$TXT Created by R at CMAI.FO-BIRM.DOMAIN.EXT (KIDS) on Wednesday, 07/27/16 at 15:39 ============================================================================= Run Date: AUG 30, 2016 Designation: PSJ*5*315 Package : PSJ - INPATIENT MEDICATIONS Priority: Mandatory Version : 5 SEQ #281 Status: Released Compliance Date: SEP 30, 2016 ============================================================================= Associated patches: (u)PSB*3*83 install with patch `PSJ*5*315' (u)PSB*3*87 install with patch `PSJ*5*315' (v)PSJ*5*216 <<= must be installed BEFORE `PSJ*5*315' (v)PSJ*5*252 <<= must be installed BEFORE `PSJ*5*315' (v)PSJ*5*255 <<= must be installed BEFORE `PSJ*5*315' (v)PSJ*5*268 <<= must be installed BEFORE `PSJ*5*315' (v)PSJ*5*278 <<= must be installed BEFORE `PSJ*5*315' (v)PSJ*5*281 <<= must be installed BEFORE `PSJ*5*315' (v)PSJ*5*285 <<= must be installed BEFORE `PSJ*5*315' (v)PSJ*5*287 <<= must be installed BEFORE `PSJ*5*315' (v)PSS*1*191 <<= must be installed BEFORE `PSJ*5*315' (v)PSJ*5*318 <<= must be installed BEFORE `PSJ*5*315' Subject: INPATIENT MEDICATIONS ENHANCEMENTS (CASDDPE) Category: - Routine - Data Dictionary - Enhancement (Mandatory) Description: ============ ******************************* ATTENTION ******************************** Clinical Ancillary Services (CAS) Development-Delivery of Pharmacy Enhancements (DDPE) VA Inpatient Medication Administration - Transdermal enhancement includes 5 patches that must be installed in the following order: 1. PSS*1*191 2. PSJ*5*315 3. PSB*3*83 4. PSB*3*87 5. OR*3*417 ATTENTION: This enhancement also includes a new Graphical User Interface (GUI) executable, BCMA GUI PSB3_P083.EXE. Installation of this GUI is required immediately after the KIDS install for the Patch to function. For retrieval and installation instructions, please see the Client Installation Instructions section. ************************************************************************** Patch PSJ*5.0*315 provides enhancements to the Inpatient Medications application and to support enhancements for the Bar Code Medications Administrations (BCMA) application for Transdermal Administrations. These enhancements include: 1. Currently Sites have to create fake removal orders to allow for appropriate removal of medications in BCMA. This patch will alleviate that issue by prompting the user for DURATION OF ADMINISTRATION based on the value stored in the PROMPT FOR REMOVAL IN BCMA field (#12) contained in the ORDERABLE ITEM file (#50.7). This field implements changes that will support enhancements to the BCMA and Inpatient Medication applications to display the removal times in Inpatient Medication orders using rules determined by the value of this field. The PROMPT FOR REMOVAL IN BCMA field (#12) can be set for Orderable Items that require removal to the following values: NULL/0=No Removal Required 1 = Removal at Next Administration 2 = Removal Period Optional Prior to Next Administration 3 = Removal Period Required Prior to Next Administration 2. Routines added for this patch will add the new DURATION OF ADMINISTRATION prompt to the option Inpatient Order Entry [PSJ OE] then calculate the appropriate removal times and display them for verification. The NON-VERIFIED ORDERS file (#53.1) and UNIT DOSE sub-file(#62) of the PHARMACY PATIENT file (#55) will be updated to include new fields that will control the removal process. These two files will have these 4 fields added: DURATION OF ADMINISTRATION field (#137), REMOVE TIMES field(#138), REMOVE PERIOD field(#139) and BCMA PROMPT FOR REMOVAL FLAG field(#140). A new field called PROMPT FOR REMOVAL IN BCMA field(#12) created in the ORDERABLE ITEMS file (#50.7) by patch PSS*1.0*191 will be used for information to be stored in the BCMA PROMPT FOR REMOVAL FLAG field(#140) in the NON-VERIFIED ORDERS file(#53.1) and the UNIT DOSE sub-file(#62) of the PHARMACY PATIENT file (#55). 3. The Edit Clinic Med Orders Start Date/Time [PSJ ECO] option will have changes to anticipate these new fields and request additional user activity when the orders require specific information that can only be entered via the Inpatient Order Entry [PSJ OE] option. 4. This patch contains a post-install routine PSJ5P315 that sends a report listing all legacy orders for Medications that require removal. In order to prevent confusion by users of the BCMA GUI application these orders will need to be discontinued and reordered to include the removal information. This same report can be recalled from the Pharmacy Data Management [PSS MGR] menu using the Orders for MRRs With Removal Properties [PSS MRR ORDERS DIAGNOSTIC RPT] option. 5. The Order View Hidden Actions Menu [PSJ LM ORDER VIEW HIDDEN ACTIONS] protocol has been modified to include a hidden action for calling the Administration History report. A new protocol, Admin History for OI [PSJ LM ADM HIST], was added for the new hidden action. This report allows viewing of other orders for the Orderable Item listed in the Order Detail for the selected Order. The menu item Other Pharmacy Options [PSJ LM OTHER PHARMACY OPTIONS] has been shortened to read Other Pharm Options in order to allow the columns to align correctly. The AH menu option will not be available during the period in which PSJ*5.0*315 is installed, but PSB*3.0*83 is not. If the user attempts to run this option during this time they will get the following message: Report not available until install of patch PSB*3.0*83. This patch requires patch PSS*1.0*191. The full functionality introduced in this patch will not be available until patches PSB*3.0*83 and possibly PSB*3.0*87 for Bar Code Back Up (BCBU) are installed. Pre-existing orders will remain unaffected with installation. ********** SPECIAL NOTE on Times Per Day (TPD) orders**********: To avoid confusion it is strongly recommended that MRR medications needing to use a TPD schedule with asynchronous administrations and removals to have the PROMPT FOR REMOVAL IN BCMA field (#12) set to a value of 3. The Pharmacist will then always be prompted for the Duration of Administration and a proper removal time can be entered in the Inpatient Order Entry [PSJ OE] option. In order to maintain adequate flexibility for Times per Day (TPD) schedules such as BID, TID and QID for MRR medication orders; these schedules are not validated to the extent that other continuous schedule types are validated. The intent was to allow a variety of administrations and removals that may be asynchronous in order to process correctly; for instance this will allow having two administrations 6 hours apart followed by a 12 hour medication-free period. Normally the frequency used by the existing ADMINISTRATION SCHEDULE file (#51.1) setup would expect a 12 hour frequency for continuous schedule types (24 hours divided by 2 administrations equals 12) and this is what is standard practice. Existing MRRs set to have the medication removed at the next Duration of Administration would need to have a Duration of Administration value entered for TPD schedules, otherwise the stored frequency in the ADMINISTRATION SCHEDULE file (#51.1) would be used and this could result in an incorrect removal period. Therefore we recommend setting the MRR value to a 3 (Duration of Administration Required). If the MRR is set to a value of 1 in the PROMPT FOR REMOVAL IN BCMA field (#12), the Pharmacist would not receive the verification screen that appears for Duration of Administration entries and may not be aware of this issue. The following is an example of using a type 1 Prompt for Removal in BCMA for TPD's (Not recommended Condition): The MRR medication needs to be administered at 0900 and removed at 1500, with a new administration added at 1500 then removed at 2100. The BID schedule is used with the PROMPT FOR REMOVAL IN BCMA field (#12) value set to a 1 and the Frequency for BID schedule set to 12 hours. The Pharmacist would only see the administration times of 0900 and 1500. The system would then use the frequency stored in the ADMINISTRATION SCHEDULE file (#51.1) of 12 hours, so that Removal Times on the enhanced BCMA would then calculate as removal at 2100 and 0300, which would be in conflict with the administration times. The following is an example of using a type 3 Prompt for Removal in BCMA for TPD's (Recommended condition): The MRR medication needs to be administered at 0900 and removed at 1500, with a new administration added at 1500 then removed at 2100. The BID schedule is used with the PROMPT FOR REMOVAL IN BCMA field (#12) value set to a 3. In this case the Frequency is no longer used. The Pharmacist would see the administration times of 0900 and 1500 and enter the appropriate Duration of Administration which would be 6 hours. The system would create a verification display showing administration at 0900 followed by and Administration and Removal at 1500 then a Removal at 2100 as ordered by the Physician. Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- NON-VERIFIED ORDERS(#53.1) DURATION OF ADMINISTRATION (#137) New NON-VERIFIED ORDERS(#53.1) REMOVE TIMES (#138) New NON-VERIFIED ORDERS(#53.1) REMOVE PERIOD (#139) New NON-VERIFIED ORDERS(#53.1) BCMA PROMPT FOR REMOVAL FLAG (#140) New PHARMACY PATIENT(#55) UNIT DOSE(#62) DURATION OF ADMINISTRATION (#137) New PHARMACY PATIENT(#55) UNIT DOSE(#62) REMOVE TIMES (#138) New PHARMACY PATIENT(#55) UNIT DOSE(#62) REMOVE PERIOD (#139) New PHARMACY PATIENT(#55) UNIT DOSE(#62) BCMA PROMPT FOR REMOVAL FLAG (#140) New 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 ------------- -------------------- Order View Hidden [PSJ LM ORDER VIEW HIDDEN ACTIONS] Actions Menu Modified Admin History by OI [PSJ LM ADM HIST] New Other Pharmacy [PSJ LM OTHER PHARMACY OPTIONS] Options Modified 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 20141012: Pharmacy Safety Enhancements: The Veterans Health Administration (VHA) Pharmacy Benefits Management (PBM) supports enhancing functionality of the VistA Pharmacy package and Bar Code Medication Administration (BCMA) software packages. This request identifies, consolidates, and combines requirements needed for near-term enhancements to VistA Pharmacy and/or BCMA. Patient Safety Issues (PSIs): ----------------------------- PSPO 3243: Results in a null stop date on an order that then causes it to enter a state where it is not accessible in the Patient Profile screen, and varying behavior in CPRS depending on whether the order is a Clinic or Inpatient order. Remedy Ticket(s) & Overview: ---------------------------- N/A Problem: ------- Resolution: ---------- Test Sites: ---------- PITTSBURGH HCS VISN2/UPSTATE NY ST. CLOUD, MN -VAMC Documentation and Software Retrieval Instructions: ----------------------------------------------------------------------- Updated documentation describing the new functionality and installation instructions introduced by this patch are available. Files can be obtained from the ANONYMOUS.SOFTWARE directory at one of the OI Field Offices. The preferred method is to retrieve the file using Secure File Transfer Protocol (SFTP) from DOWNLOAD.VISTA.DOMAIN.EXT, which will transmit the file from the first available server. Alternatively, sites may elect to retrieve the file from a specific OI Field Office. OI FIELD OFFICE FTP ADDRESS DIRECTORY Albany: domain.ext Hines: domain.ext Salt Lake City: domain.ext Documentation can also be found on the VA Software Documentation Library at: http://www4.domain.ext/vdl/ Title File Name FTP Mode ----------------------------------------------------------------------- INPATIENT MEDICATIONS RELEASE NOTES psj_5_p315_rn.pdf Binary INPATIENT MEDICATIONS NURSE'S USER MANUAL psj_5_nurse_um_r0816.pdf Binary INPATIENT MEDICATIONS PHARMACIST'S USER MANUAL psj_5_phar_um_r0816.pdf Binary INPATIENT MEDICATIONS TECHNICAL MANUAL/ SECURITY GUIDE psj_5_tm_r0816.pdf Binary Patch Installation: Pre/Post Installation Overview: ------------------------------- A post-installation routine PSJ5P315 will run with this install. See post install instructions below for details. Pre-Installation Instructions: ------------------------------ This patch may be installed with users on the system although it is recommended that it be installed during non-peak hours to minimize potential disruption to users. This patch should take less than 5 minutes to install. Patch PSS*1.0*191 is required to install this patch. Installation Instructions: -------------------------- 1. Choose the PackMan message containing this patch PSJ*5.0*315. 2. Choose the INSTALL/CHECK MESSAGE PackMan option. 3. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, you may elect to use the following options. When prompted for the INSTALL NAME enter the patch PSJ*5.0*315: a. Backup a Transport Global - This option will create a backup message of any routines exported with this patch. It will not backup any other changes such as DDs or templates. b. Compare Transport Global to Current System - This option will allow you to view all changes that will be made when this patch is installed. It compares all components of this patch (routines, DDs, templates, etc.). c. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. 4. From the Installation Menu, select the Install Package(s) option and choose the patch to install. 5. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//,' respond Yes 6. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//,' respond No Post-Installation Instructions: ------------------------------- The post-install routine generates a preliminary patient order report listing the approximate number of active patient orders that may need to be discontinued and re-created. This report is emailed to holders of the PSJI MGR, PSJU MGR, PSJU RPH, and PSJ RPHARM keys, and also the installer of this patch. Please delete the post install routine (PSJ5P315) after you have received this mailman report. Sites may periodically run "Pharmacy Data Management" [PSS MRR ORDERS DIAGNOSTIC RPT] under "Pharmacy Data Management" [PSS MGR] to update the preliminary estimates of active patient orders that may need to be discontinued and re-created. They may need to do this if they aren't able to process active orders right after install. The report should be run periodically after install to insure that all active orders get cancelled and re-ordered. Sites may also run the Orderable Items that Require Removal Report [PSS MRR ORDERABLE ITEMS RPT] under "Orderable Item Management" [PSS ORDERABLE ITEM MANAGEMENT] to verify which Orderable Items have been marked for PROMPT FOR REMOVAL IN BCMA. After both PSJ*5*315 has been installed and PROMPT FOR REMOVAL IN BCMA field (#12) have been updated for relevant orderable items, sites should generate a new "Orders for MRRs With Removal Properties" [PSS MRR ORDERS DIAGNOSTIC RPT] report for the most current and accurate list of orders that need to be addressed. Routine Information: ==================== The second line of each of these routines now looks like: ;;5.0;INPATIENT MEDICATIONS;**[Patch List]**;16 DEC 97;Build 73 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSGAH Before: n/a After: B25445995 **315** Routine Name: PSGOD Before: B24552546 After: B25616562 **67,58,111,133,181,286,281,315** Routine Name: PSGOE Before: B26201410 After: B26260388 **22,29,56,72,95,80,133,181,275,315** Routine Name: PSGOE0 Before: B12881111 After: B13276254 **110,315** Routine Name: PSGOE1 Before: B29072557 After: B29572227 **7,19,26,39,58,85,80,110,127, 133,134,315** Routine Name: PSGOE3 Before: B24652954 After: B25305463 **58,81,315** Routine Name: PSGOE41 Before: B27985656 After: B97415312 **50,63,64,69,58,111,136,113, 267,315** Routine Name: PSGOE8 Before: B48942874 After: B52703048 **47,50,65,72,110,111,188,192, 113,223,269,287,315** Routine Name: PSGOE81 Before: B32608596 After:B107835999 **26,50,64,58,82,110,111,136, 113,267,315** Routine Name: PSGOE9 Before: B40776926 After: B45686408 **11,47,50,72,110,111,188,192, 207,113,223,269,315** Routine Name: PSGOE91 Before: B37734191 After:B114506960 **50,64,58,110,111,136,113,179, 265,267,285,315** Routine Name: PSGOEE Before:B101870372 After:B103314834 **4,7,29,47,64,58,82,91,110, 111,112,142,179,181,254,267, 268,281,315** Routine Name: PSGOEE0 Before: B28840533 After: B31021765 **58,95,179,216,315** Routine Name: PSGOEEW Before: B28923213 After: B28844185 **7,58,111,315** Routine Name: PSGOEF Before:B103709466 After:B119034802 **7,30,29,35,39,47,50,56,80, 116,110,111,133,153,134,222, 113,181,260,199,281,315** Routine Name: PSGOEF1 Before: B28843982 After: B30874451 **2,7,35,39,45,47,50,63,67,58, 95,110,186,181,267,315** Routine Name: PSGOEM Before: B32911590 After: B46502031 **81,260,315** Routine Name: PSGOER Before: B85734604 After: B87272469 **11,30,29,35,70,58,95,110,111, 133,141,198,181,246,278,281, 315** Routine Name: PSGOETO Before: B38155409 After: B39634920 **3,13,25,31,33,50,68,58,85, 105,90,117,110,111,112,161,254, 267,268,315** Routine Name: PSGOT Before: B23046911 After: B23271906 **13,68,90,110,173,134,161,254, 267,257,315** Routine Name: PSGOTR Before: B21776310 After: B22276864 **110,127,133,129,267,257,255,315** Routine Name: PSGVW Before: B31699559 After: B32841979 **50,58,85,80,104,110,267,315** Routine Name: PSGVW0 Before: B10085740 After: B11075567 **49,54,85,267,315** Routine Name: PSJ5P315 Before: n/a After: B42106508 **315** Routine Name: PSJBCMA Before:B124935631 After:B138494525 **32,41,46,57,63,66,56,69,58, 81,91,104,111,112,186,159,173, 190,113,225,253,267,279,308, 318,315** Routine Name: PSJBCMA1 Before:B120598961 After:B132466379 **32,41,46,57,63,66,56,58,81, 91,104,186,159,173,253,267,279, 315** Routine Name: PSJCLOR2 Before:B116286849 After:B116946050 **275,279,315** Routine Name: PSJCLOR5 Before: B68088373 After: B94059685 **275,315** Routine Name: PSJCOM Before: B41203922 After: B42503350 **110,186,267,281,315** Routine Name: PSJCOM1 Before: B48577144 After: B49883276 **110,127,281,315** Routine Name: PSJHL3 Before: B97470088 After:B118359131 **1,11,14,40,42,47,50,56,58, 92,101,102,123,110,111,152,134, 226,267,260,281,315** Routine Name: PSJHL7 Before: B54843805 After: B55553130 **42,47,50,70,82,110,127,133, 275,279,315** Routine Name: PSJLMGUD Before: B30490889 After: B31031159 **25,58,85,116,110,111,267,275,315** Routine Name: PSJLMUDE Before: B66391198 After: B69470677 **7,47,50,63,64,58,80,116,110, 111,164,175,201,181,254,267, 228,315** Routine Name: PSJOE Before:B103230773 After:B105816972 **7,26,29,33,42,50,56,72,58, 85,95,80,110,111,133,140,151, 149,181,252,281,315** Routine Name: PSJOE1 Before: B30534447 After: B31281544 **2,7,25,30,47,56,64,179,181, 252,281,315** Routine Name: PSJOEA Before: B31162928 After: B31606537 **110,127,133,167,171,254,315** Routine Name: PSJORRE Before: B35461891 After: B37472856 **22,51,50,58,81,110,111,112, 134,225,275,315** Routine Name: PSJORRE1 Before: B41040676 After: B42580655 **22,51,50,58,81,91,110,111, 134,225,275,315** Routine list of preceding patches: 216, 228, 255, 281, 285, 287, 318 ============================================================================= User Information: Entered By : Date Entered : FEB 09, 2015 Completed By: Date Completed: AUG 30, 2016 Released By : Date Released : AUG 30, 2016 ============================================================================= Packman Mail Message: ===================== $END TXT