2022-04-14 Release 118

Features

Supplies Are Now Available for Auditing!

We are super excited to launch support for auditing medical supplies! 

When hospitals use controlled medications in the labor and delivery unit to give an epidural to a woman in labor, such as a fentaNYL epidural, RNs actually have to first check out a key from the Automatic Dispensing Cabinet (ADC) in order to give the epidural. The expected workflow looks like this: RN dispenses or removes the key from the ADC, they dispense the fentaNYL epidural, and they go to the patient's room and use the key to unlock an infusion pump. The pump is what infuses the fentaNYL into the mother's spine as she is in labor. Because fentaNYL is a controlled and highly dangerous substance, any interaction with it is kept under lock and key, literally. The RN who checked out the pump key is expected to return that key back to the ADC. These events are tracked in hospital's ADC systems and the data is fed into ControlCheck so the data is there to be audited, the form factor logic just needed to be built.

Hospitals have a variety of reasons for wanting to track these supplies like keys; most notably, they tend to get lost or never returned and that poses a significant risk to our customers. The keys are often universal keys and could even be sold on eBay by someone with access and mal-intent. For all these reasons, customers want to audit these supplies and make sure they are returned to their safe storage in the ADC.

Ability for Manager Users to Map Ignored Medications for Audit Reconciliation

Guess what? ? We have a very exciting update to share about mapping meds! Manager users can now mapped Ignored medications!

When ControlCheck customers start to implement our software, they go through a period of medication mapping. Once they are live with ControlCheck, there are continued efforts to map new medications as they come in through daily files and are seen in the Medication Mapper queue. Either during initial implementation or through continued med mapping maintenance, non-controlled medications are ignored by users because they do not need to be audited in ControlCheck or they cannot be supported for auditing by ControlCheck. As new use cases pop up for wanting to audit medications that were previously ignored, we want to make it as simple as possible to get those Ignored medications moved to a mapped and audited state in ControlCheck. With this release, we have added a new button to the Ignored Medications tab on the Manager Formulary page that allows Manager users to map a medication that is currently Ignored.

This new enhancement comes at the perfect time for the launch of new form factor support. Last release, we officially launched reconciliation for the Suppository form factor and in this release we are launching the Supply form factor. Prior to this release, in order for a medication to be moved from Ignored to Audited, our customers had to write an email to our Support team to have them map the medication for them. This workflow was extremely cumbersome, manual, and error-prone for all users involved and we are excited to remove this hurdle to using these new form factors at your site.

In the example below, we will see how to enable an Ignored suppository med for reconciliation at the hospital using this awesome new feature. To start, navigate to the Manage tab and select the Formulary page. Then click on the Ignored Medications tab and search for an ignored med you want to audit; in this example we will map a Belladonna Alkaloids-Opium 16.2mg-60mg Suppository so "bella" has been entered into the search bar. Select the medication in the list that matches the one you wish to audit and click the Map button.

Once you click Map the system will open the Medication Mapper workflow. This workflow is identical to the existing one and will be used in the same way. To find the right generic medication, enter the same keyword "bella" and select the best match in the list. Ensure the Concentration, Form Factor, PF status, and Variable Dose attributes match the desired mapping. Click Next and enter the Package Information. Click Next and select the Audit State of the medication. Finally, click Map Identifier to finish the workflow.

When you finish the mapping workflow, the page will refresh and take you back to the Manager Formulary page on the Mapped Medications tab. You can find the med you just mapped through a number of ways; in the example below, we can find the suppository med by filtering to "Supp" from the Form Factor filter.

Audit 2.0 Updates!

In this release, we added the following enhancements to the new Audit page:

1. Added Scroll to top button for users when scrolling up in the list of results.
2. Added the Reconciled Date to the event summary cards for Closed-Staff cases.

As users are scrolling dozens, potentially hundreds, of audit results in ControlCheck, they need an easy way to get back to the top of the list. It is common for users to start to feel lost in all of these results and this button is able to work as an anchor back to the top of the page. As a user starts to scroll back up the page, the Scroll to top button will appear and hover over the bottom of the page. As the user continues to scroll downwards, the button will disappear again. The button will only appear as users scroll up on the audit results.

When a user views Closed-Reconciled and Closed-Unable to reconcile audits in their data, they will now see the name of the user who reconciled the summary and the date of the reconciliation.

Flexibility for Default Audit Date Range

This release is just full of exciting updates! We updated our system and how we store your preferred Default Audit Date Range value for the Audit page. This means that we can support any custom default date range between 1-365 days for your hospital's preferred setting. Historically, ControlCheck has offered 24 hrs, 48 hrs, 7 days, 14 days, or All Time as Default Audit Date Range options. If a hospital wanted their Audit page to load the last 30 days of data for their users, that was not an option for them,  they had to pick from one of the previous options. With this update, we can offer the flexibility our customers need to support their most desired, optimal workflow.

Admin users can update this setting by navigating to the Admin Tools Hospital Settings page and entering a number from 1-365 (a number of days) into the Default Audit Date Range field for the setting. If a customer wants the default date range to be "the last six months," then it is best to enter "180" into the field for them, as shown below. Make sure to always click Update to save any changes you make to the Settings page. When any user from that hospital logs in to their Audit page, their default data will load for the last 180 days.

When a user is on the Audit page, what options will they see?

By default, they will see the date range of the hospital setting. The user can click into the Date Range filter and see the following options: 24 hrs, 48 hrs, 7 days, 14 days, 30 days, 60 days, 90 days, and Custom Range. 60 days and 90 days are new options that are being added! ? Custom Date range can be set to longer than 90 days.

If the hospital is using a date range setting that is not available in the Audit page Date Range filter as a canned option (e.g. 45 days), then the system will display the default Date Range similar to the Custom Range option. For example, let's say the default setting is 45 days and today's date is 4/12/22. When a user loads the default Date Range on the Audit page, the filter will display the date range of the last 45 days in the filter pill. In this example, the user would see 02/26 - 04/12/2022 in the filter upon default load.

With this update, we removed the All Time option from both the Default Audit Date Range option and the Date Range filter on the Audit page. For some hospitals, loading all open event summaries puts a strain on our application and the outcome is an undesirable user experience. As we start to move all customers to our newly designed Audit table experience in May, we needed to make this necessary change to support a better and faster user experience on the Audit page. Many customers have already been moved over to Audit 2.0 and have enjoyed improved performance, usability, and new features; this additional update will ensure a quicker load of the Audit page for hospitals that are currently using the All Time ption.

With this release, hospitals who are currently using the All Tim option will be moved to a Default Audit Date Range of 90 days. This can be updated to be any value between 1-365 days by a simple request to our Support team or by reaching out to your Solutions Consultant.

I have my setting set to All Time to make sure I don't miss any audits. How will ControlCheck help me with this?

It is common for old data to appear on your Audit table due to remapping of medications, users, or locations. Historical data has the potential to change when this new data is remapped. We have built a feature that moves an old, reopened event summary from Open to Open-Historial, based on your hospital’s setting of that feature. This old data is still available by filtering for Open-Historical on Run Report and on the new Audit table. The reason for this change was due to the feedback received that users cannot do much investigating on an old event summary. Old is defined at your hospital level. Please reach out to our Support Team or your Solutions Consultant if this is not setup already.

Ability to "Select-All Analytics" When Creating Security Roles

As ControlCheck scales, we are taking on more health systems and larger hospitals that have intensely unique workflows. In order to accommodate a variety of use cases, our Implementation team spends a lot of time setting up customers to have the proper Security Roles for their hospital. For a typical hospital with Nursing staff involved in the audit workflow, the Implementation Specialist likely needs to create around 50 unique security roles, one for each department in the hospital. A Nurse Manager for the Emergency Department would get a security role that only gives them access to data in that department. When the Admin user is adding Analytics and other Permissions to the security role, they are likely also toggling on all of the individual permissions. If that Admin user is creating 50 unique roles and each need to have each of the 22 permissions enabled, that is 1100 clicks!

Needless to say, this update of a Select-All checkbox added to this workflow will have a significant impact to the workflow on this page. The love doesn't stop there! This feature is also available to all Manager users who create and maintain Security Roles for their hospital.

Upgrades & Fixes

• Identified an issue with old Hospital Settings json files that are used for testing, in either Integration or QA. Ensure to always pull down the latest copy of the json file before using it to create a new hospital. 
• Fixed an issue with the new Manual File Upload Admin workflow. in R117, we launched a feature to prompt Admin users to input a Hospital's HID before the system would allow them to manually upload a file in the Integration and Production environments. That feature was inadvertently released for all users so we released Hotfix release R117.1 to resolve this issue. This feature is intended for Admin users only and should not impact customer end-users who upload data into ControlCheck. 
• Fixed an issue with patch medication reconciliation when the hospital's source systems record the patch events in different unit of measurements (UoM). This bug was inadvertently introduced in R113. For example, if the ADC recorded a dispense of the patch as "1 unit" and the EMR recorded the admin of the patch as "100 mcg/hr" because it was a fentaNYL 100mcg/hr patch, then the system was failing the reconciliation because there was a mismatch between the UoMs. To add to the complexity, the issue manifested when the ADC and EMR used the same medication identifier for the patch med and the preferred UoM in ControlCheck was "1 patch". This was causing the reconciliation logic to think there were 100 patches applied when the admin event came in as "100 mcg/hr" because the UoM wasn't being recognized or properly converted to. 
• Fixed an issue on Audit 2.0 with users that had a security role that granted them access to at least one Analytics report but not the Investigations feature. The user is still expected to see the IRIS tab on the event summary cards but the bug was preventing the user from properly seeing IRIS data if their security role did not have any Investigations access. 
• Fixed an issue on Audit 2.0 event summary cards with overflowing department names. When the department name was too long or the user zoomed the screen in too large for the length of the department name, the name would start to drop off the outline of the event summary card unexpectedly. This fix adds an ellipses to department names that are too long so that they don't fall off the card. 
• Fixed an issue with events that had a UoM in a rate value (e.g. mcg/hr) where the raw data was stored correctly but the front end interface was displaying "undefined mcg/hr" because it was not properly recognizing the UoM. 
• Fixed an issue with the Admin Tools Create Generic page that would not allow the selection of the proper UoM for IV/infusion meds when creating a new generic medication. Fixed an issue with the Minimum Time Elapsed (in Hours) field on the Action Times report that allowed a user to enter a negative number. 
• Fixed an issue displaying medication identifiers in the Medication Mapper screen when at least one Unmapped med is present. If a medication had more than two identifiers associated, the Identifiers column was not displaying the identifiers in a clean way. This fix increases the row height and adds a comma separated list of identifiers in that column. 
• Fixed an issue with failing Role Map files that had a BOM prefix. Updated the event_factory_workers spawned when PHI service posts the events to ControlCheck to create a new worker job that launches with the events, and then have that job enqueue the rest of the workers in a batch. 
• Updated the Admin Tools View Formulary page to display the concentration of the medication in the Generic Medication dropdown. 
• Updated DispenseCheck-Service to use the Zeitwerk Classloader. 
• Updated Bower D3 packages to NPM versions. 
• Improved File Encoding Detection and Handling in PHI Service. 
• Added a script for our QA testing environment to allow our engineers to refresh old data for testing. A lot of our testing data is old (like, 2018 old) and it is cumbersome to always add newly uploaded data with new dates when you're testing a lot of the same thing over and over again. It also very challenging to properly test IRIS updates without sufficient, recent test data. There is an existing script used in the Demo environment to continually move the dates forward in the database, thereby keeping the data within 30 days. We have applied this script to a hospital in the QA environment so that our testers continually have fresh data. This was a Q1 OKR for the ControlCheck team! 

Upcoming Features & Bug Fixes (next two releases) 

The feature enhancements and bug fixes below are tentatively scheduled the go live on the dates listed. For a full rundown of all new features and fixes, make sure to read the Release Notes articles for those dates. 

Release 119 

• Upgrades to the Investigate Data page for hospitals currently using Audit 2.0 
  • Note: these hospitals will be early adopters of the new Investigate Data page and all hospitals will eventually be moved to the updated page 
• Audit 2.0 Updates 
  • Ability to extend the Add Note field when entering a comment on an event summary 
  • Logic added to save a user's place in the list of event summaries once an edit is made 
  • Adding a "No Group" option to allow users to sort all data without groups of event summaries 
• Color Updates 
  • Login Page 
  • Blue bar at the top of the page is being removed 
  • Review Audit (1.0) and Audit 2.0 
  • Manage tab pages 

Release 120 

• Group 1 of customer base is moving to Audit 2.0 
• Upgrades to the Run Report page for hospitals currently using Audit 2.0 
  • Note: These hospitals will be early adopters of the new Investigate Data page and all hospitals will eventually be moved to the updated page 
• Audit reconciliation for Topical meds such as testosterone gel 
• Ability to auto-resolve PF (Preservative-Free) documentation errors for the Pharmacy module 
  • For example, if a PF NDC is ordered from the wholesaler but the pharmacy technician loads the med as a non-PF medication, ControlCheck will be able to auto-reconcile a variance caused by this, given that the hospital setting is enabled to do so 
• Color Updates 
  • IRIS reports and pages 
  • Main Navigation 
  • Menu bar