Some questions.
1)
can one patch the VA
Vista to use the HIS files or do they have to start with fileman and install HIS
packages to get RPMS
2) is there a way to install
multiple packages or is there a base install to load RPMS onto a system ,either
G.T.M or cache.
Thanks,
Marc Aylesworth
C3I
Associates AFRL/IFSE Joint Battlespace Infosphere Team
525 Brooks Rd
Rome, NY
13441-4505
Tel:315.330.2422
Fax:315.330.7009
Email:Marc[EMAIL PROTECTED]
From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Floyd Dennis
Sent: Thursday, April 21, 2005
1:38 AM
To:
hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members]
IHS system???
There appears to be some confusion
on the nature of the IHS patient file's Health Record Number. I
don't know if clarification is possible, but I'll give it a shot.
:>
1. Like many of the initial RPMS modules, the IHS Patient
Registration system is "piggybacked" onto the VA's
registration system. Much of the patient demographic information resides
in File #2 (referenced in RPMS as the VA PATIENT file). Additional
patient data captured by the RPMS patient registration system is stored in File
#9000001 (the RPMS system's PATIENT file - referred to as
PATIENT/IHS by VistA), which maintains a DINUM relationship with File #2.
Examples of such additional data are patient's tribe of membership,
level of eligibility for IHS services, etc.
2. The RPMS deals with IHS-specific mods to VA standard dictionaries in a
similar fashion; DINUM-related RPMS correspondent dictionaries are established;
and the IHS-specific mods dealt with in the corresponding dictionary. One
example of this is the IHS's method of identifying facilities. The
VA's standard dictionary of facilities is maintained in file #4
(INSTITUTION); IHS has its own standard method of facility ID coding, however,
for which (to the best of my knowledge) there is no corresponding VA code. The
RPMS solution to this was to create a LOCATION file #9999999.06 which (a) has a
DINUM relation with file #4 and (b) contains the IHS standard 6-digit ASUFAC ID
code for the facility. Simple, huh? :)
3. When looking at using the VA's DHCP software, one of the very
first hurdles IHS had to overcome was the problem of patient identification.
The VA's patient registration system uses SSN as its primary
patient identifier. IHS cannot base its patient identification on SSN,
however, because many of its patients (especially on the larger Southwestern
U.S. reservations) have never applied for nor been issued a Social Security
number.
4. The IHS solution was/is the health record number (HRN), a number which
uniquely identifies a patient within a given healthcare facility. There
is no relationship between the HRN and the SSN; the two are apples and oranges.
For facility-external references, the HRN can be concatenated onto the
end of the facility's ASUFAC code. In IHS, the HRN is limited to 6
digits; YMMV.
5. The RPMS's PATIENT file #9000001 incorporates multiple field
#4101 which contains (a) a LOCATION file pointer reference to each facility at
which a patient has been registered, and (b) the patient's HRN at that
facility. This (theoretically) allows coherent management of demographic
information for patients registered at more than one IHS facility. In
Anna's example entries, the HEALTH RECORD FAC field is the pointer
reference to the registering LOCATION file entry, and the HEALTH RECORD NO.
field is the patient's HRN at that facility. Anna's #3 entry
represents a patient TEST PATIENT,PATIENT who has been registered with chart
number 000001234 at the SOFTWARE SERVICE healthcare facility.
6. Unsurprisingly, the earlier standard FileMan lookups did not deal well
with the notion of using several data items from a multiple field as a unique
patient lookup identifier (this *was* back in the days of FileMan v16.60, after
all). The AUPNLK* routines perform that patient lookup function, as well
as providing increased security on patient lookups.
7. Since the VistA software does not acknowledge or use the RPMS #9000001
PATIENT file, this HRN-identifier lookup would not be available on the VistA
side of the house without some rewriting of a given package's patient lookup
modules. This is not an insurmountable problem; as a moment's
reflection will reveal, IHS has performed this rewrite on every VistA package
that has been adapted for use in the RPMS environment.
8. Along the same lines as #7 - since the AUPNLK* patient lookup
routines are IHS-developed software, they would be unlikely to pop up in a VA
software distribution.
NOW - is everybody sufficiently confused? :)
---------------------------------------------------
Doubt is uncomfortable; Certainty is ridiculous.
- Voltaire
Floyd Dennis
[EMAIL PROTECTED]
On 4/20/05 10:59 AM, "James Gray" <[EMAIL PROTECTED]> wrote:
I believe the input transform on the HRN field is for a max
of 6 digits. I thought that some version of the AUPNLK* routines were
included in the VistA FOIA. The lastest can be obtained from the IHS
FOIA. It would be possible for a hospital to put their own patient id's
into the HRN field as long as they are numbers no more than 6 digits long.
If you have Cache installed on a Windows machine you should be able to
load it onto Cache. I do not know about untaring (if that is the right
term) without Unix or Linux.
I was trying to say that IHS uses unmodified versions of VA Fileman and
Kernel.
Jim Gray
----- Original Message -----
From: Anna Joseph <mailto:[EMAIL PROTECTED]>
To:
hardhats-members@lists.sourceforge.net
Sent: Wednesday, April 20, 2005
12:39 AM
Subject: Re: [Hardhats-members]
IHS system???
From: James Gray <mailto:[EMAIL PROTECTED]>
To:
hardhats-members@lists.sourceforge.net
Sent: Wednesday, April 20, 2005
3:30 AM
Subject: Re: [Hardhats-members]
IHS system???
>I don't either, but I recall some things about it. If you use
the VA FOIA there is cross reference on the SSN that stuffs the SSN into
the HRN. The interesting thing is >that it violates the input
transform on the HRN field.
what is the input transform on the HRN Field? I mean does it
increase/decrease the number of digits, a specific logical
transformation...?
>If you are not going use SSN you need a different way to keep files 2
and 9000001 in synch. The cross reference (something like PX09) is
how the VA software keeps >the two files in synch. If you make
the SSN optional or do not use it then the two files will not stay in
synch. IHS does it a different way. They keep the two files
in >synch with the file 2 look up routines (the routines with the
names AUPNLK*).
Tried to locate the routine (AUPNLK ) could not find anything of that
sort in the OpenVista SemiViva 4.0 which we are using. We presume that
this contains all the FOIA routines. In which case the routines are only
available in the IHS system.
So that means that the SSN will have to be maintained (to play it safe),
though it may not be used by a hospital, which would use the HRN. In such
a case, can we generate the HRN using a M routine (Generally Hospitals
like to have their own sequence for patients numbers with respect to
their status i.e. private patient, general patient, etc.) or are there
other criteria for gernerating the HRN?
>To refer back to an earlier question, if you do not have Mumps
programmers available it will be difficult to impossible to meld RPMS and
Vista. But they are quite similar >and I do not think the isssue
would be very difficult for a Mumps programmer. I do not know if
anyone has gotten RPMS to run on a GT.M system. RPMS uses
>essentially vanilla VA Fileman and Kernel.
I wish we can have a local implementation of RPMS. I have tried to
look at the page www.ihs.gov/Cio/RPMS/index.cfm <http://www.ihs.gov/Cio/RPMS/index.cfm>
provided by Marc Aylesworth. I have not understood how one can go
about the installation of RPMS? I mean, you can only download the
.zip/.tar files as per your module selection from the site. How do we
proceed then?
RPMS apparently has not been implemented on GT.M. How does one install it
on Cache? Does one have to use UNIX (again which flavor of UNIX) or can
it be installed using Cache on Linux or Windows?
What is the meaning of Vanilla VA Fileman and Kernel? This is
apparently needed for RPMS installation. If so how does one get hold of
it?
Is there any way of atleast going thru a demo of the IHS system if
I can't have it setup here locally?
Anna
----- Original Message -----
From: Aylesworth Marc A
Contr AFRL/IFSE <mailto:[EMAIL PROTECTED]>
To:
'hardhats-members@lists.sourceforge.net'
Sent: Tuesday, April 19, 2005 9:59
AM
Subject: RE: [Hardhats-members]
IHS system???
Unfortunately I do not work with RPMS
anymore. I believe that the record number can be different from the SSN
but am unsure how to achieve it SORRYY !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Thanks,
Marc Aylesworth
C3I Associates AFRL/IFSE Joint
Battlespace Infosphere Team
525
Brooks Rd
Rome,
NY 13441-4505
Tel:315.330.2422
Fax:315.330.7009
Email:[EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]>
From:
[EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
On Behalf Of Kevin
Toppenberg
Sent: Tuesday, April 19,
2005 10:46 AM
To:
hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members]
IHS system???
Anna,
I don't know how this system works. I wonder if
Marc A., who I believe works with the IHS system, could explain this.
Kevin
Anna Joseph
<[EMAIL PROTECTED]> wrote:
That's just the captioned output of some patients in
the implementation we have here. These patients we had entered (not
sasmple patients).
STANDARD CAPTIONED OUTPUT? Yes// (Yes)
Include COMPUTED fields: (N/Y/R/B): NO// BOTH Computed Fields and
Record Number
(IEN)
NUMBER: 5
NAME:
PATIENT,SURGERY
HEALTH RECORD FAC: SOFTWARE SERVICE HEALTH RECORD
NO.: 789654123
NUMBER: 3
NAME:
TEST PATIENT,PATIENT
HEALTH RECORD FAC: SOFTWARE SERVICE HEALTH RECORD
NO.: 000001234
Anna
----- Original Message -----
From: Kevin
Toppenberg <mailto:[EMAIL PROTECTED]>
To:
hardhats-members@lists.sourceforge.net
Sent: Monday,
April 18, 2005 6:56 PM
Subject: Re:
[Hardhats-members] IHS system???
Are these patients that you entered, or are they sample
patients? What number do they have entered? Is it a SSN?
Kevin
Anna Joseph
<[EMAIL PROTECTED]> wrote:
Kevin
Yes did just check out the file. Surprising to find that all patients
have a
health record number assigned to them! Does this then mean that to have
an
implementation of the IHS software you need to apply their patches to a
VistA core?Can that be done on the GT.M database itself?
Wonder if anyone here has ever tried it or has an idea of how we can
install
it and how it works?
Anna
----- Original Message -----
From: "Kevin Toppenberg"
To:
Sent: Monday, April 18, 2005 5:21 PM
Subject: Re: [Hardhats-members] IHS system???
> Anna,
>
> See if your system has a file# 9000001
>
> This is the PATIENT/IHS file. Here are the fields as
> reported by VPE's DD
>
> File: PATIENT/IHS
> Branch: 1
> REF NODE;PIECE FLD NUM FIELD NAME
>
============================================================================
===
> 1 0;1 .01 NAME
> <-Pntr [RP2'X]
> 12;0 1201 LOCATION OF HOME
> <-WP [9000001.12]
> 2 -0;1 .01 -LOCATION OF HOME
> [W]
> 41;0 4101 HEALTH RECORD NO.
> <-Mult [9000001.41IPA]
> 3 -0;1 .01 -HEALTH RECORD FAC
> <-Pntr [P9999999.06'X]
> 4 -0;2 .02 -HEALTH RECORD NO.
> [RFX]
> 5 -0;3 .03 -DATE
> INACTIVATED/DELETED [D]
> 6 -0;5 .05 -RECORD STATUS
> [S]
> 7 -0;6 .06 -STOP INTEGRATION
> [S]
> <> <> <>
>
> I think it is fairly well integrated into the VA
> system. But I don't know if VistA depends on it. I
> don't think CPRS can use it to look up a patient by
> their HEALTH RECORD NO. however.
>
> Another option would be to use just name and DOB.
> There is a key that allows entry of patients WI THOUT a
> SSN. Or, you can just enter "P" for a SSN, and they
> will be given a pseudo-SSN.
>
> Kevin
>
>
> --- Anna Joseph wrote:
>
> > Indian Health Service runs a system similar to
> > VistA.. With the little I
> > know about it, seems like they do not use an SSN
> > number to identify the
> > patient but they have record number... which caught
> > my attention!
> > Has anyone worked with this system? Was trying to
> > have a local
> > implementation of it to explore it. Any idea of
> > where i can get the sources
> > from? how the installation etc. is to be done?
> > Anna
> >
> >
> >
> >
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