Name	Value
NAME	ADVERSE REACTION TRACKING
PREFIX	GMRA
DEVELOPER (PERSON/SITE)	RFM-WAA/HISC
DEVELOPMENT ISC	HISC
CLASS	National
CURRENT VERSION	4.0
ADDITIONAL PREFIXES	GMA
SHORT DESCRIPTION	Adverse Reaction Tracking package
AFFECTS RECORD MERGE	FILE AFFECTED: PATIENT NAME OF MERGE ROUTINE: GMRAMRG
VERSION	4.0 DATE DISTRIBUTED: 2005-11-19 00:00:00 PATCH APPLICATION HISTORY: 2 DATE APPLIED: 1996-08-12 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This Build: array in the routine GMRAPTB. 4) fixes the problem reported in NOIS NOP-0596-12146. A user presses RETURN or enters an up-arrow at the Causative Agent prompt and is prompted to enter another causative agent. 5) fixes the problem reported in NOIS ISH-0596-42277. Under certain instances the 'Sign-off' event point is not being executed. 6) modifies the field description for the REQUIRE ORIGINATOR COMMENTS field (#4) in the GMR ALLERGY SITE PARAMETERS file (#120.84). NOIS CLA-0696-20854. 7) fixes a problem where the REACTION ASSESSMENT field (#1) in the ADVERSE REACTION ASSESSMENT file (#120.86) is marked 1 (yes), but the patient does not have any active entries (i.e., entries that have not been entered-in-error) in the PATIENT ALLERGIES file (#120.8). NOIS: CMO-0696-40833. 8) identifies the patient (e.g., T1234), suspect medication and event date 1) deletes the Soundex cross-reference from the NAME field (#.01) of the on the Attachment page of the MedWatch form. NOIS: BRX-0696-11081. 9) modifies the GMRADPT utility to return "unsigned" reactions in the GMRAL array. 10) changes the ORCHK^GMRAOR utility call. If the calling routine is checking for Contrast Media Reactions and the patient is not in the ART database, then the utility will return a null value instead of a 0 (zero). GMR ALLERGIES file (#120.82). 11) fixes a bug in the GMRADPT utility which returns a GMRAL array node stating the person has No Known Allergies if the person is not in the ART database. 12) fixes a bug in the GMRANKA routine which may enter the wrong value in the ADVERSE REACTION ASSESSMENT file (#120.86), REACTION ASSESSMENT field (#1). NOIS: MAR-0696-21799. 2) fixes a possible undefined variable error (GMRAREC) in the routine GMRASIG1. 3) fixes a FOR loop which uses the wrong variable to loop through an 12 DATE APPLIED: 1998-11-04 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Allergies entered via CPRS were being entered into the ART database as unverified even if they met the criteria to be auto-verified in the ART site parameters. This patch will auto-verify those allergies entered via CPRS that meet the criteria as defined at the site. 13 DATE APPLIED: 1998-11-12 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch will make the ARTS software compatible with the National Drug File regardless of version. 14 DATE APPLIED: 1999-01-21 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: The METHOD OF NOTIFICATION field in file 120.84 is used to determine the DBIA #1471 has been retired which allowed ART to call ALLERGY^RAUTL3 in This patch corrects this error by changing the reference to use file 12d RADIOLOGY/NUCLEAR MEDICINE v 4.5 to retrieve and store information relating to allergies to radiologic contrast media. This reference is being removed from the ART software. users that should receive the chart and ID band marking bulletin. If this field is set to OE/RR TEAMS, the code made reference to PCMM team lists. CPRS has ceased use of PCMM teams for list functionality. The errant reference to PCMM caused an error when a patient with data in the ADVERSE REACTION TRACKING (ART) database was admitted. The same error can be generated when a new adverse reaction is entered and the charts and/or ID bands have not been marked. patch corrects this error by changing the reference to use the OE/RR LIST (#100.21) file. 16 DATE APPLIED: 2001-01-03 00:00:00 APPLIED BY: USER,ONE 17 SEQ #16 DATE APPLIED: 2003-12-31 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch includes a utility for updating free text entries. Please see the FORUM patch description for a detailed explanation of this patch. 19 SEQ #17 DATE APPLIED: 2004-07-02 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Update to allergy tracking package consisting of changes to the free text utility distributed in patch GMRA417 as well as updates to send bulletins from CPRS GUI upon new allergy entry. Please see the FORUM module for complete details. 18 SEQ #18 DATE APPLIED: 2005-01-18 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch will install new cross-references on files 120.8, 120.85 and 120.86 in support of the health data repository. See the patch description on FORUM for complete details. 22 SEQ #19 DATE APPLIED: 2005-01-18 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: HDR related changes. Please see FORUM patch description for details regarding this patch. 21 SEQ #20 DATE APPLIED: 2005-02-12 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Allergy updates required to support the removal of allergies as orders. After installation of this patch and CPRS GUI v25, allergies will no longer be treated as orders. Please see the FORUM patch module for a complete description. 23 SEQ #21 DATE APPLIED: 2005-08-13 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch includes changes required for continued support of the Health Data Repository project. Please see the national patch module for a full description of this patch. 5 DATE APPLIED: 1996-10-09 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This Build addresses the following problems: known allergies or adverse reactions?" prompt and does not enter a causative agent the software assesses the patient as having a reaction on file in the database. It should not. 3) The GMRA PRINT-COMPLETE LISTING option does not distinguish between patients who not in the ART database and those patients who are assessed as NKA (No Known Allergies). 4) The ART package calls an Outpatient Pharmacy utility to get and display any outpatient medications for a patient. The SIG code value for the prescription return is changing in size from one line of text to one plus lines of text. The ART package will store the first 30 characters of the SIG code for its SUSPECT and CONCOMITANT drug entries in File 120.85. 5) Changes the description for the GMRA PRINT-FDA EXCEPT BY PT option so that it accurately describes what that option does. 6) Changes the description for the GMRA PRINT-EXCEPT BY DATe option so that it accurately describes what that option does. 1) Corrects a bug introduced by the GMRA4.02 patch. Users are not being For more detailed information please see the GMRA45 patch description on FORUM. asked to sign-off on autoverified reactions in the enter/edit reaction process if they answer YES to the "Enter another Causative Agent?" prompt, but do not enter another causative agent. This results in the reaction not be considered as autoverified. 2) When a user mistakenly answers YES to the "Does this patient have any 24 SEQ #22 DATE APPLIED: 2005-08-13 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: See FORUM patch module for a full description. Updates HDR related trigger code. 25 SEQ #23 DATE APPLIED: 2005-09-05 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Update to fix blank sign/symptom issue. Please see FORUM for the complete description of this patch. 27 SEQ #24 DATE APPLIED: 2005-09-05 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch will correct the reported problem of the allergy bulletin not being fired if the contrast media has a VA DRUG CLASS of DX109. 30 SEQ #26 DATE APPLIED: 2005-11-15 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Remedy ticket HD67463 was logged because the site noticed that deceased patients were appearing on the [GMRA PRINT-PATIENT NOT ASKED] report. This report lists patients who have not been given an allergy/adverse reaction assessment. The sites then use this list and contact the patients in an attempt to get the assessment information from them. It is not desirable for the VA to inadvertently contact the family of a deceased individual in an attempt to get the allergy/adverse reaction information for that person. 34 SEQ #29 DATE APPLIED: 2006-04-10 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: Updates to HL7 messaging for HDR. See FORUM for a complete description. 35 SEQ #30 DATE APPLIED: 2006-08-07 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: POSSIBLE PROBLEM WITH LIST BY LOCATION UNASSESSED ALLERGIES. 20 SEQ #31 DATE APPLIED: 2006-09-23 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch updates the clean up utility to include ingredient based and drug class based allergies. Please see FORUM for the complete description of this patch. 36 SEQ #32 DATE APPLIED: 2007-09-04 22:38:44 APPLIED BY: USER,ONE DESCRIPTION: Removes ability to delete existing allergy entries from the roll and scroll environment. Please see the FORUM patch module for a complete description. 26 SEQ #33 DATE APPLIED: 2007-09-04 23:07:28 APPLIED BY: USER,ONE DESCRIPTION: Remote Data Interoperability updates. Please see FORUM for a full description of the updates. 37 SEQ #34 DATE APPLIED: 2007-09-04 23:12:30 APPLIED BY: USER,ONE DESCRIPTION: Updates for RDI and contrast media Please see the FORUM patch description for full details. 7 SEQ #5 DATE APPLIED: 1997-06-02 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: GMRA4.07 See National patch module for a description of the changes incorporated in this patch. 29 DATE APPLIED: 2007-09-04 23:47:20 APPLIED BY: USER,ONE DESCRIPTION: Provides an auto-update for existing free text allergies 40 SEQ #36 DATE APPLIED: 2007-12-12 22:04:07 APPLIED BY: USER,ONE DESCRIPTION: This patch reviews updates made in patch GMRA429 related to terms that begin with the text ANGIOTEN and assures that they were correctly updated. A few ANGIOTEN entries were incorrectly updated to the wrong drug class and need to be updated to the correct drug class. 33 SEQ #37 DATE APPLIED: 2008-07-22 08:06:57 APPLIED BY: USER,ONE DESCRIPTION: This patch addresses Remedy ticket, HD67403. The site reported This patch will also correct a problem with the bulletin generation during entry of Adverse Reactions described in Remedy ticket HD85125. The problem occurs when the user answers "No" to verify an observed/drug adverse reaction when it is first entered. If the user skips the verification step but then uses the GMRA PATIENT A/AR EDIT option and edits the existing observed/drug allergy and then verifies it (with or without making changes) an additional NOTIFICATION OF OBSERVED DRUG REACTION bulletin is triggered. that test patients entered in production are appearing on the This patch will modify the logic in the code so that, if the user re-enters the adverse reaction and then verifies it, a second NOTIFICATION OF OBSERVED DRUG REACTION bulletin will not be triggered. Adverse Reaction Tracking reports, and are also being included in report counts. This patch will update the Adverse Reaction Tracking reports that display the patient name and/or SSN, and reports that produce counts of reaction data so that they all exclude test patients. 38 DATE APPLIED: 2009-04-21 15:49:38 APPLIED BY: USER,SEVENTEEN 41 SEQ #39 DATE APPLIED: 2009-04-22 12:22:54 APPLIED BY: USER,SEVENTEEN DESCRIPTION: See GMRA441 in the National Patch Module 42 SEQ #40 DATE APPLIED: 2009-06-24 14:41:02 APPLIED BY: USER,SEVENTEEN DESCRIPTION: Fixes issue with historical allergy entries being associated with a progress note when the historical entry follows the entry of an observed drug reaction. Also, fixes issue with 0 node not being set correctly on XTMP node and provides failsafe for sending data to HDR. 44 SEQ #41 DATE APPLIED: 2011-03-03 11:30:43 APPLIED BY: USER,SEVENTEEN 45 DATE APPLIED: 2011-03-08 13:52:03 APPLIED BY: USER,SEVENTEEN 47 DATE APPLIED: 2014-04-07 17:24:03 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This is a companion patch to the Order Entry/Results Reporting (OE/RR) version 3.0 software patch number 345 (OR3.0345). See the patch message for a full listing of issues addressed and installation instructions. 43 SEQ #44 DATE APPLIED: 2014-06-05 13:17:44 APPLIED BY: USER,SEVENTEEN DESCRIPTION: The patch is to create a merge routine to check for allergy assessments in Patients before the merge occurs. 4 DATE APPLIED: 1997-09-22 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This build fixes several problems in the ART portion of the ART-CPRS GMRAOR4 The ART EP asked the CPRS developers to include the OBSERVER field value for all new reactions CPRS sends to the ART package. This routine was changed to recognize this piece of data when it is passed to ART. GMRAOR5 Fixes a syntax error. Simplifies some code used to check for duplicate patient reactions. interface. Fixes a bug where the reaction was not completely filed if the reaction value pointer and file was not recognized as one of the five pointed-to files used by the ART package. Modifies the code to call GMRAOR9 to store any drug ingredients or drug classes if the reaction was of a drug type. Modifies the code to add an entry to File 120.85 only if the patient reaction was an observed drug reaction. Sends the reaction as unverified so it will appear on the list of reactions to be verified. GMRAOR7 The sign/symptom data was not being stored in File 120.85 because a call to SIGN^GMRAOR6 was passing the variable GMRAL when it should send the array GMRAL. GMRAOR8 This routine was modified to correct subfile numbers being set Routine changes: in fileman. GMRAOR9 This is a new routine which stores drug ingredients and/or drug classes for a patient drug reaction. GMRAOR0 The DUPCHK entry point was quitting prematurely and therefore not accurately checking for duplicate entries. 48 SEQ #45 DATE APPLIED: 2016-05-26 15:47:43 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: This patch installs a tool that will assist sites in ensuring that the ADVERSE REACTION ASSESSMENT file (#120.86) is synced with the PATIENT ALLERGIES file (#120.8). See the associated patch description for additional details and installation instructions. 46 DATE APPLIED: 2016-05-26 15:49:10 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: UPDATES ADVERSE REACTION TRACKING TO RETURN SIGN/SYMPTOM DATA WITH COMPUTERIZED PATIENT RECORD SYSTEM (CPRS) ORDER CHECK MESSAGES AND TO INLUCDE HEALTH DATA REPOSITORY (HDR) DATA WITH THE EN1^GMRADPT APPLICATION PROGRAMMING INTERFACE (API). REFER TO THE PATCH DESCRIPTION FOR ADDITIONAL INFORMATION. 52 SEQ #47 DATE APPLIED: 2016-07-13 12:59:07 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: This patch is a follow-up patch to GMRA446. See the associated patch description for details on this patch. 49 SEQ #48 DATE APPLIED: 2016-08-15 12:39:08 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: Patch GMRA4.049 addresses the following two issues: 1. Excessive number of entries in the PATIENT ALLERGIES file (#120.8) causes issues with the allergy HL7 messages. 2. Embedded carriage returns in some old allergy HL7 messages prevented the messages from being sent. 50 SEQ #49 DATE APPLIED: 2016-12-01 15:48:04 APPLIED BY: USER,FIFTYFOUR 55 SEQ #50 DATE APPLIED: 2017-05-30 16:08:55 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: See National Patch Module for details. 54 SEQ #51 DATE APPLIED: 2017-12-27 13:46:40 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: Patch GMRA4.054 addresses the following three issues: 1. FDA report SUBSCRIPT error with non-VA drugs 2. Adverse Reaction Assessment update when no previous Reaction Assessment value 3. Allergy file allows MECHANISM to be null 58 SEQ #52 DATE APPLIED: 2018-11-02 15:31:07 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: This patch has the following enhancements for Clinical Ancillary Services the Drug code of "D", as no action was needed to be taken for this scenario. (CAS) Enhancements (RXSU2). 1. Suppress Non-Drug Ingredient-Level Alert Previously released patch GMRA450 added a new alert when the DRUG CLASSES field (#3) in the PATIENT ALLERGIES file (#120.8) is empty. This patch will add a filter, to ignore those alerts, where ALLERGY TYPE field (#3.1) in PATIENT ALLERGIES file (#120.8), does not contain 59 SEQ #53 DATE APPLIED: 2018-12-04 15:44:22 APPLIED BY: USER,FIFTYFOUR DESCRIPTION: This patch addresses NSR 20171203. See the Forum patch description for additional details. 60 SEQ #54 DATE APPLIED: 2019-10-03 15:50:37 APPLIED BY: USER,SIXTYFIVE DESCRIPTION: IEN MISMATCH ISSUE 6 SEQ #7 DATE APPLIED: 1997-10-06 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: The Description of this build can be found in the Nation Patch Module under patch GMRA4.06 53 DATE APPLIED: 2020-06-24 12:14:43 APPLIED BY: USER,SIXTYFIVE DESCRIPTION: This patch resolves issues identified during the testing of CPRS v31 as well as post-release issues with recently released patches. See the patch description for the list of issues resolved. 62 SEQ #56 DATE APPLIED: 2020-07-21 13:51:02 APPLIED BY: USER,SIXTYFIVE DESCRIPTION: This patch addresses the following issue: 1. INC9435820 - WRONG URL IN AN ALLERGY OPTION When utilizing Menu Option GMRA ALLERGY FILE EDIT the user is presented with an incorrect URL (Uniform Resource Locator) or Web Page to be used when making their request. 61 SEQ #57 DATE APPLIED: 2020-09-23 15:42:24 APPLIED BY: USER,SIXTYFIVE DESCRIPTION: This patch will resolve the following issue in the Clinical Procedures Patient Safety Issues (PSIs): ----------------------------- N/A Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 1. INC8167520 - Cannot enter NKDA into the patient's allergy assessment. (CP) Flowsheet application. Problem 1: ---------- If the user "up carats out" of the GMRA assessment utility prior to the report running, the next time a user enters the utility it will appears as though the report ran, even though it did not. Resolution 1: ------------- Routine GMRAFA was modified to kill the ^XTMP("GMRAFAL") global if the user exits before running the report. This will reset the option, allowing the user to run the report. 1. INC8167520 - Cannot enter NKDA into the patient's allergy assessment. New Service Requests (NSRs): ---------------------------- N/A 64 SEQ #58 DATE APPLIED: 2021-01-29 09:22:28 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch addresses a post-release issue identified with patch GMRA453, part of the CPRS v31b release. See the patch description for a full explanation of the issue. 63 DATE APPLIED: 2021-07-01 11:28:00 APPLIED BY: USER,SEVENTEEN 66b DATE APPLIED: 2021-07-01 00:00:00 DESCRIPTION: Backup of GMRA4.066 on Jul 01, 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. 66 SEQ #60 DATE APPLIED: 2021-07-01 11:30:22 APPLIED BY: USER,SEVENTEEN DESCRIPTION: This patch will resolve the following issue: that cannot be resolved with the Modify Assessment tool. INC17041569 - CPRS ERROR_unable to update allergies for ONE patient INC17069709 - Adverse Reaction Tracking - Allergy Assessment INC17072229 - Adverse Reaction Tracking - Allergy Assessment Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 1) INC11926924 - MAD: GMRA#### not resolve: order appeared verified by nurse in BCMA but CPRS it was found not to be. Problem: ------- The Captain James A. Lovell Federal Health Care Center reported that they were unable to modify an allergy assessment for a specific patient using the Assessment clean up utility option [GMRA ASSESSMENT UTILITY]. After some research it was discovered that when two patients were merged and the 'TO' patient (remaining patient after them merge) had not Allergy assessment while 'FROM' patient (deleted after the merge) a corrupt record was being created for the 'TO' patient. These records could not be fixed using the Assessment clean utility option [GMRA ASSESSMENT UTILITY]. 1) INC17497887 - UNABLE TO MODIFY AN ALLERGY ASSESSMENT USING THE VISTA Resolution: ---------- The root of the problem is within the Kernel Patient Merge module. However we were able to address the problem by modifying GMR code specifically designed to run right before two patients are merged. The solution applied consisted of copying the 'FROM' Allergy assessment information to 'TO' before the patient merge were performed by the Kernel Patient Merge utility. In addition to fixing this problem so no new entries are affected this patch also fixes the existing entries with the problem through a post-install routine that is described below. (HITPS-7808) ASSESSMENT CLEANUP UTILITY ECN 74075 Technical Resolution: -------------------- Modified the routine XMRAMRG by adding right at the beginning of the ASSESS tag code to identify whether the 'FROM' patient had an allergy assessment in the ADVERSE REACTION ASSESSMENT file (#120.86) and the 'TO' patient did not. If that's the case for the patient par being merged the new code will copy the 'FROM' patient allergy assessment and create an identical assessment for the 'TO' patient in the ADVERSE REACTION ASSESSMENT file (#120.86). This will effectively prevent the Kernel Patient Merge Utility from creating a corrupt Duplicate: entry for the 'TO' patient. ----------- INC16946767 - allergy info being displayed differently (incorrectly) in different areas of Vista/CPRS INC17041102 - Adverse Reaction Tracking-Allergy Assessment; 3 Discrepancies 51 DATE APPLIED: 2022-10-05 14:55:07 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: Please refer to the patch description for contents and detailed information. 70 SEQ #63 DATE APPLIED: 2023-12-15 13:21:09 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: This patch will resolve the following issue: <SUBSCRIPT>DRUG+95^GMRAOR ITEMS() Subscript 1 > 511 It was reported that a hard error was encountered when the reporting site, using CPRS, placed an inpatient medication order for hydroxyzine for a patient that has noted severe allergic reactions to hydroxyzine. The error caused CPRS to shut down and prevented the user from further processing the order. The error encountered is as follows: 68 SEQ #64 DATE APPLIED: 2024-01-25 11:57:42 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: Please see forum for a complete description of patch GMRA4.068. 8 DATE APPLIED: 1998-01-09 00:00:00 APPLIED BY: USER,ONE 72 SEQ #65 DATE APPLIED: 2024-09-03 10:36:20 APPLIED BY: USER,EIGHTYNINE DESCRIPTION: This patch addresses the following issue: INC30029401 - Inactive GMRA Allergy items found the Patient Allergies file need to be cleaned up. 9 DATE APPLIED: 1998-05-11 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: This patch will update the mark chart/id band option to use the new ACRP APIs that become available with patch SD5.3131. Please see the national patch module for a full description of this patch as well as patch 131. 10 SEQ #10 DATE APPLIED: 1998-10-26 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: See Description in the National Patch Module for Patch GMRA410. 11 DATE APPLIED: 1998-10-26 00:00:00 APPLIED BY: USER,ONE DESCRIPTION: The description of this build can be found in the National Patch Module within the patch description of GMRA4*11. DATE INSTALLED AT THIS SITE: 1996-07-15 00:00:00 INSTALLED BY: USER,ONE DESCRIPTION OF ENHANCEMENTS: The Adverse Reaction Tracking package tracks patient allergies/adverse reactions.
DESCRIPTION	This package permits clinical users to track and report patient allergies and adverse reactions. The intended users are physicians, nurses, other clinicians and clerks.

ADVERSE REACTION TRACKING (71) PACKAGE (9.4)