Support Scenarios

Incident Reporting

RPMS-EHR Technical Overview

Support Scenarios – Incident Reporting:Mary Hager RN

Presenters

General Concepts

• Always try to clarify the problem as much as possible– Ask lots of questions– User stating that they can’t sign their notes is

not sufficient for a help desk call– Be specific– If possible, duplicate the scenario or at least

watch as it occurs

Questions for the user

• Which component were you using? (not which tab were you on)

• What were you trying to do?

• What had you just finished doing?

• Can you do it again?

• Is it just this one patient or any patient?

CAC actions

• Can you do the same thing the user does and get the same error?

• If not, do other users get the error or just this user?

• One patient or all patients?• Does the error happen all the time or

intermittently?• Can you watch the provider produce the error if

you cannot.

Site Manager Actions

• Is there an error in the error trap?– This means there is a Mumps code error

• If it is a repeatable GUI error, can you see the error using the VueCentric Manager?– If no error trap error, the problem could be on

the EHR side.

Sending to IHS Help Desk

• Send as much information as possible since we don’t have access to sites

• Get all the information you can from the CAC and the user

• Send screen shots of everything if possible

• Do NOT send patient names, so the screen shots will need to be cleaned up

Error Trap Errors• Process ID: 21395 (21395)• SEP 10, 2007 09:55:34

• Username: Process Name:

• UCI/VOL: [CHNWV,CHNWV] :

• $ZA: 0 $ZB:

• Current $IO: /dev/null:21395 Current $ZIO: ^24^4

• CPU time: Page Faults:

• Direct I/O: Buffered I/O:

• $ZE= <UNDEFINED>RENEW+6^PSORENW

• S RX0=^PSRX(RXN,0),PSODRG=+$P(^PSRX(RXN,0),"^",6),ST=+^("STA"),PSODRUG0=^PSDRUG• (PSODRG,0)

• Last Global Ref: ^PSDRUG(0,0)

• Which symbol? >

• Which symbol? > ^L

• $DEVICE=• $ECODE=,M7,• $ESTACK=11• $ETRAP=D UNWIND^CIANBLIS Q:$Q 0 Q• $QUIT=0• $STACK=15• $STACK(000)=• $STACK(000,"ECODE")=• $STACK(000,"MCODE")=• $STACK(000,"PLACE")=EN+13^CIANBLIS +1• $STACK(001)=DO• $STACK(001,"ECODE")=• $STACK(001,"MCODE")=• $STACK(001,"PLACE")=LISTEN+2^CIANBLIS +3• $STACK(002)=DO• $STACK(002,"ECODE")=• $STACK(002,"MCODE")=• $STACK(002,"PLACE")=LISTEN+4^CIANBLIS +1• $STACK(003)=$$• $STACK(003,"ECODE")=• $STACK(003,"MCODE")=• $STACK(003,"PLACE")=DOACTION+14^CIANBLIS +2• $STACK(004)=DO• $STACK(004,"ECODE")=• $STACK(004,"MCODE")=• $STACK(004,"PLACE")=DOACTION+17^CIANBLIS +1• $STACK(005)=DO

$STACK(005,"ECODE")=$STACK(005,"MCODE")=$STACK(005,"PLACE")=ACTR+16^CIANBACT +2$STACK(006)=DO$STACK(006,"ECODE")=$STACK(006,"MCODE")=$STACK(006,"PLACE")=ACTR+18^CIANBACT +2$STACK(007)=DO$STACK(007,"ECODE")=$STACK(007,"MCODE")=$STACK(007,"PLACE")=DORPC+8^CIANBACT +1$STACK(008)=DO

$STACK(008,"ECODE")=$STACK(008,"MCODE")= I $$VALID^ORCACT0(ORID,ACTION,.VAL,$G(ORWNAT)) S VAL="" ; VAL=error$STACK(008,"PLACE")=VALID+32^ORWDXA +1$STACK(009)=$$$STACK(009,"ECODE")=$STACK(009,"MCODE")=RN I ACTION="RN" D RN^ORCACT01 G VQ ; renew$STACK(009,"PLACE")=RN^ORCACT0 +2$STACK(010)=DO$STACK(010,"ECODE")=$STACK(010,"MCODE")= I DG="O RX" D Q ;Outpt Meds$STACK(010,"PLACE")=RN1+2^ORCACT01 +2$STACK(011)=DO$STACK(011,"ECODE")=$STACK(011,"MCODE")= . I ORZ>1 S ORD=+$$VALUE^ORX8(+IFN,"DRUG"),X=$$RENEW^PSORENW(PSIFN,ORD,DAYS)$STACK(011,"PLACE")=RN1+8^ORCACT01 +3$STACK(012)=$$$STACK(012,"ECODE")=,M7,$STACK(012,"MCODE")= S RX0=^PSRX(RXN,0),PSODRG=+$P(^PSRX(RXN,0),"^",6),ST=+^("STA"),PSODRUG0=^PSDRUG(PSODRG,0)$STACK(012,"PLACE")=RENEW+6^PSORENW +4$STACK(013)=DO

$STACK(013,"ECODE")=$STACK(013,"MCODE")=$STACK(013,"PLACE")=ETRAP2+2^CIANBLIS +1$X $Y=24 4$ZU(56,2)=/v/v5-0-21/build6408/common/src/symbol.c 9719$ZV=Cache for UNIX (Linux Intel/32-bit) 5.0.21 (Build 6408) Tue Jan 3 2006 14:15:25 EST%1=69%DT=T%N=91%T=0%X=DUZ(%ZT("^XUTL("XQ",$J)")=ACT=RACTION=RNACTSTS=AGE=69AIFN=1APCDANE=ARG=4ARG("1")=ARG("2")=ARG("3")=ARG("4")=ATXVIS=AUPNDAYS=25393AUPNDOB=2380303AUPNDOD=AUPNPAT=38683AUPNSEX=MAUPNTALK=AUPNVSIT=104309

BLK=1CDT=12/13/06CIA("ASY")=0CIA("CTX")=CIAV VUECENTRICCIA("EOD")=255CIA("RPC")=ORWDXA VALIDCIA("UID")=34139CIA("VER")=0CIAERR("0")=0CIAIP=CIAMODE=2CIAOS=3CIAPORT=9220CIARETRY=1CIATDEV=|TCP|9220|21395CIAUCI=CHNWVCIAXUT=1CNT=8COMMENT=D0=38481DA=83DAT=DATE=6929089.0842DAYS=180DDER=0DENT=09/05/2007DFN=1835DG=O RXDIALLVAL=1DIC=^TIU(8925,DILOCKTM=1DIQ2=1605DISYS=18DIWI=Type Ii Or Unspecified Type,DIWT=5,10,15,20,25DIWTC=0DIWX=DL5=&DLGIEN=147DN=1

DOB=2380303DQ=0DT=3070910DTIME=600DUZ=3065DUZ("0")=DUZ("1")=DUZ("2")=1946DUZ("AG")=IDUZ("AUTO")=1DUZ("BUF")=1DUZ("LANG")=ECSAV=<UNDEFINED>RENEW+6^PSORENWERR=0F=1946FAC=999999FACNAM=PRIMARY CARE CLAYFDA=^TMP(21395,"XQALSET")FUN=GMRAPA=8768GMRASITE=2GMRATYPE=DGMRAYN=1GMRCA=10GMRCCT=75GMRCDA=GMRCDIF=GMRCDVL=----------------------------------------GMRCGRP("NAM")=ALL SGMRCGRP("ROOT")=1GMRCNUL=1GMRCSEX=FEMALEHH=HRCN=PRI11632I=4IEN=129

IFN=92772;1INDX=5IO=/dev/nullIO("0")=/dev/nullIOBS=$C(8)IOF=#IOHG=IOM=132ION=IOPAR=IOS=0IOSL=64IOST=P-OTHERIOST("0")=16IOT=TRMIOUPAR=IOXY=IPL=~ISIV=0IVOD=0LAB("NOT")=0LIST("13113")=13113^INSULIN NOVOLIN 70/30 INJ PENFILL 3ML^26^INJ^129^HS501LIST("13351")=13351^INSULIN HUMULIN 70/30 (NPH/REG) INJ PEN,3ML^26^INJ^129^HS501LIST("13352")=13352^INSULIN NPH HUMAN 100 U/ML INJ PEN 3ML^26^INJ^129^HS501^ILIST("13353")=13353^INSULIN,LISPRO,HUMAN 100 UNT/ML INJ,PEN,3ML^26^INJ^129^HS501LIST("13484")=13484^INSULIN NPH HUMULIN-N 100 U/ML INJ PEN 3ML^26^INJ^129^HS501LIST("13485")=13485^INSULIN NPH NOVOLIN-N 100 U/ML INJ PEN 3ML^26^INJ^129^HS501LIST("13486")=13486^INSULIN REGULAR NOVOLIN-R 100 U/ML PEN 3ML^26^INJ^129^HS501LIST("14371")=14371^INSULIN,LISPRO,HUMAN 75/25 INJ,PEN,3ML^26^INJ^129^HS501LIST("14476")=14476^INSULIN,GLARGINE,HUMAN 100 UNT/ML INJ^26^INJ^129^HS501LIST("14477")=14477^INSULIN,GLARGINE,HUMAN 100 UNT/ML INJ,CARTRIDGE,3ML^26^INJ^129^HS501

LIST("14591")=14591^INSULIN,ASPART,HUMAN 100 UNT/ML INJ^26^INJ^129^HS501LIST("14592")=14592^INSULIN,ASPART,HUMAN 100 UNT/ML INJ,CARTRIDGE,3ML^26^INJ^129^HS501LIST("14913")=14913^INSULIN,LISPRO,HUMAN 75/25 INJ,HUMALOG^26^INJ^129^HS501LIST("16199")=16199^INSULIN NPH HUMAN 100 U/ML INJ SYRINGE 1.5ML^26^INJ^129^HS501LIST("16200")=16200^INSULIN NPH HUMAN 100 U/ML INJ INNOLET 3ML^26^INJ^129^HS501LIST("16263")=16263^INSULIN,ASPART,HUMAN 70/30 INJ,NOVOLOG^26^INJ^129^HS501LIST("16264")=16264^INSULIN,ASPART,HUMAN 70/30 INJ,NOVOLOG,PENFILL,3ML^26^INJ^129^HS501LIST("16265")=16265^INSULIN,ASPART,HUMAN 70/30 INJ,NOVOLOG,FLEXPEN,3ML^26^INJ^129^HS501LIST("16280")=16280^INSULIN,ASPART,HUMAN 100U/ML,NOVOLOG,FLEXPEN,3ML^26^INJ^129^HS501LIST("16370")=16370^INSULIN REG HUMAN 100 U/ML INJ INNOLET 3ML^26^INJ^129^HS501LIST("16437")=16437^INSULIN NOVOLIN 70/30 INJ INNOLET 3ML^26^INJ^129^HS501LIST("16466")=16466^INSULIN.LISPRO,HUMAN 100 UNIT/ML INJ,CARTRIDGE,3ML^26^INJ^129^HS501^ILIST("16467")=16467^INSULIN,LISPRO,HUMAN 100 UNIT/ML INJ,CARTRIDGE,3ML^26^INJ^129^HS501LIST("16665")=16665^INSULIN,ASPART,HUMAN 100 UNIT/ML INJ,PENFILL,3ML^26^INJ^129^HS501LIST("16746")=16746^INSULIN,GLULISINE,HUMAN 100 UNIT/ML INJ^26^INJ^129^HS501LIST("821")=821^INSULIN,PROTAMINE ZINC,BEEF/PORK 100UNT/ML INJ^26^INJ^129^HS501^ILIST("822")=822^INSULIN,PROTAMINE ZINC,PORK/PURIFIED 100UNT/ML INJ^26^INJ^129^HS501^ILIST("823")=823^INSULIN,PROTAMINE ZINC,BEEF/PURIFIED 100UNT/ML INJ^26^INJ^129^HS501^I

LIST("824")=824^INSULIN,PROTAMINE ZINC,BEEF/PORK 40UNT/ML INJ^26^INJ^129^HS501^ILIST("825")=825^INSULIN,REGULAR,BEEF/PORK 100UNT/ML INJ^26^INJ^129^HS501^ILIST("826")=826^INSULIN,REGULAR,PORK/PURIFIED 100UNT/ML INJ^26^INJ^129^HS501LIST("827")=827^INSULIN,REGULAR,BEEF/PURIFIED 100UNT/ML INJ^26^INJ^129^HS501^ILIST("828")=828^INSULIN,REGULAR,HUMAN 100UNT/ML INJ^26^INJ^129^HS501LIST("829")=829^INSULIN,REGULAR,BEEF/PORK 40UNT/ML INJ^26^INJ^129^HS501^ILIST("830")=830^INSULIN,NPH,BEEF/PORK 100UNT/ML INJ^26^INJ^129^HS501LIST("831")=831^INSULIN,NPH,PORK/PURIFIED 100UNT/ML INJ^26^INJ^129^HS501LIST("832")=832^INSULIN,NPH,BEEF/PURIFIED 100UNT/ML INJ^26^INJ^129^HS501LIST("833")=833^INSULIN,NPH,HUMAN 100UNT/ML INJ^26^INJ^129^HS501LIST("834")=834^INSULIN,NPH,BEEF/PORK 40UNT/ML INJ^26^INJ^129^HS501LIST("835")=835^INSULIN,LENTE,BEEF/PORK 100UNT/ML INJ^26^INJ^129^HS501^ILIST("836")=836^INSULIN,LENTE,PORK/PURIFIED 100UNT/ML INJ^26^INJ^129^HS501LIST("837")=837^INSULIN,LENTE,BEEF/PURIFIED 100UNT/ML INJ^26^INJ^129^HS501LIST("838")=838^INSULIN,LENTE,BEEF/PORK 40UNT/ML INJ^26^INJ^129^HS501LIST("839")=839^INSULIN,REGULAR,PORK/PURIFIED CONC 500UNT/ML INJ^84^INJ,SOLN^129LNCT=1LSTDS=30LSTFD=3070908LSTRD=MEDPARM=2MSG=0^Patient Postings on fileNAME1="XQAID"NATR=NDF=1795A7544NM=NMBCOD=CLAY3OCXSEG=ZALOIIEN=0

ONSET=OR0=92772^38683;DPT(^^2924^147;ORD(101.41,^3040^3070702.1402^^^64;SC(^4^O^^225^^2^^OR3=3070702.18372^90^6^147;ORD(101.41,^^^1^^^^0ORA0=3070702.1402^NW^2924^1^2924^3070702.1837^^^^^^8^3040^1^^3070702.1837^2924ORD=0ORDSTS=6ORID=92772;1ORIFN=92772;1ORNP=2924ORTKG=ORVER=NORVP=38683;DPT(ORWCLVER=1ORWNAT=ORY=ORZ=3P=P4P1=92772;1P2=RNP3=2924P4=PKG=PSPLACER=40212PNAR=Diabetes Type 2POP=0PR=1PRI=PRMT=138PRTID=0PRV=SHARPE,HEATHERPSIFN=40212PSOCPDRG=0PSODC=INSULIN

PSODRG=0PSODTCUT=3070513PSONODD=1PSOSHH=0PXRMHRCN=PRI11632REC=72^38683^81061^^2903RESULT("1")=BLOOD PRESSURE: 130/76 (Sep 10, 2007@08:45)RESULT("2")=WEIGHT: 166.8 (0 kg) (Sep 10, 2007@08:45)RESULT("3")=HEIGHT: 69 (0 cm) (Sep 10, 2007@08:45)RESULT("4")=TEMPERATURE: 98.3 (36.8 C) (Sep 10, 2007@08:45)RESULT("5")=RESPIRATIONS: 18 (Sep 10, 2007@08:45)RESULT("6")=PULSE: 92 (Sep 10, 2007@08:45)RESULT("7")=PAIN: 0 (Sep 10, 2007@08:45)RESULT("8")=O2 SATURATION: 98 (Sep 10, 2007@08:45)RPC=878RT=P4RTN=VALID^ORWDXA(.CIAD,.P1,.P2,.P3,.P4)RX0=114258^38683^1^2924^64^^30^30^3^^W^^3070702^^^3040^^1RXN=40212SB=SEQ=\128SEX=MSSN=279347973ST=0STAT=ASTS=5SUCCESS=83124TAB=

TITLE=OUTSIDE CONSULTS, PROVIDERS AND SPECIALIST - KAY M. ConsTIUCHNG=1TIUDIV1("4","1946",".01")=PRIMARY CARE CLAYTIUDPRM("0")=3^0^2^1^^^^1^1^1^^^^^^^^0^0^TIUDPRM("5")=471^626TIUFPRIV=1TIUPRM0=1946^1^80^^2^P^0^^H^^^^^1^^C^^0TIUPRM1=^^^^^@@@^3041214TMPLST=0U=^VA("BID")=PRI11632VA("PID")=PRI11632VAC=DPQRSUVADM("1")=xxxxxxxxxVADM("10")=VADM("11")=0VADM("12")=0VADM("2")=279347973^PRI11632VADM("3")=2380303^MAR 3,1938VADM("4")=69VADM("5")=M^MALEVADM("6")=VADM("7")=VADM("8")=VADM("9")=VADMVT=VAERR=0VALMCNT=10VASITE=-1VER=3VIEN=104309VL=VUNT=0VUNT("0")=^^

VUNT("1")=^^W=TRICOUNTY US EXAMS^^^^^1X=0X0=PSO OERR^Outpatient Medications^^D^4^2^225^1^2XPARSYS=1;DIC(4.2,XQI=3070910.083134XQVOL=CHNWVXQXFLG=0^0XQXFLG("LLOG")=3070908.135618^0^1^3070713XQY=2889299XUCI=CHNWVXUENV=CHNWV^CHNWV^WVPCN1S11.corp.wvpcn.com^CHNWV:CACHEXUF=0XUF(".3")=3065XUIOP=XUVOL=CHNWV^^1000XWBAPVER=0XWBOS=OpenMXWBPTYPE=1XWBWRAP=0Y15=BUNZ=^XUTL("XQ",$J,"DUZ")=3065^XUTL("XQ",$J,"DUZ(0)")=^XUTL("XQ",$J,"DUZ(1)")=^XUTL("XQ",$J,"DUZ(2)")=1946^XUTL("XQ",$J,"DUZ(AG)")=I

^XUTL("XQ",$J,"DUZ(AUTO)")=1^XUTL("XQ",$J,"DUZ(BUF)")=1^XUTL("XQ",$J,"DUZ(LANG)")=^XUTL("XQ",$J,"IO")=/dev/null^XUTL("XQ",$J,"IOBS")=$C(8)^XUTL("XQ",$J,"IOF")=#^XUTL("XQ",$J,"IOM")=132^XUTL("XQ",$J,"ION")=^XUTL("XQ",$J,"IOS")=0^XUTL("XQ",$J,"IOSL")=64^XUTL("XQ",$J,"IOST")=P-OTHER^XUTL("XQ",$J,"IOST(0)")=16^XUTL("XQ",$J,"IOT")=TRM^XUTL("XQ",$J,"IOXY")=^XUTL("XQ",$J,"T")=1^XUTL("XQ",$J,"XQVOL")=CHNWV^XUTL("XQ",$J,0)=3070910.080732^XUTL("XQ",$J,1)=2889299^CIAV VUECENTRIC^VueCentric^^B^2869^^^^^^^

$ZE= <UNDEFINED>RENEW+6^PSORENW

S RX0=^PSRX(RXN,0),PSODRG=+$P(^PSRX(RXN,0),"^",6),ST=+^("STA"),PSODRUG0=^PSDRUG(PSODRG,0)

Last Global Ref: ^PSDRUG(0,0)

vcManager Trace Log Entries

• If there is an error then send it along with the RPC list.

• If no error, send several RPCs that are near where the problem is occurring.

• You can use screen captures or just send the text

• Send at least one list of the RPCs around the error

Sending Text• You need to use the CTL C and

CTL V to copy data from the RPC to an E-mail message

• The Parameters tell you what was sent to the M routine.

• The results tell you what came back

• Send several RPCs since you don’t know where the problem may be

• This RPC gets the boilerplate

• RPC: TIU TEMPLATE GETBOIL• ______________________________

_____Parameters___________________________________

• #1 : 18847• ______________________________

______Results_____________________________________

• This coding request pertains to the visit on: {FLD:GEN DATE}

• {FLD:CIH CODING CHOICE}• {FLD:GEN WORD PROCESSING}

• ________________________________________________________________________________

Get the text of the boilerplate• RPC: TIU TEMPLATE GETTEXT• ___________________________________Parameters________________________________

___• #1 : 3• #2 : 21;3070910.1037;A;365• #3 : • (1,0)=This coding request pertains to the visit on: {FLD:GEN DATE}• (2,0)=• (3,0)={FLD:CIH CODING CHOICE}• (4,0)={FLD:GEN WORD PROCESSING}• ____________________________________Results__________________________________

___• ^^4^4^3070910^^• This coding request pertains to the visit on: {FLD:GEN DATE}

• {FLD:CIH CODING CHOICE}• {FLD:GEN WORD PROCESSING}

• ________________________________________________________________________________

Get the data in the template fields

• RPC: TIU TEMPLATE GETTEXT• ___________________________________Param

eters___________________________________• #1 : 3• #2 : 21;3070910.1037;A;365• #3 : • (1,0)=This coding request pertains to the visit on:

{FLD:GEN DATE}• (2,0)=• (3,0)={FLD:CIH CODING CHOICE}• (4,0)={FLD:GEN WORD PROCESSING}• ____________________________________Resu

lts_____________________________________• ^^4^4^3070910^^• This coding request pertains to the visit on:

{FLD:GEN DATE}

• {FLD:CIH CODING CHOICE}• {FLD:GEN WORD PROCESSING}

• ________________________________________________________________________________

• RPC: TIU TEMPLATE GETTEXT• ___________________________________Param

eters___________________________________• #1 : 3• #2 : 21;3070910.1037;A;365• #3 : • (1,0)=This coding request pertains to the visit on:

{FLD:GEN DATE}• (2,0)=• (3,0)={FLD:CIH CODING CHOICE}• (4,0)={FLD:GEN WORD PROCESSING}• ____________________________________Resu

lts_____________________________________• ^^4^4^3070910^^• This coding request pertains to the visit on:

{FLD:GEN DATE}

• {FLD:CIH CODING CHOICE}• {FLD:GEN WORD PROCESSING}

• ________________________________________________________________________________

Data Saved• RPC: TIU SET DOCUMENT TEXT• ___________________________________Parameters______________________

_____________• #1 : 177• #2 : • ("HDR")=1^1• ("TEXT","1","0")=This coding request pertains to the visit on: 10-Sep-2007• ("TEXT","2","0")=• ("TEXT","3","0")=Please add a POV for this visit, Please add an E and M code for

this visit• ("TEXT","4","0")=because you didn't add anything• #3 : 1• ____________________________________Results_________________________

____________• 177^1^1

• ________________________________________________________________________________

Access to System

• Access to your system may take several days• Inform the NOSC to open up the port that we

need to get access• We will need access to RPMS• We generally cannot get access to the GUI

Support Scenarios

Incident Reporting

Sending Incident Report to Help Desk

• Site Information (site location, phone number)• Issue contact person (Name, Phone number)• Software Information (Version #)• How long has this problem been occurring?

(Days)• Were there any software upgrades or

configuration changes prior to this problem (Y/N)– If Yes, please list them

Sending Incident Report to Help Desk (cont.)

• Are there any sites experiencing similar problem? (Y/N)

– If Yes, please provide list

• Is this problem repeatable at the site (Y/N)• Is this problem reproducible in IHS test environment

(Y/N)– If Yes, provide test data set up and step by step instructions to

reproduce this issue. Also provide screen captures at each step.

– If No, obtain step-by-step instructions from user and also obtain screen captures at each step.

• THEN SUBMIT ISSUE to Medsphere Support by e-mailing the issue with the above information to ihs-helpdesk@medsphere.com