============================================================================= Run Date: AUG 11, 2003 Designation: OR*3*173 Package : OR - ORDER ENTRY/RESULTS REPORTING Priority: Mandatory Version : 3 SEQ #172 Status: Released Compliance Date: SEP 11, 2003 ============================================================================= Associated patches: (v)OR*3*149 <<= must be installed BEFORE `OR*3*173' (v)OR*3*165 <<= must be installed BEFORE `OR*3*173' (v)TIU*1*160 <<= must be installed BEFORE `OR*3*173' (v)TIU*1*164 <<= must be installed BEFORE `OR*3*173' Subject: CPRS GUI Version 22 Category: - Routine - Enhancement (Mandatory) Description: ============ PATCH DESCRIPTION: ================= Patch 173 implements CCOW, LM functions, notifications, and Women's Health features. -- CCOW (CLINICAL CONTEXT) - GUI 22 includes support for clinical context synchronization in accordance with the CCOW standard. This functionality requires installation of Sentillion's Vergence Desktop Components on each user workstation. If installed, any other application on that desktop which is compliant with the CCOW standard will automatically synchronize with the selected patient in CPRS, and selecting a different patient in any such application will automatically synchronize the other desktop applications, including CPRS, to the same patient. If the Vergence component is not installed, CPRS will continue to operate as it previously did. Installation of this component is not required for normal, non-CCOW CPRS operation. -- CLINICAL REMINDERS - E3R 15758: Dialog elements with the checkbox suppress will display in the progress note with or without a finding item. Post-install code was added which sets all Reminder Dialog Groups and Elements that have the checkbox suppress and no finding to be exclude from the progress note. - Added two new dialog prompts and processing logic for the Womens Health project in Clinical Reminders. These Dialog prompts will be invisible to the GUI until server side is releases of PXRM*2.0*1 or PXRM*2.0*2. - Changed Progress Note Text functionality to allow a Womens Health Force Value to populate the progress note text; will require the server release of Womens Health patch. - Change the SelectDevice Function call to accept a fourth parameter so calling units can customize the form caption. -- TIU - Added a new Refresh Patient Data Object to the Patient Data Object form. - Changed the progress note to wrap at 80 characters; works with TIU patch 164 for objects. - NOIS: LEX-1001-42510 - Modified the Encounter form to utilize the user's saved clinic appointment date range parameters (if set) instead of previously hard-coded range of 30 days. -- PRINTING MULTIPLE NOTES, CONSULTS OR DC/SUMMARIES (TO MATCH LIST MANAGER FUNCTIONALITY) - Added a new form that will present a list of Parent Nodes for each Completed Note, Consult, or DC/Summary for a given Patient. From this list the user can select one or many items to be printed. - Added a new option: File->Print Selected Items. This option is only available for selection when the user is accessing the Notes, Consults, or DC/Summary tabs. -- TEMPLATES - NOIS: PUG-0202-50989 - Deselect/toggle of a default template is now allowed. - NOIS: HEH-0503-40903, NIN-0901-41859, PAL-1101-60790, CPH-0502-40626, CPH-0702-42563, BIR-0802-31738, SHR-0902-71866, MAR-0902-22087, CHY-0203-51509, SLC-0203-52072, BIR-0303-30761, AUG-0303-31071, LAS-0901-60562, LEB-0503-22004, ATG-0503-32041 - Consults template cause "reversed order" during data entry. This has been addressed. - When importing a template with a status of inactive, if the "Hide Inactive" checkbox was checked the error "Cannot focus a disabled or invisible window" would sometimes appear. Subsequent attempts to re-import the template would then cause an access violation. This has been fixed. -- NOTES TAB - NOIS: TAM-0300-33000 - Functionality was added to the GUI to match that in the List Manager Version of CPRS, insuring a Note with its Document Parameter (allow >1 records per visit:NO) can only exist once per visit. - Inactive User - Functionality was added to determine a user's DISUSER status when selecting a co-signer or additional signer for a Note or Consult. If the user is DISUSERED, the appropriate message will be displayed. - NOIS: HOU-0403-71815, CHS-0503-40139 - Currently in CPRS when a provider creates a note and the note requires a co-signature, the cosigner can sign the note prior to the author signing. The exact process is possible in LM with the following exception: When the cosigner selects a note for signature prior to the author signing, the cosigner is prompted with a message stating: "Author hasn't signed, are you SURE you want to sign Provider A TEST NOTE?" The cosigner can then proceed by responding No to exit without signing or Yes to proceed with signing. This functionality has been added to CPRS GUI. - NOIS: LAS-0901-60562 - Consult Reason For Request is no longer inverted. - The Notes properties form used for selecting a new note title now resizes correctly for 24pt font size. -- NOTES/CONSULTS/DISCHARGE SUMMARY - NOIS: CHA-0403-30277, PUG-0403-51353, FNC-0503-30038, MOU-0503-30380 - Under certain circumstances, the TIU call to save the document can fail and return an error message. CPRS was not correctly processing this error message. This would result in a subsequent hard server error at PATVADPT+4^TIULV, because a second call to store the text of the document would pass a document IEN of "0". In this version, the existing error message returned by TIU is displayed to the user, and the second call is bypassed. This prevents the server error that would result further downstream in the update process. Investigation continues as to the underlying cause for this scenario. - The Templates treeview maintains its selection even after the note being edited is saved or signed. When starting a new note, the previous template remains selected in the treeview, whether or not the templates drawer is open. When then starting another new note, and selecting "Preview/Print Selected Template" from the note's popup menu, the template previously selected and used would be displayed. This was confusing. In this version, that menu will not be available unless the templates drawer is actually open, showing that a template is currently highlighted. - The tab order has been tweaked so that the note editor comes directly after the list of notes. -- CONSULTS - Under certain circumstances in the consult or procedure ordering process, a server error at SVCIEN+2^ORQQCN2 would occur. This has been corrected. -- HIPAA CODE SET VERSIONING - All required changes to the GUI to support the later implementation of Code Set Versioning (CSV - actually scheduled for GUI 23) have been pre-included in this release of GUI 22. Users should see no changes until the required ICD, ICPT, LEX, and IBD patches are installed later this year. At that time, codes and vocabulary terms will be checked and screened for date currency, and some changes to GUI behavior will be noted. The changes have been included now to facilitate testing and readiness for the Fall, 2003 implementation deadline. Documentation of the GUI changes will be forthcoming as CSV implementation approaches. -- SPELLCHECK/GRAMMARCHECK - The spell-checker was terminating abnormally (but safely) if the first line of the document being checked was a blank line. This has been corrected. - A problem was addressed that caused spell check to abort if the first line of the document was blank or contained only spaces. -- NOTIFICATIONS/ALERTS - The notification/alerts display on the patient selection screen has been changed to columnar format. It is now possible to click on any column heading and sort by that heading. Clicking again on the heading will reverse the sort by that heading. The new column headings for notification/alerts include: Info (information alerts are preceded with an "I") Patient name Location (patient location if known) Urgency (valued HIGH, Moderate, or low as indicated by the CPRS parameter ORB URGENCY - TIU alerts are given a "Moderate" urgency value while other alerts without a parameter value are given an urgency of "low") Alert Date/Time (date/time the alert was triggered) Message (alert message or text) Two new buttons have been added to the Notification/Alert display: "Remove" and "Forward". In addition, the "Next" button that appears in the status bar (bottom of screen) when alerts are being processed now has a pop-up menu. This menu appears when the user right-clicks the Next button. The pop-up supports the following actions: "Continue", "Forward", and "Renew". - Added alert forwarding comments and information to the alert list on the patient selection screen. A new column "Forwarded By/When" has been added to display who forwarded the alert and when (if applicable.) Like other columns on the new alerts list, the Forwarded By/When column supports sorting. This will allow users to sort alerts by who forwarded them. Also if a forwarded alert has comments from the forwarding person, those comments will be displayed when the curser hovers over the forwarded alert. To support more comment information, the Forwarding Alerts screen now has a larger comments section. Comments are limited to 180 characters to support display on the alerts screen. -- ORCH CONTEXT MEDS - In ListManager the parameter ORCH CONTEXT MEDS controls date range for display of meds; it previously had no effect in the CPRS GUI. This function has been added to GUI. Users are able to set the date range for display meds on the MEDS Tab by selecting Tools/Options/General Tab/Other parameters. -- PATIENT RECORD FLAG - Required changes to the GUI to display the patient record flag have been included in this release. Based on the availability of the API from the MSS Major Enhancement package, when doing patient selection, users will be presented with patient record flag information for violent, potentially violent, or other locally categorized patients. If the MSS API is not available the function is transparent to end users. -- ORDERS TAB - NOIS: UNY-0103-12484, SFC-0103-61604, E3Rs: 17795, 16766 - "Give First Dose Now" resulted in several medication errors. Based on recommendations made by the CPRS Clinical Workgroup the following changes were made to address these issues. 1. "Give First Dose Now" will be changed to the verbiage of "Give Additional Dose Now". 2. The "Give Additional Dose Now" option will not be available for free-text orders. 3. A pop-up information box will be generated to the provider when the "Give additional Dose Now" button is enabled. This information box will tell the provider that there were two orders entered for the same medication with each administrative schedule. - NOIS: WAS-1102-22142, WAS-0303-20992, HUN-1100-22441 - The purpose of the order comments field was ambiguous to End Users and was used for various purposes. Based on the recommendation of the CPRS Clinical Workgroup, the "Order Comments" function was disabled and the order comments field locked out. - NOIS: ELP-0303-71667 - When Renewing, changing or copying an existed copay eligible order, if the patient's current copay exemption changed, the new order still populated with the old order's copay exemptions for order signing. This was fixed. - NOIS: CLE-0403-40078 - For a medication quick order with a fractional quantity, when placing this order, the quantity always defaulted to zero. This has been fixed. - NOIS: TNV-0403-31555 - On the Orders tab, upon selection of the View menu and then the Auto DC/Release Event Orders option, the date/time of all the events ended with the same value regardless of the actual event times. This was fixed. - NOIS: BIR-0603-31392 - Some sites reported a "Class TMemo not found" error with Orderable Items. This was fixed. - Unsigned orders do not trigger the Order Requires Elec Signature notification/alert: Orders on the unsigned order list are checked by default. If you click the "Don't Sign" button while unsigned orders are checked, the alert will not trigger. If you uncheck the unsigned orders before clicking the "Don't Sign" button, the alert triggers. The fix will now tigger the alert in both cases. - The Hotkey to sign orders was changed to to match behavior of the Notes tab. - The "Save Without Signature" shortcut was changed to to make it agree with the shortcut on the notes tab. - When renewing a complex order from the Meds tab, the renewed order did not show up on the order list until the review/sign window was displayed. This was fixed. - For a transfer event, the event name did not show in the event box of the event default dialog. This was fixed. -- EVENT DELAYED ORDERS - Removed an error caused by typing in listbox of Change Release Event screen if no release events are available. -- MEDS TAB - Administration History for IV orders is now retrievable and should display correctly. - Pressing the space bar while in the complex medication grid brings up the appropriate field editor. This has been altered so that the old value of the field is used as the default value in the field editor. -- VITALS - NOIS: MWV-0103-22037 - Added an IsNumeric function to force entry of weight as numeric for graphing. - When entering vitals from the cover sheet and moving between fields using the ENTER key instead of TAB, an "invalid typecast" error would occur. This was fixed. -- PROBLEMS TAB - When viewing the list of "removed" problems, many menu actions that previously displayed an error message have now simply been disabled. - The problems tab for the inactivate and verify actions now allow multiple selections. - If CPRS timed out while the problem add/edit screen was displayed, an access violation would result. This has been corrected. - The tab order has been tweaked so that the list of active problems comes directly after the problem categories list. -- SECTION 508 CHANGES - Several dialog boxes were changed to provide text readability by text-to-speech utilities. - A 508 disclaimer was added to the splash screen and the help/about box. -- PATIENT SELECTION SCREEN - A bug that could hide reminder buttons behind the windows tool bar was fixed. - Text in buttons is no longer cut off when using larger fonts. - NOIS: PUG-0400-50702 - When first setting a Ward as the default Pt. List, room and bed information showed, but upon subsequent appearances of the list window it did not. This was fixed. -- OPTIONS - A problem was reported with the title selection list for the Consults document class. Not all available titles were selectable from the list. This has been corrected. - Pressing in the Custom Reports screen to bring up the calendar dialog no longer gives a "Cannot focus inivislbe window" error when the dialog closes. -- ICON LEGEND - The text of the Icon Legend was not always displaying completely in v21. This has been fixed. -- TOOLS - NOIS: DET-0603-41993, ERI-1202-21387 - Event Capture Interface - Inside CPRS, the "Event Capture Interface" users were not able to save the customized application path for the multi-sessions reuse. This was fixed. For sites using the "Event Capture Interface" (ECI), by using the "CPRS GUI TOOLS MENU" option, a site CAC might need to add a new entry (Event Capture Interface="path...\ECS GUI.EXE") at the system level or other appropriate level to store the default ECI path. The application name needs to be exactly the same as the words "Event Capture Interface" (not case sensitive). For full functionality, patch EC*2.0*46 (patch and EC GUI EXE) need to be installed in the same account as well. If a CPRS user has a customized ECS GUI path, the user can launch the ECI application by manually browsing the appropriate directory and the customized path will be saved on the server side for future reuse. REQUIRED BUILDS: =============== OR*3.0*149 OR*3.0*165 TIU*1.0*160 TIU*1.0*164 NOTE: Internet Explorer 4.0 (IE4) or later is REQUIRED in order for GUI version 22 to run. However IE 5.5 or later with 128-bit encryption is required for PKI functionality. 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 ============ ============ =========== ========== ORB31 6955971 7121649 6,31,88,105,139,173 ORB3MGR1 12539476 12206557 31,74,85,88,105,139,173 ORB3REC 3555874 3264453 9,85,105,173 ORCACT0 20852820 21170039 7,27,48,72,86,92,94,141, 165,177,173 ORPRF N/A 3324531 173 ORQORB 1134419 1565272 6,173 ORQPTQ11 17707170 17682805 82,85,109,132,173 ORQQPL 6630191 7150036 9,10,85,173 ORQQPL1 8531650 9008621 10,85,148,173 ORQQPL3 8144329 9205375 10,148,173 ORQQPXRM 2387325 2426793 10,85,116,173 ORWDPS4 3291947 3553814 116,125,131,141,173 ORWORB 11500350 13264632 10,85,116,148,173 ORWPCE 12248410 15820035 10,85,116,173 ORWPCE2 13132491 13922968 10,85,109,116,173 ORWPS 5131825 5723015 10,85,116,132,141,173 ORWTPD 4882594 5109306 109,120,132,148,141,173 ORWTPL 6672838 6595141 85,109,173 ORWTPR 5958556 5690196 85,173 ORY173 N/A 2236831 173 INSTALLATION FILES: ================== OR*3*173.KID is a multi-patch installation Host File. It installs both OR*3*149 and OR*3*173 in one step. The following software and documentation files, including the last file which contains Delphi source code, are exported as part of this patch: File Name Contents Retrieval Format --------- -------- ---------------- OR_30_173.KID KIDS Build ASCII OR_30_173.ZIP File(s) indented below BINARY - CPRSCHART.EXE CPRS Executable - CPRS.CNT CPRS Help CNT File - CPRS.HLP CPRS Help File - CPRSGUITM.DOC CPRS GUI Technical Manual (Word Version) - CPRSGUITM.PDF CPRS GUI Technical Manual - CPRSGUIUM.DOC CPRS GUI User Manual (Word Version) - CPRSGUIUM.PDF CPRS GUI User Manual - CPRSLMTM.DOC CPRS LM Technical Manual (Word Version) - CPRSLMTM.PDF CPRS LM Technical Manual - CPRSLMUM.DOC LM User Manual (Word Version) - CPRSLMUM.PDF LM User Manual - CPRSSETUP.DOC CPRS GUI Setup Document (Word Version) - CPRSSETUP.PDF CPRS GUI Setup Document - OR_30_149_RN.DOC CPRS GUI V20 Release Notes (Word Version) - OR_30_149_RN.PDF CPRS GUI V20 Release Notes - OR_30_173_RN.DOC CPRS GUI V21 Release Notes (Word Version) - OR_30_173_RN.PDF CPRS GUI V21 Release Notes *OR_30_173_SRC.ZIP CPRSChart Source BINARY *(This file contains, in the CPRS-Chart folder, a "README.TXT" file of major importance to sites utilizing the Delphi source code.) The files listed above may be obtained via FTP. 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 software directly from a specific server as follows: CIO FIELD OFFICE FTP ADDRESS DIRECTORY ---------------- ------------------------- -------------------- Albany ftp.fo-albany.med.va.gov [anonymous.software] Hines ftp.fo-hines.med.va.gov [anonymous.software] Salt Lake City ftp.fo-slc.med.va.gov [anonymous.software] INSTALLATION INSTRUCTIONS: ========================= This patch is installed as part of multi-patch installation. Patch OR*3*149 is also installed in the same process. Users should not be on the system during installation of this patch. This patch should be installed during non-peak hours to minimize disruption. Installation will take approximately 5 minutes or more, depending on the menu structure at your site. 1. Obtain the file OR_30_173.KID. 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 (KIDS) Menu, select the Installation menu. 4. Use Load a Distribution using OR_30_173.KID when prompted to Enter a Host File name. You may need to prepend a directory name. 5. If given the option to run any Environment Check Routine(s), answer "YES." 6. From this menu, you may then elect to use the following options (when prompted for the INSTALL NAME, enter OR*3.0*173): a. Backup a Transport Global b. Compare Transport Global to Current System c. Verify Checksums in Transport Global 7. When ready, select the Install Packages option (when prompted for the INSTALL NAME, enter CPRS GUI 22.0). 8. When prompted "Want KIDS to Rebuild Menu Trees Upon Completion of Install? Yes//", respond "YES." 9. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//', respond "YES." 10. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', respond YES. When prompted to select the options you would like to place out of order, enter the following: OR OE/RR MENU CLINICIAN CPRS Clinician Menu OR OE/RR MENU NURSE CPRS Nurse Menu OR OE/RR MENU WARD CLERK CPRS Ward Clerk Menu OR CPRS GUI CHART 11. When prompted 'Delay Install (Minutes): (0-60): 0//; respond '0.' 12. If routines were unmapped as part of step 2, they should be returned to the mapped set once the installation has run to completion. 13. Following successful installation, the pre/post-install routines ORY149 and ORY173 may be deleted. 14. Retrieve and open the file OR_30_173.ZIP. 15. Place the User and Technical Manual files in a location that can be accessed by CPRS users. 16. Move the CPRSChart.exe and help files to the appropriate directory where they can be accessed by all CPRS workstations. Routine Information: ==================== Routine Name: - ORQQPL Routine Checksum: Routine Name: - ORQQPL1 Routine Checksum: Routine Name: - ORQQPL3 Routine Checksum: Routine Name: - ORWPCE Routine Checksum: Routine Name: - ORWPCE2 Routine Checksum: Routine Name: - ORWPS Routine Checksum: Routine Name: - ORWORB Routine Checksum: Routine Name: - ORB31 Routine Checksum: Routine Name: - ORQORB Routine Checksum: Routine Name: - ORCACT0 Routine Checksum: Routine Name: - ORPRF Routine Checksum: Routine Name: - ORQQPXRM Routine Checksum: Routine Name: - ORWDPS4 Routine Checksum: Routine Name: - ORWTPD Routine Checksum: Routine Name: - ORY173 Routine Checksum: Routine Name: - ORB3MGR1 Routine Checksum: Routine Name: - ORB3REC Routine Checksum: Routine Name: - ORWTPL Routine Checksum: Routine Name: - ORWTPR Routine Checksum: Routine Name: - ORQPTQ11 Routine Checksum: ============================================================================= User Information: Entered By : SHARP,PAUL Date Entered : JAN 30, 2003 Completed By: INSLEY,MARCIA Date Completed: AUG 11, 2003 Released By : STRONG,NICK Date Released : AUG 11, 2003 ============================================================================= Packman Mail Message: ===================== No routines included