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.
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 IB*2*260, 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 PSS*1*92 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
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 PSS*1*90 (see item
#3) but was unintentionally removed by patch PSS*1*92.
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: BPS*1*3, PSO*7*247, and IB*2*342. Three patches will be released
individually and they are: PRCA*4.5*247, PSX*2.0*62, and PSS*1.0*115.
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)
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
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
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,
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 PSO*7*200 which will send the new warning label
text to OPAI and by PSX*2*54 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 PSS*1*87 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
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
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.
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 PSO*7*200.
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
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 DI*22*147, 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
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
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 BPS*1*5, IB*2*363, and PSO*7*260. 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;@
PSX*2*63 and PSS*1*127 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, PSX*2*63 and PSS*1*127 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
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
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
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.
PSO*7*257.
Field Description:
==================
59.7,49.95 DATE AUTO-EXPIRE COMPLETED 49.99;8 DATE
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
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.
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.
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 PSS*1.0*88, and was used simply as a tally routine
to identify medication routes that needed to be reviewed when the
functionality of PSS*1.0*88 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.
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.
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
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 PSO*7*303 and IB*2*405. 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 PSO*7*303 and Integrated Billing patch IB*2*405
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
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.
This patch has enhancements which extend the capabilities of the Veterans
OUTPATIENT PHARMACY (OP) V. 7.0 PSO*7*289
INTEGRATED BILLING (IB) V. 2.0 IB*2*384
ELECTRONIC CLAIMS MANAGEMENT ENGINE (ECME) V. 1.0 BPS*1*7
The last three patches (PSO*7*289, IB*2*384 and BPS*1*7) will be released
in the Kernel Installation and Distribution System (KIDS) multi-build
distribution BPS PSO IB BUNDLE 3.0. Patches PSX*2*65 and PSS*1*131 will
be released as stand-alone patches. Since there is an implementation
dependency between the multi-build distribution and the stand-alone
patches, PSX*2*65 and PSS*1*131 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 IB*2*384.
applications involved in this project along with their patch number:
APPLICATION/VERSION PATCH
--------------------------------------------------------------
CONSOLIDATED MAIL OUTPATIENT PHARMACY (CMOP) V. 2.0 PSX*2*65
PHARMACY DATA MANAGEMENT (PDM) V. 1.0 PSS*1*131
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 PSU*4.0*5
Inpatient Medications V. 5.0 PSJ*5.0*161
Outpatient Pharmacy V. 7.0 PSO*7.0*170
Registration V. 5.3 DG*5.3*671
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.
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.
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.
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 PSB*3*47 provides the BCMA portion of the project.
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 PSS*1.0*129. 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.
PSS*1.0*143 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
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.
This patch corrects a defect introduced by patch PSS*1*143 in the
HD0000000419996
Problem:
---------
Patch PSS*1*143 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
---------------
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).
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:
--------
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 PSS*1*159. 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).
Patch PSS*1*18 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 PSS*1*13. 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.
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).
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 PSO*7*343
NATIONAL DRUG FILE (NDF) V. 4.0 PSN*4*263
patients avoid serious adverse events. The FDA requires that Medication
PHARMACY DATA MANAGEMENT (PDM) V. 1.0 PSS*1*158
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 (PSS*1*158):
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
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 PSN*4*261. 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 PSN*4*262.
This patch has the following enhancements:
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
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
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.
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 PSO*7.0*379)
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
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 PSO*7*354 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
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.
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).
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 OR*2.5*49 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.
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
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 PSS*1*129 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.
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.
This patch is being released as part of the DEA e-Prescribing of
-----------------------------------------------------------------
KERNEL V. 8.0 XU*8*580
PHARMACY DATA MANAGEMENT (PDM) V. 1.0 PSS*1*166
COMPUTERIZED PATIENT RECORD SYSTEM (CPRS) V. 3.0 OR*3*306
CONTROLLED SUBSTANCES (CS) V. 3.0 PSD*3*73
OUTPATIENT PHARMACY (OP) V. 7.0 PSO*7*391
Note: Patches PSO*7*391 and PSD*3*73 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 (PSS*1*166) 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 PSS*1*159 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
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.
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)
PSS*1.0*174 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 PSJ*5.0*289 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 PSS*1.0*146.
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 PSS*1.0*146 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:
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.
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 PSS*1*169, 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. PSS*1*160
2. MOCHA_2_0.KID host file which contains PSJ*5*252, PSO*7*372 and
OR*3*345
3. PSS*1*173
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
PSJ*5*257, PSO*7*416, OR*3*311 and GMRA*4*47
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.
Patch PSS*1*16 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
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
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").
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
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".
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 PSJ*5.0*194 and *
* PSO*7.0*282 are installed. *
* *
* *
*********************************************************************
1) INC0000149525 - Problems placing PRN orders with multiple spaces/words
*********************************************************************
* WARNING *
* *
Patch PSS*1.0*191 provides enhancements to Pharmacy Data Management
order:
1. PSS*1*191
2. PSJ*5*315
3. PSB*3*83
4. OR*3*417
5. PSB*3*87
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 PSS*1.0*172 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 PSJ*5*315 is installed. Until the PSJ*5*315 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
PSS*1.0*191 does not have any dependencies for installation.
The full functionality introduced in this patch will not be
available until patches PSJ*5.0*315, PSB*3.0*83 and PSB*3.0*87
are installed.
Pre-existing orders will remain unaffected with installation.
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 PSO*7*444
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 IB*2*545
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 PSS*1*189
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 PSN*4*429
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 PSJ*5*313
- 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 PSS*1*189 In 'IN' basket. Page 1
-------------------------------------------------------------------------
The list below shows IV Solutions in your database that need to be
cleaned up before patch PSS*1*189 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 PSS*1*189 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.
$$MAXDS^PSSUTIL1(INPUT)
This API accepts an array containing the Pharmacy Orderable Item
(required) and Dispense Drug (optional) and returns the maximum number
Although patches PSJ*5*289 and PSS*1*174 introduced quite a few enhancements
of Days Supply allowed to be dispensed for the specific medication.
Parameters:
Input: INPUT("PSOI") (Required)
Pointer to the PHARMACY ORDERABLE ITEM file (#50.7).
INPUT("DRUG") (Optional)
Pointer to the DRUG file (#50). This parameter is optional.
If not passed, the API will return the highest value from all
the dispense drugs linked to the Pharmacy Orderable Item.
to the IV Additives and IV Solutions ordering functionality they did not go
Output $$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.
PSJ*5*313 and PSS*1*189 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)
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).
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.
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
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 PSS*1*193, 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:
PSJ*5*317 - Inpatient Medications V. 5.0.
PSS*1*193 - Pharmacy Data Management V. 1.0.
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
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 PSS*1*127 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.
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
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
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
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).
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.
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
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).
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 OR*3.0*487U 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.
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.
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
Patch PSS*1.0*215 is part of a Multi Build with patch PS0*7.0*452.
This build contains the Data Dictionary changes in support of PSO*7.0*452
and is a required build for PSO*7.0*452
PSO*7.0*452 contains the routine changes.
PSS*1.0*215 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.
Pharmacy Data Management PATCH PSS*1*3. This patch fixes the
Mark/Unmarking of a drug for Controlled Substances vs. Drug
Accountability/Inventory Interface.
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).
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.
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.
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:
--------------------------------------------
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.
This patch, along with patch PSN*4*569 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 PSS*1*243 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:
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.
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.
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.
The released patch PSS*1*219 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 PSS*1.0*248 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.
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 PSS*1.0*249 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.
Backup of PSS*1.0*226 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.
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 PSS*1.0*247 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.
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 PSS*1*257. 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 PSS*1*257
and no further action on PSO*7*665 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. PSS*1*257 - Vista patch that updates the Pharmacy System File
Patch PS0*7.0*665 (Automatic Printing) will be released at the same time
as this patch, PSS*1*257
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 (PSS*1*257) 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. PSO*7*665 - Information only patch that contains instructions to
update the FDA Med Guide Automatic Printing Java Application
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 PSO*7*204 and PSO*7*242 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. PSS*1*204).
Patient Safety Issues (PSIs):
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 (PSS*1*187) 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
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.
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.
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 PSJ*5.0*30 contains enhancements that utilize changes
introduced in this patch.
This patch addresses two issues.
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 OR*3.0*48, PSJ*5.0*29 and
PSO*7.0*27 are installed.
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:
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
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.
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.
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).
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).
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
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.
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, PSS*1*34, provides the tools necessary to
set up the Pharmacy files in advance of the Pharmacy Ordering Enhancements
project.
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 PSJ*5*43 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
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 PSS*1*34. 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.
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.
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.
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.
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 PSS*1*34.
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
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:
PSO*7*46
OR*3*94
PSS*1*38
PSJ*5*50
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
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:
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
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.
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%
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-
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
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.
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:
PSS*1*52 PHARMACY DATA MANAGEMENT V. 1.0
PSJ*5*68 INPATIENT MEDICATIONS V. 5.0
PSO*7*95 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
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:
PSS*1*46 PHARMACY DATA MANAGEMENT V. 1.0
PSJ*5*58 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
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
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.
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
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
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 PSS*1*29 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
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
1. This patch, in conjunction with CPRS patches OR*3.0*149 and OR*3.0*158,
problem for orders entered through CPRS GUI, and patch OR*3.0*158 will
fix this problem for orders entered through CPRS ListMan. No problems
will occur if the PSS*1.0*66 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 OR*3.0*149 and OR*3.0*158 are installed, this
functionality will work properly. Patch OR*3.0*149 will fix this
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.
**NOTE** THIS PATCH SHOULD BE LOADED BEFORE PATCH OR*2.5*49.
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 PSS*1*5 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.
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).
PSS*1*68 and OR*3*176 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: PSS*1*69, PSO*7*132, PSJ*5*107 and OR*3*187. 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
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 PSJ*5*80.
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).
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.
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
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
PSN*4*64 and PSN*4*66 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 PSO*7.0*131 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".
1. PSS*1*69 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 PSS*1*68 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
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)
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.
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.
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).
Data Dictionary (DD) changes are being made to support requested changes
for Outpatient Pharmacy V. 7.0 patch PSO*7*135. Patch PSO*7*135 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).
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
PSJ*5*119. NOIS ALT-0403-20970
This project consists of 12 patches that work together to create a new
GMPL*2*27
GMRV*4*15
LR*5.2*295
OR*3*157
PSS*1*62
PSJ*5*90
PSO*7*118
PX*1*119
RA*5*33
YS*5.01*77
Clinical Reminders index global. The purpose of this index is to provide
The purpose of this patch (PSS*1*62) 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:
PXRM*1.5*12
DG*5.3*478
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.
Phase I of the Inpatient Medications Requirements for the Special Focus
OR*3*213 ORDER ENTRY/RESULTS REPORTING V. 1.0
PSU*3*34 PHARMACY BENEFITS MANAGEMENT V. 3.0
Patches PSS*1*79, OR*3*213, and PSU*3*34 contain changes to support the
following enhancements in PSJ*5*110:
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)
PSS*1*79 PHARMACY DATA MANAGEMENT V. 1.0
PSJ*5*110 INPATIENT MEDICATIONS V. 5.0
**********************************************************************
There are three patches to support the Outpatient Pharmacy Automation
Interface project. These patches should be installed separately in the
following order:
PSO*7*156 Outpatient Pharmacy
PSS*1*82 Pharmacy Data Management
PSN*4*84 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.
* *
**********************************************************************
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.
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:
PSS*1.0*81
IB*2.0*223
IB*2.0*251
PRCA*4.5*202
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 BPS*1*0, 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 XM*DBA*160 patch. This domain must be
in place before the installation of the IB*2*251 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 PRCA*namespaces. 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 PSS*1*81, IB*2.0*223, IB*2.0*251, 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:
PRCA*4.5*202, which are listed here in order of installation. BPS*1*0 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 BPS*1*0:
a. Registration of the Pharmacy with the Vitria BusinessWare IE.
b. The Insurance Matching of Group Plans with Pharmacy Plans
Following the installation of BPS*1*0, 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
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
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.
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 PSO*7*161 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:
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).
This patch will correct an undefined variable error that occurred during
SQA testing of the Inpatient Medications patch PSJ*5.0*126. 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 PSJ*5.0*126.
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).
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
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).
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.
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.
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 PSS*1*92 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.
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.
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
This project involves six different applications that have been significantly
OUTPATIENT PHARMACY (OP) V. 7.0 PSO*7*148
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 IB*2*276
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 PSS*1*90
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 PSX*2*48
...
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 PRCA*4.5*230
ELECTRONIC CLAIMS MANAGEMENT ENGINE (ECME) V. 1.0 BPS*1*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
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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
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.
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
