Profile 8.5 Release - New Features and Changes

the following document highlights new features in profile v8 5 as well as major functionality introduced in late 8 4 new features are global, unless identified by their region meaning it is only available to that geographic region my account previously, the only way for users to edit their information was through the main provider and user list (people & places) and this often gave the user greater access to more settings and information than the administrator might wish now, in keeping with other windows applications, a my account feature, denoted by a round bubble, can be enabled, which will display in the main title bar this gives the user important user level information among other things, this lets the user (controlled by the administrator) show their availability for chatting add their most common chat partners using the updated chat feature (previously called messenger) change settings, including their email, mobile phone number language can also be change, which is used with azure ai dictation (which is accent specific to improve reliability) change password, security, and pos lock (including using the new truncated password), handover or sign out replace the initials used in the avatar with a picture handover logs you off, but when the next user logs on, the windows and patients you had open will re open based on their user settings login a new login window allows the user to handle the most obvious functions including i forgot my password – a temporary password can be sent by sms or by answering security questions (administrator choice) i am locked out – sends a message to the administrator if a handover was initiated by the prior user, then an icon will be displayed allowing them to either handover or start as usual new icons the icons seen throughout the program have been totally redesigned for a more modern appearance while maintaining the visual metaphors with which you are familiar new panels patient info panel on start up, you will notice a new patient info panel it is designed to have the look and feel of the new profile design your panel will not be displaying, and we would encourage you to try the new one as is or use the new style to build a customized panel for your needs your panel has not been lost and can be selected clinical info panel this has also been extended to be consistent with the updated interface there are more options and improvements in the horizontal and vertical handling, depending on the orientation you choose new document/letter features the attachments tab in the referral window has been moved to the letter window, allows users to attach relevant documents to a standalone letter these attachments will be printed if the letter is printed and be included if the letter is sent by cdx attachments are still available in the referral window without visible change, now linked internally to the referral letter documents are now able to be related to a parent document, plus a new grouping option called ‘relationship’ is available in the filter to show these related documents there is a new reply toolbar icon in the documents and results views, which creates a new letter as a response or follow up to a previous transactions or other type of document, similar to email the new letter will be related to the original transaction/document waiting console the patient flow screen has been enhanced and has a full screen for the organization’s use, managing the flow of patients through (typically larger) clinics in addition, a new waiting console has been developed that is patient waiting room oriented a new set of preferences allow you to configure this for your unique needs replace the banner with your information decide what columns to display and how they should be displayed for example, the patient’s name can be varied considerably display walk in vs appointments display how long the patient has been waiting (relative to a number of points) or predictive waiting time can be displayed, based on either built in algorithms or a macro display advertisements or educational information put up alert notices (e g , ‘major accident occurred; expect delays’) determine cycle time through the pages (if the lines overflow the display length) organization new preferences centre the preference menu has now been replaced with a preferences centre the various preferences are now grouped more logically into segments external pos external pos is now a formalized concept, distinguishing a person (external provider) from an organization or place (external pos) as with internal providers and pos, external providers can be added as members of an external pos existing external providers can be changed to an external pos and vice versa customer id in help/about, there is a field to hold your customer id number 8 5 will not work if this is not set it helps us identify automatic reports from your system and possibly take preventative action or advice interfaces conversion from first databank to vigilance santé (canada) with the release of profile v8 5, intrahealth is transitioning its canadian reference drug database from first databank (fdb) to vigilance santé (vs) when the first of the regular updates to vigilance santé is installed, organizations can use a batch conversion tool to transition the majority of fdb referenced usual and prior prescriptions to a vs reference for those drugs not converted by the batch tool, a one off conversion step will be presented when the medication is next prescribed prescribeit (canada – new brunswick) prescribeit®is a secure service enabling prescribers to electronically transmit a prescription to a prescribeit® enabled pharmacy and allows direct clinical communication between prescriber and pharmacy this functionality is integrated into profile 8 5 smart on fhir eforms (canada – british columbia) smart on fhir eforms are now supported in profile, providing access to eforms available on the internet which are published in conformance with the ‘smart on fhir’ standard this feature allows profile to authenticate with an eforms server, prepopulate forms with patient/provider information and store incomplete/completed forms in the patient medical record many eforms services will automatically submit forms themselves, if required this functionality opens the potential for an unlimited supply of eforms from many publishers the first supported publisher is provincial health services authority in bc, canada technical items embedded chromium intrahealth version of chromium has been added within the application package because of limitations in the microsoft supplied browsers and the pending end of internet explorer (ie) this adds substantially to the first upgrade to 8 5 (thereafter, less so) it is used for embedded browser views that were failing with ie, but use will be expanded, as necessary faster client auto updating after extensive testing, it was found that downloading the new files from the server during the profile auto update is slow for many customers due to internet transfer speeds there was always a preference in the back end to download to a local shared drive this preference has now been moved to the front, allowing users to control it this is particularly important as we now include an intrahealth version of chromium it requires some technical skills to use it, in coordination with intrahealth support, so is more suited to larger clinics 2020 bc antenatal form the 2020 bc antenatal form replicates the elements found in the updated paper version the new form has 7 tabs general, part 1, part 2, discussion topics, additional information, reference, and clinical notes major changes maximized mode profile has long supported a maximized mode, but it had limitations this feature has now been substantially reworked it now presents as a series of tabs just below the patient info panel and operates like the tabs in a browser you can randomly select any tab drag tabs into another order close any tab hover over tabs to see a popup with more information click on the double window icon on the right side to return to normal windows mode end of encounter an end of encounter (eoe) process has existed in profile for many years however, it was somewhat incomplete and subtle therefore, it was often not used, and the emr window was simply closed to trigger a partial or informal end of encounter the eoe process has been extended and enhanced to make it more effective with communication to staff new encounter window the small and innocuous eoe process icon has been made bigger and more obvious if you use the eoe process the blue arrow is intended to indicate ‘next step’ end of encounter front desk tab/window a new eoe tab has been added with several parts the user can add items to be claimed, add comments on the wait list or give additional instructions to the front desk staff, which will show when they open the appointment to the attendance tab if there are instructions to the front desk, a new icon displays, and an extended control centre/appointments list view allows follow up and confirmation that actions are completed (configurable in the filter) red and green dots show done and incomplete actions profile portal 2 and accession 2 profile patient/provider portal has been updated to the full product prior to this, profile portal was an alpha release, which means it was incomplete but usable there was excessive complexity for use, particularly with profile portal, requiring a user id and password for each patient or user, and remembering a complex url moreover, without a central location, push notifications were not possible in profile portal 2 (and accession now follows the same model), all this is eliminated on downloading the app from the stores, the user opens it directly; no urls are required main benefits the person using it just launches the application and registers once there’s no need to enter a url or specify a username and password for all the patients in your health organization, thus making patient access easier for the patient and the organization the health organization just needs to enable access for the patient and the patient uses their email address and their own password after the one time registration push notifications work (for things like appointment reminders) the user can see all the health organizations that permit them access and selects the desired one by just tapping on it the app does not hold any clinical information itself but acts as a navigation tool to establish the direct connection between the health organization and the person and makes it easier for patients to start using it new mode of operation when the clinic turns on the profile portal/accession services for a provider or a patient, it pushes to a central database (in canada azure) a complex hash key (unidirectional) based on the user’s last name first name date of birth mobile phone there is a onetime central registration with intrahealth for the user which asks them for the same information using the same algorithm, a hash key is generated centrally if this matches the health organizations, the accounts are linked allowing rapid navigation a pin is sent to the cell phone identified (by both the user and the health organization) to validate this registration once registered, the user can see and choose those organizations to which they have access registration health organizations (“services”) the health organizations control what the user can do, exactly as with previous versions of profile portal and accession the primary goal of this model is to simplify the experience and enable push notifications importance of the mobile phone because both the user and the health organization must enter the same cell phone number for the user, it is proof of identity the number is locked in profile if they are participating in profile portal or accession if the health organization changes it and the user does not change it to the same number, centrally, the linkage will break, and the health organization will not be listed for the user transition the transition from profile portal 1 (operation with profile 8 4) and profile portal 2 (tied to profile 8 5) is a onetime discontinuity the key for the health organization will be ensuring the mobile number is up to date and that the core fields for the user noted above match available profile portal packages standard patient standard provider health organizations can tell intrahealth which packages they wish to use it is even possible to develop customized packages for individual customers accession profile portal and accession do much the same thing, one on a device and one on a web browser we have aligned these so the process in 8 5, changed from 8 4, will be consistent larger customers can continue to use accession in the same way as previously coming improvements self registration of patients mismatch between central profile portal/accession db and the health organization’s data will be auto corrected (currently, the health organization will have to manually reset a value in the system) a homecare tablet package is in late stage development and is scheduled for release with 8 6 (third quarter of 2021) interfaces cdx (canada – british columbia) cdx (clinical document exchange) is a clinical document distribution service developed by interior health new in 8 5 is clinic to clinic document delivery, which allows providers to send letters, referrals, and attachments to external providers who are also using cdx the new enhancements to documents/letters enable this clinic to clinic document delivery highlights of existing functionality changes encounter changes heading bar the area above the clinical notes has been expanded if it’s a telemedicine consultation, a large blue video icon will display if the appointment is linked to the encounter, information provided by the patient for the appointment will display in a collapsible panel the short code for the encounter and the privacy are now following the standard dropdown style library there is an improved image library, so when a picture is selected, you can navigate to the correct image the type of file and how windows is configured will determine whether this is editable or read only attachments images and other files copied into the body of an encounter are now saved separately form the encounter text to improve performance and usability of the rendered display for images, smaller sizes are now automatically saved to make loading faster when the original image size isn’t required clicking an image attachment will open it in a separate window to view the original size clicking other attachments (e g , pdf) will open it with the default application in the system dictation if this allowed for the user, the microphone icon will display this requires that the module be licensed and configured for this pos and user (for individual accents) reviewing encounters historically, the contacts view in the work centre, with its default filter set to ‘unresolved contacts for me’, was used to come back to encounters for further follow up this functionality has been extended with tags tags can be defined as short codes and then added via the new/edit encounter toolbar these tagged encounters can later be located by find object queries or in the work centre/contacts view using the new filter by tags option on review, for example, the supervising provider might add a tag ‘reviewed’ clinical changes delegated authority in some situations, a provider will delegate some of their duties to a different person (“person”) who does not usually do them (for example, administering a drug might be delegated to a nurse) or possibly drafting non skilled persons to administer vaccines with a provider handling this delegation and supervision clinical guidelines short codes can be created and linked to a provider, a tag, a treatment guideline, and instructions for the user/provider to read if a provider is linked to any of the clinical guidelines short codes, the short code appears in the grants view of their profile and they can add the persons they are supervising for this activity if the person has a delegated clinical activity, the new bar will appear, and they can choose the clinical guideline under which they are operating if configured, links to review the documentation will be available to the user in the same bar the encounter will be tagged as defined in the clinical guidelines short code the work centre/contacts view can be used to find such encounters and they can be tagged as appropriate for the specific use purpose (e g , has been reviewed), whether in sample mode or 100% review email there are a few general enhancements to make email functionality more usable in profile 8 5 improved retrying for failed emails our previous retrying logic for failed emails was too broad and continuously attempted to resend emails that cannot ever be delivered successfully this was improved to give up after too many failed attempts and is limited to only those emails which might succeed upon retrying html and rtf support support has been added for storing and presenting html and rtf email format in built in email functionality letter attachments the letter window has a ‘send email’ toolbar icon previously, this didn’t include the attachments, if there were any, but now these are included in the outbound email as email attachments other enhancements ability to send appointment advice notices by email (and/or sms text message) with the previous option of printing remaining as a fallback ability to send invoices and statements by email in bulk to patients new bulk emails tab in preferences/internet to configure template text for each context miscellaneous changes chat the old messenger functionality has been renamed to chat there are many types of messages in profile, like electronic messages, patient messages, and so on, and it felt like chat more directly reflects the nature of this functionality while the window looks like the prior window, the list on the right now lists recent chats instead of the members of the organisation structure the dropdown field above allows you to select and display your availability there are settings to set text size and more these chat settings work with the my account menu alter patient communications this area has been simplified to make the communication channels much cleaner this is important now that non paper communication is more prevalent, with email, sms, profile portal and mobile patients can choose as many modes for communication as they wish and as are supported by your practice connectivity panel in alter patient/general tab before connectivity panel in alter patient/general tab after library view the library view is in the work centre and managed from the control centre it provisions various find object queries, macros, patient groups, forms, etc , into libraries from which users can select in their work centre, they can arrange the items hierarchically and position in two dimensions (like the windows desktop) this is a way of providing easy access to customized functions the user needs to perform their tasks and now the icons can be anything the administrator chooses, allowing the functions of the tools more obvious to the user toolkit view while this functionality was added in 8 3, it has not received the adoption it should it allows administrators to manage a library of customized functionality and publish it to roles it has been slightly updated in 8 5 to allow the use of any image to better reflect the purpose of the widget advanced changes emr views inside the case a limited number of emr/ehcr views can now be included in the case window, obviating the need to separately open the emr/ehcr window dynamic patient member of pos there are new preferences in preferences/organization/patient tab for member of pos these allow large organizations with multiple places of service to define rules which dictate when a patient will be considered a member of any given pos, mainly for the purpose of reporting the patient pos membership can then be evaluated from a few areas new com additions method – ispatient ismemberofpos(long posid; date aatdate) bool read write property – ispatientfilter memberofpos read write property – ispatientfilter memberofposasatdate updated method ispatientiterator open to use new ispatientfilter properties in find objects, new property member of in the patient object in groups filtering (see next section for more details) groups pos filtering groups general filtering now has member of pos options, including by current pos groups view filter now has prefilter section with options to prefilter patients by care team and member of pos prefiltering is applied before group filtering to improve performance for complex groups, especially those based on macros optimized union/intersection patient groups that use macros to filter patients by all non macro groups first before then iterating over that subset for the macro based group(s) this prevents the macro from having to iterate over every patient in the database and can greatly improve performance other pos enhancements a pos field is now available in the care team view this enables each pos to have a separate usual provider for the patient, for example also added to the care team filter, find objects, and com find objects has 2 new dynamic variables currentposcode – inserts the code of the place of service to which the user is logged in currentusercode – inserts the code of the logged in user organizational filtering organizational filtering worked incorrectly; the further down the organizational tree, the wider the search had to be this is the opposite of what was intended; the further down the organizational tree, the more specialized the unit, and therefore the more limited the set of codes, forms, etc , should be now, like roles, there are 3 states allow, revoke, inherit with the upgrade, these are configured to sustain current behavior however, it is now possible to limit the selections as the pos (or su) is more specialized locational roles when a user logs on, there is now a place to make a role take precedence over their usual uppermost roles if left blank, normal behavior continues bar codes and macros macros can now be used to intercept bar codes and manipulate them, because bar codes serve many purposes if no macro is attached, the raw interpreted code will be passed through interfaces my health record (australia) the my health record view toolbar has been updated to include several new features health record overview, which includes documents available on the pcehr since the last share health summary document list, which displays a list of my health record documents, including discharge summary event summary ereferral specialist letter ehealth prescription share health summary each document can be downloaded and stored locally my uploaded documents, which toggles the current view to include/exclude documents that have been uploaded to my health record the following my health record views retrieve a list of documents from my health record based on the date range defined by the currently selected filter the views present a snapshot at a point in time and are not stored in profile the diagnostic imaging view contains active links to related details, including radiology images the view can be grouped by authorising or requesting organisation the pathology report view contains links to related details, including detailed pathology reports and attachments the prescription and dispense view contains a list, grouped by prescription, showing prescription and dispensing events with active links to pcehr prescription and dispense records the medicare overview includes prescription details for pbs/rpbs, australian immunisation register, mbs and dva and other medicare services the medicines view displays available medicines in the my health record, sorted by date with active links to related details health summaries shared health summary displays a list of the shared health summaries not uploaded to pcehr shared health summary history displays a list of share health summaries uploaded to pcehr show preview panel displays the preview panel of the selected document major functionality introduced in late 8 4 telemedicine telemedicine became core functionality in 8 4 as a licensed module the solution is integrated into profile desktop app to provide a seamless workflow experience launches video and audio stream service linking patient and providers appointments sent by email (default) sms is supported if the clinic is signed up for the sms service appointment links are created and sent to the patient when using the appointment mode = telemedicine (instead of in person) patient video portal is launched from the email or sms appointment link patients are directed to an acknowledgement/consent page, which requires acceptance to proceed to the appointment provider launches the video consultation from a toolbar button in the new encounter view the video is launched in a separate window allowing the provider to use the profile medical record new encounter view the portal supports sending documentation, such as prescriptions or requisitions two factor authentication during covid, the need to work from home is critical however, this means access through the open internet so, we modified profile, turning it from a traditional ‘rich client’ to a ‘desktop app’, which means it functions just like your smart phone, accessing our servers (when we deliver saas) but this makes profile more vulnerable to hacking, so, like most big software companies and banks, we added two factor authentication (2fa) it relies on sending you a pin to your phone or email that you have previously provided this has several requirements you must enter a phone number or email for each user (or they can enter it themselves in their my account options) and indicate how you want to be notified if using sms, you must have a second number in the urgent field to bypass any logjams from bulk sending we must enforce strong passwords, which are complex and not easy to type, so we added the ability to enter just the first 3 characters of your password when your screen is locked when you authenticate the computer, by default it’s authenticated for 28 days for your use so, do not authenticate a public computer authenticate only your home or work computer depending on how your organization is configured, it may be possible to determine that the computer is trusted (e g , you have a fixed ip address), but, if there is any doubt, a pin code (2fa) will be sent to your phone or email you can manage the trusted list or cancel tokens, if authorized in error we put this back into the late 8 4 releases, but due to the need to move fast to support covid measures, there were many discoveries along the way these are all included in 8 5 all this is done to keep you and your patients’ information safe yes, it adds complexity, but this is the nature of trying to stay protected from hackers interfaces new zealand eprescription service (nzeps) nzeps allows electronic prescribing, using a health information exchange broker to connect prescribers and pharmacies and exchange prescription information electronically and securely this functionality was integrated into profile in 8 4 as a licensed module internet faxing internet faxing was redesigned in 8 4 alongside integrating a delivery partner in canada, srfax users are now able to send faxes directly from profile from several areas prescriptions requisitions (regional standard lab form and custom requisitions) letters (with attachments) referrals (with attachments) forms results financial reports end of encounter other features of internet faxing supports multiple recipients, either pulled from the context (e g , letter recipients), selected from external providers, or added ad hoc optionally configure a letter template as the cover page to be included automatically with all faxes, with the option of including a comment that is entered at the time of sending include a reply fax number on faxes, which can be configured differently for each pos tight integration with our other new features, esignatures esignature developed alongside our internet faxing functionality, but not limited to that use, esignature allows users or patients to capture a signature in real time this is used in a few areas prescriptions requisitions letters forms (e g , consent forms) signatures can be captured using either a hardware signature device from the leading manufacturer topaz, or with your mouse or touchscreen using the on screen software option sms integration sending sms text messages to patients from profile became core functionality in 8 4 automatic appointment reminders automatically handle replies, e g , “reply 1 to confirm, 2 to cancel” templates for default messages in various contexts messages view in medical record to support conversation bulk messaging to patient groups make custom functionality with macros available in canada, new zealand, and australia with our integration partners twilio and clicksend plus, several enhancements added in 8 5 appointment advice (new/changed appointment notification) automatic intervention reminders better handling of patients who have the same cell phone number with duplicate flag pos and privacy options for enterprise customers