LABORATORY EMERGING PATHOGENS INITIATIVE (EPI) ROLL UP MODIFICATIONS TECHNICAL AND USER MANUAL PATCH LR*5.2*281 Version 5.2 June 2004 Department of Veterans Affairs VistA Health System Design and Development Preface The Veterans Health Information Systems and Architecture (VistA) Laboratory Emerging Pathogens Initiative (EPI) Rollup Modifications Patch LR*5.2*281 Technical and User Manual provides assistance for installing, implementing, and maintaining the EPI software application enhancements. Intended Audience The intended audience for this manual includes the following users and functionalities: • Veterans Health Administration (VHA) facility Information Resource Management (IRM) staff (will be important for installation and implementation of this package) • Laboratory Information Manager (LIM) (will be important for installation and implementation of this package) • Representative from the Microbiology section in support of the Emerging Pathogens Initiative (EPI) Rollup enhancements (i.e., director, supervisor, or technologist) (will be important for installation and implementation of this package especially with parameter and etiology determinations; may also have benefit from local functionality) • Total Quality Improvement/Quality Improvement/Quality Assurance (TQI/QI/QA) staff or persons at the VHA facility with similar function (will be important for implementation of this package given broad-ranging impact on medical centers and cross-cutting responsibilities that extend beyond traditional service lines; may also have benefit from local functionality) • Infection Control Practitioner (likely to have benefit from local functionality) NOTE: It is highly recommend that the Office of the Director (00) at each VHA facility designate a person or persons who will be responsible for the routine implementation of this patch (both at the time of this installation and afterwards) and to take the lead in trouble-shooting issues that arise with the routine functioning of the process. This decision is left at the discretion of the director since the functions that persons perform locally may have different titles and meanings. The definitions of installation and implementation are provided below to help the Office of the Director in assigning the responsibility. June 2004 VistA Laboratory EPI Rollup Modifications i Technical and User Manual Preface The term installation refers to the process of actually integrating the software into the currently existent VistA system locally. This is usually a process that occurs over a short period of time and does not recur. By default, this process is usually accomplished by personnel in IRM. The term implementation refers to the process of executing the software after installation, adjusting parameters and maintaining the day-to-day functioning of the data cycle that the Laboratory EPI Rollup Modifications entail. There are two main functionalities that will need to be addressed by implementation (national functionality and local functionality). The national functionality will have limited local resource requirements, but will require periodic, on-going attention. Initial parameter set-up will take about 1-2 hours of time with personnel representing the LIM function, microbiology function and IRM function working in concert to set the parameters appropriately. Thereafter, a once-yearly review of the parameter set-up for all national EPI-specified pathogens is the minimum expected. Day-to-day functioning does not refer to the maintenance of the actual software patch, but, instead, refers to the EPI data cycle to assure that the national pathogen information has been appropriately sent to and received by the central data repository—by this definition, it is not necessarily the IRM function to oversee this. Because this will involve review of information sent, confirmation of information receipt, and, most importantly, troubleshooting of errors received from the processing into the central data repository, a local site function that has experience with numerous areas at the local facility from where the data are extracted (medical administrative services, social work, patient demographic information, laboratory information) and that cuts across multiple lines of authority should be considered by the Office of the Director (00) for this task. The local functionality resource requirements will be dependent upon the use at the local site. ii VistA Laboratory EPI Rollup Modifications June 2004 Technical and User Manual Orientation This section of the EPI Roll Up Modifications Technical and User Manual addresses package or audience-specific notations or directions pertaining to symbols used to indicate terminal dialogues and user responses, information for accessing the EPI Technical and User Manual via the Office of Information Field Offices (OIFOs) Anonymous Software directories, VistA website, VistA Documentation Library (VDL), EPI software phased installation and implementation procedures, instructions for seeding EPI historical data, and Austin Automation Center (AAC) transmission schedule for seeding the EPI historical data. EPI Roll Up Modifications Technical and User Manual The EPI Roll Up Modifications Technical and User Manual contains the following sections: Introduction - conveys the major functions, purposes, and how the software accomplishes the objectives. Security Information - addresses any legal requirements pertaining to the EPI Patch LR*5.2*281, software product and identifies any security measures necessary to protect the integrity of the product and database. Pre-Installation Information - contains information that should be acknowledged prior to the installation of Patch LR*5.2*281. Installation Instructions - provides information regarding the installation process for Patch LR*5.2*281. Post Installation Instruction - provides all the necessary information required for the IRM and LIM personnel to implement the Laboratory EPI Rollup Modifications software application. EPI Rollup Modifications User Manual - provides the necessary information for implementing and maintaining the EPI criteria. Appendix A - provides instructions for editing/printing files, using input screens, linking data, and a Workload and Suffixes Codes Request Form. Appendix B - suggest helpful hints and examples regarding for EPI preferred methods, transmissions, and data validation suggestions. Appendix C - provides VistA Health Level Seven (HL7) Protocol tables used to transmit EPI Roll Up Modifications data to the Austin Automation Center (AAC) Appendix D - provides a copy of the IMPLEMENTATION OF LOGICAL OBSERVATION IDENTIFIERS NAMES AND CODES (LOINC®) FOR LABORATORY DATA (VHA Directive 2001- 039) June 2004 VistA Laboratory EPI Rollup Modifications iii Technical and User Manual Orientation Screen Dialogue Screen Captures - The computer dialogue appears in courier font, no larger than 10 points. Example: Courier font 10 points User Response - User entry response appears in boldface type Courier font, no larger than 10 points. Example: Boldface type Return Symbol - User response to computer dialogue is followed by the <Enter> symbol that appears in Courier font, no larger than 10 points, and bolded. Example: <Enter> Tab Symbol - User response to computer dialogue is followed by the symbol that appears in Courier font, no larger than 10 points, and bolded. Example: <Tab> References Please review the following guide and manual prior to installing and implementing the VistA Laboratory EPI Rollup Modifications Patch LR*5.2*281: • Kernel Systems Manual V. 8.0 • VA FileMan V. 21.0 • VA Mailman V. 7.1 EPI Roll Up Modifications Software Phased Installation and Implementation Instructions Due to extensive historical data transmission requirements and mandated setups required for such, a phased installation and implementation of this patch (LR*5.2*281) is utilized for releasing this patch. The software download information is made available to sites attending one of the following national audio conference training calls: Tuesday, June 8 at 1:00 - 3:00 PM EST for VISNs 1-2-3-4-5-6 Thursday, June 10 at 3:00 - 5:00 PM EST for VISNs 7-8-9-10-11 Tuesday, June 15 at 4:00 - 6:00 PM EST for VISNs 12-15-16-16-23 Wednesday, June 16 at 2:00 - 4:00 PM EST for VISNs 18-19-20-21-22 Thursday, June 17 at 2:00 - 4:00 PM EST for those unable to attend the other calls. The VANTS telephone number is 1 800 767-1750 and the access code for all calls is 13143. This patch will involve reseeding of the EPI databases for each site to allow the new data created by this patch to be captured. It is imperative that each site attend an audio conference prior to installation and implementation of the EPI patch LR*5.2*281. iv VistA Laboratory EPI Rollup Modifications June 2004 Technical and User Manual Orientation Instructions for Seeding EPI Historical Data: EPI historical data must be gathered from October 1, 2000 through June 14, 2004. Use the Lab EPI Manual Run (Enhanced) [LREPI ENHANCE MANUAL RUN] option to extract and transmit 6 manual runs (consecutive runs) at a time. WARNING: SITES - DO NOT transmit the EPI historical data reports on June 16 or July 4, 2004 to avoid Austin Automation Center (AAC) capacity limitations. Batch #1: October 1, 2000 -March 31, 2001 Batch #2: April 1, 2001 - September 30, 2001 Batch #3: October 1, 2001 - March 31, 2002 Batch #4: April 1, 2002 - September 30, 2002 Batch #5: October 1, 2002 - March 31, 2003 Batch #6: April 1, 2003 - September 30, 2003 Batch #7: October 1, 2003 - March 31, 2004 Batch #8: April