$TXT Created by ANWER,MOHAMED at CMAI.FO-BIRM.MED.VA.GOV (KIDS) on Monday, 07/31/06 at 10:14 ============================================================================= Run Date: SEP 19, 2006 Designation: PSO*7*222 Package : PSO - OUTPATIENT PHARMACY Priority: Mandatory Version : 7 SEQ #217 Status: Released Compliance Date: OCT 20, 2006 ============================================================================= Associated patches: (v)PSO*7*73 <<= must be installed BEFORE `PSO*7*222' (v)PSO*7*122 <<= must be installed BEFORE `PSO*7*222' (v)PSO*7*126 <<= must be installed BEFORE `PSO*7*222' (v)PSO*7*148 <<= must be installed BEFORE `PSO*7*222' (v)PSO*7*177 <<= must be installed BEFORE `PSO*7*222' (v)PSO*7*184 <<= must be installed BEFORE `PSO*7*222' (v)YS*5.01*90 <<= must be installed BEFORE `PSO*7*222' (v)PSO*7*227 <<= must be installed BEFORE `PSO*7*222' (v)PSO*7*237 <<= must be installed BEFORE `PSO*7*222' Subject: CLOZAPINE ENHANCEMENTS Category: - Routine - Enhancement (Mandatory) - Data Dictionary Description: ============ The Department of Veterans Affairs National Clozapine Coordinating Center (NCCC), is requesting modifications to Veterans Health Information Systems and Technology Architecture (VistA) Outpatient Pharmacy and Mental Health applications to meet revisions in the Food and Drug Administration (FDA) monitoring requirements for blood monitoring in patients being treated with Clozapine. This patch PSO*7*222 is associated with the MENTAL HEALTH V. 5.01 patch YS*5.01*90 and patch YS*5.01*90 is a required patch for PSO*7*222. Please read the patch description of YS*5.01*90 for complete details of this new enhancement. This Outpatient Pharmacy patch PSO*7*222 contains the following must-do-work enhancements for Clozapine dispensing: 1. Adjust the business rules to disallow prescription processing without override if 3500/mm3>WBC>3000/mm3 and 2000/mm3>ANC>1500/mm3. These levels require twice weekly blood testing until the WBC stabilizes above 3500/mm3 and ANC above 2000/mm3 with no signs of infection. 2. Modify routine logic to recognize the new monthly status and apply the appropriate restrictions for lab draw checks. 3. Add a new field to the PRESCRIPTION file (#52) to store ANC value and modify routine logic to require both a WBC and ANC be drawn and reported before drug dispensing is allowed. 4. Modify routine logic to prevent local users from editing the Patient Status within Clozapine module. This patch transports the following fields: 1. The field length of the WBC RESULT field (#302) of the PRESCRIPTION file (#52) is modified from 3 to 5 digits to accommodate values up to 99999 as these values will be stored in 1000s. 2. A new field ANC RESULTS field (#304) is added to the PRESCRIPTION file (#52) to store the ANC test value. 3. The field name of REASON FOR LOCKOUT field (#4) of the CLOZAPINE PRESCRIPTION OVERRIDES file (#52.52) is changed to REASON FOR OVERRIDE. The set of codes have been modified and three new codes were added to accommodate the override conditions for the new ANC LAB test. The current Data Dictionary (DD) is as follows: 52.52,4 REASON FOR LOCKOUT 0;5 SET (Required) '1' FOR NO WBC RESULTS IN PREVIOUS 7 DAYS; '2' FOR NO VERIFIED WBC RESULTS IN PREVIOUS 7 D AYS; '3' FOR LAST WBC RESULT LESS THAN 3500; '4' FOR THREE SEQUENTIAL WBC RESULTS DECREASING TO LESS THAN 5000; The modified DD is as follows: 52.52,4 REASON FOR OVERRIDE 0;5 SET (Required) '1' FOR NO WBC IN LAST 7 DAYS; '2' FOR NO VERIFIED WBC; '3' FOR LAST WBC RESULT < 3500; '4' FOR 3 SEQ. WBC DECREASE; '5' FOR LAST ANC RESULT < 2000; '6' FOR 3 SEQ. ANC DECREASE ; '7' FOR NCCC AUTHORIZED; The Outpatient Pharmacy patch PSO*7*227, TRANSITIONAL PHARMACY BENEFIT (TPB) inactivation, was placing the TPB HL7 Data Extract/Transmission [PSO TPB HL7 EXTRACT] option out of order. Sites testing patch PSO*7*227 recommended that we remove this task totally from the OPTION SCHEDULING file (#19.2). Therefore, a post-install routine (PSOP222) is included in this patch PSO*7*222 to delete the TPB HL7 Data Extract/Transmission [PSO TPB HL7 EXTRACT] option from the OPTION SCHEDULING file (#19.2). The post-install routine will also provide the following changes: 1. As the patch PSO*7*227 inactivated the TPB functionality, the security access codes for the TPB ELIGIBILITY file (#52.91) still remains open. These codes will be changed to "@" sign restricting access to programmers only. 2. The read access code of the PRESCRIPTION REFILL REQUEST file (#52.43) is currently set to "@" sign (programmer access). As per the Electronic, Error and Enhancement Report (E3R) 19725 request, this will be changed to "Pp" (Pharmacy Package) access. Associated New Service Request (NSR): ===================================== N/A Associated Remedy Ticket(s): ============================ N/A Associated E3Rs: ================ 19725 Test Sites: =========== OKLAHOMA CITY, OK GREATER LOS ANGELES HCS, CA LOUISVILLE, KY Documentation Retrieval: ======================== The 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_P222_UM_CP.PDF User Manual Change Pages PSO_7_P222_RN.PDF Release Notes PSO_7_P222_TM_CP.PDF OP V. 7.0 Technical Manual/Security Guide Change Pages (3) Documentation can also be retrieved from VistA Documentation Library (VDL) on the Internet at the following address, http://www.va.gov/vdl. 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: ;;7.0;OUTPATIENT PHARMACY;**[patch list]**;DEC 1997 CHECK^XTSUMBLD results Routine Before Patch After Patch Patch List --------- ------------ ----------- ---------- PSOCLO1 36781798 13658060 1,23,37,222 PSOCLUTL 21782417 22293617 28,56,122,222 PSOCPDUP 22889610 20490621 11,27,32,130,132,192,207,222 PSODIR1 25921367 28073176 23,46,78,102,121,131,146,166,184, 222 PSODIR3 11068742 12525060 3,46,184,222 PSODRDUP 28494991 26447273 11,23,27,32,39,56,130,132,192, 207,222 PSOEXDT 3369476 3500987 23,73,222 PSOHELP 24787684 25298823 3,23,29,42,48,46,117,131,222 PSOHELP1 19745306 22539598 23,36,88,146,227,222 PSOORFI1 32311812 32799100 7,15,23,27,32,44,51,46,71,90,108, 131,152,186,210,222 PSOORFI2 34831583 35812279 7,15,23,27,46,130,146,177,222 PSOORNE2 33118731 33149397 11,21,23,27,32,37,46,84,103,117, 131,146,156,210,148,222 PSOORNE5 26418438 27238510 11,27,32,46,78,99,117,131,146,171, 180,210,222 PSOORNEW 34093705 34336756 11,23,27,32,55,46,71,90,94,106, 131,133,143,237,222 PSOORNW1 21300612 21778390 23,46,78,117,131,133,172,148,222 PSOORNW2 21480448 21567427 10,23,37,46,117,131,133,148,222 PSOP222 N/A 915770 222 PSOSIGDS 19665586 19680587 46,222 PSOSIGMX 8119946 9027455 46,78,108,131,222 PSOUTLA 19678387 19934948 1,15,23,56,126,222 Total number of routines modified: 20 Total number of deleted routines: 1 Note: The routine PSOP222 is a post-installation routine that is automatically deleted from your system upon completion of the installation. 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. Do not install this patch while Outpatient Pharmacy users are on the system or when Outpatient orders are being entered and signed through Computerized Patient Record System (CPRS). Installation will take no longer than 5 minutes. Suggested time to install: During non-peak hours. 1. Use the INSTALL/CHECK MESSAGE option on the PackMan menu. 2. From the Kernel Installation & Distribution System (KIDS) menu, select the Installation menu. 3. From this menu, you may select to use the following options (when prompted for INSTALL NAME, enter PSO*7.0*222): 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. d. Print Transport Global - this option will allow you to view the components of the KIDS build. 4. Use the Install Package(s) option and select the package PSO*7.0*222. 5. When prompted "Want KIDS to INHIBIT LOGONs during the install? YES//" respond NO. 6. When prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//" respond NO. Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSOCLO1 Before: B73912762 After: B28077371 **1,23,37,222** Routine Name: PSOCLUTL Before: B28625453 After: B29603769 **28,56,122,222** Routine Name: PSOCPDUP Before: B39161837 After: B33098913 **11,27,32,130,132,192,207,222** Routine Name: PSODIR1 Before: B62027893 After: B69320145 **23,46,78,102,121,131,146,166, 184,222** Routine Name: PSODIR3 Before: B24224437 After: B26563927 **3,46,184,222** Routine Name: PSODRDUP Before: B49880475 After: B44003984 **11,23,27,32,39,56,130,132,192, 207,222** Routine Name: PSOEXDT Before: B4706270 After: B4855517 **23,73,222** Routine Name: PSOHELP Before: B49120072 After: B49925355 **3,23,29,42,48,46,117,131,222** Routine Name: PSOHELP1 Before: B45597408 After: B52554989 **23,36,88,146,227,222** Routine Name: PSOORFI1 Before: B70328364 After: B70934716 **7,15,23,27,32,44,51,46,71,90, 108,131,152,186,210,222** Routine Name: PSOORFI2 Before: B72145536 After: B74849096 **7,15,23,27,46,130,146,177,222** Routine Name: PSOORNE2 Before: B64900877 After: B65444424 **11,21,23,27,32,37,46,84,103, 117,131,146,156,210,148,222** Routine Name: PSOORNE5 Before: B58023770 After: B59135982 **11,27,32,46,78,99,117,131,146, 171,180,210,222** Routine Name: PSOORNEW Before: B69954269 After: B70191276 **11,23,27,32,55,46,71,90,94, 106,131,133,143,237,222** Routine Name: PSOORNW1 Before: B42345668 After: B42999566 **23,46,78,117,131,133,172,148,222** Routine Name: PSOORNW2 Before: B43033604 After: B43179170 **10,23,37,46,117,131,133,148,222** Routine Name: PSOP222 Before: n/a After: B1194743 **222** Routine Name: PSOSIGDS Before: B61227434 After: B62109134 **46,222** Routine Name: PSOSIGMX Before: B13097478 After: B14444819 **46,78,108,131,222** Routine Name: PSOUTLA Before: B41420060 After: B41786781 **1,15,23,56,126,222** ============================================================================= User Information: Entered By : ANWER,MOHAMED Date Entered : SEP 13, 2005 Completed By: HSI,TUAN Date Completed: SEP 19, 2006 Released By : LESIEUR,SHIRLEY Date Released : SEP 19, 2006 ============================================================================= Packman Mail Message: ===================== $END TXT