$TXT Created by at DOSP.FO-BIRM.DOMAIN.EXT (KIDS) on Thursday, 04/03/25 at 12:29 ============================================================================= Run Date: MAY 16, 2025 Designation: PSS*1*254 Package : PSS - PHARMACY DATA MANAGEMENT Priority: Mandatory Version : 1 SEQ #232 Status: Released Compliance Date: MAY 27, 2025 ============================================================================= Associated patches: (v)PSJ*5*423 install with patch `PSS*1*254' (v)PSO*7*779 install with patch `PSS*1*254' (v)PSS*1*163 <<= must be installed BEFORE `PSS*1*254' (v)PSS*1*210 <<= must be installed BEFORE `PSS*1*254' (v)PSS*1*231 <<= must be installed BEFORE `PSS*1*254' Subject: VISTA FIXES FOR FDB FWK 4.5 UPGRADE Category: - Routine - Enhancement (Mandatory) - Data Dictionary Description: ============ This patch includes updates required for the upgrade from First Databank (FDB) MedKnowledge Framework (Fwk) 3.3 to 4.5. - This patch is approved to be installed at EHRM converted sites. This patch makes the changes listed below to the current Medication Order Check Healthcare Application (MOCHA) code in VistA to work with the upgraded version of FDB. Updates are also made to the PEPS Services (Pharmacy Enterprise Product System) options. (1) Hardcoded routes that need to be updated from 3.3 to the 4.5 values. - OTIC to OTIC (EAR) - OPHTHALMIC to OPHTHALMIC (EYE) (2) The option PEPS Services > Check Vendor Database Link updated the Database Version and Build Version fields to display properly in 4.5. (3) The option PEPS Services > Check PEPS Services Setup does a Dosing Order Check for ACETAMINOPHEN 500MG TAB - 3000MG Q4H. In 3.3, the frequency Q4H was hardcoded to Q4H. In 4.5, this value needs to be 6. This has been updated. (4) The option PEPS Services > Check PEPS Services Setup does a Drug-Drug interaction check for CIPROFLOXACIN HCL 250MG TAB and WARFARIN NA (GOLDEN STATE) 5MG TAB which is a critical interaction in 3.3 but is a significant interaction in 4.5. This resulted in the check not being able to be performed. This has been updated and is now performed. (5) The DOSE UNITS file (#51.24) has been updated with version 4.5 values in the FIRST DATABANK DOSE UNIT (#1) field: Dose Units Name New FIRST DATABANK DOSE UNIT APPLICATION(S) APPLICATIONS APPLICATORFUL(S) APPLICATORFUL CAP/TAB TABLET-CAPSULE CAPSULE(S) CAPSULES DROP(S) DROPS INCH(ES) INCHES MICROGRAM(S) MICROGRAMS MG-PE MILLIGRAM PHENYTOIN EQUIVALENT MICRO UNIT(S) MICROUNITS MILLIONUNIT(S) MILLION UNITS PIECE(S) PIECES OF GUM PUFF(S) PUFFS SCOOPFUL(S) SCOOPS SPRAY(S) SPRAY STRIP(S) STRIPS SUPPOSITORY(IES) SUPPOSITORY TABLESPOONFUL(S) TABLESPOONFUL TABLET(S) TABLETS TEASPOONFUL(S) TEASPOONFUL THOUSAND UNITS THOUSAND UNITS UNIT(S) UNITS (6) The DOSE UNIT CONVERSION File (#51.25) has been updated with 4.5 values in the DOSE UNIT 1 (#.01) field: - APPLICATION(S) to APPLICATIONS - APPLICATORFUL(S) to APPLICATORFUL - CAPSULE(S) to CAPSULES - DROP(S) to DROPS - INCH(ES) to INCHES - MICRO UNITS to MICROUNITS - MICROGRAM(S) to MICROGRAMS - MILLIONUNIT(S) to MILLION UNITS - PIECE(S) to PIECES OF GUM - PUFF(S) to PUFFS - SCOOPFULS to SCOOPS - SPRAY(S) to SPRAYS - STRIP(S) to STRIPS - SUPPOSITORY(IES) to SUPPOSITORY - TAB-CAPS to TABLET-CAPSULES - TABLESPOONFULS to TABLESPOONFUL - TABLET(S) to TABLET - TEASPOONFULS to TEASPOONFUL - TU to THOUSAND UNITS - UNIT(S) to UNITS (7) The DOSE UNITS File (#51.24) has been updated with new 4.5 values in the SYNONYM (#.01) field of the SYNONYM (#2) multiple for the below entries: CAP/TAB - TABLET-CAPSULE - TABLET-CAPSULES MG-PE - MILLIGRAM PHENYTOIN EQUIVALENTS THOUSAND UNITS - THOUSAND UNIT (8) The DOSE UNIT CONVERSION File (#51.25) has been updated with version 4.5 values in the DOSE UNIT 2 (#.01) field of the DOSE UNIT 2 (#1) multiple for the below entries: APPFUL - APPLICATORFUL(S) to APPLICATORFUL APPLIC - APPLICATION(S) to APPLICATIONS CENTIMETERS - INCH(ES) to INCHES EACH - TAB-CAPS to TABLET-CAPSULES - CAPSULE(S) to CAPSULES - PIECE(S) to PIECES OF GUM - SCOOPFULS to SCOOPS - STRIP(S) to STRIPS - SUPPOSITORY(IES) to SUPPOSITORY - TABLET(S) to TABLETS GRAMS - MICROGRAM(S) to MICROGRAMS INHALATIONS - SPRAY(S) to SPRAYS - PUFF(S) to PUFFS MICROUNITS - MILLIONUNIT(S) to MILLION UNITS - UNIT(S) to UNITS MILLIGRAMS - MICROGRAM(S) to MICROGRAMS MILLILITERS - DROP(S) to DROPS - TABLESPOONFULS to TABLESPOONFUL - TEASPOONFULS to TEASPOONFUL MILLION UNITS - MICRO UNITS to MICROUNITS - TU to THOUSAND UNITS - UNIT(S) to UNITS NANOGRAMS - MICROGRAM(S) to MICROGRAMS PUFFS - SPRAY(S) to SPRAYS SPRAYS - PUFF(S) to PUFFS THOUSAND UNITS - MILLIONUNIT(S) to MILLION UNITS - UNIT(S) to UNITS UNITS - MICRO UNITS to MICROUNITS - TU to THOUSAND UNITS - MILLIONUNIT(S) to MILLION UNITS (9) This patch updates the values of the FIRST DATABANK MED ROUTE field (#1) for the following entries in the STANDARD MEDICATION ROUTES file (#51.23): Standard Med Route FDB Med Route in 3.3 FDB Med Route in 4.5 ================== ==================== ==================== INTRA-AMNIOTIC (Not Set) INTRA-AMNIOTIC INTRATYMPANIC (Not Set) INTRATYMPANIC IONTOPHORESIS NOT APPLICABLE IONTOPHORETIC OPHTHALMIC OPHTHALMIC OPHTHALMIC (EYE) OTIC OTIC OTIC (EAR) SUBMUCOSAL SUBMUCOSAL SUBMUCOSAL INJECTION (10) Option PSS DRUG DOSING LOOKUP. Version 4.5 no longer returns intlDoseRouteDescription. The option has been updated to use doseRouteDescription. This impacts the display of FDB ROUTES. Version 4.5 updated the FDB DOSE UNITS format from X per Y per Z to X/Y/Z. The option has been updated to support the X/Y/Z format. (11) Message Suppression Version 4.5 returns data elements and additional messaging that was not in 3.3. Two of these messages will be suppressed. The first suppressed message is: Maximum Single Dose Check could not be performed for Drug: Reason(s): The status is excluded and the reason is blank due to a higher level error that causes the dose check to not be performed. This message provides no additional information and is now suppressed in this scenario. The second suppressed message is: General dosing range for (): **unknown** **unknown** . Maximum daily dose is unavailable. This message is displayed for the same reason and provides no additional information. This will be suppressed for unknown/unknown/unavailable. (12) Updates server and port for PEPS and PPS-N web services. Updates the PPS-N web service to a more secure protocol - encrypt_only_tlsv12 if it is not already setup. PROD PPSN: vaww.ppsn.domain.ext 443 PEPS: mocha.pharmacy.healthevet.domain.ext 8011 PRE-PROD PPSN: vaausapppps401.aac.domain.ext 443 PEPS: mocha-pre.pharmacy.healthevet.domain.ext 8011 (13) Additional messaging was appearing due to a wording change. In version 3.3, the text was 'Weight required.' In version 4.5 it reads 'Weight is required.' This wording change caused the test that triggers the code to eliminate the duplicates to fail and the additional messages began appearing. (14) Additional messaging was appearing due to a wording change. In version 3.3, the text was 'Body surface area required.' In version 4.5 it reads 'Body surface area is required'. This wording change caused the test that triggers the code to eliminate the duplicates to fail and the additional messages began appearing. (15) Added code that will display the top level text from the MOCHA return message if nothing exists in the Single Dose Message and the Max Daily Dose Message. (16) Added a fix to change the message to say "Dosing Checks could not be performed for Drug:" in cases where there is no detail message text back from MOCHA. (17) Files #51 and #51.1 updated the Dosing Check Frequency Field to allow for version 4.5 formatting of frequencies for the MOCHA/FDB dosing checks. Some version 3.3 formats that are no longer supported were deleted. In instances where there is no version 4.5 format, the frequency field is cleared and any drugs associated with it are also cleared. Drugs impacted are reported in the install email and includes reports for orderable items and quick orders that are impacted by the conversion. These items should be reviewed to determine if further action is necessary. Additionally, entries in both files that have the Frequency (In Minutes) field populated but the Dosing Check Frequency field not populated as well as Quick Orders with impacted File #51.1 Dosing Check Frequency values will need identified and reviewed. (18) Suppress display of the Single Dose messaging for Continuous Routes. (19) Display Age Exclusion and Contraindicated dosing messages in CPRS. (20) Corrects the display of Invalid or Undefined Frequency message displaying after the message worded as: Dosing Checks could not be performed for Drug: Reason(s) for route: Screening supports the ordered drug. However, the combination of patient and order information does not result in a match. The primary message about the route is the desired one and the rest is unnecessary. (21) Corrects a defect where both max single dose and max daily dose were displayed. Only max daily dose is necessary. (22) Displays a more meaningful description of the condition when a drug is not found in the FDB database. (23) For a Weight Based Infusion - Free Text Dosing in IV package was providing an incorrect error message in both CPRS and Pharmacy. This is corrected by changing doseUnits in XML to UNITS/HOUR. (24) Orders with a bad route will display a more meaningful message. (25) Replace custom frequency messages created in VistA for FDB version 3.3 with the standard frequency messages returned in FDB version 4.5 messaging. (26) Updates to the logic from #17 - Added support for annual dosing frequency Q12L and Q52W for MEDICATION INSTRUCTION File (#51) field DOSING CHECK FREQUENCY (#32) and ADMINISTRATION SCHEDULE File (#51.1) field DOSING CHECK FREQUENCY (#11). (27) New routes were added to the STANDARD MEDICATION ROUTES file (#51.23): ADDUCTOR CANAL BLOCK CERVICAL ECTOPIC GESTATIONAL SAC ENDOTRACHEAL HAND BULB NEBULIZER IMPLANT INFRACLAVICULAR INSTILLATION INTERSCALENE INTRACANALICULAR INTRACORONARY INTRALUMBAR INTRALYMPHATIC INTRAPERICARDIAL INTRAPROSTATIC INTRA-PYELOCALYCEAL INTRASALIVARY GLAND INTRA-SUBACROMIAL SPACE INTRA-UMBILICAL VEIN INTRAVENTRICULAR IPPB JUXTASCLERAL MISCELLANEOUS MUCOUS MEMBRANE O2 AEROSOLIZATION PERCUTANEOUS PERFUSION PERIARTICULAR PERINEURAL INJECTION SUBLESIONAL SUBRETINAL SUPRACHOROIDAL TENDON SHEATH INJ TRANSTRACHEAL TRANSURETHRAL (28) The length of the FIRST DATABANK MED ROUTE (#1) field in the STANDARD MEDICATION ROUTES file (#51.23) was increased from 30 to 40. (29) New type cross reference FDBMRT has been created for the FIRST DATABANK MED ROUTE (#1) field in the STANDARD MEDICATION ROUTES file (#51.23) to support the longer field length. (30) New type cross reference FDBMRT has been created for the NAME (#.01) field of the MEDICATION ROUTES file (#51.2) to support the longer entries in the STANDARD MEDICATION ROUTES file (#51.23). (31) New units were added to the DOSE UNITS file (#51.24): AMPULE BILLION CELLS CELL COLONY FORMING UNIT MELT MICROGRAM DIETARY FOLATE EQUIVALENT MILLICURIE MILLIGRAM FISH OIL MILLION CELLS MILLION PLAQUE FORMING UNITS MILLIUNIT PLAQUE FORMING UNIT TOWELETTE TUBE (32) Data Dictionary update to DOSE UNITS File (#51.24). Field lengths increased to 40 to support MICROGRAM DIETARY FOLATE EQUIVALENT for fields NAME (#.01) and FIRST DATABANK DOSE UNIT (#1). (33) Data Dictionary update to the SYNONYM (#.01) field of the SYNONYM (#2) multiple of the DOSE UNITS File (#51.24). Field length increased to 40 to support MICROGRAM DIETARY FOLATE EQUIVALENT. (34) In the DOSE UNITS File (#51.24), New Type Cross Reference FDBNAME was added for the NAME (#.01) field to support the longer field length. (35) In the DOSE UNITS File (#51.24), New Type Cross Reference FDBUNIT was added for the FIRST DATABANK DOSE UNIT (#1) field to support the longer field length. (36) In the DOSE UNITS File (#51.24), New Type Cross Reference FDBSYN was added to the SYNONYM (#.01) field of the SYNONYM subfile (#51.242) to support the longer field length. (37) Continuous route requests have been updated to send the appropriate duration rate. (38) Custom Frequency messages and General Dosing messages will both print on PSO LM BACKDOOR ORDERS when FIRST DATABANK messages are returned during New Order entry. (39) Adjusted the logic for displaying the General Dosing message. (40) Updated to allow selection of the PRODUCTION environment during the installation of the patch. (41) The following entries were deleted from the DOSE UNITS file (#51.24): anti-Xa unit ENEMA(S) OVULE(S) SQUIRT(S) TROCHE(S) (42) The following entries were deleted from the DOSE UNIT CONVERSION file (#51.25): ENEMAS OVULE(S) SQUIRTS TROCHES (43) The DOSE UNIT CONVERSION File (#51.25) has been updated to delete values no longer supported in version 4.5 in the DOSE UNIT 2 (#.01) field of the DOSE UNIT 2 (#1) multiple for the below entries: EACH - Deleted ENEMAS - Deleted OVULE(S) - Deleted TROCHES INHALATIONS - Deleted SQUIRTS SPRAY(S) - Deleted SQUIRTS Patch Components: ----------------- Files & Fields Associated: -------------------------- File Name (Number) Field Name (Number) New/Mod/Del ------------------ ------------------- ------------ MEDICATION INSTRUCTION (#51) DOSING CHECK FREQUENCY (#32) Modified ADMINISTRATION SCHEDULE (#51.1) DOSING CHECK FREQUENCY (#11) Modified MEDICATION ROUTES (#51.2) NAME (#.01) Modified STANDARD MEDICATION ROUTES (#51.23) FIRST DATABANK MED ROUTE (#1) Modified DOSE UNITS (#51.24) NAME (#.01) Modified FIRST DATABANK DOSE UNIT (#1) Modified SYNONYM (#2) [sub #51.242] Modified SYNONYM SUB-FIELD File (#51.242) SYNONYM (#.01) Modified 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 ----------- ---- -------------------- N/A Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A 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 --------------------- -------------------- N/A Parameter Definitions Associated: Parameter Name New/Modified/Deleted -------------- -------------------- N/A Additional Information: ----------------------- N/A New Service Requests (NSRs): ---------------------------- N/A Patient Safety Issues (PSIs): ----------------------------- N/A Defect Tracking System Ticket(s) & Overview: -------------------------------------------- N/A Test Sites: ----------- Eastern Colorado HCS, Denver, CO James A Haley VA Hospital, Tampa, FL Northampton VAMC, Northampton, MA Overton Brooks VAMC, Shreveport, LA VA Greater LA HCS, Los Angeles, CA Test Sites - SNOW Change Order #: --------------------------------- Eastern Colorado HCS - CHG0601164 James A Haley VA Hospital - CHG0602758 Northampton VAMC - CHG0601313 Overton Brooks VAMC - CHG0601388 VA Greater LA HCS - CHG0601201 Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released in a PackMan message. 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. Documentation Title File Name ------------------------------------------------------------------------ Dosing Order Check Version 2.1 User PSS_1_DOSING_ORD_CK_UM_P254.DOCX Manual PSS_1_DOSING_ORD_CK_UM_P254.PDF VistA to MOCHA Version 2.1 Interface PSS_1_VISTA_TO_MOCHA_ID_P254.DOCX Document PSS_1_VISTA_TO_MOCHA_ID_P254.PDF Pharmacy Data Management User Manual PSS_1_0_P254_UM.DOCX PSS_1_0_P254_UM.PDF Pharmacy Data Management Technical PSS_1_0_P254_TM.DOCX Manual/Security Guide PSS_1_0_P254_TM.PDF PSS*1*254 Pharmacy Data Management PSS_1_0_P254_RN.DOCX Release Notes PSS_1_0_P254_RN.PDF PSS*1*254 Deployment, Installation, PSS_1_0_P254_DIBR.DOCX Back-Out, and Rollback Guide PSS_1_0_P254_DIBR.PDF Patch Installation: ------------------- This patch should be installed with PSJ*5*423 and PSO*7*779. The order of install does not matter. Users should refer to the PSS*1*254 Deployment, Installation, Back-out, Rollback Guide (DIBR) for detailed instructions. Pre/Post Installation Overview: ------------------------------- This patch includes a post-install routine which does the following: - Updates entries in DOSE UNITS file (#51.24) and DOSE UNIT CONVERSION file (#51.25) to be in compliance with FDB version 4.5 - Updates server and port for Mocha and PPS-N web Services. - Updates entries in the STANDARD MEDICATION ROUTES file (#51.23) The install of the patch sends several MailMan messages to the installer and users with the PSNMGR key. These emails provide information about the updates made by the patch install and notification about items impacted by the conversion. Impacted items should be reviewed by appropriate personnel to determine if further action is necessary. Additionally, entries in File #51 and #51.1 where the Frequency (In Minutes) field is populated but the Dosing Check Frequency field is not populated as well as Quick Orders with impacted File #51.1 Dosing Check Frequency values will need identified and reviewed. Upon patch installation, the Environment routine (PSSP254P) and post-install routine (PSSP254) will be deleted. Pre-Installation Instructions: ------------------------------ This patch may be installed with users on the system although it is recommended that it be installed during non-peak hours to minimize potential disruption to users. This patch should take less than 5 minutes to install. Installation Instructions: -------------------------- Refer to the PSS*1*254 Deployment, Installation, Back-out, Rollback Guide (DIBR) for installation instructions. Post Installation Instructions: ------------------------------- N/A Installation Verification: -------------------------- Refer to the PSS*1*254 Deployment, Installation, Back-out, Rollback Guide (DIBR) for installation verification instructions. Back-out/Rollback Strategy: --------------------------- Back-out will be done only with the concurrence and participation of development team and appropriate VA site/region personnel. The decision to back-out or rollback software will be a joint decision between development team, VA site/region personnel and other appropriate VA personnel. The Standards and Terminology Service team should be informed of the decision to back-out. Refer to the PSS*1*254 Deployment, Installation, Back-out, Rollback Guide (DIBR) for complete instructions. Validation of Back-out Procedure --------------------------------- Refer to the PSS*1*254 Deployment, Installation, Back-out, Rollback Guide (DIBR) for detailed instructions. Routine Information: ==================== The second line of each of these routines now looks like: ;;1.0;PHARMACY DATA MANAGEMENT;**[Patch List]**;9/30/97;Build 109 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSSDRDOS Before:B159075348 After:B159859824 **160,173,195,178,206,254** Routine Name: PSSDSAPA Before:B107927231 After:B170839203 **151,160,173,178,254** Routine Name: PSSDSAPB Before: n/a After: B11384239 **254** Routine Name: PSSDSAPI Before:B207814040 After:B158584325 **117,160,173,178,206,224,254** Routine Name: PSSDSAPK Before:B230485547 After:B229160795 **117,168,160,178,254** Routine Name: PSSDSEXD Before:B183481538 After:B183626524 **178,206,224,254** Routine Name: PSSDSEXE Before:B212547613 After:B214476882 **178,206,224,254** Routine Name: PSSDSEXF Before: B6854669 After: B39918310 **224,254** Routine Name: PSSDSUTA Before:B106422259 After:B107969380 **178,224,254** Routine Name: PSSDSUTL Before:B139786830 After:B146552572 **201,178,206,224,231,254** Routine Name: PSSFDBDI Before:B154007468 After:B154243843 **160,175,201,254** Routine Name: PSSHFREQ Before: B27105352 After: B4001377 **136,254** Routine Name: PSSHREQ Before:B206597862 After:B213950608 **136,163,254** Routine Name: PSSHRIT Before:B243980583 After:B248064933 **136,168,164,173,180,184,178,254** Routine Name: PSSHRQ23 Before:B242124861 After:B269773735 **136,178,206,224,254** Routine Name: PSSHRQ24 Before: B64929944 After: B66486406 **178,206,224,254** Routine Name: PSSHRQ25 Before: B59968308 After: B62858058 **178,254** Routine Name: PSSHRQ2O Before: B48912788 After: B49284909 **136,160,254** Routine Name: PSSHRVAL Before:B170865582 After:B171945241 **136,160,178,254** Routine Name: PSSHRVL1 Before:B239921415 After:B240457333 **136,169,160,173,178,224,254** Routine Name: PSSJSV Before:B157152089 After:B202239861 **20,38,56,59,110,121,143,149, 146,189,201,210,254** Routine Name: PSSP254 Before: n/a After:B183033033 **254** Routine Name: PSSP254A Before: n/a After: B44516904 **254** Routine Name: PSSP254P Before: n/a After: B2589223 **254** Routine Name: PSSP254R Before: n/a After: B25371692 **254** Routine Name: PSSP254U Before: n/a After:B232114508 **254** Routine Name: PSSP254V Before: n/a After: B23560194 **254** Routine Name: PSSSCHMS Before:B128463744 After:B128439399 **178,206,231,254** Routine list of preceding patches: 163, 210, 231 ============================================================================= User Information: Entered By : Date Entered : AUG 04, 2021 Completed By: Date Completed: MAY 16, 2025 Released By : Date Released : MAY 16, 2025 ============================================================================= Packman Mail Message: ===================== $END TXT