$TXT Created by NABER,DAVID A at EXPCUR.FO-SLC.MED.VA.GOV (KIDS) on Thursday, 12/23/04 at 12:37 ============================================================================= Run Date: FEB 07, 2005 Designation: GMRA*4*21 Package : GMRA - ADVERSE REACTION TRACKING Priority: Mandatory Version : 4 SEQ #20 Status: Released Compliance Date: MAR 10, 2005 ============================================================================= Associated patches: (v)GMRA*4*7 <<= must be installed BEFORE `GMRA*4*21' (v)GMRA*4*11 <<= must be installed BEFORE `GMRA*4*21' (v)GMRA*4*19 <<= must be installed BEFORE `GMRA*4*21' (v)OR*3*216 <<= must be installed BEFORE `GMRA*4*21' Subject: Removal of allergies as orders Category: - Routine - Other Description: ============ This patch, along with changes in patch OR*3.0*195 (GUI v25), and patch OR*3.0*216, will remove allergies as orders. Previously, the entry of allergy related information was handled as an order through CPRS. This caused a number of problems related to accurate representation of allergies for a patient. In addition, the orders tab and the information in the postings area and the cover sheet was often inconsistent due to the "one-way" communication between order entry and allergy tracking. Upon installation of this patch, which must be done at the same time as OR*3.0*216, allergies will no longer be handled as orders. While you'll still be able to enter allergy information from the orders tab, the allergy itself will not appear as an order on the orders tab. The cover sheet in CPRS will now allow for the addition of new allergies as well as the ability to mark allergies as entered in error. You will also be able to indicate that a patient has been assessed and has no known allergies (NKA). From the ART package interface, you will now be able to remove an erroneous assessment of No Known Allergies (NKA) for a patient. When using the enter/edit patient reaction data option, if the patient is currently assessed as NKA, you may now enter the '@' sign at the "does this patient have any known allergies or adverse reactions? :No//" prompt. The patient's assessment will be returned to 'not assessed'. Upon installation of this patch, a post-installation routine will be queued to run in the background. Upon completion, a message will be sent identifying all observed allergies that are missing either the sign/symptoms or the observation date. This data is now required when entering allergies through the GUI. In addition, the post-installation will identify all patients who have an IODINE allergy. The IODINE allergy in the GMR ALLERGIES file (#120.82), which is a nationally released entry, has been updated. You'll need to review the list of patient names to make sure that the IODINE allergy information on file is correct. DOCUMENTATION: ============== An updated ART User Manual (GMRA_4_21_UM.PDF) will be distributed with this patch. This documentation will be in the form of Adobe Acrobat files. Again, the preferred method is to FTP the files from download.vista.med.va.gov. This transmits the files from the first available FTP server. Sites may also elect to retrieve documents 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 This file MUST be obtained in BINARY mode. The documentation can also be found on the Health System Design and Development Web page: (http://vista.med.va.gov/vdl/). NOIS ==== TUC-0304-60262 Allergy orders not appearing under postings LEX-0403-40160 Allergies Not Showing Up CON-0902-11414 ACTIVE ALLERGY NOT DISPLAYED ON COVER SHEET SAG-1101-40858 ALLERGY INFO INCORRECT WPB-1101-30375 Ability to discontinue allergy (orders) BED-0901-11728 Allergy orders cannot be cleaned up PAL-0100-60506 Problems with editing incorrect allergy data HVH-1099-11672 ALLERGY INTERACTION WITH CPRS WPB-0999-33224 Signature required for allergy orders to release BAY-0599-31108 Allergy Entry Shows Provider as Originator PUG-0598-52397 DC/Remove ART Order from CPRS All of the above NOIS deal with issues related to allergies as orders. For the most part, the problem is that the "order" for the allergy is not removed from the orders tab when the allergy is marked entered in error from the ART package. As allergies will no longer be treated as orders the removal of the order from the orders tab is no longer required. BIL-0600-31240 GMRAOR ALLERGY ENTER/EDIT CTX-0999-70580 Unable to create quick order for NKA BRX-0404-10531 undefined variable ORNP Previously, there were problems when a user attempted to add a quick order for an allergy. With allergies no longer being treated as orders, quick orders are no longer an issue as they are no longer possible. CLA-1099-22800 NEW ALLERGY - CAUSATIVE AGENT SCROLLS OFF SCREEN When using the list manager version of CPRS to add an allergy, it was possible to have the list of choices scroll off the screen so that the choices near the top were no longer visible. Listmanager now calls the allergy package directly for adding allergies so this is no longer a problem. BOI-1103-51156 Allergy order entry not locked in CPRS and Vista Prior to this patch it was possible for more than one user to be entering allergy information on the same patient. Locks have now been put in place so that only one person at a time may add/edit allergy data for a patient HIN-0700-41218 allergy severity Previously, an observation date wasn't required when entering an observed reaction through the GUI interface. As a result, any observed reaction without an observation date was not having its observation related data stored (this includes the severity). As a result, the severity never displayed with the detailed listing for the allergy. With this patch, the observation date is now required. In addition, the post-installation routine will identify any observed reactions that do not have an observation date so they may be updated. HUN-0898-20436 NOT PROMPT FOR MECHANISM FOR ALLERGIES When entering an allergy via the GUI interface, the user is not prompted for the mechanism. The GUI interface will now prompt for mechanism. WNY-0398-10655 DC/Remove ART Order from CPRS In the GUI interface, users are allowed to enter duplicate entries without warning. With this patch, when a user attempts to add an allergy that is already on record, they'll be alerted to the fact that this is a duplicate and the duplicate entry will not be saved. MAR-0704-20507 PROBLEM FOUND AFTER INSTALL ON PATCH 19 When verifying multiple reactions, if a user marks one of the entries as entered in error and a progress note is not filed for this entry then the user is exited from the option even though they may have more entries to review. The variable that controls whether the user has requested to exit the option was not being protected when the user is questioned about entering the progress note. This has now been fixed so that the user is not exited when marking an entry as entered in error. TUC-0704-61910 [GMRA PRINT A/AR NV] error LOU-0704-41111 FIND+14^GMRAPU:1 Error BRX-0704-10527 NULL SUBSCR ERROR SBY-0604-31758 ERROR - FIND+14^GMRAPU After the release of patch GMRA*4*19, some sites experienced an error when trying to run verification reports. The error came as a result of bad data nodes in the patient allergies file. The problem that causes these bad nodes is fixed in CPRS GUI v24 and the existing bad nodes were deleted in patch GMRA*4*17. However, some sites have had bad data added between the time patch 17 was released and the release of GUI v24. The post-install routine GMRAY21 will remove the bad data nodes. WRJ-0704-11898 ALLERGY ORDER CHECK NOT HAPPENING WITH DRUG ORDER PSI-04-041 When selecting IODINE as a causative agent, it was possible that the entry from the GMR ALLERGIES file could be erroneously assigned as the agent even if the user selected IODINE from a different file. This was due to the logic used to resolve the agent selected. IODINE is the only entry in the GMR ALLERGIES file that matched exactly with another entry from one of the other files. The problem is resolved by the changes to the allergy package removing them as orders. However, a clean up of potentially incorrect entries is required. A list of patients who had their IODINE reaction updated is provided in the post-install message. Sites should review the patients' reactions for accuracy. E3R === 14914 - Make mechanism available through the GUI interface. With the installation of patches OR*3*195, OR*3*216, and GMRA*4*21, the new allergy dialog will now prompt for the mechanism. ROUTINE SUMMARY: ================ The following is a list of the routine(s) included in this patch. The second line of each of these routine(s) will look like: ;;4.0;Adverse Reaction Tracking;**[patch list]**;Mar 29, 1996 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== GMRADSP2 10897712 12692559 21 GMRAEAB 6015757 8828134 21 GMRAFX2 13058727 13206211 17,19,21 GMRAGUI N/A 7318016 21 GMRAGUI1 N/A 17204272 21 GMRAHUT0 1731617 3679603 21 GMRAMCB 6260846 6502842 21 GMRANKA 2887186 6768620 2,21 GMRAOR1 3058095 4374433 21 GMRAOR2 4381417 6455527 21 GMRAOR6 1989086 1990047 17,21 GMRAPEM0 14054587 14463993 2,5,17,21 GMRAPEO0 4362542 4515911 8,17,21 GMRAPER0 19693128 20054393 7,21 GMRAPES0 27203878 27339816 13,17,19,21 GMRAPET0 7048876 9199688 6,17,21 GMRARAD 10615808 11187232 21 GMRAROBS 6718198 8025121 8,21 GMRASEN2 4347053 4596019 14,19,21 GMRASEND 5102198 6060255 14,19,21 GMRASIG1 6039446 8238942 2,17,21 GMRAU851 9813039 10787581 21 GMRAVAM0 11293888 11350896 11,21 GMRAY21 N/A 14822161 21 INSTALLATION ============ **NOTE** You must install patch OR*3.0*216 before installing this patch and they must be installed consecutively! Users should be off the system when these patches are installed. Failure to do so may result in errors or missed allergy entries. **NOTE** The changes that are included in GUI v25 will not become active until patch OR*3*216 and patch GMRA*4*21 are installed. You will probably want to install all three patches at the same time. Installation time should be less than 5 minutes. 1. Use the INSTALL/CHECK MESSAGE option on the PackMan menu. 2. Review your mapped set. If any of the routines listed in the ROUTINE SUMMARY section are mapped, they should be removed from the mapped set at this time. 3. From the Kernel Installation and Distribution System Menu, select the Installation menu. 4. From this menu, you may elect to use the following options (when prompted for INSTALL NAME, enter GMRA*4.0*21): a. Backup a Transport Global b. Compare Transport Global to Current System c. Verify Checksums in Transport Global 5. Use the Install Package(s) option and select the package GMRA*4.0*21. 6. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//', you may respond YES. 7. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', respond NO. 8. If routines were unmapped as part of step 2, they should be returned to the mapped set once the installation has run to completion. Routine Information: ==================== Routine Name: - GMRAGUI Routine Checksum: Routine Name: - GMRAGUI1 Routine Checksum: Routine Name: - GMRAOR2 Routine Checksum: Routine Name: - GMRAPET0 Routine Checksum: Routine Name: - GMRAY21 Routine Checksum: Routine Name: - GMRAPEM0 Routine Checksum: Routine Name: - GMRASEND Routine Checksum: Routine Name: - GMRASEN2 Routine Checksum: Routine Name: - GMRAVAM0 Routine Checksum: Routine Name: - GMRADSP2 Routine Checksum: Routine Name: - GMRAEAB Routine Checksum: Routine Name: - GMRAOR1 Routine Checksum: Routine Name: - GMRARAD Routine Checksum: Routine Name: - GMRAHUT0 Routine Checksum: Routine Name: - GMRAMCB Routine Checksum: Routine Name: - GMRAOR6 Routine Checksum: Routine Name: - GMRAU851 Routine Checksum: Routine Name: - GMRAPEO0 Routine Checksum: Routine Name: - GMRAPES0 Routine Checksum: Routine Name: - GMRAFX2 Routine Checksum: Routine Name: - GMRAPER0 Routine Checksum: Routine Name: - GMRASIG1 Routine Checksum: Routine Name: - GMRAROBS Routine Checksum: Routine Name: - GMRANKA Routine Checksum: ============================================================================= User Information: Entered By : NABER,DAVID A Date Entered : FEB 24, 2004 Completed By: HULET,LEE ANN Date Completed: JAN 31, 2005 Released By : CAMPBELL,THOMAS Date Released : FEB 07, 2005 ============================================================================= Packman Mail Message: ===================== $END TXT