Attachment 8 Computerized Patient Record System - CPRS User Guide.pdf

Computerized Patient Record System (CPRS)

User Guide: GUI Version

September 2022

Department of Veterans Affairs

Office of Information & Technology (OI&T)

Computerized Patient Record System (CPRS) ii September 2022

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Computerized Patient Record System (CPRS) iii September 2022

Revision History

Date Version/Patch Page Change Project Manager

Technical Writer

09/2022 OR*3.0*405

Added a note defining where the Clozapine requirements came from.

Indications: Added screen captures or steps for indications in Medication Orders:

• Indications Overview

• Medication Order inpatient simple dose screen capture

• Medication Order inpatient simple dose added indication step

• Medication Order inpatient complex dose screen capture

• Medication Order inpatient complex dose added indications step

• Medication Order outpatient simple dose screen capture

• Medication Order outpatient simple dose added indication step

• Medication Order complex dose indication capture

• Non-VA Meds added optional indications step

• Ordering

Medications simple dose indications capture

• Ordering

Medications simple dose added indications step

• Ordering Clinic

Medications simple

CPRS

development team

CPRS

development team

Computerized Patient Record System (CPRS) iv September 2022

Date Version/Patch Page Change Project Manager

Technical dose added indications step

• Ordering Complex

Clinic Medications added indications step

• Ordering Continuous

Clinic Infusion order capture with indications

• Ordering Continuous

Clinic Infusion order step for indication

• Ordering

Intermittent Clinic

Infusion capture with indications

• Ordering

Intermittent Clinic

Infusion added step for indications

• Ordering Outpatient

Meds simple dose capture with indications

• Ordering Outpatient

Meds simple dose added a step for indications

• Ordering Outpatient

Meds complex dose added a capture with indications

• Ordering Outpatient

Meds complex dose added a step for indications

• Indication added to the Documenting

Non-VA meds

• Continuous Infusion

Order capture with indication

• Continuous Infusion

Order step for an indication

Computerized Patient Record System (CPRS) v September 2022

Date Version/Patch Page Change Project Manager

• Intermittent Infusion

Order capture with indication

• Intermittent Infusion

Order capture with indication

NSR 20170302 –Added functionality that lets a user change various attributes when renewing an outpatient medication order

NSR 20090509 – Park a Prescription:

• Added a Park a Prescription section.

• Put “parked” updates in the Sorting the Medications View, and Viewing Orders on the Orders Tab sections.

• Updated the screenshots in the following sections:

o Simple Dose, o Complex Dose section for Ordering Outpatient Medications, o Simple Dose section for Ordering Outpatient Medications

• Fixed an error on a screenshot in the Ordering Inpatient Medications (Simple Dose).

• Updated all three screenshots in the Antimicrobial Medication Quick Orders section

Computerized Patient Record System (CPRS) vi September 2022

Date Version/Patch Page Change Project Manager

• Updated the Refill Orders dialog screenshot and instructions.

Added the Accessing a PDMP Button on a Reminder Dialog Template section.

Fixed the AOD report screenshot.

NSRs 20070920, 20071211, 20100825, 20101203 - Drug- Allergy Order Check Screen Changes:

• Updated the screenshots and descriptions in the following sections:

o Review/Sign Changes Dialog section, o Sign Selected

Orders Command section, o Signing Orders before Selecting a New Patient or Exiting CPRS section, o Entering Allergies-Method One section;

o Order Check on Acceptance Dialog section, o Order Checks Dialog on Signature Actions section, o Meds Tab - Will the Display Change? section (updated the initial paragraphs and two screenshots), o Order Check on Acceptance Dialog section, o Order Checks Dialog on Signature Actions section

Computerized Patient Record System (CPRS) vii September 2022

Date Version/Patch Page Change Project Manager

(also updated the allergy assessment paragraph), o Orders tab - Will the Display Change? - section (updated the initial paragraphs, two screenshots and deleted one screen capture), o Enter Allergy- Orders Tab section.

NSR 20130903 – Added a section on documenting a patient’s immunizations and skin tests

NSR 20080226 – Added a section on doing allergy assessments after you discontinue an order

NSR 20081008 – Added general and detailed descriptions of processed alerts on the Processed Alerts tab.

Updated the following screenshots:

• Selecting a Patient

• Provider-centric view of notifications

• Defer notification

• Notification successfully deferred message

• Notifications sorted by date

• Notification with forwarded comment

• Notification for combat veteran

Removed a screenshot about hovering over forwarded notifications

Computerized Patient Record System (CPRS) viii September 2022

Date Version/Patch Page Change Project Manager

NSR 20170512 – Added instructions on how to document complex non-VA medication orders from the Meds and Orders tabs.

Changed the name of the “Documenting Non-VA Medication Information” section to “Documenting Non- VA Medication Information for Simple Doses” in the Meds and Orders tabs sections.

09/2022 OR*3*569 Under Anatomic Pathology Orders, removed Note regarding availability

01/2022 OR*3.0*581 Redacted hyperlinks and addresses as needed and made changes to address VDL rules.

CPRS

development team

CPRS

development team

01/2022 OR*3.0*537 Remove UAP caution notes in section Using the Unified Action Profile View and Using the Discharge Meds View - (CAUTION: This functionality is delivered with an On/Off switch parameter (OR

UNIFIED ACTION PROFILE

OFF). The default setting is Off. Do not switch this feature On until CPRS v.32 (OR*3.0*539) has been released and successfully installed.)

Removed verbiage from UAP note (Note: The UAP is not currently available; however, it will be available in the near future. Sites will be notified when this feature becomes available.)

CPRS

development team

CPRS

development

10/2021 OR*3*498 144

In the General Tab section, updated the Other Parameters screenshot

Updated the Meds Tab Date Ranges section

CPRS

team

CPRS

Computerized Patient Record System (CPRS) ix September 2022

Date Version/Patch Page Change Project Manager

In the Meds Tab section - Updated the sort method and date range information and screenshot

09/2021 OR*3.0*570

Updated the sections about Flagging and Unflagging orders.

CPRS

development team

CPRS

development

09/2021 OR*3.0*513

Under the Patient Inquiry

Button section, added Display

Caregiver Information and a new screen capture of the

Patient Inquiry Dialog

CPRS

development team

CPRS

development

6/28/2021 OR*3*539

184-185

139, 146, 148, 152, 154, 157-

163, 473

186, 188, 189, 280, 281

189, 281-

282, 522

Added documentation related to the following NSRs:

NSR 20060710 – Added the notification and screenshot about Drug Class cross-checking

NSR 20071216 – Updated the Surrogate Management functionality – Removed the old Surrogate Settings section - Rearranged the Notifications section -updated all Options screenshots

NSR 20120404—updated the adverse reaction reporting file modification for historical allergies. Fixed the numbering in the Entering Allergies-Method One section.

NSR 20070203-Added allergy check enhancement instructions to these sections:

Entering Allergies-Method One (#19 to #21) and Entering New Allergies (#16 to #18).

Added Women's Health:

Potentially Unsafe Medications and Active Meds with Allergies to the Outpatient Medications Report section.

CPRS

development team

CPRS

Computerized Patient Record System (CPRS) x September 2022

Date Version/Patch Page Change Project Manager

37, 172

Error!

Bookma rk not defined.

438, 440

Added a note about the Active Meds with Allergies Report.

NSR 20110606 – Added the Confirm Provider with Similar Names instructions to these sections: Entering Encounter Provider and Location and Entering or Changing Encounter Information.

NSR 20100706: Added descriptions of new features to help identify Template Required Fields and navigate to them: Navigating Template Required Fields.

NSR 20140511: Added a section about the new Anatomic Pathology order dialog: Anatomic Pathology Orders. Added a “Note” disclaimer at the beginning of the section and outlined it in red.

NSR 20071103 and 20110719: Added some information to Flagging an Order and added an Unflagging an Order section.

NSR 20070817: Added a section about improvement for Custom Tree View

PSPO 1970: Updated VBECS section to indicate that the Date/Time Wanted applies to all Blood Components. Label changed to For All Components--Date/Time Wanted.

Added screen captures showing the Nature of Order change where the default can

Computerized Patient Record System (CPRS) xi September 2022

Date Version/Patch Page Change Project Manager

Technical Writer

116, 124, be removed (no preselection), Verbal, Telephone, or Policy with the Review/Sign Changes process, the Sign/Selected Order process, and the Sign before Exiting process.

PSPO 934: “(Documentation)” added to the labels for Non-VA medications to clarify that providers are only documenting what the patient is taking

PSPO 308/321: Added text to report display to let user know that there is additional data if the user set a maximum number of items returned.

NSR 20130714: Added a disclaimer to the beginning of the United Action Profile section and outlined it in red.

6/17/2021 OR*3*546

Various, follow links

Added a Note to subsection:

Viewing Inactive Flag History, regarding OTH Button Labels (OTH-90 and OTH-EXT) displayed when a patient has an inactive flag.

Other Than Honorable subsection: replaced image due to verbiage updates for MST. Added image of an OTH pop up window with a local message.

Liberty ITS Liberty ITS

04/28/2021 OR*3.0*542

Added new Subsection:

History of Actions Taken for

Active Nat Cat1 Flags.

Created a Subsection for PRF

Notes – no edits were made to the text.

Liberty ITS Liberty ITS

Computerized Patient Record System (CPRS) xii September 2022

Date Version/Patch Page Change Project Manager

Technical Writer

03/15/2021 OR*3.0*437

Various, follow links

Added three (3) new subjections:

1. Inactive PRF

2. Viewing Inactive Flags

3. Presumptive Psychosis

Inactive PRF History

Viewing Inactive Flag History

Presumptive Psychosis

Liberty ITS Liberty ITS

03/02/2021 OR*3*524 Global Updated dates on the Title page and footers.

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02/02/2021 OR*3*524 156 Added updated Cover Sheet screen capture—the Vitals Pane now displays the vital measurements, first in metric conversion, and then in standard, or English conversion.

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11/02/2020 OR*3*519 48

Added v31MA Prescription Drug-Monitoring Programs (PDMP) section to the manual.

Added Prescription Drug- Monitoring Programs (PDMP) to Glossary

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10/05/2020 OR*3*528 32, 35 Added information about a patient’s preferred name on the Patient Inquiry button and screen.

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9/30/2020 OR*3*377 various Merged content from OR*3*533 and OR*3*525 into manual.

Updated dates on the Title page and footers.

REDACTED REDACTED

8/11/2020 OR*3*533 Near

Global

(over 80 screen shots display provider names)

On screenshots that display a provider, listed whether or not the provider’s NPI would display.

Added these notes:

“If a provider has an NPI, it will not display on the screen.”

Computerized Patient Record System (CPRS) xiii September 2022

Date Version/Patch Page Change Project Manager

Technical Writer

“If a provider has an NPI, it will display on the screen. See the "National Provider Identifier (NPI) Display in CPRS" section for an example of an NPI displaying on a screen.”

Updated dates on the Title page and footers.

8/3/2020 OR*3*533 7 Added the National Provider Identifier (NPI) Display in CPRS section.

REDACTED REDACTED

7/2020 OR*3*525 44 Added Note: The Remote Data View Button (RDV) will always be active

Updated dates on Title page and footers

06/2020 OR*3*377 303

Added sections regarding NPO order cancellation and discontinuing.

Added an overview of support for Women’s Health in CPRS

Added a section about the auditing of Copied and pasted text.

Added information about the Other than Honorable (OTH) button that shows the episode of care and the remaining days in the current episode.

Added information about how to the Veterans Health Library

(VHL)

Patient-centric Notification information added.

Consult Template locked

Consult communication error

Computerized Patient Record System (CPRS) xiv September 2022

Date Version/Patch Page Change Project Manager

Technical Writer various

Cover Sheet Customization:

How sites can customize the Cover Sheet.

Diet Orders: Discharge effects on diet orders

Removed reference to the EXCEPT conjunction, which is no longer valid.

5/30/2020 OR*3*515 235 Added Note for the addition of new filters to the Custom Order View. Also updated the screen capture.

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4/21/2020 OR*3*497 84 Added updated criteria that triggers the different COVID- 19 Banner messages.

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4/09/2020 OR*3*485 84 Added a section about the COVID-19 identifier in CPRS.

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11/12/201

OR*3*514 34

Under Patient Inquiry Button, updated the Patient Inquiry screen captures that now display the new items that have been added to the Patient Inquiry dialog. The new items are the ENROLLMENT PRIORITY (#.07) field, ENROLLMENT SUBGROUP

(.12) field, and the

ENROLLMENT STATUS

(#.04) field. These new fields are from the PATIENT ENROLLMENT (#27.11) file.

The Status field will display as 'Category' in order to be consistent with how the information is displayed in VistA.

Revised Date on Title Page and in footers

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09/20/2019 All All Formatted complete document for 508 compliance.

Removed extra spaces between paragraphs.

Computerized Patient Record System (CPRS) xv September 2022

Date Version/Patch Page Change Project Manager

Technical Writer

07/12/2019 OR*3*427 172

Added reference to ordering clozapine

Updated information for clozapine monitoring treatment per new FDA guidelines.

Added note for Clozapine renewal.

Added note for YSCL AUTHORIZED key

Updated title page, footer, and table of contents.

REDACTED REDACTED

04/16/2019 OR*3.0*444 284 -292,

Added information about two new views available from the Orders tab: Unified Action Profile and Discharge Meds Review.

Section 508 Conformance:

Added missing alt text to images and added header rows to table that repeat across pages.

REDACTED REDACTED

3/1/2019 OR*3.0*472 34, 35,

38, 39

Updated for Disruptive Behavior Reporting System (DBRS) data sets now displayed on National Category 1 Behavioral PRFs (through patch OR*3.0*472)

Updated for inclusion of Facility data on Progress Notes Properties box, flag actions section, and the ability to now sort flags by the column title (through patch

TIU*1.0*318)

1/03/2019 OR*3*493 376

Updated the Order Details window to include Unique Consult ID (UCID).

The Consult Order Detail display was updated to display the Unique Consult ID.

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12/07/2018 OR*3.0*490 384 - 390 Added the COMMUNITY CARE Direct Schedule or Administrative Consultants section.

11/26/2018 OR*3.0*435

179-182, 184-189, 258-261, Updated information about the “Give additional dose now” option to reflect that, when using this option, two orders are

Computerized Patient Record System (CPRS) xvi September 2022

Date Version/Patch Page Change Project Manager

Technical Writer

263-265, 270-273

276-279 created, and the priority is automatically set for each.

Updated sections on inpatient medication orders and clinic medication orders with information on using the “Give additional dose now” option.

11/07/2018 GMRA*4.0*59 210, 304 Added Notes to allergy/adverse reaction procedures to describe the Mark Patient Chart email bulletin.

REDACTED REDACTED

11/05/2018 OR*3.0*441 291-293,

395-396

Added information about the display of Flagged Order comments and Ward Comments on the Orders tab and the ability to track and manage antimicrobial Quick Orders.

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3/16/2018 OR*3.0*452 Title Page, Revision History, 246, 266, 267, 268, 270 and

An update for Cost Tier Copay was made to the User Guide.

Tier information was added to the dosage. Previously, the User Guide display for Outpatients did not show the Tier information.

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11/15/2017 OR*3.0*429 217, 219 Changes for problems list features:

Added edits to the discussion of coding systems for problems.

Updated the section on Adding a new Problem

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10/26/2017 OR*3.0*434 91 Clarified some information about the renaming the JLV button.

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10/17/2017 OR*3.0*434 315 Added to the note to ensure that users know that Return to Clinic features need both the CPRS and Scheduling patch to work correctly.

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8/1/2017 OR*3.0*434 378 Added information about using the Consult Toolbox along with Consult tracking.

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6/26/2017 OR*3.0*434 72, 193 Added information about new information on the Patient Inquiry dialog, showing what

Computerized Patient Record System (CPRS) xvii September 2022

Date Version/Patch Page Change Project Manager

Technical Writer can be seen from any tab and in the section that explains about the Cover Sheet.

6/26/2017 OR*3.0*434 315 Added information about Return to Clinic orders.

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1/17/2017 OR*3.0*434 3 Added information about logging in to CPRS using your PIV card, also known as two-factor authentication (2FA).

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11/29/2016 OR*3.0*434 43 Added information about the Joint Legacy Viewer or JLV.

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3/9/2017 OR*3.0*420 191, 193,

195, 196, 198, 199, 200, 254, 256, 261, 263, 290, 291, 293, Updated medication ordering sections to indicate that lab results for the most recent lab test associated with a selected medication (Orderable Item) can be displayed in the Information field in the Inpatient Medications and Outpatient Medications dialogs.

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3/24/2016 OR*3.0*269 143, 168,

Added information about the display of the severity field when entering allergies and the remote allergy display by entering allergies and the one through entering orders.

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8/2/2014 OR*3.0*350 76 Added information about the new Camp Lejeune treatment factor that will be available when patch OR*3.0*407 is released.

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6/30/2014 OR*3.0*350 15 Added a note to explain that if set up, providers may receive a request for a NonRenewable RX that they can act on to extend the therapy using Copy to New Order because they cannot use Renew.

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6/17/2014 OR*3.0*350 28 Added to the section about primary care information to include the additional information that the updates to PCMM will bring to the detailed display.

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6/10/2014 OR*3.0*350 232 Added to the diet orders section to include that when diet orders are entered it will show the current diet if one

Computerized Patient Record System (CPRS) xviii September 2022

Date Version/Patch Page Change Project Manager

Technical Writer exists and any delayed diet orders that have been entered.

11/13/2014 OR*3.0*350 311 Added a section describing the new Supply order dialog.

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4/14/2014 OR*3.0*350 380, 382,

385, 386

Changed the name of the Earliest Appropriate Date field to the Clinically Indicated Date field for Consults ordered from the Consults tab, Consults ordered from the Orders tab, Procedures ordered from the Consults tab, and Procedures ordered from the Orders tab.

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11/13/2014 OR*3.0*350 278 Added a section for Clinic Infusions on the Orders tab.

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11/13/2014 OR*3.0*350 267 Added a section for Clinic Medications on the Orders tab.

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7/14/2014 OR*3.0*350 399 Added information about the new changes and reports to labs.

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6/4/2013 OR*3.0*312 419 Added the All Medications report to the list of Available reports. Also, under Dept. of Defense reports, designated which reports have DOD Remote data only and which have both VA and DOD remote data.

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2/12/2013 OR*3.0*306 438 Added Appendix B that deals with DEA error messages and troubleshooting.

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8/8/2012 OR*3.0*306 53 Added information about graphing the most recent items. Selecting a lab test shows all results for the test.

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8/8/2012 OR*3.0*306 52, 61 graphing_merged_labsAdding information about merging lab tests for graphs under Most Recent or under the setting display options.

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8/8/2012 OR*3.0*306 403 Added a remark about the most recent bring up all tests for a specific test.

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5/3/2012 OR*3.0*306 64 Added new information about digital signatures.

Computerized Patient Record System (CPRS) xix September 2022

Date Version/Patch Page Change Project Manager

Technical Writer

4/17/2012 OR*3.0*306 30 Added a new screen capture for the Primary Care button with the team, primary care provider, associate provider, attending physician, inpatient provider, and mental health treatment coordinator displayed on the button.

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8/26/11 OR*3.0*306 320 Added information about the Provisional Diagnosis for Procedures using SNOMED CT codes if the dialog is set to use the lexicon to search for diagnoses from the Orders tab.

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8/26/11 OR*3.0*306 387 Added information about the Provisional Diagnosis for Procedures using SNOMED CT codes if the dialog is set to use the lexicon to search for diagnoses from the Consults tab.

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8/26/11 OR*3.0*306 320 Added information about the Provisional Diagnosis for Consults using SNOMED CT codes if the dialog is set to use the lexicon to search for diagnoses from the Orders tab.

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8/26/11 OR*3.0*306 384 Added information about the Provisional Diagnosis for Consults using SNOMED CT codes if the dialog is set to use the lexicon to search for diagnoses from the Consults tab.

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8/26/11 OR*3.0*306 150, 349 Added information about the Problems tab now using SNOMED Concept Terms (SNOMED CT). The Encounter form Other Diagnosis button also uses SNOMED concepts from the Problem List subset.

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8/3/11 OR*3.0*340 24, 30,

126, 127, Added several items to show where the Mental Health Treatment Coordinator will display in CPRS from the 1) Patient Inquiry button, 2) the dialog displayed when the Primary Care button is selected,

3) Getting Additional Patient information, 4) the additional patient screen capture, and 5)

Computerized Patient Record System (CPRS) xx September 2022

Date Version/Patch Page Change Project Manager

Technical Writer the same screen capture from the Reports tab.

6/20/12 OR*3.0*348 35 Added material about the new Category I High Risk of Suicide patient record flag.

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1/18/11 OR*3.0*280 436 Added a small section to remind the user that JAWS should be started first and then CPRS launched and that the user must have administrator rights on the workstation JAWS will run on.

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1/18/11 OR*3.0*280 430 Added examples of when to use Ctrl + Tab to exit a field.

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12/3/10 OR*3.0*280 125 Added a small section showing the Tools | Options dialog Graphs tab.

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11/9/10 OR*3.0*280

(No change was made in this version, only a text change in the manual.)

387 Added a small section about forwarding a consult.

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9/14/10 OR*3.0*280 236, 244 Added a small message about the tubefeeding dialog and when the amount will calculate and added a dialog for inpatients and outpatients.

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9/9/10 OR*3.0*280 195, 202,

261, 292

Added a small item about how the quantity field is reset based on changing some criteria for complex inpatient medication and complex outpatient medication orders from the Meds tab. On the Orders tab, the inpatient medication complex order and the outpatient medication complex order was also updated.

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8/24/10 OR*3.0*280 131 - 136 Added to the note about “Give additional dose now” and a new screen capture showing the new, clearer text for medications inpatient ordering simple dose, medications

_Toc17877476

Computerized Patient Record System (CPRS) xxi September 2022

Date Version/Patch Page Change Project Manager

Technical Writer complex doses, ordering simple dose, and ordering complex doses.

8/11/10 OR*3.0*280 113 Added a warning about removing pending notifications.

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8/11/10 OR*3.0*280 104 Added a section about the expanded Tools menu items and the addition of submenus.

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8/5/10 OR*3.0*280 20 Added a section about the CPRS time out.

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8/4/10 OR*3.0*280 343 Added a section about changing a note title and the dialog for retaining text when the user changes a note title.

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8/2/10 OR*3.0*280 330 Updated the screen captures of the Notes tab.

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7/20/10 OR*3.0*280 433 Added the keyboard combination for Release Hold on the Meds tab.

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7/20/10 OR*3.0*280 208 Added a small section about releasing a hold from the Meds tab.

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7/13/10 OR*3.0*280 329 Added a note detailing that a key or a parameter setting determines if a user can manually release orders.

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7/12/10 OR*3.0*280 40 The Patient Record Flag dialog has been updated, including the number of items after each Category label.

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7/12/10 OR*3.0*280 102 CPRS remembers the last printer used. You can configure a printer and use it for the entire session or change printers as needed.

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7/2/10 OR*3.0*280 28 The Primary Care button now displays the associate provider also.

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7/1/10 OR*3.0*280 301 Added some text to describe additional changes to the

VBECS dialog.

Computerized Patient Record System (CPRS) xxii September 2022

Date Version/Patch Page Change Project Manager

Technical Writer

6/8/10 OR*3.0*280 159 Added text and a screen capture for date ranges on the Meds tab.

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6/8/10 OR*3.0*280 299 Several changes have been made to VBECS and the changes are documented starting on this page.

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6/8/10 OR*3.0*280 41 The VistaWeb button changes color when remote data is available.

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6/8/10 OR*3.0*280 403 Updated the Most Recent Labs section with the new items in the display and with a new screen capture.

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6/1/10 OR*3.0*280 161 Added a section updating order checks to include Clinical Reminder order checks and other order checking changes.

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5/20/10 OR*3.0*280 304 Added items about new Additive Frequency field on Continuous Infusion orders.

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4/23/10 OR*3.0*280 172, 197,

Updated the Meds tab inpatient instructions and outpatient instructions to talk about how CPRS determines which routes to display. Made the same update for inpatient and outpatient meds on the Orders tab. Also updated the graphic showing the Inpatient Medication dialog.

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4/12/10 OR*3.0*280 72 Updated the screen captures that show Combat Veteran status on the Consults dialog.

Includes several dialogs over several pages.

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4/6/10 OR*3.0*280 n/a Updated the Requesting a New Procedure from the Consults Tab section to include information on the Earliest Appropriate Date.

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4/5/10 OR*3.0*280 383 Updated the Creating a New Consult from the Consults Tab section to include information on the Earliest Appropriate Date.

Computerized Patient Record System (CPRS) xxiii September 2022

Date Version/Patch Page Change Project Manager

Technical Writer

4/5/10 OR*3.0*280 321 Updated the Ordering a Consults section to include information on the Earliest Appropriate Date.

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3/31/10 OR*3.0*280 320 Updated the Ordering a Consults section to include information on the Earliest Appropriate Date.

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2/8/10 OR*3.0*280 161, 117 Added a new section that discusses the new site-defined Clinical Reminder order checks in the Medications section and one in the Orders section.

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5/11/09 OR*3.0*296 331 Corrected an error. To receive lab results when available, the user must have the

ORDERER-FLAGGED

RESULTS notification enabled.

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1/21/09 OR*3.0*296 304, 310 Added notes to explain that changing the IV type also changes fields in the Infusions dialog for Continuous to Intermittent orders and from Intermittent to Continuous orders.

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1/21/09 OR*3.0*296 350 Added a short paragraph about reminder evaluation.

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9/23/08 OR*3.0*296 382 Corrected the section on completing a consults from the Consults tab.

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9/18/08 OR*3.0*296 299 Made minor changes in the VBECS section regarding the default number of days for Type and Screen tests to be valid and some small changes.

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9/18/08 OR*3.0*296 70 Added a section that shows where the new Combat Veteran markers are in CPRS.

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8/11/08 OR*3.0*243 412 Added a note that the only circumference/girth value DoD is sending CPRS is the head measurement and it is only measured in inches.

Computerized Patient Record System (CPRS) xxiv September 2022

Date Version/Patch Page Change Project Manager

Technical Writer

4/28/08 OR*3.0*243 53, 54,

55, 56, 58, 63

Described some changes to graphing, including: free-text values and comments, a new graphic, date ranges, configuring personal or public default inpatient and outpatient dates, views that use lab groups, and exporting data.

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4/1/08 OR*3.0*243 369 Expanded template field section and added information about the screen reader stop and continue field template codes.

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4/1/08 OR*3.0*243 360 Added a brief description of a search animation that developers added for templates and that template searches should be much faster.

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3/28/08 OR*3.0*243 18 Described the dialog that displays when a user opens the chart, changes a patient’s location from inpatient to outpatient or vice versa, and refreshes the patient chart before entering orders.

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3/26/08 OR*3.0*243 160, 213 Added a note on how users can right-click select items and bring up the popup menu on the Meds tab and the Orders tab.

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3/26/08 OR*3.0*243 213 Added a section about using the Refill action on the Meds tab.

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3/13/08 OR*3.0*243 215 Expanded information about sorting the Orders tab view.

Mostly definitions of the views.

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2/26/08 OR*3.0*243 24 Added content to what is included in patient inquiry information, including the new cell phone and secondary next of kin information.

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2/26/08 OR*3.0*243 77 Added small comment about sending critical order checks to ancillary packages in the order checks section of the Meds tab and the Orders tab.

Computerized Patient Record System (CPRS) xxv September 2022

Date Version/Patch Page Change Project Manager

Technical Writer

2/21/08 OR*3.0*243 348 Added the Encounter item on the Action menu.

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2/20/08 OR*3.0*243 27 Added a note about where the focus will go, depending on whether the user is a provider, in the Provider & Location for Current Activities dialog.

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2/20/08 OR*3.0*243 378 Added information about how alerts are sent when actions are taken on a consult.

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2/6/08 OR*3.0*243 353 Added information about the new Mental Health .dll and the requirements for use.

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1/15/08 OR*3.0*243 332 Added text about flags being automatically unflagged when processed if parameter is set.

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1/8/08 OR*3.0*243 420 Revised the section on fonts including the recommendation that magnifier software be used for fonts larger than 18 point.

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1/8/08 OR*3.0*243 299 Added a section about the new blood products ordering feature (VBECS).

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1/4/08 OR*3.0*243 75, 81,

Added information about the service connected condition Shipboard Hazard and Defense (SHD) and Southwest Asia Conditions (SWAC) on the problem list and the sign orders dialogs.

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12/18/07 OR*3.0*243 209, 333 Added notes about outpatient medication order comments not begin carried over on renew, copy, and change actions. Also added a note that comments are carried forward when transferring outpatient medications to inpatient medications.

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11/28/07 OR*3.0*243 233 Added a screen capture and note about possible conflict for delayed diet or outpatient meal orders.

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11/27/07 OR*3.0*243 14 Added instructions and screen captures for displaying

Computerized Patient Record System (CPRS) xxvi September 2022

Date Version/Patch Page Change Project Manager

Technical Writer forwarded comment on notifications.

11/26/07 OR*3.0*243 101, 394 Added a note about selecting cosigners in the Additional Signers section and the Discharge Summary section.

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11/21/07 OR*3.0*243 4 Added a short section Conventions section with a small discussion of dates and time, including the conversion of 00:00 to 00:01.

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11/21/07 OR*3.0*243 23 Added notes about rejoining and breaking context being disabled after a CCOW error.

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11/21/07 OR*3.0*243 412 Updated items referencing content of items in reports (Pulse Ox and HDR All Outpatient).

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11/20/07 OR*3.0*243 141, 231 Added a note and a new screen capture to show the active allergies button and to explain that the user can no longer change the allergy originator.

Also, added this note to the orders section.

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11/7/07 OR*3.0*243 40 Update the patient record flag pop-up to show the new items to make Category I flags more noticeable and altered the caption slightly.

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10/30/07 OR*3.0*243 327 Added a note about transfer events not being available for delayed orders if the patient is in an observation location.

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10/26/07 OR*3.0*243 314 Edited the steps for the Imaging orders relating to the new Reason for Study field and separating the Clinical History field. Also put in new screen capture of Imaging dialog.

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10/23/07 OR*3.0*243 333 Put in note about messages that might be received if HDR or DoD data is not available.

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10/8/07 OR*3.0*243 211 Add information to clarify what happens to unsigned, Computerized Patient Record System (CPRS) xxvii September 2022

Date Version/Patch Page Change Project Manager

Technical Writer unreleased orders when discontinued.

9/18/07 OR*3.0*243 Added information about Health Summary feedback when HDR data is not available for some reason.

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9/18/07 OR*3.0*243 403 Changed the Most Recent section in Labs to let users know that if no time is defined for a lab test, instead of displaying the date and time, only the date will display.

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8/30/07 OR*3.0*243 353 Added section about the new JAWS files.

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8/21/07 OR*3.0*243 188 Added a section on sorting the Meds tab.

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8/21/07 OR*3.0*243 189, 250 Added a small section about the new Clozapine requirement in the Meds tab section and the Orders tab section.

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8/20/07 OR*3.0*243 226 Added some information about quick orders in CPRS.

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8/16/07 OR*3.0*243 8, 117 Added some text about Personal patient list visibility.

Added information about Personal List visibility and made the instructions into steps.

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6/26/07 OR*3.0*243 77, 85 Added information about the new order location dialog used when patient status changes from outpatient to inpatient or vice versa: on Review/Sign changes and Sign Selected commands.

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6/26/07 OR*3.0*243 302 Infusion order changes. REDACTED REDACTED

5/14/07 OR*3.0*243 78 Added steps for order checks during signature.

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3/27/07 OR*3.0*232 various Changed dates and removed review comments.

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2/16/07 OR*3.0*232 166, 222 Updated a screen capture in the remote order check section in the Meds tab area and in the remote order check section in the Writing Orders area.

Computerized Patient Record System (CPRS) xxviii September 2022

Date Version/Patch Page Change Project Manager

Technical Writer

10/31/06 OR*3.0*243 194, 201,

202, 204, 208, 260, 267, 293, 295, 298

Added a new section about order checks under Medications for inpatient medications simple dose, inpatient medications complex dose, outpatient medications simple dose, outpatient medications complex dose, non-VA medications. The same information is included under orders for inpatient medications simple dose, inpatient medications complex dose, outpatient medications simple dose, outpatient medications complex dose, non-VA medications.

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10/30/06 OR*3.0*243 313 Added a note explaining that the user will be alerted if lab collection types will be automatically changed.

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10/30/06 OR*3.0*243 209 Added the step where the user will indicate whether the pending and original orders should be discontinued when discontinuing a pending renewal order.

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10/18/06 OR*3.0*243 383 Added a note about how to get Consults details to find the reason for request from the Notes tab and from the Consults tab.

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9/13/06 OR*3.0*232 184, 222 Updated a screen capture in the remote order check section in the Meds tab area and in the remote order check section in the Writing Orders area.

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8/29/06 OR*3.0*243 6 Included note about CPRS not auto-selecting patient name unless the name is unique based on what the user types.

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8/29/06 OR*3.0*243 184, 191,

258, 265

Added an explanation of when CPRS will not display an Expected First Dose for inpatient simple and complex medications on the Meds tab and simple and complex medications on the Orders tab.

Computerized Patient Record System (CPRS) xxix September 2022

Date Version/Patch Page Change Project Manager

Technical Writer

6/9/06 OR*3.0*232 169, 222 Updated the remote order check section in the Meds tab area and in the remote order check section in the Writing Orders area.

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4/5/06 OR*3.0*215 79, 85 Added information about the user choosing where to have unsigned IMO order to be administered if the patient is admitted during the ordering session.

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4/3/06 OR*3.0*215 131 Reminder evaluation warnings. REDACTED REDACTED

4/3/06 OR*3.0*215 342 Added a small blurb about the Show Details button that can be used when selecting a Progress Note title to resolve a consult.

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3/31/06 OR*3.0*215 21 Added information about the My HealtheVet/Patient Insurance and Flag button being available and the new View | Information menu items that allows access to these items even if the screen is resized too small to show them.

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3/29/06 OR*3.0*215 161, 220 Added a section on order checks that also talks about when a clinician would have to enter a justification for overriding the order check. This information was also included in the Orders section so that users can find it.

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3/27/06 OR*3.0*215 213 How to see a custom order view of IMO orders for a patient.

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3/27/06 OR*3.0*215 n/a Made changes to the section that discusses Inpatient Medications for Outpatients on the Meds tab.

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3/27/06 OR*3.0*215 N/A Made changes to the section that discusses Inpatient Medications for Outpatients on the Orders tab.

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3/21/06 OR*3.0*215 7 Added small section regarding the sorting order of characters such as ñ.

Computerized Patient Record System (CPRS) xxx September 2022

Date Version/Patch Page Change Project Manager

Technical Writer

3/3/06 OR*3.0*215 140, 143,

Added updates about allergies: the bulletin sent message, signs and symptoms, and the Entered in Error parameter.

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3/2/06 OR*3.0*215 420 Added to the “Reports” section information about graphing from the Reports tab.

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2/28/06 OR*3.0*215 338 Added information about finding the notes in the current view that contain specific text.

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2/28/06 OR*3.0*215 233 Added a note about inpatient diets being canceled and replaced when a new diet is entered.

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2/24/06 OR*3.0*215 49 To the “Available from Any Tab” section, added information about the graphing tool.

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1/30/06 OR*3.0*215 33 Added information about the Patient Insurance and My HealtheVet buttons.

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1/30/06 n/a 12 Made minor change to the keyboard sorting for notifications.

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12/01/05 OR*3.0*215 40 Added information on VistAWeb and updated RDV screen shots.

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8/2/05 OR*3.0*2

Error! Bookmark not defined.

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5/16/05 OR*3.0*215 233, 241 Added information about writing orders for outpatient meals.

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5/12/05 OR*3.0*215 34, 342 Updated Patient Record Flag information to reflect changes involved with creating a link from the progress note to the patient record flag when writing the progress note. The link information for a single note can be viewed using the note detailed display. Also, added a step about linking when selecting a PRF progress note.

Computerized Patient Record System (CPRS) xxxi September 2022

Date Version/Patch Page Change Project Manager

Technical Writer

4/12/05 OR*3.0*215 336 Added information about getting TIU note details that show PRF link information for the specific note.

REDACTED REDACTED

3/31/05 OR*3.0*231 197, 206,

252, 288, The route field for medication orders no longer must be selected from the list. Changes include inpatient meds from the Meds tab, outpatient meds from the Meds tab, non-VA Meds from the Meds tab, inpatient meds from the Orders tab, outpatient meds from the Orders tab, and Non- VA meds from the Orders tab.

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3/8/05 OR*3.0*231 197, 206,

254, 288, Added notes about auto-completion of medication, dosage, route, and schedule fields in CPRS. Changes include inpatient meds from the Meds tab, outpatient meds from the Meds tab, non-VA Meds from the Meds tab, inpatient meds from the Orders tab, outpatient meds from the Orders tab, and Non-VA meds from the Orders tab.

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12/29/04 n/a Various Updated graphics and other references to patient and provider identifiers to comply with SOP.

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11/29/04 OR*3.0*195 Updated instructions for creating JAWS configuration files.

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11/24/04 OR*3.0*195 various Additional revisions REDACTED REDACTED

11/16/04 OR*3.0*195 various Added edits from various reviews

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11/4/04 OR*3.0*195 various Made minor revisions based on team feedback.

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10/29/04 OR*3.0*222 334 Added a brief reference to the Group Notes Application.

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10/25/04 OR*3.0*195 132, 229 Made revisions to the sections that deal with entering allergies.

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9/3/04 OR*3.0*195 n/a Revised the section describing when service connection and

Computerized Patient Record System (CPRS) xxxii September 2022

Date Version/Patch Page Change Project Manager

Technical Writer treatment factor exemption button display.

8/10/04 OR*3.0*195 305 Added a new screen shot and instructions for the new Duration/Total Volume field for IV Fluids.

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7/26/04 OR*3.0*195 39 Editing the Patient Record Flag section to remove references to the information on the Patient Selection screen that was removed.

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6/11/04 OR*3.0*195 147 Revised Postings information to reflect the way users create postings for allergies, as opposed to the way users create other types of postings.

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6/9/04 OR*3.0*195 132 Updated information about entering allergies from the Orders tabs and added information about entering allergies from the Cover Sheet tab.

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6/9/04 OR*3.0*195 193, 195,

201, 278

Updated information in sections that discuss entering inpatient medications for outpatients (IMO orders):

specifically, deleted information stating that CPRS displays IMO orders as inpatient medication orders and added information about new Meds tab and Orders tab IMO displays. Also added information about how CPRS handles ADT movements for IMO orders.

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6/3/04 OR*3.0*195 69 Added official text to explain service connection and treatment factors.

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5/27/04 OR*3.0*195 194, 196,

254, 262

Added new instructions regarding the removal of free text schedules and the ability to create customized day-of-week/administration time schedule for inpatient medications using the new Other schedule item on the Meds tab for simple dose or complex dose and from the

Computerized Patient Record System (CPRS) xxxiii September 2022

Date Version/Patch Page Change Project Manager

Technical Writer

Orders tab for simple dose or complex dose.

5/12/04 OR*3.0*195 109 Added information about the user setting the date ranges for Encounters.

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5/3/04 OR*3.0*195 115 Added a screen shot for the new option on the Lists/Teams tab of the Options dialog. Also added information and screen captures for creating and maintaining a Personal Diagnosis List.

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3/16/04 OR*3.0*195 n/a Added overview of Clinical Indicators Data Capture changes to the GUI.

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4/1/04 OR*3.0*190 205, 296 Added information about order checks for non-VA meds entered on the Meds tab and the orders tab.

3/30/04 OR*3.0*190 391 Added section about the surgery tab in CPRS.

3/24/04 OR*3.0*190 11 Added information about sorting Notifications using the keyboard only.

3/3/04 OR*3.0*190 229 Modified content in the “Entering Allergies from the Orders Tab” section to reflect recent changes in the Adverse Reaction Tracking package.

(Users can no longer enter free-text allergies.)

2/20/04 OR*3.0*190 159 Replaced Meds tab screen shot with one showing Non- VA, Inpatient, and Outpatient Meds.

2/5/04 OR*3.0*190 40 Added change to describe what type of remote data users can get (including Clinical Reports).

2/4/04 OR*3.0*187 315 Added a change to the instructions and the screen capture about to how to place radiology/imaging orders to reflect the Pregnant field being mandatory.

Computerized Patient Record System (CPRS) xxxiv September 2022

Date Version/Patch Page Change Project Manager

Technical Writer

2/4/04 OR*3.0*187 110 Added a note that setting a default tab that CPRS should open to when changing patients or logging in again will not take effect without first exiting and logging back in to

CPRS.

2/2/04 OR*3.0*187 6 Clarified that patient selection displays a list of possible matches when last names and last 4 digits of the social security number match.

1/28/04 OR*3.0*190 216 Added information about the Recently Expired Orders view selection on the Orders tab.

1/28/04 OR*3.0*190 10, 11,

Added general information about removing notifications and sorting. Also, added a note about Remove button only removing those notifications placed in the ORB REMOVE parameter.

1/26/04 OR*3.0*190 39 Added text and screen shot for the new Patent Record Flag pop-up box.

1/26/04 OR*3.0*190 347 Added a screen shot and text about Combat Veteran exemption on the Encounter form.

1/26/04 OR*3.0*190 11 - 16 Added screenshots and information regarding the Combat Veteran co-pay exemption and the qualifications for Combat Veteran status on the signing dialogs.

1/22/04 OR*3.0*190 296 Added an overview and instructions for entering Non- VA medications into CPRS.

1/14/04 OR*3.0*190 229 Updated information about creating allergy orders to reflect ART changes to CPRS GUI version 24.

9/16/03 OR*3.0*191 412, 417 Added a note about DoD Consults information and the actual listing of the report.

Computerized Patient Record System (CPRS) xxxv September 2022

Date Version/Patch Page Change Project Manager

Technical Writer

8/05/03 OR*3.0*187 Added to the Meds tab and Orders tab sections instructions for ordering inpatient medications for outpatients. This functionality is new with CPRS version 23.

Added a note about sites’ ability to specify inpatient medication order stop dates. The note also mentions sites’ ability to specify the status of inpatient medication orders when patients are transferred. Also added a note explaining what happens if users change their clinic selection after they have started an order.

7/30/03 OR*3.0*187 27, 101,

321, 322, 342, 384, Added information about new functionality that makes it easier to distinguish between providers who have identical given names and surnames.

8/27/03 OR*3.0*202 384 Added a note about provisional diagnosis and inactive codes.

8/27/03 OR*3.0*202 348 Added a note and graphics as an example of a diagnosis or procedure code that needs to be changed on the Encounter form.

8/27/03 OR*3.0*202 156, 158 Added note about inactive problem codes for adding a new problem, annotating a problem, and verifying a problem.

8/26/03 OR*3.0*202 20, 125 Added Code Set Versioning overview. Added a brief note about inactive codes on the Cover sheet.

8/19/03 34 Added an overview of Patient Record Flags and a section on how to view flags.

7/1/03 OR*3.0*163 64 Minor edits to PKI information.

6/17/03 OR*3.0*173 10 Added information on comments for forwarded Notifications.

5/27/03 OR*3.0*173 103 Added instructions on how to print multiple Notes, Consults, or Discharge Summaries.

Computerized Patient Record System (CPRS) xxxvi September 2022

Date Version/Patch Page Change Project Manager

Technical Writer

5/27/03 OR*3.0*173 195, 199,

258, 265

Added changes for Give Additional Dose Now on Med tab for simple orders and for complex orders. Also, added the changes to Give Additional Dose Now for Simple orders on the Orders tab and Give Additional Dose Now for Complex inpatient dosages on

5/27/03 OR*3.0*173 10 Added sections about sorting notifications and alerts by column headings and the addition to the CPRS GUI of the Forward, Remove, and Renew actions familiar to List Manager users.

5/27/03 356 Added information about creating additional patient data object in the CPRS Template Editor.

5/19/03 OR*3.0*173 21 Added information about CCOW and application synchronization.

5/16/03 OR*3.0*180 412 Added entry that Allergies will be included as part of the Federal Health Information Exchange (FHIE) project.

3/1/03 OR*3.0*149 420 Added Appendix A – Accessibility, which contains information about how to change the font size and window color in CPRS, as well as how to set up a JAWS configuration file.

331 Added a description of the “Flagged” indicator to the Flagging an Order section.

211 Added a new description of how unsigned orders are displayed on the Orders tab.

219 Added a note about viewing results and the results history using the right-click menu on

2/13/03 OR*3.0*163 64 Added overview and instructions for digital

Computerized Patient Record System (CPRS) xxxvii…