============================================================================= Run Date: NOV 09, 2020 Designation: OR*3*519 Package : OR - ORDER ENTRY/RESULTS REPORTING Priority: Mandatory Version : 3 SEQ #453 Status: Released Compliance Date: DEC 29, 2020 ============================================================================= Associated patches: (c)GMRC*3*145 install with patch `OR*3*519' (c)TIU*1*328 install with patch `OR*3*519' (c)GMTS*2.7*134 install with patch `OR*3*519' (v)OR*3*350 <<= must be installed BEFORE `OR*3*519' (v)OR*3*377 <<= must be installed BEFORE `OR*3*519' (v)OR*3*415 <<= must be installed BEFORE `OR*3*519' (v)OR*3*441 <<= must be installed BEFORE `OR*3*519' (v)XOBW*1*6 <<= must be installed BEFORE `OR*3*519' (v)OR*3*528 <<= must be installed BEFORE `OR*3*519' (v)OR*3*533 <<= must be installed BEFORE `OR*3*519' Subject: CPRS 31MA MISSION ACT RELEASE Category: - Routine - Data Dictionary Description: ============ This patch is part of the CPRS v31MA updates. Below is a list of all the applications involved in this project along with their patch numbers: APPLICATION/VERSION PATCH --------------------------------------------------------------- ORDER ENTRY/RESULTS REPORTING v3.0 OR*3.0*519 TEXT INTEGRATION UTILITIES v1.0 TIU*1.0*328 CONSULT/REQUEST TRACKING v3.0 GMRC*3.0*145 HEALTH SUMMARY v2.7 GMTS*2.7*134 The patches (OR*3.0*519, TIU*1.0*328, GMRC*3.0*145, and GMTS*2.7*134) are being released in the Kernel Installation and Distribution System (KIDS) multi-package build CPRS V31MA COMBINED BUILD 1.0. The Computerized Patient Record System (CPRS) Graphical User Interface (GUI) v31MA is an enhancement release with the following modifications: 1) This CPRS enhancement to support Prescription Drug-Monitoring Program (PDMP) integration will allow for more efficient and effective team-based care when prescribing controlled substances to Veterans, by providing ad-hoc PDMP queries for retrieving the data and automatic generation of a progress note for the medical record. Incorporating the PDMP data in this improved way enhances patient safety and the overall quality of care. Providing users with this automated process will also facilitate effective compliance with federal and jurisdictional/state laws and regulations regarding controlled substances. BENEFIT: Enhancements to CPRS will enable prescribers, pharmacists, and delegates to submit on demand PDMP queries for use in patient care related decision making and automatically update patient medical records and notes. - View and retrieve controlled substance prescription monitoring data from external sources and within patients' electronic medical records; - Automatically generate patient progress notes; - Query and easily utilize prescription and patient prescription history on an ad-hoc and recurring basis; - Perform audit functions that ensure compliance. NOTE: At the time of national release of CPRS v31MA, not all States are participating in the automated CPRS PDMP query process. If the State where VA care is being provided is not yet participating, the following message will be displayed when initiating a PDMP query from CPRS: The PDMP functionality using CPRS from the user's Facility [division name] is currently unavailable due to state-specific legislation in [2-letter state code]. Coordinators at your facility will notify facility staff when this functionality is permitted. Please access your State PMP Portal to initiate a manual PDMP query. On the CPRS Mission Act Training Resources website, a link is displayed showing which States are currently able to use this functionality. It will be updated as new States participate. CPRS Mission Act Training Resources: https://dvagov.sharepoint.com/sites/VHAOIA/CPRSMissionAct/SitePages/Home.a spx Map of States Participation in Automated CPRS PDMP Query: https://dvagov.sharepoint.com/:i:/r/sites/VHAOIA/CPRSMissionAct/Pictures/P DMPMAP.jpg?csf=1&web=1&e=gbu7rL 2) The Veterans Health Administration (VHA) Office of Community Care created the real-time Decision Support Tool (DST) to help care providers and Veterans quickly review the criteria proscribed in the VA Mission Act of 2018, to determine whether a given Veteran is eligible and would be best served utilizing the Veterans Community Care Program, and document the decision rationale in the Veteran's health record. The existing process will be modified so DST consult ordering can fully be completed within CPRS. The DST user interface can be launched during consult ordering and tracking actions: - A Launch DST button that is active for outpatient orders when the Consult to Service/Specialty, Urgency, and Clinically Indicated Date have been selected. - A new message box located above the Launch DST button to provide status messages from the DST application. NOTE: At the time of national release, these new DST features of CPRS GUI are dormant and not enabled. Sites will continue to use their existing tools and processes regarding DST. These integrated features will be enabled in a future release of CPRS GUI. Patch Components: ================ Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- PDMP QUERY LOG PATIENT (#.01) New (#101.62) QUERIES Multiple DATE/TIME (#.01) New (#101.621) USER (#.02) New COSIGNER (#.03) New STATUS (#.04) New DATA SHARED? (#.05) New QUERY STATS (#.06) New VIEWED REPORT? (#.07) New AUTHORIZED USER? (#.08) New NOTE (#.09) New NOTE STATUS (#.1) New SESSION ID (#.11) New ERROR INFO (#1) New Forms Associated: Form Name File Number New/Modified/Deleted --------- ----------- -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- OR CPRS GUI CHART Broker Modified OR DST/CTB CPRS CONFIGURATION Menu New OR DST/CTB FEATURE SWITCH Action New OR DST/CTB URL EDIT Action New OR ENABLE CTB CONS ACT DLGS Action New Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- OR ACT ON DOCUMENT ACTION New Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Remote Procedures Associated: Remote Procedure Name New/Modified/Deleted --------------------- -------------------- ORPDMP CHCKTASK New ORPDMP GETCACHE New ORPDMP STOPTASK New ORPDMP STRTPDMP New ORPDMP VIEWEDREPORT New ORPDMPNT MAKENOTE New ORPDMPNT RECNTNOTE New ORQQCN ISPROSVC Modified ORWPT GET FULL ICN New Parameter Definitions Associated: Parameter Name New/Modified/Deleted -------------- -------------------- OR PDMP BACKGROUND RETRIEVAL New OR PDMP COMMENT LIMIT New OR PDMP COPY/PASTE ENABLED New OR PDMP DAYS BETWEEN REVIEWS New OR PDMP DELEGATION ENABLED New OR PDMP DISCLOSED TO New OR PDMP NOTE TEXT New OR PDMP NOTE TITLE New OR PDMP OPEN TIMEOUT New OR PDMP PERSON CLASS New OR PDMP POLLING INTERVAL New OR PDMP REVIEW FORM New OR PDMP SHOW BUTTON New OR PDMP TIME TO CACHE URL New OR PDMP TIMEOUT QUERY New OR PDMP TURN ON New OR PDMP USE DEFAULT BROWSER New ORQQCN CTB ADMIN COMP New ORQQCN CTB CANCEL New ORQQCN CTB COMMENT New ORQQCN CTB DC New ORQQCN CTB EDITRES New ORQQCN CTB FORWARD New ORQQCN CTB ORDER CNSLT New ORQQCN CTB PATH New ORQQCN CTB RECEIVE New ORQQCN CTB SCHEDULE New ORQQCN CTB SIGFIND New ORQQCN DST CONS DECISION New ORQQCN DST CONS SAVE New ORQQCN DST PATH New ORQQCN DST PROD URL New ORQQCN DST TEST URL New ORQQCN DST/CTB FEATURE SWITCH New Parameter Templates Associated: Parameter Template Name New/Modified/Deleted ----------------------- -------------------- ORQQCN CTB ACTION ENABLE New ORQQCN DST/CTB URL/SERVICES New Additional Information: ----------------------- New Service Requests (NSRs): N/A Patient Safety Issues (PSIs): N/A Defect Tracking System Ticket(s) & Overview: INC000000705741/jazz 1106893 INC000008189923 (DUPLICATE) Controlled substance order allowed without Dig Sig 1. INC000000705741 INC000008189923 (DUPLICATE) Controlled substance order allowed without Dig Sig Problem: ------- Through a series of renewals and discontinues of a previously discontinued order for a controlled substance, it is possible for the order to be put through again without a digital signature. Resolution: ---------- After renewing an order, the orders list in CPRS is updated. This removes any "ghost" orders that could be pushed through without a digital signature. 2. Postings window on CPRS Cover Sheet does not display postings dates (Rational Work Item #1297256) Problem: -------- The Postings pane of the Cover Sheet should display the posting and the date the posting was created. The redesigned Cover Sheet of CPRS GUI v31b inadvertently dropped the date column from the display. Resolution: ----------- The date column of the Postings pane has been restored. 3. Supplemental O2 Flow Rate Missing from CPRS Cover Sheet Vitals Pane (Rational Work Item #1294956) Problem: -------- In CPRS v31a, the Vitals panel displayed the supplemental O2 flow rate. The redesigned Cover Sheet of CPRS GUI v31b inadvertently dropped the supplemental O2 flow rate from the display. Resolution: ----------- The Supplemental O2 flow rate display has been restored. 4. Copy and paste error - Microsoft Skype and Note to Note (Rational Work Item #1288460) Problem: -------- With the copy/paste feature of CPRS v31b disabled, when pasting data from MS Skype into a note, the note text becomes locked and the text carries from patient to patient (note to note). It was also noted that when copying data from a note in CPRS, users were unable to paste that text into another note in CPRS. Resolution: ----------- The VA is transitioning from MS Skype to Teams, which will prevent users from experiencing this issue as Teams does not create the same condition with pasting into a note as found in Skype. The CPRS GUI code was also updated to prevent this sort of condition again should another application present the same environment. 5. List index out of bounds error when processing mammogram result view alerts (Rational Work Item #1295720) Problem: -------- When processing alerts through the 'old mammogram results' (pre-SMART) alert process, A 'List index out of bounds' access violation can occur. When using the SMART process, these errors are not occurring. Resolution: ----------- The CPRS GUI code was updated to remove the condition that would cause a list index out of bounds error when trying to process the alert. 6. List index out of bounds error when trying to process deferred alert. (Rational Work Item #1295615) Problem: -------- A deferred alert was not being properly removed from the list of alerts used by the CPRS GUI code. After deferring an alert and then clicking "Process All" a list index out of bounds error would occur. Resolution: ----------- The CPRS GUI code was updated to properly account for deferred in alerts. After deferring an alert, and then clicking the "Process All" button for remaining alerts, users are taken into the patient chart as expected. 7. CPRS order menus do not remember size and position. (Rational Work Item #1293334) Problem: -------- The order menu windows in CPRS GUI are often reported to open in unexpected locations, and do not remember location or size when moved or resized. Users reports described various outcomes such as the "Done" button being pushed off the visible screen and also the order menus opening over top of information the user needed to see (e.g. referencing patient age when ordering labs) Resolution: ----------- CPRS order menus will now remember both size and position. Note: users that open CPRS on different computers that have monitors/screens with different size and/or resolution, may still experience order menus opening in unexpected locations. For example, using CPRS on a computer with a large monitor one day, and then opening CPRS on a laptop with a smaller screen on the following day would be one such situation that may place the order menu in an unsatisfactory location. 8. SMART dialog not opening when processing all alerts (Rational Work Item #1277451) Problem: -------- When selecting a group of alerts on the patient selection screen of CPRS GUI, and that list includes a SMART alert, when the SMART alert is processed, the SMART dialog does not open and processing continues to the next alert. Resolution: ----------- Changes have been made to alert processing from the patient selection screen, specifically when processing multiple alerts at a time. Prior to these changes, long text alerts and SMART alerts would process first, before any other alerts. And these two types of alerts were processed from the patient selection screen, before alert processing took you to the chart for any other alert type. Processing multiple alerts from the patient selection screen will now process them in order, moving from one alert to the next using the Next button in the bottom right corner of the screen. Note that processing alerts from the View Patient Notifications dialog has not changed - since that dialog will only process one alert at a time, the existing functionality was sufficient. 1) Processing long text alerts tied to a patient (tickler alerts) will now take the user to that patient in the chart, going to the default user tab, or the current tab if the user is set up to use the last selected tab on patient change. 2) Processing SMART alerts will now take users to the Notes tab in the patient chart before prompting if the user wishes to create a new note or make an addendum to an existing note. 3) When processing multiple alerts, and any of those alerts take the user outside the patient selection screen, any long text alerts - which are not tied to a patient and are created by using the VistA XQALERT MAKE option - will now be processed within the patient chart, with no patient selected. When closing the long text alert dialog, users will be required to either process the next alert, or to stop processing alerts and return to the patient selection dialog - i.e. users will not be allowed to explore CPRS without a patient selected. 9. Support Integer Division IDs for Reminder Assignments (Rational Work Item #1283045) Problem: -------- When a site's division ID contains a decimal point, it was excluded from the list of available divisions when trying to build the list of CPRS GUI Cover Sheet reminders. Resolution: ----------- The CPRS GUI code was updated to account for decimal point in a site division ID. 10. Vitals Pane Date/Time Display is Truncated on CPRS Cover Sheet (Rational Work Item #1291631) Problem: -------- The Vitals pane cuts off the time portion of the date/time display column. The column could be widened, but that was only temporary and would be reset whenever the patient information was refreshed or a new patient was selected. Resolution: ----------- The time portion of the date/time display column is no longer cut off. Selecting a new patient or refreshing patient information will not reset the column display width and cut off the time display. 11. CPRS Issues When Copying/pasting into Note Templates and Editing Notes (Rational Work Item #1296635) Problem: -------- Seemingly random access violations were occurring in CPRS when copying and pasting text into note templates, and also when editing notes. Resolution: ----------- Two issues were corrected in CPRS GUI with the exception logging code and the code that scrubs the clipboard. 12. Women's Health Cover Sheet Form Does Not Report Error (Rational Work Item #1291420) Problem: -------- After entering data via the Women's Health - Pregnancy and Lactation Status Update form on the Cover Sheet tab, if an error occurs in VistA while saving the data, that error message is not displayed to the user. In this scenario, the error message should appear explaining why the data was not saved. Resolution: ----------- CPRS was updated to display the error message if one is received from VistA upon saving the new pregnancy and/or lactation status. 13. Women's Health Panel Shows Not Applicable Instead of Error (Rational Work Item #1291418) Problem: -------- Given a female patient between the ages of 10 and 52, when an error occurs in retrieving the data for the Women's Health panel on the Cover Sheet, the panel shows Not Applicable. When the phrase Not Applicable is clicked on, a Detail dialog does not appear. An example error message is "Could not determine applicability; Reminder definition does not exist". In this situation, the Women's Health Panel should show Error instead of Not Applicable and when the word Error is clicked, the detail dialog should appear containing the error message. Resolution: ----------- CPRS was updated to display the word Error rather than Not Applicable in the Women's Health panel and to display the error message in the Details dialog that appears when the word Error is clicked on. Test Sites: ----------- EASTERN COLORADO MADISON PITTSBURGH SALISBURY Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released using a host file. The host file is available at the following location: /srv/vista/patches/SOFTWARE/CPRS_V31MA_COMBINED_BUILD.KID The software distribution includes: Other Software Files: This release also includes other software files. Other software files can be obtained by accessing the URL: https://download.vista.domain.ext/index.html/SOFTWARE File Title File Name Format --------------------------------------------------------------------- CPRSChart.exe OR_30_519.ZIP BINARY CPRS v31MA Source Code OR_30_519_SRC.ZIP BINARY CPRS V31MA Host File CPRS_V31MA_COMBINED_BUILD.KID ASCII Documentation describing the new functionality is included in this release. Documentation can be found on the VA Software Documentation Library at: https://www.domain.ext/vdl/. Documentation can also be obtained at https://download.vista.domain.ext/index.html/SOFTWARE Note: Due to standardized software document changes and VDL updates, the documentation will be released and stored with the software on the network share for the 45 day compliance period. The documents will then be loaded and stored on the VDL around Dec 21, 2020. Documentation Title File Name ------------------------------------------------------------------- CPRS Technical Manual: GUI Version CPRSGUITM.PDF CPRS User Guide: GUI Version CPRSGUIUM.PDF CPRS Technical Manual CPRSLMTM.PDF CPRS GUI v.31 MA (Patch OR*3.0*519) OR_3_0_519_RN.PDF Release Notes CPRS GUI v.31 MA Installation Guide OR_3_0_519_DIBR.PDF Patch Installation: =================== Pre/Post Installation Overview ------------------------------ Please refer to the "CPRS v31 Mission Act Deployment, Installation, Back Out and Rollback Guide" for installation and set-up information. This document is exported as OR_3_0_519_DIBR.PDF. Back-out, Rollback Instructions: -------------------------------- Please refer to the "CPRS v31 Mission Act Deployment, Installation, Back Out and Rollback Guide" for backout/rollback information. 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 36 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ORDSTCTB Before: n/a After: B4467585 **519** Routine Name: ORMBLDGM Before: B6024774 After: B7174708 **26,68,97,190,195,280,361,350,519** Routine Name: ORMGMRC Before: B46396070 After: B47176451 **3,26,68,92,153,174,195,255, 243,280,350,415,519** Routine Name: ORPDMP Before: n/a After:B196659995 **519** Routine Name: ORPDMPHS Before: n/a After: B19015301 **519** Routine Name: ORPDMPNT Before: n/a After: B35600206 **519** Routine Name: ORPDMPWS Before: n/a After:B169255708 **519** Routine Name: ORQQCN2 Before: B36811080 After: B36865385 **10,85,125,131,149,215,242, 280,350,519** Routine Name: ORWPT Before: B78972917 After: B80612428 **10,85,132,149,206,187,190, 215,243,280,306,311,441,528, 519** Routine Name: ORWU Before: B99312497 After:B100909319 **10,85,132,148,149,187,195, 215,243,350,424,377,519** Routine Name: ORWU1 Before: B57577234 After: B58660357 **149,187,195,215,394,533,519** Routine Name: ORY519 Before: n/a After:B110527807 **519** Routine list of preceding patches: 377, 415, 528, 533 ============================================================================= User Information: Entered By : Date Entered : AUG 20, 2019 Completed By: Date Completed: NOV 09, 2020 Released By : Date Released : NOV 09, 2020 ============================================================================= Packman Mail Message: ===================== No routines included