INSTALLATION NOTES FOR BDM - Diabetes Management System Version 2.0 Patch 3 ====================================================================== PREFIX: BDM CURRENT VERSION: 2.0 PATCH 3 ================================================================ *******NOTE************NOTE************NOTE************NOTE**** READ THE ENTIRE NOTES FILE PRIOR TO ATTEMPTING ANY INSTALLATION *******NOTE************NOTE************NOTE************NOTE**** 1. GENERAL INFORMATION Changes and corrections for this patch: - Includes DM Audit 2010 both legacy and GUI. Changes to the audit in 2010: Individual Audit Form: 1. various label changes to match the new 2010 audit form and re-ordered items to match the new 2010 audit form 2. Tobacco use: the system will look back through the patient's history to find documentation of tobacco use, in the 2009 audit it only looked back 1 year 3. Weight value has to be in the past year, previously the system looked back 2 years for a weight. 4. Eye Exam: added CPT codes 2019F and 2020F to the eye exam logic definition. 5. Depression on the problem list. Changed the codes that are used to define depression to: LOW VALUE: 290.21 HIGH VALUE: 290.21 LOW VALUE: 296.00 HIGH VALUE: 296.89 LOW VALUE: 298.0 HIGH VALUE: 298.0 LOW VALUE: 300.4 HIGH VALUE: 300.4 LOW VALUE: 301.12 HIGH VALUE: 301.12 LOW VALUE: 308.3 HIGH VALUE: 308.3 LOW VALUE: 309.0 HIGH VALUE: 309.1 LOW VALUE: 309.28 HIGH VALUE: 309.28 LOW VALUE: 311. HIGH VALUE: 311. 6. DM Therapy: added a new set of drugs: Sulfonyluria-like 7. Lipid Lowering Drugs: added 6 new taxonomies to be able to list on the individual audit form what type of Lipid Lowering drugs the patient is taking: DM AUDIT FIBRATE DRUGS DM AUDIT NIACIN DRUGS DM AUDIT BILE ACID DRUGS DM AUDIT EZETIMIBE DRUGS DM AUDIT FISH OIL DRUGS DM AUDIT LOVAZA DRUGS 8. TB Testing The audit form now displays what type of TB testing was done: PPD Testing or TB Blood test. Added a new taxonomy that will contain the TB Lab tests. The taxonomy is called DM AUDIT TB LAB TESTS. 9. ECG - added CPT codes G0403-G0405, 0178T-0180T and 3120F to the ECG definition logic. 10. FLU Vaccine: modified the logic to exclude all diagnoses codes so as not to count a diagnosis that may have been used to document an H1N1 vaccine given. Removed CPT codes 90659 and 90663 from the definition of Flu Vaccine. Only looks at the audit period for a seasonal flu vaccine. 11. Modified the urine protein section to match the 2010 audit form. A new taxonomy had to be developed and needs to be populated: DM AUDIT 24HR URINE PROTEIN. 12. Modified all lab searches to only find labs with valid results. 13. Fixed an issue with the Foot Exam search whereby a variable was not being properly reset. changes to the cumulative audit: 1. Items have been re-ordered. 2. Duration of Diabetes: there is a new category for Less than 1 year 3. Mean BP: the system will now use 2 BP's to calculate mean BP if 3 BPs are not available. 4. ACE INHIBITOR (OR ARB) USE – Logic for the “Use in pts with known hypertension” will remain unchanged from previous audits. “Use in pts with elevated albuminuria” will include records with the following: UACR >30 mg/g UPCR >0.2 g/g 24 hr protein >300 mg/24hrs Microalb:Creat strip (e.g., Clinitek) category 2 or 3 (>30 mg/g) Microalbumin only (e.g., Micral) category 2 (>20 mg/L) UA dipstick category 2 (1+ or more) 5. ANTIPLATELET THERAPY – Include in the numerator and denominator only those pts who are age 40 or older (earlier it had been age 30 or older). - Modified the Diabetes Patient Care Supplement: 1. Removed Pap and Mammogram as those are not a part of the DM Audit. 2. Modified the Urine Protein section to match the individual audit form. 3. Modified the last PPD to look at both PPDs and TB lab tests. - Modified the Follow up report: 1. Added EKG to the exam section. 2. Added Urine Protein testing to the lab section. 3. Changed Flu Shot to read Seasonal Flu Shot - Letter Management Add/Edit Letters: 1. Modified the insert list to contain the following items: 1 FIRST NAME 2 LAST NAME 3 ADDRESS 4 PROVIDER NAME (REGISTER PROVIDER) 5 PRIMARY CARE PROVIDER 6 FOLLOW UP 7 CHART 8 DATE 9 EDUCATE (ALL FOLLOW UP TEXT) 10 FOOT EXAM EDUCATION 11 EYE EXAM EDUCATION 12 DENTAL EXAM EDUCATION 13 FLU SHOT EDUCATION 14 PNEUMO EDUCATION 15 TETANUS EDUCATION 16 TB TEST EDUCATION 17 A1C HEMOGLOBIN EDUCATION 18 CREATININE EDUCATION 19 LIPID PANEL EDUCATION 20 TEXT FOLLOW UP (FOLLOW UP NEEDED WITH TEXT) 21 NUTRITION EDUCATION 22 EXERCISE EDUCATION 23 ALBUMIN CREATININE RATIO EDUCATION 24 EKG EDUCATION 25 CENTER 2. Modified the text of several education inserts. - Updated the GUI interface to the DMS system. 2. CONTENTS OF DISTRIBUTION a) bdm_0200.03k - Patch kids file b) bdm_0200.03n - Notes File c) bdm_0200.03zip contains: bdm_0200.03.msi - GUI Install File bdm_0200.03setup.exe - GUI Setup File d) bdm_0200.03o.pdf - patch addendum in pdf format 3. REQUIREMENTS a) VA Kernel V 8.0 or later b) VA FileMan V 21.0 or later c) BDM Version 2.0, through patch 2 (bdm*2.0*2) d) Visual DMS 2.0, through patch 2 if using the GUI 4. INSTALLATION INSTRUCTIONS In all UCIs running the Diabetes Management System: a) Disable logins or ensure all users are off, or disable BDMMENU. b) Do routine save for routines BDM* c) This is a KIDS install. Load distribution bdm_0200.03k. After it is loaded, then install it. If you need assistance with a KIDS install please call your Area Support personnel. d) Enable logins and BDMMENU. 5. GUI INSTALLATION INSTRUCTIONS On each Users (client) PC: a) Open the window folder containing the distribution bdm_0200.03zip file and unzip it. You will have 2 files: bdm_0200.03.msi - GUI Install File bdm_0200.03setup.exe - GUI Setup File b) Double click bdm_0200.03Setup.exe. Take all of the default responses EXCEPT when it asks who to install for. Change this to Everyone from Just Me. NOTE: The file named bdm_0200.03.msi is not executed by the user. This file is simply utilized during the install execution. 6. POINT OF CONTACT IHS OIT Helpdesk Fax: 505-248-4297 Web: http://www.ihs.gov/GeneralWeb/HelpCenter/Helpdesk/index.cfm Email: support@ihs.gov