Global: ^PXRM(810.2

FileMan FileNo	FileMan Filename	Package
810.2	REMINDER EXTRACT DEFINITION	Clinical Reminders

Description

National extract definitions were sent out with Clinical Reminders V.2.0 to support site roll-up of reporting totals to the Austin Automation Center (AAC). The generic extract functionality supports corporate level management analysis by providing reports that: - summarize patient reminder compliance totals (not applicable, applicable, due, not due) - summarize finding total counts that reflect the most recent findings resulting from reminder evaluation - summarize finding total counts that reflect site activities during the reporting month. - list unique applicable patients included in the finding count (Patient List is not sent to Austin) An extract definition may be manually run or set-up to automatically run monthly or quarterly. The extract can be defined to only produce compliance totals, or to also include finding totals. Each extract definition identifies: - Which type of totals the extract will create: compliance, finding - What patient list(s) should be created first, second, third, , and what criteria should be used to build the patient list(s). - For each patient list created when the extract is run, what reminders should be run. - For each reminder run, what findings found should be used to include in finding count totals, based on the reminder status for each patient, and pre-defined counting groups. - Counting groups are used to define findings that may have been found from reminder evaluation, as well as findings that may not be in the reminder but need to be counted for utilization counts. - Counts are accumulated depending on whether the reminder status was applicable, not applicable, due or not due for the patient. - Utilization counts count how many times the findings in a counting group were entered during the reporting period for the patients in the patient list. The extract definition also identifies the last extract reporting period run and the next reporting period to be run. This information is used to support managing extract runs. The next reporting period is used by the next automated run to know which period should be run. The reporting results are stored in the REMINDER EXTRACT SUMMARY file (#811.3) The national extract definitions are defined in this file to support generic extract and roll-up needs by facility. The generic extract tools provide options to: - manage extract criteria - manage extract runs (manual and automated) - manage transmissions to AAC - view extract reporting results - view the list of patients making up the patient denominator When analyzing the results of an extract run, it is important to take note of the following information before drawing conclusions: - list rule criteria used to create the target patient lists (denominators) - reminder definition used to create applicable, not applicable, due and not due compliance and finding totals - counting rules used to accumulate totals - counting groups of findings and the type of totals accumulated (all patients, applicable, due or not due patients) The following is a comparison of Reminder Due and Reminder Extract report functionality: Reminder Due reports: Use report criteria and pre-defined report templates with location/clinic stop, provider, and team lists to build the list of patients that will be used to evaluate reminders. National Reminder Due report criteria and pre-defined report templates are not nationally distributed. The Reminder Due report evaluates reminders and provides counts for Total patients, applicable patients and patients due. The patient with a Due status can be saved in a Reminder Patient List for further follow-up Patient Demographic and Health Summary reporting. The findings in the reminder are not used to accumulate counts. An existing Reminder Patient List can be used to identify target patients, instead of report criteria and report templates. The Reminder Due report can be created in a Summary or detailed report format, and is typically queued to run in a job during off-hours. National extract reports: Defines complex extract criteria into one extract definition that is pre-defined as a national Reminder Extract Definition. Pre-defined national extract criteria uses findings (reminder terms), independent of a reminder definition, to build one or more lists of patients that are used to evaluate one or more reminders. National extract criteria used to identify patients is similar to VA External Peer Review (EPRP) performance measure reporting criteria. EPRP performance measures often require a current qualifying visit and an anchor visit during the previous year. Since some patients seen during a reporting month do not have a prior year anchor visit, the national extract's total patient counts for a given month will typically be less than the Reminder Due report's total patient counts for the same month. The lists of patients used for each reporting period's national extract are stored on the local system for sites to validate the patient denominator counts and provide local quality of care monitoring. Compliance total counts are accumulated based on the reminder status for each patient: total, applicable, not applicable, due, and not due. The extract criteria used to create the totals is stored with the total counts on the local system, as well as transmitted to the AAC. Finding total counts are accumulated for pre-defined national finding groups based on the findings found during reminder evaluation for the patient. The finding counts are totaled into categories that reflect the reminder status for each patient: total, applicable, not applicable, due and not due patient counts. The finding counts are sent to the AAC with the extract criteria used to create the counts. Utilization counts are accumulated for pre-defined national finding groups that count how many times specified findings were entered during the reporting period for patients for each patient denominator. The finding counts are sent to the AAC with the extract criteria used to create the counts. Each patient that had a finding count is stored on the local system for follow-up patient care and validation of reporting results. The patients are not sent to the AAC. The national extract tools use Mailman links with the HL7 interface to send compliance totals and finding totals for each monthly period to the AAC. AAC adds the national monthly reporting to the Compliance Totals National Database stored at the AAC. The national extract reports are generated by a job. IRM Staff can help set up each type of extract definition to automatically reschedule itself to run monthly at each site. The extract run needs to occur prior to the tenth of each month. The sites can manually rerun an extract and/or selectively retransmit an extract to AAC in the event of a failed transmission. The Extract Summary reports may be used to verify compliance totals. Parties interested in viewing the AAC Compliance Totals National Database may be granted read-only access to this data. The AAC uses the national database to create Simple Authentication and Security (SAS) files with read-only access. File relationships: The extract definition uses list rules (#810.4) to build lists of patients. If the extract definition is for Compliance and Finding Totals, the extract definition will be defined with counting rules (#810.7). The counting rules will be defined based on counting groups (#810.8). Data from the extract is stored in the extract summary file (#810.3) and patient lists are saved in the patient list file (#810.5). HL7 messages containing the extract data from the extract summary (#810.3) are passed to the HL7 package for transmission to the AAC. Individual patient level data is not sent to Austin. However, a list of patients with particular findings may be stored in the extract summary file (#810.3) for validation of patients. Nationally distributed definitions are prefixed 'VA-' and cannot be modified by site. Sites should name locally created extract definitions according to their local naming convention.

Package	Total	Routines
Clinical Reminders	14	PXRMAPI1 PXRMEPED PXRMETCO PXRMETH PXRMETHL PXRMETM PXRMETX PXRMETXR PXRMEUT PXRMEXPS PXRMLPP PXRMP4I1 PXRMRULE PXRMV2I

Package	Total	Routines
Clinical Reminders	4	PXRMEPED PXRMETX PXRMEXPD PXRMV2I

Package	Total	FileMan Files
Clinical Reminders	2	REMINDER PATIENT LIST(#810.5)[.05] REMINDER EXTRACT SUMMARY(#810.3)[1]

Package	Total	FileMan Files
Clinical Reminders	3	REMINDER DEFINITION(#811.9)[#810.22(1)] REMINDER LIST RULE(#810.4)[#810.21(.02)] REMINDER EXTRACT COUNTING RULE(#810.7)[#810.22(2)]
Kernel	1	NEW PERSON(#200)[#810.24(1)]

Fields, Total: 11

Field #	Name	Loc	Type	Details
.01	NAME	0;1	FREE TEXT	**********************REQUIRED FIELD********************** INPUT TRANSFORM: `K:$L(X)>64!($L(X)<3)!'(X'?1P.E)!('$$VNAME^PXRMINTR(.X)) X` LAST EDITED: `MAY 29, 2009` HELP-PROMPT: `Answer must be 3-64 characters in length.` DESCRIPTION: `The NAME of the extract (VA-IHD QUERI, VA-MH QUERI etc.). Extracts for national rollup are prefixed with 'VA-'.` TECHNICAL DESCR: `The national extract definitions (VA-IHD QUERI, VA-MH QUERI) in this file are used in the rollup of compliance data to the Austin Automation Center (AAC).` Extract runs transmit compliance totals as HL7 format messages but also store run totals in the REMINDER EXTRACT SUMMARY file #810.3 and extract patient lists in the REMINDER PATIENT NOTES: `XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER` FIELD INDEX: `B (#592) REGULAR IR LOOKUP & SORTING` Unique for: Key A (#40), File #810.2 Short Descr: B Index Description: New-style B index. Set Logic: S ^PXRM(810.2,"B",$E(X,1,64),DA)="" Kill Logic: K ^PXRM(810.2,"B",$E(X,1,64),DA) Whole Kill: K ^PXRM(810.2,"B") X(1): NAME (810.2,.01) (Subscr 1) (Len 64) (forwards)
.02	TYPE OF TOTALS	0;2	SET	**********************REQUIRED FIELD********************** 'CT' FOR COMPLIANCE TOTALS ONLY; 'CF' FOR COMPLIANCE AND FINDING TOTALS; LAST EDITED: `MAY 04, 2006` DESCRIPTION: `This is the type of extract totals that will be reported by the extract.` Compliance Totals Only are similar to Reminder Due Summary reports, with the difference being multiple patient lists are used to evaluate multiple reminders, resulting in compliance totals based on the reminder status (applicable, not applicable (N/A), due, and not due). Example: PATIENT LIST 1 REMINDER 1 COMPLIANCE TOTALS for Applicable, N/A, Due, Not Due REMINDER 2 COMPLIANCE TOTALS for Applicable, N/A, Due, Not Due PATIENT LIST 2 REMINDER 1 COMPLIANCE TOTALS for Applicable, N/A, Due, Not Due REMINDER 3 COMPLIANCE TOTALS for Applicable, N/A, Due, Not Due Compliance and Finding Totals will additionally report on totals for findings found during reminder evaluation. Counting rules indicate how to count findings defined in a counting group. Counting Groups often group patient cohort findings, resolution findings and information findings in different groups. The finding counts are totaled based on the reminder's status (N/A, applicable, due, not due). Example: PATIENT LIST 1 REMINDER 1 COMPLIANCE TOTALS for Applicable, N/A, Due, Not Due GROUP 1 (most recent finding counts each finding found in the group, regardless of when it was entered into VistA) FINDING 1 TOTALS for Applicable, N/A, Due, Not Due FINDING 2 TOTALS for Applicable, N/A, Due, Not Due GROUP 2 (most recent finding patient counts one finding from the group for each patient, regardless of when it was entered in VistA) FINDING 1 TOTALS for Applicable, N/A, Due, Not Due FINDING 2 TOTALS for Applicable, N/A, Due, Not Due FINDING 3 TOTALS for Applicable, N/A, Due, Not Due FINDING 4 TOTALS for Applicable, N/A, Due, Not Due GROUP 3 (utilitzation counts how many of the findings were entered during the reporting period) FINDING 3 TOTALS for Applicable, N/A, Due, Not Due FINDING 4 TOTALS for Applicable, N/A, Due, Not Due FINDING 5 TOTALS for Applicable, N/A, Due, Not Due REMINDER 2 COMPLIANCE TOTALS for Applicable, N/A, Due, Not Due GROUP 4 (most recent finding: counts each finding found in the group, regardless of when it was entered into VistA) FINDING 10 TOTALS for Applicable, N/A, Due, Not Due FINDING 11 TOTALS for Applicable, N/A, Due, Not Due FINDING 12 TOTALS for Applicable, N/A, Due, Not Due FINDING 13 TOTALS for Applicable, N/A, Due, Not Due GROUP 5 (most recent finding patient: counts one finding from the group for each patient, regardless of when it was entered in VistA) FINDING 9 TOTALS for Applicable, N/A, Due, Not Due FINDING 8 TOTALS for Applicable, N/A, Due, Not Due FINDING 7 TOTALS for Applicable, N/A, Due, Not Due GROUP 6 (utilization: counts how many of the findings were entered during the reporting period) FINDING 11 TOTALS for Applicable, N/A, Due, Not Due FINDING 12 TOTALS for Applicable, N/A, Due, Not Due PATIENT LIST 2 REMINDER 1 COMPLIANCE TOTALS for Applicable, N/A, Due, Not Due GROUP 1 (utilization counts: how many of the findings were entered during the reporting period) FINDING 1 TOTALS for Applicable, N/A, Due, Not Due FINDING 2 TOTALS for Applicable, N/A, Due, Not Due FINDING 3 TOTALS for Applicable, N/A, Due, Not Due FINDING 4 TOTALS for Applicable, N/A, Due, Not Due FINDING 5 TOTALS for Applicable, N/A, Due, Not Due TECHNICAL DESCR:
.03	DESCRIPTION	1;0	WORD-PROCESSING #810.23	DESCRIPTION:
1	REPORT FREQUENCY	0;3	SET	**********************REQUIRED FIELD********************** 'Q' FOR QUARTERLY; 'M' FOR MONTHLY; 'Y' FOR YEARLY; LAST EDITED: `MAY 04, 2006` HELP-PROMPT: `Enter the report frequency.` DESCRIPTION: `This is the frequency of the extract run. The frequency may be monthly, quarterly, yearly or by financial year.`
2	LAST REPORTING PERIOD/YEAR	0;4	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>8!($L(X)<4) X` LAST EDITED: `MAY 04, 2006` HELP-PROMPT: `Enter the period/year of the last extract run.` DESCRIPTION: `This is the date range of the last extract run. The format is period/year, e.g. Q1/2002 denotes first quarter of 2002.`
3	LAST RUN DATE	0;5	DATE	INPUT TRANSFORM: `S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X` LAST EDITED: `APR 22, 2002` HELP-PROMPT: `Enter a valid date and time.` DESCRIPTION: This is the date and time the latest extract was run.
4	NEXT REPORTING PERIOD/YEAR	0;6	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>8!($L(X)<4) X` LAST EDITED: `MAY 04, 2006` HELP-PROMPT: `Enter period/year of next extract run.` DESCRIPTION: `This is the date range of the next extract to be run. The format is period/year, e.g. Q1/2002 denotes first quarter of 2002..` This field is updated automatically on the successful completion of each extract run.
5	NEXT RUN DATE	0;7	DATE	INPUT TRANSFORM: `S %DT="ESTXR" D ^%DT S X=Y K:DT>X X` LAST EDITED: `MAY 04, 2006` HELP-PROMPT: `TYPE A DATE NOT EARLIER THAN CURRENT DATE.` DESCRIPTION: `Date of the next scheduled extract run. This field is only set for extracts that are scheduled to run as an option.` Example: the two national extracts that are being released with 2.0, VA-IHD QUERI and VA-MH QUERI, are being released as options (PXRM EXTRACT VA-IHD QUERI and PXRM EXTRACT VA-MH QUERI) that sites will need to schedule using TaskMan. When the extract is done with processing, the extract code will determine the next run date and add that value to this field.
10	EXTRACT RULES	10;0	Multiple #810.21	810.21 LAST EDITED: `MAY 16, 2002` DESCRIPTION: `This multiple contains the sequential list of extract criteria: - list rule sets used by this extract to build` patient lists - reminders that should be run against a patient list - counting rules for how findings should be counted. IDENTIFIED BY: `LIST RULE SET(#.02)[R]` PRIMARY KEY: `A (#41)` Uniqueness Index: B (#593) File, Field: 1) EXTRACT SEQUENCE (810.21,.01) INDEXED BY: `EXTRACT SEQUENCE (B)`
100	CLASS	100;1	SET	**********************REQUIRED FIELD********************** 'N' FOR NATIONAL; 'V' FOR VISN; 'L' FOR LOCAL; LAST EDITED: `MAY 04, 2006` HELP-PROMPT: `Enter the class.` DESCRIPTION: `This is the CLASS of the extract definition. National extract definitions cannot be edited.`
110	EDIT HISTORY	110;0	DATE Multiple #810.24	810.24

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Package: Clinical Reminders

Global: ^PXRM(810.2

Information

Description

Directly Accessed By Routines, Total: 14

Accessed By FileMan Db Calls, Total: 4

Pointed To By FileMan Files, Total: 2

Pointer To FileMan Files, Total: 4

Fields, Total: 11