2023-04-25 Release 144

Features 

Infusions in IRIS Analytics 

With this release, Infusion events are now officially supported in IRIS User Analytics for our Infusions beta customers. This is a major enhancement that will enable beta customers to gain greater insights into the use of infusions in their facilities. The additional support for Infusion events builds on ControlCheck's existing capabilities in tracking medication dispensing and administration. By having official support for Infusion events, customers can now easily access and analyze data related to the administration of these types of medications by their staff. This can help identify trends in usage, potential errors or inefficiencies, and can ultimately lead to better patient care.

Infusion events are now officially included in the following reports and scores:

1. Variance Trends
2. Dispense Patterns
3. Med Trends
4. Action Times (First/Last Touch and First Dispense/First Admin)
5. User Mobility
6. Shift Analysis (v1 and v2 are supported)

Waste events for mapped infusions continue to be filtered from the audit workflow so they are also now explicitly excluded from the following reports and scores:

1. Action Times (Last Admin/Last Waste)
2. Waste Networks
3. Full Package Waste

Med Trends Enhancements for Infusions 

Infusion events are now included in the Med Trends report and treated as individual units, similar to multi-chem events. This can help identify trends in infusion usage and help identify users who are dispensing two bags but only documenting one as given.

To view infusion events in the Med Trends report, start by filtering the Drug to an infusion drug. You’ll notice that in the Event Type filter, the Waste event type is removed as an option.

Customers can filter on a Total Units or Total Events Measure. Note that because infusions are treated as individual units, similar to multi-chem meds, the Total Mass option is not available.

The remaining functionality of Med Trends is available. Click into a user’s card to see their score and find their position on the chart.

Enhanced Logic to Auto-Resolve Pharmacy Module Bulk Bottles

ControlCheck's Hospital Setting for auto-resolving Pharmacy module bulk bottles is a solution to the problem of false variances occurring when bulk bottles are loaded into the Narc Vault as singular bottles instead of volume amounts. This new feature allows Pharmacy Module users to manage their medication purchasing data more efficiently by preventing unnecessary variances from cluttering the system. The Hospital Setting was implemented following the realization that the Load workflow for bulk bottles is not consistent across hospitals, with some hospitals loading in volume and others in units of bottles. The previous solution, implemented in R136, only supported the workflow for EDI customers loading the bottles in volume, leaving those who loaded in units of bottles with false variances. With the new Hospital Setting, Pharmacy Module users can now auto-resolve Pharmacy module orders that are loaded into the Narc Vault as singular bottles, providing a more complete solution and allowing for better management of medication purchasing data.

For example, lets say your facility orders a Morphine Sulfate Oral Solution that comes in a 30 mL bulk bottle. The Morphine will be used to create doses for different patient orders so the Pharmacy wants to ensure that each mL is tracked from start to finish. They’ll load the Morphine in as 30 mL and decrement doses from the total until all of the Morphine has been used. In this example below, with the new Hospital Setting enabled, two bottles of a 30 mL Methadone were ordered, so we will display 60 for the event amount because 2*30 = 60.

For other sites that have differing protocols for creating patient doses from bulk bottles, the Pharmacy just needs to know how many bottles are in stock. For example, let’s say the hospital typically keeps five Morphine bottles in stock at all times. When their stock is low, they will order the bulk bottles and load them into the vault as number of bottles. In this example below, with the new Hospital Setting disabled, six bottles of a 30 mL Methadone were ordered, so we will display 6 for the event amount.

Regardless of which process the hospital is using, as long as it is consistent within the facility, ControlCheck can properly auto-resolve your purchases and loads of bulk bottles. By default, ControlCheck will reconcile bulk bottles in volume (e.g. 30 mL). To have this setting updated to reconcile the bottles in number of units, reach out to help@bluesight.com.

Pharmacy Module Event Reconciliation Enhancement

Release 144 of ControlCheck introduces auto-resolution of false variances caused by mixed mapping of medication identifiers in the Pharmacy Audit workflow. The update allows auto-resolving invoice and load events with the same reducible drug, even if they are mapped to different medications in the ControlCheck formulary, reducing the need for manual resolution or support intervention. The mixed mapping of identifiers previously caused false variances in Pharmacy Audit, which could only be resolved by support remapping the medication ID for either the load or order. Getting med mapping 100% correct and perfect is challenging so we want to make the system as flexible as possible, without compromising on data integrity.

Currently, the Pharmacy module requires that event medication identifiers be mapped to the same medication to aggregate and reconcile events properly. However, invoice identifiers and narc vault identifiers come from different sources, leading to mixed mapping of identifiers and false variances on the Pharmacy audit table. While auto-mapping could be updated to map oral liquids with a package size in mass, there is no guarantee that end-users will manually map the narc vault identifier for the same med to the same package size. The manual med mapping process in ControlCheck is not intuitive, leading to subjective and inconsistent mapping that can cause false variances. For example, in today’s solution, this Phenobarbital below would get mapped differently by the automated system and a human doing manual mapping. When this split occurs, then the events for the two medication identifiers will also split, causing a false variance and a frustrating user experience.

• Invoiced NDC is auto-mapped as Phenobarbital 4 mg/mL with 5 mL package size
• Loaded Narc Vault med ID is manually mapped as Phenobarbital 4 mg/mL with 20 mg package size

This update is still being validated, but early testing is promising. This logic is currently feature flagged behind a hospital setting to limit the exposure of the feature. Once fully validated, the feature flag/setting will be removed and the logic will be available for all Pharmacy Module customers. Check out the next release article for more information.

Updates & Fixes 

• Enhancements to application speed on the System Benchmarks and Patient Care Audit pages. Our current testing and validation is promising a 98% speed improvement on the System Benchmarks reports! 
• Updated the Email Event Summary email to include the ES ID in the subject line for easy inbox searching. Thanks for posting this highly up-voted idea in our Bluesight Community, Verity!
• Fixed an issue with the Create Account workflow requiring a password for hospitals that use Single Sign-On (SSO) to access ControlCheck. The password fields should not be visible or required in this workflow.
• Fixed an issue with Email Notifications being scheduled for users that were not subscribed to receive that type of communication.
• Fixed two issues that would cause files to get stuck in a processing state.

Upcoming Features & Bug Fixes (next release) 

Release Ibogaine (145)! - Week of 05-09-23

• An exciting update to the new Related Events feature from our Beta Community: the addition of a Show All Medications toggle to filter in other events for the patient on a different medication. By default, the Related Events will now only load patient events for the same medication. Read more of the chatter around this enhancement on our Community page.
• Enhancements to the speed of Patient Care Audit page.
• Enhancements to ControlCheck emails to send more real-time event summary assignment emails for subscribed customers.