$TXT Created by ROCHA,MARCELO at LAWVAA.FO-BIRM.MED.VA.GOV (KIDS) on Wednesday, 12/31/03 at 08:57 ============================================================================= Run Date: JAN 07, 2004 Designation: PSO*7*160 Package : PSO - OUTPATIENT PHARMACY Priority: Mandatory Version : 7 SEQ #142 Status: Released Compliance Date: JAN 12, 2004 ============================================================================= Associated patches: (v)PSO*7*145 <<= must be installed BEFORE `PSO*7*160' Subject: TPB RX FLAG CLEANUP/PATIENT INACTIVATION/NEW REPORT Category: - Routine - Data Dictionary - Other Description: ============ This is the Outpatient Pharmacy patch for the Transitional Pharmacy Benefit (TPB) project. This patch consists of automated processes and additional tools designed to assist the sites for which Transitional Pharmacy Benefit data have not been accurately reported. Two of the most common events that have contributed to the discrepancies in the TPB data are: a) TPB prescriptions have been entered for TPB eligible patients via the wrong Outpatient Pharmacy prescription processing options, such as the Patient Prescription Processing [PSO LM BACKDOOR] option and Complete Orders from OERR [PSO LMOE FINISH] option. b) Patients who did not wish to take advantage of the TPB benefit or who are not prescribed medication after a VA appointment are still active for the TPB benefit in the system. The inactivation of the TPB benefit is automatic when the last active TPB prescription is discontinued either through an Outpatient Pharmacy package action or through an action taken in CPRS. The entry of a prescription/order will not inactivate the benefit unless the result is that the last active TPB prescription is discontinued as a result of the new entry. This patch is comprised of four components that will help the sites identify and fix the data discrepancies described above. It will also provide them with new tools to monitor events that could have an impact on patient's TPB eligibility. In some cases the patient's TPB eligibility will be updated automatically. Below is a detailed description of each component: 1) MARKING TPB PATIENT Rx's AS TPB (ONE-TIME PROCESS - POST INSTALL) ----------------------------------------------------------------- Problem: Because some prescriptions have been entered through the wrong menu options (see item a) above), these Rx's have not been correctly identified as TPB prescriptions. In other words, they have a different patient status than "NON-VA" AND do not contain a TPB flag in PRESCRIPTION file (#52), and therefore, are not identifiable as prescriptions filled under the TPB program. Solution: A Post-Install process will search for prescriptions filled under the TPB program which are not marked as such and will mark these prescriptions as TPB. The two requisites that must be fulfilled for a prescription to be marked as TPB, are: a) The prescription was entered during the period that the patient's TPB benefit was active. AND b) The provider for the prescription is a "NON-VA" provider. If the requisites above are fulfilled, the following updates will be done for the prescription: a) Patient status will be changed to "NON-VA". b) If an UNIQUE TPB clinic is identified (STOP CODE equals 161) for the site, clinic will be changed to this clinic. c) The TPB flag will be set in PRESCRIPTION file (#52). Report: At the end of this process, a Mailman message will be sent to the newly created mail group called PSO TPB GROUP. The patients reported on this message had at least one Prescription edited by the Post-Install process. The sites will have the ability to enter the coordinator of this new mail group at time of installation of this patch. Even if the coordinator is not entered, this patch assures that at least the installer of the patch is a member of the mail group. The fields reported on this Mailman message are: PATIENT NAME(LAST4SSN), Rx#, DRUG NAME, PROVIDER NAME, CLINIC (Old and New) and the Rx PATIENT STATUS (Old and New). Important: If the site identifies prescriptions on this report that have been wrongly flagged as TPB, it is possible to manually remove the TPB flag from such prescriptions through FileMan. Just repeat the steps below for each prescription you wish to remove the TPB flag (as in this example): VA FileMan 22.0 Select OPTION: ENTER OR EDIT FILE ENTRIES INPUT TO WHAT FILE: PRESCRIPTION EDIT WHICH FIELD: ALL// TPB RX THEN EDIT FIELD: Select PRESCRIPTION RX #: 123457690A TYLENOL 250MG TPB RX: YES// @ SURE YOU WANT TO DELETE? Y (Yes) 2) INACTIVATING PATIENT'S TPB BENEFIT (ONE-TIME PROCESS - POST INSTALL) -------------------------------------------------------------------- Problem: Since not all patients eligible for the TPB program chose to take advantage of the TPB benefit or, after seeing the VA provider the patient was not prescribed any medication, his/her TPB eligibility remained active, when in reality it should have been inactivated. Solution: A Post-Install process will search for TPB eligible patients and automatically inactivate the TPB eligibility of the patients that fulfill both of the following requisites: a) Patient does not have any "active" TPB prescription(s) on file. The prescription statuses considered as "active" are the following: ACTIVE, NON-VERIFIED, HOLD, DRUG INTERACTIONS, SUSPENDED and PROVIDER HOLD. AND b) Patient has had an appointment at a designated TPB Clinic (determined through a set of clinic stop codes) since the date his/her TPB benefit began. Report: At the end of this process, a Mailman message will be sent to the new mail group PSO TPB GROUP. The patients reported on this message were inactivated as TPB patients by the Post-Install process. The fields reported on this message are: PATIENT NAME, LAST 4 DIGITS OF SSN, APPOINTMENT DATE/TIME, VA CLINIC NAME. 3) PATIENT'S TPB BENEFIT INACTIVATION (ENHANCEMENT - CONTINUOUS PROCESS) --------------------------------------------------------------------- Outpatient Pharmacy software will be notified by the Scheduling software every time a patient has an appointment at a VA clinic. If the patient is eligible for the TPB benefit, the appointment was at a clinic defined as primary care for the TPB program (determined through a set of clinic stop codes) AND the patient does not have any "active" (see list of statuses on item #2a above) TPB prescription(s) on file, this patient will have the TPB eligibility automatically inactivated. The TPB primary care clinics are identified by the stop code pairs listed below: 322000 322185 322186 322187 323000 323185 323186 323187 350000 350185 350186 350187 A Mailman message will be sent to the PSO TPB GROUP mail group with the following information: The following patient had the TPB (Transitional Pharmacy Benefit) Benefit automatically inactivated because the following appointment was found: Patient : LAST,FIRST(9999) VA Clinic : EAST MIDWAY CLINIC Appointment Date: DEC 02, 2003@11:15 4) REPORT OF PATIENTS WITH TPB AND NON-TPB Rx's (NEW REPORT) [PSO TPB PATIENT RX REPORT] --------------------------------------------------------- This new report is being released as a stand-alone option. It will print a list of TPB eligible patients that have "active" TPB and Non-TPB prescriptions on file. The report can be printed for ALL or selected institutions, as well as for ALL or selected TPB patients. It will be sorted by the INSTITUTION NAME first, then by the PATIENT NAME. There will be a page-break for each individual institution. The column headings on the report are: PATIENT NAME (LAST4SSN), VA Rx#, TPB Rx#, DRUG NAME. This option should be assigned to the site TPB Coordinator, Pharmacy ADPAC and any other individual deemed appropriate by the site. In order to allow the unflagging of TPB prescriptions as described in 1) above, the TPB RX (#201) field in the PRESCRIPTION (#52) file is being changed from "UNEDITABLE" to "EDITABLE". Associated NOISs: ================= SPO-1203-50765 Test Sites: =========== PITTSBURGH HCS, PA WHITE RIVER JUNCTION, VT FAYETTEVILLE, NC SPOKANE, WA MINNEAPOLIS, MN Routine Summary: ================ The second line now reads as follows: ;;7.0;OUTPATIENT PHARMACY;**[patch list]**;DEC 1997 CHECK^XTSUMBLD results: Routine Before Patch After Patch List ================================================================= PSO160DR N/A 3995690 160 PSO160EN N/A 5087988 160 PSO160P1 N/A 11476050 160 PSO160P2 N/A 4782108 160 PSOTPCUL 76885 1239082 145,160 PSOTPINA N/A 2992949 160 PSOTPRP1 N/A 7084493 160 Installation Instructions: ========================== Users can be on the system at the time of installation but it is recommended to perform this installation after normal business hours. Installation will take about 15 minutes. 1. Use the INSTALL/CHECK MESSAGE option on the PackMan menu. 2. Review your mapped set. If the routines are mapped, they should be removed from the mapped set at this time. 3. From the Kernel Installation & Distribution System menu, select the Installation menu. 4. From this menu, you may select to use the following options: (when prompted for INSTALL NAME, enter PSO*7.0*160) a. Backup a Transport Global - this option will create a backup message of any routines exported with the patch. It will NOT backup any other changes such as DDs or templates. b. Compare Transport Global to Current System - this option will allow you to view all changes that will be made when the patch is installed. It compares all components of the patch (routines, DDs, templates, etc.). c. Verify Checksums in Transport Global - this option will ensure the integrity of the routines that are in the transport global. 5. Use the Install Package(s) option and select the package PSO*7.0*160. 6. When prompted, "Queue the Post-Install to run at what Date@Time:" respond with the appropriate date and time. 7. When prompted "Enter the Coordinator for Mail Group 'PSO TPB GROUP'", enter the name of the Transitional Pharmacy Benefit (TPB) coordinator at your site. Once the patch is installed, the coordinator should add as new members of this mail group the appropriate users. 8. When prompted "Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//" respond NO. 9. When Prompted "Want KIDS to INHIBIT LOGONs during the install? YES//" respond NO. 10. When Prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//" respond NO. 11. When prompted,"Device:HOME//" respond with the correct device and DO NOT queue this to P-Message. 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. Assign stand alone option [PSO TPB PATIENT RX REPORT] to site TPB Coordinator, Pharmacy ADPAC and any other individual designated to review eligibility of patients for the TPB program. Routine Information: ==================== Routine Name: - PSO160EN Routine Checksum: Routine Name: - PSO160DR Routine Checksum: Routine Name: - PSO160P1 Routine Checksum: Routine Name: - PSO160P2 Routine Checksum: Routine Name: - PSOTPCUL Routine Checksum: Routine Name: - PSOTPINA Routine Checksum: Routine Name: - PSOTPRP1 Routine Checksum: ============================================================================= User Information: Entered By : ROCHA,MARCELO Date Entered : NOV 24, 2003 Completed By: NEVEU,MIKE Date Completed: JAN 06, 2004 Released By : BARRON,LUANNE Date Released : JAN 07, 2004 ============================================================================= Packman Mail Message: ===================== $END TXT