| REQUIRED BUILD |
-
- PSS*1.0*174
- ACTION: Don't install, leave global
-
- PSS*1.0*160
- ACTION: Don't install, leave global
-
- PSS*1.0*170
- ACTION: Don't install, leave global
-
- PSS*1.0*94
- ACTION: Don't install, leave global
-
- PSS*1.0*188
- ACTION: Don't install, leave global
-
- PSS*1.0*191
- ACTION: Don't install, leave global
|
| DESCRIPTION OF ENHANCEMENTS |
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)
|
