$TXT Created by CMNT.FO-BIRM.DOMAIN.EXT (KIDS) on Tuesday, 04/05/16 at 16:49 ============================================================================= Run Date: JUL 07, 2016 Designation: PSS*1*189 Package : PSS - PHARMACY DATA MANAGEMENT Priority: Mandatory Version : 1 SEQ #170 Status: Released Compliance Date: AUG 06, 2016 ============================================================================= Associated patches: (v)PSS*1*94 <<= must be installed BEFORE `PSS*1*189' (v)PSS*1*160 <<= must be installed BEFORE `PSS*1*189' (v)PSS*1*170 <<= must be installed BEFORE `PSS*1*189' (v)PSS*1*174 <<= must be installed BEFORE `PSS*1*189' (v)PSS*1*188 <<= must be installed BEFORE `PSS*1*189' (v)PSS*1*191 <<= must be installed BEFORE `PSS*1*189' Subject: GREATER THAN 90 DAYS SUPPLY ENHANCEMENT & MORE Category: - Routine - Data Dictionary - Enhancement (Mandatory) - Input Template Description: ============ This patch is part of the Pharmacy Safety Updates project which was established to address specific New Service Requests (NSRs) as well as Remedy Ticket(s) and a Patient Safety Issue (PSI) related to the VistA Pharmacy applications as approved by the Health Systems Enterprise Systems Manager(ESM). This project is comprised of patches from five different applications, as shown below: APPLICATION/VERSION PATCH ----------------------------------------------------------------- PHARMACY DATA MANAGEMENT (PDM) V. 1.0 PSS*1*189 OUTPATIENT PHARMACY (OP) V. 7.0 PSO*7*444 INPATIENT MEDICATIONS (IM) V.5.0 PSJ*5*313 NATIONAL DRUG FILE (NDF) V. 4.0 PSN*4*429 INTEGRATED BILLING (IB) V. 2.0 IB*2*545 The following New service Requests (NSRs) are being addressed by this patch: NSRs 20060601/20111206 Allow Dispensing of Greater Than 90 Day Supply --------------------------------------------------------------------------- The Outpatient Pharmacy and supporting VistA applications are being modified to allow dispensing of more than 90 day supply fill for outpatient prescriptions. The new limit will be 365 days and will be set for each drug individually. See below for more information on specific menu options related to this enhancement. NSR 20110308 Addition of a STRENGTH Property to IV ADDITIVES and Premixed IV SOLUTIONS ---------------------------------------------------------------------------- Although patches PSJ*5*289 and PSS*1*174 introduced quite a few enhancements to the IV Additives and IV Solutions ordering functionality they did not go far enough in addressing all the issues originally in the NSR. Patches PSJ*5*313 and PSS*1*189 will extend the display of the IV Additive strength to other parts of the Inpatient Medications and Pharmacy Data Management applications. In addition, it will also impose a new rule where an Orderable Item can only have one IV Solution for a specific volume when it is marked to be used in the CPRS IV Fluid Order Entry. NSR 20080907 Inactivate Pharmacy Standard Schedule ---------------------------------------------------------------------------- This enhancement is a conversion of an existing Class III software solution that permits an entry in the ADMINISTRATION SCHEDULE file (#51.1) to be marked as INACTIVE via the Standard Schedule Edit [PSS SCHEDULE EDIT] option. Once marked INACTIVE the schedule is no longer shown on the CPRS ADMINISTRATION SCHEDULE list. The following Pharmacy Data Management functionality was modified: 1. New MAXIMUM DAYS SUPPLY field (#66) in the DRUG file (#50) This new field shown below was added to the DRUG file (#50) for storing the local maximum day supply value for a medication in an outpatient prescription. Field Name: MAXIMUM DAYS SUPPLY Format: Numeric INPUT TRANSFORM: D MXDAYSUP^PSSDDUT2 HELP-PROMPT: This is the maximum number of days supply for this drug. Enter ?? for important information regarding default values and copays. DESCRIPTION: This field is used to determine the maximum number for days supply that may be assigned to this drug. If this field is left blank, the MAXIMUM DAYS SUPPLY is set to a default of 90 unless the drug is a controlled substance or Clozapine. Any value greater than 90 increases the number of potential copay units above 3. The maximum value allowed for this field is 365 (days) for most drugs, however: - Schedule 2 controlled substances have a 30-day maximum days supply limit - Schedules 3 thru 5 controlled substances have a 90-day maximum days supply limit - The maximum number of days supply for this drug cannot exceed the National Drug File (NDF) maximum value if it exists - No value can be entered for Clozapine drugs as the maximum days supply is controlled by the Clozapine functionality 2. ADMINISTRATION SCHEDULE file (#51.1) a) A new field named INACTIVE (#12) shown below was added to the ADMINISTRATION SCHEDULE file (#51.1) to allow the filtering inactive schedules when providing a list to the CPRS application. Field Name: INACTIVE Format: Set of Codes ('1' FOR YES) HELP-PROMPT: Answer YES to mark this administration schedule entry as inactive. DESCRIPTION: This field is used to indicate that a Standard Schedule is inactive. Inactive schedules are filtered from the list of schedules sent to CPRS for selection when users are placing a medication order. b) The upper limit for the FREQUENCY (IN MINUTES) field (#2) was increased from 129,600 (90 days) to 525,600 (365 days). 3. MEDICATION INSTRUCTION file (#51) The upper limit for the FREQUENCY (IN MINUTES) field (#31) was increased from 129,600 (90 days) to 525,600 (365 days). 4. IV SOLUTIONS file (#52.7) New INPUT TRANSFORMS have been added to the VOLUME (#2) and USED IN IV FLUID ORDER ENTRY (#17) to enforce the following new rule introduced relating to this file: Rule: An Orderable Item can have only ONE IV solution with a specific volume when it is marked to be used in the IV Order Dialog. 5. PSSCOMMON input template The PSSCOMMON input template used by the Drug File Enter/Edit [PSS DRUG ENTER/EDIT] option was modified to include the new MAXIMUM DAYS SUPPLY field (#66) in the DRUG file (#50) so that it can be edited along with the other fields in this option. 6. PSSJ SCHEDULE EDIT Input template The PSSJ SCHEDULE EDIT input template used by the Standard Schedule Edit [PSS SCHEDULE EDIT] option was modified to include the new INACTIVE field (#12) in the ADMINISTRATION SCHEDULE file (#51.1) so that it can be edited along with the other fields in this option. 7. Edit Orderable Items [PSS EDIT ORDERABLE ITEMS] option This option was modified to display the IV Additive Strength value as seen below: ... Orderable Item -> PIPERACILLIN/TAZOBACTAM Dosage Form -> INJ Dispense Drugs: --------------- PIPERACILLIN 3/TAZOBACTAM 0.375GM/VI INJ PIPERACILLIN 2/TAZOBACTAM 0.25GM/VI INJ PIPERACILLIN 4/TAZOBACTAM 0.5GM/VI INJ PIPERACILLIN/TAZOBACTAM (A) Additive Strength: 3.375 GM PIPERACILLIN/TAZOBACTAM (A) Additive Strength: 2.25 GM PIPERACILLIN/TAZOBACTAM (A) Additive Strength: 4.5 GM ... 8. Primary Solution File (IV) [PSSJI SOLN] option This option was modified to enforce a new rule introduced to ensure that an Orderable Item can only have 1 active IV SOLUTION linked to it with a specific VOLUME when the IV SOLUTION is marked YES for the USED IN IV FLUID ORDER ENTRY field (#17). When they user tries to perform an edit that breaks this rule by editing the screen fields VOLUME, USED IN IV FLUID ORDER ENTRY or INACTIVATION DATE, the error message below will be displayed and the editing won't be permitted. Only one Active IV Solution with a specific volume can be linked to an Orderable Item or Dispense Drug when the IV Solution is marked to be used in the CPRS IV Fluid Order Entry. 9. Drug Enter/Edit [PSS DRUG ENTER/EDIT] option a) This option was modified to allow entry of the new MAXIMUM DAY SUPPLY ... NCPDP DISPENSE UNIT: EACH// NCPDP QUANTITY MULTIPLIER: 1// MAXIMUM DAYS SUPPLY: ?? This field is used to determine the maximum number for days supply that may be assigned to this drug. The maximum value allowed for this field is 365 (days) for most drugs, however: - Schedule 2 controlled substances have a 30-day maximum days supply limit - Schedules 3 thru 5 controlled substances have a 90-day maximum days supply limit - The maximum number of days supply for this drug cannot exceed the National Drug File (NDF) maximum value if it exists - No value can be entered for Clozapine drugs as the maximum days supply is controlled by the Clozapine functionality MAXIMUM DAYS SUPPLY: PRICE PER DISPENSE UNIT: 0.8280 ... b) The exact same change described above in #8 was applied to this option where the user can create, edit and link IV Solution entries to a dispense drug. 10. Lookup into Dispense Drug File [PSS LOOK] option This option was modified to display the new MAXIMUM DAYS SUPPLY (#66) field in the DRUG file (#50) along with the other dispense drug fields for the dispense drug selected, as shown below: ... DISPENSE UNIT: VA DISPENSE UNIT: CAP DISPENSE UNITS/ORDER UNIT: 20 PRICE/DISPENSE UNIT: 0.8280 NCPDP DISPENSE UNIT: EACH NCPDP QUANTITY MULTIPLIER: 1.000 MAXIMUM DAYS SUPPLY: 100 APPL PKG USE: Outpatient Unit Dose Non-VA Med STRENGTH: 10 UNIT: MG POSSIBLE DOSAGES: ... 11. Standard Schedule Edit [PSS SCHEDULE EDIT] option This option was modified to add the new INACTIVE field (#12) in the ADMINISTRATION SCHEDULE file (#51.1) to be updated for a schedule. ... OTHER LANGUAGE EXPANSION: INACTIVE: ?? This field is used to indicate that a Standard Schedule is inactive. Inactive schedules are filtered from the list of schedules sent to CPRS for selection when users are placing a medication order. Choose from: 1 YES INACTIVE: ... 12. Administration Schedule File Report [PSS SCHEDULE REPORT] option This option was modified to display the new INACTIVE field (#12) created in the ADMINISTRATION SCHEDULE file (#51.1) as seen below: ADMINISTRATION SCHEDULE FILE REPORT (All) PAGE: NN ---------------------------------------------------------------------- ... *Q4H STANDARD ADMINISTRATION TIMES: 01-05-09-13-17-21 OUTPATIENT EXPANSION: EVERY 4 HOURS OTHER LANGUAGE EXPANSION: SCHEDULE TYPE: CONTINUOUS FREQUENCY (IN MINUTES): 240 EXCLUDE FROM ALL DOSE CHECKS: EXCLUDE FROM DAILY DOSE CHECK: INACTIVE: YES ... 13. Dispense Drug/Orderable Item Maintenance [PSS MAINTAIN ORDERABLE ITEMS] & Drug Enter/Edit [PSS DRUG ENTER/EDIT] options A new rule described below is being introduced which is related to the relationship between IV Solutions and Orderable Items. Rule: An Orderable Item can only have ONE IV solution with a specific volume when it is marked to be used in the CPRS IV Order Dialog. This option was modified to check every time the user tries to link a dispense drug to an orderable item whether the new rule is being broken or not. If the new rule is being broken the message below will be displayed and the user will not be able to proceed with linking the drug to the orderable item. Matching [Dispense Drug Name] to [Orderable Item Name] would cause the orderable item to have more than one Active IV Solution with the same volume marked to be used in the IV FLUID ORDER ENTRY, which is not allowed. Please, review the IV Solutions associated with this drug before matching it to this orderable item or match it to a different orderable item. 14. IV Solution Pre-Install Manual Clean-up (Environment Check routine) An environment check routine will run before the patch is installed to ensure that an orderable item does not have more than one IV Solution with the same volume when they are marked YES to be used in the CPRS IV Fluid Order Entry. If at least one orderable item entry is found, the patch installation will be aborted and a Mailman message will be sent to all users holding the following security keys: PSIVMGR, PSJI MGR, PSNMGR. The message will contain a list of all orderable items that need to be cleaned up, as seen in the sample message below: Subj: Duplicate IV Solution Volume under same Orderable Item [#215733] From: PATCH PSS*1*189 In 'IN' basket. Page 1 ------------------------------------------------------------------------- The list below shows IV Solutions in your database that need to be cleaned up before patch PSS*1*189 can be installed. Rule: An Orderable Item can only have ONE IV solution with a specific volume when it is marked to be used in the IV Order Dialog. Run Date/Time: Jun 12, 2015@09:49:16 ------------------------------------------------------------------------- ORDERABLE ITEM (IEN) IV DISPENSE DRUG (IEN) IV SOLUTION (IEN) ------------------------------------------------------------------------- DEXTROSE (196) Solution Volume: 1000 ML DEXTROSE 10% IN WATER (620) DEXTROSE 10% (7) DEXTROSE 5% IN 0.45% NS (623) DEXTROSE 5% 1/2 NS (10) DEXTROSE 5% 1000ML INJ (627) 5% DEXTROSE (1) 15. IV Solution Post-Install Automatic Clean-up (Post-install routine) IV Solutions that are no longer used, meaning that either the IV Solution and/or the Dispense Drug and/or the Orderable Item are marked INACTIVE will have the field USED IN IV FLUID ORDER ENTRY set to 'NO'. A list of such IV Solutions will be sent to all users holding the following security keys: PSIVMGR, PSJI MGR, PSNMGR. The message will contain a list of all IV Solutions that have been automatically updated as seen in the sample message below: Subj: Auto-update of the IV Solution file [#216328] 08/18/15@09:58 From: PATCH PSS*1*189 In 'IN' basket. Page 1 *New* ------------------------------------------------------------------------- The list below shows IV Solutions in your database that had the field USED IN IV FLUID ORDER ENTRY set to 'NO' because either the Orderable Item, the Dispense Drug or the IV Solution itself was marked INACTIVE. Run Date/Time: Aug 18, 2015@09:58:38 ------------------------------------------------------------------------- ORDERABLE ITEM (IEN) IV DISPENSE DRUG (IEN) IV SOLUTION (IEN/VOLUME) ------------------------------------------------------------------------- CEFAZOLIN (106) CEFAZOLIN SOD 1GM INJ (1498) 20% DEXTROSE (2/500 ML) *** INACTIVE DATE: JAN 11, 1994 *** 20% DEXTROSE (11/500 ML) *** INACTIVE DATE: JAN 11, 1994 *** 16. New API for CPRS: $$MAXDS^PSSUTIL1 This new API was created for CPRS to retrieve the Maximum Days Supply value for a specific medication. This API is available to CPRS through the Integration Control Registration (ICR) #3239. Below is a detailed description of the API. $$MAXDS^PSSUTIL1(INPUT) This API accepts an array containing the Pharmacy Orderable Item (required) and Dispense Drug (optional) and returns the maximum number of Days Supply allowed to be dispensed for the specific medication. Parameters: Input: INPUT("PSOI") (Required) Pointer to the PHARMACY ORDERABLE ITEM file (#50.7). INPUT("DRUG") (Optional) Pointer to the DRUG file (#50). This parameter is optional. If not passed, the API will return the highest value from all the dispense drugs linked to the Pharmacy Orderable Item. Output $$MAXDS Maximum number of days supply that can be dispensed for the orderable item and/or dispense drug. 17. IV Additives and Solutions - Display "INACTIVATION DATE" The INACTIVATION DATE will display whenever a VistA lookup is done on IV Additives and Solutions. This was accomplished by making the following two fields identifiers: FIELD NAME FIELD NUMBER FILE NAME/NUMBER ---------------------------------------------------------- INACTIVATION DATE 12 IV ADDITIVES (#52.6) INACTIVATION DATE 8 IV SOLUTIONS (#52.7) Note: The following 'HELP'-PROMPT text will display for fields 8 &12 "Enter the date this drug was inactivated." ********************* EXAMPLE(1) ADDITIVES ********************* Inpatient Drug Management - Additives File [PSSJI DRUG] Select Inpatient Drug Management Option: Additives File Select IV ADDITIVES PRINT NAME: PIPERACILLIN Lookup: IV ADDITIVES PRINT NAME 1 PIPERACILLIN/TAZOBACTAM Additive Strength: 3.375 GM 2 PIPERACILLIN/TAZOBACTAM Additive Strength: 2.25 GM 3 PIPERACILLIN/TAZOBACTAM 03-5-2015 Additive Strength: 4.5 GM ********************* EXAMPLE(2) SOLUTIONS ********************* Inpatient Drug Management - Primary Solution File (IV) Select Inpatient Drug Management Option: PRImary Solution File(IV) Select IV SOLUTIONS PRINT NAME: DEXTROSE 5% / NACL Lookup: PRINT NAME 1 DEXTROSE 5% / NACL 0.2% 1000 ML 2 DEXTROSE 5% / NACL 0.33% 1000 ML 3 DEXTROSE 5% / NACL 0.45% 1000 ML 12-03-15 4 DEXTROSE 5% / NACL 0.9% 1000 ML ********************* END EXAMPLES ********************* Patch Components ================ Files & Fields Associated: File Name (#) Field Name (#) New/Modified/Deleted ------------------ ----------------------------------- -------------------- DRUG (#50) MAXIMUM DAYS SUPPLY (#66) New MEDICATION INSTRUCTION (#51) FREQUENCY (IN MINUTES) (#31) Modified ADMINISTRATION SCHEDULE (#51.1) FREQUENCY (IN MINUTES) (#2) Modified INACTIVE (#12) New IV ADDITIVES (#52.6) INACTIVATION DATE (#12) Modified IV SOLUTIONS (#52.7) VOLUME (#2) Modified INACTIVATION DATE (#8) Modified USED IN IV FLUID ORDER ENTRY (#17) Modified Forms Associated: Form Name File # 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 New/Modified/Deleted ------------- -------------------- N/A Templates Associated: Template Name Type File Name (#) New/Modified/Deleted ------------- ----- ------------------------- -------------------- PSSCOMMON INPUT DRUG (#50) Modified PSSJ SCHEDULE EDIT INPUT ADMINISTRATION SCHEDULE (#51.1) Modified New Service Requests (NSRs): ---------------------------- 20060601 20111206 20110308 20080907 Patient Safety Issues (PSIs): ----------------------------- PSPO00002098 PSPO00001088 Remedy Ticket(s) & Overviews: ----------------------------- N/A TEST Sites: =========== NEW YORK HARBOR HCS LOUISVILLE, KY HEARTLAND EAST Documentation Retrieval Instructions: ------------------------------------- Updated documentation describing the new functionality introduced by this patch is available. The preferred method is to retrieve the files from the ANONYMOUS.SOFTWARE directory on download.vista.domain.ext. using secure file transfer protocol. This transmits the files from the first available server. Sites may also elect to retrieve files directly from a specific server as follows: Albany ftp.domain.ext Hines ftp.domain.ext Salt Lake City ftp.domain.ext The documentation will be in the form of Adobe Acrobat files. Documentation can also be retrieved from the VA Software Documentation Library (VDL) on the Internet at the following address: http://www4.domain.ext/vdl. File Description File Name FTP Mode -------------------------------------------------------------------------- PHARMACY DATA MANAGEMENT RELEASE NOTES PSS_1_P189_RN.PDF BINARY PHARMACY DATA MANAGEMENT INSTALLATION PSS_1_P189_IG.PDF BINARY GUIDE PHARMACY DATA MANAGEMENT USER MANUAL PSS_1_UM_R0616.PDF BINARY Patch Installation: Pre Installation Overview ------------------------- This project is comprised of patches from five different applications as listed here. The patches will get released together and the suggested installation order is as shown. An installation guide released with patch PSS*1*189, discusses the installation process as PSS*1*189 is the patch that must be installed first. APPLICATION/VERSION PATCH ----------------------------------------------------------------- PHARMACY DATA MANAGEMENT (PDM) V. 1.0 PSS*1*189 OUTPATIENT PHARMACY (OP) V. 7.0 PSO*7*444 INPATIENT MEDICATIONS (IM) V.5.0 PSJ*5*313 NATIONAL DRUG FILE (NDF) V. 4.0 PSN*4*429 INTEGRATED BILLING (IB) V. 2.0 IB*2*545 ----------------------------------------------------------------- Item #14 above describes in detail the pre-installation requirement for installing this patch. In summary, the process is required because a new rule will be introduced by this patch that will enforce the following: An Orderable Item can only have ONE IV solution with a specific volume when it is marked to be used in the IV Order Dialog. ***Please note**** The pre-installation environment check routine will only execute in production environments. Post Installation Overview -------------------------- Item #15 above describes in detail the post-installation process for automatically setting the USED IN IV FLUID ORDER ENTRY field (#17) in the IV SOLUTIONS file (#52.7) to 'NO' for inactive entries. This will prevent inactive entries from being made active again and breaking the rule described above. Installation Instructions ------------------------- Although this installation will take no longer than 3 minutes, it is recommended that it be installed overnight to prevent any disruption of service to other users. 1. Use the INSTALL/CHECK MESSAGE option on the PackMan menu. When loading the distribution, the following text will display: "Will first run the Environment Check Routine, PSS189EN" 2. From the Kernel Installation & Distribution System (KIDS) menu, select the Installation menu. 3. From this menu, you may select to use the following options (when prompted for INSTALL NAME, enter PSS*1.0*189). a. Backup a Transport Global - This option will create a backup message of any routines exported with the patch. It will NOT back up any other changes such as DDs or templates. b. Compare Transport Global to Current System - This option will allow you to view all changes that will be made when the patch is installed. It compares all components of the patch (routines, DDs, templates, etc.). c. Verify Checksums in Transport Global - This option will ensure the integrity of the routines that are in the transport global. d. Print Transport Global - This option will allow you to view the components of the KIDS build. 4. Use the Install Package(s) option and select the package PSS*1.0*189. 5. When prompted "Want KIDS to INHIBIT LOGONs during the install? NO//" respond NO. 6. When prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//" respond NO. Routine Information: ==================== The second line of each of these routines now looks like: ;;1.0;PHARMACY DATA MANAGEMENT;**[Patch List]**;9/30/97;Build 54 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSS189EN Before: n/a After: B30409440 **189** Routine Name: PSS189PI Before: n/a After: B23976606 **189** Routine Name: PSSDDUT2 Before:B103530932 After:B170893168 **3,21,61,81,95,127,126,139, 131,143,188,189** Routine Name: PSSJSV Before: B76380727 After: B76380719 **20,38,56,59,110,121,143,149, 146,189** Routine Name: PSSLOOK Before: B85846814 After: B86061726 **3,7,15,16,20,24,29,38,68,61, 87,90,127,147,170,189** Routine Name: PSSPOIMN Before: B62103637 After: B82446313 **15,32,34,38,51,57,82,125,189** Routine Name: PSSPOIMO Before:B139454544 After:B140931303 **29,32,38,47,68,102,125,141, 153,159,166,172,191,189** Routine Name: PSSSCHED Before: B15804053 After: B16362165 **94,189** Routine Name: PSSSCHRP Before:B109553620 After:B109340534 **129,160,189** Routine Name: PSSUTIL1 Before: B37379824 After: B48136582 **38,66,69,166,189** Routine Name: PSSVIDRG Before: B83452863 After: B88124860 **2,10,32,38,125,146,174,189** Routine list of preceding patches: 94, 160, 170, 174, 188, 191 ============================================================================= User Information: Entered By : Date Entered : JAN 26, 2015 Completed By: Date Completed: JUL 07, 2016 Released By : Date Released : JUL 07, 2016 ============================================================================= Packman Mail Message: ===================== $END TXT