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Duplicate Record Merge: Patient Merge User Manual

1. TA LISTED ACROSS THE TERNAL ENTRY NUMBER H jali TE OF BIRTH IAL SECURITY NUMBE ERVICE CONNECTED Y N XXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXX X XXXXXXXX XXXXXXXXX X 100004 ERGEPATIENT 32 100007 ERGEPATIENT 33 100009 ERGEPATIENT THREE 100010 ERGEPATIENT 34 Figure 8 5 Patient records with missing SSNs Each of the patients lists that you generate can be used to identify specific patient records with errors You can then access these records to update them by correcting incorrect entries or adding entries that don t already exist Preliminary Scan of File for Errors Before you begin the process of searching the PATIENT file 2 you might consider running the option Preliminary Scan of File for Errors to identify errors in patient records This option is located on the Manager Utilities menu It scans through the file checking for records that have missing identifiers which are presumed to be significant data elements or checking for records that have other anomalies Although it is not mandatory to the process of merging records the results from this preliminary scan of File 2 might indicate that some maintenance work needs to be conducted on your files before you begin the search for potential duplicate records Based on this computer generated list
2. Select Utilities Option tsf lt RET gt Tally STATUS and MERGE STATUS Fields Duplicate records that are ready to be merged are displayed on the tally report in the figure below They are defined in the MERGE STATUS field as READY These records will be merged in the next merge process When you set up a merge process the number of patient records that are shown as READY to be merged on this report is the exact number of records that will be merged 6 8 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process This report will tally the Status and Merge Status fields for all entries in the Duplicate record file for the file that you select Tally duplicate entries for which file PATIENT SAN FRANCISCO NOV 13 1997 TALLY OF DUPLICATE RE DS STATUS ME E STATUS FIELDS E PATI Total Number of Duplicate Records for File PAT STATUS field ERIFIE NOT A DUPL OTENTIAL DUPLICATE V P REQUIRES RESOLUTIO V V ERIFIED DUPLICATE ERIFICATION IN PROC E STATUS field DY N R M I Figure 6 4 Using the tally report to view an up to date summary of the current merge process The sum total of records reported in the STATUS field should equal the total number of duplicate records
3. DEVICE Right Margin 80 April 1998 Duplicate Record Merge Patient Merge User Manual Appendix A 7 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Appendix A Display the Report on the Terminal Screen Display is the word used to indicate data printed to a terminal screen rather than on paper At the DEVICE prompt if you want to view a report on your screen press the Return key Normally if you do not specify a device number the information prints on your screen After the screen fills with the first page of the report you are prompted to press the Return key to continue with the next screen of data The process is repeated at the bottom of every screen You can exit the option at any time by entering an up arrow as shown below Press lt RET gt to continue or to quit Spool Print a Report to the Printer To spool your report to a designated printer enter the name of the printer at the device prompt show below DEVICE HOME Enter the printer name NOTE You can display a list of your available printers by entering two questions marks at the device prompt Queue Report to a Printer If you want to queue your output to run in the background type the letter Q at the DEVICE prompt Next you are prompted to enter a device number of the printer you want to use Finally enter the date and time you would like the report to print as shown below DEVICE HOME Enter
4. Figure 1 8 Manager Utilities menu Security Keys Three security keys are involved with the Patient Merge release Their purpose is to set a layer of protection on the range of available computing capabilities Two of which i e XDR and XDRMGR are used in the Duplicate Resolution System menu The accessibility of this menu is based on the level of system access granted to each user These security keys are described below 1 The XDR security key authorizes access to the Duplicate Resolution System menu on the Application Utilities menu 2 The XDRMGR security key is required in order to access the Manager Utilities menu This key should be given to IRM personnel responsible for managerial control over the file being searched for duplicate record pairs and the subsequent merge process The XDRMGR security key also authorizes the holder to add a pair of records directly into the DUPLICATE RECORD file 15 through the option Add Verified Duplicate Pair bypassing the Potential Duplicate Threshold Percentage NOTE Care should be used in granting the XDRMGR security key since other options that impact system resources e g Schedule Process to Merge Verified Duplicates are controlled by it 3 Although distributed by another package the person initiating the merge process must be authorized to hold the DG ELIGIBILITY security key The DG ELIGIBILITY security key although not required to select and run the option Identify Potenti
5. Duplicate Record File Entry 948 for the PATIENT FIL 1212 MERGEPATIENT 10 J M 888 MERGEPATIENT 10 JOHN MARK Currently listed as VERIFIED DUPLICATI Do you really want to RES POTENTIAL DUPLICATE NO YES Status RESET to POTENTIA iICATE RECORD Figure 7 10 Edit the Status Field of a Duplicate Record E NOTE Once a record has been merged the status cannot be reset Find Potential Duplicates for an Entry in a File NOTE As of Patch XT 7 3 113 users can no longer select PATIENT records from this option Finding potential duplicates will be done by PSIM The option Find Potential Duplicates for an Entry in a File is located on the Utilities menu It is used to search for potential duplicates against a single record from the file being searched The potential duplicate record pair s resulting from this search are automatically added to the DUPLICATE RECORD file 15 7 10 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities Duplicate Resolution Utilities Menu Add Verified Duplicate Pair Check rge Process Status Check Pair of Records to see if Duplicates Display Search Status Edit the Status Field of a Duplicate Record Find Potential Duplicates for an Entry in a File Identify Potential Merge Problems
6. gt O NOTE As referenced elsewhere in this manual several special processing routines have been written to handle those database entries that point to the PATIENT file 2 in an unusual manner See the section How Are Patient Records Merged in this manual for more information on special processing routines This portion of the merge process will not examine files that are involved in the special processing routines If however data errors are encountered during special processing they are written to the XTMP XDRTESTK global in the merge process The information is not lost it s just not handled in advance of the merge See the topic Use of XTMP Global for more information Merging Multiple Record Pairs A single file entry may be involved in multiple potential duplicate pairs Thus a FROM or TO entry of a selected record pair may also be associated with the FROM or TO entry of other record pairs in the DUPLICATE RECORD file 15 Related Multiple Pairs Excluded from Current Merge Given any one record pair in the DUPLICATE RECORD file 15 if any subsequent record pairs have either member of the given pair as a component then the subsequent pair s will be excluded from the merge process Thus any record may be involved in only one merge in a given merge process This does not imply that there are data errors in the record pairs being excluded Only that they are excluded from the current merge available for r
7. 6 14 three phases are Phase one The first phase of the merge process is the merging of verified duplicate records in the main or primary file i e PATIENT file 2 or any one of the special processing files In the case of Patient Merge the primary file is File 2 For example the special processing file ICR IMMUNOLOGY will only process through Phase 1 This is because this file is simply merging two duplicate record entries together After the merge completes the FROM record is deleted A stub record containing only the 01 field and a 9 node is then inserted in the PATIENT file 2 The 9 node has a value equal to the internal entry number of the TO entry If anyone tries to access the FROM entry while the merge is in progress or any time after that the expected value will be returned without an undefined error Additionally the Name and the Social Security Number fields originally contained in the FROM record are moved into the ALIAS subfile in the TO record Phase two The second phase includes the processing of all pointers to the main file which are DINUMed 01 fields or fields which can be accessed by cross references DINUMed and cross referenced pointers facilitate rapid identification As files containing DINUMed pointers to the main file are identified any pointers to these files are also identified and included in the processing Phase three The third phase is the processing of all other pointers including point
8. DUPLICATE RECORD MERGE PATIENT MERGE USER MANUAL Version 7 3 April 1998 Revised December 2010 Department of Veterans Affairs Office of Information and Technology Product Development Preface This is the User Manual for the Veterans Health Information Systems and Technology Architecture VISTA Duplicate Record Merge Patient Merge application It provides descriptive information about the VISTA Duplicate Record Merge Patient Merge application It is expected to serve as a source of information to Information Resource Management IRM staff responsible for installing and implementing it and Veterans Affairs Medical Center VAMC facility personnel responsible for its operation The Patient Merge component of Duplicate Record Merge will enhance the ability to associate appropriate data with a single patient identifier It provides the tools necessary to review patient records that have a high likelihood of being duplicates and merge verified duplicates April 1998 Duplicate Record Merge Patient Merge User Manual iii Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Revision History iv Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Revision History w em 11 2009 Final updates to documentation for release to Product Support PS Master Patient Index MPI development team Oakland CA OIFO Project Manager Danil
9. It is not intended as a source for restoration as the changing structure does not lend itself to making this process easy The name file number is MERGE IMAGES file 15 4 The global location is KDRM NOTE See the Patient Merge Technical Manual for more information on the structure of this global 4 2 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 5 Approve Verified Duplicates for Merging Before verified record pairs can be included in the next merge process they must be marked as approved Use the option Approve Verified Duplicates for Merging located in the Operations menu to give final approval The reviewer responsible for duplicate resolution performs this operation The next example shows you how to access the option Approve Verified Duplicates for Merging Duplicate Resolution Operations Menu APP Approve Verified Duplicates for Merging VPD Verify Potential Duplicates ADR Ancillary Data Review Select Operations Option app lt RET gt Approve Verified Duplicates for Merging Depending upon the number of entries verified the system could take several minutes to display the following list Entries are awaiting approval for merging Return to continue lt RET gt ERGEPATIENT 1 v 000 02 7082 121212 ERGEPATIENT 1 2 000 02 7082 6543 ERGEPATIENT 1 i 000 02 8495 123456 ERGEPATIENT 1 000 02 4895
10. Manager Account Mandatory Field Master Patient Index Austin Master Patient Index Patient Demographics April 1998 Revised December 2010 Glossary VistA software that functions as an intermediary between the host operating system and other VistA software applications so that VistA software can coexist in a standard operating system independent computing environment Kernel provides a standard and consistent user and programmer interface between software applications and the underlying M implementation The purpose of Security Keys is to set a layer of protection on the range of computing capabilities available with a particular software package The availability of options is based on the level of system access granted to each user A word or phrase used to call up several codes from the reference files in the LOCAL LOOK UP file One specific code may be called up by several different keywords Local Area Network A user s authorization to create a new entry when editing a computer file Learn As You GO allows you the ability to create new file entries To find an entry in a file using a value for one of its fields Massachusetts General Hospital Utility Multi Programming System M formerly named MUMPS is a software package which consists of a high level programming language and a built in database An entry in the MESSAGE file 3 9 The VistA electronic mail system MailMan supports local and remote networking
11. Print List of File Duplicates Scan Possible Duplicates Tally STATUS and MERGE STATUS fields View Duplicate Record Entries Select Utilities Option FIND lt RET gt Find Potential Duplicates for an Entry in a File Notice in the figure below that the user is prompted to enter the file to be searched then to select a record from that file This option will collect all Potential Duplicates for an entry in a file It will then add any pairs found to the Duplicate Record file Find Potential Duplicates for entry in what file PATIENT Find Potential Duplicates for PATIENT MERGEPATIENT 21 1 MERGEPATIENT 21 C 01 02 28 000021700 NSC VET MERGEPATIENT 21 J 12 31 42 000041687 YI SC VET MERGEPATIENT 21 M 10 11 24 000063234 YI SC VET MERGEPATIENT 21 MILTON 08 02 33 000006817 NO NSC VET CHOOSE 1 4 3 lt RET gt MERGEPATIENT 21 M 0 11 24 000063234 VETERAN 2 3 4 Hold On This may take a little while The following PATIENT entry ies are now in the Duplicate Record file as Potential Duplicates to PATIENT MERGEPATIENT 21 M MERGEPATIENT 22 M Figure 7 11 Finding duplicates for a single record A match found of one or more records from this query indicates that the record pair has met or exceeded the Potential Duplicate Threshold Percentage For exampl
12. April 1998 Revised December 2010 Glossary The host files of underlying operating systems may be treated like devices in that they may be written to e g for spooling Decentralized Hospital Computer Program now known as Veterans Health Information Systems and Technology Architecture VistA VistA software developed by VA is used to support clinical and administrative functions at VA Medical Centers nationwide It is written in M and via the Kernel runs on all major M implementations regardless of vendor VistA is composed of packages that undergo a verification process to ensure conformity with namespacing and other VistA standards and conventions Database of specifications of data and information processing resources VA FileMan s database of data dictionaries is stored in the FILE of files 1 A programmer call that is made when working in direct programmer mode A direct mode utility is entered at the MUMPS prompt e g gt D XUP Calls that are documented as direct mode utilities cannot be used in application software code A site for sending and receiving mail Symbol used in front of a Common option s menu text or synonym to select it from the Common menu For example the five character string TBOX selects the User s Toolbox Common option Patient Merge is a VistA application that provides an automated method to eliminate duplicate patient records within the VistA database 1e the VistA PATIENT file 2
13. Chapter 7 Utilities Select Utilities Option Print lt RET gt List of File Duplicates Select one of the following BRIEF CAPTIONED Choose type of list 2 lt RET gt CAPTIONED Select File you wish to list for PATIENT This utility provides reports on verified and unverified potential duplicates Select one of the following ERIFIED potential duplicates READY TO MERGE VERIFIED duplicates TO MERGE VERIFIED duplicates D VERIFIED duplicates t 1 lt RET gt UNV ED potential duplicates lt RET gt REMOTE LOGIN RIGHT MARGIN 80 lt RET gt E M ET ME THINK ABOUT THAT A MOMENT Figure 7 17 Print a list of unverified potential duplicate patient records in a Captioned format The next figure is an example of unverified potential duplicate patient records displayed in a Captioned format Unverified Potential Duplicates BP 27 1997 12345 RECORD2 M E ENT 27T ENTIAL DUPLICATE UNVERIFIED SEP 16 1997 W ED MER EATOR ON POSSIBLE SCORE 200 DC POTENTIAL DUPE THRESHOLD ATCH SCORE 137 DC DUPE MATCH PERCENTILE 69 SERVICE PRIMARY WHO DETERMINED MERGEDETERMI RMINED SEP 27 1997 09 29 16 IN FILE 2 ERWRITE
14. DRTESTK 2980303 162959 1 2Z DIERR 1 PARAM FIELD 01 DRTESTK 2980303 162959 1 Z2Z DIERR 1 PARAM FILE 2 001 DRTESTK 2980303 162959 1 2Z DIERR 1 TEXT 1 The value 345 for field MENT CLINIC in ENROLLMENT CLINIC SUB FIELD in file PATIENT is not Figure 6 8 XTMP XDRTESTK global provides a snapshot of unforeseen data errors Looking at the data shown in the previous figure the value of the zero node indicates that the data will be retained in the global for 30 days beginning with 3 4 98 through to 4 3 98 Data Error Group One The first data error reported shown in the previous figure begins with the following global node as its first line XTMP XDRTESTK 2980302 165841 1 XX 63 08 1 15950 01 OCT 21 1988 Broken down I The value 2980302 165841 indicates that an error was logged on 3 2 98 at 4 58 41 PM April 1998 Duplicate Record Merge Patient Merge User Manual 6 19 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process II The value 1 is the count number In this case the count is not significant other than for distinguishing errors recorded at the same time The count sequence will restart from 1 for both a New merge and a merge that has been restarted III The XX subscript indicates that the data which follow comes from the FDA ar
15. Figure 8 12 Completed BASIC search of the primary file for duplicate records Notice in the figure above that a search was started on May 01 1997 at 18 24 it was completed it took 27 hours and 23 minutes it searched through 66 527 records in the primary file it searched through 100 of the file and the search found 337 potential duplicate pairs When a search is started it may be monitored by the option Display Search Status from the Utilities menu NOTE The previous figure shows that the search took 27 hours and 23 minutes to run to completion However actual time for a search has been known to exceed 100 hours Be advised that searching the database for duplicate record pairs can take a long time to run to completion STOP an Active Merge Process Once a merge has been started you can stop it by using the option STOP an Active Merge Process located on the Manager s Utilities menu The merge process can also be stopped using the Task Manager option under the TBOX common menu option Only authorized persons holding the XDRMGR security key should be responsible for using this option April 1998 Duplicate Record Merge Patient Merge User Manual 8 13 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 8 Manager Utilities anager Utilities Menu EDT Edit Site Parameters IST ist File Entries Identified in Preliminary Scan SCN PRGM RES SCH SRCH STOP Preliminar
16. PATIENT MERGEPATIENT 21 MILTON lt RET gt 08 02 33 000005817 EVICE HOME lt RET gt REMOTE LOGIN RIGHT MARGIN 80 lt RET gt RD1 989898 ECORD2 878787 ENT 21 MILTON April 1998 Duplicate Record Merge Patient Merge User Manual 7 7 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities ENT 21 MILTON MALE E OF BIRT 10 11 24 08 02 33 MARITAL STAT DIVORCED MARRIE OCCUPATION N A MAINTENANCE RELIGIOUS PREFERENCE UNKNOWN NO PREFERE E PROTESTANT NO DENOMINATION A ETURN to continue or to exit POSSIBLE POSSIBLE LICATE LICATE Figure 7 8 Comparing two records to see if they are duplicates From the results of this comparison the two records in the previous figure appear not to be duplicates The DUPLICATE SCORE for them is only 30 which has not met or exceeded the Potential Duplicate Threshold default of 60 Once again this option does not add records to the DUPLICATE RECORD file 15 and the records being compared do not have to be in the DUPLICATE RECORD file 15 Display Search Status The option Display Search Status is located on the Utilities menu You can use this option to display the status of potential duplicates f
17. PN This component contains progress notes from the Generic Progress Notes Package AND progress notes from the Mental Health Package Time and maximum occurrence limits apply to this component Data presented include Progress note date time written title text of note electronic signature block including possible cosignature and cosigner comments and the note s correction text and correction date time Only those notes which have been signed with an electronic signature or for generic progress notes electronically marked signed on chart will be reported Component Name Brief Progress Notes Abbreviation BPN This component contains information from the Mental Health and Generic Progress Notes packages Time and maximum occurrence limits apply Data presented include Progress note date time title author and last correction date time Only those notes which have been signed with an electronic signature or for generic progress notes electronically marked signed on chart will be listed April 1998 Duplicate Record Merge Patient Merge User Manual Appendix C 15 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Appendix C Package Radiology Component Name Radiology Impression Abbreviation RI This component contains impressions from the Radiology Nuclear Medicine package Time and maximum occurrence limits apply Data presented include study date procedure s status diagnostic text and radiologist s or nuclea
18. PROGRESS EMOTE EGRETO HC W EALTH SUMMARY RAY Select Health Summary Type Name SAMPLE HEALTH SUMMARY Would you like to use the FM Browser to view the record pair YES lt RET gt one moment Getting first entry lt Health Summary loads here gt Your selected Health Summary for record one is loaded here one moment Getting second entry lt Health Summary loads here gt Your selected Health Summary for record two is loaded here Figure 3 7 Verifying duplicate records using selected Health Summaries You have the option of sending your selected Health Summary to the VA FileMan browser or to any device found in your local DEVICE file 3 5 The bottom of the previous figure shows you how to invoke the Browser to view your Health Summary reports Respond Yes to the prompt Would you like to use the FM Browser to view the record pair YES The next topic section shows an example of a April 1998 Duplicate Record Merge Patient Merge User Manual 3 11 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Primary Review Health Summary report for potential duplicate records as they would appear viewed through the Browser The next figure shows you how to send your selected Health Summary to a device Do this by res
19. Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 1 Site Configuration This mail group must be an entry in the MAIL GROUP file 3 8 and should contain at least one active member Sites are required to supply their own mail groups DUPLICATE MANAGER MAIL GROUP The mail group entered in this parameter will be sent an email when a pair of potential duplicate patients is added to the DUPLICATE RECORD file 15 by PSIM and will be sent a bulletin whenever any known problems occur during the duplicate checking or merging process This mail group must be an entry in the MAIL GROUP file 3 8 Sites are required to supply their own mail groups POTENTIAL DUPLICATE THRESHOLD This field contains a computed percentage based on the values defined in the duplicate tests When record pair scores evaluate equal to or above this percentage they are considered to be potential duplicates Record pairs may differ on the maximum score to which the percentage threshold is applied The default potential duplicate threshold with this application release is 60 NOTE As of Patch XT 7 3 113 the data in the POTENTIAL DUPLICATE THRESHOLD field will no longer be used for searching the PATIENT file 2 DAYS BEFORE FINAL VERIFY This is the number of days within which ancillary reviewers are expected to conduct their reviews All reviews must be resolved prior to merging the affected record pair If action is still pending by any
20. Select some file other than the PATIENT file Do you want to bypass the potential duplicate threshold check Y N y lt RET gt Yes This will add the pair of records directly into the Duplicate Record file Are you sure you want to continue NO y lt RET gt Yes Figure 7 5 Authorized personnel holding the XDRMGR security key can add records directly into the DUPLICATE RECORD file 15 bypassing the duplicate threshold 7 4 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities NOTE You cannot select the same patient as a pair to be added to File 15 if that record pair already exists in the file Check Merge Process Status The option Check Merge Process Status is located on the Utilities menu It indicates the status of all merge processes displaying the information provided by the last checkpoint during its operation This information includes the file that is being processed which stage it is in and the last internal entry processed This option is explained in greater detail in the Merge Process section of this manual Duplicate Resolution Utilities Menu Add Verified Duplicate Pair Check Merge Process Status Check Pair of Records to see if Duplicates Display Search Status Edit the Status Field of a Duplicate Record Find Potential Duplicates for an Entry in a File Identify Potential Merge Prob
21. These people must be authorized to hold the XDR security key to access these menus The Manager Utilities menu is restricted to those personnel authorized to hold the XDRMGR security key Operations Menu This menu contains options for approving duplicate records for merging and for verifying actual duplicate record pairs The next figure shows you the available options under this menu They are described in detail later in this manual April 1998 Duplicate Record Merge Patient Merge User Manual 1 15 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 1 Site Configuration Duplicate Resolution Operations Menu APP Approve Verified Duplicates for Merging VPD Verify Potential Duplicates ADR Ancillary Data Review Select Operations Option Figure 1 6 Operations menu Utilities Menu This menu is comprised of various utilities which are essential to the merge process They are designed to assist both reviewers and IRM personnel with supplementary duplicate record identification and provide a variety of status reports involved with the merge process The next figure shows you the available options under this menu They are described in detail later in this manual Duplicate Resolution Utilities Menu ADD Add Verified Duplicate Pair CMP Check rge Process Status CHCK Check Pair of Records to see if Duplicates DSS Display Search Status EDIT Edit the Status Field of a Duplicate Record FI
22. ccccsccccccececeeseseenseceeeceeeceesesecseceeeeeceseseeeseeaeeeeeesesesesaaaes 2 4 Searching the Database for Potential Duplicates 0 ccccsesseccceceeeeesesenscneceeeeeceeeesecneaeeeeeenenees 2 7 Start Halt Duplicate Search Option cccccesessccecececceeeesesecneceeeeeceeeesesseaeeeeeeeseeeensesneaeeseeeeene 2 8 Display Search Stats nii enan e enset e e ra oaa aE e haa bedava Gece adeet 2 11 Chapter 3 Review Process to Determine Duplicate Record Status esesssesesssesoscoesesessssee 3 1 Primary Revie W toara a Roar 22 20 hove bee wide oe bac ea O a a ani e aa a ara A 3 4 Begin the Venficaton Processninsennnen nnn an Nene Bal dete A ET Sean 3 4 Health Summary to View Duplicate Record Pair s cccccccccesessesseecceeececeeeesecseceeeeeeeeneeesaaas 3 10 VA FileMan Browser Evoked to View Health Summa ry c cccccccccecssssecececeeeeesesssseseeeeeees 3 12 Designate Primary Fields for OVerwiiting cccccceessececececceceeeesensececeeeeeeeseessaseeeeeeeeeseneeesaaaes 3 15 Determine Duplicate Record Status cccccccccceceesesensecneeeeeeeceseesesseeeeeeeeeeessessecseaeeeeeeseeesesaaaes 3 17 Select Merge Direc toni towers cdtvacatoes hades toveuretas eal bd os tava de cau la ees beds couse hemmed sacs E ASTEN 3 18 AmCila ry REVIC meore BOS eh ETSI EE EES SO NE OSE NEES I a ME CO 3 20 Alerts Sent to Ancillary Reviewers ccccecsessccececececeeeeesenneaeeeeeeeesseessaeeeeeeeeeeeeseesesaeaeeeeee
23. 1998 Duplicate Record Merge Patient Merge User Manual vii Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Revision History viii Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Contents REVISION HISO lt 3 22 922 se nome wsncace Meaes Levees E E based ates essay seek ae a doce sa a EOE ea v l BAD KAE A E N TEIA E A I A E E EN EA TAE AE AE xiii TE S E E A A A RR Gueeaee xvi Orientation Sos ois ne aaa ae a hau E E nga rege dade E a a e aia e a is xvii Chapter 1 Introduction siss ssiisceissssessrisseeeisroe ooien rorse tsere ieaie esso rossi ssos sieo rei ss osa esos tosses 1 1 Product Description e n re e na a Rise tie Sd oes techs aa E a aaa a o reams seems ese AP NES Ei 1 3 Quick Start Patient Merge Checkhstasrrasoronoai enia ia ea a aa ledan reaa oeta 1 5 Site Confouration oseere Ea a Ei OEE EEE A EE EEE A Er e aaeh 1 9 File Setup and Default Site Parameters cccccccccccesecsececeeeececeeeesseeeeeeeeeeessesseseeeeeeeesesseesaaaes 1 9 Menu SUUCHUITC ass cuvss esccstesduse e ireen a ieai ia aia a eE ia E aE eE i 1 15 SECU KEYS eieae eree r a e E a e aS 1 17 Chapter 2 Identifying Duplicate Records Searching the Patient File 2 0000000000000000 2 1 Preliminary Scan of the File to be Searched ceccceessecccececeeeeeeesenseceeeeeceeeesesneaeeeeeeeeeeesenesaaaes 2 1 Listing Patient Records with Errors
24. 3 125 Product Description Patient Merge provides an automated method to eliminate duplicate patient records within the VistA database It is an operational implementation of the Duplicate Resolution Utilities which were released to the field with Kernel Toolkit The overall process consists of three major subject areas the search for potential duplicate record pairs review verification and approval of those pairs and the merge process NOTE As of Patch XT 7 3 113 the PATIENT file 2 will no longer be selectable from the Search option described below Although users with access to the Duplicate Record Merge menus will still be allowed to add records to the DUPLICATE RECORD file 15 this file will mainly be populated automatically when Person Service Identity Management PSIM identifies patient pairs as matches or potential matches After patient pairs are added to the DUPLICATE RECORD file 15 the review verification approval and merge processes will continue to be performed as before The search and identification of potential duplicate records performs comparisons on key patient traits in the centralized Person Service Identify Management PSIM database The goal of PSIM is to provide an authoritative source for persons identity traits throughout the Veterans Health Administration VHA The Initiate Probabilistic Search Implementation in PSIM adds advanced search capabilities to improve the overall matching process dur
25. 3 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Appendix A Sometimes the question text includes within parentheses the different allowable responses that you can make to that question as shown below ARE YOU SURE Y N Default Prompt Sometimes the question the computer is asking you has a standard expected answer This is known as the default response In order to save you the trouble of typing the most probable answer the computer provides the answer followed with a double slash You either enter nothing also known as a null response by pressing the Return key to accept the default response as your answer or you can type a different response IS IT OKAY TO DELETE NO Invalid Response VistA software checks each answer immediately after it is entered Whenever the computer determines that an answer is invalid for any reason it beeps displays two spaces and two questions marks and repeats the question on a new line LAYGO LAYGO access is not allowed in the this Package However it is explained here to further promote your understanding of VistA VistA software checks your answers against an internally stored table of valid answers If your answer is not stored in this table but the Learn As You GO LAYGO mode is allowed the computer adds your response to this internal table If LAYGO mode is allowed an example dialogue displays something like this ARE YOU ADD
26. 4 SUBFILES FIELD NUMBERS 1 14 subfiles setting up 1 14 summary of duplicate records Produce up to date 6 7 7 19 system resources 6 19 Index 6 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 T Tally Report 6 2 6 7 7 19 8 9 Tally STATUS and MERGE STATUS fields 6 1 6 2 6 7 7 19 2 test data patient amp user names xvii Social Security Numbers xvii The Merge Process 6 1 6 14 three phases 1 4 time How to enter 4 top level duplicate record list viewing the 3 3 U Utilities menu 1 16 7 1 7 22 Check Merge Process Status 7 4 Check Pair of Records to see if Duplicates 7 6 Display Search Status 7 8 Edit the Status Field of a Duplicate Record 7 9 Find Potential Duplicates for an Entry in a File 7 10 Identify Potential Merge Problems 7 11 7 14 Print List of File Duplicates 7 14 7 17 Scan Possible Duplicates 7 17 Tally STATUS and MERGE STATUS fields 7 19 View Duplicate Record Entries 7 20 V VA FileMan browser send Health Summary to 3 8 verification process 3 3 3 1 3 21 Verify Potential Duplicates 1 7 3 1 3 16 1 2 View Duplicate Record Entries 2 View duplicate records 7 20 viewing the top level duplicate record list 3 3 VistA deleting answers using the at sign 5 entering dates and times 4 exiting 2 how it works 1 printing reports 6 prompt types 3 I
27. Ancillary Review section that follows Select one of the following ERIFIED DUPLICATE ERIFIED NOT A DUPLICATE E TO DETERMINE SUMMARY DATA AGAIN REVIEW OVERWRITES Select Action HEALTH S RY V lt RET gt V ED DUPLICATE Figure 3 15 Select a record pair as a Verified Duplicate If the primary reviewer determines that a record pair is not a duplicate the next step is to select the option Verified Not A Duplicate shown in the next figure Once this action has been taken ancillary reviewers are not notified regardless if the record pair contain ancillary data Processing for the record pair ends and these records will not be merged A remote procedure will run on the MPI system to record the patient pair in the MPI DO NOT LINK file 985 28 so that these patients will not be identified as potential duplicates in the future April 1998 Duplicate Record Merge Patient Merge User Manual 3 17 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Primary Review Select one of the following VERIFIED DUPLICATE VERIFIED NOT A DUPLICATE U E TO DETERMINE H R S EALTH SUMMARY DATA AGAIN REVIEW OVERWRITES Select Action HEALTH S RY VERIFIED NOT A DUPLICATE Figure 3 16 Select a record pair as Verified Not A D
28. Current Substance Abuse Problems and Psycho Social Assessment Package Surgery Component Name Surgery Reports Abbreviation SR Appendix C 16 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Appendix C This component contains information from the Surgery package Time and maximum occurrence limits apply Data presented include surgery date surgeon surgery report status pre operative diagnosis post operative diagnosis surgeon s dictation current procedural terminology operation code and text Only surgery reports that have been verified are reported Component Name Brief Surgery Rpts Abbreviation BSR This component contains surgery report statuses extracted from the Surgery package Time and maximum occurrence limits apply Data presented include surgery date surgical procedure and report status e g COMPLETE April 1998 Duplicate Record Merge Patient Merge User Manual Appendix C 17 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Index A Acronyms Web address 17 add duplicates bypassing duplicate threshold 7 4 Add Verified Duplicate Pair 1 7 7 1 1 ADPACs 1 9 alerts appear 3 18 disappear 3 18 sent to ancillary reviewers 1 8 setting up for individuals 1 14 3 alerts appear Why 3 18 alerts disappear Why 3 18 aliases check for system search for 3 5 Ancillary Data Review 3 17 3 18 3 19 2
29. DC TOTAL POSSIBLE SCORE DC POT PE THRESHOLD 60 DC DUPE MATCH SCORE 180 DC I F ENTILE 69 E OF BIRTH OF DEATH AIDEN NAM RATION DAT ER CS OS O SO ST J v uou gouugvgpygy g Figure 7 21 View individual test scores for each duplicate record pair 7 22 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 April 1998 Revised December 2010 Duplicate Record Merge Patient Merge User Manual Version 7 3 Kemel Toolkit Patch XT 7 3 125 Chapter 7 Utilities Chapter 8 Manager Utilities The following section describes the manager utility options available with the Patient Merge Application Only authorized IRM personnel holding the XDRMGR security key can use these utilities They are designed to assist IRM personnel with editing site parameters identifying duplicate records in the primary file merging verified duplicate records and purging files involved with the merge process that are specific to Patient Merge You can find the Manager Utilities menu on the Duplicate Resolution System Menu shown in the next figure Duplicate Resolution System Menu XDRO
30. Kernel Toolkit Patch XT 7 3 125 Appendix C apply to this component Data presented include Date range of admission through discharge length of stay LOS Principal diagnosis diagnosis for longest length of stay DXLS and secondary ICD discharge diagnoses NOTE This component provides discharge diagnoses coded in the MAS PTF file The occurrence limits are determined by the occurrence of admissions Component Name Discharges Abbreviation DC This component contains information extracted from the MAS package Time and occurrence limits apply to this component Data presented include date of discharge DXLS bedsection disposition type disposition place and outpatient treatment flag NOTE The occurrence limits are determined by the occurrence of admissions Component Name ICD Procedures Abbreviation PRC This component contains MAS coded procedures by admission extracted from the MAS package Time and occurrence limits apply to this component Data presented include procedure date procedure name and ICD 9CM procedure codes aD NOTE The occurrence limits are determined by the occurrence of admissions Component Name ICD Surgeries Abbreviation OPC This component contains MAS coded surgeries by admission extracted from the MAS package Time and occurrence limits apply to this component Data presented include surgery date procedure name and ICD 9CM procedure codes ED NOTE The occurrence limits ar
31. List File Entries Identified in Preliminary Scan 2 3 8 3 Manager Utilities menu 1 16 8 1 Preliminary Scan of File for Errors 2 1 8 5 Purge Merge Process File 8 7 Restart a Merge Process 8 8 Schedule Process to Merge Verified Duplicates 6 1 8 8 Start Halt Duplicate Search 8 10 Start Halt Duplicate Search no longer selectable for File 2 2 7 Stop an Active Merge Process 8 12 XDRTESTK 6 15 6 18 Z zero nodes list all from DUPLICATE RECORD file 7 18 2 list of potential duplicate record patients 3 4 list zero nodes of each record 7 17 missing entire record deleted 2 3 Index 8 Duplicate Record Merge Patient Merge User Manual Version 7 3 Kernel Toolkit Patch XT 7 3 125 April 1998 Revised December 2010
32. Local variable holding the user number that identifies the signed on user A local variable that holds the File Manager Access Code of the signed on user Enterprise Infrastructure Engineering Secret password that some users may need to establish in order to sign documents via the computer Pressing the return or enter key tells the computer to execute your instruction or command or to store the information you just entered VA FileMan record An internal entry number IEN the 001 field uniquely identifies an entry ina file Engineering Process Group EPG formerly known as Software Engineering Process Group SEPG A mechanism to capture system errors and record facts about the computing Duplicate Record Merge Patient Merge User Manual Glossary 5 Version 7 3 Kemel Toolkit Patch XT 7 3 125 Glossary EVS Extrinsic Function Facility Field File File Manager VA File Man Forced Queuing FORM FORUM Free Text GAL Global Variable Go Home Jump Healthe Vet VistA Glossary 6 context such as the local symbol table last global reference and routine in use Operating systems provide tools such as the ER utility The Kernel provides a generic error trapping mechanism with use of the ZTER global and XTER routines Errors can be trapped and when possible the user is returned to the menu system Enterprise VistA Support renamed to Product Support Extrinsic function is an expression that acc
33. MailMan Messages sent to Ancillary Reviewers The next example shows a MailMan message that has been generated by the primary review process Once the primary reviewer determines that a record pair is a verified duplicate if the records contain ancillary data MailMan messages are automatically sent to designated ancillary reviewers This process depends upon assigning ancillary reviewers as members of Patient Merge specific mail groups in the site configuration process The following is an example of a MailMan message sent to Pharmacy RIORITY HHttHE Subject Htt F From RMACY possible duplicates DOE MERGEPATIENT 10 JOHN ELP or to see all the other exciting things you can do essage 1 lt RET gt ACY possible duplicates ME ENT 10 J M AND MERGE ENT 10 JOHN MARK 6 27 Sep 96 09 42 4 Li ER Sender MERGESENDE F j IN basket FROM Record 0060969 MERGEPATIENT 10 J M 1212 INTO Record 0060996 MERGEPATIENT 10 JOHN MARK 888 Ancillary service name PHARMACY Select M E Action DELETE from IN basket Figure 3 20 Example of a MailMan message sent to ancillary reviewers Ancillary reviewers use information contained in MailMan messages to process record pairs using the Ancillary Data Review option Options are assigned in the site configuration process It first prompts you
34. MailMan message notification 2 ancillary file 6 12 ancillary review 3 17 3 22 3 17 3 22 alerts sent to ancillary reviewers 3 18 causes for appearance and disappearance of alerts 3 18 concurs with the primary review decision 3 16 designate ancillary fields for overwriting 3 20 Health Summary for ancillary service review 3 20 MailMan messages sent to ancillary reviewers 3 19 ancillary reviewers 1 3 3 1 setting up to receive automatic alerts 1 14 ANCILLARY SERVICE 1 14 ancillary services 1 3 3 1 Appendix A 1 7 Appendix B 1 3 Appendix C 1 16 Approve Verified Duplicates for Merging 1 8 5 1 5 2 1 asterisks 3 13 3 20 at sign use to delete answers 5 April 1998 Revised December 2010 B backup patient data 4 1 4 2 Health Summary 1 8 4 1 bars 3 13 Basic search 2 7 2 8 8 10 8 12 browser VA FileMan send Health Summary to 3 8 bypass duplicate threshold 7 4 C check for aliases system search for 3 5 Check Merge Process Status 6 1 7 4 1 Check Pair of Records to see if Duplicates 1 does not add records to File 15 7 6 users can no longer select PATIENT records 7 6 checkpoint process merge process active 6 11 cleaning up the records 2 1 8 5 comparison tests 1 3 component descriptions Health Summary 1 16 correcting incorrect entries 2 6 8 5 D data flow 3 12 3 20 dates How to enter 4 DAYS BEFORE FINAL VERIFY 1 11 DAYS BETWEEN VERIFY AND MERGE 1 12
35. PAIR This option will no longer be available for patients Find Potential Duplicates for an Entry in a File XDR FIND POTENTIAL DUPLICATES This option will no longer be available for patients Duplicate Record Merge Patient Merge User Manual Version 7 3 Kemel Toolkit Patch XT 7 3 125 e Lead Developer Tami Winn Technical Writer Susan Strack April 1998 Revised December 2010 Revision History e Updated Options Manager Utilities XDR MANAGER UTILITIES Purge Duplicate Record File XDR PURGE This option will no longer be available for patients Start Halt Duplicate Search XDR SEARCH ALL This option will no longer be available for patients ClearCase Requests CodeCRs that cover updates to this manual e MPI_CR1072 MPI_CodeCR1384 3 2 1 4 MPIF API to capture the VERIFIED NOT A DUPLICATE action MPI_CR1068 MPI_CodeCR1387 3 2 1 Duplicate record tools MPIL_CodeCR1436 3 2 1 2 KERNEL API to create POTENTIAL DUPLICATE UNVERIFIED pairs 12 2004 Implemented new conventions for displaying TEST data See Orientation Susan Strack section for details Oakland OIFO 04 1998 Initial release via PATCH XT 7 3 23 Susan Strack San Francisco ISC Joel Ivey San Francisco ISC Raul Mendoza San Francisco ISC Figure i Revision History Patch History For the current patch history related to this software please refer to the Patch Module i e Patch User Menu A1AE USER on FORUM April
36. Social Security Numbers April 1998 Duplicate Record Merge Patient Merge User Manual 8 3 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 8 Manager Utilities Select Manager Utilities Option LIST lt RET gt List File Entries Identified in Preliminary Scan Enter the number of the desired list to output 1 BAD SSN 2 ISSI 3 ISSI 4 ISSI 5 ISSI 6 ISSI 7 ISSI 8 ISSI 9 LO L1 L2 L3 L4 ISSI ISSI ISSI ISSI ISSI O ZERO AAAA AAAAQAAQQ List number Figure 8 3 List patient records with missing fields previously identified in preliminary scan The system displays the error list by missing fields and identifiers Choose the number corresponding to the list you want to view The list displayed next identifies the missing value s Missing Fields and Identifiers missing from patient records MISSING 1901 Missing Veteran Y N Figure 8 4 Missing field and identifier numbers with corresponding descriptions The default display is to your terminal but you can also print the list if you need to 8 4 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 8 Manager Utilities E NOTE See Appendix A on How to Print E lt RET gt RE E LOGIN lt RET gt LISTING OF E E ENT ER OR OTHER PROBLE ELECTED LISTING BAD SSN
37. TO record viewed through VA FileMan Browser 888 MERGEPATIENT 10 JOHN MARK 000 06 0996 ENTER lt PF1 gt S TO VIEW OTHER 05 01 97 17 58 kkeKKKKKK CONFIDENTIAL General Clinical Information SUMMARY PO 2 OS AAAK ARES ENT 10 JOHN MARK 000 06 0996 DOB 06 29 46 CH Chem amp Hematology max 10 occurrences continued ENTS AVAILABLE Refer to Interim Lab Report RXOP Outpatient Pharmacy Has Archived OP Prescriptions available available END CONFIDENTIAL General Clinical Information SUMMARY POI CELAKA RAK Col gt 1 lt PF1 gt H Help lt PF1 gt E Exit Line gt 10f51 Screen gt 3of3 Figure 3 11 Example of Health Summary merge TO record viewed through VA FileMan Browser continued 3 14 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Primary Review You can split the screen by entering PF2 and S Realize however that the screen becomes very narrow when split Splitting the screen allows you to look at two different sets of data on the same screen at the same time Enter PF1 and E or PF1 and Q to exit the split screen NOTE For more information on how to use the VA FileMan Browser see the VA FileMan User Manual Designate Primary Fields for Overwriting Should the primary reviewer determine that a particular record pair is a d
38. Using the Global Map format of this option generates an output which lists all cross references for the file selected global location of each field in the file input templates print templates and sort templates Inquire to Option File This Menu Manager option provides the following information about a specified option s option name menu text option description type of option and lock if any In addition all items on the menu are listed for each menu option Responding to Prompts When the computer prompts you with a question typically a colon follows the menu text Several types of prompts may be used including yes no select and default Prompts can be a field in a file like the basic prompt shown below DATE OF BIRTH This type of prompt is waiting for you to enter a value like March 3 1960 Don t forget to complete your interaction by pressing the Return or Enter key Select Prompt If the answer to the prompt is a choice of several alternatives the question can appear prefixed with the word Select as below Select PATIENT NAME This is referred to in the manual as the Select Prompt Yes No Prompt If the question requires either a Yes or No response in which case you can enter a Y or N upper or lower case is acceptable the question can be followed by a question mark rather than a colon shown below ARE YOU SURE April 1998 Duplicate Record Merge Patient Merge User Manual Appendix A
39. a more extensive description and or a list of choices appropriate to the prompt At the top level menu prompt two question marks will show the Common Menu available to all users as well as any Secondary Menu options for the current user Locked options are displayed if the user holds the key Three question marks displays descriptions of the options from the OPTION file 19 Four question marks displays a help frame if one has been associated with this option in the OPTION file 19 A question mark followed by the name of an option on the current menu will display a help frame if one has been named for that option in the OPTION file 19 Appendix A 2 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 AppendixA List File Attributes This FileMan option allows the user to generate documentation pertaining to files and file structure Utilization of this option via the Standard format will yield the following data dictionary information for a specified file s file name and description identifiers cross references files pointed to by the file specified files which point to the file specified input templates print templates and sort templates In addition the following applicable data is supplied for each field in the file field name number title global location description help prompt cross reference s input transform date last edited and notes
40. abnormal borderline ci NOTE This component is a summary of procedure statuses Package Mental Health Component Name MH Physical Exam Appendix C 6 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Appendix C Abbreviation MHPE The Mental Health Physical Exam component contains the results of the physical examination concerning patient s overall condition associated with the systems identified This data is being extracted from the Medical Record 90 file Package Nursing Component Name Vital Signs Abbreviation VS This component contains vital measurements extracted from the Vital Signs module of the Nursing package Time and maximum occurrence limits apply Data presented include measurement date time blood pressure as SBP DBP pulse temperature height weight and respiratory rate Component Name Vital Signs Selected Abbreviation SVS This component contains selected vital measurements extracted from the Vital Signs module of the Nursing package Time and maximum occurrence limits apply and the user is allowed to select any of the vital measurement types defined in the Vital Type file e g pulse blood pressure temperature height weight and respiration rate Data presented include measurement date time measurement type and measurement value a NOTE Formatted display is horizontal Package Order Entry Results Report
41. ancillary reviewers after this period the site may take alternative action to e notify designated persons via a mail group e establish an additional reviewer e otherwise to resolve the review This would only apply if verification of a potential duplicate pair were not completed before the site configurable time runs out The number of days entered in this field should be between zero and 30 This application is exported with the default value set to five days DAYS BETWEEN VERIFY AND MERGE This is the number of days to elapse between final verification of a duplicate pair and the earliest possible merge date i e the date records are approved to be merged This parameter is available for sites that may be concerned about possible on going actions related to entries that will be merged and want to establish a period of inactivity prior to the actual merge The value of this field is set by IRM The number of days entered in this field should be between zero and 30 The default with this application release is five days NUMBER OF THREADS This field is used to help manage the most time consuming portion of the merge process It is used to indicate the number of threads that should be used during the longest phase of the merge process Phase 3 is the longest phase of the merge process It is described in more detail in the Merge Process section of this manual Your site can set the number of threads jobs according to your system resou
42. arrows at the menu s select prompt It resembles the rubber band jump but without an option specification after the up arrows The next generation of VistA HealtheVet VistA will retain all of the capabilities of legacy VistA but will provide enhanced flexibility for future health care and Duplicate Record Merge Patient Merge User Manual Version 7 3 Kemel Toolkit Patch XT 7 3 125 April 1998 Revised December 2010 Help Frames Help Processor Help Prompt HL7 Host File Server HFS ICN ICN VPID Identity Hub IMDQ New name Healthcare Identity Management HC IdM IMDQ Toolkit April 1998 Revised December 2010 Glossary compliance with the One VA Enterprise Architecture It will allow seamless data sharing between all parts of VA to benefit veterans and their families Entries in the HELP FRAME file that may be distributed with application packages to provide online documentation Frames may be linked with other related frames to form a nested structure A Kernel module that provides a system for creating and displaying online documentation It is integrated within the menu system so that help frames associated with options can be displayed with a standard query at the menu s select prompt The brief help that is available at the field level when entering one or more question marks National standard for electronic data exchange messaging protocol A procedure available on layered systems where
43. available Component Name Brief Lab Orders Abbreviation BLO This component contains information extracted from the Lab package Time and maximum occurrence limits apply Data presented include collection date time lab test name specimen urgency and order status e g ORDERED COLLECTED PROCESSING COMPLETE Component Name Surgical Pathology Abbreviation SP This component contains information extracted from the Surgical Pathology module of the Lab package Time and maximum occurrence limits apply Data presented include collection date time accession number specimen gross description microscopic description brief clinical history supplementary report description frozen section and surgical path diagnosis Component Name Lab Tests Selected Abbreviation SLT This component contains information extracted from the Lab package Not only do time and maximum occurrence limits apply to this component but also the user is allowed to select any number of atomic Lab tests Data includes collection date time specimen test name result units and reference range Comments will also be conditionally displayed depending on the value of the DISPLAY COMMENTS ON LABS Health Summary Site Parameter Results which include comments will be indicated with the symbol in the event that the parameter is set to 0 or NO April 1998 Duplicate Record Merge Patient Merge User Manual Appendix C 5 Revised December 2010 Version 7 3 Kernel Tool
44. corresponding fields in Record 1 the merged FROM record April 1998 Duplicate Record Merge Patient Merge User Manual 3 9 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Primary Review Health Summary to View Duplicate Record Pair s Additional patient data can be examined by viewing selected Health Summary reports prior to verifying the duplicate record status To view a Heath Summary select the Health Summary option shown in the next figure NOTE The list of Health Summary reports referenced in the next figure are for the purposes of this example only Your site has the option to choose available Health Summaries for use in this application 3 10 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Primary Review Select one of the following ERIFIED DUPLICAT ERIFIED NOT A DUPLICAT E TO DETERMINE EALTH SUMMARY DATA AGAI EL REVIEW OV Select Action HEALTH S RY lt RET gt Select Health Summary Type Name Answer with HEALTH SUMMARY TYPE NAME or TITLE or OWNER LOCATION S USING THE SUMMARY Do you want the entire 15 Entry HEALTH SUMMARY TYPE List Y lt RET gt Yes Choose from BRIEF CLINICAL PLE HEALTH SUMMARY PATIENT PATIENT ALVAMC lt List of Health Summaries DICINE SUMMARY DTEST RSE PATTI TPATII POLLARD
45. deleting answers using the at sign 5 device type send Health Summary to 3 9 DG ELIGIBILITY security key 1 17 DG ELIGIBILITY security key needed to initiate the merge process 6 1 provide valid error checking results when using the option Identify Potential Merge Problems 7 12 DINUMed 01 fields 6 13 DINUMed pointers 6 13 Duplicate Record Merge Patient Merge User Manual Index 1 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Index display list of potential duplicates 3 3 DISPLAY NAMES FOR SUBFILES 1 14 Display Search Status 2 8 2 10 7 8 1 DUPLICATE MANAGER MAIL GROUP setting up 1 11 DUPLICATE RECORD file 15 3 1 7 1 7 6 add duplicates bypassing duplicate threshold 7 4 add potential duplicate record pairs 7 1 7 2 1 display list of potential duplicates 3 3 edit duplicate record status 7 9 1 list ALL zero nodes 7 18 2 list Status and Merge Status fields 6 7 7 19 2 potential duplicate status 3 15 potential duplicates automatically added 1 3 1 7 2 1 2 6 7 10 1 3 print list of file duplicates 7 14 print selected duplicates brief format 7 16 unable to determine duplicate status 3 7 3 15 DUPLICATE RECORD file 15 print selected duplicates captioned format 7 16 duplicate record Merge Status READY to merge 1 8 duplicate record summary Produce up to date 6 7 7 19 duplicate records potential marked as not duplicates 3 15 removed from consideration 3 15 DUPLICATE RESOLUTION file 1
46. error Entries may actually incorporate correct data but may be considered errors due to data in other related fields Therefore sometimes the entries in XTMP XDRTESTK are only indicators of errors elsewhere in the record A date is associated with the XDRTESTK entry that allows for purging of the entries 30 days following the date of the most recent merge process Here are some examples of errors that may be logged e Subfiles which are missing data in fields that have been indicated as identifiers e Period of service incorrect because veteran does not have a DATE OF BIRTH entered This logs an error for Period of service However the actual error is due to the lack of information in the DATE OF BIRTH field e The length of a value in a free text field is longer or shorter than allowable e NM node content doesn t match that in the parent file or subfile Some subfiles may have changed names over time The UPDATE DIE call checks that the field name indicated by the NM node in the subfile Data Dictionary matches that in the parent file or subfile The NM node is the VA FileMan convention for the name of a file or subfile Unfortunately if there are multiple NM nodes it only checks the first entry If this does not match the current name the data entry is rejected The following information is displayed related to the error that occurred date and time file or sub file being processed IENS field being proces
47. for person PATIENT 2 and NEW PERSON 200 files It is the authoritative data store within VHA for cross cutting person administrative information The Administrative Data Repository contains identification and cross cutting demographics data as well as other administrative information Brief online notices that are issued to users as they complete a cycle through the menu system Alerts are designed to provide interactive notification of pending computing activities such as the need to reorder supplies or review a patient s clinical test results Along with the alert message is an indication that the View Alerts common option should be chosen to take further action This can be a single person or group of people given the responsibility to conduct reviews of potential duplicate record pairs with data in files other than the PATIENT file 2 For example selected personnel in Laboratory Radiology and Pharmacy American National Standards Institute The M formerly known as MUMPS programming language is a standard recognized by the American National Standard Institute ANSI M stands for Massachusetts Utility Multi programming System Program calls provided for use by application programmers APIs allow programmers to carry out standard computing activities without needing to duplicate utilities in their own software APIs also further DBA goals of system integration by channeling activities such as adding new users through a limi
48. is based on the level of system access granted to each user Duplicate Record Merge Patient Merge User Manual Version 7 3 Kemel Toolkit Patch XT 7 3 125 April 1998 Revised December 2010 Site Manger IRM Chief Software Package Space bar Return Special Queuing Subscriber Subscript Supported Reference Integration Agreement Synonym Task Manager TCP IP April 1998 Revised December 2010 Glossary At each site the individual who is responsible for managing computer systems installing and maintaining new modules and serving as a liaison to the CIO Field Offices The set of programs files documentation help prompts and installation procedures required for a given application e g Laboratory Pharmacy and PIMS A VistA software environment is composed of elements specified via the PACKAGE file 9 4 Elements include files associated templates namespaced routines and namespaced file entries from the OPTION HELP FRAME BULLETIN and FUNCTION files As public domain software VistA software can be requested through the Freedom of Information Act FOIA You can answer a VA FileMan prompt by pressing the spacebar and then the Return key This indicates to VA FileMan that you would like the last response you were working on at that prompt recalled Option attribute indicating that Task Manager should automatically run the option whenever the system reboots A subscriber is an entity which receive
49. merge process 6 8 Figure 6 4 Using the tally report to view an up to date summary of the current merge process 6 9 Figure 6 5 Status report of Merge processes cceesessesececececeeseeseneeeeeeeeeeeseeessaeeeeeeeeesesesestaeeeeeees 6 11 Figure 6 6 Status report of merge processes NO PAIRS LEFT uo eee cescsceceeeeeeseeeennnaneeeeees 6 15 Figure 6 7 Stopping an active merge process sesavacccsssscsavnerdcevveenacduastaacscsssndecceorsdcatansdaedsendcoerseaaccceaes 6 15 Figure 7 1 Utilities TSA coaisarohalibuvacicidgaenssietian axdsnencehdpennthnedweashaciiesta toa ccseueboesonientacetadtoncsebeasaeeddueete 7 1 Figure 7 2 Add records to the DUPLICATE RECORD file 15 that ARE duplicates 06 7 3 Figure 7 5 Authorized personnel holding the XDRMGR security key can add records directly into the DUPLICATE RECORD file 15 bypassing the duplicate threshold ccceceesscteeeeeeeeeees 7 4 Figure 7 6 Display the status of all merge jobs including the current Job ccececccceseceeeeseessrteeeeeees 7 6 xiv Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Figures amp Tables Figure 7 7 Status report of merge processes NO PAIRS LEFT eeccecceceeseceeeeeeeeneeeeeeeneeeeeeaes 7 6 Figure 7 8 Comparing two records to see if they are duplicates cceeessececeeseeeeeceeeeeeeeeeee
50. of messages VistA software that provides a mechanism for handling electronic communication whether it s user oriented mail messages automatic firing of bulletins or initiation of server handled data transmissions UCI that can be referenced by non manager accounts such as production accounts Like a library the MGR UCI holds percent routines and globals e g ZOSF for shared use by other UCIs Field that requires a value A null response is not valid The MPI is a separate computer system located at the Austin Information Technology Center It maintains a record for VA patients and stores data such as a unique patient identifier and Treating Facility lists which tracks the sites where that ICN is known The Master Patient Index Patient Demographics MPI PD software resides in VistA enabling sites to Duplicate Record Merge Patient Merge User Manual Glossary 9 Version 7 3 Kemel Toolkit Patch XT 7 3 125 Glossary MPI PD VistA Menu System Menu Template Menu Text Menu Trees MPI Austin MPI PD Glossary 10 e Request an ICN assignment e Resolve a potential duplicate on the MPI e Review and process exceptions received from MPI including Primary View Reject exceptions e Query the MPI Austin for known data e Update the MPI when changes occur to demographic fields stored on the MPI or of interest to other facilities systems of interest The overall Menu Manager logic as it functions within th
51. pare Belg tig Mbp Man BIOWSET Output can be queued to the VA FileMan Browser or to a printer Table B 1 Duplicate Record Merge Patient Merge FAQ Reviewers and IRM personnel Appendix B 2 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Appendix B Patient Merge FAQ Staff Authorized to Hold the XDRMGR Security Key The following table presents the menu structure in a question and answer format i e Where Do I Find How To The left hand column is sorted alphabetically by the question being asked The related menu options or answers are provided in the right hand column Only those persons authorized to hold the XDRMGR security key should be responsible for using these options Assign reviewers to mail groups Edit Site Parameters Ancillary Service Information Assign reviewers to receive alerts Edit Site Parameters Ancillary Service Information Check for errors in the selected file being Preliminary Scan of File for Errors searched Check for errors in the selected file being Preliminary Scan of File for Errors searched Generate a list of patient records with missing List File Entries Identified in Preliminary Scan zero nodes missing identifiers with bad SSN values or with invalid fields Merge verified duplicate record pairs Schedule Process to Merge Verified Duplicates Print reports List File Entries Identified in Prelimina
52. repeat information you ve entered the first time by entering a space and pressing the Return or Enter key For example you might do a series of procedures for one patient Each time after the first you are asked for the patient name you can enter a space and press the Return key the computer enters the same patient Printing Reports Frequently when you ve finished some data entry you are asked if you wish to print the record file or report You can display the report on your terminal screen or produce a paper copy You are prompted to enter a device number of the printer you want to use If you do not know the printer s device number you can enter a question mark for a list of printers In some cases the device you will use has already been decided for you and you are not asked where you want to print If you need assistance in determining the device number ask your application coordinator or site manager Right Margin Sometimes you are asked to specify the right margin of the report You are not asked this in all cases as the information might be preset for the device you specify and a default answer provided Nevertheless your choices are simple Generally 80 is used for standard size paper or for displaying on the terminal screen 132 is used for wider paper as shown below Appendix A 6 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 AppendixA
53. see if Duplicates Display Search Status Edit the Status Field of a Duplicate Record Find Potential Duplicates for an Entry in a File Identify Potential Merge Problems Print List of File Duplicates Scan Possible Duplicates Tally STATUS and MERGE STATUS fields View Duplicate Record Entries t Utilities Option VIEW lt RET gt View Duplicate Record Entries The next figure shows a list of individual test scores for each duplicate record pair April 1998 Duplicate Record Merge Patient Merge User Manual 7 21 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities Select a POTENTIAL DUPLICATE ENTRY MERGEPATIENT 31 ERGEPATIENT 31 E 11 08 25 000089558 NO ERGEPATIENT 31 EVERETT 01 09 20 000060592 Y ERGEPATIENT 31 01 21 40 000043969 Y ERGEPATIENT 31 RAYMOND 12 01 32 000046757 NO ERGEPATIENT 31NY L 04 22 66 000087578 NO NSC V TO STOP OR 1 lt RET gt MERGEPATIENT 31 11 08 25 000089558 OK Yes lt RET gt Yes ENT 31 POTENTIAL DUPLICAT ERIFI EVICE E LOGIN RIGHT MARGIN 80 lt RET gt UPLICAT EP 27 1997 ECORD2 M STATUS POT PLICAT ERIFIED DATE FOUND AUG 11 1997 WHO MERG EATOR TWO
54. subsequent processing need not occur or that they are unable to determine the status Where appropriate reviewers may mark data to be overwritten Those record pairs that are determined to be verified duplicates are marked as such and are then available for approving to be merged April 1998 Duplicate Record Merge Patient Merge User Manual 1 3 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 1 Product Description The intent of the approval step is to ensure that a conscious decision will be made in taking verified duplicate record pairs and making them available for a merge process All verified record pairs or selected pairs can be approved The approval step follows a site defined waiting period Reviewers are responsible for approving verified duplicates The merge process is available for initiation by IRM personnel All approved record pairs are included ina merge process when scheduled The merge process is a lengthy process that is recommended for off peak hours Utilities are available for pausing and restarting the merge process The merge process merges verified duplicate records in the following order first files that require special handling then the primary file then the resolution of pointers The resolution of pointers for the primary file or any of those involving special processing involves three phases The first two phases permit identification of entries requiring modification based on their
55. supplementary report description brief clinical history and EM Diagnosis Component Name Microbiology Abbreviation MIC Appendix C 4 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Appendix C This component contains information extracted from the Microbiology module of the Lab Package Time and maximum occurrence limits apply Data include collection date time collection sample site specimen specimen comment tests urine screen sputum screen sterility control sterility results comments for reports smear prep acid fast stain Parasite Report organism s Mycology Report Bacteriology Report Mycobacteriology Report Gram Stain Result Culture and Susceptibility Antibiotic Serum Level and remarks Component Name Brief Microbiology Abbreviation BMIC This component contains information extracted from the Lab package Time and maximum occurrence limits apply to this component in addition to collection date time test names specimen report status Culture and Susceptibility Smear Prep Acid Fast Stain Antibiotic Serum Level and test results Component Name Lab Orders Abbreviation LO This component contains information extracted from the Lab package Time and maximum occurrence limits apply Data presented include collection date either actual or expected lab test provider accession date time ordered specimen and date time results
56. the ancillary service Alerts can also be sent to individuals separately by designating one or more reviewer in the INDIVIDUAL FOR ALERTS field Sites are required to supply their own mail groups INDIVIDUAL FOR ALERTS Optional Enter one or more ancillary reviewer Once potential duplicate record pairs are established from the search populated into File 15 and reviewed by the primary reviewers alerts are automatically sent to these designated individuals if data is present for both entries in the potential duplicate pair in the file specified as the primary file for the ancillary service Answer with the NEW PERSON NAME INITIAL SSN NICK NAME DEA or VA Sites are required to supply individuals for alerts For a review by an ancillary service to be active there must be at least one member in a specified mail group OR at least one individual specified to receive alerts Menu Structure The Patient Merge application is distributed with three menus They are the Operations Utilities and Manager Utilities menus The Duplicate Resolution System menu diagram is shown in the next figure Duplicate Resolution System Menu XDRO Operations XDRU Utilities XDRM Manager Utilities Select Duplicate Resolution System Option Figure 1 5 Duplicate Resolution System main menu The Operations and the Utilities menus should be made accessible to personnel who would be involved with the review and verification of duplicate records
57. the file and the search found 337 potential duplicate pairs When a user starts a search that search may be monitored by the Display Search Status option from the Utilities menu This option is explained further in the next topic 2 10 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 2 Identifying Duplicate Records Searching the Patient File E NOTE The previous figure shows that the search took 27 hours and 23 minutes to run to completion Be advised that searching the database for duplicate record pairs can take a long time to run to completion However actual time for a search has been known to exceed 100 hours Display Search Status The option Display Search Status is located on the Utilities menu You can use this option to display the status of potential duplicates found from searching the primary file Duplicate Resolution Utilities Menu Add Verified Duplicate Pair Check Merge Process Status Check Pair of Records to see if Duplicates Display Search Status Edit the Status Field of a Duplicate Record Find Potential Duplicates for an Entry in a File Identify Potential Merge Problems F Print List of File Duplicates SCAN Scan Possible Duplicates TSF Tally STATUS and MERGE STATUS fields VIEW View Duplicate Record Entries Select Utilities Option DSS lt RET gt Display Search Status Fi
58. the letter Q to queue the print job DEVICE HOME Enter the device name or number Requested Start Time NOW Press the Return key or enter a time here using the date and time formats discussed above e g NOW 1 for one hour from now Appendix A 8 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 AppendixA April 1998 Duplicate Record Merge Patient Merge User Manual Appendix A 9 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Appendix B Where Do I Find How To Patient Merge FAQ Reviewers and IRM Personnel The following table presents the menu structure in a question and answer format i e Where Do I Find How To The left hand column is sorted alphabetically by the question being asked The related menu options or answers are provided in the right hand column Both reviewers and IRM personnel can use these options Add a specific pair of records to the Add Verified Duplicate Pair DUPLICATE RECORD file 15 that are not NOTE As of Patch XT 7 3 113 this option no already identified as potential or verified i the f isaic check on th duplicates onger performs the fuzzy logic check on the two selected patients for the PATIENT file 2 The site will be allowed to add any two PATIENTs to File 15 DUPLICATE RECORD FILE Most duplicate records will be automatically added to the file when t
59. to enter the name of the ancillary service you represent e g Pharmacy You will next be prompted to enter the potential duplicate record pair you want to process Entering a question mark will display a list of potential duplicates 3 22 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Ancillary Review ADR Ancillary Data Review Select Operations Option ADR lt RET gt Ancillary Data Review Select ANCILLARY SERVICE Answer with ANCILLARY SERVICE Choose from LABORATORY Designated ancillary reviewers will only see the PHARMACY ancillary services listed for which they are members RADIOLOGY of the associated mail groups Select ANCILLARY SERVICE PHARMACY Select a POTENTIAL DUPLICATE ENTRY Figure 3 21 Using the option Ancillary Data Review to review ancillary data Notice in the figure above that entering a question mark at the prompt Select ANCILLARY SERVICE displayed a list of ancillary services People will only see the ancillary services listed here for which they are members of the associated mail groups NOTE See the Patient Merge Technical Manual for more information On the record comparison screen Record 1 will always be displayed as the merged FROM record to ancillary reviewers and Record 2 will always be displayed as the merged TO record The merge direc
60. value included seconds when the input transform would not permit seconds 6 20 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process Data Error Group Three The third data error reported shown in the previous figure begins with the following global node as its first line XTMP XDRTESTK 2980303 162959 1 XX 2 001 1 894 01 345 The following error indicates that the specified clinic is invalid Research elucidated that the data at that internal entry number had been deleted XTMP XDRTESTK 2980303 162959 1 2ZZ2 DIERR 1 TEXT 1 The value 345 for field ENROLLMENT CLINIC in ENROLLMENT CLINIC SUB FIELD in file PATIENT is not valid April 1998 Duplicate Record Merge Patient Merge User Manual 6 21 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process Recommendation for Efficient Use of System Resources The overall merge process is run as a background task It is initiated through Task Manager using the option Schedule Process to Merge Verified Duplicates located on the Manager Utilities menu Approving all verified duplicate record pairs as candidates for merging in a single process is the most efficient use of system resources This is the recommended approach However multiple smaller merge processes may also be in
61. zero nodes for each potential duplicate record T 10 J M M 2450629 2 000060969 SAN ANTOINIO 48 T 10 JOHN MARK M 2460629 2 3 LABORER 000060996 ERGEPATIENT 12 M 2450629 1 3 LABORER 25 000060969 PAY FIDUCIARY OUT CATCHMENT EDMONDS 53 MERGEPATIENT 12 M 2450629 1 SURVEYOR 25 000062945P PAY FIDUCIARY EDMONDS 53 4 41 Enter Return to continue listing or Select the desired entry by number 1 4 1 Figure 3 4 Select a potential duplicate record pair from a list of top level patient data At the Selecta POTENTIAL DUPLICATE ENTRY prompt shown in the previous figure you can also enter the first letter of the last name followed by the last four digits of the patient s Social Security Number This will bring up the patient s record if it exists as a potential duplicate Once you ve selected your patient record from the list the Patient Name Date of Birth Social Security Number and other primary file e g PATIENT file 2 identifiers are displayed This gives you an at a glance look at the kind of data these records contain NOTE There are times when patients will have an alias name in their record Patient Merge does check for aliases The application checks the complete name and then parses it to compare pieces ie last name only first name only middle initial or name only Primary reviewer
62. 0060969 Patient identification information No Problems Found no data errors have been encountered Figure 7 13 Query returned from the option Identify Potential Merge Problems no data errors found This option notifies you that your query is being processed when the following message is displayed WORKING HARD may take a while Checks are made against your entry while you wait The amount of time that is required to process your entry is dependent upon how much data is in the patient s record and how much other activity is occurring on the system A wait of less than a minute is to be expected for an average size record Notice in the previous figure that the first thing returned from your query is the patient identification information e g DFN 1111 MERGEPATIENT 10 J M 000060969 This is respectively the e internal entry number of the record in the PATIENT file 2 e patient name and e social security number No Errors Found in Your Selected Patient Record The message No Problems Found indicates that no data errors have been encountered from your selected patient record Actual data errors returned from a record query are shown in the next figure Errors Found in Your Selected Patient Record If data errors are found in your selected record they are reported in a detailed list immediately following the patient identification information These errors are displayed in the following format iterat
63. 04 XTME TESTK 2980302 165841 1 XX 63 08 1 15950 01 OCT 21 1988 XTME DRTESTK 2980302 165841 1 Z22 DIERR 1 1 XTME DRTESTK 2980302 165841 1 2Z2 DIERR 1 311 XTME DRTESTK 2980302 165841 1 2Z2Z2 DIERR 1 PARAM 0 1 XTME DRTESTK 2980302 165841 1 2Z DIERR 1 PARAM IENS 1 15950 XTME DRTESTK 2980302 165841 1 2ZZ2 DIERR 1 TEXT 1 The new record 1 ks some required identifiers DRTESTK 2980302 175623 2 XX 63 05 1 70735 01 AUG 14 1997 22 DRTESTK 2980302 175623 2 2Z DIERR Ad DRTESTK 2980302 175623 2 ZZ2 DIERR 1 701 DRTESTK 2980302 175623 2 ZZ DIERR 1 PARAM 0 3 DRTESTK 2980302 175623 2 ZZ DIERR 1 PARAM 3 AUG 14 1997 22 2 DRTESTK 2980302 175623 2 2ZZ DIERR 1 PARAM FIELD 01 DRTESTK 2980302 175623 2 2Z DIERR 1 PARAM FILE 63 05 DRTESTK 2980302 175623 2 2Z2 DIERR 1 TEXT 1 The value AUG 14 28 35 for field DATE TIME SPECIMEN TAKEN in MICROBIOLOGY SUB FIELD in DATA is not valid DRTESTK 2980302 175623 2 2Z2 DIERR E 701 1 DRTESTK 2980303 162959 1 XX 2 001 1 894 01 DRTESTK 2980303 162959 1 ZZ2 DIERR 1 1 DRTESTK 2980303 162959 1 ZZ2 DIERR 1 701 DRTESTK 2980303 162959 1 ZZ DIERR 1 PARAM 0 3 DRTESTK 2980303 162959 1 2Z2 DIERR 1 PARAM 3 345
64. 1 View individual test scores for each duplicate record pair ccccseeseccececeseeseesetteceeeees 7 22 Figure 8 1 Maria set Utihties Menu iossecmseteessipoc ioiii hide aiie EREE oa a aR 8 1 Figure 8 2 Editing site parameters cece incident ceases aoe ae aa wd ee 8 2 Figure 8 3 List patient records with missing fields previously identified in preliminary scan 8 4 Figure 8 4 Missing field and identifier numbers with corresponding descriptions cccccceesesseeeeeees 8 4 Figure 8 5 Patient records with missing SSNS sc ccsaewiessepedacssincdeorvinieereeiude viatwlie saavetaeredateceeyee nes 8 5 Figure 8 6 Running a preliminary scan of the patient records ceccceceeeesseeeceensneeeceeeeeeeeeeeenaeeeeeenaes 8 6 Figure 8 7 Preliminary scan of PATIENT file 2 for list of Crrors eccccceeeeseececeeeeneeeeeeeneeeeeeaaes 8 7 Figure 8 8 Queue a preliminary scan of PATIENT file 2 to Task Manager cccccccccesessrseeeeeees 8 7 Figure 8 9 Deleting entrie s in the XDR MERGE PROCESS file 15 2 that have completed the merge PTOCESS sis sds apie lecdikededcihy bidchaaesdccdaesicchannbacelnad A AA soucbaatascelaasneaehberse 8 9 Figure 8 10 Scheduling a merge process cccccccccessessenececeececeeeesenseceeecececsseeseasecaeeeeeesceeseseseeeeeees 8 10 Figure 8 11 Start a BASIC search of the primary file for duplicate records c ceceeeeseeeeeenteeeeeees 8 12 Figure 8 12 Com
65. 1112 EST EST SSN p E OF DEATH THER S MAIDEN NAM AST SEPARATION DAT Figure 7 18 Captioned format report of unverified potential duplicate patient records April 1998 Duplicate Record Merge Patient Merge User Manual 7 17 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities This report will continue to print your selection of duplicate patient records for the entire DUPLICATE RECORD file 15 It is sorted in descending order by the duplicate match percentile and the date the record was found from the search of the primary file The report formats Brief and Captioned for the other three categories of duplicate records looks the same as in the previous figures It is sorted in descending order by the duplicate match percentile and the date the record was found from the search of the primary file Scan Possible Duplicates The option Scan Possible Duplicates is located on the Utilities menu It provides a rapid scan of the DUPLICATE PATIENT file 15 for possible duplicates records whose status is POTENTIAL DUPLICATE UNVERIFIED For each record it lists the zero node from the PATIENT file 2 for each of the patients in the pair of potential duplicates Output that is not queued to a printer will be sent to the VA FileMan
66. 4444 T 30 J M 2240830 1 3 CARPENTER 5 000028379 PATI ED ON 12 01 90 ENT 30TH J M 2240830 1 3 29 000028379 Col gt 1 lt PF1 gt H Help lt PF1 gt E Exit Line gt 22 of 3635 Screen gt 1 of 166 Figure 7 19 Using the option the option Scan Possible Duplicates to list zero nodes from the DUPLICATE RECORD file 15 NOTE Refer to the VA FileMan User Manual Version 21 0 for more information on the VA FileMan Browser Tally STATUS and MERGE STATUS Fields The option Tally STATUS and MERGE STATUS fields is located on the Utilities menu It produces an up to date summary of all records that have been merged and records that are ready to be merged This report also displays up to date totals of verified duplicate records records verified as not duplicates and unverified potential duplicate records Current counts are produced for the STATUS and MERGE STATUS fields of all records in the DUPLICATE RECORD file 15 based on the primary file that you ve selected i e the PATIENT file 2 Duplicate Resolution Utilities Menu DD Add Verified Duplicate Pair P Check rge Process Status Check Pair of Records to see if Duplicates Display Search Status Edit the Status Field of a Duplicate Record Find Potential Duplicates for an Entry in a File Identify Potential Merge Problems Print List of File Duplicates SCAN Scan Possible Duplicates TS
67. 5 1 ANCILLARY SERVICE 1 14 DAYS BEFORE FINAL VERIFY 1 11 DAYS BETWEEN VERIFY AND MERGE 1 12 DISPLAY NAMES FOR SUBFILES 1 14 DUPLICATE MANAGER MAIL GROUP 1 11 edit enter site parameters 1 9 8 1 INDIVIDUAL FOR ALERTS 1 14 MAIL GROUP NAME 1 14 MERGE MAIL GROUP 1 11 NUMBER OF THREADS 1 12 POTENTIAL DUPLICATE THRESHOLD 1 11 PRIMARY FILE NUMBER 1 14 site parameters 1 10 1 14 8 2 Index 2 Duplicate Record Merge Patient Merge User Manual Version 7 3 SUBFILES FIELD NUMBERS 1 14 duplicate tests 1 3 2 6 Duplicate Threshold comparing records 7 7 E edit duplicate record status 7 9 1 Edit Site Parameters 8 1 8 2 3 Edit the Duplicate Resolution file 1 9 1 14 Edit the Status Field of a Duplicate Record 3 7 7 9 1 entering data 2 error report patient records 2 3 2 6 errors in primary file before search identify 8 5 excluded from merge records 6 3 existing mail groups using 1 9 exiting VistA 2 F file special handling 1 4 files DUPLICATE RECORD file 15 1 3 add potential duplicate record pairs 7 1 1 display list of potential duplicates 3 3 edit duplicate record status 7 9 1 list ALL zero nodes 7 18 2 list Status and Merge Status fields 6 7 7 19 2 option does not add records to File 15 7 6 potential duplicate status 3 15 potential duplicates automatically added 1 3 1 7 2 1 2 6 3 1 7 10 8 10 1 3 print list of file duplicates 7 14 print selected dupl
68. 5002 CURRENT ADMISSION DATE IENS 1212 value 0 Figure 7 14 Query returned from the option Identify Potential Merge Problems data errors found The previous figure shows that two errors have been found The first one indicates that the veteran is too young to have served in the VIETNAM ERA In this case the error is found in Field 323 PERIOD OF SERVICE However there was no DATE OF BIRTH entered for this veteran and it is the missing birth date that is likely the problem The second error appears to be that a value of 0 has been found in Field 505002 CURRENT ADMISSION DATE Note that there is no descriptive statement with this field Print List of File Duplicates The option Print List of File Duplicates is located on the Utilities menu It prints a selected list of duplicate patient records from the DUPLICATE RECORD file 15 You may choose to print Unverified Potential Duplicates Not Ready to Merge Verified Duplicates Ready To Merge Verified Duplicates Merged Verified Duplicates You can also choose to print a Brief or Captioned listing 7 14 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities Duplicate Resolution Utilities Menu Add Verified Duplicate Pair Check rge Process Status Check Pair of Records to see if Duplicates Display Search Status Edit the Status F
69. 7 2 Schedule Process to Merge Verified Duplicates 1 8 6 1 3 Search process creates potential duplicate pairs 3 3 defined 3 1 Search status display 2 10 7 8 halted 2 11 search the database for duplicate records Basic search 2 7 8 10 8 12 New search 2 7 Security and Other Common Services Acronyms 17 Glossary 17 security keys DG ELIGIBILITY 1 17 6 1 7 12 XDR 1 16 XDR security key 1 16 XDRMGBR 1 7 1 8 1 9 1 16 1 17 2 1 2 3 2 7 6 1 7 4 8 1 8 3 8 5 8 7 8 8 8 10 8 12 3 XDRMGR security key 1 17 Select Review Overwrites 3 12 selecting the merge direction 3 16 signing on 1 site parameters 1 9 1 14 ANCILLARY SERVICE 1 14 DAYS BEFORE FINAL VERIFY 1 11 DAYS BETWEEN VERIFY AND MERGE 1 12 DISPLAY NAMES FOR SUBFILES 1 14 DUPLICATE MANAGER MAIL GROUP 1 11 INDIVIDUAL FOR ALERTS 1 14 MAIL GROUP NAME 1 14 MERGE MAIL GROUP 1 11 NUMBER OF THREADS 1 12 PRIMARY FILE NUMBER 1 14 SUBFILES FIELD NUMBERS 1 14 Social Security Numbers test data xvii Spacebar Return feature 6 special processing 6 12 Start Halt Duplicate Search 8 10 no longer selectable for PATIENT file 2 1 7 2 7 8 10 3 status codes merge process 6 10 Status field POTENTIAL DUPLICATE UNVERIFIED 6 8 7 20 REQUIRES RESOLUTION 6 8 7 20 VERIFICATION IN PROCESS 6 8 7 20 VERIFIED DUPLICATE 6 8 7 20 VERIFIED NOT A DUPLICATE 6 8 7 20 STOP an Active Merge Process 6 1 6 14 8 12 3 stub record 1
70. 787878 ERGEPATIENT 000 04 5972 999699 ERGEPATIENT 1 000 04 5972 098765 ERGEPATIENT 1 s 000 04 6995 123234 ERGEPATIENT 1 000 04 6995 232323 Select entries to approve them for merging 1 4 1 Figure 5 1 Verified duplicate records awaiting approval for merging Verified duplicate record pairs must have elapsed the site specified waiting period 1e the time between when they were verified as duplicates and the time they are ready to be merged to appear on the list shown in the previous figure April 1998 Duplicate Record Merge Patient Merge User Manual 5 1 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 5 Approve Verified Duplicates for Merging As each screen lists the records for approval shown in the previous figure enter the number corresponding to the record s that you are approving for merging You can enter your selection in anyone of the following formats 1 You can enter a range of numbers such as 1 4 2 You can enter individual number in the format 1 2 3 or 3 Youcan randomize the selection process such as 1 3 4 NOTE Once you ve approved a duplicate record pair to be merged that pair will no longer appear on the list of entries waiting for approval to be merged NOTE The approval process checks the record pair as it s being selected for approval to be merged to ensure that both records st
71. 98 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Figures Figure 1 7R VISION HISTORY a a Tobe Nee cdol ck Peds sae a a a ea a aa a E AE Ea vii Figure ii How to access online help cccccccccceceesesensscecececeeeeeesensececeseceeseseeseseceeeeeesenssesseaeeeeeeees xvii Figure iii Sample dialogue for queuing a preliminary scan of PATIENT file 2 to Task Manager Xix Figure 1 2 Editing site parameters secs nnrir i a e a i ei a a a e a 1 11 Figure 1 4 Ancillary service data entry screen cccceccecccececeesessenseceeeeeeecsesessaececeeeeeseeeeesesteaeeeees 1 14 Figure 1 5 Duplicate Resolution System main MENU csssscccssserscsssereececsensnsecssrsreceesesneeeesoees 1 15 Figure l 6 Op rations Aen seryvvsacess orie nat eiie aee EEEE AEE OEE EAEE E TE aaie 1 16 Figure ee Uthies menina 20s ea sed ta a a aa enema acca A a So vn ER 1 16 Figure 1 8 Manager Utilities INST 4 2252 dest ahosee egleand yey cheer ceabnerpeieeassusus heiaog mlanea tua barsewesdntesenbabogn Gikede 1 17 Figure 2 1 Running a preliminary scan of the patient records ccccceceeeessececeeseeeeeceeeeeeeeeeeeaeeeeeeaaes 2 2 Figure 2 2 Error list generated from the preliminary scan of the PATIENT file 0 0 00 eee ceeeeeeeeeeeeeenees 2 3 Figure 2 3 Queue a preliminary scan of the PATIENT file 2 to Task Manager cecccesesseeeeeees 2 4 Figure 2 4 List patient records with missing fields previously
72. As in the Integration Agreement database on FORUM Content can be viewed using the DBA menu or the Health Systems Design amp Development s Web page Patients are assigned a unique identifier known as an Integration Control Number ICN within the process of being added to the MPI database This number links patients to their records across VHA systems The Integration Control Number is a unique identifier assigned to patients when they are added to the MPI The ICN follows the ASTM E1714 95 standard for a universal health identifier The number used to identify an entry within a file Every record has a unique internal entry number Information Resource Management A service at VA medical centers responsible for computer management and system security Information Security Officer Infrastructure and Security Services now known as Common Services Security Program IV amp V is the principal activity that oversees the successful implementation and execution of all internal control processes for financial and interfacing systems In order to ensure overall systems integrity V amp V is accomplished organizationally independent from the elements that acquire design develop or maintain the system Duplicate Record Merge Patient Merge User Manual Version 7 3 Kemel Toolkit Patch XT 7 3 125 April 1998 Revised December 2010 KERNEL Key Keyword LAN LAYGO Access Lookup M ANSI Standard Mail Message Mailman
73. Browser for on screen examination Duplicate Resolution Utilities Menu Add Verified Duplicate Pair Check rge Process Status Check Pair of Records to see if Duplicates Display Search Status Edit the Status Field of a Duplicate Record Find Potential Duplicates for an Entry in a File Identify Potential Merge Problems Print List of File Duplicates SCAN Scan Possible Duplicates TSF Tally STATUS and MERGE STATUS fields VIEW View Duplicate Record Entries Select Utilities Option SCAN lt RET gt Scan Possible Duplicates Select DUPLICATE RESOLUTION FILE TO BE CHECKED PATIENT DEVICE HOME lt RET gt By pressing the Return key at the DEVICE HOME prompt the system lists all the zero nodes from the DUPLICATE RECORD file 15 into the VA FileMan Browser as shown below T 28 T M 2220121 2 3 WAREHOUSEMAN 99 000088784 EL PASO 48 T 28H TAMS22201214 2434 000088 78444744444 T 12 M 2450629 1 3 LABORER 25 000060969 PAY FIDUCIARY OUT OF CATC 7 18 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities ENT 12 M 2450629 1 SURVEYOR 25 000062945P PAY FIDUCIARY EDMONDS T 29 L M 2230510 2 3 29 000025468 T 29TH LAM 2230510 2434 2 940000254 684444
74. CATE RECORD file 15 this file will mainly be populated automatically when Person Service Identity Management PSIM identifies patient pairs as matches or potential matches You will still be allowed to run the Preliminary Scan of Patients to search for errors that might affect the merge After patient pairs are added to the DUPLICATE RECORD file 15 the review verification approval and merge processes will continue to be performed as before Now we are ready to begin the search April 1998 Duplicate Record Merge Patient Merge User Manual 2 7 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 2 Identifying Duplicate Records Searching the Patient File Applying comparisons duplicate tests to records as they are encountered in the search identifies potential duplicates These comparisons result in a computed value based on the similarity of one record to others Both records must have data in the field being tested for a duplicate test score to be obtained The fields from the PATIENT file 2 that are used in comparing both entries are Name Social Security Number Sex Date of Birth Date of Death Last Separation Date Last Discharge Date Mother s Maiden Name and Claim Number Positive values are assigned to record pairs that meet the test scaled on how well they match Negative values are assigned to record pairs that do not meet the test The resulting value is measured against the Potential Dupl
75. Choose from MERGE 9 17 MERGE 9 18 Select rge Process to Purge MERGE 9 17 OK Yes lt RET gt Yes Are you sure you want to delete MERGE 9 17 No Yes MERGE 9 17 DELETED Figure 8 9 Deleting entrie s in the XDR MERGE PROCESS file 15 2 that have completed the merge process To delete a record from File 15 2 choose from the list of completed merge processes displayed in the previous figure As a caution you are prompted a second time asking if you want to delete that particular merge process Once you delete the record it cannot be recovered This utility helps clean up the XDR MERGE PROCESS file 15 2 Restart a Merge Process If the merge process has been stopped either manually or as a result of the system being stopped etc it may be restarted again using the option Restart a Merge Process on the Manager Utilities menu This will begin the merge process again at the phase and location file and IEN where processing had stopped You can use the option Check Merge Process Status to ensure that processing has been completed Only authorized persons holding the XDRMGR security key should be responsible for using this option April 1998 Duplicate Record Merge Patient Merge User Manual 8 9 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 8 Manager Utilities Schedule Process to Merge Verified Duplicates After y
76. D DISABILITI S VA in file 2 This will be rejected by UPDATE DIE File 2 05 DISABILITY CONDITION subfile of PATIENT file Field 01 SERVICE CONNECTED CONDITIONS IENS 1 16 value 9304 First entry in DD 2 05 0 NM does not match field name SERVIC CONDITIONS in file 2 This will be rejected by UPDATE DIE Select MESSAGE Action D E from IN basket Figure 6 2 MailMan message containing records with data errors excluded from the merge process The data errors found prior to being merged are reported in a detailed list immediately following the patient identification information These errors are displayed in the following format iterations references for each are made to the last example shown in the previous figure 1 the file or subfile number and file or subfile name are displayed e g File 2 05 DISABILITY CONDITION subfile of PATIENT file 2 field number and field name e g Field 01 SERVICE CONNECTED CONDITIONS April 1998 Duplicate Record Merge Patient Merge User Manual 6 5 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process aa internal entry number string as used by VA FileMan e g IENS 1 16 field value e g value 9304 and 5 a descriptive statement when available e g First entry in DD 2 05 0 NM
77. D file the review verification approval and merge processes will continue to be performed as before e New routine XORDADDS and remote procedure call XDR ADD POTENTIAL PATIENT DUP Both will be called from the Master Patient Index MPI system to add records to the local VistA DUPLICATE RECORD 15 file as potential matches are identified e New routine XDRDEFLG and remote procedure call XDR UPD SUPPR EMAIL The remote procedure call is called from Healthcare Identity Management HC IdM options to remotely set the field SUPPRESS NEW DUP EMAIL 99 on the DUPLICATE RESOLUTION file 15 1 e Modified Routines XDRDPICK If the status on a pair of patient records is changed to VERIFIED NOT A DUPLICATE and if this VistA system is attached to the MPI a new routine MPIFDNL calls a remote procedure MPI DNLADD UPD on the MPI server to add a record to the MPI DO NOT LINK 985 28 file XDRDEDT If the status on a patient pair is changed from VERIFIED NOT A DUPLICATE back to POTENTIAL DUPLICATE UNVERIFIED and if the VistA system is attached to the MPI a new routine MPIFDNL calls a remote procedure MPI DNL ADD UPD on the MPI server to inactivate the record on the MPI DO NOT LINK 985 28 file e Updated Options tutilities XDR UTILITIES MENU Add Verified Duplicate Pair XDR ADD VERIFIED DUPS This option will no longer calculate a score on patient pairs Check Pair of Records to see if Duplicates XDR CHECK
78. ERAN Y N are missing a particularly high number of identifiers RUN TIME 0 13 CURR IEN 151052 ENTRIES 66720 2159 1376 3 4572 3295 4 128 332 entries are missing fiel 02 SEX entries are missing fiel 03 DATE OF BIRTH entries are missing fiel 09 SOCIAL SECURITY N entries are missing fiel 301 REVIEWER CONNECT entries are missing fiel 1901 VETERAN Y N entries are missing fiel 391 TYPE ntries have NO zero node HH ER eee entries have bad SSN values non numeric etc 1403 FE entries are missing 1 of these values 1868 F entries are missing 2 of these values 2 2 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 2 Identifying Duplicate Records Searching the Patient File entries missing 3 of these values entries missing 4 of these values entries missing 5 of these values entries missing 6 of these values Figure 2 2 Error list generated from the preliminary scan of the PATIENT file April 1998 Duplicate Record Merge Patient Merge User Manual 2 3 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 2 Identifying Duplicate Records Searching the Patient File Notice in the previous figure that the zero node is missing for 128 patients The zero node of a record is where you will fi
79. F Tally STATUS and MERGE STATUS Fields VIEW View Duplicate Record Entries Select Utilities Option tsf lt RET gt Tally STATUS and MERGE STATUS Fields Duplicate records that are ready to be merged are displayed on the tally report in the figure below They are defined in the MERGE STATUS field as READY These records will be merged in the next merge process When you set up a merge process the number of patient records that are shown as READY to be merged on this report is the exact number of records that will be merged April 1998 Duplicate Record Merge Patient Merge User Manual 7 19 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities This report will tally the Status and Merge Status fields for all entries in the Duplicate record file for the file that you select Tally duplicate entries for which file PATIENT SAN FRANCISCO NOV 13 1997 TALLY OF DUPLICATE RE DS STATUS ME E STATUS FIELDS E PATIENT Total Number of Duplicate Records for File F STATUS field ERIFIED NOT A DUE OTENTIAL DUPLICATE V P REQUIRES RESOLUTIO V V ERIFIED DUPLICATE ERIFICATION IN P E STATUS field NOT READY READY MERGED IN PROGR Figure 7 20 Using the tally report to view an up to date summary of the current merge process The sum
80. Factors Abbreviation HF This component lists all the health factors associated with a particular patient for user specified time and occurrence limits The list will display health factors by category and include a level of severity for each health factor including Minimal M Moderate MO and Heavy Severe H Set the occurrence limit to 1 to list the latest unique health factors within each category E g If there were 12 Non Smoker health factor entries only the latest Non Smoker entry would display Appendix C 8 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Appendix C Component Name Health Factors Selected Abbreviation SHF This component allows a user to select specific health factors by category and then lists the health factors which apply to a particular patient for user specified time and occurrence limits Set the occurrence limit to 1 to list the latest unique health factors for each selected category E g If there were 12 Non Smoker health factor entries only the latest Non Smoker entry would display Component Name Immunizations Abbreviation IM This component lists the immunizations e g Rubella Smallpox etc and information about each immunization administered to a particular patient Component Name Location of Home Abbreviation LH This component lists directions to a particular patient s home Component Name
81. GE PAT Ty 11D ERGEF Py La POTENTIAL DUE ERIFIED Select a POTENTIAL DUPLICAT NTRY MERGEPATIENT 10 J M Searching for a PATIENT MERGEPATIENT 10 J M 06 29 46 000060969 Y VETERAN OK Yes lt RET gt Yes MERGEPATIENT 10 JOHN MARK POTENTIAL DUPLICAT ERIFIED Figure 3 3 Select a potential duplicate record pair from a list displaying the name and duplicate record status for each patient 2 Otherwise by pressing the Enter key at the prompt Do you want to select from a list of potential duplicates YES you can display a list of top level data i e the zero node for each potential duplicate record pair shown in the next figure April 1998 Duplicate Record Merge Patient Merge User Manual 3 5 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Primary Review Select a POTENTIAL DUPLICATE ENTRY lt RET gt Do you want to select from a list of potential duplicates YES lt RET gt Press the Enter key to generate a list of the
82. IED DUP ERIFIED NOT A DUPLICATE BLE TO DETERMINE EALTH SUMMARY EVIEW DATA AGAI ELECT REVIEW OVERWRITE Select Action HEALTH S ARY REVIEW DATA AGAIN Figure 3 13 Review duplicate records again from the beginning Notice in the next figure that the asterisks have been replaced with bars The bars indicate that the fields in Record 1 will overwrite the fields in Record 2 3 16 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Primary Review 888 ENT 10 JOHN MARK ENT 10 J M F ENT 10 JOHN MARK E OF BIRTH 06 29 45 06 29 46 SOCIAL SECURITY NUMBE 000060969 000060996 ZIP CODE 98493 98444 Figure 3 14 Bars on left indicate that the fields in record 1 will overwrite the fields in record 2 Determine Duplicate Record Status Once the primary reviewer is fully satisfied that a record pair is a duplicate the next step is to select the option Verified Duplicate shown in the next figure If ancillary data exists for that record pair alerts and or MailMan message notifications are sent to designated ancillary reviewers for a secondary examination This secondary data review is the last step involved in the verification process It is explained in more detail in the
83. IENs DINUMed or by cross references and are fairly rapid The third phase involves all other pointers and can be lengthy Several special processing routines have been written to handle those database entries that point to the PATIENT file 2 in an unusual manner Entries for each special processing routine have been made in the PACKAGE file 9 4 multiple AFFECTS RECORD MERGE field 20 A stub record is maintained in order to disallow reuse of PATIENT file 2 internal entry numbers Concurrent with the merge entries are made in a new global for each record making up the pair The entries are intended to provide a before merge image However please note that the merge is a non reversible process Once the pair of records is merged there is no automated way of undoing the process The application has been written to support multiple parallel jobs threads as specified by the site during the merge process However decreased overall processing time is exchanged for increased system utilization running when changes are being made to Data Dictionaries or when data conversions N ADVISORY The merge process is a background job Be aware that it should not be are taking place 1 4 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Quick Start Patient Merge Checklist On the following pages is a checklist you may find helpful as a step by step information g
84. ING A NEW CLINIC If you respond with a Y or YES or yes the software adds the new clinic in its validation table and accepts the answer If anything other than Yes is entered the original answer is invalidated and the question is repeated Appendix A 4 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 AppendixA How to Enter Dates and Times When the acceptable answer to a question is a date use the following answer formats Note that the response is not case sensitive upper or lower case input is acceptable as follows JULY 20 1969 7 20 69 20 JUL 69 10jul69 10 jul 69 072069 TODAY or Today or T or t today TODAY 1 or T 1 or t 1 tomorrow TODAY 7 or T 7 or t 7 one week ago TODAY 3W or T 3W or t 3w 3 weeks hence NOW 1H present time plus one hour Now 4M present time plus four months NOON 12 00 p m MID 12 00 a m The year portion of the date can be left off normally the system assumes the current year Occasionally the software allows you to enter a time of day in connection with a date for example 4 00 p m on July 20 1994 To do this type the date in one of the above forms followed by an at sign followed by the time For example you might enter 20 JUL 94 4PM In this mode you can enter time either as military four digit time hour AM PM or hour minute second AM PM or simply NOW or Now or
85. Kemel Toolkit Patch XT 7 3 125 Glossary Data Dictionary Access Data Integrity Data Type Database Database Management System DBMS Database National DBA DBIA Debug De fault Delimiter Department of Veterans Affairs Device Glossary 4 definitions of a file s internal structure A user s authorization to write update edit the data definition for a computer file Also known as DD Access This term refers to the condition of patient records in terms of completeness and correctness It also refers to the process in which a particular patient s data is synchronized at all the sites in which that patient receives care A specific field or type of information such as Name Social Security Number etc A set of data consisting of at least one file that is sufficient for a given purpose The VistA database is composed of a number of VA FileMan files A collection of data about a specific subject such as the PATIENT file 2 a data collection has different data fields e g patient name SSN Date of Birth and so on An organized collection of data about a particular topic A collection of software that handles the storage retrieval and updating of records in a database A Database Management System DBMS controls redundancy of records and provides the security integrity and data independence of a database A database that contains data collected or entered for all VHA sites Database Admini
86. M record viewed through VA FileMan Browser You can switch back and forth between the Health Summary listings for the merge FROM record and the merge TO record while in the Browser by selecting the keys PF1 lt S gt shown below BROWSE SWITCH MANAGER Do you wish to select from current list YES lt RET gt Choose from 2 1212 ME ENT 10 JOHN MARK 000 06 0996 Select CURRENT LIST 2 BROWSE SWITCH MANAGER April 1998 Duplicate Record Merge Patient Merge User Manual 3 13 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Primary Review We are now looking at the merge TO record 888 MERGEPATIENT 10 JOHN MARK 000 06 0996 ENTER lt PF1 gt S TO VIEW OTHER 05 01 97 17 58 kkkKKKKKK CONFIDENTIAL General Clinical Information SUMMARY POs HL AeA ENT 10 JOHN MARK 000 06 0996 DOB 06 29 46 EM Demographics Address P O BOX 412 3 DoD 0999 ANY TOWN ANY STATE Marital Status DIVORCED Religion BAPTIST Occupation LABORER Period of Service ETNAM ERA Branch of Service ARMY 04 10 66 TO 02 16 86 Combat POW Eligibility SERVICE CONNECTED 50 to 100 Status SC VA PENSION S C 50 NOK RENNI VON LIPSHNICK Relation COUSIN P O BOX 648 Phone 555 5555 NORTH BEND INDIANA 51515 Col gt 1 lt PF1i gt H Help lt PF1 gt E Exit Line gt 10f51 Screen gt 1of3 Figure 3 10 Example of Health Summary merge
87. Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Appendix C Component Name Crisis Notes Abbreviation CN This component contains crisis notes entered using the Generic Progress Note package No time or maximum occurrence limits apply to this component Crisis Notes are a type of progress note which contains important information for anyone who deals with a patient If this component is printed out on a CRT information will include title text of note electronic signature block and date posted If the printout is to another device type information will include electronic signature block and date posted to insure security of information Component Name Consult Result Abbreviation CON This is the result of a Consult Component Name Clinical Warnings Abbreviation CW This component contains clinical warning notes entered using the Generic Progress Note package No time or maximum occurrence limits apply to this component Clinical Warnings are a type of progress note which includes clinical information which clinicians need to be alerted to If this component is printed out on a CRT information will include title text of note electronic signature block and date posted If the printout is to another device type information will include electronic signature block and date posted to ensure security of information Package Generic Progress Notes Component Name Progress Notes Abbreviation
88. ND Find Potential Duplicates for an Entry in a File VAL Identify Potential Merge Problems PRNT Print List of File Duplicates SCAN Scan Possible Duplicates TSF Tally STATUS and MERGE STATUS fields VIEW View Duplicate Record Entries Select Utilities Option Figure 1 7 Utilities menu Manager Utilities Menu This menu is comprised of various manager utilities that give IRM personnel control over critical decision elements involved with the merge process They are designed to assist with editing site parameters identifying potential duplicate records in the primary file merging verified duplicate records and purging files involved with the merge process that are specific to Patient Merge The next figure shows you the available options under this menu They are described in detail later in this manual Only authorized personnel holding the XDRMGR security key can use these utilities 1 16 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 1 Site Configuration licate Manager Utilities Menu Edit Site Parameters ist File Entries Identified in Preliminary Scan Preliminary Scan of File for Errors Purge Merge Process Fil Restart a Merce Process Schedule Process to Merge Verified Duplicates Start Halt Duplicate Search STOP an Active Merge Process Select Manager Utilities Option
89. Non Tabular Measurem Abbreviation NTM This component lists measurements e g blood pressure height weight respiration s etc in a non tabular format for a particular patient for a user specified time and occurrence limits Component Name Measurement Selected Abbreviation MEAS This component lists selected measurements segments in a tabular format for a particular patient for user specified time and occurrence limits Specialized measurement segments can be set up in the Patient Care Encounter package at each site by the IRM staff to allow different measurement views Component Name Outpatient Diagnosis Abbreviation OD This component lists outpatient diagnosis ICD 9 for a particular patient The user can specify time and occurrence limits whether hospital location should be displayed or not the format of ICD 9 data e g code only long text short text or no ICD 9 data and whether the provider narrative should be displayed or not Component Name Outpatient Encounter Abbreviation OE This component lists outpatient diagnosis ICD 9 and procedure CPT for a particular patient The user can specify item and occurrence limits whether hospital location should be displayed or not the April 1998 Duplicate Record Merge Patient Merge User Manual Appendix C 9 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Appendix C format of ICD 9 data e g code only long text short text or no ICD 9 data an
90. Operations XDRU Utilities XDRM Manager Utilities Select Duplicate Resolution System Option XDRM lt RET gt Manager Utilities Figure 8 1 Manager Utilities menu Edit Site Parameters To set up patient identification and merge parameters for the PATIENT file 2 it is necessary to enter the desired data into the DUPLICATE RESOLUTION file 15 1 This can be accomplished by using the option Edit Site Parameters located on the Manager Utilities menu It is through this option that the necessary entries to File 15 1 are made The DUPLICATE RESOLUTION file 15 1 contains the parameters by which the DUPLICATE RECORD file 15 is populated File 15 also contains parameters that are specific to the merge process You must possess the XDRMGR security key to access this option By entering PATIENT at the prompt Select DUPLICATE RESOLUTION FILE TO BE CHECKED you are designating that file as your primary file for patient identification and merge processing The default parameters exported with this application are related to e how potential duplicates are identified e designating ancillary reviewers and e defining the length of waiting periods applied in the process of identifying and merging duplicate records April 1998 Duplicate Record Merge Patient Merge User Manual 8 1 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 8 Manager Utilities Your site may edit any one of these parameter
91. Process to Merge Verified Duplicates 8 8 Start Halt Duplicate Search 8 10 no longer selectable for PATIENT file 2 8 10 STOP an Active Merge Process 8 12 MAS 1 3 3 1 menu options maneuvering through the 1 3 Where Do I Find How To 1 3 menus 1 15 1 16 merge direction data flow 3 12 3 20 explained 3 16 setting up 3 15 MERGE MAIL GROUP 1 11 6 3 6 6 records excluded from merge are sent to 1l 11 6 3 6 6 MERGE PAIRS EXCLUDED DUE TO PROBLEMS 1 11 6 3 merge process 1 4 6 1 6 14 active 6 10 completed 6 11 errored out 6 11 explained 6 20 halted 6 11 NO PAIRS LEFT 6 14 7 6 queue 8 9 rescheduled 6 11 restart after halting 6 14 8 8 schedule process 8 9 stop the 6 14 8 12 unknown status 6 11 MERGE PROCESS file 15 2 delete selected record pair s 8 7 3 Merge Process File Purge 8 7 merge process status codes 6 10 Merge Process The 6 1 6 14 merging multiple record pairs 6 5 missing identifiers 2 3 8 2 missing zero nodes 2 2 April 1998 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 MPI DO NOT LINK file 985 28 add records already identified as not a duplicate pair 7 3 MPI DO NOT LINK FILE 985 28 3 7 3 14 multiple record pairs disallowed from merge 6 5 multiple record pairs merging 6 5 N New search 2 7 NO PAIRS LEFT 6 14 7 6 NUMBER OF THREADS 1 12 O online help How to access 2 Operations menu 1 15 Ancillary Data Review 3 17 Approve
92. TE RECORD file 15 will be populated as the search engine identifies patient pairs as matches or potential matches however users with access to the Duplicate Record Merge menus will still be allowed to add records to the DUPLICATE RECORD file 15 The potential duplicates populated in File 15 are then validated through a review process to verify that they are duplicates and then merged This software is intended to provide a reliable approach to correctly identify and merge duplicate records In order to competently operate this package you must be familiar with the operations of the VistA computer system in general This information can be obtained at the following Web site http vaww vista med va gov In addition Appendix A of this manual provides you a brief overview of the VistA computing environment to help you get started or serve as a reminder for experienced users A detailed understanding of VA FileMan is not required to successfully use this application However reviewing the VA FileMan User s Manual provides you with a good background for how the system works Online help is provided at all prompts by typing one or two question marks April 1998 Duplicate Record Merge Patient Merge User Manual 1 1 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 1 Introduction 1 2 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7
93. The following is an example of a Health Summary report for potential duplicate records as they would appear viewed through the VA FileMan Browser Notice that the merge FROM record is displayed first NOTE The record size for the following Health Summary examples have been reduced for the sake of brevity 3 12 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Primary Review 1212 MERGEPATIENT 10 J M 000 06 0969 ENTER lt PF1 gt S TO VIEW OTHER 05 01 97 17 58 kkeKKKKKKK CONFIDENTIAL General Clinical Information SUMMARY uo Shh eee ane A ENT 10 J M 000 06 0969 DOB 06 29 45 EM Demographics Address ERICAN LAKE Y TOWN ANY Marital Status DIVORCED Religion KNOWN NO PREFERENCE Period of Service ETNAM ERA Branch of Service ARMY 04 10 65 TO 02 16 70 Combat POW Eligibility SERVICE CONNECTED 50 to 100 Status S C S 50 NOK MERGENEXTOFKIN Relation ECE BOX 412 Phone 555 5555 ANY TOWN ANY STATE 98649 Past Clinic Visits max 10 occurrences 03 31 88 10 30 MERGEPATIENT 10 Mineral Metab 01 07 88 09 00 L MERGEPATIENT 10 Mineral Metab ED BY CLINIC amp Col gt 1 lt PFi gt H Help lt PF1 gt E Exit Line gt 10f32 Screen gt 1of2 Figure 3 9 Example of Health Summary merge FRO
94. Verified Duplicates for Merging 5 1 Verify Potential Duplicates 3 1 3 16 options Ancillary Data Review 3 17 Approve Verified Duplicates for Merging 5 1 Check Merge Process Status 7 4 Check Pair of Records to see if Duplicates 7 6 Display Search Status 7 8 Edit Site Parameters 8 1 8 2 Edit the Status Field of a Duplicate Record 7 9 Find Potential Duplicates for an Entry in a File 7 10 Identify Potential Merge Problems 7 11 7 14 List File Entries Identified in Preliminary Scan 8 2 8 5 Preliminary Scan of File for Errors 8 5 8 6 Print List of File Duplicates 7 14 7 17 Purge Merge Process File 8 7 Restart a Merge Process 8 8 Scan Possible Duplicates 7 17 Schedule Process to Merge Verified Duplicates 8 8 Start Halt Duplicate Search 8 10 STOP an Active Merge Process 8 12 Tally STATUS and MERGE STATUS fields 7 19 April 1998 Revised December 2010 Index Verify Potential Duplicates 3 1 3 16 View Duplicate Record Entries 7 20 overwrite data 3 12 asterisks 3 20 regardless of merge direction 3 12 P PACKAGE file 9 4 6 11 6 20 PAIRS EXCLUDED FROM MERGE DUE TO MULTIPLE REFERENCES 1 11 6 6 Patch History vii patient amp user names test data xvii PATIENT file 2 2 3 7 1 identify errors in patient records 8 5 no longer selectable 1 3 2 1 2 6 8 10 1 POTENTIAL DUPLICATE THRESHOLD data no longer used for searching File 2 1 11 Patient Merge Checklist Quick Start 1 5 patient
95. a Manapsal Lead Developer Tami Winn Technical Writer Susan Strack 08 2009 Kernel Toolkit Patch XT 7 3 113 changes the KERNEL Duplicate Master Patient Resolution System XDR MAIN MENU options in support of the new Index MPI PSIM Probabilistic Search This patch is related to VistA patch development team MPIF 1 0 52 and MPI patch MPI 1 0 62 Oakland CA OIFO e Search for Potential Duplicate Record Pairs e Project As of Kernel Toolkit Patch XT 7 3 113 the PATIENT file 2 will no Manager longer be selectable from the Duplicate Record Merge Search option Danila Instead the Initiate Probabilistic Search Implementation in Person Manapsal Service Identity Management PSIM will perform searches for duplicate April 1998 Duplicate Record Merge Patient Merge User Manual v Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Revision History vi patients Although users with access to the Duplicate Record Merge menus will still be allowed to add records to the DUPLICATE RECORD file this file will mainly be populated when Initiate identifies patient pairs as matches or potential matches In the case of potential matches HC IdM will use a new PSIM IMDQ Toolkit option to review the patient traits and select the Integration Control Number to retain This will cause the pair of potential matches to be added as a record to your local DUPLICATE RECORD file After patient pairs are added to the DUPLICATE RECOR
96. a screen display which lists all of the choices options available You will see only the menus options and functions which you have security clearance to use Once you have made a selection the software can branch to another menu submenu or you might be asked to answer questions which allow the computer to perform tasks How to Sign on The procedure for establishing a link to the terminal involves access and verify codes IRM staff assigns these codes Contact your supervisor if you need these codes For security reasons your access and verify codes are not displayed on the terminal screen when you type them in Please do not write your code down or reveal it to others The sign on banner shows the date and time when you last signed on The banner also shows if the account had any unsuccessful attempts at logon Periodically you are required to change your verify code Press the Return key on the keyboard A blinking cursor appears on the terminal You will then see ACCESS CODE VERIFY CODE Enter your assigned access code Enter your self assigned verify code How to Exit a VistA Process April 1998 Duplicate Record Merge Patient Merge User Manual Appendix A 1 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Appendix A In most cases when you begin an option you will continue stepping through it to its normal end At times however you might want to exit the option to do something else To stop and ex
97. al Index 3 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Index identify errors in primary file before search 2 2 8 5 Identify Potential Merge Problems 7 11 7 14 1 Identity Management Data Quality team IMDQ 1 3 IEN 6 11 incorrect entries correcting 2 6 INDIVIDUAL FOR ALERTS 1 14 Information Resource Management IRM 1 4 2 3 adds more ancillary services 1 9 staff responsibilities iii staff responsibilities 1 9 invalid fields 2 3 8 2 invalid records running a preliminary scan to find 2 2 K Kernel Toolkit 1 3 L LAYGO 4 List File Entries Identified in Preliminary Scan 8 2 8 5 3 logging in 1 MAIL GROUP file 3 8 1 11 MAIL GROUP NAME 1 14 mail groups ancillary review 3 19 DUPLICATE MANAGER MAIL GROUP 1 3 DUPLICATE RESOLUTION file 15 1 1 3 setting up to receive automatic messages 1 14 using existing 1 9 MailMan messages sent to ancillary reviewers 1 8 3 19 sent to DUPLICATE MANAGER MAIL GROUP 1 11 sent to MAIL GROUP NAME 1 14 sent to MERGE MAIL GROUP 1 11 6 3 maintenance work on patient records before the search 2 1 8 5 Manager Utilities menu 1 16 8 1 8 12 Index 4 Duplicate Record Merge Patient Merge User Manual Version 7 3 access with XDRMGER key 1 9 Edit Site Parameters 8 1 8 2 List File Entries Identified in Preliminary Scan 8 3 8 2 8 5 Preliminary Scan of File for Errors 8 5 8 6 Purge Merge Process File 8 7 Restart a Merge Process 8 8 Schedule
98. al Merge Problems is required to provide valid error checking results The key may or may not be required to actually make the necessary edits April 1998 Duplicate Record Merge Patient Merge User Manual 1 17 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 1 Site Configuration 1 18 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 2 Identifying Duplicate Records Searching the Patient File 2 NOTE As of Patch XT 7 3 113 the PATIENT file 2 will no longer be selectable from the Search option described below Although users with access to the Duplicate Record Merge menus will still be allowed to add records to the DUPLICATE RECORD file 15 this file will mainly be populated automatically when Person Service Identity Management PSIM identifies patient pairs as matches or potential matches You will still be allowed to run the Preliminary Scan of Patients to search for errors that might affect the merge After patient pairs are added to the DUPLICATE RECORD file 15 the review verification approval and merge processes will continue to be performed as before Before you begin the process of searching the PATIENT file 2 it is suggested that you run the option Preliminary Scan of File for Errors to identify errors in patient records This option scans through the file checking for records that have missing ide
99. alogue you will see when a patient pair is added to the DUPLICATE RECORD file 15 7 2 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities Select Utilities Option ADD lt RET gt Add Verified Duplicate Pair Add entries from which File PATIENT No potential duplicate threshold check will be calculated for PATII Select PATIENT MERGEPATIENT 20 lt RET gt 12 12 70 000056789 NO Another PATIENT MERGEPATIENT 20 B lt RET gt 12 12 70 000056798 VETERAN You will be adding the following pair of records to the duplicate record file RECORD1 MERGEPATIENT 20 RECORD2 MERGEPATIENT 20 B ETURN to continue or to exit lt RET gt Ok continuing hold on Figure 7 2 Add records to the DUPLICATE RECORD file 15 that ARE duplicates When a record pair is added to File 15 it is added as a status of Potential Duplicate Unverified For persons other than patients the persons will be compared and evaluated Notice in the following figure that the record pair resulted in having a Potential Duplicate Threshold of 30 This is less than the 60 April 1998 Duplicate Record Merge Patient Merge User Manual 7 3 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities default The score of 30 indicates that this record pair i
100. ameters are involved in the operation of this application They are related to how potential duplicates are identified defining reviewers naming users to a mail group and defining the length of waiting periods applied in the process IRM staff perhaps the ADPACs will set up patient identification and merge capability for the PATIENT file This depends largely on who holds the XDRMGR security key This key allows access to the Manager Utilities menu used in the site configuration of the application Either IRM or the ADPACs whoever is determined as responsible for editing this data should be given this security key Care should be used however in granting this key since other options that impact system resources e g Schedule Process to Merge Verified Duplicates are controlled by it Three default ancillary services for the PATIENT file 2 come with this application They are Laboratory Radiology and Pharmacy Your local IRM might want to add more for example Dentistry Individuals in the ancillary services will be designated to receive MailMan messages and or alerts in the file setup process File Setup and Default Site Parameters To set up patient identification and merge parameters for the PATIENT file 2 it is necessary to enter the desired data into the DUPLICATE RESOLUTION file 15 1 This can be accomplished by using the option Edit Site Parameters located on the Manager Utilities menu It is through this option that the n
101. aracters that are neither letters nor numbers e g or If entered incorrectly the system does not allow the user to access the computer To protect the user both codes are invisible on the terminal screen Veterans Health Administration Veterans Integrated Service Network Veterans Health Information Systems and Technology Architecture VistA of the Veterans Health Administration VHA Department of Veterans Affairs VA VistA software developed by the VA is used to support clinical and administrative functions at VHA sites nationwide It is both roll and scroll and GUI based software that undergoes a quality assurance process to ensure conformity with namespacing and other VistA standards and conventions see SAC Server side code is written in M and via Kernel runs on all major M implementations regardless of vendor Client side code is written in Java or Borland Delphi and runs on the Microsoft operating system Veterans Administration Personal Identifier Wide Area Network All message type and trigger event codes beginning with Z are reserved for locally defined messages No such codes will be defined within the HL7 Duplicate Record Merge Patient Merge User Manual Glossary 17 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Glossary Standard NOTE For a comprehensive list of commonly used infrastructure and security related terms and definitions please visit the Glossary Web page at the following We
102. art of a merge process at the current time or at some point in the future This option is located on the Manager Utilities menu a NOTE Be advised that the merge process can take a long time to run to completion Actual time for merging duplicate record pairs has been known to exceed 15 hours D NOTE Although distributed by another package the person initiating the merge process must be authorized to hold the DG ELIGIBILITY security key Schedule Process to Merge Verified Duplicates After you ve approved verified duplicates for merging the next step is to schedule the date and time for the merge process to run shown in the next figure To do this select the option Schedule Process to Merge Verified Duplicates from the Manager Utilities menu April 1998 Duplicate Record Merge Patient Merge User Manual 6 1 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process IRM personnel will most likely perform this function Only authorized persons holding the XDRMGR security key should be responsible for using this option NOTE Duplicate records that are ready to be merged are displayed on a tally report accessed through the option Tally STATUS and MERGE STATUS fields on the Utilities menu This is documented on the pages that follow Duplicate Manager Utilities Menu EDT Edit Site Parameters IST ist File Entries Identified in Preliminary Scan SCN Preliminary Scan of File for Error
103. b 13 1997 16 16 51 Do you want to view those results YES NO Requested Start Time NOW lt RET gt NOV 22 1997 11 11 55 Queued as task 2680 Figure iii Sample dialogue for queuing a preliminary scan of PATIENT file 2 to Task Manager The screen border indicates that this is a dialogue with the computer on the terminal screen It is an example of system prompts and responses In these examples the user s response to the computer prompt is shown in boldface type Editor s comments may be used to emphasize user interaction with prompts in computer dialogue boxes and when used are displayed in Italics April 1998 Duplicate Record Merge Patient Merge User Manual xix Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Orientation XX Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 1 Introduction This software has been developed to assist VA facility staff in identifying and merging duplicate records found in VistA files Initiate Probabilistic Search Implementation Performs Searches for Duplicate Patients in Patient File 2 As of Kernel Toolkit Patch XT 7 3 113 the PATIENT file 2 is no longer be selectable from the Duplicate Record Merge Search option Instead the Initiate Probabilistic Search Implementation in Person Service Identity Management PSIM will perform searches for duplicate patients The DUPLICA
104. b address http vaww vista med va gov iss glossary asp For a comprehensive list of acronyms please visit the Acronyms Web site at the following Web address http vaww vista med va gov iss acronyms index asp Glossary 18 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Glossary April 1998 Duplicate Record Merge Patient Merge User Manual Glossary 19 Revised December 2010 Version 7 3 Kemel Toolkit Patch XT 7 3 125 Appendix A Are You New to VistA If you are just learning to use Veterans Health Information Systems and Technology Architecture VistA software this chapter introduces you to a small but important part of VistA signing on entering data and getting out You do not have to be a computer expert or know many technical terms to use VistA software This chapter helps you get started If you are an experienced VistA user this chapter can serve as a reminder How Does VistA Work VistA software packages use the computer in an interactive fashion An interactive system involves a conversation with the computer The computer asks you to supply information and immediately processes it You will be interacting with the software by responding to prompts the questions in the program The computer recognizes your responses when you complete the interaction by pressing the Return or Enter key VistA software is menu driven A menu is
105. blems cccccccccceeeeseessececeeeseceeessesseceeeeeeeeeseeeseseaeeeeeeeenesesaaaes 7 12 Print Last of File Duphcates 3 4 atten ain Meek ie Sie adh sh alee 7 14 Scan PossiblesDuplicatess lt cec EEE E E E E E E eect EE E 7 18 Tally STATUS and MERGE STATUS Fields 256 05 sescaschcscepSeniasids uhesdcbepuacepientaaihyecbnaheeds bee posntanl 7 19 View Duplicate Record Entries c cccccccccsesscceceecececeeeesenseceeecececeesesesaeeeeeeeeeeeeeeseeeeeeeeesenes 7 20 Chapter 8 Manager Utilitie 8 ovccscccciccciccciccdccccscscisctecstscsssetccecsesscesssceveseececcsuevaticeseecsccstensvsteseetess 8 1 Edit Ste Pata meters oriori eE E AE alameda tidac es UN E au aa nmin i 8 1 List File Entries Identified in Preliminary Scan cccecsccccececeseeseessnseceeeeeceesssesseaeeeeeeesesesseesaaes 8 3 Preliminary Scan of File for Errors messinesi oaeee aa iae as e Ra E eS Eaa 8 5 Purge Duplicate Record File OUT OF ORDER Removed From XDR MANAGER UTILITIES M nujren aide daletnlce dapawsieasbebuaetaoht ledabesbdeedeel Guaetalddayielasiebtaadiebevincdbeeties 8 8 Purge Merge Process Fieres burenana aaa a ented e a E a Eo E deovie da 8 8 x Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Table of Contents Restart a Merge Process in csccdced swisayehsvedeabeiis dae eaevasetiuecacbs vacdavhanuecdehl eaudede tuiderache ueewashuadbusowuenascued 8 9 Sc
106. bs including the current job Merge Process Status Screen Message NO PAIRS LEFT When you see the message NO PAIRS LEFT on the merge process status screen it means that either due to data errors or multiple pair processing that the merge job has completed There are no pairs left in the merge job to process Hence the job has run to completion NOTE See the section Schedule Process to Merge Verified Duplicates of this manual for more information on data error and or multiple pair processing excluding records from being merged Current Current Merge Set Start Stat Last Chk Phase File Entry MERGE 2 04 08 09 20 C 04 08 09 21 DATA CHECKING 04 08 09 20 C 04 08 09 21 NO PAIRS LEFT C 04 08 09 21 Figure 7 7 Status report of merge processes NO PAIRS LEFT Check Pair of Records to see if Duplicates NOTE As of Patch XT 7 3 113 users can no longer select PATIENT records from this option Checking for potential duplicates will be done by PSIM 7 6 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities The option Check Pair of Records to see if Duplicates is located on the Utilities menu It allows you to check two discrete records to see if they are duplicates Do this by entering two records when prompted The records are run through the duplicate test software to determine their duplicate match percentile This o
107. by a file on the host system can be identified to receive output It is implemented by the Device Handler s HFS device type Patients are assigned a unique identifier known as an Integration Control Number ICN within the process of being added to the MPI database This number links patients to their records across VHA systems The Integration Control Number is a unique identifier assigned to patients when they are added to the MPI The ICN follows the ASTM E1714 95 standard for a universal health identifier A combination of Integration Control Number and Veterans Administration Personal Identifier used to uniquely identify a person or record Initiate s Probabilistic Algorithm implementation The Identity Management Data Quality Team renamed the Healthcare Identity Management Team is a group of Data Management Analysts committed to improving and safeguarding the quality and accessibility of patient data throughout the VA enterprise They are involved in many data quality initiatives but their primary role is to assist VHA facilities in all matters related to the MPI Identity Management Data Quality ToolKit The IMDQ Toolkit will provide functionality to allow HC IdM staff to search and view identity and exception information in ADR This includes the ability to view the Primary View record and any associated correlations correlation data history audit trails and IMDQ Business Rule Events captured by PSIM and MPI In addition functi
108. cate record pair that was in another merge process The prompt START DATE TIME shown in the previous figure is a Task Manager field You can either queue this job to run at a later date and time or by entering the VA FileMan command NOW you can 6 2 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process begin the merge process immediately Your input to this prompt is based on the VA FileMan conventions for date and time For more information enter a question mark at this prompt running when changes are being made to Data Dictionaries or when data conversions N ADVISORY The merge process is a background job Be aware that it should not be are taking place April 1998 Duplicate Record Merge Patient Merge User Manual 6 3 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process Patient Data Validated before Merge Many of the broken database bad data events that would have upset an actual merge can be detected at the beginning of the merge process Checks are made on the various fields of the patient s record as though the data were being filed in the record for the first time The information is checked against any input transforms or edit routines as controlled by the custodian of the data All verified duplicate record pairs that have been approved to be merged are checked first befor
109. cluded Component Name Lab Cum Selected 4 Abbreviation SCL4 This component contains information extracted from the Lab package Not only do time and maximum occurrence limits apply to this component but also the user is allowed to select as many as seven atomic Lab tests Data presented include collection date time specimen test names with results and reference flags in columnar horizontal format Comments will also be conditionally displayed depending on the value of the DISPLAY COMMENTS ON LABS Health Summary Site Parameter When comments are displayed a lower case letter will be displayed to the left of the date for entries with comments Comments will be displayed after all the results are displayed with comments being linked by the lower case letter Up to 26 comments can be included Component Name Cytopathology Abbreviation CY This component contains information extracted from the Cytopathology module of the Lab package Time and maximum occurrence limits apply Data presented include collection date time accession number specimen gross description microscopic exam brief clinical history and Cytopathology Diagnosis Component Name Electron Microscopy Abbreviation EM This component contains information extracted from the Electron Microscopy module of the Lab package Time and maximum occurrence limits apply Data presented include collection date time accession number specimen gross description microscopic exam
110. computer use and the types of Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 VA VA FileMan VAMC Variable Verify Code VISN VistA VPID WAN Zst April 1998 Revised December 2010 Glossary computer programs available The System Manager assigns the user an access level Department of Veterans Affairs VistA s Database Management System DBMS The central component that defines the way standard VistA files are structured and manipulated Veterans Affairs Medical Center Character or group of characters that refer s to a value M previously referred to as MUMPS recognizes 3 types of variables local variables global variables and special variables Local variables exist in a partition of main memory and disappear at sign off A global variable is stored on disk potentially available to any user Global variables usually exist as parts of global arrays The term global may refer either to a global variable or a global array A special variable is defined by systems operations e g TEST The Kernel s Sign on Security system uses the Verify code to validate the user s identity This is an additional security precaution used in conjunction with the Access code Verify codes shall be at least eight characters in length and contain three of the following four kinds of characters letters lower and uppercase numbers and ch
111. d if so merge using the DUPLICATE RECORD MERGE software PATIENT 1 TESTPATIENT ONE 000 27 3002 IEN 100001302 PATIENT 2 TESTPATIENT ONE JR 000 28 3002 IEN 100001304 Figure 3 1 Email message sent when entries are added to the DUPLICATE RECORD file 15 April 1998 Duplicate Record Merge Patient Merge User Manual 3 1 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Review Process to Determine Duplicate Record Status The search process for potential duplicate records is independent from the verification of duplicates and the merge process Primary and ancillary reviews may be started as soon as any potential duplicates are identified There is no need to wait for the search process to reach completion 3 2 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 April 1998 Revised December 2010 Review Process to Determine Duplicate Record Status Duplicate Record Merge Patient Merge User Manual Version 7 3 Kemel Toolkit Patch XT 7 3 125 3 3 Primary Review Primary reviewers initiate the review process Potential duplicate record pairs can be selected from a list produced by a search of the selected primary file or in the case of this application the PATIENT file 2 duplicate entries are added automatically when the PSIM system identifies potentia
112. d whether the provider narrative should be displayed or not Component Name Skin Tests Abbreviation ST This component lists the skin tests and the results e g positive negative doubtful or no take for a particular patient Some examples of skin tests are cocci mon vac PPD schick tine etc Component Name Treatments Provided Abbreviation TP This component lists treatments provided that are not covered in the IDC 9 CM procedures for a particular patient for user specified time and occurrence limits Some example of treatment types include nursing activities such as ear irrigation dental care instructions or preventive health care counseling Package Patient Information Management System PIMS Component Name Admission Discharge Abbreviation ADC This component contains information from the MAS package Time and occurrence limits apply to this component Data presented include date range of admission ward length of stay LOS last treating specialty last provider admitting diagnosis text bedsection principal diagnosis diagnosis for longest length of stay DXLS and secondary ICD diagnoses Component Name ADT History Abbreviation ADT This component contains information extracted from the MAS package It can only be used with MAS Version 5 and up Time and maximum occurrence limits apply Data presented include movement date movement type ADM Admission TR Transfer TS Treating Specialty DC Discharge m
113. ds to see if Duplicates Display Search Status EDIT Edit the Status Field of a Duplicate Record FIND Find Potential Duplicates for an Entry in a File VAL Identify Potential Merge Problems PRNT Print List of File Duplicates SCAN Scan Possible Duplicates TSF Tally STATUS and MERGE STATUS fields VIEW View Duplicate Record Entries Select Utilities Option CMP lt RET gt Check Merge Process Status The merge process keeps track of itself by making checkpoints in 5 second intervals As it s checkpomnting it updates the Last Chk column with the date and time of each inquiry This report shown in the next figure allows IRM or reviewers to follow the merge process insuring its completion The values displayed in the next figure illustrate the chronological order of events that occur during the various phases of the merge process It is a reassuring indication to the reviewer that the job is still running The range of information found on this report covers tracking merge progress for data validation special processing and primary files by phases indicating the start and completion times showing the current file being processed and showing the entry in the current file that was last processed If additional threads are specified for processing the third phase of the primary file the progress of these additional threads is tracked as well This is discussed further in this section 6 10 D
114. e Clinical Maintenance Abbreviation CM This component shows what the outcome was of information on file that is related to the Clinical Reminders The PCE REMINDER MAINTENANCE ITEM FILE is used to determine which reminders should be printed in this component with the results of the search of information in PCE Problem List or other DHCP files Component Name Education Abbreviation ED This component lists the patient education topics and a brief assessment of the patient s understanding of the topic for a particular patient for user specified time and occurrence limits Some examples of topics are complications diet disease process exercise follow up care general information lifestyle adaptations medications nutrition smoking etc Component Name Education Latest Abbreviation EDL This component lists the latest patient education for each topic and a brief assessment of the patient s understanding of the topic for a particular patient for a user specified time limit Some examples of topics are complications diet disease process exercise follow up care general information lifestyle adaptations medications nutrition smoking etc Component Name Exams Latest Abbreviation EXAM This component lists the latest examination information and results for a particular patient for a user specified time limit Some examples of exam types are eye exams ear exams neurological exams pelvis exams etc Component Name Health
115. e Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 8 Manager Utilities Notice that several fields have data in them These are the default parameters exported with this application As was mentioned previously the list of default parameters exported with this application is documented in the Configuration section of this manual List File Entries Identified in Preliminary Scan The option Preliminary Scan of File for Errors creates a summary of the errors found in the PATIENT file 2 These errors are missing identifiers and invalid fields Use this option List File Entries Identified in Preliminary Scan to view the detailed lists of errors in File 2 generated from the SCN option It is located on the Manager Utilities menu Only authorized persons holding the XDRMGR security key should use this option Duplicate Manager Utilities Menu EDT Edit Site Parameters IST ist File Entries Identified in Preliminary Scan SCN Preliminary Scan of File for Errors PRGM Purg rge Process Fil RES Restart a Merge Process SCH Schedule Process to Merge Verified Duplicates SRCH Start Halt Duplicate Search STOP STOP an Active Merge Process Select Manager Utilities Option LIST lt RET gt List File Entries Identified in Preliminary Scan The following figure illustrates how to generate error lists of patients that are missing for example
116. e notice in the previous figure that MERGEPATIENT 21 M is matched with MERGEPATIENT 22 M If other matches were found from the search they would be added to the DUPLICATE RECORD file 15 as well and displayed on the screen with the other matches April 1998 Duplicate Record Merge Patient Merge User Manual 7 11 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities Identify Potential Merge Problems The option Identify Potential Merge Problems located on the Utilities menu has been designed to display any data errors that might exist in a patient s record Although distributed by another package the DG ELIGIBILITY security key is required to provide valid error checking results with this option The key may or may not be required to actually make the necessary edits Many of the broken database bad data events that would have upset an actual merge can be detected through this option The intent is to give the site the opportunity to make any necessary edits prior to merging duplicate record pairs Errors that are not resolved prior to the merge process will result in a pair not being merged Data is checked in the various fields of the patient s record as though it were being filed in the record for the first time The information is checked against any input transforms or edit routines as controlled by the custodian of the data NOTE if the merge parameters for your site are set up for more than one pr
117. e Kernel framework An association of options as pathway specifications to reach one or more final destination options The final options must be executable activities and not merely menus for the template to function Any user may define user specific menu templates via the corresponding Common option The descriptive words that appear when a list of option choices is displayed Specifically the Menu Text field of the OPTION file 19 For example User s Toolbox is the menu text of the XUSERTOOLS option The option s synonym is TBOX The menu system s hierarchical tree like structures that can be traversed or navigated like pathways to give users easy access to various options The MPI is a separate computer system located at the Austin Information Technology Center It maintains a record for VA patients and stores data such as a unique patient identifier and Treating Facility lists which tracks the sites where that ICN is known The Master Patient Index Patient Demographics MPI PD software resides in VistA enabling sites to e Request an ICN assignment e Resolve a potential duplicate on the MPI e Review and process exceptions received from MPI including Primary View Reject exceptions e Query the MPI Austin for known data e Update the MPI when changes occur to demographic fields stored on the MPI or of interest to other facilities systems of interest Duplicate Record Merge Patient Merge User Manual April 1998 Vers
118. e determined by the occurrence of admissions Component Name Transfers Abbreviation TR This component contains information extracted from the MAS package Time and occurrence limits Appendix C 12 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Appendix C apply to this component Data presented include transfer date type destination and provider when available NOTE The occurrence limits are determined by the occurrence of admissions Component Name Treating Specialty Abbreviation TS This component contains information extracted from the MAS package Time and occurrence limits apply to this component Data presented include treating specialty change date time new treating specialty admission date and provider NOTE The occurrence limits are determined by the occurrence of admissions Package Pharmacy Component Name IV Pharmacy Abbreviation RXIV This component contains IV orders extracted from the Pharmacy package Only time limits apply Data presented include start date stop date drug additives dose status solutions and infusion rates NOTE If no time limit is defined only active IV orders are reported If a time limit is defined all ITV orders which have an expiration or cancel date within the time limit range are reported Component Name Outpatient Pharmacy Abbreviation RXOP This component contains inf
119. e following are field names and descriptions for the ancillary service site parameters References are made to both site parameters that are default values included with this application release and to fields that require the site assignment of values ANCILLARY SERVICE Duplicate record pairs may require secondary reviews when data is present in ancillary files This field is the name of the VistA ancillary service associated with each duplicate record pair Three default ancillary services are released with Patient Merge Laboratory Pharmacy and Radiology Each of these ancillary services has an associated primary file which could provide information on whether the entries are in fact duplicates or not In addition the ancillary reviewers expertise in evaluating other data in health summaries may provide information on the duplicate question This entry must be from three to 30 characters in length PRIMARY FILE NUMBER Primary file number for the main file associated with the ancillary service Enter the file number to be used for identifying duplicate record pairs for this ancillary service e g LAB DATA file 63 RADIOLOGY PATIENT file 70 PHARMACY PATIENT file 55 etc Each ancillary service distributed with this application release contains a default value for this field SUBFILES FIELD NUMBERS Subfiles in the primary file To show how many particular types of data or entries exist for some of the subfiles you can ent
120. e process is stored in this file Each merge process or job is one record entry Information is stored pertaining to the name of the merge job name of the primary file for which this merge process is being run date and time the process began or was scheduled to start date and time the merge job was halted and restarted date and time of successful completion task number associated with the merge process IENs of the TO and FROM record We have only documented some of the data stored in this file for each merge process If you require more information it can be found in the Data Dictionary for File 15 2 Once the merge process has completed that entry can be purged from the XDR MERGE PROCESS file 15 2 Only the Site Manager holding the XDRMGR key should be responsible for using this option 8 8 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 8 Manager Utilities anager Utilities Menu EDT Edit Site Parameters IST ist File Entries Identified in Preliminary Scan SCN Preliminary Scan of File for Errors PRGM Purg rge Process Fil RES Restart a Merge Process SCH Schedule Process to Merge Verified Duplicates SRCH Start Halt Duplicate Search STOP STOP an Active Merge Process Select Manager Utilities Option PRGM lt RET gt Purge Merge Process Fil Select Merge Process to Purge
121. e several types of cross references available Most generally a VA FileMan cross reference specifies that some action be performed when the field s value is entered changed or deleted For several types of cross references the action consists of putting the value into a list an index used when looking up an entry or when sorting The regular cross reference is used for sorting and for lookup you can limit it to sorting only A representation of facts concepts or instructions in a formalized manner for communication interpretation or processing by humans or by automatic means The information you enter for the computer to store and retrieve Characters that are stored in the computer system as the values of local or global variables VA FileMan fields hold data values for file entries A characteristic unit of data such as length value or method of representation VA FileMan field definitions specify data attributes The Data Dictionary is a global containing a description of the kind of data that is stored in the global corresponding to a particular file VA FileMan uses the data internally for interpreting and processing files It contains the definitions of a file s elements fields or data attributes relationships to other files and structure or design Users generally review the definitions of a file s elements or data attributes programmers review the Duplicate Record Merge Patient Merge User Manual Glossary 3 Version 7 3
122. e syntax of the jump is two up arrows followed by an option s menu text or synonym e g PRINT OPTION file If the two up arrows are not followed by an option specification the user is returned to the primary menu see Go home Jump Standards and Conventions Through a process of quality assurance all VistA software is reviewed with respect to SAC guidelines as set forth by the Standards and Conventions Committee SACC VistA s Standards and Conventions Committee This Committee is responsible for maintaining the SAC The technique of requesting that Task Manager run an option at a given time perhaps with a given rescheduling frequency VA FileMan s Screen oriented text editor It can be used to enter data into any WORD PROCESSING field using full screen editing instead of line by line editing Screen oriented display of fields for editing or simply for reading VA FileMan s Screen Manager is used to create forms that are stored in the FORM file 403 and exported with a software application Forms are composed of blocks stored in the BLOCK file 404 and can be regular full screen pages or smaller pop up pages The presentation of the interactive dialog one line at a time Compare to Screen oriented Software Engineering and Integration The purpose of Security Keys is to set a layer of protection on the range of computing capabilities available with a particular software package The availability of options
123. e that the fields in record 1 will overwrite the fields in record 2 3 17 Figure 3 15 Select a record pair as a Verified Duplicate 0 cccecscscccceeeceeeeesenseaeeeeeesesesessseeeeeees 3 17 Figure 3 16 Select a record pair as Verified Not A Duplicate eesscccesssneeeeeeeeneeeesentneeeeees 3 18 Figure 3 17 Select a record pair as Unable To Determine eeecceeceeseeeeceeeeeeeeeeceenaeeeeeenteeeeeees 3 18 Figure 3 18 Primary reviewer chooses the merge direction for duplicate records seceeeeeeeeeeeees 3 19 Figure 3 19 Example of an alert cccccccsccccececeeeeseessnneceeececessesesneaeeeeeeeeeesseseaeaeeeseesesensssaeeeeeees 3 21 Figure 3 20 Example of a MailMan message sent to ancillary revieWerS ccsccceceesseeeeeeenneeeeeees 3 22 Figure 3 21 Using the option Ancillary Data Review to review ancillary data cssscceeeeeereeeeees 3 23 Figure 3 22 Designate fields containing ancillary data in potential duplicate records for overwriting 3 25 Figure 5 1 Verified duplicate records awaiting approval for MergiNg eeeesessecececeeeeeeesesenteeeeeees 5 1 Figure 6 1 Scheduling the merge process ccccccccssessssececeeeecececessesseceeeeeeecessessaaeeeeeeeeeseessessaeeeeeess 6 2 Figure 6 2 MailMan message containing records with data errors excluded from the merge process 6 5 Figure 6 3 MailMan message containing multiple record pair s excluded from the
124. e the actual merge begins Records found that have data errors are excluded from the actual merge The record pairs STATUS is then reset to Verified Duplicate They are written to a MailMan message and sent to the mail group that has been defined in the MERGE MAIL GROUP field This is a site parameter in the DUPLICATE RESOLUTION file 15 1 and is defined at setup The subject of the MailMan message is MERGE PAIRS EXCLUDED DUE TO PROBLEMS shown below The intent of receiving this error report in a MailMan message is to give the site the opportunity to make any necessary edits prior to merging duplicate record pairs Errors that are not resolved prior to the merge process will result in a pair not being merged The following figure displays a sample MailMan message containing data errors for one record pair Notice that the patient identification information for both FROM and TO records shown below is displayed prior to the actual data errors in the MailMan message e FROM DFN 14 MERGEPATIENT 17 S 000110014 e TO DFN 16 MERGEPATIENT 18 A 000110016 This is respectively the e internal entry number of the record in the PATIENT file 2 e patient name and e social security number NOTE When a merge process results in a message stating that pairs were excluded it will still automatically send a message saying the merge completed even if no pairs were merged If both messages are sent is necessary to review the information in
125. eMan field prompts to delete data An indication to Menu Manager that the current user s menu items should be displayed automatically When auto menu is not in effect the user must enter a question mark at the menu s select prompt to see the list of menu items An authorized programmer call that may be used in any VistA application package The DBA maintains the list of DBIC approved entry pomts A symbol expressed as up caret left caret lt or right caret gt In many M systems a right caret is used as a system prompt and an up caret as an exiting tool from an option Also known as the up arrow symbol or shift 6 key The result of a mathematical computation involving the individual characters of a routine or file A combination of characters that instruct the computer to perform a specific operation The Common menu consists of options that are available to all users Entering two question marks at the menus select prompt displays any secondary menu options available to the signed on user along with the common options available to all users Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Compiled Menu System 4XUTL Global Control Key Controlled Subscription Inte gration Agreement Cross Reference Data Data Attribute Data Dictionary DD April 1998 Revised December 2010 Glossary Job specific infor
126. earch STOP an Active Merge Process Select Manager Utilities Option LIST lt RET gt List File Entries Identified in Preliminary Scan The following figure illustrates how to generate an error list of patients that are missing for example Social Security Numbers Select Manager Utilities Option LIST lt RET gt List File Entries Identified in Preliminary Scan Enter the number of the desired list to output BAD SSN ISSI ISSI ISSI ISSIN ISSI ISSIN ISSIN ISSIN ISSIN ISSIN ISSI NO ZE QAANMAANDAARAAAAAA ds 2 3 4 5 6 7 8 ISSIN 9 LO L1 L2 L3 L4 W O List number Figure 2 4 List patient records with missing fields previously identified in preliminary scan The system displays the error list by missing fields and identifiers Choose the number corresponding to the list you want to view April 1998 Duplicate Record Merge Patient Merge User Manual 2 5 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 2 Identifying Duplicate Records Searching the Patient File The following table indicates the missing field and identifier numbers with their corresponding descriptions missing from patient records MISSING 1901 Missing Veteran Y N Table 2 5 Missing field and identifier numbers with corres ponding descriptions The following figure identifies the missing values The default display is to your terminal but yo
127. ecessary entries to the File 15 1 are made File 15 1 contains the parameters by which the DUPLICATE RECORD file 15 is populated File 15 1 also contains parameters that are specific to the merge process You must possess the XDRMGR security key to access this option By entering PATIENT at the prompt Select DUPLICATE RESOLUTION FILE TO BE CHECKED you are designating the PATIENT file 2 as your primary file for patient identification and merge processing NOTE If you don t have existing mail groups to designate as recipients of the various bulletins involved with the patient identification and merge processes your site will have to create them using MailMan V 7 1 utilities If your site chooses to create mail groups they must be added to the MAIL GROUP file 3 8 For more information on application specific bulletins see the section Assign Mail Groups of the Patient Merge Installation Guide For information on creating mail groups see the VA Electronic Mail System MailMan Technical Manual and Systems Management Guide V 7 1 April 1998 Duplicate Record Merge Patient Merge User Manual 1 9 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 1 Site Configuration Edit Site Parameters Duplicate Resolution File 15 1 The default parameters exported with this application are related to how potential duplicates are identified to designating ancillary reviewers and to defining the length of wait
128. ecord pair The default ancillary services released with the Patient Merge application are Laboratory Radiology and Pharmacy April 1998 Duplicate Record Merge Patient Merge User Manual 3 20 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Ancillary Review Alerts Sent to Ancillary Reviewers The next example shows alerts that have been generated by the primary review process Once the primary reviewer determines that a record pair is a verified duplicate if the records contain ancillary data alerts are automatically sent to the designated ancillary reviewers This process depends upon ancillary reviewers having been assigned by the site configuration process to receive alerts LABORATORY possible duplicates ERGEPATIENT 10 J M AND MERGEPATIENT 10 JOHN MARK RADIOLOGY possible duplicates MERGEPATIENT 10 J M AND MERGEPATIENT 10 JOHN MARK PHARMACY possible duplicates MERGEPATIENT 10 J M AND MERGEPATIENT 10 JOHN MARK Enter VA VIEW ALE to review alerts Figure 3 19 Example of an alert If any one ancillary reviewer does not concur with the primary reviewer by selecting the option Verified Not A Duplicate all of the alerts for that particular record pair disappear for all ancillary reviewers The records will not be merged Recipients can be designated to receive alert notifications of potential dupl
129. ed on the Utilities menu It is used to edit the status field of a duplicate record pair in the DUPLICATE RECORD file 15 Use it at any time for any record pair prior to merging when you want to change the status back to Potential Duplicate Unverified Once the status of the record entry has been changed back to Potential Duplicate Unverified the pair is ready to go through the review process again starting with the primary review April 1998 Duplicate Record Merge Patient Merge User Manual 7 9 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities Duplicate Resolution Utilities Menu Add Verified Duplicate Pair Check Merge Process Status Check Pair of Records to see if Duplicates Display Search Status Edit the Status Field of a Duplicate Record Find Potential Duplicates for an Entry in a File Identify Potential Merge Problems Print List of File Duplicates Scan Possible Duplicates TSF Tally STATUS and MERGE STATUS fields VIEW View Duplicate Record Entries Select Utilities Option edit lt RET gt Edit the Status Field of a Duplicate Record Select an Entry to RESET TO POTENTIAL DUPLICATES MERGEPATIENT 10 J M Searching for a PATIENT MERGEPATIENT 10 J M 6 29 45 000060969 YES SC VETERAN OK Yes lt RET gt Yes ERGEPATIENT 10 JOHN MARK VERIFIED DUPLICAT
130. ed past the remainder of the record to the selection of the duplicate record status Figure 3 5 Verify duplicate records using the duplicate record compare screen After you have examined the data comparing the potential duplicate record pair s you are presented with the options shown in the next figure April 1998 Duplicate Record Merge Patient Merge User Manual 3 7 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Primary Review Select one of the following VERIFIED DUP VERIFIED NOT A DUPLICATE UNABLE TO DETE H R S EALTH SUMMARY DATA REVI Select Action HEALTH S RY Figure 3 6 Review actions for potential duplicate records The following is a list of the options displayed in the previous figure with a brief description A more lengthy explanation is provided on the following pages for the options Health Summary Select Review Overwrites and Verified Duplicate 1 By selecting the option Verified Duplicate you the primary reviewer have determined that the record pairs are duplicates If the records contain ancillary service data alerts and or MailMan message notifications are sent to designated ancillary reviewers for a secondary review NOTE If no ancillary reviewers are named by your site full responsibility lies with the primary reviewer for duplicate resolution When the primary re
131. een halted you may experience a lag time indicating that the search has been halted It s going to take a moment for Task Manager to respond April 1998 Duplicate Record Merge Patient Merge User Manual 8 11 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 8 Manager Utilities This is a tasked job that can be started and halted until the entire file has been checked You will initially want to perform the Basic search of the database Once this search is started its progress can be monitored with the Display Search Status on the Utilities menu We are going to start a Basic search in this example To begin the search select the option Start Halt Duplicate Search located on the Manager Utilities menu shown below NOTE If the merge parameters for your site are set up for more than one primary file this option will prompt you to select a file to be searched for duplicates i e Select file to be checked for duplicates as shown in the next example If your site is only set up for one primary file this prompt will not be displayed Duplicate Manager Utilities Menu EDT Edit Site Parameters IST ist File Entries Identified in Preliminary Scan SCN Preliminary Scan of File for Errors PRGM Purge Merge Process Fil RES Restart a Merge Process SCH Schedule Process to Merge Verified Duplicates SRCH Start Halt Duplicate Search STOP STOP an Active Merge Process Select Manage
132. eene 3 21 Causes for Appearance and Disappearance of Alerts ccesessecccececeeeeesesseceeeeeeeeeenenaaes 3 21 MailMan Messages sent to Ancillary Reviewers cccccccccccceceseesenseeececeeeeeeessecseceeeeeeeeeseesaaaes 3 22 Chapter 4 Backup before Merge s icccc cciesscccenscsosscsesecedaessacacatavacecsesvacessteveceeteneascvaseecsecenssesces 4 1 April 1998 Duplicate Record Merge Patient Merge User Manual ix Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Table of Contents Build a HealthSumimary 3 isccscc occ 8s oles ap a ia a ee eee Gad eee Seatac eae e 4 1 Betore Image Global arasen eaaa Gaba EE diets E VEETEE Mis Ee shen eee 4 2 Chapter 5 Approve Verified Duplicates for Merging ooooooesooosesesesesesococosososocosososososososos 5 1 Chapter 6 The Merge Proce S icccccicscteceiccsccuestscccseccscccesdatccatecactsaccdaducivsasccecsasctsensdedecewsevstesstses 6 1 Schedule Process to Merge Verified Duplicates 0 ccccccssssscccececeeeesenneceeeeeeeceenessaeeeeeeeeenene 6 1 Patient Data Validated before Merge ccccccccccccecessessenseceeeceeeceesesecseceeeeeeeeessnessseeeeeeeeseeses 6 4 Merging Multiple Record Pairs cccccccecsessecccecececceeeesenneceeeeececeesesseneceeeeeeeseseeeseseeeeeeseneesea 6 6 Summary of Records Merged and Ready to Merge ccccecssssccccececeeeeesenscneceeeeeeeeessesseaeeeeeeeeenes 6 8 Track Status of Merge Process ccccccccs
133. egistration for patients who already have an ICN at the Facility At the CMOR site ADT A04 Registration HL7 messages are sent to the MPI and the MPI then sends updates to those sites where the patient is known These messages update the date of last activity and any changes to descriptive data At a non CMOR site an ADT A04 message is sent to the CMOR via the MPI Duplicate Record Merge Patient Merge User Manual Glossary 13 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Glossary Remote Procedure Call RPC Resource Routine Rubber Band Jump SAC SACC Scheduling Options Screen Editor ScreenMan Forms Scrolling Mode SE amp I Security Key Glossary 14 Remote Procedure Call is a protocol that one program can use to request a service from a program located on another computer network Essentially M code may take optional parameters to do some work and then return either a single value or an array back to the client application Sequential processing of tasks can be controlled through the use of resources Resources are entries in the DEVICE file which must be allocated to a process es before that process can continue Program or a sequence of instructions called by a program that may have some general or frequent use M routines are groups of program lines which are saved loaded and called as a single unit via a specific name A menu jump used to go out to an option and then return in a bouncing motion Th
134. en merged into Record B Record A is gone Record B now is the FROM record to be merged into Records C and D FROM TO 1 Record B into Record C 2 RecordB into Record D STATUS Reset for Record Pairs Excluded from Merge The STATUS for record pairs excluded from the merge is reset differently based on the following conditions e The STATUS is reset to Potential Duplicate Unverified for record pairs excluded from the merge because the accepted pair s FROM record is part of the excluded pair This is because the FROM record will have been merged and won t be available for selection e The STATUS is reset to Verified Duplicate for record pairs excluded from the merge because the accepted pair s TO record is part of the excluded pair Excluded Records Written to MailMan message Records excluded from the merge are written to a MailMan message and sent to the mail group that has been defined in the MERGE MAIL GROUP field This is a site parameter in the DUPLICATE RESOLUTION file 15 1 and is defined at setup The subject of the MailMan message is PAIRS EXCLUDED FROM MERGE DUE TO MULTIPLE REFERENCES shown below Subj PAIRS EXCLUDED FROM ME F F E EFERENCES 2224183 06 Apr 98 10 53 4 Lines From POSTMASTER Sender ME ESE F KE i IN basket FROM DFN 135054 MERGEPATIENT 19 Y 000160581 FILE 15 IEN 1465 April 1998 Duplicate Record Merge Patient Merge Us
135. en set up with standard FileMan pointer references However there are a few April 1998 Duplicate Record Merge Patient Merge User Manual 6 23 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process VistA files that point to other VistA files using unusual methods These files require special processing to insure that they are converted correctly They are merged first by the same step by step merge procedure that is performed on the primary file Afterwards the file references are re pointed from the FROM records to the correct TO records 6 24 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 April 1998 Revised December 2010 Duplicate Record Merge Patient Merge User Manual Version 7 3 Kemel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process Chapter 7 Utilities The following section describes the utility options available with the Patient Merge application They are designed to assist both reviewers and IRM personnel with supplementary duplicate record identification editing the DUPLICATE RECORD file 15 and a variety of status reports involved with the merge process You can find the Utilities menu on the Duplicate Resolution System Menu shown in the next figure Duplicate Resolution System Menu XDRO Operations XDRU Utilities XDRM Manager Utilities Select Duplicate Resolution Syste
136. epts parameters as input and returns a value as output that can be directly assigned Geographic location at which VA business is performed In a record a specified area used for the value of a data attribute The data specifications of each VA FileMan field are documented in the file s data dictionary A field is similar to blanks on forms It is preceded by words that tell you what information goes in that particular field The blank marked by the cursor on your terminal screen is where you enter the information Set of related records treated as a unit VA FileMan files maintain a count of the number of entries or records VistA s Database Management System DBMS The central component of Kernel that defines the way standard VistA files are structured and manipulated Device attribute indicating that the device can only accept queued tasks If a job is sent for foreground processing the device rejects it and prompts the user to queue the task instead Please refer to the Glossary entry for ScreenMan Forms The central E mail system within VistA Developers use FORUM to communicate at a national level about programming and other issues FORUM is located at the OI Field Office Washington DC 162 2 A DATA TYPE that can contain any printable characters Global Address List Variable that is stored on disk M usage A menu jump that returns the user to the Primary menu presented at sign on It is specified by entering two up
137. er Manual 6 7 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process TO DFN 128031 MERGEPATIENT 19TH Y 000153563 Excluded as a multiple TO entry for ien 128031 Select MESSAGE Action DELETE from IN basket Figure 6 3 MailMan message containing multiple record pair s excluded from the merge process Summary of Records Merged and Ready to Merge Select the option Tally STATUS and MERGE STATUS fields on the Utilities menu to produce an up to date summary of all records that have been merged and all records that are ready to be merged This report also displays up to date totals of verified duplicate records records verified as not duplicates and unverified potential duplicate records Current counts are produced for the STATUS and MERGE STATUS fields of all records in the DUPLICATE RECORD file 15 based on the primary file that you ve selected i e the PATIENT file 2 Duplicate Resolution Utilities Menu Add Verified Duplicate Pair Check rge Process Status Check Pair of Records to see if Duplicates Display Search Status Edit the Status Field of a Duplicate Record Find Potential Duplicates for an Entry in a File Identify Potential Merge Problems Print List of File Duplicates SCAN Scan Possible Duplicates TSF Tally STATUS and MERGE STATUS Fields VIEW View Duplicate Record Entries
138. er the field numbers for the subfile s that should be displayed These entries should be separated by semicolons e g 1 085 2 4 5 8 Each ancillary service distributed with this application release contains a default value for this field DISPLAY NAMES FOR SUBFILES Respective subfile names for each of the specified subfiles in the primary file Specify the names that will be associated with the subfile numbers as they are entered in the field SUBFILES FIELD NUMBERS The names entered must be in the same position as their corresponding field numbers These names will appear on the screen so you might want to make them descriptive Semicolons e g Bld Bank Transfusn EM Lab Tests Mic should separate these entries Each ancillary service distributed with this application release contains a default value for this field 1 14 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 1 Site Configuration MAIL GROUP NAME Optional This field is a pointer to the MAIL GROUP file Your answer must be the name of an actual mail group entry in that file Once potential duplicate record pairs are established from the search populated into File 15 and reviewed by the primary reviewers MailMan messages are automatically sent to these designated mail groups if data is present for both entries in the potential duplicate pair in the file specified as the primary file for
139. ers that are not DINUMed to the main file ie the file currently being processed randomly points to the PATIENT its pointers are not DINUMed nor are they cross referenced Each entry in a file must be searched for any possible pointer values Any file containing one or more pointer fields which fall into this third phase must be searched record by record and in some cases subfile by subfile for possible pointers This phase requires a longer processing time to successfully complete re pointing affected files to the PATIENT file 2 NOTE If the site has set the NUMBER OF THREADS parameter to a number greater than one one or more jobs will be created to run in parallel Each thread will process one of the more time consuming files Additional threads may be used to reduce the total time required for completion of the merge process in this manner at the expense of increased system utilization by the additional jobs Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process Merge Process Status Screen Message NO PAIRS LEFT When you see the message NO PAIRS LEFT on the merge process status screen it means that either due to data errors or multiple pair processing that the merge job has completed There are no pairs left in the merge job to process Hence the job has run to completion NOTE See the section Schedule Process to Me
140. es before you begin the search for potential duplicate records Based on this information you can focus your repair efforts The option Preliminary Scan of File for Errors has replaced the old Kernel Toolkit option View Duplicate Record Entries Once you have run this preliminary scan you can use the LIST option described in the next section to identify specific patient names records where errors are found Listing Patient Records with Errors The option Preliminary Scan of File for Errors documented in the previous section creates a summary of the errors found in the PATIENT file 2 These errors are missing identifiers and invalid fields Use this option List File Entries Identified in Preliminary Scan to view the detailed lists of errors in the PATIENT file 2 generated from the SCN option This option is located on the Manager Utilities menu shown in the next figure Only authorized persons holding the XDRMGR security key may use this option 2 4 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 2 Identifying Duplicate Records Searching the Patient File Duplicate Manager Utilities Menu Edit Site Parameters ist File Entries Identified in Preliminary Scan Preliminary Scan of File for Errors Purg rge Process Fil Restart a Merge Process Schedule Process to Merge Verified Duplicates Start Halt Duplicate S
141. es or potential matches The Start Halt Duplicate Search option on the Manager Utilities menu is used to initiate a search of the database Only authorized persons holding the XDRMGR security key should be responsible for using this option Once you ve accessed this option you have a choice of two methods for searching the primary file 1 A Basic search checks all records in a file from beginning to end This search can be halted and restarted beginning with the next available record after the last record that was processed If you are running a search for potential duplicate records on a file for the first time you will probably want to run a Basic search 2 8 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 2 Identifying Duplicate Records Searching the Patient File 2 A New search checks only those records that have been added or edited since the last search was run based on a user specified cross reference It will begin with the next record number after the last one that was processed The New search like the Basic can also be halted and restarted beginning with the next available record after the last record that was processed NOTE If you Halt a search and immediately go back into the Start Halt option to verify that the search has been halted you may experience some lag time It s going to take a moment for Task Manager to react to the comma
142. essecececececceeeesesseneeeeeeeceeeeseeseeeeeeeeeeceeeesesseeeeeeeeseneeesaaaas 6 9 Stop Merge from Any Point in Processing cccscccccceceeeesessecsececeeececsesesseaeceeeeseesesesessaaeaeeeees 6 15 Restart Merge from Any Point in Processing cccessccscecececeescesensececeeeeecessessaeeeeeseseseeseesaaaes 6 15 MSS Ot DOE Global s ristoro eE E E edn sci duntudi see ka isn uid Seelsa lesen a 6 17 Recommendation for Efficient Use of System Resources 0 ccceessesecececeeeeeeesenneceeeeeeeceeseseseaeeeees 6 22 How Are Patient Records Merged ccccccccccceceeeesessenseceeececeeessesseneeeeeeseseeeesesseaeeeeeesesesesnsseaeeeees 6 23 Chapter 74 Utilitie 83i cccccscssccicettvercisccsceccesscevecectesseseesteccssovescdossasecssaswsacasadessbesattencsoatecdsascbossesseuees 7 1 Add Verified Duplicate Pair ieceri noita r a a E a aa aae 7 1 Check Merge Process Stats nicean aan a e A oon Ae ee eS 7 5 Check Pair of Records to see if Duplicates cccceccccccececeeeeesecsececececeeeesessaeceeeeeeeeesesessseeeeeees 7 6 Display Search Status cccccsccccccececessessecseceeeeeeeceseessseeeeeeeeesceesesnseeeeeeeceeeesesseaeeeeeeeseeeseeeaaaes 7 8 Edit the Status Field of a Duplicate ReCOrd cccccsessecececeececeeeeseseceeeeeeeenesesseaeeeeeeeeeeeneeeaaaes 7 9 Find Potential Duplicates for an Entry in a File eccececcccccececesseseenseceeeeeeeeeseessseeeeeeeeesenenenaaes 7 10 Identify Potential Merge Pro
143. eview and consideration in a subsequent merge process For example if three record pairs have the same FROM record two of them will be excluded from the current merge process The record pair with the lowest IEN value compared to the other multiples is included in the current merge process The following example tries to clarify this concept In this example Record A the three FROM records paired up to be merged into Record B C and D which are the three TO records FROM TO 1 Record A into Record B Record A into Record C 3 Record A into Record D 6 6 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process In the example above suppose that the Record A into B pair 1e number 1 has a lower IEN value than the other multiple pairs Since Record A is a component of the other pairs those remaining record pairs are excluded from the merge Only the Record A and B parr are processed in the current merge job FROM Record References TO Record after Merge After the merge completes the TO record becomes a union of itself and the FROM record that was merged into it It is important to note that any inquiries made to the original FROM record after the actual merge will now reference the TO record The FROM record simply goes away The following example tries to clarify this concept Based on our previous example Record A has be
144. evised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities the 60 default the record pair is considered to be a potential duplicate and is placed in the DUPLICATE RECORD file with a status of Potential Duplicate Not Verified Record pairs evaluated as potential duplicates cause the review process to initiate beginning with the primary review At this point you will review and determine the record status of this potential duplicate record pair as you would any other NOTE Refer to the Primary Review and Ancillary Review sections of this manual for more information on the primary review process NOTE Personnel authorized to hold the XDRMGR key will have the choice of bypassing the potential duplicate threshold percentage and adding records directly into the DUPLICATE RECORD file 15 Duplicate Resolution Utilities Menu ADD Add Verified Duplicate Pair CMP Check Merge Process Status CHCK Check Pair of Records to see if Duplicates DSS Display Search Status EDIT Edit the Status Field of a Duplicate Record FIND Find Potential Duplicates for an Entry in a File VAL Identify Potential Merge Problems PRNT Print List of File Duplicates SCAN Scan Possible Duplicates TSF Tally STATUS and MERGE STATUS fields VIEW View Duplicate Record Entries Select Utilities Option ADD lt RET gt Add Verified Duplicate Pair The following figure illustrates the computer di
145. example whenever an entry is made in a file a trigger could automatically enter the current date into another field holding the creation date The event that initiates an exchange of messages is called a trigger event The HL7 Standard is written from the assumption that an event in the real world of health care creates the need for data to flow among systems The real world event is called the trigger event For example the trigger event a patient is admitted may cause the need for data about that patient to be sent to a number of other systems There is a one to many relationship between message types and trigger event codes The same trigger event code may not be associated with more than one message type User Class Identification a computing area The MGR UCI is typically the Manager s account while VAH or ROU may be Production accounts In the menu system entering an up arrow followed by an option name accomplishes a jump to the target option without needing to take the usual steps through the menu pathway This term is used to refer to a limited level of access to a computer system which is sufficient for using operating a package but does not allow programming modification to data dictionaries or other operations that require programmer access Any option for example can be locked with the key XUPROGMODE which means that invoking that option requires programmer access The user s access level determines the degree of
146. for the file selected for this report shown in the previous figure As of the date that this report was run the total count of all records listed in the STATUS field is 1060 The STATUS field indicates that there are 134 records reported as VERIFIED DUPLICATE The MERGE STATUS field indicates that e 62 records were MERGED e 62 others are READY to be merged and e 10 records populate the NOT READY field The value of the NOT READY to merge field is affected by the site parameter DAYS BETWEEN VERIFY AND MERGE This field represents the site specified number of days that must pass before verified duplicate record pairs can be merged In this example 10 verified duplicate record pairs are waiting out this time period Once this time has elapsed these records will be READY to be merged Track Status of Merge Process Data is maintained on each part of the merge It can be displayed by using the option Check Merge Process Status located on the Utilities menu shown in the next figure This option allows you to check the April 1998 Duplicate Record Merge Patient Merge User Manual 6 9 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process status of all merge processes including the current process It is a valuable tool for charting the progress of a merge process to its completion Duplicate Resolution Utilities Menu Add Verified Duplicate Pair Check rge Process Status Check Pair of Recor
147. general the goal of the merge process is to create one resulting record from two within the main or primary file In the case of the Patient Merge application the primary file is the PATIENT file 2 The actual merge involves moving patient data contained in the FROM record to the TO record Existing patient data for a particular field or attribute in the TO record is not replaced unless it was specified for overwriting during the verification process NOTE For more information on selecting patient data for overwriting see the topic Designate Primary Fields for Overwriting located in both the Primary Review and Ancillary Review sections of this manual Data elements containing multiple entries e g Enrollment Clinic Dispositions etc are moved to the TO record in their entirety Again these subfiles are only moved provided that patient data does not already exist in the destination fields or that it was not specified for overwriting during the verification process Each subfile field is compared to its corresponding other The result of the merge is that the TO record contains data from both entries i e the FROM and the TO record The record from which data is moved the FROM record is then eliminated as an active record After this is accomplished only the TO records remain in the primary file Usually other files contain data that is in some way related to the primary file being merged The majority of VistA files have be
148. go back into it at any time It will update itself each time you look at it This option can be running in the background during a patient identification search and subsequent merge process The following figure illustrates the output from running a preliminary scan of patient records in File 2 8 6 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 8 Manager Utilities RUN TIME CURR IEN 151052 ENTRIES 66720 2159 1376 3 4572 3295 4 128 1332 entries are missing fiel 02 SEX entries are missing fiel 03 DATE OF BIRTH entries are missing fiel 09 SOCIAL SECURITY N entries are missing fiel 301 REVIEWER CONNECT entries are missing fiel 1901 VETERAN Y N h entries are missing fiel 391 TYPE ntries have NO zero node entries have bad SSN values non numeric etc E E E E E ja E ja E jai E Bi E fa E Ei 1403 1868 261 78 1299 2 entries missing of these values entries missing of these values entries missing of these values entries missing of these values entries missing of these values HH ae oS entries missing of these values Figure 8 7 Preliminary scan of PATIENT file 2 for list of errors The results of this scan are carefully scrutinized in the section titled Searching the Patient File in this ma
149. gure 2 9 Check on the search for duplicate records The next figure shows the Duplicate PATIENT Search status report The following information about the search is displayed in this report type of search Basic or New date and time the search was started or last restarted search statuses The different types are Completed Halted Running and Error Stop length of time the search has been running number of potential duplicate records that have been checked percentage of the primary file that has been searched April 1998 Duplicate Record Merge Patient Merge User Manual 2 11 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 2 Identifying Duplicate Records Searching the Patient File Duplicate PATIENT Search Search Typ Date Started Status hours min Records Checked MAY 02 1997 18 24 RUNNING 1 Potential Duplicate pairs found Figure 2 10 Duplicate Patient Search status screen shows the search is still running In the next figure we will halt the Basic search already in progress by using the option Start Halt Duplicate Search After indicating that we wish to halt the search notice that the next prompt to answer is Requested Start Time Although it says Start that is Task Manager asking when you want to start the process that will actually Halt the search The Start Halt Duplicate Search option located on the Manager Utilities menu acts as a toggle switch for this purpose You ha
150. he PSIM Identify search engine determines that a pair of patients are a match or a potential match Approve verified duplicate record pairs for Approve Verified Duplicates for Merging merging Check the status of a merge process Check Merge Process Status Check the status of the search for duplicate Display Search Status record pairs Check two discrete records for their duplicate Check Pair of Records to see if Duplicates status NOTE As of Patch XT 7 3 113 users can no longer select PATIENT records from this option Checking for potential duplicates will be done by PSIM Compare record pairs found from the search of Verify Potential Duplicates the primary file to see if they are duplicates Edit the assigned status of a duplicate record Edit the Status Field of a Duplicate Record pair Find potential data errors in a patient s record Identify Potential Merge Problems before it s merged Find duplicate entries for a single patient Find Potential Duplicates for an Entry in a File 2 record NOTE As of Patch XT 7 3 113 users can no April 1998 Duplicate Record Merge Patient Merge User Manual Appendix B 1 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Appendix B longer select PATIENT records from this option Finding potential duplicates will be done by PSIM Get a quick count or tally of the records in the Tally STATUS and MERGE STATUS fields DUPLICATE RECORD file grouped by status P
151. hedule Process to Merge Verified Duplicates cccccccecssssececececeeeesesseeeeceeeeeseesesseaseaeeeees 8 10 Start Halt Duplicate Search cceccccccccececesseseeesenseceeecececsseeseeceeeeeeeeeesesseseaeeeeeeseessesuaeeaeeees 8 11 STOP an Active Merge Process isi ies escccs ee nani a a A cave dl acc a NE OE Te 8 13 CGIOS SAT Ys 0 S605 Sa Se Ga SE an te AES Ae od a A Mt a8 Glossary 1 Append Ais 4 dot sre hide oc cdase ae Mert E sone E toed catenin aces Nledscwa sani ads Dasa adar ened Appendix A 1 Are You Newt Vista soc ecesten acest sie a Sheek aa blade ee hes SL Ee Appendix A 1 A PPC D destin So 2s tet Earns verteoeinee tet veces he he eh een Appendix B 1 Where Do I Find How To 2 2 2 o cccceccecsscccececeesesecseceeceeeeeceeeesesseceeeeeesesesessesseaeeseeesense Appendix B 1 Patient Merge FAQ Reviewers and IRM Personnel cccccccsesseceeeceeeeeeeeesseees Appendix B 1 Patient Merge FAQ Staff Authorized to Hold the XDRMGR Security Key Appendix B 3 UN 0 0151 OTON E GO a ear CR Eo E E AE ee ee Appendix C 1 Health Summary Component Descriptions cccesecscececeeeeeeesenseceeeeeeeesesessaeeeeeeees Appendix C 1 DOA EE AEAEE TEE colina SoS ttl ited dab A ach an desta E E E AE Index 1 April 1998 Duplicate Record Merge Patient Merge User Manual xi Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Table of Contents xii Duplicate Record Merge Patient Merge User Manual April 19
152. icate Threshold Percentage This value is a site parameter resident in the DUPLICATE RESOLUTION file 15 1 It is exported with the Patient Merge application set as a default of 60 When record pair scores evaluate equal to or above this percentage they are considered to be potential duplicates and are added to the DUPLICATE RECORD file 15 The search process may be halted at any point by using the option Start Halt Duplicate Search When restarted the search will pick up where it left off It will not begin again at the start of the file recycling through records that have already been searched This enables a site to control their system resources Should the decision be made to stop the search process mid search the user can halt the search indicate the search as complete change criteria e g Potential Duplicate Threshold Percentage and reinitiate the search NOTE Be advised that searching the database for duplicate record pairs can take a long time to run to completion Actual time for a search has been known to exceed 100 hours Start Halt Duplicate Search Option NOTE As of Patch XT 7 3 113 the PATIENT file 2 will no longer be selectable from the Search option Although users with access to the Duplicate Record Merge menus will still be allowed to add records to the DUPLICATE RECORD file 15 this file will mainly be populated automatically when Person Service Identity Management P SIM identifies patient pairs as match
153. icate record pairs as well as belong to mail groups designated to receive MailMan message notifications for the same duplicate records If recipient s who are designated to receive both forms of notification process duplicate records through alerts first the same duplicate record pairs will not be accessible through the option Ancillary Data Review for that ancillary service The opposite is also true Should the recipient s process duplicate records using the option Ancillary Data Review first the alert goes away Causes for Appearance and Disappearance of Alerts It is important to distinguish between what causes both the appearance and disappearance of alerts Two scenarios are described below 1 If at any pomt an ancillary service determines that two records are not duplicates all pending alerts related to duplicate identification for that patient disappear for all ancillary reviewers Processing for that potential duplicate record pair ends there The records will not be merged 2 If for example one Pharmacy reviewer verifies that a record pair is a duplicate then that alert disappears for any other designated recipient in Pharmacy However the pending alerts related to that same patient remain for the other ancillary services because they still have to be processed April 1998 Duplicate Record Merge Patient Merge User Manual 3 21 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Ancillary Review
154. icates brief format 7 16 captioned format 7 16 unable to determine duplicate status 3 7 3 15 VA facilities can add any two PATIENTS to File 15 7 1 DUPLICATE RESOLUTION file 15 1 1 3 ANCILLARY SERVICE 1 14 DAYS BETWEEN VERIFY AND MERGE 1 12 DISPLAY NAMES FOR SUBFILES 1 14 edit enter site parameters 1 9 INDIVIDUAL FOR ALERTS 1 14 MAIL GROUP NAME 1 14 NUMBER OF THREADS 1 12 April 1998 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 POTENTIAL DUPLICATE THRESHOLD 1 11 PRIMARY FILE NUMBER 1 14 site parameters 8 2 SUBFILES FIELD NUMBERS 1 14 file special handling 1 4 HEALTH SUMMARY COMPONENT file 142 1 1 MAIL GROUP file 3 8 1 11 MERGE PROCESS file 15 2 delete selected record pair s 3 MPI DO NOT LINK file 4985 28 add records already identified as not a duplicate pair 7 3 MPI DO NOT LINK FILE 985 28 Verified Not A Duplicate 3 7 3 14 PACKAGE file 9 4 AFFECTS MERGE field 20 6 20 AFFECTS MERGE multiple 6 11 AFFECTS RECORD MERGE field 20 1 4 PATIENT file 2 1 7 identify errors in patient records 8 5 missing identifiers and or other anomalies 1 7 no longer checks two selected patients 7 1 no longer selectable 1 3 2 1 2 6 8 10 1 POTENTIAL DUPLICATE THRESHOLD data no longer used for searching File 2 1 11 view errors in the PATIENT file 2 generated from the SCN option 2 3 XDR MERGE PROCESS file 15 2 RESTART DATE TIME field 5 6 11 Find Pote
155. ice of Information Field Office The set of programs files documentation help prompts and installation procedures required for a given application e g Laboratory Pharmacy and PIMS A VistA software environment is composed of elements specified via the PACKAGE file 9 4 Elements include files associated templates namespaced routines and namespaced file entries from the OPTION HELP FRAME BULLETIN and FUNCTION files As public domain software VistA software can be requested through the Freedom of Information Act FOIA Patient Information Management System VistA software package that includes Registration and Scheduling packages The address at which a data value is stored in computer memory A relationship between two VA FileMan files a pointer is a file entry that references another file forward or backward Pointers can be an efficient means for applications to access data by referring to the storage location at which the data exists A Data Base Management System construct where one or more fields uniquely define a record entry in a file table The fields are required to be populated for every record on the file and are unique in combination for every record on the file Duplicate Record Merge Patient Merge User Manual Glossary 11 Version 7 3 Kemel Toolkit Patch XT 7 3 125 Glossary Primary Menu Primary Reviewer Primary View Private Integration Agreement Glossary 12 The list of options prese
156. identified in preliminary scan 2 5 Figure 2 6 Patient records with missing SSNS 47 20 waeaiwes macau acwateranaaaremeen maw 2 7 Figure 2 7 Start a BASIC search of the primary file for duplicate records ccccceccceeeesessetteeeeeees 2 10 Figure 2 8 Completed BASIC search of the primary file for duplicate records cccccceesesseeeeeees 2 10 Figure 2 9 Check on the search for duplicate records ccccccccccssesseceeeceeeeceeessenseaeeeeeeeceesesssseaneeees 2 11 Figure 2 10 Duplicate Patient Search status screen shows the search is still running eee 2 12 Figure 2 11 Halting the search for duplicate records ccccccccceesesseeeeececeeeeeesesseeeeeeeeeesesesseteaeeeees 2 12 Figure 2 12 Duplicate Patient Search status screen shows the search for duplicate records has been Tel EAR E nea rec AEN EEE AE N EE E AE E E E Aue bones ated 2 13 Figure 2 13 Continuing the search for duplicate records eccceceeeeseeeeceeseeececeeeeeeeeeceenaeeeeeenneeeeeees 2 13 Figure 2 14 Duplicate Patient Search status screen shows the search has been continued 2 14 Figure 3 1 Email message sent when entries are added to the DUPLICATE RECORD file 15 3 1 Figure 3 2 Begin the duplicate record verification ProCess ccccceseesceceseeenececeeenneeeceeseaeeeeeeeaaeeeeeeaaas 3 4 Figure 3 3 Select a potential duplicate record pair from a list displaying the name and d
157. ied the responsible provider and all active comments Component Name All Problems Abbreviation PLL This component lists all known problems both active and inactive for a patient Information displayed ICD data based on ICD Text Display parameter provider narrative unless Provider Narrative Display parameter is set to NO date of onset if problem is active date problem resolved if inactive date last modified the responsible provider and all active comments for the problems Component Name Inactive Problems Abbreviation PLI This component lists all known inactive problems for a patient Information displayed ICD data based on ICD Text Display parameter provider narrative unless Provider Narrative Display parameter is set to NO date problem resolved date last modified the responsible provider and all active comments for the problem Package Generic Progress Notes Component Name Advance Directive Abbreviation CD This component contains advance directive notes entered using the Generic Progress Note package Time and maximum occurrence limits apply to this component Advance Directives are a type a progress note which includes clinical information that clinicians need to be alerted to If this component is printed to either a CRT or another device type information will include title text of note electronic signature block and date time posted Appendix C 14 Duplicate Record Merge Patient Merge User
158. ield of a Duplicate Record Find Potential Duplicates for an Entry in a File Identify Potential Merge Problems Print List of File Duplicates Scan Possible Duplicates Tally STATUS and MERGE STATUS fields View Duplicate Record Entries Select Utilities Option Print lt RET gt List of File Duplicates The following is an example of the computer dialogue necessary to display unverified potential duplicate patient records from the DUPLICATE RECORD file 15 in a Brief format Select one of the following BRIEF CAPTIONED Choose type of list 1 lt RET gt BRIEF Select File you wish to list for PATIENT This utility provides reports on verified and unverified potential duplicates Select one of the following VERIFIED potential duplicates OT READY TO MERGE VERIFIED duplicates EADY TO MERGE VERIFIED duplicates ERGED VERIFIED duplicates t 1 lt RET gt UNVERIFIED potential duplicates lt RET gt REMOTE LOGIN RIGHT MARGIN 80 lt RET gt E M ET ME THINK ABOUT THAT A MOMENT Figure 7 15 Print a list of unverified potential duplicate records in a Brief format April 1998 Duplicate Record Merge Patient Merge User Manual 7 15 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities In the next figure is a
159. ill also be conditionally displayed depending on the value of the DISPLAY COMMENTS ON LABS Health Summary Site Parameter When comments are displayed a lower case letter will be displayed to the left of the date for entries with comments Comments will be displayed after all the results are displayed with comments being linked by the lower case letter p to 26 comments can be included Component Name Lab Cum Selected 1 Abbreviation SCL1 This component contains information extracted from the Lab package Not only do time and maximum occurrence limits apply to this component but also the user is allowed to select as many as seven atomic Lab tests Data presented include collection date time specimen test names with results and reference flags in columnar horizontal format Comments will also be conditionally displayed depending on the value of the DISPLAY COMMENTS ON LABS Health Summary Site Parameter When comments are displayed a lower case letter will be displayed to the left of the date for entries with comments Comments will be displayed after all the results are displayed with comments being linked by the lower case letter Up to 26 comments can be included Component Name Lab Cum Selected 2 Abbreviation SCL2 This component contains information extracted from the Lab package Not only do time and maximum occurrence limits apply to this component but also the user is allowed to select as many as seven atomic Lab tests Data presen
160. ill exist The record pair can t be approved if one of the pair no longer exists or has been merged into another record 5 2 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process This chapter documents in detail the operations involved in completing the merge process Options are available with the Patient Merge application to further assist you with the merge process The following is a brief outline of the options available to run a successful merge job Each option is documented in expanded detail on the following pages To begin a merge process Use the option Schedule Process to Merge Verified Duplicates to merge all approved verified duplicate record pairs This option is located on the Manager Utilities menu The following options are available to further assist you with the merge process Use the option Tally STATUS and MERGE STATUS fields to produce a tally report of verified duplicate records that are ready to be merged This option is located on the Utilities menu Use the option Check Merge Process Status to track the status of a selected merge process This option is located on the Utilities menu Use the option STOP an Active Merge Process to stop a currently running merge process and any associated threads This option is located on the Manager Utilities menu Use the option Restart a Merge Process to schedule the rest
161. imary file this option will prompt you to select the duplicate resolution file you want to check for errors If your site is only set up for one primary file this prompt will not be displayed Notice in the next figure that you are prompted for a device to display the findings from your queries Add Verified Duplicate Pair Check Merge Process Status Check Pair of Records to see if Duplicates DSS Display Search Status EDIT Edit the Status Field of a Duplicate Record Find Potential Duplicates for an Entry in a File VAL Identify Potential Merge Problems PRNT Print List of File Duplicates SCAN Scan Possible Duplicates TSF Tally STATUS and MERGE STATUS Fields VIEW View Duplicate Record Entries Select Utilities Option identify lt RET gt Potential Merge Problems DEVICE lt RET gt REMOTE RIGHT MARGIN 80 lt RET gt Figure 7 12 Select a device to display findings from the option Identify Potential Merge Problems You can check a patient s record for errors by entering either the patient s name or Social Security Number shown in the next figure 7 12 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities Select Patient MERGEPATIENT 10 J M lt RET gt 06 29 46 000060969 YE WORKING HARD may take a while DFN 1111 MERGEPATIENT 10 J M 00
162. ing OE RR Component Name Current Orders Abbreviation ORC This component contains current orders from the OE RR package Since the OE RR package integrates all orders for the ancillary services the orders will be reported in most recent orders first sequence without concern for the ancillary package the order originated from for Current orders are defined as those orders with an OE RR order status other than discontinued or expired The component information includes item ordered OE RR order status start date and stop date OE RR order status abbreviations include blank Active c Complete dc Discontinued e expired 0 Flageed h Hold i incomplete p pending s scheduled Package Patient Care Encounter PCE Component Name Clinical Reminders Abbreviation CR This component lists the clinical reminders and their due dates If an item is currently due DUE April 1998 Duplicate Record Merge Patient Merge User Manual Appendix C 7 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Appendix C NOW is listed instead of a date Clinical Reminders may included Measurements BP HT WT Exams Breast Pelvic Etc Laboratory Tests Cholesterol PAP Test etc Skin Tests PPD Immunizations Influenza Tetanus Toxoid etc Patient Education topics Breast Diet etc and in certain cases diagnosis status post lung CA and procedures hysterectomy flexisigomoidoscopy etc Component Nam
163. ing Search Add and Update processes The advanced search capabilities also provide enhanced capabilities for Healthcare Identity Management HC IdM case workers who perform patient Healthcare Identity Management tasks PSIM determines that a pair of patients is a duplicate or potential duplicates Potential duplicates are further reviewed by the Healthcare Identity Management team HC IdM If a pair of patients is determined to be duplicates and if both patients are known at a VistA site the patient pair is added to the local VistA DUPLICATE RECORD file 15 An email is sent to members of the mail group found in the DUPLICATE MANAGER MAIL GROUP field of the record associated with patients in the DUPLICATE RESOLUTION file 15 1 Once a potential duplicate pair has been identified the process of verifying record pairs begins The review and verification process includes two levels of review The primary reviewer initially seen as an MAS responsibility performs a review of patient demographic information The primary reviewer initially determines if the pair represents a duplicate record If so the primary reviewer selects the merge direction If data from ancillary services is present notification via MailMan message or alert or both is sent to those designated as ancillary reviewers A site may determine reviewers based upon their business practices Reviewers determine whether the record pair is a duplicate not a duplicate so that
164. ing periods applied in the process of identifying and merging duplicate records Your site may edit any one of these parameters in the DUPLICATE RESOLUTION file 15 1 by selecting the option Edit Site Parameters located on the Manager Utilities menu Included in this section is the list of the default parameters released with this application The following example shows you how to access the option Edit Site Parameters Duplicate anager Utilities Menu Edit Site Parameters ist File Entries Identified in Preliminary Scan Preliminary Scan of File for Errors Purge Merg Restart a Process Fil erge Process Schedule Process to Merge Verified Duplicates Start Halt Duplicate Search STOP an Active Merge Process Select Manager Utilities Option EDT lt RET gt Edit Site Parameters The next figure shows the data entry screen for editing site parameters 1 10 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 1 Site Configuration DUPLICATE RESOLUTION FILE ED PATIENT MERGE MATL ANAGER MAIL ENT 1 PLICATE THRE DS BEFORE FINAL EEN VERIFY AN NUMBER OF LABORATORY PHARMACY RADIOLOGY Press lt PF1 gt H for help Insert Figure 1 2 Editing s
165. ion 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Namespace Names pacing NDBI Node Null Numeric Field OI amp T OIFO Package Software PIMS Pointer Primary Key April 1998 Revised December 2010 Glossary A convention for naming VistA package elements The Database Administrator DBA assigns unique character strings for package developers to use in naming routines options and other package elements so that packages may coexist The DBA also assigns a separate range of file numbers to each package Convention for naming VistA software elements The DBA assigns unique two to four character string prefix for software developers to use in naming routines options and other software elements so that software can coexist The DBA also assigns a separate range of file numbers to each software application National Database Integration In a tree structure a point at which subordinate items of data originate An M array element is characterized by a name and a unique subscript Thus the terms node array element and subscripted variable are synonymous In a global array each node might have specific fields or pieces reserved for data attributes such as name Empty A field or variable that has no value associated with it is null Response that is limited to a restricted number of digits It can be dollar valued or a decimal figure of specified precision Office of Information Technology Off
166. ion to merge the records regardless of the default merge direction NOTE Remember this is an example of the primary reviewer selecting the merge direction for a duplicate record pair The actual merging of the records has NOT taken place yet The next step is for the ancillary reviewers to concur with the primary reviewer thus indicating that this record pair is a Verified Duplicate The actual merging of the duplicate records will not take place until the ancillary reviewers have had a chance to make their determinations April 1998 Duplicate Record Merge Patient Merge User Manual 3 19 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Ancillary Review Once the primary reviewer has verified record pairs as duplicates and selected the merge direction for both there is the potential for a secondary or ancillary review of patient data to occur An ancillary review is designed to allow the examination of data in files other than the primary file It provides a mechanism for other individuals to assist in the determination of their duplicate status Several conditions must exist for the ancillary review to occur 1 Designated ancillary reviewers must be entered during the package setup either as members of a specified mail group or as individuals specified to receive alerts NOTE For more information see the topic Edit Ancillary Service Subfile in the Site Configuration section of this manual 2 The primary reviewe
167. ions references for each are made to the examples shown in the next figure the file or subfile number and file or subfile name are displayed e g File 2 PATIENT file field number and field name e g Field 323 PERIOD OF SERVICE internal entry number string as used by VA FileMan e g IENS 1212 field value e g value VIETNAM ERA and a descriptive statement when available e g Applicant is too young to have Qe Qt The next figure shows you an example of error data displayed to a terminal device April 1998 Duplicate Record Merge Patient Merge User Manual 7 13 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities Select Patient MERGEPATIENT 23 1 MERGEPATIENT 23 O z 000016639 YES SC VETE 2 MERGEPATIENT 23 A 10 29 69 000074399 NO NSC VETE ENTER TO STOP OR CHOOSE 1 2 1 lt RET gt MERGEPATIENT 23 O 09 23 40 000016639 YE WORKING HARD may take a while DFN 9999 ME ENT 23 O 000016639 patient identification information File 2 PATIENT file file number or subfile amp file name Field 323 PERIOD OF SERVICE ENS 1212 field number field name and IENS value VIETNAM ERA field value Applicant is too young to have served in that period of service field Desc See your supervisor if you require assistance Field 50
168. ire the site assignment of values Ancillary service field name and default data value s list the information Ancillary Service Field Name Default Data Value LABORATORY PRIMARY FILE NUMBER Yo 4 SUBFILES FIELD NUMBERS 1 085 2 4 5 8 DISPLAY NAMES FOR Bld Bank Transfusn EM Lab SUBFILES ee Mic Po MAILGROUP NAME MAILGROUP NAME NAME provided by site by site ee ee E OO i Sur evo owes WA i SUBFILES INDIVIDUAL FOR ALERTS provided by site mow PRIMARY FILE NUMBER emanet eao I SUBFILES FIELD NUMBERS FILES FIELD NUMBERS DISPLAY NAMES FOR boo SUBFILES PI GROUP NAME provided by site INDIVIDUAL FOR ALERTS provided by site Table 1 3 Ancillary service default site parameters table April 1998 Duplicate Record Merge Patient Merge User Manual 1 13 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 1 Site Configuration The next figure shows the ancillary service data displayed in the data entry screen exported with this application This is the actual format for the default site parameters as viewed by the site ANCILLARY SERVICE INFORMATION ANCILLARY SERVICE LABORATORY PRIMARY FILE NUMBER 63 SUBFILES FIELD NUMBERS 1 085 2 4 5 8 R DISPLAY NAMES FOR SUBFILES Bld Bank Transfusn EM Lab Tests Mic ATL GROUP NAME INDIVIDUAL FOR ALERTS Figure 1 4 Ancillary service data entry screen Th
169. it out of what you are doing enter an up arrow You can use the up arrow at almost any prompt to terminate the line of questioning and return to the previous level in the routine Continue entering the up arrow to completely exit the system How to Enter Data Each time you enter data that action must be followed by pressing the Return key or Enter key on some keyboards to indicate you have completed that entry In many cases you need only enter the first few letters called shortcut synonyms of an option or field and the computer fills in the rest Shortcut synonyms help increase speed and accuracy The Return key is illustrated by the symbol lt RET gt when displayed in interactive computer dialogue If you want to bypass a prompt press the Return or Enter key and the computer goes on to the next question You are allowed to bypass a question only if the information is not required to continue with the option How to Generate Online Documentation Online documentation about this package may be obtained in a number of ways as described below Retrieving Online Help Using Question Marks If you need assistance while interacting with the software you can enter question marks to receive online help shown below e Entering a single question mark at a prompt provides a brief help message From any top level menu prompt one question mark will display the items available on the menu e Two question marks entered at a prompt provides
170. ite Parameters ist File Entries Identified in Preliminary Scan Preliminary Scan of File for Errors Purge Merge Process Fil Restart a Merge Process Schedule Process to Merge Verified Duplicates Start Halt Duplicate Search STOP an Active Merge Process Select Manager Utilities Option SCN lt RET gt Preliminary Scan of File for Errors Select DUPLICATE RESOLUTION FILE TO BE CHECKED PATIENT A run was completed on Jan 25 1997 13 50 19 Do you want to view those results YES YES Figure 2 1 Running a preliminary scan of the patient records Answering Yes to the prompt Do you want to view those results shown in the previous figure will generate the output from the scan of the PATIENT file 2 shown in the next figure You can step out of this option and go back into it at any time This option can run concurrently with other processes such as the search or merge process This option looks at fields like SOCIAL SECURITY NUMBER specifically for invalid ones e g SSNs that do not contain nine digits may contain spaces and numbers or characters etc It reports entries containing missing zero nodes It looks at the identifiers for the file it is running the search on assuming that the identifiers should be there Notice in the next figure that there are several missing identifiers in the fields listed For example the fields SEX REVIEWER CONNECTED and VET
171. ite parameters Notice in this first data entry screen shown in the previous figure that the file currently being checked is displayed in the top left corner In the case of the Patient Merge application this is the PATIENT file 2 Further down the screen the underlined data entry fields represent the VA FileMan required fields Notice that several fields have data in them These are the default parameters exported with this application They are described below MERGE MAIL GROUP The mail group entered in this parameter has the following three functions 1 A bulletin is sent when a merge process has been completed 2 A MailMan message is sent comprised of FROM and TO record pairs detected as having data errors during the beginning of the actual merge process Records contained in this message are excluded from the merge process The subject of this MailMan message is MERGE PAIRS EXCLUDED DUE TO PROBLEMS 3 A MailMan message is sent comprised of FROM and TO record pairs excluded from the merge process resulting from their multiple relationship s with the record pair selected to be merged The subject of the MailMan message is PAIRS EXCLUDED FROM MERGE DUE TO MULTIPLE REFERENCES NOTE See the section Schedule Process to Merge Verified Duplicates of this chapter for more information on data error and or multiple pair processing excluding records from being merged April 1998 Duplicate Record Merge Patient Merge User Manual 1 11
172. ither manually or as a result of the system being stopped etc it may be restarted again using the option Restart a Merge Process located on the Manager Utilities menu This will begin the merge process again at the phase and location file and internal entry number IEN where processing had stopped 6 16 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process Use of XTMP Global Although some data checking occurs at the beginning of the merge process the possibility still exists that other problems may appear that were not previously identified These are the data errors that are recorded in the XTMP XDRTESTK global It is recommended that this global location be checked for any other problems Hopefully there will consistently be nothing there other than the zero node Patient Merge establishes the subscript XDRTESTK in the XTMP global to record data errors occurring during the merge process This information is then available for review by IRM personnel These errors must be manually corrected and then filed back in the TO record s to ensure a fully merged patient record The errors recorded in this global may be a result of data failing to pass the constraints of an input transform if available These errors may also result from the situation of combining the FROM and TO record data which until filing is undetectable as an
173. itiated if the site desires It is important to point out that including a smaller number of records for merging does not significantly improve the overall time required for the merge process 6 22 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process How Are Patient Records Merged The Merge processes merges verified duplicate records in the following order 1 First records are merged in files that require special handling due to non standard references pointed to by the PATIENT file 2 NOTE Exported as part of the initial release are special processing routines to handle the few VistA files that point to other VistA files using unusual methods These files require special processing to insure that they are converted correctly Entries for each special processing routine have been made in the PACKAGE file 9 4 multiple AFFECTS RECORD MERGE field 20 Some local files may need a special processing routine If necessary it is a site responsibility to accomplish this using the Kernel Toolkit V 7 3 User Manual as a reference Entries for any special processing routines must be made in the PACKAGE file 9 4 multiple AFFECTS RECORD MERGE field 20 2 Second records are merged in the primary file 1e PATIENT or special processing files 3 Third files affected are re pointed to the new merged record in the main file In
174. k module of the Lab Package Time and occurrence limits apply to this component Data presented include transfusion date and abbreviated Appendix C 2 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Appendix C blood products with total number of units transfused for each e g RBC 2 A key of the abbreviations is presented at the bottom of the display to help identify any unfamiliar blood products Component Name Chem amp Hematology Abbreviation CH This component contains information extracted from the Lab package Time and maximum occurrence limits apply to this component Data presented include collection date time specimen test name results w ref flag High Low Critical units and Reference range Comments will also be conditionally displayed depending on the value of the DISPLAY COMMENTS ON LABS Health Summary Site Parameter Results which include comments will be indicated with the symbol in the event that the parameter is set to 0 or NO Component Name Lab Cum Selected Abbreviation SCLU This component contains information extracted from the Lab package Not only do time and maximum occurrence limits apply to this component but also the user is allowed to select any number of atomic Lab tests Data presented include collection date time specimen test names with results and reference flags in columnar horizontal format Comments w
175. kit Patch XT 7 3 125 Appendix C NOTE This component corresponds to the vertical format for the Lab package s cumulative reports Package Medicine Component Name Med Abnormal Abbreviation MEDA This component contains information extracted from the Medicine package Data presented include procedure date time medical procedure name and result e g normal abnormal borderline Time and maximum occurrence limits apply Component Name Med Brief Report Abbreviation MEDB This is the brief procedure view defined by the Medicine View file This output can be managed by the local IRM staff Time and maximum occurrence limits apply Component Name Med Full Captioned Abbreviation MEDC This prints the full set of results which are present in each procedure No labels will be included which have no values associated with them Time and maximum occurrence limits apply Component Name Med Full Report Abbreviation MEDF This component provides a full report of procedures as defined by the Medicine View file This report includes labels which have no value associated with them Time and maximum occurrence limits apply Component Name Med 1 line Summary Abbreviation MEDS This component provides a one line summary view of Medicine procedures which is extracted from the Medicine package Time and maximum occurrence limits apply Data presented include procedure date time medical procedure name and result e g normal
176. l duplicates The primary reviewer can browse the list or enter a selected record pair by name Comparative data from the primary file is displayed for reviewers to determine the status of potential duplicate record pairs Health Summaries can be used as additional reports viewed through the VA FileMan browser or printed to any device to help primary reviewers further verify the status of potential duplicate record pairs Begin the Verification Process Once reviewers have identified potential duplicate record pairs the next step is to verify that the records are duplicates To begin this process select the option Verify Potential Duplicates from the Operations menu shown in the next figure NOTE If the merge parameters for your site are set up for more than one primary file this option will prompt you to select the file you want to verify potential duplicates from i e Which FILE are the potential duplicates in e g PATIENT PATIENT as shown in the next figure If your site is only set up for one primary file this prompt will not be displayed Duplicate Resolution Operations Menu Approve Verified Duplicates for Merging Verify Potential Duplicates Ancillary Data Review Select Operations Option VPD lt RET gt Verify Potential Duplicates Which FILE are the potential duplicates in e g PATIENT PATIENT lt RET gt Figure 3 2 Begin the duplicate record verification process You can either know who the
177. lecting an appropriate occurrence value and time period to develop a paper backup inclusive of all the patient data Additionally a Health Summary parameter is available that lets you print patient data for a specific date range of a pre defined summary type for multiple patients After patients are selected you can pick a date range The data for component summaries is based on the date range you ve selected This date range overrides time limits for components These date and time parameters give you the opportunity to develop a report inclusive of all the patient data D NOTE See Appendix C of this manual for Health Summary component descriptions See the Health Summary documentation or the Health Summary web site located on the VistA Software Development home page under the Product Lines category for information on how to create a Health Summary April 1998 Duplicate Record Merge Patient Merge User Manual 4 1 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 4 Backup Before Merge Before Image Global Prior to merging your local patient records the saving of information to a global occurs within the merge process This global before image is designed for archiving It includes pointer values Saving this information to the global is intended as a method to reflect the before merge data and structure of the FROM and TO record It is a separate global to facilitate movement to another media e g tape
178. lems Print List of File Duplicates SCAN Scan Possible Duplicates TSF Tally STATUS and MERGE STATUS fields VIEW View Duplicate Record Entries Select Utilities Option CMP lt RET gt Check Merge Process Status The values displayed in the next figure illustrate the chronological order of events that occur during the various phases of the merge process The range of information found on this report covers e tracking merge progress for data validation special processing and primary files by phases e indicating the start and completion times e showing the current file being processed and e showing the entry in the current file that was last processed April 1998 Duplicate Record Merge Patient Merge User Manual 7 5 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities Current Current Merge Set Start Stat Last Chk Phase File Entry A in the Stat field indicates that this job is still active MERGE 2 03 25 11 DATA CHECKING 03 25 11 ERVICE 03 25 11 INTEGRATED BILL 03 25 11 ICR IMMUNOLOG 03 25 11 T 03 25 11 PATIENT FILE 03 25 11 EAD 2 03 25 11 EAD 3 03 25 11 03 25 11 1 03 25 11 03 25 L11 03 25 11 1 03 25 11 1 03 25 LLI 03 25 14 03 25 14 03 25 14 8 879268 1364 Dp HOA QO QP Boe Pe PPP PP Figure 7 6 Display the status of all merge jo
179. lossary 15 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Glossary Threshold Auto Link Toolkit KERNEL Toolkit Trigger Trigger Event UCI Up Arrow Jump User Access Glossary 16 The Auto Link Threshold is the level at which an Identity Profile must score against a set of identity traits in order to be considered a match For most enterprise applications the Auto Link Threshold would be set at or near the Initiate suggested Auto Link Threshold Internal Identity Management Systems MPI PSIM may use a lower score perhaps the Task Threshold as an Auto Link Threshold for identity management decision processes The Toolkit is a robust set of tools developed to aid the Veterans Health Information Systems and Technology Architecture VistA development community and Information Resources Management IRM in writing testing and analysis of code They are a set of generic tools that are used by developers documenters verifiers and packages to support distinct tasks The Toolkit provides utilities for the management and definition of development projects Many of these utilities have been used by the CIO Field Office San Francisco for internal management and have proven valuable Toolkit also includes tools provided by other CIO Field Offices based on their proven utility A type of VA FileMan cross reference Often used to update values in the database given certain conditions as specified in the trigger logic For
180. m Option utilities Figure 7 1 Utilities menu Add Verified Duplicate Pair NOTE As of Kernel Toolkit Patch XT 7 3 113 this option will be changed so that for the a PATIENT file 2 it no longer performs any checking on the two selected patients as if you had answered ES to bypass the potential duplicate threshold check VA facilities will be allowed to add any two PATIENTS to the DUPLICATE RECORD file 15 however most duplicate records will be automatically added to File 15 when PSIM determines that a pair of patients are a match or a potential match The option Add Verified Duplicate Pair is located on the Utilities menu It allows you to add a pair of records to the DUPLICATE RECORD file 15 that are not already identified as being there For records other than patients the designated record pair will be evaluated by the same duplicate tests used to search for duplicate records in the initial search of the primary file The duplicate tests result in a computed value based on a comparison of one record to the other The resulting value the duplicate match percentile is measured against the Potential Duplicate Threshold Percentage The Potential Duplicate Threshold Percentage exported with this application is set to a default value of 60 It is resident in the DUPLICATE RESOLUTION file 415 1 When this computed percentage evaluates equal to or above April 1998 Duplicate Record Merge Patient Merge User Manual 7 1 R
181. mation that is kept on each CPU so that it is readily available during the user s session It is stored in the XUTL global which is maintained by the menu system to hold commonly referenced information The user s place within the menu trees is stored for example to enable navigation via menu Jumping The Control Key Ctrl on the keyboard performs a specific function in conjunction with another key In word processing for example holding down the Ctrl key and typing an A causes a new set of margins and tab settings to occur Ctrl S causes printing on the terminal screen to stop Ctrl Q restarts printing on the terminal screen Ctrl U deletes an entire line of data entry before the Return key is pressed This applies where the IA describes attributes functions that must be controlled in their use The decision to restrict the IA is based on the maturity of the custodian package Typically these IAs are created by the requesting package based on their independent examination of the custodian package s features For the IA to be approved the custodian grants permission to other VistA packages to use the attributes functions of the IA permission is granted on a one by one basis where each is based on a solicitation by the requesting package An example is the extension of permission to allow a package e g Spinal Cord Dysfunction to define and update a component that is supported within the Health Summary package file structures There ar
182. mponent descriptions by package component name and component abbreviation Notice that some packages have multiple components Package Allergy Tracking System Component Name Adv React Allerg Abbreviation ADR This component provides patient allergy adverse reaction information from the Allergy Tracking System It provides a list of all known food drug and environmental allergies or adverse reactions e g hay fever Data element included are type of reaction mechanism of reaction causative agent verification status signs symptoms for the reaction the originator and comments Component Name Brief Adv React All Abbreviation BADR This component provides patient allergy adverse reaction information from the Allergy Tracking System It provides a brief patient list of all known food drug and environmental allergies or adverse reactions e g hay fever Package Automated Medical Information Exchange AMIE Component Name Comp amp Pen Exams Abbreviation CP This component prints all compensation and pension exams for a given patient by user specified time and occurrence limits Package Dietetics April 1998 Duplicate Record Merge Patient Merge User Manual Appendix C 1 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Appendix C Component Name Dietetics Abbreviation DI This component contains information from the Dietetics package Time and occurrence limits apply to this component Data p
183. n example of a Brief report format The various data listed on the report come from two different files The following is a breakdown of the file origins for each field listed in the order that they appear on the report 1 The first IEN number displayed e g IEN 99 is from the DUPLICATE RECORD file 15 The patient name IEN numbers and Social Security Numbers in Record 1 and in Record 2 are extracts from the PATIENT file 2 3 The status e g STATUS and the duplicate match percentile e g SCORE values are from the DUPLICATE RECORD file 15 Unverified Potential Duplicates NOV 12 1997 16 01 T 24 R I LLALL SSN 000012111 T 24 Z II 555555 SSN 000012119 DUPLICATE ERIFIED ENT 25 X II 987 SSN 000012317 ENT 25TH X EN 654321 SSN 000012317 DUPLICATE ERIFIED TIENT 26 U I 666 SSN 000012646 TIENT 26TH U EN 999999 SSN 000025771 DUPLICATE ERIFIED Figure 7 16 Brief format report of selected duplicate patient records The following is an example of the computer dialogue necessary to display unverified potential duplicate patient records from the DUPLICATE RECORD file 15 in a Captioned format 7 16 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125
184. naeeeeeeaaes 7 8 Figure 7 9 Displaying the status of the search of the PATIENT file 15 cece eeeeeseeeeeesteeeeeeees 7 9 Figure 7 10 Edit the Status Field of a Duplicate Record c ccccccsssccsccsesecteossusiers ipeccdenteccdeenndovedersaacteges 7 10 Figure 7 11 Finding duplicates for a single reCOrd cccccccccecsesessnnecceeeeeeeceesesseceeeeeeesessessnteeeeeees 7 11 Figure 7 12 Select a device to display findings from the option Identify Potential Merge Problems 7 12 Figure 7 13 Query returned from the option Identify Potential Merge Problems no data errors found 7 13 Figure 7 14 Query returned from the option Identify Potential Merge Problems data errors found 7 14 Figure 7 15 Print a list of unverified potential duplicate records in a Brief format cc ceeeeeeeeeees 7 15 Figure 7 16 Brief format report of selected duplicate patient records 0 ccceeeeesceceeeenteeeeeeenneeeeeees 7 16 Figure 7 17 Print a list of unverified potential duplicate patient records in a Captioned format 7 17 Figure 7 18 Captioned format report of unverified potential duplicate patient records csceeeees 7 17 Figure 7 19 Using the option the option Scan Possible Duplicates to list zero nodes from the DUPLICATE RECORD Tue tH 1D r eiee aaa daveuldcsacel neces a e 7 19 Figure 7 20 Using the tally report to view an up to date summary of the current merge process 7 20 Figure 7 2
185. nd and halt the search This is a tasked job that can be started and halted until the entire file has been checked You will initially want to perform the Basic search of the database Once this search is started its progress can be monitored with the Display Search Status option on the Utilities menu We are going to start a Basic search in this next example To begin the search select the option Start Halt Duplicate Search located on the Manager Utilities menu shown below NOTE If the merge parameters for your site are set up for more than one primary file this option will prompt you to select a file to be searched for duplicates i e Select file to be checked for duplicates as shown in the next example If your site is only set up for one primary file this prompt will not be displayed anager Utilities Menu EDT Edit Site Parameters IST ist File Entries Identified in Preliminary Scan SCN Preliminary Scan of File for Errors PRGM Purge Merge Process Fil RES Restart a Merge Process SCH Schedule Process to Merge Verified Duplicates SRCH Start Halt Duplicate Search STOP STOP an Active Merge Process Select Manager Utilities Option SRCH lt RET gt Start Halt Duplicate Search Select file to be checked for duplicates filename Enter primary file This process will take a LONG time known to exceed 100 hours but you CAN stop and restart the process when you want using the option
186. nd the most common identifying information for a patient e g Name SSN Sex Date of Birth etc If the zero node for an entry is missing it may mean that the entire record had been deleted at some point However an invalid partial entry of that record could have been triggered back in If the zero node is missing the main identifying information is gone The remaining partial record entry should be reviewed by IRM for potential removal Also notice in the previous figure that three patients have no Social Security Number Notice that 1332 patients have bad Social Security Numbers That can mean various things but most commonly the bad SSNs might be filled with spaces or alphabetic characters Answering No to the prompt Do you want to view those results shown in the next figure will generate a new scan This job is queued off to Task Manager Select Manager Utilities Option sen lt RET gt Preliminary Scan of File for Errors Select DUPLICATE RESOLUTION FILE TO BE CHECKED PATIENT A run was completed on Jan 25 1997 13 50 19 Do you want to view those results YES n lt RET gt NO Requested Start Time NOW lt RET gt Jan 26 1997 17 15 51 Queued as task 3025 Figure 2 3 Queue a preliminary scan of the PATIENT file 2 to Task Manager As was recommended previously the results from this preliminary search might indicate that some maintenance work needs to be conducted on your fil
187. ndex VISTA tii W waiting period site specified 1 8 Web Pages Acronyms 17 Glossary 17 Where Do I Find How To Add Verified Duplicate Pair 1 Ancillary Data Review 2 Approve Verified Duplicates for Merging 1 Check Merge Process Status Check Pair of Records to see if Duplicates Display Search Status 1 Edit Site Parameters 3 Edit the Status Field of a Duplicate Record 1 Find Potential Duplicates for an Entry in a File 1 Identify Potential Merge Problems 1 List File Entries Identified in Preliminary Scan 3 Preliminary Scan of File for Errors 3 Print List of File Duplicates 2 Purge Merge Process File 3 Restart a Merge Process 3 Scan Possible Duplicates 2 Schedule Process to Merge Verified Duplicates 3 STOP an Active Merge Process 3 Tally STATUS and MERGE STATUS fields 2 Verify Potential Duplicates 1 2 View Duplicate Record Entries 2 X XDR MERGE PROCESS file 15 2 6 11 XDR security key 1 16 XDR security key needed to access Duplicate Resolution System menu 1 16 XDRMGBR security key 1 7 1 8 1 9 1 15 1 16 1 17 2 1 2 3 2 7 6 1 7 4 8 1 8 7 8 10 8 12 3 XDRMGR security key needed to access to Manager Utilities menu 1 9 signing on April 1998 Duplicate Record Merge Patient Merge User Manual Index 7 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Index add records directly into the DUPLICATE RECORD file 7 4 Edit Site Parameters 1 9 8 1
188. nent Data presented include past clinic visits dates and a visit status e g NO SHOW INPATIENT VISIT D NOTE Cancellations and Unscheduled Visits are shown Component Name Demographics Abbreviation DEM This component contains the following patient demographic data if available from the MAS package address phone county marital status religion age sex occupation period of service POW status e g Y or N branch of service combat status e g Y or N eligibility code current verified eligibility status service connected mean test next of kin NOK NOK phone number and address Component Name Brief Demographics Abbreviation BDEM This component contains information from the MAS package It provides brief patient demographic information including address phone number age sex mean test and eligibility code e g service connected 50 100 Component Name Disabilities Abbreviation DS This component provides information from the MAS package about a patient s eligibility code and eligibility status Verified and rated disabilities including the disability percentage and whether the disability is service connected or non service connected Component Name Discharge Diagnosis Abbreviation DD This component contains information extracted from the MAS package Time and occurrence limits April 1998 Duplicate Record Merge Patient Merge User Manual Appendix C 11 Revised December 2010 Version 7 3
189. now for the current date time The colon can be omitted and AM PM can also be omitted if the time being entered is between 6 a m and 6 p m Thus today at 3 30 p m can be entered as T 330 Use MID as a response to mean 12 00 a m midnight and NOON as a response to mean 12 00 p m for time associated with dates T 3W MID April 1998 Duplicate Record Merge Patient Merge User Manual Appendix A 5 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Appendix A Making Corrections When you want to delete an answer previously entered without substituting any other answer enter an at sign as a response to that prompt This leaves the answer blank as shown below DATE OF BIRTH May 21 1946 In this example the date on file has been erased and now there is no answer to the DATE OF BIRTH prompt it is null The system asks you to confirm that you really intend to delete the information You may not be able to delete a response if the information is required ARE YOU SURE This question is a safety feature giving you a chance to change your mind now without re editing later Spacebar Return Feature When using this software you might want to answer a prompt with a code meaning the same as before The computer is capable of remembering what your last response s were the last time you signed on This feature is called spacebar return and employs the spacebar and Return keys You generally can
190. nted at sign on Each user must have a primary menu in order to sign on and reach Menu Manager Users are given primary menus by Information Resource Management IRM This menu should include most of the computing activities the user needs This can be a single person or group of people given the overall responsibility to initiate reviews of potential duplicate record pairs For example selected personnel in Patient Administration or a task force or group formed to oversee and conduct the effort of reducing or eliminating the occurrence of duplicate records in the site s database Primary View of the MPI is a business process that updates the patient identity fields across VA facilities overview as follows e Primary View is an update to the patient identity fields across VA facilities e Primary View creates a centralized view of the patient data aka a Primary View e Primary View has the best data from any combination of sites for the patient e Synchronizing the patient identity fields becomes centralized under a new set of business rules on the MPI e Primary View is a transition from and disassociated with the Coordinating Master of Record CMOR view of the MPI e Primary View removes the burden placed on sites to process the Patient Data Review PDR entries e Primary View allows for VistA sites to continue to edit their own patient data Patient data is sent to a central system i e the Master Patient Index to de
191. ntial Duplicates for an Entry in a File 1 7 7 10 1 users can no longer select PATIENT records 7 10 G global before merge image 1 4 Glossary Web address 17 H Health Summary component descriptions by package 1 16 Allergy Tracking System 1 Automated Medical Information Exchange AMIE 1 Dietetics 1 Discharge Summary 2 April 1998 Revised December 2010 Index Generic Progress Notes 13 14 Laboratory 2 Medicine 5 Mental Health 6 Nursing 6 Order Entry Results Reporting OE RR 7 Patient Care Encounter PCE 7 Patient Information Management System PIMS 9 Pharmacy 12 Problem List 13 Radiology 15 Social Work 15 Surgery 16 send to device type 3 9 send to VA FileMan browser 3 8 HEALTH SUMMARY COMPONENT file 142 1 1 Home Pages Acronyms 17 Glossary 17 How to correct data errors in a patient s record pre merge 7 12 designate fields to overwrite 3 12 enter data 2 enter dates and times 4 exit VistA 2 generate online documentation 2 respond to prompts 3 restart the merge process 6 14 8 8 schedule the merge process 8 9 search the database for duplicate records 8 10 send Health Summary to a device 3 9 send Health Summary to VA FileMan browser 3 8 set up merge direction 3 15 sign on 1 use the and marks 2 How Why alerts appear 3 18 How Why alerts disappear 3 18 ICN assignment MPI VistA 9 10 national 9 10 Duplicate Record Merge Patient Merge User Manu
192. ntifiers which are presumed to be significant data elements or checking for records that have other anomalies Although it is not mandatory to the process of merging records the results from this preliminary scan of the File 2 might indicate that some maintenance work needs to be conducted on your files before you begin the search for potential duplicate records Based on this computer generated list erroneous records might be removed or other repairs made This reduces the number of errors in the patient identification and merge process allowing the system to run much faster Preliminary Scan of the File to be Searched Only authorized persons holding the XDRMGR security key should be responsible for using this option To run the scan from the Manager Utilities menu select the option Preliminary Scan of File for Errors shown in the next figure NOTE If the merge parameters for your site are set up for more than one primary file this option will prompt you to select the duplicate resolution file you want to check for errors ie Select DUPLICATE RESOLUTION FILE TO BE CHECKED as shown in the next figure If your site is only set up for one primary file this prompt will not be displayed April 1998 Duplicate Record Merge Patient Merge User Manual 2 1 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 2 Identifying Duplicate Records Searching the Patient File Duplicate Manager Utilities Menu Edit S
193. nual Answering No to the prompt Do you want to view those results shown in the next figure will generate a new scan This job is queued off to Task Manager Select Operations Option SCN lt RET gt Preliminary Scan of File for Errors Select DUPLICATE RESOLUTION FILE TO BE CHECKED PATIENT A run was completed on Feb 13 1997 16 16 51 Do you want to view those results YES NO Requested Start Time NOW lt RET gt NOV 22 1997 11 11 55 Queued as task 2680 Figure 8 8 Queue a preliminary scan of PATIENT file 2 to Task Manager Once you have run this preliminary scan you can use the option List File Entries Identified in Preliminary Scan described in this section to identify specific patient names records where errors are found April 1998 Duplicate Record Merge Patient Merge User Manual 8 7 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 8 Manager Utilities Purge Duplicate Record File OUT OF ORDER Removed From XDR MANAGER UTILITIES Menu NOTE As of Patch XT 7 3 113 the Purge Duplicate Record File option which purged entries from the DUPLICATE RECORD file 15 was placed OUT OF ORDER and removed from the XDR MANAGER UTILITIES menu option Purge Merge Process File Use the option Purge Merge Process File located on the Manager Utilities menu to remove selected records from the XDR MERGE PROCESS file 15 2 All the information about each merg
194. o be merged using one of the following three methods 1 Authorized personnel holding the XDRMGR security key use the option Start Halt Duplicate Search to run a search of the PATIENT file 2 from which potential duplicate records are automatically entered into the DUPLICATE RECORD file 15 REF For more information see the section Searching the Database for Potential Duplicates of this manual NOTE This option can t be used on the PATIENT file 2 after Patch XT 7 3 113 is installed PSIM will populate the DUPLICATE RECORD file 15 automatically with potential matches 2 Use the option Add Verified Duplicate Pair to enter specific record pairs into the DUPLICATE RECORD file 15 REF For more information see the section Add Verified Duplicate Pair of this manual 3 Use the option Find Potential Duplicates for an Entry in a File to search for potential duplicates against a single record Retrieved potential duplicate records are then automatically added to the DUPLICATE RECORD file 15 REF For more information see the section Find Potential Duplicates for an Entry in a File of this manual NOTE This option can t be used on the PATIENT file after Patch XT 7 3 113 is installed PSIM will populate the DUPLICATE RECORD file 15 automatically with potential matches The primary reviewer examines a record pair for duplicate status using the option Verify Potential Duplicates Once the review is completed seve
195. of providing a snapshot of patient data just prior to duplicate record pairs being merged It is intended to make accessible what data was available when previous clinical decisions were made This application provides two methods of backup the 1 printing of Health Summaries and 2 saving information to a global Build a Health Summary Prior to merging your local patient records it is recommended that your site specify a Health Summary which should be as complete as possible to produce a paper record for each entry in a duplicate record pair Specification of the Health Summary must be accompanied by the designation of a printer for automatic printing to occur A Health Summary is a customized clinical summary which can be created by selecting any combination of modular patient information components A Health Summary component is a brief patient data extract from various VistA software packages You can build a Health Summary template or Type containing user defined components and unique attributes to produce a comprehensive backup of all patient data available for multiple patients Parameters are available in the Health Summary package for determining occurrence and time limits for data extracts Use them to display the most recent data for a specified time period within each selected component Pressing the Return key gives you the default if there is one for each parameter within a selected component You will want to consider se
196. ommand NOW begins the merge process immediately Merge process TEST3 for Verified Duplicates in File 2 scheduled Figure 8 10 Scheduling a merge process You are prompted to give the merge process a name Each merge process must have a unique name You can set up and run several merge processes at the same time providing each process has a unique name However the most practical and efficient approach is to run fewer merge processes containing multiple pairs The prompt START DATE TIME is a Task Manager field You can either queue this job to run at a later date and time or by entering the VA FileMan command NOW you can begin the merge process 8 10 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 8 Manager Utilities immediately Your input to this prompt is based on the VA FileMan conventions for date and time For more information enter a question mark at this prompt Notice that after you ve set up and scheduled the merge process to run a notification message is displayed indicating that verified duplicates are being merged in the primary file NOTE Be advised that the merge process can take a long time to run to completion Actual time for merging duplicate record pairs has been known to exceed 15 hours Start Halt Duplicate Search NOTE As of Patch XT 7 3 113 the PATIENT file 2 will no longer be selectable f
197. on The restart time is indicated in field 05 RESTART DATE TIME of File 15 2 You can restart a merge process using the option Restart a Merge Process on the Duplicate Manager Utilities menu E ERROR EXIT This status indicates that the merge process has recorded an error and is no longer running The error message appears on the next line just below the job that errored out 4 Last Chk Last Check This value indicates the most recent date time checkpoint of the active merge process It displays the last date and time as recorded by the checkpoint process This value is used to determine whether the process is still active or not 5 Phase Phases one two and three of the merge process are explained in detail in a following section titled Merging Verified Duplicates by Phases 6 Current File This is the current file being processed as indicated at the last checkpoint of the active merge process During a merge process there is the merge of the primary file There may also be merges of related files which require special processing as indicated by entries within the AFFECTS MERGE multiple of the PACKAGE file 9 4 This entry indicates which file the associated data is related to The entry is a file number for which a merge is being run 7 Current Entry This value indicates the most recent internal entry number as check pointed within the current file being processed by the active merge process This value in conjunction
198. onality is provided to support the re hosting transition for a side by side comparison of Duplicate Record Merge Patient Merge User Manual Glossary 7 Version 7 3 Kemel Toolkit Patch XT 7 3 125 Glossary Initiate Input Template Institution Inte gration Agreements IA Inte gration Control Number ICN Internal Entry Number IEN IRM ISO ISS IV amp V Glossary 8 ADR and MPI information Identity Management software vendor that was selected by the VHA to provide an Identity Management Probabilistic Algorithm A pre defined list of fields that together comprise an editing session A Department of Veterans Affairs VA facility assigned a number by headquarters as defined by Directive 97 058 An entry in the INSTITUTION file 4 that represents the Veterans Health Administration VHA Integration Agreements define agreements between two or more VistA software applications to allow access to one development domain by another VistA software developers are allowed to use internal entry points APIs or other software specific features that are not available to the general programming public Any software developed for use in the VistA environment is required to adhere to this standard as such it applies to vendor products developed within the boundaries of DBA assigned development domains e g MUMPS AudioFax An IA defines the attributes and functions that specify access The DBA maintains and records all I
199. ormation from the Outpatient Pharmacy package Only time limits apply Data presented include drug prescription number status expiration cancellation date when appropriate quantity issue date last fill date refills remaining provider and cost fill when available NOTE If no time limit is defined only active outpatient orders are reported If a time limit is defined all outpatient pharmacy orders which have an expiration or cancel date within the time limit range are reported Component Name Unit Dose Pharmacy Abbreviation RXUD April 1998 Duplicate Record Merge Patient Merge User Manual Appendix C 13 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Appendix C This component contains Unit Dose information extracted from the Pharmacy package Only time limits apply Data presented include Drug dose pharmacy status start date stop date and sig which includes schedule instructions and route NOTE If no time limit is defined all active orders are reported If a time limit is defined all unit dose orders which have an expiration or cancel date within the time limit range are reported Package Problem List Component Name Active Problems Abbreviation PLA This component lists all known active problems for a patient Information displayed ICD data based on ICD Text Display parameter provider narrative unless Provider Narrative Display parameter is set to NO date of onset date last modif
200. ormerly named Enterprise Product Support EPS Person Service Identity Management Requesting that a job be processed in the background rather than in the foreground within the current session Jobs are processed sequentially first in first out Kernels TaskMan module handles the queuing of tasks Option attribute that specifies that the option must be processed by Task Manager the option can only be queued The option may be invoked and the job prepared for processing but the output can only be generated during the specified times A user s authorization to read information stored in a computer file Set of related data treated as a unit An entry ina VA FileMan file constitutes a record A collection of data items that refer to a specific entity e g in a name address phone number file each record would contain a collection of data relating to one person During a registration if a patient does not have an ICN the patient is checked against the entries in the MPI to determine if the patient already is established or needs to be added The MPI may return a list of patients who are possible matches If the patient is truly new and there are no potential matches on the MPI the MPI will assign an ICN and assigns the requesting site as the CMOR If the patient is already known at the MPI the ICN and CMOR is returned and a HL7 message is sent to the CMOR to add this new facility to the list of Treating Facilities for this patient R
201. ou ve approved verified duplicates for merging the next step is for you to schedule the date and time for the merge process to run shown in the next figure To do this select the option Schedule Process to Merge Verified Duplicates from the Manager Utilities menu IRM will most likely perform this function Only authorized persons holding the XDRMGR security key should be responsible for using this option NOTE Duplicate records that are ready to be merged are displayed on a tally report accessed through the option Tally STATUS and MERGE STATUS fields on the Utilities menu This is documented elsewhere in this chapter and in the chapter titled The Merge Process Duplicate Manager Utilities Menu Edit Site Parameters ist File Entries Identified in Preliminary Scan Preliminary Scan of File for Errors Purge Merge Process Fil ES Restart a Merge Process SCH Schedule Process to Merge Verified Duplicates SRCH Start Halt Duplicate Search STOP STOP an Active Merge Process Select Manager Utilities Option SCH lt RET gt Schedule Process to Merge Verified Duplicates 2 Entries Ready to be included in merge This process will take a LONG time usually over 15 hours and sometimes considerably longer but you CAN stop and restart the process when you want using the options OK YES Name for rge Process TEST3 START DATE TIME 10 30 lt RET gt OCT 07 1997 10 30 00 Entering the VA FileMan c
202. ound from searching the primary file shown in the next figure The different types of search categories are Completed Halted Running and Error Stop Also displayed are the start or last restart time of the search the internal entry number of the record last processed and the number of new potential duplicate records that have been identified 7 8 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Duplicate Resolution Utilities Menu Add Verified Duplicate Pair Check rge Process Status Check Pair of Records to see if Duplicates Display Search Status Edit the Status Field of a Duplicate Record Find Potential Duplicates for an Entry in a File Identify Potential Merge Problems Print List of File Duplicates SCAN Scan Possible Duplicates TSF Tally STATUS and MERGE STATUS fields VIEW View Duplicate Record Entries Select Utilities Option DSS lt RET gt Display Search Status The Duplicate Patient Search status screen displays Duplicate PATIENT Search Search Typ Date Started Status hours min MAY 02 1997 18 24 RUNNING Chapter 7 Utilities Records Checked 1 Potential Duplicate pairs found Figure 7 9 Displaying the status of the search of the PATIENT file 15 Edit the Status Field of a Duplicate Record The option Edit the Status Field of a Duplicate Record is locat
203. ovement description specialty and provider Component Name ADT History Expanded Abbreviation EADT This component contains information extracted from the MAS package It is a consolidated view of all the MAS components It can only be used with MAS Version 5 and up Time and maximum occurrence limits apply Data presented include patient eligibility and rated disabilities Movement data then follows with movement date movement type ADM Admission TR Transfer TS Treating Specialty DC Discharge movement description specialty and provider Admissions include the admission diagnosis if the patient hasn t been discharged Transfers included ward location and transfer facility Treating specialties includes Specialty Transfers Diagnosis Discharges include the data in the Discharge Diagnosis and Discharges components Following the data for each Appendix C 10 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Appendix C admission ICD Procedures and ICD Surgeries will be include if present Component Name Fut Clinic Visits Abbreviation CVF This component provides a listing from the MAS scheduling module that contains future clinic visit dates the clinic visited and the appointment type Component Name Past Clinic Visits Abbreviation CVP This component contains information from the MAS scheduling module Time and occurrence limits apply to this compo
204. own in the previous figure Thread The site parameter NUMBER OF THREADS is used to indicate the number of threads multiple parallel jobs that should be used during the longest phase of the merge process Phase 3 A value of 1 indicates that only the main process would run A value of 2 to 5 indicates that the main process as wellas to 4 other threads would be used during this phase The greater the number of threads the more parallel processing occurs Each thread is used to process one of the more time consuming files which reduces the amount of time the overall process takes at the expense of increased system utilization Your site can set the number of threads jobs according to your system resources April 1998 Duplicate Record Merge Patient Merge User Manual 6 13 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process The reference to THREAD shown in the previous figure corresponds to the file and record number i e IEN that was being processed at the time this report was run Merge Process Status Screen Merging Verified Duplicates by Phases The merge process is performed in phases There are up to three phases that any one merge process can take depending on the file references to the primary file being merged Using the option Check Merge Process Status will display these phases by number in the field named Phase shown in the previous figure during processing The
205. patient is that you re interested in finding duplicates for or if you need to look at a list of patients you can do one of the following two things 1 To see a list of potential duplicate record pairs displayed by name and duplicate status enter a question mark at the Selecta POTENTIAL DUPLICATE ENTRY prompt Answering Yes will display the entire list of potential duplicate record pairs resident in the DUPLICATE RECORD file 15 shown in the next figure April 1998 Duplicate Record Merge Patient Merge User Manual 3 4 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Primary Review At the following prompt select a POTENTIAL DUPLICATE ENTRY If a selection is not made you will be given a chance to select from a list if you want to Otherwise you will be returned to the menu system Select a POTENTIAL DUPLICATE ENTRY Answer with DUPLICATE RECORD RECORD1 Do you want the enti DUPLICATE RECORD List y lt RET gt Yes Choose from ERGE PATIENT FIV ERGEPATIENT FIVE R POTENTIAL DUPLICATE UNVERIFIED ERGEPATI Fp SIX Us RGEPATIENT SIX JR POTENTIAL DUPLICATE UNVERIFIED ERGE PATI T SEV FPATIENT SEVEN I POTENTIA PLICATE UNVERIFI ERGE PATI T EIT FPATIENT SEVEN S POTENTIA PLICATE UNVERIFI ERGE PAT l NIN PATIENT NINE A POTENTIAL LICATE UNVERIFIED ERGE PAT T 10 J M MBE E 10 JOHN MARK POTENTI PLICATE UNVERIFI ERGEF Pp ELA Di ERGEF Fr LL JR POTENTIAL UNVERIFIED ER
206. pleted BASIC search of the primary file for duplicate records ccccceesesseeeeeees 8 13 Figure 8 13 Stopping the merge process cccecccceesessececececceceeeesesseceeeeececeesesssaecseeeeeesceeseseeeeeeees 8 14 April 1998 Duplicate Record Merge Patient Merge User Manual xV Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Figures amp Tables Tables Table 1 1 Quick Start Patient Merge checklist cccccccccccccecseseseenteceeeceeeeeesesseaeeeeeeseesesssessaeaeeeees 1 8 Table 1 3 Ancillary service default site parameters table ceseccccessseccecessenceceesseeceseesteeeceees 1 13 Table 2 5 Missing field and identifier numbers with corresponding descriptions Table B 1 Duplicate Record Merge Patient Merge FAQ Reviewers and IRM personnel Appendix B 2 Table B 2 Duplicate Record Merge Patient Merge FAQ Staff Authorized to Hold the XDRMGR DECUPILY K CY OEE EER E vets tabs lense A EEEE E E Beast Pet ead ea de ted Appendix B 3 xvi Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Orientation How to Use This Manual This manual is organized so that anybody can use it to do the work involved with the duplicate record merge process The material is presented as sequential tasks to be completed When questions come up as they most certainly will we hope to have pointed out where to find the answe
207. ponding No to the prompt Would you like to use the FM Browser to view the record pair YES You will be prompted to send your selected Health Summary to a device type For example you can send it to a local printer your terminal screen or you can queue it to run at a specified date and time Notice that you will be prompted to enter a device type for both patient records Would you like to use the FM Browser to view the record pair YES n lt RET gt NO DEVICE FOR FIRST RECORD HOME lt RET gt EMOTE RIGHT MARGIN 80 lt RET gt lt Health Summary loads here gt Your selected Health Summary for record one is loaded here EVICE FOR SECOND RECORD HOME lt RET gt EMOTE RIGHT MARGIN 80 lt RET gt lt Health Summary loads here gt Your selected Health Summary for record two is loaded here Figure 3 8 Send Health Summaries to any device for viewing NOTE For information on how to create a Health Summary inclusive of all the patient data see Build a Health Summary Backup in the Merge Process section of this manual Please note that this section is written to accommodate backup purposes However you can use this information to build a suitable Health Summary for review purposes as well VA FileMan Browser Evoked to View Health Summary You can view your selected Health Summary by sending it to the VA FileMan Browser or to any device
208. process 2 Start represents the date and time the merge process started corresponding to the merge set name 3 Stat status codes The following status codes are used to track the current status of the merge process S SCHEDULED This status code indicates that the merge process has been scheduled or queued for some later time based on your entry at the START DATE TIME prompt If you enter the VA FileMan command NOW the code S SCHEDULED is bypassed and the job begins with the code A ACTIVE April 1998 Duplicate Record Merge Patient Merge User Manual 6 11 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process A ACTIVE As soon as the job starts running it sets the time it actually started and sets the Stat to A for ACTIVE The process is currently running and is actively updating the CURRENT TIME value in the Last Chk column C COMPLETED This indicates that the job has run through all the file entries to normal completion H HALT If something happens to interrupt the job for instance if Task Manager is notified to interrupt the process Stat would display an H for HALT U UNKNOWN LOST This is an abnormal status and is set when an active job is no longer updating the current time value for the process and has not for over 30 minutes R RESCHEDULED This indicates that the process has been scheduled to restart and will continue from its last check pointed locati
209. pter 3 Ancillary Review ECORD 1 1212 RD 2 888 ENT 10 JOHN MARK ENT STATUS EMPLOY INPATII LAST ADMISSION DATI 2860717 1538 LAST TRANSFER DAT 2880420 1447 DISCHARGE FLAG l UD ORDER CONV TO V4 1 PATIENT STATUS ERWRITE data for selected fields 1 1 1 Select the PATIENT STATUS field from RECORD1 to overwrite the PATIENT STATUS field in RECORD2 At anytime during this process the ancillary reviewer has the option to overwrite data regardless of the default merge direction Figure 3 22 Designate fields containing ancillary data in potential duplicate records for overwriting As was explained in the Primary Review section if you choose the option Review Data Again to view the fields that you ve selected to overwrite you ll see that the asterisks have been replaced by bars The bars indicate that the fields in Record 1 will overwrite the fields in Record 2 April 1998 Duplicate Record Merge Patient Merge User Manual 3 25 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Ancillary Review 3 26 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 4 Backup before Merge Making a backup is an important step in the process of identifying and merging patient records It serves as a means
210. ption does not add records to the DUPLICATE RECORD file 15 NOTE This option does not allow you to compare the same record Duplicate Resolution Utilities Menu ADD Add Verified Duplicate Pair CMP Check Merge Process Status CHCK Check Pair of Records to see if Duplicates DSS Display Search Status EDIT Edit the Status Field of a Duplicate Record FIND Find Potential Duplicates for an Entry ina File VAL Identify Potential Merge Problems PRNT Print List of File Duplicates SCAN Scan Possible Duplicates TSF Tally STATUS and MERGE STATUS fields VIEW View Duplicate Record Entries Select Utilities Option CHCK lt RET gt Check Pair of Records to see if Duplicates Once the user has selected the two records this option will generate a review screen comparing them both shown in the next figure The review screen is similar to the one used in the review process The duplicate match percentile score is displayed at the end of the screen capture compared against the Potential Duplicate Threshold Percentage COMPARE ENT MERGEPATIENT 21 ERGEPATIENT 21 C 01 02 28 000025700 NO NSC VE ERGEPATIENT 21 J 12 31 42 000041687 ES SC VE ERGEPATIENT 21 M 10 11 24 000063234 ES SC VET ERGEPATIENT 21 MILTON 08 02 33 00005817 NO NSC VE 4 3 lt RET gt MERGEPATIENT 21 M 10 11 24 000063234
211. r or that they are unable to determine the status Where appropriate reviewers may mark data to be overwritten Those record pairs that are determined to be verified duplicates are marked as such and are then available for approving to be merged NOTE As of Kernel Toolkit Patch XT 7 3 113 the DUPLICATE RECORD file 15 will mainly be populated automatically when Person Service Identity Management PSIM identifies patient pairs as matches or potential matches When a record is added to the DUPLICATE RECORD file by PSIM an email message is sent to members of the mail group defined in the DUPLICATE MANAGER MAIL GROUP field of the DUPLICATE RESOLUTION file See Figure 3 1 for an example of the email sent when entries are added to the DUPLICATE RECORD file 15 It will be important to review the DUPLICATE RECORD file frequently to see whether PSIM has identified potential duplicate records that you need to review The following is an example of the email message sent when entries are added to the DUPLICATE RECORD file 15 Subj Potential Duplicate PATIENT records found by MPI 127964 09 03 08 15 45 8 lines From POSTMASTER IN basket Page 1 The following two PATIENT records have been found to be potential duplicates by the MPI matching algorithm These records have been added to the local DUPLICATE RECORD file and assigned record number 12345 Please review these records to verify whether they are duplicates an
212. r Utilities Option SRCH lt RET gt Start Halt Duplicate Search Select file to be checked for duplicates filename Enter primary filename This process will take a LONG time known to exceed 100 hours but you CAN stop and restart the process when you want using the options OK YES The next figure shows the resulting screen display from accessing the option Start Halt Duplicate Search Duplicate filename Search Search Typ Date Started Status hours min Records Checked 0 Potential Duplicate pairs found Do You wish to RUN a search Y N y lt RET gt YES Which type of Search do you wish to run BASIC NEW BASIC BASIC Requested Start Time NOW lt RET gt MAY O1 1997 18 24 30 Figure 8 11 Start a BASIC search of the primary file for duplicate records 8 12 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 8 Manager Utilities You can start the search NOW or queue it for a different date and time This is a tasked job that can be started and halted until the entire file has been checked for potential duplicates The next figure shows the resulting screen display from a completed search of the primary file Duplicate filename Search Search Typ Date Started Status hours min Records Checked May 01 1997 18 24 COMPLETE 66527 66527 100 0 337 Potential Duplicate pairs found
213. r med physician s impression narrative Only imaging impressions that have been verified are reported Component Name Sel Rad Impression Abbreviation SRI This component contains impressions from the Radiology Nuclear Medicine package Time and occurrence limits apply Data presented include study date procedure s status diagnostic text and radiologist s or nuclear med physician s impression narrative for the procedures selected by the user e g CHEST 2 VIEWS PA amp LAT Only imaging impressions that have been verified are reported Component Name Radiology Profile Abbreviation RP This component contains information from the Radiology Nuclear Medicine package Time and maximum occurrence limits apply Data presented include study date procedure s with status es report status staff and resident interpreting physicians and the narrative fields modifier history report diagnostic text and impression Only imaging profiles that have been verified are reported Component Name Radiology Status Abbreviation RS This component contains procedure statuses from the Radiology Nuclear Medicine package Time and maximum occurrence limits apply Data presented include request date time status procedure scheduled date time and provider name Package Social Work Component Name Social Work Abbreviation SW This component provides information from the Social Work package about a patient s Social Family Relationship
214. r must have identified records as verified duplicate pairs No ancillary review is conducted for those records determined by the primary reviewer to be verified non duplicates or unable to determine 3 Each verified duplicate record pair must have data in one or more VistA ancillary file For example both records must have data in files such aa LABORATORY DATA PHARMACY PATIENT RADIOLOGY PATIENT to name a few If data is available in both records being compared alerts and or mail messages are automatically sent to the ancillary reviewers associated with these files These notifications serve to inform ancillary reviewers to begin the secondary review process However if data exists in only one verified duplicate record for a particular ancillary file sufficient information is not available to make a comparison and the secondary review is not necessary for the records to be merged Reviewers designated to receive alerts are automatically taken into the review process Reviewers designated to receive MailMan messages process potential duplicates through the option Ancillary Data Review Either way the same ancillary verification process takes place Alert and MailMan message notifications of duplicate record activity are explained further in the next sections Ancillary reviewers are able to see the same patient records as primary reviewers However this secondary review process examines ancillary service specific data for each duplicate r
215. ral steps may be taken REF For more information see the section Primary Review of this manual April 1998 Duplicate Record Merge Patient Merge User Manual 1 7 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 1 Quick Start Patient Merge Checklist Task Should the primary reviewer choose a record pair as verified duplicates the next step is to select the correct merge direction REF For more information see the section Primary Review of this manual ADVISORY Although a default direction for the merge is provided it may not always be the best one You should not assume that the record containing the most data is the record to be merged into It s important therefore that the data in both records are thoroughly checked before selecting a merge direction Ancillary reviewers provide a secondary review if data is available in files other than the primary file for both records being compared Alerts and or MailMan messages serve to inform designated ancillary reviewers associated with these files to begin the secondary review process REF For more information see the section Ancillary Review of this manual Your site should print a paper backup of the local patient records using a site specified Health Summary which should be as complete as possible REF For more information see the chapter Backup Before Merge of this manual Site Specified Waiting Period Verified duplicate record pairs mu
216. ray Thus if the variable AAA were selected to hold the FDA array the code would be S AAA 63 08 1 15950 01 OCT 21 1988 Broken down A The value 63 08 indicates the subfile that is being edited B The value 1 15950 is the Internal Entry Number String IENS indicating that 1 the subfile is under internal entry number 15950 and 2 the value 1 indicates that a new entry is being added C The 01 indicates that the 01 field is the one being edited D The value OCT 21 1988 is the value to be added This would generate an entry similar to that which was passed to VA FileMan in a call such as D UPDATE DIE E AAA BBB ERROR The information in the example array shown above is that which is recorded in the ZZ subscript 1 AAA is the variable containing the data array 2 BBB is the variable containing the internal entry number on return and 3 ERROR is the variable containing the information provided by VA FileMan on errors encountered The information in the ZZ subscript indicates that the data was rejected since the required identifiers were not included with the data which was passed to VA FileMan Data Error Group Two The second data error reported shown in the previous figure begins with the following global node as its first line XTMP XDRTESTK 2980302 175623 2 XX 63 05 1 70735 01 AUG 14 1997 22 28 35 This is an example where the date time
217. rces For example an entry of 1 would indicate that only the main process would be running An entry of 2 to 3 indicates that the main process along with 1 to 2 other threads should be used during this phase The greater the number of threads the more parallel processing occurs Each thread is used to process 1 12 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 1 Site Configuration one of the more time consuming files which reduces the amount of time the overall process takes at the expense of increased system utilization The site parameter NUMBER OF THREADS is exported with the Patient Merge application as a default of 3 The maximum allowable value is 5 It is resident in the DUPLICATE RESOLUTION file 3 8 Edit Ancillary Service Subfile The necessary default values associated with each of the three ancillary services e g Laboratory Pharmacy and Radiology are included with this application Sites are required to supply mail groups and or assign individuals to receive alerts Your site can add more ancillary services to the ancillary service multiple if desired The table shown in the next figure provides an at a glance view of the site parameters for all three ancillary services exported with this release References are made to both site parameters that are default values included with this application release and to fields that requ
218. record list missing fields 2 3 8 3 patient records error report 2 3 2 6 Person Service Identify Management PSIM automatically populates File 15 1 3 identity traits 1 3 phases three 1 4 potential duplicate records marked as not duplicates 3 15 removed from consideration 3 15 potential duplicate status not a duplicate 3 14 unable to determine 3 15 Potential Duplicate Threshold Percentage 3 3 POTENTIAL DUPLICATE THRESHOLD 1 11 potential duplicates normal list 3 3 top level list 3 4 Preliminary Scan of File for Errors 1 7 2 1 8 5 8 6 3 primary file 1 9 errors in primary file before search identify 2 2 identify errors in primary file before search 2 2 Duplicate Record Merge Patient Merge User Manual Index 5 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Index PRIMARY FILE NUMBER 1 14 primary review 3 1 3 16 determine duplicate record status 3 14 overwrite data 3 12 3 14 select merge direction 3 15 primary reviewer 1 3 3 1 Print List of File Duplicates 7 14 7 17 2 Purge Merge Process File 8 7 3 Q question marks and 2 queue the merge process 6 2 8 9 queueing reports to a printer 7 Quick Start Patient Merge Checklist 1 5 R record deleted entire missing zero node 2 3 records excluded from merge 6 3 Restart a Merge Process 6 1 6 11 6 14 8 8 3 review process ancillary review 3 17 3 22 primary review 3 1 3 16 S Scan Possible Duplicates 7 1
219. rection for the merge is provided it may not always 3 18 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Primary Review In this next example we will verify that the record pair for the fictitious patient John Doe is a duplicate Select one of the following ERIFIED DUP E ERIFIED NOT A DUPLICATE E TO DETERMINE SUMMARY DATA AGAIN REVIEW OVERWRITE Select Action HI RY V lt RET gt RECORD2 888 MERGEPATIENT 10 JOHN MARK Select one of t You can select the direction to merge the duplicate record pair ECORD1 INTO RECORD2 ECORD2 INTO RECORD1 Which record 1 or 2 should be MERGED INTO the other record RECORD1 INTO RECORD2 Figure 3 18 Primary reviewer chooses the merge direction for duplicate records Notice above that the merge direction is automatically selected for you as the default value The record being merged into Record 2 contains more data than the record merging into it Record 1 The Patient Merge application automatically determines the default direction the merge should take depending on which records contain more data Only the primary reviewer can reverse this direction As you can see from this example you have the choice of which direct
220. resented include diet orders start stop dates type of service tray e g nutritional status date assessed supplemental feedings start stop dates tube feedings start stop dates strength of product quantity ordered and daily dosages NOTE When a time limit is selected the data presented reflects orders initiated within the time period Package Discharge Summary Component Name Discharge Summary Abbreviation DCS This component prints all discharge summaries including report text for user specified time and occurrence limits Component Name Brief Disch Summary Abbreviation BDS This component prints the admission discharge and cosignature dates as the dictating and approving provider names and signature status of all discharge summaries for user specified time and occurrence limits Package Laboratory Component Name Blood Availability Abbreviation BA This component contains information from the Blood Bank module of the Lab Package Time and occurrence limits apply to this component Data presented include patient blood type whether or not units have been assigned unit expiration date unit ID blood product s cross match results last known location and a flag for autologous units NOTE An asterisked date e g 10 10 90 indicates that the unit is due to expire within the next 48 hours Component Name Blood Transfusions Abbreviation BT This component contains information from the Blood Ban
221. rge Verified Duplicates of this chapter for more information on data error and or multiple pair processing excluding records from being merged Current Current Merge Set Start Stat Last Chk Phase File Entry MERGE 2 04 08 09 20 C 04 08 09 21 DATA CHECKING 04 08 09 20 C 04 08 09 21 NO PAIRS LEFT C 04 08 09 21 Figure 6 6 Status report of merge processes NO PAIRS LEFT Stop Merge from Any Point in Processing Once a merge has started you can stop it by using the option STOP an Active Merge Process located on the Manager Utilities menu The merge process can also be stopped using the Task Manager option under the TBOX common menu option Duplicate Manager Utilities Menu EDT Edit Site Parameters IST ist File Entries Identified in Preliminary Scan CN Preliminary Scan of File for Errors Purge Merge Process Fil Schedule Process to Merge Verified Duplicates Start Halt Duplicate Search STOP STOP an Active Merge Process S P RE Restart a Merge Process S S Select Operations Option STOP lt RET gt STOP an Active Merge Process Do you want to stop TEST3 YES lt RET gt YES Figure 6 7 Stopping an active merge process Restart Merge from Any Point in Processing April 1998 Duplicate Record Merge Patient Merge User Manual 6 15 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process If the merge process has been stopped e
222. rint reports e Print List of File Duplicates e Tally STATUS and MERGE STATUS fields e Scan Possible Duplicates Output can be queued to the VA FileMan Browser or to a printer Print selected categories of duplicate record Print List of File Duplicates pairs found Review duplicate record pairs after receiving a Ancillary Data Review i ification Mailan message motngatgn You have to manually access this option after receiving the MailMan message notification Review duplicate record pairs after receiving an No menu option associated You are alert notification automatically taken into the review process It is similar to the Ancillary Data Review option Review record pairs found from the search of Verify Potential Duplicates the primary file to see if they are duplicates Verify duplicate record pairs after receiving a Ancillary Data Review i ification MalMan message noliicalion You have to manually access this option after receiving the MailMan message notification Verify duplicate record pairs after receiving an No menu option associated You are alert notification automatically taken into the review process It is similar to the Ancillary Data Review option Verify record pairs as duplicates found by Verify Potential Duplicates PSIM View data for a duplicate record pair ina View Duplicate Record Entries captioned format View zero nodes of potential duplicate record Scan Possible Duplicates i i j 2
223. rom the Gp Search option described below Although users with access to the Duplicate Record Merge menus will still be allowed to add records to the DUPLICATE RECORD file 15 this file will mainly be populated automatically when Person Service Identity Management PSIM identifies patient pairs as matches or potential matches The Start Halt Duplicate Search option on the Manager Utilities menu is used to initiate a search of the database Only authorized persons holding the XDRMGR security key should be responsible for using this option Once you ve accessed this option you have a choice of two methods for searching the primary file 1 A Basic search checks all records in a file from beginning to end This search can be halted and restarted beginning with the next available record after the last record that was processed If you are running a search for potential duplicate records on a file for the first time you will probably want to run a Basic search 2 A New search checks only those records that have been added or edited since the last search was run based on a user specified cross reference It will begin with the next record number after the last one that was processed The New search like the Basic can also be halted and restarted beginning with the next available record after the last record that was processed NOTE If you use this option to Halt a search then exit and immediately go back into it to verify that the search has b
224. rs This was done by referring you to portions of the manual where a particular task needs to be completed prior to performing the current task Or even if it needs to be done at a later time This manual is divided into one main section a glossary three appendices and an index The appendices can be extracted from the complete document for reproduction and distribution to authorized users as required This manual uses several methods to highlight different aspects of the material Snapshots of computer dialogue or other online displays are shown in a non proportional font and enclosed within a box User responses to online prompts are highlighted in boldface Boldface is also used to highlight a descriptive word or sentence The Return or Enter key is illustrated by the symbol lt RET gt when displayed in computer dialogue and is included in examples only when it may be unclear to the reader that such a keystroke must be entered The following example indicates that you should type two question marks followed by pressing the Return key when prompted to select an option Select Primary Menu option Figure ii How to access online help M code variable names acronyms the formal name of options actual field names file names and security keys e g XDR XDRMGR and DG ELIGIBILITY are represented with all uppercase letters Conventions for displaying TEST data in this document are as follows e The first three digits prefix of an
225. ry Scan Purge all duplicate entries in the XDR MERGE Purge Merge Process File PROCESS file 15 2 Restart a Merge Process Restart a Merge Process Search a primary file for potential duplicate Start Halt Duplicate Search irs pars NOTE As of Patch XT 7 3 113 this option can no longer be used on the PATIENT file 2 Edit Site Parameters Ancillary Service Information Set up the Patient Merge site parameters Edit Site Parameters Stop a merge process STOP an Active Merge Process Table B 2 Duplicate Record Merge Patient Merge FAQ Staff Authorized to Hold the XDRMGR Security Key Set up ancillary services April 1998 Duplicate Record Merge Patient Merge User Manual Appendix B 3 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 AppendixB Appendix B 4 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Appendix C Health Summary Component Descriptions A Health Summary component is a brief patient data extract from various VistA software packages This appendix contains descriptions for all components available in the Health Summary package These descriptions have been made available to aid you in producing a comprehensive backup of all patient data available for multiple patients NOTE These descriptions are provided for your convenience from the HEALTH SUMMARY COMPONENT file 142 1 The following is a list of co
226. s PRGM Purge Merge Process Fil RES Restart a Merge Process SCH Schedule Process to Merge Verified Duplicates SRCH Start Halt Duplicate Search STOP STOP an Active Merge Process Select Manager Utilities Option SCH lt RET gt Schedule Process to Merge Verified Duplicates 4 Entries Ready to be included in merge This process will take a LONG time usually over 15 hours and sometimes considerably longer but you CAN stop and restart the process when you want using the options OK YES Name for rge Process TEST3 START DATE TIME NOW lt RET gt OCT 07 1997 10 30 00 Entering the VA FileMan command NOW begins the merge process immediately Merge process TEST3 for Verified Duplicates in File 2 scheduled Figure 6 1 Scheduling the merge process Notice in the previous figure that you are prompted to give the merge process a name Each merge process must have a unique name Each merge process will automatically include all approved duplicate record pairs that have met the site specified waiting period i e the time between when they were approved as duplicate records ready to be merged and the time they are actually merged More than one merge process can be running concurrently providing each process has a unique name However the most practical and efficient approach is to run fewer merge processes containing multiple record pairs NOTE A merge process will never include a dupli
227. s OK YES The next figure shows the resulting screen display from accessing the option Start Halt Duplicate Search April 1998 Duplicate Record Merge Patient Merge User Manual 2 9 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 2 Identifying Duplicate Records Searching the Patient File Duplicate filename Search Status hours min Records Checked 0 Potential Duplicate pairs found Do You wish to RUN a search Y N y lt RET gt YES Which type of Search do you wish to run BASIC NEW BASIC BASIC Requested Start Time NOW lt RET gt MAY 02 1997 18 24 30 Figure 2 7 Start a BASIC search of the primary file for duplicate records You can start the search NOW or queue it for a different date and time This is a tasked job that can be started and halted until the entire file has been checked for potential duplicates The next figure shows the resulting screen display from a completed search of the primary file Duplicate filename Search Status hours min Records Checked May 02 1997 18 24 COMPLETE 66527 66527 100 0 337 Potential Duplicate pairs found Figure 2 8 Completed BASIC search of the primary file for duplicate records Notice in the figure above that a search was started on May 02 1997 at 18 24 it was completed it took 27 hours and 23 minutes it searched through 66527 records in the primary file it searched through 100 of
228. s can indicate whether a record pair is a verified duplicate not a duplicate or that they are unable to determine the duplicate status The following set of screen captures display a duplicate record parr for a fictitious patient This lists all of the data at the top level of the file i e subfile data is not displayed NOTE The size of the screen capture the record size in the following figure has been reduced for the sake of brevity 3 6 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Primary Review ECORD1 contains fewer data elements usually this would indicate that this record would be merged INTO the other Determine if these patients AR E NOT duplicates RECORD1 1212 ECORD2 888 MERGEPATIENT 10 J M ERGEPATIENT 10 JOHN MARK 000 06 0969 000 06 0996 BIRTH DAT JUN 29 1945 JUN 29 1946 E 51 50 I MALI ALI ETURN to continue or to exit lt RET gt 888 T 10 JOHN MARK ENT 10 J M ENT 10 JOHN MARK MALI MA OF BIRI 06 29 45 06 29 46 MARITAL STAT DIVORCED DIVORCED RAC WHITE NOT OF HISPANIC ORIGIN UPATION LABORER URN to continue or to exit Notice that by entering an up arrow at this prompt we ve jump
229. s in the DUPLICATE RESOLUTION file 15 1 by selecting the option Edit Site Parameters located on the Manager Utilities menu The list of the default parameters released with this application is documented in the Configuration section of this manual Duplicate Manager Utilities Menu EDT Edit Site Parameters IST ist File Entries Identified in Preliminary Scan SCN Preliminary Scan of File for Errors PRGM Purg rge Process Fil RES Restart a Merge Process SCH Schedule Process to Merge Verified Duplicates SRCH Start Halt Duplicate Search STOP STOP an Active Merge Process Select Manager Utilities Option edt lt RET gt Edit Site Parameters The next figure shows the resulting Duplicate Resolution File data entry screen DUPLICATE ESOLUTION FILE ENT MERGE MAIL ANAGER MAIL PLICATE THRE BEFORE FINAL VERIFY A NUMBER OF RADIOLOGY Press lt PF1 gt H for help Insert Figure 8 2 Editing site parameters Notice in this first data entry screen shown in the previous figure that the file currently being checked is displayed in the top left corner In the case of the Patient Merge application this is the PATIENT file 2 Further down the screen the underlined data entry fields represent the VA FileMan required fields 8 2 Duplicate Record Merg
230. s probably not a duplicate and will not be added to the DUPLICATE RECORD file 15 Select Utilities Option ADD lt RET gt Add Verified Duplicate Pair Add entries from which File lt RET gt Select some file other than the PATIENT file Do you want to bypass the potential duplicate threshold check Y N n lt RET gt No Potential duplicate threshold will NOT be bypassed Select PERSON MERGE 20 lt RET gt 12 12 70 000056789 NO NSC VETERAN Another PERSON MERGE 20 B lt RET gt 12 12 70 000056798 NO NSC VE You will be adding the following pair of records to the duplicate record file RECORD1 MERGE 20 RECORD2 MERGE 20 B ETURN to continue or to exit lt RET gt Ok continuing hold on This pair of PERSONs has a duplicate percentage of only 30 which is less than the minimal percentage for potential duplicates 60 Persons not added Figure 7 4 Records that are NOT duplicates will not be added to the DUPLICATE RECORD file 15 The XDRMGBR security key authorizes you to add a pair of records directly to the DUPLICATE RECORD file 15 bypassing the Potential Duplicate Threshold Percentage The next figure illustrates the computer dialogue necessary to add a record pair of non patients directly into the DUPLICATE RECORD file 15 Select Utilities Option ADD lt RET gt Add Verified Duplicate Pair Add entries from which File
231. s updates to a patient s descriptive data from other sites All treating facilities are also made subscribers as part of the MPI PD processes A symbol that is associated with the name of a set to identify a particular subset or element In M a numeric or string value that is enclosed in parentheses is appended to the name of a local or global variable and identifies a specific node within an array This applies where any VistA application may use the attributes functions defined by the IA these are also called Public An example is an JA that describes a standard API such as DIE or VADPT The package that creates maintains the Supported Reference must ensure it is recorded as a Supported Reference in the IA database There is no need for other VistA packages to request an IA to use these references they are open to all by default A field in the OPTION file Options may be selected by their menu text or synonym see Menu Text Kernel module that schedules and processes background tasks also called TaskMan Transaction Control Protocol Internet Protocol A set of protocols for Layers 3 Network and 4 Transfer of the OSI network model TCP IP has been developed over a period of 15 years under the auspices of the Department of Defense It is a de facto standard particularly as higher level layers over Ethernet Although it builds upon the OSI model TCP IP is not OSI complhant Duplicate Record Merge Patient Merge User Manual G
232. screen shows the search has been continued You may come across errors while running a search When an error is encountered the duplicate record search stops and informs you of the type of error found Once that error is fixed you can then restart the search and it will continue from where it left off You don t have to go back to the beginning of the file and start from the first entry again 2 14 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 April 1998 Revised December 2010 Chapter 2 Identifying Duplicate Records Searching the Patient File Duplicate Record Merge Patient Merge User Manual Version 7 3 Kemel Toolkit Patch XT 7 3 125 2 15 Chapter 3 Review Process to Determine Duplicate Record Status The review and verification process includes two levels of review The primary reviewer initially seen as an MAS responsibility performs a review of patient demographic information The primary reviewer initially determines if the pair represents a duplicate record If so the primary reviewer selects the merge direction If data from ancillary services is present notification via MailMan message or alert or both is sent to those designated as ancillary reviewers A site may determine reviewers based upon their business practices Reviewers determine whether the record pair is a duplicate not a duplicate so that subsequent processing need not occu
233. sed and the data value in error Cy GEN April 1998 Duplicate Record Merge Patient Merge User Manual 6 17 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process The global structure is XTMP XDRTESTK date time file or sub file number TENS field number This structure is set equal to the data value passed to it Each error consists of an XX subscript node with descendant ZZ subscript nodes Following the XX subscript is the information as it appeared in the FDA array passed to the UPDATE DIE call in VA FileMan including file or subfile number the IENS string and the field number The value of the node is the value passed to VA FileMan for that entry in the FDA array Descendant to the ZZ subscript is the information about the error passed back from VA FileMan in the DIERR array While this information is in a standard format usually it doesn t offer actual information about why the value is not valid The next figure displays a sample file capture of the XTMP XDRTESTK global with an explanation of its contents Blank lines separate each group of XX and ZZ subscript nodes for the purposes of this example only 6 18 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process Global XTMP XDRTESTK XTMP XDRTESTK XTMP XDRTESTK 0 2980403 29803
234. st elapse the site specified waiting period i e the time between when they are verified as duplicates and the time they are ready to be merged After the waiting period these duplicate records are categorized with the status of READY to merge The primary reviewer uses the option Approve Verified Duplicates for Merging to give final approval for selected duplicate record pairs to be included in the next merge process REF For more information see the chapter Approve Verified Duplicates for Merging of this manual Authorized personnel holding the XDRMGR security key initiate a merge process using the option Schedule Process to Merge Verified Duplicates REF For more information see the chapter The Merge Process of this manual Site Specified Waiting Period Each merge process will automatically include all approved duplicate record pairs that have met the site specified waiting period i e the time between when they were approved as duplicate records ready to be merged and the time they are actually merged Table 1 1 Quick Start Patient Merge checklist 1 8 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Site Configuration This portion of the User Manual covers the options available with the Duplicate Record Merge Patient Merge application that offers managerial control over files being searched for potential duplicate records Several par
235. strator oversees software development with respect to VistA Standards and Conventions SAC such as namespacing In addition this term refers to the Database Administration function and staff Database Integration Agreement see Integration Agreements To correct logic errors or syntax errors or both types in a computer program To remove errors from a program Response the computer considers the most probable answer to the prompt being given It is identified by double slash marks immediately following it This allows you the option of accepting the default answer or entermg your own answer To accept the default you simply press the Enter or Return key To change the default answer type in your response Special character used to separate a field record or string VA FileMan uses the caret character as the delimiter within strings The Department of Veterans Affairs formerly known as the Veterans Administration Peripheral connected to the host computer such as a printer terminal disk drive modem and other types of hardware and equipment associated with a computer April 1998 Revised December 2010 Duplicate Record Merge Patient Merge User Manual Version 7 3 Kemel Toolkit Patch XT 7 3 125 DHCP Dictionary Direct Mode Utility Domain Double Quotes Duplicate Record Merge Patient Merge DUZ DUZ 0 EIE Electronic Signature Code Enter lt RET gt Entry EPG Error Trap
236. t have been approved to be merged are checked first before the actual merging of records This event is in progress when the message Data Checking is displayed on this report The field Last Chk indicates the date and time this procedure completed Records found that have data errors are excluded from the actual merge They are written to a MailMan message and sent to the mail group that has been defined in the MERGE MAIL GROUP field Merge Process Status Screen File Descriptions The following are descriptions of the files involved with this application They are displayed in the previous figure on the merge process status screen Intermittently launching the option Check Merge Process Status shows the progress as they are being merged PATIENT FILE is the primary file being merged in this process as is designated in the option Edit Site Parameters LAB SERVICE INTEGRATED BILLING ICR IMMUNOLOGY CASE REGISTRY and TOOLKIT are names denoting the actual ancillary files being processed which reference the primary file e PATIENT file 2 These files contain records having fields that are affected by record entries in the PATIENT file 2 In some cases related data in still other files reference them These files must be merged first before the record entries in File 2 are merged because they reference the PATIENT file 2 Merge Process Status Screen Number of Threads The following is a description of the Thread field as sh
237. t in the corresponding merge TO field in Record 2 that data is merged to the merge TO field If you don t want to merge data from a particular merge FROM field in Record 1 to the corresponding merge TO field in Record 2 you will have to delete the merge FROM data independently from this software April 1998 Duplicate Record Merge Patient Merge User Manual 3 15 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Primary Review ECORD2 888 T 10 JOHN MARK ENT 10 J M F ENT 10 JOHN MARK OF BIRTH 06 29 45 06 29 46 SOCIAL SECURITY NUMBE 000060969 000060996 ZIP CODE 98493 98444 NAME DATE OF BIRTH SOCIAL SECURITY NUMBE ZIP CODE ERWRITE data for selected fields 1 4 1 3 Select these two fields from RECORD1 to overwrite the same fields in RECORD2 At anytime during this process the primary reviewer has the option to overwrite data regardless of the default merge direction Figure 3 12 Designate fields in potential duplicate records for overwriting Once a field is designated to be overwritten by another that action will not take place until the actual merge process If you choose the option Review Data Again as shown in the next figure the system redisplays the data for the record pair you ve just selected to overwrite Select one of the following ERIF
238. te feature Ancillary reviewers examine their service specific data e g Pharmacy reviewers examine pharmacy data Once reviewers determine that particular record pairs are duplicates they have the option to select fields to be overwritten Notice in the Pharmacy specific record display shown in the next figure that the PATIENT STATUS field is again preceded by four asterisks As was explained for the primary review the asterisks indicate that these particular fields have data in both Record 1 and Record 2 However the data is different in both records Notice the prompt OVERWRITE data for selected fields 1 1 at the bottom of the screen By selecting the number 1 you are choosing to overwrite the PATIENT STATUS field in Record 2 with the PATIENT STATUS field in Record 1 Anytime during this verification process ancillary and primary reviewers have the option to overwrite data regardless of merge direction NOTE Keep in mind that if data exists in the merge FROM field in Record 1 but not in the corresponding merge TO field in Record 2 that data is merged to the merge TO field If you don t want to merge data from a particular merge FROM field in Record 1 to the corresponding merge TO field in Record 2 you will have to delete the merge FROM data independently from this software 3 24 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Cha
239. ted number of callable entry points VistA APIs fall into the following three categories Duplicate Record Merge Patient Merge User Manual Glossary 1 Version 7 3 Kemel Toolkit Patch XT 7 3 125 Glossary Application Coordinator Array AT SIGN Auto Menu Callable Entry Point Caret Checksum Command Common Menu Glossary 2 e The first category is Supported API These are callable routines which are supported for general use by all VistA applications e The second category is Controlled Subscription API These are callable routines for which you must obtain an Integration Agreement IA formerly referred to as a DBIA to use e The third category is Private API where only a single application is granted permission to use an attribute function of another VistA package These IAs are granted for special cases transitional problems between versions and release coordination Designated individuals responsible for user level management and maintenance of an application package such as IFCAP Lab Pharmacy Mental Health etc An arrangement of elements in one or more dimensions An M array is a set of nodes referenced by subscripts that share the same variable name A VA FileMan security Access code that gives the user programmer level access to files and to VA FileMan s developer features See Programmer Access Also the character i e at sign Shift 2 key on most keyboards is used at VA Fil
240. ted include collection date time specimen test names with results and reference flags in columnar horizontal format Comments will also be conditionally displayed depending on the value of the DISPLAY COMMENTS ON LABS Health Summary Site Parameter When comments are displayed a lower case letter will be displayed to the left of the date April 1998 Duplicate Record Merge Patient Merge User Manual Appendix C 3 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Appendix C for entries with comments Comments will be displayed after all the results are displayed with comments being linked by the lower case letter Up to 26 comments can be included Component Name Lab Cum Selected 3 Abbreviation SCL3 This component contains information extracted from the Lab package Not only do time and maximum occurrence limits apply to this component but also the user is allowed to select as many as seven atomic Lab tests Data presented include collection date time specimen test names with results and reference flags in columnar horizontal format Comments will also be conditionally displayed depending on the value of the DISPLAY COMMENTS ON LABS Health Summary Site Parameter When comments are displayed a lower case letter will be displayed to the left of the date for entries with comments Comments will be displayed after all the results are displayed with comments being linked by the lower case letter Up to 26 comments can be in
241. termine validity and quality This is an enterprise view of the most current data for a patient based on authority scoring and the latest data rules Edits to patient identity traits are evaluated based on the same The highest score achieves the best quality of data updates to the Primary View Where only a single application is granted permission to use an attribute function of another VistA package These IAs are granted for special cases transitional problems between versions and release coordination A Private IA is also Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Production Account Programmer Access Protocol PS PSIM Queuing Queuing Required Read Access Record Registration Process April 1998 Revised December 2010 Glossary created by the requesting package based on their examination of the custodian package s features Example one package distributes a patch from another package to ensure smooth installation The UCI where users log on and carry out their work as opposed to the manager or library account The ability to use VistA features reserved for programmers Having the programmer s at sign when DUZ 0 enables programmer access Entry in the PROTOCOL file 101 Used by the Order Entry Results Reporting OE RR package to support the ordering of medical tests and other activities Product Support f
242. the pairs excluded messages address data discrepancies and start another merge process to complete the merge on any previously excluded pairs 6 4 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process EXCLUDED TO PROBLEMS 2224123 22 Mar 98 20 17 Sender in IN basket DFN 14 M T 17 S 000110014 DFN 16 M T 18 A 000110016 File 2 PATIENT file Field 2201 E ZIP 4 ENS 16 value 98503 EMERGENCY CONTACT name must be specified to enter edit this field 302 SERVICE CONNECTED PERCENTAGE IENS 16 50 Only applies service connected applicants 333 E STREET ADDRESS LINE 1 TENS 16 5706 TH AVE SE EMERGENCY CONTACT name must be specified to enter edit this field 338 E ZIP CODE TENS 16 8570 EMERGENCY CONTACT name must be specified to enter edit this field OTHER ENTITLED ELIGIBILITIES subfile of PATIENT file ELIGIBILITY IENS 1 16 ERVICE CONNECTED 50 to 100 File 2 04 DISABILITY DX subfile of PATIENT file Field 01 RATED DISABILITIES VA IENS 1 16 value 291 IMPAIRED HEARING First entry in DD 2 04 0 NM does not match field name RATE
243. tion is standardized for the ancillary reviewer based on the direction set by the primary reviewer This will keep the review process uniform Recipients can be designated to receive alert notifications of potential duplicate record pairs as well as belong to mail groups designated to receive MailMan message notifications for the same duplicate entries Should the recipient s process alerts first the same duplicate record pairs will not be accessible through the option Ancillary Data Review The opposite is also true Should the recipient s process duplicate entries using the option Ancillary Data Review first the alert goes away Health Summary for Ancillary Service Review Ancillary reviewers can examine additional patient data by viewing selected Health Summary reports prior to verifying the duplicate record pair status See the previous section Health Summary to View Duplicate Record Pair s of this manual April 1998 Duplicate Record Merge Patient Merge User Manual 3 23 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Ancillary Review Designate Ancillary Fields for Overwriting During the actual merge if data exists in the merge FROM field in Record 1 but not in the corresponding merge TO field in Record 2 that data is merged to the merge TO field However if data exists in both the merge FROM and merge TO fields the merge TO field is not overwritten unless you specify otherwise using this overwri
244. total of records reported in the STATUS field should equal the total number of duplicate records for the file selected for this report shown in the previous figure As of the date that this report was run the total count of all records listed in the STATUS field is 1060 The STATUS field indicates that there are 134 records reported as VERIFIED DUPLICATE The MERGE STATUS field indicates that e 62 records were MERGED e 62 others are READY to be merged and e 10 records populate the NOT READY field The value of the NOT READY to merge field is affected by the site parameter DAYS BETWEEN VERIFY AND MERGE This field represents the site specified number of days that must pass before verified duplicate record pairs can be merged In this example 10 verified duplicate record pairs are waiting out this time period Once this time has elapsed these records will be READY to be merged View Duplicate Record Entries 7 20 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 7 Utilities The option View Duplicate Record Entries is located on the Utilities menu It is used to view duplicate records in a captioned format It allows you to view the individual test scores for each duplicate record pair e g scores for NAME DOB SSN SEX etc Duplicate Resolution Utilities Menu Add Verified Duplicate Pair Check rge Process Status Check Pair of Records to
245. u can also print the list if you need to See Appendix A of this manual on How to Print 2 6 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 2 Identifying Duplicate Records Searching the Patient File EVICE HOME lt RET gt RE E LOGIN lt RET gt LISTING OF ENTRIES IN FILE 2 WITH IDENTIFIER OR OTHER PROBLE ELECTED LISTING BAD SSN TA LISTED ACROSS THE ENTRY NUMBER TE OF BIRTH OCIAL SECURITY NUMBE ERVICE CONNECTED Y N XXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXX X XXXXXXXX XXXXXXXXX X 100004 MERGEPATIENT 100007 MERGEPATIENT T 100009 MERGEPATIENT T 100010 MERGEPATIENT Figure 2 6 Patient records with missing SSNs Each of the patient lists that you generate can be used to identify specific patient records with errors You can then access these records to update them by correcting incorrect entries or adding entries that don t already exist Searching the Database for Potential Duplicates NOTE As of Patch XT 7 3 113 the PATIENT file 2 will no longer be selectable from the Search option described below Although users with access to the Duplicate Record Merge menus will still be allowed to add records to the DUPLI
246. uide It has been designed to help you through the review verification and approval of potential duplicate patient pairs and through the actual merge process itself References are made to chapters and sections of this manual where you can find further information on each step documented in the checklist You may also find Appendix B of this manual helpful Where Do I Find How To It has been designed to help you in maneuvering through the Duplicate Resolution System menus to accomplish the Patient Merge process April 1998 Duplicate Record Merge Patient Merge User Manual 1 5 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 1 Quick Start Patient Merge Checklist This page intentionally left blank 1 6 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 1 Quick Start Patient Merge Checklist Quick Start Patient Merge Checklist Disclaimer Not all options are referenced This is an overview of the basic sequence of operations z oom Authorized personnel holding the XDRMGR security key may run the option Preliminary Scan of File for Errors This option identifies records in the PATIENT file 2 that have missing identifiers and or other anomalies REF For more information see the section Finding Errors in the Patient File of this manual Obtain a pool of potential duplicate record pairs that you want t
247. uplicate If the primary reviewer is unable to determine the duplicate status of a record pair the next step is to select the option Unable To Determine shown in the next figure Once this action has been taken alerts and or MailMan message notifications are not sent to any ancillary reviewers The records remain in a potential duplicate status in the DUPLICATE RECORD file 15 Select one of the following VERIFIED DUP VERIFIED NOT A DUPLICATE UNABLE TO DETERMINE H R S EALTH SUMMARY DATA AGAIN REVIEW OVERWRITES Select Action HEALTH S RY U lt RET gt UNABLE Figure 3 17 Select a record pair as Unable To Determine Select Merge Direction Once the primary reviewer has verified a record pair as duplicates the next step is to determine the correct merge direction between records The most likely direction of the overall merge is offered as a default to the primary reviewer The Patient Merge application automatically determines the default direction the merge should take based on which record contains more data The overall direction can however be changed be the best one You should not assume that the record containing the most data is the record to be merged into It s important therefore that the data in both records are thoroughly checked before selecting a merge direction N IMPORTANT Although a default di
248. uplicate they have the option to select fields to be overwritten regardless of the merge direction for that record pair Anytime during the verification process primary and ancillary reviewers have the option to overwrite data regardless of merge direction During the actual merge if data exists in the merge FROM field in Record 1 but not in the corresponding merge TO field in Record 2 that data is merged to the merge TO field However if data exists in both the merge FROM and merge TO fields the merge TO field is not overwritten unless you specify otherwise using this overwrite feature When you choose the option Select Review Overwrites the system will display only those fields that contain dissimilar data for both records Notice in the next figure that the fields NAME DATE OF BIRTH SOCIAL SECURITY NUMBER and ZIP CODE are preceded by four asterisks The asterisks indicate that these particular fields have data in both Record and Record 2 However in both records the data is different Notice the prompt OVERWRITE data for selected fields 1 4 at the bottom of the screen in the next figure You are presented with the choice of selecting 1 through 4 representing each field respectively By selecting numbers 1 and 3 you are choosing to overwrite the fields NAME and SOCIAL SECURITY NUMBER in Record 2 with the corresponding fields in Record 1 NOTE Keep in mind that if data exists in the merge FROM field in Record 1 but no
249. uplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process Current Current Merge Set Start Stat Last Chk Phase File Entry MERGE 1 09 30 17 DATA CHECKING 09 30 17 AB SERVICE 09 30 17 21 EGRATED BILL 09 30 17 IMMUNOLOG 09 30 17 21 LKIT 09 19 17 ENT E 09 30 17 HRI HRI 09 30 22 14 C in the Stat field indicates 09 30 17 21 that this job has completed 09 30 17 21 09 30 17 21 09 30 17 21 09 30 17 21 09 30 21 50 09 30 22 14 09 30 21 12 09 30 20 19 09 30 19 07 HRI OO OF OO NTAGAAO0O GA ERGE 2 DATA CHECKING AAB SERVICE INTEGRATED BILI IMMUNOLOG LKIT ENT FILE HRI THRI A in the Stat field indicates 03 25 1081 03 25 11 03 25 11 1 03 25 1 03 25 1 03 25 1 03 25 1 03 25 14 03 25 14 that this job is still active 8 879268 1364 w YTO G G O Pp Boe BPP PPP PB D Figure 6 5 Status report of merge processes Merge Process Status Screen Field Descriptions The following are descriptions of the fields in the previous figure NOTE Phases one two and three of the merge process are explained in detail in a following section titled Merging Verified Duplicates by Phases 1 Merge Set is the user defined name for a merge
250. uplicate record status for each patient 7 Cnsi ii eke Sica ae hal a ai Lana el ea ene 3 5 Figure 3 4 Select a potential duplicate record pair from a list of top level patient data c eee 3 6 Figure 3 5 Verify duplicate records using the duplicate record compare sereen scceeeeeesteeeeeenees 3 7 Figure 3 6 Review actions for potential duplicate records cececeessecececececceeessenseceeeeeeeesssesenseaeeeees 3 8 Figure 3 7 Verifying duplicate records using selected Health Summaries cceceeseeeeeeeeeeeeeeeees 3 11 April 1998 Duplicate Record Merge Patient Merge User Manual xiii Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Figures amp Tables Figure 3 8 Send Health Summaries to any device for viewing ccccccceceeeesseteceeeeeeeeeeseesetteeeeeees 3 12 Figure 3 9 Example of Health Summary merge FROM record viewed through VA FileMan Browser 3 13 Figure 3 10 Example of Health Summary merge TO record viewed through VA FileMan Browser 3 14 Figure 3 11 Example of Health Summary merge TO record viewed through VA FileMan Browser Contini dsher E E Tn gs eee dee Sane ste ee eS 3 14 Figure 3 12 Designate fields in potential duplicate records for OVErWIitiNg ceceeeeeseeeeeeeneneeeeeees 3 16 Figure 3 13 Review duplicate records again from the beginning ccccccceesssseceeeeeeeeeeesesseseeeeeees 3 16 Figure 3 14 Bars on left indicat
251. ve two options to halt a search 1 Select the VA FileMan command NOW to begin halting immediately 2 Halt the search at a specified time in the future Select Manager Utilities Option SRCH lt RET gt Start Halt Duplicate Search Select file to be checked for duplicates PATIENT Duplicate PATIENT Search Search Typ Date Started Status hours min Records Checked 1997 18 24 RUNNING 232 66572 1 Potential Duplicate pairs found Do You wish to HALT this search Y N Y lt RET gt YES Requested Start Time NOW lt RET gt MAY 02 1997 18 27 00 Figure 2 11 Halting the search for duplicate records NOTE Once a search is started you cannot start another search You can only halt a search in progress The search can then be restarted using the NOW command or it can be queued for a later date and time 2 12 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 2 Identifying Duplicate Records Searching the Patient File When we run the option Display Search Status again notice that the date and time of the last action is recorded and the status field reflects that you ve halted the search Select Utilities Option dss lt RET gt Display Search Status Duplicate PATIENT Search hours min Records Checked 1997 18 24 HALTE 1 Potential Duplicate pairs found Figure 2 12 Duplicate Patient Search status screen sho
252. viewer determines that the pair is a duplicate then the record is verified and moves to a pending approval status 2 By selecting the option Verified Not A Duplicate you ve determined that the record pairs are not duplicates and processing ends here A remote procedure will run on the MPI system to record the patient pair in the MPI DO NOT LINK FILE 985 28 so that these patients will not be identified as potential duplicates in the future 3 By selecting the option Unable To Determine the record pair is put back into the DUPLICATE RECORD file 15 and processing ends here In order for these entries to be processed again you must use the option Edit the Status Field of a Duplicate Record to change their status back to potential duplicates ay NOTE See the section Utilities of this manual for more information on this option 4 By selecting the Health Summary option you can view additional patient data via the health summaries 5 By selecting the option Review Data Again the system redisplays the data for the record pair you ve just viewed 3 8 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 3 Primary Review 6 By selecting the option Select Review Overwrites the system will display only those fields that contain dissimilar data for both records You can choose to overwrite the selected data in Record 2 the merged TO record with the
253. which case you will need to read those chapters detailing your assignment and those whose work you manage Are You New to VistA If you are just learning to use VistA or if you feel you need to review some basic concepts refer to Appendix A Are You New to VistA This section introduces you to a small but important part of VistA signing on entering data and getting out It is designed to help you get started and feel more comfortable with the VistA computing environment If you are an experienced VistA user this chapter can serve as a reminder Where Do I Find How To Appendix B answers questions about which options to use to perform the various component functions involved with the duplicate record merge process Tables present the menu structure in a question and answer format The related menu options are presented in the right hand column This section is designed to answer questions about which options to use to perform the various functions involved with the duplicate record merge process xviii Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Orientation Computer Dialogue Sample Online Displays The following is a sample of computer dialogue Select Operations Option SCN lt RET gt Preliminary Scan of File for Errors Select DUPLICATE RESOLUTION FILE TO BE CHECKED PATIENT A run was completed on Fe
254. with the other checkpoint data is intended for use in tracking the progress of the merge process and if necessary to permit the merge process to be restarted in the vicinity where it was last processing The fields Phase Current File and Current Entry are closely associated The processing phase is displayed for the current file entry inclusive of file number and record IEN in five second intervals If something happens to interrupt the merge process all of these pieces of information you see displayed for that five second interval are recorded in the XDR MERGE PROCESS file 15 2 Once this job is restarted it can begin exactly where it left off based on this tracking information 6 12 Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Chapter 6 The Merge Process This guarantees that once a merge process is started it can be tracked and restarted if necessary until it runs to completion Merge Process Status Screen Data Checking Many of the broken database bad data events that would have upset an actual merge can be detected at the beginning of the merge process This is done by checking the various fields of the patient s record as though data were being filed in the record for the first time The information is checked against any input transforms or edit routines as controlled by the custodian of the data All verified duplicate record pairs tha
255. ws the search for duplicate records has been halted You can begin the search again exactly where you left off by using the option Start Halt Duplicate Search Indicate that you want to continue it by responding Yes to the prompt Do You wish to CONTINUE this search Y N Select Manager Utilities Option SRCH lt RET gt Start Halt Duplicate Search Select file to be checked for duplicates PATIENT Duplicate PATIENT Search Search Typ Date Restarted Status hours min Records Checked MAY 02 1997 18 24 HALTE 232 66572 1 Potential Duplicate pairs found Do You wish to CONTINUE this search Y N y lt RET gt YES Requested Start Time NOW lt RET gt MAY 02 1997 18 31 40 Figure 2 13 Continuing the search for duplicate records And again the next figure shows that when we run the option Display Search Status the Status field reflects the search is RUNNING the number of records searched and the percentage of records checked has again continued to increment April 1998 Duplicate Record Merge Patient Merge User Manual 2 13 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 2 Identifying Duplicate Records Searching the Patient File Select Utilities Option DISplay Search Status Duplicate PATIENT Search Search Typ Date Restarted Status hours min Records Checked 1997 18 31 RUNNING 3 Potential Duplicate pairs found Figure 2 14 Duplicate Patient Search status
256. y Scan of File for Errors Purg rge Process Fil Restart a Merge Process Schedule Process to Merge Verified Duplicates Start Halt Duplicate Search STOP an Active Merge Process Select Manager Utilities Option STOP lt RET gt STOP an Active Merge Process Do you want to stop TEST3 YES lt RET gt YES Figure 8 13 Stopping the merge process Duplicate Record Merge Patient Merge User Manual April 1998 Version 7 3 Revised December 2010 Kernel Toolkit Patch XT 7 3 125 Glossary Abbreviated Response Access Code Active Patients ADPAC ADR Alerts Ancillary Revie wer ANSI ANSI M API April 1998 Revised December 2010 This feature allows you to enter data by typing only the first few characters for the desired response This feature will not work unless the information is already stored in the computer A code that along with the Verify code allows the computer to identify you as a user authorized to gain access to the computer Your code is greater than 6 and less than 20 characters long can be numeric alphabetic or a combination of both and is usually assigned by a site manager or application coordinator It is used by the Kernel s Sign on Security system to identify the user see Verify Code Patients who have been seen at a site within the past three years Automated Data Processing Application Coordinator The Administrative Data Repository is a centralized database repository
257. y Social Security Numbers SSN will begin with either 000 or 666 e Patient and user names will be formatted as follows Application Name PATIENT N and Application Name USER N respectively where Application Name is defined in the Approved Application Abbreviations document located on the web site and where N represents the first name as a number spelled out and incremented with each new entry For example Duplicate Record Merge test patient and user names would be documented as follows MERGEPATIENT ONE MERGEPATIENT TWO MERGEPATIENT 10 etc and MERGEUSER ONE MERGEUSER TWO MERGEUSER 10 etc April 1998 Duplicate Record Merge Patient Merge User Manual xvii Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Orientation Who Should Read This Manual This manual was written with many job functions in mind These include the computer related functions and the non computer related functions Since each site will determine who will control the patient merge process what considerations are followed how the review will be accomplished and when the merge should be started stopped everyone involved with the merge should read this manual You don t necessarily have to read every chapter however unless it refers to a specific task or oversight responsibility that you have been assigned We do encourage everyone to review the Product Description section which provides an overview of the entire process In
258. you can have IRM remove several erroneous records This reduces the number of errors in the patient identification and merge process allowing the system to run much faster April 1998 Duplicate Record Merge Patient Merge User Manual 8 5 Revised December 2010 Version 7 3 Kernel Toolkit Patch XT 7 3 125 Chapter 8 Manager Utilities Only authorized persons holding the XDRMGR security key should be responsible for using this option To run the scan select the option Preliminary Scan of File for Errors shown in the next figure Duplicate Manager Utilities Menu EDT Edit Site Parameters IST ist File Entries Identified in Preliminary Scan SCN Preliminary Scan of File for Errors PRGM Purg rge Process Fil RES Restart a Merge Process SCH Schedule Process to Merge Verified Duplicates SRCH Start Halt Duplicate Search STOP STOP an Active Merge Process Select Manager Utilities Option SCN lt RET gt Preliminary Scan of File for Errors Select DUPLICATE RESOLUTION FILE TO BE CHECKED PATIENT A run was completed on JAN 25 1997 13 50 19 Do you want to view those results YES lt RET gt Figure 8 6 Running a preliminary scan of the patient records Answering Yes to the prompt Do you want to view those results shown in the previous figure will generate the output from the scan of the PATIENT file 2 shown in the next figure You can step out of this option and

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