April FOIA VistA Patch Installation

[Benjamin Irwin]

All of the April patches installed successfully on both Cache and GT.m.

Note:  ICD*18.0*118 takes a long time to install about 30 - 45 minutes.

[Sam Habiel]

I install the patches monthly. It would be good to have a monthly thread where you and I can put in our observations about difficult stuff to install.

For me, the KMP patches are uninstallable (I think there was one 1 or 2 months ago) on GT.M/YottaDB since they consist entirely of Cache Objectscript. I have to put a lot of "quit"s in various places to ensure that the code won't run during installation.

--Sam

On Thu, May 23, 2024 at 6:25 AM Benjamin Irwin <benon...@gmail.com> wrote:

All of the April patches installed successfully on both Cache and GT.m.

Note:  ICD*18.0*118 takes a long time to install about 30 - 45 minutes.

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[Nancy Anthracite]

Thanks for checking it out, especially so quickly, Ben.

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Nancy Anthracite

[GarV]

Hellow Everyone,

We would like to inquire about the availability of an ICD-11 patch. Could you please confirm if a patch for ICD-11 is currently available?

If so, we would appreciate it if you could share the download link so we can obtain the latest codes and proceed with installation on our local server.

Looking forward to your response.

[Sam Habiel]

It’s unlikely that the US will implement ICD-11 in the next 10 years. I don’t think there will ever be ICD-11 support for VistA. You can develop it, but it will take at least 2 years of effort. I say this as an expert who has modified the Lexicon before. 

—Sam

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[Rob Kellock]

I thought to myself, ICD-11 can't be that diabolical can it?  85,000 nodes... uh, Ok.  My non-medical brain thinks that with 85,000 different choices, time-pressed staff are bound to constantly mis-categorise patients trying to use something like this. To try to limit that problem it's probably some kind of hierarchical database, but it would have to be deeply nested to prevent excessive scanning to find the right branches but then to avoid premature narrowing...  Better download it and see what they've done.  Doesn't seem to be any way to download it. Well, that's no good! What if we ended up being off-line? This thing would completely ham-string your facility if you need to be in the cloud to use it and the cloud goes down... which is becoming a certainty now. There's a local API... that sounds suspiciously like it's simply a redirection back to the cloud database, but let's download it and have a look. 57MB compressed download. That seems large. The database must be in there after all. Open the archive which now has reached 140MB. A huge collection of binary files, mainly from Microsoft, doing just about everything under the sun and... no data :-(

[Nancy Anthracite]

Well put!

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Nancy Anthracite

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[ivaldes]

10 years from now current EHR's will be unrecognizable. However, the more things change the more things stay the same.  All EHR's are being retrofitted now with large language model AI support which is the only way in my opinion that ICD-10 or 11 can be reasonably wielded by a user.   I only use about the same 7-10 codes as it is for ICD-10. Who do these coding systems actually benefit anyway? They who control the coding system(s) controls medicine. Coding systems are used by insurance/government to deny/delay/frustrate care.