The first VistA-Office EHR release will in fact have the RPMS code to handle HRNs as used by IHS. While the formal release by VHA of the code to VistA may not happen until after the release of VistA-Office due among other things to routine overlaps in patches slated to be released by VHA in the next couple of months, incomplete patch verification, e.g. the necessary regression testing, etc. I am confident that in the months following the release by CMS of VistA-Office, the patch streams will converge to the benefit of VA, IHS and users of VistA-Office.
-----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Kevin Toppenberg Sent: Thursday, April 21, 2005 7:20 AM To: hardhats-members@lists.sourceforge.net Subject: Re: [Hardhats-members] IHS system??? Let me see if I understand. 1. The HRN is a good system for the IHS 2. Althought file 9000001 is distributed with the FOIA vista, it is not fully integrated, i.e. the lookup routines are not there. 3. It shouldn't be too hard to achieve this integration. If this is true, and if such a HRN is needed by so many non-VA sites, would it be worth a little effort to have our next WorldVistA version support this? Perhaps VistA Office is going to solve this problem for us, but I don't want to have unrealistic expectations as to what they can achieve in a limited amount of time. Kevin --- Floyd Dennis <[EMAIL PROTECTED]> wrote: > There appears to be some confusion on the nature of > the IHS patient fileıs > Health Record Number. I donıt know if clarification > is possible, but Iıll > give it a shot. :> > > 1. Like many of the initial RPMS modules, the IHS > Patient Registration > system is ³piggybacked² onto the VAıs registration > system. Much of the > patient demographic information resides in File #2 > (referenced in RPMS as > the VA PATIENT file). Additional patient data > captured by the RPMS patient > registration system is stored in File #9000001 (the > RPMS systemıs PATIENT > file referred to as PATIENT/IHS by VistA), which > maintains a DINUM > relationship with File #2. Examples of such > additional data are patientıs > tribe of membership, level of eligibility for IHS > services, etc. > > 2. The RPMS deals with IHS-specific mods to VA > standard dictionaries in a > similar fashion; DINUM-related RPMS correspondent > dictionaries are > established; and the IHS-specific mods dealt with in > the corresponding > dictionary. One example of this is the IHSıs method > of identifying > facilities. The VAıs standard dictionary of > facilities is maintained in > file #4 (INSTITUTION); IHS has its own standard > method of facility ID > coding, however, for which (to the best of my > knowledge) there is no > corresponding VA code. The RPMS solution to this > was to create a LOCATION > file #9999999.06 which (a) has a DINUM relation with > file #4 and (b) > contains the IHS standard 6-digit ASUFAC ID code for > the facility. Simple, > huh? :) > > 3. When looking at using the VAıs DHCP software, > one of the very first > hurdles IHS had to overcome was the problem of > patient identification. The > VAıs patient registration system uses SSN as its > primary patient identifier. > IHS cannot base its patient identification on SSN, > however, because many of > its patients (especially on the larger Southwestern > U.S. reservations) have > never applied for nor been issued a Social Security > number. > > 4. The IHS solution was/is the health record number > (HRN), a number which > uniquely identifies a patient within a given > healthcare facility. There is > no relationship between the HRN and the SSN; the two > are apples and oranges. > For facility-external references, the HRN can be > concatenated onto the end > of the facilityıs ASUFAC code. In IHS, the HRN is > limited to 6 digits; > YMMV. > > 5. The RPMSıs PATIENT file #9000001 incorporates > multiple field #4101 which > contains (a) a LOCATION file pointer reference to > each facility at which a > patient has been registered, and (b) the patientıs > HRN at that facility. > This (theoretically) allows coherent management of > demographic information > for patients registered at more than one IHS > facility. In Annaıs example > entries, the HEALTH RECORD FAC field is the pointer > reference to the > registering LOCATION file entry, and the HEALTH > RECORD NO. field is the > patientıs HRN at that facility. Annaıs #3 entry > represents a patient TEST > PATIENT,PATIENT who has been registered with chart > number 000001234 at the > SOFTWARE SERVICE healthcare facility. > > 6. Unsurprisingly, the earlier standard FileMan > lookups did not deal well > with the notion of using several data items from a > multiple field as a > unique patient lookup identifier (this *was* back in > the days of FileMan > v16.60, after all). The AUPNLK* routines perform > that patient lookup > function, as well as providing increased security on > patient lookups. > > 7. Since the VistA software does not acknowledge or > use the RPMS #9000001 > PATIENT file, this HRN-identifier lookup would not > be available on the VistA > side of the house without some rewriting of a given > packageıs patient lookup > modules. This is not an insurmountable problem; as > a momentıs reflection > will reveal, IHS has performed this rewrite on every > VistA package that has > been adapted for use in the RPMS environment. > > 8. Along the same lines as #7 since the AUPNLK* > patient lookup routines > are IHS-developed software, they would be unlikely > to pop up in a VA > software distribution. > > > NOW is everybody sufficiently confused? :) > > > --------------------------------------------------- > Doubt is uncomfortable; Certainty is ridiculous. > > - Voltaire > > Floyd Dennis > [EMAIL PROTECTED] > > > > > On 4/20/05 10:59 AM, "James Gray" <[EMAIL PROTECTED]> > wrote: > > > I believe the input transform on the HRN field is > for a max of 6 digits. I > > thought that some version of the AUPNLK* routines > were included in the VistA > > FOIA. The lastest can be obtained from the IHS > FOIA. It would be possible > > for a hospital to put their own patient id's into > the HRN field as long as > > they are numbers no more than 6 digits long. > > > > If you have Cache installed on a Windows machine > you should be able to load it > > onto Cache. I do not know about untaring (if that > is the right term) without > > Unix or Linux. > > > > I was trying to say that IHS uses unmodified > versions of VA Fileman and > > Kernel. > > > > Jim Gray > >> > >> ----- Original Message ----- > >> > >> From: Anna Joseph <mailto:[EMAIL PROTECTED]> > >> > >> To: hardhats-members@lists.sourceforge.net > >> > >> Sent: Wednesday, April 20, 2005 12:39 AM > >> > >> Subject: Re: [Hardhats-members] IHS system??? > >> > >> > >> > >> > >> From: James Gray <mailto:[EMAIL PROTECTED]> > >> > >> To: hardhats-members@lists.sourceforge.net > >> > >> Sent: Wednesday, April 20, 2005 3:30 AM > >> > >> Subject: Re: [Hardhats-members] IHS system??? > >> > >> > >> > >> > >>> >I don't either, but I recall some things about > it. If you use the VA FOIA > >>> there is cross reference on the SSN that stuffs > the SSN into the HRN. The > >>> interesting thing is >that it violates the > input transform on the HRN > >>> field. > >> > >> > >> > >> what is the input transform on the HRN Field? I > mean does it > >> increase/decrease the number of digits, a > specific logical > >> transformation...? > >> > >> > >> > === message truncated === __________________________________________________ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com ------------------------------------------------------- This SF.Net email is sponsored by: New Crystal Reports XI. Version 11 adds new functionality designed to reduce time involved in creating, integrating, and deploying reporting solutions. 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