The following is a list of enhancements included in R4+ Version 8.10.0. All fixes are cumulative (each new release contains all new fixes as well as all fixes from the previous release).
We have implemented a Patient Record integration between R4+ and Overjet IRIS, an AI-native imaging solution, in preparation to support future incorporation of Overjet IRIS functionality. Please note that to use the Overjet feature requires a separate commercial agreement with Overjet prior to activation.
After activation with Overjet, in R4+ navigate to Clinical Chart > Tools > Options > X-Ray Programs on each Machine to enable the Integration.
After enabling, under Clinical Chart > Tools > Options > X-Ray Programs, click the Config button to Map the active R4+ Clinic(s) Location to the expected IRIS Clinic ID(s) for Patient Registration. A New Icon is then presented on the Imaging Toolbar within the Clinical Chart.
Note: This is only required once or any time the Clinic alignment needs to be updated between the two products. This relationship allows for both 1:1 and 1:n mapping, dependent on how users wish to align Patient Records between both systems.
Click the New Icon on the Imaging Toolbar within the Clinical Chart to allow launching into IRIS to Create or Access the Loaded Patient in IRIS and access their associated Images.
Note: You will be required to login using your IRIS credentials at first launch.
After activation, R4+ supports the Transfer of the following Patient Information* to Overjet IRIS:
-- Patient's External Reference
-- Patient's Forename and Surname, Date of Birth, and Gender
-- Patient's Registered Clinic (based on the specified Clinic Mapping in point 3)
* If a Patient has not opted in to “Allow A.I. Services” on their Patient Record, the IRIS Launch Button and Menu option will remain disabled when they are accessed in the Clinical Chart. Please note that this option is an Opt-In rather than an Opt-Out, so it remains the Patient’s choice to share their Patient Record PII with Overjet IRIS.
IMPORTANT NOTES:
There are some caveats to be aware of with this Integration.
When setting up with Overjet IRIS:
If you are moving between an existing Imaging Product to Overjet IRIS and have been using a Custom Patient Reference, IRIS only supports a Numeric Reference whereas R4+ allows Custom Alphanumeric References. If the Existing Reference is not compatible, IRIS will flag this against the Patient Key in the displayed Create Patient Screen. To avoid Patient Fragmentation in these cases, it will be required to Renumerate Patients in your Database and any corresponding existing local image repository before continuing to use IRIS which may require assistance from the Carestream Support Desk.
If you have an existing Local Image Repository when moving to IRIS you will need to use the “Overjet Extension” application found under your user profile menu in IRIS to batch ingest images directly into IRIS, existing images can also be uploaded or dragged into IRIS for analysis during use on a per patient basis instead.
If New Clinics are added to a Site already using Overjet IRIS Integration, the user will be warned in Clinical Chart if no Mapping between the new Clinic and an IRIS Clinic ID exists when launching. The user can choose to continue, but the Patient’s Registered Clinic in IRIS will assume its default so this will result in Patient Fragmentation between systems or Cancel the launch and correct the Configuration (per the preceding step 3) to continue without being warned.
On a Patient's launch into IRIS:
If an IRIS Clinic ID has been entered against the Patient’s clinic that is unknown by the IRIS User Account, IRIS will default to its own 1st registered Clinic at Patient Creation, which may not align with a Patients Registered Clinic in R4+. You can choose to continue Patient Creation in such cases, manually correct or cancel and correct the R4+ Clinic Mapping per the preceding step 3 to avoid patient fragmentation.
If a Patients Forename, Surname, Gender, Date of Birth or Registered Clinic changes over time in R4+ after initial registration in IRIS, these changes are not automatically updated in Overjet when launched. In these cases, you will need to make the appropriate updates to the Patient in IRIS manually to keep up to date.
A New option is now available under Main Settings > System 1 Tab > Patients Comms Method Frame called “Create Skeleton Patient Default Method”. This provides the ability to change the Comms Method that is automatically set when Creating a New Patient Record Between the available methods of Letter, eMail or SMS.
This option will default to Letter to maintain compatibility with pre-existing Installations or will default to SMS if a Site is using the Prior “Use SMS as Preferred Communication” option in the Add-Ins 1 Tab. Additionally, this legacy option has been removed as its functionality is now automatically absorbed by this new option.
Finally, the ability to set this option as either SMS or eMail is dependent on that Method being configured 1st so is available to use via Add-Ins 1 Tab > SMS Messaging or Add-Ins 1 Tab > Scheduler settings. This is to avoid Patients being created using a method that is not available for use, which would result in Patients Failing to receive Communications like Recare Reminders, Appointment Cancellation or DNA Notifications.
A New option is now available under Main Settings > System 1 Tab > Patients Comms Method Frame called “Use Priority Order for recalls/Cancellations/DNA”. This provides the ability to specify the Comms Method Order that is used when attempting to send Batch Communications to Patients for Recalls, Appointment Cancellations, Late Cancellations or Postponement, DNA or WNB Letters, instead of only attempting using the Patient's Preferred Communication Type.
This affects the following Screens:
Springboard > Recare Widget > Not Booked KPI > Contact Selected Patients
Planner > Recall Patients
Planner > Cancellation Letters
The Following Rules are applied to how the Method Order is used for Patient Contact:
1st Contact Attempt will always use each Patients Preferred communication type set in their respective Comms Tab.
If that Method fails so not available R4+ will proceed to try the 1st method in the specified order (if that method is not already the 1st), or if the 1st method was the Patients Preferred Method it will attempt to use the 2nd before the 3rd skipping the method that was already attempted based on their Preference.
Each Contact Method attempt is reliant on the following Conditions:
The Method (SMS / eMail) has been configured and is available to be used in R4+ or MS Word is present (Letter).
The Necessary Document Templates in Doc Mgr > Standard Letter Templates for each respective method for each required Letter Type has been configured and are available for use with the Contact attempt.
The Patient has a Mobile No / eMail Address recorded to allow that method of Contact to be used.
Any Method Response failure (i.e. unrecognized email from Mail Server Daemon / Delivery Failure from Mobile Network) is still considered a successful send as the attempt did successfully leave the system, so it is still possible for a Patient Communication attempt to fail but due to a bad email or Mobile number being recorded.
Appointment Reminder and Recare Scheduler Tasks do not use this ordering logic as each Task is configured to use only the exact Method Specified by that task based on Patients Preferred Methods.
Two Quality of Life Improvements have been added to the Planner > View > Closures and Holidays Screen:
If the User is either a System Administrator or has Clinic Additional Access Rights and has an opening hour pattern split between locations, they will now be prompted to apply the selected pattern closure across all available clinics for the given date. If the User chooses no, then the closure is only made to the logged-in location. If they choose yes, the same pattern is applied to each location automatically to save the user from repeating the chosen action more than once.
As a Clinic Closure can now affect more than the logged-in location, the Cancel Appointments sub-screen has also been adjusted to make it easier to Cancel affected Appointments. The screen will still default to the Logged-in Clinic, but if the User is a system administrator or has Clinic Additional rights access, the other Clinics allowed by those permission types will be available in a dropdown without having to log out or switch clinics.
A New Opt-In setting has been added to the Patient Record Screen. This option is designed to provide sharing control with future AI-based products and services on a per patient basis so the sharing of Patient Record PII data remains the Patient’s choice.
When this option is Enabled or Disabled, an Audit Record and a Clinical Note is generated to record when and by which R4+ user this setting was set or changed for auditing purposes.
Currently, this option will only affect Sites who use the Overjet IRIS Integration.
Five new Stock Queries have been added which can be used in User Search Filters or Custom Query Reports where needed:
EXAM – Manual Recalls
EXAM – No Recall Dates
EXAM – Suspended Recalls
EXAM – Unenabled Recalls
HYGIENE – Patients Who’ve Had a 1020/1030/1035 in the Last 2 Yrs
To Aid the New Stock System Queries mentioned in the preceding section, a new Search Operator for “Includes” has been added to the Patients > Who have had a… > Treatment Code Criteria Query.
This allows the use of groups of Treatment Codes in the Criteria screen as a single query using Comma Separated Values. For example, if you wish to create a Query looking for Examinations and Fillings, you can now specify a value of 101,1401 instead of just the inclusion or exclusion of a singular Treatment Code.
Any FP17 Claim Schedule Response where the Patients NHS Alternate Name details contained either an apostrophe or hyphen would result in that Claim failing to process and remain in a Sent state. This has now been fixed in R4+ v8.10.0.
If a User has split opening hours between two clinics in the Morning and Afternoon and they closed one part of the day and then attempted to Close the other, it would undo the earlier Closure. This has now been fixed in R4+ v8.10.0.