$TXT Created by ELLZEY,LINDA J at DEVVII.FO-ALBANY.MED.VA.GOV (KIDS) on Wednesday, 10/19/05 at 18:18 ============================================================================= Run Date: NOV 15, 2005 Designation: PSO*7*219 Package : PSO - OUTPATIENT PHARMACY Priority: Mandatory Version : 7 SEQ #193 Status: Released Compliance Date: DEC 16, 2005 ============================================================================= Associated patches: (v)PSO*7*143 <<= must be installed BEFORE `PSO*7*219' Subject: CIDC - OUTPATIENT PHARMACY FOLLOW UP PATCH Category: - Routine - Enhancement (Mandatory) Description: ============ This patch is a follow up for Outpatient Pharmacy Clinical Indicator Data Capture (CIDC) patch PSO*7*143. Functional Description: ---------------------- This Outpatient Pharmacy patch PSO*7*219 corrects the following issues: 1. The Application Program Interface (API) that is provided to Computerized Patient Record System (CPRS) with the service connection (SC) and environmental indicator (EI) questions was not set correctly for non service connected (NSC) patients, as a result the following issues were reported: a. In CPRS, the SC related questions were incorrectly prompted for NSC patients, and it should not have done so. It should prompt SC/EI question only if applicable (remedy ticket 114219). b. Holders of the PSO COPAY key, the ordering provider, and the finishing pharmacist were receiving increased volumes of mailman messages in Outpatient Pharmacy. Mailman messages were incorrectly sent for NSC patients upon refill, new, and renewed orders (remedy ticket 114219). These messages have been eliminated. Mailman messages will or will not be generated for the following scenarios: SC percentage changed to E/I question Type to >0% added? Mailman Message sent? --------- -------------- ------------- ------------------------- NSC N N N NSC N Y Y only if question was not answered before the prescription is released NSC Y N/A Y if question was not answered before the prescription is released SC=>0%<50% N/A Y Y however, NO mailman message will be sent if any SC/EI = YES on the original prescription For SC>50% prescriptions and if patient has a new SC/EI added, the appropriate questions will be asked upon RENEW or COPY of the original prescription. At release, a MailMan message will not be sent if the patient, patient status, or drug is exempt from copay. Because the information requested by these Mailman messages are used to determine the final VA copay and/or insurance billable status, the text and format has changed. The subject line was changed from "RX COPAY STATUS REVIEW NEEDED" to "PRESCRIPTION QUESTIONS REVIEW NEEDED" and the body of the message has additional information. Also, the eligibility and disability information is now included after the patient name. The following is an example: Subj: PRESCRIPTION QUESTIONS REVIEW NEEDED (800) [#164897] 10/07/05@13:39 37 lines From: OUTPATIENT PHARMACY PACKAGE In 'IN' basket. Page 1 *New* ------------------------------------------------------------------------- PATIENT,TEST (XXXX) Eligibility: SC LESS THAN 50% SC%: 10 REIMBURSABLE INSURANCE Disabilities: ARTHRITIS-10%(SC), FOREARM CONDITION-5%(NSC), FOREARM CONDITION-4%(NSC), BENIGN EYE GROWTH-0%(NSC), LOSS OF FIELD OF VISION-20%(SC), Rx# #######B (1) NO COPAY AMITRIPTYLINE 100MG Due to a change in criteria, additional information listed below is needed to determine the final VA copay and/or insurance billable status for this Rx so that appropriate action can be taken by pharmacy personnel. Is this Rx for a Service Connected Condition? This message has been sent to the provider of record, the pharmacist who finished the prescription order, and all holders of the PSO COPAY key. Providers: Please respond with your answer to the question(s) as a reply to this message. The prescription will be updated by the appropriate staff. Staff assigned to update the Prescription responses: Please use the RESET COPAY STATUS/CANCEL CHARGES option to enter the responses to the questions above, which may result in a Rx copay status change and/or the need to remove VA copay charges or may result in a charge to the patient's insurance carrier. Note: The SC question is now asked for Veterans who are SC>49% in order to determine if the Rx can be billed to a third party insurance. These Veterans will NOT be charged a VA copay. Supply and investigational drugs are not charged a VA copay but could be reimbursable by third party insurance. Enter message action (in IN basket): Ignore// c. In CPRS, SC/EI related questions were not asked for supply items and investigational drugs (remedy ticket 113764). CPRS and backdoor Outpatient Pharmacy users will be required to complete SC/EI questions for supplies and investigational drugs. Supply items and investigational drugs could be reimbursable by third party insurance. Also, a VA copay will not be charged for these. 2. During use of Complete Orders from OERR option [PSO LMOE FINISH], the default answers for SC/EI's for CPRS SC>50% renewed orders were occasionally displaying the previous orders answers during the finish process. A modification was made to display the SC/EI information entered during the CPRS renewal process. This anomaly was encountered during unit testing, and there is no associated remedy ticket. 3. For renewal orders in Complete Orders from OERR option [PSO LMOE FINISH] and Patient Prescription Processing option [PSO LM BACKDOOR ORDERS], a message was erroneously displayed after the SC/EI prompts for SC>50% prescriptions. The following is an example of the message displayed when eligibility is changed or the user enters an up arrows (^) at an outpatient classification prompt. Note that the bracketed information can be SERVICE CONNECTED or NON SERVICE CONNECTED depending upon the user's response to the question. Or if the user up arrows (^) out of the prompt, the default answer determines the value. Was treatment for a Service Connected condition? YES// ^ This Renewal has been designated as [SERVICE CONNECTED] Please use the 'Reset Copay Status/Cancel Charges' option to make corrections. The "Please use the 'Reset Copay Status/Cancel Charges' option to make corrections" sentence will no longer be displayed for supply items, investigational drugs, and SC>50% patients. The first sentence will remain in order to continue to inform the user of the answer stored for the prompt. Note that similar messages are displayed for environmental indicator prompts and this change applies to them. The associated remedy tickets are 113931. 4. For CPRS prescription orders finished using the Complete Orders from OERR option [PSO LMOE FINISH] or the Patient Prescription Processing option [PSO LM BACKDOOR ORDERS], a copay related message was displayed for SC>50% patients, supply items and investigational drugs. The following is an example, and please note that bracketed information can be either COPAY or NO COPAY depending on the providers response to the clinical indicator. Do you want to enter a Progress Note? No// NO SC Percent: 40% Disabilities: NONE STATED This Rx has been flagged by the provider as: [NO COPAY] Was treatment for Service Connected condition? YES The "This Rx has been flagged by the provider as: [COPAY/NO COPAY]" message will no longer be displayed for SC>50% patients, supply items, and investigational drugs. There is no associated remedy ticket. 5. When an edit that creates a new order is performed in Outpatient Pharmacy, a message is displayed to notate that the orderable item was changed. This message is displayed in the Complete Orders from OERR [PSO LMOE FINISH] option and the Patient Prescription Processing option [PSO LM BACKDOOR ORDERS]. The following is an example: CARBAMAZEPINE 100MG TAB PROVIDER,NAME PROVIDER,NAME # of Refills: 3 The Pharmacy Orderable Item has changed for this order. Please review any existing medication copay exemption defaults carefully for appropriateness. SC Percent: 40% Disabilities: NONE STATED Was treatment for Service Connected condition? YES// The above message has been modified to the following: The Pharmacy Orderable Item has changed for this order. Please review any existing SC or Environmental Indicator defaults carefully for appropriateness. Technical Description: ---------------------- The following correlates to each sequence in the Functional Description above and the routines modified are shown in parentheses by each function: 1. The SCNEW^PSOCP API provided to obtain the SC/EI questions to ask during prescription order etnry was modified to return correct information for NSC patients. By doing so, the following issues were eliminated. a. The SCNEW^PSOCP API was modified to not return the PSOTG("SC")="" variable for NSC patients. When a null value was previously returned, CPRS was erroneously prompting for SC on NSC patients. b. Backdoor Outpatient Pharmacy uses the SCNEW^PSOCP API during the release of a prescription. Because the null value was returned on NSC patients, Mailman messages for "RX COPAY STATUS REVIEW NEEDED" information was sent in error for NSC prescriptions at release of the prescription. These issues were corrected with the elimination of the null retuned value for the PSOTG("SC") variable, and the PSOCPE routine was modified to show the patient's eligibilities and disabilities as well as impart more accurate information. Also, the subject line of the Mailman message changed to "PRESCRIPTION QUESTION REVIEW NEEDED". c. For supply items and investigational drugs, the SCNEW^PSOCP API was modified to return the SC/EI questions that are flagged for the veteran in enrollment to be asked during the prescription order process. These types of prescriptions could be reimburseable by third party insurance. 2. Modified renewal routines to always pull default SC/EI answers from the data passed on the renewed order from CPRS (PSORENW1, PSORN52, PSORN52D). This change affects renewals from CPRS and backdoor Outpatient Pharmacy orders. 3. For SC>50% prescriptions, supply items and investigational drugs, eliminated the display of "Please use the 'Reset Copay Status/Cancel Charges' option to make corrections." sentence (PSOCPB, PSOMLLD2, PSOMLLDT), but it will continue to be displayed for SC<50% prescriptions. 4. For SC>50% prescriptions, supply items and investigational drugs, eliminated the display of "This Rx has been flagged by the provider as: [COPAY/NO COPAY]" (PSOCPB, PSONEWF, PSORN52). This message will continue to be displayed for SC<50% patients. 5. For SC 0-100%, supply items and investigational drugs, modified the wording of the message displayed when a prescription edit that creates a new order is performed (PSOCPB, PSONEWF, PSONEWG). Associated New Service Request (NSR): ===================================== N/A Associated Remedy Ticket(s): ============================ HD0000000114318, HD0000000114219, HD0000000113931, HD0000000113764, HD0000000119997 Associated E3Rs: =========== 18553, 18602 Test Sites: =========== PUGET SOUND, WA CLEVELAND, OH PALO ALTO, CA 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 21661953 21618068 20,46,71,85,137,157,143,219 PSOCPB 31027202 31710625 72,71,85,185,143,219 PSOCPE 24658364 29757281 26,71,85,114,157,219 PSODIAG 21941710 21605445 143,219 PSOMLLD2 13355955 17414283 143,219 PSOMLLDT 35516592 36947396 71,157,143,219 PSON52 23955816 23766769 1,16,23,27,32,46,71,111,124,117 131,139,157,143,219 PSONEWF 23064279 24667753 71,157,143,219 PSONEWG 12548314 13204704 71,157,143,219 PSOORED6 21715596 21652179 78,104,117,133,143,219 PSORENW1 25063940 25287539 20,37,51,46,71,117,157,143,219 PSORN52 28512387 28547147 1,11,27,37,46,79,71,100,117,157, 143,219 PSORN52D 26941168 21621894 143,219 Total number of routines: 13 File Summary: ============= N/A Field Summary: ============== N/A Installation Instructions: ========================== Do not install this patch while Outpatient Pharmacy users are on the system or when Outpatient Pharmacy orders are being entered and signed through CPRS. Installation will take no longer than 5 minutes. Suggested time to install: During non-peak. 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*219) 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 allow you to ensure the integrity of the routines that are in the transport global. d. Print Transport Global - this option will allow you to view the components of the KIDS build. 5. Use the Install Package(s) option and select the package PSO*7.0*219. 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. When prompted,"Device:Home//" respond with the correct device and DO NOT queue this to P-Message. 9. If routines were unmapped as part of step 2 (DSM for Open VMS sites only), they should be returned to the mapped set once the installation has run to completion. Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSOCP Before: B75761381 After: B75128860 **20,46,71,85,137,157,143,219** Routine Name: PSOCPB Before: B84161951 After: B82075464 **72,71,85,185,143,219** Routine Name: PSOCPE Before: B58851917 After: B79963827 **26,71,85,114,157,219** Routine Name: PSODIAG Before: B62047244 After: B63400905 **143,219** Routine Name: PSOMLLD2 Before: B18143810 After: B22361376 **143,219** Routine Name: PSOMLLDT Before: B85011495 After: B88490307 **71,157,143,219** Routine Name: PSON52 Before: B58027930 After: B56762334 **1,16,23,27,32,46,71,111,124, 117,131,139,157,143,219** Routine Name: PSONEWF Before: B42076489 After: B44037297 **71,157,143,219** Routine Name: PSONEWG Before: B21031672 After: B21775279 **71,157,143,219** Routine Name: PSOORED6 Before: B52070560 After: B51610545 **78,104,117,133,143,219** Routine Name: PSORENW1 Before: B54536370 After: B55639962 **20,37,51,46,71,117,157,143,219** Routine Name: PSORN52 Before: B69149232 After: B69065416 **1,11,27,37,46,79,71,100,117, 157,143,219** Routine Name: PSORN52D Before: B50476982 After: B45252333 **143,219** ============================================================================= User Information: Entered By : ELLZEY,LINDA Date Entered : AUG 31, 2005 Completed By: LYNCH,MARY F. Date Completed: NOV 15, 2005 Released By : CONSENTINO,ALBERT Date Released : NOV 15, 2005 ============================================================================= Packman Mail Message: ===================== $END TXT