Kevin,
I suspect that this is what you have done, if not this is how I approach editing issues in many of the pharmacy files I work on (or any file), please beware that this method is not always appropriate for some editing.
Since the Drug file (50) points to Pharmacy Orderable Item file (50.7) you can use FM to edit File50 based on parameters in a edit loop as follows:
Lets say that you wanted to manual edit the Generic Name field and the Inactive Date field of all drugs that are Tablets
After you do the ^LOOP in the Select prompt you just need to enter either "Pharmacy Orderable Item:" or "2.1:" which will then put you in File 50.7 to select the next parameter. The ".02" field is Dosage Form.
The ^LOOP along with the "///" stuff convention allows one to force values into fields quickly and painlessly. (I didn't give an example of this for I didn't want to edit any fields in my database, just be careful in the /// stuff you can get in trouble quickly.) If you wanted to change the INACTIVE DATE to today for all drugs that had Tablet in the Dosage form field of file 50.7 you would just need to change the THEN EDIT FIELD prompt to:
EDIT WHICH FIELD: ALL//INACTIVE DATE///T - Then when LOOPING FM will put todays date into the INACTIVE DATE field of all drugs that meet the criteria.
There are Drug files out there that will have all this done for a user. The soon to be released VistAOfficeEHR will have it and a couple of other places (the HUI has done a couple of nice things related to meds maybe somebody there will comment). We will have our File50 cleaned up to about 2500 items (estimated) and are working on an auto update service to add new medications to File50 as the are released by the FDA along with herbals and some supplies as they reach market so they would be available to a MD for medication entry. We are also trying to address some drug safety issues like TALLman lettering, look alike sound alike, PMI sheets plus addressing NDC and GCN codes to name a few.
The National Drug File is updated via the patch stream you just need to get the appropriate patch last month the VA released the following to NDF patches. You would just install them via the patch process, we use something Jim work on that he calls Simple Patch, pertly straight forward.
National Drug File - PSN
PSN-4_SEQ-90_PAT-95.TXT
PSN-4_SEQ-91_PAT-97.TXTHope this is what you are looking for now.
Mark
*EXAMPLE*
VA FileMan 22.0
Select OPTION: ENTER OR EDIT FILE ENTRIES
INPUT TO WHAT FILE: DRUG// EDIT WHICH FIELD: ALL// GENERIC NAME THEN EDIT FIELD: INACTIVE DATE THEN EDIT FIELD:
Select DRUG GENERIC NAME: *^LOOP* EDIT ENTRIES BY: GENERIC NAME// *2.1:* PHARMACY ORDERABLE ITEM FIELD: *.02* DOSAGE FORM START WITH DOSAGE FORM: FIRST// *TAB* GO TO DOSAGE FORM: LAST// *TABX* WITHIN DOSAGE FORM, EDIT ENTRIES BY: ...HMMM, JUST A MOMENT PLEASE...
ZZAZATHIOPRINE 50MG TAB 10-06-00 USE ENTRY WITH CORRECT SPELLING
GENERIC NAME: ZZAZATHIOPRINE 50MG TAB Replace
INACTIVE DATE: OCT 6,2000//
ZZBUSULFAN 2MG TAB AN100 10-06-00 NONE IN STOCK GENERIC NAME: ZZBUSULFAN 2MG TAB// INACTIVE DATE: OCT 6,2000//
ZZMELPHALAN 2MG TAB AN100 03-09-01 GENERIC NAME: ZZMELPHALAN 2MG TAB// ^
WANT TO STOP LOOPING? Yes// (Yes)
LOOP ENDED!
Select DRUG GENERIC NAME:
Kevin Toppenberg wrote:
I have been spending a fair amount of time lately figuring out the small portion of the pharmacy package that allows one to order a drug from CPRS.
I have put my understanding of four key files here: http://openforum.worldvista.org/~forum/index.php?title=Pharmacy_Issues -- especially the first two sections. Following these steps, I have been able to get a few drugs to show up in CPRS, and I can successfully order them for a patient.
Feeling that I was ready to try to get *all* the drugs available, I have worked on the following steps
1. Scan through all the VA DRUG CLASSes to see if there are some general classes I don't want (for example, bandages, investigational etc.)
2. Scan through all drugs in the DRUG file (#50), and exclude all those belonging to an excluded class, or with invalid records.
3. Group entries differing only by dose -- i.e. AMOXICILLIN 250 and AMOXICILLIN 500 are combined.
My plan was to then to create one PHARMACY ORDERABLE ITEM record and link relevent entries from the DRUG file to it.
The problem I have run up against is that records in
the DRUG file don't appear to have the drug form (i.e.
tablet, capsule, elixer) stored as a separate field. Instead, it is stored as free text in the name--and
the nominclature is inconsistent. I have to have this
information when creating the PHARMACY ORDERABLE ITEM
record. The information IS in the VA PRODUCT file,
but I can't see how to find the associated record in
that file, given an entry in the DRUG file.
But the big picture of all this is that I am having
trouble doing this manually. I know that there is a
"proper" way to do this, namely with option PSA DRUG
ENTER/EDIT. The problem with this, though, is that it
wants the user to carefully pick through the details
of every drug. I don't have the time to do this. There are 5000+ entries in the DRUG file. At 1
minute/drug, we're talking about 80+ solid hours of
work. Plus, it keeps asking me for
national-drug-codes that I have no effecient way of
supplying.
In a pharmacy situation, one must be that careful with tracking drug quantity on hand etc. etc., but I just want the names to be available in CPRS so I can indicate what my patient is taking.
Is there no way to automatically populate the files so all possible outpatient drugs are available in CPRS?
If so, this really ought to be set up for the upcoming OpenVista release.
Any thoughts?
Kevin
P.S. can anyone comment on the process that will be
needed to update one's pharmacy package with new VA
PRODUCT files data (i.e. National drug file data)? For example, the database that came with the OpenVistA
has some drugs in a class, but not all.
Such shortfalls, combined with an inability for one to
write a prescription if the drug isn't there, would
cause the system to be immediately rejected if I put
it into use as-is.
Thanks Kevin
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