STANDARD DATA DICTIONARY #393 -- INCOMPLETE RECORDS FILE 3/24/25 PAGE 1
STORED IN ^VAS(393, *** NO DATA STORED YET *** SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 1.0)
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
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This file is the main file for the Incomplete Records Tracking package IRT This is where all of the data is stored that will be
displayed for each deficiency on the enter/edit screens and on all of the reports.
DD ACCESS: @
RD ACCESS: d
WR ACCESS: D
DEL ACCESS: D
LAYGO ACCESS: D
IDENTIFIED BY:
"WRITE": S DGJT=^(0) D WR^DGJTUTL
POINTED TO BY: IRT RECORD field (#1403) of the TIU DOCUMENT File (#8925)
CROSS
REFERENCED BY: ATTENDING PHYSICIAN(AAT), SERVICE(AC), DICTATED BY(ADB), DATE DICTATED(ADD), ADMISSION(ADM), DATE REVIEWED(ADR),
DATE SIGNED(ADS), DATE TRANSCRIBED(ADT), REVIEWED BY(ARB), SIGNED BY(ASB), TRANSCRIBED BY(ATB), PATIENT(B),
EVENT DATE(C)
393,.01 PATIENT 0;1 POINTER TO PATIENT FILE (#2) (Required)
LAST EDITED: JAN 09, 1991
HELP-PROMPT: Enter the patient for which this summary was created.
DESCRIPTION:
Enter the patient for which this summary or op report has been recorded.
CROSS-REFERENCE: 393^B
1)= S ^VAS(393,"B",$E(X,1,30),DA)=""
2)= K ^VAS(393,"B",$E(X,1,30),DA)
393,.02 TYPE OF DEFICIENCY 0;2 POINTER TO IRT TYPE OF DEFICIENCY FILE (#393.3) (Required)
LAST EDITED: MAR 05, 1993
DESCRIPTION:
Enter the type of deficiency that is being tracked.
393,.03 EVENT DATE 0;3 DATE (Required)
INPUT TRANSFORM: S %DT="ESTX" D ^%DT S X=Y K:3991231X) X
LAST EDITED: JUL 26, 1991
HELP-PROMPT: TYPE A DATE BETWEEN 1/1/1980 AND 12/31/2099
DESCRIPTION: Enter the date of the event (discharge date for discharge summaries, date of summary for interim
summaries, or date of surgery for op reports).
CROSS-REFERENCE: 393^C
1)= S ^VAS(393,"C",$E(X,1,30),DA)=""
2)= K ^VAS(393,"C",$E(X,1,30),DA)
393,.04 ADMISSION 0;4 POINTER TO PATIENT MOVEMENT FILE (#405)
INPUT TRANSFORM: S DIC("S")="I $P(^(0),""^"",2)=1,($P(^(0),""^"",3)=+^DGPM(DA,0))" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0
X
LAST EDITED: MAR 05, 1993
HELP-PROMPT: Enter the admission associated with this report.
DESCRIPTION:
Enter the admission associated with this report. Enter nothing if this is an outpatient op report.
SCREEN: S DIC("S")="I $P(^(0),""^"",2)=1,($P(^(0),""^"",3)=+^DGPM(DA,0))"
EXPLANATION: Only admissions and only for same patient.
CROSS-REFERENCE: ^^TRIGGER^393^.13
1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^VAS(393,D0,0)):^(0),1:"") S X=$P(Y(1),U,13),X=X S D
IU=X K Y S X=DIV S X=1 X ^DD(393,.04,1,1,1.4)
1.4)= S DIH=$S($D(^VAS(393,DIV(0),0)):^(0),1:""),DIV=X S $P(^(0),U,13)=DIV,DIH=393,DIG=.13 D ^DICR:
$N(^DD(DIH,DIG,1,0))>0
2)= Q
CREATE VALUE)= S X=1
DELETE VALUE)= NO EFFECT
FIELD)= INPA
CROSS-REFERENCE: 393^ADM
1)= S ^VAS(393,"ADM",$E(X,1,30),DA)=""
2)= K ^VAS(393,"ADM",$E(X,1,30),DA)
393,.05 LOCATION 0;5 POINTER TO HOSPITAL LOCATION FILE (#44) (Required)
INPUT TRANSFORM: S DIC("S")="N CA S CA=$S($D(DGJTAIFN):DGJTAIFN,1:+$P(^VAS(393,DA,0),U,4)) I $P(^SC(+Y,0),U,3)=$S(CA
:""W"",1:""C"")" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: FEB 10, 1992
HELP-PROMPT: Enter the location of the patient at the time of the event.
DESCRIPTION:
Enter the location of the patient at the time of the event (discharge operation or interim summary.
SCREEN: S DIC("S")="N CA S CA=$S($D(DGJTAIFN):DGJTAIFN,1:+$P(^VAS(393,DA,0),U,4)) I $P(^SC(+Y,0),U,3)=$S(CA
:""W"",1:""C"")"
EXPLANATION: Screen WARDS for inpatients, CLINICS for outpatients
393,.06 DIVISION 0;6 POINTER TO MEDICAL CENTER DIVISION FILE (#40.8) (Required)
INPUT TRANSFORM: S DIC("S")="I $D(^DG(40.8,+Y,0)) I $D(^DG(40.8,+Y,""DT"")) I $P(^DG(40.8,+Y,""DT""),""^"",1)=1" D ^
DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: FEB 10, 1992
HELP-PROMPT: Enter the division at which this event took place.
DESCRIPTION:
Enter the division at which this event took place. Will initially be determined by the WARD field.
SCREEN: S DIC("S")="I $D(^DG(40.8,+Y,0)) I $D(^DG(40.8,+Y,""DT"")) I $P(^DG(40.8,+Y,""DT""),""^"",1)=1"
EXPLANATION: ONLY THOSE DIVISIONS THAT TRACK RECORDS.
393,.07 SPECIALTY 0;7 POINTER TO FACILITY TREATING SPECIALTY FILE (#45.7) (Required)
INPUT TRANSFORM: S DIC("S")="I $$ACTIVE^DGACT(45.7,Y,$G(DGJTDT))" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: JUL 31, 1995
HELP-PROMPT: Enter the patient's treating specialty. This must be an active treating specialty.
DESCRIPTION:
Enter the treating specialty the patient had at the time of this event.
SCREEN: S DIC("S")="I $$ACTIVE^DGACT(45.7,Y,$G(DGJTDT))"
EXPLANATION: Allows only active treating specialties.
393,.08 SERVICE 0;8 POINTER TO MAS SERVICE FILE (#393.1) (Required)
LAST EDITED: AUG 05, 1991
DESCRIPTION: Enter the service responsible for filing this report. This field will be used to generate reports
that are incomplete by service.
CROSS-REFERENCE: 393^AC
1)= S ^VAS(393,"AC",$E(X,1,30),DA)=""
2)= K ^VAS(393,"AC",$E(X,1,30),DA)
393,.09 PRIMARY PHYSICIAN 0;9 POINTER TO NEW PERSON FILE (#200) (Required)
LAST EDITED: JAN 22, 1993
HELP-PROMPT: Enter the physician responsible for dictation of this report.
DESCRIPTION: Enter the physician responsible for the patient... usually the physician that will be responsible
for the dictation of the summary or report.
CROSS-REFERENCE: ^^TRIGGER^393^.12
1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^VAS(393,D0,0)):^(0),1:"") S X=$P(Y(1),U,12),X=X S D
IU=X K Y S X=DIV S X=DIV,X=X X ^DD(393,.09,1,1,1.4)
1.4)= S DIH=$S($D(^VAS(393,DIV(0),0)):^(0),1:""),DIV=X S $P(^(0),U,12)=DIV,DIH=393,DIG=.12 D ^DICR:
$N(^DD(DIH,DIG,1,0))>0
2)= Q
CREATE VALUE)= INTERNAL(PRIMARY PHYSICIAN)
DELETE VALUE)= NO EFFECT
FIELD)= PHYSICIAN RESPONSIBLE
This trigger will update the Physician Responsible field with the value of the Primary Physician
field.
393,.1 ATTENDING PHYSICIAN 0;10 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: JUL 20, 1993
HELP-PROMPT: Enter the physician responsible for reviewing this summary.
DESCRIPTION:
Enter the physician responsible for reviewing this summary (if applicable).
CROSS-REFERENCE: 393^AAT^MUMPS
1)= S DGJATTD=1 D PHYDEF^DGJTUTL
2)= S DGJATTD=1 D PHYDEF^DGJTUTL
This MUMPS cross reference acts like a trigger that updates the Physician for Deficiency field in
file 393. If the attending physician is changed the record status is transcribed and the Physician
for Signature is set to attending then the Physician for Deficiency will be updated with the new
attending physicians name.
393,.11 STATUS 0;11 POINTER TO IRT STATUS FILE (#393.2) (Required)
INPUT TRANSFORM: D STATUS^DGJTHLP D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: JUL 20, 1993
DESCRIPTION:
Enter the status of this report at the present time.
SCREEN: D STATUS^DGJTHLP
EXPLANATION: Choose a STATUS
393,.12 PHYSICIAN RESPONSIBLE 0;12 POINTER TO NEW PERSON FILE (#200) (Required)
LAST EDITED: MAR 16, 1993
HELP-PROMPT: Enter the physician who is responsible for the dictation of the summary or report.
DESCRIPTION:
This is the physician that is responsible for the dictation of the report.
NOTES: TRIGGERED by the PRIMARY PHYSICIAN field of the INCOMPLETE RECORDS File
CROSS-REFERENCE: ^^TRIGGER^393^.14
1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X D PHYSRTRG^DGJTUTL I X S X=DIV S Y(1)=$S($D(^VAS(393,D0,
0)):^(0),1:"") S X=$P(Y(1),U,14),X=X S DIU=X K Y S X=DIV S X=DIV,X=X X ^DD(393,.12,1,1,1.4)
1.4)= S DIH=$S($D(^VAS(393,DIV(0),0)):^(0),1:""),DIV=X S $P(^(0),U,14)=DIV,DIH=393,DIG=.14 D ^DICR:
$N(^DD(DIH,DIG,1,0))>0
2)= Q
CREATE CONDITION)= D PHYSRTRG^DGJTUTL
CREATE VALUE)= INTERNAL(PHYSICIAN RESPONSIBLE)
DELETE VALUE)= NO EFFECT
FIELD)= PHYSICIAN FOR DE
This trigger updates the Physician for Deficiency field.
393,.13 INPATIENT REPORT? 0;13 SET (Required)
'1' FOR YES;
'0' FOR NO;
HELP-PROMPT: Enter 1 if this is an inpatient summary or op report, otherwise 0.
DESCRIPTION:
Enter 1 if this report is for an inpatient episode. Enter 0 if it is an outpatient op report.
WRITE AUTHORITY: ^
NOTES: TRIGGERED by the ADMISSION field of the INCOMPLETE RECORDS File
393,.14 PHYSICIAN FOR DEFICIENCY 0;14 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: MAR 02, 1993
DESCRIPTION: This field contains the name of the physician that is responsible for the deficiency at the present
time. This field changes whenever an action is taken against a deficiency and the status changes.
This field will be displayed on all the IRT reports as well as all of the enter/edit screens.
NOTES: TRIGGERED by the PHYSICIAN RESPONSIBLE field of the INCOMPLETE RECORDS File
393,10.01 DATE DICTATED DT;1 DATE
INPUT TRANSFORM: S %DT(0)="-NOW",%DT="ETX" D ^%DT K %DT(0) S X=Y K:Y<1 X
LAST EDITED: MAR 03, 1993
HELP-PROMPT: ENTER A DATE IN THE PAST OR NOW
DESCRIPTION:
Enter the date on which this record was dictated. Time of day may also be entered.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 393^ADD^MUMPS
1)= S DGJFDIC=1 D PHYDEF^DGJTUTL
2)= S DGJFDIC=1 D PHYDEF^DGJTUTL
This MUMPS cross reference acts like a trigger that updates the Physician for Deficiency field in
file 393.
393,10.02 DICTATED BY DT;2 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: MAR 03, 1993
HELP-PROMPT: Enter the person who dictated this report
DESCRIPTION:
Enter the user responsible for dictation of this summary or op report.
CROSS-REFERENCE: 393^ADB^MUMPS
1)= S DGJFDIC=1 D PHYDEF^DGJTUTL
2)= S DGJFDIC=1 D PHYDEF^DGJTUTL
This MUMPS cross reference acts like a trigger that updates the Physician for Deficiency field in
file 393.
393,10.03 DATE TRANSCRIBED DT;3 DATE
INPUT TRANSFORM: S %DT(0)="-NOW",%DT="ETX" D ^%DT K %DT(0) S X=Y K:Y<1 X
LAST EDITED: MAR 02, 1993
HELP-PROMPT: ENTER A DATE IN THE PAST OR NOW
DESCRIPTION:
Enter the date (or date/time) on which this report was transcribed.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 393^ADT^MUMPS
1)= S DGJFSIG=1 D PHYDEF^DGJTUTL
2)= S DGJFSIG=1 D PHYDEF^DGJTUTL
This MUMPS cross reference acts like a trigger that updates the Physician for Deficiency field in
file 393.
393,10.04 TRANSCRIBED BY DT;4 VARIABLE POINTER
FILE ORDER PREFIX LAYGO MESSAGE
200 1 P n PERSON
440 2 V n VENDOR
LAST EDITED: MAR 02, 1993
DESCRIPTION:
Enter the person or vendor that transcribed this report.
TECHNICAL DESCR:
CROSS-REFERENCE: 393^ATB^MUMPS
1)= S DGJFSIG=1 D PHYDEF^DGJTUTL
2)= S DGJFSIG=1 D PHYDEF^DGJTUTL
This MUMPS cross reference acts like a trigger that updates the Physician for Deficiency field in
file 393.
393,10.05 DATE SIGNED DT;5 DATE
INPUT TRANSFORM: S %DT(0)="-NOW",%DT="ETX" D ^%DT K %DT(0) S X=Y K:Y<1 X
LAST EDITED: MAR 02, 1993
HELP-PROMPT: ENTER A DATE IN THE PAST OR NOW
DESCRIPTION:
Enter the date on which this summary was signed by the responsible provider.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 393^ADS^MUMPS
1)= S DGJFREV=1 D PHYDEF^DGJTUTL
2)= S DGJFREV=1 D PHYDEF^DGJTUTL
This Mumps Cross reference acts like a trigger. It will update the Physician for Deficiency field.
393,10.06 SIGNED BY DT;6 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: MAR 02, 1993
HELP-PROMPT: Enter the name of the user that signed this report or summary.
DESCRIPTION:
Enter in this field the name of the provider that signed this summary or op report.
CROSS-REFERENCE: 393^ASB^MUMPS
1)= S DGJFREV=1 D PHYDEF^DGJTUTL
2)= S DGJFREV=1 D PHYDEF^DGJTUTL
This Mumps Cross reference acts like a trigger. It will update the Physician for Deficiency field.
393,10.07 DATE REVIEWED DT;7 DATE
INPUT TRANSFORM: S %DT(0)="-NOW",%DT="ETX" D ^%DT K %DT(0) S X=Y K:Y<1 X
LAST EDITED: MAR 03, 1993
HELP-PROMPT: ENTER A DATE IN THE PAST OR NOW
DESCRIPTION: Enter the date on which this summary or op report was reviewed. Entry of a review date/reviewer is
optional.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 393^ADR^MUMPS
1)= S DGJREVD=1 D PHYDEF^DGJTUTL
2)= S DGJREVD=1 D PHYDEF^DGJTUTL
This MUMPS cross reference acts like a trigger that updates the Physician for Deficiency field in
file 393.
393,10.08 REVIEWED BY DT;8 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: MAR 03, 1993
HELP-PROMPT: Enter the name of the physician responsible for reviewing this report.
DESCRIPTION:
Enter the name of the individual responsible for reviewing the signed summary or op report.
CROSS-REFERENCE: 393^ARB^MUMPS
1)= S DGJREVD=1 D PHYDEF^DGJTUTL
2)= S DGJREVD=1 D PHYDEF^DGJTUTL
This MUMPS cross reference acts like a trigger that updates the Physician for Deficiency field in
file 393.
393,20.01 COMMENTS MSG;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>200!($L(X)<3) X
LAST EDITED: DEC 01, 1992
HELP-PROMPT: Answer must be 3-200 characters in length.
DESCRIPTION: This field is a free text field that the user may add any comments that they need to, in regards to
the deficiency. Each deficiency has a comment field.
FILES POINTED TO FIELDS
FACILITY TREATING SPECIALTY
(#45.7) SPECIALTY (#.07)
HOSPITAL LOCATION (#44) LOCATION (#.05)
IRT STATUS (#393.2) STATUS (#.11)
IRT TYPE OF DEFICIENCY (#393.3) TYPE OF DEFICIENCY (#.02)
MAS SERVICE (#393.1) SERVICE (#.08)
MEDICAL CENTER DIVISION (#40.8) DIVISION (#.06)
NEW PERSON (#200) PRIMARY PHYSICIAN (#.09)
ATTENDING PHYSICIAN (#.1)
PHYSICIAN RESPONSIBLE (#.12)
PHYSICIAN FOR DEFICIENCY (#.14)
DICTATED BY (#10.02)
TRANSCRIBED BY (#10.04)
SIGNED BY (#10.06)
REVIEWED BY (#10.08)
PATIENT (#2) PATIENT (#.01)
PATIENT MOVEMENT (#405) ADMISSION (#.04)
VENDOR (#440) TRANSCRIBED BY (#10.04)
INPUT TEMPLATE(S):
DGJ EDIT IRT RECORD MAR 24, 1993@14:48 USER #0 ^DGJXE
DGJ ENTER IRT DEFICIENCY MAR 10, 1993@11:26 USER #0
DGJ ENTER IRT RECORD DEC 01, 1992@15:48 USER #0 ^DGJXA
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):