============================================================================= Run Date: MAY 24, 2016 Designation: PSO*7*411 Package : PSO - OUTPATIENT PHARMACY Priority: Mandatory Version : 7 SEQ #380 Status: Released Compliance Date: JUN 24, 2016 ============================================================================= Associated patches: (v)PSO*7*294 <<= must be installed BEFORE `PSO*7*411' (v)PSS*1*175 <<= must be installed BEFORE `PSO*7*411' (v)PSO*7*427 <<= must be installed BEFORE `PSO*7*411' (v)PSO*7*429 <<= must be installed BEFORE `PSO*7*411' (v)PSO*7*436 <<= must be installed BEFORE `PSO*7*411' (v)PSO*7*438 <<= must be installed BEFORE `PSO*7*411' Subject: MOCHA UFT ENHANCEMENTS 2 PSO Category: - Routine - Enhancement (Mandatory) Description: ============ This patch is part of the Medication Order Check Healthcare Application (MOCHA) Enhancements 2 group of patches. A host file was created to simplify installation at Veterans Health Administration (VHA) facilities. The host file MOCHA_ENH_2_GMRA_OR_PSJ_PSO.KID contains: PSO*7*411, PSJ*5*281, OR*3*269 and GMRA*4*46. In addition, there is the stand alone patch PSS*1*175 which must be installed before the combined build. Important: Recently released patch GMRA*4*48 contains an Allergy Assessment Clean Up utility tool that produces a report that identifies discrepancies between the ADVERSE REACTION ASSESSMENT file (#120.86) and the PATIENT ALLERGIES file (#120.8). It is imperative that GMRA*4*48 be installed prior to the installation of PSO*7*411 and its associated patches, and that all data discrepancies identified by GMRA*4*48 have been corrected. If not, then installing PSO*7*411 and its associated patches may result in drug allergy order checks not displaying in Computerized Patient Record System (CPRS) and pharmacy during the medication order entry processes. This patch PSO*7*411 contains the following functionality: 1. This patch adds BSA (m2) to the Medication Profile report [PSO P] option header display. 2. Add to the backdoor pharmacy order entry process functionality to evaluate the orderable item for a specific patient using the Clinical Reminder Order Check (CROC) API. 3. Modifies the hidden DA option to display all allergy order checks when multiple allergy checks exist for an order. 4. Modifies the patient information screen to display remote allergies. 5. Modifies the hidden CK option to display allergy information. 6. Adds functionality for requiring an intervention if the allergy is severe. 7. Adds sign/symptoms to allergy order check display for remote orders. Patch Components ================ Files & Fields Associated: -------------------------- N/A Forms Associated: ----------------- N/A Mail Groups Associated: ----------------------- N/A Options Associated: ------------------- N/A Protocols Associated: --------------------- N/A Security Keys Associated: ------------------------- N/A Templates Associated: --------------------- N/A Additional Information: New Service Requests (NSRs) --------------------------- 20080334 - A Clinical decision Support System is being requested to further enhance drug order checking to improve patient care and reduce costs. This request is to address work mandated as determined by Patient Safety Incident (PSI) evaluation. Patient Safety Issues (PSIs) ---------------------------- 457/2072 - Remedy ticket # 130757/173383/510151 - The wrong reactant is being displayed in the allergy check. The drug being ordered is being displayed as the causative agent, but now the actual causative agent will be displayed correctly, from the PATIENT ALLERGIES (#120.8) File. 2530 - Remedy ticket # 960690/960714/975660 - Under certain circumstances, ordering a drug for which a patient has a remote allergy to that drug but no local allergy to that drug, an allergy warning is not displayed in Outpatient Pharmacy. Duplicate of PSI 2549. 2561 - If a patient has a drug on the remote profile, but not on the local profile, and you enter a drug that causes a drug-drug interaction order check against that remote drug, the order check does not display in Outpatient Pharmacy. 2585 - Remedy ticket # 1004240/1015745/1043694/1093605 - Erroneous Allergy/Interaction display 2069 - CPRS and Vista Pharmacy package return inadequate alert message for allergy information. Duplicate of PSI 2099. Remedy Ticket(s) & Overview: ---------------------------- 1. 960714 - AEU reports the site is not getting allergy checks done for remote allergies when processing medication orders. Problem: ------- If the remote reaction was an Adverse Drug Reaction (ADR) rather than an Allergy, the remote reaction is not firing allergy order checks in CPRS or in VistA Pharmacy. It is also not displaying as a remote reaction on the patient information screen in VistA Pharmacy. You can see the remote ADR in CPRS via Remote Data or VistaWeb. Resolution: ----------- This patch will correct the code to trigger an allergy alert if the remote action was an ADR rather than an Allergy. 2. 933381 - Incorrect allergy/drug order checks reported by the site Problem: -------- Incorrect allergy/drug order checks reported by the site. Resolution: ----------- This patch will correct the code to report correct allergy/drug order checks. 3. 1055309 - Pharmacist does not see the Provider Override Reason for an allergy alert when verifying an order that was finished by a technician. Problem: -------- If an order was originally entered through CPRS and an allergy was shown to the person entering the order, and a Provider Override reason was entered, and a technician finishes that order in Pharmacy, the technician will see that Provider Override Reason. But if that order then goes into a Non-Verified state, the Pharmacist will not see that Provider Override reason when verifying the order. Resolution: --------- The Pharmacist will now see the same Provider Override Reason that the technician saw. 4. 1232967 - Drug Interactions against pending outpatient orders with only a PHARMACY ORDERABLE ITEM (#50.7) File entry assigned, but no DRUG (#50) File entry assigned, do not display in Outpatient Pharmacy. Problem: -------- If a prescription is entered through Outpatient Pharmacy that has a drug interaction against an entry in the PENDING OUTPATIENT ORDERS (#52.41) File, and that pending order only has a PHARMACY ORDERABLE ITEM (#50.7) File entry assigned, but no DRUG (#50) File entry assigned, that interaction order check will not display to the pharmacist. Resolution: ----------- Drug interactions against pending outpatient orders with only a PHARMACY ORDERABLE ITEM (#50.7) File entry assigned, but no DRUG (#50) File entry assigned, will now display during the medication order entry process in Outpatient Pharmacy. Blood Bank Clearance: --------------------- n/a Test Sites: ----------- Maryland HCS Sioux Falls, SD Orlando, FL Documentation Retrieval Instructions: ------------------------------------- Updated documentation describing the new functionality introduced by this patch is available. The preferred method is to use Secure File Transfer Protocol (SFTP) to retrieve the files from download.vista.domain.ext. This transmits the files from the first available server. Sites may also elect to retrieve documentation directly from a specific server as follows: Albany: domain.ext Hines: domain.ext Salt Lake City: domain.ext The documentation will be in the form of Adobe Acrobat files. Documentation can also be found on the VA Software Document Library at: http://www.domain.ext/vdl/ FILE NAME DESCRIPTION ========= =========== PSS_1_PSJ_5_PSO_7_RN_R0416.PDF MOCHA Enhancements 2 Release Notes PSS_1_PSJ_5_PSO_7_MOCHA_E2_CB_IG.PDF MOCHA Enhancements 2 Installation Guide PSO_7_MAN_UM_R0416.PDF Outpatient Pharmacy Manager's User Manual v7.0 PSO_7_PHAR_UM_R0416.PDF Outpatient Pharmacy Pharmacist's User Manual v7.0 PSO_7_TECH_UM_R0416.PDF Outpatient Pharmacy Technician's User Manual v7.0 PSO_7_TM_R0416.PDF Outpatient Pharmacy Technical Manual/Security Guide v7.0 FTP Instructions: ----------------- MOCHA Enhancements 2 includes the following patches. The host files were created to simplify installation at Veterans Health Administration (VHA) facilities for these pharmacy patches. File Name Contents Retrieval Format -------------------------------- -------- ---------------- PSS_1_175.KID PSS*1*175 ASCII MOCHA_ENH_2_GMRA_OR_PSJ_PSO.KID GMRA*4*46 ASCII OR*3*269 PSJ*5*281 PSO*7*411 Installation Instructions ------------------------- Refer to the MOCHA Enhancements 2 Installation Guide for installation instructions. Install Order: 1. PSS_1_175.KID 2. MOCHA_ENH_2_GMRA_OR_PSJ_PSO.KID Routine Information: ==================== The second line of each of these routines now looks like: ;;7.0;OUTPATIENT PHARMACY;**[Patch List]**;DEC 1997;Build 95 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSOCAN2 Before: B85372649 After: B85734991 **8,18,62,46,88,164,235,148, 259,281,287,251,375,379,396, 390,372,416,411** Routine Name: PSOCROC Before: n/a After: B8829845 **411** Routine Name: PSODDPR2 Before:B107649994 After:B133640558 **251,375,379,390,372,416,411** Routine Name: PSODDPR5 Before:B160751448 After:B163007377 **251,375,379,390,372,416,438,411** Routine Name: PSODDPR7 Before: B68911471 After:B148972341 **390,411** Routine Name: PSODDPRE Before:B133385173 After:B139774341 **251,375,387,379,390,372,416,411** Routine Name: PSODEM Before: B15804329 After: B16428757 **5,19,233,258,326,390,411** Routine Name: PSODGAL1 Before: B81652199 After:B113259514 **251,401,390,424,429,411** Routine Name: PSODGAL2 Before: B20866110 After:B104733405 **390,411** Routine Name: PSODGAL3 Before: n/a After:B172651497 **411** Routine Name: PSODRG Before: B79401497 After: B93593274 **20,23,36,53,54,46,112,139, 207,148,243,268,324,251,375, 387,398,390,427,411** Routine Name: PSONEW Before: B43522881 After: B33443923 **11,27,32,46,94,130,268,225, 251,379,390,417,313,411** Routine Name: PSONEWOA Before: n/a After: B40166209 **411** Routine Name: PSONEWOC Before: n/a After: B28895423 **411** Routine Name: PSOOCKV1 Before: n/a After: B14894586 **411** Routine Name: PSOORCPY Before: B32700347 After: B34153930 **10,21,27,32,46,100,117,148, 313,411** Routine Name: PSOOREDT Before: B80361820 After: B82334396 **4,20,27,37,57,46,78,102,104, 119,143,148,260,281,304,289, 298,379,377,391,313,427,411** Routine Name: PSOORNE4 Before: B98202057 After:B101859322 **11,27,32,36,46,75,96,103,99, 117,131,225,386,390,391,313, 411** Routine Name: PSOORNEW Before: B93914156 After: B94643833 **11,23,27,32,55,46,71,90,94, 106,131,133,143,237,222,258, 206,225,251,386,390,391,372, 416,431,313,408,436,411** Routine Name: PSOORUT2 Before: B95782995 After: B97954565 **11,146,132,182,233,243,261, 268,264,305,390,411** Routine Name: PSOQRART Before: B5971862 After: B6101502 **294,411** Routine Name: PSORENW Before: B44953613 After: B47375085 **11,27,30,46,71,96,100,130, 148,206,388,390,417,313,411** Routine Name: PSORENW0 Before: B83644019 After: B84910963 **11,27,32,59,64,46,71,96,100, 130,237,206,251,375,379,372, 411** Routine Name: PSORENW4 Before: B62985403 After: B66539714 **11,23,27,32,37,64,46,75,71, 100,130,117,152,148,264,225, 301,390,313,411** Routine Name: PSOUTL Before:B132826044 After:B147729082 **1,21,126,174,218,259,324,390, 313,411** Routine Name: PSOVER1 Before:B126246906 After:B126108249 **32,46,90,131,202,207,148,243, 268,281,324,358,251,375,387, 379,390,372,416,411** Routine list of preceding patches: 294, 427, 429, 436, 438 ============================================================================= User Information: Entered By : Date Entered : JUN 22, 2012 Completed By: Date Completed: MAY 19, 2016 Released By : Date Released : MAY 24, 2016 ============================================================================= Packman Mail Message: ===================== No routines included