My Blog
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- ADT Interface – Completed a series of test registrations in DB.TEST while working with facility to address issues that were reported with the initial set of integrated test patients. Based on their feedback, had to modify the e*Gate routing and transformation rules to only send a single NK1 segment, default the value “EP” in NK1.7 for that single NK1, filter out all ADT events except the A01, A04, A05, A08 and A18 (translated from A34) and to filter out all OBX segments from output to the client facility. After making the changes, completed series of detailed unit tests to ensure the changes functioned as designed. Subsequently, completed another set of test registrations in DB.TEST and worked with the facility to confirm that the new test patients filed properly.
- Created Interface Requirements document for this interface and completed implementation within e*Gate production environment. Sent out the standard email to the interface team regarding the go-live including the requirement document, updated the downtime list and provided information on the new event type to track in the Queue Status scripts.
- Completed production implementation of the ADT interface to Project for the final 3 ministries. This e*Gate build was extensive, requiring a new BOB and File e*Way for each ministry and a new JMS bridge e*Way for one interface to bridge a remote site’s ADT messages to the CS Schema for delivery to Project on a single port / feed. As part of the process, first built new modules in the conversion environment, using the same e*Gate routing/transformation code from the first 3 ministries and followed this up with the same build steps in the production environment. Once the process was complete, sent the standard notification email to the Integration Team to address the downtime list, support information and new event types.
- Cardiology ITS Reports Interface – Worked to support troubleshooting emails with the IT support team from one of the remote locations. The issue reported was the same issue from the past where they fail to return an ACK in a timely fashion and e*Gate re-sends the previous message which results in duplicate reports within the site’s Allscripts. Ultimately, bumped the read timeout for ACK’s from 10 seconds to 30 seconds and sent out detailed email to all interested parties that we would keep an eye on things, but to expect this issue to occur if Allscripts does not send an ACK back within 30 seconds of message receipt.
- Based on email regarding issue with messages backing up for recently implemented JMS “Bridge” e*Ways. Researched the issue and provided log file evidence that the backups were related to inadvertently triggered collaboration shutdown/restarts based on users accessing the shared collaboration rule “crPassThru”. Shared my findings in email to the team, instructing them to take care when working within the production environment with shared components like “crPassThru”.
- Completed gap analysis for the ADT (including ABS generated BAR^P01 messages) interface between Meditech and SITE HL7 Specifications including some additional updates to the “Health Comments” section of the Meditech HL7 Specifications. I documented the gap analysis information via Word Comments added to the SITE provided “Default Message Set” HL7 ADT Interface Specification. Notes were added at the field level to document the fields that are not supported/sent by the Meditech ADM/ABS outbound HL7 interfaces. Also, general notes were added regarding supported event types and in some cases field level value notes were included for critical fields (e.g. Meditech Patient Type Values for PV1.18).
- I did some research on monitors for the team. Unfortunately no major vendor seems to want to do any sort of “on-site” demonstration of their touch screen monitors unless the hospital is looking to buy in “major bulk (1,000 or more) or sign a “long-term replacement contract”. A few on Epic’s list of “preferred vendors” claim they don’t even have them and are not sure what Epic is referring too. So I’m going to do more research of “non-listed” vendors and turn that all over to another team member next week.
- ASAP finished presenting workflows to Ops this week. They also re-presented the physician workflows to Ops so that the physician lead could weigh in with any suggestions he has. Some suggestions are currently being researched to see if the Orlando office can be accommodated. They are also preparing for the upcoming build that will be starting very soon.
- HOD team completed Gap Analysis documentation and completed the final workflows and received sign-off on all with the exception of the integrated Sedation workflow. The team continues to participate in calls and e-mails surrounding that workflow. The team is prepping for the upcoming build sessions.
- OpTime team completed all gap analysis documentation and finalized the sign-off of all workflows. The team is involved in the sedation discussions as well. They are currently prepping for the upcoming build sessions as well.
- Completed all the Orders workflows and the gap analysis documentation. This team, like many others, are involved in the sedation discussions and prepping for upcoming build sessions.
- For Radiant, excluding sedation, all (10) workflows are completed and have obtained Ops signoff. The workflows were uploaded to TeamShare and the workflow tracker updated. The Radiant team met with the PACS team to identify any potential issues or gaps with Radiant/PACS integration. At this time, both teams concur there are no identifiable issues or gaps at this time. The PACS projects (upgrade to Powerscribe 360 & implementation of Poesis) are in early planning phases estimated to be completed in February 2012. The Radiant and PACS team will continue to remain in communication with particular attention to the design/analysis phases of the PACS projects. Gap analysis documentation was completed. The sedation workflows have the potential to moderately impact gap analysis documentation and build plan; gap analysis documentation will be updated in concert with sedation workflow development and documentation.
- Spent time getting updated on the status of the 5.5 Medicity ProAccess Deployment.
- Educated technical anaylst on the the project management and organization’s processes for technical deployments.
- Identified project risks and began developing mitigation plan.
- Advised staff on course of action for issues identified throughout the week.
- Created the Medicity ProAccess 5.5.1 Workplan.
- Continued LAB Business Process Development to ensure all departments meets all CAP testing and validation requirements with this implementation.
- 5 practices are scheduled for go-live the week of 10/9.
- Continued Business Process Development with the Support Team that will be handling Teir 1 support calls for iNexx, eOrders, and Results Delivery.
- EzEMR’s Orders and Results Implementation contract is under review.
- Continued Business Process Development for EMR implmentation communications.
- Worked with the team to mitigate the identified risks to roll-out of iNexx and EMR interfaces.
- Carestream Status”
- Got New build of nuclear medicine tests for ordering in EPIC
- There was no way or no inclination from EPIC to treat these as Panel type tests
- Solution worked out was to use Rhapsody to use a SQL table to store ordered procedure codes with information to match them up with the proper order so when a result is returned the Series code will be returned to EPIC as the result code so it will file
- The problem is one result is returned and it may not be the same one for all exams because the exam consists of individual discrete elements.
- CT Abdomen/Pelvis studies will have ordered code stored and will always send the code 298 to Carestream, any matching result will have the ordered procedure code sent back to EPIC
- Charges- got the billing team to finally map all of their MPI ID values and went from 523 failures out of 854 down to 11 failures out of 854
- On the Safety Surveillor, worked with Med team to facilitate extracting administration date and time from a Chronicles extract
- In progress Route Design FTP log/DB logger to capture Financial transaction between Meditech/Lawson/LSS (Testing)
- Redesigning SQL table for FTP log
- Started populating FTP Log Db for monitoring through put
- Redesign Javascript for FTP log
- Created new HL7 Adt message definitions to handle new interfaces
- Designed new naming convention for ADT interfaces
- Debugged QuickCharge to Lawson Javascript to handle T-2 with client
- Debugged and redesigned Centura Pyxis Javascript to increase msg throughput
- Assisted adding JVM memory to FTP and TCP instances to prevent Memory Errors
- Completed remaining ePI testing scenarios prior to activation.
- Planning for ADT backload into ePI/LAB on 10/3.
- Preparation for ePI activation on 10/10.
- Completed specifications for Allscripts eLink HDOHDecryption interface.
- Completed specifications for Allscripts eLink HDOHCleanup Interface.
- Started HL7Encrypt2Lvl and Allscripts eLink HL7Decrypt2Lvl translator specs.
- ITS Routing Rules Research and Changes – Completed detailed research on the content of ITS ORU messages in production and provided this information to the client along with a request for guidance regarding their requirements for identifying Radiology vs. Transcribed Reports. Worked to designate a Meditech ITS Expert IT resource to help with the ITS departments and report types. Ultimately, I was able to identify a relatively simple rule for identifying Radiology reports which was any reports for ITS report department “DIS” with all others being considered “Departmental” in the Provena vernacular and roughly analogous to the clients “Transcribed” reports. Based on this information, updated the routing rules in the client schema to route Radiology reports and Transcribed reports in separate data feeds on their way to the client and was able to start the backload for those data types. Did not move forward with the changes and backload until I received word from the Microsoft Project Manager that he was in agreement with our analysis of Radiology vs. Transcribed within the context of Meditech ITS.
- Backload of Historical Data – Completed backload of Historical Data from 7/1/11 forward. Completed backload of historical data for all data types and all six ministries. The historical backload processing required some very detailed baby sitting in order to ensure that all historical data files were processed through the client schema and delivered in sequence to the client from 7/1/11 forward. In total, there were 18 separate data file archive locations for pulling the data files for the backload and some tricky issues dealing with the nature of the “robocopy” setup that “archives the archives” from the active e*Gate servers to the ACN013 data archive server.
- Production Implementation of Schema Bridges to client Schema – Up front, worked within the Integration Team’s “Ports” MS Access database file on the X drive to identify and assign ports for 4 control brokers, 7 JMS IQ Managers and 4 outbound HL7 e*Ways to the client including a separate set of ports for TEST and PROD. Recorded within the “Ports” MS Access file all inventory for all of the above. Subsequently, exported the schema from ACN015 and imported that schema into ACN016. Completed configuration changes to update all control brokers, IQ Managers and HL7 e*Ways to use the port assignments from PROD. Also, updated all IQ Manager, JMS e*Way Connections and Batch e*Way Connections to point to the new PROD drive letter for logical server AEGT14T which is the L: drive (change from I: drive for TEST AEGT11T). Also, created Cluster Resources for all new control brokers and configured them per conventions established from the current e*Gate environment’s Cluster Resource configuration defaults. Subsequently, turned on production interface components to provide real-time data feeds to the client from data fed from the schema bridges in the current environment. Turned on these live feeds once the historical backload was complete.
- Production Implementation of the client Schema – Completed production implementation for all four client Bridge schemas. This work was intensive on ensuring that the proper message subscriptions were defined for the 18 different data feeds from the six ministries. Prior to the configuration of subscriptions in PROD, exported each module from its respective CONV schema and then imported them into the analogous PROD.
- Changing 5.6 access for consultants and analysts for different testing scenarios.
- Creation of EPIC training users.
- Modification of NUR 200 menu.
- This week, the ASAP team presented three new workflows to Ops. We are also preparing for two Ops meetings coming up next week. We need to present past workflows to Physician administration. During the second meeting next week, we will be presenting our final three workflows. The ASAP team has been preparing for the upcoming start of the build phase therefore we have been researching Clindoc documentation and familiarizing ourselves with our northern location’s setup.
- The team held a Gap Analysis meeting and discussed electronic charges in Epic, Reports, and Build trackers. We were able to review all OpTime online reports this week. We ran all of the Norther location’s OpTime online reports and sent them to for review. We were also able to review all of the northern location’s Clarity Reports in production as well as start to document in the build tracker and prepare for documenting the Gap Analysis.
- This week the remaining Radiant workflows (excepting sedation) were completed. All workflows except one have received NCH signoff. Signoff for the remaining workflow was deferred until next week given team availability during UGM week. Review of the orders list distributed by the Orders team was completed; no immediate revisions were required. There has been some preliminary discussion by the team toward taking advantage of the opportunity to tweak preference lists as part of this project. The team will discuss this further next week and report any developments to the Orders team.
- Performed Rhapsody testing and pointing out build deficiencies that need to be addressed prior to go live.
- In progress Rhapsody Route Design FTP log/DB logger to capture Financial transaction between Meditech/Lawson/LSS (Testing)
- Redesigning SQL table for FTP log (Waiting for DB to be populated)
- Created new HL7 Rhapsody Adt message definitions to handle new interfaces.
- Created Rhapsody ADT Routes for Meditech to MedData App
- Created Rhapsody ADT Route for Meditech to IPC App
- Created Rhapsody ADT Route for Meditech to Penrad App
- Created Rhapsody ADT Route for Meditech to TeamHealth App
- Debugged Javascript for message filtering from Meditech
- Completed specifications for Hawaii Server translator.
- Began work on HDOHDecryption and HDOHCleanup translators
- Completed cross system merge testing.
- Continued work on complex merge testing.
- Activation preparation activities.
- We had several pre-DBV sessions to prepare for the DBV’s. I’m currently working on a vendor selection for Monitors and have contacted 3 of the larger monitors that were recommended by Epic. I am hoping to get these companies to come in and demonstrate their monitors during the DBV sessions.d record testing for the Carestream system. Identified 158 tests that are not built correctly in PRC and will fail.
- ASAP this week provided screen captures of all of the navigators currently used in Northern facility and created PowerPoint Presentations for Ops’ review. They also presented three workflows to Ops for vetting and validation. They have now started reviewing documentation for Workflow Engine Rules to prepare for the upcoming start of build.
- Workflows that can be shown have been shown besides one small part on Infusion and all of the Sedation workflow. HOD resources will be showing these next week. I’ve started to put together a draft of the Gap Analysis document and will work to develop some sort of template that all the teams can use when turning in their gap analysis document.
- The team held several workflow meetings with Ops and achieved 100% sign-off on the remaining workflows they had. The team also started to develop the gap analysis documentation needed. Attended a meeting for wall of knowledge on 9/13 and received a takeaway of creating a custom status board report. The team also met and reviewed the reports in Epic Hyperspace and gave a quick overview of reporting with Epic. Reports were ran from Epic Hyperspace and prepared for materials to send to client resources for review.
- Attended nursing validation session for Orders with Operations. Also completed physician validation of 4 physician order entry workflows. Started draft of Gap Analysis documentation due Sep 30.
- Radiant remains on track to complete workflow gap analysis by the end of September – with the previously reported possible exception of sedation workflows. Signoff has been obtained for the order entry, imaging exam, and one of two scheduling workflows – the remaining scheduling workflow is expected to receive signoff early next week pending final revisions. Check-in workflow alignment with the Cadence check-in workflow remains in progress and expected to be completed next week and submitted for client approval. No final decisions regarding client sedation workflows were produced by this meeting and so a follow-up meeting has been scheduled for 9/27. Also in progress is gap analysis for imaging orders. Effort so far indicates the order list provided by the Orders team is complete. Detailed review will continue next week.
- Safety Surveillor - Started looking into sending dispense messages to Safety Surveillor.
- CareStream
- Mapped Record testing
- Watching over the users entering orders and results-
- IP orders are all placed with only a handful where the MPI ID lookups failed.
- Held up OP testing due to multiple scheduling issues
- 1420 procedures need to be ordered and resulted for IP and then repeated for OP
- Got the reason for test items fixed and crossing the interface, the linkages were not correctly built in the orders build
- Worked on getting the Nuclear Med radiology exams to work correctly
- Changed the approach from looking at each piece as a discrete item to looking at each exam as a panel
- Problems with the build being able to look at these tests as part of a panel
- There is a workaround that was devised that allows the process flow to work like the providers think of these tests but will require more training of the schedulers
- Started work on charge mapped record testing
- Continued Eclipsys SCM cross system merge testing with ePI. Only two scenarios remain.
- ePI activation preparation. Will travel to site on 10/10 for activation.
- Assisted with refinement of SQL queries creating extract to load historic demographic data into ePI and LIS.
- RIS configuration activities.
- Discussion regarding cleanup of Tawas provider licenses in SCM.
- In progress Route Design FTP log/DB logger to capture Financial transaction between Meditech/Lawson/LSS (Testing)
- Redesigning SQL table for FTP log (Waiting for DB to be populated)
- Created new HL7 Adt message definitions to handle new interfaces
- Created ADT Routes for Meditech to Obix App
- Created ADT Route for Meditech to Paml App
- Created ADT Route for Meditech to Pweb App
- Created ADT Route for Meditech to Responder App
- Debugged LSS FTP route to encrypt files with Centura
- Continued provisioning in ProAccess & Grid; assisted Cottage eHP team with communications to Pilot Participants for scheduling DropBox & ProAccess deployment; addressed questions & issues from demo DropBox configured for Cottage SMEs as part of DropBox training.
- Received information from vendors on interim solution with existing software version for Phase 3 (manual CCD exchange); completed Practice Planner for first Greenway practice and initiated request with Medicity per SOP for first Phase 1 interface due 10/24; continued work with Cottage eHP Program staff on collecting Practice Planner information from all Greenway practices.
- Medicity completed development of EMR Definition; working with Prime Clinical on compendium and testing; monitoring project status and tracking milestones & deliverables.
- Wealth Engine SFTP Interfaces Troubleshooting – Received report that client did not receive Wealth Engine response files on 8/27 and 8/30. Completed research of the e*Gate logs for PCMC’s Wealth Engine SFTP interface and discovered that while the Wealth Engine request files were sent to Wealth Engine on 8/27 and 8/30 that Wealth Engine did not return the response files to e*Gate so that they could be passed on to the Y drive folder for PCMC. Sent a detailed email to Wealth Engine contacts explaining my findings. Subsequently, received email explaining that the Wealth Engine server experienced performance issues that prevented it from returning the 8/27 and 8/30 files to e*Gate. They explained that the issues were resolved as of 8/31 so I proceeded to resend the request files for 8/27 and 8/30, then returned the response files from Wealth Engine to the Y drive in order to provide my client with the missing files.
- Project ADT Interfaces – Worked at length to report and resolve several cases where the e*Gate TCP/IP e*Way was yet again unable to connect to the RED Server thus causing message backlogs within the e*Gate environment. Subsequently, worked to map out the strategy for dealing with future outages in a more timely fashion.
- Project ADT Interfaces – Completed e*Gate build and testing followed by production implementation to replace the “PassThrough” collaboration rules with new collaboration rules that apply the standard message filters for ADT interfaces for all three Project interfaces. These changes included filtering out ADT messages where the PID.3 field is empty/null (Meditech Medical Record Number not yet assigned), filtering out A34 messages where the MRG.1 (Prior Medical Record Number) field is empty/null and filtering out A35 messages where the MRG.3 (Prior Account Number) field is empty/null.
- VendorFTP Schema Test Environment Set up and Configuration – Worked at length to establish the Vendor FTP schema as a fully functional test environment that mirrors the production environment. Exported all modules from production and imported those copies into the test environment. Installed “Core FTP Server” freeware software on ACN013 in order to implement a local SFTP server on ACN013 to be used for testing. This SFTP server software can be used to test e*Gate “SFTP” enabled e*Ways prior to production deployment and before availability of an actual third party vendor SFTP connection. For the Datanex SFTP interface, created public/private SSH key-based authentication files and configured a proxy Datanex SFTP server to use the public key. Installed Putty software on ACN013 server and copied all production SFTP scripts (Datanex and Wealth Engine SFTP interfaces) from ACN010 and modified them to accommodate the ACN013 environment’s drive letter assignments. Worked at length to identify the password for the ACL014 Cluster Administrator account which was lost. This account must be used when configuring and installing the Putty SFTP connections since SSH authentications are all tied the process owner which in the clustered e*Gate environment is always the Cluster Administrator account.
- VendorFTP Schema Production – Updated all components for Datanex, Wealth Engine, Medmined and HillRom to include detailed reporting of the specific eWay and Collaboration Names for “bmail” alerting emails that are generated when SFTP connections are down. Also, updated the bmail recipient list to include all members of the client Integration Team.
- Replaced Rhapsody ADT mapper as it was clipping off data at end of PV1 segment.
- Mapped record testing for the Carestream system. Identified 158 tests that are not built correctly in PRC and will fail.
- Conversations with Safety Surveillor on transmitting med admins to them as well.
- The team attended meetings for Anesthesia and validated SME attendance for Validation Sessions in October and schedule of Validation Sessions. They also worked on mapping of Model Migration errors to Nemours build. They met with Epic to review Model Migration error spreadsheet and project plan. Attended meeting with Cadence regarding Resource Assignment workflow for sedation procedures. They met with HOD team to discuss Sedation workflow outside of the OR. The team also worked on finalizing the project documentation (project plan and scope document) for Anesthesia project and sent to project stakeholders for sign off.
- This week, the ASAP team demonstrated the Sedation and Trauma workflows to Ops. They continue to modify the workflows for the southern location and upload them to Team share for Ops’ to review and approval. Team member took screen captures of 11 navigators currently used for the northern location and these will be uploaded to the Team Share site for Ops to familiarize themselves with. They continue to have a weekly team meeting, a weekly Ops meeting and a wrap up meeting following each Ops meeting to clarify changes before modifying that week’s workflows.
- The team spent most of the week preparing for next week’s workflow (Infusion) presentation to Operations. They also continued to review their part in the sedation integrated workflow. Met with Anesthesia team to discuss the sedation workflow outside of the OR.
- Busy week for the OpTime team. They had a Gap Analysis meeting on (9/8). We were able to get thru several workflows. Management was able to sign off on 27 OpTime workflows. The team reviewed ordersets for OpTime at the northern location in preparation of putting them in front of Operations for approval. The team then had another Gap Analysis meeting on (9/9): a terrific demonstration of the Optime Navigators and Flowsheets for Pre-Op, Intra-Op and Post-Op where received.
- The team attended nursing validation session for Orders with Operations. Also completed physician validation of 6 physician order entry workflows and completed meeting minutes.
- Exported all orders-related SmartTexts and identified those that are specific to AIDHC.
- Work on 5 additional Orders workflows and update validated Orders workflows.
- Radiant remains on track to complete workflow gap analysis by the end of September. This week the six imaging exam workflows were reviewed by and obtained signoff from NCH Ops pending modifications that were identified during the session. The modifications have been completed and the final approved imaging exam workflows are on TeamShare. The Cadence/Radiant imaging scheduling and check-in workflow reconciliation began this week and is expected to be completed next week.
- The primary workflow remaining is the sedation workflows. The team continues to engage into sedation workflow discussions.
- For a Rhapsody client,
- In progress Route Design FTP log/DB logger to capture Financial transaction between Meditech/Lawson/LSS(Testing)
- Designing SQL query to handle file properties and build email notifications (Waiting for DB to be populated)
- Integration Team Project Planning meeting
- Created 3 ADT Routes for Meditech to Impac
- Created ADT Route for Meditech to Lumedx
- Created ADT Route for Meditech to Medquist
- Created a debatch route to extract Egate Msgs for testing log files
- For Radiology,
- Final workflows sent out for approval except IR and X-Ray/Flouro; will be sent next week
- Held security meeting to get some new users setup for build/test activities
- Scheduled design/build sessions with IS&T clinical documentation, orders, Radiant and other analysts will be pulled in as needed
- Scheduled a presentation review meeting with Radiology to have a kickoff with the Radiologists
- Scheduled a meeting with Radiology Child Life specialists to discuss this project and see if there is anything we need to include for them in Radiology
- Scheduled Webb Bridge hardware walkthrough week of 9/12
- Working on re-scheduling a sedation workflow/existing build discussion; scheduled meeting for 9/14 did not work out
- I have included all the folks and the PM from the ED ASAP implementation in this meeting; they are more familiar with the current build and any issues.
- 9 EMR Vendors have now begun technical implementation discussions with Ingalls since the project kicked off 3 weeks ago.
- Completed creating the Medicity practice profile data base.
- Begin developing support protocols with Ingalls Support Team.
- Begin development of long term Community Exchange organizational chart with the Business Development Team.
- Replaced Rhapsody ADT mapper as it was clipping off data at end of PV1 segment.
- Using the same input and output definition now to make it easier to maintain and put in place.
- Carestream Radiology:
- Started mass record testing for inpatient studies.
- The order side build looks good but there are still issues with the PRC portion for the outpatient ordering piece.
- Outpatient MRIs stopped working on results as ordering provider was not being returned. Messages look identical to inpatient orders fro MRIs so forwarded to Carestream.
- Coded for email counts on charge files and to make a copy of the professional services billing file.
- Started cutover checklist plans for systems for go live.
- Anesthesia completed Anesthesia Gap Analysis for hospital. All workflows validated by Clinical Team.
- Anesthesia team member attended integrated application meeting regarding Sedation out of the OR. Also met with Epic to finalize agenda for kickoff meeting which occurred Aug 31 – Sep 1. The team attended a demonstration of model system for Anesthesia as well as meetings with Epic to work on project scope, project plan documentation, validation session planning, and model build migration into hospital environment. They also attended a meeting with Interface team to begin discussions on device integration. Anesthesia worked on finalizing project documentation for the planning/current state analysis/gap analysis phase of the Anesthesia project as well as notes from kickoff meeting for future reference.
- the ASAP team demonstrated all of the Discharge workflows to Ops. They continue to modify the workflows and upload them to Team share for Ops’ to review and approval. They are also uploading screen captures of the all or North Site navigators for Ops to become familiar with and to bring any suggestions for changes. Sample reporting workbench reports have also been run and uploaded to Team share this week. They continue to have a weekly team meeting, a weekly Ops meeting and a wrap up meeting following each Ops meeting to clarify changes before modifying that week’s workflows.
- The HOD team held their bi-weekly status meeting with Operations on Friday. A few Ops folks felt they still didn’t understand the HOD concept. Documentation was sent to them to help clear up HOD. Asked LS to hold a class for Operations on HOD. Until they see the product on how HOD works inside the IP & OP environments. LS is working on a date/time for the training. The team prepared to demonstrate Infusion and Audiology workflows to Operations next week. The team also participated in the Sedation Integration meeting.
- Team discussed the plan for building preference card at southern location. They also reviewed NCH Preference Cards (16,000 procedures). The team reviewed Orlando Minor procedure list and compared with NCH procedures along with sending the list of NCH preference cards to management. Team Memeber attended the sedation meeting outside the OR and the biweekly Status Update meeting with Operations where they discussed preference cards, ordersets, and flowsheets. The team documented for Gap Analysis for preference cards. They also met with OHC about collaborating with OpTime team to help facilitate future meetings. A plan was developed to ensure going forward that OHC would be on the calls. Andrew also had initial discussions about creating new flowsheets for OpTime.
- The team attended Orders bi-weekly meeting with Operations and completed physician validation of 4 physician order entry workflows (transfer (change in level of care and change of service), discharge, and consult orders) as well as validated the facility IP preference lists for NCH and order content. Continued identification of AIDHC specific order content to review with 5 additional Orders workflows and update validated Orders workflows.
- Radiant remains on track to complete workflow gap analysis by the end of September. NCH versions of the six imaging exams were drafted and ready for presentation to NCH Ops on Tuesday of next week. (NCH Ops absent from Friday’s meeting so ‘make-up’ meeting scheduled for Tuesday). Our dependency on Sedation workflows at NCH in the absence of a Day Medicine department begins to raise mild concern since no final decision has been reached regarding what department will be performing sedations.
- Not counting Tuesday’s ‘make-up’ session, two more sessions will be required to obtain signoff on remaining workflows – Sedation, Scheduling, and Check-In. The Scheduling and Check-In workflows had been reviewed and approved in a previous session with the hospital Operations. However this week we learned that the Cadence team produced Imaging Scheduling and Check-In workflows. We will reconcile the Cadence workflows against the Radiant workflows and modify the Radiant workflows if/as necessary. If the Radiant workflows are modified, the modified workflows will be submitted to the Ops team again for to obtain signoff.
- In Rhapsody, progress Route Design FTP log/DB logger to capture Financial transaction between Meditech/Lawson/LSS(Testing)
- Designing SQL query to handle file properties and build email notifications in Rhapsody. (Waiting for DB to be populated)
- Created Rhapsody ADT Route for Meditech to Ecin
- Created Rhapsody ADT Route for Meditech to FormFast
- Created Rhapsody ADT Route for Meditech to GE Centricity
- Created Rhapsody ADT Route for Meditech to HillRom
- Continued provisioning in Medicity ProAccess & Grid, continued review of ProAccess default roles with ISD for ProAccess Pilot, researched HL7 flag issues with ISD & Medicity in regards to DropBox Pilot.
- ProAccess 5.3 Upgrade: Executing Phase – working with Cottage Integration Manager and ancillary system SMEs on testing & validation, validation of third party data from interfaces (HCS & MHCW), tracking & escalation of testing issues with Medicity.
- Nearing completion of Advance Directives Interface Project, working through network connectivity and UI (AKA cosmetic) issues, should be ready to begin testing next week.
- Worked with Greenway & Medicity on scheduling Phase 1 deliverables for first EHR go-live, and working with eHP Program staff on collecting Medicity Practice Planner information.
- Continued work with Medicity and Prime Clinical on developing Grid-EHR interface, monitor & track project milestones & status.
- Continued education of ProAccess default Roles with Client.
- Worked with Medicity tore-instate change to RAD message with repeating OBX:5 field converted to individual NTE segments, Copy value of OBR:25 to PBX:11 (Report Status)
- Notified Meridian that changes were made, asked for status on other message types
- Messages continue to be written (masked) to folders at Practice. I was not getting a response from the , EMR vendor – I finally got response form him late in the week, but still validation of all messages types.
- Vrad to Mckesson Star Go-Live
- Integration and Vrad Team meeting
- Javascript to filter Chest Xrays for NICU patients
- In progress Route Design FTP log/DB logger to capture Financial transaction between Meditech/Lawson/LSS
- Designing SQL query to handle file properties and build email notifications
- Integration Team Project Planning meeting
- Created javascript to provide a flatfile to HL7 batched msg count
- Created javascript to check Meditech flat file data for current date
- Mentor Integration team on Rhapsody best practices
- Am overseeing the coordination of the different build groups so all builds contain he proper information required
- Reviewed all tests for inactive vs active status—set up a master spread sheet for all 1600 procedure codes
- 41 legacy codes need to be added to the system for the legacy conversion
- 32 codes need to be added to the orders build
- Several dozen need to be updated for the EPIC Cadence – outpatient portion
- Have Phase 2 codes identified to go in by Oct 15th
- In the process of analyzing all 1866 charge to reconcile with the 513 billing think they need.
- Set up a master comparison spreadshseet for this item
- Testing some new workflows being introduced which are causing some non- expected behavior
- Conducted cross system merge testing with ePI, documenting findings.
- Participated in initial ADT testing with Eclipsys RIS.
- High Level Overview of RSA KBA Project, the purpose of the project including the players and their roles. There are three goal dates for the project, 10/01/11 – Original Date Internal Roll Out, 11/01/11- Modified Internal Roll Out Based on Six week timeline, 01/01/12 – Roll out to entire community.
- Review initial database and software requirements as well as system access needs for the RSA KBA Project.
- Get more detailed requirements for the project and document in a specification.
- Completed build, unit testing and integrated testing for ADT Bridge e*Way’s in the e*Gate “CONV” environment schemas based on the design that was approved last week. I had to create one in the CS schema and one in the CS_Southern schema.
- Began build of LAB Results Bridge e*Way in the e*Gate “CONV” environment’s “EICU” schema based on the design that was approved last week.
- Completed build, unit testing and integrated testing of LAB Results Bridge e*Way in the e*Gate “CONV” environment’s “EICU” schema based on the approved design.
- Completed build, unit testing and integrated testing of ITS Results Bridge e*Way in the e*Gate “CONV” environment’s “PACS” schema based on the approved design.
- Completed changes necessary to reorganize the schema from 1 control broker to 4 control brokers including _ADT for ADT message processing for all ministries, _LAB for LAB results message processing for all ministries, _ITS for Radiology and Transcription report message processing for all ministries and finally _Backload_TA which is a temporary control broker that will house all of the File e*Ways required to support the up front data backload for data types and ministries. These changes included the creation of new JMS IQ Managers in the _ADT, _LAB and _ITS schemas along with new JMS e*Way Connections for each new JMS IQ Manager followed by the configuration changes necessary to ensure that the new JMS e*Way Connections are used for all schema collaboration publications and subscriptions.
- Completed build, unit testing and integrated testing of the RTR BOB for ITS reports that will be used to split ITS reports out into two event types (one for RAD Radiology reports and one for TRA Transcription reports) based on the value of OBR.20 (Report Department) prior to processing by two separate TRX BOBs. Completed build, unit testing and integrated testing of the RAD and TRA TRX BOBs in order to isolate separate placeholders for future transformation business rules for RAD Radiology reports and TRA Transcription reports.
- Completed extensive set of message volume tests using production data archives for all data types and all ministries. This volume test was from end to end test moving data from the target schemas in the “CONV” environment (CS, CS_Southern, EICU and PACS) through the schema bridges to the schema all the way through the standardized set of RTR and TRX BOB’s that were previously built in the schema for handling the currently lightweight routing and transformation required for the data feeds. An additional volume test was also executed using the File e*Ways instead of the schema bridges as input mechanisms in order to ensure that that path produces the same set of results as the tests that used the schema bridges as the input mechanism.
- Completed production implementation of the changes to expand the Project ADT interfaces including a new Outbound HL7 TCP/IP e*Way that sends ADT messages for all 3 ministries outbound to Project on a single port. Subsequently, completed build/updates for the Project e*Gate components in the “CONV” schemas in order to ensure that production and test are synchronized.
- Per issue reported, completed re-send of ADT messages that had to be deleted from the queue when the interface was down for 3 days over the weekend because Project support both on the client side and on the Project side were extremely slow to respond to a lost/dropped TCP/IP connection from e*Gate to the Server.
- Successful Cert deployment for primary Hospital facility.
- A very successful kickoff led to even more productive team meetings this week. Each of the teams accomplished generally more than they had anticipated going in. Each of the teams took the opportunity to get to know each other, figure out their strengths and weaknesses, and then begin to plan their attack on the Gap Analysis phase. Orchestrate was very impressed by the amount of pre-work accomplished by the client analysts and each team member felt they were more than ready to begin this project. I believe this step of physically being on-site will end up being the perfect spring board to a successful Florida build.
- The team members from Orchestrate were able to test their logon’s and access to Hyperspace environments prior to working remotely.
- The Anesthesia team began current state analysis of the application. The team began to put together a plan to implement the only application that is actually an “install” rather than a rollout. This team will not only need to present to the operations team, but continue to take into account the implementation at their secondary location next year. Contacts and decision makers in both states will need to be heard and continually communicated with. Weekly meetings were decided upon and this team has more to do than any other.
- The ASAP team accomplished a tremendous amount of work surrounding their workflows. The team has come up with a plan moving forward to finish the remaining workflows. The ASAP team and others had the opportunity to tour the Emergency Department and the Transport Center to get a physical look at the layout of the Emergency Department as well as a history of decisions at this facility. Personally one of the best tours I have seen from any department super user in my 12 years of working with Epic.
- Meetings between Administration and myself were very successful in laying out what workflows were already captured on paper and we started to capture the workflows that were not. We also toured two different HOD Departments (Dialysis and Day Medicine). Both provided some great ideas and lessons learned from the implementation to keep in mind while building the HOD’s in their remote facility. We’ll continue to keep in contact via weekly meetings and start to take a look at the project plan and task builders in next week’s conference call.
- OHC had several meetings with their counterpart to begin analyzing the workflows and current state of the OpTime build. Several undocumented workflows were documented during the meetings and the team decided on a meeting schedule moving forward. The team will meet weekly and next week start to look at the week by week plan and assign out tasks moving forward.
- Through face to face meetings, the team feels that we have a good grip on the client EAP, Order Set and Order Transmittal build decisions. Orders being unique to other applications. This team needs to provide the remote facility with a list of EAP items, Order Sets and then adjust as needed. Order Transmittal can utilize some of the Order Transmittal, but as with any rollout of a different Service Area, the Instructions in Order Transmittal will basically need to be built from scratch.
- Complete multiple Medicity office definitions to the point of enablement.
- In progress Route Design FTP log/DB logger to capture Financial transaction between Meditech/Lawson
- Local Database schema designed and migrated to test environment
- Testing Transactions
- Created a spreadsheet with all procedure codes on it as master so can coordinate between Radiology so can get all the codes in place.
- Client is making sure the spread sheet is accurate and current so team can build the missing records in EAP and then also add the legacy codes that will be needed for conversion records and the remote facility results we will be filing until Phase 2 go live
- Once EAP build is complete, team members will take and build the PRC records properly
- Help meeting held Wednesday to go over spreadsheet to assist in the understanding the key to radiology orders is not the modality or naming conventions but is the 3 character procedure code
- Reviewing the resource rooms and which tests are performed in those rooms, which will bebuit properly in the SER and link them in to the PRC records properly.
- An extra resource room called Waiting room be created as it is used for scheduling purposes when a resource gets double booked with an inpatient exam.
- Based on the spreadsheet and review, there are 1233 procedures to be tested for mapped record testing, which has to be doubled as the outpatient process requires a separate test
- Made numerous tweaks to the interface mapping to accommodate the requirements of Carestream. Most of these tweaks involved reducing field lengths so Carestream would file them
- All is dependent on the title field being populated in the SER record. If the title field is not populated then the message is not transmitted.
- Updated profile variables to allow for the scheduling messages to work properly and also for the processing of remote facility results through the interface between phase 1 and phase 2.
- Conducted further testing of MedSelect medication mixtures
- Working to answer his questions for various order types
- Continued provisioning in ProAccess & Grid, configured DropBox in CERT for training, configured test provider in ProAccess CERT for training, assisted with initiating communications with Pilot Participants regarding DropBox & ProAccess, participated in conference calls with consultant & legal counsel on HIE financing models and legal structure.
- 5.3 upgrade to CERT environment complete, working with Integration Manager and ancillary system SMEs on testing & validation, tracking & escalation of testing issues with Medicity.
- Advance Directives Interface nearing completion, working through network connectivity and UI (AKA cosmetic) issues, should be ready to begin testing next week.
- Greenway Gateway - Vendors to collaborate on interim solution with existing software version for Phase 3 (manual CCD exchange) and circle back with Client. Worked with Greenway & Medicity on scheduling for first EHR go-live, and working with eHP Program staff on collecting Practice Planner information.
- Medicity working with Prime Clinical on developing Grid interface (EMR Definition), monitor & track project milestones & status
- Opened ticket with Medicity to develop new EMR definition for e-MDs
- Had call with EMR implementer and e-MD EMR vendor
- Reviewed vendor message validation
- Enabled e-MD office on the Medicity GRID.
- Reviewing HawaiiServer DLL before creating specifications
- Manage new practices introduced to the GRID.
- Verify that practices are attached to new Medicity node.
- Added provider for the practices to the GRID.
- Worked with client to get additional examples, involved EMR vendor as the issues results, admission & discharge summaries and H&P were issues with the EMR.
- Cache Upgrade Projected completed with accomplished code processing in production. No issues.
- Identified a Carestream problem with free text Degree field not being Consistent. Decision is to use the title field instead which is a drop down list, however, it is not a required field. Training issue will have to be that the title field is filled in on every record involving a provider.
- About 20% of the charges do not have a Cost Center associated with them so they fail in Bridges. Most are supply charges. Working with client to correct.
- Received the information for most of the charges and the ones that were missing will be updated by Monday 8/15
- Most outpatient integrated tests are failing due to invalid RIS Procedure Codes, Invalid Resource Room visit types and invalid ordering providers. We feel we have identified the problem and I am creating a master spreadsheet which will have all tests and resources in one location for us to work from. This will eliminate each group doing something different. By the beginning of next week we should have a plan in place to address correcting all the visit types in the TST build.
- Expectation is next week this will change to having a recovery plan in place
- Providers will need to have a correct title chosen in order for them to update Carestream properly
- Once we have a list of procedures that we feel is accurate we will start mapped record testing. This was not started yet because of the inconsistencies in the lists of procedures and resources.
- EPIC MedSelect - Found additional EPIC workflow issues when MedOrder dispense location was changed
- EPIC MedSelect - Mixture issue resolved by Epic Medselect and is now making changes to consume multi component orders
- EPIC MedSelect - Continuing to test Incomng test script
- EPIC Mosaiq - Awaiting resolution of Data courier issue of moving updated Cancer Center workflow from POC to TST
- EPIC Mosaiq - In depth Charge interface testing can continue after workflow issue above is resolved
- Completed core build of the File e*Way Feeders, HL7 Outbound e*Ways and routing/transformation BOB’s for all data types and for all ministries in preparation for the 60-day backload that will have to begin as soon as the SOW is signed and returned to client. For the routing/transformation BOB’s have only implemented a couple simple transformation rules: one to ensure that the Specific Facility Code (MSH.4) is valued properly for all outbound messages and to replace the event for BAR^P01 to be ADT^A08 per request. Completed exhaustive testing to ensure that this core set of modules will work for all remaining data types: LAB Results, RAD Reports and Departmental Reports.
- Create design document for bridging ADT, LAB and ITS data. Spent some time researching some options for meeting the requirement for moving data (via JMS “Push”) from the current e*Gate environments (CS, EICU and PACS) to the new e*Gate Update 2 client schema. Settled on solution that will minimize the footprint on the CS/EICU/PACS side while still allowing for site-specific message processing on the client side of the fence. The design calls for the use of JMS “properties”, specifically a JMS property named “MessageSourceMinistry” that will be attached to all outbound events and will identify the ministry that generated the message using the site-specific facility codes that are sent in MSH.4 for each facility.
- Completed work to build out and thoroughly test all of the components required to move all ADT events for all sites in the CS schema to the client schema for subsequent delivery. This new e*Way is a Multi-mode e*Way that subscribes to 6 events on the input side and publishes to 1 event on the output side with the new “MessageSourceMinistry” JMS property attached to each output event published.
- Completed work to beef up and finalize the Interface Requirements Document for the SSC ADT interface. Subsequently, sent out email to the team with all necessary new support information for JMS and the downtime list along with a copy and location for the recently finalized interface requirements document.
- Completed all of the up-front work to build out all e*Ways and modules that will be required to support adding multiple sites to the data feed. Will complete the activation of these modules next week.
- Completed the creation of detailed technical specification documents for all of the Datanex FTP and SFTP interfaces that are now live in the VendorFTP schema. These modules use the Batch e*Way for Java and also use “Putty” under the hood for the SFTP interface for the DRA Tool so decided that it would be helpful for the team to have this additional document that describes all of the pieces and parts in glorious detail. Also, as part of this process, created separate interface requirements document for each interface. Subsequently, sent out a detailed email to the team with the new documentation attached.
- Worked at length to research the issue that was raised on the call regarding Sentry’s inability to identify 16 claims in a 52 claims file as “Medicaid” claims. Requested specific information regarding now their code checks for this information for each claim. Based on this information, was able to help the team identify that the 16 claims in question were “Medicaid” secondary claims and that Sentry needs to beef up their logic to identify these properly for future claims.
- Worked at length to ultimately re-stabilize the Control Broker issues with this schema. One of the 4 control brokers in this schema was not responding to requests for status, start/stops, etc.. Ultimately, solved the problem by clearing out a longer list of folder client/runtime data from the ..\eGate\client directory. Once the control brokers were re-started, all was well again. Subsequently, sent out detailed email to the team describing the steps taken with specific directories that were cleared so that this solution can be used in the future for similar CB issues.
- Attempted to complete office definition - could not. Still stopped at “Remotely Enable Office”, due to access issues.
- Made copy of Meridian EMR definition (Meridian-2), to modify for this specific interface.
- CareStream Charges are processing correctly through transmittal process.
- NYSID information is now processing
- Changed coding so Rhapsody will handle leading 0s on provider ids less than 5 characters in length.
- Asked to assist with internal Lab Charge Process using Rhapsody Engine for dataflow processing.
- Production deployment preparation with internal Medicity Team.
- Worked up outstanding Medicity Rally defects.
- Eclipsys planning for cross system merge testing.
- Eclipsys RIS ADT mapping activities.
- Created Eclipsys eLink interface documentation direct from code for Rhapsody migration project. Will take existing elink logic and perform efficiency analysis during the Rhapsody design process.
- eClinical Works practice Planner created, Primary Pilot Site-practice activated with message flow verified, and CERT version 5.3 deployed containing ADT interfaces and selected defect fixes. ADT was assigned to CERT. Transcription received approval in Development with promotion to QA expected Next week, Q/A sign-off the week after with CERT deployment the end of that week. Dropbox Template build completion scheduled next week.
- Lab – Data flow initiated from Cloverleaf to Nexus with data feed migrated from PROD to Cert Lab.
- Identified issued with OBR.7 not populating. Technical team working on a resolution to the field not populating.
- Client wide initiative for Physician satisfaction policy applied to the copy to physician matrix.
- Lab Orders HL7 2.3 Specification submitted to client.
- Path – Data flow initiated from Cloverleaf to Nexus with data feed migrated from PROD to Cert Path.
- Rad – Data flow initiated from Cloverleaf to Nexus. Data feed migrated from PROD to Cert Radiology next week.
- Currently testing Radiology dataflow and HL7 message integrity based on the Radiology Specification.
- ADT (Invision) – Interface delivered to QA. Some issues were identified with a number of these resolved. Promoted to CERT with testing of ADT scheduled for next week.
- Transcription – This is in Development at this time with projected promotion. To stay on task, QA sign-off is expected within 1 ½ weeks with deployment to CERT by end of the month.
- Anticipated result volumes across all facilities is currently being calculated by client.
- We have seen very good message flow through Lab and Radiology. There are still some testing to take place with specific identified issues (Rally Defects) currently being researched and resolved.
- Dropbox template build in development.
- All client users have access to the Baycare dropbox.
- Transcription interface rebuild required due to miscalculation of client in relation to their existing transcription interface. Working with client team to help identify efficiencies to expedite the process.
- Solution research to the issue where practices with multiple offices would like to have the OutReach Results routed to the office based on “location”.
- Multiple patient types across client systems add complexity to integration. Decisions were made regarding Grid filtering and patient type mappings. Some of this setup within Nexus and the Grid remains.
- Mined a total of 6 complete use cases from the production ADT message for remote site facility. For each use case, pulled together all ADT messages associated with a given patient visit/account into a data file, documented in the Use Cases spreadsheet each event that occurred for the given patient visit/account and pulled patient activity reports for each patient visit/account. At the end, provided detailed email to the team for using the above information to complete these use cases in the 5.65 environment for use in subsequent message comparison/contrasts.
- Meditech 5.65 Upgrade Project – For the first use case of the six that I mined from production, completed all ADM application events using the same exact patient information (except for SSN) into the 5.65 environment. Ultimately, was able to generate 5.65 messages that were analogous to the production 5.54 messages. Subsequently, completed detailed messages compares using work flow involving Interface Explorer message compare and also used Ultra-Edit text based compare to make up for some of the weakness’ of the Interface Explorer compare. Identified a handful of differences that most likely need to be addressed either with Meditech fix or e*Gate code to ensure exact matches between 5.54 and 5.65 messages.
- Meditech 5.65 Upgrade Project – Worked to create and then update the format and content of the composite message Discrepancies list which will contain ALL issues identified for ALL ministries for ALL data types so that when we are done, we have a list of discrepancies to address via Meditech fix or e*Gate coding.
- Meditech 5.65 Upgrade Project – In order to leverage the field level metrics that I previously generated, I used the metrics spreadsheets to create a new documents that should be used to check off each field that has been successfully tested for the 5.65 migration. Subsequently, reviewed all test results from first use case and updated the checklist accordingly. At the end, there were still a couple segments (DG1 and PR1) that have not been tested yet and a few fields on existing segment that have not been tested.
- Received request to answer a question regarding the uniqueness of the Filler Order Number field. Completed some research on this against production laboratory results data for all types and all sites and also worked to put the same question to the Meditech support team. Got the answers we needed from Meditech and provided response to client. Client also requested sample messages for all 4 sub-types, so pulled those from production, de-identified the patient and provider data within and shared with client.
- Worked at length to generate a list of specific questions regarding how client will handle Meditech’s particular nuances with Laboratory result messages with particular emphasis on Microbiology results.
- Received detailed request to track down the details on a specific patient’s specific lab test result HL7 message. Tracked the message down and provided detailed information to prove that the lab test event did in fact occur based on the transmit date, visit information and lab test information. It was ultimately discovered that the messages was re-processed recently causing confusion on his side regarding when the lab test was performed and where.
- Pulled production copy of the “PhysicianIntegration” schema and copied to “PhysicianIntegration_Conv” schema in order to re-synchronize production and test per request from the team once it was discovered that they were out of synchronization.
- Issue research/changes related to sunset of “Magic”. Received request to research an issue with messages backing up to the SOI ELR e*Gate transformation module. Ultimately identified that this module contained 2 subscriptions that were now obsolete based on changes that were made to sunset the “Magic” lab result feeds. Completed changes to remove the subscriptions, bounced the module, confirmed that backlog of messages was completely processed and notified the team.
- Completed Datagate to Rhapsody test Scripts and testing.
- Completed remaining client single system merge testing. Documented findings.
- Final cleanup of client providers in SCM.
- Review of ADT translations to RIS and testing preparation.
- ePI and RIS related meetings and correspondence.
- Revision and review of ePI issues list
- continued calls with Medicity PM to track status & timeline, verified interface will be live with ProAccess 5.3 upgrade and forwarded screenshots as examples to client.
- Conducted meeting to vet Use Cases, User Scenarios, and IHE Profiles documentation to provide direction to vendors for on-site meeting on Aug 8 with Medicity & Greenway, forwarded approved draft documentation to vendors with requests for more information & missing dates.
- Completed VPN configuration for client to access Medicity Grid Hospital Node & Orders Work List, tested & verified connectivity.
- Conducted training session with IT support staff for PDL, provided training reference guides to eHP Program Manager & Director
- Attended technical conference call on Wednesday 7/27 to discuss next steps for the project, specifically the sending to the initial 60 day production data backload for each data type.
- Arranged and participating in meeting to discuss the issues with Meditech’s HL7 outbound interface for BBK and PTH lab result messages and their impact on the Epic project.
- Completed research of several BBK and several PTH production lab results, then sent out email to the team describing the format issues I encountered along with the “corrupt” PV1 issue I observed. My research essentially confirmed what the internal analyst already discovered 3 years hence, but was able to communicate these issues to the entire team before any commitment was made to share this data until Meditech can be engaged to resolve the format and corrupt PV1 segment.
- Began work to pull from the data archives 60 days of data for all six ministries and all 4 data types over to the ACN015 server’s C: drive in preparation for the backload which will need to be turned on as soon as the SOW. Also, started the e*Gate module builds for the components that will be minimally required to support the backload. To start off, I have defined 4 new event types, 4 new outbound HL7 e*Ways and 4 new feeders. Began development on simple Collaboration that I will use to ensure that all messages MSH.4 value is consistently sent based on the message source ministry on their way out to target system. Completed testing and moved into place within the ADT feed.
- Completed changes, testing and production implementation based on a change to filter out NTE segments (under OBX segments) that are cluttering up their displays with redundant reporting the performing laboratory name and address (already reported in OBX.15).
- Began production data research focused on the Meditech ITS value OBR.20 (Report Department) which is the field that will be used to distinguish what client considers to be Radiology Reports from what it considers to be Transcribed reports. Meditech sends all ITS report types via the same data feed (port) so e*Gate routing rules will be necessary to route them to MCHIE via separate data feeds (ports). Completed research, yielding a list of Meditech Report Departments that are currently being used for each ministry.
- During my research of the production ITS report data, discovered that Meditech is not sending “HIM” (OBR.20) reports outbound. Communicated this information to client, who confirmed my findings and added to the list “CAR” reports which were also not turned on. Subsequently, completed e*Gate routing and code research necessary to identify the modules that process ITS reports in order to ensure that the change to turn on “HIM” and “CAR” reports will result in no impact on these modules and associated interfaces. Confirmed that no changes were necessary (one BOB was identified and it had logic to only send reports for a specific list of Meditech Report Departments which did not include “HIM” or “CAR”), but that changes would be necessary for one BOB at remote site for specific provider practice interface. I made the changes in TEST to ensure that the new “HIM” and “CAR” reports will not be sent to the practice once they are turned on and completed series of tests to ensure that the code changes were sound. Subsequently, moved these changes into production and notified the team once that was complete. By the end of the week, reports were turned on to all outbound facilities.
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