IHS RPMS FOIA Distribution Version Configuration Guide Addendum I
IHS RPMS FOIA Distribution Version Configuration Guide Addendum I
IHS RPMS
FOIA Distribution Version
Office of Information Technology (OIT) Division of Information Resource Management Albuquerque, New Mexico
Version 1.0
Preface
This document is part of the distribution package for the Indian Health Services (IHS) Freedom of Information Act (FOIA) release of the RPMS system. In order to comply with policies and laws concerning patient privacy and commercial software licensing, it has been necessary to remove certain parts of the system. This document identifies those areas that have been modified, as well as identifying areas where it will be necessary for the user of this system to make additional modifications in order for the system to perform properly. This document will not tell the user how to fix any issues that will arise in implementing this system, but rather indicates areas where modifications have been made. Because this system is a combination of the Veterans Administration VistA system and the IHS RPMS system, there are some areas that are not used by IHS. These areas have been identified and should be ignored by the user.
Preface
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Table of Contents
Introduction to Installation .................................................................................1 Documentation for the System ..........................................................................2 Interfaces between IHS M Environment and Other Systems...........................3 Interfaces Within IHS ..................................................................................3 Interfaces Within the Database Not Used by IHS .....................................10 Remote Procedure Calls (RPCs) .............................................................11 Routines Modified for FOIA ..............................................................................13 Imbedded Telephone Numbers ................................................................13 Imbedded Email Addresses ......................................................................14 Imbedded IP Addresses ...........................................................................15 Imbedded DNS Addresses .......................................................................15 Security Hashing ......................................................................................16 Cleaned Data Files (Globals) ............................................................................17 Nodes .....................................................................................................19 Other Modifications...........................................................................................20 Security ....................................................................................................20 MailMan ....................................................................................................20 Appendix I. VueCentric .....................................................................................21 Licensing ..................................................................................................21 Collaboration ............................................................................................23 Contact Information ..........................................................................................24
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Introduction to Installation
The basic installation of the IHS RPMS Medical System requires that the Intersystems Inc. CACH be on the system where the environment will reside. Use the Version 2008.2 or later. Instructions for installing this environment are available from the Intersystems Inc. web site, http://www.intersystems.com/ under their standard licensing agreements. Contact Intersystems directly for information about purchasing this licensed product. Once the CACH environment is established, the steps in the installation guide can be followed to install the M portion of this system.
Introduction to Installation
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Internal M Interfaces PCC Suite of programs. (Patient Care Component) HL7 Using a link between RPMS and MS Word, produces a real-time customized encounter form.
Version 1.0
IHS Interfaces
HL7/GUI
Use
HL7
Can send ADT (Admissions, Discharge, Transfer) to data warehouse. The National Data Warehouse (NDW) project is upgrading the Indian Health Service's (IHS) national data repository, the National Patient Information Reporting System (NPIRS), to a new, state-of-the-art, enterprise-wide data warehouse environment. This is the Generic Interface System that is used by IHS to transport HL7 messages within the environment and outside the environment Clinical Health Record The GUI version of the software contains most of the existing functionality of the traditional roll and scroll FRPMS application, including patient management, register maintenance, running reports, and running the Diabetes Audit.
Data Warehouse
HL7
HL7/GUI C# .NET
HL7 via FTP/Kermit GUI Visual Basic .NET and iCare Population Management GUI
The Automated Dispensing System interface sends RPMS patient data and orders to the Automated Dispensing System in real-time, as transactions occur.
External COTS Interfaces TIU Dictation Support HL7 Uploads and downloads dictation service files.
Version 1.0
IHS Interfaces
HL7/GUI
Use
Reference Lab Inbound Messages DynaCare LabCore Inbound Messages Sonora Quest Lab Inbound Messages Quest Lab Inbound Messages
HL7
HL7 HL7
HL7
Interfaces to Quest Laboratory. Interfaces to Quest Diagnostics Laboratory. Interfaces to RML Laboratory. Interfaces to SCC Laboratory. Interfaces to Unilab Laboratory. Creates a Host file to be sent to IMMServe - commercial software called ImmServe, distributed by Medical Decisions Associates, Inc. (MDA). This software is an immunization forecasting utility. Written in C. Transmits billing information to external billing system.
Quest Diagnostics Lab Inbound HL7 Message RML Lab Inbound Messages SCC Lab Inbound Messages Unilab Lab Inbound Messages ImmServe File formatting HL7 HL7 HL7 HL7/HOST
Interfaces to hardware Pyxis Medication dispensers OmniCell Medication dispensers Script pro (APSS) dispensing system HL7 HL7 Medication dispensing machine. Medication dispensing machine.
Data to a printer
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IHS Interfaces
HL7/GUI
Use
HL7
Interface to pen based system. Transfers medical information from a lab instrument to the database. Interface through bar code readers.
HL7
External Interfaces Not to COTS Products Lab HL7 Receive file of CHR transactions from a remote computer. The extract menu option collects and forwards CDMIS data to the Area office, and is consolidated and forwarded to Division of Data Processing Services (DDPS) by the close of business on the 25th of the month after the quarter ends. This interface, while an IHS interface, is not appropriate for other organizations and should not be utilized when downloaded. Exports immunization records to national database. Extracts data from the National Drug file for use inside the system.
Chemical Dependency
HOST
HL7/HOST
HL7
Version 1.0
IHS Interfaces
HL7/GUI
Use
The Area Data Consolidation Export System (BXP) is designed to consolidate and merge data sent to the National Patient Information Reporting System (NPIRS) in Albuquerque, New Mexico. The facilities send the unprocessed data to the Area Office where it is processed and sent on to NPIRS to be merged and consolidated. Electronic Health Record system Windows-based graphical interface that helps providers manage all aspects of patient care.
EHR
GUI - VueCentric Framework, using the following: Delphi v7, RoboHelp X5 v13.10.801, AuthorIT 4.1, Visual Basic 6.0, C# (VS 2003), Medsphere OpenSource, Mozilla Public License 1.1, Larcom & Young, Raize Software, Dart Communications, FreeVBcode.com, Clever Components GUI Microsoft .NET v 2.0
ICare
Population Management (BQI) Allows providers to create and manage their own personalized panels (populations) of patients with user-defined common characteristics - HIV Management System merged into iCare. Creates Encounter forms.
VEN
GUI MS Visual Studio, .NET Framework with RPC calls GUI Visual CRS, Visual Basic .NET
CRS
Clinical Reporting System (BGP) Allows sites and Areas to review and report on local RPMS clinical data for GPRA and developmental performance indicators.
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IHS Interfaces
HL7/GUI
Use
Scheduling
GUI - Microsoft .NET v Schedules patient visits (BSDX). 2.0 GUI - Visual Basic through RPC calls GUI - Windows .NET Displays a patients chart (BPC).
Patient Chart
Diabetes (BDM)
Diabetes-specific patient management tool. Exports patient registration and visit data to the IHS National Data Warehouse. This is not useful for nonIHS sites. To various third party billing environments. The Pharmacy Auto Refill system enables RPMS to interact with a commercial automated telephone system (AudioCare) to refill prescriptions. The system will also check on prescription status and provide feedback to patients who are calling to have prescriptions refilled. Creates 5 of the 10 reports required for IHS sites receiving grants administered by the Bureau of Primary Health Care (BPHC). The reports are manually sent to BPHC. Creates a UB-92 Electronic Claim File. Helps providers make clinical decisions about immunizations and follow up with patients and communities with low immunization coverage to ensure they are protected.
HL7
HOST
Host file
Version 1.0
IHS Interfaces
HL7/GUI
Use
The Immunization Data Exchange Interface is a two-way Generic Interface System (GIS) HL7 interface that allows the exchange of immunization data for children from birth (0) to 19 years of age with State immunization registries. The Indian Health Service (IHS) Computerized Public Health Activity Data System (CPHAD) application provides for the entry of public health activity being performed by clinicians or other providers of public health activities. This software application will work in conjunction with the existing Resource and Patient Management (RPMS) applications. Automated data transfer to the Referred Care Information System (RCIS). Electronic Explanation Of Benefits Report (EOBR) transmission. Medical data with automated transfer to the Patient Care Component (PCC). The PCC Data Transmission system is designed to process and transmit Patient Registration and clinical data to the IHS Division of Data Processing Services in Albuquerque, New Mexico, for national statistical reporting purposes. Generic interfaces to outside Radiology Reporting packages. Report entry can be done through vendor-supplied voice recognition units with an HL7 interface provided partially by this package and partially by the vendor (MedSpeak, PowerScribe, TalkStation, and so on.
HOST
HL7
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Non-IHS (VistA) Interfaces CAREVUE - CARELIFE LIFELOG External Interfaces Not to COTS Products CPRS Registration National Flag Assignment IFC event Capacity Management RUM NATIONAL DATA BASE
The establishment of the permissions is covered in the Remote Procedure Call Manual at http://www4.va.gov/vdl/application.asp?appid=23. This manual explains in detail all of the necessary permissions that must be established, as well as how to use RPCs. The M structure that must be built to handle RPCs is in a global called Remote Procedure and currently contains 2,631 entries that cover the entire VA and IHS RPC environment. This file is used as a repository of server-based procedures in the context of the Client/Server architecture. By using the RPC broker, applications running on client workstations can invoke (call) the procedures in this file to be executed by the server and the results will be returned to the client application. Each remote procedure entry is associated with an entry point (ROUTINE with optional TAG). Calls to these procedures can include parameters of different value types. The resulting value of the call can be either a string, a list of strings or a word processing string as indicated by the RETURN VALUE TYPE field (.04).
Configuration Guide - Addendum I March 2010 Interfaces between IHS M Environment and Other Systems
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A PRINT of this file can show the Name, Routine, Tag and Description of the call. An example is given in the table below.
Name Routine Tag Description
ORQORB SORT
ORQORB
SORT
ORQPT
ORQPTQ3
ATTPRIM
ORQPTQ2
CLINPTS
ORQPTQ2 ORQPTQ2
CLIN CDATRANG
ORQPTQ11
DEFSORT
ORQPTQ11
DEFSRC
Returns the notification sort method for user/division/system/pkg. Returns a patient's attending physician and primary provider. Returns patients with appointments at a clinic between start and stop dates. Function returns a list of clinics. Returns default start and stop dates for clinics in the form: start^stop. Start and stop are free text and are not in FM format. Returns the current user's default patient selection list SORT ORDER setting. Function returns the source of the current user's default patient list.
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ORY131 ORY85 PSJVINIS PSOCLUTL PSSDINT SD53P234 SR54UTL XMAH1CP XMR1 XPDCUST XTINEND XUCSRV
ORY132 PSBSAGG PSN4P4 PSOCPBAK PSUTL1 SDHPIB SROATCM2 XMDIR1A XMRPCTS1 XPDIST XTINITY XUPSPD1
ORY141 PSGWINIS PSO55FX2 PSOCPIB3 PXICLN1 SDOQMP VALMINIY XMDIR1B XMS1 XQABGEN XU8343R
ORY148 PSJIPST PSO55FX3 PSOTPPOS SCMSP0 SDWLCU1 XGKB1 XMGAPI3 XMS2 XTCMFILN XUCMNIT4
Imbedded IP Addresses
There were a significant number of M routines that contained imbedded IP addresses which would only be applicable to IHS. These IP addresses were manually changed to a standard dummy IP value. The table below shows the routines where the IP addresses were modified. ABSPOSAB BARPT18 BDW1VBLI VENPCCM1 ABSPOSJ1 BARPT172 BDWCVAR XLFNSLK AZFMENV BARPT173 BDWDDR XMR0BLOB BAREISS BARPT174 BDWDWPX1 XWBTCPZ
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BJPC1P1 XBTRK
BKUCW2KV
BPXRMP4I
XB3P9
Security Hashing
Routines containing content associated with the secure transmission of access and verify codes have been sanitized. The consumer of the FOIA product(s) will need to provide their own encryption/decryption algorithms. Security Hashing - Access and Verify code are not hashed. The following routines will need your own hashing code added in the appropriate places: XUSHSH XUSHSHP
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^HLEV(776 - HL7 MONITOR JOB file With each Monitor Master Job run, the master job checks every monitor entry in the HL Event Monitor file (#776.1). If it is time for the monitor to be queued, a background job is queued to run that monitor. At the time of queuing an entry is created in this file holding (among other values) the internal entry number of the monitor entry in file 776.1. The IEN is stored in the Monitor field (#3), and this M cross-reference holds the IEN of the monitor. Note: The Monitor field does not point to the monitor, strictly speaking, because this field is a free-text field. However, since it holds the IEN, it is a functional pointer to the monitor file. (The field was created this way to enable monitors to be deleted at will without worry about dangling pointers.) ^HLEV(776.1 - HL7 MONITOR file. Under HL7 Main Menu Option -> Message Management Options - > Purge Messages This option should be run to purge the listed messages. This job utilized the AI cross-reference to purge records in file 772 and 773 with maximum efficiency. It is not guaranteed to purge all records that need purging, but should quickly purge the vast majority of such records. Its main limitation is that it limits itself to messages that have a status of Successfully Completed. There are two Fast Purge jobs. This one is the main job, in that it should be running nearly continuously. The second job will be started less frequently, and if there is no work to do will go back to sleep for several hours. Its purpose is to prevent purging from getting backed up when the messaging system is under very heavy load. ^HLEV(776.2 - HL7 MONITOR MASTER JOB FILE On a parameter-controlled frequency, a master job is run to determine whether individual monitors should be run. When these master jobs start, an entry is made in the HL Event Master Job file (#776.2). The .01 field of this file is Creation Time, and this B xref is created based on the date/time value in this field. ^HLEV(776.3 - HL7 MONITOR EVENT TYPE FILE - It appears that this file keeps track of error events that occur during message sending. ^HLEV(776.4 - HL7 MONITOR EVENT file It appears that this file is ordered by date and could therefore be specific to actions that have occurred in the past. ^HLEV(776.5 - HL7 MONITOR EVENTS PROFILE FILE ^HLEV(776.999 - HL7 MONITOR PARAMETERS FILE ^HLMA( - HL7 MESSAGE ADMINISTRATION FILE - This file is used to create and maintain unique message IDs. It also contains a date/time when each ID was created.
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^INRHD - INTERFACE DESTINATION - This file holds the information necessary to route a transaction to its appropriate location. For outgoing transaction either a Transceiver Routine or a Mail Recipient is defined. For incoming transactions a Transaction Type is defined. ^INXPORT Not a FileMan File structure. - IN GIS Package Exporter - BHL IHS Interfaces with GIS - this routine will take all components of a package and export to transport global ^INXPORT. This global will then get moved to the remote system and get imported into GIS. This will act as a replacement to the KIDS data install. ^LAHM(62.94 This file is used to store the messages that are sent or received by the Lab Messaging system. This file is populated by application routines and should not be edited by users.
Nodes
The nodes in ^BAR indicated below should be modified to reflect the appropriate information. ^BAR(90052.03,2,1,4,0)=" [enter organization description here]" ^BAR(90052.03,2,1,5,0)=" [enter division description here]" ^BAR(90052.03,2,1,6,0)=" [enter site here]" ^BAR(90052.03,2,1,7,0)=" [enter office here]" ^BAR(90052.03,2,1,19,0)=" [enter phone number here] We appreciate your cooperation." ^BAR(90052.03,2,1,24,0)=" [enter name here]" ^BAR(90052.03,6,1,1,0)=" [enter organization description here]" ^BAR(90052.03,6,1,2,0)=" [enter division description here]" ^BAR(90052.03,6,1,3,0)=" [enter site here]" ^BAR(90052.03,6,1,4,0)=" [enter office here]" ^BAR(90052.03,6,1,16,0)=" [enter phone number here]. We appreciate your cooperation." ^BAR(90052.03,6,1,21,0)=" [enter name here]" ^BAR(90052.03,10,1,15,0)=" ~W !?6,""DEPOSIT#: "",$G(BARSCHED)" ^BAR(90052.03,10,1,23,0)=" ~W !,""Transaction number:___________________________""" ^BAR(90052.03,11,1,13,0)=" ~W !?6,""DEPOSIT #: "",$G(BARSCHED)" ^BAR(90052.03,11,1,20,0)=" ~W !!,""Entry by:____________________________________ ^BAR(90052.03,13,1,13,0)=" ~W !?6,""DEPOSIT #: "",$G(BARSCHED)"
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Other Modifications
Security
The following Access and Verify Codes are pre-set for the database for the initial installation: User: ADAM,ADAM Access Code: ADAM.01 Verify Code: USER.001 User: MANAGER,SYSTEM Access Code: SYSTEM.01 Verify Code: USER.001
MailMan
The MailMan Domain Name must remain as IHS.GOV.
Other Modifications
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Appendix I. VueCentric
Medsphere VueCentric Copyright (c) 2004-2010 Medsphere Systems Corporation VueCentric is a framework designed to support providers across a variety of care settings. It is used in the EHR component of the RPMS system.
Licensing
VueCentric includes software developed by Medsphere, Copyright (C) 2004-2010 Medsphere Systems Corporation. VueCentric is open source, but different pieces of VueCentric use 3rd party licensing terms. The details of all the pieces are laid out below. Reference 1 Vendor MSC Usage Prod none Dev none Redistribution Binary none Source none License Terms Reference IHS contract # GS-35F0240R; Response to SOW and Addendums for license terms. Reference IHS contract # GS35F-0240R; Response to SOW and Addendums for license terms.
MSC
Binary none Source proprietary Binary none Source none Open Source Mozilla Public License 1.1.
see http://sourceforge.net/projects/jcl see http://www.borland.com
Appendix I. VueCentric
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Reference 6
Binary none Source n/a Binary none Source proprietary Binary none Source proprietary Binary none Source proprietary Binary none Source proprietary Binary none Source proprietary Binary none Source none
n/a
see http://www.lyoung.com
Raize Software
see http://www.raize.com
10
see http://www.powertcp.com
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12
ComponentOne
see http://www.componentone.com
13
FreeVBcode.co m
14
n/a
Appendix I. VueCentric
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Reference 15
16
Dev License
Source proprietary
Collaboration
VueCentric will be part of larger open source projects. Aspects of the design, requirements definition, development, and testing may be done in the community. Medsphere.org will be the central location for this collaborative development process.
Appendix I. VueCentric
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Contact Information
If you have any questions or comments regarding this distribution, please contact the OIT Help Desk (IHS).
Phone: (505) 248-4371 or (888) 830-7280 (toll free) Fax: Web: (505) 248-4363 http://www.ihs.gov/GeneralWeb/HelpCenter/Helpdesk/index.cfm
Email: [email protected]
Contact Information
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