Version 20.1
Release notes for V20.1.
V20.1 is a limited release for enterprise customers, containing major changes to medications, new features, and extensive maintenance updates and bug fixes.
Prerequisites
Because of the schema changes associated with the medications overhaul, all existing customers should run the Unprescribed Regular Medications report before upgrading to V20.1.
Major updates to medications
V20.1 contains major changes to the way medications are recorded and handled in Communicare.
The prescribing screen has been split into three new actions:
- Write a prescription - use when you want to print a prescription and give it to a patient to fill outside your health service. See Write a Prescription for more information.
- Create a Medication Order - use when you want to Administer or Supply medication from within your health service. See Create a Medication Order for more information.
- Record Medication History - use when you want to record any medication the patient may have taken, but it was not provided by your health service. Users for whom the Medication View module is enabled and who belong to a User Group with 'Medication History' system rights can use this option. See Medication History for more information.
Also updated are:
- Administer & Supply - with the introduction of Medication Orders, dispensing a medication is no longer required to record the administration or supply of medication. We have merged the Supply and Administration screens into a single screen called 'Administer & Supply' that shows all administration and supply actions performed in a single service, to make it easier for customers who typically supply medication but may administer a single dose before the patient leaves. See Administer and Supply Medication for more information. Other changes include:
- For both Administer and supply records, you can now record decimal quantities and units.
- Imprest recording has been separated from the recording of administration and supply quantity. We have introduced the concept of 'Open Stock' which refers to an item of medication that has been opened and had some of its contents removed. You can now record 'New Open Stock' when you open a pack or bottle of medication to administer or supply some of the contents and have stored the medication back in the drug cupboard or fridge. You can also record 'Open Stock Finished' when the provider finishes off a bottle or pack of medication that was previously opened.
- You can record multiple administration attempts and reasons for failure, such as if the patient reacted to the medication and vomited. Administration attempts over the last 24 hours are now always shown to give you an insight into how much medication is currently in a patient's system.
- Scope of Practice - we've changed the way Communicare determines if a verbal telephone order is required when adding a medication. You can still configure the provider and select the drug schedules that require verbal orders. You can also use the Scope of Practice which replaces the Standing Order functionality. See Verbal Orders for more information. We have made the following changes in this release:
- Renamed 'Is Standing Order' to 'Use Scope of Practice'.
- Added the ability to have multiple Scope of Practice formularies.
- Each user group can be configured to use only the Scope of Practice formularies required for their roles.
- Drug to Pregnancy interactions - Communicare now supports pregnancy-based interaction decision support when you're adding a medication for a pregnant patient.
- When adding a medication for a patient who is marked as pregnant, Communicare will now check for any interactions with the generic components of that medication. Any resulting interactions are displayed in the Drug Interactions warning window and require the clinician accept the warning.
- The categories used are defined by the Australian Drug Evaluation Committee (ADEC) which oversees the Australian categorisation system for prescribing medicines in pregnancy (https://www.tga.gov.au/australian-categorisation-system-prescribing-medicines-pregnancy).
- Note: Each interaction has its own Pregnancy Category. Therefore, it is possible for a medication to have a different pregnancy category to its specific interactions or for a medication to have a high pregnancy category but not produce a pregnancy interaction warning. It is the clinician's responsibility to check the pregnancy category of the medication as well as any specific interactions.
Structured alerts
We've added a new Clinical Item class type of Alert to allow health services to control what information they capture for an Alert. Structured alerts can be used in Recall rules to create clinical workflows within your practice. Alert clinical items have an additional status property used to track the state of the medical alert for the patient. These statuses are:
- Active - the alert is current and requires consideration by the health service.
- Inactive - the alert is no longer current but may have an impact on future encounters.
- Resolved - the alert is closed and no longer requires consideration by the health service.
- Entered In Error - the alert was documented in error, either because the history was reported incorrectly or it was entered in error.
In addition to the clinical item type, health services can now toggle the Structured Alerts module in System Parameters to replace the free text alerts area with a grid that lists all Alert clinical items and their current state. If you toggle to Structured Alerts, the alerts entered in free text are not migrated to the new alert clinical items. If you would like to migrate your existing alerts, please give us a call and we can discuss the best approach for your implementation.
The Alerts and Other Information Control system module has been renamed to Security on Alerts to clearly state what it does. Continue to use this option to restrict access to the medical alerts section of the clinical record.
SNOMED Codification
You can now map a SNOMED concept against a clinical item type: in the 'Clinical Item Type Maintenance window, click 'Advanced' and enter the SNOMED Concept you want to use.
To make it easier to find the correct SNOMED concept, we have also linked to SHRIMP, a free online browser of SNOMED terms provided by the CSIRO. Concepts are validated after entry and will return the Concept Name, Version and Code system using FHIR.
Central Clinical Items have also been updated and clinically coded to include the SNOMED concept. If you have cloned these items, the concept is not updated against your cloned item. In these cases it is best to copy the concept over from the item that was cloned, however if you have a large volume of cloned clinical items that you would like to update, please contact us to discuss the best way to proceed.
Integration Events
For our enterprise customers, in this release we've introduced pseudo-realtime events to better integrate Communicare data with other systems. These events are lightweight data contracts that are used to bring data into, and take data out of Communicare. This release includes the following events:
- Adding and Updating a Patient's Biographics
- Adding and Updating a Clinical Item
- Adding, Updating and Cancelling an Investigation Result
- Finishing a Service
More events will be added in future releases.
To enable this feature, in , 'Integration' tab, set 'Enable Integration Events'.
Note: To use integration events, you must have an nServiceBus licence.
Other new features
- Patient banner - now includes action required information comprising an actions list and important clinical information. See Action Required Banner for more information.
- Reasons For Visit - record up to four reasons for visit for the encounter, selected from clinical items, general lookup values or free text. See Reasons For Visit for more information.
Updated features
The following features have been updated:
- Regular medications now support program rights.
- CDA - instead of sending CDA documents like the Event Summary and Shared Health Summary to My Health Record directly, large health services can now use a private repository. See CDA Third Party Storage for more information.
Minor enhancements
- Clinical items can be marked as read-only to prevent them from being edited in Communicare. Use for integrations where the record may belong to an external system.
- Patient search now filters across multiple search fields.
- You can now store additional patient identifiers against a patient, which can also be used in the Patient search to find a patient. This is useful when you have more than one MRN or want to use identifiers from other systems to find patients within Communicare. To enable this feature, in , 'Patient' tab, set 'Enable Extended Identifiers'.
- We've changed patient search in the Patient Payer Management window, to use the standard Patient Search when you add a new payer.
- If you have integrated your Enterprise Master Patient Index (EMPI) with Communicare, you can now search the EMPI for patient details before adding them to Communicare. To enable this feature, in , 'System' tab, set 'EMPI Search'. If you would like to integrate your EMPI with Communicare, please contact Communicare Support.
- We've split Printer Assignments for investigations into two settings 'Investigations - Pathology' and 'Investigations - Imaging'. This means that you can use different printers or trays when printing investigation requests for pathology or investigation requests for imaging. To use this feature, in , set the printer and tray for each option.
- We've added new options to . Appointments now include: 'Appointment Facilities', 'Requirements' and 'Public Holidays'.
- We've added a new 'Death Notification Source' field to 'Patient Death' so that you can record how you were notified of a patient's death.
- We've added two new telehealth encounter modes in addition to Telehealth Video, used to record services where the contact between the Communicare provider and the patient was by using video conferencing.
- Telehealth - Provider - use to record remote telehealth consultations during the COVID-19 pandemic, between a Communicare provider and a patient, using a telephone or another device such as a computer, with or without video. Services recorded using this mode are included in OSR and nKPI reports and for automated patient status updates. Use instead of Telephone.
- Telehealth - Recipient - use where a consultation happened between a provider elsewhere and a patient, such as between a specialist and patient at a hospital, and the Communicare provider facilitated the contact by providing a room and remote conferencing equipment. Services recorded using this mode are included in OSR and nKPI reports and for automated patient status updates.
- You can now modify the message displayed when a user logs into the Communicare. Select , 'Appearance' tab and in the 'Login Message' field, enter the message displayed in the 'Important' text area, in the Communicare login window.
- We've added 7 new kin types and the ability to record extra kin information in Patient Biographics. To enable extra kin information, select , 'System' tab and set 'Structured Contacts'.
- Also in Patient Biographics, you can have custom fields added to the 'Additional' tab. If you would like custom fields, please contact Communicare Support.
- We've added 33 new specialty types.
- We've been working with Medical-Objects to improve incoming results.
- New central clinical item: Assessment;Indigenous Risk Impact Screen known as IRIS.
- We've added the ability to backdate a clinical program exit item if the enrolment and exit clinical program items have got out of step.
- For FNQ:
- We've made additional biographics fields mandatory:
- Sex
- DOB
- Family Name
- Title
- Indigenous Status
- Address Line 1
- Usual GP
- Preferred Language
- Country of Birth
- Marital Status
- Interpreter Required
- Medicare Expiry - when a Medicare number is provided
- Medicare Reference Number - when a Medicare number is provided
- We've updated pathology and radiology request forms.
- We've made additional biographics fields mandatory:
- For WACHS, in the Incoming Referral window, when documents are attached, the user can now cancel a cancellation.
- On official documents, a patient's 'Medicare' name is now printed instead of 'Preferred' name.
- For Clinical Item Type maintenance and Recall Type maintenance windows, a 'Hide Disabled' option is now included.
- In patient biographics, a prompt for birth weights 5-10kg is only displayed if the birth weight has been added or changed.
- We've updated Pathology and Diagnostic Imaging CDA-Based overviews to the latest style sheet so that Pathology and Diagnostic Imaging Overviews are rendered correctly.
- In the Documents and Results window, we've improved keyboard support for date range selection and improved performance by limiting the number of documents listed to 100. If more than 100 documents are included in the search the message "More than 100 records returned, please refine your filters" is displayed.
- You can now paste text from Microsoft Word into Progress Notes. Formatting is automatically removed because only plain text is supported.
- We've added extra logging details for Argus calls.
- If IHI validation fails, a message is displayed to the user.
- For data errors, we've added extra details to error message.
- We've renamed organization.name in EPD search code (also included in V19.2).
- We've improved Imprest and related screens.
- We've added in the time when editing clinical items.
- SafeScript now supports TLS 1.1 & TLS 1.2.
- You can no longer add new organisations.
- For the new Integration Events functionality, allow the caller to specify whether an event is raised when an API command is completed.
Disabled in this release
The following features have been disabled in this release, with plans to be reinstated in future releases:
- For medications:
- Batch repeat functionality
- Medication summary shortcuts to toggle between Once Off and Regular medications
- Health Centre Prescribing (HCP)
- Data Synchronisation Client
- Real Time Prescription Monitoring and SafeScript
Deprecated
The following features have been deprecated:
- Support for multiple organisations. Each customer must now have only a single organisation. Adding and deleting organisations has also been deprecated.
- Printing labels from windows other than from the Prescribing and Administer and Supply windows is no longer supported.
- Dispensing a medication.
Database schema updates
The schema for medications has changed to support the new streamlined approach to regular
medications and different types of medications. If you have any custom reports that
use these tables or views directly, contact Communicare Support to discuss your
migration options.
| PAT_PRESCRIPTION | MEDICATION_TYPE
|
| PAT_REGULAR_MEDICATION_VIEW |
|
| PAT_REGULAR_MEDICATION | Renamed to PAT_REGULAR_MEDICATION_DEPRECATED to prevent access to stale data |
| PAT_REG_MED_PRESCRIPTION_VIEW | Deprecated, to be removed in a future release |
Bug fixes
We've fixed the following bugs:
- Investigation requests with more than one page of investigation items missing some items.
- Users without clinical access can view investigation results in Progress Notes. Viewing rights are now respected.
- Birth Notifications failing to be processed because of long names or addresses. We've increased the maximum field length to 255 characters.
- No indication on the Queue that a Birth Notification has been matched. We've added two columns 'Mother Matched' and 'Child Matched' which show when a birth notification has been matched.
- Duplicate patients being added to Communicare when babies are being registered from import from HL7 messages received to HBCIS.
- Reports failing because of invalid characters. A warning is now displayed when an invalid character is are entered in the Subject of a Scheduled Report.
- Clinical Item missing when editing. Qualifiers for the DateTime and Time types are now saved and can be reopened displaying the correct values. These values still remain after the clinical item has been edited and saved.
- Two entries appearing in the Outgoing Documents tab. Now only the Care Plan is displayed, instead of both the care plan and the care plan template.
- , 'Results Arrived' column not sorted in descending order by default. Now sorted correctly.
- Ordering in 'Documents and Results' window. The ordering set by the user now persists between sessions, for example, by 'Received Date'.
- When a clinical item type with a rule code also has a summary qualifier, the summary is updated and committed before any message that the item cannot be added: when the item is rolled back, the summary update is not. The qualifier summary is no longer updated.
- In the Clinical Record, removed the problem causing the error message "Cannot make a visible window modal" to be displayed.
- Service Record window does not appear for the services marked as not claimable. For WACHS, the Service Record window is now displayed for all services.
- When checking Medicare numbers if there is no Internet connection the application doesn't display an error message. An error message is now displayed.
- Services created at a timed encounter place are missing from the Patient Summary report. In the Patient Summary report, when you click 'Customise' and on the 'Consultations' tab, specify a date in the 'To' field, the report now includes all consultations on that date until midnight.
- Letter item for investigation results has no ordering. The Investigation Result selector now behaves the same as the Progress Notes selector with the latest result at the top by default, then alphabetic ordering.
- Verbal orders appear in the unreviewed verbal order list when the medication has been deleted. Deleted medications are no longer displayed in the unreviewed verbal order list.
- Display deceased status on patient details for S100 Orders and Inventory.
- For MeHR, on slow network connections, in the Clinical Record, when the user clicks 'MeHR Profile', the MeHR window freezes. The MeHR window no longer freezes.
- For MeHR, an error is displayed when the user clicks 'Send CHP' for dual registered patients. The error has been resolved.
- Nightly backup fails when weekly backup generated. Now, backups are created for every day, including when the weekly file is created.
- Approval Number Conversion error when calling Safescript. Authorisation codes containing alphanumeric values are now accepted.
- Factor Windows spooler issues. Users who were unable to open clinical records, or use printer redirection can now do so.
- Care plans lost if they exceed the maximum configured document size. Users can now edit care plans after exceeding the maximum size rather than losing their work. Only BMP, JPG and TIF images can be attached.
- Fix incorrect number formatting on qualifier previous values in V19.2. Trailing zeroes are no longer displayed.
- Fix "Cannot make a visible window modal" error. The cause of this error has been addressed.
- Clinical item definition editor is broken.
New Central Clinical Items and Reports
You can review new clinical items and reports using these reports:
- - enter the days since the upgrade and select 'Central'.
- - enter the date of the upgrade.
Installation Requirements
- .Net 4.5.2 or later
- HQBird 2.5.9 is now an external dependency. Firebird 2.5 and earlier is no longer supported.