$TXT Created by AUGUSTINIAK,MARK at MNTVBB.FO-ALBANY.DOMAIN.EXT (KIDS) on Wednesday, 08/15/12 at 16:15 ============================================================================= Run Date: SEP 03, 2013 Designation: OR*3*363 Package : OR - ORDER ENTRY/RESULTS REPORTING Priority: Mandatory Version : 3 SEQ #321 Status: Released Compliance Date: OCT 04, 2013 ============================================================================= Associated patches: (v)OR*3*268 <<= must be installed BEFORE `OR*3*363' (v)OR*3*280 <<= must be installed BEFORE `OR*3*363' Subject: DISPENSE DRUG ISSUES,COMPLEX ORDER ISSUE Category: - Routine Description: ============ This patch will resolve the following issues in the Computerized Patient Record System (CPRS) package: 1. If the dispensed drug is changed when an inpatient medication order is finished by pharmacy there may be no indication visible on the CPRS Order Tab View Orders or Meds tab that a change has been made. The new drug is only displayed in the "Dispensed Drug" text of the order detail. 2. Remove routine created by OR*3*268. 3. If pharmacy changes the drug while processing an outpatient medication order there may be no indication visible on the CPRS Order Tab View Orders view or Meds tab that a change has been made. The new drug is only displayed in the "Dispensed Drug" text of the order detail. 4. Large complex outpatient orders erroneously indicate a change has been made by pharmacy when viewed on the CPRS Order Tab View Orders when no change was actually made. ASSOCIATED REMEDY: ================== 1. HD0000000102172 - RENEWAL ORDER PRINTING WRONG DISPENSE DRUG PSPO #205 Duplicate: HD0000000711874 PSPO #2260 2. HD0000000258432 - Need to remove routine created in OR*3*268 3. HD0000000618076 - MIS-MATCH BETWEEN ORDER TAB CPRS AND ACTUAL SIG PSPO #2250 Duplicates: HD0000000398679 HD0000000710861 HD0000000800113 PSPO #2364 4. HD0000000735586 - Canceling a complex order change creates an unwanted action in CPRS PARTICIPATING TEST SITES: ======================== Upstate NY HCS (Albany, Buffalo) NY Mountain Home VAMC, TN VA Salt Lake City HCS, UT Orlando VAMC, FL Cleveland VAMC, OH REMEDY OVERVIEW: ================ 1. HD0000000102172 -RENEWAL ORDER PRINTING WRONG DISPENSE DRUG Patient Safety Issue: PSPO #205 Problem: -------- When pharmacy [PSJ OE] changes the dispensed drug of an inpatient medication order, and no other fields are changed, this edit may not be recognized by the order entry software as a service correction or change to the order when viewed again in CPRS. This problem is most noticeable with medications dispensed as inhalants or drops. The dispensed drug entered by pharmacy displays in the CPRS order detail view in the "Dispensed Drugs (units/dose):" field, but without a change indicator to prompt the user to view the order detail, this information could be missed and patients could receive incorrect doses. Resolution: ----------- Routine ORMPS2 has been modified to recognize a change to the dispensed drug by pharmacy as a service correction. In CPRS, when in View Orders view, the medication will be preceded by an asterisk (*) indicating that the order was changed as a service correction, and a new entry in the order's activity log will record the change. In some instances, depending on the medication ordered, the medication information displayed in View Orders will update to include the dispensed drug information. 2. HD0000000258432 - Remove routine created in OR*3*268 Problem: -------- Patch OR*3.0*268 created the temporary routine ORY268 to produce a one-time MailMan message that reported when updating completed for the NAME field (#.01) and the MESSAGE TEXT field (#.03) of two OE/RR NOTIFICATIONS: IMAGING RESULTS, NON CRITICAL and ABNL IMAGING RESLT, NEED ATTN. The compliance date for OR*3*268 was October 6, 2009. Routine ORY268 is now obsolete and should be removed from the system. Resolution: ----------- Installing OR*3*363 deletes routine ORY268 if it is present. 3. HD0000000618076 - MIS-MATCH BETWEEN ORDER TAB CPRS AND ACTUAL SIG Patient Safety Issue: PSPO #2250 Problem: -------- When processing an outpatient medication order, if pharmacy [PSO LM BACKDOOR] dispenses a different strength of tablet with a different number of tablets to take, keeping the total dosage unchanged, there may be no indication visible on the CPRS Order Tab View Orders view or Meds tab that a change has been made. The new strength and number is only displayed in the "Dispensed Drug" text of the order detail, but without a change indicator to prompt the user to view the order detail, it is possible that a patient could be given the incorrect dose information displayed in the View Orders view. Resolution: ----------- Routine ORMPS2 has been modified to recognize a change to the strength of the medication and number of tablets to take as a service correction. In CPRS, when in View Orders, the medication will be preceded by an asterisk (*) indicating that the order was changed as a service correction, and a new entry in the order's activity log will record the change. The new medication strength and number of tablets to take will be displayed in View Orders on the Orders and Meds tab, and also in the order details. 4. HD0000000735586 - Canceling a complex order change creates an unwanted action in CPRS Problem: -------- When pharmacy [PSO LM BACKDOOR] finishes a large complex outpatient order (at least 3 lines), or aborts an edit to an active large complex outpatient order, when the order is viewed again in CPRS on the Order Tab View Orders view and Meds tab the medication is preceded by an asterisk (*) and an entry in the order's activity log is recorded as if a change was made, when in fact, no change was actually made. Resolution: ----------- The HL7 returned from PSO was longer than expected resulting in one piece getting pushed to another segment, causing the record to be evaluated as a change. The code has been changed to use the $$FIND^ORM API to find the quantity and refill codes in the HL7 message so the evaluation is done on the correct values. 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*363): 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*363. 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 1 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ORMPS2 Before: B47758235 After: B49592916 **94,116,129,134,186,190,195, 215,265,243,280,363** Routine Name: ORY268 Before: B3844585 After: Delete Routine list of preceding patches: 280 ============================================================================= User Information: Entered By : AUGUSTINIAK,MARK Date Entered : JUL 16, 2012 Completed By: HULET,LEE ANN Date Completed: AUG 28, 2013 Released By : DILTZ-ANDARY,TAMARA Date Released : SEP 03, 2013 ============================================================================= Packman Mail Message: ===================== $END TXT