$TXT Created by MNTVBB.DOMAIN.EXT (KIDS) on Tuesday, 12/31/24 at 10:12 ============================================================================= Run Date: APR 23, 2025 Designation: GMRA*4*73 Package : GMRA - ADVERSE REACTION TRACKING Priority: Mandatory Version : 4 SEQ #66 Status: Released Compliance Date: MAY 23, 2025 ============================================================================= Associated patches: (v)GMRA*4*70 <<= must be installed BEFORE `GMRA*4*73' Subject: DRUG-ALLERGY ORDER CHECK NOT DISPLAYING Category: - Routine Description: ============ This patch addresses the following issue: 1. INC36741881 - DRUG-ALLERGY ORDER CHECK NOT DISPLAYING EHRM Impact Statement: ---------------------- This patch can be installed at all sites, including EHRM converted sites. 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: ----------------------- New Service Requests (NSRs): N/A Patient Safety Issues (PSIs): ----------------------------- HITPS-12207 Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 1. INC36741881 - DRUG-ALLERGY ORDER CHECK NOT DISPLAYING Problem: -------- The problem is a drug allergy returned from the Health Data Repository (HDR) when ordering a medication in a Pharmacy application may not be checked against for the drug allergy order check. This issue can happen at any VA location. We believe this only happens with remote Cerner meds in the HDR, because of some issues getting assessment data to the HDR from Cerner. The problem is with allergy assessment data. Pharmacy calls ORCHK2^GMRAOR for the remote drug allergy checks. When evaluating these remote allergies, the GMRA code first checks for a local allergy assessment, and if there is one, no further assessment checks are needed. But if there is no local assessment, the GMRA code looks for any remote assessment returned from the HDR, and if there is also no remote assessment, any remote allergies that are returned will not be checked against, because there are no local or remote allergy assessments. Pharmacy Benefits Management decided that, though this will not resolve the problem of inconsistent assessment data in the HDR of Cerner Data versus VistA data, the code should be modified to perform the order check against any remote allergy returned, regardless of whether there is local or remote assessment data. Resolution: ----------- The assessment checks in question are at ORCHK2+37^GMRAOR through ORCHK2+42^GMRAOR. The code at line ORCHK2+42^GMRAOR quits if there is no local and no remote assessment, even if there is a remote drug allergy returned. Routine GMRAOR is modified to add a line before ORCHK2+42^GMRAOR and check for remote allergies and if there are any, allow processing to continue past line ORCHK2+42^GMRAOR. Technical Resolution: --------------------- Add the following at line ORCHK2+42^GMRAOR: ;GMRA*4*73 I $D(^TMP("GMRAOC",$J,"API"))!$D(^TMP("GMRAOC",$J,"APC")) S GMRASESS=1 Test Sites: ----------- VA Manchester VA Medical Center (Manchester, NH) Carl Vinson VA Medical Center (Dublin, GA) Test Sites - SNOW Change Order #: -------------------------------- MAN - CHG0589619 DUB - CHG0580946 Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released in a PackMan message. 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. 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 that are in the transport global. When prompted for the INSTALL NAME enter the patch or build name (ex. GMRA*4.0*73) 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*73 iii. When prompted for the following, enter "R" for Routines or "B" for Build. Select one of the following: B Build R Routines Backup Type: B// 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 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. Prior to installing an updated KIDS package, the site/region should have saved a backup of the build in a mail message using the Backup a Transport Global [XPD BACKUP] menu option (this is done at time of install). The message containing the backed-up build can be loaded with the "Xtract PackMan" function at the Message Action prompt. The Packman function "INSTALL/CHECK MESSAGE" is then used to install the backed up routines onto the VistA System. The back-out plan is to restore the build from the backup created. No data was modified by this patch installation and, therefore, no rollback strategy is required. Validation of Back-out Procedure: --------------------------------- The Back-out Procedure can be verified by printing the first 2 lines of the routines contained in this patch using the option First Line Routine Print [XU FIRST LINE PRINT]. Once the build contained in the GMRA*4.0*73 patch has been backed out, the first two lines of the routine will no longer contain the designation of this patch in the patch list section on line 2. Routine Information: ==================== The second line of each of these routines now looks like: ;;4.0;Adverse Reaction Tracking;**[Patch List]**;Mar 29, 1996;Build 3 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: GMRAOR Before:B186206489 After:B188056373 **2,13,26,37,41,42,44,46,52, 53,63,70,73** Routine list of preceding patches: 70 ============================================================================= User Information: Entered By : Date Entered : DEC 27, 2024 Completed By: Date Completed: APR 22, 2025 Released By : Date Released : APR 23, 2025 ============================================================================= Packman Mail Message: ===================== $END TXT