Pharmacy Issues
From VistApedia
This page will contain notes to work out pharmacy programming issues.
Initiated by K. Toppenberg 4/2005
Contents
- 1 Keys Needed for Pharm. Setup
- 2 Files and Relationships
- 3 Example of Data
- 4 Example Entry
- 5 Other Important Pharmacy Files and Relationships
- 6 Steps to Adding One Drug / Making Available in CPRS
- 7 Relevent Menu Options
- 8 Emails Regarding Adding Drugs
- 9 Instructions for entering a drug through menus
Keys Needed for Pharm. Setup
We 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: 50dot68
- VA GENERIC file (file #50.6, ^PSNDF(50.6))
- 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 50dot7
- 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 101dot43
- ORDER QUICK VIEW file (file #101.44, ^ORD(101.44,*)) holds "quick order" entries. This links to above. File Info 101dot44
Summary of Pharmacy File Linkages
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)
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.
File 101.43 (ORDERABLE ITEM), field ID holds a text pointer to this file, e.g.
"10;99PSP" <---- 10 is IEN in file #50.7
There is no pointer field 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)). HOWEVER, File #50's
"ASP" cross-reference for the field "PHARMACY ORDERABLE ITEM (#2.1) i.e.
^PSDRUG("ASP",IEN_in_50.7,*), contains list of linked records in file #50
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)
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. 101.44 (ORDER QUICK VIEW) 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 of Data
File 101.44 (PHARMACY ORDERABLE ITEM)
.01-NAME : ORWDSET O RX
6-LAST UPDATE : 60414,61441
20-SET MEMBER :
-snip-
Multiple Entry #15 <--- notice that there are no doses
.01-SET MEMBER : SILDENAFIL TAB <-- pointer to 101.43
2-DISPLAY TEXT : SILDENAFIL TAB
-snip-
Multiple Entry #17 <--- notice that there are no doses
.01-SET MEMBER : SILDENAFIL TAB <-- pointer to 101.43
2-DISPLAY TEXT : VIAGRA <SILDENAFIL TAB>
-snip-
File 101.43 (ORDERABLE ITEM)
.01-NAME : SILDENAFIL TAB
1-SYNONYMS :
Multiple Entry #1
.01-SYNONYM : VIAGRA
1.1-PACKAGE NAME : SILDENAFIL TAB
2-ID : 4;99PSP <--- pointer to IEN=4 in 50.7
5-DISPLAY GROUP : PHARMACY
9-SET MEMBERSHIP :
Multiple Entry #1
.01-SET : RX
-snip-
File 50.7 (PHARMACY ORDERABLE ITEM)
.01-NAME : SILDENAFIL
.02-DOSAGE FORM : TAB
.05-DAY (nD) or DOSE (nL) LIMIT : 2L
.07-SCHEDULE TYPE : FILL ON REQUEST
2-SYNONYM :
Multiple Entry #1
.01-SYNONYM : VIAGRA <-- free text
7-PATIENT INSTRUCTIONS : [Do not take with nitroglycerin]
ASP index in file 50 allows link from 50.7 --> 50
^PSDRUG("ASP",4,7118) = IEN# 4 in 50.7 --> IEN# 7118 in 50
File 50 (DRUG file) (some noncontributory fields edited)
.001-NUMBER : 7118
.01-GENERIC NAME : SILDENAFIL (Viagra) 50MG TAB
2.1-PHARMACY ORDERABLE ITEM : SILDENAFIL
9-SYNONYM :
Multiple Entry #2
.01-SYNONYM : VIAGRA
1-INTENDED USE : TRADE NAME
14.5-DISPENSE UNIT : TAB
20-NATIONAL DRUG FILE ENTRY : SILDENAFIL
21-VA PRODUCT NAME : SILDENAFIL CITRATE 50MG TAB
22-PSNDF VA PRODUCT NAME ENTRY : SILDENAFIL CITRATE 50MG TAB
101-MESSAGE : Use for 25mg dose only
215-QUANTITY DISPENSE MESSAGE : MAX 4 DOSES PER MONTH - CONTRAINDICATED WITH
NITRATES
901-STRENGTH : 50
902-UNIT : MG
903-POSSIBLE DOSAGES :
Multiple Entry #1
.01-DISPENSE UNITS PER DOSE : 1
2-PACKAGE : IO
Multiple Entry #2
.01-DISPENSE UNITS PER DOSE : .5
2-PACKAGE : O
Multiple Entry #3
.01-DISPENSE UNITS PER DOSE : 1
1-DOSE : 50
2-PACKAGE : IO
Multiple Entry #4
.01-DISPENSE UNITS PER DOSE : 2
1-DOSE : 100
2-PACKAGE : IO
Example Entry
Here is an example of entering the drug the "proper" way, via menu options: Drug Entry Edit Example
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:
ADD Drug Enter/Edit [PSS DRUG ENTER/EDIT]
cv Protocol Conversion Utilities ... [ORCM CONVERSION UTILITIES]
EOI Edit Orderable Items [PSS EDIT ORDERABLE ITEMS]
Mgr Pharmacy Data Management ... [PSS MGR]
NDF National Drug File Menu ... [PSNMGR]
Out Outpatient Pharmacy Manager ... [PSO MANAGER]
xxx Enter/Edit a Drug [PSA DRUG ENTER/EDIT] <--- don't use this one
Drug Accountability Menu ... [PSA DRUG ACCOUNTABILITY MENU]
Drug Receipt History Review [PSA DRUG HISTORY]
Drug Transaction History [PSA DRUG DISPLAY]
Inquire/Compare DRUG file/ITEM MASTER file [PSA DRUG INQUIRE]
Emails Regarding Adding Drugs
Moved here: Pharmacy Setup Emails
Helpful post here: Instructions for New Drug Entry
