=============================================================================
Run Date: MAR 24, 2014                     Designation: OR*3*345
Package : OR - ORDER ENTRY/RESULTS REPORTING  Priority: Mandatory
Version : 3       SEQ #330                      Status: Released
                  Compliance Date: JUL 31, 2014
=============================================================================

Associated patches: (v)OR*3*346    <<= must be installed BEFORE `OR*3*345'
                    (v)OR*3*357    <<= must be installed BEFORE `OR*3*345'

Subject: MOCHA 2.0 ORDER CHECK CPRS CHANGES

Category: 
  - Routine

Description:
============

 This patch is part of a group of patches that make up the Medication 
 Order Check Healthcare Application version 2 software (MOCHA v2.0).
 These patches will add a maximum single dose order check to the current 
 VistA medication order checking system that uses the First DataBank (FDB) 
 business logic and database.  FDB custom dosing tables will be used to 
 store custom dosing changes to FDB standard reference drug tables. 
 Pharmacy Enterprise Customization System (PECS) version 2.2 application 
 was developed to meet the customization requirements.
  
 Specific issues that have been addressed in this patch include the 
 following:
  
 - On the copy/renew/change of an Infusion or Unit Dose order where the 
 Dispense Drug was not matched to the National Drug File, there were 
 multiple duplicative messages indicating the order checks could not be 
 done.  The duplicate messages will now only display once.
  
 - When a pending order does not have a dispense drug assigned and all 
 drugs associated with the Orderable Item are matched to National Drug 
 File and another order is placed for the same drug, both a duplicate drug 
 and duplicate therapy order check are displayed. This has been modified 
 such that in this situation only the duplicate drug order check will 
 display.
  
 - The status of Non-VA meds were sometimes showing as PENDING in the 
 DRUG-DRUG order checks when it was in fact ACTIVE.  Now the status will 
 show as "ACTIVE NON-VA" when an active Non-VA med is returned as an order 
 check.
  
 - CPRS was showing duplicate exception messages when order checks could 
 not be done for a drug.  With this patch, only a single exception message 
 is shown.
  
 - For 2 unsigned med orders that have a drug interaction and both have 
 Dispense Drugs, upon signing either one you get the order check showing 
 the interaction with the other, which is correct.  However, if one of 
 them is entered as a Free Text Dose and the other has a Dispense Drug, 
 then when signing the order that has a Dispense Drug the drug interaction 
 order check was not firing.  This has been addressed such that in all 
 cases the correct interaction order check shows.
  
 - Unit Dose Complex medication doesn't generate Duplicate Drug Order 
 Check on Accept for Renewal.  This now works as expected.
  
 - CPRS can now handle displaying multiple messages relating to General 
 Dosing order checks for a complex med order.
  
 - After the release of OR*3*294, Cache would throw the following error 
 into the error trap when Remote Data Interoperability could not connect 
 to the Health Data Repository:  <FUNCTION>zSend+2^%Net.HttpRequest   
 Since an InterSystems Fix would take too long to be released we decided 
 to preempt the error in the Order Entry code so this error should no 
 longer be displayed in the error trap.
  
 - In certain scenarios, DRUG INTERACTION would be displayed as the 
 status of a med in the DRUG-DRUG order checks instead of PENDING or 
 NON-VERIFIED.  With this patch the correct status will be displayed.
  
 - When a drug was entered that was not matched to National Drug File, 
 two exception messages were returned as order checks that the order 
 checks could not be done.  Only one relevant message will now be 
 displayed.
  
 - When the First Data Bank (FDB) Server was down or inaccessible, 
 information from the message that lists what order checks were not 
 displayed was being dropped when signing off or when the order check 
 info gets stored with the order. This has been fixed
  
 - When an orderable item was setup as both an additive and a non-premix 
 solution, CPRS never performed enhanced order checks on the orderable 
 item when it was marked as an additive in an infusion order. 
 Additionally, for an infusion order with a non-premix solution and an 
 additive, CPRS performed enhanced order checks for both the non-premix 
 solution and the additive. CPRS should never perform enhanced order 
 checks on non-premix solutions. With this patch, CPRS will only perform 
 enhanced order checks on all orderable items in an infusion order that 
 are either an additive or a premix solution.
  
 - When an Infusion was being entered via CPRS the First Data Bank server 
 was getting accessed for each of the components (additives and bases) in 
 the order and thus creating slowdowns for the user.  This has been 
 streamlined now to only access the server once for Dosage and once for 
 Enhanced order checks.
  
 - If a Unit Dose or Outpatient Med drug is selected, a free text dose is 
 entered and before the order is accepted all of the dispense drugs are 
 inactivated in back door, no order checks will occur and no message will 
 display indicating that order checks were not done.  In this situation, 
 CPRS will now let the user know that the checks were not done and that 
 they should do manual checks.
  
 - Exception messages were not being displayed for Prospective (newly 
 entered) drug orders when order checking.  This has been fixed such that 
 any exceptions on the new order being entered will show to the user.
  
 - If an orderable item is tagged as a supply in the scenario where there 
 are a mixture of dispense drugs (tagged as supply or not supply) tied to 
 that Orderable Item, if a med is entered through CPRS which would normally
 result in dup therapy order checks, the duplicate order checks are 
 screened out and not displayed. It appears this only affects the 
 prospective drug. Now CPRS will not screen out supply items that the 
 Duplicate Therapy are based on and the screening is done on the Backdoor 
 site for the specific dispense drug instead of at the Orderable Item 
 level.
  
 - Lab result order checks will only fire on the first entry to the LOCAL 
 TERM TEXT multiple (#860.91) in the ORDER CHECK NATIONAL TERM file 
 (#860.9) if there is more than a single entry. This would cause only the 
 first entry to be returned as an order check, when there may be other 
 more recent results. Routine ORKPS has been modified to search through 
 all entries in the LOCAL TERM TEXT multiple (#860.91) for matches, then 
 return the most recent result.
  
  Components Sent With Patch
  --------------------------
    
  Routine Summary:
  ================
  The following is a list of the routine(s) included in this patch.
    
  Total number of routines modified: 12
  Total number of new routines: 0
  Total number of routines: 12
   
  The following is a list of files included in this patch:
  ========================================================
  There are no files associated with this patch.   
    
  Test Sites:
  -----------
  Charleston
  Tuscaloosa
  Kansas
  Boise
  Palo Alto
  Northern California - Martinez
  
  Remedy Tickets Resolved
  -----------------------
  475656 
    
   INSTALLATION INSTRUCTIONS:
   ==========================
   The following patches will be distributed in a phased release and sites 
   will be given access to the host files during their scheduled phase of 
   implementation:
  
   1. PSS_1_160.KID
   2. PSS_1_173.KID
   3. MOCHA_2_0.KID contains: PSO*7*372, PSJ*5*252, and OR*3*345
   4. MOCHA_2_0_FOLLOW_UP_COMBINED_BUILD.KID contains: PSO*7*416,
         PSJ*5*257, GMRA*4*47, and OR*3*311.
   5. OR_3_381.KID - HOST file with patch name OR*3*381.
   6. MOCHA_2_0_FAST_TRACK_BUILDS.KID contains: PSJ*5*299, PSO*7*431
  
   To find out your wave deployment status, please see:
  
 http://vaww.oed.portal.domain.ext/projects/pre/PRE_M2_Deploy_Trng/PRE_VA_User_
 M2_Deploy_Trng/SitePages/Home.aspx
  
  
   Refer to the MOCHA v2.0 Installation Guide PSS_1_P160_MOCHA_CB_IG.doc.

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 33

The checksums below are new checksums, and
 can be checked with CHECK1^XTSUMBLD.

Routine Name: ORCHECK
    Before:B109213586   After:B120169317  **7,56,70,94,141,215,243,293,
                                           280,346,357,352,345,311,269**
Routine Name: ORDSGCHK
    Before: B90665074   After:B109034124  **280,352,345,311**
Routine Name: ORKCHK
    Before: B42414888   After: B42660256  **6,32,94,105,123,232,267,243,
                                           280,345**
Routine Name: ORKCHK4
    Before: B22903679   After: B27733732  **6,32,74,87,94,123,162,190,
                                           249,272,345**
Routine Name: ORKCHK5
    Before: B43550798   After: B65644966  **6,32,74,94,123,190,280,357,
                                           345,269**
Routine Name: ORKCHK6
    Before: B26376206   After: B28204591  **6,32,74,87,94,123,162,190,
                                           249,280,272,346,345,269**
Routine Name: ORKPS
    Before: B67862708   After: B95306003  **6,32,74,94,123,141,190,232,
                                           316,272,346,345**
Routine Name: ORKPS1
    Before: B76491746   After: B80576469  **232,272,346,352,345,311**
Routine Name: OROCAPI1
    Before: B44857555   After: B59009199  **293,346,345,269**
Routine Name: ORRDI2
    Before: B25393824   After: B31690107  **232,294,345**
Routine Name: ORWDXC
    Before: B61402104   After: B69748924  **10,141,221,243,280,346,345,
                                           311,269**
Routine Name: ORWDXR01
    Before: B20020938   After: B28161629  **187,190,195,215,280,345,311**
 
Routine list of preceding patches: 269, 294

=============================================================================
User Information:
Entered By  :                               Date Entered  : FEB 01, 2011
Completed By:                               Date Completed: MAR 24, 2014
Released By :                               Date Released : MAR 24, 2014
=============================================================================


Packman Mail Message:
=====================

No routines included