============================================================================= Run Date: JUN 10, 2013 Designation: OR*3*306 Package : OR - ORDER ENTRY/RESULTS REPORTING Priority: Mandatory Version : 3 SEQ #317 Status: Released Compliance Date: NOV 04, 2013 ============================================================================= Associated patches: (v)OR*3*181 <<= must be installed BEFORE `OR*3*306' (v)OR*3*204 <<= must be installed BEFORE `OR*3*306' (v)GMPL*2*36 <<= must be installed BEFORE `OR*3*306' (v)HDI*1*11 <<= must be installed BEFORE `OR*3*306' (v)LEX*2*58 <<= must be installed BEFORE `OR*3*306' (v)XU*8*502 <<= must be installed BEFORE `OR*3*306' (v)OR*3*331 <<= must be installed BEFORE `OR*3*306' (v)OR*3*340 <<= must be installed BEFORE `OR*3*306' (v)MHV*1*9 <<= must be installed BEFORE `OR*3*306' (v)PSO*7*391 <<= must be installed BEFORE `OR*3*306' Subject: CPRS v29 Category: - Routine - Enhancement (Mandatory) Description: ============ The Computerized Patient Record System (CPRS) Graphical User Interface (GUI) v29 is an enhancement release with modifications for the Drug Enforcement Agency (DEA) electronic prescribing (ePCS) of controlled substances, Problem List changes for the use of SNOMED CT codes, and the display of Mental Health Treatment Coordinator information entered through the Primary Care Management Module. In addition to these enhancements, software changes are being made to correct several Patient Safety Issues (PSIs), Section 508 issues, and additional miscellaneous defect fixes. CPRS GUI v29 consists of several host files, an updated CPRS GUI and several Help files, too many to list (which will be located in a single directory name HELP): HDI_1_11.KID which contains the HDI*1*11 patch PSS_1_166.KID which contains the PSS*1*166 patch CPRSV29_PSO_PSD.KID which contains the PSO*7*391 and PSD*3*73 patches OR_GMPL_GMTS_XU_29.KID which contains the XU*8*609, GMPL*2*36, GMTS*2.7*86 and OR*3*306 patches CPRSChart.exe OR_30_371.KID which contains the OR*3*371 patch PSO_7_426.KID which contains the PSO*7*426 patch The host files were created to simplify installation and control the phased implementation of CPRS v29 at the Veterans Health Administration (VHA) facilities. To see the current status and target dates for Sites/VISN/Regions please refer to the following site: http://vaww.oed.portal.va.gov/projects/CPRS/v29_main/Public/Forms/AllItems .aspx Click on the CPRS GUI v29 Deployment Schedule folder. Then open the document "CPRS GUI v29 Deployment Schedule.xslx". Patch Information: ================== HDI*1*11 supports CPRS v29 functionality by adding data for the Problem List Domain to the HDIS DOMAIN file (#7115.1). PSS*1*166, PSD*3*73 and PSO*7*391 support the DEA ePCS functionality. GMPL*2*36 is an extension to accommodate SNOMED-CT GMTS*2.7*86 supports the Problem List Standardization XU*8*609 ePCS Support OR*3*306 New CPRS version 29 which contains several Remedy ticket fixes and enhanced the Primary Care button by adding the Mental Health Treatment Coordinator and the Associate Provider. Adds a new Bulletin "OR PROBLEM NTRT BULLETIN" and reissues Mail Group OR CACS. By default, this bulletin will be delivered to the OR CACS Mail Group. It may be configured to be delivered to separate local mail groups for each Medical Center Division by setting the new OR PROBLEM NTRT BY DIVISION parameter. The bulletin informs its recipients that a new NTRT Request has been initiated by a Clinician at their facility. OR*3*371 includes support for CPRS v29 - ePCS and encounters. PSO*7*426 ePCS Support Associated Remedy ticket(s): ============================ HD0000000069944 HD0000000070892 HD0000000266396 HD0000000276744 HD0000000278019 HD0000000325209 HD0000000328643 HD0000000334617 HD0000000360890 HD0000000385673 HD0000000396719 HD0000000417043 HD0000000429709 HD0000000437940 HD0000000444275 HD0000000478780 HD0000000483700 HD0000000486375 HD0000000486635 HD0000000486696 HD0000000499883 HD0000000516561 HD0000000581482 Associated NSR(s): ================== N/A Test Sites: =========== Charleston, SC Cleveland, OH Heartland East HCS, MO Heartland West HCS, KS Hines, IL Loma Linda, CA Palo Alto HCS, CA San Diego HCS, CA Tampa, FL Remedy Overview: ================ 1. No Remedy Ticket - MHTC for Same Button_Associate Provider Problem: ======== When the CPRS Workgroup reviewed the Primary Care button, it was decided that the Mental Health Treatment Coordinator and the Associate Provider should be on the button. But it was also felt that the location of the Associate Provider on the button could be confusing to providers and they might misinterpret what it meant. Resolution: =========== Following the recommendation from the workgroup, the layout of the information on the button was changed to be clearer, as follows: . Top line: Primary Care Team / Primary Care Provider / Associate Primary Care Provider (if assigned) . Second line (if patient is an inpatient): Inpatient Attending / Inpatient Provider . Third line: Mental Health Treatment Coordinator (if assigned) 2. HD0000000069944 - Problem list - SC vs. NSC vs. Unknown Problem: ======== There was an inconsistency between the designation of service connection and treatment factors on the Problems Tab and the signature dialogs. On the Problems tab, the user was presented with a single check box to indicate Yes or No. If left blank, CPRS interpreted the blank as a No. On the signature dialogs, however, the same information had two check boxes, one for Yes and one for No. If neither was checked, CPRS interpreted this as Unknown. Resolution: =========== CPRS developers changed the Problems tab so that it now has two check boxes for Yes and No and the system will now accept a blank entry for both as Unknown. 3. HD0000000070892 - Details of Old Orders Problem: ======== For orders prior to the install of the first CPRS GUI release, users are receiving a message "Detail view is not available for selected order". Resolution: =========== CPRS developers corrected the problem. 4. HD0000000266396 - ORWCH BOUNDS Question Problem: ======== Some dialogs were not saving their position nor size in the ORWCH BOUNDS parameter as they should. Therefore, when changing the size of a dialog and then closing the session and reopening, the dialog returned to its default size. Resolution: =========== CPRS developers corrected the problem and the dialogs should appropriately retain their size from session to session in CPRS. 5. HD0000000276744 - Quick Order Quantity Quandary with Decimal Point Problem: ======== When the user entered a quick order with a fractional value and Auto-verify was set to YES, CPRS gave an Invalid Integer Error. Resolution: =========== CPRS developers corrected this problem and fractional values can be entered. 6. HD0000000278019 - Free-Text Dosage Display in Patient Instructions/SIG Problem: ======== When a provider entered a free-text dosage rather than picking one from the drop-down list, the text displayed in the Patient Instructions/SIG and order details in CPRS. It was assumed that this might be dangerous as the patients could misunderstand the dose they were to take-especially if the dosage contained a concentration for a medication such as insulin. Resolution: =========== Corrected the display. 7. HD0000000325209 - Cannot Do Chart Check on DC'd Entered in Error Orders Problem: ======== CPRS would allow verification of discontinued orders, but it did not allow 24-hour chart check. Resolution: =========== CPRS developers corrected this problem. 8. HD0000000328643 - Rx Patient Status Field Works Erratically Problem: ======== Outpatient prescription fields do not display consistently in CPRS. Resolution: =========== CPRS developers made some corrections to the file to make it function correctly. 9. HD0000000334617 - Attempting to Copy to a New Order Resulting in a GUI Error Problem: ======== When attempting an action on an order with more than 9 actions, the user would get an error that read, "NUMBER' is not a valid integer" (where NUMBER was something like 12621991). Resolution: =========== CPRS developers corrected the problem. 10. HD0000000360890 - Problem in CPRS causing error in Lab Problem: ======== Error in Lab which originates with an issue with Lab urgency in CPRS. Resolution: =========== CPRS developers corrected this problem. 11. HD0000000385673 - Complex Dose Different than Single Dose Problem: ======== The dosage for a simple versus complex order for the same medication could result in getting a different dosage. For example, the simple dose might be a 40 mg tablet, which the complex might use an 80 mg tablet and use half-tablets for part of the complex dose. Resolution: =========== Developers corrected this problem. If the single tablet is better, that dose will be used. 12. HD0000000396719 - Error Local Dosage Field Translation Problem: ======== The translation for local dosages was not working correctly. Resolution: =========== CPRS developers changed the translation so that instead of 1.2 being put in the instructions as "1.2 tablets", it will now read "one and .2 tablets". This is the correct translation. 13. HD0000000417043 - Cytopathology report that printed with the wrong Veteran's name in the header Problem: ======== If the user was on a patient's record and had viewed a report and then processed an alert for a different veteran's results and then tried to print the Most Recent report, CPRS printed the report incorrectly. The information was for the second patient while the header was for the first patient. Resolution: =========== Printing from the Most Recent display was disabled. It should not have been allowed. 14. HD0000000429709 - Double-Clicking an Order via the Order Menu Will Create Two Order Dialogs Problem: ======== Rapidly double-clicking on an order menu item could bring up multiple dialogs. In the reported case, double-clicking on an inpatient medications item instead brought up two outpatient medication dialogs. Resolution: =========== CPRS developers corrected this problem. 15. HD0000000437940 - Wrong Location Dialog Box Displays when a Provider Tries to Renew Problem: ======== When a provider tries to sign the renewal orders sent from AudioRenewal, they get print location box. They should get Provider & Location for Current Activities. Resolution: =========== CPRS developers corrected this problem. The correct dialog now displays. 16. HD0000000444275 - User Is Being Prompted to Sign DC'd Order that Was Cancelled Problem: ======== Previously, cancelling orders caused problems with both order checks and the signature dialog. Resolution: =========== CPRS developers corrected this problem. If you cancel an order on the signature dialog the order checks will update and the order will no longer display again to be signed on the signature dialog after it has been cancelled. 17. HD0000000478780 - Cannot Focus a Disabled or Invisible Window Error Msg Appears when Clicking on an Appt on the Cover Sheet Problem: ======== Cannot Focus a Disabled or Invisible Window Error Msg Appears when Clicking on an Appt on the Cover Sheet Resolution: =========== CPRS developers corrected this problem. 18. HD0000000483700 - Force CPRS to Always Use MH DLL to Resolve Reminders Problem: ======== The Mental Health team requested that CPRS be changed to always use the new Mental Health dll when resolving a mental-health related reminder. Resolution: =========== CPRS developers now force reminders to use the Mental Health DLL to resolve reminders. If the MH DLL is not available, CPRS will not proceed. 19. HD0000000486375 - RDI Currently Uses a Truncated, 10-Digit Version of the ICN in Its Calls to HDR Problem: ======== RDI Currently Uses a Truncated, 10-Digit Version of the ICN in Its Calls to HDR Resolution: =========== CPRS developers changed Remote Data Interoperability to use the full identifier rather than a truncated one. 20. HD0000000486635 - Note Label Disappearing Problem: ======== The line that displays how many notes have been entered for the patient disappeared when the user selected the New Note button. Resolution: =========== CPRS developers corrected this problem. The number of notes for the patient will display above the Notes tree view display. 21. HD0000000486696 - Cannot Edit Notes for Reminder Dialogs Problem: ======== Users were unable to edit notes for reminder dialogs using the template editor. When importing a Clinical Reminder Dialog Template into Shared Templates the Show Template Notes did not display. Resolution: =========== CPRS developers corrected this problem. 22. HD0000000499883 - Free-Text Results "Collide" When Graphing Multiple Lab Tests Problem: ======== Under a specific set of circumstances, it was possible for the lab test free-text result from one lab test to incorrectly be displayed as the result in another test. The following conditions were necessary to produce this error: . Multiple lab tests must be selected. . At least two of these lab tests must have values that are free-text. . The values must be different. . The graphs must be separate (Individual Graphs checked). . One of the lab tests with a free-text value must be the very top item in the Items list. Resolution: =========== Developers corrected this issue. The entries should now read correctly. 23. HD0000000516561 - Another Person Editing Orders Problem: ======== In CPRS 28, when a user entered an allergy from the Orders tab, CPRS locked ordering for the selected patient until the entire CPRS session was closed-even if the user changed patients in the original session, the lock remained until the session was completely closed. A user in a different session could not order anything on the locked patient until the first session was closed. This problem did not occur if the allergy was entered from the Cover Sheet, only from the Orders tab. Resolution: =========== CPRS developers corrected this problem. The lock should be released as soon as the provider is done placing orders, including allergies, on the Orders tab. 24. HD0000000581482 - Allergy Issue - Observed entries set to default value MODERATE Problem: ======== CPRS Observed allergies defaulted to the Severity of Moderate. Because users could accept the default without making a conscious decision about severity, there could be a potential risk of using a medication that is listed with an existing Adverse Reaction (ADR)/Allergy, but with an unexpected level of reaction. This could delay treatment of lifesaving medication because the severity is rated higher than it should be, or it could cause the clinician to give a medication that causes a severe reaction when only a moderate reaction was expected. Resolution: =========== Developers changed the default for all observed ADR/Allergy entries to be BLANK (NULL), and CPRS now requires the user to select an ADR severity (Mild/Moderate/Severe). Patch Components ================ Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- OE/RR NOTIFICATION (#100.9)no field, sending data for new notification ORDER DIALOG (#101.41) no field - sending new dialog ORDER DEA ARCHIVE INFO all fields New Forms Associated: Form Name File # New/Modified/Deleted --------- ------ -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- OR CACS Modified Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- OR CPRS GUI CHART Broker Modified OR EPCS CS RX BY PROVIDER Run Routine New Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- ORES Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Documentation and Software Retrieval: ===================================== The following documents can be downloaded from the FTP address as directed by the CPRS Implementation team. The updated documentation associated with this patch is: File Name Contents --------- -------- CPRSGUITM.DOC CPRS GUI Technical Manual (Word version) CPRSGUITM.PDF CPRS GUI Technical Manual CPRSGUIUM.DOC CPRS GUI User Manual (Word version) CPRSGUIUM.PDF CPRS GUI User Manual CPRSLMTM.DOC CPRS LM Technical Manual (Word version) CPRSLMTM.PDF CPRS LM Technical Manual OR_30_306_IG.DOC CPRS GUI v.29 and Associated Patches Installation Guide (Word Version) OR_30_306_IG.PDF CPRS GUI v.29 and Associated Patches Installation Guide OR_30_306_RN.DOC CPRS GUI V29 Release Notes (Word Version) OR_30_306_RN.PDF CPRS GUI V29 Release Notes OR_30_306_SRC.ZIP CPRSChart Source Binary CPRS documentation can also be found in the VA Software Document Library: http://www.va.gov/vdl. Software Retrieval and Installation Instructions: ================================================= Please refer to the "CPRS GUI v.29 Installation Guide" for installation and set-up information. This document is exported as OR_30_306IG.doc and OR_30_306IG.pdf and is included in OR_30_306.ZIP Installation of these host files must be coordinated among the personnel affected because these host files will be installed in one installation session. Sites will retrieve VistA software from an FTP address as directed by the CPRS Implementation team. Installation instructions will be distributed when your site begins the implementation process. The software distribution includes: File Name Contents Retrieval Format --------- -------- ---------------- OR_30_306.ZIP CPRSCHART.EXE Binary CPRS.CNT CPRS.HLP Documentation files listed above OR_30_306_SRC.ZIP CPRS v29 Source Binary OR_GMPL_GMTS_XU_29.KID KIDS Builds Ascii HDI_1_11.KID KIDS Build Ascii OR_39_372.KID KIDS Build Ascii PSO_7_426.KID KIDS Build Ascii PSS_1_166.KID KIDS Build Ascii 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 43 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: OR3CONV Routine Name: OR3CONV1 Routine Name: ORCACT0 Before: B58407841 After: B64282861 **7,27,48,72,86,92,94,141,165, 177,173,190,215,243,289,204, 306** Routine Name: ORCACT01 Before: B66127888 After: B73162250 **94,116,134,141,163,187,190, 213,243,306** Routine Name: ORCHTAB2 Before: B22410347 After: B22057058 **27,58,181,306** Routine Name: ORCMED Before: B41444759 After: B52490414 **4,7,38,48,94,141,178,190,195, 243,306** Routine Name: ORCSAVE Before: B92624396 After: B93570621 **7,56,70,73,92,94,116,141,163, 187,190,195,243,303,293,280, 306** Routine Name: ORCXPND1 Before: B77575358 After: B82803363 **26,67,75,89,92,94,148,159, 188,172,215,243,280,340,306** Routine Name: ORCXPND4 Before: B16971380 After: B27943000 **67,306** Routine Name: ORDEA Before: n/a After: B85981983 **306** Routine Name: ORDEAAUD Before: n/a After: B166040 **306** Routine Name: ORDV04 Before: B57992153 After: B74664100 **109,148,160,208,195,241,215, 274,256,243,306** Routine Name: ORMPS Before: B79586894 After: B82154291 **3,54,62,86,92,94,116,138,152, 141,165,149,213,195,243,306** Routine Name: ORQQPL Before: B17756509 After: B25909130 **9,10,85,173,306** Routine Name: ORQQPL1 Before: B62165510 After: B77752949 **10,85,148,173,203,206,249, 243,280,306** Routine Name: ORQQPL2 Before: B22211060 After: B35231801 **10,306** Routine Name: ORQQPL3 Before: B54712722 After: B52966029 **10,148,173,243,280,306** Routine Name: ORQQPL4 Before: n/a After: B10666256 **306** Routine Name: ORQQPXRM Before: B18382115 After: B16643774 **10,85,116,173,187,190,215,243,306** Routine Name: ORRDI1 Before:B113020386 After:B113704699 **232,294,306** Routine Name: ORWDCN32 Before: B17224910 After: B19324752 **10,85,306** Routine Name: ORWDPS1 Before: B49131928 After: B56868000 **85,132,141,163,215,255,243,306** Routine Name: ORWDX Before: B66882759 After: B66876839 **10,85,125,131,132,141,164, 178,187,190,195,215,246,243, 283,296,280,306** Routine Name: ORWDXA Before: B82710229 After: B82710229 **10,85,116,132,148,141,149, 187,213,195,215,243,280,306** Routine Name: ORWDXR Before: B54764735 After: B54765656 **10,85,125,131,134,141,149, 187,190,213,243,331,306** Routine Name: ORWOR Before: B42185290 After: B50635965 **10,85,132,141,163,187,190, 215,243,307,330,280,347,306** Routine Name: ORWOR1 Before: B21551426 After: B26597352 **132,141,163,306** Routine Name: ORWORR Before: B67327939 After: B76813647 **10,92,116,110,132,141,163, 189,195,215,243,280,306** Routine Name: ORWPCE Before: B60867098 After: B53783465 **10,85,116,173,190,195,215, 243,295,280,306** Routine Name: ORWPCE1 Before: B63538675 After: B67787627 **10,85,116,132,148,187,190, 215,243,280,306** Routine Name: ORWPCE2 Before: B49058348 After: B50908533 **10,85,109,116,173,195,243,306** Routine Name: ORWPCE3 Before: B43187706 After: B55452326 **10,85,116,190,280,306** Routine Name: ORWPCE4 Before: n/a After: B12891193 **10,85,116,173,190,195,215, 243,295,280,306** Routine Name: ORWPT Before: B60483737 After: B63799384 **10,85,132,149,206,187,190, 215,243,280,306** Routine Name: ORWPT1 Before: B19631349 After: B25961923 **10,109,280,340,306** Routine Name: ORY306 Before: n/a After:B144132481 **306** Routine Name: ORY3060 Before: n/a After: B15649990 **306** Routine Name: ORY30601 Before: n/a After: B71971190 **306** Routine Name: ORY30602 Before: n/a After: B78115782 **306** Routine Name: ORY30603 Before: n/a After: B84895361 **306** Routine Name: ORY30604 Before: n/a After: B59036369 **306** Routine Name: ORY30605 Before: n/a After: B67798372 **306** Routine Name: ORY30606 Before: n/a After: B65314465 **306** Routine Name: ORY30607 Before: n/a After: B10957549 **306** Routine Name: ORY3061 Before: n/a After: B40551451 **306** Routine Name: ORY3062 Before: n/a After: B26766778 **306** Routine Name: ORY3063 Before: n/a After: B12996430 **306** Routine Name: ORY3064 Before: n/a After: B13526334 **306** Routine Name: ORY306ES Before: n/a After: B12634847 **306** Routine Name: ORY306PR Before: n/a After: B2637944 **306** Routine Name: ORYCHKE Before: B2490043 After: B2490043 **280,306** Routine list of preceding patches: 181, 204, 294, 331, 340, 347 ============================================================================= User Information: Entered By : LEYVA,KATHRYN Date Entered : DEC 02, 2008 Completed By: BARLOW,KENNETH Date Completed: JUN 10, 2013 Released By : SCHMIT,BECKY Date Released : JUN 10, 2013 ============================================================================= Packman Mail Message: ===================== No routines included