============================================================================= Run Date: SEP 14, 2018 Designation: GMTS*2.7*94 Package : GMTS - HEALTH SUMMARY Priority: Mandatory Version : 2.7 SEQ #113 Status: Released Compliance Date: OCT 15, 2018 ============================================================================= Associated patches: (v)PSO*7*294 <<= must be installed BEFORE `GMTS*2.7*94' Subject: MEDICATION RECONCILIATION HS COMPONENT TOOL #1 (MED RECON PROFILE) Category: - Routine - Other Description: ============ The purpose of this patch is to correct a series of issues reported with the Medication Reconciliation Tool #1. This patch also creates a replica of this called Medication Reconciliation No Glossary Tool #1. When the end user selects the Essential Med List For Review option, it will generate similar report data but without the glossary at the end. This patch is part of a multi-package build that contains the following two patches: GMTS*2.7*94 PSO*7.0*314 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 ----------- ---- -------------------- GMTS PS MED RECON CONFIG CHECK run routine New GMTS IRM/ADPAC MAINT MENU menu Modified 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 Additional Information: New Service Requests (NSRs): ---------------------------- Patient Safety Issues (PSIs): ----------------------------- PSPO #1262 - Medications from remote VA data missing from Medication Reconciliation profile PSPO #1861 - The CPRS Medication Reconciliation Report omits Inpatient Meds for Outpatient (IMO) IV orders with a schedule type of "On Call" PSPO #1922 - Med Recon "Remote Data Object" active medications displaying incomplete prescription information from DoD - private pharmacy prescriptions retrieval PSPO #2376 - Med Recon omits some expired medications PSPO #2570 - Medication Reconciliation Health summary does not provide an inclusive list of all Expired/Discontinued medications from the last year PSPO #2605 - several instances whereby the Medication Reconciliation Health Summary (from the CPRS Reports tab) printed/displayed erroneous prescription directions (SIG) for 'Pending' outpatient prescriptions Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 1. INC 290787 - Meds held from remote VA data are not being pulled in med reconciliation profile. INC 1241749 - Health Summary - Other Problem: ------- There was no (local) Inpatient order for simvastatin, but there was a remote Outpatient order that the clinical pharmacist using the report couldn't see. This was due to the fact the remote medication was on hold. Resolution: ---------- Usage of data from other VA pharmacies via Remote Data Interoperability (RDI) updated to include prescriptions where the status is 'HOLD'. 2. INC 296479 - Med Recon Tool #1 sometimes missing BCMA data Problem: ------- In some cases, the BCMA last action is not reported for all items, particularly large volume IVs. Resolution: ---------- The issue was caused due to the structure of the code that was retrieving order text information. For any order without certain order text, the processing would stop before retrieving the BCMA last action. The code has been restructured to prevent this. 3. INC 297716 - Medication Reconciliation Report Problem: ------- Clinic Medications have no indication that they are clinic meds. They appear with 'INPT' as the service. Resolution: ---------- A new Application Programming Interface (API) has been provided to allow the tool to determine if an order is a Clinic Medication. The clinic medications will now display 'CLIN', rather than 'INPT'. 4. INC 297723 - Most recent order not showing on med reconciliation report INC 300608 - Wrong release date shown in med reconciliation tool #1 INC 314592 - Medication reconciliation summary not working as expected INC 347375 - Medication missing from Med Rec HS INC 439391 - Tool #1 Medication Reconciliation Profile - medication not displaying INC 528436 - Drugs displayed wrong on Meds tab INC 812381 - Outpatient Pharmacy - Medication Reconciliation issue INC 1001674 - Health Summary Medication Reconciliation Class I not pulling all the data into this reports which is additionally affecting our local reports which depends on it. INC 1000262 - Med Rec not displaying correct medication order Problem: ------- There were two orders for the same medication but the one that displayed on the report was the older of the two. Resolution: ---------- The program has been revised to look at the correct date field on the prescriptions and no longer infer that the latest expiration date implied the latest prescription. 5. INC 413004 - Med Reconciliation Awkward for Provider Comments Problem: ------- Provider comments that contained multiple lines were not printing correctly. Resolution: ---------- The tool was modified to display multiple line provider comments in a more readable fashion. 6. INC 432276 - Remote Meds Object and DoD Meds INC 620679 - RDIM pulls up old info which is still listed as active INC 831528 - Old DoD order on med rec health summary Problem: ------- The issue is caused due to the fact that the Clinical/Health Data Repository (CHDR) has no update that marks Department of Defense (DoD) prescriptions have expired. Resolution: ---------- The program was updated to assume that DoD prescriptions with an issue date more than 1 year in the past must be, by definition, now expired or discontinued and will no longer be considered 'ACTIVE' even though that is precisely what is returned by the CHDR data. 7. INC 469644 - Medication Reconciliation Component INC 1019113 - Medication Reconciliation displaying wrong Sig for medication Problem: ------- The section of the report that showed 'Other medications previously dispensed in the last year' was misleading. For example, prescriptions with no refills that were over 120 days old would not display at all. In some cases, this led to the belief that the Sig that was displaying was incorrect. Resolution: ---------- The section in question has been removed from the report and the medications needed for the report were incorporated into the main body of the report. 8. INC 616298 - IV Order with OC set does not show on Med Recon report Problem: ------- Whenever an IV order was set to On Call (not the schedule On Call), then the order no longer appeared on the Medication Reconciliation Report. Resolution: ---------- System was modified to recognize the On Call property flag for IV types of admixtures. Test Sites: ---------- Tennessee Valley VAMC Sheridan VAMC Software and Documentation Retrieval Instructions: ---------------------------------------------------- Software being released as a host file and/or documentation describing the new functionality introduced by this patch are 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 software and/or documentation directly using Secure File Transfer Protocol (SFTP) from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Hines: domain.ext Salt Lake City: domain.ext Documentation can also be found on the VA Software Documentation Library at: https://www.domain.ext/vdl/ Title File Name FTP Mode ----------------------------------------------------------------------- Medication Reconciliation GMTS_2_7_P94_PSO_7_P314_IG Binary Health Summary (HS) Component (Tool #1) and Allergies/ADRs Component (Tool #5) Installation Guide Health Summary User Manual GMTS_2_7_UM.DOCX Binary GMTS_2_7_UM.PDF Binary Health Summary Technical Manual GMTS_2_7_TM.DOCX Binary GMTS_2_7_TM.PDF Binary The software is being released in a multi-package build: GMTS_2_7_94_PSO_7_314.KID ASCII Patch Installation: Pre/Post Installation Overview: ------------------------------- 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 10 minutes to install. Installation Instructions: -------------------------- 1. Load the host file using the "Load a Distribution" option on the VistA XPD Installation Menu. 2. 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 NAME enter: GMTS*2.7*94 / PSO*7.0*314 COMBINED BUILD 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//' 6. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//' 7. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//' 8. If prompted 'Delay Install (Minutes): (0 - 60): 0//' respond 0. Post-Installation Instructions: ------------------------------- The Post Installation routine GMTSPI94 can be manually deleted after it runs; it does not get automatically deleted. Back-out / Rollback Strategy: ---------------------------- In the event of a catastrophic failure, the Facility CIO may make the decision to back-out the patch. In order to Back-out the patch, the following steps should be undertaken: 1. Use GMTS TYPE ENTER/EDIT VistA option to change the HS Type "Essential Med List for Review" from the HEALTH SUMMARY TYPE (#142) File back to "Medication Reconciliation." Within the same option delete HS Components MRT1 (or alternately MRR1) & MRT5 from this HS Type. Then add back in BADR, RART & MRP Components. 2. Use the Disable/Enable Health Summary Component option underneath the Health Summary Maintenance menu [GMTS IRM/ADPAC MAINT MENU] to Disable the HS Components MRT1, MRT4, MRT5 & MRR1 from the HEALTH SUMMARY COMPONENT (#142.1) File. When prompted for DISABLE FLAG, choose P - permanent. Also, you must enter in an appropriate OUT OF ORDER MESSAGE such as 'GMTS*2.7*94 / PSO*7*314 Backed Out per Facility CIO.' 3. Modify VistA menu [GMTS IRM/ADPAC MAINT MENU] Health Summary Maintenance Menu to take out the call to [GMTS PS MED RECON CONFIG CHECK] Check Medication Reconciliation Configuration VistA option. 4. Delete VistA option [GMTS PS MED RECON CONFIG CHECK] Check Medication Reconciliation Configuration. 5. Use [XTRDEL] Delete Routines VistA option to delete GMTSGLOS, GMTSPI94, GMTSPSCK, GMTSPST1, GMTSPST4, GMTSPST5, GMTSPSTN and GMTSPSTR routines. 6. From the Transport Global Backup, restore the PSO5241 routine to its original pre-PSO*7.0*314 version. There are no Rollback instructions for this patch. Routine Information: ==================== The second line of each of these routines now looks like: ;;2.7;Health Summary;**[Patch List]**;Oct 20, 1995;Build 40 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: GMTSGLOS Before: n/a After: B14557009 **94** Routine Name: GMTSPI94 Before: n/a After: B7561147 **94** Routine Name: GMTSPSCK Before: n/a After: B5589868 **94** Routine Name: GMTSPST1 Before: n/a After:B167015680 **94** Routine Name: GMTSPST4 Before: n/a After: B17358718 **94** Routine Name: GMTSPST5 Before: n/a After: B13367450 **94** Routine Name: GMTSPSTN Before: n/a After:B180171627 **94** Routine Name: GMTSPSTR Before: n/a After: B1733586 **94** ============================================================================= User Information: Entered By : Date Entered : NOV 19, 2009 Completed By: Date Completed: SEP 13, 2018 Released By : Date Released : SEP 14, 2018 ============================================================================= Packman Mail Message: ===================== No routines included