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Patches and Enhancements

RPMS EHR is not a finished product. Development continues on a number of fixes and enhancements, many of which have been recommended by clinicians who use EHR on a daily basis for patient care.

To submit an Enhancement Request please visit the Resources and Patient Management System (RPMS) Feedback page.

EHR Version 1.1 patch 22 – February 2017

Overview of Changes

ICD-10 updates

  • None

Enhancements/New Features

  • Direct Mail Button Enhancements
    • New pop up now displays in EHR for patients without a PHR (Personal Health Record)
    • Button now displays green if patient has a PHR and red if patient does not have PHR.

Problem fixes/Routine updates (see patch notes for complete list)

  • Changes to the EHR now fix the slowness issues that sites were reporting when the Direct Mail Button was added to the GUI Template

EHR Version 1.1 patch 21 – October 2016

Overview of Changes
ICD-10 updates

  • None

Enhancements/New Features

  • Direct Mail - Develop a button that will allow a provider/EP to send a secure message to the patient in an automated manner.
  • Read all associated documentation and information regarding this new feature.

Problem fixes/Routine updates (see patch notes for complete list)

  • None

EHR Version 1.1 patch 20 – September 2016

Overview of Changes
ICD-10 updates

  • None

Enhancements/New Features

Problem fixes/Routine updates (see patch notes for complete list)

  • Fixes context change errors, EHR freezing issues, and access violation errors when changing patients

EHR Version 1.1 patch 19 – August 2016

Overview of Changes
ICD-10 updates

  • Laterality Equivalence Rules
  • Further extension of mapping to include prompting for laterality

Enhancements/New Features

  • Usability focused on de-cluttering problem display, ease management of problems, improve POV Management
  • Laterality prompts in SNOMED CT Search and on Picklists
  • New tabular Design and Core Problems Landing Tab with additional status tabs
  • Clean up option to reassign statuses based on default DTS statues
  • Option to inactive problems as “Episodic” if problem has not been used as POV in site defined Time Frame
  • User configuration of IPL

Problem fixes/Routine updates (see patch notes for complete list)

  • Fixes issues on Reproductive Factors component with EDD and Past Date Not Allowed Error

EHR Version 1.1 patch 18 – April 2016

Overview of Changes
ICD-10 updates

  • See Enhancements/New Features that leverage new conditional maps delivered in BSTS patch 6 that consider additional visit and patient data when deriving the SNOMED CT to ICD-10 map on storing Purpose of Visit (POV) in the EHR.

Enhancements/New Features

  • New prompt for Normal/Abnormal
    • Users will be prompted to enter with or without abnormal findings for specified terms when problem is set as POV on Integrated Problem List (IPL) and POV Dialog
  • When POVs are stored, the system will invoke “conditional maps” for Age at visit, Sex, BMI, Trimester, Eposidicity, and with/without abnormal findings

Problem fixes/Routine updates (see patch notes for complete list)

EHR Version 1.1 patch 17 – December 2015

Overview of Changes
ICD-10 updates

  • None

Enhancements/New Features

  • None

Problem fixes/Routine updates (see patch notes for complete list)

  • Sites no longer experiencing a lag/error/EHR timeout when using the "Other" Zip Code radio button while transmitting to an outside pharmacy (e-Prescribing sites only)
  • Integrated Problem List
    • Unchecking POV from Edit Problem dialog now removes the problem from POV and un-flag “used as POV” on IPL.
    • When writing in the “provider text” field in the POV section, user can now go back in with cursor to change a wording. Users no longer need to erase all text.
    • Fixed .NET error in IPL. Users were unable to bring up the problem list on certain patients because of the carriage return/line feeds in the Visit Instruction File.
  • Suicide Reporting Form (SRF)
    • SRF now displaying 24 digit IEN. 24 IEN digits containing the Facility ASUFAC is no longer truncated.
    • SRF now displaying the provider discipline and initials when edited.
    • SRF now displaying most current 5 SRF entered by date of act
  • PPD Display Visit Detail – now displays correct patient.
  • Superbill-Picklist now defaults to VIS date populated for the vaccine in the Immunization package instead of “today’s” date.
  • Historical Services - Surgical filter Minor Procedures now being filtered out

EHR Version 1.1 patch 16 – September 2015

Overview of Changes
ICD-10 updates

  • None

Enhancements and fixes

  • Corrected issue with a large number of calls being returned when storing problem as POV using POV dialog
  • Corrected issue with absent dosages on medications
  • Corrected issue with lookup in minor procedures that was causing significant lag and slowness in the EHR when changing patients

EHR Version 1.1 patch 15 – September 2015

Overview of Changes
ICD-10 updates

  • None

Enhancements and fixes

  • CCDA - Save, Submit and Print buttons added. Save functionality requires strict adherence to HIPAA, IHS and local policies
  • Vital Measurements component - extended flow rate entry for O2 Qualifiers from .5 to .25

Problem fixes/Routine updates (see patch notes for complete list)

  • Graphing - blood pressure graph corrected
  • IPL - corrected issue with problems remaining on IPL after patient is cleared, date of injury save correctly when stored as POV, imprecise date of injury no longer causes removes IPL display
  • Patient - full SSN does not display
  • Reproductive Factors component - saves Definitive EDD correctly
  • Rx Print Templates - no longer prints blank pages and BEHORX PRINT FORMAT honors parameter setting
  • Vital sign - entry of vitals no longer allows entry for future time/date

EHR Version 1.1 patch 14 – Controlled Release Starts June 2015

Information on the release of EHRv1.1 Patch 14 and other associated patches can be found at: ICD-10 or contact your area office.

Overview of Changes
ICD-10 updates

  • EHR components updated to transition to ICD-10 after the changeover date. Integrated Problem List will re-map to ICD-10 on the changeover date. Look ups for visit related data are context aware and will store ICD-9 and ICD-10 based on visit date.

Enhancements and fixes

  • Integrated problem list – priority and POV display columns added, SNOMED CT-ICD-10 map advice exposed via hover, SNOMED CT search is executed with or clicking ellipsis, care planning fields Tiu template functionality delivered
  • Integrated Problem List – care planning template functionality improved
  • Pharm Ed (Medication Counseling) – POV information may now be added
  • Pick Lists – may now select synonym for Pick List selection, pick lists now have option to allow pick list selections to store as POV, now honors settings in pick list manager
  • POV dialog – E&M documentation for office visits, provider text column renamed “Alternate POV provider text” for clarity, Primary diagnosis dropdown now honors user selection, care planning fields Tiu template functionality delivered
  • Prenatal Issues and Problem List (PIP) – Updated application to synchronize with IPL (requires BJPNv2 and BJPNv2p1)
  • Reproductive factors – allows deletion (entered in error) of family planning methods
  • Superbill – Diagnosis (SNOMED CT) associations added
  • Stroke Component – new feature
  • AMI Component – new feature

EHRv1.1p14 and related application release notices

  • RPMS Program Release Notice_EHRv1.0 patch 14
  • RPMS Program Release Notice_GMRC v3 Patch 1005
  • RPMS Program Release Notice_BHS
  • RPMS Program Release Notice_BJPN v2.
  • RPMS Program Release Notice_GMRC v3 Patch 1005
  • RPMS Program Release Notice_GMRV
  • RPMS Program Release Notice_TIU patch 1013
  • RPMS Program Release Notice_PXRM v2.0 patch 1003

Associated Links and Documents
Please read all documentation associated with the general release of EHRv1.1 p14 and related applications on the RPMS Clinical Applications webpage under the following sections:

  • Electronic Health Record (EHR)
  • VA Clinical Reminders (PXRM)
  • Adverse Reactions (GMRA)
  • Health Summary Components BHS
  • Prenatal Care Module (BJPN)

Please read all documentation associated with general release of TIU and related applications on the RPMS Administrative Applications under the following section:

  • Text Integration Utility (TIU)

Additional Training
Training dates and times can be found at: ICD-10 Training

EHR Version 1.1 patch 13 – September 2014

Enhancements/New Features

  • New non-redundant SNOMED CT® based Integrated Problem List (IPL) replaces the Problem List
    • Treatment/Regimen
    • Goals
    • Care Planning
    • Visit Instructions
  • Picklists
  • New Family History SNOMED CT® based Component
  • Orders - Clinical indications will now be presented in SNOMED CT® for Lab, Med and Consult orders
  • CCDA Component replaces C32 Component to generate Transition of Care and Clinical Summary Documents for Visits and Referrals
  • CIR (Clinical Information Reconciliation) Component
    • Displays incoming CCDA, CCDA and C32 documents
    • Provides tool to reconcile outside facility Meds, Allergies and Problems or reconcile data from patient or caregiver

EHRv1.1p13 and related application release notices

  • EHRp13v1.0p13
  • BHSv1.0p9 Release Notice
  • TIU 1011 and 1012 Release Notice
  • Reminders 2.0, Patches 1001/1002 Release Notice
  • BSTSv1.0

Associated Links and Documents
Please read all documentation associated with the general release of EHRv1.1 p13 and related applications on the RPMS Clinical Applications webpage under the following sections:

  • Electronic Health Record (EHR)
  • Health Summary Components (BHS)
  • VA Clinical Reminders (PXRM)

Please read all documentation associated with general release of TIU and related applications on the RPMS Administrative Applications under the following section:

  • Text Integration Utility (TIU)

Additional Training

EHR Version 1.1 patch 12 – December 2013

Enhancements/New Features

  • Designated Provider - Users may now add, edit, delete designated providers from the new EHR component.
  • eRx Enhancements

Problem fixes/Routine updates (see patch notes for complete list)

  • Community Alert Splash Screen – Synced with iCare
  • Inpatient Meds for Outpatient (IMO) – Infusions now display as “Clinic Orders” in IMO designated clinics
  • Reminder Dialog – Skin test site and Volume prompts added
  • Service – HCPCS search fixed
  • Skin Test – Date applied now populated when entered skin test
  • Visits – Inpatient ancillary lab and pharmacy visits are not displayed or selectable

EHR v1.1 Patch 11 Fixes

ICD-10 and Meaningful Use

It’s time to start prepping your databases for the coming updates and patches for meeting the mandatory change to ICD-10 and meeting Meaningful Use. EHRv1.1p10 includes some infrastructure to support the near future upgrades.

EHR Version 1.1 patch 11 – Controlled Release available June 2013

Patch 11 is a controlled release patch. Please see the RPMS Website and EHRv1.1 Patch 11 FTP site for more information on pre-install instructions, scheduling an appointment for support, prerequisites/dependencies and Office Hours materials. RPMS Clinical Applications Website

EHR Version 1.1 patch 10 - Released July 2012

Patch 10 includes enhancements/new features/updates/fixes to the following functions:

  • Asthma Action Red/Yellow Zone component (New)
  • Immunizations:
    • Ability to enter inactive vaccine as historical immunization
    • Display of invalid doses in EHR
  • Measurements:
    • EGA - Estimated Gestational Age
    • MMSE - Mini Mental Status Exam
  • Medication orders – default pick up locations enhanced
  • Patient Goals Component (New)
  • Personal History – ability to enter CPT refusals
  • Quick notes – added ability for user to assign co-signer
  • Reminder Dialog Prompts added:
    • Asthma Control
    • EGA - Estimated Gestational Age
    • MMSE - Mini Mental Status Exam
  • Reproductive History Component – major changes to reflect updates to the Reproductive Factors file including addition of Lactation Status, ability to enter different Estimated Due Dates for pregnant women based in method used to calculate, ability to enter multiple concurrent contraceptive methods, age at menarche, age at coitarche, age at menopause.
  • eRx: Support for eRx refill request messaging (infrastructure for future upgrades – nothing visible for EHR user)

Associated links and documents:

Associated patch releases:

  • APSP v7.0 P1013 (required for EHRv1.1p10)
  • TIU 1.0 p1009

EHR Version 1.1 patch 9 - Released January 2012

The majority of patch 9 updates and fixes are to meet ePrescribing requirements. Patch 9 includes updates/fixes to the following functions:

  1. Enhancements
    Medication prescribing:
    • Much more flexible configurability facilitating sites with on-site pharmacies to implement electronic prescribing (requires separate configuration and deployment of Surescripts®).
    • Medication order dialog enhanced for improved usability.
    • Auto-finish and printing behavior configurable by facility type and may be used in advance of electronic prescribing.
    • Printing functionality is now highly configurable and streamlined for user.
    • Clinical indication now required for each medication order.
    • Electronic prescribing now requires ICD-9 code for transmission
  2. Problem fixes/Routine updates (see patch notes for complete list)
    • Allergy/ADR: now filters out "Other Reaction" for both reactant and signs/symptoms.
    • CCD Viewer: hanging with VPN session, PDF generation with Internet Explorer 9 resolved.
    • Chart Review: Adding problem from Visit Diagnosis or Historical Diagnosis now stores Reviewed and Updated.
    • CSV: ICD-9 look up now returns long narrative text.
    • Immunizations: No longer populates CPT codes, Education now stores properly when "Patient/Family Counseled by provider" checked.
    • Notifications: Flagged expiring notifications now work properly.
    • Order checks: Height and weight limits now honored for CT and MRI orders.
    • Outside Med details: Documented by now displays logged in user who entered information
    • Patient Education: Text now wraps properly when viewing standards.
    • Reminder dialogs: Measurements "done elsewhere" now store the correct date/time.
    • Requestor no longer displays on Outside Medication entries.
    • Suicide form: Updated to current Behavioral Health GUI.
    • Visit Context: Now excludes ancillary visits on inpatients.
    • Windows 7: Superbill and Patient Education check box behavior resolved.
    • Patient Context: Accessing a patient chart from notifications will now honor the BEHOPTCX REQUIRES HRN parameter. Users will see notifications for patients from all divisions but if this parameter is set, the user will need to log into the division in which the patient is registered to access the patient's record.

Associated links and documents:

Associated patch releases:

  • APSP v7.0 P1011, 1012 (required for EHRv1.1p9)
  • BHS v1.0 p6

EHR Version 1.1 patch 8 - Released June 2011

The majority of patch 8 updates and fixes are to meet certification and Meaningful Use requirements. Patch 8 includes updates/fixes to the following functions:

  • Problem List
  • Attach Images fix
  • Allergy enhancements
  • Help menu fixes for Windows 7
  • Patient detail
  • Chart Review component
  • Patient education
  • Summary of care document and viewer
  • This patch includes GMRA v4.0 P1002

Associated links and documents:

There will be associated patches released between patches 7 and 8 to include the following updates/fixes: New "missing text" report and clean up utility for TIU notes, new reassigned document report, new/fixed data objects, health summary components, CPT modifiers, vitals entered in error, Patient Education - allow more than one entry per topic per day, Work/chart copy printing, Restore ability to select rows in Lab tab, Pharmacy package - additional updates for e-Prescribing, multi-divisional drug file, new drug file maintenance reports, Adverse Reaction package

EHR Version 1.1 patch 7 - Released February 2011

Patch 7 includes updates/fixes the following functions:

  • Vital Measurement
  • "Clear" Function - correctly clears reproductive history and infant feeding data
  • Skin tests
  • Historical Services
  • POC Lab - NEW parameter to allow either for ordering provider to be visit provider, or to have user select the provider each time
  • Patient Detail
  • Medication Ordering
  • DM Registry
  • Notes - NEW Quick Note Module
  • POV narrative
  • Suicide Form

EHR Version 1.1 patch 6 - Released August 2010

EHR Version 1.1 patch 5 - Released July 2009

EHR Version 1.1 patch 4 (EHR License file) - Released in November 2008

The License file in patch 4 will not expire.

EHR Version 1.1 patch 3 (EHR License file) - Released in August 2008

EHR Version 1.1 patch 1 - Released April 2008

EHR Version 1.1 - Released in October, 2007

EHR Well Child Module

Behavioral Health

Behavioral Health providers who are co-located at primary care facilities that have deployed the EHR can now enter their individual behavioral health encounters into RPMS using the EHR. These behavioral health records will populate both the Behavioral Health System (AMH) database and the Patient Care Component (PCC) database. This functionality supports the integration of primary and behavioral health care and offers behavioral health providers access to features available in the EHR that are also critical to the provision of behavioral health care, including electronic order entry of medications. Additionally, behavioral health providers now have the convenience and security of template-based TIU notes that are developed to meet their unique business needs. The applications required to support this functionality in the EHR are AMH Behavioral Health System v3.0 patch 10, BPC IHS Patient Chart v1.5 patch 05 and BGU IHS RPC Broker v1.5 patch 04. Visit the Integrated Behavioral