

=============================================================================
Run Date: NOV 05, 2014                      Designation: PSJ*5*281  TEST v20
Package : INPATIENT MEDICATIONS             Priority   : MANDATORY
Version : 5                                 Status     : UNDER DEVELOPMENT
=============================================================================

Associated patches: (v)PSJ*5*257   <<= must be installed BEFORE `PSJ*5*281'
                    (v)PSJ*5*260   <<= must be installed BEFORE `PSJ*5*281'
                    (v)PSJ*5*275   <<= must be installed BEFORE `PSJ*5*281'
                    

Subject:  MOCHA UFT ENHANCEMENTS 2 PSJ

Category:  ROUTINE

Description:
===========
 
This patch is part of the Medication Order Check Healthcare Application
(MOCHA) v1 Enhancements 2 group of patches. A host file was created to
simplify installation at Veterans Health Administration (VHA) facilities.
The host file MOCHA_ENH_2_COMBINED_BUILD.KID contains: GMRA*4*46,
OR*3*269, PSJ*5*281 and PSO*7*411. In additions there is the stand alone
patch PSS*1*175.
 
This patch PSJ*5*281 contains the following functionality:
 
1. This patch will add enhancements to Inpatient prescription edit 
sequence to perform order checks when the dosage field is modified.
(CR2831/CCR2987)
 
2. Add an enhancement to the hidden CK option associated with backdoor
Inpatient Medications. When using the CK option the Order Status is
displayed with all orders within the Order Check messages.
(CR1007/CCR5980)
 
3. Add to the backdoor pharmacy order entry process functionality to
evaluate the orderable item for a specific patient using the Clinical
Reminder Order Check (CROC) API. (CR3286/CCR6312)
 
4. This patch corrects Outpatient hidden CK Option when a supply item 
lists first on med profile the CK option displays supply item error
message and will not complete order checks. (CR1007/CCR6205)
 
5) Double return to continue displays on Inpatient hidden CK option.
(CR1007/CCR6198)
 
6. When editing a Non-Verify order, the dosing warning is displayed after 
accepting the order and then again when the user selected to verify the 
order. This fix will prevent the second display when verifying the order. 
CCR 6425.
 
7. When editing the Med route for a Non-Verified IV fluid order, a new 
order is not created and Computerized Patient Record System (CPRS) 
doesn't update the change. This is happened when the USED IN IV FLUID 
ORDER ENTRY FIELD (#13) of the IV ADDITIVE FILE (#52.6) is marked to Yes.
This fix will cause a new order and send update to CPRS. CCR 6596.
 
8. The order checks are not performed when verifying a Non-Verified Unit 
Dose order. This only happened after an edit was made to a Dosage Ordered 
field or any star fields and enter "SO (Select Order)" to select the 
order to verify from the profile. If a number is entered instead of 
entering "SO" to select the order, the order checks works correctly. CCR
6673.
 
9. When editing Dosage Ordered (or any star fields) of a Non-Verified 
Unit Dose order, the Dosing check was performed but the Drug Interactions 
and Duplicate Therapy checks were not done during the verify process. CCR 
6692.
 
10. When finishing a Unit order using the Speed Finish (SF) action, the 
hard error occurred if the user respond "no" to "Do you wish to continue 
with the current order? YES//" prompt. This patch will correct this 
error. CCR 6695.
 
11. When the Non-Verified/Pending Orders option was the first option 
selected after entering the Inpatient Medications application, the 
PSJNEWOE variable was not defined and caused the order checks not to 
perform. CCR 6722.
 
12. For outpatient pharmacy if there is a drug on remote profile, not on 
local profile and you enter a drug that will cause a drug-drug 
interaction order check, the order check is occurring in CPRS but not 
backdoor pharmacy. A correction has been made to display the drug 
interaction order check.  CCR 6960 PSPO 2561
 
13. When transferring an active outpatient order to inpatient, the free
text dosage is displayed in the dosage field when an order is entered
through CPRS and is finished through backdoor. Upon finish, "&" 
ampersands are returned to CPRS within the updated order information 
which perpetuates the problem.  This issue has been corrected to display
the free text dosage in the dosage field.  CCR 6952
 
14. For an inpatient to outpatient transfer of a pending order, the free
text dosage is displayed in the dosage field when an order is entered
through CPRS and is finished through backdoor. Upon finish, "&" ampersands
are returned to CPRS within the updated order information which
perpetuates the problem.  This issue has been corrected to display the
free text dosage in the dosage field. CCR 6958
 
15. Hydrochlorothiazide 25MG tab is IEN 2068 in the VA Product File.  
Under LATEX in the Drug Ingredient File, there are several Drug
Identifiers containing 2068, but this is where the VA Generic IEN is, and
in this case is BANDAGE. The software shouldn't be interpreting the
2068 as the VA Product entry, but that is what it appears to be doing in
this case.
 
16. Inconsistencies when editing Non-Verified Unit dose orders.  This 
patch will correct the issue.  CCR 6673
 
17. IV Renew and Copy options not displaying all messaged required by 
user story 5297.  This patch will correct the issue.  CCR 6676
 
18. Adds new functionality for Allergy Order checks per user story 1007.  
CCR 6703, 6878, 6971
 
19. Maximum dosage message does not display for certain IV's. This patch 
corrects the issues. CCR 6996
 
20. Maximum dosage message displays at Accept and Verify while still in 
the order.  Therapeutic Duplication also displays twice.  This patch will 
correct the issues.  CCR 6999
 
21. Hidden DA action allergy check display does not match user story.  
This patch corrects the issue.  CCR 7001
 
22. Inpatient IV "Order not copied" message is not received when severe 
intervention is refused.  This patch corrects the issue.  CCR 7012
 
23. On Speed Renewal, if severe intervention is refused for first order, 
none of the remaining orders renew. This patch corrects the issue.
 CCR 7014
 
24. Inpatient IV "No changes made to this order" message is not received 
when severe intervention is refused on Renew.  This patch corrects the 
issue.  CCR 7015
 
25. When verifying an order,  the system prompts for another intervention
for the drug-allergy twice even though an intervention has already been
logged.  This is for a non-verified order when the pharmacist goes into
verify the order.  This patch corrects the issue.  CCR 7017
 
26. Inpatient IV allergy checks for some drugs are not showing.  This 
patch corrects the issue.  CCR 7022
 
27. Hard error received when replying YES to intervention for Speed 
Renew.  This patch corrects the issue.  CCR 7027
 
 
Patch Components
================
 
Files & Fields Associated:
--------------------------
 
Forms Associated:
 
 File Name (Number)         Field Name (Number)  New/Modified/Deleted
 ------------------         -------------------  --------------------
 N/A
 
 
Mail Groups Associated:
 
 Mail Group Name          New/Modified/Deleted
 ---------------          -------------------- 
 N/A
 
 
Options Associated:
 
 Option Name                 Type       Action
 -----------                 ----       ------
 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
 
 
Additional Information:
 
Associated Change Requests: 
---------------------------
CR2831/CCR2987
CR1007/CCR5980
CR1007/CCR6205
CR3286/CCR6312
CCR's 6646, 6673, 6676, 6695, 6703, 6722, 6757, 6807, 6878, 6881, 6948, 
6952, 6958, 6961, 6968, 6972, 6987, 6991, 6971, 6975, 6995, 6996, 6999, 
7000, 7001, 6979, 6766, 6645, 6692, 6649, 6650, 6696, 61619, 6124, 6204, 
6425, 6398, 6424, 6852, 6396, 6466, 6493, 6584, 6586, 6586, 6587, 6595, 
6596, 6620, 6628, 6658, 6780, 6781, 6784, 6998, 7012, 7014, 7015, 7017, 
7022
 
New Service Requests (NSRs)
---------------------------
N/A
 
 
Patient Safety Issues (PSIs)
----------------------------
2530 - Remedy ticket # 960690/960714 - "Under certain circumstances, 
ordering a drug for which a patient has a remote allergy but no local 
allergy, an allergy warning is not displayed in Outpatient Pharmacy"
 
2585 - Remedy ticket # 1004240 - Erroneous Allergy/Interaction display
 
2545 - An Inpatient Pharmacy order entered via the Inpatient Medications 
order entry option with the "Nature of Order" prompt delineated as 
"Written" and a documented pharmacy intervention, did not display on the 
BCMA Coversheet in the highlighted format to alert the BCMA end user of 
the intervention. 
 
 
Remedy Ticket(s) & Overview:
----------------------------
1. 960690 - AEU reports it appears remote allergy order checks in 
Pharmacy is not working.
    Duplicate 975660
    Duplicate 1004240 
 
Problem:
--------
If a patient has no local allergies, NKA or non-drug allergies
and a remote drug allergy, a warning will not trigger when an order is 
entered for the remote allergy drug (CCR 6962)
 
Resolution:
-----------
This patch will correct the code to trigger an allergy alert if a remote 
allergy exists.
 
2. 960714 - AEU reports the site is not getting allergy checks done for 
remote allergies when processing medication orders.
 
Problem:
-------
If the remote reaction was an ADR rather than an Allergy, the
remote reaction is not firing allergy order checks in CPRS or in VistA
Pharmacy.  It is also not displaying as a remote reaction on the patient 
information screen in VistA Pharmacy.  You can see the remote ADR in 
CPRS via Remote Data or VistaWeb. (CCR 6962)
 
Resolution:
-----------
This patch will correct the code to trigger an allergy alert if the 
remote action was an ADR rather than an Allergy.
 
3. 933381 - Incorrect allergy/drug order checks reported by the site
 
Problem:
--------
Incorrect allergy/drug order checks reported by the site (CCR 
6963)
 
Resolution:
-----------
This patch will correct the code to report correct allergy/drug order 
checks.
 
4. 861870 - IP - Unable to verify an active IV order
 
Problem:
--------
An issue was introduced in PSJ_5_260 in which a pharmacist is now unable 
to verify an active IV order which lacks a verifying pharmacist.  
(indicated by the "->" symbol). 
 
Resolution:
-----------
Modified routine PSJLIACT so that the code introduced in PSJ_5_260 
causing this issue has been removed.
 
5. 769980 - Enhanced Order Checks Not Occurring with Speed Renew
 
Problem:
--------
When you select multiple unit dose orders using Speed Renew, Enhanced 
Order Checks are only performed on the first order.  No order checks 
occur for the following orders.
 
Resolution:
----------- 
Routines PSGOERS, PSGOER0 and PSJNEWOC have been modified to perform
checks on all orders in the Speed Renew.
