1. MailMan and Pharmacy June 2011

2. Objectives At the end of this session, participants should be able to: Set up user parameters for MailMan Navigate within MailMan Identify MailMan bulletins that may be useful Recommend MailMan groups to set up with site manager Take appropriate action based on the various MailMan bulletins

3. MailMan explained (in basic fashion) MailMan is a message system within RPMS “Roll and Scroll”—it is NOT an email program like Outlook! –Can be used to communicate with other RPMS users, though they can only see these inside the RPMS “Roll & Scroll” –Other items such as Outlook email, notifications, broadcasts, and chats are more useful for this now.

4. MailMan explained (in basic fashion) Still useful for getting information from/about packages, updates, and drug file problems Users need to know how to get to MailMan, and some configuration options that can make it easier to use.

5. Accessing MailMan At most menu prompts that are NOT asking for patient information, type “MAIL” Or, enter two question marks at any menu prompt and look for the “common” menu options (they will vary by user): FAC Change User's Selected Facility [AZUX DUZ(2) CHANGE] PATH Menu Path [XUZUSERPATH] TBOX User's Toolbox... [XUSERTOOLS] VA View Alerts [XQALERT] Continue [XUCONTINUE] Halt [XUHALT] MailMan Menu... [XMUSER] Restart Session [XURELOG] Time [XUTIME] Where am I? [XUSERWHERE]

6. Customizing MailMan The Main MailMan menu: NML New Messages and Responses RML Read/Manage Messages SML Send a Message Query/Search for Messages AML Become a Surrogate (SHARED,MAIL or Other) Personal Preferences... Other MailMan Functions... Help (User/Group Info., etc.)...

7. Personal Preferences User Options Edit Banner Edit Surrogate Edit Message Filter Edit Delivery Basket Edit GML Enroll in (or Disenroll from) a Mail Group Personal Mail Group Edit Forwarding Address Edit

8. User Options Select Personal Preferences Option: user Options Edit Editing data in the MAILBOX file: BANNER: The banner is displayed to others whenever they address mail to you. MESSAGE ORDER: Newest First// ? In which order do you want your messages to appear? Choose from: N Newest First O Oldest First NEW MESSAGES READ ORDER: Newest First// ? MESSAGE READER: Detailed Full Screen// ?? There are several ways to read and manage your messages: Classic - the one that has been around for years. Detailed Full Screen - full screen, with a detailed message list. Summary Full Screen - full screen, with a summary message list. 'Classic' is the default, if you don't choose any. In the next prompt, 'message reader prompt', you will be able to specify whether the reader you choose should be used all the time or whether you want to be asked each time.

9. MESSAGE READER PROMPT: ? Should MailMan ask you which message reader to use every time you go to read messages? Choose from: Y Yes, ask me N No, don't ask me, just use the default NEW MESSAGES DEFAULT OPTION: LIST ALL NEW MESSAGES// ? Select default new messages option Choose from: LB LIST BASKETS WITH NEW MAIL LN LIST ALL NEW MESSAGES P PRINT ALL NEW MESSAGES R READ NEW MAIL BY BASKET SHOW MESSAGE PREVIEW: ? Do you want to see a preview of the message subject and sender? Choose from: Y YES, SHOW MESSAGE PREVIEW N NO, DO NOT SHOW IT MESSAGE ACTION DEFAULT: DELETE// ? Enter an 'I' for 'Ignore' or a 'D' for 'Delete'. Choose from: I IGNORE D DELETE

10. ASK BASKET?: ? If no, MailMan will not ask basket name when user sends message to himself. Choose from: y YES n NO SHOW TITLES: ? Enter 'Yes' if you want to see senders' and recipients' titles. Choose from: 1 YES 0 NO PRIORITY RESPONSES FLAG: ? Choose from: 0 Responses are PRIORITY 1 Responses are ORDINARY PRIORITY RESPONSES PROMPT: ? Enter 'Ask' or 'Do not ask'. Choose from: 0 ASK EACH TIME MESSAGE IS READ 1 DO NOT ASK EACH TIME MESSAGE IS READ P-MESSAGE FROM: MAILMAN INSTITUTION: NETWORK SIGNATURE LINE 1 OF 3: NETWORK SIGNATURE LINE 2 OF 3: NETWORK SIGNATURE LINE 3 OF 3: INTRODUCTION: No existing text Edit? NO//

11. Editing the priority order for reading baskets with new messages. Note: You don't need priority ordering unless you want to change the default 'read new messages' basket from IN to other basket(s). Select BASKET: ? Answer with BASKET Choose from: Editing data in the NEW PERSON file: PREFERRED EDITOR: SCREEN EDITOR - VA FILEMAN// ? Answer with ALTERNATE EDITOR NAME Choose from: LINE EDITOR - VA FILEMAN SCREEN EDITOR - VA FILEMAN XTENSIBLE EDITOR STREET ADDRESS 1: STREET ADDRESS 2: STREET ADDRESS 3: CITY: STATE: ZIP CODE: OFFICE PHONE: FAX NUMBER: VOICE PAGER: DIGITAL PAGER: ADD'L PHONE 1: ADD'L PHONE 2:

12. Filter Messages Select Personal Preferences Option: message Filter Edit FILTER MESSAGES?: ? If you have mail filters set up, do you want to use them? Choose from: N NO Y YES Select FILTER: ?? You may enter a new FILTER, if you wish This is the name of your filter. The filter is used by MailMan to determine into which basket to place a message. Messages can be filtered based on up to three criteria which must all be true: - Subject contains - Message is from - Message is to For example, if you specify 'subject contains' and 'message is from', the filter takes effect only if the subject contains the string you specify AND the message is from the person you specify. If you wish the filter to take effect upon 'subject contains' OR 'message is from' you must create two filters, one with 'subject contains', and the other with 'message is from'. Filtering takes place during message delivery and can also be selected as a basket action. The filter is ignored during delivery under the following conditions: - The message already exists in one of your baskets. - The message is from you, and you specified a basket (other than the IN basket) at the transmit prompt. - The sender has specified a delivery basket and you have allowed it.

13. Select Personal Preferences Option: MESSage Filter Edit FILTER MESSAGES?: YES// Select FILTER: ALLERGY Are you adding 'ALLERGY' as a new FILTER (the 1ST for this MAILBOX)? No// Y (Yes) ORDER: ? Type a Number between 1 and 999, 0 Decimal Digits BASKET: ALLERGIES Are you adding 'ALLERGIES' as a new BASKET (the 3RD for this MAILBOX)? No// Y (Yes) STATUS: ? Choose from: 0 OFF 1 ON STATUS: 1 ON SUBJECT CONTAINS: ? Answer must be 3-25 characters in length. SUBJECT CONTAINS: REACTION FROM: ADDRESSED TO: VAPORIZE DAYS: ? Type a Number between 7 and 365, 0 Decimal Digits VAPORIZE DAYS: DELIVER NEW?: ?? If you don't answer, or delete the answer, the default is YES. YES means that the message will be delivered as usual, and made new as usual. NO means that the message will be delivered as usual, but it won't be made new, so you won't know it's arrived unless you check. This will only apply to new messages which you have not seen before. It won't apply to responses or forwarded messages with responses. It won't apply when you filter messages which are already in your mailbox. Choose from: Y YES N NO Select FORWARD TO:

14. Processing MailMan Messages If you set your message option to LIST, you can perform actions on several messages at once Delete, Resequence, Print, Later, New, etc. –LATER will make the message new at a later time –RESEQUENCE re-numbers the messages if you have deleted a few –You can DELETE those messages you can see in the list, or some of them Use 1-52; or 2-5, 6-12; etc.

15. Enter message number or command: ??? Enter a message number (1-52) to read a message in this basket. Enter an internal message number to read any message still on the system, which you ever sent or received. Enter: ?string Search for messages in this basket whose subject contains the specified string ??string Search for messages you once sent or received whose subject begins with the specified string.(-)n or n-m,a,c-d (de)select message n or a list of messages.(-)* (de)select all messages CD Change Detail P Print messages D Delete messages Q Query (search for) messages F Forward messages R Resequence messages H Headerless Print messages S Save messages to another basket L Later messages T Terminate messages N New message list V Vaporize date set messages NT New Toggle messages Press ENTER or + to go to the next page. Enter +n to page forward n pages. Enter = to refresh this page; ^ to exit this list.

16. Mail Groups A Site Manager can enter users into different mail groups to receive bulletins –A bulletin is a message within RPMS Roll and Scroll—it is NOT an email message! –Are sometimes informational, but other times they indicate some action needs to be taken –Users CAN delete these without taking the action, so it is important that they are looked at and taken care of promptly Site Manager needs to assign people to the groups Site Manager needs to assign groups to the bulletins

17. Some available Bulletins: National Drug File AWP updates (tasked or single) Missing Costs (Unit Dose or IV, mostly) Adverse Reaction Tracking –Allergy to Verify –Allergy Entered in Error –P&T, change to Signs/symptoms, etc. –Request New Reactant

18. National Drug File Patches Often get several messages, not all of which require action Impacts drug file, allergy tracking, POS/Billing, etc.

19. Sample messages Subj: Products with changed classes [#13062] 02/25/10@14:18 44 lines From: NDF MANAGER In 'IN' basket. Page 1 ------------------------------------------------------------------------------- Product: BARRIER,ASSURA COLOPLAST #14233 Old Class: XA600 New Class:XA602 Product: CATHETER,SELF-CATH COUDE 14FR COLOPLAST #50202 Old Class: XA599 New Class:XA510 Product: CATHETER,SELF-CATH COUDE 14FR COLOPLAST #50203 Old Class: XA599 New Class:XA510 Product: CATHETER,SELF-CATH COUDE 16FR COLOPLAST #50204 Old Class: XA599 New Class:XA510 Product: DRESSING,BIOPATCH 4MM JJ#4150 Old Class: XA100 New Class:XA105

20. Subj: DRUGS UNMATCHED FROM NATIONAL DRUG FILE [#13060] 02/25/10@14:18 69 lines From: NDF MANAGER In 'IN' basket. Page 1 ------------------------------------------------------------------------------- The following active entries in your DRUG file (#50) have been unmatched from the National Drug File (NDF). The VA Product name and CMOP ID corresponding to the unmatched local drug file name are listed on the indented line beneath each entry. An Inactivation Date may be listed for entries when this reason applies. Until you rematch these entries to NDF, they will not transmit to CMOP and drug-drug interaction checks will not check for these products. It is critical that you rematch these products immediately. You may also need to match a new orderable item. Any possible dosages and local possible dosages for these unmatched products have been deleted. Therefore, the dosages for each unmatched product should be reviewed after the rematch or recreated if the product can not be rematched to a VA Product through the NDF matching process. DRUG IEN INACTIVATION DATE ------------------------------------------------------------------------------- NONE

21. Subj: UPDATED INTERACTIONS [#13059] 02/25/10@14:18 263 lines From: NDF MANAGER In 'IN' basket. Page 1 ------------------------------------------------------------------------------- The following interactions in National Drug File (NDF) have been added, edited or inactivated. These changes are the result of review and recommendations from the NDF support group. ADDED INTERACTIONS ALFENTANIL/ISOCARBOXAZID Critical ALFENTANIL/LINEZOLID Critical ALFENTANIL/PHENELZINE Critical ALFENTANIL/RASAGILINE Critical ALFENTANIL/SELEGILINE Critical ALFENTANIL/TRANYLCYPROMINE Critical AMPRENAVIR/DELAVIRDINE MESYLATE Critical AMPRENAVIR/RIFABUTIN Significant AMPRENAVIR/ROSUVASTATIN Significant AMPRENAVIR/TADALAFIL Significant ATAZANAVIR/ATORVASTATIN CALCIUM Significant ATAZANAVIR/DEXLANSOPRAZOLE Critical ATAZANAVIR/ESOMEPRAZOLE Critical

22. Subj: DATA UPDATE FOR NDF [#13058] 02/25/10@14:18 540 lines From: NDF MANAGER In 'IN' basket. Page 1 ------------------------------------------------------------------------------- The following VA Products have been added to the National Drug File. You may wish to review, then match or unmatch local drug file entries based on this updated information. ATTENDS BRIEF PULL-ON XX-LARGE (CMOP - XT311) (DISPENSE UNIT - EA) 999004-6395-39 BANDAGE,DERMACEA 2IN X 4YD NONSTERILE KEN#441124 (CMOP - XT340) (DISPENSE UNIT - EA) 008884-4411-24 BANDAGE,DERMACEA 2IN X 4YD STERILE KEN#441108 (CMOP - XT336) (DISPENSE UNIT - EA) 008884-4411-08 BANDAGE,DERMACEA 3IN X 4YD NONSTERILE KEN#441123 (CMOP - XT341) (DISPENSE UNIT - EA) 008884-4411-23 BANDAGE,DERMACEA 3IN X 4YD STERILE KEN#441107 (CMOP - XT337) (DISPENSE UNIT - EA)

23. Subj: INTERACTIONS and ALLERGIES UPDATED [#13047] 02/25/10@13:02 29 lines From: NDF MANAGER In 'IN' basket. Page 1 ------------------------------------------------------------------------------- The following interactions have been edited because they involved ingredients that are not primary ingredients. none found The following interactions have been deleted because Primary Ingredient/Other Ingredient combination already exists in the DRUG INGREDIENTS file involved ingredients that are not primary ingredients. GATIFLOXACIN/PIOGLITAZONE HCL GEMFIBROZIL/PIOGLITAZONE HCL ================================================================ Allergy information for the following patients has been changed. Patient: Pxxx,Bxxx Lxxx Non-primary ingredient PIOGLITAZONE HCL was replaced with primary ingredient PIOGLITAZONE HCL

24. AWP Updates (from tasked job) These are triggered every time the TaskMan job for AWP updating is run, OR when the AWP Manual Update option is run. Usually 5 or more messages Often require action: editing the drug file entry to comply with the needed information Might involve NDC numbers, dispense units per order unit, or other information preventing the local file from being updated with new AWP information. Also looks at AAC, but is NOT looking at the price per order unit you manually enter.

25. Subj: Outpatient Pharmacy AWP Automatic Update [#12995] 02/23/10@15:04 200 lines From: OUTPATIENT PHARMACY DEVELOPER In 'IN' basket. Page 1 ------------------------------------------------------------------------------- A Pricing update was performed on your system on FEB 23,2010. The total number of records updated = 650 Listed below are the active drugs that were not updated and the error codes. Please review and correct all errors before attempting to run the manual AWP update option. Note: any 'missing 660 node' errors means that information like (ie. Reorder Level, Order Unit, Price Per Order Unit, Dispense Units Per Order unit, Price Per Dispense Unit, etc) is missing! DOPamine 400MG/250ML INJ - MISSING 660 NODE IN DRUG FILE BETHANECHOL 10MG TAB U/D - MISSING DISPENSE UNIT IN DRUG FILE ACETAMINOPHEN 120MG SUPP - DISP UNITS DON'T MATCH - Medi = 237 / Local = 12 ACYCLOVIR 200MG CAPS - NDC'S DON'T MATCH ACETAMINOPHEN 120MG SUPP - NO ACTUAL ACQUISTION PRICE FOR THIS NDC IN AWP MED-TRANSACTION FILE Sample messages

26. AWP Updates (single item) Subj: NOTIFICATION OF DRUG PRICE (AWP/AAC) UPDATE [#13319] 03/17/10@14:06 10 lines From: PHARMACY NOTIFICATION In 'IN' basket. Page 1 *New* ----------------------------------------------------------------------- THE NDC NUMBER HAS BEEN UPDATED FOR THE DRUG BELOW BY USER,ESTUDENT. THE RESULTS OF THE AWP AND AAC UPDATE PRICES ARE (86137) LAP NACL 0.9% 50ML ADDV BAG-0040710166 - NDC'S DON'T MATCH OR: Subj: NOTIFICATION OF DRUG PRICE (AWP/AAC) UPDATE [#13316] 03/17/10@13:55 10 lines From: PHARMACY NOTIFICATION In 'IN' basket. Page 1 *New* ------------------------------------------------------------------------------- THE NDC NUMBER HAS BEEN UPDATED FOR THE DRUG BELOW BY USER,LSTUDENT. THE RESULTS OF THE AWP AND AAC UPDATE PRICES ARE (86135) CLEOCIN PHOS/D5W 300MG 50ML 24-00009338102 - NO ACTUAL ACQUISTION PRICE FOR THIS NDC# IN THE AWP MED-TRANSACTION FILE (86135) CLEOCIN PHOS/D5W 300MG 50ML 24-00009338102 - NO PROBLEM WITH THIS PRICE UPDATE FOR AWP AND AAC

27. Missing Cost (Unit Dose) Subj: COST NOT FOUND ON DRUG ITEMS [#13171] 03/16/10@12:46 39 lines From: MEDICATIONS,UNIT DOSE In 'IN' basket. Page 1 ------------------------------------------------------------------------------- The following items from your DRUG file were found to have NO DATA in their PRICE PER DISPENSE UNIT field: ATROPINE SULF 1% OPTH SOL. (15ML) LACTULOSE 10GM/15ML SYRUP HOMATROPINE 5% OPHTH SOLN-5ML ALBUTEROL MDI (17GM) HYDROXYZINE= 25MG TAB CARBAMIDE PEROXIDE 6.5% OTIC (15ML) MORPHINE SULFATE 30MG *SR* TAB METHYLPREDNISOLONE 125MG INJ (2ML) KETOROLAC TROMETHAMINE 30MG/ML INJ IBUPROFEN 100MG/5ML SUSP. (473ML) NICOTINE TRANSDERMAL 7MG/DAY LORazepam 2MG/1ML TUBEX INJ (10'S) GREEN LADY/LIDOCAINE 50:50 CLOTRIMAZOLE 1% CREAM (30GM) AEROCHAMBER PLUS WITH FLOWSIGNAL OXYCODONE/APAP 5/325MG TAB (6'S) PREPACK ASPIRIN 81MG CHEW TAB U/D

28. Missing Cost (Additives and Solutions) Subj: MISSING COST INFORMATION [#13178] 3/16/10@16:46 1 line From: IV PHARMACY PACKAGE In 'IN' basket. Page 1 --------------------------------------------------------------- REGULAR INSULIN IN THE ADDITIVES FILE.

29. Adverse Reaction Tracking Subj: ALLERGY/ADVERSE REACTION TO BE VERIFIED [#12989] 02/23/10@14:03 10 lines From: NIESEN,MARY ANN In 'IN' basket. Page 1 ------------------------------------------------------------------------------- The following allergy/adverse reaction needs to be verified for the following patient: Patient: Txxx,Axxx M SSN: 10-87-37 Reaction: CEFTRIAXONE OBS/HIS: Observed Location: OUT PATIENT Signs/Symptoms Date Observed ------------------------------------------------------------ RASH Feb 20, 2010

30. Subj: REACTION ENTERED IN ERROR [#12990] 02/23/10@14:44 17 lines From: USER,ZSTUDENT In 'IN' basket. Page 1 ------------------------------------------------------------------------------- The following reaction has been ENTERED IN ERROR. Please ensure that the patient's Chart/ID Band are updated to reflect this change. Patient: Txxx,Axxx M SSN: 10-87-37 Reaction: PENE Location: OUT PATIENT Originator: USER,ASTUDENT Entered in Error by: USER,ZSTUDENT Entered in Error on: Feb 23, 2010@14:44:04 Comments: ENTERED IN ERROR Date: Feb 23, 2010@14:44:04 User: USER,ZSTUDENT Title: CAUSATIVE AGENT MIS-SPELLED, CORRECTED ENTRY ALREADY PRESENT.

31. Subj: Request to add new reactant [#4895] 05/04/11@08:25 18 lines From: ALLERGY PACKAGE In 'IN' basket. Page 1 --------------------------------------------------------------------------- A request to add SEABASS as a new reactant was entered User's contact information: Title : PHARMACIST Office Phone : Digital Pager: The user added the following comment: This patient has throat swelling from seabass. Please verify with the user the intended reactant and then take the appropriate action. Be sure to try alternate spellings, etc before requesting new reactants. If this reactant does require review for addition, please submit through the IHS RPMS Feedback page at http://www.ihs.gov/RPMS using the RPMS Application ‘Pharmacy-New Reactant/Symptom Request (PRSR)’ Please note, an allergy to SEABASS was NOT entered for this patient! Enter message action (in IN basket): Delete//