| DESCRIPTION OF ENHANCEMENTS |
This patch is being released as part of the DEA e-Prescribing of
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Data Name CPRS File Pharmacy Pending File
--------- --------- ---------------------
QTY PRESCRIBED 15 30
If the error code is related to 'certificate expired', the pending
order will be processed (will not be auto discontinued) and a
notification will be sent to the provider with the message, "DEA
certificate expired. Renew your certificate."
KERNEL V. 8.0 XU*8*580
2. When finishing a pending CS order, if the user does not hold the new
PSDRPH security key, the order will be marked as 'Non-Verified'.
3. To verify a 'Non-Verified' CS order, PSDRPH security key is now
required.
4. To discontinue a pending CS order, PSDRPH security key is now required.
5. The pending order screen will now display the provider's DEA/VA #, the
PHARMACY DATA MANAGEMENT (PDM) V. 1.0 PSS*1*166
DETOX# (if available) and the site address.
6. When finishing a new pending CS order, the orderable item, dosage,
provider name, or the number of refills will not be allowed to be
edited. Also, if the changes to the dispense drug would result in
a new order being created, this will not be allowed for digitally
signed orders. The user WILL be allowed to select other dispense drugs
for the same Orderable Item as long as it does not change the
prescribed dosage.
COMPUTERIZED PATIENT RECORD SYSTEM (CPRS) V. 3.0 OR*3*306
7. When finishing a new pending CS order, the days supply or the quantity
will not be allowed to increase, but can be decreased. If the days
supply is decreased, the number of refills will also be adjusted
accordingly depending on the drug setup (maximum refills, not
refillable etc).
8. In patch PSO*7*99, a change was made for pending orders not to
recalculate the quantity for CS drugs on selecting a different strength
of the same drug and resulting in the same prescribed dosage. This
change is removed in this patch.
CONTROLLED SUBSTANCES (CS) V. 3.0 PSD*3*73
9. When finishing a pending CS order or verifying a CS order by the PSDRPH
key holder, any edit to some of the key fields like dispense drug,
dosage, dispense units, issue date, day's supply, quantity or number of
refills, will now be captured and stored in the activity log.
10. In the Complete Orders From OERR [PSO LMOE FINISH] option, a new sort
selection, 'CS' is included to select digitally signed CS orders
separately.
OUTPATIENT PHARMACY (OP) V. 7.0 PSO*7*391
11. A new field BACKDOOR SIGNATURE STATUS (#311) is being added to the
PRESCRIPTION file (#52) and will be set to '1' to indicate that the CS
order was entered via pharmacy backdoor and was not digitally signed.
12. A new field, DIRECTIONS FOR USE (#120) is being added to the PENDING
OUTPATIENT ORDERS file (#52.41) to store the raw HEALTH LEVEL SEVEN
(HL7) dosage data as sent from CPRS. This will be used to validate the
integrity (hash count) against the CPRS digitally signed orders.
13. Currently, the pending order screen displays only the number of
refills ordered by the provider. For digitally signed orders, this
is modified to include the days supply and the quantity. Here is a
screen capture:
(6) Issue Date: SEP 17,2012 (7) Fill Date: SEP 17,2012
(8) Days Supply: 45 (9) QTY ( ): 45
Provider ordered: days supply 45, quantity 45 & refills 1
(10) # of Refills: 1 (11) Routing: WINDOW
14. The protocols PSO LM ACCEPT and PSO LM RENEW MENU are being modified
to add code to the SCREEN field (#24) and the HEADER field (#26) of
Note:
the PROTOCOL file (#101) to ensure users are limited to ListMan
actions based on their security key.
15. As part of this project, Kernel patch XU*8*580 introduced the
following new fields to the NEW PERSON file (#200). Apart from the
DEA#/VA# requirement, DEA further classifies what CS schedule a
provider is authorized to write.
55.1 SCHEDULE II NARCOTIC (S), [PS3;1]
55.2 SCHEDULE II NON-NARCOTIC (S), [PS3;2]
1. A new security key named "PSDRPH", has been sent out in the Controlled
55.3 SCHEDULE III NARCOTIC (S), [PS3;3]
55.4 SCHEDULE III NON-NARCOTIC (S), [PS3;4]
55.5 SCHEDULE IV (S), [PS3;5]
55.6 SCHEDULE V (S), [PS3;6]
If any one of the above fields are populated for a provider then when
placing a new order in backdoor pharmacy, the software will now check
for the drug schedule with the provider privileges. If the provider
does not have the credentials to write such orders then the software
will display a message (as shown below) and will not allow the
Substances patch PSD*3*76, which is a required patch for this patch.
selection that provider.
Example: When the provider does not have schedule 2 privileges, this
message is displayed:
"Provider not authorized to write Federal Schedule 2 prescriptions."
16. When placing an order for a CS Detoxification drug, the software will
now check for a valid Detoxification number for the provider. If the
provider does not have a Detoxification number then the software will
display a message "Provider must have a DETOX# to order this drug."
Controlled Substances (CS) project using Public Key Infrastructure (PKI)
This key authorizes pharmacists to finish/verify a digitally signed
17. The Released and Unreleased Prescription Report [PSO RELEASE REPORT]
is being modified to include CS as a selection to the input. The drug
name and CS schedule is being added to the output. Here are the
changes:
You are currently logged in under the CHEYENNE VAM&ROC division.
Do you want to select a different division? NO//
Do you want ONLY Unreleased Prescriptions? NO//
Include (C)S Rx only, (N)on CS Rx only, or (B)oth (C/N/B): B// Controlled
Schedule II-V CS orders placed via CPRS and should be assigned to
Substances Rxs Only
Select controlled substance schedules
Select one of the following:
1 SCHEDULES I - II
2 SCHEDULES III - V
3 SCHEDULES I - V
registered pharmacists working with Schedule II-V drugs.
Select Schedule(s): 3//
The report currently shows the count of unreleased and copay
prescriptions, but not the count of released prescriptions. The report is
modified with this patch to include the count of released prescriptions.
18. The following options are being modified to include the
DETOX/MAINTENANCE ID NUMBER field (#53.11) and the DEA EXPIRATION DATE
field (#747.44) of the NEW PERSON file (#200) as part of the screen.
The DEA EXPIRATION DATE field will be prompted only if the PROVIDER
TYPE field (#53.6) of the NEW PERSON file (#200) is marked as "FEE
BASIS".
Add New Providers [PSO PROVIDER ADD]
Edit Provider [PSO PROVIDER EDIT]
View Provider [PSO PROVIDER INQUIRE]
19. Currently, the default days supply for all drugs is set from the DAYS
SUPPLY field (#3) of the RX PATIENT STATUS file (#53) up to a maximum
of 90. With this project, the default for CS schedule II-V drugs will
2. Patches PSO*7*391 and PSD*3*73 are being released in the Kernel
be set to 30 or from the DAYS SUPPLY field (#3) of the RX PATIENT
STATUS file (#53) if it is less than 30. Also, the Integration Control
Registration #3278 that returns days supply (DSUP^PSOSIGDS) to CPRS is
modified to return 30 or from the DAYS SUPPLY field (#3) of the RX
PATIENT STATUS file (#53) if it is less than 30 for CS schedule II-V
drugs.
20. The pharmacy release slip portion of the Laser Label is being
modified to include the text "(DSIG)" or "(NOT DSIG)" after the
patient's name to indicate that the prescription is digitally signed
Installation and Distribution System (KIDS) multi-build distribution
or not digitally signed.
21. This patch addresses the issue reported in REMEDY ticket #595795, to
ensure that when editing an orderable item/dispensed drug, the
instruction field is displayed only when editing the pending order
and not when editing an active or non-verified order.
22. The Expire Prescriptions [PSO EXPIRE PRESCRIPTIONS] option that
currently runs as a nightly job is being modified to check for the
Institutional DEA 'expiration date'. If the expiration date is within
CPRSV29_PSO_PSD.
30 calendar days or past expiration then a mail message will be
generated and sent to PSDMGR key holders. Here is an example when the
expiration date is within 30 days:
Subj: 500:Institutional DEA Expiration Date is about to expire [#140331]
03/20/12@11:57 3 lines
From: POSTMASTER In 'IN' basket. Page 1 *New*
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Please update Institutional DEA Certification Date. Will expire on
3/24/12.
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Here is an example when the DEA Expiration Date is past expiration date:
Subj: 500:Institutional DEA Expiration Date has expired [#140333]
03/20/12@12:08 3 lines
From: POSTMASTER In 'IN' basket. Page 1 *New*
The following modifications and enhancements are included in this patch
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Please update Institutional DEA Certification Date. Expired on 2/19/12.
**********************************
(PSO*7*391):
to satisfy requirements requested by the Drug Enforcement Administration
1. When processing a digitally signed pending order, the integrity of the
original order placed in CPRS is now being checked to ensure that the data
fields listed below are not altered from the time the order is signed in
CPRS and later selected for processing in backdoor pharmacy. This is done
by passing the data elements listed below to a Kernel Application
Programming Interface (API), Integration Control Registration (ICR) #3539,
along with the CPRS hash count, provided by ICR #5709. The Kernel API
compares these two hash values and returns an "OK" if the pending order is
unaltered or otherwise, returns a "-1^error code^error message."
(DEA).
Example: "-1^89802016^Mismatched digital signature hash values."
These are the fields used in the hash check:
Date of Issuance
Full Name and Address of the Patient
Drug Name
Quantity Prescribed
Directions for Use
Prescriber Name
The applications involved in this project along with their patch numbers
Prescriber Address (site address)
Prescriber DEA / VA Registration Number
Order Number (CPRS)
The Kernel API will also check for the validity of the DEA certificate. If
the certificate is revoked or expired then the API will return the
appropriate error code.
If the error code is related to hash mismatch or the DEA certificate is
revoked then the following events will be triggered during pending order
processing:
are listed below and the same order should be followed when installing
The order will be auto discontinued.
First line of the pending order screen will have the message "Digital
Signature Failed: Corrupted (Hash mismatch)" or "Certificate revoked"
concatenated with "Order Auto Discontinued", and the message will be
highlighted in reverse video.
The status bar of the screen will have the message "Signature Failed:
Corrupted (Hash mismatch)" or Certificate revoked."
A mail message will be generated to the holders of the PSDMGR key
notifying that the order has been auto discontinued (similar to the
example listed below).
the patches.
If the discontinuation is due to a hash mismatch as a result of altering
one of the fields listed above then the mail message will show the
altered fields with the discrepancies. Here is an example:
Subj: DIGITALLY SIGNED NEW ORDER AUTO DISCONTINUED [#196353]
03/20/12@17:1024 lines
From: POSTMASTER In 'IN' basket. Page 1 *New*
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Following order was auto discontinued when finishing a pending order
due to Corrupted (Hash mismatch) - 89802016
Division : GREELEY CLINIC
CPRS Order # : 5587651
Issue Date : MAR 7,2012
Patient : TEST,PATIENT (0908)
Address : P.O. BOX 31
LAPORTE, CA 95981
Drug : CODEINE SULFATE 60MG TAB
APPLICATION PATCH
Dosage Ordered: 120(MG)
Dosage Form : TABLETS
Quantity : 54
Provider : TEST,PROVIDER
DEA# : TA1234563
Site Address : 2360 E PERSHING BLVD
2360 East Pershing Boulevard
CHEYENNE
Differences in CPRS and Pharmacy Pending File
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