$TXT Created by MALMROSE,CARY at ROX-DCM.FO-SLC.MED.VA.GOV (KIDS) on Monday, 07/21/03 at 11:12 ============================================================================= Run Date: JUL 23, 2003 Designation: OR*3*163 Package : OR - ORDER ENTRY/RESULTS REPORTING Priority: Mandatory Version : 3 SEQ #169 Status: Released Compliance Date: AUG 23, 2003 ============================================================================= Associated patches: (v)OR*3*141 <<= must be installed BEFORE `OR*3*163' (v)XU*8*267 <<= must be installed BEFORE `OR*3*163' (v)XU*8*288 <<= must be installed BEFORE `OR*3*163' Subject: PKI/DEA DIGITAL SIGNATURE FOR SCH II MEDS Category: - Routine Description: ============ Note: This patch can only be installed at sites running CPRS; however, the functionality will remain dormant until implementation of the DEA/PKI Digital Signature project. DESCRIPTION: ============ Pharmacy Benefits Management (PBM) Strategic Healthcare Group, in collaboration with the Drug Enforcement Administration (DEA), requested the development of the first Public Key Infrastructure (PKI) VistA pilot project, named Public Key Infrastructure for Electronic Prescriptions Pilot Project. The objective is to develop an electronic order entry system for Schedule II controlled substances using digital signatures. A Memorandum of Understanding between the DEA and the Department of Veterans Affairs authorizes only specified sites to use the full functionality of this pilot, although additional functionality is included that will benefit non-pilot sites. This patch contains the functionality required for this pilot and lays the foundations for the future implementation of the PKI once the DEA regulations are revised and published. It is installed with the PKI functionality disabled and will not have any impact until the PKI functionality is enabled. PKI functionality can be enabled via Computerized Patient Record System (CPRS) parameters at a site level and a user level. Additional hardware and software is required from various sources before PKI can be implemented at a site. DO NOT enable the PKI parameters until all required software and hardware has been installed. To make this project viable, modifications to the following packages were identified: National Drug File (NDF) V. 4.0 Kernel V. 8.0 (This patch and XU*8*288) Computerized Patient Record System (CPRS) V. 1.0 Pharmacy Data Management (PDM) V. 1.0 Outpatient Pharmacy (OP) V. 7.0 Controlled Substances (CS) V. 3.0 WEBSITES: ========= Information on the PKI project can be found on the following Websites: Other aspects of CPRS and clinical software: http://www.va.gov/vdl Overview of VA PKI projects: https://vaww.webdev.med.va.gov/techsvc/projects/vapki.asp The VA PKI project, for this project: http://vaww.va.gov/techsvc/projects/vapkidea/vapkidea.asp DOCUMENTATION: ============== Documentation related to the PKI project is available at the usual FTP sites, including an updated CPRS Technical Manual and user manual, describing the new functionality introduced by this patch. 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 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 Documentation files to get from the download sites include: HINESPKIUSERGUIDE.doc This is a word document to help in the installation and implementation of PKI for DEA/VA Schedule II drugs. CPRSGUITM.PDF, CPRSGUITM.DOC This is the CPRS GUI technical manual in both PDF and Word Document format. CPRSGUIUM.PDF, CPRSGUIUM.DOC This is the CPRS GUI user manual in both PDF and Word Document format. CERT_HOW_TOUPDATED11-5-02.PDF This is from a DEA contractor and shows how to view a DEA Cert. KRN8_OP283SP.PDF This documents the digital signature from the Kernel point of view during the development phase. RELATED PATCHES: ================ Here is a list of the related patches for this project: PSN*4*65 PSS*1*61 PSO*7*131 PSD*3*40 XU*8*267 XU*8*283 XU*8*288 IMPORTANT ITEMS: =============== 1) Kernel patch XU*8*267 added a new field to the Institution file (#4), called FACILITY DEA NUMBER, which must have a value before this patch is installed. Integrated sites, Multi-divisional sites and sites that have sub-stations that users are able to sign in to (clinics, nursing homes, etc.) must also have the Facility DEA Number entered for those sub-station entries in the Institution file (#4). 2) If you install this patch without entering all the required Facility DEA Numbers, your physicians will not be able to order controlled substances. You should be able to get the Facility DEA# from the Pharmacy or Pharmacy Chief. With the Facility DEA# and your institution name, use VA FileMan to enter the data, as follows: Select OPTION: ENTER OR EDIT FILE ENTRIES INPUT TO WHAT FILE: INSTITUTION// EDIT WHICH FIELD: ALL// FACILITY DEA NUMBER THEN EDIT FIELD: Select INSTITUTION NAME: FACILITY DEA NUMBER: 3) At this time, ONLY sites participating in the DEA/PKI pilot should implement this functionality, which is done by editing the following parameters. PARAMETERS: ORWOR PKI SITE - PKI Functionality Site Enabled This parameter may be set for a division or a system. It is used to require digital signatures for schedule II and schedule IIn controlled substance for the division or system. This parameter is set to yes when a site is ready to turn on PKI functionality for at least one user. ORWOR PKI USE - Allow PKI Functionality This parameter may be set for a user, a division or a system. It is used to enable a user to enter digital signatures utilizing PKI technology. With these 2 parameters turned off, CPRS operates as it always has with respect to Schedule 2 meds. Once these parameters are activated, users will see different functionality, depending on the environment they are working in (PKI Workstation, Non-PKI Workstation). Here are some of the expected scenarios: Parameter OPT Non-PKI SCH ----------------------------------------------- Site On/User On X X 2, 2n Expected Outcome Site Parameter prevents electronic signing of CSII and CSIIn orders in Non-PKI environment (no card reader). Presents message to user: ORDER NOT SENT TO PHARMACY This Schedule II medication cannot be electronically entered without a Digital Signature. Please cancel/discontinue this order and create a hand written order for manual processing, or digitally sign the order at a PKI-enabled workstation. Parameter OPT PKI SCH ----------------------------------------------- Site On/User On X X 2, 2n Expected Outcome Site Parameter prevents electronic signing of CSII and CSIIn orders in PKI environment (card reader). Presents message to user: ORDER SENT TO PHARMACY upon correct identification of user and entry of a PIN number, which is given at the time of signing the order. OTHER FIXES =========== CPRS needs to allow inactive orderable items to be renewed for Medication Orders. This was disabled with a recent patch and will be re-enabled with this patch. TEST SITES FOR THIS PATCH: ========================== Hines VAMC RELATED NOIS: ============= CLA-0103-22211 TOM-0203-41466 NHM-0203-10772 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 ============ ============ =========== ========== ORCACT01 21539734 26009616 94,116,134,141,163 ORCSAVE 17748750 18448547 7,56,70,73,92,94,116,141,163 ORCSAVE1 10422357 10820707 92,132,141,163 ORWDPS1 5637099 7890172 85,132,141,163 ORWOR 7975190 7975190 10,85,132,141,163 ORWOR1 5253640 6940614 132,141,163 ORWORR 13648694 14283828 10,92,116,110,132,141,163 ORX8 7475367 7774532 13,21,48,68,92,141,163 ORY163 N/A 1107400 163 INSTALLATION INSTRUCTIONS: ========================== This patch should be loaded during non-peak hours to minimize disruption to users. Installation will take less than 1 minute. Users may remain on the system. 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*163): 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 OR*3.0*163. 6. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//' respond NO. 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: - ORWOR Routine Checksum: Routine Name: - ORWORR Routine Checksum: Routine Name: - ORCACT01 Routine Checksum: Routine Name: - ORX8 Routine Checksum: Routine Name: - ORY163 Routine Checksum: Routine Name: - ORWDPS1 Routine Checksum: Routine Name: - ORWOR1 Routine Checksum: Routine Name: - ORCSAVE1 Routine Checksum: Routine Name: - ORCSAVE Routine Checksum: ============================================================================= User Information: Entered By : MALMROSE,CARY Date Entered : NOV 20, 2002 Completed By: CONDIE,KENNY Date Completed: JUL 21, 2003 Released By : PASTERNOCK,JOY Date Released : JUL 23, 2003 ============================================================================= Packman Mail Message: ===================== $END TXT