$TXT Created by CPRS28.DOMAIN.EXT (KIDS) on Friday, 04/22/16 at 15:55 ============================================================================= Run Date: MAY 24, 2016 Designation: GMRA*4*48 Package : GMRA - ADVERSE REACTION TRACKING Priority: EMERGENCY Version : 4 SEQ #45 Status: Released Compliance Date: MAY 26, 2016 ============================================================================= Associated patches: (v)GMRA*4*36 <<= must be installed BEFORE `GMRA*4*48' Subject: ASSESSMENT CLEAN UP UTILITY Category: - Routine Description: ============ During review of the three defect tickets submitted regarding a hard error in allergy order checking, it was discovered there was a data integrity issue with some entries in the ADVERSE REACTION TRACKING (GMRA) system. This patch will install the Assessment Clean Up Utility, allowing sites to identify and correct any discrepancies between the ADVERSE REACTION ASSESSMENT file (#120.86) and the PATIENT ALLERGIES file (#120.8). Patch Components ================ Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- N/A Forms Associated: Form Name File # New/Modified/Deleted --------- ------ -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- GMRA ASSESSMENT UTILITY run routine New Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- GMRA ASSESS DET ALL EIE New GMRA ASSESS DET ASSESSMENT New GMRA ASSESS DET MENU New GMRA ASSESS DET REVIEW New GMRA ASSESS MENU New GMRA ASSESS SELECT PATIENT New Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A New Service Requests (NSRs) ---------------------------- N/A Patient Safety Issues (PSIs) ----------------------------- PSPO 3111 Remedy Ticket(s) & Overview --------------------------- 1. 827602 Adverse Reaction Tracking - Receiving Error (Undefined, NullSubscript, etc): 831129 Adverse Reaction Tracking - Allergy Order Checks: 833419 Outpatient Pharmacy - Other: Problem: ------- When a pharmacist processes a prescription, a DSPLY+4^PSODGAL1 *GMRAL error is generated, preventing the pharmacist from finishing the prescription. This error is generated when the ADVERSE REACTION ASSESSMENT file (#120.86) data is out of sync with the PATIENT ALLERGIES file (#120.8) data, specifically, the patient had a value of NO for the assessment yet had active reactions. Outpatient Pharmacy patch PSO*7*390 enabled the pharmacy order checks to display sign and symptom data in the text of a drug-allergy order check message. To accomplish this, two allergy APIs were called: one that performed the order check (which ignored the assessment data) and another that retrieved the sign and symptom data (which did not ignore the assessment data). Resolution: ---------- This data issue was caused by version 2 of the Adverse Reaction Tracking software package (the current version is 4). The current version of the software prevents this data problem from occurring. Therefore, the Assessment Clean Up Utility tool was created to enable sites to identify patients in this situation and manually correct the appropriate data so that both files are in agreement. **NOTE: Installation of this patch does not by itself prevent the undefined error from occurring. Sites must use the tool to correct any problems that it identifies in order to prevent the error from occurring. Test Sites: ---------- Syracuse VA Medical Center (Syracuse, NY) James J. Peters VA Medical Center (Bronx, NY) VA Maryland Health Care System Louis Stokes Cleveland VA Medical Center (Cleveland, OH) Software and Documentation Retrieval Instructions: ------------------------------------------------- Documentation describing the new functionality introduced by this patch is available. The preferred method is to retrieve files from download.vista.domain.ext. This transmits the files from the first available server. Sites may also elect to retrieve files directly from a specific server. Sites may retrieve the documentation directly using Secure File Transfer Protocol (SFTP) from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Albany: domain.ext Hines: domain.ext Salt Lake City: domain.ext Documentation can also be found on the VA Software Documentation Library at: http://www4.domain.ext/vdl/ Title File Name FTP Mode ----------------------------------------------------------------------- Adverse Reaction Tracking gmra_4_um.doc Binary User Manual gmra_4_um.pdf Adverse Reaction Tracking gmra_4_tm.doc Binary Technical Manual gmra_4_tm.pdf Patch Installation: Pre/Post Installation Overview ------------------------------ During the post installation, the B cross-reference in the ADVERSE REACTION ASSESSMENT file (#120.86) is re-indexed. After the install has completed, KIDS will automatically delete the post install routine once the install successfully completes. After installing this patch, sites must run the utility and correct all problems identified. Sites should not run the utility while patient merges are in progress. Refer to the Track Status of Merge Process section in the Duplicate Record Merge: Patient Merge User Manual to determine if there are any patient merges in progress. If the utility's patient list contains patients without names, sites should submit a CA SDM ticket for support in deleting the list of patients and re-running the utility. This patch may be installed with users on the system. Sites are strongly encouraged to queue this patch to install outside of normal business hours as the post installation may impact users entering adverse reaction assessments. This patch should take less than 5 minutes to install. There are no options to disable for this installation. Installation Instructions ------------------------- 1. Choose the PackMan message containing this patch. 2. Choose the INSTALL/CHECK MESSAGE PackMan option. 3. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, you may elect to use the following options. When prompted for the INSTALL enter the patch # : GMRA*4*48 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 DDs 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, DDs, 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. From the Installation Menu, select the Install Package(s) option and choose the patch to install. 5. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//', answer NO. 6. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer NO. 7. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', answer NO. Post-Installation Instructions ------------------------------ *****Important Note***** It is imperative that sites run the GMRA ASSESSMENT UTILITY to identify any potential data issues and correct them as soon as possible in order to mitigate any potential patient safety issues from improper allergy order checks. Sites should ensure there are no patient merges in progress while the background task builds the list of patients with data issues. In order to coordinate, you will have to determine who performs patient merges for your facility. Sites have different departments involved in patient merges. Some sites use a team of the MPI coordinator and OIT representatives. Others use HIMs or potentially the business office. *****Important Note***** These discrepancies must be corrected before the installation of the Medication Order Check Healthcare Application (MOCHA) Enhancements 2 (ME2) patches. The first time GMRA ASSESSMENT UTILITY is accessed, a search will process through the ADVERSE REACTION ASSESSMENT file (#120.86) and the PATIENT ALLERGIES file (#120.8) looking for any possible discrepancies. When the search is complete, a MailMan message with the subject GMRA ASSESSMENT FIX LIST BUILD STATUS, will be sent to the person who started the task as well as any additional recipients specified. At this time, the patients and discrepancies need to be reviewed and corrected to mitigate any potential patient safety issues. Use the GMRA ASSESSMENT UTILITY to see the list of patients, if any, and the discrepancies found. For further instructions, as well as examples, please refer to the Adverse Reaction Tracking User Manual (GMRA_4_UM_R0416). Routine Information: ==================== The second line of each of these routines now looks like: ;;4.0;Adverse Reaction Tracking;**[Patch List]**;Mar 29, 1996;Build 13 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: GMRAFA Before: n/a After: B82868608 **48** Routine Name: GMRAFA1 Before: n/a After: B22448935 **48** Routine Name: GMRANKA Before: B12980471 After: B14671193 **2,21,36,48** Routine Name: GMRAY48 Before: n/a After: B544104 **48** Routine list of preceding patches: 36 ============================================================================= User Information: Entered By : Date Entered : MAR 28, 2013 Completed By: Date Completed: MAY 20, 2016 Released By : Date Released : MAY 24, 2016 ============================================================================= Packman Mail Message: ===================== $END TXT