$TXT Created by ANWER,MOHAMED at MAIVAA.FO-BIRM.MED.VA.GOV (KIDS) on Tuesday, 02/10/04 at 14:28 ============================================================================= Run Date: MAY 13, 2004 Designation: PSO*7*157 Package : PSO - OUTPATIENT PHARMACY Priority: Mandatory Version : 7 SEQ #149 Status: Released Compliance Date: JUN 14, 2004 ============================================================================= Associated patches: (v)PSO*7*120 <<= must be installed BEFORE `PSO*7*157' (v)PSO*7*137 <<= must be installed BEFORE `PSO*7*157' (v)PSO*7*139 <<= must be installed BEFORE `PSO*7*157' Subject: COMBAT VETERANS PHASE II PROJECT Category: - Routine - Data Dictionary - Enhancement (Mandatory) Description: ============ ***********************************NOTE*********************************** This patch does NOT conflict with CoreFLS and can be installed at CoreFLS sites. ************************************************************************** PATCH OVERVIEW The Chief Business Office (CBO) is requesting modifications to several Veterans Health Information Systems and Technology Architecture (VistA) packages to support implementation of VHA Directive 2002-049 - "Combat Veterans Are Eligible For Medical Services For 2-Years After Separation From Military Service Notwithstanding Lack Of Evidence For Service Connection", which iterates VA's policy to provide medical care and other medical services to combat veterans despite the absence of proof of service connection. Software to support the Combat Veteran (CV) initiative is being developed and introduced in a phased implementation strategy. The reason for this type of deployment is due to the complexity of the functionality and the number of product line dependencies. Phase I: Combat Veteran Interim Solution (CVIS) was a VistA only solution that involved development in the Integrated Billing (IB) and Registration/Enrollment product lines. It provided the logic to identify those veterans who met the criteria for the combat veteran eligibility and provided billing reports cross-referenced against this identifier to aid in the copayment billing process. Phase II of this initiative will involve multiple product lines and additional VistA only development. The main goals of Phase II will be to fully automate the copayment billing processing of combat vets based on episode of care by providing the appropriate questions at check-out as supplied by CPRS. Product lines that have a stake in Phase II development include Enrollment/Registration (VistA), IB, Outpatient Pharmacy, Consolidated Mail Outpatient Pharmacy (CMOP), CPRS/TIU, Patient Care Encounter (PCE), Ambulatory Care, Event Capture, Scheduling and PTF. The National Patient Care Database (NPCD) will also require modifications to capture workload reporting. The patches are listed below in the order that they must be installed: Outpatient Pharmacy PSO*7*157 PSX*2*50 PCE/PTF/Event Capture/Scheduling - PIMS Host file PX*1.0*130 SD*5.3*325 DG*5.3*565 EC*2.0*54 Integrated Billing IB*2.0*247 CPRS OR*3.0*190 Product Features There are three main areas addressed by this enhancement: a. Identification/Notification of a CV Status veteran seeking medical care - The clinical applications shall obtain the CV Status for those veterans who qualify as such per the directive. - The CV Status identification shall be displayed to the appropriate audience (pharmacist, clinician providing care, intake personnel, schedulers, etc.). - Provider shall be able to identify whether care provided CV veteran was for a condition potentially related to combat service in the same manner as identification of exposure related care; care for SC conditions, etc. b. Assistance in the communication of a treatment being determined as Combat Related - Provide a means for the billing and pharmacy software package to identify these patients and services provided care for a combat related condition. c. Automatically precludes inpatient and outpatient medical care, prescription and Long-term care copayments for CV Status veterans whose treatment/service has been deemed combat related by provider or unless changed by pharmacist. This is the Outpatient Pharmacy patch PSO*7*157 that provides the functionality changes to accommodate the new copay classification called "Combat Veteran". 1. For the following options, when creating a new order, renewing an existing order, copying an existing order to a new order, or editing an existing order that results in a new order, the copay status of the prescription needs to be determined for billing purposes. a. Patient Prescription Processing [PSO LM BACKDOOR ORDERS] b. TPB Rx (Prescription) Entry [PSO TPB RX ENTRY] c. Barcode Batch Prescription Entry [PSO BATCH BARCODE] d. Complete Orders from OERR [PSO LMOE FINISH] Depending on the patient eligibility, the software currently provides the following copay exemption questions to the pharmacist during prescription finishing process: "Is this Rx for treatment of Vietnam-Era Herbicide (Agent Orange) exposure?" "Is this Rx for treatment of ionizing radiation exposure?" "Is this Rx for treatment of environmental contaminant exposure during the Persian Gulf War?" "Is this Rx for treatment of Military Sexual Trauma?" "Is this Rx related to treatment of Head and/or Neck Cancer?" and/or Neck Cancer veterans; To fulfill the Directive 2002-049, this patch will add the following Combat Veteran (CV) copay exemption question to the current copay list: "Is this Rx potentially for treatment related to Combat?" In the event that a patient is eligible for more than one copay exemption, the CV prompt will be presented to the pharmacist first. A 'YES' or 'NO' response will be stored in the COMBAT VETERAN field (#122) of the PRESCRIPTION file (#52). This is a new field introduced in this patch. 2. The Integration Agreement (IA) 2534 provides CPRS the copay related questions that need to be asked during the outpatient medication order entry process. This IA is modified to include the CV copay classification, if applicable. 3. The PENDING OUTPATIENT ORDERS file (#52.41) that stores the pharmacy orders (new/renew) entered via CPRS is modified to include the provider's response to the CV question. The provider's response will be stored in the COMBAT VETERAN field (#110.1) of the PENDING OUTPATIENT ORDERS file (#52.41). The COMBAT VETERAN field (#110.1) is a new field introduced in this patch. 4. During the release of a prescription, medication copay exemptions are re-evaluated to see if there is a change in the billing status. This logic is modified to include the CV copay classification. If a copay exemption question applies and is unanswered, a MailMan message is generated. This message is sent to the pharmacist, ordering provider, and holders of the PSO COPAY key, to get answers to the exemption questions and reset the prescription copay status if needed, using the Reset Copay Status/Cancel Charges [PSOCP RESET COPAY STATUS] option . 5. The Reset Copay Status/Cancel Charges [PSOCP RESET COPAY STATUS] option is modified to include the CV copay classification wherever applicable. 6. During label printing of a prescription, if a prescription is deemed billable then the software does a check on the following copay exemption fields of the PRESCRIPTION file (#52): 117 MILITARY SEXUAL TRAUMA 118 AGENT ORANGE EXPOSURE 119 IONIZING RADIATION EXPOSURE 120 ENVIRONMENTAL CONTAMINANT 121 HEAD AND/OR NECK CANCER 122 COMBAT VETERAN If the prescription is identified as copay exempt, the software will print "NO COPAY". Associated NOISs: ================= N/A Test Sites: =========== ALTOONA, PA HEARTLAND-WEST, KS MADISON, WI NEW YORK HARBOR HCS, NY NORTH TEXAS HCS, TX GREATER LOS ANGELES HCS, CA EL PASO, TX 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 Patch List ======================================================================== PSOCP 19725930 20178669 20,46,71,85,137,157 PSOCPC 24142718 25365048 10,9,71,85,114,157 PSOCPE 24639841 24658364 26,71,85,114,157 PSOHLNE1 24228465 24391034 1,9,46,71,98,111,117,131,157 PSOHLSN1 30766487 31152888 1,10,24,27,55,46,71,101,99,121,139,157 PSOHLSNC 16696539 17086440 111,157 PSOLBL 33806965 34084741 8,19,30,36,47,71,92,120,157 PSOLLLI 24917671 25195447 120,157 PSOMLLDT 30092800 33319253 71,157 PSON52 23156382 23311220 1,16,23,27,32,46,71,111,124,117,131, 139,157 PSONEW2 12656594 13009435 32,37,46,71,94,124,139,157 PSONEWF 10996562 12417539 71,157 PSONEWG 9971091 10932930 71,157 PSOPTPST 14299906 14412045 7,71,88,146,157 PSORENW1 22585409 23659551 20,37,51,46,71,117,157 PSORN52 27815524 27909127 1,11,27,37,46,79,71,100,117,157 PSORN52A N/A 1743097 157 Documentation Retrieval: ======================== The VISTA documentation is available on the ANONYMOUS.SOFTWARE directory at one of the following Office of Information (OI) Field Offices. Sites may retrieve documentation in one of the following ways: (1) The preferred method is to FTP the files from download.vista.med.va.gov, which will transmit the files from the first available FTP server. (2) 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 documentation distribution includes: FILE NAME DESCRIPTION PSO_7_UM_R0504.PDF User Manual PSO_7_P157_UM_CP.PDF User Manual Change Pages Document PSO_7_TM_R0504.PDF Technical Manual PSO_7_P157_TM_CP.PDF Technical Manual Change Pages Document PSO_7_P157_and_PSX_2_P50_RN.PDF CV Release Notes Phase II (3) Documentation can also be retrieved from VISTA Documentation Library (VDL) on the Internet at the following address, http://www.va.gov/vdl. Installation Instructions: ========================== Before installing this patch, use the List Tasks [XUTM INQ] option on the Taskman Management [XUTM MGR] menu to list currently running tasks. This patch should be installed when there are no Outpatient Pharmacy users on the system, and also when Outpatient Pharmacy orders are not being acted upon through Computerized Patient Record System (CPRS). Installation of this patch should take no longer than 5 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*157) 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*157. 6. When prompted, "Queue the Post-Install to run at what Date@Time:" respond with the appropriate date and time. 7. When prompted, "Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//" respond NO. 8. When prompted, "Want KIDS to INHIBIT LOGONs during the install? YES//" respond NO. 9. When prompted, "Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//" respond NO. 10. When prompted,"Device:Home//" respond with the correct device and DO NOT queue this to P-Message. 11. 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: - PSOCP Routine Checksum: Routine Name: - PSOCPC Routine Checksum: Routine Name: - PSOCPE Routine Checksum: Routine Name: - PSOHLNE1 Routine Checksum: Routine Name: - PSOHLSN1 Routine Checksum: Routine Name: - PSOHLSNC Routine Checksum: Routine Name: - PSOLBL Routine Checksum: Routine Name: - PSOMLLDT Routine Checksum: Routine Name: - PSON52 Routine Checksum: Routine Name: - PSONEW2 Routine Checksum: Routine Name: - PSONEWF Routine Checksum: Routine Name: - PSONEWG Routine Checksum: Routine Name: - PSOPTPST Routine Checksum: Routine Name: - PSORENW1 Routine Checksum: Routine Name: - PSORN52 Routine Checksum: Routine Name: - PSOLLLI Routine Checksum: Routine Name: - PSORN52A Routine Checksum: ============================================================================= User Information: Entered By : ANWER,MOHAMED Date Entered : NOV 05, 2003 Completed By: COSTELLO,KELLY ANNE Date Completed: MAY 12, 2004 Released By : KIMBLE,BRUCE Date Released : MAY 13, 2004 ============================================================================= Packman Mail Message: ===================== $END TXT