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Release Notes

SAP for Healthcare


SAP enhancement package 4 for SAP ERP 6.0

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Business Function SAP Ambulatory Care Management: Legal Process
Adoption ...................................................................................................... 11
ISH_AMB_MISC1: SAP Ambulatory Care Mgmt: Legal Process Adoption (New) .......... 11
ISH_AMB_MISC1: Renewable Doc. Management: Independent Ren. Doc. (New) ........ 13
ISH_AMB_MISC1: ES: Renewable Doc. Mgmt: Country Version Spain (New) .............. 14
ISH_AMB_MISC1: Ren. Doc. Mgmt in Outp. Clinic/Serv. Fac. Work Station (New) ....... 16
ISH_AMB_MISC1: Documentation Work Station: New Documentation Objects (New) .. 18
Business Function SAP Patient Management Rearchitecture BP/OM ........ 20
ISH_BP_OM: Business Function SAP Pat Mgmt Rearchitecture BP/OM (New) ............. 20
ISH_BP_OM: Overview (New) ......................................................................................... 22
ISH_BP_OM: Value Helps of Hospital Structure and Business Partner (New) ............... 25
ISH_BP_OM: Migration of BP and Hosp. Structure Data (New) ...................................... 26
ISH_BP_OM: Maintenance of Org., Building, and Hierarchy Data (New) ....................... 27
ISH_BP_OM: Existing/New Infotypes and Their Semantics (New) ................................. 29
ISH_BP_OM: Institution (New) ......................................................................................... 31
ISH_BP_OM: Transactions (New) .................................................................................... 32
ISH_BP_OM: Identification Key for Org. and Building Units (New) ................................. 33
ISH_BP_OM: Mig. Programs for Phase 1 - Mig. Prep. (New) ......................................... 35
ISH_BP_OM: Programs for Phase 3- Steps During Downtime (New) ............................. 37
ISH_BP_OM: Data Migration Programs for Phase 4 (New) ............................................ 39
ISH_BP_OM: Adaptation of Customer Code in OM (New) .............................................. 40
ISH_BP_OM: Changeover (New)..................................................................................... 43
ISH_BP_OM: Business Partner Terminology (New) ........................................................ 44
ISH_BP_OM: New Transactions (New) ........................................................................... 45
ISH_BP_OM: New Roles and Corresponding Role Categories for BPs (New) ............... 46
ISH_BP_OM: Address Validation (New) .......................................................................... 48
ISH_BP_OM: Locator Search - To Search a Business Partner (New) ............................ 49
ISH_BP_OM: Business Partner Relationships (New) ...................................................... 50
ISH_BP_OM: Integration with FI (New) ........................................................................... 51
ISH_BP_OM: User Interface Changes (New) .................................................................. 52
ISH_BP_OM: Adaptation of Customer Code in BP (New) ............................................... 53
ISH_BP_OM: AT, CH, FR: Business Partner: New Fee Recipient Role (New) ............... 54
ISH_BP_OM: BP Migration: Phases (New) ..................................................................... 55
ISH_BP_OM: BP Migration: Number Assignments (New) ............................................... 57
ISH_BP_OM: BP Migration: SAP BP Customizing (New) ............................................... 58
ISH_BP_OM: BP Migration: Invalid FI Assignments (New) ............................................. 59
ISH_BP_OM: BP Migration: FI Synchronization Links (New) .......................................... 60
ISH_BP_OM: BP Migration: Master Data and Relationships (New) ................................ 61
ISH_BP_OM: BAPI "BAPI_BUSPARTNER_CHANGE" (New) ........................................ 64
ISH_BP_OM: Business Partner Grouping for Patients and Next of Kin (New) ................ 65
ISH_BP_OM: Address Maintenance for Patient from CPB (New) ................................... 66
ISH_BP_OM: Maintaining Next of Kin from CPB (New) .................................................. 67
ISH_BP_OM: Patient's Employer - Additional Name Field (New) ................................... 68
ISH_BP_OM: Death Data Subscreen in Clinical Process Builder (New) ......................... 69
ISH_BP_OM: Risk Factors Subscreen in CPB (New)...................................................... 70

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ISH_BP_OM: Address Usages for Patient Addresses (New) .......................................... 71
Business Function SAP Patient Management Country Version France ...... 72
ISH_CV_FR: Business Function SAP Pat Mgmt Country Version France (New) ........... 72
ISH_CV_FR: Institution (New) .......................................................................................... 75
ISH_CV_FR: Institution-Related Country-Specific Control Table .................................... 76
ISH_CV_FR: Insurance Provider Master Data (New) ...................................................... 78
ISH_CV_FR: Physician Master Data (New) ..................................................................... 79
ISH_CV_FR: Service Master Data (New) ........................................................................ 80
ISH_CV_FR: Importing Service Catalogs ........................................................................ 82
ISH_CV_FR: Import Diagnosis Catalog CIM10 (New) ..................................................... 83
ISH_CV_FR: Import Diagnosis Category Catalog CMD (New) ....................................... 84
ISH_CV_FR: Movement Data (New)................................................................................ 85
ISH_CV_FR: Movement Types (New) ............................................................................. 86
ISH_CV_FR: Movement Data (New)................................................................................ 87
ISH_CV_FR: Movement Types (New) ............................................................................. 88
ISH_CV_FR: Case Categories (New) .............................................................................. 89
ISH_CV_FR: Patient Master Data - Birth Rank (New) ..................................................... 90
ISH_CV_FR: Insurance Card Carte Vitale: Import Card Data (new) ............................... 91
ISH_CV_FR: Close Radiotherapy Preparation Case (New) ............................................ 92
ISH_CV_FR: Outpatient Visit: Entry of Coordinated Care Path (New) ............................ 93
ISH_CV_FR: Health Ins. Card Carte Vitale: Insurance Relationship (New) .................... 94
ISH_CV_FR: Ins. Relationships for Statutory Health Ins. Schemes (New) ..................... 95
ISH_CV_FR: Check When Entering Insurance Relationships (New) .............................. 96
ISH_CV_FR: Check on Social Insurance Number (New) ................................................ 97
ISH_CV_FR: Contract Schemes: Grouping Key (New) ................................................... 98
ISH_CV_FR: Diagnosis Entry (New) ................................................................................ 99
ISH_CV_FR: New Fields in Service Entry (New) ........................................................... 100
ISH_CV_FR: Service Rules: F00 - Gen. of Patient Contribution Service ...................... 101
ISH_CV_FR: Service Rules: F01 - Complementary Services (New) ............................. 102
ISH_CV_FR: Service Rules: F02 - Fee Surcharge (New) ............................................. 103
ISH_CV_FR: Service Rules: F03 - Remap NABM Services (New) ............................... 105
ISH_CV_FR: Service Rules: F04 - LPP Material Services (New) .................................. 106
ISH_CV_FR: Service Rules: F06 - Association Code (New) ......................................... 107
ISH_CV_FR: Service Rules: F05 - Patient Contribution Exemption (New) ................... 108
ISH_CV_FR: Service Rules: F07 - Generate Daily Hospital Rate (GHS) (New) ........... 109
ISH_CV_FR: Service Rules: F08 - GHS Service (Mother-Child) (New) ........................ 110
ISH_CV_FR: Service Rules: F09 - Generate EXH Surcharge (GHS) (New) ................. 111
ISH_CV_FR: Service Rules: F10 - Per Diem Fee.......................................................... 112
ISH_CV_FR: Service Rules: F11 - Per Diem Fee - Public Hospital (New) .................... 113
ISH_CV_FR: DRG Work Station: Process DRG-Relevant Data (New) ......................... 114
ISH_CV_FR: Billing Type Determination (New) ............................................................. 115
ISH_CV_FR: Insurance Verification: ISH_CV_FR: Payment Distribution: Enhancement of
Payment Distribution (new) ........................................................................................... 116
Create, Print IV Requests (new)..................................................................................... 117
ISH_CV_FR: Fee-Based Billing (New) ........................................................................... 118
ISH_CV_FR: Display of EDI Status in Case-Related Billing (New) ............................... 119
ISH_CV_FR: EDI: RSF - Std Inv. Messages in Private Sector - Outp. Clinic ................ 120
ISH_CV_FR: Communication: B2 - Electronic Invoice Transfer .................................... 121

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ISH_CV_FR: EDI Comm.: LPP - FICHKOMP File for Medical Products (New) ........... 122
ISH_CV_FR: EDI - Comm.: RSF - Standardized Inv. Messages Inpatient (new) ......... 123
ISH_CV_FR: EDI: RSP - Standardized Message for Radiotherapy Prep. (new) ......... 124
ISH_CV_FR: EDI - Communication: RSS - Standardized Discharge Message (new) . 125
ISH_CV_FR: EDI - Comm.: UCD - FICHKOMP File for Drugs (new) ........................... 126
ISH_CV_FR: EDI - Comm.: VIDHOSP-File for Treatments (new) ................................ 127
ISH_CV_FR: Response to Electronic Invoice - NOEMIE (New) .................................... 128
ISH_CV_FR: Rules for Creating FI Document/Electronic Invoice (B2) (New) ............... 129
Business Function SAP Patient Management Country Version Italy ........ 130
ISH_CV_IT: Business Function SAP Patient Management: CV Italy ............................ 130
ISH_CV_IT: Patient Data at Case Level for Inpatient Cases (New) .............................. 130
ISH_CV_IT: Billing of Treatment Certificates (New) ...................................................... 130
ISH_CV_IT: Calculating the Patient Contribution (New) ................................................ 131
ISH_CV_IT: Default Amount for Down Payments (New) ............................................... 132
ISH_CV_IT: Enhancement for Treatment Certificates (New) ........................................ 133
ISH_CV_IT: Collective Invoice (Changed) ..................................................................... 134
Business Function SAP Patient Management........................................... 136
ISH_MAIN: Business Function SAP Patient Management ............................................ 136
ISH_MAIN: Field Catalog Enhancement in Report RNAENT00 (Enhanced) ................ 138
ISH_MAIN: Form Output with PDF-Based Print Forms (New) ....................................... 138
ISH_MAIN: Proc. Rules for Gen. Single-Quantity and Summary PCs (New) ................ 139
ISH_MAIN AT: Scoring - EDI System Control (Changed) ............................................. 143
ISH_MAIN AT: Insurance Relationships / Third-Party Payers (Changed) ..................... 144
ISH_MAIN AT: Valuation Formula "22" (Changed) ........................................................ 145
ISH_MAIN AT: P321 - BAdI Enhancements (Enhanced) .............................................. 146
ISH_MAIN AT: Patient Management - Electronic Health Ins. Card (E-Card) ................ 147
ISH_MAIN AT: Data Medium Exchange with Private Insurers (EDIVKA) ...................... 148
ISH_MAIN AT: EDI Workb./Worklist - Dispatch Orders for Outp.Cases (Chgd) ............ 149
ISH_MAIN AT: File Creation (Changed) ........................................................................ 150
ISH_MAIN AT: EDI Data Medium Exchange - ELDAL Comm. Procedure (Changed) .. 151
ISH_MAIN AT: Movements and Case Revision with Intensive Care Data (New) .......... 152
ISH_MAIN AT: EDI Data Medium Exchange - Messages (Changed) ........................... 153
ISH_MAIN AT: Printing Coverage Extensions (Changed) ............................................. 154
ISH_MAIN AT: EDI Worklist - Dependent Messages (Changed) .................................. 155
ISH_MAIN AT: Coverage Evidence List (RNWATKUELIST) (Changed) ....................... 156
ISH_MAIN AT: LR A5/15, A9 - Use of Max. Values (with Groups) (Changed) .............. 157
ISH_MAIN AT: Service Rule for Pat. Contribution Gen. (AK) (Changed) ...................... 158
ISH_MAIN AT: Message Control (Changed) ................................................................. 159
ISH_MAIN AT: Settings for Cancelling Dependent Services (New) .............................. 160
ISH_MAIN AT: EDI Communication Procedure P321 (Changed) ................................. 161
ISH_MAIN AT: Changed Behavior for Receipt of Messages (Changed) ....................... 162
ISH_MAIN AT: New Report IS-H AT: Coverage Reminder (New) ................................. 163
ISH_MAIN AT: Collective Printing of Admission/Discharge Notifs (Changed) .............. 164
ISH_MAIN AT: EDI Data Transfer - Comm. Proc. SCO04 (Changed) .......................... 165
ISH_MAIN AT: Layout of Scoring Work Station (Changed) ........................................... 166
ISH_MAIN AT: Overriding Content of WIKRAF-V Record (New) .................................. 167
ISH_MAIN AT: Statutory Stats for Stat. Cases (RNWATSTATISTIK) (Chgd) ............... 168
ISH_MAIN AT: Statutory Statistics for Outpatient Cases (Changed)............................. 169

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ISH_MAIN AT: CPB - Subscreen AT: Contract Partner Number (Changed) ................. 170
Business Function SAP Patient Management: Legal Process Adoption ... 171
ISH_MISC1: Business Function SAP Pat. Mgmt: Legal Process Adoption (New) ........ 171
ISH_MISC1: SAPscript for Long Text and Comment Fields (New) ............................... 177
ISH_MISC1: Checking Prerequisites Before Calling an API/BAPI (New) ...................... 178
ISH_MISC1: New Features of the Clinical Work Station (New) ..................................... 179
ISH_MISC1: Add. Fields for Assessing Vitality in Delivery Data (New) ......................... 180
ISH_MISC1: Checks on Req. Entry Fields on CPB Subscreens (New) ........................ 181
ISH_MISC1: Sec. View for Outpat.Clinic/Svce Facility Type Views (New) .................... 183
ISH_MISC1: Where-Used List for Function- or User-Related Objects (New) ................ 184
ISH_MISC1: Search for Similar Patients by Social Insurance Number (New) .............. 185
ISH_MISC1: Delivery Date Entered by Default as Birthdate of Newborn (New) ........... 186
ISH_MISC1: Displaying DRG Long Texts in SAPscript (New) ...................................... 187
ISH_MISC1: Procedures - Default Values from Movement (New) ................................ 188
ISH_MISC1 DE: Classifying Surgical Diagnoses (New) ................................................ 189
ISH_MISC1: Risk Information - Displaying Change Documents (New) ......................... 190
ISH_MISC1: Final Billing Possible Without (Billable) Services (New) ........................... 191
ISH_MISC1: Enhanced Catalog Column Determination (New) ..................................... 192
ISH_MISC1: BAdI ISH_INVOICE_CHECK - Interface Enhancement (New) ................. 193
ISH_MISC1: Service Entry - Simplified Physician Entry Function (New)....................... 195
ISH_MISC1: Contract Scheme (New) ............................................................................ 196
ISH_MISC1 Interface for Invoice Form - VAT Registration Number (New) ................... 198
ISH_MISC1: New Fields in the Service Master (New) ................................................... 199
ISH_MISC1: Coding Procedures Using External Module (New) ................................... 200
ISH_MISC1: Default Entry for Cancellation Date (New) ................................................ 201
ISH_MISC1: Individual Payment Distribution (New) ...................................................... 202
ISH_MISC1: Checking Catalogs/Proposals/Closets Against Mat. Master (New) .......... 203
ISH_MISC1: Mass Maintenance of Material Catalogs (New) ........................................ 204
ISH_MISC1: Output Authorization for Specific OUs in Reports (New) .......................... 205
ISH_MISC1: Case Exclusions for Communication Procedures (New) .......................... 206
ISH_MISC1: Search help for document number (New) ................................................. 208
ISH_MISC1: Enhanced report Mass Maint. Mat. Catlgs (RNUMKAT4)(new)................ 209
ISH_MISC1: Requirement Prioritization (new) ............................................................... 210
ISH_MISC1: Maintain Material Proposal List (New) ...................................................... 211
ISH_MISC1: Service-Based Appointment Search (New) .............................................. 212
ISH_MISC1: Catalog Column Determination (New) ...................................................... 214
ISH_MISC1: Pricing (New) ............................................................................................. 215
ISH_MISC1: Outbound Processing of Services (New) .................................................. 216
ISH_MISC1: Inbound Processing of Services (New) ..................................................... 218
ISH_MISC1: Enterprise Services (New) ........................................................................ 221
ISH_MISC1: IS-H IHE/HL7 compliant services (new) .................................................... 229
ISH_MISC1, ISHMED_MAIN: Interface IF_ISH_OBJECT_TYPES (Deleted) ............... 230
ISH_MISC1 AT: Work Center - Online Scoring/Int. Care Data Integrated ..................... 234
ISH_MISC1 AT: LKF Scoring for Services (SMS) (New) ............................................... 235
ISH_MISC1 AT: Data Exchange Comm. Procedure P321/ELDAL (Changed) .............. 236
ISH_MISC1 AT: File Import Program for IV for Inpatient Cases (New) ......................... 238
ISH_MISC1 AT: User-Specific Scoring Parameters in Control Table (New) ................. 239
ISH_MISC1 AT: Statistics of Inpatient Cases (New)...................................................... 240

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ISH_MISC1 AT: Address - Checks on Postal Code / City (New) ................................... 242
ISH_MISC1 AT: RN1FKLA0 - "Movements - Classification" (Deleted) .......................... 243
ISH_MISC1 CH, AT, FR: Determine Fee-Based Services (New) .................................. 244
ISH_MISC1 CH: INXML 4.0 - Suppressing "Zero Invoices" (New) ................................ 245
ISH_MISC1 CH: IV - Specifying Printer on Selection Screen (New) ............................. 246
ISH_MISC1 CH: Report for Assigning Contract Scheme (New) .................................... 247
ISH_MISC1 CH: Organizational Management - Division (New) .................................... 248
ISH_MISC1 CH: Item Data for Billing Agreement (New) ............................................... 249
ISH_MISC1 AT, CH, FR: Depreciation of Fee-Based Services (New) .......................... 250
ISH_MISC1 CH: Service Rules (New) ........................................................................... 251
ISH_MISC1 CH: Service Rule - Assign Fee Physician / Function (New) ..................... 253
Business Function SAP Patient Management Treatment Certificates ...... 254
ISH_TC: Business Function SAP Pat Mgmt Treatment Certificates (New) ................... 254
ISH_TC: Treatment Certificate Administration (New) .................................................... 255
ISH_TC: Case Revision: Reassigning Treatment Certificates (New) ............................ 260
ISH_TC: View Type for Treatment Certificates (New) ................................................... 261
Business Function Klinisches System Enhanced Documentation Processes
.................................................................................................................. 262
ISHMED_EDP: Business Function Clinical System EDP .............................................. 262
ISHMED_EDP: Implementation Support - Overview (New) ........................................... 263
ISHMED_EDP: Implementation Support: Customizing Transfer Manager (New) ......... 264
ISHMED_EDP: Implementation Support: Customizing Export Wizard (New) ............... 266
ISHMED_EDP: Implementation Support: Customizing Import Wizard (New) ............... 268
ISHMED_EDP: Implementation Support - PMD Import Wizard (New) .......................... 270
ISHMED_EDP: Implementation Support - Licensing (New) .......................................... 271
ISHMED_EDP: Clinical Documentation: Inpatient Progress Note (New) ...................... 272
ISHMED_EDP: Application Logging - Overview (New).................................................. 273
ISHMED_EDP: Application Logging - Setup Functions (New) ...................................... 276
ISHMED_EDP: Application Logging - Technical Implications (New) ............................. 280
ISHMED_EDP: Surgery Work Station - Template Management (New)......................... 287
ISHMED_EDP: Radiology Work Station - Preparation (New) ........................................ 289
ISHMED_EDP: Radiology Work Station (New) .............................................................. 291
ISHMD_EDP: Ward Documentation Work Station (New) .............................................. 294
ISHMD_EDP: Clinical Task Management for Care Units (New) .................................... 296
ISHMED_EDP: Clinical Overview (New) ........................................................................ 297
ISHMD_EDP: Ward Documentation Work Station - Charting (New) ............................. 299
Business Function Klinisches System ....................................................... 300
ISHMED_MAIN: Business Function Clinical System ..................................................... 300
ISH_MISC1, ISHMED_MAIN: Interface IF_ISH_OBJECT_TYPES (Deleted) ............... 305
ISHMED_MAIN: List of Available User Parameters (Deleted) ....................................... 309
ISHMED_MAIN: Cardiology Departmental Solution (New) ............................................ 310
ISHMED_MAIN: Delete Obsolete ABAP Objects (Deleted) ........................................... 311
ISHMED_MAIN: Call Layout Control (Changed) ............................................................ 312
ISHMED_MAIN: Maintenance Doc.Ctgrs Gen.Ver.1 Discontinued (Changed) ............. 313
ISHMED_MAIN: New and Changed API Methods (Changed) ....................................... 314
ISHMED_MAIN: Parameterization of Combo Boxes (Changed) ................................... 315
ISHMED_MAIN: Copying and Transporting Document Categories (Changed) ............. 316

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ISHMED_MAIN: Print Format XLSFO (New) ................................................................. 317
ISHMED_MAIN: Print Format BAdI (Changed) .............................................................. 318
ISHMED_MAIN: Text Modules in Long Text Fields (Changed) ..................................... 319
ISHMED_MAIN: Integration of Your Own Long Text Editor (New) ................................ 320
ISHMED_MAIN: Print Preview of Enhanced Texts and Long Texts (Changed) ............ 321
ISHMED_MAIN Implementation Support for PMDs (New) ............................................ 322
ISHMED_MAIN: PMD System Transport- Program RN2UTDTS3 (Changed) .............. 323
ISHMED_MAIN: PMD System Transport - Program RN2UTDTS_EUOBJ (New) ......... 324
ISHMED_MAIN: Using Document Categories RN2UTDT_USE (New) ......................... 325
ISHMED_MAIN: New Report for Copying Document Types (Changed) ....................... 326
ISHMED_MAIN: Dictation Work Station (New) .............................................................. 327
ISHMED_MAIN: Provisional Patients Without Last Names (New) ................................ 330
ISHMED_MAIN: Procedure Generation - Service Assignment (New) ........................... 331
ISHMED_MAIN: Outpatient Clinic/Service Facility View Type - N1_WP_LSTAMB
(Modified)........................................................................................................................ 332
ISHMED_MAIN: Clinical Orders View Type - Selection Screen (Changed) .................. 333
ISHMED_MAIN: End of Maintenance for Obsolete ABAP Objects (Deleted) ................ 334
ISHMED_MAIN: Use of Dictation Systems in i.s.h.med (New) ...................................... 335
ISHMED_MAIN: Integration of Dictation Functions in PMDs (New) .............................. 336
ISHMED_MAIN: Functions of DICTATION Link Module (New) ..................................... 337
ISHMED_MAIN: Dictation and Speech Recognition via Dialog Box (New) ................... 340
ISHMED_MAIN: Dictation and Speech Recognition in the WordContainer (New) ........ 341
ISHMED_MAIN: Laboratory Cumulative Findings - Web Dynpro Application (New) ..... 342
ISHMED_MAIN: Delete Obsolete ABAP Objects (Deleted) ........................................... 343
ISHMED_MAIN: Print Format XLSFO (New) ................................................................. 344
ISHMED_MAIN: Print Format BAdI (Changed) .............................................................. 345
ISHMED_MAIN: Dispatch Route EDIVKA for Document Dispatch AT (New) ............... 346
ISHMED_MAIN: OU-Related Document Profile (Changed) .......................................... 347
ISHMED_MAIN: Service-Related Document Profile (Changed) .................................... 349
ISHMED_MAIN: Evaluations - Master Data (Enhanced) ............................................... 351
ISHMED_MAIN: Use of Selection Variants (New) ......................................................... 352
ISHMED_MAIN: WordContainer Documents - "Get Data" (Enhanced) ......................... 353
ISHMED_MAIN: BAdI ISHMED_DOC_CONTENT Has Been Replaced (Enhanced) ... 354
ISHMED_MAIN: Dispatch Control (New) ....................................................................... 355
ISHMED_MAIN: Maintenance for Document Dispatch Discontinued (Changed) .......... 356
ISHMED_MAIN: Message Control in Diagnosis Processing (Changed) ....................... 357
ISHMED_MAIN: Preregistration - Business Add-Ins (Deleted) ...................................... 358
ISHMED_MAIN: Clinical Order - New Business Add-Ins (New) .................................... 359
ISHMED_MAIN: Order Item Component for Questions (New) ...................................... 360
ISHMED_MAIN: Enhanced Selection List for Order Types (New) ................................. 361
ISHMED_MAIN: Order Templates (New) ....................................................................... 362
ISHMED_MAIN: Clinical Order - Various Changes (Changed) ..................................... 364
ISHMED_MAIN: Header/Item Components - Flagging of Required Entry Fields (New) 367
ISHMED_MAIN: Order Item - Integration in Component Concept (New) ...................... 368
ISHMED_MAIN: Order Item - Service Planning/Scheduling (Changed) ........................ 370
ISHMED_MAIN: Service Component - Integration of Planning (New) ........................... 372
ISHMED_MAIN: Patient Organizer - New Functions and Objects (New) ...................... 374
ISHMED_MAIN: Patient Organizer - Inpatient Progress Note (New) ............................ 375

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ISHMED_MAIN: Service Component - Integration of Planning (New) ........................... 377
ISHMED_MAIN: Planning Authority for all Organizational Units (New) ......................... 379
ISHMED_MAIN: Planning Grid - Open Clinical Order in Change Mode (New) ............. 380
ISHMED_MAIN: Planning Grid - Print Function (New) .................................................. 381
ISHMED_MAIN: Planning Grid Variant Management (Changed) .................................. 382
ISHMED_MAIN: Planning Grid - New and Enhanced Business Add-Ins (New) ............ 384
ISHMED_MAIN: Planning Grid - Uniform Platform (Changed) ...................................... 385
ISHMED_MAIN: Planning Grid - Planning and Displaying Day-Based Appointments
(New) .............................................................................................................................. 386
ISHMED_MAIN: Planning Functions - Integration of Group Appointments (New) ........ 388
ISHMED_MAIN: Maintain Appointment - Admission Appointments (New) .................... 389
ISHMED_MAIN: Planning - Time Slot Synchronization (New) ...................................... 390
ISHMED_MAIN: Planning - Various Changes and Enhancements (Changed) ............. 391
ISHMED_MAIN: Planning - Optimized Process Support in Appointment Planning (New)
........................................................................................................................................ 394
ISHMED_MAIN: Planning - Replaced User Exits (Deleted) .......................................... 395
ISHMED_MAIN: Discontinued Surgery Transactions (Deleted) .................................... 396
ISHMED_MAIN: Surgery Times (Enhanced) ................................................................. 398
ISHMED_MAIN: Surgical Documentation (Enhanced) .................................................. 400
ISHMED_MAIN: Surgery Complications (Enhanced) .................................................... 401
ISHMED_MAIN: OR - Hierarchy in Input Helps (Changed) ........................................... 402
ISHMED_MAIN: Authorizations for Surgery Times (Enhanced) .................................... 403
ISHMED_MAIN: DE: Business Premises Number in the Data Export Program (Changed)
........................................................................................................................................ 404
ISHMED_MAIN: DE: Coding of the Export Files (Changed) .......................................... 405
ISHMED_MAIN: DE: Creating a Minimum Data Record (New) ..................................... 407
ISHMED_MAIN: Drug Master - General (New) .............................................................. 408
ISHMED_MAIN: Structuring in Drug Master (New) ........................................................ 409
ISHMED_MAIN: Drug Master - General Parameters (New) .......................................... 410
ISHMED_MAIN: Drug Messages (New) ........................................................................ 411
ISHMED_MAIN: Assignment of Drugs to Fill Sources (New) ....................................... 412
ISHMED_MAIN: New Drug Search - Customizing (New) .............................................. 413
ISHMED_MAIN: New Drug Search - General (New) ..................................................... 415
ISHMED_MAIN: Medication - User Favorites (New)...................................................... 416
ISHMED_MAIN: Medication - User-Specific Presettings (New) .................................... 417
ISHMED_MAIN: Cycle - Enhancements (New) ............................................................. 418
ISHMED_MAIN: Medication Order - Various New Features (New) ............................... 419
ISHMED_MAIN: Order Activities (New) ......................................................................... 422
ISHMED_MAIN: Order Sequences (New) ..................................................................... 423
ISHMED_MAIN: Integration of Order in Documentation Work Station (New) ............... 425
ISHMED_MAIN: Integration of Chart in Order (New) ..................................................... 426
ISHMED_MAIN: Simplified Dose Definition (New)......................................................... 427
ISHMED_MAIN: Ordering Generic Drugs (New) ........................................................... 429
ISHMED_MAIN: Patient Transport Service - Means of Transport (New) ...................... 430
ISHMED_MAIN: Transport Orders for Provisional Patients (New) ................................ 431
ISHMED_MAIN: Patient Transport Service - Web Services (New) ............................... 432
ISHMED_MAIN: Connectivity (Changed) ....................................................................... 433
ISHMED_EDP: Radiology Work Station - Preparation (New) ........................................ 437

9
ISHMED_MAIN: i.s.h.med pathways: Overview of Changes (Changed) ....................... 439
ISHMED_MAIN: Customizing Work Station Layout (Changed) ..................................... 440
ISHMED_MAIN: Enhancement of Information Units (Changed) .................................... 441
ISHMED_MAIN: Revision of Dialog Layouts (Changed) ............................................... 443
ISHMED_MAIN: Note Function (Enhanced) .................................................................. 444
ISHMED_MAIN: Pathway Proposals in the Clinical Work Station (New)....................... 447
ISHMED_MAIN: Patient Pathways in the Clinical Work Station (Enhanced) ................ 449
ISHMED_MAIN: Pathway Log (New) ............................................................................. 450
ISHMED_MAIN: Undoing Activities (New) ..................................................................... 451
ISHMED_MAIN: Evaluations (New) ............................................................................... 452
ISHMED_MAIN: Changing Active Pathways (New) ....................................................... 454
ISHMED_MAIN: Deleting Treatment Pathways (New) .................................................. 456
ISHMED_MAIN: Deleting Treatment Pathway Assignments (New) .............................. 457
ISHMED_MAIN: Unique Indicator (New) ....................................................................... 458
ISHMED_MAIN: Action Behavior at Status Change (New) ........................................... 459
ISHMED_MAIN: BAdI for Activities (New) ..................................................................... 460
ISHMED_MAIN: Treatment Pathways - Further Changes (Enhanced) ......................... 461
ISHMED_MAIN: Patient Pathways in the Clinical Work Station (Enhanced) ................ 462

10
Business Function SAP Ambulatory Care Management: Legal
Process Adoption
ISH_AMB_MISC1: SAP Ambulatory Care Mgmt: Legal Process
Adoption (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4, (IS-
H 604), the business function SAP Ambulatory Care Management: Legal Process
Adoption (ISH_AMB_MISC1) is available. You can use this business function to
implement enhancements that include improvements to processes based on legal
changes.
The business function supports your outpatient processes. It includes new functions in
SAP Ambulatory Care Management and supports you in renewable document
management.
Users benefit from the enhanced functions and increased transparency, which speed
up treatment and simplify documentation. The renewable document management
function allows the user to document the layout of various forms for initial and renewed
documents.
o Documentation Work Station: new documentation objects (enhanced)
Target group: users of the documentation work station in SAP Ambulatory Care
Management. The documentation work station in SAP Ambulatory Care
Management contains the additional documentation objects renewable
documents and accident data.
These functions allow the user to define tasks for renewable documents and to
enter accident data for use in the documentation work station. This increases
transparency and improves efficiency in the user's day-to-day work.
o Renewable Document Management
Target group: all users of SAP Ambulatory Care Management.
Renewable document management allows the user to generate renewed
documents for initial documents, for example work incapacity certificates, which
can then be edited at the same location.

For more information, see the following release notes:


o ISH_AMB_MISC1: Renewable Doc. Management: Independent
Ren. Doc. (New)
o ISH_AMB_MISC1: ES: Renewable Doc. Mgmt: Country Version
Spain (New)
o ISH_AMB_MISC1: Ren. Doc. Mgmt in Outp. Clinic/Serv. Fac.
Work Station (New)
o ISH_AMB_MISC1: Doc. Work Station: New Documentation
Objects (New)
Effects on System Administration
To use this function, you must activate the business function SAP Ambulatory Care
Management (ISH_AMBULATORY).
See also
For more information, see the SAP Library under Business Function Sets and
Business Functions -> Healthcare -> SAP Patient Management -> SAP

11
Ambulatory Care Management: Legal Process Adoption.
For more information about Support Package release notes for SAP Patient
Management and SAP Ambulatory Care Management, see SAP Service Marketplace
under the quick link /healthcare-releasenotes.

12
ISH_AMB_MISC1: Renewable Doc. Management: Independent Ren.
Doc. (New)
Use
Up to and including SAP ECC 6.0, Industry Extension Healthcare, Enhancement
Package 4 (IS-H 604), you were able to create an initial document, a number of
renewed documents, and a final document for a renewable document chain. As of SAP
ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H 604),
Business Function SAP Ambulatory Care Management: Legal Process Adoption
(ISH_AMB_MISC1), a new renewable document category, "Independent Renewable
Document", has been created.
You can enter an independent renewable document for information and documentation
purposes. An independent renewable document lies outside of the chronological
sequence of an existing renewable document chain.
Examples:
o Application for health resort treatment
o Application for recognition of a severe disability, for example, in cases of chronic
illness
You can create up to 1000 renewable documents in a renewable document chain,
including independent documents.

13
ISH_AMB_MISC1: ES: Renewable Doc. Mgmt: Country Version Spain
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Ambulatory Care Management: Legal Process
Adoption (ISH_AMB_MISC1), changes have been made to the screens for the
Spanish country version of renewable document management.
Effects on Existing Data
o Details subscreen 310 (changed):
- Days field added
- Months field added
- SI Proc. Type (social insurance processing type) field added; the values
for the dropdown list box are supplied by method
GET_LISTBOX_VALUES of the Business Add-In (BAdI)
ISH_NREDOMA_LAYOUT.
- Empl. Type (employment type) field added
o Diagnoses subscreen 320 (changed):
- Only one diagnosis is allowed in the Spanish country version.
- The system does not display the long text.
- DTEXT3 (which contains the second long text field from the diagnosis
catalog) is visible in display mode.
o Employer subscreen 350 (new):
- This subscreen was developed for the country version Spain and is visible
there only.
- The table is provided by the customer using the BUILD_GUI_ALV_GRID
method of the ISH_NREDOMA_LAYOUT Business Add-In (BAdI) and
should contain employer data.
- The Responsible Employer field is a dropdown list box; the values are
provided using the GET_LISTBOX_VALUES method of the
ISH_NREDOMA_LAYOUT-GET_LISTBOX_VALUES BAdI.
o Confirmation/Discharge subscreen 360 (new):
- This subscreen was developed for the country version Spain and is visible
there only.
- The Discharge Reason field is a dropdown list box; the values are
provided using the GET_LISTBOX_VALUES method of the
ISH_NREDOMA_LAYOUT-GET_LISTBOX_VALUES BAdI.
o Invalidity Record subscreen 370 (new):
- This subscreen was developed for the country version Spain and is visible
there only.
- The Application Result field is a dropdown list box; the values are
provided using the GET_LISTBOX_VALUES method of the
ISH_NREDOMA_LAYOUT BAdI.

The INIT_OVERVIEW_TREE method of the ISH_NREDOMA_LAYOUT BAdI is still

14
available, allowing the customer to change the layout of the renewable document
overview (ALV tree) on the overview subscreen.
The UPDATE_OVERVIEW_TREE method of the ISH_NREDOMA_LAYOUT BAdI
refreshes the renewable document overview when changes are made.

15
ISH_AMB_MISC1: Ren. Doc. Mgmt in Outp. Clinic/Serv. Fac. Work
Station (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Ambulatory Care Management: Legal Process
Adoption (ISH_AMB_MISC1), the outpatient clinic/service facility work
station (outpatient view of the clinical work station) contains the following
functions for renewable document management. You can now display various
renewable documents (for example, WI work incapacity certificate, AM work incapacity
certificate for mothers, and so on) in the worklist in the clinical work station and execute
the functions listed below.
You can incorporate columns in the layout of the outpatient clinic/service facility work
station to display the following attributes of a renewable document:
o RenStart - renewable document start
o Ren. End - renewable document end
o Ren.Pl.E - renewable document planned end
o RenDocCg - renewable document category (for example, initial document,
independent renewable document)
o Ren.Sts - renewable document status
o RenDocTy - renewable document type (for example, WI, AM, fit-for-sport
certificate FFS)
Choose Change Selection (and/or use the selection variant) to select the renewable
document types the system is to include for display.
You can only display the current renewable document for each patient.
The following functions are available:
o Renewable document overview:
You use the Renew. Doc. Overview function to display the renewable
documents for the selected patient in Renewable Document Management.
o Create final document
You use the Create Final Doc. function to create a final document based on the
current renewable document.
o Create independent renewable document
You use the Create Indep. Ren. Doc. function to create an independent
document based on the current renewable document.
o Renew document
You use the Renew Document function to create a renewed document based
on the current renewable document.
o Cancel renewable document
You use the Cancel Renew. Doc. function to cancel the current renewable
document.
o Release renewable document
You use the Release Renew. Doc. function to release the current renewable
document.
o Print renewable document
You use the Print Renew. Doc. function to print the current renewable
document.

16
o Create renewable document
You use the Create Renew. Doc. function to create a new document based on
the selected patient.
Effects on Customizing
In Customizing for SAP Ambulatory Care Management under SAP Ambulatory Care
Management -> Administration -> Renewable Document Management ->
Maintain Assignment of Document Types, you can specify that new
renewable documents are to be created automatically or displayed in Renewable
Document Management for completion.

17
ISH_AMB_MISC1: Documentation Work Station: New Documentation
Objects (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Ambulatory Care Management: Legal Process
Adoption (ISH_AMB_MISC1), the new documentation objects Renewable
Documents and Accident Data are available in the outpatient documentation work
station in SAP Ambulatory Care Management.
The following new base item types have been designed for this purpose:
o Renewable documents
You can use a base item of this type to edit renewable documents for a patient.
You can use one of the following actions:
- Display renewable document
- Maintain renewable document
- Create initial document (for a specific renewable document type)
For example, Maintain Initial WI Document (WI: work incapacity
certificate). Before you can do this, you must create the relevant
renewable document type in the Customizing settings for Renewable
Document Management (Customizing activity Define Document Types)
and select it for the corresponding base item.
o Accident data
You can use a base item of this type to edit accident data for a patient. You can
use one of the following actions:
- Display accident data
- Maintain accident data
Configuration Examples
If you want to use the new documentation object Renewable Documents in the
documentation work station, you should proceed as follows:
1. On the SAP Easy Access screen, choose Hospital -> SAP Ambulatory Care
Management -> Treatment -> Template Management Documentation Work
Station (transaction N2WLD).
2. Define a base item of the type Renewable Documents, for example with the title
Create Renewable Document.
3. Generate a task template based on this base item.
Choose the initial action Maintain Renewable Document.
1. Add this task template to a situation template.
2. If you now assign this situation template to a patient, the system creates the task
Create Renewable Document for the patient.

If you want to use the new documentation object Accident Data in the documentation
work station, you should proceed in the same way for the base item type Accident
Data:

Enhancements to the Patient Viewer


The patient viewer now contains the new aspect Renewable Documents.

18
If you access the dialog box for the movement data in the patient viewer, the system
displays any accident data that exists as a subscreen for the corresponding movement.

19
Business Function SAP Patient Management Rearchitecture
BP/OM
ISH_BP_OM: Business Function SAP Pat Mgmt Rearchitecture BP/OM
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4, (IS-
H 604), the business function SAP Patient Management: Rearchitecture BP/OM is
available. This business function allows you to use the generic SAP Business Partner
for patients and healthcare-related business partners in SAP Patient Management. You
can also use generic Organizational Management for the organizational units, the
organizational structure, and the building units.
Note: Please note that the conversion of the new BP to the previous patient
structures increases the runtime for extraction to BI/BW.
For more information, see the following release notes:
o ISH_BP_OM: Overview (New)
o ISH_BP_OM: Value Helps of Hospital Structure and Business
Partner (New)
o ISH_BP_OM: Migration of BP and Hosp. Structure Data (New)
o ISH_BP_OM: Maintenance of Org., Building, and Hierarchy
Data (New)
o ISH_BP_OM: Existing/New Infotypes and Their Semantics
(New)
o ISH_BP_OM: Institution (New)
o ISH_BP_OM: Transactions (New)
o ISH_BP_OM: Identification Key for Org. and Building Units
(New)
o ISH_BP_OM: Programs for Phase 0 - General Mig. Prep. (New)
o ISH_BP_OM: Mig. Programs for Phase 1 - Mig. Prep. (New)
o ISH_BP_OM: Programs for Phase 3 - Steps During Downtime
(New)
o ISH_BP_OM: Data Migration Programs for Phase 4 (New)
o ISH_BP_OM: Adaptation of Customer Code in OM (New)
o ISH_BP_OM: Changeover (New)
o ISH_BP_OM: Business Partner Terminology (New)
o ISH_BP_OM: New Transactions (New)
o ISH_BP_OM: New Roles and Corresponding Role Categories
for BPs (New)
o ISH_BP_OM: Address Validation (New)
o ISH_BP_OM: Locator Search - To Search a Business Partner
(New)

20
o ISH_BP_OM: Business Partner Relationships (New)
o ISH_BP_OM: Integration with Financial Accounting (FI) (New)
o ISH_BP_OM: Changes to the User Interface (New)
o ISH_BP_OM: Adaptation of Customer Code in BP (New)
o ISH_BP_OM: AT, CH, FR: Business Partner: New Fee Recipient
Role (New)
o ISH_BP_OM: BP Migration: Phases (New)
o ISH_BP_OM: Business Partner Migration: Number
Assignments (New)
o ISH_BP_OM: BP Migration: SAP BP Customizing (New)
o ISH_BP_OM: BP Migration: Invalid FI Assignments (New)
o ISH_BP_OM: BP Migration: FI Synchronization Links (New)
o ISH_BP_OM: BP Migration: Master Data and Relationships
(New)
o ISH_BP_OM: BAPI "BAPI_BUSPARTNER_CHANGE" (New)
o ISH_BP_OM: Business Partner Grouping for Patients and Next
of Kin (New)
o ISH_BP_OM: Address Maintenance for Patient from CPB (New)
o ISH_BP_OM: Maintaining Next of Kin from CPB (New)
o ISH_BP_OM: Patient's Employer - Additional Name Field (New)
o ISH_BP_OM: Death Data Subscreen (New)
o ISH_BP_OM: Risk Factors Subscreen in CPB (New)
o ISH_BP_OM: Address Usages for Patient Addresses (New)

Effects on Existing Data


To use this business function, you must also activate the business function ISH_MAIN.
See also
For more information, see Business Function Sets and Business Functions ->
Healthcare -> SAP Patient Management -> SAP Patient Management:
Rearchitecture BP/OM in the SAP Library and in SAP Note 1638932.
For more information about Support Package release notes for SAP Patient
Management and SAP Ambulatory Care Management, see SAP Service
Marketplace under the quick link /healthcare-releasenotes.

21
ISH_BP_OM: Overview (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Managment Rearchitecture BP/OM(ISH_BP_OM),
you can migrate the proprietary SAP Patient Management business partner and
organizational and building structure to the new SAP standard and central functions:
o SAP Business Partner (SAP BP)
o Organizational Management (OM)
Examples
The business partners in a hospital are usually the following:
o Other hospitals
o Physicians (external and internal)
o Insurers
o Other agencies
The organizational and building structures are used to describe a healthcare provider's
organizational structure. For example:
o Clinics
o Medical departments
o Wards
o X-ray rooms
Preconditions
Before the new functions can be used, the system must be upgraded to SAP ECC
6.0,Industry Extension Healthcare, Enhancement Package 4.

Timeline
You can carry out the changeover to the new functionality of SAP BP and OM for the
whole maintenance period of the SAP ECC 6.0, Industry Extension Healthcare,
Enhancement Package 4 release.
Please refer to the other release notes concerning the migration process and steps that
must be completed before you can change over to the new functionality. This includes
implementing a detailed concept (using tools, reports, XPRAs, and so on, provided by
SAP) to migrate your legacy data and customer-developed functions (modifications), if
you have any.
Note: The switch can only be set for SAP BP and OM at the same time. It is not
possible to apply the new functionality only to Business Partner or only to
Organizational Management.
Goals and Motivation
There are two goals of this large retrofit project: the first is to move the Healthcare
business partner and patient object to SAP Business Partner (standard), and the
second is to have one unified application and data structure for all organizational
questions a healthcare provider is faced with.
For Business Partner, this means that Healthcare business partner and patient data are
located where the central object SAP BP is. It utilizes existing SAP BP services such as
the following:

22
o Address validation
o Extensibility via Business Data Toolset (BDT)
o Relationships BP-BP
o Role concept
The SAP for Healthcare solution will also benefit from future developments in the area
of the standard SAP BP, for example, the planned integration to master data
management (MDM).
For Organizational Management, this means that all organizational and geographic
data now resides in one place: the central OM. All necessary changes can be
maintained with this central tool, which replaces the maintenance of the SAP Patient
Management-specific structures in the proprietary functions for maintaining
organizational structures. This enables you to utilize existing OM services and
advantages such as the following:
o High flexibility of the structural definitions
o Infotypes
o Job descriptions
o Automatic workflow functions (for example, automatically finding a deputy)
This eliminates the need, where organizational issues are concerned, for maintaining
redundant data in the system . And SAP for Healthcare will benefit from future
developments in the area of OM such as enterprise service-oriented architecture
(enterprise SOA) enabling.
Benefits: Business Partner
o One central object for all business partner interactions.
- Uniform look and feel for maintenance of all business partner roles
- Synergies for customers already using other roles of SAP BP, for
example, in the area of SAP for Higher Education & Research (SAP for
HE&R) (students are business partners)
- Reducing duplicate data entry
o Easy access and integration to other parts of the SAP Business Suite.
- Connection to Customer Relationship Management (CRM) customer, for
example, combining and synchronizing patient data with CRM customer
data
- Bi-directional synchronization: SAP BP - Financial Accounting (FI)
customer
- Existing integration between Human Capital Management (HCM) person
and SAP business partner
o Open infrastructure.
- Easy Enhancement Workbench (EEW) - allows you to extend the data
model of SAP BP and its relationships by adding new fields and tables
- Business Data Toolset (control tool) for maintaining master data and
simple transaction data
- Integration via business concepts
Benefits: Organizational Management
o One central tool to maintain all units of organizational hierarchies, including
building units.

23
- Uniform look and feel for maintenance of all organizational objects
- Less duplicate data entry
- Synergies for customers already using OM, for example, in the area of
personnel planning
o Drag-and-drop when reorganizing company structure (merger or acquisitions) is
much faster than the manual process involving the functions for maintaining
organizational and building structures in SAP Patient Management
o Mapping of multiple institutions in one client
o Using structural authorization can help to reduce the number of authorization
profiles required
Future Benefits (planned):
o Integrated appointment planning
1. Start with a CRM contact in the Interaction Center in CRM.
2. Find an open time slot for an organizational unit in SAP Patient Management.
3. Find a resource (for example, a physician, nurse, or technician) in HCM which
fits the following criteria:
- Is available
- Is able to provide the necessary service

24
ISH_BP_OM: Value Helps of Hospital Structure and Business Partner
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Managment Rearchitecture BP/OM (ISH_BP_OM),
all functions make the hierarchical value help of the hospital structure available for input
fields for organizational units or building units, and the business partner search
available for input fields for business partners. This does not apply to master data
maintenance.
Up to SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Managment Rearchitecture BP/OM (ISH_BP_OM),
the input fields for organizational units or building units only partially used the
hierarchical value help of the hospital structure. The same was true for the input fields
for the business partner, which only partially used the business partner search.

25
ISH_BP_OM: Migration of BP and Hosp. Structure Data (New)
Use
The migration of the business partner (BP) data and hospital structure data enables
you, as of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4
(IS-H 604), Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM) to transfer the use and management of IS-H-specific data into SAP
Business Partner (SAP BP) and Organizational Management (OM) (component PA-OS
).
This migration comprises various steps that must be peformed in different phases. The
following Customizing activities in the IS-H Implementation Guide guide you through
the different steps in the migration process.
Phases
o Phase 0: General Migration Activities
o Phase 1: Migration Preparation
o Phase 2: Data Migration During Uptime
Note: As the migration of hospital structures does not require steps in Phase 2,
Customizing activities are not provided for this phase.
o Phase 3: Data Migration During Downtime
o Phase 4: Activities After Migration
Steps
The different phases take you into the migration cockpit, where you can start the
relevant steps. The cockpit contains the following types of steps:
o Obligatory steps (identified by Obligatory in the title of the step)
o Steps that are not obligatory, but whose execution we recommend (identified by
Recommended in the title of the step)
Effects on Existing Data
Notes
Phases 0 and 1 of the migration of hospital structures and BPs contain activities with
similar contents, but which need not be performed concurrently. In both migration
projects, Phase 3 is to be performed during the system downtime. This means that
downtime for both projects needs to start at the same time. Only when you confirm the
last step in Phase 3 is the system configured in such a way that it accesses the
migrated data instead of the old data. Due to the fact that the configurations for the
changeover to OM and BP are modified concurrently, both migration projects must
reach the end of Phase 3 at the same time to avoid lengthy downtimes.
Effects on Customizing
In the IS-H Implementation Guide, see the information about Customizing for SAP
Healthcare - Industry-Specific Components for Hospitals under Tools -> Migration
of Business Partner and Hospital Structure -> General Introduction to
Migration of OM and BP.
All the Customizing activities for the migration of the hospital structure data and BP
data are located under this node. You can view information about the various
Customizing activities and individual steps for each phase by clicking the i information
button beside each step.

26
ISH_BP_OM: Maintenance of Org., Building, and Hierarchy Data (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Rearchitecture BP/OM
(ISH_BP_OM), with Organizational Management (OM) activated, the potential benefits
of the OM framework include transparency and clarity in the management of data.
The user interface contains a simplified view for accessing the hierarchy units at both
overview and detailed level. It also provides a search option to find any unit of interest.
On searching for a particular unit (based on a variety of filtering constraints), all units
matching the criteria appear in the selection area along with their hierarchy units. You
can display the overview of a unit, which contains some basic fields, in the overview
area by double-clicking the unit in the selection area.
In the overview area you can trace the hierarchy above and below the unit of interest.
This gives a clear overall picture of the units participating in the hierarchy, and relations
in the hospital structure. You can view the hierarchy, and hence the relations of the
objects, with different details. You can access this function by choosing the relationship
type from the first option in the overview toolbar.
In the overview area, you can also change the hierarchy at any node by right-clicking
the node and choosing the option to either create a new unit or assign an existing unit
from the system. The details of the same are filled into the detail area and saved. You
can display the information in the detail area by double-clicking a particular unit in the
overview area.
The information in the detail area is grouped semantically in various tabs. The screens
in these tabs are similar to the old SAP Patient Management screens.
Previously, in the planning characteristics you could maintain an Organizational Unit
(OU) with regard to departmental assignments between OU and Building Unit (BU).
Now, the relationship between an OU and a BU is defined through the relationship 865
(Is Org. Assigned Below/Above).
Also, planning characteristics and facility characteristics are now directly attached to
the building unit.
In the framework, you can maintain OUs, BUs and their relationships. In order to give
an oversight of the different relationships, the framework offers the following views on
the hierarchies:
o Complete Hospital Hierarchy
Displays the complete hospital hierarchy.
o Departmental Assignments to Org. Units
Displays the hierarchy involving departmental OUs and the BUs assigned to
them via departmental relationship.
o Building Unit Hierarchy
Displays the hierarchy involving BU relationships, showing both primary and
secondary relationships.
o Organizational Complete Hierarchy
Displays a complete hierarchy involving interdepartmental relationships between
OUs.
o Organizational Hierarchy Assignments
Displays an organizational hierarchy with only assignment relationships.
o Organizational Inter-dept. Assignment
Displays an organizational hierarchy with only interdepartmental relationships.

27
28
ISH_BP_OM: Existing/New Infotypes and Their Semantics (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Rearchitecture BP/OM (ISH-BP-OM),
with Organizational Management (OM) activated, organizational units (OUs) and
building units (BUs) are assigned an object type in the OM framework to identify the
semantics of the object. The OM framework contains a predefined object type, 'O', for
OUs. SAP Patient Management OUs will reuse this type. For BUs, the object type 'N0'
is provided to cater to the needs of SAP Patient Management.
In the backend of the OM framework, infotypes are used to store the data. Infotypes
are collections of semantically-matching objects. For example, an 'Address' infotype
caters to the need for address storage, the 'Basic Data' infotype caters to the need for
key information, and so on.
To maintain the data for various OUs and BUs, the OM framework provides a well-
managed user interface providing exhaustive functionalities. The user interface
contains a detail area, where semantically-grouped data fields serve as information
entry points. This detail area comes with an overview area and an object manager,
giving complete access to the entire hierarchy and allowing easy maintenance.
Some infotypes already exist in the OM framework and are reused. These infotypes are
common to both OUs and BUs:
o Infotype ID: 1000
Stores the object's basic information such as name, short text, and validity dates.
o Infotype ID: 1001
Stores the complete information of relationships. Data that has previously been
stored in the tables TN10H, TN10I, TN11H, and TN11O is now be stored in this
infotype table.
o Infotype ID: 1002
Description (comments for OUs).
o Infotype ID: 1027
Site-Dependent Info (for calendar).
o Infotype ID: 1028
Address: Stores address-related information. Data that has previously been
stored in the tables NADR and NADR2 is now stored in this infotype table.
o Infotype ID: 1032
E-mail Address: Stores the e-mail address information that has previously been
stored in the table NADR.
The following infotypes are new and are specific to OUs:
o Infotype ID: 6080
Key Data: Stores the SAP Patient Management mapping data. The Healthcare
(HC) OU ID and the OU category are stored here.
o Infotype ID: 6081
Administrative Data: Stores the blocking, releasing, and deletion indicator details
of NORG.
o Infotype ID: 6082
HC Specialty Details & Indicators: Stores specialty indicator details and other
indicators of NORG.
o Infotype ID: 6083
Additional Telephone Data

29
o Infotype ID: 6084
Additional Specialty Details
o Infotype ID: 6085
Additional Name (language-dependent)
The following infotypes are new and are specific to BUs:
o Infotype ID: 6091
Administrative Data: Stores the releasing and deletion indicator details .
o Infotype ID: 6092
Facility Characteristics Data: Stores the data that has previously been stored in
the table TN11A.
o Infotype ID: 6093
Planning Characteristics Data: Stores the data that has previously been stored in
the table TN11P.
o Infotype ID: 6083
Additional Telephone Data
See also
For more information on available functionalities, see the release note Maintenance
of Organizational, Building, and Hierarchy Data.

30
ISH_BP_OM: Institution (New)
Use
As of SAP ECC 6.0 Industry Extension Healthcare, Enhancement Package4,
Business Function SAP Patient Management Rearchitecture BP/OM
(ISH_BP_OM), with Organizational Management (OM) activated, the institution
semantics for SAP Patient Management have been preserved. The root must be
defined for every hierarchy in the OM framework.
An institution is now an organizational unit which participates as the root unit of the
hierarchy in OM.

31
ISH_BP_OM: Transactions (New)
Use
As of SAP ECC 6.0 Industry Extension Healthcare, Enhancement Package4,
Business Function SAP Patient Managment Rearchitecture BP/OM (ISH_BP_OM),
with Organizational Management (OM) activated, all SAP Patient Management
transaction codes pertaining to organizational structure (NB20 - NB28) and building
structure (NB30 - NB38) are unchanged. These transactions are available in the SAP
Easy Access menu. This makes it easier for you to adapt to the OM hierarchy
framework.
You can create an institution in Customizing for SAP Healthcare - Industry-Specific
Components for Hospitals under Basic Settings -> Create Institution. This has
a field, Org. Unit, which is used to map the institution to an object in the OM
framework. With this Customizing activity, you can also create an object in the OM
framework and use it as an institution.
However, in virtue of re-architecture, the potential functionality of a few transactions
have been modified, such as the following:
o Transaction: NB20
Functionality in SAP Patient Management framework: Create organizational unit
(OU)
Potential functionality in OM: Maintenance of organizational and building
hierarchy and maintenance of OU and building unit (BU)
o Transaction: NB21
Functionality in SAP Patient Management framework: Change OU
Potential functionality in OM: Maintenance of organizational and building
hierarchy and maintenance of OU and BU
o Transaction: NB30
Functionality in SAP Patient Management framework: Create BU
Potential functionality in OM: Maintenance of organizational and building
hierarchy and maintenance of OU and BU
o Transaction: NB31
Functionality in SAP Patient Management framework: Change BU
Potential functionality in OM: Maintenance of organizational and building
hierarchy and maintenance of OU and BU
As the transactions now have a higher number of functionalities, authorization handling
must also be adapted. For transactions mapping tomultiple functionalities, multiple
transaction-level authorizations mustbe catered for.
The authorization object N_EINR_TCO is still used. In the OM framework, the
transactions NB20-26 and NB29-40 are all relevant to maintaining the organizational
hierarchy and building hierarchy. Hence, you must have access permissions to all of
NB20-26 and NB29-40 in order to maintain the organizational hierarchy or building
hierarchy.

32
ISH_BP_OM: Identification Key for Org. and Building Units (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), with Organizational Management (OM) activated, the semantics of
unique ID for organizational units (OUs) and building units (BUs) are, in general,
preserved after the re-architecture.
You find the identification key relevant for SAP Patient Management for OUs in the
field HC OU and for BUs in the field HC BU. Previously, these fields were technically-
named ORGID and BAUID respectively. You can enter values for these fields during
the creation of an OU or BU.
If you are using internal numbering, you can leave this field empty. The system does
not assign internal numbers immediately following the input (as in the former SAP
Patient Management maintenance). Instead, it assigns the internal numbers when you
run the release report for OUs (transaction NB53) or the release report for BUs (NB43)
separately.
For existing OUs and BUs, the system displays the identification key in the overview
area (column name HC OU/BU).
During the creation of any object, the system also generates the identification key
relevant for OM automatically. The system displays this identification key (technical
name OBJID) in the overview area also (column name ID). The system needs the
identification key within the OM transactions to identify the objects. It has no further
relevance for SAP Patient Management.

33
ISH_BP_OM: Programs for Phase 0- General Mig. Prep. (New)

Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), the migration of data from SAP Patient Management to Organizational
Management (OM) consists of four phases.
In Phase 0: General Migration Activities for OM, the system offers the following steps:
o Confirm Understanding of Hospital Structure Migration
We recommend that you complete this step to get an overview of the preparation
required for the entire migration process.
o Confirm Customer Code Adaptation
We recommend that you complete this step to confirm that you have adapted
any customer-specific source code that accesses the database tables which are
undergoing re-architecture.
o Confirm Test Migration Run
We recommend that you complete this step to familiarize yourself with the entire
migration process in a simulated environment. The test environment allows you
to see if you have completed the prerequisite steps before the actual migration.
Thus, this step offers a landscape for you to document the migration process. No
data is migrated at the end of this step.
o Confirm Training of Users on OM Transactions
Documentation on the use of the OM transactions is offered to train users in the
use of the new features.

Effects on Customizing
You can access the data migration programs of Phase 0 and see further information in
Customizing for SAP Healthcare - Industry-Specific Components for Hospitals
under Tools -> Migration of Business Partner and Hospital Structure -> Migration
of Hospital Structure -> Phase 0: General Migration Activities for OM.

34
ISH_BP_OM: Mig. Programs for Phase 1 - Mig. Prep. (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), the migration of data from SAP Patient Management to Organizational
Management (OM) consists of four phases.
In Phase 1: Migration Preparation for OM, the system offers the following steps:
o Confirm Adaptation of OM Customizing
We recommend this step as it provides functions that you can utilize to complete
the required adaptation. For example, you can include customer-specific
infotypes and tab pages here.
o Confirm Status of OM Data
With this obligatory step you tell the system whether you are already using OM to
represent IS-H organizational structures. If this is the case, you must maintain
the mapping of IS-H to OM data in a mapping table before you can use the
migration programs that are run during Phase 3.
o Maintain Mapping Table
This step allows you to map the existing organizational units (OUs) in SAP
Patient Management with those of objects in OM. This caters to the scenario
where you are already using OM.
You are offered a Customizing view for the purpose of mapping. This view is only
accessible if OM already in use is selected in the step Confirm Status of OM
Data. This view offers a Propose Values pushbutton which generates a
proposal for every SAP Patient Management OU and institution based on
matching the short text of the OU or institution and the abbreviation of an object.
Double-clicking on an SAP Patient Management OU in the view displays the
respective details.
You can check the consistency of the generated proposals by clicking the Check
Consistency pushbutton. Specific consistency messages are shown for
reference, but these messages are not logged in the database.
When you click the Release Data pushbutton, the specific consistency
messages are shown and logged for future reference. Data can only be released
successfully when no error message is displayed in the log. Releasing data is
one of the prerequisites for downtime.
The Customizing view allows you to confirm the mapping so that the mapping
information is taken into account in the data migration reports of institution data
and SAP Patient Management OUs. During release, the system checks if all
data is confirmed. Data can only be released if every SAP Patient Management
OU is either confirmed to be linked to, or unlinked to, an OM organizational unit.
Limitations:
The logon language is used for matching the SAP Patient Management short
text to the OM object abbreviation. If more than one short text is matched to an
object abbreviation, only the first match is displayed as a proposal. However, the
view has a dialog box indicating that more than one match exists, offering you
the possibility to search for other objects and then make a final proposal.
o Run Migration of Screen Modification (Test)
We recommend that you carry out this step. In it, the screen modification entries
are migrated so that the master data maintenance screens are mapped to the
tab pages of the hierarchy framework transactions. This step allows you to
simulate this migration in test mode without changing anything in the database.
o Run Migration for Screen Modification (Prod.)
This migration step runs the migration in productive mode, as simulated in the

35
preceding test mode.

Effects on Customizing
You can access the data migration programs of Phase 1 in Customizing for SAP
Healthcare - Industry-Specific Components for Hospitals under Tools -> Migration
of Business Partner and Hospital Structure -> Migration of Hospital Structure ->
Phase 1: Migration Preparation for OM.

36
ISH_BP_OM: Programs for Phase 3- Steps During Downtime (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), the migration of data from SAP Patient Management to Organizational
Management (OM) consists of four phases.
In Phase 3: Steps During Downtime, the system offers the following steps :
o Confirm Downtime
This obligatory step marks the downtime of the system to start the migration of
the operative data.
o Run Consistency Check (Test Mode)
o Run Consistency Check (Productive Mode)
o Run Migration of Institution Data (Test Mode)
We recommend this step as it performs a test run of the migration of institution
data. No changes are made in the database at the end of this step. The system
logs all errors and warnings (if any) to allow for a consistency check before the
actual migration process.
This step can be executed before the downtime.
o Run Migration of Institution Data (Productive Mode)
This step performs the actual migration of institution data. The system logs all
errors and warnings (if any) for reviewing.
Limitations:
During data transfer, while creating the infotype 1000 (basic infotype of the
object), the system models an institution in the logon language as an
organizational unit with the corresponding abbreviation and name as attributes.
o Run Migration of IS-H Data (Test Mode)
We recommend this step as it performs a test run of the migration of SAP
Patient Management data. No changes are made in the database at the end of
this step. The system logs all errors and warnings (if any) to allow for a
consistency check before the actual data migration process.
This step can be executed before the downtime.
o Run Migration of IS-H Data (Production Mode)
This step performs the actual migration of SAP Patient Management data. The
system logs all errors and warnings (if any) for reviewing.
o Run Release Program (Test Mode)
We recommend this step as it performs a test run of the release program for
releasing the organizational units and building units. No changes are made in the
database at the end of this step. The system logs all errors and warnings (if any)
to allow for a consistency check before the actual data migration process.
o Run Release Program (Production Mode)
This step performs the actual release program process. Datasets for those
organizational and building units that are consistent in hierarchy and attributes
are marked to set the release indicators. The system logs all errors and warnings
(if any) for reviewing.
o Confirm Migration Success
This step activates the Customizing switch that confirms the use of OM for SAP
Patient Management hospital structure management.

Effects on Customizing

37
You can access the data migration programs for Phase 3 in Customizing for SAP
Healthcare - Industry-Specific Components for Hospitals under Tools -> Migration
of Business Partner and Hospital Structure -> Migration of Hospital Structure ->
Phase 3: Data Migration for OM During Downtime.

38
ISH_BP_OM: Data Migration Programs for Phase 4 (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM) the migration of the SAP Patient Management hospital structure to
Organizational Management (OM) consists of four phases.
This is the final phase, and it consists of only one step:
o Confirm Test Scenario with OM Data in IS-H
We recommend this step as it provides documentation to help you execute a test
scenario in OM with the migrated SAP Patient Management data, to ensure that
every function works as expected after migration.
Effects on Customizing
You can access the data migration program of Phase 4 in Customizing for SAP
Healthcare - Industry-Specific Components for Hospitals under Tools -> Migration
of Business Partner and Hospital Structure -> Migration of Hospital Structure ->
Phase 4: Activities for OM After Migration.

39
ISH_BP_OM: Adaptation of Customer Code in OM (New)
Use
This release note is only relevant for you if you enhanced SAP Patient Management
with your own specific logic for the hospital structure.
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), with Organizational Management (OM) activated, SAP recommends
finishing all necessary adaptations before the final changeover from the hospital
structure of SAP Patient Management to OM. After the changeover, any access to the
affected SAP Patient Management database tables is invalid.
Database Access
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), with OM activated, data relating to the hospital structure is stored in OM
database tables. After the changeover, the following tables are replaced:

IS-H Database Tables OM Database Tables


Organizational Units (NORG) Object (HRP1000)
Description (HRP1002)
Calendar (HRP1027)
Address (HRP1028)
HC Identification (HRP6080)
Administrative Data OU (HRP6081)
Specialties + Indicators (HRP6082)
Additional Name OU (HRP6085)
Building Units (NBAU) Object (HRP1000)
Description (HRP1002)
HC Identification (HRP6080)
Administrative Data BU (HRP6091)
Planning Characteristics (TN11P) Planning Characteristics (HRP6093)
Facilities Characteristics (TN11A) Facilities Characteristics (HRP6092)
Hierarchy of Organizational Units (TN10H) Relationships (HRP1001)
Inter-Dept. Bed Asgnmts in
an OU by Another OU (TN10I) Relationships (HRP1001)
Hierarchy of Building Units (TN11H) Relationships (HRP1001)
Assign Building Units to Org. Units (TN11O) Relationships (HRP1001)
Specialty-to-Organizational Unit
Assignment (TNKFO) Additional Specialties (HRP6084)
You must adapt the direct accesses to the described tables in your specific source
code.

40
SAP provides function modules to access affected data. These function modules return
the data in the established structures. SAP may change these function modules at any
time without notice.
Some of the function modules cater to both SAP Patient Management data and OM
data, depending on your current migration status. They supply the appropriate data
before and after the changeover:
o Read Organizational Units (NORG):
ISH_READ_NORG
o Read Building Units (NBAU):
ISH_READ_NBAU
o Read Building Units (TN11P):
ISH_TN1P_READ
o Read Specialty-to-Organizational Unit Assignment (TNKFO):
ISH_OU_SPECIALTY_GET
You can use the following function modules to explicitly access OM database tables.
You cannot use these function modules to access the hospital structure of SAP Patient
Management before the changeover:
o Read Organizational Units (NORG):
ISH_OM_OU_GET
o Read Building Units (NBAU):
ISH_OM_BU_GET
o Read Planning Characteristics (TN11P):
ISH_OM_PLAN_DATA_GET
o Read Facilities Characteristics (TN11A):
ISH_OM_FAC_DATA_GET
o Read Organizational Hierarchy (TN10H):
ISH_OM_ORG_HRCHY_LEVEL_DOWN
ISH_OM_ORG_HRCHY_LEVEL_UP
o Read Inter-Departmental Assignments (TN10I):
ISH_OM_INTERDEP_GET
ISH_OM_INTERDEP_LEVEL_DOWN
ISH_OM_INTERDEP_LEVEL_UP
o Read Building Hierarchy (TN11H):
ISH_OM_BLD_HRCHY_RELATION_GET
ISH_OM_BLD_HRCHY_LEVEL_DOWN
ISH_OM_BLD_HRCHY_LEVEL_UP
o Read Building Unit-to-Organizational Unit Assignments (TN11O):
ISH_OM_BU_OU_ASSIGNMENT_GET
ISH_OM_BU_ASSIGNED_TO_OU_GET
ISH_OM_OU_ASSIGNED_TO_BU_GET
o Read Specialty-to-Organizational Unit Assignments (TNKFO):
ISH_OM_OUSPLTY_GET
For more information about these function modules, see the function module
documentation.
Business Add-In for filling customer-specific fields
If you enhanced the database tables for organizational units (NORG), building units
(NBAU), or planning characteristics (TN11P), you can use the following BAdIs to
preserve the current system behaviour:

41
o ISH_OM_CUST_FILL_NORG
o ISH_OM_CUST_FILL_NBAU
o ISH_OM_CUST_FILL_TN11P
You can implement these BAdIs to fill your customer-specific fields. The system will run
these BAdIs whenever function modules for reading organizational units, building units,
or planning characteristics are called.

42
ISH_BP_OM: Changeover (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Business Function SAP
Patient Management Rearchitecture BP/OM (ISH_BP_OM) you can use the SAP
Business Partner (SAP BP) and Organizational Management (OM) frameworks to
maintain the business partner, patient, and hospital structure data.
To achieve this, you must migrate the existing business partner, patient, organizational,
building, and hierarchy data. Once migration is completed, the corresponding
changeover for SAP BP and OM is activated. Activation of the changeover ensures the
productive use of SAP BP and OM for data maintenance henceforth.
See also
For more information about migration, see release note Overview (New).

43
ISH_BP_OM: Business Partner Terminology (New)
Use
Please note the following changed and new terminology as of SAP ECC 6.0, Industry
Extension Healthcare, Enhancement Package 4, Business Function SAP Patient
Management: Rearchitecture BP/OM (ISH_BP_OM):
In relation to the previous business partner in SAP Patient Management (in texts about
the migration from the previous to the new concept generally referred to as 'IS-H
business partner' and/or 'HC business partner'), the German term 'Rolle' in the
documentation was translated with the English term 'function'. Note that for the new
concept SAP Business Partner for Healthcare (SAP BP-HC), the English translation
'role' is used.

44
ISH_BP_OM: New Transactions (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), separate roles are maintained with SAP Business Partner (SAP BP) for
the business partners: HC Employee, HC Physician, and HC External Physician.
Hence, six new transactions (in addition to the three transactions used before this
release) are used to maintain them. These transactions are described below:
o Transactions NG04E, NG05E, and NG06E (New)
Create, change, and display business partner role HC External Physician.
o Transactions NG04I, NG05I, and NG06I (New)
Create, change, and display business partner role HC Physician.
o Transactions NG04, NG05, and NG06 (Existing)
Create, change, and display business partner role HC Employee.
You can access these transactions in the SAP Easy Access menu under:
o Hospital -> Basic Data Administration -> Business Partners -> External
Physician -> Create (NG04E) / Change (NG05E) / Display (NG06E)
o Hospital -> Basic Data Administration -> Business Partners -> Physician ->
Create (NG04I) / Change (NG05I) / Display (NG06I)
o Hospital -> Basic Data Administration -> Business Partners -> Employee ->
Create (NG04) / Change (NG05) / Display (NG06)

45
ISH_BP_OM: New Roles and Corresponding Role Categories for BPs
(New)
Use
SAP Patient Management handles healthcare processes on the provider side. It
manages patient details, cases, movements, billing for customers, and maintains
details of all related business partners (BPs).
The business object Business Partner includes persons or entities with which an
institution maintains business relations.
The BPs related to healthcare processes are:
o Hospital
o Insurance provider
o Employer (of the patient)
o Physician
o External physician
o Employee (of the hospital)
o Customer (self-payer, for example)
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), with SAP Business Partner (SAP BP) activated, the BPs are maintained
using SAP BP, which provides central management for them. In SAP BP, BPs are
classified as 'roles', depending on their functions. Data which is common to all BPs
(name, title, address and communication data, identification details) is stored centrally.
Furthermore, each role has data specific to its function, for example, a HC Physician
has details about his or her specialization.
BP data can be created, changed, and deleted using the SAP BP transactions. An
integrated user interface is available for data entry and modification of all BP data.
SAP BP classifies partners into the following three categories:
o Person
o Organization
o Group
A partner in SAP BP can simultaneously exist in many roles belonging to a particular
category. Relationships amongst BPs can also be maintained. For example, one
insurance provider can be the head office of another insurance provider.
For SAP Patient Management, the roles required are:
o HC Insurance Provider
o HC Hospital
o HC Employer
o HC Customer
o HC Employee, HC Physician, and HC External Physician
The mappings between BP roles and categories are as follows:

46
BP Role BP Category
HC Insurance Provider Organization
HC Hospital Organization
HC Employer Organization
HC Customer Person/Organization
HC Employee Person
HC Physician Person
HC External Physician Person

47
ISH_BP_OM: Address Validation (New)
Use
As of SAP ECC 6.0 Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), with SAP Business Partner (SAP BP) activated, the Business Address
Service (BAS) performs address validation and a check on postal code correctness.
BAS provides an address validation tool via regional structure, which ensures that the
address you provide exists and the data is consistent.
The following fields are relevant for the check:
o Street
o Postal Code
o City
BAS carries out the check depending on the country key.

48
ISH_BP_OM: Locator Search - To Search a Business Partner (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), with SAP Business Partner (SAP BP) activated, you can search for
business partners (BPs) using a customizable locator search. Before creating a BP,
use this search to check whether it already exists in the system.
The search locator allows you to search for BPs based on their categories (person,
organization, or group). After you choose the category, you can limit the search using
various search criteria, such as partner number, address, and name. Hits are listed
beneath the search area.
The search locator has been extended to provide a different search criterion for each of
the BP roles available. This keeps the search screen for each BP similar to that
provided by SAP Patient Management before this release.
Note: depending on the search criteria you provide, it is possible to search for BPs that
are blocked or have their deletion indicator set, or that are both blocked and have their
deletion indicator set.

49
ISH_BP_OM: Business Partner Relationships (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), with SAP Business Partner (SAP BP) activated, business partner (BP)
relationship control is used to establish relationships between the BPs. A relationship
between two BPs can be characterized by a relationship category.
The relationship categories allow you to:
o Assign four types of relationship between HC Insurance Providers:
- Is Form Recipient of
- Is HC SC Head Office of
- Is Invoice Recipient of
- Is Head Office for Data Exchange acc. to P301 SGB V (DE) of
o Assign an HC Insurance Provider to an HC Employer acting as the accident
insurance provider.
o Assign an HC Insurance Provider to any BP acting as a responsible PPA.

50
ISH_BP_OM: Integration with FI (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), with SAP Business Partner (SAP BP) activated, Master Data
Synchronization (MDS) is the module used for integrating business partners (BPs) with
FI customers.
The IS-H customer is the link between the BP in the IS-H system and the customer in
the Financial Accounting (FI) system. The IS-H customer data is a subset of the
customer master data in FI. The FI customer number is stored in the master record of
the IS-H customer.
MDS allows you to integrate SAP applications that make technical use of the BP in
their user interface and use the customer master as a technical basis in subsequent
business procedures. From the BP interface, it is possible to create and display FI
customer data.
The system can be configured to automatically create a corresponding FI customer
when an IS-H customer is created. FI data for the customer can be displayed from the
integrated user interface.
The synchronization process is defined as a one-way process between the source
object type (IS-H customer) and the target object type (FI customer). This means that
changes in the IS-H customer are reflected in the FI customer but not vice-versa.

51
ISH_BP_OM: User Interface Changes (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), with SAP Business Partner (SAP BP) activated, the following changes
are made in the user interface used for the maintenance of the business partners
(BPs):
o The search locator is embedded within the user interface.
o The central and role-specific data for each BP is displayed in a tab page format
on the user interface.
o You can access general data, relationship data, and FI-specific data by choosing
the relevant option on the title bar. The option for FI-specific data appears only
for the role HC Customer.
o The blocking details are now available as fields on the user interface. You can
unblock blocked BPs by removing the blocking dates.
o A deletion indicator is provided on the user interface.
o You can access the comments specific to the role from the user interface.
SAPscript texts are used to store comments for BP roles.

52
ISH_BP_OM: Adaptation of Customer Code in BP (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), with SAP Business Partner (SAP BP) activated, the customer-specific
source code must be adapted so that data can be retrieved from the tables created for
this release. The adaptation is relevant for the customer code of both business partners
(BPs) and patients. The status of the switch is first checked. If SAP BP is active, the
code is retained, otherwise redirection is necessary.
o Database access
All accesses to the database tables created before this release, for both BPs and
patients, must be redirected to the SAP BP and HC role-specific tables created
for this release.
o Programs
All standard programs are already adapted as part of the changeover. Any
customer-specific programs must be adapted so that data is retrieved from the
new HC-specific tables.
o Views
All standard views are already adapted as part of the changeover. Only
customer-specific views and source code must be adapted.
All views containing one or more of the specified tables must be adapted to work
correctly after the changeover.
Adapting different view types:
- Maintenance views
Delete the affected table from the view definition. For the fields that were
located within the deleted table, create and replace global fields where
required.
Create a new PBO module by using existing function modules to retrieve
the values for the replaced fields. The re-architecture switch must be
checked so that the correct tables are accessed, depending on the switch
setting.
- Database views
For the direct selects on a database view containing the specified tables,
the switch must be checked. If it is not active, the direct select can be
executed. When the switch is activated, the exact information that would
have been retrieved by executing the earlier select statement will be
retrieved from the database tables created for this release. This is done by
having a direct select statement on the joins between these tables.
- Search helps
The redirection of search helps involves a check on the status of the
switch. If SAP BP is active, the search is redirected to the search locator
screen, which searches the new tables.

53
ISH_BP_OM: AT, CH, FR: Business Partner: New Fee Recipient Role
(New)
Use
Note: The information in the following release note only applies if you have activated
the SAP Business Partner in SAP Patient Management (IS-H).
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management BP/OM (ISH_BP_OM), the central
SAP Business Partner is available for business partner administration if you have
activated conversion to the SAP Business Partner.
The role HC Fee Recipient has been created so that fee recipient master data can
also be entered for the central SAP Business Partner (transaction BP).
Fee recipient master data is institution- or company code-dependent, as was previously
the case.

54
ISH_BP_OM: BP Migration: Phases (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), if you want to use SAP Business Partner (SAP BP) for maintaining BP
and patient data, you must migrate the existing data located in SAP Patient
Management.
The data that must be migrated can be separated into three categories. The
dependencies between the categories (for example, category 3 depends on category 2,
and category 2 depends on category 1) determine the sequence in which the data is
migrated.
1. Customizing data
Parts of IS-H-specific Customizing for table fields that will be migrated to tables
owned by SAP BP, for example Form of Address and Marital Status.
1. Master data
IS-H BPs and BP functions
- IS-H Patients
- IS-H Patients with Provisional Master Data
1. Object link data (data modeling relationships between objects)
- Implicit relationship (for example, the patient's next of kin is stored as free
text)
- Foreign key relationships and references to keys of other objects (for
example, reference to patient's employer)
- Separate foreign key assignment tables modeling relationships

Effects on Customizing
The data is migrated in the following phases:
o Phase 0: General Migration Activities for BP
You can access the data migration programs for Phase 0 in Customizing for SAP
Healthcare - Industry-Specific Components for Hospitals under Tools ->
Migration of Business Partner and Hospital Structure -> Migration of
Business Partner -> Phase 0: General Migration Activities for BP.
o Phase 1: Migration Preparation for BP
You can access the data migration programs for Phase 1 in Customizing for SAP
Healthcare - Industry-Specific Components for Hospitals under Tools ->
Migration of Business Partner and Hospital Structure -> Migration of
Business Partner -> Phase 1: Migration Preparation for BP.
o Phase 2: Data Migration for BP During Uptime
You can access the data migration programs for Phase 2 in Customizing for SAP
Healthcare - Industry-Specific Components for Hospitals under Tools ->
Migration of Business Partner and Hospital Structure -> Migration of
Business Partner -> Phase 2: Data Migration for BP During
Uptime.
o Phase 3: Data Migration for BP During Downtime
You can access the data migration programs for Phase 3 in Customizing for SAP
Healthcare - Industry-Specific Components for Hospitals under Tools ->
Migration of Business Partner and Hospital Structure -> Migration of

55
Business Partner -> Phase 3: Data Migration for BP During
Downtime.
o Phase 4: Activities for BP After Migration
You can access the data migration programs for Phase 4 in Customizing for SAP
Healthcare - Industry-Specific Components for Hospitals under Tools ->
Migration of Business Partner and Hospital Structure -> Migration of
Business Partner -> Phase 4: Activities for BP After Migration.

56
ISH_BP_OM: BP Migration: Number Assignments (New)
Use
SAP Patient Management (IS-H) provides separate number range objects for the
business partner (with sub-objects per business partner function), for the patient, and
for the patient with provisional master data. Each number range object can be assigned
a separate number interval for internal and external number assignment. Multiple
number range objects can share the same number interval. As of SAP ECC 6.0,
Industry Extension Healthcare, Enhancement Package 4 (IS-H 604), Business
Function SAP Patient Management: Rearchitecture BP/OM (ISH_BP_OM), SAP
Business Partner (SAP BP) offers the same function through the use of number
groupings and the assignment of groupings to number range intervals.
SAP BP number ranges may already be in use which overlap or interfere with the
various IS-H number ranges for business partners and patients. An identical mapping
of some IS-H intervals to SAP BP intervals may not be possible since business
partners with an identical primary key may already exist. In such cases, you must
choose alternative SAP BP number ranges for the migration.

Effects on Customizing
You can access the data migration programs for Phase 1 in Customizing for SAP
Healthcare - Industry-Specific Components for Hospitals under Tools -> Migration
of Business Partner and Hospital Structure -> Migration of Business Partner ->
Phase 1: Migration Preparation for BP.

57
ISH_BP_OM: BP Migration: SAP BP Customizing (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), IS-H Customizing tables are migrated to SAP Business Partner (SAP
BP) Customizing tables, as a part of the migration of Customizing data. The
Customizing data to be migrated includes title, form of address, name prefix, name
affix, marital status, and sex indicator.
SAP BP Customizing tables for academic title, form of address, marital status, and so
on, may already contain entries which prevent the IS-H Customizing data from being
migrated with identical keys and values. You must identify and manually resolve
conflicting keys or already existing values.
You provide information on the following:
o Whether IS-H Customizing must be mapped to identical SAP BP Customizing
o Alternative mapping of IS-H key or value to SAP BP Customizing entries in case
of conflicts
The program checks:
o Whether SAP BP Customizing tables are empty
o Whether identical mapping of Customizing entries is possible
The program to prepare SAP BP Customizing displays any conflicting entries and
allows you to enter an alternative mapping. The program saves the alternative
mappings in a Customizing mapping table for reference later during data migration. No
SAP BP Customizing tables are filled.
The program to migrate the Customizing tables fills the SAP BP Customizing tables
with entries from IS-H Customizing. It checks whether you provided alternative
mappings.
Both of the programs are repeatable during Phase 1. Once data has been migrated to
SAP BP based on these mapping settings, these programs are no longer repeatable.
Effects on Customizing
You can access the data migration programs of Phase 1 in Customizing for SAP
Healthcare - Industry-Specific Components for Hospitals under Tools -> Migration
of Business Partner and Hospital Structure -> Migration of Business Partner ->
Phase 1: Migration Preparation for BP.

58
ISH_BP_OM: BP Migration: Invalid FI Assignments (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), during Phase 1 of migration the invalid Financial Accounting (FI)
assignments for SAP Patient Management (IS-H) business partners are handled in the
following manner:
o Invalid FI assignments for IS-H business partner
For IS-H business partners in the Customer function, the reference to the FI
customer can be manually set to any customer in FI, including FI customers from
account groups that are assigned to patients (self-payer). Therefore it is possible
that multiple IS-H customers can be assigned the same FI customer (n:1).
Secondly, if an IS-H customer is maintained for more than one company code,
then a different FI customer can be assigned for each company code (1:n).
o Reasons for need to resolve invalid FI customer assignments
Since Master Data Synchronization (MDS) only supports 1:1 synchronization, all
assignments that are not 1:1 are invalid from the perspective of MDS.
During data migration, a synchronization link between business partners and
existing FI customers will be created from references in IS-H tables to FI
customers. If multiple assignments exist, the migration tool cannot determine
which assignment should be migrated and which ones are invalid. You must
resolve invalid assignments and decide which one should be migrated.
Unresolved assignments cannot be migrated to synchronization links. This will
not affect the billing processes in IS-H, or prevent you from working with the
system. However, changes in SAP Business Partner master data will not be
updated in the related FI customer.

Effects on Customizing
You can access the data migration programs for Phase 1 in Customizing for SAP
Healthcare - Industry-Specific Components for Hospitals under Tools -> Migration
of Business Partner and Hospital Structure -> Migration of Business Partner ->
Phase 1: Migration Preparation for BP.
You can access the data migration programs for Phase 3 in Customizing for SAP
Healthcare - Industry-Specific Components for Hospitals under Tools -> Migration
of Business Partner and Hospital Structure -> Migration of Business Partner ->
Phase 3: Data Migration for BP During Downtime.

59
ISH_BP_OM: BP Migration: FI Synchronization Links (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), with SAP Business Partner (SAP BP) activated, Master Data
Synchronization (MDS) is used after migration to provide integration between business
partners in role HC Customer and FI customers. MDS offers the same functions
(creation, synchronization, BAdIs for custom mapping) for integration with FI and also
allows for two-directional synchronization. The synchronization is always defined as a
one-way synchronization depending on the synchronization direction (SAP BP -> FI, FI
-> SAP BP) that is active. If both directions are active then the synchronization
becomes undirected.
To use MDS you must set up the necessary MDS Customizing. This includes:
o Activate synchronization direction SAP BP -> FI customer
o Activate synchronization direction FI customer -> SAP BP (if you want business
partners to be automatically created when creating an FI customer)
o Specify the business partner roles for which FI customers will be created
o Specify the FI account groups and the business partner roles in which the
business partner is to be created (direction FI -> SAP BP)
o Map SAP BP groupings to FI account groups
o Map FI account groups to SAP BP groupings
MDS Customizing must be performed only after the data migration has been
completed, since the creation of business partners during migration could lead to
duplicate FI customers. Active MDS Customizing also considerably slows down the
creation of business partners using direct input during migration.
It is essential that the program to establish FI synchronization links is executed last in
Phase 3, before the SAP BP switch is changed to active.
If the migration status is set to SAP BP Active, the program will directly update the
synchronization links between the business partner and FI customer according to your
changes.
Effects on Customizing
The data migration programs for Phase 3 can be accessed in Customizing for SAP
Healthcare - Industry-Specific Components for Hospitals under Tools -> Migration
of Business Partner and Hospital Structure -> Migration of Business Partner ->
Phase 3: Data Migration for BP During Downtime.

60
ISH_BP_OM: BP Migration: Master Data and Relationships (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Rearchitecture BP/OM
(ISH_BP_OM), there are separate new tables to store the master data. All central data
(common data) for all the business partners, patients, and patients with provisional
master data is stored in the BUT000 table provided by SAP Business Partner (SAP
BP). BUT000 has foreign-key relationships to the Address (BUT020), Roles (BUT100)
and Relationships (BUT050) tables. Table NBUP hosts all data that is common to all
SAP Patient Management (IS-H) business partners but is not handled by SAP BP (in
other words, by BUT000). New tables are created to store the role-specific data for
business partners, patients, and patients with provisional master data.
The following table gives the relationships between the tables that existed prior to this
release and the new tables:
o For business partners:

IS-H BP SAP BP Re-Architecture Description


NGPA BUT000 and NBUP General business
partner data
NDEB NCUS Customer
NKRH NHSP Hospital
NABG NEPR Employer
NPER NPRS Person*
NKTR NINS Insurance provider
*Person refers to physicians, external physicians, and employees.
o For patients:

IS-H Data Source SAP BP Data Target


NPAT BUT000
NPNT
o For patients with provisional master data:

IS-H Data Source SAP BP Data Target


NPAP BUT000
NPPT
Data must be migrated from the IS-H data source to the SAP BP data target mentioned
above.
The primary keys of master data tables NGPA and NPAT must be stored as references
to the old records in the corresponding tables of SAP BP (NBUP and NPNT,
respectively). This is necessary for the IS-H programs to distinguish between business
partners in non-patient roles and business partners in HC Patient role. The reference
also facilitates the update of migrated business partners where their corresponding IS-

61
H object has changed in the meantime (delta migration before switching to SAP BP).
The primary key of table NPAP will not be stored in the SAP BP table NPPT as
reference. Instead, the old primary key of NPAP and references to this key in other IS-
H tables will be updated during migration with the primary key of the SAP BP in role HC
Patient w. Prov. Data. The references of the dependent tables for the HC Patient w.
Prov. Data (in other words, other tables that store references to the primary key of
NPAP) will be updated with the SAP BP keys.
The following are also migrated: IS-H BPs with the deletion indicator set, IS-H patients
with the cancellation indicator set . IS-H patients with provisional master data with the
cancellation indicator set are not migrated.
o For Address Data
SAP BP uses Business Address Service (BAS) for address validation and postal code
correctness. BAS stores address details in its own table (ADRC). Thus, data is
migrated from the NADR table (which was used to store address details prior to this
release) to the ADRC table. Except for the geographical area, all NADR fields can be
mapped to table ADRC of BAS. The geographical area is stored in table NPNT for
business partners in role Patient only.
o For Relationship Data
- For business partners:
Relationships amongst insurance providers are stored in the BUT050 table
(contains central details for the relationship) and NIPR table (contains data
specific to the Insurance Provider - Insurance Provider relationship). Data
is migrated from TNREL to these tables. These include the following
relationships:
Is Form Recipient of
Is HC SC Head Office of
Is Invoice Recipient of
Is Head Office for Data Exchange acc. to 301 SGB V (DE) of
In this release, an employer acting as the accident insurance provider
(stored in NABG table) is stored as a relationship between an HC
Insurance Provider and an HC Employer. Also, the responsible PPA
stored in the insurance provider table (NKTR) is stored as a relationship
between an HC Insurance Provider and a business partner. The
relationship details of these two relationships are stored in the BUT050
table.
- For Patient:
Next of Kin
The details of the two next of kin of the patient were stored in the NPAT
table prior to this release. After migration, this data is maintained as
relationships to the patient, and data is stored in the BUT050 and NNOK
(table to store data specific to next of kin relationship) tables after
migration.
Patient's Employer
If the patient's employer is maintained as free text in the NPAT table then
these details are migrated into the corresponding fields of the NPNT table.
In this release, if an employer is assigned to a patient, this is stored as a
Patient-Employer relationship. After migration, data is stored in the
BUT050 and NPEP (table to store data specific to Patient-Employer
relationship) tables.
Patient's Physician
In this release, the referral and family physician assigned to a patientare
stored as relationships to a patient. Data is stored in the BUT050 table.

62
Effects on Customizing
The data migration programs of Phase 2 can be accessed in Customizing for SAP
Healthcare - Industry-Specific Components for Hospitals under Tools -> Migration
of Business Partner and Hospital Structure -> Migration of Business Partner ->
Phase 2: Data Migration for BP During Uptime.
The data migration programs of Phase 3 can be accessed in Customizing for SAP
Healthcare - Industry-Specific Components for Hospitals under Tools -> Migration
of Business Partner and Hospital Structure -> Migration of Business Partner ->
Phase 3: Data Migration of BP During Downtime.

63
ISH_BP_OM: BAPI "BAPI_BUSPARTNER_CHANGE" (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management BP/OM (ISH_BP_OM), you can
use the Business Application Programming Interface (BAPI)
BAPI_BUSPARTNER_CHANGE to delete a business partner's title, name affix, and
name prefix.
It was not possible to delete this data until now, because the BAPI only took the data
into account if the fields TITLE, AFFIX, and PREFIX were not initial in the BAPI change
structure BAPI1309BPARTINX.

You can now use the BAPI to change the business partner's short name.
The field for the short name was previously not available in the change structure
BAPI1309BPARTINX. The fields SHORT_NAME_BP and SHORT_NAME_BPX have
now been added to the structure for this purpose.

64
ISH_BP_OM: Business Partner Grouping for Patients and Next of Kin
(New)
Use
Note: The information in the following release note only applies if you have activated
the SAP Business Partner in SAP Patient Management (IS-H).
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management BP/OM (ISH_BP_OM), you
maintain patients and next of kin as SAP business partners in the Clinical
Process Builder if you have activated conversion to the SAP Business Partner.
You must specify a business partner grouping to create SAP business
partners.

Effects on Customizing
You must define the business partner grouping for new patients and next of kin in the
Customizing activity Maintain Business Partner Grouping for Patients and Next of
Kin according to the institution.
See also
For more information, see Patient Management -> Patients -> Maintain Business
Partner Grouping for Patients and Next of Kin in Customizing for Healthcare.

65
ISH_BP_OM: Address Maintenance for Patient from CPB (New)
Use
Note: The information in the following release note only applies if you have activated
the SAP Business Partner in SAP Patient Management (IS-H).
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management BP/OM (ISH_BP_OM), you can
maintain more than two addresses for a patient if you have activated conversion to the
SAP Business Partner.
An additional dialog box now displays an overview of all the addresses for a patient.
You can also access functions for creating and deleting addresses and for maintaining
address details from this dialog box.
The dialog box for editing several telephone numbers for an address now contains two
additional fields:
o Country for the country code
o Comment for entering an additional text on a telephone number

66
ISH_BP_OM: Maintaining Next of Kin from CPB (New)
Use
Note: The information in the following release note only applies if you have activated
the SAP Business Partner in SAP Patient Management (IS-H).
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management BP/OM (ISH_BP_OM), you can
maintain more than two next of kin for a patient if you have activated conversion to the
SAP Business Partner.
Effects on Existing Data
An additional dialog box now displays an overview of all next of kin for a patient. You
can also access functions for creating and deleting next of kin and for maintaining
details on next of kin from this dialog box.

67
ISH_BP_OM: Patient's Employer - Additional Name Field (New)
Use
Note:
The information in the following release note only applies if you have activated the SAP
Business Partner in SAP Patient Management (IS-H).
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management BP/OM (ISH_BP_OM), you can
record an additional or second name for the patient's employer if you have activated
conversion to the SAP Business Partner.

68
ISH_BP_OM: Death Data Subscreen in Clinical Process Builder (New)
Use
Note: The information in the following release note only applies if you have activated
the SAP Business Partner in SAP Patient Management (IS-H).
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management BP/OM (ISH_BP_OM), a Death
Data subscreen is available in the Clinical Process Builder if you have activated
conversion to the SAP Business Partner.
You can incorporate this subscreen in customer-defined variants.
You can still maintain death data as before, by choosing the menu path Extras ->
Death Data.

69
ISH_BP_OM: Risk Factors Subscreen in CPB (New)
Use
Notes:
o The information in the following release note only applies if you have activated
the SAP Business Partner in SAP Patient Management (IS-H).
o This release note applies to all country versions except Singapore and Canada.
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management BP/OM (ISH_BP_OM), a Risk
Factors subscreen is available in the Clinical Process Builder if you have
activated conversion to the SAP Business Partner.
You can incorporate this subscreen in customer-defined variants.
You can still maintain risk information as before by means of the menu path
Extras -> Risk Factors or the transaction codes NP04 (IS-H: Maintain Risk
Information) and NP05 (IS-H: Display Risk Information).

70
ISH_BP_OM: Address Usages for Patient Addresses (New)
Use
Note: The information in the following release note only applies if you have activated
the SAP Business Partner in SAP Patient Management (IS-H).
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management BP/OM (ISH_BP_OM), you can
maintain one or more address usages for a patient address if you have activated
conversion to the SAP Business Partner. An address usage is created when an
address is assigned to an address type.
You can also assign each patient a standard address type. You can use this role-
specific address type in combination with the address usages to control how the main
address is displayed and how the corresponding geographical area is determined.
Effects on Customizing
You can define address types as you wish in Customizing for the SAP Business
Partner under Define Address Types.
Please note that SAP delivers a standard address type XXDEFAULT, which you must
not delete.
See also
For more information, see the following documentation:
o Customizing under Cross-Application Components -> SAP Business Partner
-> Business Partner -> Basic Settings -> Address Determination -> Define
Address Types.
o F1 help for the address type Patient Role.

71
Business Function SAP Patient Management Country Version
France
ISH_CV_FR: Business Function SAP Pat Mgmt Country Version
France (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), the business function SAP Patient Management Country Version France
(ISH_CV_FR) is available. You can use this business function to access the special
functions and fields for the country version France.
For more information, see the following release notes:
o ISH_CV_FR: Institution (New)
o ISH_CV_FR: Institution-Related Country-Specific Control Table
(New)
o ISH_CV_FR: Insurance Provider Master Data (New)
o ISH_CV_FR: Physician Master Data (New)
o ISH_CV_FR: Service Master Data (New)
o ISH_CV_FR: Import Service Catalogs (New)
o ISH_CV_FR: Import Diagnosis Catalog CIM10 (New)
o ISH_CV_FR: Import Diagnosis Category Catalog CMD (New)
o ISH_CV_FR: Movement Data (New)
o ISH_CV_FR: Movement Types (New)
o ISH_CV_FR: Case Categories (New)
o ISH_CV_FR: Patient Master Data - Birth Rank (New)
o ISH_CV_FR: Insurance Card Carte Vitale: Import Card Data
(New)
o ISH_CV_FR: Close Radiotherapy Preparation Case (New)
o ISH_CV_FR: Outpatient Visit: Entry of Coordinated Care Path
(New)
o ISH_CV_FR: Insurance Card Carte Vitale: Insurance
Relationship (New)
o ISH_CV_FR: Insurance Relationships for Statutory Health Ins.
Schemes (New)
o ISH_CV_FR: Check When Entering Insurance Relationships
(New)
o ISH_CV_FR: Check Social Insurance Number (New)
o ISH_CV_FR: Contract Schemes: Grouping Key (New)
o ISH_CV_FR: Diagnosis Entry (New)
o ISH_CV_FR: New Fields in Service Entry (New)

72
o ISH_CV_FR: Service Rules: F00 - Gen. Patient Contribution
Service (New)
o ISH_CV_FR: Service Rules: F01 - Complementary Services
(New)
o ISH_CV_FR: Service Rules: F02 - Fee Surcharge (New)
o ISH_CV_FR: Service Rules: F03 - Remap NABM Services (New)
o ISH_CV_FR: Service Rules: F04 - LPP Material Services (New)
o ISH_CV_FR: Service Rules: F05 - Patient Contribution
Exemption (New)
o ISH_CV_FR: Service Rules: F06 - Association Codes (New)
o ISH_CV_FR: Service Rules: F07 - Generate Daily Hospital
Rates (GHS) (New)
o ISH_CV_FR: Service Rules: F08 - GHS Service (Mother-Child)
(New)
o ISH_CV_FR: Service Rules: F09 - Generate EXH Surcharge
(GHS) (New)
o ISH_CV_FR: Service Charges: F10 - Per Diem Fee (New)
o ISH_CV_FR: Service Charges: F11 - Per Diem Fee - Public
Hospital (New)
o ISH_CV_FR: DRG Work Station: Process DRG-Relevant Data
(New)
o ISH_CV_FR: Determine Billing Type (New)
o ISH_CV_FR: Insurance Verification: Create, Print IV Requests
(New)
o ISH_CV_FR: Payment Distribution: Enhancement of Payment
Distribution (New)
o ISH_CV_FR: Fee-Based Billing (New)
o ISH_CV_FR: Display EDI Status in Case-Related Billing (New)
o ISH_CV_FR: EDI Comm.: RSF - Standardized Inv. Messages
Outpatient (New)
o ISH_CV_FR: Communication: B2 - Electronic Invoice Transfer
(New)
o ISH_CV_FR: ISH_CV_FR: EDI - Comm.: LPP - FICHKOMP File
for Medical Products (New)
o ISH_CV_FR: EDI Comm.: RSF - Standardized Inv. Messages
Inpatient (New)
o ISH_CV_FR: EDI: RSP - Standardized Message for
Radiotherapy Prep. (New)
o ISH_CV_FR: EDI Communication: RSS - Standardized
Discharge Message (New)

73
o ISH_CV_FR: EDI Comm.: UCD - FICHKOMP File for Drugs
(New)
o ISH_CV_FR: EDI Comm.: VIDHOSP File for Treatments (New)
o ISH_CV_FR: Response to Electronic Invoice - NOEMIE (New)
o ISH_CV_FR: Rules for Creating FI Doc. / Electronic Invoice
(B2) (New)

Effects on Existing Data


To use this business function, you must also activate the business function ISH_MAIN.
To make the enhancements for fee-based billing and payment distribution available for
use, you must also activate business function ISH_MISC1.

See also
For further information on Support Package Release Information for SAP Patient
Management and SAP Ambulatory Care Management, see SAP Service
Marketplace under the quick link /healthcare-releasenotes.

74
ISH_CV_FR: Institution (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), the following indicators have been added to the Customizing settings for
institutions:

o FINESS Chain
The number specified here is the legal FINESS number of the hospital or
hospital group. It is used for statutory reporting (for example, for the standardized
RSS discharge message).
o Legal Form
Legal form of your hospital.
o Price Specification
Indicates the method used to specify prices.

Effects on Customizing
You can find these indicators in Customizing under SAP Healthcare - Industry-
Specific Components for Hospitals -> Basic Settings -> Create Institution.

75
ISH_CV_FR: Institution-Related Country-Specific Control Table
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), the institution-related control table FR: System Control Parameters
(Instit.- and Time-Dep.) (/ISHFR/PARAM) is available for defining the following
parameters:

Parameter Short Description


CC_DAYS IV: Deadline for Automatic
Transfer in Days
COL_GPRS Column for Displaying Base Price
in Service Entry
F07_SERV Service for Daily Hospital Rate
F09_SERV EXH Surcharge
FRB2_CTYPE EDI Procedure FRB2: Excluded
Case Type
MCO_FACT MCO Coefficient
MCO_GFILES Grouper - Path for Input and
Output Files
MCO_GPATH Grouper - Path Grouper and Inifile
(grpmco.exe + mcofg.ini)
MCO_GPROG Grouper - Program Name
(grpmco.exe)
MCO_GTABLE Grouper - Path to \tables Directory
SPP_GHS Self-Payer Contribution for DRG
Service (in Percent)
F02_SERV Service for Fee Surcharge
F02_ZUOTP Assignment Type for Fee
Surcharge
CV_PATH Carte Vitale: Path for Data Files
(pdt-cdc-011.csv,...)
CP_TMPFILE Carte Vitale: Path for temporary file
with card data

For more information about each parameter, see the F1 help.

76
Effects on Customizing
You can access the parameters in Customizing under SAP Healthcare - Industry-
Specific Components for Hospitals -> Basic Settings -> System Parameters ->
FR: Institution-Related Country-Specific Control Table.

77
ISH_CV_FR: Insurance Provider Master Data (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), the following France-specific fields have been added to the Other
Control Information subscreen for insurance provider master data (NKTR) and
insurance provider types (V_TN18):

o Complementary Insurance
o Insurance Provider ALSACE
o Without Per Diem
o Limit Payment Distribution by Contract Scheme
o Insurer Type

Effects on Customizing
You can also maintain the above fields for the insurance provider type.
The new fields are available in Customizing under SAP Healthcare - Industry-
Specific Components for Hospitals -> Patient Accounting -> Business Partners /
Insurance Relationships -> Define Insurance Provider Types.

78
ISH_CV_FR: Physician Master Data (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), the following France-specific fields have been added to the physician
master data:

o Charge Zone
o Charge Zone Function
The system requires this data when performing the communication procedure FRB2
(Transfer of Electronic Invoices).

Effects on Customizing
You specify which charge zone can be combined with which function in Customizing
under SAP Healthcare - Industry-Specific Components for Hospitals -> Hospital
Basic Data -> Business Partners -> FR: Define Charge Zone.

79
ISH_CV_FR: Service Master Data (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), a new Gen. France tab page has been added for use in maintaining
France-specific fields. The fields are displayed in the various subscreens on this tab
page, depending on the charge type.

The following fields are available:


o General Data
- Service Type
- SI Reimbursement
- Patient Contribution Exemption
- Insurance Verification Request Necessary
- Prevention
- Grouping Key
- Outpatient Grouping Key
- Pharmacy Sales Indicator
- TA2 Indicator
- Official Price Indicator
- Additional Costs Indicator
o Fee Data
- Fee-Relevant
- Fee Type
- Fee Subgroup
o GHS Data
- Maximum Length of Stay
- Average Length of Stay
- Minimum Length of Stay
- Service Price
- EXH Price
- Discount
- Daily Hospital Rate Included

You can also maintain the assignment of service exclusions and the assignment of
modification codes and association codes for each activity and phase to the service
master data.

Effects on Customizing
You must define the grouping keys, the medical category, and the modification codes.

80
You can access the grouping codes in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Hospital Basic Data -> Service
Master Data -> CCAM -> Maintain Grouping Keys.
You can access the medical category in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Hospital Basic Data -> Service
Master Data -> CCAM -> Maintain Medical Category.
You can access the modification codes in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Hospital Basic Data -> Service
Master Data -> CCAM -> Maintain Modification Code.

81
ISH_CV_FR: Importing Service Catalogs
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), reports are available for importing the various service catalogs.
You can access these programs as follows in Customizing:
o SAP Healthcare - Industry-Specific Components for Hospitals -> Hospital
Basic Data -> Catalogs -> IS-H FR: Import CCAM Service Master
Data (/ISHFR/RNWFRCCAM_LOAD)
o SAP Healthcare - Industry-Specific Components for Hospitals -> Hospital
Basic Data -> Catalogs -> IS-H FR: Import GHM Service Master
Data (/ISHFR/RNWFRGHM_LOAD)
o SAP Healthcare - Industry-Specific Components for Hospitals -> Hospital
Basic Data -> Catalogs -> IS-H FR: Import GHT Service Master Data
(/ISHFR/RNWFRGHT_LOAD)
o SAP Healthcare - Industry-Specific Components for Hospitals -> Hospital
Basic Data -> Catalogs -> IS-H FR: Import GHS Service Master Data
(/ISHFR/RNWFRGHS_LOAD)
o SAP Healthcare - Industry-Specific Components for Hospitals -> Hospital
Basic Data -> Catalogs -> IS-H FR: Import NABM Service Master
Data (/ISHFR/RNWFRNABM_LOAD)
o SAP Healthcare - Industry-Specific Components for Hospitals -> Hospital
Basic Data -> Catalogs -> IS-H FR: Import UCD Service Master Data
(/ISHFR/RNWFRUCD_LOAD)
o SAP Healthcare - Industry-Specific Components for Hospitals -> Hospital
Basic Data -> Catalogs -> IS-H FR: Import LPP Service Master Data
(/ISHFR/RNWFRLPP_LOAD)

82
ISH_CV_FR: Import Diagnosis Catalog CIM10 (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), you can use the IS-H FR: CIM10 Import Report
(/ISHR/RNWFRUICIM10) to import the diagnosis catalog CIM10.

See also
For more information, see Customizing under SAP Healthcare - Industry-Specific
Components for Hospitals -> Hospital Basic Data -> Catalogs -> IS-H FR:
Import Diagnosis Catalog CIM10.

83
ISH_CV_FR: Import Diagnosis Category Catalog CMD (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), the report IS-H FR: CMD Import Report
(/ISHFR/RNWFRUICMD) is available for importing the CMD diagnosis category
catalog.

See also
For more information, see Customizing under SAP Healthcare - Industry-Specific
Components for Hospitals -> Hospital Basic Data -> Catalogs -> IS-H FR:
Import CMD Diagnosis Category Catalog.

84
ISH_CV_FR: Movement Data (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), a new Palliative indicator has been added to the movement data, so
that you can mark treatment as palliative on an admission or transfer.

85
ISH_CV_FR: Movement Types (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), the following indicators have been added to the Customizing settings for
movement types:

o Admission - Retransfer (retransfer after 48 hours)


Indicates whether the movement type involves admitting a patient who is
retransferred after a stay of more than 48 hours in an external hospital.
o Visit Types - Pharm. Sale (pharmacy sales)
Indicates that this outpatient visit involves the sale of a drug to the patient by the
hospital.

Effects on Customizing
You can enter and indicate these movement types in Customizing under SAP
Healthcare - Industry-Specific Components for Hospitals -> Patient Management ->
Movements -> FR: Define Movement Types.

86
ISH_CV_FR: Movement Data (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), a new Palliative indicator has been added to the movement data, so
that you can mark treatment as palliative on an admission or transfer.

87
ISH_CV_FR: Movement Types (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), the following indicators have been added to the Customizing settings for
movement types:

o Admission - Retransfer (retransfer after 48 hours)


Indicates whether the movement type involves admitting a patient who is
retransferred after a stay of more than 48 hours in an external hospital.
o Visit Types - Pharm. Sale (pharmacy sales)
Indicates that this outpatient visit involves the sale of a drug to the patient by the
hospital.

Effects on Customizing
You can enter and indicate these movement types in Customizing under SAP
Healthcare - Industry-Specific Components for Hospitals -> Patient Management ->
Movements -> FR: Define Movement Types.

88
ISH_CV_FR: Case Categories (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), the following two new case categories are available:

o R - Radiotherapy
o D - Dialysis

Effects on Customizing
You can find these case categories in Customizing under SAP Healthcare - Industry-
Specific Components for Hospitals -> Patient Management -> Cases -> Define
Case Categories .

89
ISH_CV_FR: Patient Master Data - Birth Rank (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), a new Birth Rank indicator is available in patient master data, allowing
you to specify the birth sequence.
The birth rank is used to distinguish between insured persons who were born on the
same day (twins, triplets, or spouses).
The default value is 1.

90
ISH_CV_FR: Insurance Card Carte Vitale: Import Card Data (new)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), the following functions are available for further processing of the data
stored on the EHC health insurance card (Carte Vitale).
o You can have the system preassign the data stored on the health insurance card
in the patient search. You can search directly for patient data using the Copy
Card Data function in the Clinical Process Builder (transaction NV2000), if the
health insurance card of the patient you are searching for is in the reader. The
system displays all the insured persons' data on the card (for example, mother
and children under 16) in a list, from which you select the desired patient.
o The system executes the patient search with the health insurance number or
birth date and birth rank. If the system does not find a patient who matches
these criteria, it searches with the birthdate and the first letter of the patient's
first and last names. When creating a new patient (for example if there is no
patient in the system who matches the selection criteria), the system uses the
patient data stored on the card as default data.
o In addition to the Clinical Process Builder, you can import card data or enter
replace documentation when maintaining insurance relationships (also using
the Copy Card Data function).
o If the health insurance card is not in the reader or there is no reader connected
to the system when card data is transferred, you always have the option of
entering replacement documention using the same function. The system displays
a list of document categories that can be entered and you must select the
desired document. This means the card data that can be read optically can be
entered manually in the system.

Effects on Customizing
You make the settings for document categories for replacement documentation in
Customizing under SAP Healthcare - Industry-Specific Components for Hospitals
-> Communication -> Carte Vitale -> EHIC Health Ins. Card - Assign Document
Categories.
You activate the BAdIs in Customizing under SAP Healthcare - Industry-Specific
Components for Hospitals -> Communication -> Carte Vitale -> BAdI: Connection
to Carte Vitale.

91
ISH_CV_FR: Close Radiotherapy Preparation Case (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), the Close Preparation Case function is available for use with
discharges (NV2001).
Preparations for radiotherapy can take place as part of outpatient cases. These
outpatient cases must be assigned to the inpatient case or to the last day hospital case
in which the therapy took place, by means of case-to-case assignment (internal
function = R - Radiotherapy).
You can use the new Close Preparation Case function to make this case-to-case
assignment when discharging a patient.
This procedure is necessary so that the RSP file is created correctly.

Effects on Customizing
Create a function with the internal type R (Radiotherapy) in Customizing under SAP
Healthcare - Industry-Specific Components for Hospitals -> Patient Management -
> Cases -> Define Functions of a Case-to-Case Assignment.

See also
For more information, see the section about the RSP procedure in the documentation
for the report Manual Message Generation for Various MCO
Communication Procedures.

92
ISH_CV_FR: Outpatient Visit: Entry of Coordinated Care Path (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), you can specify whether each outpatient visit in an outpatient case
takes place as part of a "coordinated care path".
"Coordinated care path" is the term that describes a legal requirement in France
requires each statutorily insured person over the age of 16 to declare a leading
physician. The patient is to visit this leading physician first for outpatient treatment; they
can then refer them to other physicians. Patients who do not declare a leading
physician or who consult other physicians directly must pay a higher patient
contribution. Certain specialties or patients living a long distance from their place of
residence can be excluded from this rule.
You enter this information in the Referral Type field in the visit data. The system
prompts you to enter the patient's leading physician when you enter a referral type that
requires this entry. Enter the leading physician in the Family Physician field.

Effects on System Administration


We recommend that you create a variant in the Clinical Process Builder that positions
the Visit Data and Physicians subscreens one above the other for outpatient visit
maintenance.
Effects on Customizing
Create possible referral types and assign them to the internal values for entering
physician arrivals, which are used when creating the electronic invoice (B2).
For more information, see Maintain Referral Types/Postdischarge Treatment Types
in Customizing for SAP Healthcare.

93
ISH_CV_FR: Health Ins. Card Carte Vitale: Insurance Relationship
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), the following functions are available for entering default health data in
case-related insurance relationships:
o You can read the health insurance card or enter a replacement document using
the Copy Card Data function.
o If you wish, you can have the system propose an insurance relationship (with an
assignment to the card or replacement document) based on the data imported
from the card or replacement document.
When doing so, the system attempts to make an assignment to an insurance
provider based on the entries in the Health Insurer Type, Health Insurer, and
Administration fields. If it does not succeed in doing this, you must enter the
insurance provider manually.
o You can assign this data to the current case-related insurance relationship when
you create a new case in document selection (by means of the Copy Card Data
function) for patients for whom card or replacement document data already
exists in the system.
o You can cancel an assignment between an insurance relationship and data for
the insurance card or replacement document using the Delete Assignment
function.
o If the patient master data from the health insurance card does not match the
existing master data in the system (for example, birthdate), the system displays a
screen on which you can decide which data is to be copied.
o In the case of insurance relationships involving coinsured patients, you can also
use the MI Data function to display the data on the main person insured (social
insurance number, first and last name) and add any missing data.

94
ISH_CV_FR: Ins. Relationships for Statutory Health Ins. Schemes
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), the following new fields are available with the function for entering case-
related insurance relationships for entering information on statutory health insurance
schemes correctly:
o Billable SI field:
This field indicates the coverage status of the current case in relation to the
statutory health insurance scheme. The information is transmitted to the regional
health authority (ARH), for example, with the VIDHOSP file. You can define
possible values for this field in Customizing.
o Insurance Provider Category field:
You can use this field to specify that the patient in the current case is covered by
the national health insurance scheme (AME), the complementary national health
insurance scheme (AME-C), or has (complementary) general basic health
insurance (CMU and CMUC). The statutory health insurance scheme assumes
the role of insurance provider for these forms of coverage.
o Insurance Provider Alsace indicator
In the Alsace-Moselle region, there are patients who belong to the local health
insurance scheme "Alsace-Moselle". This local health insurance fund type has its
own coverage and billing rules. You can use the new indicator to identify these
cases.
o Copayment Waiver field
In this field, you specify the reason why the patient is exempted from paying the
patient contribution.
Please note that the system also enters exemption reasons automatically using
service rule F05.

Effects on System Administration


If you select the Alsace indicator in the insurance provider's master record, the system
automatically selects the indicator as a default value in the insurance relationship with
this insurance provider.
Effects on Customizing
Maintain the possible values for the Billable SI field in Customizing under SAP
Healthcare - Industry-Specific Components for Hospitals -> Patient Accounting ->
Business Partners / Insurance Relationships -> Coverage Status for Social
Insurance.
Maintain reasons for patient contribution exemptions in Customizing. Specify whether
the exemption reason also constitutes an exemption from the daily hospital rate. To do
this, choose SAP Healthcare - Industry-Specific Components for Hospitals ->
Patient Accounting -> Business Partners / Insurance Relationships -> Maintain
Reasons for Exemption from Fixed Patient Contribution.

95
ISH_CV_FR: Check When Entering Insurance Relationships (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), the system runs the following checks when you enter insurance
relationships:

o Check on billing type determination


A column for the contract scheme has been added to billing type determination
(Determine Billing Type table (/ISHFR/TN21A)).

To avoid errors during billing, the system checks whether a billing type can be
determined for the combination entered when saving the insurance relationships.
The F4 help for the contract scheme only displays the contract schemes that you
have defined for the case type in question.
The system cannot determine the billing organizational unit at the stage at which
the insurance relationships are entered, which means it is not taken into account
during the check on billing type determination.
o Check on social insurance indicator
There can only be one insurance provider with a social insurance indicator in its
master data in the insurance relationships for each case and time. This means
there cannot be overlapping social insurance relationships.
o Check on copayment waiver
If a case includes several insurance relationships with social insurance schemes,
they must all have the same value in the Copayment Waiver
(ISH_NIRA_DISPLAY-NZZGR) field. If this is not the case, the system displays
an error message.

Effects on Customizing
You make the necessary settings in Customizing under SAP Healthcare - Industry-
Specific Components for Hospitals -> Patient Accounting -> Billing -> HyperLink:
SIMG./ISHFR/ABRART FR: Determine Billing Types .

96
ISH_CV_FR: Check on Social Insurance Number (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), the system checks the check digit when you enter the social insurance
number (patient and main person insured). If it is incorrect, the system displays a
message. You can specify which type of message is to be displayed.
The system only checks the data for the main person insured if the type of coverage is
"dependent coverage".

When calculating the check digit, the system converts the entry for the dpartement for
insured persons on Corsica to a numerical value: 2A = 19, 2B = 18.

The system calculates the check digit for the insured person's SI number as follows
(modulo 97):
1. The 13-digit SI number is divided by 97.
2. The check digit is the difference between the remainder from point 1 and 97.

Example: SI number 1290278551031


1. 1290278551031 : 97 => remainder 27
2. 97-27 = 70
Check digit = 70

97
ISH_CV_FR: Contract Schemes: Grouping Key (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR) you can use contract schemes for billing, using service groups
(combined using the grouping key) as a basis. You can define complementary
contract schemes in addition to standard ones. You enter the grouping key in the
service master data, for example PH8 (inpatient) or PHH (outpatient).
Flag complementary contract schemes by making an entry in the field Complementary
(/ISHFR/KOMPL) in the master data. When you set this indicator, the system interprets
the percentage field as the total of the percentage of social insurance cover and
supplementary insurance.
You can define criteria to be applied to a specific service group (using the grouping
key, such as PH8 grouped) in the contract schemes' item data (such as
Maximum/Case) (Include indicator is set). You can make exceptions for specific
services in the same way (Exclude indicator is set). To do this enter the grouping
key value in the Field Name field, and enter the grouping codein the field Field Value.

Effects on Customizing
Make the necessary settings in Customizing under SAP Healthcare - Industry-
Specific Components for Hospitals -> Patient Accounting -> Business Partners /
Insurance Relationships ->Maintain Contract Schemes.

98
ISH_CV_FR: Diagnosis Entry (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), the new Related Department Main Diagnosis indicator is available in
diagnosis entry (NV2001 or NP61).

99
ISH_CV_FR: New Fields in Service Entry (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), a new France tab page has been added to service entry (NL10N),
where you can maintain the following fields:

o Activity
o Phase
o Modification Code 1- 4
o Association Code
o Base Price
o LPP Purchase Price
o NABM Coefficient
o NABM Unit
o Price
o Price/Fee Surcharge
o SI Reimbursement
o Prescription Date
o Exemption from Patient Contribution

100
ISH_CV_FR: Service Rules: F00 - Gen. of Patient Contribution Service
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), service rule F00 is available for generating patient contribution services
(charge type F0).
The system generates patient contribution services when a case contains billable or, in
the case of public institutions, non-billable services, with the exemption type A or B
(NLEI-/ISHFR/EXO_CP).
You define whether an institution is private or public in the Hospital Type field.
Each time the service rule is executed, the system redetermines all the services that
are to be generated. It compares these services with the existing generated patient
contribution services to determine which new patient contribution services are to be
inserted and which existing ones can be deleted.
The patient contribution services generated by the service rule can also be created
manually. The service rule never cancels manual patient contribution services.

Effects on Customizing
o You must activate service rule F00 in the check procedure.

You activate the service rule in Customizing under SAP Healthcare - Industry-
Specific Components for Hospitals -> Patient Accounting -> Service Rules -
> Define Rule Types and Maintain Check Procedure.
o You define which prerequisites must be fulfilled before the service can be
generated in the Customizing table FR: Generate Patient Contribution (F00).

You make the settings for this function in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Patient Accounting ->
Service Rules -> FR: Service Rules -> FR: Generate Patient
Contribution (F00).

o You must define a condition type with requirement 117 and calculation formula
132 in the pricing procedure.
For more information, see Customizing under SAP Healthcare - Industry-
Specific Components for Hospitals -> Patient Accounting -> Billing ->
Configure Special Forms of Billing -> FR: Notes on Setting Up Forms
of Billing.
See also
For more information, see the documentation in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Patient Accounting -> Service
Rules -> FR: Service Rules -> FR: Service Rules Overview.

101
ISH_CV_FR: Service Rules: F01 - Complementary Services (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France, the service
rule F01 is available for use in checking complementary services.
You can mark a complementary service by entering the corresponding value in the
Service Type field (ISHFR/NTPK-LEIST_ART) in the master data for a CCAM service.
The service rule checks whether there is at least one other billable service that is not a
complementary service in the system for the case in addition to one complementary
service per day.

Effects on Customizing
You must activate the service rule in the check procedure.
You make the Customizing settings for this function under SAP Healthcare - Industry-
Specific Components for Hospitals -> Patient Accounting -> Service Rules ->
Define Rule Types and Maintain Check Procedure.

See also
For more information, see Customizing under SAP Healthcare - Industry-Specific
Components for Hospitals -> Patient Accounting -> Service Rules -> Country-
Specific Service Rules -> FR: Service Rules Overview .

102
ISH_CV_FR: Service Rules: F02 - Fee Surcharge (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), service rule F02 is available for generating fee surcharges.
Physicians can charge prices that exceed those specified in the service catalog
(including surcharges resulting from modifications, and so on). However, the social
insurance scheme only covers a certain percentage (for example, 80%) of the specified
price. The rest (including any fee surcharges) is paid by the private insurance fund or
the self-payer.
You enter the final amount (including fee surcharges) in the Price/Fee Surcharge field
(NLEI-/ISHFR/HOPRICE) on the detail screen for the service.
The service rule simulates pricing and generates a surcharge service. You must specify
the service code of this fee surcharge service once in the control table FR: System
Control Parameters (Institution- and Time-Dependent) (/ISHFR/PARAM).
You must link the fee surcharge service with the original service. You can do this using
the Asgmt of Svce to Mat., to Pers. Costs, to Svce table (NLLZ) and the assignment
type defined in the control table (Fee Surcharge Assignment Type parameter). You
must create the assignment type with the property S.
When generating the fee surcharge service, the system displays a message indicating
the service based on which the fee surcharge service is generated.

Effects on Customizing
o You must create the surcharge service in the service catalog.
o You must create an assignment type with the maintenance indicator
S(assignment of services performed).
You do this in Customizing under SAP Healthcare - Industry-Specific
Components for Hospitals -> Hospital Basic Data -> Service Master Data ->
Define Assignment Types .
o You must enter the service code of the surcharge service in the Fee Surcharge
Service parameter in the control table FR: System Control Parameters
(Institution- and Time-Dependent) (/ISHFR/PARAM). You must also specify
the assignment type that is used to link the fee service with the original service in
the Fee Surcharge Assignment Type parameter.

You make these entries in Customizing under SAP Healthcare - Industry-


Specific Components for Hospitals -> Basic Settings -> System Parameters
-> FR: Institution-Related Country-Specific Control Table.
o You must activate service rule F02 in the check procedure.
You do this in Customizing under SAP Healthcare - Industry-Specific
Components for Hospitals -> Patient Accounting -> Service Rules ->
Define Rule Types and Maintain Check Procedure.

See also
For more information, see the documentation in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Patient Accounting -> Service
Rules -> FR: Service Rules -> Service Rules Overview .

103
104
ISH_CV_FR: Service Rules: F03 - Remap NABM Services (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), service rule F03 is available for remapping laboratory services.
This service rule remaps laboratory services (catalog NABM) to an allocatable service.
Laboratory services from the NABM catalog belong to charge type F3. You must
specify the allocatable service (NABM_TALST) in the service master for these services
(table FR: Additional Fields for Service Master France (/ISHFR/NTPKFR) together
with the corresponding conversion coefficient, to which the system is to remap the
services.
This service rule now makes entries in the Billing Catalog, Billing Service, and
NABM Coefficient fields for each NABM service entered.
The system takes account of the value entered in the NABM Coefficient field during
pricing.

Effects on Customizing
You must activate service rule F03 in the check procedure.
You do this in Customizing under SAP Healthcare - Industry-Specific Components
for Hospitals -> Patient Accounting -> Service Rules -> Define Rule Types and
Maintain Check Procedure.

See also
For more information, see the documentation in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Patient Accounting -> Service
Rules -> FR: Service Rules -> Service Rules Overview .

105
ISH_CV_FR: Service Rules: F04 - LPP Material Services (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), service rule F04 is available for calculating the prices of material
services from the LPP catalog.
Material services in the LPP catalog are assigned charge type F4 in the service master.
You can enter the purchase price in the Purchase Price field (NLEI-/ISHFR/PUR_PR)
in service entry. You must maintain the reference price in the catalog columns for the
service master. The system simulates pricing in order to determine the reference price.
The system determines the column for the reference price and the statutory factor from
the LPP Pricing table.

The service rule determines the price for LPP services as follows:
o If the purchase price is higher than the reference LPP price, the reference LPP
price is allocated.
o If the purchase price is lower than the reference LPP price, the system calculates
the price as follows:
price = purchase price plus (reference LPP price minus purchase price)
multiplied by factor.
The service rule enters the price to be allocated in the Manual Price field to prevent
pricing from taking place during billing.

Effects on Customizing
o You must activate service rule F04 in the check procedure.

You do this in Customizing under SAP Healthcare - Industry-Specific


Components for Hospitals -> Patient Accounting -> Service Rules ->
Define Rule Types and Maintain Check Procedure.
o You must define a reference price column and a factor for the service used in the
Customizing table FR: LPP Pricing.

You make these settings in Customizing under SAP Healthcare - Industry-


Specific Components for Hospitals -> Patient Accounting -> Service Rules -
> Country-Specific Service Rules -> FR: LPP Pricing (F04).

See also
For more information, see the documentation in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Patient Accounting -> Service
Rules -> FR: Service Rules -> Service Rules Overview .

106
ISH_CV_FR: Service Rules: F06 - Association Code (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), service rule F06 is available.
Service rule F06 checks which associated services are defined for the main service.
You must enter the value 1 manually in the Association Code field (NLEI-
/ISHFR/ASS_CD) in service entry for the main service. You must enter associated
services as individual services.
If the case contains associated services that are assigned the same date / activity /
phase / performing physician (internal function 02) as the main service, the service rule
enters the association code in the Association Code field (NLEI- /ISHFR/ASS_CD) or
overwrites it (with a warning message), depending on the settings in the master data.

Effects on Customizing
You must activate service rule F06 in the check procedure.

You do this in Customizing under SAP Healthcare - Industry-Specific Components


for Hospitals -> Patient Accounting -> Service Rules -> Define Rule Types
and Maintain Check Procedure.

See also
For more information, see the documentation in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Patient Accounting -> Service
Rules -> FR: Service Rules -> Service Rules Overview.

107
ISH_CV_FR: Service Rules: F05 - Patient Contribution Exemption
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), service rule F05 is available.
Service rule F05 (/ISHFR/CHECK_SERVICES_F05) automatically selects the Service-
Related Patient Contribution Exemption field (NLEI-/ISHFR/EXO_CP) if an
exemption reason is specified.
The service rule also checks whether the indicator needs to be cancelled or changed.

Effects on Customizing
o You must activate service rule F05 in the check procedure.

You do this in Customizing under SAP Healthcare - Industry-Specific


Components for Hospitals -> Patient Accounting -> Service Rules ->
Define Rule Types and Maintain Check Procedure.
o You can define the threshold value for each contract scheme in the Customizing
table Maximum Limit for Exemptions (/ISHFR/TNWFRLVTY).

You make these settings in Customizing under SAP Healthcare - Industry-


Specific Components for Hospitals -> Patient Accounting -> Service Rules -
> Country-Specific Service Rules -> Threshold for Exemption per
Contract Scheme (F05).

See also
For more information, see the documentation in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Patient Accounting -> Service
Rules -> FR: Service Rules -> Service Rules Overview .

108
ISH_CV_FR: Service Rules: F07 - Generate Daily Hospital Rate (GHS)
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), service rule F07 is available.
Service ruleF07 determines the period in a case for which a daily hospital rate (charge
type F6) is to be generated. This service rule only applies if GHS services are billed for
the case.

Effects on Customizing
o You must activate service rule F07 in the check procedure.

You do this in Customizing under SAP Healthcare - Industry-Specific


Components for Hospitals -> Patient Accounting -> Service Rules ->
Define Rule Types and Maintain Check Procedure.
o You should have created the daily hospital rate service as an extended service
with charge type F06 in service master data. You must specify the service code
of this service in the Service for Daily Hospital Rate parameter in the control
table FR: Institution-Related Country-Specific Control Table.

You can find this parameter in Customizing under SAP Healthcare - Industry-
Specific Components for Hospitals -> Basic Settings -> System Parameters
-> Institution-Related Country-Specific Control Table.

See also
For more information, see the documentation in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Patient Accounting -> Service
Rules -> FR: Service Rules -> Service Rules Overview .

109
ISH_CV_FR: Service Rules: F08 - GHS Service (Mother-Child) (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), service rule F08 is available. This service rule makes the necessary
adjustments to the GHS service for newborn infants.
The grouper returns a GHS service (billable DRG service) for newborn infants that are
admitted for inpatient treatment, as for all other inpatient cases. The system then
creates this service in the case.
Newborn infants are not invoiced for the GHS service. The service must be billed for
the mother's case.
For this reason, this service rule copies the GHS service for the child to the mother's
case and sets the service for the child to non-billable.

Effects on Customizing
o You must activate service rule F08 in the check procedure.

You do this in Customizing under SAP Healthcare - Industry-Specific


Components for Hospitals -> Patient Accounting -> Service Rules ->
Define Rule Types and Maintain Check Procedure.
See also
For more information, see the documentation in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Patient Accounting -> Service
Rules -> FR: Service Rules -> Service Rules Overview .

110
ISH_CV_FR: Service Rules: F09 - Generate EXH Surcharge (GHS)
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), service rule F09 is available for generating EXH surcharges. This
service rule only applies if there is a billable DRG service in the system.
Service rule F09 determines the number of EXH surcharge services and their price.

Effects on Customizing
o You must activate service rule F09 in the check procedure.

You do this in Customizing under SAP Healthcare - Industry-Specific


Components for Hospitals -> Patient Accounting -> Service Rules ->
Define Rule Types and Maintain Check Procedure.
o You should have created the EXH surcharge service as an extended service with
charge type F09 in service master data. You must specify the service code of
this service in the EXH Surcharge parameter in the control table IS-H FR:
System Control Parameters (Instit.- and Time-Dep.) (/ISHFR/PARAM). You
must also define the MCO Coefficient parameter in the control table. The
system uses this parameter in pricing.

You can find this parameter in Customizing under SAP Healthcare - Industry-
Specific Components for Hospitals -> Basic Settings -> System Parameters
-> Institution-Related Country-Specific Control Table.
o You must define the MCO coefficient as a condition with condition class A
(surcharges or deductions), calculation type G (formula), and an item condition.
Then specify this condition type in your pricing procedure with requirement 115
and calculation formula 130.
For more information, see the Customizing documentation under SAP
Healthcare - Industry-Specific Components for Hospitals -> Patient
Accounting -> Billing -> Configure Special Forms of Billing -> Notes on
Configuring Forms of Billing.

See also
For more information, see the documentation in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Patient Accounting -> Service
Rules -> Country-Specific Service Rules -> Service Rules Overview .

111
ISH_CV_FR: Service Rules: F10 - Per Diem Fee
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), service rule F10 is available for generating a per diem fee (charge type
FA) for inpatient and day patient cases.
The system generates services for the periods between the movements admission,
transfer, absence, and discharge. If the patient has not yet been discharged, the
system generates the services up to a key date (default = system date).
You can also enter per diem fee services manually. However, if your entries conflict
with the services to be generated by the service rule, the system modifies the services
you enter manually. In some cases, this can mean that the system deletes per diem fee
services that have been entered manually.
You can change the billing indicator for per diem fee services manually. The system
does not use it when comparing new and existing services.

Effects on Customizing
o You must activate service rule F10 in the check procedure.

You do this in Customizing under SAP Healthcare - Industry-Specific


Components for Hospitals -> Patient Accounting -> Service Rules ->
Define Rule Types and Maintain Check Procedure.
o You specify which prerequisites must be fulfilled before the per diem fee can be
generated in the Customizing table FR: Generate Per Diem Fee.
You make the settings for this function in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Patient Accounting ->
Service Rules -> FR: Service Rules -> FR: Generate Patient
Contribution (F00).

See also
For more information, see the documentation in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Patient Accounting -> Service
Rules -> FR: Service Rules -> FR: Service Rules Overview.

112
ISH_CV_FR: Service Rules: F11 - Per Diem Fee - Public Hospital (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), service rule F11 is available.
This service rule is relevant for French hospitals that still bill daily per diem nursing
charges. The rule determines the period in a case for which a daily hospital rate
(charge type F6) is to be generated, and generates the corresponding service.
The service can only be generated if a valid insurance relationship exists for the
statutory health insurance scheme on the discharge date.
The system generates the daily hospital rate for the period from the admission date to
the discharge date minus 1. The system generates a separate service item for the
discharge date.
Daily hospital rates are not generated for absence days.

Effects on Customizing
o You must activate service rule F11 in the check procedure.

You make the settings for this function in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Patient Accounting ->
Service Rules -> Define Rule Types and Maintain Check
Procedure.
o You must also specify the service that is to be generated by the service rule in
the Service for Daily Hospital Rate field. You make this setting in the IMG activity
Institution-Related Country-Specific Control Table.
See also
For more information, see the documentation in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Patient Accounting -> Service
Rules -> FR: Service Rules -> FR: Service Rules Overview.

113
ISH_CV_FR: DRG Work Station: Process DRG-Relevant Data (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France (ISH_CV_FR),
the DRG work station is available for processing and controlling DRG-relevant data for
inpatient cases.
To access the DRG work station, you create and use a variant in the Clinical Process
Builder. This function allows you to document diagnoses and services that need to be
valuated. The system only displays CCAM services in the overview, since no other
services are relevant.
After the system exports the data to the DRG grouper, the grouper returns the MDC
code and a billable GHS service. The grouper also categorizes the diagnoses into
principal and secondary diagnoses.
On the tab page DRG-Data the system displays both data for the GHS service
(average length of stay and so on) and RSS data (standardized discharge messages)
with the individual RUMs (standardized transfer messages).

Effects on Customizing
o Define the DRG grouper in Customizing under
SAP Healthcare - Industry-Specific Components for Hospitals ->
Communication -> DRG Data Exchange -> Define DRG grouper.
o You also need to define the DRG grouper assignment.
Do this in Customizing under SAP Healthcare - Industry-Specific
Components for Hospitals -> Communication -> DRG Data Exchange ->
Define DRG Grouper Assignment.
o You also need to define the DRG grouper file conventions.
Do this in Customizing under SAP Healthcare -Industry-Specific
Components for Hospitals -> Communication -> DRG Data Exchange -
>Define DRG Grouper File Conventions.
o You must enter the following grouper paths in table /ISHFR/PARAM:
For more information, see Customizing under SAP Healthcare - Industry-
Specific Components for Hospitals -> Basic Settings-> System Parameters-
> FR:Institution-Related Country-Specific Control Table.
o You must define the parameters of the DRG documentation.
Do this in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Medical/Nursing
Documentation -> DRG Documentation ->Set Parameters for DRG
Documentation .

114
ISH_CV_FR: Billing Type Determination (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), the contract scheme is available as an additional criterion for
determining the billing type.

Effects on Customizing
You can add the contract scheme as a criterion for determining the billing type in
Customizing under SAP Healthcare - Industry-Specific Components for Hospitals
-> Patient Accounting -> Billing -> FR: Determine Billing Types.

115
ISH_CV_FR: Insurance Verification: ISH_CV_FR: Payment
Distribution: Enhancement of Payment Distribution (new)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France (ISH_CV_FR),
enhanced functions are available for payment distribution.
You can use the field Cost Reimbursement SI (KOERS_SV) = 1' to define in the
service master data whether the relevant services are covered by social insurance. You
can also use service rule F05to enter exemption reasons on the service level if social
insurance covers 100% of the costs.
You can define complementary supplementary insurances in addition to standard
supplementary insurances. For contract schemes of this type, the contract defines the
percentage of the service amount is transferred to totals (social insurance +
supplementary insurance). You can use the complementary button to set the indicator
in the contract scheme.
Example:
Service A: Copayment price (excluding manually entered fee surcharges) = 100

SI covers 80% of the service copayment price = 80
SI + Supp. Ins. cover up to 150% of the service price = 150
Maximum portion covered by Supp.Ins. = 150 - SI portion = 150 - 80 = 70
When a physician bills 190 for service A, the system generates a surcharge
service (using service rule F02) with the alternative price 90. During billing, the
payment distribution would be as follows:
Social Insurance: 80 for service A
Supplementary Insurance: 20 for service A, 50 for fee surcharge
Self-payer: 40 for fee surcharge
The system uses a separate price determination as the basis for distribution for private
hospital institutions. Price determination uses a specific contract scheme as a basis,
which you set in Customizing under FR: Payment Distribution by Contract
Scheme. This special price determination (limit by contract scheme) is only used for
distribution (that is, the calculation of the sum that is transferred from the POS). The
system uses the pricing defined by the contract scheme entered in the insurance
relationship to create invoices.

Effects on Customizing
You maintain contract schemes under SAP Healthcare - Industry-Specific
Components for Hospitals -> Patient Accounting -> Business Partners /
Insurance Relationships ->Maintain Contract Schemes.
You assign the billing types in Customizing under SAP Healthcare - Industry-
Specific Components for Hospitals -> Patient Accounting -> Billing ->FR:
Determine Billing Types.

116
Create, Print IV Requests (new)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), a function for creating insurance verification requests is available.
Specific services are only covered by social insurance under certain circumstances.
You must flag these services in the service master data on the tab page France
General. If you enter the value 3 in the Cost Reimbursement SI field on the France
General tab page, an insurance verification request is required for this service.
You can access insurance verification from case-related invoice processing. The
system then displays all services that are relevant for insurance verification. No other
services are displayed here, since they do not require an IV request. At this point, you
can document IV requests, confirmations or rejections for the coverage of individual
services. You can print IV requests from this transaction, and send them to the insurer.
Effects on Customizing
The work organizer type for insurance verification is KUANFR.
You can use the PDF-based form /ISHFR/NINSVERF_REQUEST as a standard form
for insurance verification requests.
You must define the period after which the system should automatically confirm the
insurance verification in the control table in the parameter IV Deadline for Automatic
Transfer in Days (CC_DAYS).
For more information, see Customizing under SAP Healthcare - Industry-Specific
Components for Hospitals -> Basic Settings-> System Parameters -> FR:
Institution-Dependent Country-Specific Control Table.

117
ISH_CV_FR: Fee-Based Billing (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), all the functions of fee-based billing are available.

Effects on Customizing
You make the necessary settings in Customizing under SAP Healthcare - Industry-
Specific Components for Hospitals -> Patient Accounting -> Billing -> CH, AT,
FR: Fee-Based Billing.

See also
For more information, see Hospital -> Patient Accounting -> Billing -> Fee-Based
Billing in the SAP Library.

118
ISH_CV_FR: Display of EDI Status in Case-Related Billing (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), you can display details of the EDI status for the invoices created in
case-related invoice processing.
The electronic data interchange information is relevant when processing invoices for
which electronic invoice messages (B2) are created and dispatched, and for which you
then receive receipt notifications (NOEMIE). The system displays the following
information on the invoice documentation on the Invoice Overview tab in case-related
invoice processing.
o Dispatch status: status relating to electronic invoice B2
o Date sent: date on which the last B2 message for the invoice was sent
o Receipt status: information on the status of the payment message received
(NOEMIE). The possible statuses are Payment made or Payment rejected.
o Receipt date: date on which the last message was received
o Receipt code and description: displays errors or information from the NOEMIE
message.

Effects on Customizing
The NOEMIE receipt messages contain a message code. Maintain all the possible
message codes in Customizing and assign them an internal code category. The system
uses the internal code category to distinguish between success messages and error
messages. This controls how the dispatch status of the B2 message is displayed.
Maintain the message codes in Customizing under SAP Healthcare - Industry-Specific
Components for Hospitals -> Communication -> Electronic Data Interchange -> Country
Specifics -> Country Specifics for France -> Conversion of Receipt Codes.

See also

The receipt status of the NOEMIE message can only be displayed if the messages are
imported into the system. See release note ISH_CV_FR: Response to Electronic
Invoice - NOEMIE (New).

119
ISH_CV_FR: EDI: RSF - Std Inv. Messages in Private Sector - Outp.
Clinic
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), the EDI communication procedure FRACE is available for creating and
transmitting standardized invoice messages for outpatient treatment at public
healthcare institutions (RSFACE) by means of electronic data interchange (this is
required for PMSI).
The system identifies all the outpatient cases admitted to an organizational unit marked
with M, C, or O and that match the criteria for the event generation report.
You can use the report IS-H FR: RSF-ACE - Create Dispatch Orders Manually
(ISHFR/RN_ACE_ORDER_CREATE) to trigger message order generation manually. If
you do this, you must then use the EDI Workbench to create and send the messages.

Effects on Customizing
For more information, see SAP Healthcare - Industry-Specific Components for
Hospitals -> Communication -> Electronic Data Interchange -> Customizing Step-
By-Step -> FR: Procedure for FRACE Customizing in Customizing.

120
ISH_CV_FR: Communication: B2 - Electronic Invoice Transfer
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), the EDI communication procedure FRB2 is available for sending
electronic invoices to the social insurance provider according to B2 (CP).
The system creates the dispatch orders automatically at invoice creation. However, you
can also use the report FR: B2 - Create Dispatch Orders Manually
(/ISHFR/RN_B2_ORDER_CREATE) to trigger message order generation manually.
You can carry out further processing, such as message creation and dispatch, using
the EDI Workbench (transaction NEDI).
You can define various criteria according to which the system is to dispatch invoices
(for example, for specific insurance providers or insurance provider categories) in
Customizing. You also specify whether the invoices are to be transferred to FI in the
Customizing settings.
You can create your own B2 messages for specific services (for example, CT, MRI) in
outpatient cases that are covered separately by the social insurance scheme. You must
make an entry in the FR: Control Settings for B2 Dispatch table for this
purpose. You must enter the entry you defined in the source code for the services (for
example, CT to characterize CT services) in the user field.
You can dispatch B2 invoices for foreign patients temporarily visiting France. Before
you can do this, you must enter the EHIC data in IS-H. There must be an international
agreement between France and the patient's country of origin. You must make a
corresponding entry in the FR: Control Settings for B2 Dispatch table (the
EHIC and B2 Dispatch indicators must be selected).
You can use the B2 Data Exchange BAdI to override the system entries for invoice
data and the settings for B2 dispatch and FI postings.

Effects on Customizing
For more information, see SAP Healthcare - Industry-Specific Components for
Hospitals -> Communication -> Electronic Data Interchange - Procedure Guides -
> Customizing for FRB2 Procedure.
See also the Customizing activities under SAP Healthcare - Industry-Specific
Components for Hospitals -> Communication -> Electronic Data Interchange ->
Country Specifics -> Country Specifics for France -> Invoice Transfer B2.

121
ISH_CV_FR: EDI Comm.: LPP - FICHKOMP File for Medical Products
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France (ISH_CV_FR),
the EDI communication procedure FLPP is available for creating and transmitting LPP
files using electronic data interchange (this is required for PMSI).
The following prerequisites must be fulfilled if material (from the LPP catalog) is to be
included in the communication procedure:
o You must assign the charge type F4 to the material.
o The material must be flagged as billable in the service master data.
o You must select the option T2A in the service master data.
The system only processes inpatient cases when they have already been discharged, a
standardized discharge message (RSS) has been sent, and the discharge executed in
the desired period. The system only generates messages from movements to MCO
organizational units.
You can use the LPP option of report Manual message generation for various MCO
communications procedures (/ISHFR/RN_MCO_ORDER_CREATE) to trigger message
generation manually. You then need to execute the message generation and dispatch.

Effects on Customizing
For more information, see SAP Healthcare - Industry-Specific Components for
Hospitals -> Communication -> Electronic Data Interchange - Procedure Guides ->FR:
Customizing for MCO Procedure .

122
ISH_CV_FR: EDI - Comm.: RSF - Standardized Inv. Messages
Inpatient (new)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France (ISH_CV_FR),
the communication procedure FRRSF is available for creating and transmitting
standardized invoice messages (RSF) in the private sector (this is required for PMSI).
The system considers all cases that have active invoices (B2 invoices that have been
sent and not cancelled later). The system takes the data for RSF messages directly
from the B2 invoices. Messages for invoices that are not transferred using B2
communication are created with the status "stopped". If the system dispatches the B2
messages for these cases at some point, it dispatches the stopped messages the next
time the FRRSF communication procedure runs.
You can use report Create Dispatch Orders Manually
(ISHFR/RN_RSF_ORDER_CREATE) to manually trigger message generation.
Proceed with message generation and message dispatching as usual.

Effects on Customizing
For more information, see SAP Healthcare - Industry-Specific Components for
Hospitals -> Communication -> Electronic Data Interchange - Procedure Guides ->
HyperLink: SIMG./ISHFR/KOMM_FRRSFFR: Customizing for FRRSF Procedure.

123
ISH_CV_FR: EDI: RSP - Standardized Message for Radiotherapy Prep.
(new)
&USE
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France (ISH_CV_FR),
the communication procedure FRRSP is available for creating and transmitting
standardized messages for radiotherapy preparation (RSP) (this is required for PMSI).
Treat radiotherapy preparation cases as outpatient cases with the case category
radiotherapy. You must also create a case-to-case assignment from an inpatient case
or from the last of a number of day patient cases.
If the system is to generate RSP messages from outpatient preparation cases, you
must ensure that the original cases are eligible.
You can use the RSP option of Manual message generation for various MCO
communications procedures (/ISHFR/RN_MCO_ORDER_CREATE) to manually trigger
message generation. Then proceed with message generation and dispatching as
usual.

Effects on Customizing
You need to define the case categories Radiotherapy and Dialysis in Customizing
under SAP Healthcare - Industry-Specific Components for Hospitals -> Patient
Management-> Cases-> Define Case Categories.
For more information, see SAP Healthcare - Industry-Specific Components for
Hospitals -> Communication -> Electronic Data Interchange - Procedure Guides -> FR:
Customizing for MCO Procedure.

124
ISH_CV_FR: EDI - Communication: RSS - Standardized Discharge
Message (new)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France (ISH_CV_FR),
the communication procedure FRRSS is available for creating and transmitting
standardized messages (RSS) (this is required for PMSI).
The system takes an inpatient or day patient case into account if it has a discharge
movement and its discharge date falls into the period that you select. The system only
generates messages from movements to MCOorganizational units. Movements of the
case categories dialysisand radiotherapy are exceptions. You need not flag the
organizational unit with M, C or O for such cases. The system always includes these
movements in RSS communication.
The system creates an individual RUM sequence for each eligible movement. The
system enters the elements week of gestation, transfer to a palliative care bed, SAPS II
- points into the RUM sequences. When a patient returns after an absence caused by a
transfer to an external hospital:
o If the patient returns to a different organizational unit, the system creates a new
RUM
or
o If the patient returns to the same organizational unit as before, the system
continues to use the existing RUM.
You can use the RSS option of the report HyperLink:
RE./ISHFR/RN_MCO_ORDER_CREATE Manual message generation for various
MCO communications procedures (/ISHFR/RN_MCO_ORDER_CREATE) to manually
trigger message generation. Then proceed with message generation and dispatching
as usual.

Effects on Customizing
You need to define the case categories Radiotherapy and Dialysis in Customizing
under SAP Healthcare - Industry-Specific Components for Hospitals -> Patient
Management-> Cases-> Define Case Categories.
For more information, see SAP Healthcare - Industry-Specific Components for
Hospitals -> Communication -> Electronic Data Interchange - Procedure Guides -> FR:
Customizing for MCO Procedure.

125
ISH_CV_FR: EDI - Comm.: UCD - FICHKOMP File for Drugs (new)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France (ISH_CV_FR),
the communication procedure FRUCD is available for creating and transmitting UCD
files for drugs (this is required for PMSI).
The following prerequisites must be fulfilled if material (from the UCD catalog) is to be
included in the communication procedure:
o You must assign the charge type F8 to the material.
o The material must be flagged as billable in the service master data.
o You must select the option T2A in the service master data.
The system only processes inpatient cases when they have already been discharged, a
standardized discharge message (RSS) has been sent, and the discharge executed in
the period you have selected. The system only generates messages from movements
to MCO organizational units.
You can use the UCD option of report Manual message generation for various MCO
communications procedures (/ISHFR/RN_MCO_ORDER_CREATE) to manually
trigger message generation. You must then proceed with message generation and
dispatching using the appropriate programs.

Effects on Customizing
For more information, see SAP Healthcare - Industry-Specific Components for
Hospitals -> Communication -> Electronic Data Interchange - Procedure Guides -> FR:
Customizing for MCO Procedure.

126
ISH_CV_FR: EDI - Comm.: VIDHOSP-File for Treatments (new)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France (ISH_CV_FR),
the communication procedure FRVID is available for creating and transmitting files for
inpatient and home treatment (this is required for PMSI).
The system considers all invoices for organizational units flagged with M, C, O or HAD
for inpatient or daycare stays that have not been cancelled and fall in the billing period
that you have selected Movements of the case categories dialysis, radiotherapy or
termination of pregnancy are exceptions, since the organizational unit need not be
flagged in such cases. All treatments related to such movements are eligible for
VIDHOSP communication.
You can use the VIDHOSP option of the report HyperLink:
RE./ISHFR/RN_MCO_ORDER_CREATE Manual message generation for various
MCO communications procedures (/ISHFR/RN_MCO_ORDER_CREATE) to manually
trigger message generation. You must then proceed with message generation and
dispatching using the appropriate programs.

Effects on Customizing
You need to define the case categories Radiotherapy, Termination of Pregnancy
and Dialysis in Customizing under SAP Healthcare - Industry-Specific Components
for Hospitals -> Patient Management-> Cases-> Define Case Categories.
For more information, see SAP Healthcare - Industry-Specific Components for
Hospitals -> Communication -> Electronic Data Interchange - Procedure Guides -> FR:
Customizing for MCO Procedure.

127
ISH_CV_FR: Response to Electronic Invoice - NOEMIE (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), you can use the standard EDI file import program (file at operating
system level) (RNC301I0) to import the NOEMIE file (version NOEMIE PS 2004
published in May 2004), the response to the electronic invoice.
You can display the imported NOEMIE message in the EDI worklist, where you can
also display the corresponding B2 message.

128
ISH_CV_FR: Rules for Creating FI Document/Electronic Invoice (B2)
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version France
(ISH_CV_FR), you can define rules in Customizing for creating electronic invoice
messages (B2) and for transferring invoice documents to Financial Accounting (FI).
Public hospitals in France currently only bill some of their invoices directly to the
statutory health insurance fund; for example, invoices for services for foreign nationals
from other EU countries, or for drug sales. These invoices must be transferred to FI and
electronic invoice messages must also be created.
While outpatient invoices for patients in France with statutory health insurance are not
billed directly (no transfer), the electronic invoice (B2) must be transferred for
information purposes.
You can define these rules in the new Customizing table. You can define the rules for
specific insurance providers (insurance provider types and categories) and case
categories in this table. You can also create rules according to the content of the user
field in the billing document.

Effects on Customizing
Define the rules for creating electronic invoice messages (B2) and for transferring
billing documents to Financial Accounting in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Communication -> Electronic Data
Interchange -> Country Specifics -> Country Specifics for France -> Invoice Transfer
B2 -> Control Settings for B2 Dispatch.

129
Business Function SAP Patient Management Country Version
Italy
ISH_CV_IT: Business Function SAP Patient Management: CV Italy
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4, (IS-H
604), the business function SAP Patient Management: CV Italy is available. This
business function contains functions for inpatient and outpatient processing in the
country version Italy, and thus supports localization in SAP Patient Management.
The new functions in SAP Patient Management for the country version Italy include
new fields in the Clinical Process Builder for inpatient and outpatient processes in
private and state hospitals in Italy, such as:
Italian tax number
Local health authority
ISTAT code
Region
For example, you can save the Italian tax number as a patient attribute for automatic
generation.
A number of Customizing activities also support inpatient and outpatient processes in
private or state hospitals in Italy.
For more information, see the following release notes:
ISH_CV_IT: Patient Data at Case Level (Changed)
ISH_CV_IT: Billing of Treatment Certificates (New)
ISH_CV_IT: Calculating the Patient Contribution (New)
ISH_CV_IT: Default Amount for Down Payments (New)
ISH_CV_IT: Enhancement for Treatment Certificates (New)
ISH_CV_IT: Collective Invoice (Changed)

ISH_CV_IT: Patient Data at Case Level for Inpatient Cases (New)


Use
As of SAP ECC 6.0 Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management Country Version Italy (ISH_CV_IT),
a new Patient's Country of Residence field is available for inpatient cases in patient
data at case level

ISH_CV_IT: Billing of Treatment Certificates (New)


Use
As of SAP ECC 6.0 Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management Country Version Italy (ISH_CV_IT),
you can bill treatment certificates for outpatient cases.
The new 'Invoice per Treatment Certificate' indicator is available for this purpose in

130
Patient Accounting. When you select this indicator, the system groups the services for
a case in billing to form logical invoices. This is done as follows:
Each treatment certificate is grouped with the assigned services to form a
logical invoice
All services that are not assigned to a treatment certificate constitute a logical
invoice
In the processing options for the invoice overview in case-related invoice processing
(transaction NA30), you can specify that the 'Invoice per Treatment Certificate' indicator
is always to be selected when billing outpatient cases. You can also have the system
display the document numbers of the treatment certificates billed in the invoice
overview for the logical invoices. This field remains blank for invoices that refer to
services that are not assigned to a treatment certificate.
When you bill the services for a treatment certificate, the system assigns the treatment
certificate the status 'Billed'.
Interim Billing Date
You can also execute treatment certificate billing in the billing mode 'Interim Billing'. The
system handles the specified interim billing date in the following way:
The system bills treatment certificates whose treatment date is before the
interim billing date.
The system does not take treatment certificates without a treatment end date
into account.
Services without a treatment certificate assignment are only taken into account
if all the services have been performed before the specified interim billing date.

Invoice Restrictions for Interim Billing


You can restrict treatment certificate billing to individual treatment certificates, or to
services that do not have a treatment certificate assignment.
Service Entry After Billing
Once you have created invoices for a case, your scope for performing services and
assigning them to treatment certificates is limited.
You can enter billable services at any time for cases with the status 'Interim Billed'. You
can assign these services to a certificate that has not yet been billed or enter them in
the system without a certificate assignment. You cannot make any further changes to
the service assignment for treatment certificates that have already been billed. You
cannot assign new services or delete existing assignments to a billed certificate.
If you enter services subsequently without a treatment certificate assignment, please
note that you can only bill the new services if you have cancelled the invoice created
beforehand, since all services without a treatment certificate assignment constitute a
billing unit.

ISH_CV_IT: Calculating the Patient Contribution (New)


Use
As of SAP ECC 6.0 Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management Country Version Italy (ISH_CV_IT),
you can calculate the patient contribution and include it in treatment certificate billing for
SSN treatment certificates.

131
Definition of Maximum Patient Contribution
A new Customizing activity has been created for defining the maximum patient
contribution:
In Customizing for SAP Healthcare, choose SAP Healthcare - Industry-Specific
Components for Hospitals -> Patient Accounting -> Copayment / Down Payment ->
Outpatient Copayment -> Maintain Maximum Patient Contribution for SSN Treatment
Certificates.
In this activity, you can define the maximum patient contribution for a specific date and
movement type. The system evaluates your entries as follows when billing treatment
certificates for the SSN insurance relationship:
Movement type
The system determines the relevant movement type for a treatment certificate
from the first visit to which the treatment certificate is assigned.
Date
The system interprets your entry as the performance date in the treatment
certificate.
A new Business Add-In (BAdI) is also available in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Patient Accounting -> Copayment /
Down Payment -> Business Add-Ins for Copayment/Down Payment -> BAdI: Change
Maximum Patient Contribution.
You can use this BAdI to change the value of the maximum patient contribution for a
specific customer.
Taking Account of the Patient Contribution During Billing
To include the patient contribution in billing, the system uses the concept of the
contract scheme maximum. The following steps are necessary:
1. Define a rule to calculate the contract scheme maximum with the internal
calculation task 'Deduct Patient Contribution'. You can do this in the following
Customizing activity:
In Customizing for SAP Healthcare, choose SAP Healthcare - Industry-Specific
Components for Hospitals -> Patient Accounting -> Business Partners / Insurance
Relationships -> Settings for Contract Scheme Maximum.
2. Define a contract scheme that uses this rule to calculate the contract scheme
maximum at header level.
3. Assign this contract scheme to the SSN insurance relationship for the outpatient
case.
During billing, the system uses the above settings to determine the maximum patient
contribution and deducts it from the invoice amount for the SSN insurance relationship.

ISH_CV_IT: Default Amount for Down Payments (New)


Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version Italy (ISH_CV_IT), a
default amount function is available.
The system calculates the amount the self-payer would have to pay for billable services
that have not yet been cleared, based on billing for treatment certificates.
The system also takes account of services with the status Planned.

132
ISH_CV_IT: Enhancement for Treatment Certificates (New)
Use
Note: These functions are only available if you activate the business function SAP
Patient Management: Treatment Certificates.
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management Country Version Italy (ISH_CV_IT), the
following fields are available in treatment certificate data:
Unique External ID
External Treatment Certificate Number
Exemption Category
The exemption category describes the main reason why a patient is exempted
from the patient contribution. It is normally specified by the service provider
(and not by the physician who issues the treatment certificate).
Exemption Code
The exemption code describes in detail why a patient is exempted from the
patient contribution. It is specified by the physician who issues the treatment
certificate.
Service Rendering Date
The service rendering date for a treatment certificate is the date on which the
request for the services listed on the certificate is started or regarded as
performed.
Priority
The physician who issues the treatment certificate determines its priority. You
can also specify a priority for treatment certificates issued by the hospital itself
in emergencies to indicate the urgency of treatment.
Performance Mode
The performance mode describes the manner in which services assigned to a
treatment certificate were performed or the more general context in which they
were performed.
Treatment Certificate Class
The Italian national health service (SSN) uses the treatment certificate class to
group treatment certificates that require special attention, for example because
they involve a long wait time for patients.
Recommended Treatment
The recommended treatment is noted on the treatment certificate by the
physician issuing it. The field remains blank if the services are requested
directly by the physician who signed the treatment certificate. The system
enters an 'S' in this field if the services were proposed by the physician who
signed the certificate, for example by a medical specialist or by the attending
physicians at the hospital. The Italian national health service (SSN) assigns the
costs relating to the requested services to the physician who proposed them.
Text for External Physician
The text for the external physician either contains 5-character regional codes or
the tax number of the physician who issues the treatment certificate.
Application Status
The application status indicates the current status of the treatment certificate
relative to the ambulatory report.

133
The internal categories for insurance verification/treatment certificates have been
enhanced:
"7" - cyclic SSN treatment certificate
"8" - non-cyclic SSN treatment certificate
You can use these two new categories to distinguish between treatment certificates
that contain cyclic services and those that do not.
Effects on Customizing
You can maintain the certificate categories with the internal categories 7, Cyclic
Treatment Certificate, and 8, Non-Cyclic SSN Treatment Certificate, in Customizing
under SAP Healthcare - Industry-Specific Components for Hospitals -> Patient
Accounting -> Insurance Verification and Certificates -> Define Certificate Categories.
You can enter the application statuses in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Communication -> Electronic Data
Interchange -> Set Up EDI Procedure -> Maintain Application Status.
The following sections contain information on new Customizing activities:
You can enter the exemption categories in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Patient Accounting -> Insurance
Verification and Certificates -> Maintain Exemption Categories.
You can enter the exemption codes under SAP Healthcare - Industry-Specific
Components for Hospitals -> Patient Accounting -> Insurance Verification and
Certificates -> Maintain Exemption Codes.
You can enter treatment certificate priorities under SAP Healthcare - Industry-Specific
Components for Hospitals -> Patient Accounting -> Insurance Verification and
Certificates -> Maintain Priorities of Treatment Certificates.
You can enter the performance modes under SAP Healthcare - Industry-Specific
Components for Hospitals -> Patient Accounting -> Insurance Verification and
Certificates -> Maintain Performance Modes.
You can enter the treatment certificate classes under SAP Healthcare - Industry-
Specific Components for Hospitals -> Patient Accounting -> Insurance Verification and
Certificates -> Maintain Treatment Certificate Class.
You can enter recommended treatments under SAP Healthcare - Industry-Specific
Components for Hospitals -> Patient Accounting -> Insurance Verification and
Certificates -> Maintain Recommended Treatments.

ISH_CV_IT: Collective Invoice (Changed)


Use
In Italy, treatment certificates are of particular importance when dealing with outpatient
cases. This applies in particular to communication with the national healthcare system
(SSN) and billing for outpatient cases.
As of SAP ECC 6.0 Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management Country Version Italy (ISH_CV_IT),
the treatment certificate selection concept is available, together with functions for
collective invoices.
A treatment certificate selection is a freely definable grouping of treatment certificates,
which you can use, like a case selection, as a worklist. You can create and update
treatment certificate selections using the ambulatory report.

134
The collective invoice function includes the following features:
You can also use treatment certificate selections when creating invoice
selections. For example, this allows you to restrict selection to the treatment
certificates reported in the ambulatory report.
Field ISHBELNR has been added to the results lists of the following
reports/transactions. In invoices created using treatment certificate billing, this
field contains the number of the corresponding treatment certificate.
o Report RNASELR0 (Create Invoice Selections)/transaction NA90
o Report RNASEL00 (Create Collective Invoices)/transaction NA92
o Report RNASEL01 (Print Collective Invoices)/transaction NA93
Field ISHBELNR has been added to the print structure RNFP2S. This means the
treatment certificate number of an invoice is also available for collective invoice
printing.
Effects on Customizing
Check whether you need to make changes or additions to your Customizing settings.
This applies in particular to the following activities:
Check whether you require additional collective invoice categories and whether you
need to make changes or enhancements to the checks for BAdI
ISH_COLLECTIVE_INVOICE:
o SAP Healthcare - Industry-Specific Components for Hospitals -> Patient
Accounting -> Billing -> Define Collective Invoice Categories
o SAP Healthcare - Industry-Specific Components for Hospitals -> Patient
Accounting -> Billing -> Business Add-Ins for Billing -> BAdI: Collective Invoice
Check
Check whether you need to adjust the Customizing settings for work organizer
management:
o SAP Healthcare - Industry-Specific Components for Hospitals -> Tools -> Work
Organizer Management -> Work Organizers
o SAP Healthcare - Industry-Specific Components for Hospitals -> Tools -> Work
Organizer Management -> Business Add-Ins for Work Organizer Management
-> BAdI: Fill Form Structure RNFP2S (Collective Invoice Items)
o SAP Healthcare - Industry-Specific Components for Hospitals -> Tools -> Work
Organizer Management -> Business Add-Ins for Work Organizer Management
-> BAdI: Work Organizer Management: Output Control
See also
See also the release notes on treatment certificates, the ambulatory report, and on
treatment certificate billing.

135
Business Function SAP Patient Management
ISH_MAIN: Business Function SAP Patient Management
Use
You can find the release notes for SAP ECC 6.0, Industry Extension Healthcare,
Business Function SAP Patient Management (ISH_MAIN) on the SAP Service
Marketplace under the quick link /healthcare-releasenotes -> Release Notes. The
release notes for the relevant support packages are available under Release Notes for
Support Packages.
For more information about the enhancements for this business function that are
available with SAP ECC, Industry Extension Healthcare, Enhancement Package 4,
see the following release notes:
o ISH_MAIN: Proc. Rules for Gen. Single-Quantity and Summary
PCs (New)
o ISH_MAIN AT: Scoring - EDI System Control (Changed)
o ISH_MAIN AT: Insurance Relationships / Third-Party Payers
(Changed)
o ISH_MAIN AT: Valuation Formula "22" (Changed)
o ISH_MAIN AT: P321 - BAdI Enhancements (Enhanced)
o ISH_MAIN AT: Patient Management - Electronic Health Ins.
Card (E-Card)
o ISH_MAIN AT: Data Medium Exchange with Private Insurers
(EDIVKA)
o ISH_MAIN AT: EDI Workb./Worklist - Dispatch Orders for
Outp.Cases (Chgd)
o ISH_MAIN AT: File Creation (Changed)
o ISH_MAIN AT: EDI Data Medium Exchange - ELDAL Comm.
Procedure (Changed)
o ISH_MAIN AT: Movements and Case Revision with Intensive
Care Data (New)
o ISH_MAIN AT: EDI Data Medium Exchange - Messages
(Changed)
o ISH_MAIN AT: Printing Coverage Extensions (Changed)
o ISH_MAIN AT: EDI Worklist - Dependent Messages (Changed)
o ISH_MAIN AT: Coverage Evidence List (RNWATKUELIST)
(Changed)
o ISH_MAIN AT: LR A5/15, A9 - Use of Max. Values (with Groups)
(Changed)
o ISH_MAIN AT: Service Rule for Pat. Contribution Gen. (AK)
(Changed)
o ISH_MAIN AT: Message Control (Changed)
o ISH_MAIN AT: Settings for Cancelling Dependent Services

136
(New)
o ISH_MAIN AT: EDI Communication Procedure P321 (Changed)
o ISH_MAIN AT: Changed Behavior for Receipt of Messages
(Changed)
o ISH_MAIN AT: New Report IS-H AT: Coverage Reminder (New)
o ISH_MAIN AT: Collective Printing of Admission/Discharge
Notifs (Changed)
o ISH_MAIN AT: EDI Data Transfer - Comm. Proc. SCO04
(Changed)
o ISH_MAIN AT: Layout of Scoring Work Station (Changed)
o ISH_MAIN AT: Overriding Content of WIKRAF-V Record (New)
o ISH_MAIN AT: Statutory Stats for Stat. Cases
(RNWATSTATISTIK) (Chgd)
o ISH_MAIN AT: Statutory Statistics for Outpatient Cases
(Changed)
o ISH_MAIN AT: CPB - Subscreen AT: Contract Partner Number
(Changed)

137
ISH_MAIN: Field Catalog Enhancement in Report RNAENT00
(Enhanced)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management (ISH_MAIN), an enhanced field
catalog is available for the output list for report RNAENT00 (Billing Status of
Inpatient Cases).
Effects on Existing Data
The following fields have been added:
Med. Doc. Status Text (text for status of medical documentation)
Med. Doc. Status Key (key for status of medical documentation)
Status Profile (status profile of inpatient case)

ISH_MAIN: Form Output with PDF-Based Print Forms (New)


Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management (ISH_MAIN), new functions are
available for form output using PDF-based print forms (Adobe).
The following tables list the SAPscript forms and Smart Forms together with the
corresponding new PDF-based print forms. The forms that have been reworked are
marked with (*).

SAPscript Form PDF-Based Print Form Description


N_INVOICE01 ISH_BILLING Invoice
N_INVOICE02 ISH_INVOICE02 Invoice List
N_INVOICE10 ISH_BILL_AMB Invoice for
Outpatient Self-Payer
N_SG_INVOICE01DE ISH_SG_BILL_D Detailed Bill
N_SG_INVOICE01SE ISH_SG_BILL_E Summary Bill
N_MATANF_OE ISH_MATREQ_OU (*) Material Requisition
OU
N_MATANF_CASE ISH_MATREQ_CASE (*) Material Requisition
per Case
N_KRANKENSCHEIN ISH_SICKNESS_CERT (*) Sickness Certificate
N_NOTFALLSCHEIN ISH_EMERGENCY_CERT (*) Emergency Case
Certificate
N_UEBERSCHEIN ISH_REFERRAL_CERT (*) Referral Certificate
N_ETI ISH_PATIENT_LABEL (*) Patient Labels
N_TERMIN_BENACHR ISH_VISIT_APPOINTMENT (*) Outpatient
Appointment Notification

138
N_ZUZ_RUECK ISH_COPAYMENT_BACK (*) Copayment: Post
Back Form
N_ZUZ_AVIS ISH_COPAYMENT_ADV (*) Copayment:
Payment Advice

Smart Form PDF-Based Print Form Description


ISH_BILL ISH_BILLING Invoice
ISH_COLLECTIVE_BILL ISH_COLLECTIVE_BILL (*) Collective Invoice
ISH_MATERIAL_CATALOGUE ISH_MATERIAL_CATALOGUE (*) Material
Catalog
ISH_CLOSET_LIST ISH_CLOSET_LIST (*) Closet List

Effects on Customizing
These are all sample forms. If you want to use PDF-based forms, you must create your
own forms and adjust output control for your work organizers accordingly.
See also
For an overview of how the forms are used by work organizer types and the names of
the function modules, see the SAP Library documentation under Healthcare -> SAP
Patient Management -> Appendix -> Forms in SAP Patient Management.

ISH_MAIN: Proc. Rules for Gen. Single-Quantity and Summary PCs


(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management (ISH_MAIN), you can use
procedure rules to generate a single-quantity PC (procedure code) from case-related
material consumptions and a summary PC from one or more single-quantity PCs. The
system can then generate a billable additional charge from a summary PC using
service rule R22.

Single-Quantity Procedure Codes


A single-quantity PC is a customer-specific quantity-based procedure that must always
be entered together with a quantity and unit of measure. Since single-quantity PCs are
not official procedures, you must enter them with charge type 81 ("Quantity-Based
PC"). Medical staff can use a single-quantity PC to document the quantity of a
particular active ingredient that is consumed during the course of the treatment period.
The quantity consumed comprises case-related material consumptions that are entered
using one or more single-quantity PCs.

139
Summary Procedure Codes
A summary PC is an officially defined procedure for collating the corresponding
customer-specific quantity-based procedures (single-quantity PCs). A summary PC
must not have charge type 81 and does not have a quantity or a unit of measure. A
summary PC is a procedure that is relevant for generating additional charges. Single-
quantity PCs are used to determine which official procedure code is to be documented
for the quantity of an active ingredient administered in a case from the total quantity for
all single-quantity PCs.
The procedure rules P1 or P2 are available for generating single-quantity and summary
procedure codes. The procedure rules are part of the new procedure framework
function. Like to service rules, the system can use procedure rules to create, change,
or cancel procedures using event-controlled procedure rule Customizing settings and
function modules, provided the prerequisites defined in the function module are met.

Procedure Rule P1
Procedure rule P1 checks and generates a single-quantity PC if there is a case-related
material consumption and the material used is assigned to a single-quantity PC in
Customizing under SAP Healthcare - Industry-Specific Components for Hospitals -
> Medical/Nursing Documentation -> Maintain Assignment of Single-Qty
Proc.Code to Matl and Summary Proc.Code. If you cancel the material consumption
used to generate the single-quantity PCs, the system also cancels the corresponding
single-quantity PCs.
Each individual material consumption counts towards additional charges such as those
for blood transfusions, administering medication, or radiotherapy. In the case of Blood,
the system determines the additional charges in transfusion units (TU). For example,
16 TU of blood would result in an additional charge: 16 TU means that blood was
administered 16 times.
While the actual quantity of blood administered in milliliters with each individual
transfusion is of course important from a medical point of view, it is irrelevant when
generating additional charges. In this context, each individual material consumption
counts.
You can generate single-quantity procedure codes with a quantity of 1 by selecting the
indicator in the new Indiv. column in Customizing under SAP Healthcare - Industry-
Specific Components for Hospitals -> Medical/Nursing Documentation ->
Maintain Assignment of Single-Qty Proc.Code to Matl and Summary Proc.Code.
Procedure rule P1 then generates the corresponding single-quantity PC with a quantity
of 1 and counts these single-quantity PCs singly when calculating the summary PC.
If you select the indicator in the Indiv. column for the assignment rule in the
Customizing activity, procedure rule P1 works as follows: the system generates the
corresponding single-quantity PC with a quantity of 1 and the unit of measure from the
assignment rule (for example, ST) for each case-related material consumption. This
means each single-quantity PC is created independently of the actual material
consumption and the actual unit of measure for the consumption.

Example of Additional Charges ZE33.01


ZE33.01 is defined as follows in the service master: ZE33.01 "Thrombocyte
Concentrates (8-800.80 - 16 TU up to 24 TU)". This means that ZE33.01 can be billed if
at least 16 but no more than 23 transfusions of thrombo concentrates were
administered.
There must be a summary PC 8-800.80 for the case so that service rule R22

140
(Generate Additional Charges) can generate ZE33.01. The system can generate the
summary PC using procedure rule P2 if at least 16 but no more than 23 single-quantity
PCs exist for the administration of thrombocyte concentrates.
The system can generate the required number of 16 - 23 single-quantity PCs using
procedure rule P1 if at least 16 but no more than 23 material consumptions of thrombo
concentrates are recorded in the system ("case-related material consumption"). For
example, if thrombo concentrates are administered three times ("material
consumption") in quantities of 450 ml, 400 ml, and 350 ml, procedure rule P1 generates
three single-copy PCs, each with a quantity of 1 and the unit of measure ST. This
means each transfusion is assigned a quantity of 1 (representing one transfusion) and
the unit of measure selected in the Customizing activity for the assignment rule.

Procedure Rule P2
Procedure rule P2 generates a summary PC if single-quantity PCs exist for the case
and single-quantity PCs are assigned to summary PCs in Customizing under SAP
Healthcare - Industry-Specific Components for Hospitals -> Medical/Nursing
Documentation -> Maintain Assignment of Single-Qty Proc.Code to Matl and
Summary Proc.Code. If you cancel one or more single-quantity PCs that have led to
the generation of a summary PC, the system cancels the summary PCs and, if
applicable, creates a new summary PC.
Note: If you want the system to generate a billable additional charge when it generates
a summary PC, activate service rule R22 (DE: Generate Additional Charges (FPV)).
The system calculates some age-dependent additional charges using a variety of age-
dependent summary PCs. In doing so, the system can generate different summary PCs
for the same single-quantity PC and material depending on the patient's age.
You can define age-dependent summary PCs in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Medical/Nursing Documentation -
> Maintain Assignment of Single-Qty Proc.Code to Matl and Summary Proc.Code.
When executing procedure rule P2, the system checks whether the summary PC in
question is age-dependent.
If this is the case, the system checks whether the patient's age on the admission date is
between the minimum and maximum ages for the procedure code. If this is also the
case, the system generates the summary PC.
You must enter the minimum and maximum ages in the master data for the summary
PC beforehand. To generate single-quantity PCs using procedure rule P1 and
summary PCs using procedure rule P2, you must also make settings in the following
Customizing activities:
o SAP Healthcare - Industry-Specific Components for Hospitals ->
Medical/Nursing Documentation -> Maintain Assignment of Single-Qty
Proc.Code to Matl and Summary Proc.Code
o SAP Healthcare - Industry-Specific Components for Hospitals -> Patient
Accounting -> Procedure Rules -> Define Rule Types and Maintain Check
Procedure

Effects on Customizing
To generate single-quantity PCs using procedure rule P1 and summary PCs using
procedure rule P2, you must make settings in the following Customizing activities:
o SAP Healthcare - Industry-Specific Components for Hospitals ->
Medical/Nursing Documentation -> Maintain Assignment of Single-Qty
Proc.Code to Matl and Summary Proc.Code

141
o SAP Healthcare - Industry-Specific Components for Hospitals -> Patient
Accounting -> Procedure Rules -> Define Rule Types and Maintain Check
Procedure
The following events (callup points) are available for the procedure framework check
procedure:
o NPR000: Procedure Check During Procedure Entry
o NPR001: Procedure Check in DRG Work Station
o NPR002: Procedure Check in Surgery Data
o NPR003: Procedure Check for Readmission
o NPR004: Procedure Check for Entry of Case-Rel.Matl. Cons.
o NPR005: Procedure Check Before Billing
o NPR006: Procedure Check Before Test Billing
See also

Notes
The system currently only supports automatic generation of procedures and services
during entry of case-related materials in transaction NMMC1. The system does not
generate procedures or services when saving case-related material consumption in
transactions NMM5 and NMM7.
When you enter services for a case in transaction NL10N, the system performs all the
procedure actions defined in Customizing for event NPRC000 when you save. When
you execute the Rules function in service entry, the system only processes service
rules. The Rules function is linked to the current object; this means the system does
not process procedure rules when you select the Rules function in service entry.

142
ISH_MAIN AT: Scoring - EDI System Control (Changed)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

143
ISH_MAIN AT: Insurance Relationships / Third-Party Payers
(Changed)

Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

144
ISH_MAIN AT: Valuation Formula "22" (Changed)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

145
ISH_MAIN AT: P321 - BAdI Enhancements (Enhanced)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

146
ISH_MAIN AT: Patient Management - Electronic Health Ins. Card (E-
Card)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

147
ISH_MAIN AT: Data Medium Exchange with Private Insurers (EDIVKA)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

148
ISH_MAIN AT: EDI Workb./Worklist - Dispatch Orders for Outp.Cases
(Chgd)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

149
ISH_MAIN AT: File Creation (Changed)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

150
ISH_MAIN AT: EDI Data Medium Exchange - ELDAL Comm. Procedure
(Changed)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

151
ISH_MAIN AT: Movements and Case Revision with Intensive Care
Data (New)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

152
ISH_MAIN AT: EDI Data Medium Exchange - Messages (Changed)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

153
ISH_MAIN AT: Printing Coverage Extensions (Changed)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

154
ISH_MAIN AT: EDI Worklist - Dependent Messages (Changed)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

155
ISH_MAIN AT: Coverage Evidence List (RNWATKUELIST) (Changed)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

156
ISH_MAIN AT: LR A5/15, A9 - Use of Max. Values (with Groups)
(Changed)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

157
ISH_MAIN AT: Service Rule for Pat. Contribution Gen. (AK) (Changed)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

158
ISH_MAIN AT: Message Control (Changed)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

159
ISH_MAIN AT: Settings for Cancelling Dependent Services (New)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

160
ISH_MAIN AT: EDI Communication Procedure P321 (Changed)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

161
ISH_MAIN AT: Changed Behavior for Receipt of Messages (Changed)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

162
ISH_MAIN AT: New Report IS-H AT: Coverage Reminder (New)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

163
ISH_MAIN AT: Collective Printing of Admission/Discharge Notifs
(Changed)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

164
ISH_MAIN AT: EDI Data Transfer - Comm. Proc. SCO04 (Changed)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

165
ISH_MAIN AT: Layout of Scoring Work Station (Changed)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

166
ISH_MAIN AT: Overriding Content of WIKRAF-V Record (New)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

167
ISH_MAIN AT: Statutory Stats for Stat. Cases (RNWATSTATISTIK)
(Chgd)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

168
ISH_MAIN AT: Statutory Statistics for Outpatient Cases (Changed)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

169
ISH_MAIN AT: CPB - Subscreen AT: Contract Partner Number
(Changed)
Use
This release note is relevant for the country version Austria only. Documentation is not
available in English.

170
Business Function SAP Patient Management: Legal Process
Adoption
ISH_MISC1: Business Function SAP Pat. Mgmt: Legal Process
Adoption (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4, (IS-
H 604), the business function SAP Patient Management: Legal Process Adoption is
available. You can use this business function to implement enhancements that include
improvements to processes based on legal changes.
The enhancements available with SAP Patient Management include improved user
interaction and enhancements for material requisitions, coding, and billing processes.
Preassignments (for example, date of birth), additional consistency checks (for
example, in the material catalog), other checks (for example, for similar patients),
automatically generated characteristics (such as absences), additional information (for
example, secondary views in the clinical work center), and automatic generation of
business data all contribute to your productivity.
System Behavior when Activating Business Function
If you activate the Business Function SAP Patient Management: Legal Process
Adoption (technical key: ISH_MISC1), this does not result in significant changes to the
system behavior for the business user. You should note the following exceptions:
Exceptions
o Clinical Work Station: change selection: If you activate the Business Function,
the Change Selection function can be accessed directly using the Change
Selection in the pushbutton toolbar of the clinical work station for a view which is
currently active. You can find more information in the release note ISH_MISC1:
Innovations in Clinical Work Station (New) for enhancement package 4.
o Delivery data: If you activate the business function, two additional fields are
available in the delivery data for assessing the vitality of newborns. This means
you can repeat the initial assessment at certain intervals (for example, after 5
and 10 minutes). You can find more information in the release note ISH_MISC1:
Add. Fields for Assessing Vitality in Delivery Data (New) for enhancement
package 4.
o Birthdate: If you activate the business function, the system presets the date and
time of birth when processing delivery data for the first newborn with the delivery
date and time of the mother. You can find more information in the release note
ISH_MISC1: Delivery Date Entered by Default as Birthdate of Newborn (New) for
enhancement package 4.
o Procedures - default values from movement: If you activate the business
function, you can use the Copy Movement Data function in procedure data
maintenance to copy the data, time, and organizational units from a movement to
the selected procedures as default values. You can find more information in the
release note ISH_MISC1: Procedures - Default Values from Movement (New) for
enhancement package 4.
o Material proposal list: Previously, it was only possible to maintain the material
proposal list with the Customizing activity Define Material Proposal. If you
activate this business function, you can adjust the material proposal list using the
Maintain Material Requisition transactions (NMM1 und NMM5). To do so, choose
the Maintain Material Proposal pushbutton on the Material Proposal tab page.
You can find more information in the release note ISH_MISC1: Maintain Material

171
Proposal List (New) for enhancement package 4.
o Individual payment distribution: A new pushbutton for payment distribution is
available in Patient Accounting, transaction NA30, for the countries that use this
function. You can find more information in the release note ISH_MISC1:
Individual Payment Distribution (New) for enhancement package 4.
Changes for System Administration
o Procedure coding using external module: If you activate this business
function, the system then only uses Business Add-In (BAdI)
ISHMED_PROC_ENCODING; while the SAP enhancement NPRV0001 with
component EXIT_SAPLN042_001 still exists, the system no longer uses or
supports it. Check whether you need to transfer the enhancements in
EXIT_SAPLN042_001 (which you can process using transaction CMOD) to the
BAdI ISHMED_PROC_ENCODING or whether the BAdI already contains them.
You can find more information in the release note ISH_MISC1: Coding
Procedures Using External Module (New) for enhancement package 4.
o Output authorization for specific organizational units (OUs) in reports:
Maintain the new authorization object (N_REP_OE) and assign it to your users
before you activate the business function. You must maintain at least one
generic ("*") entry for the OU and report to retain the existing functions without
restrictions. The authorization check applies to the new function Output
Authorization for Specific OUs in Reports. For more information, see the release
note ISH_MISC1: Output Authorization for Specific OUs in Reports (New).
o Interface IF_ISH_OBJECT_TYPES deleted: If you activate the business
function SAP Patient Management: Legal Process Adoption (technical key:
ISH_MISC1) or the business function Clinical System (ISHMED_MAIN) in the
Clinical System i.s.h.med, the interface IF_ISH_OBJECT_TYPES, in which the
type constants of the classes in IS-H and i.s.h.med were defined up to now, is no
longer used. You have to correct all places in your programs in which the old
object types are used. For more information, see the release note ISH_MISC1,
ISHMED_MAIN: Interface IF_ISH_OBJECT_TYPES (Deleted) for enhancement
package 4.
Changes to Country Versions
o Country version Germany: outpatient copayment: posting repayments: If you
have activated this business function, you can post repayments in the Outpatient
Copayment subscreen in transaction NV2000. A new Repayment checkbox in
the Payment group box is available for this purpose. For more information, see
the release note ISH_MISC1 DE: Posting Repayments in Outpatient Copayment
(New) for the country version Germany and enhancement package 4.
o Country version Austria: data exchange communication procedure P321/ELDAL:
If you activate this business function, the system behavior changes as follows:
o EDI system control: You can make user-specific entries for the scoring
parameters. In this case, these replace the previous scoring user
parameters.
o EDI worklist: The system now also makes entries in the Departmental
Assignment and Nursing Assignment fields. You can now also prevent
manual changes to the message status using an authorization check.
o P321 - import file: If a file contains messages for an institution that does
not exist in the system, the system cancels processing and assigns the
entire file the status "Incorrect" (external error).
o All EDI procedures: The system now lists the path and name of the file
created in the log of the message file creation program (RNC30101).

172
o P321 - import insurance verifications for inpatient cases: Based on the
coverage confirmation from the social insurance fund, the system
generates an insurance verification automatically if it does not yet exist for
the case. This is done on the basis of the preapproved insurance and
default values. If there are several suitable open insurance verifications,
the system reduces this to one.
For more information, see the release notes ISH_MISC1 AT: Data Exchange
Comm. Procedure P321/ELDAL (New) for the country version Austria and
enhancement package 4 and ISH_MISC1 AT: File Import Program for IV for
Inpatient Cases (New) for the country version Austria and enhancement package
4.
o Country version Austria: address - checks on postal code / city: If you
activate this business function, new checks are run on the Postal Code and City
fields during address entry if you choose the country AT. When you enter a
postal code, the system determines or checks the city accordingly. For more
information, see the release note ISH_MISC1 AT: Address - Checks on Postal
Code / City (New) for the country version Austria and enhancement package 4.
o Country version Austria: statistics of inpatient cases: If you activate this
business function, the program for evaluating inpatient cases refers to some new
IS-H tables, which you must maintain. For more information, see the release
note ISH_MISC1 AT: Statistics of Inpatient Cases (New) for the country version
Austria and enhancement package 4.
o Country version Austria: RN1FKLA0 - "Movements - Classifications": If you
activate this business function, this program is no longer available. For more
information, see the release note ISH_MISC1 AT: RN1FKLA0 - "Movements -
Classification" (Deleted) for the country version Austria and enhancement
package 4.
o Country version Switzerland: Organizational Management - division: If you
activate this business function, the organizational units and building units in
Organizational Management are represented by object types. A new infotype ID
6076 Assignment of OU -> Division is available for organizational units in the
country version Switzerland. For more information, see the release note
ISH_MISC1 CH: Organizational Management - Division (New) for the country
version Switzerland and enhancement package 4.
For more information, see the following release notes:
o ISH_MISC1: SAPscript for Long Text and Comment Fields
(New)
o ISH_MISC1: Checking Prerequisites Before Calling an
API/BAPI (New)
o ISH_MISC1: New Features of the Clinical Work Station (New)
o ISH_MISC1: Add. Fields for Assessing Vitality in Delivery Data
(New)
o ISH_MISC1: Checks on Req. Entry Fields on CPB Subscreens
(New)
o ISH_MISC1: Sec. View for Outpat.Clinic/Svce Facility Type
Views (New)
o ISH_MISC1: Where-Used List for Function- or User-Related
Objects (New)
o ISH_MISC1: Search for Similar Patients by Social Insurance

173
Number (New)
o ISH_MISC1: Delivery Date Entered by Default as Birthdate of
Newborn (New)
o ISH_MISC1: Displaying DRG Long Texts in SAPscript (New)
o ISH_MISC1: Procedures - Default Values from Movement (New)
o ISH_MISC1: Classifying Surgical Diagnoses (New)
o ISH_MISC1: Risk Factors - Displaying Change Documents
(New)
o ISH_MISC1: Final Billing Possible Without (Bill.) Service(s)
(New)
o ISH_MISC1: Enhanced Catalog Column Determination (New)
o ISH_MISC1: BAdI ISH_INVOICE_CHECK - Interface
Enhancement (New)
o ISH_MISC1: Service Rule R24 - Passing on Physician
(Enhanced)
o ISH_MISC1: Service Entry - Simplified Physician Entry
Function (New)
o ISH_MISC1: Contract Scheme (Enhanced)
o ISH_MISC1: Interface for Invoice Form - VAT Registration
Number (New)
o ISH_MISC1: New Fields in the Service Master (New)
o ISH_MISC1: Coding Procedures Using External Module (New)
o ISH_MISC1: Default Entry for Cancellation Date (New)
o ISH_MISC1: Individual Payment Distribution (New)
o ISH_MISC1: Checking Catalogs/Proposals/Closets Against
Material Master (New)
o ISH_MISC1: Mass Maintenance of Material Catalogs (New)
o ISH_MISC1: Output Authorization for Specific OUs in Reports
(New)
o ISH_MISC1: Case Exclusions for Communication Procedures
(New)
o ISH_MISC1: Additional Selection Options in Case Selection
(New)
o ISH_MISC1: Search Help for Document Number (New)
o ISH_MISC1: Enhanced Report for Mass Maintenance of
Material Catalogs (New)
o ISH_MISC1: Requirement Prioritization (New)
o ISH_MISC1: Maintain Material Proposal List
o ISH_MISC1: Service-Based Appointment Search (New)

174
o ISH_MISC1: Catalog Column Determination (New)
o ISH_MISC1: Pricing (New)
o ISH_MISC1: Outbound Processing of Services (New)
o ISH_MISC1: Inbound Processing of Services (New)
o ISH_MISC1: Enterprise Services (New)
o ISH_MISC1: IS-H IHE HL7 Compliant Services (New)
o ISH_MISC1, ISHMED_MAIN: Interface IF_ISH_OBJECT_TYPES
(Deleted)
o ISH_MISC1 AT: Work Center - Online Scoring/Intensive Care
Data Integrated
o ISH_MISC1 AT: LKF Scoring for Services (SMS) (New)
o ISH_MISC1 AT: Data Exchange Comm. Procedure P321/ELDAL
(New)
o ISH_MISC1 AT: File Import Program for IV for Inpatient Cases
(New)
o ISH_MISC1 AT: User-Specific Scoring Parameters in Control
Table (New)
o ISH_MISC1 AT: Statistics of Inpatient Cases (New)
o ISH_MISC1 AT: Address - Checks on Postal Code / City (New)
o ISH_MISC1 AT: RN1FKLA0 - "Movements - Classification"
(Deleted)
o ISH_MISC1 CH: Determine Fee-Based Services (New)
o ISH_MISC1 CH: INXML 4.0 - Suppressing "Zero Invoices"
(New)
o ISH_MISC1 CH: Insurance Verification - Specifying Printer on
Selection Screen (New)
o ISH_MISC1 CH: Report for Assigning Contract Scheme (New)
o ISH_MISC1 CH: Organizational Management - Division (New)
o ISH_MISC1 CH: Item Data for Billing Agreement (New)
o ISH_MISC1 AT, CH, FR: Depreciation of Fee-Based Services
(New)
o ISH_MISC1 CH: Service Rules (Enhanced)
o ISH_MISC1 CH: Service Rule - Assign Fee Physician /
Function (New)
Effects on Existing Data
To use this business function, you must also activate the business function ISH_MAIN.
Effects on System Administration

175
Maintain the new authorization object (N_REP_OE) and assign it to your users before
you activate the business function ISH_MISC1. You must maintain at least one generic
("*") entry for the OU and report to retain the existing functions without restrictions. The
authorization check applies to the new function "Output Authorization for Specific OUs
in Reports". For more information, see the following release note: ISH_MISC1:
Output Authorization for Specific OUs in Reports (New)
See also
For more information, see the SAP Library under Business Function Sets and
Business Functions -> Healthcare -> SAP Patient Management -> SAP Patient
Management: Legal Process Adoption.
For more information about Support Package release notes for SAP Patient
Management and SAP Ambulatory Care Management, see the SAP Service
Marketplace under the quick link /healthcare-releasenotes.

176
ISH_MISC1: SAPscript for Long Text and Comment Fields (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), you can use the BAPI BAPI_HCSRVCAT_ADDITEM to connect to and
transfer SAPscript long texts. You can use the tables DOCINFO and DOCCONTENT to
add long texts in SAPscript format for the long text and comment on a service.
DOCINFO transfers the keys and references lines from table DOCCONTENT.
The key for table DOCINFO comprises the following information:
- Institution (4 characters)
- Catalog (2 characters)
- Service (10 characters)
- Text type - distinguishes between long text (01) and comment (02) (2
characters)
Please note that you must always use the full number of characters in each case.

177
ISH_MISC1: Checking Prerequisites Before Calling an API/BAPI (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), you can use the Business Add-In (BAdI) ISH_API_PREREQUISITS
in certain application functions that save data using an Application
Programming Interface (API) or a Business Application Interface
(BAPI) to check that the data is complete and add any missing data before executing
the API/BAPI.
For example, you can use this BAdI with the bed assignment functions in the clinical
work station to make sure an attending physician is entered. To do this, you can
implement a dialog for entering the attending physician in the BAdI and then save the
physician using the API/BAPI that was called by the function.

178
ISH_MISC1: New Features of the Clinical Work Station (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the Change Selection function is available for an active view in the
toolbar in the clinical work station.
You still have the option of dynamically controlling the default view displayed for a user
when they access the clinical work station. If the parameter WP_VIEW_DEFAULT is
specified in a user's master data, the system stores the view that was last active for
that user in the user parameters when they exit the clinical work station. When the user
accesses the work station again, the system then displays the view recorded.
Effects on System Administration
If you want the system to determine the default view dynamically for certain users, you
must enter the parameter WP_VIEW_DEFAULT in these users' master data. You do
not need to enter a value for this user parameter, since the system enters this value
when the user exits the clinical work station.

179
ISH_MISC1: Add. Fields for Assessing Vitality in Delivery Data (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement
Package 4 (IS-H 604), Business Function SAP Patient Management: Legal Process
Adoption (ISH_MISC1), two fields have been added for use in assessing the vitality of
newborn infants in the delivery data. This means you can repeat the initial assessment
at certain intervals (for example, after 5 and 10 minutes).
The three fields provided for this purpose are displayed after the field text Assessment
in the delivery data.

180
ISH_MISC1: Checks on Req. Entry Fields on CPB Subscreens (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the system also checks the required entry fields on certain subscreens
that are not currently active in the Clinical Process Builder (CPB). The following
entries must exist for the relevant client and the type PA16 of the function module in the
table IS-H: Clinical Process Builder - Modules for View (NWVIEW_A02).
View Short Text Name of Function
Module
SAP_ACC Accident Data
ISH_ACCIDENT_SUBSCREEN_REQ
SAP_ADR Address
ISH_ADDRESS_SCREEN_REQ
SAP_ALD Outpatient Service Data
ISH_AT_ALD_SUB_REQ
SAP_ASLD Care Certificate/Cause
ISH_AT_ASLD_SUB_REQ
SAP_ASS Next of Kin
ISH_PAT_ASSOC_SUBSCREEN_REQ
SAP_AT_FAD Case-Related Address
ISH_AT_FADR_SUB_REQ
SAP_AT_VPN Contract Partner Number
ISH_AT_UWD_SUBSCREEN_REQ
SAP_CAS Case
ISH_CASE_SUBSCREEN_REQ
SAP_CAS1 Outpatient Case
ISH_AMB_CASE1_SUBSCREEN_REQ
SAP_EDOC External Physicians
ISH_FPZ_SUBSCREEN_EXTERNAL_REQ
SAP_EMP Employer
ISH_PAT_EMPL_SUBSCREEN_REQ
SAP_IDOC Internal Physicians
ISH_FPZ_SUBSCREEN_INTERNAL_REQ
SAP_IND Patient Indicators
ISH_PAT_INDIC_SUBSCREEN_REQ
SAP_NAM Patient Name
ISH_PAT_NAME_SUBSCREEN_REQ

181
SAP_ORG Movements
ISH_MOVEMENT_SUBSCREEN_REQ
SAP_OTH Other Patient Data
ISH_PAT_OTHER_SUBSCREEN_REQ
SAP_PAT1 Outpatient Check on Patient Name
ISH_AMB_PAT_NAME1_SUBSC_REQ
SAP delivers these entries.
You specify the required fields for the subscreen in question in the Customizing activity
Maintain Screen Modification.
You should refer to the documentation for the function modules.
The function module checks the subscreen fields for required entries and returns the
fields for which required entries do not exist to the calling program. The interface of this
function module is predefined by SAP. The system calls this function module in the
SAP program Form <Object1>check_required_screen_fields() (SAPMNPA10). The
call takes place only if the call of the form check_required_screen_fields() is done by
the relevant implementation in the Business Add-In (BAdI) ISH_NV2000_PAI_COMPL
(sample coding).
See also
For more information, see SAP Healthcare - Industry-Specific Components for
Hospitals -> Basic Settings -> Screen Control -> Maintain Screen
Modification.

182
ISH_MISC1: Sec. View for Outpat.Clinic/Svce Facility Type Views
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), users processing an Outpatient Clinic/Service Facility type view can
now open a secondary view of the same type, which allows them to work in two
different views at the same time.
Effects on Existing Data
A Display View as Secondary View function has been added to the context menu for
an Outpatient Clinic/Service Facility type view in the overview tree for navigation in
the clinical work station.
When the system displays a view as a secondary view, a Switch Off Secondary View
pushbutton appears in the application toolbar in the clinical work station. The system
saves the activation/deactivation of secondary views for Outpatient Clinic/Service
Facility views on a user basis.

183
ISH_MISC1: Where-Used List for Function- or User-Related Objects
(New)
Use
In SAP Patient Management, you can define function- or user-specific work
environments for a number of applications. As of SAP ECC 6.0, Industry Extension
Healthcare, Enhancement Package 4 (IS-H 604), Business Function SAP Patient
Management: Legal Process Adoption (ISH_MISC1), a where-used list function is
available for the following objects when defining these user-specific work environments.
o Clinical Process Builder (transaction NV2000)
- Dialog element
The where-used list indicates which variant of the dialog element is being
used by which function or user.
- Toolbar
The where-used list indicates which variant of the toolbar is being used,
and by which function or user.
o Clinical Work Station (transaction code NWP1)
- View
The where-used list indicates the work environment in which the view is
being used, and by which function or user.
- Selection variant
The where-used list indicates the view in which the selection variant is
used.
- Layout
The where-used list indicates the view in which the layout is used.
- Function variant
The where-used list indicates the view in which the function variant is
used.
o Service Entry (transaction NL10)
- View
The where-used list indicates the work environment in which the view is
being used, and by which function or user.
o Visit Scheduling (transaction NR16)
- Search variant
The where-used list indicates the work environment in which the search
variant is being used, and by which function or user.

184
ISH_MISC1: Search for Similar Patients by Social Insurance Number
(New)
Use
Report RNUPATCMP searches the IS-H database for patients that are similar to the
patient master records created or changed during a period according to certain
comparison criteria. As of SAP ECC 6.0, Industry Extension Healthcare,
Enhancement Package 4 (IS-H 604), Business Function SAP Patient
Management: Legal Process Adoption (ISH_MISC1), the patient's social insurance
number has been added as a new comparison criterion.

185
ISH_MISC1: Delivery Date Entered by Default as Birthdate of Newborn
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the system automatically enters the mother's delivery date and time as
the birthdate and time when editing the delivery data for the first newborn.

186
ISH_MISC1: Displaying DRG Long Texts in SAPscript (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), a pushbutton from the catalog has been added to the DRG data
maintenance transaction beside the existing field for displaying the DRG long text. If a
SAPscript long text has been defined for a DRG code in the catalog, you can use the
pushbutton to call it up.

187
ISH_MISC1: Procedures - Default Values from Movement (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), you can use the Copy Movement Data function in procedure data
maintenance to copy the data, time, and organizational units from a movement to the
selected procedures as default values.
The procedures remain assigned to the case.

188
ISH_MISC1 DE: Classifying Surgical Diagnoses (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), you can flag diagnoses that are connected to surgical visits as
department and hospital main diagnoses in diagnosis documentation at various points
in the system.
Effects on Existing Data
This is possible in the following contexts:
o In the transaction codes NP61/N222 (Maintain Diagnoses for
Case/Department)
o In the DRG work station (transaction code NPDRG2)
o Diagnosis subscreens in the Clinical Process Builder
As before, you cannot flag diagnoses that are linked to other outpatient visits as a main
diagnosis.
Department and hospital main diagnoses are used for communication as per 301.

189
ISH_MISC1: Risk Information - Displaying Change Documents (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), you can display a change history for risk information by choosing Goto -
> Change Documents in the Maintain Risk Information (NP04) and Display Risk
Information (NP05) transactions.
This applies to all country versions except Canada and Singapore.

190
ISH_MISC1: Final Billing Possible Without (Billable) Services (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), you can perform final billing without (billable) service(s). To do this, you
must process the message that is assigned to Patient Accounting (function A000), No
billable services for case & (billing not possible) (N8 313).
The system delivers the message with the type Error.
Please note that you cannot suppress the message.
If you perform interim billing without (billable) services, this does not change the billing
status of the case.

See also
You can maintain messages under SAP Healthcare - Industry-Specific Components
for Hospitals -> Basic Settings -> System Parameters -> Message Control ->
Maintain Messages in Customizing.

191
ISH_MISC1: Enhanced Catalog Column Determination (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the system contains new customer-specific rule types.
The following intervals are now reserved for customers:
o ZA - ZZ
o Z6 - Z9

192
ISH_MISC1: BAdI ISH_INVOICE_CHECK - Interface Enhancement
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the interface for the Business Add-In (BAdI) IS-H: Check Invoice
Creation (ISH_INVOICE_CHECK) also contains information indicating whether live or
test billing is taking place (I_RNAB0-EABKZ, I_RNAB0-KZZWA).
See also
For information about the BAdI, see SAP Healthcare - Industry-Specific
Components for Hospitals -> Patient Accounting -> Billing -> Business Add-Ins
for Billing -> BAdI: Check Invoice Creation in Customizing.

193
ISH_MISC1: Service Rule R24 - Passing on Physician (Enhanced)

Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1) you can copy the ordering physician from the case-related material
consumption to the service-to-business partner assignment (NNLZ) for service rule R24
- Create and Adjust Material Services.

Effects on Customizing
Define whether the ordering physician is to be copied from the material consumption,
and if so, in which function, by selecting the Prescriber Material Consumption
indicator for the corresponding function(s) under SAP Healthcare - Industry-Specific
Components for Hospitals -> Patient Accounting -> Service Entry -> Define
Functions of a Service-to-Business Partner Asgmt in Customizing.

194
ISH_MISC1: Service Entry - Simplified Physician Entry Function (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), you can assign functions in the service-to-business partner assignment
to the columns on the overview screen for service entry. This makes the function for
entering physicians significantly more user-friendly, both on the overview screen and
on the details screen in service entry (NL10). You can also specify whether or not a
function can be used more than once in a service.
Effects on Customizing
Specify whether or not a function can be used more than once for a service using the
Once indicator under SAP Healthcare - Industry-Specific Components for
Hospitals -> Patient Accounting -> Service Entry -> Define Functions of a
Service-to-Business Partner Asgmt.
You can assign five functions to the columns on the overview screen in service entry
and define a header under SAP Healthcare - Industry-Specific Components for
Hospitals -> Patient Accounting -> Service Entry -> Assign Function to Item
in Service Entry.

195
ISH_MISC1: Contract Scheme (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), criteria such as the service category, charge type, tariff type, and
grouping key are available in addition to the service code or service group for use in
defining the validity of contract scheme items.
The Service Code field has been replaced by Field Name and Field Value fields in
item data maintenance for the contract scheme (V_TN16P).
In the Field Name field, you specify the criterion according to which the service group
is to be created. In the Field Value field, you define the actual value the criterion must
have.
You can add customer-specific selection criteria using the Business Add-In (BAdI)
ISH_CONTRACT_SCEME.
Effects on Existing Data
The following applies to contract scheme item data that already exists in the system:
The system automatically enters the service code value (NTPK-TALST) in the Field
Name field. The content of the Service Code field is displayed in the Field Value field.
The data in the Contract Scheme Items table (TN16P) remains unchanged. This
means the service code is still stored in field TN16P-SERIN or TN16P-SEREX. Even if
you make a new entry in the Field Name field with the service code value (NTPK-
TALST), the system also makes an entry in one of these two fields in addition to field
TN16P-FVALUE, as was previously the case.
This means you do not need to make changes to customer-specific programs that use
this table.
Effects on Customizing
You can access the list of selection criteria in Customizing under SAP Healthcare -
Industry-Specific Components for Hospitals -> Patient Accounting -> Business
Partners / Insurance Relationships -> Selection Criteria for Contract Scheme
Items.
You make the settings under SAP Healthcare - Industry-Specific Components for
Hospitals -> Patient Accounting -> Business Partners / Insurance Relationships -
> Maintain Contract Schemes.
You activate the BAdI under Healthcare - Industry-Specific Components for
Hospitals -> Patient Accounting -> Business Partners / Insurance Relationships -
> Business Add-Ins for Contract Schemes -> IS-H: BAdI for Contract
Schemes.

See also
For more information, see SAP Healthcare - Industry-Specific Components for
Hospitals -> Patient Accounting -> Business Partners / Insurance Relationships -
> Maintain Contract Schemes in Customizing.
For more information about the BAdI, see SAP Healthcare - Industry-Specific
Components for Hospitals -> Patient Accounting -> Business Partners /
Insurance Relationships -> Business Add-Ins for Contract Schemes -> IS-H:
BAdI for Contract Schemes.

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ISH_MISC1 Interface for Invoice Form - VAT Registration Number
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the VAT registration number is available in structures RNF111 and
RNF116 (field STCEG) for use in entering the data in your invoice form.

198
ISH_MISC1: New Fields in the Service Master (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), new fields are available in the service master.
o The Billing Block field has been added to the Classification tab page. If the
billing block is set, you cannot perform billing for a case for which the service has
been entered. The system displays the error message N8/434 ("Service & is
blocked for billing").
o The new Customer-Spec. tab page (customer-specific fields) contains the
following fields:
- Switch 1
- Switch 2
- Quantity
- Unit
- Start Date
- End Date
- Text 1
- Text 2
- Text 3
- Text 4
- Text 5
You can use customer-specific fields to enter additional service data for individual
solutions or purposes.

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ISH_MISC1: Coding Procedures Using External Module (New)
Use

User Exit Used


As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the system only uses the Business Add-In (BAdI)
ISHMED_PROC_ENCODING. The system no longer uses or supports the parallel SAP
enhancement NPRV0001 with the component EXIT_SAPLN042_001.
Check whether you need to transfer the enhancements in EXIT_SAPLN042_001
(which you can process using transaction CMOD) to the BAdI
ISHMED_PROC_ENCODING or whether the BAdI already contains them.

Changes in Coding Procedures


When coding procedures using an external coding module, it was not previously
possible to HyperLink: GLOS.E7DADECEA03D1E4B9B2ED5D103F84178 overwrite
an existing procedure code. The procedure code selected in the external coding
module always had to be created, or added, in the system.
o As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package
4, if you select a line on the procedures screen, the external coding module can
overwrite the selected procedure code with another procedure code.

When overwriting, only single-selection mode is active: this means you


can only transfer one procedure code from the external coding tool.

Restriction: A code is not overwritten if it is a surgery-related procedure code and


you are not using the surgery transaction (transaction code NP38).

Surgery-related procedure codes can only be overwritten in the relevant surgery


movement or when explicitly selected in the transaction for maintaining surgical
data.
o When you position the cursor anywhere on the procedure screen, the system
calls the coding module in multiple selection mode. This means that you
can transfer more than one procedure code from the external coding module.

The system always adds the transferred procedure codes; an existing procedure
code is not overwritten.

General Restriction
You cannot code procedures in the following cases:
o Final billing has been performed for the case.
o The medical status prohibits changes.

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ISH_MISC1: Default Entry for Cancellation Date (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), you can specify the billing date or the current date as the default entry
for the cancellation date if you want to cancel an invoice in case-related invoice
processing or in service entry.
An additional option is available in the Default Cancellation Data group box under
Environment -> Editing Options in the Maintain Editing Options dialog box in case-
related invoice processing. You can choose whether the system is to enter the billing
date or the current date as the cancellation date when performing a cancellation. The
applies both in case-related invoice processing (Full Cancellation of Billing
Documents dialog box) and when cancelling an invoice from service entry
(Cancellation Prompt dialog box).
You can specify that the current date is to be entered by default for the cancellation
date by entering an "X" in the new user parameter NA30NSTOCDAT ("IS-H: Default
Setting Cancellation Date = Current Date"). If you do not make an entry for this user
parameter or do not specify it for the user, the system enters the billing date by default.
If you change the default entry for the cancellation date in case-related invoice
processing in the Maintain Editing Options dialog box under Environment -> Editing
Options, the system changes user parameter NA30NSTOCDAT accordingly:
o If you specify that the billing date is to be the default entry for the cancellation
date, the system overrides any user parameter.
o If you specify that the current date is to be the cancellation date, the system sets
the user parameter and creates it if it did not previously exist.

201
ISH_MISC1: Individual Payment Distribution (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the Individual Payment Distribution function is available in case-
related invoice processing (NA30N).
You can use this function to make manual adjustments to the proposal from standard
payment distribution. If you create an individual contract scheme, the corresponding
payment distribution result is displayed immediately. If you have already processed a
case using the Supplement Tool (country version CH), the system can only display the
service items but cannot change them. This is also the case when a case is assigned a
contract scheme that has defined a customer function module.
To ensure that the service rules have created and updated all the services, the system
executes all the service rules that are assigned to the Interim Billing event when you
access Individual Payment Distribution. The system then performs pricing and
payment distribution and displays the result.
This function is not released for the country version France.

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ISH_MISC1: Checking Catalogs/Proposals/Closets Against Mat.
Master (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), you can check material catalogs, material proposals, and care unit
storage facilities/closets against the material master.
Until now, the report IS-H MM: Check Consistency of Catalogs, Proposals, and
Closets (RNUMKAT2) supported a consistency check on materials in material catalogs
against the material master. The report simply compared the material proposals and
care unit storage facilities/closets with the materials listed in the catalogs.
Now the following checks and adjustments are made:
o Material catalogs:
- Delete materials with a deletion flag
- Delete archived materials
- Replace follow-up materials
- Adjust units of measure
o Material proposals:
- Delete materials with a deletion flag
- Delete archived materials
- Replace follow-up materials
- Adjust units of measure
o Care unit storage facilities/closets:
- Delete materials with a deletion flag
- Replace follow-up materials

203
ISH_MISC1: Mass Maintenance of Material Catalogs (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the program IS-H: Mass Maintenance of Material Catalogs
(RNUMKAT4) now also contains functions for creating and deleting a material in all
the relevant catalogs at the same time.
You can create materials with the following attributes in one or more catalogs in a
single step:
o Plant (required entry)
o Quantity (required entry)
o Minimum quantity
o Maximum quantity
o Unit of measure (required entry)
o Approval type (required entry)
o Unloading point

204
ISH_MISC1: Output Authorization for Specific OUs in Reports (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), a new authorization object is available for assigning organizational units
(OUs) to reports. You can use it to restrict output by OUs according to the relevant
reports.
If the relevant objects (for example, movements or services) are assigned several OUs
(for example, requesting and nursing OUs), these are output if the user has
authorization for at least one of the OUs for the object. The system informs you
whether output has been restricted according to the new authorization control for OUs.
You can also use this authorization object to check the data according to the
corresponding OU hierarchies. For example, if the user has authorization for a
department, this means he or she also has authorization for all the OUs assigned to it,
even though this is not specified explicitly in the authorization object.
The following reports have been modified to accommodate the new authorization object
with this Enhancement Package:
o RNLAMB00 (Evaluation of Outpatient Visits)
o RNLAMB01 (Outpatient Visits (with Name of Physician))
o RNLAMB02 (Evalutation of Outpatient Visits Without Services)
o RNAPRV04 (Cost Reimbursement - Direct Patient Billing)
o RNLAPPDL (Details of Appointments for Different Entities)
o RNLDIA01 (Evaluate Diagnoses)
o RNLDIA02 (Key Figures for Diagnosis and Procedure Documentation)
o RNLFPZ00 (Evaluation Program for Persons Assigned)
o RNLLST01 (Case/Service Evaluation for Day Patient/Inpatient Cases)
o RNLLST02 (Case/Service Evaluation for Outpatient Cases)
o RNLPFB00 (Movement Lists)
o RNLSTA09 (Service and Billing Statistics)
o RNPFKL00 (Evaluation Program for Case Classification)
o RNSL302 (L 3 - Patient Census Statistics of Departments)
o RNSMNS01 (Midnight Census Statistics)
o RNUQSFP0 (Data Determination for Quality Assurance)
Effects on System Administration
Maintain the new authorization object (N_REP_OE) and assign it to your users before
activating business function ISH_MISC1. You must make at least one generic ("*")
entry for the OU and report to retain unrestricted access to the previous functions.

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ISH_MISC1: Case Exclusions for Communication Procedures (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the maintenance transaction for case exclusions now contains the new
fields Standardized First Name and Birthdate.

206
ISH_MISC1: Additional Selection Options in Case Selection (New)

Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the following new selection criteria are available in case selection (report
RNASEL00):
Effects on Existing Data
o Exclude admission type
o Exclude cases with statistics block
o Select or exclude cases according to companions

207
ISH_MISC1: Search help for document number (New)
Use
As of SAP ECC 6.0 Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management: Competitive Requirements based
on Legal Changes (ISH_MISC1), the document number can be searched by case
number and departmental Organizational Unit (OU) in the following transactions:
o Return Medical Record: Collective Entry (ND04)
o Borrow Medical Record: Collective Entry (ND13)
To search for a document number by case number and departmental OU, you can
enter appropriate values in the fields Case and Departmental Asgmt. Previously, it
was not possible to search for document numbers in the transactions mentioned above.

208
ISH_MISC1: Enhanced report Mass Maint. Mat. Catlgs
(RNUMKAT4)(new)
Use
Previously, the program IS-H: Mass Maintenance of Material Catalogs (RNUMKAT4)
supported the creation and changing of a specified material in all of the catalogs in
which the material is valid in a single processing step.
As of SAP ECC 6.0 Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management: Competitive Requirements based
on Legal Changes (ISH_MISC1), the program has been enhanced to delete materials
with the following attributes in one or more material catalogs in a single processing
step:
o Plant (obligatory)
The program then deletes the specified material of a plant from all the catalogs in which
the material is valid in a single processing step.

209
ISH_MISC1: Requirement Prioritization (new)
Use
As of SAP ECC 6.0 Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management: Competitive Requirements based
on Legal Changes (ISH_MISC1), the requirement urgency can be specified during the
material requisition process via the Maintain Material Requisition transactions
(NMM1 and NMM5). You can use Requirement Prioritization to specify that you want
material requisitions to be handled in the supply chain according to their urgency.
When the material requisition is converted to reservation or purchase requisition, the
requirement urgency is also copied.

Effects on Customizing
Carry out the following Customizing for Materials Management activities:
o Define Requirement Urgency Groups
o Define and Assign Requirement Urgencies
o Define Requirement Priorities
o Activate Requirement Prioritization

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ISH_MISC1: Maintain Material Proposal List (New)
Use
Previously, it was only possible to maintain the material proposal list with the
Customizing activity Define Material Proposal.
As of SAP ECC 6.0 Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), you can maintain the material proposal list using the Maintain Material
Requisition transactions (NMM1 and NMM5). To do so, choose the Maintain Material
Proposal pushbutton on the Material Proposal tab page.
An additional authorization check is performed at the organizational unit when you
maintain the material proposal list. This authorization check also applies for the above-
mentioned Customizing activity.

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ISH_MISC1: Service-Based Appointment Search (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the service-based appointment search is available for the country
version Italy.
You can use the service-based appointment search instead of the appointment search
you used until now for the 'standard search' and the 'enhanced search'. Both
procedures are based on a concept that uses the time slots specified in week and day
programs for a planning object (organizational unit, person, building unit) for the
appointment search. The time slots in the day programs are described by what are
termed 'scheduling types'.
If you want to use the service-based appointment search, you can organize the
services in your in-house service catalog to form service groups and then assign these
service groups to the scheduling types. You can use scheduling types defined in this
way to create the service-based time slots for your planning objects in week and day
programs.
In a service-based appointment search, you enter a service to be scheduled instead of
a scheduling type. The system determines the corresponding service group and the
scheduling types defined for it. The system displays the time slots found using the
scheduling types in a list, which you can then use to book appointments.
The service for an appointment is saved as a provisional service and is later copied as
the service for the visit when you create a case or visit. You can edit the appointment
data using the appointment editor, where you can access the services for the
appointment on the new Services tab. You can still display the provisional services for
a date in the following ways:
o 'Outpatient Clinic/Service Facility' view type (clinical work station)
o Appointment lists (RNLAPPDL)
o Forms (work organizer type APP_DATA)
When you use the service-based appointment search, the following additional functions
are available in the patient appointments and in the 'Outpatient Clinic/Service Facility'
view type (clinical work station):
o Billing (NA30N)
o Copayment (NE11)
o Down payment (NE20)
This means billing functions are available for the case immediately after you have
created a case or visit for an appointment.
Effects on System Administration
The new enhancement spot ES_ISH_APP_SEARCH_AND_BOOK allows you to make
customer-specific enhancements to the service-based appointment search. The BAdIs
in this enhancement spot are also available for non-service-based appointment
searches.
o In the appointment search, the system searches for a corresponding time slot for
each service to be scheduled, and displays it in the time slot list. You can use the
BAdI: Adjust Search Variants to change the search variant so that the
system only searches for one time slot for the services to be scheduled. The
system then saves the services that are to be scheduled for an appointment
when posting this time slot.

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o You can use the BAdI: Display Information for Appointment
Search to display price information for the service in the service-based
appointment search. If an implementation is active for this BAdI, a function key
for displaying the information appears in the toolbar in transaction NR16.
o You can access the Clinical Process Builder for an appointment in the
appointment editor so as to create a case or a visit. When you do this, the
system copies the required appointment and service data to the case. You can
use the BAdI: Enter Default Values for Clinical Process Builder
from Appointment to add data (for example, additional service data) when
creating a case or a visit.
Effects on Customizing
You must make an entry in Customizing under Define Parameters for Service-
Based Appointment Search to activate the service-based appointment search
for the institution. Only then can you switch to service-based appointment searches on
the Settings tab in visit scheduling (NR16). This switches the search dialogs on the
Standard Search and Enhanced Search tabs to the service-based appointment
search.
You can assign service groups to scheduling types under Define Outpatient
Scheduling Types.
You can enter a business partner for each service in the search dialog for the service-
based appointment search. You can define the business partner functions in
Customizing under Define Functions of a Service-to-Business Partner
Asgmt. You can define the default entries for the services as regards the business
partner assignment for use in copying the scheduled services to a case or visit under
Assign Function to Position in Service Entry.
Access types play a central role in the service-based appointment search. The
access type determines the result of the service-based appointment search, depending
on the attribute selected. Access types are business partner-dependent methods for
executing the service-based appointment search. You can specify the business
partners who are relevant for the service-based appointment search together with their
access types under Define Assignments of Business Partners to
Access Types.
Priority classes are a central concept in the service-based appointment search.
The priority class is used when defining the time slot for a service to specify that the
time slot is only to be taken into account in the service-based appointment search for
patients with the specified priority class. You can define the priority class for a planning
object in time slot definition for the day program.

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ISH_MISC1: Catalog Column Determination (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1) the Business Add-In (BAdI) Catalog Column Determination
(ISH_FIND_COLUMN) is available for changing the catalog column determined by the
system in pricing.

See also
For more information, see SAP Healthcare - Industry-Specific Components for
Hospitals -> Patient Accounting -> Billing -> Pricing (Using Conditions) -> IS-H:
BAdI for Catalog Column Determination in Customizing.

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ISH_MISC1: Pricing (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), you can specify a business partner (in the role of Insurance Provider) for
services.
This allows you to control pricing so that the system uses a specific insurance provider
in pricing for this service.
For information about how to control pricing according to service attributes, see the
release note Enhancements to Contract Scheme.
To exclude a service from coverage by an insurance provider even though this
insurance provider would normally cover this specific service, you can mark the service
in the Billing Category field. You must also customize an entry with an "exclusion" in
the insurance provider's contract scheme for this billing category.

215
ISH_MISC1: Outbound Processing of Services (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the broadcast of information about changes in SAP Patient Management
systems to non-SAP connected systems is possible with enterprise services. For more
information on service-enabling, and a list of services available for SAP Patient
Management, see the release note for
<DS:RELN.ISH_604_ISHMISC1_ES2>ISH_MISC1: Enterprise Services (New). A set
of services is available to connect SAP Patient Management to SAP NetWeaver
Process Integration (SAP NetWeaver PI).
Note: All outbound services for SAP Patient Management offered by SAP are
asynchronous services. Therefore, there is no description for synchronous services.
Asynchronous Service Operations
As of this release, SAP only offers asynchronous outbound notifications. With every
creation or change of either patient or movement details, an Hospital Communication
Module (HCM) event is created. After that, a report can be scheduled on a regular
basis that collects all these events. It performs an assignment to the relevant service
operation and reads data from the database. This data is then converted from a data
type format to a global data type (GDT) format. The relevant service interface is called
dynamically and data is sent from the back-end to the SAP NetWeaver PI system. The
SAP NetWeaver PI system broadcasts the information sent by the service operation.
Example:
Patient data is created and should be broadcast using SAP NetWeaver PI:
o The patient is created in the SAP Standard Variant transaction (NV2000).
o After saving, an HCM event is stored in the relevant database table.
o The report HCF: Event Processor RNHCF_EVENTS_PROCESSOR is
scheduled and running regularly.
o The event is analysed, and the corresponding patient data is read during the
report run.
o The report determines the service operations that have to be activated.
o The information is sent to SAP NetWeaver PI.
Error handling:
If an error occurs, the entry can be displayed by the Postprocessing Office
transaction (/SAPPO/PPO2)
Services and HCM
This new functionality now offers an alternative to the standard HCM dispatch
functionality that was previously used for hospital internal communication, and will
coexist with the previous functionality.
Whereas the old HCM dispatch offers classical file functionality with a well-established
but very SAP Patient Management-specific data model, the new functionality is based
on new Web-based standards, such as Web services, XML and an SAP-wide
consolidated data model.
Effects on Existing Data
Existing HCM events are reused.

216
Effects on Customizing
You can find the functions for asynchronous outbound messaging in Customizing for
SAP Healthcare - Industry-Specific Components for Hospitals by choosing
Communication -> Prepare Service Enabling -> Asynchronous Outbound
Processing.
See also
For more information on inbound services, see the release note for ISH_MISC1:
Inbound Processing of Services (New).

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ISH_MISC1: Inbound Processing of Services (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), you can access SAP Patient Management using enterprise services. An
introduction to service-enabling in SAP Patient Management, and a list of the available
services, can be found in the release note for ISH_MISC1: Enterprise Services
(New). SAP offers a set of service operations with which you can display, create, or
change several objects in the patient management system such as patients, patient
encounters, and medical activities. Interface fields of service operations are
represented by so-called global data types.
Service operations can be either synchronous or asynchronous.
Synchronous Service Operations
Synchronous service operations can reach the SAP Patient Management system either
through Web services or through the SAP NetWeaver Process Integration (SAP
NetWeaver PI) system. They are executed in the back-end system and in the case of
an error the error is entered in a log structure which is then sent to the user.
Service operation patterns supported
Inbound service operations belong to either of the following patterns:
o Synchronous Query Response
o Synchronous Request Confirmation
Asynchronous Service Operations
Asynchronous service operations require an SAP NetWeaver PI system as an
integration server attached to the SAP Patient Management system and cannot access
the system using Web services. That means that service requests come in through
SAP NetWeaver PI and are routed there to the correct back-end system.
In SAP NetWeaver PI, checks on the quality of service are also carried out to
guarantee that a service operation is processed only once.
Error handling of asynchronous service operations
In the case of a technical error, the error will be written into the Monitor for Processed
XML Messages, which can be found in the Integration Engine: Monitoring
transaction (SXMB_MONI). In the case of a business error (for example, if a dataset is
already locked by another user) the entry can be displayed by the Postprocessing
Desktop transaction (/SAPPO/PPO2).
Service operation patterns supported
The following asynchronous service operation patterns are supplied:
o Request Confirmation
o Asynchronous Notification
HL7 compliance
A subset of these services have been designed to meet IHE (Integrating the Healthcare
Enterprise) compliance requirements. They all belong to the so-called patient
administration profiles (PAM). With this pattern it is possible to admit, transfer, and
discharge patients in a way which has been designed to meet IHE compliance
requirements. Furthermore, the patient demographic query (PDQ) pattern is supplied.
SAP offers two ways to use these profiles:

218
o As a supplier:
SAP stores the main patient information and sends the required information to
the corresponding systems.
o As a consumer:
SAP receives patient information from connected systems where the patient
information is already stored.
For more information about IHE, visit their official Web site.
In combination with an SAP NetWeaver PI system, which fulfills the task of a integration
server, and the required configuration, these service operations will enable the system
to receive data that is sent in HL7 format. That means that the SAP NetWeaver PI
system receives data in an HL7 format, which is converted from HL7 to XML format by
an appropriate adaptor installed by the customer, so that the data received in HL7
messages is mapped to the corresponding fields of the proxies supplied by the SAP
Patient Management system.
Error handling
Errors are collected in a log and are displayed directly to the user.
Services operations and HCM
Services are offered by SAP in addition to the Human Capital Management (HCM)
receipt processes which are already available. In contrast to HCM, service operations
offer an easy and fast way to communicate with other hospital systems and to receive
messages from the connected systems.
Note:
The business function SAP Patient Management: Legal Process Adoption
(ISH_MISC1) must be activated in the Switch Framework transaction (SFW5), and the
related switch must then be activated in the Business Function transaction (SFW2).
Effects on System Administration
The use of HL7 messages requires SAP NetWeaver PI for synchronous and
asynchronous service operations as HL7 data has a completely different data format to
the data types supplied with the service interfaces. This data is converted using
mapping that is supplied by SAP in the SAP NetWeaver PI systems.
o Synchronous inbound service operations
All synchronous service operations can be called using Web services and do not
need an SAP NetWeaver PI system connected. Nevertheless, if the data sent to
the back-end is in HL7 format or another format which requires mapping, this can
only be done in an SAP NetWeaver PI system.
o Asynchronous inbound service operations
SAP NetWeaver PI and SAP NetWeaver PI configuration are necessary to
connect to the back-end.
o Synchronous outbound service operations
Not supported by SAP for Patient Management.
o Asynchronous outbound service operations
SAP NetWeaver PI has to be configured such that all systems which receive
outgoing messages are linked to the SAP NetWeaver PI system.
Effects on Customizing
To use services for communication, a set of Customizing activities have to be
maintained.
o As described above, services do not use data elements but global data types.
These global data types can have their own values which differ from entries in

219
the SAP Patient Management Customizing. Therefore, a mapping has to be
performed in the activities under Customizing for SAP Healthcare - Industry-
Specific Components for Hospitals by choosing Communication ->
Preparation Service-Enabling.

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ISH_MISC1: Enterprise Services (New)
Use
Overview
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), SAP delivers enterprise services for the first time. Similar to BAPIs,
enterprise services allow you to access the functionality of SAP Patient Management
applications from other systems.
However, in contrast to BAPIs, enterprise services are based on standard web service
technology and do not use any proprietary technology. Furthermore, BAPIs were
developed in such a way that they made internal interfaces available externally (the
'inside-out approach'), whereas the design of enterprise services is driven by external
requirements (the 'outside-in approach') and does not necessarily expose SAP-internal
structures externally. Therefore, enterprise services make external access possible for
functionalities of SAP Patient Management that were previously unavailable externally,
such as changing the case type.
The requirements for the enterprise services are collected by SAP in discussions with
customers, partners, and other software vendors. One forum for this are Community
Definition Groups, where community members can work directly with SAP to define
enterprise services. These are organized within SAP's Enterprise Services Community
(ES Community), a network which is open to every customer and partner.
Enterprise services can be used in different ways. They might, for example, help you to
connect sub-systems to SAP Patient Management and thus use SAP Patient
Management as the leading system holding all patient master data. Enterprise services
can also be used to connect the SAP system to other systems and use the SAP
system, for example, as a billing machine for data from the other systems. Furthermore,
enterpriseservices can be used to build new, separate applications that make use of
SAP Patient Management functionality and enhance it in a way that is tailored to your
needs.
The enterprise services for SAP Patient Management are designed to support the
Integrating the Healthcare Enterprise (IHE) standard profile Patient Administration
Management (PAM). For more information, see the release note for ISH_MISC1:
IS-H IHE/HL7 Compliant Services (New).
Service operations always belong to one particular business object, for example, the
business object Patient contains service operations to change and create patients.
Every business object belongs to a process component, which is a building block that
contains at least one business object and is designed to support a certain business
process. The business object Patient, for example, is part of the process component
Healthcare Business Partner Data Management.
Note: These business objects are not related to the business objects that can be found
in the Business Object Repository (BOR) for BAPIs.
How to Find Service Operations
Apart from this technical categorization, service operations are also grouped within
enterprise service bundles. Enterprise service bundles are collections of service
operations which have a similar business background, for example, most service
operations of the business object Patient belong to the bundle Patient
Administration. One service operation can belong to several bundles.
An overview of existing bundles and service operations can be accessed on the
Enterprise Service Workplace, a part of the SAP developer network (SDN):
http://sdn.sap.com -> Enterprise SOA -> Explore Enterprise Services -> ES

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Workplace. Information is also available on the Enterprise Service wiki
(https://www.sdn.sap.com/irj/sdn/wiki?path=/display/ESpackages/Home)
Please remember that the bundles are structures in the Enterprise Service Workplace
and do not have technical representatives in the back-end system. Neither can
enterprise service operations be downloaded from the SDN. They are shipped with all
other ERP functionalities within the enhancement packages (EHPs).
To discover which enterprise service operations are available in your own SAP ERP
system, call the SOA Manager (transaction SOAMANAGER), choose the tab page
Application and Scenario Communication, click Single Service Administration and
search (for example, using the internal name '*ISH*').
For a more technical view on the service operation you can also access them using the
Object Navigator (transaction SPROXY). Open the navigation tree at IS-H 604. Here,
all service operations are listed under Service Interfaces.
Enterprise Service Oriented Architecture (Enterprise SOA)
All SAP Patient Management enterprise service operations are based on SAP's
Enterprise SOA (see http://www.sdn.sap.com/irj/sdn/enterprisesoa). As stated above,
enterprise service operations do not use any proprietary technology and are based on
standard web service technology. All of SAP's enterprise service operations are
structured according to a harmonized enterprise model based on business objects,
process components, and global data types (GDTs). This means that for all SAP
applications, there is one central model. For example, there is only one SAP-wide GDT
which defines a medical risk factor - not one for a hospital information system, one for
an insurance application and one for an HR application.
The interfaces of the service operations are created by SAP using global data types
which are based on UN/CEFACT CCTS and other industry standards where available.
The service operations are described according to WSDL (Web Service Description
Language). To call an enterprise service operation from another system (for example,
into a .NET application), only the WSDL file must be imported.
Communicational Patterns
SAP Patient Management provides service operations that can be called from other
systems (inbound service operations) as well as service operations that broadcast
information to other systems (outbound service operations).
Apart from that, there are different communicational patterns used by enterprise service
operations.
o Request/confirmation
Messages are sent back and forth.Objects maintained by the service operation
may change on the database in the back-end system.
o Query/response
Messages are sent back and forth. The state maintained by the service operation
does not change.
o Notification
A notification is a (formal) notice or advice regarding a state or subject matter. An
answer is not expected but it is expected that the recipient takes notice of the
message.
Example:Notification about a shipping in transit, a demand forecast, the progress
of production, or a hazardous incident at a plant.
o Information
Information is an (informal) message regarding a state or subject matter. An
answer is not expected, and it cannot be expected that the recipient takes notice
of the message.
Note: Information is sent to let business partners or business applications know

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about a subject matter. An information is not composed for a specific usage.
Example: Information about product announcement or advertisement
Both direction and communicational pattern can be derived from the name of the
service operation. For example, the service operation
PatientERPMergeRequestConfirmation_In is an inbound service operation with the
pattern 'request/confirmation'.
List of Services (ordered by business object)
The list that follows gives an overview of all enterprise service operations that are
delivered with this release.
All enterprise service operations are independent from each other and can be used
separately, as well as in scenarios where different service operations work together (for
example, searching for a patient and then changing the found patient).
"Service interface" and "operation" are terms that are used in the ES Workplace,
whereas the "technical name" is the name that is used in the ERP as well as in the PI
system.
SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H 604)
delivers the following process components and business objects:
o Healthcare Business Partner Management, including business object Patient
o Patient Encounter Management, including business object Patient Encounter
o Patient Financials, including business object Medical Activity
The service operations contained in each of these business objects are listed below.
o Business Object Patient
Service operations for the business object Patient are designed to read, create
and change patient master data externally, and to broadcast information about
change and creation of patient master data in the SAP system to other systems.
Service Interface Manage Patient In (synchronous inbound services):
- Operation Create Patient (technical name:
PatientERPCreateRequestConfirmation_In)
This service operation creates a Patient business object, which stores
patient records.
- Operation Update Patient (technical name:
PatientERPUpdateRequestConfirmation_In)
This service operation updates a Patient business object.
- Operation Read Patient (technical name:
PatientERPByIDQueryResponse_In)
This service operation reads the detail information for a patient with a
given ID (internal or external).
- Operation Read Patient Private Patient Indicator (technical name:
PatientERPPrivatePatientIndicatorByIDQueryResponse_In)
This service operation provides the information, for a given patient,
whether the patient is a private patient or not.
Service Interface Patient Action In (synchronous inbound services):
- Operation Merge Patient (technical name:
PatientERPMergeRequestConfirmation_In)
This service operation merges two patients, where one is deactivated and
the other remains active (major and minor patients).
- Operation Deactivate Patient (technical name:
PatientERPDeactivateRequestConfirmation_In)
This service operation deactivates (cancels) a patient.

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- Operation Check Patient Bad Debt Party (technical name:
PatientERPBadDebtPartyCheckQueryResponse_In)
- This service operation checks whether a given patient is a bad debt party.
A bad debt party is a person to whom the user's attention is drawn by the
system during the admission procedure.
Service Interface Patient Event Out (asynchronous outbound services):
- Operation Inform of Patient Identification Change (technical name:
PatientERPIdentificationChangedInformation_Out)
This service operation sends out information to all connected systems that
an identifier of a patient has been changed.
- Operation Inform of Patient Creation (technical name:
PatientERPCreatedInformation_Out)
This service operation sends out information to all connected systems that
a new patient has been created.
- Operation Inform of Patient Change (technical name:
PatientERPChangedInformation_Out)
This service operation sends out information to all connected systems that
a patient has been changed.
- Operation Inform of Patient Merge (technical name:
PatientERPMergedInformation_Out)
This service operation sends out information to all connected systems that
two patients have been merged.
Service Interface Patient In (asynchronous inbound services):
- Operation Merge Patient based on Patient Merged Notification
(technical name: PatientERPMergedNotification_In)
This service operation merges two patients as a reaction to a received
notification.
- Operation Change Patient based on Patient Changed Notification
(technical name: PatientERPChangedNotification_In)
This service operation changes a patient as a reaction to a received
notification.
- Operation Create Patient based on Patient Created Notification
(technical name: PatientERPCreatedNotification_In)
This service operation creates a patient as a reaction to a received
notification.
- Operation Maintain Patient (technical name: PatientERPRequest_In)
This service operation changes a patient in the Patient Demographic
Consumers System to reflect a change made in the Patient Demographics
Source System. It also creates the patient if it does not exist.
- Operation Merge Patient (technical name:
PatientERPMergeRequest_In)
This service operation merges two patients, where one is deactivated and
the other remains active (major and minor patients).
- Operation Deactivate Patient based on Patient Deactivated
Notification (technical name: PatientERPDeactivatedNotification_In)
This service operation deactivates (cancels) a patient based on an
incoming notification.
Service Interface Patient Out (asynchronous outbound services):
- Operation Confirm Patient Maintenance (technical name:
PatientERPConfirmation_Out)
This service operation is the asynchronous response to the service
operation Maintain Patient.

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- Operation Confirm Patient Merge (technical name:
PatientERPMergeConfirmation_Out)
This service operation is the asynchronous response to the service
operation Merge Patient.
Service Interface Query Patient Out (synchronous outbound services):
- Operation Find Patient by Basic Data (technical name:
PatientERPBasicDataByBasicDataQueryResponse_Out)
This service operation provides a patient search function during
admission, to avoid duplicate patient records.
Service Interface Query Patient In (asynchronous inbound services):
- Operation Find Patient by Identifying Elements (technical name:
PatientERPSimpleByIdentifyingElementsQueryResponse_In)
This service operation provides a patient search function that searches by
identifying attributes of the patient.
- Operation Find Patient by Basic Data (technical name:
PatientERPBasicDataByBasicDataQueryResponse_In)
This service operation provides a patient search function during
admission, to avoid duplicate patient records.
o Business object Patient Encounter
Service operations for the business object Patient Encounter are designed to
read, create and change patient encounters. A patient encounter describes an
interaction between a patient and a healthcare provider. A patient encounter
spans a period of time, the length and detail of which may vary according to local
procedures and rules. In classical SAP Patient Management terms a patient
encounter would consist of one or two movements.
Service Interface Manage Patient Encounter In (synchronous inbound
services):
- Operation Create Patient Encounter (technical name:
PatientEncounterERPCreateRequestConfirmation_In)
This service operation creates a patient encounter.
- Operation Update Patient Encounter (technical name:
PatientEncounterERPUpdateRequestConfirmation_In)
This service operation updates a patient encounter.
- Operation Cancel Patient Encounter (technical name:
PatientEncounterERPCancelRequestConfirmation_In)
This service operation cancels a patient encounter.
- Operation Find Patient Encounter Patient List by Elements (technical
name:
PatientEncounterERPPatientListByElementsQueryResponse_In)
This service operation provides a list of patient encounters based on
specified critera. For example, patient encounters with patients that have
been admitted in the last month, are planned discharges in the next week,
have been transferred to different departments.
- Operation Read Patient Encounter (technical name:
PatientEncounterERPByIDQueryResponse_In)
This service operation reads the detailed information for a patient
encounter with a given ID (internal or external).
o Business object Medical Activity
Service operations for the business object Medical Activity are designed to read,
create and change medical activities. In SAP Patient Management terminology,
medical activities are equivalent to "services which are assigned to a case".
Service Interface Manage Medical Activity In (synchronous inbound
services):

225
- Operation Maintain Medical Activity (technical name:
CollectiveMedicalActivityERPRequestConfirmation_In)
This service operation maintains a set of medical activities for a given
Billing Patient Encounter Group (BPEG).
- Operation Read Medical Activity (technical name:
MedicalActivityERPByIDQueryResponse_In)
This service operation returns the detailed information for a given medical
activity ID.
- Operation Find Medical Activity by Elements (technical name:
MedicalActivityERPBasicDataByElementsQueryResponse_In)
This service operation shows a list of medical activities (with basic in
formation) that exist for a given BPEG or encounter.
o Business object Billing Patient Encounter Group
Service"Service interface" and "operation" are terms that are used in the ES
Workplace, whereas the "technical name" is the name that is used in the ERP as
well as in the PI system. Clarify with Nektarios how this is connected with
"integrated ARIS".s for the business object Billing Patient Encounter Gr our are
designed to track the costs of treating a patient and calculate the total bill for the
patient at the end of treatment. In SAP Patient Management, billing patient
encounter group is equivalent to "case".
Service interface Billing Patient Encounter Group Action In (synchronous
inbound services):
- Service Operation Calculate Accrual (technical name:
BillingPatientEncounterGroupERPAccrualCalculateQueryResponse_I
n)
This service operation calculates the accrued revenue for a patient, even if
the patient's treatment is not yet finished.
Examples
The following examples give a brief explanation of how both synchronous and
asynchronous service operations function.
Synchronous Scenarios
An external system uses a UI to find, display and update Patients. Typically, this is a
synchronous scenario, as the connected UI requires the response and confirmation
before it can continue with its processes. To find a patient, you can provide criteria,
which are taken from the UI and used as search criteria for the message
PatientERPBasicDataByBasicDataQuery_sync.
The result of the query is returned with the message
PatientERPBasicDataByBasicDataResponse_sync. This response contains selected
patient details and their identifications, which can be displayed on the UI as a search
result.
Now, you select a patient and want to read the complete record in order to update it. To
do this, the system uses the PatientID, which has been retrieved, as the parameter for
the message PatientERPByIDQuery_sync. The system returns the entire patient
synchronous with the message PatientERPByIDResponse_sync".
The UI displays the patient details, you make any changes you need, and then the UI
passes over the changed patient with the message PatientERPUpdateRequest_sync.
Finally, the system confirms the change with the message
PatientERPUpdateConfirmation_sync.
This is one typical synchronous scenario.
Asynchronous Scenarios
You have a system landscape where SAP Patient Management is the primary system

226
for storing patients. Therefore, you want it to notify other systems whenever a patient is
created or changed.
SAP Patient Management sends out information messages:
o "PatientERPCreatedInformation" when a patient is created in SAP Patient
Management
o "PatientERPChangedInformation" when a patient is changed in SAP Patient
Management
The systems which are interested in these messages have typically been specified as
receivers of these messages in XI.
When we need to create or change a patient to reflect one created or changed
somewhere else, we can receive messages such as:
"PatientERPCreatedNotification" - when a patient was created somewhere else
"PatientERPChangedNotification" - when a patient was changed somewhere else
Effects on Existing Data
Though services are designed with an outside-in approach, they are fully compatible
with the existing backend functionality. The SAP system maps the external data to the
internal data and vice versa.
BAPIs are not affected by the services. All BAPIs still function and will continue to be
supported.
Since the interfaces of the service operations were designed using industry standards,
they look very different from the interfaces of BAPIs or any other existing internal
names. An explanation on the meaning of every parameter in the interfaces is given in
the documentation of the enterprise services in the ES Workplace.
Effects on Customizing
Customizing for the services of SAP Patient Management can be found in Customizing
for SAP Healthcare - Industry-Specific Components for Hospitals under
Communication -> Vorbereitung Service-Enabling (This Customizing can only be
accessed if the business function SAP Patient Management: Legal Process
Adoption (ISH_MISC1) is switched on.)
General customizing for service operations can be found in Customizing for Enterprise
Services [CA-SOA]
See also
More information about configuration for the inbound and outbound processing of the
service operations can found in the following release notes:
o ISH_MISC1: IS-H IHE/HL7-compliant services (New)
o ISH_MISC1: Legal Process Adoption (New)
More information is also available in the sources listed below.
o Information on service bundles of SAP Patient Management:
- Bundle Medical Activities, Patient Invoicing & Billing
- Bundle Patient Administration
http://wiki.sdn.sap.com/wiki/display/ESpackages/Patient+Administration
From the SAP Community Network (http://www.sdn.sap.com) choose Wiki
in the navigation bar, then follow the path Enterprise Services Wiki ->
Resource and Supply Chain Planning for Healthcare Providers. From
here, scroll down to Related ES Bundles and follow the link to Patient
Administration.

227
o SAP's Help Portal on enterprise SOA: http://help.sap.com -> Enterprise SOA
o Enterprise Service Workplace: http://esoadocu.sap.com
o Resource and Supply Chain Planing for Healthcare Providers
Follow the path for the Patient Administration bundle above.
o Blogs on the SAP Developer Network:
https://www.sdn.sap.com/irj/sdn/weblogs?blog=/pub/wlg/9153

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ISH_MISC1: IS-H IHE/HL7 compliant services (new)
Use
One of the significant milestones within this release is the provision of IHE/HL7-
compliant enterprise services. As of SAP ECC 6.0, Industry Extension Healthcare,
Enhancement Package 4 (IS-H 604), Business Function SAP Patient
Management: Legal Process Adoption (ISH_MISC1), SAP Patient Management
contains HL7-ready services which correspond to certain IHE integration profiles and
actors.
Background information on IHE and HL7
o HL7 (Healthcare Level Seven) is a common healthcare message standard that is
widely used for the transformation of patient information among healthcare
applications.
o IHE (Integrating the Healthcare Enterprise) is a healthcare initiative of healthcare
providers and professionals. IHE defines healthcare integration profiles and
actors for each integration profile. It also recommends that healthcare providers
implement these integration profiles according to the actors in their products.
This helps healthcare providers and customers to simplify the interoperability of
integration between different healthcare vendors and reduce the integration cost.
IHE does not define any healthcare standards. Instead, its integration definition is
based on existing healthcare standards, for example, HL7 or DICOM.
This release provides HL7-compliant services according to the following IHE Integration
Profiles and actors:
o Patient Administration Management (PAM)
The PAM Integration Profile defines transactions based on message exchanges
to support patient identity and encounter information, as well as movements
within an acute care encounter.
SAP Patient Management acts as both Patient Demographics Supplier and
Consumer to transmit patient information, for example, when creating, updating,
and merging.
These can be used in acute care settings for both inpatients (patients who are
assigned a bed at the facility) and outpatients (patients who are not assigned a
bed at the facility).
o Patient Demographics Query (PDQ)
The PDQ profile provides ways for distributed applications to query a central
patient information server for a list of patients, based on user-defined search
criteria such as ID or patient name. Patient demographics data can be entered
directly into the application from which you are querying, by picking the
appropriate record from a list of possible matches (called a patient pick list).
SAP Patient Management acts as Patient Demographics Supplier to return
demographic information for all patients matching the demographic criteria
provided by the Patient Demographics Consumer.
The IHE services above are implemented based on HL7 2.5 encoding rules (which are
published on the HL7 organization page). Consequently, the IHE services are mapped
to the HL7 2.5 XML and delivered in this release.
As well as consuming these services, you may also use these HL7 2.5 XML messages
as an integration start point for your own integration purpose, with any IHE PAM- and
PDQ-compliant and/or HL7-compliant applications.
For more information on the HL7 service list, see the release note for ISH_MISC1:
Enterprise Services (new).

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ISH_MISC1, ISHMED_MAIN: Interface IF_ISH_OBJECT_TYPES
(Deleted)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MIISC1) in SAP Patient Management (IS-H) and Business Function Clinical
System (ISHMED_MAIN) in the Clinical System i.s.h.med, the interface
IF_ISH_OBJECT_TYPES, in which the type constants of the classes in IS-H and
i.s.h.med were defined up to now, is no longer used.
Instead of using the constants of this interface, the system now uses constants with
the name CO_OTYPE_.... that are defined directly in the relevant classes. This is to
improve the performance and readability of the programs.
Examples:
o Class CL_ISH_CORDER has a constant CO_OTYPE_CORDER
o Class CL_ISHMED_CORDPOS has a constant CO_OTYPE_CORDPOS_MED
o Class CL_ISHMED_SERVICE can have two types (normal service and anchor
service) and therefore has two of these constants:
- CO_OTYPE_MED_SERVICE
- CO_OTYPE_ANCHOR_SRV
In addition, the data type of these constants has been changed from INTEGER to a
new type ISH_OBJECT_TYPE defined per data element. Since ISH_OBJECT_TYPE is
actually type I also, problems cannot arise during the changeover.
These constants define the type of a class and are used when the methods
GET_TYPE, IS_A, and IS_INHERITED_FROM are called, this means in all places
where the program wishes to determine the type of a reference variable in order to
subsequently perform a cast, for example.
Prior to SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-
H 604), Business Function Clinical System (ISHMED_MAIN), this was programmed,
for example, as follows:
DATA: lr_object TYPE REF TO IF_ISH_IDENTIFY_OBJECT,
lr_corder TYPE REF TO CL_ISH_CORDER,
l_type TYPE I.
...
...
* lr_object is filled with any object from the caller. The
* current program however needs a reference of the class CL_ISH_CORDER and must
* thus ask this object what it is
CALL METHOD lr_object->get_type
IMPORTING
e_object_type = l_type.
IF l_type = IF_ISH_OBJECT_TYPES=>CO_TYPE_CORDER.
* If it is CORDER => Perform desired action
ENDIF.

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...
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), this is programmed as
follows (changes to the previous source code are shown in bold type):
DATA: lr_object TYPE REF TO IF_ISH_IDENTIFY_OBJECT,
lr_corder TYPE REF TO CL_ISH_CORDER,
l_type TYPE ISH_OBJECT_TYPE.
...
...
* lr_object is filled with any object from the caller. The
* current program however needs a reference of the class CL_ISH_CORDER and must
* thus ask this object what it is
CALL METHOD lr_object->get_type
IMPORTING
e_object_type = l_type.
IF l_type = CL_ISH_CORDER=>CO_OTYPE_CORDER.
* If it is CORDER => Perform desired action
ENDIF.
...
Similarly, the methods GET_TYPE and IS_INHERITED_FROM now no longer return
the constant value from IF_ISH_OBJECT_TYPES, but the constant value defined in
the relevant class, instead.
Example: Class CL_ISH_CORDER:
Prior to SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-
H 604), Business Function Clinical System (ISHMED_MAIN), this was programmed,
for example, as follows:
METHOD if_ish_identify_object~get_type .
e_object_type = if_ish_object_types~co_type_corder.
ENDMETHOD.
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), this appears as follows
(changes to the previous source code are shown in bold type):
METHOD if_ish_identify_object~get_type .
e_object_type = cl_ish_corder=>co_otype_corder.
ENDMETHOD.

Effects on Your Customer-Specific Programs


You have to correct all places in your programs in which the old object types are used.
Proceed as follows:
1. Call transaction SE80 and open your customer-specific packages.
2. Choose Class Library -> Classes.

231
3. Select all classes, open the context menu (by clicking the right-hand mouse
button) and choose the Find function.
4. Search for CO_TYPE.
You have to correct all occurrences you find, regardless of whether directly from
IF_ISH_OBJECT_TYPES, IF_ISH_IDENTIFY_OBJECT, or similar.
Thus, for example, from
- if_ish_object_types~co_type_corder --> cl_ish_corder=>co_otype_corder
- if_ish_object_types=>co_type_corder --> also
cl_ish_corder=>co_otype_corder
- if_ish_identify_object=>co_type_corder --> similarly
cl_ish_corder=>co_otype_corder
1. When you have completed the corrections in the classes, remain in transaction
SE80, and choose the Programs node.
2. Select all programs and search for CO_TYPE, as above in the classes. Replace
the found occurrences in the source code with the respective new constants.
You do not have to create new constants here.
3. Now repeat the same procedure for the function groups (and function modules):
- Choose the Function Groups node
- Select all
- Search and replace as in the Programs node
4. Now remove the interface IF_ISH_OBJECT_TYPES from your classes, if
required.
5. Execute the Where-Used List function for IF_ISH_IDENTIFY_OBJECT
(important: not IF_ISH_OBJECT_TYPES) to find all classes that implement this
interface.
6. Open every one of these classes and switch to change mode.
7. The system asks you if you want to modify the class. Make the modification. This
modification is necessary to remove the interface IF_ISH_OBJECT_TYPES (that
was contained in the class via IF_ISH_IDENTIFY_OBJECT) from the class
completely.
8. You must then clean up the aliases. To do this, in the menu choose Utilities ->
Clean Up -> Aliases.
9. Re-activate the class.

Important Information:
You can user the report RNOBJECT_TYPES to determine the names of the classes for
the constants you have found. Simply run the report (without entering criteria on the
initial screen). The report shows a list of classes that derive from
IF_ISH_IDENTIFY_OBJECT and thus have constants.
In general, the new constants have the same name as the old constants, except
CO_OTYPE_... in place of CO_TYPE_... , thus for example co_otype_corder instead
of co_type_corder.
You obtain the name of the class in which a constant is defined by calling this report
and searching for CO_OTYPE_.... The system shows all of the classes found together
with their class name.
Standard Modifications:

232
If you have modified standard programs, you also have to correct these. You thus also
have to replace the old constants CO_TYPE#) by the new ones (class
=>CO_OTYPE#) in the modified standard programs.
If you have defined your own constants in the interface IF_ISH_OBJECT_TYPES, you
have to replace these too. This should not actually be necessary, since a change to
IF_ISH_OBJECT_TYPES means a standard modification. The table
N1CUSTOMER_TYPES has been created for customer-specific objects. You can store
your customer-specific object types in this table. In such cases, there is no need to
make changes to your source code, since the use of the constants in this class remains
effective and has not been changed.
However, if you have added your own constants to IF_ISH_OBJECT_TYPES using a
standard modification, you need to proceed as follows:
1. In the class in which this constant is used as an object type, you have to add a
constant with the same name (but CO_OTYPE# instead of CO_TYPE#!) of the
type ISH_OBJECT_TYPE.
2. Then replace - as explained in item 1 - all users of the original constants. In
doing this, do not forget the GET_TYPE and IS_INHERITED_FROM method of
the class in which this constant is defined.

General Information:
For SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the interface
IF_ISH_OBJECT_TYPES has been retained to facilitate the Release upgrade and
adapt your customer-specific programs. This interface will be deleted with a future
release of IS-H and i.s.h.med. For this reason, do not forget to adapt your programs.
IF_ISH_OBJECT_TYPES has been removed from the interface
IF_ISH_IDENTIFY_OBJECT in SAP ECC 6.0, Industry Extension Healthcare,
Enhancement Package 4 (IS-H 604), Business Function Clinical System
(ISHMED_MAIN). Previously, IF_ISH_IDENTIFY_OBJECT also inherited from
IF_ISH_OBJECT_TYPES (and thus all of its constants). IF_ISH_IDENTIFY_OBJECT
is still in use since it contains the methods for identifying an object, thus GET_TYPE,
IS_A and IS_INHERITED_FROM.

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ISH_MISC1 AT: Work Center - Online Scoring/Int. Care Data Integrated
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement
Package 4, Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the Scoring and Intensive Care Data functions have been added to the
function list for the views. This means you can add transactions NWATISV (Intensive
Care Data) and/or Scoring to the function variant for your view.

234
ISH_MISC1 AT: LKF Scoring for Services (SMS) (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the system records a history of the entries in the LKF Scoring for
Services (SMS) table (NAKR2). This means the system no longer deletes entries. This
means it is possible to track when and by whom changes or cancellations are made.
The following fields have been added to the table for this purpose:
o Created On
Date the record was created
o Created By
Name of user who created the record
o Changed On
Date on which record was last changed
o Changed By
Name of user who made the last change
o Cancellation Date
o Cancellation Indicator
o Name of user who cancelled record
You can display the change documents using the function available in the online
scoring work station (History button in the SMS Code screen area). Note that the
toolbar must be displayed and the screen area must be included in the variant.

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ISH_MISC1 AT: Data Exchange Comm. Procedure P321/ELDAL
(Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the following changes have been made to the system behavior:
o EDI system control
The User field has been added to the EDI system control table. You can make
user-specific settings for the following parameters in this table:
- Scoring - Max. Number of Cases for Scoring Access
- Scoring - Online Formatting Type
- Scoring - File Directory
- Scoring - Intensive Care Data
- Scoring - Neonatology and Pediatrics Checks
- Scoring - Program Directory
- Scoring - External Program Name
- Scoring - RFC Destination
- Scoring - Program Path for System Data
This renders the scoring user parameters invalid; they will be deleted with the
next release. You can use the report IS-H AT: Conversion Report -
Scoring GET/SET Parameters - NWATPARAM (RNWATUTL19) to
copy the current user settings to the new parameters.
o EDI Worklist
- Departmental Assignment and Nursing Assignment fields
From now on, the system also enters data in the Departmental
Assignment and Nursing Assignment fields. The data entered is taken
from the current assignment of the movement. This means if you change
the departmental or nursing assignment after sending a message, the
change is also reflected in the workbench display. However, if an
outpatient admission notification is cancelled and a new one created, for
example when a visit is entered subsequently, the system displays the
data on the corresponding movement.
In the case of VZE messages (K03), the system displays the
organizational units (OUs) for the admission and/or the first visit in the
quarter (outpatient treatment), whereas it displays the OUs for the
message assigned in the case of comments (K12) and error messages
(Exx).
- Change message status manually
You can prevent manual changes to the message status using an
authorization check. The authorization check is run separately for outgoing
and incoming messages (profiles N_AT_EDI_IN and N_AT_EDI_OUT).
For more information, see the documentation on authorization object
N_AT_EDI.
o EDI procedure P321
Import file:
If a file contains messages for an institution that does not exist in the system, the
system cancels processing and assigns the entire file the status "Incorrect"
(external error).

236
o All EDI procedures
The system now lists the path and name of the file created in the log of the
program IS-H EDI: Create Message File (RNC30101).

237
ISH_MISC1 AT: File Import Program for IV for Inpatient Cases (New)
Use
Until now, the file import program used to import confirmations of health insurance
coverage for inpatient cases was dependent on the existence open insurance
verification requests.
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the file import program is also able to generate an insurance verification
for inpatient cases if it does not yet exist. The system determines the service (group) for
which it generates the verification from the data on preapproved insurance and default
values. If there are several suitable open insurance verifications, the system reduces
this to one.

238
ISH_MISC1 AT: User-Specific Scoring Parameters in Control Table
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), you can specify the following user-specific parameters in the
Customizing activity AT: EDI System Control:
o Scoring - File Directory (In-/Output Files for Up-/Download)
o Scoring - Program Directory
o Scoring - Program Path for System Data
o Scoring - External Program Name (for example, LKFSCORING.EXE)
o Scoring - RFC Destination
o Scoring - Intensive Care Data
o Scoring - Neonatology and Pediatrics Checks
o Scoring - Max. Number of Cases for Scoring Access
Effects on Customizing
Make your user-specific changes in Customizing under SAP Healthcare - Industry-
Specific Components for Hospitals -> Communication -> Electronic Data
Interchange -> Country Specifics -> Country Specifics for Austria -> AT: EDI
System Control.

239
ISH_MISC1 AT: Statistics of Inpatient Cases (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the following changes have been made to the statistics:
o IS-H AT: Bed Management - Bed Capacity Utilization (RNABAUSL)
The IS-H AT: Bed Management - Bed Capacity Utilization program
(RNABAUSL) is no longer available (locked). It will be deleted in the release
following 7.00.
o IS-H AT: Beds per Care Unit (TNABETTEN)
As of SAP Patient Management Release 4.72, the system contains the
enhanced table IS-H AT: Number of Beds per Department and Care Unit
(TNWATBETTEN). You can enter the bed data according to each combination of
departmental/nursing OU. You should use this table from now on. Table
TNABETTEN will be deleted in the release following 7.00.
o IS-H AT: Table for Entire Totals Block (N1GES)
You can enter data in this table in Customizing in the statistics structure. As of
this release, it has been replaced by the IS-H AT: Table for Entire Totals Block
table (NWATGES), which contains the additional selection criteria Valid From
and Valid To. The "Chief Physician Statistics" and "Accommodation Statistics"
evaluations (which both belong to the IS-H AT: Inpatient Statistics program
(RNWATSTATISTIK)) use this table.
The data is transferred by the program IS-H AT: XPRA for 7.00 - NWATGES =
N1GES + Validity + Stamp (RNWATUTL16).
Table N1GES will be deleted in the release following 7.00.
o IS-H AT: Table for Departmental Nursing OUs (N1FAPF)
You can enter data in this table in Customizing in the statistics structure. As of
this release, it has been replaced by the IS-H AT: Table for Departmental
Nursing OUs table (NWATFAPF), which contains the additional selection criteria
Valid From and Valid To. The "Chief Physician Statistics" and "Accommodation
Statistics" evaluations (which both belong to the IS-H AT: Inpatient Statistics
program (RNWATSTATISTIK)) use this table.
The data is transferred by the program IS-H AT: XPRA for 7.00 - NWATFAPF =
N1FAPF + Validity + Stamp (RNWATUTL17).
Table N1FAPF will be deleted in the release following 7.00.
o The following statistics tables now have delivery class "A", which means they can
be maintained directly in any system:
- IS-H AT: Beds per Department and Care Unit (TNWATBETTEN)
- IS-H AT: Table for Entire Totals Block (NWATGES)
- IS-H AT: Table for Departmental Nursing OUs (NWATFAPF)
- IS-H AT: Selection Procedure for Hospital Statistics (TNA30A)
- IS-H AT: Selection Procedure - Bed Classes and Services (TNA30B)
- IS-H AT: Selection Procedure for Hosp. Stats A2 Case Class.
(TNA30C)
- IS-H AT: Geographical Areas - Location (TNA30E)
- IS-H AT: Line Texts for Age Structure (TNA30S)
- IS-H AT: Insurance Statistics (TNA30V)
See also

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You can maintain the tables IS-H AT: Table for Entire Totals Block (NWATGES) and
IS-H AT: Table for Departmental Nursing OUs (NWATFAPF) in the following
Customizing activities:
o SAP Healthcare - Industry-Specific Components for Hospitals ->
Information Systems -> Statistics Structure -> AT: Define Complete
Totals Block
o SAP Healthcare - Industry-Specific Components for Hospitals ->
Information Systems -> Statistics Structure -> AT: Define Dept. OU to
Nursing OU Assignment

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ISH_MISC1 AT: Address - Checks on Postal Code / City (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the system changes its behavior as follows when checking the Postal
Code, City, and Geographical Area fields if you enter "AT" in the Country field:
o If there is an entry in the Postal Code field and this postal code exists on the
database, the system determines the city and geographical area in this way.
o If you have also entered a city and this does not match the city determined by
the system from the postal code, the system displays the new message "City and
geographical location will be overwritten because of postal code" (NV 355). The
default message type is "Error" but you can change this. If you change the
message type to "Warning", the system overwrites both the city you have
entered and the geographical area.
o If there is an entry in the Postal Code field and this postal code does not exist on
the database, the system displays the message "Postal code & & is not
supported (re-enter or enter city)" (N1 006) as before. From now on, the system
displays this same message if you also enter a city.
o If you only enter a city, the system saves it (as was previously the case).
See also
You can manage postal codes in Customizing under SAP Healthcare - Industry-
Specific Components for Hospitals -> Basic Settings -> Maintain Postal
Codes.

242
ISH_MISC1 AT: RN1FKLA0 - "Movements - Classification" (Deleted)
Use
This program checks if each movement is assigned a class.
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4,
Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), this program is no longer available (locked). It will be deleted from the
subsequent release.

243
ISH_MISC1 CH, AT, FR: Determine Fee-Based Services (New)
Use
If you restrict selection in the IS-H CH: Determine Fee-Based Services report
(RNWCHHONERM) to cases, for example, the report also processes services in other
cases if there have been any changes since they were last transferred. This is a safety
measure to ensure that subsequent changes to fee services are not forgotten.
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), you can use the new Inc. Changed Fee-Based Services checkbox to
have the system determine fee-based services that match your selection criteria.
Note the following:
o The indicator is selected by default in the report, which processes the data as
before.
o If you do not select the indicator, the report only transfers services to the fee that
actually match your selection criteria.

244
ISH_MISC1 CH: INXML 4.0 - Suppressing "Zero Invoices" (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), you can have the system automatically suppress invoices for an amount
of zero when dispatching electronic invoices.
The checkbox IS-H CH: Indicator for Zero Invoices by EDI has been added to the
table IS-H CH: Control Data for EDI Procedure for Ins. Provider (TNWCH_EDIKTR).
Select this indicator if you want the system to also transmit "zero invoices"
electronically.
The indicator is not selected as standard and the system suppresses zero invoices
automatically.

245
ISH_MISC1 CH: IV - Specifying Printer on Selection Screen (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the Printer field is no longer a required field. You should therefore note
the following:
o If you do not specify a printer, the system defaults to the Customizing settings.
o If you specify a printer, the system overrides the Customizing settings.
The following programs have been adjusted:
o IS-H CH: Print IV Request (RNWCHKUDR)
o IS-H CH: Insurance Verification Reminder (RNWCHKUMA)
o IS-H CH: Print IV Request Subsequently (RNWCHKUND)
o IS-H CH: Extend Insurance Verification (RNWCHKUVL)
o IS-H CH: Collective Print Admission/Discharge Notifications
(RNWCHKUPR)
Effects on Customizing
Check the Customizing settings for the printer assignment, which the system now takes
into account when executing the above reports, under SAP Healthcare - Industry-
Specific Components for Hospitals -> Tools -> Work Organizer Management ->
Work Organizers -> Assign Printers to Work Organizers.

246
ISH_MISC1 CH: Report for Assigning Contract Scheme (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), you can have the system exclude cases that do not have a billing
agreement (ABRV) from the assignment to a contract scheme. The checkbox
Excl.Cases w/o Billg Agrt has been added for this purpose to the report IS-H CH:
Assign Contract Scheme (RNWCHKUVZ).
The following options are available:
o If you do not select the Excl.Cases w/o Billg Agrt checkbox, you can also edit
cases that are not assigned a billing agreement in the list generated by the
system.
o If you select the checkbox, you cannot edit cases that are not assigned a billing
agreement (in this case, the field for selecting these cases is not ready for input).

247
ISH_MISC1 CH: Organizational Management - Division (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the organizational units and building units in Organizational
Management are represented by object types.
The following infotype has been created for the organizational units for the country
version Switzerland (CH):
Infotype ID: 6076 Assignment of OU -> Division
Contains the assignment information on the organizational unit assigned to the division.
The system now stores data that was previously stored in table NORG_SPRT in this
infotype table.

248
ISH_MISC1 CH: Item Data for Billing Agreement (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1) the item data in the billing agreement includes the additional selection
criteria Movement Category and Movement Type.

249
ISH_MISC1 AT, CH, FR: Depreciation of Fee-Based Services (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), you can use the ISH-CH: Fee Depreciation program
(RNWCHHONABS) to include irrecoverable debts in fee-based billing.
The following options are possible for each invoice when executing depreciation:
o Complete depreciation at the hospital's expense
All fee-based services with the selected invoice number are depreciated in their
entirety
The physician receives the fee.
o Complete depreciation at the physician's expense
All fee-based services with the selected invoice number are depreciated in their
entirety
In this case, the physician is not paid the fee and may have to refund payments.
o Partial depreciation
You can decide which amount is to be depreciated for each fee-based service in
the selected invoice.
The IS-H-CH: Post Depreciated Fees program (RNWCHHONVB_ABS) is available for
posting the depreciated fee-based services. The report only processes depreciated fee-
based services with the status "C" - cancelled.

Effects on Customizing
You define the required document type for depreciation in Customizing under SAP
Healthcare - Industry-Specific Components for Hospitals -> Patient Accounting ->
Billing -> CH; AT, FR: Fee-Based Billing -> CH, AT, FR: Maintain System
Parameters for Fee-Based Billing in parameter HON_BAA.

You make the required settings for the depreciation account in Customizing under SAP
Healthcare - Industry-Specific Components for Hospitals -> Patient Accounting ->
Billing -> CH; AT, FR: Fee-Based Billing -> CH, AT, FR: Account
Determination.

250
ISH_MISC1 CH: Service Rules (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), you can limit the validity of the entries in the service rule tables by
specifying a validity date. In addition, the fields Insurance Provider, Insurance
Provider Type, and Self-Payer/Third-Party Payer have been added to the selection
criteria in some of the service rule tables.
It is now possible to specify a validity period for the following service rules:
o C1/C2 - Billability/Flat Rate (ISH_CH_CHECK_SERVICES_BILLABLE)
o C3 - Service Breakdown (ISH_CH_CHECK_SERVICES_SPLITS)
o C4 - Maximum Service Values (ISH_CH_CHECK_SERVICES_MAX_VAL)
o C5 - Surcharge Service (ISH_CH_CHECK_SERVICES_EXTRA)
o C6 - Radiology Rule (ISH_CH_CHECK_SERVICES_RD)
o C7 - PC Rule (ISH_CH_CHECK_SERVICES_OP)
o C18 - Service Duration Re-Mapping (ISH_CH_CHECK_TARMED_TIMEMARK)
o C23 - Division Surcharge (ISH_CH_CHECK_TARMED_DIVISION)
Service rules C1, C2, C3, C4, C5, C7, and C18 check the validity periods defined in the
Customizing tables against the performance date of the service(s) specified in
Customizing to restrict the use of the rule.
Service rules C6 and C23 check the validity dates defined in the Customizing tables
against the admission date or against the date of the first outpatient visit.
The selection criteria Insurance Provider, Insurance Provider Type, and Self-
Payer/Third-Party Payer have been added to the following service rules:
o C1/C2 - Billability/Flat Rate (ISH_CH_CHECK_SERVICES_BILLABLE)
o C3 - Service Breakdown (ISH_CH_CHECK_SERVICES_SPLITS)
o C4 - Maximum Service Values (ISH_CH_CHECK_SERVICES_MAX_VAL)
o C5 - Surcharge Service (ISH_CH_CHECK_SERVICES_EXTRA)
o C7 - PC Rule (ISH_CH_CHECK_SERVICES_OP)
o C28 - Billability of Materials (ISH_CH_CHECK_TARMED_MATBILL)
The system uses the main insurance provider for the check.
To initialize the new fields in the Customizing tables, you must execute the following
conversion reports once:

o RNWCHUTL38_604
o RNWCHUTL39_604
o RNWCHUTL40_604
o RNWCHUTL41_604
o RNWCHUTL42_604
o RNWCHUTL43_604
o RNWCHUTL44_604
o RNWCHUTL45

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o RNWCHUTL46_604

252
ISH_MISC1 CH: Service Rule - Assign Fee Physician / Function (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MISC1), the service rule C32 is available for automatic generation of fee
physicians for fee-relevant services.
You can define the rules for generating physicians in Customizing in the Assign Fee
Physician / Function table (TNWCHFEEPHYS).
The service rule takes both billable and non-billable fee-relevant services into account.
If a fee physician is specified for a service, the service rule does not overwrite this
entry; this means the system does not change manually entered fee physicians.
Effects on Customizing
You maintain the settings for generating fee physicians in Customizing under SAP
Healthcare - Industry-Specific Components for Hospitals -> Patient Accounting ->
Service Rules -> CH: Service Rules ->
CH: Assign Fee Physician / Function.
You must activate the service rule in the check procedure in Customizing under SAP
Healthcare - Industry-Specific Components for Hospitals -> Patient Accounting ->
Service Rules -> Define Rule Types and Maintain Check Procedure.

See also
For more information, see SAP Healthcare - Industry-Specific Components for
Hospitals -> Patient Accounting -> Service Rules -> CH: Service Rules -> Assign
Fee Physician / Function in Customizing.

253
Business Function SAP Patient Management Treatment
Certificates
ISH_TC: Business Function SAP Pat Mgmt Treatment Certificates
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4, (IS-
H 604), the business function SAP Patient Management: Treatment Certificates is
available. This business function allows you to use new, more user-friendly treatment
certificates in SAP Patient Management.
The improvements generally improve efficiency as a result of redesigned user
interfaces and simplified work processes. For example, you can have the system enter
default values based on existing data according to the treatment certificate category
and type to reduce the work involved in data entry.
For more information, see the following release notes:
o ISH_TC: Treatment Certificate Administration (Changed)
o ISH_TC: Case Revision: Reassigning Treatment Certificates
(New)
o ISH_TC: View Type for Treatment Certificates (New)
Effects on Existing Data
To use this business function, you must also activate the business functions ISH_MAIN
and ISH_CV_IT.
See also
For more information, see Business Function Sets and Business Functions ->
Healthcare -> SAP Patient Management -> SAP Patient Management: Treatment
Certificates in the SAP Library.
For more information about Support Package release notes for SAP Patient
Management and SAP Ambulatory Care Management, see SAP Service
Marketplace under the quick link /healthcare-releasenotes.

254
ISH_TC: Treatment Certificate Administration (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Treatment Certificates
(ISH_TC), the functions for treatment certificate administration have been reworked.
Note: These functions have only been released for the country version Italy in
EHP4.
The following sections describe the changes made.
Concept
The treatment certificate functions have been redesigned so that it is now possible to
enter several treatment certificates for a case and perform billing for outpatient cases.
The system attempts to assign services to treatment certificates. When doing so, the
system evaluates the assignment of a service to a movement. If this movement is only
assigned one treatment certificate, the system assigns the service to this certificate.
You can change this assignment manually.
You can bill individual treatment certificates in Patient Accounting or PPA Billing.
During PPA billing, the system sets the case to Final Billed once all the certificates for
a case have been billed.
Additional Customizing activities have been added to support you when creating and
cancelling treatment certificates. For example, you can control whether processes are
to run in the background while creating a case, changing case type, or creating a
movement. These processes might, for example, include creating treatment certificates
for a specific certificate category and type, or automatic cancellation of certificates
when the case type changes. Together with enhancements for preassigning treatment
certificate data and the option of preassigning data using the BAdIs in the Clinical
Process Builder (CPB), these changes allow you to automate the treatment certificate
management process to a significant extent.
The system does not support billing of services according to treatment certificates for
inpatient treatment.
Treatment Certificate Administration
A variant of the CPB replaces the previous administration transaction for treatment
certificates. It can be used to manage treatment certificates for a patient. You can
access treatment certificate administration as before, using transactions NP44
(Change) and NP45 (Display). The function consists of an overview screen that
displays all of the patient's cases with the related treatment certificates. If you select a
treatment certificate in the overview, you can display and edit details on a further
subscreen. You can also create new treatment certificates and delete existing ones.
Integration with Other CPB Variants
You can also integrate the various subscreens of Treatment Certificate Management in
customer-specific variants of the CPB. The layout of the overview screen changes with
the case reference of the variant. If you integrate this subscreen in a case-related
variant of the CPB, the system only displays this case with the corresponding treatment
certificates to give you a better overview.
The new subscreens have been integrated in the admission variants SAP ACM
Complete and SAP ACM PPA, and in the PPA Work Station, as standard. These
variants of the CPB are available to you in the ACM module.
Processing Dependent Objects
o Movements

255
You can assign more than one movement to a treatment certificate. The
movement assignment controls the assignment of services to treatment
certificates. You can make settings for automatic movement assignment in
Customizing. In detail processing for a treatment certificate, you can change the
assignment to the movement currently being processed using an indicator if the
subscreen is integrated in a movement-related variant. Otherwise, you can also
set the movement assignment in a dialog box that is accessed from the detailed
view of a treatment certificate.
o Services
The system automatically assigns the services for a movement to the treatment
certificate, if the movement has a unique assignment to the treatment certificate
and the services are billable. The indicator at service level (NLEI-NLKZA) must
also be selected if the system is to assign services to treatment certificates
automatically. The indicator NLKZA is selected by default for each new service if
the business function ISH_TC is active. When you assign a service to a
treatment certificate manually, the system deletes indicator NLKZA for this
service. This ensures that the system does not change the assignments of
services and treatment certificates for existing cases automatically, leading to
errors. You can (re)activate indicator NLKZA for selected services using the
Determine Certificate function. To do this, choose Edit -> More Functions in
service entry in the Clinical Process Builder (full screen).

The system now only requires the service assignment when billing treatment
certificates using NA30. The system also evaluates the service assignment in
PPA billing.
o Other data
If you change object data that is also used in the treatment certificates, the
system displays a warning if inconsistencies arise. For example, if you cancel the
case-related insurance relationship but it is still used in the treatment certificate,
the system displays a warning. For example, if the treatment organizational unit
in the movement assigned does not match the billing organizational unit in the
treatment certificate, the system also displays a warning.
Billing
o Transaction NA30
You can bill the services for a treatment certificate in transaction NA30. The
treatment certificate is assigned the status Final Billed when you bill all the
services that are assigned to it. If you only bill some of the services assigned, the
certificate is assigned the status Interim Billed. Caution: The system does not
support partial billing of treatment certificates for all forms of billing.
o PPA billing
You can bill individual treatment certificates in PPA billing. The certificates are
then assigned the status Final Billed. The case can only be assigned the status
Final Billed once you have billed the last treatment certificate with billable
services. In PPA billing, the system automatically sets the case to Final Billed
when you bill the last treatment certificate with billable services.
Effects on Existing Data
The following information is relevant to the dataset:
o Existing treatment certificates remain in the system, since the new functions are
based on the existing database tables.

Fields that are no longer required in PPA billing as certified in 2007 have not
been included in the interface. This applies to the following fields:

256
Technical field name Short Description
NKSD-BFEKZ IS-H: Early Detection Entitlement
Certificate Exists
NKSD-FEDAT IS-H: Issue Date of Early Detection
Entitlement Certificate
NKSD-BMVKZ IS-H: Prenatal Care Entitlement
Certificate Exists
NKSD-MVDAT IS-H: Issue Date of Prenatal Care
Entitlement Certificate
NKSD-ENTBT IS-H: Expected Delivery Date
NKSD-GLTVK IS-H: Expiration Date of Healthcare
Smart Card
NKSD-VORLD IS-H: Date when Healthcare Smart
Card Last Submitted
NKSD-VSLKZ IS-H: Indicator for Pension-Relevant
Condition
NKSD-ARBUN IS-H: Work Incapacity To-Date
NKSD-AUFLS IS-H: Services that Are to Be
Performed in the Order
NKSD-KONSU IS-H: Reasons for Performing a
Consultation Examination
NKSD-MWBEH IS-H: Reasons for Associated,
Continued Treatment and Others
NKSD-LSRKZ IS-H: LSR Specification in Prenatal
Care
NKSD-ABOKZ IS-H: Determ. of Blood Group and
RH Factor in Prenatal Care
NKSD-HAHKZ IS-H: Determ. of
Hemagglut.Inhib.Test Titre in Prenatal Care
NKSD-MAKKZ IS-H: Antibody Identification in
Prenatal Care

o The system continues to evaluate the system parameter BEH_STAT (entry of


treatment certificates for inpatient cases).
o The system no longer evaluates the system parameter SBZ_LEIF (certificate-
related service entry on/off) if the business function ISH_TC is activated, since
the parameter is not used in the new concept.
Effects on Data Transfer

257
Data transfer is not necessary.
Effects on System Administration
Additional Customizing settings are available for Treatment Certificate Administration.
Effects on Customizing
The following sections contain information on new Customizing activities:
Treatment Certificates - Maintain Automatic Processing
In this activity, you can specify whether or not the system is to process treatment
certificates in background processing. To access this Customizing activity, choose SAP
Healthcare - Industry-Specific Components for Hospitals -> Patient Accounting ->
Insurance Verification and Certificates -> Treatment Certificates - Maintain
Automatic Processing.
You have the following options:
o Case indicator
If you select the Edit Case indicator, the system automatically creates a
treatment certificate when you create a new case. You can define default values
for this process in Customizing under Patient Accounting -> Insurance
Verification and Certificates -> Treatment Certificates - Default
Values for Automatic Processing.
If you cancel a case with a treatment certificate, the system automatically
cancels the treatment certificate as well.
If you change certain data for a case, the system displays a customizable
message if the data in the treatment certificate no longer matches your default
values.
o Change Case Type indicator
If you change the case type from outpatient to inpatient and select the Change
Case Type indicator, the system automatically cancels the treatment certificate
in background processing if the system parameter BEH_STAT does not allow
the treatment certificates for inpatient cases. Otherwise, the system only displays
a warning if the values in the treatment certificate no longer match the default
values from Customizing. When you change the case type from inpatient to
outpatient, the system creates a treatment certificate in background processing
according to the Customizing settings you made under Patient Accounting ->
Insurance Verification and Certificates -> Treatment Certificates -
Default Values for Automatic Processing.
o Movement Assignment indicator
When you create a new movement, the system automatically assigns it to the
treatment certificate for the case if there is only one certificate for the case.
Treatment Certificates - Default Values for Automatic Processing
In this Customizing activity, you can define default values for automatic treatment
certificate creation. You can specify the certificate category and type of the certificate to
be created, according to the following criteria. The following criteria are available:
o Case type
o Case category
o Movement category
o Movement type
o Treatment organizational assignment
o Departmental organizational assignment

258
You can select the Not Relevant indicator for combinations for which the system is not
to create treatment certificates in background processing.

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ISH_TC: Case Revision: Reassigning Treatment Certificates (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Treatment Certificates
(ISH_TC), you can use the functions Case Revision -> Reassign Visit and Case
Revision -> Reassign Subobjects to reassign treatment certificates.
Note: This function is only released for the country version Italy in EHP4.

260
ISH_TC: View Type for Treatment Certificates (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Service Package 01, Business Function SAP Patient Management:
Treatment Certificates (ISH_TC), the new view type Treatment Certificates in
Service Entry in the Clinical Process Builder (transaction NV2000) is available.
Note: This function is only released in EHP4 for the country version Italy.
In the country version Italy, the view tree for service entry automatically displays the
Treatment Certificates folder if the case is assigned at least one treatment certificate.
The Treatment Certificates folder then contains a view for each treatment certificate
and a view entitled Not Assigned. The Not Assigned view lists all the services that
are not assigned to a treatment certificate.
In other country versions, the system does not display the Treatment Certificates view
type automatically, but you can use the Other Views function to activate it.
The new Treatment Certificates view is also available in full screen mode for service
entry in the Clinical Process Builder (NV2000) but not in service entry in transaction
NL10.

Effects on Customizing
You can show and hide the Treatment Certificates view in the service entry work
environment.

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Business Function Klinisches System Enhanced
Documentation Processes
ISHMED_EDP: Business Function Clinical System EDP
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), the business function Clinical System Enhanced Documentation Processes
(ISHMED_EDP) is available. You can use this Business Function to implement new
functions.
For further information, see the following Release Notes:
For implementation support:
ISHMED_EDP: Implementation Support - Overview (New)
ISHMED_EDP: Implementation Support - Customizing Transfer Manager (New)
ISHMED_EDP: Implementation Support - Customizing Export Wizard (New)
ISHMED_EDP: Implementation Support - Customizing Import Wizard (New)
ISHMED_EDP: Implementation Support - PMD Import Wizard (New)
ISHMED_EDP: Implementation Support - Licensing (New)
For the inpatient progress note
ISHMED_EDP: Clinical Documentation: Inpatient Progress Note (New)
For application logging
ISHMED_EDP: Application Logging - Overview (New)
ISHMED_EDP: Application Logging - Setup Functions (New)
ISHMED_EDP: Application Logging - Technical Implications (New)
For the surgery work station:
ISHMED_EDP: Surgery Work Station - Overview and Introduction (New)
ISHMED_EDP: Surgery Work Station - Components (New)
ISHMED_EDP: Surgery Work Station - Base Item Types (New)
ISHMED_EDP: Surgery Work Station - Template Management (New)
For the radiology work station
ISHMED_EDP: Radiology Work Station - Preparation (New)
ISHMED_EDP: Radiology Work Station (New)
For the ward documentation work station:
ISHMD_EDP: Ward Documentation Work Station (New)
ISHMD_EDP: Clinical Task Management for Care Units (New)
ISHMED_EDP: Clinical Overview (New)
ISHMED_EDP: Ward Documentation Work Station - Charting (New)

- See also
You can obtain the Support Package Release Notes for i.s.h.med Clinical System at
www.ishmed.com under Customer Service -> Release Info Download .

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ISHMED_EDP: Implementation Support - Overview (New)
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Process
(ISHMED_EDP), implementation support is provided. This component enables you to
transfer object-specific Customizing from one SAP system landscape to another.
As of SAP ECC 6.0 Industry Extension Healthcare, Enhancement Package 4 (IS-H 604
) the system supports object-specific transports for Basis Customizing and
parameterized documents (PMDs) within implementation support. The following options
are available to you for transport:
o Transport using BC sets
o Download or upload of the created installation packages as XML files; a
completed export is provided as an installation package in the Customizing
Transfer Manager
The Customizing Transfer Manager function is provided as a management interface
for implementation support (transaction N1IMSU). From the Customizing Transfer
Manager you can start object-specific wizards, search for available installation
packages and start a transport, an upload or a download for them.
To create installation packages from a source system or install them on a target
system, you can use the following object-specific wizards:
o Customizing Export Wizard
o Customizing Import Wizard
o PMD Export Wizard
o PMD Import Wizard
Note that it is important for you to know the exact structure of the source system and
the target system when performing implementation support. In order to describe an
installation package's contents, you can create a description of contents for the
installation package.
You can call implementation support from the SAP Easy Access screen by choosing
Basic Clinical Data -> Implementation Support
-

- See also
o For further information about the Customizing Transfer Manager, see the
Release Note ISHMED_EDP: Implementation Support - Cust.
Transfer Manager (New).
o For further information on the Customizing Export Wizard, see the Release
Note ISHMED_EDP: Implementation Support - Customizing
Export Wizard (Implementation Support) .
o For further information about the Customizing Import Wizard, see the Release
Note ISHMED_EDP: Implementation Support - Customizing
Import Wizard (Implementation Support) .
o For further information about the PMD Import Wizard, see the Release Note
ISHMED_EDP: Implementation Support - PMD Import Wizard
(Implementation Support).

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ISHMED_EDP: Implementation Support: Customizing Transfer Manager
(New)
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Process
(ISHMED_EDP), implementation support is provided.
You use the Customizing Transfer Manager (transaction N1IMSU) for managing and
editing installation packages. This acts as a uniform access dialog for all the object-
specific wizards available on the system for performing implementation support.
The Customizing Transfer Manager provides the following functions:
o Create Installation Package
The Create Installation Package function calls an object-specific export wizard
which enables you to create a new installation package for transport into another
SAP system landscape.
o Install Installation Package
The Install Installation Package function calls an object-specific import wizard
which enables you to install an installation package available on the system.
o Continue Session
While using the Customizing Import Wizard you have the option of saving the
settings already made in a session (e.g. if you must interrupt). To continue this
session, use the Continue Session function. The system displays the saved
sessions beneath the installation package in the ALV tree.
o Delete Session
If you have saved a session for an installation package, you can delete this
session from the system with this function.
o Create Transport Request
After you have created an installation package, you can transport this installation
package to other systems via the SAP transport route.
o Activate BC Set
An installation package that has been transported onto a target system via the
SAP transport route has to be activated for implementation support.
o Download Installation Package
After you have created an installation package, you can use download to
download this installation package as an XML file.
o Upload Installation Package
After you have created an installation package, you can download this
installation package by means of download as an XML file.
o Edit Content Description
While using the Customizing Export Wizard you can create a description of
contents for the installation package. To reedit this description, use the Edit
Content Description function.
o Detail Screen
Using the detail screen enables you to display more exact information on the
selected installation package.
o Filter
To only display certain installation packages in the Customizing Transfer
Manager, you can activate a filter.
- See also

264
For further information about implementation support, see the following Release Notes:
o ISHMED_EDP: Implementation Support - Overview (New)
o ISHMED_EDP: Implementation Support - Customizing Export
Wizard (New)
o ISHMED_EDP: Implementation Support - Customizing Import
Wizard (New)
o ISHMED_EDP: Implementation Support - PMD Import Wizard
(New)

265
ISHMED_EDP: Implementation Support: Customizing Export Wizard
(New)
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Process
(ISHMED_EDP), implementation support is provided.
You use the Customizing Export Wizard to create an installation package for Basis
Customizing. You can call the Customizing Export Wizard from the Customizing
Transfer Manager (N1IMSU).
The Customizing Export Wizard is divided into the following work chapters:
o Start
In the starting dialog you enter the institution for which you wish the export to
occur. In addition, you have to enter a name under which the installation
package will subsequently be displayed in the Customizing Transfer Manager.
o OU/BU hierarchy
You select the organizational units (OUs) in the OU/BU hierarchy selection
dialog. In the subsequent work chapters the system creates proposals for the
selection based on this selection.
o Clinical Order Types
In the Clinical Order Types work chapter you select order types for the source
system's clinical orders for the installation package which you wish to create.
You can export elemental order types and profile types. In the case of a profile
type, the system includes the associated elemental order types automatically in
the installation package
o Employee Customizing
In the Employee Customizing work chapter you select the positions and the
associated tasks of the source system for the installation package that you wish
to create. The selection of the objects to be exported is based on the positions.
The system automatically includes the tasks in the installation package which
belong to the selected position.
o OU Parameters
In the OU Parameters work chapter you select the source system organizational
unit-related parameters (OU parameters) for the installation package which you
wish to create. The selection is made according to the OU. Every OU parameter
available on the target system for the selected OU is exported into the
installation package by the system.
If you would also like to include asterisk (*) entries (valid for all OUs) in the installation
package, you have to select them explicitly.
o Clinical Work Station
You select work areas for export in the selection dialog for the Clinical Work
Station. Selection is based on the work areas. Selection is based on the work
areas. Views such as selection variants, function variants and layout variants
which belong to the selected work area are automatically included in the
installation package by the system. You cannot select any individual work area
views.
The following views are covered by implementation support:
- Occupancy View (occupancy view type)
- Arrivals View (arrivals view type)
- Departures View (departures view type)

266
- Clinical Orders (clinical orders view type)
- Document View (document view type)
- Outpatient Clinic/Service Facility View (outpatient clinic/service facility view
type)
- Coding Analyses View (coding analyses view type)
- Preregistration View (preregistration view type)
- Appointment Planning View (appointment planning view type)
Generally the structure of the work area where you select objects is arranged such that
it displays objects available for selection on the source system in the right-hand area of
the screen and the ones selected on the left-hand area. The system always offers a
proposal in the top right-hand area of the screen compiled on the basis of the OUs
selected in the first work chapter. Below, the system displays the remaining objects
that have no direct reference to the OUs.
Note that the system always only displays those objects that are currently valid on the
source system at any one time.
- See also
For further information about implementation support, see the following Release Notes:
o ISHMED_EDP: Implementation Support - Overview (New)
o ISHMED_EDP: Implementation Support - Customizing Transfer
Manager (New)
o ISHMED_EDP: Implementation Support - Customizing Import
Wizard (New)

267
ISHMED_EDP: Implementation Support: Customizing Import Wizard
(New)
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Process
(ISHMED_EDP), implementation support is provided.
You use the Customizing Import Wizard to install an installation package for Basis
Customizing. You can call the Customizing Import Wizard from the Customizing
Transfer Manager (N1IMSU).
It is the task of the Customizing Import Wizard to adjust objects to be created on the
target system in such a way to enable you to import them into the target system. In
order to do so, you have to enter unique IDs for transported objects so that there won't
be any conflicts on the target system (e.g. the variant name of a selection variant must
be unique). You also have to compare referenced objects in such a way that they
match the objects available on the target system. For example, you have to compare
the source system status profile of a Clinical Order order type with the target system
status profile.
The work area provides a comparison screen for each object for this purpose.
o The system always lists the object that the installation package contains in the
left-hand screen area of the work area.
o In the right-hand screen area the system lists all the target system objects
applicable for a comparison.
To compare the installation package object with one on the target system, you can use
Drag&Drop to move an object from the left-hand area of the screen to the right-hand
area or you can make this comparison using the corresponding pushbutton.
For each comparison screen the upper screen area provides an additional help text.
After making the check the system displays a check log in the lower screen area. This
check log enables you to see which installation package objects have been compared
to which target system objects. In addition, the system may also display error
messages after executing the check function. These messages help you to recognize
in which area problems have occurred.
So that you always know in which work chapter you are located, the system shows a
navigation area In the navigation area one mouse click enables you to navigate to a
specific comparison dialog or select Next or Back, in order to reach the next or
previous chapter in each case.
The system builds the navigation bar dynamically depending on which objects the
installation package contains. The following work chapters are always available in the
highest level of the hierarchy irrespective of the contents:
o Starting dialog
You have to enter which institution the installation is intended for in the starting
dialog. In addition, you can select which work chapters are to be edited. This
selection is independent of the objects in the installation package.
The system makes a suitable selection of every chapter which you do not wish to
edit in the navigation area. The system also shows a list of available header data
containing information on the origin of an installation package.
o OU/BU hierarchy
In the OU/BU Hierarchy chapter you can compare the installation package
organizational units (OUs) with those of the target system. The system transfers
this comparison to the following work chapters as a default value.
Example

268
You are comparing an OU of the installation package (CHIRSTAT) with an OU of
the target system (CHIRA). A clinical order type which this installation package
also contains is defined in such a way that clinical orders of the OU CHIRSTAT
can be initiated with this order type. The system automatically enters OU CHIRA
as a default value at OU CHIRSTAT in the initiating OU's comparison screen.
The indicators defined for an OU have to be the same in both OUs (except the
indicator Inter-Departmentally Occupiable).
o Clinical Order Types
In the work chapter for Clinical Order order types you can edit the installation
package's order types so that they can be created on the target system.
If you do not wish to import one of the installation package's order types into the
target system, you can exclude it from the import.
o Employee Customizing
In the Employee Customizing work chapter you can import positions and
associated tasks into the target system. You can exclude a position from the
import. Then the system does not import associated tasks either
o Clinical Work Station
In the Clinical Work Station work chapter you can edit the installation package's
work areas for the import. You can exclude work areas from the import. Views,
selection variants, function variants and display variants belonging to a
deactivated work area are also automatically excluded from the import.
o OU Parameters
In the OU Parameters work chapter you can prepare the installation package's
organizational unit related parameters (OU parameters) for import into the target
system. You can exclude OU parameters from import (corresponding highlighting
in the navigation area).
Note that you have to explicitly list asterisk entries (valid for all OUs).
- See also
For further information about implementation support, see the following Release Notes:
o ISHMED_EDP: Implementation Support - Overview (New)
o ISHMED_EDP: Implementation Support - Customizing Transfer
Manager (New)
o ISHMED_EDP: Implementation Support - Customizing Export
Wizard (New)

269
ISHMED_EDP: Implementation Support - PMD Import Wizard (New)
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Process
(ISHMED_EDP), implementation support is provided.
The PMD Import Wizard is used for installing a PMD installation package.You can call
the PMD Import Wizard from the PMD Transfer Manager (N1IMSU).
It is the task of the PMD Import Wizard to install the definition elements of PMDs on a
target client of your system. All the existing elements and element relationships with a
counterpart in the elements of the installation package are removed and replaced by
the installation package's new elements. For this purpose an initial check is made of
which elements already exist.
The entire process is a linear process flow of check routines which displays the
respective check result to you. You may have to check your existing structures. The
inspection processes can be interrupted at any time.
Your data will not be changed until you select Install at the end of the process.
- See also
ISHMED_EDP: Implementation Support - Customizing Transfer
Manager (New)

270
ISHMED_EDP: Implementation Support - Licensing (New)
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Process
(ISHMED_EDP), implementation support is provided.
In order to be able to use the object-specific export wizards of implementation
support, you need a valid license for each available export wizard (Customizing Export
Wizard and PMD Export Wizard)
As exporter you also have the option to protect the installation package separately.
During an object-specific export you select a license which has to be available on the
target system. If this license is not active on the target system, the installation package
cannot be imported.
Example
An installation package is created for a special PMD for the departmental solution
Cardiology. During the export the exporter selects that this installation package can
only be imported on the target system, if a license ifor the departmental solution
Cardiology exists. If this license does not exist, it is not possible to import the
installation package on the target system.
If you do not wish to create installation packages, but only to import installation
packages on your system, no license is necessary for implementation support.
If you wish to obtain the necessary license, please contact your sales partner T-
Systems on +43 (0) 57057 8373 or email to licence-info@t-systems.at, or contact GSD
on +49 (0)30 383 70 361 or email to licence- info@gsd berlin.de. The use of this
functionality requires a license. You can get a copiable request text by means of the
transaction N2LIZENZ using the button Text for Email.

271
ISHMED_EDP: Clinical Documentation: Inpatient Progress Note (New)
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Processes
(ISHMED_EDP), the inpatient progress note is available in the clinical progress
documentation.
You use the inpatient progress note to enter information on the progress of a patient's
treatment in free-text note form. You can use text modules for this. You can structure
the notes by assigning an occupational group and user-defined categories to them.
Additionally, you can enter contextual information, such as the documenting
organizational unit or the employee responsible.
The inpatient progress report supports this form of medical documentation by
displaying the entered notes individually and connected chronologically. You can use
filter functions to create special views of the inpatient progress report.
The authorization object N_2IPPD prevents unauthorized access to your data.
- Integration
Use in the Ward Documentation Work Station
In the ward documentation work station, the inpatient progress note is available as a
documentation object that is connected with a task by means of a base item. The
inpatient progress report is displayed in the patient viewer.
Use in the Patient Organizer
The inpatient progress note is available as an independent standard aspect of the
patient organizer. The individual notes are displayed in tabular form in the standard
aspect. The complete set of notes is output as an inpatient progress report in the detail
window of the patient organizer.
- Effects on Customizing
Define your own (main) categories and combine these in category sets in the
Customizing activity Manage Categories. You can then assign these sets to
organizational units and occupational groups. The system will only then display the
categories that are relevant for the given documenting unit, rather than all the defined
categories, for selection.
Perform the Customizing activity Maintain Cancellation Reasons to define
cancellation reason that can be selected when you cancel an inpatient progress note.

- See also
For information about the inpatient progress note in the patient organizer, see the
Release Note HyperLink: RELN.ISHMED604_MAIN_MRO20 ISHMED_MAIN: Patient
Organizer: Integration of Inpatient Progress Note (New)

272
ISHMED_EDP: Application Logging - Overview (New)
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Processes
(ISHMED_EDP) , the new Application Logging function is available. If you have an
i.s.h.med Basis license, as of SAP ECC 6.0, Industry Extension Healthcare,
Enhancement Package 4 (IS-H 604), Business Function Clinical System
Enhanced Documentation Processes (ISHMED_EDP) you can activate application
logging and use the functions contained within.
To activate application logging, you must execute the settings in Customizing and
create and activate the required logging profiles.
This Release Note provides an overview of application logging. It also describes the
benefits which this application can bring.
Use of Application Logging
In i.s.h.med patients' records are managed. Many users access medical documents,
clinical orders, medication data etc. at various times, or make changes to the data of
the electronic patient record of a patient.
Using application logging you can log all accesses (display, change, etc.) to the
patient record, as well as specific functions executed on individual objects. The system
logs actions of the user or the system in the form of messages, which can then be
evaluated by a user with special authorization.
In order to be able to use application logging correctly and purposefully, you should
formulate the questions which should be answered by the logging, before you start to
use it. You must identify in particular, the patient record objects which should be
subject to a logging. You should therefore note that, due to the considerable resulting
data quantities, you should not use application logging non-specifically.
The messages of application logging contain relevant information for answering, for
example, the following questions:
o Which users have printed the discharge summary of a specific patient?
o How did a specific user display a certain document (e.g. PDF display, dialog
application)?
o Which users used the patient organizer to access the electronic patient record of
a certain patient?
This results in a number of application logging usage scenarios such as, for
example:
o You can use application logging to evaluate the internally configured
authorization system in i.s.h.med. You can use application logging to execute
evaluations which should determine that users can only access patient record
objects for which they are actually authorized.
o In case of data misuse you can execute improved evaluations which can help to
determine the cause of the misuse. You can create, for example, a list of all
users who executed actions with a specific document or who generally accessed
a patient's medical record.
Application logging is a service which runs in the background - often after the actual
user interaction, which has no effect on the user's daily work. The messages and logs
created in application logging are only available to specially authorized users.
From a functional point of view, application logging consists of the following
transactions

273
o Transaction for configuring application logging
o Transaction for evaluating messages and logs (N1ALEVAL)
Further functions for archiving logs are available in the SAP basis transactions SLG1
and SLG2. Using the authorization object N_EINR_TCO (IS-H: authorization for
configurations and transactions) or S_TCODE (transaction authorization) you can
protect access to these two functions. For detailed information on the basis application
log from SAP (archiving or deleting expired logs, etc.) see the online documentation for
the SAP basis components.
The system also logs all changes to the settings of application logging in i.s.h.med, in
order to be able to subsequently track any changes.

Applications with Logging Functionality


As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Processes
(ISHMED_EDP), the following applications offer logging functionality:
o Clinical orders
o Medical documentation
o Medication orders (Medication component)
o Medication events (Medication component)
o Patient Organizer
In all other i.s.h.med applications there are currently no application logging functions.

Messages in Application Logging


A message in i.s.h.med application logging describes an action of a user or a system
activity on a specific object of the electronic patient record.
The system saves these messages in the structure BAL_S_MSG. In the message text
the system uses message variable to transfer information on the object, the user and
the event. The system uses a sequence of message variables and field labels to write
the data in the message. This data is also always available in structured form in the
context. It is therefore also possible to filter or sort these columns.
Example
The message for creating a clinical order reads:
"Clinical order: 2005001201(001); User: MUSTER; Event: Created; 20.04.2006 11:06
In the context of the message, additional columns are reserved for the order number,
the user, the event, and the time stamp. These values are also contained there.
Messages from the patient organizer or from the medical documentation have a similar
appearance.
You can customer-specifically enhance the context of the messages. As standard the
system will store a specific set of information as the context of the messages. By
enhancing the structure RN1_ALENTRY_CONTEXT with an append structure, you can
also include further information in the context of the messages. You should note that
the length of the entire context (standard + customer append structure) may not be
longer than 256 characters. You can extend the context by 50 characters.
Furthermore the enhancement spot N1_ALENTRY_FINALIZE with the
FINALIZE_ALENTRY method is also available. When a new message is logged, the
system calls this enhancement spot. You can use the IR_ALENTRY->SET_CONTEXT

274
method to fill your customer/specific context information. The system will automatically
display the customer/specific context information in the technical information and in the
columns of the output table for messages.

Evaluate Logged Messages


The transaction N1ALEVAL is available for executing patient-related or user-related
evaluations. There are two different log types available (user-related or patient-related
log type).
Depending on which option you select, you can specifically select the log of a user or of
a patient.
You should note that you can only select, for example, a user-related log, if you have
also configured user-related logging profiles in the setup function.
You have to selectively access logs and messages in order to be able to handle the
increased data quantities to be expected. i.s.h.med therefore recommends that you
select one log type and execute the evaluation with this log type. You can also only
select using the time period in which the log was created.
In the log view you can show or hide the log header.
If you hide the log header, the system will display all messages for the logs which
qualify for selection according to the restrictions on the selection screen. Otherwise you
can navigate through the relevant logs and log classes of the relevant log. The list of
messages contains all fields of the message as separate columns. You can use the
sort options of the ALV grid to sort and filter the set of messages, or export them into
an external program (e.g. Excel) for further processing.
You can use the Technical Information function to display an HTML view of a
previously selected message.
In case of messages which were triggered by a medical document, you can also use
the Toggle to Application function to branch directly to the display of the medical
document, as standard.

Restrictions when Logging User Actions


The system logs the actions of the user (display document, etc.) in message form. For
each message the system also stores the context, which contains further information
on the document (ID, from which program the document was displayed, etc.).
This context information is technically limited and cannot be extensively designed.
Therefore the system cannot save, for example, the entire status of a document at the
time when it is displayed. You therefore cannot subsequently determine which
information a specific user received when the document was displayed.
- Effects on Customizing
You use transaction N1ALDEF to configure application logging in i.s.h.med.
- See also
For detailed information about system load and the anticipated memory space
requirement, see the Release Note ISHMED_EDP: Application Logging -
Technical Implications (New).
For detailed information about transaction N1ALDEF, see the Release Note
ISHMED_EDP: Application Logging - Setup Functions (New).

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ISHMED_EDP: Application Logging - Setup Functions (New)
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Processes
(ISHMED_EDP), the new Application Logging function is available.
This section describes the setup functions the application logging.
In general, the setup functions for i.s.h.med application logging involve the following
settings:
o Basic settings
o Logging profile
o Logging configurations
In addition, you have to create a background process which ultimately processes the
messages.

Basic setting for application logging


To use application logging in i.s.h.med, you must activate a switch in the application
logging basic settings in transaction N1ALDEF by choosing Goto -> Basic Settings. If
application logging is not activated, no logging will take place on this client. You can
therefore prepare and configure logging, but guarantee that no logging entry is written
during configuration.
Regardless of this switch you can configure logging profiles and logging configurations.
In the basic settings you can also define that application logging should be executed
asynchronously. This means that application logging does not take place during the
user execution in the dialog, but the system temporarily saves the events. You can
process these events later at a time convenient to you using a background process.
Activate asynchronous processing as follows
1. In transaction N1EVDEF choose Goto -> Basic Settings to call a dialog box in
which you can activate the Asynchronous Processing option. You therefore
define that you allow asynchronous processing of events.
2. Call transaction N1ALDEF and choose Goto -> Basic Settings and the option
AppLog Asynchronous Goto -> Basic Settings (determines that application
logging should actually run asynchronously).
You can change these options during system operation. These global settings are
deliberately not connected to the transport system. If you transport a functioning setting
from a test system to a productive system, you must separately adapt these basic
settings on the target system. This has the advantage that you can select different
basic settings in the test and productive systems.

Logging Configurations
Once you have determined the basic settings for application logging, you can set up
logging configurations.
Logging configurations specify the conditions under which an activity is logged to an
electronic patient record (medical record) element.
Only an active configuration in an active logging profile will result in the logging of
activities. The logging configuration is often a combination of application events and

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filter conditions relating to the logging application.
Examples
o Clinical orders logging application:
- Event: Displayed
- Filter: Urological surgery order type
o Medical documentation logging application
- Events: Printed and displayed
- Filter: Document category ENT discharge summary
When you create a new configuration, you must enter an institution. You can therefore
take into account specific application-related customizing options.
For each logging configuration you can activate application-specific events and define
relevant filter criteria. You can use problem classes and degrees of detail to structure
the application logging log.

Logging Profile
If you have defined and activated several logging configurations, you can combine
these configurations in logging profiles. The logging configuration controls the attributes
of the messages, the logging profile controls the attributes of the log.
Example
For a display logging you create a logging configuration, in which the display events are
activated, for each logging application. You collate these different configurations in a
logging profile, which you can name, for example, "Display Log".
You must assign a log type to each logging profile. You cannot subsequently change
this data.
Patient-Related Log Type
The system creates a log for each patient. If a user executes an activity, e.g. on a
clinical order or a document, the system checks whether there is already a log for this
user which is active and valid.
o If an active valid log already exists, the system writes the message in this log.
o If this is not the case, the system creates a new log for this patient, with the
properties defined in the logging profile. The system writes the message in this
newly created log.
You use the patient-related log type particularly if you wish to receive an evaluation,
from the patient's point of view, to see, which users have accessed the documents,
clinical orders, etc. of this patient. This setting is particularly suitable for converting a
"Display log".
User-Related Log Type
The system creates a log for each user. If a user executes an activity, e.g. on a clinical
order or a document, the system checks whether there is already a log for this user
which is active and valid.
o If an active valid log already exists, the system writes the new message in this
log.
o If this is not the case, the system creates a new log for this user, with the
properties defined in the logging profile. The system writes the message in this
newly created log.

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Use the user-related log particularly if you wish to receive an evaluation from the user's
point of view, concerning which documents, clinical orders, etc. a specific user has
viewed, modified, printed, etc. This setting is particularly suitable if a specific user or a
group of users is to be monitored (for example following the allocation of a temporary
treatment contract).
Logging Profile Settings
o You must provide logging profiles with a profile ID in order to be able to
differentiate between them. The profile name further specifies the logging profile.
Logging profiles have a specific validity.
o You can determine when created logs are to expire. To do this, you enter an
expiry date when creating a log. You can therefore automatically complete and
periodically archive or delete logs once this time period has expired. Enter a
relative time interval in days, weeks, months, or years after creating a log.
o You can activate a logging profile restricted to specific users/roles or a specific
group of users/roles. You enter the relevant users/roles when restricting the
logging profile. Note that events which are triggered by system actions (in the
background) are also logged. If you do not wish to log these events, you must
exclude the users with which the background process is started, from the logging
profile.
o You can assign the previously defined logging configurations to a logging profile.
Once you have defined these settings, you can activate the logging configurations and
logging profiles.
You can only change an activated logging configuration or activated logging profile if
you deactivate it first.

Background Process for Processing Events


As already mentioned, i.s.h.med recommends asynchronous processing for application
logging. During asynchronous processing the system first saves the application logging
messages in the table N1ASYNCEVENT and only transfers them to their final
destination at a time selected by you.
To enable this transfer you must configure a periodic background process. The
corresponding report for asynchronous processing is the report RN1_EVA_PROCESS.
You can freely select the time interval at which the data should be transferred. The
shorter the time intervals, the more up-to-date the messages and logs are, but the
more the system load is increased during periods of high activity.

Archiving Logs
You can archive the created logs using the archiving object BC_SBAL. Archive expired
logs which result from i.s.h.med application logging regularly and delete these logs
from the database. If required, you can load these archived logs from the archive
(transaction SLG1).
i.s.h.med application logging causes significant quantities of data in the database. You
must therefore calculate an increased memory requirement following the introduction of
application logging. You can keep these memory requirements constant with the
regular archiving and deletion of logs.
For further information about the archiving of logs, see the online documentation
undeSAP Library -> SAP NetWeaver Components -> SAP Web Application Server
-> Basis Services / Communication Interface-> Application Log -> Application
Log - Guidelines for End Users.

278
- Effects on Customizing
You execute the application logging set up functions in Customizing for i.s.h.med under
Industry-Specific Component Clinical System -> Basic Settings-> Application Logging->
Setup Application Logging or using the transaction code N1ALDEF.
- See also
For detailed information on data quantities and memory requirements, see the Release
Note ISHMED_EDP: Application Logging - Technical Implications
(New).

279
ISHMED_EDP: Application Logging - Technical Implications (New)
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Processes
(ISHMED_EDP), the new Application Logging function is available.
This chapter contains important information on application logging for system
administrators, which concerns memory requirements and performance. You should
note that an unmonitored approach to the implementation of this function can lead to
database problems concerning memory requirements.
- Effects on System Administration
The introduction of i.s.h.med application logging involves an increased system load.
Particularly during periods of high activity, where many users are editing patient
records in parallel, application logging programs are processed in addition to the
existing programs of the individual applications. You can use a suitable application
logging implementation strategy to assess whether your system landscape can cope
with this additional system load without problems, or whether bottlenecks (storage or
database requirements, updates, processor activity) may occur during individual
aspects.
The implementation of application logging should therefore always be executed in
several steps, during which you monitor the system behavior. If bottlenecks or
problems do occur, you can therefore quickly revert from the current step to the last
functioning settings.
You should particularly monitor the following parameters:
o Mean response time per dialog step (system load monitor)
o Storage requirements in central memory and on database
o Utilization of dialog processes in process overview
o Utilization of update processes in process overview and update statistics
At the beginning, configure a logging profile which selectively logs only specific
activities. For example, you could log only the printing of discharge summaries. It is
also sensible to restrict the logging profile to a manageable number of users.
Only when this logging functions without impairing the system should you increase the
logging configurations and logging profiles by adding new events and users or reducing
the filter conditions.

Effects on Mean Response Time


Due to the asynchronous processing of events which are triggered by the user, the
response behavior of i.s.h.med application logging should be minimized. In the dialog
process, which is operated by individual users, the system only executes the necessary
checks and actions, in order to ensure subsequent processing. Following these checks
the system continues the relevant program logic of the application.

Effects on Memory Requirements in Database


As soon as you activate application logging, more storage capacity is required on the
database. The size of this extra storage capacity is oriented toward the number of
messages which are logged. You should successively increase the number of logged
messages in a suitable application logging implementation strategy.

280
A message has the data type BAL_S_MSG. This structure has a total of approximately
600 characters. For each message approximately 1200 bytes (1.2 kByte) of storage is
required.
You must multiply this 1.2 kByte with the number of messages per period, in order to
determine the overall storage requirements per period.
You can archive messages in order to archive and then delete expired logs, so that the
storage requirements of the database are kept constant on a long-term basis. For
further information on archiving messages, see the Release Note
ISHMED_EDP: Application Logging - Setup Functions (New).

281
- ISHMED_EDP: Surgery Work Station - Overview and Introduction
(New)
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Process
(ISHMED_EDP), the surgery work station is provided.
The surgery work station is an application enabling process-oriented monitoring and
documentation of one or more surgeries. While monitoring and documenting surgeries
in the surgery work station, documents receive a reference to a task or to a situation.
The surgery work station is a development of the documentation work station which
has already been available since SAP ECC Industry Extension Healthcare 6.0 and
which will supersede the surgery monitor in the future.
You can currently use the surgery monitor and the surgery work station in parallel on
your system. However, parallel use of these two programs within one operating
department is not recommended.
You can call the surgery work station in the same places as the surgery monitor.
Furthermore, the surgery work station is also available in the Outpatient
Clinic/Service Facility view type in the clinical work station.
You should note that an i.s.h.med OR System license is necessary for the use of the
surgery work station.
- Effects on Existing Data
You can also document existing surgeries with the surgery work station. The surgery
work station will treat a surgery which has already been documented using the surgery
monitor, as undocumented, as the documents do not have a reference to a task or a
situation. These are created when the surgery work station is called.
- Effects on Customizing
To call and use the surgery work station, you must first create situation, profile and task
templates (see Release Note <DS:RELN.ISHMED604_EDP_OR40>ISHMED_EDP:
Surgery Work Station - Template Management (New). You also have to adapt the
Customizing of calls in the clinical work station (e.g. function variants).
You must also adapt the authorizations. You can use the corresponding BAdIs for
adjustments in the way the content is displayed in the surgery work station.
- See also
For general information about the Documentation Work Station (of which the Surgery
Work Station is a development), see the Release Notes for the chapter Outpatient
Documentation Work Station of SAP ECC Industry Extension Healthcare 6.0.

282
- ISHMED_EDP: Surgery Work Station - Components (New)

- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Process
(ISHMED_EDP), the surgery work station is provided.
The surgery work station like the Outpatient Clinic Work Station is divided into several
components. The individual enhanced components along with the monitoring function
are described more exactly here.

Header area
The header area has been supplemented by date of birth, case, care unit and
appointment details.
For appointment the system displays the planned appointment. If no date is available,
the system shows the desired date with "Ordered for". The system displays the latest
time stamp with description and time in this field for a surgery which has already begun.

Patient Overview
The Patient Overview is used to show the content of the current surgery, the status of
the surgery and to display medical information.
The items Patient Consent, Surgeon's Release, Completely Premedicated and
Surgery Begun enable interaction like with the surgery monitor.
The medical information area displays any surgeries already performed on the patient.
In the case of a surgery already performed you can use Link to include this surgery in
the surgery work station. The system then transfers the situations of the selected
surgery to the list of situations in the left-hand screen area of the surgery work sation.

Situation List and Tasks


The situation list and tasks dialog is aligned to the task component of the outpatient
clinic work station.
The system lists all the situations to be documented within the upper area. If you
activate a situation, the system displays the task list assigned to the situation in the
lower part of the tasks. Unlike the outpatient clinic work station there is no status for the
situation itself. This means that a situation in the surgery work station can never be
closed.
The Cumulative Display function is a new function only available in the surgery work
station. This function enables you to create a view showing all the tasks of all the
surgery's anchor service(s). In this view the system displays the information
hierarchically as follows:
o Highest level: Situation description
o Second level: Profiles and tasks without profile
o Third level: Tasks assigned to a profile

Patient Viewer
The behavior of the Patient Viewer and the interaction between the Patient Viewer and
the surgery work station are transferred from the outpatient clinic work station.

283
Monitoring
The surgery work station provides a monitoring component enabling the occupational
groups involved to evaluate a surgery's progress in the pre-, intra- or postoperative
stage.
You assume that a user activity causes a task to be completed which in turn sets a
profile - which this task is integrated into - into a specific status.
In the profile template you can define if you wish to create a profile with monitoring. If
you have selected it, you can monitor the completion status of the profile in the surgery
work station.
- See also
For general information about the documentation work station, see the Release Notes
for the chapter Outpatient Documentation Work Station of SAP ECC Industry
Extension Healthcare 6.0.

284
- ISHMED_EDP: Surgery Work Station - Base Item Types (New)

- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Process
(ISHMED_EDP), the surgery work station is available.
The following new base item types are available for the surgery work Station:
o Surgical documentation
o Surgery times
o Complications
o Textual order
o Team entry
o Material entry
The base item type service entry has been enhanced (see below).

Surgical Documentation
This new base item type enables you to enter, code, and combine diagnoses,
procedures and the surgery team for a surgery (OP). For further information, see the
Release Note
ISHMED_MAIN: Surgical Documentation (Enhanced).

Surgery Times
This new base item type enables you to document different times associated with a
surgery (e.g. incision - suture). For further information, see the Release Note
ISHMED_MAIN: Surgery Times (Enhanced).

Complications
This new base item type enables you to document operative events and anesthetic
course observations related to a surgery. For further information, see the Release
Note
ISHMED_MAIN: Surgery Complications (Enhanced).

Textual Order
In a textual order, information is stored in the form of a free text which is relevant for the
clinical statement, for example patient information sheet (required procedure), required
prefindings: ECG, blood count, and X-ray.
This new base item type enables you to define the assignment type as pre-, post- and
intraoperative.

Team Entry
This new base item type enables you to perform team entry in the surgery work station.
You can define a team proposal for this in the base item. If no team proposal is defined,
the system uses the team proposal based on the anchor service.

285
Material Entry
This new base item type enables you to call material entry.

Service Entry
You can enter medical services for a surgery from the in-house service catalog. When
you configure the associated base item you can differentiate between pre-, intra- and
postoperative service entry.
The Display Case List When Service Processing Called option is now available for
this base item type. You can use this option to stipulate that the case list is always
displayed when service entry is accessed.
- See also
For general information about the documentation work station, see the Release Notes
for the chapter Outpatient Documentation Work Station of SAP ECC Industry
Extension Healthcare 6.0.

286
ISHMED_EDP: Surgery Work Station - Template Management (New)
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Processes
(ISHMED_EDP), the surgery work station is provided.
In transaction N2WLD which hasbeen available since SAP ECC Industry Extension
Healthcare 6.00 you can create situation templates, profile templates, task templates,
base items, information items, and so on.
When you access this transaction, besides the Outpatient Clinic variant, the system
also provides the Surgery variant in the surgery area as of SAP ECC 6.0, Industry
Extension Healthcare, Enhancement Package 4 (IS-H 604), Business Function
Clinical System Enhanced Documentation Processes (ISHMED_EDP).
Note that for use within the Surgery area only templates of the Surgery category are
permissible.

Surgery Situation Template


Unlike with SAP Ambulatory Care Management (outpatient clinic work station), the
system automatically assigns the surgery situation template to a surgery at the first call
of the surgery work station. You must therefore make sure that there is a suitable
situation template in Customizing.
When creating/editing a situation template you can use the additional tab page
Proposal Criteria. This tab page is used to automatically assign a situation template to
a surgery. For this you can enter one or more operating organizational units and
additionally select between principal surgery, secondary surgery, and anesthesia.
When starting the surgery work station you can override these automatic checks with
the Business Add-In (BAdI) ISHMED_SURG_WS_GET. The system technically
appends the situation template to the respective anchor service (main surgery,
secondary surgery or anesthesia anchor service). There is also an anesthesia anchor
service for each principal surgery.

Surgery Profile Template


A surgery profile template is used to clearly structure a surgery situation template's task
templates and so it can be linked to a surgery situation template. It enables you to
separately monitor the completion degree of a profile's tasks.
For example, you create profile templates for pre-, intra- and postoperative
documentation.

Environment Functions
You can store function variants in Cusomizing for the surgery situation template.
Every function from the outpatient clinic work station can also be used in the surgery
work station. Additionally there are also the following surgery-specific functions in the
surgery work station function list:
o Start Surgery
o Patient Consent Given
o Surgeon's Release

287
o Premedication Complete
o Assign Case
o Create Secondary Surgery
o Cancel Secondary Surgery
o Exit Material Entry
- See also
For general information about the documentation work station, see the Release Notes
for the chapter Outpatient Documentation Work Station of SAP ECC Industry
Extension Healthcare 6.0.

288
ISHMED_EDP: Radiology Work Station - Preparation (New)
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Processes
(ISHMED_EDP), the Radiology Work Station is provided.
The requirement for switching over to the Radiology Work Station is the replacement of
radiological requests with clinical orders. Radiological requests are no longer supported
since the change to the Radiology Work Station. So the replacement of radiological
requests has to be complete before switching to the Radiology Work Station.
The Radiology Work Station offers the following benefits compared to the previous
Findings Work Station:
o Enhanced functionality for selecting the findings selection
o Support for fixed categories of findings tasks
o Enhanced functionality when accessing detail data and additional data for
findings tasks
The following changes to the internal mapping of the application process flow also
become effective for radiology at the same time as the switch to the Radiology Work
Station:
o Radiological examinations are completely ommitted. The system no longer
generates and supports the N7EXAM documents previously generated for all
imaging services. Consequently, the customer enhancement
ISHMED_RAD_PA_EXTSTAT for processing after setting the examination status
is also omitted.
o The application component CREATE_RAD_DOCUS is completely omitted in
clinical orders.
o Customizing for the creation times for EXAM/STUDY documents is completely
omitted. The system automatically generates the necessary STUDY documents
at the respective times required.
o It is no longer imperative to assign a STUDY to only one imaging service. You
can also assign a STUDY to several services. There can also be several
STUDIES for one imaging service.
o If the Transaction Broker is used for communication with the PACS system you
can receive the MPPS messages from PACS or the modalities. The assignment
of MPPS messages to imaging services occurs automatically. For unassignable
messages there is a tool for manually reconciling these messages. When you
receive MPPS messages you have customer enhancements available for
controlling assignment, both for automatic and manual assignment. There are
also customer enhancements available to you to enable further specific
processing of data from these MPPS messages.

- Effects on Existing Data


The switch from radiology requests to clinical orders must be complete.
- Effects on Customizing
Note that the Radiology Work Station can only be activated system-wide and that
activation cannot be reversed.
For this you can use the institution-independent, time-independent system parameter
N1RADDWS. This parameter enables you to control if you support the Radiology Work

289
Station or if you want to continue working with the already familiar Findings Work
Station.
You define this system parameter in the Implementation Guide under Industry-
Specific Component Clinical System -> Radiology -> Maintain Parameters ->
Maintain Institution-Independent System Parameters
You can implement the customer enhancement ISHMED_RAD_BASE for processing
after you set the status of the service.
- See also
For further information about the Radiology Work Station, see the Release Note
ISHMED_EDP: Radiology Work Station (New).

290
ISHMED_EDP: Radiology Work Station (New)
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Processes
(ISHMED_EDP), the Radiology Work Station is available.
You control the activation of the Radiology Work Station via the system parameter
N1RADDWS. The Radiology Work Station offers the following benefits compared to the
previous Findings Work Station:
o enhanced functionality for selecting the findings selection
o fixed categories of findings tasks
o enhanced functionality when accessing detail data and additional data for
findings tasks
The procedure in the Radiology Work Station is based on findings tasks. You can
create these tasks either in the Radiology Work Station or the system generates them
automatically. The tasks have the following predefined status model:
o open
o in processing
o completed
o rejected
In addition there are fixed categories of tasks within the system. The following types of
tasks are provided:
o Create Findings Report
o Edit Findings Report
o Verify Findings Report
o Secondary Findings
o Clinical Demonstration
The system creates tasks of the "Create Findings Report" type by default when
confirming imaging services outside of the Radiology Work Station. These tasks
supersede the previous creation of worklists by using N7RADEXAM document control.
You can enhance or adjust the functions of the Radiology Work Station by means of
the customer enhancement (enhancement spot)
ES_ISHMED_RAD_DWS_FUNCTION. This makes the changed or enhanced functions
available as buttons in the Radiology Work Station

Findings Selection
The Radiology Work Station lets you create as many findings selections as you wish.
The system uses SAP Variant Management for the findings selections. Each findings
selection can contain different types of findings tasks. The user can change the findings
selections during a session. In addition the user can also create new findings selection
variants.
The user parameter N2_RAD_DWS_START enables you to define which findings
selection is called when initially accessing the Radiology Work Station. You can
override this parameter by selecting the Restore Worklists field in the Radiology Work
Station settings.

291
The Create Findings Selection function enables you to define additional findings
selections. If there are several findings selections, you can navigate through them.
You can define your own layout for the findings selection.
The findings selection in which you document findings for services provides you with
the Select Task column. This column enables you to select tasks which you want to
document together in a findings document. If you select the hotspot on the Execute
Task column, you can trigger the execution of the respective task.
Note that you can also create tasks for clinical demonstrations. You can select and
display them in a findings selection of their own.
The following Business Add-Ins (BAdIs) are provided for the customer-specific
enhancement of findings selections:
o You can adjust the component for displaying findings selections using the
customer enhancement BADI_ISHMED_DWS_RAD_FWL_VIEW. It enables you
to vary the graphic design of the component or also, if necessary, to display
additional columns.
o You can determine data specific to services for the findings selection using the
customer enhancement BADI_ISHMED_RAD_FWL_SEL_DATA. In order to
provide the data specific to services in the selection screen, you can also
implement the customer enhancement BADI_ISHMED_RAD_SELECTIONSCR.

General
o Documents (PMD Generator Version 2) always run embedded in the Radiology
Work Station.
o The Radiology Work Station enables you to display prefindings data to the
patient in the Patient Viewer. You call the Patient Viewer using the Hide/Display
Patient Viewer function. The customer enhancement provided in the Patient
Viewer enables access to the Radiology Work Station context. So, you can
select specific objects adjusted to the findings tasks respectively selected in the
Patient Viewer.
o In order to access the detail information of a findings task, you can use BAdI
BADI_ISHMED_RAD_FWL_DETAILS which can be used several times. It lets
you implement different detail views of the individual findings tasks.
o If you execute the "Create Findings Report" task, the system creates findings
for the services selected and displays them to you (embedded in the Radiology
Work Station). If you save these findings, the "Create Findings Report" task is
converted by default to the task type "Edit Findings Report" in "Completed"
status. You can, however, use a customer enhancement to change the task type
and task status in accordance with the document status.
o When you execute a task the system automatically updates the detail area if it is
shown. Note that when several services are selected the first service always
serves as a basis for the detail area. If you want to display details for other tasks,
you can use the Info column (hotspot).
o If you execute the "Edit Findings Report" task, the Radiology Work Station
either displays the previously created findings document or subject to its status
provides it in change mode.
- Effects on Data Transfer
You can use the report RN2_RAD_DWS_FWL_MIGRATION to migrate the worklist
from the Findings Work Station.
- Effects on System Administration

292
Activate the Radiology Work Station using the system parameter N1RADDWS.
- Effects on Customizing
You customize the Radiology Work Station in the Implementation Guide under
Industry-Specific Component Clinical System -> Radiology -> Radiology Work
Station
- See also
For further information about preparing the Radiology Work Station, see the Release
Notes ISHMED_EDP: Radiology Work Station - Preparation (New).

293
ISHMD_EDP: Ward Documentation Work Station (New)
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Process
(ISHMED_EDP), a documentation work station is available for the inpatient
environment.
This work station enables you to map inpatient processes in such a way that all
required documentation steps can be completed correctly and in full.
The design of the ward documentation work station is to a great extent similar to that of
the work stations for the outpatient clinic (SAP ACM) and for the operating room
(i.s.h.med Surgery). There are, however, a number of enhancements that are only
available in the ward variant in Enhancement Package 4. The standardization of all
work stations is planned for a future Release.
Work Station Header
This is the area in which the system displays superordinate data of a work situation.
The variant shipped with the standard software shows simple patient data and
information about the current situation. You cannot suppress the display of the work
station header.
Global Toolbar
You can assign a function variant to each situation template created in transaction
N2WLD. The system shows a toolbar providing functions that are not suited for task-
related execution.
Clinical Overview
This is a new information component that is only available in the ward variant of the
work station. It provides the same function as the patient overview in the outpatient
clinic and surgery documentation work stations. For a detailed description of the clinical
overview, see the Release Note for the clinical overview .
Task Components
The work station component and task management allow the efficient control of the
clinical processes on a care unit. As an enhancement to the hitherto existing
situations, the ward work station provides dynamic situations that enable you to create
worklists. For a detailed description of the new features of task management, see the
following Release Note.
Patient Viewer
As in all other documentation work stations the patient viewer is available here.
Charting Component
As an alternative to the patient viewer, you can display a new charting component that
graphically displays selected data of the clinical statement on a common time axis. You
can only display this component as an alternative to the patient viewer. For a detailed
description of the charting component, see the Release Note for the Charting
component.
Documentation Objects
The brand new documentation objects inpatient progress note and the medication
order dialog are available. For a detailed description, see the Release Note for the
inpatient progress note and the Release Notes for Medication.
- Effects on Existing Data

294
You can use general profile templates and task templates, which you defined for the
outpatient clinic documentation work station, in the ward documentation work station
also.

- Effects on Customizing
The new work area INPA (care unit) is provided for setting up the ward documentation
work station in transaction N2WLD. Maintain the situation templates, profile templates,
and task templates, the base items, info items, and define the layout and functional
scope of the ward documentation work station here.
As an enhancement to the existing documentation work stations, you can create
templates for dynamic situations here and assign variants of the chart or of the clinical
overview to the situations and tasks.

295
ISHMD_EDP: Clinical Task Management for Care Units (New)
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Processes
(ISHMED_EDP), clinical task management is available in the ward documentation work
station.
Clinical task management has a template management function which lets you
combine applications for a predictable work situation, which were until now used
individually, in a navigatable task selection for each situation.
At individual task level, you can use the Responsibility property to map processing
chains.
You can use work situation templates to create patient-related tasks for all occupational
groups involved. You can select information for each task and situation, and display it
in the view components of the documentation work station.
To provide targeted support for processing steps, you can define situations and filter
the tasks according to criteria such as responsibility or organizational unit.
Navigation
The ward documentation work station has a navigation component in which the
situations and tasks for the selected patients can be displayed and edited.
You define the content displayed in the navigation component by means of the clinical
work station functions Create Situation, Assign Situation, All Situations, Edit
Situation, or Edit Task List.
Integration
Clinical task management is a component of the ward documentation work station and
is available there only.

- Effects on Customizing
o In the Customizing activity Edit Tasks for Occupational Groups, define the
persons responsible for the completion of tasks.
o In the Customizing activity Assign Occupational Groups, assign occupational
groups to the persons responsible.
o The organizational Customizing activity Design Situation Templates provides
information about how to design situation templates.
o In the Customizing activity Define Standard Layout for Layout Situation, you
can define an initial layout for the situation list.
o In the Customizing activity Maintain Lifetime of Situations, you can define the
lifetime of situations whose lifetime depends on the Customizing of the work area
(According to Work Area Customizing indicator)
o In the Customizing activity Schedule Deletion Report for Situations, you can
close and delete situations if Customizing allows this.
- See also
For more information, see:
ISHMD_EDP: Ward Documentation Work Station (New)

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ISHMED_EDP: Clinical Overview (New)
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Processes
(ISHMED_EDP), the clinical overview is available in the ward documentation work
station.
Alongside the patient viewer and the charting component, the clinical overview is a
further component for displaying a patient's administrative and clinical data. It displays
a concise set of relevant data in aggregated form to provide the healthcare professional
with a quick overview.
The clinical overview has the same function as the patient overview in the outpatient
clinic and surgery documentation work stations. In the ward documentation work
station it is displayed on the interface where the documentation objects are also
displayed. You therefore see either a documentation object or the clinical overview.
The standard system delivery contains 19 info blocks. These are components that
display specific objects of the patient or information contexts. In Customizing, you
assign info blocks to one of the nine supplied floor plans, thereby creating a variant of
the clinical overview.
You can assign situation templates of the ward documentation work station to clinical
overviews. This makes it possible to create a specific view of patient data for each
situation.
The supplied info blocks and floor plans cannot be changed. However, you can
program your own info blocks.
Info Blocks Supplied
N2CLIO_IB_CASELIST - Info block Case List
N2CLIO_IB_CONTACT_PERSONS - Info block Relatives/Persons to Contact
N2CLIO_IB_DIAGNOSES - Info block Diagnoses
N2CLIO_IB_DOCUMENT_LIST - Info block Document List
N2CLIO_IB_EXT_PHYSICIANS - Info block Referrer and Family Physician
N2CLIO_IB_INSURANCE - Info block Insurance Relationships
N2CLIO_IB_LAB_FINDINGS - Info block Laboratory Values
N2CLIO_IB_MOVEMENTS - Info block Movements
N2CLIO_IB_PAT_DATA - Info block Patient Data
N2CLIO_IB_PAT_HEADER - Info block Patient Header
N2CLIO_IB_PHYSICIANS - Info block Patient's Physicians
N2CLIO_IB_PRESCRIPTIONS - Info block Medication Orders
N2CLIO_IB_RISK_FACTORS - Info block Risk Factors
N2CLIO_IB_SURG - Info block Surgeries
N2CLIO_IB_VITALSIGNS - Info block Vital Signs
N2IPPD_OVERVIEW - Inpatient Progress Report

Technical Info Block Components Supplied


N2CLIO_IB_DEFAULT - This info block is shown if no info block has yet been entered
for a floor plan area. It is used chiefly for test purposes and enables you to test the

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configuration before you have defined an info block for all areas.
N2CLIO_IB_EMPTY - Enter this info block in unneeded floor plan areas.
Example: You are using the one-column floor plan N2CLIO_FP_ONE_COLUMN. This
floor plan provides four areas, of which you want to display only three info blocks. Enter
the info block N2CLIO_IB_EMPTY in the fourth area.
N2CLIO_IB_SAMPLE - Copy template for customer-specific info blocks.
Floor Plans Supplied
N2CLIO_FP_SINGLE - Floor plan for one info block only
N2CLIO_FP_ONE_COLUMN - One-column floor plan with four areas
N2CLIO_FP_2COLUMNS - Two-column floor plan with four areas each
N2CLIO_FP_COMMON - Floor plan with different sized areas
N2CLIO_FP_NAV - Floor plan with a T split
N2CLIO_FP_2COL_1CEL_3CEL - Two-column floor plan; the left column provides one
area, the right column three areas.
N2CLIO_FP_2COL_HEAD_FOOT - Two-column floor plan with four areas each, as
well as header and footer area.
N2CLIO_FP_COMPLEX - Complex floor plan with areas of different sizes, as well as
header and footer area.
Note: Use this complex floor plan with a large number of info blocks only if a work
situation actually requires a great deal of information. A large number of info blocks can
negatively impact on performance.
N2CLIO_FP_SAMPLE - Copy template for creating your own floor plan components
- Effects on System Administration
The interfaces of the clinical overview and the Customizing application are realized
using Web Dynpro for ABAP. We therefore strongly recommend you to use Single
Sing-On and to configure it accordingly. For information about this, see Customizing.
- Effects on Customizing
Clinical overviews are created by means of a Web Dynpro application that enables the
assignment of info blocks to various areas of a floor plan.
For more information about this, see the Implementation Guide .
You can assign defined clinical overviews (configurations) to situation templates in the
Care Unit work area in transaction N2WLD.

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ISHMD_EDP: Ward Documentation Work Station - Charting (New)
- Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Processes
(ISHMED_EDP), charting is available in the ward documentation work station. Charting
displays a patient's medical and clinical data, such as vital signs, medication, and
documentation events, over a common time axis and its graphical formatting provides a
fast overview.
When you process the tasks of a situation, the system provides the chart with the
structure and configuration stipulated in the chart layout.
The chart can display the existence of documents of the selected document categories.
Clicking the document icon opens the document relevant for this event for viewing. In
Customizing for Charting, you define which document categories are to be offered in
the chart.
The chart provides different display functions, such as, crosshair cursor, magnifying
glass function, and zoom.
- Effects on System Administration
The chart is not a part of the SAP GUI. It is supplied separately and must be installed
on the PC work stations in your hospital.
- Effects on Customizing
In Customizing you define the data to display as chart elements and combine them in a
chart layout. A chart layout can be defined for each situation.

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Business Function Klinisches System
ISHMED_MAIN: Business Function Clinical System
Use
Since SAP ECC 6.0, Industry Extension Healthcare the business function Clinical
System (ISHMED_MAIN) has provided new and enhanced functions in various
components of i.s.h.med.
For detailed information about the new features available in SAP ECC 6.0, Industry
Extension Healthcare, Enhancement Package 4 (IS-H 604), see the following
Release Notes:
for General Areas:
ISH_MISC1, ISHMED_MAIN: Interface IF_ISH_OBJECT_TYPES
(Deleted)
ISHMED_MAIN: List of Available User Parameters (Deleted)
for the Departmental Solution Cardiology:
ISHMED_MAIN: Cardiology Departmental Solution (New)
for Enhanced Basic Data:
ISHMED_MAIN: Deletion of Obsolete ABAP Objects (Deleted)
ISHMED_MAIN: Maintenance for Gen.Vers. 1 Doc.Ctgrs
Discontinued (Changed)
ISHMED_MAIN: New and Changed API Methods (Changed)
ISHMED_MAIN: Parameterization of Combo Boxes (Changed)
ISHMED_MAIN: Copying and Transporting Document Categories
(Changed)
ISHMED_MAIN: Print Format XLSFO (New)
ISHMED_MAIN: Print Format BADI (Changed)
ISHMED_MAIN: Text Modules in Long Text Fields (Modified)
ISHMED_MAIN: Integration of Your Own Long Text Editor (New)
ISHMED_MAIN: Implementation Support for PMDs (New)
ISHMED_MAIN: PMD System Transport - Program RN2UTDTS3
(Modified)
ISHMED_MAIN: PMD System Transport - Program
RN2UTDTS_EUOBJ (New)
ISHMED_MAIN: Using Document Categories RN2UTDT_USE (New)
ISHMED_MAIN: New Report for Copying Document Categories
(Changed)
ISHMED_MAIN: Dictation Work Station (New)
for Clinical Patient Management::
ISHMED_MAIN: Provisional Patients Without Surnames (New)

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for Service Management:
ISHMED_MAIN: Procedure Generation - Service Assignment (New)
ISHMED_MAIN: Clinical Orders View Type - Selection Screen
(Changed)
for Clinical Documentation:
ISHMED_MAIN: End of Maintenance for Obsolete ABAP Objects
(Deleted)
ISHMED_MAIN: Use of Dictation Systems in i.s.h.med (New)
ISHMED_MAIN: Integration of Dictation Functions in PMDs (New)
ISHMED_MAIN: Functions of the DICTATION Link Module (New)
ISHMED_MAIN: Dictation and Speech Recognition Via Dialog Box
(New)
ISHMED_MAIN: Dictation and Speech Recognition in the
WordContainer (New)
ISHMED_MAIN: Laboratory Cumulative Findings - Web Dynpro
Application (New)
ISHMED_MAIN: Deletion of Obsolete ABAP Objects (Deleted)
ISHMED_MAIN: Print Format XLSFO (New)
ISHMED_MAIN: Print Format BADI (Changed)
ISHMED_MAIN: EDIVKA Dispatch Route for AT Document Dispatch
(New)
ISHMED_MAIN: OU-Related Document Profile (Changed)
ISHMED_MAIN: Service-Related Document Profile (Changed)
ISHMED_MAIN: Evaluations - Master Data (Enhanced)
ISHMED_MAIN: Using Selection Variants (New)
ISHMED_MAIN: WordContainer Documents - "Get Data"
(Enhanced)
ISHMED_MAIN: BAdI ISHMED_DOC_CONTENT was Replaced
(Enhanced)
ISHMED_MAIN: Dispatch Control (New)
ISHMED_MAIN: Message Control in Diagnosis Processing
(Modified)
for Clinical Order:
ISHMED_MAIN: Preregistration - Business Add-Ins (Deleted)
ISHMED_MAIN: Clinical Order - New Business Add-Ins (New)
ISHMED_MAIN: Order Item Component for Questions (New)
ISHMED_MAIN: Enhanced Selection List for Order Types (New)
ISHMED_MAIN: Clinical Order - Various Changes (Changed)

301
ISHMED_MAIN: Header/Item Components - Flagging of Required
Fields (New)
ISHMED_MAIN: Order Item - Integration in Component Concept
(New)
ISHMED_MAIN: Order Item - Service Planning/Scheduling
(Changed)
ISHMED_MAIN: Service Component - Integration of Planning (New)
for Patient Organizer:
ISHMED_MAIN: Patient Organizer - New Functions and Objects
(New)
ISHMED_MAIN: Patient Organizer - Inpatient Progress Note (New)
for Planning:
ISHMED_MAIN: Planning Authority for all Organizational Units
(New)
ISHMED_MAIN: Planning Grid - Open Clinical Order in Change
Mode (New)
ISHMED_MAIN: Planning Grid - Print Functions (New)
ISHMED_MAIN: Planning Grid - Variant Management (Changed)
ISHMED_MAIN: Planning Grid - New and Enhanced Business Add-
Ins (New)
ISHMED_MAIN: Planning Grid - Uniform Platform (Changed)
ISHMED_MAIN: Planning Grid - Planning and Displaying Day-Based
Appointments (New)
ISHMED_MAIN: Planning Functions - Integration of Group
Appointments (New)
ISHMED_MAIN: Maintain Appointment - Admission Appointments
(New)
ISHMED_MAIN: Planning - Time Slot Synchronization (New)
ISHMED_MAIN: Planning - Various Changes and Enhancements
(Changed)
ISHMED_MAIN: Planning - Optimized Process Support in
Appointment Planning (New)
ISHMED_MAIN: Planning - Replaced User Exits (Deleted)
for Surgery System:
ISHMED_MAIN: Discontinued Surgery Transactions (Deleted)
ISHMED_MAIN: Surgery Times (Enhanced)
ISHMED_MAIN: Surgical Documentation (Enhanced)
ISHMED_MAIN: Surgical Complications (Enhanced)
ISHMED_MAIN: Surgery Hierarchy in Input Help (Changed)

302
ISHMED_MAIN: Authorizations for Surgery Times (Enhanced)
for Perinatal Medicine:
ISHMED_MAIN: DE: Workplace Number in Data Export Progam
(Enhanced)
ISHMED_MAIN: DE: Coding of the Export Files (Changed)
ISHMED_MAIN: DE: Creating a Minimum Data Record (New)
for Medication:
ISHMED_MAIN: Drug Master - General (New)
ISHMED_MAIN: Structuring in Drug Master (New)
ISHMED_MAIN: Drug Master - General Parameters (New)
ISHMED_MAIN: Drug Alerts (New)
ISHMED_MAIN: Assignment of Drugs to Fill Sources (New)
ISHMED_MAIN: New Drug Search - Customizing (New)
ISHMED_MAIN: New Drug Search - General (New)
ISHMED_MAIN: Medication - User Favorites (New)
ISHMED_MAIN: Medication - User-Specific Presettings (New)
ISHMED_MAIN: Cycle - Enhancements (New)
ISHMED_MAIN: Medication Order - Various New Features (New)
ISHMED_MAIN: Order Activities (New)
ISHMED_MAIN: Order Sequences (New)
ISHMED_MAIN: Integration of Order in Documentation Work Station
(New)
ISHMED_MAIN: Integration of Chart in Order (New)
ISHMED_MAIN: Simplified Dose Definition (New)
ISHMED_MAIN: Ordering Generic Drugs (New)
for Patient Transport Service:
ISHMED_MAIN: Patient Transport Service - Means of Transport
(New)
ISHMED_MAIN: Transport Orders for Provisional Patients (New)
ISHMED_MAIN: Patient Transport Service - Web Services (New)
for Connectivity:
ISHMED_MAIN: Connectivity (Changed)
For Radiology:
ISHMED_MAIN: Reconciliation Tool (New)
for Pathways:
ISHMED_MAIN: i.s.h.med pathways: Overview of Changes
(Changed)

303
ISHMED_MAIN: Customizing Work Station Layout (Changed)
ISHMED_MAIN: Enhancement of Information Units (Changed)
ISHMED_MAIN: Revision of Dialog Layouts (Changed)
ISHMED_MAIN: Note Function (Enhanced)
ISHMED_MAIN: Pathway Proposals in the Clinical Work Station
(New)
ISHMED_MAIN: Pathway Log (New)
ISHMED_MAIN: Undoing Activities (New)
ISHMED_MAIN: Evaluations (New)
ISHMED_MAIN: Changing Active Pathways (New)
ISHMED_MAIN: Deleting Treatment Pathways (New)
ISHMED_MAIN: Deleting Treatment Pathway Assignments (New)
ISHMED_MAIN: Unique Indicator (New)
ISHMED_MAIN: Action Behavior at Status Change (New)
ISHMED_MAIN: BAdI for Activities (New)
ISHMED_MAIN: Treatment Pathways - Further Changes (Enhanced)
ISHMED_MAIN: Patient Pathways in the Clinical Work Station
(Enhanced)
See also
For further information, see the SAP Library under Business Function Sets and
Business Functions -> Healthcare -> i.s.h.med Clinical System.
For further information about Support Package Release Notes for i.s.h.med Clinical
System see the website www.ishmed.de on the Customer Services tab page under
Release Info Download.

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ISH_MISC1, ISHMED_MAIN: Interface IF_ISH_OBJECT_TYPES
(Deleted)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function SAP Patient Management: Legal Process Adoption
(ISH_MIISC1) in SAP Patient Management (IS-H) and Business Function Clinical
System (ISHMED_MAIN) in the Clinical System i.s.h.med, the interface
IF_ISH_OBJECT_TYPES, in which the type constants of the classes in IS-H and
i.s.h.med were defined up to now, is no longer used.
Instead of using the constants of this interface, the system now uses constants with
the name CO_OTYPE_.... that are defined directly in the relevant classes. This is to
improve the performance and readability of the programs.
Examples:
Class CL_ISH_CORDER has a constant CO_OTYPE_CORDER
Class CL_ISHMED_CORDPOS has a constant CO_OTYPE_CORDPOS_MED
Class CL_ISHMED_SERVICE can have two types (normal service and anchor service)
and therefore has two of these constants:
CO_OTYPE_MED_SERVICE
CO_OTYPE_ANCHOR_SRV
In addition, the data type of these constants has been changed from INTEGER to a
new type ISH_OBJECT_TYPE defined per data element. Since ISH_OBJECT_TYPE is
actually type I also, problems cannot arise during the changeover.
These constants define the type of a class and are used when the methods
GET_TYPE, IS_A, and IS_INHERITED_FROM are called, this means in all places
where the program wishes to determine the type of a reference variable in order to
subsequently perform a cast, for example.
Prior to SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-
H 604), Business Function Clinical System (ISHMED_MAIN), this was programmed,
for example, as follows:
DATA: lr_object TYPE REF TO IF_ISH_IDENTIFY_OBJECT,
lr_corder TYPE REF TO CL_ISH_CORDER,
l_type TYPE I.
...
...
* lr_object is filled with any object from the caller. The
* current program however needs a reference of the class CL_ISH_CORDER and must
* thus ask this object what it is
CALL METHOD lr_object->get_type
IMPORTING
e_object_type = l_type.
IF l_type = IF_ISH_OBJECT_TYPES=>CO_TYPE_CORDER.
* If it is CORDER => Perform desired action
ENDIF.

305
...
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), this is programmed as
follows (changes to the previous source code are shown in bold type):
DATA: lr_object TYPE REF TO IF_ISH_IDENTIFY_OBJECT,
lr_corder TYPE REF TO CL_ISH_CORDER,
l_type TYPE ISH_OBJECT_TYPE.
...
...
* lr_object is filled with any object from the caller. The
* current program however needs a reference of the class CL_ISH_CORDER and must
* thus ask this object what it is
CALL METHOD lr_object->get_type
IMPORTING
e_object_type = l_type.
IF l_type = CL_ISH_CORDER=>CO_OTYPE_CORDER.
* If it is CORDER => Perform desired action
ENDIF.
...
Similarly, the methods GET_TYPE and IS_INHERITED_FROM now no longer return
the constant value from IF_ISH_OBJECT_TYPES, but the constant value defined in
the relevant class, instead.
Example: Class CL_ISH_CORDER:
Prior to SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-
H 604), Business Function Clinical System (ISHMED_MAIN), this was programmed,
for example, as follows:
METHOD if_ish_identify_object~get_type .
e_object_type = if_ish_object_types~co_type_corder.
ENDMETHOD.
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), this appears as follows
(changes to the previous source code are shown in bold type):
METHOD if_ish_identify_object~get_type .
e_object_type = cl_ish_corder=>co_otype_corder.
ENDMETHOD.

Effects on Your Customer-Specific Programs


You have to correct all places in your programs in which the old object types are used.
Proceed as follows:
Call transaction SE80 and open your customer-specific packages.
Choose Class Library -> Classes.

306
Select all classes, open the context menu (by clicking the right-hand mouse button) and
choose the Find function.
Search for CO_TYPE.
You have to correct all occurrences you find, regardless of whether directly from
IF_ISH_OBJECT_TYPES, IF_ISH_IDENTIFY_OBJECT, or similar.
Thus, for example, from
if_ish_object_types~co_type_corder --> cl_ish_corder=>co_otype_corder
if_ish_object_types=>co_type_corder --> also cl_ish_corder=>co_otype_corder
if_ish_identify_object=>co_type_corder --> similarly
cl_ish_corder=>co_otype_corder
When you have completed the corrections in the classes, remain in transaction SE80,
and choose the Programs node.
Select all programs and search for CO_TYPE, as above in the classes. Replace the
found occurrences in the source code with the respective new constants. You do
not have to create new constants here.
Now repeat the same procedure for the function groups (and function modules):
Choose the Function Groups node
Select all
Search and replace as in the Programs node
Now remove the interface IF_ISH_OBJECT_TYPES from your classes, if required.
Execute the Where-Used List function for IF_ISH_IDENTIFY_OBJECT (important:
not IF_ISH_OBJECT_TYPES) to find all classes that implement this interface.
Open every one of these classes and switch to change mode.
The system asks you if you want to modify the class. Make the modification. This
modification is necessary to remove the interface IF_ISH_OBJECT_TYPES (that
was contained in the class via IF_ISH_IDENTIFY_OBJECT) from the class
completely.
You must then clean up the aliases. To do this, in the menu choose Utilities -> Clean
Up -> Aliases.
Re-activate the class.

Important Information:
You can user the report RNOBJECT_TYPES to determine the names of the classes for
the constants you have found. Simply run the report (without entering criteria on the
initial screen). The report shows a list of classes that derive from
IF_ISH_IDENTIFY_OBJECT and thus have constants.
In general, the new constants have the same name as the old constants, except
CO_OTYPE_... in place of CO_TYPE_... , thus for example co_otype_corder instead
of co_type_corder.
You obtain the name of the class in which a constant is defined by calling this report
and searching for CO_OTYPE_.... The system shows all of the classes found together
with their class name.
Standard Modifications:
If you have modified standard programs, you also have to correct these. You thus also
have to replace the old constants CO_TYPE#) by the new ones (class
=>CO_OTYPE#) in the modified standard programs.

307
If you have defined your own constants in the interface IF_ISH_OBJECT_TYPES, you
have to replace these too. This should not actually be necessary, since a change to
IF_ISH_OBJECT_TYPES means a standard modification. The table
N1CUSTOMER_TYPES has been created for customer-specific objects. You can store
your customer-specific object types in this table. In such cases, there is no need to
make changes to your source code, since the use of the constants in this class remains
effective and has not been changed.
However, if you have added your own constants to IF_ISH_OBJECT_TYPES using a
standard modification, you need to proceed as follows:
In the class in which this constant is used as an object type, you have to add a constant
with the same name (but CO_OTYPE# instead of CO_TYPE#!) of the type
ISH_OBJECT_TYPE.
Then replace - as explained in item 1 - all users of the original constants. In doing this,
do not forget the GET_TYPE and IS_INHERITED_FROM method of the class in
which this constant is defined.

General Information:
For SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the interface
IF_ISH_OBJECT_TYPES has been retained to facilitate the Release upgrade and
adapt your customer-specific programs. This interface will be deleted with a future
release of IS-H and i.s.h.med. For this reason, do not forget to adapt your programs.
IF_ISH_OBJECT_TYPES has been removed from the interface
IF_ISH_IDENTIFY_OBJECT in SAP ECC 6.0, Industry Extension Healthcare,
Enhancement Package 4 (IS-H 604), Business Function Clinical System
(ISHMED_MAIN). Previously, IF_ISH_IDENTIFY_OBJECT also inherited from
IF_ISH_OBJECT_TYPES (and thus all of its constants). IF_ISH_IDENTIFY_OBJECT
is still in use since it contains the methods for identifying an object, thus GET_TYPE,
IS_A and IS_INHERITED_FROM.

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ISHMED_MAIN: List of Available User Parameters (Deleted)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), a detailed description of
all available user parameters is available in the online documentation.
You find the documentation of the available user parameters, organized according to
the component in which they are used, in the online documentation under Clinical
System -> Appendix -> User Parameters in i.s.h.med.
The list of the available user parameters provided up to now in the Implementation
Guide under Basic Settings -> Display Available User Parameters is thus no longer
maintained for SAP ECC 6.0, Industry Extension Healthcare, Enhancement
Package 4 (IS-H 604), Business Function Clinical System (ISHMED_MAIN).
Note that the list of the available user parameters in the Implementation Guide will be
deleted with one of the patches for SAP ECC 6.0, Industry Extension Healthcare,
Enhancement Package 4 (IS-H 604). This list will thus cease to be available in all
subsequent Releases.

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ISHMED_MAIN: Cardiology Departmental Solution (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the departmental
solution i.s.h.med cardiology is available.
This enables fast creation of a differentiated cardiological work environment based on
supplied templates. This means all necessary objects are supplied and some of these
objects (mainly PMD-related) are then copied into the customer namespace. The
customer is then responsible for these. The majority of the objects remain in the SAP
namespace, is used by the customer copies and can, if necessary, be updated with the
import of add-on support packages or notes.
i.s.h.med Cardiology consists of three pillars:
The first and most extensive pillar consists of document templates for the most
important functional areas:
Cardiac catheter
Echocardiography (transthoracic/transesophageal, stress echo)
MRI
ECG (resting ECG, 24 hour ECG, ergometry, 24 hour blood pressure)
Angiology (vascular sonography)
and also lung functions (spirometry, ergospirometry)
It also includes document-enhancing comfort functions (e.g. progress per field,
notification of the requester).
The second pillar consists of functions for the connection of devices. This is roughly
restricted to server-based software. The connection of individual devices such as, for
example, pacemaker analysis devices, is not intended. This solution has been primarily
developed and tested for three subareas:
Cardiac catheter, connection for import of measured data from CC measuring
stations (e.g. Siemens Sensis)
Echocardiography, connection (e.g. using middleware TomTec) for importing
measured data from sonography devices
ECG, integration of an ECG software suite (e.g. Schiller SEMA) for calling ECG
entry and the import of measured data as well as references to ECG
graphics, if this is possible in external software.
The connection has been implemented for any manufacturer. Sample solutions,
however, will only be provided for established manufacturers, with whom cooperation
has been negotiated.
The third pillar comprises workflow-supporting functions such as separate components
in the clinical order which were specifically created for the individual areas.

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ISHMED_MAIN: Delete Obsolete ABAP Objects (Deleted)
Use
As announced in Release SAP ECC Industry Extension Healthcare 6.00, the following
ABAP objects have been deleted with SAP ECC 6.0, Industry Extension Healthcare,
Enhancement Package 4 (IS-H 604), Business Function Clinical System
(ISHMED_MAIN):
Function module ISH_N2_DOCUMENT_SELECT
If you used the module to select documents without dialog (parameter
SS_DYNPRO = 'NO'), you should now use the function module
ISH_N2_MEDDOC_GETLIST.
If you used the module to select a document from a list of documents in the
dialog (parameter SS_DYNPRO = SPACE / 'YES'), you should now use the
function module ISH_N2_DOC_F4_DOC.
Function module ISH_N2_MAP_BAPIRET_2_MESG
Use the static method CL_ISHMED_DOC_MAP=>BAPIRET_2_MESG instead.
Function module ISH_N2_MAP_VCODE_2_METHOD
Use the static method CL_ISHMED_DOC_MAP=>VCODE_2_METHOD instead.
Function module ISH_N2_MAP_DOCDATA_2_DVSDATA
Use the static method CL_ISHMED_DOC_MAP=>DOCDATA_2_DVSDATA
instead.
Function module ISH_N2_MAP_DOCDATAIN_2_DVSDATA
Use the static method CL_ISHMED_DOC_MAP=>DOCDATAIN_2_DVSDATA
instead.
Function module ISH_N2_MAP_DOCDATAX_2_DVSDATAX
Use the static method CL_ISHMED_DOC_MAP=>DOCDATAX_2_DVSDATAX
instead.
Function module ISH_N2_MAP_DRAW_ETC_2_DOCDATA
Use the static method CL_ISHMED_DOC_MAP=>DRAW_ETC_2_DOCDATA
instead.
Function module ISH_N2_MAP_DRAW_ETC_2_DVSDATA
Use the static method CL_ISHMED_DOC_MAP=>DRAW_ETC_2_DVSDATA
instead.

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ISHMED_MAIN: Call Layout Control (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the layout control can no
longer be executed if system settings prevent program modifications.
It should thus always be possible to call the layout control on development systems,
while this should generally not be the case on production systems.
Background:
The layout control makes a program modification in the background.
The check module used (SAP Basis technology) now checks the corresponding system
settings.

312
ISHMED_MAIN: Maintenance Doc.Ctgrs Gen.Ver.1 Discontinued
(Changed)
Use
Maintenance for generator version 1 (PMD 1) document categories is being phased
out. This has the following consequences:
Current Release SAP ECC 6.0, Industry Extension Healthcare, Enhancement
Package 4 (IS-H 604), Business Function Clinical System (ISHMED_MAIN)
Errors in PMD 1 document categories are only corrected if they cause data loss.
No new document categories or document category versions may be created with
generator version 1.
Subsequent Releases
PMD 1 document categories are no longer maintained. This means that errors are no
longer corrected.
PMD 1 document categories can no longer be changed. The PMD 1 generator is
switched off.
Effects on Existing Data
The transition from PMD 1 == > PMD 2 does not affect user data. Documents produced
with PMD 1 can be edited with PMD 2.

Effects on System Administration


Migrate your previous document categories to generator version 2 (PMD 2).
The original restriction that all document category versions must have the same
generator version has been modified:
Creating a new document category version now produces a new function group.
Old data sets in which several versions were generated in the same function group still
has to have the same generator version, since creating function groups with
different generator versions is incompatible.

313
ISHMED_MAIN: New and Changed API Methods (Changed)
Use
With SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the following changes
will take effect:
API__DIALOG_IS_VISIBLE (new)
In the document start user exit you can use this method to determine whether
the dialog is visible.
API__GET_ELEMENT and API__GET_ELEMENTS (changed)
The method also returns the data
ELEMLEVEL - nesting level of the element
ELEM_ID - ident of the associated documentation element

314
ISHMED_MAIN: Parameterization of Combo Boxes (Changed)
Use
Combo Box Elements
With SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the following changes
take effect:
With elements of the type Combo Box in the definite design on the Dialog tab page
you can define that users may only select from the list via F4 help i.e. may not enter
any values of their own. The element then functions like an element of the Selection
Field type, however, it cannot be displayed as a dropdown list box.
You can then use an input help user exit to manipulate the combo box values to be
proposed to users.

315
ISHMED_MAIN: Copying and Transporting Document Categories
(Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the system provides a
central point of access to the various reports for copying and transporting document
categories.
The pushbuttons in report RN2PMD_DISTRIBUTION enable you to select the utilities
required for the task to hand. From this single interface you access reports for
distributing document calls on a system's clients, for copying definition elements, and
for transporting various object types.
Develop, revise, and generate PMDs only on one of your development systems
development clients and transport document category data and generated objects by
transport request to the quality assurance and production systems.
To achieve valid test results and have a realistic development environment, the
development, test and production systems should always have synchronized PMD
states (except for PMDs currently in development).
Do not generate PMDs on production systems! Document categories are not
maintained in the production system. Generation in the consolidation and production
system is not permissible.
If you want to use an existing document category on several clients/institutions of a
system, you need simply transfer the header data. This ensures that you work with the
same generated objects. You should only make corrections in your development client.
If you want to create a new document category by using an existing one as a copy
template, you should give new names to the definition objects you wish to create, if
they are not supplied by external data modules. If you do not assign new names, the
definition objects will be used by several document categories and any changes in the
object properties will affect all the document categories.

See also
Using Document Categories RN2UTDT_USE (New)
New Report for Copying Document Types (Changed)
PMD System Transport: Program RN2UTDTS3 (Changed)
PMD System Transport: Program RN2UTDTS_EUOBJ (New)

316
ISHMED_MAIN: Print Format XLSFO (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can print
parameterized documents (PMDs) including image data.
Link elements can be included in PMDs. The user can display or enter further data,
such as images, within these link elements. Such a link element belongs to the
interface for digital image management. The link element is used to enter images
within a PMD.
Previously, these images could not be printed at sufficient resolution in SAPscript
standard, which meant that alternative solutions had to be worked with (text printing via
SAPscript and separate image printing from within the image program).
Effects on System Administration
This print application requires a JAVA service in addition to the shipped ABAP objects.
For further information, see the XSLFO print application manual in the SAP Note
920867.

See also
This print application is available as part of image integration within the departmental
solution i.s.h.med gastro (gastroenterology). If you are interested, please contact
Siemens Medical Solutions GSD Sales.

317
ISHMED_MAIN: Print Format BAdI (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can implement your
own print procedure for parameterized documents. For this, you have to enter the
format BADI for the action Print or Print Preview in a document category.
Using the enhancement spot ES_ISHMED_DOC_FORMAT_BADI you can implement
your print solution. You can override the standard print output by implementing this
BAdI.
The defined filters make it possible to implement the BAdI for specific document
categories.

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ISHMED_MAIN: Text Modules in Long Text Fields (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the concept of text
modules has been enhanced by the assignment level text module set. This level is
only used in departmental solutions.
Explanation
The specialist documentation i.s.h.med gastro uses text modules in combination with
findings hit lists to support physicians with branch-specific or examination-specific
guideline-compliant findings documentation. A separate findings hit list with a defined
"set" of text modules is provided for each special examination.
Beyond the context of a departmental solution like i.s.h.med gastro content for text
modules or markers is not provided.
When administrators of text modules call text module management (transaction code
N2TBS), the system displays the following assignment levels for selection
Institution
Departmental OU
Documenting OU
User
Text module set
The text module set level is not used beyond the departmental solution i.s.h.med
gastro.

319
ISHMED_MAIN: Integration of Your Own Long Text Editor (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can integrate an
editor that you have developed yourself using the implementation of the new
enhancement spot ES_ISHMED_PMD_EDITOR.
The i.s.h.med long text editor used hitherto is included in the standard system.

320
ISHMED_MAIN: Print Preview of Enhanced Texts and Long Texts
(Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can explicitly
position the first paragraph of the text next to or beneath the label.
You can use the new indicator Value Under Label to control the position of the text.
Indicator set : Text is output beneath the label (paragraph format like label)
Indicator not set: Text is output next to the label (paragraph format SPACE for body
text)
To implement this, the system now generates four text elements for elements of the
type enhanced text and long text in the SAPscript form:
BEZ_alias (unchanged) for the output of the label
VAL_alias_FIRST (changed)
Previously, the system branched to this text element at each paragraph start
Now it branches to this text element only for the output of the first text line.
VAL_alias_PARAGRAPH (new) for the output of the first line of subsequent
paragraphs
VAL_alias (unchanged) for all subsequent lines in all paragraphs (body text)

Effects on Existing Data


To use this possibility, you have to regenerate the form (or adapt your own form) and
regenerate the program.
If you only regenerate the program and not the form, the system calls up the FIRST text
element instead of the (missing) PARAGRAPH text element, as previously. This means
that this text element is used to output each paragraph start.

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ISHMED_MAIN Implementation Support for PMDs (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), there are new
procedures for transporting and copying development elements of clinical documents.
Documentation elements are deliverd as BC sets with installation packages by
transport route. File download is a further available means of delivery. The transfer
manager N1IMSU is provided for BC set activation and the subsequent process of
installation. The transfer manager manages various types of installation packages. You
have to select and install the appropriate package. Every object generated is delivered
via the transport route, as previously.
Several reports are available for the continued use and distribution of the document
categories. To simplify execution, all necessary reports can be accessed using the
report RN2PMD_DISTRIBUTION.
The requirement for only one development client per system with simultaneous
availability of one document category on several clients is supported by the report for
sharing document categories RN2UTDT_USE.
There are also reports for creating copies of document categories and for transports
within a system landscape.

See also
Copying and Transporting Document Categories
Implementation Support: Customizing Transfer Manager
Implementation Support: PMD Import Wizard

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ISHMED_MAIN: PMD System Transport- Program RN2UTDTS3
(Changed)
Use
With SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the program
RN2UTDTS3 has been simplified. As a customer you can use it to transport PMDs
between the development and production systems. It creates a correction request with
the table entries (definition data) for a document category (all versions) or with the
objects generated for a document category. The report is provided centrally via
RN2PMD_DISTRIBUTION.
See also
Copying and Transporting Document Categories

323
ISHMED_MAIN: PMD System Transport - Program RN2UTDTS_EUOBJ
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can use the program
RN2UTDTS_EUOBJ to transport all or selected development objects for the document
category (all versions). The program creates a correction request. The report is
provided centrally via RN2PMD_DISTRIBUTION.

See also
Copying and Transporting Document Categories

324
ISHMED_MAIN: Using Document Categories RN2UTDT_USE (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), client-specific and
institution-related access can be created for PMDs that are to be used on several
clients of a system. The program has to be called on the target client.
The report is provided centrally via RN2PMD_DISTRIBUTION.

See also
Copying, and Transporting Document Categories

325
ISHMED_MAIN: New Report for Copying Document Types (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the new report
RN2UTDT_COPY is provided for copying document categories. The report is provided
centrally via RN2PMD_DISTRIBUTION.
The previous programs RN2UTDT2 and N2T5 should not be used any longer.

See also
Copying and Transporting Document Categories (Changed)

326
ISHMED_MAIN: Dictation Work Station (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN, the new view type
Dictations is available in the Clinical Work Station. This view type lets you
configure the Clinical Work Station so that it can be used by a physician for entering
and managing dictations and by clerks for processing dictations.
Dictations and recordings for dictations have a context for a patient, for an employee
responsible, or for a parameterized document.
The aim of the Dictations view type is to generate worklists in the Clinical Work Station
based on predefined selections.

Selection Screen for Dictations View Type


On the Dictations Selection Screen you determine the institution and evaluation period
in which the dictations and recordings are created.
Dictation field group
Here you control the scope of the worklist using Expiry Date, as well as the
dictation's reference to a patient, employee responsible, parameterized
document or Word document.
Recording field group
Here you control the scope of the worklist using Author, Recording Status,
Recording Type, Transcript. By and Dictation System.
Documents with Dictation Reference field group
Here you control the scope of the worklist using the selection criteria Document
Category ID, Documenting Organizational Unit and Document Date.
By means of an indicator you can stipulate whether the selection screen is always to be
displayed first when the Dictations view type is called.

Field Catalog
The column selection for the Dictations view type has the following areas:
Patient Data with patient information
Dictation Information with specific dictation details such as the title, priority and expiry
date
Recording Information with further details on the recording such as the title, author,
creation date and type
Context Information with details on the context, for example EmR
Document Data with information such as the document category, institution,
document. OU and document date
Customer-specific data

Features
Process Recording opens the recording for processing in the dictation context.
Employee Responsible/Patient Context
Dictations and all recordings are displayed in a dialog box. Recording and

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dictation-specific information is displayed.
Document Context
The dictations and recordings are displayed in a docking container or in a
dialog box of the document.
The display scope is determined by the
RELN.ISHMED604_MAIN_DO54 DICTATION link module.
Display Recording displays the recording in the dictation context.
You can play a recording directly in the system using Play Recording.
You can set actions in the dictation system using the method Play Recording
of the Business Add-In (BAdI) Implement Speech Recording
Functions.
You use Delete Recording to delete a recording and its dependent objects in the
system.
You can set further actions in the dictation system using the method Discard
Recording of the Business Add-In (BAdI) Implement Speech
Recording Functions.
You use DocContext to create a new dictation with a recording with a reference to a
document.
You use PatContext to create a new dictation with a recording with a reference to a
patient.
You use EmR Context to create a new dictation with a recording with a reference to a
responsible employee.
You use Assign Document to assign an existing dictation with its recordings from the
EmR context to the Document context.
Patient Context
The system displays the document selection dialog. This dialog shows
documents that already exist for the patient. If you do not select any of the
existing documents or if there are no documents for the patient, the system will
display the document selection dialog for creating a document. After you have
selected or created the document, the system assigns the recording.
Employee Responsible Context
The patient selection dialog is displayed first; the subsequent procedure is as
described under Patient Context.
Document/WordDocument Context
The function is not permitted in this context.
You use Assign Patient to assign a dictation with its recordings from the EmR context
to the Patient context. For this purpose, the patient selection dialog is opened.
No dictation dialog is displayed in this assignment function.
The function is not permitted in the Document/Word Document context.
You use Patient Organizer to call the patient organizer.
You use Next Period to determine the next selection period for the evaluation period.
You use Previous Period to determine the previous selection period for the evaluation
period.
You use Patient to switch to the patient organizer.
Double-clicking the Recording Type icon plays a recording directly in the system.
Double-clicking the Context icon accesses the edit mode of a recording.
You use Export as Local File and Export to Excel to export the data of the displayed

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view.
Note that if a view layout is too large, it cannot be exported to Excel.
Effects on System Administration
To use the Dictations view type, the dictation system has to be configured or a
dictation system has to be simulated on your work station.
Effects on Customizing
For more information about the Business Add-In for the Dictations view type, see
the Clinical System Implementation Guide under SAP Healthcare Industry-
Specific Component Clinical System -> Clinical Work Station:
BAdI: Customer-Specific Enhancement for Dictations View Type

See also
For more information about Dictation and Speech Recognition, see the Release Notes:
Use of Dictation Systems in i.s.h.med (New)
Integration of Dictation Function in PMDs (New)
Functions of DICTATION Link Module (New)
Dictation and Speech Recognition via Dialog Box (New)
Dictation and Speech Recognition in the WordContainer (New)

329
ISHMED_MAIN: Provisional Patients Without Last Names (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), it is no longer mandatory
to specify a last name when you enter provisional data for patients.
Note that you cannot use provisional patients without data (in particular the last name,
first name, birthdate) as search criteria, because the system assigns the unique
identification (PAPID) and this field is not intended as search criteria.
If you still wish to prevent the entry of provisional patient data without names, you must
define the relevant fields of the dialogs concerned as required entry fields using screen
modification.

330
ISHMED_MAIN: Procedure Generation - Service Assignment (New)
Use
Previously the system only saved procedures generated during service release on a
case-related basis. Only in the surgery area did the system generate procedures with a
service reference (to the surgery anchor service).
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can assign
procedures, which are generated when a service is replaced, to the original service.
If you want to continue to save procedures on a purely case-related basis, you can
control this using the system parameter N1ICPCA..
Effects on Existing Data
Note that conversion of the case-related procedures currently already stored is not
possible, as no automatic inference to the associated services can be made.

331
ISHMED_MAIN: Outpatient Clinic/Service Facility View Type -
N1_WP_LSTAMB (Modified)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), this business add-in
(BAdI) N1_WP_LSTAMB can no longer be used several times.
The corresponding setting in the definition of this BAdI was withdrawn. Check in your
BAdI implementations if you use the multiple implementation of this BAdI. If you have
created several implementations, combine the logic from the different implementations
into one implementation.
Thus this BAdI behaves like the other BAdIs in the clinical work station.

332
ISHMED_MAIN: Clinical Orders View Type - Selection Screen
(Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the fields Patient and
Case are ready for input in the selection screen of the Clinical Orders view type in the
clinical work station. Thus you can define these fields as required entry fields using
selection variants.

Background
To get a complete view of all of a patient's clinical orders, selection criteria were hardly
ever defined in practice within a view of the Clinical Orders and Requests view type.
If a user had mistakenly called this view without having previously selected a patient,
this caused all this institution's clinical orders and requests to be selected. This resulted
in a long runtime when the view was called.
Defining the fields Patient and Case as required entry fields takes the user in the
scenario described above to the selection screen, where they can enter the patient and
the case. By this means the user limits the view according to the criteria entered and so
avoids long runtimes when calling the view.

333
ISHMED_MAIN: End of Maintenance for Obsolete ABAP Objects
(Deleted)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the following ABAP
objects are obsolete and no longer maintained. Note that these objects will no longer
be available with the next Release.
Function module ISH_N2_GET_STRUCT_DATA
The where-used list identifies this module as not used.
Function module ISH_N2_FILL_MULTIPLE_STRUCTURE
The where-used list identifies this module as not used.
Function module ISH_N2_GET_TEXT_TABLE
The where-used list identifies this module as not used.
Function module ISH_N2_GET_TEXT_SAPSRIPT
The where-used list identifies this module as not used.
The classic BAdI ISHMED_DOC_CONTENT is no longer maintained. Use the
enhancement spot ES_ISHMED_DOC_CONTENT only.
The enhancement spot technology offers better performance than using classic BAdIs.

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ISHMED_MAIN: Use of Dictation Systems in i.s.h.med (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the generic
programming interface i.s.h.med dictation API is available. This object-oriented
programming interface comprises interfaces and classes which can be used to
integrate dictation and speech recognition systems in i.s.h.med objects in abstracted
and standardized form.
Using this interface you can create and manage dictations for patients, for employees
responsible, and for documents (PMD documents or WordContainer documents).
These functions are incorporated in the new view type Dictations in the Clinical Work
Station.
To use the dictation API you require the license key Interface for Dictation
Connection.
Effects on Customizing
Perform the following IMG activities to connect a dictation and speech recognition
system using the dictation API:
Initialize Dictation and Speech Recognition System
BAdI: Implement Speech Recording Functions
BAdI: Implement Speech Recognition Functions
Maintain Dictation and Speech Recognition System
Assign Dictation and Speech Recognition System to a Terminal
See also
Dictation Work Station (New)
Integration of Dictation Functions in PMDs (New)
Functions of DICTATION Link Module (New)
Dictation and Speech Recognition via Dialog Box (New)
Dictation and Speech Recognition Functions in the WordContainer (New)

335
ISHMED_MAIN: Integration of Dictation Functions in PMDs (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN) , you can use dictation
systems in parameterized documents (PMDs). This is accommodated by the
DICTATION link module or a modal dialog box.
In order to integrate the DICTATION link module you have to create a documentation
element of the link element type. You integrate this documentation element in the
document category definition of your PMD. This documentation element then enables
you to control the functions of the dictation system.
To integrate the modal dialog box, create your own includes for data and routines in the
document category definition of your PMD on the User Exits tab page.
To access the document category definition, choose Clinical System -> Basic Clinical
Data -> Clinical Documentation -> Document Definition -> Document Element ->
Create.

See also
Use of Dictation Systems in i.s.h.med (New)
Functions of DICTATION Link Module (New)
Dictation and Speech Recognition via Dialog Box (New)

336
ISHMED_MAIN: Functions of DICTATION Link Module (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the DICTATION link
module lets you integrate functions of installed dictation and speech recognition
systems in a PMD.
The module can be used in enhanced or simplified mode.
Enhanced mode includes a pushbutton for executing dictation functions and a tree
display in which dictations, recordings and additional information are displayed.
In simplified mode, the application toolbar contains fewer functions and has no tree
structure. The number of recordings created is displayed in an information line. We
recommend that you use this mode if you process only one recording at a time.
You can adapt the standard functions in the application toolbar to satisfy your
requirements by using the IMG activity Adapt Application Toolbar.
Not all functions are possible in every status of a recording.
The behavior of the functions described in the following depends on the actual
implementation.
Functions in Enhanced Mode (Standard Mode)
Use Create Dictation to create a dictation and a corresponding recording in the
system. A dictation comprises one or more recordings.
You use Create Recording to create new recordings for a dictation. A recording can
be of the Dictation, Additional Information, Work Instruction or Correction type.
You use Change Author to change the author of your recording. This function can only
be executed in the recording status.
You use Dictate to start the speech recording. For further information about this, see
the IMG activity Implement Speech Recording Functions.
You use Speech Recognition to start the online speech recognition.
You use Start Transcription/Correction to start the transcription or correction of a
recording.
You can interrupt the transcription using Interrupt Transcription.
You can end transcription using End Transcription.
You can play the recording using Listen/
Display Dictations
Dictations and recordings are displayed in a tree display. Each recording
includes information on the author, clerk, recording status, recording type,
creation date, and creation time.
Functions in Simplified Mode
You use Dictate to create a recording for a dictation and start speech recording. If no
dictation exists, the system will create one.
You use Speech Recognition to create a recording for a dictation. If no dictation
exists, the system will create one.
The system will start the online speech recognition.
The following functions behave in the same way as in enhanced mode:
Start Transcription/Correction

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Interrupt Transcription
End Transcription
Listen
Display Dictations
The system displays the number of recordings in an information line. If only one
recording exists, the system will also show the status of this recording.
Settings in the DICTATION Link Module via the Tools Pushbutton
Use Simplified Mode indicator
Define keywords for speech recognition and stipulate insert mode.
You make the setting in the document category definition of the PMD. On the SAP
Easy Access screen, choose Clinical System -> Basic Clinical Data -> Clinical
Documentation -> Document Definition -> Document Category or perform the IMG
activity Assign Keywords to Text Fields.

Authorizations
You control the authorizations for dictation and speech recognition by means of the
authorization object N_2DIKTAT.
The fields
Author of speech recording
Clerk
Activity
Create Dictation
Create Recording
Dictate
Speech Recognition
Play Recording
Transcription
Delete Recording
let you protect your dictations and recording against unauthorized access.
User Parameters
N2DI_AUTHOR Preset the Author of the Recording
N2DI_HIDE Suppress Dialog for Selecting Author
X Selection dialog will be suppressed
Parameter not set: Selection dialog will be displayed

Effects on System Administration


To use dictation functions in parameterized documents, a dictation system must be
configured or simulated on your work station. For further information about this, see the
Release Note Use of Dictation Systems in i.s.h.med (New).

See also
For more information about Dictation and Speech Recognition, see Customizing for
i.s.h.med under SAP Healthcare - Industry-Specific Component Clinical System ->

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Clinical Documentation-> Dictation and Speech Recognition.
Implement Speech Recording Functions
Implement Speech Recognition Functions

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ISHMED_MAIN: Dictation and Speech Recognition via Dialog Box
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can integrate
functions of a dictation system in a dialog box of a PMD. This dialog box is also
available in the Dictation view type of the Clinical Work Station.
You integrate the modal dialog box in the PMD as follows:
Create your own includes for data and routines (for example, Z*_TOP and Z*_FUNC) in
the documentation category definition on the User Exits tab page.
Incorporate the shipped include rn2di_integration_pmd2_top into your own data
include.
Incorporate the shipped include rn2di_integration_pmd2_top into your own routine
include.
Create subroutines for the events PAI, Start, End (for example, Z_UEX_PAI...) in your
own routine include.
In the respective subroutine, call the relevant routines from the shipped routine include
rn2di_integration_pmd2_exit.
PAI: n2di_gen2_pai
Start: n2di_gen2_start
End: n2di_gen2_end
Create your own GUI status on the Dialog Interfaces tab page (using a main program
for function groups, using a module pool or a report).
Copy the GUI status DATAMUL in the program SAPLN2PT into your own status and
enhance this with a pushbutton that has the function code N2DI for calling the
dictation and speech recognition functions.
Effects on System Administration
To use the dictation functions, a dictation and speech recognition system must be
configured or simulated on your work station. For further information about this, see the
Release Note Use of Dictation Systems in i.s.h.med (New).

See also
For further information about the functional scope of the dialog box, see the Release
Note Functions of DICTATION Link Module (New).
For further information about Dictation and Speech Recognition, see the Release Notes
Use of Dictation Systems in i.s.h.med (New) and Integration of
Dictation Functions in PMDs (New) .
For information about the Dictation view type, see the Release Note Dictation Work
Station (New).

340
ISHMED_MAIN: Dictation and Speech Recognition in the
WordContainer (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can use functions of
implemented dictation and speech recognition systems in the WordContainer in a
modeless dialog box.
In the Word template, you have to create a macro for transferring the dictation.
For sample program code and further information, see the documentation for the IMG
activity Assign Dictation Function to a WordContainer Document Category.
Effects on Customizing
To integrate dictation systems in the WordContainer, perform the IMG activity
Assign Dictation Function to a WordContainer Document Category.
See also
For information about the scope of the function, see the Release Note Dictation Work
Station (New).
For further information about Dictation and Speech Recognition, see the Release Notes
Use of Dictation Systems in i.s.h.med (New) and Integration of Dictation
Functions in PMDs (New).

341
ISHMED_MAIN: Laboratory Cumulative Findings - Web Dynpro
Application (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), cumulative findings are
provided in a web dynpro.
The cumulative findings web dynpro is an alternative display function for laboratory
values to previous display in ABAP list format. This function is available to you both for
individual patients and for all patients on a care unit. The values are presented as
expanded value groups and, in each case, contain unit, normal range and value label
together with the value itself. You are also provided with a graphic display of the
evolution of each value. A time transferred by the laboratory interface is assigned to
each value in the graphic and the list.
Integration
You can access the function on the initial screen of the cumulative findings using the
new buttons Web Display and Web Display (Care Unit).
Effects on Customizing
You can also define the number of lines for the cumulative findings web dynpro in
Customizing.

342
ISHMED_MAIN: Delete Obsolete ABAP Objects (Deleted)
Use
As announced in Release SAP ECC Industry Extension Healthcare 6.00, the following
ABAP objects have been deleted with SAP ECC 6.0, Industry Extension Healthcare,
Enhancement Package 4 (IS-H 604), Business Function Clinical System
(ISHMED_MAIN):
Function module ISH_N2_DOCUMENT_SELECT
If you used the module to select documents without dialog (parameter
SS_DYNPRO = 'NO'), you should now use the function module
ISH_N2_MEDDOC_GETLIST.
If you used the module to select a document from a list of documents in the
dialog (parameter SS_DYNPRO = SPACE / 'YES'), you should now use the
function module ISH_N2_DOC_F4_DOC.
Function module ISH_N2_MAP_BAPIRET_2_MESG
Use the static method CL_ISHMED_DOC_MAP=>BAPIRET_2_MESG instead.
Function module ISH_N2_MAP_VCODE_2_METHOD
Use the static method CL_ISHMED_DOC_MAP=>VCODE_2_METHOD instead.
Function module ISH_N2_MAP_DOCDATA_2_DVSDATA
Use the static method CL_ISHMED_DOC_MAP=>DOCDATA_2_DVSDATA
instead.
Function module ISH_N2_MAP_DOCDATAIN_2_DVSDATA
Use the static method CL_ISHMED_DOC_MAP=>DOCDATAIN_2_DVSDATA
instead.
Function module ISH_N2_MAP_DOCDATAX_2_DVSDATAX
Use the static method CL_ISHMED_DOC_MAP=>DOCDATAX_2_DVSDATAX
instead.
Function module ISH_N2_MAP_DRAW_ETC_2_DOCDATA
Use the static method CL_ISHMED_DOC_MAP=>DRAW_ETC_2_DOCDATA
instead.
Function module ISH_N2_MAP_DRAW_ETC_2_DVSDATA
Use the static method CL_ISHMED_DOC_MAP=>DRAW_ETC_2_DVSDATA
instead.

343
ISHMED_MAIN: Print Format XLSFO (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can print
parameterized documents (PMDs) including image data.
Link elements can be included in PMDs. The user can display or enter further data,
such as images, within these link elements. Such a link element belongs to the
interface for digital image management. The link element is used to enter images
within a PMD.
Previously, these images could not be printed at sufficient resolution in SAPscript
standard, which meant that alternative solutions had to be worked with (text printing via
SAPscript and separate image printing from within the image program).
Effects on System Administration
This print application requires a JAVA service in addition to the shipped ABAP objects.
For further information, see the XSLFO print application manual in the SAP Note
920867.

See also
This print application is available as part of image integration within the departmental
solution i.s.h.med gastro (gastroenterology). If you are interested, please contact
Siemens Medical Solutions GSD Sales.

344
ISHMED_MAIN: Print Format BAdI (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can implement your
own print procedure for parameterized documents. For this, you have to enter the
format BADI for the action Print or Print Preview in a document category.
Using the enhancement spot ES_ISHMED_DOC_FORMAT_BADI you can implement
your print solution. You can override the standard print output by implementing this
BAdI.
The defined filters make it possible to implement the BAdI for specific document
categories.

345
ISHMED_MAIN: Dispatch Route EDIVKA for Document Dispatch AT
(New)
Use
This Release Note is relevant for the country version Austria only. Documentation is not
available in English.

346
ISHMED_MAIN: OU-Related Document Profile (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), OU-related document
profiles are processed in standardized table maintenance.
You access processing by choosing Clinical System -> Basic Clinical Data ->
Clinical Documentation -> Document Definition -> OU-Related Document Profile.
Besides the standard functions such as the transport connection, table comparison, BC
sets and validity specifications, additional functions are also provided.
Table maintenance is institution-specific and is performed in a two-level dialog in the
navigation tree.
OU-Related Document Profile
Here you enter the organizational units (OUs) for which a document profile is to be
created or edited.
You can copy existing OU profiles with all their properties.
OU-Related Document Profile pushbutton
Here you receive a list of the document profiles of the selected OUs.
Document Category Assignments
Here you assign document categories and the corresponding profiles to the selected
OU.
Where-Used List pushbutton
Here you can see the OUs which use the selected combinations of document
category and document profile.
Assign Documents pushbutton
You can assign entries from the OU-related document profile to other OUs.
Select the corresponding document category assignments and chooseAssign
Documents. You then select the OUs to which you wish to assign these
document categories in the same way. In addition, you can determine the period
of validity for the document category assignments to be created. This entry is
optional.
During the assignment process, the system transfers all attributes of the selected
document category assignment to the new document category assignment, for
example, document profile and validity specification.
Note that this function only creates new document category assignments but
does not overwrite existing assignments.
Terminate Documents pushbutton
You can simultaneously terminate document category assignments for all OUs.
Select the corresponding document category assignments and then choose
Terminate Documents.
Enter the end of validity. The system will then simultaneously terminate the
document category assignment entry with the highest valid to date for all OUs.
Note that only the stored dataset is analyzed during evaluations.
If you wish to use the transport connection and comparison options, you must ensure
that the document categories referenced in the document profiles exist on the target
system.
See also
The following reports for processing an OU-related document profile are obsolete and
can no longer be executed:

347
RN2_DOKUMENT_OE_AENDERN Change Document Category
Assignment to OU (Table N2DO)
RN2_DOKUMENT_ORGEINHEIT Assign Documents to Organizational
Unit (Table N2DO)

348
ISHMED_MAIN: Service-Related Document Profile (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), service-related
document profiles are processed in standardized table maintenance.
You access processing by choosing Clinical System -> Basic Clinical Data ->
Clinical Documentation -> Document Definition -> Service-Related Document
Profile.
Besides the standard functions, such as the transport connection, table comparison,
BC sets and validity specifications, additional functions are also provided.
Table maintenance is institution-related and is performed in a two-level dialog in the
navigation tree.
Service-Related Document Profile
Here you enter the services for which a document profile is to be created.
At this level, you can also copy existing service profiles with all their properties.
Service-Related Document Profile pushbutton
Here you receive a list of the document profiles that are assigned to the selected
services.
Service-Document Category Assignments
Here you assign document categories and their corresponding properties to the
selected service.
Where-Used List pushbutton
Here you can see which services the selected document categories are assigned
to.
Assign Documents pushbutton
You can copy document profiles from the service-document category assignment
for other services.
Select the rows with the corresponding assignments and choose Assign
Documents. You then select the services to which you wish to assign these
document profiles. In addition, you can determine the period of validity for the
document category assignments to be created. This entry is optional.
During the assignment process, the system transfers all attributes of the selected
document category assignment to the new document category assignment such
as, for example, the document profile and validity specification.
Note that this function only creates new document category assignments; it does
not overwrite existing assignments.
Terminate Documents pushbutton
You can simultaneously terminate document category assignments for all
services. Select the corresponding document category assignments and then
choose Terminate Documents. Enter the validity period. The system will then
simultaneously terminate the document category assignment entry with the
highest valid to date for all services.
Note that only the stored dataset is analyzed during evaluations.
If you wish to use the transport connection and comparison options, you must ensure
that the document categories referenced in the document profiles exist on the target
systems.
See also
The following report for processing the service-related document profile is obsolete and

349
can no longer be executed:
RN2_DOKUMENT_LEISTUNG Assign Documents to Services (Table
N2DL)

350
ISHMED_MAIN: Evaluations - Master Data (Enhanced)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the following additional
evaluations are available under
Clinical System -> Basic Clinical Data - Clinical Documentation -> Evaluations ->
Master Data:
List Report OU-Related Document Profile
List Report Where-Used List of Document Categories in OUs
List Report Service-Related Document Profile
List Report Where-Used List of Document Categories for Services

Effects on Customizing
To set up the reports, you have to perform the IMG activity Assign Reports to
Report Groups under Report Control in Customizing for IS-H.
The new reports are delivered in the report group MD Med. Basic
Lists/Documentation.

351
ISHMED_MAIN: Use of Selection Variants (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can define selection
variants to determine which documents a link element of the type DocViewer is to
output.
You can use the following characteristics for the selection:
Case
Documenting OU
Employee Responsible
Document Type
Document
Document Category ID
Changed By
Document Date
Changed On
Created On
Maximum Number of Hits
Ignore Own Document
Since these characteristics can also be changed at runtime, Case and Document,
which are not useful in a preset selection variant, are also included.
The system uses the specified selection variant when loading the DocViewer to
determine the initial set of the displayed documents. Patient and case are added by the
system.
You can change the selection options at runtime using the Change Selection
Parameters pushbutton.
You can switch the case reference on and off using the Case Reference pushbutton.
Effects on System Administration
The settings dialog has been enhanced. A selection field has been added for the
selection variant. Pushbuttons for the following functions have also been added to the
selection variant:
Create
Change
Copy
Delete (relationship to the document category)
Transport
Display
Where-Used List
The previous selection conditions can be replaced by selection variants. Old settings
remain effective.

352
ISHMED_MAIN: WordContainer Documents - "Get Data" (Enhanced)
Use
In WordContainer documents, a dialog can be opened via the Get Data function, in
which the DocViewer displays all the documents for the patient/case.
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), it is possible to restrict
the number of documents displayed in this dialog. To do this, you can specify a
selection variant in Customizing for the relevant document, which the system takes into
account when selecting the documents.
You define which documents are selected in the respective document definition using
the Get Data function.

353
ISHMED_MAIN: BAdI ISHMED_DOC_CONTENT Has Been Replaced
(Enhanced)
Use
Some i.s.h.med applications display medical documents in their own dialog. The
Patient Organizer displays them, for example, in PDF format. The function module
ISH_N2_MEDDOC_GETCONTENT is used for this purpose.
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN) the enhancement spot
ES_ISHMED_DOC_CONTENT can be used to convert documents into another format,
for example PDF.
The classic BAdI ISHMED_DOC_CONTENT with the same functionality is no longer
maintained. Please use only the enhancement spot ES_ISHMED_DOC_CONTENT.
The new enhancement spots perform better than classic BAdIs.

354
ISHMED_MAIN: Dispatch Control (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), there is an additional
module for dispatching clinical documents. Dispatch control, like document dispatch
(which is already used) too, is integrated in a document. Dispatch control provides
flexible options for presetting order fillers dependent on document category, institution,
and documenting organizational unit. Documents can also be dispatched by fax and
email. You can integrate the address table directly into the document as a link element.
Using presettings, input fields can be defined with custom entry of address. Every
presetting can be changed prior to dispatch. A log record is created of the dispatch.

Effects on Customizing
In Customizing for i.s.h.med all the modules for dispatching documents are grouped
under Clinical Documentation -> Dispatch Document. The settings for dispatch
control are located under the identically named subnode. Here you can make the
relevant presettings. You can find the BAdIs for customer-specific enhancement under
Dispatch Control Enhancement Options.

355
ISHMED_MAIN: Maintenance for Document Dispatch Discontinued
(Changed)
Use
The maintenance for document dispatch is being phased out. This has the following
consequences:
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), errors will only be
corrected if they cause data loss.
As of the next Enhancement Package, maintenance for document dispatch will cease
completely.
Document dispatch is replaced by dispatch control. Since the maintenance for
document categories of generation version 1 is also being discontinued, we strongly
recommend that you take the opportunity to change over to dispatch control when you
migrate the document categories from generator version 1 to generator version 2.
Effects on Existing Data
For information about transferring existing data, see SAP Note 1132519.

See also
ISHMED_MAIN: Dispatch Control (New)
ISHMED_MAIN: Maintenance Doc.Ctgrs Gen.Ver.1 Discontinued
(Changed)

356
ISHMED_MAIN: Message Control in Diagnosis Processing (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can control whether
and with which message type the following message is to occur in diagnosis
processing:
NG341 - Diagnosis & is assigned to a document
This message is issued if you attempt to cancel a diagnosis in diagnosis processing
which is already assigned to a medical document via the external data module. The
default type for this message is W (warning).
You can selectively suppress the output of this message for diagnosis processing via
message control. To do this, set the Suppress indicator for this message there.
Effects on Customizing
To change the preset message output or to suppress messages in diagnosis
processing, in Customizing for IS-H choose SAP Healthcare - Industry-Specific
Components for Hospitals -> Basic Settings -> System Parameters -> Message
Control -> Maintain Messages.

357
ISHMED_MAIN: Preregistration - Business Add-Ins (Deleted)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the following Business
Add-Ins (BAdIs) for the (old) preregistration, which has been superseded by the clinical
order since Release 4.72, are no longer available in the system:
N1_PREREG_CHECK (Check Preregistration in Dialog)
N1_PREREG_PREALLOC (Preset Preregistration in Dialog)
N1_PREREG_USER_COMM (Preregistration (Dialog) - Function Handling)
N1_VKPRINT (BAdI for Preregistration List)
These BAdIs have been deleted in the system.

358
ISHMED_MAIN: Clinical Order - New Business Add-Ins (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the following new
Business Add-Ins (BAdIs) are available for the clinical order:
ISHMED_CHEAD_DIALOG: Control Dialog for Header Components
You can use this BAdI to determine whether the system displays header
components in expanded or collapsed form.
Note that an implementation of this BAdI overrides the user parameter
N1CORD_HEAD.
ISHMED_CPOS_DIALOG: Control Dialog for Order Items
You can use this BAdI to determine whether the system displays an order item in
expanded or collapsed form.
Additionally, you can use this BAdI to determine which data the system is to
display in the Date/Time field of an order item. As of SAP ECC 6.0, Industry
Extension Healthcare, Enhancement Package 4 (IS-H 604), Business
Function Clinical System (ISHMED_MAIN), this date and time can be an
appointment template, an appointment, or a movement (see Release Note
Order Item - Integration in Component Concept (New)). You an
also make presettings using this BAdI.
Note that an implementation of this BAdI overrides the user parameter
N1CORD_POS as well as the standard logic for displaying appointment,
template, appointments, or movements.
ISHMED_CPOS_PREALLOC: Presetting of New Order Items
To supplement the existing BAdI N1_CORDER_PREALLOC for presetting the
header data of a clinical order, the BAdI ISHMED_CPOS_PREALLOC lets you
preset new order items. This BAdI enables the customer-specific presetting of
the following information:
Order Filler
Preregistered indicator
Case
Tab page data for application components of an item
Note that it is not possible to preset the item status, as this is set by the initial
status according to the status profile when an item is created.
The system runs this BAdI
When creating an order item or when changing the order type of an item, as
soon as the user has confirmed the deletion of the existing item
When creating a clinical order by means of the hit list (once per selected order
type)
When expanding a profile type (once per elemental type)
ISHMED_CORD_GUISTAT: Override GUI Status
You can use this BAdI to adapt the GUI status of the dialog for creating,
displaying, and editing a clinical order to satisfy customer-specific requirements.
The new BAdIs are combined in the enhancement spot ES_ISHMED_CORDER.

359
ISHMED_MAIN: Order Item Component for Questions (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), a new item component
called Questions is available for the clinical order.
Previously, you could collectively enter the questions for all items at header level. Now
you can design an order type that allows the entry of questions at item level. This is
essentially accommodated by a long text field.
Effects on Existing Data
The corresponding field for questions in the General Medical Data header component
is retained and still allows you to enter questions that apply to all items.
Note that the system does not synchronize both forms of questions (at header and at
item level).
Effects on Customizing
Incorporate the new item component Questions in the usual way in Customizing for the
clinical order types.

360
ISHMED_MAIN: Enhanced Selection List for Order Types (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the selection list for
order types is available with enhanced functionality.
The new selection list for order types optimizes handling thanks to a clearer
visualization of the selection process and also supports enhanced processes (for
example, inter-departmental occupancy scenarios or central planning scenarios).
The following variants of the selection list are now available:
Selection list with the possibility of assigning appointments
Standard selection list
Both variants display an enhanced dialog screen. The major new feature here is the
preselection area in the right-hand part of the dialog screen. In one variant, you can
link order types with appointments which were searched for beforehand, in this area. In
both variants, you can refine the selection of order types, services, and so on (for
example, deselect services from order templates).
You can also change the initiator and filter order fillers in the selection list.
Beyond the existing options for calling the selection list for order types, it is now
possible to call the selection list from planning tools. These calls enable you to assign
appointments and order types as efficiently as possible in the selection list.

361
ISHMED_MAIN: Order Templates (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the order template
functionality is provided for the clinical order.
An order template is a template for a clinical order, based on an order type. The system
administrator can define specific data, such as services and questions, in the template.
If the user selects the template instead of an order type when creating a clinical order,
the system prefills the clinical order with the data from the template.
The plausibility checks that execute when an order template is created or changed are
the same as those for a clinical order. This means that required entry fields that are to
be checked beyond the status-dependent required entry field check also must contain
valid values. This particularly concerns the treatment organizational unit for
surgery/treatment items.
The system displays the order templates in the selection list for order types below the
relevant order type. Within a template, the user can display (expand) the order items
and their services for information purposes, but cannot change them in the selection list
for order types. The user can only ever select either a template or order types in the
selection list for order types.
Note that particular patient-related data is excluded from the template definition. This
data includes, for example, the radiology-related information and specifications for
appointment template and appointment (excluding time dependencies for global
planning). Furthermore, it is not possible to define an initiator in a template, since the
order initiator is already known when the clinical order is created using the selection list
for order types.
You can, however, use the Business Add-In (BAdI) N_APP_CONSTR_CHG to prefill
the appointment template for an order item when an order item is created.

Effects on System Administration


The transport of order templates is coupled with that of the order types. This means
that when the templates are changed, the complete order type must be transported.
Effects on Customizing
Configure new order templates in the function for setting up order types (transaction
code N1COT, Create / Change Order Type function, Order Templates tab page).
Each template has a freely selectable description. By default, this is the name of the
order type.
Note:
You must activate order templates in the column provided for this purpose in the
template overview to ensure that these templates are displayed in the selection
list for order types. You can deactivate order templates that are no longer
required.
There is no technical data connection between an order template and a clinical order
that is created in the system using this template. Consequently, the deletion of
an order template causes this to be physically deleted from the database.
The order type on which a template is based must exist in the system at the time the
template is created. From this it follows that the system saves the order type if
you are creating the order type and while doing so create a new template.

362
When the user deletes address data at order type level, the system informs them of
possible effects on existing data (templates and clinical orders). The system
does not check whether the deleted order filler is contained in a template. The
system cannot save a clinical order, which is based on such a template and
whose fillers are restricted, without a change to the order filler.
When application components are added for an order type, these are subsequently
also available in the template. When you delete application components from an
order type, these are also deleted from the template (note that you can only
delete components from an order type if there are not yet any clinical orders for
this order type).

363
ISHMED_MAIN: Clinical Order - Various Changes (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the following changes
and enhancements are available for the clinical order:

Service Component: Method SET_SERVICE_2_UA


You can use this new method of the service component to reset several services to the
service status "Unconfirmed Requested" in one step when the status of the order item
is changed.
The new method SET_SERVICE_2_UA is thus the counterpart of the method
SET_SERVICE_2_CF with which you can confirm the services, which are entered in
the service component of the clinical order, by changing the item status.
You can incorporate these new status-dependent methods on the Methods tab page in
the function for maintaining clinical order types (N1COT). The prerequisite is that you
use the services component in the corresponding order type.

Print Functions
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the submenu for printing a
clinical order has been restructured, as follows:
Overview Print -> Standard Form
Overview Print -> Choose Form
Order -> Standard Form (previously Detail Printout of Order)
Order -> Choose Form (new)
Order Item -> Standard Form (previously Detail Printout of Item)
Order Item -> Choose Form (new)
Print -> Log
You can call these print functions in the clinical order in the menu under Order -> Print.
In the new menu options you can use forms developed by customers when printing
clinical orders and/or their items. The corresponding function codes are also available
in the relevant views of the clinical work station.

Employee as Order Filler


The Release Notes for SAP ECC Industry Extension Healthcare 6.0 (chapter 2.7.2)
state that you can address a clinical order to persons who are defined as physicians in
the system. This information is not correct. There is no dialog box for you to confirm
that the employee to whom the clinical order is addressed is a physician.
Note that you can address clinical orders to all kinds of employees who are created in
the system.

364
BAdI N1_PERFORM_SERVICE: Sample Code for Checking Postdischarge
Treatments
The system currently does not prevent services from being released and movements
from being created when the patient has already been discharged (postdischarge
treatments). However, legal requirements in certain countries do not allow this. For this
reason, you can use the Business Add-In (BAdI) N1_PERFORM_SERVICE to
configure a customer-specific check.
To facilitate the implementation of this kind of check, corresponding sample code for
the BAdI N1_PERFORM_SERVICE is available as of SAP ECC 6.0, Industry
Extension Healthcare, Enhancement Package 4 (IS-H 604), Business Function
Clinical System (ISHMED_MAIN).

New Order Item - Selection List


As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), when you create new
order items or change existing order items, the system will always branch into the
selection list for order types. This change replaces in particular the list box for selecting
clinical order types in the item overview row.

Display Telephone Number of Employee Responsible


As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the system displays the
telephone number of the employee responsible (EmR) in the clinical order dialog when
the user clicks the name of the EmR and this telephone number (extension number) is
maintained in the employee data.

Order Type: Service Selection Required in Service List for Order Types indicator
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), in Customizing you can
stipulate for an order type that the selection of a service is mandatory in the selection
list for order types. For this order type this means that the user must select a service in
the selection list.
Note that this setting only concerns the behavior of the selection list. You still use
status-dependent screen modification to stipulate whether services in a specific order
item status are actually required.

Clinical Order: New Object Classes (New)


Note that the following classes are obsolete and have been replaced by others:
CL_ISH_SCR_CORDPOS_SHORT replaced by CL_ISH_SCR_CPOS_SHORT
CL_ISHMED_SCR_CORDPOS_SHORT replaced by
CL_ISHMED_SCR_CPOS_SHORT
Check any BAdI implementations or modifications, and adapt these, if required.
For further information, see the Release Note. ISHMED_MAIN: Order Item -

365
Integration in Component Concept (New)

366
ISHMED_MAIN: Header/Item Components - Flagging of Required Entry
Fields (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the system can flag tab
pages of header components and item components of a clinical order using red and
green LEDs (icons).
The system flags the tab pages as follows:
Green LED: Indicates that all entry fields required for a status change are filled
Red LED: Indicates that not all entry fields required for a status change are filled
Effects on Customizing
You can use the system parameter N1COICON to activate and deactivate this flagging
with green and red LEDs. For user-specific settings, the identically named SET/GET
parameter is available that overrides the system parameter setting.
If you activate this flagging, the system must check for each field on each tab page for
header or item level components to see whether it is a required entry field, depending
on the status of each item. You should therefore note that the activation of this flagging
may have consequences for the performance of the system. The flagging of the tab
pages is therefore not active as standard.

367
ISHMED_MAIN: Order Item - Integration in Component Concept (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the order item row of a
clinical order, in the same way as order data, patient data, and header data, is an
application component as used in the component concept of the clinical order.
Consequently, the following order item data is also integrated into the status-dependent
screen modification:
Treatment Organizational Unit (OU)/Addressed Person
Departmental OU
Status
Preregistered indicator
Date and time of the appointment
Date and time of the appointment template (desired time)
Date and time of the admission/visit
Case
Pushbuttons: Treatment OU/Addressed Person, Change Appointment Template,
Change Appointment, Find Appointment, Display More Appointments,
Remove from Case, Create Admission/Visit
Effects on Existing Data
In the course of the changeover to SAP ECC 6.0, Industry Extension Healthcare,
Enhancement Package 4, Business Function Clinical System (ISHMED_MAIN),
the system initializes the order item fields of all existing order types as optional entry
fields.
Note that this does not affect the program-technical difference between optional entry
fields and required entry fields because the status-dependent screen modification has
always constituted an extension to the required entry field check by the application.
Effects on Customizing
The creation and editing of order types and the associated management of the status-
dependent screen modification is performed, as usual, using transaction N1COT or in
the IMG activity Set Up Order Types for Clinical Order.
The following new status-dependent methods are available for the item row in the
standard system:
SET_PLNICON_2_APCN: When the status changes, the system displays the
appointment template data in the Date/Time field.
SET_PLNICON_2_APPMT: When the status changes, the system displays the
appointment data in the Date/Time field.
SET_PLNICON_2_VISIT: When the status changes, the system displays the visit data
in the Date/Time field.
For further information about these methods, see the Release Note ISHMED_MAIN:
Order Item: Service Planning/Scheduling (Changed) under Display of Desired
Appointment, Appointment, and Movement.
Note that the following classes are obsolete and have been replaced by others:
CL_ISH_SCR_CORDPOS_SHORT replaced by CL_ISH_SCR_CPOS_SHORT

368
CL_ISHMED_SCR_CORDPOS_SHORT replaced by
CL_ISHMED_SCR_CPOS_SHORT
Check any BAdI implementations or modifications, and adapt these, if required.

369
ISHMED_MAIN: Order Item - Service Planning/Scheduling (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the following
enhancements to the planning and scheduling of services are available in the clinical
order environment:
Display of desired appointment, appointment, and movement
The field header Appointment of the item row has been renamed as Date/Time.
The pushbuttons Change Appointment Template and Change Appointment
have been combined in a dropdown box, in which it is also possible to display a
visit time. Choose appointment, or movement from the dropdown box. When you
click the displayed icon (for example, for the appointment template), the system
calls the Edit Appointment Template dialog box or the Maintain Appointment
dialog box depending on this icon.
Depending on which icon is shown, the system will display the following
information in the Date/Time field of the order item:
Time of the desired appointment (can be changed)
Time of the appointment (can be changed)
Time of the visit (can be changed)
Note that you cannot create or change a visit by entering or changing the value
in the Date/Time field, since the specific checks of the Clinical Process Builder
(NV2000) are not available here. This means that you must still create
movements using the Admission/Visit pushbutton.
The presetting of the Date/Time field obeys a logic that is described in detail in
the online documentation. You can override the presetting logic to satisfy
customer-specific requirements using the Business Add-In (BAdI)
ISHMED_CPOS_DIALOG.
Note that content checks are not affected by this enhancement.
Display More Appointments function
An order item can be linked with other appointments (and consequently visits
also) by means of the services. However, for reasons of space and clarity, the
system can only ever display one entry in the Date/Time field of the order item.
Dependent on the existing data, this is the chronologically first appointment that
has not yet been attended or the chronologically last visit.
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4
(IS-H 604), Business Function Clinical System (ISHMED_MAIN), next to the
function for calling the planning tool in the item row, a pushbutton is provided that
is always active when the service component is integrated in an item.
If more than one appointment exists for an order item, the system indicates this
by coloring the pushbutton (similarly to the pushbuttons for multiple selections).
When you choose the pushbutton, the system expands the order item and
displays the service component.
If you show the appointment data and visit data in the layout of the service
component, you can thus easily display all appointment-relevant and movement-
relevant data of an order item.
Note that the established function, which, when there are several appointments,
displays a dialog box when you choose the Change Appointment pushbutton,
remains unchanged.
These changes are also to be seen as part of the integration of the order item in the
component concept of the clinical order. For detailed information about this integration,
see the Release Note. ISHMED_MAIN: Order Item - Integration in
Component Concept (New).

370
Effects on Customizing
You can use the BAdI ISHMED_CPOS_DIALOG to override the standard logic that
determines whether the system displays desired appointment, appointment, or visit in
the order item. For details about the standard logic, see the online documentation.
Furthermore you can use the following status-dependent methods for the item row
when changing the status of the order item to change the information displayed in the
Date/Time field:
SET_PLNICON_2_APCN: When the status is changed, the system always displays the
appointment template data.
SET_PLNICON_2_APPMT: When the status is changed, the system always displays
the appointment data.
SET_PLNICON_2_VISIT: When the status is changed, the system always displays the
visit data.
See also Release Note ISHMED_MAIN: Order Item - Integration in
Component Concept (New)
See also
For detailed information about the appointment-relevant and movement-relevant fields
that have been added to the column set of the service component, see the Release
Note. ISHMED_MAIN: Service Component - Integration of Planning
(New).

371
ISHMED_MAIN: Service Component - Integration of Planning (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the service component
of the clinical order has been enhanced to enable you to display and plan appointments
for individual services and display the date and time of desired appointment and visits.
The column set of the service component contains the following additional columns:
Date and time of the appointment with which the service is connected
Date and time of the desired appointment according to appointment template
Date and time of the visit with which the service is connected
Moreover, the following new pushbuttons are available in the GUI status of the service
component:
Create / Change Appointment
In the same way as for the order item and depending on whether an appointment
already exists, this pushbutton calls the Create Appointment or Change
Appointment function (appointment editor) for one or more appointment(s), as
follows:
If none of the selected services has an appointment, all services receive the new
joint appointment.
If you select exactly one service with an appointment, the system changes the
existing appointment.
If you select several services with several appointments, the system behaves in
the same was as for the Enter Appointment function of the clinical work
station. In other words, the system connects all services with a joint
appointment and cancels the remaining appointments without dialog.
If you do not select a service, or none of the selected services are plannable, the
system displays an error message.
Create Visit
You can use this pushbutton to create a new visit for a service (with or without
appointment) using the Clinical Process Builder (transaction NV2000). Note the
following system behavior:
If an appointment already exists, the system assumes that all other services
which are connected with the appointment, also belong to this visit.
If you call this function with several selected services, calling is only possible if
none of the services have an appointment (in this case, the system
connects all services with the visit to be created) or all services have the
same appointment.
If you do not select a service and choose this pushbutton, the system displays an
error message.
It is not possible to call a planning tool, since this is also possible from the order
item and, as a rule, all services of an order item are listed for scheduling.
The desired date is always the same for all services of an item, as this is
connected with the order item. It is still contained in the column selection,
so that you can simply compare it with the appointment and movement
data.
Note the following special features:

372
Services of a surgery item must always be connected with the same appointment and
the same movement. It is not therefore possible to change appointment and
movement data in the service component for surgery items.
In the collective mode of the clinical order, the desired date and appointment are not
ready for input in the service component.
When you copy a service in the service component (Duplicate Row function) the
system does not copy appointments.
For technical reasons it is still necessary for the system to check all services of an item
when planning only one appointment for one or more service(s). This can lead to
you not being able to plan an appointment for a service, because, when calling
the planning tool, the system determined that a required entry for another service
has not been filled.

Effects on Customizing
The new columns of the service component are also integrated in the status-dependent
screen modification. This means you can show or hide individual fields depending on
the item status. It is therefore not necessary for you to manage the columns using the
(user-specific) layout management.
See also
For further information about the display of desired appointment, appointment, and
movement, see the Release Note
<DS:RELN.ISHMED604_MAIN_CO25>ISHMED_MAIN: Order Item - Service
Planning/Scheduling (Changed).

373
ISHMED_MAIN: Patient Organizer - New Functions and Objects (New)
Use

Showing and Hiding the Case List in the Patient Organizer


As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN) you can use the new
user parameter N1PO_CASELIST to control display of the case list after calling the
patient organizer (transaction N1PATORG).
The case and the movement provide context information to the patient organizer when
you create new objects such as documents, clinical orders, and medication orders.
These objects require information on which case or which movement they are created
for.
The information which the object in the patient organizer requires depends on the
corresponding object type. For example, when you enter a service, a visit and a case
are required, for clinical orders the patient or the case are sufficient.
If you deactivate the user parameter (default value), the system will only display the
case list when a new object is created and context information is missing.
If you activate the user parameter (value X), the system will always show the case list if
a user calls the patient organizer by means of transaction N1PATORG.
Integration of New Object Types into the Patient Organizer
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can use the
enhancement spot ES_ISHMED_PATORG to integrate new object types into the
patient organizer. If, for example, you have saved data relevant for the electronic
patient record (clinical statement) in customer tables, you can integrate this into the
patient organizer using the Business Add-Ins (BAdIs) in the enhancement spot. For
detailed information, see the documentation for these BAdIs.
Renewable Documents and Accident Data in the Patient Organizer
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the new objects
Renewable Documentas and Accident Data are provided in patient organizer.
In the patient organizer, you can use the new Renewable Documents aspect for the
renewable documents.
If you call the movement data in the patient organizer, the system displays the accident
data as a subscreen for the corresponding movement, provided that such data exists.

374
ISHMED_MAIN: Patient Organizer - Inpatient Progress Note (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), inpatient progress notes
are integrated into the patient organizer.
Integration is accommodated by the new medical object type "inpatient progress note"
that is available in the new standard aspect inpatient progress report and in other
standard aspects. The inpatient progress report aspect shows all entered inpatient
progress notes in chronological order in the list display.
Integration of the inpatient progress notes is also available in the following standard
aspects, in addition to the new aspect inpatient progress report:
Day
Week
Month
Quarter
Year
Case
Problem
Outpatient Clinic Folder
You can use the functions of the patient organizer and the context menu to create,
change, cancel, display, or print inpatient progress notes.
The detail view of the patient organizer displays the inpatient progress report -
comprising all individual inpatient progress notes entered, and in chronological context,
using Web Dynpro technology.
The inpatient progress report has a tabular format and outputs the following information
about an inpatient progress note:
Creation date and time
Note text
Supplementary indicator
Category
Cancellation indicator
Status
Occupational group
Documenting nursing organizational unit
Documenting departmental organizational unit
Employee responsible
You can show further information by means of the column set.
To include all inpatient progress notes in the overview, the system displays the first 50
characters of the note text. You can display longer texts by means of the popin function
provided by the Web Dynpro technology.
Filter functions let you create special views of the inpatient progress report (for
example, all inpatient progress notes that were entered by the occupational group

375
Physician or all progress notes of a particular category).
Communication exists between the inpatient progress notes in the overview display
and the inpatient progress report in the detail view. This means that the system
displays an inpatient progress note selected in the overview as focused in the inpatient
report. Sorting and filtering in the list display has no effect on the inpatient progress
report, and vice versa.
Effects on System Administration
You can deactivate the display of inpatient progress notes in Customizing, for example
if you do not wish to document inpatient progress notes or for other reasons do not
wish inpatient progress notes in the patient organizer.
To activate the display, perform the following steps:
Call transaction SM30.
In the maintenance of table N1WVIEWZ, remove all entries in which the view with ID
SAPIPD01 occurs.
Call transaction SM30.
In the maintenance of table NWPVZ, remove all entries in which the view with ID
SAPIPD01 occurs.

Authorization Check in Patient Organizer


The authorization object N_2IPPD provides the authorization check for the display of
inpatient progress notes.
Effects on Customizing
For the inpatient progress notes to be available in the aspects in the patient organizer,
use the view SAPIPD01 of the object type "inpatient progress note". The inpatient
progress notes are provided as separate nodes in all standard aspects listed above.
See also
For further information about inpatient progress notes, see the Release Note
ISHMED_EDP: Clinical Documentation: Inpatient Progress Note
(New)

376
ISHMED_MAIN: Service Component - Integration of Planning (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the service component
of the clinical order has been enhanced to enable you to display and plan appointments
for individual services and display the date and time of desired appointment and visits.
The column set of the service component contains the following additional columns:
Date and time of the appointment with which the service is connected
Date and time of the desired appointment according to appointment template
Date and time of the visit with which the service is connected
Moreover, the following new pushbuttons are available in the GUI status of the service
component:
Create / Change Appointment
In the same way as for the order item and depending on whether an appointment
already exists, this pushbutton calls the Create Appointment or Change
Appointment function (appointment editor) for one or more appointment(s), as
follows:
If none of the selected services has an appointment, all services receive the new
joint appointment.
If you select exactly one service with an appointment, the system changes the
existing appointment.
If you select several services with several appointments, the system behaves in
the same was as for the Enter Appointment function of the clinical work
station. In other words, the system connects all services with a joint
appointment and cancels the remaining appointments without dialog.
If you do not select a service, or none of the selected services are plannable, the
system displays an error message.
Create Visit
You can use this pushbutton to create a new visit for a service (with or without
appointment) using the Clinical Process Builder (transaction NV2000). Note the
following system behavior:
If an appointment already exists, the system assumes that all other services
which are connected with the appointment, also belong to this visit.
If you call this function with several selected services, calling is only possible if
none of the services have an appointment (in this case, the system
connects all services with the visit to be created) or all services have the
same appointment.
If you do not select a service and choose this pushbutton, the system displays an
error message.
It is not possible to call a planning tool, since this is also possible from the order
item and, as a rule, all services of an order item are listed for scheduling.
The desired date is always the same for all services of an item, as this is
connected with the order item. It is still contained in the column selection,
so that you can simply compare it with the appointment and movement
data.
Note the following special features:

377
Services of a surgery item must always be connected with the same appointment and
the same movement. It is not therefore possible to change appointment and
movement data in the service component for surgery items.
In the collective mode of the clinical order, the desired date and appointment are not
ready for input in the service component.
When you copy a service in the service component (Duplicate Row function) the
system does not copy appointments.
For technical reasons it is still necessary for the system to check all services of an item
when planning only one appointment for one or more service(s). This can lead to
you not being able to plan an appointment for a service, because, when calling
the planning tool, the system determined that a required entry for another service
has not been filled.

Effects on Customizing
The new columns of the service component are also integrated in the status-dependent
screen modification. This means you can show or hide individual fields depending on
the item status. It is therefore not necessary for you to manage the columns using the
(user-specific) layout management.
See also
For further information about the display of desired appointment, appointment, and
movement, see the Release Note
<DS:RELN.ISHMED604_MAIN_CO25>ISHMED_MAIN: Order Item - Service
Planning/Scheduling (Changed).

378
ISHMED_MAIN: Planning Authority for all Organizational Units (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), when you maintain time
slots you can use a wildcard entry (*) to assign planning authority for a specific
planning object for a particular time interval of a day program for all organizational units
(OUs). This makes it possible to grant planning authority to all OUs for a specific
planning object using a singe entry in the Customizing table.
Therefore you can make extensive use of those planning tools which check planning
authorities (especially the planning grid, appointment search and appointment entry)
This means that you no longer have to set up planning authorities explicitly for each OU
involved.

Effects on Customizing
You can use the wildcard entry both in the dialog for changing the planning authority in
the Change Day Program function (transaction NR20) and at the level of day-based
planning authority in the planning grid.
Note that excessive use of the wildcard entry can adversely affect the performance
when the planning grid is called. This is particularly relevant if you have not defined
display variants for the planning grid. In such a case, the system calls the planning grid
with the standard variant which contains all the planning objects in which the planning
OU has planning authority.

379
ISHMED_MAIN: Planning Grid - Open Clinical Order in Change Mode
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can use the
planning grid to open a clinical order which was created for an appointment.
Note that it is not possible to call the clinical order recursively by this means. This
means that you can open a clinical order in change mode from the planning grid and
that you can branch back from the clinical order to the planning grid (new planning grid
instance) in order to, for example, plan a new appointment. However, you cannot then
subsequently open an additional order dialog (e.g. for another clinical order) from the
second planning grid call.

380
ISHMED_MAIN: Planning Grid - Print Function (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can print the time
grid of the planning grid.
For the planning grid printout you can make various settings and presettings (e.g.
adjustment of page orientation; setting whether to display time slots). These depend on
the display variants of the planning grid.
Note that only the tab page currently selected is printed in each case.
The Business Add-In BAdI: Planning Grid Print Settings is available if you
want to make customer-specific changes to the standard print behavior.

Effects on Customizing
In the Create Display Variant or Change Display Variant functions you can use the
Print Settings button to set the print parameters stored for a display variant.
See also
Note that you must have the valid planning grid version installed for SAP ECC 6.0,
Industry Extension Healthcare, Enhancement Package 4 (IS-H 604), Business
Function Clinical System (ISHMED_MAIN). For further information see the following
SAP Notes:
SAP Note 1013957 (Java planning grid under SAPGUI for Windows)
SAP Note 1013958 (Java planning grid under SAPGUI for Java)

381
ISHMED_MAIN: Planning Grid Variant Management (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), enhancements are
provided for managing planning grid display variants.
If several valid display variants exist for a combination of role, user, planning
organizational unit (OU) and planning grid call mode (normal planning, initial visit,
follow-up visit), you can use a new indicator to define one of the variants as a
presetting. The system will no longer display an additional dialog when you call the
planning grid, if several valid display variants are available.
You can use the new user parameter N1PT_INF_DV_UPD_OFF to suppress the check
and update of the following user parameters:
N1PT_INF_DV_NM: (General planning mode display variant )
N1PT_INF_DV_IV (Initial visit mode display variant )
N1PT_INF_DV_FV (Follow-up visit mode display variant)
When you call the planning grid, the logic for determining a display variant is also
adapted according to the new user parameter as follows:
Check 1
The system checks if the user parameter N1PT_INF_DV_UPD_OFF is set:
Yes: Continue with check 3
No: Continue with check 2
Check 2
Depending on the call mode (general planning, initial visit, follow-up visit) the
system checks whether the display variant stored in the corresponding user
parameter for general planning (N1PT_INF_DV_NM), for initial visits
(N1PT_INF_DV_IV) or for follow-up visits (N1PT_INF_DV_FV) is valid for the
current combination of role, user, and planning OU.
Yes: The system calls the planning grid with this variant.
No: Continue with check 3
Check 3
The system checks whether exactly one valid display variant exists for the
planning OU and is also valid:
Yes: The system calls the planning grid with this variant. If the user parameter
N1PT_INF_DV_UPD_OFF is not set, the system also stores this variant in
the corresponding user parameter (depending on call mode).
No: Continue with check 4
Check 4
The system checks if there is exactly one display variant for the current role,
user, and planning OU combination that the Presetting indicator is set for:
Yes: The system calls the planning grid with this variant. If the user parameter
N1PT_INV_UPD_OFF is not set, the system also stores this variant in the
corresponding user parameter (depending on call mode).
No: Continue with check 5
Check 5
The system checks if the user parameter N1PT_INF_DV_SE is set:
Yes: The system displays the dialog for selecting a display variant.

382
Yes: The system calls the planning grid with the standard variant.
With appropriate Customizing, the modified logic enables you to use different display
variants for different planning organizational units (OUs) without the system displaying
the dialog box for selecting a display variant when the planning OU changes.
The check logic is not used if the system can transfer a display variant when the call is
peformed (e.g. with Appointment planning view type or the new Business Add-In BAdI:
Transfer of a Display Variant (ISHMED_PG_DISP_VARIANT).
This new BAdI for transferring a display variant enables you to override the check logic
for determining a display variant. You can transfer an existing variant when the
planning grid is called or dynamically compile the tab pages and columns.

Effects on Customizing
You can set the Presetting indicator in the dialog for assigning display variants to
roles, users, call modes and planning OUs. Note that unlike in the variant management
of ALV grids, several presettings are possible, as the indicator is always only valid for
exactly one combination of these attributes.
The new BAdI for display variant transfer (see above) is provided for the customer-
specific adjustment of planning grid variant management. You can use this BAdI to
both transfer an existing variant when you call the planning grid and compile a dynamic
variant.
See also
For additional customer-specific adjustments to the planning grid, new or enhanced
BAdIs are provided for SAP ECC 6.0, Industry Extension Healthcare, Enhancement
Package 4 (IS-H 604), Business Function Clinical System (ISHMED_MAIN). For
more detailed information, see the Release Note ISHMED_MAIN: Planning Grid
- New and Enhanced Business Add-Ins (New).

383
ISHMED_MAIN: Planning Grid - New and Enhanced Business Add-Ins
(New)
Use
For SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the following Business
Add-Ins (BAdIs) were enhanced for the planning grid:
BAdI: Labeling Planned Appointments
BAdI: Labeling Free Appointments in Time Slots
BAdI: Labeling Time Grid
The following new BAdIs are also available:
BAdI: Labeling Appointment Proposals
BAdI: Labeling Plan Releases
BAdI: Labeling Day Comments
BAdI: Planning Grid Print Settings
In addition to the content (e.g. appointment labeling) and depending upon the
respective BAdI you can make customer-specific adjustments to one or more of the
following attributes:
Font
Font size
Bold print Yes/No
Italics Yes/No
Font color
Background color of appointments and time slots
Display name of scheduling types for group appointments (Yes/No)

384
ISHMED_MAIN: Planning Grid - Uniform Platform (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), there is no longer any
support for the Visual Basic version of the planning grid used in earlier releases: This
version is superseded by the Java version. The Java version of the planning grid has
been in use in the SAPGUI for Java since Release 4.72 and is now also integrated into
the SAPGUI for Windows.
The new versions of the planning grid will therefore be shipped as of SAP ECC 6.0,
Industry Extension Healthcare, Enhancement Package 4 (IS-H 604) as part of the
patch of SAP GUI Compilation 2.

Effects on System Administration


Generally the SAP server recommendations are sufficient for the operation of the
planning grid.
However, in order to operate the Java version of the planning grid, you have to have
Java Runtime installed on the corresponding Client. Under Windows XP we
recommend that you use Sun Java Runtime Environment version 1.4.2 or 1.5.0.
See also the following SAP Notes:
SAP Note 1013957 (Java planning grid under SAPGUI for Windows)
SAP Note 1013958 (Java planning grid under SAPGUI for Java)

See also
For up-to-date information about the planning grid, see the i.s.h.med website
www.ishmed.com, where the archived planning grid versions also continue to be
available.

385
ISHMED_MAIN: Planning Grid - Planning and Displaying Day-Based
Appointments (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can plan and display
day-based appointments in the planning grid, i.e. appointments with a date but without
a time. For this purpose the planning grid's time grid has its own graphic area within
which you can plan day-based appointments in the same way as time-based
appointments.
You can use Drag & Drop to move appointments between the areas for day-based and
time-based appointments. In this way, the system also supports, for example, multi-
level planning according to which a service facility at first plans on a day basis for the
long-term and only allocates the appointments to a day's free time slots in a second
step.
Furthermore, the familiar function from time-based planning Create Appointment with
Template and multiple selection with collective processing are provided.
You can click and drag the mouse to increase or reduce the size of the area for day-
based appointments in the planning grid's time grid or completely hide it using the
menu function. In addition you can use the menu to optionally display day-based
appointments horizontally (above each other, such as in Microsoft Outlook) or vertically
(alongside each other, such as with time-based appointments in the planning grid).
Note the following restrictions:
The system does not support the release of appointment plans for day-based
appointments.
The option to plan and display day-based appointments in the planning grid does not
replace i.s.h.med quota planning (day-based planning function). Day-based
planning checks service and admission quotas, the planning grid does not check
these quotas.

Effects on Customizing
Effects on Customizing:
The Business Add-In (BAdI) N1_PG_LABEL_TIMEGRID has been enhanced so that
you can adjust the labeling of the day-based appointments area to your needs.
You can hide the day-based appointments area by means of a menu function. The
system saves this setting in the user parameter N1PT_DBA_ONOFF.
You can use the user parameter N1PT_DBA_DSP to define the display type for day-
based appointments (horizontal or vertical).
You define the standard height of a day-based appointment (in Twips) using the
organizational unit-related parameter (OU parameter) N1PTDBAPPH.
You define the height of the area for day-based appointments by means of the user
parameter N1PT_DBA_HEIGHT.
The system also checks the OU parameters N1PTRCHS (time grid positioning
depending on the patient selected), OE_DISPTYP and N1PTBKED (plan with or
without processing dialog) when appointments are day-based.
An organizational unit (OU) has planning authority for day-based appointments if it has
planning authority for time-based appointments in any time interval of a day.

386
387
ISHMED_MAIN: Planning Functions - Integration of Group
Appointments (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), i.s.h.med planning
functions support the SAP Patient Management (IS-H) construction "group
appointments". These are appointments that involve several patients. You define these
using the appropriate scheduling type.
Thus you can enter a permissible number of patients in Customizing for a scheduling
type. The system checks and utilizes the overbooking capacity only when the number
of appointments booked in a time interval of this scheduling type matches the number
of patients defined in Customizing.
On the initial screen of the appointment search, group appointments are available as a
search option in checkbox form. The appointment search itself interprets a time interval
for group appointments as a free time interval, as long as the defined maximum
number of patients has not been reached.
The planning grid displays time intervals with time slots for group appointments on a
shaded background.
Note:
According to the SAP Patient Management concept of "group appointments", all the
appointments of a group start and end at the same time as the time interval
provided for them. Although it is possible to plan deviating appointments, the
group quota is not "counted" down.
In SAP Patient Management the details in the appointment (e.g. scheduling type)
always override the details of the time slot. The planning functions of i.s.h.med
behave in the same way.
Exception:
i.s.h.med will continue to flag a time slot as a time slot for group appointments if
you plan an appointment within the provided time interval using a scheduling
type that is not defined as a scheduling type for group appointments in the time
slot.
Effects on Customizing
In scheduling type management (transaction ONDT) you define in the Number of
Patients column how many patients (appointments) the user may plan in a time
inverval of this scheduling type, before the system checks the authorization for
overbooking.
The Business Add-In (BAdI) N1_PG_LABEL_TIMESLOT has been enhanced so that
you can adjust the shading color for the day-based appointments area to your needs or
even deactivate it.

388
ISHMED_MAIN: Maintain Appointment - Admission Appointments
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can also create,
change, and display admission appointments in the Maintain Appointment function for
displaying and editing an appointment (appointment editor).
You can call admission appointments from the following places in the system in the
enhanced form:
Clinical order item: Change Appointment function
Planning grid: Patient appointment overview

389
ISHMED_MAIN: Planning - Time Slot Synchronization (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the system synchronizes
the time slot in the planning tools in the same way as SAP Patient Management.
Therefore the planning tools also react to short-term changes to how time slots are
displayed in a more dynamic and user-friendly way. In earlier releases the time slot and
planning authority were only read for display and displayed accordingly each time a
planning tool was called. The system did not react to interim changes to the time slot
(e.g. the blocking of a room) when displaying it in the planning tool. So the system may
not have shown the user the current status of the time slot in the planning tool. That
resulted, for example in the user receiving an error message due to a missing time slot
despite the planning tool displaying the contrary. In appointment planning the system
has always accessed the current status of a time slot.
The enhancement applies to the following planning tools:
Planning grid
Surgeries view type
Day-based planning
See also
For detailed information on synchronizing time slots, see the Release Notes for SAP
Patient Management (IS-H).

390
ISHMED_MAIN: Planning - Various Changes and Enhancements
(Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the following changes
and enhancements are available in planning:

Behavior of the OU Parameter OE_DISPTYP


As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN) the behavior of the
organizational unit-related parameter (OU parameter) OE_DISPTYP is changed in the
dialog for editing appointments and in the i.s.h.med appointment search as follows:
The system presets the scheduling type as follows:
In planning the system presets the scheduling type using the OU parameter
OE_DISPTYP if it does not preset the scheduling type in another way such as
based on to the time slot.
Presetting occurs once, i.e. if the user removes the preset scheduling type, the system
does not preset the value again.
Note the following exception:
If, when changing an appointment, the user chooses a different treatment OU
(OU) or other date, the scheduling type is only preset if the user does not select
a different scheduling type. When you choose a different treatment OU, the
system deletes the content of the Scheduling Type field. If the user does not
assign a new scheduling type, while checking or saving the system presets the
scheduling type using the value of the OU parameter OE_DISPTYP.
If the value of the OU parameter OE_DISPTYP is invalid or not maintained, the system
uses the first valid scheduling type from the table TN40B for the OU.
If you replan an existing appointment without dialog changing the treatment OU and
thereby making the scheduling type no longer valid, the system makes a new
presetting based on the parameter OE_DISPTYP. For example, this is the case,
if the user selects an appointment in the planning grid and moves this
appointment into a time slot where the treatment OU does not match the original
treatment OU.
If the user double-clicks a free time interval in the planning grid, the system no longer
automatically calls the dialog if the scheduling type is missing. The system
presets the scheduling type using the value of the OU parameter OE_DISPTYP.

Presettings in Appointment Planning


As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the system - also in
i.s.h.med - presets appointments based on day program settings in accordance with
SAP Patient Management (IS-H) appointment planning functions, if the corresponding
settings are defined for the day program.
In these settings for the day program of a planning object for each combination of time
interval and scheduling type you can also store the department, the specialty, the
treatment room (for person planning objects) or the treatment person (for building unit
planning objects) which the system then presets in appointment planning.

391
Planning: Business Add-In N_APP_CONSTR_CHG
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), sample source code is
available in the Business Add-In (BAdI) N_APP_CONSTR_CHG for presetting the
appointment template.

Planning Grid: OU Parameter N1PTTMNZT (New)


As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), a new organizational
unit-related parameter (OU parameter) is provided for the planning grid. You can use
this OU parameter to define that the system presets an appointment time using the
start time that results from the scheduling type according to the time slot.
The system checks this OU parameter N1PTTMNZT for the respective planning OU in
planning with and without dialog.
The following parameter values are possible:
Space: When planning an appointment, the system presets the time (as previously) on
the basis of the time grid according to the OU parameter N1PTTMNR (default
value).
X: When planning an appointment, the system presets the time on the basis of the start
time that results from the scheduling type.
Note:
If you set value of the OU parameter to X, the time displayed in the cursor quick info of
the planning grid is also based on the start of the scheduling type.
If you use Drag & Drop to move an appointment or change the duration of an
appointment by increasing or reducing the appointment, the time grid continues
to apply for presetting the time.
If you plan an appointment in a time interval for which there is no time slot (but only
planning authority), the time grid also applies for presetting the time.

Planning Grid: Menu Structure in the Planning Grid (Changed)


As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the menu structure in the
planning grid is redesigned.

Service Scheduling: System Parameter N1DPTM


As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can use the
institution-specific, time-independent system parameter N1DPTM for appointment entry
(appointment editor) to optionally define that the appointment time is preset with the
exact system time.
You can enter the following values for this system parameter:
X: The system presets the appointment with the exact system time.

392
Space: When it presets the appointment, the system rounds up to the next half hour
(default value).

Create Visit for Appointment: Check for Physician Indicator


When you plan an appointment, the system does not check if the Physician indicator is
set for the assigned person in the Attending Person field.
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the system now no
longer checks the Physician indicator when creating a visit for an appointment either.

Planning: Check of Admission Capacities in General Planning Functions


Previously, checking admission quotas only used to be an integral part of day-based
planning. The system only checked the admission capacities defined in the time slot
within day-based planning or, as the case may be, the maintenance of admission
quotas was a mandatory prerequisite for using day-based planning. The user could
therefore circumvent checking admission quotas by e.g. directly entering appointments.
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), this check is also
provided in the general planning functions and can be performed in each planning
process of an admission appointment.
Since you may not previously have worked with day-based planning and therefore also
do not use planning quotas, you can use system parameters to stipulate whether you
would like to activate admission quota checking in the general planning functions.
If you would generally like to use admission quota checking in the general planning
functions, you have to set system parameter N1AACCHK to the value "X".
You must not set the system parameter if you wish the system to continue checking the
admission quotas in day-based planning only.

User Parameter N1PT_SCHEVER No Longer Active


The internal user parameter N1PT_SCHEVER for determining the planning grid version
to use is no longer relevant due to changes to a uniform platform.
For further information, see the Release Note
ISHMED_MAIN: Planning Grid - Uniform Platform (Changed)
Planning: Change to Planning Employee Check
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement
Package 4 (IS-H 604), Business Function Clinical System (ISHMED_MAIN) the check
on the valid planning employee (for example, when an appointment is being changed)
is modified.
Since the check on the planning employee against the planned appointment resulted in
problems in cases where the employee has left the hospital, system now checks
against the date when the appointment was created or last changed.

393
ISHMED_MAIN: Planning - Optimized Process Support in Appointment
Planning (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), process support in
appointment planning has been optimized. You can create appointments and an
associated clinical order within appointment planning.
This new development enables you to use one work step to concurrently search, for
example in a central planning facility, for appointments and create a clinical order for
the appointments found. Furthermore enhancement of the selection list for clinical
orders allows you to enter several order items for several appointments. See Release
Note ISHMED_MAIN: Enhanced Selection List for Order Types (New)
This function for creating a clinical order is provided in the following areas in planning:
Appointment proposal list
Appointment list
Change Appointment function (appointment editor).
Planning grid context menu
In the enhanced selection list for order types you can assign order types to the
appointments in the preselection. Note that you can assign an order for ten
appointments at the most. You also have the option to transfer order types into the
preselection without appointment assignment. In such cases, the maximum number of
order items must not exceed ten.

394
ISHMED_MAIN: Planning - Replaced User Exits (Deleted)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the following user exits
in the planning environment are no longer available:
N1MSCHED (appointment labeling for scheduling control)
N1PLANT (user exits for the planning grid)
These user exits have been deleted since they have been superseded by
corresponding Business Add-Ins (BAdIs) since Release 4.72.

395
ISHMED_MAIN: Discontinued Surgery Transactions (Deleted)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the surgery planning list
(transaction N1PN) and the OR Schedule (transaction N1PG) are no longer available:
These transactions have been completely replaced by the Surgeries view type in the
clinical work station. This means that you can no longer call the surgery planning list or
the OR schedule.
The discontinuation of these two transactions also means that the following system
parameters, user parameters, user exits, Business Add-Ins (BAdIs), and authorization
objects become invalid:
System Parameters:
N1OPANL: Create Surgery Transaction
User Parameters
NPV Planning List: Layout (planning view)
NPW: Planning List: Layout - Performer's View
NPWA: Planning List: Layout - Requestor's View
NPWB: Planning List: Layout - Treatment Room View
NPWMC Planning List: Layout - Employee's View
NRV OR Schedule: Layout (plannable surgeries) - Room
NRVA: OR Schedule: Layout (plannable surgeries) - Requestor's View
NRVB: OR Schedule: Layout (plannable surgeries) - Requestor's View
NRVE: OR Schedule: Layout (plannable surgeries) - Performer
NRVM: OR Schedule: Layout (plannable surgeries) - Employee's View
NRVN: OR Schedule: Layout (plannable surgeries) - Name View
NSV: OR Schedule: Layout (plannable surgeries) - Room
NSVA: OR Schedule: Layout (non-plannable surgeries) - Requestor's View
NSVB: OR Schedule: Layout (non-plannable surgeries) - Treatment Room View
NSVE: OR Schedule: Layout (non-plannable surgeries) - Performer
NSVM: OR Schedule: Layout (non-plannable surgeries) - Employee's View
NSVN: OR Schedule: Layout (non-plannable surgeries) - Name View
GRANDPA: OR Schedule: Work Station
OPC: Planning List: Performing OU
OPD: OR Schedule: Surg. Date
OPH: OR Schedule: Surg. Area
OPM: OR Schedule. - Selection Using Time Stamps
OPN: OR Schedule: View
OPO: OR Schedule: Initial Screen
OPQ: Planning List - View: P, E, A, B, M
OPR: Planning List: Sorting

396
OPXA: Planning List - Requester (View)
OPXB: Planning List /OR Schedule: Treatment Room (View)
OPXE: OR Schedule: Performer for Performer View
OPXM: Planning List /OR Schedule: Employee (View)
PHY: OR Schedule: Hide Header Lines
PHZ: Planning List: Hide Header Lines
PLE: User Parameter For Presetting Planning Date in OR Schedule
LZP: Display Additional List Lines (planning list)
PLE: Planning List Planning Date
AG0 AG9: Planning List Task for Display
PAO: Anesthetist Required
PUR: Planning List with Rooms Available to All OUs
PPH: Requesting Nursing with Hierarchy
OEH: Surgery Planning List with Hierarchy (Performing OU)
PWB: Surgery Planning List Selection Period to nn Days
PWV: Surgery Planning List Selection Period from nn Days

User Exits and BAdIs:


SAPLN1ON: Check OR Plan
SAPLN1OP: OR Plan Printout
SAPLN1OR: OR Schedule Printout
SAPLN1OO: OP Schedule Enhancements
SAPLN1O1: Menu Exit 1
SAPLN1O2: Menu Exit 2
SAPLN1O3: Menu Exit 3
SAPLN1OS: Additional Doubleclick Function
N1_OP_PROGRAMM: Automatic Updating
Authorization Objects:
N_OP_PLAN
N_OP_PRG
The corresponding functions for calling the OR Schedule have been
removed from the function list of the following clinical work station view types:
Occupancy view type
Arrivals view type
Departures view type

397
ISHMED_MAIN: Surgery Times (Enhanced)
Use
The Surgery Times function has been reworked for SAP ECC 6.0, Industry
Extension Healthcare, Enhancement Package 4 (IS-H 604), Business Function
Clinical System (ISHMED_MAIN).
If you previously used the corresponding user exits, you have to replace these
with the new Business Add-Ins (BAdIs).
Layout
An ALV grid is provided for entering surgery times in the surgery work station via the
base item type SRG TIMES. Here you can enter and display relevant times.
You define the times for surgery times on the SAP Easy Access screen by choosing
Clinical System -> Basic Clinical Data -> Surgery System -> OR Documentation -
> Time Definition..
Only fields that you are authorized to process are ready for input.
You can enter the time and date for each time (= timepoint). If you only enter the time,
the system transfer the date from the surgery. The duration of two contiguous times is
calculated by the system. The system checks whether the entered time pair and the
relationships between times that are defined as consecutive are logical.
Functions
Using the toolbar functions you can check, save, delete or release times entered. Using
Change Documents you can display the change history for surgery times.
You can only release times if you have authorization to do so (authorization object
N_2ZTPKT1).
The plausibility checks for time stamps take the areas of responsibility (area like
surgery, surgical nursing, anesthesia) into account.
When the system checks dependencies between individual time stamps and calculates
durations it distinguishes between dependent time stamps that pertain to one area and
those that pertain to multiple areas. Separate messages exist for each variant and can
be configured using IS-H message control.
Example:
For the release of dependent time stamps you can stipulate whether these can only be
released together. The messages 202 and 208 in the message class N2OP are
provided for this purpose.
Variant 1:
If dependent time stamps of one area may only be released together, change the
default message type of the message 202 from W (warning) to E (error).
Variant 2:
If dependent time stamps of different areas may only be released together, change the
default message type of the message 208 from W (warning) to E (error).
Released times are shown in display mode for users without subsequent entry
authorization. Users with subsequent entry authorization can correct released times.
Already released, but subsequently entered times retain their release status.
Message Control
You can now use IS-H message control for selected messages of the application area
NMED for the entry of surgery times. This applies to the messages (N2OP), 201
(N2OP), 202 (N2OP), 206 - 212 (N2OP), and 562(NG).

398
Business Add-Ins (BAdIs)
Using the BAdIs for surgery times you can implement your own program behavior for
saving, checking, and releasing. The following BAdIs supersede previous user
EXITs for surgery times:
ISHMED_SRGTIMES_CHECK
Using this BAdI you can perform your own checks after entering surgery times. It
replaces the user exit EXIT_SAPLN2OPZEITEN_001 (customer enhancement
check in the surgery times report).
ISHMED_SRGTIMES_RELEASE
Using this BAdI you can perform your own checks when releasing surgery times.
It replaces the user exit EXIT_SAPLN2OPZEITEN_003 (customer enhancement
before release in the surgery times report).
ISHMED_SRGTIMES_SAVE
Using this BAdI you can perform your own checks before saving surgery times. It
replaces the user exit EXIT_SAPLN2OPZEITEN_002 (customer enhancement
before save in the surgery times report).

Effects on System Administration


If you have implemented the previous user exits EXIT_SAPLN2OPZEITEN_001,
EXIT_SAPLN2OPZEITEN_002 or EXIT_SAPLN2OPZEITEN_003, you must transfer
the implementation into the BAdIs.
Effects on Customizing
For further information about setting up BAdIs for surgery times, see Customizing for
i.s.h.med under Surgery System -> Surgery Documentation -> Business Add-Ins
for Surgery Documentation
BAdI: Check Surgery Times
BAdI: Release Surgery Times
BAdI: Save Surgery Times
See also
Surgery Work Station: Base Item Types (New)
Authorizations for Surgery Times (Enhanced)

399
ISHMED_MAIN: Surgical Documentation (Enhanced)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), there are the following
changes or functional enhancements for surgical documentation:
Link Diagnoses
You can use the new function Link Diagnoses to link the primary diagnoses to
dependent secondary or additional diagnoses.
The Lnkd Diagnoses (linked diagnoses) column has been added to the diagnoses
table.
To link the diagnoses, select the primary diagnosis and call the Link Diagnoses
function using the associated button.
The Edit Linked Diagnoses dialog box lists all the diagnoses that you can link to the
primary diagnosis.
By double-clicking the required diagnosis you can link diagnoses, or undo a link.
Improvement in Synchronization with IS-H in Plausibility and Error Checks
When saving and checking Surgical Documentation many checks in diagnoses and
procedures have been standardized by using check routines from the IS-H area.
As a result of additional checks from the IS-H environment the number of messages in
surgical documentation can increase.
If, in individual cases, messages prove to be incomprehensible, we recommend that
you call the diagnosis overview for the case when messages concern diagnoses and
that you call surgery maintenance from the IS-H environment when messages concern
procedures.
Previous Function Rules Renamed
Similar to the user interfaces in IS-H, the Rules function has been renamed
Consistency.
Value Help for Procedure Also Transfers Long Text from Catalog
As of this Release, when you use the value help to enter a procedure, the system also
transfers the associated long text from the catalog into the surgical documentation.

400
ISHMED_MAIN: Surgery Complications (Enhanced)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN) Surgery Complications
has the following new features:
Layout
An ALV grid is provided for entering surgical events or anesthetic course observations
in the surgery work station using the base item type COMPLICATIONS (For further
information about base item types see the Release Note Surgery Work Station:
Base Item Types (New). You can enter the degree of complication and the time
phase. The date and the time are preset with the surgery date and the surgery time.
Input Help
You enter the anesthetic course observation code in the Cmp column.
for Surgery Complications/ Course Observations (Changed) provides
you with a catalog of operative events and anesthetic course observations. This catalog
has a hierarchical structure. You access catalog maintenance in the SAP Easy Access
menu by choosing Clinical System -> Basic Clinical Data -> Surgery System ->
Organizational Unit -> Complications.
Functions
Using the toolbar functions you can check entered complications, save or cancel and
show or hide canceled complications. Change Documents enables you to display the
change history for surgical complications. You can also use additional standard ALV
Grid functions.

401
ISHMED_MAIN: OR - Hierarchy in Input Helps (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), there is a change to the
input help for surgery complications or course observations:
Layout
Depending on whether you call the input help for operative events or anesthetic course
observations, the system displays a hierarchy of complications or a hierarchy of course
observations.
Functions
The function bar provides you with the following functions in the form of buttons:
Select
After positioning the cursor you can select an entry.
Expand Subtree
The simultaneous selection of subtrees is possible; they can then be expanded.
Collapse Subtree
The simultaneous selection of subtrees is possible; they can then be collapsed.
Search
Text search is also performed on unopened subtrees.
Print
The print function can be executed on the current view or the entire hierarchy.
Cancel
After highlighting an entry, you can select both by a doubleclick or using Enter.

402
ISHMED_MAIN: Authorizations for Surgery Times (Enhanced)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you use the
authorization objects N_2ZTPKT and N_2ZTPKT1 for surgery times to control
authorizations for time entry, release, and subsequent entry.
N_2ZTPKT Authorization Object for Surgery Time Entry (Changed)
This is used to define authorizations for displaying and changing surgery times in
relation to individual times.
Activities 01 and 43 have been removed.
Authorization Object N_2ZTPKT1 Surgery Time Entry for Release and Subsequent
Entry (New)
Authorization object N_2ZTPKT1 supplements authorization object N_2ZTPKT with the
Release and Subsequent Entry authorizations. A prerequisite for release and
subsequent entry authorizations is the authorization to change surgery times, granted
by the authorization object N_2ZTPKT.
Unlike the authorization object N_2ZTPKT, which gives authorization to change and
display for each time, the authorization to release and make subsequent entries is
global. A restriction is only possible in relation to area.
If there is no release authorization, the Release function is not available in surgery time
editing.
Authorization for subsequent entry should only be given in exceptional cases. It is
useful only if you work with release authorization in your institution.
Effects on System Administration
If you have worked with the function Release of surgery times in your institution and
you would like to continue using this function, you have to maintain the authorization
object N_2ZTPKT1.

403
ISHMED_MAIN: DE: Business Premises Number in the Data Export
Program (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), in the data medium
creation program (RN1PERDT) there is a new input field for the business premises
number.
The business premises number is preset to 1 by default.

404
ISHMED_MAIN: DE: Coding of the Export Files (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the program RN1PERDT
can now code the exported files and write them to a zip archive.
The program RN1PERDT can now unpack the BQS answer file and decode it.
You decide in the selection screen whether you use automatic coding or code the file
yourself
Coding by the program isthe default setting.
This change has already been delivered with SAP ECC Industry Extension
Healthcare 6.0 Add-On Support Package 05.
Effects on Customizing
The following data is required for coding by the program under Settings:
Country ID
Coding code which you obtained from the BQS
Name of the command file executing the coding or decoding
Coding program geqik3des.exe
Start directory followed by \
Export directory relative to the start directory followed by \
The system unloads the uncoded export files (header, mother, child) to this
directory
Transaction directory followed by \
The system writes the coded ZIP archives for dispatching to BQS to this
directory.
Import directory followed by \
The system writes the decoded BQS answer files (confirmation, error) to this
directory.
Answer directory followed by \
You place the coded and archived BQS answer file into this directory.
Example:
Country ID HH
Key code 1234567890
Command file perinatexport.cmd
Cod.Prog geqik3des.exe
StartDir. C:\Perinat\
ExportDir. Export\
Transact.Dir. C:\Perinat\Transact\
ImportDir. C:\Perinat\Import\
AnswerDir. C:\Perinat\Answer \
The coding program geqik3des.exe expects three files in its own directory::
zip.dll

405
unzip.dll
QuantPacker.dll
Users of i.s.h.med perinat can receive these program libraries as ZIP archive
3des_perinat.zip (see note 849624) on request directly by mail or by download from
SAP Service Marketplace.

406
ISHMED_MAIN: DE: Creating a Minimum Data Record (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the program
RN1PERDT_MDS is available which creates a minimum data record (MDS) according
to BQS specifications. The files to be exported can be encoded and written to a ZIP file
(like the procedure in report RN1PERDT).
The program RN1PERDT_MDS can now unpack the BQS answer files and decode
them.
You decide in the selection screen whether you use automatic coding or code the file
yourself
Coding by the program is the default setting.
This change has already been delivered with SAP ECC Industry Extension
Healthcare 6.0 Add-On Support Package 15.
Effects on Customizing
For coding by the system, you make the same settings as for the report RN1PERDT in
Customizing for i.s.h.med under Settings.

407
ISHMED_MAIN: Drug Master - General (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), a reworked and
enhanced version of drug management is available.
To simplify the management and processing of drugs (drug master data) and the use of
drugs when creating and processing medication orders, the following changes have
been made in drug management:
Structuring in drug master
Generic parameters added to drug master
Introduction of drug messages
Assignment of drugs to fill sources
Assignment of several price types per drug
Definition of drug strength by means of the agent quantity per reference dose
Introduction of an alternative reference dose (for example, drops as an alternative
reference dose for ml)
Dosage type to define whether dosing in the medication order is to be according to
reference dose or by agent
Maintenance of medication order templates (directly) for drug management
Standard infusion and drug kit added to drug categories.

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ISHMED_MAIN: Structuring in Drug Master (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can define levels in
the drug master and create drug hierarchies.
You can define up to three levels for each formulary (= internal drug catalog). The
following drug levels are available:
Generic drugs
Generic drugs with package information
Brand drugs
Brand drugs with package information
Per drug level, for each purpose you can preset whether a drug of this level may be
used in the following application areas:
In the medication order
Only in the drug search
In the medication event
Not at all
You can change this presetting for the respective drug in drug management.
You have to assign a level of the relevant formulary to each drug. If you have defined
several drug levels in the formulary, you can include drugs in a hierarchy. You assign
drugs to a hierarchy in drug management.
At least the following attributes of drugs in the same hierarchy must be identical:
Reference dose
Unit of reference dose
Dosage form
Agents
Generic name
Formulary
For all other attributes, you can stipulate whether attributes are to be inherited by lower-
level drugs in the hierarchy.

Effects on Customizing
Define drug levels and their purpose for each formulary in the Implementation Guide by
choosing SAP Healthcare - Industry-Specific Component Clinical System ->
Medication -> Drug Catalog -> Manage Drug Catalogs.

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ISHMED_MAIN: Drug Master - General Parameters (New)

As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H


604), Business Function Clinical System (ISHMED_MAIN), you can assign general
parameters (for example, Special Order by Pharmacy Required indicator) and values
to drugs.
Two general parameters for document categories for medication orders and for
document categories for medication events are provided as standard.
For drug properties that have no corresponding fields in the standard software delivery,
you can create any number of customer-specific general parameters in Customizing.
You can assign these parameters to a drug on the General Parameters tab page in
drug management and specify the relevant value for a particular institution.
For each entry you make for a general parameter, you can set the Inheritance
indicator to stipulate whether the parameter value is to be inherited within the hierarchy.

Effects on Customizing
Define general parameters in the Implementation Guide by choosing SAP Healthcare
- Industry-Specific Component Clinical System -> Medication -> Drug Catalog ->
Manage Generic Drug Parameters.

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ISHMED_MAIN: Drug Messages (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System ( ISHMED_MAIN), you can assign drug
messages to each drug in the drug master. The system shows these messages in the
dialog box for error messages, warnings, and information messages of the respective
function executed (for example, create medication order).
You can define drug message classes that you can then assign to a message in the
drug master. The following message classes are available to you:
001 Order information (assigned drug messages displayed during the order process)
002 Administration information (assigned drug messages displayed during the
administration process)
003 Order and administration information (assigned drug messages displayed during
the order and administration process)
A drug message is composed of:
Message class
Message type (information, warning, error, success message)
Start and end dates
Inheritance indicator
Drug message short text
Drug message long text
Example of a drug message
Order information, information, "Drug must be ordered externally"
Effects on Customizing
Define groups of drug messages in the Implementation Guide by choosing SAP
Healthcare - Industry-Specific Component Clinical System -> Medication -> Drug
Catalog -> Manage Groups for Drug Messages.

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ISHMED_MAIN: Assignment of Drugs to Fill Sources (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), a separate transaction is
provided for assigning drugs to fill sources.
You can use this function to maintain all drugs for a fill source that are kept in stock in
this fill source. You can access this function in the SAP Easy Access menu by
choosing Clinical System -> Basic Clinical Data -> Medication -> Drug Master ->
Drug - Fill Source Assignment.
You can, however, continue to enter or edit the assignment of a fill source to a drug on
the Storage tab page in drug management (drug master).
You can call the management of fill sources in the Implementation Guide or in drug
management.
In the Assigned Drugs screen area, you can assign drugs of any level. In the Lower-
Level Drugs screen area, you can specify for each assigned drug which lower-level
drug is actually kept in stock in a specific period in the fill source.
Example
You assign the generic drug acetylsalicylic acid100mg Tbl to a fill source. You assign
the following lower-level drugs:
Aspirin 100mg Tbl, from 01.01.2008 to 04.30.2008
Aspro 100mg Tbl, from 05.01.2008 to 12.31.9999
Effects on Customizing
Define fill sources in the Implementation Guide by choosing
SAP Healthcare - Industry-Specific Component Clinical System -> Medication ->
Inventory Management -> Maintain Fill Source for Drugs.

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ISHMED_MAIN: New Drug Search - Customizing (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the new drug search is
available.
To use it, the following settings must be made in the Implementation Guide by
choosing SAP Healthcare - Industry-Specific Component Clinical System -
Medication - Drug Search and SAP Healthcare - Industry-Specific Component
Clinical System - User-Specific Presettings.
Maintain Search Field Label
In this IMG activity, you define shortcuts and customer-specific alternate search field
names that can be used in the drug search. By defining a shortcut (for example, "D" for
the drug description), you allow users to define shortcut indicators (for example, "/").
From the Drug ID field in the compressed display of the order dialog, the user can thus
search for drugs directly. For example, by entering D/Asp*, the user can search for
drugs with the drug description Asp* directly.
Maintain Grouping Attributes
In this IMG activity, you define grouping attributes for grouping the drugs in the result of
the drug search. Standard grouping attributes (for example, drug category) are
provided by means of a switch BC set. You can add further grouping attributes, if
required.
Maintain Template Grouping Areas
In this IMG activity, you define grouping attributes for grouping order template groups in
the result of the drug search. Standard grouping attributes (for example, diagnoses) are
provided by means of a switch BC set. You can add further grouping attributes, if
required.
Maintain User Favorites
In this IMG activity, you can assign user favorites to users. User favorites could be
frequently used drugs, for example. It is also possible to define user favorites directly
from the drug search. You can create favorites as follows:
By manual assignment in the maintenance dialog
By searching for the drugs you ordered
You can define a period and number of hits for this. The system displays the
result of the search sorted according to frequency of use. You can then assign
drugs from the result list to your favorites.
By displaying the favorites of another user
For further information, see the Release Note ISHMED_MAIN: Medication -
User Favorites (New).
Maintain User-Specific Presettings
For further information about making user-specific presettings, see Release Note
ISHMED_MAIN: Medication - User-Specific Presettings.
For customer-specific enhancements, the Business Add-Ins (BAdIs) listed under
'System Administration' are provided.
Effects on System Administration
The new drug search is available as an Add-On as of Release 6.00. If you already use
this Add-On and implement SAP ECC 6.0, Industry Extension Healthcare,

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Enhancement Package 4 (IS-H 604), Business Function Clinical System
(ISHMED_MAIN), you must update existing Customizing settings, or maintain them
anew.
This applies for all settings listed above.
Note that you must also copy all existing BAdI implementations from the Add-On to the
new BAdIs created. For this purpose, create implementations for following BAdIs, if
required:
N1MEDS_SRCH_CRIT: Default Search Criteria
N1MEDS_DRUGSEARCH: Drug Search
N1MEDS_FAVORITES: User Favorites
N1MEDS_PREF_OVERVIEW: Overview Dialog for User-Specific Presettings
N1MEDS_PREF_DETAIL Detail dialog for User-Specific Presettings
You must replace the existing authorization objects from the Add-On by new
authorization objects in i.s.h.med:
N_1USRFAV: Authorization object for user favorites
N_1USRPREF: Authorization object for user-specific presettings
You must enhance your authorizations to enable the display and maintenance of the
user-specific presettings and user favorites.
Effects on Customizing
To use this function, you must activate the Clinical System (ISHMED_MAIN) business
function.
See also
See Release Note ISHMED_MAIN: New Drug Search - General (New)

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ISHMED_MAIN: New Drug Search - General (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), a new drug search is
available.
The new drug search enables a more comfortable and faster search for drugs and
medication order templates.
You can specify the search options on the General and Advanced tab pages. The
system presets these options from the user-specific presettings.
The Classification Codes tab page provides a search using classification systems that
have been maintained accordingly. You can thus find drugs and order templates by
means of their assignment to an ATC code, for example.
The presentation of the search results is determined by the settings in the user-specific
presettings. You can also adjust these user-specific presettings from the search dialog.
In addition, you can call the maintenance of the user favorites from the search dialog.
If it is possible to select multiple drugs in the result list returned by drug search, a
shopping cart is displayed. You can temporarily store selected drugs or order templates
in the shopping cart while you perform a new search.
When you choose the Order function in the drug search, the system transfers all drugs
and order templates you have selected or that are in the shopping cart into the order
dialog.
The following Business Add-Ins (BAdIs) are provided for customer-specific
adjustments:
N1MEDS_SRCH_CRIT
N1MEDS_DRUGSEARCH

Effects on Customizing
Make the following Customizing settings in the Implementation Guide by choosing
SAP Healthcare - Industry-Specific Component Clinical System -> Medication ->
Drug Search:
Maintain Search Field Label
Maintain Grouping Attributes
Maintain Template Grouping Areas
For further information about customizing the new drug search, see the Release Note
ISHMED_MAIN: New Drug Search - Customizing (New).
For further information about user-specific presettings and user favorites, see the
Release Notes:
ISHMED_MAIN: Medication - User-Specific Presettings (New)
ISHMED_MAIN: Medication - User Favorites (New)

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ISHMED_MAIN: Medication - User Favorites (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can define and
manage user favorites for medication.
User favorites are drugs that the user orders frequently. The user favorites are
available to the user in the new drug search. The system presents them separately for
the user in the drug search. See also Release Note ISHMED_MAIN: New Drug
Search - General (New)
The function for maintaining user favorites provides the following ways of defining
drugs as user favorites:
Add a user favorite directly in the left-hand screen area using the drug search
Transfer the user favorites from the list of the drugs ordered by the user which is sorted
by order frequency
Transfer the user favorites from the list of user favorites for another user
The Business Add-In (BAdI) N1MEDS_FAVORITES is provided for customer-specific
adjustments of the function for maintaining user favorites.
Effects on Customizing
Define user favorites in the Implementation Guide by choosing SAP Healthcare -
Industry-Specific Component Clinical System -> Medication -> Drug Search ->
User Favorites -> Maintain User Favorites.

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ISHMED_MAIN: Medication - User-Specific Presettings (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can enter and
manage user-specific presettings for medication.
User-specific presettings are available for presetting the search options and display
options in the new drug search and in the medication order dialog.
In the user-specific presettings, you can enter the desired presettings on the following
tab pages:
On the Search tab page, you can create and edit all presettings that can influence the
execution of the drug search (for example, preset search fields).
For further information about the new drug search, see the Release Note
ISHMED_MAIN: New Drug Search - General (New)
On the Result tab page, you can create and edit all presettings that can influence the
presentation of the search results of the new drug search (for example, sort
criteria).
On the Assignments tab page, you can stipulate which assignments (for example,
indications) of a drug are supplied to the calling program (for example, order
template, order dialog).
On the Favorites tab page, you can create and edit all presettings that concern the
dialog for maintaining the user favorites (for example, selection period).
For further information about user favorites, see the Release Note
ISHMED_MAIN: Medication - User Favorites (New)
On the Order tab page, you can create and edit all presettings that influence the input
behavior and display behavior in the order dialog (for example, control behavior
when renewing an order).
The following Business Add-Ins (BAdIs) are provided for customer-specific adjustments
of the user-specific presettings:
N1MEDS_PREF_OVERVIEW
N1MEDS_PREF_DETAIL

Effects on Customizing
Define user-specific presettings in the Implementation Guide by by choosing SAP
Healthcare - Industry-Specific Component Clinical System -> Medication ->
Maintain User-Specific Presettings.

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ISHMED_MAIN: Cycle - Enhancements (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the cycle has been
enhanced as follows:
Definition of day cycles
You can use these cycles in connection with the simplified dose definition.
For further information about the simplified dose unit, see the Release Note
ISHMED_MAIN: Simplified Dose Definition (New)
Fixed interval
When cycles have a fixed interval (for example, every 8 hours), you can specify
the start time (From Time field) of event generation by selecting the Define
From Time checkbox. Event generation will take into account the cycle start time
independently of the order start time.
Retroactive and future time interval in minutes
This enables you to stipulate that the system is to additionally generate a
medication event at the order start if the retroactive time interval is fallen short of
or if the future time interval is exceeded.
Examples
Retroactive time interval in minutes
The order starts at 08:15. The cycle defines the times 08:00, 12:00, and
16:00. Without a retroactive time interval, the first event would be
generated at 12:00. You define a time interval of 30 minutes. The first
event of the day could be generated at 08:00 (that is 15 minutes before
the order start). The possible time interval of 30 minutes is fallen short of.
As a result, an additional event is generated at the order start at 08:15.
This means that the system generates an additional event if the time of the
first possible event was narrowly missed by the order start.
Future time interval in minutes
The order starts at 08:15. The cycle defines the times 08:00, 12:00, and
16:00. You define a time interval of 180 minutes. Since the first event is
not generated until 225 minutes after the order start, the possible time
interval of 180 minutes is exceeded. As a result, an additional event is
generated at 08:15.
This means that the system generates an additional event if the time of the
first event is too far from the order start.

The rules for retroactive and future are always used together. This means that
the system creates at most one additional event at the order start. You can also
generally determine minutes by means of the following organizational unit-
related parameters (OU parameters):
N1ME_RETRO
N1ME_FWARD
Explicit specifications you make in the cycle will override these OU parameters.

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ISHMED_MAIN: Medication Order - Various New Features (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the following new
features or changes are available in the medication order:

Order Start/Order End

You can determine the time for the order start using a combination of the organizational
unit-related parameter (OU parameter) N1ME_DTIM and a user-specific presetting.
The default value of the OU parameter is "system time". You can, however, also
stipulate "00:00". The user-specific presetting lets you override the value set for the
OU, if required.
You can define the order end time, as previously, by means of the order duration. A
user-specific presetting lets you change this behavior and define a concrete end
date/time.
Note that you can also create a medication order without specifying a duration or an
end date/time. After activating this order, you can adjust it using the Change Order
Validity function. This function replaces the Extend Medication Order function, but
also enables you to shorten the validity of the medication order. For orders with the
internal status "Saved", you can use this function to adjust the order start also.

Administration Duration

Whether or not you can define the administration duration in the compressed view of
the medication order depends on whether the Application Duration indicator is set in
Customizing for the dosage form of the drug to be ordered (IMG activity Edit Dosage
Form).
Note that in the case of infusions and total parental nutrition you can always fill the
Administration Duration field in the order dialog irrespective of the indicator setting in
Customizing for the dosage form. Dependent on the system parameter N1MEICAL, you
can manually enter the flow rate duration as well as the flow rate here. When you enter
the flow rate, the system displays the concatenated text from the system parameters
N1ADRU and N1ADTIMU (for example, ML/MIN) in the Administration Duration Unit
field.

Dispensing Quantity Unit

Previously, the dispensing quantity unit was restricted to the package unit.
Alternatively, you can now set the unit to the dosage unit of the drug. This enables you,
for example, to define 15 TBL for dispensing. You control the presetting of the unit by
using a combination of the organizational unit-related parameter (OU parameter)
N1ME_DEFDU and a user-specific presetting.
For information about defining the unit for generic drugs, see the Release Note
ISHMED_MAIN: Order Generic Drugs (New).

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Messages from the Drug Master

You can assign messages for the message types '001' (medication orders) and '003'
(Order/Admin.) to a drug in the drug master. After you select a drug, the system
displays these messages with the defined message type in the order dialog.
For more information about drug messages, see the Release Note ISHMED_MAIN:
Drug Messages (New).

Details Area in the Order Dialog

The content of the previously separate tab pages Medication Order and Details is
now combined on the Medication Order tab page. The following changes have been
made to this data:
The order validity data is only contained in the compressed display of the order dialog
and has been removed from the detail display.
The administrative data (Created By, and so on) can be accessed by means of a
pushbutton in the Order Information detail area.
The Consulting OU and Consulting Employee fields have been removed.
In the Patient Own Med. field you can stipulate that a patient has brought along their
own medication. Here you can differentiate whether the patient has entrusted the
medication to staff or continues self-administration.
You can assign indications to the medication order.

As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H


604), Business Function Clinical System (ISHMED_MAIN), all essential fields are
available in the compressed view of the medication order. As a result, it is only
necessary to call the detail display in rare cases (for example, to enhance or change
ingredients. To call the medication order without automatically opened detail view, use
the relevant user-specific presetting.

Planned Dose Changes for Events

You can change the planned dose of events on the Event tab page of the detail view of
the medication order. Here you can also reset the planned dose to 0. However, if you
have documented a drug as administered, you can no longer adjust the planned dose.

Order Type

As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H


604), Business Function Clinical System (ISHMED_MAIN), it is no longer mandatory
to specify a medication order type.
In the master data for the medication order types you can classify whether an order
type accommodates anamnesis. You can use these order types only when you create
a new order in the "drug anamnesis" call mode. This function is available both in the
clinical work station and directly in the medication order.

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Drug ID

Previously, it was possible to change a drug of a saved medication order directly in the
compressed view of the medication order. However, the change was limited to
alternative drugs.
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), it is no longer possible to
change the drug ID directly. You can change the drug by means of the Propose
Alternatives function.

Execute Function

The Execute function is now restricted to medication orders with the 'Administration'
purpose. At execution, the system resets the order dosage to 1 dose. This is not useful
for orders for dispensing or prescription printout.

Order Confirmation

With the new function Confirm Order you can confirm an active order independently of
the order validity. Upon confirmation, the system sets a time stamp in the medication
order.
You can use customer-specific checks to evaluate this time stamp and, for example,
prevent the administering of a drug if the order was not confirmed within the last 24
hours.

Creation of Standard Infusions, Compounds, and TPNs

With the new functions Create Infusion, Create Compound, and Create TPN you can
influence the behavior for calling the order or the new drug search. In theses situations,
the drug search is performed using the ingredients. The system transfers the selected
ingredients into the order. The detail view of the order is visible and the Ingredients tab
page is open.
Maintain the drugs, which the system is to transfer into the Drug ID field in the
compressed view of the medication order when the above named functions are called,
in the Implementation Guide under SAP Healthcare - Industry-Specific Component
Clinical System - Medication - Medication Order - Define Drugs for Orders.

Additional Changes in Medication Orders View Type


Selection Variant
The Consulting Employee and Consulting OU fields are no longer available.
Instead of the External Medication checkbox, an input field is provided in which
you can also make a selection according to the patient's own medication. The
new field Indication is also available. It accommodates multiple selection.
Layout Variant
The External Medication column shows the patient's own medication. Several
columns (for example, Name of Consulting Employee) have been flagged as
obsolete. Suppress them from your layout variants.

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ISHMED_MAIN: Order Activities (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can switch the
status of a medication order when a future planned time is specified.
When you use this type of planned times, the system creates "order activities".
These order activities are available for the following status transitions and functions:
Suspend an order (status switch from active to inactive)
Resume an order (status switch from inactive to active)
End an order (status switch from active/inactive to ended)
The system displays the planned status switch in the status overview for the order. You
can change (date/time) or cancel planned order activities in the status overview.
You can also process order activities without dialog, and link these with specific actions
in the system.
Example
You are planning a surgery. All orally administered drugs are to be suspended 24 hours
before the start of surgery. For this purpose, implement the Business Add-In (BAdI)
ISH_PLANNING_SAVE, and create an order activity with the activity type "Suspend" in
your implementation. If required, you can also schedule an order activity "Resumee (for
example, 24 hours after the end of surgery).

Effects on System Administration


The system processes order activities in parallel to the planned status switch.
For this purpose, schedule the report RN1ME_OAPROC as a background job. This
report should run at regular intervals (for example, every 5 minutes). You can select the
following options in the report:
Process the order activities
Define an interval (in minutes, for example 10 minutes) in which the system is to
look for and process order activities. Note that order activities that the report
cannot process correctly (for example, because the order is currently locked) are
automatically included in the next report run.
Delete canceled order activities
You can use this option to stipulate that order activities that are flagged as
canceled will be automatically deleted.
Delete successfully processed order activities
You define an interval (in days, for example 3 days). All order activities that are
older than the specified interval will be automatically deleted.
You can schedule the last two options in a separate background job (for example,
running daily) to shorten the runtime of the background jobs that run periodically.
Effects on Customizing
To provide users with a rapid overview of planned status switches, the following new
columns are available in the layout field catalog of the Medication Orders view type of
the clinical work station:
Order Activity Exists
Planned Date/Time Order Activity

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ISHMED_MAIN: Order Sequences (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can use different
functions (for example, Change Dosage, Change Drug, Order Intravenous) to
convert existing, actively saved orders to new orders.
For this purpose, the following functions are available in the Medication Orders view
type of the clinical work station and in the order dialog:
Change Dosage
The original drug is retained in the renewed order. You can adjust the dosage or
the cycle for the order. For mixed drugs (for example, infusions), the user-
specific presettings enable you to first display a dialog in which you can easily
adjust the dosage (total dose, only active ingredients, or all ingredients without
solution) by specifying a percentage.
Change Drug
The substitution dialog appears. An additional row for each drug to be replaced
is available in the dialog. It provides access to the drug search if the desired drug
is not directly available in the substitution dialog. The system then transfers the
drug selected in the drug search into the substitution dialog. On confirming the
substitution dialog, you transfer the selected drug into the follow-on order.
Change Administration Route
The substitution dialog appears with all the alternative drugs the system has
determined on the basis of the desired administration route. Note that only one
administration route can be defined as the standard administration route for
"orally" and for "intravenous", in each case.
You can define standard administration routes in the Implementation Guide
under SAP Healthcare - Industry-Specific Component Clinical System -
Medication - Drug Catalog - Edit Administration Routes.
Change Order Purpose
The substitution dialog appears with all the alternative drugs the system has
determined with a different (desired) order purpose.
This enables you make the following adjustment to orders that result from a patient's
inpatient stay:
Transfer the anamnestic orders into the admission medication
Make the necessary dose adjustments when the patient is transferred from an intensive
to a regular care unit
Create medication proposals at patient discharge based on the anamnestic and
inpatient medication
The possibility to define prices in the drug master means that you can display these
prices in the substitution dialog and sort the drugs by price to order the lowest priced
drug.
When you use the new functions, the system creates an order sequence between the
original and the renewed order.
Additionally, the system uses the chain of preceding orders to determine and display
the treatment day of the renewed order. This means that when the administered drug is
changed, you can identify the current treatment day concerned (for example, the 7th
treatment day since the start of the first order of the order sequence). Note that the
display of the treatment day is essentially dependent on the settings on the drug master
(Messages tab page).
You can remove a renewed order from the order sequence or re-assign a removed

423
order to the order sequence. Relevant functions are provided for this purpose.

Effects on Customizing
You can use the user-specific presetting Skip Alternative Dialog to influence the
behavior of the dialog when creating a renewed order. The system calls different
dialogs from possible alternatives.
Example: You wish to change the drug to be administered and the user-specific
presetting is set:
If no alternative drugs are found, the system branches directly into the drug search
If exactly one alternative drug is found, the system selects this drug automatically and
transfers it into the renewed order
If several alternative drugs are found, the system branches into the substitution dialog
Note that you can change the user-specific presetting from the medication order.

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ISHMED_MAIN: Integration of Order in Documentation Work Station
(New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the medication order
(order) is available as a new base item type.
The base item type enables you to document the orders for the patient in the
documentation work station. In the new base item type, you can do the following, for
example:
Define presettings for calling the order
Define layout variants, function variants, and selection variants for the compressed
order view
Define presettings for calling functions within the order

Effects on System Administration


Note that if you use the new base item type, the environment functions for creating
orders in other integrated work stations (for example, surgery work station) are no
longer possible.
Remove the functions for processing orders from the function variants of the situation
templates and replace these with appropriate tasks.
Effects on Customizing
Maintain situation templates and task templates in Customizing for the documentation
work station (transaction N2WLD).

425
ISHMED_MAIN: Integration of Chart in Order (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the order dialog uses the
advanced possibilities of the documentation work station.
This includes the use of the patient header of the documentation work station.
Additionally, you can show a chart in the order dialog, independently of the call of the
documentation work station in the Ward variant.
When you select an order in the chart, the system transfers this into the compressed
order view where it is available for further processing.

Effects on Customizing
You can perform Customizing for charting in the Implementation Guide under SAP
Healthcare - Industry-Specific Component Clinical System -> Charting ->
Customizing Settings.
In the user-specific presettings for the order dialog, define the chart to be used, which
ideally displays the medication orders that exist for the patient. Note that this setting is
only necessary if you use the order outside of the documentation work station. In the
documentation work station determine the chart to be displayed in the definition of the
task templates and situation templates.

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ISHMED_MAIN: Simplified Dose Definition (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can, by way of an
alternative, order drugs using the simplified dose definition.
The simplified dose definition is available in addition to the existing possibility of
defining dose and cycle.
To use the simplified dose definition, you have to maintain the OU times and can use
the system parameter N1MESICY for the automatic defaulting of the day cycle.
Day Cycle
In the system parameter N1MESICY, define the day cycle that is preset for the
simplified dose definition. You define day cycles in the same way as for conventional
cycles in cycle maintenance. Note that you can set the Day Cycle indicator only for
cycles that are used exclusively in Medication. Quantities and time definitions are not
available for day cycle master data.
Examples for day cycles are daily, weekly, monthly, every 2 days.
OU Times
You can define any number of administration times for each organizational unit. The
system defaults the following times, which can be changed, for all organizational units:
08:00
12:00
16:00
20:00
Simplified Dose Definition
You enter the simplified dose definition in the Dose Strength field in the compressed
order view. The system interprets this in accordance with the specified OU times.
The following characters can be interpreted:
- to separate several doses or times, for example 1 - 0 - 1 - 0
. or , for decimal numbers, for example 1.5 - 0 - 1.5 - 0 or 1,5 - 0 - 1,5 - 0
/ Fraction line, for example 1/2-0-1 1/2 - 0 ( = 0.5 - 0 - 1.5 - 0)
( Start of a time definition outside of the OU times, for example, 1 - 0 - 1
(13:35) - 0 - 1
: Separation of hours and minutes
) End of a time definition outside of the OU times
Dosage Type
The system always interprets the quantity in accordance with the set dose unit.
Switching the dose unit causes the system to automatically convert the dose definition.
Example
Day cycle DAILY, definition 1-0-1, dose unit TBL
Every day the system generates events with 1 tablet for the first and third OU
time, thus at 8:00 and 16:00, for example.
Day cycle every 2 days, definition 75 (14:00), dose unit mg (agent A)
Every second day the system generates an event with 75mg at 14:00.

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If you switch the dosage type to "reference unit", the system converts the dose
definition to 1.5 (14:00) (for a divisible 50mg tablet).
The system further takes into account the divisibility of the dose, and rounds up or
down, if required.
You can switch the dose unit by means of the pushbutton in the Dose Type column of
the compressed order view. You can default the dosage type on the Presentation tab
page in the drug master. Additionally, you can use the hotspot on the Dose Unit
column. In the value help, you can select the dose unit, the alternative dose unit (if
defined in the drug master) and the agents with the associated strength units.
Effects on Customizing
Customize the OU times to be able to use the simplified dose definition easily.
Define the value of the system parameter N1MESICY.

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ISHMED_MAIN: Ordering Generic Drugs (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can order generic
drugs for which package information is not available.
You can stipulate whether the generic drug is only to be found in the search and when
you select this drug the system is to automatically transfer the drug defined as "default"
at a lower level of the drug master into the order. Alternatively, you can stipulate
whether the generic drug itself can be used in the order.
You make this distinction in the drug master by means of the following selection option
for the order purpose (administration, dispensing, prescription print):
Yes: The drug can be transferred directly into the order.
Only Search: The drug is used in the drug search. However, the system automatically
transfers the drug defined as "default" if the hierarchy of the generic drug into the
order.
No: The drug cannot be ordered and is not used in the drug search either.
This specification lets you simplify the search and selection behavior in the drug search
for your users.
When you transfer a drug into the order and the drug master does not contain a
package size and the order purpose is "dispensing" or "prescription print", you can
determine the dispensing quantity from a selection list containing all package sizes that
are available for this hierarchy.
This information is then used for event generation.
Example
You order the drug ASPIRIN 500 MG for dispensing. The drug is available in package
sizes of 20 and 50 tablets. Consequently, the selection list box for the dispensing
quantity contains the following two entries:
PKG with 20 TBL
PKG with 50 TBL

Effects on Customizing
For more information about setting levels in the drug master, see the Release Note
ISHMED_MAIN: Structuring in Drug Master (New).

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ISHMED_MAIN: Patient Transport Service - Means of Transport (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the component Patient
Transport Service has been enhanced to include means of transport. This
enhancement does not constitute transport equipment management in the strict sense,
but is simply a further attribute of a transport order.
The following view types of the clinical work station have been supplemented by
addition of the fields Means of Transport (Internal) and Means of Transport.
Transport Orders
Occupancy
Arrivals
Departures
Outpatient Clinic/Service Facility
In addition, all the tables in the dispatcher work station have been supplemented
through the addition of the fields listed above.
When entering transport orders, it now possible to enter a means of transport (selection
list is available) that is linked to transport type selection. You can use the new
checkbox Means of Transport Is Available to indicate that the means of transport is
standing by in the transport order's pick-up OU. The user can also select a means of
transport on the initial screen the dispatcher work station.
The structures for the Businesses Add-Ins (BAdIs) and user exits for the patient
transport servie have been supplemented accordingly.
The application component of the clinical order for transport orders has also been
enhanced by enabling the entry of a means of transport.
The report RN1PTSSTAT1 now takes the means of transport into account too.
Effects on Customizing
Define any means of transport that you want to be available for transport order
processing in the Implementation Guide under Industry-Specific Component
Clinical System -> Patient Transport Service -> Maintain Means of Transport.
You can also only assign a means of transport to specific transport types in order to
restrict the input help for means of transport when processing transport orders.

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ISHMED_MAIN: Transport Orders for Provisional Patients (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can also create
transport orders for patients with provisional patient master data (provisional patients).
Previously the creation of a transport order for provisional patients was not possible,
therefore the system showed an error message at any attempt to create a transport
order.
You can also create the transport order with a reference to an appointment of a
provisional patient.
In addition, when you allocate an appointment for a clinical order with the Transport
Orders application component, the system will also create a transport order with an
appointment reference for provisional patients.

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ISHMED_MAIN: Patient Transport Service - Web Services (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), a new web service
N1PatientTransportService is available for the Patient Transport Service.
This web service is used to connect external systems to the Patient Transport Service
in i.s.h.med and consists of the following function modules:
ISHMED_WS_PTS_ORDER_UPDATE (Change Transport Orders)
You can use this function module to change transport orders using a web
service. This function is available, for example, for reporting the return of
transporters, whereby a transport order within i.s.h.med can be flagged as
completed.
ISHMED_WS_PTS_ORDER_CANCEL (Cancel Transport Orders)
You can use this function module to cancel transport orders.
ISHMED_WS_PTS_ORDER_SELECT (Read Transport Orders)
With this function module third-party systems can read transport orders. For
example, you can use this mdoule to read all transport orders in i.s.h.med which
have a specific status and should take place on a certain day.
ISHMED_WS_PTS_DRIVER_UPDATE (Change Trransporter Availability)
You can use this function module to enable a third party system to inform
i.s.h.med that a transporter is available or not available.

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ISHMED_MAIN: Connectivity (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the Connectivity
component has been enhanced by a number of functions to support the exchange
(receipt, dispatch) of clinical orders and appointments with third-party systems (other
i.s.h.med installations, external systems, subsystems).
This enables the following use cases to be mapped:
Query order types that are available to an external initiator
Query the structure of an order type, which is available to an external initiator
Query appointment types that are available to an external initiator
Creation of patient master data by an external initiator
Query patient master data by an external initiator
Creation of a clinical order by an external initiator
Creation of a clinical order with appointment by an external initiator
Creation of a clinical order with desired appointment by an external initiator
Query orders that have been initiated by an external initiator
Query details of a clinical order that has been initiated by an external initiator
Communication of clinical order data to an external system

Patient Creation / Search by an External Initiator


For queries (clinical order/appointment/documents) that are received from external
parties, an appropriate assignment to patients in i.s.h.med is required. This assignment
must both satisfy data protection requirements and be open for future patient
assignment methods (Master Patient Index PMI, Patient Identifier Cross Referencing
PIX, #).
Furthermore, the external party should at all times be able to search for entities it
initiated and "locate" patients it introduced into i.s.h.med, even if these have been
merged with other patient master data in i.s.h.med, for example, during the admission
or other organizational activities.
Different installations also have varying needs concerning the possibility i.s.h.med
offers of managing provisional patients and real patients. In many scenarios, it can be
an advantage to initially enter patients introduced by external parties as provisional
patients, until they appear for admission, in order to then convert them into real
patients. In other scenarios, the creation of real patient master records will be desired
(for example, when an internal PMI exists).
These requirements have been implemented in i.s.h.med Connectivity as follows:
All queries initiated by an external system relate to a local patient ID, in other words the
patient ID in the external system. In i.s.h.med, this local patient ID of the business
partner is assigned either to a provisional patient or an actual patient, dependending on
how the system is configured. This means that:
For external systems, it is consequently irrelevant whether i.s.h.med works with
provisional or real patients and whether a patient merge or the conversion of
provisional patients into real patients modifies the patient ID. The external
system always identifies its patient with his/her local patient ID.

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The external system only has access to patients for whom a corresponding assignment
exists in i.s.h.med. A patient in i.s.h.med can be assigned to several business
partners using individual entries. You can link business partner-dependent
authorizations to this.
You use the cross-institutional system parameter N1CXPAT (Connectivity; Control
External Patient Creation) to control whether a provisional patient or a real patient is
created when a patient master record is created in i.s.h.med by a business partner.
The external initiator can perform the desired actions for the patient using the following
services:
N1CREATEPATIENT
N1GETPATIENTSEARCH
In i.s.h.med you can also manually assign patients to external business partners and to
the respective local patient IDs using the report RN1CONNPATASS.

Planning by External Initiators


In connection with clinical orders, you can enable external initiators (business partners)
to plan appointments or specify desired appointments.
To enable planning in the usual way also for external initiators, the following approach
has been adopted:
The i.s.h.med Connectivity component uses "proxy OUs" (existing organizational units
or organizational units specially set up for this purpose), for which the
authorization to plan on time slots is granted in the usual way. Subsequently, you
assign a proxy OU to all initiating business partners and/or, at a greater level of
detail, special proxy OUs to individual external business partners.
By means of the Web service N1GETPLANNINGOBJECTS, the external initiator can
query the appointment types (i.s.h.med planning objects) authorized for them for
each possible order filler and use these in a subsequent planning step.

Creation/Change of Clinical Orders by External Initiator


External initiators can create and edit clinical orders using Web services. The standard
delivery of i.s.h.med Connectivity contains a number of services - differing in complexity
- for this, as examples. You can use the following services directly and/or indirectly as
templates for customer-specific services:
N1CREATECLINICALORDERSIMPLE
N1CREATECLINICALORDERSTANDARD
N1CREATECLINICALORDERADMISSION
N1CREATECLINICALORDERPROVAPP
N1CREATECLINICALORDERSTANDARDAPP
N1UPDATEORDERSTATUS
N1CANCELCLINICALORDER
A registration function enables the definition of services as services for i.s.h.med
Connectivity and makes sure that these services are available and can be used in
Customizing for clinical order types.
Customizing is performed in the function for setting up clinical order types (transaction
N1COT). The Connectivity tab page is displayed here if you have a license for the
Connectivity component. This tab page contains a table in which your can specify

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different services for different operations for each business partner entered on the
Initiators tab page.
The external business partner can query the order types released for them using a
Web service. The address of the (technical) description of the respective service is also
returned in this query. By calling this address, for example in a Web browser, and
analyzing the result, the third-party system can create Web service consumers
statically or dynamically that can be used by the services offered by i.s.h.med
Connectivity.
N1GETCLINICALORDERTYPES
N1GETCLINICALORDETYPEDESCR

Query Order Data by an External Initiator


For the external initiator, the standard delivery of i.s.h.med Connectivity provides the
following services, by means of which the clinical orders initiated by the business
partner can be queried both in overview and in detail mode:
N1GETCLINICALORDERS
N1GETCLINICALORDERDETAIL

Communication of Clinical Order Data to an External System


The following utilities and functions are available for outbound Connectivity
(transmission of data to third-party systems):
Generic application component for the clinical order that can be configured for different
scenarios
Sustained integration in processes of the clinical order by means of component
methods with the possibility of linking to actions for the clinical order (change of
status, save)
i.s.h.med Connectivity handler framework for the central and standardized
administration of the entire outbound communication of the clinical order data
using various communication channels
Handler of the variants
HTTP, local, RFC, Web service
Supports CRUD operations (Create, Read, Update, Delete)
Contains connectivity logging
Delivered example handler for each variant
The Connectivity handler framework provides:
A standardized programming model
A number of standard functions (such as logging)
Automated integration in the dialog for the Customizing of clinical order types and in the
ordering process
Example implementations for various communication channels
The connectivity handler framework basically consists of a class model which provides
the basic functionality for the following types of communication channels:
HTTP
Transmission of clinical order data via a "simple Web interface"; suitable for third-

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party systems with restricted capabilities
RFC
Transmission to other SAP systems, in particular older SAP systems
Web services
Transmission to any modern (i.e. Web service-enabled) third-party systems
Local storage
Transmission to file system, customer-specific table, BDS, for example.
For each of these communication channels, one or more example implementations are
provided as derivations of the respective base classes.
You can use these example implementations in production. However, in connectivity
scenarios, scenario-specific adaptations are almost always necessary. You can make
such adaptations in customer-specific handler classes by deriving from the respective
base classes or the example implementations. You can use the example
implementations as templates for this.
Each of the available base classes allows the implementation of one or more of the
following operations in derived handlers:
Create
Read
Update
Delete
In the handler registration, you can assign handlers and handler operations to the
clinical order function. This is the interface between developers and application
support. This means that developers create a service consumer (for example Web
service client). They "pack" this into an i.s.h.med Connectivity handler of the suitable
action (for example, create) and register it using handler registration. The handler is
available in Customizing from this time onwards.
You can also deactivate a handler (temporarily or permanently) using the handler
registration.
You activate the communication of order data by integrating the Connectivity
application component in the clinical order type and with the following customizing of
the component and the available methods.
Effects on Customizing
Perform Customizing as follows:
Make the required Customizing settings in the Implementation Guide under SAP
Healthcare - Industry-Specific Component Clinical System -> Connectivity.
Maintain the assignment of a service (inbound) or the order component and further
specification (outbound) in transaction N1COT for managing clinical order types.

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ISHMED_EDP: Radiology Work Station - Preparation (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System Enhanced Documentation Processes
(ISHMED_EDP), the Radiology Work Station is provided.
The requirement for switching over to the Radiology Work Station is the replacement of
radiological requests with clinical orders. Radiological requests are no longer supported
since the change to the Radiology Work Station. So the replacement of radiological
requests has to be complete before switching to the Radiology Work Station.
The Radiology Work Station offers the following benefits compared to the previous
Findings Work Station:
Enhanced functionality for selecting the findings selection
Support for fixed categories of findings tasks
Enhanced functionality when accessing detail data and additional data for findings
tasks
The following changes to the internal mapping of the application process flow also
become effective for radiology at the same time as the switch to the Radiology Work
Station:
Radiological examinations are completely ommitted. The system no longer generates
and supports the N7EXAM documents previously generated for all imaging
services. Consequently, the customer enhancement
ISHMED_RAD_PA_EXTSTAT for processing after setting the examination status
is also omitted.
The application component CREATE_RAD_DOCUS is completely omitted in clinical
orders.
Customizing for the creation times for EXAM/STUDY documents is completely omitted.
The system automatically generates the necessary STUDY documents at the
respective times required.
It is no longer imperative to assign a STUDY to only one imaging service. You can also
assign a STUDY to several services. There can also be several STUDIES for
one imaging service.
If the Transaction Broker is used for communication with the PACS system you can
receive the MPPS messages from PACS or the modalities. The assignment of
MPPS messages to imaging services occurs automatically. For unassignable
messages there is a tool for manually reconciling these messages. When you
receive MPPS messages you have customer enhancements available for
controlling assignment, both for automatic and manual assignment. There are
also customer enhancements available to you to enable further specific
processing of data from these MPPS messages.

Effects on Existing Data


The switch from radiology requests to clinical orders must be complete.
Effects on Customizing
Note that the Radiology Work Station can only be activated system-wide and that
activation cannot be reversed.
For this you can use the institution-independent, time-independent system parameter
N1RADDWS. This parameter enables you to control if you support the Radiology Work

437
Station or if you want to continue working with the already familiar Findings Work
Station.
You define this system parameter in the Implementation Guide under Industry-
Specific Component Clinical System -> Radiology -> Maintain Parameters ->
Maintain Institution-Independent System Parameters
You can implement the customer enhancement ISHMED_RAD_BASE for processing
after you set the status of the service.
See also
For further information about the Radiology Work Station, see the Release Note
ISHMED_EDP: Radiology Work Station (New).

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ISHMED_MAIN: i.s.h.med pathways: Overview of Changes (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), there are extensive
changes and enhancements supplied for the i.s.h.med Pathways module.
Generally only user interfaces and functions are affected by the changes, not, however,
the structure or contents of treatment pathways. You can continue to use your existing
treatment pathways without any restriction and any adjustments.
Current patient pathways can continue to be processed or displayed without any
restrictions. They do not, however, offer the new functions and every evaluation option,
because these are only available subsequent to generation of the patient pathways.
The contents and structure of existing patient pathways are not changed.
Initially most changes do not affect the current system; they only take effect if the
system administrator has made corresponding settings in Customizing. In this way,
measures, such as updating the user manual or user trainings, can be planned and
system adjustments can be activated at a time of your choosing.
Unfortunately this has not been possible for every change. Please take careful note of
the following exceptions:
Revisions to the dialog layout: Importing the Release renders every adjustment to the
interfaces visible, such as screen layout, new function buttons, and changes to
the menu or context menus, which cannot be influenced by Customizing.
Function keys of functions which users are sometimes still unfamiliar with, such
as the deletion of pathway assignments or undoing activities, are also visible and
thus usable. We recommend that you inform any affected users concerned by
training or other means.
Customizing work station layouts: Work station layout settings personally defined by
the user are rendered ineffective, the supplied layout or one you have centrally
defined is always used. We recommend that you give advance information to
any affected users.
Enhancement of the note function: The integration of the comment dialog into the
various confirmation dialogs changes the sequence of operations for the users.
In order to prevent incorrect inputs or necessary inputs from being skipped, we
recommend detailed information or supplementary user training.
Please bear in mind that notes created before importing the Release into patient
pathways are only visible to the user if the procedure for data conversion, described
below, has been executed.
The above points are described in detail in the other Release Notes in this chapter.
A large part of the enhancements has already been delivered with Add-On Support
Packages for Releases i.s.h.med 4.72 and SAP ECC Industry Extension Healthcare
5.0.

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ISHMED_MAIN: Customizing Work Station Layout (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can make
adjustments to main dialog layouts centrally. For the assignment dialog, processing
dialog and the pathway monitor you can establish which information units are displayed
and in which information window. In addition, you can determine the size of the
information windows or completely hide them.
You can make these settings using program RN2GL_ADM_LAYOUT.
Using the authorization object N_2GL_LAY you can define if a user may process a
layout for the entire institution, for an organization, for themselves, or not at all.
Effects on Existing Data
Layout adjustments defined and saved prior to the upgrade are no longer effective; the
centrally defined layout is displayed. If no layout is defined, the supplied standard
layout is displayed.
Users who have used user-specific layouts have to reset their layouts after the
appropriate authorization has been assigned.
Effects on Data Transfer
In order to enable users to continue to process their own layouts, the authorization
object N_2GL_LAY has to be maintained.
The supplied standard layout is used as long as no new layouts have been defined.
The information units supplied previously are displayed if no Customizing changes are
made subsequent to importing the patch.

Effects on Customizing
You access the documentation for this program in Customizing for i.s.h.med under
Define Layout.
You can also find the dialog in the menu of the respective dialog by choosing Utilities -
> Layout -> Process
Here you define the desired reference level for the layout; the selection option depends
on the user's authorizations.
You define the relative size of the two information areas in relation to the work area.
This is the proposal list, the step list, or the monitor list.
You define the information area you wish to display the available information units in.
You define which information unit you wish to display with initial values and in which
information area. If no information unit is assigned to an information area, this area is
hidden.

440
ISHMED_MAIN: Enhancement of Information Units (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), new information units
are supplied. You now also have enhanced options for defining your own information
units and for determining the sequence in which the information units are displayed in
the information areas.
The choice of available information units in the application dialogs has been improved.
The technical basis of the information units has been changed, so that now all
controllable techniques (Smart Form/HTML. Dynamic document, HTML) can be used
for standard or customer-specific information units.
The following information units are available:
Treatment pathway (unchanged)
Display of clinical information on the pathway and all of the pathway steps. The basis is
the Smart Form N2GL_PATHWAYWAY_CLINICAL_V, the class
CL_ISHMED_GL_INFO_V_GL is supplied.
Graphic (unchanged)
Graphic of the pathway, the basis is the SVG diagram created from the graphic editor,
which is displayed in a browser control. The class CL_ISHMED_GL_INFO_V_GRAPH
is supplied.
Documents (unchanged)
List of all the patient documents with the option of a detail view, the basis is the
document viewer. The class supplied is CL_ISHMED_GL_INFO_V_DOC.
Treatment data (unchanged)
Selected information on the patient and the case. The basis is the Smart Form
N2GL_PATHWAY_PATIENT_V, the class CL_ISHMED_GL_INFO_V_PAT is supplied.
Clinical Info Step (unchanged)
Clinical information on the step currently selected. The basis is the Smart Form
N2GL_PATHWAYS_STEP_CLIN_INFO, the class
CL_ISHMED_GL_INFO_V_TMS_CLIN is supplied.
Pathway Comments (new)
Chronological display of all comments on the pathway. The basis is the supplied class
CL_ISHMED_GL_INFO_V_TM_NOTES with the implementation of a dynamic
document.
Step Comments (new)
Chronological display of all comments on the currently selected step. This information
unit replaces the previous "Notes on the Step". The basis is the supplied class
CL_ISHMED_GL_INFO_V_TMS_NOTES with the implementation of a dynamic
document.
Step Details (unchanged)
Technical and organizational information on the currently selected step. The basis is
the Smart Form N2GL_PATHWAYS_STEP_INFO_V, the class
CL_ISHMED_GL_INFO_V_TMS_INFO is supplied.
Step Activities (new)
Chronological display of all activities on the currently selected step. The basis is the

441
supplied class CL_ISHMED_GL_INFO_V_TMS_ACT with the implementation of a
dynamic document.
Pathway Activities (new)
Chronological display of all activities on the pathway. The basis is the supplied class
CL_ISHMED_GL_INFO_V_TM_ACT with the implementation of a dynamic document.
Step Link (new)
Display of the URL saved in the definition data for the currently selected step. The
basis is the supplied class CL_ISHMED_GL_INFO_V_TMS_URL.
Pathway Link (new)
Display of the URL saved in the definition data for the current step. If several pathways
are displayed in the work list, the URL of the pathway for the currently selected step is
displayed. The basis is the supplied class CL_ISHMED_GL_INFO_V_TM_URL.
If several information units are assigned to an information area, it is possible to display
the selection by using buttons in the information area header. A fixed sequence is
supplied; you can, however, enter a different sequence in Customizing.

Effects on Existing Data


The upgrade does not have any effect on Smart Forms for previous information units
defined by the user; you can continue to use them unchanged.

Effects on Customizing
If, in future, you define information units with Smart Forms, you have the following
options:
You use the procedure, which has been valid thus far, as described in the
Implementation Guide under Industry-Specific Component Clinical System ->
Pathways -> Use Customer-Specific Smart Forms
Use the general procedure for creating information units described in the following.
Steps for creating your own information units:
Implement a class derived from CL_ISHMED_GL_INFO_COMP_BASE
In Customizing for i.s.h.med pathways enter the new information unit in the IMG
activity Pathways -> Set Up Assignment -> Adapt Layout of
Applications -> Edit Information Units
In the desired layouts, assign the new information unit to an information area.
You can find further information in the i.s.h.med Implementation Guide Industry-
Specific Component Clinical System -> Pathways -> Set Up Assignment -> or Set
up Patient Pathway under the IMG activity Adapt Layout of Applications -> Edit
Information Units.
You can optionally override the standard sequence of the information units. You can
access the setting in Customizing for i.s.h.med under Industry-Specific Component
Clinical System -> Pathways -> Set Up Assignment or Set Up Patient Pathway by
choosing the IMG activity Adapt Layout of Applications -> Override Sequence of
Information Units

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ISHMED_MAIN: Revision of Dialog Layouts (Changed)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN, improvements have been
made to the operation of the main dialogs of the i.s.h.med Pathways module.
Screen Layout
The arrangement of the work area and the information areas in the assignment dialog
has been adapted to the editing dialog, i.e. the proposal list is now positioned at the top
left, the information areas on the right and below the work area.
Enhancement of the work area in the assignment dialog
The assignment dialog work area has been supplemented with a list of the patient
pathways already assigned. In this list the patient pathway status is recognizable,
detailed information can be seen and it is possible to navigate to the editing dialog for
the respective patient pathway. Wrongly assigned pathways can also be deleted in this
list. Completed patient pathways are not displayed in this list.
Revision of the menus and button bars
Menus and button bars have been standardized in all the dialogs with regard to
terminology and layout.
Context menus in the work areas
The proposal list in the assignment dialog and the work list in the editing dialog now
feature context menus. Every major and frequent function is accessible via the main
menu, the button bars and also the right mouse button.

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ISHMED_MAIN: Note Function (Enhanced)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), a new comment function
is available. It supersedes the previous function for commenting on pathway steps.
Use
Comments on patient pathways are now entered in relation to activities instead of
steps.
You can still enter comments on steps, i.e. without explicit activity. If there is a
comment for the step, an icon is displayed in Comment column in the worklist
(previously:Note). You enter comments for the pathway uisng the Comment on
Pathway button in the worklist toolbar.
Activities on a pathway are
Assign Pathway
Terminate Pathway
Undo Terminate Pathway
Comment Pathway
End Pathway
Reschedule Pathway
Reschedule Start Time
Confirm Step
Reject Step
Comment Step
Make a Decision
Revise Decision
Continue Pathway
Undo Continue Pathway
Undo Step Status
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the dialog for the entry
of a comment is integrated into the confirmation dialog, which facilitates entry and
avoids a sequence of query dialogs.
A comment consists of a category and a free text note. It is possible to save the free
text of a comment or to release it, so that subsequently it can no longer be changed.
Comments are categorized by means of category catalog that you compile yourself
(category set). It is possible to define a category set for each treatment pathway
separately according to activity.
Both for categories and for the free text note you can define for each activity if an entry
is required, optional, or not applicable. If the entry of a category or a note is defined as
unnecessary, this data is hidden in the confirmation dialogs for the activities.
You can edit comments or enter supplements for released comments in a dialog that
you access from the menu by choosing Patient Pathway -> Edit Comments or for the
currently selected step by choosing Step -> Edit Comments.

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All the comments are displayed for the pathway or the selected step. One comment
can be selected for editing in each case. The category of the comment can no longer
be changed, a change to the free text note is possible if this note has not been
released.
Released notes are displayed. It is possible to enter a supplement for a released note.
Subsequent entry can be prevented for each activity via the category set.
You can analyze comments on the basis of their category.
Effects on Existing Data
Notes previously entered for steps can no longer be displayed. After importing the
release you have to migrate the data. The system assigns all notes for comments to
the step of the activity Comment Step.
Additionally, the existing Customizing for note categories, reasons for rescheduling
reasons and cancellation of the note function is also migrated. The data is transferred
to a category set which is created during the data migration.
To perform the data migration, proceed exactly in the order described as follows.
Import the release into your development system.
Execute the program RN2GL_MIGRATE. Enter the category set and the main category
which you wish to create for the Customizing to be transferred.
If necessary, make more adjustments to the Customizing and include these changes in
a transport request.
Import the release into your production system.
Execute the program RN2GL_MIGRATE. Enter the category set and the main category
which you wish to create for the Customizing to be transferred. Use the same
values as in step 2.
Import the transport with the additional adjustments from the development system.

Effects on Customizing
To categorize comments, first you have to maintain a category catalog. In this catalog
you can create main categories (e.g. staff) and under them maintain any desired
categories (Physician unavailable, Nurse delayed, etc.). You can access catalog
maintenance for categories by choosing Industry-Specific Component Clinical
System -> Pathways -> Set Up Categorization and Comments -> Edit Main
Categories and Industry-Specific Component Clinical System -> Pathways -> Set
Up Categorization and Comments -> Edit Categories.
You can maintain a category set by creating a set and assigning categories for all
activities from the catalog. For each activity in the set you can also define whether
categorization and free text note are to be required or optional entries or not entered at
all and if the comment is to be released when it is saved.
You can access the maintenance dialog for category sets by choosing Industry-
Specific Component Clinical System -> Pathways -> Set Up Categorization and
Comments -> Set Up Activity Categories.
One of the available sets can be defined as standard for all institutions.
To enable the user to categorize activities, a predefined set must be assigned to a
treatment pathway. This is done in the dialog for treatment pathway definition on the
tab page Header Data.
If no category set is entered for a treatment pathway, the system uses the set which is

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flagged as standard.
See also
Documentation for program RN2GL_MIGRATE

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ISHMED_MAIN: Pathway Proposals in the Clinical Work Station (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN) a new functionality is
available. After new diagnoses have been entered the system checks if there are
suitable treatment pathways for them and saves these proposals in relation to patients.
In the clinical work station view types which are able to display pathway information it is
now possible to display a column that contains an icon when a proposal exists. This
icon is only visible to the user if they the authorization to assign or enter at least one of
the suggested pathways.
If the user is allowed to assign pathways, they can open an assignment dialog by
clicking the icon column hotspot, check proposals, assign either one or several
pathways or delete the proposals.
If the user is only allowed to display pathways, the icon column hotspot opens an
information dialog displaying the treatment pathways that are suitable for assignment.
An assignment is not possible.
The proposal list resulting from newly entered diagnoses supplements the previously
available proposal list that is based on all the diagnoses for the patient and the case.
You can switch between both types of proposal in the toolbar. This also permits an
assignment to be made according to the previous procedure.
In this new dialog, which can be initiated by a hotspot (popup dialog), the assignment is
always made via newly entered diagnoses. In the previous assignment dialog
(transaction N2GA) the proposal list is provided with initial values which are based on
all the diagnoses of the patient and current case.
If the treatment pathways proposed by newly entered diagnoses are not suitable for an
assignment, the user can delete the proposal signal. If the same diagnosis is reentered
at a later time, the corresponding proposal is also regenerated.
The proposals are deleted by the system if you delete the proposal signal or if you have
assigned at least one of the pathway proposals. Some rare constellations are
conceivable causing proposals never to be edited and thus never deleted. In order to
prevent the accumulation of unused data, SAP ECC 6.0, Industry Extension
Healthcare, Enhancement Package 4 (IS-H 604), Business Function Clinical
System (ISHMED_MAIN) delivers the deletion report RN2GL_PROPOSAL_DELETE.
Using this report you can delete proposals according to different criteria.
The check module can be integrated into each dialog for diagnosis entry. The popup
dialog for assigning treatment pathways can also be integrated into your own
applications.
The proposal check at diagnosis entry in appropriate clinical work station worklists
informs the user whether they can assign a pathway to a patient. This allows a more
selective and more reliable assignment of pathways.

Effects on Customizing
In order for proposals for pathway assignment to be created in your system, you must
execute the static method call
CL_ISHMED_GL_TRIGGER=>SET_PROPOSAL_BY_BADI_NP61 in the BAdI method
ISH_DIAGNOSIS_NP61->RNDIA_CREATE. The procedure is described in the
Implementation Guide under Industry-Specific Component Clinical System ->
Pathways -> Pathway Proposal in Diagnosis Processing -> Edit Pathway
Proposal in Diagnosis Processing.

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For existing proposals to be recognizable to the user, in a suitable clinical work station
view (e.g. Occupancy) you have to add the Pathway Proposal Icon column.
If there are regularly proposals in your application configuration which are not deleted
by the application, we recommend that you execute the delete report
RN2GL_PROPOSAL_DELETE manually or schedule it as a job.
See also
For further information about the deletion report, see the report documentation.

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ISHMED_MAIN: Patient Pathways in the Clinical Work Station
(Enhanced)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the following new field is
available in the Patient Information area in the field catalogs of the view types
Occupancies, Admissions, Discharges, Coding Analyses, Clinical Order,
Outpatients/Service Facility and Surgery:
Pathway Proposal Icon - indicates if there are any pathway proposals for the case
Features
Clicking Pathway Proposal takes you into the assignment dialog for editing pathway
proposals.

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ISHMED_MAIN: Pathway Log (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), it is possible to display
patient pathway data in an HTML view. All the data of a patient pathway can be
displayed in a structured document.
Two sample views are supplied; the implementation of additional views is possible.
These can be displayed as supplements to or as replacements for the supplied views in
different applications. The implemented component must be able to be displayed in a
GUI container. Dynamic documents, for example, are suitable for this.
In the standard system it is possible to display in the assignment dialog, editing dialog,
pathway history and patient organizer.
A pathway log is able to provide an easily readable display of all the key information of
a patient pathway which does not depend on the editing dialog. The standard views
supplied can be used immediately; you can implement specific views, thus overriding
the ones supplied.
Effects on Existing Data
Prior to the upgrade the case number entered for the step of a patient pathway was the
case number known on creation of the step. For most steps this was the case number
in the context of which the pathway was assigned.
This release changes behavior in such a way that the case number, which was current
when the step was last edited is saved for the step.

Effects on System Administration


To user the delivered function, no settings are required in the system.

See also
Hiding standard views, implementing your own views and displaying them in various
applications is described in the Implementation Guide under Industry-Specific
Component Clinical System -> Pathways -> Set Up Patient Pathway -> Adjust
Pathway Log.

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ISHMED_MAIN: Undoing Activities (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can undo various
processing steps (activities).
Unexpected events in the treatment of a patient or incorrect handling of the application
can make it necessary to undo certain activities, in order to ensure that the patient
pathway continues to be correctly processed.
The following activities can be redone:
Terminate Pathway
Make Decision
Confirm Step
Reject Step
Continue Treatment
When you undo an activity, the system generates the following activities
Resume Pathway
The termination of a pathway can be undone. Automatically confirmed steps are set to
the status for processing. The status of the patient pathway is set to in processing.
Revise Decision
A decision can be undone. This is only possible as long as any steps resulting from the
decision remain unprocessed. Decision revision can be used, if there has been an
operating error or if after the decision it becomes clear from the resulting visible steps
that this mode of processing is not an appropriate way to proceed.
Undo Continue Pathway
The continuation of a pathway can be undone by processing a break step, as long as
no subsequent steps have been processed. This can be used, if, for example, there is
an abrupt delay in the inpatient admission of a patient, if, however, the pathway has
already been resumed or in the event of an operating error.
Undo Step Status
The processing status of a step can be reset from Completed or Rejected to Open.
This is only possible as long as the assigned action has not been executed.
Thus it is possible to correct falsely confirmed or rejected steps.
The execution of all activities and also the undoing of activities is logged, this log is
visible in the activity information units (step) and activities (pathway).
The undo functions should only be used in exceptional cases. They are not available
from the context menu; they can only be accessed from the menu via Step -> Reset
Status.
You can access the activity Undo Terminate Pathway via the menu Patient Pathway
-> Resume Pathway.

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ISHMED_MAIN: Evaluations (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), standard reports are
supplied for pathways.
You can access the evaluations for pathways from the program RN2GL_REPORTING
or from the SAP Easy Access screen by choosing Clinical System -> Evaluations -
> Patient Pathways.
The following functions are provided in all evaluations:
Grouping of data
Aggregation of data by grouping
Choice between different display variants
Graphic display of results (exception: overview of patient pathways)
Export of the result data
The following evaluations are available:
Pathway usage
With this evaluation you can get an idea of how often pathways were used and the exit.
This evaluation provides you with information about which treatment pathways were
assigned in which period and in which department. Here a distinction is made between
the processing or completion status of the pathways. You get the data in absolute and
percentage terms; the average runtime of the pathways is also shown.
Restrict the analysis data according to treatment pathways or versions, assigning
department or assignment period, processing or completion status of pathways.
The display is groupable by pathway, pathway version, assignment year, assignment
month or assigning department.
Pathway Usage - Steps
This evaluation provides you with information about the processing of the steps of your
patient pathways. By this evaluation you can get an idea of whether the processing of
your pathways' steps was on time and the result.
Information is output on how many steps were processed which deviated from the
standard, split according to early and late processing. You can see how many steps
were processed in compliance with the pathway. These details are also displayed for
each step status (confirmed and rejected). You can preselect according to treatment
pathways or version, assigning department or assignment period, processing or
completion status of pathways.
The display is groupable by pathway, pathway version, pathway steps, assignment
year, assignment month, assigning department and the processing group responsible.
Pathway assignment
This evaluation provides you with information on the assignment type of treatment
pathways. With this evaluation you can get an idea of the strategies by which your
users assign treatment pathways and if, possibly, assignment patterns must be
improved.
You can display the number of pathways assigned on the basis of the pathway
proposal, the list of all pathways, the search of pathways or of the system of assigned
pathways. Display is in absolute numbers and as a percentage.

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You can preselect according to treatment pathways or versions, assigning department
or assignment period, processing or completion status of pathways.
The display is groupable by pathway, pathway version, assignment year, assignment
month or assigning department.
Activity
This evaluation provides you with information on how often activities were performed in
your pathways and how the comment on them was categorized. The evaluation is
mainly for analyzing the reasons for pathway deviations.
The number of the activities is displayed in each case. The evaluation is made for a
selected activity in each case; you can also preselect according to treatment pathways
or versions, assigning department or assignment period and the processing or
completion status of pathways.
The display is groupable by pathway, pathway version, assignment year, assignment
month or assigning department, main category and category..
Decision process
This evaluation provides you with information on how users decide with regard to a
patient pathway. The evaluation enables quantitative statements to be made about a
treatment pathway's variants and can be used, where applicable, to optimize treatment
pathways through simplification or more appropriate options for responses.
You can display by decision how often the possible answers were selected and
whether this occurred too early, on time or late. This is indicated as an absolute
number and as a percentage.
The evaluation is made for one treatment pathway version in each case, you can also
preselect according to assigning department or assignment period and the processing
or completion status of pathways.
Overview of patient pathways
You can get an idea of the patient pathways' processing status and the relevant
properties of the patient pathways displayed. From the patient pathways list you can
navigate via a context menu to the patient organizer, to the case list, to the documents
list, to pathway processing, to the pathway log and to treatment pathway data.
You can preselect according to treatment pathway or versions, assigning department or
assignment period, processing or completion status of pathways.
The pathway overview can be used as tool for monitoring patient pathways. The
overview makes it possible to identify pathways the processing of which has become
delayed. By displaying the pathway data and the option of navigating to relevant case
data at runtime a pathway controller can, for example, recognize the causes of delayed
treatment processes and intervene systematically.
In order to achieve a satisfactory runtime for the evaluations, you should restrict the
data quantity.

Effects on Customizing
In order to use the standard reports, no setting changes need to be made to the
system.
It is possible to supplement the list of evaluations provided by your own reports or to
override the standard evaluations. Reports, function modules and transactions can be
used. The procedure is described in the Implementation Guide under Add
Evaluations.

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ISHMED_MAIN: Changing Active Pathways (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you have the option of
changing certain properties of active or inactive pathways. This is only possible if the
authorization object N2_GL_S gives you the authorization to change active or inactive
pathways.
Changing Individual Pathways
By means of this functionality it is possible to make small editorial changes to individual
pathways without having to create a new version. For example, these include
correcting typographical errors or changes in file systems (link) and changes to key
word schemas or coding catalogs for diagnoses and procedures.
We urge you only to use this functionality in exceptional cases, as sometimes the
assignment behavior or the information available to the user does not change in a
comprehensible manner at runtime. These changes, such as to the clinical information
or the patient information, also operate in pathways that are already assigned.
Changes in active pathways are not logged and they can sometimes no longer be
retraced, which therefore also leads to legal problems.
In the default dialog of the pathway definition you effect the change by selecting an
active or inactive pathway for processing.
The following data can be changed for the treatment pathway:
description
date of check and behavior
validity
link
clinical information
patient information
employee responsible for the pathway and contacts
unique flag and search strings for diagnoses, procedures and key word and customer
parameters
The following data can be changed for the pathway steps:
description
pathway relevance
occupational group responsible
link
clinical information
patient information
customer parameters
None of the data which changes the structure and the behavior of the pathway is
changeable. Therefore, the graphic editor and the dialog for maintaining base items are
not available in the change mode for active or inactive pathways.
If an active or inactive pathway has been changed, an icon is displayed beside the
changing user.

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Changing Several Pathways
In order to simplify the execution of Germany's usual annual update of diagnosis and
procedure coding catalogs for treatment pathway assignment criteria, functionality is
supplied for changing diagnosis and procedure assignment criteria that makes changes
to the catalogs in all of the system's treatment pathways.
The function for changing diagnoses displays a list of all the institution's treatment
pathways and diagnoses saved as search strings. You can now select the new
diagnosis coding catalog and select all the diagnoses in all the desired pathways. The
button Adjust now supplements the search strings with the appropriate entry from the
new catalog. If the new catalog should require changes to the search string, you can
manually reedit the new entries for this case. When you save the data entries, the
system then transfers your changes to the treatment pathways.
You proceed in a similar way to change the search strings of procedures.
Having maintained the new catalogs in your system, this function enables you to adjust
the search strings of your treatment pathways swiftly and conveniently.

Effects on Customizing
In order to enable users to change active or inactive pathways, you maintain the
authorization object N2_GL_S. Authorizations can be assigned per treatment pathway.
If you have the appropriate authorization, you can find the function in the pathway
monitor via the menu Edit -> Enhance Diagnoses or Enhance Procedures.

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ISHMED_MAIN: Deleting Treatment Pathways (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can delete treatment
pathways.
This function enables you to remove trial pathways and obsolete designs from a
development system. It improves the clarity of the selection list of treatment pathways
and the pathway monitor.
There is never a physical deletion of treatment pathways. Patient pathways, based on a
deleted treatment pathway, continue to be completely editable and visible.
Delete Treatment Pathway
In order to delete a treatment pathway, select a pathway version in the initial screen of
the pathway definition and using the Delete button or in the menu under Treatment
Pathway -> Delete you can set a deletion indicator for the selected pathway. You can
also decide if you wish to transport the deletion to receiving systems.
The Delete Treatment Pathways function is also available in the pathway monitor.
If further versions are created after deleting a pathway version, the new version number
is determined from the currently highest version number. Any gaps in the version
sequence that result from deletion are not closed.
Undo Pathway Deletion
You can display deleted pathways in the pathway monitor by selecting the Deleted
pathways indicator in the initial screen. This enables the Undo pathway deletion
button in the pathway monitor button bar. Using this, you can remove a treatment
pathway's deletion indicator.

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ISHMED_MAIN: Deleting Treatment Pathway Assignments (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can undo the
assignment of a treatment pathway to a patient.
The assignment dialogs have been extended by the list of pathways already assigned
to the respective patient. This is positioned below the proposal list of possible treatment
pathways. Thus you can directly control which pathways are currently assigned to the
patient. A deletion icon is displayed in the Delete Pathway column for pathways in
which no steps have yet been edited and which can therefore still be deleted. The
hotspot on this column executes the assignment deletion function.
The deletion of pathway assignments enables you to directly remove inadvertently
assigned pathways. You no longer have to switch to the editing dialog and terminate
the pathway. This both simplifies use and makes for more meaningful analyses for path
usage.

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ISHMED_MAIN: Unique Indicator (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can use the unique
indicator to prevent a treatment pathway being assigned to a patient several times.
When defining treatment pathways you can use the unique indicator on the
assignments tab page to define that this treatment pathway can only be assigned to a
patient once.
When determining proposals, the system checks each pathway, for which the Unique
indicator is set, to see if the pathway is already assigned to the patient. If this is the
case, the treatment pathway is not displayed in the proposal list.
If proposals are determined by a search or the display of all pathways, the unique
indicator is not considered. If you try to assign a pathway for which the Unique
indicator is set, the system issues an error message.
In addition to displaying already assigned pathways and the possibility to delete
accidental assignmetns, the unique indicator provides another function that prevents
the inadvertent multiple assignment of pathways.
Effects on Existing Data
The unique indicator is not set in all treatment pathways created prior to importing the
release.
Effects on Customizing
You must set the unique indicator for all current or new pathways, so that the treatment
pathway in the proposal list is not offered for multiple assignment.

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ISHMED_MAIN: Action Behavior at Status Change (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you can define for
pathway steps with system action if you wish the action to be execution on confirmation
of the step.
You can determine behavior when processing a patient pathway step for items of a
treatment pathway with a linked base item.
You can define the following behaviours for when the step status is changed to
Confirmed:
Do not execute action
If you select this option, the action is not executed at a step status change. You can,
however, execute the action manually at a later point.
Ask before execution
If you select this option, the system asks if or not you wish to execute the action at a
step status change. You can decide if you wish to execute the action immediately or if
you want to execute the action later. The appropriate dialog is then directly opened.
Execute action
If you select this option, the action of the step is executed immediately after
confirmation of the step. Confirming the step takes you directly to the processing of the
object saved.
Since the definition occurs on a step by step basis, you can define a patient pathway's
sequence of operations according to your needs.
It is possible to process patient pathways faster and more conveniently through the
option of executing the action via the change of status.
Effects on Existing Data
The new data field is preset with the option Ask before execution for all pathways
created before the upgrade. This does not change system behavior when processing
patient pathways by importing the upgrade.

Effects on Customizing
In order to adjust the behavior of pathway steps on confirmation, you have to change
the entry On confirmation on the Base Item tab page in your treatment pathways for
steps.

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ISHMED_MAIN: BAdI for Activities (New)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the BAdI
ISHMED_GL_ACTIVITY is available. Through appropriate implementations you can
change the behavior of your system before and after the execution of activities.
The BAdI ISHMED_GL_ACTIVITY is processed in the editing dialog for patient
pathways and in the dialog for assigning treatment pathways before and after the
execution of all activities (e.g. assign pathway, cancel pathway)

Effects on Customizing
Create an implementation for the desired activity and activate the implementing class.
Activate the BAdI implementation.
See also
For further information, see the Implementation Guide under Industry-Specific
Component Clinical System -> Pathways -> Set Up Assignment -> BAdI:
Enhance Execution of an Activity.

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ISHMED_MAIN: Treatment Pathways - Further Changes (Enhanced)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), you have the following
enhanced or new functions for pathways:
Service Request Base Item Type (Enhanced)
You can now also use request profiles and a caseless request.
When defining base items of the service request type you can also enter a request
profile as a service to be requested. A breakdown into individual services is not
possible in the base item. After executing a step with base item with request profile, the
individual requests created cannot be called through patient pathway processing.
Using the Caseless indicator you can define that a caseless service request is created
when you execute the base items.
Merging Patients for Pathways (New)
Patient pathways are taken into account while merging patients.
Case Revision for Pathways (New)
Patient pathways are taken into account during case revision. The objects Patient
pathway and Patient Pathway Proposal are supported.
If you do not use the case revision central authorization check, the user has to be
assigned the authorization to display patient pathways.
Programming Interface for Patient Pathways (Changed)
The programming interface for patient pathways (class
CL_ISHMED_API_PAT_PATHWAY) now enables you to access activities and their
comments.
If you have previously used the method GET_STEP_DETAIL of the class
CL_ISHMED_API_PAT_PATHWAY, in order to read notes, you now have to use the
methods GET_ACTIVITIES and GET_COMMENTS_FOR_ACTIVITY.

See also
Documentation for class CL_ISHMED_API_PAT_PATHWAY

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ISHMED_MAIN: Patient Pathways in the Clinical Work Station
(Enhanced)
Use
As of SAP ECC 6.0, Industry Extension Healthcare, Enhancement Package 4 (IS-H
604), Business Function Clinical System (ISHMED_MAIN), the following new field is
available in the Patient Information area in the field catalogs of the view types
Occupancies, Admissions, Discharges, Coding Analyses, Clinical Order,
Outpatients/Service Facility and Surgery:
Pathway Proposal Icon - indicates if there are any pathway proposals for the case
Features
Clicking Pathway Proposal takes you into the assignment dialog for editing pathway
proposals.

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