============================================================================= Run Date: AUG 20, 2008 Designation: PSO*7*225 Package : PSO - OUTPATIENT PHARMACY Priority: Mandatory Version : 7 SEQ #262 Status: Released Compliance Date: OCT 06, 2008 ============================================================================= Associated patches: (v)PSO*7*206 <<= must be installed BEFORE `PSO*7*225' (v)PSO*7*264 <<= must be installed BEFORE `PSO*7*225' (v)PSO*7*274 <<= must be installed BEFORE `PSO*7*225' (v)PSO*7*275 <<= must be installed BEFORE `PSO*7*225' (v)PSO*7*278 <<= must be installed BEFORE `PSO*7*225' (v)PSO*7*292 <<= must be installed BEFORE `PSO*7*225' Subject: PHARMACY CHANGES TO SUPPORT CPRS GUI V27 AND EVC R2 Category: - Routine - Enhancement (Mandatory) - Data Dictionary - Informational Description: ============ This patch contains changes in support of the Enrollment VistA Changes (EVC) project and Computerized Patient Record System (CPRS) GUI v27 release. CPRS GUI v27 consists of two host files: OR_PSJ_PSO_27.KID and CPRS_BUNDLE_GUI_27_REQ_REL.KID. These two host files contain software patches that support CPRS GUI v27 functionality. The host files were created to simplify installation at Veterans Health Administration (VHA) facilities. Please refer to the "CPRS GUI v.27 and Associated Patches Installation Guide" for installation sequence information. This document is exported as OR_30_243IG.doc and OR_30_243IG.pdf and is included in OR_30_243.ZIP. No additional installation or set-up steps specific to Outpatient Pharmacy are required once the software is installed. The Enrollment VistA Changes (EVC) project is being undertaken to support technology and business changes that are occurring with the implementation of the Health Eligibility Center (HEC) Enrollment System Redesign (ESR) project. Some modified and new business functionality is being included in the new system and corresponding changes are necessary in VistA for preliminary determination of veterans Enrollment and Eligibility status. The EVC project has been rolled out in three phases. This release represents the third and last phase called EVC Release 2. This patch provides the functionality changes to determine, process and disseminate the newly added Environmental Indicator (EI) called Project 112/SHAD Exposure (a.k.a SHAD), where applicable. This patch also changed the EI, "Environmental Contaminant" to read as "Southwest Asia Conditions". 1. For the following options, when creating a new order, renewing an existing order, copying an existing order to a new order, or editing an existing order that results in a new order, the copay status of the prescription needs to be determined for billing purposes. a. Patient Prescription Processing [PSO LM BACKDOOR ORDERS] b. Barcode Batch Prescription Entry [PSO BATCH BARCODE] c. Complete Orders from OERR [PSO LMOE FINISH] If a patient is found eligible for SHAD then the prompt "Was treatment related to PROJ 112/SHAD?" will be presented to the pharmacist. A "YES" or "NO" response will be stored in the new fields, PROJ 112/SHAD field (#122.01) of the PRESCRIPTION file (#52) and in the PROJ 112/SHAD field (#8) of the ICD DIAGNOSIS sub-file (#52.052311) of the PRESCRIPTION file (#52). 2. The Integration Control Registration (ICR) #2534, provides Computerized Patient Record System V. 1.0 (CPRS) with all the eligible EI questions that will be prompted during the pharmacy order entry process. This ICR is modified to include the SHAD prompt. 3. When a verbal or telephone order is placed in backdoor pharmacy, it requires an electronic signature from the provider. During the signature entry process in CPRS, the provider may update the SC, EI, or the ICD diagnosis information. This updated information is passed back to pharmacy via the ICR #4666, which is modified to include the SHAD changes. 4. The PENDING OUTPATIENT ORDERS file (#52.41) that stores the pharmacy orders entered via CPRS is modified to include the provider's response to the SHAD question. The provider's response will be stored in the new fields, PROJ 112/SHAD field (#110.2) of the PENDING OUTPATIENT ORDERS file (#52.41) and the PROJ 112/SHAD field (#8) of the DIAGNOSIS sub-file (#52.41311) of the PENDING OUTPATIENT ORDERS file (#52.41). 5. During the release of a prescription, if the SHAD question applies and is unanswered, the MailMan message that is sent to the finishing pharmacist, ordering provider, and holders of the PSO COPAY key, to get answers to the EI questions will have the SHAD question if applicable. 6. The Reset Copay Status/Cancel Charges [PSOCP RESET COPAY STATUS] option is modified to include the SHAD question wherever applicable. 7. During label printing, if the prescription is flagged as SHAD then the text "NO COPAY" will be printed in the label. Unrelated to the Enrollment VistA Changes (EVC) features, this patch also provides the following changes to support CPRS v27. a. To add the proper escape sequences to the standard HEALTH LEVEL SEVEN (HL7) encoding characters to messages sent to CPRS / remove escape sequences received from CPRS and replace them with standard HL7 encoding characters. This will help avoid errors that can occur if special delimiting characters are encountered during parsing of the HL7 messages. b. Integration Control Registration (ICR) #2400, will be modified to provide new sorting sequences of the patient medication profile that is viewed under the CPRS-Meds Tab including the Non-VA medications. VIEW 0 or null - This provides the medication list as it was prior to GUI 27 so that other applications calling this API will not see any changes. VIEW 1 - This provides the medication list sorted by prescription Status Group and Stop Date/Expiration Date. Following is the order: Pending group Non-Verified Pending Active group: Active Hold Suspended (Active/Susp) Provider Hold Expired group Expired Discontinued/Deleted group Discontinued by Provider Discontinued (Edit) VIEW 2 - This provides the medication list sorted by prescription Status Group, Status, and Drug Name. Active group: Active Hold Pending group Non-Verified Pending Discontinued Discontinued by Provider Discontinued (Edit) VIEW 3 - This provides the medication list sorted by Drug Name, active/suspended and Stop Date/Expiration Date. c. Flag/Un-Flag functionality (PSI-06-041) It was requested in the Remedy ticket #133716 that the flagging capability that is available in CPRS be made available for Outpatient Pharmacy use. This patch provides the flagging functionality for Pending orders only. d. As per the E3R numbers 19973 and 19876, to improve communication between the provider and the pharmacist, Outpatient Pharmacy will now send the actual comments made by the pharmacist to CPRS when a prescription is put on Hold, Discontinued, and Returned to Stock replacing the generic "per pharmacy request" text. e. When the DC-Discontinue ListMan option is used to discontinue a pending "renewal" order, the software will now check for an active prescription for the same drug. If found it will prompt the following: "There is an active Rx for this pending order, Discontinue both (Y/N)". This will provide the user with the option to discontinue both pending and the active order. f. A problem was reported in one of the error messages displayed on CPRS side when a provider tries to discontinue an Outpatient Pharmacy order from the Orders Tab and that order for some reason is not found in the PRESCRIPTION file (#52). The solution provided is to replace the error message "Unable to locate order" with "Invalid Pharmacy order number" to be in consistent with the Inpatient Medications V. 5.0 error messages. g. At the request of CPRS active calls to obsolete routine OR3CONV have been removed from Outpatient Pharmacy V. 7.0. h. When finishing a pending order placed in CPRS, it was reported that the patient instructions sent across to CPRS was getting truncated. This patch fixes the problem. i. PSI-07-057 - Potential of inappropriate or misleading provider comments to be automatically included on new medication orders. To fix this problem CPRS is dropping (will not carry over) the original provider comments during renewals of Outpatient Pharmacy medications. To follow suit with CPRS, Outpatient Pharmacy is also dropping the original provider comments from all backdoor renewals. Associated Patient Safety Issues: ================================= PSI-06-041 PSI-07-057 Associated New Service Request (NSR): ===================================== N/A Associated Remedy Ticket(s): ============================ HD0000000096952 HD0000000133716 HD0000000137210 HD0000000144709 HD0000000152435 HD0000000179478 HD0000000181591 Associated E3Rs: ================ 19973 19876 Test Sites: =========== CHARLESTON, SC CLEVELAND, OH HEARTLAND-EAST HCS HUDSON VALLEY HCS LOMA LINDA, CA NORTHERN CALIFORNIA HCS PALO ALTO HCS PHILADELPHIA, PA SAN DIEGO, CA TAMPA, FL Documentation Retrieval: ======================== The documentation is available on the ANONYMOUS.SOFTWARE directory at one of the following Office of Information (OI) Field Offices. Sites may retrieve documentation in one of the following ways: (1) The preferred method is to FTP the files from download.vista.med.va.gov, which will transmit the files from the first available FTP server. (2) Sites may also elect to retrieve documentation directly from a specific server as follows: Albany ftp.fo-albany.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov The documentation distribution includes: FILE NAME DESCRIPTION PSO_7_MAN_UM_R0808.PDF Manager's User Manual PSO_7_P225_MAN_UM_CP.PDF Manager's User Manual Change Pages PSO_7_PHAR_UM_R0808.PDF Pharmacist's User Manual PSO_7_P225_PHAR_UM_CP.PDF Pharmacist's User Manual Change Pages PSO_7_TECH_UM_R0808.PDF Technician's User Manual PSO_7_P225_TECH_UM_CP.PDF Technician's User Manual Change Pages PSO_7_TM_R0808.PDF Technical Manual/Security Guide PSO_7_P225_TM_CP.PDF Technical Manual/Security Guide Change Pages PSJ_5_PSO_7_PSS_1_RN.PDF Pharmacy Changes to Support CPRS GUI v27 Release Notes (3) Documentation can also be retrieved from VistA Documentation Library (VDL) on the Internet at the following address, http://www.va.gov/vdl. Installation Instructions: ========================== CPRS GUI version 27 consists of three patches. The patches are combined in host file OR_PSJ_PSO_27.KID in order to simplify installation at Veterans Health Administration (VHA) facilities. Installation of this file should be coordinated among the three packages affected since only one installation is necessary. The patches are: PSJ*5.0*134 INPATIENT MEDICATIONS PSO*7.0*225 OUTPATIENT MEDICATIONS OR*3.0*243 ORDER ENTRY/RESULTS REPORTING Routine Information: ==================== The second line of each of these routines now looks like: ;;7.0;OUTPATIENT PHARMACY;**[Patch List]**;DEC 1997;Build 29 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSOCAN3 Before: B73551199 After: B70221168 **15,24,27,32,36,94,88,117,131, 146,139,132,223,235,148,249, 225** Routine Name: PSOCAN3N Before: n/a After: B656532 **225** Routine Name: PSOCAN4 Before: B42203941 After: B42375050 **20,24,27,63,88,117,131,259, 268,225** Routine Name: PSOCIDC2 Before: B70634486 After: B71704423 **226,225** Routine Name: PSOCP Before: B65342782 After: B67321239 **20,46,71,85,137,157,143,219, 239,201,225** Routine Name: PSOCP1 Before: B5020940 After: B5367762 **137,239,225** Routine Name: PSOCPC Before: B69783975 After: B74796456 **10,9,71,85,114,157,143,239, 201,275,225** Routine Name: PSOCPE Before: B80510322 After: B80668529 **26,71,85,114,157,219,268,225** Routine Name: PSODIAG Before: B63073470 After: B63590551 **143,219,239,268,225** Routine Name: PSOHLDA Before: B10413296 After: B10014334 **148,225** Routine Name: PSOHLNE1 Before: B72518246 After: B73330251 **1,9,46,71,98,111,117,131,157, 181,143,235,239,225** Routine Name: PSOHLNE2 Before: B59959932 After: B60250922 **1,7,59,46,225** Routine Name: PSOHLNE3 Before: B56031313 After: B61361284 **143,239,201,225** Routine Name: PSOHLNE4 Before: B10329069 After: B17206219 **201,225** Routine Name: PSOHLNEW Before: B77643201 After: B80329211 **1,7,15,46,71,98,111,124,117, 131,146,132,143,223,235,148, 239,249,225** Routine Name: PSOHLPII Before: B53689474 After: B53884421 **46,225** Routine Name: PSOHLPIS Before: B63830287 After: B64280169 **46,225** Routine Name: PSOHLSN1 Before: B82545457 After: B71972158 **1,10,24,27,55,46,71,101,99, 121,139,157,181,143,235,239, 292,225** Routine Name: PSOHLSN2 Before: B9304423 After: B7919233 **143,226,239,225** Routine Name: PSOHLSN3 Before: n/a After: B4822097 **225** Routine Name: PSOHLSNC Before: B54609968 After: B54704997 **111,157,143,225** Routine Name: PSOHLUP Before: B19956951 After: B20030650 **5,225** Routine Name: PSOLBL Before: B70822934 After: B63143813 **8,19,30,36,47,71,92,120,157, 244,206,225** Routine Name: PSOLBL1 Before: B23861694 After: B29469598 **107,110,225** Routine Name: PSOLLLI Before: B65877294 After: B66409595 **120,157,189,161,244,200,206,225** Routine Name: PSOLMAO Before: B221625 After: B247627 **225** Routine Name: PSOLMPO Before: B844163 After: B1183408 **46,225** Routine Name: PSOLMPO1 Before: B853281 After: B1200387 **46,71,225** Routine Name: PSOLMPO2 Before: B527625 After: B590140 **46,71,225** Routine Name: PSOLMRN Before: B502787 After: B567748 **11,46,84,225** Routine Name: PSOLMUTL Before: B10324003 After: B10572703 **19,46,84,99,131,132,148,268,225** Routine Name: PSOMLLD2 Before: B18734428 After: B28319271 **143,219,239,225** Routine Name: PSOMLLDT Before: B88755927 After: B86446402 **71,157,143,219,278,225** Routine Name: PSON52 Before: B62362504 After: B62785056 **1,16,23,27,32,46,71,111,124, 117,131,139,157,143,219,148, 239,201,268,260,225** Routine Name: PSONEW Before: B28071554 After: B28292272 **11,27,32,46,94,130,268,225** Routine Name: PSONEW2 Before: B31577282 After: B32398190 **32,37,46,71,94,124,139,157, 143,226,237,239,225** Routine Name: PSONEWF Before: B35718015 After: B38013501 **71,157,143,219,226,239,225** Routine Name: PSONEWG Before: B23242345 After: B25309370 **71,157,143,219,226,239,225** Routine Name: PSONFI Before: B8417929 After: B9036524 **46,94,131,225** Routine Name: PSOORFI1 Before: B72652086 After: B74027837 **7,15,23,27,32,44,51,46,71, 90,108,131,152,186,210,222,258, 260,225** Routine Name: PSOORFI2 Before: B74849096 After: B90909677 **7,15,23,27,46,130,146,177,222,225** Routine Name: PSOORFI3 Before: B74956889 After: B74814603 **15,27,32,46,84,99,130,117, 139,172,225** Routine Name: PSOORFI5 Before: n/a After: B18224487 **225** Routine Name: PSOORFI6 Before: n/a After: B23497771 **225** Routine Name: PSOORFIN Before: B69856075 After: B59563720 **7,15,27,32,44,46,84,106,111, 117,131,146,139,195,225** Routine Name: PSOORFL Before: n/a After: B917206 **225** Routine Name: PSOORNE4 Before: B67601401 After: B68513696 **11,27,32,36,46,75,96,103,99, 117,131,225** Routine Name: PSOORNE5 Before: B60770626 After: B60780567 **11,27,32,46,78,99,117,131, 146,171,180,210,222,268,206, 225** Routine Name: PSOORNEW Before: B66909716 After: B72157265 **11,23,27,32,55,46,71,90,94, 106,131,133,143,237,222,258, 206,225** Routine Name: PSOORRL Before: B56134945 After: B64370128 **4,20,9,34,54,82,124,132,159, 214,225** Routine Name: PSOORRL3 Before: n/a After: B23985690 **225** Routine Name: PSOORRLN Before: n/a After: B43625961 **225** Routine Name: PSOORRLO Before: n/a After: B39129717 **225** Routine Name: PSOORRNW Before: B20892446 After: B24091362 **11,27,51,46,71,94,130,131, 146,206,225** Routine Name: PSOORUT1 Before: B66564679 After: B67437810 **1,14,30,46,132,148,233,274,225** Routine Name: PSOORUTL Before: B42770378 After: B42932698 **14,46,146,132,118,199,223, 148,249,274,225** Routine Name: PSOPFSU0 Before: B16719657 After: B16719729 **201,225** Routine Name: PSOPFSU1 Before: B33416408 After: B33416502 **201,225** Routine Name: PSOPTPST Before: B26961793 After: B27932490 **7,71,88,146,157,143,225** Routine Name: PSORENW1 Before: B64596305 After: B60533620 **20,37,51,46,71,117,157,143, 219,239,225** Routine Name: PSORENW4 Before: B57297144 After: B56219403 **11,23,27,32,37,64,46,75,71, 100,130,117,152,148,264,225** Routine Name: PSORN52 Before: B43085141 After: B46207711 **1,11,27,37,46,79,71,100,117, 157,143,219,148,239,201,225** Routine Name: PSORN52A Before: B18015106 After: B18565756 **157,148,268,225** Routine Name: PSORN52C Before: B49841543 After: B49927643 **1,7,11,27,46,75,87,100,111, 124,117,131,146,148,200,225** Routine Name: PSORN52D Before: B30768895 After: B41922848 **143,219,239,225** Routine list of preceding patches: 5, 110, 172, 177, 195, 206, 214, 226 259, 260, 264, 274, 275, 278, 292 ============================================================================= User Information: Entered By : ANWER,MOHAMED Date Entered : OCT 27, 2005 Completed By: FARMER,LINDA Date Completed: AUG 07, 2008 Released By : VECE,VIRGINIA Date Released : AUG 20, 2008 ============================================================================= Packman Mail Message: ===================== No routines included