As you have probably noticed (particularly) if you are a nurse, we made some pretty big changes to med history in our last release. These changes were made to ensure data integrity between Med History and the MAR. While the change was absolutely the right one, we did miss some work flow issues which make medication history too awkward to work with just now and for that I apologize. We are working on both short and long term solutions to these.
Let me start by going over why we made the change. When you look at the MAR and see that someone clicked a box to give a medication, you need to know what that medication was and what the instructions were that the staff who signed for it. Because each medication on the MAR refers to just one Medication History record, if anything on the Med History changes, then there needs to be a new section on the MAR for that medication. So, if the instructions for giving a medication change half way through a month, there is no way to have two sets of instructions, instead, the new instructions are shown next to the new medication.
This is a problem for users in two ways: firstly, the workflow of stopping one version of the medication and starting the new version is clumsy and requires too many clicks. Secondly, There is a need to maintain a start date for the Medication and for the current order separately. We only have one set of dates so it is difficult to track both the length of the order and the length of time on that medication.
There is also a related issue when staff create a medication and submit it for the nurse, it is not editable prior to going on the MAR.
Finally, you may have noticed that we included the ability to associate diagnoses with a medication, but they can only by added directly after saving (not submitting) the medication.
For just now, you will need to go to the medication (probably the quickest way is from the MAR Configuration Screen) and copy it to make the required changes. If the medication was previously documented against on the MAR, you should go back and discontinue it. If it wasn’t administered then you should delete it.
In the short term we are working on adding a number of links and guidance on the Medication History and its associated “Done” pages which will make this progress. We will get these changes to you as soon as is feasible.
With the move to building a pharmacy interface, we already had plans to move Medication History away from being controlled by Health Tracking roles so that it has it’s own set or is governed by MAR. This will include an approval process for medications and should solve all the problems above.
While I am sorry for the confusion that this change has caused (and the additional work), it was a change that had to be made to keep your data working properly.
If you have any questions or comments, please let us know.