$TXT Created by at MNTVBB.DOMAIN.EXT (KIDS) on Wednesday, 07/10/24 at 12:03 ============================================================================= Run Date: AUG 21, 2024 Designation: GMRA*4*72 Package : GMRA - ADVERSE REACTION TRACKING Priority: Mandatory Version : 4 SEQ #65 Status: Released Compliance Date: SEP 21, 2024 ============================================================================= Subject: INACTIVE GMR ALLERGIES IN PATIENT ALLERGY FILE Category: - Routine Description: ============ This patch will resolve the following issues: INC29547110 - Inactive causative agents can be selected as reactants. INC30029401 - Inactive allergies from the GMR ALLERGY file (#120.82) are erroneously populated in the PATIENT ALLERGY file (#120.8). Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- N/A 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: ----------------------- None New Service Requests (NSRs): ---------------------------- N/A Patient Safety Issues (PSIs): ----------------------------- HITPS-11020 Additional Information: ----------------------- Defect Tracking System Ticket(s) & Overview: INC30029401 - Inactive allergies from the GMR ALLERGY file (#120.82) are erroneously populated in the PATIENT ALLERGY file (#120.8). Problem: -------- Incorrect configurations in a Kernel file allowed a user to select inactive allergies from file #120.82 with inactive VUID's. Those inactive reactants may have incomplete allergy information such as ingredients and VA Drug Classes which may prevent proper allergy checks on pharmacy orders and thus create a patient safety issue. NOTE - the Kernel file configuration at the reporting sites has been updated to prevent further occurrences of the problem but the erroneous entries in file #120.8 need to be found and cleaned up. Resolution: ----------- The following changes were made to address the issue: A patch post-install routine has been created to find and attempt to clean up the incorrectly built records in the PATIENT ALLERGY file (#120.8). Technical Resolution: --------------------- The following changes were made to address the issue: The post-install routine does the following: 1. Scan active records in the PATIENT ALLERGIES file (#120.8) and look in the GMR ALLERGY field (#1) for pointers to inactive records in the GMR ALLERGY file (#120.82). Patient allergy records marked as "Entered in Error" and those with pointers in field 1 to files other than #120.82 are not processed. Also, records for deceased and test patients are not repaired. 2. The ALLERGY TYPE field (#3.1) is then examined to determine if it is a DRUG allergy and if so, then the REACTANT field (#.02) is retrieved to see if the same drug can be found in the 50.6 (VA GENERIC) file as it might contain an EXACT match in the "B" cross-reference. 3. If an EXACT drug match is found: a. The original patient allergy record is saved in the ^XTMP global for 90 days for potential retrieval via the BACKOUT functionality in this routine. b. The #50.6 matching IEN and "^PSNDF(50.6," are written to the GMR ALLERGY field. c. The ^PSNDF(50.6,"APRO" index is then examined to determine the VA Drug Class(es) for the matching IEN. If there are no pre-existing VADC'S for that patient allergy record and none can be found, then the existing record is NOT updated and the changes in 3b are backed out. Any newly-found VADC's are written to that allergy record. d. A comment is also inserted into the COMMENTS field of the repaired record indicating the update. 4. If a drug match is NOT found or a record can not be updated for any reason, that record ID is saved in a node in the ^XTMP global for examination via the REPORT functionality provided in the routine. Note: The routine is not deleted after install since it is tasked and the BACKOUT functionality needs to remain available. A future patch can be used to delete the routine, if needed. Test Sites: ----------- Manchester VA Medical Center (Manchester, NH) Puget Sound VA HCS (Seattle, WA) SNOW Change Order Number: ------------------------- Manchester - CHG0504209 Puget Sound - CHG0505887 Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released in a PackMan message. Documentation describing the new functionality is not included in this release. Patch Installation: ------------------- 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. It is not necessary to disable any options. Installation Instructions: -------------------------- 1. Choose the PackMan message containing this build. Then select the INSTALL/CHECK MESSAGE PackMan option to load the build. 2. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu: A. Select the Verify Checksums in Transport Global option to confirm the integrity of the routines in the transport global. When prompted for the INSTALL NAME, enter the patch or build name: GMRA*4.0*72 NOTE: Using will not bring up a Multi-Package build even if it was loaded immediately before this step. It will only bring up the last patch in the build. B. Select the Backup a Transport Global option to create a backup message. You must use this option and specify what to backup; the entire Build or just Routines. The backup message can be used to restore the routines and components of the build to the pre-patch condition. i. At the Installation option menu, select Backup a Transport Global. ii. At the Select INSTALL NAME prompt, enter your build GMRA*4.0*72 iii. When prompted for the following, enter "R" for Routines or "B" for Build. Select one of the following: B Build R Routines Enter response: Build iv. When prompted "Do you wish to secure your build? NO//", press and take the default response of "NO". v. When prompted with, "Send mail to: Last name, First Name", press to take default recipient. Add any additional recipients. vi. When prompted with "Select basket to send to: IN//", press and take the default IN mailbox or select a different mailbox. C. You may also elect to use the following options: i. Print Transport Global - This option will allow you to view the components of the KIDS build. ii. 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 of the components of this patch, such as routines, DDs, templates, etc. D. Select the Install Package(s) option and choose the patch to install. i. If prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//', answer NO. ii. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer NO. iii. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', answer NO. a. If prompted 'Enter options you wish to mark as 'Out Of Order':', press the Enter key. b. If prompted 'Enter protocols you wish to mark as 'Out Of Order':', press the Enter key. c. If prompted 'Delay Install (Minutes): (0 - 60): 0//', answer 0 Post-Installation Instructions: ------------------------------ Upon successful installation of the patch, the installer and users holding the GMRA-SUPERVISOR or PSNMGR keys should receive three reports via a MailMan message - a Summary, Fixed, and NotFixed record report. Sample Summary Report: Subj: GMRA*4.0*72 Post-Install Summary Information [#461874] 05/21/24@14:38 18 lines From: GMRA*4.0*72 Post-Install In 'IN' basket. Page 1 *New* -------------------------------------------------------------------------- ********** GMRA*4.0*72 Post-Install Routine Summary Report ********** Process was run by USER,INSTALLER on May 21, 2024 Total Patient Allergy records examined = 30087 Deceased patient bad records found = 5178 Test patient bad records found = 94 Total active bad records found = 14 Bad records that could not be repaired = 5 _______ Bad records fixed = 9 The original version of the corrected records, if any, are stored for 90 days at ^XTMP("GMRA*4.0*72 POST INSTALL",0,"FIXED",recordID). *************************** End of Report **************************** Sample FIXED report: Subj: GMRA*4.0*72 FIXED Record Report Information [#461875] 05/21/24@14:38 19 lines From: GMRA*4.0*72 REPORT In 'IN' basket. Page 1 *New* -------------------------------------------------------------------------- ************************* GMRA*4.0*72 Report ************************ FIXED Report was requested by USER,INSTALLER on May 21, 2024 You are receiving this report as a holder of the GMRA-SUPERVISOR or PSNMGR key #120.8 ID^PATIENT NAME^DRUG ALLERGY NAME 31633^AAAFLDHU,TSHUADYF A^IODINE 31634^INPATIENT,PADE TWO^IODINE 31635^MJALRUHY,TELYL^IODINE 31667^AZDJB,TLRA B^ASPIRIN 31672^HDAAH,QDYJH IPDFES^ASPIRIN 31678^DMLZL,TLRA ILAH^ASPIRIN 31688^AFFLUPLA,INALY U^ASPIRIN 31691^EFH,NQHSSH^ASPIRIN 31706^JLCD,CLY G CU^ASPIRIN *************************** End of Report *************************** Sample NOTFIXED Report: Subj: GMRA*4.0*72 NOTFIXED Record Report Information [#461876] 05/21/24@14:38 15 lines From: GMRA*4.0*72 REPORT In 'IN' basket. Page 1 *New* -------------------------------------------------------------------------- ************************* GMRA*4.0*72 Report ************************ NOTFIXED Report was requested by USER,INSTALLER on May 21, 2024 You are receiving this report as a holder of the GMRA-SUPERVISOR or PSNMGR key #120.8 ID^PATIENT NAME^DRUG ALLERGY NAME 146^PLZWADY,SHUUHAA Z^CINNAMON OIL 8831^KULTXQHJ,ZXUFLY ZLUB^CINNAMON OIL 9412^IWXKLUULT,QLYJH C^CINNAMON OIL 10277^PUHQXTS,HTSHU^CINNAMON OIL 22742^GRLUHYX,TXY ILQDI^CINNAMON OIL *************************** End of Report *************************** If the NOTFIXED report has records, please open a SNOW ticket for further assistance. Back-Out/RollBack Strategy: --------------------------- NOTE - this is different than the usual plan as there are no components being modified or added to the system permanently, so nothing needs to be backed up prior to installation. There is only a post-install routine which runs after patch installation. Backup of any affected data is done when the post-install routine is running and before the data is corrected. The original version of the corrected records can be found for 90 days in the ^XTMP("GMRA*4.0*72 POST INSTALL") global. Data modified by this patch installation can be restored by running a backout process included in the post-install routine. If needed, please open a Service Now ticket to request assistance in this process. IMPORTANT - this action should only be taken with the concurrence and participation of the development team and appropriate VA site/region personnel. Validation of Back-out Procedure: --------------------------------- N/A Routine Information: ==================== The second line of each of these routines now looks like: ;;4.0;ADVERSE REACTION TRACKING;**[Patch List]**; 30 Oct 98;Build 5 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: GMRA72P Before: n/a After:B225698766 **72** ============================================================================= User Information: Entered By : Date Entered : DEC 14, 2023 Completed By: Date Completed: AUG 21, 2024 Released By : Date Released : AUG 21, 2024 ============================================================================= Packman Mail Message: ===================== $END TXT