$TXT Created by THOMPSON,SETH at DAYT17.FO-BAYPINES.MED.VA.GOV (KIDS) on Tuesday, 11/02/10 at 11:40 ============================================================================= Run Date: JAN 07, 2011 Designation: OR*3*336 Package : OR - ORDER ENTRY/RESULTS REPORTING Priority: Mandatory Version : 3 SEQ #284 Status: Released Compliance Date: FEB 07, 2011 ============================================================================= Associated patches: (v)OR*3*243 <<= must be installed BEFORE `OR*3*336' Subject: AUDIOCARE RENEWAL Category: - Routine Description: ============ This patch is a replacement patch for OR*3*290, which has been entered in error. If you installed OR*3*290 successfully, do not uninstall it. Whether you have installed OR*3*290 successfully or not, you will need to install OR*3*336. There is no replacement patch for PSO*7*328 or the VEXRX routines. This patch addresses a site reported problem where a narcotic order replaced an audiology consult order in the ORDERS file (#100). Associated Remedy: ================== HD0000000296920 Unexpected narcotic order found in OERR for a patient Associated NSR(s): ================== N/A Test Sites: =========== North Chicago VA Medical Center, IL Oklahoma City VA Medical Center , OK VA Puget Sound HCS, WA Tomah VA Medical Center, WI Southern Arizona VA Health Care System, AZ Ralph H. Johnson VA Medical Center - Charleston, SC Chalmers P. Wylie VA OPC - Columbus, OH Overview: ========= Problem: -------- An unexpected narcotic order was found in Order Entry/Results Reporting (OERR) for a patient. Upon examination of the affected order in file #100 (ORDERS) it was discovered that one patient's Audiology consult order had been overwritten by a different patient's Outpatient controlled drug order. The Outpatient order was a prescription renewal order generated by the AudioCARE AudioRENEWAL function. The class III code which performs the renewal process was not getting the assigned order number for the renewal the same way that Computerized Patient Records System (CPRS) does, causing the overwrite. This problem is tracked by Patient Safety PSPO #1218. The AudioCARE AudioRENEWAL Module was de-activated by all 43 locations on Jan.16, 2009 to prevent the problem from occurring. Resolution: ----------- A new Class I interface has been written so the AudioCARE AudioRENEWAL process can obtain the assigned order number the same way that Computerized Patient Records System (CPRS) does. Patch OR*3*336 installs the new interface. In order to implement the new interface, modifications to the renewal code in the Class III routine VEXRX were necessary. The refill code of the VEXRX routine was not affected. The AudioRENEWAL process will now use a standard CPRS Application Programming Interface (API) to perform the renewal. This new Class I interface has been written in such a way that other renewal systems will be able to utilize the same API to renew Outpatient prescriptions. However, other renewal systems have not been tested using this software. OR*3*336 introduces the new mail group, AUTORENEWAL. Messages to this group will contain information about prescription renewals that could not be automatically processed. For example: a lock on the order failed, or the CPRS order number is missing from the PRESCRIPTION file (#52). A new parameter has been added: OR AUTORENEWAL USER. The auto renewal process uses a proxy user to be the 'entered by' person in the ORDERS (#100) file. This parameter defines that user. Sites previously using the renewal function may already have USER,AUDIOCARE PHONE set up for renewals. If not, set up a proxy user such as "RENEWAL,AUTO" in the NEW PERSON (#200) file to place in the new parameter. A new notification is being released with this patch: OP RX RENEWAL REQUEST. This notification is exported with package parameter values set as follows: . ORB ARCHIVE PERIOD - 30 . ORB DELETE MECHANISM - All Recipients . ORB FORWARD BACKUP REVIEWER - No . ORB FORWARD SUPERVISOR - No . ORB FORWARD SURROGATES - No . ORB PROCESSING FLAG - Disabled . ORB PROVIDER RECIPIENTS - Ordering Provider, Attending, Primary and Teams (OAPT) . ORB URGENCY - High ***Important Note*** Notifications are processed by IEN (internal entry number) from the OE/RR NOTIFICATIONS file (100.9). Any site-defined notifications run the risk of being over-written by new notifications that are nationally released. If you have locally defined notifications, you may need to renumber them before this patch will install. Specifically, IEN #73 is being added. Documentation Retrieval: ======================== An updated CPRS Technical Manual, CPRS GUI Technical Manual, and a combined Release Notes/Installation Guide will be distributed with OR*3*336. The documents are 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.med.va.gov, 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.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov The documentation distribution includes: FILE NAMES DESCRIPTION FORMAT PSO_7_P328_IG.pdf Release Notes and Installation BINARY Guide - AudioCARE Renewal CPRSLMTM.pdf CPRS Technical Manual BINARY CPRSGUITM.pdf CPRS GUI Technical Manual BINARY (3) Documentation can also be retrieved from VHA Software Document Library (VDL) on the Internet at the following address, http://www.va.gov/vdl. Installation Instructions: ========================== All sites are expected to install OR*3*336 to their production Vista system, even if they are not currently using AudioCARE applications. This installation does not change the functionality of CPRS or Outpatient Pharmacy applications. For the renewal process to be fully functional using the new Class I interface sites licensed to run the AudioRENEWAL Module must install the following patches: PSO*7*328 OUTPATIENT PHARMACY OR*3*336 ORDER ENTRY/RESULTS REPORTING PSO*7*328 is an information only patch that explains how to download the updated routine VEXRX (Class III refill). The updated VEXRX should be installed prior to installing OR*3*336 at all sites using AudioCARE applications, even if they are not using the AUDIORENEWAL module. Note: If you have already installed the updated VEXRX routine from PSO*7*328, then you do not need to install it again. The VEXRX routine has not changed since the release of PSO*7*328. ENVIRONMENT CHECK: OR*3*336 contains an environment check that looks for the renewal version of VEXRX that was being used when the problem was reported in January 2009. If the January 2009 renewal version of VEXRX is found, the installation of OR*3*336 aborts. If this occurs retrieve and install the correct VEXRX routine, then use the 'Restart Install of Package(s)' option to complete the OR*3*336 patch installation. For sites not using AudioCARE refill or renewal, the pre-environment checks will be skipped if the Class III VEXRX routine is not in the system. ***Before installing patch OR*3*336, consult with the Pharmacy staff to determine the appropriate person to coordinate the membership for the AUTORENEWAL mail group used in the renewal process. Messages to this group will contain information on renewals not sent to providers and processed record count totals.*** Below is a step-by-step procedure for installing OR*3*336. This patch can be installed with users in the system. However, no AudioCARE processing should take place during the installation. Processing during installation may result in a system error. Installation will take less than five minutes. Suggested time to install: non-peak requirement hours. 1. Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. NOTE: If patch OR*3*290 was not installed routines ORAREN and ORY290 will not exist before installing OR*3*336. If you have installed patch OR*3*290, which has now been marked entered in error, the "before" checksums for ORAREN and ORY290 will match the "before" checksum in the Routine Information section of this patch, OR*3*336. Both routines have been modified by this patch and the "after" checksum should match what is provided in this patch description. Do not uninstall patch OR*3*290. 2. Start up the Kernel Installation and Distribution System Menu [XPD MAIN] and select Installation. 3. From the Installation menu, you may select to use the following options (When prompted for the INSTALL NAME, enter OR*3.0*336): a. Backup a Transport Global - This option will create a backup message of any routines exported with this patch. It will not backup any other changes such as DD's or templates. b. Compare Transport Global to Current System - This option will allow you to view all changes that will be made when this patch is installed. It compares all components of this patch (routines, DD's, templates, etc.). c. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. 4. Use the Install Package(s) option and select the package OR*3.0*336 5. When prompted 'Enter the Coordinator for Mail Group 'AUTORENEWAL', answer with the name of the person provided by Pharmacy that will be responsible for coordinating the members of this mail group. 6. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', respond NO. 7. When prompted 'Want to DISABLE Scheduled Options and Menu Options and Protocols? NO//', respond NO. 8. After patch installation completes sites can manually delete the post-install routine ORY290. IMPORTANT NOTE: If this site is NOT using the AudioRENEWAL Module, your installation is complete. Post-Installation Instructions: =============================== This section is only for sites licensed to use the AudioRENEWAL Module. The purpose of this section is to provide information for consideration after routine VEXRX and patch OR*3*336 are installed. IRM, Pharmacy, and Providers should work together to completed this section and monitor renewal activity. Refer to the Release Notes/Installation Guide for additional information about the steps below. 1. Assign members to the AUTORENEWAL mail group using the option Mail Group Edit [XMEDITMG]. 2. If necessary, set up the proxy user in the NEW PERSON (#200) file for filing renewal requests. Sites may already have USER,AUDIOCARE PHONE set up for renewals. This is the user that will be the 'entered by' person in CPRS for the automatic renewal orders. No menu options, person classes, or keys need to be added to this user. 3. Edit the parameter OR AUTORENEWAL USER and enter the proxy user defined in step 2. 4. Review the settings for the notification OP RX RENEWAL REQUEST very closely and determine the settings which are most appropriate for your usage of AudioRENEWAL. If your site elects to use this new notification, level changes can be made for system, division, location, service, team(OE/RR), or user entities. Do not edit the exported package level parameter settings. 5. If using the new notification OP RX RENEWAL REQUEST, enable the notification using the option Enable/Disable Notifications [ORB3 PROCESSING FLAG] at the appropriate hierarchy level for your usage. 6. Update AudioRENEWAL Clinic List on the AudioCARE server. 7. Reactivate the AudioRENEWAL Module on the AudioCARE server. 8. Notify Pharmacy, Providers, and Nurses that AudioRENEWAL has been reactivated and who to contact for problems. After running the option to process refills/renewals: 9. Confirm that the AUTORENEWAL mail group is receiving expected messages. 10. Confirm that the View Alerts and Notifications are occurring as expected for non-renewal drugs (if enabled) and signature requests. 11. Verify the Refill Count report (Mailman message). Routine Information: ==================== The second line of each of these routines now looks like: ;;3.0;ORDER ENTRY/RESULTS REPORTING;**[Patch List]**;Dec 17, 1997;Build 24 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ORAREN Before: B24271399 After: B23956192 **336** Routine Name: ORY290 Before: B5117347 After: B5259457 **336** ============================================================================= User Information: Entered By : THOMPSON,SETH Date Entered : JUL 27, 2010 Completed By: HULET,LEE ANN Date Completed: DEC 13, 2010 Released By : PASTERNOCK,JOY Date Released : JAN 07, 2011 ============================================================================= Packman Mail Message: ===================== $END TXT