$TXT Created by WHITE,ELAINE at CMNT.FO-BIRM.MED.VA.GOV (KIDS) on Friday, 11/24/06 at 08:47 ============================================================================= Run Date: JAN 25, 2007 Designation: PSX*2*54 Package : PSX - CMOP Priority: Mandatory Version : 2 SEQ #54 Status: Released Compliance Date: FEB 25, 2007 ============================================================================= Associated patches: (v)PSX*2*50 <<= must be installed BEFORE `PSX*2*54' (v)PSX*2*52 <<= must be installed BEFORE `PSX*2*54' Subject: NEW WARNING SOURCE, SIG SEGMENT CHANGES, AND BAI Category: - Routine - Enhancement (Mandatory) Description: ============ *** This patch addresses Patient Safety Issue (PSI) - PSI-06-091 *** Duplicate SIG's are being placed on the NTE|7 segment of the Consolidated Mail Outpatient Pharmacy (CMOP) transmission. This causes the prescription to be rejected by the CMOP and not dispensed. This is delaying the filling of the patient's Outpatient Medications. The problem is caused when the patient's OTHER LANGUAGE PREFERENCE field (#106) from the PHARMACY PATIENT file (#55) is set to Yes, but the patient's PMI LANGUAGE PREFERENCE field (#106.1) in the PHARMACY PATIENT file (#55) is not set to Spanish. This patch will require both to be set before sending the SIG in both English and Spanish. The issue arose because if the Spanish translations are not set up for a site, the "Spanish" SIG will look very much like the English SIG and CMOP expects to receive the SIG in both languages if the patient's preference is Spanish. Non-PSI changes in this patch: ------------------------------ As part of the Outpatient Pharmacy V. 7.0 Laser Labels Phase II project, a new commercial data source is utilized to provide warning label source information. The new warning labels are enabled for printing on the laser labels when the WARNING LABEL SOURCE field (#16) of the PHARMACY SYSTEM file (#59.7) is set to "N" for "New". Parameters for using the new warning labels are set using the Pharmacy System Parameters Edit [PSS SYS EDIT] option. For the Consolidated Mail Outpatient Pharmacy (CMOP) to utilize the new warning labels, this patch uses a new CMOP WARNING LABEL SOURCE field (#16.1) in the PHARMACY SYSTEM file (#59.7), also set by using the Pharmacy System Parameters Edit [PSS SYS EDIT] option. This should be set to "N" for "New" to send the new warnings to CMOP. This field is added by patch PSS*1*120. If the BAD ADDRESS INDICATOR field (#.121) in the PATIENT file (#2) is set and there is no active temporary address for the patient, the fill will appear on the CMOP reject log and will remain in suspense, but unmarked for CMOP. It will print when the local print from suspense is done to be filled locally. **************** NOTE *************************************************** As the CMOP side also had to make programming changes, verify that the CMOP that your site sends to can receive the new warning label format. Then after setting the CMOP WARNING LABEL SOURCE field (#16.1) to "New", send a small batch and verify that it was received and able to be processed successfully. (As of the release of this patch, only the Bedford CMOP was not yet ready to receive the new format). ************************************************************************** This patch adds the sending of the INTEGRATION CONTROL NUMBER field (#991.01) from the PATIENT file (#2) if it is a national number. This number is concatenated with the letter "V" and the ICN CHECKSUM field (#991.02) from the PATIENT file (#2) and is sent as the 18th subscript of the PID segment. (See example under item 1 below). When the CMOP WARNING LABEL SOURCE is "New", the format and/or content of the following segments will be changed: 1. For the Patient Identification (PID) segment, the Patient Medication Instruction (PMI) preference will be sent as "ENG" for English or "SPA" for Spanish instead of the current numeric values. Example: PID|||000007890^1^M11||OPPATIENT^ONE||||||12345 S MAIN ST^ADDRESS LINE2^MADISON ^WI^53705||(000)555-1212|SPA|||1011007381V739824 2. Currently, the first part of the English language medication instruction (SIG) is sent in the RX1 segment and continuations are sent in NTE|7 segments. If a patient has a Spanish language preference, the SIG is sent to the CMOP in both English and Spanish. Additional fields added to the NTE|7| segment when the new warning source flag is set are: NTE|7|RX NUMBER|LANGUAGE CODE|NUMBER|TEXT (TEXT is up to 100 characters per NTE|7| segment) Where: RX NUMBER is the external prescription number from the PRESCRIPTION file (#52). LANGUAGE CODE will be "ENG" for English or "SPA" for Spanish. NUMBER is a sequence number for the SIG lines starting at 1 for each different language code. Example: RX1|500-300993-1|||||||||||90||D0132^DOXEPIN HCL 25MG CAP^L|||||11| 20061122|11| ||20071123|20061122|300993||||TAKE TWO CAPSULES MOUTH THREE TIMES A DAY FOR 7 D AYS, THEN TAKE ONE CAPSULE NTE|7|300993|ENG|1|TWICE A DAY FOR 7 DAYS, THEN TAKE ONE CAPSULE AT BEDTIME FOR 7 DAYS, THEN TAKE NTE|7|300993|ENG|2|ONE CAPSULE EVERY OTHER DAY FOR 7 DAYS NTE|7|300993|SPA|1|TAKE DOS CAPSULES MOUTH THREE TIMES A DAY PARA 7 DIAS, THEN TAKE UNO CAPSULE NTE|7|300993|SPA|2|TWICE A DAY PARA 7 DIAS, THEN TAKE UNO CAPSULE AT BEDTIME PARA 7 DIAS, THEN NTE|7|300993|SPA|3|TAKE UNO CAPSULE EVERY OTHER DAY PARA 7 DIAS 3. Instead of sending warning label numbers in the ZX1 segment, the warning label text will be sent in the new NTE|11|segments. Note: A maximum of 5 warning labels can be printed, so only the first 5 for a drug will be sent to CMOP. If the patient has a PMI Language Preference other than English, the first 5 warning labels in each language will be sent. If the DEA, SPECIAL HDLG field (#3) in the DRUG file (#50) begins with numbers 1,2,3,4, or 5, the NO TRANSFER warning text from the RX CONSULT file (#54) entry number 20 will be sent as one of the first 5 warnings. The fields for the new warning labels are: NTE|11|RX NUMBER|LANGUAGE CODE|RECORD NUMBER|WARNING LABEL TEXT Where: RX NUMBER is the external prescription number from the PRESCRIPTION file (#52). LANGUAGE CODE will be "ENG" for English or "SPA" for Spanish. RECORD NUMBER is either the internal entry number from the RX CONSULT file (#54) or the internal entry number from the WARNING LABEL-ENGLISH file (#50.625) followed by an "N" when the LANGUAGE CODE is "ENG" or the internal entry number from the WARNING LABEL-SPANISH file (#50.626) followed by an "N" when the LANGUAGE CODE is "SPA". WARNING LABEL TEXT is the complete text of the specified warning number (maximum length is 200 characters). Example: ZX1|300993|514^TROY|M|1|(1of12)|OPPROVIDER,ONE|1|(***/***)|20061122|1|1| 1|30||500-5294709||SCL50|UNKNOWN NTE|11|300993|ENG|1N|May cause drowsiness. Alcohol may intensify this effect. Use care when operating a car or dangerous machines. NTE|11|300993|ENG|62N|May cause dizziness NTE|11|300993|ENG|11N|Avoid prolonged or excessive exposure to direct and/or ar tificial sunlight while taking this medication. NTE|11|300993|ENG|61N|May cause blurred vision NTE|11|300993|ENG|13N|It is very important that you take or use this exactly as directed. Do not skip doses or discontinue unless directed by your doctor. NTE|11|300993|SPA|1N|Puede causar somnolencia. El alcohol puede intensificar es te efecto. Tenga cuidado cuando conduzca veh!culos automotores u opere maquinar ia peligrosa. NTE|11|300993|SPA|62N|Puede causar mareo. NTE|11|300993|SPA|11N|Evite exponerse excesivamente o por per!odos prolongados a los rayos solares directos y/o artificiales mientras tome este medicamento. NTE|11|300993|SPA|61N|Puede causar visi"n borrosa. NTE|11|300993|SPA|13N|Es muy importante que lo tome o lo use exactamente seg#n las indicaciones. No omita ninguna dosis ni lo deje de usar a menos que lo mande el mdico. Also included in this patch is a fix for several Remedy tickets regarding a null subscript when a prescription was discontinued during transmission. If the prescription was discontinued, the CMOP TRANSMISSION file (#550.2) reference for that prescription is cleaned up. Also added to this patch is the check for the value of the PROJ 112/SHAD field (#122.01) in the PRESCRIPTION file (#52) as an additional Environmental Indicator check to determine whether to send a copay or no copay indicator to CMOP. The patch that creates this new field, PSO*7*225, will be released along with Computerized Patient Record System (CPRS) GUI27. The added check in this patch will have no effect until PSO*7*225 is installed. Associated New Service Requests (NSR): ====================================== 20011109 20031001 Associated REMEDY tickets: ========================== HD0000000067608 HD0000000067828 HD0000000067836 HD0000000067869 HD0000000068124 HD0000000068236 HD0000000068446 HD0000000068688 HD0000000091487 HD0000000120368 HD0000000125490 HD0000000148333 HD0000000168388 Associated E3R: =============== N/A Test Sites: =========== DURHAM, NC LOUISVILLE, KY MONTANA HCS NEW YORK HCS OKLAHOMA CITY, OK 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 PSX_2_TM_R0107.PDF Consolidated Mail Outpatient Pharmacy (CMOP) Technical Manual PSX_2_P54_TM_CP.PDF Consolidated Mail Outpatient Pharmacy (CMOP) Technical Manual 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. Installation Instructions: ========================== This patch can be installed with users on the system, but transmissions should not be in progress. Installation will take less than 1 minute. There are no other scheduling restrictions or recommendations. 1. Sites typically use nightly tasks that send controlled substances and non-controlled substances prescription transmissions to their CMOP hosts. Unschedule all CMOP automatic transmissions by using the CMOP options: Setup Auto-transmission [PSXR AUTO TRANSMIT] Setup CS Auto-transmission [PSXR AUTO TRANSMIT CS] 2. Use the INSTALL/CHECK MESSAGE option on the PackMan menu. 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 PSX*2.0*54): 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. 5. Use the Install Package(s) option and select the package PSX*2.0*54. 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. Sites typically use nightly tasks that send controlled substances and non-controlled substances prescription transmissions to their CMOP hosts. Re-schedule the CMOP automatic transmissions for controlled substances and non-controlled substances nightly tasks, as appropriate for your site, by using the CMOP options: Setup Auto-transmission [PSXR AUTO TRANSMIT] Setup CS Auto-transmission [PSXR AUTO TRANSMIT CS] 9. When turning on the parameter to send the new warning label format to CMOP, send a small batch at first and verify with the CMOP that the batch was received and able to be processed successfully. At the time of the release of this patch, only the Bedford CMOP is not ready to receive the new warning label format, so the parameter should not be turned on yet if your site sends to the Bedford CMOP. Routine Summary: ================ The following routines are included in this patch. The second line of the routines now looks like: ;;2.0;CMOP;**[patch list]**;11 Apr 97 CHECK^XTSUMBLD results Routine Name Before Patch After Patch Patch List ------------ ------------ ----------- ---------- PSXBLD 17904423 21184450 3,23,29,28,43,41,50,54 PSXBLD2 N/A 1415047 54 PSXERR 14903784 15745967 1,3,28,30,42,41,52,54 PSXMISC1 13861876 14728510 3,18,23,28,30,42,41,52,54 PSXRXQU 7343926 8129054 7,12,25,33,40,41,54 Total number of routines modified: 4 Total number of new routines: 1 Total number of routines: 5 Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSXBLD Before: B54134734 After: B68209583 **3,23,29,28,43,41,50,54** Routine Name: PSXBLD2 Before: n/a After: B1742280 **54** Routine Name: PSXERR Before: B33005571 After: B35308373 **1,3,28,30,42,41,52,54** Routine Name: PSXMISC1 Before: B32974838 After: B38388550 **3,18,23,28,30,42,41,52,54** Routine Name: PSXRXQU Before: B13155316 After: B15657498 **7,12,25,33,40,41,54** ============================================================================= User Information: Entered By : WHITE,ELAINE Date Entered : MAY 17, 2004 Completed By: LEONARD,KEN Date Completed: JAN 22, 2007 Released By : PARRIS,CHRIS Date Released : JAN 25, 2007 ============================================================================= Packman Mail Message: ===================== $END TXT