============================================================================= Run Date: SEP 29, 2022 Designation: OR*3*405 Package : OR - ORDER ENTRY/RESULTS REPORTING Priority: Mandatory Version : 3 SEQ #499 Status: Released Compliance Date: DEC 16, 2022 ============================================================================= Associated patches: (v)OR*3*562 <<= must be installed BEFORE `OR*3*405' (v)OR*3*571 <<= must be installed BEFORE `OR*3*405' (v)OR*3*179 <<= must be installed BEFORE `OR*3*405' (v)OR*3*312 <<= must be installed BEFORE `OR*3*405' (v)OR*3*449 <<= must be installed BEFORE `OR*3*405' (v)OR*3*453 <<= must be installed BEFORE `OR*3*405' (v)OR*3*465 <<= must be installed BEFORE `OR*3*405' (v)OR*3*476 <<= must be installed BEFORE `OR*3*405' (v)OR*3*498 <<= must be installed BEFORE `OR*3*405' (v)OR*3*501 <<= must be installed BEFORE `OR*3*405' (v)OR*3*507 <<= must be installed BEFORE `OR*3*405' (v)OR*3*512 <<= must be installed BEFORE `OR*3*405' (v)OR*3*515 <<= must be installed BEFORE `OR*3*405' (v)OR*3*521 <<= must be installed BEFORE `OR*3*405' (v)OR*3*527 <<= must be installed BEFORE `OR*3*405' (v)OR*3*539 <<= must be installed BEFORE `OR*3*405' (v)OR*3*547 <<= must be installed BEFORE `OR*3*405' (v)OR*3*559 <<= must be installed BEFORE `OR*3*405' Subject: CPRS V32B Category: - Routine - Other - Enhancement (Mandatory) - Data Dictionary Description: ============ This patch is part of the Computerized Patient Record System (CPRS) v32B updates. Below is a list of all the applications involved in this project along with their patch numbers: APPLICATION/VERSION PATCH --------------------------------------------------------------- TEXT INTEGRATION UTILITIES v1.0 TIU*1.0*289 OUTPATIENT PHARMACY v7.0 PSO*7.0*441 CLINICAL REMINDERS v2.0 PXRM*2.0*65 HEALTH SUMMARY v2.7 GMTS*2.7*115 PCE PATIENT CARE ENCOUNTER v1.0 PX*1.0*217 BAR CODE MEDICATION ADMINISTRATION v3.0 PSB*3.0*93 ORDER ENTRY/RESULTS REPORTING v3.0 OR*3.0*405 INPATIENT MEDICATIONS v5.0 PSJ*5.0*399 ADVERSE REACTION TRACKING v4.0 GMRA*4.0*51 MENTAL HEALTH v5.01 YS*5.01*211 PHARMACY DATA MANAGEMENT v1.0 PSS*1.0*187 KERNEL v8.0 XU*8.0*662 PSS*1.0*187 and XU*8.0*662 are being released as host files, but they will not be included in the multi-package build. The remaining patches are being released in the KIDS multi-package build CPRS V32B COMBINED BUILD 1.0. Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- ORDER CHECK OVERRIDE REASONS (#100.04) NAME (#.01) New SYNONYM (#.02) New TYPE (#.03) New ACTIVE (#.04) New ORDER CHECK INSTANCES (#100.05) COMMENT ON REMOTE ALLERGY (#11) New PDMP QUERY LOG (#101.62), QUERIES Multiple (#101.621) FROM REMINDERS (#.12) New Forms Associated: Form Name File # New/Modified/Deleted --------- ------ -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A New File Entries Associated: File Name (Number) Field (Number) Value ------------------ --------------- ----- ORDER REASON (#100.03) NAME (#.01) Allergy/Adverse Drug Reaction SYNONYM (#.03) ADR INACTIVE (#.04) ACTIVE PACKAGE (#.05) ORDER ENTRY/RESULTS REPORTING NATURE OF ACTIVITY (#.07) REJECTED Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- ORCM MGMT Menu Modified ORCM UPD INDICATION QO Action New ORCM UPDATE TITRATION QO Action New OR CPRS GUI CHART Broker Modified OR INDICATION USAGE REPORT Routine New OR PARAM COORDINATOR MENU Menu Modified OR VIMM IMM NOTE TITLE Action New OR VIMM IMM REM DEFINITIONS Action New OR VIMM MENU Menu New OR VIMM REMINDER DIALOG ONLY Action New OR VIMM SKIN TEST REM DEFS Action New OR IMM CONTACT INFO Action New OR IMM COVERSHEET DIAGNOSIS Action New ORCM REPORT/CONV UTILITIES Menu New ORCM UPDATE TITRATION QO Action New Parameter Definitions Associated: Parameter Definition Name New/Modified/Deleted ------------------------- -------------------- ORB DAYS FOR PROCESSED ALERTS New ORB MAX PROCESSED ALERTS New ORWCV1 COVERSHEET LIST Modified ORWDPS ROUTING DEFAULT Modified OR CPRS CLOZAPINE CUSTOM MSG Modified OR IMM CONTACT INFORMATION New OR IMM COVERSHEET DIAGNOSIS New OR IMM REMINDER DIALOG New OR IMMUNIZATION DOCUMENT TITLE New OR VIMM IMM REMINDERS New OR VIMM SKIN REMINDERS New OR VIMM USE ICE New OR RTN PROCESSED ALERTS New Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Remote Procedure Calls Associated: Remote Procedure Call Name New/Modified/Deleted -------------------------- -------------------- ORB3U2 GETRCPNT New ORFEDT BLDLAYOT New ORFEDT BLDRESLT New ORFEDT GETLAYOT New ORQQPXRM REMINDER DIALOG Modified ORTO GETRVW Modified ORTO SET UAP FLAG Modified ORTO SETRVW Modified ORTO UAPOFF Modified ORUTL4 DLL Modified ORVIMM CHKTITLE New ORVIMM GETCODES New ORVIMM GETCTINF New ORVIMM GETHIST New ORVIMM GETITEMS New ORVIMM MAKENOTE New ORVIMM PLOC New ORVIMM USEICE New ORVIMM VIMMREM New ORWDCN32 ORDRMSG Modified ORWDPS33 IVIND Modified ORWDXC ALLERGY New ORWDXC REASON New ORWDXC SAVEMCHK New ORWDXR01 WARN New ORWORB PROUSER New ORWPCE4 STDCODES New ORWPCE5 MAGDAT New ORWPCE5 NOTEDATE New ORWPCE5 NOTELOC New ORWPCE5 REMTAX New ORWPCE5 REPLCODE New ORWPCE5 TAXCODES New ORWPCE5 UCUMLIST New ORWTPR GETARCHP New 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): ---------------------------- NSR #20090509 Park-A-Prescription-Active Prescriptions Awaiting Patient Request To Be Dispensed This request is for the creation of a process that allows Pharmacy Service to process a prescription request without an immediate accompanying requirement to dispense the prescription or be required to set a prescription fill date. This is intended to allow the patient to request the original fill for a prescription much like a refill. The scope of this request includes any necessary updates to VistA or CPRS displays of prescriptions to indicate a verified-but-never-dispensed prescription. The status of a prescription processed in this manner is ACTIVE, and does not need a new status designation, although it may warrant other indicators and/or methods to inform the patient about the new Rx number allocated to the prescription. NSR #20100101 Indication on all Prescriptions and Medication Orders The purpose of this NSR is to modify medication order dialogs to have a specific and unique method for recording the medication's indication. The justification for this request is the Joint Commission standard relating to medication management. NSR 20100825 Drug Allergy Order Check Enhancements and Improved Detail The current drug-allergy order check displays the first matching ingredient OR drug class (CPRS) and the first matching ingredient AND drug class (Pharmacy), but does not take into account the nuances of allergies recorded to multi-ingredient products, especially when the reaction is likely only caused by one of the components. Recommend that the display of a drug-allergy order check show ALL ingredients AND the drug class associated with the entry in the allergy file, so that the ordering clinician can make a better informed decision of whether to continue the prescription/order being placed. NOTE: One of the user requirements for this NSR will only function properly with an update to the First DataBank interface. That story has been moved to a future release. NSR #20170512 Complex Non-VA Med Orders The Non-VA Medication Order dialog does not give a provider the opportunity to enter a complex medication order. For example when patient is taking the same medication but different doses on different days or different doses at different times in one day. If the patient has an outside medication that fits this criterion, it can't be clearly documented. This is a patient safety issue because currently it requires 2 separate entries for the same drug. NSR #20111006 Prevent Confusion over CPRS Status Display IT Patient Safety has determined that five separate, but similar, patient safety issues have been reported and each involved confusion over the display of status of orders and the actions available on the orders screens. Items for review include inconsistent use of the terms "DISCONTINUE/CANCEL" and ramifications of unsigned orders and disparate functionality between the MEDS tab and ORDERS tab, among others. The CPRS Clinical Workgroup reviewed 4 recommendations that seek to improve Graphical User Interface (GUI) usability and reduce the likelihood of an error by displaying more precisely what the current status is for an order, and what actions are available to change that status. A request has been made for a comprehensive review and redesign of the CPRS MED tab and CPRS ORDERS tab displays as they pertain to the status of orders and available actions. NSR #20070920 Button to link No Assessment warning to Allergy Assessment Screens Anne Lubischer, Pharmacist at Portland VAMC VISN 20, is requesting the addition of a button will make it easier for providers to enter allergy information. When providers receive a warning about No Allergy Assessment while they enter prescription orders, a button/link could be added that automatically takes them to the Allergy Assessment screens. Currently, providers pass the warning without entering allergy information. Pharmacy has to call each one delaying filling of Rxs. Most of the pharmacies get 70 - 100 of these incidents per month. The provider must be able to override the No Allergy Assessment order check and continue with entering the medication order, when allergy assessment information is not attainable. NSR #20060710 Real-time notification of potentially missed order checks The Pharmacy Benefits Management (PBM) and Strategic Health Care Group, is requesting a method within CPRS GUI that would notify a provider of a real-time allergy data entry. The desired functionality would notify the provider if they select a drug ingredient as the reactant. They would then be alerted that there is a potential for missed cross-interaction order checks and give them the opportunity to either confirm their selection or choose from a different source file that would be able to appropriately generate the order check. This request is in response to a patient safety issue where by order checks did not perform based on allergy information that is coded with a DRUG INGREDIENT and does not have drug class information available for cross-checking. NSR #20080226 D/C Order by Adverse Reaction Patient Care Services (including Pharmacy Benefits Management) support the ability to input an adverse drug reaction (ADR) when discontinuing a medication order due to the patient having an ADR to the medication. Incorporating this ability would improve workflow for the provider as they would not have to remember to enter the allergy after they have discontinued the medication. As always, if provider doesn't feel an ADR is appropriate to record for permanent reference, the provider can elect to cancel the ADR window and not proceed. NSR #20081008 CPRS Notification Alert Processing Improvement Based on an RCA at our medical center, we became aware of a design improvement in the processing of notifications in CPRS. If a user clicks on process all notfications, they currently have the option of moving forward between notification and patients' charts by clicking NEXT. However, if a user clicks next too quickly or wants to go back to look at a previous notification already processed in the same session, they cannot retrieve the already processed notification, nor can they go back to the main page and find the notification listed because it has been cleared by CPRS. To help in the patient safety themed issue, it would be great be able to retrieve already processed notifications perhaps by the use of a BACK button feature. NSR: 20141111 Filter Provider Drop Down List Updates were made to the user selection list to exclude inactive, non-CPRS users. Users must be assigned CPRS GUI "core" tabs with a current Effective Date to be selectable as an additional signer. OR CPRS USER CLASS EXCLUDE is the parameter that allows sites to declare ASU User Classes whose members will no longer appear in the additional signer user selection list. This parameter takes precedence and will exclude users even if they are active with CPRS GUI "core" tab access. NSR: 20120101 Limiting Additional Signers List This NSR was originally released as part of CPRS GUI v32a (OR*3.0*539). An issue was identified where members of user classes added to the OR CPRS USER CLASS EXCLUDE, were no longer allowed to author a progress note. The feature has been modified in CPRS GUI v32b such that users excluded via the parameter are still allowed to author progress notes. NSR: 20071211 Changes to Allergy/Pharmacy Packages This request has identified several areas related to allergy notifications and allergy alerts triggered during the medication order process that will work toward eliminating the potential for patient allergy information being overlooked by clinical staff. Most notably allergy order checks will occur at drug selection, and allergy order checks will be separated from other order checks when displayed together. NSR: 20170302 When renewing an Rx in CPRS, allow the provider to edit the days supply and quantity. The Eastern Colorado Health Care System and PBM are requesting an enhancement to CPRS related to adding days supply and updating the priority status when a medication order is renewed. Providers will start patients on a 30-day Rx supply, with minimal refills, to minimize unnecessary copays, and ensure patient safety. However, when the medication is needed to be renewed for a longer period of time, the provider can only increase the number of refills and the delivery method, but cannot edit the days supply. The only way a provider can change the days supply is to create a new order. Creating a new order is more time consuming than a renewal, risks errors resulting from changes, creates confusion for the patient, and creates extra work for the pharmacist to calculate the next fill date. This can also lead to errors where patients can get medications too early, and unnecessary copays. Whereas as single refill with a greater quantity will reduce dispensing and copay costs. NSR: 20101203 CRITICAL/HIGH ORDER CHECK DISPLAY This NSR is requesting that changes be made to the existing CPRS order check application. Currently, there is only one prompt presented to clinicians to justify all CPRS order checks for a patient. In addition, regular/low-risk order checks are grouped together with critical/high-risk order checks in the same window. This causes confusion among clinicians about which order checks actually require justification and have higher priority over others. To remove this confusion, individual display windows for each degree of order checks need to be established with individual justification prompts for each order check that requires a physician override. This would force the provider to be aware of all order checks, with overlapping priority given to critical/high-risk order checks, and would require the provider to independently enter a justification for each order check before the order would be allowed to become active. Patient Safety Issues (PSIs): ----------------------------- HITPS-1046 Outpatient Medications HOLD status confusing to patients and providers. Resolved by NSR 20090509: Park a Prescription HITPS-2013 Non-VA Meds not released appropriately. HITPS-776 Provider selected wrong medication (oral chemotherapeutic agent instead of an antidiarrheal agent) due to single spacing of the medication list in CPRS upon ordering. Resolved by NSR 20100101: Indications for Use HITPS-793 A patient with active PRN orders for two medications that look and sound alike can possibly receive the wrong medication during an episode of care. Resolved by NSR 20100101: Indications for Use HITPS-1538 Hard stop on order entries for patients without allergy assessment. Resolved by NSR 20070920: Button Link to No Assessment Warning HITPS-6472 VBECS update adds or removes modifiers requested by provider during the ordering process of blood products. HITPS-419 Outpatient Pharmacy does not allow two active Rx's with the exact same dispense drug. This was resolved by adding titration functionality to CPRS. Users can now mark a complex outpatient medication order with a "then" conjunction as "Titration" in CPRS. When an outpatient order is marked as titration, it will indicate that on the Orders and Meds tab. When copying a titration order, it will repeat the titration instructions. When renewing a titration order, only the maintenance portion of the Rx will be renewed. When placing an order for a Controlled Substance Rx (Class III, IV, or V) that is marked for titration, it will not allow refills to be added. HITPS-202 Critical order check window presenting data poorly Corrected by NSR 20201203. HITPS-796 Surrogates accumulate many notifications. Corrected by NSR 20081008 HITPS-972 Resident interpreted 'cancelled' status as a cancelled active medication order. Corrected by NSR 20111006 HITPS-985 Radiology/Imaging test was inadvertently performed on a patient when CPRS Imaging order should have been discontinued. Corrected by NSR 20111006 HITPS-1330 CPRS is displaying a DC order - when you detail display, it shows the original order instead of the actual order that is discontinued. Corrected by NSR 20111006 HITPS-1422 Two critical drug order checks but only one comment allowed. Corrected by NSR 20101203 HITPS-1566 Free-text results collide when graphing multiple lab tests. HITPS-1603 'Split' TIU template field can cause unexpected behavior. HITPS-1963 Unauthorized provider who attempted to order Clozapine bypassed alert and assumed the medication had been ordered HITPS-2096 CPRS Alert Review - Physicians May Be Losing Alerts Requiring Action. Corrected by NSR 20081008. HITPS-2123 Providers can back-date the "Effective Date/Time" for a diet order causing a patient to be on a diet they shouldn't be on HITPS-2470 **Patient Safety Issue: COMPLETED consult alert in CPRS only displays "Significant Findings: **Yes**", does NOT display actual significant findings! HITPS-6443 Action alerts instead of Informational for flag Notifications: Flagged OI Expiring and Flagged OI Order-Output. Corrected by NSR 20081008. HITPS-8857 Diet Order Patient Safety Issue with order display inconsistency vs order details Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 1. I16009412FY17 - Old Date Time Wanted included in VistA Blood Establishment Computer Software (VBECS) Order. Problem: -------- On Aug 3, 2017 a provider entered a request for TAS, 1- PlT, 4- RBC, and 2-FFP. The associated order number is for a request that was done in 2013. How does this happen?? The patient has since been discharged and did not need anything at this time. He did have surgery in 2013. Solution: --------- The problem is that the old date/time wanted was copied over from the original VBECS component order. A change has been made in CPRS v32 so that if a blood component order is copied and the date/time wanted is in the past, the date/time wanted will be 'blanked out' which will force the order dialog to open and the provider will be required to enter the appropriate date/time wanted. 2. I6466595FY16 - Selecting encounter in CPRS, edit, and problem selecting diagnosis. Problem: -------- Have a user at St Cloud who selects encounter form in CPRS, edits it, brings up the problem list up, and selects a diagnosis. The search box comes up but the problem that they selected does not have a check mark in it and another problem has the check mark in it. Resolution: ----------- The problem was caused by a component in the CPRS GUI that was causing some unintended scrolling. This has been corrected. 3. I10052250FY16 - Provider able to RENEW a unit dose order for CLOZAPINE without the YSCL AUTHORIZED KEY. INC4356738 - Duplicate Problem: -------- Even though the CPRS manual states that the YSCL AUTHORIZED KEY was required to enter/renew a Clozapine order, the provider was allowed to renew one of these on the Meds tab. Resolution: ----------- Modified the CPRS GUI so that the Meds tab behaves as the Orders Tab in that it prevents the renewal of the Clozapine order if the provider doesn't hold the YSCL AUTHORIZED KEY. 4. I6276207FY16 - Notifications do not clear until someone goes into the system and clears it. I16764627FY18 - Duplicate Problem: -------- Notifications are not automatically clearing when processed. The problem specifically dealt with alerts for unsigned notes that were renewed after the note was signed. Resolution: ----------- The CPRS GUI was modified in order to deal with renewed alerts on notes that were already signed. 5. I9259852FY16 - TIU Template Field, CPRS GUI adding code that causes problems. Problem: -------- When using the Reminder Exchange an error would occur when trying to install a new Reminder Element. If this Reminder Element contained a Template Field that included a control character an Index Missing error would occur. Resolution: ----------- The CPRS GUI was modified to prevent control characters from being present in single line edit box template fields. 6. I10142391FY16 - OERR Orders Tab: Expiring Med Alert Problem: -------- When providers get view alerts for expiring medications this will include one-time meds. The provider will take action on the non-one-time meds, but the view alert will remain until manually removed by selecting File-->remove current notification. Since one-time orders should not trigger this view alert, can the alert be removed automatically when all other non-one-time meds are addressed? Resolution: ----------- The software has been modified so that inpatient medications with one-time schedules are not taken into account before deciding to delete the MEDICATIONS EXPIRING - INPT notification. 7. I10133526FY16 - Medication nearing expiration issue. Problem: -------- The process for deleting this MEDICATIONS EXPIRING - INPT notification is not evaluating only inpatient medication orders. It is also taking outpatient prescriptions into account. The notification remains if a patient also has an expiring outpatient med and will not be deleted until that med is renewed, changed or discontinued. Resolution: ----------- The software has been modified so that outpatient meds are not taken into account before deciding to delete the MEDICATIONS EXPIRING - INPT notification. 8. I7546770FY16 CPRS - problem with displaying orders Problem: -------- When reviewing orders on the CPRS orders tab, autodc release event orders may not show, based on previous view. Resolution: ----------- The CPRS GUI has been modified to properly display auto-dc release event orders in all cases. 9. R11575957FY17 TIU TEMPLATE EDITOR ISSUE - END USERS ARE ABLE TO "SORT" THE SHARED TEMPLATES DRAWER Problem: -------- The issue is that regular end users are able to go into the template editor, open up the Shared Templates folder and go to Action and "Sort". Even with their limited ability of highlighting "My Templates" and "Options" "Edit Templates", if they move over to the Shared Templates window, open up the folder and then click on "Action" the "Sort" button is active. What is odd is that the "Sort" button for "My Templates" appears to never be active, but it should be. Having end users have the "blanket" ability to Sort the Shared Templates drawer at the root level, has caused issues. We have a huge number of templates in Shared, some are archived in folders, others are stand alone and in some cases some folders and stand-alone templates are positioned at the top of the Shared Templates drawer (out of alphabetical order), specifically because these are ones that end users use frequently. If an end user inadvertently sorts the folder, then everything falls in line alphabetical and we have to go back in and re-establish the folder the way it was previously. It should be set just like the TIU TEMPLATE FIELD EDITOR CLASSES, limiting that ability to only those who possess the user class established by the local sites. Resolution: ----------- Modified the CPRS GUI so that someone who does not have CLINICAL COORDINATOR user class cannot sort the Shared Templates. 10. R7092191FY16 - Non-VA Meds marked as released when they weren't. I13413770FY17 - Non-VA Meds not releasing properly. Problem: -------- When entering non-VA meds it is possible for these meds to go into a sort of "limbo" state where they will not show as available for signature when refreshing the patient, selecting a new patient or closing CPRS. Resolution: ----------- The CPRS GUI has been modified to not mark the Non-VA meds as released until they are truly released. 11. I10034909FY16 - undefined error TRAY+6^ORMBLDFH Problem: -------- The VistA dietetics (Nutrition and Food Services) package does not allow the creation of late tray outpatient meals with no time selected. CPRS GUI is allowing this and the orders are creating errors later in life cycle of the order. Resolution: ----------- Modified the CPRS GUI to remove the check for outpatient that allowed the user to bypass the time selection. 12. I16790944FY18 - CPRS issue Problem: -------- If the user attempts to write a complex Clozapine order that includes a free text dose, the system will not return the correct default value for the day supply. While unit testing, It was also discovered that the "And" Conjunction is (in certain cases) is causing the system to return a Quantity of 0 (even though there IS enough information to calculate quantity). VistA was adding the durations of the doses connected by the "And" conjunction while the GUI was selecting the larger of the 2 durations. If this second issue was not fixed, it would become much more apparent after this ticket's fix is put into place. To avoid the perception that we are introducing a new bug, and because they are in the same PSO name space, I'm going to treat them as the same Bug and fix both issues Resolution: ----------- If a "free text" dose is used in a Clozapine complex order, the system will now search all drugs associated with the orderable item. If the search finds that at least one Clozapine drug is associated with the Orderable Item. It will return the Default day supply for Clozapine (default will vary from patient to patient, but should be either 7, 14, or 28 days supply). Also modified the VistA code that calculates Quantity to handle "And" conjunctions properly. 13. I11551298FY17 - Transfer to Outpatient for Backdoor Orders Dosage Issue Problem: ------- Local dosages might not display as defaults when using the CPRS Transfer to Outpatient option. This issue occurs when the order was entered through the VistA backdoor order entry option PSJ OE. (The issue does not occur for orders entered through CPRS.) If more than one dosage is defined for an orderable item, healthcare personnel must then spend time researching the prescription in order to determine the proper dosage. Resolution: ---------- Modify routine ORMPS1 to correctly set the Local Possible Dosage into the Order (#100) file when filing backdoor Inpatient Medications orders. This modification allows the local dosage to appear as a default when invoking the CPRS Transfer to Outpatient option. The change affects orders placed after patch install. The issue remains for orders placed previously to patch install. 14. R10248420FY16 - Clozapine Days Supply Issue Problem: -------- If the user attempts to write a complex Clozapine order the day supply text field becomes un-editable. This was occurring because the complex dose was entering the single dose logic under false pretenses Resolution: ----------- Updated the GUI code (FODmeds.pas) to check which tab is currently selected prior to going through the single dose logic. This then allows the field to be editable and also allows it to calculate and populate day supply based on the selected durations. 15. R18028257FY18 - VBECS orders problem Problem: ------- When a lab or VBECS order is placed for a division that is not listed as an immediate collection division, the CPRS GUI returns an "index out of bounds" error. Resolution: ---------- While nothing being returned from the server is a valid return, the GUI had to be updated to handle this correctly. All logic was already there however there were no safeguards for a "blank" return. 16. R19047817FY18 - Delayed orders designated as Immediate Collect do not print Problem: ------- When a lab order is entered as an event delayed order, then manually released, the lab order is not printing at the time of manual release. Resolution: ---------- Routine ORWDX has been modified to appropriately print the lab orders that are manually released from a delayed status. 17. I19075037FY18 - VBECS QUICK ORDER INAPPROPRIATE PROMPT FOR T&S Problem: ------- When requesting a blood components order via quick order in CPRS on the VBECS/Blood Products form, if the Type & Screen order was entered more than 3 days ago (this number will vary according to the Vista parameter ORWDXVB VBECS TNS CHECK), even if the specimen collected is still valid, the VBECS form will prompt for a new Type & Screen order. Resolution: ---------- The GUI code that checks to make sure a valid specimen is available was fixed to refer to the specimen even if the Type & Screen order that requested the specimen was entered more than (ORWDXVB VBECS TNS CHECK) days ago. 18. R9119851FY16 - SALEM: OERR - Orders Tab: VBECS LC order with NOW time I9677456FY16 (duplicate) Problem: ------- When creating a "Lab Collect" blood bank order for an inpatient, if the user manually enters a collection date+time (e.g., "NOW"), that date+time is not being verified against the available lab collection times. Also, the manually entered value is being stored in the order (not converted to a date+time). Resolution: ---------- In the blood bank form, during the validation step performed when the user clicks "Accept Order", the manually entered date+time is checked against available lab collection times. The value is also converted to a date+time. 19. I7304146FY16 -- Expired Type and Screen Orders Issue Problem: --------- An expired Type and Screen should not be associated with a VBECS order. However, this can erroneously occur. An expired order is one which is outside the date range determined by the parameter which defines how long Type and Screen orders can be used for VBECS component orders. An expired Type and Screen could be associated with a VBECS order if the "Date/Time Wanted" for the order is more than three days (or however the associated parameter is defined) in the future. Solution: --------- Modify the CPRS logic to evaluate the T&S parameter against the "Date and Time Wanted". 20. INC0063186 - A COMPLETED consult alert in CPRS only displays "Significant Findings: **Yes**", it does NOT display actual significant findings Problem: ------- When completing a consult alert in CPRS, the information that is displayed is only the summary of the Consult Alert indicating that significant findings were "Yes". What should be displayed is the detailed information, including the comment for the significant findings. Solution: -------- The GUI was updated so that when significant findings were found, the detailed information was displayed, not the summary. 21. INC3435911 - New VBECS update adds or removes modifiers requested by provider during the ordering process of blood products. Problem: ------- When multiple blood products ordered modifiers were either added or removed unnecessarily. Two separate issues are reported during blood component (VBECS) ordering in CPRS: 1) Modifiers that are placed on some but not all blood components ordered. Before the Order is accepted, if one of the blood components is removed so that it may be re-ordered without the modifier, the remaining blood components that originally had a modifier(s) are erroneously removed as well. 2) Modifiers are placed on some but not all blood components ordered. Before the Order is accepted, the order summary appears correct. However, after eSig, the order now erroneously reflects modifiers on ALL the blood components. Solution: -------- Modified the CPRS Graphical User Interface (fODBBank.pas) to retain the modifiers on the remove press 22. INC3998447 - Component orders attaching themselves to previous Blood Bank specimens in VBECS despite orders NOT being accessioned in VISTA Problem: ------- Expired lab Type and Screen orders are tied to future blood component orders. These are not expired on the order entry date will be expired for the date that the blood component order is requested. Solution: -------- If a Blood Product was not selected first, and type and screen selected, information from previous order was not reset, they are being reset now. 23. VBECS Issue #740140 Expired VBECS Component orders still active in CPRS Problem: -------- VBECS component orders that are not associated with a Type & Screen, and which are not filled, and expire are still not on the Incomplete Test Status report for Blood Bank. In CPRS, these component orders have a status of active and VBECS child shows expired, but the Lab child shows active. Solution: --------- The code in CPRS that updates Expired VBECS orders was changed to check all child orders and make the appropriate status update when an order expires. 24. INC9855034 CPRS Template Field Error-Template field for Calendar Problem: ------- If CPRS is run prior to midnight, it will cache the current date. Which cached date it will still be using after midnight. Resolution: ---------- The current date is no longer cached. The current date is always requested from the server. 25. INC11378087 Rejected VBECS Order Displays Incorrect User on Lab Child Order INC13157399 (duplicate) Problem: ------- VistA option "Order/test status" (LROS) is not displaying the name of the user who rejected an order in VBECS. Instead, it shows the "canceled by" user as the user who last started the VBECS-OERR HL7 logical link in VistA. Resolution: ---------- Modify routine ORMVBEC to store the information regarding the user who rejected the order in VBECS on the Lab child order as is done for the parent order and the VBECS child order. 26. INC11420967 CPRS "Give additional dose now" warning presenting twice Problem: ------- When creating a Medication Quick Order with "Give additional dose NOW?" set to "YES" and placing that on a menu, the provider is presented with a warning TWO TIMES and must select "OK" twice. Resolution: ---------- The extra warning, triggered as a side effect of activating the quick order, has been suppressed. 27. INC14093517 Laboratory Quick Order Display Issue Problem: -------- When a Lab test is selected in the Add New Orders (or similar) CPRS ordering menu, any Lab orderable item which is defined as "quick order only" and which collates after the selected test within the next 44 sequences will display in the "Order a Lab test" dialog. The selected Lab test orderable item should display regardless of whether it is defined as "quick order only". But no other Lab tests should display if defined as quick order only. This issue does not occur if the user scrolls backward or forward past 44 sequences. Resolution: ----------- Add logic to routine ORWDX so that if subsequent Lab test orderable items are defined as "quick order only", the tests do not display in the "Order a Lab test" dialog. 28. INC19422036 Since CPRS 32A was installed users reported the Lab quick orders requiring specimen input, the specimen pop up box appears 4 times. Problem: -------- Since CPRS 32A was installed users reported the Lab quick orders requiring specimen input, the specimen pop up box appears 4 times. When ordering from the generic lab order menu, the specimen box appears twice. Resolution: ----------- The specimen pop up box no longer appears multiple times - functionality reverted to how it behaved before CPRS 32A was installed. 29. INC10288037 Default procedure quantity ignored on CPRS encounter form Problem: -------- When a default quantity greater than 1 is defined for a procedure on the encounter form, and that procedure is selected in the CPRS GUI, the default is ignored and the quantity reverts back to 1. This effects units in the billing of the patient. Resolution: ----------- CPRS encounter form now pulls in the default procedure quantity. 30. Problem: Patch OR*3*539 (CPRS v32A) released a new parameter, OR NATURE DEFAULT, which was used to determine the default option selected for the Nature of Order, when an ORELSE key holder is releasing an order in CPRS. This caused problems for facilities who wanted users that held both ORELSE and PROVIDER to have a default nature of order of POLICY. Resolution: ----------- After review with the sites, the decision was to a) release patch OR*3*571 with a temporary fix that will allow sites to run a nightly task that will set the OR NATURE DEFAULT parameter to POLICY for users who hold both the ORELSE and PROVIDER keys if the site wishes to have a default; b) in this patch (OR*3*405) remove the functionality to allow sites to set the default Nature of Order prompt. The NSR (20120601) that requested this change will have to be revisited at a later date. 31. INC19285357, INC11887436, INC19446620, INC19360675, INC19329592, INC19366752, INC19403415, INC19469828, INC19473374, INC19482188, INC19565743, INC19704953, INC19717553, INC19740942, INC19769285, INC19770575, INC19921988, INC20160077, INC20443354, INC20763967, INC22430037, INC22887163, INC22887255, INC22888400 Access Violation Resolution: ----------- Several different access violations were fixed. Test Sites: ----------- Fresno, CA Northern California HCS North Florida / South Georgia HCS Software and Documentation Retrieval Instructions: -------------------------------------------------- Sites may retrieve the software and documentation directly using the deployment download server provided by the CPRS Implementation team. Instructions will be distributed when your site begins the implementation process. After the wave deployment has been completed, documentation can be found on the VA Software Documentation Library at: http://www.domain.ext/vdl/ The software for this patch is being released using a host file. After the wave deployment has been completed, the host file will be available at the following location: /srv/vista/patches/SOFTWARE/CPRS_V32B_COMBINED_BUILD.KID Other Software Files: This release also includes other software files. Other software files can be obtained by accessing the URL: https://download.vista.domain.ext/index.html/SOFTWARE File Name Contents Retrieval Format --------- -------- ---------------- OR_30_405.ZIP CPRSChart.exe BINARY RoboEx32.dll borlndmm.dll CPRSChart.map CRC.TXT YS_MHA_A_XE10.dll HELP Directory OR_30_405_SRC.ZIP CPRS v32B Source BINARY CPRS_V32B_COMBINED_BUILD.KID CPRS V32B COMBINED ASCII XU_8_662.KID Kernel Changes ASCII PSS_1_187.KID PDM Changes ASCII Documentation describing the new functionality is included in this release. Documentation can be found on the VA Software Documentation Library at: https://www.domain.ext/vdl/. Documentation can also be obtained at https://download.vista.domain.ext/index.html/SOFTWARE. Both the VDL and the SOFTWARE folder will be updated after deployment has been completed. Title File Name --------------------------------------------------------- CPRS v32b (OR*3.0*405) Deployment, OR_3_0_405_DIBR.DOCX Installation, Back-Out, and Rollback Guide OR_3_0_405_DIBR.PDF CPRS GUI v32b Release Notes OR_3_0_405_RN.DOCX OR_3_0_405_RN.PDF CPRS v32b Setup and Configuration Guide OR_3_0_405_SETUP.DOCX OR_3_0_405_SETUP.PDF Installation Instructions: -------------------------- ***Installation of this build must NOT be queued.*** Please refer to the "CPRS v32b (OR*3.0*405) Deployment, Installation, Back Out, and Rollback Guide" for installation and set-up information. This document is exported as OR_3_0_405_DIBR.PDF and OR_3_0_405_DIBR.DOCX. Post-Installation Instructions: ------------------------------- Please refer to the "CPRS v32b (OR*3.0*405) Deployment, Installation, Back Out, and Rollback Guide" for installation and partial set-up information. For the remaining setup instructions, please refer to the "Computerized Patient Record System (CPRS) Version 32b Build (OR*3.0*405) Setup and Configuration Guide". This document is exported as OR_3_0_405_SETUP.PDF and OR_3_0_405_SETUP.DOCX. Back-Out/Roll Back Plan: ------------------------ Please refer to the "CPRS v32b (OR*3.0*405) Deployment, Installation, Back Out, and Rollback Guide" for back-out and rollback information, along with risks and criteria for back-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 211 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ORALWORD Before: B87912660 After:B101161399 **243,427,405** Routine Name: ORAREN Before: B56454750 After: B56787761 **336,349,350,540,405** Routine Name: ORB3U2 Before: B91861349 After: B97536048 **9,74,105,179,498,405** Routine Name: ORCDPS1 Before: B85374723 After: B85709181 **94,117,141,149,195,215,243, 280,337,311,350,377,405** Routine Name: ORCDPS2 Before: B72806724 After: B72931965 **94,116,125,131,243,311,350, 377,413,405** Routine Name: ORCDPS3 Before: B45751820 After: B59259383 **94,116,134,158,149,190,277, 243,289,317,350,405** Routine Name: ORCHECK Before:B130588470 After:B145083422 **7,56,70,94,141,215,243,293, 280,346,357,352,345,311,269, 382,545,405** Routine Name: ORCMEDT8 Before: B78288682 After: B79098905 **245,243,280,405** Routine Name: ORCSAVE Before:B113627173 After:B119940206 **7,56,70,73,92,94,116,141,163, 187,190,195,243,303,293,280, 306,286,269,423,421,382,397, 377,453,405** Routine Name: ORCSAVE2 Before: B99294281 After:B103460867 **4,27,56,70,94,116,190,157, 215,265,243,293,280,346,269, 421,382,377,405** Routine Name: ORCSEND1 Before: B99881718 After:B102281747 **4,29,45,61,79,94,116,138,158, 149,187,215,243,282,323,394, 435,507,405** Routine Name: ORCSEND3 Before: B25968577 After: B26194709 **243,282,280,409,405** Routine Name: ORDSGCHK Before: B98880623 After:B104676225 **280,352,345,311,384,395,382, 481,413,405** Routine Name: ORDV06 Before: B41792290 After: B42683150 **109,118,167,208,215,274,243, 312,405** Routine Name: ORFEDT Before: n/a After: B36843407 **405** Routine Name: ORFIMM Before: n/a After:B184651996 **405** Routine Name: ORFIMM1 Before: n/a After:B127100033 **405** Routine Name: ORFIMM2 Before: n/a After: B24997789 **405** Routine Name: ORFSKT Before: n/a After:B175502675 **405** Routine Name: ORINDRP Before: n/a After: B57852694 **405** Routine Name: ORKCHK Before: B42929027 After: B43445623 **6,32,94,105,123,232,267,243, 280,345,539,405** Routine Name: ORKCHK5 Before: B91622138 After:B111961506 **6,32,74,94,123,190,280,357, 345,269,382,539,562,405** Routine Name: ORMBLDPS Before: B94048957 After: B94496686 **7,38,54,86,97,94,116,129,141, 190,195,237,254,243,293,280, 266,395,405** Routine Name: ORMPS1 Before: B79616579 After: B85031239 **86,92,94,116,134,152,158,149, 190,195,215,265,275,243,280, 350,382,397,413,405** Routine Name: ORMPS2 Before: B57616139 After: B58601210 **94,116,129,134,186,190,195, 215,265,243,280,363,350,462, 413,405** Routine Name: ORMPS3 Before: B32903269 After: B35632895 **213,243,413,547,405** Routine Name: ORMTIME Before: B20712545 After: B10041387 **40,253,243,377,571,405** Routine Name: ORMVBEC Before: B25556094 After: B30521368 **212,309,332,405** Routine Name: OROCAPI1 Before: B59785777 After: B63045840 **293,346,345,269,405** Routine Name: ORORDDSC Before: B13143468 After: B16082124 **301,295,280,405** Routine Name: ORPDMP Before:B196659995 After:B200992718 **519,405** Routine Name: ORPDMPNT Before: B35626953 After: B36345008 **519,498,405** Routine Name: ORQ2 Before: B69326826 After: B95628724 **12,56,75,94,141,213,195,243, 282,293,280,346,361,471,453, 405** Routine Name: ORQ21 Before: B43976767 After: B46334719 **141,190,195,215,243,361,350, 417,377,521,405** Routine Name: ORQOCONV Before: n/a After:B225221120 **405** Routine Name: ORQOCONV1 Before: n/a After: B9628802 **405** Routine Name: ORQOUTL Before: B14665061 After: B17934360 **377,405** Routine Name: ORQQCN1 Before: B20903877 After: B21078828 **10,98,85,109,148,405** Routine Name: ORQQPXRM Before: B14969381 After: B15273793 **10,85,116,173,187,190,215, 243,306,389,377,405** Routine Name: ORUTL3 Before: B3158346 After: B4735089 **111,397,405** Routine Name: ORVIMM Before: n/a After: B22836933 **405** Routine Name: ORWDAL32 Before: B83355096 After: B99855158 **10,85,109,190,195,233,243,539,405** Routine Name: ORWDPS1 Before: B70522709 After: B71799910 **85,132,141,163,215,255,243, 306,350,435,377,405** Routine Name: ORWDPS2 Before: B67243163 After: B83696939 **85,116,125,131,132,148,141, 195,215,258,243,424,420,454, 452,377,413,405** Routine Name: ORWDPS33 Before: B41340191 After: B56346164 **243,280,350,405** Routine Name: ORWDX Before:B113669404 After: B56871552 **10,85,125,131,132,141,164, 178,187,190,195,215,246,243, 283,296,280,306,350,424,421, 461,490,397,377,539,405** Routine Name: ORWDX2 Before: B18156659 After: B28124909 **246,243,280,331,405** Routine Name: ORWDX3 Before: n/a After: B81621572 **405** Routine Name: ORWDXA Before:B127264071 After:B136529198 **10,85,116,132,148,141,149, 187,213,195,215,243,280,306, 390,421,436,434,397,377,539, 405** Routine Name: ORWDXA1 Before: B49218549 After: B53654970 **539,405** Routine Name: ORWDXC Before:B124720231 After:B168890943 **10,141,221,243,280,346,345, 311,395,269,469,377,539,405** Routine Name: ORWDXM1 Before:B127137244 After:B135636474 **10,85,131,132,141,178,185, 187,215,243,280,331,388,350, 423,434,494,397,377,512,498, 405** Routine Name: ORWDXM3 Before:B132401126 After:B180440808 **10,85,131,132,141,185,187, 190,195,215,243,303,296,280, 350,434,441,397,377,498,405** Routine Name: ORWDXR Before: B60290017 After: B88854698 **10,85,125,131,134,141,149, 187,190,213,243,331,306,349, 374,409,397,405** Routine Name: ORWDXR01 Before: B29178545 After: B53629363 **187,190,195,215,280,345,311, 350,405** Routine Name: ORWDXVB Before: B45633676 After: B45776656 **215,243,212,309,332,405** Routine Name: ORWDXVB2 Before: B13660185 After: B13712964 **215,243,212,309,332,405** Routine Name: ORWLR1 Before: B41237102 After: B42544529 **172,212,309,332,375,527,405** Routine Name: ORWORB Before: B99052906 After:B134615724 **10,85,116,148,173,190,215, 243,296,329,334,410,377,498, 405** Routine Name: ORWORR Before: B88333428 After:B105370200 **10,92,116,110,132,141,163, 189,195,215,243,280,306,471, 444,515,405** Routine Name: ORWPCE Before: B75579296 After: B70859664 **10,85,116,173,190,195,215, 243,295,280,306,361,385,398, 377,476,539,405** Routine Name: ORWPCE1 Before: B79390544 After: B26217249 **10,85,116,132,148,187,190, 215,243,280,306,361,501,559, 405** Routine Name: ORWPCE2 Before: B51147724 After: B52085738 **10,85,109,116,173,195,243, 306,361,405** Routine Name: ORWPCE3 Before: B65944434 After:B127855652 **10,85,116,190,280,306,371, 361,385,377,498,405** Routine Name: ORWPCE4 Before: B24454182 After: B32225182 **306,361,350,423,465,405** Routine Name: ORWPCE5 Before: n/a After: B8246411 **405** Routine Name: ORWPS Before: B87678827 After: B95057018 **10,85,116,132,141,173,203, 190,195,265,275,243,280,350, 498,405** Routine Name: ORWPS1 Before: B2052314 After: B3211164 **10,539,405** Routine Name: ORWPT Before: B81289007 After: B82449401 **10,85,132,149,206,187,190, 215,243,280,306,311,441,528, 519,544,405** Routine Name: ORWRPL Before: B49132980 After: B67922154 **10,85,109,332,405** Routine Name: ORWRPP Before: B43489612 After: B47942611 **10,85,109,192,332,449,405** Routine Name: ORWRPP1 Before: B23947124 After: B38253617 **109,160,192,263,449,405** Routine Name: ORWTITR Before: n/a After: B37486259 **405** Routine Name: ORWTPN Before: B43115795 After: B64758634 **85,149,187,195,405** Routine Name: ORWTPP Before: B25731400 After: B26181840 **85,149,243,377,539,405** Routine Name: ORWTPR Before: B28898110 After: B34767386 **85,173,215,243,280,415,458, 539,405** Routine Name: ORWTPUA Before: B6535953 After: B6975557 **85,243,296,539,405** Routine Name: ORWU Before:B104193432 After:B108890887 **10,85,132,148,149,187,195, 215,243,350,424,377,519,539, 405** Routine Name: ORX2 Before: B12368575 After: B13705240 **16,48,158,168,183,190,195,292,405** Routine Name: ORY405 Before: n/a After:B155068258 **405** Routine Name: ORY405E Before: n/a After: B1343969 **405** Routine Name: ORY405NV Before: n/a After: B75905392 **405** Routine list of preceding patches: 292, 312, 427, 449, 453, 465, 498, 507 515, 521, 527, 540, 544, 545, 547, 559, 562, 571 ============================================================================= User Information: Entered By : Date Entered : OCT 21, 2014 Completed By: Date Completed: SEP 28, 2022 Released By : Date Released : SEP 29, 2022 ============================================================================= Packman Mail Message: ===================== No routines included