$TXT Created by MNTVBB.DOMAIN.EXT (KIDS) on Friday, 04/10/26 at 18:55 ============================================================================= Run Date: SEP 09, 2026 Designation: PSS*1*270 Package : PSS - PHARMACY DATA MANAGEMENT Priority: Mandatory Version : 1 SEQ #235 Status: Released Compliance Date: OCT 10, 2026 ============================================================================= Associated patches: (v)PSJ*5*464 install with patch `PSS*1*270' (v)PSS*1*268 <<= must be installed BEFORE `PSS*1*270' Subject: PGX SUPPRESSION AND NON-VA LAB RESULTS ISSUES Category: - Routine Description: ============ This patch addresses the following issues: 1. Pharmacogenomic (PGx) order suppression rules are sometimes not being adhered to in VistA Inpatient Order Entry. 2. Laboratory results from non-VA sources might not have a "Result Date" field and thus might not be recognized during PGx order checking. EHRM Impact Statement: ---------------------- This patch should have no EHRM impact, and can be installed at all sites, including EHRM converted sites. 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: ----------------------- New Service Requests (NSRs): N/A Patient Safety Issues (PSIs): ----------------------------- N/A Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 1. INC40265106: Pharmacogenomic (PGx) Order Check Suppression Issue Problem: -------- When an IV/Clinic Infusion order is renewed in CPRS, Inpatient Meds creates a new pending order and sets the original order's status to "Renewed." According to the PGx suppression rules for moderate severity PGx order checks, the system should not display a PGx Order Check if the patient already has a local Inpatient order containing the ingredient that triggers the check. In this situation, however, the pending IV/Clinic Infusion renewal for that ingredient is not being recognized by the PGx checking process. As a result, if a new order is entered for a drug with the same ingredient, the system incorrectly triggers a moderate severity (informational) PGx order check. Under the suppression rules, that check should be suppressed. But instead, it is displayed to the user. Resolution: ----------- Update routines PSJORUT2 and PSSPGXPR so they correctly identify pending renewal orders. Routine PSSPGXPR sets variable PSSPGXCK to 1. Companion patch PSJ*5.0*464's routine PSJORUT2 checks the value of PSSPGXCK, and when it finds it set to 1, it treats pending renewal orders as eligible for PGx order check suppression. This ensures pending renewals are properly included in the PGx suppression logic. 2. INC41567113: PGx Order Check Lab Result Date Issue Issue: ------ PGx Lab results which are received from non-VA sources might not have a "Result Date" data field populated. Pharmacogenomic functionality assumes that this field is always populated. These lab results then are not sent to the Mocha Server when performing PGx order checks. Also, the results do not display when presenting all PGx Lab results to the user in option Check Pharmacogenomic Interaction [PSS CHECK PGX INTERACTION]. Resolution: ----------- Routine PSSHDPG1 has been modified to check the "Modified Date" data field if the "Result Date" field is not populated. The "Modified Date" field is always populated for results received from non-VA sources. Test Sites: ----------- Martinsburg VAMC, Martinsburg WV Charleston VAMC, Charleston SC Test Sites - SNOW Change Order #: -------------------------------- Martinsburg: CO# CHG0766856 Charleston: CO# CHG0765845 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. Documentation Title File Name --------------------------------------------------------------------- N/A Patch Installation: ------------------- ************************************************************************ * PSS*1.0*270 and PSJ*5.0*464 are being * * released concurrently. * * * * PSS*1.0*270 and PSJ*5.0*464 may be installed in any * * order. * ************************************************************************ 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 or build name (ex. PSS*1.0*270) 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 PSS*1.0*270 iii. When prompted for the following, enter "R" for Routines or "B" for Build. Select one of the following: B Build R Routines 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 Back-out/Rollback Strategy: --------------------------- 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. The back-out plan is to restore the routines from the backup created. Validation of Back-out Procedure: --------------------------------- The Back-out Procedure can be verified by confirming the checksums have been returned to the pre-patch value using CHECK1^XTSUMBLD. It can also be verified by printing the first two lines of the PSJ routine contained in this patch using the option First Line Routine Print [XU FIRST LINE PRINT]. After the routines contained in this patch have been backed out, the second line of each routine will no longer contain the designation of patch PSS*1.0*270. Routine Information: ==================== The second line of each of these routines now looks like: ;;1.0;PHARMACY DATA MANAGEMENT;**[Patch List]**;9/30/97;Build 8 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSSHDPG1 Before: B63742056 After: B67871380 **262,270** Routine Name: PSSPGXPR Before:B153686641 After:B154294054 **262,268,270** Routine list of preceding patches: 268 ============================================================================= User Information: Entered By : Date Entered : OCT 08, 2025 Completed By: Date Completed: SEP 08, 2026 Released By : Date Released : SEP 09, 2026 ============================================================================= Packman Mail Message: ===================== $END TXT