============================================================================= Run Date: APR 06, 2020 Designation: PSO*7*574 Package : PSO - OUTPATIENT PHARMACY Priority: EMERGENCY Version : 7 SEQ #486 Status: Released Compliance Date: APR 15, 2020 ============================================================================= Associated patches: (v)PSO*7*457 <<= must be installed BEFORE `PSO*7*574' Subject: MENTAL HEALTH NCC WARRANTY RELEASE 5.01 Category: - Routine Description: ============ The MENTAL HEALTH NCC WARRANTY RELEASE 5.01 multi-build is a warranty release for the National Clozapine Registry (NCR) software. This release will fix the defects and incidents reported by the sites to the developers of the National Clozapine Coordination (NCC) Project. The project is also referred to as the Clozapine Modernization (ClozMod) Project. The NCR is maintained by the National Clozapine Coordinating Center (NCCC). The NCCC is responsible for VA's compliance with the clozapine Risk Evaluation and Mitigation Strategy (REMS), which is mandated by the Food and Drug Administration (FDA) for tracking clozapine patients. The multi-build contains the Mental Health patch YS*5.01*154 and the Outpatient Pharmacy patch PSO*7.0*574. The list of defects and their resolution is below. This patch is also being released with PSJ*5*402 which is an informational patch for updates to the Inpatient Pharmacist's User Manual. Defect Tracking System Ticket(s) & Overview: -------------------------------------------- Patch PSO*7.0*574 contains the following fixes: 1. Incorrect computation of drug costs Defect 1132310 INC7277287 - Unit cost of released & renewed and suspended/unreleased prescriptions are being populated with the dispense units per order unit. INC7340377 - UNIT PRICE OF DRUG ISSUE - ALREADY REPORTED INC7277287 Problem: -------- Users would see incorrect values for the costs of prescriptions. The unit cost of released and renewed and suspended/unreleased prescriptions are being populated with the dispense units per order unit. This often leads prescriptions to show an incorrect, extremely high unit cost per tablet for inexpensive drugs Resolution: ----------- The PSODRG routine has been updated to fix the problem with incorrect computation for prescription costs. The PSODRG routine was incorrectly referencing this field for the drug cost: 50,15 DISPENSE UNITS PER ORDER UNIT 660;5 NUMBER It has been changed to this field: 50,16 PRICE PER DISPENSE UNIT 660;6 NUMBER 2. During backdoor pharmacy process of Outpatient 4 Day Override order, a field called LIMITED DURATION appears. Defect 981761 Problem: -------- When entering a clozapine prescription for an Outpatient 4 Day Override order, a field called LIMITED DURATION is presented. The IOC sites stated that this may be misleading to the pharmacy staff and want it removed. Resolution: ----------- The logic in routine PSOORED5 was modified to remove the LIMITED DURATION field for clozapine prescriptions. Routine PSONEW1 was modified to correct the sig for the clozapine prescription. 3. Patients who are actively receiving clozapine (e.g. had a prescription last month) are discontinued. Defect 1132329 Problem: -------- The YSCL DAILY TRANSMISSION option checks for clozapine patients who should be discontinued. The code uses a Mail Group and an ^XTMP storage location that are in the Pharmacy namespace. Resolution: ----------- The PSO574P pre-init routine was created to correct issues with clozapine patients being discontinued erroneously when the YSCL DAILY TRANSMISSION option runs at the site. Note: There are routines in the YS*5.01*154 patch that also address this defect. 4. The Register Clozapine Patient option needs a restriction to only allow registered patients. Defect 1133724 Problem: -------- The Register Clozapine Patient [PSOL REGISTER PATIENT] option needs a restriction to only allow patients that have a CLOZAPINE REGISTRATION NUMBER in the CLOZAPINE PATIENT LIST file (#603.01). The option updates fields in the PHARMACY PATIENT file (#55). Resolution: ----------- The PSOCLUTL routine was modified to only allow patients who have a registration number to be updated in the PHARMACY PATIENT file (#55). 5. Temporary Clozapine Authorization Number not in correct format Defect 1132422 Problem: -------- At least one site has reported temporary registration starting with the letter "R" when they were expecting it to start with "Z". Resolution: ----------- The PSO574P pre-init routine also updates the CLOZAPINE WEEKEND REGISTRATION list that is stored in ^XTMP("PSJ CLOZ"). This will ensure that any temporary registration numbers that were generated during IOC tests and were not used will be recovered. This issue was revealed in the MailMan messages sent to the CLOZAPINE ROLL-UP Mail Group in Forum. 6. Ensure "Expires:" Date is Correct Defect 1132368 Problem: -------- The CPRS team found a typo in routine PSODIR2. The code had a comma where it should have a less than sign. Only clozapine prescriptions would have been affected. This logic is used to create the value for the "Expires:" prompt in Patient Prescription Processing. Resolution: ----------- Routine PSODIR2 was corrected. 7. Dose default is missing for active or pending prescriptions. Defect 1106891 Problem: -------- The default dose is missing when editing all prescriptions in Pharmacy backdoor orders. It should be there for non-clozapine prescriptions. The prior fix removed this for all prescriptions. Resolution: ----------- The logic in routines PSOBKDED and PSONEW1 was modified to only remove the default dose for Clozapine prescriptions. 8. Remove the "Quantity Being Changed" message displaying during backdoor pharmacy processing of a Clozapine Outpatient 4 Day Override Order. Defect 1155637 Problem: -------- The "Quantity Being Changed" message was being displayed when a pharmacist was editing a 4 day temporary override Clozapine prescription. Users at the IOC sites found this to be confusing and requested its removal. Resolution: ----------- The routine PSOSIG was modified to display this message ONLY for non-clozapine prescriptions. 9. CPRS Complex Order Default Dose Incorrect Defect 1180952 Problem: -------- Complex orders which have multiple dosages were not displaying the correct defaults during dosage edit. Resolution: ----------- Routine PSOBKDED was modified to add the default dose. 10. Missing Unit Price of Drug Defect 1181628 Problem: -------- Prescriptions for certain medications were not storing the UNIT PRICE OF DRUG field. This occurred when the DRUG had a REORDER LEVEL field (#11) value of zero or null. Resolution: ----------- The branching logic in the SET^PSODRG subroutine was corrected. 11. Temporary numbers generated off the date Defect 1181858 Problem: -------- The logic to generate a temporary clozapine registration number was not always generating a sequential counter. Resolution: ----------- The logic in FINDNEXT^PSOCLUTL was modified. 12. ^XTMP("PSJ CLOZ",0) purge date Defect 1181868 Problem: -------- The purge date in the ^XTMP("PSJ CLOZ",0) global node was not always set to the same number of days in the future. This is a matter of programming style. No error was generated; no functionality was affected. The development accepted this as a defect to end the discussion. The change cannot be seen by users and there is no way to test this. Resolution: ----------- Routine PSOCLO1 was changed to call the line tag XTMPZRO^PSOCLOU. 13. Expiration Date Calculated Incorrectly Defect 1182728 Problem: -------- When a Clozapine prescription was being edited the expiration date may not have been computed correctly. This was related to editing the quantity and days' supply values. Resolution: ----------- Routines PSOCLO1, PSODIR1, and PSOORED6 were modified. The logic to compute the expiration was moved to the new subroutine EXPDT^PSOCLO1. 14. Patient Lookup in Register Clozapine Patient [PSOL REGISTER PATIENT] Defect 1210946 Problem: -------- The Patient Lookup in the Register Clozapine Patient [PSOL REGISTER PATIENT] option doesn't allow a user to enter the last initial and last 4 digits of the patient's Social Security Number (SSN). Resolution: ----------- Routine PSOCLUTL was modified in the REG subroutine to add an "M" to the DIC(0) value to allow a patient lookup on multiple cross-references. 15. Error on Clozapine Inpatient Medication Defect 1227862 Problem: -------- When a user enters the Inpatient Order Entry [PSJ OE] option for Clozapine patients an error occurs. The PSODFN variable is undefined, Resolution: ----------- Routine PSOCLO1 was modified to set PSODFN if it's undefined, based on the value in DFN. * * * * * * Test Sites: ---------- - West Los Angeles VAMC (691) - N. Florida /S. Georgia VAMC (573) - VA Connecticut Healthcare System - West Haven Division (689) Software and Documentation Retrieval Instructions: -------------------------------------------------- Software being released as a host file and/or documentation describing the new functionality introduced by this patch are available. The preferred method is to retrieve files from download.vista.domain.ext. This transmits the files from the first available server. Sites may also elect to retrieve files directly from a specific server. Sites may retrieve the software and/or documentation directly using Secure File Transfer Protocol (SFTP) from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Hines: domain.ext Salt Lake City: domain.ext Documentation can also be found on the VA Software Documentation Library at: https://www.domain.ext/vdl/ -------------------------------------------------------------------------- Title File Name FTP Mode -------------------------------------------------------------------------- MENTAL HEALTH NCC PROJECT 5.01 MH_NCC_WARRANTY_5_01.KID (ASCII) User Manual - Manager - Outpatient Pharmacy V.7.0 pso_7_0_p574_man_um.pdf (binary) Patch Installation: Pre/Post Installation Overview: ------------------------------- There are no tasks to be performed before the installation of this multi-build. Note that the routines should be backed up to a PackMan message before installing the build. 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. It should not be installed when the YSCL DAILY TRANSMISION option is running. If unsure when that is check the OPTION SCHEDULING file (#19.2) using FileMan: Select VA FileMan Option: Inquire to File Entries Output from what File: OPTION SCHEDULING// (17 entries) Select OPTION SCHEDULING NAME: YSCL DAILY TRANSMISSION Another one: Standard Captioned Output? Yes// (Yes) Include COMPUTED fields: (N/Y/R/B): NO// - No record number (IEN), no Computed Fields NAME: YSCL DAILY TRANSMISSION QUEUED TO RUN AT WHAT TIME: OCT 05, 2019@01:30 RESCHEDULING FREQUENCY: 1D TASK ID: 2577736 Installation Instructions: -------------------------- 1. Place the KIDS multi-build file into a local directory and use the KIDS option Load a Distribution option to load it into the transport global. 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: MENTAL HEALTH NCC WARRANTY RELEASE 5.01 a. Backup a Transport Global - This option will create a backup message of any routines exported with this patch. 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 allows 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 (MENTAL HEALTH NCC WARRANTY RELEASE 5.01). 5. Accept the default when prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//' 6. Accept the default when prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//' 7. Accept the default when prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//' 8. If prompted 'Delay Install (Minutes): (0 - 60): 0// enter 0 (zero). Backout /Rollback Strategy: --------------------------- Backout will be done only with the concurrence and participation of development team and appropriate VA site/region personnel. The decision to backout the software will be a joint decision between development team, VA site and regional personnel, and other appropriate VA personnel. Rollback applies to data only and is not applicable to this multi-build. Prior to installing the KIDS multi-build, the site/region should have saved a backup of the routines in a PackMan message using the Backup a Transport Global [XPD BACKUP] menu option (this is done at time of install). The message containing the backed-up routines can be loaded with the "Xtract PackMan" function at the Message Action prompt. The PackMan function "INSTALL/CHECK MESSAGE" is then used to install the backed up routines onto the VistA System. Validation of Backout Procedure ------------------------------- The backout Procedure can be verified by printing the first 2 lines of the PSO* and YS* Routines contained in the MENTAL HEALTH NCC WARRANTY RELEASE 5.01 multi-build using the option First Line Routine Print [XU FIRST LINE PRINT]. Once the old routines listed in the multi-build patch have been restored, the first two lines of the Routines will no longer contain the designation of patch 574 (for Outpatient Pharmacy PSO* routines) and patch 154 (for Mental Health YS* routines) in the patch list section on line 2 of the routines. Routine Information: ==================== The second line of each of these routines now looks like: ;;7.0;OUTPATIENT PHARMACY;**[Patch List]**;DEC 1997;Build 54 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSO574P Before: n/a After: B1692338 **574** Routine Name: PSOBKDED Before: B95683954 After:B101355784 **11,46,91,78,99,117,133,143, 268,378,416,282,450,402,518, 525,538,457,557,574** Routine Name: PSOCLO1 Before:B149456436 After:B207810764 **1,23,37,222,457,574** Routine Name: PSOCLOU Before: B77943063 After: B79141906 **457,574** Routine Name: PSOCLUTL Before:B101965385 After:B110091416 **28,56,122,222,268,457,574** Routine Name: PSODIR1 Before:B108575993 After:B110146447 **23,46,78,102,121,131,146,166, 184,222,268,206,266,340,391, 444,446,505,543,457,574** Routine Name: PSODIR2 Before: B32390771 After: B31690418 **3,9,26,46,124,146,139,152, 166,504,526,457,574** Routine Name: PSODRG Before: B99583322 After:B100773722 **20,23,36,53,54,46,112,139, 207,148,243,268,324,251,375, 387,398,390,427,411,458,504, 517,457,574** Routine Name: PSOEXDT Before: B6433054 After: B6664815 **23,73,222,486,574** Routine Name: PSONEW1 Before: B21636420 After: B22417680 **46,104,117,143,422,457,574** Routine Name: PSOORED2 Before: B79410912 After: B80807728 **2,51,46,78,102,114,117,133, 159,148,247,260,281,289,276, 358,251,385,427,538,574** Routine Name: PSOORED3 Before: B66908103 After: B68311355 **46,78,99,117,133,148,249,251, 379,378,372,416,313,444,402, 515,574** Routine Name: PSOORED4 Before: B58529910 After: B59779291 **46,91,78,99,111,117,133,159, 148,251,391,372,416,313,437, 282,402,515,507,574** Routine Name: PSOORED5 Before:B114405743 After:B115791466 **46,75,78,100,99,117,133,251, 378,372,416,313,450,486,402, 500,507,525,537,555,457,574** Routine Name: PSOORED6 Before: B63254797 After: B64222067 **78,104,117,133,143,219,148, 247,268,260,269,251,372,422, 574** Routine Name: PSOOREDT Before: B90555441 After: B93222791 **4,20,27,37,57,46,78,102,104, 119,143,148,260,281,304,289, 298,379,377,391,313,427,411, 505,517,574** Routine Name: PSOSIG Before:B103751531 After:B104287072 **46,99,114,391,313,282,455, 446,402,500,515,514,574** ============================================================================= User Information: Entered By : Date Entered : AUG 26, 2019 Completed By: Date Completed: APR 03, 2020 Released By : Date Released : APR 06, 2020 ============================================================================= Packman Mail Message: ===================== No routines included