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=============================================================================
Run Date: AUG 18, 2014                     Designation: OR*3*269
Package : OR - ORDER ENTRY/RESULTS REPORTING  Priority: Mandatory
Version : 3                                     Status: Under Development
=============================================================================

Associated patches: (v)OR*3*286    <<= must be installed BEFORE `OR*3*269'
                    (v)OR*3*306    <<= must be installed BEFORE `OR*3*269'
                    (v)OR*3*311    <<= must be installed BEFORE `OR*3*269'
                    (v)OR*3*346    <<= must be installed BEFORE `OR*3*269'
                    (v)OR*3*352    <<= must be installed BEFORE `OR*3*269'
                    (u)GMRA*4*46   <<= must be installed BEFORE `OR*3*269'

Subject: ADD SIGN/SYMPTOMS TO ALLERGY-DRUG INTERACTION ORDER CHECK MESSAGES

Category: 
  - Routine

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$TXT Created by XXX at XXX.GOV  (KIDS) on Monday, 08/
18/14 at 08:42
=============================================================================
Run Date: AUG 18, 2014                     Designation: OR*3*269
Package : OR - ORDER ENTRY/RESULTS REPORTING  Priority: Mandatory
Version : 3                                     Status: Under Development
=============================================================================

Associated patches: (v)OR*3*286    <<= must be installed BEFORE `OR*3*269'
                    (v)OR*3*306    <<= must be installed BEFORE `OR*3*269'
                    (v)OR*3*311    <<= must be installed BEFORE `OR*3*269'
                    (v)OR*3*346    <<= must be installed BEFORE `OR*3*269'
                    (v)OR*3*352    <<= must be installed BEFORE `OR*3*269'
                    (u)GMRA*4*46   <<= must be installed BEFORE `OR*3*269'

Subject: ADD SIGN/SYMPTOMS TO ALLERGY-DRUG INTERACTION ORDER CHECK MESSAGES

Category: 
  - Routine
  - Data Dictionary

Description:
============

 1. This patch will enable the Computerized Patient Record System (CPRS) 
 version 1.0.29 to display the sign/symptom and the severity of an adverse 
 reaction to a medication in its ALLERGY-DRUG INTERACTION order check
 messages.  It will also update the Remote Data Interoperability (RDI)
 component within CPRS to retrieve the sign/symptom, severity, and
 observed/historical data values from the Health Data Repository (HDR) for
 adverse reactions.
  
 2. During testing of an unrelated patch, it was discovered that order 
 checks performed during the AudioCare renewal process were stored
 in the ORDER CHECK INSTANCES (#100.05) file using the user who processed 
 the refills, rather than the proxy user. Since the routine required to 
 correct this issue was already present in OR*3*269, the correction for 
 this problem was added to OR*3*269.
  
 This patch is released in conjunction with the Adverse Reaction Tracking 
 package version 4 patch 46 (GMRA*4*46) as a multiple build KIDS host file.
  
 Patch Components
 ================
  
 Files & Fields Associated:
  
 File Name (Number)         Field Name (Number)  New/Modified/Deleted
 ------------------         -------------------  --------------------
 ORDER CHECK INSTANCES      ORDER (#.01)         Modified
  (#100.05)                 STATUS (#1)          Modified
                            OCCURRENCE (#2)      Modified
                            USER (#3)            Modified
                            OCCURRENCE           Modified
                               DATE/TIME (#4)
                            ORDER CHECK (#5)     Modified
                            CLINICAL DANGER      Modified
                               LEVEL (#6)
                            OVERRIDE REASON (#7) Modified
                            PHARMACIST OVERRIDE  Modified
                               COMMENTS (#13)
                            PHARMACIST (#14)     Modified
                            PHARMACIST COMMENTS  Modified
                               DATE/TIME (#14.1)
                            MONOGRAPH TERM (#16) Modified
                            DRUG ALLERGIES (#17) Modified
                            DISPENSE DRUGS (#50) New
                            GROUP ONE PHARMACY   New
                               ORDERS (#60)
                            GROUP TWO PHARMACY   New
                               ORDERS (#70)
                            INTERVENTION (#81)   New
                            CLOZAPINE DISPENSING New
                               FREQUENCY (#82)
                            DRUG INTERACTION     New
                               SEVERITY (#83)
                            DATABASE (#84)       New
                            CLOZAPINE LAB        New
                               RESULTS (#90)
                            CLINICAL EFFECTS     New
                               (#100)
 DRUG ALLERGIES SUB-FIELD   INTERACTING          Deleted
  (#100.517)                   MEDICATION (#.01)
                            REACTANT (#.01)      New
                            LOCATION (#1)        Deleted
                            CAUSATIVE AGENT (#2) Modified
                            VA DRUG CLASSES (#3) Modified
                            DRUG INGREDIENTS     Modified
                               (#4)
                            SIGNS/SYMPTOMS (#5)  Modified
                            REMOTE LOCATION      Deleted
                               (#6)
                            LOCATION TYPE (#6)   New
                            INTERVENTION (#7)    Deleted
                            REMOTE LOCATION      New
                               (#7)
                            DATABASE (#8)        Deleted
                            ORIGINATION DATE/    New
                            TIME (#8)
                            OBSERVED/HISTORICAL  Modified
                               (#9)
                            SEVERITY (#10)       Modified
  
  
 Forms Associated:
  
 Form Name             File #       New/Modified/Deleted
 ---------             ------       --------------------
 N/A
  
  
 Mail Groups Associated:
  
 Mail Group Name          New/Modified/Deleted
 ---------------          --------------------
 N/A
  
  
 Options Associated:
  
 Option Name            Type               New/Modified/Deleted
 -----------            ----               -------------------- 
 N/A
  
  
 Protocols Associated:
  
 Protocol Name       New/Modified/Deleted
 -------------       -------------------- 
 N/A
  
  
 Security Keys Associated:
  
 Security Key Name
 -----------------
 N/A
  
  
 Templates Associated:
  
 Template Name      Type      File Name (Number)  New/Modified/Deleted 
 -------------      ----      ------------------  --------------------
 N/A
  
  
 New Service Requests (NSRs)
 ----------------------------  
 20100825 Drug-Allergy Order Check Enhancements and Improved Detail
          The following features are introduced by this patch:
          1. Add signs/symptoms and severity data to the drug-allergy 
             order check message.
          2. Replace the site designation (local/remote) with the name of 
             the site that documented the allergy and the date and time of
             when the documentation was entered.
          3. Populate the DRUG ALLERGIES field (#17) in the ORDER CHECK 
             INSTANCES file (#100.05) for drug-allergy order checks.
  
  
 Patient Safety Issues (PSIs)
 -----------------------------
 PSPO 2069
 When a provider is shown an adverse reaction order check message, the 
 provider has to cancel the order and then navigate to the coversheet to 
 review both the severity and the signs and symptoms of the reaction. This 
 patch addresses this issue by including the reaction's severity and its 
 signs and symptoms in the order check message. For example, Previous 
 MODERATE adverse reaction to IODINE resulted in VOMITTING (ANN ARBOR VAMC 
 entered on 01/14/2013@14:27).
  
 PSPO 2099
 When a provider is shown an adverse reaction order check message with 
 (LOCAL) at the end of the message, providers have misinterpreted this to 
 mean the patient experienced a localized reaction (such as a rash) 
 instead of the fact that the reaction was documented locally. This patch 
 addresses this issue by replacing the site designation (local/remote) 
 with the name of the site that documented the allergy and the date and 
 time of when the documentation was entered. For example, (ANN ARBOR VAMC 
 entered on 01/14/2013@14:27).
  
  
 Remedy Ticket(s) & Overview
 ---------------------------
 N/A
 