We are working with TELUS to investigate an issue that appears to occasionally cause an Ocean note to overwrite another Ocean note in the PS Suite patient chart when multiple forms are completed in the same Ocean session (e.g. a patient using a tablet to complete multiple forms). The issue can cause one of the new notes to disappear from the chart. It remains visible in the PS Suite "note change history" for the patient although it appears crossed out as if it had been replaced by a subsequent note.
The issue has been reported by three independent clinics running PS Suite versions 5.13.406 and 5.13.407 in the past two days so we are treating it as a high severity issue even though it's not fully understood nor has it been reproduced in internal TELUS or CognisantMD test instances. The issue appears to be limited to notes added via the TELUS API (e.g. via Cloud Connect) as opposed to the legacy Ocean custom form. We do not expect any impact on eReferral functionality.
To work around the issue, log into Cloud Connect, click "Edit Settings" and enable "Combine Progress Notes". That will cause a single merged note to be added even if multiple forms were completed in the same session.
We are awaiting analysis from TELUS that will inform next steps. In the meantime, if you have encountered this issue, please apply the workaround described above, and let us know at email@example.com.
2019-06-10 5PM EST: According to the latest info from TELUS, the issue is associated with the receipt of multiple notes within a single second for a single patient. Ocean notes are often added in rapid succession upon patient session completion when "combine progress notes" is disabled, often within the one-second threshold and therefore a subset of the notes may not render in the UI due to this bug, which has not yet been traced to a specific PSS version. The workaround "combine progress notes" documented above would only protect new Ocean notes from being affected, but it would not help with previous notes -- a fix from TELUS will be required to make such notes visible again. In order to mitigate the issue based on this information from TELUS, we are planning to patch the behaviour of Ocean Cloud Connect tonight (June 10) so that all new Ocean notes in a single patient session are combined for a given patient in PSS. In other words, we will deploy the workaround for all PSS clients. We will update this ticket when such action is taken.
2019-06-11 4PM EST: The "combine note" workaround patch was deployed yesterday evening and no issues have been reported so far today with the updated behaviour, which would have affected approximately two-thirds of our PSS client base. We plan to revert to previous behaviour (i.e. to respect the setting in the Cloud Connect configuration) once TELUS' fix is in place.
TELUS reports that the root cause is triggered by multiple progress notes on a chart with identical transaction ID's inserted via the API; these notes failed to appear on version 5.13.404 or higher.
It has a preliminary fix in 5.14.303 and later, which ensures that the notes display even when the transaction ID is duplicated. Existing progress notes are fixed via a repair which was released in 5.15.400.