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August 1993 7th Edition
Written by Bruce Clutcher and Faith Thompson
Edited by Bruce Clutcher Published by Faith Thompson

PHARMACY USER GROUP UPDATE

(-submitted by Doug Kent)

The INVISION Pharmacy Users Group met in Denver, Colorado Sunday, June 6, 1993 - prior to the 50th Annual meeting of the American Society of Hospital Pharmacists. Doug Kent, Ken Stewart, Bernice Eves and Joe Garger represented SMS. Charles Lacy, R.Ph., Pharmacy Systems Analyst at United Health Services in Binghamton, NY presided as chairperson for the Users Group.

Following a luncheon sponsored by SMS, Doug Kent presented an update on INVISION Pharmacy Direction and current development projects which included:

· Enhanced IVs

· Enhanced Order Entry

· Auto NDDF Update

Doug also went on to address those projects in planned development:

· Workload Management

· Online DUE

Charles Lacy shared an Intervention Reporting feature he created using OAS tools and using a database on a PC for reporting capabilities.

Roxie Miles, R.Ph., Clinical Pharmacist at United Health Services provided additional input for utilization of data and benefits to the Pharmacy program at United.

Ken Stewart presented a futures direction for Pharmacy in an interactive forum style. Items discussed were Outpatient Pharmacy Systems, Dispensing Systems (Pyxis, ATC212, etc.), and other future needs for Pharmacy. A positive response was received from all users present.

The Meeting concluded after a lively open forum discussion.

It was a very productive meeting. The Customers were very positive about the presentations and provided valuable input about future development. The ability to share OAS adaptations continues to provide positive user response.

Please contact Doug with any questions regarding the meeting.

INSTALL ACTIVITY

The following people "survived a LIVE" on INVISION Pharmacy applications at the specified hospitals. Congratulations to all!!!

STUMP THE STARS

Don't forget to send in your questions for publication in this section; if you have ideas or answers, please contact the person who has submitted the question directly.

• Jerry Johnson wants feedback from anyone using extensive Outpatient processing - to include multiple charging schemes for Outpatients (ex: employee prescriptions, VIP prescriptions, Nursing Home meds).

• Bruce Clutcher submitted the following brain teaser:

When entering a one time (i.e. one occurrence) continuous IV with a run in of 24 hours, the order only shows on a display of active orders until midnight. After midnight the order is not considered active since the only occurrence (and order stop D/T) is before midnight, despite the fact that the bottle could be running from 11PM today until 11PM tomorrow night. Has this been an issue with any of your clients, and if so has anyone figured out a way to make this order qualify for active displays until the bottle is completed? Please contact Bruce.

• Faith Thompson wants to know if anyone else has heard complaints from clients about the Duplicate/Interaction screen. Some clients would like to be able to branch out of the path at this point, go change or discontinue other orders, then branch back into the Enter Order path again where they left off (at the Duplicate/Interaction screen). Has anyone come up with a work-around for this?

IV ORDER DURATION FIELD - HOW TO AUTOMATICALLY VALUE BASED ON INDIVIDUAL INGREDIENTS' MAXIMUM DURATION

(by Faith Thompson)

The Med Order Entry path makes use of the Service Master "Rx Default Stop Days" (C2238) field to value Order Duration (C1216). However, the IV Order Entry path does not evaluate C2238, and it is also not available in the AUDA for the IV ingredients.

Because of the above situation, if the Pharmacy wants to be able to evaluate a "maximum duration" value for individual IV ingredients, then update C1216 based on the smallest value, the following work-around must be implemented:

1. Store "maximum duration" in Service Master Labeler User Data1 (C2497) for all IV ingredients (additives and solutions). Remember, if the ingredient is an additive which can also be used as a med, you should still value C2238 as well. When program CHPPO100 runs, the data in C2497 is automatically dumped into C1281#xx (Med Solution Segment User1 Text15 in the Active Patient database) - where "xx" represents the ingredient position number in the AUDA (ex: C1281#02 for the first IV ingredient, C1281#03 for the second IV ingredient, etc.).

(NOTE: if you have implemented an IV mnemonic entry path for your client, then "max duration" could be stored in profile PRMNE component PCMNEODN instead of C2497)

2. Build a series of "cascading" TCLs which are stacked in the IV order entry path, just after program CHPPO100 runs. These TCLs will evaluate

C1281#02 through C1281#20, select the smallest number and value C1216 (Order Duration) with that number.

"Cascading" simply means that the first TCL stacks the second, the second TCL stacks the third, etc. The first TCL should assign a default value to C1216. Subsequent TCLs evaluate each of the C1281 components that are in the AUDA to see if they are smaller than C1216; if so, then assign C1216 = C1281#xx.

For example, the first TCL could be called CHKDUR01 and it would:

stack--> $T=CHKDUR02

DVA--> C1216=999

The second TCL, CHKDUR02 would begin to evaluated the IV ingredients as follows:

conditional stack-->where all of "C1281#02" is valued

and "C1281#02" LT "C1216"

then "C1216"="C1281#02"

stack--> $T=CHKDUR03

Likewise, the third TCL would evaluate C1281#03 and stack the fourth TCL, and so on. Ultimately, C1216 will contain the smallest "max duration" value from the IV ingredients that were selected for the order.
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