ORELSE Key

[bayan....@ehs.com.jo]

Dears,

I need to customize the “ ORELSE” key functionality (privilege) to
disallow “Signature On Sign” .
I referred to the “CPRS Technical” and ”CPRS Setup” manuals (“Order
Entry Signature Keys” and “Key Assignment and Electronic Signature
Setup” sections)

I tried the following:
1- Remove “ORC SIGN ORDERS” item from “ORC ORELSE ORDER ACTIONS”
protocol but this is does not effect the CPRS (User still can
“Signature On Chart” if he has “ORELSE” key)

My reference was the following link:
http://groups.google.com/group/hardhats/browse_thread/thread/ebedca0bb281635c/a7ebd34a769a8c3b?lnk=gst&q=ORC+ORELSE+ORDER+ACTIONS#a7ebd34a769a8c3b

2- There is “SIGNATURE REQUIRED” field in the “ORDER” file where the
description of this field is
“This is the OR key required to sign this order. If set to 2, only
users
with the ORES key will be allowed to sign this order; if set
to 1, users
with either the ORELSE or ORES keys will be allowed to sign.
A 0 or ""
indicates that no signature is required.”

I tested that,
- User Key:ORELSE
- “SIGNATURE CODE” field value is “ORELSE”
and the system allow the user “Signature On Chart” !!

Note: “ORES” value assigned by default to the “SIGNATURE REQUIRED”
field in the “ORDER” file, when the user enters a new order.

Thanks

[Sam Habiel]

Bayan,

Just as a background for everybody else, it looks like Bayan is trying
to disable the ability of people in CPRS to specify that a signature
is on the paper chart.

Bayan, I think you have to look at the CPRS source code to see what
parameters it references. Changing stuff on the M side won't be useful
if CPRS has other ways of doing things.

Sam

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[David Whitten]

I could be confused, but I think "Signature on Chart" is a way of
saying that the Signature is not required to be recorded in VistA.
(i.e. saying that a wet signature is on a piece of paper somewhere)

Removal of the "Signature on Chart" functionality would effectively
force the system to be paperless, as there would be no way to "sign"
something except electronically.

I think "Signature on Chart" is directly opposed to "Signature on
Sign". A document either is signed electronically (with a status of
'signature on sign') , signed on paper (with a status of 'signed on
chart') or unsigned. I can't think of any other choices.

[Sam Habiel]

Bayan,

Does the Hakeem Project want to complete remove the ability for having
a hybrid system (paper for some stuff and electronic for others)?
That's what this really amounts to. The ability to say signed on chart
is so that orders can be written on the paper chart and then for them
to co-exist in the computer entered by others. I have to admit I don't
think writing an order twice is ever a good idea; but it's a problem
that the VA had to wrestle with for a long time as physicians wouldn't
use CPRS back in the day.

Sam

[Nancy Anthracite]

Isn't this mainly a way to handle verbal orders?

--
Nancy Anthracite

[Sam Habiel]

ORELSE is the nurse and pharmacist key. It lets you handle several cases:

Like OREMAS, it lets you enter chart signed orders; when you do that,
the ordering provider doesn't get a notification to sign.

In addition to OREMAS, it lets you handle verbal, telephone, and
policy (standing) orders; I believe the first two generate a
notification for the ordering provider; policy orders don't. Like in
the paper world, and corresponding to several states' laws,
verbal/telephone orders get signed after they have been released.

From my experience, it has been a struggle aligning these concepts
with the changing regulatory environment. I had some real fun with
standing orders in IHS. And ORELSE doesn't quite fit what a pharmacist
does in the expanding pharmacy roles.

Sam

[bayan....@ehs.com.jo]

Thanks all for your reply,,

Sam, actually we don't let the Nurse sign the order but we need the
other privileges of the ORELSE key. My question is does that
configurable rather then code change ?

> >> On Wed, May 16, 2012 at 10:32 AM, David Whitten <whit...@worldvista.org>

> > wrote:
> >> > I could be confused, but I think "Signature on Chart" is a way of
> >> > saying that the Signature is not required to be recorded in VistA.
> >> > (i.e. saying that a wet signature is on a piece of paper somewhere)
>
> >> > Removal of the "Signature on Chart" functionality would effectively
> >> > force the system to be paperless, as there would be no way to "sign"
> >> > something except electronically.
>
> >> > I think "Signature on Chart" is directly opposed to "Signature on
> >> > Sign". A document either is signed electronically (with a status of
> >> > 'signature on sign') , signed on paper (with a status of 'signed on
> >> > chart') or unsigned.   I can't think of any other choices.
>

> >> > On Wed, May 16, 2012 at 7:03 AM, bayan.has...@ehs.com.jo

[Sam Habiel]

What priviliges exactly?

[bayan....@ehs.com.jo]

All the other functionalities of the "ORELSE" key.

On May 19, 6:30 pm, Sam Habiel <sam.hab...@gmail.com> wrote:
> What priviliges exactly?
>

> On Sat, May 19, 2012 at 6:20 AM, bayan.has...@ehs.com.jo