$TXT Created by at MNTVBB.DOMAIN.EXT (KIDS) on Tuesday, 01/28/14 at 17:00 ============================================================================= Run Date: APR 21, 2014 Designation: OR*3*334 Package : OR - ORDER ENTRY/RESULTS REPORTING Priority: Mandatory Version : 3 SEQ #335 Status: Released Compliance Date: MAY 22, 2014 ============================================================================= Associated patches: (v)OR*3*329 <<= must be installed BEFORE `OR*3*334' Subject: INCREASE IN AUTO UNFLAG ACTIVITY Category: - Routine - Other Description: ============ This patch corrects one issue within the ORDER ENTRY/RESULTS REPORTING (OR) package: 1. The Auto-Unflagging of orders with the ORPF AUTO UNFLAG parameter set to YES has resulted in pharmacy queries or recommendations not being read or responded to. ASSOCIATED NSR(s): ================== N/A ASSOCIATED REMEDY: ================== 1. INC000000584451 - Increase in Auto Un-Flag activity for Outpatient Medication Orders PSPO #2176 PARTICIPATING TEST SITES: ========================= Upstate NY HCS Shreveport VAMC Hudson Valley HCS REMEDY OVERVIEW: ================ 1. INC000000584451 - Increase in Auto Un-Flag activity for Outpatient Medication Orders Patient Safety Issue: PSPO #2176 Problem: ======== Through testing at the site, it was determined that the increase in auto unflagged orders was due to the ORPF AUTO UNFLAG parameter setting of YES. A typical scenario went something like this: 1. Pharmacist flags a medication order to a provider via Veterans Health Information Systems and Technology Architecture (VistA) Outpatient Pharmacy or Computerized Patient Record System (CPRS) (here, VistA Outpatient Pharmacy). For example, the provider flagged is the ordering provider and the flag is asking a question about a dose or recommending a different medication. 2. Provider who was flagged in step 1 receives a CPRS notification for the flagged order. 3. Provider processes the notification in CPRS. The action of processing automatically unflags the order for him/her and other recipients of the order flag. 4. Once the order is unflagged, the pharmacist from step 1 notices the order is auto unflagged with the system-generated (automatic) comment of "Auto-Unflagged". The increase in auto-unflagging of orders with the ORPF AUTO UNFLAG parameter set to YES is leading to the patient safety issue that flagged concerns are not being addressed. Resolution: =========== The ORPF AUTO UNFLAG parameter will be set to NO and editing will be disabled. 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*334): 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*334. 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 5 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ORCB Before: B51269339 After: B49591069 **7,36,48,70,108,116,243,334** Routine Name: ORWORB Before: B72691529 After: B73567288 **10,85,116,148,173,190,215, 243,296,329,334** Routine Name: ORY334 Before: n/a After: B21763040 **334** Routine list of preceding patches: 329 ============================================================================= User Information: Entered By : Date Entered : JUN 29, 2010 Completed By: Date Completed: APR 18, 2014 Released By : Date Released : APR 21, 2014 ============================================================================= Packman Mail Message: ===================== $END TXT