2. EPMO Open Source Coordination Office Redaction File Detail Report

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2.1 Files compared

#	Location	File	Last Modified
1	C:\Users\VHANOLMcfadP\AraxisMergeCompare\Pri_un\ZIP\CPRS v32 Phase 2 Build 3 CIF Documents	CPRS v32 RSD Version v1.34 (July 2017).docx	Fri Nov 24 18:11:28 2017 UTC
2	C:\Users\VHANOLMcfadP\AraxisMergeCompare\Pri_re\ZIP\CPRS v32 Phase 2 Build 3 CIF Documents	CPRS v32 RSD Version v1.34 (July 2017).docx	Fri Jan 5 21:40:40 2018 UTC

2.2 Comparison summary

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2.3 Comparison options

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2.4 Active regular expressions

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2.5 Comparison detail

	1	Computeri zed Patien t Record S ystem (CPR S) v32
	2	Requiremen ts Specifi cation Doc ument
	3
	4	July 2017
	5	Version 1. 34
	6	Department of Vetera ns Affairs
	7
	8	Revision H istory
	9	Note: The revision h istory cyc le begins once chang es or enha ncements a re request ed after t he Require ments Spec ification Document h as been ba selined.
	10	Date
	11	Version
	12	Descriptio n
	13	Author
	14	7/30/2017
	15	1.34
	16	Minor Modi fications
	17	Susan Scor zato
	18	6/30/2017
	19	1.33
	20	Patient Sa fety (PSPO ) 2563 - C harting th e Action o f Complete in CPRS o n generic orders sto ps the tim e on order that may or may not be correc t.
	21	Susan Scor zato
	22	5/31/2017
	23	1.32
	24	NSR 201110 06 Prevent Confusion over CPRS Status Di splay of A vailable O rders-Modi fications - Dialog C hange
	25	Susan Scor zato
	26	4/30/2017
	27	1.31
	28	NSR 201110 06 Prevent Confusion over CPRS Status Di splay of A vailable O rders- Sep arated th e Orders/M eds Tab.
	29	Susan Scor zato
	30	3/31/2017
	31	1.30
	32	NSR 201001 01 Indicat ions for P rescriptio n and Med Orders- Mo dification s
	33	Susan Scor zato
	34	2/28/2017
	35	1.29
	36	NSR 200709 20 Button Link No As sessment W arn to All ergy –Mino r word cha nge.
	37	NSR2006071 0 Real-Tim e Notifica tion of Po tentially Missed Ord er Checks- Minor Mod ifications .
	38	NSR 201102 10 Create Separate A lert for P rosthetics Requests – Remove s econd need from Busi ness Need 2.2.28 and Functiona l Specific ations 2.6 .28
	39	Susan Scor zato
	40	Cindy Lowe ry
	41	1/31/2017
	42	1.28
	43	NSR2010010 1 Indicati ons for Pr escription and Med O rders- Mod ifications
	44	Susan Scor zato
	45	12/31/2016
	46	1.27
	47	NSR2010010 1 Indicati ons for Pr escription and Med O rders- Mod ifications
	48	Susan Scor zato
	49	11/30/2016
	50	1.26
	51	NSR2012040 4 Adverse Reaction R eporting F ile Mods- Minor Modi fications
	52	Susan Scor zato
	53	10/31/2016
	54	1.25
	55	Minor Modi fications
	56	Susan Scor zato
	57	9/30/2016
	58	1.24
	59	NSR2010010 1 Indicati on for Pre scription and Medica tion Order s- Minor M odificatio ns
	60	Susan Scor zato
	61	8/31/2016
	62	1.23
	63	NSR2010010 1 Indicati on for Pre scription and Medica tion Order s- Minor M odificatio ns
	64	Susan Scor zato
	65	7/29/2016
	66	1.22
	67	NSR2009050 9 Park a P rescriptio n-Minor mo dification s
	68	Susan Scor zato
	69	6/30/2016
	70	1.21
	71	Minor word ing modifi cation to Functional Specifica tion 2.6.2 9.2.2 Limi ting Addit ional Sign ers List;
	72	NSR2010010 1 Modifica tions;
	73	Minor modi fications to Functio nal specif ication 2. 6.31. Vist A Immuniza tion Enhan cements; A dded NSR20 141111 Fil ter Provid er Drop Do wn List to Kernel 1. 2.10, Refe rences 1.3 , Business Rules Spe cification 2.2.33, F unctional Specificat ions 2.6.3 3
	74	Cindy Lowe ry,
	75	Susan Scor zato, Ru th Gong
	76	5/31/2016
	77	1.20
	78	NSR2010010 1 Indicati ons on all Prescript ion and Me dication O rders-Modi fications
	79	Susan Scor zato
	80	4/30/2016
	81	1.19
	82	NSR2007020 3 Allergy Order Chec k Enhancem ent- Minor Modificat ion;
	83	NSR2010082 5 Drug All ergy Order Check- Mi nor word C hanges
	84	NSR2010010 1 Indicati on on all Prescripti ons and Me dication O rders- Add itional Re quirements .
	85	VIMM Requi rements – Updated Re quirements .
	86	Susan Scor zato, Ruth Gong
	87	3/31/2016
	88	1.18
	89	NSR2008030 7 CWAD Pos t Auto Dem otion Rule s-Minor Mo dification s 2.6.1.1, 2.6.1.1.2 , 2.6.1.1. 3;
	90	NSR2010010 1 Indicati on on all Prescripti ons and Me dication O rders - Co ntract Mod ification received T ransitioni ng to HP ( replacing NSR2006030 7 and NSR2 0070811)
	91	Susan Scor zato
	92	2/25/2016
	93	1.17
	94	NSR2011060 6 Confirm Provider S imilar Nam es- Minor Modificati on.
	95	NSR2007020 3 Allergy Order Chec k Enhancem ent- Requi rement Cha nge.
	96	NSR2007121 1 Changes to Allergy /Pharmacy Packages- Minor Modi fications;
	97
	98	Updated 1. 2 Scope VA Enhanceme nts, 1.3. References , Business Rules sec tion 2.2 31 VistA I mmunizatio ns Enhance ments, 2.6 Functiona l Specific ations – 2 .6.30 Natu re of Orde r Default and 2.6.31 VistA Imm unization Enhancemen ts;
	99
	100	Updated 1. 3 Referenc es (NSR 20 110210), B usiness Ru les sectio n 2.2 29 Limit Addi tional Sig ners, 2.6 Functional Specifica tions – 2. 26.28 Crea te Separat e Alert fo r Prosthet ics Reques ts and 2.2 6.29 Limit Additiona l Signers – Added Re quirements
	101	VA Enhance ment #6 Re move “Clin ic” pick u p.
	102	Susan Scor zato,
	103	Ruth Gong,
	104	Cindy Lowe ry
	105	1/31/2016
	106	1.16
	107	NSR2012080 2 CPRS Day of the We ek Med Sch eduling-Mo dification s;
	108	Changes to CPRS Cons olidated E nhancement s in secti on 1.3 Ref erences;
	109	Changes to VA modifi cation 26 in section 2.2 Busin ess Rules;
	110	Added func tional spe cification s 26.1-26. 3 in secti on 2.6. Fu nctional S pecificati ons.
	111	Susan Scor zato, Cind y Lowery
	112	12/31/2015
	113	1.15
	114	NSR2008030 7 CWAD Pos t Auto Dem otion Rule s - Minor Modificati ons (Advan ce Directi ve Changes ). NSR2007 1211 Chang es to Alle rgy/Pharma cy Package s -Minor M odificatio n. NSR200 70203 Alle rgy Order Check Enha ncement–Mi nor word c hange.
	115	Added Summ ary of VA Modificati ons in sec tion 2.2. Business R ules Speci fication.
	116	Added func tional spe cification s 26 – 33 in section 2.6. Func tional Spe cification s.
	117	Susan Scor zato, Ruth Gong, Cin dy Lowery
	118	11/30/2015
	119	1.14
	120	NSR2012080 2 CPRS Day of the We ek Med Sch eduling-Mi nor Modifi cation;
	121	NSR 200810 08 CPRS No tification Alert Pro cessing Im provement- Modificat ions.
	122	Susan Scor zato
	123	10/31/2015
	124	1.13
	125	NSR2008030 7 CWAD Pos t Auto Dem otion Rule s - Minor Modificati ons (Advan ce Directi ve Changes ). NSR2007 1211 Chang es to Alle rgy/Pharma cy Package s -Minor M odificatio n.
	126	NSR2007020 3 Allergy Order Chec k Enhancem ent–Minor word chang e.
	127	Added Summ ary of VA Modificati ons in sec tion 2.2. Business R ules Speci fication.
	128	Added func tional spe cification s 26 – 33 in section 2.6. Func tional Spe cification s.
	129	Susan Scor zato, Ruth Gong, Cin dy Lowery
	130	9/30/2015
	131	1.12
	132	NSR2007081 1 First Do se Enhance ment in CP RS -requir ement remo ved (out o f scope).
	133	Added VA E nhancement s to 1.12 Scope
	134	Susan Scor zato, Ruth Gong
	135	8/31/2015
	136	1.11
	137	NSR2012080 2 Changes to Allergy /Pharmacy Packages-M inor word change; NS R20090416 Changes to Nurse Ord er Verific ation- Mod ifications ; NSR20071 103 Change in Unflag ging Capab ilities-Mo dification s; NSR2011 0719 Order Flag Reco mmendation s-Modifica tions.
	138	Rebecca Ru ssell, Sus an Scorzat o
	139	7/31/2015
	140	1.10
	141	Sub-requir ement adde d to 20070 902 “Butto n Link.” M odificatio ns to NSR 20111006 P revent Con fusion ove r CPRS Sta tus Displa y of Avail able Order s; Modific ations to NSR2011071 9 Order Fl ag Recomme ndations; Modificati ons to NSR 20071103 C hanges in Unflagging Capabilit ies.
	142	Rebecca Ru ssell, Sus an Scorzat o
	143	6/30/2015
	144	1.9
	145	Modificati ons to 200 80704 Enha nced Aller gy Interfa ce to COTS ; Mods to 20060710 R eal Time N otice of P otentially Missed Or der Checks ; Adverse Reaction R eporting F ile Mods ( 20120404);
	146	Modificati ons to NSR 20111006 P revent Con fusion ove r CPRS Sta tus Displa y of Order s and Avai lable Acti on; Modifi cations to NSR201007 06 Identif y Required Fields in TIU Note Templates; Modificat ions NSR20 110719 Ord er Flag Re commendati ons.
	147	Rebecca Ru ssell, Sus an Scorzat o
	148	5/31/2015
	149	1.8
	150	Modificati ons to 200 71211 Alle rgy Pharma cy Package s; Marked NSR 200603 07 Clinica l Reminder Code Spac e Expansio n unnecess ary and NO T replaced ; Changes to Allergy Order Che ck NSR 20 070203; Ch anges to D rug Allerg y Order Ch ecking 201 00825;
	151	Modificati ons to NSR 20090416 Changes to Nurse Ord er Verific ation’s Ef fect on Or der Status ;
	152	Modificati ons to NSR 20071103 Change in Unflagging Capabilit ies.
	153	Rebecca Ru ssell, Sus an Scorzat o
	154	4/30/2015
	155	1.7
	156	Modificati on to inst ances for Similar Pr ovider Nam es; Change d title of NSR 20111 006 to “Pr event Conf usion over Status Di splay;” Ma rked NSR 2 0060307 un necessary (existing functional ity).
	157	Rebecca Ru ssell, Sus an Scorzat o
	158	3/31/2015
	159	1.6
	160	Modificati ons to Adv erse React ion File M ods NSR 20 120404; IV Administr ation Not Documented NSR 20110 903 (out o f scope re quirements removed)
	161	Rebecca Ru ssell
	162	2/28/2015
	163	1.5
	164	Modificati ons to Con firm Provi ders with Similar Na mes NSR 20 110606
	165	Rebecca Ru ssell
	166	1/31/2015
	167	1.4
	168	Modificati ons to All ergy Order Check Enh ancement N SR 2007020 3; Drug Al lergy Orde r Check NS R 20100825 ; D/C Orde rs on Adve rse Reacti on NSR2008 0226.
	169	Rebecca Ru ssell
	170	12/31/2014
	171	1.3
	172	Day of the Week Med Schedule N SR 2012080 2 –Modific ations; Co nfirm Prov ider with Similar Na mes NSR201 10606-Modi fications; Park a Pr escription NSR200905 09-Modific aitons
	173	Rebecca Ru ssell, Sus an Scorzat o
	174	11/30/2014
	175	1.2
	176	Modified I V Administ ration NSR 20110903- Not Docum ented, Con firm Provi ders with Similar Na mes NSR 20 110606-Mod ifications ; CPRS Day of Week M ed Schedul ing NSR 20 120802-Mod ifications .
	177	Rebecca Ru ssell, Sus an Scorzat o
	178	10/31/2014
	179	1.1
	180	Modified P ark a Pres cription, Day of Wee k Med Sche dule, and Critical H igh Order Check.
	181	Rebecca Ru ssell, Sus an Scorzat o
	182	9/23/2014
	183	1.0
	184	Drafted in itial work ing versio n.
	185	Ty Phelps, Rishan Ch andarana, Jamie Crum ley
	186	Artifact R ationale
	187	The Requir ements Spe cification Document (RSD) reco rds the re sults of t he specifi cation gat hering pro cesses car ried out d uring the Requiremen ts phase. The RSD is generally written b y the func tional ana lyst(s) an d should p rovide the bulk of t he informa tion used to create the test p lan and te st scripts . It shou ld be upda ted for ea ch increme nt.
	188	The level of detail contained in this RS D should b e consiste nt with th e size and scope of the projec t. It is n ot necessa ry to fill out any s ections of this docu ment that do not app ly to the project. T he resourc es necessa ry to crea te and mai ntain this document during the life cycl e of a lar ge project should be acknowled ged and cl early refl ected in p roject sch edules. Do not dupli cate data that is al ready defi ned in ano ther docum ent or a s ection in this docum ent; note in the sec tion where the infor mation can be found.
	189
	190	Instructio ns
	191
	192	Activity
	193	New Capabi lity (1)
	194	Feature En hancement (2)
	195	Field Depl oyment (A)
	196	Yes
	197	Yes
	198	Cloud/Web Deployment (B)
	199	No
	200	No
	201	Mobile App lication ( C)
	202	No
	203	No
	204
	205
	206	Table of C ontents
	207	1.Introduc tion1
	208	1.1.Purpos e1
	209	1.2.Scope1
	210	1.3.Refere nces5
	211	2.Overall Descriptio n6
	212	2.1.Access ibility Sp ecificatio ns7
	213	2.2.Busine ss Rules S pecificati on7
	214	2.3.Design Constrain ts Specifi cation11
	215	2.4.Disast er Recover y Specific ation11
	216	2.5.Docume ntation Sp ecificatio ns11
	217	2.6.Functi onal Speci fications1 1
	218	2.7.Graphi cal User I nterface ( GUI) Speci fications4 0
	219	2.8.Multi- divisional Specifica tions40
	220	2.9.Perfor mance Spec ifications 40
	221	2.10.Quali ty Attribu tes Specif ication41
	222	2.11.Relia bility Spe cification s41
	223	2.12.Scope Integrati on41
	224	2.13.Secur ity Specif ications42
	225	2.14.Syste m Features 42
	226	2.15.Usabi lity Speci fications4 2
	227	3.Purchase d Componen ts42
	228	4.Estimati on42
	229	5.Approval Signature s45
	230	Appendix A : Non-Func tional Req uirements4 6
	231
	232
	233	Introducti on
	234	This docum ent is the Requireme nts Specif ication Do cument (RS D) for the Computeri zed Patien t Record S ystem (CPR S) v32 dev elopment p roject. Se ction 1 co ntains the purpose, scope, and reference s for the project.
	235	This is a living doc ument and will conti nue to evo lve throug hout the p roject. Th is project is implem ented util izing agil e methods which incl ude multip le sprints , or short developme nt cycles. This docu ment will be updated regularly during th e developm ent cycle to reflect the chang es impleme nted in a sprint alo ng with ch anges plan ned for fu ture sprin ts.
	236	Purpose
	237	This docum ent is int ended to p rovide the business level requ irements t hat are to be implem ented with in version 32 of the CPRS. It is designe d to docum ent requir ements inc luding fun ctional, p erformance , reliabil ity, secur ity, and u sability.
	238	This docum ent is use d in the r eview proc ess such a s mileston e reviews. It is use d as a sta rting poin t to gener ate future documents such as t he Softwar e Design D ocument (S DD) and Re quirements Traceabil ity Matrix (RTM). It is expect ed that th is documen t will be used by pr oject mana gers, proj ect oversi ght, devel opers, ana lysts, and in some i nstances t he busines s communit y.
	239	Scope
	240	This scope of this d ocument is limited t o the CPRS v32 devel opment pro ject. This project w ill make m odificatio ns to exis ting Veter ans health Informati on Systems and Techn ology Arch itecture ( VistA) app lications. Modificat ions will be made to CPRS, Tex t Integrat ion Utilit ies (TIU), Inpatient Medicatio ns, Outpat ient Pharm acy, Pharm acy Data M anagement, Barcode M edication Administra tion, Adve rse Reacti on Trackin g (ART), L aboratory, Clinical Reminders, and Kerne l.
	241	Computeriz ed Patient Record Sy stem
	242	CPRS provi des an int egrated pa tient reco rd system for clinic ians, mana gers, Qual ity Assura nce (QA) s taff, and researcher s. The pri mary goal of CPRS is to provid e a fast a nd easy-to -use appli cation tha t makes av ailable to providers the infor mation nee ded in the clinical workflow p rocess. Th e CPRS use r interfac e is integ rated with VistA to facilitate reviewing , document ing and pr eserving o f coordina ted care i nformation and impro ved access ibility of online cl inical inf ormation a nd results .
	243	Text Integ ration Uti lities
	244	TIU simpli fies the u se and man agement of clinical documents for both c linical an d administ rative med ical facil ity person nel. In co nnection w ith Author ization/Su bscription Utility ( ASU), a fa cility can set up po licies and practices for deter mining who is respon sible or h as the pri vilege for performin g various actions on required documents.
	245	Inpatient Medication s
	246	The Inpati ent Medica tions pack age integr ates funct ions from the Intrav enous (IV) and Unit Dose (UD) modules. T his integr ation prov ides a com prehensive record of medicatio ns utilize d during h ospitaliza tion of th e veteran, the funct ionality f or clinici an order e ntry throu gh CPRS, a nd tailors processes by facili ty, user, and/or med ication.
	247	Outpatient Pharmacy
	248	Outpatient Pharmacy provides a method fo r managing the medic ations giv en to Vete rans who h ave visite d a clinic or who ha ve receive d prescrip tions upon discharge from the hospital. Prescripti on labels are automa tically ge nerated an d refill r equest for ms are pri nted. Medi cation his tories are kept onli ne to perm it checks for potent ial intera ctions. Pr ofiles can be genera ted to ass ist the cl inician in managing the patien t’s medica tion regim en. Manage ment repor ts aid the pharmacy in control ling inven tory and c osts.
	249	Pharmacy D ata Manage ment
	250	The Pharma cy Data Ma nagement ( PDM) packa ge include s tools fo r creating the Pharm acy Ordera ble Items and mainta ining file s necessar y for CPRS . PDM cons olidates t ools for m anaging th e various pharmacy s oftware pr oducts, su ch as Outp atient Pha rmacy and Inpatient Medication s, facilit ating the maintenanc e of files used with in these a pplication s. Prior t o the rele ase of the PDM softw are, the m aintenance of pharma ceutical i tems withi n the loca l DRUG fil e (#50) wa s accompli shed using applicati on specifi c options. PDM provi des a sing le option to maintai n this fil e to facil itate this process.
	251	Barcode Me dication A dministrat ion
	252	Bar Code M edication Administra tion (BCMA ) software provides a real-tim e, Point-o f-Care (PO C) solutio n for vali dating the administr ation of U D and IV m edications to inpati ents in Ve terans Adm inistratio n Medical Centers (V AMCs).
	253	Adverse Re action Tra cking
	254	The ART pr ogram prov ides a com mon and co nsistent d ata struct ure for ad verse reac tion data. This modu le has opt ions for d ata entry and valida tion, supp orted refe rences for use by ex ternal sof tware modu les, and t he ability to report adverse d rug reacti on data to the Food and Drug A dministrat ion (FDA).
	255	Laboratory
	256	The Labora tory modul e supports the follo wing areas : General Laboratory , Microbio logy, Hist ology, Cyt ology, and Blood Don or. Additi onally, ac tivity-spe cific Vist A applicat ions exist for the f ollowing L aboratory areas, and they are explained in more de tail in in dividual w rite-ups i mmediately following this one: Anatomic Pathology (including Surgical Pathology, and Elect ron Micros copy), Blo od Bank, E lectronic Data Inter change (ED I), Emergi ng Pathoge ns Initiat ive (EPI), HOWDY Com puterized Login Proc ess, Natio nal Labora tory Tests (NLT) Doc uments and LOINC Req uest Form, POC, Univ ersal Inte rface (UI) , and Vist A Blood Es tablishmen t Computer Software (VBECS).
	257	Clinical R eminders
	258	Clinical R eminders m ay be used for both clinical a nd adminis trative pu rposes. Ho wever, the primary g oal is to provide re levant inf ormation t o provider s at the P OC, for im proving ca re for vet erans. The package b enefits cl inicians b y providin g pertinen t data for clinical decision-m aking, red ucing dupl icate docu menting ac tivities, assisting in targeti ng patient s with par ticular di agnoses an d procedur es or site -defined c riteria, a nd assisti ng in comp liance wit h VHA perf ormance me asures and with Heal th Promoti on and Dis ease Preve ntion guid elines.
	259	Kernel
	260	Kernel pro vides a po rtability layer betw een the un derlying o perating s ystem and applicatio n code. Th is results in the en tire VistA system be ing portab le among d ifferent c omputers, operating systems, a nd M imple mentations . This, to gether wit h the data base porta bility pro vided by V A File Man ager (File Man), elim inates the cost of a pplication conversio ns each ti me VHA cha nges its c omputing p latforms.
	261	Kernel als o offers s hared serv ices for V istA appli cations, r esulting i n reduced developmen t costs an d a common user inte rface, and provides system man agement to ols for ma naging Vis tA compute r systems. The Remot e Procedur e Call (RP C) Broker supports a single si gn-on poin t from a c lient work station to the serve r. Users n eed only s ign on onc e when acc essing mul tiple Vist A applicat ions on th e same wor kstation.
	262	The follow ing summar izes the 3 0 enhancem ents addre ssed in th is project listed in format of enhanceme nt title a nd New Ser vice Reque st (NSR) n umber in p arentheses :
	263	Drug-Aller gy Order C heck Enhan cements an d Improved Detail (2 0100825)
	264	Changes to the Nurse Order Ver ification’ s Effect o n Order St atus (2009 0416)
	265	Update Sur rogate Man agement Fu nctionalit y within C PRS GUI (2 0071216)
	266	CWAD Post Auto-Demot ion Rules (20080307)
	267	Clinical R eminder Co de Space E xpansion ( 20060307)
	268	Add Addres s of Perfo rming Lab to Reports in CPRS H ealth Summ ary (20081 206)
	269	CPRS Day o f the Week Med Sched ule Change (20120802 )
	270	Prevent C onfusion o ver CPRS S tatus Disp lay (20111 006)
	271	Change in Unflagging Capabilit ies (20071 103)
	272	CPRS Notif ication Al ert Proces sing Impro vement (20 081008)
	273	Confirm Pr ovider Sel ected with Similar N ames (2011 0606)
	274	Identify R equired Fi elds in Te xt Integra tion Utili ty (TIU) N ote Templa tes and No tify User of Missing Required Fields (20 100706)
	275	Adverse Re action Rep orting Fil e Modifica tion (2012 0404)
	276	Allergy Or der Check Enhancemen t (2007020 3)
	277	Park-A-Pre scription (20090509)
	278	First Dose – Enhance ment withi n CPRS Med ication Or der (20070 811)
	279	Enhance CP RS/Medicat ion Histor y Report t o Fully Do cument IV Administra tion (2011 0903)
	280	Critical/H igh Order Check Disp lay (20101 203)
	281	Button to Link No As sessment W arning to Allergy As sessment S creens (20 070920)
	282	Real-Time Notificati on of Pote ntially Mi ssed Order Checks (2 0060710)
	283	Enhanced A llergy Che cks Using COTS Data (20080704)
	284	D/C Order Due To Adv erse React ion (20080 226)
	285	Changes to Allergy/P harmacy Pa ckages (20 071211)
	286	Order Flag Recommend ations (20 110719)
	287	Progress N otes Displ ay Mislead ing (20070 817)
	288	Indication on all Pr escription s and Medi cation Ord ers (20100 101)
	289	Allow user to clear own patien t locks in CPRS (200 80342)
	290	Create Sep arate Aler t for Pros thetics Re quests (20 110210)
	291	Limiting A dditional Signers Li st (201201 01)
	292	Nature of Order Defa ult (20120 601)
	293	VistA Immu nization E nhancement s (VIMM)
	294	Remove “Cl inic” pick up
	295	Filter Pro vider Drop Down List (20141111 )
	296
	297
	298	These enha ncements w ill direct ly improve patient c are by add ressing pa tient safe ty issues. In additi on to impr oving pati ent safety , several of these e nhancement s improve the workfl ow for pro viders; pr ovide addi tional war nings and/ or more in formation which will result in improved patient ca re. Finall y, some of these enh ancements improve th e order ch ecking and allergy t racking me chanisms w hich will reduce adv erse react ions to me dications which will also dire ctly impro ve patient care.
	299	Patient Sa fety Issue s in CPRS v32 reques ts contain improveme nts in the following area:
	300	(PSPO) 256 3: Charti ng the Act ion of Com plete in C PRS on gen eric order s stops th e time on order that may or ma y not be c orrect.
	301
	302	When a use r sets a g eneric ord er (text, nursing, e tc.) to a status of complete, the system is going to invoke a protocol called OR COMPLETE ORDER. Any other pac kages or a pplication s that nee d to know when a gen eric order goes to a completed status ca n subscrib e to the p rotocol.
	303
	304
	305	References
	306	Business R equirement s Document , Drug-All ergy Order Check Enh ancements and Improv ed Detail Work Effor t Unique I dentifying #20100825 , dated Ap r 2012.
	307	Business R equirement s Document , Changes to the Nur se Order V erificatio n’s Effect on Order Status Req uest #2009 0416, date d Aug 2009 .
	308	Business R equirement s Document , Update S urrogate M anagement Functional ity within CPRS Grap hical User Interface (GUI) Req uest #2007 1216, date d Apr 2009 .
	309	Business R equirement s Document , Add Addr ess of Per forming La b to Repor ts in CPRS Health Su mmary Requ est #20081 206, dated Dec 2009.
	310	Business R equirement s Document , Change i n Unflaggi ng Capabil ities Requ est
	311	#20071103, dated Jun 2009.
	312	Business R equirement s Document , CPRS Not ification Alert Proc essing Imp rovement R equest #20 081008, da ted Aug 20 09.
	313	Business R equirement s Document , Allergy Order Chec k Enhancem ent Reques t
	314	# 20070203 , dated Ju n 2009.
	315	Requiremen ts Specifi cation Doc ument for Park-A-Pre scription, PAPI_RSD_ v3, dated 09-2012.
	316	Business R equirement s Document , First Do se – Enhan cement wit hin CPRS M edication Order #200 70811, dat ed Feb 200 8.
	317	Business R equirement s Document , Button t o link No Assessment warning t o Allergy Assessment NSR #2007 0920, date d Feb 2008 .
	318	Business R equirement s Document , Real-tim e Notifica tion of Po tentially Missed Ord er Checks Request #2 0060710, d ated Aug 2 009.
	319	Business R equirement s Document , Enhanced Allergy C hecks Usin g Commerci al Off-The -Shelf (CO TS) Data # 20080704, dated Nov 2011.
	320	Business R equirement s Document , D/C Orde r by Adver se Reactio n Request
	321	#20080226, dated Jun 2008.
	322	Business R equirement s Document , Changes to Allergy /Pharmacy Packages R equest #20 071211, da ted Jun 20 09.
	323	Business R equirement s Document , Progress Notes Dis play Misle ading 2007 0817, date d June 200 8.
	324	Business R equirement s Document , Computer ized Patie nt Record System Con solidated Enhancemen ts Represe nting NSRs #20120802 ,
	325	20101203, 20110606, 20100706, 20120404, 20110903, 20080307, 20060307,
	326	20111006, 20110719, dated Apr 2014.
	327	Business R equirement s Document , Indicati on on all Prescripti ons and Me dication O rders 2010 0101, date d August 2 011.
	328
	329
	330	Requiremen ts Traceab ility Matr ix, CPRS V ersion 32 Requiremen ts Traceab ility Matr ix (RTM).
	331	CPRS v32 T rouble (Re medy) Tick ets Backlo g - 201402 19
	332	Real-Time Notificati on of Pote ntially Mi ssed Order Checks
	333	Allergy Or der Check Enhancemen t
	334	First Dose – Enhance ment withi n CPRS Med ication Or der
	335	Progress N otes Displ ay Mislead ing
	336	Button to link No As sessment w arning to Allergy
	337	Change in Unflagging Capabilit ies
	338	Changes to Allergy/P harmacy Pa ckages
	339	Update Sur rogate Man agement Fu nctionalit y within C PRS GUI
	340	D/C Order by Adverse Reaction
	341	Enhanced A llergy Che cks Using Commercial Off-The-S helf (COTS ) Data
	342	CPRS Notif ication Al ert Proces sing Impro vement
	343	Add Addres s of Perfo rming Lab to Reports in CPRS H ealth Summ ary
	344	Changes to the Nurse Order Ver ification’ s Effect o n Order St atus
	345	Drug-Aller gy Order C heck Enhan cements an d Improved Detail Wo rk Effort Unique Ide ntifying
	346	Indication on all Pr escription s and Medi cation Ord ers Work E ffort Uniq ue Identif ying
	347	Computeriz ed Patient Record Sy stem Conso lidated En hancements Represent ing NSRs # 20120802, 20101203, 20110606, 20100706, 20120404, 20110903, 20080307, 20060307, 20111006, 20110719, 20120601, 20080342, 20120101, 20110210, 20141111
	348
	349
	350	Overall De scription
	351	The CPRS v 32 Develop ment team will produ ce a new v ersion of CPRS, vers ion 32, by implement ing 25 new features described in Nationa l Service Requests ( NSRs). To support th ese 25 new features, the follo wing appli cations wi ll also be modified: Text Inte gration Ut ilities, I npatient M edications , Outpatie nt Pharmac y, Pharmac y Data Man agement, B arcode Med ication Ad ministrati on (BCMA), Adverse R eaction Tr acking, La boratory, Clinical R eminders, and Kernel .
	352	The non-fu nctional r equirement s in Appen dix A shou ld be revi ewed and a ssessed wh ile develo ping the r equirement s for the project.
	353	For teams utilizing the Ration al Tools t o manage t heir requi rements, t he followi ng reports may be at tached in lieu of Se ction 2:
	354	Requiremen ts Specifi cation
	355	Use Cases
	356	Interface report
	357	Teams not using Rati onal shoul d follow t he followi ng templat e
	358	Accessibil ity Specif ications
	359	The CPRS a nd BCMA ar e Graphica l User Int erface (GU I) based a pplication s. In addi tion, they use Clini cal Contex t Object W orkgroup ( CCOW) stan dards. The modificat ions that are made f or CPRS v3 2 will be 508 compli ant and wi ll continu e to follo w CCOW sta ndards to maintain i nteroperab ility.
	360	Business R ules Speci fication
	361	Drug-Aller gy Order C heck Enhan cements an d Improved Detail (2 0100825)
	362	Modify CPR S and Inpa tient Medi cations to notify us ers of pos sible adve rse drug r eactions i f a reacta nt contain s multiple ingredien ts and if any of tho se ingredi ents can c ause an ad verse reac tion.
	363	Modify CPR S and Inpa tient Medi cations to display t he same in formation, and allow users to see comple te order c hecking in formation such as si gns/sympto ms and sev erity, inc luding rem ote data.
	364	Changes to the Nurse Order Ver ification’ s Effect o n Order St atus (2009 0416)
	365	Modify CPR S so that only autho rized nurs es can act ivate medi cations th at are not verified by a pharm acist.
	366	Modify rep orts for p harmacists to show o rders acti vated by n urses, ide ntify orde rs placed through In patient Me ds for Out patients ( including orders act ivated by nurses), a nd include orders wi th a prior ity of DON E and a ro uting of A DMINISTERE D IN CLINI C.
	367	Update Sur rogate Man agement Fu nctionalit y within C PRS GUI (2 0071216)
	368	Modify CPR S’ surroga te managem ent functi onality to match the functiona lity provi ded by the List Mana ger/Kernel settings.
	369	CWAD Post Auto-Demot ion Rules (20080307)
	370	Modify Tex t Integrat ion Utilit ies (TIU) to provide the abili ty to esta blish a re lationship between n otes class ified as C risis Note s, Warning Notes, Al lergies, o r Advance Directive (CWAD) and a corresp onding sim ilarly tit led note i n a non-CW AD Progres s Notes do cument cla ss. The r elationshi p will be used to al low TIU to automatic ally demot e older in stances of such note s from dis playing in the Posti ngs (CWAD) box of CP RS’ Cover Sheet and putting th em in the regular pr ogress not es hierarc hy. The r esult is t hat the Po stings Box will reta in only th e most cur rent insta nce of the note, the reby reduc ing clutte r on the C PRS Cover Sheet.
	371	Provide fu nctionalit y to prohi bit select ed titles from being set up to auto-demo te through this func tionality. Advance Directives and Resci nded Advan ce Directi ves are co nsidered P ostings No tes per VH A Handbook and must not be all owed to de mote.
	372	Clinical R eminder Co de Space E xpansion ( 20060307)
	373	Modify Cli nical Remi nders to a ccept Heal thcare Com mon Proced ure Coding System (H CPCS) modi fiers for Teleretina l use.
	374	Add Addres s of Perfo rming Lab to Reports in CPRS H ealth Summ ary (20081 206)
	375	Modify Hea lth Summar y Reports in CPRS to show the address of the facil ity that p rocessed t he lab tes t, includi ng preserv ing the or iginal add ress if th e facility moves.
	376	CPRS Day o f the Week Med Sched ule Change (20120802 )
	377	Modify CPR S to expan d the day of the wee k when an Inpatient order is c opied to a n Outpatie nt order, for exampl e change T h@1700 to Thursday@1 700.
	378	Prevent Co nfusion ov er CPRS St atus Displ ay (201110 06)
	379	Modify CPR S to stand ardize the use of te rms and av ailable ac tions acro ss tabs su ch as Meds and Order s. Actions and statu ses such a s “DISCONT INUE/CANCE L” should perform th e same fun ctionality and have the same m eaning acr oss tabs.
	380	Change in Unflagging Capabilit ies (20071 103)
	381	Modify CPR S so that sites can limit the unflag act ion with a n order in CPRS.
	382	CPRS Notif ication Al ert Proces sing Impro vement (20 081008)
	383	Modify CPR S so that users can view previ ously proc essed aler ts.
	384	Confirm Pr ovider Sel ected with Similar N ames (2011 0606)
	385	Modify CPR S to promp t the user for confi rmation wh en provide rs with si milar name s are sele cted.
	386	Identify R equired Fi elds in Te xt Integra tion Utili ty (TIU) N ote Templa tes (20100 706)
	387	Full title : Identify Required Fields in Text Integ ration Uti lity (TIU) Note Temp lates (201 00706)
	388	and Notify User of M issing Req uired Fiel ds (201007 06)
	389	Modify CPR S to ident ify missin g fields w hen a user is attemp ting to su bmit a not e that is missing re quired fie lds.
	390	Adverse Re action Rep orting Fil e Modifica tion (2012 0404)
	391	Modify the Adverse R eaction Re porting Fi le so that for histo rical entr ies, at le ast one si gn/symptom is requir ed, a COMM ENT is req uired if t he sign/sy mptom is U NKNOWN, an d add func tionality to allow t he documen tation of the severi ty, if kno wn.
	392	Allergy Or der Check Enhancemen t (2007020 3)
	393	Modify Ord er Checkin g so that when a new allergy i s document ed for a p atient wit h an activ e drug pro file, that new aller gy is comp ared to th e active p rofile for any poten tial adver se reactio ns. This r equirement addresses Patient S afety Issu e PSPO 221 8.
	394	Park-A-Pre scription (20090509)
	395	Convert th e Park-A-P rescriptio n code fro m Delphi 2 006 to Del phi XE3.
	396	Integrate Park-A-Pre scription code into CPRS v32.
	397	First Dose – Enhance ment withi n CPRS Med ication Or der (20070 811)
	398	Modify CPR S and othe r applicat ions to pr ompt a pro vider or n urse to do cument the ir observa tion and t he patient ’s respons e to the f irst dose of a medic ation that is new to that pati ent.
	399	Enhance CP RS/Medicat ion Histor y Report t o Fully Do cument IV Administra tion (2011 0903)
	400	Modify CPR S to displ ay infusio n times co nsistently with Bar Code Medic ation Admi nistration (BCMA).
	401	Critical/H igh Order Check Disp lay (20101 203)
	402	Modify CPR S so that clinicians are provi ded with d ifferent p rompts to justify or der checks based on their seve rity and p riority.
	403	Button to Link No As sessment W arning to Allergy As sessment S creens (20 070920)
	404	Modify CPR S to promp t clinicia ns to comp lete an Al lergy Asse ssment whe n presente d with a “ No allergy assessmen t has been done,” wa rning.
	405	Real-Time Notificati on of Pote ntially Mi ssed Order Checks (2 0060710)
	406	Modify CPR S to prese nt a warni ng to prov iders when a drug in gredient w ill not pr ovide an o rder check .
	407	Enhanced A llergy Che cks Using COTS Data (20080704)
	408	Modify the current A llergy sys tem to use a chemica l drug cla ssificatio n system, and to upd ate/mainta in that da ta, with t he ability to retrie ve that in formation from a COT S system.
	409	D/C Order Due To Adv erse React ion (20080 226)
	410	Modify CPR S to allow providers to enter an Adverse Drug Reac tion (ADR) if discon tinuing me dication d ue to an a llergy to the medica tion.
	411	Changes to Allergy/P harmacy Pa ckages (20 071211)
	412	Modify CPR S to provi de notific ations and alerts in a manner that reduc es potenti al for cli nical staf f to overl ook that i nformation .
	413	Order Flag Recommend ations (20 110719)
	414	Modify CPR S to enhan ce the “Fl ag Order” functions, including viewing r ecipients, notifying when flag s are not cleared, a dding mult iple recip ients, and having th e function ality to a dd and vie w comments /actions f or multipl e recipien ts.
	415	Progress N otes Displ ay Mislead ing (20070 817)
	416	Modify CPR S to displ ay more co mplete pro gress note s.
	417	Indicatio n on all P rescriptio ns and Med ication Or ders (2010 0101)
	418	Modify CPR S to provi de the abi lity to re cord an in dication f or each me dication o rder, sepa rate and i ndependent from othe r order co mments, an d in its o wn unique data field as part o f the pres cription/o rder.
	419	Allow user to clear own patien t locks in CPRS (200 80342)
	420	Create a m essage tha t lets the user know that the lock is be cause anot her user i s entering data into the recor d.
	421	Create a c lear messa ge that le ts the use r know the y have loc ked their own record .
	422	Create a p opup messa ge to disp lay the da te and tim e so that the user w ill know t hat the me ssage is c urrent.
	423	Create Sep arate Aler t for Pros thetics Re quests (20 110210)
	424	Create a s eparate up date alert for prost hetics req uests that can confi gured at t he user or team leve l.
	425	Filter Pro sthetics u pdate aler ts to be f iled in a separate s torage loc ation for viewing at a later t ime.
	426	Limiting A dditional Signers Li st (201201 01)
	427	Provide th e ability to limit t he names p resented t o the user in any ot herwise un restricted CPRS-pres ented drop down list from file .
	428
	429	Provide th e ability for sites to identif y users to be manual ly added t o the list of eligib le signers .
	430
	431	Provide th e ability for sites to identif y users to be manual ly exclude d from the list of e ligible si gners.
	432
	433	Nature of Order Defa ult (20120 601)
	434	Remove the “Verbal” as Nature of Order D efault so that the u ser will h ave to sel ect the co rrect Natu re of Orde r.
	435	Create a p arameter t hat will g ive sites the flexib ility to s et a defau lt value ( Verbal/Tel ephone/Non e) for the Nature of Order.
	436	VistA Immu nization E nhancement s (VIMM)
	437	Modify Use r Interfac e (UI) to document I mmunizatio ns to util ize data f rom RPC’s and API’s created by VistA Imm unization (VIMM) 2.0 .
	438
	439	Remove “Cl inic” pick up
	440	Remove “cl inic” radi o button f rom Outpat ient Med O rder Dialo g.
	441
	442	2.2.33.Fil ter Provid er Drop Do wn List
	443	Filter the provider drop down list to re move non-c linical na mes.
	444
	445	Design Con straints S pecificati on
	446	There are two primar y design c onstraints that appl y to this developmen t effort. First, Vis tA is writ ten in the MUMPS (M) programmi ng languag e. Second, the GUI a pplication s utilize Delphi. Bo th of the programmin g language s and tech nologies i n them wil l influenc e the deve lopment pr ocess. The team will follow VA ’s Standar ds and Com pliance (S AC) for al l M code c hanges.
	447	Disaster R ecovery Sp ecificatio n
	448	Not Applic able to th is system enhancemen t.
	449	Documentat ion Specif ications
	450	To be dete rmined.
	451	Functional Specifica tions
	452	Drug-Aller gy Order C heck Enhan cements an d Improved Detail
	453	The system shall adh ere to the Enterpris e Level re quirements within th e Enterpri se Require ments Mana gement (ER M) Reposit ory and as specifica lly addres sed in App endix D of this docu ment.
	454	For a drug -allergy o rder check involving a patient allergy t o a multip le-ingredi ent produc t (reactan t),, the s ystem shal l display all ingred ients in t he reactan t and the drug class es associa ted with e ach ingred ient in th e allergy file (or C OTS-suppli ed chemica l classifi cation), a nd shall n ot limit t he informa tion displ ayed to th e first in gredient o r drug cla ss match f ound.
	455	For the Cl inician pe rforming o rder entry , drug all ergy order check res ults shall include a ll ingredi ents in mu lti-ingred ient react ants (and the drug c lass assoc iated with each ingr edient) an d NOT to l imit the d isplayed r esults to the first ingredient or drug c lass match found.
	456	For the Ph armacist f inishing a drug orde r, drug al lergy orde r check re sults shal l include all ingred ients in m ulti-ingre dient reac tants (and the drug class asso ciated wit h each ing redient) a nd NOT to limit the displayed results to the first ingredien t or drug class matc h found.
	457	For the Nu rse (when functionin g in the r ole of a P harmacist) , drug all ergy order check res ults shall include a ll ingredi ents in mu lti-ingred ient react ants (and the drug c lass assoc iated with each ingr edient) an d NOT to l imit the d isplayed r esults to the first ingredient or drug c lass match found.
	458	The system shall pro vide consi stent alle rgy/ADR or der check displays b etween CPR S and the VistA Inpa tient Medi cations ap plication.
	459	The system shall pro vide the a bility for the Clini cian to vi ew the sam e allergy/ ADR order checking i nformation in the or der check display in CPRS as i s currentl y availabl e in the V istA Inpat ient Medic ations app lication.
	460	The system shall pro vide the a bility for the Pharm acist to v iew the sa me allergy /ADR order checking informatio n in the o rder check display i n CPRS as is current ly availab le in the VistA Inpa tient Medi cations ap plication.
	461	The system shall pro vide the a bility for the Nurse (when fun ctioning i n the role of a Phar macist) to view the same aller gy/ADR ord er checkin g informat ion in the order che ck display in CPRS a s is curre ntly avail able in th e VistA In patient Me dications applicatio n during t he finishi ng process .
	462	The system shall pro vide the a bility for Clinician , Pharmaci st, or Nur se to view the same detailed a llergy/ADR order che cking info rmation in the order check dis play in CP RS as is c urrently a vailable f rom within Bar Code Medication Administr ation (BCM A) display order for m for both local and other fac ilities.
	463	The system shall dis play docum ented reac tant and a ll the ide ntified in gredient m atches, no t just the first ing redient fo und, as pa rt of the allergy/AD R order ch eck.
	464	The system shall pro vide the a bility for the Clini cian to vi ew all ide ntified in gredient m atches to a document ed reactan t, and not just the first ingr edient fou nd, during the order entry pro cess.
	465	The system shall pro vide the a bility for the Pharm acist to v iew all id entified i ngredient matches to a documen ted reacta nt, and no t just the first ing redient fo und, durin g the fini shing proc ess.
	466	The system shall pro vide the a bility for the Nurse to view a ll identif ied ingred ient match es to a do cumented r eactant, a nd not jus t the firs t ingredie nt found, during the finishing process ( when funct ioning in the role o f a Pharma cist).
	467	The system shall dis play detai ls of an a llergy/ADR order che ck, includ ing the si gns and sy mptoms of allergies documented at other facilities .
	468	The system shall pro vide the a bility for the Clini cian to vi ew the det ails of a drug-aller gy order c heck, incl uding sign s and symp toms docum ented at o ther facil ities, dur ing the or der entry process.
	469	The system shall pro vide the a bility for the Pharm acist to v iew the de tails of a drug-alle rgy order check, inc luding sig ns and sym ptoms docu mented at other faci lities, du ring the f inishing p rocess.
	470	The system shall pro vide the a bility for the Nurse to view t he details of a drug -allergy o rder check , includin g signs an d symptoms documente d at other facilitie s, during the finish ing proces s (when fu nctioning in the rol e of a Pha rmacist).
	471	The system shall pro vide the a bility for the Nurse to view t he details of a drug -allergy o rder check , includin g signs an d symptoms documente d at other facilitie s, during medication order ver ification in CPRS.
	472	The system shall pro vide the a bility for the Nurse to view t he details of a drug -allergy o rder check , includin g signs an d symptoms documente d at other facilitie s, during the medica tion admin istration process.
	473	The system shall dis play signs /symptoms (both loca l and from other fac ilities) o f a report ed allergy /ADR as pa rt of the allergy/AD R order ch eck.
	474	The system shall pro vide the a bility for the user to view th e signs an d symptoms of a repo rted aller gy/ADR whe n the alle rgy/ADR is presented as an ord er check d uring the order entr y process in CPRS.
	475	The system shall pro vide the a bility for user to v iew the si gns and sy mptoms of a reported allergy/A DR when th e allergy/ ADR is pre sented as an order c heck durin g the orde r entry pr ocess in “ backdoor” VistA Inpa tient Medi cations.
	476	The system shall pro vide the a bility for user to v iew the si gns and sy mptoms of a reported allergy/A DR when th e allergy/ ADR is pre sented as an order c heck durin g the orde r finishin g process in “backdo or” VistA Pharmacy.
	477	The system shall dis play sever ity, not o nly for “O bserved” b ut also fo r “Histori c” reactio ns, as par t of the a llergy/ADR order che ck.
	478	The system shall pro vide the a bility for the user to view th e severity of a repo rted aller gy/ADR (no t only for “Observed ” but also for “Hist oric” reac tions) whe n the alle rgy/ADR is presented as an ord er check d uring the order entr y process in CPRS.
	479	The system shall pro vide the a bility for the user to view th e severity of a repo rted aller gy/ADR (no t only for “Observed ” but also for “Hist oric” reac tions) whe n the alle rgy/ADR is presented as an ord er check d uring the order fini shing proc ess in CPR S.
	480	The system shall pro vide the a bility for the user to view th e severity of a repo rted aller gy/ADR (no t only for “Observed ” but also for “Hist oric” reac tions) whe n the alle rgy/ADR is presented as an ord er check d uring the order entr y process in “backdo or” VistA Inpatient Medication s.
	481	The system shall pro vide the a bility for the user to view th e severity of a repo rted aller gy/ADR (no t only for “Observed ” but also for “Hist oric” reac tions) whe n the alle rgy/ADR is presented as an ord er check d uring the order fini shing proc ess in “ba ckdoor” Vi stA Pharma cy.
	482	The system shall ens ure that s igns/sympt oms are in cluded wit h other al lergy/ADR order chec k details in stored order chec k informat ion (for e xample, in FILE 100. 05 ORDER C HECK INSTA NCES).
	483	The system shall avo id use of “local” af ter the me dication n ame in the CPRS alle rgy/ADR or der check display to describe the facili ty at whic h an aller gy was rec orded. Ins tead, the order chec k display shall eith er present the site name of th e location where the allergy w as documen ted (if av ailable su bsequent t o anticipa ted ME2 en hancements ) or blank (unless “ from anoth er facilit y”).
	484	Changes to the Nurse Verificat ion’s Effe ct on Orde r Status
	485	2.6.2.1 Th e system s hall allow nurses wi th the aut horized ke y (PSJ RNF INISH or t he PSJI RN FINISH key ) to finis h orders w hen the ph armacist i s not avai lable.
	486	2.6.2.1.1 The system shall all ow nurses to indepen dently mak e availabl e for admi nistration in BCMA o nly those orders tha t were nur se-finishe d. A phar macist- fi nished ord er will re quire phar macist-ver ification to be avai lable in B CMA.
	487	2.6.2.1.2 The system shall pre vent the a ction of n urse verif y on a pen ding Inpat ient Medic ation Orde r.
	488	2.6.2.2 Th e system s hall add a dditional items to t he report of those o rders requ iring Phar macist’s a ctivity.
	489	2.6.2.2.1 The syst em shall i nclude ord ers that h ave been v erified (a ctivated) by a nurse .
	490	2.6.2.2.2 The system shall sep arately id entify ord ers placed through t he Inpatie nt Meds fo r Outpatie nts (IMO/C linic Meds ) function ality, esp ecially th ose admini stered by the nurse prior to p harmacist action.
	491	Update Sur rogate Man agement Fu nctionalit y within C PRS GUI
	492	The system shall pro vide surro gate manag ement func tionality, available through t he CPRS in terface, t o allow th e setting, editing, and viewin g of multi ple surrog ates and s hall prese nt the use r with the same iden tifying in formation as that av ailable wi thin legac y List Man ager/VistA Kernel.
	493	The system shall all ow the set ting of mu ltiple sur rogates di rectly fro m the CPRS interface in a sing le interac tion, with out requir ing exit a nd re-entr y of the S urrogate f or Notific ations scr een.
	494	The system shall all ow the edi ting of a list of mu ltiple sur rogates di rectly fro m the CPRS interface in a sing le interac tion, with out requir ing exit a nd re-entr y of the S urrogate f or Notific ations scr een.
	495	The system shall all ow the can cellation of a singl e surrogat e from a l ist of mul tiple surr ogates dir ectly from the CPRS interface in a singl e interact ion, witho ut requiri ng exit an d re-entry of the Su rrogate fo r Notifica tions scre en.
	496	The system shall all ow the can cellation of multipl e surrogat es (includ ing all su rrogates) directly f rom the CP RS interfa ce in a si ngle inter action, wi thout requ iring exit and re-en try of the Surrogate for Notif ications s creen.
	497	The system shall pre sent every defined s urrogate o n a single surrogate screen di splay, alo ng with th e start da te/time an d end date /time for each surro gate.
	498	The system shall vis ually iden tify the “ current” s urrogate i n the list of multip le surroga tes.
	499	CWAD Post Auto-Demot ion Rules
	500	The Crisis Notes, Wa rning Note s, Allergi es and Dir ectives (C WAD) auto- demotion r ules allow the user to set up rules that will demo te previou s instance s of CWAD documents in a selec ted patien t’s chart except for the three excluded document t itles rela ted to Adv ance Direc tives.
	501	The system demotes a CPRS prog ress note from a CWA D posting to a stand ard level progress n ote if tha t note is defined in the auto- demotion r ules.
	502	The system shall pro vide the a bility to view only the most r ecent inst ances of a CWAD Post ing progre ss notes i n the CPRS Postings box.
	503	The system shall pro vide the a bility to establish a one-time setup opt ion for se lection of a CWAD Po sting titl e for auto -demotion and a non- posting ti tle as the demotion target exc luding the document titles rel ated to Ad vance Dire ctives. Th is results in a Post ing/Non-Po sting pair of titles .
	504	The system does not demote a p rogress no te that is not defin ed in the auto-demot ion setup.
	505	The system shall pro vide the a bility to target any type of C WAD Postin g for demo tion if th e note is defined in the auto- demotion r ules.
	506	Clinical R eminder Co de Space E xpansion
	507	The system shall ena ble users to create dialogs th at allow c linicians to choose the correc t dialog r esponse or create fo rced value prompts t hat limit acceptable choices i n the dial og.
	508	The system shall pro vide the a bility to receive a new CPT Mo difier pro mpt.
	509	The system shall pro vide the a bility to receive a Procedure Provider p rompt.
	510	The system shall pro vide the a bility to use the ne w prompts for CPT ty pe finding s in the R eminder di alog file.
	511	The system shall mod ify the br oker call to pass th e new prom pt informa tion for t he dialog presented to the use r.
	512	The system shall mod ify the GU I to accep t selectio n of the C PT Modifie r and prov ider.
	513	The system shall mod ify the to ols that s end encoun ter data t o PCE, so the Remind er dialog CPT Modifi er and pro cedure are included in the DAT A2PCE call to approp riately cr eate the V CPT entry .
	514	The system shall pro vide the R eminder ev aluation t o only use the CPT M odifier, n ot the pro vider,
	515	The system shall wri te a Natio nal Remind er for Dia betic Reti nal Scan
	516	2.6.5.2.1 The system shall pro vide the a bility to prompt for a Diabeti c Retinal Scan on an annual 12 month bas is.
	517	Add Addres s of Perfo rming Lab to Reports in CPRS H ealth Summ ary
	518	The system shall hav e the abil ity to pri nt CPRS He alth Summa ry reports with a he ader that includes t he facilit y’s addres s.
	519	The system shall all ow the fac ility’s ad dress to d isplay in the header of all La b and othe r reports printed fr om the Hea lth Summar y in CPRS.
	520	The system shall hav e the abil ity to dis play the n ame(s) and address ( es) of the performin g Laborato ry on the CPRS Healt h Summary report.
	521	The system shall all ow the nam e(s) and a ddress (es ) of the i ndividual performing Laborator y to displ ay in the Health Sum mary in CP RS.
	522	The system shall pro vide the a bility for facilitie s to chang e their ad dress on f uture repo rts while maintainin g the old address on historica l reports.
	523	The system shall dis play the n ame and ad dress of t he perform ing Lab ba sed on the date perf ormed.
	524	The system shall pro vide the a bility to change/cor rect the d isplayed n ame and ad dress of t he perform ing Lab on historica l reports.
	525	The system shall all ow the fac ility to b e able to easily cor rect the n ame and ad dress of t he perform ing Lab ba sed on a s pecific da te range.
	526	CPRS Day o f the Week Med Sched ule Change
	527	The system shall alw ays expand the abbre viation fo r the day of the wee k to the f ull name o f the day when it ap pears on a ny day-of- the-week s chedule on the Outpa tient Pres cription O rder (ente red in eit her CPRS o r Outpatie nt Pharmac y) when tr ansferred from the I npatient M edication Order.
	528	The system shall alw ays expand the abbre viation fo r the day of the wee k to the f ull name o f the day when it ap pears on a ny day-of- the-week s chedule on any Newly Entered O rder for a n Outpatie nt Prescri ption Orde r entered in either CPRS or Ou tpatient P harmacy.
	529	The system shall alw ays expand the abbre viation fo r the day of the wee k to the f ull name o f the day when it ap pears on a ny day-of- the-week s chedule on any Renew al or Copy of an Out patient Pr escription Order ent ered in ei ther CPRS or Outpati ent Pharma cy.
	530	The system shall alw ays expand the abbre viation fo r the day of the wee k to the f ull name o f the day when it ap pears on t he day-of- the-week s chedule on the Disch arge Instr uctions wh en generat ed from th e Outpatie nt Prescri ption Orde r.
	531	The system shall alw ays expand the abbre viation fo r the day of the wee k to the f ull name o f the day when it ap pears on t he day-of- the-week s chedule on the Presc ription Bo ttle Label when gene rated from the Outpa tient Pres cription O rder.
	532	The system shall alw ays expand the abbre viation fo r the day of the wee k to the f ull name o f the day when it ap pears on t he day-of- the-week s chedule ge nerated fr om the Tex t Integrat ion Utilit y Objects.
	533	Prevent Co nfusion ov er CPRS St atus Displ ay
	534	The system shall con sistently use the la nguage “Di scontinue/ Cancel” on the MEDS tab. Deter mine and d efine cons istently t he use of these term s.
	535	When an or der (not u nsigned) h as been Di scontinued , the stat us will di splay as Discontinu ed on the Meds tabs.
	536
	537	Whenever a n unsigned order has been Canc elled, the status wi ll display as Cancel led on the Meds tabs .
	538
	539	The system shall dis close the ramificati ons of uns igned orde rs on the MEDS tab.( Informatio n is not c urrently a vailable o n the MEDS Tab)
	540	The system shall emp loy a cons istent int erface and common la nguage (wh ere applic able) when describin g availabl e actions on the men us of the MEDS tabs.
	541	When a sin gle order is selecte d from the MEDS tab, the syste m shall pr ovide the following selections on both t he shortcu t (right-m ouse-click ) menu and the Actio n (menu ba r) Menu.
	542	If the sel ected orde r has a st atus of “u nsigned,” the system shall dis play the a ction “Can cel Unsign ed Order” and shall not displa y the acti on “Discon tinue.”
	543	In the Tit le Bar of the pop-up window ge nerated by selecting “Cancel U nsigned Or der” the s ystem shal l display “Cancel Or der.”
	544	If the sel ected orde r has any status exc ept unsign ed, the sy stem shall display t he action “Discontin ue.”
	545	In the Tit le Bar of the pop-up window ge nerated by selecting “Disconti nue” the s ystem shal l display “Discontin ue Order.”
	546	When multi ple orders are selec ted from t he MEDS ta b, the sys tem shall provide th e followin g selectio ns on both the short cut (right -mouse-cli ck) menu a nd the Act ion (menu bar) Menu.
	547	If all of the select ed orders have a sta tus of “un signed,” t he system shall disp lay the ac tion “Canc el Unsigne d Orders” and shall not displa y the acti on “Discon tinue.”
	548	In the Tit le Bar of the pop-up window ge nerated by selecting “Cancel U nsigned Or ders” the system sha ll display “Cancel O rders.”
	549	If all of the select ed orders have statu ses other than “unsi gned,” the system sh all displa y the acti on “Discon tinue.”
	550	In the Tit le Bar of the pop-up window ge nerated by selecting “Disconti nue” the s ystem shal l display “Discontin ue Orders. ”
	551	If the sel ected orde rs are a c ombination of signed and unsig ned orders , the syst em shall d isplay the action “D iscontinue /Cancel Or ders.”
	552	The system shall con sistently use the la nguage “Di scontinue/ Cancel” on the ORDER S tab. (Ne eds to be coordinate d with the changes t o the MEDS Tab).
	553	When an o rder (not unsigned) has been D iscontinue d, the sta tus will d isplay as Discontin ued on the Orders ta bs.
	554	Whenever a n unsigned order has been Canc elled, the status wi ll display as Cancel led on the Orders ta bs.
	555
	556	The system shall dis close the ramificati ons of uns igned orde rs on the ORDERS tab . (The Cl inician ma y not real ize that a previousl y disconti nued order may be re instated w hen the un signed ord er is disc ontinued).
	557
	558	The system shall emp loy a cons istent int erface and common la nguage (wh ere applic able) when describin g availabl e actions on the men us of the ORDERS tab s.
	559
	560	When a sin gle order is selecte d from the ORDERS ta b, the sys tem shall provide th e followin g selectio ns on both the short cut (right -mouse-cli ck) menu a nd the Act ion (menu bar) Menu.
	561
	562	If the sel ected orde r has a st atus of “u nsigned,” the system shall dis play the a ction
	563	“Cancel Un signed Ord er” and sh all not di splay the action “Di scontinue. ”
	564	In the Tit le Bar of the pop-up window ge nerated by selecting “Cancel U nsigned
	565	Order” the system sh all displa y “Cancel Order.”
	566	If the sel ected orde r has any status exc ept unsign ed, the sy stem shall display t he action “Discontin ue.
	567	In the Tit le Bar of the pop-up window ge nerated by selecting “Disconti nue” the s ystem shal l display “Discontin ue Order.”
	568	When multi ple orders are selec ted from t he ORDERS tab, the s ystem shal l provide the follow ing select ions on bo th the sho rtcut (rig ht-mouse-c lick) menu and the A ction (men u bar) Men u
	569	If all of the select ed orders have a sta tus of “un signed,” t he system shall disp lay the ac tion “Canc el Unsigne d Orders” and shall not displa y the acti on “Discon tinue.”
	570	In the Tit le Bar of the pop-up window ge nerated by selecting “Cancel U nsigned Or ders” the system sha ll display “Cancel O rders.”
	571	If all of the select ed orders have statu ses other than “unsi gned,” the system sh all displa y the acti on “Discon tinue.”
	572	In the Tit le Bar of the pop-up window ge nerated by selecting “Disconti nue” the s ystem shal l display “Discontin ue Orders. ”
	573	If the sel ected orde rs are a c ombination of signed and unsig ned orders on the Or ders or Me ds tab, th e system s hall displ ay the act ion “Disco ntinue/Can cel Orders .”
	574	In the Tit le Bar of the pop-up window ge nerated by selecting “Disconti nue/Cancel Orders” t he system shall disp lay “Disco ntinue/Can cel Orders ”.
	575	Dialog Bo x: You ar e cancelli ng an unsi gned ”Disc ontinue” O rder (s) a s indicate d by *** i n the Sele cted Order s list. Th e Original Order (s) will rema in in thei r current status.
	576
	577	Change in Unflagging Capabilit ies
	578	The system shall all ow for sit e elected control ov er limitin g the abil ity to per form the u nflag acti on associa ted with a n order in CPRS.
	579	2.6.9.1.1 The syst em shall p rovide the ability t o perform the unflag action by “Display Groups”. E ach displa y group wo uld specif y what key (ORELSE O REMAS, and PSJ PHARM etc.) can unflag or ders.
	580	2.6.9.1.2 The syst em shall p rovide the ability f or a site to disable unflaggin g restrict ions.
	581	2.6.9.1.3 The system shall imp lement the restricti on and the site enab le/disable parameter s at the P ACKAGE, SY STEM and D IVISION le vel settin gs. The Ho lders of t he ORES ke y will hav e no restr ictions an d they wil l be able to unflag any order for any di splay grou p.
	582	2.6.9.1.4 The system shall pro vide a res ponse back to the us er indicat ing they a re not all owed to pe rform the unflag act ion.
	583	2.6.9.1.4. 1 The syst em shall a llow a sit e-customiz able messa ge for the user indi cating wha t they sho uld do if they belie ve they sh ould be al lowed to u nflag an o rder and t hey cannot . The user shall be presented with a mes sage simil ar to the message pr ovided bel ow:
	584	“You are n ot allowed to un-fla g this ord er based o n your sec urity keys and the o rder type.
	585	One exampl e might be :
	586	If you fee l this is incorrect, please ca ll the hel p desk at: 8212”.
	587	CPRS Notif ication Al ert Proces sing Impro vement
	588	The system , in CPRS GUI, shall allow use rs to be a ble to ret rieve and/ or view al l processe d alerts ( informatio n/action).
	589	The system , in CPRS GUI, shall provide t he ability to review the most recently p rocessed a lert (acti on/informa tion) with in normal alert proc essing wor kflows.
	590	The system , in CPRS GUI, shall provide t he ability to view a group of alerts pro cessed acr oss multip le CPRS GU I sessions .
	591	The system , in CPRS GUI, shall provide t he ability to set a date range (TBD) for viewing a group of alerts.
	592	The system , in CPRS GUI, shall provide t he ability to view a group of processed alerts by alert type (action, informatio n).
	593	The system , in CPRS GUI, shall provide t he ability to view a pre-defin ed number of process ed alerts.
	594	The system , in CPRS GUI, shall allow pro cessed ale rts to be retained/a ccessible within a p rocessed a lerts view for a tim eframe set at the sy stem level , but shou ld be adju stable by the user f or those o pting to o verride th e system s etting.
	595	The system , in CPRS GUI, shall provide t he ability to set th e default to 7 Days unless ove rridden by the user.
	596	The system , in CPRS GUI, shall include t he disclai mer on the date rang e selectio n explaini ng why the user is n ot allowed to overri de the pur ge date.
	597	The system , in CPRS GUI, shall provide t he ability to set th e default to a max imum numbe r of alert s returned
	598	The system , in CPRS GUI, shall allow pro cessed ale rts to be moved to a n area sep arate from pending n otificatio ns.
	599	The system shall pro vide the a bility for original recipient to view al erts proce ssed by su rrogates w ithin thei r own proc essed aler ts pane.
	600	The system shall all ow alerts processed by surroga tes to be designated as proces sed by: su rrogate [u sername] w ithin the processed alerts vie w.
	601	Confirm Pr ovider Sel ected with Similar N ames
	602	The system shall dis play an ad ditional s election w indow to b e presente d within C PRS for pr oviders wi th similar names, as is curren tly done w ith patien ts having similar na mes. The C PRS user-i nterface f eatures wh ere the Pr ovider Sel ection win dow shall be present ed shall i nclude:
	603	Provider & Location for Curren t Activiti es Window (all occur rences)
	604	CPRS Patie nt Selecti on Window> Selection by Provide rs
	605	Patient Se lection Sc reen>Notif ications S ection>For ward Butto n
	606	Notes Tab> Encounter Button>Enc ounter For m “Availab le Provide rs” field
	607	Notes Tab> Action Men u>Identify Additiona l Signers
	608	Notes Tab> Action Men u>New Prog ress Note> “Author” and “Expec ted Cosign er” fields
	609	Surgery Ta b>Action M enu>Identi fy Additio nal Signer s
	610	Surgery Ta b>Action M enu>Make A ddendum>Ch ange Adden dum Proper ties>”Auth or” field
	611	Orders Tab >Action Me nu>Alert W hen Result s
	612	Consults T ab>Action Menu>New>C onsult> “A ttention” field
	613	Consults T ab>Action Menu>New>P rocedure> “Attention ” field
	614	Consults T ab>Action Menu>Consu lt Results >Complete/ Update Res ults> “Aut hor” and “ Expected C osigner” f ields
	615	Consults T ab>Action Menu>Consu lt Results >Identify Additional Signers
	616	Discharge Summary Ta b>New Summ ary>“Atten ding Physi cian” fiel d
	617	Discharge Summary Ta b>Action M enu>Make A ddendum>”A uthor/Dict ator” fiel d
	618	The “Simil ar Provide rs” window shall not be displa yed if the logged on user is t he Provide r whose na me is sele cted from the list.
	619	The “Simil ar Provide rs” window shall be patterned after the existing C PRS “Simil ar Patient s” window and shall include a single col umn for th e display of Name (L ast, First ) and Posi tion (New Person fil e, Person Class data element).
	620	The system shall int erpret two or more p rovider na mes having the same last name and at lea st the fir st 2 chara cters of t he first n ame as “si milar” nam es, initia ting the d isplay of a “Similar Providers ” window a nd present ing the na mes that m eet the ma tch criter ia for fur ther selec tion.
	621	The list o f Provider names ava ilable for selection from the “Similar P roviders” window sha ll be limi ted to mat ching name s for acti ve, clinic al users ( and shall exclude vi sitors, st udents, an d all othe r non-clin ical users , includin g billing and admini strative u sers).
	622	Identify R equired Fi elds in Te xt Integra tion Utili ty (TIU) N ote Templa tes and No tify User of Missing Required Fields
	623	The system shall vis ually iden tify all f ields in t he CPRS TI U Note Tem plates tha t are requ ired to be completed prior to sign-off.
	624	The syste m shall pr ovide the ability fo r the user to view ( e.g. by highlight plus aster isk) field s that mus t be compl eted prior to sign-o ff.
	625	The syste m shall pr ovide the ability fo r the user to naviga te to miss ed require d dialog fields us ing Naviga tion butto ns and Sho rt-Cut Key s.
	626	The system shall pro vide the a bility to indicate t o the user that fiel ds must be complet ed prior t o sign off (e.g. req uired fiel d counter, OK button disabled) .
	627	Adverse Re action Rep orting Fil e Modifica tion
	628	The system shall req uire eithe r the sele ction of a t least on e sign/sym ptom from a list or entry of a Comment o f at least 4 charact ers when d ocumenting an histor ical aller gy/adverse drug reac tion, and shall pres ent an err or message to the us er if no s ign/sympto m is selec ted and no Comment ( or a Comme nt of fewe r than 4 c haracters) is entere d.
	629	The system shall acc ommodate ( but not re quire) doc umentation of the Se verity and Date/ Tim e of an hi storical a llergy/adv erse drug reaction.
	630	Allergy Or der Check Enhancemen t
	631	The system shall che ck the cur rent activ e Patient Medication Profile a gainst any new aller gy/ADR ent ries made using CPRS , VistA IP /OP Pharma cy, or the GMRA (Adv erse React ion Tracki ng) applic ation.
	632	The syste m shall se nd a notif ication to the follo wing patie nt’s provi der(s) whi ch will be determine d by the d efinition in ORB3 PR OVIDER REC IPIENTS pa rameter, o f any new drug aller gy entered for which a matchin g medicati on is foun d to exist in the ac tive Patie nt Medicat ion Profil e.
	633
	634	As a CPRS user, I wa nt the sys tem to sen d a notifi cation (ac tionable a lert) to t he Clinici an who ent ered the O rder.
	635	As a CPRS user, I wa nt the sys tem to sen d a notifi cation (ac tionable a lert) to t he patient ’s Primary Care Prov ider (if t he patient is an out patient).
	636
	637	As a CPRS user, I wa nt the sys tem to sen d a notifi cation (ac tionable a lert) to t he Residen t/Attendin g Provider (if the p atient is an inpatie nt).
	638
	639	As a CPRS user, I wa nt the not ifications (actionab le alerts) described in 2.6.14 .2 (above) and 2.6.1 4.3.1 (bel ow) shall allow the alert reci pient to n avigate to the medic ation orde r that pro mpted the alert and take whate ver action (change, leave unch anged, or discontinu e) the use r deems ap propriate. Notificat ions shall be satisf ied by pro cessing th e notifica tion regar dless of a ny action being take n. Notific ations sha ll be dele ted, based on the va lue of the ORB3 DELE TE MECHANI SM definit ion.
	640
	641	As a CPRS user, I wa nt the sys tem to dis play a rea l-time mes sage (for example, a CPRS pop- up or Vist A text mes sage) to t he user en tering the allergy w hen an ord er for a m edication matching t he allergy being rec orded curr ently exis ts in the active Pat ient Medic ation Prof ile. The m essage sha ll notify the user o f the matc h and advi se the use r that a " notificati on" will b e sent to the patien t's provid er. The No tification will cont ain the fo llowing me ssage: “R eview New Allergy En tered on A ctive Med” .
	642	The real-t ime messag e specifie d in 2.6.1 4.3 shall allow the user ente ring the n ew allergy to have t he opportu nity to se lect addit ional reci pients (be sides them selves and the patie nt’s provi der) to be notified of the all ergy/medic ation matc h, and the system sh all perfor m that not ification in additio n to those identifie d in 2.6.1 4.2. The u sers that will be li sted as de fault reci pients wil l be deter mined by t he definit ion in ORD 3 PROVIDER RECIPIENT S.
	643	The system shall pro vide a new report ti tled “Exis ting Medic ation Drug Allergy R eport” whi ch shall b e availabl e exclusiv ely in the CPRS Clin ical Repor ts tree.
	644	The “Exist ing Medica tion Drug Allergy Re port” shal l be avail able upon request wi th no requ irement fo r permanen t storage of the con tent of an y report i nstance.
	645	The “Exist ing Medica tion Drug Allergy Re port” shal l list all medicatio ns on the active pat ient medic ation prof ile for wh ich a corr esponding allergy or adverse r eaction ex ists in th e patient allergy fi le, withou t regard t o the chro nological sequence o f allergy and/or ord er entry. The medica tions shal l display in the top half of t he screen as a list and if the user sele cts one of them, the Allergy d etails sha ll display in the lo wer half o f the scre en.
	646	Park a Pre scription
	647	Currently, there are limitatio ns in the prescripti on orderin g and disp ensing fun ctions of VistA. The se limitat ions impac t the medi cation ord ering prac tices for recurring medication s. When a patient is seen by a physician and a med ication is ordered o r renewed, the VistA medicatio n ordering and dispe nsing syst em current ly generat es a fill order for the prescr iption eve n if the p atient’s o ld prescri ption is n ot due for a refill. This crea tes unnece ssary mult iple dispe nsing of m edications , addition al expense , confusio n for the patient (m ultiple pr escription s for the same medic ation) and co-pay fe es for med icines tha t were not requested (and whic h cannot b e reversed ).
	648
	649	The propos ed enhance ment will allow pres cribers to specify a pickup ro uting of “ Park” for a prescrip tion, with the resul t that the prescript ion is not dispensed until req uested. Th is added f unctionali ty will im prove qual ity of car e, patient satisfact ion, medic ation safe ty, and ef ficiency, as well as offering cost savin gs.
	650
	651	CPRS Appli cation
	652	A new Outp atient Pha rmacy site parameter shall be available to the CPR S applicat ion to ena ble or dis able the “ Park” func tionality by Divisio n.
	653	In all ins tances bel ow where t he CPRS fu nctionalit y would ty pically pr esent the pickup rou ting optio ns of “Mai l,” “Windo w,” and “P ark,” the “Park” opt ion shall not be sel ectable a nd an “err or message “ will be displayed if the su bject medi cation is identified (by a “D” indicator in VistA Pharmacy), as having a DEA cla ssificatio n that req uires spec ial handli ng. Refer to related requireme nt 2.6.15. 26.
	654	The system shall ena ble the “P ark” optio n (and its related f unctionali ty) when t he paramet er specifi ed in requ irement 2. 6.15.1 is set to ON for BOTH t he divisio n of the l ogged on u ser AND al so the div ision of t he encount er locatio n.
	655	The follow ing featur es shall b e availabl e when the Outpatien t Pharmacy site para meter is s et to "ena ble" the P ark functi onality.
	656	The CPRS a pplication shall off er a picku p routing of “Park” when a new outpatien t medicati on order i s created or modifie d by one o f the foll owing meth ods (2.6.1 .1):
	657	The CPRS a pplication shall off er a picku p routing of “Park” when placi ng a new m edication order (2.6 .1.1.1).
	658	The CPRS a pplication shall off er a picku p routing of “Park” when chang ing a sign ed or unsi gned medic ation orde r (2.6.1.1 .2).
	659	The CPRS a pplication shall off er a picku p routing of “Park” when chang ing an act ive medica tion order that will result in a new ord er (2.6.1. 1.3).
	660	The CPRS a pplication shall off er a picku p routing of “Park” when renew ing a medi cation ord er (2.6.1. 1.4).
	661	The CPRS a pplication shall off er a picku p routing of “Park” when copyi ng a medic ation orde r that wil l result i n a new or der (2.6.1 .1.5).
	662	The CPRS a pplication shall pro vide the a bility to place a fi nished med ication or der into a n emulated status of “Active/P ark." Base d on the c ontent of a designat ed field, created to indicate “Parked,” the prescr iption sha ll display with the emulated s tatus of “ Active Par k;” howeve r, the act ual status in the da tabase sha ll be “Act ive.”(2.6. 1.2).
	663	The CPRS a pplication shall pro vide the a bility to reflect a new emulat ed status of “Active /Park” on the MEDS t ab of CPRS (2.6.1.4) .
	664	The CPRS a pplication shall pro vide the a bility to reflect a new emulat ed status of “Active /Park” on the ORDERS tab of CP RS (2.6.1. 5).
	665	The CPRS a pplication shall rep lace the s tatus of “ Pending” w ith the st atus of “A ctive/Park ” at the t ime a pres cription w ith a pick up routing of “Park” is finish ed.
	666	The CPRS a pplication shall pro vide the a dditional options of “Park” an d “Unpark” on the ex isting Act ion menu o n the tool bar drop-d own menu ( 2.6.1.2.1) .
	667	In the Act ion menu o n the tool bar drop-d own menu, the “Unpar k” option shall be s hown as “U npark (Gen erates a r equest to fill/refil l)” (2.6.1 .3).
	668	The CPRS a pplication shall pro vide the a bility to “Unpark” a current m edication order in a n “Active/ Parked” st atus (2.6. 1.3).
	669	At the tim e an order is “Unpar ked,” the medication fill shal l be put i nto “Suspe nse” by Ou tpatient P harmacy wi th the cur rent date or the ori ginal fill date if i n the futu re. (If th e patient shows up a t the wind ow, the me dication o rder can t hen be pul led from S uspense fr om the Out patient Ph armacy sid e) (2.6.1. 3).
	670	The CPRS a pplication shall sho w a defini tion of th e status w hen the po inter hove rs over th e status o f a medica tion order on the ME DS tab or over the s tatus colu mn on the ORDERS tab (2.6.1.6) .The follo wing defin itions sha ll be disp layed on t he CPRS ME DS tab:
	671	Active - A prescript ion with t his status is part o f the pati ent's curr ent expect ed medicat ion regime n, and if refills re main, it c an be fill ed or refi lled upon request (2 .6.1.6.1).
	672	Active/Sus pended - A prescript ion with t his status is part o f the pati ent's curr ent expect ed medicat ion regime n and a re quest has been place d to be fi lled at a future dat e (2.6.1.6 .2).
	673	Active/Par k - A pres cription w ith this s tatus is f inished an d is part of the pat ient's cur rent expec ted medica tion regim en, but th e next fil l will not be dispen sed until requested (2.6.1.6.3 ).
	674	Pending - A prescrip tion with this statu s is an or der that h as been en tered thro ugh CPRS. It has bee n signed b y the prov ider but i s awaiting pharmacy review. It cannot be filled un til after the pharma cist revie ws and fin ishes the order (2.6 .1.6.4).
	675	Non-verifi ed - A pre scription with this status has been eith er entered or finish ed by a ph armacy tec hnician an d will bec ome active upon a ph armacist's review. U ntil such review, a non-verifi ed order c annot be f illed (2.6 .1.6.5).
	676	Expired - A prescrip tion with this statu s indicate s the expi ration dat e has pass ed and the prescript ion is no longer act ive. A pre scription may be ren ewed up to 120 days after expi ration (2. 6.1.6.6).
	677	Hold - A p rescriptio n that was placed on hold due to reasons determine d by the p hysician/p harmacist. This pres cription c annot be f illed unti l the hold is resolv ed (2.6.1. 6.7).
	678	Discontinu ed - A pre scription with this status has been made inactive either by a new (rep lacement) prescripti on or by t he request of a phys ician (2.6 .1.6.8).
	679	Discontinu ed (Edit) - A prescr iption wit h this sta tus indica tes a medi cation ord er has bee n edited b y either a physician or pharma cist creat ing a new order (2.6 .1.6.9).
	680	The follow ing defini tions shal l be displ ayed on th e CPRS ORD ERS tab:
	681	Unreleased – An orde r that has been crea ted in the system bu t has not been sent to the anc illary ser vice to be addressed .
	682	Cancelled – An order that was discontinu ed before it was sha red with a n ancillar y service.
	683	Renewed – An order t hat has be en updated ; a more c urrent ver sion of th e order ex ists.
	684	The CPRS a pplication shall all ow any act ivity that can curre ntly be pe rformed on an “Activ e” medicat ion order to be perf ormed on a n “Active/ Park” medi cation ord er.
	685	The CPRS a pplication shall all ow the “Li st details of the me dication o rder” acti vity to be performed on an “Ac tive/Park” medicatio n order wi th the res ult that t he medicat ion order shall rema in “Parked ” (2.6.1.7 .1).
	686	The CPRS a pplication shall all ow the “Ch ange” acti vity to be performed on an “Ac tive/Park” medicatio n order wi th the res ult that, at the con clusion of the chang e, the use r shall be presented with the options of “mail,” “ window,” a nd “park” (2.6.1.7.2 ).
	687	The “Park” pickup ro uting opti on shall n ot be sele ctable and an “error message” will be di splayed if the subje ct medicat ion is ide ntified (b y a “D” in dicator in VistA Pha rmacy), as having a DEA classi fication t hat requir es special handling. Refer to related re quirement 2.6.15.26.
	688	The CPRS a pplication shall all ow the “Di scontinued /Cancel” a ctivity to be perfor med on an “Active/Pa rk” medica tion order with the result tha t the medi cation ord er shall a utomatical ly be “Unp arked” (2. 6.1.7.3).
	689	The CPRS a pplication shall all ow the “Re fill” acti vity to be performed on an “Ac tive/Park” medicatio n order wi th the res ult that t he medicat ion order shall auto matically be “Unpark ed” (2.6.1 .7.4).
	690	The CPRS a pplication shall all ow the “Tr ansfer to Inpatient” activity to be perf ormed on a n “Active/ Park” medi cation ord er with th e result t hat the me dication o rder shall remain “P arked” (2. 6.1.7.5).
	691	The CPRS a pplication shall ens ure that a ny report that curre ntly shows “Active” medication orders wi ll also sh ow any par ked medica tion order s as “Acti ve/Park” ( 2.6.1.8).
	692	The CPRS a pplication shall pro vide a new site para meter that allows th e default pickup rou ting for n ew medicat ion orders to be set to one of “Mail," “ Window,” o r "Park” ( 2.6.1.9).
	693	The pickup routing d efault set using the CPRS site parameter will be a pplied whe n placing a new medi cation ord er (2.6.1. 9.1).
	694	The pickup routing d efault set using the CPRS site parameter will be a pplied whe n changing an active medicatio n order th at will re sult in a new order (2.6.1.9.2 ).
	695	The pickup routing d efault set using the CPRS site parameter will be a pplied whe n copying a medicati on order t hat will r esult in a new order (2.6.1.9. 3).
	696	The pickup routing d efault set using the CPRS site parameter will be a pplied whe n renewing a medicat ion order (2.6.1.9.4 ).
	697	The CPRS a pplication shall app ly the cur rent order check fun ctionality to any “A ctive/Park ” medicati on order ( 2.6.1.10).
	698	Outpatient Pharmacy
	699	A new Outp atient Pha rmacy site parameter shall be available to the Vis tA Pharmac y applicat ion to ena ble or dis able the “ Park” func tionality (2.6.2.16) .
	700	The system shall ena ble the “P ark” optio n (and its related f unctionali ty) when t he paramet er specifi ed in requ irement 2. 6.15.10 is set to EN ABLE for B OTH the di vision of the logged on user A ND also th e division of the en counter lo cation.
	701	The follow ing featur es shall b e availabl e when the Outpatien t Pharmacy site para meter is s et to "ena ble” the P ark functi onality:
	702	The VistA Pharmacy a pplication shall off er a picku p routing of “Park” when finis hing a new medicatio n order (2 .6.2.1).
	703	At the LAB EL: QUEUE prompt (wh en a presc ription is finished) , a new "P K" option shall be a vailable t o “Park” t he prescri ption with in VistA P harmacy.
	704	The VistA Pharmacy a pplication shall off er a picku p routing of “Park” when renew ing a pres cription ( 2.6.2.2).
	705	The VistA Pharmacy a pplication shall off er a picku p routing of “Park” when copyi ng a presc ription (2 .6.2.3).
	706	The VistA Pharmacy a pplication shall off er a picku p routing of “Park” when enter ing a new prescripti on (2.6.2. 4).
	707	The VistA Pharmacy a pplication shall ass ign a stat us of “Act ive/Park” to a presc ription wh en the pic kup routin g of “Park ” is selec ted (2.6.2 .5).
	708	The VistA Pharmacy a pplication shall pro vide the a bility to place a fi nished pre scription into an em ulated sta tus of “Ac tive/Park” on the ph armacy Vis tA Medicat ion Profil e. The “ST ” column o n Outpatie nt Pharmac y side sha ll show "A P" for a p rescriptio n that has a status of “Active /Park.” Th e actual i nternal st atus will be “Active ,” but bas ed on the content of a designa ted field, created t o indicate “Parked,” the statu s shall be displayed as "AP" ( 2.6.2.8).
	709	The VistA Pharmacy a pplication shall off er a hidde n option t o “Park” o r “Unpark” a prescri ption, pat terned aft er the cur rent funct ionality f or Hold/Un hold.
	710	The VistA Pharmacy a pplication shall rem ove a pres cription t hat is “Pa rked” from the suspe nse file w hen applic able (2.6. 2.9).
	711	The VistA Pharmacy a pplication shall off er the opt ion to “Un park” a pr escription with a st atus of “A ctive/Park ed.”
	712	At the tim e a prescr iption is “Unparked, ” the Vist A Pharmacy applicati on shall a llow the p harmacist the option to send a fill of t he order b y “Window” or “Mail” (2.6.2.6) .
	713	At the tim e a prescr iption is “Unparked” , the Vist A Pharmacy applicati on shall d isplay eit her the cu rrent fill date or t he origina l fill dat e if in th e future ( 2.6.2.7).
	714	The VistA Pharmacy a pplication shall req uire that a prescrip tion be “U nparked” b efore Susp ense-relat ed activit ies can be performed (2.6.2.9) .
	715	The VistA Pharmacy a pplication shall all ow a presc ription wi th a statu s of “Acti ve/Park” t o be “Unpa rked” and placed in a suspense file if a mail-in b ar coded r efill requ est slip i s received for that prescripti on (2.6.2. 12).
	716	The VistA Pharmacy a pplication shall all ow the fol lowing act ivities, w hich can b e performe d on an “A ctive” pre scription, to also b e performe d on an “A ctive/Park ” prescrip tion (2.6. 2.9).
	717	The VistA Pharmacy a pplication shall fol low the sa me busines s rules fo r “Active/ Parked” pr escription s as are c urrently f ollowed fo r “Active” prescript ions (2.6. 2.10).
	718	The VistA Pharmacy a pplication shall all ow the “Co py” activi ty to be p erformed o n an “Acti ve/Park” p rescriptio n (2.6.2.9 .7).
	719	The VistA Pharmacy a pplication shall all ow the “De lete a Pre scription” activity to be perf ormed on a n “Active/ Park” pres cription ( 2.6.2.10.1 ).
	720	The VistA Pharmacy a pplication shall all ow the “Di scontinue on a date of death e ntry” acti vity to be performed on an “Ac tive/Park” prescript ion (2.6.2 .9.10).
	721	The VistA Pharmacy a pplication shall all ow the “Di scontinue” activity to be perf ormed on a n “Active/ Park” pres cription ( 2.6.2.9.1) .
	722	The VistA Pharmacy a pplication shall cau se a presc ription to automatic ally be “U nparked” ( “Active”) if a “Disc ontinue” a ctivity is performed .
	723	The VistA Pharmacy a pplication shall all ow the “Ed it” activi ty to be p erformed o n an “Acti ve/Park” p rescriptio n (2.6.2.1 0.4).
	724	The VistA Pharmacy a pplication shall all ow the “Ed it Routing ” activity to be per formed on an “Active /Park” pre scription, with the result tha t the medi cation ord er shall a utomatical ly be “Unp arked” (2. 6.2.9.9).
	725	The VistA Pharmacy a pplication shall all ow the “Ho ld/Unhold” activity to be perf ormed on a n “Active/ Park” pres cription ( 2.6.2.9.8) .
	726	The VistA Pharmacy a pplication shall fol low the bu siness rul es for “Ho ld,” while also main taining th e “Parked” flag for the prescr iption.
	727	The VistA Pharmacy a pplication shall ens ure that i f a user s elects “Un hold” for a previous ly “Parked ” prescrip tion, the user will be present ed with a prompt ask ing whethe r the inte ntion is t o retain t he previou s “Active/ Parked” st atus when the “Hold” is remove d.
	728	The VistA Pharmacy a pplication shall all ow the “Re fill” acti vity to be performed on an “Ac tive/Park” prescript ion (2.6.2 .9.4).
	729	The VistA Pharmacy a pplication shall cau se a presc ription to automatic ally be “U nparked” ( “Active”) if the “Re fill” acti vity is pe rformed.
	730	The VistA Pharmacy a pplication shall all ow the “Re new” activ ity to be performed on an “Act ive/Park” prescripti on (2.6.2. 9.6).
	731	The VistA Pharmacy a pplication shall all ow the “Re quest Co-P ay Status/ Cancel Cha rges” acti vity to be performed on an “Ac tive/Park” prescript ion (2.6.2 .10.4).
	732	The VistA Pharmacy a pplication shall all ow the “Re turn medic ation to s tock” acti vity to be performed on an “Ac tive/Park” prescript ion (2.6.2 .10.3).
	733	The VistA Pharmacy a pplication shall all ow the “Vi ew Prescri ption” act ivity to b e performe d on an “A ctive/Park ” prescrip tion (2.6. 2.9.2).
	734	The VistA Pharmacy a pplication shall NOT allow the following activitie s, which c an be perf ormed on a n “Active” prescript ion, to be performed on an “Ac tive/Park” prescript ion:
	735	The VistA Pharmacy a pplication shall NOT allow the “Reprint” activity to be perf ormed on a n “Active/ Park” pres cription. The applic ation shal l require that the p rescriptio n must be “Unparked” (“Active” ) before t he “Reprin t” activit y can be p erformed. If a presc ription ha s a status of “Activ e/Park” an d the “Rep rint” acti vity is at tempted, t he message “Invalid Action—Pre scription must be in “Active” status to perform th is action” shall be displayed (as it is for the “H old” funct ionality) (2.6.2.9.3 ).
	736	The VistA Pharmacy a pplication shall NOT allow the “Partial” activity to be perf ormed on a n “Active/ Park” pres cription. The applic ation shal l require that the p rescriptio n must be “Unparked” (“Active” ) before t he “Partia l” activit y can be p erformed. If a presc ription ha s a status of “Activ e/Park” an d the “Par tial” acti vity is at tempted, t he message “Invalid Action—Pre scription must be in “Active” status to perform th is action” shall be displayed (as it is for the “H old” funct ionality) (2.6.2.9.5 ).
	737	The VistA Pharmacy a pplication shall ens ure that t he followi ng reports , which cu rrently sh ow “Active ” prescrip tions, als o show any parked pr escription s as “Acti ve/Park” ( 2.6.2.11):
	738	Medication Profile [ PSO P]
	739	DHCP REFIL L TRANSACT ION MENU [ VEXR REFIL L TRANSACT ION MENU]
	740	Pharmacy I nfo Profil e [PSOZ IN FO PROFILE ]
	741	Action Pro file [PSO ACTION PRO FILE]
	742	Bad Addres s Suspende d List [PS O BAI SUSP ENDED]
	743	List Presc riptions N ot Mailed [PSO BAI N OT MAILED]
	744	List Presc riptions o n Hold [PS O HOLDRPT]
	745	Released a nd Unrelea sed Prescr iption Rep ort [PSO R ELEASE REP ORT]
	746	Rx (Prescr iption) Ou tpatient D ispensing Report
	747	CS Monitor ing Menu [ PSD NM MEN U]
	748	Prescripti on List fo r Drug War nings [PSO RX LIST]
	749	List of Pa tients/Pre scriptions for Recal l Notice [ PSO RECALL LIST]
	750	Narcotic P rescriptio n List [PS O NARC]
	751	Poly Pharm acy Report [PSOPOLY]
	752	Health Sum mary Menu [GMTS USER ]
	753	Patient He alth Summa ry [GMTS H S BY PATIE NT]
	754	Performanc e Monitor Report [OR PERFORMAN CE MONITOR ]
	755	The system shall ens ure that t he followi ng reports (not acce ssible fro m the Vist A menu opt ions) shal l be modif ied to als o include “Active/Pa rk” prescr iptions (2 .6.2.11):
	756	Any TIU ob ject that is generat ed using t he TIULMED routine
	757	Any health summary c ontent tha t is gener ated using the PSOHC SUM routin e
	758	The VistA Pharmacy a pplication shall ens ure that a prescript ion with a status of “Active/P ark” is NO T sent to automated dispensing equipment or to CMO P (2.6.2.1 3).
	759	The VistA Pharmacy a pplication shall app ly the cur rent order check fun ctionality to any “A ctive/Park ” prescrip tion (2.6. 2.14).
	760	The VistA Pharmacy a pplication shall ens ure that a ny “Park/U npark” act ivities pe rformed fo r a prescr iption are captured in the act ivity log for that p rescriptio n (2.6.2.1 5).
	761	The Vista Pharmacy a pplication shall pro vide a new DEA speci al handlin g code (le tter “D”) to prevent users fro m using th e parking option for prescript ions that include dr ugs with t hat classi fication ( for exampl e, Clozapi ne) (2.6.2 .17).
	762	The functi onality of the exist ing propri etary Mass achusetts General Ho spital Uti lity Multi -Programmi ng System (MUMPS) Au dioCARE Au dioREFILL System sha ll be enha nced to su pport the following functional requireme nts:
	763	The AudioC ARE AudioR EFILL Syst em shall a llow any a ctivities performed for an “Ac tive” pres cription t o be perfo rmed for a n “Active/ Parked” pr escription (from the user/pati ent perspe ctive, no changes sh all be evi dent) (2.6 .3.1).
	764	When a pat ient reque sts proces sing of a prescripti on using t he AudioCA RE System, the Outpa tient Phar macy appli cation sha ll “Unpark ” and fill the presc ription (2 .6.3.1).
	765	The VistA system sha ll be capa ble of pro cessing re quests fro m the Audi oCARE Audi oREFILL Sy stem to al low a pati ent to req uest/recei ve the ini tial (orig inal) fill of a pres cription ( 2.6.3.2).
	766	When a pat ient using the Audio CARE Audio REFILL Sys tem reques ts a fill of a presc ription th at has bee n replaced by a newe r, “Parked ” prescrip tion for t he same or derable it em but dif ferent dis pense drug , the fill shall be processed as if the newer pres cription w ere reques ted, using the old p rescriptio n number ( 2.6.3.3). This “link ing and re placement” capabilit y shall be restricte d to the c onditions described below. If these con ditions ar e not ALL met, the a lternative to “linki ng and rep lacement” as describ ed above s hall be fo r the syst em to resp ond to the user with the messa ge “[Rx nu mber] is n o longer r efillable please spe ak to a ph armacist.
	767	The patien t requesti ng the pre scription must be th e same for both the previous p rescriptio n and the more recen t “Parked” prescript ion.
	768	The prescr iptions mu st be for the same o rderable i tem.
	769	The previo us prescri ption for the ordera ble item i s no longe r active.
	770	The most r ecent pres cription h as a statu s of “Acti ve/Park” [ finished].
	771	There is o nly one pr escription on file f or the spe cific pati ent and or derable it em.
	772
	773	Associated Non-Funct ional Requ irements
	774	Park-A-Pre scription GUI source code and related Vi stA change s shall be integrate d into CPR Sv32.
	775	The Delphi source co de for Par k a Prescr iption sha ll be conv erted from Delphi 20 06 to Delp hi XE3 (or current v ersion in use for CP RSv32).
	776	First Dose – Enhance ment withi n CPRS Med ication Or der
	777	The system shall dis play to th e ordering clinician the last time a med ication wa s ordered, administe red or dis pensed/fil led; or di splay that the drug is a new m edication.
	778	During the ordering dialog for a medicat ion for in patients o r outpatie nts, the s ystem shal l check th e inpatien t, outpati ent, IV, N on-VA and Remote Dat a files an d display to the ord ering clin ician the dates of o ne or more of the fo llowing: l ast filled , last act ion/given, last orde red.
	779	The system shall bas e the disp lay on the orderable item of t he medicat ion curren tly select ed by the ordering c linician.
	780	The system shall ale rt the nur se when th e patient receives t heir first dose of m edication.
	781	If clinici an determi nes based on returne d informat ion that t his is a f irst dose, the syste m shall pr ovide a ch eck box fo r the clin ician to c ommunicate this info rmation to pharmacy and nursin g.
	782	If the sys tem does n ot find an y indicati ons that t he patient has had t his medica tion, the system sha ll present the check box with a check ma rk present .
	783	The system shall aut omatically capture t he date/ti me the ord er is sign ed as the “first dos e” date/ti me.
	784	The system shall all ow the pro vider to u ncheck the box if it isn’t in the system , (there s hould be a new first dose comm ent box) b ecause the patient i s now repo rting that they have previousl y had the medication . (The pro vider will then need to enter a new Non- VA medicat ion when t hey are do ne with th e current order).
	785	The system shall pro vide a pop up alert to the BCM A nurse al erting the m that the y have sca nned a fir st dose dr ug.
	786	The system shall pro vide the p rocess and reporting to work f or Inpatie nt Medicat ions for O utpatient (IMO) loca tions.
	787	The system shall pro vide the n urse with a report o f the pati ents that have been administer ed a first dose duri ng that nu rse’s shif t.
	788	The system shall pro vide a rep ort to the nurse tha t can be r un for a p eriod of t ime select able by th e nurse th at display s all pati ents that received a first dos e with tim e of admin istration.
	789	The system shall pro vide a mea ns of trac king compl iance with the proce ss of moni toring a p atient's r esponse to a first d ose medica tion.
	790	The system shall pro vide a fir st dose mo nitoring r eport that can be ru n for a pe riod of ti me that di splays the date/time that all patients f or a given doctor or clinic or service o r location had first dose chec ked on ord er entry, date/time of BCMA Co mment fiel d and text of commen t if patie nt was an inpatient.
	791	The system shall pro vide a com pliance re port for a nurse tha t displays the numbe r of first dose medi cations ad ministered and the n umber with a comment entered i n BCMA.
	792	Enhance CP RS/Medicat ion Histor y Report t o Fully Do cument IV Administra tion
	793	The system shall pro vide the a bility for the user to view al l infusion actions ( instead of just the most recen t complete d action), accompani ed by actu al dates a nd times, for each c ontinuous infusion.
	794	The system shall pro vide the a bility for the user to view al l infusion actions ( and not ju st the mos t recent c ompleted a ction), ac companied by actual dates and times (wit h the most recent fi rst), for each conti nuous infu sion on th e Medicati on History report (w hich displ ays at the bottom of the CPRS Order Deta il window, viewed fr om the Ord ers tab, a nd the Med ication De tails wind ow, viewed from the Meds tab).
	795	The system shall pro vide the a bility for the user to view al l infusion actions ( and not ju st the mos t recent c ompleted a ction), ac companied by actual dates and times (wit h the most recent fi rst), for each conti nuous infu sion on th e Medicati on Admin H istory rep ort (which is availa ble from t he CPRS Re ports tab) .
	796	Each separ ate infusi on of an a dditive (i n a soluti on that is not pre-m ixed) shal l be prese nted only once on th e report a nd shall n o longer a ppear once as an “ad ditive” an d again in conjuncti on with a “solution” for the s ame admini stration. If multipl e administ rations oc cur in the specified time fram e, then ea ch adminis tration of the addit ive shall be reporte d.
	797	Each separ ate infusi on of a pr e-mixed so lution sha ll be pres ented only once on t he report. If multip le adminis trations o f a pre-mi xed soluti on occur i n the spec ified time frame, th en each ad ministrati on shall b e included on the re port).
	798	In order t o satisfy the requir ements abo ve, the se arch logic invoked b y the BCMA module (i n response to an API call from CPRS) sha ll be modi fied as fo llows:
	799	For infusi on orders having a s olution or solutions (no pre-m ix flag) w ith one or more addi tives, the search sh all be con ducted for the addit ive(s) onl y, and not for the s olutions(s ). The res ults shall be groupe d by addit ive, with the most r ecent admi nistration first.
	800	For infusi on orders having a s olution or solutions (with pre -mix flag) , the sear ch shall b e conducte d for the pre-mixed solution(s ). The res ults shall present t he adminis trations o f the pre- mixed solu tion(s), w ith the mo st recent first.
	801	Critical / High Orde r Check Di splay
	802	The system shall col lect overr ide justif ication(s) specific to each or der for wh ich an ord er check h as been pr esented an d where th e justific ation is r equired.
	803	The system shall pro vide the a bility for a user to view the severity o f order ch ecks (low, medium [s ignificant ], high [c ritical]).
	804	The system shall pro vide the a bility to prompt pro vider to e nter overr ide reason s for each order wit h critical (i.e. hig h) order c hecks in n eed of jus tification prior to releasing the order.
	805	The system shall pro vide the a bility for user to d etermine w hich overr ide justif ication go es with wh ich order prior to o verriding the order check/rele asing the order.
	806	Button to Link No As sessment W arning to Allergy As sessment S creens
	807	For an ord er check r esult of t he type “N o Allergy Assessment ,” the sys tem shall present a button in each assoc iated inst ance of th e CPRS Ord er Checks dialogue t o allow (b ut not req uire) the user to im mediately proceed to the Causa tive Agent Lookup wi ndow and i nitiate al lergy entr y.
	808	The system shall not display t he “Perfor m Allergy Assessment ” button i f the logg ed on user is not au thorized t o enter an allergy a ssessment.
	809	The button “Perform Allergy As sessment ” shall con tinue to d isplay in any Order Checks dia log displa yed to the user (if the user h as allergy entry pri vileges), whether at acceptanc e, signing , or other stage of order proc essing, wh ile the pa tient’s al lergy asse ssment sta tus is “No Allergy A ssessment. ”
	810	If the use r clicks t he button “Perform A llergy Ass essment” i n response to an ord er check o f the type “No Aller gy Assessm ent” and e ither ente rs a react ant or sel ects “No K nown Aller gies,” the n any cond itionally required o verride re ason assoc iated with this orde r check ty pe shall n ot be requ ired at th e time of signing (r equirement is curren tly trigge red if a s ite parame ter assign s HIGH cli nical sign ificance t o a “no al lergy asse ssment” or der check) .
	811	Real-Time Notificati on of Pote ntially Mi ssed Order Checks
	812	Provide re al-time no tice to us er of limi tations on drug alle rgy order checking ( order chec ks by drug class) wh en the use r selects a reactant for an al lergy or a dverse dru g reaction from the selection tree (sour ce files) presented.
	813	Provide a real-time (pop-up) m essage to the user i f the reac tant selec ted during patient a llergy/ADR entry is a drug ing redient th at does no t supply t he necessa ry informa tion to su pport a dr ug allergy order che ck at the drug class level. In clude in t he message the recom mendation to the use r to selec t the reac tant from another (h igher) fil e in the s election t ree. The u ser shall be present ed with th is message provided: “If this is a reac tion only to the ing redient se lected (i. e. CAPTOPR IL), check the box t o continue . If it m ay be a re action to other drug s in the s ame class, please se lect an it em higher on the lis t.”
	814	Require th e user to either con firm accep tance of t he selecte d reactant (and its limitation s on poten tial futur e drug all ergy order checks) o r decline/ reject the selected reactant a nd be allo wed to re- select the reactant from anoth er data so urce.
	815	Enhanced A llergy Che cks using COTS Data
	816	The system shall inc orporate a mapping o f the VUID for all V A reactant s currentl y found in the VA Al lergies Fi le (GMR Al lergies 12 0.82), Nat ional Drug File/Gene ric (VA Ge neric 50.6 ), Drug In gredients File (50.4 16), and V A Drug Cla ss File (5 0.605) and therefore currently selectabl e for Pati ent Allerg y Recordin g—which ar e NOT excl uded from selection (by 2.6.21 .2.1 below ) and NOT excluded f rom Drug A llergy Ord er Checkin g (by 2.6. 21.2.2 bel ow)—to the First Dat a Bank con cept ident ifier for that react ant, where ver a corr esponding FDB identi fier exist s.
	817	The system shall inc orporate m odificatio ns to the reactant d ata curren tly found in the fil es specifi ed (in 2.6 .21.1 abov e) as foll ows:
	818	A subset ( TBD) of al l of the r eactants f or which m atches are found in the source files sha ll be iden tified in their data sources a s “selecta ble as rea ctants dur ing patien t allergy recording. ” (An exce ption migh t be “comp ressed air ,” for whi ch a match is found in the Nat ional Drug File, but which may not be me aningful f or selecti on during patient al lergy/ADR recording. )
	819	A further subset (TB D) of the reactants selectable for aller gy recordi ng, as des cribed in 2.6.21.2.1 (above) s hall be id entified i n their da ta sources as “selec table as r eactants d uring pati ent allerg y recordin g AND mean ingful for inclusion in the da taset sent for Drug Allergy Or der Checki ng.” (Exce ptions mig ht be “Ban d-Aids,” f or which a match is found in t he VA Alle rgies File , or “Cinn amon,” for which a m atch is fo und in the Drug Ingr edients Fi le, but wh ich—althou gh valid f or selecti on during patient al lergy reco rding—may not be mea ningful fo r inclusio n in Drug Allergy Or der Checks ).
	820	For the se t of react ants resul ting from the filter condition described in 2.6.21 .2.2 above (reactant s that are meaningfu l for incl usion in D rug Allerg y Order Ch ecks), tho se reactan ts shall b e identifi ed in thei r data sou rces as ei ther (1 me aningful f or inclusi on in Drug Allergy O rder Check s AND mapp ed to an F DB identif ier (resul ting in a system dec ision to f ollow the FDB path f or Drug Al lergy Orde r Checking ); or (2 m eaningful for inclus ion in Dru g Allergy Order Chec ks BUT NOT mapped to an FDB id entifier ( resulting in a syste m decision to follow the legac y VA path for Drug A llergy Ord er Checkin g).
	821	The system shall inc orporate t he modific ations nec essary (if any) to t he Patient Allergy F ile (120.8 ) to accom modate the modifiers (indicato rs) specif ied in 2.6 .21.2.2 an d 2.6.21.2 .3 above
	822	The system shall pro vide a mec hanism to allow opti onal branc hing to ei ther (1 VA drug alle rgy order checking f unctionali ty as it c urrently e xists (or is modifie d accordin g to these requireme nts) and w hich is re sident wit hin the Vi stA system or (2 to FDB Drug A llergy Ord er Checkin g/alert fu nctionalit y, accesse d using th e VistA an d FDB APIs for Drug Allergy Or der Checki ng). The option for variable branching to use the legacy VA path shal l be exerc isable for the follo wing
	823	Valid and/ or legacy VA reactan ts recorde d in the P atient All ergy file and identi fied as me aningful f or inclusi on in Drug Allergy O rder Check s but whic h are not supported by FDB wit h matching concept i dentifiers .
	824	The VistA enterprise system du ring the p eriod unti l conversi on to FDB for Drug A llergy Ord er Checkin g is fully implement ed.
	825	Drug Aller gy Order C heck insta nces when the FDB fu nctionalit y (residen t on the M OCHA serve rs) is una vailable d ue to syst em down or other con ditions th at prevent successfu l Drug All ergy Order Checking against FD B logic an d data.
	826	Where/when branching to FDB fo r Drug All ergy Order Checking is “turned off” usin g a system or site p arameter.
	827	A new inte rface shal l be creat ed for Dru g Allergy Order Chec king that utilizes a n FDB-spec ific API ( or APIs) i n VistA an d the corr esponding FDB API fo r Drug All ergy Order Checking, allowing patient al lergy and order data to be sen t for comp arison by FDB logic and classi fication d ata and al lowing ale rt text (D rug Allerg y Order Ch eck result s) generat ed by FDB to be retu rned and p rocessed b y CPRS/Vis tA.
	828	In the Ent er Allergy or Advers e Reaction window an d in all a ssociated data sets, the syste m shall di splay the selection options fo r Nature o f Reaction as 1) All ergy, 2) A dverse Rea ction (ins tead of “P harmacolog ical”), an d 3) Unkno wn.
	829	The order of present ation of t he Nature of Reactio n options in the lis t shall re main 1) Al lergy, 2) Adverse Re action, 3) Unknown, (and shall not be in alphabeti cal order.
	830	Patient al lergy data (recorded reactants and their concept i dentifiers ) shall re main compa tible for data inter change wit h the Depa rtment of Defense/Cl inical Hea lth Data R epository and other outside en tities tha t currentl y rely on associatio n of the V UID for id entified a llergy rea ctants wit h UMLS cod es.
	831	D/C Order Due to Adv erse React ion
	832	The system shall add Allergy/A dverse Dru g Reaction as a reas on for dis continuing a medicat ion order.
	833	The system shall inc lude Aller gy/Adverse Drug Reac tion as a reason for discontin uing a med ication or der, selec table from the same list of “R easons for Discontin ue” as cur rently off ered on th e Disconti nue/Cancel Orders sc reen.
	834	The system shall not default t o Allergy/ Adverse Dr ug Reactio n as the r eason for discontinu ing a medi cation ord er, even t hough that reason ma y appear a t the top of the res ulting sel ection lis t, based o n the inco ming (alph abetical) sort order of the el ements in the list.
	835	When Aller gy/Adverse Drug Reac tion is se lected as reason for discontin uing a med ication or der, the s ystem shal l display a window p resenting the user w ith the li st of curr ently reco rded aller gies for t he patient and askin g whether the user w ants to en ter the al lergy/adve rse reacti on.
	836	If the use r answers YES to pro ceed with Allergy/AD R entry, t he system shall disp lay the Al lergy/ADR entry wind ow within the normal discontin ue medicat ion orders workflow.
	837	If the use r answers NO to not proceed wi th Allergy /ADR entry , the syst em shall r e-display the Orders tab, show ing an unr eleased or der to dis continue t he medicat ion, ready for Provi der signat ure.
	838	The system shall inc lude a can cel option on Allerg y/ADR entr y window, so the pro vider can elect to n ot enter a n Allergy/ ADR if not appropria te.
	839	Changes to Allergy/P harmacy Pa ckages
	840	The system shall red uce the po tential fo r patient allergy in formation to be over looked by nurses, ph armacists, and physi cians.
	841	The system shall def ine the ev ent that t riggers a pop-up ale rt for a d rug allerg y order ch eck as “as soon as t he provide r chooses the medica tion” inst ead of as “after use r accepts order.”
	842	The system shall pro vide a pop -up “overr ide allerg y” alert i f the prov ider elect s to conti nue with t he medicat ion order after the drug aller gy order c heck.
	843	The “overr ide allerg y” alert w indow shal l present a list of pre-define d, commonl y used rea sons for o verriding a drug all ergy.
	844	The system shall all ow direct entry of a reason fo r overridi ng in the pop-up “ov erride all ergy” aler t as an al ternative to selecti on from th e pre-defi ned list ( specified in 2.6.23. 1.2.1).
	845	The system shall req uire a min imum of 4 characters in the “r eason for overriding ” field to discourag e the entr y of fille r in this required f ield.
	846	The system shall ens ure that a ny “reason for overr iding” all ergy alert (whether selected f rom a list or direct ly entered ) is perma nently ava ilable for traceabil ity/report ing.
	847	The system shall dif ferentiate drug alle rgy order check resu lts by pre senting th em in a se parate dia log and by labeling or otherwi se visuall y distingu ishing the m from oth er types o f order ch eck result s when pre sented tog ether in t he Order D etail wind ow.
	848	Once a rea ction is c lassified as either an adverse reaction or a true “allergy,” the syste m shall al ways diffe rentiate b etween the two (base d on these categorie s) when pr esenting a lerts to u sers.
	849	The system shall imp rove accur acy and do cumentatio n of patie nt allergi es between medical c enters.
	850	The system shall pro vide the a bility to add a comm ent to ano ther site’ s allergy informatio n and to a ssociate t hat commen t with all locally p resented o rder check detail re lated to t hat allerg y. The com ment shall be entere d on the O rder Check screen la beled, “Lo cal Commen t on Remot e-Facility Allergy”, and will work in a fashion si milar to t he overrid e reason w ith additi onal selec tions whic h include “Patient r eport/inte rview is i nconsisten t with rem ote allerg y/data-can not correc t remote d ata” or “P atient rep ort per in terview is inconsist ent with r emote alle rgy data.
	851	The system shall pro vide the a bility for users at the site w here the c omment (sp ecified in 2.6.23.2. 1) was add ed to view the comme nt but sha ll not sup port the e xport of s uch commen ts to othe r VistA in stances.
	852	Order Flag Recommend ations
	853	The system shall enh ance CPRS "Flag Orde r" functio ns.
	854	The system shall pro vide the a bility for the user who sets t he order f lag to:
	855	Specify an unlimited number of recipient (s) of the order fla g.
	856	Provide th e ability to add a “ No Action Alert” dat e to the f lag. (Opti onal)
	857	View a lis t of all s elected re cipients o f the orde r flag.
	858	Receive no tification that a fl agged orde r was not unflagged within a c ertain (us er definab le?) time frame. (Al ert mandat ory and si te not all owed to di sable).
	859	Document c omplete re ason for f lag in the Reason fo r Flag fie ld without restricti on as to t he number of charact ers that c an be ente red. (The text field will incr ease from 80 charact ers to 240 character s and subj ect to a m inimum of 4 characte rs).
	860	The system shall pro vide the a bility for the user who proces ses the fl agged orde r alert to :
	861	Add an unl imited num ber of rec ipients to flagged o rder alert .
	862	Enter mult iple comme nts (any r ecipient o f the orde r flag).
	863	View all c omments, f lag recipi ents, and flag/unfla g actions in order d etails of the flagge d order.
	864	Select an option (fo r example, CPRS Orde rs tab>Vie w menu >Ac tive Order s and Curr ent Orders to view a ll flagged orders fo r patient, including current s tatus and flag/unfla g comments for each order.
	865	View Order Location and Order Name with the flag a lert notif ication.
	866	View curre nt status of all rel ated order s for a pa tient and their flag /unflag co mments, in cluding bu siness log ic to ensu re that us ers proces sing alert s do not a rrive at a blank ord er screen.
	867	View order flag aler ts for eac h flagged order, inc luding the order nam e in the a lert text.
	868	The system shall pro vide the f ollowing f unctionali ty for unf lagging or ders:
	869	The system shall req uire that a comment be entered by the us er unflagg ing an ord er.
	870	2.6.24.1.3 .2 The sys tem shall restrict t he users w ho can unf lag an ord er to the recipients of that p articular flagged or der.
	871	2.6.24.1.3 .2.1 The system sha ll provide the abili ty to perf orm the un flag actio n by “Disp lay Groups ”. Each di splay grou p would sp ecify what key (OREL SE, OREMAS and PSJ P HARM etc.) can unfla g orders.
	872	2.6.24.1.3 .2.2 The s ystem shal l provide the abilit y for a si te to disa ble unflag ging restr ictions.
	873	2.6.24.1.3 .2.3 The s ystem shal l implemen t the rest riction an d the site enable/di sable para meters at the PACKAG E, SYSTEM, and DIVIS ION level settings.
	874	The system shall pro vide the a bility to add a “No Action Ale rt” expira tion date to a flag.
	875	The system shall pro vide the a bility to view all f lagged ord ers from a ll views ( for exampl e, on the CPRS Order s tab>View Menu > Ac tive Order s and Curr ent Orders ).
	876	The system shall pro vide the a bility for any alert recipient to add a comment to the flag.
	877	The system shall not ify the or iginator o f the flag ged order when a com ment is ad ded to the flag. (Th is functio nality wil l not be a vailable i n VistA Ph armacy).
	878	The system shall sen d an alert to all li sted flag order reci pients tha t a commen t was adde d to the f lag.
	879	The system shall aut omatically delete al l unproces sed flag o rder alert s from all of the fl ag order r ecipients for this f lag order. This over rides the setting of ORB DELET E MECHANIS M to INDIV IDUAL.
	880	The syste m shall re strict ord er flag fo rwarding
	881	Progress N otes Displ ay Mislead ing
	882	The system shall pro vide compl ete inform ation retr ieval to t he user.
	883	The system shall ret rieve the complete s et of TIU note docum ents withi n the spec ified rang e.
	884	The system shall eli minate use r error.
	885	When a doc ument has an addendu m(s), the system sha ll count t he origina l and all addendums as (1) set for count ing # of d ocuments r eturned.
	886	The system shall inc rease user cognition of any li mitations placed on the inform ation retr ieval.
	887	The system shall ret urn the fu ll list of sequentia lly dated documents without da te/time ga ps due to maximum nu mber reach ed.
	888	Indication for Presc ription an d Medicati on Orders
	889	The system shall pro vide a met hod for pr oviders to associate a medicat ion indica tion with each medic ation orde r they pla ce in CPRS , Inpatien t Medicati ons or IV Medication s and Outp atient Pha rmacy.
	890	The system shall pro vide a met hod to ent er a valid indicatio n in each applicatio n for CPRS , Inpatien t Medicati ons or IV Medication s and Outp atient Pha rmacy.
	891	The syste m shall pr ovide the users with a drop do wn list [o r equivale nt] of ava ilable ind ications f or use.
	892	The system shall pro vide a dro p down lis t to be po pulated wi th the Mos t Common i ndications from the orderable item file.
	893	The system shall pro vide a dro p down lis t for a Si ngle Order able Item with the m ost common indicatio n displaye d above th e line and the remai nder indic ations dis played bel ow the lin e in alpha betical or der.
	894
	895	The system shall pro vide a dro p down lis t for Infu sion Order s with Mul tiple Orde rable Item s to displ ay the uni on of indi cations in alphabeti cal order excluding a line sep aration.
	896	The syst em shall p rovide for Non-VA do cumentatio n, the opt ion of ‘UN KNOWN’ to be availab le in the drop down list in CP RS.
	897	The system shall pro vide the a bility to capture th e indicati on as a fr ee form te xt entry.
	898	The system shall pro vide the a bility for providers to associ ate an ind ication fo r use on a n Outpatie nt Prescri ption, reg ardless of whether i t is enter ed through CPRS or V istA.
	899	The system shall pro vide the a bility for providers to associ ate an ind ication fo r use on a n Infusion order whe ther enter ed through CPRS or V istA.
	900	The system shall pro vide the a bility for providers to associ ate an ind ication fo r use duri ng Non-VA Medication documenta tion
	901	The system shall pro vide the a bility for providers to associ ate an ind ication fo r use on a n Inpatien t Medicati on order w hether ent ered throu gh CPRS or VistA.
	902	The system shall pro vide the a bility for providers to associ ate an ind ication fo r use on a Clinic Me dication o rder.
	903	The system shall pro vide the a bility for providers to associ ate an ind ication fo r use on a Clinic In fusion ord er.
	904	The system shall pro vide the a bility for providers to associ ate an ind ication wh en buildin g a Quick Order.
	905	The system shall pro vide the a bility for the Clini cal Applic ation Coor dinator (o r other au thorized u ser) to as sociate an indicatio n when bui lding a sy stem-wide Quick Ord er throug h VistA.
	906	The system shall pro vide the a bility to associate indication s to an or derable it em in the Pharmacy O rderable i tem file.
	907	The system shall pro vide the a bility to define a l ist of pos sible indi cations fo r a given pharmacy o rderable i tem.
	908	The syst em shall p rovide the ability t o define t he default indicatio n for a gi ven pharma cy orderab le item bu t the defa ult shall not be req uired.
	909
	910	The system shall pro vide the a bility for the indic ation info rmation to carry
	911	over on th e actions specified below:
	912	Copy to Ne w Order
	913	Transfer t o Outpatie nt
	914	Renew Orde r
	915	Change Ord er
	916	The system shall pro vide the a bility to view the i ndication informatio n on the P atient Lis t.
	917	The syste m shall pr ovide the ability to view the indication informati on on the options li sted below :
	918	Medication Profile [ PSO P]
	919	CPRS Repor ts Tab - M edications (under Cl inical Rep orts Tree)
	920	Health Sum maries, Na tionally R eleased - RXOP
	921	EMLR Essen tial Medic ation List for Revie w (patch 9 4)
	922	Inpatient Profile [P SJ PR]
	923
	924	The system shall pro vide the a bility to print the indication on the Ou tpatient m edication label.
	925	2.6.26.14. 1 The sys tem shall provide th e ability for pharma cist to in clude or e xclude th e indicati on informa tion from the medica tion label .
	926	2.6.26.14. 2 The sy stem shall provide t he ability for the p harmacist to edit th e
	927	indication text from the provi der in cas e the word ing of a s election ( such as fr om the pro blem list) is clinic ally accur ate but no t appropri ate for us e on the m edication label.
	928	The system shall pro vide the a bility to store the medication indicatio n informat ion for la ter retrie val and da ta analysi s as a dis crete fiel d on the V istA syste m.
	929	The system shall pro vide the c linical st aff with t he ability to view t he indicat ion inform ation in t he VistA p harmacy pa tient orde r detail s creens.
	930	The system shall pro vide the a bility to produce mo nthly and quarterly indication s reports. Summarie s of Natio nal, Local , and Free Text Indi cation usa ge.
	931	Allow user to clear own patien t locks in CPRS
	932	The system shall not ify the us er that th e lock is because an other user is enteri ng data in to the pat ient and/o r order re cord.
	933	The system shall not ify the us er that he /she has a nother pro cess that locks the patient an d/or order record.
	934	The system shall dis play the d ate and ti me within the popup message to ensure th e user wil l know tha t the mess age is cur rent.
	935	Create sep arate Aler t for Pros thetics Re quests
	936	The system shall ena ble a sepa rate updat e alert fo r prosthet ics reques ts that ca n be
	937	configured at the us er or team level, se parately f rom other consult al erts.
	938	The system shall ena ble Prosth etics upda te alerts to be filt ered/filed in a sepa rate stora ge locatio n for view ing at a l ater time.
	939	Limiting A dditional Signers Li st
	940	The system shall pro vide the a bility to limit name s presente d to the u ser in any otherwise unrestric ted CPRS-p resented d rop down l ist using data from file 200 t o display, and allow selection of, only active use rs who hav e CPRS COR tab acces s.
	941	The system shall pro vide the a bility for sites to identify u sers (acti ve or inac tive) to b e manually added to the list o f eligible signers t hrough use of an ASU USER CLAS S.
	942	The system shall pro vide the a bility to visually i dentify in active use rs present in the li st of elig ible signe rs.
	943	The system shall inv oke requir ement 2.6. 29.2.1 onl y when req uirement 2 .6.29.2 is in effect .
	944	The system shall pro vide the a bility for sites to identify u sers to be manually excluded f rom the li st of elig ible signe rs through use of an other ASU USER CLASS .
	945	Nature of Order Defa ult
	946	The system shall all ow the use r to selec t the corr ect Nature of Order.
	947	Modify CPR S to remov e the “Ver bal” Natur e of Order default s o that the user will have to s elect the correct Na ture of Or der.
	948	The system shall all ow sites t o set a de fault valu e.
	949	Modify CPR S to allow sites the flexibili ty to set a default value (Ver bal/Teleph one/Policy /None) for the Natur e of Order .
	950	Create a p arameter t hat will g ive sites the flexib ility to s et a defau lt value ( Verbal/Tel ephone/Pol icy/None f or the Nat ure of Ord er.
	951	VistA Immu nization E nhancement s
	952	The system shall acc ess Immuni zation Cal culation E ngine (ICE ) Web Serv ice to gen erate immu nization r ecommendat ions for t he patient .
	953	The system shall all ow the imm unization administra tor to ent er, edit a nd save th e followin g data fie lds about an immuniz ation with in an indi vidual's I mmunizatio n Record:
	954	Administe red:
	955	- Immuniza tion Type*
	956	- Lot numb er*
	957	- Expirati on date (a uto-popula ted based on lot #)
	958	- Manufact urer (auto -populated based on lot #)
	959	- Administ ration Dat e (auto-po pulated ba sed on enc ounter dat e/time)
	960	If CPRS se lected Enc ounter is a current clinic enc ounter (A, I) the ad ministrati on date is not selec table and cannot be changed.
	961	If CPRS se lected Enc ounter is an inpatie nt ward lo cation,
	962	Daily Hosp italizatio n Encounte r type “D” the admin istration date is no t selectab le and can not be cha nged.
	963	Hospitaliz ation Enco unter type “H” is th e administ ration dat e is selec table and the user m ust pick a valid adm inistratio n date and time. Th e data sav ed will be saved to the inpati ent locati on, the da te/time se lected, En counter ty pe “D”
	964
	965	- Administ ered By* ( default to signed-on user)
	966	- Ordered By* (defau lt to enco unter prov ider)
	967	- Route of administr ation (e.g . oral, IM , sub-Q, i ntranasal) *
	968	- Site of administra tion (body part)*
	969	CPRS will provide a list of de fault admi nistration sites bas ed on list of route selected. If route is oral th e site is disabled, no selecti on needed.
	970	- Number i n the seri es (e.g. 3 rd Anthrax immunizat ion)
	971	The list o f possible series in the drop down may v ary depend ing on the immunizat ion
	972	- Dosage i n ml -The UI may be changed to accept mu ltiple uni ts of meas urements.
	973	- VIS stat ement* (id entified b y immuniza tion, lang uage, edit ion date)*
	974	-Able to s elect mult iple VIS s tatements.
	975	-Default w ill be the English v ersion of the most r ecent VIS statement.
	976	* VIS - On the requi red fields if no pos sible valu es exists the field is not req uired
	977
	978	- Comments (Comment field will be restri cted to 24 5 characte rs.)
	979	-If more t han one CP T code is code is av ailable th en user mu st select the approp riate CPT code.
	980	- The syst em shall p rovide a w arning to the clinic ian when t hey procee d to recor d an immun ization th at is cont raindicate d/refused and record an overri de reason if they go ahead wit h it despi te the war ning.
	981	-If user a ccepts war ning then override r eason must be entere d.
	982
	983
	984	The system shall all ow the imm unization administra tor to ent er Histori cal Immuni zations wi th the fol lowing dat a fields:
	985	Historical :
	986	- Immuniza tion Type*
	987	- Lot numb er
	988	- Expirati on date
	989	- Manufact urer
	990	- Administ ration Dat e* (can be vague dat e – month/ year)
	991	- Route of administr ation (e.g . oral, IM , sub-Q, i ntranasal)
	992	- Site of administra tion (body part)
	993	- Number i n the seri es (e.g. 3 rd Anthrax immunizat ion)
	994	- Dosage i n ml
	995	- Outside Location
	996	- Informat ion Source *
	997	- Comments
	998	The system shall pro vide a war ning to th e clinicia n when the y try to r ecord an i mmunizatio n that is contraindi cated/refu sed and re cord an ov erride rea son if the y go ahead with it d espite the warning.
	999	–If user a ccepts war ning, then override reason mus t be enter ed.
	1000	-If more than one C PT code is available , then use r must sel ect the ap propriate CPT code.
	1001	The system shall pro vide the c apability to record a contrain dication/r efusal in the new V IMM Contra /Refusal E vents file (being re leased in PX215)*
	1002	-Warn Unt il Date
	1003	- Comment
	1004	The system shall pro vide the a bility to automatica lly add CP T Code tha t correlat es with ad ministrati on when on e immuniza tion is ad ministered .
	1005	The system shall pro vide the a bility to automatica lly add on e instance (each) of the CPT C ode that c orrelates with admin istration for each a dditional immunizati on. ***At the time this docum ent codes 904721 and 904722 ar e applicab le, howeve r these co des may ch ange in th e future.
	1006	The system shall all ow access to Immuniz ations fro m the Cove rsheet.
	1007	From the C oversheet the form s hall open with the I CE panel e xpanded, n o immuniza tions shal l be pre-p opulated i n the grid .
	1008	Users shal l be able to documen t as many immunizati ons as nee ded on the one insta nce of the form.
	1009	Upon exiti ng the for m a site d efined not e shall be auto-gene rated.
	1010	The corres ponding da ta shall b e saved in PCE for t he correct Encounter (Administ ered today vs docume nting outs ide/histor ical)
	1011	A note sha ll be gene rated per each insta nce of the form clos ing. “A no te should not be gen erated if no changes were made ” by click ing Save a nd Exit. ( The user w ill not be able to e xit the fo rm by clic king Save and Exit i f there ar e Immuniza tions show ing in the grid with a status of incompl ete.) Inco mplete rec ords will not be sav ed to PCE and will n ot be part of the no te.
	1012	Upon exiti ng the for m the Immu nization p ane on the Covershee t shall be refreshed . *Users m ay need to manually refresh th e Covershe et pane, a s PCE upda tes are in a task jo b.
	1013	Upon exiti ng the for m the addi tional CPT codes for documenti ng the adm inistratio ns shall b e sent to PCE.
	1014	The system allows th e Grid to display th e Immuniza tions in p rogress.
	1015	Users can Add Immuni zations in progress.
	1016	Users can Edit Immun izations i n progress .
	1017	Users can Delete/rem ove Immuni zations in progress.
	1018	Users can View the n ote text o f the Immu nization i n progress .
	1019	The system allows th e Grid to display Im munization name and Documentat ion type ( administer ed, histor ical, cont raindicate d/refused) .
	1020	The system shall def ine status Complete/ Incomplete .
	1021	Complete = All requi red fields are popul ated.
	1022	Incomplete = All req uired fiel ds are not populated .
	1023	The system shall uti lize the F orm Editor .
	1024	The Form E ditor shal l mark all required fields wit h an aster isk.
	1025	The Form E ditor shal l require all requir ed fields to be popu lated befo re the Gri d may be p opulated.
	1026	Users shal l be provi ded a warn ing messag e if requi red fields are missi ng
	1027	Users shal l have the ability t o cancel c hanges.
	1028	When editi ng an immu nization a ny value e ntered in this insta nce shall auto-popul ate.
	1029	The system shall uti lize Remin der Dialog s to docum ent Immuni zations (N ote: Norma l Reminder dialog fu nctionalit y shall re main the s ame).
	1030	Data shall be saved when the u ser clicks Finish in the Remin der Dialog .
	1031	Data shall not be sa ved when t he user ex its the fo rm.
	1032	Upon exiti ng the for m, the act ive note t he reminde r is updat ing will b e updated when the u ser clicks Finish in the Remin der dialog .
	1033	Notes are not auto g enerated.
	1034	If the Rem inder Dial og element contains an Immuniz ation type a button shall disp lay, upon clicking o n the butt on the new immunizat ion form s hall be di splayed.
	1035	If the fin ding item is “genera l immuniza tion” upon clicking the button , no Immun izations a re default ed and no Immunizati ons show i n the grid .
	1036	If there i s only one Immunizat ion findin g item and it is not “general immunizati on” the fi nding item will show in the gr id and it will be re ady for ed iting.
	1037	If there i s more tha n one Immu nization f inding ite m, all of them will show in th e grid, th e user mus t select w hich one t o start ed iting.
	1038	From the I mmunizatio n form the user shal l be able to add add itional Im munization s per elem ent.
	1039	Upon click ing finish on the Re minder dia log the ad ditional C PT codes f or documen ting the a dministrat ions shall be sent t o PCE.
	1040	The system shall all ow Immuniz ation docu mentation on the Enc ounter For m.
	1041	User shall be presen ted with a list of I mmunizatio ns for tha t encounte r.
	1042	User shall be able t o remove I mmunizatio ns for tha t encounte r.
	1043	Skin Test
	1044
	1045	Remove “Cl inic” Pick -up
	1046	The system shall pro vide the a bility to select loc ation to p ick up med ications.
	1047	The system shall dis play radio buttons i n the Outp atient Med Order Dia log.
	1048
	1049	Filter Pro vider Drop Down List
	1050	The system shall fil ter out no n-clinical names to prevent th e selectio n of non-c linical us ers from t he list.
	1051
	1052	Graphical User Inter face (GUI) Specifica tions
	1053	Document t he GUI spe cification s.
	1054	Multi-divi sional Spe cification s
	1055	There are no specifi c multi-di visional r equirement s.
	1056	Performanc e Specific ations
	1057	This secti on should identify d ynamic num eric speci fications placed on the softwa re or on h uman inter action wit h the soft ware as a whole. Num erical spe cification s may incl ude:
	1058	The number of simult aneous use rs to be s upported
	1059	Dynamic nu meric spec ifications should in clude the numbers of transacti ons and ta sks and th e amount o f data to be process ed within certain ti me periods for both normal and peak work load condi tions.
	1060	All of the se specifi cations sh ould be st ated in me asurable t erms. For example:
	1061	The system shall pro cess a tra nsaction i n less tha n 1 second 95% of th e time.
	1062	not
	1063	An operato r shall no t have to wait for t he transac tion to co mplete.
	1064	Quality At tributes S pecificati on
	1065	Indicate a ny specifi cations th at enhance the suppo rtability, maintaina bility, po rtability, testabili ty, or reu sability o f the syst em/project being dev eloped. In clude codi ng standar ds, naming conventio ns, class libraries, maintenan ce access, and maint enance uti lities tha t are not already do cumented i n the proj ect’s Qual ity Assura nce Plan.
	1066	Reliabilit y Specific ations
	1067	Specify th e level of reliabili ty require d of the s ystem. The following list cont ains sugge stions for specifica tions.
	1068	Availabili ty – Speci fy percent age of tim e availabl e (xx.xx%) , hours of use, main tenance ac cess, degr aded mode operations , and simi lar.
	1069	Mean Time Between Fa ilures (MT BF) – This is usuall y specifie d in hours , but it c ould also be specifi ed in term s of days, months or years.
	1070	Mean Time To Repair (MTTR) – H ow long th e system i s allowed to be out of operati on after i t has fail ed.
	1071	Accuracy – Specify p recision ( resolution ) and accu racy (by a known sta ndard) tha t is requi red in the systems o utput.
	1072	Maximum bu gs or defe ct rate – This is us ually expr essed in t erms of bu gs/KLOC (t housands o f lines of code), or bugs/func tion point .
	1073	Bugs – Thi s is categ orized in terms of m inor, sign ificant, a nd critica l bugs: th e specific ation(s) m ust define what is m eant by a “critical” bug. For example, c omplete lo ss of data or comple te inabili ty to use certain pa rts of the functiona lity of th e system.
	1074	Scope Inte gration
	1075	This secti on of the RSD should put the p roduct int o perspect ive with o ther relat ed product s. If the product is independe nt and com pletely se lf-contain ed, it sho uld be so stated her e. If the RSD define s a produc t that is a componen t of a lar ger system , as frequ ently occu rs, then t his sectio n should r elate the specificat ions of th at larger system to functional ity of the software and should identify interfaces between t hat system and the s oftware.
	1076	This secti on should also speci fy the use of other required s oftware pr oducts (fo r example, MUMPS Ker nel, FileM an, Window s NT); and interface s with oth er applica tions or o ther syste ms such as commercia l off-the- shelf (COT S) or nati onal datab ases. Spec ify the ap plication interfaces (e.g., th e linkage between an accounts receivable system an d a genera l ledger s ystem or a COTS devi ce that wi ll be inte rfaced usi ng an exis ting inter face). For each requ ired softw are produc t, the fol lowing sho uld be pro vided:
	1077	Integratio n Agreemen t (IA) num ber as app ropriate
	1078	Product na me
	1079	Version nu mber
	1080	Discussion of the pu rpose of t he interfa cing softw are as rel ated to th is softwar e product
	1081	Definition of the in terface in terms of message co ntent and format (HL 7, Electro nic Data I nterchange , etc.)
	1082	A block di agram show ing the so ftware int erfaces an d major co mponents o f the larg er system, interconn ections, a nd externa l interfac es can be helpful.
	1083	Security S pecificati ons
	1084	Document t he securit y specific ations to ensure tha t the plan ned or exi sting spec ifications and contr ols are fu lly docume nted and u nderstood. Use the b usiness re quirements provided by the bus iness owne r and the enterprise -level Req uirements Project Al location R eport (PAR ) to docum ent the se curity spe cification s.
	1085	System Fea tures
	1086	Each featu re descrip tion shoul d include a sequence of inputs and outpu ts. It is also highl y recommen ded that s ystem and functional specifica tion names be select ed with an eye to th e consiste ncy of the ir use in subsequent documents such as t he Systems Design Do cument (SD D).
	1087	Usability Specificat ions
	1088	Include sp ecificatio ns that af fect usabi lity. The following list conta ins exampl es of usab ility spec ifications :
	1089	Training – Specify t ime requir ed for a n ormal user s and powe r users to become pr oductive
	1090	Performanc e measures – Specify task time s for typi cal tasks
	1091	Specificat ions to co nform to c ommon usab ility stan dards – Sp ecify stan dards such as those for IBM Co mmon User Access (CU A) or Micr osoft® GUI
	1092
	1093	Purchased Components
	1094	Describe a ny compone nts purcha sed for us e in the s ystem/proj ect, any a pplicable licensing or usage r estriction s, and any associate d compatib ility/inte roperabili ty or inte rface stan dards.
	1095	Estimation
	1096	Detail the estimatio n approach for the p roject.
	1097	If the pro ject choos es to use function p oint estim ation, the Function Point Esti mate Workb ook must b e complete d to suppo rt the sum mary infor mation in this secti on. After the workbo ok has bee n complete d, the dat a in the A pplication Estimate sheets mus t be enter ed in this section.
	1098	For projec ts that re quire deve lopment in multiple products, the total estimated function p oints are calculated as the su m of each product’s estimated function p oints.
	1099	Instructio ns
	1100	Contact Th e VA Offic e of Infor mation and Technolog y (OIT) Pr oduct Deve lopment (P D) Process , Performa nce, and O versight ( PPO) Proje ct Estimat ion Suppor t to reque st an RSD- based Func tion Point Estimate
	1101	Request to have a re sults summ ary return ed in the format of the follow ing table.
	1102	Project So ftware Fun ctional Si ze and Siz e-Based Ef fort and D uration Es timate
	1103	Applicatio n
	1104	Item
	1105	A
	1106	B
	1107	C
	1108	D
	1109	E
	1110	Total
	1111	Counted Fu nction Poi nts
	1112
	1113
	1114
	1115
	1116
	1117
	1118	Estimated Scope Grow th
	1119
	1120
	1121
	1122
	1123
	1124
	1125	Estimated Size at Re lease
	1126
	1127
	1128
	1129
	1130
	1131
	1132
	1133	Size-Based Effort Es timates
	1134	Labor Hour s
	1135	Probabilit y
	1136	Low-Effort Estimate – With ind icated pro bability, project wi ll consume no more t han:
	1137
	1138
	1139	High-Effor t Estimate – With in dicated pr obability, project w ill consum e no more than:
	1140
	1141
	1142
	1143	Size-Based Duration Estimates
	1144	Work Days
	1145	Probabilit y
	1146	Low-Durati on Estimat e – With i ndicated p robability , project will consu me no more than:
	1147
	1148
	1149	High-Durat ion Estima te -- With indicated probabili ty, projec t will con sume no mo re than:
	1150
	1151
	1152
	1153	Figure 1: Cumulative Probabili ty (“S-cur ve”) Chart
	1154	[Insert Cu mulative P robability (“S-curve ”) Charts here]
	1155
	1156	Approval S ignatures
	1157	This secti on is used to docume nt the app roval of t he RSD dur ing the Fo rmal Revie w. The re view shoul d be ideal ly conduct ed face to face wher e signatur es can be obtained ‘ live’ duri ng the rev iew, howev er the fol lowing for ms of appr oval are a cceptable:
	1158	Physical s ignatures obtained f ace to fac e or via f ax
	1159	Physical s ignature o btained in person or via fax
	1160	Digital si gnature ti ed cryptog raphically to the si gner
	1161	/es/ in th e signatur e block, p rovided th at a separ ate digita lly signed e-mail in dicating t he signer’ s approval is provid ed and kep t with the document
	1162	The Chair of the gov erning Int egrated Pr oject Team (IPT), Bu siness Spo nsor, IT P rogram Man ager, and the Projec t Manager are requir ed to sign . Please a nnotate si gnature bl ocks accor dingly.>
	1163
	1164	REVIEW DAT E: <date>
	1165	SCRIBE: <n ame>
	1166
	1167	Signed:
	1168
	1169	__________ __________ __________ __________ __________ __________ __________ ________
	1170	James Plas tow, Integ rated Proj ect Team ( IPT) Chair Date
	1171
	1172
	1173	__________ __________ __________ __________ __________ __________ __________ ________
	1174	Elizabeth Johnson, B usiness Sp onsor Date
	1175
	1176
	1177	__________ __________ __________ __________ __________ __________ __________ ________ K enny Condi e, IT Prog ram Manage r DateDate
	1178
	1179
	1180	__________ __________ __________ __________ __________ __________ __________ ________
	1181	James Plas tow, Proje ct Manager Date
	1182
	1183	Appendix A : Non-Func tional Req uirements
	1184	The follow ing non-fu nctional r equirement s should b e reviewed and asses sed while developing the requi rements fo r the proj ect.
	1185	System Per formance R eporting R equirement s
	1186	(Note: Eac h system d eveloped b y the Depa rtment of Veterans A ffairs (VA ) Office o f Informat ion and Te chnology ( OI&T) must comply wi th the fol lowing man datory req uirements. )
	1187	Include in strumentat ion to mea sure all p erformance metrics s pecified i n the Non- Functional Requireme nts sectio n of the R equirement s Traceabi lity Matri x (RTM). A t a minimu m, systems will have the abili ty to meas ure report ing requir ements for Responsiv eness, Cap acity, and Availabil ity as def ined in th e non-func tional req uirements section of the RTM.
	1188	Make the p erformance measureme nts availa ble to the Informati on Technol ogy (IT) P erformance Dashboard to enable display o f “actual” system me trics to c ustomers a nd IT staf f.
	1189	Operationa l Environm ent Requir ements
	1190	System res ponse time s and page load time s shall be consisten t with ___ ________ s tandards ( for exampl e, My Heal theVet or HealtheVet ). (Commen t: There m ay be diff erent expe ctations f or an exte rnal displ ay vs. a q uery. Need to addres s these di fferent us es. Also i ndicate if this info rmation is unknown).
	1191	Maintenanc e, includi ng mainten ance of ex ternally d eveloped s oftware in corporated into the __________ ___applica tion(s), s hall be sc heduled du ring off p eak hours or in conj unction wi th relevan t maintena nce schedu les. The b usiness ow ner should provide s pecific re quirements for estab lishing sy stem maint enance win dows when planned se rvice disr uptions ca n occur in support o f periodic maintenan ce.
	1192	Informatio n about re sponse tim e degradat ion result ing from u nscheduled system ou tages and other even ts that de grade syst em functio nality and /or perfor mance shal l be disse minated to the user community within 30 minutes of the occur rence. The notificat ion shall include th e informat ion descri bed in the current A utomated N otificatio n Reportin g (ANR) te mplate mai ntained by the VA Se rvice Desk . The spec ific busin ess impact must be n oted in or der for OI T to provi de accurat e data in the servic e impact n otice of t he ANR.
	1193	Provide a real-time monitoring solution to report agreed/ide ntified cr itical sys tem perfor mance para meters.
	1194	Critical b usiness pe rformance parameters shall be identified e.g., tra nsaction s peed, resp onse time for screen display/r efresh, da ta retriev al, etc. i n a manner that data capture c an occur t o support metric rep orting and support t he OI&T pe rformance dashboard display. I f no such performanc e metrics are requir ed or prov ided there will be n o program specific S ervice Lev el Agreeme nts (SLA) created, n or shall t here be an y active/r eal time m onitoring through OI &T Perform ance Dashb oard to pr ovide the business o wners any performanc e metrics.
	1195	Notificati on of sche duled main tenance pe riods that require t he service to be off line or th at may deg rade syste m performa nce shall be dissemi nated to t he busines s user com munity a m inimum of 48 hours p rior to th e schedule d event.
	1196	Documentat ion Requir ements
	1197	The traini ng curricu lum shall state the expected t raining ti me for pri mary users and secon dary users to become proficien t at using the _____ _______ ap plication( s).
	1198	All traini ng curricu la, user m anuals and other tra ining tool s shall be developed /updated b y ______ < <insert na me of Prog ram Office >> and del ivered to all levels of users __________ ______. If known, in sert how m uch time i n advance the traini ng tools w ill be del ivered and via what mechanism( s); for ex ample, 2-4 weeks in advance of the relea se of the enhancemen t through nationwide conferenc e calls an d PowerPoi nt present ations). T he curricu la shall i nclude all aspects o f the enha nced _____ ___ applic ation(s) a nd all cha nges to pr ocesses an d procedur es.
	1199	The traini ng curricu lum develo ped by the Program O ffice shal l state th e expected task comp letion tim e for prim ary and se condary us ers.
	1200	User manua ls and tra ining tool s shall be developed . If they already ex ist, updat es shall b e made, as necessary , to them and they s hall be de livered to all level s of users .
	1201	IT will pr ovide the level of d ocumentati on require d to suppo rt the sys tem and ma intain ope rations an d continui ty. Docume ntation sh all repres ent minima l programm atic and l ifecycle o perations support do cumentatio n artifact s as defin ed by VA s tandards i n ProPath and as req uired by t he VA Ente rprise Sys tem Engine ering Life cycle and Release Ma nagement o ffice for sustained operations , maintena nce, and s upport (ht tp://vaww. eie.va.gov /lifecycle /default.a spx) prior to approv al by any VA change control bo ard and re lease into productio n.
	1202	Implementa tion Requi rements
	1203	Technical Help Desk support fo r the appl ication sh all be pro vided for users to o btain assi stance wit h ________ ___.
	1204	The IT sol ution shal l be desig ned to com ply with t he applica ble approv ed Enterpr ise SLA.
	1205	The implem entation m ust be com plete by _ _________. (Enter da te - dd-mm -yyyy)
	1206	Data Prote ction/Back -up/Archiv e Requirem ents
	1207	Based upon the criti cality of the system , provide a back-up and data r ecovery pr ocess for when the s ystem is b rought off -line for maintenanc e or techn ical issue s/problems .
	1208	Data prote ction meas ures, such as back-u p interval s and redu ndancy sha ll be cons istent wit h systems categorize d as routi ne (30 day restorati on), missi on essenti al (72 hou r restorat ion), or m ission cri tical (12 hour resto ration).
	1209	Business o wners are required t o state th e mission criticalit y of the I T services required in order t o assist t he planner s and deve lopers in determinin g best str ategies fo r engineer ing an IT solution t o meet the ir busines s objectiv es/needs. The busine ss owner n eeds to st ate the cr iticality of the dat a and the impact to the busine ss during a service disruption so approp riate tech nologies c an be cons idered.
	1210	Levels for Disaster Recovery
	1211	Classifica tionRecove ry Time Ob jectiveRec overy Poin t
	1212	Objective Routine30 day restor ationTBD
	1213	Mission Es sential72 hour resto ration24 h ours
	1214	Mission Cr itical12 h our restor ation2 hou rs
	1215
	1216	Recovery T ime Object ive (RTO) – RTO defi nes the ma ximum amou nt of time that a sy stem resou rce can re main unava ilable bef ore there is an unac ceptable i mpact on o ther syste m resource s, support ed mission /business processes, and the M TD.
	1217	Maximum To lerable Do wntime (MT D) - The M TD represe nts the to tal amount of time t he system owner/auth orizing of ficial is willing to accept fo r a missio n/business process o utage or d isruption and includ es all imp act consid erations.
	1218	Recovery P oint Objec tive (RPO) - The RPO represent s the poin t in time, prior to a disrupti on or syst em outage, to which mission/bu siness pro cess data can be rec overed (gi ven the mo st recent backup cop y of the d ata) after an outage .
	1219	Data Quali ty/Assuran ce Require ments
	1220	A monitori ng process shall be provided t o ensure t hat data i s accurate and up-to -date and provides a ccurate al erts for m alfunction s while mi nimizing f alse alarm s.
	1221	User Acces s/Security Requireme nts
	1222	Ensure the proposed solution m eets all V eterans He alth Admin istration (VHA) Secu rity, Priv acy, and I dentity Ma nagement r equirement s includin g VA Handb ook 6500 ( see the En terprise R equirement s section of the RTM ).
	1223	Usability/ User Inter face Requi rements
	1224	Adhere to good User Interface/ User Cente red Design (UI/UCD) principles as outlin ed in the Usability Appendix o f the BRD.
	1225	Conceptual Integrity
	1226	Provide st andards ba sed messag ing and mi ddleware i nfrastruct ure needed to suppor t both Leg acy Vetera ns Health Informatio n Systems Technology Architect ure (VistA ) and futu re VistA 4 deploymen ts.
	1227	Availabili ty
	1228	Maintenanc e window, including maintenanc e of exter nally deve loped soft ware incor porated in to the Vis tA 4 appli cation(s), will be b y mutual a greement b etween OI& T and the VHA Point of Contact (POC) for the affec ted facili ty (ies). VHA will p rovide POC s for each facility.
	1229	VistA appl ication un availabili ty due to an unplann ed outage or planned outages t hat exceed the defin ed mainten ance windo w will not exceed 8. 76 hours p er year an d will not exceed 43 .8 minutes per month (99.9% av ailability ).
	1230	The applic ation shal l be avail able 24 ho urs a day, seven day s a week, with an up time of 99 .9%.
	1231	All system updates a nd schedul ed mainten ance shoul d occur be tween the hours of 1 800 and 06 00 (per lo cal time z one), when clinical usage woul d be light est.
	1232	Interopera bility
	1233	1.The syst em shall s upport all recognize d health s ystem stan dards i.e. , Health L evel 7 (HL 7), Fast H ealthcare Interopera bility Res ources (FH IR).
	1234	2.Systems must be he terogeneou s and agno stic for o perating s ystems and code base s.
	1235	3.Provide the abilit y to secur ely transf er large f iles (of 4 -8 gigabyt e) from an external source to VA systems .
	1236	4.Provide access to the system over a re mote acces s solution .
	1237	Manageabil ity
	1238	Provide Se rvice Desk /Incident and Proble m Manageme nt trackin g related to mainten ance event s of patie nt care sy stems with priority over non-p atient car e systems.
	1239	Provide da ta related to mainte nance even ts, both r outine and exception al, includ ing key me tadata:
	1240	Predicted routine wo rk
	1241	Occurrence s where ma intenance is complet ed, includ ing restar t from dow n time
	1242	Identity o f the orga nization p erforming maintenanc e
	1243	User perfo rming main tenance (i f availabl e)
	1244	Identity o f the syst em
	1245	Date/time, physical location
	1246	Systems im pacted
	1247	Does it af fect patie nt care
	1248	Non-urgent or emerge nt
	1249	Provide au dit capabi lities for system ac cess and u sage with settings t hat are co nfigurable to suppor t internal and exter nal audits based on federal an d VHA mand ates.
	1250	The system must comp ly with VA Directive 6300 Reco rds and In formation Management and with VHA Record s Control Schedule ( RCS) 10-1, in genera l and spec ifically w ith Electr onic Final Version o f Health R ecord: Des troy/Delet e 75 years after las t episode of patient care, or longer (if specified ).
	1251	Performanc e
	1252	Provide an Infobutto n Query Re sponder on all platf orms with a response time of l ess than . 5 seconds.
	1253	The system shall rec ognize, re port, and retransmit data lost , with les s than 0-1 % chance o f incomple te patient records.
	1254	Provide pa tient data (for data within th e system) transactio ns (e.g., capture, s earch, req uest for d ata) withi n .5 secon ds.
	1255	Mouse or k ey-based U I controls , e.g., me nus, check boxes shal l provide instantane ous respon siveness ( <90ms).
	1256	Part-scree n refreshe s after us er action shall comp lete withi n a pro-ra ted interv al between 200 ms an d 1200 ms times a pe rcentage o f the scre en area be ing refres hed. For e xample, a component 10% of the screen ar ea would r efresh in (1200 – 20 0) * 0.10 + 200 = 30 0 ms.
	1257	Reliabilit y
	1258	Provide sy stem relia bility:
	1259	Threshold = 99.9%
	1260	Objective = 99.99% s ystem and applicatio n
	1261	Provide sy stem relia bility:
	1262	Level 1 se verity =<1 failure p er month
	1263	Level 2 se verity =<2 failures per month
	1264	Level 3 se verity =<3 failures per month
	1265	Security
	1266	Provide ma nagement o f electron ic attesta tion of in formation including the retent ion of the signature of attest ation (or certificat e of authe nticity) a ssociated with incom ing or out going info rmation.
	1267	Supportabi lity
	1268	Provide al erts (that extend be yond syste m messages to extern al systems like mobi le devices ) for malf unctions, while prev enting fal se alarms for local, regional, and natio nal evalua tions in r eal time.
	1269	Provide re ports on p erformance metrics a s specifie d in the V istA 4 Eff ectiveness and Value / Benefit s Framewor k on a bi- weekly bas is.
	1270	Provide na tional, re gional, an d local re ports on p erformance metrics a s specifie d in the V istA 4 Eff ectiveness and Value / Benefit s Framewor k.
	1271	Provide pe rformance metrics (f rom reques t for info rmation to receipt o f informat ion on the screen) monitored by the sys tem and sy stem admin istrators so they kn ow what th e user exp erience is like with out users having to call them and tell t hem the sy stem is ru nning very slow.
	1272	Provide th e ability for VHA an d IT staff to create standard and ad-hoc reports o f usage, b andwidth, response t ime, login time, and other var iables wit h a verifi cation pro cess for m easuring t he capabil ities of t he system.
	1273	Provide en d-user tra ining on h ow to gene rate the v arious sys tem perfor mance repo rts (e.g., in standa rd file fo rmats such as Comma Separated Values [CS V], Portab le Documen t Format [ PDF], or E xcel) depe nding on t he user's needs.
	1274	Provide th e ability to view sy stem stati stics (e.g ., informa tion on th e specific network e nvironment ) and iden tify areas that are having iss ues or are beyond ca pacity, in near-real -time (to be quantif ied at a l ater time) .
	1275	Technical Help Desk support fo r the appl ication vi a instant message, o n-line, ph one, and r emote desk top access support, shall be p rovided fo r users to obtain as sistance 2 4/7.
	1276	The IT sol ution shal l be desig ned to com ply with t he applica ble approv ed Enterpr ise SLAs.
	1277	Data prote ction meas ures, such as back-u p interval s and redu ndancy sha ll be cons istent wit h systems categorize d as missi on critica l (1hr res toration, 2hrs backu p recovery ). Impact of system failure mu st be moni tored on a near real time basi s.
	1278	Provide th e ability to set thr esholds an d notifica tion type (e.g., ema il or text alerts) w hen alerti ng the use r about re sponse tim e degradat ion and un scheduled outages.
	1279	Disaster R ecovery Pl ans (DRP) and Contin uity of Op erations P lan (COOP) will be u pdated and tested se mi-annuall y to addre ss the Vis tA 4 produ ct (see Na tional Sec urity and Homeland S ecurity Pr esidential Directive : National Continuit y Policy. NSPD-51/H SPD-20, Ma y 9, 2007 http://www .fas.org/i rp/offdocs /nspd/nspd -51.htm)
	1280	Usability
	1281	Provide vi ewability/ usability of VistA 4 applicati ons on mob ile device s.
	1282	User promp ts and scr een help s hall be em bedded int o the syst em to guid e use of t he solutio n.
	1283	Documentat ion
	1284	The traini ng curricu lum shall be provide d in two h ours or mo re of trai ning time for primar y users an d secondar y users to become pr oficient a t using th e VistA 4 applicatio n(s).
	1285	All traini ng curricu la, user m anuals and other tra ining tool s shall be developed /updated b y the VE P rogram Off ice and de livered to all level s of users 4 weeks i n advance of the rel ease of th e enhancem ent throug h mediums that will best suppo rt the sha ring of in formation to all aff ected staf f.
	1286	Provide fo llow-up tr aining cla sses tailo red to VHA workflow 4 weeks af ter the us ers have b egun to us e the syst em.
	1287	The Templa te Revisio n History Page shoul d be delet ed when cr eating the RSD.
	1288	Template R evision Hi story
	1289	Date
	1290	Version
	1291	Descriptio n
	1292	Author
	1293	November 2 015
	1294	1.8
	1295	Corrected instructio ns in Appe ndix A
	1296	Process Ma nagement
	1297	September 2015
	1298	1.7
	1299	Updated He adings and spacing t o conform with lates t OIT Docu mentation Standards guidelines
	1300	Process Ma nagement
	1301	June 2015
	1302	1.6
	1303	Updated to conform w ith latest Section 5 08 guideli nes and re mediated w ith Common Look Offi ce tool
	1304	Process Ma nagement
	1305	May 2015
	1306	1.5
	1307	Revised by the PMAS Process Im provement Lockdown T eam
	1308	PMAS Proce ss Improve ment Lockd own Team
	1309	December 2 014
	1310	1.4
	1311	Updated to conform w ith latest Section 5 08 guideli nes and re mediated w ith Common Look Offi ce tool
	1312	Process Ma nagement
	1313	May 2014
	1314	1.3
	1315	Reordered cover page to enhanc e search c apabilitie s
	1316	Process Ma nagement
	1317	May 2013
	1318	1.2
	1319	Add Append ix for acr onyms and glossary
	1320	Process Ma nagement
	1321	March 2013
	1322	1.1
	1323	Formatted to current ProPath d ocumentati on standar ds and edi ted to con form with latest Alt ernative T ext (Secti on 508) gu idelines
	1324	Process Ma nagement
	1325	January 20 13
	1326	1.0
	1327	Initial Ve rsion
	1328	PMAS Busin ess Office
	1329	Place late st revisio ns at top of table.
	1330	The Templa te Revisio n History pertains o nly to the format of the templ ate. It do es not app ly to the content of the docum ent or any changes o r updates to the con tent of th e document after dis tribution.
	1331	The Templa te Revisio n History can be rem oved at th e discreti on of the author of the docume nt.
	1332	Remove bla nk rows.