============================================================================= Run Date: MAR 24, 2014 Designation: PSJ*5*252 Package : PSJ - INPATIENT MEDICATIONS Priority: Mandatory Version : 5 SEQ #255 Status: Released Compliance Date: JUL 31, 2014 ============================================================================= Associated patches: (v)PSJ*5*270 <<= must be installed BEFORE `PSJ*5*252' (v)PSJ*5*271 <<= must be installed BEFORE `PSJ*5*252' Subject: MEDICATION ORDER CHECK HEALTHCARE APPLICATION v2.0 Category: - Routine - Enhancement (Mandatory) Description: ============ This patch is part of a group of host file patches that make up the new Medication Order Check Healthcare Application v2.0 (MOCHA). These patches contain software that supports MOCHA v2.0 functionality. The host files were created to simplify installation at Veterans Health Administration (VHA) facilities. The following patient safety issue has also been addressed in this release: PSPO #2069 - CPRS and VistA Inpatient Pharmacy package return inadequate alert message for allergy information. Patch Information: ------------------ 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 6. MOCHA_2_0_FAST_TRACK_BUILDS.KID contains: PSO*7*431, PSJ*5*299 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 PSS_1_160 and PSS_1_173 include the components necessary for the interface that will be used in MOCHA v2.0. The MOCHA 2.0 and MOCHA 2.0 FOLLOW UP COMBINED BUILD include the modifications to implement Max Single Dose Order checks for the Order Entry Results Reporting (OERR), Inpatient Medications and Outpatient Pharmacy applications. 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. In this initial phase of dosing functionality, the Maximum Single Dose information will be displayed to the user. The following scenarios describe the types of messaging added: 1. If the dosage entered passes the dosing checks, no message will be displayed. 2. If the dosage entered is too high, the Single Dose warning message will be displayed. 3. If the dose checks were not able to be performed, a generic message will be displayed notifying the user that a manual check needs to be completed to verify appropriate dosing. ************************************************************************** When using the option Compare Transport Global to Current System [XPD COMPARE TO SYSTEM] with the host file MOCHA_2_0.KID you will see the following warnings on certain routines: Host file: MOCHA_2_0.KID contains: PSO*7*372, PSJ*5*252, and OR*3*345 PSJ*5*252: Routine: PSJBLDOC *** WARNING, your routine has more patches than the incoming routine *** Routine: PSJGMRA, PSJOC, PSJOCDI *** WARNING, your routine has different patches than the incoming routine *** These warnings are due to the sequence of released patches prior to MOCHA v2.0. Once all the MOCHA v2.0 patches are installed, the second lines of the routines will be updated appropriately. ************************************************************************** The following issues are also addressed by this patch: 1. When entering or finishing an order with a drug that causes an interaction to the additives/premixes of an IV order, the order is displayed multiple times on the drug interaction warning. This patch screens out the duplicate and only displays the order one time. Code Change Request (CCR) #3987. 2. The stop date may not be calculated correctly if during the finish of an order an additive is not selected until the accept/edit screen. The patch will recalculate the stop date when the additive/solution is edited during the finishing of an order. CCR #4336. 3. An undefined error occurred at CPRS+7^PSJOCOR when the dispense drug used in the order was not tied to an Orderable Item. This is a data issue but the code is corrected to prevent the error from happening. HD0000000507452 (CCR #4512). 4. The default response on the allergy alert question "Do you want to intervene?" is set at "NO" for the Inpatient Medications (IP) orders and "YES" for the Outpatient orders. Prior to installation of MOCHA v1.0 the default for IP orders was also set to "YES". PSPO #2069, HD0000000508384 (CCR #4526) 5. Fix the Single dose amount calculation for Requirement 3.8.11.123. This change removed the screening of drugs with the VA CLASSIFICATION of "TN" so the "CONTINUED INFUSTION" route can be used in the dosing checks. CCR #4069. 6. The dosing message currently displayed in VistA and Computerized Patient Record System (CPRS) for orders with a duration greater than or equal to 24 hours is confusing and does not match the requirements. This change corrects the calculation and displays the message clearer when the single dose amount is adjusted. CCR #4281. 7. Multiple exception messages are displayed for the same drug by CPRS. This change will help pass a flag to the interface code to eliminate the extra message. CCR #4290. 8. In order for the dosing checks to work, the unit of Liter had to be used for drugs containing "Potassium". First DataBank (FDB) is now able to accept Milliliter. This change removes the unit conversion from "ML" to "L". CCR #4439. 9. Corrects the spelling of "INTRATHECAL" when checking for the FDB mapping of this Medication Route. CCR #4440. 10. If the patient has multiple orders on the profile with the same drug and the user is entering or finishing an order using the same drug that is not matched to National Drug File (NDF) or has no GCNSEQNO, the exceptions are displayed twice. CCR #4523. 11. An unexpected error occurs during dosing check when finishing a pending unit dose order with a duration less than 24 hours. The frequency is incorrectly set to zero. This patch will fix this problem. CCR #4981. 12. The wrong dosing message was displayed after the Dosage Ordered for a Unit Dose order was edited. This patch will make sure the correct dosage is used in the dosing checks. CCR #4764. 13. Two additional FDB continuous dose routes have to be added to the dosage check logic for IV orders. They are Cont Intraosseous and Cont Caudal infusion. The code is modified to check for these two routes. CCR #5026. Components exported with this patch: ------------------------------------ N/A (Only routines exported) New Service Requests (NSRs): ---------------------------- N/A Patient Safety Issues (PSIs): ----------------------------- PSPO #2069 - The question "Do you want to intervene?" for a drug allergy alert was unintentionally changed to "No" with MOCHA v1.0. Remedy Ticket(s) & Overview: ---------------------------- 1. HD0000000507452 - CPRS+7^PSJOCOR Problem: ------- An undefined error occurred at CPRS+7^PSJOCOR Resolution: ---------- Modified ^PSJOCOR to correct the problem Test Sites: ---------- BOISE, ID CHARLESTON, SC KANSAS CITY, MO NORTHERN CALIFORNIA HCS, CA PALO ALTO HCS, CA TUSCALOOSA, AL Documentation Retrieval Instructions ------------------------------------ Updated documentation describing the new functionality introduced by this patch is available. The preferred method is to FTP the files from ftp://download.vista.domain.ext/. This transmits the files 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://www.domain.ext/vdl/ Title File Name FTP Mode ---------------------------- -------- -------- Inpatient Medications Nurse's PSJ_5_NURSE_UM_R0314.PDF (binary) User Manual PSJ_5_NURSE_UM_R0314.DOC (binary) Inpatient Medications PSJ_5_PHAR_UM_ R0314.PDF (binary) Pharmacist's User Manual PSJ_5_PHAR_UM_ R0314.DOC (binary) Inpatient Supervisor's User PSJ_5_SUPR_UM_ R0314.PDF (binary) Manual PSJ_5_SUPR_UM_ R0314.DOC (binary) Inpatient Medications PSJ_5_TM_ R0314.PDF (binary) Technical Manual/Security PSJ_5_TM_ R0314.DOC (binary) Guide Dosing Order Check User PSS_PSJ_PSO_Dosing_Ord_ (binary) Manual Ck_User_Manual.PDF PSS_PSJ_PSO_Dosing_Ord_ (binary) Ck_User_Manual.DOC Medication Order Check PSS_1_PSO_7_PSJ_5_RN_R0314.PDF (binary) Healthcare Application PSS_1_PSO_7_PSJ_5_RN_ R031.DOC (binary) (MOCHA) v2.0 Release Notes MOCHA v2.0 Combined Build PSS_1_P160_MOCHA_CB_IG.PDF (binary) Installation Guide PSS_1_P160_MOCHA_CB_IG.DOC (binary) VistA to MOCHA v2.0 Interface PSS_1_VistA_to_MOCHA_ID.PDF (binary) Document PSS_1_VistA_to_MOCHA_ID.DOC (binary) FTP Instructions: MOCHA 2.0 includes the following patches. The host files were created to simplify installation at Veterans Health Administration (VHA) facilities and to assist in the phased implementation release method for MOCHA 2.0. File Name Contents Retrieval Format ---------------------------- -------- ---------------- PSS_1_160.KID PSS*1*160 ASCII PSS_1_173.KID PSS*1*173 ASCII MOCHA_2_0.KID PSO*7*372 ASCII PSJ*5*252 OR*3*345 MOCHA_2_0_FOLLOW_UP_ COMBINED_BUILD.KID PSO*7*416 ASCII PSJ*5*257 GMRA*4*47 OR*3*311 ================INSTALLATION INSTRUCTIONS ================= This group of patches will be part of a phased implementation and sites will be given access to the MOCHA V2.0 INSTALLATION GUIDE and patches during their phase of implementation. Routine Information: ==================== The second line of each of these routines now looks like: ;;5.0;INPATIENT MEDICATIONS ;**[Patch List]**;16 DEC 97;Build 69 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSIVEDT Before: B49813774 After: B51363050 **4,110,127,133,134,181,252** Routine Name: PSIVOCDS Before:B112584128 After:B114348606 **181,252** Routine Name: PSIVOPT Before: B57262738 After: B58375431 **17,27,58,88,104,110,155,181, 271,252** Routine Name: PSIVORE Before: B42579774 After: B43371041 **18,29,50,56,58,81,110,127, 133,157,203,213,181,252** Routine Name: PSJAPIDS Before: B29473329 After: B34568784 **181,252** Routine Name: PSJBLDOC Before: B43936297 After: B27080671 **181,263,252** Routine Name: PSJGMRA Before: B26285552 After: B22580264 **181,270,252** Routine Name: PSJLIFN Before: B28721093 After: B29270381 **1,29,34,37,42,47,50,56,94, 80,116,110,181,261,252** Routine Name: PSJMISC2 Before: B11318290 After: B12038651 **181,252** Routine Name: PSJOC Before: B27066758 After: B24678878 **181,252** Routine Name: PSJOCDI Before: B91203881 After: B84788026 **181,252** Routine Name: PSJOCDS Before: B61757941 After: B73599009 **181,252** Routine Name: PSJOCDSD Before: B19852742 After: B25300673 **181,252** Routine Name: PSJOCERR Before: B3747914 After: B3766638 **181,252** Routine Name: PSJOCOR Before: B3349794 After: B3732046 **181,252** Routine Name: PSJOE Before: B83867833 After: B88042799 **7,26,29,33,42,50,56,72,58, 85,95,80,110,111,133,140,151, 149,181,252** Routine Name: PSJOE1 Before: B27457189 After: B28274486 **2,7,25,30,47,56,64,179,181,252** Routine list of preceding patches: 261, 263, 270, 271 ============================================================================= User Information: Entered By : Date Entered : NOV 23, 2010 Completed By: Date Completed: MAR 24, 2014 Released By : Date Released : MAR 24, 2014 ============================================================================= Packman Mail Message: ===================== No routines included