]], the server-side software code must match. The files are found at ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ and the source code is in the "Programs" subdirectory of this directory

Thus:

[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/ <nowiki>ftp://ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ </nowiki>]

The Delphi source code for each of these (e.g. OR_30_235_SRC.ZIP) will be found in the subdirectory
[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/Programs/ <nowiki>...Packages/Order Entry-Results Reporting - OR/Programs/ </nowiki>]

The wget(1) utility is capable of fetching the files from this server

AceFTP is a freeware FTP program that works, if needed
http://software.visicommedia.com/en/productsfreeware/

''(In the past this FTP site could not be reached with Mozilla/Firefox. That has been corrected.)''
----

=== 1.0.26.69 (and TMG-CPRS) spoof --> 1.0.26.76 ===

Since the changes between 1.0.26.69 and 1.0.26.76 are relatively minor, in this case, version can be used by changing the option in the option file like this:

D P^DI

VA FileMan 22.0

Select OPTION: 1 ENTER OR EDIT FILE ENTRIES

INPUT TO WHAT FILE: OPTION//
EDIT WHICH FIELD: ALL//

Select OPTION NAME: OR [[CPRS~|CPRS]] GUI CHART [[CPRS~|CPRS]]Chart version 1.0.26.76
NAME: OR CPRS GUI CHART//
MENU TEXT: CPRSChart version 1.0.26.76 Replace 76 With 69
Replace
CPRSChart version 1.0.26.69
----
When using TMG-CPRS, another way of reaching the exact same result is to add ''' "SPOOF-VER=1.0.26.76" ''' to the end of the Windows shortcut to [[CPRS~|CPRS]] like so:

... S=192.168.xxx.xxx P=92xx CCOW=DISABLE SPOOF-VER=1.0.26.76

(This method has the (admittedly dubious) advantage of allowing ''both'' a CPRS v1.0.26.68 ''and'' a v1.0.26.76 to connect without changing the server side.

'''Caution:''' One needs to know that the two versions truly are compatible or be willing to risk nasty side-effects, perhaps even damage to the server's database.
----
=== SSH Tunnel ===
Communications between CPRS and the VistA server are not encrypted by default. Access/Verify Codes and all patient data are transmitted in the clear. However, these can be protected by setting up an encrypted "tunnel" between client and server.

[[Setting up an SSH Tunnel between CPRS & VistA]]
----
=== Automatic Windows Installer ===

The [http://sourceforge.net/projects/worldvistaautoi/files Astronaut] suite of automatic installers includes cprs, tmg-cprs and many other clients, available in point-click windows .exe installers. IP address and port number are entered by the user.
----
=== Wine/Crossover compatability ===

[[Wine/Crossover]]

CPRS Installation

2016-07-09T14:28:19Z

Anthracite:

__TOC__

This page [[record~|Record]]s the process of installation of the [[CPRSComputerized Patient Record System]] Graphical User Interface client program on the [[Microsoft Windows OS]].

=== [[CPRS~|CPRS]] Versions ===

This table will list links for the various [[CPRS~|CPRS]] versions. (The most current version is at the top)

{| class="grey" border="1" cellpadding="2"
|+ [[CPRS~|CPRS]] Versions
|-
! Version Number
! Distribution File
! Availability
! Date
|-
| version 1.0.27.90
| OR-3_SEQ-273_PAT-296.ZIP
| http://foia-vista.osehra.org/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/OR-3_SEQ-273_PAT-296.ZIP Download folder on the OSEHRA site]
| 8/2009
|-
| version 1.0.27.83
| OR_30_304.ZIP
| http://foia-vista.osehra.org/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/or_30_304.zip Download folder on OSEHRA site]
| 11/2008 Emergency Correction of Patient Safety Issues
|-
| version 1.0.27.77
| OR_30_243.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer/OR_30_243.ZIP or Download folder OSEHRA site http://foia-vista.osehra.org/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/OR_30_243.ZIP]
| 08/2008
|-
| version 1.0.26.69
| OR_30_270.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server] or
[https://downloads.va.gov/files/FOIA/Software/VistA_FOIA_Historical_Files/VISTA_FOIA_RELEASES_BEFORE_2008/OR-Order%20Entry-Results%20Reporting/ Download folder on VA site]
|-
| version 1.0.26.69
| for WorldVistA EHR
| on the Sourceforge WorldVistA EHR site and http://opensourcevista.net:8888/NancysVistAServer
| (dated June 2007)

|-
| version 1.0.26.68
| OR_30_258.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| Note Below (NB):(dated July 17, 2006)
|-
| version 1.0.25.42
| OR_30_235.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated July 09, 2005) Note: Replace .25.40 with .25.42 for patient safety
|-
| version 1.0.25.40
| OR_30_231.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated May 06, 2005)
|-
| version 1.0.25.28
| OR_30_195.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Feb 09, 2005)
|-
| version 1.0.24.27
| OR_30_224.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Sep 03, 2004)
|-
| version 1.0.24.26
| OR_30_190.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Aug 02, 2004)
|-
| version 1.0.23.15
| OR_30_187.ZIP
| *Sourceforge WorldVistA and [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 02/04)
|-
| version 1.0.22.16
| OR_30_206.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 01/04)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 11/02)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
|(dated about 11/02)
|-
| version 1.0.19.7
| OR_30_132.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 05/02)
|-
| version 1.0.18.2
| OR_30_125.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 12/01)
|}

----

=== version change trick ===
NB: There is a trick to making version 1.0.26.68. It is done for you in CPRSDir.zip which can be found along with the instructions for creating it at:

http://downloads.opensourcevista.net/VADemo9-26-06

To find out which version to use, look next to the option [[OPTION OR CPRS GUI CHART|named "OR CPRS GUI CHART"]] like this example where [[~|CPRS~|CPRS]] version 1.0.23.15 was needed:

D Q^DI

VA FileMan 22.0
Select OPTION: 5 INQUIRE TO FILE ENTRIES

OUTPUT FROM WHAT FILE: DEVICE// OPTION
1 OPTION (10126 entries)
2 OPTION SCHEDULING (116 entries)
CHOOSE 1-2: 1 OPTION (10126 entries)
Select OPTION NAME: OR CPRS GUI CHART CPRSChart version 1.0.23.15
ANOTHER ONE:

To use a particular version of [[CPRS~|CPRS]], the server-side software code must match. The files are found at ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ and the source code is in the "Programs" subdirectory of this directory

Thus:

[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/ <nowiki>ftp://ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ </nowiki>]

The Delphi source code for each of these (e.g. OR_30_235_SRC.ZIP) will be found in the subdirectory
[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/Programs/ <nowiki>...Packages/Order Entry-Results Reporting - OR/Programs/ </nowiki>]

The wget(1) utility is capable of fetching the files from this server

AceFTP is a freeware FTP program that works, if needed
http://software.visicommedia.com/en/productsfreeware/

''(In the past this FTP site could not be reached with Mozilla/Firefox. That has been corrected.)''
----

=== 1.0.26.69 (and TMG-CPRS) spoof --> 1.0.26.76 ===

Since the changes between 1.0.26.69 and 1.0.26.76 are relatively minor, in this case, version can be used by changing the option in the option file like this:

D P^DI

VA FileMan 22.0

Select OPTION: 1 ENTER OR EDIT FILE ENTRIES

INPUT TO WHAT FILE: OPTION//
EDIT WHICH FIELD: ALL//

Select OPTION NAME: OR [[CPRS~|CPRS]] GUI CHART [[CPRS~|CPRS]]Chart version 1.0.26.76
NAME: OR CPRS GUI CHART//
MENU TEXT: CPRSChart version 1.0.26.76 Replace 76 With 69
Replace
CPRSChart version 1.0.26.69
----
When using TMG-CPRS, another way of reaching the exact same result is to add ''' "SPOOF-VER=1.0.26.76" ''' to the end of the Windows shortcut to [[CPRS~|CPRS]] like so:

... S=192.168.xxx.xxx P=92xx CCOW=DISABLE SPOOF-VER=1.0.26.76

(This method has the (admittedly dubious) advantage of allowing ''both'' a CPRS v1.0.26.68 ''and'' a v1.0.26.76 to connect without changing the server side.

'''Caution:''' One needs to know that the two versions truly are compatible or be willing to risk nasty side-effects, perhaps even damage to the server's database.
----
=== SSH Tunnel ===
Communications between CPRS and the VistA server are not encrypted by default. Access/Verify Codes and all patient data are transmitted in the clear. However, these can be protected by setting up an encrypted "tunnel" between client and server.

[[Setting up an SSH Tunnel between CPRS & VistA]]
----
=== Automatic Windows Installer ===

The [http://sourceforge.net/projects/worldvistaautoi/files Astronaut] suite of automatic installers includes cprs, tmg-cprs and many other clients, available in point-click windows .exe installers. IP address and port number are entered by the user.
----
=== Wine/Crossover compatability ===

[[Wine/Crossover]]

CPRS Installation

2016-07-09T14:27:03Z

Anthracite:

__TOC__

This page [[record~|Record]]s the process of installation of the [[CPRSComputerized Patient Record System]] Graphical User Interface client program on the [[Microsoft Windows OS]].

=== [[CPRS~|CPRS]] Versions ===

This table will list links for the various [[CPRS~|CPRS]] versions. (The most current version is at the top)

{| class="grey" border="1" cellpadding="2"
|+ [[CPRS~|CPRS]] Versions
|-
! Version Number
! Distribution File
! Availability
! Date
|-
| version 1.0.27.90
| OR-3_SEQ-273_PAT-296.ZIP
| [http://foia-vista.osehra.org/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/OR-3_SEQ-273_PAT-296.ZIP Download folder on the OSEHRA site]
| 8/2009
|-
| version 1.0.27.83
| OR_30_304.ZIP
| http://foia-vista.osehra.org/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/or_30_304.zip Download folder on OSEHRA site]
| 11/2008 Emergency Correction of Patient Safety Issues
|-
| version 1.0.27.77
| OR_30_243.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer/OR_30_243.ZIP or Download folder OSEHRA site http://foia-vista.osehra.org/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/OR_30_243.ZIP]
| 08/2008
|-
| version 1.0.26.69
| OR_30_270.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server] or
[https://downloads.va.gov/files/FOIA/Software/VistA_FOIA_Historical_Files/VISTA_FOIA_RELEASES_BEFORE_2008/OR-Order%20Entry-Results%20Reporting/ Download folder on VA site]
|-
| version 1.0.26.69
| for WorldVistA EHR
| on the Sourceforge WorldVistA EHR site and http://opensourcevista.net:8888/NancysVistAServer
| (dated June 2007)

|-
| version 1.0.26.68
| OR_30_258.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| Note Below (NB):(dated July 17, 2006)
|-
| version 1.0.25.42
| OR_30_235.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated July 09, 2005) Note: Replace .25.40 with .25.42 for patient safety
|-
| version 1.0.25.40
| OR_30_231.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated May 06, 2005)
|-
| version 1.0.25.28
| OR_30_195.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Feb 09, 2005)
|-
| version 1.0.24.27
| OR_30_224.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Sep 03, 2004)
|-
| version 1.0.24.26
| OR_30_190.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Aug 02, 2004)
|-
| version 1.0.23.15
| OR_30_187.ZIP
| *Sourceforge WorldVistA and [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 02/04)
|-
| version 1.0.22.16
| OR_30_206.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 01/04)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 11/02)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
|(dated about 11/02)
|-
| version 1.0.19.7
| OR_30_132.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 05/02)
|-
| version 1.0.18.2
| OR_30_125.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 12/01)
|}

----

=== version change trick ===
NB: There is a trick to making version 1.0.26.68. It is done for you in CPRSDir.zip which can be found along with the instructions for creating it at:

http://downloads.opensourcevista.net/VADemo9-26-06

To find out which version to use, look next to the option [[OPTION OR CPRS GUI CHART|named "OR CPRS GUI CHART"]] like this example where [[~|CPRS~|CPRS]] version 1.0.23.15 was needed:

D Q^DI

VA FileMan 22.0
Select OPTION: 5 INQUIRE TO FILE ENTRIES

OUTPUT FROM WHAT FILE: DEVICE// OPTION
1 OPTION (10126 entries)
2 OPTION SCHEDULING (116 entries)
CHOOSE 1-2: 1 OPTION (10126 entries)
Select OPTION NAME: OR CPRS GUI CHART CPRSChart version 1.0.23.15
ANOTHER ONE:

To use a particular version of [[CPRS~|CPRS]], the server-side software code must match. The files are found at ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ and the source code is in the "Programs" subdirectory of this directory

Thus:

[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/ <nowiki>ftp://ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ </nowiki>]

The Delphi source code for each of these (e.g. OR_30_235_SRC.ZIP) will be found in the subdirectory
[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/Programs/ <nowiki>...Packages/Order Entry-Results Reporting - OR/Programs/ </nowiki>]

The wget(1) utility is capable of fetching the files from this server

AceFTP is a freeware FTP program that works, if needed
http://software.visicommedia.com/en/productsfreeware/

''(In the past this FTP site could not be reached with Mozilla/Firefox. That has been corrected.)''
----

=== 1.0.26.69 (and TMG-CPRS) spoof --> 1.0.26.76 ===

Since the changes between 1.0.26.69 and 1.0.26.76 are relatively minor, in this case, version can be used by changing the option in the option file like this:

D P^DI

VA FileMan 22.0

Select OPTION: 1 ENTER OR EDIT FILE ENTRIES

INPUT TO WHAT FILE: OPTION//
EDIT WHICH FIELD: ALL//

Select OPTION NAME: OR [[CPRS~|CPRS]] GUI CHART [[CPRS~|CPRS]]Chart version 1.0.26.76
NAME: OR CPRS GUI CHART//
MENU TEXT: CPRSChart version 1.0.26.76 Replace 76 With 69
Replace
CPRSChart version 1.0.26.69
----
When using TMG-CPRS, another way of reaching the exact same result is to add ''' "SPOOF-VER=1.0.26.76" ''' to the end of the Windows shortcut to [[CPRS~|CPRS]] like so:

... S=192.168.xxx.xxx P=92xx CCOW=DISABLE SPOOF-VER=1.0.26.76

(This method has the (admittedly dubious) advantage of allowing ''both'' a CPRS v1.0.26.68 ''and'' a v1.0.26.76 to connect without changing the server side.

'''Caution:''' One needs to know that the two versions truly are compatible or be willing to risk nasty side-effects, perhaps even damage to the server's database.
----
=== SSH Tunnel ===
Communications between CPRS and the VistA server are not encrypted by default. Access/Verify Codes and all patient data are transmitted in the clear. However, these can be protected by setting up an encrypted "tunnel" between client and server.

[[Setting up an SSH Tunnel between CPRS & VistA]]
----
=== Automatic Windows Installer ===

The [http://sourceforge.net/projects/worldvistaautoi/files Astronaut] suite of automatic installers includes cprs, tmg-cprs and many other clients, available in point-click windows .exe installers. IP address and port number are entered by the user.
----
=== Wine/Crossover compatability ===

[[Wine/Crossover]]

CPRS Installation

2016-07-09T14:23:20Z

Anthracite:

__TOC__

This page [[record~|Record]]s the process of installation of the [[CPRSComputerized Patient Record System]] Graphical User Interface client program on the [[Microsoft Windows OS]].

=== [[CPRS~|CPRS]] Versions ===

This table will list links for the various [[CPRS~|CPRS]] versions. (The most current version is at the top)

{| class="grey" border="1" cellpadding="2"
|+ [[CPRS~|CPRS]] Versions
|-
! Version Number
! Distribution File
! Availability
! Date
|-
| version 1.0.27.90
| OR-3_SEQ-273_PAT-296.ZIP
| [http://foia-vista.osehra.org/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/OR-3_SEQ-273_PAT-296.ZIP Download folder on the OSEHRA site]
| 8/2009
|-
| version 1.0.27.83
| http://foia-vista.osehra.org/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/OR_30_243.ZIP
| [https://downloads.va.gov/files/FOIA/Software/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/ Download folder on VA site]
| 11/2008 Emergency Correction of Patient Safety Issues
|-
| version 1.0.27.77
| OR_30_243.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer/OR_30_243.ZIP or Download folder OSEHRA site http://foia-vista.osehra.org/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/OR_30_243.ZIP]
| 08/2008
|-
| version 1.0.26.69
| OR_30_270.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server] or
[https://downloads.va.gov/files/FOIA/Software/VistA_FOIA_Historical_Files/VISTA_FOIA_RELEASES_BEFORE_2008/OR-Order%20Entry-Results%20Reporting/ Download folder on VA site]
|-
| version 1.0.26.69
| for WorldVistA EHR
| on the Sourceforge WorldVistA EHR site and http://opensourcevista.net:8888/NancysVistAServer
| (dated June 2007)

|-
| version 1.0.26.68
| OR_30_258.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| Note Below (NB):(dated July 17, 2006)
|-
| version 1.0.25.42
| OR_30_235.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated July 09, 2005) Note: Replace .25.40 with .25.42 for patient safety
|-
| version 1.0.25.40
| OR_30_231.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated May 06, 2005)
|-
| version 1.0.25.28
| OR_30_195.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Feb 09, 2005)
|-
| version 1.0.24.27
| OR_30_224.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Sep 03, 2004)
|-
| version 1.0.24.26
| OR_30_190.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Aug 02, 2004)
|-
| version 1.0.23.15
| OR_30_187.ZIP
| *Sourceforge WorldVistA and [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 02/04)
|-
| version 1.0.22.16
| OR_30_206.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 01/04)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 11/02)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
|(dated about 11/02)
|-
| version 1.0.19.7
| OR_30_132.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 05/02)
|-
| version 1.0.18.2
| OR_30_125.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 12/01)
|}

----

=== version change trick ===
NB: There is a trick to making version 1.0.26.68. It is done for you in CPRSDir.zip which can be found along with the instructions for creating it at:

http://downloads.opensourcevista.net/VADemo9-26-06

To find out which version to use, look next to the option [[OPTION OR CPRS GUI CHART|named "OR CPRS GUI CHART"]] like this example where [[~|CPRS~|CPRS]] version 1.0.23.15 was needed:

D Q^DI

VA FileMan 22.0
Select OPTION: 5 INQUIRE TO FILE ENTRIES

OUTPUT FROM WHAT FILE: DEVICE// OPTION
1 OPTION (10126 entries)
2 OPTION SCHEDULING (116 entries)
CHOOSE 1-2: 1 OPTION (10126 entries)
Select OPTION NAME: OR CPRS GUI CHART CPRSChart version 1.0.23.15
ANOTHER ONE:

To use a particular version of [[CPRS~|CPRS]], the server-side software code must match. The files are found at ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ and the source code is in the "Programs" subdirectory of this directory

Thus:

[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/ <nowiki>ftp://ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ </nowiki>]

The Delphi source code for each of these (e.g. OR_30_235_SRC.ZIP) will be found in the subdirectory
[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/Programs/ <nowiki>...Packages/Order Entry-Results Reporting - OR/Programs/ </nowiki>]

The wget(1) utility is capable of fetching the files from this server

AceFTP is a freeware FTP program that works, if needed
http://software.visicommedia.com/en/productsfreeware/

''(In the past this FTP site could not be reached with Mozilla/Firefox. That has been corrected.)''
----

=== 1.0.26.69 (and TMG-CPRS) spoof --> 1.0.26.76 ===

Since the changes between 1.0.26.69 and 1.0.26.76 are relatively minor, in this case, version can be used by changing the option in the option file like this:

D P^DI

VA FileMan 22.0

Select OPTION: 1 ENTER OR EDIT FILE ENTRIES

INPUT TO WHAT FILE: OPTION//
EDIT WHICH FIELD: ALL//

Select OPTION NAME: OR [[CPRS~|CPRS]] GUI CHART [[CPRS~|CPRS]]Chart version 1.0.26.76
NAME: OR CPRS GUI CHART//
MENU TEXT: CPRSChart version 1.0.26.76 Replace 76 With 69
Replace
CPRSChart version 1.0.26.69
----
When using TMG-CPRS, another way of reaching the exact same result is to add ''' "SPOOF-VER=1.0.26.76" ''' to the end of the Windows shortcut to [[CPRS~|CPRS]] like so:

... S=192.168.xxx.xxx P=92xx CCOW=DISABLE SPOOF-VER=1.0.26.76

(This method has the (admittedly dubious) advantage of allowing ''both'' a CPRS v1.0.26.68 ''and'' a v1.0.26.76 to connect without changing the server side.

'''Caution:''' One needs to know that the two versions truly are compatible or be willing to risk nasty side-effects, perhaps even damage to the server's database.
----
=== SSH Tunnel ===
Communications between CPRS and the VistA server are not encrypted by default. Access/Verify Codes and all patient data are transmitted in the clear. However, these can be protected by setting up an encrypted "tunnel" between client and server.

[[Setting up an SSH Tunnel between CPRS & VistA]]
----
=== Automatic Windows Installer ===

The [http://sourceforge.net/projects/worldvistaautoi/files Astronaut] suite of automatic installers includes cprs, tmg-cprs and many other clients, available in point-click windows .exe installers. IP address and port number are entered by the user.
----
=== Wine/Crossover compatability ===

[[Wine/Crossover]]

RPMS Installation

2014-07-09T01:34:05Z

Anthracite: /* RPMS Installation Instructions */

= RPMS Installation Instructions =
Written by [[User:Shabiel|Sam Habiel]]. I want to acknowledge Rick Pullen and Nancy Anthracite, who helped me put this together.

For development use; consult a Vista [[Cache]] expert for production system set-up. Optional steps marked with *.

# Install [[Cache]] or Ensemble (lastest versions); answer no to the question that asks whether to put the key in now if you have the key as a file.
# In the Mgr directory, copy the key and make sure it's named cache.key
# In the C:\Intersystems\[Cache or Ensemble]\mgr directory, make a subdirectory (let's call it rpms) for you database and place your RPMS cache.dat into that [rpms] directory.
# Log into the System Mangement Portal. Right-click on notification icon, choose that option, and if you set a password, log in
# Home > [[Configuration~|Configuration]] > Advanced Settings (newer Cache, different places, as below)
## IO ([[Configuration~|Configuration]] > Compatibility Settings)
##* <tt>Filemode = True</tt>
##* <tt>Openmode = 1 for Read/Write</tt>
## Memory (Can't find in newest version of Cache, 2010)
##* <tt>GenericHeapSize = 10000. More may be needed for shadowed systems.</tt>
##* <tt>ZFHEAP = 125000 (minimum). May require more depending on software running and OS platform.</tt>
## Miscellaneous ([[Configuration~|Configuration]] > Startup Settings)
##* <tt>WebServerPort = 57772 (default) This can be changed and is the port number that the System Management Portal uses.</tt>
## ObjectScript ([[Configuration~|Configuration]] > Compatibility Settings)
##* <tt>Set ZEOF = True</tt>
## Telnet ([[Configuration~|Configuration]] > Device Settings > Telnet Settings)
##* <tt>DNSLookup = True (if DNS server is available). Set to False if no DNS server available. Only affects Windows OS.</tt>
## *Home > [[Configuration~|Configuration]] > Memory and Startup
##* <tt>Routine Cache: Min 50MB</tt>
##* <tt>Database Cache (8 KB): Min 1500MB. Leave 2 KB Cache at 0.</tt>
# Create your database
## [[Configuration~|Configuration]] > Local Databases > Create New Database
## Give it the same name you gave the mgr subdirectory (perhaps rpms) earlier in the process and choose that directory. When you click next, Cache or Ensemble should find the Cache,dat you placed in the mgr subdirectory you creaated. Accept using it. The database size will be set automatically.
## Jounal: No
# Create a namespace
## [[Configuration~|Configuration]] > Namespaces > Create New Namespace
## Give it the same name as your DB created in #4
## Map it to your DB
## Don't copy any mappings
# Create the mappings (Namespaces, Global Mappings and Routine Mappings)
## Globals: <tt>(%Z*, %z*) to your namespace; (UTILITY, TMP, TEMP, XTMP) to CACHETEMP</tt>
## Routines: <tt>%DT*, %HOSTCMD, %INET, %RCR, %Serenj*, %XB*, %XU*, %ZI*, %ZO*, %ZT*, %ZU*, %ZV*, %ZDEBUG</tt>
# *Home > Security Management > Users
## Add accounts. Copy from SuperUser. Add Password. Set Namespace. If this is intended for general use, set the routine to be ^ZU, otherwise, leave it blank.
# *Home > Security Management > CSP Applications > Edit /csp/sys (this portal). Uncheck unauthenticed and check password to allow only authenticated users to use the system management portal.
# *Home > Security Management > Services > Edit %Service_Telnet. Enable it and choose appropriate authentication.
# *Home > Security Management > Resources > Edit %Development and enable it (only for systems on which development will be performed).
# *For databases migrated from Cache 5.0.x, recompile the routines and update database objects.
#* Enter Programmer Mode
#* Go to your namespace
#* Execute the following:
#** <tt>D ^%RCOMPIL</tt>
#** <tt>Routine(s): %*</tt>
#** <tt>Routine(s): **</tt>
#** <tt>ZN "%SYS"</tt>
#** <tt>W $System.OBJ.UpgradeAll()</tt>
#* Go back to your namespace
#** <tt>D RebuildIndex^%R("","",1)</tt>
# In Programmer mode, [[ROUTINE ZTMGRSET|D ^ZTMGRSET]], choose OpenM for OS, and type your namespace on the three quetions, and rename fileman routines.
# Correct the Volume Set and Primary HFS Directory fields in the [[FILE 8989.3 |Kernel Systems Parameters]] file
# Correct the Volume in [[FILE 14.5|Volume Set]] file
# Taskman Site Parameters need to be XXX:CACHE or XXX:ENSEMBLE or XXX:<INSTANCE NAME>
# Check the Mailman Site Params file for the correct entry in the below field: CPU (UCI,VOL) FOR FILER TO RUN: XXX,XXX
# Before you proceed, fix the volume set field for devices |TRM| and |TNT| or otherwise you won't be able to use FileMan features.
# In [[FILE 19.2|Option Scheduling]] file, correct Volume field for tasks by stuffing the right one
# In [[FILE 3.5|Device]] File, correct Volume Set field also by stuffing
# Kill [[GLOBAL %ZTSK|^%ZTSK]] and [[GLOBAL %ZTSCH|^%ZTSCH]]. Reindex the Option Scheduling file (all indices)
# Fix the RPMS Site file. Set OS to DOS
# In CIA LISTENER file, correct UCI.
# In XUP, go to [[OPTION CIANB MAIN MENU|CIANB MAIN MENU]], edit the CIA broker package parameters and remove old UCI and put new one.
# Start the listener.
# In BMXMENU, edit all the ports to have a correct namespace, and then start all of them.
# In the portal, go to system services and enable telnet.
# Go to XUP, and add yourself as a user.
# Find your [[DUZ~|DUZ]]
# Give yourself the "@"
# Assign yourself all the keys in the universe by [[ROUTINE AKMOSUSR|D ^AKMOSUSR]]
# Make a folder where your ehr client will reside. Share that folder with read access to all users.
# Find lastest major version of EHR (currently 1.1) and double click on the exe and extract the files to folder you just created.
# In the resulting dialog, put the UNC path of the shared folder in the first box; in the last box, add /trace to enable tracing by default (for developers).
# Install EHR 1.1 patch 1
# Install EHR 1.1 patch 4. It contains the last license (the permanent one).
# Edit the VueCentric Framework defaults. In [[ROUTINE XUP|XUP]], choose [[OPTION CIAV MANAGER|CIAV MANAGER]]
#* Choose site parameter edit
#* Object source path is the UNC to your lib folder
#* You may choose to change the default VueCentric Template now or later

Stuff to do later...
There is so much set-up you can work on. Here are some things that are needed:
# *Add Mailman Domain; Christen; have Kernel point to it.
# *Add Institution; Set-up Medical Center Division to point to it; have Kernel point to default division.
# *Setup Backup and Journalling in Cache/Ensemble.

RPMS Installation

2014-03-09T02:58:23Z

Anthracite: /* RPMS Installation Instructions */

= RPMS Installation Instructions =
Written by [[User:Shabiel|Sam Habiel]]. I want to acknowledge Rick Pullen and Nancy Anthracite, who helped me put this together.

For development use; consult a Vista [[Cache]] expert for production system set-up. Optional steps marked with *.

# Install [[Cache]] or Ensemble (lastest versions); answer no to the question that asks whether to put the key in now if you have the key as a file.
# In the Mgr directory, copy the key and make sure it's named cache.key
# In the C:\Intersystems\[Cache or Ensemble]\mgr directory, make a subdirectory (let's call it rpms) for you database and place your RPMS cache.dat into that [rpms] directory.
# Log into the System Mangement Portal. Right-click on notification icon, choose that option, and if you set a password, log in
# Home > [[Configuration~|Configuration]] > Advanced Settings (newer Cache, different places, as below)
## IO ([[Configuration~|Configuration]] > Compatibility Settings)
##* <tt>Filemode = True</tt>
##* <tt>Openmode = 1 for Read/Write</tt>
## Memory (Can't find in newest version of Cache, 2010)
##* <tt>GenericHeapSize = 10000. More may be needed for shadowed systems.</tt>
##* <tt>ZFHEAP = 125000 (minimum). May require more depending on software running and OS platform.</tt>
## Miscellaneous ([[Configuration~|Configuration]] > Startup Settings)
##* <tt>WebServerPort = 57772 (default) This can be changed and is the port number that the System Management Portal uses.</tt>
## ObjectScript ([[Configuration~|Configuration]] > Compatibility Settings)
##* <tt>Set ZEOF = True</tt>
## Telnet ([[Configuration~|Configuration]] > Device Settings > Telnet Settings)
##* <tt>DNSLookup = True (if DNS server is available). Set to False if no DNS server available. Only affects Windows OS.</tt>
## *Home > [[Configuration~|Configuration]] > Memory and Startup
##* <tt>Routine Cache: Min 50MB</tt>
##* <tt>Database Cache (8 KB): Min 1500MB. Leave 2 KB Cache at 0.</tt>
# Create your database
## [[Configuration~|Configuration]] > Local Databases > Create New Database
## Give it the same name you gave the mgr subdirectory (perhaps rpms) earlier in the process and choose that directory. When you click next, Cache or Ensemble should find the Cache,dat you placed in the mgr subdirectory you creaated. Accept using it. The database size will be set automatically.
## Jounal: No
# Create a namespace
## [[Configuration~|Configuration]] > Namespaces > Create New Namespace
## Give it the same name as your DB created in #4
## Map it to your DB
## Don't copy any mappings
# Create the mappings (Namespaces, Global Mappings and Routine Mappings)
## Globals: <tt>(%Z*, %z*) to your namespace; (UTILITY, TMP, TEMP, XTMP) to CACHETEMP</tt>
## Routines: <tt>%DT*, %HOSTCMD, %INET, %RCR, %Serenj*, %XB*, %XU*, %ZI*, %ZO*, %ZT*, %ZU*, %ZV*, %ZDEBUG</tt>
# *Home > Security Management > Users
## Add accounts. Copy from SuperUser. Add Password. Set Namespace. If this is intended for general use, set the routine to be ^ZU, otherwise, leave it blank.
# *Home > Security Management > CSP Applications > Edit /csp/sys (this portal). Uncheck unauthenticed and check password to allow only authenticated users to use the system management portal.
# *Home > Security Management > Services > Edit %Service_Telnet. Enable it and choose appropriate authentication.
# *Home > Security Management > Resources > Edit %Development and enable it (only for systems on which development will be performed).
# *For databases migrated from Cache 5.0.x, recompile the routines and update database objects.
#* Enter Programmer Mode
#* Go to your namespace
#* Execute the following:
#** <tt>D ^%RCOMPIL</tt>
#** <tt>Routine(s): %*</tt>
#** <tt>Routine(s): **</tt>
#** <tt>ZN "%SYS"</tt>
#** <tt>W $System.OBJ.UpgradeAll()</tt>
#* Go back to your namespace
#** <tt>D RebuildIndex^%R("","",1)</tt>
# In Programmer mode, [[ROUTINE ZTMGRSET|D ^ZTMGRSET]], choose OpenM for OS, and type your namespace on the three quetions, and rename fileman routines.
# Correct the Volume Set and Default HFS fields in the [[FILE 8989.3 |Kernel Systems Parameters]] file
# Correct the Volume in [[FILE 14.5|Volume Set]] file
# Taskman Site Parameters need to be XXX:CACHE or XXX:ENSEMBLE or XXX:<INSTANCE NAME>
# Check the Mailman Site Params file for the correct entry in the below field: CPU (UCI,VOL) FOR FILER TO RUN: XXX,XXX
# Before you proceed, fix the volume set field for devices |TRM| and |TNT| or otherwise you won't be able to use FileMan features.
# In [[FILE 19.2|Option Scheduling]] file, correct Volume field for tasks by stuffing the right one
# In [[FILE 3.5|Device]] File, correct Volume Set field also by stuffing
# Kill [[GLOBAL %ZTSK|^%ZTSK]] and [[GLOBAL %ZTSCH|^%ZTSCH]]. Reindex the Option Scheduling file (all indices)
# Fix the RPMS Site file. Set OS to DOS
# In CIA LISTENER file, correct UCI.
# In XUP, go to [[OPTION CIANB MAIN MENU|CIANB MAIN MENU]], edit the CIA broker package parameters and remove old UCI and put new one.
# Start the listener.
# In BMXMENU, edit all the ports to have a correct namespace, and then start all of them.
# In the portal, go to system services and enable telnet.
# Go to XUP, and add yourself as a user.
# Find your [[DUZ~|DUZ]]
# Give yourself the "@"
# Assign yourself all the keys in the universe by [[ROUTINE AKMOSUSR|D ^AKMOSUSR]]
# Make a folder where your ehr client will reside. Share that folder with read access to all users.
# Find lastest major version of EHR (currently 1.1) and double click on the exe and extract the files to folder you just created.
# In the resulting dialog, put the UNC path of the shared folder in the first box; in the last box, add /trace to enable tracing by default (for developers).
# Install EHR 1.1 patch 1
# Install EHR 1.1 patch 4. It contains the last license (the permanent one).
# Edit the VueCentric Framework defaults. In [[ROUTINE XUP|XUP]], choose [[OPTION CIAV MANAGER|CIAV MANAGER]]
#* Choose site parameter edit
#* Object source path is the UNC to your lib folder
#* You may choose to change the default VueCentric Template now or later

Stuff to do later...
There is so much set-up you can work on. Here are some things that are needed:
# *Add Mailman Domain; Christen; have Kernel point to it.
# *Add Institution; Set-up Medical Center Division to point to it; have Kernel point to default division.
# *Setup Backup and Journalling in Cache/Ensemble.

RPMS Installation

2014-03-09T02:56:33Z

Anthracite: /* RPMS Installation Instructions */

= RPMS Installation Instructions =
Written by [[User:Shabiel|Sam Habiel]]. I want to acknowledge Rick Pullen and Nancy Anthracite, who helped me put this together.

For development use; consult a Vista [[Cache]] expert for production system set-up. Optional steps marked with *.

# Install [[Cache]] or Ensemble (lastest versions); answer no to the question that asks whether to put the key in now if you have the key as a file.
# In the Mgr directory, copy the key and make sure it's named cache.key
# In the C:\Intersystems\[Cache or Ensemble]\mgr directory, make a subdirectory (let's call it rpms) for you database and place your RPMS cache.dat into that [rpms] directory.
# Log into the System Mangement Portal. Right-click on notification icon, choose that option, and if you set a password, log in
# Home > [[Configuration~|Configuration]] > Advanced Settings (newer Cache, different places, as below)
## IO ([[Configuration~|Configuration]] > Compatibility Settings)
##* <tt>Filemode = True</tt>
##* <tt>Openmode = 1 for Read/Write</tt>
## Memory (Can't find in newest version of Cache, 2010)
##* <tt>GenericHeapSize = 10000. More may be needed for shadowed systems.</tt>
##* <tt>ZFHEAP = 125000 (minimum). May require more depending on software running and OS platform.</tt>
## Miscellaneous ([[Configuration~|Configuration]] > Startup Settings)
##* <tt>WebServerPort = 57772 (default) This can be changed and is the port number that the System Management Portal uses.</tt>
## ObjectScript ([[Configuration~|Configuration]] > Compatibility Settings)
##* <tt>Set ZEOF = True</tt>
## Telnet ([[Configuration~|Configuration]] > Device Settings > Telnet Settings)
##* <tt>DNSLookup = True (if DNS server is available). Set to False if no DNS server available. Only affects Windows OS.</tt>
## *Home > [[Configuration~|Configuration]] > Memory and Startup
##* <tt>Routine Cache: Min 50MB</tt>
##* <tt>Database Cache (8 KB): Min 1500MB. Leave 2 KB Cache at 0.</tt>
# Create your database
## [[Configuration~|Configuration]] > Local Databases > Create New Database
## Give it the same name you gave the mgr subdirectory (perhaps rpms) earlier in the process and choose that directory. When you click next, Cache or Ensemble should find the Cache,dat you placed in the mgr subdirectory you creaated. Accept using it. The database size will be set automatically.
## Jounal: No
# Create a namespace
## [[Configuration~|Configuration]] > Namespaces > Create New Namespace
## Give it the same name as your DB created in #4
## Map it to your DB
## Don't copy any mappings
# Create the mappings (Namespaces, Global Mappings and Routine Mappings)
## Globals: <tt>(%Z*, %z*) to your namespace; (UTILITY, TMP, TEMP, XTMP) to CACHETEMP</tt>
## Routines: <tt>%DT*, %HOSTCMD, %INET, %RCR, %Serenj*, %XB*, %XU*, %ZI*, %ZO*, %ZT*, %ZU*, %ZV*, %ZDEBUG</tt>
# *Home > Security Management > Users
## Add accounts. Copy from SuperUser. Add Password. Set Namespace. If this is intended for general use, set the routine to be ^ZU, otherwise, leave it blank.
# *Home > Security Management > CSP Applications > Edit /csp/sys (this portal). Uncheck unauthenticed and check password to allow only authenticated users to use the system management portal.
# *Home > Security Management > Services > Edit %Service_Telnet. Enable it and choose appropriate authentication.
# *Home > Security Management > Resources > Edit %Development and enable it (only for systems on which development will be performed).
# Shutdown Cache/Ensemble, put your real CACHE.DAT in the folder, and start Cache/Ensemble again.
# *For databases migrated from Cache 5.0.x, recompile the routines and update database objects.
#* Enter Programmer Mode
#* Go to your namespace
#* Execute the following:
#** <tt>D ^%RCOMPIL</tt>
#** <tt>Routine(s): %*</tt>
#** <tt>Routine(s): **</tt>
#** <tt>ZN "%SYS"</tt>
#** <tt>W $System.OBJ.UpgradeAll()</tt>
#* Go back to your namespace
#** <tt>D RebuildIndex^%R("","",1)</tt>
# In Programmer mode, [[ROUTINE ZTMGRSET|D ^ZTMGRSET]], choose OpenM for OS, and type your namespace on the three quetions, and rename fileman routines.
# Correct the Volume Set and Default HFS fields in the [[FILE 8989.3 |Kernel Systems Parameters]] file
# Correct the Volume in [[FILE 14.5|Volume Set]] file
# Taskman Site Parameters need to be XXX:CACHE or XXX:ENSEMBLE or XXX:<INSTANCE NAME>
# Check the Mailman Site Params file for the correct entry in the below field: CPU (UCI,VOL) FOR FILER TO RUN: XXX,XXX
# Before you proceed, fix the volume set field for devices |TRM| and |TNT| or otherwise you won't be able to use FileMan features.
# In [[FILE 19.2|Option Scheduling]] file, correct Volume field for tasks by stuffing the right one
# In [[FILE 3.5|Device]] File, correct Volume Set field also by stuffing
# Kill [[GLOBAL %ZTSK|^%ZTSK]] and [[GLOBAL %ZTSCH|^%ZTSCH]]. Reindex the Option Scheduling file (all indices)
# Fix the RPMS Site file. Set OS to DOS
# In CIA LISTENER file, correct UCI.
# In XUP, go to [[OPTION CIANB MAIN MENU|CIANB MAIN MENU]], edit the CIA broker package parameters and remove old UCI and put new one.
# Start the listener.
# In BMXMENU, edit all the ports to have a correct namespace, and then start all of them.
# In the portal, go to system services and enable telnet.
# Go to XUP, and add yourself as a user.
# Find your [[DUZ~|DUZ]]
# Give yourself the "@"
# Assign yourself all the keys in the universe by [[ROUTINE AKMOSUSR|D ^AKMOSUSR]]
# Make a folder where your ehr client will reside. Share that folder with read access to all users.
# Find lastest major version of EHR (currently 1.1) and double click on the exe and extract the files to folder you just created.
# In the resulting dialog, put the UNC path of the shared folder in the first box; in the last box, add /trace to enable tracing by default (for developers).
# Install EHR 1.1 patch 1
# Install EHR 1.1 patch 4. It contains the last license (the permanent one).
# Edit the VueCentric Framework defaults. In [[ROUTINE XUP|XUP]], choose [[OPTION CIAV MANAGER|CIAV MANAGER]]
#* Choose site parameter edit
#* Object source path is the UNC to your lib folder
#* You may choose to change the default VueCentric Template now or later

Stuff to do later...
There is so much set-up you can work on. Here are some things that are needed:
# *Add Mailman Domain; Christen; have Kernel point to it.
# *Add Institution; Set-up Medical Center Division to point to it; have Kernel point to default division.
# *Setup Backup and Journalling in Cache/Ensemble.

Instructions for New Drug Entry

2013-03-06T23:11:34Z

Anthracite:

EDIT: Here is a more reliable page created by a pharmacist who actually uses the system on a regular basis: [[Enter_A_Drug]]

Here is some helpful facts about entering a drug from the terminal.

Also, there is some training on http://MyVeHUCampus.com Sign up and get a user name and password, then sign in, go to MAP, Learning Center, Training Starts Here, Pick Key Word, sort by Year and the find this course.

Pharmacy Data Management (PDM) Course #: 105H / Year: 2004

This hands-on session guides participants through the necessary steps of adding an outpatient medication, inpatient medication, and intravenous medication. The session includes matching to the National Drug File, creating dosages, marking to the appropriate applications, and creating the orderable item.

New Drug Entry

PSORPH is the key that designates you as a Pharmacist, it will allow the Clinical Coordinator to perform any drug function, like adding a drug to the VOE System

I. Under Pharmacy Data Management / Drug Enter/Edit option [PSS DRUG ENTER/EDIT], ---> enter the name of the drug you want to add.

II. Under the National Drug File menu, do Rematch / Match Single Drugs [PSNDRUG]

III. Under the National Drug File menu, do Verify Single Match [PSNVFY]

IV. Under the National Drug File menu, do Merge National Drug File Data into Local File [PSNMRG]

V. Under Pharmacy Data Management/Orderable Item Management, do DISPENSE Drug/Orderable Item Maintenance [PSS MAINTAIN ORDERABLE ITEMS]

From this point, you will navigate to the appropriate menu screen so that you may add a new drug.

Note: "TYPE" with a word in "quotations" means to type out the word in quotations and hit the Enter key.

Select Core [[Application~|Application]] Option: '''<TYPE "PSM">'''
Select PHARMACY DATA MANAGEMENT Option: '''<TYPE "DRUG ENTER/EDIT ">'''

Select DRUG GENERIC NAME: '''<TYPE "EXAMPLE DRUG">'''
Are you adding 'EXAMPLE DRUG' as a new DRUG (the #)? No// '''<TYPE "YES">'''
DRUG NUMBER: <TYPE "94183">//
DRUG VA CLASSIFICATION: '''<TYPE "AM900">'''
ANTI-INFECTIVES, '''<TYPE "OTHER">'''
DRUG FSN:
DRUG NATIONAL DRUG CLASS: '''<TYPE "AM900">''' //
DRUG LOCAL NON-FORMULARY:
DRUG INACTIVE DATE:
DRUG MESSAGE:
DRUG RESTRICTION:

GENERIC NAME: EXAMPLE DRUG//
VA CLASSIFICATION: '''<TYPE "AM900">''' //
DEA, SPECIAL HDLG:

NATIONAL FORMULARY INDICATOR: '''<TYPE "Not Matched To NDF">'''
LOCAL NON-FORMULARY:
VISN NON-FORMULARY:

Select DRUG TEXT ENTRY:
Select FORMULARY ALTERNATIVE:
Select SYNONYM:
MESSAGE:
RESTRICTION:
FSN:
NDC: '''<TYPE "0069-1530-66">'''
INACTIVE DATE:
WARNING LABEL:
ORDER UNIT:
PRICE PER ORDER UNIT:
DISPENSE UNIT:
DISPENSE UNITS PER ORDER UNIT:
PRICE PER DISPENSE UNIT:
Just a reminder...you are editing EXAMPLE DRUG.

LOCAL POSSIBLE DOSAGES:

Do you want to edit Local Possible Dosages? N// O

MARK THIS DRUG AND EDIT IT FOR:
O - Outpatient
X - Non-VA Med

Enter your choice(s) separated by commas : '''<TYPE "O">''' Outpatient
** You are NOW editing OUTPATIENT fields. **

AN Outpatient Pharmacy ITEM? No//'''<TYPE "YES">'''
CORRESPONDING INPATIENT DRUG:
MAXIMUM DOSE PER DAY:
LOCAL NON-FORMULARY:
NORMAL AMOUNT TO ORDER: '''<TYPE "30">'''
SOURCE OF SUPPLY:
CURRENT INVENTORY: '''<TYPE "500">'''
[[ACTION~|Action]] PROFILE MESSAGE: '''<TYPE "OP">'''
MESSAGE:
QUANTITY DISPENSE MESSAGE:

Do you wish to mark/unmark as a LAB MONITOR or CLOZAPINE DRUG?
Enter Yes or No: '''<TYPE "NO">'''

** You are NOW in the ORDERABLE ITEM matching for the dispense drug. **

Choose Dosage Form: '''<TYPE "CAP,ORAL">'''

Match to another Orderable Item with same Dosage Form? NO//

Dosage Form -> CAP,ORAL
Dispense Drug -> EXAMPLE DRUG

Orderable Item Name: '''<TYPE "EXAMPLE DRUG">'''

Matching EXAMPLE DRUG
to
EXAMPLE DRUG CAP,ORAL

Is this OK? '''<TYPE "YES">''' //
Match Complete!

Now editing Orderable Item:
EXAMPLE DRUG CAP,ORAL

FORMULARY STATUS:
Select OI-DRUG TEXT ENTRY:
INACTIVE DATE:
DAY (nD) or DOSE (nL) LIMIT:
MED ROUTE:
SCHEDULE TYPE:
SCHEDULE: '''<TYPE "QID">'''

Outpatient Expansion:
FOUR TIMES A DAY

PATIENT INSTRUCTIONS:

Select SYNONYM:

Select DRUG GENERIC NAME:

Select Pharmacy Data Management Option:

Select National Drug File Menu Option: '''<TYPE "REMA">''' Rematch / Match Single Drugs

Enter name of drug from your local drug file and a match
with the National Drug File will be attempted.
Press return at the "Select DRUG GENERIC NAME: " [[prompt~|Prompt]] to exit.

Select DRUG GENERIC NAME: '''<TYPE "EXAMPLE DRUG">''' AM900

This drug has been manually classed but not matched (merged with NDF).
Do you wish to match/rematch it? N//'''<TYPE "YES">'''

Deleting Possible Dosages...

Match local drug EXAMPLE DRUG
ORDER UNIT:
DISPENSE UNITS/ORDER UNITS:
DISPENSE UNIT:
I will try to match NDC: 0069-1530-66 to NDF.

Local drug EXAMPLE DRUG
matches AMLODIPINE BESYLATE 5MG TAB
PACKAGE SIZE: 100
PACKAGE TYPE: BOTTLE
Is this a match ?
Enter Yes or No: '''<TYPE "YES">'''

Select National Drug File Menu Option: '''<TYPE "SVER">''' Verify Single Match

Enter name of drug from your local drug file and if the
drug has been matched, you will be asked to verify the match.
Press return at the "Select DRUG GENERIC NAME: " [[prompt~|Prompt]] to exit.

Select DRUG GENERIC NAME: <TYPE "EXAMPLE DRUG"> AM900
LOCAL DRUG NAME:<TYPE "EXAMPLE DRUG">
ORDER UNIT:
DISPENSE UNITS/ORDER UNITS:
DISPENSE UNIT:
VA PRODUCT NAME:<TYPE "AMLODIPINE BESYLATE 5MG TAB">
VA PRINT NAME: <TYPE "AMLODIPINE BESYLATE 5MG TAB"> CMOP ID: A0547
VA DISPENSE UNIT: <TYPE "TAB"> MARKABLE FOR CMOP:<TYPE "YES">
PACKAGE SIZE: <TYPE "100">
PACKAGE TYPE: <TYPE "BOTTLE">
VA CLASS:<TYPE "CV200 CALCIUM CHANNEL BLOCKERS">

CS FEDERAL SCHEDULE:
INGREDIENTS: '''<TYPE "AMLODIPINE BESYLATE 5 MG">'''
NATIONAL FORMULARY INDICATOR:'''<TYPE "YES">'''
NATIONAL FORMULARY RESTRICTION:
Refer to PBM/MAP criteria for use of long-acting dihydropyridine calcium

< Enter "Y" for yes, "N" for no >
< Press RETURN to Pass to Next Drug >

Is this a match ? '''Y'''

Select National Drug File Menu Option: '''<TYPE "MERG">''' Merge National Drug File Data Into Local File

This option will merge NDF fields into your local drug file. This will also produce an Error Report for entries in the translation file which are not in the local file if they should exist. These exceptions will not be merged.

You may queue this report if you wish.

Select Printer: '''<TYPE name of your printer.>'''

Select OPTION NAME: '''<TYPE "PSM">''' PHARMACY DATA MANAGEMENT PSS MGR

Select Pharmacy Data Management Option: '''<TYPE "ORDERABLE ITEM MANAGEMENT">'''

Select Orderable Item Management Option: '''<TYPE "DISPENSE Drug/Orderable Item Maintenance">'''

This option enables you to match Dispense Drugs to an entry in the Pharmacy
Orderable Item file, or create a new Pharmacy Orderable Item entry for a Dispense Drug.

Select DISPENSE DRUG: '''<TYPE "EXAMPLE DRUG">''' CV200

There are other Dispense Drugs with the same VA Generic Name and same Dose
Form already matched to orderable items. Choose a number to match, or enter
'^' to enter a new one.

Disp. drug -> EXAMPLE DRUG

1 AMLODIPINE TAB

Choose number of Orderable Item to match, or '^' to enter a new one: 1

Matching EXAMPLE DRUG
to
AMLODIPINE TAB

Is this OK? YES//
Match Complete

Thanks to all who helped me put these instructions together.
--Kevin Toppenberg

Register a Patient

2013-03-06T11:17:59Z

Anthracite: /* Importing legacy data */

__toc__

===Standard Method for Registering A Patient ===

Use the menu option,

REGISTER A PATIENT

or the menu option

LOAD/EDIT PATIENT DATA

=== Kevin's Add / Edit Patient Method ===

EDITPT(AddOK)
;"Purpose: To ask for a patient name, and then allow editing
;"Input: AddOK: if 1, then adding new patients is allowed
;"Result: none

do LO^DGUTL
set DGCLPR=""
new DGDIV set DGDIV=$$PRIM^VASITE

if DGDIV>0 set %ZIS("B")=$piece($get(^DG(40.8,+DGDIV,"DEV")),U,1)

kill %ZIS("B")
if '$data(DGIO),$piece(^DG(43,1,0),U,30) do
. set %ZIS="N",IOP="HOME"
. do ^%ZIS

A do ENDREG^DGREG($get(DFN))
do if (Y<0) goto EditDone
. W !!
. if $get(AddOK)=1 do
. . set DIC=2,DIC(0)="ALEQM"
. . set DLAYGO=2
. else do
. . set DIC=2,DIC(0)="AEQM"
. . set DLAYGO=0
. kill DIC("S")
. do ^DIC
. kill DLAYGO
. if Y<0 quit
. set (DFN,DA)=+Y
. set DGNEW=$P(Y,"^",3)
. new Y
. do PAUSE^DG10
. do BEGINREG^DGREG(DFN)
. if DGNEW D NEW^DGRP

if +$get(DGNEW) do
. ;" query CMOR for Patient [[Record~|Record]] Flag Assignments if NEW patient and
. ;" display results.
. if $$PRFQRY^DGPFAPI(DFN) do DISPPRF^DGPFAPI(DFN)

set (DGFC,CURR)=0
set DA=DFN
set DGFC="^1"
set VET=$select($data(^DPT(DFN,"VET")):^("VET")'="Y",1:0)

set %ZIS="N",IOP="HOME"
do ^%ZIS
set DGELVER=0
;"do EN^DGRPD
;"if $data(DGRPOUT) do goto A
;". do ENDREG^DGREG($G(DFN))
;". do HL7A08^VAFCDD01
;". kill DFN,DGRPOUT

;"do [[HINQ~|HINQ]]^DG10
if $D(^DIC(195.4,1,"UP")) if ^("UP") do ADM^RTQ3

do REG^IVMCQ($G(DFN)) ;" send financial query

set DGRPV=0
do EN1^DGRP

EditDone

quit

To use this function, you will need to put it into a file. In my system, I have it saved in /usr/local/OpenVistA_UserData/r/TMGMISC.m

To execute it, one could do this: do EDITPT^TMGMISC(1) but this must be done from a programmer's [[prompt~|Prompt]]--not good for a final running system.

So the best way is to create a menu option that executes this.

I'll try to come back later and specify how this is done. But in short, create a menu that is an [[action~|Action]]. And make the execution [[action~|Action]] to be: DO EDITPT^TMGMISC(1)

Here is an e-mail that I wrote with more instructions: [[KT setting up Add-Edit Patient]]

Kevin Toppenberg 4-2-2005

=== Importing legacy data ===

[Back to Contents]

This actually applies to any file import, like referring doctors, cpt codes, etc. Helpful resources here are VPE http://www.hardhats.org/tools/vpe/vpe_db.html and the FileMan documentation from VDL http://www.va.gov/vdl/default.asp.

1. FileMan has "mandatory" fields for each file, so you either need to import these, or change the file attributes so that they are no longer "mandatory". The latter is actually easier. You can display a list of "required" fields for any file if you install VPE. Alternetively, using the Data Dictonary option in FileMan, display the fields, and make note of those, "mandatory" fields you don't want to import. Then, from FileMan’s main option, "MODify file attributes" to change "mandatory" to "no" for these fields.

2. FileMan can import external data directly from spreadsheets (Excel, 1-2-3) in various formats, or from user defined formats including comma or tab delimited and fixed length fields. In, theory you could use any delimiter. I have used CSV files with quoted text. You could write a routine to parse your data or export data from your old system to a spreadsheet, choose the fields you want to import and save those columns. Make note of the order of the fields and the data they contain. See the Fileman Advanced Users Manual HTML version on Hardhats.org http://www.hardhats.org/fileman/u2/index.html or here in the VistA Documentation Library http://www.va.gov/VDL/application.asp?appid=5.

3. Some formatting Issues here. You will probably have to do some editing of your data. FileMan likes names as: LAST,FIRST M, dates as: MMDDCCYY, phone numbers and SSN’s as numeric, unformatted. I haven’t tried to import “name components” directly to see if FileMan would fill the full name field directly. Watch out for programs which supress leading zeros in dates and SSN’s, they need to have the proper number of digits.

4. Enter FileMan and under "OTHer options", choose “IMport data”. You have 'external data', choose your saved format under 'foreign format' or just tell FileMan how you saved it: no to fixed length, comma delimited and yes to fields quoted. Enter the full path of the directory where you saved source file then the file name. Then enter "Patient" or the destination file in “Primary file”.

5. Choose 'field selection page'. You are then presented with the selection page where you specify the fields, in the order that they appear in the saved file. You can save this as a template to repeat the same import a second time.

6. When you have selected all the fields you wish to import, exit, save and run the import. If you didn't fill or remove the 'mandatory' for a required field you'll get an error which doesn't tell you which field. Format errors, like dates and SSN’s are identified.

Mike Schrom 10/31/05

=== Misc [[Configuration~|Configuration]] Scripts ===
(Registering a patient)

Contents

Notes
Adding a Menu to Register a Patient
Overview of Registering a Patient
Installing CIRN and the MPI Infrastructure

Editor's Notes:

This was sent to me by Nancy Anthracite. I was searching for a way to register a patient--i.e. how to add a new patient to the system. She wrote "Kevin - I think this stuff may already be installed, but the second section will explain some of what you want to know. -Nancy".

These example scripts are run on a Cache' system. I assume that the steps will be applicable to GT.M

[Back to Contents]

Assigning a Menu to Register a Patient

[Back to Contents]

In order to register a patient, you can use your powers as System Manager with all of the keys to do it, but instead, you can set up a Director of Admissions who has the ability to work with the MASTER PATIENT INDEX/PATIEND DEMOGRAPHICS (MPI/PD) system and register a patient. This Director of Admissions was give access to three menus as indicated below, the last of which allows registration of a patient. Throughout this document BOLD RED indicates user input.

VISTA>D ^ZU

Volume set: VISTA:CACHEWEB UCI: VISTA Device: |TRM|:|4052 (TRM:)

ACCESS CODE: *******

VERIFY CODE: ********

Good afternoon MANAGER,SYSTEM

You last signed on Jun 2,2003 at 00:0

Select TERMINAL TYPE NAME: C-VT100//

Digital Equipment Corporation VT-100 video

WARNING -- TASK MANAGER DOESN'T SEEM TO BE RUNNING!!!!

Select Systems Manager Menu Option: FM VA FileMan

VA FileMan Version 22.0

Select VA FileMan Option:

Select VA FileMan Option: ENTER or Edit File Entries

INPUT TO WHAT FILE: NEW PERSON//

EDIT WHICH FIELD: ALL// PRIMARY MENU OPTION

THEN EDIT FIELD: SECONDARY MENU OPTIONS (multiple)

EDIT WHICH SECONDARY MENU OPTIONS SUB-FIELD: ALL//

THEN EDIT FIELD:

Select NEW PERSON NAME: DA ADMISSIONS,DIRECTOR DA

PRIMARY MENU OPTION: MPI/PD MASTER MENU RGMGR MPI/PD Master Menu

Select SECONDARY MENU OPTIONS: RG ADMIN COORD MENU MPI/PD Patient Admin Coordinator Menu

Are you adding 'RG ADMIN COORD MENU' as a new SECONDARY MENU OPTIONS (the 1ST for this NEW PERSON)? No// Y (Yes)

SYNONYM: CORD

Select SECONDARY MENU OPTIONS: RG ADMIN COORD MENU

// DG REGISTRATION MENU Registration Menu

Are you adding 'DG REGISTRATION MENU' as a new SECONDARY MENU OPTIONS (the 2ND for this NEW PERSON)? No// Y (Yes)

SYNONYM: REGM

Select SECONDARY MENU OPTIONS:

Overview of Registering a Patient

[Back to Contents]

When you actually register your test patient, it might be helpful to you to know some information and terminology. All test patients in the VistA system at the VA are given social security numbers beginning with 5 zeros. These are recognized as test patients and automatically excluded from any uploads to central patient directories. Patients may also be given pseudo social security numbers in some circumstances, for instance, when the SS number is not known.

Information about PSEUDO SOCIAL SECURITY NUMBERS can be found by typing ?? at the [[prompt~|Prompt]] to enter the social security number when you are registering a patient. If you just enter a number followed by a P, that will also give you more information as the system will admonish you for not doing it right and tell you what to do. If you still don't do it correctly, the Pseudo SS number will be generated for you.

The most important fields used in keeping track of patients in the VA are the NAME, SS#, DOB (Date of Birth) and (DFN - file number of some sort??). If you follow this convention, it is likely to help you utilize the more advanced features for finding patients in other clinics, etc., if you ever utilize this system in a grand scale. It is also recommended that auditing be done AT LEAST of changes in these fields and SEX. (Auditing is discussed later on in this document.)

When registering a new patient, an attempt will be made to access the MPI (Master Patient Index) which, for the VA, is a centralized master patient file in Austin, Texas. You will also see mention of the CMOR (Coordinating Master of [[Record~|Record]]), which is the main site where a patient receives care and where the main [[record~|Record]]] of the patient is maintained. There is also the ICN - the Integration Control Number - which is like a patient number that can be assigned locally or where the Master Patient Index is maintained (i.e., Austin for the VA).

Installing CIRN and the MPI Infrastructure

Checking the Patch Level
Checking for RG* Globals
Unmapping routines
Journaling
Find the Value of a Field in a File
Be sure DUZ(0)=@ and U="^"
Proceed with the KIDS installation

[Back to Contents]

You may simply register a patient using this assigned menu, but because it may not be desirable to use social security numbers for patient identifiers within a medical care system, documentation of how to install the Master Patient Index system short of actually having it contact Austin , Texas follows. This will allow for the generation of ICNs that have the first 3 numbers as identifiers of the location where the patient was registered. This would be useful with a medical care system with multiple clinics, etc., as it might help to keep track of patients from various clinics if they are gathered in one central database. This is the equivalent of installing the test account for the Clinical Information Resource Network - Patient Demographics (CIRN-PD) and the Master Patient Index (MPI).

Installing the test account is the same as installing the full system except that the patch HL*1.6*39 is not installed. That is the patch that actually allows the system to contact Austin, Texas where the central VA Master Patient index is maintained. HL*1.6*39 must not be installed or your system will sending unwanted information to the VA MPI in Austin.

The installation of this system is documented in the Clinical Information Resource Network Patient Demographiscs (CIRN-PD) and Master Patient Indes (MPI) Installation and Implementation Guide, Version 2, Package Version 1.0, August 2000, Draft which can be found at : http://www.va.gov/vdl/documents/Infrastructure/Master_Patient_Index_(MPI)/rg1_0_ig2.doc

You will need to obtain these instructions as this document is made to supplement that document to allow "newbies" to use the official instructions.

Checking the Patch Level [back]

Beginning right on page 1 of the manual, you will need to check the patch level of various packages listed to be sure they are patched as they should be. Vista Platinum is patched to the current level in almost all packages, so this is unlikely to be a problem, but you will need to check. This is done by assigning yourself the XPD PRINT PACKAGE PATCHES, or Display Patches for a Package as a Secondary Menu. Assuming you have followed the prior documentation and are now the SM or "Manager, System" with all of the keys assigned, you will assign this menu to yourself in the New Person file, secondary menu field as follows (except the KIDS synonym may already be entered for you):

VISTA>D Q^DI

VA FileMan 22.0

Select OPTION: ENTER OR EDIT FILE ENTRIES

INPUT TO WHAT FILE: HL LOGICAL LINK// 200 NEW PERSON (8 entries)

EDIT WHICH FIELD: ALL// SECONDARY MENU OPTIONS (multiple)

EDIT WHICH SECONDARY MENU OPTIONS SUB-FIELD: ALL// SYNONYM

THEN EDIT SECONDARY MENU OPTIONS SUB-FIELD: (Hit enter here)

THEN EDIT FIELD:(Hit enter here)

Select NEW PERSON NAME: SM MANAGER,SYSTEM SM Clinical Coordinator

Select SECONDARY MENU OPTIONS: // XPD PRINT PACKAGE PATCHES Display Patches for a Package

...OK? Yes// (Hit enter here) (Yes)

//

SYNONYM: // KIDS

Select SECONDARY MENU OPTIONS: ^

On page 1 and 2 is a table with a list of the packages and patches. You will need to go into the programmers [[prompt~|Prompt]], select the secondary menu and list the patches for the patches. The tricky part is how you ask for the packages. In the order that they appear, I have listed what you type in to get the package you want at the [[prompt~|Prompt]] "Select PACKAGE NAME." There doesn't seem to be any rhyme or reason to whether you need to enter the package namespace like XT or whether you enter a name like Clinical Info Resource Network. The table below has the VA [[Application~|Application]] name on the left and what you need to type at the [[prompt~|Prompt]] on the right. The way to figure out what to try is to look at the file custody document and the namespaces document in the software directory on ftp://ftp.va.gov/vista/software .

[[Application~|Application]] Name in pg. 1 & 2

What to enter at Select PACKAGE NAME:

CIRN

CLINICAL INFO RESOURCE NETWORK

Scheduling

SCHEDULING

PIMS

DG REGISTRATION

Hl7

HL

MailMan

MAILMAN

Kernel

(note: Kevin T gave up trying to format at this point.
I can't figure out what I am formatting. I think it was
formatted HTML that was cut-n-pasted here.)

XU KERNEL

Kernel Toolkit

XT

VA Fileman

VA FILEMAN

Extensible Editor

RGED - Not included in Platinum Release 4/2003*

Run Time Library

RGUT

Pharmacy

PHARMACY

Inpatient Medications

PSJ

Outpatient Pharmacy

PSO

*It was removed with patch RGED*2.6*1 in Aug. 2001 because it contained a global with control characters. See the below for more information. Thanks to Fil Beza for providing this information.

PATCH NUMBER: RGED*2.6*01 PACKAGE NAME: EXTENSIBLE EDITOR

SUBJECT: EXTENSIBLE EDITOR - ELIMINATION OF PACKAGE

DATE APPLIED TO PRODUCTION: AUG 21, 2001@20:18:16

DATE ENTERED: AUG 13, 2001 DATE VERIFIED: OCT 02, 2001

PACKAGE NAMESPACE: RGED SEQUENCE NUMBER: 1

PRIORITY: MANDATORY

TEXT OF PATCH:

-------------------------------------------

Run Date: OCT 02, 2001 Designation: RGED*2.6*1

Package : RGED - EXTENSIBLE EDITOR Priority: Mandatory

Version : 2.6 SEQ #1 Status: Released

-------------------------------------------

Subject: EXTENSIBLE EDITOR - ELIMINATION OF PACKAGE

Category:

- Routine

- Other

Description:

-------------------------------------------

Installation of patch RGED*2.6*1 is OPTIONAL.

Extensible Editor 2.6 was initially released to support

functionality within Master Patient Index/Patient Demographics

(MPI/PD) 1.0. The dependencies by MPI/PD on the Extensible Editor

product have been eliminated. All formal integration agreements

have been retired. Extensible Editor 2.6 is no longer supported

nationally, making it Class II software. If you choose to do so,

you can install patch RGED*2.6*1 to remove the Extensible Editor

package from VistA. This is a local decision, and the installation

of this patch is OPTIONAL.

It is STRONGLY recommended that all facilities install this patch.

The Extensible Editor [[application~|Application]] contains a global that has embedded

control characters. This violates the VA Standards and Conventions

(SAC) and it is also in violation of the current ANSI MDC X11.1

Portability Standards.

The following demonstrates starting the job described above:

VISTA>D ^XUP

Setting up programmer environment

Terminal Type set to: C-VT100

Select OPTION NAME: EVE

1 EVE Systems Manager Menu

2 EVENT CAPTURE (ECS) EXTRACT AU ECX ECS SOURCE AUDIT Event Capture

(ECS) Extract Audit

3 EVENT CAPTURE DATA ENTRY ECENTER Event Capture Data Entry

4 EVENT CAPTURE EXTRACT ECXEC Event Capture Extract

5 EVENT CAPTURE MANAGEMENT MENU ECMGR Event Capture Management Menu

Press <RETURN> to see more, '^' to exit this list, OR

CHOOSE 1-5: 1 EVE Systems Manager Menu

WARNING -- TASK MANAGER DOESN'T SEEM TO BE RUNNING!!!!

Select Systems Manager Menu Option: KIDS Display Patches for a Package

Select PACKAGE NAME: CLINICAL INFO RESOURCE NETWORK RG

Select VERSION: 1.0// (Hit enter here) 04-28-99

Do you want to see the Descriptions? NO// (Hit enter here)

DEVICE: // HOME CONSOLE

PACKAGE: CLINICAL INFO RESOURCE NETWORK Jun 19, 2003 4:54 pm PAGE 1

PATCH # INSTALLED INSTALLED BY

-------------------------------------------------------------------------------

VERSION: 1.0 JUN 28, 1999 MANAGER,SYSTEM

2 SEQ #1 OCT 19, 1999 MANAGER,SYSTEM

1 SEQ #2 JAN 25, 2000 MANAGER,SYSTEM

3 SEQ #3 MAY 25, 2000 MANAGER,SYSTEM

4 SEQ #4 JUL 24, 2000 MANAGER,SYSTEM

7 SEQ #5 AUG 24, 2000 MANAGER,SYSTEM

5 SEQ #6 SEP 05, 2000 MANAGER,SYSTEM

8 SEQ #7 OCT 04, 2000 MANAGER,SYSTEM

6 SEQ #8 OCT 27, 2000 MANAGER,SYSTEM

9 SEQ #9 NOV 27, 2000 MANAGER,SYSTEM

11 SEQ #10 NOV 27, 2000 MANAGER,SYSTEM

10 SEQ #11 JAN 03, 2001 MANAGER,SYSTEM

14 SEQ #12 FEB 28, 2001 MANAGER,SYSTEM

15 SEQ #13 FEB 28, 2001 MANAGER,SYSTEM

12 SEQ #14 APR 05, 2001 MANAGER,SYSTEM

16 SEQ #15 APR 05, 2001 MANAGER,SYSTEM

Enter RETURN to continue or '^' to exit:

///

Checking for RG* Globals [back]

The next job is to see if you need to place the RG* globals in the system. For this, check in Cache explorer to see if they are there. The following screen captures show how that is done.

Go to the Cache Cube, Click on Cache explorer, choose namespace VISTA and then Globals.

Now expand the list of globals by clicking on it and look for the RG* globals (^RGSITE, ^RGHL7, ^RGEQASN, RGEQEXC, ^RGSTAT, and ^RGEQ). You will see that in this version of VistA Platinum, they are present, but they are not mapped to a namespace because they are already in the vista namespace where they need to be. I have selected them in the screen capture below to make it easier to see.

Unmapping routines [back]

Next you are asked to find out if any of the routines listed on page 5 of the manual are mapped. This is not necessary to do that for Cache on Windows.

Journaling [back]

On page 5 you are asked to turn off journaling for ^RG* during the installation and then re-enabled. You are also advised to read patch HL*1.6*52 recommendations about global journaling. This is how that is done in Cache.

Locate the Namespace where ^RG* is translated. This will display whether journaling is enabled or not. Note Jrn column for Journaling. This will show listings for 300+ globals. Excerpts are shown below.

D ^%GD

Device: Right margin: 80=>

Show detail? No => YES

Global Directory Display of VISTA

4:26 PM Jun 20 2003

Global Vacant Own Grp Wld Net Growth 1st PB Jrn Keep

^%Z RWD R R RWD 2300 1120 N N

Data Location: c:\cachesys\mgr\vista\

Lock Location: c:\cachesys\mgr\vista\

Replications:

Collation: Cache standard

^%ZIS RWD R R RWD 2300 6 N N

Data Location: c:\cachesys\mgr\vista\

Lock Location: c:\cachesys\mgr\vista\

Replications:

Collation: Cache standard

///

///

^RGEQ RWD N N RWD 2300 1014 N N

Data Location: c:\cachesys\mgr\vista\

Lock Location: c:\cachesys\mgr\vista\

Replications:

Collation: Cache standard

^RGEQASN RWD N N RWD 2300 1015 N N

Data Location: c:\cachesys\mgr\vista\

Lock Location: c:\cachesys\mgr\vista\

Replications:

Collation: Cache standard

^RGEQEXC RWD N N RWD 2300 1016 N N

Data Location: c:\cachesys\mgr\vista\

Lock Location: c:\cachesys\mgr\vista\

Replications:

Collation: Cache standard

^RGHL7 RWD N N RWD 2300 1017 N N

Data Location: c:\cachesys\mgr\vista\

Lock Location: c:\cachesys\mgr\vista\

Replications:

Collation: Cache standard

^RGSITE RWD N N RWD 2300 1018 N N

Data Location: c:\cachesys\mgr\vista\

Lock Location: c:\cachesys\mgr\vista\

Replications:

Collation: Cache standard

^RGSTAT RWD N N RWD 2300 1019 N N

Data Location: c:\cachesys\mgr\vista\

Lock Location: c:\cachesys\mgr\vista\

Replications:

Collation: Cache standard

^RMPF RWD N N RWD 2300 1020 N N

Data Location: c:\cachesys\mgr\vista\

Lock Location: c:\cachesys\mgr\vista\

Replications:

Collation: Cache standard

///

To later turn Journaling on or off, use D ^%JOURNAL and enable/disable journaling as needed. In this case, Journaling was already disabled so no change was made when a request was made to disable it.

USER>D ^%CD

Namespace: VISTA

You're in namespace VISTA

Default directory is c:\cachesys\mgr\vista\

VISTA>D ^%JOURNAL

Enable or Disable journaling of a set of globals.

Do you want to Enable or Disable journaling? (E or D) E=> D

All Globals? No => NO

Global ^RG*

6 items selected from

313 available globals

Global ^

Global ^RGEQ No change

Global ^RGEQASN No change

Global ^RGEQEXC No change

Global ^RGHL7 No change

Global ^RGSITE No change

Global ^RGSTAT No change

VISTA>

USER>D ^%CD

To find out what patch HL*1.6*52 says about globals, follow the instructions for checking for patches and check for patches to HL and say yes to "Do you want to see the descriptions" instead of just hitting enter to accept the "No" default.

Find the Value of a Field in a File [back]

Another task you will be asked to do is to find the contents of File #870, Field #21. This turns out not to be as simple an exercise as it might seem. At first blush, one might just decide to use the entry point D Q^DI, inquire into the contents of file 870 and then field 21. This is an excerpt of what you happen when you do that.

VISTA>D Q^DI

VA FileMan 22.0

Select OPTION: INQUIRE TO FILE ENTRIES

OUTPUT FROM WHAT FILE: NEW PERSON// 870 HL LOGICAL LINK

(183 entries)

Select HL LOGICAL LINK NODE: ??

Choose from:

AMB-CARE

DGMST-SEND

EPI-LAB

HUI PROV

///

(All 183 entries are here and none of them are likely to have anything to do with what you have entered so far in you install of VistA Platinum in a non-VA setting)

////

XUMF TEST

YS GAF-SND

Select HL LOGICAL LINK NODE:

You need to find out what the entry is for your site, and at the moment, you do not have a location number for this job site because you presumably are not at VA hospital of clinic. This is NOT the same number you assigned in step 78 and 79 of Chapter 1 of the installation instructions. Notice that the next to the last entry is XUMF TEST. You can use this for now and add your site as an entry later. What follows is the output you will get for XUMF TEST if you say YES to STANDARD CAPTION OUTPUT.

Select HL LOGICAL LINK NODE: XUMF TEST

ANOTHER ONE:

STANDARD CAPTIONED OUTPUT? Yes// Y (Yes)

Include COMPUTED fields: (N/Y/R/B): NO// BOTH Computed Fields and [[Record~|Record]] Number

(IEN)

NUMBER: 175 NODE: XUMF TEST

LLP TYPE: TCP QUEUE SIZE: 10

RE-TRANSMISSION ATTEMPTS: 5 ACK TIMEOUT: 600

EXCEED RE-TRANSMIT [[ACTION~|Action]]: shutdown TCP/IP ADDRESS: 10.4.229.23

TCP/IP PORT: 5000 TCP/IP SERVICE TYPE: CLIENT (SENDER)

This is what you get if you say NO to STANDARD CAPTION OUTPUT and ask for field #21.

OUTPUT FROM WHAT FILE: HL LOGICAL LINK//

Select HL LOGICAL LINK NODE: XUMF TEST

ANOTHER ONE:

STANDARD CAPTIONED OUTPUT? Yes// NO (No)

FIRST PRINT FIELD: 21 QUEUE SIZE

THEN PRINT FIELD:

Heading (S/C): HL LOGICAL LINK LIST Replace

DEVICE: CONSOLE Right Margin: 80//

HL LOGICAL LINK LIST JUN 20,2003 08:49 PAGE 1

QUEUE

SIZE

--------------------------------------------------------------------------------

10

Be sure DUZ(0)=@ and U="^" [back]

To do this, enter ZW at the Vista [[prompt~|Prompt]] after you have entered using the programmers environment using D ^XUP. I have shown you the output both before and after D ^XUP below. Note DUZ(0) and U are correct.

USER>D ^%CD

Namespace: VISTA

You're in namespace VISTA

Default directory is c:\cachesys\mgr\vista\

VISTA>ZW

VISTA>D ^XUP

Setting up programmer environment

Access Code:

Terminal Type set to: C-VT100

Select OPTION NAME: ^PG

VISTA>ZW

DT=3030623

DTIME="600"

DUZ=1

DUZ("0")="@"

DUZ("1")=""

DUZ("2")=1

DUZ("AG")="V"

DUZ("BUF")=1

DUZ("LANG")=""

IO="|TRM|:|3288"

IO("0")="|TRM|:|3288"

IO("1","|TRM|:|3288")=""

IO("ERROR")=""

IO("HOME")="5^|TRM|:|3288"

IO("ZIO")="TRM:"

IOBS="$C(8)"

IOF="#,$C(27,91,50,74,27,91,72)"
IOM=80
ION="CONSOLE"
IOS=5
IOSL="24"
IOST="C-VT100"
IOST(0)=9
IOT="VTRM"
IOXY="W $C(27,91)_((DY+1))_$C(59)_((DX+1))_$C(72)"
U="^"

XQXFLG="^^XUP"

VISTA>

Proceed with the KIDS installation [back]

For this you will need to find RG_1_0.KID which is located at

[Back to Contents]

Register a Patient

2013-03-06T10:52:06Z

Anthracite: /* Standard Method for Registering A Patient */

__toc__

===Standard Method for Registering A Patient ===

Use the menu option,

REGISTER A PATIENT

or the menu option

LOAD/EDIT PATIENT DATA

=== Kevin's Add / Edit Patient Method ===

EDITPT(AddOK)
;"Purpose: To ask for a patient name, and then allow editing
;"Input: AddOK: if 1, then adding new patients is allowed
;"Result: none

do LO^DGUTL
set DGCLPR=""
new DGDIV set DGDIV=$$PRIM^VASITE

if DGDIV>0 set %ZIS("B")=$piece($get(^DG(40.8,+DGDIV,"DEV")),U,1)

kill %ZIS("B")
if '$data(DGIO),$piece(^DG(43,1,0),U,30) do
. set %ZIS="N",IOP="HOME"
. do ^%ZIS

A do ENDREG^DGREG($get(DFN))
do if (Y<0) goto EditDone
. W !!
. if $get(AddOK)=1 do
. . set DIC=2,DIC(0)="ALEQM"
. . set DLAYGO=2
. else do
. . set DIC=2,DIC(0)="AEQM"
. . set DLAYGO=0
. kill DIC("S")
. do ^DIC
. kill DLAYGO
. if Y<0 quit
. set (DFN,DA)=+Y
. set DGNEW=$P(Y,"^",3)
. new Y
. do PAUSE^DG10
. do BEGINREG^DGREG(DFN)
. if DGNEW D NEW^DGRP

if +$get(DGNEW) do
. ;" query CMOR for Patient [[Record~|Record]] Flag Assignments if NEW patient and
. ;" display results.
. if $$PRFQRY^DGPFAPI(DFN) do DISPPRF^DGPFAPI(DFN)

set (DGFC,CURR)=0
set DA=DFN
set DGFC="^1"
set VET=$select($data(^DPT(DFN,"VET")):^("VET")'="Y",1:0)

set %ZIS="N",IOP="HOME"
do ^%ZIS
set DGELVER=0
;"do EN^DGRPD
;"if $data(DGRPOUT) do goto A
;". do ENDREG^DGREG($G(DFN))
;". do HL7A08^VAFCDD01
;". kill DFN,DGRPOUT

;"do [[HINQ~|HINQ]]^DG10
if $D(^DIC(195.4,1,"UP")) if ^("UP") do ADM^RTQ3

do REG^IVMCQ($G(DFN)) ;" send financial query

set DGRPV=0
do EN1^DGRP

EditDone

quit

To use this function, you will need to put it into a file. In my system, I have it saved in /usr/local/OpenVistA_UserData/r/TMGMISC.m

To execute it, one could do this: do EDITPT^TMGMISC(1) but this must be done from a programmer's [[prompt~|Prompt]]--not good for a final running system.

So the best way is to create a menu option that executes this.

I'll try to come back later and specify how this is done. But in short, create a menu that is an [[action~|Action]]. And make the execution [[action~|Action]] to be: DO EDITPT^TMGMISC(1)

Here is an e-mail that I wrote with more instructions: [[KT setting up Add-Edit Patient]]

Kevin Toppenberg 4-2-2005

=== Importing legacy data ===

[Back to Contents]

This actually applies to any file import, like referring doctors, cpt codes, etc. Helpful resources here are VPE http://www.hardhats.org/tools/vpe/vpe_db.html and the FileMan documentation from VDL http://www.va.gov/vdl/default.asp.

1. FileMan has "mandatory" fields for each file, so you either need to import these, or change the file attributes so that they are no longer "mandatory". The latter is actually easier. You can display a list of "required" fields for any file if you install VPE. Alternetively, using the Data Dictonary option in FileMan, display the fields, and make note of those, "mandatory" fields you don't want to import. Then, from FileMan’s main option, "MODify file attributes" to change "mandatory" to "no" for these fields.

2. FileMan can import external data directly from spreadsheets (Excel, 1-2-3) in various formats, or from user defined formats including comma or tab delimited and fixed length fields. In, theory you could use any delimiter. I have used CSV files with quoted text. You could write a routine to parse your data or export data from your old system to a spreadsheet, choose the fields you want to import and save those columns. Make note of the order of the fields and the data they contain.

3. Some formatting Issues here. You will probably have to do some editing of your data. FileMan likes names as: LAST,FIRST M, dates as: MMDDCCYY, phone numbers and SSN’s as numeric, unformatted. I haven’t tried to import “name components” directly to see if FileMan would fill the full name field directly. Watch out for programs which supress leading zeros in dates and SSN’s, they need to have the proper number of digits.

4. Enter FileMan and under "OTHer options", choose “IMport data”. You have 'external data', choose your saved format under 'foreign format' or just tell FileMan how you saved it: no to fixed length, comma delimited and yes to fields quoted. Enter the full path of the directory where you saved source file then the file name. Then enter "Patient" or the destination file in “Primary file”.

5. Choose 'field selection page'. You are then presented with the selection page where you specify the fields, in the order that they appear in the saved file. You can save this as a template to repeat the same import a second time.

6. When you have selected all the fields you wish to import, exit, save and run the import. If you didn't fill or remove the 'mandatory' for a required field you'll get an error which doesn't tell you which field. Format errors, like dates and SSN’s are identified.

Mike Schrom 10/31/05

=== Misc [[Configuration~|Configuration]] Scripts ===
(Registering a patient)

Contents

Notes
Adding a Menu to Register a Patient
Overview of Registering a Patient
Installing CIRN and the MPI Infrastructure

Editor's Notes:

This was sent to me by Nancy Anthracite. I was searching for a way to register a patient--i.e. how to add a new patient to the system. She wrote "Kevin - I think this stuff may already be installed, but the second section will explain some of what you want to know. -Nancy".

These example scripts are run on a Cache' system. I assume that the steps will be applicable to GT.M

[Back to Contents]

Assigning a Menu to Register a Patient

[Back to Contents]

In order to register a patient, you can use your powers as System Manager with all of the keys to do it, but instead, you can set up a Director of Admissions who has the ability to work with the MASTER PATIENT INDEX/PATIEND DEMOGRAPHICS (MPI/PD) system and register a patient. This Director of Admissions was give access to three menus as indicated below, the last of which allows registration of a patient. Throughout this document BOLD RED indicates user input.

VISTA>D ^ZU

Volume set: VISTA:CACHEWEB UCI: VISTA Device: |TRM|:|4052 (TRM:)

ACCESS CODE: *******

VERIFY CODE: ********

Good afternoon MANAGER,SYSTEM

You last signed on Jun 2,2003 at 00:0

Select TERMINAL TYPE NAME: C-VT100//

Digital Equipment Corporation VT-100 video

WARNING -- TASK MANAGER DOESN'T SEEM TO BE RUNNING!!!!

Select Systems Manager Menu Option: FM VA FileMan

VA FileMan Version 22.0

Select VA FileMan Option:

Select VA FileMan Option: ENTER or Edit File Entries

INPUT TO WHAT FILE: NEW PERSON//

EDIT WHICH FIELD: ALL// PRIMARY MENU OPTION

THEN EDIT FIELD: SECONDARY MENU OPTIONS (multiple)

EDIT WHICH SECONDARY MENU OPTIONS SUB-FIELD: ALL//

THEN EDIT FIELD:

Select NEW PERSON NAME: DA ADMISSIONS,DIRECTOR DA

PRIMARY MENU OPTION: MPI/PD MASTER MENU RGMGR MPI/PD Master Menu

Select SECONDARY MENU OPTIONS: RG ADMIN COORD MENU MPI/PD Patient Admin Coordinator Menu

Are you adding 'RG ADMIN COORD MENU' as a new SECONDARY MENU OPTIONS (the 1ST for this NEW PERSON)? No// Y (Yes)

SYNONYM: CORD

Select SECONDARY MENU OPTIONS: RG ADMIN COORD MENU

// DG REGISTRATION MENU Registration Menu

Are you adding 'DG REGISTRATION MENU' as a new SECONDARY MENU OPTIONS (the 2ND for this NEW PERSON)? No// Y (Yes)

SYNONYM: REGM

Select SECONDARY MENU OPTIONS:

Overview of Registering a Patient

[Back to Contents]

When you actually register your test patient, it might be helpful to you to know some information and terminology. All test patients in the VistA system at the VA are given social security numbers beginning with 5 zeros. These are recognized as test patients and automatically excluded from any uploads to central patient directories. Patients may also be given pseudo social security numbers in some circumstances, for instance, when the SS number is not known.

Information about PSEUDO SOCIAL SECURITY NUMBERS can be found by typing ?? at the [[prompt~|Prompt]] to enter the social security number when you are registering a patient. If you just enter a number followed by a P, that will also give you more information as the system will admonish you for not doing it right and tell you what to do. If you still don't do it correctly, the Pseudo SS number will be generated for you.

The most important fields used in keeping track of patients in the VA are the NAME, SS#, DOB (Date of Birth) and (DFN - file number of some sort??). If you follow this convention, it is likely to help you utilize the more advanced features for finding patients in other clinics, etc., if you ever utilize this system in a grand scale. It is also recommended that auditing be done AT LEAST of changes in these fields and SEX. (Auditing is discussed later on in this document.)

When registering a new patient, an attempt will be made to access the MPI (Master Patient Index) which, for the VA, is a centralized master patient file in Austin, Texas. You will also see mention of the CMOR (Coordinating Master of [[Record~|Record]]), which is the main site where a patient receives care and where the main [[record~|Record]]] of the patient is maintained. There is also the ICN - the Integration Control Number - which is like a patient number that can be assigned locally or where the Master Patient Index is maintained (i.e., Austin for the VA).

Installing CIRN and the MPI Infrastructure

Checking the Patch Level
Checking for RG* Globals
Unmapping routines
Journaling
Find the Value of a Field in a File
Be sure DUZ(0)=@ and U="^"
Proceed with the KIDS installation

[Back to Contents]

You may simply register a patient using this assigned menu, but because it may not be desirable to use social security numbers for patient identifiers within a medical care system, documentation of how to install the Master Patient Index system short of actually having it contact Austin , Texas follows. This will allow for the generation of ICNs that have the first 3 numbers as identifiers of the location where the patient was registered. This would be useful with a medical care system with multiple clinics, etc., as it might help to keep track of patients from various clinics if they are gathered in one central database. This is the equivalent of installing the test account for the Clinical Information Resource Network - Patient Demographics (CIRN-PD) and the Master Patient Index (MPI).

Installing the test account is the same as installing the full system except that the patch HL*1.6*39 is not installed. That is the patch that actually allows the system to contact Austin, Texas where the central VA Master Patient index is maintained. HL*1.6*39 must not be installed or your system will sending unwanted information to the VA MPI in Austin.

The installation of this system is documented in the Clinical Information Resource Network Patient Demographiscs (CIRN-PD) and Master Patient Indes (MPI) Installation and Implementation Guide, Version 2, Package Version 1.0, August 2000, Draft which can be found at : http://www.va.gov/vdl/documents/Infrastructure/Master_Patient_Index_(MPI)/rg1_0_ig2.doc

You will need to obtain these instructions as this document is made to supplement that document to allow "newbies" to use the official instructions.

Checking the Patch Level [back]

Beginning right on page 1 of the manual, you will need to check the patch level of various packages listed to be sure they are patched as they should be. Vista Platinum is patched to the current level in almost all packages, so this is unlikely to be a problem, but you will need to check. This is done by assigning yourself the XPD PRINT PACKAGE PATCHES, or Display Patches for a Package as a Secondary Menu. Assuming you have followed the prior documentation and are now the SM or "Manager, System" with all of the keys assigned, you will assign this menu to yourself in the New Person file, secondary menu field as follows (except the KIDS synonym may already be entered for you):

VISTA>D Q^DI

VA FileMan 22.0

Select OPTION: ENTER OR EDIT FILE ENTRIES

INPUT TO WHAT FILE: HL LOGICAL LINK// 200 NEW PERSON (8 entries)

EDIT WHICH FIELD: ALL// SECONDARY MENU OPTIONS (multiple)

EDIT WHICH SECONDARY MENU OPTIONS SUB-FIELD: ALL// SYNONYM

THEN EDIT SECONDARY MENU OPTIONS SUB-FIELD: (Hit enter here)

THEN EDIT FIELD:(Hit enter here)

Select NEW PERSON NAME: SM MANAGER,SYSTEM SM Clinical Coordinator

Select SECONDARY MENU OPTIONS: // XPD PRINT PACKAGE PATCHES Display Patches for a Package

...OK? Yes// (Hit enter here) (Yes)

//

SYNONYM: // KIDS

Select SECONDARY MENU OPTIONS: ^

On page 1 and 2 is a table with a list of the packages and patches. You will need to go into the programmers [[prompt~|Prompt]], select the secondary menu and list the patches for the patches. The tricky part is how you ask for the packages. In the order that they appear, I have listed what you type in to get the package you want at the [[prompt~|Prompt]] "Select PACKAGE NAME." There doesn't seem to be any rhyme or reason to whether you need to enter the package namespace like XT or whether you enter a name like Clinical Info Resource Network. The table below has the VA [[Application~|Application]] name on the left and what you need to type at the [[prompt~|Prompt]] on the right. The way to figure out what to try is to look at the file custody document and the namespaces document in the software directory on ftp://ftp.va.gov/vista/software .

[[Application~|Application]] Name in pg. 1 & 2

What to enter at Select PACKAGE NAME:

CIRN

CLINICAL INFO RESOURCE NETWORK

Scheduling

SCHEDULING

PIMS

DG REGISTRATION

Hl7

HL

MailMan

MAILMAN

Kernel

(note: Kevin T gave up trying to format at this point.
I can't figure out what I am formatting. I think it was
formatted HTML that was cut-n-pasted here.)

XU KERNEL

Kernel Toolkit

XT

VA Fileman

VA FILEMAN

Extensible Editor

RGED - Not included in Platinum Release 4/2003*

Run Time Library

RGUT

Pharmacy

PHARMACY

Inpatient Medications

PSJ

Outpatient Pharmacy

PSO

*It was removed with patch RGED*2.6*1 in Aug. 2001 because it contained a global with control characters. See the below for more information. Thanks to Fil Beza for providing this information.

PATCH NUMBER: RGED*2.6*01 PACKAGE NAME: EXTENSIBLE EDITOR

SUBJECT: EXTENSIBLE EDITOR - ELIMINATION OF PACKAGE

DATE APPLIED TO PRODUCTION: AUG 21, 2001@20:18:16

DATE ENTERED: AUG 13, 2001 DATE VERIFIED: OCT 02, 2001

PACKAGE NAMESPACE: RGED SEQUENCE NUMBER: 1

PRIORITY: MANDATORY

TEXT OF PATCH:

-------------------------------------------

Run Date: OCT 02, 2001 Designation: RGED*2.6*1

Package : RGED - EXTENSIBLE EDITOR Priority: Mandatory

Version : 2.6 SEQ #1 Status: Released

-------------------------------------------

Subject: EXTENSIBLE EDITOR - ELIMINATION OF PACKAGE

Category:

- Routine

- Other

Description:

-------------------------------------------

Installation of patch RGED*2.6*1 is OPTIONAL.

Extensible Editor 2.6 was initially released to support

functionality within Master Patient Index/Patient Demographics

(MPI/PD) 1.0. The dependencies by MPI/PD on the Extensible Editor

product have been eliminated. All formal integration agreements

have been retired. Extensible Editor 2.6 is no longer supported

nationally, making it Class II software. If you choose to do so,

you can install patch RGED*2.6*1 to remove the Extensible Editor

package from VistA. This is a local decision, and the installation

of this patch is OPTIONAL.

It is STRONGLY recommended that all facilities install this patch.

The Extensible Editor [[application~|Application]] contains a global that has embedded

control characters. This violates the VA Standards and Conventions

(SAC) and it is also in violation of the current ANSI MDC X11.1

Portability Standards.

The following demonstrates starting the job described above:

VISTA>D ^XUP

Setting up programmer environment

Terminal Type set to: C-VT100

Select OPTION NAME: EVE

1 EVE Systems Manager Menu

2 EVENT CAPTURE (ECS) EXTRACT AU ECX ECS SOURCE AUDIT Event Capture

(ECS) Extract Audit

3 EVENT CAPTURE DATA ENTRY ECENTER Event Capture Data Entry

4 EVENT CAPTURE EXTRACT ECXEC Event Capture Extract

5 EVENT CAPTURE MANAGEMENT MENU ECMGR Event Capture Management Menu

Press <RETURN> to see more, '^' to exit this list, OR

CHOOSE 1-5: 1 EVE Systems Manager Menu

WARNING -- TASK MANAGER DOESN'T SEEM TO BE RUNNING!!!!

Select Systems Manager Menu Option: KIDS Display Patches for a Package

Select PACKAGE NAME: CLINICAL INFO RESOURCE NETWORK RG

Select VERSION: 1.0// (Hit enter here) 04-28-99

Do you want to see the Descriptions? NO// (Hit enter here)

DEVICE: // HOME CONSOLE

PACKAGE: CLINICAL INFO RESOURCE NETWORK Jun 19, 2003 4:54 pm PAGE 1

PATCH # INSTALLED INSTALLED BY

-------------------------------------------------------------------------------

VERSION: 1.0 JUN 28, 1999 MANAGER,SYSTEM

2 SEQ #1 OCT 19, 1999 MANAGER,SYSTEM

1 SEQ #2 JAN 25, 2000 MANAGER,SYSTEM

3 SEQ #3 MAY 25, 2000 MANAGER,SYSTEM

4 SEQ #4 JUL 24, 2000 MANAGER,SYSTEM

7 SEQ #5 AUG 24, 2000 MANAGER,SYSTEM

5 SEQ #6 SEP 05, 2000 MANAGER,SYSTEM

8 SEQ #7 OCT 04, 2000 MANAGER,SYSTEM

6 SEQ #8 OCT 27, 2000 MANAGER,SYSTEM

9 SEQ #9 NOV 27, 2000 MANAGER,SYSTEM

11 SEQ #10 NOV 27, 2000 MANAGER,SYSTEM

10 SEQ #11 JAN 03, 2001 MANAGER,SYSTEM

14 SEQ #12 FEB 28, 2001 MANAGER,SYSTEM

15 SEQ #13 FEB 28, 2001 MANAGER,SYSTEM

12 SEQ #14 APR 05, 2001 MANAGER,SYSTEM

16 SEQ #15 APR 05, 2001 MANAGER,SYSTEM

Enter RETURN to continue or '^' to exit:

///

Checking for RG* Globals [back]

The next job is to see if you need to place the RG* globals in the system. For this, check in Cache explorer to see if they are there. The following screen captures show how that is done.

Go to the Cache Cube, Click on Cache explorer, choose namespace VISTA and then Globals.

Now expand the list of globals by clicking on it and look for the RG* globals (^RGSITE, ^RGHL7, ^RGEQASN, RGEQEXC, ^RGSTAT, and ^RGEQ). You will see that in this version of VistA Platinum, they are present, but they are not mapped to a namespace because they are already in the vista namespace where they need to be. I have selected them in the screen capture below to make it easier to see.

Unmapping routines [back]

Next you are asked to find out if any of the routines listed on page 5 of the manual are mapped. This is not necessary to do that for Cache on Windows.

Journaling [back]

On page 5 you are asked to turn off journaling for ^RG* during the installation and then re-enabled. You are also advised to read patch HL*1.6*52 recommendations about global journaling. This is how that is done in Cache.

Locate the Namespace where ^RG* is translated. This will display whether journaling is enabled or not. Note Jrn column for Journaling. This will show listings for 300+ globals. Excerpts are shown below.

D ^%GD

Device: Right margin: 80=>

Show detail? No => YES

Global Directory Display of VISTA

4:26 PM Jun 20 2003

Global Vacant Own Grp Wld Net Growth 1st PB Jrn Keep

^%Z RWD R R RWD 2300 1120 N N

Data Location: c:\cachesys\mgr\vista\

Lock Location: c:\cachesys\mgr\vista\

Replications:

Collation: Cache standard

^%ZIS RWD R R RWD 2300 6 N N

Data Location: c:\cachesys\mgr\vista\

Lock Location: c:\cachesys\mgr\vista\

Replications:

Collation: Cache standard

///

///

^RGEQ RWD N N RWD 2300 1014 N N

Data Location: c:\cachesys\mgr\vista\

Lock Location: c:\cachesys\mgr\vista\

Replications:

Collation: Cache standard

^RGEQASN RWD N N RWD 2300 1015 N N

Data Location: c:\cachesys\mgr\vista\

Lock Location: c:\cachesys\mgr\vista\

Replications:

Collation: Cache standard

^RGEQEXC RWD N N RWD 2300 1016 N N

Data Location: c:\cachesys\mgr\vista\

Lock Location: c:\cachesys\mgr\vista\

Replications:

Collation: Cache standard

^RGHL7 RWD N N RWD 2300 1017 N N

Data Location: c:\cachesys\mgr\vista\

Lock Location: c:\cachesys\mgr\vista\

Replications:

Collation: Cache standard

^RGSITE RWD N N RWD 2300 1018 N N

Data Location: c:\cachesys\mgr\vista\

Lock Location: c:\cachesys\mgr\vista\

Replications:

Collation: Cache standard

^RGSTAT RWD N N RWD 2300 1019 N N

Data Location: c:\cachesys\mgr\vista\

Lock Location: c:\cachesys\mgr\vista\

Replications:

Collation: Cache standard

^RMPF RWD N N RWD 2300 1020 N N

Data Location: c:\cachesys\mgr\vista\

Lock Location: c:\cachesys\mgr\vista\

Replications:

Collation: Cache standard

///

To later turn Journaling on or off, use D ^%JOURNAL and enable/disable journaling as needed. In this case, Journaling was already disabled so no change was made when a request was made to disable it.

USER>D ^%CD

Namespace: VISTA

You're in namespace VISTA

Default directory is c:\cachesys\mgr\vista\

VISTA>D ^%JOURNAL

Enable or Disable journaling of a set of globals.

Do you want to Enable or Disable journaling? (E or D) E=> D

All Globals? No => NO

Global ^RG*

6 items selected from

313 available globals

Global ^

Global ^RGEQ No change

Global ^RGEQASN No change

Global ^RGEQEXC No change

Global ^RGHL7 No change

Global ^RGSITE No change

Global ^RGSTAT No change

VISTA>

USER>D ^%CD

To find out what patch HL*1.6*52 says about globals, follow the instructions for checking for patches and check for patches to HL and say yes to "Do you want to see the descriptions" instead of just hitting enter to accept the "No" default.

Find the Value of a Field in a File [back]

Another task you will be asked to do is to find the contents of File #870, Field #21. This turns out not to be as simple an exercise as it might seem. At first blush, one might just decide to use the entry point D Q^DI, inquire into the contents of file 870 and then field 21. This is an excerpt of what you happen when you do that.

VISTA>D Q^DI

VA FileMan 22.0

Select OPTION: INQUIRE TO FILE ENTRIES

OUTPUT FROM WHAT FILE: NEW PERSON// 870 HL LOGICAL LINK

(183 entries)

Select HL LOGICAL LINK NODE: ??

Choose from:

AMB-CARE

DGMST-SEND

EPI-LAB

HUI PROV

///

(All 183 entries are here and none of them are likely to have anything to do with what you have entered so far in you install of VistA Platinum in a non-VA setting)

////

XUMF TEST

YS GAF-SND

Select HL LOGICAL LINK NODE:

You need to find out what the entry is for your site, and at the moment, you do not have a location number for this job site because you presumably are not at VA hospital of clinic. This is NOT the same number you assigned in step 78 and 79 of Chapter 1 of the installation instructions. Notice that the next to the last entry is XUMF TEST. You can use this for now and add your site as an entry later. What follows is the output you will get for XUMF TEST if you say YES to STANDARD CAPTION OUTPUT.

Select HL LOGICAL LINK NODE: XUMF TEST

ANOTHER ONE:

STANDARD CAPTIONED OUTPUT? Yes// Y (Yes)

Include COMPUTED fields: (N/Y/R/B): NO// BOTH Computed Fields and [[Record~|Record]] Number

(IEN)

NUMBER: 175 NODE: XUMF TEST

LLP TYPE: TCP QUEUE SIZE: 10

RE-TRANSMISSION ATTEMPTS: 5 ACK TIMEOUT: 600

EXCEED RE-TRANSMIT [[ACTION~|Action]]: shutdown TCP/IP ADDRESS: 10.4.229.23

TCP/IP PORT: 5000 TCP/IP SERVICE TYPE: CLIENT (SENDER)

This is what you get if you say NO to STANDARD CAPTION OUTPUT and ask for field #21.

OUTPUT FROM WHAT FILE: HL LOGICAL LINK//

Select HL LOGICAL LINK NODE: XUMF TEST

ANOTHER ONE:

STANDARD CAPTIONED OUTPUT? Yes// NO (No)

FIRST PRINT FIELD: 21 QUEUE SIZE

THEN PRINT FIELD:

Heading (S/C): HL LOGICAL LINK LIST Replace

DEVICE: CONSOLE Right Margin: 80//

HL LOGICAL LINK LIST JUN 20,2003 08:49 PAGE 1

QUEUE

SIZE

--------------------------------------------------------------------------------

10

Be sure DUZ(0)=@ and U="^" [back]

To do this, enter ZW at the Vista [[prompt~|Prompt]] after you have entered using the programmers environment using D ^XUP. I have shown you the output both before and after D ^XUP below. Note DUZ(0) and U are correct.

USER>D ^%CD

Namespace: VISTA

You're in namespace VISTA

Default directory is c:\cachesys\mgr\vista\

VISTA>ZW

VISTA>D ^XUP

Setting up programmer environment

Access Code:

Terminal Type set to: C-VT100

Select OPTION NAME: ^PG

VISTA>ZW

DT=3030623

DTIME="600"

DUZ=1

DUZ("0")="@"

DUZ("1")=""

DUZ("2")=1

DUZ("AG")="V"

DUZ("BUF")=1

DUZ("LANG")=""

IO="|TRM|:|3288"

IO("0")="|TRM|:|3288"

IO("1","|TRM|:|3288")=""

IO("ERROR")=""

IO("HOME")="5^|TRM|:|3288"

IO("ZIO")="TRM:"

IOBS="$C(8)"

IOF="#,$C(27,91,50,74,27,91,72)"
IOM=80
ION="CONSOLE"
IOS=5
IOSL="24"
IOST="C-VT100"
IOST(0)=9
IOT="VTRM"
IOXY="W $C(27,91)_((DY+1))_$C(59)_((DX+1))_$C(72)"
U="^"

XQXFLG="^^XUP"

VISTA>

Proceed with the KIDS installation [back]

For this you will need to find RG_1_0.KID which is located at

[Back to Contents]

WorldVista

2013-03-06T10:49:37Z

Anthracite: /* WorldVistA manual installation */

= Introduction =
[http://www.worldvista.org WorldVistA] is a direct descendant of the VA's VistA EHR system, with many of the original architects of VistA (the HardHats) still contributing and supervising WorldVistA's development.

The philosophy of WorldVistA is to always provide a free open-source platform (as consistent as possible with the public-domain nature of the VA's VistA platform) while enhancing and furthering development in a co-operative fashion.

WorldVistA uses the open source version of the MUMPS database. GT.M. WorldVistA is a 501(c)(3) nonprofit organization.

== Installing WorldVistA using Astronaut ==
The integrated Astronaut installer can be used to install the WorldVistA server as well as CPRS (and other) client packages.

* See [[Astronaut_VistA#Installation Instructions|Astronaut WorldVistA]]

**Pros: Easiest to install, standards-based, most all-in-one solution available. Some bugs such as IPv6 are fixed. Enables use, collaboration and development. Probably the best choice for newcomers, those not interested in installation details, and developers. Has Virtual machine/Windows version. Both server and client installers are available.
**Cons: Could be more modular. Currently Beta, but evolving quickly. WorldVistA version is not the official WorldVistA EHR Release.

== WorldVistA Toasters ==

*[[Toasters]] (Sourceforge download [http://sourceforge.net/projects/worldvista-ehr/files/WorldVistA%20EHR%20_VOE%201.0/WorldVistA%20EHR%20_VOE%201.0%20Release%206-2008/WVEHRVOE10Release6-08Toaster.zip/download here])

**Pros: Virtual machine-based, some convenience, can run on Windows. Demonstrates concepts.
**Cons: Virtual machine-based, so integration, migration, and upgrades might be an issue.

*[[SemiVivA]] (Sourceforge download [http://downloads.sourceforge.net/worldvista-ehr/WorldVistAEHRVOE1.0SemiVivALite.tar.bz2.nc here])

**Pros: Architecture more conducive to ASP model.
**Cons: Patches for clinical client support are lacking. Requires more expertise to install.

== WorldVistA manual installation ==

*[http://worldvista.org/Software_Download/worldvista_ehr_servers Server]
*[http://worldvista.org/Software_Download/worldvista_ehr_clients Client]
*[http://opensourcevista.net:8888/NancysVistAServer/WVEHR-2.0-Install-GTM Instructions for GT.M]
*[http://opensourcevista.net:8888/NancysVistAServer/WVEHR-2.0-Install-Cache Instructions for Cache]
*[[Nancy's Installation Method]]

**Pros: Official WorldVistA release. Perform and understand the raw basics of a VistA installation.
**Cons: Installation requires familiarity with computer systems, requires separate installation of clients.

WorldVista

2013-03-06T10:42:26Z

Anthracite: /* Installing WorldVistA using Astronaut */

= Introduction =
[http://www.worldvista.org WorldVistA] is a direct descendant of the VA's VistA EHR system, with many of the original architects of VistA (the HardHats) still contributing and supervising WorldVistA's development.

The philosophy of WorldVistA is to always provide a free open-source platform (as consistent as possible with the public-domain nature of the VA's VistA platform) while enhancing and furthering development in a co-operative fashion.

WorldVistA uses the open source version of the MUMPS database. GT.M. WorldVistA is a 501(c)(3) nonprofit organization.

== Installing WorldVistA using Astronaut ==
The integrated Astronaut installer can be used to install the WorldVistA server as well as CPRS (and other) client packages.

* See [[Astronaut_VistA#Installation Instructions|Astronaut WorldVistA]]

**Pros: Easiest to install, standards-based, most all-in-one solution available. Some bugs such as IPv6 are fixed. Enables use, collaboration and development. Probably the best choice for newcomers, those not interested in installation details, and developers. Has Virtual machine/Windows version. Both server and client installers are available.
**Cons: Could be more modular. Currently Beta, but evolving quickly. WorldVistA version is not the official WorldVistA EHR Release.

== WorldVistA Toasters ==

*[[Toasters]] (Sourceforge download [http://sourceforge.net/projects/worldvista-ehr/files/WorldVistA%20EHR%20_VOE%201.0/WorldVistA%20EHR%20_VOE%201.0%20Release%206-2008/WVEHRVOE10Release6-08Toaster.zip/download here])

**Pros: Virtual machine-based, some convenience, can run on Windows. Demonstrates concepts.
**Cons: Virtual machine-based, so integration, migration, and upgrades might be an issue.

*[[SemiVivA]] (Sourceforge download [http://downloads.sourceforge.net/worldvista-ehr/WorldVistAEHRVOE1.0SemiVivALite.tar.bz2.nc here])

**Pros: Architecture more conducive to ASP model.
**Cons: Patches for clinical client support are lacking. Requires more expertise to install.

== WorldVistA manual installation ==

*[http://worldvista.org/Software_Download/worldvista_ehr_servers Server]
*[http://worldvista.org/Software_Download/worldvista_ehr_clients Client]
*[http://opensourcevista.net:8888/NancysVistAServer/WVEHR-VOE1.0-Install/InstallWVEHR-VOE1.0-GTM.doc Instructions]
*[[Nancy's Installation Method]]

**Pros: Official WorldVistA release. Perform and understand the raw basics of a VistA installation.
**Cons: Installation requires familiarity with computer systems, requires separate installation of clients.

Outpatient Meaningful Use Stage One

2013-01-27T16:15:01Z

Anthracite:

''This page was originally created by Dr. Kevin Toppenberg, MD, a primary care physician in Greenville, TN. It was created as a documentation for how to pursue meaningful use certification with VistA. It has since been expanded by WorldVistA. Note that this document references external documents either from CMS or from WorldVistA.''

==Q: Where can I find the certification status of WorldVistA?==
* Go to [http://oncchpl.force.com/ehrcert/ehrproductsearch CMS Certified Health IT Products]
* Search for "WorldVistA" -- '''NOTE''': the search engine on this page is flaky. I found that when I clicked the search button, it would return a list of ALL technology. But when I then simply '''clicked search AGAIN''' (with WorldVistA still in the search term box), then it would find it.

==Q: There seem to be so many steps involved in getting ready for Stage One attestation. It's overwhelming. Any overview sites?==
* I recommend starting with this overview: [https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Meaningful_Use.html#BOOKMARK7 CMS EHR Meaningful Use Overview]. The information I am posting here is from this site.
* Alternatively, here are the slides from a [https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/CQM_Webinar_10-25-2011.pdf CMS webinar presentation.]
* Here is another [http://tinyurl.com/bu9n4b9 CMS document (2010)] document with similar detail.
* A very good presentation from IHS giving an overview of Meaningful Use can be found [ftp://ftp.ihs.gov/pubs/EHR/Training/Manuals/EHR%20for%20Meaningful%20Use%20-%202011/TAB%2002%20-%20MU%20Overview%20and%20Incentive%20Payment%20Estimator/T2.1%20%20-%20MU_EP_EH-Final.PPTX here]

==Q: What's the bottom line? What do I have to do to be ready to attest meaningful use?==
# Meet '''20 of 25 "Meaningful Use Objectives'''" [https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/EP-MU-TOC.pdf source]
#* Must meet 15 "core" measures
#* Must also meet 5 of 10 possible "menu" set measures
# Meet '''6 of 41 "Clinical Quality Measures (CQM's)'''" [https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures/index.html?redirect=/QualityMeasures/03_ElectronicSpecifications.asp source]
#* Must meet 3 required core quality measures
#* must also meet 3 of 38 possible additional quality measures
# Attest to meeting requirements using Y/N answers and by supplying data from the Quality Measures package.
(TO-DO SMH: Reference and write about the Quality Measures package.)

==Q: Can you tell me more about the 15 "core" meaningful use measures? (all are required)==
Detailed instructions on meeting these will be provided in more detail below. Detailed instructions on reporting can be found here: [[C0Q_Quality_Reporting_1.0 | Quality Measures package documentation]].
{| class="wikitable"
|-
! Measure !! Link to CMS Source !! VISTA fulfillment !! Attestation Type !! Quality Measures Package Logic
|-
| CPOE -- Provider directly enters in orders || [http://www.cms.gov/EHRIncentivePrograms/Downloads/1_CPOE_for_Medication_Orders.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.306.a%20CPOE.pdf Fulfillment] || Rate > 30% || Check for the presence of electronically prescribed medications stored in the Non-VA Multiple in file 55 for this patient
|-
| Implement drug-drug and drug-allergy interaction checks || [http://www.cms.gov/EHRIncentivePrograms/Downloads/2_Drug_Interaction_ChecksEP.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.a%20Drug-drug,%20drug-allergy%20interaction%20checks.pdf Fulfillment] || Yes/No || Not checked. Report YES. Core VISTA functionality. Also part of electronic prescribing.
|-
| Maintain an up-to-date problem list of current and active diagnoses || [http://www.cms.gov/EHRIncentivePrograms/Downloads/3_Maintain_Problem_ListEP.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.c-%20Maintain%20up-to-date%20problem%20list%20IN.pdf Fullfillment] || Rate > 80% || Checks active problems.
|-
| Generate and transmit permissible prescriptions electronically (eRx) || [http://www.cms.gov/EHRIncentivePrograms/Downloads/4_e-prescribing.pdf Source] || not available || Rate > 40% || Check for the presence of electronically prescribed medications stored in the Non-VA Multiple in file 55 for this patient
|-
| Maintain active medication list || [http://www.cms.gov/EHRIncentivePrograms/Downloads/5_Active_Medication_List.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.d%20Maintain%20active%20medication%20list%20IN.pdf Fulfillment] || Rate > 80% || Check for the presence of electronically prescribed medications stored in the Non-VA Multiple in file 55 for this patient
|-
| Maintain active medication allergy list || [http://www.cms.gov/EHRIncentivePrograms/Downloads/6_Medication_Allergy_List.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.e%20Maintain%20active%20medication%20allergy%20list%20IN.pdf Fulfillment] || Rate > 80% || Check for the presence of allergies for this patient
|-
| Record required demographics || [http://www.cms.gov/EHRIncentivePrograms/Downloads/7_Record_Demographics.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.306.b%20Record%20demographics.pdf Fulfillment] || Rate > 50% || Check for the presence of Sex, DOB, Primary ID, Preferred Language, Race, Ethnicity for this patient. Lack of any one disqualifes you.
|-
| Record required vital signs || [http://http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/8%2520Record%2520Vital%2520Signs%25202011.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.f.1%20Vital%20Signs.pdf Fulfillment] || Rate > 50% || Check vital signs from July 3rd 2011 to present for this patient.
|-
| Record smoking status for patients aged 13 yrs and up || [http://www.cms.gov/EHRIncentivePrograms/Downloads/9_Record_Smoking_Status.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.g%20Smoking%20Status.pdf Fulfillment] || Rate > 50% || Check health factors in the category Tobacco; see if patient will have these. If none found in the category, each possible health factor in a list is tried by itself.
|-
| Report clinical quality measures to CMS || [http://www.cms.gov/EHRIncentivePrograms/Downloads/10_Clinical_Quality_Measures.pdf Source] ||[https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.306.i%20Calculate%20and%20submit%20clinical%20quality%20measure.pdf Fulfillment] || Yes/No (Measures are reportable rates however) || Not checked. Report YES.
|-
| Implement 1 clinical decision support rule || [http://www.cms.gov/EHRIncentivePrograms/Downloads/11_Clinical_Decision_Support_Rule.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.306.c%20Clinical%20decision%20support%20H.pdf Fulfillment] || Yes/No || Not checked. Report YES.
|-
| Provide patients with an electronic copy of their health information || [http://www.cms.gov/EHRIncentivePrograms/Downloads/12_Electronic_Copy_of_Health_Information.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.306.d.2%20Electronic%20copy%20of%20health%20information%20Discharge%20Summary.pdf Fulfillment] || Rate > 50% || '''NOT COLLECTIBLE IN VISTA. NO RELEASE OF INFORMATION PACKAGE. COLLECT MANUALLY'''
|-
| Provide clinical summaries for patients for each office visit within 3 days || [http://www.cms.gov/EHRIncentivePrograms/Downloads/13_Clinical_Summaries.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.v%20Encryption%20when%20exchanging%20electronic%20health%20information.pdf Fulfillment] || Rate > 50% || '''NOT COLLECTIBLE IN VISTA. NO RELEASE OF INFORMATION PACKAGE. COLLECT MANUALLY'''
|-
| Perform at least 1 test of exchanging key clinical information with another entity electronically || [http://www.cms.gov/EHRIncentivePrograms/Downloads/14_Electronic_Exchange_of_Clinical_Information.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.v%20Encryption%20when%20exchanging%20electronic%20health%20information.pdf Fulfillment] || Yes/No || Not checked. Report YES.
|-
| Protect electronic health information || [http://www.cms.gov/EHRIncentivePrograms/Downloads/15_Core_ProtectElectronicHealthInformation.pdf Source] ||
[https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.o%20Access%20Control.pdf 1]
[https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.p%20Emergency%20Access.pdf 2]
[https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.q%20Automatic%20Log-Off.pdf 3]
[https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.r%20Audit%20logDraft.pdf 4]
[https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.s%20Integrity.pdf 5]
[https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.t%20Authentication.pdf 6]
|| Yes/No || Not checked. Report YES.
|}

==Q: What about the 5 "menu" set of meaningful use objectives? (5 of 10 possible are required)==
{| class="wikitable"
|-
! Measure !! Link to CMS Source !! VISTA fulfillment !! Attestation Type !! Quality Measures Package Logic
|-
| Implement drug formulary checks || [http://www.cms.gov/EHRIncentivePrograms/Downloads/1_Drug_Formulary_Checks.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.b%20Drug-formulary%20checks.pdf Fulfillment] || Yes/No || Not Checked. Report YES. Automatic functionality in VISTA.
|-
| Incorporate lab results into EHR as structured data || [http://www.cms.gov/EHRIncentivePrograms/Downloads/2_Clinical_Lab_Test_Results.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.h%20Incorporate%20Laboratory%20Test%20Results.pdf Fulfillment] || Rate > 40% || Not Checked. If you use Lab Package, report 100%; otherwise, 0%.
|-
| Generate list of patients by specific conditions for quality improvement || [http://www.cms.gov/EHRIncentivePrograms/Downloads/3_Patient_Lists.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.i%20Generate%20patient%20lists.pdf Fulfillment] || Yes/No || Not Checked. Report YES. Automatic functionality in VISTA.
|-
| Send patient reminders per patient preference || [http://www.cms.gov/EHRIncentivePrograms/Downloads/4_Patient_Reminders.pdf Source] || Doc. Needed || Doc. Needed || Documentation Needed
|-
| Provide patients with timely electronic access to their health information || [http://www.cms.gov/EHRIncentivePrograms/Downloads/5_Patient_Electronic_Access.pdf Source] || [https://trac.opensourcevista.net/svn/Djigzo/SecurePatientEmailDeliveryWithDjigzo.zip Fulfillment] || See ==> || Contact nancy at worldvista dot org
|-
| Provide patient-specific education resources || [http://www.cms.gov/EHRIncentivePrograms/Downloads/6_Patient-Specific_Education_Resources.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.m%20Patient-specific%20education%20resources.pdf Fulfillment] || Rate > 10% || Use Medline Plus
|-
| Perform medication reconcilliation || [http://www.cms.gov/EHRIncentivePrograms/Downloads/7_Medication_Reconciliation.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.j%20Medication%20Reconciliation.pdf Fulfillment] || Rate > 50% || If you use electronic prescribing, it is tracked.
|-
| Send summary care record to other providers || [http://www.cms.gov/EHRIncentivePrograms/Downloads/8_Transition_of_Care_Summary.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.v%20Encryption%20when%20exchanging%20electronic%20health%20information.pdf Fulfillment] || Rate > 50% || Documentation needed.
|-
| Submit data to immunization registries || [http://www.cms.gov/EHRIncentivePrograms/Downloads/9_Immunization_Registries_Data_Submission.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.k%20Submission%20to%20Immunization%20Registries.pdf Fulfillment] || Yes/No || Report YES. Enhanced functionality in WORLDVISTA.
|-
| Submit syndromic surveillance data || [http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&ved=0CCIQFjAA&url=http%3A%2F%2Fwww.cms.gov%2FRegulations-and-Guidance%2FLegislation%2FEHRIncentivePrograms%2Fdownloads%2F10HM-SyndromicSurveillanceDataSubmission.pdf&ei=7ftpUMLnFqe7iwLx44CwBw&usg=AFQjCNGwj3T8jslE8iVME4Wt7EI4x9NcuQ&sig2=dY6e5UXAq2TvDe_jF932Aw Source] || Doc. Needed || Doc. Needed || Documentation Needed
|}

==Q: What about the required Clinical Quality Measures (CQM)?==
You must report the 3 core measures. If any of the 3 core measures are reported with zero values for the denominator, you are required to
pick an alternate core measure to report in addition, even if these yield zero. For example if: NQF 0028 & NQF 0421 are 0; report 2 measures from the alternate core measures.

In addition to the core/alternate core measures, you need to report an additional 3 measures from the additional list of 38 CQMs.

[http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/CQM_EPs_2012_02_02.pdf Click here for a list of all measures afrom the CMS website along with the instructions just above.]

NB: If you see the numerator and denomiator logic filled out, it means that the measure is fully supported in the Quality Measurement Package. If they are not there, then they are unsupported; you may still report on them, but you will have to do extra work on your end to make them work.
==== Core Measures ====
{| class="wikitable"
|-
! Measure !! Description !! Sources !! Denominator in VISTA !! Numerator in VISTA
|-
|NQF0013 || Hypertension: Blood Pressure Measurement || [http://helpdesk.medteam.net/ClinicalQualitymeasures/NQF0013.pdf details2] || Patients with Hypertenstion || Blood Pressure recorded as a Vital
|-
|rowspan=2 | NQF0028 || Tobacco: Use Asessment || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=391&print=0&entityTypeID=1 details] || Patients || Health factors in NFQ0028AB Tobacco Managment Dialog
|-
| Tobacco Cessation Intervention || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=391&print=0&entityTypeID=1 details] || Patients who smoke || Health factors in NFQ0028AB Tobacco Managment Dialog
|-
| NQF0421||Adult Weight Screening and Follow-up || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=526&print=0&entityTypeID=1 details] || Patients with high BMI || Health factors in MU NQF0421 BMI DI
|-
|}

==== Alternate Core Measures ====
If you reported 0 for all 3 core measures, you must report on all 3 alternate core measures even if you will report zeroes for all 6 measures.
{| class="wikitable"
|-
! Measure !! Description !! Sources !! Denominator in VISTA !! Numerator in VISTA
|-
| NQF 0024||BMI for age 2-18||[http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1247&print=0&entityTypeID=1 details]|| Obese Patients in the Date Range (using Vitals package)|| ICD9/CPT codes V65.3, 97802, G0270, S9449, S9452, S9470
|-
| NQF 0041||Influenza vaccination||[http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=397&print=0&entityTypeID=1 details]||Patients|| Immunization (IM FLU, 3 yrs) in MU NQF0041 INFLUENZA MANAGEMENT DI
|-
| NQF 0038||Childhood immunization status||[http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=395&print=0&entityTypeID=1 details]|| Patients <= 2 yo || Dialog MU NQF0038 IMMUNE MANAGEMENT DI
|}
==== Additional Core Measures ====
An additional '''3 from a list of 38 CQM's''' must be reported. Only the first three are supported by the Quality Measures package right now. If you need to add more, get in contact with George Lilly or Sam Habiel.
{| class="wikitable"
|-
! Measure !! Description !! Sources !! Denominator in VISTA !! Numerator in VISTA
|-
| NQF0059 || Diabetes: Hemoglobin A1c Poor Control || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1225&print=0&entityTypeID=1 details] || Diabetics via Meds or Diagnosis || Lab HEMOGLOBIN A1C or Health Factor PQRI HBA1C>9 MK
|-
| NQF0061 || Diabetes: Low Density Lipoprotein (LDL) Management and Control || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1228&print=0&entityTypeID=1 details] || Diabetics via Meds or Diagnosis || Lab LDL CHOLESTEROL or Health Factor PQRI LDL < 100
|-
| NQF0064 || Diabetes: Blood Pressure Management || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1235&print=0&entityTypeID=1 details] || Diabetics via Meds or Diagnosis || Blood Pressure entered via Vitals Package.
|-
|colspan=5 | '''The rest of these are not fully supported in the Quality Measures package.'''
|-
| NQF0081 || Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD) || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=383&print=0&entityTypeID=1 details]
|-
| NQF0070 || Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI) || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=377&print=0&entityTypeID=1 details]
|-
| NQF0043 || Pneumonia Vaccination Status for Older Adults || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=492&print=0&entityTypeID=1 details]
|-
| NQF0031 || Breast Cancer Screening || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=392&print=0&entityTypeID=1 details]
|-
| NQF0034 || Colorectal Cancer Screening || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=394&print=0&entityTypeID=1 details]
|-
| NQF0067 || Coronary Artery Disease (CAD): Oral Antiplatelet Therapy Prescribed for Patients with CAD || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=376&print=0&entityTypeID=1 details]
|-
| NQF0083 || Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=384&print=0&entityTypeID=1 details]
|-
| NQF0105 || Anti-depressant medication management: (a) Effective Acute Phase Treatment, (b)Effective Continuation Phase Treatment || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=855&print=0&entityTypeID=1 details]
|-
| NQF0086 || Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=436&print=0&entityTypeID=1 details]
|-
| NQF0088 || Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=438&print=0&entityTypeID=1 details]
|-
| NQF0089 || Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=439&print=0&entityTypeID=1 details]
|-
| NQF0047 || Asthma Pharmacologic Therapy || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=368&print=0&entityTypeID=1 details]
|-
| NQF0001 || Asthma Assessment || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=366&print=0&entityTypeID=1 details]
|-
| NQF0002 || Appropriate Testing for Children with Pharyngitis || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=370&print=0&entityTypeID=1 details]
|-
| NQF0387 || Oncology Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/Progesterone Receptor (ER/PR) Positive Breast Cancer || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=631&print=0&entityTypeID=1 details]
|-
| NQF0385 || Oncology Colon Cancer: Chemotherapy for Stage III Colon Cancer Patients || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=628&print=0&entityTypeID=1 details]
|-
| NQF0389 || Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=624&print=0&entityTypeID=1 details]
|-
| NQF0027 || Smoking and Tobacco Use Cessation, Medical Assistance: a) Advising Smokers and Tobacco Users to Quit, b) Discussing Smoking and Tobacco Use Cessation Medications, c) Discussing Smoking and Tobacco # Use Cessation Strategies || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=390&print=0&entityTypeID=1 details]
|-
| NQF0055 || Diabetes: Eye Exam || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1223&print=0&entityTypeID=1 details]
|-
| NQF0062 || Diabetes: Urine Screening || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1226&print=0&entityTypeID=1 details]
|-
| NQF0056 || Diabetes: Foot Exam || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1224&print=0&entityTypeID=1 details]
|-
| NQF0074 || Coronary Artery Disease (CAD): Drug Therapy for Lowering LDL-Cholesterol || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=379&print=0&entityTypeID=1 details]
|-
| NQF0084 || Heart Failure (HF): Warfarin Therapy Patients with Atrial Fibrillation
|-
| NQF0073 || Ischemic Vascular Disease (IVD): Blood Pressure Management || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1231&print=0&entityTypeID=1 details]
|-
| NQF0068 || Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1229&print=0&entityTypeID=1 details]
|-
| NQF0004 || Initiation and Engagement of Alcohol and Other Drug Dependence Treatment: a)Initiation, b) Engagement || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1245&print=0&entityTypeID=1 details]
|-
| NQF0012 || Prenatal Care: Screening for Human Immunodeficiency Virus (HIV)
|-
| NQF0014 || Prenatal Care: Anti-D Immune Globulin -- NQF 0014
|-
| NQF0018 || Controlling High Blood Pressure || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1236&print=0&entityTypeID=1 details]
|-
| NQF0032 || Cervical Cancer Screening || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=393&print=0&entityTypeID=1 details]
|-
| NQF0033 || Chlamydia Screening for Women || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1253&print=0&entityTypeID=1 details]
|-
| NQF0036 || Use of Appropriate Medications for Asthma || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=367&print=0&entityTypeID=1 details]
|-
| NQF0052 || Low Back Pain: Use of Imaging Studies || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1220&print=0&entityTypeID=1 details]
|-
| NQF0075 || Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1232&print=0&entityTypeID=1 details]
|-
| NQF0575 || Diabetes: Hemoglobin A1c Control (<8.0%) || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=944&print=0&entityTypeID=1 details]
|}

Outpatient Meaningful Use Stage One

2013-01-27T16:06:18Z

Anthracite:

''This page was originally created by Dr. Kevin Toppenberg, MD, a primary care physician in Greenville, TN. It was created as a documentation for how to pursue meaningful use certification with VistA. It has since been expanded by WorldVistA. Note that this document references external documents either from CMS or from WorldVistA.''

==Q: Where can I find the certification status of WorldVistA?==
* Go to [http://oncchpl.force.com/ehrcert/ehrproductsearch CMS Certified Health IT Products]
* Search for "WorldVistA" -- '''NOTE''': the search engine on this page is flaky. I found that when I clicked the search button, it would return a list of ALL technology. But when I then simply '''clicked search AGAIN''' (with WorldVistA still in the search term box), then it would find it.

==Q: There seem to be so many steps involved in getting ready for Stage One attestation. It's overwhelming. Any overview sites?==
* I recommend starting with this overview: [https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Meaningful_Use.html#BOOKMARK7 CMS EHR Meaningful Use Overview]. The information I am posting here is from this site.
* Alternatively, here are the slides from a [https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/CQM_Webinar_10-25-2011.pdf CMS webinar presentation.]
* Here is another [http://tinyurl.com/bu9n4b9 CMS document (2010)] document with similar detail.
* A very good presentation from IHS giving an overview of Meaningful Use can be found [ftp://ftp.ihs.gov/pubs/EHR/Training/Manuals/EHR%20for%20Meaningful%20Use%20-%202011/TAB%2002%20-%20MU%20Overview%20and%20Incentive%20Payment%20Estimator/T2.1%20%20-%20MU_EP_EH-Final.PPTX here]

==Q: What's the bottom line? What do I have to do to be ready to attest meaningful use?==
# Meet '''20 of 25 "Meaningful Use Objectives'''" [https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/EP-MU-TOC.pdf source]
#* Must meet 15 "core" measures
#* Must also meet 5 of 10 possible "menu" set measures
# Meet '''6 of 41 "Clinical Quality Measures (CQM's)'''" [https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures/index.html?redirect=/QualityMeasures/03_ElectronicSpecifications.asp source]
#* Must meet 3 required core quality measures
#* must also meet 3 of 38 possible additional quality measures
# Attest to meeting requirements using Y/N answers and by supplying data from the Quality Measures package.
(TO-DO SMH: Reference and write about the Quality Measures package.)

==Q: Can you tell me more about the 15 "core" meaningful use measures? (all are required)==
Detailed instructions on meeting these will be provided in more detail below. Detailed instructions on reporting can be found here: [[C0Q_Quality_Reporting_1.0 | Quality Measures package documentation]].
{| class="wikitable"
|-
! Measure !! Link to CMS Source !! VISTA fulfillment !! Attestation Type !! Quality Measures Package Logic
|-
| CPOE -- Provider directly enters in orders || [http://www.cms.gov/EHRIncentivePrograms/Downloads/1_CPOE_for_Medication_Orders.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.306.a%20CPOE.pdf Fulfillment] || Rate > 30% || Check for the presence of electronically prescribed medications stored in the Non-VA Multiple in file 55 for this patient
|-
| Implement drug-drug and drug-allergy interaction checks || [http://www.cms.gov/EHRIncentivePrograms/Downloads/2_Drug_Interaction_ChecksEP.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.a%20Drug-drug,%20drug-allergy%20interaction%20checks.pdf Fulfillment] || Yes/No || Not checked. Report YES. Core VISTA functionality. Also part of electronic prescribing.
|-
| Maintain an up-to-date problem list of current and active diagnoses || [http://www.cms.gov/EHRIncentivePrograms/Downloads/3_Maintain_Problem_ListEP.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.c-%20Maintain%20up-to-date%20problem%20list%20IN.pdf Fullfillment] || Rate > 80% || Checks active problems.
|-
| Generate and transmit permissible prescriptions electronically (eRx) || [http://www.cms.gov/EHRIncentivePrograms/Downloads/4_e-prescribing.pdf Source] || not available || Rate > 40% || Check for the presence of electronically prescribed medications stored in the Non-VA Multiple in file 55 for this patient
|-
| Maintain active medication list || [http://www.cms.gov/EHRIncentivePrograms/Downloads/5_Active_Medication_List.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.d%20Maintain%20active%20medication%20list%20IN.pdf Fulfillment] || Rate > 80% || Check for the presence of electronically prescribed medications stored in the Non-VA Multiple in file 55 for this patient
|-
| Maintain active medication allergy list || [http://www.cms.gov/EHRIncentivePrograms/Downloads/6_Medication_Allergy_List.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.e%20Maintain%20active%20medication%20allergy%20list%20IN.pdf Fulfillment] || Rate > 80% || Check for the presence of allergies for this patient
|-
| Record required demographics || [http://www.cms.gov/EHRIncentivePrograms/Downloads/7_Record_Demographics.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.306.b%20Record%20demographics.pdf Fulfillment] || Rate > 50% || Check for the presence of Sex, DOB, Primary ID, Preferred Language, Race, Ethnicity for this patient. Lack of any one disqualifes you.
|-
| Record required vital signs || [http://http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/8%2520Record%2520Vital%2520Signs%25202011.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.f.1%20Vital%20Signs.pdf Fulfillment] || Rate > 50% || Check vital signs from July 3rd 2011 to present for this patient.
|-
| Record smoking status for patients aged 13 yrs and up || [http://www.cms.gov/EHRIncentivePrograms/Downloads/9_Record_Smoking_Status.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.g%20Smoking%20Status.pdf Fulfillment] || Rate > 50% || Check health factors in the category Tobacco; see if patient will have these. If none found in the category, each possible health factor in a list is tried by itself.
|-
| Report clinical quality measures to CMS || [http://www.cms.gov/EHRIncentivePrograms/Downloads/10_Clinical_Quality_Measures.pdf Source] ||[https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.306.i%20Calculate%20and%20submit%20clinical%20quality%20measure.pdf Fulfillment] || Yes/No (Measures are reportable rates however) || Not checked. Report YES.
|-
| Implement 1 clinical decision support rule || [http://www.cms.gov/EHRIncentivePrograms/Downloads/11_Clinical_Decision_Support_Rule.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.306.c%20Clinical%20decision%20support%20H.pdf Fulfillment] || Yes/No || Not checked. Report YES.
|-
| Provide patients with an electronic copy of their health information || [http://www.cms.gov/EHRIncentivePrograms/Downloads/12_Electronic_Copy_of_Health_Information.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.306.d.2%20Electronic%20copy%20of%20health%20information%20Discharge%20Summary.pdf Fulfillment] || Rate > 50% || '''NOT COLLECTIBLE IN VISTA. NO RELEASE OF INFORMATION PACKAGE. COLLECT MANUALLY'''
|-
| Provide clinical summaries for patients for each office visit within 3 days || [http://www.cms.gov/EHRIncentivePrograms/Downloads/13_Clinical_Summaries.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.v%20Encryption%20when%20exchanging%20electronic%20health%20information.pdf Fulfillment] || Rate > 50% || '''NOT COLLECTIBLE IN VISTA. NO RELEASE OF INFORMATION PACKAGE. COLLECT MANUALLY'''
|-
| Perform at least 1 test of exchanging key clinical information with another entity electronically || [http://www.cms.gov/EHRIncentivePrograms/Downloads/14_Electronic_Exchange_of_Clinical_Information.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.v%20Encryption%20when%20exchanging%20electronic%20health%20information.pdf Fulfillment] || Yes/No || Not checked. Report YES.
|-
| Protect electronic health information || [http://www.cms.gov/EHRIncentivePrograms/Downloads/15_Core_ProtectElectronicHealthInformation.pdf Source] ||
[https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.o%20Access%20Control.pdf 1]
[https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.p%20Emergency%20Access.pdf 2]
[https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.q%20Automatic%20Log-Off.pdf 3]
[https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.r%20Audit%20logDraft.pdf 4]
[https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.s%20Integrity.pdf 5]
[https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.t%20Authentication.pdf 6]
|| Yes/No || Not checked. Report YES.
|}

==Q: What about the 5 "menu" set of meaningful use objectives? (5 of 10 possible are required)==
{| class="wikitable"
|-
! Measure !! Link to CMS Source !! VISTA fulfillment !! Attestation Type !! Quality Measures Package Logic
|-
| Implement drug formulary checks || [http://www.cms.gov/EHRIncentivePrograms/Downloads/1_Drug_Formulary_Checks.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.b%20Drug-formulary%20checks.pdf Fulfillment] || Yes/No || Not Checked. Report YES. Automatic functionality in VISTA.
|-
| Incorporate lab results into EHR as structured data || [http://www.cms.gov/EHRIncentivePrograms/Downloads/2_Clinical_Lab_Test_Results.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.h%20Incorporate%20Laboratory%20Test%20Results.pdf Fulfillment] || Rate > 40% || Not Checked. If you use Lab Package, report 100%; otherwise, 0%.
|-
| Generate list of patients by specific conditions for quality improvement || [http://www.cms.gov/EHRIncentivePrograms/Downloads/3_Patient_Lists.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.i%20Generate%20patient%20lists.pdf Fulfillment] || Yes/No || Not Checked. Report YES. Automatic functionality in VISTA.
|-
| Send patient reminders per patient preference || [http://www.cms.gov/EHRIncentivePrograms/Downloads/4_Patient_Reminders.pdf Source] || NOT DONE || NOT DONE || NOT DONE
|-
| Provide patients with timely electronic access to their health information || [http://www.cms.gov/EHRIncentivePrograms/Downloads/5_Patient_Electronic_Access.pdf Source] || [https://trac.opensourcevista.net/svn/Djigzo/SecurePatientEmailDeliveryWithDjigzo.zip Fulfillment] || NOT DONE|| NOT DONE
|-
| Provide patient-specific education resources || [http://www.cms.gov/EHRIncentivePrograms/Downloads/6_Patient-Specific_Education_Resources.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.m%20Patient-specific%20education%20resources.pdf Fulfillment] || Rate > 10% || NOT DONE
|-
| Perform medication reconcilliation || [http://www.cms.gov/EHRIncentivePrograms/Downloads/7_Medication_Reconciliation.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.j%20Medication%20Reconciliation.pdf Fulfillment] || Rate > 50% || If you use electronic prescribing, it is tracked.
|-
| Send summary care record to other providers || [http://www.cms.gov/EHRIncentivePrograms/Downloads/8_Transition_of_Care_Summary.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.v%20Encryption%20when%20exchanging%20electronic%20health%20information.pdf Fulfillment] || Rate > 50% || NOT DONE
|-
| Submit data to immunization registries || [http://www.cms.gov/EHRIncentivePrograms/Downloads/9_Immunization_Registries_Data_Submission.pdf Source] || [https://trac.opensourcevista.net/svn/mu-tests/stage-1/170.302.k%20Submission%20to%20Immunization%20Registries.pdf Fulfillment] || Yes/No || Report YES. Enhanced functionality in WORLDVISTA.
|-
| Submit syndromic surveillance data || [http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&ved=0CCIQFjAA&url=http%3A%2F%2Fwww.cms.gov%2FRegulations-and-Guidance%2FLegislation%2FEHRIncentivePrograms%2Fdownloads%2F10HM-SyndromicSurveillanceDataSubmission.pdf&ei=7ftpUMLnFqe7iwLx44CwBw&usg=AFQjCNGwj3T8jslE8iVME4Wt7EI4x9NcuQ&sig2=dY6e5UXAq2TvDe_jF932Aw Source] || NOT DONE || NOT DONE || NOT DONE
|}

==Q: What about the required Clinical Quality Measures (CQM)?==
You must report the 3 core measures. If any of the 3 core measures are reported with zero values for the denominator, you are required to
pick an alternate core measure to report in addition, even if these yield zero. For example if: NQF 0028 & NQF 0421 are 0; report 2 measures from the alternate core measures.

In addition to the core/alternate core measures, you need to report an additional 3 measures from the additional list of 38 CQMs.

[http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/CQM_EPs_2012_02_02.pdf Click here for a list of all measures afrom the CMS website along with the instructions just above.]

NB: If you see the numerator and denomiator logic filled out, it means that the measure is fully supported in the Quality Measurement Package. If they are not there, then they are unsupported; you may still report on them, but you will have to do extra work on your end to make them work.
==== Core Measures ====
{| class="wikitable"
|-
! Measure !! Description !! Sources !! Denominator in VISTA !! Numerator in VISTA
|-
|NQF0013 || Hypertension: Blood Pressure Measurement || [http://helpdesk.medteam.net/ClinicalQualitymeasures/NQF0013.pdf details2] || Patients with Hypertenstion || Blood Pressure recorded as a Vital
|-
|rowspan=2 | NQF0028 || Tobacco: Use Asessment || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=391&print=0&entityTypeID=1 details] || Patients || Health factors in NFQ0028AB Tobacco Managment Dialog
|-
| Tobacco Cessation Intervention || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=391&print=0&entityTypeID=1 details] || Patients who smoke || Health factors in NFQ0028AB Tobacco Managment Dialog
|-
| NQF0421||Adult Weight Screening and Follow-up || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=526&print=0&entityTypeID=1 details] || Patients with high BMI || Health factors in MU NQF0421 BMI DI
|-
|}

==== Alternate Core Measures ====
If you reported 0 for all 3 core measures, you must report on all 3 alternate core measures even if you will report zeroes for all 6 measures.
{| class="wikitable"
|-
! Measure !! Description !! Sources !! Denominator in VISTA !! Numerator in VISTA
|-
| NQF 0024||BMI for age 2-18||[http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1247&print=0&entityTypeID=1 details]|| Obese Patients in the Date Range (using Vitals package)|| ICD9/CPT codes V65.3, 97802, G0270, S9449, S9452, S9470
|-
| NQF 0041||Influenza vaccination||[http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=397&print=0&entityTypeID=1 details]||Patients|| Immunization (IM FLU, 3 yrs) in MU NQF0041 INFLUENZA MANAGEMENT DI
|-
| NQF 0038||Childhood immunization status||[http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=395&print=0&entityTypeID=1 details]|| Patients <= 2 yo || Dialog MU NQF0038 IMMUNE MANAGEMENT DI
|}
==== Additional Core Measures ====
An additional '''3 from a list of 38 CQM's''' must be reported. Only the first three are supported by the Quality Measures package right now. If you need to add more, get in contact with George Lilly or Sam Habiel.
{| class="wikitable"
|-
! Measure !! Description !! Sources !! Denominator in VISTA !! Numerator in VISTA
|-
| NQF0059 || Diabetes: Hemoglobin A1c Poor Control || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1225&print=0&entityTypeID=1 details] || Diabetics via Meds or Diagnosis || Lab HEMOGLOBIN A1C or Health Factor PQRI HBA1C>9 MK
|-
| NQF0061 || Diabetes: Low Density Lipoprotein (LDL) Management and Control || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1228&print=0&entityTypeID=1 details] || Diabetics via Meds or Diagnosis || Lab LDL CHOLESTEROL or Health Factor PQRI LDL < 100
|-
| NQF0064 || Diabetes: Blood Pressure Management || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1235&print=0&entityTypeID=1 details] || Diabetics via Meds or Diagnosis || Blood Pressure entered via Vitals Package.
|-
|colspan=5 | '''The rest of these are not fully supported in the Quality Measures package.'''
|-
| NQF0081 || Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD) || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=383&print=0&entityTypeID=1 details]
|-
| NQF0070 || Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI) || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=377&print=0&entityTypeID=1 details]
|-
| NQF0043 || Pneumonia Vaccination Status for Older Adults || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=492&print=0&entityTypeID=1 details]
|-
| NQF0031 || Breast Cancer Screening || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=392&print=0&entityTypeID=1 details]
|-
| NQF0034 || Colorectal Cancer Screening || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=394&print=0&entityTypeID=1 details]
|-
| NQF0067 || Coronary Artery Disease (CAD): Oral Antiplatelet Therapy Prescribed for Patients with CAD || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=376&print=0&entityTypeID=1 details]
|-
| NQF0083 || Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=384&print=0&entityTypeID=1 details]
|-
| NQF0105 || Anti-depressant medication management: (a) Effective Acute Phase Treatment, (b)Effective Continuation Phase Treatment || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=855&print=0&entityTypeID=1 details]
|-
| NQF0086 || Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=436&print=0&entityTypeID=1 details]
|-
| NQF0088 || Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=438&print=0&entityTypeID=1 details]
|-
| NQF0089 || Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=439&print=0&entityTypeID=1 details]
|-
| NQF0047 || Asthma Pharmacologic Therapy || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=368&print=0&entityTypeID=1 details]
|-
| NQF0001 || Asthma Assessment || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=366&print=0&entityTypeID=1 details]
|-
| NQF0002 || Appropriate Testing for Children with Pharyngitis || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=370&print=0&entityTypeID=1 details]
|-
| NQF0387 || Oncology Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/Progesterone Receptor (ER/PR) Positive Breast Cancer || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=631&print=0&entityTypeID=1 details]
|-
| NQF0385 || Oncology Colon Cancer: Chemotherapy for Stage III Colon Cancer Patients || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=628&print=0&entityTypeID=1 details]
|-
| NQF0389 || Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=624&print=0&entityTypeID=1 details]
|-
| NQF0027 || Smoking and Tobacco Use Cessation, Medical Assistance: a) Advising Smokers and Tobacco Users to Quit, b) Discussing Smoking and Tobacco Use Cessation Medications, c) Discussing Smoking and Tobacco # Use Cessation Strategies || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=390&print=0&entityTypeID=1 details]
|-
| NQF0055 || Diabetes: Eye Exam || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1223&print=0&entityTypeID=1 details]
|-
| NQF0062 || Diabetes: Urine Screening || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1226&print=0&entityTypeID=1 details]
|-
| NQF0056 || Diabetes: Foot Exam || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1224&print=0&entityTypeID=1 details]
|-
| NQF0074 || Coronary Artery Disease (CAD): Drug Therapy for Lowering LDL-Cholesterol || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=379&print=0&entityTypeID=1 details]
|-
| NQF0084 || Heart Failure (HF): Warfarin Therapy Patients with Atrial Fibrillation
|-
| NQF0073 || Ischemic Vascular Disease (IVD): Blood Pressure Management || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1231&print=0&entityTypeID=1 details]
|-
| NQF0068 || Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1229&print=0&entityTypeID=1 details]
|-
| NQF0004 || Initiation and Engagement of Alcohol and Other Drug Dependence Treatment: a)Initiation, b) Engagement || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1245&print=0&entityTypeID=1 details]
|-
| NQF0012 || Prenatal Care: Screening for Human Immunodeficiency Virus (HIV)
|-
| NQF0014 || Prenatal Care: Anti-D Immune Globulin -- NQF 0014
|-
| NQF0018 || Controlling High Blood Pressure || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1236&print=0&entityTypeID=1 details]
|-
| NQF0032 || Cervical Cancer Screening || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=393&print=0&entityTypeID=1 details]
|-
| NQF0033 || Chlamydia Screening for Women || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1253&print=0&entityTypeID=1 details]
|-
| NQF0036 || Use of Appropriate Medications for Asthma || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=367&print=0&entityTypeID=1 details]
|-
| NQF0052 || Low Back Pain: Use of Imaging Studies || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1220&print=0&entityTypeID=1 details]
|-
| NQF0075 || Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1232&print=0&entityTypeID=1 details]
|-
| NQF0575 || Diabetes: Hemoglobin A1c Control (<8.0%) || [http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=944&print=0&entityTypeID=1 details]
|}

How to Get WorldVistA EHR

2013-01-27T15:41:51Z

Anthracite:

[[category:Installers]] [[Category:HOWTO]]
By mid-2009 a dedicated group of workers had created a solidly functioning set of installers for WorldVistA EHR. Here is a situation overview from then-president K.S. Bhaskar of WorldVistA [http://groups.google.com/group/Hardhats/browse_thread/thread/288b85582d62184f/e4ce800eedccce23?hl=en#e4ce800eedccce23]:
----
The official web site for WorldVistA EHR is the WorldVistA web site. Links to downloads and installation instructions for the supported version of WorldVistA EHR can be found there. WorldVistA EHR 2.0 is the Meaningful Use 2011 certified version that is available for download.

* http://worldvista.org

The distribution point for the supported version of WorldVistA EHR is Source Forge
* http://sourceforge.net/projects/worldvista-ehr

and the WorldVistA web site points you to the Source Forge site.

Astronaut WorldVistA auto-installer Suite (rpm/deb server, point-click .exe for clients)

* [http://vistapedia.net/index.php?title=Astronaut_Installers Astronaut Installers]

Built on the release of WorldVistA EHR from Source Forge are
distributions of repackaged software, sometimes with enhancements.
Ignacio's Astronaut packages are an example. By way of analogy, the
WorldVistA EHR distributions are like Linux kernels from http://kernel.org
whereas the redistributions are like GNU/Linux distributions from
Debian, Red Hat, Ubuntu, etc.

New releases of WorldVistA EHR will appear on Source Forge, and will
be announced on [http://groups.google.com/group/Hardhats HardHats], as well as elsewhere.

----

With relative ease, the installers do a complete initial set up of a production-grade instance of the VistA server on a Linux platform, ready to connect to the CPRS front end.

* [[Astronaut Installers]] (thanks to Ignacio Valdes and many others) -- links and descriptions

Installing VistA is only the beginning; security, journaling, backup, replication, and failover all need to be addressed. Configuring it to improve user productivity is a lengthy and ongoing task. Here is some help:

* [[Intracare Implementation Log|Implementation Log]] (from Hardhats) -- an extended Howto

* [[VistA Standard Base]] (from Hardhats) -- some Linux infrastructure

How to Get WorldVistA EHR

2013-01-27T15:40:48Z

Anthracite:

[[category:Installers]] [[Category:HOWTO]]
By mid-2009 a dedicated group of workers had created a solidly functioning set of installers for WorldVistA EHR. Here is a situation overview from then-president K.S. Bhaskar of WorldVistA [http://groups.google.com/group/Hardhats/browse_thread/thread/288b85582d62184f/e4ce800eedccce23?hl=en#e4ce800eedccce23]:
----
The official web site for WorldVistA EHR is the WorldVistA web site. Links to downloads and installation instructions for the supported version of WorldVistA EHR can be found there.

* http://worldvista.org

The distribution point for the supported version of WorldVistA EHR is Source Forge
* http://sourceforge.net/projects/worldvista-ehr

and the WorldVistA web site points you to the Source Forge site.

Astronaut WorldVistA auto-installer Suite (rpm/deb server, point-click .exe for clients)

* [http://vistapedia.net/index.php?title=Astronaut_Installers Astronaut Installers]

Built on the release of WorldVistA EHR from Source Forge are
distributions of repackaged software, sometimes with enhancements.
Ignacio's Astronaut packages are an example. By way of analogy, the
WorldVistA EHR distributions are like Linux kernels from http://kernel.org
whereas the redistributions are like GNU/Linux distributions from
Debian, Red Hat, Ubuntu, etc.

New releases of WorldVistA EHR will appear on Source Forge, and will
be announced on [http://groups.google.com/group/Hardhats HardHats], as well as elsewhere.

----

With relative ease, the installers do a complete initial set up of a production-grade instance of the VistA server on a Linux platform, ready to connect to the CPRS front end.

* [[Astronaut Installers]] (thanks to Ignacio Valdes and many others) -- links and descriptions

Installing VistA is only the beginning; security, journaling, backup, replication, and failover all need to be addressed. Configuring it to improve user productivity is a lengthy and ongoing task. Here is some help:

* [[Intracare Implementation Log|Implementation Log]] (from Hardhats) -- an extended Howto

* [[VistA Standard Base]] (from Hardhats) -- some Linux infrastructure

CPRS Installation

2012-12-12T01:54:53Z

Anthracite: /* CPRS Versions */

__TOC__

This page [[record~|Record]]s the process of installation of the [[CPRS|Computerized Patient Record System]] Graphical User Interface client program on the [[Microsoft Windows OS]].

=== [[CPRS~|CPRS]] Versions ===

This table will list links for the various [[CPRS~|CPRS]] versions. (The most current version is at the top)

{| class="grey" border="1" cellpadding="2"
|+ [[CPRS~|CPRS]] Versions
|-
! Version Number
! Distribution File
! Availability
! Date
|-
| version 1.0.27.90
| OR-3_SEQ-273_PAT-296.ZIP
| [https://downloads.va.gov/files/FOIA/Software/Patches_By_Application/OR-ORDER%20ENTRY_RESULTS%20REPORTING/ Download folder on VA site]
| 8/2009
|-
| version 1.0.27.83
| OR_30_304.ZIP
| [https://downloads.va.gov/files/FOIA/Software/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/ Download folder on VA site]
| 11/2008 Emergency Correction of Patient Safety Issues
|-
| version 1.0.27.77
| OR_30_243.ZIP
| [https://downloads.va.gov/files/FOIA/Software/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/ Download folder on VA site]
| 08/2008
|-
| version 1.0.26.69
| OR_30_270.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server] or
[https://downloads.va.gov/files/FOIA/Software/VistA_FOIA_Historical_Files/VISTA_FOIA_RELEASES_BEFORE_2008/OR-Order%20Entry-Results%20Reporting/ Download folder on VA site]
|-
| version 1.0.26.69
| for WorldVistA EHR
| on the Sourceforge WorldVistA EHR site and http://opensourcevista.net:8888/NancysVistAServer
| (dated June 2007)

|-
| version 1.0.26.68
| OR_30_258.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| Note Below (NB):(dated July 17, 2006)
|-
| version 1.0.25.42
| OR_30_235.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated July 09, 2005) Note: Replace .25.40 with .25.42 for patient safety
|-
| version 1.0.25.40
| OR_30_231.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated May 06, 2005)
|-
| version 1.0.25.28
| OR_30_195.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Feb 09, 2005)
|-
| version 1.0.24.27
| OR_30_224.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Sep 03, 2004)
|-
| version 1.0.24.26
| OR_30_190.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Aug 02, 2004)
|-
| version 1.0.23.15
| OR_30_187.ZIP
| *Sourceforge WorldVistA and [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 02/04)
|-
| version 1.0.22.16
| OR_30_206.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 01/04)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 11/02)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
|(dated about 11/02)
|-
| version 1.0.19.7
| OR_30_132.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 05/02)
|-
| version 1.0.18.2
| OR_30_125.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 12/01)
|}

----

=== version change trick ===
NB: There is a trick to making version 1.0.26.68. It is done for you in CPRSDir.zip which can be found along with the instructions for creating it at:

http://downloads.opensourcevista.net/VADemo9-26-06

To find out which version to use, look next to the option [[OPTION OR CPRS GUI CHART|named "OR CPRS GUI CHART"]] like this example where CPRS version 1.0.23.15 was needed:

D Q^DI

VA FileMan 22.0
Select OPTION: 5 INQUIRE TO FILE ENTRIES

OUTPUT FROM WHAT FILE: DEVICE// OPTION
1 OPTION (10126 entries)
2 OPTION SCHEDULING (116 entries)
CHOOSE 1-2: 1 OPTION (10126 entries)
Select OPTION NAME: OR CPRS GUI CHART CPRSChart version 1.0.23.15
ANOTHER ONE:

To use a particular version of CPRS, the server-side software code must match. The files are found at ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ and the source code is in the "Programs" subdirectory of this directory

Thus:

[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/ <nowiki>ftp://ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ </nowiki>]

The Delphi source code for each of these (e.g. OR_30_235_SRC.ZIP) will be found in the subdirectory
[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/Programs/ <nowiki>...Packages/Order Entry-Results Reporting - OR/Programs/ </nowiki>]

The wget(1) utility is capable of fetching the files from this server

AceFTP is a freeware FTP program that works, if needed
http://software.visicommedia.com/en/productsfreeware/

''(In the past this FTP site could not be reached with Mozilla/Firefox. That has been corrected.)''
----

=== 1.0.26.69 (and TMG-CPRS) spoof --> 1.0.26.76 ===

Since the changes between 1.0.26.69 and 1.0.26.76 are relatively minor, in this case, version can be used by changing the option in the option file like this:

D P^DI

VA FileMan 22.0

Select OPTION: 1 ENTER OR EDIT FILE ENTRIES

INPUT TO WHAT FILE: OPTION//
EDIT WHICH FIELD: ALL//

Select OPTION NAME: OR CPRS GUI CHART CPRSChart version 1.0.26.76
NAME: OR CPRS GUI CHART//
MENU TEXT: CPRSChart version 1.0.26.76 Replace 76 With 69
Replace
CPRSChart version 1.0.26.69
----
When using TMG-CPRS, another way of reaching the exact same result is to add ''' "SPOOF-VER=1.0.26.76" ''' to the end of the Windows shortcut to CPRS like so:

... S=192.168.xxx.xxx P=92xx CCOW=DISABLE SPOOF-VER=1.0.26.76

(This method has the (admittedly dubious) advantage of allowing ''both'' a CPRS v1.0.26.68 ''and'' a v1.0.26.76 to connect without changing the server side.

'''Caution:''' One needs to know that the two versions truly are compatible or be willing to risk nasty side-effects, perhaps even damage to the server's database.
----
=== SSH Tunnel ===
Communications between CPRS and the VistA server are not encrypted by default. Access/Verify Codes and all patient data are transmitted in the clear. However, these can be protected by setting up an encrypted "tunnel" between client and server.

[[Setting up an SSH Tunnel between CPRS & VistA]]
----
=== Automatic Windows Installer ===

The [http://sourceforge.net/projects/worldvistaautoi/files Astronaut] suite of automatic installers includes cprs, tmg-cprs and many other clients, available in point-click windows .exe installers. IP address and port number are entered by the user.
----
=== Wine/Crossover compatability ===

[[Wine/Crossover]]

Volunteer Coordinator

2012-12-12T01:40:45Z

Anthracite:

If you wish to consider voluteering to work with WorldVistA, please contact Nancy Anthraciate by email at nancy at worldvista dot org to arrange a time to talk about it. WorldVistA would like volunteers to work on projects where they will enjoy what they are doing.

Clinical Application Coordinator

2012-11-18T17:54:43Z

Anthracite:

A clinically experienced person who guides and supports
clinicians, IT experts, and others through design, adoption,
tailoring, and use of clinical computing systems such as an
electronic medical record. A CAC teaches, trains, supports and
innovates.

This article is a stub and needs to be fleshed out. You can help us by writing an article here. Contact Fred Trotter to help.

This definition is borrowed from the VistA Institute...

This is how to set up a User as a Clinical Application Coordinator so they can create and publish shared templates.

1. First set the Parameter TEMPLATE FIELD EDITOR USER CLASSES

CHOOSE 1-5: 1 EVE Systems Manager Menu
Core Applications ...

Select Systems Manager Menu Option: CORe Applications

...
IRM CPRS Configuration (IRM) ...

Select Core Applications Option: IRM CPRS Configuration (IRM)

OC Order Check Expert System Main Menu ...
TI ORMTIME Main Menu ...
UT CPRS Clean-up Utilities ...
XX General Parameter Tools ...
HD HealtheVet Desktop Configuration ...
RD Remote Data Order Checking Parameters

Select CPRS Configuration (IRM) Option: XX General Parameter Tools

LV List Values for a Selected Parameter
LE List Values for a Selected Entity
LP List Values for a Selected Package
LT List Values for a Selected Template
EP Edit Parameter Values
ET Edit Parameter Values with Template
EK Edit Parameter Definition Keyword

Select General Parameter Tools Option: EP Edit Parameter Values
--- Edit Parameter Values ---

Select PARAMETER DEFINITION NAME: TEMPL
1 TEMPLATE FIELD EDITOR USER CLASSES TIU FIELD EDITOR CLASSES
Template
Field Editor User Classes
2 TEMPLATES FOR VITALS V5 GMV TEMPLATE Templates for vitals V5
CHOOSE 1-2: 1 TIU FIELD EDITOR CLASSES Template Field Editor User Classes

TIU FIELD EDITOR CLASSES may be set for the following:

1 User USR [choose from NEW PERSON]
3 Service SRV [choose from SERVICE/SECTION]
4 Division DIV [choose from INSTITUTION]
5 System SYS
6 Package PKG [TEXT INTEGRATION UTILITIES]

Enter selection: 5 System
---- Setting TIU FIELD EDITOR CLASSES for System:
Select Sequence Number: ?

Sequence Number Value
--------------- -----
3 CLINICAL COORDINATOR

2. Then Add the person to the USR Class CLINICAL COORDINATOR

>D ^XUP

Setting up programmer environment
This is a TEST account.

Terminal Type set to: C-VT100

You have 108 new messages.
Select OPTION NAME: USR LIST MEMBERSHIP BY CLASS List Membership by Class
List Membership by Class
Select CLASS: CLINICAL COORDINATOR
User Class Members Nov 16, 2012@18:55:14 Page: 1 of
1
CLINICAL COORDINATORs 7
Members
Member Effective Expires
1 AMUNDSON,MARK 10/27/05
2 ANDERSON,MAGGIE 10/27/05
3 COORDINATOR,CLINICAL 06/01/05
4 DEWAYNE,ROBERT 07/19/05
5 JUTZI,WILLIAM 02/22/05
6 MANAGER,SYSTEM 06/06/05
7 WVEHR,PATCH INSTALLER 11/27/06

+ Next Screen - Prev Screen ?? More Actions
>>>
Add Remove Change View
Edit Schedule Changes Quit

Select Action: Quit// ADD Add
Select MEMBER: JONES,JOSEPH JJJ IRM ANALYST
MEMBER: JONES,JOSEPH//
EFFECTIVE DATE: T (NOV 16, 2012)
EXPIRATION DATE:

Select Another MEMBER:

Configuration Overview

2011-12-15T13:53:19Z

Anthracite: /* Documentation from WorldVistA & VistA Community Volunteers. */

The documentation for VistA can be classified in several groups:

== Specialized Configuration/Installation Pages ==
* [[Basic Installation of Doctor Office]]
* [[Basic Installation of Clinic]]
* [[Basic Installation of Hospital]]
* [[Basic Configuration of Doctor Office]]
* [[Basic Configuration of Clinic]]
* [[Basic Configuration of Hospital]]

This is part of the [[End to End VistA Guide]]

== Documentation from WorldVistA & VistA Community Volunteers. ==
Mark Street / Nancy Anthracite's GT.M Configuration Walk-Through
[[Begin_Configuration_of_Vista]]

How to Register a Patient
[[Register_a_Patient]]

See Vitals/Measurements below for setting up Vitals Templates

Pharmacy Issues

BCMA Configuration Information
Information from Jordan about installing BCMA
http://opensourcevista.net:8888/NancysVistAServer/BCMA_Setup_v0.3.pdf
[http://opensourcevista.net:8888/NancysVistAServer/BCMA_Setup_v0.3.pdf]

== Configuration Documentation from sofware and hardware vendors of VistA. ==

(Psst, put in documentations here...)

== Configuration Documentation from the [[VistA Documentation Library]] (VDL) ==

=== Clinical ===
<TABLE summary="This table is for formatting purposes only." class = "toc" cellpadding="5" border="">
<TR>
<td>[[Configuration of Admission Discharge Transfer (ADT)]]</TD>
<td>[[Configuration of Electronic Wait List]]</TD>
<td>[[Configuration of Medicine]]</TD>
<td>[[Configuration of Pharmacy Prescription Practices (PPP)]]</TD>
</TR><TR>
<td>[[Configuration of Ambulatory Care Reporting]]</TD>
<td>[[Configuration of Functional Independence Measurement (FIM)]]</TD>
<td>[[Configuration of Mental Health]]</TD>
<td>[[Configuration of Primary Care Management Module (PCMM)]]</TD>
</TR><TR>
<td>[[Configuration of Beneficiary Travel]]</TD>
<td>[[Configuration of Group Notes]]</TD>
<td>[[Configuration of Nursing]]</TD>
<td>[[Configuration of Prosthestics]]</TD>
</TR><TR>
<td>[[Configuration of Care Management]]</TD>
<td>[[Configuration of Home Based Primary Care (HBPC)]]</TD>
<td>[[Configuration of Oncology]]</TD>
<td>[[Configuration of Quality Audiology Speech Anal & Rpting (QUASAR)]]</TD>
</TR><TR>
<td>[[Configuration of Clinical Case Registries]]</TD>
<td>[[Configuration of Immunology Case Registry (ICR)]]</TD>
<td>[[Configuration of Patient Care Encounter (PCE)]]</TD>
<td>[[Configuration of Radiology / Nuclear Medicine]]</TD>
</TR><TR>
<td>[[Configuration of Clinical Procedures]]</TD>
<td>[[Configuration of Incomplete Records Tracking (IRT)]]</TD>
<td>[[Configuration of Pharmacy Automatic Replenish / Ward Stock (AR/WS)]]</TD>
<td>[[Configuration of RAI/MDS]]</TD>
</TR><TR>
<td>[[Configuration of Computerized Patient Record System (CPRS)]]</TD>
<td>[[Configuration of Intake and Output]]</TD>
<td>[[Configuration of Pharmacy Bar Code Medication Administration (BCMA)]]</TD>
<td>[[Configuration of Remote Order Entry System (ROES)]]</TD>
</TR><TR>
<td>[[Configuration of CPRS Adverse Reaction Tracking (ART)]]</TD>
<td>[[Configuration of Laboratory Anatomic Pathology]]</TD>
<td>[[Configuration of Pharmacy Benefits Management (PBM)]]</TD>
<td>[[Configuration of Scheduling]]</TD>
</TR><TR>
<td>[[Configuration of CPRS Authorization Subscription Utility (ASU)]]</TD>
<td>[[Configuration of Laboratory Blood Bank]]</TD>
<td>[[Configuration of Pharmacy Consolidated Mail Outpatient Pharmacy]]</TD>
<td>[[Configuration of Social Work]]</TD>
</TR><TR>
<td>[[Configuration of CPRS Clinical Reminders]]</TD>
<td>[[Configuration of Laboratory Blood Bank Workarounds]]</TD>
<td>[[Configuration of Pharmacy Controlled Substances]]</TD>
<td>[[Configuration of Spinal Cord Dysfunction]]</TD>
</TR><TR>
<td>[[Configuration of CPRS Consult/Request Tracking]]</TD>
<td>[[Configuration of Laboratory Electronic Data Interchange (LEDI)]]</TD>
<td>[[Configuration of Pharmacy Data Management (PDM)]]</TD>
<td>[[Configuration of Surgery]]</TD>
</TR><TR>
<td>[[Configuration of CPRS Health Summary]]</TD>
<td>[[Configuration of Laboratory Emerging Pathogens Initiative]]</TD>
<td>[[Configuration of Pharmacy Drug Accountability]]</TD>
<td>[[Configuration of VISTA Imaging System]]</TD>
</TR><TR>
<td>[[Configuration of CPRS Problem List]]</TD>
<td>[[Configuration of Laboratory National Laboratory Tests/ LOINC Request Form]]</TD>
<td>[[Configuration of Pharmacy Electronic Claims Management Engine (ECME)]]</TD>
<td>[[Configuration of Visual Impairment Service Team (VIST)]]</TD>
</TR><TR>
<td>[[Configuration of CPRS Text Integration Utility (TIU)]]</TD>
<td>[[Configuration of Laboratory Universal Interface]]</TD>
<td>[[Configuration of Pharmacy Inpatient Medications]]</TD>
<td>[[Configuration of Vitals / Measurements]]</TD>
</TR><TR>
<td>[[Configuration of Dentistry]]</TD>
<td>[[Configuration of Laboratory]]</TD>
<td>[[Configuration of Pharmacy National Drug File (NDF)]]</TD>
<td>[[Configuration of Women's Health]]</TD>
</TR><TR>
<td>[[Configuration of Dietetics]]</TD>
<td>[[Configuration of Lexicon Utility]]</TD>
<td>[[Configuration of Pharmacy Outpatient Pharmacy]]</TD>
</TR></TABLE>
=== Infrastructure ===
<TABLE summary="This table is for formatting purposes only." class = "toc" cellpadding="5" border="">
<TR>
<td>[[Configuration of Capacity Management Tools]]</TD>
<td>[[Configuration of Kernel Delphi Components (KDC)]]</TD>
<td>[[Configuration of Minimal Patient Dataset (MPD)]]</TD>
<td>[[Configuration of SlotMaster (Kernel ZSLOT)]]</TD>
</TR><TR>
<td>[[Configuration of Duplicate Record Merge- Patient Merge]]</TD>
<td>[[Configuration of Kernel Configuration and Distribution System (KIDS)]]</TD>
<td>[[Configuration of Name Standardization]]</TD>
<td>[[Configuration of SQL Interface (SQLI)]]</TD>
</TR><TR>
<td>[[Configuration of Electronic Error and Enhancement Reporting (E3R)]]</TD>
<td>[[Configuration of Kernel Toolkit]]</TD>
<td>[[Configuration of National Online Information Sharing (NOIS)]]</TD>
<td>[[Configuration of Standard Files and Tables]]</TD>
</TR><TR>
<td>[[Configuration of FileMan]]</TD>
<td>[[Configuration of Kernel Unwinder]]</TD>
<td>[[Configuration of National Patch Module]]</TD>
<td>[[Configuration of Statistical Analysis of Global Growth (SAGG)]]</TD>
</TR><TR>
<td>[[Configuration of FileMan Delphi Components (FMDC)]]</TD>
<td>[[Configuration of List Manager]]</TD>
<td>[[Configuration of Network Health Exchange (NHE)]]</TD>
<td>[[Configuration of Survey Generator]]</TD>
</TR><TR>
<td>[[Configuration of HL7 (VistA Messaging)]]</TD>
<td>[[Configuration of M-to-M Broker]]</TD>
<td>[[Configuration of Patient Data Exchange (PDX)]]</TD>
<td>[[Configuration of VistA Data Extraction Framework (VDEF)]]</TD>
</TR><TR>
<td>[[Configuration of Institution File Redesign (IFR)]]</TD>
<td>[[Configuration of MailMan]]</TD>
<td>[[Configuration of Remote Procedure Call (RPC) Broker]]</TD>
<td>[[Configuration of XML Parser (VistA)]]</TD>
</TR><TR>
<td>[[Configuration of Kernel]]</TD>
<td>[[Configuration of Master Patient Index (MPI)]]</TD>
<td>[[Configuration of Resource Usage Monitor]]</TD>
</TR></TABLE>
=== Financial-Administrative ===
<TABLE summary="This table is for formatting purposes only." class = "toc" cellpadding="5" border="">
<TR>
<td>[[Configuration of Accounts Receivable (AR)]]</TD>
<td>[[Configuration of Engineering (AEMS / MERS)]]</TD>
<td>[[Configuration of IFCAP]]</TD>
<td>[[Configuration of Patient Representative]]</TD>
</TR><TR>
<td>[[Configuration of Auto Safety Incdnt Surv Trak Sys (ASISTS)]]</TD>
<td>[[Configuration of Enrollment Application System]]</TD>
<td>[[Configuration of Incident Reporting]]</TD>
<td>[[Configuration of Personnel and Accounting Integrated Data (PAID)]]</TD>
</TR><TR>
<td>[[Configuration of Automated Information Collection System (AICS)]]</TD>
<td>[[Configuration of Equipment / Turn-In Request]]</TD>
<td>[[Configuration of Income Verification Match (IVM)]]</TD>
<td>[[Configuration of Police and Security]]</TD>
</TR><TR>
<td>[[Configuration of Automated Medical Information Exchange (AMIE)]]</TD>
<td>[[Configuration of Event Capture]]</TD>
<td>[[Configuration of Integrated Billing (IB)]]</TD>
<td>[[Configuration of Quality Management Integration Module]]</TD>
</TR><TR>
<td>[[Configuration of Clinical Monitoring System]]</TD>
<td>[[Configuration of Fee Basis]]</TD>
<td>[[Configuration of Integrated Patient Funds]]</TD>
<td>[[Configuration of Record Tracking]]</TD>
</TR><TR>
<td>[[Configuration of Compensation & Pension Records Interchange (CAPRI)]]</TD>
<td>[[Configuration of Generic Code Sheet (GCS)]]</TD>
<td>[[Configuration of Library]]</TD>
<td>[[Configuration of Release of Information (ROI) Manager]]</TD>
</TR><TR>
<td>[[Configuration of Current Procedural Terminology (CPT)]]</TD>
<td>[[Configuration of Health Eligibility Center (HEC)]]</TD>
<td>[[Configuration of Missing Patient Register]]</TD>
<td>[[Configuration of Veterans Identification Card (VIC/PICS)]]</TD>
</TR><TR>
<td>[[Configuration of Decision Support System (DSS) Extracts]]</TD>
<td>[[Configuration of Hospital Inquiry (HINQ)]]</TD>
<td>[[Configuration of Occurrence Screen]]</TD>
<td>[[Configuration of Voluntary Service System (VSS)]]</TD>
</TR><TR>
<td>[[Configuration of Diagnostic Related Group (DRG) Grouper]]</TD>
<td>[[Configuration of ICD-9-CM]]</TD>
</TR></TABLE>

Configuration Overview

2011-12-15T13:51:26Z

Anthracite: /* Documentation from WorldVistA & VistA Community Volunteers. */

The documentation for VistA can be classified in several groups:

== Specialized Configuration/Installation Pages ==
* [[Basic Installation of Doctor Office]]
* [[Basic Installation of Clinic]]
* [[Basic Installation of Hospital]]
* [[Basic Configuration of Doctor Office]]
* [[Basic Configuration of Clinic]]
* [[Basic Configuration of Hospital]]

This is part of the [[End to End VistA Guide]]

== Documentation from WorldVistA & VistA Community Volunteers. ==
Mark Street / Nancy Anthracite's GT.M Configuration Walk-Through
[[Begin_Configuration_of_Vista]]

How to Register a Patient
[[Register_a_Patient]]

See Vitals/Measurements below for setting up Vitals Templates

Pharmacy Issues

BCMA Configuration Information
Information from the experience from installing BCMA in Jordan
http://opensourcevista.net:8888/NancysVistAServer/BCMA_Setup_v0.3.pdf
[http://opensourcevista.net:8888/NancysVistAServer/BCMA_Setup_v0.3.pdf]

== Configuration Documentation from sofware and hardware vendors of VistA. ==

(Psst, put in documentations here...)

== Configuration Documentation from the [[VistA Documentation Library]] (VDL) ==

=== Clinical ===
<TABLE summary="This table is for formatting purposes only." class = "toc" cellpadding="5" border="">
<TR>
<td>[[Configuration of Admission Discharge Transfer (ADT)]]</TD>
<td>[[Configuration of Electronic Wait List]]</TD>
<td>[[Configuration of Medicine]]</TD>
<td>[[Configuration of Pharmacy Prescription Practices (PPP)]]</TD>
</TR><TR>
<td>[[Configuration of Ambulatory Care Reporting]]</TD>
<td>[[Configuration of Functional Independence Measurement (FIM)]]</TD>
<td>[[Configuration of Mental Health]]</TD>
<td>[[Configuration of Primary Care Management Module (PCMM)]]</TD>
</TR><TR>
<td>[[Configuration of Beneficiary Travel]]</TD>
<td>[[Configuration of Group Notes]]</TD>
<td>[[Configuration of Nursing]]</TD>
<td>[[Configuration of Prosthestics]]</TD>
</TR><TR>
<td>[[Configuration of Care Management]]</TD>
<td>[[Configuration of Home Based Primary Care (HBPC)]]</TD>
<td>[[Configuration of Oncology]]</TD>
<td>[[Configuration of Quality Audiology Speech Anal & Rpting (QUASAR)]]</TD>
</TR><TR>
<td>[[Configuration of Clinical Case Registries]]</TD>
<td>[[Configuration of Immunology Case Registry (ICR)]]</TD>
<td>[[Configuration of Patient Care Encounter (PCE)]]</TD>
<td>[[Configuration of Radiology / Nuclear Medicine]]</TD>
</TR><TR>
<td>[[Configuration of Clinical Procedures]]</TD>
<td>[[Configuration of Incomplete Records Tracking (IRT)]]</TD>
<td>[[Configuration of Pharmacy Automatic Replenish / Ward Stock (AR/WS)]]</TD>
<td>[[Configuration of RAI/MDS]]</TD>
</TR><TR>
<td>[[Configuration of Computerized Patient Record System (CPRS)]]</TD>
<td>[[Configuration of Intake and Output]]</TD>
<td>[[Configuration of Pharmacy Bar Code Medication Administration (BCMA)]]</TD>
<td>[[Configuration of Remote Order Entry System (ROES)]]</TD>
</TR><TR>
<td>[[Configuration of CPRS Adverse Reaction Tracking (ART)]]</TD>
<td>[[Configuration of Laboratory Anatomic Pathology]]</TD>
<td>[[Configuration of Pharmacy Benefits Management (PBM)]]</TD>
<td>[[Configuration of Scheduling]]</TD>
</TR><TR>
<td>[[Configuration of CPRS Authorization Subscription Utility (ASU)]]</TD>
<td>[[Configuration of Laboratory Blood Bank]]</TD>
<td>[[Configuration of Pharmacy Consolidated Mail Outpatient Pharmacy]]</TD>
<td>[[Configuration of Social Work]]</TD>
</TR><TR>
<td>[[Configuration of CPRS Clinical Reminders]]</TD>
<td>[[Configuration of Laboratory Blood Bank Workarounds]]</TD>
<td>[[Configuration of Pharmacy Controlled Substances]]</TD>
<td>[[Configuration of Spinal Cord Dysfunction]]</TD>
</TR><TR>
<td>[[Configuration of CPRS Consult/Request Tracking]]</TD>
<td>[[Configuration of Laboratory Electronic Data Interchange (LEDI)]]</TD>
<td>[[Configuration of Pharmacy Data Management (PDM)]]</TD>
<td>[[Configuration of Surgery]]</TD>
</TR><TR>
<td>[[Configuration of CPRS Health Summary]]</TD>
<td>[[Configuration of Laboratory Emerging Pathogens Initiative]]</TD>
<td>[[Configuration of Pharmacy Drug Accountability]]</TD>
<td>[[Configuration of VISTA Imaging System]]</TD>
</TR><TR>
<td>[[Configuration of CPRS Problem List]]</TD>
<td>[[Configuration of Laboratory National Laboratory Tests/ LOINC Request Form]]</TD>
<td>[[Configuration of Pharmacy Electronic Claims Management Engine (ECME)]]</TD>
<td>[[Configuration of Visual Impairment Service Team (VIST)]]</TD>
</TR><TR>
<td>[[Configuration of CPRS Text Integration Utility (TIU)]]</TD>
<td>[[Configuration of Laboratory Universal Interface]]</TD>
<td>[[Configuration of Pharmacy Inpatient Medications]]</TD>
<td>[[Configuration of Vitals / Measurements]]</TD>
</TR><TR>
<td>[[Configuration of Dentistry]]</TD>
<td>[[Configuration of Laboratory]]</TD>
<td>[[Configuration of Pharmacy National Drug File (NDF)]]</TD>
<td>[[Configuration of Women's Health]]</TD>
</TR><TR>
<td>[[Configuration of Dietetics]]</TD>
<td>[[Configuration of Lexicon Utility]]</TD>
<td>[[Configuration of Pharmacy Outpatient Pharmacy]]</TD>
</TR></TABLE>
=== Infrastructure ===
<TABLE summary="This table is for formatting purposes only." class = "toc" cellpadding="5" border="">
<TR>
<td>[[Configuration of Capacity Management Tools]]</TD>
<td>[[Configuration of Kernel Delphi Components (KDC)]]</TD>
<td>[[Configuration of Minimal Patient Dataset (MPD)]]</TD>
<td>[[Configuration of SlotMaster (Kernel ZSLOT)]]</TD>
</TR><TR>
<td>[[Configuration of Duplicate Record Merge- Patient Merge]]</TD>
<td>[[Configuration of Kernel Configuration and Distribution System (KIDS)]]</TD>
<td>[[Configuration of Name Standardization]]</TD>
<td>[[Configuration of SQL Interface (SQLI)]]</TD>
</TR><TR>
<td>[[Configuration of Electronic Error and Enhancement Reporting (E3R)]]</TD>
<td>[[Configuration of Kernel Toolkit]]</TD>
<td>[[Configuration of National Online Information Sharing (NOIS)]]</TD>
<td>[[Configuration of Standard Files and Tables]]</TD>
</TR><TR>
<td>[[Configuration of FileMan]]</TD>
<td>[[Configuration of Kernel Unwinder]]</TD>
<td>[[Configuration of National Patch Module]]</TD>
<td>[[Configuration of Statistical Analysis of Global Growth (SAGG)]]</TD>
</TR><TR>
<td>[[Configuration of FileMan Delphi Components (FMDC)]]</TD>
<td>[[Configuration of List Manager]]</TD>
<td>[[Configuration of Network Health Exchange (NHE)]]</TD>
<td>[[Configuration of Survey Generator]]</TD>
</TR><TR>
<td>[[Configuration of HL7 (VistA Messaging)]]</TD>
<td>[[Configuration of M-to-M Broker]]</TD>
<td>[[Configuration of Patient Data Exchange (PDX)]]</TD>
<td>[[Configuration of VistA Data Extraction Framework (VDEF)]]</TD>
</TR><TR>
<td>[[Configuration of Institution File Redesign (IFR)]]</TD>
<td>[[Configuration of MailMan]]</TD>
<td>[[Configuration of Remote Procedure Call (RPC) Broker]]</TD>
<td>[[Configuration of XML Parser (VistA)]]</TD>
</TR><TR>
<td>[[Configuration of Kernel]]</TD>
<td>[[Configuration of Master Patient Index (MPI)]]</TD>
<td>[[Configuration of Resource Usage Monitor]]</TD>
</TR></TABLE>
=== Financial-Administrative ===
<TABLE summary="This table is for formatting purposes only." class = "toc" cellpadding="5" border="">
<TR>
<td>[[Configuration of Accounts Receivable (AR)]]</TD>
<td>[[Configuration of Engineering (AEMS / MERS)]]</TD>
<td>[[Configuration of IFCAP]]</TD>
<td>[[Configuration of Patient Representative]]</TD>
</TR><TR>
<td>[[Configuration of Auto Safety Incdnt Surv Trak Sys (ASISTS)]]</TD>
<td>[[Configuration of Enrollment Application System]]</TD>
<td>[[Configuration of Incident Reporting]]</TD>
<td>[[Configuration of Personnel and Accounting Integrated Data (PAID)]]</TD>
</TR><TR>
<td>[[Configuration of Automated Information Collection System (AICS)]]</TD>
<td>[[Configuration of Equipment / Turn-In Request]]</TD>
<td>[[Configuration of Income Verification Match (IVM)]]</TD>
<td>[[Configuration of Police and Security]]</TD>
</TR><TR>
<td>[[Configuration of Automated Medical Information Exchange (AMIE)]]</TD>
<td>[[Configuration of Event Capture]]</TD>
<td>[[Configuration of Integrated Billing (IB)]]</TD>
<td>[[Configuration of Quality Management Integration Module]]</TD>
</TR><TR>
<td>[[Configuration of Clinical Monitoring System]]</TD>
<td>[[Configuration of Fee Basis]]</TD>
<td>[[Configuration of Integrated Patient Funds]]</TD>
<td>[[Configuration of Record Tracking]]</TD>
</TR><TR>
<td>[[Configuration of Compensation & Pension Records Interchange (CAPRI)]]</TD>
<td>[[Configuration of Generic Code Sheet (GCS)]]</TD>
<td>[[Configuration of Library]]</TD>
<td>[[Configuration of Release of Information (ROI) Manager]]</TD>
</TR><TR>
<td>[[Configuration of Current Procedural Terminology (CPT)]]</TD>
<td>[[Configuration of Health Eligibility Center (HEC)]]</TD>
<td>[[Configuration of Missing Patient Register]]</TD>
<td>[[Configuration of Veterans Identification Card (VIC/PICS)]]</TD>
</TR><TR>
<td>[[Configuration of Decision Support System (DSS) Extracts]]</TD>
<td>[[Configuration of Hospital Inquiry (HINQ)]]</TD>
<td>[[Configuration of Occurrence Screen]]</TD>
<td>[[Configuration of Voluntary Service System (VSS)]]</TD>
</TR><TR>
<td>[[Configuration of Diagnostic Related Group (DRG) Grouper]]</TD>
<td>[[Configuration of ICD-9-CM]]</TD>
</TR></TABLE>

CPRS Overview

2011-09-05T18:13:49Z

Anthracite:

= Overview of CPRS =

CPRS provides clinicians, managers, support staff, researchers, and others an integrated patient record system. [[VISTA~|VISTA]] software for [[Pharmacy~|Pharmacy]], [[Laboratory~|Lab]], Radiology, Allergy Tracking, Consults, Dietetics, Progress Notes, Problem List, [[Scheduling~|Scheduling]], MAS (A/D/T), Kernel, [[VA FileMan|FileManager]], Vitals, [[PCMM~|PCMM]], [[PCE~|PCE]], [[TIU~|TIU]], [[ASU~|ASU]] and [[Clinical_Lexicon~|Clinical Lexicon]] packages was written or modified to support and communicate with CPRS. OE/RR was completely re-written. Together, these clinical components of VISTA provide a single interface for physicians to manage patient care and records, as well as an efficient means for others to access and use patient information.

== Features: ==

=== Smooth transition from OE/RR ===
When a [[VAMC~|VAMC]] installs CPRS, a fully automated process converts existing orders, order dialogs, orderable items, medications, labs, consults, clinical notifications and other components into CPRS. No patient data is lost and little or no manual conversion is required. Installation of CPRS only requires 1-2 hours of system downtime, with little impact on users and patient care. Because of its “user-friendly” design, most VA clinicians can use CPRS with minimal training.

=== OE/RR core module. ===
All basic CPRS tasks occur within the M environment. Tasks relegated to the GUI workstation include those necessary to communicate with the server and to present and obtain data. Specific components of the core M module for OE/RR include:
==== Order processing and storage. ====
Processing orders in CPRS includes: 1) order dialog presentation, 2) order checking, 3) appropriate holding/processing/status assignment related to user credentials, order signature status, and filling package, 4) HL7 formatting, and 5) event posting for filling package and other interested parties, 6) receiving order status messages from filling package, and 7) updating the appropriate data files. Order storage in CPRS includes a complete, date/time-stamped history of all events related to the order including status changes, ordering, requesting, and signatory personnel, related order checks, and override reason, flagged order data, and various components related to the filling package.
==== Mechanism for clinical orderable items. ====
Orderable items are phrased in physician-friendly terms, centrally stored and can be updated at individual VAMCs. Updating is coordinated between OE/RR core and ancillary packages via HL7 messages.
==== Flagged orders. ====
An order can be flagged when it requires special attention. A notification regarding the flagged order is sent to appropriate caregivers assigned to the patient.
==== Electronic signature. ====
Orderable items can be assigned varying degrees of electronic signature requirements. Unsigned orders trigger a notification to appropriate patient caregivers.
==== Encounter management. ====
Orders are linked with specific patient encounters, facilitating point-of-care management and data exchange with encounter-oriented management processes.

==== Patient selection. ====
Extensive patient selection capabilities allow physicians to build patient lists based on ward, room-bed, clinic appointment, patient’s primary provider/attending physician, team and individual patient. Once created, providers’ preferred patient lists are automatically loaded when they access CPRS. For example, a provider can set up a patient list based on each day’s clinic appointments. This list is built automatically each day and displayed to facilitate easier patient selection.

=== List Manager Interface. ===
Non-GUI, ANSI terminals use the CPRS List Manager interface. Designed with a great deal of clinician usability feedback, this interface displays allergies, lab results, medications, existing orders, consults, and other clinical data in a format conducive to decision making. The order entry process has been streamlined to gather the most pertinent information necessary to fill the order.

=== GUI Interface. ===
Clinical workstations in the Windows environment access CPRS through a Delphi-based Graphical User Interface (GUI). Based on years of prototyping, usability studies, and actual clinical use, the CPRS GUI is a full implementation of results reporting and order entry. It communicates with CPRS server processes through the Kernel Broker client-server utility. Data is exchanged via an extensive list of remote procedure calls.

=== HL7 Messaging/Event Processing. ===
Communication between VISTA packages participating in CPRS is accomplished primarily through event-driven HL7 messaging. This approach allows multiple processes to subscribe to a single CPRS event. The structure and content of the HL7 message provides consistent data for processes subscribing to an event. Additional application programmer interfaces (APIs) exist between OE/RR and ancillary packages to provide data not supported by HL7.

=== VAMC Parameters and Defaults. ===
Every VAMC has specialized needs regarding CPRS functionality and processing. To allow variation and modification among VAMCs, CPRS provides a hierarchically structured set of parameters. Each parameter can have a user, team, service/section, patient location, division, system, and package value. The extensive set of parameters exported with CPRS allows VAMC administrators and CPRS users to fine-tune the functionalities and processes specific to their needs.

=== Remote Procedure Calls. ===
Generically written data extraction/storage remote procedure calls (RPCs) provide access to VISTA clinical data for CPRS interfaces, VAMC-developed software, and HOST/COTS applications.

=== Consult/Request Tracking. ===
A fully functional consulting package is exported with CPRS. Integrated tightly with CPRS, consults provides consult ordering/requesting, tracking, and resulting. Consulting events such as requesting and resulting trigger notifications to appropriate health care providers, who can then quickly react to the request or result.

=== Patient/Team Lists. ===
Patient and Team List functionality in CPRS provides several methods for linking health care providers with patients. Team relationships can be based on ward, room-bed, provider, specialty, and/or clinic. Membership is updated automatically when patients are admitted, discharged, transferred, or assigned to a clinic.

=== Expert System. ===
The CPRS Expert System is a modular, rule-oriented, knowledge-based system. It supports CPRS as the basis for real-time order checking (e.g. critical drug interactions, duplicate orders) and background notifications (e.g. critical lab results, expiring medications.) Components include: a Meta-Dictionary for linking discrete medical concepts with data located in files, messages and dialogs; a Rule Editor for creating and editing medical logic modules (MLMs) or rules which relate meta-dictionary concepts in logical expressions; an Inferencing Engine for processing the rules against data; and a Router for distributing results or messages.

=== Clinical Notifications. ===
The Notifications component generates patient-specific clinical alerts regarding order entry, consult, radiology, lab, pharmacy, dietetics, and A/D/T information.Alerts are displayed to VISTA users when they sign onto the computer. They can also be delivered to printers, files, and terminals. Many alerts allow recipients to take related follow-up actions. For example, a patient’s unsigned order triggers an alert to appropriate health care providers. When a recipient selects the alert, the follow-up action displays the patient’s unsigned orders and prompts for electronic signature. Via parameters, VAMCs can disable or enable notifications for users, teams, patient locations, services, divisions, and systems.

=== Order Checking. ===
Order Checks are messages interactively displayed to the ordering provider during an ordering session. They occur in real-time and are driven by responses entered by the ordering provider in conjunction with existing patient data. Order Checks are rated according to potential clinical danger level. Order check messages with a low or moderate clinical danger level can be ignored. High clinical danger level order checks require the entry of a reason if they are overridden. This information is passed on to the filling package (e.g. pharmacy) as part of the order. All order check messages include a prompt to cancel or change the order. Via parameters, VAMCs can adjust order check clinical danger levels and disable or enable order checks for users, teams, patient locations, services, divisions, and systems.

=== Online CPRS Demo ===

You can quickly see a demo of CPRS by downloading the [http://www1.va.gov/cprsdemo/ VA CPRS Demo] from the VA.

=== Adding Remote Procedures for Use with CPRS ===

For CPRS RPCs, you must add them to the Option OR CPRS GUI CHART like this:

GTM>D P^DI
VA FileMan 22.0

Select OPTION: 1 ENTER OR EDIT FILE ENTRIES

INPUT TO WHAT FILE: OPTION
1 OPTION (9906 entries)
2 OPTION SCHEDULING (18 entries)
CHOOSE 1-2: 1 OPTION (9906 entries)
EDIT WHICH FIELD: ALL// RPC (multiple)
EDIT WHICH RPC SUB-FIELD: ALL//
THEN EDIT FIELD:

Select OPTION NAME: OR CPRS GUI CHART CPRSChart version 1.0.27.83
Select RPC: ORWPT OTHER-RADIOBUTTONS// <=== ADD THE RPC NAME HERE

Billing

2011-09-05T15:18:44Z

Anthracite:

Billing encompasses many things

Billing is complex and good documentation has not been written for how to set it up outside of the VA, but there are some documents that might help you if you are trying here. They show some of the configuration settings that were necessary in two setups that did "work":

http://opensourcevista.net:8888/NancysVistAServer/BillingNotes

* [[HCFA_1500_MENTIONS | Search Results for "HCFA 1500" in all routines]]

VistALink

2011-09-05T15:13:14Z

Anthracite: /* Setup VistALink 1.5 */

Information for running the VistALink tester including an install script for Linux and easy instructions for Windows can be found here. This has not been verified to allow use of any of the Java applications, however. The instructions that follow from Minto Tsai will likely allow it.

http://opensourcevista.net:8888/NancysVistAServer/VistALinkFiles/

== Setup VistALink 1.5 ==
on VistA Office EHR SemiViva 2.3.1
by Minto Tsai

==Background:==
VistALink is a utility provided by the VA to allow JAVA applications to execute Remote Procedure Calls (RPC) on the VistA/M server.

== Environment: ==
Ubuntu 7.04 (Feisty Fawn)
JDK 1.5.0_12
J2EE SDK 5.02
VistA Office EHR SemiViva 2.3.1
VistALink 1.5 (Listener is already installed on VistA Office EHR SemiViva 2.3.1)
Sea Island Systems' modified VistALink routines

Setup VistALink 1.5 on VistA Office EHR SemiViva 2.3.1
by Minto Tsai

Background:
VistALink is a utility provided by the VA to allow JAVA applications to execute Remote Procedure Calls (RPC) on the VistA/M server.

Environment:
Ubuntu 7.04 (Feisty Fawn)
JDK 1.5.0_12
J2EE SDK 5.02
VistA Office EHR SemiViva 2.3.1
VistALink 1.5 (Listener is already installed on VistA Office EHR SemiViva 2.3.1)
Sea Island Systems' modified VistALink routines

== Setup Steps: ==

1. Install VistA Office EHR SemiViva 2.3.1
2. Verify VistALink 1.5 is already installed:
GTM> '''D ^XUP''' <enter>
Terminal Type set to: '''C-VT100''' <enter>
Select OPTION NAME: '''eve''' <enter>
CHOOSE 1-5: '''1''' <enter>
Select Systems Manager Menu Option: '''programmer''' <enter>
Select Programmer Options Option: '''kids''' <enter>
Select Kernel Installation & Distribution System Option: '''utilities''' <enter>
Select Utilities Option: '''display''' <enter>
Select PACKAGE NAME: '''vistalink''' <enter>
CHOOSE 1-2: '''1''' <enter>
Select VERSION: 1.5// <enter>
Do you want to see the Descriptions? NO// <enter>
DEVICE: HOME// <enter>

''Output should be:''
PACKAGE: VISTALINK Jul 15, 2007 10:03 pm PAGE 1
PATCH # INSTALLED INSTALLED BY
-------------------------------------------------------------------------------
VERSION: 1.5 OCT 08, 2006 SCHLEHUBER,CAMERON

1 NOV 06, 2006@15:11:19 SCHLEHUBER,CAMERON

3. Save original ^XOB* routines (See ReadMe.txt from Sea Island Systems', see references below)
GTM> D ^%RO <enter>
Routine: ^XOB* <enter>
Routine: <enter>
Output device: <terminal>: /tmp/xob_orig.ro <enter>
Header Label: <enter>
String comments <No>?: <enter>
4. Restore modified routines from xobv-gtm.ro (download from Sea Island Systems', see references below)
GTM> D ^%RI <enter>
Formfeed delimited <No>? <enter>
Input device: <terminal>: /tmp/xobv-gtm.ro <enter>
Output directory: <VistAOfficeEHR>/gtm_V5.2-000/r/ <enter> <-- don't forget the last slash
5. Verify modified routines installed
GTM> ZLINK "XOBVTCPL" WRITE $TEXT(+5^XOBVTCPL) <enter>
''Output should be:''
; SIS/LM - Modified for GT.M - Mar 23, 2004

6. Start the listener
GTM> JOB LISTENER^XOBVTCPL(8001) <enter>

7. Verify listener has started
GTM> <Press CTRL-Z>
$ lke show all <enter>
''Output should be:''

DEFAULT
^%ZIS(8994.171,RPCB Listener,ROU,VAH,ROU:KLW133,9210)
Owned by PID= 32102 which is an existing process
^XOB(18.01,VistALink Listener,ROU,VAH,ROU:KLW133,8001)
Owned by PID= 18338 which is an existing process
$ fg

8. Telnet test to listener
telnet localhost 8001
you should connect if the listener is up

9. Create a user (or use existing user)
User's Access/Verify Code must use capital letters

10. Grant Kernel Access to Sample Application
In User Edit, for Primary/Secondary Menu Options, assign “XOBV VISTALINK TESTER”

11. Installing VistALink sample application files
unzip XOB_1_5.ZIP
cd vlj-1.5.0.026/samples/J2SE

'''copy VistALink libraries (under vlj-1.5.0.026/jars dir)'''
vljConnector-1.5.0.026.jar
vljFoundationsLib-1.5.0.026.jar
vljSecurity-1.5.0.026.jar

'''copy supporting library files'''
j2ee.jar (get from J2EE SDK)
jaxen-dom.jar (under vlj-1.5.0.026/rar/ExplodedVistaLinkRAR/lib dir)
jaxen-core.jar
saxpath.jar
log4j-1.2.8.jar

'''create setVistaLinkEnvironment.sh from setVistaLinkEnvironment.bat'''
'''create runSwingTester.sh from runSwingTester.bat'''

== Running SwingTester sample application ==

'''source setVistaLinkEnvironment.sh'''
. ./setVistaLinkEnvironment.sh

'''launch SwingTester'''
./runSwingTester.sh'

'''connect to M server'''
enter IP: localhost
enter Port: 8001
click Connect
enter Access/Verify code

References:

VistALink VA Documentation - [http://www.va.gov/vdl/application.asp?appid=163]

Vistapedia Documentation (see item 14)- [http://www.vistapedia.org/~forum/index.php?title=Installation_How_To_VistA_GT.M_Ubuntu_Linux]

Sea Island Systems' modified VistALink routines - [http://www.seaislandsystems.com/Downloads/VistALink/]

CPRS Installation

2011-07-07T00:30:01Z

Anthracite: /* CPRS Versions */

__TOC__

This page records the process of installation of the [[CPRS|Computerized Patient Record System]] Graphical User Interface client program on the [[Microsoft Windows OS]].

=== CPRS Versions ===

This table will list links for the various CPRS versions. (The most current version is at the top)

{| class="grey" border="1" cellpadding="2"
|+ CPRS Versions
|-
! Version Number
! Distribution File
! Availability
! Date
|-
| version 1.0.27.90
| OR-3_SEQ-273_PAT-296.ZIP
| [https://downloads.va.gov/files/FOIA/Software/Patches_By_Application/OR-ORDER%20ENTRY_RESULTS%20REPORTING/ Download folder on VA site]
| 11/2010
|-
| version 1.0.27.83
| OR_30_304.ZIP
| [https://downloads.va.gov/files/FOIA/Software/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/ Download folder on VA site]
| 11/2008 Emergency Correction of Patient Safety Issues
|-
| version 1.0.27.77
| OR_30_243.ZIP
| [https://downloads.va.gov/files/FOIA/Software/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/ Download folder on VA site]
| 08/2008
|-
| version 1.0.26.69
| OR_30_270.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server] or
[https://downloads.va.gov/files/FOIA/Software/VistA_FOIA_Historical_Files/VISTA_FOIA_RELEASES_BEFORE_2008/OR-Order%20Entry-Results%20Reporting/ Download folder on VA site]
|-
| version 1.0.26.69
| for WorldVistA EHR
| on the Sourceforge WorldVistA EHR site and http://opensourcevista.net:8888/NancysVistAServer
| (dated June 2007)

|-
| version 1.0.26.68
| OR_30_258.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| Note Below (NB):(dated July 17, 2006)
|-
| version 1.0.25.42
| OR_30_235.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated July 09, 2005) Note: Replace .25.40 with .25.42 for patient safety
|-
| version 1.0.25.40
| OR_30_231.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated May 06, 2005)
|-
| version 1.0.25.28
| OR_30_195.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Feb 09, 2005)
|-
| version 1.0.24.27
| OR_30_224.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Sep 03, 2004)
|-
| version 1.0.24.26
| OR_30_190.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Aug 02, 2004)
|-
| version 1.0.23.15
| OR_30_187.ZIP
| *Sourceforge WorldVistA and [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 02/04)
|-
| version 1.0.22.16
| OR_30_206.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 01/04)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 11/02)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
|(dated about 11/02)
|-
| version 1.0.19.7
| OR_30_132.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 05/02)
|-
| version 1.0.18.2
| OR_30_125.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 12/01)
|}

----

=== version change trick ===
NB: There is a trick to making version 1.0.26.68. It is done for you in CPRSDir.zip which can be found along with the instructions for creating it at:

http://downloads.opensourcevista.net/VADemo9-26-06

To find out which version to use, look next to the option [[OPTION OR CPRS GUI CHART|named "OR CPRS GUI CHART"]] like this example where CPRS version 1.0.23.15 was needed:

D Q^DI

VA FileMan 22.0
Select OPTION: 5 INQUIRE TO FILE ENTRIES

OUTPUT FROM WHAT FILE: DEVICE// OPTION
1 OPTION (10126 entries)
2 OPTION SCHEDULING (116 entries)
CHOOSE 1-2: 1 OPTION (10126 entries)
Select OPTION NAME: OR CPRS GUI CHART CPRSChart version 1.0.23.15
ANOTHER ONE:

To use a particular version of CPRS, the server-side software code must match. The files are found at ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ and the source code is in the "Programs" subdirectory of this directory

Thus:

[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/ <nowiki>ftp://ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ </nowiki>]

The Delphi source code for each of these (e.g. OR_30_235_SRC.ZIP) will be found in the subdirectory
[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/Programs/ <nowiki>...Packages/Order Entry-Results Reporting - OR/Programs/ </nowiki>]

The wget(1) utility is capable of fetching the files from this server

AceFTP is a freeware FTP program that works, if needed
http://software.visicommedia.com/en/productsfreeware/

''(In the past this FTP site could not be reached with Mozilla/Firefox. That has been corrected.)''
----

=== 1.0.26.69 (and TMG-CPRS) spoof --> 1.0.26.76 ===

Since the changes between 1.0.26.69 and 1.0.26.76 are relatively minor, in this case, version can be used by changing the option in the option file like this:

D P^DI

VA FileMan 22.0

Select OPTION: 1 ENTER OR EDIT FILE ENTRIES

INPUT TO WHAT FILE: OPTION//
EDIT WHICH FIELD: ALL//

Select OPTION NAME: OR CPRS GUI CHART CPRSChart version 1.0.26.76
NAME: OR CPRS GUI CHART//
MENU TEXT: CPRSChart version 1.0.26.76 Replace 76 With 69
Replace
CPRSChart version 1.0.26.69
----
When using TMG-CPRS, another way of reaching the exact same result is to add ''' "SPOOF-VER=1.0.26.76" ''' to the end of the Windows shortcut to CPRS like so:

... S=192.168.xxx.xxx P=92xx CCOW=DISABLE SPOOF-VER=1.0.26.76

(This method has the (admittedly dubious) advantage of allowing ''both'' a CPRS v1.0.26.68 ''and'' a v1.0.26.76 to connect without changing the server side.

'''Caution:''' One needs to know that the two versions truly are compatible or be willing to risk nasty side-effects, perhaps even damage to the server's database.
----
=== SSH Tunnel ===
Communications between CPRS and the VistA server are not encrypted by default. Access/Verify Codes and all patient data are transmitted in the clear. However, these can be protected by setting up an encrypted "tunnel" between client and server.

[[Setting up an SSH Tunnel between CPRS & VistA]]
----
=== Automatic Windows Installer ===

The [http://sourceforge.net/projects/worldvistaautoi/files Astronaut] suite of automatic installers includes cprs, tmg-cprs and many other clients, available in point-click windows .exe installers. IP address and port number are entered by the user.
----
=== Wine/Crossover compatability ===

[[Wine/Crossover]]

CPRS Installation

2011-07-07T00:26:43Z

Anthracite: /* CPRS Versions */

__TOC__

This page records the process of installation of the [[CPRS|Computerized Patient Record System]] Graphical User Interface client program on the [[Microsoft Windows OS]].

=== CPRS Versions ===

This table will list links for the various CPRS versions. (The most current version is at the top)

{| class="grey" border="1" cellpadding="2"
|+ CPRS Versions
|-
! Version Number
! Distribution File
! Availability
! Date
|-
| version 1.0.27.90
| OR-3_SEQ-273_PAT-296.ZIP
| [https://downloads.va.gov/files/FOIA/Software/Patches_By_Application/OR-ORDER%20ENTRY_RESULTS%20REPORTING/ Download folder on VA site]
| 11/2010
|-
| version 1.0.27.77
| OR_30_243.ZIP
| [https://downloads.va.gov/files/FOIA/Software/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/ Download folder on VA site]
| 08/2008
|-
| version 1.0.27.83
| OR_30_304.ZIP
| [https://downloads.va.gov/files/FOIA/Software/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/ Download folder on VA site]
| 09/2008 Emergency Correction of Patient Safety Issues
|-
| version 1.0.26.69
| OR_30_270.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server] or
[https://downloads.va.gov/files/FOIA/Software/VistA_FOIA_Historical_Files/VISTA_FOIA_RELEASES_BEFORE_2008/OR-Order%20Entry-Results%20Reporting/ Download folder on VA site]
|-
| version 1.0.26.69
| for WorldVistA EHR
| on the Sourceforge WorldVistA EHR site and http://opensourcevista.net:8888/NancysVistAServer
| (dated June 2007)

|-
| version 1.0.26.68
| OR_30_258.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| Note Below (NB):(dated July 17, 2006)
|-
| version 1.0.25.42
| OR_30_235.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated July 09, 2005) Note: Replace .25.40 with .25.42 for patient safety
|-
| version 1.0.25.40
| OR_30_231.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated May 06, 2005)
|-
| version 1.0.25.28
| OR_30_195.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Feb 09, 2005)
|-
| version 1.0.24.27
| OR_30_224.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Sep 03, 2004)
|-
| version 1.0.24.26
| OR_30_190.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Aug 02, 2004)
|-
| version 1.0.23.15
| OR_30_187.ZIP
| *Sourceforge WorldVistA and [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 02/04)
|-
| version 1.0.22.16
| OR_30_206.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 01/04)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 11/02)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
|(dated about 11/02)
|-
| version 1.0.19.7
| OR_30_132.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 05/02)
|-
| version 1.0.18.2
| OR_30_125.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 12/01)
|}

----

=== version change trick ===
NB: There is a trick to making version 1.0.26.68. It is done for you in CPRSDir.zip which can be found along with the instructions for creating it at:

http://downloads.opensourcevista.net/VADemo9-26-06

To find out which version to use, look next to the option [[OPTION OR CPRS GUI CHART|named "OR CPRS GUI CHART"]] like this example where CPRS version 1.0.23.15 was needed:

D Q^DI

VA FileMan 22.0
Select OPTION: 5 INQUIRE TO FILE ENTRIES

OUTPUT FROM WHAT FILE: DEVICE// OPTION
1 OPTION (10126 entries)
2 OPTION SCHEDULING (116 entries)
CHOOSE 1-2: 1 OPTION (10126 entries)
Select OPTION NAME: OR CPRS GUI CHART CPRSChart version 1.0.23.15
ANOTHER ONE:

To use a particular version of CPRS, the server-side software code must match. The files are found at ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ and the source code is in the "Programs" subdirectory of this directory

Thus:

[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/ <nowiki>ftp://ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ </nowiki>]

The Delphi source code for each of these (e.g. OR_30_235_SRC.ZIP) will be found in the subdirectory
[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/Programs/ <nowiki>...Packages/Order Entry-Results Reporting - OR/Programs/ </nowiki>]

The wget(1) utility is capable of fetching the files from this server

AceFTP is a freeware FTP program that works, if needed
http://software.visicommedia.com/en/productsfreeware/

''(In the past this FTP site could not be reached with Mozilla/Firefox. That has been corrected.)''
----

=== 1.0.26.69 (and TMG-CPRS) spoof --> 1.0.26.76 ===

Since the changes between 1.0.26.69 and 1.0.26.76 are relatively minor, in this case, version can be used by changing the option in the option file like this:

D P^DI

VA FileMan 22.0

Select OPTION: 1 ENTER OR EDIT FILE ENTRIES

INPUT TO WHAT FILE: OPTION//
EDIT WHICH FIELD: ALL//

Select OPTION NAME: OR CPRS GUI CHART CPRSChart version 1.0.26.76
NAME: OR CPRS GUI CHART//
MENU TEXT: CPRSChart version 1.0.26.76 Replace 76 With 69
Replace
CPRSChart version 1.0.26.69
----
When using TMG-CPRS, another way of reaching the exact same result is to add ''' "SPOOF-VER=1.0.26.76" ''' to the end of the Windows shortcut to CPRS like so:

... S=192.168.xxx.xxx P=92xx CCOW=DISABLE SPOOF-VER=1.0.26.76

(This method has the (admittedly dubious) advantage of allowing ''both'' a CPRS v1.0.26.68 ''and'' a v1.0.26.76 to connect without changing the server side.

'''Caution:''' One needs to know that the two versions truly are compatible or be willing to risk nasty side-effects, perhaps even damage to the server's database.
----
=== SSH Tunnel ===
Communications between CPRS and the VistA server are not encrypted by default. Access/Verify Codes and all patient data are transmitted in the clear. However, these can be protected by setting up an encrypted "tunnel" between client and server.

[[Setting up an SSH Tunnel between CPRS & VistA]]
----
=== Automatic Windows Installer ===

The [http://sourceforge.net/projects/worldvistaautoi/files Astronaut] suite of automatic installers includes cprs, tmg-cprs and many other clients, available in point-click windows .exe installers. IP address and port number are entered by the user.
----
=== Wine/Crossover compatability ===

[[Wine/Crossover]]

CPRS Installation

2011-07-07T00:24:18Z

Anthracite: /* CPRS Versions */

__TOC__

This page records the process of installation of the [[CPRS|Computerized Patient Record System]] Graphical User Interface client program on the [[Microsoft Windows OS]].

=== CPRS Versions ===

This table will list links for the various CPRS versions. (The most current version is at the top)

{| class="grey" border="1" cellpadding="2"
|+ CPRS Versions
|-
! Version Number
! Distribution File
! Availability
! Date
|-
| version 1.0.27.90
| OR-3_SEQ-273_PAT-296.ZIP
| [https://downloads.va.gov/files/FOIA/Software/Patches_By_Application/OR-ORDER%20ENTRY_RESULTS%20REPORTING/ Download folder on VA site]
| 11/2010
|-
| version 1.0.27.77
| OR_30_243.ZIP
| [https://downloads.va.gov/files/FOIA/Software/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/ Download folder on VA site]
| 05/2009
|-
| version 1.0.27.83
| OR_30_304.ZIP
| [https://downloads.va.gov/files/FOIA/Software/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/ Download folder on VA site]
| 09/2008 Emergency Correction of Patient Safety Issues
|-
| version 1.0.26.69
| OR_30_270.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server] or
[https://downloads.va.gov/files/FOIA/Software/VistA_FOIA_Historical_Files/VISTA_FOIA_RELEASES_BEFORE_2008/OR-Order%20Entry-Results%20Reporting/ Download folder on VA site]
|-
| version 1.0.26.69
| for WorldVistA EHR
| on the Sourceforge WorldVistA EHR site and http://opensourcevista.net:8888/NancysVistAServer
| (dated June 2007)

|-
| version 1.0.26.68
| OR_30_258.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| Note Below (NB):(dated July 17, 2006)
|-
| version 1.0.25.42
| OR_30_235.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated July 09, 2005) Note: Replace .25.40 with .25.42 for patient safety
|-
| version 1.0.25.40
| OR_30_231.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated May 06, 2005)
|-
| version 1.0.25.28
| OR_30_195.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Feb 09, 2005)
|-
| version 1.0.24.27
| OR_30_224.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Sep 03, 2004)
|-
| version 1.0.24.26
| OR_30_190.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Aug 02, 2004)
|-
| version 1.0.23.15
| OR_30_187.ZIP
| *Sourceforge WorldVistA and [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 02/04)
|-
| version 1.0.22.16
| OR_30_206.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 01/04)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 11/02)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
|(dated about 11/02)
|-
| version 1.0.19.7
| OR_30_132.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 05/02)
|-
| version 1.0.18.2
| OR_30_125.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 12/01)
|}

----

=== version change trick ===
NB: There is a trick to making version 1.0.26.68. It is done for you in CPRSDir.zip which can be found along with the instructions for creating it at:

http://downloads.opensourcevista.net/VADemo9-26-06

To find out which version to use, look next to the option [[OPTION OR CPRS GUI CHART|named "OR CPRS GUI CHART"]] like this example where CPRS version 1.0.23.15 was needed:

D Q^DI

VA FileMan 22.0
Select OPTION: 5 INQUIRE TO FILE ENTRIES

OUTPUT FROM WHAT FILE: DEVICE// OPTION
1 OPTION (10126 entries)
2 OPTION SCHEDULING (116 entries)
CHOOSE 1-2: 1 OPTION (10126 entries)
Select OPTION NAME: OR CPRS GUI CHART CPRSChart version 1.0.23.15
ANOTHER ONE:

To use a particular version of CPRS, the server-side software code must match. The files are found at ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ and the source code is in the "Programs" subdirectory of this directory

Thus:

[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/ <nowiki>ftp://ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ </nowiki>]

The Delphi source code for each of these (e.g. OR_30_235_SRC.ZIP) will be found in the subdirectory
[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/Programs/ <nowiki>...Packages/Order Entry-Results Reporting - OR/Programs/ </nowiki>]

The wget(1) utility is capable of fetching the files from this server

AceFTP is a freeware FTP program that works, if needed
http://software.visicommedia.com/en/productsfreeware/

''(In the past this FTP site could not be reached with Mozilla/Firefox. That has been corrected.)''
----

=== 1.0.26.69 (and TMG-CPRS) spoof --> 1.0.26.76 ===

Since the changes between 1.0.26.69 and 1.0.26.76 are relatively minor, in this case, version can be used by changing the option in the option file like this:

D P^DI

VA FileMan 22.0

Select OPTION: 1 ENTER OR EDIT FILE ENTRIES

INPUT TO WHAT FILE: OPTION//
EDIT WHICH FIELD: ALL//

Select OPTION NAME: OR CPRS GUI CHART CPRSChart version 1.0.26.76
NAME: OR CPRS GUI CHART//
MENU TEXT: CPRSChart version 1.0.26.76 Replace 76 With 69
Replace
CPRSChart version 1.0.26.69
----
When using TMG-CPRS, another way of reaching the exact same result is to add ''' "SPOOF-VER=1.0.26.76" ''' to the end of the Windows shortcut to CPRS like so:

... S=192.168.xxx.xxx P=92xx CCOW=DISABLE SPOOF-VER=1.0.26.76

(This method has the (admittedly dubious) advantage of allowing ''both'' a CPRS v1.0.26.68 ''and'' a v1.0.26.76 to connect without changing the server side.

'''Caution:''' One needs to know that the two versions truly are compatible or be willing to risk nasty side-effects, perhaps even damage to the server's database.
----
=== SSH Tunnel ===
Communications between CPRS and the VistA server are not encrypted by default. Access/Verify Codes and all patient data are transmitted in the clear. However, these can be protected by setting up an encrypted "tunnel" between client and server.

[[Setting up an SSH Tunnel between CPRS & VistA]]
----
=== Automatic Windows Installer ===

The [http://sourceforge.net/projects/worldvistaautoi/files Astronaut] suite of automatic installers includes cprs, tmg-cprs and many other clients, available in point-click windows .exe installers. IP address and port number are entered by the user.
----
=== Wine/Crossover compatability ===

[[Wine/Crossover]]

CPRS Installation

2011-07-07T00:22:31Z

Anthracite: /* CPRS Versions */

__TOC__

This page records the process of installation of the [[CPRS|Computerized Patient Record System]] Graphical User Interface client program on the [[Microsoft Windows OS]].

=== CPRS Versions ===

This table will list links for the various CPRS versions. (The most current version is at the top)

{| class="grey" border="1" cellpadding="2"
|+ CPRS Versions
|-
! Version Number
! Distribution File
! Availability
! Date
|-
| version 1.0.27.90
| OR-3_SEQ-273_PAT-296.ZIP
| [https://downloads.va.gov/files/FOIA/Software/Patches_By_Application/OR-ORDER%20ENTRY_RESULTS%20REPORTING/ Download folder on VA site]
| 11/2010
|-
| version 1.0.27.77
| OR_30_243.ZIP
| [https://downloads.va.gov/files/FOIA/Software/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/ Download folder on VA site]
| 05/2009
|-
| version 1.0.27.83
| OR_30_304.ZIP
| [https://downloads.va.gov/files/FOIA/Software/Patches_By_Application/CPRS%20GUI%20FILES/CPRS%20VERSION%2027/ Download folder on VA site]
| 09/2008
|-
| version 1.0.26.69
| OR_30_270.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server] or
[https://downloads.va.gov/files/FOIA/Software/VistA_FOIA_Historical_Files/VISTA_FOIA_RELEASES_BEFORE_2008/OR-Order%20Entry-Results%20Reporting/ Download folder on VA site]
|-
| version 1.0.26.69
| for WorldVistA EHR
| on the Sourceforge WorldVistA EHR site and http://opensourcevista.net:8888/NancysVistAServer
| (dated June 2007)

|-
| version 1.0.26.68
| OR_30_258.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| Note Below (NB):(dated July 17, 2006)
|-
| version 1.0.25.42
| OR_30_235.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated July 09, 2005) Note: Replace .25.40 with .25.42 for patient safety
|-
| version 1.0.25.40
| OR_30_231.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated May 06, 2005)
|-
| version 1.0.25.28
| OR_30_195.zip
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Feb 09, 2005)
|-
| version 1.0.24.27
| OR_30_224.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Sep 03, 2004)
|-
| version 1.0.24.26
| OR_30_190.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated Aug 02, 2004)
|-
| version 1.0.23.15
| OR_30_187.ZIP
| *Sourceforge WorldVistA and [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 02/04)
|-
| version 1.0.22.16
| OR_30_206.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 01/04)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 11/02)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
|(dated about 11/02)
|-
| version 1.0.19.7
| OR_30_132.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 05/02)
|-
| version 1.0.18.2
| OR_30_125.ZIP
| [http://opensourcevista.net:8888/NancysVistAServer Nancy's VistA Server]
| (dated about 12/01)
|}

----

=== version change trick ===
NB: There is a trick to making version 1.0.26.68. It is done for you in CPRSDir.zip which can be found along with the instructions for creating it at:

http://downloads.opensourcevista.net/VADemo9-26-06

To find out which version to use, look next to the option [[OPTION OR CPRS GUI CHART|named "OR CPRS GUI CHART"]] like this example where CPRS version 1.0.23.15 was needed:

D Q^DI

VA FileMan 22.0
Select OPTION: 5 INQUIRE TO FILE ENTRIES

OUTPUT FROM WHAT FILE: DEVICE// OPTION
1 OPTION (10126 entries)
2 OPTION SCHEDULING (116 entries)
CHOOSE 1-2: 1 OPTION (10126 entries)
Select OPTION NAME: OR CPRS GUI CHART CPRSChart version 1.0.23.15
ANOTHER ONE:

To use a particular version of CPRS, the server-side software code must match. The files are found at ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ and the source code is in the "Programs" subdirectory of this directory

Thus:

[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/ <nowiki>ftp://ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ </nowiki>]

The Delphi source code for each of these (e.g. OR_30_235_SRC.ZIP) will be found in the subdirectory
[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/Programs/ <nowiki>...Packages/Order Entry-Results Reporting - OR/Programs/ </nowiki>]

The wget(1) utility is capable of fetching the files from this server

AceFTP is a freeware FTP program that works, if needed
http://software.visicommedia.com/en/productsfreeware/

''(In the past this FTP site could not be reached with Mozilla/Firefox. That has been corrected.)''
----

=== 1.0.26.69 (and TMG-CPRS) spoof --> 1.0.26.76 ===

Since the changes between 1.0.26.69 and 1.0.26.76 are relatively minor, in this case, version can be used by changing the option in the option file like this:

D P^DI

VA FileMan 22.0

Select OPTION: 1 ENTER OR EDIT FILE ENTRIES

INPUT TO WHAT FILE: OPTION//
EDIT WHICH FIELD: ALL//

Select OPTION NAME: OR CPRS GUI CHART CPRSChart version 1.0.26.76
NAME: OR CPRS GUI CHART//
MENU TEXT: CPRSChart version 1.0.26.76 Replace 76 With 69
Replace
CPRSChart version 1.0.26.69
----
When using TMG-CPRS, another way of reaching the exact same result is to add ''' "SPOOF-VER=1.0.26.76" ''' to the end of the Windows shortcut to CPRS like so:

... S=192.168.xxx.xxx P=92xx CCOW=DISABLE SPOOF-VER=1.0.26.76

(This method has the (admittedly dubious) advantage of allowing ''both'' a CPRS v1.0.26.68 ''and'' a v1.0.26.76 to connect without changing the server side.

'''Caution:''' One needs to know that the two versions truly are compatible or be willing to risk nasty side-effects, perhaps even damage to the server's database.
----
=== SSH Tunnel ===
Communications between CPRS and the VistA server are not encrypted by default. Access/Verify Codes and all patient data are transmitted in the clear. However, these can be protected by setting up an encrypted "tunnel" between client and server.

[[Setting up an SSH Tunnel between CPRS & VistA]]
----
=== Automatic Windows Installer ===

The [http://sourceforge.net/projects/worldvistaautoi/files Astronaut] suite of automatic installers includes cprs, tmg-cprs and many other clients, available in point-click windows .exe installers. IP address and port number are entered by the user.
----
=== Wine/Crossover compatability ===

[[Wine/Crossover]]

MU Stage1 Final Rule - Record Demographics (EP)

2011-04-29T02:32:41Z

Anthracite:

'''SECTION # '''
Section 170.304(c)—Record Demographics

'''MU OBJECTIVE'''
Record demographics:
• preferred language
• gender
• race
• ethnicity
• date of birth

'''MU STAGE 1 MEASURE'''
More than 50% of all unique patients seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) have demographics recorded as structured data

'''CERTIFICATION CRITERION'''
Final Rule Text: §170.304(c).
Record demographics. Enable a user to electronically record, modify, and retrieve patient demographic data including preferred language, gender, race, ethnicity, and date of birth. Enable race and ethnicity to be recorded in accordance with the standard specified at 170.207(f).

'''STANDARDS'''
170.207(f)
http://www.whitehouse.gov/omb/fedreg_1997standards/

'''TEST CRITERIA #'''
§170.304(c)
http://healthcare.nist.gov/docs/170.304.c_RecordDemographicsAmb_v1.1.pdf
{| class="grey" border="1" cellpadding="2"
! USERS
! CORE / MENU
! SOLUTION DEVELOPERS
! STATUS
|-
| EP
| CORE
| TBD
| TBD
|}
----
'''SOLUTION DESIGN / TECHNOLOGY'''
(Add details here)

'''SOLUTION COMPONENTS'''
(Add details here - Ex. KIDS patch, Delphi code, User guide, Web resources, Manual test script, etc)

'''DEPENDENCIES'''
(Add details here)

'''COMMENTS / NOTES'''

At a minimum, the values in following three sections (Race, Ethnicity, Language) must be supported in some way for certification testing.

Race 
- American Indian or Alaska Native 
- Asian 
- Black or African American 
- Native Hawaiian or Other Pacific Islander 
- White 

(the above race values are mentioned in the NIST test criteria. Peter Bodtke)

Ethnicity: 
- Hispanic or Latino 
- Not Hispanic or Latino 

(the above ethnicity values are mentioned in the NIST test criteria. Peter Bodtke)

Language: 
English 
Japanese 
French 
Italian 
Portuguese 
Russian 

(the above ethnicity values are mentioned in the NIST test criteria. Peter Bodtke)

[Below Nancy Anthracite has noted the inconsistencies between the NIST test criteria demographic values (referenced with a broken link and described as "OMB Standards for Maintaining, Collecting, and Presenting Federal Data") and data provided as part of the Physician Quality Reporting Initiative program.]

Race and ethnicity required for quality reporting has not been harmonized by with the Meaningful use requirements by the Office of the National Coordinator for Health IT. A query regarding this has been sent to the ONC.
In general, there has been general movement in the direction of harmonization but this seems to have escaped scrutiny. However, WV learned in general terms on a PQRI related call that efforts are still underway to harmonize Meaningful Use and PQRI.

For now, what WorldVistA has done is to follow the race and ethnicity standards that are specified by Meaningful Use for PQRI as the same entries are duplicated in the extendsive list for the PQRI reporting. Thus, they will be valid entries for PQRI. The information is stored as a pointer in the Race Information field and in the ethnicity information field in the patient file.

1. VistA does not record preferred language at this point and it will be desirable to pick some sort of reasonable standard list of languages to standardize against across the community of VistA users. Also, to my mind just preferred language is not enough. With requirements for translators to be provided in certain circumstances, it is not enough to know, for instance, if Spanish is the preferred language without knowing if a translator is need and if the patient will provide a translator, so this sounds simple, but it is not so simple.

WV has decided to use the ISO standard http://www.loc.gov/standards/iso639-2/ascii_8bits.html in the language file 0.85. There are also additional enhancements under discussion which may or may not be added by the time of Meaningful Use testing.

Chris Richardson is doing the preliminary work of adding the standard to the file. The work of making it available to select and record as the preferred language of the patient is pending. Thoughts on the subject and help doing it are welcome.

2. Race and Ethnicity was defined by the ONC for Meaningful Use, but so was quality reporting and the race and ethnicity required for quality reporting is daunting. I am happy to see that race has been expanded to stop using just various Hispanic peoples and not much else, but recording 900+ of what I would think is not race and ethnicity but ethnicity one and ethnicity two choices with no guidance how to handle those of mixed "race" seems rather ridiculous but even more disturbing, and invasion of privacy. This has been brought to the attention of the ONC but there has been no response to a query about that. In the meantime, you can see what the requirements for Quality Reporting are in the following two lists of race and ethnicity

Race:
American Indian or Alaska Native, American Indian, Abenaki, Algonquian, Apache, Chiricahua, Fort Sill Apache, Jicarilla Apache, Lipan Apache, Mescalero Apache, Oklahoma Apache, Payson Apache, San Carlos Apache, White Mountain Apache, Arapaho, Northern Arapaho, Southern Arapaho, Wind River Arapaho, Arikara, Assiniboine, Assiniboine Sioux, Fort Peck Assiniboine Sioux, Bannock, Blackfeet, Brotherton, Burt Lake Band, Caddo, Oklahoma Cado, Cahuilla, Agua Caliente Cahuilla, Augustine, Cabazon, Los Coyotes, Morongo, Santa Rosa Cahuilla, Torres-Martinez, California Tribes, Cahto, Chimariko, Coast Miwok, Digger, Kawaiisu, Kern River, Mattole, Red Wood, Santa Rosa, Takelma, Wappo, Yana, Yuki, Canadian and Latin American Indian, Canadian Indian, Central American Indian, French American Indian, Mexican American Indian, South American Indian, Spanish American Indian, Catawba, Cayuse, Chehalis, Chemakuan, Hoh, Quileute, Chemehuevi, Cherokee, Cherokee Alabama, Cherokees of Northeast Alabama, Cherokees of Southeast Alabama, Eastern Cherokee, Echota Cherokee, Etowah Cherokee, Northern Cherokee, Tuscola, United Keetowah Band of Cherokee, Western Cherokee, Cherokee Shawnee, Cheyenne, Northern Cheyenne, Southern Cheyenne, Cheyenne-Arapaho, Chickahominy, Eastern Chickahominy, Western Chickahominy, Chickasaw, Chinook, Clatsop, Columbia River Chinook, Kathlamet, Upper Chinook, Wakiakum Chinook, Willapa Chinook, Wishram, Chippewa, Bad River, Bay Mills Chippewa, Bois Forte, Burt Lake Chippewa, Fond du Lac, Grand Portage, Grand Traverse Band of Ottawa-Chippewa, Keweenaw, Lac Courte Oreilles, Lac du Flambeau, Lac Vieux Desert Chippewa, Lake Superior, Leech Lake, Little Shell Chippewa, Mille Lacs, Minnesota Chippewa, Ontonagon, Red Cliff Chippewa, Red Lake Chippewa, Saginaw Chippewa, St. Croix Chippewa, Sault Ste. Marie Chippewa, Sokoagon Chippewa, Turtle Mountain, White Earth, Chippewa Cree, Rocky Boy's Chippewa Cree, Chitimacha, Choctaw, Clifton Choctaw, Jena Choctaw, Mississippi Choctaw, Mowa Band of Choctaw, Oklahoma Choctaw, Chumash, Santa Ynez, Clear Lake, Coeur D'Alene, Coharie, Colorado River, Colville, Comanche, Oklahoma Comanche, Coos, Lower Umpqua, Siuslaw, Coos, Coquilles, Costanoan, Coushatta, Alabama Coushatta, Cowlitz, Cree, Creek, Alabama Creek, Alabama Quassarte, Eastern Creek, Eastern Muscogee, Kialegee, Lower Muscogee, Machis Lower Creek Indian, Poarch Band, Principal Creek Indian Nation, Star Clan of Muscogee Creeks, Thlopthlocco, Tuckabachee, Croatan, Crow, Cupeno, Agua Caliente, Delaware, Eastern Delaware, Lenni-Lenape, Munsee, Oklahoma Delaware, Rampough Mountain, Sand Hill, Diegueno, Campo, Capitan Grande, Cuyapaipe, La Posta, Manzanita, Mesa Grande, San Pasqual, Santa Ysabel, Sycuan, Eastern Tribes, Attacapa, Biloxi, Georgetown, Moor, Nansemond, Natchez, Nausu Waiwash, Nipmuc, Paugussett, Pocomoke Acohonock, Southeastern Indians, Susquehanock, Tunica Biloxi, Waccamaw-Siousan, Wicomico, Esselen, Fort Belknap, Fort Berthold, Fort Mcdowell, Fort Hall, Gabrieleno, Grand Ronde, Gros Ventres, Atsina, Haliwa, Hidatsa, Hoopa, Trinity, Whilkut, Hoopa Extension, Houma, Inaja-Cosmit, Iowa, Iowa of Kansas-Nebraska, Iowa of Oklahoma, Iroquois, Cayuga, Mohawk, Oneida, Onondaga, Seneca, Seneca Nation, Seneca-Cayuga, Tonawanda Seneca, Tuscarora, Wyandotte, Juaneno, Kalispel, Karuk, Kaw, Kickapoo, Oklahoma Kickapoo, Texas Kickapoo, Kiowa, Oklahoma Kiowa, Klallam, Jamestown, Lower Elwha, Port Gamble Klallam, Klamath, Konkow, Kootenai, Lassik, Long Island, Matinecock, Montauk, Poospatuck, Setauket, Luiseno, La Jolla, Pala, Pauma, Pechanga, Soboba, Twenty-Nine Palms, Temecula, Lumbee, Lummi, Maidu, Mountain Maidu, Nishinam, Makah, Maliseet, Mandan, Mattaponi, Menominee, Miami, Illinois Miami, Indiana Miami, Oklahoma Miami, Miccosukee, Micmac, Aroostook, Mission Indians, Miwok, Modoc, Mohegan, Mono, Nanticoke, Narragansett, Navajo, Alamo Navajo, Canoncito Navajo, Ramah Navajo, Nez Perce, Nomalaki, Northwest Tribes, Alsea, Celilo, Columbia, Kalapuya, Molala, Talakamish, Tenino, Tillamook, Wenatchee, Yahooskin, Omaha, Oregon Athabaskan, Osage, Otoe-Missouria, Ottawa, Burt Lake Ottawa, Michigan Ottawa, Oklahoma Ottawa, Paiute, Bishop, Bridgeport, Burns Paiute, Cedarville, Fort Bidwell, Fort Independence, Kaibab, Las Vegas, Lone Pine, Lovelock, Malheur Paiute, Moapa, Northern Paiute, Owens Valley, Pyramid Lake, San Juan Southern Paiute, Southern Paiute, Summit Lake, Utu Utu Gwaitu Paiute, Walker River, Yerington Paiute, Pamunkey, Passamaquoddy, Indian Township, Pleasant Point Passamaquoddy, Pawnee, Oklahoma Pawnee, Penobscot, Peoria, Oklahoma Peoria, Pequot, Marshantucket Pequot, Pima, Gila River Pima-Maricopa, Salt River Pima-Maricopa, Piscataway, Pit River, Pomo, Central Pomo, Dry Creek, Eastern Pomo, Kashia, Northern Pomo, Scotts Valley, Stonyford, Sulphur Bank, Ponca, Nebraska Ponca, Oklahoma Ponca, Potawatomi, Citizen Band Potawatomi, Forest County, Hannahville, Huron Potawatomi, Pokagon Potawatomi, Prairie Band, Wisconsin Potawatomi, Powhatan, Pueblo, Acoma, Arizona Tewa, Cochiti, Hopi, Isleta, Jemez, Keres, Laguna, Nambe, Picuris, Piro, Pojoaque, San Felipe, San Ildefonso, San Juan Pueblo, San Juan De, San Juan, Sandia, Santa Ana, Santa Clara, Santo Domingo, Taos, Tesuque, Tewa, Tigua, Zia, Zuni, Puget Sound Salish, Duwamish, Kikiallus, Lower Skagit, Muckleshoot, Nisqually, Nooksack, Port Madison, Puyallup, Samish, Sauk-Suiattle, Skokomish, Skykomish, Snohomish, Snoqualmie, Squaxin Island, Steilacoom, Stillaguamish, Suquamish, Swinomish, Tulalip, Upper Skagit, Quapaw, Quinault, Rappahannock, Reno-Sparks, Round Valley, Sac and Fox, Iowa Sac and Fox, Missouri Sac and Fox, Oklahoma Sac and Fox, Salinan, Salish, Salish and Kootenai, Schaghticoke, Scott Valley, Seminole, Big Cypress, Brighton, Florida Seminole, Hollywood Seminole, Oklahoma Seminole, Serrano, San Manual, Shasta, Shawnee, Absentee Shawnee, Eastern Shawnee, Shinnecock, Shoalwater Bay, Shoshone, Battle Mountain, Duckwater, Elko, Ely, Goshute, Panamint, Ruby Valley, Skull Valley, South Fork Shoshone, Te-Moak Western Shoshone, Timbi-Sha Shoshone, Washakie, Wind River Shoshone, Yomba, Shoshone Paiute, Duck Valley, Fallon, Fort McDermitt, Siletz, Sioux, Blackfoot Sioux, Brule Sioux, Cheyenne River Sioux, Crow Creek Sioux, Dakota Sioux, Flandreau Santee, Fort Peck, Lake Traverse Sioux, Lower Brule Sioux, Lower Sioux, Mdewakanton Sioux, Miniconjou, Oglala Sioux, Pine Ridge Sioux, Pipestone Sioux, Prairie Island Sioux, Prior Lake Sioux, Rosebud Sioux, Sans Arc Sioux, Santee Sioux, Sisseton-Wahpeton, Sisseton Sioux, Spirit Lake Sioux, Standing Rock Sioux, Teton Sioux, Two Kettle Sioux, Upper Sioux, Wahpekute Sioux, Wahpeton Sioux, Wazhaza Sioux, Yankton Sioux, Yanktonai Sioux, Siuslaw, Spokane, Stewart, Stockbridge, Susanville, Tohono O'Odham, Ak-Chin, Gila Bend, San Xavier, Sells, Tolowa, Tonkawa, Tygh, Umatilla, Umpqua, Cow Creek Umpqua, Ute, Allen Canyon, Uintah Ute, Ute Mountain Ute, Wailaki, Walla-Walla, Wampanoag, Gay Head Wampanoag, Mashpee Wampanoag, Warm Springs, Wascopum, Washoe, Alpine, Carson, Dresslerville, Wichita, Wind River, Winnebago, Ho-chunk, Nebraska Winnebago, Winnemucca, Wintun, Wiyot, Table Bluff, Yakama, Yakama Cowlitz, Yaqui, Barrio Libre, Pascua Yaqui, Yavapai Apache, Yokuts, Chukchansi, Tachi, Tule River, Yuchi, Yuman, Cocopah, Havasupai, Hualapai, Maricopa, Mohave, Quechan, Yavapai, Yurok, Coast Yurok, Alaska Native, Alaska Indian, Alaskan Athabascan, Ahtna, Alatna, Alexander, Allakaket, Alanvik, Anvik, Arctic, Beaver, Birch Creek, Cantwell, Chalkyitsik, Chickaloon, Chistochina, Chitina, Circle, Cook Inlet, Copper Center, Copper River, Dot Lake, Doyon, Eagle, Eklutna, Evansville, Fort Yukon, Gakona, Galena, Grayling, Gulkana, Healy Lake, Holy Cross, Hughes, Huslia, Iliamna, Kaltag, Kluti Kaah, Knik, Koyukuk, Lake Minchumina, Lime, Mcgrath, Manley Hot Springs, Mentasta Lake, Minto, Nenana, Nikolai, Ninilchik, Nondalton, Northway, Nulato, Pedro Bay, Rampart, Ruby, Salamatof, Seldovia, Slana, Shageluk, Stevens, Stony River, Takotna, Tanacross, Tanaina, Tanana, Tanana Chiefs, Tazlina, Telida, Tetlin, Tok, Tyonek, Venetie, Wiseman, Southeast Alaska, Tlingit-Haida, Angoon, Central Council of Tlingit and Haida Tribes, Chilkat, Chilkoot, Craig, Douglas, Haida, Hoonah, Hydaburg, Kake, Kasaan, Kenaitze, Ketchikan, Klawock, Pelican, Petersburg, Saxman, Sitka, Tenakee Springs, Tlingit, Wrangell, Yakutat, Tsimshian, Metlakatla, Eskimo, Greenland Eskimo, Inupiat Eskimo, Ambler, Anaktuvuk, Anaktuvuk Pass, Arctic Slope Inupiat, Arctic Slope Corporation, Atqasuk, Barrow, Bering Straits Inupiat, Brevig Mission, Buckland, Chinik, Council, Deering, Elim, Golovin, Inalik Diomede, Inupiaq, Kaktovik, Kawerak, Kiana, Kivalina, Kobuk, Kotzebue, Koyuk, Kwiguk, Mauneluk Inupiat, Nana Inupiat, Noatak, Nome, Noorvik, Nuiqsut, Point Hope, Point Lay, Selawik, Shaktoolik, Shishmaref, Shungnak, Solomon, Teller, Unalakleet, Wainwright, Wales, White Mountain, White Mountain Inupiat, Mary's Igloo, Siberian Eskimo, Gambell, Savoonga, Siberian Yupik, Yupik Eskimo, Akiachak, Akiak, Alakanuk, Aleknagik, Andreafsky, Aniak, Atmautluak, Bethel, Bill Moore's Slough, Bristol Bay Yupik, Calista Yupik, Chefornak, Chevak, Chuathbaluk, Clark's Point, Crooked Creek, Dillingham, Eek, Ekuk, Ekwok, Emmonak, Goodnews Bay, Hooper Bay, Iqurmuit (Russian Mission), Kalskag, Kasigluk, Kipnuk, Koliganek, Kongiganak, Kotlik, Kwethluk, Kwigillingok, Levelock, Lower Kalskag, Manokotak, Marshall, Mekoryuk, Mountain Village, Naknek, Napaumute, Napakiak, Napaskiak, Newhalen, New Stuyahok, Newtok, Nightmute, Nunapitchukv, Oscarville, Pilot Station, Pitkas Point, Platinum, Portage Creek, Quinhagak, Red Devil, St. Michael, Scammon Bay, Sheldon's Point, Sleetmute, Stebbins, Togiak, Toksook, Tulukskak, Tuntutuliak, Tununak, Twin Hills, Georgetown, St. Mary's, Umkumiate, Aleut, Alutiiq Aleut, Tatitlek, Ugashik, Bristol Bay Aleut, Chignik, Chignik Lake, Egegik, Igiugig, Ivanof Bay, King Salmon, Kokhanok, Perryville, Pilot Point, Port Heiden, Chugach Aleut, Chenega, Chugach Corporation, English Bay, Port Graham, Eyak, Koniag Aleut, Akhiok, Agdaagux, Karluk, Kodiak, Larsen Bay, Old Harbor, Ouzinkie, Port Lions, Sugpiaq, Suqpigaq, Unangan Aleut, Akutan, Aleut Corporation, Aleutian, Aleutian Islander, Atka, Belkofski, Chignik Lagoon, King Cove, False Pass, Nelson Lagoon, Nikolski, Pauloff Harbor, Qagan Toyagungin, Qawalangin, St. George, St. Paul, Sand Point, South Naknek, Unalaska, Unga, Asian, Asian Indian, Bangladeshi, Bhutanese, Burmese, Cambodian, Chinese, Taiwanese, Filipino, Hmong, Indonesian, Japanese, Korean, Laotian, Malaysian, Okinawan, Pakistani, Sri Lankan, Thai, Vietnamese, Iwo Jiman, Maldivian, Nepalese, Singaporean, Madagascar, Black or African American, Black, African American, African, Botswanan, Ethiopian, Liberian, Namibian, Nigerian, Zairean, Bahamian, Barbadian, Dominican, Dominica Islander, Haitian, Jamaican, Tobagoan, Trinidadian, West Indian, Native Hawaiian or Other Pacific Islander, Polynesian, Native Hawaiian, Samoan, Tahitian, Tongan, Tokelauan, Micronesian, Guamanian or Chamorro, Guamanian, Chamorro, Mariana Islander, Marshallese, Palauan, Carolinian, Kosraean, Pohnpeian, Saipanese, Kiribati, Chuukese, Yapese, Melanesian, Fijian, Papua New Guinean, Solomon Islander, New Hebrides, White, European, Armenian, English, French, German, Irish, Italian, Polish, Scottish, Middle Eastern or North African, Assyrian, Egyptian, Iranian, Iraqi, Lebanese, Palestinian, Syrian, Afghanistani, Israeili, Arab, Other Race, Other Pacific Islander

Ethnicity:

Hispanic or Latino, Spaniard, Andalusian, Asturian, Castillian, Catalonian, Belearic Islander, Gallego, Valencian, Canarian, Spanish Basque, Mexican, Mexican American, Mexicano, Chicano, La Raza, Mexican American Indian, Central American, Costa Rican, Guatemalan, Honduran, Nicaraguan, Panamanian, Salvadoran, Central American Indian, Canal Zone, South American, Argentinean, Bolivian, Chilean, Colombian, Ecuadorian, Paraguayan, Peruvian, Uruguayan, Venezuelan, South American Indian, Criollo, Latin American, Puerto Rican, Cuban, Dominican, Not Hispanic or Latino

'''PREVIOUS NOTES'''
(none)

'''DEVELOPMENT STATUS'''
(Add details here)

'''ACTION ITEMS / NEXT STEPS'''

'''OPEN ISSUES / QUESTIONS'''
(Add details here)

CPRS Installation

2011-02-07T20:58:31Z

Anthracite: /* CPRS Versions */

__TOC__

This page records the process of installation of the [[CPRS|Computerized Patient Record System]] Graphical User Interface client program on the [[Microsoft Windows OS]].

=== CPRS Versions ===

This table will list links for the various CPRS versions. (The most current version is at the top)

{| class="grey" border="1" cellpadding="2"
|+ CPRS Versions
|-
! Version Number
! Distribution File
! Availability
! Date
|-
| version 1.0.27.90
| OR-3_SEQ-273_PAT-296.ZIP
| http://downloads.va.gov/FOIA/Software/Patches_By_Application/OR-ORDER ENTRY_RESULTS REPORTING/
| 11/2010
|-
| version 1.0.27.83
| OR_30_243.ZIP
| http://downloads.va.gov//FOIA/Software/Patches_By_Application/CPRS GUI FILES/CPRS VERSION 27
| 05/2009
|-
| version 1.0.27.77
| OR_30_304.ZIP
| http://downloads.va.gov//FOIA/Software/Patches_By_Application/CPRS GUI FILES/CPRS VERSION 27
| 09/2008
|-
| version 1.0.26.69
| OR_30_270.zip
| on http://opensourcevista.net:8888/NancysVistAServer and on ftp://ftp.va.gov/vista/Software/VISTA_FOIA_RELEASES_BEFORE_2008/
|-
| version 1.0.26.69
| for WorldVistA EHR
| on the Sourceforge WorldVistA EHR site and http://opensourcevista.net:8888/NancysVistAServer
| (dated June 2007)

|-
| version 1.0.26.68
| OR_30_258.zip
| http://opensourcevista.net:8888/NancysVistAServer
| Note Below (NB):(dated July 17, 2006)
|-
| version 1.0.25.42
| OR_30_235.zip
| http://opensourcevista.net:8888/NancysVistAServer
| (dated July 09, 2005) Note: Replace .25.40 with .25.42 for patient safety
|-
| version 1.0.25.40
| OR_30_231.zip
| http://opensourcevista.net:8888/NancysVistAServer
| (dated May 06, 2005)
|-
| version 1.0.25.28
| OR_30_195.zip
| http://opensourcevista.net:8888/NancysVistAServer
| (dated Feb 09, 2005)
|-
| version 1.0.24.27
| OR_30_224.ZIP
| http://opensourcevista.net:8888/NancysVistAServer
| (dated Sep 03, 2004)
|-
| version 1.0.24.26
| OR_30_190.ZIP
| http://opensourcevista.net:8888/NancysVistAServer
| (dated Aug 02, 2004)
|-
| version 1.0.23.15
| OR_30_187.ZIP
| *Sourceforge WorldVistA and http://opensourcevista.net:8888/NancysVistAServer
| (dated about 02/04)
|-
| version 1.0.22.16
| OR_30_206.ZIP
| http://opensourcevista.net:8888/NancysVistAServer
| (dated about 01/04)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| http://opensourcevista.net:8888/NancysVistAServer
| (dated about 11/02)
|-
| version 1.0.20.21
| OR_30_148.ZIP
| http://opensourcevista.net:8888/NancysVistAServer
|(dated about 11/02)
|-
| version 1.0.19.7
| OR_30_132.ZIP
| http://opensourcevista.net:8888/NancysVistAServer
| (dated about 05/02)
|-
| version 1.0.18.2
| OR_30_125.ZIP
| http://opensourcevista.net:8888/NancysVistAServer
| (dated about 12/01)
|}

----

=== version change trick ===
NB: There is a trick to making version 1.0.26.68. It is done for you in CPRSDir.zip which can be found along with the instructions for creating it at:

http://downloads.opensourcevista.net/VADemo9-26-06

To find out which version to use, look next to the option [[OPTION OR CPRS GUI CHART|named "OR CPRS GUI CHART"]] like this example where CPRS version 1.0.23.15 was needed:

D Q^DI

VA FileMan 22.0
Select OPTION: 5 INQUIRE TO FILE ENTRIES

OUTPUT FROM WHAT FILE: DEVICE// OPTION
1 OPTION (10126 entries)
2 OPTION SCHEDULING (116 entries)
CHOOSE 1-2: 1 OPTION (10126 entries)
Select OPTION NAME: OR CPRS GUI CHART CPRSChart version 1.0.23.15
ANOTHER ONE:

To use a particular version of CPRS, the server-side software code must match. The files are found at ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ and the source code is in the "Programs" subdirectory of this directory

Thus:

[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/ <nowiki>ftp://ftp.va.gov/vista/Software/Packages/Order Entry-Results Reporting - OR/ </nowiki>]

The Delphi source code for each of these (e.g. OR_30_235_SRC.ZIP) will be found in the subdirectory
[ftp://ftp.va.gov/vista/Software/Packages/Order%20Entry-Results%20Reporting%20-%20OR/Programs/ <nowiki>...Packages/Order Entry-Results Reporting - OR/Programs/ </nowiki>]

The wget(1) utility is capable of fetching the files from this server

AceFTP is a freeware FTP program that works, if needed
http://software.visicommedia.com/en/productsfreeware/

''(In the past this FTP site could not be reached with Mozilla/Firefox. That has been corrected.)''
----

=== 1.0.26.69 (and TMG-CPRS) spoof --> 1.0.26.76 ===

Since the changes between 1.0.26.69 and 1.0.26.76 are relatively minor, in this case, version can be used by changing the option in the option file like this:

D P^DI

VA FileMan 22.0

Select OPTION: 1 ENTER OR EDIT FILE ENTRIES

INPUT TO WHAT FILE: OPTION//
EDIT WHICH FIELD: ALL//

Select OPTION NAME: OR CPRS GUI CHART CPRSChart version 1.0.26.76
NAME: OR CPRS GUI CHART//
MENU TEXT: CPRSChart version 1.0.26.76 Replace 76 With 69
Replace
CPRSChart version 1.0.26.69
----
When using TMG-CPRS, another way of reaching the exact same result is to add ''' "SPOOF-VER=1.0.26.76" ''' to the end of the Windows shortcut to CPRS like so:

... S=192.168.xxx.xxx P=92xx CCOW=DISABLE SPOOF-VER=1.0.26.76

(This method has the (admittedly dubious) advantage of allowing ''both'' a CPRS v1.0.26.68 ''and'' a v1.0.26.76 to connect without changing the server side.

'''Caution:''' One needs to know that the two versions truly are compatible or be willing to risk nasty side-effects, perhaps even damage to the server's database.
----
=== SSH Tunnel ===
Communications between CPRS and the VistA server are not encrypted by default. Access/Verify Codes and all patient data are transmitted in the clear. However, these can be protected by setting up an encrypted "tunnel" between client and server.

[[Setting up an SSH Tunnel between CPRS & VistA]]
----
=== Automatic Windows Installer ===

The [http://sourceforge.net/projects/worldvistaautoi/files Astronaut] suite of automatic installers includes cprs, tmg-cprs and many other clients, available in point-click windows .exe installers. IP address and port number are entered by the user.
----
=== Wine/Crossover compatability ===

[[Wine/Crossover]]

MU Stage1 Final Rule - Incorporate Laboratory Test Results

2011-01-19T14:17:40Z

Anthracite:

'''SECTION # '''
Section 170.302(g)—Incorporate Laboratory Test Results

'''MU OBJECTIVE'''
Incorporate clinical lab-test results into certified EHR technology as structured data.

'''MU STAGE 1 MEASURE'''
More than 40% of all clinical lab tests results ordered by the EP or by an authorized provider of the eligible hospital or CAH for patients admitted to its inpatient or emergency department (POS 21 or 23) during the EHR reporting period whose results are

'''CERTIFICATION CRITERION'''
Interim Final Rule Text:
(1) Receive results. Electronically receive clinical laboratory test results in a structured format and display such results in human readable format.
(2) Display codes in readable format. Electronically display in human readable format any clinical laboratory tests that have been received with LOINC® codes.
(3) Display test report information. Electronically display all the information for a test report specified at 42 CFR 493.1291(c)(1) through (7).
(4) Update. Enable a user to electronically update a patient’s record based upon received laboratory test results.
Final Rule Text: §170.302(h).
(1) Unchanged.
(2) Display test report information. Electronically display all the information for a test report specified at 42 CFR 493.1291(c)(1) through (7).
(3) Incorporate results. Electronically attribute, associate, or link a laboratory test result to a laboratory order or patient record.

'''STANDARDS'''
42 CFR 493.1291(c)(1) through (7)
http//:edocket.access.gpo.gov/cfr_2006/octqtr/pdf/42cfr493.1291.pdf

'''TEST CRITERIA #'''
§170.302(h)
http://healthcare.nist.gov/docs/170.302.h_IncorpLabTest_v1.1.pdf
{| class="grey" border="1" cellpadding="2"
! USERS
! CORE / MENU
! SOLUTION DEVELOPERS
! STATUS
|-
| All
| MENU
| TBD
| TBD
|}
----
'''SOLUTION DESIGN / TECHNOLOGY'''
(Add details here)

'''SOLUTION COMPONENTS'''
(Add details here - Ex. KIDS patch, Delphi code, User guide, Web resources, Manual test script, etc)

'''DEPENDENCIES'''
(Add details here)

'''COMMENTS / NOTES'''
(Add details here)

'''PREVIOUS NOTES'''

VistA does store data in a structured format and can receive data but only if it was ordered properly in the first place and the order sent to the lab. The problem of receiving data that was not previously ordered and documented in the standard way used for sending samples to a referral laboratory needs to be tackled and will be as part of the VistA Lab Project (now on hiatus) that meets on Monday nights.

Also, the data received will need to be associated with tests within VistA in order to be pulled and graphed properly. This also has to deal with receiving data from multiple labs.

Fortunately the NIST Test Scripts do not require that tests that were not ordered be incorporated into VistA so that LEDI can be used to enter the results.

'''DEVELOPMENT STATUS'''
(Add details here)

'''ACTION ITEMS / NEXT STEPS'''
(Add details here)

'''OPEN ISSUES / QUESTIONS'''
(Add details here)

MU Stage1 Final Rule - Automatic Log-Off

2011-01-16T22:53:58Z

Anthracite:

'''SECTION # '''
Section 170.302(q)—Automatic Log-Off

'''MU OBJECTIVE'''
Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.

'''MU STAGE 1 MEASURE'''
Conduct or review a security risk analysis per 45 CFR 164.308 (a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process.

'''CERTIFICATION CRITERION'''
Interim Final Rule Text:
Automatic log-off. Terminate an electronic session after a predetermined time of inactivity.
Final Rule Text: §170.302(q).
Unchanged.

'''STANDARDS'''
45 CFR 164.308
http://edocket.access.gpo.gov/cfr_2003/octqtr/pdf/45cfr164.308.pdf

'''TEST CRITERIA #'''
§170.302(q)
http://healthcare.nist.gov/docs/170.302.q_AutomaticLogOff_v1.1.pdf
{| class="grey" border="1" cellpadding="2"
! USERS
! CORE / MENU
! SOLUTION DEVELOPERS
! STATUS
|-
| All
| CORE
| TBD
| TBD
|}
----
'''SOLUTION DESIGN / TECHNOLOGY'''
(Add details here)

'''SOLUTION COMPONENTS'''
http://opensourcevista.net:8888/NancysVistAServer/UserTimeoutsVistA.odt

'''DEPENDENCIES'''
(Add details here)

'''COMMENTS / NOTES'''
(Add details here)

'''PREVIOUS NOTES'''
(none)

'''DEVELOPMENT STATUS'''None needed. Only documentation of the steps to configure it and demonstrate it are necessary.

'''ACTION ITEMS / NEXT STEPS'''
(Add details here)

'''OPEN ISSUES / QUESTIONS'''
(Add details here)

MU Stage1 Final Rule - Record Demographics (EP)

2010-12-23T15:31:35Z

Anthracite:

'''SECTION # '''
Section 170.304(c)—Record Demographics

'''MU OBJECTIVE'''
Record demographics:
• preferred language
• gender
• race
• ethnicity
• date of birth

'''MU STAGE 1 MEASURE'''
More than 50% of all unique patients seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) have demographics recorded as structured data

'''CERTIFICATION CRITERION'''
Final Rule Text: §170.304(c).
Record demographics. Enable a user to electronically record, modify, and retrieve patient demographic data including preferred language, gender, race, ethnicity, and date of birth. Enable race and ethnicity to be recorded in accordance with the standard specified at 170.207(f).

'''STANDARDS'''
170.207(f)
http://www.whitehouse.gov/omb/fedreg_1997standards/

'''TEST CRITERIA #'''
§170.304(c)
http://healthcare.nist.gov/docs/170.304.c_RecordDemographicsAmb_v1.1.pdf
{| class="grey" border="1" cellpadding="2"
! USERS
! CORE / MENU
! SOLUTION DEVELOPERS
! STATUS
|-
| EP
| CORE
| TBD
| TBD
|}
----
'''SOLUTION DESIGN / TECHNOLOGY'''
(Add details here)

'''SOLUTION COMPONENTS'''
(Add details here - Ex. KIDS patch, Delphi code, User guide, Web resources, Manual test script, etc)

'''DEPENDENCIES'''
(Add details here)

'''COMMENTS / NOTES'''

At a minimum, the values in following three sections (Race, Ethnicity, Language) must be supported in some way for certification testing.

Race 
- American Indian or Alaska Native 
- Asian 
- Black or African American 
- Native Hawaiian or Other Pacific Islander 
- White 

(the above race values are mentioned in the NIST test criteria. Peter Bodtke)

Ethnicity: 
- Hispanic or Latino 
- Not Hispanic or Latino 

(the above ethnicity values are mentioned in the NIST test criteria. Peter Bodtke)

Language: 
English 
Japanese 
French 
Italian 
Portuguese 
Russian 

(the above ethnicity values are mentioned in the NIST test criteria. Peter Bodtke)

[Below Nancy Anthracite has noted the inconsistencies between the NIST test criteria demographic values (referenced with a broken link and described as "OMB Standards for Maintaining, Collecting, and Presenting Federal Data") and data provided as part of the Physician Quality Reporting Initiative program.]

Race and ethnicity required for quality reporting has not been harmonized by with the Meaningful use requirements by the Office of the National Coordinator for Health IT. A query regarding this has been sent to the ONC.
In general, there has been general movement in the direction of harmonization but this seems to have escaped scrutiny. However, WV learned in general terms on a PQRI related call that efforts are still underway to harmonize Meaningful Use and PQRI.

For now, what WorldVistA has done is to follow the race and ethnicity standards that are specified by Meaningful Use for PQRI as the same entries are duplicaed in the extendsive list for the PQRI reporting. Thus, they will be valid entries for PQRI.

1. VistA does not record preferred language at this point and it will be desirable to pick some sort of reasonable standard list of languages to standardize against across the community of VistA users. Also, to my mind just preferred language is not enough. With requirements for translators to be provided in certain circumstances, it is not enough to know, for instance, if Spanish is the preferred language without knowing if a translator is need and if the patient will provide a translator, so this sounds simple, but it is not so simple.

WV has decided to use the ISO standard http://www.loc.gov/standards/iso639-2/ascii_8bits.html in the language file 0.85. There are also additional enhancements under discussion which may or may not be added by the time of Meaningful Use testing.

Chris Richardson is doing the preliminary work of adding the standard to the file. The work of making it available to select and record as the preferred language of the patient is pending. Thoughts on the subject and help doing it are welcome.

2. Race and Ethnicity was defined by the ONC for Meaningful Use, but so was quality reporting and the race and ethnicity required for quality reporting is daunting. I am happy to see that race has been expanded to stop using just various Hispanic peoples and not much else, but recording 900+ of what I would think is not race and ethnicity but ethnicity one and ethnicity two choices with no guidance how to handle those of mixed "race" seems rather ridiculous but even more disturbing, and invasion of privacy. This has been brought to the attention of the ONC but there has been no response to a query about that. In the meantime, you can see what the requirements for Quality Reporting are in the following two lists of race and ethnicity

Race:
American Indian or Alaska Native, American Indian, Abenaki, Algonquian, Apache, Chiricahua, Fort Sill Apache, Jicarilla Apache, Lipan Apache, Mescalero Apache, Oklahoma Apache, Payson Apache, San Carlos Apache, White Mountain Apache, Arapaho, Northern Arapaho, Southern Arapaho, Wind River Arapaho, Arikara, Assiniboine, Assiniboine Sioux, Fort Peck Assiniboine Sioux, Bannock, Blackfeet, Brotherton, Burt Lake Band, Caddo, Oklahoma Cado, Cahuilla, Agua Caliente Cahuilla, Augustine, Cabazon, Los Coyotes, Morongo, Santa Rosa Cahuilla, Torres-Martinez, California Tribes, Cahto, Chimariko, Coast Miwok, Digger, Kawaiisu, Kern River, Mattole, Red Wood, Santa Rosa, Takelma, Wappo, Yana, Yuki, Canadian and Latin American Indian, Canadian Indian, Central American Indian, French American Indian, Mexican American Indian, South American Indian, Spanish American Indian, Catawba, Cayuse, Chehalis, Chemakuan, Hoh, Quileute, Chemehuevi, Cherokee, Cherokee Alabama, Cherokees of Northeast Alabama, Cherokees of Southeast Alabama, Eastern Cherokee, Echota Cherokee, Etowah Cherokee, Northern Cherokee, Tuscola, United Keetowah Band of Cherokee, Western Cherokee, Cherokee Shawnee, Cheyenne, Northern Cheyenne, Southern Cheyenne, Cheyenne-Arapaho, Chickahominy, Eastern Chickahominy, Western Chickahominy, Chickasaw, Chinook, Clatsop, Columbia River Chinook, Kathlamet, Upper Chinook, Wakiakum Chinook, Willapa Chinook, Wishram, Chippewa, Bad River, Bay Mills Chippewa, Bois Forte, Burt Lake Chippewa, Fond du Lac, Grand Portage, Grand Traverse Band of Ottawa-Chippewa, Keweenaw, Lac Courte Oreilles, Lac du Flambeau, Lac Vieux Desert Chippewa, Lake Superior, Leech Lake, Little Shell Chippewa, Mille Lacs, Minnesota Chippewa, Ontonagon, Red Cliff Chippewa, Red Lake Chippewa, Saginaw Chippewa, St. Croix Chippewa, Sault Ste. Marie Chippewa, Sokoagon Chippewa, Turtle Mountain, White Earth, Chippewa Cree, Rocky Boy's Chippewa Cree, Chitimacha, Choctaw, Clifton Choctaw, Jena Choctaw, Mississippi Choctaw, Mowa Band of Choctaw, Oklahoma Choctaw, Chumash, Santa Ynez, Clear Lake, Coeur D'Alene, Coharie, Colorado River, Colville, Comanche, Oklahoma Comanche, Coos, Lower Umpqua, Siuslaw, Coos, Coquilles, Costanoan, Coushatta, Alabama Coushatta, Cowlitz, Cree, Creek, Alabama Creek, Alabama Quassarte, Eastern Creek, Eastern Muscogee, Kialegee, Lower Muscogee, Machis Lower Creek Indian, Poarch Band, Principal Creek Indian Nation, Star Clan of Muscogee Creeks, Thlopthlocco, Tuckabachee, Croatan, Crow, Cupeno, Agua Caliente, Delaware, Eastern Delaware, Lenni-Lenape, Munsee, Oklahoma Delaware, Rampough Mountain, Sand Hill, Diegueno, Campo, Capitan Grande, Cuyapaipe, La Posta, Manzanita, Mesa Grande, San Pasqual, Santa Ysabel, Sycuan, Eastern Tribes, Attacapa, Biloxi, Georgetown, Moor, Nansemond, Natchez, Nausu Waiwash, Nipmuc, Paugussett, Pocomoke Acohonock, Southeastern Indians, Susquehanock, Tunica Biloxi, Waccamaw-Siousan, Wicomico, Esselen, Fort Belknap, Fort Berthold, Fort Mcdowell, Fort Hall, Gabrieleno, Grand Ronde, Gros Ventres, Atsina, Haliwa, Hidatsa, Hoopa, Trinity, Whilkut, Hoopa Extension, Houma, Inaja-Cosmit, Iowa, Iowa of Kansas-Nebraska, Iowa of Oklahoma, Iroquois, Cayuga, Mohawk, Oneida, Onondaga, Seneca, Seneca Nation, Seneca-Cayuga, Tonawanda Seneca, Tuscarora, Wyandotte, Juaneno, Kalispel, Karuk, Kaw, Kickapoo, Oklahoma Kickapoo, Texas Kickapoo, Kiowa, Oklahoma Kiowa, Klallam, Jamestown, Lower Elwha, Port Gamble Klallam, Klamath, Konkow, Kootenai, Lassik, Long Island, Matinecock, Montauk, Poospatuck, Setauket, Luiseno, La Jolla, Pala, Pauma, Pechanga, Soboba, Twenty-Nine Palms, Temecula, Lumbee, Lummi, Maidu, Mountain Maidu, Nishinam, Makah, Maliseet, Mandan, Mattaponi, Menominee, Miami, Illinois Miami, Indiana Miami, Oklahoma Miami, Miccosukee, Micmac, Aroostook, Mission Indians, Miwok, Modoc, Mohegan, Mono, Nanticoke, Narragansett, Navajo, Alamo Navajo, Canoncito Navajo, Ramah Navajo, Nez Perce, Nomalaki, Northwest Tribes, Alsea, Celilo, Columbia, Kalapuya, Molala, Talakamish, Tenino, Tillamook, Wenatchee, Yahooskin, Omaha, Oregon Athabaskan, Osage, Otoe-Missouria, Ottawa, Burt Lake Ottawa, Michigan Ottawa, Oklahoma Ottawa, Paiute, Bishop, Bridgeport, Burns Paiute, Cedarville, Fort Bidwell, Fort Independence, Kaibab, Las Vegas, Lone Pine, Lovelock, Malheur Paiute, Moapa, Northern Paiute, Owens Valley, Pyramid Lake, San Juan Southern Paiute, Southern Paiute, Summit Lake, Utu Utu Gwaitu Paiute, Walker River, Yerington Paiute, Pamunkey, Passamaquoddy, Indian Township, Pleasant Point Passamaquoddy, Pawnee, Oklahoma Pawnee, Penobscot, Peoria, Oklahoma Peoria, Pequot, Marshantucket Pequot, Pima, Gila River Pima-Maricopa, Salt River Pima-Maricopa, Piscataway, Pit River, Pomo, Central Pomo, Dry Creek, Eastern Pomo, Kashia, Northern Pomo, Scotts Valley, Stonyford, Sulphur Bank, Ponca, Nebraska Ponca, Oklahoma Ponca, Potawatomi, Citizen Band Potawatomi, Forest County, Hannahville, Huron Potawatomi, Pokagon Potawatomi, Prairie Band, Wisconsin Potawatomi, Powhatan, Pueblo, Acoma, Arizona Tewa, Cochiti, Hopi, Isleta, Jemez, Keres, Laguna, Nambe, Picuris, Piro, Pojoaque, San Felipe, San Ildefonso, San Juan Pueblo, San Juan De, San Juan, Sandia, Santa Ana, Santa Clara, Santo Domingo, Taos, Tesuque, Tewa, Tigua, Zia, Zuni, Puget Sound Salish, Duwamish, Kikiallus, Lower Skagit, Muckleshoot, Nisqually, Nooksack, Port Madison, Puyallup, Samish, Sauk-Suiattle, Skokomish, Skykomish, Snohomish, Snoqualmie, Squaxin Island, Steilacoom, Stillaguamish, Suquamish, Swinomish, Tulalip, Upper Skagit, Quapaw, Quinault, Rappahannock, Reno-Sparks, Round Valley, Sac and Fox, Iowa Sac and Fox, Missouri Sac and Fox, Oklahoma Sac and Fox, Salinan, Salish, Salish and Kootenai, Schaghticoke, Scott Valley, Seminole, Big Cypress, Brighton, Florida Seminole, Hollywood Seminole, Oklahoma Seminole, Serrano, San Manual, Shasta, Shawnee, Absentee Shawnee, Eastern Shawnee, Shinnecock, Shoalwater Bay, Shoshone, Battle Mountain, Duckwater, Elko, Ely, Goshute, Panamint, Ruby Valley, Skull Valley, South Fork Shoshone, Te-Moak Western Shoshone, Timbi-Sha Shoshone, Washakie, Wind River Shoshone, Yomba, Shoshone Paiute, Duck Valley, Fallon, Fort McDermitt, Siletz, Sioux, Blackfoot Sioux, Brule Sioux, Cheyenne River Sioux, Crow Creek Sioux, Dakota Sioux, Flandreau Santee, Fort Peck, Lake Traverse Sioux, Lower Brule Sioux, Lower Sioux, Mdewakanton Sioux, Miniconjou, Oglala Sioux, Pine Ridge Sioux, Pipestone Sioux, Prairie Island Sioux, Prior Lake Sioux, Rosebud Sioux, Sans Arc Sioux, Santee Sioux, Sisseton-Wahpeton, Sisseton Sioux, Spirit Lake Sioux, Standing Rock Sioux, Teton Sioux, Two Kettle Sioux, Upper Sioux, Wahpekute Sioux, Wahpeton Sioux, Wazhaza Sioux, Yankton Sioux, Yanktonai Sioux, Siuslaw, Spokane, Stewart, Stockbridge, Susanville, Tohono O'Odham, Ak-Chin, Gila Bend, San Xavier, Sells, Tolowa, Tonkawa, Tygh, Umatilla, Umpqua, Cow Creek Umpqua, Ute, Allen Canyon, Uintah Ute, Ute Mountain Ute, Wailaki, Walla-Walla, Wampanoag, Gay Head Wampanoag, Mashpee Wampanoag, Warm Springs, Wascopum, Washoe, Alpine, Carson, Dresslerville, Wichita, Wind River, Winnebago, Ho-chunk, Nebraska Winnebago, Winnemucca, Wintun, Wiyot, Table Bluff, Yakama, Yakama Cowlitz, Yaqui, Barrio Libre, Pascua Yaqui, Yavapai Apache, Yokuts, Chukchansi, Tachi, Tule River, Yuchi, Yuman, Cocopah, Havasupai, Hualapai, Maricopa, Mohave, Quechan, Yavapai, Yurok, Coast Yurok, Alaska Native, Alaska Indian, Alaskan Athabascan, Ahtna, Alatna, Alexander, Allakaket, Alanvik, Anvik, Arctic, Beaver, Birch Creek, Cantwell, Chalkyitsik, Chickaloon, Chistochina, Chitina, Circle, Cook Inlet, Copper Center, Copper River, Dot Lake, Doyon, Eagle, Eklutna, Evansville, Fort Yukon, Gakona, Galena, Grayling, Gulkana, Healy Lake, Holy Cross, Hughes, Huslia, Iliamna, Kaltag, Kluti Kaah, Knik, Koyukuk, Lake Minchumina, Lime, Mcgrath, Manley Hot Springs, Mentasta Lake, Minto, Nenana, Nikolai, Ninilchik, Nondalton, Northway, Nulato, Pedro Bay, Rampart, Ruby, Salamatof, Seldovia, Slana, Shageluk, Stevens, Stony River, Takotna, Tanacross, Tanaina, Tanana, Tanana Chiefs, Tazlina, Telida, Tetlin, Tok, Tyonek, Venetie, Wiseman, Southeast Alaska, Tlingit-Haida, Angoon, Central Council of Tlingit and Haida Tribes, Chilkat, Chilkoot, Craig, Douglas, Haida, Hoonah, Hydaburg, Kake, Kasaan, Kenaitze, Ketchikan, Klawock, Pelican, Petersburg, Saxman, Sitka, Tenakee Springs, Tlingit, Wrangell, Yakutat, Tsimshian, Metlakatla, Eskimo, Greenland Eskimo, Inupiat Eskimo, Ambler, Anaktuvuk, Anaktuvuk Pass, Arctic Slope Inupiat, Arctic Slope Corporation, Atqasuk, Barrow, Bering Straits Inupiat, Brevig Mission, Buckland, Chinik, Council, Deering, Elim, Golovin, Inalik Diomede, Inupiaq, Kaktovik, Kawerak, Kiana, Kivalina, Kobuk, Kotzebue, Koyuk, Kwiguk, Mauneluk Inupiat, Nana Inupiat, Noatak, Nome, Noorvik, Nuiqsut, Point Hope, Point Lay, Selawik, Shaktoolik, Shishmaref, Shungnak, Solomon, Teller, Unalakleet, Wainwright, Wales, White Mountain, White Mountain Inupiat, Mary's Igloo, Siberian Eskimo, Gambell, Savoonga, Siberian Yupik, Yupik Eskimo, Akiachak, Akiak, Alakanuk, Aleknagik, Andreafsky, Aniak, Atmautluak, Bethel, Bill Moore's Slough, Bristol Bay Yupik, Calista Yupik, Chefornak, Chevak, Chuathbaluk, Clark's Point, Crooked Creek, Dillingham, Eek, Ekuk, Ekwok, Emmonak, Goodnews Bay, Hooper Bay, Iqurmuit (Russian Mission), Kalskag, Kasigluk, Kipnuk, Koliganek, Kongiganak, Kotlik, Kwethluk, Kwigillingok, Levelock, Lower Kalskag, Manokotak, Marshall, Mekoryuk, Mountain Village, Naknek, Napaumute, Napakiak, Napaskiak, Newhalen, New Stuyahok, Newtok, Nightmute, Nunapitchukv, Oscarville, Pilot Station, Pitkas Point, Platinum, Portage Creek, Quinhagak, Red Devil, St. Michael, Scammon Bay, Sheldon's Point, Sleetmute, Stebbins, Togiak, Toksook, Tulukskak, Tuntutuliak, Tununak, Twin Hills, Georgetown, St. Mary's, Umkumiate, Aleut, Alutiiq Aleut, Tatitlek, Ugashik, Bristol Bay Aleut, Chignik, Chignik Lake, Egegik, Igiugig, Ivanof Bay, King Salmon, Kokhanok, Perryville, Pilot Point, Port Heiden, Chugach Aleut, Chenega, Chugach Corporation, English Bay, Port Graham, Eyak, Koniag Aleut, Akhiok, Agdaagux, Karluk, Kodiak, Larsen Bay, Old Harbor, Ouzinkie, Port Lions, Sugpiaq, Suqpigaq, Unangan Aleut, Akutan, Aleut Corporation, Aleutian, Aleutian Islander, Atka, Belkofski, Chignik Lagoon, King Cove, False Pass, Nelson Lagoon, Nikolski, Pauloff Harbor, Qagan Toyagungin, Qawalangin, St. George, St. Paul, Sand Point, South Naknek, Unalaska, Unga, Asian, Asian Indian, Bangladeshi, Bhutanese, Burmese, Cambodian, Chinese, Taiwanese, Filipino, Hmong, Indonesian, Japanese, Korean, Laotian, Malaysian, Okinawan, Pakistani, Sri Lankan, Thai, Vietnamese, Iwo Jiman, Maldivian, Nepalese, Singaporean, Madagascar, Black or African American, Black, African American, African, Botswanan, Ethiopian, Liberian, Namibian, Nigerian, Zairean, Bahamian, Barbadian, Dominican, Dominica Islander, Haitian, Jamaican, Tobagoan, Trinidadian, West Indian, Native Hawaiian or Other Pacific Islander, Polynesian, Native Hawaiian, Samoan, Tahitian, Tongan, Tokelauan, Micronesian, Guamanian or Chamorro, Guamanian, Chamorro, Mariana Islander, Marshallese, Palauan, Carolinian, Kosraean, Pohnpeian, Saipanese, Kiribati, Chuukese, Yapese, Melanesian, Fijian, Papua New Guinean, Solomon Islander, New Hebrides, White, European, Armenian, English, French, German, Irish, Italian, Polish, Scottish, Middle Eastern or North African, Assyrian, Egyptian, Iranian, Iraqi, Lebanese, Palestinian, Syrian, Afghanistani, Israeili, Arab, Other Race, Other Pacific Islander

Ethnicity:

Hispanic or Latino, Spaniard, Andalusian, Asturian, Castillian, Catalonian, Belearic Islander, Gallego, Valencian, Canarian, Spanish Basque, Mexican, Mexican American, Mexicano, Chicano, La Raza, Mexican American Indian, Central American, Costa Rican, Guatemalan, Honduran, Nicaraguan, Panamanian, Salvadoran, Central American Indian, Canal Zone, South American, Argentinean, Bolivian, Chilean, Colombian, Ecuadorian, Paraguayan, Peruvian, Uruguayan, Venezuelan, South American Indian, Criollo, Latin American, Puerto Rican, Cuban, Dominican, Not Hispanic or Latino

'''PREVIOUS NOTES'''
(none)

'''DEVELOPMENT STATUS'''
(Add details here)

'''ACTION ITEMS / NEXT STEPS'''

'''OPEN ISSUES / QUESTIONS'''
(Add details here)

MU Stage1 Final Rule - Record Demographics (EP)

2010-12-23T15:30:38Z

Anthracite:

'''SECTION # '''
Section 170.304(c)—Record Demographics

'''MU OBJECTIVE'''
Record demographics:
• preferred language
• gender
• race
• ethnicity
• date of birth

'''MU STAGE 1 MEASURE'''
More than 50% of all unique patients seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) have demographics recorded as structured data

'''CERTIFICATION CRITERION'''
Final Rule Text: §170.304(c).
Record demographics. Enable a user to electronically record, modify, and retrieve patient demographic data including preferred language, gender, race, ethnicity, and date of birth. Enable race and ethnicity to be recorded in accordance with the standard specified at 170.207(f).

'''STANDARDS'''
170.207(f)
http://www.whitehouse.gov/omb/fedreg_1997standards/

'''TEST CRITERIA #'''
§170.304(c)
http://healthcare.nist.gov/docs/170.304.c_RecordDemographicsAmb_v1.1.pdf
{| class="grey" border="1" cellpadding="2"
! USERS
! CORE / MENU
! SOLUTION DEVELOPERS
! STATUS
|-
| EP
| CORE
| TBD
| TBD
|}
----
'''SOLUTION DESIGN / TECHNOLOGY'''
(Add details here)

'''SOLUTION COMPONENTS'''
(Add details here - Ex. KIDS patch, Delphi code, User guide, Web resources, Manual test script, etc)

'''DEPENDENCIES'''
(Add details here)

'''COMMENTS / NOTES'''

At a minimum, the values in following three sections (Race, Ethnicity, Language) must be supported in some way for certification testing.

Race 
- American Indian or Alaska Native 
- Asian 
- Black or African American 
- Native Hawaiian or Other Pacific Islander 
- White 

(the above race values are mentioned in the NIST test criteria. Peter Bodtke)

Ethnicity: 
- Hispanic or Latino 
- Not Hispanic or Latino 

(the above ethnicity values are mentioned in the NIST test criteria. Peter Bodtke)

Language: 
English 
Japanese 
French 
Italian 
Portuguese 
Russian 

(the above ethnicity values are mentioned in the NIST test criteria. Peter Bodtke)

[Below Nancy Anthracite has noted the inconsistencies between the NIST test criteria demographic values (referenced with a broken link and described as "OMB Standards for Maintaining, Collecting, and Presenting Federal Data") and data provided as part of the Physician Quality Reporting Initiative program.]

Race and ethnicity required for quality reporting has not been harmonized by with the Meaningful use requirements by the Office of the National Coordinator for Health IT. A query regarding this has been sent to the ONC.
In general, there has been general movement in the direction of harmonization but this seems to have escaped scrutiny. However, WV learned in general terms on a PQRI related call that efforts are still underway to harmonize Meaningful Use and PQRI.

For now, what WorldVistA has done is to follow the race and ethnicity standards that are specified by Meaningful Use for PQRI as the same entries are duplicaed in the extendsive list for the PQRI reporting. Thus, they will be valid entries for PQRI.

1. VistA does not record preferred language at this point and it will be desirable to pick some sort of reasonable standard list of languages to standardize against across the community of VistA users. Also, to my mind just preferred language is not enough. With requirements for translators to be provided in certain circumstances, it is not enough to know, for instance, if Spanish is the preferred language without knowing if a translator is need and if the patient will provide a translator, so this sounds simple, but it is not so simple.

We have decided to use the ISO standard http://www.loc.gov/standards/iso639-2/ascii_8bits.html in the language file 0.85. There are also additional enhancements under discussion which may or may not be added by the time of Meaningful Use testing.

Chris Richardson is doing the preliminary work of adding the standard to the file. The work of making it available to select and record as the preferred language of the patient is pending. Thoughts on the subject and help doing it are welcome.

2. Race and Ethnicity was defined by the ONC for Meaningful Use, but so was quality reporting and the race and ethnicity required for quality reporting is daunting. I am happy to see that race has been expanded to stop using just various Hispanic peoples and not much else, but recording 900+ of what I would think is not race and ethnicity but ethnicity one and ethnicity two choices with no guidance how to handle those of mixed "race" seems rather ridiculous but even more disturbing, and invasion of privacy. This has been brought to the attention of the ONC but there has been no response to a query about that. In the meantime, you can see what the requirements for Quality Reporting are in the following two lists of race and ethnicity

Race:
American Indian or Alaska Native, American Indian, Abenaki, Algonquian, Apache, Chiricahua, Fort Sill Apache, Jicarilla Apache, Lipan Apache, Mescalero Apache, Oklahoma Apache, Payson Apache, San Carlos Apache, White Mountain Apache, Arapaho, Northern Arapaho, Southern Arapaho, Wind River Arapaho, Arikara, Assiniboine, Assiniboine Sioux, Fort Peck Assiniboine Sioux, Bannock, Blackfeet, Brotherton, Burt Lake Band, Caddo, Oklahoma Cado, Cahuilla, Agua Caliente Cahuilla, Augustine, Cabazon, Los Coyotes, Morongo, Santa Rosa Cahuilla, Torres-Martinez, California Tribes, Cahto, Chimariko, Coast Miwok, Digger, Kawaiisu, Kern River, Mattole, Red Wood, Santa Rosa, Takelma, Wappo, Yana, Yuki, Canadian and Latin American Indian, Canadian Indian, Central American Indian, French American Indian, Mexican American Indian, South American Indian, Spanish American Indian, Catawba, Cayuse, Chehalis, Chemakuan, Hoh, Quileute, Chemehuevi, Cherokee, Cherokee Alabama, Cherokees of Northeast Alabama, Cherokees of Southeast Alabama, Eastern Cherokee, Echota Cherokee, Etowah Cherokee, Northern Cherokee, Tuscola, United Keetowah Band of Cherokee, Western Cherokee, Cherokee Shawnee, Cheyenne, Northern Cheyenne, Southern Cheyenne, Cheyenne-Arapaho, Chickahominy, Eastern Chickahominy, Western Chickahominy, Chickasaw, Chinook, Clatsop, Columbia River Chinook, Kathlamet, Upper Chinook, Wakiakum Chinook, Willapa Chinook, Wishram, Chippewa, Bad River, Bay Mills Chippewa, Bois Forte, Burt Lake Chippewa, Fond du Lac, Grand Portage, Grand Traverse Band of Ottawa-Chippewa, Keweenaw, Lac Courte Oreilles, Lac du Flambeau, Lac Vieux Desert Chippewa, Lake Superior, Leech Lake, Little Shell Chippewa, Mille Lacs, Minnesota Chippewa, Ontonagon, Red Cliff Chippewa, Red Lake Chippewa, Saginaw Chippewa, St. Croix Chippewa, Sault Ste. Marie Chippewa, Sokoagon Chippewa, Turtle Mountain, White Earth, Chippewa Cree, Rocky Boy's Chippewa Cree, Chitimacha, Choctaw, Clifton Choctaw, Jena Choctaw, Mississippi Choctaw, Mowa Band of Choctaw, Oklahoma Choctaw, Chumash, Santa Ynez, Clear Lake, Coeur D'Alene, Coharie, Colorado River, Colville, Comanche, Oklahoma Comanche, Coos, Lower Umpqua, Siuslaw, Coos, Coquilles, Costanoan, Coushatta, Alabama Coushatta, Cowlitz, Cree, Creek, Alabama Creek, Alabama Quassarte, Eastern Creek, Eastern Muscogee, Kialegee, Lower Muscogee, Machis Lower Creek Indian, Poarch Band, Principal Creek Indian Nation, Star Clan of Muscogee Creeks, Thlopthlocco, Tuckabachee, Croatan, Crow, Cupeno, Agua Caliente, Delaware, Eastern Delaware, Lenni-Lenape, Munsee, Oklahoma Delaware, Rampough Mountain, Sand Hill, Diegueno, Campo, Capitan Grande, Cuyapaipe, La Posta, Manzanita, Mesa Grande, San Pasqual, Santa Ysabel, Sycuan, Eastern Tribes, Attacapa, Biloxi, Georgetown, Moor, Nansemond, Natchez, Nausu Waiwash, Nipmuc, Paugussett, Pocomoke Acohonock, Southeastern Indians, Susquehanock, Tunica Biloxi, Waccamaw-Siousan, Wicomico, Esselen, Fort Belknap, Fort Berthold, Fort Mcdowell, Fort Hall, Gabrieleno, Grand Ronde, Gros Ventres, Atsina, Haliwa, Hidatsa, Hoopa, Trinity, Whilkut, Hoopa Extension, Houma, Inaja-Cosmit, Iowa, Iowa of Kansas-Nebraska, Iowa of Oklahoma, Iroquois, Cayuga, Mohawk, Oneida, Onondaga, Seneca, Seneca Nation, Seneca-Cayuga, Tonawanda Seneca, Tuscarora, Wyandotte, Juaneno, Kalispel, Karuk, Kaw, Kickapoo, Oklahoma Kickapoo, Texas Kickapoo, Kiowa, Oklahoma Kiowa, Klallam, Jamestown, Lower Elwha, Port Gamble Klallam, Klamath, Konkow, Kootenai, Lassik, Long Island, Matinecock, Montauk, Poospatuck, Setauket, Luiseno, La Jolla, Pala, Pauma, Pechanga, Soboba, Twenty-Nine Palms, Temecula, Lumbee, Lummi, Maidu, Mountain Maidu, Nishinam, Makah, Maliseet, Mandan, Mattaponi, Menominee, Miami, Illinois Miami, Indiana Miami, Oklahoma Miami, Miccosukee, Micmac, Aroostook, Mission Indians, Miwok, Modoc, Mohegan, Mono, Nanticoke, Narragansett, Navajo, Alamo Navajo, Canoncito Navajo, Ramah Navajo, Nez Perce, Nomalaki, Northwest Tribes, Alsea, Celilo, Columbia, Kalapuya, Molala, Talakamish, Tenino, Tillamook, Wenatchee, Yahooskin, Omaha, Oregon Athabaskan, Osage, Otoe-Missouria, Ottawa, Burt Lake Ottawa, Michigan Ottawa, Oklahoma Ottawa, Paiute, Bishop, Bridgeport, Burns Paiute, Cedarville, Fort Bidwell, Fort Independence, Kaibab, Las Vegas, Lone Pine, Lovelock, Malheur Paiute, Moapa, Northern Paiute, Owens Valley, Pyramid Lake, San Juan Southern Paiute, Southern Paiute, Summit Lake, Utu Utu Gwaitu Paiute, Walker River, Yerington Paiute, Pamunkey, Passamaquoddy, Indian Township, Pleasant Point Passamaquoddy, Pawnee, Oklahoma Pawnee, Penobscot, Peoria, Oklahoma Peoria, Pequot, Marshantucket Pequot, Pima, Gila River Pima-Maricopa, Salt River Pima-Maricopa, Piscataway, Pit River, Pomo, Central Pomo, Dry Creek, Eastern Pomo, Kashia, Northern Pomo, Scotts Valley, Stonyford, Sulphur Bank, Ponca, Nebraska Ponca, Oklahoma Ponca, Potawatomi, Citizen Band Potawatomi, Forest County, Hannahville, Huron Potawatomi, Pokagon Potawatomi, Prairie Band, Wisconsin Potawatomi, Powhatan, Pueblo, Acoma, Arizona Tewa, Cochiti, Hopi, Isleta, Jemez, Keres, Laguna, Nambe, Picuris, Piro, Pojoaque, San Felipe, San Ildefonso, San Juan Pueblo, San Juan De, San Juan, Sandia, Santa Ana, Santa Clara, Santo Domingo, Taos, Tesuque, Tewa, Tigua, Zia, Zuni, Puget Sound Salish, Duwamish, Kikiallus, Lower Skagit, Muckleshoot, Nisqually, Nooksack, Port Madison, Puyallup, Samish, Sauk-Suiattle, Skokomish, Skykomish, Snohomish, Snoqualmie, Squaxin Island, Steilacoom, Stillaguamish, Suquamish, Swinomish, Tulalip, Upper Skagit, Quapaw, Quinault, Rappahannock, Reno-Sparks, Round Valley, Sac and Fox, Iowa Sac and Fox, Missouri Sac and Fox, Oklahoma Sac and Fox, Salinan, Salish, Salish and Kootenai, Schaghticoke, Scott Valley, Seminole, Big Cypress, Brighton, Florida Seminole, Hollywood Seminole, Oklahoma Seminole, Serrano, San Manual, Shasta, Shawnee, Absentee Shawnee, Eastern Shawnee, Shinnecock, Shoalwater Bay, Shoshone, Battle Mountain, Duckwater, Elko, Ely, Goshute, Panamint, Ruby Valley, Skull Valley, South Fork Shoshone, Te-Moak Western Shoshone, Timbi-Sha Shoshone, Washakie, Wind River Shoshone, Yomba, Shoshone Paiute, Duck Valley, Fallon, Fort McDermitt, Siletz, Sioux, Blackfoot Sioux, Brule Sioux, Cheyenne River Sioux, Crow Creek Sioux, Dakota Sioux, Flandreau Santee, Fort Peck, Lake Traverse Sioux, Lower Brule Sioux, Lower Sioux, Mdewakanton Sioux, Miniconjou, Oglala Sioux, Pine Ridge Sioux, Pipestone Sioux, Prairie Island Sioux, Prior Lake Sioux, Rosebud Sioux, Sans Arc Sioux, Santee Sioux, Sisseton-Wahpeton, Sisseton Sioux, Spirit Lake Sioux, Standing Rock Sioux, Teton Sioux, Two Kettle Sioux, Upper Sioux, Wahpekute Sioux, Wahpeton Sioux, Wazhaza Sioux, Yankton Sioux, Yanktonai Sioux, Siuslaw, Spokane, Stewart, Stockbridge, Susanville, Tohono O'Odham, Ak-Chin, Gila Bend, San Xavier, Sells, Tolowa, Tonkawa, Tygh, Umatilla, Umpqua, Cow Creek Umpqua, Ute, Allen Canyon, Uintah Ute, Ute Mountain Ute, Wailaki, Walla-Walla, Wampanoag, Gay Head Wampanoag, Mashpee Wampanoag, Warm Springs, Wascopum, Washoe, Alpine, Carson, Dresslerville, Wichita, Wind River, Winnebago, Ho-chunk, Nebraska Winnebago, Winnemucca, Wintun, Wiyot, Table Bluff, Yakama, Yakama Cowlitz, Yaqui, Barrio Libre, Pascua Yaqui, Yavapai Apache, Yokuts, Chukchansi, Tachi, Tule River, Yuchi, Yuman, Cocopah, Havasupai, Hualapai, Maricopa, Mohave, Quechan, Yavapai, Yurok, Coast Yurok, Alaska Native, Alaska Indian, Alaskan Athabascan, Ahtna, Alatna, Alexander, Allakaket, Alanvik, Anvik, Arctic, Beaver, Birch Creek, Cantwell, Chalkyitsik, Chickaloon, Chistochina, Chitina, Circle, Cook Inlet, Copper Center, Copper River, Dot Lake, Doyon, Eagle, Eklutna, Evansville, Fort Yukon, Gakona, Galena, Grayling, Gulkana, Healy Lake, Holy Cross, Hughes, Huslia, Iliamna, Kaltag, Kluti Kaah, Knik, Koyukuk, Lake Minchumina, Lime, Mcgrath, Manley Hot Springs, Mentasta Lake, Minto, Nenana, Nikolai, Ninilchik, Nondalton, Northway, Nulato, Pedro Bay, Rampart, Ruby, Salamatof, Seldovia, Slana, Shageluk, Stevens, Stony River, Takotna, Tanacross, Tanaina, Tanana, Tanana Chiefs, Tazlina, Telida, Tetlin, Tok, Tyonek, Venetie, Wiseman, Southeast Alaska, Tlingit-Haida, Angoon, Central Council of Tlingit and Haida Tribes, Chilkat, Chilkoot, Craig, Douglas, Haida, Hoonah, Hydaburg, Kake, Kasaan, Kenaitze, Ketchikan, Klawock, Pelican, Petersburg, Saxman, Sitka, Tenakee Springs, Tlingit, Wrangell, Yakutat, Tsimshian, Metlakatla, Eskimo, Greenland Eskimo, Inupiat Eskimo, Ambler, Anaktuvuk, Anaktuvuk Pass, Arctic Slope Inupiat, Arctic Slope Corporation, Atqasuk, Barrow, Bering Straits Inupiat, Brevig Mission, Buckland, Chinik, Council, Deering, Elim, Golovin, Inalik Diomede, Inupiaq, Kaktovik, Kawerak, Kiana, Kivalina, Kobuk, Kotzebue, Koyuk, Kwiguk, Mauneluk Inupiat, Nana Inupiat, Noatak, Nome, Noorvik, Nuiqsut, Point Hope, Point Lay, Selawik, Shaktoolik, Shishmaref, Shungnak, Solomon, Teller, Unalakleet, Wainwright, Wales, White Mountain, White Mountain Inupiat, Mary's Igloo, Siberian Eskimo, Gambell, Savoonga, Siberian Yupik, Yupik Eskimo, Akiachak, Akiak, Alakanuk, Aleknagik, Andreafsky, Aniak, Atmautluak, Bethel, Bill Moore's Slough, Bristol Bay Yupik, Calista Yupik, Chefornak, Chevak, Chuathbaluk, Clark's Point, Crooked Creek, Dillingham, Eek, Ekuk, Ekwok, Emmonak, Goodnews Bay, Hooper Bay, Iqurmuit (Russian Mission), Kalskag, Kasigluk, Kipnuk, Koliganek, Kongiganak, Kotlik, Kwethluk, Kwigillingok, Levelock, Lower Kalskag, Manokotak, Marshall, Mekoryuk, Mountain Village, Naknek, Napaumute, Napakiak, Napaskiak, Newhalen, New Stuyahok, Newtok, Nightmute, Nunapitchukv, Oscarville, Pilot Station, Pitkas Point, Platinum, Portage Creek, Quinhagak, Red Devil, St. Michael, Scammon Bay, Sheldon's Point, Sleetmute, Stebbins, Togiak, Toksook, Tulukskak, Tuntutuliak, Tununak, Twin Hills, Georgetown, St. Mary's, Umkumiate, Aleut, Alutiiq Aleut, Tatitlek, Ugashik, Bristol Bay Aleut, Chignik, Chignik Lake, Egegik, Igiugig, Ivanof Bay, King Salmon, Kokhanok, Perryville, Pilot Point, Port Heiden, Chugach Aleut, Chenega, Chugach Corporation, English Bay, Port Graham, Eyak, Koniag Aleut, Akhiok, Agdaagux, Karluk, Kodiak, Larsen Bay, Old Harbor, Ouzinkie, Port Lions, Sugpiaq, Suqpigaq, Unangan Aleut, Akutan, Aleut Corporation, Aleutian, Aleutian Islander, Atka, Belkofski, Chignik Lagoon, King Cove, False Pass, Nelson Lagoon, Nikolski, Pauloff Harbor, Qagan Toyagungin, Qawalangin, St. George, St. Paul, Sand Point, South Naknek, Unalaska, Unga, Asian, Asian Indian, Bangladeshi, Bhutanese, Burmese, Cambodian, Chinese, Taiwanese, Filipino, Hmong, Indonesian, Japanese, Korean, Laotian, Malaysian, Okinawan, Pakistani, Sri Lankan, Thai, Vietnamese, Iwo Jiman, Maldivian, Nepalese, Singaporean, Madagascar, Black or African American, Black, African American, African, Botswanan, Ethiopian, Liberian, Namibian, Nigerian, Zairean, Bahamian, Barbadian, Dominican, Dominica Islander, Haitian, Jamaican, Tobagoan, Trinidadian, West Indian, Native Hawaiian or Other Pacific Islander, Polynesian, Native Hawaiian, Samoan, Tahitian, Tongan, Tokelauan, Micronesian, Guamanian or Chamorro, Guamanian, Chamorro, Mariana Islander, Marshallese, Palauan, Carolinian, Kosraean, Pohnpeian, Saipanese, Kiribati, Chuukese, Yapese, Melanesian, Fijian, Papua New Guinean, Solomon Islander, New Hebrides, White, European, Armenian, English, French, German, Irish, Italian, Polish, Scottish, Middle Eastern or North African, Assyrian, Egyptian, Iranian, Iraqi, Lebanese, Palestinian, Syrian, Afghanistani, Israeili, Arab, Other Race, Other Pacific Islander

Ethnicity:

Hispanic or Latino, Spaniard, Andalusian, Asturian, Castillian, Catalonian, Belearic Islander, Gallego, Valencian, Canarian, Spanish Basque, Mexican, Mexican American, Mexicano, Chicano, La Raza, Mexican American Indian, Central American, Costa Rican, Guatemalan, Honduran, Nicaraguan, Panamanian, Salvadoran, Central American Indian, Canal Zone, South American, Argentinean, Bolivian, Chilean, Colombian, Ecuadorian, Paraguayan, Peruvian, Uruguayan, Venezuelan, South American Indian, Criollo, Latin American, Puerto Rican, Cuban, Dominican, Not Hispanic or Latino

'''PREVIOUS NOTES'''
(none)

'''DEVELOPMENT STATUS'''
(Add details here)

'''ACTION ITEMS / NEXT STEPS'''

'''OPEN ISSUES / QUESTIONS'''
(Add details here)

MU Stage1 Final Rule - Record and Chart Vital Signs

2010-12-16T03:11:49Z

Anthracite:

''SECTION # '''
Section 170.302(e)—Record and Chart Vital Signs

'''MU OBJECTIVE'''
Record and chart changes in vital signs:
- Height
- Weight
- Blood pressure
- Calculate and display BMI
(Plot and display growth charts for children 2-20 years, including BMI)

'''MU STAGE 1 MEASURE'''
For more than 50% of all unique patients age 2 and over seen by the EP or admitted to eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23), height, weight and blood pressure are recorded as structured data

'''CERTIFICATION CRITERION'''
Interim Final Rule Text:
(1)Vital signs. Enable a user to electronically record, modify, and retrieve a patient’s vital signs including, at a minimum, the height, weight, blood pressure, temperature, and pulse.
(2)Calculate body mass index. Automatically calculate and display body mass index (BMI) based on a patient’s height and weight.
(3) Plot and display growth charts. Plot and electronically display, upon request, growth charts for patients 2–20 years old.
Final Rule Text: §170.302(f).
(1)Vital signs. Enable a user to electronically record, modify, and retrieve a patient’s vital signs including, at a minimum, height, weight, and blood pressure.
(2) Unchanged
(3) Unchanged

'''STANDARDS'''
N/A

'''TEST CRITERIA #'''
§170.302 (f) 
http://healthcare.nist.gov/docs/170.302.f.1_vitalsigns_v1.1.pdf 
http://healthcare.nist.gov/docs/170.302.f.2_BMI_v1.1.pdf 
http://healthcare.nist.gov/docs/170.302.f.3_growthcharts_v1.1.pdf 
{| class="grey" border="1" cellpadding="2"
! USERS
! CORE / MENU
! SOLUTION DEVELOPERS
! STATUS
|-
| All
| CORE
| TBD
| TBD
|}
----
'''SOLUTION DESIGN / TECHNOLOGY'''
(Add details here)

'''SOLUTION COMPONENTS'''
(Add details here - Ex. KIDS patch, Delphi code, User guide, Web resources, Manual test script, etc)

There is an all open source PHP based application already built for use with VistA. There is information and documentation at http://opensourcevista.net:8888/NancysVistAServer/PGC.

For international use, data files need to have the WHO data added and verified. That is partially done but needs more work.

Once ePrescribing changes to CPRS that are necessary for Meaningful Use are done, changes will probably be made to the software to make it easier to install.

Kevin Toppenberg has also built a pediatric growth chart application which has one proprietary component that he has licensed on behalf of the community and runs only with the Internet Explorer browser and is easy to install.

WorldVistA will probably use Kevin's solution at least until ePrescribing is released and installation of the first solution gets easier.

'''DEPENDENCIES'''
(Add details here)

'''COMMENTS / NOTES'''
(Add details here)

'''PREVIOUS NOTES'''
(none)

'''DEVELOPMENT STATUS'''
(Add details here)

'''ACTION ITEMS / NEXT STEPS'''
(Add details here)

'''OPEN ISSUES / QUESTIONS'''
(Add details here)

MU Stage1 Final Rule - Record Demographics (EP)

2010-12-16T03:03:38Z

Anthracite:

'''SECTION # '''
Section 170.304(c)—Record Demographics

'''MU OBJECTIVE'''
Record demographics:
• preferred language
• gender
• race
• ethnicity
• date of birth

'''MU STAGE 1 MEASURE'''
More than 50% of all unique patients seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) have demographics recorded as structured data

'''CERTIFICATION CRITERION'''
Final Rule Text: §170.304(c).
Record demographics. Enable a user to electronically record, modify, and retrieve patient demographic data including preferred language, gender, race, ethnicity, and date of birth. Enable race and ethnicity to be recorded in accordance with the standard specified at 170.207(f).

'''STANDARDS'''
170.207(f)
http://www.whitehouse.gov/omb/fedreg_1997standards/

'''TEST CRITERIA #'''
§170.304(c)
http://healthcare.nist.gov/docs/170.304.c_RecordDemographicsAmb_v1.1.pdf
{| class="grey" border="1" cellpadding="2"
! USERS
! CORE / MENU
! SOLUTION DEVELOPERS
! STATUS
|-
| EP
| CORE
| TBD
| TBD
|}
----
'''SOLUTION DESIGN / TECHNOLOGY'''
(Add details here)

'''SOLUTION COMPONENTS'''
(Add details here - Ex. KIDS patch, Delphi code, User guide, Web resources, Manual test script, etc)

'''DEPENDENCIES'''
(Add details here)

'''COMMENTS / NOTES'''

At a minimum, the values in following three sections (Race, Ethnicity, Language) must be supported in some way for certification testing.

Race 
- American Indian or Alaska Native 
- Asian 
- Black or African American 
- Native Hawaiian or Other Pacific Islander 
- White 

(the above race values are mentioned in the NIST test criteria. Peter Bodtke)

Ethnicity: 
- Hispanic or Latino 
- Not Hispanic or Latino 

(the above ethnicity values are mentioned in the NIST test criteria. Peter Bodtke)

Language: 
English 
Japanese 
French 
Italian 
Portuguese 
Russian 

(the above ethnicity values are mentioned in the NIST test criteria. Peter Bodtke)

[Below Nancy Anthracite has noted the inconsistencies between the NIST test criteria demographic values (referenced with a broken link and described as "OMB Standards for Maintaining, Collecting, and Presenting Federal Data") and data provided as part of the Physician Quality Reporting Initiative program.]

Race and ethnicity required for quality reporting has not been harmonized by with the Meaningful use requirements by the Office of the National Coordinator for Health IT. A query regarding this has been sent to the ONC.
In general, there has been general movement in the direction of harmonization but this seems to have escaped scrutiny. However, WV learned in general terms on a PQRI related call that efforts are still underway to harmonize Meaningful Use and PQRI.

For now, what WorldVistA has done is to follow the race and ethnicity standards that are specified by Meaningful Use for PQRI as the same entries are duplicaed in the extendsive list for the PQRI reporting. Thus, they will be valid entries for PQRI.

1. VistA does not record preferred language at this point and it will be desirable to pick some sort of reasonable standard list of languages to standardize against across the community of VistA users. Also, to my mind just preferred language is not enough. With requirements for translators to be provided in certain circumstances, it is not enough to know, for instance, if Spanish is the preferred language without knowing if a translator is need and if the patient will provide a translator, so this sounds simple, but it is not so simple. This is worth discussing in the community to get suggestions as it would be desirable to end up with some computable data, not just a free text field to fill this requirement. In addition, there is the whole question of International Use and translation of VistA. We have folks trying to figure out a way to move forward with what is needed for Meaningful Use in a manner that will support that effort and to do that, the bigger picture is being explored by Dave Whitten, Kevin Toppenberg and Chris Richardson. If you have an interest in the subject of translating VistA, please send an email to info at worldvista dot org and we will get you involved in the discussion.

Medsphere provided the information that IHS is planning to use the ISO standard in file 9999999.99 for language and that OpenVista will do the same. We would like to see all flavors of VistA aligned on this so Nancy Anthracite is exploring whether or not the VA plans to do the same or if they would consider using the same file and standard. A copy of the ISO standard can be found here: http://www.loc.gov/standards/iso639-2/ascii_8bits.html. However, discussions with VistA expert in our community suggest that the current language file, file 0.85 may be preferable and WorldVistA is definitely leaning in that direction at the moment.

2. Race and Ethnicity was defined by the ONC for Meaningful Use, but so was quality reporting and the race and ethnicity required for quality reporting is daunting. I am happy to see that race has been expanded to stop using just various Hispanic peoples and not much else, but recording 900+ of what I would think is not race and ethnicity but ethnicity one and ethnicity two choices with no guidance how to handle those of mixed "race" seems rather ridiculous but even more disturbing, and invasion of privacy. This has been brought to the attention of the ONC but there has been no response to a query about that. In the meantime, you can see what the requirements for Quality Reporting are in the following two lists of race and ethnicity

Race:
American Indian or Alaska Native, American Indian, Abenaki, Algonquian, Apache, Chiricahua, Fort Sill Apache, Jicarilla Apache, Lipan Apache, Mescalero Apache, Oklahoma Apache, Payson Apache, San Carlos Apache, White Mountain Apache, Arapaho, Northern Arapaho, Southern Arapaho, Wind River Arapaho, Arikara, Assiniboine, Assiniboine Sioux, Fort Peck Assiniboine Sioux, Bannock, Blackfeet, Brotherton, Burt Lake Band, Caddo, Oklahoma Cado, Cahuilla, Agua Caliente Cahuilla, Augustine, Cabazon, Los Coyotes, Morongo, Santa Rosa Cahuilla, Torres-Martinez, California Tribes, Cahto, Chimariko, Coast Miwok, Digger, Kawaiisu, Kern River, Mattole, Red Wood, Santa Rosa, Takelma, Wappo, Yana, Yuki, Canadian and Latin American Indian, Canadian Indian, Central American Indian, French American Indian, Mexican American Indian, South American Indian, Spanish American Indian, Catawba, Cayuse, Chehalis, Chemakuan, Hoh, Quileute, Chemehuevi, Cherokee, Cherokee Alabama, Cherokees of Northeast Alabama, Cherokees of Southeast Alabama, Eastern Cherokee, Echota Cherokee, Etowah Cherokee, Northern Cherokee, Tuscola, United Keetowah Band of Cherokee, Western Cherokee, Cherokee Shawnee, Cheyenne, Northern Cheyenne, Southern Cheyenne, Cheyenne-Arapaho, Chickahominy, Eastern Chickahominy, Western Chickahominy, Chickasaw, Chinook, Clatsop, Columbia River Chinook, Kathlamet, Upper Chinook, Wakiakum Chinook, Willapa Chinook, Wishram, Chippewa, Bad River, Bay Mills Chippewa, Bois Forte, Burt Lake Chippewa, Fond du Lac, Grand Portage, Grand Traverse Band of Ottawa-Chippewa, Keweenaw, Lac Courte Oreilles, Lac du Flambeau, Lac Vieux Desert Chippewa, Lake Superior, Leech Lake, Little Shell Chippewa, Mille Lacs, Minnesota Chippewa, Ontonagon, Red Cliff Chippewa, Red Lake Chippewa, Saginaw Chippewa, St. Croix Chippewa, Sault Ste. Marie Chippewa, Sokoagon Chippewa, Turtle Mountain, White Earth, Chippewa Cree, Rocky Boy's Chippewa Cree, Chitimacha, Choctaw, Clifton Choctaw, Jena Choctaw, Mississippi Choctaw, Mowa Band of Choctaw, Oklahoma Choctaw, Chumash, Santa Ynez, Clear Lake, Coeur D'Alene, Coharie, Colorado River, Colville, Comanche, Oklahoma Comanche, Coos, Lower Umpqua, Siuslaw, Coos, Coquilles, Costanoan, Coushatta, Alabama Coushatta, Cowlitz, Cree, Creek, Alabama Creek, Alabama Quassarte, Eastern Creek, Eastern Muscogee, Kialegee, Lower Muscogee, Machis Lower Creek Indian, Poarch Band, Principal Creek Indian Nation, Star Clan of Muscogee Creeks, Thlopthlocco, Tuckabachee, Croatan, Crow, Cupeno, Agua Caliente, Delaware, Eastern Delaware, Lenni-Lenape, Munsee, Oklahoma Delaware, Rampough Mountain, Sand Hill, Diegueno, Campo, Capitan Grande, Cuyapaipe, La Posta, Manzanita, Mesa Grande, San Pasqual, Santa Ysabel, Sycuan, Eastern Tribes, Attacapa, Biloxi, Georgetown, Moor, Nansemond, Natchez, Nausu Waiwash, Nipmuc, Paugussett, Pocomoke Acohonock, Southeastern Indians, Susquehanock, Tunica Biloxi, Waccamaw-Siousan, Wicomico, Esselen, Fort Belknap, Fort Berthold, Fort Mcdowell, Fort Hall, Gabrieleno, Grand Ronde, Gros Ventres, Atsina, Haliwa, Hidatsa, Hoopa, Trinity, Whilkut, Hoopa Extension, Houma, Inaja-Cosmit, Iowa, Iowa of Kansas-Nebraska, Iowa of Oklahoma, Iroquois, Cayuga, Mohawk, Oneida, Onondaga, Seneca, Seneca Nation, Seneca-Cayuga, Tonawanda Seneca, Tuscarora, Wyandotte, Juaneno, Kalispel, Karuk, Kaw, Kickapoo, Oklahoma Kickapoo, Texas Kickapoo, Kiowa, Oklahoma Kiowa, Klallam, Jamestown, Lower Elwha, Port Gamble Klallam, Klamath, Konkow, Kootenai, Lassik, Long Island, Matinecock, Montauk, Poospatuck, Setauket, Luiseno, La Jolla, Pala, Pauma, Pechanga, Soboba, Twenty-Nine Palms, Temecula, Lumbee, Lummi, Maidu, Mountain Maidu, Nishinam, Makah, Maliseet, Mandan, Mattaponi, Menominee, Miami, Illinois Miami, Indiana Miami, Oklahoma Miami, Miccosukee, Micmac, Aroostook, Mission Indians, Miwok, Modoc, Mohegan, Mono, Nanticoke, Narragansett, Navajo, Alamo Navajo, Canoncito Navajo, Ramah Navajo, Nez Perce, Nomalaki, Northwest Tribes, Alsea, Celilo, Columbia, Kalapuya, Molala, Talakamish, Tenino, Tillamook, Wenatchee, Yahooskin, Omaha, Oregon Athabaskan, Osage, Otoe-Missouria, Ottawa, Burt Lake Ottawa, Michigan Ottawa, Oklahoma Ottawa, Paiute, Bishop, Bridgeport, Burns Paiute, Cedarville, Fort Bidwell, Fort Independence, Kaibab, Las Vegas, Lone Pine, Lovelock, Malheur Paiute, Moapa, Northern Paiute, Owens Valley, Pyramid Lake, San Juan Southern Paiute, Southern Paiute, Summit Lake, Utu Utu Gwaitu Paiute, Walker River, Yerington Paiute, Pamunkey, Passamaquoddy, Indian Township, Pleasant Point Passamaquoddy, Pawnee, Oklahoma Pawnee, Penobscot, Peoria, Oklahoma Peoria, Pequot, Marshantucket Pequot, Pima, Gila River Pima-Maricopa, Salt River Pima-Maricopa, Piscataway, Pit River, Pomo, Central Pomo, Dry Creek, Eastern Pomo, Kashia, Northern Pomo, Scotts Valley, Stonyford, Sulphur Bank, Ponca, Nebraska Ponca, Oklahoma Ponca, Potawatomi, Citizen Band Potawatomi, Forest County, Hannahville, Huron Potawatomi, Pokagon Potawatomi, Prairie Band, Wisconsin Potawatomi, Powhatan, Pueblo, Acoma, Arizona Tewa, Cochiti, Hopi, Isleta, Jemez, Keres, Laguna, Nambe, Picuris, Piro, Pojoaque, San Felipe, San Ildefonso, San Juan Pueblo, San Juan De, San Juan, Sandia, Santa Ana, Santa Clara, Santo Domingo, Taos, Tesuque, Tewa, Tigua, Zia, Zuni, Puget Sound Salish, Duwamish, Kikiallus, Lower Skagit, Muckleshoot, Nisqually, Nooksack, Port Madison, Puyallup, Samish, Sauk-Suiattle, Skokomish, Skykomish, Snohomish, Snoqualmie, Squaxin Island, Steilacoom, Stillaguamish, Suquamish, Swinomish, Tulalip, Upper Skagit, Quapaw, Quinault, Rappahannock, Reno-Sparks, Round Valley, Sac and Fox, Iowa Sac and Fox, Missouri Sac and Fox, Oklahoma Sac and Fox, Salinan, Salish, Salish and Kootenai, Schaghticoke, Scott Valley, Seminole, Big Cypress, Brighton, Florida Seminole, Hollywood Seminole, Oklahoma Seminole, Serrano, San Manual, Shasta, Shawnee, Absentee Shawnee, Eastern Shawnee, Shinnecock, Shoalwater Bay, Shoshone, Battle Mountain, Duckwater, Elko, Ely, Goshute, Panamint, Ruby Valley, Skull Valley, South Fork Shoshone, Te-Moak Western Shoshone, Timbi-Sha Shoshone, Washakie, Wind River Shoshone, Yomba, Shoshone Paiute, Duck Valley, Fallon, Fort McDermitt, Siletz, Sioux, Blackfoot Sioux, Brule Sioux, Cheyenne River Sioux, Crow Creek Sioux, Dakota Sioux, Flandreau Santee, Fort Peck, Lake Traverse Sioux, Lower Brule Sioux, Lower Sioux, Mdewakanton Sioux, Miniconjou, Oglala Sioux, Pine Ridge Sioux, Pipestone Sioux, Prairie Island Sioux, Prior Lake Sioux, Rosebud Sioux, Sans Arc Sioux, Santee Sioux, Sisseton-Wahpeton, Sisseton Sioux, Spirit Lake Sioux, Standing Rock Sioux, Teton Sioux, Two Kettle Sioux, Upper Sioux, Wahpekute Sioux, Wahpeton Sioux, Wazhaza Sioux, Yankton Sioux, Yanktonai Sioux, Siuslaw, Spokane, Stewart, Stockbridge, Susanville, Tohono O'Odham, Ak-Chin, Gila Bend, San Xavier, Sells, Tolowa, Tonkawa, Tygh, Umatilla, Umpqua, Cow Creek Umpqua, Ute, Allen Canyon, Uintah Ute, Ute Mountain Ute, Wailaki, Walla-Walla, Wampanoag, Gay Head Wampanoag, Mashpee Wampanoag, Warm Springs, Wascopum, Washoe, Alpine, Carson, Dresslerville, Wichita, Wind River, Winnebago, Ho-chunk, Nebraska Winnebago, Winnemucca, Wintun, Wiyot, Table Bluff, Yakama, Yakama Cowlitz, Yaqui, Barrio Libre, Pascua Yaqui, Yavapai Apache, Yokuts, Chukchansi, Tachi, Tule River, Yuchi, Yuman, Cocopah, Havasupai, Hualapai, Maricopa, Mohave, Quechan, Yavapai, Yurok, Coast Yurok, Alaska Native, Alaska Indian, Alaskan Athabascan, Ahtna, Alatna, Alexander, Allakaket, Alanvik, Anvik, Arctic, Beaver, Birch Creek, Cantwell, Chalkyitsik, Chickaloon, Chistochina, Chitina, Circle, Cook Inlet, Copper Center, Copper River, Dot Lake, Doyon, Eagle, Eklutna, Evansville, Fort Yukon, Gakona, Galena, Grayling, Gulkana, Healy Lake, Holy Cross, Hughes, Huslia, Iliamna, Kaltag, Kluti Kaah, Knik, Koyukuk, Lake Minchumina, Lime, Mcgrath, Manley Hot Springs, Mentasta Lake, Minto, Nenana, Nikolai, Ninilchik, Nondalton, Northway, Nulato, Pedro Bay, Rampart, Ruby, Salamatof, Seldovia, Slana, Shageluk, Stevens, Stony River, Takotna, Tanacross, Tanaina, Tanana, Tanana Chiefs, Tazlina, Telida, Tetlin, Tok, Tyonek, Venetie, Wiseman, Southeast Alaska, Tlingit-Haida, Angoon, Central Council of Tlingit and Haida Tribes, Chilkat, Chilkoot, Craig, Douglas, Haida, Hoonah, Hydaburg, Kake, Kasaan, Kenaitze, Ketchikan, Klawock, Pelican, Petersburg, Saxman, Sitka, Tenakee Springs, Tlingit, Wrangell, Yakutat, Tsimshian, Metlakatla, Eskimo, Greenland Eskimo, Inupiat Eskimo, Ambler, Anaktuvuk, Anaktuvuk Pass, Arctic Slope Inupiat, Arctic Slope Corporation, Atqasuk, Barrow, Bering Straits Inupiat, Brevig Mission, Buckland, Chinik, Council, Deering, Elim, Golovin, Inalik Diomede, Inupiaq, Kaktovik, Kawerak, Kiana, Kivalina, Kobuk, Kotzebue, Koyuk, Kwiguk, Mauneluk Inupiat, Nana Inupiat, Noatak, Nome, Noorvik, Nuiqsut, Point Hope, Point Lay, Selawik, Shaktoolik, Shishmaref, Shungnak, Solomon, Teller, Unalakleet, Wainwright, Wales, White Mountain, White Mountain Inupiat, Mary's Igloo, Siberian Eskimo, Gambell, Savoonga, Siberian Yupik, Yupik Eskimo, Akiachak, Akiak, Alakanuk, Aleknagik, Andreafsky, Aniak, Atmautluak, Bethel, Bill Moore's Slough, Bristol Bay Yupik, Calista Yupik, Chefornak, Chevak, Chuathbaluk, Clark's Point, Crooked Creek, Dillingham, Eek, Ekuk, Ekwok, Emmonak, Goodnews Bay, Hooper Bay, Iqurmuit (Russian Mission), Kalskag, Kasigluk, Kipnuk, Koliganek, Kongiganak, Kotlik, Kwethluk, Kwigillingok, Levelock, Lower Kalskag, Manokotak, Marshall, Mekoryuk, Mountain Village, Naknek, Napaumute, Napakiak, Napaskiak, Newhalen, New Stuyahok, Newtok, Nightmute, Nunapitchukv, Oscarville, Pilot Station, Pitkas Point, Platinum, Portage Creek, Quinhagak, Red Devil, St. Michael, Scammon Bay, Sheldon's Point, Sleetmute, Stebbins, Togiak, Toksook, Tulukskak, Tuntutuliak, Tununak, Twin Hills, Georgetown, St. Mary's, Umkumiate, Aleut, Alutiiq Aleut, Tatitlek, Ugashik, Bristol Bay Aleut, Chignik, Chignik Lake, Egegik, Igiugig, Ivanof Bay, King Salmon, Kokhanok, Perryville, Pilot Point, Port Heiden, Chugach Aleut, Chenega, Chugach Corporation, English Bay, Port Graham, Eyak, Koniag Aleut, Akhiok, Agdaagux, Karluk, Kodiak, Larsen Bay, Old Harbor, Ouzinkie, Port Lions, Sugpiaq, Suqpigaq, Unangan Aleut, Akutan, Aleut Corporation, Aleutian, Aleutian Islander, Atka, Belkofski, Chignik Lagoon, King Cove, False Pass, Nelson Lagoon, Nikolski, Pauloff Harbor, Qagan Toyagungin, Qawalangin, St. George, St. Paul, Sand Point, South Naknek, Unalaska, Unga, Asian, Asian Indian, Bangladeshi, Bhutanese, Burmese, Cambodian, Chinese, Taiwanese, Filipino, Hmong, Indonesian, Japanese, Korean, Laotian, Malaysian, Okinawan, Pakistani, Sri Lankan, Thai, Vietnamese, Iwo Jiman, Maldivian, Nepalese, Singaporean, Madagascar, Black or African American, Black, African American, African, Botswanan, Ethiopian, Liberian, Namibian, Nigerian, Zairean, Bahamian, Barbadian, Dominican, Dominica Islander, Haitian, Jamaican, Tobagoan, Trinidadian, West Indian, Native Hawaiian or Other Pacific Islander, Polynesian, Native Hawaiian, Samoan, Tahitian, Tongan, Tokelauan, Micronesian, Guamanian or Chamorro, Guamanian, Chamorro, Mariana Islander, Marshallese, Palauan, Carolinian, Kosraean, Pohnpeian, Saipanese, Kiribati, Chuukese, Yapese, Melanesian, Fijian, Papua New Guinean, Solomon Islander, New Hebrides, White, European, Armenian, English, French, German, Irish, Italian, Polish, Scottish, Middle Eastern or North African, Assyrian, Egyptian, Iranian, Iraqi, Lebanese, Palestinian, Syrian, Afghanistani, Israeili, Arab, Other Race, Other Pacific Islander

Ethnicity:

Hispanic or Latino, Spaniard, Andalusian, Asturian, Castillian, Catalonian, Belearic Islander, Gallego, Valencian, Canarian, Spanish Basque, Mexican, Mexican American, Mexicano, Chicano, La Raza, Mexican American Indian, Central American, Costa Rican, Guatemalan, Honduran, Nicaraguan, Panamanian, Salvadoran, Central American Indian, Canal Zone, South American, Argentinean, Bolivian, Chilean, Colombian, Ecuadorian, Paraguayan, Peruvian, Uruguayan, Venezuelan, South American Indian, Criollo, Latin American, Puerto Rican, Cuban, Dominican, Not Hispanic or Latino

'''PREVIOUS NOTES'''
(none)

'''DEVELOPMENT STATUS'''
(Add details here)

'''ACTION ITEMS / NEXT STEPS'''

'''OPEN ISSUES / QUESTIONS'''
(Add details here)

MU Stage1 Final Rule - Record Demographics (EP)

2010-12-15T22:15:52Z

Anthracite:

'''SECTION # '''
Section 170.304(c)—Record Demographics

'''MU OBJECTIVE'''
Record demographics:
• preferred language
• gender
• race
• ethnicity
• date of birth

'''MU STAGE 1 MEASURE'''
More than 50% of all unique patients seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) have demographics recorded as structured data

'''CERTIFICATION CRITERION'''
Final Rule Text: §170.304(c).
Record demographics. Enable a user to electronically record, modify, and retrieve patient demographic data including preferred language, gender, race, ethnicity, and date of birth. Enable race and ethnicity to be recorded in accordance with the standard specified at 170.207(f).

'''STANDARDS'''
170.207(f)
http://www.whitehouse.gov/omb/fedreg_1997standards/

'''TEST CRITERIA #'''
§170.304(c)
http://healthcare.nist.gov/docs/170.304.c_RecordDemographicsAmb_v1.1.pdf
{| class="grey" border="1" cellpadding="2"
! USERS
! CORE / MENU
! SOLUTION DEVELOPERS
! STATUS
|-
| EP
| CORE
| TBD
| TBD
|}
----
'''SOLUTION DESIGN / TECHNOLOGY'''
(Add details here)

'''SOLUTION COMPONENTS'''
(Add details here - Ex. KIDS patch, Delphi code, User guide, Web resources, Manual test script, etc)

'''DEPENDENCIES'''
(Add details here)

'''COMMENTS / NOTES'''

At a minimum, the values in following three sections (Race, Ethnicity, Language) must be supported in some way for certification testing.

Race 
- American Indian or Alaska Native 
- Asian 
- Black or African American 
- Native Hawaiian or Other Pacific Islander 
- White 

(the above race values are mentioned in the NIST test criteria. Peter Bodtke)

Ethnicity: 
- Hispanic or Latino 
- Not Hispanic or Latino 

(the above ethnicity values are mentioned in the NIST test criteria. Peter Bodtke)

Language: 
English 
Japanese 
French 
Italian 
Portuguese 
Russian 

(the above ethnicity values are mentioned in the NIST test criteria. Peter Bodtke)

[Below Nancy Anthracite has noted the inconsistencies between the NIST test criteria demographic values (referenced with a broken link and described as "OMB Standards for Maintaining, Collecting, and Presenting Federal Data") and data provided as part of the Physician Quality Reporting Initiative program.]

Race and ethnicity required for quality reporting has not been harmonized by with the Meaningful use requirements by the Office of the National Coordinator for Health IT. A query regarding this has been sent to the ONC.
In general, there has been general movement in the direction of harmonization but this seems to have escaped scrutiny. However, WV learned in general terms on a PQRI related call that efforts are still underway to harmonize Meaningful Use and PQRI.

For now, what WorldVistA has done is to follow the race and ethnicity standards that are specified by Meaningful Use for PQRI as the same entries are duplicaed in the extendsive list for the PQRI reporting. Thus, they will be valid entries for PQRI.

1. VistA does not record preferred language at this point and it will be desirable to pick some sort of reasonable standard list of languages to standardize against across the community of VistA users. Also, to my mind just preferred language is not enough. With requirements for translators to be provided in certain circumstances, it is not enough to know, for instance, if Spanish is the preferred language without knowing if a translator is need and if the patient will provide a translator, so this sounds simple, but it is not so simple. This is worth discussing in the community to get suggestions as it would be desirable to end up with some computable data, not just a free text field to fill this requirement. In addition, there is the whole question of International Use and translation of VistA. We have folks trying to figure out a way to move forward with what is needed for Meaningful Use in a manner that will support that effort and to do that, the bigger picture is being explored by Dave Whitten, Kevin Toppenberg and Chris Richardson. If you have an interest in the subject of translating VistA, please send an email to info at worldvista dot org and we will get you involved in the discussion.

Medsphere provided the information that IHS is planning to use the ISO standard in file 9999999.99 for language and that OpenVista will do the same. We would like to see all flavors of VistA aligned on this so Nancy Anthracite is exploring whether or not the VA plans to do the same or if they would consider using the same file and standard. A copy of the ISO standard can be found here: http://www.loc.gov/standards/iso639-2/ascii_8bits.html. However, discussions with VistA expert in our community suggest that the current language file, file 0.85 may be preferable. An option to add a preferred language also needs to be added somewhere sensible.

2. Race and Ethnicity was defined by the ONC for Meaningful Use, but so was quality reporting and the race and ethnicity required for quality reporting is daunting. I am happy to see that race has been expanded to stop using just various Hispanic peoples and not much else, but recording 900+ of what I would think is not race and ethnicity but ethnicity one and ethnicity two choices with no guidance how to handle those of mixed "race" seems rather ridiculous but even more disturbing, and invasion of privacy. This has been brought to the attention of the ONC but there has been no response to a query about that. In the meantime, you can see what the requirements for Quality Reporting are in the following two lists of race and ethnicity

Race:
American Indian or Alaska Native, American Indian, Abenaki, Algonquian, Apache, Chiricahua, Fort Sill Apache, Jicarilla Apache, Lipan Apache, Mescalero Apache, Oklahoma Apache, Payson Apache, San Carlos Apache, White Mountain Apache, Arapaho, Northern Arapaho, Southern Arapaho, Wind River Arapaho, Arikara, Assiniboine, Assiniboine Sioux, Fort Peck Assiniboine Sioux, Bannock, Blackfeet, Brotherton, Burt Lake Band, Caddo, Oklahoma Cado, Cahuilla, Agua Caliente Cahuilla, Augustine, Cabazon, Los Coyotes, Morongo, Santa Rosa Cahuilla, Torres-Martinez, California Tribes, Cahto, Chimariko, Coast Miwok, Digger, Kawaiisu, Kern River, Mattole, Red Wood, Santa Rosa, Takelma, Wappo, Yana, Yuki, Canadian and Latin American Indian, Canadian Indian, Central American Indian, French American Indian, Mexican American Indian, South American Indian, Spanish American Indian, Catawba, Cayuse, Chehalis, Chemakuan, Hoh, Quileute, Chemehuevi, Cherokee, Cherokee Alabama, Cherokees of Northeast Alabama, Cherokees of Southeast Alabama, Eastern Cherokee, Echota Cherokee, Etowah Cherokee, Northern Cherokee, Tuscola, United Keetowah Band of Cherokee, Western Cherokee, Cherokee Shawnee, Cheyenne, Northern Cheyenne, Southern Cheyenne, Cheyenne-Arapaho, Chickahominy, Eastern Chickahominy, Western Chickahominy, Chickasaw, Chinook, Clatsop, Columbia River Chinook, Kathlamet, Upper Chinook, Wakiakum Chinook, Willapa Chinook, Wishram, Chippewa, Bad River, Bay Mills Chippewa, Bois Forte, Burt Lake Chippewa, Fond du Lac, Grand Portage, Grand Traverse Band of Ottawa-Chippewa, Keweenaw, Lac Courte Oreilles, Lac du Flambeau, Lac Vieux Desert Chippewa, Lake Superior, Leech Lake, Little Shell Chippewa, Mille Lacs, Minnesota Chippewa, Ontonagon, Red Cliff Chippewa, Red Lake Chippewa, Saginaw Chippewa, St. Croix Chippewa, Sault Ste. Marie Chippewa, Sokoagon Chippewa, Turtle Mountain, White Earth, Chippewa Cree, Rocky Boy's Chippewa Cree, Chitimacha, Choctaw, Clifton Choctaw, Jena Choctaw, Mississippi Choctaw, Mowa Band of Choctaw, Oklahoma Choctaw, Chumash, Santa Ynez, Clear Lake, Coeur D'Alene, Coharie, Colorado River, Colville, Comanche, Oklahoma Comanche, Coos, Lower Umpqua, Siuslaw, Coos, Coquilles, Costanoan, Coushatta, Alabama Coushatta, Cowlitz, Cree, Creek, Alabama Creek, Alabama Quassarte, Eastern Creek, Eastern Muscogee, Kialegee, Lower Muscogee, Machis Lower Creek Indian, Poarch Band, Principal Creek Indian Nation, Star Clan of Muscogee Creeks, Thlopthlocco, Tuckabachee, Croatan, Crow, Cupeno, Agua Caliente, Delaware, Eastern Delaware, Lenni-Lenape, Munsee, Oklahoma Delaware, Rampough Mountain, Sand Hill, Diegueno, Campo, Capitan Grande, Cuyapaipe, La Posta, Manzanita, Mesa Grande, San Pasqual, Santa Ysabel, Sycuan, Eastern Tribes, Attacapa, Biloxi, Georgetown, Moor, Nansemond, Natchez, Nausu Waiwash, Nipmuc, Paugussett, Pocomoke Acohonock, Southeastern Indians, Susquehanock, Tunica Biloxi, Waccamaw-Siousan, Wicomico, Esselen, Fort Belknap, Fort Berthold, Fort Mcdowell, Fort Hall, Gabrieleno, Grand Ronde, Gros Ventres, Atsina, Haliwa, Hidatsa, Hoopa, Trinity, Whilkut, Hoopa Extension, Houma, Inaja-Cosmit, Iowa, Iowa of Kansas-Nebraska, Iowa of Oklahoma, Iroquois, Cayuga, Mohawk, Oneida, Onondaga, Seneca, Seneca Nation, Seneca-Cayuga, Tonawanda Seneca, Tuscarora, Wyandotte, Juaneno, Kalispel, Karuk, Kaw, Kickapoo, Oklahoma Kickapoo, Texas Kickapoo, Kiowa, Oklahoma Kiowa, Klallam, Jamestown, Lower Elwha, Port Gamble Klallam, Klamath, Konkow, Kootenai, Lassik, Long Island, Matinecock, Montauk, Poospatuck, Setauket, Luiseno, La Jolla, Pala, Pauma, Pechanga, Soboba, Twenty-Nine Palms, Temecula, Lumbee, Lummi, Maidu, Mountain Maidu, Nishinam, Makah, Maliseet, Mandan, Mattaponi, Menominee, Miami, Illinois Miami, Indiana Miami, Oklahoma Miami, Miccosukee, Micmac, Aroostook, Mission Indians, Miwok, Modoc, Mohegan, Mono, Nanticoke, Narragansett, Navajo, Alamo Navajo, Canoncito Navajo, Ramah Navajo, Nez Perce, Nomalaki, Northwest Tribes, Alsea, Celilo, Columbia, Kalapuya, Molala, Talakamish, Tenino, Tillamook, Wenatchee, Yahooskin, Omaha, Oregon Athabaskan, Osage, Otoe-Missouria, Ottawa, Burt Lake Ottawa, Michigan Ottawa, Oklahoma Ottawa, Paiute, Bishop, Bridgeport, Burns Paiute, Cedarville, Fort Bidwell, Fort Independence, Kaibab, Las Vegas, Lone Pine, Lovelock, Malheur Paiute, Moapa, Northern Paiute, Owens Valley, Pyramid Lake, San Juan Southern Paiute, Southern Paiute, Summit Lake, Utu Utu Gwaitu Paiute, Walker River, Yerington Paiute, Pamunkey, Passamaquoddy, Indian Township, Pleasant Point Passamaquoddy, Pawnee, Oklahoma Pawnee, Penobscot, Peoria, Oklahoma Peoria, Pequot, Marshantucket Pequot, Pima, Gila River Pima-Maricopa, Salt River Pima-Maricopa, Piscataway, Pit River, Pomo, Central Pomo, Dry Creek, Eastern Pomo, Kashia, Northern Pomo, Scotts Valley, Stonyford, Sulphur Bank, Ponca, Nebraska Ponca, Oklahoma Ponca, Potawatomi, Citizen Band Potawatomi, Forest County, Hannahville, Huron Potawatomi, Pokagon Potawatomi, Prairie Band, Wisconsin Potawatomi, Powhatan, Pueblo, Acoma, Arizona Tewa, Cochiti, Hopi, Isleta, Jemez, Keres, Laguna, Nambe, Picuris, Piro, Pojoaque, San Felipe, San Ildefonso, San Juan Pueblo, San Juan De, San Juan, Sandia, Santa Ana, Santa Clara, Santo Domingo, Taos, Tesuque, Tewa, Tigua, Zia, Zuni, Puget Sound Salish, Duwamish, Kikiallus, Lower Skagit, Muckleshoot, Nisqually, Nooksack, Port Madison, Puyallup, Samish, Sauk-Suiattle, Skokomish, Skykomish, Snohomish, Snoqualmie, Squaxin Island, Steilacoom, Stillaguamish, Suquamish, Swinomish, Tulalip, Upper Skagit, Quapaw, Quinault, Rappahannock, Reno-Sparks, Round Valley, Sac and Fox, Iowa Sac and Fox, Missouri Sac and Fox, Oklahoma Sac and Fox, Salinan, Salish, Salish and Kootenai, Schaghticoke, Scott Valley, Seminole, Big Cypress, Brighton, Florida Seminole, Hollywood Seminole, Oklahoma Seminole, Serrano, San Manual, Shasta, Shawnee, Absentee Shawnee, Eastern Shawnee, Shinnecock, Shoalwater Bay, Shoshone, Battle Mountain, Duckwater, Elko, Ely, Goshute, Panamint, Ruby Valley, Skull Valley, South Fork Shoshone, Te-Moak Western Shoshone, Timbi-Sha Shoshone, Washakie, Wind River Shoshone, Yomba, Shoshone Paiute, Duck Valley, Fallon, Fort McDermitt, Siletz, Sioux, Blackfoot Sioux, Brule Sioux, Cheyenne River Sioux, Crow Creek Sioux, Dakota Sioux, Flandreau Santee, Fort Peck, Lake Traverse Sioux, Lower Brule Sioux, Lower Sioux, Mdewakanton Sioux, Miniconjou, Oglala Sioux, Pine Ridge Sioux, Pipestone Sioux, Prairie Island Sioux, Prior Lake Sioux, Rosebud Sioux, Sans Arc Sioux, Santee Sioux, Sisseton-Wahpeton, Sisseton Sioux, Spirit Lake Sioux, Standing Rock Sioux, Teton Sioux, Two Kettle Sioux, Upper Sioux, Wahpekute Sioux, Wahpeton Sioux, Wazhaza Sioux, Yankton Sioux, Yanktonai Sioux, Siuslaw, Spokane, Stewart, Stockbridge, Susanville, Tohono O'Odham, Ak-Chin, Gila Bend, San Xavier, Sells, Tolowa, Tonkawa, Tygh, Umatilla, Umpqua, Cow Creek Umpqua, Ute, Allen Canyon, Uintah Ute, Ute Mountain Ute, Wailaki, Walla-Walla, Wampanoag, Gay Head Wampanoag, Mashpee Wampanoag, Warm Springs, Wascopum, Washoe, Alpine, Carson, Dresslerville, Wichita, Wind River, Winnebago, Ho-chunk, Nebraska Winnebago, Winnemucca, Wintun, Wiyot, Table Bluff, Yakama, Yakama Cowlitz, Yaqui, Barrio Libre, Pascua Yaqui, Yavapai Apache, Yokuts, Chukchansi, Tachi, Tule River, Yuchi, Yuman, Cocopah, Havasupai, Hualapai, Maricopa, Mohave, Quechan, Yavapai, Yurok, Coast Yurok, Alaska Native, Alaska Indian, Alaskan Athabascan, Ahtna, Alatna, Alexander, Allakaket, Alanvik, Anvik, Arctic, Beaver, Birch Creek, Cantwell, Chalkyitsik, Chickaloon, Chistochina, Chitina, Circle, Cook Inlet, Copper Center, Copper River, Dot Lake, Doyon, Eagle, Eklutna, Evansville, Fort Yukon, Gakona, Galena, Grayling, Gulkana, Healy Lake, Holy Cross, Hughes, Huslia, Iliamna, Kaltag, Kluti Kaah, Knik, Koyukuk, Lake Minchumina, Lime, Mcgrath, Manley Hot Springs, Mentasta Lake, Minto, Nenana, Nikolai, Ninilchik, Nondalton, Northway, Nulato, Pedro Bay, Rampart, Ruby, Salamatof, Seldovia, Slana, Shageluk, Stevens, Stony River, Takotna, Tanacross, Tanaina, Tanana, Tanana Chiefs, Tazlina, Telida, Tetlin, Tok, Tyonek, Venetie, Wiseman, Southeast Alaska, Tlingit-Haida, Angoon, Central Council of Tlingit and Haida Tribes, Chilkat, Chilkoot, Craig, Douglas, Haida, Hoonah, Hydaburg, Kake, Kasaan, Kenaitze, Ketchikan, Klawock, Pelican, Petersburg, Saxman, Sitka, Tenakee Springs, Tlingit, Wrangell, Yakutat, Tsimshian, Metlakatla, Eskimo, Greenland Eskimo, Inupiat Eskimo, Ambler, Anaktuvuk, Anaktuvuk Pass, Arctic Slope Inupiat, Arctic Slope Corporation, Atqasuk, Barrow, Bering Straits Inupiat, Brevig Mission, Buckland, Chinik, Council, Deering, Elim, Golovin, Inalik Diomede, Inupiaq, Kaktovik, Kawerak, Kiana, Kivalina, Kobuk, Kotzebue, Koyuk, Kwiguk, Mauneluk Inupiat, Nana Inupiat, Noatak, Nome, Noorvik, Nuiqsut, Point Hope, Point Lay, Selawik, Shaktoolik, Shishmaref, Shungnak, Solomon, Teller, Unalakleet, Wainwright, Wales, White Mountain, White Mountain Inupiat, Mary's Igloo, Siberian Eskimo, Gambell, Savoonga, Siberian Yupik, Yupik Eskimo, Akiachak, Akiak, Alakanuk, Aleknagik, Andreafsky, Aniak, Atmautluak, Bethel, Bill Moore's Slough, Bristol Bay Yupik, Calista Yupik, Chefornak, Chevak, Chuathbaluk, Clark's Point, Crooked Creek, Dillingham, Eek, Ekuk, Ekwok, Emmonak, Goodnews Bay, Hooper Bay, Iqurmuit (Russian Mission), Kalskag, Kasigluk, Kipnuk, Koliganek, Kongiganak, Kotlik, Kwethluk, Kwigillingok, Levelock, Lower Kalskag, Manokotak, Marshall, Mekoryuk, Mountain Village, Naknek, Napaumute, Napakiak, Napaskiak, Newhalen, New Stuyahok, Newtok, Nightmute, Nunapitchukv, Oscarville, Pilot Station, Pitkas Point, Platinum, Portage Creek, Quinhagak, Red Devil, St. Michael, Scammon Bay, Sheldon's Point, Sleetmute, Stebbins, Togiak, Toksook, Tulukskak, Tuntutuliak, Tununak, Twin Hills, Georgetown, St. Mary's, Umkumiate, Aleut, Alutiiq Aleut, Tatitlek, Ugashik, Bristol Bay Aleut, Chignik, Chignik Lake, Egegik, Igiugig, Ivanof Bay, King Salmon, Kokhanok, Perryville, Pilot Point, Port Heiden, Chugach Aleut, Chenega, Chugach Corporation, English Bay, Port Graham, Eyak, Koniag Aleut, Akhiok, Agdaagux, Karluk, Kodiak, Larsen Bay, Old Harbor, Ouzinkie, Port Lions, Sugpiaq, Suqpigaq, Unangan Aleut, Akutan, Aleut Corporation, Aleutian, Aleutian Islander, Atka, Belkofski, Chignik Lagoon, King Cove, False Pass, Nelson Lagoon, Nikolski, Pauloff Harbor, Qagan Toyagungin, Qawalangin, St. George, St. Paul, Sand Point, South Naknek, Unalaska, Unga, Asian, Asian Indian, Bangladeshi, Bhutanese, Burmese, Cambodian, Chinese, Taiwanese, Filipino, Hmong, Indonesian, Japanese, Korean, Laotian, Malaysian, Okinawan, Pakistani, Sri Lankan, Thai, Vietnamese, Iwo Jiman, Maldivian, Nepalese, Singaporean, Madagascar, Black or African American, Black, African American, African, Botswanan, Ethiopian, Liberian, Namibian, Nigerian, Zairean, Bahamian, Barbadian, Dominican, Dominica Islander, Haitian, Jamaican, Tobagoan, Trinidadian, West Indian, Native Hawaiian or Other Pacific Islander, Polynesian, Native Hawaiian, Samoan, Tahitian, Tongan, Tokelauan, Micronesian, Guamanian or Chamorro, Guamanian, Chamorro, Mariana Islander, Marshallese, Palauan, Carolinian, Kosraean, Pohnpeian, Saipanese, Kiribati, Chuukese, Yapese, Melanesian, Fijian, Papua New Guinean, Solomon Islander, New Hebrides, White, European, Armenian, English, French, German, Irish, Italian, Polish, Scottish, Middle Eastern or North African, Assyrian, Egyptian, Iranian, Iraqi, Lebanese, Palestinian, Syrian, Afghanistani, Israeili, Arab, Other Race, Other Pacific Islander

Ethnicity:

Hispanic or Latino, Spaniard, Andalusian, Asturian, Castillian, Catalonian, Belearic Islander, Gallego, Valencian, Canarian, Spanish Basque, Mexican, Mexican American, Mexicano, Chicano, La Raza, Mexican American Indian, Central American, Costa Rican, Guatemalan, Honduran, Nicaraguan, Panamanian, Salvadoran, Central American Indian, Canal Zone, South American, Argentinean, Bolivian, Chilean, Colombian, Ecuadorian, Paraguayan, Peruvian, Uruguayan, Venezuelan, South American Indian, Criollo, Latin American, Puerto Rican, Cuban, Dominican, Not Hispanic or Latino

'''PREVIOUS NOTES'''
(none)

'''DEVELOPMENT STATUS'''
(Add details here)

'''ACTION ITEMS / NEXT STEPS'''

'''OPEN ISSUES / QUESTIONS'''
(Add details here)

MU Stage1 Final Rule - Drug-Drug Drug-Allergy Checks

2010-12-12T23:16:42Z

Anthracite:

'''SECTION # '''
Section 170.302(a)—Drug-Drug, Drug-Allergy, Drug-Formulary Checks

'''MU OBJECTIVE'''
Implement drug-drug and drug-allergy interaction checks

'''MU STAGE 1 MEASURE'''
The EP/eligible hospital/CAH has enabled this functionality for the entire EHR reporting period

'''CERTIFICATION CRITERION'''
Final Rule Text: §170.302(a).
(1) Notifications. Automatically and electronically generate and indicate in real-time, notifications at the point of care for drug- drug and drug-allergy contraindications based on medication list, medication allergy list, and computerized provider order entry (CPOE).
(2) Adjustments. Provide certain users with the ability to adjust notifications provided for drug-drug and drug-allergy interaction checks.

'''STANDARDS'''
N/A

'''TEST CRITERIA #'''
§170.302 (a)
http://healthcare.nist.gov/docs/170.302.a_DrugDrugDrugAllergy_v1.1.pdf
{| class="grey" border="1" cellpadding="2"
! USERS
! CORE / MENU
! SOLUTION DEVELOPERS
! STATUS
|-
| All
| CORE
| Oroville
| In development
|}
----
'''SOLUTION DESIGN / TECHNOLOGY'''
(Add details here)

'''SOLUTION COMPONENTS'''
(Add details here - Ex. KIDS patch, Delphi code, User guide, Web resources, Manual test script, etc)

'''DEPENDENCIES'''
(Add details here)

'''COMMENTS / NOTES'''
(Add details here)

'''PREVIOUS NOTES'''
(none)

'''DEVELOPMENT STATUS'''Although VistA does this now, the need for other interaction checking will be coming and the ability of the purely open source VistA to do this will be leaving because the VA is implementing the use of FirstData and will not be maintaining the interactions in the National Drug File. ePrescribing that is being built by Oroville will need to pick up that function for both patients who have new prescriptions and those who don't as outpatients and it is the current understanding that will not be a problem for outpatients.

Drug-Drug interactions are supposed to be editable in a way to allow some users to have them not displayed to avoid "alert fatigue." In version 1.0 of the scripts, editing of the interaction data itself, much like editing the National Drug File or the First Databank database was required. That was corrected.

The commercial drug databases generally allow the system to display varying severity levels of interaction to avoid alert fatigue. That should be possible with ePrescribing for outpatients.

For inpatients using the National Drug File for interaction checking, VistA has the option of locally editing the severity of a drug-drug interaction from "significant" to "critical" and then allowing the display of significant reactions to be optional. It is in the Drug Interactions Menu which includes several local drug interaction editing options that are quite limited.

Enter/Edit Local Drug Interaction [PSS INTERACTION LOCAL ADD] option will be deleted with pharmacy re-engineering in the VA. In the US, the requirement for use of a commercial drug database is almost certain if we can't identify or create and open source interaction database or the National Library of Medicine does not get involved, which is not likely as that would cause an uproar and a massive increase in lobbying, but overseas, the need for using the National Drug File Inteactions or something like it in places that cannot afford a commercial drug database will continue so NOT deleting that menu item should be considered seriously outside of the VA.

A link to a document describing how to do that needs to be added here.Please creating such a document and add it here! A link to a file with a screen shot that can help found here
http://download.opensourcevista.net/downloads/SignificantDrugInteractionTurnOff.doc
and the the use of the local drug interaction menu items should help someone write that document.

A document describing adding and allergy, marking it entered in error and also editing an entry in the roll and scroll instead of marking it entered in error and reentering it with corrections can be found at this link:

http://download.opensourcevista.net/downloads/Drug-Drug_Drug-Allergy302a.doc

It is it very interesting that the description of of an observed vs. historical reaction is different and more in line with what physicians generally expect in the roll and scroll versus what is in CPRS when it comes to entering allergies. CPRS describes Historical as something of no significance any longer (paraphrasing) and the roll and scroll describes it as "historical data gathered by the patient. Nancy will see if she can get some information about this from the VA to see if it might be something that will be changed in the future. If not, we might consider changing it.

To quote, CPRS has

"HISTORICAL: reported by patient as occurring in the past. No longer requires intervention" (See the yellow highlighting in the document).

CPRS also has "OBSERVED: directly observed and occurring while the patient was on the suspected causative agent. Use for new information about an allergy/adverse reaction and for recent reactions caused by VA-prescribed medications."

This, too, is also not quite right for our purposes, or frankly, I would think also not for the VA's use either.

Meaningful Use criteria requires that certain allergies be able to be changed and implies that they not be displayed for certain users. Nancy Anthracite has written to the Office of the National Coordinator as this is almost certainly a mistake and just an inadvertent spillover from the desire to mark particular Drug/Drug interactions not to display for certain users to avoid "Alert Fatigue".

Nancy has proposed that we not put any work into adding this functionality to VistA in hopes that ONC testers will accept being able to edit an allergy as sufficient to pass because this is something we DO NOT WANT VISTA TO DO!

If we elect to write code for this, Nancy thinks we make that one of the last things we do as it is likely to be removed when the 1.2 criteria are released and it would be a shame to waste a lot of effort on something nobody should ever use.

There is information in the roll and scroll which might help with the mapping of the allergies to meds to RxNorm. See the green highlighting.

'''ACTION ITEMS / NEXT STEPS'''
(Add details here)

'''OPEN ISSUES / QUESTIONS'''
(Add details here)

MU Stage1 Final Rule - Drug-Drug Drug-Allergy Checks

2010-12-12T23:04:59Z

Anthracite:

'''SECTION # '''
Section 170.302(a)—Drug-Drug, Drug-Allergy, Drug-Formulary Checks

'''MU OBJECTIVE'''
Implement drug-drug and drug-allergy interaction checks

'''MU STAGE 1 MEASURE'''
The EP/eligible hospital/CAH has enabled this functionality for the entire EHR reporting period

'''CERTIFICATION CRITERION'''
Final Rule Text: §170.302(a).
(1) Notifications. Automatically and electronically generate and indicate in real-time, notifications at the point of care for drug- drug and drug-allergy contraindications based on medication list, medication allergy list, and computerized provider order entry (CPOE).
(2) Adjustments. Provide certain users with the ability to adjust notifications provided for drug-drug and drug-allergy interaction checks.

'''STANDARDS'''
N/A

'''TEST CRITERIA #'''
§170.302 (a)
http://healthcare.nist.gov/docs/170.302.a_DrugDrugDrugAllergy_v1.1.pdf
{| class="grey" border="1" cellpadding="2"
! USERS
! CORE / MENU
! SOLUTION DEVELOPERS
! STATUS
|-
| All
| CORE
| Oroville
| In development
|}
----
'''SOLUTION DESIGN / TECHNOLOGY'''
(Add details here)

'''SOLUTION COMPONENTS'''
(Add details here - Ex. KIDS patch, Delphi code, User guide, Web resources, Manual test script, etc)

'''DEPENDENCIES'''
(Add details here)

'''COMMENTS / NOTES'''
(Add details here)

'''PREVIOUS NOTES'''
(none)

'''DEVELOPMENT STATUS'''Although VistA does this now, the need for other interaction checking will be coming and the ability of the purely open source VistA to do this will be leaving because the VA is implementing the use of FirstData and will not be maintaining the interactions in the National Drug File. ePrescribing that is being built by Oroville will need to pick up that function for both patients who have new prescriptions and those who don't.

Drug-Drug interactions are supposed to be editable in a way to allow some users to have them not displayed to avoid "alert fatigue." In version 1.0 of the scripts, editing of the interaction data itself, much like editing the National Drug File or the First Databank database was required. That was corrected.

The commercial drug databases generally allow the system to display varying severity levels of interaction to avoid alert fatigue.

VistA has the option of locally editing the severity of a drug-drug interaction from "significant" to "critical" and then allowing the display of significant reactions to be optional. It is in the Drug Interactions Menu which includes several local drug interaction editing options that are quite limited.

Enter/Edit Local Drug Interaction [PSS INTERACTION LOCAL ADD] option will be deleted with pharmacy re-engineering in the VA. In the US, the requirement for use of a commercial drug database is almost certain if we can't identify or create and open source interaction database or the National Library of Medicine does not get involved, which is not likely as that would cause an uproar and a massive increase in lobbying, but overseas, the need for using the National Drug File Inteactions or something like it in places that cannot afford a commercial drug database will continue so NOT deleting that menu item should be considered seriously outside of the VA.

A link to a document describing how to do that needs to be added here.Please creating such a document and adding it here! A link to a file with a screen shot that can help and the the use of the local drug interaction menu items should help someone write that document.

A document describing adding and allergy, marking it entered in error and also editing an entry in the roll and scroll instead of marking it entered in error and reentering it with corrections can be found at this link:

http://download.opensourcevista.net/downloads/Drug-Drug_Drug-Allergy302a.doc

It is it very interesting that the description of of an observed vs. historical reaction is different and more in line with what physicians generally expect in the roll and scroll versus what is in CPRS when it comes to entering allergies. CPRS describes Historical as something of no significance any longer (paraphrasing) and the roll and scroll describes it as "historical data gathered by the patient. Nancy will see if she can get some information about this from the VA to see if it might be something that will be changed in the future. If not, we might consider changing it.

To quote, CPRS has

"HISTORICAL: reported by patient as occurring in the past. No longer requires intervention" (See the yellow highlighting in the document).

CPRS also has "OBSERVED: directly observed and occurring while the patient was on the suspected causative agent. Use for new information about an allergy/adverse reaction and for recent reactions caused by VA-prescribed medications."

This, too, is also not quite right for our purposes, or frankly, I would think also not for the VA's use either.

Meaningful Use criteria requires that certain allergies be able to be changed and implies that they not be displayed for certain users. Nancy Anthracite has written to the Office of the National Coordinator as this is almost certainly a mistake and just an inadvertent spillover from the desire to mark particular Drug/Drug interactions not to display for certain users to avoid "Alert Fatigue".

Nancy has proposed that we not put any work into adding this functionality to VistA in hopes that ONC testers will accept being able to edit an allergy as sufficient to pass because this is something we DO NOT WANT VISTA TO DO!

If we elect to write code for this, Nancy thinks we make that one of the last things we do as it is likely to be removed when the 1.2 criteria are released and it would be a shame to waste a lot of effort on something nobody should ever use.

There is information in the roll and scroll which might help with the mapping of the allergies to meds to RxNorm. See the green highlighting.

'''ACTION ITEMS / NEXT STEPS'''
(Add details here)

'''OPEN ISSUES / QUESTIONS'''
(Add details here)

MU Stage1 Final Rule - Drug-Drug Drug-Allergy Checks

2010-12-12T23:01:54Z

Anthracite:

'''SECTION # '''
Section 170.302(a)—Drug-Drug, Drug-Allergy, Drug-Formulary Checks

'''MU OBJECTIVE'''
Implement drug-drug and drug-allergy interaction checks

'''MU STAGE 1 MEASURE'''
The EP/eligible hospital/CAH has enabled this functionality for the entire EHR reporting period

'''CERTIFICATION CRITERION'''
Final Rule Text: §170.302(a).
(1) Notifications. Automatically and electronically generate and indicate in real-time, notifications at the point of care for drug- drug and drug-allergy contraindications based on medication list, medication allergy list, and computerized provider order entry (CPOE).
(2) Adjustments. Provide certain users with the ability to adjust notifications provided for drug-drug and drug-allergy interaction checks.

'''STANDARDS'''
N/A

'''TEST CRITERIA #'''
§170.302 (a)
http://healthcare.nist.gov/docs/170.302.a_DrugDrugDrugAllergy_v1.1.pdf
{| class="grey" border="1" cellpadding="2"
! USERS
! CORE / MENU
! SOLUTION DEVELOPERS
! STATUS
|-
| All
| CORE
| Oroville
| In development
|}
----
'''SOLUTION DESIGN / TECHNOLOGY'''
(Add details here)

'''SOLUTION COMPONENTS'''
(Add details here - Ex. KIDS patch, Delphi code, User guide, Web resources, Manual test script, etc)

'''DEPENDENCIES'''
(Add details here)

'''COMMENTS / NOTES'''
(Add details here)

'''PREVIOUS NOTES'''
(none)

'''DEVELOPMENT STATUS'''Although VistA does this now, the need for other interaction checking will be coming and the ability of the purely open source VistA to do this will be leaving because the VA is implementing the use of FirstData and will not be maintaining the interactions in the National Drug File. ePrescribing that is being built by Oroville will need to pick up that function for both patients who have new prescriptions and those who don't.

Drug-Drug interactions are supposed to be editable in a way to allow some users to have them not displayed to avoid "alert fatigue." In version 1.0 of the scripts, editing of the interaction data itself, much like editing the National Drug File or the First Databank database was required. That was corrected.

The commercial drug databases generally allow the system to display varying severity levels of interaction to avoid alert fatigue.

VistA has the option of locally editing the severity of a drug-drug interaction from "significant" to "critical" and then allowing the display of significant reactions to be optional. Enter/Edit Local Drug Interaction [PSS INTERACTION LOCAL ADD] option will be deleted with pharmacy re-engineering in the VA. In the US, the requirement for use of a commercial drug database is almost certain if we can't identify or create and open source interaction database or the NLM does not get involved, which is not likely as that would cause an uproar and a massive increase in lobbying, but overseas, the need for using the NDF or something like it in places that cannot afford a commercial drug database will continue so NOT deleting that menu item should be considered seriously outside of the VA.

A link to a document describing how to do that needs to be added here.Please creating such a document and adding it here! A link to a file with a screen shot that can help and the the use of the local drug interaction menu items should help someone write that document.

A document describing adding and allergy, marking it entered in error and also editing an entry in the roll and scroll instead of marking it entered in error and reentering it with corrections can be found at this link:

http://download.opensourcevista.net/downloads/Drug-Drug_Drug-Allergy302a.doc

It is it very interesting that the description of of an observed vs. historical reaction is different and more in line with what physicians generally expect in the roll and scroll versus what is in CPRS when it comes to entering allergies. CPRS describes Historical as something of no significance any longer (paraphrasing) and the roll and scroll describes it as "historical data gathered by the patient. Nancy will see if she can get some information about this from the VA to see if it might be something that will be changed in the future. If not, we might consider changing it.

To quote, CPRS has

"HISTORICAL: reported by patient as occurring in the past. No longer requires intervention" (See the yellow highlighting in the document).

CPRS also has "OBSERVED: directly observed and occurring while the patient was on the suspected causative agent. Use for new information about an allergy/adverse reaction and for recent reactions caused by VA-prescribed medications."

This, too, is also not quite right for our purposes, or frankly, I would think also not for the VA's use either.

Meaningful Use criteria requires that certain allergies be able to be changed and implies that they not be displayed for certain users. Nancy Anthracite has written to the Office of the National Coordinator as this is almost certainly a mistake and just an inadvertent spillover from the desire to mark particular Drug/Drug interactions not to display for certain users to avoid "Alert Fatigue".

Nancy has proposed that we not put any work into adding this functionality to VistA in hopes that ONC testers will accept being able to edit an allergy as sufficient to pass because this is something we DO NOT WANT VISTA TO DO!

If we elect to write code for this, Nancy thinks we make that one of the last things we do as it is likely to be removed when the 1.2 criteria are released and it would be a shame to waste a lot of effort on something nobody should ever use.

There is information in the roll and scroll which might help with the mapping of the allergies to meds to RxNorm. See the green highlighting.

'''ACTION ITEMS / NEXT STEPS'''
(Add details here)

'''OPEN ISSUES / QUESTIONS'''
(Add details here)

MU Stage1 Final Rule - Drug-Drug Drug-Allergy Checks

2010-12-12T22:50:35Z

Anthracite:

'''SECTION # '''
Section 170.302(a)—Drug-Drug, Drug-Allergy, Drug-Formulary Checks

'''MU OBJECTIVE'''
Implement drug-drug and drug-allergy interaction checks

'''MU STAGE 1 MEASURE'''
The EP/eligible hospital/CAH has enabled this functionality for the entire EHR reporting period

'''CERTIFICATION CRITERION'''
Final Rule Text: §170.302(a).
(1) Notifications. Automatically and electronically generate and indicate in real-time, notifications at the point of care for drug- drug and drug-allergy contraindications based on medication list, medication allergy list, and computerized provider order entry (CPOE).
(2) Adjustments. Provide certain users with the ability to adjust notifications provided for drug-drug and drug-allergy interaction checks.

'''STANDARDS'''
N/A

'''TEST CRITERIA #'''
§170.302 (a)
http://healthcare.nist.gov/docs/170.302.a_DrugDrugDrugAllergy_v1.1.pdf
{| class="grey" border="1" cellpadding="2"
! USERS
! CORE / MENU
! SOLUTION DEVELOPERS
! STATUS
|-
| All
| CORE
| Oroville
| In development
|}
----
'''SOLUTION DESIGN / TECHNOLOGY'''
(Add details here)

'''SOLUTION COMPONENTS'''
(Add details here - Ex. KIDS patch, Delphi code, User guide, Web resources, Manual test script, etc)

'''DEPENDENCIES'''
(Add details here)

'''COMMENTS / NOTES'''
(Add details here)

'''PREVIOUS NOTES'''
(none)

'''DEVELOPMENT STATUS'''Although VistA does this now, the need for other interaction checking will be coming and the ability of the purely open source VistA to do this will be leaving because the VA is implementing the use of FirstData and will not be maintaining the interactions in the National Drug File. ePrescribing that is being built by Oroville will need to pick up that function for both patients who have new prescriptions and those who don't.

Drug-Drug interactions are supposed to be editable in a way to allow some users to have them not displayed to avoid "alert fatigue." In version 1.0 of the scripts, editing of the interaction data itself, much like editing the National Drug File or the First Databank database was required. That was corrected.

The commercial drug databases generally allow the system to display varying severity levels of interaction to avoid alert fatigue.

VistA has the option of locally editing the severity of a drug-drug interaction from "significant" to "critical" and then allowing the display of significant reactions to be optional.

A link to a document describing how to do that needs to be added here.Please creating such a document and adding it here!

A document describing adding and allergy, marking it entered in error and also editing an entry in the roll and scroll instead of marking it entered in error and reentering it with corrections can be found at this link:

http://download.opensourcevista.net/downloads/Drug-Drug_Drug-Allergy302a.doc

It is it very interesting that the description of of an observed vs. historical reaction is different and more in line with what physicians generally expect in the roll and scroll versus what is in CPRS when it comes to entering allergies. CPRS describes Historical as something of no significance any longer (paraphrasing) and the roll and scroll describes it as "historical data gathered by the patient. Nancy will see if she can get some information about this from the VA to see if it might be something that will be changed in the future. If not, we might consider changing it.

To quote, CPRS has

"HISTORICAL: reported by patient as occurring in the past. No longer requires intervention" (See the yellow highlighting in the document).

CPRS also has "OBSERVED: directly observed and occurring while the patient was on the suspected causative agent. Use for new information about an allergy/adverse reaction and for recent reactions caused by VA-prescribed medications."

This, too, is also not quite right for our purposes, or frankly, I would think also not for the VA's use either.

Meaningful Use criteria requires that certain allergies be able to be changed and implies that they not be displayed for certain users. Nancy Anthracite has written to the Office of the National Coordinator as this is almost certainly a mistake and just an inadvertent spillover from the desire to mark particular Drug/Drug interactions not to display for certain users to avoid "Alert Fatigue".

Nancy has proposed that we not put any work into adding this functionality to VistA in hopes that ONC testers will accept being able to edit an allergy as sufficient to pass because this is something we DO NOT WANT VISTA TO DO!

If we elect to write code for this, Nancy thinks we make that one of the last things we do as it is likely to be removed when the 1.2 criteria are released and it would be a shame to waste a lot of effort on something nobody should ever use.

There is information in the roll and scroll which might help with the mapping of the allergies to meds to RxNorm. See the green highlighting.

'''ACTION ITEMS / NEXT STEPS'''
(Add details here)

'''OPEN ISSUES / QUESTIONS'''
(Add details here)

MU Stage1 Final Rule - Drug-Drug Drug-Allergy Checks

2010-12-12T22:40:48Z

Anthracite:

MU Stage1 Final Rule - Drug-Drug Drug-Allergy Checks

2010-12-12T22:39:13Z

Anthracite:

MU Stage1 Final Rule - Drug-Drug Drug-Allergy Checks

2010-12-12T22:38:38Z

Anthracite:

MU Stage1 Final Rule - Record Demographics (EP)

2010-12-09T13:35:10Z

Anthracite:

'''SECTION # '''
Section 170.304(c)—Record Demographics

'''MU OBJECTIVE'''
Record demographics:
• preferred language
• gender
• race
• ethnicity
• date of birth

'''MU STAGE 1 MEASURE'''
More than 50% of all unique patients seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) have demographics recorded as structured data

'''CERTIFICATION CRITERION'''
Final Rule Text: §170.304(c).
Record demographics. Enable a user to electronically record, modify, and retrieve patient demographic data including preferred language, gender, race, ethnicity, and date of birth. Enable race and ethnicity to be recorded in accordance with the standard specified at 170.207(f).

'''STANDARDS'''
170.207(f)
http://www.whitehouse.gov/omb/fedreg_1997standards/

'''TEST CRITERIA #'''
§170.304(c)
http://healthcare.nist.gov/docs/170.304.c_RecordDemographicsAmb_v1.1.pdf
{| class="grey" border="1" cellpadding="2"
! USERS
! CORE / MENU
! SOLUTION DEVELOPERS
! STATUS
|-
| EP
| CORE
| TBD
| TBD
|}
----
'''SOLUTION DESIGN / TECHNOLOGY'''
(Add details here)

'''SOLUTION COMPONENTS'''
(Add details here - Ex. KIDS patch, Delphi code, User guide, Web resources, Manual test script, etc)

'''DEPENDENCIES'''
(Add details here)

'''COMMENTS / NOTES'''

At a minimum, the values in following three sections (Race, Ethnicity, Language) must be supported in some way for certification testing.

Race 
- American Indian or Alaska Native 
- Asian 
- Black or African American 
- Native Hawaiian or Other Pacific Islander 
- White 

(the above race values are mentioned in the NIST test criteria. Peter Bodtke)

Ethnicity: 
- Hispanic or Latino 
- Not Hispanic or Latino 

(the above ethnicity values are mentioned in the NIST test criteria. Peter Bodtke)

Language: 
English 
Japanese 
French 
Italian 
Portuguese 
Russian 

(the above ethnicity values are mentioned in the NIST test criteria. Peter Bodtke)

[Below Nancy Anthracite has noted the inconsistencies between the NIST test criteria demographic values (referenced with a broken link and described as "OMB Standards for Maintaining, Collecting, and Presenting Federal Data") and data provided as part of the Physician Quality Reporting Initiative program.]

Race and ethnicity required for quality reporting has not been harmonized by with the Meaningful use requirements by the Office of the National Coordinator for Health IT. A query regarding this has been sent to the ONC.
In general, there has been general movement in the direction of harmonization but this seems to have escaped scrutiny.

For now, what WorldVistA has done is to follow the race and ethnicity standards that are specified by Meaningful Use for PQRI as the same entries are duplicaed in the extendsive list for the PQRI reporting. Thus, they will be valid entries for PQRI.

1. VistA does not record preferred language at this point and it will be desirable to pick some sort of reasonable standard list of languages to standardize against across the community of VistA users. Also, to my mind just preferred language is not enough. With requirements for translators to be provided in certain circumstances, it is not enough to know, for instance, if Spanish is the preferred language without knowing if a translator is need and if the patient will provide a translator, so this sounds simple, but it is not so simple. This is worth discussing in the community to get suggestions as it would be desirable to end up with some computable data, not just a free text field to fill this requirement. In addition, there is the whole question of International Use and translation of VistA. We have folks trying to figure out a way to move forward with what is needed for Meaningful Use in a manner that will support that effort and to do that, the bigger picture is being explored by Dave Whitten, Kevin Toppenberg and Chris Richardson. If you have an interest in the subject of translating VistA, please send an email to info at worldvista dot org and we will get you involved in the discussion.

Medsphere provided the information that IHS is planning to use the ISO standard in file 9999999.99 for language and that OpenVista will do the same. We would like to see all flavors of VistA aligned on this so Nancy Anthracite is exploring whether or not the VA plans to do the same or if they would consider using the same file and standard. A copy of the ISO standard can be found here: http://www.loc.gov/standards/iso639-2/ascii_8bits.html

2. Race and Ethnicity was defined by the ONC for Meaningful Use, but so was quality reporting and the race and ethnicity required for quality reporting is daunting. I am happy to see that race has been expanded to stop using just various Hispanic peoples and not much else, but recording 900+ of what I would think is not race and ethnicity but ethnicity one and ethnicity two choices with no guidance how to handle those of mixed "race" seems rather ridiculous but even more disturbing, and invasion of privacy. This has been brought to the attention of the ONC but there has been no response to a query about that. In the meantime, you can see what the requirements for Quality Reporting are in the following two lists of race and ethnicity

Race:
American Indian or Alaska Native, American Indian, Abenaki, Algonquian, Apache, Chiricahua, Fort Sill Apache, Jicarilla Apache, Lipan Apache, Mescalero Apache, Oklahoma Apache, Payson Apache, San Carlos Apache, White Mountain Apache, Arapaho, Northern Arapaho, Southern Arapaho, Wind River Arapaho, Arikara, Assiniboine, Assiniboine Sioux, Fort Peck Assiniboine Sioux, Bannock, Blackfeet, Brotherton, Burt Lake Band, Caddo, Oklahoma Cado, Cahuilla, Agua Caliente Cahuilla, Augustine, Cabazon, Los Coyotes, Morongo, Santa Rosa Cahuilla, Torres-Martinez, California Tribes, Cahto, Chimariko, Coast Miwok, Digger, Kawaiisu, Kern River, Mattole, Red Wood, Santa Rosa, Takelma, Wappo, Yana, Yuki, Canadian and Latin American Indian, Canadian Indian, Central American Indian, French American Indian, Mexican American Indian, South American Indian, Spanish American Indian, Catawba, Cayuse, Chehalis, Chemakuan, Hoh, Quileute, Chemehuevi, Cherokee, Cherokee Alabama, Cherokees of Northeast Alabama, Cherokees of Southeast Alabama, Eastern Cherokee, Echota Cherokee, Etowah Cherokee, Northern Cherokee, Tuscola, United Keetowah Band of Cherokee, Western Cherokee, Cherokee Shawnee, Cheyenne, Northern Cheyenne, Southern Cheyenne, Cheyenne-Arapaho, Chickahominy, Eastern Chickahominy, Western Chickahominy, Chickasaw, Chinook, Clatsop, Columbia River Chinook, Kathlamet, Upper Chinook, Wakiakum Chinook, Willapa Chinook, Wishram, Chippewa, Bad River, Bay Mills Chippewa, Bois Forte, Burt Lake Chippewa, Fond du Lac, Grand Portage, Grand Traverse Band of Ottawa-Chippewa, Keweenaw, Lac Courte Oreilles, Lac du Flambeau, Lac Vieux Desert Chippewa, Lake Superior, Leech Lake, Little Shell Chippewa, Mille Lacs, Minnesota Chippewa, Ontonagon, Red Cliff Chippewa, Red Lake Chippewa, Saginaw Chippewa, St. Croix Chippewa, Sault Ste. Marie Chippewa, Sokoagon Chippewa, Turtle Mountain, White Earth, Chippewa Cree, Rocky Boy's Chippewa Cree, Chitimacha, Choctaw, Clifton Choctaw, Jena Choctaw, Mississippi Choctaw, Mowa Band of Choctaw, Oklahoma Choctaw, Chumash, Santa Ynez, Clear Lake, Coeur D'Alene, Coharie, Colorado River, Colville, Comanche, Oklahoma Comanche, Coos, Lower Umpqua, Siuslaw, Coos, Coquilles, Costanoan, Coushatta, Alabama Coushatta, Cowlitz, Cree, Creek, Alabama Creek, Alabama Quassarte, Eastern Creek, Eastern Muscogee, Kialegee, Lower Muscogee, Machis Lower Creek Indian, Poarch Band, Principal Creek Indian Nation, Star Clan of Muscogee Creeks, Thlopthlocco, Tuckabachee, Croatan, Crow, Cupeno, Agua Caliente, Delaware, Eastern Delaware, Lenni-Lenape, Munsee, Oklahoma Delaware, Rampough Mountain, Sand Hill, Diegueno, Campo, Capitan Grande, Cuyapaipe, La Posta, Manzanita, Mesa Grande, San Pasqual, Santa Ysabel, Sycuan, Eastern Tribes, Attacapa, Biloxi, Georgetown, Moor, Nansemond, Natchez, Nausu Waiwash, Nipmuc, Paugussett, Pocomoke Acohonock, Southeastern Indians, Susquehanock, Tunica Biloxi, Waccamaw-Siousan, Wicomico, Esselen, Fort Belknap, Fort Berthold, Fort Mcdowell, Fort Hall, Gabrieleno, Grand Ronde, Gros Ventres, Atsina, Haliwa, Hidatsa, Hoopa, Trinity, Whilkut, Hoopa Extension, Houma, Inaja-Cosmit, Iowa, Iowa of Kansas-Nebraska, Iowa of Oklahoma, Iroquois, Cayuga, Mohawk, Oneida, Onondaga, Seneca, Seneca Nation, Seneca-Cayuga, Tonawanda Seneca, Tuscarora, Wyandotte, Juaneno, Kalispel, Karuk, Kaw, Kickapoo, Oklahoma Kickapoo, Texas Kickapoo, Kiowa, Oklahoma Kiowa, Klallam, Jamestown, Lower Elwha, Port Gamble Klallam, Klamath, Konkow, Kootenai, Lassik, Long Island, Matinecock, Montauk, Poospatuck, Setauket, Luiseno, La Jolla, Pala, Pauma, Pechanga, Soboba, Twenty-Nine Palms, Temecula, Lumbee, Lummi, Maidu, Mountain Maidu, Nishinam, Makah, Maliseet, Mandan, Mattaponi, Menominee, Miami, Illinois Miami, Indiana Miami, Oklahoma Miami, Miccosukee, Micmac, Aroostook, Mission Indians, Miwok, Modoc, Mohegan, Mono, Nanticoke, Narragansett, Navajo, Alamo Navajo, Canoncito Navajo, Ramah Navajo, Nez Perce, Nomalaki, Northwest Tribes, Alsea, Celilo, Columbia, Kalapuya, Molala, Talakamish, Tenino, Tillamook, Wenatchee, Yahooskin, Omaha, Oregon Athabaskan, Osage, Otoe-Missouria, Ottawa, Burt Lake Ottawa, Michigan Ottawa, Oklahoma Ottawa, Paiute, Bishop, Bridgeport, Burns Paiute, Cedarville, Fort Bidwell, Fort Independence, Kaibab, Las Vegas, Lone Pine, Lovelock, Malheur Paiute, Moapa, Northern Paiute, Owens Valley, Pyramid Lake, San Juan Southern Paiute, Southern Paiute, Summit Lake, Utu Utu Gwaitu Paiute, Walker River, Yerington Paiute, Pamunkey, Passamaquoddy, Indian Township, Pleasant Point Passamaquoddy, Pawnee, Oklahoma Pawnee, Penobscot, Peoria, Oklahoma Peoria, Pequot, Marshantucket Pequot, Pima, Gila River Pima-Maricopa, Salt River Pima-Maricopa, Piscataway, Pit River, Pomo, Central Pomo, Dry Creek, Eastern Pomo, Kashia, Northern Pomo, Scotts Valley, Stonyford, Sulphur Bank, Ponca, Nebraska Ponca, Oklahoma Ponca, Potawatomi, Citizen Band Potawatomi, Forest County, Hannahville, Huron Potawatomi, Pokagon Potawatomi, Prairie Band, Wisconsin Potawatomi, Powhatan, Pueblo, Acoma, Arizona Tewa, Cochiti, Hopi, Isleta, Jemez, Keres, Laguna, Nambe, Picuris, Piro, Pojoaque, San Felipe, San Ildefonso, San Juan Pueblo, San Juan De, San Juan, Sandia, Santa Ana, Santa Clara, Santo Domingo, Taos, Tesuque, Tewa, Tigua, Zia, Zuni, Puget Sound Salish, Duwamish, Kikiallus, Lower Skagit, Muckleshoot, Nisqually, Nooksack, Port Madison, Puyallup, Samish, Sauk-Suiattle, Skokomish, Skykomish, Snohomish, Snoqualmie, Squaxin Island, Steilacoom, Stillaguamish, Suquamish, Swinomish, Tulalip, Upper Skagit, Quapaw, Quinault, Rappahannock, Reno-Sparks, Round Valley, Sac and Fox, Iowa Sac and Fox, Missouri Sac and Fox, Oklahoma Sac and Fox, Salinan, Salish, Salish and Kootenai, Schaghticoke, Scott Valley, Seminole, Big Cypress, Brighton, Florida Seminole, Hollywood Seminole, Oklahoma Seminole, Serrano, San Manual, Shasta, Shawnee, Absentee Shawnee, Eastern Shawnee, Shinnecock, Shoalwater Bay, Shoshone, Battle Mountain, Duckwater, Elko, Ely, Goshute, Panamint, Ruby Valley, Skull Valley, South Fork Shoshone, Te-Moak Western Shoshone, Timbi-Sha Shoshone, Washakie, Wind River Shoshone, Yomba, Shoshone Paiute, Duck Valley, Fallon, Fort McDermitt, Siletz, Sioux, Blackfoot Sioux, Brule Sioux, Cheyenne River Sioux, Crow Creek Sioux, Dakota Sioux, Flandreau Santee, Fort Peck, Lake Traverse Sioux, Lower Brule Sioux, Lower Sioux, Mdewakanton Sioux, Miniconjou, Oglala Sioux, Pine Ridge Sioux, Pipestone Sioux, Prairie Island Sioux, Prior Lake Sioux, Rosebud Sioux, Sans Arc Sioux, Santee Sioux, Sisseton-Wahpeton, Sisseton Sioux, Spirit Lake Sioux, Standing Rock Sioux, Teton Sioux, Two Kettle Sioux, Upper Sioux, Wahpekute Sioux, Wahpeton Sioux, Wazhaza Sioux, Yankton Sioux, Yanktonai Sioux, Siuslaw, Spokane, Stewart, Stockbridge, Susanville, Tohono O'Odham, Ak-Chin, Gila Bend, San Xavier, Sells, Tolowa, Tonkawa, Tygh, Umatilla, Umpqua, Cow Creek Umpqua, Ute, Allen Canyon, Uintah Ute, Ute Mountain Ute, Wailaki, Walla-Walla, Wampanoag, Gay Head Wampanoag, Mashpee Wampanoag, Warm Springs, Wascopum, Washoe, Alpine, Carson, Dresslerville, Wichita, Wind River, Winnebago, Ho-chunk, Nebraska Winnebago, Winnemucca, Wintun, Wiyot, Table Bluff, Yakama, Yakama Cowlitz, Yaqui, Barrio Libre, Pascua Yaqui, Yavapai Apache, Yokuts, Chukchansi, Tachi, Tule River, Yuchi, Yuman, Cocopah, Havasupai, Hualapai, Maricopa, Mohave, Quechan, Yavapai, Yurok, Coast Yurok, Alaska Native, Alaska Indian, Alaskan Athabascan, Ahtna, Alatna, Alexander, Allakaket, Alanvik, Anvik, Arctic, Beaver, Birch Creek, Cantwell, Chalkyitsik, Chickaloon, Chistochina, Chitina, Circle, Cook Inlet, Copper Center, Copper River, Dot Lake, Doyon, Eagle, Eklutna, Evansville, Fort Yukon, Gakona, Galena, Grayling, Gulkana, Healy Lake, Holy Cross, Hughes, Huslia, Iliamna, Kaltag, Kluti Kaah, Knik, Koyukuk, Lake Minchumina, Lime, Mcgrath, Manley Hot Springs, Mentasta Lake, Minto, Nenana, Nikolai, Ninilchik, Nondalton, Northway, Nulato, Pedro Bay, Rampart, Ruby, Salamatof, Seldovia, Slana, Shageluk, Stevens, Stony River, Takotna, Tanacross, Tanaina, Tanana, Tanana Chiefs, Tazlina, Telida, Tetlin, Tok, Tyonek, Venetie, Wiseman, Southeast Alaska, Tlingit-Haida, Angoon, Central Council of Tlingit and Haida Tribes, Chilkat, Chilkoot, Craig, Douglas, Haida, Hoonah, Hydaburg, Kake, Kasaan, Kenaitze, Ketchikan, Klawock, Pelican, Petersburg, Saxman, Sitka, Tenakee Springs, Tlingit, Wrangell, Yakutat, Tsimshian, Metlakatla, Eskimo, Greenland Eskimo, Inupiat Eskimo, Ambler, Anaktuvuk, Anaktuvuk Pass, Arctic Slope Inupiat, Arctic Slope Corporation, Atqasuk, Barrow, Bering Straits Inupiat, Brevig Mission, Buckland, Chinik, Council, Deering, Elim, Golovin, Inalik Diomede, Inupiaq, Kaktovik, Kawerak, Kiana, Kivalina, Kobuk, Kotzebue, Koyuk, Kwiguk, Mauneluk Inupiat, Nana Inupiat, Noatak, Nome, Noorvik, Nuiqsut, Point Hope, Point Lay, Selawik, Shaktoolik, Shishmaref, Shungnak, Solomon, Teller, Unalakleet, Wainwright, Wales, White Mountain, White Mountain Inupiat, Mary's Igloo, Siberian Eskimo, Gambell, Savoonga, Siberian Yupik, Yupik Eskimo, Akiachak, Akiak, Alakanuk, Aleknagik, Andreafsky, Aniak, Atmautluak, Bethel, Bill Moore's Slough, Bristol Bay Yupik, Calista Yupik, Chefornak, Chevak, Chuathbaluk, Clark's Point, Crooked Creek, Dillingham, Eek, Ekuk, Ekwok, Emmonak, Goodnews Bay, Hooper Bay, Iqurmuit (Russian Mission), Kalskag, Kasigluk, Kipnuk, Koliganek, Kongiganak, Kotlik, Kwethluk, Kwigillingok, Levelock, Lower Kalskag, Manokotak, Marshall, Mekoryuk, Mountain Village, Naknek, Napaumute, Napakiak, Napaskiak, Newhalen, New Stuyahok, Newtok, Nightmute, Nunapitchukv, Oscarville, Pilot Station, Pitkas Point, Platinum, Portage Creek, Quinhagak, Red Devil, St. Michael, Scammon Bay, Sheldon's Point, Sleetmute, Stebbins, Togiak, Toksook, Tulukskak, Tuntutuliak, Tununak, Twin Hills, Georgetown, St. Mary's, Umkumiate, Aleut, Alutiiq Aleut, Tatitlek, Ugashik, Bristol Bay Aleut, Chignik, Chignik Lake, Egegik, Igiugig, Ivanof Bay, King Salmon, Kokhanok, Perryville, Pilot Point, Port Heiden, Chugach Aleut, Chenega, Chugach Corporation, English Bay, Port Graham, Eyak, Koniag Aleut, Akhiok, Agdaagux, Karluk, Kodiak, Larsen Bay, Old Harbor, Ouzinkie, Port Lions, Sugpiaq, Suqpigaq, Unangan Aleut, Akutan, Aleut Corporation, Aleutian, Aleutian Islander, Atka, Belkofski, Chignik Lagoon, King Cove, False Pass, Nelson Lagoon, Nikolski, Pauloff Harbor, Qagan Toyagungin, Qawalangin, St. George, St. Paul, Sand Point, South Naknek, Unalaska, Unga, Asian, Asian Indian, Bangladeshi, Bhutanese, Burmese, Cambodian, Chinese, Taiwanese, Filipino, Hmong, Indonesian, Japanese, Korean, Laotian, Malaysian, Okinawan, Pakistani, Sri Lankan, Thai, Vietnamese, Iwo Jiman, Maldivian, Nepalese, Singaporean, Madagascar, Black or African American, Black, African American, African, Botswanan, Ethiopian, Liberian, Namibian, Nigerian, Zairean, Bahamian, Barbadian, Dominican, Dominica Islander, Haitian, Jamaican, Tobagoan, Trinidadian, West Indian, Native Hawaiian or Other Pacific Islander, Polynesian, Native Hawaiian, Samoan, Tahitian, Tongan, Tokelauan, Micronesian, Guamanian or Chamorro, Guamanian, Chamorro, Mariana Islander, Marshallese, Palauan, Carolinian, Kosraean, Pohnpeian, Saipanese, Kiribati, Chuukese, Yapese, Melanesian, Fijian, Papua New Guinean, Solomon Islander, New Hebrides, White, European, Armenian, English, French, German, Irish, Italian, Polish, Scottish, Middle Eastern or North African, Assyrian, Egyptian, Iranian, Iraqi, Lebanese, Palestinian, Syrian, Afghanistani, Israeili, Arab, Other Race, Other Pacific Islander

Ethnicity:

Hispanic or Latino, Spaniard, Andalusian, Asturian, Castillian, Catalonian, Belearic Islander, Gallego, Valencian, Canarian, Spanish Basque, Mexican, Mexican American, Mexicano, Chicano, La Raza, Mexican American Indian, Central American, Costa Rican, Guatemalan, Honduran, Nicaraguan, Panamanian, Salvadoran, Central American Indian, Canal Zone, South American, Argentinean, Bolivian, Chilean, Colombian, Ecuadorian, Paraguayan, Peruvian, Uruguayan, Venezuelan, South American Indian, Criollo, Latin American, Puerto Rican, Cuban, Dominican, Not Hispanic or Latino

'''PREVIOUS NOTES'''
(none)

'''DEVELOPMENT STATUS'''
(Add details here)

'''ACTION ITEMS / NEXT STEPS'''

'''OPEN ISSUES / QUESTIONS'''
(Add details here)

MU Stage1 Final Rule - Automatic Log-Off

2010-09-03T18:49:15Z

Anthracite:

'''SECTION # '''
Section 170.302(q)—Automatic Log-Off

'''MU OBJECTIVE'''
Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.

'''MU STAGE 1 MEASURE'''
Conduct or review a security risk analysis per 45 CFR 164.308 (a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process.

'''CERTIFICATION CRITERION'''
Interim Final Rule Text:
Automatic log-off. Terminate an electronic session after a predetermined time of inactivity.
Final Rule Text: §170.302(q).
Unchanged.

'''STANDARDS'''
45 CFR 164.308
http://edocket.access.gpo.gov/cfr_2003/octqtr/pdf/45cfr164.308.pdf

'''TEST CRITERIA #'''
§170.302(q)
http://healthcare.nist.gov/docs/170.302.q_AutomaticLogOff_v1.0.pdf
{| class="grey" border="1" cellpadding="2"
! USERS
! CORE / MENU
! SOLUTION DEVELOPERS
! STATUS
|-
| All
| CORE
| TBD
| TBD
|}
----
'''SOLUTION DESIGN / TECHNOLOGY'''
(Add details here)

'''SOLUTION COMPONENTS'''
(Add details here - Ex. KIDS patch, Delphi code, User guide, Web resources, Manual test script, etc)

'''DEPENDENCIES'''
(Add details here)

'''COMMENTS / NOTES'''
(Add details here)

'''PREVIOUS NOTES'''
(none)

'''DEVELOPMENT STATUS'''None needed. Only documentation of the steps to configure it and demonstrate it are necessary.

'''ACTION ITEMS / NEXT STEPS'''
(Add details here)

'''OPEN ISSUES / QUESTIONS'''
(Add details here)

MU Stage1 Final Rule - Emergency Access

2010-09-03T18:48:01Z

Anthracite:

'''SECTION # '''
Section 170.302(p)—Emergency Access

'''MU OBJECTIVE'''
Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.

'''MU STAGE 1 MEASURE'''
Conduct or review a security risk analysis per 45 CFR 164.308(a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process.

'''CERTIFICATION CRITERION'''
Interim Final Rule Text:
Emergency access. Permit authorized users (who are authorized for emergency situations) to access electronic health information during an emergency.
Final Rule Text: §170.302(p).
Unchanged.

'''STANDARDS'''
45 CFR 164.308
http//:edocket.access.gpo.gov/cfr_2003/octqtr/pdf/45cfr164.308.pdf

'''TEST CRITERIA #'''
§170.302(p)
http://healthcare.nist.gov/docs/170.302.p_EmergencyAccess_v1.0.pdf
{| class="grey" border="1" cellpadding="2"
! USERS
! CORE / MENU
! SOLUTION DEVELOPERS
! STATUS
|-
| All
| CORE
| TBD
| TBD
|}
----
'''SOLUTION DESIGN / TECHNOLOGY'''
(Add details here)

'''SOLUTION COMPONENTS'''
(Add details here - Ex. KIDS patch, Delphi code, User guide, Web resources, Manual test script, etc)

'''DEPENDENCIES'''
(Add details here)

'''COMMENTS / NOTES'''
(Add details here)

'''PREVIOUS NOTES'''
(none)

'''DEVELOPMENT STATUS'''
The devil is in the details of the scripts here as to whether or not the emergency access controls are adequate if a privileged user can grant access to another or if the ordinary user had to be able to break the box to privileged user status without a supervisor providing for that access.

'''ACTION ITEMS / NEXT STEPS'''
(Add details here)

'''OPEN ISSUES / QUESTIONS'''
(Add details here)

MU Stage1 Final Rule - Access Control

2010-09-03T18:45:36Z

Anthracite:

'''SECTION # '''
Section 170.302(o)—Access Control

'''MU OBJECTIVE'''
Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.

'''MU STAGE 1 MEASURE'''
Conduct or review a security risk analysis per 45 CFR 164.308 (a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process.

'''CERTIFICATION CRITERION'''
Interim Final Rule Text:
Access control. Assign a unique name and/or number for identifying and tracking user identity and establish controls that permit only authorized users to access electronic health information.
Final Rule Text: §170.302(o).
Unchanged.

'''STANDARDS'''
45 CFR 164.308
http://edocket.access.gpo.gov/cfr_2003/octqtr/pdf/45cfr164.308.pdf

'''TEST CRITERIA #'''
§170.302(o)
http://healthcare.nist.gov/docs/170.302.o_AccessControl_v1.0.pdf
{| class="grey" border="1" cellpadding="2"
! USERS
! CORE / MENU
! SOLUTION DEVELOPERS
! STATUS
|-
| All
| CORE
| TBD
| TBD
|}
----
'''SOLUTION DESIGN / TECHNOLOGY'''
(Add details here)

'''SOLUTION COMPONENTS'''
(Add details here - Ex. KIDS patch, Delphi code, User guide, Web resources, Manual test script, etc)

'''DEPENDENCIES'''
(Add details here)

'''COMMENTS / NOTES'''
(Add details here)

'''PREVIOUS NOTES'''
(none)

'''DEVELOPMENT STATUS'''
We believe that VistA has this capability already. All of the various security methods and how they are used and access needs some documentation.

'''ACTION ITEMS / NEXT STEPS'''
(Add details here)

'''OPEN ISSUES / QUESTIONS'''
(Add details here)

MU Stage1 Final Rule - Access Control

2010-09-03T18:44:33Z

Anthracite:

'''SECTION # '''
Section 170.302(o)—Access Control

'''MU OBJECTIVE'''
Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.

'''MU STAGE 1 MEASURE'''
Conduct or review a security risk analysis per 45 CFR 164.308 (a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process.

'''CERTIFICATION CRITERION'''
Interim Final Rule Text:
Access control. Assign a unique name and/or number for identifying and tracking user identity and establish controls that permit only authorized users to access electronic health information.
Final Rule Text: §170.302(o).
Unchanged.

'''STANDARDS'''
45 CFR 164.308
http://edocket.access.gpo.gov/cfr_2003/octqtr/pdf/45cfr164.308.pdf

'''TEST CRITERIA #'''
§170.302(o)
http://healthcare.nist.gov/docs/170.302.o_AccessControl_v1.0.pdf
{| class="grey" border="1" cellpadding="2"
! USERS
! CORE / MENU
! SOLUTION DEVELOPERS
! STATUS
|-
| All
| CORE
| TBD
| TBD
|}
----
'''SOLUTION DESIGN / TECHNOLOGY'''
(Add details here)

'''SOLUTION COMPONENTS'''
(Add details here - Ex. KIDS patch, Delphi code, User guide, Web resources, Manual test script, etc)

'''DEPENDENCIES'''
(Add details here)

'''COMMENTS / NOTES'''
(Add details here)

'''PREVIOUS NOTES'''
(none)

'''DEVELOPMENT STATUS'''
We believe that VistA has this capability already.
(Add details here)

'''ACTION ITEMS / NEXT STEPS'''
(Add details here)

'''OPEN ISSUES / QUESTIONS'''
(Add details here)

MU Stage1 Final Rule - Clinical Decision Support (EP)

2010-09-03T18:39:18Z

Anthracite:

'''SECTION # '''
Section 170.304(e)—Clinical Decision Support

'''MU OBJECTIVE'''
Implement one clinical decision support rule related to a high priority hospital condition along with the ability to track compliance with that rule

'''MU STAGE 1 MEASURE'''
Implement one clinical decision support rule

'''CERTIFICATION CRITERION'''
Final Rule Text: §170.304(e).
(1) Implement rules. Implement automated, electronic clinical decision support rules (in addition to drug-drug and drug-allergy contraindication checking) based on the data elements included in: problem list; medication list; demographics; and laboratory test results.
(2) Notifications. Automatically and electronically generate and indicate in real-time, notifications and care suggestions based upon clinical decision support rules.

'''STANDARDS'''
N/A

'''TEST CRITERIA #'''
§170.304(e)
http://healthcare.nist.gov/docs/170.304.e_ClinicalDecisionSupportAmb_v1.0.pdf
{| class="grey" border="1" cellpadding="2"
! USERS
! CORE / MENU
! SOLUTION DEVELOPERS
! STATUS
|-
| EP
| CORE
| TBD
| TBD
|}
----
'''SOLUTION DESIGN / TECHNOLOGY'''
(Add details here)

'''SOLUTION COMPONENTS'''
(Add details here - Ex. KIDS patch, Delphi code, User guide, Web resources, Manual test script, etc)

'''DEPENDENCIES'''
(Add details here)

'''COMMENTS / NOTES'''
(Add details here)

'''PREVIOUS NOTES'''
(none)

'''DEVELOPMENT STATUS'''
Reminders of some sorts are already built into VistA instances that can serve to demonstrate this capability. Additional reminders are being developed to support several phases of quality reporting. Please contact Matt King if you are someone who can help. Reminders classes will hopefully be beginning soon as well.

'''ACTION ITEMS / NEXT STEPS'''
(Add details here)

'''OPEN ISSUES / QUESTIONS'''
(Add details here)