Difference between revisions of "Pharmacy Issues"

Revision as of 19:11, 5 November 2005

This page will contain notes to work out pharmacy programming issues.

Initiated by K. Toppenberg 4/2005

Keys Needed for Pharm. Setup

David Whitten searched pharmacy routines and found keys that were needed for some of the pharmacy setup routines. Here are the keys that were found: 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

Files and Relationships

• VA PRODUCT file (file #50.68, ^PSNDF(50.68,*)) holds ALL possible drugs. Some people refer to this as the National Drug File. File Info #50.68
• DRUG file (file #50, ^PSDRUG(*)) holds all the drugs in the local formulary. This links to above. File Info #50
• PHARMACY ORDERABLE ITEM file (file #50.7, ^PS(50.7,*)) holds things that can be ordered from the pharmacy. This links to above. File Info #50-7
• ORDERABLE ITEM file (file #101.43, ^ORD(101.43,*)) holds things that can be ordered, including labs and drugs. This links to above. File Info #101-43
• ORDER QUICK VIEW file (file #101.44, ^ORD(101.44,*)) holds "quick order" entries. This links to above. File Info #101-44

What I Have Learned so Far

1. File 50.7 (PHARMACY ORDERABLE ITEM):

 **A record in this file should be created first.  
 .01 field should be the generic name of the drug.
 When the record is created, an entry in fle 101.43 (ORDERABLE ITEM) will automatically be made.
 Also, a record in in ORDER QUICK VIEW will also be created (but it is incomplete--see below.)
 Note: new drugs may not be added unless PSEDITNM>0.  So to setup a drug in fileman,
       set PSEDITNM=1 from the command-line, then DO D^DI to get into Fileman with vars intact.
 In the MED ROUTE field, the input transform does not allow an input of "ORAL".  (If left
 blank ORAL will be shown in CPRS)
 There is no direct link from file 50.7 up to file 50.  The link is FROM file #50 TO #50.7 (via 
 file #50's field 2.1(PHARMACY ORDERABLE ITEM))
 This file can hold the synonyms of a drug etc.
 When this record is created, for some reason it is automatically given the current
   date in the INACTIVE DATE field--meaning it is created in an inactive state.  One must
   go back and edit the record a second time to remove the entry from this field.
 

2. In file# 50 (DRUG, ^PSDRUG):

 This file will hold a separate record for every different medication/tablet size.
 For example, there will be one for AMOXICILLIN 250, and another for AMOXICILLIN 500.
 Both of the above records would be linked to one record in the PHARMACY ORDERABLE ITEM,
 i.e. an AMOXICILLIN record.
 The link should be in field 2.1 (the PHARMACY ORDERABLE ITEM field), which will
   hold a pointer to file 50.7 (PHARMACY ORDERABLE ITEM file)
 
 (old, confused notes--best ignored)
 There must be an entry coresponding to the ID from 101.43, i.e. The "ASP" 
 cross-reference for the field "PHARMACY ORDERABLE ITEM (#2.1) i.e. ^PSDRUG("ASP",+ID,*)
 should exist.  

3. In file 101.43 (ORDERABLE ITEM) an entry for the drug must exist like this:

  This entry should have been made automatically when the PHARMACY ORDERABLE ITEM was
  created.
 
 file 101.43
 record: .01 NAME = LISINOPRIL
           2 ID = "Unique identifier, created from primary key passed in the 
                  Orderable Items update message from each package; it will be 
                  in the form of 'package code;99XXX' where XXX indicates the 
                  package table originating this item (i.e. RAP,LRT,etc.)
                  [e.g. in my system, then entry for DILTIAZEM TAB is 1;99PSP]
                  "Package code" should be the IEN on the PHARMACY ORDERABLE ITEM (#50.7)

4. For meds to show up in the dialog box in CPRS, it must have a entry like this:

 Again, this entry should have been created automatically when the PHARMACY ORDERABLE ITEM
 was created.  But for some reason, the DISPLAY TEXT field is not filled in.  Without this,
 the drug will not appear in CPRS.  So this must be manually supplied.

file: 101.44 (ORDER QUICK VIEW);  
 record: ORWDSET O RX;  
   subfile: SET MEMBER (101.442)
     record: SET MEMBER: _IEN_ pointer to 101.43 (ORDERABLE ITEM)   ... a drug would go here
             DISPLAY TEXT: "A name to appear in CPRS appears here.
     record: SET MEMBER: _IEN_ pointer to 101.43 (ORDERABLE ITEM)   ... a drug would go here
             DISPLAY TEXT: "A name to appear in CPRS appears here.
     record: SET MEMBER: _IEN_ pointer to 101.43 (ORDERABLE ITEM)   ... a drug would go here
             DISPLAY TEXT: "A name to appear in CPRS appears here.
     record: SET MEMBER: _IEN_ pointer to 101.43 (ORDERABLE ITEM)   ... a drug would go here
             DISPLAY TEXT: "A name to appear in CPRS appears here.

Example Entry

Here is a sample inquirery of one successfuly added drug: furosemide (NOTICE: in this system, there is only 1 orderable drug from CPRS)

OUTPUT FROM WHAT FILE: NEW PERSON// 50.7  PHARMACY ORDERABLE ITEM
                                          (1 entry)
(NOTE: reformatted for easier reading)
Select PHARMACY ORDERABLE ITEM NAME: ?
    Answer with PHARMACY ORDERABLE ITEM NAME, or SYNONYM, or OI-DRUG TEXT ENTRY:
   FUROSEMIDE      FUROSEMIDE     TAB

Select PHARMACY ORDERABLE ITEM NAME: furOSEMIDE       TAB
ANOTHER ONE:
STANDARD CAPTIONED OUTPUT? Yes//   (Yes)
Include COMPUTED fields:  (N/Y/R/B): NO// b  BOTH Computed Fields and Record Number (IEN)

NUMBER: 1                               
  NAME: FUROSEMIDE
  SYNONYM: LASIX
  DOSAGE FORM: TAB

Select PHARMACY ORDERABLE ITEM NAME:

OUTPUT FROM WHAT FILE: 101.43  ORDERABLE ITEMS//
(NOTE: reformatted for easier reading)
Select ORDERABLE ITEMS NAME: furose
     1   FUROSEMIDE
     2   FUROSEMIDE TAB
CHOOSE 1-2: 1  FUROSEMIDE
ANOTHER ONE: furo
     1   FUROSEMIDE
     2   FUROSEMIDE TAB
CHOOSE 1-2: 2  FUROSEMIDE TAB
ANOTHER ONE:
STANDARD CAPTIONED OUTPUT? Yes//   (Yes)
Include COMPUTED fields:  (N/Y/R/B): NO// b  BOTH Computed Fields and Record Number (IEN)

NUMBER: 774                             
  NAME: FUROSEMIDE
  ID: 828;99LRT                         
  DISPLAY GROUP: LABORATORY
  PACKAGE NAME: FUROSEMIDE
  SYNONYM: LASIX
  SET: LAB
  TYPE: both


NUMBER: 1659                            
  NAME: FUROSEMIDE TAB
  ID: 1;99PSP  <---- x;99PSP  x=IEN in file# 50.7 (PHARMACY ORDERABLE ITEM)
  DISPLAY GROUP: PHARMACY
  PACKAGE NAME: FUROSEMIDE TAB
  SET: RX
  SET: UD RX
  SET: O RX
    INPATIENT MED: YES                    
    OUTPATIENT MED: YES
    IV BASE: NO                           
    IV ADDITIVE: NO
    SUPPLY: NO                            
    NON-FORMULARY: NO
    NON-VA MEDS: NO


Select ORDERABLE ITEMS NAME:

OUTPUT FROM WHAT FILE: 101.44  ORDER QUICK VIEW
                                          (2 entries)
(NOTE: reformatted for easier reading)
Select ORDER QUICK VIEW NAME: ?
    Answer with ORDER QUICK VIEW NAME
   Choose from:
   ORWDQ PKG35 DO
   ORWDSET O RX

Select ORDER QUICK VIEW NAME: orwdset O RX
ANOTHER ONE:
STANDARD CAPTIONED OUTPUT? Yes//   (Yes)
Include COMPUTED fields:  (N/Y/R/B): NO// b  BOTH Computed Fields and Record Number (IEN)

NUMBER: 2                               
  NAME: ORWDSET O RX
  LAST UPDATE: 60201,74282
  SET MEMBER: FUROSEMIDE TAB              
    DISPLAY TEXT: FUROSEMIDE TAB

Select ORDER QUICK VIEW NAME:

Other Important Pharmacy Files and Relationships

Steps to Adding One Drug / Making Available in CPRS

GTM>set PSEDITNM=1
GTM>D D^DI

VA FileMan 22.0
Select OPTION: enter OR EDIT FILE ENTRIES

INPUT TO WHAT FILE: DRUG// 50.7  PHARMACY ORDERABLE ITEM
                                          (3 entries)
EDIT WHICH FIELD: ALL//

Select PHARMACY ORDERABLE ITEM NAME: VIAGRA
 Are you adding 'VIAGRA' as a new PHARMACY ORDERABLE ITEM (the 4TH)? No// Y
 (Yes)
  PHARMACY ORDERABLE ITEM DOSAGE FORM: tab
    1   TAB
    2   TAB,BUCC,SA
    3   TAB,BUCCAL
    4   TAB,CHEWABLE
    5   TAB,CHEWG GUM
Press <RETURN> to see more, '^' to exit this list, OR
CHOOSE 1-5: 1  TAB
  PHARMACY ORDERABLE ITEM INACTIVE DATE:
DOSAGE FORM: TAB//   (No Editing)
IV FLAG:
INACTIVE DATE:
DAY (nD) or DOSE (nL) LIMIT: ??
    Type a whole number between 0 and 99, 0 decimal digits, followed by either
    a "D" (for NUMBER OF DAYS) or an "L" (for DOSE LIMIT).
DAY (nD) or DOSE (nL) LIMIT: 2L
MED ROUTE:
SCHEDULE TYPE: r  FILL ON REQUEST
SCHEDULE:
SUPPLY:
Select SYNONYM: VIAGRA
 Are you adding 'VIAGRA' as a new SYNONYM (the 1ST for this PHARMACY ORDERABLE ITEM)? No// Y  (Yes)
Select SYNONYM:
Select OI-DRUG TEXT ENTRY:
PATIENT INSTRUCTIONS: [Do not take with nitroglycerin]

[Do not take with nitroglycerin]
OTHER LANGUAGE INSTRUCTIONS:
NON-VA MED:

Select PHARMACY ORDERABLE ITEM NAME:

Select OPTION:

Note: You have to go back and edit the INACTIVE DATE, and delete the value.

Now create link from #50, field 2.1 --> 50.7

Select OPTION: eNTER OR EDIT FILE ENTRIES

INPUT TO WHAT FILE: DRUG// 50  DRUG       (5173 entries)
EDIT WHICH FIELD: ALL// pharmACY ORDERABLE ITEM
THEN EDIT FIELD:

Select DRUG GENERIC NAME: viagra
1  VIAGRA  SILDENAFIL (Viagra) 50MG TAB   GU900  Use for 25mg dose only
2  VIAGRA  SILDENAFIL (Viagra) 100MG TAB  GU900  ONLY 4 DOSES PER MONTH ALLOWED
CHOOSE 1-2: 1  SILDENAFIL (Viagra) 50MG TAB  GU900  Use for 25mg dose only
PHARMACY ORDERABLE ITEM: viagra  TAB  04-25-2005 <--- Date is an INACTIVE data. Delete value in 50.7 

Select DRUG GENERIC NAME: viag
1  VIAGRA  SILDENAFIL (Viagra) 50MG TAB   GU900  Use for 25mg dose only
2  VIAGRA  SILDENAFIL (Viagra) 100MG TAB  GU900  ONLY 4 DOSES PER MONTH ALLOWED
CHOOSE 1-2: 2  SILDENAFIL (Viagra) 100MG TAB  GU900 ONLY 4 DOSES PER MONTH ALLOWED
PHARMACY ORDERABLE ITEM: viagra   TAB  04-25-2005 <--- Date is an INACTIVE data. Delete value in 50.7

Select DRUG GENERIC NAME:

Select OPTION:

... to be continued later.....

Relevent Menu Options

Here is a pharmacy option/menu setup I gathered:

  cv     Protocol Conversion Utilities ... [ORCM CONVERSION UTILITIES]
  Mgr    Pharmacy Data Management ... [PSS MGR]
  NDF    National Drug File Menu ... [PSNMGR]
  Out    Outpatient Pharmacy Manager ... [PSO MANAGER]
         Drug Accountability Menu ... [PSA DRUG ACCOUNTABILITY MENU]
         Drug Receipt History Review [PSA DRUG HISTORY]
         Drug Transaction History [PSA DRUG DISPLAY]
         Enter/Edit a Drug [PSA DRUG ENTER/EDIT]
         Inquire/Compare DRUG file/ITEM MASTER file [PSA DRUG INQUIRE]

Emails Regarding Adding Drugs

Moved here: Pharmacy Setup Emails