V21.1 Release Notes

Communicare V21.1 includes the major changes to medication management made for enterprise users in V20.1 and V20.2 and makes them available for our other users. V21.1 also includes new features, and maintenance updates and bug fixes.

Prerequisites

Read the V20.2 release notes.

Because of the schema changes associated with the medications changes, all existing customers should run the following report before upgrading to V21.1 and resolve any issues: Unprescribed Regular Medications.

Note: If you have any custom reports that use medications tables or views directly, ensure you check Database Schema changes in the V20.2 release notes. If you are affected, discuss migration options with Communicare Support.

Medications management changes

Communicare V21.1 consolidates major changes to the way medications are recorded and handled in Communicare. Ensure that you check the V20.2 release notes first.

Consolidated Orders

If you stock your patient's prescription medications at your health service, or are the health provider for a remote site that stocks prescription medications for your patients, you can use medication requests to help manage the patient's medications and consolidated orders to manage the inventory.
Consolidated orders are groups of medication requests that can be sent to an external pharmacy for supply. For example, after a clinician has reviewed and updated a patient's medications and created and submitted a medication request, the Imprest manager can use consolidated orders to manage the inventory and order medication requests for multiple patients from a supplier. When the clinic receives the order, the Imprest manager can note the quantities received in the order. A health worker can then supply the patient's medication to them and the inventory is adjusted.
Note: Medication requests replace Health Centre Prescriptions, Rural Prescribing and S100 Prescribing.
Tip: Consolidated orders are part of the Medications Management module. To use consolidated orders, both medication requests and consolidated orders must be enabled and you must belong to a user group which has the Consolidated Order - Manage system right set. For more information, see System Parameters - Prescription Forms.

To display the Consolidated orders summary window, select File > Imprest Management > Manage Patient Consolidated Orders.

For more information about using consolidated orders, see Consolidated Orders.

COVID-19 Immunisation changes

To allow COVID-19 immunisations to be uploaded to the AIR, we've added two new fields to the Immunisation clinical item. Clinicians can:
  • Use the Serial Number field to record the serial number of the vaccine. For COVID-19 immunisations you can make inclusion of a serial number mandatory. For more information, see Clinical Item Type Properties.
  • Use the Administered overseas field instead of the Performed at current encounter place field to indicate historical immunisations that were performed overseas.
The following patient and provider identifier information is now also uploaded to the AIR:
  • The patient's IHI
  • Information about who administered the immunisation and who entered the data, for both the individual, using the HPI-I, and organisation, using the HPI-O
For more information, see Recording immunisations and Australian Immunisation Register uploads.

Medication labels

If you don't use the Administer and Supply feature, and your health service supplies medication from a medication order, you can print medication labels to adhere to the medication.
Tip: If your health service uses this approach for supplying medications, the Medications Management module is not enabled in File > System Parameters > System tab and Enable label printing is set in File > System Parameters > Clinical tab.

SMS

In Communicare V21.1 and later, you can send appointment reminders to patients using Telstra Health's SMS gateway (TH Notify) and a new interface. You can:
  • Send SMS messages or reminders directly to individual patients from their biographics or clinical record
  • SMS multiple patients manually
  • Set up appointment reminder templates to automatically send SMS messages to patients with an appointment on a particular day
  • Receive SMS replies from patients
  • If enabled, automatically cancel appointments if a patient rejects an appointment by SMS
For more information, see SMS messages and reminders.

You can continue to use the old SMS system with Burst until your credit expires, or use both messaging services together.

Contact Communicare Support if you want to enable this feature.

Clinical Decision Support

In Communicare V21.1 and later, for pregnancy and condition interaction checking, Communicare links to the current MIMS database online using the CDS service instead of using the MIMS databases that you have downloaded and installed locally.

The CDS service is cloud-based so will always access the most recent MIMS data available.

Communicare continues to use the MIMS databases installed locally for drug to drug interaction checking, product and consumer information and other warnings.

CDS is enabled in the Communicare Demo by default.

For more information, see Decision Support.

My Health Record integration enhancements

We've improved the performance and logging of CDA documents, including the Event Summary, Shared Health Summary, eReferral and Discharge Summary. These documents should now be generated and upload faster. We've also changed the way you select information to include or exclude in the documents: if you select a child topic, the parent is also selected; if you deselect all child topics, the parent topic is also deselected.

CDA documents now also support extemporaneous preparations.

DataSync

The offline client now supports medication requests. For more information, see Data Synchronisation.

Minor enhancements

V21.1 includes the following minor enhancements:
  • When supplying medication requests, we added the option to show or hide medications included in a medication request for which there is no inventory. For more information, see Supply Medication Requests.
  • We changed the medication values used in V20.1 so that after a medication is added to a record, it maintains the record of what was prescribed at the time, even if the medication details are changed in MIMS.
  • We added the Script No. column to Bulk Represcribe, Stop Medications, Add Medication Request Finalise, Patient inventory, so that the script number, Order or History are included.
  • We've limited viewing medication requests to only those providers who belong to a user group with Prescribing Full or Prescribing Once Off/Short Course system rights.
  • In the Requested medications section of the Administer and Supply Medication window, we've added a Request status field, so you know which medications are part of an active medication request.
  • We've reinstated the option for a username and password check if prescribing to a patient who has had an adverse reaction. To enable this option, set Require password on adverse reaction prescribing on the System Parameters - Clinical tab.
  • We've improved the UI for when you're prescribing a medication using a DAA, so that its clear that you can't also add dosage instructions.
  • We've added the ability to customise the name of Medication Requests and related fields to System Parameters - Prescription Forms.
  • If you add a drawing to a clinical item that includes a drawing qualifier, such as Exam;skin, and then add that drawing to a letter, the drawing key is now also included. For more information, see Add drawings to clinical items.
  • We've added support for qualifier values to be recorded with both time and date to support the increase in point-of-care tests and medical devices which record the same test or observation more than once per day. The most recent value is displayed in the Qualifier Summary, and all values are displayed in the Previous measurements table and chart.
  • We've added a new setting to the System Parameters > Clinical tab. Set Always record date and time to override the Date Only option for existing clinical item types so that you don't have to update each type manually.
  • The following documents have been removed from the Help > Forms menu, because there is a more recent version on the Communicare Client Portal or because the document is no longer required:
    • Communicare eLearning Request Form
    • Reset Administrator Password Form
    • Telephone Training Request Form
    • Hearing Services Program Information
    • My Health Record > Assisted Registration Essential Information
  • If you add medications to a letter using Clinical Record > Current/Regular Medication, current medication history items are included with a comment prefix of [External Medication History].
  • You can test CDS service in the Communicare V21.1 Demo where it is enabled by default.
  • In the Administer and Supply Medication window, we've improved the message displayed when you set Remove from inventory.
  • The medication request template now supports fields needed for Health Centre Prescriptions.
  • If you're represcribing multiple medications at once (in bulk), a warning is now displayed if MIMS has deleted a medication. Medications deleted by MIMS cannot be represcribed and are not listed in the Represcribe Medications window.
  • We've added the following templates for prescribing, which you can select on the File > System Parameters > Prescription Forms tab.
    • For Health Centre Prescribing, select one of the following templates from the Medication Request Template list. Ensure that you also set Use Health Centre Prescription defaults on the File > System Parameters > Clinical tab.
      • Health Centre Prescription with Dispense Record - use this template for medication requests if you'd previously had Use rural prescription form > Don't Print Dispensing Record on form selected on the File > System Parameters > Clinical tab.
      • Health Centre Prescription - no Dispense Record - use for medication requests.
    • Medication Request - Default - use for medication requests. Select from the Medication Request Template list.
    • Consolidated Order - Default - use for consolidated orders. Select from the Consolidated Order Template list
  • We've added the following new care plan templates. To add a care plan to a patient's clinical record, click Add iconNew Care Plan on the Summary > Care Plan tab.
    • Cancer Screening Care Plan Female
    • Cancer Screening Care Plan Male
  • To address inconsistent timestamps, we've changed to 24-hour time format wherever a timestamp is used, regardless of the system setting on your workstation. The only exception to this is the content of SMS texts sent to patients from Communicare, which display 12-hour format.
  • We've updated the following reports to use both date and time:
    • Patient Measurement History
    • Patient Multiple Qualifier History
  • We've updated the Colonoscopy Referral Form Template (Clinical Care Standards) to the latest version.

Central Data changes

You can review new clinical items and reports using these reports:
  • Report > Reference Tables > Clinical Item Types Added - enter the days since the upgrade and choose Central.
  • Report > Database Consistency > Central Reports

For a list of new and modified items, see Central Data changes since V19.2.

Maintenance items

  • Fixed documents and results provider filtering
  • Added annual scheduled report to send licence usage to Communicare if scheduled reports are configured
  • Migration performance improvements related to the Med_Supply table and regular medications view

Bug fixes

The following bugs have been fixed in V21.1:

  • Fixed bug where stopped medication in offline client doesn't sync to online client
  • System settings values are not saved in demo releases
  • Able to make changes in system parameters with incorrect access code
  • Remove MIMS markup from medication details
  • Extend CDA document generation to correctly classify extemporaneous medications
  • Fix documents and results provider filtering to ensure all providers can be selected
  • Finalise screen is truncated when resolution is under 1920x1080
  • Increase column size of email fields to be consistent
  • An exception occurred when user clicked on "Medication Overview" button from Administer and Supply screen
  • Status tag not displayed in Clinical Record detail tab
  • Fix saving medication as default throws error if a medication has large name
  • Communicare no longer tries to upload immunisations performed prior to 01 January 1996 to AIR
  • Show printer dialog doesn't work
  • Expanded the address field validation rules to recognise most legitimate email addresses in scheduled reports
  • Scheduled reports do not support parameters of the type FUNCTION="...
  • Create medication request by default option is still set even when medication requests are not set.
  • We've fixed an error that occurred if you added a medication to the letter writer longer than 120 characters
  • NWHHS HBCIS: handle active null in names
  • Care plan data not rendered on first page of care plan document
  • Modifying incoming referrals causes error
  • We've fixed the Not HL7 V3 Clinical Document error which may occur when receiving some CDA documents
  • We've fixed an error that caused Communicare to crash when opening a clinical item from the Detail tab when the clinical record contains a medication history item
  • We've fixed an error that occurred if you opened the medication overview after a medication was supplied but MIMS deleted the record for that medication
  • Communicare no longer uploads immunisations for fictitious patients to AIR, which resulted in calls from Services Australia about invalid data.
  • On Investigation request forms, we've moved the Indigenous Status field to after the clinical notes so that the information prints correctly
  • You can no longer add executable files, or shortcuts or links to executable files, to Communicare. For more information, see Adding custom forms.
  • The buttons displayed in the Medication Warnings window are now consistent regardless of whether you are reviewing a prescription or a medication order.
  • We've added an indicator to show that Communicare is working when opening the Administer and Supply Medication window, so that you know what's happening when opening records with lots of medications.
  • For MIMS-related decision support, we've fixed a bug where drug to pregnancy category interactions were displayed incorrectly. Where only non-specific category interactions are included, they are now displayed in descending order of category severity.
  • We've fixed an error that stopped you printing a medication request for a patient if the sex of the patient was not recorded.
  • We've updated the Healthcare Identifier Service (HI Service) certificate in the demonstration versions of Communicare so that you can test Medicare interactions in the demos.
  • We've fixed a time out error that was introduced with the recent AIR updates which stopped the MeHR integration from working.
  • Related to the timestamp work, we've removed the seconds displayed in the following places:
    • Clinical record, Adverse Reaction Summary > Assessment Date
    • The Session Selection window
    • Appointment Book
    • Service list for a patient
  • In the Letter Writer, when you add Clinical Record > Latest Qualifier it now correctly displays the most recently recorded value for the selected qualifier.
  • We've fixed the validation that was occurring when you added or represcribed a medication.
  • We've fixed a bug for MeHR users, where the MeHR upload options weren't selected by default when you closed a service.
  • We've fixed an issue with a column size in the Database Consistency Check.
  • We've fixed a bug where the Medication Order you created from a prescription and edited after saving showed a duration of 0 days.
  • We've fixed a problem that was stopping you from searching the EPD.
  • We've fixed a bug where previous measurements weren't being displayed for clinical items with a qualifier of type memo.
  • We've added support for long medication names so that the database can be upgraded.
  • We've reinstated old release notes in the Help for reference.
  • We've fixed a problem with the Letter Template printing with incorrect patient details.
  • We've fixed a bug with the export of patient data from Communicare for import into ISOH /Titanium. Ensure you are running .Net 4.5.2.
  • We've fixed a problem where the wrong RTPM alert is displayed for high quantities of a medication.

Deprecated features

The following features have been deprecated:
  • Health Centre Prescriptions (HCP)
    HCP and rural prescribing are now included in the medication requests workflow. To enable HCP in medication requests:
    1. Contact Communicare Support for assistance with this update.
    2. Enable medication requests and ensure you set Print S8 prescriptions on a separate page. For more information, see System Parameters - Prescription Forms.
    3. On the File > System Parameters > Clinical tab, set Use Health Centre Prescription defaults. For more information, see System Parameters - Clinical.

Installation Requirements

  • Communicare V21.1 is supported on Windows 10 and later and Windows Server 2016 and later. Security and other updates from Microsoft must be installed as they become available.
  • .Net 4.5.2 or later
    • If you want to use Telstra Health's SMS gateway (TH Notify), .Net 4.8 or later is required
  • Java Runtime Environment 1.8.0_202 for uploading to the AIR
  • HQBird 2.5.9 is now an external dependency. Firebird 2.5 and earlier is no longer supported.