CPRS Patch OR*3.0*296 (CPRS GUI v.27.90)
Release Notes
August 2009


Table of Contents
Table of Contents
Installation Requirements
Required Patches
Related Patches
Release Method: Monitored Release
Patient Safety Issues
Known Issue
New Functionality
Combat Veteran Markers
Mental Health
Defect Fixes
Bidirectional Health Information Exchange (BHIE)
CPRS Splash Screen
Delayed Orders/Encounter Information
Display Issue (PSPO 1089) Warning
Document Searches
Encounters
Encounter Location Switching Form
Graphing
Labs Tab
Medication Quick Orders
Notifications
Orders
Problem List
Reminders
Remote Data
Reports
Templates
Template Editor
VBECS (Blood Bank)
Vitals Lite




Installation Requirements
Required Patches
Below is a list of patches that you must verify are properly installed on your system before OR*3.0*296 can be installed:

Related Patches
The following patches are required for functionality but are not required for installation:


Note: OR*3.0*296 (CPRS GUI version 27.90) requires Internet Explorer 4.0 (IE4) or later. However, Public Key Infrastructure (PKI) functionality requires IE 5.5 or later with 128-bit encryption.
Release Method: Monitored Release
OR*3.0*296 will follow a Monitored Release. A Monitored Release consists of releasing software that is closely monitored by an Implementation Team to assess impact and limit potential negative consequences.   A Monitored Release does not intend to replace or remove any of the current testing and release processes, but rather to enhance the release phase with additional monitoring for earlier detection of issues.
Patient Safety Issues

In CPRS v.26, if you asked to view microbiology results on the Labs tab, you viewed ALL results. Now with v.27, the default is 7 days and if you select All results, you see the last 10 reports. The same applies to the reports tab. Those settings can be changed at the Individual Reports level, which with v.27 is now set to a max of 10, whereas with v.26 that max setting was 100. The reports now look the same in both the Labs tab and the Reports tab.
Resolution: Developers changed the maximum back to 100 for both Labs and Reports tabs.

Resolution: Developers corrected the problem. Now, when a user enters the "IN", it correctly defaults in the dialog, and when finished in Pharmacy, the IV is a "Piggyback", which is correct.

Resolution: This problem will be resolved in two steps:
1) OR*3.0*303 and RA*5.0*98 will be released as an interim fix. These patches will detect the problem and correct the data before storing it.
2) OR*3*296 (CPRS GUI v27.90) will correct the source of the problem by removing any carriage returns from the text entered through the CPRS GUI. The CPRS GUI modification will resolve the problem before the data is stored or passed.

Resolution: Developers changed the way the comments were stored. The comment should now wrap appropriately in the display and should not cause problems with HL7 transmissions for Inter-Facility Consults.

Resolution: Developers corrected this problem in CPRS. All values should now appear.

Resolution: Developers made several changes to resolve these issues.

  1. Developers changed CPRS to require a unique schedule when leaving the schedule field in the Unit Dose dialog.
  2. Developers changes what happens when the user presses the <Enter> key while the focus is still on a drop-down list. Previously, pressing the <Enter> key selected the item and accepted the order, but now pressing the <Enter> key will be the same as pressing the <Tab> key—it will select the item and move to the next field.
  3. CPRS will also check for a control character in the schedule field when placing an order. If CPRS finds a control character, then it displays an error message to the user and the order cannot be saved until the schedule field is corrected.


Known Issue

Workaround:

Resolution: Developers will correct this issue in CPRS GUI v.28.

Workaround: 

Resolution: Developers will correct this issue in CPRS GUI v. 28.
New Functionality
Combat Veteran Markers
CPRS has new Combat Veteran (CV) markers to help users recognize that a veteran has Combat Veteran status. The markers are found on the patient selection screen, on the consult tab, on notifications, order details screen, on the SF-513, and on a button available from any tab.
Note:The Combat Veteran marker does not take into account the type of military discharge. Whether the discharge is honorable, dishonorable, etc., the CV marker is the same.





Mental Health


Defect Fixes
Bidirectional Health Information Exchange (BHIE)

Resolution: Developers fixed this problem and CPRS should refresh correctly now.
CPRS Splash Screen

Resolution: CPRS developers replaced the 508 team's email with information on entering a Remedy Ticket if any issues are encountered:

Delayed Orders/Encounter Information

Similarly, if a similar type of user tried to enter new delayed orders or tried to add to existing delayed orders, CPRS prompted the user for a provider and a location. The location was not necessary for the delayed orders.
Resolution: Developers changed CPRS to prompt for the encounter provider if needed, but the encounter location is not required for delayed orders. When a user, who is not assigned as the encounter provider and who does not hold the Provider key, is writing new delayed orders or adding to existing delayed orders, CPRS will force the user to select an encounter provider, but CPRS does not force the user to enter an encounter location.
Display Issue (PSPO 1089) Warning

Resolution: Under the direction of the Patient Safety Office, developers removed the reference because it was not necessary. The rest of the text provides the needed information.
Document Searches

Resolution: CPRS now highlights the searched item in the note text.
Encounters


Resolution: Developers changed CPRS to prevent the previous patient's encounter data from carrying over to the second patient's chart.
Encounter Location Switching Form

Resolution: Developers changed CPRS so that delayed order no longer display on the Encounter Location switching form.
Graphing

Resolution: Developers corrected this problem in CPRS. All values should now appear.

Resolution: To address the possibility of too heavy a load on the system, developers added a way to disable the background process to cache patient data.
Labs Tab

Resolution: Developers corrected this problem, and the tabs will now display for remote data when appropriate.

Resolution: Developers changed the maximum back to 100.

In CPRS v.26, if you asked to view microbiology results on the lab tab you viewed ALL results. Now with v.27, the default is 7 days and if you select All results, you see the last 10 reports. The same applies to the reports tab. Those settings can be changed at the Individual Reports, which with v.27 is now set to a max of 10 whereas with v.26 that max setting was 100. The display of the reports now looks the same in both the lab tab and the reports tab.
Resolution: Developers ensured that the changed value stays.

Resolution: Developers corrected this problem.

Resolution: This problem occurred when a user cancelled out of a test selection screen on the Selected Tests report because the previous report was activated but not reselected. Developers changed CPRS to reselect the report, thus repopulating the report screen with the correct data.
Medication Quick Orders

Resolution: Developers corrected the errors in the text.

Resolution: The description of this option was rewritten to better define what the report shows.

Resolution: For IV medication quick orders, CPRS now checks whether the auto-accept prompt should display based on whether the quick order provides all the information to complete the order. If the user creating or editing the quick order has defined all the necessary information, then the quick order editor displays the auto-accept prompt. If the quick order will need additional user interaction, the quick order cannot be auto-accepted and the prompt will not display.

Resolution: Developers changed VistA quick orders to accept a fractional amount for an infusion rate.
Notifications

Resolution: Developers corrected this problem and CPRS will now remove the surrogate appropriately.
Orders

Resolution: Developers changed CPRS so that the Infuse Over Time field only accepts numbers—preventing this error.

Resolution: Developers corrected CPRS to select the appropriate item when the user types the letters.

Resolution: Developers corrected CPRS and users can either type the letters or use the mouse to select "Other".

Resolution: Developers corrected this problem, and the Verify Order form displays so that the user can choose what to do.

Resolution: Developers corrected this problem: The dialog will now behave appropriately.

Resolution: Developers corrected this problem and the administration time will update appropriately.

Resolution: Developers made changes so that the order can now be set to auto-accept.

Resolution: Developers corrected this problem, and changing from one IV Type to another clears the appropriate fields.

Resolution: Developers changed this option to include the prompt and the following description:
The option generates two reports (printed to an e-mail message sent to the originator of the report) of Quick Orders that should be evaluated due to the addition of three new fields in CPRS 27: Route, IV Type and Schedule. One report includes QOs that are contained in an order menu, order set or a reminder dialog. The other report includes QOs that are stand alone and not included in another entry.

Resolution: Developers corrected the spelling error.

Resolution: CPRS should now catch the problem, display the dialog, and require the user to enter a schedule.

Resolution: Developers changed CPRS. Now, when a nurse is writing new delayed orders or adding to existing delayed orders, CPRS requires the nurse to select a provider, but the nurse will not be required to select a location.

Resolution: When switching the IV Type from either continuous to intermittent or from intermittent to continuous, both the Schedule field and the Infusion Rate/Infuse over Time field will be blanked out.

Resolution: Developers changed the Inpatient Medication order dialog's Schedule field will not auto-match unless enough characters have been entered to uniquely identify a schedule.

Resolution: Developers changed these dialogs so that the <Enter> key will work as it does on other order dialogs. If in a drop-down box, for example, pressing the <Enter> key will activate the selected item and move to the next control (drop-down, text field, etc.) and will not accept the order. The user will need to explicitly click the Accept button or tab to it and then press Enter in order to accept the order.

Resolution: Developers changed CPRS so that administration times for a PRN schedule do not display—even if the schedule has administration times defined.

Resolution: Developers changed CPRS to only check the PRN checkbox for a changed order in the above scenario if a PRN schedule is not defined. This change also fixes the problem with the Expected First Dose value appearing incorrectly.

Resolution: Developers changed CPRS to recognize the first action correctly so that the quantity field will calculate, as it should. In the above scenario, CPRS will readjust the quantity to zero if the user has not done a manual correction to the quantity value. If the user does manually change the Quantity value and then makes any adjustment to the schedule, the Days Supply value should update and not the quantity value. This returns to the functionality that existed in CPRS GUI v.26.

Resolution: Developers changed CPRS so that the drop-down list does not maintain the value when the user pressed the <Backspace> key for the Patient Selection screen and the Medication Order dialog.

  1. Launch the Inpatient Medications order dialog.
  2. Select the Complex tab.
  3. In lower case (this must be lower case), type the first few characters of a schedule such as BID —choose a schedule for which the first few characters are NOT unique (i.e., BID is not enough to unique match between BID and BID AC). Or, type in an invalid schedule.
  4. Without leaving the Schedule field, press CTRL+ENTER to activate the default button on the form (Accept Order).

The order saves without a schedule. If you entered an invalid schedule, CPRS displays several error dialogs: first, CPRS displays the invalid schedule dialog, and then two "Cannot focus on a disabled or invisible window" messages.

  1. Launch the Inpatient Medications order dialog.
  2. Switch to the Complex tab.
  3. In lower case (this must be lower case), type the first few characters of a schedule such as BID —choose a schedule for which the first few characters are NOT unique (i.e., BID is not enough to unique match between BID and BID AC) .
  4. While still in the Schedule field, click the X (Close button) in the upper right corner.






Resolution: Developers made several changes to resolve these issues.

  1. Developers changed CPRS to require a unique schedule when leaving the schedule field in the Unit Dose dialog.
  2. Developers changes what happens when the user presses the <Enter> key while the focus is still on a drop-down list. Previously, pressing the <Enter> key selected the item and accepted the order, but now pressing the <Enter> key will be the same as pressing the <Tab> key—it will select the item and move to the next field.
  3. CPRS will also check for a control character in the schedule field when placing an order. If CPRS finds a control character, then it displays an error message to the user and the order cannot be saved until the schedule field is corrected.


Resolution: Developers corrected this problem.

Problem List

Resolution: Two patches fixed this error: GMPL*2.0*37 and this patch, OR*3.0*296. The first patch went through and corrected null entries that were in the sites' databases. Patch OR*3.0*296, CPRS GUI v.27.90, prevents the null value from being set or passed to the Problem List package.

Resolution: Developer corrected the problem list so that it now sends the correct data. A separate Problem List patch will correct the incorrect data.
Reminders

"Remote Procedure ORWCV POLL is not registered to the option YS BROKER1."
Resolution: OWCV POLL RPC is a background job that CPRS checks every couple of seconds for the cover sheet data. This error occurs if a Mental Health test is accessed while this background job is processing. Developers modified CPRS to pause in checking the OWCV POLL job while the Mental Health DLL is open.

The conflict occurred when the user opened the Vitals DLL while the Reminders evaluation was occurring. When the Vitals DLL is launched, CPRS gave control over to the DLL. When the DLL closed, it gave control back to CPRS, but the Reminders evaluation did not complete, so no Reminders were shown as due.
Resolution: Developers changed CPRS to begin the Reminders evaluation again if it is not complete.
Remote Data

Resolution: Developers corrected this problem, and the tabs will now display for remote data when appropriate.

Resolution: Developers corrected this, and on one tab will display for remote sites, as it should.

Resolution: Developers changed the message logic/text to make more sense. CPRS will not display the message if HDR is turned on.

Resolution: Developers changed CPRS so that the "view VistaWeb" message only pops up when the HDR parameter is turned off.

Resolution: Developers disabled the automatic rechecking of the HDR site disabled.

Resolution: The text of the message has been changed to be more clear: "The HDR is currently inactive in CPRS. You must use VistaWeb to view this report." Also, the message should only appear when the user is on the Reports tab.

Resolution: CPRS should display only one tab per remote location.

Resolution: Developers corrected this error and the correct report now displays.
Reports

Resolution: Developers changed CPRS to prevent the problems.

Resolution: Developers changed the maximum back to 100.
Templates

Resolution: Developers corrected this problem.
Template Editor

Resolution: CPRS now allows the user to type in characters to select the appropriate consult as it did before v.27.

VBECS (Blood Bank)
Note: CPRS users will not see the VistA Blood Establishment Computer Software (VBECS) dialog and related changes until the VBECS product and associated patches are nationally released. However, these changes are in CPRS and so they are documented here.

Resolution: Developers corrected this problem and the tab should be labeled "Lab Results Available" only when there is some data.

Resolution: CPRS no longer allows free-text in that field. Users must choose a selection from the list.

Resolution: Developers changed CPRS to correctly retrieve and send the Urgency. This change requires both OR*3.0*296 and OR*3.0*212, which activates the VBECS dialog in CPRS.

Resolution: Developers corrected this problem.

Resolution: Developers corrected this problem.

Resolution: Developers corrected CPRS so that the user can select only those sites from which the user wants to view data.

Resolution: Developers changed CPRS so that if the patient has a Type and Screen done within a specified number of days, the user will get a warning that the patient has a valid Type and Screen. The user can still order a type and screen. Your clinical coordinator can define the number of days for a valid Type and Screen in a parameter.

Resolution: CPRS developers corrected this problem and the warning should display appropriately.

Resolution: CPRS now accepts and correctly processes the tests and blood products regardless of which is ordered first.

Resolution: Developer changed CPRS so the flashing cursor no longer occurs.

Resolution: Developers corrected the disparity between the Collection Type in the CPRS-VBECS orders and lab orders. They should now be consistent.

Resolution: Developers corrected the disparity between the Urgency in the CPRS-VBECS orders and lab orders. They should now be consistent.

Resolution: CPRS should now prompt for Type and Screen test when one is required.

Resolution: Developers changed CPRS so that hovering the cursor over a long reason for request will show the entire reason.

Resolution: To prevent this problem and others from occurring, CPRS disabled auto-accept for CPRS VBECS quick orders. For CPRS VBECS quick orders, the dialog will display and users must accept the order from the dialog. This will ensure that appropriate checks take place.

Resolution: Developers changed CPRS so that when a quick order is selected, CPRS will open to the second tab, the Blood Bank Orders tab.
Vitals Lite

Resolution: Developers found that the problem seemed to be when users double-clicked when launching Vitals Lite. Developers corrected the problem and a double-click will no longer cause this problem.