Difference between revisions of "Ignacio Valdes Implementation Log/Episode13"

Latest revision as of 04:36, 13 November 2020

Ordering Configuration

The Intracare Implementation Log Episode12 (Back to Log Homepage) Episode14nn

The Problem

• Original thread on Hardhats [1]

Ignacio Valdes Date: Tue, 16 Sep 2008 16:38:42 -0500

Let the ordering Configuration begin! This looks like it will be by far the most complicated part of all this.

I have uploaded to the files section a copy of our admission order form:

• http://groups.google.com/group/Hardhats/web/ICH-118%20Revised%2007-06.rtf

for RTF and 

• http://groups.google.com/group/Hardhats/web/ICH-118%20Revised%2007-06.doc

as .doc just in case.

What is the best way to proceed in getting this into ordering so that one does not have to go to multiple sub-headings to do a set of orders. I am aware of 'Order Sets' but not if they can be sub-selectable like for instance one does not normally enter urine pregnancy test on males.

The first part, Admitting diagnosis will be a DSM IV Axis I diagnosis. Inpatient, partial and outpatient are covered elsewhere so they are not an issue. I do not know what to do about 'Programs:' as that is a local bed control issue to be done.

So that leaves Precautions which should definitely be executable orders in effect for a certain period and possibly canceled after a period of time, for instance Suicide precautions. How/where should I add the different Precautions into ordering? Same with Restrictions.

When one enters a generic consult, how do consultantee's know that they are being consulted?

How does one 'bundle' Vital signs Pulse, Respriation, BP?

Probably many more questions to come...

-- IV

ivaldes Date: Wed, 17 Sep 2008 11:51:05 -0700 (PDT)

Seems like I am getting into little trodden territory. Is there a CAC manual for defining order sets? If so, can anyone furnish a link to the right manual? -- IV

First Answer, be sure to read the manual

Sam Habiel Date: Wed, 17 Sep 2008 19:41:46 -0700

Both the VA and IHS have good manuals on how to do this sort of thing, but you will fumble a little at the beginning.

Go to

• http://www.va.gov/vdl, look for CPRS, and look for the CPRS set-up

manual. Or

• http://www.ihs.gov/cio/ehr.

Here are the steps:

1.Admitting  Diagnosis:         (ICD in Encounter; DSM not available in CPRS)

2. Allergies: (Allergies Component)
Height:          Weight:                (vitals)
3.   Admit to:  ÿ Inpatient                    ÿ Partial Hospital Program     ÿ
Intensive Outpatient Program
(Generic Order; part of an order set possibly)

4.   Programs:  ÿ PICU (Adult)                 ÿ Adolescent Program   □  D.A.P.A.  
                ÿ Adult General Program                ÿ Children's Program             □  Other
______________________
(Generic Order etc.)                            

5.   Precautions:       ÿ Seizure                      ÿ Assault                      ÿ Fall             ÿ Homicidal
                ÿ Detox                        ÿ Elopement            ÿ Suicide       ÿ Other ____________________
                ÿ Sexual Acting Out            ÿ May go off unit to smoke with staff escort &
at staff discretion.
                ÿ Unit restriction first 24 hours        ÿ May go off unit for
recreation therapy
(Generic Order)
6.  Restrictions:       ÿ No Restriction of Telephone and/or Visitors.
                ÿ Restriction of Telephone, Requires Clinical Justification:                                          
                ÿ Restriction of Visitors, Requires Clinical Justification:                                                    
ÿ Complete Personal/Body Search, Requires Clinical Justification                                              
ÿ Search personal belongings and pat search, Requires Clinical
Justification
(Generic Order)
7.   Vital Signs:       ÿ Routine : Q 4 hours while awake X 24 hours
                ÿ Other: ________________________________________________________________________________________
(Generic Order)
8.   Diet:              ÿ Regular      ÿ Other:
_______________________________________________________________________
(Dietetics Order if you use the package; otherwise, Generic Order)
9.   Lab:               ÿ Routine Admit Panel (CMP, CBC, RPR,TSH, T4 FREE)
ÿ Urine Pregnancy Test ÿ UDS           ÿ U/A
                ÿ Other:                                                                                              
(Lab order)
10. Tuberculosis Screen:        ÿ PPD  (0.1cc intradermal)     ÿ Chest X-Ray,
Clinical Justification:
(Text order or Radiology order)

11. Contract Physician or other: ______________________________ for:
                                        ________________
(notes; part of history)
ÿ History & Physical       ÿ Other:                                                                      
(notes; part of history)
12.  Medications:               Children                                                Adults and Adolescents
                ÿ Maalox 15cc p.o. q 4 h. prn indigestion              ÿ Maalox 30cc p.o. q 4 h.
prn indigestion
                ÿ Tylenol          mg. p.o. q 4 h. prn headache/pain/temp      ÿ Tylenol
650mg. p.o. q 4 h. prn headache/pain/temp
(pharmacy orders)
        AGE
4-5 years
6-8 years
9-10 years
11 years
Weight
36-47 LB
48-59 LB
60-71 LB
72-95 LB
Tylenol
240 mg.
320 mg.
400 mg.
480 mg.
13. ÿ Psychosocial History
14. ÿ Individual Therapy       ÿ Unit Staff   ÿ Affiliate Staff  (Name of
Affiliate Staff)
15. ÿ Family Therapy   ÿ Unit Staff   ÿ Affiliate Staff  (Name of
Affiliate Staff)
16. ÿ Chemical Dependency Assessment  
17. ÿ Recreation Therapy
(14-17: notes)
                        ÿ A.M.  ÿ P.M.
DATE ORDERED    TIME ORDERED

The way I would do it is as follows, assuming you have lab, pharmacy, and radiology running (if not, you will have to use generic orders).

Create individual generic orders for all your items. There's a steep learning curve, but you eventually get the hang of it. Create quick orders for labs, pharmacy, radiology

Create an order set, possibly several of them depending on the circumastances (e.g. males don't get hcg because... well... because...)

After ordering and signing, create a note template that will include the rest of the information, and that pulls in all orders automatically into the note text.

Your workflow may look like this:

1. Initial evaluation note, saved, not signed.
2. Vitals, Allergies, etc.
3. Order Set.
4. Complete note.
5. Encounter information

Sam

This is the manual

ivaldes Date: Thu, 18 Sep 2008 10:23:59 -0700 (PDT)

Is this the right manual?

• http://www.va.gov/vdl/documents/Clinical/Comp_Patient_Recrd_Sys_(CPRS)/cprssetup.pdf

Sam Habiel Date: Thu, 18 Sep 2008 18:03:57 -0700

Yes.

DSM IV Axis I psychiatric diagnoses are in fact available

I, Valdes Date: Fri, 19 Sep 2008 09:30:43 -0700 (PDT)

FYI everyone, the Diagnosis dialog DOES have access to apparently all DSM IV Diagnostic and Statistic Manual of Mental Disorders Axis I, however, you have to go to the Other Diagnosis dialog and search for them. It looks good enough for what we do. The mental leap is that the default Psychiatric Diagnosis set has only very basic diagnosis but it seems that all or most with qualifiers ARE available through the Other Diagnosis search.

-- IV

I, Valdes Date: Thu, 25 Sep 2008 11:14:39 -0700 (PDT)

Try it out

Okay, I tried to put in some text orders into CPRS but when I try to save them as quick orders, it says that the text orders dialog box does not support quick orders. I looked at the CPRS manual setup it looks daunting. -- IV

I, Valdes Date: Thu, 25 Sep 2008 13:35:41 -0700 (PDT)

Is anyone willing to talk me through creating order sets by phone? If so, please contact me offline. -- IV

I, Valdes Date: Fri, 26 Sep 2008 11:45:14 -0700 (PDT)

I spoke to Sam today and we got through much of defining an order set. The full terminal session for this is below. However, the new order set menu did not show up because the system is not 'christened'? Per Sam, the menu below shows the problem which is that system is pointing at BETA.VISTA-OFFICE.ORG and not INTRACARE HOSPITAL INSTITUTION? He said to please post this to Hardhats on how to christen the system.

Select PARAMETER DEFINITION NAME:    ORWOR WRITE ORDERS LIST   Write
Orders (Inpatient)

ORWOR WRITE ORDERS LIST may be set for the following:

     1   User          USR    [choose from NEW PERSON]
     2   Location      LOC    [choose from HOSPITAL LOCATION]
     2.3 Service       SRV    [choose from SERVICE/SECTION]
     2.7 Division      DIV    [INTRACARE HOSPITAL INSTITUTION]
     3   System        SYS    [BETA.VISTA-OFFICE.ORG]
     4   Package       PKG    [ORDER ENTRY/RESULTS REPORTING]

Full terminal session for creating an order set menu that consists of CBC, TSH and RPR:

Script started on Fri 26 Sep 2008 12:54:09 PM CDT
[vista@vista ~]$ gtm

GTM>S DUZ=60 D ^XUP

Setting up programmer environment
This is a TEST account.

Terminal Type set to: C-VT100

Select OPTION NAME: OR PARAM
     1   OR PARAM ADD MENU       Assign Primary Order Menu
     2   OR PARAM CHART COPY       Chart Copy Parameters
     3   OR PARAM COORDINATOR MENU       CPRS [[Configuration~|Configuration]] (Clin
Coord)
     4   OR PARAM IRM MENU       CPRS [[Configuration~|Configuration]] (IRM)
     5   OR PARAM ORDER MISC       Miscellaneous Parameters
Press <RETURN> to see more, '^' to exit this list, OR
CHOOSE 1-5: 3  OR PARAM COORDINATOR MENU     CPRS [[Configuration~}Configuration]] (Clin
Coord)

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select CPRS [[Configuration~|Configuration]] (Clin Coord) Option: ?

   AL     Allocate OE/RR [[Security Key~|Security Key]]s
   KK     Check for Multiple Keys
   DC     Edit DC Reasons
   GP     GUI Parameters ...
   GA     GUI Access - Tabs, RPL
   MI     Miscellaneous Parameters
   NO     Notification Mgmt Menu ...
   OC     Order Checking Mgmt Menu ...
   MM     Order Menu Management ...
   LI     Patient List Mgmt Menu ...
   FP     Print Formats
   PR     Print/Report Parameters ...
   RE     Release/Cancel Delayed Orders
   US     Unsigned orders search
   EX     Set Unsigned Orders View on Exit
   NA     Search orders by Nature or Status
   CM     Care Management Menu ...
   DO     Event Delayed Orders Menu ...
   PM     Performance Monitor Report

Enter ?? for more options, ??? for brief descriptions, ?OPTION for
help text.

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select CPRS [[Configuration~|Configuration]] (Clin Coord) Option: MM  Order Menu
Management

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select Order Menu Management Option: ?

   OI     Manage orderable items ...
   PM     Enter/edit [[prompt~|Prompt]]s
   GO     Enter/edit generic orders
   QO     Enter/edit quick orders
   QU     Edit personal quick orders by user
   ST     Enter/edit order sets
   AC     Enter/edit [[action~|Action]]s
   MN     Enter/edit order menus
   AO     Assign Primary Order Menu
   CP     Convert protocols
   SR     Search/replace components
   LM     List Primary Order Menus
   DS     Disable/Enable order dialogs
   CS     Review Quick Orders for Inactive ICD9 Codes

Enter ?? for more options, ??? for brief descriptions, ?OPTION for
help text.

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select Order Menu Management Option: QO  Enter/edit quick orders
Select QUICK ORDER NAME: LRZ CBC NOW
  Are you adding 'LRZ CBC NOW' as a new ORDER DIALOG? No// Y  (Yes)
TYPE OF QUICK ORDER: ?
 Answer with DISPLAY GROUP NAME
 Do you want the entire DISPLAY GROUP List? ?
TYPE OF QUICK ORDER: LAB  LABORATORY
NAME: LRZ CBC NOW//
DISPLAY TEXT: CBC
VERIFY ORDER: N  NO
DESCRIPTION:
  No existing text
  Edit? NO//
ENTRY [[ACTION~|Action]]:

Lab Test: CBC
     1   CBC
     2   CBC & MORPHOLOGY (NO DIFF)
     3   CBC & MORPHOLOGY (WITH DIFF)
     4   CBC PROFILE
CHOOSE 1-4: 1    CBC

This is just a test...

SEND TO LAB - Means the patient is ambulatory and will be sent to the
Laboratory draw room to have blood drawn.
WARD COLLECT - Means that either the physician or a nurse will be
collecting
the sample on the ward.
LAB BLOOD TEAM - Means the phlebotomist from Lab will draw the blood
on the
ward.  This method is limited to laboratory defined collection times.

     SP        Send patient to lab
     WC        Ward collect & deliver
     LC        Lab blood team
Collected By: LC  Lab blood team
There are no lab collection times defined!
Collected By:
Collection Sample: BLOOD  //
Collection Date/Time: N  (SEP 26, 2008@13:00)
Urgency: Routine
How often: once       1600

-------------------------------------------------------------------------------
                    Lab Test: CBC
           Collection Sample: BLOOD
                    Specimen: BLOOD
        Collection Date/Time: NOW
                     Urgency: ROUTINE
                   How often: ONCE
-------------------------------------------------------------------------------

(P)lace, (E)dit, or (C)ancel this quick order? PLACE//
Auto-accept this order? NO//

Select QUICK ORDER NAME: RPR
  Are you adding 'RPR' as a new ORDER DIALOG? No// Y  (Yes)
TYPE OF QUICK ORDER: lab  LABORATORY
NAME: RPR//
DISPLAY TEXT: RPR
VERIFY ORDER: N  NO
DESCRIPTION:
  No existing text
  Edit? NO//
ENTRY [[ACTION~|Action]]:

Lab Test: RPR

SEND TO LAB - Means the patient is ambulatory and will be sent to the
Laboratory draw room to have blood drawn.
WARD COLLECT - Means that either the physician or a nurse will be
collecting
the sample on the ward.
LAB BLOOD TEAM - Means the phlebotomist from Lab will draw the blood
on the
ward.  This method is limited to laboratory defined collection times.

     SP        Send patient to lab
     WC        Ward collect & deliver
     LC        Lab blood team
Collected By: LC  Lab blood team
There are no lab collection times defined!
Collected By:
Collection Sample: BLOOD  //
Collection Date/Time: N  (SEP 26, 2008@13:02)
Urgency: Routine
How often: once       1600

-------------------------------------------------------------------------------
                    Lab Test: RPR
           Collection Sample: BLOOD
                    Specimen: SERUM
        Collection Date/Time: NOW
                     Urgency: ROUTINE
                   How often: ONCE
-------------------------------------------------------------------------------

(P)lace, (E)dit, or (C)ancel this quick order? PLACE//
Auto-accept this order? NO//

Select QUICK ORDER NAME: TSH
  Are you adding 'TSH' as a new ORDER DIALOG? No// Y  (Yes)
TYPE OF QUICK ORDER: lab  LABORATORY
NAME: TSH//
DISPLAY TEXT: TSH
VERIFY ORDER: N  NO
DESCRIPTION:
  No existing text
  Edit? NO//
ENTRY [[ACTION~|Action]]:

Lab Test: TSH
The input value contains control characters.
Enter a lab test to be ordered for this patient.

Lab Test: rsh ??
Enter a lab test to be ordered for this patient.

Lab Test: tsh      TSH

SEND TO LAB - Means the patient is ambulatory and will be sent to the
Laboratory draw room to have blood drawn.
WARD COLLECT - Means that either the physician or a nurse will be
collecting
the sample on the ward.
LAB BLOOD TEAM - Means the phlebotomist from Lab will draw the blood
on the
ward.  This method is limited to laboratory defined collection times.

     SP        Send patient to lab
     WC        Ward collect & deliver
     LC        Lab blood team
Collected By: LC  Lab blood team
There are no lab collection times defined!
Collected By:
Collection Sample: BLOOD  //
Collection Date/Time: Now  (SEP 26, 2008@13:03)
Urgency: Routine
How often:

-------------------------------------------------------------------------------
                    Lab Test: TSH
           Collection Sample: BLOOD
                    Specimen: SERUM
        Collection Date/Time: NOW
                     Urgency: ROUTINE
-------------------------------------------------------------------------------

(P)lace, (E)dit, or (C)ancel this quick order? PLACE//
Auto-accept this order? NO//

Select QUICK ORDER NAME:

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select Order Menu Management Option: ST  Enter/edit order sets
Select ORDER SET NAME: ORZ Routine Admit Panel
  Are you adding 'ORZ Routine Admit Panel' as
    a new ORDER DIALOG? No// Y  (Yes)
Do you wish to copy an existing order set? YES// NO
NAME: ORZ Routine Admit Panel  Replace
DISPLAY TEXT: Routine Admit Panel
DESCRIPTION:
  No existing text
  Edit? NO//
ENTRY [[ACTION~|Action]]:
EXIT [[ACTION~|Action]]:
Select COMPONENT SEQUENCE#: 10
SEQUENCE: 10//
ITEM: LRZ CBC NOW

Select COMPONENT SEQUENCE#: 20
SEQUENCE: 20//
ITEM: LRZ TSH??
     Enter an order dialog; a dialog that is an ancestor may not also
be a
     sub-item.
ITEM: TSH

Select COMPONENT SEQUENCE#: 30
SEQUENCE: 30//
ITEM: RPR

Select COMPONENT SEQUENCE#:

Select ORDER SET NAME:

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select Order Menu Management Option: MN  Enter/edit order menus
Select ORDER MENU: ?
 Answer with ORDER DIALOG NAME
 Do you want the entire ORDER DIALOG List? ??
        You may enter a new ORDER DIALOG, if you wish
        This is the name of the dialog; entries that were converted
from the
        Protocol file will retain the same name.  Namespacing is not
required,
        but still encouraged.

Select ORDER MENU: ??

   Choose from:
   FHWMENU
   GMRVORMENU
   OR ADD MENU CLINICIAN
   OR GMENU ACTIVITY ORDERS
   OR GMENU ORDER SETS
   OR GMENU OTHER ORDERS
   OR GMENU PATIENT CARE ORDERS
   OR GXMOVE PATIENT MOVEMENT

        You may enter a new ORDER DIALOG, if you wish
        This is the name of the dialog; entries that were converted
from the
        Protocol file will retain the same name.  Namespacing is not
required,
        but still encouraged.

Select ORDER MENU: OR ADD MENU CLINICIAN
Menu Editor                   Sep 26, 2008@13:09:44          Page:
1 of    3
Menu: OR ADD MENU CLINICIAN                                    Column
Width: 26
                              Sep 26, 2008@13:09:44
|0  ORDER SETS...          30 PATIENT CARE...        70 LABORATORY...
|1  Patient Movement       31 Condom Catheter        71 Chem 7
|2  Diagnosis              32 Guaiac Stools          72 T&S
|3  Condition              33 Incentive Spirometer   73 Glucose
+4  Allergies              34 Dressing Change        74 CBC w/Diff
|                                                    75 PT
|10 PARAMETERS...          40 DIETETICS...           76 PTT
|11 TPR B/P                41 Regular Diet           77 CPK
|12 Weight                 42 Tubefeeding            78 CPK
113 I & O                  43 NPO at Midnight        79 LDH
|14 Call HO on                                       80 Urinalysis
|                          50 IV FLUIDS...           81 Culture &
Suscept
|20 ACTIVITY...            51 OUTPATIENT MEDS...
|21 Ad Lib                 55 INPATIENT MEDS...      90 OTHER
ORDERS...
+23 Bed Rest / BRP                                   91 EKG: Portable
|24 Ambulate TID           60 IMAGING ...
|25 Up in Chair TID        61 Chest 2 views PA&LAT   99 Text Only
Order

+         + Next Screen  - Prev Screen  ?? More
[[Action~|Action]]s                      >>>

EXIT is not a valid selection.
Select [[Action~|Action]]: Next Screen// q   Q

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select Order Menu Management Option:

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select CPRS [[Configuration~|Configuration]] (Clin Coord) Option:

Do you really want to halt? YES//

Logged out at Sep 26, 2008 1:12 pm

GTM>
GTM>S DUZ=60 D ^XUP

Setting up programmer environment
This is a TEST account.

Terminal Type set to: C-VT100

Select OPTION NAME: XPAR MENU TOOLS       General Parameter Tools

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select General Parameter Tools Option: LV  List Values for a Selected
Parameter
Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDERS LIST     Write
Orders (Inpatient)

Values for ORWOR WRITE ORDERS LIST

Parameter                      Instance             Value
----------------------------------------------------------------------------
PKG: ORDER ENTRY/RESULTS REPOR 20                   GMRAOR [[ALLERGY~|Allergy]]
ENTER/EDIT
PKG: ORDER ENTRY/RESULTS REPOR 55                   PSO OERR
PKG: ORDER ENTRY/RESULTS REPOR 60                   LR OTHER LAB TESTS
PKG: ORDER ENTRY/RESULTS REPOR 70                   RA OERR EXAM
PKG: ORDER ENTRY/RESULTS REPOR 80                   GMRCOR CONSULT
PKG: ORDER ENTRY/RESULTS REPOR 85                   GMRCOR REQUEST
PKG: ORDER ENTRY/RESULTS REPOR 90                   GMRVOR
PKG: ORDER ENTRY/RESULTS REPOR 99                   OR GXTEXT WORD
PROCESSING OR

Enter RETURN to continue or '^' to exit: EP

Enter either RETURN or '^'.

Enter RETURN to continue or '^' to exit:

Enter either RETURN or '^'.

Enter RETURN to continue or '^' to exit: ^

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select General Parameter Tools Option: EP  Edit Parameter Values
                         --- Edit Parameter Values ---

Select PARAMETER DEFINITION NAME:    ORWOR WRITE ORDERS LIST   Write
Orders (Inpatient)

ORWOR WRITE ORDERS LIST may be set for the following:

     1   User          USR    [choose from NEW PERSON]
     2   Location      LOC    [choose from HOSPITAL LOCATION]
     2.3 Service       SRV    [choose from SERVICE/SECTION]
     2.7 Division      DIV    [INTRACARE HOSPITAL INSTITUTION]
     3   System        SYS    [BETA.VISTA-OFFICE.ORG]
     4   Package       PKG    [ORDER ENTRY/RESULTS REPORTING]

Enter selection: 2.7  Division   INTRACARE HOSPITAL INSTITUTION

 Setting ORWOR WRITE ORDERS LIST  for Division: INTRACARE HOSPITAL
INSTITUTION
Select Sequence: 10
Are you adding 10 as a new Sequence? Yes//   YES

Sequence: 10//    10
Order Dialog: ?
 Answer with ORDER DIALOG NAME, or DISPLAY TEXT
 Do you want the entire ORDER DIALOG List? Y  (Yes)
   Choose from:
   1300
   FHW OP MEAL
   FHW SPECIAL MEAL
   FHW1
   FHW2
   FHW3
   FHW4
   FHW7
   FHW8
   FHWMENU
   FHWN1
   FHWN2
   GMRCOR CONSULT
   GMRCOR REQUEST
   GMRCR NEUROLOGY INPATIENT
   GMRVOR
   GMRVORADMIT V/M
   GMRVORB/P
   GMRVORHT
   GMRVORMENU
   '^' TO STOP:

   GMRVORPULSE
   GMRVORRESP
   GMRVORTEMP
   GMRVORTPR
   GMRVORTPR B/P
   GMRVORWT
   IRON
   LR OTHER LAB TESTS
   LRTZ GLUCOSE SERUM SP TODAY
   LRZ CBC NOW
   LRZ HEMOGLOBIN AIC
   LRZ HGB TODAY
   LRZ LIPID PROFILE
   LRZ MICROALBUMIN
   LRZ OCCULT BLOOD
   LRZ PLATELET TODAY
   LRZ PT/PTT TODAY
   LRZ WBC TODAY
   NUTRITION
   Neurology Inpatient
   OR ADD MENU CLINICIAN
   OR GMENU ACTIVITY ORDERS
   '^' TO STOP:

   OR GMENU ORDER SETS
   OR GMENU OTHER ORDERS
   OR GMENU PATIENT CARE ORDERS
   OR GWCOND CONDITION
   OR GWDIAG DIAGNOSIS
   OR GWINST DNR
   OR GXACTV AD LIB
   OR GXACTV AMBULATE
   OR GXACTV AMBULATE TID
   OR GXACTV BATHROOM PRIVILEGES
   OR GXACTV BED REST
   OR GXACTV BED REST / BRP
   OR GXACTV HOB UP
   OR GXACTV MAY LEAVE WARD
   OR GXACTV OTHER ACTIVITY ORDER
   OR GXACTV OUT OF BED
   OR GXACTV PROVIDE TRAPEZE
   OR GXACTV ROM EXERCISE
   OR GXACTV TURN PATIENT
   OR GXACTV UP IN CHAIR
   OR GXACTV UP IN CHAIR TID
   OR GXHEMO ARTERIAL LINE
   '^' TO STOP:

   OR GXHEMO ARTERIAL SHEATH
   OR GXHEMO CARDIAC OUTPUT
   OR GXHEMO HEMODYNAMICS ITEM
   OR GXHEMO SWAN GANZ CATHETER
   OR GXHEMO VENOUS SHEATH
   OR GXMISC GENERAL
   OR GXMOVE ADMIT PATIENT
   OR GXMOVE DISCHARGE
   OR GXMOVE EVENT
   OR GXMOVE PATIENT MOVEMENT
   OR GXMOVE TRANSFER
   OR GXMOVE TREATING SPECIALTY
   OR GXNURS CHEST TUBE
   OR GXNURS GLASCOW COMA
   OR GXNURS GUAIAC ASPIRATE
   OR GXNURS GUAIAC EMESIS
   OR GXNURS GUAIAC STOOLS
   OR GXNURS NEURO CHECK
   OR GXNURS NURSING ITEM
   OR GXNURS PUSH FLUIDS
   OR GXNURS URINE PH
   OR GXNURS URINE SPEC GRAV
   '^' TO STOP:

   OR GXOXGN MASK 35 PER CENT
   OR GXOXGN MASK 40 PER CENT
   OR GXOXGN MASK 50 PER CENT
   OR GXOXGN O2 3 LT NASAL CANNUL
   OR GXOXGN O2 4 LT NASAL CANNUL
   OR GXOXGN OXYGEN THERAPY ITEM
   OR GXOXGN VENTILATOR
   OR GXPARM CALL HO ON
   OR GXPARM I AND O
   OR GXRESP CHEST PT
   OR GXRESP INCENTIVE SPIROMETER
   OR GXRESP RESPIRATORY ITEM
   OR GXRESP SUCTION
   OR GXRESP TCDB
   OR GXRESP TRACH CARE
   OR GXSKIN AIR MATTRESS
   OR GXSKIN COLD PACKS
   OR GXSKIN DRESSING CHANGE
   OR GXSKIN SHEEPSKIN
   OR GXSKIN SKIN AND WOUND ITEM
   OR GXSKIN WARM PACKS
   OR GXSKIN WARM SOAKS
   '^' TO STOP: ^

Select Sequence:

ORWOR WRITE ORDERS LIST may be set for the following:

     1   User          USR    [choose from NEW PERSON]
     2   Location      LOC    [choose from HOSPITAL LOCATION]
     2.3 Service       SRV    [choose from SERVICE/SECTION]
     2.7 Division      DIV    [INTRACARE HOSPITAL INSTITUTION]
     3   System        SYS    [BETA.VISTA-OFFICE.ORG]
     4   Package       PKG    [ORDER ENTRY/RESULTS REPORTING]

Enter selection:
-------------------------------------------------------------------------------

Select PARAMETER DEFINITION NAME:

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select General Parameter Tools Option:

Do you really want to halt? YES//

Logged out at Sep 26, 2008 1:17 pm

GTM>
GTM>S DUZ=60 D ^XUP

Setting up programmer environment
This is a TEST account.

Terminal Type set to: C-VT100

Select OPTION NAME: OR PARAM
     1   OR PARAM ADD MENU       Assign Primary Order Menu
     2   OR PARAM CHART COPY       Chart Copy Parameters
     3   OR PARAM COORDINATOR MENU       CPRS [[Configuration~|Configuration]] (Clin
Coord)
     4   OR PARAM IRM MENU       CPRS [[Configuration~|Configuration]] (IRM)
     5   OR PARAM ORDER MISC       Miscellaneous Parameters
Press <RETURN> to see more, '^' to exit this list, OR
CHOOSE 1-5: 3  OR PARAM COORDINATOR MENU     CPRS [[Configuration~|Configuration]] (Clin
Coord)

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select CPRS [[Configuration~|Configuration]] (Clin Coord) Option: MM  Order Menu
Management

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select Order Menu Management Option: MN  Enter/edit order menus
Select ORDER MENU: OR ADD MENU CLINICIAN
Menu Editor                   Sep 26, 2008@13:18:27          Page:
1 of    3
Menu: OR ADD MENU CLINICIAN                                    Column
Width: 26
                              Sep 26, 2008@13:18:59
2
|0  ORDER SETS...          30 PATIENT CARE...        70 LABORATORY...
+1  Patient Movement       31 Condom Catheter        71 Chem 7
|
|
+
|
|
|
|
3
|
|
|
|

+         + Next Screen  - Prev Screen  ?? More
[[Action~|Action]]s                      >>>
    Menu Items                Text or Header            Row

Add: Menu   Menu Items
ITEM: ORZ Routine Admit Panel
ROW: 20
COLUMN: 1
DISPLAY TEXT:
MNEMONIC:

ITEM:

Rebuilding menu display ...
Menu Editor                   Sep 26, 2008@13:20:11          Page:
2 of    3
Menu: OR ADD MENU CLINICIAN                                    Column
Width: 26
                              Sep 26, 2008@13:23:07
3
|
|
4
|
|
|
|
+
|
|
|
|
5
|

          + Next Screen  - Prev Screen  ?? More
[[Action~|Action]]s                      >>>

Select [[Action~|Action]]: Quit//    QUIT

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select Order Menu Management Option:

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select CPRS [[Configuration~|Configuration]] (Clin Coord) Option:

Do you really want to halt? YES//

Logged out at Sep 26, 2008 1:23 pm

GTM>h
[vista@vista ~]$ exit
exit

Script done on Fri 26 Sep 2008 01:23:20 PM CDT
[vista@vista ~]$ 

Christen a new Domain

Sam Habiel Date: Fri, 26 Sep 2008 19:26:50 -0700

I.e. A domain was not created and/or was not pointing to the right institution.

Sam

I, Valdes Date: Tue, 30 Sep 2008 09:46:56 -0700 (PDT)

Can anyone please guide me as how to rectify this problem? -- IV

Nancy Anthracite Date: Tue, 30 Sep 2008 14:00:29 -0400

See http://www.hardhats.org/projects/VistA_Install/Vista_Install.html Step 41 or the wiki

I, Valdes Date: Tue, 30 Sep 2008 14:22:25 -0700 (PDT)

I did steps 41-48 and it worked somehow. However, I had to go back and re-constitute the Routine Admit Panel menu as it did not recognize it immediately then I restarted CPRS and it appeared. An un-wanted side effect is that all of the default Order menu items like labs and such disappeared. Sam says I will have to re-constitute all of that myself unless there is another way to get them back along with the menu I just created?

-- IV

The bad news

Sam Habiel Date: Thu, 2 Oct 2008 17:01:40 -0700

"Sam says I will have to re-constitute all of that myself unless there is another way to get them back along with the menu I just created?"

Sorry to break the bad news to you: the fact is sites take at least 6 months to get ready for EHR, and a lot of that time (at least 2 months FTE) gets spent on configuring the pharmacy package, the lab package, the radiology package, creating all the quick orders, the menus, hanging the quick orders on the menus, hanging the menus on CRPS, configuring note titles, configuring Allergy tracking, configuring consults and list goes on... To speak nothing of creating TIU Templates, which takes forever depending on how many templates you want to create.

Sam

Restore default ordering menus

I, Valdes Date: Fri, 3 Oct 2008 06:43:02 -0700 (PDT)

That's about what I expected, however, I'm still trying to understand why creating a single order set made all the useful default WorldVistA ordering menus disappear? -- IV

Sam Habiel Date: Fri, 3 Oct 2008 11:52:57 -0700

It's done so that you can customize the ordering by division, service, user class etc. Once you set a list at a lower level, it overrides what is set at a higher level. Initially, this didn't work because you didn't have your system set up correctly.

To reconstitute the list, look at orwor write orders list for system, and copy the menus that you see. It should less than take 5 minutes.

Sam

I, Valdes Date: Fri, 10 Oct 2008 09:44:51 -0700 (PDT)

So here is the terminal session done with Sam Habiel for how one brings back the default WorldVistA ordering menus after adding a custom order set. I miskeyed a few things such as XBAR instead of XPAR so just note and probably ignore the mistakes I made. This also shows how to change the order such as adding an inpatient medication item. You do the following, then restart CPRS and the menus are all back. I will show in the next note how to remove the inpatient medication list that I have as sequence 5 using the apparently commonly used @

[vista@vista ~]$ gtm

GTM>S DUZ=60 D ^XUP

Setting up programmer environment
This is a TEST account.

Terminal Type set to: C-VT100

Select OPTION NAME: XBAR MENU TOOLS ??

Select OPTION NAME: XBAR MENU TOOLS ??

Select OPTION NAME: XBAR ??

Select OPTION NAME: XPAR MENU TOOLS       General Parameter Tools

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select General Parameter Tools Option: ORWOR WRITE ORDERS LIST  ??

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select General Parameter Tools Option: LV  List Values for a Selected
Parameter
Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDERS LIST     Write
Orders (Inpa
tient)

Values for ORWOR WRITE ORDERS LIST

Parameter                      Instance             Value
----------------------------------------------------------------------------
SYS: VISTA.ICH.LOCAL           10                   ORZ Routine Admit
Panel
PKG: ORDER ENTRY/RESULTS REPOR 20                   GMRAOR [[ALLERGY~|Allergy]]
ENTER/EDIT
PKG: ORDER ENTRY/RESULTS REPOR 55                   PSO OERR
PKG: ORDER ENTRY/RESULTS REPOR 60                   LR OTHER LAB TESTS
PKG: ORDER ENTRY/RESULTS REPOR 70                   RA OERR EXAM
PKG: ORDER ENTRY/RESULTS REPOR 80                   GMRCOR CONSULT
PKG: ORDER ENTRY/RESULTS REPOR 85                   GMRCOR REQUEST
PKG: ORDER ENTRY/RESULTS REPOR 90                   GMRVOR
PKG: ORDER ENTRY/RESULTS REPOR 99                   OR GXTEXT WORD
PROCESSING OR

Enter RETURN to continue or '^' to exit:

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select General Parameter Tools Option: EDIT
    1    Edit Parameter Definition Keyword
    2    Edit Parameter Values
    3    Edit Parameter Values with Template
CHOOSE 1-3: 2  Edit Parameter Values
                         --- Edit Parameter Values ---

Select PARAMETER DEFINITION NAME:    ORWOR WRITE ORDERS LIST   Write
Orders (Inpatient)

ORWOR WRITE ORDERS LIST may be set for the following:

     1   User          USR    [choose from NEW PERSON]
     2   Location      LOC    [choose from HOSPITAL LOCATION]
     2.3 Service       SRV    [choose from SERVICE/SECTION]
     2.7 Division      DIV    [INTRACARE HOSPITAL INSTITUTION]
     3   System        SYS    [VISTA.ICH.LOCAL]
     4   Package       PKG    [ORDER ENTRY/RESULTS REPORTING]

Enter selection: 3  System   VISTA.ICH.LOCAL

-------- Setting ORWOR WRITE ORDERS LIST  for System: VISTA.ICH.LOCAL
--------
Select Sequence: ?

Sequence  Value
--------  -----
10        ORZ Routine Admit Panel

Select Sequence: 20
Are you adding 20 as a new Sequence? Yes//   YES

Sequence: 20//    20
Order Dialog: PSO OERR
Select Sequence: 30
Are you adding 30 as a new Sequence? Yes//   YES

Sequence: 30//    30
Order Dialog: LR OTHER LAB TESTS
Select Sequence: 40
Are you adding 40 as a new Sequence? Yes//   YES

Sequence: 40//    40
Order Dialog: GMRAOR [[ALLERGY~|Allergy]] ENTER/EDIT ??
Order Dialog: GMRAOR [[ALLERGY~|Allergy]]
The input value contains control characters.
Order Dialog: GMRAOR [[ALLERGY~|Allergy]] ??
Order Dialog: GMRAOR ??
Order Dialog: GMRAOR ??
Order Dialog: RA OERR EXAM
Select Sequence: 50
Are you adding 50 as a new Sequence? Yes//   YES

Sequence: 50//    50
Order Dialog: GMRCOR CONSULT
Select Sequence: 60
Are you adding 60 as a new Sequence? Yes//   YES

Sequence: 60//    60
Order Dialog: GMRCOR REQUEST
Select Sequence: 70
Are you adding 70 as a new Sequence? Yes//   YES

Sequence: 70//    70
Order Dialog: GMRVOR
     1   GMRVOR
     2   GMRVORADMIT V/M
     3   GMRVORB/P
     4   GMRVORHT
     5   GMRVORMENU
Press <RETURN> to see more, '^' to exit this list, OR
CHOOSE 1-5: 1  GMRVOR
Select Sequence: 80
Are you adding 80 as a new Sequence? Yes//   YES

Sequence: 80//    80
Order Dialog: OR GTEXT WORD PROCESSING ??
Order Dialog: OR GXTEXT
     1   OR GXTEXT TEXT ONLY ORDER
     2   OR GXTEXT WORD PROCESSING ORDER
CHOOSE 1-2: 2  OR GXTEXT WORD PROCESSING ORDER
Select Sequence:

ORWOR WRITE ORDERS LIST may be set for the following:

     1   User          USR    [choose from NEW PERSON]
     2   Location      LOC    [choose from HOSPITAL LOCATION]
     2.3 Service       SRV    [choose from SERVICE/SECTION]
     2.7 Division      DIV    [INTRACARE HOSPITAL INSTITUTION]
     3   System        SYS    [VISTA.ICH.LOCAL]
     4   Package       PKG    [ORDER ENTRY/RESULTS REPORTING]

Enter selection:
-------------------------------------------------------------------------------

Select PARAMETER DEFINITION NAME:

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select General Parameter Tools Option: ORWOR WRITE ORDERS  ??

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select General Parameter Tools Option: ORWOR  ??

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select General Parameter Tools Option: LV  List Values for a Selected
Parameter
Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDERS LIST     Write
Orders (Inpa
tient)

Values for ORWOR WRITE ORDERS LIST

Parameter                      Instance             Value
----------------------------------------------------------------------------
SYS: VISTA.ICH.LOCAL           10                   ORZ Routine Admit
Panel
SYS: VISTA.ICH.LOCAL           20                   PSO OERR
SYS: VISTA.ICH.LOCAL           30                   LR OTHER LAB TESTS
SYS: VISTA.ICH.LOCAL           40                   RA OERR EXAM
SYS: VISTA.ICH.LOCAL           50                   GMRCOR CONSULT
SYS: VISTA.ICH.LOCAL           60                   GMRCOR REQUEST
SYS: VISTA.ICH.LOCAL           70                   GMRVOR
SYS: VISTA.ICH.LOCAL           80                   OR GXTEXT WORD
PROCESSING OR
PKG: ORDER ENTRY/RESULTS REPOR 20                   GMRAOR [[ALLERGY~|Allergy]]
ENTER/EDIT
PKG: ORDER ENTRY/RESULTS REPOR 55                   PSO OERR
PKG: ORDER ENTRY/RESULTS REPOR 60                   LR OTHER LAB TESTS
PKG: ORDER ENTRY/RESULTS REPOR 70                   RA OERR EXAM
PKG: ORDER ENTRY/RESULTS REPOR 80                   GMRCOR CONSULT
PKG: ORDER ENTRY/RESULTS REPOR 85                   GMRCOR REQUEST
PKG: ORDER ENTRY/RESULTS REPOR 90                   GMRVOR
PKG: ORDER ENTRY/RESULTS REPOR 99                   OR GXTEXT WORD
PROCESSING OR

Enter RETURN to continue or '^' to exit:

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select General Parameter Tools Option: ?

   LV     List Values for a Selected Parameter
   LE     List Values for a Selected Entity
   LP     List Values for a Selected Package
   LT     List Values for a Selected Template
   EP     Edit Parameter Values
   ET     Edit Parameter Values with Template
   EK     Edit Parameter Definition Keyword

Enter ?? for more options, ??? for brief descriptions, ?OPTION for
help text.

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select General Parameter Tools Option: EP  Edit Parameter Values
                         --- Edit Parameter Values ---

Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDERS LIST  The input
valu
e contains control characters.
Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDERS LIST     Write
Orders (Inpa
tient)

ORWOR WRITE ORDERS LIST may be set for the following:

     1   User          USR    [choose from NEW PERSON]
     2   Location      LOC    [choose from HOSPITAL LOCATION]
     2.3 Service       SRV    [choose from SERVICE/SECTION]
     2.7 Division      DIV    [INTRACARE HOSPITAL INSTITUTION]
     3   System        SYS    [VISTA.ICH.LOCAL]
     4   Package       PKG    [ORDER ENTRY/RESULTS REPORTING]

Enter selection: 3  System   VISTA.ICH.LOCAL

-------- Setting ORWOR WRITE ORDERS LIST  for System: VISTA.ICH.LOCAL
--------
Select Sequence: 5
Are you adding 5 as a new Sequence? Yes//   YES

Sequence: 5//    5
Order Dialog: PSJ
     1   PSJ OR PAT OE
     2   PSJI OR PAT FLUID OE
     3   PSJQ1 EPINEPHRINE
     4   PSJZ AMINOPN 1GM
CHOOSE 1-4: 1  PSJ OR PAT OE
Select Sequence:

ORWOR WRITE ORDERS LIST may be set for the following:

     1   User          USR    [choose from NEW PERSON]
     2   Location      LOC    [choose from HOSPITAL LOCATION]
     2.3 Service       SRV    [choose from SERVICE/SECTION]
     2.7 Division      DIV    [INTRACARE HOSPITAL INSTITUTION]
     3   System        SYS    [VISTA.ICH.LOCAL]
     4   Package       PKG    [ORDER ENTRY/RESULTS REPORTING]

Enter selection:
-------------------------------------------------------------------------------

Select PARAMETER DEFINITION NAME:

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select General Parameter Tools Option:

Do you really want to halt? YES//

Logged out at Oct 10, 2008 11:30 am
GTM>h

Remove an ordering menu with the @ sign

I, Valdes Date: Fri, 10 Oct 2008 09:46:40 -0700 (PDT)

Here is how you remove a ordering menu item with use of the @ sign. Pretty simple. Please ignore the few times I went off into the weeds. -- IV

[vista@vista ~]$ gtm

GTM>S DUZ=60 D ^XUP

Setting up programmer environment
This is a TEST account.

Terminal Type set to: C-VT100

Select OPTION NAME: XPAR
     1   XPAR EDIT BY TEMPLATE       Edit Parameter Values with
Template
     2   XPAR EDIT KEYWORD       Edit Parameter Definition Keyword
     3   XPAR EDIT PARAMETER       Edit Parameter Values
     4   XPAR LIST BY ENTITY       List Values for a Selected Entity
     5   XPAR LIST BY PACKAGE       List Values for a Selected Package
Press <RETURN> to see more, '^' to exit this list, OR
CHOOSE 1-5: ^

Select OPTION NAME: XPAR MENU TOOLS       General Parameter Tools

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select General Parameter Tools Option: ?

   LV     List Values for a Selected Parameter
   LE     List Values for a Selected Entity
   LP     List Values for a Selected Package
   LT     List Values for a Selected Template
   EP     Edit Parameter Values
   ET     Edit Parameter Values with TemplateSelect PARAMETER DEFINITION NAME:    ORWOR WRITE ORDERS LIST   Writ
   EK     Edit Parameter Definition Keyword

Enter ?? for more options, ??? for brief descriptions, ?OPTION for
help text.

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select General Parameter Tools Option: ED
    1    Edit Parameter Definition Keyword
    2    Edit Parameter Values
    3    Edit Parameter Values with Template
CHOOSE 1-3: 2  Edit Parameter Values
                         --- Edit Parameter Values ---

Select PARAMETER DEFINITION NAME: ??

   Choose from:
   ANRV GUI VERSION      Active ANRV Executable
   BPS USRSCR      Display claims for ONE or ALL users
   DENTV CPT QUICK LIST
   DENTV CVISION      CVision Setup Parameters
   DENTV DATE RANGE      Dental Date Range Parameter
   DENTV DRM ADMINISTRATOR
   DENTV DRM BOILERPLATE [[PROMPT~|Prompt]]
   DENTV DRM DAS TURNOFF      Turn off sending data to DAS (file 221)
   DENTV DRM DEF ENC TAB
   DENTV DRM DEF STARTUP TAB      Default DRM Startup Tab
   DENTV DRM DEF TEMP FOLDER      Temporary Folder Location for PC
   DENTV DRM DEF TX TAB      Default [[treatment~|Treatment]] tab display
   DENTV DRM DIVISION
   DENTV DRM EXCEL EXTRACT
   DENTV DRM EXTRACT FOLDER      Default history extract folder
   DENTV DRM EXTRACT IP
   DENTV DRM EXTRACT PORT
   DENTV DRM EXTRACT SERVER      Excel Extract Server Name
   DENTV DRM NOTE WIDTH      Progress note wordwrap width
   DENTV DRM USER CHAR ACCESS
   DENTV ICD9 QUICK LIST
   DENTV PAGE SETUP      Printing Page Setup Param
   DENTV TP CODE BOILERPLATE      CODE BOILERPLATE (COMPREHENSIVE
EXAM)
   DENTV TP DX [[PROMPT~|Prompt]]      USER OPTION TO ADD DX TO PLANNED ITEMS
   DENTV TP NOTE OBJECTS      DRM [[TREATMENT~|Treatment]] SYSTEM NOTE DATA OBJECTS
   DENTV TP NOTE SEQUENCE      NOTE SEQUENCE
   DENTV TP TREEVIEW DEFAULT      DEFAULT TREEVIEW DISPLAY
   DENTV TX CODELINKS      [[Treatment~|Treatment]] Planning Personal Code Links
   DENTV TX HNPRESETS      Common Head & Neck Findings
   DENTV TX SPEEDCODES      Tretment Planning Personal Speed Codes
   DG PT DIRECTORY CALL CENTER      Enable Patient Directory Call
Center
   DGMT MAPR 0 DEPENDENTS      Max. Ann. Rate - 0 Dependents
   DGMT MAPR 1 DEPENDENTS      Max. Ann. Rate - 1 Dependents
   DGMT MAPR GLOBAL RATE      Allowable Medical Expense Rates
   DGMT MAPR N DEPENDENTS      Max. Ann. Rate - 1+n Dependents
   DGPF QUERY TRY LIMIT      Patient [[Record~|Record]] Flags Query Try Limit
   DGQE VIC REQUEST EXPIRATION      VIC Request Expiration
   DGQE VIC REQUEST PURGE      VIC Request Purge
   DGRR PL GENDER      Gender
   DGRR PL MAX NUM PATIENTS RET      Maximum Number of Patients
Returned
   DGRR PL NUM PATIENTS PER PAGE      Number of Patients per Page
                ^
Select PARAMETER DEFINITION NAME: EP ??

Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDER LISTS ??

Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDERS LIST     Write
Orders (Inpa
tient)

ORWOR WRITE ORDERS LIST may be set for the following:

     1   User          USR    [choose from NEW PERSON]
     2   Location      LOC    [choose from HOSPITAL LOCATION]
     2.3 Service       SRV    [choose from SERVICE/SECTION]
     2.7 Division      DIV    [INTRACARE HOSPITAL INSTITUTION]
     3   System        SYS    [VISTA.ICH.LOCAL]
     4   Package       PKG    [ORDER ENTRY/RESULTS REPORTING]

Enter selection: 3  System   VISTA.ICH.LOCAL

-------- Setting ORWOR WRITE ORDERS LIST  for System: VISTA.ICH.LOCAL
--------
Select Sequence: 5

Sequence: 5// @  ...deleted

ORWOR WRITE ORDERS LIST may be set for the following:

     1   User          USR    [choose from NEW PERSON]
     2   Location      LOC    [choose from HOSPITAL LOCATION]
     2.3 Service       SRV    [choose from SERVICE/SECTION]
     2.7 Division      DIV    [INTRACARE HOSPITAL INSTITUTION]
     3   System        SYS    [VISTA.ICH.LOCAL]
     4   Package       PKG    [ORDER ENTRY/RESULTS REPORTING]

Enter selection:
-------------------------------------------------------------------------------

Select PARAMETER DEFINITION NAME:

You have PENDING ALERTS
          Enter  "VA to jump to VIEW ALERTS option

Select General Parameter Tools Option:

Do you really want to halt? YES//

Logged out at Oct 10, 2008 11:36 am
GTM>h

Woodhouse Gregory Date: Fri, 10 Oct 2008 10:26:12 -0700

On Oct 10, 2008, at 9:44 AM, I, Valdes wrote:

> Select OPTION NAME: XBAR MENU TOOLS ??

So, you're a traditional Chomskian at heart? (Look up "X bar theory" in linguistics.)

I, Valdes Date: Fri, 10 Oct 2008 11:13:30 -0700 (PDT)

I'd say I am an accidential Chomskian but it is a good read on wikipedia. It answers the eternal question as to why o why I had to do all of that sentence diagramming in grade and high school. -- IV

Once again, RTFM

I, Valdes Date: Mon, 1 Dec 2008 13:01:11 -0800 (PST)

Sam is there any particular vdl or other document for setting up order sets and pharmacy? -- IV

Sam Habiel Date: Mon, 1 Dec 2008 14:20:53 -0800

http://www.va.gov/vdl/documents/Clinical/Comp_Patient_Recrd_Sys_(CPRS)/cprssetup.pdf

You need to read this manual from the first page to the end. It's the bible.

Sam

Nurses get ORES key

I, Valdes Date: Wed, 3 Dec 2008 13:37:14 -0800 (PST)

The default Nurse ID's in WVEHR have Security Key ORES vs ORELSE. The nurses in admissions frequently take orders by phone (especially late night) from the physicians and sign them on behalf of the physician which the physician then signs later. Is ORES what they should have in this situation?

Per CPRSsetup guide:

• ORES
  • Assigned to users authorized to write and sign orders.
  • Typically assigned to licensed physician.
  • Allows holders to electronically sign orders.
• ORELSE
  • Assigned to users authorized to release physician’s orders.
  • Typically assigned to RN’s.
• OREMAS
  • Assigned to users authorized to release patient orders as signed on chart.
  • Typically assigned to Ward Clerks.

-- IV

David Whitten Date: Wed, 3 Dec 2008 18:03:50 -0600

I suspect it depends on the practice at the site. If you expect the nurses in admissions to write and sign orders, then you need to give them ORES. I did a search through the code and found that there are two PROTOCOLs which specify Actions for the separate keys:

They look mostly alike, the ORELSE protocol has ORC VERIFY MENU and ORC ALERT RESULTS whereas the ORES one doesn't.

I expect that CPRS can be used to enforce whatever policy your site has.

Best Regards, David

Select OPTION: INQUIRE TO FILE ENTRIES

OUTPUT FROM WHAT FILE:  101  PROTOCOL
Select PROTOCOL NAME: ORC ORES ORDER [[ACTION~|Action]]S       Order [[action~|Action]] menu for
ORES key holders
ANOTHER ONE: ORC ORELSE ORDER [[ACTION~|Action]]S       Order [[action~|Action]] menu for ORELSE key
holders
ANOTHER ONE:
STANDARD CAPTIONED OUTPUT? Yes//   (Yes)
Include COMPUTED fields:  (N/Y/R/B): NO// BOTH Computed Fields and [[Record~|Record]]
Number (IEN)

NAME: ORC ORES ORDER [ACTION~|Action]]S
  ITEM TEXT: Order [[action~|Action]] menu for ORES key holders
  TYPE: menu
  COLUMN WIDTH: 20                      MNEMONIC WIDTH: 2
ITEM: ORC CHANGE ORDERS                 SEQUENCE: 11
ITEM: ORC RENEW ORDERS                  SEQUENCE: 12
ITEM: ORC SIGN ORDERS                   SEQUENCE: 21
ITEM: ORC WARD COMMENTS                 SEQUENCE: 34
ITEM: ORC DETAILED DISPLAY              SEQUENCE: 41
ITEM: ORC DISCONTINUE ORDERS            SEQUENCE: 14
ITEM: ORC HOLD ORDERS                   SEQUENCE: 23
ITEM: ORC FLAG ORDERS                   SEQUENCE: 32
ITEM: ORC PRINT ORDERS                  SEQUENCE: 44
ITEM: ORC UNHOLD ORDERS                 SEQUENCE: 24
ITEM: ORC UNFLAG ORDERS                 SEQUENCE: 33
ITEM: ORC ALERT RESULTS                 SEQUENCE: 43
ITEM: ORC COMPLETE ORDERS               SEQUENCE: 22
ITEM: ORC DELAY EVENT                   SEQUENCE: 31
ITEM: ORC REWRITE ORDERS                SEQUENCE: 13
ITEM: ORC RESULTS DISPLAY               SEQUENCE: 42
  EXIT [[ACTION~|Action]]: D DESELECT^ORCHART(ORNMBR):'$G(OREBUILD)
  ENTRY [[ACTION~|Action]]: S XQORM(0)="1AD\",(XQORM("?"),XQORM("??"))="D
ITEMHELP^ORCHART",
VALMBCK="",ORNMBR=$P(XQORNOD(0),"=",2) D SELECT^ORCHART(ORNMBR)
  HEADER: W ""                          MENU [[PROMPT~|Prompt]]: Select [[Action~|Action]]:

NAME: ORC ORELSE ORDER[[ ACTION~|Action]]S
  ITEM TEXT: Order [[action~|Action]] menu for ORELSE key holders
  TYPE: menu
  COLUMN WIDTH: 20                      MNEMONIC WIDTH: 2
ITEM: ORC CHANGE ORDERS                 SEQUENCE: 11
ITEM: ORC RENEW ORDERS                  SEQUENCE: 12
ITEM: ORC SIGN ORDERS                   SEQUENCE: 21
  DISPLAY NAME: Sign/On Chart
ITEM: ORC WARD COMMENTS                 SEQUENCE: 34
ITEM: ORC DETAILED DISPLAY              SEQUENCE: 42
ITEM: ORC DISCONTINUE ORDERS            SEQUENCE: 14
ITEM: ORC VERIFY MENU                   SEQUENCE: 31
ITEM: ORC HOLD ORDERS                   SEQUENCE: 23
ITEM: ORC FLAG ORDERS                   SEQUENCE: 32
ITEM: ORC PRINT ORDERS                  SEQUENCE: 44
ITEM: ORC UNHOLD ORDERS                 SEQUENCE: 24
ITEM: ORC UNFLAG ORDERS                 SEQUENCE: 33
ITEM: ORC COMPLETE ORDERS               SEQUENCE: 22
ITEM: ORC DELAY EVENT                   SEQUENCE: 41
ITEM: ORC REWRITE ORDERS                SEQUENCE: 13
ITEM: ORC RESULTS DISPLAY               SEQUENCE: 43
  EXIT [[ACTION~|Action]]: D DESELECT^ORCHART(ORNMBR):'$G(OREBUILD)
  ENTRY [[ACTION~|Action]]: S XQORM(0)="1AD\",(XQORM("?"),XQORM("??"))="D
ITEMHELP^ORCHART",
VALMBCK="",ORNMBR=$P(XQORNOD(0),"=",2) D SELECT^ORCHART(ORNMBR)
  HEADER: W ""                          MENU [[PROMPT~|Prompt]]: Select [[Action~|Action]]

Nancy Anthracite Date: Wed, 03 Dec 2008 20:32:33 -0500

In the VA, as I understand it, the nurses can write nursing orders and they can take verbal orders that later need to be signed. They do not get the ORES key.

Nancy Anthracite Date: Wed, 03 Dec 2008 20:34:13 -0500

Except Nurse Practitioners do get ORES. -- Nancy Anthracite

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