$TXT Created by F at CLN1G1.AAC.DOMAIN.EXT (KIDS) on Monday, 08/16/21 at 10:09 ============================================================================= Run Date: JAN 05, 2022 Designation: PSO*7*649 Package : PSO - OUTPATIENT PHARMACY Priority: Mandatory Version : 7 SEQ #538 Status: Released Compliance Date: FEB 05, 2022 ============================================================================= Associated patches: (v)PSO*7*457 <<= must be installed BEFORE `PSO*7*649' (v)PSO*7*621 <<= must be installed BEFORE `PSO*7*649' Subject: DUPLICATE MAINTENANCE RX ON THE PATIENT PROFILE Category: - Routine Description: ============ This patch resolves the following issue: 1. INC18871441 - Patient has duplicate prescription (Rx) in VistA Outpatient package Additional Information: ----------------------- Patient Safety Issues (PSIs): HITPS-8075 (INC18871441) Defect Tracking System Ticket(s) & Overview: 1. INC18871441 - Patient has duplicate Rx in VistA Outpatient package dup INC18557780 Problem: -------- The WM. Jennings Bryan Dorn VA Medical Center reported that the same Rx (with an identical Rx number) is showing twice in the Medication Profile when viewing a patient in the Patient Prescription Processing [PSO LM BACKDOOR ORDERS] option. While researching this problem, two additional issues (#1 & #2 below) were identified that lead to the issue (#3 below) described by the site: 1) When the user uses the TR (Convert Titration Rx) option to create a Maintenance Rx from the Titration Rx, the Issue Date assigned to the new Maintenance Rx is the current date. The correct Issue Date for the Maintenance Rx should be the same as the original Titration Rx. The Expiration Date is correctly copied from the Titration Rx to the Maintenance Rx. 2) When the user selects the new Maintenance Rx, uses the ED (Edit) option, enters 6 (Issue Date), and clicks < Enter > through the field without changing the date, the software re-calculates the Expiration Date based on the Issue Date that was originally set with the wrong value (per issue #1). 3) The edit performed in issue #2 fails to correctly update the cross- reference "P"/"A" in the PHARMACY PATIENT file (#55). Instead of killing off the existing cross-reference for the previous Expiration Date and setting a new entry for the recalculated Expiration Date, it is only setting the additional entry, causing the prescription to have two entries in the "P"/"A" cross-reference. This is what causes the duplicate Rx listing in the Medication Profile. Resolution: ----------- Two changes were made to fully address the three issues listed above: 1) The Issue Date from the Titration Rx will be copied to the Maintenance Rx when the user selects the TR (Convert Titration Rx) option. 2) The software will correctly kill off and then re-set the "P"/"A" cross-reference when the Expiration Date is changed. Technical Resolution: --------------------- Two changes were made to address the three issues listed above: 1) Added code at RFN+5 in the PSOORED1 routine to copy the Issue Date value from the Titration Rx to the newly created Maintenance Rx. 2) Added code at DT+11 in the PSOEXDT routine to reset the "P"/"A" cross-reference in the PHARMACY PATIENT file (#55) every time the Expiration Date is changed. Test Sites: ----------- Wm. Jennings Bryan Dorn VAMC (Columbia, SC) VA Central California HCS (Fresno, CA) Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released in a PackMan message. Documentation describing the new functionality is not included in this release. Patch Installation: ------------------- 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 is not necessary to disable any options. Installation Instructions: 1. Choose the PackMan message containing this build. Then select the INSTALL/CHECK MESSAGE PackMan option to load the build. 2. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, A. Select the Verify Checksums in Transport Global option to confirm the integrity of the routines that are in the transport global. When prompted for the INSTALL NAME enter the patch or build name. (ex. or XXXXX BUILD X.X) NOTE: Using will not bring up a Multi-Package build even if it was loaded immediately before this step. It will only bring up the last patch in the build. B. Select the Backup a Transport Global option to create a backup message. You must use this option and specify what to backup; the entire Build or just Routines. The backup message can be used to restore the routines and components of the build to the pre-patch condition. i. At the Installation option menu, select Backup a Transport Global. ii. At the Select INSTALL NAME prompt, enter your build PSO*7.0*649. iii. When prompted for the following, enter "R" for Routines or "B" for Build. Select one of the following: B Build R Routines Enter response: Build iv. When prompted "Do you wish to secure your build? NO//", press and take the default response of "NO". v. When prompted with, "Send mail to: Last name, First Name", press to take default recipient. Add any additional recipients. vi. When prompted with "Select basket to send to: IN//", press and take the default IN mailbox or select a different mailbox. C. You may also elect to use the following options: i. Print Transport Global - This option will allow you to view the components of the KIDS build. ii. 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 of the components of this patch, such as routines, DDs, templates, etc. D. Select the Install Package(s) option and choose the patch to install. i. If prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//', answer NO. ii. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer NO. iii. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', answer NO. Back-Out/Roll Back Plan: ------------------------ Back-out will be done only with the concurrence and participation of development team and appropriate VA site/region personnel. The decision to back-out or rollback software will be a joint decision between development team, VA site/region personnel and other appropriate VA personnel. Prior to installing an updated KIDS package, the site/region should have saved a backup of the routines in a mail 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. If the patch was backed up for the build, from the Kernel Installation and Distribution System Menu, select the Installation Menu. Then select the Install Package(s) option and choose the patch (PSO*7.0*649b) to install. The back-out plan is to restore the routines from the backup created. No data was modified by this patch installation and, therefore, no rollback strategy is required. Validation of Back-out Procedure: --------------------------------- The Back-out Procedure can be verified by printing the first two lines of the routines contained in this patch using the First Line Routine Print [XU FIRST LINE PRINT] option. After the routines contained in this patch have been backed out, the second line of the routines will no longer contain the designation of this patch in the patch list section. Routine Information: ==================== The second line of each of these routines now looks like: ;;7.0;OUTPATIENT PHARMACY;**[Patch List]**;DEC 1997;Build 1 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSOEXDT Before: B6289216 After: B7504878 **23,73,222,486,574,621,649** Routine Name: PSOORED1 Before: B79193159 After: B81631902 **5,23,46,78,114,117,131,146, 223,148,244,249,268,206,313, 444,422,457,649** Routine list of preceding patches: 457, 621 ============================================================================= User Information: Entered By : Date Entered : AUG 10, 2021 Completed By: Date Completed: JAN 05, 2022 Released By : Date Released : JAN 05, 2022 ============================================================================= Packman Mail Message: ===================== $END TXT