============================================================================= Run Date: AUG 27, 2024 Designation: OR*3*608 Package : OR - ORDER ENTRY/RESULTS REPORTING Priority: Mandatory Version : 3 SEQ #524 Status: Released Compliance Date: OCT 11, 2024 ============================================================================= Associated patches: (v)OR*3*560 <<= must be installed BEFORE `OR*3*608' (v)OR*3*588 <<= must be installed BEFORE `OR*3*608' Subject: CPRS GUI v33SWD (SIGI/SHRPE, WEIGHT, DEMOGRAPHICS) Category: - Routine - Other - Enhancement (Mandatory) Description: ============ This patch is part of the Computerized Patient Record System (CPRS) v33SWD updates. Below is a list of all the applications involved in this project along with their patch numbers: APPLICATION/VERSION PATCH --------------------------------------------------------------- ORDER ENTRY/RESULTS REPORTING v3.0 OR*3.0*608 TEXT INTEGRATION UTILITIES v1.0 TIU*1.0*318 MENTAL HEALTH v5.01 YS*5.01*237 This patch covers several New Service Requests (NSRs). 1. NSR #20110405 Notifications from Consults - Part 1 aims to overhaul the approach to generating notifications for actions taken on consults and procedures. The overarching goal is to better separate clinical and administrative actions, and to generate notifications only to the users needing to take action and/or be informed about updates. A small portion of this NSR is being delivered in this version of CPRS. The text displayed on the Add Comment to Consult action dialog is being updated. The aim of the text update is to better inform users as to when the ordering provider will be notified for an Add Comment to Consult action, and also prevent users from needlessly sending notifications to providers when no action is required on the provider's part. The current text is generated based on the role and update authority of who is taking the action and can be one of three versions: "An alert will automatically be sent to the ordering provider." "An alert will automatically be sent to the notification recipients for this service." "An alert will automatically be sent to the ordering provider and to notification recipients for this service." With this release, the text has been updated and, only during the Add Comment to Consult action, regardless of user role/update authority, will be the following. "Only alert Providers when their action is required." "++ NOTE: To alert Provider use "Send additional alerts" option below, or use Significant Findings. ++" 2. NSR #20131005 which aims to reduce the likelihood of selecting the wrong patient, a patient safety issue. To address this, additional information related to the patient and their last visit will be included on the patient selection screen. In addition, if a similar name is detected, the pop-up box has three new fields for assisting in selecting a patient. On the patient selection screen Primary Care Provider, Inpatient Provider, Attending, Last Location, and Last Visited (date) have been added. For the pop-up box, physician (dependent on the last visit), last location, and last visit have been added. 3. NSR #20130305 - Currently VHA CPRS displays a patient's biologic sex but does not display gender identity. These are related but distinct demographic characteristics. There are clinical and medicolegal reasons to capture both as distinct data elements. This NSR request is to change the label 'Sex' to 'Birth Sex' and add Self-Identified Gender Identity (SIGI) to demographic display. 4. NSR #20150513 - Functionality of CPRS Weight Display. To address this, CPRS has been modified to allow sites to change how certain vitals are displayed on the coversheet, in the encounter portion of the Note display on the Notes tab, and on the Vitals tab in the encounter form. By division or for the entire system, a site may now choose to display either metric or imperial values first, for those vitals that have both. 5. NSR #20160415 - Progress Notes Flag Action allows CPRS to display the 'Originating Facility' data in the Progress Notes Properties unlinked Patient Record Flags (PRF) flag actions section. This enhancement implements PRF functionality extended by DG*5.3*951, part of the Suicide High Risk Patient Enhancements (SHRPE) supporting the enhanced care protocols established for Veterans at high risk for suicide. 6. NSR #20201003 - Add Pronouns to Demographics bar next to new SIGI field 7. NSR #20220818 - The VHA Office of Informatics and Analytics is requesting the ability to limit the Clinically Indicated Date (CID) in the CPRS for future orders to no more than 390 days when ordering diagnostics exams in CPRS to prevent delaying diagnosis and treatment of patients. This release of CPRS addresses Imaging and Consult orders. Lab orders will be addressed in a future release. A new version of the Mental Health Dynamic Link Library (DLL) used by CPRS GUI is included with this release. Please refer to the YS*5.01*237 patch description for details. Additional information has been added to the CPRS exception log module to assist developers with debugging access violation errors. 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 New File Entries Associated: File Name (Number) Field (Number) Value ------------------ --------------- ------------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- OR CPRS GUI CHART Broker Modified Parameter Definitions Associated: Parameter Definition Name New/Modified/Deleted ------------------------- -------------------- OR CPRS ACTIVITY LOG SIZE New OR CPRS EXCEPTION EMAIL Modified OR CPRS EXCEPTION LOGGER Modified OR CPRS EXCEPTION PURGE Modified OR CPRS EXCEPTION MODULE INFO New OR CPRS RPC EXCEPTION LOG SIZE New OR CPRS WIN MESSAGE LOG SIZE New ORCDGMRC FUTURE DATE LIMIT New ORCDRA FUTURE DATE LIMIT New ORQQVI METRIC FIRST Modified Parameter Template Name New/Modified/Deleted ----------------------- -------------------- Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Remote Procedure Calls Associated: Remote Procedure Call Name New/Modified/Deleted -------------------------- ------------------ ORQQVI SWPVIT New ORUTL4 DLL Modified ORWPT SELECT Modified ORWPT ID INFO Modified ORWPT2 ID INFO New ORWPT2 LOOKUP New Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Additional Information: ----------------------- Report entry for ORCV VITALS is being modified. ORDER DIALOG (#101.41) file entries RA OERR EXAM and GMRCOR CONSULT are modified in support of NSR #20220818/HITPS-7598. Blood Bank Team Coordination: N/A New Service Requests (NSRs): ---------------------------- 20110405 - Notifications from Consults - Part 1 20130305 - Gender/Sex (SIGI) Field in CPRS 20131005 - Patient Selection Similar Patients Box 20150513 - Functionality of CPRS Weight Display 20160415 - Progress Notes Flag Action 20201003 - Add Pronouns to Demographics bar next to new SIGI field 20220818 - Limit Date Selection for CPRS Orders in the Extreme Future Patient Safety Issues (PSIs): ----------------------------- HITPS-196 HITPS-521 PSPO 540 HITPS-1596 PSI-07-087 (Remedy #189451) HITPS-2453 PSPO 3657 HITPS-7598 Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 1. INC18782546 - CPRS - Display of some vitals are duplicated in the PCE display area below the progress note view. Problem: ------- When displaying the patient's vitals below the note editor, sometimes the Weight information is displayed twice. This happens because the result string for function FormatVitalForNote was not being properly initialized, thus "defaulting" to the previous return value in some cases. Resolution: ---------- The result string for function FormatVitalForNote is now set to '' (empty string) on entering. 2. INC11869026 - Click Clock, Reminders window opens: If you scroll the right side the left side scrolls automatically, if you scroll the left side the side doesn't scroll. Duplicates: INC29725716, INC29684548 Problem: ------- In the Available Reminders form in CPRS, the DUE DATES and other information aren't scrolling when the mousewheel is used to scroll the tree of reminders. Resolution: ---------- The Available Reminders form overrides the mousewheel handling to keep both right and left sides of the reminders in sync. 3. INC13824577 - VISN 23 has frequent reports of consult order dialogs disappearing after data is entered and before it is accepted or signed. Problem: ------- When the Order a Consult form is opened from an order menu, and the user clicks on the Lexicon menu to choose a diagnosis, sometimes the Order a Consult form is getting hidden behind the order menu. Resolution: ---------- After closing the Lexicon form, the Order a Consult form brings itself to the front of the stack of open CPRS forms. 4. INC12188466 - In this new version of CPRS, when I use a template, the lines that should be blank now have a space at the beginning, and the lines that should have a space at the end do not. Problem: ------- When inserting boilerplate templates, lines that formatting spaces at the end are having those spaces stripped. And what were blank lines in the template now have a space. Resolution: ---------- Lines shorter than 70 characters are no longer subject to having ending whitespace removed, and blank lines are restored. 5. INC16329726 - CPRS coversheet reminder view Education Topic Definition not working Problem: ------- When a user right-clicks on an active clinical reminder and chooses Education Topic Definition, then HTN Medication Adherence, the information displayed is incorrect. This is because the wrong RPC is called. Resolution: ---------- The menu command handler for Education Topic Definition, HTM Medication Adherence now calls the correct RPC. 6. INC28129476 (numerous child tickets) CPRS Spell Check Broken Problem: ------- In mid-2023, a Microsoft update to Office 365 introduced a defect to the Office functionality used by CPRS to invoke spell checking. Misspelled words were no longer appearing in the "Not in dictionary" section of the spell check window. A manual workaround was identified where users had to click on the Options button of the spell check window, and then close the Options window. This action restored visibility of any text appearing in the "Not in dictionary" section. Resolution: ---------- In this version of CPRS, a change has been made that automates the manual workaround and also keeps the Options window from being seen as it is opened and then closed. Effectively, users will see spell checking behave as it previously had, before Microsoft introduced the defect. 7. INC29884189 - CPRS Diet error: Access Violation at address 00FB5694 in Module 'CPRSchart.exe'. Read Address 00000014 Problem: ------- CPRS v32c (v32.515.2) introduced a potential bug where some order dialog configurations could cause an access violation when trying to create diet orders. Resolution: ---------- This access violation should no longer occur regardless of order dialog configuration. 8. INC31027958 - Add legacy pop-up box to the list of boxes that will retain user sizing/settings when stretched to a different size. Problem: ------- The Patient Lookup Messages window that displays when a patient requires a means test or when the patient has legacy data does not retain any user settings for sizing. Resolution: ---------- This window will now retain size settings when the user has stretched the window to a different size than default. 9. INC25256062 Consult Reason for Request text still in reverse order. Problem: ------- If a new consult includes a template, the content of the template is sometimes being inserted line-by-line backward into the "Reason for Request" field. This is due to the Windows richedit control sometimes returning 0 for the number lines in the "Reason for Request" field, and how TStrings.Text processes assigning a string. Resolution: ---------- CPRS GUI has been updated to use the Windows Rich Edit control more directly, to stream the content into the control, rather through the extra layer of Delphi's abstraction classes. 10. INC20159582 ATTN: CLIN2/CPRS Developers - Reproducible TIU Template CPRS Crash. Problem: ------- Certain combinations of required fields in nested templates, that are selected and deselected multiple times can generate an access violation in CPRS GUI. When working in a template, CPRS keeps track of the template fields and their state (i.e., a checkbox is checked or unchecked). CPRS also tracks a list of the required fields in each template. In certain scenarios, as required items are selected or deselected, the required field list is not always updated and when CPRS tries to read that list, an access violation occurs. Resolution: ---------- The required field tracking logic in CPRS GUI templates has been updated to correct the access violation. Test Sites: ----------- Heartland East Health Care System, MO Salisbury Health Care System, NC Upstate New York Health Care System Test Sites - SNOW Change Order #: Heartland East Health Care System, MO: Change Order #CHG0484780 Salisbury Health Care System, NC: Change Order #CHG0483721 Upstate New York Health Care System: CHG0466747 Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released using a host file. This release of CPRS is NOT following a wave deployment. The host file will be available at the following location: /srv/vista/patches/SOFTWARE/CPRS_V33SWD_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_608.ZIP CPRSChart.exe BINARY RoboEx32.dll borlndmm.dll CPRSChart.map CRC.TXT WebView2Loader.dll YS_MHA_A_XE10.dll HELP Directory OR_30_608_SRC.ZIP CPRS v33SWD Source BINARY CPRS_v33SWD_COMBINED_BUILD.KID CPRS v33SWD COMBINED 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. Title File Name ---------------------------------------------------------------------- CPRS v33SWD (OR*3.0*608) Deployment, OR_3_0_608_DIBR.DOCX Installation, Back-Out, and Rollback Guide OR_3_0_608_DIBR.PDF CPRS GUI v33SWD Release Notes OR_3_0_608_RN.DOCX OR_3_0_608_RN.PDF Computerized Patient Record System (CPRS) CPRSLMTM.DOCX Technical Manual: List Manager Version CPRSLMTM.PDF Computerized Patient Record System (CPRS) CPRSGUIUM.DOCX User Guide: GUI Version CPRSGUIUM.PDF Computerized Patient Record System (CPRS) CPRSGUITM.DOCX Technical Manual: GUI Version CPRSGUITM.PDF Installation Instructions: -------------------------- ***Installation of this build must NOT be queued.*** Please refer to the "CPRS v33SWD (OR*3.0*608) Deployment, Installation, Back Out, and Rollback Guide" for installation and set-up information. This document is exported as OR_3_0_608_DIBR.PDF and OR_3_0_608_DIBR.DOCX. Post-Installation Instructions: ------------------------------- Please refer to the "CPRS v33SWD (OR*3.0*608) Deployment, Installation, Back Out, and Rollback Guide" for installation and set-up information. Back-Out/Roll Back Plan: ------------------------ Please refer to the "CPRS v33SWD (OR*3.0*608) 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 15; The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ORACCES2 Before:B111430937 After:B108464110 **588,608** Routine Name: ORCDGMRC Before: B41619023 After: B46456843 **4,26,68,100,181,361,608** Routine Name: ORCDRA Before: B30425287 After: B37709753 **8,53,95,141,608** Routine Name: ORDSTCTB Before: B4432190 After: Delete Routine Name: ORGMRC Before: n/a After: B6004197 **608** Routine Name: ORQQVI Before: B46320078 After: B46419090 **10,198,215,250,260,285,286, 414,524,557,560,608** Routine Name: ORWPAR1 Before: n/a After: B467957 **608** Routine Name: ORWPT Before: B82449401 After: B89644815 **10,85,132,149,206,187,190, 215,243,280,306,311,441,528, 519,544,405,608** Routine Name: ORWPT2 Before: B359041 After: B6696868 **485,608** Routine Name: ORWU Before:B141318037 After:B156223976 **10,85,132,148,149,187,195, 215,243,350,424,377,519,539, 405,596,588,608** Routine Name: ORY608 Before: n/a After: B32484791 **608** Routine list of preceding patches: 141, 361, 485, 560, 588 ============================================================================= User Information: Entered By : Date Entered : AUG 18, 2023 Completed By: Date Completed: AUG 22, 2024 Released By : Date Released : AUG 27, 2024 ============================================================================= Packman Mail Message: ===================== No routines included