$TXT Created by at VIPDEV12.AAC.DOMAIN.EXT (KIDS) on Tuesday, 02/20/18 at 13:48 ============================================================================= Run Date: DEC 04, 2018 Designation: OR*3*435 Package : OR - ORDER ENTRY/RESULTS REPORTING Priority: Mandatory Version : 3 SEQ #415 Status: Released Compliance Date: JAN 04, 2019 ============================================================================= Associated patches: (v)OR*3*350 <<= must be installed BEFORE `OR*3*435' (v)OR*3*394 <<= must be installed BEFORE `OR*3*435' Subject: FIRST DOSE NOW Category: - Routine Description: ============ **Note: Delivery of this patch is required to meet VA VistA Standardization requirements. The functionality in this patch is not dependent on the OR*3.0*405 VistA build (CPRS V32 COMBINED BUILD 1.0); however, the GUI code needed to run the new functionality created by this patch will not be available until the CPRS V32 cprschart.exe is released. OR*3.0*435 enables clinicians working in the Computerized Patient Record System (CPRS) to order a new medication for an inpatient where the first dose is to be administered immediately and ongoing doses are scheduled for administration on a regular schedule. Before implementation of this patch, when clinicians checked the "Give additional dose now" checkbox in the Inpatient Medications dialog box, two orders were created and both were given the same priority. If the assigned priority was ROUTINE, then the dose prescribed for immediate administration was processed during routine background processing and consequently not administered immediately as the clinician intended. Similarly, if the assigned priority was set to ASAP, then both orders were processed immediately when only the first dose required immediate processing. OR*3.0*435 implements enhancements to the CPRS Graphical User Interface (GUI) and VistA routines so that the first dose is automatically set to the priority ASAP and the ongoing order is set to the priority ROUTINE when "Give additional dose now" is selected. Sites that do not use the priority ASAP can select a site-specific alternative during patch installation. A Warning message notifies users that two orders are created and the dosing schedule and priority (ASAP and ROUTINE) are set automatically for each. Although the priority of the first dose defaults to ASAP, the clinician may select any available alternative from the Priority field before accepting the order. If "Give additional dose now" is selected and the Priority field is blank when the order is accepted, then the first dose will default to ASAP when the order is signed. If a value for the Priority field is selected before the "Give additional dose now" checkbox is enabled, a message notifies the user that the priority will be changed to default values (ASAP and ROUTINE). When the "Give additional dose now" checkbox is left unchecked, only one new medication order is created. The dosing priority and schedule are based on the priority and schedule specified by the clinician who creates and signs the order. A new parameter [ORDER URGENCY ASAP ALTERNATIVE] in VistA enables sites that do not have the priority ASAP in the Order Urgency file (#101.42) to use this enhancement. If the priority ASAP is not found during installation, then the installation program prompts the user to select an alternative urgency from the Order Urgency file. This alternative selection is stored in the PARAMETER DEFINITION file (# 8989.51) in the ORDER URGENCY ASAP ALTERNATIVE parameter. If an alternative priority is defined at installation, then CPRS displays the alternative to ASAP when a new inpatient medication order is placed and "Give additional dose now" is selected. BLOOD BANK Clearance: -------------------- EFFECT ON BLOOD BANK FUNCTIONAL REQUIREMENTS: Patch OR*3.0*435 contains changes to a package referenced in ProPath standard titled: BBM Team Review of VistA Patches. This patch does not alter or modify any VistA Blood Bank software design safeguards or safety critical elements functions. RISK ANALYSIS: Changes made by patch OR*3.0*435 have no effect on Blood Bank software functionality, therefore RISK is none. Patch Components: ----------------- Files & Fields Associated: ---------------------------- N/A Forms Associated: ---------------------------- N/A Mail Groups Associated: ---------------------------- N/A Options Associated: ---------------------------- N/A Protocols Associated: ---------------------------- N/A Security Keys Associated: ---------------------------- N/A Templates Associated: ---------------------------- N/A Remote Procedures Associated: New/Modified/Deleted ---------------------------- -------------------- ORWDPS1 GETPRIOR NEW ORWDPS1 GETPRIEN NEW Parameters Associated: New/Modified/Deleted --------------------- -------------------- ORDER URGENCY ASAP ALTERNATIVE New Additional Information: N/A New Service Requests (NSRs) ---------------------------- 20130802 First Dose Now Patient Safety Issues (PSIs) ----------------------------- N/A Remedy Ticket(s) & Overview --------------------------- N/A Problem: -------- N/A Resolution: ----------- N/A Test Sites: ---------- VA Portland Health Care System Portland, OR North Florida/South Georgia Veterans Health System, Gainesville, FL Software and Documentation Retrieval Instructions: ---------------------------------------------------- The software is being released as a KIDS build and the associated documentation describing the new functionality introduced by this patch will be available for downdload. 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: Hines: domain.ext Salt Lake City: domain.ext Documentation can also be found in the VA Software Document Library (VDL) at: https://www.domain.ext/vdl/. Title File Name FTP Mode ----------------------------------------------------------------------- CPRS User Guide: GUI Version cprsguium.doc Binary CPRS User Guide: GUI Version cprsguium.pdf Binary CPRS Technical Manual: GUI Version cprsguitm.doc Binary CPRS Technical Manual: GUI Version cprsguitm.pdf Binary CPRS Technical Manual cprslmtm.doc Binary CPRS Technical Manual cprslmtm.pdf Binary Patch Installation: Pre/Post Installation Overview ------------------------------ Review the Pre-Installation Instructions provided before beginning installation of the patch. 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. This patch utilizes the post-installation routine ORFD435P that runs at the end of the installation; the notification ""Running Post-Install Routine: ^ORFD435P" displays when the post-installation routine runs. This routine prompts sites that do not have ASAP in the Order Urgency file to select an alternative urgency. If the priority ASAP is not available in the Order Urgency file, then the following prompt displays, instructing the user to select an alternative urgency from the site's Order Urgency file. "Your sites' Order Urgency file does not contain 'ASAP', please select an alternative to the "ASAP" urgency for your site" If ASAP is available, then the existing ASAP priority will be used by default. The new prompt will not display, the installation will complete, and the following message will display. "Running Post-Install Routine: ^ORFD435P The ORDER URGENCY ASAP ALTERNATIVE parameter has already been set" Refer to the Post-Installation Instructions section of this document for additional details about the post-installation routine. Installation Instructions ----------------------------- To install the patch: 1. Choose the PackMan message containing this patch. 2. Choose the INSTALL/CHECK MESSAGE PackMan option. 3. From the Kernel Installation and Distribution System (KIDS) menu, select the Installation Menu. From this menu, you may elect to use the following options. When prompted for the INSTALL NAME, enter the patch number OR*3.0*435. a. Verify Checksums in Transport Global - This option will help ensure the integrity of the routines that are in the transport global. b. Print Transport Global - This option will enable viewing the components of the KIDS build. c. Compare Transport Global to Current System - This option will enable viewing all changes that will be made when this patch is installed. It compares all components of this patch (routines, data dictionaries, templates, etc.). d. Back up a Transport Global - This option will create a backup message of any routines exported with this patch. It will not back up any other changes such as data dictionaries or templates. 4. From the Installation Menu, select the Install Package(s) option and choose the patch to install. 5. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', press . 6. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', press 7. If prompted 'Delay Install (Minutes): (0 - 60): 0//', press . 8. If prompted 'Enter the Device you want to print the Install messages. You can queue the install by enter a 'Q' at the device prompt. Enter a '^' to abort the install. DEVICE: HOME// HOME (CRT)', press . Post-Installation Instructions ------------------------------ After the final installation prompt, the system displays a series of notifications related to the installation of patch components. The post-installation routine ORFD435P runs automatically. The notification "Running Post-Install Routine: ^ORFD435P" displays when the routine runs. Note: These post-installation instructions are only necessary for sites that do not have the priority "ASAP" in the Order Urgency file (#101.42). If ASAP is an available priority, then the installation of the patch will complete using the priority ASAP in conjunction with the "Give additional dose now" option. Sites that have the priority ASAP in the Order Urgency file when this patch is installed will not be prompted for an alternative by the post-installation routine; the existing ASAP priority will be used by default. The installation will complete and display the following message: "Running Post-Install Routine: ^ORFD435P The ORDER URGENCY ASAP ALTERNATIVE parameter has already been set" When the priority ASAP is not available in the Order Urgency file, the patch installer prompts the user to select an alternative urgency from the site's Order Urgency file. This alternative selection is stored in the PARAMETER DEFINITION file (#8989.51) in the ORDER URGENCY ASAP ALTERNATIVE parameter definition. Installation cannot continue until an alternative is selected. The selected alternative is used in place of the ASAP priority when "Give additional dose now" is selected. If the priority ASAP is not available and thus cannot be set during installation, the following displays: "Your sites' Order Urgency file does not contain 'ASAP', please select an alternative to the "ASAP" urgency for your site" "Setting ORDER GIVE ADDITIONAL DOSE SITE URGENCY for System: exampl.dns.domain.ext SITE ASAP ORDER URGENCY ALTERNATIVE:?" Type a question mark at the prompt to display the order urgency entries available in the Order Urgency file. "Answer with ORDER URGENCY NAME, or ABBREVIATION, or USAGE Do you want the entire 15-Entry ORDER URGENCY List? Y (Yes)" Choose from: DONE EMERGENCY INPATIENT NEXT AVAILABLE NOW PRE-OP ROUTINE STAT TODAY WITHIN 1 MONTH WITHIN 1 WEEK WITHIN 24 HOURS WITHIN 48 HOURS WITHIN 72 HOURS URGENTASAP "SITE ASAP ORDER URGENCY ALTERNATIVE: URGENTASAP" "URGENTASAP: Was recorded as your sites selection for an alternative to "ASAP"" Note: The post-installation routine adds the Remote Procedure Calls (RPCs) ORWDPS1 GETPRIOR and ORWDPS1 GETPRIEN to the OR CPRS GUI CHART option, if not already present. Backout Procedure: ------------------ Backout of this patch will be performed only with the concurrence and participation of the appropriate VA site/region personnel. The decision to back out the patch will be a joint decision between VA site/region personnel and other appropriate VA personnel. Note: Due to the complexity of this patch, it is not recommended for backout. However, in the event that a site decides to back out this patch, the site should contact the National Service Desk (NSD) to submit a CA Technologies Service Desk Manager (CA SDM) ticket. The development team will then assist with the backout process. The items listed in the Patch Components section of this patch description must be manually removed by OIT personnel using current approved methods. Validation of Backout Procedure: -------------------------------- The Backout procedure can be verified by printing the first two lines of the OR routines contained in this patch using the option First Line Routine Print [XU FIRST LINE PRINT]. Once the OR routines have been backed out, the first two lines of the routines will no longer contain the designation of patch OR*3.0*435 on line 2 in the patch list section. Note: This validation procedure only verifies that routine changes have been backed out; it does not confirm that other patch component changes have been backed out. Routine Information: ==================== The second line of each of these routines now looks like: ;;3.0;ORDER ENTRY/RESULTS REPORTING;**[Patch List]**;Dec 17, 1997;Build 29 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ORCSEND1 Before: B66241171 After: B75776613 **4,29,45,61,79,94,116,138,158, 149,187,215,243,282,323,394, 435** Routine Name: ORFD435P Before: n/a After: B7794799 **435** Routine Name: ORWDPS1 Before: B58422591 After: B65920710 **85,132,141,163,215,255,243, 306,350,435** Routine list of preceding patches: 350, 394 ============================================================================= User Information: Entered By : Date Entered : AUG 04, 2016 Completed By: Date Completed: DEC 03, 2018 Released By : Date Released : DEC 04, 2018 ============================================================================= Packman Mail Message: ===================== $END TXT