My Blog
Description of my blog
- Continued preparation of Rhapsody test Scripts and testing.
- Production remediation meeting and sent BOM for Prod Deployment for review.
- EPIC ADT are pure messages, no trigger events are changed by EPIC like IDX does. Client is validating to make sure the pure messages work
- Pharmacy Order messages are processing and Look good
- Got a micro negative sent across from Soft Lab and am trying to get a couple of sensitivities to be sent to test those
- Send a micro result with sensitivities and it is not the same as in Production- used same route and mapper set up from the existing routes.
- From discussions with client, may require a redo of the mapping and way route handles lab results-between Safety Surveillor application and Rhapsody with no EPIC involvement.
- Once Procedure codes were in place the general providers and schedulers would not work, which will be corrected at the beginning of next week.
- Turned on the scheduling piece so testing can take place next week.
- Accounting people are changing the information they want in the charge files. Have to add a billing location to the 1600+ charge codes in Scheduling systems and billing now wants another couple of items as well
- EPIC ADT and Results are working through OrionHealth Rhapsody Engine.
- Results from SoftLab are now being transmitted with only the desired tests mapped, the rest are not mapped
- Research found that JVM is pegging the memory and causing engine issues- lack of message processing etc. Alerted client to the issues and suggested correction of issue. Working with client to resolve this issue prior to load testing.
- Provided activation support for Cerner EMR.
- Provided activation support for Standish facility being brought into CORE SCM database.
- Followed cert package to ensure readiness for tomorrow’s deployment.
- On top of the outstanding items for cert next week.
- Worked at length to turn on pilot LIVE ADT feed to RED Server. Initial connectivity test was successful, but the HL7 TCP/IP e*Way did not like the ACK/NAK string that was being returned. Subsequently, worked to explain that we need a “true” HL7 MLLP ACK/NAK message back from them with MSH segment and MSA segment. Once these issues were worked out, was able to successfully turn on the pilot LIVE ADT feed from the e*Gate TEST environment.
- Once the pilot LIVE ADT feed was in place and messages and acknowledgements were flowing properly, received a series of email-based questions from the client regarding the Meditech ADT message format. Completed the necessary research, provided the most current copy of the Meditech ADT interface specification document and also provided detailed responses on some of the customizations that were done for current version of the Meditech ADT interface (e.g. PD1 segment’s non-HL7 Standard ordinal position, PV2 segments extended fields that were not added to the HL7 Standard until v2.3, etc.).
- After the e*Gate downtime on 6/19, there were all sorts of issues with these interfaces. For some reason, the e*Way start/stop schedules were no longer functioning properly. Worked at length to attempt to resolve these issues with no success so decided to punt and revert back to the running all the time option to ensure that the underlying collaboration schedules would function properly and run the collaborations at the designated times. Also, had to manually send the backlog of files that built up during the time that the e*Way’s were not running.
- Worked at length to process multiple on-demand NPR Extract files in order to process the backlog of ABS messages that were not previously fully processed by the MIDAS system. This work spanned each day of the week and ended with the successful identification of an issue with the configuration of the MIDAS inbound ABS HL7 interface.
- Received word from that TMG stopped receiving lab results. Subsequently, identified that a routing change that was made over the weekend for a project that resulted in the elimination of lab results traffic. Once the issue was identified, it was relatively simple the make the necessary changes to fix the routing issue and then re-send the messages that were previously skipped because of the routing changes.
- Worked at length to implement change to the ADT interface code to send the Meditech Confidential Indicator (PV2.22) to the DG1.3 field on the ResponderNet side. Complete the changes and testing in CONV then moved the changes into production.
- Pulled together list of e*Gate servers to include in the VPN tunnel configuration for this interface and provided that list to client after receiving confirmation that the list was correct.
- Received call to discussed at length the interface requirements for the Meditech ADT interface.
- Client contacted EMR resource, waiting to receive EMR specs to complete EMR info in Practice Planner, scheduling Kick Off call and installing Practice Agent.
- EMR was engaged, working with Medicity Grid Engineer to utilize Meridian EMR definition from HCA, received EMR specs, finishing incomplete Practice Planner, working with practice IT resource on Monday to install Practice Agent. Meridian wants to schedule go-live for 8/15/11.
- We verified the provider had been removed from the Practice Definition. Contacted practice to research & troubleshoot issue with ghost results.
- Working with practices wanting to connect to hospital via Medicity. Received four Practice Planners, contacting practice & vendor resources.
- Escalated Issues regarding modality and mutli-OBR filters twice with Medicity, received status that Grid Engineer has been assigned.
- Standby activation support for client facility becoming part SCM core.
- Added new content to RIS ADT mapping document, describing translations required from three registration systems.
- Continued single system merge testing to ePI.
- Maintenance of ePI issues list.
- Rework licenses for client providers.
- Completed specification for Allscripts Elink interface ChangeAsciiToHex DLL.
- Worked on specifications for Allscripts Elink interface CleanUpFiles and ChangeHexToAscii DLLs.
- Continued preparation of Rhapsody test Scripts and testing.
- Production remediation meeting and sent BOM for Prod Deployment for review.
- Reviewed all in process data sender’s code sets (with Myriah) for
- • Participated in the following discussions:
- RIS ADT Mapping call
- Weekly ePI status call
- Weekly RIS status call
- • Updated the RIS ADT mapping document to describe each translation variable coming from three registration system
- • Created provider load file for single facility, in preparation for the 7/18 activation of this facility with SCM core.
- • Scheduled Campus wide merge testing calls.
- Prod remediation meeting and sent BOM for Prod Deployment to Preston for review.
- Kick-off or Medicity orders plan.
- Reviewed all in process data sender’s code sets for corrections to be made prior to cert deployments.
- Working to complete cert package, defect failed QA.
- Tracking QA packages and other outstanding defects that need to be addressed.
- Continued preparing Epic to Orion Rhapsody Test Scripts and testing.
- Approval of Phase 1 Medicity results processing by client. Project Plan finalized and distributed to the Medicity client team.
- Met with client to determine port assignments and connectivity timeline for Medicity Results inbound.
- Updated Medicity Project workbook. This workbook is used and shared with client showing current contacts, issues, pilot medical facilities, pilot practices, meeting schedule, and Organizational structure.
- Met with client to discuss the new e*Gate Update 2 environment (ACN015/ACN016). Shared with her the Installation Steps/Notes document and walked her through the documented steps for copying a schema from the current environment over to the new ACN015/ACN016 environment. Continued to provide support and feedback throughout the week for any questions that they had regarding the ACN015/ACN016 environment or the VM configuration for their lap tops.
- Received request to investigate issue with code for Transolutions interface for the conversion. Client attempting to set up the code to handle OBR.28 (Copy To) processing per Meditech inbound ITS HL7 requirements and to handle the case when Transolutions returns a CC provider without a provider mnemonic. Initially, client was experiencing an String index out of bounds exception, so I researched the code, modified it to eliminate the exception and to meet the requirements for OBR.28 processing and turned it back over to Larry once the testing was complete and successful.
- Researched the heat log for this work request and spun my wheels a bit here because of the confused and verbose nature of each update to the heat log. Ultimately, worked out the correct port to use and how to make the routing change happen. Subsequently, emailed client requesting a time early next week to schedule the implementation of this routing change.
- Worked to help client understand the formal process required by existing Engine for setting up each ministry on the system’s SFTP interface. Sent out multiple detailed emails describing the role of e*Gate within the interface framework and the dependency on Meditech extract jobs to generate the file and for the establishment of a drop-off directory for the file that is retrieved/returned.
- Received request to make a change to the interface mapping for OBX.15 (Producer). client wanted to see the “Description” instead of the “Code” for the performing laboratory (called Producer in HL7 vernacular). Completed the change and tested it before moving it into production. Also, worked with him in an attempt to investigate the issues he is experiencing with the “Quarantine” folder for patient matching for inbound lab results to his Medinformatix system. Ultimately, helped the client realize that the limitations are with the patient trait matching business rules on the Medinformatix side and that there was nothing I could do with the message format to avoid the amount of traffic he sees hitting the “Quarantine” folder because most of the lab results he receives from hospitals are for patients that do not yet exist in his Medinformatix patient index.
- Completed work to document Meditech delivery service information (MIS Outbox) for all outbound interfaces defined within the Meditech LAB database which includes both Lab Orders and Lab Results. Subsequently, completed work to generate field level detail message metrics for both each ministries lab orders and lab results interfaces.
- Cardiology Lab Results Interface – Practice representative reported that they were no longer receiving results for a physician assistant. Completed research of old emails and found that her provider mnemonic was changed a few months after the practice go-live. Subsequently, updated the associated data map file to ensure that the new provider mnemonic would be used for the lab results filter logic within the e*Gate collaboration. Moved the new data map file into production and then confirmed a day later that physician assistant’s lab results were being routed to Heartland. Also, notified client of the same.
- VendorFTP Schema Interfaces Start/Stop Schedule Issues – Worked at length to research why after the most recent down time that the start/stop e*Way schedules were no longer functioning as configured. Ultimately, discovered via Oracle web site knowledge base research that the –ns parameter cannot be included in the e*Gate Control Broker start up script if the user wishes to configure a stop/start schedule for e*Ways within that Control Broker. Modifed the startup script for the Control Broker to remove the –ns parameter, bounced the control broker, re-set the schedules and confirmed that the start/stop schedules were working properly once again.
- TMG (eMDS) Interface for Conversion – Completed e*Gate changes and testing to filter out NTE segments (within OBX segments) that were redundantly reporting the performing laboratory site (already sent in OBX.15 – Producer’s ID). Once the changes were successfully tested, moved the change into production and notified TMG of the change.
- ResponderNet ADT Interface – Received a report that the e*Gate collaboration for A34 (merge) messages was throwing the exception labeled “NoSuchMethodError”. This one took a while because the line of code for which the exception was thrown was perfectly fine. Ultimately, identified the fact that the underlying ETD was corrupt. Created new ETD as an exact copy of the original and then used this new ETD to recompile the collaboration rule that was throwing the exception. Once the new ETD was in place, the exception was no longer thrown and the 50+ messages that were sitting in the queue were processed successfully. Subsequently, sent out detailed email to the team warning them to keep a look out for this error and listed for the team the resolution path that I used.
- MCHIE Project Data Flow Diagram – Completed development of the data flow diagram (Visio) including changes after client’s review and then delivered the completed document to MCHIE representative. Also, worked to confirm that it would be OK to pull copies of the Meditech HL7 Interface Specfication documents based on her review. After thier review, pulled the copies together and sent them to our client.
- MCHIE Project Message Metrics – Created a utility for generating message count metrics that was tailored from a similar utility created for the Meditech 5.6 Upgrade project. The purpose of the utility is to generate and provide message volume metrics to the MCHIE team. The metrics they are asking for include maximum messages per day, peak volumes and average message sizes for each of the 4 data types: ADT, LAB, RAD and Dictation.
- AEGT11 Registry Service Issues – Worked at length at various times during the week to research the potential causes of this latest registry service issue which required that the registry be bounced each morning this week from Tuesday 7/5 through Friday 7/8. The symptoms of this issue are that nobody on the team is able to access schemas defined to the AEGT11 registry. Ultimately, identified that there was a rogue e*Gate BOB running out side of the control broker and was using credentials that were obsolete as of 7/4 when user A01JOHTH changed his password. The other modules running under the control broker were fine, but this one was failing its sign-on every 30 seconds and each time increasing the number of connections to the registry closer and closer to the maximum number of connections value (increased to 3072 by the end of the week). Final work on this issue was to kill the rogue process which stabilized the AEGT11 registry service once again (did not have to bounced throughout the weekend and seems stable this morning Monday 7/11).
- Neuroscience (SSC) ADT Interface – Worked at length with client representatives to research and identify a method for filtering ADT events based on the Consulting Provider field in the ADT message (PV1.9). It turns out that testing/validation performed Wednesday morning 7/6 was incorrectly focused on the wrong ADT feed from Meditech. Final decision after several go rounds was to use a list of provider mnemonics (captured in an e*Gate datamap file) to allow ADT messages with Neuroscience providers acting as consulting providers to be sent to the SSC system. Also, identified overriding filter rule that will send all ADT messages where the patient location is set to the new location that has been defined specifically for the Neuroscience clinic/site.
- Transolutions “CrossOver” BOB Exceptions (2 hours) – Worked to resolve two separate exceptions that were occurring since go-live related to the use of the “substring” method within this BOB.
- Datanex DRA Tool PSFTP Interface – Worked to perform a series of manual file transfers to and from Sentry to move us closer to loading all of the historical outpatient claims data into Senty and to provide the reports from Sentry back to the CBO staff.
- Contacted Meridian Integration Manager to obtain EMR resource.
- Preparation for Prod package deployment, review of package and issue resolution.
- Found that ADT is different in test from PROD but client approved and requested these configuration changes be left in place.
- Reconfiguration was required with the Results interface once the Micro with susceptibilities result messages were reviewed.
- Discovered the softlab test interface transmits results differently than production. Pulled body source from an NTE and it does not send a numeric value in OBX 5 but does send the S or R flag. Coded Rhapsody to handle this difference. All other tests successful.
- Witt appears to work and transmit fine
- Telerehab ADT passes appropriately
- Carestream configuration completed and tested successfully.
- EPIC Inpatient orders and results posted properly.
- Outpatient order and scheduling configuration completed.
- Identification of new charge centers.
- Additional configurations completed on Providers.
- Medicity CERT build for updates requested.
- Medicity Specification review for ADT and Patient Matching from client.
- Medicity Specification review for Transcription from client.
- Medicity CERT package successful deployment.
- Analysis and Resolution of OID issues.
- Continued Script building for DataGate to Rhapsody interfaces.
- Completed detailed analysis of EPIC messages into Medicity GRID.
- Facilitated testing & validation of live lab results from Remote Location via interface with client, assisted with troubleshooting.
- Assisted Medicity to facilitate assigning e-MD resource.
- Escalating Meridian functionality issue with Medicity Grid Engineers.
- Further defined scope (ProAccess and DropBox) and continued work on identifying participants.
- Assisted with ProAccess 5.3 Upgrade.
- Calls with Medicity on project status & timeline for Advance Directives Interface.
- Calls with Greenway on project phases, deliverables, & timeline for Greenway Gateway.
- Calls with Epic, PDL, and Medicity on deliverables & timeline for Sansum-PDL Interface
- Met with Cardio Practice to complete Practice Planner and direct their IT staff on installing Medicity Practice Agent on EHR application server.
- Completed Medicity training for new practice, provided list of ProAccess Audit Reports for HIM Director.
- NPR Extract – Completed build of the e*Gate interface code in the production environment. Created timeline content for this interface in the client conversion timeline spreadsheet.
- TMG (eMDS) Interface for client Conversion – Created timeline content for this interface in the conversion timeline spreadsheet. Updated program compare content for this interface in the conversion program compare spreadsheet. Completed final check of datamap file support for this interface and moved the datamap file changes into production. Received request from TMG Office Manager to remove extra NTE segments that report the performing laboratory. Will make this change early next week.
- IDPH (ELR) Interface for Conversion – Completed e*Gate changes for this interface in production. Created timeline content for this interface in the conversion timeline spreadsheet.
- Wealth Engine Interface – Completed build of e*Gate interface code in the production environment. Completed connectivity test using the recently provided credentials from Sally Boucher from Wealth Engine. Worked to make changes to grant the ACL005 cluster administrator account access to the return file drop off directory for this interface. Completed first file delivery to Wealth Engine server and subsequently worked to identify miscommunication regarding the format of the extract file and frequency of the file delivery. Status for this interface is on hold pending re-negotiation of contract terms for daily file delivery instead of weekly.
- Neuroscience (SSC) ADT Interface – Completed build of e*Gate interface modules in the test environment. Completed connectivity test for this interface which required a VPN connection negotiation. Completed 4 hours pilot of live ADT messages and subsequently deleted the production JMS subscriptions. Currently waiting on feedback from vendor regarding the 2000+ ADT messages that were delivered during the pilot.
- e*Gate Update 2 Environment Support – Met with and worked at length with staff to adjust the Windows Server 2008 R2 cluster resource configurations for the e*Gate registry and control broker. Researched and resolved problem reported regarding commit/promote error. Ultimately identified that the collaboration rule name exceeded e*Gate’s threshold for its length. Worked to resolve issue with the password for the e*Gate “Administrator” account which he accidentally changed to a value he could not recall. Researched the Oracle support web site’s knowledge base to find the method for temporarily disabling security which allowed us to set the “Administrator” password back to what it was before client’s mistaken update of that password.
- Transolutions “CrossOver” Solution Support – Worked at length to resolve issue with the extra line feed character that was being added to reach “CrossOver” record via an ETD change and to setup and configure a solution for the “LongTerm” cross over file. Completed test to ensure that the solution to have a File e*Way write/create content in a datamap file while having a BOB use that datamap file long term.
- Transolutions Reports Interface for Conversion – Worked at length to resolve a “String Index out of Bounds” exception with the code. Also, worked at length to resolve a coding issue that caused the content of OBR.28 to not be as precise as Meditech requires it to be. Generally worked to support the conversion go-live for this interface.
- ResponderNet ADT Interface – Worked at length with ResponderNet interface contacts to modify the mapping for “Confidential Indicator” to map its value (PV2.22) to PID.15 instead of DG1.3. This final change was prompted by the fact that the users were seeing Diagnosis codes and Confidential Indicator in the same place in the ResponderNet application.
- Preparation for Prod package deployment, review of package and issue resolution.
- Working on getting items through QA for Cert deployment.
- Successful connectivity testing with Central Medicity Practice Location.
- Got Rhapsody access to the folders where billing charge files are located and rhapsody can pull the information.
- Scheduling-Came up with a work around for the lack of an ordering Provider in the Scheduling message.
- Placed some code changes in the EPIC messaging which required editing the definition file and the route logic twice
- Uncovered roadblock where the procedure codes used in the Visit Type for scheduling were not the same codes configuration, these need to be re-mapped
- Got the correct procedure codes into the hands of the order group to remap the ordered procedure codes
- Spent time in test learning the system to assist with testing
- Interface Testing for ADT from EPIC to Siemens RMS.
- Interface Testing for Orders from EPIC to Siemens RMS.
- ORU Results for Muse to Epic.
- Facesheet code redesign for Epic HL7 Adt to QuickChart Facesheet format
- Provided supporting documentation of interfaces.
- Assisted with Rhapsody testing
- EPIC to Rhapsody Mapping and Design requirements identified.
- Radiology Interface Vrad testing scheduled
- Work with Client representative to build referral network in pilot practices and beyond in preparation for iNexx inbox deployment with the referral app.
- Working in the Medicity Nexus application, identifying issues and working with client to resolve these.
- Preparation for Prod package deployment, review of package and issue resolution.
- Scheduled a Medicity iNexx demonstration with one of our Medicity pilot sites. Demonstration incorporates a hospital site as well as three different pilot practices. Each presenting unique input into how iNexx can help their individualized practices.
- Safety Surveillor
- Conference call with Premier
- Premier will set up their conversion plan with explanation of their go live “freeze out” of 48 hours
- Pharmacy Order messages are processing and Look good
- Got a micro negative sent across from Soft Lab and am trying to get a couple of sensitivities to be sent to test those
- Completed the Lab Results Test Script
- Completed the Pharm Orders Test Script
- CareStream
- Got access to Carestream system so I can access the system and look at messages etc without having to wait for Jun from Carestream
- Learning about the RIS system
- We may have a workaround for the State ID number for the Physician update messages.
- Completed the Lab Results to RIS Test Script
- Orders worked into the RIS
- Results were filed in EPIC after some minor manipulation
- Biomedical
- ADT is working as are Results
- Results from SoftLab are now being transmitted with only the desired tests mapped, the rest are not mapped
- Completed Test Plan for Biomedical Team
- Telerehab
- ADT passing well into test system
- Completed the ADT Test Script
- Practice Execution Phase - facilitated testing & validation of live lab results from Los Alamos via interface with practice. Assisted with troubleshooting.
- Physician Health Services Initiating Phase – researching e-MD resources with Medicity.
- Urology Initiating Phase – researching Meridian issue with accession number with Medicity.
- Project Management related correspondence with client and Medicity.
- HIE Pilot Planning: Further defined scope (ProAccess and Drop Box) and identifying participants (ED and ambulatory practices receiving HIM reports)
- ProAccess 5.3 Upgrade: Calls with Medicity on timeline updates.
- Advance Directives Interface: Calls with Medicity on project scope & timeline.
- Greenway Interface: Calls with Greenway on project scope & timeline.
- Sansum-PDL Interface: Calls with Epic, PDL, and Medicity on defining scope & deliverables.
- SB Cardio-PDL Interface: Contacted Prime Clinical to initiate interface project.
- Medicity Training: Provided ProAccess and Drop Box configuration information to eHP Provider Survey, conducted ProAccess training for ISD Security team.
- Project Management related correspondence with Greenway and Medicity.
- Support existing egate interfaces, both MONK and java while client migrates to new HIS and new interface engine.
- Support Day to Day operations of eGate
- Modify existing eGate code in response to user request
- Review specifications for new eGate interfaces.
- Manage assigned tickets in client’s incident reporting system
- Conduct tests
- Report results
- Modify code in response to test results
- Organize move to production utilizing client’s go live procedures
- Support users for troubleshooting and testing by accessing Meditech client server (ITS) and HCIS interface console support tools.
- Meditech 5.6 Upgrade Project – ADT testing in 5.65 environments (4 hours) – Generally worked within the 5.65 environment for Elgin (DB.TEST5.65) to first familiarize myself with the user interfaces for the ADM and MIS applications within. Completed an inpatient admission for the first test patient, but was unable to generate an HL7 message. When I checked the MIS “Interface Manager” I discovered that almost all background jobs for the HL7 Outbound interfaces were listed with a status of “Never Ran”. So, message generators and delivery services for the HL7 interfaces were not running. Reported this issue to Jan and the rest of the team requesting that a Meditech administrator configure and activate the necessary background jobs for each 5.65 environment. This was a great exercise despite the initial lack of success generating the HL7 ADT messages because I was able to familiarize myself with the slight different user interfaces exposed with Meditech 5.65.
- Meditech 5.6 Upgrade Project – RDE message metrics generation (12 hours) – Pulled one month of archived production HL7 RDE messages for each ministry that is currently live on Meditech 5.5. Modified the HL7 Field Description data map file (used by the message metric utility) after the first run in order to add descriptions for all of the new HL7 fields from the RDE segments (e.g. RXE, RXC, RXR, etc.). After updating the data map file, generated message metrics (via e*Gate Message Metric generation utility) for each ministries HL7 RDE archives. Also, update the Test Status spreadsheet to reflect the segment level content for each RDE HL7 feed. Moved all generated message metrics spreadsheets and updated Test status spreadsheet up to the X drive. Also, gathered detailed information for each RDE feed from Meditech to e*Gate in order to document the links between Meditech and the HL7 inbound e*Ways and their associated data archive folders.
- Meditech 5.6 Upgrade Project – LAB message metrics generation – Completed 50% of the work to complete the same set of steps as described in the item #5 above, but in this case for the HL7 outbound feeds from Meditech to e*Gate for both lab results and lab orders.
- Cardiology PSJMC Lab Results Interface – Received request from *****start here******to answer some questions he had concerning the lab results interface from PSJMC to Heartland Cardiology. Answering his questions required some research of the e*Gate interface’s collaboration filtering and transformation rules. Based on my responses and Kurt’s feedback, will be implementing a simple change to send the description instead of the code for the OBX.15 field (Performing Laboratory) and will complete that work next week.
- Gricelda Batch e*Way for Java Training (6 hours) – Received from Gricelda to provide training and guidance for building a batch interface for the Essence interface project. She needs to process HL7 ADT messages from Meditech as input, creating an output file containing “|” delimited data records transformed from the input HL7 ADT messages. She also needs to create the file every fours and send the file to Essence via SFTP. Completed some preparation for two training sessions to train Gricelda on how to use the Batch e*Way for Java to implement the interface using two Multi-mode e*Ways. The first e*Way generates the Essence flat file using JMS input and a LocalFileETD / BatchRecordETD pair for output to a local file. The second e*Way picks up the file and transmits it to Essence via SFTP using Putty’s psftp.exe command line scripting. Completed the two training sessions that totaled 3 hours aggregate. This task required some up front work on my part to prepare some temporary collaborations and collaboration rules for demonstration purposes.
- NPR Extract interface for PSMH conversion (6 hours) – Met with Kellie Mueller on Thursday 6/9 to discuss this interface. Subsequently, built out the e*Gate interface for PSMH/Kankakee in the “SouthernRegion” schema in CONV. Built the interface by cloning/copying the existing e*Gate components for PCMC/Urbana. Completed a pilot test for the interface to ensure that NPR Extract files will process smoothly once the first integrated test is performed which is scheduled for next week.
- Larry Krueger support (1 hour) – Worked with Larry to identify and resolve a couple build/test issues he experienced with his work on the PSMH conversion. He was experiencing some Unmarshal exceptions and I worked with him to help him understand how to interpret the cryptic log file entries associated with Unmarshal exceptions thrown the by the underlying Monk HL7 parsing/encoding software.
- Preparation for Prod package deployment, review of package and issue resolution.
- Worked on the resolution of the Medicity/client Patient merge issue.
- Safety Surveillor
- Sent ADT and Lab samples to Premier
- Got Results route and Mapper completed
- Set up call with Premier
- Pharmacy Orders also sent to Premier- they now have to adjust to an RDE order message
- CareStream
- Got MFN messages configured and mapper in place for physician updates- Problem with EPIC and Morrissey interface. Also Wpic may not have the ability to transmit NY State ID # until after go live date.
- Sent samples to Jun for verification of the MFN messages sent to Carestream
- These were verified
- The MFN portion did not make the June 3rd deadline and may not make the go live date due to the Lack of NY State ID # by EPIC
- Scheduling testing is not complete because the files created with Room resources are not set up correctly. Mike D said the SER were not correct and they need to be redone. Will pass this back to Cadence group Monday as this prevented any testing completions.
- Lab Result messages are configured to process to Carestream results
- Set up the RHIO route- get positive acknowledgements in return
- Made adjustments to the NK1 phone number fields as they have a size limitation in Carestream- they are formatted differently than the phone fields in the PID segment.
- Biomedical
- ADT is working as are Results
- Completed test script for ADT
- Made changes in mapper to only send the 12 desired tests from Softlab instead of all tests in the message containing the one desired one.
- Telerehab
- ADT is working
- Completed Test Script for ADT
- Meditech 5.6 Upgrade Project – Message Metric Utility – Completed series of changes to the e*Gate message metric utility to add HL7 Field descriptions to the output report (via data map file with descriptions pulled from Meditech HL7 specifications and HL7 Standard document when Meditech specification document was not complete). Also, added separate reporting that adds Patient Type in addition to Message Type and Trigger Event to the message metric breakdown.
- Meditech 5.6 Upgrade Project – Message Metric Generation for ADT interfaces – Pulled 30 days worth of production data for each ADT interface (Midas and Pyxis) for each ministry that is currently live on 5.5. Pushed each set of data through the message metric utility and converted the output to Excel spreadsheets (via CSV imports from output text files). Modified each Excel spreadsheet to include two worksheets separating the regular Message Type / Trigger Event breakdown from the breakdown that adds Patient Type. Sorted all of the output within the spreadsheet to make things more human readable. Completed the generation of all metric spreadsheets for all ADT interfaces and moved the resulting spreadsheets up to this project’s folder on the X: drive per Jan’s request.
- Meditech 5.6 Upgrade Project – Test Status Spreadsheet for ADT interfaces – Using the message metric spreadsheets, updated the Test Status spreadsheets to reflect the HL7 ADT segment level content for each ADT interface (Midas and Pyxis) for each ministry. In total, there are 5 spreadsheets each with a separate HL7 ADT segment level content matrix for both the Midas and Pyxis ADT feeds. Copied the updated spreadsheet up the X: drive.
- Meditech 5.6 Upgrade Project – Acquire/Verify access to Meditech web-site, 5.5 environments and 5.6 environments – Worked at length to assess the level of access I currently have for the ADM and MIS modules within both 5.5 and 5.6 environments. Pulled together list of access that I currently do not have in the 5.5 environments and sent off the list to the project manager requesting the necessary access/permission changes. Once the changes were complete, verified my access. Also, once access was granted to the 5.6 environments, started poking around in that environment after receiving good direction from a team member on how to access the new environments via Citrix web client.
- Support for the JMS Null Pointer Exception issue – Continued to work with Oracle support on this issue with no success trying the steps suggested by Oracle support. Ultimately, solved this problem by consolidating all of the new e*Gate modules for the Senior Services schema under the “PressGaney” control broker. This eliminated the AEGT16 participating host from the schema. I had to create the Cluster Resource for the “PressGaney” control broker, but once that was complete, the issue was resolved. No more JMS exceptions and was able to continue his development and testing. Closed the associated Oracle Service Request once the issue was resolved.
- Parkview Code set questions and data analysis review.
- Medicity Client Prod Package reviewed, Centura UAT, SLVRMC UAT,
- regarding Grid-EHR interface.
- Cert deployment to ensure all client environments are in sync prior to prod deployment.
- Working on Cert package for the lab interface.
- Cert package for client Lab published, BOM sent to client
- Prod package in process for deployment next week
- Multiple discussions regarding testing and issues, updated code sets and processed 275 new prod ADT messages to cert for issue analysis.
- Successful Cert deployment for CORHIO SLVRMC Lab interface. Sent 125 prod messages to cert with only 1 failed message.
- Client UAT issues
- Assisted in testing the merge functionality in PA
- Reviewed MHS code sets and sent back for some clarification
- Merge issue - clarified
- DB parser issue - resolved
- UAT issue – in progress
- Continued preparation of Rhapsody Test Scripts and testing.
- Continued creation and comparison of the 1500 HL7 messages sent from the VITL providers for Medicity.
- Participated in the ePI Super user training.
- Helped reconcile providers as part of core Eclipsys RIS load.
- Interfaces built for Epic Outbound Testing:
- ADT from EPIC to ancillary systems:
- -MUSE EKG
- -Xcelera Cardiology
- -Xper Cardiac Cath Lab
- -Cerner Copath
- EPIC and Rhapsody Documentation
- Rhapsody testing
- Mapping and Design requirements
- Epic to Hyland Onbase Documentation Session meeting
- Radiology Interface Vrad Team Meeting
- HL7 field testing radiology results to ADT/ORU/ORM to Mckesson Star
- Safety Surveillor
- Sent ADT and Lab samples to Premier
- Got Results route and Mapper completed
- Set up call with Premier
- Pharmacy Orders also sent to Premier- they now have to adjust to an RDE order message
- CareStream
- Got MFN messages configured and mapper in place for physician updates- Problem with EPIC and Morrissey interface. Also Epic may not have the ability to transmit State ID # until after go live date.
- Sent samples for verification of the MFN messages sent to Carestream
- The MFN portion will not make the June 3rd deadline and may not make the go live date due to the Lack of State ID # by EPIC
- Discussion with Physician and team per email from received where Epic was saying some scheduling would be done in Carestream. Clinical Team said “NO”
- Set up special call for May 31st to work out the process flow for scheduling- Cadence group, Orders group.
- Lab Result messages are configured to process to Carestream results
- Set up the RHIO route- need to test next week
- MedSelect Medication Dispensing System
- Continued Unit testing
- Sent Dispense messages from MedSelect to Epic
- State Immunization Registry
- Requested Extract for Testing of Conversion to EPIC.
- Prepared checklist document to use with EPIC to highlight responsibility for Data transformation issues highlighted in testing
- Radiation Oncology System
- Continued Unit testing
- Encounter Conversions data to EPIC
- Assisted making changes to interface highlighted by EPIC testing.
- Physician Credentialing system
- Test data flowing from TEST instance to Rhapsody.
- Meditech 5.6 Upgrade Meeting with Meditech – Attended meeting with Meditech regarding the HL7 interface changes for the Meditech 5.6 upgrade project.
- e*Gate Update 2 Project Control Broker “-egst” parameter issue (20 hours) – Continued to work the issue by focusing on the issue of the Windows Server 2008 R2 Cluster Service running under the “Local System” user which is a change from the Cluster Service for Windows Server 2003 which ran under a user defined domain “Cluster Administrator” account. Completed research on this issue (Microsoft Windows Server 2008 R2 Technical Specifications web site) and discovered that this is a fundamental change for Windows Server 2008 R2 and that it should not be changed. Worked to confirm this was in fact the case. Attempted to modify the “Log On As” user for the Cluster Service with no success. User then contacted Microsoft support who confirmed that the Cluster Service must run under the “Local System” account based on the new design/configuration for the cluster service with Windows Server 2008 R2. Returned focus to the e*Gate Update 2 application and found references to e*Gate defined Windows Registry entries. Ultimately found an e*Gate registry key called “Base Directory” that was superseding the specified “-egst” parameter for the control broker start up scripts. After deleting this Windows Registry entry, the problem was resolved. Success! Once the solution was confirmed with some additional testing against other logical servers/drives, contacted Lori and Tony to notify them that the issue was resolved and turned my attention to documenting this workaround and to re-installing the e*Gate Update 2 software based on the new solution.
- e*Gate Update 2 Project Re-install / documentation update after “-egst” issue resolved – Completed documentation of the workaround to delete the “BaseDirectory” Windows Registry Key. Completed re-install of the e*Gate Update 2 environment while validating/updating the installation document one final time. Once the install was complete, notified the team that we are now ready to utilize the e*Gate Update 2 environment with the necessary flexibility to use whichever logical server/drive for a participating host that we choose. The main impact is that this allows us to create the new environment to truly mirror the current environment.
- Meditech 5.6 Upgrade Project – Received some solid direction to get started with analysis of the Meditech HL7 ADT feeds that are sent to e*Gate in order to document the Message Types, Trigger Events, Segment and Field usage for each of the data feeds for each ministry for the current Meditech 5.5 environments. A team member shared a template spreadsheet to work with that I soon expanded to meet the specific needs for ADT messages from Meditech. Began development of an e*Gate collaboration service utility that will process any number of messages producing a report that lists all of the Message Types, Trigger Events, Segments and Fields that are actually used in production HL7 ADT messages. Structured the utility in a generic fashion so that it can be used for all future HL7 feed analysis (Lab Results, Text reports, RX Orders, etc.) Also, documented for each Meditech ADT feed to e*Gate the associated e*Gate module that receives the feed and the e*Gate archive folder/file specifications for each.
- Support for the Null Pointer Exception issue – Worked to open a Service Request with Oracle for the issue he is experiencing with a newly established TEST control broker in the SeniorServices schema. Subsequently, identified with Oracle’s support that the issue seems to be related to the JMS e*Way Connection configuration for the new control broker. Will continue to work this issue with Oracle next week.
- Parkview Code set questions and data analysis review.
- Medicity Client Prod Package reviewed, Centura UAT, SLVRMC UAT, CDPHE deliverables.
- Project Management correspondence with client and Medicity regarding Grid remote access and Grid-EHR interface for initial pilot practice.
- Worked with Client, Initial Practice, Medicity, and SRS on Grid-SRSsoft interface for the initial practice. Practice Agent installed, Hospital Agent configured, connectivity established, Medicity sending test data & validating with SRS.
- Tested ADT successfully with the exception of Merge Messages, which will be tested at a later date.
- Tested ADT message flow through the Carestream Radiology system.
- Interfaces built for Epic Outbound Testing of ADT from EPIC to ancillary systems
- -Standing Stone Anticoagulation Clinic
- -Dolbey Transcription
- -MCR Healthtouch
- -Hyland Onbase Document Mgt
- EPIC/Rhapsody Documentation for client use.
- Rhapsody testing of EPIC interfaces.
- Mapping and Design requirements for Epic to Cerner Copath.
- Epic Weekly Interface Team meeting
- Route Transferred to client ADT/ORU results from Vrad to Mckesson Star
- Completed client facility-1 registration / update testing to ePI, SCM, and LIS.
- Completed client facility-2 registration / update testing to ePI, SCM, and LIS.
- Assist with cross facility provider identification.
- Participated in ADT, orders (bidi) and mpi backload mapping discussions.
- Integration Team - Provided short demonstration of the new Windows Server 2008 R2 / e*Gate Update 2 failover clustered environment including the VMware lap top with e*Gate Update 2 installed on the VM side.
- Metro HIE project – Attended early adopter technical discussion presented by the HIE team and discussed the project and the three options identified based on the Meditech 5.6 upgrade project impacts.
- e*Gate Update 2 Project – Worked to re-assign the drive letters for the Update2 ACL017 cluster environment to be in synchronization with the associated production ACL005 cluster environment.
- e*Gate Update 2 Project – On Monday 5/16, after drive letter re-assignment was complete, re-installed the e*Gate Update 2 software to both ACN015 and ACN016 including all necessary cluster resource configuration while updating and refining the e*Gate Update Install Steps/Notes document. Added additional instructions for configuring the cluster resources for each e*Gate registry service and control broker, staging the “.egate.store” files for each logical server / drive, Windows Registry changes to define both AEGT11T and AEGT12T registry services on each node of the cluster to support failover between the two nodes, modifying the e*Gate Administrator password, creating e*Gate accounts for each member of the team and copying the “egate\client” folder from an existing participating host to the remaining seven logical server drives to build support for running the participating hosts on any logical server / drive.
- e*Gate Update 2 Project VMware – Met with team members to discuss a VMware solution for supporting both e*Gate environments from a single lap top. Some members agreed that a VMware partitioned machine with 1.5 GB of RAM could be a performance issue. The original machine with VMware has 1.5 GB RAM. Through some more detailed testing (Collaboration building and collaboration rule class compiling) I discovered that this machine’s performance for running e*Gate Update 2 on the VM side was not acceptable. The team subsequently added additional disk space which improved the virtual memory paging performance and made a huge difference for the e*Gate Update 2 performance on the VM. After these changes, I used that machine’s VM as my primary GUI’s for the new ACN015/ACN016 environment and although slower than normal, the application response time was acceptable enough for routine configuration maintenance and basic interface monitoring. Worked to install the e*Gate Update 2 software on the spare lap top that was previously configured to use VMware and had a VM ready to go and that machine is now ready for use with the new ACN015/ACN016 environment.
- e*Gate Update 2 Project – While working to configure the Epic_Test schema to run on the AEGT11T (O: drive) participating host, discovered an issue with where the logs, stcms, etc. data was being routed/written. e*Gate is ignoring the “-egst” parameter that tells is which logical drive to route/write the data to and always writing to whichever logical drive the participating host was installed to. The troubleshooting process started with a series of system configuration comparisons between the current Win2003 / eGate environment against the new Win2008R2 / eGate Update 2 environment. Ultimately worked directly with selected team members to demonstrate the issue to them first hand and get some advice on how things were installed/configured for the current environment. At the end of the week, opened Service Request with Oracle which began a dialogue with their support team that provided a few ideas, but really did not help us fix the issue. As of the end of the week, the problem is still not resolved. Will work next week on this and Oracle support team to continue to work this issue next week.
- Java coding support – Worked to get a team member on the right path to solving a Java String coding issue that had to modify code to strip a “.” From the end of a particular string with an OUR report’s OBX.5 repetition value.
- Physician e*Gate message routing (1 hour) – Was provided a print out of the associated Heat Log and I read through the entire document. The request is to have a change to the IP Address and Port that they connect to for sending lab results. It is currently routed to AEGT17 (MicroBilling schema) and needs to be routed directly to AEGT15 (Physician Integration schema). I accessed the production schema and modified the existing component to listen on port 10000 per the heat log. The module is currently in the “inactive” CB. Will move it to the active CB once I work out the timing next week.
- Physician Executing Phase - facilitated testing & validation of live lab results from Los Alamos via interface. Assisted with troubleshooting.
- EMR Initiating Phase – researching e-MD resources with Medicity.
- Urology Initiating Phase – researching Meridian issue with accession number with Medicity.
- Project Management correspondence with Client, Medicity, and SRS regarding Grid-EHR interface.
- Organized and attended HL7 interface discussion meeting multiple project leads on Friday 3/25.
- Medicity Project Management correspondence with client regarding Grid remote access and Grid-EHR interface for providers.
- Working through DataGate/Munk code to develop Rhapsody test case.
- Preparing Rhapsody Test cases for client from DataGate logic in existing interfaces.
- Datagate to Rhapsody migration meeting
- Staff mentoring on Rhapsody.
- Interfaces built for Epic Outbound in Testing Phase.
- ADT from EPIC to ancillary systems.
- Standing Anticoagulation Clinic
- Dolbey Transcription
- MCR Healthtouch
- Hyland Onbase Document Mgt
- Cerner Copath Results back to Epic
- Documentation
- Rhapsody testing
- Mapping and Design requirements
- Tested Route ADT from Star HLO
- Built Route to handle ORU results from Vrad to Mckesson Star
- Waiting on Epic to add Provider Names/codes Results Codes, Filtering logic
- Worked on Route development of Encounter Data Conversion
- Worked on Mapping questions
- For the MedSelect Medication Dispensing Systerm, hosted calls on Monday and Tuesday to Iron ADT and Other Data interface questions from Pharmacy. EPIC and MedSelect
- Completed ADT mapping
- Began Pharmacy. EPIC and MedSelect
- Began creation of detailed test scripts that incorporate scenarios revealed during group calls
- Submitted 2 files from EPIC to State for review
- Received communication from State as to issues with sample files
- Discussed via Phone to develop strategy to resolve state identified issues.
- Physician Credentialing System
- Made progress on MFN mapping for Physician Data.
- Impac Mosaiq Radiological Oncology System
- Finalized route development for Impac Mosaiq Radiological Oncology System.
- Conducted Unit test preparation.
- EHR Meaningful Use Requirements Research – Continued research of Certification Criteria for EHR Technology (Federal Register – 45 CFR Part 170) and the associated Medicare/Medicaid EHR Incentive programs. Opened a service request with Oracle support to ask product management if they have plans to pursue ONC-ATCB EHR Module Certification. I included in the request the recent report from ONC-ATCB that Corepoint recently achieved EHR Module Certification on 5/4/2011 for their Corepoint Interface Engine application making it the first “Interface Engine” application that has achieved EHR Module Certification.
- Wealth Engine SFTP – Requested change to modify the “target folder” for the Meditech extract for the Wealth Engine SFTP interface. This request was made in order to create a more uniform folder structure (AEGT19) for the two ministries that are live on the client Engine SFTP interface. I had to modify the e*Gate interface code and configuration along with the associated Putty “PSFTP” scripts to accommodate the newly updated “target folder” for the extract. Subsequent to the change, completed a manual run of both the “put” and “get” steps for this interface and the newly updated code and configuration functioned perfectly.
- Conversion for eMDS Lab Results Interface – During initial testing of the e*Gate interface changes for the conversion, worked to identify an HL7 TCP/IP exchange problem that was allowing them to receive (and acknowledge) HL7 ORU messages at the TCP/IP level, but was not allowing them to view the associated lab result data in their eMDS application. Worked at length to essentially force practice to look at the problem from their end. Subsequently, they identified and corrected an issue on their side (some interface flag had been inadvertently turned off) and they requested that I resend the messages that were not properly stored during this interval of time. Worked to complete the message resends and notified them that they were complete.
- Worked to send a total of 7 test messages (pulled from DJ.TEST and edited to point the PID to “Mickey Mouse”) to the e*MDS system using the production connection on AEGT15. Subsequently, worked to confirm that all 7 test lab results were successfully filed and viewable within “Mickey Mouse’s” patient chart.
- e*Gate Update 2 Project – Installed Process Explorer application in order to bring the new environment more in line with the installed software on the current e*Gate environment setup/configuration.
- Datanex DRA SFTP interface – Worked to complete the sending of the first “historical” Medicaid Outpatient claims file to the Datanex SFTP server.
- EMR Interface – Created the first draft of the Interface Requirements document for this interface based on the original set of proposed HL7 interfaces for this project. The output of the call was a phased approach that would implement one-way (unsolicited) lab result and text report feeds to the physician’s EMR for the first phase followed by the implementation of a bi-directional interface that would introduce an Orders feed from the physician’s EMR to Meditech.
- Messages filing in Carestream Test system from EPIC.
- Interfaces for Safety Surveillor in place.
- Hosted the Interface Carestream Interface conference call for the client. In attendance was EPIC as well as Carestream representatives.
- Demographic (ADT) Messages
- Able to transmit a Patient Update Message (A08) from Epic to Carestream
- Information appeared correct in the message, there was no admission for the patient so it was not filed.
- team will be working on more messages this week
- Goal is to have ADT completed by May 20
- Team will work on the Patient and visit Merge messages to make sure they work correctly
- Order Messages (ORM)
- Clinical team to set up some test order codes and add those in to the RIS system so we can test orders next week
- codes will be added in to the Epic translation table in the next few days
- Study Groups and lower level procedure codes are required to set up the system correctly. Currently being handled by members of the integration team.
- Charges
- Scheduled to add the 10 character MRN to the charge file so it has MRN for EPIC
- Charges route and mappings documentation completed, except for final testing against actual charge messages
- Goal to finish by May 20
- Scheduling
- Communication works but no schedule messages to test with yet
- Department codes need to be updated between the two systems.
- The Dep’t code mapping appears easiest to do in Rhapsody once the updated files are received from both Epic and Carestream
- Need Process flow or final policy decision made about how the changes in procedure codes and cancellation of messages will occur
- Possible scenario last discussed- Prior to patient arrival all changes and cancellations occur in EPIC
- Post patient arrival all changes and cancellations are made in RIS and then status messages are sent back to EPIC
- This policy needs to have a decision made soon so we can code it properly
- Contacted Premier Inc for Safety Surveillor
- Their representative will get a programming/developer resource assigned for May 23
- NWK messages can stay as is because they will be split off and filed in their own DB while RGH ones will be filed in their own one as well. In March the two can be married together
- Premier stated they will have the developer resource look over the A18/A45 differences
- Developer will look into the A28/A31 replacement of A99s
- Placing the transfer DTTM in EVN.2 is fine as well as losing the ZVI segment
- Coordination with Premier removing the filtering currently done on anti infectious drugs vs infectious drugs. Premier is going to a new platform that will want all drugs and we are changing this. They might as well accept all and filter them out themselves so when their new platform goes in it will just be changes on their side
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