Intracare Implementation Log Episode 43: Pharmacy.

[Ignacio Valdes]

Okay, lab is now a little on the back-burner due to local delays. On
to pharmacy! I've taken a look at the pharmacy menus and have done a
initial query on the fine pharmacy manuals:
http://www.va.gov/vdl/search.asp?group=document&terms=pharmacy of
which there seems to be a large number. I will be initially doing
inpatient pharmacy so I need to focus on that yet these document
titles do not seem to refer to inpatient. Is there 'the one' document
for setting up and using this that is especially helpful?

-- IV

[John McCormack]

http://www.va.gov/vdl/application.asp?appid=88
http://www.va.gov/vdl/application.asp?appid=83

Ignacio Valdes wrote:

No virus found in this incoming message.
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[Ignacio Valdes]

Is there a 10,000 foot overview for setting up pharmacy inpatient in
the private-sector? Is setting up the local drug file the first step?
If so, is there a document that shows how to do this? We have about
500 meds on inpatient formulary. No IV's, we do IM and oral only. --
IV

[I, Valdes]

This looks good: http://vistapedia.net/index.php?title=Pharmacy_Issues

On Jun 30, 3:13 pm, Ignacio Valdes <ival...@hal-pc.org> wrote:
> Is there a 10,000 foot overview for setting up pharmacy inpatient in
> the private-sector? Is setting up the local drug file the first step?
> If so, is there a document that shows how to do this? We have about
> 500 meds on inpatient formulary. No IV's, we do IM and oral only. --
> IV
>

[ivhalpc]

Allocate security keys to setup pharmacy: XUMAINT-->Allocation of
Security keys allocate the keys, select who will hold the key.
Possible keys per kdtop are: PSA ORDERS, PSAMGR, PSJ RPWARN, PSB
MANAGER, PSB CPRS MED BUTTON, PSB INSTRUCTOR, PROVIDER, PSD TECH,
PSDMGR, PSD BUMGR, PSD ERROR, PSD PARAM, PSD TRAN -- IV

On Jun 30, 8:50 pm, "I, Valdes" <ival...@hal-pc.org> wrote:
> This looks good:http://vistapedia.net/index.php?title=Pharmacy_Issues
>
> On Jun 30, 3:13 pm, Ignacio Valdes <ival...@hal-pc.org> wrote:
>

> > Is there a 10,000 foot overview for setting uppharmacyinpatient in

> > the private-sector? Is setting up the local drug file the first step?
> > If so, is there a document that shows how to do this? We have about
> > 500 meds on inpatient formulary. No IV's, we do IM and oral only. --
> > IV
>
> > On Wed, Jan 14, 2009 at 5:52 PM, Ignacio Valdes<ival...@hal-pc.org> wrote:
> > > Okay, lab is now a little on the back-burner due to local delays. On

> > > topharmacy! I've taken a look at thepharmacymenus and have done a

> > > initial query on the finepharmacymanuals:
> > >http://www.va.gov/vdl/search.asp?group=document&terms=pharmacyof
> > > which there seems to be a large number. I will be initially doing

> > > inpatientpharmacyso I need to focus on that yet these document

[ivhalpc]

Also per this document on allocating security keys:
http://vistapedia.net/index.php?title=Configuring_An_Administrator_User

[I, Valdes]

Hmmm, I gave sys.admin ORES and PROVIDER keys but it isn't allowing
that id to order in tmg-cprs.

-- IV

On Jul 6, 8:27 pm, ivhalpc <ivald...@gmail.com> wrote:
> Also per this document on allocating security keys:http://vistapedia.net/index.php?title=Configuring_An_Administrator_User
>
> On Jul 6, 8:26 pm, ivhalpc <ivald...@gmail.com> wrote:
>

> > Allocate security keys to setuppharmacy: XUMAINT-->Allocation of

[I, Valdes]

OR plain old cprs either. -- IV

[kdtop]

Post the RPC call that fails when you try to sign it.

Kevin

[I, Valdes]

It doesn't fail, it just gives me a you are not authorized to write
orders message. -- IV

[kdtop]

But there has to be an RPC that asks if you have the permission. If I
know that RPC, then we can look into that server code and see what it
is looking for.

Kevin

[I, Valdes]

Which method allows me to find and report this to you? -- IV

[Sam Habiel]

Ignacio,

There are three places to look:
1. If you get "You are not authorized to order meds", you need to mark
"AUTHORIZED TO ORDER MEDS" field in the New Person file with a yes.
2. If ordering is completely disabled, look at the parameter ORWOR
DISABLE ORDERING.
3. If it is ordering but not letting you sign, you need the ORES key.

Sounds to me that you have #1.

Sam

[Distheone]

Have you assigned a person class?

> >> > > > > > > > > -- IV- Hide quoted text -
>
> - Show quoted text -

[I, Valdes]

#1 is correct! -- IV

On Jul 19, 1:13 am, Sam Habiel <sam.hab...@gmail.com> wrote:
> Ignacio,
>
> There are three places to look:
> 1. If you get "You are not authorized to order meds", you need to mark
> "AUTHORIZED TO ORDER MEDS" field in the New Person file with a yes.
> 2. If ordering is completely disabled, look at the parameter ORWOR
> DISABLE ORDERING.
> 3. If it is ordering but not letting you sign, you need the ORES key.
>
> Sounds to me that you have #1.
>
> Sam
>

[kdtop]

In CPRS, look under the HELP menu. If you have the proper key (I
think it is XUPROGMODE), then you will see something about RPC calls.
You can then look at the RPC's that have been made from CPRS, and the
results that were returned. Turn the number of saved calls from 10 up
to 40 or something and then try to do what you are wanting to do.

Kevin

[JohnLeo Zimmer]

On Sun, Jul 19, 2009 at 11:32 AM, kdtop <kdt...@gmail.com> wrote:
> ...

> You can then look at the RPC's that have been made from CPRS,
> and the results that were returned.  Turn the number of saved calls

> from 10 up to 40 or something...

Is this default of 10 calls hard-wired into the CPRS Delphi code or
can it be set somewhere? In know CIS has a much more useful default,
50, I think.

jlz

[I, Valdes]

A little broad overview:

WV comes with a large list of medications already present in CPRS--
>Orders-->Meds, Outpatient. I have a 500 or so list that the hospital
actually uses and they will be Meds, Inpatient (currently not
present). So I am guessing that I have to activate or add all if not
present the 500 local formulary medications?

-- IV

On Jun 30, 8:50 pm, "I, Valdes" <ival...@hal-pc.org> wrote:

[Sam Habiel]

If they already exist in the drug file, you can activate them; and
then inactivate everything else you don't need.

Sam

[kdtop]

Yes it is hardcoded. Should I change it for tmg-cprs?

Kevin

[JohnLeo Zimmer]

I know of no downside to making it something like 50 or 60.
Someone may know otherwise.

jlz

[I, Valdes]

Wishing for a pointy-clicky way of doing that with a 500 medication
formulary spreadsheet right about now...

-- IV

[David Whitten]

Personally, the first thing I do when I start debugging CPRS is to change it to 100.
As defaults to 10, there are a whole lot of calls that are not recorded in the initial
flurry of activity that happens when CPRS starts up.  I think having initial default
would help many people.

David

[I, Valdes]

Is there a preferred way of activating and inactivating? -- IV

On Jul 19, 1:55 pm, Sam Habiel <sam.hab...@gmail.com> wrote:

[I, Valdes]

Here is a quick sample of the formulary:

acetaminophen 325, 500 MG TAB 28 08 04 TYLENOL
acetaminophen 80MG CHEW TAB 28 08 04 TYLENOL JR.
acetaminophen 160MG/5ML ELIXIR 28 08 04 TYLENOL ELIXIR
acetaminophen/codeine 300MG/30MG TAB 28 08 08 TYLENOL/CODEINE #3
acetaminophen suppository 120MG SUPP 28 08 04 FEVERALL SUPP
acetaminophen/aspirin/caffeine 250MG/250MG/65MG TAB 28 08 04 EXCEDRIN
acyclovir 200 MG CAP 08 18 00 ZOVIRAX
acyclovir 5% CREAM 84 04 06 ZOVIRAX
albuterol 90 MCG/METERED SPRAY 12 12 00 VENTOLIN INHALER
allopurinol 100MG TAB 40 40 00 ALLOPURINOL
alpha hydroxy acid lotion 5%, 12% LOTION 84 24 00 LAC-HYDRIN LOTION
alprazolam 0.25, 0.5, 1 MG TAB 28 24 08 XANAX

On Jul 19, 1:55 pm, Sam Habiel <sam.hab...@gmail.com> wrote:

[I, Valdes]

So there seems to be a huge number of already entered and activated
orderable medications. I conjecture that I should probably inactivate
them all and then re-activate the 400 or so that I have. I am
wondering how to do that in bulk. -- IV

[I, Valdes]

I gave a try at ORDER QUICK VIEW NAME: orwdset O RX. It looks like
ORDER QUICK VIEW NAME: orwdset O RX has already been pre-populated
with a large number of medications. This suggestion came from here:
http://vistapedia.net/index.php?title=Pharmacy_Setup_Emails

-- IV

[Sam Habiel]

Yes you can deactivate that in bulk through a fileman loop. Call me
for show and tell.

I presume the most important item in the formulary is alprazolam. I
need it right now. Let's face it: we don't have decent (read:
moderately usable) scheduling API's.

Sam

[I, Valdes]

On Jul 24, 12:00 am, Sam Habiel <sam.hab...@gmail.com> wrote:
> I presume the most important item in the formulary is alprazolam. I
> need it right now. Let's face it: we don't have decent (read:
> moderately usable) scheduling API's.

Oof. -- IV

[I, Valdes]

As per our session with Sam, here is how you inactivate all the
medications via Fileman as well as activate a medication:

Select OPTION: ENTER OR EDIT FILE ENTRIES

INPUT TO WHAT FILE: DRUG//
EDIT WHICH FIELD: ALL// INACTIVE DATE///JUL 25 2008
THEN EDIT FIELD:

Select DRUG GENERIC NAME: ^LOOP
EDIT ENTRIES BY: GENERIC NAME//
START WITH GENERIC NAME: FIRST//

Select OPTION: ENTER OR EDIT FILE ENTRIES


How to activate a medication:

INPUT TO WHAT FILE: DRUG//
EDIT WHICH FIELD: ALL// inactive date
THEN EDIT FIELD:


Select DRUG GENERIC NAME: RISPERI
1 RISPERIDONE 0.25MG CN709 07-25-08
2 RISPERIDONE 0.5MG CN709 07-25-08
3 RISPERIDONE 1MG CN709 07-25-08
4 RISPERIDONE 1MG U/D CN709 07-25-08
5 RISPERIDONE 2MG CN709 07-25-08
Press <RETURN> to see more, '^' to exit this list, OR
CHOOSE 1-5: 1 RISPERIDONE 0.25MG CN709 07-25-08
INACTIVE DATE: JUL 25,2008// @
SURE YOU WANT TO DELETE? Y (Yes)


Select DRUG GENERIC NAME:

[Matt]

I don't believe you should inactivate the Meds. Patients come in on
all sorts of medications and you will want that on their "non-Va
medication list to allow for medication inaction checks.

m

[I, Valdes]

Good point. Sheesh this looks complicated. -- IV