$TXT Created by ANDERSON,CURTIS at DEVCUR.FO-SLC.MED.VA.GOV (KIDS) on Tuesday, 09/17/02 at 13:54 ============================================================================= Run Date: NOV 04, 2002 Designation: OR*3*127 Package : OR - ORDER ENTRY/RESULTS REPORTING Priority: Mandatory Version : 3 SEQ #147 Status: Released ============================================================================= Associated patches: (v)OR*3*105 <<= must be installed BEFORE `OR*3*127' Subject: OPIOID DRUG CLASS CHECK Category: - Enhancement (Mandatory) Description: ============ Note: This patch can only be installed at sites running CPRS. Documentation: ============== Other aspects of CPRS Notifications/Order Checks are available on our web site: http://vaww.vista.med.va.gov/cprs/ The CPRS Technical Manual was last updated on 7/1/02. Appendix E already contains the updated information regarding the new Duplicate Opioid Medications order check described in OR*3.0*127. The preferred method is to FTP the document files from download.vista.med.va.gov. This transmits the files from the first available FTP server. 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 Adobe Acrobat file CPRSLMTM.PDF can be retrieved in BINARY format from the above ftp address. -------------------------------------------------------------------------- | This patch uses the Order Check Expert System Rule Transporter to | | install the Duplicate Opioid Medications order check. | -------------------------------------------------------------------------- IT Service Request: #20010802 - Initial Opioid Decision Making Issue: #1: [IT Service Request #20010802] Adds a new order check specifically for duplicate opioid medication orders. If the patient already has an active or pending order for an opioid medication, the order check occurs. Currently an opioid medication is any medication that falls into VA Drug Classes OPIOID ANALGESICS or OPIOID ANTAGONIST ANALGESICS. Here is an example of the order check message: >>> Duplicate opioid medications: MORPHINE SULFATE EXT REL TAB,SA 60MG PO BID [PENDING] Please note that if you are already using the Duplicate Drug Class order check, users will get a similar message from that order check. Here is an example of both order checks occurring together: >>> Duplicate drug class order: OPIOID ANALGESICS (MORPHINE SULFATE EXT REL TAB,SA [PENDING]) >>> Duplicate opioid medications: MORPHINE SULFATE EXT REL TAB,SA 60MG PO BID [PENDING]>>> This order check is exported with the following package-level parameter values: ORK PROCESSING FLAG "Disabled" ORK CLINICAL DANGER LEVEL "Moderate" A "moderate" clinical danger level indicates the person entering the order will NOT be prompted for an order check over-ride reason. *** SPECIAL NOTE *** -------------------- An ORK PROCESSING FLAG value of "disabled" indicates this order check will not operate after patch installation. To make this order check work at your site you must use the Order Check Mgmt menu to change the parameter value to "enabled": Select CPRS Configuration (Clin Coord) Option: OC Order Checking Mgmt Menu 1 Enable/Disable an Order Check ... Select Order Checking Mgmt Menu Option: 1 Enable/Disable an Order Check Enable/Disable an Order Check Order Check Processing Flag may be set for the following: 1 User USR [choose from NEW PERSON] 2 Location LOC [choose from HOSPITAL LOCATION] 3 Service SRV [choose from SERVICE/SECTION] 4 Division DIV [choose from INSTITUTION] 5 System SYS [DEVCUR.ISC-SLC.VA.GOV] Enter selection: 5 System DEVCUR.ISC-SLC.VA.GOV --- Setting Order Check Processing Flag for System: DEVCUR.ISC-SLC.VA.GOV --- Select Order Check: DUPLICATE OPIOID MEDICATIONS Are you adding DUPLICATE OPIOID MEDICATIONS as a new Order Check? Yes// YES Order Check: DUPLICATE OPIOID MEDICATIONS// DUPLICATE OPIOID MEDICATIONS Value: Enabled 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: ;;3.0;ORDER ENTRY/RESULTS REPORTING;**[patch list]**;Dec 17, 1997 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== ORQOR1 1922552 2375265 78,127 ORY127 N/A 1160400 127 ORY1270 N/A 6041396 127 ORY12701 N/A 9071128 127 ORY12702 N/A 7157349 127 ORY12703 N/A 5905469 127 ORY12704 N/A 15203915 127 ORY12705 N/A 12024321 127 ORY12706 N/A 11137103 127 ORY12707 N/A 7779434 127 ORY12708 N/A 693836 127 ORY1271 N/A 10404407 127 ORY1272 N/A 8097303 127 ORY1273 N/A 5844193 127 ORY1274 N/A 6283774 127 ORY127ES N/A 5472400 127 INSTALLATION INSTRUCTIONS: ========================= This patch should be loaded during non-peak hours to minimize disruption to users. Users may be on the system during installation. Installation will take 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 OR*3.0*127): a. Backup a Transport Global b. Compare Transport Global to Current System c. Verify Checksums in Transport Global 5. Use the Install Package(s) options and select the package OR*3*127. 6. When prompted 'Want KIDS to INHIBIT LOGONS during install? YES//', respond "NO". 7. When prompted 'Want to DISABLE Scheduled Options, Menu Options and Protocols? YES//', respond "NO". 8. This patch uses the Order Check Expert System Rule Transporter to add the new Duplicate Opioid Medications rule. The transporter is initiated by the ORY127 post-install routine. When the rule transporter is running, you will see several messages outlining changes to the rules. Here is an example of the information displayed by the transporter. *** YOUR DISPLAY WILL NOT EXACTLY MATCH THIS EXAMPLE. *** Order Check Expert System Rule Transporter Created: JAN 7,2002 at 15:36 at DEVCUR.ISC-SLC.VA.GOV Current Date: JAN 7,2002 at 16:34 at DEMCUR.ISC-SLC.VA.GOV Loading Data . . . . . . . Installing '863.8 OCX MDD PARAMETER' records... . . . . . . . . . . . . . . . . . . . . . . . Installing '864.1 OCX MDD DATATYPE' records... . . . . Installing '863.7 OCX MDD PUBLIC FUNCTION' records... . . . . Installing '863.9 OCX MDD CONDITION/FUNCTION' records... . . . . Installing '863.4 OCX MDD ATTRIBUTE' records... . . OCX MDD ATTRIBUTE: DUP OPIOIDS record missing... NAME: DUP OPIOIDS ...Correct data Filed PARAMETER NAME: DATA TYPE ...Correct data Filed VALUE: BOOLEAN ...Correct data Filed . OCX MDD ATTRIBUTE: DUP OPIOIDS TEXT record missing... NAME: DUP OPIOIDS TEXT ...Correct data Filed PARAMETER NAME: DATA TYPE ...Correct data Filed VALUE: FREE TEXT ...Correct data Filed . . . . . . Installing '863.2 OCX MDD SUBJECT' records... . Installing '863.3 OCX MDD LINK' records... . . OCX MDD LINK: PATIENT.DUP OPIOID MEDS record missing... NAME: PATIENT.DUP OPIOID MEDS ...Correct data Filed PARENT SUBJECT: PATIENT ...Correct data Filed ATTRIBUTE: DUP OPIOIDS ...Correct data Filed LIST ORDER: 3455 ...Correct data Filed PARAMETER NAME: OCXO EXTERNAL FUNCTION CALL ...Correct data Filed VALUE: OPIOID(|PATIENT IEN|) ...Correct data Filed PARAMETER NAME: OCXO UP-ARROW PIECE NUMBER ...Correct data Filed VALUE: 1 ...Correct data Filed . OCX MDD LINK: PATIENT.DUP OPIOID MEDS TEXT record missing... NAME: PATIENT.DUP OPIOID MEDS TEXT ...Correct data Filed PARENT SUBJECT: PATIENT ...Correct data Filed ATTRIBUTE: DUP OPIOIDS TEXT ...Correct data Filed LIST ORDER: 5679 ...Correct data Filed PARAMETER NAME: OCXO EXTERNAL FUNCTION CALL ...Correct data Filed VALUE: OPIOID(|PATIENT IEN|) ...Correct data Filed PARAMETER NAME: OCXO UP-ARROW PIECE NUMBER ...Correct data Filed VALUE: 2 ...Correct data Filed . . . . . . . Installing '860.9 ORDER CHECK NATIONAL TERM' records... . . . . . . . . . . . . . Installing '860.8 ORDER CHECK COMPILER FUNCTIONS' records... . . . . . . . . . . . ORDER CHECK COMPILER FUNCTIONS: OPIOID MEDICATIONS record missing... NAME: OPIOID MEDICATIONS ...Correct data Filed LINE LABEL: OPIOID ...Correct data Filed . . Installing '860.6 ORDER CHECK DATA CONTEXT' records... . . . . Installing '860.5 ORDER CHECK DATA SOURCE' records... . . . . . Installing '860.4 ORDER CHECK DATA FIELD' records... . ORDER CHECK DATA FIELD: DUPLICATE OPIOID MEDICATIONS FLAG record missing... NAME: DUPLICATE OPIOID MEDICATIONS FLAG ...Correct data Filed ABBREVIATION: DUP OPIOIDS FLAG ...Correct data Filed DATATYPE: BOOLEAN ...Correct data Filed DATA CONTEXT: DATABASE LOOKUP ...Correct data Filed DATA SOURCE: DATABASE LOOKUP ...Correct data Filed META DICTIONARY LINK: PATIENT.DUP OPIOID MEDS ...Correct data Filed . ORDER CHECK DATA FIELD: DUPLICATE OPIOID MEDICATIONS TEXT record missing... NAME: DUPLICATE OPIOID MEDICATIONS TEXT ...Correct data Filed DATATYPE: FREE TEXT ...Correct data Filed DATA CONTEXT: DATABASE LOOKUP ...Correct data Filed DATA SOURCE: DATABASE LOOKUP ...Correct data Filed META DICTIONARY LINK: PATIENT.DUP OPIOID MEDS TEXT ...Correct data Filed . . . . . Installing '860.3 ORDER CHECK ELEMENT' records... . ORDER CHECK ELEMENT: DUP OPIOID MEDS record missing... NAME: DUP OPIOID MEDS ...Correct data Filed ELEMENT CONTEXT: DATABASE LOOKUP ...Correct data Filed EXPRESSION SEQUENCE NUMBER: 1 ...Correct data Filed DATA FIELD 1: DUPLICATE OPIOID MEDICATIONS FLAG ...Correct data Filed OPERATOR/FUNCTION: LOGICAL TRUE ...Correct data Filed . ORDER CHECK ELEMENT: OPIOID MED ORDER record missing... NAME: OPIOID MED ORDER ...Correct data Filed ELEMENT CONTEXT: CPRS ORDER PRESCAN ...Correct data Filed EXPRESSION SEQUENCE NUMBER: 2 ...Correct data Filed DATA FIELD 1: ORDER MODE ...Correct data Filed OPERATOR/FUNCTION: EQ FREE TEXT ...Correct data Filed CONDITIONAL VALUE 1: SELECT ...Correct data Filed EXPRESSION SEQUENCE NUMBER: 3 ...Correct data Filed DATA FIELD 1: FILLER ...Correct data Filed OPERATOR/FUNCTION: STARTS WITH ...Correct data Filed CONDITIONAL VALUE 1: PS ...Correct data Filed EXPRESSION SEQUENCE NUMBER: 4 ...Correct data Filed DATA FIELD 1: VA DRUG CLASS ...Correct data Filed OPERATOR/FUNCTION: EQUALS ELEMENT IN SET ...Correct data Filed CONDITIONAL VALUE 1: OPIOID ANALGESICS,OPIOID ANTAGONIST ANALGESICS ...Correct data Filed Installing '860.2 ORDER CHECK RULE' records... . ORDER CHECK RULE: OPIOID MEDICATIONS record missing... NAME: OPIOID MEDICATIONS ...Correct data Filed LABEL: OPIOID MED ORDER ...Correct data Filed TYPE: SIMPLE DEFINITION ...Correct data Filed ELEMENT NAME: OPIOID MED ORDER ...Correct data Filed LABEL: DUP OPIOID MEDS ...Correct data Filed TYPE: SIMPLE DEFINITION ...Correct data Filed ELEMENT NAME: DUP OPIOID MEDS ...Correct data Filed RELATION INDEX: 1 ...Correct data Filed RELATION EXPRESSION: OPIOID MED ORDER AND DUP OPIOID MEDS ...Correct data Filed ORDER CHECK: DUPLICATE OPIOID MEDICATIONS ...Correct data Filed ORDER CHECK MESSAGE: Duplicate opioid medications: |DUPLICATE OPIOID MEDICATIONS TEXT| ...Correct data Filed No data filing errors. Transport Finished... 9. If routines were unmapped as part of step 2, they should be returned to the mapped set once the installation has run to completion. 10. After successful patch installation, delete the ORY127* routines. These routines were used to transport the expert system components for the Duplicate Opioid Medications order check and perform patch installation. [Note: KIDS automatically deletes routine ORY127 after patch installation.] Routine Information: ==================== Routine Name: - ORY127 Routine Checksum: Routine Name: - ORY1270 Routine Checksum: Routine Name: - ORY12701 Routine Checksum: Routine Name: - ORY12702 Routine Checksum: Routine Name: - ORY12703 Routine Checksum: Routine Name: - ORY12704 Routine Checksum: Routine Name: - ORY12705 Routine Checksum: Routine Name: - ORY12706 Routine Checksum: Routine Name: - ORY12707 Routine Checksum: Routine Name: - ORY1271 Routine Checksum: Routine Name: - ORY1272 Routine Checksum: Routine Name: - ORY1273 Routine Checksum: Routine Name: - ORY1274 Routine Checksum: Routine Name: - ORY127ES Routine Checksum: Routine Name: - ORQOR1 Routine Checksum: Routine Name: - ORY12708 Routine Checksum: ============================================================================= User Information: Entered By : EBERT,AL Date Entered : NOV 08, 2001 Completed By: GREEN,JOANN Date Completed: NOV 04, 2002 Released By : KREUZ,SHERI B Date Released : NOV 04, 2002 ============================================================================= Packman Mail Message: ===================== $END TXT