1Q97 Pages 3 & 4
LINCOLNS BIRTHDAY EDITION 16th Edition Written & Edited by Bruce Clutcher, R.Ph., Senior Consultant, SSG
The latest customer memos for INVISION Pharmacy, Med/IV Charting and related areas are listed belo.:
Please note, the auto NDDF synchronization for INVISIONs SM and clinical files is only performed in the context of a stand-along SMS Pharmacy product. The auto NDDF update feature is not available for INVISION Pharmacy customers without SMS Pharmacy being used as the parent system. Also, see Customer Memo #991 above for initial features.
1. If you run an ad hoc and only get 31 days of past data, you may need to have the Unload Days for the SYSIN set higher. Model ad hoc Unload Days for the SYSIN are delivered as 31 days. You may want to set the Unload Days to at least as long as your purge criteria. To have the SYSIN changed, call Tech Support. They will open a ticket and change the value for you.
2. If you enter an open ended order, occurrences are generated 3-9 days into the future depending on the hospital setting in PRORP (PCORPOED). You should make sure the number of days in the future to generate occurrences is sufficiently long enough to cover any med/IV cart with a long future window. For example, if you normally pull a 72 hr weekend cart and a holiday falls on a Monday and you therefore need to pull a 96 hour cart, make sure PRORP is set to at least 4 to cover occurrences for the whole cart. The day end program that generates occurrences does so based on the prod version of PRDFQ. The job does not look at the test version. Be aware of this in case you enter orders with a new frequency only found at the test status of PRDFQ. The day end occurrence generation program will bomb out trying to find the frequency.
3. Challenge: one client supported an enteral feeding lab. Due to the stability of some of the admixtures, the contents of the liter bag had to be spit out into 2-6 smaller bags and hung over short intervals. The order was placed on INVISION with the liter portion representing one occurrence. Multiple labels were needed per occurrence to label the smaller bags. The number of labels per occurrence were determined at order entry on an order by order basis. Solution: The number of initial supply labels were easily accommodated using %RXNOLBL processing. The difficulty was storing the number of labels per occurrence so the batch IV processing would produce the desired number of labels. I borrowed C1299 (Rx DEA #) to hold the number of labels on the data file and forced the user to key in #labels for enterals rather than letting the 1 default. The number of labels needs to be DVAd in C1299#02 in enter order, eventually getting stored (and processed on the label) as C1299 by the IV batch programs.
4. %OMBEDID=1 must be in the AUDA for all visit create pathways to make all OP not in a bed process like inpatients for pharmacy orders (see March 94 - 9th Edition of the Rx-Pert). %OMBEDID=1 causes C0269 to be valued. Once C0269 gets valued, it never gets unvalued. However, we recently discovered that C0269 can get unvalued if %OMBEDID=1 is not valued in the patient status upgrade pathways (e.g. Register Preregister Patient, Verify Temporary or Verify Emergency patient function). If you have %OMBEDID=1 in the Preregister Patient function (valuing C0269) but later do not value %OMBEDID=1 in the Register Preregister Patient function, C0269 gets unvalued. Your pharmacy orders will go in as OP (i.e. take home) type orders and CHPPRX51 will not calculate #DU for meds or IV ingredients. Therefore, remember to value %OMBEDID=1 in all visit create and status upgrade pathways
5. Issue: You discontinue (D/C) an order with a future D/C D/T. The order correctly continues to show on the active display/print until the end of day on the D/C date (or until the D/C D/T < %SYS D/T if %ORDSDIS=1 in Display Orders). However, the Order Status is set to DISCONTD and a D shows in the displays priority column, confusing the end user. Solution: conditionally value %ORCNDSC=V-DISCON in the D/C function, setting the Order Status to V-DISCON. The active order display will show a V, although the detail will reveal a V-DISCON future D/C order. The order will automatically drop off the active display when the D/C date (or date and time) has been reached.
6. In case your pharmacy customers wonder what happened to interaction code #159/841 (Insulin/Levothyroxin) - First DataBank removed the interaction pair four years ago because their clinical staff deemed the interaction not clinically relevant.