Name	Value
NAME	PHARMACY DATA MANAGEMENT
PREFIX	PSS
DEVELOPER (PERSON/SITE)	TATUM/BIRM
DEVELOPMENT ISC	BIR
CURRENT VERSION	1.0
SHORT DESCRIPTION	Maintenance of Pharmacy files.
VERSION	1.0 DATE DISTRIBUTED: 2005-11-19 00:00:00 PATCH APPLICATION HISTORY: 2 SEQ #1 DATE APPLIED: 1997-11-05 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Pharmacy Data Management PATCH PSS12. This fixes a no-compiled routine and null subscript error. 15 SEQ #12 DATE APPLIED: 1998-09-23 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch utilizes the new NDF APIs. 113 SEQ #101 DATE APPLIED: 2006-07-11 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: The Computerized Patient Record System (CPRS) V. 1.0 has requested a modification to an Application Programming Interface (API) from Pharmacy Data Management V. 1.0. The modified API will provide CPRS with a flag to indicate a default Medication Route is being supplied from the PHARMACY ORDERABLE ITEM (#50.7) file. 92 SEQ #102 DATE APPLIED: 2006-07-11 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This Pharmacy Data Management (PDM) patch is part of the Patient Financial replacement system. The project consists of the implementation of the billing replacement system, business process improvements, and enhancements to VistA to support integration with the COTS billing replacement system. Significant changes to VistA legacy systems and ancillary packages are necessary. Some of the PFSS software components are not operational until the PFSS On/Off Switch, distributed with patch IB2260, is set to "ON". The ability for the local site to set the switch to "ON will be provided at the appropriate time with the release of a subsequent Integrated Billing Services System (PFSS) project. PFSS patches are being released on various patch. For more information about the PFSS project, review the documentation accompanying this patch and refer to the following website: http://vista.domain.ext/billreplace/. Functional Description: ======================= The Charge Description Master (CDM) is an industry standard financial tool schedules. Some patch functionality will not be active until a new PFSS common to all commercial billing systems and used in virtually every private hospital. The CDM is a comprehensive listing of all services performed, drugs supplied, or supplies provided in a particular hospital along with the value of those services/drugs/items, or charge amounts. Each of these entries are represented by a Charge Code, and the Charge Code is made up of a Department Code and Service Code. The Charge Code for Pharmacy will be the department code 160 concatenated with the assigned Service Code for the drug. The Department Code 160 will not be stored in any files and the Service Code will be established/approved by a central CDM Change Control Board (CCB). The implementation of the COTS billing switch is activated during final implementation. PFSS will initially be system requires the VA PRODUCT file (#50.68)/DRUG file (#50) to link the service master Service Code to every Pharmacy prescription fill or refill. For drugs that are not associated with an entry in the VA PRODUCT file (#50.68), the approved Service Code must be populated by the user. Technical Description: ====================== This PDM patch PSS192 provides the following functionality needed to support the PFSS project: implemented at select pilot sites ONLY. 1. A new SERVICE CODE field (#400) was added to the DRUG file (#50). 2. The PSSCOMMON Input template was modified to accommodate the new SERVICE CODE field (#400) to be used with the DRUG ENTER/EDIT [PSS DRUG ENTER/EDIT] option for drugs that are not associated with an entry in the VA PRODUCT file (#50.68). 3. The Integration Agreement (IA) #4483 was modified to include the new SERVICE CODE field (#400). The purpose of the PFSS project is to prepare the Veterans Health Information Systems and Technology Architecture (VistA) environment for the implementation of a commercial off-the-shelf (COTS) billing 110 SEQ #103 DATE APPLIED: 2006-08-24 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1) Only allow uppercase alphabet for the NAME field in files #51.1 and #51. 2) Allow elligible drugs to be marked for 'OP External Dispense'. 115 SEQ #104 DATE APPLIED: 2006-09-23 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch supports the National Council for Prescription Drug Programs (NCPDP) claim; updates to the Rx Activity Log; and permanent storage of Claims activity information as reported by the ECME Billing Events Report. This patch restores the ability to edit the DAW CODE field through the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option in the Pharmacy Data Management (PDM) application. This field was originally created by the patch PSS190 (see item #3) but was unintentionally removed by patch PSS192. The following input template is included in this patch: standard which was adopted under the Healthcare Insurance Portability and Template Name File Name (Number) ------------- ------------------ PSSCOMMON DRUG (50) Accountability Act (HIPAA) for pharmacy claims. This patch is one of six to be released. Three patches will be released in a KIDS multi-build distribution containing: BPS13, PSO7247, and IB2342. Three patches will be released individually and they are: PRCA4.5247, PSX2.062, and PSS1.0115. Enhancements included in the release of the six patches are a new option that will enable the user to reopen a closed Electron Claims Management Engine (ECME) 108 SEQ #105 DATE APPLIED: 2006-09-23 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch contains updated Application Program Interfaces (APIs) that will Patient file (#55). The DIC^PSSDI API has been modified to allow drug selection with matches to certain VA Classes that are passed to the call. Classes to be included or excluded are to be set up in the PSSVACL array within the DIC component. For example, if only drugs with a VA Class of DX201 & DX202 were to be available for selection, the local variable array would look like this: be used by calling applications that currently do direct global reads or PSSVACL("DX201")="" PSSVACL("DX202")="" PSSVACL("R")="" - The "R" means only drugs with these classes will be available for selection. If these classes were to be excluded, the letter "P" would be used instead. A new API was added to routine PSS51P1. The PSSDQ component displays all the entries in the Administrative Schedules file (#51.1). writes to the Pharmacy Data Management files. The ORDERABLE ITEM STATUS TRACKER (#81) field has been added as a returned data element for the PSS^PSS59P7 API on the Pharmacy System file (#59.7). The ORIGINAL WARD (#9), OTHER PRINT INFO (#31) & MED ROUTE (#132) fields were added to the PSS436 component of the PSS55 API on the Pharmacy 112 SEQ #106 DATE APPLIED: 2006-11-22 23:43:59 APPLIED BY: USER,ONE DESCRIPTION: This patch enhances an original Pharmacy Data Management API call Re-Engineering (PRE) API Manual. Additionally, this patch introduces an API STATUS^PSS55MIS which requires three parameters. The set of codes for STATUS field in the PHARMACY PATIENT file (#55) subfiles is returned. This API will invoke the FIELD^DID Fileman call and data will be returned to the calling application as specified in the FIELD^DID FileMan documentation. Specifications for this API can be found in the Pharmacy Re-Engineering (PRE) API Manual. DATA^PSS50. By replacing FileMan calls with direct reads, data retrieval Finally, this patch introduces CLINIC^PSS55MIS which requires three parameters. This API returns a clinic from the HOSPITAL LOCATION file (#44) based on a provided order number and patient DFN. This API invokes the GETS^DIQ data retrieval call. Specifications for this API can be found in the Pharmacy Re-Engineering (PRE) API Manual. from the DRUG file (#50) speed has been greatly improved. Specifications for this API can be found in the Pharmacy Re-Engineering (PRE) API Manual. This patch also enhances an original Pharmacy Data Management API call ALL^PSS51P2. By replacing FileMan calls with direct reads, data retrieval from the MEDICATION ROUTES file (#51.2) speed has been greatly improved. Specifications for this API can be found in the Pharmacy 114 SEQ #107 DATE APPLIED: 2007-06-27 21:33:29 APPLIED BY: USER,ONE DESCRIPTION: 1. In response to a patient safety issue, the Computerized Patient Record a utility is provided to allow assignment of a route to multiple orderable items, based on the dosage form. A new menu option has been set up for this feature. The new menu option is [PSS ADD DEFAULT MED ROUTE] and will be removed in a future patch. System V. 1.0 was modified to no longer always use a default in the medication ordering dialog. Therefore, sites are required to enter a default in the PHARMACY ORDERABLE ITEM file (#50.7). However, in support of the previous business logic, a default of ORAL was not allowed. This patch changes this requirement and allows ORAL as a default medication route. HD 144208, PSI-06-063 2. In order to assist sites in assigning a new default medication route, 120 SEQ #108 DATE APPLIED: 2007-06-27 22:13:07 APPLIED BY: USER,ONE DESCRIPTION: As part of the Outpatient Pharmacy V. 7.0 Laser Labels Phase II project, another parameter is being added to turn on sending the new warnings to the Outpatient Pharmacy Automation Interface (OPAI). This is to accommodate vendors who may need to make changes to receive the new warnings. Currently the Bedford CMOP is the only CMOP not ready to receive the new format. Until the parameters are turned on, warning labels from the old RX CONSULT file (#54) are used. When they are turned on, warnings from the WARNING a new commercial data source is utilized to provide warning label LABEL-ENGLISH (#50.625) or the WARNING LABEL-SPANISH (#50.626) file will be used. When the parameters are turned on, the "Do not transfer" warning label 20 from the old RX CONSULT file (#54) is automatically added, when applicable, during label printing, transmitting to CMOP, or sending to OPAI. Example warning labels for a drug when the warning source is set to "New": Take medication on an empty stomach one hour before or two to the three hours after a meal unless otherwise directed by your doctor. information. This drug may impair the ability to drive or operate machinery. Use care until you become familiar with its effects. CAUTION: Federal law prohibits the transfer of this drug to any person other than the patient for whom it was prescribed. This patch is required by PSO7200 which will send the new warning label text to OPAI and by PSX254 which will send the new warning label text to CMOP. The following changes are included in this patch: Data Dictionary Changes: ======================= New fields: 1. CMOP WARNING LABEL SOURCE field (#16.1) in the PHARMACY SYSTEM file (#59.7). A parameter was provided by patch PSS187 to turn on the new warning The new warning label processing is not fully functional for CMOP until this field is set to "N" for "New" in the Pharmacy System Parameters Edit [PSS SYS EDIT] option. 2. OPAI WARNING LABEL SOURCE field (#16.2) in the PHARMACY SYSTEM file (#59.7). The new warning label processing is not fully functional for the Outpatient Pharmacy Automation Interface (OPAI) until this field is set to label format. This is currently being used in association with printing "N" for "New" in the Pharmacy System Parameters Edit [PSS SYS EDIT] option. Routine Changes: ================ Routine PSSYSP was modified to prompt for the above new fields. Example: Select OPTION NAME: PSS SYS EDIT Pharmacy System Parameters Edit laser labels. However, since not all Consolidated Mail Outpatient Pharmacy System Parameters Edit PMIS PRINTER: L8150$PRT// PMIS LANGUAGE: English// WARNING LABEL SOURCE: NEW// CMOP WARNING LABEL SOURCE: ? Enter "N" for NEW to use commercial data source for CMOP warning labels. Choose from: N NEW Pharmacy (CMOP) facilities are reprogrammed to receive the new format, a CMOP WARNING LABEL SOURCE: N NEW OPAI WARNING LABEL SOURCE: N NEW new parameter is being added for turning on the new warnings for CMOP. And 118 SEQ #109 DATE APPLIED: 2007-06-29 21:07:18 APPLIED BY: USER,ONE DESCRIPTION: This patch adds ORDERABLE ITEM field (#108) from the PHARMACY PATIENT * PSS435^PSS55 * PSS436^PSS55 Additionally, this patch clears up an issue in DIC^PSSDI, DATA^PSS50, ALL^PSS51P2, and MIX^PSSDI where in rare circumstances, an error could occur due to incorrect API initialization. Finally, this patch introduces the parameter PSSFREQ to AP^PSS51P1. PSSFREQ is compared to the FREQUENCY field (#2) in the ADMINISTRATION SCHEDULE file (#51.1) to filter records based on the frequency of file (#55), NAME field (#.01) from the PHARMACY ORDERABLE ITEM file delivery. (#50.7), DOSAGE FORM field (#.02) from the PHARMACY ODERABLE ITEM file (#50.07), and NAME field (#.01) from the DOSAGE FORM file (#50.606) to the following APIs. * PSS431^PSS55 * PSS432^PSS55 * PSS433^PSS55 121 SEQ #110 DATE APPLIED: 2007-09-04 22:23:13 APPLIED BY: USER,ONE DESCRIPTION: Fixes the one time PRN orders problem. 13 DATE APPLIED: 1998-10-07 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch fixes data dictionaries for Pharmacy Patient (#55), Pharmacy System (#59.7), and Drug (#50) files, as well as a couple of enhancement routines. 122 SEQ #111 DATE APPLIED: 2007-09-04 23:09:12 APPLIED BY: USER,ONE DESCRIPTION: This patch contains the second quarter enhancements for the Pharmacy Data defined must have a subtype prefixed with "P-". This prefix in the subtype indicates that the device is a printer. If no data is defined in this multiple, the ScripTalk printer tied to the division will be used. The use of this multiple builds upon existing ScripTalk functionality, so a divisional ScripTalk device must be defined for the mapped device functionality to work properly and to have a default device defined. a. LABEL PRINTER TO BE MAPPED field (#.01) - This field contains the Pharmacy label printer(s) that the ScripTalk device is mapped. When the printer device defined in this field is selected as the Pharmacy Management V 1.0 package. The following data dictionary additions are print device by the user, ScripTalk labels will print on the corresponding mapped ScripTalk device. b. SCRIPTALK DEVICE field (#.02) - This field contains the ScripTalk print device that will be tied to regular Pharmacy label device(s) defined in the "LABEL PRINTER TO BE MAPPED" field. included for PHARMACY SYSTEM file (#59.7) and supports modifications made in Outpatient Pharmacy patch PSO7200. 1. SCRIPTALK PRINT DEVICE MAPPING multiple (#47) - adds the capability to tie a ScripTalk printer to regular Pharmacy label printer(s) to control where the ScripTalk labels print for multi-divisions. Multiple print devices may be mapped to a ScripTalk printer, and any device 125 SEQ #112 DATE APPLIED: 2007-09-05 01:11:52 APPLIED BY: USER,ONE DESCRIPTION: With the deployment of Cache version 5, it was discovered that the short modifies all routines that currently use a lock timeout value of less than 3 seconds to check for the node ^DD("DILOCKTM") and to use the value defined there, otherwise the lock timeout value is set to a default value of 3 seconds. lock timeout values could generate a lock failure. Patch DI22147, which has already been released, provided a solution to resolve this issue and future lock issues. This patch instituted a new default lock timeout of three seconds based on a global node setting of ^DD("DILOCKTM")=3. In order to avoid the lock issue in Pharmacy Data Management, this patch 88 SEQ #113 DATE APPLIED: 2007-09-05 01:21:27 APPLIED BY: USER,ONE DESCRIPTION: 1. A site reported a problem with the medication route being blank on the 2. During internal testing, it was discovered that there was a problem with the Application Programming Interface (API) handled by routine PSS55. This patch corrects this problem. 3. To assist Pharmacy in appropriately setting the new PROMPT FOR INJ. SITE IN BCMA field (#8), a search routine will execute when this patch is installed. The purpose of this routine is to look for all Medication Route abbreviations that contain ID, IV, IM, SC or SQ. A message with the subject of "PDM - Check Med Route Abbreviations" will be sent to the Bar Code Medication Administration (BCMA) V. 3.0 Virtual Due List. During person who installs the patch. investigation of possible corrections for this, it was determined that another issue needed to be addressed with how to determine when to prompt for an injection site. This patch assists to correct these problems by adding the PROMPT FOR INJ. SITE IN BCMA field (#8) to the MEDICATION ROUTES file (#51.2). In addition, the new field has been added to the input template PSS MEDICATION ROUTES. HD0000000166204, HD0000000164890, PSI-06-152, PSI-06-158 127 SEQ #114 DATE APPLIED: 2007-12-12 21:48:26 APPLIED BY: USER,ONE DESCRIPTION: The general purpose of this patch is to meet the requirements in support the patches. This patch modifies the Pharmacy Data Management V. 1.0 application as described below: 1. The following fields were added to DRUG file (#50) for determining metric quantity for electronic 3rd Party billing: a. NCPDP DISPENSE UNIT field (#82) - Allows entry of EA for EACH, GR for GRAMS or ML for MILLILITERS. of ePharmacy enhancements. This patch is one of five to be released. Three b. NCPDP QUANTITY MULTIPLIER field (#83) - This field contains the number that will be multiplied by the quantity in the prescription in order to determine the correct quantity to bill electronic 3rd party insurance companies. Only products with an NCPDP DISPENSE UNIT of GM or ML should have a value different than 1 (one) in this field. Numbers between 0.001 and 99999.999 are allowed entry into this field. 2. The two fields above will be auto-populated by a post-install routine, patches will be released in the KIDS multi-build distribution BPS PSO IB which will be executed when this patch is installed. Although the majority of drugs will be updated with EA (EACH) for the NCPDP DISPENSE UNIT and 1 (one) for the NCPDP QUANTITY MULTIPLIER fields, a large number of drugs will be updated with GM (GRAMS) or ML (MILILLITERS). Furthermore, some drugs will also have a number different for the NCPDP QUANTITY MULTIPLIER field. The post-install routine relies on a built-in list provided by the National Drug File (NDF) group that contains the necessary information for the update being performed. Once this patch is installed, the user should be able to verify the BUNDLE 2.0, which contains BPS15, IB2363, and PSO7260. Patches auto-population results by running the following Fileman Print option: OUTPUT FROM WHAT FILE: DRUG// SORT BY: GENERIC NAME// NCPDP DISPENSE UNIT START WITH NCPDP DISPENSE UNIT: FIRST// WITHIN NCPDP DISPENSE UNIT, SORT BY: GENERIC NAME START WITH GENERIC NAME: FIRST// WITHIN GENERIC NAME, SORT BY: FIRST PRINT FIELD: GENERIC NAME;@ PSX263 and PSS1127 will be released as stand-alone patches. Since THEN PRINT FIELD: NCPDP DISPENSE UNIT THEN PRINT FIELD: NCPDP QUANTITY MULTIPLIER THEN PRINT FIELD: Heading (S/C): DRUG LIST// DEVICE: ;;999 UCX/TELNET Right Margin: 80// 3. For the DRUG ENTER/EDIT [PSS DRUG ENTER/EDIT] option, the PSSCOMMON input template for DRUG file (#50) was modified to allow entry/edit of the NCPDP DISPENSE UNIT field (#82) and the NCPDP QUANTITY MULTIPLIER there is an implementation dependency between the multi-build distribution field (#83). The following give additional information on definition and validation of these fields: a. When new drugs are defined, the values of EA for EACH and 1 (one) will be the default values for these new fields. b. When the NCPDP DISPENSE UNIT is changed from one value to another, the NCPDP QUANTITY MULTIPLIER will be defaulted to 1 (one) and a message stating such will be displayed. If the NCPDP QUANTITY MULTIPLIER field already contains 1 (one), no change will be made and the stand-alone patches, PSX263 and PSS1127 must be installed nor will a message be displayed. c. When a valid value greater than or less than 1 (one) is entered for the NCPDP QUANTITY MULTIPLIER, a warning message will be displayed stating that typically a value of 1 (one) should be defined for this field. Then the user will be prompted to continue processing thereby accepting the new value or to edit and view extended help text for the type of NCPDP DISPENSE UNIT selected. If the user elects to ^ (shift six) to exit the "Ok to continue (Y/N)" prompt, the system will default the NCPCP QUANTITY MULTIPLIER to 1 (one) prior to the installation of the multi-build. For more specific and give a warning message stating such. 4. The LOOKUP INTO DISPENSE DRUG FILE [PSS LOOK] option was modified to list the new NCPDP DISPENSE UNIT and NCPDP QUANTITY MULTIPLIER fields after the PRICE/DISPENSE UNIT field. instructions please refer to the installation steps provided in each of 109 SEQ #115 DATE APPLIED: 2007-12-12 22:18:45 APPLIED BY: USER,ONE DESCRIPTION: During testing of the Bar Code Medication Administration (BCMA) project field (#128) of the UNIT DOSE sub-file (#55.06) of the PHARMACY PATIENT file (#55) which is exported in this patch. BCMA-HSC Phase III, an issue was discovered with the order flag comments for unit dose orders. There is not enough space to store the entire comment, so the text is truncated. This patch corrects this problem for BCMA by storing the most recent text in an additional location. The comment will still be stored in the current location. It will also be in the MOST RECEMT FLAG COMMENT field (#129) of the NON-VERIFIED/PENDING file (#53.1) which is exported in an Inpatient Medications V5.0 patch. For active unit dose orders, it will be stored in the MOST RECENT FLAG COMMENT 124 SEQ #116 DATE APPLIED: 2008-02-03 21:34:13 APPLIED BY: USER,ONE DESCRIPTION: This patch will correct the issues reported in: 1) HD68616 - PSSMARK DRUG INACTIVE DATE IN FUTURE BLOCKS CMOP MARK TODAY 2) HD70218 - PSSHLU Drug file edits change value in orderable item file 126 SEQ #117 DATE APPLIED: 2008-05-26 15:06:16 APPLIED BY: USER,ONE DESCRIPTION: This patch will update the heptext for the DEA field in the DRUG file. As well as send a mailman message concerning the changing DEA codes. 132 SEQ #118 DATE APPLIED: 2008-05-26 15:47:19 APPLIED BY: USER,ONE DESCRIPTION: This patch will correct the issues reported in: HD229420 - PSSHLU Orderable item is active but not appearing in CPRS 128 SEQ #119 DATE APPLIED: 2008-05-26 15:52:50 APPLIED BY: USER,ONE DESCRIPTION: The following data dictionary addition is included for PHARMACY SYSTEM Last Date Auto-Expire Processed INPUT TRANSFORM: S %DT="E" D ^%DT S X=Y K:X<1 X LAST EDITED: MAY 18, 2007 HELP-PROMPT: Last Date Auto-Expire Processed DESCRIPTION: This is the last date that the nightly auto-expire processed. Processing will continue from this date the next time the job runs. file (#59.7) and supports modifications made in Outpatient Pharmacy patch TECHNICAL DESCR: This is the last date that the nightly auto-expire processed. Processing will continue from this date the next time the job runs and will expire prescriptions with expiration dates up to and including DT-1. PSO7257. Field Description: ================== 59.7,49.95 DATE AUTO-EXPIRE COMPLETED 49.99;8 DATE 130 SEQ #120 DATE APPLIED: 2008-07-22 07:36:49 APPLIED BY: USER,ONE DESCRIPTION: This patch will correct the issues reported in: CLASS field (#25) index (^PSDRUG("VAC") and identify drugs with multiple VAC indexs. If a drug has multiple indexs, re-index the VAC index. After the ^DRUG("VAC" has been re-indexed, send a MailMan message with the names, old VA DRUG CLASS indexs and the new VA DRUG CLASS index. 1) HD0000000194979 - Orderable Item dialog box issue Modify the INPUT TRANSFORM for the PHARMACY ORDERABLE ITEM file (#50.7) SYNONYM subfile (#50.72) SYNONYM field #2 to use S X=$$TRIM^XLFSTR(X,"R"," ") to strip trailing spaces. 2) HD0000000177768 - Lookup by VA Class brings up incorrect meds Create PSSP130 routine to step through the DRUG file (#50) VA DRUG 12 SEQ #14 DATE APPLIED: 1998-11-04 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch fixes an error which occurs when an IV order is entered with a non-standard schedule which contains a leading space. It also corrects an error that occurs when an IV or Unit Dose order is entered in the Computerized Patient Record System (CPRS) that contains an invalid schedule. This patch makes changes to the Pharmacy Data Management routines that are used to control the validation of schedules when orders are entered in CPRS and Inpatient Medications. 134 SEQ #121 DATE APPLIED: 2009-04-20 16:08:04 APPLIED BY: USER,ONE DESCRIPTION: This patch will create a post install routine that will loop through the Drug file (#50) and get all the Local Possible Doses for each drug and call the API to reformat it. A report will then be generated that will display the drug ien, drug name, original Local Possible Dose and the reformatted Local Possible Dose. The report will be sent to the holders of the PSNMGR key and Venessa France, developer of the patch. . Venessa France, developer of the patch. 94 SEQ #122 DATE APPLIED: 2009-04-21 15:47:26 APPLIED BY: USER,SEVENTEEN DESCRIPTION: 1. In support of the project Inpatient Medications Requirements for 3. In support of the Computerized Patient Record System (CPRS) GUI v27 release, the validation of schedules from the GUI has been modified. The change was to allow day-of-week schedules to be entered in the format: day@schedule. Schedule, in this case, is an already defined schedule such as BID. So, now a day-of-week schedule may be entered as MO-WE-FR@BID to signify you want to use the BID administration times on Monday, Wednesday and Friday. 4. In support of CPRS GUI v27, a modification has been made to the the Special Focus Group Initial Request Analysis (IMR) Phase III, list of available Medication Routes sent back to CPRS from Inpatient Pharmacy when using the IV Dialog. If there is one orderable item in the order, Inpatient Pharmacy will return any default med route that may be defined in the Pharmacy Orderable Item File #50.7 along with any other med routes defined for the dosage form #50.606. Duplicate entries will be removed. If there is more than one orderable item in the order, Inpatient Pharmacy will return a list of the common med routes that match all orderable items. 5. In support of CPRS GUI v27, remedy ticket, HD0000000220080 - "^ in two changes have been made in the input template PSSJ SCHEDULE EDIT. the Schedule field" was addressed. Problem: -------- Users are allowed to include an "^" in the schedule when placing an order in CPRS GUI. Resolution: ----------- Routine PSSGSGUI will be modified to disallow an "^" in the text of a First, if the schedule type is continuous and it is an odd schedule, schedule. 6. The routine PSS0088 is being deleted with this patch. The routine was part of patch PSS1.088, and was used simply as a tally routine to identify medication routes that needed to be reviewed when the functionality of PSS1.088 was installed. The tally routine's functionality is no longer necessary, so the routine will be deleted. 7. In support of CPRS GUI v27, the array of schedules from the ADMINISTRATION SCHEDULE file #51.1 that is returned to CPRS for schedule the system will no longer allow the entry of administration times. selection on an order is being modified. Currently, a site can have multiple schedules with the same name for the same package. The array of schedules presented for selection in CPRS GUI v26 only takes the schedule with the lowest IEN number in the ADMINISTRATION SCHEDULE file #51.1 if a duplicate exists. With the changes in CPRS GUI v27, if there is a duplicate schedule, and if one of them contains ward-specific admin times for the ward location of the patient, the schedule returned for inclusion in the array of selectable schedules in CPRS will be the one with the ward- Continuous, non-odd schedules will still require administration times. specific admin times. If no duplicate has ward-specific admin times for the ward location of the patient, the schedule with the lowest IEN number will be returned. If both (or more than one) duplicate schedules have ward-specific admin times for the ward location of the patient, the schedule with the lowest IEN number in the ADMINISTRATION SCHEDULE file #51.1 will be the schedule in the array returned to CPRS. 2. The second IMR change for the input template is if the schedule type is on-call, the system will no longer require a frequency. 123 SEQ #123 DATE APPLIED: 2009-04-21 15:52:23 APPLIED BY: USER,SEVENTEEN 138 SEQ #124 DATE APPLIED: 2009-04-22 12:04:22 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch will address the issues in Remedy tickets: 1)HD0000000206450 - & in the NOUN field of the Dosage Form file When the NOUN in the DOSAGE FORM contains a "&", it causes CPRS to error when ordering medications. 2)HD0000000249646 - 6 VA CLASSIFICATION Field The VA CLASSIFICATION field (#2) of the DRUG file (#50) allows user to delete the data in this field which is matched to National Drug File. 133 SEQ #125 DATE APPLIED: 2009-04-22 12:21:35 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch contains a set of APIs to be used by Clinical Reminders. The calls are all to routine PSSCLINR. The APIs are: IX(PSSCRIX,PSSCRIV) Returns AND or VAC index of File 50 DRUG(PSSCLID) Returns the Drug name from file 50 ITEM(PSSCLII) Returns the Pharmacy Orderable Item pointer from file 50. ING(PSSING) Return Drug Ingredient IEN from file 50.416 NEPS() Return Number of entries in file 55 139 SEQ #126 DATE APPLIED: 2009-04-22 15:52:36 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch has enhancements which extend the capabilities of the Veterans activate unless instructed specifically by the CBO. This patch is being released along with PSO7303 and IB2405. These patches can be installed in any order but the full functionality contained within these patches will not be available until all 3 patches are installed. This patch modifies the Pharmacy Data Management v1.0 application as described below: Health Information Systems and Technology Architecture (VistA) electronic 1. A new Drug Enforcement Administration (DEA) Special Handling code, N for Nutritional Supplement, was added as a selection to the DEA SPECIAL HDLG prompt for DRUG ENTER/EDIT [PSS DRUG ENTER/EDIT] option. Once Outpatient Pharmacy patch PSO7303 and Integrated Billing patch IB2405 is installed, any drug defined with this new code will be treated in the same manner as supply items and investigational drugs. The N DEA Special Handling code must be defined manually. pharmacy (ePharmacy) billing system. All sites should install this patches regardless of whether or not they have been activated for ePharmacy by the Central Business Office (CBO). After the installation of these patches, the activation status of the site will not be impacted. As before, activation of the ePharmacy product will require instructions provided by the CBO. Sites are not to 129 SEQ #127 DATE APPLIED: 2009-04-23 10:50:33 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch provides the functionality needed to prepare for the release of Pharmacy Re-Engineering V. 0.5, which will change the current Pharmacy Order Checking system from using the data stored in Vista to using data from the First DataBank commercial database system. There is set-up work that is requred to be completed prior to the installation of Pharmacy Re-Engneering V. 0.5, and this patch provides the tools needed to complete that set-up work. 137 SEQ #128 DATE APPLIED: 2009-06-03 11:36:43 APPLIED BY: USER,SEVENTEEN 131 SEQ #129 DATE APPLIED: 2009-07-14 09:09:50 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch has enhancements which extend the capabilities of the Veterans OUTPATIENT PHARMACY (OP) V. 7.0 PSO7289 INTEGRATED BILLING (IB) V. 2.0 IB2384 ELECTRONIC CLAIMS MANAGEMENT ENGINE (ECME) V. 1.0 BPS17 The last three patches (PSO7289, IB2384 and BPS17) will be released in the Kernel Installation and Distribution System (KIDS) multi-build distribution BPS PSO IB BUNDLE 3.0. Patches PSX265 and PSS1131 will be released as stand-alone patches. Since there is an implementation dependency between the multi-build distribution and the stand-alone patches, PSX265 and PSS1131 must be installed prior to the Health Information Systems and Technology Architecture (VistA) electronic installation of the multi-build. For more specific instructions please refer to the installation steps provided in each of the patches. All sites should install these patches regardless of whether or not they have been activated for ePharmacy by the Central Business Office (CBO). After the installation of these patches, the activation status of the site will not be impacted. As before, activation of the ePharmacy product will require instructions provided by the CBO. Sites are not to activate unless instructed specifically by the CBO. pharmacy (ePharmacy) billing system. Below is a list of all the This patch modifies the Pharmacy Data Management v1.0 application as described below: 1. A new Drug Enforcement Administration (DEA) Special Handling code, U for Sensitive Diagnosis, was added as a selection to the DEA SPECIAL HDLG prompt for DRUG ENTER/EDIT [PSS DRUG ENTER/EDIT] option. When a signed Release of Information (ROI) is on file and the drug is marked with this new code, the drug may be third party billable. Drugs must be manually marked with this new code, and this functionality works in conjunction with ROI modifications made in IB2384. applications involved in this project along with their patch number: APPLICATION/VERSION PATCH -------------------------------------------------------------- CONSOLIDATED MAIL OUTPATIENT PHARMACY (CMOP) V. 2.0 PSX265 PHARMACY DATA MANAGEMENT (PDM) V. 1.0 PSS1131 99 SEQ #130 DATE APPLIED: 2009-07-14 15:21:44 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch adds a MUMPS style cross-reference to the FIRST SERVICE DATE field (#.07) in the PHARMACY PATIENT file (#55). When the FIRST SERVICE DATE field (#.07) is updated for a patient then the cross-reference is triggered and the patient is queued for transmission. The following applications were also updated as part of the PBM Extracts Enhancement #3 project: This patch addresses a request which support the Pharmacy Application/Version Patch ------------------------------------------------------------- Pharmacy Benefits Management V. 4.0 PSU4.05 Inpatient Medications V. 5.0 PSJ5.0161 Outpatient Pharmacy V. 7.0 PSO7.0170 Registration V. 5.3 DG5.3671 Benefits Management (PBM) Extracts Enhancement #3 project. In order to allow the retransmission of only those patients who have had demographic updates, Pharmacy Data Management V. 1.0 was modified to build an entry for re-transmission in PBM PATIENT DEMOGRAPHICS file (#59.9) whenever the FIRST SERVICE DATE field (#.07) in the PHARMACY PATIENT file (#55) is updated. 17 DATE APPLIED: 1998-11-20 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This build is a patch to DRUG file (#50) which changes the data dictionary for fields NATIONAL DRUG FILE ENTRY (#20) and PSNDF VA PRODUCT NAME ENTRY (#22) to pointers. This patch requires National Drug File V. 4.0 to be installed. 140 SEQ #131 DATE APPLIED: 2009-10-14 12:46:55 APPLIED BY: USER,SEVENTEEN DESCRIPTION: Description: NO YES All med routes from dosage form display. Default med route pre-populates the selection box. NO NO All med routes from dosage form display. Nothing pre-populates the selection box. Additionally, this patch will provide a new option called Default Med Route For OI Report [PSS DEF MED ROUTE OI RPT] that will be added to the Problem: Medication Routes Management [PSS MEDICATION ROUTES MGMT] menu. The site can use this report to identify the current default medication route for the orderable item. Here is an example of the report: DEFAULT MED ROUTE FOR ORDERABLE ITEM REPORT JUN 17,2009 PAGE 1 OI NAME DOSAGE FORM ASSOCIATED ROUTES DEFAULT ROUTE DRUG -------------------------------------------------------------------------- -------- IBERET LIQUID ORAL (BY MOUTH) IBERET-500 ORAL IBUPROFEN TAB ORAL (BY MOUTH) IBUPROFEN 600MG IDOXURIDINE OINT,OPH RIGHT EYE LEFT EYE BOTH EYES IDOXURIDINE 0.5% IMIPRAMINE TAB ORAL (BY MOUTH) IMIPRAMINE 25MG IMIPRAMINE 50MG INDOCYANINE INJ,SOLN INTRAMUSCULAR INTRAVENOUS INTRAVENOUS INDOCYANINE 25MG INSULIN INJ INTRAMUSCULAR Currently, for unit dose orders and Outpatient Pharmacy orders, all INTRAVENOUS ORAL SUBCUTANEOUS INTRAVENOUS INSULIN LENTE INSULIN NPH medication routes for the dosage form of the orderable item are being displayed in CPRS as possible medication routes to be selected. Even if an orderable item is to be given only Intramuscular (IM), the provider sees a dropdown list to select a potentially inappropriate medication route of Subcutaneous (SC) or Intravenous (IV). =========== Resolution: ----------- This enhancement affects both Inpatient Medications unit dose orders entered via the Inpatient Medications order dialog in CPRS as well as Outpatient Pharmacy orders entered via CPRS. A new parameter will be added to the PHARMACY SYSTEM file (#59.7) to support this functionality (see below). With this parameter set to YES, CPRS order dialogs will display only the default medication route for the orderable item in the medication route selection list in CPRS if a default medication route is defined in the PHARMACY ORDERABLE ITEM file (#50.7). If there is no default medication route defined for the orderable item, then the current functionality will be retained and all possible medication routes for the dosage form will be displayed to the provider for selection in CPRS. Routine PSSJORDF will be modified for this enhancement. This enhancement adds the DEFAULT MED ROUTE FOR CPRS field (#80.7) to the PHARMACY SYSTEM file (#59.7) to support the functionality of this patch. The field will serve as a toggle, allowing the site to choose whether they want to implement the features of this patch in their system. This field is maintained by the Pharmacy System Parameters Edit [PSS SYS EDIT] This enhancement is an interim resolution approved by the Inpatient option. The default for this field is YES when first accessing this field from this option. This field may be set to YES or NO. An example of setting this to YES appears below. Example screen: Select Pharmacy Data Management Option: Pharmacy System Parameters Edit PMIS PRINTER: NULL DEVICE// PMIS LANGUAGE: English// WARNING LABEL SOURCE: Medications Workgroup and Pharmacy Legacy Quarterly Enhancement (PLQE) CMOP WARNING LABEL SOURCE: OPAI WARNING LABEL SOURCE: AUTOMATE CPRS REFILL: DEFAULT MED ROUTE FOR CPRS: Y YES DATA NAME GLOBAL DATA ELEMENT TITLE LOCATION TYPE -------------------------------------------------------------------------- 59.7,80.7 DEFAULT MED ROUTE FOR CPRS 80;7 SET User Group for Patient Safety Issue PSI 08-026, PSPO #852 as described in '0' FOR NO; '1' FOR YES; LAST EDITED: MAY 28, 2009 HELP-PROMPT: Enter Y to display only the default med route in CPRS or N to continue with the current functionality. DESCRIPTION: This field should be marked "YES" if the site prefers the MED ROUTE field (#.06) in the PHARMACY ORDERABLE ITEM file (#50.7) to Remedy Ticket HD233682. This patch will help mitigate incorrect medication appear as the default/only entry during CPRS order entry. If no default medication route is defined in the PHARMACY ORDERABLE ITEM file (#50.7), then the routes from the DOSAGE FORM file (#50.606) will display. This field will affect only orders entered via the Inpatient Medications dialog or the Outpatient Medications dialog in CPRS. It will not impact IV Fluids entered via CPRS or routes being displayed for selection in the Computerized Patient Record orders entered via backdoor Pharmacy. TECHNICAL DESCR: Set of codes. "YES" to display only the default med route in CPRS and "NO" to continue with the current functionality. The following table summarizes the functionality of this patch. NOTE This patch will be exported with the new parameter set to YES. Default OI Med System V. 3.0 (CPRS). Site Parameter Route Defined CPRS Med Route Selection List -------------- -------------- ----------------------------- YES YES Default med route is the only route in selection list. Default med route pre-populates the selection box. YES NO All med routes from dosage form display. Nothing pre-populates the selection box. 141 SEQ #132 DATE APPLIED: 2009-12-01 14:25:50 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch provides the Pharmacy Data Management support for the Class III to Class I conversion project Immunizations Documentation by BCMA. Included in the patch is the addition of the ASSOCIATED IMMUNIZATION field (#9) in the PHARMACY ORDERABLE ITEM file (#50.7) and revisions to the options Edit Orderable Items [PSS EDIT ORDERABLE ITEMS] and Dispense Drug/Orderable Item Maintenance [PSS MAINTAIN ORDERABLE ITEMS]. Patch PSB347 provides the BCMA portion of the project. 147 SEQ #133 DATE APPLIED: 2010-03-02 10:11:32 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch will make some additional enhancements to the Pharmacy this patch. This mail group will be used for various purposes, all The following is a list of security keys included in this patch: Security Key ------------ PSS_CUSTOM_TABLES_ADMIN SEND TO SITE PSS_CUSTOM_TABLES_APPROVER SEND TO SITE PSS_CUSTOM_TABLES_REL_MAN SEND TO SITE PSS_CUSTOM_TABLES_REQUESTOR SEND TO SITE relating to the Pharmacy Re-Engineering (PRE) V. 0.5 project. The following is a list of protocols included in this patch: Protocol -------- PSS MED ROUTE RECEIVE SEND TO SITE 2) Data from the DOSE UNIT (#4) Field and the NUMERIC DOSE (#5) Field of the LOCAL POSSIBLE DOSAGE (#50.0904) Subfile of the DRUG (#50) File will be added as display elements to the Lookup into Dispense Drug File [PSS LOOK] option and the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option. 3) A Vista Mail message will be sent to the PSS ORDER CHECKS Mail Group when an update is made to the STANDARD MEDICATION ROUTES (#51.23) File by Re-Engineering (PRE) V. 0.5 Pre-Release functionality that was released in the New Term Rapid Turnaround (NTRT) process. This mail message will include what was updated, and will also include any automatic mapping activities that occurred from the MEDICATION ROUTES (#51.2) File to the STANDARD MEDICATION ROUTES (#51.23) File. 4) The Request Change to Standard Medication Route [PSS MEDICATION ROUTE REQUEST] option has been changed to now refer the requestor to a web site to make the request. 5) A new ADDITIVE FREQUENCY (#18) Field has been added to the IV ADDITIVES patch PSS1.0129. This patch also sends out four Vista Security Keys to (#52.6) File. This field will be used to provide a default value for the Additive Frequency field in Computerized Patient Record System (CPRS) when continuous IV orders with additives are entered. Data will be auto-populated by a Post-Install routine for this patch, and this data should be reviewed and edited as necessary. This new field can be edited using the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option or the ADditives File [PSSJI DRUG] option. These defaults will not start to appear in CPRS until Pharmacy Re-Engineering (PRE) V. 0.5. A new IV Additive Report [PSS IV ADDITIVE REPORT] option has also been added, and this report, in addition to the current IV Solution Report [PSS IV SOLUTION REPORT] be used in the Pharmacy Enterprise Customization System (PECS) option, will now be located under the new IV Additive/Solution Reports [PSS ADDITIVE/SOLUTION REPORTS] Menu option, which will be located under the Pharmacy Data Management [PSS MGR] Menu option. A Mail Message will be sent to the PSS ORDER CHECKS Mail Group and the patch installer upon completion of patch installation. This patch addresses the following New Service Request (NSR): ------------------------------------------------------------- Application, which will be released at a later date. There is no NSR associated with this patch. This patch addresses the following Remedy Ticket(s): ---------------------------------------------------- There are no Remedy tickets associated with this patch. Overview of Remedy Ticket(s): ----------------------------- There are no Remedy tickets associated with this patch. Components Exported With Patch: ------------------------------- The following is a list of fields included in this patch: Field Name (Number) File Name (Number) The enhancements to the Pre-Release functionality include: ----------------------------------- ------------------------------ ADDITIVE FREQUENCY 18 IV ADDITIVES 52.6 The following is a list of templates included in this patch: Template Name Type File Name (Number) ------------- ---- ------------------ PSSIV ADD Input IV ADDITIVES (#52.6) The following is a list of options included in this patch: Option Name Type Action ----------- ---- ---------------------- PSS IV ADDITIVE REPORT RUN SEND TO SITE PSS ADDITIVE/SOLUTION REPORT MENU SEND TO SITE The following is a list of mail groups included in this patch: 1) A new PSS ORDER CHECKS Mail Group will be created upon installation of Mail Group ---------- PSS ORDER CHECKS Please note that the PSS ORDER CHECKS Mail Group is not an actual component of the KIDS Build, but it is created during the Environment Check routine. 143 SEQ #134 DATE APPLIED: 2010-06-23 16:48:17 APPLIED BY: USER,SEVENTEEN DESCRIPTION: PSS1.0143 adds validation checks to the PSS SCHEDULE EDIT option frequency. 2. Schedule Edit Validation Two The system shall validate for frequencies greater than one day (1440 minutes), that only one administration time is permitted. The system shall present a warning message to the user if more than one administration time is entered. 3. Schedule Edit Validation Three In Ward Administration Times field in the PSS SCHEDULE EDIT option, for to prevent the Standard Administration Times and Ward Administration a schedule that has a Schedule Type of Continuous, the system shall prevent a user from entering administration times to Odd Schedules, a schedule whose frequency is not evenly divisible by or into 1440 minutes (1 day). 4. Schedule Edit Validation Four Add validation to TYPE OF SCHEDULE field in PSS SCHEDULE EDIT to remove frequency from the schedule file entry if the TYPE OF SCHEDULE is changed from CONTINUOUS to ONE TIME, PRN, ON CALL, or DAY OF WEEK. times fields of a schedule from conflicting with the schedule's 5. Schedule Edit Validation Five In the PSS SCHEDULE EDIT option, the system shall prevent a user from creating Day of Week (DOW) schedules that are not in the correct day of week order. The correct order is: SU-MO-TU-WE-TH-FR-SA. 6. Modify VistA Help Text The Help Text in Standard Schedule Edit was modified to add additional text so the user is able to see the added constraints when entering Administration Times. frequency if the frequency is numeric and the schedule type is Continuous. 1. Schedule Edit Validation One The system shall validate for frequencies of 1 day (1440 minutes) or less that the number of administration times equals 1440 divided by the 144 SEQ #135 DATE APPLIED: 2011-01-27 09:11:35 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch will correct the issues reported in: 3) HD0000000324175 - 6 Enter/Edit Dosages In the "Enter/Edit Dosages" option in Pharmacy Data Management, there is a problem with the BCMA UNITS PER DOSE prompt when editing a Possible Dosage. The BCMA UNITS PER DOSE prompt should only be given if the Possible Dosage Package field is marked for Inpatient ("I"), and the Application Packages Use field for the drug contains a "I" or "U". Currently the prompt appears twice if the Possible Dosage Package and Drug is marked for Inpatient, (and it should only appear once). When the drug is not marked Inpatient, The prompt appears only once when it should not appear at all. 4) HD0000000157266 - Synonym DUOU field does not allow for input of decimal The input template for DISPENSE UNITS PER ORDER UNIT (^DD(50,15)) allows for the input of decimal values (e.g. 2.5). 1) HD0000000111095 - PSS WARNING BUILDER option fails to respond properly When using the VistA "Warning Builder" [PSS WARNING BUILDER] option and the user enters a ? or ?? for additional help information, the program returns very little help information. 2) HD0000000133036 - Drug Synonym triggers are inconsistent Drug Synonym triggers are inconsistent with those on the drug level. 157 SEQ #136 DATE APPLIED: 2011-02-10 14:46:16 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch corrects a defect introduced by patch PSS1143 in the HD0000000419996 Problem: --------- Patch PSS1143 changed the Standard Schedule Edit [PSS SCHEDULE EDIT] option to prevent the prompt for Admin Time from displaying when the schedule's Type is PRN, making it difficult to remove the admin times from existing PRN schedules. When the schedule type of an existing schedule is changed from Continuous to PRN, the admin times are removed, however, when an existing schedule with a schedule type of PRN is edited, Standard Schedule Edit [PSS SCHEDULE EDIT] option. the admin times are not removed. In addition, an inconsistency exists within the same option: at the initial prompt for Schedule Type, entering or accepting a default of "PRN", has no affect on the value of admin times. However, after pressing Enter or Return to exit the Schedule Type prompt, if an up-arrow, or caret "^", is used to return to the Schedule Type field, then entering "PRN" or accepting the default of "PRN" the second time the prompt is displayed does delete the admin times from the schedule. Solution: ---------- Change the Standard Schedule Edit [PSS SCHEDULE EDIT] option to delete admin times from the schedule anytime "PRN" is entered, or accepted as a default, at the Schedule Type field. For existing PRN schedules, admin times may be deleted by re-entering "PRN", or accepting the default value "PRN", at the prompt for Schedule Type. Change the same option to make the Schedule Type prompt to have the same effect on the schedule's admin times for the initial and all subsequent prompts. HD0000000419996 - Admin times cannot be deleted from PRN schedules via the Schedule Enter/Edit [PSS SCHEDULE EDIT] option. Remedy Overview --------------- 151 DATE APPLIED: 2011-03-08 13:51:03 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch is part of a set of patches that make up Pharmacy This patch addresses the following New Service Request (NSR): ------------------------------------------------------------- There is no NSR associated with this patch. This patch addresses the following Remedy Ticket(s): ---------------------------------------------------- There are no Remedy tickets associated with this patch. Re-engineering version 0.5. Version 0.5 will replace the current Overview of Remedy Ticket(s): ----------------------------- There are no Remedy tickets associated with this patch. Components Exported With Patch: ------------------------------- See the National Patch Module for specifics relating to this patch. medication order checking system with a new system that uses data from First DataBank (FDB). In addition to replacing the current Drug Interaction and Duplicate Class checks with the FDB equivalent of these checks, Maximum Single Dose and Daily Dose Range Checks will now also occur in Outpatient Pharmacy, Inpatient Medications, and Computerized Patient Record System (CPRS). 142 DATE APPLIED: 2011-03-08 13:51:32 APPLIED BY: USER,SEVENTEEN DESCRIPTION: Currently, for IV orders, if there is more than one orderable item on the order, no default medication route is being denoted as a default in the CPRS selection list even if all the orderable items on the order share the same default med route. Resolution: ----------- This enhancement for IV orders will denote the default med route in the selection list in CPRS if all of the orderable items on the order have This enhancement is an interim resolution approved by the Inpatient the same default med route defined. If one or more orderable items on the order have different default med routes, the current functionality will be retained, and no med route in the selection list for CPRS will be denoted as a default. Routine PSSJORDF will be modified for this enhancement. Medications Workgroup for Patient Safety Issue PSI 08-025, PSPO #852 as described in Remedy Ticket HD233682. This patch will help resolve incorrect medication routes being displayed for selection in the Computerized Patient Record System (CPRS). Problem: -------- 153 SEQ #139 DATE APPLIED: 2011-03-31 16:51:14 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch is being released in preparation for the medication routes - The USE DOSAGE FORM MED ROUTE LIST field (#10) is added to the PHARMACY ORDERABLE ITEM file (#50.7) with YES/NO values. The above fields will be available when editing an existing or adding a new orderable item using the following options: - Edit Orderable Items [PSS EDIT ORDERABLE ITEMS] - Drug Enter/Edit [PSS DRUG ENTER/EDIT - Dispense Drug/Orderable Item Maintenance [PSS MAINTAIN ORDERABLE ITEMS] enhancement patch PSS1159. This patch contains the following: The Default Med Route For OI Report [PSS DEF MED ROUTE OI RPT] option is modified to include printing of the POSSIBLE MED ROUTES multiple. In addition, a post install routine will run to update the USE DOSAGE FORM MED ROUTE LIST field (#10) based on the value of the DEFAULT MED ROUTE FOR CPRS field (#80.7) of the PHARMACY SYSTEM file (#59.7). The USE DOSAGE FORM MED ROUTE LIST field (#10) will be exported with "YES" for sites that have the DEFAULT MED ROUTE FOR CPRS field (#80.7) set to NO. Otherwise, the USE DOSAGE FORM MED ROUTE LIST field (#10) will be set to NO. - The MED ROUTE field (#.06) of the PHARMACY ORDERABLE ITEM file (#50.7) is renamed DEFAULT MED ROUTE. - The POSSIBLE MED ROUTES multiple (#50.711) is added to the PHARMACY ORDERABLE ITEM file (#50.7). This multiple is pointing to the MEDICATION ROUTES file (#51.2). 136 DATE APPLIED: 2011-04-28 15:59:28 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This is the package that holds the routines responsible for the pharmacy XML interface for drug order checks from First DataBank. 18 SEQ #16 DATE APPLIED: 1998-11-25 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Patch PSS118 has three purposes. 3. This patch contains a minor change to the DDs in the PHARMACY PATIENT file (#55). In reference to the Volume field (#1) under the IV sub-file, we changed the input transformer by increasing the range from 3000 to 9999. 1. This patch corrects a problem with patch PSS113. A routine entry call was changed to access three entry points in routine PSSGS0. 2. This patch contains a new field called MAR SORT (#26.4). It is located in the PHARMACY SYSTEM file (#59.7). This field is a set of codes that allows the user to (0) sort by order's Schedule Type and then Medication Names and (1) sort by order's Medication Names. 117 SEQ #141 DATE APPLIED: 2011-04-28 16:05:56 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch is part of a set of patches that make up Pharmacy This patch addresses the following New Service Request (NSR): ------------------------------------------------------------- There is no NSR associated with this patch. This patch addresses the following Remedy Ticket(s): ---------------------------------------------------- There are no Remedy tickets associated with this patch. Re-engineering version 0.5. Version 0.5 will replace the current Overview of Remedy Ticket(s): ----------------------------- There are no Remedy tickets associated with this patch. Components Exported With Patch: ------------------------------- medication order checking system with a new system that uses data from The following is a list of fields included in this patch: Field Name (Number) File Name (Number) ----------------------------------- ------------------------------ DISPLAY STATUS 157 IV Subfile 55.01 of PHARMACY PATIENT 55 DISPLAY STATUS 136 UNIT DOSE Subfile 55.06 of PHARMACY PATIENT 55 HOURS OF RECENTLY DC/EXPIRED 26.8 PHARMACY SYSTEM 59.7 First DataBank (FDB). In addition to replacing the current Drug The following is a list of options exported in this patch: Option Name Type Action ----------- ---- ---------------------- PSS ADDITIVE/SOLUTIONS Menu Send to Site PSS ADDITIVE/SOLUTION REPORTS Menu Delete at Site PSS DRG INTER MANAGEMENT Menu Delete at Site PSS ENHANCED ORDER CHECKS Menu Delete at Site PSS INTERACTION LOCAL ADD Run Delete at Site Interaction and Duplicate Class checks with the FDB equivalent of these PSS INTERACTION SEVERITY Action Delete at Site PSS INTERFACE SCHEDULER Run Send to Site PSS LOCAL DOSAGES EDIT Run Delete at Site PSS LOCAL DOSAGES EDIT ALL Run Delete at Site PSS MAP ONE MED ROUTE Run Delete at Site PSS MARK PREMIX SOLUTIONS Run Send to Site PSS MED ROUTES INITIAL MAPPING Run Delete at Site PSS ORDER CHECK CHANGES Run Send to Site PSS ORDER CHECK MANAGEMENT Menu Send to site PSS SCHEDULE PEPS INTERFACE CK Run Send to Site checks, Maximum Single Dose and Daily Dose Range Checks will now also PSS STRENGTH MISMATCH Run Delete at Site occur in Outpatient Pharmacy, Inpatient Medications, and Computerized Patient Record System (CPRS). 158 SEQ #142 DATE APPLIED: 2011-04-28 16:14:24 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch contains software modifications to the Pharmacy Data Management . Patient decision-making should be advised by information about a known serious side effect with a product, or . Patient adherence to directions for the use of a product is essential to its effectiveness. The features in the FDA Medication Guides project are being delivered in incremental releases. This patch is part of the Increment 2 release. The features included in this release are: . Establishment of a Server Repository for FDA Medication Guides within (PDM) V. 1.0 application to support the FDA Medication Guides project. The the VA network. . Updates to 900+ entries in the VA PRODUCT file (#50.68) to store the corresponding FDA Medication Guide document name will be provided via the NDF Monthly Data Update patches. . Introduction of a PC based Java software component to enable the automatic retrieval of an FDA Medication Guide from within VistA. The software does not require any direct user interaction. It works as a bridge between VistA and the PC where it is installed. The software project objective is to allow pharmacy staff to retrieve the FDA Medication identifies a request from VistA for a specific FDA Medication Guide and automatically retrieves it from the Server Repository and displays to the user via the Internet Explorer browser. . Introduction of a new option called Display FDA Medication Guide [PSN MED GUIDE] to the National Drug File V. 4.0 application for retrieving and displaying the FDA Medication Guide for a specific VA Product. . Introduction of new functionality to the Patient Prescription Processing [PSO LM BACKDOOR] option in the Outpatient Pharmacy V. 7.0 application Guide for prescriptions that contain FDA approved information that can help for retrieving and displaying the FDA Medication Guide for a specific prescription. Below is a list of all the applications involved in this release along with their patch number: APPLICATION/VERSION PATCH ----------------------------------------------------------------- OUTPATIENT PHARMACY (OP) V. 7.0 PSO7343 NATIONAL DRUG FILE (NDF) V. 4.0 PSN4263 patients avoid serious adverse events. The FDA requires that Medication PHARMACY DATA MANAGEMENT (PDM) V. 1.0 PSS1158 The FDA Medication Guides project is expected to complete in three increments. Among other features, the next Increment will automate the printing of FDA Medication Guides for prescriptions dispensed by the VA via Outpatient Pharmacy application when the prescription label is printed. The following modifications are included in this patch (PSS1158): 1. New Data Dictionary field added to PHARMACY SYSTEM (#59.7) file Guides be included with certain prescribed drugs and biological products A new field called FDA MED GUIDE SERVER URL (#100) is being added to the PHARMACY SYSTEM (#59.7) file. This field will be used to store the FDA Medication Guide Web server URL which will be used in conjunction with the FDA MED GUIDE (#100) field in the VA PRODUCT (#50.68) file to compose the complete FDA Medication Guide URL for a specific VA Product entry. 2. A post-install routine will run to set this new field with the value shown below, which is the current FDA Medication Guides web Server URL: when the Agency determines that: http://vaww.national.cmop.domain.ext/FDAMedGuides/ Note: Integration Control Registration (ICR) #2613 is being modified to include this new field in the list of fields that can be read by the National Drug File (NDF) application. . Certain information is necessary to prevent serious adverse effects 155 SEQ #143 DATE APPLIED: 2011-04-28 16:16:28 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch addresses the New Service Request (NSR) #20070434 to prevent 1. This enhancement utilizes three new fields that were added to the VA PRODUCT file (#50.68) as part of patch PSN4261. These fields will be used during the Match/Rematch process of the Drug Enter/Edit [PSS DRUG ENTER/EDIT] and the Enter/Edit Dosages [PSS EDIT DOSAGES] options to determine if possible dosages should be auto- created or not. The three fields are: - CREATE DEFAULT POSSIBLE DOSAGE field (#40) - POSSIBLE DOSAGES TO CREATE field (#41) - PACKAGE field (#42) the inadvertent creation of supra-therapeutic possible dosages for high When CREATE DEFAULT POSSIBLE DOSAGE field (#40) is "YES", then the existing functionality of auto-creating possible dosages will be retained. When this field is "NO", it will be used in combination with the value in POSSIBLE DOSAGES TO CREATE field (#41) to determine the auto-creation of possible dosages. The following conditions will apply when CREATE DEFAULT POSSIBLE DOSAGE field (#40) is "NO": a. If POSSIBLE DOSAGES TO CREATE field (#41) is "NO", no possible risk medications during the dosage creation segment of Pharmacy Data dosages will be auto-created and the following message will be displayed: "Due to National Drug File settings no possible dosages were auto-created." b. If POSSIBLE DOSAGES TO CREATE field (#41) is "O", 1x possible dosage will be auto-created for the package specified by the new PACKAGE field (#42) and the following message will be displayed: "Due to National Drug File settings only one possible dosage will be Management and National Drug File (NDF) updates. The Pharmacy Data auto-created. If other dosages are needed, create POSSIBLE DOSAGES or LOCAL POSSIBLE DOSAGES as appropriate." c. If POSSIBLE DOSAGES TO CREATE field (#41) is "B", 1x and 2x possible dosages will be auto-created for the package specified by the new PACKAGE field (#42). 2. This patch retires the Auto Create Dosages [PSS DOSAGE CONVERSION] option. This option is retired because, if it is run inadvertently, it Management V. 1.0 and the National Drug File V. 4.0 were modified will delete all existing "Possible Dosages" and "Local Possible Dosages" and will re-set the Possible Dosages back to NDF settings. The changes that were entered locally by the site for "Possible Dosages" and "Local Possible Dosages" will be lost. Upon patch installation, this option will be removed from the Dosages [PSS DOSAGES MANAGEMENT] menu. to satisfy the request. The NDF portion is addressed in patch PSN4262. This patch has the following enhancements: 163 DATE APPLIED: 2011-08-12 13:58:31 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch makes a change to the interface when order checks are sent from application that the message indicating order checks were not performed be displayed to the user. Additionally, any time order checks are sent through the interface for the PSS INTERFACE SCHEDULER job or as an individual user, certain fields are required numeric values. Is these fields are not numeric, the interface request will fail. This patch will check those fields and substitute a value if necessary. These fields are as follows: DUZ (User's internal entry number) - the software will replace with 0. VistA to the Medication Order Check HealthCare Application (MOCHA). When Job Number - the software will replace with 0. Station Number - the software will use the leading numerics, but if there are no leading numerics, the software will replace with 0. Order Checks cannot be performed for any reason, a warning message is displayed to the user that order checks did not occur. There was an occurrence reported in a test account where Order Checks did not occur, but no message was displayed to the user. At the end of all the order check processing, this patch will add an additional check to see if the flag that indicates the success or failure of the order checks is set. If it is not set, it will set the flag that will indicate to the calling 149 SEQ #145 DATE APPLIED: 2011-08-29 15:55:10 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch will correct the issues reported in Remedy Tickets: the user enters a schedule with "QD","QOD","HS","TIW" the user is kicked out of Vista with this error <UNDEFINED>ENPSJ+6^PSSJSV X. 1) HD0000000222760 - Pharmacy standard schedule problem The use of the @ in the ADMINISTRATION SCHEDULE file #51.1 Name field .01 with the exception of day-of-week schedules, causes the user to be locked into a prescription for a 1 time order (reorder) 2) HD0000000422160 - <UNDEFINED>ENPSJ+6^PSSJSV X When using the VistA Standard Schedule Edit[ PSS SCHEDULE EDIT] option and 159 SEQ #146 DATE APPLIED: 2011-12-07 15:19:05 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This enhancement, approved by the Pharmacy Legacy Enhancement (PLE) User The pharmacy Integration Control Registration (ICR) #2418 is modified to return appropriate medication routes for the orderable item (OI) in CPRS ordering dialog with the following conditions. Note: The fields referenced below are from the PHARMACY ORDERABLE ITEM file (#50.7): 1. ICR Modifications - Default Med Route It will be derived from the DEFAULT MED ROUTE field (#.06) if it's Group, will resolve Patient Safety Issue PSI-08-026/PSPO #852 reported in populated or from the POSSIBLE MED ROUTES multiple (#50.711) if it's populated with single entry and the USE DOSAGE FORM MED ROUTE LIST field (#10) is set to "NO." - Optional Med Routes The medication route selection list in CPRS will be populated with entries from the POSSIBLE MED ROUTES multiple (#50.711) if the USE DOSAGE FORM MED ROUTE LIST field (#10) is set to "NO." Otherwise, it will be populated from the medication routes associated with the orderable item's dosage form, which is the current logic. Remedy Ticket HD233682. 2. The logic for editing the medication route has been modified in the following options: - Edit Orderable Items [PSS EDIT ORDERABLE ITEMS] - Drug Enter/Edit [PSS DRUG ENTER/EDIT] - Dispense Drug/Orderable Item Maintenance [PSS MAINTAIN ORDERABLE ITEMS] The software will now ensure that the DEFAULT MED ROUTE field (#.06) of the PHARMACY ORDERABLE ITEM file (#50.7) is either defined and/or at least one entry is defined in the POSSIBLE MED ROUTES multiple (#50.711) or the USE DOSAGE FORM MED ROUTE LIST field (#10) is set to YES so that the medication route selection during order entry is listed appropriately. Note: This patch will change USE DOSAGE FORM MED ROUTE LIST field (#10) of the PHARMACY ORDERABLE ITEM file (#50.7) from not required to a required field. In order to use the new functionality introduced in this patch, it is imperative that the user marks this field YES or NO. This field will be used to This patch will help mitigate incorrect medication routes being displayed determine the medication route selection during order entry. 3. The Pharmacy System Parameters Edit [PSS SYS EDIT] option is modified to remove the DEFAULT MED ROUTE FOR CPRS field (#80.7) of the PHARMACY SYSTEM file (#59.7) from the list of fields that can be edited. for selection in the Computerized Patient Record System (CPRS) V. 3.0. This enhancement affects Inpatient Medications unit dose orders, IV Fluids orders, and Outpatient Pharmacy orders entered via CPRS orders dialog. 168 SEQ #147 DATE APPLIED: 2012-02-06 14:49:14 APPLIED BY: USER,SEVENTEEN DESCRIPTION: When calls are made to the Medication Order Check Healthcare Application will be aborted with the message indicating that order checks cannot be performed. This patch also addresses an issue (in conjunction with patch PSO7.0379) concerning Orderable Items that are flaggeed as Supplies. If an order check is to be performed on an order that only has an Orderable Item with no Dispense Drug, an attempt is made to find the best drug available that is matched to the Orderable Item for the order check. Currently, if the Orderable Item is marked as a supply, no order checks are performed. But if the Orderable Item has both Supply and non-Supply Items matched to it, (MOCHA), a "Ping" type of call is made first to test the communication, order checks can possibly be performed on one of the non-supply items. This patch makes the change to look for non-Supply Items matched to the supply Orderable Item to perform the order checks on. and if that is successful, the subsequent order check call is made. If either call fails, the process is aborted, and a message is displayed indicating that order checks cannot be performed. What this patch introduces is a "re-try" if either of these calls fail. After a three second hang, the call (Ping or order check) will be attempted again, then if the same call fails a second time, the process 156 SEQ #148 DATE APPLIED: 2012-03-07 10:50:12 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch is being released as part of Pharmacy Legacy Enhancements Fiscal than one Automated Dispensing Device (ADD) communicating with Veterans Health Information Systems and Technology Architecture (VistA) through OPAI. 1.A new OPAI sub-file (#50.0906) was added to the DRUG file (#50). It gives sites the flexibility to define ADDs at the drug level. The sub-file (#50.0906) contains the following new fields: DIVISION - This is the division associated with the ADD for the drug. This field is a pointer to the OUTPATIENT SITE file (#59). WINDOW - This field is a pointer to the PHARMACY AUTOMATED DISPENSING DNS NAME DEVICES file (#52.53). Orders with a route of WINDOW will be Year 2011 to address the Outpatient Pharmacy Automation Interface (OPAI) sent to this ADD. MAIL - This field is a pointer to the PHARMACY AUTOMATED DISPENSING DNS NAME DEVICES file (#52.53). Orders with a route of MAIL will be sent to this ADD. 2. The Drug Enter/Edit [PSS DRUG ENTER/EDIT] option was modified to include the new fields as part of data entry. Enhancements. The Outpatient Pharmacy patch PSO7354 is also being released as part of this enhancement. Veterans Affairs Medical Center (VAMC) facilities have moved to using multiple vendors for automated medication dispensing systems to improve the efficiency of outpatient pharmacy operations. The following enhancements were made to the Pharmacy Data Management software to allow any one division to have more 167 SEQ #149 DATE APPLIED: 2012-04-30 11:41:29 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch is an enhancement patch. It will create five (5) new security This patch addresses the following Remedy Ticket(s): ---------------------------------------------------- There are no Remedy tickets associated with this patch. Associated PSIs: ---------------- N/A Overview of Remedy Ticket(s): ----------------------------- keys. They will be used to authenticate users using Kernel Authentication N/A Components Exported With Patch: ------------------------------- The following is a list of Security Keys included in this patch: Security Key Name Action ------------------- ------- & Authorization for J2EE (KAAJEE). Users using the Pharmacy Product System- PSS_PPSN_MANAGER SEND TO SITE PSS_PPSN_MIGRATOR SEND TO SITE PSS_PPSN_SECOND-APPROVER SEND TO SITE PSS_PPSN_SUPERVISOR SEND TO SITE PSS_PPSN_VIEWER SEND TO SITE National (PPS-N) should be assigned these keys after installing this patch. PPS-N is a new development effort underway, which is a re-engineered product to eventually replace the National Drug File Management System (NDFMS). No routines are included in this patch. 146 SEQ #150 DATE APPLIED: 2012-08-29 11:13:23 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch corrects a patient safety issue in which editing the IV This process has been enhanced by displaying the previously entered Print Name as the default if only one is entered. Example: +------------------------------------------------------------+ \| Select IV ADDITIVES PRINT NAME: ADDITIVE1// \| +------------------------------------------------------------+ If more than one Print Name were previously entered, the software will display the list of all linked Additives and/or Solutions to select from so an edit may be made. Example: ADDITIVES file (#52.6) and/or IV SOLUTIONS file (#52.7) using the Drug Example: +------------------------------------------------------------+ \| <DRUG NAME> currently linked to the following IV Additives:\| \| \| \| 1. ADDITIVE1 \| \| 2. ADDITIVE2 \| \| \| \| Select 1-2 from list above or type 'NEW' to link \| \| to a new IV Additive: \| Enter/Edit [PSS DRUG ENTER/EDIT] option is problematic. The current +------------------------------------------------------------+ The new enhancement will also allow the user to enter a new Additive or Solution and link it to the dispense drug. The software will give the user the choice to enter and link the dispense drug to a new Additive or Solution as well as require a confirmation of the selected dispense drug that will be linked to the selected Additive/Solution. Example (Create new IV Additive and link to drug): +--------------------------------------------------------------------+ functionality needs to be changed to prevent erroneous matching with \| <DRUG NAME> currently linked to the following IV Additives: \| \| \| \| 1. ADDITIVE1 \| \| 2. ADDITIVE2 \| \| \| \| Select 1-2 from list above or type 'NEW' to link \| \| to a new IV Additive: NEW \| \| \| \| Select IV ADDITIVES PRINT NAME: TEST \| \| Are you adding 'TEST' as a new IV ADDITIVES (the 33RD)? No// Yes \| Dispense Drugs. It is very easy to select the wrong item and incorrectly \| IV ADDITIVES DRUG UNIT: GM GM \| \| PRINT NAME: TEST// \| \| Select DRUG GENERIC NAME: CEFAMANDOLE 1GM INJ// AM116 \| \| ARE YOU SURE YOU WANT TO SELECT CEFAMANDOLE 1GM INJ? No// Y (Yes) \| \| ... \| \| \| \| <DRUG NAME> currently linked to the following IV Additives: \| \| \| \| 1. ADDITIVE1 \| \| 2. ADDITIVE2 \| change the PRINT NAME field (#.01) of the additives or solutions files. \| 3. TEST \| \| \| \| Select 1-3 from list above or type 'NEW' to link \| \| to a new IV Additive: NEW \| +--------------------------------------------------------------------+ The new enhancement will also create the new sub-menu Inpatient Drug Management [PSS INP MGR]. This sub-menu will be located under the Pharmacy Data Management [PSS MGR] menu and will include the following options: Also, once an additive or solution is selected, it is unclear as to - ADditives File [PSSJI DRUG] - Dispense Drug Fields [PSSJU DRG] - Dispense Drug/ATC Set Up [PSSJU DRUG/ATC SET UP] - Edit Cost Data [PSSJU DCC] - EDit Drug Cost (IV) [PSSJI EDIT DRUG COST] - MARk/Unmark Dispense Drugs For Unit Dose [PSSJU MARK UD ITEMS] - PRimary Solution File (IV) [PSSJI SOLN] In addition to these enhancements, an unrelated defect that was discovered whether or not the user is still selecting or editing. with the PSSIV ADD Input Template during testing was corrected in this patch. The error prevented valid ADMINISTRATION TIMES from being associated with the IV ADDITIVE as well as QUICK CODES associated with the IV ADDITIVE. The error was addressed by correctly validating the ADMINISTRATION TIMES fields using the same validation as is used in the ADMINISTRATION SCHEDULE file (#51.1). 14 SEQ #17 DATE APPLIED: 1998-12-14 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch creates a new Pharmacy Data Management option, Pharmacy quick order correction for CPRS [PSS QUICK1]. This option will allow the pharmacy quick orders that weren't converted in the OR2.549 patch conversion to be manually corrected and converted to the quick order in Computerized Patient Record System. The invalid data in each quick order will be shown and the user will be prompted to correct the item. This option is not distributed on any menu. It should be assigned to the appropriate person in pharmacy that would make decisions about editing these quick orders. 171 SEQ #151 DATE APPLIED: 2012-09-12 16:25:59 APPLIED BY: USER,SEVENTEEN DESCRIPTION: Special Instructions/Other Print Info for IV). Special Instructions and Other Print Info may also be entered and/or edited from within Inpatient Medications V. 5.0 order entry options. Prior to this enhancement, Inpatient Medications maximum character length for Special Instructions was 180 characters and for Other Print Info the maximum length was 60 characters. This enhancement resolves Patient Safety Issues PSPO 42, 1466 / Remedy Ticket HD336419 ________________________________________ - Comment lengths between CPRS and Pharmacy. No Allergy Assessment ________________________ The No Allergy Assessment enhancement provides an interactive alert to the pharmacist in Inpatient Medications V. 5.0 when no allergy assessment is on file for the patient, and a method for the pharmacist to enter an allergy assessment after receiving the alert. A pharmacy intervention is automatically created if the pharmacist chooses to not enter an assessment. With this enhancement, Special Instructions and Other Print Info have been The No Allergy Assessment functionality will be available at the following options: Delete Orders [PSJI DELETE ORDER] Inpatient Order Entry [PSJ OE] Non-Verified/Pending Orders [PSJU VBW] Order Entry [PSJU NE] Order Entry (IV) [PSJI ORDER] Profile (IV) [PSJI PROFILE] modified to support an unlimited amount of text. The existing When a patient with no allergy assessment is selected from one of the affected options, the following message will be displayed to the pharmacist: "NO ALLERGY ASSESSMENT exists for this patient! Would you like to enter one now?" - If the pharmacist enters 'YES' at this prompt, they are prompted for allergy information. functionality that copies the provider comments from the Computerized - If the pharmacist enters 'NO' at this prompt, a pharmacist intervention is created, with a type of 'NO ALLERGY ASSESSMENT'. The pharmacist is then prompted for Provider and Recommendation. A new Recommendation, 'UNABLE TO ASSESS', has been created specifically for this type of intervention. This enhancement will address Patient Safety Issue PSPO 445. Patient Record System (CPRS) to be copied into each field has been retained, and an additional action has been added to optionally open a word processing edit dialog after copying the provider comments into the appropriate field (Special Instructions for Unit Dose, Other Print Info 164 SEQ #152 DATE APPLIED: 2013-02-12 10:38:22 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch makes three enhancements to Pharmacy Data Management (PDM) The second enhancement is a change to the menu option entitled "Print PEPS Services Setup" {PSS CHECK PEPS SERVICES SETUP]. Additional functionality is provided to the user with a device prompt to send the output to a printer device or they may choose to print to the screen. The third enhancement deals with the way entries in the DOSE UNITS file (#51.24) are displayed. Some of the entries in this file are composed of TallMan lettering (mixed case). Under the menu option entitled "Request Change to Dose Unit" [PSS DOSE UNIT REQUEST], if a user and re-introduces an option from PSS1129 as a "stand alone" option: requests a change to an entry that is composed of Tallman lettering, previously, these entries did not collate as desired. Any entry composed of TallMan lettering is converted to uppercase when doing the lookup so that alphabetic sorting is maintained while still preserving Ta1lMan lettering. A Post-Install routine PSS164P is included to re-index the DOSE UNITS file (#51.24). The option "Find Unmapped Local Possible Dosages" [PSS LOCAL DOSAGES EDIT ALL] is exported and re-introduced as a "stand alone" option. The option loops through all Local Possible Dosages, identifies entries eligible for dosage checks that do not have data in the new Dose Unit and Numeric Dose fields, and prompts for data entry into these fields. It was purposely deleted with the install of MOCHA V1.0. It was thought that it was no longer needed. It is being exported at the request of the sites. It was found that some had not fully mapped their dosages completely and have since added new drugs to DRUG file (#50) as well as have unmatched some drugs to National Drug File (NDF). The first enhancement adds a new menu option under the menu option entitled "PEPS Services" [PSS PEPS SERVICES]. This new option is entitled "Print Interface Data File" [PSS VENDOR INTERFACE REPORT]. This report prints entries from the VENDOR INTERFACE DATA file (#59.74). The user is asked for a date/time range and the report is sorted by the most recent downtime first. 169 SEQ #153 DATE APPLIED: 2013-02-12 10:38:29 APPLIED BY: USER,SEVENTEEN 150 SEQ #154 DATE APPLIED: 2013-03-27 15:04:24 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch will correct the following issues: Update the calculation for slashed dosages in outpatient pharmacy by correctly calculating duration in reation to dosage. Prevent display of non-editable field IV FLAG (#.03) in the PHARMACY ORDERABLE ITEM FILE (#50.7) from displaying when attempting to edit via fileman. 166 DATE APPLIED: 2013-06-14 09:01:29 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch is being released as part of the DEA e-Prescribing of ----------------------------------------------------------------- KERNEL V. 8.0 XU8580 PHARMACY DATA MANAGEMENT (PDM) V. 1.0 PSS1166 COMPUTERIZED PATIENT RECORD SYSTEM (CPRS) V. 3.0 OR3306 CONTROLLED SUBSTANCES (CS) V. 3.0 PSD373 OUTPATIENT PHARMACY (OP) V. 7.0 PSO7391 Note: Patches PSO7391 and PSD373 will be released in the Kernel Installation and Distribution System (KIDS) multi-build distribution CPRSV29_PSO_PSD. Controlled Substances (CS) project using Public Key Infrastructure (PKI) This is the Pharmacy Data Management patch (PSS1166) that provides the following enhancements and will be in the KIDS distribution PSS_1_166. 1. This patch modifies Integration Control Registration (ICR) #3737 by adding the following two new Application Programming Interface (API): a. The API $$DETOX^PSSOPKI will return a "1" (one) if the drug name contains "BUPREN", a detoxification drug or a "0" (zero) otherwise. b. The API $$OIDETOX^PSSOPKI is provided to CPRS to determine to satisfy requirements requested by the Drug Enforcement Administration whether an orderable item has an associated detoxification drug. 2. This patch modifies ICR #3784 - API $$IVDEA^PSSUTIL1 to return the specific CS FEDERAL SCHEDULE field (#19) code of the VA PRODUCT file (#50.68) or the specific DEA, SPECIAL HDLG field (#3) code of the DRUG file (#50) of the drugs tied to the Orderable Item. 3. Patch PSS1159 introduced an issue where the user was prevented from up-arrowing (^) to quit out of the template in the Edit Orderable Items [PSS EDIT ORDERABLE ITEMS] option. This patch resolves that issue by (DEA). allowing the user to up-arrow out of the template. The applications involved in this project along with their patch numbers are listed below and the same order should be followed when installing the patches. APPLICATION PATCH 176 SEQ #156 DATE APPLIED: 2013-09-11 11:50:15 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch will correct the issues reported in: INC000000720652 - Audit File/Drug File Issue The DRUG file (#50) uses a cross-reference trigger to update the PRICE PER DISPENSE UNIT field (#16) whenever the PRICE PER ORDER UNIT field (#13) and/or the DISPENSE UNITS PER ORDER UNIT field (#15) are changed. These cross-reference triggers are currently configured incorrectly and when sites turn auditing on for these fields no data is collected. INC000000607659 - Incorrect Drug Cost in Outpt Rx Clean up need Incorrect drug costs in Outpatient Pharmacy associated with the National Drug Class (NDC) When a prescription is released, the multiple, NDC BY OUTPATIENT SITE (#50.032) in the DRUG file (#50) is getting stored. Only the drugs that are E-PAYABLE should have this multiple stored in the DRUG file. 174 SEQ #157 DATE APPLIED: 2013-12-03 15:23:43 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch will address Patient Safety Issue PSPO00001088 and at the GENERIC DRUG prompt and introduced this issue. Patch 5) This patch will also enhance the capabilities of the IV ADDITIVES File (#52.6) and IV SOLUTIONS File (#52.7) so that a user can enter a new additive or solution that has the same name as an existing entry. Previously, a Fileman workaround had to be used to enter an identically named entry. With this patch, if the user types in a name that already exists in the file, they will first be presented with a list of available selections. If the user scrolls through the list without selecting an entry, they will be presented with the prompt to add a new entry. For example - IV ADDITIVES File (#52.6) PSS1.0174 will fix this problem by properly allowing the CHOOSE 1-2: 1 PSSJI DRUG ADditives File ADditives File Select IV ADDITIVES PRINT NAME: TESTDRUG Lookup: PRINT NAME 1 TESTDRUG Additive Strength: 10 MG 2 TESTDRUG Additive Strength: N/A 3 TESTDRUG Additive Strength: 5 GM user to exit the GENERIC DRUG prompt by using the caret (^). 4 TESTDRUG Additive Strength: 12 GM CHOOSE 1-4: Are you adding 'TESTDRUG' as a new IV ADDITIVES (the 77TH)? No// Y (Yes) For example - IV SOLUTIONS File (#52.7) Select OPTION NAME: PSSJI SOLN PRimary Solution File (IV) PRimary Solution File (IV) Select IV SOLUTIONS PRINT NAME: 0.9% SODIUM CHLORIDE Lookup: PRINT NAME 1 0.9% SODIUM CHLORIDE 250 ML 2 0.9% SODIUM CHLORIDE 50 ML 3 0.9% SODIUM CHLORIDE 25 ML CHOOSE 1-3: 2) Another issue addressed with this patch is the wording when the Are you adding '0.9% SODIUM CHLORIDE' as a new IV SOLUTIONS (the 32ND)? No// Y (Yes) 6) This patch will also allow the addition of identically named IV ADDITIVES and IV SOLUTIONS from the DRUG ENTER/EDIT [PSS DRUG ENTER/EDIT] option when linking an additive or solution to the drug. For example - new additive: User is linking an IV Additive to a Generic Drug at the AN IV ITEM? Yes// Y (Yes) Edit Additives or Solutions: Select one of the following: A ADDITIVES S SOLUTIONS Enter response: ADDITIVES GENERIC DRUG prompt in menu option ADditives File [PSSJI DRUG]. It was CEFAZOLIN SOD 1GM INJ currently linked to the following IV Additives: 1. TESTDRUG Additive Strength: 10 MG 2. TESTDRUG Additive Strength: 5 GM 3. TESTDRUG Additive Strength: 12 GM unclear which drug name was the Additive and which was the 4. TESTDRUG Additive Strength: 12.5 GM Select 1-4 from list above or type 'NEW' to link to a new IV Additive: NEW Select IV ADDITIVES PRINT NAME: TESTDRUG Lookup: PRINT NAME 1 TESTDRUG Additive Strength: 10 MG 2 TESTDRUG Additive Strength: 5 GM Generic Drug when selecting. This patch will remove the 3 TESTDRUG Additive Strength: 12 GM 4 TESTDRUG Additive Strength: 12.5 GM CHOOSE 1-4: Are you adding 'TESTDRUG' as a new IV ADDITIVES (the 78TH)? No// Y (Yes) uncertainty by clearly stating to the user which is the For example - new solution: AN IV ITEM? Yes// (Yes) Edit Additives or Solutions: Select one of the following: A ADDITIVES S SOLUTIONS New Service Request (NSR) 20110308 as well as defects introduced IV Additive and which is the Generic Drug. For example: Enter response: SOLUTIONS CEFAZOLIN SOD 1GM INJ currently linked to IV Solutions: 1. 0.9% SODIUM CHLORIDE 300 ML 2. 0.9% SODIUM CHLORIDE 300 ML 3. 0.9% SODIUM CHLORIDE 450 ML 4. 0.9% SODIUM CHLORIDE 254 ML Select 1-4 from list above or type 'NEW' to link to a new IV Solution: NEW Select IV SOLUTIONS PRINT NAME: 0.9% SODIUM CHLORIDE Lookup: PRINT NAME 1 0.9% SODIUM CHLORIDE 250 ML 2 0.9% SODIUM CHLORIDE 50 ML 3 0.9% SODIUM CHLORIDE 25 ML 4 0.9% SODIUM CHLORIDE 10 ML 5 0.9% SODIUM CHLORIDE 1000 ML PRINT NAME: CEFAZOLIN// Press <RETURN> to see more, '^' to exit this list, '^^' to exit all lists, OR CHOOSE 1-5: Are you adding '0.9% SODIUM CHLORIDE' as a new IV SOLUTIONS (the 33RD)? No// Y (Yes) GENERIC DRUG: CEFAZOLIN SOD 10GM M/D INJ// CEFAZ NOTE This patch must be installed in conjunction with the Inpatient Medications v. 5.0 patch PSJ5.0289 for the full functionality to be realized. 1 CEFAZOLIN OPTH SOLN 50MG/CC (15CC) 2 CEFAZOLIN SOD 10GM M/D INJ AM115 3 CEFAZOLIN SOD 1GM INJ AM115 N/F CHOOSE 1-3: 3 CEFAZOLIN SOD 1GM INJ AM115 N/ You are about to change the GENERIC DRUG linked to this ADDITIVE. by patch PSS1.0146. ADDITIVE CEFAZOLIN is currently linked to GENERIC DRUG CEFAZOLIN SOD 10GM M/D INJ. Are you sure you want to link ADDITIVE CEFAZOLIN to GENERIC DRUG CEFAZOLIN SOD 1GM INJ? No// 3) This patch will also serve as the overall resolution to the issue of ambiguous IV Additive strength when a pharmacist is finishing an IV by adding a STRENGTH (#19) field to the IV ADDITIVES File (#52.6). The new STRENGTH (#19) field can be populated when adding a new IV Additive or when editing an existing IV Additive via menu option ADditives File [PSSJI DRUG]. For example: PRINT NAME: CEFAZOLIN// GENERIC DRUG: CEFAZOLIN SOD 10GM M/D INJ// AM115 USED IN IV FLUID ORDER ENTRY: YES// DRUG UNIT: GM// STRENGTH: 1// ?? 1) When adding a new IV Additive to the IV ADDITIVES File (#52.6), This field identifies the numeric amount of medication that is provided by one unit-of-use for the identified product. For example, if one vial contains 50 MG of medication, the STRENGTH will be entered as '50'. The DRUG UNIT of 'MG' is populated by the DRUG UNIT (#2) field. Whenever a lookup is performed on the IV ADDITIVES File (#52.6), the and the user is at the GENERIC DRUG prompt, there is no way STRENGTH (#19) field will display next to the NAME (#.01) field with the words "Additive Strength:" and then its value. Additionally, the DRUG UNIT (#2) field will be appended to the STRENGTH (#19) field. If the STRENGTH (#19) field is not populated for the IV Additive, the text "N/A" will display, and the DRUG UNIT (#2) field will not display. For example: Select IV TYPE: PIGGYBACK. to exit from the prompt. The input does not allow the user Select ADDITIVE: CEFAZOL 1 CEFAZOLIN Additive Strength: 1 GM IV ROOM ONLY 2 CEFAZOLIN Additive Strength: 2 GM 3 CEFAZOLIN PREMIX Additive Strength: N/A CHOOSE 1-3: 4) Additionally, this patch makes a small enhancement to the display to use the caret (^) to exit. The code that was modified of Quick Codes during the selection of an IV ADDITIVE during order entry. When a lookup is performed on an IV ADDITIVE, if there are QUICK CODES defined for the IV ADDITIVE, the QUICK CODE STRENGTH (#1) field and the USUAL IV SCHEDULE (#4) field from the QUICK CODE Subfile (#52.61) will display next to the QUICK CODE. If the QUICK CODE STRENGTH (#1) field is null, "N/A" will be displayed. If the USUAL IV SCHEDULE (#4) field is null, "N/A" will be displayed. For example: Select ADDITIVE: CEFAZ in routine PSSVIDRG for patch PSS1.0146 changed the code 1 CEFAZOLIN Additive Strength: 1 GM - CEFAZ1GM - Quick Code Strength: 1 GM Schedule: N/A - CEFAZ2GM - Quick Code Strength: N/A Schedule: BID 2 CEFAZOLIN Additive Strength: 2 GM IV ROOM ONLY 3 CEFAZOLIN PREMIX Additive Strength: N/A CHOOSE 1-3: 172 SEQ #158 DATE APPLIED: 2013-12-12 14:11:31 APPLIED BY: USER,SEVENTEEN DESCRIPTION: IMR6 - HIGH RISK/ALERT MEDICATION FIELD ADDED TO PHARMACY ORDERABLE ITEM FILE #50.7 160 DATE APPLIED: 2014-04-07 17:22:55 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch will activate the new Dosing Order Check functionality for This patch addresses the following New Service Request (NSR): ------------------------------------------------------------- There is no NSR associated with this patch. This patch addresses the following Remedy Ticket(s): ---------------------------------------------------- There are no Remedy tickets associated with this patch. Single Dose checking only for Inpatient Medications, Outpatient Pharmacy, Overview of Remedy Ticket(s): ----------------------------- There are no Remedy tickets associated with this patch. Components Exported With Patch: ------------------------------- and Computerized Patient Record System (CPRS). A message will be displayed The following is a list of fields included in this patch: Field Name (Number) File Name (Number) ---------------------------------------- ------------------------------ EXCLUDE FROM ALL DOSE CHECKS 9 ADMINISTRATION SCHEDULE 51.1 EXCLUDE FROM DAILY DOSE CHECK 10 ADMINISTRATION SCHEDULE 51.1 DOSING ON/OFF 95 PHARMACY SYSTEM 59.7 DOSING ACTIVITY DATE AND TIME subfile 82 of PHARMACY SYSTEM 59.7: DOSING ACTIVITY DATE AND TIME .01 PERSON MAKING CHANGE 1 to the user if the Single Dose entered for the medication order and all ENABLE/DISABLE 2 The following is a list of data included in this patch: File Entry ------------------- ------------- DOSE UNITS (#51.24) FILM(S) DOSE UNITS (#51.24) ELISA UNIT(S) DOSE UNITS (#51.24) MILLIONUNIT(S) new synonyms only: MILLION UNIT the other pertinent data is able to be properly converted for a valid MILLION UNITS The following is a list of templates included in this patch: Template Name Type File Name (Number) ------------------ ----- ------------------------------- PSSJ SCHEDULE EDIT Input ADMINISTRATION SCHEDULE (#51.1) Dosing Check, and the result is an out-of-range warning. An error message The following is a list of options included in the patch: Option Name Type -------------------------- ---- PSS DRUG DOSING LOOKUP Run PSS DOSING ORDER CHECKS Run PSS TRAILING SPACES REPORT Run The following is a list of security keys included in this patch: will be displayed if for any reason the Single Dose check cannot be Security Key Name ----------------- PSS ORDER CHECKS performed. 173 DATE APPLIED: 2014-04-07 17:23:12 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch is part of a group of patches that make up the new Medication This patch also makes a second line patch list correction to the routine PSS551. In patch PSS1169, the second line of the routine mistakenly listed patch 260. This patch removes the 260 designation. MOCHA v2.0 consists of the following patches: 1. PSS1160 2. MOCHA_2_0.KID host file which contains PSJ5252, PSO7372 and OR3345 3. PSS1173 This patch is part of a group of patches that make up the new Medication 4. MOCHA_2_FOLLOW UP COMBINED BUILD.KID host file which contains PSJ5257, PSO7416, OR3311 and GMRA447 These files and patches contain software that supports MOCHA v2.0 functionality. The host files were created to simplify installation at Veterans Health Administration (VHA) facilities. Please refer to the Installation Guide for installation instructions. Order Check Healthcare Application v2.0 (MOCHA). These patches will add a maximum single dose order check to the current Veterans Health Information Systems and Technology Architecture medication order checking system that uses the First DataBank (FDB) business logic and database. FDB custom dosing tables will be used to store custom dosing changes to FDB standard reference drug tables. Pharmacy Enterprise Customization System v.2.2 (PECS) application was developed to meet the customization requirements. 16 SEQ #18 DATE APPLIED: 1998-12-29 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Patch PSS116 contains resolutions to the following issues: DA variable from the Kill logic and placed it in a clean up routine PSSDEE2. 2. In routine PSSDEE at APP+0, we changed the statement, "MARK THIS DRUG FOR AND EDIT" to "MARK THIS DRUG AND EDIT IT FOR:". 3. It corrects a problem indicated in NOIS BIR-1098-32686. The site indicated that the CMOP ID is no longer appearing in the Lookup into Dispense Drug File [PSS LOOK] option. This patch will correct this problem. 1. It corrects a problem indicated in NOIS LOU-0698-40167. In the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option, the system encountered an undefined variable (DA) when a user tried to mark a drug as Clozapine. The error was detected at UD^PSSDEE; however after further analysis, the culprit was really discovered in routine PSSCLDRG. In routine PSSCLDRG, ASK+3,END+0, and UNMARK+1, the DA variable is a part of the Kill logic. In this patch, we removed the 170 SEQ #161 DATE APPLIED: 2014-06-12 09:12:10 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch will correct the issues reported. performed automatically. This happens before the user gets asked the question 'Do you want to merge new Local Possible Dosages?' 3) HD0000000347730 - Errors in reminder index for non-VA meds The VistA 'Clinical Reminders Index Build' [PXRM INDEX BUILD] option runs the ^PSSSXRD routine used to create and rebuild the Clinical Reminders Index and the ^PSOPXRMU routine used by the cross-reference to keep the index current differ in how they set the discontinued date when that it is missing. The differences in the discontinued date cause the Clinical Reminders to be inaccurate. 4) HD0000000500625 - Medication Reconciliation national component displaying on scalp instead of subcutaneous When users change the name of a Medication Instruction using the VistA Medication Instruction File Add/Edit [PSSJU MI] option, the system does perform the duplicate entry check. This allows users to create duplicate entries which in turn cause the Medication Reconciliation to display the incorrect data. 5) HD0000000507504 - User unable to mark/unmark drugs for CMOP 1) HD0000000174282 - Problem with PSS LOOK option When using the VistA 'CMOP Mark/Unmark (Single drug)' [PSSXX MARK] option and the users tries to mark or unmark drugs for CMOP the system displays "Do you wish to mark this drug to transmit to CMOP?" "Enter Yes or No: " If the user enters a "Yes" or "No" response, the system repeats the prompt. If the user enters a "Y", "y", "N" or "n" the system accepts the entry. The VistA option 'Lookup into Dispense Drug File' [PSS LOOK] does not work the same as the 'Drug File Inquiry' [PSB DRUG INQUIRY] option. 2) HD0000000230104 - Using Drug Enter/Edit Option in PDM, local possible dosage merge performed automatically. When Using Drug Enter/Edit Option in PDM, local possible dosage merge 183 SEQ #162 DATE APPLIED: 2014-08-14 14:37:29 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch modifies the Application Programming Interfaces (API), $$DETOX^PSSOPKI to return a "1" (one) only if the drug name contains "BUPREN" and the dosage form does not contain "PATCH", otherwise a 0 ("zero"). 180 SEQ #163 DATE APPLIED: 2014-11-04 10:42:28 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch will correct the following reported issues: Drug Enter/Edit options, the prompt for Additive Frequency is missing. Currently the only way to edit the ADDITIVE FREQUENCY field (#18) is through FileMan. 3) INC000000942809 - Message Sent field (#3) in the Vendor Interface Data file (#59.74) not populating. A defect was discovered with the population of the Message Sent field (#3) in the Vendor Interface Data file (#59.74). When the Interface Scheduler [PSS INTERFACE SCHEDULER] job receives an error indicating that the Vendor Database is down, it makes an entry in the Vendor Interface Data file (#59.74) and sends a VistA MailMan message to the mail group PSS ORDER CHECKS. When the message is sent, the message sent field(#3) is not being updated with the message sent flag. 1) INC000000324382 - Drug Enter/Edit option The Drug Enter/Edit [PSS DRUG ENTER/EDIT] VistA option deletes a drugs Possible Dosage of an inactive drug if the user answers YES to the "Do you wish to match/rematch to NATIONAL DRUG file?" prompt. 2) INC000000861438 - PSSIV ADD Input Template When editing an IV Additive, using both the Additives File and the 177 SEQ #164 DATE APPLIED: 2015-01-21 13:39:43 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch will correct the issue reported in: INC000000824872 - UPDATE FDA MED GUIDES URL The automatic printing functionality does not connect to the secure Sharepoint to retrieve the requested guide and a sheet of paper prints on my printer "ERROR: UNABLE TO AUTOMATICALLY PRINT MEDICATION GUIDE". 190 SEQ #165 DATE APPLIED: 2015-06-16 12:22:09 APPLIED BY: USER,SEVENTEEN DESCRIPTION: Patch PSS1.0190 addresses the following issue: Unable to enter new national drug interactions into Drug Interactions file (#56). 119 SEQ #166 DATE APPLIED: 2015-09-16 14:21:39 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch will correct the issue reported: * This patch contains an environment check and will only install * * if one of the following conditions is met. * * * * 1) If the site is a CMOP site this patch will be installed. * * * * 2) If you are NOT a CMOP site and patches PSJ5.0194 and * * PSO7.0282 are installed. * * * * * ******************************************************************* 1) INC0000149525 - Problems placing PRN orders with multiple spaces/words ******************************************************************* * WARNING * * * 188 SEQ #167 DATE APPLIED: 2016-02-11 17:15:15 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: HAPE EDI Revenue project - NCPDP Continuous Maintenance Standards 191 SEQ #168 DATE APPLIED: 2016-03-28 12:34:51 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: Patch PSS1.0191 provides enhancements to Pharmacy Data Management order: 1. PSS1191 2. PSJ5315 3. PSB383 4. OR3417 5. PSB387 ATTENTION: This enhancement also includes a new Graphical User Interface (GUI) executable, BCMA GUI PSB3_P083.EXE. Installation of this GUI is to support changes to the BCMA and Inpatient Medications required immediately after the KIDS install for the Patch to function. For retrieval and installation instructions, please see the Client Installation Instructions section. ************************************************************************ These enhancements are made to address NSR 20141012. They include: 1. Currently Sites have to create fake removal orders to allow for applications for Transdermal Administrations. appropriate removal of medications in BCMA. This patch will alleviate that issue by adding a field to the ORDERABLE ITEM (#50.7) file titled PROMPT FOR REMOVAL IN BCMA (#12). This field implements changes that will support enhancements to the BCMA and Inpatient Medication applications to display the removal times in Inpatient Medication orders using rules determined by the value of this field. The PROMPT FOR REMOVAL IN BCMA (#12) field can be set for Orderable Items that require removal to the following values: NULL/0=No Removal Required 1 = Removal at Next Administration 2 = Removal Period Optional Prior to Next Administration 3 = Removal Period Required Prior to Next Administration 2. A post installation routine, PSS1P191, will update the new PROMPT FOR REMOVAL IN BCMA (#12) field to a value of 1 for all Orderable Items with a Dosage Form that contain the word "PATCH". A message will be sent to the installer as well as all users holding the PSJU and PSJI MGR keys providing a list of Orderable items that were updated during this process. The PROMPT FOR REMOVAL IN BCMA (#12) field is only updated if it is *************************** ATTENTION ****************************** currently set to a value of NULL so subsequent installations will not update the PROMPT FOR REMOVAL IN BCMA (#12) field again. 3. Routines edited for this patch will add the prompt "PROMPT FOR REMOVAL IN BCMA:" to the following three options: - Edit Orderable Items [PSS EDIT ORDERABLE ITEMS] - Drug Enter/Edit [PSS DRUG ENTER/EDIT] - Dispense Drug/Orderable Item Maintenance [PSS MAINTAIN ORDERABLE ITEMS] 4. Patch PSS1.0172 inadvertently missed adding the prompt, HIGH RISK/HIGH ALERT, to the following options, which is being added in this patch: - Drug Enter/Edit [PSS DRUG ENTER/EDIT] - Dispense Drug/Orderable Item Maintenance [PSS MAINTAIN ORDERABLE ITEMS] 5. A second post install routine PSSP191A will create another Clinical Ancillary Services (CAS) Development-Delivery of Pharmacy email report. This report will display orders for Medications Requiring Removal that do not contain the necessary file structures to allow for the new removal functionality to execute. The primary purpose for this information is to allow the site to determine the approximate amount of resources needed to discontinue these orders and re-create them after patch PSJ5315 is installed. Until the PSJ5315 patch is installed the capability for processing these orders will not be available. More detailed procedures and recommendations for this process are in the installation section of this Patch Description. A copy of this report will be added to the Pharmacy Data Management [PSS MGR] menu as the Orders Enhancements (DDPE) VA Inpatient Medication Administration - Transdermal for MRRs With Removal Properties [PSS MRR ORDERS DIAGNOSTIC RPT] option. 6. Two more reports will be added to the Orderable Item Management [PSS ORDERABLE ITEM MANAGEMENT] sub menu as options. The new report options, Orderable Items that Require Removal Report [PSS MRR ORDERABLE ITEMS RPT] option and Orderable Items Report for High Risk\High Alert [PSS HR/HA ORDERABLE ITEMS RPT] option, will allow review of the settings in the Orderable Items file (#50.7) for the values of the respective fields indicated in the report titles. enhancement includes 5 patches which must be installed in the following PSS1.0191 does not have any dependencies for installation. The full functionality introduced in this patch will not be available until patches PSJ5.0315, PSB3.083 and PSB3.087 are installed. Pre-existing orders will remain unaffected with installation. 175 DATE APPLIED: 2016-05-26 15:48:05 APPLIED BY: USER,FIFTYFOUR 189 SEQ #170 DATE APPLIED: 2016-07-13 12:43:30 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: This patch is part of the Pharmacy Safety Updates project which was APPLICATION/VERSION PATCH New INPUT TRANSFORMS have been added to the VOLUME (#2) and USED IN IV FLUID ORDER ENTRY (#17) to enforce the following new rule introduced relating to this file: Rule: An Orderable Item can have only ONE IV solution with a specific volume when it is marked to be used in the IV Order Dialog. 5. PSSCOMMON input template The PSSCOMMON input template used by the Drug File Enter/Edit [PSS DRUG ENTER/EDIT] option was modified to include the new MAXIMUM ----------------------------------------------------------------- DAYS SUPPLY field (#66) in the DRUG file (#50) so that it can be edited along with the other fields in this option. 6. PSSJ SCHEDULE EDIT Input template The PSSJ SCHEDULE EDIT input template used by the Standard Schedule Edit [PSS SCHEDULE EDIT] option was modified to include the new INACTIVE field (#12) in the ADMINISTRATION SCHEDULE file (#51.1) so that it can be edited along with the other fields in this option. 7. Edit Orderable Items [PSS EDIT ORDERABLE ITEMS] option OUTPATIENT PHARMACY (OP) V. 7.0 PSO7444 This option was modified to display the IV Additive Strength value as seen below: ... Orderable Item -> PIPERACILLIN/TAZOBACTAM Dosage Form -> INJ Dispense Drugs: --------------- PIPERACILLIN 3/TAZOBACTAM 0.375GM/VI INJ INTEGRATED BILLING (IB) V. 2.0 IB2545 PIPERACILLIN 2/TAZOBACTAM 0.25GM/VI INJ PIPERACILLIN 4/TAZOBACTAM 0.5GM/VI INJ PIPERACILLIN/TAZOBACTAM (A) Additive Strength: 3.375 GM PIPERACILLIN/TAZOBACTAM (A) Additive Strength: 2.25 GM PIPERACILLIN/TAZOBACTAM (A) Additive Strength: 4.5 GM ... 8. PRimary Solution File (IV) [PSSJI SOLN] option This option was modified to enforce a new rule introduced to ensure that an Orderable Item can only have 1 active IV SOLUTION linked to it with a PHARMACY DATA MANAGEMENT (PDM) V. 1.0 PSS1189 specific VOLUME when the IV SOLUTION is marked YES for the USED IN IV FLUID ORDER ENTRY field (#17). When they user tries to perform an edit that breaks this rule by editing the screen fields VOLUME, USED IN IV FLUID ORDER ENTRY or INACTIVATION DATE, the error message below will be displayed and the editing won't be permitted. Only one Active IV Solution with a specific volume can be linked to an Orderable Item or Dispense Drug when the IV Solution is marked to be used in the CPRS IV Fluid Order Entry. NATIONAL DRUG FILE (NDF) V. 4.0 PSN4429 9. Drug Enter/Edit [PSS DRUG ENTER/EDIT] option a) This option was modified to allow entry of the new MAXIMUM DAY SUPPLY ... NCPDP DISPENSE UNIT: EACH// NCPDP QUANTITY MULTIPLIER: 1// MAXIMUM DAYS SUPPLY: ?? This field is used to determine the maximum number for days supply that may be assigned to this drug. The maximum value allowed for this field is 365 (days) for most drugs, however: INPATIENT MEDICATIONS (IM) V.5.0 PSJ5313 - Schedule 2 controlled substances have a 30-day maximum days supply limit - Schedules 3 thru 5 controlled substances have a 90-day maximum days supply limit - The maximum number of days supply for this drug cannot exceed the National Drug File (NDF) maximum value if it exists - No value can be entered for Clozapine drugs as the maximum days supply is controlled by the Clozapine functionality MAXIMUM DAYS SUPPLY: PRICE PER DISPENSE UNIT: 0.8280 ... b) The exact same change described above in #8 was applied to this option where the user can create, edit and link IV Solution entries to a dispense drug. 10. Lookup into Dispense Drug File [PSS LOOK] option This option was modified to display the new MAXIMUM DAYS SUPPLY (#66) field in the DRUG file (#50) along with the other dispense drug fields for the dispense drug selected, as shown below: ... DISPENSE UNIT: VA DISPENSE UNIT: CAP DISPENSE UNITS/ORDER UNIT: 20 PRICE/DISPENSE UNIT: 0.8280 NCPDP DISPENSE UNIT: EACH NCPDP QUANTITY MULTIPLIER: 1.000 MAXIMUM DAYS SUPPLY: 100 APPL PKG USE: Outpatient Unit Dose Non-VA Med STRENGTH: 10 UNIT: MG The following New service Requests (NSRs) are being addressed by this patch: POSSIBLE DOSAGES: ... 11. Standard Schedule Edit [PSS SCHEDULE EDIT] option This option was modified to add the new INACTIVE field (#12) in the ADMINISTRATION SCHEDULE file (#51.1) to be updated for a schedule. ... OTHER LANGUAGE EXPANSION: INACTIVE: ?? established to address specific New Service Requests (NSRs) as well as a This field is used to indicate that a Standard Schedule is inactive. Inactive schedules are filtered from the list of schedules sent to CPRS for selection when users are placing a medication order. Choose from: 1 YES INACTIVE: ... 12. Administration Schedule File Report [PSS SCHEDULE REPORT] option NSRs 20060601/20111206 Allow Dispensing of Greater Than 90 Day Supply This option was modified to display the new INACTIVE field (#12) created in the ADMINISTRATION SCHEDULE file (#51.1) as seen below: ADMINISTRATION SCHEDULE FILE REPORT (All) PAGE: NN ---------------------------------------------------------------------- ... Q4H STANDARD ADMINISTRATION TIMES: 01-05-09-13-17-21 OUTPATIENT EXPANSION: EVERY 4 HOURS OTHER LANGUAGE EXPANSION: --------------------------------------------------------------------------- SCHEDULE TYPE: CONTINUOUS FREQUENCY (IN MINUTES): 240 EXCLUDE FROM ALL DOSE CHECKS: EXCLUDE FROM DAILY DOSE CHECK: INACTIVE: YES ... 13. Dispense Drug/Orderable Item Maintenance [PSS MAINTAIN ORDERABLE ITEMS] & Drug Enter/Edit [PSS DRUG ENTER/EDIT] options A new rule described below is being introduced which is related to the The Outpatient Pharmacy and supporting VistA applications are being modified relationship between IV Solutions and Orderable Items. Rule: An Orderable Item can only have ONE IV solution with a specific volume when it is marked to be used in the CPRS IV Order Dialog. This option was modified to check every time the user tries to link a dispense drug to an orderable item whether the new rule is being broken or not. If the new rule is being broken the message below will be displayed and the user will not be able to proceed with linking the drug to the orderable item. to allow dispensing of more than 90 day supply fill for outpatient Matching [Dispense Drug Name] to [Orderable Item Name] would cause the orderable item to have more than one Active IV Solution with the same volume marked to be used in the IV FLUID ORDER ENTRY, which is not allowed. Please, review the IV Solutions associated with this drug before matching it to this orderable item or match it to a different orderable item. prescriptions. The new limit will be 365 days and will be set for each drug 14. IV Solution Pre-Install Manual Clean-up (Environment Check routine) An environment check routine will run before the patch is installed to ensure that an orderable item does not have more than one IV Solution with the same volume when they are marked YES to be used in the CPRS IV Fluid Order Entry. If at least one orderable item entry is found, the patch installation will be aborted and a Mailman message will be sent to all users holding the following security keys: PSIVMGR, PSIJ MGR, PSNMGR. The message will contain a list of all orderable items that need to be cleaned up, as seen in the sample message below: individually. See below for more information on specific menu Subj: Duplicate IV Solution Volume under same Orderable Item [#215733] From: PATCH PSS1189 In 'IN' basket. Page 1 ------------------------------------------------------------------------- The list below shows IV Solutions in your database that need to be cleaned up before patch PSS1189 can be installed. Rule: An Orderable Item can only have ONE IV solution with a specific volume when it is marked to be used in the IV Order Dialog. Run Date/Time: Jun 12, 2015@09:49:16 options related to this enhancement. ------------------------------------------------------------------------- ORDERABLE ITEM (IEN) IV DISPENSE DRUG (IEN) IV SOLUTION (IEN) ------------------------------------------------------------------------- DEXTROSE (196) Solution Volume: 1000 ML DEXTROSE 10% IN WATER (620) DEXTROSE 10% (7) DEXTROSE 5% IN 0.45% NS (623) DEXTROSE 5% 1/2 NS (10) DEXTROSE 5% 1000ML INJ (627) 5% DEXTROSE (1) 15. IV Solution Post-Install Automatic Clean-up (Post-install routine) IV Solutions that are no longer used, meaning that either the IV Solution and/or the Dispense Drug and/or the Orderable Item are marked INACTIVE will have the field USED IN IV FLUID ORDER ENTRY set to 'NO'. A list of such IV Solutions will be sent to all users holding the following security keys: PSIVMGR, PSIJ MGR, PSNMGR. The message will NSR 20110308 Addition of a STRENGTH Property to IV ADDITIVES and Premixed contain a list of all IV Solutions that have been automatically updated as seen in the sample message below: Subj: Auto-update of the IV Solution file [#216328] 08/18/15@09:58 From: PATCH PSS1189 In 'IN' basket. Page 1 New* ------------------------------------------------------------------------- The list below shows IV Solutions in your database that had the field USED IN IV FLUID ORDER ENTRY set to 'NO' because either the Orderable Item, the Dispense Drug or the IV Solution itself was marked INACTIVE. Remedy Ticket and a Patient Safety Issue (PSI) related to the VistA Pharmacy IV SOLUTIONS Run Date/Time: Aug 18, 2015@09:58:38 ------------------------------------------------------------------------- ORDERABLE ITEM (IEN) IV DISPENSE DRUG (IEN) IV SOLUTION (IEN/VOLUME) ------------------------------------------------------------------------- CEFAZOLIN (106) CEFAZOLIN SOD 1GM INJ (1498) 20% DEXTROSE (2/500 ML) * INACTIVE DATE: JAN 11, 1994 * 20% DEXTROSE (11/500 ML) * INACTIVE DATE: JAN 11, 1994 * ---------------------------------------------------------------------------- 16. New API for CPRS: $$MAXDS^PSSUTIL1 This new API was created for CPRS to retrieve the Maximum Days Supply value for a specific medication. This API is available to CPRS through the Integration Control Registration (ICR) #3239. Below is a detailed description of the API. $$MAXDS^PSSUTIL1(INPUT) This API accepts an array containing the Pharmacy Orderable Item (required) and Dispense Drug (optional) and returns the maximum number Although patches PSJ5289 and PSS1174 introduced quite a few enhancements of Days Supply allowed to be dispensed for the specific medication. Parameters: Input: INPUT("PSOI") (Required) Pointer to the PHARMACY ORDERABLE ITEM file (#50.7). INPUT("DRUG") (Optional) Pointer to the DRUG file (#50). This parameter is optional. If not passed, the API will return the highest value from all the dispense drugs linked to the Pharmacy Orderable Item. to the IV Additives and IV Solutions ordering functionality they did not go Output $$MAXDS Maximum number of days supply that can be dispensed for the orderable item and/or dispense drug. 17. IV Additives and Solutions - Display "INACTIVATION DATE" The INACTIVATION DATE will display whenever a VistA lookup is done on IV Additives and Solutions. far enough in addressing all the issues originally in the NSR. Patches This was accomplished by making the following two fields identifiers: FIELD NAME FIELD NUMBER FILE NAME/NUMBER ---------------------------------------------------------- INACTIVATION DATE 12 IV ADDITIVES (#52.6) INACTIVATION DATE 8 IV SOLUTIONS (#52.7) Note: The following 'HELP'-PROMPT text will display for fields 8 & 12 "Enter the date this drug was inactivated. PSJ5313 and PSS1189 will extend the display of the IV Additive strength ******************* EXAMPLE(1) ADDITIVES ***************** Inpatient Drug Management - Additives File [PSSJI DRUG] Select Inpatient Drug Management Option: Additives File Select IV ADDITIVES PRINT NAME: PIPERACILLIN to other parts of the Inpatient Medications and Pharmacy Data Management Lookup: IV ADDITIVES PRINT NAME 1 PIPERACILLIN/TAZOBACTAM Additive Strength: 3.375 GM 2 PIPERACILLIN/TAZOBACTAM Additive Strength: 2.25 GM 3 PIPERACILLIN/TAZOBACTAM 03-5-2015 Additive Strength: 4.5 GM ***************** EXAMPLE(2) SOLUTIONS ***************** Inpatient Drug Management - Primary Solution File (IV) applications. In addition, it will also impose a new rule where an Orderable Select Inpatient Drug Management Option: PRImary Solution File(IV) Select IV SOLUTIONS PRINT NAME: DEXTROSE 5% / NACL Lookup: PRINT NAME 1 DEXTROSE 5% / NACL 0.2% 1000 ML 2 DEXTROSE 5% / NACL 0.33% 1000 ML 3 DEXTROSE 5% / NACL 0.45% 1000 ML 12-03-15 4 DEXTROSE 5% / NACL 0.9% 1000 ML ***************** END EXAMPLES ******************* Item can only have one IV Solution for a specific volume when it is marked to be used in the CPRS IV Fluid Order Entry. applications as approved by the Health Systems Enterprise Systems Manager NSR 20080907 Inactivate Pharmacy Standard Schedule ---------------------------------------------------------------------------- This enhancement is a conversion of an existing Class III software solution that permits an entry in the ADMINISTRATION SCHEDULE file (#51.1) to be marked as INACTIVE via the Standard Schedule Edit [PSS SCHEDULE EDIT] option. Once marked INACTIVE the schedule is no longer shown on the CPRS ADMINISTRATION SCHEDULE list. (ESM). The following Pharmacy Data Management functionality was modified: 1. New MAXIMUM DAYS SUPPLY field (#66) in the DRUG file (#50) This new field shown below was added to the DRUG file (#50) for storing the local maximum day supply value for a medication in an outpatient prescription. Field Name: MAXIMUM DAYS SUPPLY Format: Numeric INPUT TRANSFORM: D MXDAYSUP^PSSDDUT2 HELP-PROMPT: This is the maximum number of days supply for this drug. DESCRIPTION: This field is used to determine the maximum number for days supply that may be assigned to this drug. The maximum value allowed for this field is 365 (days) for most drugs, however: - Schedule 2 controlled substances have a 30-day maximum days supply limit - Schedules 3 thru 5 controlled substances have a 90-day This project is comprised of patches from five different applications, as maximum days supply limit - The maximum number of days supply for this drug cannot exceed the National Drug File (NDF) maximum value if it exists - No value can be entered for Clozapine drugs as the maximum days supply is controlled by the Clozapine functionality 2. ADMINISTRATION SCHEDULE file (#51.1) a) A new field named INACTIVE (#12) shown below was added to the shown below: ADMINISTRATION SCHEDULE file (#51.1) to allow the filtering inactive schedules when providing a list to the CPRS application. Field Name: INACTIVE Format: Set of Codes ('1' FOR YES) HELP-PROMPT: Answer YES to mark this administration schedule entry as inactive. DESCRIPTION: This field is used to indicate that a Standard Schedule is inactive. Inactive schedules are filtered from the list of schedules sent to CPRS for selection when users are placing a medication order. b) The upper limit for the FREQUENCY (IN MINUTES) field (#2) was increased from 129,600 (90 days) to 525,600 (365 days). 3. MEDICATION INSTRUCTION file (#51) The upper limit for the FREQUENCY (IN MINUTES) field (#31) was increased from 129,600 (90 days) to 525,600 (365 days). 4. IV SOLUTIONS file (#52.7) 20 SEQ #19 DATE APPLIED: 1999-02-23 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This KIDS Build contains the Pharmacy Data Management Enhancement patch. 2. The Enter/Edit Drug Interaction [PSS INTERACTION LOCAL ADD] option will be modified to generate a MailMan message whenever a local drug interaction are added or a change is made to the severity of a nationally entered drug interaction. 3. Two new fields were added to the PHARMACY SYSTEM file (#59.7). The fields are PMIS PRINTER (#13) and PMIS LANGUAGE (#14). The Parameters Edit [PSS SYS EDIT] option will allow the user to access the fields. 4. In reference to the Lookup into Dispense Drug File [PSS LOOK] option, It contains DDs for specific files and routines. code was added to routine PSSLOOK to display the National Formulary and National Restriction fields. 5. In reference to the CMOP Mark/Unmark [PSXX MARK] option, code was added to routine PSSDINT to display the reasons why a drug cannot be marked for CMOP use. 6. This patch also corrects a potential problem found when generating the default frequency using the option Standard Schedule Edit [PSS SCHEDULE EDIT]. The following issues are included in the KIDS Build: 1. A new INACTIVATION DATE field (#7) was added to the DOSAGE FORUM file #50.606. Also, a new INACTIVATION DATE field (#5) was added to the MEDICATION ROUTES file (#51.2). 194 SEQ #171 DATE APPLIED: 2016-07-13 12:58:11 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: This patch addresses three (3) issues: 3. Incorrect cross references may remain, and errors may occur during execution of the PSS EDIT TEXT option. 1. Users may not be aware that changing a drug's strength does not change the concentration. 2. The FileMan Description on the SYNONYM (#.01) field of the SYNONYM SUB-FIELD (#50.1) file for the DRUG (#50) file does not match the Input Transform. 192 DATE APPLIED: 2016-08-29 12:56:29 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: MCCF ePharmacy Compliance Phase 3 184 SEQ #173 DATE APPLIED: 2016-09-16 13:41:56 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: This patch will correct the following reported issues: in option PSS SCHEDULE PEPS INTERFACE CK is set to a low value, resulting in system issues. 4) Drug-Drug Interaction Order Check cannot be validated when performing option PSS CHECK PEPS SERVICES SETUP. 1) An error occurs during the drug renewal process if the drug has a lengthy drug-drug interaction check. 2) An error may occur in the option PSS SCHEDULE EDIT if the user jumps ahead to various fields. 3) Numerous background tasks might be tasked if the scheduling frequency 193 SEQ #174 DATE APPLIED: 2016-10-06 13:02:07 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: The Pharmacy Interface Automation Project will provide a new standard Note: The patches should be installed in the order listed above as the logical link, PSJ PADE used in the PSS patch is transported in the PSJ patch. As part of this patch PSS1193, the following enhancements were made: 1. Two new protocols PSS MFNM01 CLIENT and PSS MFNM01 SERVER were added to facilitate sending MFN HL7 drug messages to PADE. bi-directional HL7 interface to the Pharmacy Automated Dispensing 2. The Send Entire Drug File to External Interface [PSS MASTER FILE ALL] option was modified to allow transmission of the drug file to an Inpatient Interface (PADE) depending on the PADE setup. It also provides the flexibility of sending all drugs marked for Unit Dose, Intravenous (IV) or Ward Stock or send selected drugs to PADE. Since this option now allows to send all or selected drugs to PADE, the option name "Send Entire Drug File to External Interface" was changed to "Send Drug File Entries to External Interface" Equipment (PADE) located at the point of care areas such as Inpatient 3. A new PSS PADE INIT security key was added so that holders of this key can only send "all" drugs to PADE noted in item 2. 4. Option Drug Enter/Edit [PSS DRUG ENTER/EDIT] was modified to send an addition/update/both or none to PADE provided it is setup to receive such updates. wards, Outpatient Clinics etc. The outbound HL7 messages will be triggered when drugs are added or modified depending on the site parameter setup. The following two patches are provided for this project: PSJ5317 - Inpatient Medications V. 5.0. PSS1193 - Pharmacy Data Management V. 1.0. 199 SEQ #175 DATE APPLIED: 2016-12-12 12:10:49 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: This patch will correct the following issues: user may not be aware that not all lines are displaying on the screen. 3) Outpatient Pharmacy CK Action not working after Check Drug Interactions option is invoked if user enters "^" to exit out. 1) The API DRGIEN^PSS50P7 that returns the Dispense Drugs in the DRUG file (#50) matched to a PHARMACY ORDERABLE ITEM file (#50.7) is not returning all matches if a Dispense Drug happens to have the same internal entry number in the DRUG (#50) file as the PHARMACY ORDERABLE ITEM (#50.7) file entry it points to. 2) Lines may scroll off the screen when checking drug interactions. The 200 DATE APPLIED: 2016-12-20 15:21:35 APPLIED BY: USER,FIFTYFOUR 207 SEQ #177 DATE APPLIED: 2017-01-23 14:16:52 APPLIED BY: USER,FIFTYFOUR 197 DATE APPLIED: 2017-01-23 14:26:30 APPLIED BY: USER,FIFTYFOUR 198 SEQ #179 DATE APPLIED: 2017-05-04 17:35:52 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: This patch addresses the following three (3) issues: (3) The FIRST DATABANK UNIT (#1) field of the DOSE UNITS (#51.24) file for "APPLICATORFUL(S)" should be "APPLICATORFUL" instead of "APPLICATORFUL/S", and for "SUPPOSITOR(IES)", it should be "SUPPOSITORY" instead of "SUPPOSITORY/IES". (1) Patch PSS1127 incorrectly populated the NCPDP DISPENSE UNIT (#82) field of the DRUG (#50) file entry matched to VA PRODUCT (#50.68) file entry "MEMANTINE HCL 5MG/10MG TAB TITRATION PAK,49" (internal entry number 16512) as "RA" instead of "EA". (2) When invoking the PSS MAINTAIN ORDERABLE ITEMS option, several issues may occur involving the "INACTIVE DATE" prompt. 201 SEQ #180 DATE APPLIED: 2017-06-01 16:26:21 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: MOCHA 2.1 Dosing Enhancements. 1 DATE APPLIED: 1999-04-16 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch is only installed by the CPRS group of package builds. PSS PRIMARY DRUG EDIT PSS PRIMARY/VA GENERIC REPORT PSS VA GENERIC DRUG REPORT These options are deleted at the site. This patch SHOULD NOT be installed outside of the CPRS build. Re-Install File 55 (Pharmacy Patient) for Inpatient Medications V. 5.0. Options PSS CREATE ORDERABLE ITEMS PSS ORDERABLE ITEM STATUS PSS PRE-RELEASE MANUAL MATCH 195 SEQ #181 DATE APPLIED: 2017-08-30 15:01:49 APPLIED BY: USER,FIFTYFOUR 208 SEQ #182 DATE APPLIED: 2017-11-28 12:44:45 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: This patch addresses three (3) issues: between 0 and 222, 4 decimal digits". This does not accurately reflect the data stored in this field. There are many drug items on the market with a Price Per Dispense Unit greater than $222. The Data Dictionary needs to be updated to more accurately reflect the content of the field. 3. There is an issue with the PRINT NAME Field (#.01) in the IV ADDITIVE File (#52.6) when it contains a tilde (~). When an IV label is printed for an additive that has a print name that contains a tilde, it may not display the amount of the IV additive. When the tilde is removed, the IV additive amount will print. 1. When using Drug Enter/Edit [PSS DRUG ENTER/EDIT] Option for a drug that has been unmatched from the NDF, the NATIONAL FORUMULARY INDICATOR field on the screen displays 'YES" instead of 'NOT Matched to NDF'. 2. The Data Dictionary for the DRUG File (#50) PRICE PER DISPENSE UNIT Field (#16) is incorrect. The Prompt Message displays "Type a Number 213 SEQ #183 DATE APPLIED: 2017-12-01 12:43:45 APPLIED BY: USER,FIFTYFOUR 212 SEQ #184 DATE APPLIED: 2018-01-30 15:35:41 APPLIED BY: USER,FIFTYFOUR 209 SEQ #185 DATE APPLIED: 2018-02-28 17:16:45 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: This patch addresses one issue: 1. New BUPRENORPHINE Dosage Form (FILM,BUCCAL) has been approved for the treatment of chronic pain and necessitates an update in the Detox API 178 DATE APPLIED: 2018-03-02 14:04:29 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: MOCHA 2.1 Dosing Enhancements. 206 DATE APPLIED: 2018-03-02 14:09:21 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: MOCHA 2.1b Follow Up patch. 204 SEQ #188 DATE APPLIED: 2018-04-03 15:49:05 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: This build has been created to provide a Packman message-type patch for Indications for Use for Prescriptions and Medication Orders. This will give the user the ability to enter most common indications and/or additional indications for the medications in the Pharmacy Orderable Items file (#50.7). 211 SEQ #189 DATE APPLIED: 2018-04-03 17:25:36 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: This patch implements Medications Dosage Form domain changes required by the Collaborative Terminology Tooling & Data Management (CTT & DM) Native Standardization (NDS) project. Please see FORUM for full patch description and installation instructions. 217 SEQ #190 DATE APPLIED: 2018-04-24 16:15:29 APPLIED BY: USER,FIFTYFOUR 21 SEQ #20 DATE APPLIED: 1999-04-17 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch addresses three issues. processes. 3. It corrects a typo in the data dictionary for the DISPENSE DRUG field (#.02) of the DISPENSE LOG sub-file (#55.0611) in the PHARMACY PATIENT file (#55). The sub-file number was changed from 5506.11 to 55.0611. 1. The IV SOLUTIONS file (#52.7) VOLUME field (#2) has an upper limit of 4000ml. This patch will increase the volume field to 9999ml to meet the needs of the sites to enter solutions with a volume of greater than 4000ml. 2. It corrects a problem when displaying non-formulary drugs associated with the formulary alternative during the drug enter and edit 210 SEQ #191 DATE APPLIED: 2018-05-01 14:21:26 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: 1. Free text is accepted in the NAME field (#.01) of the ADMINISTRATION SCHEDULE file (#51.1) when the TYPE OF SCHEDULE field (#5) is set to D (Day of the Week). 2. Changes made to the NAME field (#.01) of the PHARMACY ORDERABLE ITEMS file (#50.7) via the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option are not always reflected in the ORDERABLE ITEMS file (#101.43). 203 SEQ #192 DATE APPLIED: 2018-06-01 15:08:38 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: EPIP PSS REMEDIATION 1.0 224 DATE APPLIED: 2018-07-06 15:42:47 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: Warranty issue repairs for MOCHA 2.1B. 219 SEQ #194 DATE APPLIED: 2018-09-04 15:33:29 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: Updates to dosage forms for Buprenorphine containing products. 227 SEQ #195 DATE APPLIED: 2018-09-07 13:13:03 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: PSS1.0227 229 SEQ #196 DATE APPLIED: 2018-10-04 14:51:08 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: Issues: 2. When invoking option PSSJI SOLN: a) An error occurs if a solution is defined to have 'UNIT DOSE MEDICATIONS" usage defined as "quick order only". b) Quick order restrictions are removed if "IV MEDICATIONS" and/or "IV SOLUTIONS" usages are defined as "quick order only". Resolution: ---------- Modified routines PSSVIDRG and ORMFN to preserve quick order settings on additives and solutions. These changes also prevented the error which occurred when a solution or additive was defined to have unit doses as "quick order only". Routine ORMFN is included in patch OR3.0487U which will be installed along with routine PSSVIDRG in this patch. 1. When invoking option PSSJI DRUG: a) An error occurs if an additive is defined to have "UNIT DOSE MEDICATIONS" usage defined as "quick order only". b) Quick order restrictions are removed if "IV MEDICATIONS" and/or "IV ADDITIVES" usages are defined as "quick order only. 218 SEQ #197 DATE APPLIED: 2018-11-02 15:29:01 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: This patch has the following enhancements for Clinical Ancillary Services Help text added for this field during PSS DRUG ENTER/EDIT option: "K Not Renewable (by telephone) 2. Manage Lookup List Inactive Entries The following files have added a new field identifier to their data dictionaries to indicate if they are marked as Inactive entries. (CAS) Enhancements (RXSU2). a. ADMINISTRATION SCHEDULE file (#51.1) the INACTIVE field (#12). b. DRUG TEXT file (#51.7) the INACTIVATION DATE field (#2). 1. Update DEA SPECIAL HANDLING Field Documentation A new code letter "K" was added to for the DEA, SPECIAL HDLG (#3) in the DRUG file (#50) to document in VistA when providers renew medications for patients that cannot be automatically renewed by the patient via Audiocare. 220 SEQ #198 DATE APPLIED: 2018-12-06 16:04:09 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: 1) Errors when using the PSS LOOK option in VistA 2) Hard error within PSS DRUG ENTER/EDIT option for Lab Monitoring 3) Duplicate prompt to create a new Orderable Item when entering a new Drug File entry 215 DATE APPLIED: 2018-12-06 16:17:04 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: Patch PSS1.0215 is part of a Multi Build with patch PS07.0452. This build contains the Data Dictionary changes in support of PSO7.0452 and is a required build for PSO7.0452 PSO7.0452 contains the routine changes. PSS1.0215 contains the DD changes. The NSRs involved in this build are: NSR20150311 High Cost Rx Report; NSR20151109 Pharmacy Print from Suspense by Category; NSR20150512 Early Warning Advisory for Approaching the end of Rx Number Ranges; and NSR20151001 Pharmacy Patient Demographics. 214 DATE APPLIED: 2019-02-01 14:38:00 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: MCCF EDI TAS EPHARMACY BUILDS 5 & 6 3 SEQ #2 DATE APPLIED: 1997-11-18 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Pharmacy Data Management PATCH PSS13. This patch fixes the Mark/Unmarking of a drug for Controlled Substances vs. Drug Accountability/Inventory Interface. 23 SEQ #21 DATE APPLIED: 1999-05-10 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch resolves two issues. Neither the field nor template is used by current software. References to the USER file (#3) are contained in the field and template. The PHARMACISTS field was flagged for deletion. 1. It creates a new sub-file EXEMPT WARD FROM AUTOCANCEL (#59.701) in the PHARMACY SYSTEM file (#59.7). This new sub-file will be used by Outpatient Pharmacy to exempt ward locations when prescriptions are auto-canceled. 2. It deletes the PHARMACISTS field (#6) from the INPATIENT SITE file (#59.4) and PSJIORE input template from the PHARMACY PATIENT file (#55). 225 SEQ #201 DATE APPLIED: 2019-02-01 15:21:07 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: This patch addresses the request from NSR #20170515 - Adds Respiratory Therapy Report. This patch distributes one new field, #15, added to file #50.7. The option Edit Orderable Items [PSS EDIT ORDERABLE ITEMS] is updated by this patch via its driver routine PSSPOIMO, and is used to mark a drug for use in respiratory therapy treatment of patients. The drugs prescribed to patients for respiratory therapy treatment will be displayed in the Report for Respiratory Therapy Medications. 231 SEQ #202 DATE APPLIED: 2019-03-01 15:41:15 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: Subject: FIX ERRORS CALLING DOSAGE CHECK 1) Dosing check fails when values are added and then deleted from field DRUG(S) FOR DOSING CHK FREQ (#11.1) in the ADMINISTRATION SCHEDULE FILE (#51.1) 2) Dosing check fails when an OLD SCHEDULE NAME(S) is used with a PRN designation. 232 SEQ #203 DATE APPLIED: 2019-04-01 17:08:34 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: This patch will resolve the following issue. INC2574335 - Our drug file entry will not let me add the labs associated with the drug Clozapine that needs labs attached so that drug checks can be performed Problem: -------- Noth Texas VAMC reported a problem when trying to use the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option to mark a dispense drug a 'Clozapine' drug. After entering the lab test (WBC) and Specimen Type (BLOOD) they would get a double question mark (??) after answering 'YES' at the 'Is this Correct?' prompt. Resolution: ----------- The problem was a result of an internal call to Fileman to save the lab test data. Fileman was getting lost because it found more than one match to the IEN for 'BLOOD' in the TOPOGRAPHY FIELD file (#61) because it did not restrict the lookup to IEN only and other entries in that file had the ABBREVIATION field (#6) set with a value that matched the IEN for 'BLOOD'. INC2574335 - Our drug file entry will not let me add the labs associated with Technical Resolution: --------------------- Changed the routine PSSCLOZ at CLOZAD2+2 to use 4 slashes (////) instead of 3 slashes (///) when saving SPECIMEN TYPE FIELD (#2), as shown below: S DIC("DR")="2////"_PSSPTYN_";3///"_PSSTUFF the drug Clozapine that needs labs attached so that drug checks can be performed Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 233 SEQ #204 DATE APPLIED: 2019-04-02 16:47:43 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: This patch addresses some display issues in the Lookup into Dispense Drug File Option [PSS LOOK] 235 SEQ #205 DATE APPLIED: 2019-05-01 15:55:12 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: The description of this build can be found in the National Patch Module under PSS1235. 234 SEQ #206 DATE APPLIED: 2019-07-08 16:39:50 APPLIED BY: USER,SIXTYFIVE DESCRIPTION: The purpose of this build is to export the data dictionary for the PHARMACY ORDERABLE ITEM file (#50.7) in order to update the APPLICATION GROUP field to add GMTS. In addition, it exports the routine to return the pharmacy orderable item information in order to support the Ad Hoc report summary. 236 SEQ #207 DATE APPLIED: 2019-10-24 12:14:11 APPLIED BY: USER,SIXTYFIVE DESCRIPTION: The description of this build can be found in the National Patch Module under PSS1236. 240 SEQ #208 DATE APPLIED: 2020-02-11 09:56:13 APPLIED BY: USER,SIXTYFIVE DESCRIPTION: CORRECT THE URL FOR MEDICATION ROUTE REQUEST 238 SEQ #209 DATE APPLIED: 2020-03-25 10:24:31 APPLIED BY: USER,SEVENTY 243 SEQ #210 DATE APPLIED: 2020-06-24 14:04:52 APPLIED BY: USER,SIXTYFIVE DESCRIPTION: This patch, along with patch PSN4569 will address the following ePrescribing -------------------------------------------- 1. INC9317643 - We have noticed a number of drugs that do not auto match for inbound eRx orders DUPLICATE - INC9105989 - erx software auto-matched wrong drug product Problem: -------- The VA Health Administration Center Denver reported and issue with incoming ePrescribing orders (eRx) not automatically matching the ordered drug with a (eRx) issue: VistA corresponding Dispense Drug, even when the NDC received matches 1 to 1 with a specific VA Product entry. They also noticed the issue to be more prevalent with dispense drugs that have been recently re-matched to a different VA Product entry due to changes from MG to MGC in the strength. After researching this issue it was determined that the root cause of the problem was a 'corruption' of the "APR" cross-reference in the DRUG file (#50) which was not properly set or killed after Dispense Drugs were matched, un-matched or re-matched to VA Product entries. Such cross-reference is used by the eRx drug auto-matching processing and that's the reason it failed for some drugs. It turned out that two other cross-references "AND" and "APN" also had the same issue. No user functionality side-effects have been reported related to these other two cross-references though. Resolution: ----------- The setting and killing of the "APR", "AND" and "APN" cross-reference have been completely reviewed at every point where a Dispense Drug is matched, un-matched or re-matched to a VA Product and after this patch is installed they should be properly maintained. Furthermore, a post-install routine 1. INC9317643 - We have noticed a number of drugs that do not auto match for will completely kill off the 3 cross-references and re-build them completely. The NDF (National Drug File) patch PSS1243 is also being released along with this patch because the matching functionality is available in both applications, NDF and PDM (Pharmacy Data Management). Technical Resolution: --------------------- Changed the routines PSSDEE1 and PSSUTIL to kill and set the cross-references "AND", "APN" and "APR" properly. inbound eRx orders DUPLICATE - INC9105989 - erx software auto-matched wrong drug product Defect Tracking System Ticket(s) & Overview: 19 SEQ #22 DATE APPLIED: 1999-06-22 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch contains the following enhancements: 2. Within the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option, a significant enhancement to the Mark/Unmark for Lab Monitor or Clozapine procedure was made. A. When updating Clozapine information, the user will have a choice to add, edit, or delete Clozapine Lab Test(s) for the selected drug. B. When updating Clozapine information, the user will have to add identification of two laboratory tests, WBC and Absolute Neutrophil Count (ANC). C. In the post-installation process, we added code to move data from the CLOZ node to the CLOZ2 node in the DRUG file (#50). (This is 3. In the DRUG file (#50), we expanded the field length of the WARNING LABEL field (#8) to 25 characters to allow longer names. 4. The routine PSSPOIDT was updated to properly delete data from the INACTIVE DATE field (#100) in the DRUG file (#50) when a drug is reactivated. 1. In the pre-installation process, we added code to: A. Delete the DRUG GROUP/INTERACTION field (#7) from the DRUG file (#50). This field has been marked for deletion. B. Delete the "I" node in the DRUG file (#50) if it does not contain data. 241 SEQ #211 DATE APPLIED: 2020-07-21 13:46:41 APPLIED BY: USER,SIXTYFIVE DESCRIPTION: Remove HANG command from ST in PSSPRICE. 242 SEQ #212 DATE APPLIED: 2020-08-10 12:52:53 APPLIED BY: USER,SIXTYFIVE DESCRIPTION: This patch provides the functionality to add the other language Indications for Use in the PHARMACY ORDERABLE ITEMS file (#50.7). The menu options Edit Orderable Items [PSS EDIT ORDERABLE ITEMS], Dispense Drug/Orderable Item Maintenance [PSS MAINTAIN ORDERABLE ITEMS] and Drug Enter/Edit [PSS DRUG ENTER/EDIT] have been modified to prompt for other indications for use. 245 SEQ #213 DATE APPLIED: 2020-08-19 11:27:22 APPLIED BY: USER,SIXTYFIVE DESCRIPTION: 1. INC9511598 Med Instructions Display incorrectly with Clinic Medications Resolution: ---------- This patch adds a new report which displays matches between the Medication Instruction file (#51) and the Medication Routes file (#51.2). The MEDICATION INSTRUCTION Name field (File #51) and MEDICATION ROUTE Abbreviation field (File #51.2) may have entries that use similar terminology and abbreviations but with different clinical meanings. The MED INSTRUCTION MED ROUTE TERM REPORT option identifies instances where the MEDICATION INSTRUCTION Name field and the MEDICATION ROUTE Abbreviation field are identical to facilitate review and correction of clinically inconsistent terminology between the two files. Local Pharmacy Informaticists should review and evaluate this report for possible corrective action to ensure that reports which use the expansion from the MEDICATION INSTRUCTION file are clinically valid when the data originates in the MEDICATION ROUTE file. This patch adds the Med Instruction Med Term Route Report to the Medication Instruction Management menu (PSS MED INSTRUCTION Problem: MANAGEMENT) and the Medication Routes Management menu (PSS MEDICATION ROUTES MGMT). Upon running the report, sites should refer to the Pharmacy Data Management User Manual located on the VistA Software Document Library for the dedicated Pharmacy website to discuss the potential options for file management or to see previous site's decisions on how similar entries were handled. Documentation updates are applied to the Pharmacy Data Management User ------- Manual as well as the Pharmacy Data Management Technical Manual/Security Guide. The Med Route abbreviation for Clinic Meds and Inpatient Meds expands in the EMLR using the Med Instruction Name if the abbreviation is identical, which may result in a mismatch of clinical terminology if the fields were not defined properly. 246 SEQ #214 DATE APPLIED: 2020-11-06 16:15:15 APPLIED BY: USER,SEVENTEEN DESCRIPTION: The released patch PSS1219 provided functionality to exclude buccal film. buprenorphine-containing products from requiring an X-number (Detox Number) when they are specifically FDA approved with indication for the treatment of pain. This was done by dosage form so that Butrans (patch) and Belbuca (film, buccal), the products available at the time, could be excluded. However, a new product, Bunavail has been released to market. This is also a buccal film but is primarily indicated for treatment of opioid substance use disorder. Therefore, changes are needed that will require an X-number when a Bunavail order is placed with a dosage form of 248b DATE APPLIED: 2021-05-13 00:00:00 DESCRIPTION: Backup of PSS1.0248 on May 13, 2021 Warning: Installing this backup patch message will install older versions of routines and Build Components (options, protocols, templates, etc.). Please verify with the Development Team that it is safe to install. 248 SEQ #215 DATE APPLIED: 2021-05-13 17:15:14 APPLIED BY: USER,SEVENTEEN DESCRIPTION: The current CMOP Share site is being decommissioned and will be https://vaww.cmopnational.domain.ext/CR/FDAMedGuides/ To: https://vaww.vashare.domain.ext/sites/PBMNat/FDAMedGuides/ inaccessible for Med Guide retrieval. The application requires a configuration upgrade and installation to access the new URL. This patch will update the Pharmacy System File (File #59.7) FDA MED GUIDE SERVER URL field (Field #100) with the new secure URL. Post-init routine PSS248P will change the FDA MED GUIDE SERVER URL field from this: 249b DATE APPLIED: 2021-06-17 00:00:00 DESCRIPTION: Backup of PSS1.0249 on Jun 17, 2021 Warning: Installing this backup patch message will install older versions of routines and Build Components (options, protocols, templates, etc.). Please verify with the Development Team that it is safe to install. 249 SEQ #216 DATE APPLIED: 2021-06-17 13:03:28 APPLIED BY: USER,SEVENTEEN 226b DATE APPLIED: 2021-07-13 00:00:00 DESCRIPTION: Backup of PSS1.0226 on Jul 13, 2021 Warning: Installing this backup patch message will install older versions of routines and Build Components (options, protocols, templates, etc.). Please verify with the Development Team that it is safe to install. 226 SEQ #217 DATE APPLIED: 2021-07-13 09:22:38 APPLIED BY: USER,SEVENTEEN DESCRIPTION: The description of this build can be found in the National Patch Module under PSS1.0226. 22 SEQ #23 DATE APPLIED: 1999-06-22 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch contains two enhancements: Interaction Management [PSS DRG INTER MANAGEMENT] menu. 1. In the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option, we made modifications to routine PSSDEE to identify an entry when it is marked for Ward Stock. 2. A new option, Report of Locally Entered Interactions [PSS REPORT LOCAL INTERACTIONS] has been added. This report displays locally entered drug interactions and their severity. It is included on the Drug 247b DATE APPLIED: 2021-08-09 00:00:00 DESCRIPTION: Backup of PSS1.0247 on Aug 09, 2021 Warning: Installing this backup patch message will install older versions of routines and Build Components (options, protocols, templates, etc.). Please verify with the Development Team that it is safe to install. 247 SEQ #218 DATE APPLIED: 2021-08-09 10:50:43 APPLIED BY: USER,SEVENTEEN DESCRIPTION: The description of this build can be found in the National Patch Module under PSS1.0247. 252 DATE APPLIED: 2022-01-19 15:52:46 APPLIED BY: USER,SEVENTEEN 255 SEQ #220 DATE APPLIED: 2022-02-02 11:04:35 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch will fix the following: Some prescriptions for DEA Schedule II medication are allowed to be entered for greater than a 30 days supply. 257 SEQ #221 DATE APPLIED: 2022-03-21 19:26:38 APPLIED BY: USER,EIGHTYSIX DESCRIPTION: FDA Medication Guide Automatic Printing functionality Component installed on servers to work with the new CMOP SharePoint URL. If your site is currently utilizing the FDA Med Guide Auto Printing the updated Java Application Components included in this release, must be installed immediately following the installation of PSS1257. Failure to do so will disable Automatic printing functionality until the updated Java Application Component software is installed. includes 2 patches which must be installed in the following order: **If your site does not utilize the FDA Med Guide Auto Printing software, you only need to install Vista patch PSS1257 and no further action on PSO7665 is necessary. ************************************************************************ The previous SharePoint address is hard-coded and stored in the Pharmacy System File (File #59.7) FDA MED GUIDE SERVER URL field (Field #100). This patch will update the Pharmacy System File (File #59.7) FDA MED GUIDE SERVER URL field (Field #100) with the new secure VA Share URL. Post-init routine PSS257P will change the FDA MED GUIDE SERVER URL field from this: "https://vaww.vashare.domain.ext/sites/PBMNat/FDAMedGuides/" to this: file://v12.domain.ext/v12/PBM/Workgroup/VistA_MedGuides/ 1. PSS1257 - Vista patch that updates the Pharmacy System File Patch PS07.0665 (Automatic Printing) will be released at the same time as this patch, PSS1257 Information only patches contain instructions to retrieve the necessary files and documentation to update the Java Application Component software to make this URL work with the system. This patch (PSS1257) only makes the file update and does not alter any VistA functionality. (File#59.7) FDA MED GUIDE SERVER URL field (Field 100) with the new secure CMOP SharePoint URL. 2. PSO7665 - Information only patch that contains instructions to update the FDA Med Guide Automatic Printing Java Application 256 SEQ #222 DATE APPLIED: 2022-04-21 16:55:03 APPLIED BY: USER,EIGHTYSIX DESCRIPTION: This patch will resolve the following issues: ----------------------------- N/A Additional Information: ----------------------- Defect Tracking System Ticket(s) & Overview: INC20326718 Problem: -------- It was reported by the Sacramento VA Medical Center that the Edit Orderable Items [PSS EDIT ORDERABLE ITEMS] menu inappropriately jumps several prompts with use of an up carat "^" and a question mark "?". Resolution: ----------- The following changes were made to address the issue: 1. INC20326718 - Edit Orderable Items [PSS EDIT ORDERABLE ITEMS] menu 1) Fix the logic so it does not inappropriately jump several prompts with use of an up carat "^" and a question mark "?". Technical Resolution: --------------------- The following changes were made to address the issue: 1) Routine PSSPOIMO was updated in the DIR tag to move the 4 indication fields (14, 13, 14.1, and 14.2) added with PSO7204 and PSO7242 to the DR string variable. This will resolve the issue of the indicator fields inappropriately jumps with use of an up carat "^" and a question mark displaying after the user enters an up carat "^" to quit out of the option. In addition, the logic was updated in the DIR tag to not skip prompts if a question mark is used for the help text. "?". It was reported that the issue started occurring after the indication fields were added (i.e. PSS1204). Patient Safety Issues (PSIs): 187 DATE APPLIED: 2022-10-05 14:49:54 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: The Computerized Patient Record System (CPRS) Graphical User Interface 20170512: Complex Non-VA Med Orders For a complete listing of patches included in this release, please refer to the CPRS GUI v32 Release Notes. (GUI) v32 is an enhancement release. This patch (PSS1187) is a part of that enhancement release. This patch provides the needed functionalities to support the following NSRs: 20090509: Park a Prescription 20100101: Indication on all Prescriptions and Medication Orders 258 SEQ #224 DATE APPLIED: 2023-02-28 12:41:31 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: This patch will update the PPSN web service to a more secure protocol: "encrypt_only_tlsv12". 260 DATE APPLIED: 2023-11-03 09:49:46 APPLIED BY: USER,EIGHTYNINE 261 SEQ #226 DATE APPLIED: 2023-12-06 15:38:39 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: See FORUM patch description. 24 SEQ #24 DATE APPLIED: 1999-06-28 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch contains two enhancements: 1. In the Lookup into Dispense Drug File [PSS LOOK] option, we made modifications to routine PSSLOOK to correct a typo. Indicatior changed to Indicator. 2. In the Standard Schedule Edit [PSS SCHEDULE EDIT] option, we made modifications to routine PSSJEEU to set DLAYGO to the file number. This correction should allow users to look up and add new entries to the file. 259 SEQ #227 DATE APPLIED: 2024-03-25 09:56:13 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: Computerized Patient Record System (CPRS) v33 MOE will address NSR 20090602: Addition of a Function to Enter Stop and Start Dates for Inpatient Medications in CPRS. This patch is the preparation patch for the installation of CPRS v33 MOE. It gives pharmacy informatics the ability to define one-time administration schedules that should be excluded from the Start/Stop functionality in CPRS. The exclusion schedules can be defined at system or division level. 239 SEQ #228 DATE APPLIED: 2024-07-26 10:36:27 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: See FORUM for patch description details. 25 SEQ #25 DATE APPLIED: 1999-08-03 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. It adds a new AOC cross-reference to the VA CLASSIFICATION field (#2) in the DRUG file (#50). 2. In the PHARMACY PATIENT file (#55), it corrects a typo in a screen placed on the DISPENSE DRUG field (#.01) from the DISPENSE DRUG multiple (#55.07). The code was modified to reference the PHARMACY ORDERABLE ITEM field (#2.1) instead of the PRIMARY DRUG field (#64). NOTE This patch requires the installation of Inpatient Medications V. 5.0. Facilities using Inpatient Medications V. 4.5 do not need to install this patch. Inpatient Medications V. 5.0 patch PSJ5.030 contains enhancements that utilize changes introduced in this patch. This patch addresses two issues. 26 SEQ #26 DATE APPLIED: 1999-09-14 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch distributes a common pharmacy locking routine (PSSLOCK). This patch supports the patient and single order locking changes in Inpatient Medications V. 5.0 and Outpatient Pharmacy V. 7.0. This patch will NOT change locking functionality until patches OR3.048, PSJ5.029 and PSO7.027 are installed. 30 SEQ #27 DATE APPLIED: 2000-02-29 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch deletes the VENDOR sub-file (#50.535001) from the DRUG file ^PSDRUG(D0,535000,D1,0) ==>(#.01) VENDOR [1P] ^ (#1) PRIMARY VENDOR [2S] ^ (#2) ==>VENDOR'S PRICE PER ORDER UNIT [3N] ^ (#3) VENDOR'S ==>ORDER UNIT [4P] ^ (#4) DISPENSE UNITS PER ORDER UNIT ==> [5N] ^ (#5) COMPANY STOCK NUMBER [6F] ^ (#6) START ==>DATE [7D] ^ (#7) STOP DATE [8D] ^ (#8) DUMMY [9F] ^ ==>(#9) PRICE PER DISPENSE UNIT [10N] ^ (#50) and the associated data. The VENDOR sub-file (#50.535001) does not provide national support of current activities related to the Pharmacy Data Management (PDM) application. The following multiple and associated data will be deleted with this patch: 29 SEQ #28 DATE APPLIED: 2000-02-29 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This build contains routines, options, files, fields, and templates for the National Formulary Indicator enhancement patch. 27 SEQ #29 DATE APPLIED: 2000-04-05 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch contains the following enhancements. DISPENSE UNITS PER ORDER UNIT field (#15) in the DRUG file (#50). 3. In reference to the MEDICATION INSTRUCTION file (#51), this patch: a. Replaces erroneous %D subscripts in the ^PS(51 data globals by restoring the MEDICATION INSTRUCTION file (#51) data dictionary. (ex. ^PS(51,%D,...). b. Re-indexes the "A" cross-references on the NAME field (#.01). c. Reinstalls full set of DDs related to the MEDICATION INSTRUCTION file (#51). 4. During the Computerize Patient Record System (CPRS) Order Entry process, the schedule input transform routine PSSGSO was not allowing schedules 5TIMES/DAY and 5X/DAY to pass as valid non-standard schedules. This patch contains modifications to routine PSSGS0 to allow these schedules to be entered. 1. In the Standard Schedule Edit [PSS SCHEDULE EDIT] option, it increases the maximum value of the Frequency (IN MINUTES) field (#2) from 50000 to 129600 minutes in the ADMINISTRATION SCHEDULE file (#51.1). 2. In the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option, it increases the decimal length from three to four digits when displaying the 28 SEQ #30 DATE APPLIED: 2000-05-16 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Modifications were made to two options, CMOP Mark/Unmark (Single drug) 2. The program currently checks for a "C" - CONTROLLED SUBSTANCES - NON NARCOTIC in the DEA, SPECIAL HDLG field (#3) of the drug to be marked for transmission. Routine PSSMARK was modified to check for a "1" - SCHEDULE 1, or a "2" - SCHEDULE 2 in the DEA, SPECIAL HDLG field (#3). If these values are assigned to the selected drug, the option will not allow the user to mark the drug for CMOP transmission. 3. Routines PSSMARK and PSSDEE were modified to change the current message display, "It is a controlled substance" to "It is a schedule I or schedule II controlled substance" when a user attempts to mark [PSSXX MARK] and Drug Enter/Edit [PSS DRUG ENTER/EDIT]. These a controlled substance drug that does contains a "1" or "2" in the DEA SPECIAL HDLG field (#3). 4. The Drug Enter/Edit [PSS DRUG ENTER/EDIT] option was modified to display a new message to reflect changes to the option. Routine PSSMARK was modified to check for a "1" or a "2" in the DEA, SPECIAL HDLG field (#3). If either of these values exist and the drug is already marked for CMOP transmission, the option shall display a message to the user indicating that the drug has been unmarked for CMOP transmission. modifications were required to enable drugs identified as a Schedule 5. The Drug Enter/Edit [PSS DRUG ENTER/EDIT] option has been enhanced to provide a list of reasons why a drug can not be marked for CMOP transmission. III-V controlled substance to be marked for CMOP transmission. 1. Both options were modified to remove the screen that disallows a drug identified as a Schedule III-V controlled substance to be marked for CMOP transmission. 4 SEQ #3 DATE APPLIED: 1998-02-27 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch removes the INPATIENT PRESCRIPTION PROFILE (#70) and the INPATIENT NARRATIVE (#21) fields from the PHARMACY PATIENT file (#55). Field #21 was added with the release of Pharmacy Data Management (PDM) and it is conflicting with reserved fields designated for Outpatient Pharmacy. This patch will delete all data and DDs related to these fields. 37 SEQ #32 DATE APPLIED: 2000-07-10 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: The option, Synonym Enter/Edit [PSS SYNONYM], has been created to provide easy access to the update the synonym information for an entry in the local DRUG file (#50). 31 SEQ #31 DATE APPLIED: 2000-07-10 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch contain two enhanancements: 1. It restores the DDs related to the "AND" cross-reference placed on the NATIONAL DRUG FILE ENTRY field (#20) in the DRUG file (#50). 2. It removes the CHEMOTHERAPY DRUG field (#202) and data from the DRUG File (#50). 36 SEQ #33 DATE APPLIED: 2000-07-10 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch contains one resolution. Drug Enter/Edit [PSS DRUG ENTER/EDIT] option, entries in the "AOC" MUMPS cross-reference only exist if the VA CLASSIFICATION field (#2) was entered after the PHARMACY ORDERABLE ITEM field (#2.1) in the DRUG file (#50). Solution: To make sure entries are properly set, this patch replaces the "AOC" MUMPS cross-reference with a new "AOC" compound index associated with the VA CLASSIFICATION field (#2) and PHARMACY ORDERABLE ITEM field (#2.1) in the DRUG file (#50). This solution will create an entry in the "AOC" compound index anytime both fields are modified regardless of the order. Problem: This patch resolves a problem related to a report created by the Patients on Specific Drug(s) [PSJ PDV] option associated with the Inpatient Medications V. 5.0 application. The Pharmacy Data Management (PDM) V. 1.0 application allows the Patients on Specific Drug(s) [PSJ PDV] option to access data stored in the "AOC" MUMPS cross-reference to produce a report on specific VA Classification. A facility reported that they noticed missing entries after generating the report. When using the 32 SEQ #34 DATE APPLIED: 2000-08-16 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch contains several problems and resolutions related Pharmacy Resolution: The characteristics of the INACTIVE DATE field (#.04) in the PHARMACY ORDERABLE ITEM file (#50.7) was enhanced by classifying the field as an identifier. When the user performs a lookup on selectable orderable items, the option will display the inactive date associated with the orderable item. 2. Problem: In the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option, the user noticed excessive looping after matching or tying an IV Additive or Solution to an orderable item. The user is asked repeatedly to enter another IV Additive or Solution. The user has to press return several Data Management V. 1.0. times to move to the next section in the option. Resolution: The Drug Enter/Edit [PSS DRUG ENTER/EDIT] option was enhanced to allow the user to decide whether to enter another IV Additive or Solution before moving to the next section. 3. Problem: In the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option, the user encountered an <UNDEFINED> UD^PSSDEE error when editing a drug that has been previously marked for CMOP. After the "Do you wish to UNmark this drug to transmit to CMOP? " prompt, the problem occurred as a result of killing the DA variable found at line tag UNMARK+1 in the PSSMARK routine. When the coding logic returned to the PSSDEE routine, the DA variable was detected as undefined since it was not reset to its original value. Resolution: In reference to the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option, the PSSDEE routine was modified to store the value of the DA variable into an alternate variable so that the value of the DA variable can be retained for further use. 1. Problem: In the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option, a 4. Problem: A minor enhancement was added to the Edit Orderable Items [PSS EDIT ORDERABLE ITEMS] option. When editing the CORRESPONDING IV ITEM field (#4) or CORRESPONDING UD ITEM field (#3) in the PHARMACY ORDERABLE ITEM file (#50.7), the default prompt only showed the orderable item name and did not include any reference to the DOSAGE FORM field (#.02) in the PHARMACY ORDERABLE ITEM file (#50.7). The selection process was confusing if there were multiple orderable items with the same name with different dosage forms. Resolution: To alleviate confusion, the Edit Orderable Items [PSS EDIT problem was discovered with identifying an inactive orderable item ORDERABLE ITEMS] option was enhanced to display a message to the user prior to the prompt. The message will indicate both the orderable item name and dosage form information. 5. Problem: In the Edit Orderable Items [PSS EDIT ORDERABLE ITEMS] option, the user noticed a problem with modifying and storing information related to the orderable item. The problem was related to an outdated global reference to a reconstructed National Drug File (NDF) file within the input transform placed on the PHARMACY ORDERABLE ITEM field (#2.1) in the DRUG file (#50). before it is matched or tied to a dispense drug. Users find it difficult Resolution: To resolve this problem, the input transform associated with the PHARMACY ORDERABLE ITEM field (#2.1) was modified by replacing the old NDF global reference with a NDF Application Programming Interfaces (API) call to retrieve the dosage form information from the proper file. 6. Problem: The Drug Enter/Edit [PSS DRUG ENTER/EDIT] option failed to notify the user when a dispense drug is matched or tied to an inactive orderable item. The user would like to see a warning message before s/he to select an active orderable item since the inactive date is not is asked, "Do you want to match to a different Orderable Item? NO//." Resolution: To resolve this problem, the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option was enhanced to warn the user when a dispense drug is matched or tied to an inactive orderable item and provide the name of the option where the user can make the proper changes. displayed. 34 SEQ #35 DATE APPLIED: 2000-10-27 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch provides the functionality needed to prepare for the Pharmacy The Implementation Guide and Installation Guide for this patch can be obtained on the VISTA Pharmacy Data Management web page. The address is http://vista.domain.ext/pdm. The Implementation Guide and Installation Guide are also available on the ANONYMOUS.SOFTWARE directory at one of the following Office of Information (OI) Field Offices. The file names are PDM1P34_IG.PDF for the Installation Guide, and PDM1P34_IMPG.PDF for the Implementation Guide. Ordering Enhancements project. This project will involve patches by four OI FIELD OFFICE FTP ADDRESS DIRECTORY =============== =========== ========= Albany 152.127.1.5 anonymous.software Hines 152.129.1.110 anonymous.software Salt Lake City 152.131.2.1 anonymous.software packages; Computerized Patient Record System (CPRS), Inpatient Medications, Outpatient Pharmacy, and Pharmacy Data Management. This Pharmacy Data Management patch, PSS134, provides the tools necessary to set up the Pharmacy files in advance of the Pharmacy Ordering Enhancements project. 35 SEQ #36 DATE APPLIED: 2000-10-27 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. Several sites have reported a problem when trying to document the PARAMETERS file (#53.45) and the DISPENSE DRUG sub-file (#53.11) of the NON-VERIFIED ORDERS file (#53.1). The problem with the input transform also exists in the PHARMACY PATIENT file (#55), UNIT DOSE sub-file (#55.06), DISPENSE DRUG sub-file (#55.07), UNITS PER DOSE field (#.02). Patch PSJ543 corrects the problem in the INPATIENT USER PARAMETERS file (#53.45) and the NON-VERIFIED ORDERS file (#53.1). This patch corrects this problem in the PHARMACY PATIENT file (#55). NOIS#s NOL-0300-71473, HOU-0300-71626, and CMO-0300-43187. 2. Site reported a problem where they entered an infusion rate of @x and dispensing of medications through the Bar Code Med Admin (BCMA) x labels didn't print. Only 1 label printed. The issue is that only one administration time was specified. The administration time overrides the entry of @x when determining how many labels will print. This patch modifies the field descriptions and the documentation for INFUSION RATE in order to clarify which field determines the number of labels. Modified USUAL INFUSION RATE field (#2) in the IV ADDITIVES file (#52.6), QUICK CODE sub-file (#52.61) and the INFUSION RATE field (#.08) in the PHARMACY PATIENT file (#55), IV sub-file (#55.01). 3. The vendor for the ATC systems called to say they now have two software. The sites have reported receiving the following error: machines with canister numbers higher than currently allowed. This patch modifies the ATC CANISTER field (#1) of the DRUG file (#50), ATC CANISTER sub-file (#50.0212) to increase the canister limit from 500 to 800 and remove the references to Baxter since the company name has changed. This patch also modified the following entries to remove the references to the company name of Baxter: DRUG file (#50), ATC CANISTER sub-file (#212), field description, DRUG file (#50), ATC MNEMONIC field (#212.2), DRUG file (#50), ATC CANISTER sub-file (#212), WARD GROUP FOR ATC CANISTER field (.01). 4. An inconsistency was discovered between the Computerized Patient Record System (CPRS) and the Inpatient Medications validation of Provider Comments/Special Instructions. CPRS allows entry of text with no spaces while Inpatient Medications requires spaces. This patch corrects this problem by modifying the validation of Special Instructions to allow an entry with no spaces. 5. The INPATIENT PRESCRIPTION PROFILE field (#70) in the PHARMACY PATIENT file (#55) is no longer used. This patch deletes this field. 1. Data Validation Error: 701: The value 'AC' for field DOSES ORDERED in DISPENSE DRUG SUB-FIELD in file BCMA MEDICATION LOG is not valid. The problem was with the input transform on the UNITS PER DOSE field (#.02) in the DISPENSE DRUG sub-file (#53.4502) of the INPATIENT USER 33 SEQ #37 DATE APPLIED: 2001-02-05 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: See Patch PSS133 in the National Patch Module for description of the Build. 39 SEQ #38 DATE APPLIED: 2001-02-27 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: See patch PSS139 in the National Patch Module for description of the build. 42 SEQ #39 DATE APPLIED: 2001-03-19 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch adds a new field, NDF UPDATE (#5) to the ACTIVITY LOG multiple (#214) in the DRUG file (#50). 40 SEQ #40 DATE APPLIED: 2001-03-19 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch exports two new options that can be used to assist sites in the Orderable Item/Dosages Report [PSS ORDERABLE ITEM DOSAGES] option: This option prints a report that displays Inpatient and Outpatient Dosages for Pharmacy Orderable Items. These are the dosages that will display for selection through Computerized Patient Record System (CPRS) when an Orderable Item is selected for a medication order. The report is sorted by Pharmacy Orderable Item. Along with each dosage that is displayed on the report, the name of the Drug entry from the DRUG file (#50) that provides the dosage will also display. Not every dosage from the DRUG file (#50) will display on this report. For example, if there are pharmacy set-up work for the Pharmacy Ordering Enhancements (POE) project. duplicate Possible Dosages for a Pharmacy Orderable Item, and there are different Dispense Units per Dose, then only the Possible Dosage with the lowest Dispense Units per Dose will display on the report. If there are Possible Dosages and Local Possible Dosages for drugs tied to the Pharmacy Orderable Item, then only the Possible Dosages will display on the report. In summary, this report will screen out Possible Dosages and Local Possible Dosage when appropriate, so only the dosages selectable through CPRS will display on this report. The two options are named: Patient Instructions Report [PSS INSTRUCTIONS/ITEMS REPORT] option: Due to numerous requests, a change has been made to the PATIENT INSTRUCTIONS field (#7) of the PHARMACY ORDERABLE ITEM file (#50.7). Data in this field will now be checked for possible expansions, by running each word through the MEDICATION INSTRUCTION file (#51), similar to how the SIG has been traditionally expanded in the Outpatient Pharmacy application. The data will still be stored in condensed form, but will print in expanded form when used by the various applications in POE. This includes all reports, displays in CPRS, displays in Outpatient Pharmacy, and when the SIG prints on the Outpatient Pharmacy labels. It is important that any Patient Instructions entered prior the installation of this patch be reviewed, to ensure that if a word didn't expand when originally entered and now does expand, that the expansion is appropriate. The Patient Instructions Report option can be used to review any Patient Instructions that are entered in the PHARMACY ORDERABLE ITEM file (#50.7). In addition to the new Patient Instructions Report, this patch makes a change to the PATIENT INSTRUCTIONS field (#7) of the PHARMACY ORDERABLE ITEM file (#50.7). When data is entered into this field, the expanded version of the data will now echo back to the user. Orderable Item/Dosages Report [PSS ORDERABLE ITEM DOSAGES] Change pages have been issued for the Pharmacy Ordering Enhancements Pharmacy Data Management Pre-Release Implementation Guide, initially distributed with patch PSS134. These change pages can be obtained on the VISTA Pharmacy Data Management web page at http://vista.domain.ext/PDM/pdm_documentation.htm . The Pharmacy Ordering Enhancements Pharmacy Data Management Pre-Release Patient Instructions Report [PSS INSTRUCTIONS/ITEMS REPORT] Implementation Guide is also available on the ANONYMOUS.SOFTWARE directory at one of the following Office of Information (OI) Field Offices. The Implementation Guide's file name is PDM1P34_IMPG.PDF. OI FIELD OFFICE FTP ADDRESS DIRECTORY =============== =========== ========= Albany 152.127.1.5 anonymous.software Hines 152.129.1.110 anonymous.software Salt Lake City 152.131.2.1 anonymous.software These options will be accessible under the Orderable Item Management [PSS ORDERABLE ITEM MANAGEMENT] menu option. 6 SEQ #4 DATE APPLIED: 1998-03-18 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch contains an update to the ^DD global for the field TO SERVICE (1) of the D/C ON SERVICE TRANSFER (#23) multiple in the PHARMACY SYSTEM file (#59.7). This field had a typographical error in the executable help, resulting in an error. 43 SEQ #41 DATE APPLIED: 2001-04-30 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch provides the functionality needed to fix NOIS PTH-0301-21164. This will fix the problem of bad interactions presently on your system as well. 41 SEQ #42 DATE APPLIED: 2001-06-08 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: When using the PRimary Solution File (IV) [PSSJI SOLN] option, and the ADditives File [PSSJI DRUG] option, it was reported that at the end of the dialogue, the system is not responding correctly to the "YES" answer when prompted "Would you like to enter another IV Additive or Solution? NO//". This patch fixes this problem. 45 SEQ #43 DATE APPLIED: 2001-06-08 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Phase 1 of the Pharmacy Ordering Enhancements (POE) project introduced that entry to have Possible Dosages is that the combination of Dosage Form and Unit from the National Drug File match must be marked as convertible in the DOSAGE FORM (#50.606) file. This data in the DOSAGE FORM (#50.606) file was populated at the Field Office and exported with patch PSS134. This data should only be edited and exported from the Field Office, so this patch is exporting the data again, and will put restrictions on those particular fields. This patch will also put restrictions on fields in the DRUG (#50) file, to prevent invalid Possible Dosages from being created. In addition, this patch will look for any invalid Possible Dosages in the DRUG (#50) file, and either delete that Possible Dosage, or functionality to create Possible Dosages and Local Possible Dosages in the remove the invalid package reference from that Possible Dosage. A mail message will also be generated that lists any drugs that were affected by this install. This message will be sent to the person installing the patch, and all PSNMGR key holders. Reasons that a Possible Dosage would have to be deleted are: 1) The drug is not matched to the National Drug File. 2) The match to the National Drug File does not produce a valid Unit or Dosage Form. 3) The Unit from the National Drug File match does not match the Unit in DRUG (#50) file. This work is being done in preparation of phase 2 of the the DRUG (#50) file. 4) The combination of Dosage Form/Unit from the National Drug File match is not marked as convertible in the DOSAGE FORM (#50.606) file. POE project, when these Possible Dosages and Local Possible Dosages will be selectable during the Medication Ordering process in Outpatient Pharmacy, Inpatient Medications, and Computerized Patient Record System (CPRS). One of the criteria that an entry in the DRUG (#50) file must meet for 38 DATE APPLIED: 2001-09-26 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: The Pharmacy Ordering Enhancements (POE) project provides enhancements Inpatient Medications and Outpatient Pharmacy applications. This project directly supports Computerized Patient Record System (CPRS), which is a key component of Veterans Health Administration's (VHA) plan to expand support for clinical operations. Additionally, order checks will be provided for medication orders for which a dispense drug has not been selected during the CPRS order entry process. It is also intended as a way to help meet the goal outlined in Objective 8, Action 1 in the Prescription for Change, which outlines the need to coordinate national/Veterans Integrated Service Network (VISN) formularies and share drug treatment guideline information. This project will promote system- to Pharmacy Data Management (PDM) V. 1.0, Inpatient Medications wide sharing of drug reviews and treatment guidelines thereby enhancing patient safety. This project consists of four patches that work together to accomplish these goals listed in order of install: PSO746 OR394 PSS138 PSJ550 V. 5.0, Outpatient Pharmacy V. 7.0, and Order Entry/Results Reporting Installation Instructions and Documentation Retrieval: ====================================================== The Installation Guide, Release Notes, revised Pharmacy Data Management (PDM) Technical Manual, and Pharmacy Data Management (PDM) User Manual are on the ANONYMOUS.SOFTWARE directory at one of the following Office of Information (OI) Field Offices. (OE/RR) V. 3.0 medication ordering dialogues to eliminate redundant entry Sites may retrieve documentation in one of the following ways: (1) The preferred method is to FTP the files from download.vista.domain.ext, which will transmit the files from the first available FTP server. (2) Sites may also elect to retrieve documentation directly from a specific server as follows: Albany ftp.fo-albany.domain.ext of drug information during medication order entry, provide a more Hines ftp.fo-hines.domain.ext Salt Lake City ftp.fo-slc.domain.ext The software distribution includes: FILE NAMES DESCRIPTION CPRS_POE_10.KID CPRS/Pharmacy Ordering Enhancements 1.0 Master Build CPRS_POE_1_1_IG.PDF Installation Guide CPRS_POE_1_0_RN.PDF Release Notes consistent medication order entry process, provide expanded order PDM_1_0_TM.PDF Technical Manual/Security Guide PDM_1_0_UM.PDF User Manual (3) Documentation can also be retrieved from VISTA Document Library (VDL) on the VA Intranet at the following address, http:/vista.domain.ext/vdl. checking, display documented drug formulary statuses and corresponding restriction/guidelines to the provider and pharmacist at the time of order entry, and improve the process of medication order transfer between 49 SEQ #45 DATE APPLIED: 2001-12-31 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1) A problem has been reported concerning certain dosage selections in - The Review Dosages Report [PSS DOSAGE REVIEW REPORT] option. - The Orderable Item/Dosages Report [PSS ORDERABLE ITEM DOSAGES] option. - Display the leading zero when editing Dosages through either the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option or the Enter/Edit Dosages [PSS EDIT DOSAGES] option. - The display of Dispense Units per Dose has also been changed in the Pharmacy Data Management options to display a leading zero when the number begins with a decimal point. 2) This patch also contains a change that will affect Computerized Patient Inpatient Medications V. 5.0 and Computerized Patient Record System Record System (CPRS). The Pharmacy Data Management package returns information to CPRS regarding the DEA Special Handling indication of a Pharmacy Orderable item, which is based on the DEA Special Handling information from the Dispense Drugs tied to the Pharmacy Orderable Item. Currently, if the DEA Special Handling code contains a "1", or contains a "2", or contains both the "3" and the "A", this indicates to CPRS that a wet signature is required. If this first condition is not met, but the DEA Special Handling code contains a "4", or contains a "5", or contains a "3" and not the "A", then a wet signature is not required, but it does indicate that it is a controlled substance. This (CPRS) V. 3.0. The problem is in the Dosages that contain a "/", and patch changes that logic. With the installation of this patch, if the DEA Special Handling code contains a "1", or contains a "2", this indicates to CPRS that a wet signature is required. If this first condition is not met, but the DEA Special Handling code contains a "3", or contains a "4", or contains a "5", then a wet signature is not required, but it does indicate that it is a controlled substance. when the second part of that Dosage begins with a decimal point. A leading zero was not being added to that second part of the Dosage. For example, a Dosage that is currently being displayed as 0.25MG/.5ML will be displayed as 0.25MG/0.5ML. This change will affect the following: 44 DATE APPLIED: 2001-12-31 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. A site reported a problem where a one-time order could not be system parameter is not defined, the system will use the continuous order parameters to determine the stop date, rather than the start and stop date being equal. Then, when BCMA marks the medication as 'Given', Inpatient Medications will expire the order. NOIS# BUT-0501-20609 2. With the release of the Pharmacy Ordering Enhancements patches two spaces were allowed in the schedule field. In testing, it was discovered that a user could enter the two spaces at the end of the schedule and it was accepted by the software. The software was not intended to work this way. Upon installation of this patch, the trailing spaces will be discontinued by the provider because it was expired due to the start and stripped off the text the user enters at the schedule prompt. stop date being the same. However, the medication still displayed in Bar Code Medication Administration (BCMA) V. 1.0 because of the 12-hour rule for displaying one-time orders on the Virtual Due List. This patch corrects this problem by changing the way the stop date for one-time orders is calculated. There will be a ward parameter, system parameter and the standard calculation. The hierarchy will be to check the one-time ward parameter first, if not defined, check the system parameter. If the 51 SEQ #47 DATE APPLIED: 2002-02-04 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. A problem has been reported in the Drug Enter/Edit [PSS DRUG 2. A problem was reported in the Dispense Drug/Orderable Item Maintenance [PSS MAINTAIN ORDERABLE ITEMS] option. If a drug is not marked for Outpatient (O), Unit Dose (U), or IV (I) in the APPLICATION PACKAGES' USE (#63) field of the DRUG (#50) file, then it is not selectable in this option. These drugs will now be selectable. They will still not be selectable for ordering, but now they can be matched to a Pharmacy Orderable Item. ENTER/EDIT] option. If a drug is edited that is not matched to Pharmacy Orderable Item, and the drug is matched to a Pharmacy Orderable Item in this option, then the Possible Dosages are reset after completion of the match. Possible Dosages should only be reset if the drug is matched to a Pharmacy Orderable Item when the option is first accessed, and the drug is rematched to a different Pharmacy Orderable Item with a different Dosage Form. 53 SEQ #48 DATE APPLIED: 2002-02-26 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: A problem can occur in Computerized Patient Record System (CPRS) when In this example, the first and third Dosages come from different Dispense Drugs, but since each of these drugs has a top level Strength and Unit from the National Drug File match, the Strength and Unit are displayed instead of the Dispense Drug name, which makes the selection ambiguous. In addition, no matter which of these Local Possible Dosages is selected, the first or the third, the same Dispense Drug is assigned to the order. To fix this problem, this patch will make a change to the way Local Possible Dosages are returned to CPRS for display and selection. As in duplicate Local Possible Dosages are displayed for selection in the this case, if there are duplicate Local Possible Dosages in the list, and one of the duplicate sets also has a duplicate Strength and Unit for different Dispense Drugs, then the Strength will not be returned to CPRS along with the Local Possible Dosages. Then instead of CPRS displaying the Strength and Unit, CPRS will display the Dispense Drug name, which should differentiate the selection display, as long as the Dispense Drug names are different. This will also resolve the selection problem of the same Dispense Drug being assigned to the order, regardless of the selection. medication order entry process, and these duplicate Local Possible Dosages have a duplicate Strength and Unit as part of the display. For example, a dosage selection display such as: SMALL AMOUNT OF 0.1% SMALL AMOUNT OF 0.025% SMALL AMOUNT OF 0.1% 48 SEQ #49 DATE APPLIED: 2002-03-15 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. It was reported that although some Dosage Form entries are inactivated, times it picks a wrong drug. This problem is due to the existence of an old cross-references ("IV", "IV1", and "IV2") in the DRUG file (#50). This patch fixes this problem. they are still showing up in the following options: -Dosage Form File Enter/Edit [PSS DOSAGE FORM EDIT]. -Noun/Dosage Form Report [PSS DOSE FORM/NOUN REPORT]. This patch insures that the inactivated entries will not be displayed in those options. 2. When using the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option, it was reported that if the drug is selected using the synonym entry, some- 50 SEQ #50 DATE APPLIED: 2002-04-08 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. When using the Drug Enter/edit [PSS DRUG ENTER/EDIT] option and the populate from the STRENGTH field (#2) of the VA PRODUCT file (#50.68). - The software will populate the Unit of the drug from the UNIT field (#902) of the DRUG file (#50) if it is defined, otherwise it will populate from the UNIT field (#3) of the VA PRODUCT file (#50.68). - If both the Strength and the Unit fields are not populated then the software will display null values. 2. When creating new dosages for a drug, the PACKAGE field (#3) in Enter/Edit dosages [PSS EDIT DOSAGES] option, currently the software the DOSAGES multiple (#903) of the DRUG file (#50) is case- sensitive (allows only capital letters). This patch modifies the Input Transform of the PACKAGE field to accept lowercase letters as well. 3. When using the Dosage Form File Enter/Edit [PSS DOSAGE FORM EDIT] option, it was reported that the MED ROUTE FOR DOSAGE FORM field (#.01) in the MED ROUTE FOR DOSAGE FORM multiple (#50.6061) of the DOSAGE FORM file (#50.606) can be assigned a Medication Route entry with a PACKAGE USE field (#3) of "FOR NATIONAL DRUG FILE ONLY" from the MEDICATION ROUTES file (#51.2). This patch prevents such Medication Route entries displays the Strength and the Unit of a drug only if it finds Possible from being assigned to the MED ROUTE FOR DOSAGE FORM multiple. Dosages assigned to that drug. This patch modifies routines PSSDOS and PSSDOSER to display the Strength, and the Unit of a drug that also has Local Possible Dosages assigned for the following conditions: - The software will populate the Strength of the drug from the STRENGTH field (#901) of the DRUG file (#50) if it is defined, otherwise it will 7 SEQ #5 DATE APPLIED: 1998-03-18 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch corrects a problem when using the option Lookup into Dispense Drug File [PSS LOOK]. Drugs with an application defined for use were inadvertently displayed as "none" under some circumstances. This patch also corrects a problem with the display of synonyms under certain circumstances. 52 DATE APPLIED: 2002-04-23 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: As a part of the Pharmacy Benefits Management (PBM) Extract enhancement packages affected since only one installation is necessary. The patches, in order of install, are: PSS152 PHARMACY DATA MANAGEMENT V. 1.0 PSJ568 INPATIENT MEDICATIONS V. 5.0 PSO795 OUTPATIENT PHARMACY V. 7.0 Upon completion of the installation of these three patches, the master build will start a routine that will build the two new fields from historical data in the PHARMACY PATIENT file (#55). When the build is project, two new fields were added to the PHARMACY PATIENT file (#55). complete, the user who initiated the install and the members of the PSU PBM mail group will receive a message with a subject of BUILD OF FIRST PHARMACY SERVICE INFO COMPLETE. They are FIRST SERVICE DATE (#.07) and ACTUAL/HISTORICAL FLAG (#.08). With the addition of these two fields, Inpatient Medications V. 5.0 and Outpatient Pharmacy V. 7.0 have been modified to set this information when the first order for a patient becomes active. This project consists of three patches combined in a master build. Installation of this master build should be coordinated among the three 46 DATE APPLIED: 2002-05-28 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. The Bar Code Medication Administration (BCMA) V. 2.0 release provides Med Order button in BCMA V. 2.0. This project consists of two patches and a new version of BCMA that work together to accomplish these goals listed in order of install: PSS146 PHARMACY DATA MANAGEMENT V. 1.0 PSJ558 INPATIENT MEDICATIONS V. 5.0 BAR CODE MED ADMIN 2.0 enhancements to Pharmacy Data Management (PDM) V. 1.0, and Inpatient Medications V. 5.0. The BCMA V. 2.0 release expands and improves the process of medication administration, especially in the area of IV medications. In support of this, Inpatient Medications V. 5.0 and PDM V. 1.0 have added the ability to print barcode identifiers on IV labels, IV order verification and the ability to receive done priority orders via the CPRS 54 SEQ #53 DATE APPLIED: 2002-09-06 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. A site reported a problem with quitting the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option using the "^". When the user quits with an "^" at the prompt "Match to another Orderable Item with same Dosage Form?" this will not properly clean up. This has resulted in improper prompting when using the Edit Data for a Patient in the Clozapine Program [PSO EDIT] option. This patch fixes this problem. NOIS PUG-0202-52260 2. A site reported a problem with the display of the cost information for a drug. This patch corrects this problem. NOIS NYH-1001-12352 60 SEQ #54 DATE APPLIED: 2002-10-08 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: A new field is being added to the IV multiple of the Pharmacy Patient file (#55) to support a change in functionality for auto-reinstating Inpatient Medications orders. Inpatient Medications orders which were on hold at the time a patient movement occurred which caused them to be auto-discontinued were not returned to on hold if the movement was deleted and the orders were auto-reinstated. This patch corrects this problem. NOIS: AAA-0802-N1994. 56 SEQ #55 DATE APPLIED: 2002-10-08 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. Currently Inpatient Medications V. 5.0 recognizes the following Medication Administration (BCMA) V. 1.0 correctly. The problem was that the frequency for the medication administration was being calculated inappropriately. This patch corrects this problem. NOIS: HUN-0502-22756 3. A site reported a problem quick orders not displaying entries from the SCHEDULE ADMINISTRATION file (#51.1) correctly when attempting to define outpatient quick orders. This patch corrects this problem. NOIS: DUB-1201-30587 schedules as One Time schedules: NOW, ONCE, STAT, ONE TIME, 1 TIME, 1TIME, 1-TIME , ONE-TIME, ONETIME This patch will update the routines that Pharmacy Data Management (PDM) V. 1.0 uses to validate schedules for Computerized Patient Record System (CPRS) V. 1.0 to be consistent with Inpatient Medications V. 5.0. 2. A site reported a problem with an order not appearing in Bar Code 57 SEQ #56 DATE APPLIED: 2002-10-25 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: HUI/VHA CIO SD&D PHARMACY DATA INTERCHANGE protocol SEND DRUG UPDATE MESSAGE [PSS HUI DRUG UPDATE] as a subscriber. To activate the sending of these HL7 messages the text from DISABLE field must be deleted and at least one receiving protocol added as a subscriber. For those sites who ARE NOT part of the Hui/VHA CIO SD&D Pharmacy Data Interchange project, NO FURTHER ACTION is necessary after installation of the patch. 2. When performing drug lookups, two issues were identified. First, the was not aware of which item was being matched. For example, was the match for the GENERIC NAME of the drug or was it the SYNONYM. The second issue had to do with the search matching to the NATIONAL DRUG CLASS NAME first, before checking for a GENERIC NAME. This patch makes two changes to the drug lookup. First, the search will display the item being searched on. Second, if a match is found on an item, but the user doesn't select one of the matches displayed, the search will continue through all other items. 1. This patch is in support of the Hui/VHA CIO SD&D Pharmacy Data Interchange project. The project provides a method for the one-way electronic transfer of prescription orders from an external system to VistA The purpose of this patch is to provide an HL7 notification of the addition of new drugs and drug updates to the DRUG file (#50). To receive this notification, the receiving protocol must be attached to the sending 55 SEQ #57 DATE APPLIED: 2002-11-16 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: one or all entries. The Drug Text Enter/Edit [PSS DRUG TEXT ENTER/EDIT] option was changed to enhance the text displayed when editing or inactivating an entry. The new text identifies the specific option that can be used to display linked items. The following cross-references were created for use in generating a list of DRUG file (#50) entries and PHARMACY ORDERABLE ITEM file (#50.7) entries associated with a DRUG TEXT file (#51.7) entry and for generating The Pharmacy Data Management Drug Text Enter/Edit [PSS DRUG TEXT the report in the Drug Text File Report [PSS DRUG TEXT FILE REPORT] option: 1. A full file cross-reference on the DRUG TEXT ENTRY field (#50.037) in the DRUG file (#50). 2. A full file cross-reference on the OI-DRUG TEXT ENTRY field (#50.76) of the PHARMACY ORDERABLE ITEM file (#50.7). Note: The population of the new 'DTXT' cross reference is done in a post-install background job. When this job completes, it will send a MailMan message to the installer of the patch and holders of the ENTER/EDIT] option is being enhanced and a new Drug Text File Report [PSS PSNMGR key. The new Drug Text File Report [PSS DRUG TEXT FILE REPORT] option should then be run for all drug text entries in the DRUG TEXT file (#51.7) to verify that the correct drug text is associated with the correct entries in the PHARMACY ORDERABLE ITEM file (#50.7) and the DRUG file (#50). A listing of the original drug text file entries distributed with Patch PSS129 is provided in the Pharmacy Data Management user manual. There will be updates to the Pharmacy Data Management V.1.0 User and Technical manuals for this patch. DRUG TEXT FILE REPORT] option is being added. The Drug Text File Report [PSS DRUG TEXT FILE REPORT] option displays the drug text name, synonyms, drug text, inactive date if inactive, and lists all drug and orderable items linked to it. This report can be printed for 58 SEQ #58 DATE APPLIED: 2002-12-09 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. When a user cannot access a patient order due to the order being locked Add field# 148 FLAGGED to the IV multiple of the PHARMACY PATIENT file (#55). Add field# 124 FLAGGED to the UNIT DOSE multiple of the PHARMACY PATIENT file (#55). Changed field# .02 TYPE OF ACTIVITY, added two new codes to the existing set of codes. 'G' FOR FLAGGED; 'UG' FOR UNFLAGGED. This is in the ACTIVITY LOG multiple (#55.04). Changed field# .04 REASON FOR ACTIVITY, increased the field size from 75 to 102. This is also in the ACTIVITY LOG multiple (#55.04). by another user, a warning message is displayed and hung for a couple second before scrolling off the screen. This patch will pause and require a return from the user before continuing with the process. 2. The following DD changes are being made in order to support requested changes to Inpatient Medications to allow flagging functionality. E3R #11177 and #12382 66 SEQ #59 DATE APPLIED: 2003-03-29 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. This patch, in conjunction with CPRS patches OR3.0149 and OR3.0158, problem for orders entered through CPRS GUI, and patch OR3.0158 will fix this problem for orders entered through CPRS ListMan. No problems will occur if the PSS1.066 patch is installed without either one or both of the CPRS patches, but the functionality will not work properly until all patches are installed. NOIS JAC-0602-72390 2. A site reported a problem with entering the cost information for drugs with cost like NNNNN.NNN per order unit. Currently, the PRICE PER ORDER UNIT field (#13) in the DRUG file (#50) only allows 4 digits before the decimal point. This patch modifies the Data Dictionary of this field to fixes a problem that can occur when entering an order for an outpatient accommodate 5 digits. NOIS POR-0902-50198 3. A minor change has been made to the Pharmacy Data Management (PDM) Application Program Interface (API) to allow other pharmacy packages to make use of it, whenever they update the DRUG file (#50) so that PDM possibly generates an HL7 outgoing drug message. 4. A site reported a problem with the display of the cost information for drugs with local possible dosages. This patch corrects this problem. NOIS REN-0902-60126 in Computerized Patient Record System (CPRS) using the IV Fluids order dialogue. The DEA Special Handling check does not always function when entering those orders. So it is possible for a Provider without a DEA# or a VA# to enter an order through this dialogue for an Orderable Item, when that order should not be allowed to be placed. When this patch and both CPRS patches OR3.0149 and OR3.0158 are installed, this functionality will work properly. Patch OR3.0149 will fix this 67 SEQ #60 DATE APPLIED: 2003-03-29 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: As part of the Outpatient Pharmacy V. 7.0 project to add Patient Medication Information (PMI) print to labels, a new field must be added to the PHARMACY SYSTEM file (#59.7). The new field, PMIS SECTION DELETE (#15) will allow the Pharmacy Benefits Manager to mark certain PMI sections to delete them from printing on labels. This patch adds this new field and populates it appropriately. 5 SEQ #6 DATE APPLIED: 1998-04-03 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: NOTE THIS PATCH SHOULD BE LOADED BEFORE PATCH OR2.549. This procedure call has been changed to return an additional data element. The Default Schedule name for the Orderable Item is now returned in ^TMP("PSJSCH",$J). ^TMP("PSJSCH",$J)= DEFAULT SCHEDULE NAME. Problem #2: This patch resolves a problem related to the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option. In routine PSSDEE, modifications were made to allow the user to enter a new drug. The PSS15 patch resolves two problems with the Pharmacy Data Management package. They are listed below. Problem #1: This patch contains modifications to routine PSSJORDF. The procedure call START^PSSJORDF(PSJORD) is called by Consolidated Patient Record System (CPRS) and passes the Orderable Item internal entry number. 47 SEQ #61 DATE APPLIED: 2003-04-03 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch provides new functionality that allows the Veteran Affairs The other language translations are entered by using the new option OTHER LANGUAGE TRANSLATION SETUP [PSS OTHER LANGUAGE SETUP]. This new option is not linked to any menu, but must be assigned to the person(s) responsible for maintaining this functionality. The following options must be used to enter the remaining language translations data: DRUG ENTER/EDIT [PSS DRUG ENTER/EDIT] DOSAGES ...[PSS DOSAGES MANAGEMENT] DOSAGE FORM FILE ENTER/EDIT [PSS DOSAGE FORM EDIT] Medical Centers to print a patient's prescription bottle label in another MEDICATION INSTRUCTION FILE ADD/EDIT [PSSJU MI] MEDICATION ROUTE FILE ENTER/EDIT [PSS MEDICATION ROUTES EDIT] ORDERABLE ITEM MANAGEMENT ... [PSS ORDERABLE ITEM MANAGEMENT] EDIT ORDERABLE ITEMS [PSS EDIT ORDERABLE ITEMS] STANDARD SCHEDULE EDIT [PSS SCHEDULE EDIT] language. This functionality is accomplished by identifying which patients has another language preference. To identify patients as having another language preference use the option UPDATE PATIENT RECORD [PSO PAT] and the protocol action PATIENT RECORD UPDATE [PSO PATIENT RECORD UPDATE] and enter Yes in the new field OTHER LANGUAGE PREFERENCE field (#106) in the PHARMACY PATIENT file (#55). 64 SEQ #62 DATE APPLIED: 2003-05-20 00:00:00 APPLIED BY: USER,ONE 68 SEQ #63 DATE APPLIED: 2003-06-28 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: PSS168 and OR3176 are the first of a total of 6 patches that will Veterans Affairs (VA). These types of medications are commonly referred to as "Non-VA Meds." Below is a list of functionalities that will be available at your site once all 6 patches are installed: 1. Add common herbal and OTC products to the DRUG File and mark them as Non-VA Med. 2. Enhance current Outpatient Pharmacy software to display patients use of Non-VA Med. comprise the Non-VA Meds (Herbals/OTC) project. These two patches are 3. Screen for drug-herbal and drug-drug interactions and display the results in both Inpatient and Outpatient Pharmacy. 4. Display Non-VA Med drugs on the Orders and Meds tab in CPRS. 5. Display of drug interaction information involving Non-VA Med through CPRS. The Phase 1 of this project comprises functionality 1 only. It gives the sites the ability to add common herbal and OTC products to the DRUG File and mark them as Non-VA Med through the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option. Furthermore, it also allows the user to mark existing being released together to deliver Phase 1 of this project, which is dispense drugs as Non-VA Med. Once a drug is marked as Non-VA Med, a physician using the CPRS GUI Version 23 application will be able to document the patient's use of such drug. Which is done by entering a Non-VA Med order for the patient. Functionalities 2 through 5 are part of the Phase 2 of this project and will be delivered in a later time. An important part of this patch is the update of the Drug file. As mentioned before, besides Herbal supplements and Over-the-Counter drugs (usually non-prescription drugs), any prescribed medication currently dispensed by the VA could be acquired by the patient from another source explained in more details below. Phase 2 will contain the following 4 other than the VA. Therefore, these drugs must also be marked as Non-VA Med. In order to reduce the amount of work necessary to mark the existing dispense drug for Non-VA Med use, the following update will occur automatically with the installation of this patch: EVERY ACTIVE DISPENSE DRUG MARKED FOR OUTPATIENT USE WILL BE MARKED FOR NON-VA MED USE. The following menu options have also been modified: patches: PSS169, PSO7132, PSJ5107 and OR3187. They will be 1. Lookup into Dispense Drug File [PSS LOOK] If the dispense drug is marked as Non-VA, it will now print "Non-VA Med" in the "APPL PKG USE:" field. 2. Enter/Edit Dosages [PSS EDIT DOSAGES] If the dispense drug is marked as Non-VA, it will now print "Non-VA Med" under "This entry is marked for the following PHARMACY packages:." released in a later time. Once all patches are installed, they will 3. Edit Orderable Items [PSS EDIT ORDERABLE ITEMS] If the orderable item is marked as Non-VA, it will now print "This Orderable Item is marked as a Non-VA Med." right after the indication of Formulary/Non-Formulary is printed. A new field NON-VA MED (#8) has been added to the PHARMACY ORDERABLE ITEM File (#50.7). provide the sites the ability to document herbal supplements, over-the-counter (OTC)(non-prescription) medications and other medications taken by patients but not dispensed by the Department of 71 SEQ #64 DATE APPLIED: 2003-06-28 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Data Dictionary (DD) changes are being made in order to support requested The ORDERS FILE PARENT ORDER sub-field (#150) was added to the IV multiple (#100) of the PHARMACY PATIENT file (#55). The ORDERS FILE PARENT ORDER sub-field (#125) was added to the UNIT DOSE multiple (#62) of the PHARMACY PATIENT file (#55). changes to Inpatient Medications V. 5.0 included in patch PSJ580. The REQUESTED DURATION sub-field (#151) was added to the IV multiple (#100) of the PHARMACY PATIENT file (#55). The REQUESTED DURATION sub-field (#126) was added to the UNIT DOSE multiple (#62) of the PHARMACY PATIENT file (#55). 73 SEQ #65 DATE APPLIED: 2003-08-02 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Several sites have noted that the common brand names printed on a Patient Medication Instruction Sheet are not always appropriate. This patch stops the printing of common brand names on PMIs printed in conjunction with the laser label. **NOTE** The stand alone option Print a PMI Sheet [PSNPMIS PRINT] is not modified by this patch. 70 SEQ #66 DATE APPLIED: 2003-08-02 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. This patch fixes the problem reported in NOIS HON-0403-60272 to codes contains the National Drug Code (NDC) number in a new format called "Global Trade Item Number (GTIN)". The GTIN has a 14-digit data structure, which is used within the EAN.UCC system for unique identification of trade items worldwide. This will allow BCMA GUI will correctly read the GTIN and search the synonym field for a matching NDC number. prevent the undefined variable error that occurs whenever DRUG file (#50) get updates and HL7 outgining drug message is sent out. 2. This patch deletes the Pharmacy quick order correction for CPRS [PSS QUICK1] option, as it is an obsolete option. NOIS SBY-0403-30493 3. This patch modifies the SYNONYM field (#.01) in the DRUG file (#50) to allow data entry using the new Reduced Space Symbology (RSS) bar 61 SEQ #67 DATE APPLIED: 2003-08-02 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Pharmacy Benefits Management (PBM) Strategic Healthcare Group in Kernel V. 8.0 Computerized Patient Record System (CPRS) V. 1.0 Pharmacy Data Management (PDM) V. 1.0 Outpatient Pharmacy (OP) V. 7.0 Controlled Substances (CS) V. 3.0 This is the PDM patch that provides the following new functionalities: 1. It provides CPRS with new API's 3737 and 3739 (these are modifications of existing API's 3373 and 3233 which shall remain unchanged). The logic collaboration with the Drug Enforcement Administration (DEA), requested of deriving at the DEA SPECIAL HDLG code for drugs associated with an orderable item has changed. The National Drug File data update patches PSN464 and PSN466 assign a CS Federal Schedule to controlled substances and identify controlled substances as narcotics or non-narcotics by populating the CS FEDERAL SCHEDULE field (#19) of the VA PRODUCT file (#50.68). If any of the active dispense drugs associated with the Pharmacy orderable item for the specified package are matched to an entry in NDF, then the most restrictive CS FEDERAL SCHEDULE code will be returned. If there is no match or the CS FEDERAL SCHEDULE code is undefined, then the most restrictive DEA SPECIAL HDLG code mapped to the the development of the first Public Key Infrastructure (PKI) VistA corresponding CS FEDERAL SCHEDULE code will be returned using the following table: CS FEDERAL SCHEDULE DEA, SPECIAL HDLG Code Schedule I narcotics 1 1 Schedule II narcotics 2 2A Schedule II non-narcotics 2n 2C Schedule III narcotics 3 3A Schedule III non-narcotics 3n 3C pilot project, named Electronic Prescription Order Entry for Schedule II Schedule IV narcotics 4 4 Schedule V narcotics 5 5 2. It includes a Post-Install routine to identify those drugs that show discrepancies between the CS FEDERAL SCHEDULE field (#19) of the VA PRODUCT file (#50.68) and DEA SPECIAL HDLG field (#3) of the DRUG file (#50), and generates the following 4 mail messages to the installer and the holders of the PSNMGR keys: CS FEDERAL SCHEDULE AND DEA, SPECIAL HDLG DISCREPANCIES CONTROLLED SUBSTANCES NOT MATCHED Controlled Substances. The objective is to develop an electronic order CONTROLLED SUBSTANCES NOT SET CORRECTLY DISCREPANCY IN DEA WITHIN DRUGS TIED TO AN OI These mail messages can be used to clean up the DEA SPECIAL HDLG code in the DRUG file where appropriate. 3. It also provides the following new menu options to generate reports of the above mail messages: Controlled Substances/PKI Reports [PSS CS/PKI REPORTS] menu has the following 4 new options: entry system for Schedule II controlled substances using digital 1 DEA Spec Hdlg & CS Fed Sch Discrepancy [PSS DEA VS CS FED. SCH. DISCR.] 2 Controlled Substances Not Matched to NDF [PSS CS NOT MATCHED TO NDF] 3 CS (DRUGS) Inconsistent with DEA Spec Hdlg [PSS CS DRUGS INCON WITH DEA] 4 CS (Ord. Item) Inconsistent with DEA Spec Hdlg [PSS CS (OI) INCON WITH DEA] This new menu Controlled Substances/PKI Reports [PSS CS/PKI REPORTS], will be added to the Pharmacy Data Management [PSS MGR] menu. signatures. To make this project viable, modifications to the following 4. When using the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option, if the CS FEDERAL SCHEDULE field (#19) of the VA PRODUCT file (#50.68) and the DEA SPECIAL HDLG field (#3) of the DRUG file (#50) have a discrepancy, then this patch displays a warning message, "The CS Federal Schedule associated with this drug in the VA Product file represents a DEA, Special Handling code of XX", where XX is the CS FEDERAL SCHEDULE code mapped to corresponding DEA SPECIAL HDLG code as defined in the above table. 5. This patch ensures that the newly populated CS FEDERAL SCHEDULE field (#19) of the VA PRODUCT file (#50.68) is also included as part of the packages were identified: drug details in the Lookup into Dispense Drug File [PSS LOOK] option. 6. This patch introduces a new code "F" for NON REFILLABLE for the DEA SPECIAL HDLG field (#3) of the DRUG file (#50). This will allow sites to mark drugs other than controlled substances or clozapine drugs as NON REFILLABLE. This functionality will be effective in the Outpatient Pharmacy V. 7.0 package only if the patch PSO7.0131 is installed. 7. The designation "A" which stands for "NARCOTICS AND ALCOHOLICS" used in the DEA, SPECIAL HDLG field (#3) of the DRUG file (#50), is changed in National Drug File (NDF) V. 4.0 this patch to read as "NARCOTICS AND ALCOHOLS". 69 SEQ #68 DATE APPLIED: 2003-10-02 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. PSS169 provides additional internal preparation at your site for used as a supply if the entry in the PHARMACY ORDERABLE ITEM file (#50.7) it is associated with has the SUPPLY field (#.09) set to 1 (one). Many sites have expressed their concern about having supply items automatically marked for Non-VA Med use. Therefore, sites can automatically unmark such items through this patch. The unmarking of supply items as Non-VA Meds will be optional. During the patch installation the installer will be prompted "Unmark supply items as Non-VA Meds? Y //". If 'YES' is selected, every supply item in the DRUG file (#50) marked for Non-VA Med use will be unmarked. If for any reason the installer chooses NOT to un-mark supply items for Non-VA the eventual release of the Herbal/OTC/Non-VA Meds Documentation Med use and later wishes to do so, run the Mumps routine PSSUNMSI distributed with this patch. 2. A new multiple field NON-VA MEDS (#52.2), has been added to the PHARMACY PATIENT file (#55). This field will be used in the future to store Non-VA Med orders. 3. The NON-VA MED field (#8) in the PHARMACY ORDERABLE ITEM file (#50.7) is being modified to be "Uneditable". project. An important part of this patch is the update of the DRUG file (#50). The Post-install routine for patch PSS168 automatically marked for Non-VA Med use every active dispense drug that was marked for outpatient use. Some of these dispense drugs marked for Non-VA Med use were actually being used as supply items. A dispense drug is being 75 SEQ #69 DATE APPLIED: 2003-10-23 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch provides functionality to allow an indicator to determine if a patient has at least one active prescription. This new routine PSSRXACT is to be used as a function call. The patient's internal dfn is required. the number 1 is returned to indicate that the patient has at least one active prescription, otherwise 0 (zero) is returned. S X=$$EN^PSSRXACT(DFN) 76 SEQ #70 DATE APPLIED: 2003-10-23 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch will fix an undefined error encountered when using the DEA Spec Hdlg & CS Fed Sch Discrepancy [PSS DEA VS CS FED. SCH. DISCR.] option which is under the Controlled Substances/PKI Reports [PSS CS/PKI REPORTS] menu. PSSPKIPR is the only routine contained in this patch. 8 SEQ #7 DATE APPLIED: 1998-04-03 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch makes the following changes to address Year 2000 compliance Routine : PSSCREAT Line Tag : PSSCREAT+12 Exception : Failure to include "F" in %DT parameter string Resolution: Replaces call to %DT with call that includes "F" in %DT parameter string. Routine : PSSPOIM1 Line Tag : CHECK+1 Exception : The call C^%DTC makes a comparison to an FileMan internal date format. FileMan dates are within compliances. issues in the Pharmacy Data Management package. Resolution: Later determined no action necessary Routine : PSSGMI Line Tag : ENDTC+2 ENDTC1+2 Exception : Not a legal document; two digit year is allowed. Resolution: Later determined no action necessary Routine : PSSLAB Line Tag : BEG+4 BEG+5 Exception : Not a legal document; two digit year is allowed. Resolution: Later determined no action necessary. 77 SEQ #71 DATE APPLIED: 2003-11-21 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch modifies the SYNONYM field (#.01) in the DRUG file (#50). Barcode Medication Administration (BCMA) uses the Global Trade Item Number (GTIN) format for barcodes. The GTIN has a 14-digit data structure, which is used within the Uniform Code Council/European Article Numbering (UCC/EAN) system for unique identification of trade items worldwide. This patch corrects the problem in which scanned GTIN entries stored in the SYNONYM field were not recognized when doing a lookup on entries withing the DRUG file (#50). 72 SEQ #72 DATE APPLIED: 2003-11-21 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Data Dictionary (DD) changes are being made to support requested changes for Outpatient Pharmacy V. 7.0 patch PSO7135. Patch PSO7135 implements the ScripTalk(R) 'talking' prescription labels functionality. The DD changes in this patch are to provide new fields to store the history of patients' ScripTalk(R) enrollment activity. The SCRIPTALK ENROLLMENT ACTIVITY multiple (#55.0108) was added to the PHARMACY PATIENT file (#55). 74 SEQ #73 DATE APPLIED: 2003-12-31 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This change will add the new ROUND ATC PICK LIST UNITS field (#26.7) in the PHARMACY SYSTEM file (#59.7) for Inpatient Medications V 5.0 patch PSJ5119. NOIS ALT-0403-20970 62 SEQ #74 DATE APPLIED: 2004-03-30 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This project consists of 12 patches that work together to create a new GMPL227 GMRV415 LR5.2295 OR3157 PSS162 PSJ590 PSO7118 PX1119 RA533 YS5.0177 Clinical Reminders index global. The purpose of this index is to provide The purpose of this patch (PSS162) is to lay the groundwork for these changes by creating a new cross-reference in the PHARMACY PATIENT file (#55) at both the UNIT DOSE multiple (#62) and the IV multiple (#100). This patch can be installed independently of the other patches. The documentation describing the new functionality will be available when all associated patches are released. rapid access to clinical data. All of the standard Clinical Reminders finding types are included in the index. The 12 patches that comprise this project are: PXRM1.512 DG5.3478 80 SEQ #75 DATE APPLIED: 2004-04-27 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: The VAPN index for the Drug File (#50) was incorrectly set to the length of the VA Product Name All the routines that use the index use a maximum of 30 characters to do the lookup. This patch deletes the existing VAPN index and creates a new one using the DD definition for the VA Product Name field. 84 SEQ #76 DATE APPLIED: 2004-05-21 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Correct typo in file 54 (RX CONSULT), entry NO TRANSFER. 79 DATE APPLIED: 2004-10-15 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Phase I of the Inpatient Medications Requirements for the Special Focus OR3213 ORDER ENTRY/RESULTS REPORTING V. 1.0 PSU334 PHARMACY BENEFITS MANAGEMENT V. 3.0 Patches PSS179, OR3213, and PSU334 contain changes to support the following enhancements in PSJ5110: 1. The Extend Stop Date on Renewal enhancements will allow an order to be renewed without creating a new order. Editing of the start date will no longer be allowed during the renewal process. In addition, limits have been set on the length of time after an order expires that it may be Group IRA project consists of four patches. The patches are combined in renewed. This is outlined in the BCMA 2001 Special Focus Report, Requirement #11. 2. The Complex Order enhancements will change the way complex orders are handled by linking complex components (child orders) together. If the actions Finish, Verify, Discontinue, or Renew are taken on one child order, the user will be alerted that the action must be taken on all of the complex component orders in the set. The user will then be prompted to take the appropriate action on each child order in the complex order set. This is outlined in BCMA 2001 Special Focus Report, Requirement #8. host file PSJ_PSS_OR_PSU_110.KID in order to simplify installation at VHA 3. The STAT and NOW Order Notification enhancements will alert users subscribing to new mail group PSJ STAT NOW PENDING ORDER when a pending STAT or NOW order has been received from Computerized Patient Record System (CPRS) V. 1.0. Users subscribing to the new mail group PSJ STAT NOW ACTIVE ORDER will receive an alert when a STAT or NOW order is made active. This is outlined in BCMA 2001 Special Focus Report, Requirement #12. In order to support the Extend Stop Date for Renewals changes, new fields facilities. Installation of this host file should be coordinated among will be created in the PHARMACY PATIENT file (#55) and the PHARMACY SYSTEM file (#59.7). 1. The PREVIOUS ORDERS FILE ENTRY sub-field (#4) will be added to the LAST RENEW multiple (#114) in the UNIT DOSE multiple (#62) in the PHARMACY PATIENT file (#55). 2. The PREVIOUS ORDERS FILE ENTRY sub-field (#4) will be added to the LAST RENEW multiple (#138) in the IV multiple (#100) in the PHARMACY PATIENT file (#55). the four packages affected since only one installation is necessary. The 3. The EXPIRED IV TIME LIMIT field (#34) will be added to the PHARMACY SYSTEM file (#59.7). 4. In support of Complex Orders changes, a new cross-reference will be created to group complex child orders by their parent order. For Unit Dose orders, the cross-reference will be indexed by the ORDERS FILE PARENT ORDER field (#125), the ORDERS FILE ENTRY field (#66), and the Unit Dose order number appended with "U". For IV orders, the cross- reference will be indexed by the ORDERS FILE PARENT ORDER field (#150), patches, in order of install, are: the ORDERS FILE ENTRY field (#110), and the IV order number appended with "V". The cross-reference definition will be created by the pre-install routine PSSCMPLX. These are the new cross-references added to the PHARMACY PATIENT file (#55) and the fields used as the trigger-points. The type of these cross-references is "New", not "Traditional". X-ref File/Sub-file Trigger-point field(s) ----------------------------------------------------------------- ACX PHARMACY PATIENT (#55) ORDERS FILE PARENT ORDER (#125) /UNIT DOSE (#62) ORDERS FILE ENTRY (#66) ACX1 PHARMACY PATIENT (#55) ORDERS FILE PARENT ORDER (#150) /IV (#100) ORDERS FILE ENTRY (#110) PSS179 PHARMACY DATA MANAGEMENT V. 1.0 PSJ5110 INPATIENT MEDICATIONS V. 5.0 82 SEQ #78 DATE APPLIED: 2004-10-29 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: ********************************************************************** There are three patches to support the Outpatient Pharmacy Automation Interface project. These patches should be installed separately in the following order: PSO7156 Outpatient Pharmacy PSS182 Pharmacy Data Management PSN484 National Drug File They contain routines, templates, options, and data dictionary changes to implement the Outpatient Pharmacy Automation Interface features. Please * This patch is part of the Outpatient Pharmacy Automation Interface * refer to the individual patch description of the other patches to get the names of the documentation files. Each patch will share the same starting description with more detail for each patch in the corresponding namespace patch number. There is only one installation guide. It can be found on the anonymous directory. The name of the installation guide PS_OUTPATIENT_AUTOMATION_INTERFACE_IG.doc. * Project and must be installed at all sites by * The patch enhances the current Health Level Seven (HL7) interface to ensure that the interface is compatible with all current Outpatient Pharmacy package V. 7.0 automation systems used by the Veterans Affairs Medical Centers (VAMCs). The current national VISTA HL7 interface is written to HL7 standard V. 2.2. Automated dispensing systems, such as the Baker APS Pharmacy 2000, are currently using an interface written to HL7 V. 2.3.1 standard using locally developed software. The automated dispensing systems have committed to be HL7 V. 2.4 compliant. This patch includes the following new features: * December 31, 2004 * 1. Creates an HL7 interface to the current HL7 V. 2.4 standard. 2. The interface transmits drug data to multiple vendor systems utilized by VAMCs whenever the following options are selected: A. Drug Enter/Edit [PSS DRUG ENTER/EDIT] option. B. Edit Orderable Items [PSS EDIT ORDERABLE ITEMS] option. C. Enter/Edit Dosages [PSS EDIT DOSAGES] option. D. Dispense Drug/Orderable Item Maintenance [PSS MAINTAIN ORDERABLE ITEMS] option. E. CMOP Mark/Unmark (Single drug) [PSSXX MARK] option. F. Synonym Enter/Edit [PSS SYNONYM EDIT] option. * * HL7 Interface: ============== This patch installs the following new HL7 Protocols: 1. PDM Master File Update [PSS EXT MFU SERVER] protocol. 2. PDM Master File Update Client [PSS EXT MFU CLIENT] protocol. This patch installs the following new HL7 Application Parameters: 1. PSS VISTA * Please review the Installation heading of this patch for * 2. PSS DISPENSE New Option: =========== A new option has been added to the PSS MGR menu called Send Entire Drug File to External Interface [PSS MASTER FILE ALL]. This is used to send the entire drug file to a dispensing system at first start-up to bring the dispensing system in synch with the National Drug file (#50). Each dispensing system will decide if they can receive these messages and a parameter setting ENABLE MASTER FILE UPDATE will need to be turned on * Installation Guide retrieval information * in the OUTPATIENT SITE file (#59) in order for these messages to be sent across. * * ********************************************************************** 85 SEQ #79 DATE APPLIED: 2004-10-29 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch contains Application Programmer Interface's (API's) that will These are the files that are affected. If any application is making direct global reads or writes to any of these files, they must be replaced by using the API's exported with this patch. File Name: File Number: DRUG 50 DRUG ELECTROLYTES 50.4 DOSAGE FORM 50.606 PHARMACY ORDERABLE ITEM 50.7 be used by calling applications that currently do direct global reads or MEDICATION INSTRUCTION 51 ADMINISTRATION SCHEDULE 51.1 MEDICATION ROUTES 51.2 ORDER UNIT 51.5 IV ADDITIVES 52.6 IV SOLUTIONS 52.7 RX CONSULT 54 APSP INTERVENTION TYPE 9009032.3 APSP INTERVENTION RECOMMENDATION 9009032.5 writes to the Pharmacy Data Management files. Since the DRUG file (#50), and other drug-related files are being replaced by a vendor product, any direct M-based global reads or writes to these files must be replaced by calling the API's provided in this patch. When the new data source is in place, the calling applications will not be required to make any changes, because these API's will be flexible enough to retrieve the requested data from the vendor product, when the time comes. 81 DATE APPLIED: 2004-10-29 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Description: of claim responses (including drug utilization review responses and Documentation Retrieval: ======================== The ECME documentation is available on the ANONYMOUS.SOFTWARE directory at one of the following Office of Information (OI) Field Offices. Sites may retrieve documentation in one of the following ways: (1) The preferred method is to FTP the files from download.vista.domain.ext, which will transmit the files from the warnings) on a real-time basis, is being developed and introduced in a first available FTP server. (2) Sites may also elect to retrieve documentation directly from a specific server as follows: Albany ftp.fo-albany.domain.ext Hines ftp.fo-hines.domain.ext Salt Lake City ftp.fo-slc.domain.ext The documentation distribution includes: phased implementation strategy. This deployment strategy was utilized due FILE NAME DESCRIPTION BPS_1_0_IG.PDF HIPAA NCPDP CONNECTION FOR EDI PHARMACY (DORMANT RELEASE) INSTALLATION GUIDE BPS_1_0_RN.PDF HIPAA NCPDP CONNECTION FOR EDI PHARMACY (DORMANT RELEASE) RELEASE NOTES (3) Documentation can also be retrieved from VISTA Documentation Library to the complexity of the functionality and the number of product line (VDL) on the Internet at the following address, http://www.domain.ext/vdl. Installation Instructions: ========================== The software for this patch is being distributed via a host file. The host file will contain the following package and builds: Host file name BPS_1_0.KID dependencies. Package: BPS_1 Builds: PSS1.081 IB2.0223 IB2.0251 PRCA4.5202 Sites may retrieve the software directly by using FTP from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Albany: ftp.fo-albany.domain.ext Hines: ftp.fo-hines.domain.ext Salt Lake City: ftp.fo-slc.domain.ext Do not install this patch while Pharmacy Data Management users are using the software. Installation will take no longer than 15 minutes. There are no scheduling restrictions or recommendations. The first release of this two part implementation is BPS10, comprised of Installation Steps 1. Use VA FileMan to add the new domain, EPHARMACY.VITRIA-EDI.AAC.DOMAIN.EXT, to the DOMAIN file (#4.2). The installation instructions are included in the patch description for the XMDBA160 patch. This domain must be in place before the installation of the IB2251 patch that is included in the BPS 1.0 Master Build. 2. Download the KIDS file BPS_1_0.KID via FTP. This file needs to be retrieved in ASCII format. the new Electronic Claims Management Engine (ECME) package (in the BPS 3. Review mapped sets for the PSS, IB, and PRCAnamespaces. If the routines are mapped, they should be removed from the mapped set at this time. 4. From the Kernel Installation & Distribution System menu, select the Installation menu. 5. From this menu, select the Load a Distribution option. When prompted for a file name, enter the directory name where you FTPd the build, namespace), plus the patches PSS181, IB2.0223, IB2.0251, and followed by BPS_1_0. In our example, the file name is USER$:[ANONYMOUS]BPS_1_0.KID. Determine the location where you stored your build to decide the correct file name entry. 6. At the "Want to Continue with Load? YES//" prompt, enter YES. 7. At the "Want to RUN the Environment Check Routine: YES//" prompt, answer YES. 8. From this menu, the installer may select to use the following options: PRCA4.5202, which are listed here in order of installation. BPS10 is a (When prompted for INSTALL NAME, enter BPS 1.0) a. Backup a Transport Global - This option will create a backup message of any routines exported with the patch. It will NOT backup any other changes such as DDs or templates. b. Compare Transport Global to Current System - This option will allow you to view all changes that will be made when the patch is installed. It compares all components of the patch (routines, DDs, templates, =========== dormant release that only allows each site to perform preliminary setup etc.). c. Verify Checksums in Transport Global - This option will ensure the integrity of the routines that are in the transport global. 9. At the "Select Installation Option:" prompt, enter 6 Install Package(s) 10. At the "Select INSTALL NAME:" prompt, enter BPS 1.0. work and to confirm that the software does not adversely affect other 11. When prompted, "Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//" respond NO. 12. When prompted, "Want KIDS to INHIBIT LOGONs during the install? YES//" respond NO. 13. When prompted, "Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//" respond NO. 14. When prompted, "Device:Home//" respond with the correct device and DO packages. NOT queue this to P-Message. 15. If routines were unmapped as part of step 3, they should be returned to the mapped set once the installation has run to completion. There are two main areas addressed by BPS10: a. Registration of the Pharmacy with the Vitria BusinessWare IE. b. The Insurance Matching of Group Plans with Pharmacy Plans Following the installation of BPS10, each site must register their pharmacy with Vitria and match applicable insurance group plans using the insurance matching screens. These processes are detailed in the HIPAA NCPDP CONNECTION FOR EDI PHARMACY INSTALLATION GUIDE and the E-PHARMACY CLAIMS INSURANCE PROCESS document. Both of these documents are located on the anonymous directory. It is very important that the IRM or person installing the patch at each facility provide a copy of these documents to its ADPAC(s) and any other relevant staff who will be responsible for registering their pharmacy with Vitria and completing the insurance matching process. PATCH OVERVIEW At a later date, additional HIPAA NCPDP patches will be released to activate all of the HIPAA NCPDP functionality. Until that time, sites will not be able to electronically submit claims utilizing this new functionality. The HIPAA NCPDP project was created in response to a Chief Business Office (CBO) request for modifications to several Veterans Health Information Systems and Technology Architecture (VistA) software applications in accordance with HIPAA Electronic Data Interchange (EDI) transactions and NCPDP mandated format standards, specifically the NCPDP Telecommunication Standard v.5.1. The specific functionality for this patch is listed below. Overview of the Process: The changes to Pharmacy Data Management are as follows: 1. DEA, SPECIAL HDLG field (#3) in the DRUG (#50) file. The Healthcare Insurance Portability and Accountability Act National Routine PSSDDUT2 was modified to accommodate the use of the letter 'E' within the DEA, SPECIAL HDLG field (#3) of the DRUG file (#50). Data Dictionary Changes in Outpatient Pharmacy: 1. For the DRUG file (#50), the DEA, SPECIAL HDLG (#3) field for the drug will need to accommodate the use of the letter 'E' to indicate that a drug is billable for ECME purposes. The routine dealing with the Help Text of this field was modified to accommodate the inclusion of an 'E' within the Council for Prescription Drug Programs (HIPAA NCPDP) initiative, whose list of possible entries. Associated NOISs: ================= N/A Test Sites: =========== ultimate goal is to provide functionality allowing electronic transmission NEW YORK HARBOR HCS NORTH TEXAS HCS ANN ARBOR, MI BATTLE CREEK, MI DETROIT, MI IRON MOUNTAIN, MI Routine Summary: ================ The second line now reads as follows: of Outpatient Pharmacy (OP) prescription claims to payers and the receipt <TAB>;;7.0;PHARMACY DATA MANAGEMENT;[patch list]; 9/30/97 CHECK^XTSUMBLD results: Routine Before Patch After Patch Patch List ======= ============ =========== ========== PSSDDUT2 16160245 16615950 3,21,61,81 9 SEQ #8 DATE APPLIED: 1998-04-23 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Install new Dose Forms in DOSAGE FORM file (#50.606). 89 DATE APPLIED: 2004-12-28 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Add the non-VA med multiple from file #55 to the Clinical Reminders index. 91 SEQ #82 DATE APPLIED: 2004-12-28 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch contains updated Application Program Interfaces (APIs) that Active status. The API manual has been modified since the original version to indicate Active and Inactive APIs. If the API(s) you need have an Inactive status, please contact the Pharmacy Re-Engineering team at the Birmingham Field Office. will be used by calling applications that currently do direct global reads or writes to the Pharmacy Data Management files. A review of the previously released APIs showed several entry points where additional pieces of data were required to be returned. If you have already made code modifications, or have made plans to make code modifications to use any of the new APIs, please check the latest version of the API manual to verify that the API(s) in question have an 59 DATE APPLIED: 2005-02-04 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. The Inpatient Medications Orders for Outpatients project will allow a 2. A new parameter has been added to the PHARMACY SYSTEM file (#59.7). It is the AUTO-DC IMO ORDERS field (#26.8). This new parameter will allow sites to control whether or not Inpatient Medications Orders for Outpatients are automatically discontinued during patient movements. This parameter will only be effective if sites are using Inpatient Medications to control discontinues on patient movements. If the site is using the CPRS auto-dc rules, this parameter will have no effect. 3. As a part of the Inpatient Medications Requirements for the Special Focus Group IRA project, this patch modifies the definition of schedules user the ability to order unit dose medications for outpatients. This is in the ADMINISTRATION SCHEDULE file (#51.1). TO accomplish this, the following changes are being made to the PSSJ SCHEDULE EDIT input template: a. Do not allow entry of a schedule with the name of OTHER. b. Do not allow entry of administration times for odd schedules. c. Display the calculated frequency to the user. 4. Based on the upcoming requirement from the Joint Commission on Accreditation of Hospital Organizations, schedule names that are considered dangerous will no longer be allowed. The four schedules that accomplished through modifications to Inpatient Medications V. 5.0, will no longer be allowed are: QD, HS, TIW and QOD. These schedules cannot be used either alone or as part of a schedule name. For example: QD is not allowed. Neither is QD ONCE. 5. The Inpatient Medications Requirements for the Special Focus Group IRA project will prevent users from entering free text schedules for inpatient medication orders. This patch helps accomplish this by changing the validation of schedules entered through Computerized Patient Record System (CPRS) V. 1.0. This validation requires that schedules be defined in the ADMINISTRATION SCHEDULE file (#51.1) or be a valid day-of-week, PRN or Computerized Patient Record System (CPRS) V. 1.0, and Scheduling V. 5.3. administration time schedule before allowing the schedule to be added to an inpatient order. 6. A provider entering an order into Computerized Patient Record System (CPRS) V. 1.0 must be permitted to place a limitation on the duration of an inpatient medication order. This capability exists for Unit Dose orders and Inpatient IV orders, but not for IV Fluid orders. This patch helps accomplish this by adding a new field to the PHARMACY PATIENT file (#55), IV multiple (#100) called REQUESTED IV LIMITATION (#152). The purpose of this patch is to create three new fields in the PHARMACY PATIENT file (#55). In the UNIT DOSE multiple (#62), the CLINIC field (#130) and the APPOINTMENT DATE/TIME field (#131) have been added. In the IV multiple (#100), the APPOINTMENT DATE/TIME field (#139) has been added. 83 SEQ #84 DATE APPLIED: 2005-03-11 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: In some cases when ordering a drug the incorrect dispense unit shows. 87 SEQ #85 DATE APPLIED: 2005-04-26 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: As part of the Outpatient Pharmacy V. 7.0 Laser Labels Phase II project, Data dictionary changes: =========================== New fields: 1. PHARMACY SYSTEM file (#59.7), WARNING LABEL SOURCE field (#16) The new warning label processing is not fully functional until this field is set to "N" for "New" in the Pharmacy System Parameters Edit [PSS SYS EDIT] option. 2. DRUG file (#50), NEW WARNING LABEL LIST field (#8.1) If the default warnings for a drug are not sufficient, a custom list of warning numbers can be created and stored in this field. a new commercial data source will be utilized to provide warning label 3. DRUG file (#50), GENDER SPECIFIC LBLS ON ALL RX field (#8.2) If the commercial data source has indicated that a particular warning only applies to one gender, then if this flag is null or "Y", the warning will print for all patients. If this field is "N", the warning will only print for this drug when the patient is that specific gender. 4. RX CONSULT file (#54), WARNING MAPPING field (#2) 5. RX CONSULT file (#54), SPANISH TRANSLATION field (#3) The last 2 fields in the above list will have some entries populated automatically in a post-install routine with this patch. The mapping is information. used for matching entries in the old RX CONSULT file (#54) with the equivalent entry in the new WARNING LABEL-ENGLISH file (#50.625). New options under the PSS Manager [PSS MGR] option: ================================================== 1. Warning Builder [PSS WARNING BUILDER] option allows the user to print a copy of the old and new warning file entries and to choose various ways to select drugs to review which warnings will print when the flag is turned to use the new warning label source. It also allows the user to override the default warning labels to create a custom warning label list for the selected drug. This is done by specifying a list of warning numbers from the old RX CONSULT file (#54) and/or the new commercial data source warning file. 2. Warning Mapping [PSS WARNING MAPPING] option can be used to match an entry from the old RX CONSULT file (#54) to the WARNING LABEL-ENGLISH file (#50.625) to aid in using the Warning Builder (to identify local warnings that do not have an equivalent entry in the new commercial data source). The user can also enter a Spanish translation for an RX CONSULT file (#54) entry, if desired, but whenever possible, the new commercial data source's warnings should be used. This patch is required by PSO7161 which does the printing of the Template changes: ================= This patch modifies the DRUG file (#50) INPUT template [PSSCOMMON] to allow the user to view the new warning labels for a drug and edit the NEW WARNING LABEL LIST field (#8.1), if desired. For drugs that have a gender-specific warning associated with them, the new GENDER SPECIFIC LBLS ON ALL RX field (#8.2) will also be prompted. warning labels on the laser labels form. The following changes are included in this patch: 86 SEQ #86 DATE APPLIED: 2005-05-25 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: A request has been made to allow sites to define inpatient orders for outpatients auto-dc capabilities on a clinic-by-clinic basis. This patch helps to accomplish this goal by removing the AUTO-DC IMO ORDERS field (#26.8) and associated data from the PHARMACY SYSTEM file (#59.7). 95 SEQ #87 DATE APPLIED: 2005-06-25 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch will correct an undefined variable error that occurred during SQA testing of the Inpatient Medications patch PSJ5.0126. When the analyst tried to use the ? or ?? lookup/help functionality for the TO SERVICE field in option [PSJ AC SETUP], the error occurred and prevented the analyst from further testing CLE-0604-40092 (NOIS)/HD0000000068038. This patch will be installed with patch PSJ5.0126. 96 SEQ #88 DATE APPLIED: 2005-08-13 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: CHANGE DATA DESCRIPTION FOR MEDICATION ROUTE FIELD #3 IN NON-VA MEDS SUB-FILE #55.05 IN PHARMACY PATIENT FILE #55. CHANGE FIELD LENGTH FROM 20 TO 40. 97 SEQ #89 DATE APPLIED: 2005-08-13 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch makes a change to one of the Pharmacy Data Management encapsulation routines. A new component has been added that will allow other packages to perform VA FileMan data retrieval through a Pharmacy Application Program Interface (API). 101 SEQ #90 DATE APPLIED: 2005-12-02 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch contains Application Program Interfaces (APIs) that will be source, when the time comes. These are the files that are affected. If any application is making direct global reads or writes to any of these files, they must be replaced by using the APIs exported with this patch. File Name: File Number: RX PATIENT STATUS 53 PHARMACY PATIENT 55 PHARMACY SYSTEM 59.7 used by calling applications that currently do direct global reads or writes to the Pharmacy Data Management files. Since the PHARMACY PATIENT file (#55) and PHARMACY SYSTEM file (#59.7) are being replaced as part of the Pharmacy Re-engineering project, any direct M-based global reads or writes to these files must be replaced by calling the APIs provided in this patch. When the new data source is in place, the calling applications will not be required to make any changes, because these APIs will be flexible enough to retrieve the requested data from the new data 10 SEQ #11 DATE APPLIED: 1998-06-22 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch fixes three problems and provides one enhancement. It will allow you to edit the IV Additives and IV Solutions Print Names. The patch expands the help text on the GENERIC NAME field and updates a typo in the data dictionary in the VA Classification field in DRUG file (#50). The post-install routine re-indexes the NATIONAL DRUG CLASS field, also in DRUG file (#50). 102 SEQ #91 DATE APPLIED: 2005-12-21 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch will fix the problem with lookups in the Pharmacy Orderable Item file (#50.7) when entering in lowercase drug names. 103 SEQ #92 DATE APPLIED: 2005-12-21 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. PSI-05-051: A priority status of ASAP is not easily seen by the The site can select STAT, ASAP, or NOW orders, or any combination of the three for notification via the mail group functionality. This patch is adding two additional fields (parameters) to file 59.7, PHARMACY SYSTEM FILE to enable the sites to select the priorities that will be used in the Inpatient Medications PENDING and ACTIVE order notification software. This will solve the reported problem in HD98412 / PSI-05-051 by enabling the site to be notified when ASAP orders are submitted by the physician. finishing pharmacist. A STAT order is displayed as blinking and highlighted, but a ASAP order does not have any special visual effects. In order to avoid adding more special visual effects to the screen this patch is designed to provide two System Parameters that will allow the site a choice of what orders are sent to the PSJ STAT NOW ACTIVE ORDER and PSJ STAT NOW PENDING ORDER mail groups. 105 SEQ #93 DATE APPLIED: 2006-03-08 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch fixes an error that could occur when invoking the VAC^PSS50 or ASP^PSS50 Application Program Interface, which are both supported by Integration Agreement 4533. 100 DATE APPLIED: 2006-03-08 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch will add MG-PE & NANOGRAM to the DRUG UNIT field #2 of IV ADDITIVES file #52.6 104 SEQ #95 DATE APPLIED: 2006-03-08 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: A change has been made to the DIC^PSSDI and MIX^PSSDI components of DBIA A new component, FNAME^PSSDI has been added to DBIA 4551. This component will return the LABEL attribute of the Field passed into the call. Patch PSS192 adds the SERVICE CODE field to the output of the DATA^PSS50 component of DBIA 4533. This patch cirrect the problem where this field is not being returned if a "??" value is passed into the call. 4551. DIC("S") will be killed within these components. Two new input parameters have been added to address screening issues. If the file you are passing in has an Inactivation Date field, and you want to screen on that field, a new date input parameter is being added to the components, and if a date is passed in, a screen will be set for the calling application. If the file you are passing in is the DRUG file (#50), and you want to screen on the APPLICATION PACKAGES' USE field (#63), and new input paramter has been added for that also. 98 SEQ #96 DATE APPLIED: 2006-04-10 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch will correct the reported problems with in the WARNING BUILDER option [PSS WARNING BUILDER]. It will also modify the input transform for the VOLUME field of IV SOLUTIONS file #52.7 to allow a leading zero. 93 SEQ #97 DATE APPLIED: 2006-05-04 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: 1. The Computerized Patient Record System (CPRS) V. 1.0 has requested a schedule selected had PRN in the name, an Expected First Dose is displayed which is not correct. This patch assists in correcting this problem by modifying the TYPE OF SCHEDULE field (#5) in the ADMINISTRATION SCHEDULE file (#51.1) to allow PRN. This information will then be provided in an API to CPRS. PSI-05-026. new Application Programming Interface (API) from Pharmacy Data Management V. 1.0. The new API will allow CPRS to request the current status of any order for both Inpatient Medications V. 5.0 and Outpatient Pharmacy V. 7.0. 2. During internal testing, it was discovered that the Expected First Dose display in CPRS was inconsistent for PRN orders. If a provider checked the PRN box, no Expected First Dose is displayed. However, if the 90 SEQ #98 DATE APPLIED: 2006-05-25 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This project involves six different applications that have been significantly OUTPATIENT PHARMACY (OP) V. 7.0 PSO7148 field (#81). When a new prescription is entered for a specific drug, the DAW CODE from the drug is stored in the PRESCRIPTION file (#52) for each fill. This field is solely being used for electronic billing purposes. It communicates to the third party payer that a drug has a special characteristic, which will hopefully prevent the payer from rejecting the claim. Below are all 10 existing DAW CODES: 0 - NO PRODUCT SELECTION INDICATED 1 - SUBSTITUTION NOT ALLOWED BY PRESCRIBER 2 - SUBSTITUTION ALLOWED-PATIENT REQUESTED PRODUCT DISPENSED INTEGRATED BILLING (IB) V. 2.0 IB2276 3 - SUBSTITUTION ALLOWED-PHARMACIST SELECTED PRODUCT DISPENSED 4 - SUBSTITUTION ALLOWED-GENERIC DRUG NOT IN STOCK 5 - SUBSTITUTION ALLOWED-BRAND DRUG DISPENSED AS A GENERIC 6 - OVERRIDE 7 - SUBSTITUTION NOT ALLOWED-BRAND DRUG MANDATED BY LAW 8 - SUBSTITUTION ALLOWED-GENERIC DRUG NOT AVAILABLE IN MARKETPLACE 9 - OTHER Note: The existing entries in the DRUG file (#50) will NOT be automatically populated with a DAW CODE value upon installation of this patch. PHARMACY DATA MANAGEMENT (PDM) V. 1.0 PSS190 However, the null value is automatically save as 0 (zero) - NO PRODUCT SELECTION INDICATED in a prescription entered for a drug with a null DAW CODE. 3. The Drug Enter/Edit [PSS DRUG ENTER/EDIT] option has been modified to allow the user to associate a DAW CODE to a drug in the DRUG file (#50). 4. The Lookup into Dispense Drug File [PSS LOOK] option has been modified to display the DAW CODE field (#81) content for the drug being displayed. Below is the exact point where the DAW CODE is displayed: CONSOLIDATED MAIL OUTPATIENT PHARMACY (CMOP) V. 2.0 PSX248 ... DEA, SPECIAL HDLG: 6 NDC: 00172-4390-18 DAW CODE: 5 - SUBSTITUTION ALLOWED-BRAND DRUG DISPENSED AS A GENERIC CS FEDERAL SCHEDULE: ... ACCOUNTS RECEIVABLE (AR) V. 4.5 PRCA4.5230 ELECTRONIC CLAIMS MANAGEMENT ENGINE (ECME) V. 1.0 BPS1*1 Veterans Health Information Systems and Technology Architecture (VistA) software applications and infrastructure were enhanced, in order to allow the electronic transmission of outpatient pharmacy prescription claims (WINDOW and changed to enable VA Medical Centers to perform third party electronic billing MAIL fills) to third party payers via the network connections available through the Austin Automation Center (AAC). VistA will be enhanced to receive electronic adjudicated responses from the third party payers, which include real-time processing for Drug Review Utilization and Refill Too Soon rejects. Reject information will be displayed to the pharmacist as the prescription is being processed. The pharmacist will have the capability to take the appropriate action to ensure patient safety or to override the reject and resubmit the claim to the payer for payment. When a status of "PAYABLE" is returned by the payer for a released prescription, VistA will automatically create the bill in IB, authorize it and immediately create the receivable in for prescriptions. the AR application. Since the exact amount being paid by the payer is known, a decrease adjustment will be automatically generated and applied so that the receivable is equal to the net amount due from the payer. The system also provides electronic payment matching capability (for electronically billable outpatient pharmacy prescriptions) using the existing Electronic Data Interchange (EDI) Lockbox functionality which processes other electronic payments from third party payers. This real-time electronic claims processing capability will be provided in accordance with the Healthcare Insurance Portability and Accountability Act (HIPAA), EDI transactions and the National Council for Prescription Drug Programs (NCPDP) mandated format standards, specifically NCPDP Telecommunication Standard V. 5.1. Additional functionality delivered with this project includes: . Auto-Release/Outpatient Pharmacy Automation Interface (OPAI) Integration. . Back-billing capability to allow electronic billing of claims from within the IB application. . Capability to MOVE a group of subscribers from one insurance plan to another while automatically "expiring" the old plan, which is a major time saver. Below is a list of all the applications involved in this project along with . Pharmacy Dispensed As Written (DAW) prescription processing. Overview of the Process: When a prescription is about to be filled and dispensed by the pharmacy, the OP application submits the prescription to the new ECME application. ECME then contacts IB to verify whether or not the prescription is electronically billable. If so, ECME gathers the information necessary to generate a NCPDP claim. The claim information is passed to the VistA Health Level Seven (HL7) package. The HL7 package then sends the billing information to the AAC, where their patch number: it is routed to the corresponding third party insurance via Emdeon (formerly WebMD). Once the payer processes the information, the response coming back from the payer is passed back to the site that made the request, and the information is stored in the ECME package. If the third party payer accepted the claim, the adjudicated information is passed along to IB. If the claim was rejected the problem can be worked on and a new claim can be submitted to the payer. For electronically billable CMOP prescription processing, the third party claim is sent before the prescription information is transmitted to the CMOP facility to be filled. Once the adjudicating response is electronically received from the third party payer, if there are no Drug Utilization Review or Refill Too Soon rejects, the prescription is then transmitted to the CMOP facility. When the CMOP center sends the dispensing information back to VistA, the National Drug Code (NDC) information is checked against the NDC sent to the third party payer and, if different, a new claim is generated in the background and is sent to the third party payer. In case the CMOP facility indicates that it is unable to fill a "PAYABLE prescription fill, a reversal is automatically submitted to the third party payer for the corresponding APPLICATION/VERSION PATCH fill. This patch modifies PDM V. 1.0 to support the other applications in the electronic claims generation process. It does not interface with the ECME application at all. The changes to this application are the following: 1. A new multiple field has been added to the DRUG file (#50) to store the latest NDC numbers that have been dispensed at window as well as by CMOP for a specific division. This way, when the next prescription is entered by the division for the same drug, the last used NDC is automatically ----------------------------------------------------------------- retrieved from this new multiple, stored in the PRESCRIPTION file (#52) and sent to the third party payer through ECME. Below is the multiple field and the fields under it: 32 NDC BY OUTPATIENT SITE .01 OUTPATIENT SITE 1 LAST LOCAL NDC 2 LAST CMOP NDC 2. A new field has been added to the DRUG file (#50) to store the DAW CODE 107 SEQ #99 DATE APPLIED: 2006-05-26 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch will fix the UNDEFINED error that occurs when Using 'Drug Enter/Edit' [PSS DRUG ENTER/EDIT] option. It will also modify the trigger for PRICE PER ORDER UNIT field #13 of the DRUG file (#50) to use 4 decimal places instead of 3. 106 SEQ #100 DATE APPLIED: 2006-07-11 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch contains Application Program Interfaces (APIs) that will be enough to retrieve the requested data from the new data source when the time comes. If any application is making direct global reads or writes to this file they must be replaced by using the APIs exported with this patch. used by calling applications that currently do direct global reads or writes to the Pharmacy Data Management file. Since the PHARMACY PATIENT file (#55) is being replaced as part of the Pharmacy Re-engineering project, any direct M-based global reads or writes to this file must be replaced by calling the APIs provided in this patch. When the new data source is in place, the calling applications will not be required to make any changes, because these APIs will be flexible DATE INSTALLED AT THIS SITE: 1997-10-28 00:00:00 INSTALLED BY: USER,ONE DESCRIPTION OF ENHANCEMENTS: MANAGEMENT OF PHARMACY DATA FILES.
DESCRIPTION	For maintenance of Pharmacy files and fields.

PHARMACY DATA MANAGEMENT (164) PACKAGE (9.4)