This file is used to define all of the components that work together to define a reminder dialog. Reminder dialog definitions are used by the CPRS GUI for reminder resolution. This file contains a combination of nationally distributed entries, local auto-generated entries, site and VISN exchanged entries and local manually created entries. Nationally distributed dialog, element, and group entries have their name prefixed with VA-. Nationally distributed Prompts, Forced Value, Result Groups, and Result Elements have their name prefixed with PXRM. Entries in this file may be auto-generated via the Dialog Management Menu option. Manually created dialog entries should use local namespacing conventions. Nationally distributed entries will have their class type defined as National. Entries created at the VISN level should be defined as VISN and entries created at a site should be defined as Local. This file is similar to the option file where there are different types of entries (reminder dialog, dialog elements (sentences), prompts, and groups of elements, result elements and groups of result elements). Where an option has menu items, the dialog file has components that are entered, with the sequence field as the .01 field. A prompt is defined for PCE prompts, WH Notification Purpose, or as locally created comment check-boxes. The prompts will not have any components within them. PXRM-prefixed prompts are distributed in this file with the Clinical Reminder package. A dialog element is defined primarily to represent sentences to display in the CPRS window with a check-box. When the user checks the sentence off, the FINDING ITEM in the dialog element and the ADDITIONAL FINDINGS will be added to the list of PCE updates, orders, WH Notification Purposes, and mental health tests. The updates won't occur on the CPRS GUI until the user clicks on the FINISH button. Dialog elements may have components added to them. Auto-generated components will be based on the additional prompts defined in the Finding Type Parameters. Once a dialog element is auto-generated, the sites can modify them. Dialog elements may also be instructional text or a header. The FINDING ITEM and components would not be defined in dialog elements. A dialog group is similar to menu options. It groups dialog elements and dialog groups within its component multiple. The dialog group can be defined with a finding item and a check-box. The components in the group can be hidden from the CPRS GUI window until the dialog group is checked off. A result element contains special logic that uses information entered during the resolution process to create a sentence to add to the progress note. The special logic contains a CONDITION that, when true, will use the ALTERNATE PROGRESS NOTE TEXT field to update the progress note. A separate result element is used for each separate sentence needed. The result element is only used with mental health test finding items. Default result elements are distributed for common mental health tests, prefixed with PXRM and the mental health test name. Sites may copy them and modify their local versions as needed. A result group contains all of the result elements that need to be checked to create sentences for one mental health test finding. The dialog element for the test will have its RESULT GROUP/ELEMENT field defined with the result group. Default result groups for mental health tests are distributed with the Clinical Reminders package. Sites may copy them and modify their local versions as needed. Sites should name locally created items according to their local naming convention.
.01name(+)0;1FREE TEXTThis is the name of the dialog entry. Dialogs that are auto-generated from a reminder will default to the name of the reminder for ease in identifying the reminder dialog entry. Dialog elements that are auto-generated use the following naming convention: Finding type prefix_ _Name from finding file_ _Resolution Status. Examples of two dialog element entry names generated from an Exam file entry for DIABETIC EYE EXAM follow. EX DIABETIC EYE EXAM DONE EX DIABETIC EYE EXAM DONE ELSEWHERE Any item created locally can use any type of naming convention. Your site may want to create special namespacing for dialog entries that you create locally. Entries prefixed with PXRM are prompts, result groups, and result elements that were distributed with the Clinical Reminders package. The PXRM-prefixed prompts are the additional prompts that can be asked for particular types of PCE findings and WH Notification Purpose. For example: PXRM COMMENT can be added to any PCE file to allow the user to enter an additional COMMENT beyond the dialog element's progress note text, and the PXRM LEVEL OF UNDERSTANDING can only be used with PCE Education Topic findings.
2source reminder0;2POINTER811.9AGThis identifies which reminder definition is associated with this "Reminder Dialog" entry. "Reminder Dialog" type entries are the only entries that require this field.
3disable0;3SET OF CODES0:NO
This field disables the use of a dialog item. If a dialog item is marked as DISABLE AND SEND MESSAGE and a user tries to use it in CPRS, a message will be sent to the Clinical Reminders mail group.
4type(+)0;4SET OF CODESP:prompt
E:dialog element
R:reminder dialog
F:forced value
G:dialog group
S:result group
T:result element
TYPEThis field defines what type of dialog component this entry is. The type determines the processing that can occur with this entry. Reminder dialogs are the dialog entries that can be mapped to a reminder definition. Reminder dialogs will typically contain several dialog elements and/or dialog groups. Dialog elements that are auto-generated represent a finding item and resolution status combination, based on the Finding Type Parameters for auto-generation. The dialog elements can be defined manually if needed. Dialog elements must have the FINDING ITEM field defined in order to cause the finding to be updated automatically. When no finding item is defined, the dialog element is treated as a header or instruction text in the CPRS GUI. Sites can also add Additional Finding items to automatically update when a dialog element is checked off. An example of using the additional finding would be for a dialog element for a diagnosis, that must always be recorded with a second diagnosis. Another example is when an Exam or Education Topic dialog element checked off should automatically add an additional ICD9 and/or CPT finding to PCE. Dialog elements will use the DIALOG/PROGRESS NOTE TEXT to display in the CPRS GUI window. This text will also be added to the progress note, unless the optional ALTERNATE PROGRESS NOTE TEXT field is defined. If the dialog text to display to the user needs to be different from the text to add to the progress note, use the ALTERNATE PROGRESS NOTE TEXT field to define the progress note text. Dialog Groups can be used to group dialog elements together. Groups can be displayed with a box around them and have selection rules applied to them (e.g., select one, one or more) A dialog element can be changed to a dialog group by changing its TYPE. Prompts are distributed in the PXRM namespace to represent additional fields that the user can enter when an element is checked off. Prompts are added to dialog elements during auto-generation based on the finding type parameters. The PXRM COMMENT field is a generic comment field that can be used on all PCE related finding items. Dialog elements for "DONE ELSEWHERE" need to require the historical visit date prompt. The forced value is similar to a prompt, except it represents a stuffed prompt which doesn't need to be presented to answer. The PXRM prompts can be copied for local modification to create additional forced value entries if necessary. Prompts created locally (not copies of PXRM prompts) are treated as display text with checkboxes, which, when checked off, add text to a comment field which is added to the progress note text. Refer to these as Local Comment Prompts. Result Groups and Result Elements are distributed in the PXRM namespace and are associated with Mental Health Instrument finding items during auto-generation of a reminder dialog. When the mental health instrument finding item dialog element is selected by the CPRS GUI user, a window will be opened which contains the test's questions and probable answers. The selected answers are sent to the mental health package when the user selects OK. The mental health package returns the score and results which can be used within sentences. These sentences are defined as Result Elements, and can vary depending on the test score. If multiple sentences are possible depending on the score, the result elements should be defined in a result group. The result group should be added to the mental health test's dialog elements RESULT GROUP/ELEMENT field. Mental Health tests for use by Mental Health clinicians only are not available for CPRS reminder resolution. A reminder dialog can be made into a dialog group and added to another reminder's dialog. This allows multiple reminders to be addressed by one reminder dialog. Reminder Dialogs can include dialog elements that don't have anything to do with the findings defined in the reminder. Taxonomy dialogs are auto-generated based on the Taxonomy Dialog Parameters. The taxonomy dialog can be used as a black box that allows the users to enter current or historical encounter diagnoses or procedures, based on the selectable list of diagnosis parameters. Alternatively, a taxonomy can have individual dialog elements created for each coded value in the selectable list of diagnoses and procedures. It may be more useful for sites to create dialog elements for the common diagnoses and procedures they actively use and add them to groups, similar to the encounter form section and coded value groupings.
5caption0;5FREE TEXTThe caption is used for prompt, dialog group, and reminder components. When a prompt has a caption defined, this is the text that should be used whenever the prompt is asked (e.g., Comment:). A dialog group can use the caption field to specify a header to use on a box around the group of dialog elements. The reminder dialog component can use the caption to specify a header to use on a box around the dialog elements for a reminder.
This flag will be used to determine whether the components will be presented to the user in a box. If the caption field is defined, it will appear as header text in the top line of the box.
7number of indents0;7NUMERICThis is the number of indents that should be made before presenting the group's components/elements. Indent is used only for dialog groups.
8share common prompts0;8BOOLEAN1:YES
This field is used only for a dialog group where different dialog elements have common prompts. Prompts will be shared for all dialog elements unless otherwise selected.
Used for dialog groups only. 1 indicates that only one element in the dialog group may be selected. 2 indicates that one or more elements must be selected. 3 indicates that either none or one selection is required. 4 indicates all selections are required. 0 or null indicates no selection required.
10components10;0MULTIPLE801.412This field contains the components that are used to process a reminder. Generally the components relate to the TYPE of entry in the Reminder Dialog File: Reminder dialogs have dialog group or dialog element components. Dialog groups have a combination of dialog element components. Dialog elements have prompt and forced value components.
13resolution type1;3POINTER801.9This field contains what type of resolution is represented by this dialog entry.
14finding type1;4POINTER801.451f an additional prompt is restricted to use with only one type of finding item this field contains the mnemonic of the finding type. The mnemonics allowed are: CPT Procedure ED Education Topic EX Exam HF Health Factor IM Immunization OI Orderable Item POV Diagnosis (ICD9) ST Skin Test VM Vital Measurement WH WH Notification Purpose (e.g. PXRM Contraindicated is restricted to IMMUNIZATION, finding type IM)
15finding item1;5VARIABLE-POINTER9999999.09, 9999999.14, 9999999.28, 9999999.15, 9999999.64, 120.51, 811.2, 101.41, 601.71, 790.404This is the finding item that should be created if the dialog element/group is checked in CPRS. Additional findings may be entered into the additional findings field.
17orderable item1;7POINTER101.43Orderable item from the reminder definition.
18additional findings3;0MULTIPLE801.4118
21default value2;1FREE TEXTThis is the default value for an additional prompt. If entering defaults for the PXRM VISIT DATE prompt (or copies) then the following codes are available: 0 - no year is initially set (forces required dates to be entered). M - Month is required. M0 - Month is required, no year initially set.
22forced value2;2FREE TEXTThis is the value that will be used for a forced value type dialog.
23exclude from progress note2;3BOOLEAN1:YES
This field indicates that the question text of the dialog element will be excluded from the progress note.
24prompt caption2;4FREE TEXTThis is the caption that will be used for this prompt. This caption can be overridden by the OVERRIDE PROMPT CAPTION field in the ITEMS multiple, which can be more specific for the instance of the prompt.
25dialog/progress note text25;0WORD-PROCESSINGThis is the sentence text that will appear in the reminder dialog and progress note.
35alternate progress note text35;0WORD-PROCESSINGThis field is only required if the text on the progress note differs from the dialog text.
45checkbox sequence45;0MULTIPLE801.4145Comment prompts (with a GUI Process ID of COM) may have a number of checkboxes associated with the comment prompt.
46gui process id46;1POINTER801.42Additional prompts and forced values which update PCE should have a GUI Process ID. If an additional prompt or forced value is created by copying one of the PXRM prompts, the GUI Process ID field will automatically be populated by the copy process.
50hide/show group0;10SET OF CODES1:HIDE
Used for dialog groups. 1 indicates that the group will be hidden until checked 0 indicates that the group will be displayed
51suppress checkbox0;11SET OF CODES1:SUPPRESS
If the field is set to SUPPRESS, the dialog element or group header will be displayed without a checkbox. Otherwise the WP text will be presented with a checkbox. If the dialog element or group header has a finding item associated with it the SUPPRESS CHECKBOX flag will be ignored. Also if the HIDE/SHOW GROUP field is set to hide, then the SUPPRESS CHECKBOX field will be ignored (the group header question must be a checkbox).
52indent progress note text0;12SET OF CODES1:INDENT
In a dialog group the dialog questions may be indented. This field allows the progress note text to be indented also.
53result condition0;13FREE TEXTThis field is used for dialog result elements only. The result condition determines if the progress note text of the result element will be included in the progress note e.g., I SCORE<2 will insert the text in the progress note if the SCORE from the mental health test is below 2. Result Elements will only use the Raw Score returned from a MH test.
54exclude mh test from pn text0;14BOOLEAN1:YES
This flag is used to control whether or not a mental health instrument question will be excluded from the progress note text when the component is acted upon.
100class(+)100;1SET OF CODESN:NATIONAL
This is the class of dialog. National dialogs cannot be edited.
101sponsor100;2POINTER811.6This is the organization or group that sponsors this dialog.
102review date100;3DATE-TIMEThe REVIEW DATE is used to determine when the dialog should be reviewed, to verify that it is current with the latest standards and guidelines.
110edit history110;0MULTIPLE801.44This multiple is used to record a history of changes to the dialog.
111identify0;16FREE TEXTACThis field will associate a dialog with a package or module. Example: if the field contained the letters IHD, then this dialog would be part of the Ischemic Heart Disease project. If one dialog had IHD1 in this field and another had IHD2 located in this field, we would know that they were associated with each other and were both part of the same project.
112patient specific0;17SET OF CODES1:TRUE
This field is used to identify a Reminder Dialog that has branching logic defined in the dialog. It is used in conjunction with three additional fields (Reminder Term, Reminder Term Status, and Replacement Element/group) defined at the item level of the Reminder Dialog. This field is used by CPRS to identify if the dialog set-up should be cached or re-built between every use. If the field is set to Yes, then the dialog will be re-loaded every time it is opened in CPRS. If the field is set to No or Null, the dialog set-up will be stored in CPRS the first time the dialog is loaded for the user.
113mh test required0;18SET OF CODES0:Optional open and optional complete (partial complete possible)
1:Required open and required complete before finish
2:Optional open and required complete or cancel before finish
The value defined in this field is used to control whether or not a mental health (MH) test is required to open from the reminder dialog, and whether the test must be completed before the reminder dialog can be finished in CPRS. If the value is 0, the user is not required to select/open the MH test before the reminder dialog can be finished. If the value is 1, the user is required to select/open and complete the MH test in the reminder dialog before the reminder dialog can be finished. If the value is 2, the user is not required to select/open the MH test in the reminder dialog; however, if the user opens the MH test, then the user is required to complete or Cancel the MH test before the reminder dialog can be finished. Clicking Cancel in the MH test dialog is considered the same as not opening the MH test. A value of 2 only works with CPRS 27 and the YS_MHA.dll file. If 2 is used in a pre-CPRS 27 environment, the value of 2 will be considered the same as the value 1.
This field is used to "Lock" a reminder dialog, dialog element, and/or a dialog group from being copied and/or edited. It will prevent any copying and/or editing of a dialog element if a finding item is defined or if the only finding item defined for the element/group is an order.
116reminder term49;1POINTER811.5This field is a pointer to file 811.5. If a reminder term is defined in this field when the dialog is loaded by CPRS, the reminder term will be evaluated. The Reminder Term evaluation will return either a True of False value. The value returned by the Reminder Term evaluation is used in conjunction with the Reminder Term Status field.
117reminder term status49;2SET OF CODES1:TRUE
This field is used in conjunction with the Reminder Term field. It will be used to determine if a Reminder Dialog Element/Group should do a special action. When the Reminder Term is defined in field #116, the True/False result of the term evaluation will be compared to the value defined in this field. If the value matches the dialog, it will complete the action defined in field #118. If the reminder term evaluation value does not match the value defined in this field, the default action of the element/group is loaded into CPRS.
118replacement element/group49;3POINTER801.41This field is used to determine if a dialog element/group should be replaced with another element/group or if the original element/group should be suppressed in the Dialog. If the Reminder Term defined in field #116 is evaluated and matches the value defined in field #117, then the dialog element/group will either be replaced or suppressed depending on the value defined in this field. This field points to file 801.41. If there is an active element/group defined in this field, then the original dialog element/group will be replaced with the new dialog element/group. If this field is null, then the original dialog element/group will be suppressed in CPRS.
119mh test50;1POINTER601.71This field is used to assign a mental health test to a result group. The value assigned to this field must match the mental health test assigned to the dialog element finding item.
120mh scale50;2NUMERICThis field stores the mental health scale number used when obtaining a score for the mental health test defined in the MH Test field #119.
121result group list51;0MULTIPLE801.41121This multiple assigns one or more result groups to the MH Test finding item, field #119, for creating progress note text. The text will change depending on the score of the MH Test. The score depends on the scale defined in the MH Scale field, #120.
123taxonomy pick listTAX;1SET OF CODESA:ALL
This field is used to determine how a Taxonomy should be display to an user in CPRS. A selection of: A: Displays two pick lists one for Diagnosis Codes and one for procedure codes. D: Displays a pick list for Diagnosis Codes only. The procedures codes will automatically be filed to VistA when the dialog is finish. P: Displays a pick list for Procedure Codes only. The diagnosis codes will automatically be filed to VistA when the dialog is finish. N: Does not displays a pick list. Both the diagnosis and procedures codes will be filed to VistA when the dialog is finish.
141pov headerPOV;1FREE TEXTThis field is used to set the diagnosis header text to display in CPRS when using a Taxonomy.
142cpt headerCPT;1FREE TEXTThis field is used to set the Procedure Text to display in CPRS when using a Taxonomy.

Referenced by 4 types

  1. REMINDER DIALOG (801.41) -- replacement element/group
  2. REMINDER FINDING ITEM PARAMETER (801.43) -- dialog element/group
  3. REMINDER DEFINITION (811.9) -- linked reminder dialog
  4. TIU TEMPLATE (8927) -- reminder dialog