PIT Files

Abstract

PIT files are text files that can be sent securely from one medical practitioner to another.  They are typically used to transmit diagnostic reports.  This knowledgebase article discusses PIT files and how to integrate them effectively into Capable 21C.

Underlying challenge

There are three fundamental challenges with PIT files:

1. The software that receives the PIT files might not alert staff that the files have arrived.
2. PIT files do not necessarily have the patient's case number in them, so an operator must attach them to Capable 21C manually.
3. PIT files are text files.  They can be viewed easily using a package such as Windows Notepad.  However, to view them within Capable 21C requires a minor modification to the configuration of Windows Internet Explorer.

Resolution

How to know when a PIT file has arrived

Software packages that receive PIT files do not necessarily alert staff that the files have arrived.  It may be necessary for staff to check the location where the PIT files arrive to see if new ones have arrived.

To do this, create a periodic task that will appear daily at a prescribed time.

Attaching a PIT file to a patient file

1. Browse the PIT folder to see if a new file has arrived. A shortcut to this folder on the desktop is an easy way to get to the folder.
2. If a new file is present, open it.  See below for configuring Windows to open PIT files appropriately.
3. Make a mental note of the patient name, and then close the file.
4. Back on your Capable 21C screen, open the visit notes for that patient.
5. On the images tab, click the Add button.
6. Navigate to the PIT folder, and nominate the new file.
7. Capable 21C will prompt whether you want to delete the old file or not.  This decision should be made discretely for each office.

Modifying Windows and Internet Explorer to view PIT files

Whilst PIT files are just simple text files, Windows and Internet Explorer will not immediately recognise them as such.  Both tools must be configured to allow PIT files to be viewed.  Follow this procedure to reconfigure them appropriately:

1. To configure Windows Explorer to open PIT files using the NotePad application, browse to the PIT folder and double click on any PIT file.
2. When asked, Select the Program from a List.
3. Nominate Notepad, and tick the box to 'Always use this program to open this kind of file'.
4. To configure Internet Explorer requires a change to the Windows Registry.  Changing the Windows Registry can be dangerous, and should only be done with care.
5. Click the Windows Start button, and choose Run.
6. Type REGEDIT and press Enter.
7. On the RegEdit window, expand the branch for HKEY_CLASSES_ROOT.
8. Locate the branch for .PIT and click on it.
9. Right click on the right hand side, and choose New.  In the submenu, choose String Value.
10. Type Content Type and press ENTER.
11. Double click on the new 'Content Type' entry.
12. Set its value to be text/plain
13. Close RegEdit.

To assist PC technicians, a Registry patch has been created and saved onto the Capable Software webserver, it can be downloaded here.

Detailed Informationiled Information

There are a couple of annoyances regarding PIT files.  Firstly, they are crude text files.  There is no formatting, and each line of the file is numbered.  This makes the readability of the file somewhat limited.  Unfortunately, Capable Software is unable to affect this.  PIT files comply with a medical standard and cannot be readily changed.

A more significant annoyance with PIT files is that they cannot be automatically linked onto a patient file.  This is largely caused the absence of any kind of patient identification system.  There could easily be two 'John Smiths' on file, and at one Capable Software site, there are two patients with the same name, and the same date of birth.  The Australian government is currently working towards a unique numbering system so that every Australian citizen and visitor can be identified.  The debate rages on between the advocates and the civil libertarians - however, at the time this KBA was written, it appears that the numbering system will be rolled out by 2015.  At that time, Capable 21C will be able to be modified to support such a system and automatically attach PIT files to patient files.

The instructions for attaching a PIT file include a step to navigate to the PIT folder (step 6).  Capable 21C will remember this location after the first PIT file is attached and use it again for subsequent files.  However, if files are retrieved and attached from a variety of folder locations, the operator will have to spend significant time navigating around folders.  Capable Software recommends that either a single folder is used for all types of files (eg scan images and save PDFs into the same folder as for PIT files) - or that different PCs in the network are nominally used to retrieve different document types (eg one PC for PIT files, and another one for scanned images).  This should improve efficiency on attaching files.

Copyright 2008 Capable Software Pty Ltd

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