$TXT Created by ESCALERA,DIEGO at VMPDEV20.FO-BAYPINES.MED.VA.GOV (KIDS) on Thursday, 02/10/11 at 16:31 ============================================================================= Run Date: OCT 20, 2011 Designation: OR*3*329 Package : OR - ORDER ENTRY/RESULTS REPORTING Priority: Mandatory Version : 3 SEQ #295 Status: Released Compliance Date: NOV 20, 2011 ============================================================================= Associated patches: (v)OR*3*296 <<= must be installed BEFORE `OR*3*329' Subject: PROBLEM WITH ORPF AUTO UNFLAG PARAMETER AND FLAG ORDER NOTIFICATION Category: - Routine Description: ============ This patch corrects 2 issues within the ORDER ENTRY/RESULTS REPORTING package: 1. When the ORPF AUTO UNFLAG parameter is set to YES and a Provider processes the FLAG ORDER FOR CLARIFICATION notification, in certain situations other flagged orders for the patient are erroneously unflagged. 2. A flagged order recipient doesn't receive the FLAG ORDER FOR CLARIFICATION notification if another order for the same patient has just been flagged to a different Provider. ASSOCIATED NSR(s): ================== N/A ASSOCIATED REMEDY: ================== 1. HD0000000378709 - CPRS - Medication Errors PSPO #1656 2. HD0000000447412 - Flagged order recipient doesn't see alert PARTICIPATING TEST SITES: ========================= Upstate NY HCS (Albany), NY Edward Hines Jr. VA Hospital, IL Atlanta VAMC, GA Coatesville VAMC, PA REMEDY OVERVIEW: ================ 1. HD0000000378709 - CPRS - Medication Errors Problem: -------- When the ORPF AUTO UNFLAG parameter is set to YES and a Provider processes a single FLAG ORDER FOR CLARIFICATION notification, other flagged orders for the patient are erroneously unflagged. When a patient has multiple orders flagged to different Providers and one of the Providers processes his displayed FLAG ORDER FOR CLARIFICATION notification, the orders tab opens to the Orders View 'All Services, Flagged'. Only the orders flagged to this Provider are displayed. When the Provider refreshed the patient information or selects a new patient, the flagged orders that were displayed are automatically unflagged. The problem is that ALL of the patient's flagged orders are being unflagged, not just the ones assigned to this Provider. The other Providers that had this patient's orders flagged to them still have the FLAG ORDER FOR CLARIFICATION notification, but when they select and process the notification no orders display in the Orders View "All Services, Flagged", since none of the patient's orders are still flagged. Resolution: ----------- When the ORPF AUTO UNFLAG parameter is set to YES and a Provider processes a FLAG ORDER FOR CLARIFICATION notification, only the orders that displayed in the Orders View 'All Services, Flagged' for that provider will be auto unflagged. 2. HD0000000447412 - Flagged order recipient doesn't see alert Background: ----------- When the MESSGAGE TYPE (#.04) field in the OE/RR NOTIFICATION (#100.9) FILE contains the value 'NOT', notifications are not generated if the same notification has already been generated for the patient in the same minute. The rationale is that we do not want to display two notifications with same date, time and message. The exception to this rule is that two orders with different ordering providers will generate separate notifications because the notifications potentially have different recipients. Problem: -------- The OE/RR Notification "FLAG ORDER FOR CLARIFICATION" differs from other 'NOT' message types in that the user can select a recipient in addition to the Primary Care Provider (PCP) or Ordering provider. If the user flags two orders for different recipients within the same minute and both orders have the same ordering provider, then the second notification (meant for recipient B) will not be generated; and recipient B will not receive the expected "FLAG ORDER FOR CLARIFICATION" notification. Resolution: ----------- A flagged order notification will now be generated if the successive recipient is different from the recipient flagged for the prior order that was just flagged. The Informatics Patient Safety office has recognized that patch OR*3*329 corrects the unflagging problem warned about with Patient Safety Alert (PSA) AL10-12 distributed June 30, 2010. PSA AL10-12 instructed VA facilities to set the ORPF AUTO UNFLAG parameter value to NO. After installing patch OR*3*329, PSA AL10-12 is no longer effective and sites can set parameter ORPF AUTO UNFLAG to YES if so desired. - If the ORPF AUTO UNFLAG = YES: When a user processes a flagged order(s) alert, all the orders flagged for that provider (for the specified patient) will be automatically unflagged. Orders flagged to other providers (for the same patient) will not be unflagged. - If the ORPF AUTO UNFLAG = NO: When a user processes a flagged order(s) alert, no orders are unflagged. The alert remains until the user manually unflags all orders belonging to him or her (for the specified patient). INSTALLATION INSTRUCTIONS ========================= This patch can be loaded with users in the system but it is recommended that it be installed when user activity is low. Installation time will be less than 2 minutes. 1. Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. Start up the Kernel Installation and Distribution System Menu [XPD MAIN]: Edits and Distribution ... Utilities ... Installation ... Select Kernel Installation & Distribution System Option: Installation --- 1 Load a Distribution 2 Verify Checksums in Transport Global 3 Print Transport Global 4 Compare Transport Global to Current System 5 Backup a Transport Global 6 Install Package(s) Restart Install of Package(s) Unload a Distribution 3. From this menu, you may elect to use the following options (When prompted for the INSTALL NAME, enter OR*3.0*329): 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*329. a. When prompted "Want KIDS to INHIBIT LOGONs during the install? NO//", answer NO. b. When prompted "Want to DISABLE Scheduled Options and Menu Options and Protocols? NO//", answer NO. 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 8 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ORB31 Before: B31957768 After: B34930090 **6,31,88,105,139,173,220,215,329** Routine Name: ORWORB Before: B69468448 After: B72691529 **10,85,116,148,173,190,215, 243,296,329** Routine list of preceding patches: 296 ============================================================================= User Information: Entered By : ESCALERA,DIEGO Date Entered : MAR 17, 2010 Completed By: HULET,LEE ANN Date Completed: OCT 17, 2011 Released By : SCHMIT,BECKY Date Released : OCT 20, 2011 ============================================================================= Packman Mail Message: ===================== $END TXT