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CONSULT/REQUEST TRACKING
TECHNICAL MANUAL
Version 4.0
November 2019
Product Development
Office of Information and Technology
Department of Veterans Affairs
Revision History
RevisionPage #DateTechnical Writer/Project ManagerGMRC*3.0*139
Added to DST Consult handling.Pages PAGEREF _Ref25315376 \h 2, PAGEREF _Ref25315351 \h 193November 2019G. Scorca, C. StewartGMRC*3.0*123
Added details for new patchPages HYPERLINK \l "_GMRC*3.0*123" 3, HYPERLINK \l "_Set_Up_Consult" 21- HYPERLINK \l "_Set_Up_Consult" 22, HYPERLINK \l "_Package_Interface" 129- HYPERLINK \l "_HL7_Fields" 132, HYPERLINK \l "_HL7_Protocols" 135-HYPERLINK \l "_HL7_Referral_Messages"140, HYPERLINK \l "_REF_IN_Message_Definition" 173- HYPERLINK \l "_REF_IN_Message_Definition" 176, HYPERLINK \l "_HL_7_Mailbox" 179, HYPERLINK \l "_Routine_Descriptions" 224June 2019A. Pilozzi/
S. BurkeGMRC*3.0*124
Adds Decision Support Tool (DST) comment to a Consult when a Consult Order is signed and there is a DST comment listed in the Order.Pages HYPERLINK \l "p182_124" \o "p182_124" 182, HYPERLINK \l "p209_124" \o "p209_124" 207, HYPERLINK \l "p216_124" \o "p216_124" 214May 2019F. Perez/ C. StewartGMRC*3.0*112
Added details for new patchPage HYPERLINK \l "_GMRC*3.0*123" 3April 2019A. Pilozzi/
S. BurkeGMRC*3.0*113
Added details for Cancelled To Discontinued ConsultsPages HYPERLINK \l "GMRC_113_CancelledtoDiscontinuedConsu" 70 - HYPERLINK \l "GMRC_113_CancelledtoDiscontinuedpg3" 72February 2019G. Scorca, K. Marchant/ J. CantrellGMRC*3.0*110
Added text and new screen shot to show the new field UCID Display on the order detail.Pages HYPERLINK \l "UCID_Conversion" 70January 2019K.Marchant, M. Needham,
J.CantrellGMRC*3.0*107
Added details for new GMRC Reports to support the ADMIN KEY consults for consults that are Administratively released by Policy.Pages HYPERLINK \l "GMRC_3_0_107_AdminKeyReports" 69December 2018G. Scorca, K.Marchant, P.Jacobson/ J.CantrellGMRC*3.0*99 and GMRC*3.0*106
Added features and setup for new logical linkPages HYPERLINK \l "_GMRC*3.0*99" 3 and HYPERLINK \l "_HL7_Logical_Link"135September 2018S.Burke/
S. WeaverGMRC*3.0*89
Added information related to new functionality: Consult Closure Tool, Secondary Printer option for SF 513, and printing age and cell phone number on SF 513 Pages PAGEREF GMRC_89_MenuOpList \h 8, PAGEREF GMRC_89_FuncEnabled \h 13, PAGEREF GMRC_89_SecPrinterDef \h 15, PAGEREF GMRC_89_SecPrinterScreen \h 19, PAGEREF GMRC_89_SecPrinterScreen2 \h 21, PAGEREF GMRC_89_ClosureToolInstructionsBegin \h 49- PAGEREF GMRC_89_ClosureToolInstructionsEnd \h 57, PAGEREF GMRC_89_OptionName1 \h 109, PAGEREF GMRC_89_OptionName2 \h 110, PAGEREF GMRC_89_RoutineDesc1 \h 219, PAGEREF GMRC_89_RoutineDesc2 \h 225 March 2018T. Turowski/
R. Beltran-WestGMRC*3.0*83
Added information about the new MUMPS cross reference AG to be used only by the Scheduling PackagePages 2, 110, 122April 2016C. Rodriguez/
Doug Vick
HPEGMRC*3.0*81
Changed Earliest Appropriate Date to Clinically Indicated DatePages PAGEREF CID_patch_81_descript \h \* MERGEFORMAT 36, PAGEREF CID_Performance_monitor \h \* MERGEFORMAT 38, PAGEREF CID_quantity_timing \h \* MERGEFORMAT 133, PAGEREF CID_REF_I12 \h \* MERGEFORMAT 145, PAGEREF CID_REF_I13 \h \* MERGEFORMAT 154, PAGEREF CID_REF_I13_OBR \h \* MERGEFORMAT 164, PAGEREF CID_REF_I14_OBR \h \* MERGEFORMAT 172February 2016T. Robinson/
K.CondieGMRC*3.0*75
Added information on components of a bi-directional interface that will connect Consults and HCPS.Pages PAGEREF GRMC_75_HCPS_CONSULT_SRVC_SETUP \h 21, PAGEREF GRMC_75_HL7_FIELDS \h 129- PAGEREF GRMC_75_HL7_FIELDS_NOTES \h 133, PAGEREF GRMC_75_HCPS_HL7_INFO_1 \h 135- PAGEREF GRMC_75_HCPS_HL7_INFO_2 \h 181, PAGEREF GRMC_75_HCPS_HL7_HCPS_DEFINITION \h 197- PAGEREF GRMC_75_NVC_DEFINITION \h 198, PAGEREF GRMC_75_GMRC75P \h 218, PAGEREF GRMC_75_GMRCHL7H_GMRCHL7I_GMRCHL7P \h 220February 2015J. Pappas,
P. YeagerGMRC*3*73 ICD-10 Updates
Added info about changes made for the ICD-10 project.Pages PAGEREF gmrc73 \h 2, February 2014J. Green
C. Hinton
Clarified Service Team to Notify field in Add Consult Services option.Page PAGEREF SERVICETEAMTONOTIFY \h 16, PAGEREF SERVICETEAMTONOTIFY2 \h 28February 2014J. GreenGMRC*3.0*76
Added notes that the Ordering Provider will NOT receive an alert; added note that the clinician who requested the order is notified electronically
Noted EARLIEST APPROPRIATE DATE will be used in place of DATE OF REQUEST.Pages PAGEREF _Ref364069660 \h 2, 29.
PAGEREF _Ref364069749 \h 36, =30+1 31August 2013R SuttonGMRC*3.0*74
Added Define Fee Services (GMRC FEE PARAM) option and GMRC FEE SERVICES parameter and supporting GMRCFP* routinesPages HYPERLINK \l "_Implementation_and_Maintenance" 5, HYPERLINK \l "_Define_Fee_Services" 45-48, HYPERLINK \l "_GMRC_CONSULT_LIST" 86-87, HYPERLINK \l "_Exported_Menus" 93, HYPERLINK \l "_GMRCACTM_PHARMACY_PKG" 157October 2012C2/DSS TeamGMRC*3.0*71
Modified description for CONSULT/REQUEST UPDATED Page HYPERLINK \l "Consults_60a" 64August 2011G WernerEarliest Appropriate DatePage HYPERLINK \l "Consults_66" 111February 2011C Arceneaux, K CondieGMRC*3.0*63
Modified report formatPage 50June 2009G WernerPerformance Monitor Report Patch 60Pages HYPERLINK \l "Consults_60a1" 16, HYPERLINK \l "Consults_60a2" 17, HYPERLINK \l "Consults_60b" 33June 2008C Arceneaux, K CondiePerformance Monitor, Patch 41April 2005Include Patch 22April 2002Include Patch 23January 2002Include Patch 17October 2001Include Patch 21June 2001Include Patch 15, 19, and 20February 2001Include Patches 13, 14, 16, and 18October 2000Add Patches 6 thru 8, 11, and 12May 2000Include Patches 1 thru 5August 1998Originally releasedDecember 1997
This page left blank on purpose.
Table of Contents
TOC \o "1-3" \h \z HYPERLINK \l "_Toc25315675" Product Development PAGEREF _Toc25315675 \h i
HYPERLINK \l "_Toc25315676" Introduction PAGEREF _Toc25315676 \h 1
HYPERLINK \l "_Toc25315677" Purpose of the Consult/Request Tracking Package PAGEREF _Toc25315677 \h 1
HYPERLINK \l "_Toc25315678" Scope of the Manual PAGEREF _Toc25315678 \h 1
HYPERLINK \l "_Toc25315679" Audience PAGEREF _Toc25315679 \h 1
HYPERLINK \l "_Toc25315680" New Features PAGEREF _Toc25315680 \h 2
HYPERLINK \l "_Toc25315681" Package Orientation PAGEREF _Toc25315681 \h 5
HYPERLINK \l "_Toc25315682" Implementation and Maintenance PAGEREF _Toc25315682 \h 7
HYPERLINK \l "_Toc25315683" Install, Planning, and Implementation Checklist PAGEREF _Toc25315683 \h 7
HYPERLINK \l "_Toc25315684" Menu/Option Diagram PAGEREF _Toc25315684 \h 7
HYPERLINK \l "_Toc25315685" Define Service Hierarchy PAGEREF _Toc25315685 \h 9
HYPERLINK \l "_Toc25315686" Determine Service Functionality PAGEREF _Toc25315686 \h 12
HYPERLINK \l "_Toc25315687" Set Up Consult Services (SS) PAGEREF _Toc25315687 \h 14
HYPERLINK \l "_Toc25315688" Quick Orders PAGEREF _Toc25315688 \h 23
HYPERLINK \l "_Toc25315689" Service Consults Pending Resolution PAGEREF _Toc25315689 \h 27
HYPERLINK \l "_Toc25315690" Service User Management (SU) PAGEREF _Toc25315690 \h 28
HYPERLINK \l "_Toc25315691" Group Update (GU) PAGEREF _Toc25315691 \h 33
HYPERLINK \l "_Toc25315692" Consults Performance Monitor Report (PM) PAGEREF _Toc25315692 \h 36
HYPERLINK \l "_Toc25315693" Print Consults by Provider, Location, or Procedure (PL) PAGEREF _Toc25315693 \h 40
HYPERLINK \l "_Toc25315694" Print Test Page (TP) PAGEREF _Toc25315694 \h 42
HYPERLINK \l "_Toc25315695" Determine Users' Update Authority (UA) PAGEREF _Toc25315695 \h 42
HYPERLINK \l "_Toc25315696" Determine if User is Notification Recipient (UN) PAGEREF _Toc25315696 \h 43
HYPERLINK \l "_Toc25315697" Determine Notification Recipients for a Service (NR) PAGEREF _Toc25315697 \h 44
HYPERLINK \l "_Toc25315698" Test Default Reason for Request (TD) PAGEREF _Toc25315698 \h 45
HYPERLINK \l "_Toc25315699" List Consult Service Hierarchy (LH) PAGEREF _Toc25315699 \h 47
HYPERLINK \l "_Toc25315700" Copy Prosthetics Services (CP) PAGEREF _Toc25315700 \h 48
HYPERLINK \l "_Toc25315701" Consult Closure Tool (CCT) PAGEREF _Toc25315701 \h 49
HYPERLINK \l "_Toc25315702" Edit Configuration Component PAGEREF _Toc25315702 \h 50
HYPERLINK \l "_Toc25315703" Inquire Configuration Component PAGEREF _Toc25315703 \h 52
HYPERLINK \l "_Toc25315704" Run Configuration Component PAGEREF _Toc25315704 \h 52
HYPERLINK \l "_Toc25315705" Duplicate Sub-Service (DS) PAGEREF _Toc25315705 \h 57
HYPERLINK \l "_Toc25315706" Define Fee Services (FS) PAGEREF _Toc25315706 \h 57
HYPERLINK \l "_Toc25315707" IFC Requests PAGEREF _Toc25315707 \h 62
HYPERLINK \l "_Toc25315708" Print IFC Requests PAGEREF _Toc25315708 \h 65
HYPERLINK \l "_Toc25315709" IFC Requests by Patient PAGEREF _Toc25315709 \h 66
HYPERLINK \l "_Toc25315710" IFC Requests by Remote Ordering Provider PAGEREF _Toc25315710 \h 67
HYPERLINK \l "_Toc25315711" ADMIN KEY Reports PAGEREF _Toc25315711 \h 69
HYPERLINK \l "_Toc25315712" Unique Consult ID (UCID) Conversion PAGEREF _Toc25315712 \h 70
HYPERLINK \l "_Toc25315713" Unique Consult ID (UCID) Display PAGEREF _Toc25315713 \h 70
HYPERLINK \l "_Toc25315714" Cancelled to Discontinued Consults PAGEREF _Toc25315714 \h 70
HYPERLINK \l "_Toc25315715" Overview PAGEREF _Toc25315715 \h 70
HYPERLINK \l "_Toc25315716" Overnight Job PAGEREF _Toc25315716 \h 71
HYPERLINK \l "_Toc25315717" Update of the New Index During Installation of Patch GMRC*3.0*113 PAGEREF _Toc25315717 \h 71
HYPERLINK \l "_Toc25315718" Installation Background Job that Updates the Index PAGEREF _Toc25315718 \h 71
HYPERLINK \l "_Toc25315719" Editing the Entries in the New Parameter PAGEREF _Toc25315719 \h 71
HYPERLINK \l "_Toc25315720" Inter-Facility Consults Management Options PAGEREF _Toc25315720 \h 72
HYPERLINK \l "_Toc25315721" Test IFC Implementation PAGEREF _Toc25315721 \h 73
HYPERLINK \l "_Toc25315722" List incomplete IFC transactions PAGEREF _Toc25315722 \h 74
HYPERLINK \l "_Toc25315723" IFC Transaction Report PAGEREF _Toc25315723 \h 76
HYPERLINK \l "_Toc25315724" Locate IFC by Remote Consult Number PAGEREF _Toc25315724 \h 79
HYPERLINK \l "_Toc25315725" Monitor IFC Background Job Parameters PAGEREF _Toc25315725 \h 81
HYPERLINK \l "_Toc25315726" Notification Parameters PAGEREF _Toc25315726 \h 82
HYPERLINK \l "_Toc25315727" Consult Service Tracking PAGEREF _Toc25315727 \h 82
HYPERLINK \l "_Toc25315728" Functionality PAGEREF _Toc25315728 \h 82
HYPERLINK \l "_Toc25315729" Text Integration Utilities (TIU) Setup PAGEREF _Toc25315729 \h 84
HYPERLINK \l "_Toc25315730" Consults Resulting Process PAGEREF _Toc25315730 \h 84
HYPERLINK \l "_Toc25315731" Recommended Document Hierarchies PAGEREF _Toc25315731 \h 86
HYPERLINK \l "_Toc25315732" TIU Setup Options PAGEREF _Toc25315732 \h 89
HYPERLINK \l "_Toc25315733" TIU Maintenance PAGEREF _Toc25315733 \h 94
HYPERLINK \l "_Toc25315734" Correcting Misdirected Results PAGEREF _Toc25315734 \h 94
HYPERLINK \l "_Toc25315735" Medicine Interface PAGEREF _Toc25315735 \h 96
HYPERLINK \l "_Toc25315736" Procedure Setup PAGEREF _Toc25315736 \h 97
HYPERLINK \l "_Toc25315737" Linking Med Results to Procedure Request PAGEREF _Toc25315737 \h 101
HYPERLINK \l "_Toc25315738" Removing Medicine Results from a Request PAGEREF _Toc25315738 \h 101
HYPERLINK \l "_Toc25315739" Parameters PAGEREF _Toc25315739 \h 102
HYPERLINK \l "_Toc25315740" GMRC CONSULT LIST DAYS PAGEREF _Toc25315740 \h 102
HYPERLINK \l "_Toc25315741" GMRC FEE SERVICES PAGEREF _Toc25315741 \h 102
HYPERLINK \l "_Toc25315742" Files PAGEREF _Toc25315742 \h 105
HYPERLINK \l "_Toc25315743" File Globals PAGEREF _Toc25315743 \h 106
HYPERLINK \l "_Toc25315744" Exported Menus PAGEREF _Toc25315744 \h 109
HYPERLINK \l "_Toc25315745" Cross-References PAGEREF _Toc25315745 \h 113
HYPERLINK \l "_Toc25315746" Archiving and Purging PAGEREF _Toc25315746 \h 121
HYPERLINK \l "_Toc25315747" External Relations PAGEREF _Toc25315747 \h 125
HYPERLINK \l "_Toc25315748" Private DBIA Agreements PAGEREF _Toc25315748 \h 126
HYPERLINK \l "_Toc25315749" Internal Relations PAGEREF _Toc25315749 \h 127
HYPERLINK \l "_Toc25315750" Package-Wide Variables PAGEREF _Toc25315750 \h 127
HYPERLINK \l "_Toc25315751" Package Interface PAGEREF _Toc25315751 \h 129
HYPERLINK \l "_Toc25315752" HL7 Fields PAGEREF _Toc25315752 \h 129
HYPERLINK \l "_Toc25315753" HL7 Protocols PAGEREF _Toc25315753 \h 135
HYPERLINK \l "_Toc25315754" HL7 Application Parameters PAGEREF _Toc25315754 \h 136
HYPERLINK \l "_Toc25315755" HL7 Logical Link PAGEREF _Toc25315755 \h 137
HYPERLINK \l "_Toc25315756" HL7 Referral Messages PAGEREF _Toc25315756 \h 138
HYPERLINK \l "_Toc25315757" REF_I12 Message Definition Tables PAGEREF _Toc25315757 \h 140
HYPERLINK \l "_Toc25315758" REF_I13 Message Definition Tables PAGEREF _Toc25315758 \h 149
HYPERLINK \l "_Toc25315759" RRI_I13 Message Definition Tables PAGEREF _Toc25315759 \h 158
HYPERLINK \l "_Toc25315760" REF_I14 Message Definition Tables PAGEREF _Toc25315760 \h 167
HYPERLINK \l "_Toc25315761" REF_IN Message Definition Tables PAGEREF _Toc25315761 \h 173
HYPERLINK \l "_Toc25315762" HL7 ACK Messages PAGEREF _Toc25315762 \h 176
HYPERLINK \l "_Toc25315763" HL 7 Mailbox PAGEREF _Toc25315763 \h 179
HYPERLINK \l "_Toc25315764" Order Event Messages PAGEREF _Toc25315764 \h 179
HYPERLINK \l "_Toc25315765" Front Door Consults PAGEREF _Toc25315765 \h 179
HYPERLINK \l "_Toc25315766" Back Door Consults PAGEREF _Toc25315766 \h 183
HYPERLINK \l "_Toc25315767" Orderable Item Updates PAGEREF _Toc25315767 \h 186
HYPERLINK \l "_Toc25315768" Orderable Item Updates PAGEREF _Toc25315768 \h 188
HYPERLINK \l "_Toc25315769" Ordering Parameters PAGEREF _Toc25315769 \h 190
HYPERLINK \l "_Toc25315770" Procedure Calls PAGEREF _Toc25315770 \h 190
HYPERLINK \l "_Toc25315771" Auto-forwarding PAGEREF _Toc25315771 \h 191
HYPERLINK \l "_Toc25315772" How to Generate On-Line Documentation PAGEREF _Toc25315772 \h 193
HYPERLINK \l "_Toc25315773" Routines PAGEREF _Toc25315773 \h 193
HYPERLINK \l "_Toc25315774" Globals PAGEREF _Toc25315774 \h 193
HYPERLINK \l "_Toc25315775" Menu/Options PAGEREF _Toc25315775 \h 194
HYPERLINK \l "_Toc25315776" XINDEX PAGEREF _Toc25315776 \h 194
HYPERLINK \l "_Toc25315777" Glossary PAGEREF _Toc25315777 \h 195
HYPERLINK \l "_Toc25315778" Appendix A: Install, Planning, and Implementation Checklist PAGEREF _Toc25315778 \h 197
HYPERLINK \l "_Toc25315779" Appendix B: Consult Tracking Worksheets PAGEREF _Toc25315779 \h 205
HYPERLINK \l "_Toc25315780" Appendix C: Request Services Distributed with Consults PAGEREF _Toc25315780 \h 209
HYPERLINK \l "_Toc25315781" Appendix D: Package Security PAGEREF _Toc25315781 \h 211
HYPERLINK \l "_Toc25315782" Service Update and Tracking Security PAGEREF _Toc25315782 \h 211
HYPERLINK \l "_Toc25315783" Menu/Option Access PAGEREF _Toc25315783 \h 212
HYPERLINK \l "_Toc25315784" GMRC MGR menu PAGEREF _Toc25315784 \h 213
HYPERLINK \l "_Toc25315785" GMRC GENERAL SERVICE USER menu PAGEREF _Toc25315785 \h 213
HYPERLINK \l "_Toc25315786" GMRC SERVICE TRACKING option PAGEREF _Toc25315786 \h 214
HYPERLINK \l "_Toc25315787" GMRC PHARMACY TPN CONSULTS option PAGEREF _Toc25315787 \h 214
HYPERLINK \l "_Toc25315788" Security Keys PAGEREF _Toc25315788 \h 214
HYPERLINK \l "_Toc25315789" Service Update Tracking Security PAGEREF _Toc25315789 \h 214
HYPERLINK \l "_Toc25315790" Routine Descriptions PAGEREF _Toc25315790 \h 216
HYPERLINK \l "_Toc25315791" Appendix D: Algorithms PAGEREF _Toc25315791 \h 227
HYPERLINK \l "_Toc25315792" User Authority PAGEREF _Toc25315792 \h 227
HYPERLINK \l "_Toc25315793" Index PAGEREF _Toc25315793 \h 228
Introductionxe "Introduction"
Purposexe "Purpose" of the Consult/Request Tracking Package
The Consult/Request Tracking package (Consults) was developed to improve the quality of patient care by providing an efficient mechanism for clinicians to order consults and requests using Computerized Patient Record System (CPRS) Order Entry, and to permit hospital services to track the progress of a consult order from the point of receipt through its final resolution.
Scope of the Manualxe "Scope of the Manual"
This manual provides technical descriptions of Consults tracking routines, protocols, files, globals, options, security data, menu diagrams and any other information required to effectively set up and use the Consults package.
From time to time improvements are made to the Consults package. The latest information about Consults, as well as the latest version of this manual, is posted on the Consults Web Page at:
vista.med.va.gov/consults
Audiencexe "Audience"
Information in this manual is technical in nature and is intended to be used by Veterans Affairs Medical Center (VAMC) Information Resource Management Service (IRMS) staff members and Clinical Application Coordinators (CAC's).
New Features
GMRC*3.0*139
This patch adds Auto-forwarding XE "Auto-forwarding" \b functionality. When the Decision Support Tool (DST) transmits the Auto-forward information to CPRS, the existing CPRS RPC process will detect the Auto-forward request and forward the Order to a new Consult location, which is referenced in the REQUEST SERVICE file (#123.5).
Overview of Consults/Request Trackingxe "Overview"
The Consults package provides an interface with CPRS Order Entry which permits clerks or clinicians to enter, edit, and review consults and requests within the CPRS package.
Service/Specialty personnel targeted to receive consults may use this package to:
Have consults or requests electronically relayed to them.
Track the service/specialty's activity concerning the consult or request, from the time of its receipt to its final resolution.
Associate Text Integration Utility (TIU)xe "Text Integration Utility (TIU)" consult reports with the consult request.
When a consult or request is updated on-line to a "completed or discontinued status by the specialty service personnel, the original clinician who requested the order is notified electronically of the order's resolution. The clinician may then use View Alerts or the Detailed Display option in either the Consults or CPRS packages to review any comments or results which may be associated with the order's resolution.
( Note: When using the Group Update functionality, the Ordering Provider will NOT receive an alert when a consult or request is updated online to a completed or discontinued status.
Functionality has been provided for IRMS/ADPACxe "ADPAC" personnel to set up and manage the consult service hierarchy.
A checklistxe "Checklist" is provided (in Appendix A of this manual) to help you install, plan, and implement the Consults package. Use the checklist in conjunction with the detailed information provided in the Implementation and Maintenance section of this manual.
Package Orientationxe "Package Orientation"
This technical manual provides IRMS/ADPACxe "ADPAC" personnel with technical descriptions of Consults routines, files, options, and other necessary information required to effectively implement and use the Consults package.
This manual should assist you in:
Setting up a hierarchy of site specific services/specialties.
Setting up Notification users/teams related to a service, who will be notified when an order is released by CPRS order entry.
Setting up tracking update capabilities for specific services/specialties to track the progress of ordered consults or procedures from receipt to their completion or discontinuance.
Setting up procedures to be used in the resulting process for specified services.
( Note: The primary care clinician and clinic clerk add, edit, discontinue, and sign capabilities for ordering consults or requests are provided through CPRS V. 1.0. See the CPRS Clinical Coordinator & User Manual for descriptions of how to use the CPRS options.
For package-specific user conventions, please refer to the Package Orientation section of the Consult/Request Tracking User Manual.
Implementation and Maintenancexe "Implementation and Maintenance"
Install, Planning, and Implementation Checklistxe "Install, Planning, and Implementation Checklist"xe "Checklist"
A checklist is provided to help you install, plan, and implement the Consults package (see Appendix A). Use the checklist in conjunction with the detailed information provided in this "Implementation and Maintenance" section.
Menu/Option Diagram
The tools required to implement and maintain the Consults package are found in the Consult Management [GMRC MGR] menu. The following menu diagram illustrates all of the options distributed with the Consults package.
Consult Management [GMRC MGR]
RPT Consult Tracking Reports ...
ST Completion Time Statistics
PC Service Consults Pending Resolution
CC Service Consults Completed
CP Service Consults Completed or Pending Resolution
IFC IFC Requests
IP IFC Requests By Patient
IR IFC Requests by Remote Ordering Provider
NU Service Consults with Consults Numbers
PI Print IFC Requests
PL Print Consults by Provider, Location, or Procedure
PM Consult Performance Monitor Report
PR Print Service Consults by Status
SC Service Consults By Status
TS Print Completion Time Statistics Report
SS Set up Consult Services
SU Service User Management
CS Consult Service Tracking
RX Pharmacy TPN Consults
TP Print Test Page
GU Group update of consult/procedure requests
UA Determine users' update authority
UN Determine if user is notification recipient
NR Determine notification recipients for a service
TD Test Default Reason for Request
LH List Consult Service Hierarchy
PR Setup procedures
CP Copy Prosthetics services
CCT Menu for Closure Tools
EDT Consult Closure Tool Edit Configuration
INQ Consult Closure Tool Inquire Configuration
RUN Consult Closure Tool Run Configuration
DS Duplicate Sub-Service
FS Define Fee Services
IFC IFC Management Menu
TI Test IFC implementation
LI List incomplete IFC transactions
IFC IFC Requests
TR IFC Transaction Report
LK Locate IFC by Remote Cslt #
BK Monitor IFC background job parameters
IP IFC Requests By Patient
IR IFC Requests by Remote Ordering Provider
PI Print IFC Requests
To get you started placing CONSULT... orders via CPRS, the option above which requires immediate attention is the Set up Consult Services (SS) option. Before setting up services, you should define your service hierarchy and determine service functionality.
Define Service Hierarchyxe "Define Service Hierarchy"
At this point the site must determine which services/specialties should be set up to receive consults and requests. Consults Tracking Service Worksheets, along with descriptions of the type of information that should be recorded in each field on the worksheets, are provided in Appendix B of this manual to assist you in this process.
The Request Services file (#123.5)xe "REQUEST SERVICES file (123.5)" is distributed with a small selection of services. The hierarchical relationships are not in place upon distribution. See Appendix C for an example of how these services could be related hierarchically to get you started. Appendix C will:
Illustrate the file's hierarchy capabilities (similar to the Option file (#19) hierarchy) with ALL SERVICES representing the top of the hierarchy.
( NOTE: Due to the tight relationship between CPRS orderable items and this file, a service should NEVER be deleted at any point. The best recommendation would be to disable the service and remove it from the ALL SERVICE hierarchy.
The Service/Specialty hierarchy you define can be as complex as needed to meet service requirements at your site. To get started you will probably want to specify a small subset of services/specialties and add to them over a period of time. "ALL SERVICES" needs to be the top entry in the hierarchy.
( NOTE: ALL SERVICES should be the top hierarchy service. All Services should never be the sub-service of another service.
In order to build the service hierarchy, you will need to know how the service entry in the Request Services filexe "REQUEST SERVICES (123.5) file" (#123.5) is used. Some services will be used as a GROUPER ONLY and other services may be used for TRACKING ONLY. The SERVICE USAGE field is provided for you to differentiate the services in the hierarchy.
To see your site's hierarchy use the List Consult Service Hierarchy [GMRC LIST HIERARCHY] option.
( Hint: If your site is getting an allocation of partition space type of error when ALL SERVICES or another service is specified at the "Select Service/Specialty:" prompt, this is an indication that the hierarchy is set up wrong. This is typically caused by a service being made a sub-service of itself. A service being a sub-service of one of its own sub-services will also manifest this error.
Service Usage Definition
Whenever a value is defined for the SERVICE USAGE field in the Set up Consults Services [GMRC SETUP REQUEST SERVICESxe "GMRC SETUP REQUEST SERVICES"] option, the Service entry will NOT be selectable to send consults to in the CPRS ordering process. Instead, entries in this field reserve the service for special uses within the Consults flow of information.
Service Usages cause functioning as follows:
UBLANKU - Permits consults and procedure requests to be sent to this service. A service may be reset to blank by entering an @ sign.
UGROUPER ONLYU - Permits a service to be used for grouping other services together for review purposes, and aids in defining the service hierarchy (e.g., ALL SERVICES, INPATIENT SERVICES, OUTSIDE SERVICES). During the order process, a user selecting a grouper only service will be shown the service hierarchy under that service grouper. A grouper only service should never be a service a consult is sent to.
UTRACKING ONLYU - Permits a service to be defined in a hierarchy, but does not permit users ordering consults in CPRS to be able to see or select a service marked for TRACKING ONLY (e.g., Psychology may be defined with its Service Usage blank, and its sub-specialty multiple defined with services of which some or all may be TRACKING ONLY services. This hierarchy facilitates the situation when a service such as Psychology prefers a UcommonU location for all related consults to be sent to. A tracking user at the UcommonU location then Forward(s) the request to one of the TRACKING ONLY services for completion).
These services are viewable and may be selected directly by update users for that service.
UDISABLEDU - Disabled services are not selectable for ordering or tracking.
An example of a potential hierarchy a user would see when ? or ?? are entered at a Select Service/Specialty: ALL SERVICES prompt follows. It includes notations for Service Usage definition examples.
Select Service/Specialty: ??GROUPERALL SERVICESGROUPER INPATIENT SERVICES PSYCHIATRY GROUPER RMS OCCUPATIONAL THERAPY PHYSICAL THERAPY CORRECTIVE THERAPYGROUPER MEDICINE CARDIOLOGYTRACKING INVASIVE PROCEDURESTRACKING ECHOTRACKING PACEMAKER GASTROENTEROLOGY HEMATOLOGY PULMONARY RHEUMATOLOGY ENDOCRINOLOGY NEPHROLOGY INFECTIOUS DISEASE DERMATOLOGY NEUROLOGY GENERAL MEDICINE ONCOLOGY GETU RENALGROUPER PSYCHOLOGY SMOKING CESSATION FAMILY/MARRIAGE COUNSELINGand so forth
Determine Service Functionalityxe "Determine Service Functionality"
The primary option needed to set up your hierarchy of services is the Set up Consults Services (SS) option. This option updates the Request Services file (#123.5).xe "REQUEST SERVICES file (123.5)."
You can enable the following functionality, depending on how much information you define for each hospital service in the Request Services file (#123.5).
Functionality you define may vary by Service/Specialty. Also, functionality may or may not be inherited, depending on the setting of the PROCESS PARENTS FOR UPDATES (.07) and PROCESS PARENTS FOR NOTIFS (.08) fields. If a child service has a Yes in these fields, then parents are checked for the appropriate actions XE "Actions" . If all services are set to Yes, then all services are checked to the top of the service hierarchy. Alternately, some services can be marked Yes and others marked No. In this case the hierarchy is checked until a No is encountered.
Two options provided in the Consult Management [GMRC MGR] menu option permit definition and maintenance of this functionality. All of the fields below may be updated using the Set Up Consult Services [GMRC SETUP REQUEST SERVICESxe "Services [GMRC SETUP REQUEST SERVICES"] option. For ongoing maintenance of service users specified in 3 and 4 below, use the Service User Management [GMRC SERVICE USER MGMT] option.
FUNCTIONALITY ENABLEDRELATED FIELDS
THAT MAY BE COMPLETED
Field # Field NameOrdering consults from the "ALL SERVICES" hierarchy in CPRS and Review of Consults via the Consults options distributed to users..01
2
10NAME
SERVICE USAGE
SUB-SERVICE/SPECIALTY (multiple)Automatic print of a Consultation Form (SF 513) at the service receiving the consult when CPRS order entry releases the order.123.09SERVICE PRINTER
FUNCTIONALITY ENABLEDRELATED FIELDS
THAT MAY BE COMPLETEDService/Specialty update of Consults activity with automatic notification to the requesting service and to the original requester of the order upon resolution..06
123.03
123.04
123.08
123.1
123.3
123.31
123.35UNRESTRICTED ACCESS
NOTIFY SERVICE ON DC
SERVICE INDIVIDUAL TO NOTIFY
SERVICE TEAM TO NOTIFY (multiple)
UPDATE USERS W/O NOTIFICATIONS (multiple)
UPDATE TEAMS W/O NOTIFICATIONS (multiple)
UPDATE USER CLASSES W/O NOTIFS (multiple)Automatic notification to service individuals or teams when CPRS releases the order. Assuming these users have the "NEW SERVICE CONSULT" notification turned on.123.08
123.1
123.2
SERVICE INDIVIDUAL TO NOTIFY
SERVICE TEAM(S)
TO NOTIFY (multiple)
NOTIFICATION BY PATIENT LOCATION (multiple)Ability to administratively complete consults, either singly or by date range. 123.33
123.34
123.5ADMINISTRATIVE UPDATE USER (multiple)
ADMINISTRATIVE UPDATE TEAM (multiple)
SPECIAL UPDATES INDIVIDUALAbility to administratively complete consults, either singly or by date range. 123.33
123.34
123.5ADMINISTRATIVE UPDATE USER (multiple)
ADMINISTRATIVE UPDATE TEAM (multiple)
SPECIAL UPDATES INDIVIDUALInter-Facility Service Configuration. 123.5134
IFC ROUTING SITE
IFC REMOTE NAME
IFC SENDING FACILITY
IFC COORDINATORSecondary Consult Service Printer for Consultation Form (SF 513)689SECONDARY PRINTER
Set Up Consult Services (SS)
The Set Up Consult Services command creates and maintains new records in the REQUEST SERVICES (#123.5) file. The following fields are involved:
SERVICE NAME XE "Service Name" : This is the Name of a service or specialty which may receive consult/requests. This may also be a name which represents a group of services or specialties.
ABBREVIATED PRINT NAME XE "Abbreviated Print Name" : This is a commonly known Abbreviation for this Service/Specialty. This name is used to build Consult Notifications and must be 7 characters or less in length.
INTERNAL NAME in an alternate name for the service. This name does not appear on printouts or displays, but can be used to access the service through the Setup Services (SS) option, or with FileMan.
SYNONYM XE "Synonym" : Identifies the commonly known names and abbreviations for the Service named in the .01 Name field. Synonyms identified here are used in the look-up of services at Select Service/Specialty: prompts as well as during ordering in CPRS.
SERVICE USAGE XE "Service Usage" : Whenever a value is defined in the SERVICE USAGE field, the Service entry will NOT be selectable to send consults TO in the OE/RR ordering process. Service Usages cause functioning as follows:
GROUPER ONLY XE "Grouper Only" - Allows a service to be used for grouping other services together for review purposes, and aids in defining the service hierarchy (e.g., ALL SERVICES, INPATIENT SERVICES, OUTSIDE SERVICES). During the order process, a user selecting a grouper only service will be shown the service hierarchy under that service grouper. A Grouper ONLY service should never be a "TO" Service on a consult.
TRACKING ONLY XE "Tracking Only" - Allows a service to be defined in a hierarchy, but will not allow users ordering consults in OE/RR to be able to see or select a service marked for TRACKING ONLY. (e.g., Psychology may be defined with its Service Usage blank, and its Sub-specialty multiple defined with services of which some or all may be "TRACKING ONLY" services. This hierarchy facilitates the situation when a service, such as Psychology, prefers a common location for all related consults to be sent to. A Tracking user at the common location then "Forwards" the request to one of the sub-service TRACKING ONLY services for completion.) Update users for the service can see and order directly to a tracking service.
DISABLED XE "Disabled" - Disabled services are not selectable for ordering or tracking. Existing requests for a disabled service may still be processed to completion.
SERVICE PRINTER XE "Service Printer" : Allows the service/specialty to identify a device that will be used for printing Consult Forms (SF 513) 'automatically' at the service when the consult/request order is released by CPRS. If the device is not defined, the Consult Form will not print unless a default service copy device is defined for the Consults package for the ordering location. The default service copy device parameter can be found by using the Print Parameters for Wards/Clinics [OR PARAM PRINTS (LOC)] option.
SECONDARY PRINTER: Allows the service/specialty to identify a secondary printer device that will be used for printing Consult Forms (SF 513) at a second location when the consult/request order is released by CPRS and during any print request for SF 513.
NOTIFY SERVICE ON DC XE "Notify Service on DC" : Controls when members configured to receive notifications for this service in the Consult hierarchy will be alerted to a consult being discontinued. This field can be set to ALWAYS, NEVER, or REQUESTOR ACTION. REQUESTOR ACTION stipulates notification only if the user discontinuing the consult is not an update user for the consulting service.
REPRINT 513 ON DC XE "Reprint 513 on DC" : This field will determine if the SF 513 should reprint to the consulting service when a consult is discontinued. Again the three choices are ALWAYS, NEVER, or REQUESTOR ACTION. REQUESTOR ACTION stipulates reprinting only if the user discontinuing the consult is not an update user for the consulting service.
PROVISIONAL DX PROMPT XE "Provisional DX Prompt" : Used by CPRS to determine how to prompt for the provisional diagnosis when ordering consults for this service. If this field is set to OPTIONAL, the user will be prompted for the provisional diagnosis but may bypass answering the prompt. If the field is set to SUPPRESS, the user will not be presented with the provisional diagnosis prompt. If set to REQUIRED, the user must answer the prompt to continue placing the order.
Provisional DX Input XE "PROVISIONAL DX INPUT" : Determines the method that CPRS uses to prompt the user for input of the provisional diagnosis when ordering a consult. If set to FREE TEXT, the user may type any text from 2-80 characters in length. If set to LEXICON, the user will be required to select a coded diagnosis from the Clinical Lexicon.
PREREQUISITE XE "Prerequisite" : This word-processing field is utilized to communicate pre-requisite information to the ordering person prior to ordering a consult to this service. This field is presented to the ordering person upon selecting a Consult service and allows them to abort the ordering at that time if they choose. TIU objects may be embedded within this field which are resolved for the current patient during ordering. Any TIU objects must be contained within vertical bars (e.g. |BLOOD PRESSURE|).
DEFAULT REASON FOR REQUEST XE "Default Reason For Request" : The default text used as the reason for request when ordering a consult for this service. This field allows a boilerplate of text to be imported into the reason for request when placing consult orders for this service. If the user places an order using a quick order having boilerplate text, that text supersedes any default text stored in this field. This field may contain any text including TIU objects. TIU Objects must be enclosed in vertical bars (e.g. |PATIENT NAME|).
RESTRICT DEFAULT REASON EDIT Xe "Restrict Default Reason Edit" : If a DEFAULT REASON FOR REQUEST exists for this service this field effects the ordering person's ability to edit the default reason while placing an order. This variable can be set to UNRESTRICTED, NO EDITING, or ASK ON EDIT ONLY. If the third value, ASK ON EDIT ONLY, is used, the user is only allowed to edit the default reason if the order is edited before releasing to the service.
The following three fields are only filled in if this is an Inter-Facility consult. The first two are used if you are a requesting facility. The third, IFC SENDING FACILITY, is used if you are a consulting facility.
IFC ROUTING SITE: This field contains the VA facility that will perform consults requested for this service. When a consult for this service is ordered, it will automatically be routed to the VA facility in this field.
IFC REMOTE NAME: This field contains the name of the service that will be requested at the VAMC defined in the IFC ROUTING SITE field. Enter the name of the service exactly as it is named at the remote facility. If this name does not match the name of the service at the routing site, the request will fail to be filed at the remote site. This will delay or prohibit the performance and processing of this request.
IFC SENDING FACILITY: This is a multiple containing the facilities from which your site may receive Inter-Facility Consults for this consult. As with all IFC fields, they must be an exact match.
SERVICE INDIVIDUAL TO NOTIFY XE "Service Individual to Notify" : A user may be identified in this field as having primary responsibility for receiving consults and tracking them through to completion or discontinuance. This individual will receive a "NEW SERVICE CONSULT" notification type when a new order is released to the service through CPRS. The user must have the "NEW SERVICE CONSULT/REQUEST" notification type enabled.
SERVICE TEAM TO NOTIFY Xe "Service Team to Notify" : The name of the Service Team that is to receive notifications of actions taken on a consult. A team of users may be identified (from the OE/RR LIST file #100.21) who will receive a "NEW SERVICE CONSULT" notification when a new order is released to the service through OE/RR. The individuals on the teams must have the "NEW SERVICE CONSULT/REQUEST" notification type turned "ON". Team members will be able to perform update tracking capabilities.
NOTE: The service team does not receive the CONSULT/REQUEST UPDATED notification if another member of that team or an update user is the user adding the comment. (Remedy Ticket 903302 pointed this out.)
NOTIFICATION BY PT LOCATION Xe "Notification by Pt Location" : A ward location or hospital location which the service wishes to assign a service individual or team to. When a consult or request is ordered, notifications to the receiving service checks to see if the patients location is defined here. If defined, notifications are sent to an individual and/or members of a team specifically associated with this location.
PROCESS PARENTS FOR NOTIFS XE "Process Parents for Notifs" : This field, if set to YES, causes the parent service of this service to be processed when determining notification recipients. The check is carried up the chain until ALL SERVICES is reached or until a service is marked NO.
UPDATE USERS W/O NOTIFICATIONS XE "Update Users W/O Notifications" : A list of individuals who can do update tracking, but who will not get a notification.
UPDATE TEAMS W/O NOTIFICATIONS Xe "Update Teams W/O Notifications" : A list of teams to be assigned update authority for this service. All clinicians in the teams have update authority no matter what patients are in the teams.
UPDATE USER CLASS W/O NOTIFS Xe "Update User Class W/O Notifs" : A list of user classes to be assigned update authority for this service. All persons assigned to the user classes included have update authority with the current service.
ADMINISTRATIVE UPDATE USER XE "Administrative Update User" : A list of the users for a service who can perform Administrative Completes (Completes without a note attached). Optionally, this individual can be set as a notification recipient.
ADMINISTRATIVE UPDATE TEAM Xe "Administrative Update Team" : This is a list that contains the names of team lists from the OE/RR LIST (#100.21) file. All provider/users of the teams will have administrative update authority for requests directed to this service and the teams can optionally be designated as notification recipients.
PROCESS PARENTS FOR UPDATES Xe "Process Parents for Updates" : This field, if set to YES, will cause the parent services of this service to be screened to determine update authority for a given user. Hence, if an individual is set as an update user in a grouper service, this individual will have privileges for all sub-services that have this field set to YES.
SPECIAL UPDATES INDIVIDUAL XE "Special Updates Individual" : This individual will have privileges to perform group status updates for this service or any of the entries in the SUB-SERVICE/ SPECIALTY field. It is recommended that this individual be a responsible service update user or a Clinical Application Coordinator. If given the option Group update of consult/procedure requests [GMRCSTSU], the user will be able to choose all requests within a date range that are pending, active or both and update the request to discontinued or complete. This will also update the related order in CPRS to the same status.
RESULT MGMT USER CLASS Xe "Result Mgmt User Class" : This field defines the Authorization/Subscription User Class that is permitted to disassociate a Medicine result from a Consult request. It is recommended that this function be restricted to a very select group of individuals.
UNRESTRICTED ACCESS XE "Unrestricted Access" : This field, if set to yes will allow all users to perform the full range of update activities on consult or procedure requests directed to this service. If this field is set to yes, all other fields related to assignment of update users are ignored. The SERVICE INDIVIDUAL TO NOTIFY and the SERVICE TEAM(S) TO NOTIFY fields are still used to determine notification recipients for each individual service.
SUB-SERVICE/SPECIALTY XE "Sub-Service/Specialty" \t "See" : This is the list of sub-service/specialties that are grouped under this Service. The sub-service/specialty entries must each be defined as entries in this file. There is no limit on how deep the hierarchy of services may be defined. The only requirement is that the "ALL SERVICES" entry be at the top of the hierarchy. It is also highly recommended that a service be defined as the sub-service of only one entry in the hierarchy.
ADMINISTRATIVE XE "Administrative" : This field, if set to yes, will allow requests placed to this service to be excluded from the Consults Performance Monitor report. When a request is directed to a service marked as administrative, the request itself is also marked as administrative. This is done via a Trigger cross-reference on the TO SERVICE field of file 123.
Example:
In this example a new service, arthritis, is set up:
Select Consult Management Option: SS Set up Consult Services
Select Service/Specialty:ARTHRITIS
Are you adding 'ARTHRITIS' as a new REQUEST SERVICES (the 38TH)? No// Y
(Yes)
SERVICE NAME: ARTHRITIS//
ABBREVIATED PRINT NAME (Optional): ARTH
INTERNAL NAME:
Select SYNONYM: AR
Are you adding 'AR' as a new SYNONYM (the 1ST for this REQUEST SERVICES)? No//
Y
(Yes)
Select SYNONYM:
SERVICE USAGE: ?
Enter '1' if the service is Grouper Only, 2 if the service is to be used
for TRACKING Only, and 9 to DISABLE the service.
Choose from:
1 GROUPER ONLY
2 TRACKING ONLY
9 DISABLED
SERVICE USAGE: 2 TRACKING ONLY
SERVICE PRINTER: LASER
1 LASER PRINTER ROOM LN11 12 PITCH _LTA36: P-LN03.1
2
2 LASERJET 4SI OVER THERE _LTA318: P-HPLASER-P12
3 LASERJET COMPRESSED NORTHWEST QUAD _LTA318: P-HPL
J3-COMPR. PORT MODE
CHOOSE 1-3: 1 LASER PRINTER ROOM LN11 12 PITCH _LTA36: P-LN
03.12
SECONDARY PRINTER:
NOTIFY SERVICE ON DC:
REPRINT 513 ON DC:
PROVISIONAL DX PROMPT:
PROVISIONAL DX INPUT:
PREREQUISITE:
1>
DEFAULT REASON FOR REQUEST:
1>
RESTRICT DEFAULT REASON EDIT:
Inter-facility information
IFC ROUTING SITE:
IFC REMOTE NAME:
Select IFC SENDING FACILITY:
SERVICE INDIVIDUAL TO NOTIFY: CPRSPROVIDER,ONE OC PHYSICIAN
Select SERVICE TEAM TO NOTIFY:
Select NOTIFICATION BY PT LOCATION:
PROCESS PARENTS FOR NOTIFS:
Select UPDATE USERS W/O NOTIFICATIONS: CPRSSTUDENT,ONE OC MEDICAL STUDENT III
Are you adding CPRSSTUDENT,ONE as
a new UPDATE USERS W/O NOTIFICATIONS (the 1ST for this REQUEST SERVICES)? No
// Y
(Yes)
Select UPDATE USERS W/O NOTIFICATIONS: CPRSPROVIDER,TWO TC CHIEF,
MIS
Are you adding CPRSPROVIDER,TWO as
a new UPDATE USERS W/O NOTIFICATIONS (the 2ND for this REQUEST SERVICES)? No
// Y
(Yes)
Select UPDATE USERS W/O NOTIFICATIONS:
Select UPDATE TEAMS W/O NOTIFICATIONS: RED
Are you adding 'RED' as
a new UPDATE TEAMS W/O NOTIFICATIONS (the 1ST for this REQUEST SERVICES)? No
// y
(Yes)
Select UPDATE TEAMS W/O NOTIFICATIONS:
Select UPDATE USER CLASS W/O NOTIFS: ORTHOTIST/PROSTHETIST
Are you adding 'ORTHOTIST/PROSTHETIST' as
a new UPDATE USER CLASSES W/O NOTIFS (the 1ST for this REQUEST SERVICES)? No
// Y
(Yes)
Select UPDATE USER CLASS W/O NOTIFS: RHEUMATOLOGIST
Are you adding 'RHEUMATOLOGIST' as
a new UPDATE USER CLASSES W/O NOTIFS (the 2ND for this REQUEST SERVICES)? No
// Y
(Yes)
Select UPDATE USER CLASS W/O NOTIFS:
Select ADMINISTRATIVE UPDATE USERS: CPRSTECHNICIAN,FOUR FC MEDICAL RECORD TECHNICIAN
Are you adding CPRSTECHNICIAN,FOUR' as
a new ADMINISTRATIVE UPDATE USERS(the 1ST for this REQUEST SERVICES)? No
// Y
(Yes)
Select NOTIFICATION RECIPIENT:
Select ADMINISTRATIVE UPDATE USERS:
Select ADMINISTRATIVE UPDATE TEAMS:
PROCESS PARENTS FOR UPDATES: Y YES
SPECIAL UPDATES INDIVIDUAL: CPRSPROVIDER,THREE TC CHIEF, MEDICAL SERVICE
RESULT MGMT USER CLASS: CHIEF, MIS
UNRESTRICTED ACCESS: N NO
Select SUB-SERVICE/SPECIALTY:
ADMINISTRATIVE: ?
ENTER 'YES' IF THIS SERVICE IS ADMINSTRATIVE IN NATURE.
Choose from:
0 NO
1 YES
ADMINISTRATIVE: 0 No
Add/Edit Another Service? N//
Select Consult Management Option:
( Note: When you create a new service, it is not automatically linked into the Consults hierarchy. You must explicitly group each service under ALL SERVICES or under another service that in turn is grouped under ALL SERVICES. Until this is done, the new service is not visible in the service hierarchy and cannot be selected for any action.
Use the Set Up Consult Services (SS) XE "Set Up Consult Services (SS)" action XE "Action" to group services. In the following example, we group the ARTHRITIS service under ALL SERVICES:
Select Consult Management Option: SS Set up Consult Services
SERVICE NAME: ALL SERVICES
ABBREVIATED PRINT NAME (Optional):
Select SYNONYM:
SERVICE USAGE: GROUPER ONLY//
SERVICE PRINTER:
SECONDARY PRINTER:
NOTIFY SERVICE ON DC:
REPRINT 513 ON DC:
PROVISIONAL DX PROMPT:
PROVISIONAL DX INPUT:
PREREQUISITE:
1>
DEFAULT REASON FOR REQUEST:
1>
RESTRICT DEFAULT REASON EDIT:
SERVICE INDIVIDUAL TO NOTIFY:
Select SERVICE TEAM TO NOTIFY:
Select NOTIFICATION BY PT LOCATION:
PROCESS PARENTS FOR NOTIFS:
Select UPDATE USERS W/O NOTIFICATIONS:
Select UPDATE USER CLASS W/O NOTIFS:
Select ADMINISTRATIVE UPDATE USER:
Select ADMINISTRATIVE UPDATE USER:
Select ADMINISTRATIVE UPDATE TEAM:
PROCESS PARENTS FOR UPDATES:
SPECIAL UPDATES INDIVIDUAL:
UNRESTRICTED ACCESS:
Select SUB-SERVICE/SPECIALTY: Oncology// ARTHRITIS
Are you adding 'ARTHRITIS' as a new SUB-SERVICE (the 15TH for this REQUEST SER
VICES)? No// Y
(Yes)
MNEMONIC:
Select SUB-SERVICE/SPECIALTY:
Add/Edit Another Service?
HCPS, CCRA COMMUNITY CARE, and DOD TREATMENT Consult Service Set-up XE "HCPS:Consult Service Set-up"
Use the following steps to send a consult to HCPS or to CCRA:
Select SS Set Up Consult Services.
Set up a new consult service that contains NON VA CARE HCPS (e.g., NON VA CARE HCPS HEMODIALYSIS). Note that the service name must contain NON VA CARE HCPS as the prefix in order to be processed by HCPS. This naming convention was created to adhere to existing Non VA Care (NVC) naming and reporting standards. All NVC services begin with NON VA CARE. HCPS was also added to identify the transactions that will be sent to the Healthcare Claims Processing System (HCPS). All services that are intended to be sent to HCPS must contain HCPS after NON VA CARE (e.g., NON VA CARE HCPS
). To send consults to CCRA, the consult service needs to being with COMMUNITY CARE-. This exact naming will allow the system to transfer community care consults to CCRAs HealthShare Referral Manager (HSRM) application. Similarly, for DOD, the service name needs to begin with DOD TREATMENT.
Associate the new consult service with the appropriate template.
When the template is selected from the Order a Consult screen, it will be routed to HCPS once filled out and accepted.
Quick Orders
Enter/edit quick orders [ORCM QUICK ORDERS] is available within the Order Menu Management (ORCM MGMT) option of the CPRS Configuration (Clin Coord) menu. There are two steps to setting up a quick order:
Define the quick order with the Enter/edit quick orders option of the Order Menu Management menu.
Put the quick order on an order entry menu with the Enter/edit order menus option of the Order Menu Management menu.
In the following example we set up a quick order called NUTRITION:
Select Order Menu Management Option: ?
OI Enter/edit orderable items
PM Enter/edit prompts
GO Enter/edit generic orders
QO Enter/edit quick orders
ST Enter/edit order sets
AC Enter/edit actions
MN Enter/edit order menus
AO Assign Primary Order Menu
CP Convert protocols
SR Search/replace components
Enter ?? for more options, ??? for brief descriptions, ?OPTION for help text.
Select Order Menu Management Option: QO Enter/edit quick orders
Select QUICK ORDER NAME: NUTRITION
NAME: NUTRITION//
DISPLAY TEXT: NUTRITION CONSULT
VERIFY ORDER:
DESCRIPTION:
1>Nutrition Consult
2>
EDIT Option:
Consult to Service/Specialty: DIETARY
Reason for Request: . . .
1> [ ]food preferences by pt request [ ]nutrition assessment
2> [ ]chewing/swallowing problems [ ]nutrient intake study (calories)
3> [ ]recommended oral supplements [ ]recommended diet order
4> [ ]malnutrition - diagnosis [ ]NPO/clear liquids > 5 days
5> [ ]initiate tube feeding [ ]monitor tube feeding
6> [ ]renal nutrition consult [ ]diet intruction
7> [ ]see MD re:patient [ ]schedule to nutrition class
8> [ ]10-1 referral [ ]outpatient nutrition education
9>
10>Present Diagnosis:
11>Nutritionally relevant PMH/PSH:
12>Current diet rx:
13>Current albumin: Date:
14>Current weight (kg): Date:
15>H/O wt changes or problems with intake:
16>
17> **** Fill in this form before transmitting ****
18>
EDIT Option:
Category:
Urgency:
Place of Consultation:
Attention:
Provisional Diagnosis:
-------------------------------------------------------------------------------
Consult to Service/Specialty: DIETARY
Reason for Request: [ ]food preferences by pt request [ ]n ...
-------------------------------------------------------------------------------
(P)lace, (E)dit, or (C)ancel this quick order? PLACE//
Select QUICK ORDER NAME:
Select Order Menu Management Option: MN Enter/edit order menus
Select ORDER MENU: OR GMENU OTHER ORDERS
Menu Editor Mar 31, 1998 13:18:25 Page: 1 of 3
Menu: OR GMENU OTHER ORDERS Column Width: 26
U 1 2 3 4
|0 CONSULT... 30 PROCEDURE...
| Family/Marriage Counsel
|
|
+
|
|
|
|
1
|
|
|
|
+
|
|
+ + Next Screen - Prev Screen ?? More Actions >>>
Menu Items Text or Header Row
Add: me Menu Items
ITEM: NU
1 NUTRITION
2 NURSING OR GXNURS NURSING ITEM
CHOOSE 1-2: 1 NUTRITION
ROW: 3
COLUMN: 1
DISPLAY TEXT: Nutrition
MNEMONIC: NU
ITEM:
Rebuilding menu display ...
Menu Editor Mar 31, 1998 13:20:13 Page: 1 of 3
Menu: OR GMENU OTHER ORDERS Column Width: 26
U 1 2 3 4
|0 CONSULT... 30 PROCEDURE...
| Family/Marriage Counsel
|NU Nutrition
|
+
|
|
|
|
1
|
|
|
|
+
|
|
+ + Next Screen - Prev Screen ?? More Actions >>>
Add ... Edit ... Assign to User(s) Select New Menu
Remove ... Toggle Display Order Dialogs ... Quit
Select Action: Next Screen//
Service Consults Pending Resolutionxe "Service Consults Pending Resolution"
The purpose of the Service Consults Pending Resolution option is to list the pending and active consults. Use it to stay informed about the overall status of consults for your service. Someone in each clinic or service should review this list daily to make sure that all consults are being attended to.
In the following example, the option is used to view pending and active Pulmonary consults:
Select Consult Service Tracking Option: ?
CS Consult Service Tracking
PC Service Consults Pending Resolution
ST Completion Time Statistics
Enter ?? for more options, ??? for brief descriptions, ?OPTION for help text.
Select Consult Service Tracking Option: PC Service Consults Pending Resolution
Select Service/Specialty: PULMONARY
UGMRC PENDING CONSULTS Oct 08, 1997 08:16:39 Page: 1 of 2(U
SERVICE CONSULTS PENDING RESOLUTION
To Service: PULMONARY
U Status Last Action Request Date Patient Name Pt Location (U
Pending ENTERED IN OE/RR 10/07/97 CPRSPATIENT,O. (0001) PULMONARY CLINIC
Pending ENTERED IN OE/RR 10/07/97 CPRSPATIENT,T. (0002) PULMONARY CLINIC
Pending ENTERED IN OE/RR 10/07/97 CPRSPATIENT,T. (0003) PULMONARY CLINIC
Pending ENTERED IN OE/RR 05/06/97 CPRSPATIENT,F. (0004)
Pending COMPLETED 05/06/97 CPRSPATIENT,F. (0004)
Active ENTERED IN OE/RR 09/04/97 CPRSPATIENT,F. (0005) 2B
Active ENTERED IN OE/RR 08/21/97 CPRSPATIENT,S. (0006) 1A
Active ENTERED IN OE/RR 08/21/97 CPRSPATIENT,S. (0007) 1A
Active ENTERED IN OE/RR 08/21/97 CPRSPATIENT,E. (0008) 2B
Active ENTERED IN OE/RR 07/21/97 CPRSPATIENT,N. (0009) 2B
Active ENTERED IN OE/RR 07/16/97 CPRSPATIENT,R. (0010) 1A
Active ENTERED IN OE/RR 05/21/97 CPRSPATIENT,E. (0008) 2B
Active ENTERED IN OE/RR 05/21/97 CPRSPATIENT,S. (0007) PULMONARY CLINIC
Active ENTERED IN OE/RR 02/03/97 CPRSPATIENT,E. (0011)
Active ENTERED IN OE/RR 02/03/97 CPRSPATIENT,E. (0011)
Active ENTERED IN OE/RR 01/15/97 CPRSPATIENT,T. (0012) 1A
+ Enter ?? for more actions
Select Item(s): Next Screen//
Service User Management (SU)xe "Service User Management"
This option is used to make the most commonly needed changes after a service has been created. This option changes fields that are all in records in the REQUEST SERVICES (#123.5) file They are:
SERVICE INDIVIDUAL TO NOTIFY: An individual who will receive a default notification of any action taken on a consult.
SERVICE TEAM TO NOTIFY: The name of the Service Team that is to receive notifications of any actions taken on a consult.
NOTE: The service team does not receive the CONSULT/REQUEST UPDATED notification if another member of that team or an update user is the user adding the comment. (Remedy Ticket 903302 pointed this out.)
NOTIFICATION BY PT LOCATION: The name of a hospital location that is to receive notifications of any actions taken on a consult.
UPDATE USERS W/O NOTIFICATIONS: The name of an individual who can do update tracking, but who will not get a notification.
UPDATE TEAMS W/O NOTIFICATIONS: A team list of users to be assigned update authority for this service.
UPDATE USER CLASS W/O NOTIFS: A user class to be assigned update authority for this service.
ADMINISTRATIVE UPDATE USER: An individual who can perform Administrative Completes (Completes without a note attached).
ADMINISTRATIVE UPDATE TEAM: A team who can perform Administrative Completes (Completes without a note attached).
SPECIAL UPDATES INDIVIDUAL: This is the individual who can perform special updates for this particular service.
In order for the Service users to actually receive a new consult notification, the users must have the notification NEW SERVICE CONSULT/REQUEST turned ON for their use. See the CPRS Clinical Coordinator & User Manual, NOTIFICATION MGMT MENU option for more information on notifications and how to set them up.
Teams of users may be defined by an individual or team members with access to the Team Management Menu provided by CPRS. See the CPRS Clinical Coordinator & User Manual for more information on Team Management and its recommended menu access. It is important to know that team users are sent the notification regardless of any patients who may be defined in that team list.
An example of setting up notifications is shown on the next page.
In the following example no changes are made. The prompts in the Service User Management option are cycled through so you can see what they are:
Select OPTION NAME: GMRC MGR Consult Management menu
Select Consult Management Option: SU Service User Management
Select Service/Specialty: ARTHRITIS
SERVICE INDIVIDUAL TO NOTIFY: CPRSPROVIDER,FOUR//
Select SERVICE TEAM TO NOTIFY:
Select NOTIFICATION BY PT LOCATION:
Select UPDATE USERS W/O NOTIFICATIONS: SNOW,CHARLES R
//
Select UPDATE TEAMS W/O NOTIFICATIONS:
Select UPDATE USER CLASS W/O NOTIFS:
Select ADMINISTRATIVE UPDATE USER:
Select ADMINISTRATIVE UPDATE TEAM:
SPECIAL UPDATES INDIVIDUAL:
Select Service/Specialty:
The individual and team names that are displayed are the current default values. In most cases they are the most recently used value for that prompt.
To set up an individual to have update activities but receive no notification, do the following. This example sets up CPRSProvider, Three to have update privileges:
Select OPTION NAME: GMRC MGR Consult Management menu
Select Consult Management Option: SU Service User Management
Select Service/Specialty: MEDICINE
SERVICE INDIVIDUAL TO NOTIFY: CPRSPROVIDER,FOUR//
Select SERVICE TEAM TO NOTIFY:
Select NOTIFICATION BY PT LOCATION:
Select UPDATE USERS W/O NOTIFICATIONS: CPRSPROVIDER,ONE
// ?
Answer with UPDATE USERS W/O NOTIFICATIONS
Choose from:
CPRSPROVIDER,SIX
CPRSPROVIDER,SEVEN
CPRSPROVIDER,FIVE
CPRSPROVIDER,ONE
You may enter a new UPDATE USERS W/O NOTIFICATIONS, if you wish
Enter the name of individual who can do update tracking, but who will
not get a notification.
Answer with NEW PERSON NAME, or INITIAL, or SSN, or VERIFY CODE, or
NICK NAME, or KEY DELEGATION LEVEL, or DEA#, or VA#, or
SOCIAL WORKER ?, or POSITION/TITLE, or TRANSCRIPTIONIST ID, or
ALIAS
Do you want the entire 101-Entry NEW PERSON List? N (No)
Select UPDATE USERS W/O NOTIFICATIONS: CPRSPROVIDER,ONE
// CPRSPROVIDER,THREE TC CHIEF, MEDICAL SERVICE
Are you adding CPRSPROVIDER,THREE as
a new UPDATE USERS W/O NOTIFICATIONS (the 5TH for this REQUEST SERVICES)? No
// Y
(Yes) ??
Select UPDATE USERS W/O NOTIFICATIONS: CPRSPROVIDER,THREE
//
Select UPDATE TEAMS W/O NOTIFICATIONS:
Select UPDATE USER CLASS W/O NOTIFS:
Select ADMINISTRATIVE UPDATE USER:
Select ADMINISTRATIVE UPDATE TEAM:
SPECIAL UPDATES INDIVIDUAL:
Select Service/Specialty:
Select Consult Management Option:
Sometimes it is necessary to administratively Completexe "Administrative Complete" (CT) consults that for one reason or another have not been resolved. To set up an individual who can complete other peoples consults do the following. This example sets up Ben Casey as an administrative user who can complete any Medicine Consult without a signaturexe "signature:without".
Select Consult Management Option: SU Service User Management
Select Service/Specialty: MEDICINE
SERVICE INDIVIDUAL TO NOTIFY: AUTRY,MIKE//
Select SERVICE TEAM TO NOTIFY: GOLD TEAM//
Select NOTIFICATION BY PT LOCATION: 1A//
NOTIFICATION BY PT LOCATION: 1A//
INDIVIDUAL TO NOTIFY:
TEAM TO NOTIFY:
Select NOTIFICATION BY PT LOCATION:
Select UPDATE USERS W/O NOTIFICATIONS: CPRSPROVIDER,EIGHT
//
Select UPDATE TEAMS W/O NOTIFICATIONS:
Select UPDATE USER CLASS W/O NOTIFS:
Select ADMINISTRATIVE UPDATE USER: CPRSPROVIDER,N CPRSPROVIDER,NINE NC ASST CHI
EF, MEDICAL SERVICE
Are you adding CPRSPROVIDER,NINE as
A new ADMINISTRATIVE UPDATE USERS (the 1ST for this REQUEST SERVICES)? No//
Y
(Yes)
NOTIFICATION RECIPIENT:
Select ADMINISTRATIVE UPDATE USER: (gu)
Select ADMINISTRATIVE UPDATE TEAM:
SPECIAL UPDATES INDIVIDUAL:
Select Service/Specialty: Select Service/Specialty:
Select Consult Management Option:
Providers in the following categories have the authority XE "Signature authority" to complete a consult for a service by writing a TIU document or attaching a medicine result:
SERVICE INDIVIDUAL TO NOTIFY
SERVICE TEAM TO NOTIFY
NOTIFICATION BY PT LOCATION
NOTIFICATION BY PT LOCATION, INDIVIDUAL and/or TEAM
UPDATE USERS W/O NOTIFICATIONS
UPDATE TEAMS W/O NOTIFICATIONS
UPDATE USER CLASS W/O NOTIFS
Administrative updates differ from other complete actions in that they do not require a TIU note. The intention is for consults that are not to be completed normally (i.e., pt no-show) to be taken off the books. In the GUI (Windows) interface, Administrative Complete has its own menu command under consults tracking. If the current user has these privileges, then the menu command is activated by the program. In the List Manager interface, there is only the Complete (CT) command. If a user has both regular completion privileges and Administrative Complete privileges, the program inquires about which complete to pursue.
To set up an individual who has update privileges and receives NEW SERVICE CONSULT/REQUEST notifications do the following. This example sets up Dr. Maven to receive alerts when a consult comes to the Medicine clinic:
Select OPTION NAME: GMRC MGR Consult Management menu
Select Consult Management Option: SU Service User Management
Select Service/Specialty: MEDICINE
SERVICE INDIVIDUAL TO NOTIFY: CPRSPROVIDER,ELEVEN// CPRSPROVIDER,TEN TC
PHYSICIAN
Select SERVICE TEAM TO NOTIFY:
Select NOTIFICATION BY PT LOCATION:
Select UPDATE USERS W/O NOTIFICATIONS: CPRSPROVIDER,ONE
//
Select UPDATE TEAMS W/O NOTIFICATIONS:
Select UPDATE USER CLASS W/O NOTIFS:
Select ADMINISTRATIVE UPDATE USER: CPRSPROVIDER,FIVE
//
ADMINISTRATIVE UPDATE USER: CPRSPROVIDER,FIVE//
NOTIFICATION RECIPIENT:
Select ADMINISTRATIVE UPDATE USER:
Select ADMINISTRATIVE UPDATE TEAM:
SPECIAL UPDATES INDIVIDUAL: CPRSPROVIDER,FIVE//
Select Service/Specialty:
To set up a predefined team of clinicians for a service that has update privileges and receives NEW SERVICE CONSULT/REQUEST notifications do the following. In this example, to set up the Gold team to receive notifications do the following: (Team set up is discussed in the CPRS Clinical Coordinator & User Manual.)
Select OPTION NAME: GMRC MGR Consult Management menu
Select Consult Management Option: SU Service User Management
SERVICE INDIVIDUAL TO NOTIFY: CPRSPROVIDER,ELEVEN//
Select SERVICE TEAM TO NOTIFY: GOLD
Select NOTIFICATION BY PT LOCATION:
Select UPDATE USERS W/O NOTIFICATIONS: SNOW,CHARLES R
//
Select UPDATE TEAMS W/O NOTIFICATIONS:
Select UPDATE USER CLASS W/O NOTIFS:
Select ADMINISTRATIVE UPDATE USER: CPRSPROVIDER,FIVE
//
ADMINISTRATIVE UPDATE USER: CPRSPROVIDER,FIVE//
NOTIFICATION RECIPIENT:
Select ADMINISTRATIVE UPDATE USER:
Select ADMINISTRATIVE UPDATE TEAM:
SPECIAL UPDATES INDIVIDUAL: CPRSPROVIDER,FIVE//
Select Service/Specialty:
To set up individuals and a predefined team associated with a hospital ward location that have update activities and receives NEW SERVICE CONSULT/REQUEST notifications: (In this example we set up ward 2B Medical to receive notifications, along with Dr. Snow and the Green team. Team set up is discussed in the CPRS Clinical Coordinator & User Manual.) The users entered in the NOTIFICATION BY LOCATION sub-fields will ONLY be notified if the requesting location for the consult matches the location for which they are entered here. So in the case of the following example CPRSPROVIDER,ONE would only be notified for consults coming from 2B MED
Select Consult Management Option: SU Service User Management
Select Service/Specialty: MEDICINE
SERVICE INDIVIDUAL TO NOTIFY: CPRSPROVIDER,ELEVEN//
Select SERVICE TEAM TO NOTIFY:
Select NOTIFICATION BY PT LOCATION: 1A// 2B
Searching for a Enter Ward Location
1 2B 2B
2 2B MED 2B MED
CHOOSE 1-2: 2 2B MED
INDIVIDUAL TO NOTIFY: CPRSPROVIDER,ONE OC PHYSICIAN
TEAM TO NOTIFY: GREEN
Select NOTIFICATION BY PT LOCATION:
Select UPDATE USERS W/O NOTIFICATIONS: CPRSPROVIDER,ONE
//
Select UPDATE TEAMS W/O NOTIFICATIONS:
Select UPDATE USER CLASS W/O NOTIFS:
Select ADMINISTRATIVE UPDATE USER: CPRSPROVIDER,FIVE
//
ADMINISTRATIVE UPDATE USER: CPRSPROVIDER,FIVE//
NOTIFICATION RECIPIENT:
Select ADMINISTRATIVE UPDATE USER:
Select ADMINISTRATIVE UPDATE TEAM:
SPECIAL UPDATES INDIVIDUAL: CPRSPROVIDER,FIVE//
Select Service/Specialty:
Group Update (GU)
A Group Update can only be performed by an individual who has been set as the Special Updates Individual with the Set Up Consult Service (SS) or Service User Management (SU) option of the Consult Management (GMRC MGR) menu. This option should be exercised with great care because it can affect a large number of consults.
In this example, all consults before the first of the year that are not complete are discontinued for a specific service:
Select Consult Management Option: gu Group update of consult/procedure requests
Select Service/Specialty: ALL SERVICES// CARD
1 CARDIOLOGY
2 CARDIOLOGY (SOUTH) TRACKING ONLY
CHOOSE 1-2: 1 CARDIOLOGY
The first order in Consults has an entry date of MAR 28,1992
Update Status Start Date: MAR 28,1992// (MAR 28, 1992)
Update Status Stop Date: DEC 31, 2000 (DEC 31, 2000)
1 = Pending
2 = Active
3 = Scheduled
4 = All
Enter any combination of numbers separated
by a comma or hyphen: (1-4): 4
If orders in the date range still have the selected status, this option
will change their status in consults, and update the order.
You may change the status to COMPLETE or DISCONTINUED.
Change their status to: DIS Discontinued
Enter the Comment to be applied to all selected Consults
1>Discontinue old consults ref.
2>
EDIT Option:
Records will be updated for:
------------------------------------------------------------------------------
Service: CARDIOLOGY
Beginning: Mar 28, 1992
Ending: Dec 31, 2000
Update: Active, Pending, and Scheduled Consults
To: DISCONTINUED
Update Comment:
Discontinue old consults ref.
------------------------------------------------------------------------------
Is this correct? NO// Y YES
Searching database for entries matching search criteria
............................
Select one of the following:
1 Print report only
2 Print report & update records
3 Quit
Choose the method to handle the report: 2 Print report & update records
The device selected will print a list of entries from file 123 that will be
updated to DISCONTINUED.
If you choose to update records, the update of the consult entries will take
place upon completion of the report.
It is highly advised that a printer be selected!
Select device for report: WORK PRINTER ROOM
Do you want your output QUEUED? NO// (NO)
Select one of the following:
Y To Update
N To Quit without Updating
Enter update status : Y To Update
Select Consult Management Option:
( Note: When using the Group Update functionality, the Ordering Provider will NOT receive an alert when a consult or request is updated online to a completed or discontinued status by the specialty service personnel. The original clinical who requested the order is notified electronically of the orders resolution.
Consult Tracking Reportsxe "Consult Tracking Reports"
The Consult Tracking Reports [GMRC REPORTS] option provides eight on-screen reports. They are:
Completion Time Statistics (ST) for QA and others interested in volume and service turn-around times.
Service Consults Pending Resolution (PC) helps users track individual consults.
Service Consults Completed (CC) for management and others interested in volume.
Service Consults Completed or Pending Resolution (CP) for clerical staff and others interested in pending consults.
Service Consults by Status either with or without Consults Numbers (NU and SC).
Print Consults by Provider, Location, or Procedure (PL).
Print Completion Time Statistics (TS, same as ST for printed output).
Print Service Consults by Status (PR, same as SC for printed output).
The Service Consults Pending Resolution [GMRC RPT PENDING CONSULTS] option may be added to a service user's primary or secondary option menu. See the Consult/Request Tracking User Manual for details related to this option. This option is also contained on the Consult Service Tracking and Pharmacy TPN Consults menus.
Consults Performance Monitor Report (PM) XE "Consults Performance Monitor Report (PM)"
This report was added with Consults patch GMRC*3*41 to satisfy performance monitor reporting requirements of the Veterans Integrated Service Network (VISN) Support Services Center (VSSC). For FY08, the VHA Deputy Undersecretary for Health for Operations and Management has published updates to the monitor definitions, and patch GMRC*3.0*60 implements those updates.
This report comes in two forms, a summary report for local use in tracking performance XE "tracking performance" , and a delimited report for use with spreadsheets software. The report will now have the following exclusions: Prosthetics consults, consults with a status of Cancelled or Discontinued, Administrative consults, and Inpatient consults.
The ability to mark a service as administrative (via the Setup Services option) is new in patch GMRC*3.0*60. This new capability is an attempt to further refine the process of measuring the completion rate performance.
With Patch GMRC*3.0*81, developers changed the report to use CLINICALLY XE "Clinically Indicated Date" INDICATED DATE in place of EARLIEST APPROPRIATE DATE.
In the following example a Summary report is printed for the Cardiology service for the third quarter of FY05:
Select Consult Tracking Reports Option: ?
ST Completion Time Statistics
PC Service Consults Pending Resolution
SH Service Consults Schedule-Management Report
CC Service Consults Completed
CP Service Consults Completed or Pending Resolution
IFC IFC Requests
IP IFC Requests By Patient
IR IFC Requests by Remote Ordering Provider
NU Service Consults with Consults Numbers
PI Print IFC Requests
PL Print Consults by Provider, Location, or Procedure
PM Consult Performance Monitor Report
PR Print Service Consults by Status
SC Service Consults By Status
TS Print Completion Time Statistics Report
Select Consult Tracking Reports Option: PM Consult Performance Monitor Report
Select Service/Specialty: CARDIOLOGY
Ensure you are providing fiscal year, NOT calendar year.
Current Fiscal Year (i.e. 2008): 2005
For which quarter are you running the report: first, second, third or fourth?
Enter a number 1 - 4: (1-4): 3
Select one of the following:
S Summary
D Delimited
What type of report: S Summary
DEVICE: HOME// HOME
Run Date: Jun 03, 2008@08:01:51 Page: 1
------------------------------------------------------------------------------
Consult/Request Performance Monitor - 2QFY05
Fiscal Quarter Dates: Jan 01, 2005 - Mar 31, 2005
30 Days Before Start/End: Dec 02, 2004 - Mar 01, 2005
60 Days Before Start/End: Nov 02, 2004 - Jan 30, 2005
...EXCUSE ME, JUST A MOMENT PLEASE...
SERVICE: CARDIOLOGY
WITHIN IFC IFC
FACILITY SENT REC'D
All Requests in 30 Days Before Start/End of Qtr: 1 0 0
All Requests in 60 Days Before Start/End of Qtr: 1 0 0
Complete with Results in 30 Days of Request: 0 0 0
Complete with Results 31-60 Days of Request: 0 0 0
All Requests Created 60 Days Before Qtr Start: 228 1 15
All Requests Pending 60 Days Before Qtr Start: 79 0 7
Percent Complete w/Results in 30 Days of Request: 0.00% N / A N / A
Percent Complete w/Results 31-60 Days of Request: 0.00% N / A N / A
Percent Still Pending Created Before Qtr Start: 34.65% 0.00% 46.67%
Resubmitted requests are evaluated based on the original Date of Request.
The following are excluded from this report:
-Requests sent to test patients.
-Requests not marked as Outpatient in the REQUEST/CONSULTATION file.
-Services flagged as part of the interface between Consults/Request Tracking
and Prosthetics.
-Administrative requests flagged via the Administrative fields in the
REQUEST SERVICES and REQUEST/CONSULTATION files. This is not retroactive
and only applies to services/requests leveraging the Administrative-flagging
capability included in GMRC*3.0*60, available on or about June 2008.
-The report utilizes the CLINICALLY XE "Clinically Indicated Date" INDICATED DATE field from the
REQUEST/CONSULTATION file to determine request totals for a given Date range.
This is true even for requests that have been re-submitted using the
Edit/Resubmit functionality.
In this example a Delimited report is generated covering the Medicine grouper for second quarter, FY 2005 (setting the columns to 256 will prevent values from wrapping to the next line):
DEVICE: HOME// ;256; HOME
Run Date: Jun 03, 2008@08:02:59 Page: 1
Consult/Request Performance Monitor - 2QFY05
Fiscal Quarter Dates: Jan 01, 2005 - Mar 31, 2005
30 Days Before Start/End: Dec 02, 2004 - Mar 01, 2005
60 Days Before Start/End: Nov 02, 2004 - Jan 30, 2005
...EXCUSE ME, HOLD ON...
Svc;30DayRng;60DayRng;CmpIn30;Cmp31-60;B4Qtr;PndB4Qtr;%Cmp30;%Cmp60;%UnRsB4Qtr;IS30Rng;IS60Rng;ISCmp30;ISCmp31-60;ISB4Qtr;ISPndB4Qtr;%ISCmp30;%ISCmp60;%ISUnRsB4Qtr;IR30Rng;IR60Rng;IRCmp30;IRCmp31-60;IRB4Qtr;IRPndB4Qtr;%IRCmp30;%IRCmp60;%IRUnRsB4Qtr MEDICINE;0;0;0;0;13;0;N/A;N/A;0.00;0;0;0;0;0;0;N/A;N/A;N/A;0;0;0;0;0;0;N/A;N/A;N/A;
CARDIOLOGY;1;1;0;0;229;80;0.00;0.00;34.93;0;0;0;0;1;0;N/A;N/A;0.00;0;0;0;0;15;7;N/A;N/A;46.67;
GASTROENTEROLOGY;1;1;0;0;26;9;0.00;0.00;34.62;0;0;0;0;0;0;N/A;N/A;N/A;0;0;0;0;1;1;N/A;N/A;100.00;
MEDICINE,SOUTH;0;0;0;0;5;2;N/A;N/A;40.00;0;0;0;0;0;0;N/A;N/A;N/A;0;0;0;0;0;0;N/A;N/A;N/A;
CS CARDIOLOGY (SOUTH);0;0;0;0;10;5;N/A;N/A;50.00;0;0;0;0;2;2;N/A;N/A;100.00;0;0;0;0;0;0;N/A;N/A;N/A;
PULMONARY (SOUTH);0;0;0;0;9;5;N/A;N/A;55.56;0;0;0;0;0;0;N/A;N/A;N/A;0;0;0;0;0;0;N/A;N/A;N/A;
MENTAL HEALTH SERVICES;0;0;0;0;0;0;N/A;N/A;N/A;0;0;0;0;0;0;N/A;N/A;N/A;0;0;0;0;0;0;N/A;N/A;N/A;
PSYCHIATRY;0;0;0;0;13;10;N/A;N/A;76.92;0;0;0;0;0;0;N/A;N/A;N/A;0;0;0;0;0;0;N/A;N/A;N/A;
FAMILY MARRIAGE COUNSELING;0;0;0;0;4;1;N/A;N/A;25.00;0;0;0;0;0;0;N/A;N/A;N/A;0;0;0;0;0;0;N/A;N/A;N/A;
PSYCHOLOGY;0;0;0;0;2;2;N/A;N/A;100.00;0;0;0;0;0;0;N/A;N/A;N/A;0;0;0;0;0;0;N/A;N/A;N/A;
PSYCHOLOGY - BOISE;0;0;0;0;0;0;N/A;N/A;N/A;0;0;0;0;4;3;N/A;N/A;75.00;0;0;0;0;0;0;N/A;N/A;N/A;
PULMONARY;0;0;0;0;101;27;N/A;N/A;26.73;0;0;0;0;0;0;N/A;N/A;N/A;0;0;0;0;1;1;N/A;N/A;100.00;
GROUPER:MEDICINE;2;2;0;0;412;141;0.00;0.00;34.22;0;0;0;0;7;5;N/A;N/A;71.43;0;0;0;0;17;9;N/A;N/A;52.94;
Resubmitted requests XE "Resubmitted requests" are evaluated based on the original Date of Request.
The following are excluded from this report:
-Requests sent to test patients.
-Requests not marked as Outpatient in the REQUEST/CONSULTATION file.
-Services flagged as part of the interface between Consults/Request Tracking
and Prosthetics.
-Administrative requests flagged via the Administrative fields in the
REQUEST SERVICES and REQUEST/CONSULTATION files. This is not retroactive
and only applies to services/requests leveraging the Administrative-flagging
capability included in GMRC*3.0*60, available on or about June 2008.
Print Consults by Provider XE "Print Consults by Provider" XE "Print Consults by Location" XE "Print Consults by Procedure" , Location, or Procedure (PL)
This provides three different reports under one menu option [GMRC PRINT BY SEARCH]. The option asks for search criteria: Sending Provider, Location, or Procedure. You can further limit the search by entering a date range and CPRS status. The option also prompts for report format. The report format can be one of the following:
80 column standard print [STANDARD].
132 column standard print.
Table without headers (export to another application).
In this example, a list of EKG consults is generated:
Select Consult Tracking Reports Option: ?
ST Completion Time Statistics
PC Service Consults Pending Resolution
CC Service Consults Completed
CP Service Consults Completed or Pending Resolution
IFC Inter-Facility Consult Requests
NU Service Consults with Consults Numbers
PL Print Consults by Provider, Location, or Procedure
PR Print Service Consults by Status
SC Service Consults By Status
TS Print Completion Time Statistics Report
Enter ?? for more options, ??? for brief descriptions, ?OPTION for help text.
Select Consult Tracking Reports Option: PL Print Consults by Provider, Location
, or Procedure
Enter Search criteria:
1 = Sending Provider
2 = Location
3 = Procedure
Search criteria: (1-3): 1// 3
Enter 'YES' if you want all PROCEDURES? NO//
ENTER PROCEDURE: EKG
1 EKG - BOISE
2 EKG ELECTROCARDIOGRAM
CHOOSE 1-2: 2 ELECTROCARDIOGRAM
ENTER PROCEDURE:
Please select an output format from the following:
1 - 80 column standard print [STANDARD]
2 - 132 column standard print
3 - Table without headers (export to another application)
Enter response: 1// 1 80 column
Display sort sequence & page breaks between sub-totals? YES//
List From Starting Date (ALL): T-30// T-60 (NOV 09, 2001)
List To This Ending Date: (NOW)
Only Display Consults With Status of: All Status's//
DEVICE: HOME// ANYWHERE Right Margin: 80//
U PROCEDURE: ELECTROCARDIOGRAM Jan 08, 2002 9:44:39 am Page 1 .
CONSULTS GENERATED BY PROCEDURES(S), FOR SPECIFIED DATE(S)
FROM: Nov 09, 2001 TO: Jan 08, 2002
CONSULT REQ DATE PROCEDURE PATIENT NAME SSN TO SERVICE ST
-------------------------------------------------------------------------------
2189 11/21/01 ELECTROCARDIOGRA CPRSPATIENT,THIRTEEN 0013 CARDIOLOGY c
2211 11/21/01 ELECTROCARDIOGRA CPRSPATIENT,THIRTEEN 0013 CARDIOLOGY dc
2208 11/21/01 ELECTROCARDIOGRA CPRSPATIENT,THIRTEEN 0013 CARDIOLOGY c
2209 11/21/01 ELECTROCARDIOGRA CPRSPATIENT,THIRTEEN 0013 CARDIOLOGY c
2210 11/21/01 ELECTROCARDIOGRA CPRSPATIENT,FOURTEEN 0014 CARDIOLOGY c
2212 11/22/01 ELECTROCARDIOGRA CPRSPATIENT,THIRTEEN 0013 CARDIOLOGY c
2213 11/22/01 ELECTROCARDIOGRA CPRSPATIENT,THIRTEEN 0013 CARDIOLOGY c
2224 11/27/01 ELECTROCARDIOGRA CPRSPATIENT,FIFTEEN 0015 CARDIOLOGY p
2225 11/27/01 ELECTROCARDIOGRA CPRSPATIENT,FIFTEEN 0015 CARDIOLOGY p
2226 11/28/01 ELECTROCARDIOGRA CPRSPATIENT,SIXTEEN 0016 CARDIOLOGY a
9881 12/3/01 ELECTROCARDIOGRA CPRSPATIENT,THIRTEEN 0013 CARDIOLOGY c
9895 12/5/01 ELECTROCARDIOGRA CPRSPATIENT,THIRTEEN 0013 CARDIOLOGY p
9896 12/5/01 ELECTROCARDIOGRA CPRSPATIENT,THIRTEEN 0013 CARDIOLOGY p
9902 12/17/01 ELECTROCARDIOGRA CPRSPATIENT,SEVENTEEN 0017 CARDIOLOGY c
9903 12/17/01 ELECTROCARDIOGRA CPRSPATIENT,SEVENTEEN 0017 CARDIOLOGY p
9905 12/17/01 ELECTROCARDIOGRA CPRSPATIENT,SEVENTEEN 0017 CARDIOLOGY p
Enter RETURN to continue or '^' to exit:
Print Test Page (TP)
Sometimes the pagination on SF 513 is correct on some printers but incorrect on others. The Print Test Page command is provided for diagnosing incorrectly paginated SF 513s. Instructions for correcting this situation are printed with the test page. Bring the test page to IRM for resolution of the problem.
In this example, we run the Print Test Page option on a specified printer:
Select Consult Management Option: TP Print Test Page
Print consults printer setup page.
DEVICE: HOME// LAZER PRINTER ROOM LN11 12 PITCH Right Margin: 80//
Do you want your output QUEUED? NO// (NO)
Select Consult Management Option:
Determine Users' Update Authority (UA)
Sometimes it is necessary to quickly check on the authority of a service user. The Determine Users Update Authority option of the Consults Management menu does this.
In this example, the authority for Dr. Snow is checked for the Cardiology service:
Select Consult Management Option: UA Determine users' update authority
This option will allow you to check a user's update authority for any given
service in the consults hierarchy. If the PROCESS PARENTS FOR UPDATES field
is set to YES, all ancestors of the selected service will be checked.
The type of update authority and the service to which they are assigned will
be displayed.
Select Consult Service: CARDIOLOGY
Choose user to check for update status: SNOW SNOW,CHARLES R. CA
MD Surgeon
This user is an update user for: CARDIOLOGY
via the UPDATE USERS W/O NOTIFICATIONS field.
Select Consult Service:
Determine if User is Notification Recipient (UN)
Sometimes it is necessary to quickly check a users notification status for a service. The Determine if User is Notification Recipient option of the Consults Management menu accomplishes this.
In the following example CPRSPROVIDER,ONE notification status is checked for the Podiatry Clinic:
Select Consult Management Option: UN Determine if user is notification recipient
This option will list how a given user became a notification recipient
for a selected consult service. If the PROCESS PARENTS FOR NOTIFS field is
set to YES, all the parents of the service will also be processed to
determine if the user is a recipient via that service.
Select Consult Service: POD FOOT CLINIC
Choose notification recipient: CPRSPROVIDER CPRSPROVIDER,ONE OC PHYSICI
AN
This user is a notification recipients for FOOT CLINIC
Select Consult Service:
Determine Notification Recipients for a Service (NR)
Occasionally it is necessary to see the entire list of notification recipients for a service. The Determine Notification Recipients for a Service option of the Consults Management menu performs the function.
In the following example, notification recipients are listed for the Medicine service:
Select Consult Management Option: NR Determine notification recipients for a se
rvice
Select Service: MEDICINE
UConsult Notif Recipients May 10, 2000 19:46:44 Page: 1 of 1(
Notification Recipients for: MEDICINE
U Notification Recipient Service (
CPRSPROVIDER,TWELVE MEDICINE
CPRSPROVIDER,FOUR MEDICINE
CPRSPROVIDER,ONE MEDICINE
CPRSPROVIDER,NINE MEDICINE
CPRSPROVIDER,THIRTEEN MEDICINE
CPRSPROVIDERR,FOURTEEN MEDICINE
CPRSPROVIDER,FIFTEEN MEDICINE
CPRSPROVIDER,SIXTEEN MEDICINE
CPRSPROVIDER,SEVENTEEN MEDICINE
CPRSPROVIDER,EIGHTEEN MEDICINE
CPRSPROVIDER,NINETEEN MEDICINE
Enter ?? for more actions
SS Select new Service
Select Item(s): Quit//
Test Default Reason for Request (TD)
The Test Default Reason for Request option of the Consults Management menu is provided so that the boilerplate entered in the default reason for request can be tested. It is important to test this boilerplate, especially if it contains TIU objects (TIU objects are contained in vertical bars as such: |PATIENT NAME|.)
TIU can vary from site to site. There are only a certain number of objects that are common to all sitesthese are the Supported Objects. The following table contains a list of these objects:
Object NameObject NameACTIVE MEDICATIONS PATIENT HEIGHT ACTIVE MEDICATIONSPATIENT NAME ACTIVE MEDS COMBINEDPATIENT RACE ALLERGIES/ADR PATIENT RELIGION BLOOD PRESSURE PATIENT SEX CURRENT ADMISSION PATIENT SSN DETAILED ACTIVE MEDSPATIENT WEIGHT DETAILED RECENT MEDSPULSE NOW RECENT MEDICATIONSPAINRECENT MEDS COMBINEDPATIENT AGE RESPIRATION PATIENT DATE OF BIRTH TEMPERATURE PATIENT DATE OF DEATH+ Status TODAY'S DATE Further information about objects can be obtained at the following VA intranet address:
vista.med.va.gov/softserv/clin_bro.ad/tiu/html/objects.html
In the following example, we first use the SS option to enter a default reason for request as such:
. . .
DEFAULT REASON FOR REQUEST:
1>|PATIENT NAME| is a |PATIENT AGE| y/o |PATIENT RACE| |PATIENT SEX|
2>currently taking |ACTIVE MEDICATIONS|
3>
4>
5>Allergies:
6>|ALLERGIES/ADR|
7>
8>Latest BP: |BLOOD PRESSURE|
9>
10>Patient to be seen for full cardiac evaluation.
EDIT Option:
. . .
Now, to check this we use the TD option to check this for a specific patient:
Select Consult Management Option: TD Test Default Reason for Request
Test default for service or procedure? ?
Enter a code from the list.
Select one of the following:
S service
P procedure
Test default for service or procedure? Service
Select Service: CARDIOLOGY
Select PATIENT: CPRSPATIENT,EIGHTEEN CPRSPATIENT,EIGHTEEN 5-19-46 000180018 YES SC VETERAN
Enrollment Priority: Category: IN PROCESS End Date:
Gathering Allergy Data..
UDefault Reason for Request May 10, 2000 20:15:56 Page: 1 of 1(
Service: CARDIOLOGY
Patient: CPRSPATIENT,EIGHTEEN
U (
CPRSPATIENT,EIGHTEEN is a 53 y/o BLACK, NOT OF HISPANIC ORIGIN MALE
currently taking Active Inpatient Medications (excluding Supplies):
Pending Inpatient Medications Status
=========================================================================
1) WARFARIN TAB 10MG PO PRN PENDING
Allergies:
BEEF
Latest BP: Blood Pressure: 130/80/100 (06/02/1999 13:17)
Patient to be seen for full cardiac evaluation.
Enter ?? for more actions
SS Select new service SP Select new patient
Select Item(s): Quit//
List Consult Service Hierarchy (LH)
This option of the Consults Management menu gives a complete list of the Consult Service Hierarchy as it currently exists. All services, including disabled ones, are listed with their current status. At the end of the hierarchy listing it will show any services that are not part of the hierarchy.
In this example we start to list the service hierarchy from our test account on the computer screen:
Select Consult Management Option: LH List Consult Service Hierarchy
DEVICE: HOME// VAX
Consult Hierarchy list Page: 1
------------------------------------------------------------------------------
ALL SERVICES (Grouper Only)
ARTHRITIS (Tracking Only)
FOOT CLINIC (Tracking Only)
GASTROENTEROLOGY
GERIATRICS
HYPERTENSION
MARCIA'S SPECIALTY
MEDICINE (Grouper Only)
CARDIOLOGY
GASTROENTEROLOGY
PULMONARY
MEDICINE VISN
MEDICINE (EAST)
MEDICINE,SOUTH
CARDIOLOGY (SOUTH)
Press RETURN to continue, ^ to exit:
Copy Prosthetics Services (CP)
The Copy Prosthetics Services option of the Consult Management menu is provided to assist you in configuring the prosthetics services at your medical center. . . .
The four (4) nationally exported services for Prosthetics are:
1) PROSTHETICS REQUEST
2) EYEGLASS REQUEST
3) CONTACT LENS REQUEST
4) HOME OXYGEN REQUEST
The basis of the interface between Consult/Request Tracking and Prosthetics is the name of the Consult service being requested. When a request for a consult is ordered, if the name of the service requested is one of the nationally exported services, the order will be filed in the Prosthetics package as well as Consult/Request Tracking. Since the name of the service is critical to the stability of the interface, the name of each of the above services will not be editable.
Each of the services have several other fields defined based on requirements of the interface. The fields that are restricted are:
(#.01) NAME
(#1.01) PROVISIONAL DX PROMPT
(#1.02) PROVISIONAL DX INPUT
(#124) DEFAULT REASON FOR REQUEST
When a request is copied, all these fields remain intact so that a request to that service is processed by the Prosthetics Package.
In the following example, the Copy Prosthetics action is used to create an Eyeglass Request service with the location name Provo appended to it. To be useful, the following additional actions should be taken:
Use the Setup Service (SS) action to place the service in the hierarchy.
Use the Setup Service (SS) action to activate the service.
Select Consult Management Option: CP Copy Prosthetics services
Select the Prosthetics Service to clone: Eyeglass Request DISABLED
Enter text to append to national service name: Provo
The new service name will be:
EYEGLASS REQUEST - Provo
Is this OK? Y YES
EYEGLASS REQUEST - Provo created
The new Service is currently DISABLED. To activate this service for use in
the Prosthetics interface, you MUST use the Setup Consult Services option
and delete the DISABLED flag from the SERVICE USAGE field.
Select Consult Management Option:
Consult Closure Tool (CCT)
The Consult Closure Tool provides options to identify consult requests that are incorrectly left in Pending status and efficiently closes out those consults. Search parameters can be configured in the tool, providing a list that allows you to close out consults by attaching a relevant note within the tool. There are also options to export the search results from the tool to a printable format and update a team list in CPRS.
The VistA Consult Closure tool consists of three components:
Edit Configuration: Enables the user to configure the tool to identify pending consults based on search parameters, including clinics, orders, consult services, and procedures. The user also selects relevant note titles to use in closing pending consults. One or more valid configurations must be created prior to using the Run Configuration option.
Inquire Configuration: Enables the user to print and view the configuration to ensure that it is set up properly.
Run Configuration: Enables the user to select eligible note titles to close an open consult, perform the closure action, and/or create team lists that are viewable in CPRS.
The Consult Closure Tool is located in the GMRC MGR menu. This menu is normally allocated to IRMS/ADPAC personnel.
Navigate to the GMRC MGR menu option.
Type CCT to open the Menu for Closure Tools.
The following options appear:
EDT Consult Closure Tool Edit Configuration
INQ Consult Closure Tool Inquire Configuration
RUN Consult Closure Tool Run Configuration
Edit Configuration Component
The first step is to set up the configuration(s) using the Consult Closure Tool Edit Configuration menu option.
The key points when setting up a Consult Closure configuration are:
The Config Name is free text. It is strongly suggested that simple names be used for the configurations and that they closely match existing consult service naming conventions.
Configurations may contain Clinical Procedure requests, as well as specific consult orderable items, in addition to standard consult services. For example, one configuration for PULMLAB might encompass Pulmonary Function Test Request Consults, CP Pulmonary Function Test Procedure Requests, and specific orderable items for Pulmonary Sleep Studies.
In order to view the team lists that can be generated out of this tool in CPRS, team lists must be created in VistA prior to using this tool. It is strongly suggested that a naming convention be established prior to creating the first configuration. For example, begin the team list name with "CONSULT_REPORT_" with the specific configuration name following. In this way, all of the team 's patient lists created within this tool are in sequence when browsed for on the CPRS Patient Selection screen in the Patient List pane.
In the Configuration Editor screen, each of the four Consults fields are optional, but at least one of the four must be filled in to run the configuration. All four of the options allow for multiple selections. The search operates as a Boolean AND search for the entries into these fields. Therefore, each additional entry narrows your search because a consult request must meet all of the entries.
( Note: Wildcard selection (ABC*) or exclusion (-ABC*) can be used in the editor in all of the entry fields. For example, all note titles beginning with ABC would be selected by entering ABC*. To exclude all note titles beginning with ABC, you would enter ABC*.
The key components of the editor are shown in the example below.
*************** Consult Closure Tool Configuration Editor *****************
-------------------------------------------------------------------------------
Config Name: UNIT TEST Days Cons->Appt: 365 Inactive:
CPRS Team: TEAM CLOSURE Days Appt->Note: 365 NO
Consults - Service: Consults - Procedure:
MEDICAL SERVICE OTHER CATHETERIZATION
PULMONARY IFC DENVER
Consults - Order Item: Consults - Clinical Procedure:
Clinics: - and/or - Stop Code: 706 Note Titles:
CHY UROL MCPEAK 10-10ED EMERGENCY DEPARTMENT NOTE
___________________________________________________________________________
COMMAND: Press H for help Insert
To create or edit a Consult Closure configuration:
In the GMRC MGR menu, type "CCT" and then press Enter to open the Menu for Closure Tools.
Type "EDT" and then press Enter.
At the initial Consult Closure Tool Edit Configuration prompt, enter the new or existing configuration name. For a new configuration, type Yes when asked if you want to add this as a new consult configuration.
Press Enter. The Configuration Editor screen opens with the Config Name field highlighted and editable.
In the Days Cons -> Apt field, enter the maximum number of days between the date of the consult entry and the clinic appointment. The tool will search for pending consults that fall within this time period. A shorter interval will make the tool run faster.
In the CPRS Team field, enter the name of the CPRS team that will be populated when this configuration is run. The team must already exist.
In the Days Appt -> Note field, enter the maximum number of days between the clinic appointment date and the date of the eligible note that can be associated with the consult in the Run Configuration option.
In the Inactive field, enter NO (the default option) to make this configuration active. If a configuration is marked inactive, it is not selectable when running the Consult Closure Tool. It is still selectable in the Edit and Inquire options.
(optional) In the Consults - Service field, enter the name(s) of the consult service(s) to be used as search parameters.
(optional) In the Consults - Procedure field, enter the Procedure(s) to be used as search parameters. The Consults-Procedure field is for Medicine package procedure requests that do not use the Clinical Procedure (CP) interface.
(optional) In the Consults Order Item field, enter specific orderable item(s) to be used as search parameters.
(optional) In the Consults Clinical Procedure field, enter the Clinical Procedure(s) to be used as search parameters.
In the Clinics field, enter the Clinics to be used as search parameters. In lieu of entering individual clinics, you can enter the relevant Stop Code(s) to capture all associated clinics if they have already been correctly mapped in VistA. Adding more clinics broadens your search (operating as a Boolean "OR"), as the patient only has to be associated with one of them for their consult request to be returned when running the configuration.
In the Note Titles field, enter all eligible note titles to be associated with pending consults during Run Configuration. Define an appropriately comprehensive set of note titles, but be aware that an overly broad list might result in a higher likelihood of incorrect association with a pending consult.
This step is key as it allows non consult-class TIU documents that have been completed subsequent to a consult request to be associated with the consult, thus converting that pending consults status to Completed.
Press E to save and exit. This returns you to the CCT menu. For a complete list of help options, press H.
If the configuration is incomplete, you are notified when saving the configuration. Once the search configuration is completed, you are able to run a report using the Run Configuration option.
Inquire Configuration Component
Once a configuration is created, it can be viewed and printed using the Consult Closure Tool Inquire Configuration menu option. This option is useful for verifying that the configuration is set up properly. At the Menu for Closure Tools, type "INQ" to view the configuration information.
Run Configuration Component
Use the Consult Closure Tool Run Configuration menu option to implement the search for pending consults. When you are done using the Run Configuration, press E to return to the CCT menu.
Select CONSULT CONFIGURATION: UNIT TEST//
Select a consult date range
Monthly, Quarterly, Semi-Annually, Yearly, Fiscal Yearly, User Selectable
Select date range: U// USER SELECTABLE
Enter beginning and ending dates for the desired time period:
Beginning Date: 01/01/2017//10/1/2010 (OCT 01, 2010)
Ending Date: 01/31/2017// (JAN 31, 2017)
Range selected: 10/01/2010 to 01/31/2017
Select an appointment status for the report
1 - Seen in clinic
0 - Not seen in clinic
Select APPOINTMENT STATUS: 1// 0 Not seen in clinic
Select a note status for the report
1 - Has a note
0 - Does not have a note
Select NOTE STATUS: 1// Has a note
Interactive consult update: Yes// YES
Searching for patient consults / appointments / notes
To run a configuration:
In the GMRC MGR menu, type "CCT" and then press Enter to open the Menu for Closure Tools.
On the CCT menu screen, type RUN and then press Enter.
At the Select CONSULT CONFIGURATION: prompt, enter the name of the configuration to be run and then press Enter. This prompt defaults to the your last selection, allowing you to just press Enter to access the last run configuration.
At the Select date range: prompt, select a consult request date range. Type the first letter of the desired range (e.g., "M" for monthly). The default range is U for User Selectable. Note: The larger the selected date range, the longer the Consult Closure Tool takes to run.
If you selected User Selectable, enter the desired date range at the Beginning date: and Ending date: prompts. The default dates are the beginning and ending day of the previous month.
At the Select APPOINTMENT STATUS: prompt, choose consult requests for which the patients have been seen or not seen in a clinic (the clinic list or stop code was delineated in the Configuration Editor). The default option is Seen in clinic.
At the Select NOTE STATUS: prompt, choose consult requests that have an eligible note or no eligible note. The default option is Has a note. This is the standard selection for completing consults with an encounter for which a note has been written. Most commonly, this involves a non-consult class note title being selected for the care documentation.
If you selected Has a note, then the Interactive consult update: prompt displays. The default response is Yes. Select Yes to interactively view the pending consults and the notes specified in the configuration, and optionally complete each consult by selecting a note to associate with it. More information is provided in the Closing Out Consults section below. Select No to print a report of the pending consults and notes and/or update the CPRS team list associated with the selected configuration. The default selection when selecting No is to both print and update the CPRS team list.
If "Does not have a note" is selected, you have the option to print a report of the pending consults and notes and/or update the CPRS team list associated with the selected configuration.
Closing Out Consults
If you selected Yes at the Interactive consult update: prompt while running the configuration, then you can use the Closure Tool to review and close out pending consults. The tool will search for patient consults, appointments, and notes. This might take some time (possibly up to 20 minutes) depending on the search criteria specified in the configuration and the date range. When the search is complete, the number of patients, consults, and notes is displayed.
The Consult Closure Tool has identified Patients: 6 Consults: 6 Notes: 9 that meet your selected criteria.
Press RETURN to continue
Press Enter to see the first patients Consult Narrative. The patients Consult Narrative screens appear in alphabetical order by patient last name:
Consult closure for patient: CPRSPatient,One (M9668) 09/25/1933
MEDICAL SERVICE OTHER (p) 11/12/2010
Consult Narrative (1 of 3)
Current PC Provider: CPRSProvider,One
Current PC Team: TEAM GLY 1
Current Pat. Status: Outpatient
Primary Eligibility: NSC(VERIFIED)
Patient Type: NSC VETERAN
OEF/OIF: NO
Order Information
To Service: MEDICAL SERVICE OTHER
From Service: C SURGERY
Requesting Provider: CPRSProvider,Two
Service is to be rendered on an OUTPATIENT basis
Place: Consultant's choice
Urgency: Today
Clinically Ind. Date:
Orderable Item: MEDICAL SERVICE OTHER
Consult: Consult Request
Provisional Diagnosis: medical care/ management of DM
Reason For Request:
management of DM, medical clearance for possible laparotomy in am
Col> Use S to Switch between views of the consult and progress note(s)
Use R to Return to the previously viewed consult or progress note(s)
Col> 1 |Press H for help| Line> 20 of 38 Screen> 1 of 2
Patient and consult information is displayed first, followed by the consult and/or notes associated with the patient. You can scroll through the text by using the arrow and page up/down keys.
The Consult Narrative appears first for each patient. To toggle to the eligible notes on the BROWSE SWITCH MANAGER, select Num-Lock/S or S. This opens the BROWSE SWITCH MANAGER screen, where you can view the notes available to close out the consult.
BROWSE SWITCH MANAGER
Choose from:
2 Note 01: 10-10ED EMERGENCY DEPARTMENT NOTE
Select CURRENT LIST:
BROWSE SWITCH MANAGER
The BROWSE SWITCH MANAGER screen displays the eligible notes selected in the Configuration Editor. Selecting a note displays the contents of the note. When viewing the selected note, press S to return to the list of notes on the BROWSE SWITCH MANAGER screen. After you have reviewed the consult and the identified notes and are ready to close the consult or move on to the next patient, press Num-Lock/E or E to exit the current screen. This opens the Consult closure screen.
( Note: The notes on the BROWSE SWITCH MANAGER screen are displayed in reverse chronological order, grouped by note title. If there are multiple available and relevant note titles for a given patient within each of the note title groups, then the oldest note appears at the bottom. However, the note at the bottom of the list is only the oldest for that note title group, and might not be the oldest note of all note titles (that is, closest in time to the date of the pending consult itself) that are available for that patient.
Consult closure for patient: CPRSPatient,One 09/25/1933 MEDICAL SERVICE OTHER (p) 11/12/2010
Select the note to close the consult 0 - Do not close the consult 1 - Note 01: 10-10ED EMERGENCY DEPARTMENT NOTE 2 - Redisplay the consult/progress note(s) ^ - Exit the Consult Closure Tool Select NOTE TO CLOSE CONSULT: 2//
In the Consult closure screen (pictured above), you can select from the following options: a) Do not close the consult, b) Close the consult with one of the identified notes, c) Return to the consult/note display screen for further review, or d) Exit the Consult Closure Tool. If you select option a), then no action is taken on the consult and the tool automatically displays the next consult. If you select option b), then the tool closes the consult with the selected note and automatically displays the next patients Consult Narrative. This process continues until all consults are processed or you exit the Consult Closure Tool.
Printing/Updating the CPRS Team List
If you selected No at the"Interactive consult update" prompt in Run Configuration, then you can print a consult/note report list and/or update the CPRS team list associated with the selected configuration. The default is to both print the report and update the team list.
Select the output type for the report
1 - Print report
2 - Team update
Select OUTPUT TYPE: 1,2//
Delimited output: No// NO
This report requires a 132 column output device
DEVICE: HOME// ;;9999999 HOME (CRT) Right Margin: 80//
For the Print option, the report may be printed in a human readable format (the default No option) or a carat (^) delimited format for import into another program (such as an Excel spreadsheet). The report requires a 132-column output device.
For the Team update option, the selected configuration updates the CPRS patient team list associated with it. When run, any pre-existing patients on the list are removed and replaced with the newly-identified patients. The user running the Consult Closure Tool and the users associated with the team list will receive alerts when the team update has completed.
Duplicate Sub-Service (DS)
The Duplicate Sub-Service option of the Consult Management menu is provided to assist you in debugging your service hierarchy. It displays services that are listed as a sub-service of more than one service. Having a service as a sub-service of more than one service has several undesirable effects. These include:
Reports that span more than one level of the hierarchy inaccurately report statistics.
Notification recipients may be inaccurately determined.
In this example, we run the DS option on our local test account:
Select Consult Management Option: DS Duplicate Sub-Service
Service GASTROENTEROLOGY is a sub service of:
ALL SERVICES
MEDICINE
There is 1 service that is a sub-service for more than one service.
Select Consult Management Option:
Define Fee Services (FS)
The Define Fee Services option of the Consult Management menu is provided to assist you in modifying the list of services defined as being fee basis services in the GMRC FEE SERVICES system parameter.
In the following example, we begin with an empty list of services.
Edit Fee Services Mar 01, 2012@15:39:09 Page: 0 of 0
Services defined in GMRC FEE SERVICES system parameter
as fee-basis services.
+ Next Screen - Prev Screen ?? More Actions
Add Save
Remove Quit
Select Action:Quit//
We then add a service (leaving the REQUEST SERVICES SERVICE NAME prompt blank will cancel the entry).
Edit Fee Services Mar 01, 2012@15:39:09 Page: 0 of 0
Services defined in GMRC FEE SERVICES system parameter
as fee-basis services.
+ Next Screen - Prev Screen ?? More Actions
Add Save
Remove Quit
Select Action:Quit//a Add
Select REQUEST SERVICES SERVICE NAME: NON-VA GasTROENTEROLOGY
( Note: Although trackers and groupers may be available when selecting services to add to the list, they should not be added. Only actual services should be included in this list.
Edit Fee Services Mar 01, 2012@15:44:50 Page: 1 of 1
Services defined in GMRC FEE SERVICES system parameter
as fee-basis services.
1 NON-VA GASTROENTEROLOGY
**GASTROENTEROLOGY ADDED**
Add Save
Remove Quit
Select Action:Quit//
Now, starting with a list of a few services, we delete a service.
Edit Fee Services Mar 01, 2012@15:44:50 Page: 1 of 1
Services defined in GMRC FEE SERVICES system parameter
as fee-basis services.
1 NON-VA GASTROENTEROLOGY
2 NON-VA CARDIOLOGY
3 NON-VA PHYSICAL THERAPY
+ Next Screen - Prev Screen ?? More Actions
Add Save
Remove Quit
Select Action:Quit// r Remove
Select service by number in list above: (1-4): 2
Edit Fee Services Mar 01, 2012@15:44:50 Page: 1 of 1
Services defined in GMRC FEE SERVICES system parameter
as fee-basis services.
1 NON-VA GASTROENTEROLOGY
2 NON-VA PHYSICAL THERAPY
**CARDIOLOGY REMOVED**
Add Save
Remove Quit
Select Action:Quit// r Remove
Finally, we save our list and quit.
Edit Fee Services Mar 01, 2012@15:44:50 Page: 1 of 1
Services defined in GMRC FEE SERVICES system parameter
as fee-basis services.
1 NON-VA GASTROENTEROLOGY
2 NON-VA PHYSICAL THERAPY
+ Next Screen - Prev Screen ?? More Actions
Add Save
Remove Quit
Select Action:Quit// s Save
Edit Fee Services Mar 01, 2012@15:44:50 Page: 1 of 1
Services defined in GMRC FEE SERVICES system parameter
as fee-basis services.
1 NON-VA GASTROENTEROLOGY
2 NON-VA PHYSICAL THERAPY
**CURRENT LIST SAVED**
Add Save
Remove Quit
Select Action:Quit// q Quit
( Note: The list must be saved for changes to take effect. If the user quits without saving, he or she will be prompted to save changes before quitting. Inter-Facility Consults Reports XE "Inter-Facility Consults:Reports"
The Inter-Facility Consults reports are available on the Consult Tracking Reports menu [GMRC REPORTS] and the IFC Management Menu [GMRC IFC MGMT]. Currently four Inter-Facility Consults reports show up on this menu. They are:
Report SynonymReport NameOption NameIFCIFC Requests[GMRC IFC RPT CONSULTS]IPIFC Requests by Patient[GMRC IFC RPT CONSULTS BY PT]PIPrint IFC Requests[GMRC IFC PRINT RPT NUMBERED] IRIFC Requests by Remote Ordering Provider[GMRC IFC RPT CONSULTS BY REMPR]IFC Requests (IFC) provides detailed information regarding inter-facility consults. The Inter-Facility Consult Requests (PI) is the same report formatted for a printer.
The IFC Request by Patient (IP) is similar to option Consult Service Tracking, except only displays inter-facility consults as a requesting or consulting facility.
The IFC Requests by Remote Ordering Provider (IR) provides detailed information regarding inter-facility consults by remote ordering provider for consulting sites to utilize. The display is similar to the IFC/PI options.
IFC Requests XE "IFC Requests"
This report provides such information as:
Total Requests to Service
Total Requests Scheduled to Service
Total Requests Completed to Service
Mean Days Completed to Service
This report provides information for both requesting and consulting facilities.
In the following example, we examine all Dental consults originating by us as a requesting facility:
Select IFC Management Menu Option: IFC Inter-Facility Consult Requests
Are you the Requesting site or the Consulting site: (R/C): R REQUESTING
Only Display Consults With Status of: All Status's// ?
Enter a code from the list.
Select one of the following:
al All Status's
ap All Pending
dc Discont.
c Completed
p Pending
a Active
s Scheduled
pr Incomplete
x Cancelled
Only Display Consults With Status of: All Status's// All Status's
Select Service/Specialty: DENTAL
List From Starting Date: ALL DATES//
...SORRY, LET ME THINK ABOUT THAT A MOMENT...
U Inter-facility Consults Feb 07, 2002@11:06:22 Page: 1 of 1.
IFC Requests: Requesting Site
Service: DENTAL
From: ALL To: JAN 31,2002
U Status Last Action Request Date Patient Name Pt Location .
IF Consult/Request By Status - Requesting Site
FROM: ALL TO: JAN 31,2002
SERVICE: DENTAL
Discont. DISCONTINUED 10/18/01 CPRSPATIENT,N. (0019) 2B MED
Discont. DISCONTINUED 10/18/01 CPRSPATIENT,T. (0020) 1A(1&2)
Completed ADDENDUM ADDED TO 10/23/01 CPRSPATIENT,N. (0019) 2B MED
Pending CPRS RELEASED ORDER 12/20/01 CPRSPATIENT,T. (0020) 1A(1&2)
Pending CPRS RELEASED ORDER 12/03/01 CPRSPATIENT,T. (0020) 1A(1&2)
Pending CPRS RELEASED ORDER 11/30/01 CPRSPATIENT,T. (0021) OUTHOUSE
Pending CPRS RELEASED ORDER 11/13/01 CPRSPATIENT,T. (0022) 2B MED
Pending CPRS RELEASED ORDER 10/18/01 CPRSPATIENT,N. (0019) 2B MED
Pending CPRS RELEASED ORDER 10/03/01 CPRSPATIENT,T. (0020) 1A(1&2)
Pending CPRS RELEASED ORDER 10/02/01 CPRSPATIENT,T. (0020) 2B MED
Pending ADDED COMMENT 10/01/01 CPRSPATIENT,T. (0020) 2B MED
+ Enter ?? for more actions >>>
Service Number on/off Description of Data
Status Print List
Select Item(s): Next Screen//
There are additional fields that are not visible on an 80 column screen such as the screen in the example. They can be viewed by using the Shift to View Right action (>). Using the Shift to View Left (, >>
SC Select new Consult DD Detailed Display
PL Print List CV Change View
Select action:Next Screen// DD
Select a Consult number from the display: (1-9999999): 2206
UIFC Transactions Mar 14, 2002@16:38:17 Page: 1 of 1.
Detailed Display
Consult#: 2206
U .
ENTRY DATE/TIME: NOV 21, 2001@15:47:53
FACILITY: BOISE
MESSAGE #: 66036920
ACTIVITY #: 1
INCOMPLETE: YES
TRANS. ATTEMPTS: 1
ERROR: Service not matched to receiving facility
Enter ?? for more actions >>>
SC Select new Consult DD Detailed Display
PL Print List CV Change View
Select action:Quit//
Locate IFC by Remote Consult Number XE "Locate IFC by Remote Consult Number" XE "Remote Consult Number"
This option is designed to assist consulting facilities with consult inquiries from requesting facilities. E.g., Do you have the consult with Boise number 845? All other reports are based on the local consult number. When a call is made from a requesting facility for information on the status of a consult, they are not likely to have the consulting facilitys numberonly their own number for that consult. This option gets around that problem by keying on the original consult number.
In this example, a CAC at Salt Lake assists a Physician at Boise in looking up Boise consult number 845:
Select IFC Management Menu Option: ?
TI Test IFC implementation
LI List incomplete IFC transactions
IFC IFC Requests
TR IFC Transaction Report
LK Locate IFC by Remote Cslt #
BK Monitor IFC background job parameters
IP IFC Requests By Patient
IR IFC Requests by Remote Ordering Provider
PI Print IFC Requests
Enter ?? for more options, ??? for brief descriptions, ?OPTION for help text.
Select IFC Management Menu Option: LK Locate IFC by Remote Cslt #
Choose the facility to which the remote entry belongs: ?
Answer with INSTITUTION NAME, or STATUS, or STATION NUMBER, or
OFFICIAL VA NAME, or CURRENT LOCATION, or NAME (CHANGED FROM)
Do you want the entire INSTITUTION List? N (No)
Choose the facility to which the remote entry belongs: BOISE
1 BOISE ID VAMC 531
2 BOISE ID RO 347
3 BOISE ID M&ROC 447
4 BOISE ID CHEP 932
CHOOSE 1-4: 1 BOISE ID VAMC 531
Select the Remote Consult Entry #: (1-9999999): 845
Select one of the following:
B brief
D detailed
Display type: B// detailed
UConsult Detailed Display Jan 31, 2002@08:20:11 Page: 1 of 5
CPRSPATIENT,THIRTEEN 000-13-0013 DEC 9,1950 (51)
Consult No.: 9943 Wt.(lb): No Entry
U .
Current Pat. Status: Outpatient
Order Information
To Service: PLASTIC SURGERY
From Service:
Requesting Provider:
Service is to be rendered on an OUTPATIENT basis
Place: Consultant's choice
Urgency: Routine
Orderable Item:
Consult: Consult Request
Reason For Request:
Can surgery correct this patients aging process??
Inter-facility Information
+ Enter ?? for more actions
Select Action:Next Screen//
Monitor IFC Background Job Parameters XE "Monitor IFC Background Job Parameters" XE "Background Job Parameters"
This option lists the current state of parameters covering the IFC background jobs. It also gives an alternate method of changing these parameters. E.G., If the running of the IFC Background job should be delayed for any reason (e.g. to install a GMRC patch or system maintenance), it may be delayed by using the Edit background job start parameter action and setting the start time parameter to a date/time in the future.
In this example, we view the IFC background job parameters:
Select IFC Management Menu Option: BK Monitor IFC background job parameters
URL Refresh background parameter list .
IFC Background Parameters Mar 14, 2002@16:27:11 Page: 1 of 1
Inter-facility Consults background job parameter display
U .
The IFC background job last started: Mar 14, 2002@15:48:57
The IFC background job last finished: Mar 14, 2002@15:48:57
The IFC background job is on schedule or is
running.
It may be delayed by editing the start time
to a future date/time using the Edit start
time action.
Enter ?? for more actions
ES Edit background job start parameter
RL Refresh background parameter list
Select action:Quit//
Notification Parameters XE "Notification Parameters"
There are four (4) Consults notifications:
#23 CONSULT/REQUEST RESOLUTION XE "CONSULT/REQUEST RESOLUTION"
#27 NEW SERVICE CONSULT/REQUEST XE "NEW SERVICE CONSULT/REQUEST"
#30 CONSULT/REQUEST CANCEL/HOLD XE "CONSULT/REQUEST CANCEL/HOLD"
#63 CONSULT/REQUEST UPDATED XE "CONSULT/REQUEST UPDATED"
Any user who wants to receive these notifications must have the notifications enabled for themselves. To turn on these notifications, use the Enable/Disable Notifications option of the NOTIFICATION MGMT MENU, ORB NOT MGR MENU.
( NOTE: Unless Consult notifications are set to mandatory, individual users may use the Enable/Disable My Notifications option of the Notifications Management Menu to individually disable the notifications they do not want to receive.
Also, the deletion parameter for these notifications is set to Individual Recipient. This means that when an individual reviews one of these notifications, the notification is deleted for only that individual. This parameter may be set to All Recipients, in which case a notification is deleted for all recipients when any one of them reviews it.
To change the deletion parameter for any of the Consults notifications, use the Set Deletion Parameters for Notifications option of the Notification Mgmt Menu.
The newest notification, #63, CONSULT/REQUEST UPDATED, is triggered when a comment is added to consult or the consult is scheduled. Comments may be added either with the Add Comment (CM) action or the Schedule (SC) action. The text of the alert is altered depending on which one of these actions initiated the alert as follows:
Adding a Comment #63 "Comment Added to Consult: . . ."
Scheduling #63 "Scheduled Consult: . . ."
Consult Service Tracking
xe "Consult Service Tracking"
Functionalityxe "Functionality"
The Consult Service Tracking (GMRC SERVICE TRACKING) option is a generic User option that:
Provides a by patient lookup of consults and procedure requests which is similar to CPRSs by patient lookup of orders.
Provides a by Service lookup of consults and procedure requests. Users may select a service/specialty at any level in the hierarchy of services defined by IRMS/ADPACxe "ADPAC" personnel.
( Note: The Consults Select Service (SS) XE "Select Service (SS)" action XE "Action" lumps all consult and procedure request orders under a Display Group called CONSULT... The only way for users to breakdown these orders by request service is to use the Select Service (SS) action provided by this option.
Displays a review screen of consults/requests in sequence by inverted order released date/time (most recent consults first).
Includes the Services Last Activity update and the updated CPRS status for each consult/request displayed.
Provides basic Select Action: prompt capabilities which parallel CPRS actions. Exactly which actions are displayed depends on the privileges accorded to the person using the system. Privileged actions such as Complete (CT) XE "Complete (CT)" , Cancel (DY) XE "Cancel (DY)" , Discontinue (DC) XE "Discontinue (DC)" , Forward (FR) XE "Forward (FR)" , Receive (RC) XE "Receive (RC)" , Schedule (SC) XE "Schedule(SC)" , Significant Findings (SF) XE "Significant Findings (SF)" , and Make Addendum (MA) XE "Make Addendum (MA)" are not displayed if the user cannot perform them.
To make a determination of whether a user can perform privileged actions or not, Consults checks the following fields from the Requests Services (#123.5) file:
Service Individual to Notify123.08
Service Team(s) to Notify123.08
Update Users W/O Notifications123.1
Update Teams W/O Notifications123.3
Administrative update users123.33
Administrative update teams123.34
Text Integration Utilities (TIU) Setupxe "Text Integration Utilities (TIU) Setup"
The Text Integration Utilities package is essential for completing consults under V. 3.0. It gives you several benefits not previously available. Among them are the ability to use boilerplate for selected consult types and the ability to file results in the TIU data base.
In this section we first review the process of Consults resulting. Then we present two different document definition hierarchies that may be used for Consults results. Finally, we present the TIU options you need to set up the TIU part of Consults Resulting.
Consults Resulting Process
The diagram, Consults Resulting Process, shows the consults process with emphasis on the resulting phase. To complete a consult, three things must happen:
An authorized user must select the complete action XE "Complete action" .
The results must be entered or uploaded.
The results must be signed (and, if appropriate, cosigned).
If TIUs upload utility is used, the use of the complete action may be bypassed. TIU generates a notification permitting the responsible person to sign the results and complete the consult.
If the end-user is to enter the results, either the complete action prompts for results, or the results may be entered through TIU directly. If the results are entered through TIU, the user is prompted to link the TIU document with a consult request. In doing this, TIU lists consults that are available for resulting. The parameter GMRC CONSULT LIST DAYS XE "GMRC CONSULT LIST DAYS" controls how many days back TIU searches for qualifying consults. (The package default for this parameter is 365 days.)
Once these three things are accomplished, the consult is marked as complete and TIU files the results. Also, a chart copy of the completed consult may be printed.
Your site may choose to result consults by use of Progress Notes. In this case the resulting user sees essentially the same prompts, but the results entered are visible both as a consult result and in the Progress Notes system.
Recommended Document Hierarchiesxe "Recommended Document Hierarchies"xe "Document Hierarchies"
You should have TIU already set up on your system and be familiar with the Text Integration Utilities (TIU) Implementation Guide.
We present here two document hierarchies found useful by hospitals in the VHA system. Strategy A creates Consults as an independent class under Clinical Documents. Strategy B creates Consults as a document class under Progress Notes.
Strategy A Advantages:
Provides a CLEAR separation of Consults from Progress Notes, and minimizes the number of choices for the end-user.
Simple, with few concerns for maintainability (e.g., no question as to whether heritable methods and properties of Progress Notes were appropriately overridden, etc.).
Strategy A Disadvantages:
Not necessarily consistent with the way providers have been documenting their Consult Results in the past. (i.e., if they've been using PN titles to "result" consults, and referring to the notes on the SF 513's in the past, this will be a departure from that practice).
Limits flexibility of access to the information. (i.e., if set-up this way, they may only access the data through Integrated Document Management options on the TIU-side, and through the Consults tab of the CPRS chart).
Strategy B Advantages:
1. Consistent with the way many providers have been documenting their Consult Results in the past. (i.e., if they've been using PN titles to "result" consults, they may continue to do so, with the results showing up on both the 509 and SF 513).
2. Enhances flexibility of access to the information. (i.e., if set-up this way, they may access the data through any option on the TIU side, as well as through EITHER the Consults or Progress Notes tabs of the CPRS chart).
Strategy B Disadvantages:
1. Does NOT Provide a CLEAR separation of Consults from Progress Notes, and may offer too many choices for the end-user.
2. Complex, with some concerns for maintainability (e.g., if printing or filing appear incorrect, may result from heritable methods and properties of Progress Notes not being appropriately overridden, etc.).
You need to plan the set-up of the Document Definition Hierarchy in some detail, including the titles you want to use at your site, before proceeding with the TIU DEFINE CONSULTS option. The worksheet included in Appendix A of the Text Integration Utilities (TIU) Implementation Guide may prove useful in this process.
The option TIU DEFINE CONSULTS, exported with TIU*1*4, is used to select one or the other of these strategies and set them up at your hospital.
TIU Setup Optionsxe "TIU Setup Options"
TIU DEFINE CONSULTS
This option is exported with TIU*1*4. Once you have decided which Document Definition strategy to use, run the TIU DEFINE CONSULTS option. This option must be run before Consults may be completed using TIU documents.
In the following example we elect Plan B from the discussion on the preceding pages:
Select OPTION NAME: TIU DEFINE CONSULTS Define CONSULTS for
TIU/CT Interface
Define CONSULTS for TIU/CT Interface
I'm going to create a new Document Definition for CONSULTS now.
GREAT! A new Document Definition has been created for CONSULTS.
Next, you need to decide whether you want CONSULTS to be set up
as a separate CLASS (comparable to DISCHARGE SUMMARY or PROGRESS
NOTES), or whether you want CONSULTS defined as a DOCUMENT CLASS
under PROGRESS NOTES. The benefits of each strategy are outlined
in the POST-INSTALLATION instructions for this patch.
NOTE: If you're not yet CERTAIN which strategy you want your site
to adopt, then quit here, and get consensus first (it's easier to
get permission than forgiveness, in this case)!
Select one of the following:
CL Class
DC Document Class
Define CONSULTS as a CLASS or DOCUMENT CLASS: DC Document Class
Okay, you've indicated that you want to make CONSULTS a Document Class.
Okay to continue? NO// YES
FANTASTIC! Your NEW DOCUMENT CLASS CONSULTS will now be added under
the PROGRESS NOTES Class...
Okay, I'm done...Please finish your implementation of CONSULTS by adding
any Titles as appropriate using the Create Document Definitions Option
under the TIUF DOCUMENT DEFINITION MGR Menu, as described in Step #3 of
the Post-Installation Instructions.
Press RETURN to continue...
Create Document Definitionsxe "Create Document Definitions"
After TIU DEFINE CONSULTS has been run, you need to enter the rest of the TIU hierarchy. You should have planned this out in detail according to instructions given in the Text Integration Utility (TIU) Implementation Guide. The Create Document Definitions option permits you to enter this hierarchy.
In the following example, a document title CARDIOLOGY CONSULT is added to the TIU document hierarchy:
Select OPTION NAME: TIU IRM MAINTENANCE MENU TIU Maintenance Menu
menu
Select TIU Maintenance Menu Option: ?
1 TIU Parameters Menu ...
2 Document Definitions (Manager) ...
3 User Class Management ...
Enter ?? for more options, ??? for brief descriptions, ?OPTION for help text.
Select TIU Maintenance Menu Option: 2 Document Definitions (Manager)
--- Manager Document Definition Menu ---
Select Document Definitions (Manager) Option: ?
1 Edit Document Definitions
2 Sort Document Definitions
3 Create Document Definitions
4 Create Objects
Enter ?? for more options, ??? for brief descriptions, ?OPTION for help text.
Select Document Definitions (Manager) Option: 3 Create Document Definitions....
.....
(Continued on next page.)
UCreate Document Definitions Jan 15, 1998 14:07:53 Page: 1 of 1(
BASICS
U Name Type
1 CLINICAL DOCUMENTS CL
2 DISCHARGE SUMMARY CL
3 PROGRESS NOTES CL
4 ADDENDUM DC
5 OLD CONSULTS CL
6 PHYSICAL THERAPY NOTES CL
7 TEST CLASS CL
8 TEST NOTES CL
New Users, Please Enter '?NEW' for Help >>>
Class/DocumentClass Next Level Detailed Display/Edit
(Title) Restart Status...
(Component) Boilerplate Text Delete
Select Action: Next Level// Next Level
Select CLINICAL DOCUMENTS Item (Line 2-8): 3.............
UCreate Document Definitions Jan 15, 1998 14:13:20 Page: 1 of 1(
BASICS
U Name Type
1 CLINICAL DOCUMENTS CL
2 PROGRESS NOTES CL
3 ADVANCE DIRECTIVE DC
4 ADVERSE REACTION/ALLERGY DC
5 CRISIS NOTE DC
6 CLINICAL WARNING DC
7 HISTORICAL TITLES DC
8 ADDICTION SEVERITY INDEX DC
9 RAT NOTES DC
10 TEST2 NOTES DC
11 CONSULTS DC
?Help >ScrollRight PS/PL PrintScrn/List +/- >>>
Class/DocumentClass Next Level Detailed Display/Edit
(Title) Restart Status...
(Component) Boilerplate Text Delete
Select Action: Next Level// Next Level
Select PROGRESS NOTES Item (Line 3-11): 11
(Continued on next page.)
UCreate Document Definitions Jan 15, 1998 14:16:16 Page: 1 of 1(
BASICS
U+ Name Type
2 PROGRESS NOTES CL
3 CONSULTS DC
4 MEDICINE CONSULTS TL
5 SURGERY CONSULTS TL
6 NEUROLOGY CONSULTS TL
7 PULMONARY CONSULTS TL
?Help >ScrollRight PS/PL PrintScrn/List +/- >>>
(Class/DocumentClass) Next Level Detailed Display/Edit
Title Restart Status...
(Component) Boilerplate Text Delete
Select Action: Title// Title
Enter the Name of a new CONSULTS: CARDIOLOGY CONSULTS
CLASS OWNER: CLINICAL COORDINATOR Replace
STATUS: (A/I/T): INACTIVE// A ACTIVE
SEQUENCE: 8
MENU TEXT: Cardiology Consults//
Entry Created
If you wish, you may enter another CONSULTS:
UCreate Document Definitions Jan 15, 1998 14:20:59 Page: 1 of 1(
BASICS
U+ Name Type
2 PROGRESS NOTES CL
3 CONSULTS DC
4 MEDICINE CONSULTS TL
5 SURGERY CONSULTS TL
6 NEUROLOGY CONSULTS TL
7 PULMONARY CONSULTS TL
8 CARDIOLOGY CONSULTS TL
?Help >ScrollRight PS/PL PrintScrn/List +/- >>>
(Class/DocumentClass) Next Level Detailed Display/Edit
Title Restart Status...
(Component) Boilerplate Text Delete
Select Action: Title//
TIU Maintenancexe "TIU Maintenance"
Correcting Misdirected Resultsxe "Correcting Misdirected Results"
Occasionally a consult result is linked to the wrong consult. If this is detected prior to signature, it is possible for the author of a consult result to re-direct the record to a different consult request by any of several methods:
Through the Link to Request actionxe "Link to Request action", when processing the alert for the unsigned Consult Result.
Through the Individual Patient Document option .
You may choose the Link action from the All My Unsigned Documents Option.
From the CPRS Chart.
There are examples of the above four methods in the Consult/Request Tracking User Manual.
Following signature, such corrections can only be made by those persons who are granted permission to do so under the Authorization/ Subscription Utility (ASU). Information on how to make this kind of correction is shown here:
--- MIS Managers Menu ---
1 Individual Patient Document
2 Multiple Patient Documents
3 Print Document Menu ...
4 Search for Selected Documents
5 Statistical Reports ...
Select Text Integration Utilities (MIS Manager) Option: S
1 Search for Selected Documents
2 Statistical Reports
CHOOSE 1-2: 1 Search for Selected Documents
Select Status: UNVERIFIED// COM completed
Select CLINICAL DOCUMENTS Type(s): Discharge Summaries// ALL
Discharge Summaries Progress Notes Addendum Consults
Select SEARCH CATEGORIES: AUTHOR// PAT Patient
Select PATIENT: CPRSPATIENT,TWENTYFOUR 01-01-67 000-24-0024P ACTIVE DUTY
A: Known allergies
Start Reference Date [Time]: T-7// (JAN 20, 1998)
Ending Reference Date [Time]: NOW// (JAN 27, 1998@14:20)
Searching for the documents.
(Continued on the next page.)
U Clinical Documents Jan 27, 1998 14:07:13 Page: 1 of 1(
by PATIENT (CPRSPATIENT,TWENTYFOUR) from 01/20/98 to 1 documents
U Patient Document Ref Date Status (
1 CPRSPATIENT,T(W0024) PULMONARY CONSULT 01/26/98 completed
+ Next Screen - Prev Screen ?? More Actions >>>
Find Delete Document Browse
On Chart Reassign Print
Edit Link with Request Change View
Verify/Unverify Send Back Quit
Amend Document Detailed Display
Select Action: Quit// L Link with Request
You must link your Result to a Consult Request...
The following CONSULT REQUEST(S) are available:
1> JAN 23, 1998@11:14 759 PULMONARY
2> JAN 23, 1998@11:14 760 PULMONARY
CHOOSE 1-2: 2 760
Refreshing the list.
UClinical Documents Jan 27, 1998 14:07:13 Page: 1 of 1(
by PATIENT (CPRSPATIENT,TWENTYFOUR ) from 01/20/98 to 1 documents
U Patient Document Ref Date Status (
1 CPRSPATIENT,T.(W0024) PULMONARY CONSULT 01/26/98 completed
** Item 1 Reassigned. ** >>>
Find Delete Document Browse
On Chart Reassign Print
Edit Link with Request Change View
Verify/Unverify Send Back Quit
Amend Document Detailed Display
Select Action: Quit//
Medicine Interface XE "Medicine Interface"
The Procedures module of Consult/Request Tracking has been enhanced. The two major enhancements are:
A complete change to the method of creating and activating procedures for use in CPRS and Consult/Request Tracking is introduced including a new file to store the procedures data.
The ability to link results stored in the VistA Medicine package to a procedure request has been re-established.
Procedure Setup
The following is the process used to add new procedures or to modify existing procedures:
( Warning: The GMRC PROCEDURES (#123.3) file should NOT be edited via VA FileMan. The interface between CPRS and Consult/Request Tracking depends on the use of the Setup procedures [GMRC PROCEDURE SETUP] option.
Select Consult Management Option: PR Setup procedures
Select Procedure:GI ENDOSCOPIC
Are you adding 'GI ENDOSCOPIC' as a new GMRC PROCEDURE (the 39TH)? No// Y
(Yes) NAME: GI ENDOSCOPIC//
The new procedure will not be orderable unless the INACTIVE flag is deleted.
INACTIVE: YES// N NO
Select SYNONYM: GIENDO
INTERNAL NAME:
Are you adding 'GIENDO' as a new SYNONYM (the 1ST for this GMRC PROCEDURE)? No
// Y (Yes) SYNONYM: GIENDO//
Select SYNONYM:
Select RELATED SERVICES: GASTROENTEROLOGY
Are you adding 'GASTROENTEROLOGY' as a new RELATED SERVICES (the 1ST for this GMRC PROCEDURE)? No// Y (Yes) Select RELATED SERVICES: TYPE OF PROCEDURE: GI ENDO 1 GI ENDOSCOPIC GIENDO GI ENDOSCOPIC 2 GI ENDOSCOPIC GI ENDOSCOPIC CHOOSE 1-2: 1 GIENDO GI ENDOSCOPIC PREREQUISITE: 1> PROVISIONAL DX PROMPT: ? Enter a code to indicate the type of input allowed by CPRS when entering a provisional diagnosis Choose from: O OPTIONAL R REQUIRED S SUPPRESS PROVISIONAL DX PROMPT: R REQUIRED PROVISIONAL DX INPUT: ? Enter a code to indicate the type of input allowed by CPRS when entering a provisional diagnosis Choose from: F FREE TEXT L LEXICON PROVISIONAL DX INPUT: L LEXICON DEFAULT REASON FOR REQUEST: 1> RESTRICT DEFAULT REASON EDIT:
Inter-facility information:
IFC ROUTING SITE:
IFC REMOTE PROC NAME:
Select IFC SENDING FACILITY:
Orderable Item Updated Select Consult Management Option:
INTERNAL NAME in an alternate name for the service. This name does not appear on printouts or displays, but can be used to access the service through the Setup Services (SS) option, or with FileMan.
The RELATED SERVICES field in the procedure setup indicates which services from the Consult hierarchy will receive and process procedures of this type. If more than one related service is entered in this field the ordering person will have to choose which service to direct the procedure to. The users that will be notified and the users allowed to update procedure requests of this type are determined by the receiving service.
The TYPE OF PROCEDURE field in the procedure setup essentially turns on the interface to the Medicine package for this type of procedure. The field is a pointer to the PROCEDURE/SUBSPECIALTY (#697.2) file in the Medicine package. If this field is not set, no medicine procedure results may be linked to this type of procedure request.
PROVISIONAL DX PROMPT: Used by CPRS to determine how to prompt for the provisional diagnosis when ordering this procedure. If this field is set to OPTIONAL, the user will be prompted for the provisional diagnosis but may bypass answering the prompt. If the field is set to SUPPRESS, the user will not be presented with the provisional diagnosis prompt. If set to REQUIRED, the user must answer the prompt to continue placing the order.
PROVISIONAL DX INPUT: Determines the method that CPRS uses to prompt the user for input of the provisional diagnosis when ordering this procedure. If set to FREE TEXT, the user may type any text from 2-80 characters in length. If set to LEXICON, the user will be required to select a coded diagnosis from the Clinical Lexicon.
PREREQUISITE: This word-processing field is utilized to communicate pre-requisite information to the ordering person prior to ordering this procedure. This field is presented to the ordering person upon selecting a procedure and allows them to abort the ordering at that time if they choose. TIU objects may be embedded within this field which are resolved for the current patient during ordering. Any TIU objects must be contained within vertical bars (e.g. |BLOOD PRESSURE| ).
DEFAULT REASON FOR REQUEST: The default text used as the reason for request when ordering this procedure. This field allows a boilerplate of text to be imported into the reason for request when placing orders for this procedure. If the user places an order using a quick order having boilerplate text, that text supersedes any default text stored in this field. This field may contain any text including TIU objects. TIU Objects must be enclosed in vertical bars (e.g. |PATIENT NAME| ).
RESTRICT DEFAULT REASON EDIT: If a DEFAULT REASON FOR REQUEST exists for this service this field effects the ordering person's ability to edit the default reason while placing an order. This variable can be set to UNRESTRICTED, NO EDITING, or ASK ON EDIT ONLY. If the third value, ASK ON EDIT ONLY, is used, the user is only allowed to edit the default reason if the order is edited before releasing to the service.
IFC ROUTING SITE: This field contains the VA facility that will perform consults requested for this service. When a consult for this service is ordered, it will automatically be routed to the VA facility in this field.
IFC REMOTE NAME: This field contains the name of the service that will be requested at the VAMC defined in the IFC ROUTING SITE field. Enter the name of the service exactly as it is named at the remote facility. If this name does not match the name of the service at the routing site, the request will fail to be filed at the remote site. This will delay or prohibit the performance and processing of this request.
IFC SENDING FACILITY: This is a multiple containing the facilities from which your site may receive Inter-Facility Consults for this consult. As with all IFC fields, they must be an exact match.
Linking Med Results XE "Linking Medicine Results" to Procedure Request
In the Consult Service Tracking option and in CPRS list manager Consults tab, medicine results can be associated with the procedure request by using the complete/update action. If the selected item is a procedure and is configured for medicine resulting, users will be given the option of attaching medicine procedure result and/or writing a TIU document. In the CPRS GUI, associating medicine procedure results will be done via a separate menu item on the Action Menu of the Consults tab.
Removing Medicine Results XE "Removing Medicine Results" from a Request
This action provides a mechanism to disassociate a medicine result from a request that was linked by mistake. The ability to take this action is controlled by membership in a USR USER CLASS. A new field was exported for the REQUEST SERVICES (#123.5). Field (#1.06) RESULT MGMT USER CLASS is a pointer to the USR USER CLASS (#8930) file and the appropriate user class of individuals who may take this action should be listed here. It is recommended that the user class entered here be in line with the business rule involving the LINK action as it pertains to TIU documents.
The action to disassociate a medicine result is provided through an action on the Consult Service Tracking option or the Consults tab of CPRS list manager and CPRS GUI.
Parameters
There are two parameters associated with the Consults package: GMRC CONSULT LIST DAYS and GMRC FEE SERVICES XE "GMRC CONSULT LIST DAYS" .
GMRC CONSULT LIST DAYS
The GMRC CONSULT LIST DAYS parameter controls the number of days TIU searches for consults that can be associated with a TIU note.
When completing consults from the notes tab, after selecting a title, you are given a list of consults to which the note may be linked. This list is limited to consults entered in the last 365 days by default. The parameter GMRC CONSULT LIST DAYS allows sites to vary this value. The default parameter PKG is set to 365 days.
The following example shows setting this parameter for a division (in a multi-divisional medical center) to 180 days:
XPAR EDIT PARAMETER Edit Parameter Values action Edit Parameter Values --- Edit Parameter Values --- Select PARAMETER DEFINITION NAME: GMRC CONSULT LIST DAYS CONSULT LIST DAYS GMRC CONSULT LIST DAYS may be set for the following: 6 Division DIV [choose from INSTITUTION] 7 System SYS [DEVCUR.ISC-SLC.VA.GOV] 9 Package PKG [CONSULT/REQUEST TRACKING] Select INSTITUTION NAME: SALT 1 SALT LAKE CITY 660 2 SALT LAKE OEX UT ISC 5000 CHOOSE 1-2: 2 SALT LAKE OEX UT ISC 5000 -------- Setting GMRC CONSULT LIST DAYS for Division: SALT LAKE OEX -------- Days: 180 GMRC CONSULT LIST DAYS may be set for the following: 6 Division DIV [choose from INSTITUTION] 7 System SYS [DEVCUR.ISC-SLC.VA.GOV] 9 Package PKG [CONSULT/REQUEST TRACKING] Enter selection:
GMRC FEE SERVICES
The GMRC FEE SERVICES parameter controls which services (from the REQUEST SERVICES (#123.5) file) are defined as fee basis services.
When a commercial-off-the-shelf (COTS) fee basis system, such as Fee Basis Claims System (FBCS) or Healthcare Claims Processing System (HCPS), accesses a list of consults, it will use this parameter to limit its search to consults with fee basis services.
The list of consult services is stored internally as a word-processing field consisting of the IENs for FEE Basis or NON VA Care Consults stored in the REQUEST SERVICES (#123.5) file. This list can be modified using the Define Fee Services [GMRC FEE PARAM] option under the GMRC MGR menu.
( Note: This parameter cannot be edited via the XPAR menu. It should only be edited using the Define Fee Services [GMRC FEE PARAM] option under the GMRC MGR menu.
Filesxe "Files"
* Request/Consultation (#123)
This file contains consult and request orders originating primarily via the CPRS process. Once the order exists in this file, receiving service users perform update activities. An audit trail of the update activities is maintained in this file.
* Request Action Types (#123.1)
This file identifies the action types that may be used by a service to track activity related to a consult or request.
* GMRC Procedures (#123.3)
This file identifies procedures that may be ordered and processed in CPRS.
File 123.3 must NOT be edited via VA FileMan. The interface between CPRS and Consult/Request Tracking depends on the use of the Setup procedures [GMRC PROCEDURE SETUP] option.
* Request Services (#123.5)xe "REQUEST SERVICES file (#123.5)"
This file permits Services and Specialties to be grouped in a hierarchy representing the sites available services. This grouping capability may be used with Review screens to filter out consults to a service, sub service, specialty, or sub-specialty of consults/requests.
The main entry in this file is the ALL SERVICES entry. Other entries should be subordinate in the hierarchy.
The ALL SERVICES entry is used to display the hierarchy of the hospital services when the Clinician ordering the consult is prompted for Select Service/Specialty: to send the consult to.
* IFC Message Log (#123.6)
This is a log used by the Inter-Facility Consults software to insure transmission of Inter-Facility Consult requests. The IFC background job checks this log and takes appropriate action on requests that have not yet successfully completed.
File Globalsxe "File Globals"
The following is a listing of the files contained in the Consults package. Listed for each file are its file number, name, global location, and an indicator as to whether or not data comes with the file.
NumberNameGlobalData123REQUEST/CONSULTATION FILE^GMR(123,NO123.1REQUEST ACTION TYPES^GMR(123.1YES123.3GMRC PROCEDURES^GMR(123.3YES123.5REQUEST SERVICESxe "REQUEST SERVICES file (#123.5)"^GMR(123.5YES123.6IFC MESSAGE LOG^GMR(123.6NOA file diagram of the above Consults package files and their relationship to other packages is shown on the following page.
EMBED Word.Picture.8
Exported Menusxe "Exported Menus"
There are five menus distributed with the Consults package. The GMRC MGR option is a composite of all Option file (#19) entries distributed in the GMRC namespace. The GMRC REPORTS is a composite of reports distributed with Consults. The GMRC GENERAL SERVICE USER, and GMRC PARMACY USER contain the most frequently performed actionsxe "Actions" for their respective user types.
Option NameDisplay TextGMRC MGR GMRC REPORTSConsults Tracking Reports GMRC SETUP REQUEST SERVICESxe "GMRC SETUP REQUEST SERVICES"Set up Consults Services GMRC SERVICE USER MGMTService User Management GMRC SERVICE TRACKINGConsults Service Tracking GMRC PHARMACY TPN CONSULTSPharmacy TPN Consults GMRC PRINT TEST PAGEPrint Test Page GMRCSTSUGroup Update of Consults Requests GMRC UPDATE AUTHORITYDetermine Users' Update Authority GMRC USER NOTIFICATIONDetermine if User is Notification Recipient GMRC NOTIFICATION RECIPSDetermine Notification Recipients for a Service GMRC TEST DEFAULT REASONTest Default Reason for Request GMRC LIST HIERARCHYList Consult Service Hierarchy GMRC PROCEDURE SETUPSetup Procedures GMRC CLONE PROSTHETICSCopy Prosthetics services GMRC CONSULT CLOSURE TOOLMenu for Closure Tools GMRC DUPLICATE SUB-SERVICEDuplicate Sub-Service GMRC FEE PARAMDefine Fee Services GMRC IFC MGMTIFC Management Menu
Option NameDisplay TextGMRC REPORTS GMRC COMPLETION STATISTICSCompletion Time Statistics GMRC RPT PENDING CONSULTSService Consults Pending Resolution GMRC RPT COMPLETE CONSULTSService Consults Completed GMRC RPT COMPLETE/PENDINGService Consults Completed or Pending Resolution GMRC IFC RPT CONSULTSIFC Requests GMRC IFC RPT CONSULTS BY PTIFC Requests By Patient GMRC IFC RPT CONSULTS BY REMPRIFC Requests by Remote Ordering Provider GMRC RPT NUMBERED CONSULTSService Consults with Consults #s GMRC IFC PRINT RPT NUMBEREDPrint IFC Requests GMRC PRINT BY SEARCHPrint Consults by Provider, Location, or Procedure GMRC RPT PERF MONITORPrint Consult Performance Monitor Report GMRC PRINT RPT NUMBEREDPrint Service Consults by Status GMRC RPT CONSULTS BY STATUSService Consults By Status GMRC PRINT COMPLETION STATPrint Completion Time Statistics Report
Option NameDisplay TextGMRC GENERAL SERVICE USER GMRC SERVICE TRACKINGConsults Service Tracking GMRC RPT PENDINGService Consults Pending GMRC COMPLETION STATISTICSCompletion Time Statistics
Option NameDisplay TextGMRC PHARMACY USER GMRC PHARMACY TPN CONSULTSPharmacy TPN Consults GMRC RPT PENDINGService Consults Pending GMRC COMPLETION STATISTICSCompletion Time Statistics
Option NameDisplay TextGMRC CONSULT CLOSURE TOOL GMRC CONSULT CLOSE TOOL EDTConsult Closure Tool Edit Configuration GMRC CONSULT CLOSE TOOL INQConsult Closure Tool Inquire Configuration GMRC CONSULT CLOSE TOOL RUNConsult Closure Tool Run Configuration
Option NameDisplay TextGMRC IFC MGMT GMRC IFC TEST SETUPTest IFC implementation GMRC IFC INC TRANSList incomplete IFC transactions GMRC IFC RPT CONSULTSIFC Requests GMRC IFC TRANSIFC Transaction Report GMRC IFC REMOTE NUMBERLocate IFC by Remote Cslt # GMRC IFC BKG PARAM MONMonitor IFC background job parameters GMRC IFC RPT CONSULTS BY PTIFC Requests By Patient GMRC IFC RPT CONSULTS BY REMPRIFC Requests by Remote Ordering Provider GMRC IFC PRINT RPT NUMBEREDPrint IFC RequestsIt should be noted that the following options:
GMRC PHARMACY TPN CONSULTS
GMRC SERVICE TRACKING
are options which utilize review screens and Select Action: capabilities similar to CPRS review screen protocol menus. These three options should be distributed to the appropriate users, based on the Menu/Option Access recommendations found in the Package Security section of this manual.
In addition to the Option file (#19) menu, the Protocol file (#101) has several protocol menus distributed in the GMRC namespace. These menus are not for distribution to users. These menus represent the set of responses permitted at specific prompts during Consults processing.
Cross-Referencesxe "Cross-References"
The Consults files contain the following cross-references:
Request/Consultation file (#123)
AC ^GMR(123, AC, OE/RR FILE NUMBER, DA)
This cross-reference permits determination of the request entry in this file based on the ORIFN (pointer to File 100) from CPRS.
AD ^GMR(123, AD, Patient, Inverted Date of Request, DA)
This is the primary cross-reference used by Consults to display consults/requests for a patient, with the most recent Date of Request first.
AD1 ^GMR(123, AD1, Date of Request, DA)
AE ^GMR(123, AE, To Service, CPRS Status, Inverted Date of Request, DA)
This cross-reference is used to display consults/requests for a particular service and CPRS status, with the most recent Date of Request first.
AE1 ^GMR(123, AE1, Date of Request, DA)
AE2 ^GMR(123, AE2, CPRS Status, DA)
AIFC ^GMR(123,AIFC,ROUTING FACILITY,REMOTE CONSULT FILE ENTRY,DA)
This cross-reference is used to prevent duplicate entries from being filed if a new inter-facility consult is sent multiple times.
AG This cross reference contains entries of the REQUEST/CONSULTATION file that do not have an appointment scheduled. This is determined based on the content and order of the entries in the REQUEST PROCESSING ACTIVITY multiple field 40. This cross reference will be updated with any update to the ACTIVITY field under the REQUEST PROCESSING ACTIVITY multiple and that update will be determined based on all REQUEST PROCESSING ACTIVITY entries. This cross reference was added in GMRC*3.0*83.
AL ^GMR(123,AL,PATIENT LOCATION,DA)
AP ^GMR(123,AP,PROCEDURE/REQUEST TYPE,DA)
B ^GMR(123, B, File Entry Date, DA)
The B Cross-reference is the regular cross-
reference for this file.
C ^GMR(123, C, TO Service, DA)
The C cross-reference enables VA FileMan look-up of information based on the TO Service.
D ^GMR(123, D, CPRS Status, DA)
The D cross-reference enables VA FileMan lookup of information based on the CPRS status.
E ^GMR(123, E, Date of Request, DA)
The E cross-reference enables VA FileMan lookup of information based on the Date of Request.
F ^GMR(123, F, Patient, DA )
The F cross-reference enables VA FileMan lookup of information based on the Patient Name.
G ^GMR(123,"G",sending provider,DA)
The G cross-reference allows look-up of consults by sending provider.
H ^GMR(123,"H",requesting location,DA)
The H cross-reference allows look-up of consults by the requesting location.
R ^GMR(123,R,associated result,DA)
The R cross-reference allows look-up of consults based on the results associated with them.
Request Action Types file (#123.1
AC ^GMR(123.1, AC, CPRS Status, DA)
This cross-reference is used when the call to RESULT^GMRCR returns a CPRS status. This CPRS status is used to determine the action type to use to update activity tracking.
B ^GMR(123.1, B, Action Type, DA)
The B cross-reference is the regular cross-reference for this file.
C ^GMRC(123.1, C, Related Action Protocol, DA)
This cross-reference is used to associate the action type with the protocol selected from the Select Action: prompt. The action type internal number is then used to set the variable GMRCA for audit trail processing.
GMRC PROCEDURES file (#123.3)
AP ^GMR(123.3,"AP",protocol number,DA)
This cross-reference is utilized during the procedure conversion process and will be removed in a future enhancement.
B ^GMR(123.3,"B",procedure name,DA)
The B cross-reference is the regular cross-reference for this file, permitting lookup by procedure name.
C ^GMR(123.3,"C",synonym,DA)
The C cross-reference permits SYNONYMS to be used to look up the procedure by synonym.
E ^GMR(123.3,E,internal name,DA)
Request Services file (#123.5)xe "REQUEST SERVICES file (123.5)"
B ^GMR(123.5, B, Service Name, DA)
The B cross-reference is the regular cross-reference for this file, permitting lookup by Service Name.
C ^GMR(123.5, C, Related Treating Specialty, DA)
The C cross-reference enables VA FileMan lookup of information, based on the RELATED TREATING SPECIALTY. (Note: This field exists, but is not currently used by the package.)
D ^GMR(123.5, D, Synonym, DA)
The D cross-reference permits SYNONYMS to be used to find the Service to send a consult/request to.
E ^GMR(123.5,E,internal name,DA)
AAT ^GMR(123.5, ADMINISTRATIVE UPDATE TEAM,DA)
This cross-reference is used to locate and delete pointers to the OE/RR LIST (#100.21) file that have been deleted.
AC1 ^GMR(123.5, SERVICE NAME, DA)
This cross-reference is what helps maintain the alphabetical look-up of services.
ANT ^GMR(123.5, TEAM TO NOTIFIY, DA)
The "ANT" cross reference is used for deletion of pointer values when an entry is deleted from the OE/RR LIST (#100.21) file.
APC ^GMR(123.5, SUB-SERVICE/SPECIALTY, DA)
This cross-reference is used to find the parents of a given service. This helps identify AC cross-references that need to be updated when the .01 name changes, and helps manage forwarding to services.
APR ^GMR(123.5, PROCEDURE TYPE, DA)
This cross reference is used to find all services which process a procedure type.
AST ^GMRC(123.5, SERVICE TEAM TO NOTIFY, DA)
The "AST" cross reference is used for deletion of pointer values when an entry is deleted from the OE/RR LIST (#100.21) file.
AUT ^GMR(123.5, UPDATE TEAMS W/O NOTIFICATIONS, DA)
This cross-reference is used to locate and delete pointers to the OE/RR LIST (#100.21) file that have been deleted.
IFC MESSAGE LOG (#123.6)
AC ^GMR(123.6,AC,CONSULT/REQUEST #,ACTIVITY #,INCOMPLETE,DA)
This cross-reference is used by the IFC background job to manage incomplete entries.
AI ^GMR(123.6, INCOMPLETE, DA)
The AI cross-reference is used to locate IFC consults that have not been processed successfully.
AM ^GMR(123.6, MESSAGE #, DA)
The AM cross-reference is used to locate the HL7 message number.
B ^GMR(123.6, DATE/TIME OF ENTRY, DA)
The B cross-reference if the regular cross-reference for this file, permitting lookup by DATE/TIME of Entry.
C ^GMR(123.6,C,CONSULT/REQUEST #,ACTIVITY #,DA)
This cross-reference is used to look up IFC MESSAGE LOG entries by consult number.
Archiving and Purgingxe "Archiving and Purging"
No archiving or purging utilities are provided in this version for the Consults distributed files.
External Relationsxe "External Relations"
The Consults package is dependent upon other VA software to function correctly.
PACKAGEVERSIONNOTESVA FileMan21OE/RR3.0KERNEL8.0 (+ Patches)Select Action:prompts, and Alert capabilitiesPIMS5.3Calls to VADPT
Private DBIA Agreements
xe "Private DBIA Agreements"
DBA NumberCustodial PackageDBA NumberCustodial Package147Medicine2638OE/RR165OE/RR2290OE/RR167Kernel2699TIU169Kernel2700OE/RR181OE/RR2713OE/RR510VA FileMan2761OE/RR615Medicine2764OE/RR616Medicine2849OE/RR627OE/RR3042MEDICINE628OE/RR3138CLINICAL PROC629OE/RR3168OE/RR630OE/RR3171OE/RR631OE/RR6184GMRC632Kernel635OE/RR636OE/RR637OE/RR638OE/RR639OE/RR640OE/RR861OE/RR862OE/RR863OE/RR864OE/RR865OE/RR866OE/RR867OE/RR868OE/RR869OE/RR870OE/RR871OE/RR872OE/RR873OE/RR875OE/RR2038OE/RR
Internal Relationsxe "Internal Relations"
All options are independently evocable.
Package-Wide Variablesxe "Package-Wide Variables"
There are no package-wide variables exported with this package that require SACC exemption.
Package Interfacexe "Package Interface"
HL7 Fieldsxe "HL7 Fields"
The following is a list of HL7 fields that are used in transactions between OE/RR V. 3.0 and the Consult package. Not every field will be used in every message.
SEGSEQFIELD NAMEEXAMPLEHL7 TYPEMSH1Field Separator|string2Encoding Characters^~\&string3Sending ApplicationORDER ENTRYstring4Sending Facility660string9Message TypeORMIDRF11Referral StatusIP^ADDED COMMENTstring2Referral PriorityROUTINEstring3Referral Type553^NON-VA COLONOSCOPY^^32563^NON-VA COLONOSCOPY v6.2coded element5Referral CategoryOtable 2846Originating Referral Identifier486410string7Effective Date201403111904-0400timestampPRD1Provider RoleRPtable 2862Provider NameCPRSPROVIDER^THREE^^^^^^^10000000046composite ID3Provider Address1 STREET ADDRESS^^CITY^ST^00011string5Provider Communication Information^^^CPRS3@VA.GOV^^555^555-5555stringIN11 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3ASetIDIN1&FIELD=1&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:SetIDIN1" SetIDIN1 2 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AInsurancePlanID&FIELD=2&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:InsurancePlanID" InsurancePlanIDCoded element3 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AInsuranceCompanyID()&FIELD=3&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:InsuranceCompanyID()" InsuranceCompanyIDID4 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AInsuranceCompanyName()&FIELD=4&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:InsuranceCompanyName()" InsuranceCompanyNamestring5 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AInsuranceCompanyAddress()&FIELD=5&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:InsuranceCompanyAddress()" InsuranceCompanyAddressaddress6 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AInsuranceCoContactPerson()&FIELD=6&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:InsuranceCoContactPerson()" InsuranceCoContactPersonstring7 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AInsuranceCoPhoneNumber()&FIELD=7&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:InsuranceCoPhoneNumber()" InsuranceCoPhoneNumberstring8 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AGroupNumber&FIELD=8&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:GroupNumber" GroupNumberstring9 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AGroupName()&FIELD=9&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:GroupName()" GroupNamestring10 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AInsuredsGroupEmpID()&FIELD=10&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:InsuredsGroupEmpID()" InsuredsGroupEmpIDstring11 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AInsuredsGroupEmpName()&FIELD=11&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:InsuredsGroupEmpName()" InsuredsGroupEmpNamestring12 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3APlanEffectiveDate&FIELD=12&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:PlanEffectiveDate" PlanEffectiveDatedate13 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3APlanExpirationDate&FIELD=13&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:PlanExpirationDate" PlanExpirationDatedate14 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AAuthorizationInformation&FIELD=14&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:AuthorizationInformation" AuthorizationInformationstring15 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3APlanType&FIELD=15&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:PlanType" PlanTypestring16 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3ANameOfInsured()&FIELD=16&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:NameOfInsured()" NameOfInsuredstring17 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AInsuredsRelationshipToPatien&FIELD=17&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:InsuredsRelationshipToPatien" InsuredsRelationshipToPatienstring18 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AInsuredsDateOfBirth&FIELD=18&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:InsuredsDateOfBirth" InsuredsDateOfBirthdate19 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AInsuredsAddress()&FIELD=19&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:InsuredsAddress()" InsuredsAddressaddress20 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AAssignmentOfBenefits&FIELD=20&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:AssignmentOfBenefits" AssignmentOfBenefitsstring21 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3ACoordinationOfBenefits&FIELD=21&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:CoordinationOfBenefits" CoordinationOfBenefitsstring22 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3ACoordOfBenPriority&FIELD=22&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:CoordOfBenPriority" CoordOfBenPrioritystring23 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3ANoticeOfAdmissionFlag&FIELD=23&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:NoticeOfAdmissionFlag" NoticeOfAdmissionFlagstring24 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3ANoticeOfAdmissionDate&FIELD=24&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:NoticeOfAdmissionDate" NoticeOfAdmissionDatedate25 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AReportOfEligibilityFlag&FIELD=25&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:ReportOfEligibilityFlag" ReportOfEligibilityFlagstring26 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AReportOfEligibilityDate&FIELD=26&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:ReportOfEligibilityDate" ReportOfEligibilityDatedate27 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AReleaseInformationCode&FIELD=27&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:ReleaseInformationCode" ReleaseInformationCodestring28 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3APreAdmitCertPAC&FIELD=28&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:PreAdmitCertPAC" PreAdmitCertPACstring29 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AVerificationDateTime&FIELD=29&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:VerificationDateTime" VerificationDateTimedate30 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AVerificationBy()&FIELD=30&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:VerificationBy()" VerificationBystring31 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3ATypeOfAgreementCode&FIELD=31&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:TypeOfAgreementCode" TypeOfAgreementCodestring32 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3ABillingStatus&FIELD=32&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:BillingStatus" BillingStatusstring33 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3ALifetimeReserveDays&FIELD=33&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:LifetimeReserveDays" LifetimeReserveDaysnumber34 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3ADelayBeforeLRDay&FIELD=34&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:DelayBeforeLRDay" DelayBeforeLRDaynumber35 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3ACompanyPlanCode&FIELD=35&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:CompanyPlanCode" CompanyPlanCodestring36 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3APolicyNumber&FIELD=36&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:PolicyNumber" PolicyNumberstring37 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3APolicyDeductible&FIELD=37&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:PolicyDeductible" PolicyDeductiblenumber38 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3APolicyLimitAmount&FIELD=38&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:PolicyLimitAmount" PolicyLimitAmountnumber39 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3APolicyLimitDays&FIELD=39&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:PolicyLimitDays" PolicyLimitDaysnumber40 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3ARoomRateSemiPrivate&FIELD=40&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:RoomRateSemiPrivate" RoomRateSemiPrivatenumber41 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3ARoomRatePrivate&FIELD=41&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:RoomRatePrivate" RoomRatePrivatenumber42 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AInsuredsEmploymentStatus&FIELD=42&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:InsuredsEmploymentStatus" InsuredsEmploymentStatusstring43 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AInsuredsAdministrativeSex&FIELD=43&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:InsuredsAdministrativeSex" InsuredsAdministrativeSexstring44 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AInsuredsEmployersAddress()&FIELD=44&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:InsuredsEmployersAddress()" InsuredsEmployersAddressaddress45 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AVerificationStatus&FIELD=45&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:VerificationStatus" VerificationStatusstring46 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3APriorInsurancePlanID&FIELD=46&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:PriorInsurancePlanID" PriorInsurancePlanIDstring47 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3ACoverageType&FIELD=47&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:CoverageType" CoverageTypestring48 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AHandicap&FIELD=48&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:Handicap" Handicapstring49 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AInsuredsIDNumber()&FIELD=49&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:InsuredsIDNumber()" InsuredsIDNumberID50 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3ASignatureCode&FIELD=50&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:SignatureCode" SignatureCodestring51 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3ASignatureCodeDate&FIELD=51&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:SignatureCodeDate" SignatureCodeDatedate52 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AInsuredsBirthPlace&FIELD=52&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:InsuredsBirthPlace" InsuredsBirthPlacestring53 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN1%3AVIPIndicator&FIELD=53&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN1" \o "IN1grp().IN1:VIPIndicator" VIPIndicatorstringIN31 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ASetIDIN3&FIELD=1&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:SetIDIN3" SetIDIN3 2 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ACertificationNumber&FIELD=2&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:CertificationNumber" CertificationNumberstring3 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ACertifiedBy()&FIELD=3&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:CertifiedBy()" CertifiedBystring4 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ACertificationRequired&FIELD=4&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:CertificationRequired" CertificationRequiredstring5 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3APenalty&FIELD=5&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:Penalty" Penaltystring6 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ACertificationDateTime&FIELD=6&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:CertificationDateTime" CertificationDateTimedate7 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ACertificationModifyDateTime&FIELD=7&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:CertificationModifyDateTime" CertificationModifyDateTimedate8 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3AOperator()&FIELD=8&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:Operator()" Operatorstring9 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ACertificationBeginDate&FIELD=9&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:CertificationBeginDate" CertificationBeginDatedate10 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ACertificationEndDate&FIELD=10&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:CertificationEndDate" CertificationEndDatedate11 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ADays&FIELD=11&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:Days" Daysnumber12 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ANonConcurCodeDescription&FIELD=12&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:NonConcurCodeDescription" NonConcurCodeDescriptionstring13 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ANonConcurEffectiveDateTime&FIELD=13&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:NonConcurEffectiveDateTime" NonConcurEffectiveDateTimedate14 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3APhysicianReviewer()&FIELD=14&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:PhysicianReviewer()" PhysicianReviewerstring15 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ACertificationContact&FIELD=15&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:CertificationContact" CertificationContactstring16 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ACertificationContactPhoneNum()&FIELD=16&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:CertificationContactPhoneNum()" CertificationContactPhoneNumstring17 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3AAppealReason&FIELD=17&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:AppealReason" AppealReasonstring18 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ACertificationAgency&FIELD=18&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:CertificationAgency" CertificationAgencystring19 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ACertificationAgencyPhoneNumb()&FIELD=19&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:CertificationAgencyPhoneNumb()" CertificationAgencyPhoneNumbstring20 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3APreCertificationRequirement()&FIELD=20&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:PreCertificationRequirement()" PreCertificationRequirementstring21 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ACaseManager&FIELD=21&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:CaseManager" CaseManagerstring22 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ASecondOpinionDate&FIELD=22&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:SecondOpinionDate" SecondOpinionDatedate23 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ASecondOpinionStatus&FIELD=23&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:SecondOpinionStatus" SecondOpinionStatusstring24 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ASecondOpinionDocumentationRe()&FIELD=24&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:SecondOpinionDocumentationRe()" SecondOpinionDocumentationRestring25 HYPERLINK "http://10.247.79.41/csp/healthshare/vahcvista/EnsPortal.HL7.SchemaPath.cls?PATH=IN1grp().IN3%3ASecondOpinionPhysician()&FIELD=25&MS=MS%3AFromVistaRefRri%3AREF_I12&SS=SS%3A2.5.1%3AIN3" \o "IN1grp().IN3:SecondOpinionPhysician()" SecondOpinionPhysicianstringPID3Patient ID5340747composite ID5Patient NameDoe,John Hpatient name19SSN Number Patient123456789stringDG13Diagnosis Code DG1784.0^Headachecoded elementPV12Patient ClassItable 43Patient Location32^234-4user table7Attending Doctor1234^DOE, JOHN Mcomposite ID16VIP IndicatorRuser table17Admitting Doctor1234^DOE, JOHN Mcomposite ID19Visit Number1241243composite ID{ ORC}1Order ControlNWtable 1192Placer Order Number234123;1^ORnumber^application3Filler Order Number870745^GMRCnumber^application5Order StatusIPtable 387Quantity/Timing^^^19940415^^R^^^timestamp^^priority
coded per HL7 4.4 9Date/Time of Transaction199404141425timestamp10Entered By1166composite ID12Ordering Provider1270composite ID15Order Effective D/T199404141430timestamp16Order Control ReasonS^Service Correction^99ORN^^^coded element NTE1Set ID16set ID2Source of CommentLtable 1053CommentCancelled by Serviceformatted text OBR2Placer Order Number5587658;1^ORnumber^application 3Filler Order Number486410;GMRC^GMRCnumber^application4Universal Service ID^^^58^Cardiology^99CONcoded element 6Requested Date/Time20140311timestamp18Placer Field 1 (used for place of consultation)Bstring19Placer Field 2 (used for attention)1044string22Results Rpt/Status Change - Date/Time199404150635timestamp25Result StatusFtable 12332Principle Result Interpreter1345composite ID ZSV1Request Service ID^^^12^Psychiatry^99CONcoded element2Consult TypeFamily Counselingstring { OBX }1Set ID1number2Value TypeTXtable 1253Observation ID2000.02^Reason for Request^AS4coded element4Observation Sub-ID1string5Observation Valuer/o TBstring}8Abnormal FlagNtable 78
Notes:
Sending Application is the name of the DHCP package generating the message; Sending Facility is the station number.
Originating Referral Identifier is the IEN of the record entry in the Request/Consultation file.
Patient ID is patient DFN (pointer to file 2)
Patient Location, for an inpatient, is Hospital Location IEN^Room-Bed. For and outpatient, it is the Hospital Location IEN. In both cases it is the location from which the order is being placed.
VIP Indicator is R if patient is restricted/sensitive.
Visit Number is the IEN of the visit in the Visit file.
Placer Order Number is the OE/RR order number.
Filler Order Number is the Consult order number.
Order Status is needed when Consults releases an order; possible values from HL7 table 38 include:
DC=DiscontinuedSC=Active A=Partial ResultsCM=CompletedZC=ScheduledCA=Cancelled (Denied)IP=PendingRP=DCd due to EditQuantity/Timing will contain Clinically XE "Clinically Indicated Date" Indicated Date in the fourth ^-piece and urgency in the sixth ^-piece, whose possible values include:
S=StatZ24=Within 24 hoursZW=Within 1 weekR=RoutineZ48=Within 48 hoursZM=Within 1 monthZT=TodayZ72=Within 72 hoursZNA=Next availableZE=EmergencyEntered By and Ordering Provider are IENs in the New Person file.
Universal Service ID is a national code in the first part. The alternate code is a pointer to either the Request Services or GMRC Procedures file.
Placer Field 1 will contain the place of consultation, as a set of codes. Possible values include:
B=Bedside
E=Emergency Room
OC=Consultants choice
Placer Field 2 will contain the IEN in the New Person file of the user to whom this consult should be directed.
The OBX segment is used to transmit related data about the patient when placing a consult request; possible observation IDs include:
Reason for Request (AS4 2000.02) = text
Provisional Diagnosis (not coded) = text
Provisional Diagnosis (coded element) = ICD ^ text
The Observation ID is used for ordering OBX segments.
HL7 Protocols XE "HL7:Protocols"
Patch GMRC*3.0*75 added the capability of using the following HL7 protocols to enable the communications between the consult system communication with the Healthcare Claims Processing System (HCPS), which processes Non-VA healthcare.
GMRC CONSULTS TO HCP - Creates and sends an REF^12, REF^13, or REF^14 HL7 message to the HCPS application when a consult is generated for Non-VA Care.
GMRC HCP REF-I12 SERVER - Sends REF^I12 HL7 messages to the HCPS application for new Non-VA Care Referrals.
GMRC HCP REF-I12 CLIENT - Sends REF^I12 HL7 messages to the HCPS application for new Non-VA Care referrals.
GMRC HCP REF-I13 SERVER - Sends HL7 REF^I13 messages to CPRS application for updated Non-VA Care Referrals originating in HCPS (RAS).
GMRC HCP REF-I13 CLIENT - Sends HL7 REF^I13 messages from HCPS to CPRS application for updated Non-VA Care Referrals originating in HCPS (RAS).
GMRC HCP RRI-I13 SERVER - Sends HL7 RRI^I13 messages to CPRS application for updated Non-VA Care Referrals originating in HCPS (RAS).
GMRC HCP RRI-I13 CLIENT - Sends HL7 RRI^I13 messages from HCPS to CPRS application for updated Non-VA Care Referrals originating in HCPS (RAS).
GMRC HCP REF-I14 SERVER - Sends REF^I14 HL7 messages to the HCPS application for canceled or discontinued Non-VA Care referrals.
GMRC HCP REF-I14 CLIENT - Sends REF^I14 HL7 messages to the HCPS application for cancelled or discontinued Non-VA Care referrals.
Patch GMRC*3.0*99 added the capability of using the following HL7 protocols to enable the communications between the consult system communication with CCRA for Non-VA COMMUNITY CARE consults.
GMRC CCRA REF-I12 CLIENT - Sends HL7 REF^I12 v2.5 messages from CCRA to HSRM application for new Non-VA Care Referrals.
GMRC CCRA REF-I13 CLIENT - Sends HL7 REF^I13 v2.5 messages to CCRA application for updated Non-VA Care Referrals.
GMRC CCRA REF-I14 CLIENT - Sends HL7 REF^I14 v2.5 messages from CPRS to CCRA application for canceled or discontinued Non-VA Care Referrals.
GMRC CCRA-HSRM REF-I12 SERVER - Sends HL7 REF^I12 v2.5 messages from CPRS to CCRA application for new Non-VA Care Referrals.
GMRC CCRA-HSRM REF-I13 SERVER - Sends HL7 REF^I13 v2.5 messages from CPRS to CCRA application for new Non-VA Care Referrals.
GMRC CCRA-HSRM REF-I14 SERVER - Sends HL7 REF^I14 v2.5 messages from CPRS to CCRA application for cancellation of Non-VA Care Referrals.
Patch GMRC*3.0*123 added the capability of using the following HL7 protocols to enable the communications between the consult system communication with CCRA for Non-VA COMMUNITY CARE consults
GMRC HSRM-CCRA REF-I13 CLIENT - Sends HL7 REF^I13 v2.5 messages from HSRM application to CPRS. This is to update the consult record with new status (scheduled/complete)
GMRC HSRM-CCRA REF-I13 SERVER - Sends HL7 REF^I12 v2.5 messages from HSRM application to CPRS This is for consult status updates from HSRM
GMRC HSRM-CCRA REF-I14 CLIENT - Sends HL7 REF^I14 v2.5 messages from HSRM application to CPRS. This message type is to send to VistA an update to cancel the consult
GMRC HSRM-CCRA REF-I14 SERVER - Sends HL7 REF^I12 v2.5 messages from HSRM application to CPRS. This is for consult status updates - cancel appointment
HL7 Application Parameters XE "HL7:Application Parameters"
Patch GMRC*3.0*75 added the capability of using the following HL7 application parameters to enable communication between the consult system and the HCPS.
GMRC HCP SEND - This parameter is used to set up the sending facility.
GMRC HCP RECEIVE - This parameter is used to set up the receiving facility.
Patch GMRC*3.0*99 added the capability of using the following HL7 application parameters to enable communication between the consult system and the CCRA.
GMRC CCRA SEND - This parameter is used to set up the sending facility.
GMRC CCRA RECEIVE - This parameter is used to set up the receiving facility.
Patch GMRC*3.0*123 added the capability of using the following HL7 application parameters to enable communication between the consult system and the CCRA.
GMRC HSRM-CCRA SEND - This parameter is used to set up the sending facility.
GMRC HSRM-CCRA RECEIVE - This parameter is used to set up the receiving facility.
HL7 Logical Link XE "HL7:Logical Link"
GMRCHCP - Logical link is used to setup the network path between Consults and Heathcare Claims Processing System (HCPS).
GMRCCCRA This Logical link is used to set up the network path between CPRS and CCRA. This was created by patch GMRC*3.0*99
CCRA-NAK This logical link is used to send HSRM an application NAK when a message is rejected because the user does not exist or have permissions in VistA to make updates. This was created by patch GMRC*3.0*123
GMRC*3.0*99 To enable the HL7 interface link created by this patch, go into the VistA HL main menu and select the Filer and Link Management Options. From there, select the SL Stop/Start Links option, as shown below.
Once this logical link is thus enabled, messages can proceed through the interface.
GMRC*3.0*106 This logical link is the same as the one for GMRC*3.0*99.
HL7 Referral Messages XE "HL7:Referral Messages"
Patch GMRC*3.0*75 added the capability of using the following HL7 referral messages to enable communication between the consult system and HCPS.
REF_I12 will be sent from CPRS to HCPS for new referrals (signed Non-VA Care Consult). NTE segments will contain the Entered By, Date/time stamp, the Reason for Request header, and Non-VA Care Referral template data.
REF_I13 will be sent from CPRS to HCPS for status updates and resubmitted referrals. NTE segments will contain the Entered By and Date/time stamp, Progress Note header, and Non-VA Care Referral template data.
REF_I13 will be sent from CPRS to HCPS for complete and addended note referrals. NTE segments will contain the Entered By, Date/time stamp, Progress Note header, and Non-VA Care Referral template data.
RRI_I13 will be sent from HCPS to CPRS for changes made in HCPS-RAS. A proxy user will be implemented in VistA to populate the Entered By field. The proxy user will identify updates to CPRS/Consults originating in HCPS-RAS and transmitted via the interface.
REF_I14 will be sent from CPRS to HCPS for cancelled or discontinued referrals. NTE segments will contain Activity Comment header and Non-VA Care Referral template date.
Note that IN1 and IN3 segments were added to the REF messages. Since these segments are the same, they will be listed once at the end of the section previously created in this manual.
The REF messages will contain the following standard segments:
MSH Message Header REQUIRED
RF1 Referral Information REQUIRED
PRD Provider Data REQUIRED
PID Patient Identification REQUIRED
IN1 Patient Insurance OPTIONAL
IN3 Patient Insurance OPTIONAL
DG1 Diagnosis OPTIONAL
OBR Observation Request REQUIRED
PV1 Patient Visit REQUIRED
NTE Notes and Comments REQUIRED
A standard HL7 v2.5 RRI message will be generated for status updates and/or changes made to an existing referral in HCPS. This event triggers a message to update CPRS with changes made in HCPS. The RRI message will contain the following standard segments:
MSH Message Header REQUIRED
RRI Return Referral Information REQUIRED
PRD Provider Data REQUIRED
PID Patient Identification REQUIRED
DG1 Diagnosis OPTIONAL
OBR Observation Request REQUIRED
PV1 Patient Visit REQUIRED
NTE Notes and Comments REQUIRED
The following tables contain the HL7 message definition for the REF/RRI/ACK messages.
The table columns are:
SEQ = HL7 sequence#
LEN = HL7 field length
DT = HL7 data type
R/O = R=Require, O=Optional, C=Conditional, NS=Not supported
TBL = HL7 table definition
Element Name = HL7 field name
VistA Description = information on what will be pulled from VistA for this element, or hard-coded data.
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION
XE "HL7:REF_I12 Message Definition Tables" REF_I12 Message Definition Tables
REF_I12 MSH - Message Header Segment (generated by the VistA HL7 package using the HL7 Application and Protocol entries for the GMRC components)
REF_I12 Message Header Table
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION11STRField Separator|24STREncoding Characters^~\&315STRSending ApplicationGMRC HCP SEND420STRSending FacilitySending Facility, from the FACILITY NAME field of the HL7 APPLICATION entry GMRC HCP SEND530STRReceiving ApplicationGMRC HCP RECEIVE630STNSReceiving FacilityReceiving Facility, from the FACILITY NAME field of the HL7 APPLICATION entry GMRC HCP RECEIVE726TSRDate/Time Of MessageSystem date/time generated by the VistA HL7 package840STNSSecurityNot used97CMR0076
0003Message TypeREF^I121020STRMessage Control IDFacility and sequence number automatically generated by the VistA HL7 Package111IDRProcessing IDP for Production, T for Test128IDR0104Version ID2.51315NMNSSequence NumberNot used14180STNSContinuation PointerNot used152IDR0155Accept Acknowledgment TypeAL=Always162IDR0155Application Acknowledgment TypeAL=Always173IDR0399Country CodeUSA
(MSH fields past MSH.17 are not used and not shown to save space)
VistA MSH.16 does not support ER to just return Application Acknowledgments for errors, so all messages required acknowledgment either AA or AE in the MSA.
REF_I12 RF1 - Referral Information Segment
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION1250CEO0283Referral StatusNW^CPRS RELEASED ORDER2250CEO0280Referral PriorityFrom File 123, Field 5 (Urgency). Values are: 1 WEEK, NEXT AVAILABLE, ROUTINE, STAT, TODAY, TOMORROW AM, WITHIN 1 MONTH, WITHIN 1 WEEK, WITHIN 24 HOURS, WITHIN 72 HOURS3250CEOReferral TypeService IEN^Service Name^^Template IEN
^Template Name
Service IEN is pointer to File 123.5, Template IEN is pointer to File 8927.4250CENSReferral DispositionNot used5250CEO0284Referral CategoryI for Inpatient, O for Outpatient based on File 123, field 14 (Service Rendered as In or Out). This could be different than the PV1.1 current patient status.630EIROriginating Referral IdentifierIEN to File 123726TSOEffective DateReferral Date of Request from File 123, field .01826TSNSExpiration DateNot used926TSNSProcess DateNot used10250CENSReferral ReasonNot used1130EINSExternal Referral IdentifierNot used
REF_I12 PRD - Provider Data Segment (same for all message types)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION1250CER0286Provider RoleRP for Referring Provider2250XPNOProvider NameProvider Last Name^Provider First Name^Provider Middle Initial^^^^^^Provider DUZ
Provider from File 123, field 103250XADOProvider AddressStreet Address 1^Street Address 2^City^State^Zip from File 200, fields .111, .112, .114, .115, .116460PLNSProvider LocationNot used5250XTNOProvider Communication Information^^^Email Address^^Office Phone Area Code^Office Phone Number from File 200, fields .151, .1326250CENSPreferred Method of ContactNot used7100PLNNSProvider IdentifiersNot used826TSNSEffective Start Date of Provider RoleNot used926TSNSEffective End Date of Provider RoleNot used
REF_I12 PID-Patient Id Segment (generated by the VistA API; same for all msg types)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIOSet ID PIDSequential Number220CXRPatient IDICN, including V checksum for backwards compatibility3250CXRPatient Identifier List (list is not in any specified order)
Following are PID.3.5 Indentifier Type Codes:
NI=ICN
PI=Patient DFN
SS=SSN
PN=Claim NumberIntegration Control Number (including V and checksum), Social Security Number, DFN, Claim Number, all entries in the ICN History Multiple, and all alias SSNs which will correspond directly to the alias name in the name field (pid-5). 420CXNSAlternate Patient ID PIDNot used5250XPNRPatient NamePatient Name and all Alias entries6250XPNOMothers Maiden NameMothers Maiden Name726TSODate/Time of BirthDate of Birth81ISO0001Administrative SexSex9250XPNNSPatient AliasNot used. Alias is passed in PID-510250CEO0005RaceRace Information. Example: 2106-3-SLF^^0005^2106-3^^CDC See Appendix A for coded values. 0005 and CDC are hardcoded.11250XADOPatient AddressP=Permanent Address~N=Place of Birth~Confidential Address124ISO0289County CodeCounty13250XTNOPhone Number HomeHome Phone~Work Phone~Cell Phone~Pager^NET^INTERNET^email14250XTNOPhone Number BusinessWork Phone (backward compatibility)15250CENS0296Primary LanguageNot used16250CEO0002Marital StatusMarital Status^^^^^^M17250CEO0006ReligionReligious Preference (code)18250CXNSPatient Account NumberNot used1916STRSSN Number PatientSSN2025DLNNSDrivers License Number PatientNot used21250CXNSMothers IdentifierNot used22250CEO0189Ethnic GroupEthnicity Information. Example: 2186-5-SLF^^0189^2186-5^^CDC
See Appendix A for coded values. 2186 and CDC are hardcoded.23250STOBirth PlacePlace of birth city and place of birth state241IDO0136Multiple Birth IndicatorMultiple Birth Indicator [Y for multiple birth](PID fields past PID.24 not used and not shown to save space)
REF_I12 DG1 - Diagnosis Segment (same for all message types)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIRSet ID DG1122IDNSDiagnosis Coding MethodNot used3250CER0051Diagnosis Code DG1Provisional Diagnosis Code^Diagnosis Description from File 123, field 30440STBDiagnosis DescriptionNot Used526TSODiagnosis Date/TimeNot Used62ISR0052Diagnosis TypeW - Working (DG1 fields past DG1.6 are not used and not shown to save space)
REF_I12 OBR - Observation Request Segment (same for all message types)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIRSet ID OBR1222EIRPlacer Order NumberOrder entry internal number;Orderable Item entry^OR from File 123, field .03322EIRFiller Order NumberConsult entry internal number;GMRC^GMRC4250CERUniversal Service IdentifierHardcoded value of ZZ52IDNSPriority OBRNot used626TSORequested Date/TimeClinically XE "Clinically Indicated Date" Indicated Date from File 123, field 17
(OBR fields past OBR.6 are not used and not shown to save space)
REF_I12 PV1 Patient Visit Segment (same for all message types)
The PV1 segment data is creating using the IN5^VADPT call to determine current inpatient status. See PIMS technical manual for definition of the returned array VAIP. Fields not returned by the IN5^VADPT API are not used in the PV1 segment.
REF I12 PV1 - Patient Visit Segment (Same for all message types)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIRSet ID PV1121ISR0004Patient ClassI: inpatient
O: outpatient380PLOAssigned Patient LocationLocation of last inpatient movement event from VAIP(5)42ISNSAdmission TypeNot used5250CXNSPreadmit NumberNot used680PLNSPrior Patient LocationNot used7250XCNO0010Attending DoctorAttending Provider from VAIP(18)8250XCNO0010Referring DoctorNot used (Referring provider sent in PRD segment)9250XCNNSConsulting DoctorNot used103ISNSHospital ServiceNot used1180PLNSTemporary LocationNot used122ISNSPreadmit Test IndicatorNot used132ISNSRe-admission IndicatorNot used146ISNSAdmit SourceNot used152ISNSAmbulatory StatusNot used162ISO0099VIP IndicatorR if patient restricted/sensitive17250XCNOAdmitting DoctorPrimary Physician for admission from VAIP(13,5)(PV1 fields past PV1.17 are not used and not shown to save space)
REF_I12 NTE - Notes and Comments segment
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIOSet ID NTESequential Number 1-n28IDO0105Source of CommentP for Placer365536FTOCommentReason for Request from file 123, field 204250CEOComment TypeNot used.Example: New, signed Referral for Non VA Care Radiology
MSH|^~\&|GMRC HCP SEND|500|GMRC HCP RECEIVE|200|20120315080804-0500||REF^I12|5008755|P|2.5|||AL|AL|USA
RF1|NW^CPRS RELEASED ORDER|R|87^NON VA CARE RADIOLOGY^^2108^NON VA CARE RADIOLOGY||O|600|201203150808-0500||||
PRD|RP|CPRSPROVIDER^THREE^^^^^^^10000000046|1 STREET ADDRESS^^CITY^ST^00011||^^^CPRS3@VA.GOV^^555^555-5555|
PID|1|5000000240V461023|5000000240V461023^^^USVHA&&0363^NI^VA FACILITY ID&500&L^^20120315~666660202^^^USSSA&&0363^SS^VA FACILITY ID&500&L~100003^^^USVHA&&0363^PI^VA FACILITY ID&500&L||DATABRIDGE^PATIENTEIGHT^^^^^L||19010101|M|||^^^^
^^P^^~^^^^^^N||||||||666660202||||||||||||
DG1|1||784.0^Headache|
OBR|1|19144;1^OR|600;GMRC^GMRC|||20120323
PV1|1|I|5^3 NORTH SURG|||10000000049^CPRSATTENDING,TWO|||||||||||11829^PROVIDER,TEST
NTE|1|P|Reason for Request
NTE|2||Sub-Specialty Service: MRI
NTE|3||Care Setting: Outpatient
NTE|4||Justification for Non-VA Care: VA Facility does not provide the required
NTE|5||service
NTE|6||Type of Service: Evaluation and Recommendations
NTE|7||Procedure (1):MRI HEAD/NECK
NTE|8||Procedure (2):
NTE|9||Procedure (3):
NTE|10||Chief Complaint: HEADACHE
NTE|11||Patient History / Clinical Findings / Diagnosis (Co-Morbidities):
NTE|12||HX OF HEADACHE 12 MONTHS
NTE|13||Patient Pregnant: No
NTE|14||Diabetic: No
NTE|15||Motor Vehicle Accident/Work Related Injury: No
NTE|16||Non VA Care Coordination Required? Yes
NTE|17||Allergies: PEANUTS
NTE|18||Active Inpatient Medications (including Supplies):
NTE19||Pending Inpatient Medications Status
NTE|20||=========================================================================
NTE|21||1) MULTIVITAMINS TAB TAB PO QD PENDING
NTE|22||History of Trauma N/A
NTE|23||Type of MRI? Open
NTE|24||Is Patient Claustrophobic? Yes
NTE|25||Closed Procedure with Sedation Tried? No
NTE|26||Patient Weight 187 lb [85.0 kg] (03/15/2012 07:58)
NTE|27||Patient Height 70 in [177.8 cm] (03/15/2012 07:58)
NTE|28||Creatinine Results within 30 days:
NTE|29||Contra-indications: None
NTE|30||Metal Injury to Eyes? No
NTE|31||Shrapnel or Gunshot Wound? Yes
NTE|32||History of Brain Surgery? No
NTE|33||History of Cardiac Surgery? No"
NTE|34||History of Other Surgery in the Past 2 Months? No"
Example: New, signed Referral for Non VA Care Dental
MSH|~^\&|GMRC HCP SEND|500|GMRC HCP RECEIVE|200|20120424160315-0500||REF^I12|5008820|P|2.5|||AL|AL|USA
RF1|NW^CPRS RELEASED ORDER|A|89^NON VA CARE DENTAL^^2060^NON VA CARE DENTAL||O|615|201204241603-0500||||
PRD|RP|CPRSPROVIDER,THREE^^^^^^^10000000046|1 STREET ADDRESS^^CITY^ST^00011||^^^CPRS3@VA.GOV^^555^555-5555|
PID|1||666001222^^^USSSA&&0363^SS^VA FACILITY ID&500&L~100136^^^USVHA&&0363^PI^VA FACILITY ID&500&L||FEEBASIS^ONE^^^^^L||19010101|M|||^^^^^^P^^~^^CITY^ST^^^N|||||S|13||666001222||||CITY ST||||||||
DG1|1||525.13^Loss of teeth due to Caries|
OBR|1|19165;1^OR|615;GMRC^GMRC|||20120427
PV1|1|O|||||||||||||||
NTE|1|P|Reason for Request
NTE|2||Sub-Specialty Service: Surgical
NTE|3||Care Setting: Outpatient
NTE|4||Justification for Non-VA Care: VA Facility cannot timely provide the
NTE|5||required
NTE|6||service
NTE|7||Type of Service: Evaluation and Treatment
NTE|8||Procedure (1): D0140 - LIMITED EXAM
NTE|9||Procedure (2): D7140 - EXTRACTION ERUPTED TOOTH
NTE|10||Procedure (3):
NTE|11||Patient Pregnant: No
NTE|12||Chief Complaint: TOOTHACHE
NTE|13||Patient History / Clinical Findings / Diagnosis (Co-Morbidities):
NTE|14||CARIES, PERIODONTAL DISEASE
NTE|15||Diabetic: No
NTE|16||Motor Vehicle Accident/Work Related Injury: No
NTE|17||Non VA Care Coordination Required? No
NTE|18||Allergies: No Allergy Assessment
NTE|19||Active Outpatient Medications (including Supplies):
NTE|20||No Medications Found
NTE|21||History of Trauma NO
NTE|22||Dental Classification: Class 4
NTE|23||Tooth Number: 14
NTE|24||Area: WHOLE TOOTH
NTE|25||Surface:
REF_I13 Message Definition Tables XE "HL7:REF_I13 Message Definition Tables"
REF_I13 MSH - Message Header Segment
MSH - Message Header Segment (generated by the VistA HL7 package using the HL7 Application and Protocol entries for the GMRC components)
REF_I13 MSH - Message Header Segment
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION11STRField Separator|24STREncoding Characters^~\&315STRSending ApplicationGMRC HCP SEND420STRSending FacilitySending Facility, from the FACILITY NAME field of the HL7 APPLICATION entry GMRC HCP SEND530STRReceiving ApplicationGMRC HCP RECEIVE630STNSReceiving FacilityReceiving Facility, from the FACILITY NAME field of the HL7 APPLICATION entry GMRC HCP RECEIVE726TSRDate/Time Of MessageSystem date/time generated by the VistA HL7 package840STNSSecurityNot used97CMR0076
0003Message TypeREF^I131020STRMessage Control IDFacility and sequence number automatically generated by the HL7 Package111IDRProcessing IDP for Production, T for Test128IDR0104Version ID2.51315NMNSSequence NumberNot used14180STNSContinuation PointerNot used152IDR0155Accept Acknowledgment TypeAL=Always162IDR0155Application Acknowledgment TypeAL=Always173IDR0399Country CodeUSA(MSH fields past MSH.17 are not used and not shown to save space)
MSH.16 does not support ER to just return Application Acknowledgements for errors, so all messages required acknowledgement either AA or AE in the MSA.
REF_I13 RF1 Referral Information Segment
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION1250CEO0283Referral StatusSC^RECEIVED
SC^SCHEDULED
IP^RESUBMITTED
IP^ADD COMMENT
XX^FORWARDED
CM^COMPLETE
CM^ADDENDED 2250CEO0280Referral PriorityFrom File 123, Field 5 (Urgency). Values are:
1 WEEK,
NEXT AVAILABLE,
ROUTINE,
STAT,
TODAY,
TOMORROW AM,
WITHIN 1 MONTH,
WITHIN 1 WEEK,
WITHIN 24 HOURS,
WITHIN 72 HOURS3250CEOReferral TypeService IEN^Service Name^^Template IEN
^Template Name
Service IEN is pointer to File 123.5, Template IEN is pointer to File 8927.4250CENSReferral DispositionNot used5250CEO0284Referral CategoryI for Inpatient, O for Outpatient based on File 123, field 14 (Service Rendered as In or Out). This could be different than the PV1.1 current patient status.630EIROriginating Referral IdentifierIEN to File 123726TSOEffective DateReferral Date of Request from File 123, field .01826TSNSExpiration DateNot used926TSNSProcess DateNot used10250CENSReferral ReasonNot used1130EINSExternal Referral IdentifierNot usedHCPS will send the Originating Referral Identifier that was sent in the initial REF^I12 from VistA and blanks for everything else.
REF_I13 PRD - Provider Data Segment (Same for all message types)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION1250CER0286Provider RoleRP for Referring Provider2250XPNOProvider NameProvider Last Name^Provider First Name^Provider Middle Initial^^^^^^Provider DUZ
Provider from File 123, field 103250XADOProvider AddressStreet Address 1^Street Address 2^City^State^Zip from File 2, fields .111, .112, .114, .115, .116460PLNSProvider LocationNot used5250XTNOProvider Communication Information^^^Email Address^^Office Phone Area Code^Office Phone Number from File 2, fields .151, .1326250CENSPreferred Method of ContactNot used7100PLNNSProvider IdentifiersNot used826TSNSEffective Start Date of Provider RoleNot used926TSNSEffective End Date of Provider RoleNot usedHCPS will send the Provider Role that was sent in the initial REF^I12 from VistA and blanks for everything else.
REF_I13 PID Patient Id Segment (generated by the VistA API; Same for all message types)
(PID fields past PID.24 not used and not shown to save space)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIRSet ID PIDSequential Number220CXRPatient IDICN, including V checksum for backwards compatibility3250CXRPatient Identifier List (list is not in any specified order)
Following are PID.3.5 Identifier Type Codes:
NI=ICN
PI=Patient DFN
SS=SSN
PN=Claim NumberIntegration Control Number (including V and checksum), Social Security Number, DFN, Claim Number, all entries in the ICN History Multiple, and all alias SSNs which will correspond directly to the alias name in the name field (pid-5).420CXNSAlternate Patient ID PIDNot used5250XPNRPatient NamePatient Name and all Alias entries6250XPNOMothers Maiden NameMothers Maiden Name726TSODate/Time of BirthDate of Birth81ISO1Administrative SexSex9250XPNNSPatient AliasNot used. Alias is passed in PID-510250CEO5RaceRace Information. Example: 2106-3-SLF^^0005^2106-3^^CDC See Appendix A for coded values. 0005 and CDC are hardcoded.11250XADOPatient AddressP=Permanent Address~N=Place of Birth~Confidential Address124ISO289County CodeCounty13250XTNOPhone Number HomeHome Phone~Work Phone~Cell Phone~Pager^NET^INTERNET^email14250XTNOPhone Number BusinessWork Phone (backward compatibility)15250CENS296Primary LanguageNot used16250CEO2Marital StatusMarital Status^^^^^^M17250CEO6ReligionReligious Preference (code)18250CXNSPatient Account NumberNot used1916STRSSN Number PatientSSN2025DLNNSDrivers License Number PatientNot used21250CXNSMothers IdentifierNot used22250CEO189Ethnic GroupEthnicity Information. Example: 2186-5-SLF^^0189^2186-5^^CDCSee Appendix A for coded values. 2186 and CDC are hardcoded.23250STOBirth PlacePlace of birth city and place of birth state241IDO136Multiple Birth IndicatorMultiple Birth Indicator [Y for multiple birth]HCPS will only send the original information in the initial REF^I12 from VistA for sequences 1, 2, 3, 5, and 19.
REF_I13 DG1 Diagnosis Segment (Same for all message types)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIRSet ID DG1122IDNSDiagnosis Coding MethodNot used3250CERDiagnosis Code DG1Provisional Diagnosis Code^Diagnosis Description from File 123, field 30440STBDiagnosis DescriptionNot Used526TSODiagnosis Date/TimeNot Used62ISR0052Diagnosis TypeW - Working(DG1 fields past DG1.6 are not used and not shown to save space)
REF_I13 OBR Observation Request Segment (Same for all message types)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIRSet ID OBR1222EIRPlacer Order NumberOrder entry internal number;Orderable Item entry^OR from File 123, field .03322EIRFiller Order NumberConsult entry internal number;GMRC^GMRC for all comments and TIU note internal entry number; TIU^TIU for all signed progress notes and addendums. 4250CERUniversal Service IdentifierHardcoded value of ZZ52IDNSPriority OBRNot used626TSORequested Date/TimeClinically XE "Clinically Indicated Date" Indicated Date from File 123, field 17(OBR fields past OBR.6 are not used and not shown to save space)
REF_I13 PV1 Patient Visit Segment (same for all message types)
The PV1 segment data is creating using the IN5^VADPT call to determine current inpatient status. See PIMS technical manual for definition of the returned array VAIP.
Fields not returned by the IN5^VADPT API are not used in the PV1 segment.
REF_I13 PV1 - Patient Visit Segment (Same for all message types)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIRSet ID PV1121ISR0004Patient ClassI: inpatient
O: outpatient380PLOAssigned Patient LocationLocation of last inpatient movement event from VAIP(5)42ISNSAdmission TypeNot used5250CXNSPreadmit NumberNot used680PLNSPrior Patient LocationNot used7250XCNO0010Attending DoctorAttending Provider from VAIP(18)8250XCNO0010Referring DoctorNot used (Referring provider sent in PRD segment)9250XCNNSConsulting DoctorNot used103ISNSHospital ServiceNot used1180PLNSTemporary LocationNot used122ISNSPreadmit Test IndicatorNot used132ISNSRe-admission IndicatorNot used146ISNSAdmit SourceNot used152ISNSAmbulatory StatusNot used162ISO0099VIP IndicatorR if patient restricted/sensitive17250XCNO0010Admitting DoctorPrimary Physician for admission from VAIP(13,5)HCPS will only send the original information in the initial REF^I12 from VistA for sequences 1 and 2.
(PV1 fields past PV1.17 are not used and not shown to save space)
REF_I13 NTE Notes and Comments Segment
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIOSet ID NTESequential Number 1-n28IDO0105Source of CommentP for Placer
L for Ancillary365536FTOCommentBased on message type, Resubmitted consults messages (RF1.1= IP^RESUBMITTED)
will contain Reason for Request from file 123, field 20, Completed or Addended (RF1.1= CM^COMPLETE
CM^ADDENDED) will contain TIU Progress Note from file 8925 (signed notes/addendums only). All other I13 messages will contain Activity Comments from file 123, subfile 123.25 field 5.4250CEOComment TypeNot used.HCPS will send Notes/Comments/Status changes made in the Referral in HCPS.
Example Receive Referral
MSH|^~\&|GMRC HCP SEND|500|GMRC HCP RECEIVE|200|20120315082327-0500||REF^I13|5008756|P|2.5|||AL|AL|USA
RF1|SC^RECEIVED|R|87^NON VA CARE RADIOLOGY^^2108^NON VA CARE RADIOLOGY||O|600|201203150808-0500||||
PRD|RP|CPRSPROVIDER^THREE^^^^^^^10000000046|1 STREET ADDRESS^^CITY^ST^00011||^^^CPRS3@VA.GOV^^555^555-5555|
PID|1|5000000240V461023|5000000240V461023^^^USVHA&&0363^NI^VA FACILITY ID&500&L^^20120315~666660202^^^USSSA&&0363^SS^VA FACILITY ID&500&L~100003^^^USVHA&&0363^PI^VA FACILITY ID&500&L||DATABRIDGE^PATIENTEIGHT^^^^^L||19010101|M|||^^^^
^^P^^~^^^^^^N||||||||666660202||||||||||||
DG1|1||784.0^Headache|
OBR|1|19144;1^OR|600;GMRC^GMRC|||20120323
PV1|1|I|5^3 NORTH SURG|||10000000049^CPRSATTENDING,TWO|||||||||||11829^PROVIDER,TEST
NTE|1|L|Actvity Comment
NTE|2||Referral received comment.
Example: Schedule Referral *(no comment entered during Schedule, so no NTE segment sent)
MSH|^~\&|GMRC HCP SEND|500|GMRC HCP RECEIVE|200|20120315082633-0500||REF^I13|5008757|P|2.5|||AL|AL|USA
RF1|SC^SCHEDULED|R|87^NON VA CARE RADIOLOGY^^2108^NON VA CARE RADIOLOGY||O|600|201203150808-0500||||
PRD|RP|CPRSPROVIDER^THREE^^^^^^^10000000046|1 STREET ADDRESS^^CITY^ST^00011||^^^CPRS3@VA.GOV^^555^555-5555|
PID|1|5000000240V461023|5000000240V461023^^^USVHA&&0363^NI^VA FACILITY ID&500&L^^20120315~666660202^^^USSSA&&0363^SS^VA FACILITY ID&500&L~100003^^^USVHA&&0363^PI^VA FACILITY ID&500&L||DATABRIDGE^PATIENTEIGHT^^^^^L||19010101|M|||^^^^
^^P^^~^^^^^^N||||||||666660202||||||||||||
DG1|1||784.0^Headache|
OBR|1|19144;1^OR|600;GMRC^GMRC|||20120323
PV1|1|I|5^3 NORTH SURG|||10000000049^CPRSATTENDING,TWO|||||||||||11829^PROVIDER,TEST
Example: Comment Referral
MSH|^~\&|GMRC HCP SEND|500|GMRC HCP RECEIVE|200|20120424133548-0500||REF^I13|5008819|P|2.5|||AL|AL|USA
RF1|XX^ADDED COMMENT|A|87^NON VA CARE RADIOLOGY^^2108^NON VA CARE RADIOLOGY||I|614|201204241333-0500||||
PRD|RP|CPRSPROVIDER^THREE^^^^^^^10000000046|1 STREET ADDRESS^^CITY^ST^00011||^^^CPRS3@VA.GOV^^555^555-5555|
PID|1|5000000240V461023|5000000240V461023^^^USVHA&&0363^NI^VA FACILITY ID&500&L^^20120424~666660202^^^USSSA&&0363^SS^VA FACILITY ID&500&L~100003^^^USVHA&&0363^PI^VA FACILITY ID&500&L||DATABRIDGE^PATIENTEIGHT^^^^^L||19010101|M|||^^^^
^^P^^~^^^^^^N||||||||666660202||||||||||||
DG1|1||786.05^Shortness of breath|
OBR|1|19164;1^OR|614;GMRC^GMRC|||20120424
PV1|1|I|5^3 NORTH SURG|||10000000049^CPRSATTENDING,TWO|||||||||||11829^TEST,TESTDOC
NTE|1|L|Activity Comment
NTE|2||COMMENT FOR RAD CONSULT
Example: Complete Referral
MSH|^~\&|GMRC HCP SEND|500|GMRC HCP RECEIVE|200|20120315152311-0500||REF^I13|5008772|P|2.5|||AL|AL|USA
RF1|CM^COMPLETE|R|87^NON VA CARE RADIOLOGY^^2108^NON VA CARE RADIOLOGY||I|596|201203121144-0500||||
PRD|RP|CPRSPROVIDER^THREE^^^^^^^10000000046|1 STREET ADDRESS^^CITY^ST^00011||^^^CPRS3@VA.GOV^^555^555-5555|
PID|1|5000000063V126746|5000000063V126746^^^USVHA&&0363^NI^VA FACILITY ID&500&L^^20120315~666666789^^^USSSA&&0363^SS^VA FACILITY ID&500&L~740^^^USVHA&&0363^PI^VA FACILITY ID&500&L||ACMPATIENT^EIGHT^^^^^L||19501206|M|||5555 TEST BLV
D^^PALM BEACH GARDENS^FL^33410^USA^P^^~^^ALBANY^NY^^^N||(518)555-2345^PRN^PH|||S|0||666666789||||ALBANY NY||||||||
OBR|1|19138;1^OR|596;GMRC^GMRC|||20120316
PV1|1|I|19^SURGERY|||11698^TEST,ATTENDING|||||||||||11698^TEST,ATTENDING
NTE|1|P|Progress Note
NTE|2||LOCAL TITLE: NON VA CARE CONSULT
NTE|3||STANDARD TITLE: NONVA CONSULT
NTE|4||DATE OF NOTE: MAR 15, 2012@15:43 ENTRY DATE: MAR 15, 2012@15:43:31
NTE|5||AUTHOR: CPRSPROVIDER,THREE EXP COSIGNER:
NTE|6||URGENCY: STATUS: COMPLETED
NTE|7||ACMPATIENT,EIGHT presented to vamc w/complaints of:
NTE|8||headache. MRI notes attached from Non VA Provider.
NTE|9||ADDING TEXT TO UNSIGNED NOTE.
NTE|10||/es/ THREE CPRSPROVIDER
NTE|11||Signed: 03/15/2012 15:47
RRI_I13 Message Definition Tables XE "HL7:RRI_I13 Message Definition Tables"
HCPS will update CPRS with information entered into HCPS via HL7 message RRI (Return Referral Information). The RRI^I13 message structure is exactly the same as the REF^I13 used by CPRS to send referral information to HCPS.
RRI_I13 MSH - Message Header Segment (generated by the VistA HL7 package using the HL7 Application and Protocol entries for the GMRC components)
RRI_I13 MSH - Message Header Segment Table
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION11STRField Separator|24STREncoding Characters^~\&315STRSending ApplicationGMRC HCP SEND420STRSending FacilitySending Facility, from the FACILITY NAME field of the HL7 APPLICATION entry GMRC HCP SEND530STRReceiving ApplicationGMRC HCP RECEIVE630STNSReceiving FacilityReceiving Facility, from the FACILITY NAME field of the HL7 APPLICATION entry GMRC HCP RECEIVE726TSRDate/Time Of MessageSystem date/time generated by the VistA HL7 package840STNSSecurityNot used97CMR0076
0003Message TypeRRI^I131020STRMessage Control IDFacility and sequence number automatically generated by the HL7 Package111IDRProcessing IDP for Production, T for Test128IDR0104Version ID2.51315NMNSSequence NumberNot used14180STNSContinuation PointerNot used152IDR0155Accept Acknowledgment TypeAL=Always162IDR0155Application Acknowledgment TypeAL=Always173IDR0399Country CodeUSA(MSH fields past MSH.17 are not used and not shown to save space)
MSH.16 does not support ER to just return Application Acknowledgements for errors, so all messages required acknowledgement either AA or AE in the MSA.
RRI_I13 RF1 Referral Information Segment
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION1250CEO0283Referral StatusSC^RECEIVED
SC^SCHEDULED
IP^RESUBMITTED
IP^COMMENT
XX^FORWARDED
CM^COMPLETE
CM^ADDENDED 2250CEO0280Referral PriorityFrom File 123, Field 5 (Urgency). Values are:
1 WEEK,
NEXT AVAILABLE,
ROUTINE,
STAT,
TODAY,
TOMORROW AM,
WITHIN 1 MONTH,
WITHIN 1 WEEK,
WITHIN 24 HOURS,
WITHIN 72 HOURS3250CEOReferral TypeService IEN^Service Name^^Template IEN
^Template Name
Service IEN is pointer to File 123.5, Template IEN is pointer to File 8927.4250CENSReferral DispositionNot used5250CEO0284Referral CategoryI for Inpatient, O for Outpatient based on File 123, field 14 (Service Rendered as In or Out). This could be different than the PV1.1 current patient status.630EIROriginating Referral IdentifierIEN to File 123726TSOEffective DateReferral Date of Request from File 123, field .01826TSNSExpiration DateNot used926TSNSProcess DateNot used10250CENSReferral ReasonNot used1130EINSExternal Referral IdentifierNot usedHCPS will send the Originating Referral Identifier that was sent in the initial REF^I12 from VistA and blanks for everything else.
RRI_I13 PRD - Provider Data Segment (Same for all message types)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION1250CER0286Provider RoleRP for Referring Provider2250XPNOProvider NameProvider Last Name^Provider First Name^Provider Middle Initial^^^^^^Provider DUZ
Provider from File 123, field 103250XADOProvider AddressStreet Address 1^Street Address 2^City^State^Zip from File 2, fields .111, .112, .114, .115, .116460PLNSProvider LocationNot used5250XTNOProvider Communication Information^^^Email Address^^Office Phone Area Code^Office Phone Number from File 2, fields .151, .1326250CENSPreferred Method of ContactNot used7100PLNNSProvider IdentifiersNot used826TSNSEffective Start Date of Provider RoleNot used926TSNSEffective End Date of Provider RoleNot usedHCPS will send the Provider Role that was sent in the initial REF^I12 from VistA and blanks for everything else.
RRI_I13 PID Patient Id Segment (generated by the VistA API; Same for all message types)
(PID fields past PID.24 not used and not shown to save space)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIRSet ID PIDSequential Number220CXRPatient IDICN, including V checksum for backwards compatibility3250CXRPatient Identifier List (list is not in any specified order)
Following are PID.3.5 Identifier Type Codes:
NI=ICN
PI=Patient DFN
SS=SSN
PN=Claim NumberIntegration Control Number (including V and checksum), Social Security Number, DFN, Claim Number, all entries in the ICN History Multiple, and all alias SSNs which will correspond directly to the alias name in the name field (pid-5).420CXNSAlternate Patient ID PIDNot used5250XPNRPatient NamePatient Name and all Alias entries6250XPNOMothers Maiden NameMothers Maiden Name726TSODate/Time of BirthDate of Birth81ISO0001Administrative SexSex9250XPNNSPatient AliasNot used. Alias is passed in PID-510250CEO0005RaceRace Information. Example: 2106-3-SLF^^0005^2106-3^^CDC See Appendix A for coded values. 0005 and CDC are hardcoded.11250XADOPatient AddressP=Permanent Address~N=Place of Birth~Confidential Address124ISO0289County CodeCounty13250XTNOPhone Number HomeHome Phone~Work Phone~Cell Phone~Pager^NET^INTERNET^email14250XTNOPhone Number BusinessWork Phone (backward compatibility)15250CENS0296Primary LanguageNot used16250CEO0002Marital StatusMarital Status^^^^^^M17250CEO0006ReligionReligious Preference (code)18250CXNSPatient Account NumberNot used1916STRSSN Number PatientSSN2025DLNNSDrivers License Number PatientNot used21250CXNSMothers IdentifierNot used22250CEO0189Ethnic GroupEthnicity Information. Example: 2186-5-SLF^^0189^2186-5^^CDCSee Appendix A for coded values. 2186 and CDC are hardcoded.23250STOBirth PlacePlace of birth city and place of birth state241IDO0136Multiple Birth IndicatorMultiple Birth Indicator [Y for multiple birth]HCPS will only send the original information in the initial REF^I12 from VistA for sequences 1, 2, 3, 5, and 19.
RRI_I13 DG1 Diagnosis Segment (Same for all message types)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIRSet ID DG1122IDNSDiagnosis Coding MethodNot used3250CERDiagnosis Code DG1Provisional Diagnosis Code^Diagnosis Description from File 123, field 30440STBDiagnosis DescriptionNot Used526TSODiagnosis Date/TimeNot Used62ISR0052Diagnosis TypeW - Working(DG1 fields past DG1.6 are not used and not shown to save space)
RRI_I13 OBR Observation Request Segment (Same for all message types)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIRSet ID OBR1222EIRPlacer Order NumberOrder entry internal number;Orderable Item entry^OR from File 123, field .03322EIRFiller Order NumberConsult entry internal number;GMRC^GMRC for all comments and TIU note internal entry number; TIU^TIU for all signed progress notes and addendums. 4250CERUniversal Service IdentifierHardcoded value of ZZ52IDNSPriority OBRNot used626TSORequested Date/TimeClinically XE "Clinically Indicated Date" Indicated Date from File 123, field 17(OBR fields past OBR.6 are not used and not shown to save space)
RRI_I13 PV1 Patient Visit Segment (same for all message types)
The PV1 segment data is created using the IN5^VADPT call to determine current inpatient status. See PIMS technical manual for definition of the returned array VAIP.
Fields not returned by the IN5^VADPT API are not used in the PV1 segment.
RRI PV1 - Patient Visit Segment (Same for all message types)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIRSet ID PV1121ISR0004Patient ClassI: inpatient
O: outpatient380PLOAssigned Patient LocationLocation of last inpatient movement event from VAIP(5)42ISNSAdmission TypeNot used5250CXNSPreadmit NumberNot used680PLNSPrior Patient LocationNot used7250XCNO0010Attending DoctorAttending Provider from VAIP(18)8250XCNO0010Referring DoctorNot used (Referring provider sent in PRD segment)9250XCNNSConsulting DoctorNot used103ISNSHospital ServiceNot used1180PLNSTemporary LocationNot used122ISNSPreadmit Test IndicatorNot used132ISNSRe-admission IndicatorNot used146ISNSAdmit SourceNot used152ISNSAmbulatory StatusNot used162ISO0099VIP IndicatorR if patient restricted/sensitive17250XCNO0010Admitting DoctorPrimary Physician for admission from VAIP(13,5)HCPS will only send the original information in the initial REF^I12 from VistA for sequences 1 and 2.
(PV1 fields past PV1.17 are not used and not shown to save space)
RRI_I13 NTE Notes and Comments Segment
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIOSet ID NTESequential Number 1-n28IDO0105Source of CommentP for Placer
L for Ancillary365536FTOCommentBased on message type, Resubmitted consults messages (RF1.1= IP^RESUBMITTED)
will contain Reason for Request from file 123, field 20, Completed or Addended (RF1.1= CM^COMPLETE
CM^ADDENDED) will contain TIU Progress Note from file 8925 (signed notes/addendums only). All other I13 messages will contain Activity Comments from file 123, subfile 123.25 field 5.4250CEOComment TypeNot used.HCPS will send Notes/Comments/Status changes made in the Referral in HCPS.
Example Receive Referral
MSH|^~\&|GMRC HCP SEND|500|GMRC HCP RECEIVE|200|20120315082327-0500||RRI^I13|5008756|P|2.5|||AL|AL|USA
RF1|SC^RECEIVED|R|87^NON VA CARE RADIOLOGY^^2108^NON VA CARE RADIOLOGY||O|600|201203150808-0500||||
PRD|RP|CPRSPROVIDER^THREE^^^^^^^10000000046|1 STREET ADDRESS^^CITY^ST^00011||^^^CPRS3@VA.GOV^^555^555-5555|
PID|1|5000000240V461023|5000000240V461023^^^USVHA&&0363^NI^VA FACILITY ID&500&L^^20120315~666660202^^^USSSA&&0363^SS^VA FACILITY ID&500&L~100003^^^USVHA&&0363^PI^VA FACILITY ID&500&L||DATABRIDGE^PATIENTEIGHT^^^^^L||19010101|M|||^^^^
^^P^^~^^^^^^N||||||||666660202||||||||||||
DG1|1||784.0^Headache|
OBR|1|19144;1^OR|600;GMRC^GMRC|||20120323
PV1|1|I|5^3 NORTH SURG|||10000000049^CPRSATTENDING,TWO|||||||||||11829^PROVIDER,TEST
NTE|1|L|Actvity Comment
NTE|2||Referral received comment.
Example: Schedule Referral *(no comment entered during Schedule, so no NTE segment sent)
MSH|^~\&|GMRC HCP SEND|500|GMRC HCP RECEIVE|200|20120315082633-0500||RRI^I13|5008757|P|2.5|||AL|AL|USA
RF1|SC^SCHEDULED|R|87^NON VA CARE RADIOLOGY^^2108^NON VA CARE RADIOLOGY||O|600|201203150808-0500||||
PRD|RP|CPRSPROVIDER^THREE^^^^^^^10000000046|1 STREET ADDRESS^^CITY^ST^00011||^^^CPRS3@VA.GOV^^555^555-5555|
PID|1|5000000240V461023|5000000240V461023^^^USVHA&&0363^NI^VA FACILITY ID&500&L^^20120315~666660202^^^USSSA&&0363^SS^VA FACILITY ID&500&L~100003^^^USVHA&&0363^PI^VA FACILITY ID&500&L||DATABRIDGE^PATIENTEIGHT^^^^^L||19010101|M|||^^^^
^^P^^~^^^^^^N||||||||666660202||||||||||||
DG1|1||784.0^Headache|
OBR|1|19144;1^OR|600;GMRC^GMRC|||20120323
PV1|1|I|5^3 NORTH SURG|||10000000049^CPRSATTENDING,TWO|||||||||||11829^PROVIDER,TEST
Example: Comment Referral
MSH|^~\&|GMRC HCP SEND|500|GMRC HCP RECEIVE|200|20120424133548-0500||RRI^I13|5008819|P|2.5|||AL|AL|USA
RF1|XX^ADDED COMMENT|A|87^NON VA CARE RADIOLOGY^^2108^NON VA CARE RADIOLOGY||I|614|201204241333-0500||||
PRD|RP|CPRSPROVIDER^THREE^^^^^^^10000000046|1 STREET ADDRESS^^CITY^ST^00011||^^^CPRS3@VA.GOV^^555^555-5555|
PID|1|5000000240V461023|5000000240V461023^^^USVHA&&0363^NI^VA FACILITY ID&500&L^^20120424~666660202^^^USSSA&&0363^SS^VA FACILITY ID&500&L~100003^^^USVHA&&0363^PI^VA FACILITY ID&500&L||DATABRIDGE^PATIENTEIGHT^^^^^L||19010101|M|||^^^^
^^P^^~^^^^^^N||||||||666660202||||||||||||
DG1|1||786.05^Shortness of breath|
OBR|1|19164;1^OR|614;GMRC^GMRC|||20120424
PV1|1|I|5^3 NORTH SURG|||10000000049^CPRSATTENDING,TWO|||||||||||11829^TEST,TESTDOC
NTE|1|L|Activity Comment
NTE|2||COMMENT FOR RAD CONSULT
Example: Complete Referral
MSH|^~\&|GMRC HCP SEND|500|GMRC HCP RECEIVE|200|20120315152311-0500||RRI^I13|5008772|P|2.5|||AL|AL|USA
RF1|CM^COMPLETE|R|87^NON VA CARE RADIOLOGY^^2108^NON VA CARE RADIOLOGY||I|596|201203121144-0500||||
PRD|RP|CPRSPROVIDER^THREE^^^^^^^10000000046|1 STREET ADDRESS^^CITY^ST^00011||^^^CPRS3@VA.GOV^^555^555-5555|
PID|1|5000000063V126746|5000000063V126746^^^USVHA&&0363^NI^VA FACILITY ID&500&L^^20120315~666666789^^^USSSA&&0363^SS^VA FACILITY ID&500&L~740^^^USVHA&&0363^PI^VA FACILITY ID&500&L||ACMPATIENT^EIGHT^^^^^L||19501206|M|||5555 TEST BLV
D^^PALM BEACH GARDENS^FL^33410^USA^P^^~^^ALBANY^NY^^^N||(518)555-2345^PRN^PH|||S|0||666666789||||ALBANY NY||||||||
OBR|1|19138;1^OR|596;GMRC^GMRC|||20120316
PV1|1|I|19^SURGERY|||11698^TEST,ATTENDING|||||||||||11698^TEST,ATTENDING
NTE|1|P|Progress Note
NTE|2||LOCAL TITLE: NON VA CARE CONSULT
NTE|3||STANDARD TITLE: NONVA CONSULT
NTE|4||DATE OF NOTE: MAR 15, 2012@15:43 ENTRY DATE: MAR 15, 2012@15:43:31
NTE|5||AUTHOR: CPRSPROVIDER,THREE EXP COSIGNER:
NTE|6||URGENCY: STATUS: COMPLETED
NTE|7||ACMPATIENT,EIGHT presented to vamc w/complaints of:
NTE|8||headache. MRI notes attached from Non VA Provider.
NTE|9||ADDING TEXT TO UNSIGNED NOTE.
NTE|10||/es/ THREE CPRSPROVIDER
NTE|11||Signed: 03/15/2012 15:47
REF_I14 Message Definition Tables XE "HL7:REF_I14 Message Definition Tables"
MSH - Message Header Segment (generated by the VistA HL7 package using the HL7 Application and Protocol entries for the GMRC components)
REF_I14 MSH - Message Header Segment
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION11STRField Separator|24STREncoding Characters^~\&315STRSending ApplicationGMRC HCP SEND420STRSending FacilitySending Facility, from the FACILITY NAME field of the HL7 APPLICATION entry GMRC HCP SEND530STRReceiving ApplicationGMRC HCP RECEIVE630STNSReceiving FacilityReceiving Facility, from the FACILITY NAME field of the HL7 APPLICATION entry GMRC HCP RECEIVE726TSRDate/Time Of MessageSystem date/time generated by the VistA HL7 package840STNSSecurityNot used97CMR0076
0003Message TypeREF^I141020STRMessage Control IDFacility and sequence number automatically generated by the VistA HL7 Package111IDRProcessing IDP for Production, T for Test128IDR0104Version ID2.51315NMNSSequence NumberNot used14180STNSContinuation PointerNot used152IDR0155Accept Acknowledgment TypeAL=Always162IDR0155Application Acknowledgment TypeAL=Always173IDR0399Country CodeUSA
REF_I14 RF1 Referral Information Segment
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION1250CEO0283Referral StatusCA^CANCELLED
DC^DISCONTINUED2250CEO0280Referral PriorityFrom File 123, Field 5 (Urgency). Values are: 1 WEEK, NEXT AVAILABLE, ROUTINE, STAT, TODAY, TOMORROW AM, WITHIN 1 MONTH, WITHIN 1 WEEK, WITHIN 24 HOURS, WITHIN 72 HOURS3250CEOReferral TypeService IEN^Service Name^^Template IEN
^Template Name
Service IEN is pointer to File 123.5, Template IEN is pointer to File 8927.4250CENSReferral DispositionNot used.5250CEO0284Referral CategoryI for Inpatient, O for Outpatient based on File 123, field 14 (Service Rendered as In or Out). This could be different than the PV1.1 current patient status.630EIROriginating Referral IdentifierIEN to File 123726TSOEffective DateReferral Date of Request from File 123, field .01826TSNSExpiration DateNot used926TSNSProcess DateNot used10250CENSReferral ReasonNot used1130EINSExternal Referral IdentifierNot used
REF_I14 PRD Provider Data Segment (same for all message types)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION1250CER0286Provider RoleRP for Referring Provider2250XPNOProvider NameProvider Last Name^Provider First Name^Provider Middle Initial^^^^^^Provider DUZ
Provider from File 123, field 103250XADOProvider AddressStreet Address 1^Street Address 2^City^State^Zip from File 200, fields .111, .112, .114, .115, .116460PLNSProvider LocationNot used5250XTNOProvider Communication Information^^^Email Address^^Office Phone Area Code^Office Phone Number from File 200, fields .151, .1326250CENSPreferred Method of ContactNot used7100PLNNSProvider IdentifiersNot used826TSNSEffective Start Date of Provider RoleNot used926TSNSEffective End Date of Provider RoleNot used
REF_I14 PID Patient Id Segment (generated by the VistA API) (same for all msg types)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIRSet ID PIDSequential Number220CXRPatient IDICN, including V checksum for backwards compatibility3250CXRPatient Identifier List (list is not in any specified order)
Following are PID.3.5 Identifier Codes:
NI=ICN
PI=Patient DFN
SS=SSN
PN=Claim NumberIntegration Control Number (including V and checksum), Social Security Number, DFN, Claim Number, all entries in the ICN History Multiple, and all alias SSNs which will correspond directly to the alias name in the name field (pid-5). 420CXNSAlternate Patient ID PIDNot used5250XPNRPatient NamePatient Name and all Alias entries6250XPNOMothers Maiden NameMothers Maiden Name726TSODate/Time of BirthDate of Birth81ISO0001Administrative SexSex9250XPNNSPatient AliasNot used. Alias is passed in PID-510250CEO0005RaceRace Information. Example: 2106-3-SLF^^0005^2106-3^^CDC See Appendix A for coded values. 0005 and CDC are hardcoded.11250XADOPatient AddressP=Permanent Address~N=Place of Birth~Confidential Address124ISO0289County CodeCounty13250XTNOPhone Number HomeHome Phone~Work Phone~Cell Phone~Pager^NET^INTERNET^email14250XTNOPhone Number BusinessWork Phone (backward compatibility)15250CENS0296Primary LanguageNot used16250CEO0002Marital StatusMarital Status^^^^^^M17250CEO0006ReligionReligious Preference (code)18250CXNSPatient Account NumberNot used1916STRSSN Number PatientSSN2025DLNNSDrivers License Number PatientNot used21250CXNSMothers IdentifierNot used22250CEO0189Ethnic GroupEthnicity Information. Example: 2186-5-SLF^^0189^2186-5^^CDC
See Appendix A for coded values. 2186 and CDC are hardcoded.23250STOBirth PlacePlace of birth city and place of birth state241IDO0136Multiple Birth IndicatorMultiple Birth Indicator [Y for multiple birth](PID fields past PID.24 not used and not shown to save space)
REF_I14 DG1 - Diagnosis Segment (Same for all message types)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIRSet ID DG1122IDNSDiagnosis Coding MethodNot used3250CERDiagnosis Code DG1Provisional Diagnosis Code^Diagnosis Description from File 123, field 30440STBDiagnosis DescriptionNot used526TSODiagnosis Date/TimeNot used62ISR0052Diagnosis TypeW - Working(DG1 fields past DG1.6 are not used and not shown to save space)
REF_I14 OBR Observation Request Segment (Same for all message types)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIRSet ID OBR1222EIRPlacer Order NumberOrder entry internal number;Orderable Item entry^OR from File 123, field .03322EIRFiller Order NumberConsult entry internal number;GMRC^GMRC 4250CENSUniversal Service IdentifierHardcoded value of ZZ52IDNSPriority OBRNot used626TSORequested Date/TimeClinically XE "Clinically Indicated Date" Indicated Date from File 123, field 17(OBR fields past OBR.6 are not used and not shown to save space)
REF_I14 PV1 Patient Visit Segment (same for all message types)
The PV1 segment data is created using the IN5^VADPT call to determine current inpatient status. See PIMS technical manual for definition of the returned array VAIP.
Fields not returned by the IN5^VADPT API are not used in the PV1 segment.
REF_14 PV1 Patient Visit Segment (Same for all message types)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIRSet ID PV1121ISR0004Patient ClassI: inpatient
O: outpatient380PLOAssigned Patient LocationLocation of last inpatient movement event from VAIP(5)42ISNSAdmission TypeNot used5250CXNSPreadmit NumberNot used680PLNSPrior Patient LocationNot used7250XCNO0010Attending DoctorAttending Provider from VAIP(18)8250XCNNSReferring DoctorNot used (Referring provider sent in PRD segment)9250XCNNSConsulting DoctorNot used103ISNSHospital ServiceNot used1180PLNSTemporary LocationNot used122ISNSPreadmit Test IndicatorNot used132ISNSRe-admission IndicatorNot used146ISNSAdmit SourceNot used152ISNSAmbulatory StatusNot used162ISO0099VIP IndicatorR if patient restricted/sensitive17250XCNO0010Admitting DoctorPrimary Physician for admission from VAIP(13,5)(PV1 fields past PV1.17 are not used and not shown to save space)
REF_I14 NTE Notes and Comments Segment
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14SIOSet ID NTESequential Number 1-n28IDO0105Source of CommentL for Ancillary365536FTOCommentActivity Comments from file 123, subfile 123.25 field 54250CEOComment TypeNot used.Example: Cancel Referral
MSH|^~\&|GMRC HCP SEND|500|GMRC HCP RECEIVE|200|20120315083119-0500||REF^I14|5008758|P|2.5|||AL|AL|USA
RF1|CA^CANCELLED|R|87^NON VA CARE RADIOLOGY^^2108^NON VA CARE RADIOLOGY||O|600|201203150808-0500||||
PRD|RP|CPRSPROVIDER^THREE^^^^^^^10000000046|1 STREET ADDRESS^^CITY^ST^00011||^^^CPRS3@VA.GOV^^555^555-5555|
PID|1|5000000240V461023|5000000240V461023^^^USVHA&&0363^NI^VA FACILITY ID&500&L^^20120315~666660202^^^USSSA&&0363^SS^VA FACILITY ID&500&L~100003^^^USVHA&&0363^PI^VA FACILITY ID&500&L||DATABRIDGE^PATIENTEIGHT^^^^^L||19010101|M|||^^^^
^^P^^~^^^^^^N||||||||666660202||||||||||||
DG1|1||784.0^Headache|
OBR|1|19144;1^OR|600;GMRC^GMRC|||20120323
PV1|1|I|5^3 NORTH SURG|||10000000049^CPRSATTENDING,TWO|||||||||||11829^PROVIDER,TEST
NTE|1|L|Actvity Comment
NTE|2||Cancelled this referral, patient not eligible.
Example: Discontinue Referral *(no dx entered during order entry, no DG1 segment sent, PID with more fields, Sensitive Patient)
MSH|^~\&|GMRC HCP SEND|500|GMRC HCP RECEIVE|200|20120315085614-0500||REF^I14|5008762|P|2.5|||AL|AL|USA
RF1|DC^DISCONTINUED|R|89^NON VA CARE DENTAL^^2060^NON VA CARE DENTAL||O|601|201203150854-0500||||
PRD|RP|CPRSPROVIDER^THREE^^^^^^^10000000046|1 STREET ADDRESS^^CITY^ST^00011||^^^CPRS3@VA.GOV^^555^555-5555|
PID|1|5000000056V781752|5000000056V781752^^^USVHA&&0363^NI^VA FACILITY ID&500&L^^20120315~666660005^^^USSSA&&0363^SS^VA FACILITY ID&500&L~6^^^USVHA&&0363^PI^VA FACILITY ID&500&L||CPRSPATIENT^FIVE^S^^^^L|MAIDENLAST^^^^^^M|19010101|M||2054-5-SLF^^0005^
2054-5^^CDC|1 STREET ADDRESS^^CITY^ST^00011^USA^P^^083~^^CITY^ST^^^N|083|555-5555^PRN^PH~555-5555^WPN^PH~555-5555^ORN^CP~^NET^INTERNET^CPRSP5@TESTADDR.COM|555-5555||S|22||666660005|||2186-5-SLF^^0189^2186-5^^CDC|CITY ST|Y||||
OBR|1|19146;1^OR|601;GMRC^GMRC|||20120316
PV1|1|I|66^VCM-IN|||10000000103^IDOSEDOCTOR,THREE||||||||||R|10000000102^IDOSEDOCTOR,TWO
NTE|1|L|Actvity Comment
NTE|2||D/C THIS REFERRAL, RE-CHECK VA ORAL SURGERY AVAILABILITY
REF_IN Message Definition Tables
REF_IN1 Segment (valid for all above REF messages)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14 R SetIDIN1Set ID - IN12250Coded elementR InsurancePlanIDInsurance Plan ID3250IDR InsuranceCompanyIDInsurance Company ID4250stringO InsuranceCompanyNameInsurance Company Name5250addressO InsuranceCompanyAddressInsurance Company Address6250stringO InsuranceCoContactPersonInsurance Co Contact Person7250stringO InsuranceCoPhoneNumberInsurance Co Phone Number812stringO GroupNumberGroup Number9250stringO GroupNameGroup Name10250stringO InsuredsGroupEmpIDInsured's Group Emp ID11250stringO InsuredsGroupEmpNameInsured's Group Emp Name128dateO PlanEffectiveDatePlan Effective Date138dateO PlanExpirationDatePlan Expiration Date14239stringO AuthorizationInformationAuthorization Information153stringO PlanTypePlan Type16250stringO NameOfInsuredName Of Insured17250stringO InsuredsRelationshipToPatienInsured's Relationship To Patient1826dateO InsuredsDateOfBirthInsured's Date Of Birth19250addressO InsuredsAddressInsured's Address202stringO AssignmentOfBenefitsAssignment Of Benefits212stringO CoordinationOfBenefitsCoordination Of Benefits222stringO CoordOfBenPriorityCoord Of Ben. Priority231stringO NoticeOfAdmissionFlagNotice Of Admission Flag248dateO NoticeOfAdmissionDateNotice Of Admission Date251stringO ReportOfEligibilityFlagReport Of Eligibility Flag268dateO ReportOfEligibilityDateReport Of Eligibility Date272stringO ReleaseInformationCodeRelease Information Code2815stringO PreAdmitCertPACPre-Admit Cert (PAC)2926dateO VerificationDateTimeVerification Date/Time30250stringO VerificationByVerification By312stringO TypeOfAgreementCodeType Of Agreement Code322stringO BillingStatusBilling Status334numberO LifetimeReserveDaysLifetime Reserve Days344numberO DelayBeforeLRDayDelay Before L.R. Day358stringO CompanyPlanCodeCompany Plan Code3615stringO PolicyNumberPolicy Number3712numberO PolicyDeductiblePolicy Deductible3812numberB PolicyLimitAmountPolicy Limit - Amount394numberO PolicyLimitDaysPolicy Limit - Days4012numberB RoomRateSemiPrivateRoom Rate - Semi-Private4112numberB RoomRatePrivateRoom Rate - Private42250stringO InsuredsEmploymentStatusInsured's Employment Status431stringO InsuredsAdministrativeSexInsured's Administrative Sex44250addressO InsuredsEmployersAddressInsured's Employer's Address452stringO VerificationStatusVerification Status468stringO PriorInsurancePlanIDPrior Insurance Plan ID473stringO CoverageTypeCoverage Type482stringO HandicapHandicap49250IDO InsuredsIDNumberInsured's ID Number501stringO SignatureCodeSignature Code518dateO SignatureCodeDateSignature Code Date52250stringO InsuredsBirthPlaceInsured's Birth Place532stringO VIPIndicatorVIP Indicator
REF_IN3 Segment (valid for all above REF messages)
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION14 R SetIDIN3Set ID - IN32250stringO CertificationNumberCertification Number3250stringO CertifiedByCertified By41stringO CertificationRequiredCertification Required523stringO PenaltyPenalty626dateO CertificationDateTimeCertification Date/Time726dateO CertificationModifyDateTimeCertification Modify Date/Time8250stringO OperatorOperator98dateO CertificationBeginDateCertification Begin Date108dateO CertificationEndDateCertification End Date116numberO DaysDays12250stringO NonConcurCodeDescriptionNon-Concur Code/Description1326dateO NonConcurEffectiveDateTimeNon-Concur Effective Date/Time14250stringO PhysicianReviewerPhysician Reviewer1548stringO CertificationContactCertification Contact16250stringO CertificationContactPhoneNumCertification Contact Phone Number17250stringO AppealReasonAppeal Reason18250stringO CertificationAgencyCertification Agency19250stringO CertificationAgencyPhoneNumbCertification Agency Phone Number2040stringO PreCertificationRequirementPre-Certification Requirement2148stringO CaseManagerCase Manager228dateO SecondOpinionDateSecond Opinion Date231stringO SecondOpinionStatusSecond Opinion Status241stringO SecondOpinionDocumentationReSecond Opinion Documentation Received25250stringO SecondOpinionPhysicianSecond Opinion Physician
HL7 ACK Messages XE "HL7:ACK Messages"
Patch GMRC*3.0*75 added the ability to use the following HL7 ACK messages to enable communications between the consult system communication with the Healthcare Claims Processing System (HCPS). Accept Acknowledgment (AA) will be sent for messages that are parsed correctly and sent to HCPS. Application Error (AE) will be sent when a parsing issue is discovered, such as missing a required field.
HL7 v2.5 ACK messages will sent to HCPS in enhanced mode as follows:
Commit accept (CA) in MSA-1 acknowledgment code if the message can be accepted for processing
Commit reject (CR) is MSA-1 acknowledgment code if one of the values of MSH-9 message type, MSH-12 version ID or MSH-11 processing ID is not acceptable to the receiving application
Commit error (CE) in MSA-1 acknowledgment code if the message cannot be accepted for any other reason
A standard HL7 v2.5 ACK message will be returned by HCPS for each consult message received. The ACK message will contain the following standard segments:
MSH Message Header REQUIRED
MSA Message Acknowledgment REQUIRED
ERR Error OPTIONAL
The following tables contain the HL7 message definition for the ACK messages.
The table columns are:
SEQ = HL7 sequence#
LEN = HL7 field length
DT = HL7 data type
R/O = R=Require, O=Optional, C=Conditional, NS=Not supported
TBL = HL7 table definition
Element Name = HL7 field name
VistA Description = information on what will be pulled from VistA for this element, or hard-coded data.
SEQLENDTR/OTBL#ELEMENT NAMEVistA DESCRIPTION
ACK MSH - Message Header Segment
SEQLENDTR/OTBL#ELEMENT NAMEDESCRIPTION11STRField Separator|24STREncoding Characters~^\&315STRSending ApplicationGMRC HCP RECEIVE420STRSending FacilitySending Facility530STRReceiving ApplicationGMRC HCP SEND630STNSReceiving FacilityReceiving Facility726TSRDate/Time Of MessageSystem date/time840STNSSecurityNot used97CMR0076
0003Message TypeACK1020STRMessage Control IDReturn the Message Control ID from the REF^I1n message received from VistA111IDRProcessing IDP for Production, T for Test128IDR0104Version ID2.51315NMNSSequence NumberNot used14180STNSContinuation PointerNot used152IDR0155Accept Acknowledgment TypeAL162IDR0155Application Acknowledgment TypeNE173IDR0399Country CodeUSA
ACK MSA - Message Acknowledgment Segment
SEQLENDTR/OTBL#ELEMENT NAMEDESCRIPTION12IDR0008Acknowledgment CodeAA for Application Accept
AE for Application Error220STRMessage Control IDSame as MSH.10 above380STNSText MessageNot supported415NMNSExpected Sequence NumberNot used5NSDelayed Acknowledgment TypeNot used6250CENSError ConditionNot used
ACK ERR - Error Segment
SEQLENDTR/OTBL#ELEMENT NAMEDESCRIPTION1493ELDNSError Code and LocationNot used218ERLOError LocationSegment^Sequence^Field^Fld Repetition^Component^Sub-component3705CWER0357HL7 Error CodeValue^Description
See table 0357 below(ERR fields past ERR.3 are not used and not shown to save space)
HL7 Table 0357 - Message Error Condition Codes
ValueDescriptionComment0Message AcceptedSuccess. Optional, as the AA conveys success. Used for systems that must always return a status code.100Segment Sequence ErrorError: The message segments were not in proper order, or required segments are missing.101Required Field MissingError: A required field is missing from a segment.102Data Type ErrorError: The field contained data of the wrong data type, e.g., an NM field contained FOO.103Table Value Not FoundError: A field of data type ID or IS was compared against the corresponding table, and no match was found.200Unsupported Message TypeRejection: The Message Type is not supported.201Unsupported Event CodeRejection: The Event Code is not supported.202Unsupported Processing IDRejection: The Processing ID is not supported.203Unsupported Version IDRejection: The Version ID is not supported.204Unknown Key IdentifierRejection: The ID of the patient, order, etc., was not found. Used for transactions other than additions, e.g., transfer of a non-existent patient.205Duplicate Key IdentifierRejection: The ID of the patient, order,etc., already exists. Used in response to addition transactions (Admit, New Order, etc.)206Application Record LockedRejection: The transaction could not be performed at the application storage level, e.g., database locked.207Application Internal ErrorRejection: A catchall for internal errors not explicitly covered by other codes.
For the Application NACK that GMRC *3.0*123 returns for Errors during processing of the REF I13/I14 messages, the MSA segment will be populated as in the table below:
MSA Message for NACK Negative Application Acknowledgment Segment
SEQLENDTR/OTBL#ELEMENT NAMEDESCRIPTION12IDR0008Acknowledgment CodeAE for Application Error220STRMessage Control IDSame as MSH.10 of the Request Message 380STNSText MessageError Message Description 415NMNSExpected Sequence NumberNot used5NSDelayed Acknowledgment TypeNot used6250CENSError ConditionPatient ICN^Patient NAME^Station ID^Consult ID^Date/Time Stamp when the REF I12/I13 Message is being processed on the VistA System
HL 7 Mailbox XE "HL7:Mailbox"
GMRC HCP HL7 MESSAGE - Used to report errors in HL7 message generation and processing for GMRC consults.
Order Event Messagesxe "Order Event Messages"
The following tables identify the HL7 fields that are passed in each kind of event associated with OE/RR. For each event there is an order control code and a set of fields listed. For any given event, however, some of the fields may be empty (observation sub-id, for example).
The protocols identified in the tables use OE/RR namespacing conventions. The messages sent by OE/RR will use the OR namespaced protocols indicated. Individual packages may use whatever protocol names they wish.
Front Door Consults
ActionRequest from OE/RRConsults acceptsConsults rejectsProtocolOR EVSEND GMRCGMRC EVSEND ORGMRC EVSEND OROrder ControlNW (new order)OK (accepted)OC (canceled)HL7 FieldsMSH: 1,2,3,4,9
PID: 3,5
PV1: 2,3,19
ORC: 1,2,7,10,12,15
OBR: 4,18,19
OBX: 1,2,3,5MSH: 1,2,3,4,9
PID: 3,5
ORC: 1,2,3
MSH: 1,2,3,4,9
PID: 3,5
ORC: 1,2,3,12,15,16
OBR: 4ProtocolOR EVSEND GMRCGMRC EVSEND ORGMRC EVSEND OROrder ControlCA (cancel)
DC (discontinue)
HD (hold)
RL (release)CR (canceled)
DR (discontinued)
HR (held)
OR (released)UC (unable to cancel)
UD (unable to dc)
UH (unable to hold)
OC (order canceled)HL7 FieldsMSH: 1,2,3,4,9
PID: 3,5
ORC: 1,2,3,10,12,15,16MSH: 1,2,3,4,9
PID: 3,5
ORC: 1,2,3,5MSH: 1,2,3,4,9
PID: 3,5
ORC: 1,2,3,16
Example: Pulmonary Consult at bedside to rule out pneumonia
New Order
Array: MSG(1)="MSH|^~\&|ORDER ENTRY|660|||||ORM"
MSG(2)="PID|||270||CPRSPATIENT,TWENTYFIVE"
MSG(3)="PV1||I|12^4101-B||||||||||||||||10185"
MSG(4)="ORC|NW|934;1^OR|||||^^^19940920^^R|||10||6|||199409151430"
MSG(5)="OBR||||^^^25^^99CON||||||||||||||B|1044
MSG(6)="OBX|1|TX|2000.02^Reason for Request^AS4|1|R/o pneumonia"
MSG(7)=OBX|2|TX|^Provisional Diagnosis|1|Viral infection
Call: D MSG^XQOR("OR EVSEND GMRC",.MSG) ; New order from OE/RR
Array: MSG(1)="MSH|^~\&|CONSULTS|660|||||ORR"
MSG(2)="PID|||270||CPRSPATIENT,TWENTYFIVE"
MSG(3)="ORC|OK|934;1^OR|233445^GMRC"
Call: D MSG^XQOR("GMRC EVSEND OR",.MSG) ; Consults accepts, returns order #
Hold an Order
Array: MSG(1)="MSH|^~\&|ORDER ENTRY|660|||||ORM"
MSG(2)="PID|||270||CPRSPATIENT,TWENTYFIVE"
MSG(3)="ORC|HD|92234;2^OR|233445^GMRC|||||||10||6|||199409151430"
Call: D MSG^XQOR("OR EVSEND GMRC",.MSG) ; OE/RR requests holding order
MSG(2)="PID|||270||CPRSPATIENT,TWENTYFIVE"
MSG(3)="ORC|HR|92234;2^OR|233445^GMRC"
Call: D MSG^XQOR("GMRC EVSEND OR",.MSG) ; Consults holds order
Discontinue an Order
Array: MSG(1)="MSH|^~\&|ORDER ENTRY|660|||||ORM"
MSG(2)="PID|||270||CPRSPATIENT,TWENTYFIVE"
MSG(3)="ORC|DC|92234;3^OR|233445^GMRC|||||||10||6|||199409151430"
Call: D MSG^XQOR("OR EVSEND GMRC",.MSG) ; OE/RR requests discontinuing order
Array: MSG(1)="MSH|^~\&|CONSULTS|660|||||ORR"
MSG(2)="PID|||270||CPRSPATIENT,TWENTYFIVE."
MSG(3)="ORC|DR|92234;3^OR|233445^GMRC"
Call: D MSG^XQOR("GMRC EVSEND OR",.MSG) ; Consults discontinues order
Example: EKG at bedside
New Order
Array: MSG(1)="MSH|^~\&|ORDER ENTRY|660|||||ORM"
MSG(2)="PID|||270||CPRSPATIENT,TWENTYFIVE"
MSG(3)="PV1||I|12^4101-B||||||||||||||||10185"
MSG(4)="ORC|NW|935;1^OR|||||^^^19940920^^R|||10||6|||199409151430"
MSG(5)="OBR||||^^^2553^^99PRO||||||||||||||B|1044
MSG(6)="OBX|1|TX|2000.02^Reason for Request^AS4|1|Monitoring progress"
Call: D MSG^XQOR("OR EVSEND GMRC",.MSG) ; New order from OE/RR
Array: MSG(1)="MSH|^~\&|CONSULTS|660|||||ORR"
MSG(2)="PID|||270||CPRSPATIENT,TWENTYFIVE"
MSG(3)="ORC|OK|935;1^OR|233446^GMRC"
Call: D MSG^XQOR("GMRC EVSEND OR",.MSG) ; Consults accepts, returns order #
Example: Family Counseling consult
New Order
Array: MSG(1)="MSH|^~\&|ORDER ENTRY|660|||||ORM"
MSG(2)="PID|||270||CPRSPATIENT,TWENTYFIVE"
MSG(3)="PV1||I|12^4101-B||||||||||||||||"
MSG(4)="ORC|NW|936;1^OR|||||^^^19940920^^R||199409151425|10||6|||
199409151430"
MSG(5)="OBR||||^^^15^PSYCHIATRY^99CON||||||||||||||OC|1044"
MSG(6)="ZSV|^^^15^PSYCHIATRY^99CON|Family Counseling"
MSG(7)="OBX|1|TX|2000.02^Reason for Request^AS4|1|"
Call: D MSG^XQOR("OR EVSEND GMRC",.MSG) ; New order from OE/RR
Array: MSG(1)="MSH|^~\&|CONSULTS|660|||||ORR"
MSG(2)="PID|||270||CPRSPATIENT,TWENTYFIVE"
MSG(3)="ORC|OK|936;1^OR|233447^GMRC"
Call: D MSG^XQOR("GMRC EVSEND OR",.MSG); Consults accepts, returns order #
Back Door Consultsxe "Back Door Consults"
Back door orders are handled by sending OE/RR the ORM message for a Consult order with a send number order control code. This permits OE/RR to store the order in its database and return the OE/RR order number to consults with a number assigned order control code. OE/RR cannot actually reject Consult events. The data errors order control code is just used as some way to communicate to Consults that OE/RR could not interpret the ORM message. This should generally not happen. Use of the back door by packages for ordering is optional. It is still necessary to post an event when results are available.
Back Door Consults
ActionEvent from ConsultsOE/RR acceptsOE/RR rejectsProtocolGMRC EVSEND OROR EVSEND GMRCOR EVSEND GMRCOrder ControlSN (send number)NA (number assigned)DE (data errors)HL7 FieldsMSH: 1,2,3,4,9
PID: 3,5
PV1: 2,3,19
ORC: 1,3,7,10,12,15
OBR: 4,18,19
OBX: 1,2,3,4,5MSH: 1,2,3,4,9
PID: 3,5
ORC: 1,2,3
MSH: 1,2,3,4,9
PID: 3,5
ORC: 1,3,16ProtocolGMRC EVSEND OROR EVSEND GMRCOrder ControlOC (cancel)
OD (discontinue)
OH (hold)
RL (release)There is no return event. OE/RR must accept the instruction from Consults.DE (data errors)HL7 FieldsMSH: 1,2,3,4,9
PID: 3,5
ORC: 1,2,3,12,15,16
OBR: 4
MSH: 1,2,3,4,9
PID: 3,5
ORC: 1,2,3,16ProtocolGMRC EVSEND OROR EVSEND GMRCOrder ControlSC (accepted)DE (data errors)
ActionEvent from ConsultsOE/RR acceptsOE/RR rejectsHL7 FieldsMSH: 1,2,3,4,9
PID: 3,5
ORC: 1,2,3,5,12,15
OBR: 4There is no return event. OE/RR must accept the instruction from Consults.MSH: 1,2,3,4,9
PID: 3,5
ORC: 1,2,3,16ProtocolGMRC EVSEND OROR EVSEND GMRCOrder ControlXX (forwarded)DE (data errors)HL7 FieldsMSH: 1,2,3,4,9
PID: 3,5
ORC: 1,2,3,7,10,12,15
OBX: 1,2,3,4,5There is no return event. OE/RR must accept the instruction from Consults.MSH: 1,2,3,4,9
PID: 3,5
ORC: 1,2,3,16ProtocolGMRC EVSEND OROR EVSEND GMRCOrder ControlRE (completed)DE (data errors)HL7 FieldsMSH: 1,2,3,4,9
PID: 3,5
ORC: 1,2,3,12,15
OBR: 4,7,22,25,32
OBX: 1,2,3,4,5,8There is no return event. OE/RR must accept the instruction from Consults.MSH: 1,2,3,4,9
PID: 3,5
ORC: 1,2,3,16
Example: Pulmonary consult at bedside to rule out pneumonia
New Order
Array: MSG(1)="MSH|^~\&|CONSULTS|660|||||ORM"
MSG(2)="PID|||270||CPRSPATIENT,TWENTYFIVE"
MSG(3)="PV1||I|1D^4101-B||||||||||||||||10185"
MSG(4)="ORC|SN||233445^GMRC||||^^^19940920^^R|||10||6|||199409151430"
MSG(5)="OBR||||^^^25^^99CON||||||||||||||B|1044
MSG(6)="OBX|1|TX|2000.02^Reason for Request^AS4|1|R/o pneumonia"
Call: D MSG^XQOR("GMRC EVSEND OR",.MSG) ; New order from Consults
Array: MSG(1)="MSH|^~\&|ORDER ENTRY|660|||||ORR"
MSG(2)="PID|||270|| CPRSPATIENT,TWENTYFIVE"
MSG(3)="ORC|NA|92234^OR|234455^GMRC"
Call: D MSG^XQOR("OR EVSEND GMRC",.MSG) ; OE/RR returns order number
Discontinue an Order
Array: MSG(1)="MSH|^~\&|CONSULTS|660|||||ORM"
MSG(2)="PID|||270|| CPRSPATIENT,TWENTYFIVE"
MSG(3)="ORC|OD|92234^OR|234455^GMRC|||||||||||||^^^^Denied by service"
Call: D MSG^XQOR("GMRC EVSEND OR",.MSG) ; Consults discontinued order
Service Accepted the Order
Array: MSG(1)="MSH|^~\&|CONSULTS|660|||||ORM"
MSG(2)="PID|||270|| CPRSPATIENT,TWENTYFIVE"
MSG(3)="ORC|SC|92234^OR|234455^GMRC"
MSG(4)="OBR||||^^^25^^99CON
Call: D MSG^XQOR("GMRC EVSEND OR",.MSG) ; Consults accepted order
Completed Order
Array: MSG(1)="MSH|^~\&|CONSULTS|660|||||ORU"
MSG(2)="PID|||270|| CPRSPATIENT,TWENTYFIVE"
MSG(3)="ORC|RE|92234^OR|234455^GMRC"
MSG(4)="OBR||||^^^25^^99CON|||199409160810|||||||||||||||
199409160910|||F|||||||455"
MSG(5)="OBX|1|TX|^^^25^^99CON||Pneumonia|||A"
Call: D MSG^XQOR("GMRC EVSEND OR",.MSG) ; Consults completed order
Orderable Item Updatesxe "Orderable Item Updates"
When Consults makes request services available for ordering, OE/RR needs to be notified. This is done via a protocol event point which should be defined by Consults. When this event point is invoked, an HL7 master file update message is sent. Information that should be available in this segment is listed in the following table.
SEGSEQFIELD NAMEEXAMPLEHL7 TYPEMSH1Field Separator|string2Encoding Characters^~\&string3Sending ApplicationCONSULTSstring4Sending Facility660string9Message TypeMFNIDMFI1Master File ID123.5^Request Services^99DDcoded element3File-Level Event CodeREPtable 1786Response Level CodeNEtable 179{ MFE1Record-Level Event CodeMADtable 1804Primary Key^^^25^Cardiology Consult^99CONcoded element ZCS1Service Usage2coded value (1=Grouper only, 2=Tracking only) { ZSY }1Set ID1Numeric}2SynonymCARDstring
Notes:
When doing the initial population of the orderable items file, the File Level Event Code should be REP. After the initial population, subsequent changes should have the UPD code.
Orderable item updates always originate from Consults.
There may be multiple MFE segments passed in a single transaction.
The record-level event code tells whether this transaction is an update, addition, inactivation, etc.
The primary key is the coded element that is normally passed when creating an order. By using the coded element, we can know the national and local names for a consult.
Example:
Adding new request services
Array: MSG(1)="MSH|^~\&|CONSULTS|660|||||MFN"
MSG(2)="MFI|123.5^Request Services^99DD||REP|||NE
MSG(3)="MFE|MAD|||^^^4^CARDIOLOGY^99CON"
MSG(4)=ZCS|2
Call: D MSG^XQOR("GMRC ORDERABLE ITEM UPDATE",.MSG)
Inactivating a request service
Array: MSG(1)="MSH|^~\&|CONSULTS|660|||||MFN"
MSG(2)="MFI|123.5^Request Services^99DD||UPD|||NE
MSG(3)="MFE|MDC|||^^^2^MEDICINE^99CON
Call: D MSG^XQOR("GMRC ORDERABLE ITEM UPDATE",.MSG)
Orderable Item Updatesxe "Orderable Item Updates"
When Consults makes procedures available for ordering or inactivates a procedure, OE/RR needs to be notified. This is done via a protocol event point which should be defined by Consults. When this event point is invoked, an HL7 master file update message is sent. Information that should be available in this segment is listed in the following table.
SEGSEQFIELD NAMEEXAMPLEHL7 TYPEMSH1Field Separator|string2Encoding Characters^~\&string3Sending ApplicationPROCEDURESstring4Sending Facility660string9Message TypeMFNIDMFI1Master File ID123.3^Procedures^99DDcoded element3File-Level Event CodeREPtable 1786Response Level CodeNEtable 179{ MFE1Record-Level Event CodeMADtable 1804Primary Key^^^1225^Electrocardiogram^99PRCcoded element { ZSY}1Set ID1numeric}2SynonymEKGstring
Notes:
When doing the initial population of the orderable items file, the File Level Event Code should be REP. After the initial population, subsequent changes should have the UPD code.
Orderable item updates always originate from Consults.
There may be multiple MFE segments passed in a single transaction.
The record-level event code tells whether this transaction is an update, addition, inactivation, etc.
The primary key is the coded element that is normally passed when creating an order. By using the coded element, we can know the national and local names for a procedure.
Example:
Adding new procedures
Array: MSG(1)="MSH|^~\&|PROCEDURES|660|||||MFN"
MSG(2)="MFI|123.3^GMRC PROCEDURE^99DD||REP|||NE
MSG(3)="MFE|MAD|||^^^1688^Atrial Lead Implant^99PRC
MSG(4)=ZSY|1|A-L Imp
MSG(5)="MFE|MAD|||^^^1705^Bone Marrow Aspirate^99PRC"
Call: D MSG^XQOR("GMRC ORDERABLE ITEM UPDATE",.MSG)
Inactivating a procedure
Array: MSG(1)="MSH|^~\&|PROCEDURES|660|||||MFN"
MSG(2)="MFI|123.3^GMRC PROCEDURE ^99DD||UPD|||NE
MSG(3)="MFE|MDC|||^^^1705^Bone Marrow Aspirate^99PRC
Call: D MSG^XQOR("GMRC ORDERABLE ITEM UPDATE",.MSG)
Ordering Parameters
There are no Consult ordering parameters identified at this time.
Procedure Calls
We need entry points defined in the Consults package that will handle the following procedure calls. It is up to the developers exactly how entry points are defined and named. Note that to behave properly in a windowed environment, all variables used in the calls must be NEWed properly. The calls must also be silent (no reads or writes).
Return Consult/Procedure List
OER^GMRCSLM1(DFN,SERV,BEG,END,STS,CPRS)
passed: DFN: Patient DFN
SERV: Request service IEN
BEG: Beginning date
END: Ending date
STS: Order status IEN
CPRS: 1=CPRS List Manager, 2=CPRS GUI
returned: ^TMP("GMRCR",$J,"CS",#,0) = IEN^request date^order status^
service^procedure name or consult
Return Narrative of Report
DT^GMRCSLM2(IEN)
passed: IEN: IEN of request in Request/Consultation file #123
returned: ^TMP("GMRCR",$J,"DT",#,0) = line of report text
Return Results Report
RT^GMRCGUIA(IEN,ARRAY)
passed: IEN: IEN of request in Request/Consultation file #123
ARRAY:name of array to return report text
returned: @ARRAY@(#,0) = line of report text
Return List of Services the Current User may Order From
SERV1^GMRCASV
passed: GMRCTO: 1
GMRCDG: 1
returned: ^TMP("GMRCSLIST",$J,#) = IEN^service name^grouper IEN^+^usage
where + indicates a grouper with members following,
and Usage is 1 if Grouper Only or 2 if Tracker Only
Return List of Services for a Procedure
GETSVC^GMRCPRO(.ARRAY,ID)
passed: ARRAY:array to return list of services
ID: procedure identifier, in HL7 format `IEN;99PRC
returned: ARRAY=number of services in list
ARRAY(#) = IEN ^ name of service
Return Default Reason for Request
GETDEF^GMRCDRFR(ARRAY,SERV,DFN,RESLV)
passed: ARRAY:name of array to return default text
SERV: IEN of Request Service in file #123.5
DFN: Patient DFN [optional]
RESLV:1 or 0, if embedded TIU objects are to be resolved
returned: @ARRAY@(#,0) = line of text
Return Allowable Editing Flag for Reason
$$REAF^GMRCDRFR(IEN)
passed: SERV: IEN of Request Service in file #123.5
returned: 0 if unrestricted, 1 for Edit only, or 2 if no editing allowed
Return Provisional Diagnosis requirements
$$PROVDX^GMRCUTL1(SERV)
passed: SERV: IEN of Request Service in file #123.5
returned: A^B: A = O (optional), R (required), or S (suppress)
B = F (free text) or L (Lexicon entry)
Query Decision Support Tools and place data in Consult comment
$$PROT^GMRCDST(.MSG)
passed: Message array with details of HL7 content. Specifically extracts Order Number from ORC Segment
returned: 0 if failed to file comment 1 if successfully found and filed
DST comment
Auto-forwarding XE "Auto-forwarding" \b
A new feature, Auto-forwarding, has been added with patch GMRC*3.0*139. When the Decision Support Tool (DST) determines that a Consult should be forwarded to a different location, the DST data returned will contain the text DAF-DST Auto-forwarding:. When the routine ^GMRCDST detects this text, it will examine the text after the colon. If it detects YES, then the code will mark this Consult as being forwarded. The routine will then look for the text AFD-DST Forward to: text and forward this Consult Order to the requested REQUEST SERVICE entry (#123.5), using the $$FR^GMRCGUIA utility.
If the REQUEST SERVICE entry does not exist, the error message "DVE-DST Error from VistA: Auto-foward target not found" will be placed in the original Consult entry. If DST does not send the AFD-DST Forward to: text, the error message will appear as "DVE-DST ID ISSUE: No Content sent from DST". This error message will be placed in the Original Consult entry.
How to Generate On-Line Documentationxe "On-Line Documentation"
Routinesxe "Routines"
The namespace for the Consults package is GMRC. A listing/printout of any or all of the Consults routines can be produced by using the Kernel option XUPRROU (List Routines). This option is found on the XUPROG (Programmer Options) menu, which is a sub-menu of the EVE (Systems Manager Menu) option. When prompted with routine(s) ? >: type in GMRC* to get a listing of all Consults routines.
The first line of each routine contains a brief description of the general function of the routine. A listing of just the first line of each Consults routine can be produced by using the Kernel option XU FIRST LINE PRINT (First Line Routine Print). This option is found on the XUPROG (Programmer Options) menu, which is a sub-menu of the EVE (Systems Manager Menu) option.
Globalsxe "Globals"
The globals used in the Consults package are ^GMR(123, ^GMR(123.1, ^GMR(123.3, ^GMR(123.5 and ^GMR(123.6. A listing/printout of any of these globals can be produced by using the Kernel option XUPRGL (List Global). This option is found on the XUPROG (Programmer Options) menu, which is a sub-menu of the EVE (Systems Manager Menu) option.
Filesxe "Files"
The number-space for Consults files is 123. A listing of these files can be obtained by using the VA FileMan option DILIST (List File Attributes). Depending on the FileMan template used to print the listing, this option will print out all or part of the data dictionary for the Consults files.
Menu/Optionsxe "Menu/Options"
The menu and options exported by the Consults package all begin with the GMRC namespace. Individual options can be viewed by using the Kernel option XUINQUIRE (Inquire). This option is found on the menu XUMAINT (Menu management), which is a sub-menu of the EVE (Systems Manager Menu) option.
A diagram of the structure of the Consults menu and its options can be produced by using the Kernel option XUUSERACC (Diagram Menus). Choosing XUUSERACC permits you to further select XUUSERACC1 or XUUSERACC2 menu diagrams with entry/exit actions or abbreviated menu diagrams. This option is found on the menu XUMAINT (Menu management), which is a sub-menu of the EVE (Systems Manager Menu) option.
XINDEXxe "XINDEX"
XINDEX is a routine that produces a report called the VA Cross-Referencer. This report is a technical and cross-reference listing of one routine or a group of routines. XINDEX provides a summary of errors and warnings for routines that do not comply with VA programming standards and conventions, a list of local and global variables and what routines they are referenced in, and a listing of internal and external routine calls.
XINDEX is invoked from programmer mode: D ^XINDEX.
When selecting routines, select GMRC*.
Glossaryxe "Glossary"
Actionxe "Action" An action in Consults can be selected throughout processing to 1) control screen movement, or 2) process existing orders.
Consultxe "Consult" Referral of a patient by the primary care physician to another hospital service/specialty, to obtain a medical opinion based on patient evaluation and completion of any procedures, modalities, or treatments the consulting specialist deems necessary to render a medical opinion. For instance, if a primary care physician orders a patient evaluation from Cardiology Service, and the cardiology specialist orders an Electrocardiogram (EKG) to complete the evaluation and provide an opinion concerning the patients condition, this type of order is considered a Consult.
Discontinued Ordersxe "Discontinued Orders" Orders that are discontinued. When an order is discontinued, it must be completely re-entered to be resubmitted. However, if an order is canceled, it can be edited to correct some deficiency and resubmitted.
Orderxe "Order" A request for a consult (service/sub-specialty evaluation) or procedure (Electrocardiogram) to be completed for a patient.
Order Cancellationxe "Order Cancellation" The cancellation of a consult or procedure request which allows the requesting provider to edit a portion of the original request and re-submit the request to the consulting service.
Order Discontinuationxe "Order Discontinuation" A request to stop (discontinue) performance of a consult/procedure request.
HCPSxe "Healthcare Claims Processing System" The Healthcare Claims Processing System is a centralized, automated system that will support the management of purchased care referrals/authorizations.
IFC Inter-Facility Consults permits the transmitting of consults and related information between Department of Veterans Affairs facilities. Consult requests are made to remote facilities because the needed service is not locally available or for patient convenience. Although the Consult Package is utilized in the hospital settings, Consult requests between facilities have been done manually in the past.
MPI Master Patient Index. An index of VA patients that is global in nature, showing patients that have been seen by more than one VA facility and giving information about which facilities are involved.
NVC XE "Non VA Care" Non VA Care. Care provided to eligible Veterans when VA facilities are not feasibly available.
Procedure Requestxe "Procedure Request" Any procedure (EKG, Stress Test, etc.) which may be ordered from another service/specialty without requiring formal consultation first.
Resultxe "Result" A consequence of an order. Refers to evaluation or status results. In regards to Consult/Request Tracking, results refer to a TIU document or Medicine procedure result attached to the consult or procedure request.
Requestorxe "Requestor" This is the health care provider (e. g., the physician/clinician) who requests the order to be done.
Screen Contextxe "Screen Context" This term refers to the particular selection of orders displayed on the screen (e. g., Medicine consults for the patient Ralph Jones).
Servicexe "Service" A clinical or administrative specialty (or department) within a Medical Center.
Status xe "Status Result" A result that indicates the processing state of an order; for example, a Cardiology Consult order may be discontinued (dc) or completed (c).
Status Symbolsxe "Status Symbols" Codes used in order entry and Consults displays to designate the status of the order.
Appendix A: Install, Planning, and Implementation Checklistxe "Checklist"
This checklist can help you determine if you have completed the steps needed to implement the Consults package. IRMS/ADPACxe "ADPAC" personnel should carefully read the Consult/Request Tracking Technical Manual for the details related to IRMS/ADPAC implementation.
( NOTE: Important changes since Consults/Request Tacking Version 2.5 are emphasized with a note.
INSTALL NOTES:
The Consult/Request Tracking V. 3.0 package installs automatically when CPRS V. 1.0 installed.
PLANNING NOTES:
Participants: IRMS/ADPACxe "ADPAC" and Service personnel.
( NOTE: Effective with Consults/Request Tracking V. 3.0:
A service is only selectable for update/tracking if it is defined as part of the ALL SERVICES hierarchy.
Disabled services can be left in the ALL SERVICES hierarchy so their order results can be returned, but are not selectable in the ordering process.
Tracking services must be in the ALL SERVICES hierarchy in order to be receive forwarded consults. The tracking service can only be selectable in the order forwarding process if the user is an update user for the tracking service or its parent service.
Plan the Consult Service Hierarchy
1a. Identify services to receive consults or to be Inter-Facility Services.
1b. Determine if the service should be selectable in the ordering process from CPRS.
For some consults, the order may need to be sent to a Service control point for Forwarding by the control point to a service which has been identified as a Tracking Only service. (Tracking Only services are not selectable during the initial CPRS order process.) Where a service control point is preferred, the tracking services should be sub-specialties under the control point service within the ALL SERVICES hierarchy.
1c. Determine if there should be a service that would be used as a Grouper Only (e.g., Inpatient Services, Outpatient Services, and Outside Services might be good Services to define as groupers).
When a Grouper Only service is selected in the CPRS order process, the service hierarchy defined under the grouper service will be displayed to select from. The Grouper Only cannot be selected to receive an order. The ALL SERVICES service is a Grouper Only provided to build the Consult Service hierarchy upon.
For each Service:
Identify the Service
2a. Select a unique name to identify the service while ordering. If the service is to be on Inter-Facility Consults (IFC) service, we suggest you include the site name in the service (Example: Eye ClinicBoise).
2b. Optionally, select an abbreviated print name to be used when displaying notifications. This should be a short name that is easily recognized by users as belonging to the service.
2c. Optionally, select one or more synonyms that can be used when entering the service name into the computer.
3. Identify the service printer which will be used to automatically print Consult Form SF 513 when a consult order is received from CPRS.
( NOTE: Effective with Consult/Request Tracking V. 3.0, All Consult Form SF 513 prints are done from consult routines. OE/RR print formats are no longer used for consult prints.
Plan Actions to take for a Discontinued Consult
4a. Decide if the service should be notified when a consult is discontinued.
4b. Decide if the SF 513 should be reprinted to the receiving service when a consult is discontinued.
Determine Provisional Diagnosis requirements for the service.
5a. Decide if consults going to this service should be required to have a provisional diagnosis. The provisional diagnosis can be required, set as optional, or suppressed.
5b. Decide if provisional diagnosis going to this service should be taken from the Clinical Lexicon, or if free text is allowed.
Plan Prerequisites and Boilerplate
6. Decide if consults going to this service should have a prerequisite. A prerequisite is a text message that reminds the referring physician what needs to be done before a consult can be sent to this service. The prerequisite message gives the referring physician a chance to back out of the consult dialog.
7a. Decide if consults going to this service should provide a default reason for request when an order is placed. This is a piece of boilerplate text, including TIU objects, that is consistent for each consult received.
7b. If this service is to be an IFC service, then enter the IFC Remote Site name and IFC Remote Service name.
7c. If this service is to be an to receive IFC requests from other sites, then enter the IFC Sending Facility name(s).
7d. Decide if editing of the default reason for request should be restricted. Editing can be unrestricted, restricted, or allowed only before release to the service.
Plan Notification Recipients
8a. Identify individuals at the receiving service who should be notified when a consult is being sent to the receiving service.
8b. Identify service teams of clinicians or service users which should receive notifications. Team definitions may be used in addition to or in lieu of naming individuals to receive notifications.
8c. Identify hospital locations that are assumed to be part of this service. Any consult activity on patients in that location triggers a notification. Specify one individual to notify and/or a team to notify.
9. Decide if parent services of this service should be notified of activities occurring on consults for this service.
10. Decide if notifications should be deleted on an individual basis, or if all notifications should be deleted when one individual reviews it. The default is Individual Recipient, so if All Recipients is desired, use the Set Deletion Parameters for Notifications option of the Notification Mgmt Menu to change this value for each of the four consult notifications. These are:
#23 CONSULT/REQUEST RESOLUTION
#27 NEW SERVICE CONSULT/REQUEST
#30 CONSULT/REQUEST CANCEL/HOLD
#63 CONSULT/REQUEST UPDATED
Plan Service Users
10. Decide if you are going to allow unrestricted access to this service. If so, you may skip to step 13.
11a. Identify individuals at the receiving service who will NOT receive notifications about new consults, but should be able to perform update capabilities for this service.
11b. Identify teams at the receiving service who will NOT receive notifications about new consults, but should be able to perform update capabilities for this service.
11b. Identify user classes who will NOT receive notifications about new consults, but should be able to perform update capabilities for this service.
11e. Identify administrative update users. Such a user can perform administrative completions on consults at this service. These users can, optionally, be included as notifications recipients for this service.
11f. Identify administrative update teams for this service. The members of these teams can, optionally, be included as notifications recipients for this service.
12. Decide if update users of the parent services should be allowed to update consults for this service.
13. Identify a special updates individual (someone who can perform group updates) for this service. This individual should already be a service user.
14. Identify sub-services of this service.
IMPLEMENTATION AND MAINTENANCE (Abbreviated guidelines)
Participants: IRMS/ADPACxe "ADPAC"
1. You may set up a team for each consult service. The team members being the identified clinical users. Use the Team Mgmt Menu option, ORLP TEAM MENU.
2. Turn on the NEW SERVICE CONSULT/REQUEST notification for each of the individuals who were identified to receive notifications. Use the Enable/Disable Notifications option of the NOTIFICATION MGMT MENU, ORB NOT MGR MENU.
( NOTE: Unless Consult notifications are set to mandatory, individual users may use the Enable/Disable My Notifications option of the Notifications Management Menu to individually disable the notifications they do not want to receive.
3. Turn on the CONSULT/REQUEST RESOLUTION notification for each ordering provider identified to receive this notification, or train them to do it themselves. Use the Enable/Disable Notifications option of the NOTIFICATION MGMT MENU, ORB NOT MGR MENU.
4. Turn on the CONSULT/REQUEST CANCEL/HOLD notification for each ordering provider identified to receive this notification, or train them to do it themselves. Use the Enable/Disable Notifications option of the NOTIFICATION MGMT MENU, ORB NOT MGR MENU.
5. Turn on the CONSULT/REQUEST UPDATED notification for each ordering provider identified to receive this notification, or train them to do it themselves. Use the Enable/Disable Notifications option of the NOTIFICATION MGMT MENU, ORB NOT MGR MENU.
6. Define the Service hierarchy in the Request Services File (#123.5)xe "Request Services File (123.5)" with the associated users and service printer. Use the Set up Consult Services option, GMRC SETUP REQUEST SERVICESxe "GMRC SETUP REQUEST SERVICES".
( NOTE: You must NOT use VA FileMan to modify services in the hierarchy. The Consult/Request Tracking interface to CPRS depends on the services being defined using the GMRC SETUP REQUEST SERVICES option.
7. Assign the Setup Service Users GMRC SETUP SERVICE USERS option to the users permitted to manage service users.
8. Assign the following two options to Service update users primary or secondary menu option: Consult Tracking [GMRC SERVICE TRACKING] and Service Consults Pending Resolution [GMRC RPT PENDING CONSULTS].
TIU Setup
9. Plan your hospitals TIU hierarchy. See the Text Integration Utility (TIU) Implementation Guide for details on this step.
10. If you have not already done so, install TIU*1*4.
11. Run the TIU DEFINE CONSULTS option.
( NOTE: If you do not run the TIU DEFINE CONSULTS option, no status update takes place when the TIU note is entered.
12. Enter the rest of your planned TIU document hierarchy using the Manager Document Definition Menu.
13. Define consult document parameters (as recommended on page REF DDP \* MERGEFORMAT PAGEREF DDP \* MERGEFORMAT 93 of this manual) using the Document Parameter Edit option.
( NOTE: We particularly recommend entering Yes to ALLOW >1 RECORDS PER VISIT.
14. Check the value for parameter GMRC CONSULT LIST DAYS XE "GMRC CONSULT LIST DAYS" . The parameter controls how many days are searched when looking for consult to associate with a progress note. The default is 365 days. Appendix B: Consult Tracking Worksheetsxe "Consult Tracking Worksheets"
In this section there are several worksheets that may be removed from the manual and copied. These worksheets assist you in setting up each Service/Specialty and in setting up Service Notification assignments for individuals or teams who will be receiving consult results.
The first and second worksheets may be used for small Services, with very few Specialty services under them, who will be receiving on-line consults and/or procedure requests.
The third and fourth worksheets should be used by large complex Services with multiple Specialty services under them, who will be receiving on-line consults and/or procedure requests.
Consult Services Worksheet
Service Set up
Service/Specialty Name: _________________
Abbreviated Print Name: _________________
This optional abbreviation are used when building notifications.
Synonyms: _____ _____ _____
These optional abbreviations are used when selecting the service.
Service Usage: Blank Grouper Tracking
Service Printer: _________________
A service may define a device to which its Consult forms automatically print.
Notify Service on DC: Yes No
Update users of a service may be notified when a consult is discontinued.
Reprint 513 on DC: Yes No
The SF 513 may be reprinted to the consulting service when a consult is discontinued.
Provisional DX Prompt: Required Optional Suppressed
Set whether a diagnosis is required, optional, or suppressed when ordering.
Provisional DX Input: Lexicon Free Text
If the diagnosis is not suppressed, specifies whether the diagnosis must be from the Clinical Lexicon or not.
Prerequisite:
Prerequisite information may be displayed to the consult ordering physician before proceeding with the ordering of a consult to this service. This may include TIU fields (enclosed in |).
_____________________________________________________ _____________________________________________________ _____________________________________________________
Default Reason for Request:
Boilerplate may be supplied for the reason for request. This may include TIU fields (enclosed in |).
_____________________________________________________ _____________________________________________________ _____________________________________________________
Restrict Default Reason Edit: Unrestricted No Editing Ask
Determines if the boilerplate can be edited by the ordering physician.
Page 1 of 3
Consult Services Worksheet
Notification Users
Service Individual to Notify: _________________
Individual who needs to receive Notifications for this service should be listed here.
Service Team to Notify:
All full update users to receive notifications need to be defined on one of these teams.
_________________ _________________ _________________
Notification by Pt Location:
Locations in which all patients are considered belonging to this service should be listed here. For each location, you can specify one individual and one team to be notified.
Location _________________ Individual _________________ Team _________________
Location _________________ Individual _________________ Team _________________
Process Parents for Notifications: Yes No
Determines whether the notification recipients defined for the parent service should be notified of actions on consults directed to this service.
Update Users
Update Users without Notifications:
Service users who should be able to perform update capabilities, but DO NOT receive notifications should be defined here. The same algorithm is used to determine the recipients for all types of consult notifications.
_________________ _________________ _________________ _________________ _________________ _________________
Update Teams without Notifications:
_________________ _________________ _________________ Update User Class without Notifications:
_________________ _________________ _________________
Page 2 of 3
Consult Services Worksheet
Administrative Update Users:
Users who may close consults without attaching a TIU note are defined here.
_________________ Notification Recipient? Yes No
_________________ Notification Recipient? Yes No
Administrative Update Teams:
Teams whose members may close consults without attaching a TIU note are defined here.
_________________ Notification Recipient? Yes No
_________________ Notification Recipient? Yes No
Process Parents for Updates: Yes No
Determines whether the update users defined for the parent service should have the same update privileges on consults directed to this service.
Special Update Individual: _________________
A user who is allowed to perform batch updating of status on consults.
Unrestricted Access: Yes No
If marked yes, any user may have update access to this service.
Miscellaneous
Sub-Service Specialty:
Services that are below this one in the Consults Service Hierarchy.
_________________ _________________ _________________ _________________ _________________ _________________
Page 3 of 3 Appendix C: Request Servicesxe "Request Services" Distributed with Consults
( Note: The distributed services are those services shown below with an asterisk(*). The hierarchy shown below via the sub-service specialty column is not distributed. Use the Set up Consults Services option to build the hierarchy for your service. Remember, the top of the hierarchy must be ALL SERVICES.
REQUEST SERVICES LIST
NAME
SUB-SERVICE SPECIALTY
*ALL SERVICES
MEDICINE
PHARMACY SERVICE
*CARDIOLOGY
*GASTROENTEROLOGY
*HEMATOLOGY
*MEDICINE
CARDIOLOGY
GASTROENTEROLOGY
HEMATOLOGY
PULMONARY
RHEUMATOLOGY
*PHARMACY SERVICE
*PULMONARY
*RHEUMATOLOGY
The indented services represent sub-service/specialties making up the hierarchy.
( Caution: New services must be added to ALL SERVICES if not a sub-service specialty.
Appendix D: Package Securityxe "Package Security"
Service Update and Tracking Security
You can use the Consult Service User Management option, in conjunction with availability to various menus and options, to control access to Consults functionality. The menus that can be provided are:
Consult Service Tracking
Pharmacy Consult User
The Consult Service Tracking menu provides access to basic consult tracking functions and reports, but can also provide complete update capabilities if you have been granted update privileges by your ADPAC.
Individual options in the Consults package that may be useful to users, and what access they provide, are detailed in the following table:
OptionServicesConsult Service TrackingTracking and/or update functionality depending upon your individual privileges.Pharmacy TPN ConsultsTracking, and update functionality.Completion Time StatisticsReporting.Service Consults Pending ResolutionReporting.
With the GMRC Service User Management option you can set users up to be update users for one or more services at your hospital. In addition, you can grant the ability to receive consult notifications according to criteria outlined in the following table:
Category Notifications ReceivedUPDATE USERS W/O NOTIFICATIONSUnless otherwise set up, will not receive notifications.SERVICE INDIVIDUAL TO NOTIFYReceive consult notifications for your service.SERVICE TEAM TO NOTIFYReceive consult notifications for your service. These teams send notifications regardless of the patients contained on them. NOTIFICATION BY PT LOCATION
INDIVIDUAL TO NOTIFYReceive all consult notifications for your service for patients in a specified ward.NOTIFICATION BY PT LOCATION
TEAM TO NOTIFYReceive consult notifications for patients in a specified ward.These categories are not mutually exclusive, meaning a user may receive notifications based on being present on one or more of the lists detailed in the preceding table.
The following table lists privileges a user may want and who that privilege is granted to:
xe "Security"
PrivilegeGrantedOriginate a consultAnyone with access to CPRSSign a consultAnyone who can sign an orderChange a consult statusAnyone with update privilegesView or print a consultAnyone with the Consult Service Tracking option or access to CPRS. In summary, update user capabilities vary depending on
The option(s) that you are assigned.
Privileges granted in the Consults Service User Management option.
Menu/Option Accessxe "Menu/Option Access"
The following menus/options are available with the Consults package for distribution to users.
Option Name File
GMRC MGR 19
GMRC GENERAL SERVICE USER 19
GMRC PHARMACY USER 19
GMRC SERVICE TRACKING 19
GMRC TPN CONSULTS 19
GMRC RPT PENDING CONSULTS 19
GMRC REVIEW SCREEN 101
GMRC MGRxe "GMRC MGR" menu
This option should be given to IRMS/ADPACxe "ADPAC" personnel. It is composed of all options distributed with the Consults package.
GMRC GENERAL SERVICE USER menu
This menu provides access to the most commonly used Consults options that a general user, other than Medicine, would be interested in. This option should be added to their primary or secondary menu options.
GMRC PHARMACY USER menuxe "GMRC PHARMACY USER menu"
This menu provides access to the most commonly used Consults options that a user of the Pharmacy TPN option would be interested in. This option should be added to their primary or secondary menu options.
GMRC SERVICE TRACKINGxe "GMRC SERVICE TRACKING" option
The Consult Service Tracking (GMRC SERVICE TRACKING) option may be given to review only UANDU service update users. This option should be added to their primary or secondary menu options.
You may want to add the GMRC SERVICE TRACKING option to the OR MAIN MENU options in the Option file (#19) as well, since users of these OR options are likely interested in reviewing consult/request activities services may have taken.
GMRC PHARMACY TPN CONSULTSxe "GMRC PHARMACY TPN CONSULTS" option
Pharmacy personnel who need to be able to update File 123, REQUEST/CONSULTATION file, with service activity tracking updates should have the GMRC PHARMACY TPN CONSULTS option added to their primary or secondary menu options.
Security Keysxe "Security Keys"
File Security
The following is a list of recommended VA FileMan access codes associated with each file contained in the Consults package:
File Number
File NameDD AccessRD AccessWR AccessDEL AccessLAYGO Access(#123)Request/Consultation (#123.1)Request Action Types (#123.3)GMRC Procedures(#123.5)Request Services xe "REQUEST SERVICES file (#123.5)"@
Service Update Tracking Securityxe "Service Update Tracking Security"
The Consults Package is distributed for all Services at a facility to track consult/request activity. Security at the Service level is set up by IRMS/ADPACxe "ADPAC" personnel in the Request Services file (#123.5). Specific fields which provide security restrictions include:
GMRCACTM PHARMACY PKG MENU
This is the PROTOCOL ACTION MENU exported for use by Pharmacy Service personnel to process Pharmacy TPN Consults.
Routine Descriptions
GMRC101 Create Protocol entries for OE/RR ADD orders screens.
GMRC101C Create Protocol entries for OE/RR ADD orders screens (Continued)
GMRC101H Set up HL-7 message to update OERR orderable items file with new consult type.
GMRC15EN Environment check GMRC*3*15
GMRC513U Obsolete utility deleted with GMRC*3*4.
GMRC7L List Template Exporter.
GMRC75P Add the HCPS, APPLICATION PROXY user the the NEW PERSON (#200) file.
GMRCA1 Actions taken from Review Screens.
GMRCA2 Select prompt for processing actions.
GMRCAAC Administrative Complete action consult logic.
GMRCACMT Comment Action and alerting.
GMRCACTM Set GMRCACTM with action menu based on Service.
GMRCADC Discontinue Action taken from List Manager.
GMRCAFRD Forward Req (FR) Action from Review Screen.
GMRCALOR Process a consult from an alert notification.
GMRCALRT List Manager alert action interface.
GMRCAR Associate Results (AR) Action taken from Review Screen.
GMRCART Result display logic.
GMRCASF Significant Findings Action.
GMRCAST Select OE/RR Status (ST) Action.
GMRCASV Build ^TMP("GMRCS" of Svc(s)/Specialties.
GMRCASV1 Hierarchy Mgmt cont'd.
GMRCAU Action Utilities.
GMRCCA Report Prompting for Configuration Tool
GMRCCB Data Gathering
GMRCCC Output Data
GMRCCD Interactive Consult Update
GMRCCX Configuration File Utilities
GMRCCY Consult Closure Tool: Date Range Selector
GMRCCLR Kill-off all variables used for consults tracking.
GMRCCPRS Routine To Give Actions For Consults From The OE/RR Menu's.
GMRCDDX AC cross-referenc logic for 123.5, field .01.
GMRCDST Retrieve decision from DST server
GMRCDIS LM routine to disassociate med results
GMRCDPCK Check for a duplicate Consult/Request that has a status of active, pending or scheduled.
GMRCDRFR Default reason for request utils.
GMRCEDIT Edit cancelled consult-main driver.
GMRCEDT1 Edit a consult and re-send as new.
GMRCEDT2 Resubmit a cancelled consult.
GMRCEDT3 For a Cancelled Consult - File edited data for tracking consult.
GMRCEDT4 Utilities for editing fields.
GMRCFP GMRC FEE PARAM List Utilities
GMRC FPA GMRC FEE PARAM List Utilities
GMRCFX23 Consult postinit file maintenance.
GMRCGUIA File Consult actions from GUI.
GMRCGUIB GUI actions for consults.3
GMRCGUIC GUI actions for editing consults.
GMRCGUIU Kill off variables from GUI routines.
GMRCHK GMRC check for programmer access.
GMRCHL7 HL-7 formatting routine for consult information to be passed to OER.
GMRCHL72 HL-7 formats OBX and NTE segments.
GMRCHL7A Receive HL-7 Message form OERR and break it into its components and store it in File 123.
GMRCHL7B Process order parameters from ^GMRCHL7A and place data into ^GMR(123 global.
GMRCHL7H Receive consult event messages. Called by GMRCACMT and GMRCGUIB.
GMRCHL7I Processes incoming messages from HCPS.
GMRCHL7P Generate HL7 v2.5 REF messages. Called by GMRCH7H.
GMRCHL7U Utilities associated with HL7 messages.
GMRCHLP List Manager help logic.
GMRCIAC1 File IFC activities cont'd.
GMRCIAC2 File IFC activities cont'd.
GMRCIACT Process actions on IFC.
GMRCIBKG IFC background error processor.
GMRCIBKM Monitor IFC background params.
GMRCIERR Process IFC message error alert.
GMRCIEV1 IFC events cont'd .
GMRCIEVT Process events and build HL7 message.
GMRCILKP Look up IFC by remote consult number.
GMRCIMSG IFC message handling routine.
GMRCINC List incomplete IFC transactions.
GMRCIR IFC request data & statistics.
GMRCISEG Create IFC HL7 segments.
GMRCISG1 Build IFC HL7 segments cont'd.
GMRCITR IFC transactions.
GMRCITST Test IFC setup.
GMRCIUTL Utilities for inter-facility consults.
GMRCMCP List Manager Format Routine To Collect Medicine Package Consults and format them for display by List Manager.
GMRCMED Medicine interface routines.
GMRCMED1 Extract medicine results for consult tracking.
GMRCMENU Select List Manager menu for user characteristics.
GMRCMER Print Medicine Results in List Manager Format.
GMRCMP List Manager routine: Medical Service and sub-specialty consults.
GMRCMSS Setup Request Services.
GMRCMU Add protocols to GMRC protocol menus.
GMRCNOTF Notification recipient utilities.
GMRCP Message audit and status process.
GMRCP5 Print Consult form 513 (main entry).
GMRCP513 Print Consult form 513.
GMRCP5A Print Consult form 513 (Gather Data - TIU Results).
GMRCP5B Print Consult form 513 (Gather Data - Footers, Provisional Diagnosis and Reason For Request).
GMRCP5C Print Consult form 513 (Assemble Segments And Print).
GMRCP5D Print Consult form 513 (Gather Data - Addendums, Headers, Service reports and Comments).
GMRCPC List Manager Routine: Collect and display consults by service and status.
GMRCPC1 List Manager Routine: Collect and display consults by service and status.
GMRCPH Process XQORM helps.
GMRCPOR Get DOC,LOC,TS in interactive defaults.
GMRCPOS Consult postinit file maintenance.
GMRCPOS1 Post init to move Services from file 123.5 to the orderable items file, 101.43, and orderables in file 101 to file 101.43.
GMRCPOS2 Consult postinit file maintenance.
GMRCPOST Post init driver routine.
GMRCPP Print GMRC consult/request tracking protocols - List Manager routine.
GMRCPR GMRC List Manager Routine - Get information for abbreviated print of GMRC protocols and format for List Manager.
GMRCPR0 Data Entry Promptint actions.
GMRCPREF Setup package/procedure protocols.
GMRCPROT Consult postinit file maintenance.
GMRCPRP Set protocol information into ^TMP global for print and display by List Manager.
GMRCPRPS List Manager GMRC Routine -- List GMRC (Consults/Request) Protocols in abbreviated form.
GMRCPS Select Service/specialty to send Consult to.
GMRCPSL1 Main entry point for reports search by provider, location, or procedure.
GMRCPSL2 Build ^TMP(GMRCRPT) for GMRCPSL1.
GMRCPSL3 Generate reports using ^TMP(GMRCRPT).
GMRCPSL4 Generate reports using ^TMP(GMRCRPT).
GMRCPSL1 Special Consult reports.
GMRCPSL2 Special Consult reports.
GMRCPSL3 Special Consult reports.
GMRCPSEL Select Range Of Items From List.
GMRCPURG Purge orders from the Order File 100.
GMRCPX Select a new pharmacy patient for list manager consult tracking display.
GMRCPZ GMRC List Manager Routine -- Main menu actions for Pharmacy consults request tracking.
GMRCQC GMRC List Manager routine to print Consults pending resolution for QC purposes.
GMRCQCST Gather all consults for QC that do not have status of discontinued, complete, or expired.
GMRCR Driver for reviewing patient consult/requests - Used by Medicine Package to link Consults to Medicine results.
GMRCR0 Add original consult via backdoor service.
GMRCR06 Complete a consult/request.
GMRCRA Build ^TMP("GMRCR",$J, array of consults.
GMRCREXT Clean-up all variables and ^TMP globals upon exit.
GMRCRFIX Consult postinit save GMRCR protocol file links.
GMRCRPOS Consult postinit save GMRCR protocol file links.2
GMRCS Review consults by Patient and Service.
GMRCSL Active Consults by Service.
GMRCSLDT Get a consults detailed tracking history formatted for List Manager.
GMRCSLM List Mgr routine for consult tracking list.
GMRCSLM1 Gather data and format ^TMP global for consult tracking Silent call for use by List Manager and GUI.
GMRCSLM2 List Manager routine - Detailed consult display and printing.
GMRCSLM3 Extract medicine results for consult tracking.
GMRCSLM4 List Manager routine - Activity Log Detailed Display.
GMRCSLMA List Manager protocol entry, exit actions.
GMRCSLMU Utilities for displaying consults in List manager.
GMRCSLMV Set Video attributes for list manager screens.
GMRCSPD Change Date Range in CSLT Tracking Module.
GMRCSRVS Add/Edit services in File 123.5.
GMRCSSP List Manager Format Routine To Collect Pharmacy TPN Consults that are Not Completed Or Have Been Discontinued.
GMRCST Statistics on how how long to complete consult/requests for a service.
GMRCST0 Statistics on how how long to complete consult/requests for a service.
GMRCST00 Statistics on how how long to complete consult/requests for a service.
GMRCSTAT List Manager Ancilliary routine - Restrict display of consults to a given status or satuses on List Manager Screen.
GMRCSTL1 List Manager Format Routine - Get Active Consults by service - pending, active, scheduled, incomplete, etc.
GMRCSTL2 List Manager Format Routine - Get Active Consults by service - pending, active, scheduled, incomplete, etc.
GMRCSTLM List Manager Format Routine - Get Active Consults by service - pending, active, scheduled, incomplete, etc.
GMRCSTS Group update status of consult and order.
GMRCSTS1 Group update of consults cont'd.
GMRCSTS2 Change status based on result activity.
GMRCSTSI Special processing to change status of selected consult and order
GMRCSTSU Change status based on current order status.
GMRCSTSZ Loop "AE" and get entries, dump in ^TMP.
GMRCSTU Statistic Utilities for Consult/Request Package.
GMRCSTU1 Statistic Utilities for Consult/Request Package.
GMRCSUBS Routine to check if a Service has more that one patient service.
GMRCSVCU Utility to put services from file 123.5 into file 101.43 when service exists in 123.5 but not.
GMRCT Get DUZ's of users for notification to service.
GMRCTIU TIU utilities for exchanging info with Consults.
GMRCTIU1 More CT/TIU interface modules.
GMRCTIU2 Enter TIU Browse with DFN and TIUDA.7
GMRCTIU3 Extract medicine results for consults tracking.
GMRCTIUA Add the TIU note to the results multiple.
GMRCTIUE Complete/Update TIU notes.
GMRCTIUL Get list of existing results for consults.
GMRCTIUP TIU utilities for exchanging info with Consults.
GMRCTU Consults - Terminated users/remove pointers.
GMRCTU1 Get DD Info.
GMRCU Consult/Request Utilities.
GMRCUTIL Utilities for formatting word procesing fields and setting into ^TMP("GMRCR" globals for use by List Manager routines.
GMRCUTL1 General Utilities.
GMRCUTL2 Secondary Printer for printing SF 513
GMRCXQ Routine to allow follow-up on legacy alerts.
GMRCYP15 Convert procedures from 101 to 123.3
GMRCYP16 PRE/POST INSTALL FOR GMRC*3*16.
GMRCYP18 Post Install for patch 18.
GMRCYP23 Post Install for patch 23.
GMRCYP7 Consult clean-up unreleased at test sites.
GMRCYP8 Post Install for GMRC*3*8.
GMRCCCRA Generates the appropriate HL7 messages when a community care consult is entered into the system. ( Modified by patches 99, 106 and 123)
POST^GMRCP99 Used during the installation process to set up the appropriate HL7 application protocols and logical links. (Patch 99)
GMRCGUIB This existing routine is modified at the line tag CMT. A line of code was added to verify that a consult was created for community care; if so, it will trigger a new HL7 message to HSRM that includes the comment. (Patch 99)
GMRCACMT This existing routine is modified at the line tag COMMENT. A line of code was added to verify that a consult was created for community care; if so, it will trigger a new HL7 message to HSRM that will include the comment. (Patch 99)
GMRCCCR1 This is a subroutine from GMRCCCRA created in Patch 106 and updated for patch 123. It also contains subroutines used by the GMRCCCRI routine.
GMRCCCRI This routine is used by VistA to parse and process the consult update received from HSRM. This routine is new in patch 123.
LINK^GMRC123P This is a pre-install routine used by patch 123. It checks to see if the CCRA-NAK logical link exists in the system. If not, it asks for the Health Connect Server IP Address and Port number, then creates the logical link in the VistA system. This link is required to receive consult updates from HSRM to VistA.
Routine Mappingxe "Routine Mapping"
For systems that can use routine mapping, this is a list of routines in the Consults package that should be mapped.
Routine Prefix Routine Usage
GMRCA* Action routines
GMRCP* CPRS interface routines
GMRCR* Consults review/tracking routines
GMRCS Service entry point to review/tracking routines
GMRCU* Utility routines
GMRCXQ View Alerts followup
GMRCD* Decision Support Tool Utilities
The asterisk (*) is a wild card specification. Any routines beginning with the characters before the asterisks are included in the set.
The other routines do not need to be mapped due to their smaller frequency of usage.
Appendix D: Algorithms
User Authority
The flow chart on the next page represents processing accomplished to determine the user authority for any given user. This authority can be check by using the Determine Users' Update Authority (UA) action on the Consult Management Menu.
Example:
Select Consult Management Option: ua Determine users' update authority
This option will allow you to check a users update authority for any given
service in the consults hierarchy. If the PROCESS PARENTS FOR UPDATES field
is set to YES, all ancestors of the selected service will be checked.
The type of update authority and the service to which they are assigned will
be displayed.
Select Consult Service: arth Arthritis
Choose user to check for update status: CPRSPROVIDER,ONE OC PHY
SICIAN
This user is an update user for: Arthritis
via the UPDATE TEAMS W/O NOTIFICATIONS field.
Select Consult Service: arth Arthritis
Choose user to check for update status: CPRSPROVIDER,THREE TC CHIEF,
MEDICAL SERVICE
This user has no update authority
Select Consult Service:
Enhanced User Authority
Index
INDEX \e " " \c "2" \z "1033" Abbreviated Print Name 14
Action 21, 83, 195
Actions 12, 109
Administrative 18
Administrative Complete 30
Administrative Update Team 17
Administrative Update User 17
ADPAC 3, 5, 82, 197, 202, 213, 214
Archiving and Purging 121
Audience 1
Auto-forwarding 2, 191
Back Door Consults 183
Background Job 76
Background Job Parameters 81
Cancel (DY) 83
Checklist 3, 7, 197
Clinically Indicated Date 36, 38, 133, 145, 154, 163, 171
Complete (CT) 83
Complete action 84
Consult 195
Consult Tracking Reports 34
Consult Service Tracking 82
Consult Tracking Worksheets 205
CONSULT/REQUEST CANCEL/HOLD 82
CONSULT/REQUEST RESOLUTION 82
CONSULT/REQUEST UPDATED 82
Consults Performance Monitor Report (PM) 36
Correcting Misdirected Results 94
Create Document Definitions 90
Cross-References 113
Default Reason For Request 15
Define Service Hierarchy 9
Determine Service Functionality 12
Disabled 14
Discontinue (DC) 83
Discontinued Orders 195
Document Hierarchies 86
Exported Menus 109
External Relations 125
File Globals 106
Files 105, 193
Forward (FR) 83
Functionality 82
Globals 193
Glossary 195
GMRC CONSULT LIST DAYS 84, 102, 204
GMRC MGR 213
GMRC PHARMACY TPN CONSULTS 214
GMRC PHARMACY USER menu 214
GMRC SERVICE TRACKING 214
GMRC SETUP REQUEST SERVICES 10, 109, 202
Grouper Only 14
HCPS
Consult Service Set-up 21
Healthcare Claims Processing System 195
HL7 73
ACK Messages 176
Application Parameters 136
Logical Link 137
Mailbox 179
Protocols 135
REF_I12 Message Definition Tables 140
REF_I13 Message Definition Tables 149
REF_I14 Message Definition Tables 167
Referral Messages 138
RRI_I13 Message Definition Tables 158
HL7 Fields 129
IFC Requests 62
IFC Requests by Patient 66
IFC Requests by Remote Ordering Provider 67, 69
IFC Transaction Report 76
Implementation and Maintenance 7
Install, Planning, and Implementation Checklist 7
Inter-Facility Consults
Reports 61
Internal Relations 127
Introduction 1
Link to Request action 94
Linking Medicine Results 101
List incomplete IFC transactions 74
Locate IFC by Remote Consult Number 79
Make Addendum (MA) 83
Management Options 72
Medicine Interface 96
Menu/Option Access 212
Menu/Options 194
Monitor IFC Background Job Parameters 81
NEW SERVICE CONSULT/REQUEST 82
Non VA Care 196
Notification by Pt Location 16
Notification Parameters 82
Notify Service on DC 15
On-Line Documentation 193
Order 195
Order Cancellation 195
Order Discontinuation 195
Order Event Messages 179
Orderable Item Updates 186, 188
Overview 3
Package Interface 129
Package Orientation 5
Package Security 211
Package-Wide Variables 127
Prerequisite 15
Print Consults by Location 40
Print Consults by Procedure 40
Print Consults by Provider 40
Print IFC Requests 65
Private DBIA Agreements 126
Procedure Name 73
Procedure Request 196
Process Parents for Notifs 17
Process Parents for Updates 17
PROVISIONAL DX INPUT 15
Provisional DX Prompt 15
Purpose 1
Receive (RC) 83
Recommended Document Hierarchies 86
Remote Consult Number 79
Remote Ordering Provider 67, 69
Removing Medicine Results 101
Reprint 513 on DC 15
Request Services 209
REQUEST SERVICES (123.5) file 9
REQUEST SERVICES file (#123.5) 105, 106, 214
Request Services File (123.5) 202
REQUEST SERVICES file (123.5) 9, 116
REQUEST SERVICES file (123.5). 12
Requestor 196
Requests by Remote Ordering Provider 67, 69
Restrict Default Reason Edit 15
Resubmitted requests 39
Result 196
Result Mgmt User Class 17
Routine Mapping 225
Routines 193
Schedule(SC) 83
Scope of the Manual 1
Screen Context 196
Security 212
Security Keys 214
Select Service (SS) 83
Service 196
Service Consults Pending Resolution 27
Service Individual to Notify 16
Service Name 14, 73, 74
Service Printer 14
Service Team to Notify 16
Service Update Tracking Security 214
Service Usage 14
Service User Management 28
Services [GMRC SETUP REQUEST SERVICES 12
Set Up Consult Services (SS) 21
signature
without 30
Signature authority 30
Significant Findings (SF) 83
Special Updates Individual 17
Status Result 196
Status Symbols 196
Sub-Service/Specialty See
Synonym 14
Test IFC Implementation 73
Text Integration Utilities (TIU) Setup 84
Text Integration Utility (TIU) 3
TIU Maintenance 94
TIU Setup Options 89
Tracking Only 14
tracking performance 36
Transaction Report 76
Unrestricted Access 17
Update Teams W/O Notifications 17
Update User Class W/O Notifs 17
Update Users W/O Notifications 17
XINDEX 194
Table of Contents
Table of Contents
November 2019 Consult/Request Tracking V. 4.0 Technical Manual
November 2019 Consult/Request Tracking V. 4.0 Technical Manual PAGE \* roman \* MERGEFORMAT v
Introduction
November 2019 Consult/Request Tracking V. 4.0 Technical Manual PAGE \* Arabic \* MERGEFORMAT 1
Files
Files
Implementation and Maintenance
Implementation and Maintenance
Files
Files
Cross-References
Cross-References
Cross-References
Cross-References
External Relations
Package Interface
Package Interface
Package Interface
How to Generate On-Line Documentation
Package Interface
November 2019 Consult/Request Tracking V. 4.0 Technical Manual
Glossary
Appendix A: Install, Planning, and Implementation Checklist
Appendix A: Install, Planning, and Implementation Checklist
Appendix B: Consult Tracking Worksheets
Appendix B: Consult Tracking Worksheets
Appendix D: Package Security
Appendix D: Package Security
Appendix C: Algorithms
Files
CPRS
Consults
TIU
Request for
Consult
Is Placed
Consulting Service Receives the Request
Scheduling
Consulting Service Schedules Visit Between Consultant and Patient
Consultant Sees the Patient
Acquires own Hx & PE
Orders/Conducts Tests &/or Procedures
Interprets Results
Consultant Reports Findings
Dictation, Transcription, & Upload
Direct Entry
Enter/Edit Document
Complete
Action
Complete
Action
Direct Entry
Enter Progress Note
Consultant
Signs/Cosigns
Report
Update Consult
Request Status
to Completed
Update Order Status to Complete
Consults Resulting Process
Plan A: Class CONSULTS
Clinical Documents
Progress Notes
Discharge Summary
Consults
Pulmonary
ARDS
Asthma/COPD
Dietary
TPN
Tube-feeding
Surgery
Thoracic
Surgery
Orthopedic Surgery
Mental Health
PTSD
Chronic Pain
Plan B: Document Class CONSULTS
Clinical Documents
Progress Notes
Discharge Summary
Consults
Asthma/COPD
TPN
Tube-feeding
Thoracic
Surgery
PTSD
Orthopedic Surgery
Chronic Pain
Mental Health
Pulmonary
Primary Care
ARDS
VALIDATE USER
Service of consult being acted upon
Check UNRESTRICTED ACCESS (#.06)
NOT FOUND
NO
AUTHORITY
NO
YES
PARENT SERVICE
NO PARENTS
Validate parent service
Check for parent service
Check PROCESS PARENTS FOR UPDATES (#.07)
Result of Validate User
ADMIN or UPDATE USER
Update user will have full range of actions including clinical consult completion.
Administrative user will have full range of actions but only allowed administrative completion of consults.
If no update authority, user will only have review capabilities.
UpdateUser
Check to see if user is member of any user class in UPDATE USER CLASSES W/O NOTIFS (#123.35)
NOT FOUND
Check to see if user is member of any team in ADMINISTRATIVE TEAMS W/O NOTIF (#123.31)
NOT FOUND
Check to see if user is member of any team in UPDATE TEAMS W/O NOTIFICATIONS (#123.31)
NOT FOUND
Check to see if user is member of any team in SERVICE TEAMS TO NOTIFY (#123.1)
NOT FOUND
Check ADMINISTRATIVE USERS W/O NOTIF (#123.33)
Check SERVICE INDIVIDUAL TO NOTIFY (#123.08)
Check UPDATE USERS W/O NOTIFICATIONS (#123.3)
NOT FOUND
NOT FOUND
NOT FOUND
Loop stops with current user authority
Admini strat ive User
NO
Authority
