$TXT Created by ALVIN JR at DOSO.FO-BIRM.DOMAIN.EXT (KIDS) on Tuesday, 05/07/24 at 17:36 ============================================================================= Run Date: JUL 16, 2024 Designation: PSO*7*740 Package : PSO - OUTPATIENT PHARMACY Priority: Mandatory Version : 7 SEQ #626 Status: Released Compliance Date: AUG 16, 2024 ============================================================================= Associated patches: (v)PSS*1*239 <<= must be installed BEFORE `PSO*7*740' (v)PSO*7*736 <<= must be installed BEFORE `PSO*7*740' Subject: ONEVA DRUG RESTRICTIONS (ABSORBED PSO*7*752) Category: - Data Dictionary - Routine - Enhancement (Mandatory) Description: ============ ************************************************************************* ************************************************************************* This patch is part of a release that includes the following patches that should be installed in the following order: PSS*1.0*239 PSO*7.0*740 ************************************************************************** ************************************************************************** The OneVA Pharmacy application provides the Veterans Health Administration (VHA) with the capability to allow Veterans travelling across the United States to refill/partial fill their active VA prescription at any VA Pharmacy regardless of where the prescription originated. The OneVA Pharmacy application design consists of 3 main components: VistA Medication Profile screen, Health Data Record Clinical Data Service (HDR/CDS), and OneVA Pharmacy message flow. The VistA Medication Profile screen expands available pharmacy information in VistA to provide pharmacists direct access to query, and refill/partial fill patient's active and refillable prescriptions. The HDR/CDS provides a patient's active and refillable prescriptions. The OneVA Pharmacy message flow enables the secure, bi-directional exchange of electronic health records between local/remote VistA Servers, and between VistA servers and HDR. Currently, drugs classified as controlled substances are not permitted to be processed using OneVA Pharmacy functionality. Additional flexibility is required to prevent drugs from being processed that are not classified as controlled substances. This patch introduces two new 'filters' that prevent specific drugs from being processed. Restrict for OneVA Pharmacy Field in Drug File ---------------------------------------------------- A new field is required to restrict certain drug file items (e.g. REMS drugs, restricted medications, infusions, etc.) from OneVA Pharmacy processing so that they do not get filled inadvertently. When new RESTRICT FOR ONEVA PHARMACY field (#907) in the DRUG file (#50) is set to YES via the Drug Enter/Edit option [PSS DRUG ENTER/EDIT], prescriptions for the drug will not be permitted to be filled or refilled using OneVA Pharmacy functionality. A 'Yes' in the 'Restrict for OneVA Pharmacy' field indicates that the drug item is restricted from OneVA Pharmacy processing. No data (blank) in the 'Restrict for OneVA Pharmacy' Field indicates that the drug is NOT restricted from OneVA Pharmacy processing. Block Clozapine Prescriptions from OneVA Pharmacy processing ------------------------------------------------------------------ Clozapine prescriptions are blocked from OneVA Pharmacy processing of a refill/partial. A Clozapine prescription is identified by having the MONITOR ROUTINE Field (#17.5) in the DRUG File (#50) set to 'PSOCLO1'. If a drug is identified for 'Clozapine' monitoring at either the host site or dispensing site for a refill, the following message will be displayed at the dispensing site: 'This is a clozapine prescription. Cannot refill Rx #XXXX.' If a drug is identified for 'Clozapine' monitoring at either the host site or dispensing site for a partial, the following message will be displayed at the dispensing site: 'This is a clozapine prescription. Cannot process a partial fill for Rx #XXXX.' Incorrect Drug Linked in Automated Dispensing System from OneVA Pharmacy ------------------------------------------------------------------------ This patch also addresses several related defects. Defect INC27427008 reported that an incorrect local drug was matched to a host site prescription by OneVA Pharmacy functionality. This defect was addressed in patch PSO*7*729; however, PSO*7*729 was marked 'Entered in Error' after national release in response to a new defect introduced by the patch. Original Defect Addressed By Entered-In-Error Patch PSO*7.0*729 --------------------------------------------------------------------- Defect INC31053112 reported an error with the drug lookup logic in PSO*7*729 that failed to find a local drug with a VA Product Identifier matching the VA Product Identifier of the host site drug. The VA Product Identifier lookup was not performed when an exact drug name match was found and presented to the user for selection, but the user declined to select the drug. INC27427008 - Incorrect Drug Linked In Automated Dispensing System from OneVA Pharmacy Duplicates: INC26949869 PSI HITPS-10360 Defect Introduced By PSO*7.0*729, Resulting in 'Entered-In-Error' Status ------------------------------------------------------------------------- INC31053112 - No matching drug could be found for Cefadroxil 500mg cap, VA Product Identifier C0144, when attempting to pull a OneVA partial fill. Host site and dispensing site drug files were matched correctly, drug was selectable prior to the installation of PSO*7*729. When requesting a partial fill, the drug lookup at the dispensing site first attempted to find an exact match by drug name in the DRUG (#50) file. If no matching drug was found by name, or if the user did not select the matching drug, the the VA PRODUCT (#50.68) file was searched for a matching VA Product Identifier, and if a match was found, the associated DRUG (#50) file entry was presented to the user for selection. However, if there were two or more matching VA Product Identifiers found, only the first entry found was presented to the user for selection. Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- N/A Forms Associated: Form Name File Number 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 ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Remote Procedures Associated: Remote Procedure Name New/Modified/Deleted --------------------- -------------------- N/A Parameter Definitions Associated: Parameter Name New/Modified/Deleted -------------- -------------------- N/A Additional Information: ----------------------- N/A New Service Requests (NSRs): N/A Patient Safety Issues (PSIs): HITPS-10360 - INCORRECT DRUG LINKED IN AUTOMATED DISPENSING SYSTEM FROM ONEVA Defect Tracking System Ticket(s) & Overview: -------------------------------------------- INC27427008 - INCORRECT DRUG LINKED IN AUTOMATED DISPENSING SYSTEM FROM ONEVA Problem: ------- The original reported issue was the drug matching logic forced an incorrect drug selection. The OneVA Rx sent dose for Nasal Spray. The pharmacist inadvertently accepted the bad drug with dose form tablet, likely because it was the only choice offered. Resolution: ----------- This patch will enhance the drug lookup logic. The pharmacist will be presented with a list of local Drug file lookup results matching the host site drug, rather than being prompted to enter a drug name. List of requirements that are requested 1. If no VA Product Identifier is received from the Health Data Repository (HDR) associated with the host (remote) site drug, the user is presented with the message: Remote site VA PRODUCT IDENTIFIER: VA Product Identifier *** NOT FOUND ***" 2. The VA Product Identifier that is returned from the HDR for the host site drug item is used to identify the VA Product that the host site drug is matched to. If the VA PRODUCT ID matches a product in file VA PRODUCT (#50.68) that is marked as a controlled substance in field CS FEDERAL SCHEDULE (#19) (1-5), a message indicates that controlled substances are not allowed for OneVA Pharmacy dispensing, and processing stops. 3. If there is a single drug match using the drug name returned from the HDR and the VA Product ID, a check is performed to verify the matching drug is active, marked for outpatient use, associated with a Pharmacy Orderable Item, and not a controlled substance. If the matching drug passes this validation, the drug is displayed to the user with the prompt, 'Would you like to use the system matched drug for this refill/partial fill? NO//'. If no matching drugs were found by name, or if a match drug was found but not accepted by the user, or if more than one matching drug was found, processing will continue to step 4. 4. All local (dispensing site) drugs with a VA Product ID matching the remote (host) site drug's VA Product ID are identified. Drugs that are inactive, not marked for outpatient use, not associated with a Pharmacy Orderable Item, or are controlled substance are eliminated. Matching drugs that pass the validation are presented to the user with the prompt 'Select drug from list (#-#) or to quit processing:' 5. If no matching drug could be located or no drug was selected, the user is presented the message: No other local match could be found for DRUG NAME You may need to update your Drug file to process this order" Type to continue or '^' to exit: NOTE: If no VA Product Identifier is received from HDR this mess will display after the message in step 1. Technical Resolution: --------------------- The DRUGMTCH subroutine in the PSORRX1 routine has been modified to search for a local (dispensing site) DRUG (#50) file item with a matching Product Identifier in the VA PRODUCT IDENTIFIER (#6) field in the VA PRODUCT (#50.68) file, which is pointed to by the PSNDF VA PRODUCT NAME ENTRY (#22) field of the DRUG (#50) file. If no match is found, the message "Remote site VA PRODUCT IDENTIFIER: *** NOT FOUND ***"" is displayed and execution is returned to the calling routine. If a single matching drug is found that meets the following criteria, it is presented to the user for selection: - The GENERIC NAME (#.01) field in the DRUG (#50) file matches the drug name from the host site. - The INACTIVE DATE (#100) field in the DRUG (#50) file must not be prior to the current date. - The APPLICATION PACKAGE' USE (#63) field in the DRUG (#50) file must include Outpatient Pharmacy. - The PHARMACY ORDERABLE ITEM (#2.1) field in the DRUG (#50) file must be populated. - The leading digit in the DEA, SPECIAL HDLG (#3) field in the DRUG (#50) file is less than 1 or greater than 6. If no DRUG (#50) file item is found with a matching GENERIC NAME, or if a match was found and not selected, the "C" cross reference in the VA PRODUCT is searched to identify drug items with a matching VA Product Identifier. If drug items with a matching Product Identifier are found that also meet the additional search criteria (status, package, orderable item, non-controlled substance), the drug items are displayed to the user in a numbered list for selection. INC31053112 - No matching drug could be found for Cefadroxil 500mg cap, VA Product Identifier C0144, when attempting to pull a OneVA partial fill. Problem: ---------- Defect introduced by 'Entered-In-Error' patch PSO*7.0*729. When requesting a partial fill, the drug lookup at the dispensing site first attempted to find an exact match by drug name in the DRUG (#50) file. If no matching drug was found by name, or if the user did not select the matching drug, the VA PRODUCT (#50.68) file was searched for a matching VA Product Identifier, and if a match was found, the associated DRUG (#50) file entry was presented to the user for selection. However, if there were two or more matching VA Product Identifiers found, only the first entry found was presented to the user for selection. Solution: ----------- When requesting a partial fill, if no exact match is found by drug name or if the user did not select the matching drug, display all local (dispensing site) drugs with a VA Product ID matching the remote (host) site drug's VA Product ID that are also active, marked for outpatient use, associated with a Pharmacy Orderable Item, and are not a controlled substance to the user with the prompt 'Select drug from list (#-#) or to quit processing:' Test Sites: ------------ VA Miami HCS, Miami, FL VA Minneapolis HCS, Minneapolis, MN VA New Jersey HCS, East Orange, NJ Test Sites - SNOW Change Order #: ------------------------------------ VA Miami HCS: Change Order # vA Minneapolis HCS: Change Order # VA New Jersey HCS: Change Order # Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released in a PackMan message. Documentation describing the new functionality is included in this release. Documentation can be found on the VA Software Documentation Library at: https://www.domain.ext/vdl/. Documentation can also be obtained at https://download.vista.domain.ext/index.html/SOFTWARE. Documentation Title File Name -------------------------------------------------------------------- Deployment, Installation, Backout, PSO_7_0_P740_DIBRG.DOCX Rollback Guide (DIBRG) PSO_7_0_P740_DIBRG.PDF Outpatient Pharmacy (PSO) Version PSO_7_0_P740_ONEVA_UM.DOCX 7.0 OneVA Pharmacy User Manual PSO_7_0_P740_ONEVA_UM.PDF Patch Installation: ------------------- Pre/Post Installation Overview: 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. 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 PSO*7.0*740. 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 "PSO*7.0*740". iii. When prompted for the following, enter "B" for Build. Select one of the following: B Build (including Routines) R Routines Only Backup Type: B// 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. Post-Installation Instructions: Validate that the routine checksums now match the 'after checksums' listed in the patch description. 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. Routine Information: ==================== The second line of each of these routines now looks like: ;;7.0;OUTPATIENT PHARMACY;**[Patch List]**;DEC 1997;Build 18 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSORREF Before: B67040800 After: B74201946 **454,475,497,643,740** Routine Name: PSORRPA1 Before: B80719351 After:B116292673 **454,475,497,643,740** Routine Name: PSORRX1 Before:B156717075 After:B180118983 **454,499,509,519,532,594,643, 736,740** ============================================================================= User Information: Entered By : Date Entered : SEP 26, 2023 Completed By: Date Completed: JUL 15, 2024 Released By : Date Released : JUL 16, 2024 ============================================================================= Packman Mail Message: ===================== $END TXT