============================================================================= Run Date: MAR 24, 2014 Designation: OR*3*311 Package : OR - ORDER ENTRY/RESULTS REPORTING Priority: Mandatory Version : 3 SEQ #331 Status: Released Compliance Date: JUL 31, 2014 ============================================================================= Associated patches: (v)OR*3*337 <<= must be installed BEFORE `OR*3*311' (v)OR*3*345 <<= must be installed BEFORE `OR*3*311' (v)OR*3*371 <<= must be installed BEFORE `OR*3*311' Subject: MOCHA 2.0 ORDER CHECK CPRS CHANGES FOLLOW-UP 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. **NOTE** When this patch is installed in step 4 of the MOCHA v2.0 installation process, the 'before' checksum of routine ORCMED will be incorrect, as will the second line of that routine because it will not include patch OR*3*380. The functionality introduced with patch OR*3*380 is overwritten by this patch. However, when patch OR*3*381 is installed in step 5 of the MOCHA v2.0 installation process, that will correct the second line of routine ORCMED and restore the functionality from patch OR*3*380. This patch will address the following issues identified by the MOCHA v2.0 test sites: 1. When a medication quick order is created with a dosage that does not match any of the local possible dosages associated with that medication, the creator is not warned that dosage checks may not work when the quick order is used to create an order. This patch will enable the software to warn the quick order creator of the unmatched dosage. 2. When a medication quick order is created for a drug with only local possible dosages and the quick order's dosage is free-text, the quick order will not have a dispense drug attached to it. Without a dispense drug, dosage order checks will not occur on orders created with this quick order. This patch will enable the software to warn the clinical application coordinator that dosage order checks will not occur. 3. When a prescription is entered through Outpatient Pharmacy Backdoor with a local possible dosage and the associated Computerized Patient Record System order is either transferred to inpatient or copied and then changed, the dosage is converted to free text preventing the software from executing the dosage order check. This patch will prevent the software from converting the local possible dosage to free text. 4. When transferring, copying, or editing a medication order entered through Pharmacy, dosage order checks were not properly performed for simple and complex orders containing local possible or free-text dosages. This patch will enable the software to perform dosage order checks on orders containing local possible and free-text dosages transferred, copied, or edited from an order entered through Pharmacy. 5. Previously CPRS evaluated a Duplicate Therapy message returned from Pharmacy that checks all the drugs listed in the Duplicate Therapy message, and if all of those drugs were also in a Duplicate Drug message, the Duplicate Therapy message was not shown. But if a duplicate drug was entered in CPRS, and there was also a second drug already on the profile that was part of the duplicate therapy, when that evaluation was made on that Duplicate Therapy message, there is now one drug in the Duplicate Therapy message that's not in a Duplicate Drug message, and one drug that is, so the Duplicate Therapy message is shown. With this patch, in this case CPRS still shows the Duplicate Therapy message but only lists the drug(s) in the Duplicate Therapy that were not also returned in a Duplicate Drug message. Patch Components ================ Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- N/A Forms Associated: Form Name File # New/Modified/Deleted --------- ------ -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- N/A Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A New Service Requests (NSRs) ---------------------------- None Patient Safety Issues (PSIs) ----------------------------- PSPO 1689 N/A See associated Remedy ticket HD849668 for description and resolution. Remedy Ticket(s) & Overview --------------------------- 1. HD756345 6 No duplicate therapy order check displayed to the provider. Problem: ------- A provider places a medication order and receives a duplicate therapy order check message for that order. The provider places additional orders and then signs all of the orders at once. When the provider signs all of the orders, the duplicate therapy order check message is not displayed. Resolution: ---------- During session order checking, if there are duplicate duplicate therapy order check messages, the duplicates are supposed to be deleted. However, too many duplicate therapy order check messages were deleted. The code has been modified to delete the correct number of duplicate therapy order check messages. 2. HD849668 OERR - Orders Tab: Problem: ------- A pharmacist enters an order using option Patient Prescription Processing [PSO LM BACKDOOR ORDERS]. A provider then uses CPRS to either copy that order to a new order and edits the new order or edit the existing order. When the new or updated order is sent to Pharmacy, the dosage field contains the drug's strength. This extraneous information makes it difficult for patients to read the label that is printed for their medication. Resolution: ---------- The code that loads an existing order into CPRS was modified to correctly differentiate between a pre-defined dosage and free-text dosages. This modification prevents CPRS from sending the order to Pharmacy with extraneous information in the dosage field. Test Sites: ---------- Charleston Tuscaloosa Kansas Boise Palo Alto Northern California - Martinez Documentation Retrieval Instructions ------------------------------------ Installation documentation is available. The preferred method is to FTP the file from ftp://download.vista.domain.ext/. This transmits the file from the first available FTP server. Sites may also elect to retrieve software directly from a specific server as follows: Albany ftp.domain.ext Hines ftp.domain.ext Salt Lake City ftp.domain.ext Documentation can also be found on the VA Software Documentation Library at: http://www4.domain.ext/vdl/ Patch Installation: 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 24 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ORCDPS1 Before: B78578103 After: B80784611 **94,117,141,149,195,215,243, 280,337,311** Routine Name: ORCDPS2 Before: B67090529 After: B67607141 **94,116,125,131,243,311** Routine Name: ORCHECK Before:B120169317 After:B120029142 **7,56,70,94,141,215,243,293, 280,346,357,352,345,311** Routine Name: ORCMED Before: B63172692 After: B75152203 **4,7,38,48,94,141,178,190,195, 243,306,371,311** Routine Name: ORDSGCHK Before:B109034124 After:B109034124 **280,352,345,311** Routine Name: ORKPS1 Before: B80576469 After: B80576469 **232,272,346,352,345,311** Routine Name: ORWDXC Before: B69748924 After: B67359281 **10,141,221,243,280,346,345,311** Routine Name: ORWDXR01 Before: B28161629 After: B28161629 **187,190,195,215,280,345,311** Routine Name: ORWPT Before: B63799384 After: B64148022 **10,85,132,149,206,187,190, 215,243,280,306,311** Routine Name: ORY311 Before: n/a After: B4599008 **311** Routine list of preceding patches: 337, 345, 371 ============================================================================= User Information: Entered By : Date Entered : APR 15, 2009 Completed By: Date Completed: MAR 24, 2014 Released By : Date Released : MAR 24, 2014 ============================================================================= Packman Mail Message: ===================== No routines included