Latte (MOCHA Bypass)

Latte is a KIDS build to apply to VISTA. It will allow you to run VISTA pharmacy and CPRS without the need for an external data source for drugs. Latte restores VISTA's ability to use its own drug files to do the drug-related order checks by leveraging the MOCHA interface and decoupling the interface from the First Databank Generic Code Number (GCN). Latte also allows you to interface to alternate databases other than First Databank. In the latest release (4.0) it allows you to interface to the following databases:

• Native VistA Drug Data
• Drug Information Technologies (DIT) (http://www.ditonline.com/).
• ANSM, as translated and coded by Nancy Van Ness (http://ansm.sante.fr/)
• Drugbank.ca, as provided by RxNav (https://rxnav.nlm.nih.gov/)

Installation for Latte

• Latte 1.0 should not be installed. It's kept here for historical reasons.
• Latte 2.0 should be installed for all MOCHA 1.0 and MOCHA 1.0 Enhancements systems. Follow this link.
• Latte 3.1 should be installed for all MOCHA 2.0 systems. Follow this link.
• Latte 4.0 should be installed with MOCHA 2.0 Enhancements 1. Follow this link.
• Mocha 2.1 has not been released yet. When it is released, Latte will be updated to include the latest changes in the routines.

License

(C) Sam Habiel 2014-2017.

ANSM Data Translation and codification (c) Nancy Van Ness 2014-2017, distributed under Apache 2.0.

ANSM Data (c) L’Agence nationale de sécurité du médicament et des produits de santé (ANSM).

Latte comes under an open source license (AGPL 3.0). A commercial license is available for commercial VISTA users for whom an open source license is inappropriate. The open source license text is available in the files you received as LICENSE.txt. The commercial license is available as LICENSE-COMMERCIAL.txt. If you are unsure which license applies to you, contact the author at sam.habiel@gmail.com.

Statement of Problem to Solve

Starting in February 2011, Drug Order Checking in VISTA (drug interactions and duplicate drug classes) was replaced with web service calls to an external program that looks at First Databank data combined with VA customized data. This external program runs on Oracle or Cache as databases and WebLogic as the server. Without a license with First Databank, and the associated Oracle and WebLogic licenses for the middleware, you can no longer use VISTA for order checking. Furthermore, the ability to update CPRS and Pharmacy in your VISTA instance beyond February 2011 is impaired.

Three order checks are supported by MOCHA:

• Drug-Drug Interaction Checks
• Duplicate Therapy Checks
• Dosage Checks

The general flow of data in MOCHA looks like this:

Solution

Latte intercepts the XML from VISTA and sends it to Latte. Latte reads the XML and performs the requested operations (Drug Interactions or Duplicate Therapy Checks) against the configured data source. The data source can be set by the parameter C0D DRUG CHECK SERVICE. If the parameter is not set, then the default data source is VISTA.

------ Setting C0D DRUG CHECK SERVICE  for System: GOLD.VAINNOVATION.US ------
Value: RXNORM// ?

Enter a code from the list.

     Select one of the following:

          V         VISTA
          D         DIT
          A         ANSM
          R         RXNORM

Value: RXNORM// 

The drugs are extracted from the XML message and matched to VISTA using their VUIDs, which are sent in the message.

The new flow looks like this:

Limitations

Because the DRUG INTERACTION file does not have any text content on the interaction, only the severity of the interaction is returned. Other content expected from the MOCHA interface is replaced with pre-programmed values.

If you use the DIT interface, all the data is supplied back.

Dosage checks are currently disabled in VISTA. If they are enabled and requested they always return an empty tag to prevent VISTA from going into MOCHA error processing mode.

Toggling between MOCHA and Latte

The parameter C0D LATTE ENABLE? is supplied to enable you to switch between MOCHA and Latte. A value of Yes enables Latte. When you install Latte, it's turned on by default.

User interaction changes.

No changes are performed to the user interface.

RxNorm Installation Warning

RxNorm installation is not needed except for using DIT.

BECAUSE RXNORM DATA IN ^C0CRXN ARE REFERENCE DATA THAT CONTAIN 2.5 GB OF TOTAL DATA, IT IS HIGHLY RECOMMENDED THAT YOU MAP ^C0CRXN TO AN UNJOURNALED REGION OF YOUR MUMPS DATABASE. IT'S ALSO RECOMMENDED THAT YOU PUT IT IN A SEPARATE DATA FILE OTHER THAN YOUR MAIN VISTA DATABASE. BOTH CACHE AND GT.M HAVE WAYS YOU CAN ACCOMPLISH THAT.