INTRODUCTION TO PATHOLOGY OFFICE.
DRAFT COPY ONLY.
(Procedure 190).
G. William Moore, MD, PhD.
Chief, Quality Assurance Section.
Chief, Autopsy Section.
Lawrence A. Brown, MD.
Chief, Chemistry Section.
Automated Data Processing Application Coordinator.
http://www.netautopsy.org/axsop/axsop190.htm
NEXT PAGE
PREVIOUS PAGE
RETURN TO TABLE OF CONTENTS
United States Government Work, uncopyrighted, public-domain,
DRAFT COPY ONLY. This document does not necessarily represent the views
or policies of any United States Government agency.
This document is provided "as is", without warranty of any kind,
express or implied, including but not limited to the warranties
of merchantability, fitness for a particular purpose and
non-infringement. In no event shall the authors be liable
for any claim, damages or other liability, whether in an
action of contract, tort or otherwise, arising from, out of,
or in connection with the document or the use or other dealings
made with the document.
PRINCIPLE OF THE TEST.
A suite of office software is available to Baltimore VAMHCS employees
in the Pathology and Laboratory Medicine Service, for quality assurance
projects. The office functions include: desktop; screen buffer;
word-processor; email; Internet browser; spreadsheet; database;
image capture; image editor; and slide presentation.
SPECIMEN REQUIRED.
Not applicable.
REAGENTS, INSTRUMENTATION.
Not applicable.
STEP-BY-STEP DESCRIPTION.
1. A suite of office software
is available to Baltimore VAMHCS employees in the Pathology and Laboratory
Medicine Service, for quality assurance projects. The office functions
include: desktop; screen buffer; word-processor; email; Internet browser;
spreadsheet; database; image capture; image editor; and slide presentation.
2.
The office functions in the Baltimore VAMHCS workstations are:
Procedure Generic Microsoft® product.
Procedure 190 Introduction .....
Procedure 191 Word/text-processor Microsoft® Word/Notepad
Procedure 192 VistA® email Microsoft® Outlook
Procedure 193 VistA® Filemanager .....
Procedure 194 Internet browser Microsoft® Internet Explorer
Procedure 195 Spreadsheet Microsoft® Excel
Procedure 196 Relational Database Microsoft® Access
Procedure 197 VistA® Image capture .....
Procedure 198 Image editor Microsoft® Photo Editor
Procedure 199 Slide presentation Microsoft® Powerpoint
3. Why repeat the
Microsoft® product documentation? Because Microsoft®
documentation is scattered all over the place, and is, in many cases,
poorly written, not targeted to medical/pathology applications, and
expensive. The documentation resides in thick, all-purpose books.
An entire set of these books costs hundreds of dollars, and typically
resides in a library that is locked-up or otherwise unavailable when needed.
4. GETTING STARTED.
To sign onto the Baltimore VAMHCS computer, one must have a
NETWORK USER NAME and PASSWORD and NETWORK LOG ONTO DOMAIN;
and a CPRS/VistA® ACCESS CODE and VERIFY CODE.
Your network user name is vhaballastnf, where lastn
is the first five letters of your lastname (surname), and f
is your first initial. For example, the network user name for
Joseph Pathologist is: vhabalpathoj. Your network
log onto domain name is: VHA05. If one does not have
the other codes that are neede needed, or if these codes have expired,
then one should contact: Chief,
Automated Data Processing Section or
Chief, Quality Assurance Section.
If you are outside the Pathology and Laboratory Medicine Service,
then you should contact your departmental administrator.
5. PASSWORD SECURITY.
Every person entitled to examine Baltimore VAMHCS records has
signon/password codes, and they should be kept confidential
in the same manner that you would keep confidential
your personal identification number (PIN) to your bank account
or debit/credit card. The U. S. Federal Government is allowed
to examine all transactions carried out on your computer account,
and you are held responsible for them. You should not divulge
these codes even to your supervisor. If the supervisor has need
to examine your computer account in your absence, then this is done
by changing your password through administrative channels,
and informing you when you return to work.
6. SIGNING ON TO THE NETWORK.
To SIGN ONTO the network, press CONTROL-ALT-DELETE (together),
and enter your NETWORK USER NAME and NETWORK PASSWORD.
The LOG ONTO DOMAIN at the Baltimore VAMHCS is VHA05.
If somebody else is signed onto the computer in front of you,
then sign off, and sign on under your own identifiers.
You should not use somebody else's open network connection.
7. SIGNING OFF THE NETWORK.
To SIGN OFF the network, click on START (bottom left),
then click on SHUTDOWN... (bottom menu selection). You will be
given several options, including LOGOFF, RESTART, SHUT_DOWN.
Whenever you leave your computer workstation, you should sign off
using one of these options. The fastest option is LOGOFF.
For further details, see:
Procedure 7. Anatomic Pathology Computer System.
8. DESKTOP
is the layout of the initial computer screen, or monitor,
after one first signs onto the Baltimore VAMHCS network.
The desktop consists of: the START BUTTON (lower left corner):
the WORKSTATION ID (upper right corner):
and ICONS (left half of screen):
Click on the START BUTTON, to start any function, or
to close your workstation. Click on the appropriate ICON
(small cartoon) to start a workstation function. All your commonly-used
workstation functions should be present as icons on your desktop.
You should have the WORKSTATION ID available when you are
troubleshooting (IRM HELP: 330-1115 within the VAMHCS;
410-642-2411, ext 1115, outside the VAMHCS).
9. SCREEN BUFFER, or Microsoft® Clipboard®,
is a temporary memory location (random-access-memory, RAM), where one can
temporarily hold: TEXT, an IMAGE, FILENAMES,
or SPREADSHEET RECORDS, for transfer to another location
on your computer workstation. For example, you may have a text-screen
from VistA®, CPRS, an email, or text from the internet,
that you wish to copy into another file:
You may either drag-left-click the mouse over the desired text, or else
click on EDIT then click on SELECT ALL:
The selected area on the screen will darken. Place the cursor where you wish,
and click on COPY. DO NOT USE the CUT command, since
this deletes the information from the original location. If something goes
wrong, you may accidentally lose everything from the original location, and
not be able to recover it:
Open up a new target location, such as NOTEPAD:
Click on EDIT:
Click on PASTE.
Don't forget to SAVE your file with an appropriate name.
1. TEXT. Select and copy text from the source file, and paste
the text into the target file.
2. IMAGE. Select and copy an image from the source file.
If you wish to select the entire screen, then press the
PRINT SCREEN key, immediately to the right of the
function keys, F1, F2, .... Paste the image into the target file.
3. FILENAMES. Select and copy one-or-more filenames
from the source folder, and paste the filenames into the target folder.
This action transfers all the contents of selected-pasted folders,
as well as their subfolders.
4. SPREADSHEET RECORDS. Select and copy a records
from the source spreadsheet, and paste the records into the target
spreadsheet. For Baltimore VAMHCS quality assurance processes, the
usual use of this functionality is to transfer the records in
a Microsoft® Access® database file (source) into
a Microsoft® Excel® spreadsheet (target) file. The Microsoft®
Access® database holds very large datasets, but the Microsoft®
Excel® spreadsheet environment is much easier to work with.
10. WORD/TEXT PROCESSOR
(Procedure 191) is a computer program
that captures, displays, and prints text information. A text-processor
(Microsoft® Notepad®) manages simple text: Click on:
The following screen will appear:
A text-file, denoted *.txt, consists of TEXT ONLY.
A word-processor (Microsoft® Word®) manages text with embedded
formatting information, such as paragraphing, boldface,
italics, colors,
fonts and föréìgñ
àλphâßëts.
Click on:
The following screen will appear:
A word-processor-file, denoted *.doc, consists of
TEXT AND MARKUP, i.e., text and instructions to the
word processor software for showing and printing special displays.
We currently live in a word-processor Tower of Babel,
where different text-processing products are incompatible with one another.
Thus, when one transfers text information from one product to another,
one almost always requires the text-processor as an intermediary.
For example, one cannot simply take a Microsoft® Word® file
and load it directly into a VistA® screen.
11. EMAIL (Procedure 192)
VistA® email is provided on each desktop for secure email communications
that includes patient identifying information. Click on:
The following screen will appear:
Patient identifiers or other confidential information should NEVER
be included in the SUBJECT LINE of VistA® email.
The subject line should include a generic header,
such as URGENT PATHOLOGY REPORT and a
HIPAA-secure patient-identifier (see Procedure 153), such as BSP 04-1234.
You can only transmit text-information on VistA® email,
and no ATTACHMENTS are permitted. Sometimes you will receive unsolicited
gibberish on your VistA® email. These are formatted files and images,
which should be deleted.
Commercial email (Microsoft® Outlook®) is provided on each
desktop for non-secure email communications, within and outside the
VA system. Click on:
The following screen will appear:
Patient identifying information or other confidential information (such as
internal hospital conference proceedings) should NEVER be communicated
by commercial email. The same enhancements on commercial email that allow
formatting and attachments also cause security-leaks in commercial email.
12. VistA® FILEMANAGER
(Procedure 193)
is the HIERARCHICAL DATABASE in which all data in the Baltimore
VAMHCS system are maintained: Click on:
The following screen will appear:
VistA® Filemanager sits upon a platform of MUMPS/CACHÉ
(See: Procedure 151. MUMPS/CACHÉ Primer.),
which is an inherently hierarchical language (MUMPS/CACHÉ compilers,
in turn, are written in C). Unlike a relational database, which is organized
as a set of rectangular tables with linkages among the row-names
and column-names, a hierarchical database has a tree-structure.
Several departmental administrative processes require the use of
VistA® Filemanager for downloading the data as rectangular tables.
For example, the process for preparing the READBACK report for the Invasive
Procedures Review Committee (Procedure 138):
12.1. Download/CAPTURE anatomic pathology data from VistA®
FILEMANAGER screen dump. Resulting file: rdbkyymm.txt.
12.2. Convert screen-dump data into a ^-DELIMITED FILE,
using Perl-program convert.pl. Resulting file:
rdbkoutp.txt.
12.3. Upload ^-delimited-file-data, into
Microsoft® Access®. Resulting file: rdbkoutp.mdb.
12.4. Transfer Microsoft® Access® database into
Microsoft® Excel® spreadsheet for analysis. The reason for
this final step is that Microsoft® Access® is considerably
more cumbersome to work with than Microsoft® Excel®.
Resulting file: rdbkoutp.xls.
13. INTERNET BROWSER (Procedure 194)
is a screen for examining internet pages.
Click on:
The following screen will appear:
At the Baltimore VAMHCS,
internet connections are used to find PubMed abstracts, ASCP teaching sets,
and AFIP teaching sets. Employee activity on internet browsers is monitored,
and certain internet sites may be blocked by security software.
You should only use your internet browser for work-related activities.
14. SPREADSHEET (Procedure 195) is
a rectangular table, or collection of rectangular tables.
Click on:
The following screen will appear:
Typically, the rows correspond to individual patients or cases,
and the columns correspond to attributes of these patients or cases,
such as date-of-birth, sex (for patients) and
date-received, date-signed-out, diagnosis-code (for cases).
For example:
| Name | Gender |
Date-of-birth | Service-connected |
|---|
| Mary Smith | F |
11/11/1918 | TRUE |
| Bill Jones | M |
12/7/1941 | TRUE |
| Pat Miller | M |
9/11/2001 | FALSE |
The available spreadsheet software, Microsoft® Excel®,
is easy-to-use, and has powerful graphics and programming features.
However, there is a strict limit of 65,536 rows and 255 columns.
At this writing, there are 115,000 surgical pathology specimens
since computerization of Baltimore VAMHCS pathology in 1989,
so that some preprocessing of these files must be performed
before the data can fit into Microsoft® Excel®.
15. RELATIONAL DATABASE
( Procedure 196) is a rectangular table,
or collection of rectangular tables, which have defined relationships
to one another. Click on:
A relational database is organized as a set of rectangular tables with
linkages among the row-names and column names. Several departmental
administrative processes require the use of VistA® Filemanager
for downloading the data as rectangular files. The available
relational database software, Microsoft® Access®, accommodates
the large data-files that are downloaded from VistA® Filemanager.
However, Microsoft® Access®, is much more cumbersome to use than
Microsoft® Excel®, and the graphics and statistical functions in
Microsoft® Access® are less powerful. Therefore, a common strategy
is to download data from VistA® Filemanager into
Microsoft® Access®; then trim the Microsoft® Access®;
file over to Microsoft® Excel®, for graphics and statistics.
16. IMAGE CAPTURE ( Procedure 197).
17.IMAGE EDITOR ( Procedure 198) is
available as Microsoft Office® Picture Manager®. Click on:
The following screen will appear:
18. SLIDE PRESENTATION
(Procedure 199) is available as
Microsoft® Powerpoint®. Click on:
The following screen will appear:
Many outside meetings are able to handle this software. Also,
sometimes files from Medical Media are given to us
as CDs containing Microsoft® Powerpoint® files. Click on the
Microsoft® Powerpoint® icon on your desktop. For beginners,
click on the AUTOCONTENT WIZARD, and walk through the steps.
TABLE OF CONTENTS appears on the left, and SLIDE IMAGE on the right.
To save your presentation, click on FILE. Then click on SAVE AS,
and enter the name your new file.
19.
The DESKTOP is the layout of the COMPUTER SCREEN or
MONITOR at your workstation. After you POWER UP or RESTART
the computer and LOGIN to the network, a collection
of ICONS (small cartoons) appears on the computer screen desktop,
starting at the upper left corner. In Microsoft® DESKTOP,
the START BUTTON in the lower left corner is the launch-point
for all software applications, including SHUTDOWN. (This is ironic:
to shut down your computer, click on the START BUTTON).
20.
The BOTTOM TOOLBAR contains linkages to frequently-used
software-applications. Double-click on any of these icons in order
to launch a desired software-application. The TOP TOOLBAR also
contains linkages to software-applications, but is being phased out
in more modern versions of Microsoft® DESKTOP.
21.
The TOP-RIGHT CORNER of the screen contains a block of information
that identifies the computer. If you have any problems, you should identify
the computer workstation by the information in the top-right corner.
The HELP-DESK for IRM is: 1-410-642-2411.
22.
Every Microsoft® Windows® networked computer operating system
comes with standard ICONS, a collection of 1 x 1 cm cartoons,
on the left side of the screen. An attending pathologist computer
workstation might contain the following icons:
| Name | Icon |
| MY COMPUTER |
 |
| INTERNET EXPLORER |
|
| POWERPOINT |
|
| NOTEPAD |
|
| WORD |
|
| EXCEL |
|
| PICTURE MANAGER |
|
| RECYCLE BIN |
 |
| VistA® |
|
| CPRS |
 |
| ACCESS |
|
| OUTLOOK |
|
23. MAKE YOUR OWN ICONS.
Any icon that you wish to have on your desktop exists as a FILE.
On the desktop, click on MY COMPUTER.:
Find the file-of-interest.
Right-click the file.
Click on
CREATE SHORTCUT.
A new file-banner will be created, named
SHORTCUT TO....
Left-click and drag the shortcut-file-banner to the desktop.
You may wish to RENAME shortcut icon.
Right-click the file.
Click on RENAME.
24. The MOUSE
has a LEFT-BUTTON for ACTION and a RIGHT-BUTTON
for MENU-SELECTION. A left-click action might include:
show a text-file, display an image-file, play an audio-file,
execute an executable-file, etc. Most users use the left-button
most of the time. Most ordinary actions require
a DOUBLE-LEFT-CLICK on the desired icon.
A SINGLE-RIGHT-CLICK on the icon causes a
MENU to appear, that includes such options as:
OPEN
CUT
COPY
CREATE SHORTCUT
DELETE
RENAME
PROPERTIES
SAVE TARGET AS
If you don't find what you want after a left-click, always try a right-click.
25. Data-files are stored
in the computer in a hierarchical manner, as folders, subfolders,
and finally the file of interest. The top folder in the hierarchy is
MY-COMPUTER, which should be located on the TOP-RIGHT CORNER
of your desktop.
To view or copy a FILE,
double-left-click on MY-COMPUTER, and then progressively
double-left-click on the FILE or FOLDER of interest.
26. You may wish to make
a particular file ready for immediate use from
your DESKTOP. To make a desktop icon for a file, first double-left-click
on MY-COMPUTER, and then progressively double-left-click on the
FILE or FOLDER of interest. Then right-click on the
file-icon, and left-click on CREATE SHORTCUT. A new, shortcut-icon
will appear. You can DRAG the shortcut-icon from its original folder
and DROP the shortcut-icon on your desktop, by placing
the cursor-arrow over the shortcut-icon, and holding down
the left-click-button while moving the cursor-arrow to the desktop.
Suggested icons for your desktop include:
VistA®.
CPRS.
Gynecologic cytology disclaimer.
Gynecologic cytology HPV_DNA text.
VistA® Image capture
Microsoft® Notepad text-processor.
Microsoft® Word word-processor.
Microsoft® Internet Explorer
Microsoft® Excel spreadsheet
Microsoft® Access Pathmaster database.
Microsoft® Photo Editor.
Microsoft® Powerpoint.
27.
You may wish to RENAME your desktop shortcut-icon at this time.
Right-click on the file-icon, and left-click on RENAME and
type in the desired name.
28. FILE MANAGEMENT.
Nearly all Microsoft® products have a FILE BUTTON
on the upper left corner (toolbar, top left of screen), with
the following sub-buttons:
NEW
OPEN
CLOSE
SAVE
SAVE AS
PRINT
PAGE-SETUP
EXIT
and an EDIT BUTTON immediately to the right of the file button,
with the following sub-buttons:
COPY
PASTE
SELECT ALL
FIND
These buttons are the most frequently used by novices.
To OPEN a file, double-left-click on the FILE BUTTON,
then double-left-click on the OPEN option,
and enter the name of the desired source-file, followed by OK.
29. TEXT-FILE MANAGEMENT.
CHARACTER TEXT may exist either in raw form, i.e., unformatted;
or else within a formatted document, produced by a WORD PROCESSOR,
such as Microsoft® Word, XYWrite®, Word Perfect®,
or Hypertext Markup Language (=HTML). A word processor document
is a string of computer-characters, or file, consisting of TEXT
and MARKUP. TEXT is the actual textual information
in the document. MARKUP is the set of instructions
that specify sizes, fonts, colors, linkages to images or the internet, etc.
There is a dizzying Tower of Babel of word processor markup formats,
nearly all of them incompatible with one another, and many of them
proprietary. In the hypertext markup language (HTML), a public-domain
language that dominates the internet, the markup commands consist
of such MARKUP TAGS as:
<p>=start-paragraph, </p>=end-paragraph,
<b>=start-boldface, </b>=end-boldface,
<i>=start-italic, </i>=end-italic, etc.
30.
If you wish to transfer text from one word processor environment
to another, you must first transfer them into a neutral area,
called the CLIPBOARD. The clipboard is a behind-the-scenes
temporary memory location in the computer, in which information
can be transferred from one location to another. The most frequent use
for the clipboard is to transfer partial or complete text files,
but images, video, audio, and spreadsheet inforamtion
may also be relocated using the clipboard.
31.
To transfer text into the clipboard, first bring up the source-document
on your screen. Then SELECT the desired source-text
from the source-document on the screen. This selection is done
either by DRAGging the mouse-arrow over
the desired text, or by clicking on EDIT then SELECT ALL.
Next, click on EDIT then COPY the selected-text
into the clipboard.
32.
Finally, bring the target-document up onto the screen.
The target-document may be an existing word-processor document
into which you wish to insert the source-text,
or the target-document may be a blank text-document.
The generic blank text-document is Microsoft® NOTEPAD.
To call up a blank Microsoft® NOTEPAD document,
click on START, then click on PROGRAMS,
then click on ACCESSORIES, then click on NOTEPAD.
33.
Place the cursor into the target-document. Click on EDIT,
then click on PASTE. Don't forget to SAVE your new document.
Click on FILE then click on SAVE AS,
then enter your new filename.
34.
Microsoft® WORD is the available word-processor package
in Microsoft® Office, and by far the weakest of all the software packages
in the office-suite. Its many shortcomings are well-documented
(Microsoft Word Annoyances, 1996). The only rational reason to use
Microsoft® Word is its dominance in the marketplace.
To start up Microsoft® Word, click on START,
then click on PROGRAMS, then click on ACCESSORIES,
then click on Microsoft® WORD. A blank screen will appear.
Start typing your document. At periodic intervals, be sure to
SAVE your new document. Click on FILE
(toolbar, upper left), then click on SAVE AS,
then type in your new filename.
35.
Instead of COPYing text from the source-document,
alternatively you can CUT text from the source-document,
i.e., copy the text into the clipboard and delete it from the source file.
However, if the clipboard transfer fails for some reason, then you may have
irrevocably damaged the source-document. Novices should avoid
the CUT operation.
36.
When you COPY text or other information into the clipboard,
you overwrite whatever was there before. If you SELECTed from the
source-document but forget to copy, then the clipboard retains whatever
you already have in the clipboard. Novices beware: do not save
the target-document until you are certain
that you have copied in the correct clipboard contents.
37.
Nearly all Microsoft® Office products have a FILE BUTTON
on the upper left corner (toolbar, top of screen); and an EDIT BUTTON,
immediately to the right of the file button.
These are the most frequently used buttons on the toolbar.
File options include:
NEW
OPEN
SAVE
SAVE AS
PAGE SETUP
PRINT
PRINT PREVIEW
Edit options include:
CUT
COPY
PASTE
SELECT ALL
FIND ON THIS PAGE
In order to open up a new file, click on FILE, then click on
NEW, and enter the name of the desired source file.
In order to open an existing file, click on FILE, then click on
OPEN, and enter the name of the desired source file.
38. email.
EMAIL or electronic mail, is a method for exchanging
text-messages and for sending other types of computer files
(hypertext, images, video, audio, powerpoint) over the internet.
The chief advantages of email over traditional paper mail
are speed, copiability, and verification feedback,
namely, a notification that the email has reached a valid email address.
39. Parts of the email message. Every email contains a SUBJECT LINE
and a MESSAGE SECTION; and many emails contain ATTACHMENTS,
that might contain hypertext, images, video, audio, powerpoint files, etc.
The subject line of an email is like a postcard:
hundreds, perhaps thousands, of persons and computer-servers
can view it. The subject line should be short and informative,
but should not contain patient identifying information,
such as name, birthdate, or social security number.
Simply the fact the message is coming from a medical institution
or physician and contains a patient's identifiers informs
the onlooker that that patient is in the hospital,
which may be protected health information for that patient.
40. MESSAGE SECTION of the email message.
The message section is secure in VistA® email, but not in
Microsoft® Outlook email.
You should not send confidential protected
patient information in the
message-section of
Microsoft® Outlook email.
Protected information that should not be included in
Microsoft® Outlook email are:
(a) Names;
(b) All geographic subdivisions smaller than a State....
(c) All elements of dates (except year)....
(d) Telephone numbers;
(e) Fax numbers;
(f) Electronic mail addresses;
(g) Social security numbers;
(h) Medical record numbers;
(i) Health plan beneficiary numbers;
(j) Account numbers;
(k) Certificate/license numbers;
(l) Vehicle identifiers and serial numbers, including license plate numbers;
(m) Device identifiers and serial numbers;
(n) Worldwide Web Universal Resource Locators (URLs);
(o) Internet Protocol (IP) address numbers;
(p) Biometric identifiers, including finger and voice prints;
(q) Full face photographic images and any comparable images;
(r) Any other unique identifying number, characteristic, or code.....
41. ATTACHMENTS in email.
ATTACHMENTS are the most versatile, but also potentially
the most dangerous, components, of an email. Attachments may include
hypertext, word-processor files, images, video, audio, powerpoint,
and executable computer programs. An executable computer program
could be launched and destroy your computer's memory (see below).
YOU SHOULD NEVER OPEN EMAIL ATTACHMENTS FROM SENDERS THAT YOU DON'T KNOW,
NOR OPEN AN ATTACHMENT FROM A KNOWN SENDER THAT SEEMS UNCHARACTERISTIC
FOR THAT SENDER.
VistA® does not permit attachments,
and accepts only text messages, which are never executable files.
You will sometimes receive VistA® emails that are full of gibberish.
These are probably attachments, but they are harmless in VistA® email.
42. Unwanted email.
The chief drawback of email is the crushing overload of email
boxes by unwanted, unsolicited messages, so-called SPAM.
Most spam consists of unwanted pornography or get-rich-quick schemes.
Some spam consists of a VIRUS orWORM.
A worm fills up the user's computer with invisible junk,
and causes the computer to slow down its operation to a crawl.
A virus takes over the user's computer, and destroys its contents.
After either a worm or virus has invested the user's computer,
one must contact
Information Resources Management (IRM),
in order to clean up the computer's memory.
Some or all of your computer's memory may be lost.
Therefore, essential files should be backed up on a periodic basis,
to protect against such hostile infestations.
43. Protection against unwanted email.
The best way to protect against a virus or worm infesting
your computer is not to accept email from senders that you don't know,
nor to accept email from a known sender that seems uncharacteristic
for that sender, as for example, the notorious I LOVE YOU virus.
Thus, if you receive an email even from a person you know, who is unlikely
to say I LOVE YOU on the subject line, don't open the mail.
44. VistA® email
is a public-domain, non-proprietary email system,
available to all U. S. citizens through the Freedom of Information
Act. If you want a copy, go to URL:
http://www.hardhats.org
VistA® email accepts exclusively text-only email messages.
Since every virus or worm must be launched by an executable file,
VistA® email is effectively virus-proof.
VistA® email is also approved by the U. S. Federal Government
as being secure (in the Message Section only) for patient-specific
information. VistA® email is recommended for all communications
in the Veterans Affairs system that include exact patient identifiers,
or PROTECTED HEALTH INFORMATION (PHI), as defined by the
Health Insurance Portability and Accountability Act (HIPAA).
According to the Baltimore VAMHCS privacy office (see:
Procedure 153. Patient Privacy),
VistA® email is secure, but
Microsoft® Outlook email is not secure
for purposes of transmitting PHI.
45.
Microsoft® Outlook email is a proprietary commercial product,
which is very versatile, i.e., it accepts all kinds of input in the form
of attachments, that may be opened and copied by the recipient.
However, this versatility lso mean that an unwanted attachment
could launch a virus or worm in the user's computer. Furthermore,
Microsoft® Outlook email is subject to unauthorized viewing
by hostile outsiders, and is not secure for purposes of transmitting PHI.
46. Using VistA® email
LOGIN to VistA®. Then:
Select LABORATORY MENU Option: MAILMan Menu
VA MailMan 8.0 service for PATHOLOGIST.JOHN_Q@BALTIMORE.MED.VA.GOV
You last used MailMan: 04/08/03@10:36
You have 3 new messages.
Select MailMan Menu Option: N New Messages and Responses
Select New mail option: Read new mail by basket//
Subj: Hello World [#12345678] 04/08/03@11:40
From: SURGEON,JACK (VAMHCS BALTIMORE DIVISION) In 'IN' basket. Page 1
.........
Enter message action (in IN basket): Ignore//
47. Using VistA® email.
At the end of the email, you are prompted
to ENTER A MESSAGE ACTION.
You have the following choices:
Enter a code from the list.
A Answer P Print
B Backup Q Query
BR Print to the Browser Q xxx Query recipient(s) xxx
C Copy QC Query Current
D Delete QD Query Detailed
F Forward QN Query Network
H Headerless Print QNC Query Not Current
HG Help:Group Information QT Query Terminated
HU Help:User Information S Save
I Ignore T Terminate
L Later V Vaporize date edit
N New W Write
P=Print is particularly valuable, because it tells you who has
received the message and who has read the message, including yourself.
48. VistA® P=Print is particularly valuable,
because it tells you who has received the message
and who has read the message, including yourself.
Select MailMan Menu Option: RML Read/Manage Messages
Select message reader: Classic//
Read mail in basket: IN// SURGEON (5100 messages)
Last message number: 6100 Messages in basket: 5100
Enter ??? for help.
CONFIRM Basket Message: 1// 5100
Subj: Confirmation of message [#12345678] 03/08/03@11:35 3 lines
From: SURGEON,JACK In 'SURGEON' basket. Page 1
Your message:
Subj: URGENT PATHOLOGY REPORT BCY 03-1234.
has been read by SURGEON,JACK
Enter message action (in SURGEON basket): Ignore// Print
Print recipient list? No// YES
Select one of the following:
D Detail
S Summary
Print Detail or Summary recipient chain: Summary// Detail
DEVICE: HOME// VIRTUAL TERMINAL
MailMan message for PATHOLOGIST,JOHN Q PATHOLOGIST
Printed at BALTIMORE.MED.VA.GOV 04/08/03@13:54
Subj: Confirmation of message [#12345678] 03/08/03@11:35 3 lines
From: SURGEON,JACK In 'CONFIRM' basket. Page 1
Your message:
Subj: URGENT PATHOLOGY REPORT BCY 03-1234.
has been read by SURGEON,JACK.
Local Message-ID: 12345678BALTIMORE.MED.VA.GOV (1 recipient)
PATHOLOGIST,JOHN Q Last read: 04/08/03@13:54 [First read: 03/08/03@14:21]
Enter message action (in CONFIRM basket): Ignore//
49.
VistA® email is useful, because you may obtain a
listing of URGENT PATHOLOGY REPORTS that have not been responded-to:
Select LABORATORY MENU Option: PRINT Pathology Messages not read
Enter Start Date to look at messages: 9/1/2003 (SEP 01, 2003)
Enter End Date to look at messages: 9/30/2003 (SEP 30, 2003)
DEVICE: HOME// VIRTUAL TERMINAL Right Margin: 80//
Message Subject Message # Sender
URGENT PATHOLOGY REPORT BCY 03-1234 12345678 PATHOLOGIST,JOHN Q
URGENT PATHOLOGY REPORT BCY 03-5678 90123456 PATHOLOGIST,JOHN Q
URGENT PATHOLOGY REPORT BCY 03-9012 78901234 SPECIALIST,MARY G
URGENT PATHOLOGY REPORT BCY 03-3456 56789012 SPECIALIST,MARY G
URGENT PATHOLOGY REPORT BSP 03-7890 34567890 SPECIALIST,MARY G
URGENT PATHOLOGY REPORT BSP 03-1234 12345678 SPECIALIST,MARY G
URGENT PATHOLOGY REPORT BSP 03-5678 90123456 SPECIALIST,MARY G
Select LABORATORY MENU Option:
Each patient/report is checked to determine whether some other electronic
followup has been documented, such as a CPRS note from the same
service that submitted the original report. If no such CPRS report
is apparent, then the case is reported to the IPRC.