What's New?

The following changes are included in the Vision 3 SIS10650 release:

Northern Ireland Only

• Vision+ Templates and Data Entry - QOF 39 Indicator DM006 is updated to include Proteinuria and Microalbuminuria clinical codes and medication.

Vision+ Pathways

• We have improved the loading time of Vision+, this is useful for users with multiple pathways downloaded.

Vision+ SNOMED CT

• SIS 10650 includes the latest v35.2 SNOMED CT dictionary release.

  Note - All countries have access to the latest terms using Vision local codes which map to SNOMED CT terms in the background, see Vision Local Codes for details.

This release also addresses the following issues:

• Template header and footer images are no longer disabled.

• The intermittent "Invalid variant type" error no longer occurs.

• The blank Structured Data Area (SDA) form when prescribing a read coded drug no longer displays.

• You can now open a Patient Group from Practice Reports.

• If you are on SIS 10640 or SIS 10645 and have experienced an issue with data extracted into Outcomes Manager being incorrect or incomplete, this release addresses the issue.

The following changes are included in the Vision 3 release SIS 10646:

Northern Ireland Only

• Vision+ Templates and Data Entry - QOF 39 Indicator DM006 is updated to include Proteinuria and Microalbuminuria clinical codes and medication.

This release also addresses the following issues:

• Template header and footer images are no longer disabled.

• The intermittent "Invalid variant type" error no longer occurs.

• The blank Structured Data Area (SDA) form when prescribing a read coded drug no longer displays.

• You can now open a Patient Group from Practice Reports.

The following changes are included in the Vision 3 release SIS 10645:

Vision+ Calculators

• We have removed the electronic Frailty Index (eFI) Calculator from Vision+ in preparation for a new electronic Frailty Index (eFI) Calculator to be released.

Northern Ireland Only

• Vision+ is updated in line with QOF39 Business Rules for Northern Ireland only. This includes the following:
  • Notification Alerts
  • Data Entry Templates
  • Practice Reports
  • Contract Manager

November 2022

The following changes are included in the Vision 3 release SIS10640:

Wales, Scotland and Northern Ireland only

• Medication Codes - Vision+ pathways that contain medication items or prescription criteria have previously been limited by the lack of new items defined within the READ2 dictionary. In this release, we've switched medication criteria in pathways to use the DM+D codes from the SNOMED dictionary, currently used in England, that contains up-to-date medication and prescription items. This means that your pathways can now include these newer items within your notification alerts, data entry templates and practice reports:

  

Vision+ Data Entry

• Blood Pressure Data Entry - The blood pressure data entry control now includes labels for systolic and diastolic values and also provides validation to ensure the values entered are within an expected range.

  See Recording Blood Pressure Values for details.

• Recording Immunisations through Templates - This release introduces an additional screen to capture the Immunisation Type and Immunisation Stage, where immunisations are recorded through a Vision+ Template. This can help ensure that different alerts and reports are accurate for COVID, Influenza and other vaccination pathways.

  See Adding Immunisations on a Vision+ Template for details.

Vision+ Templates

• This release adds the ability to show or hide attachments, images or hyperlinks in Vision+ templates based on other non-coded controls elsewhere on the template. Your authoring team need to build this functionality into any templates before distributing to practices.

• In previous versions of Vision+, the description text for clinical codes displaying within either Radio Group or Checkbox Group controls was cut short to accommodate a set length, making some descriptions illegible. The layout now changes based on the description text length for the clinical code, so that the full description is visible.

  See Adding Clinical term Group Rows to the Template for more information.

Vision+ Practice Reports

• When running a Vision+Practice Report the report run date now displays in the title bar of the report results screen:

  

• We have updated the message that displays when you run a Vision+ practice report to include the chosen report date as part of the message text:

  

• You no longer have to close down a report to change the report run date. You can now select File to return to the Practice Reports screen to select a different report date and run it again.

Vision+ Mail Merge

• When performing a bulk insert of clinical codes from the Mail Merge screen, it is now possible for the code that is inserted to include a pre-defined default value or text. Your authoring team need to build this functionality in to any Vision+ reports before distributing to practices:

  

• When performing a bulk insert of clinical codes from the Mail Merge screen, a message now displays to inform you that the bulk insert process is complete:

  

  See Adding Codes to Multiple Patient Records for more information.

• When a user completes a mail merge the generated document saves in a .DOC format, even if the document editing application is not Microsoft Word. This ensures all attachments generated via Vision+ can be successfully transferred via GP2GP and other data transfer processes.

• When generating mail merge documents, for example patient leaflets, care plans, referral forms, from within a Vision+ template, you can now generate multiple entries into a document, for example, multiple result values, as well as just the latest entry. Your authoring team need to build this functionality into any Vision+ templates before distributing to practices:

  

Vision+ Data Extracts

• Category Analysis - You can now view the Report Date and the Run Date in a data extract file when generating a Pseudonymised CSV File:

  

• The issue of a data extract for a month including the data from the 1st of the following month, is addressed.

The following changes are included in the Vision 3 SIS10635 release:

QOF Vision+Practice Reports - England Only

• Vision+Practice Reports is updated in line with QOF47 Business Rules.

Vision+ SNOMED CT

• SIS 10635 includes the latest v33.0.0 SNOMED CT dictionary release.

  Note - All countries have access to the latest terms using Vision local codes which map to SNOMED CT terms in the background, see Vision Local Codes for details.

The following changes are included in the Vision 3 SIS10630 release:

Practice Reports - Letter Templates

We now have the ability to select from multiple word processing applications when creating and using letter templates in Vision+:

• To create a letter template you now have the option to select from the word processing applications you have installed:

  

  See Creating a New Recall Letter Template for details.

• When selecting letter templates from the Mailings screen you can now view which word processing application the template was created in:

  

  • - Letter templates created in Word

  • - Letter templates created in LibreOffice

  • - Letter templates created in Docmail

  See Recalling Patients by Letter for details.

Patient Summary Printout

We have improved the Patient Summary Printout in line with template changes:

QAIF Vision+ Practice Reports - Wales Only

• Vision+ Practice Reports is updated in line with QAIF 2021/2022 Business Rules.

QOF Vision+ Practice Reports - England Only

• Vision+ Practice Reports is updated in line with QOF46 Business Rules.

Vision+ SNOMED CT

• SIS 10630 includes the latest v32.10.0 SNOMED CT dictionary release.

  Note - All countries have access to the latest terms using Vision local codes which map to SNOMED CT terms in the background, see Vision Local Codes for details.

We have also addressed the following issues in this release:

• Warfarin Audit Report - The report was showing an error if the patient's record contains an International normalised ratio (INR) clinical term without a value, this has now been fixed.

• User Feedback - We have fixed an incompatibility issue with the User Feedback form and Internet Explorer 11. To improve the product we ask you to feedback any issues you may have, see User Feedback for details.

The following changes are included in the Vision 3SIS10620 release:

Downloading Web Files

• When downloading web files you must read all the information that displays and scroll down to the bottom of the Download Information screen before Yes is activated:

  

Vision+ SNOMED CT

• SIS 10620 includes the latest v32.7.0 SNOMED CT dictionary release, this contains additional Coronavirus concepts. For more information on Cegedim Healthcare Solutions latest Coronavirus guidance see Vision Coronavirus Advice.

  Note - All countries have access to the latest Coronavirus terms using Vision local codes which map to SNOMED CT terms in the background, see Vision Local Codes for details.

The following changes are included in the Vision 3 SIS10610 release:

Vision+

• Customer Feedback Form - We have introduced a new User Feedback Form where you can send us feedback and enhancement requests for Vision+.

  See User Feedback for details.

• Indicator Logic screen - A scroll bar now displays on the Indicator Logic screen to allow you to view all the relevant codes and the specific triggered code for the selected logic rule:

  

  See Indicator Logic Tool for details.

• Mail Merge - You can now generate a mail merge that includes a range value.

Vision+ Template Designer

• Template Designer Required and Mandatory controls - When creating a template in Template Designer you can now set a control as mandatory.

  See Setting Controls as Required or Mandatory for details.

Vision+ SNOMED CT

• SIS 10610 includes the latest v32.2.0 SNOMED CT dictionary release, this contains additional Coronavirus concepts. For more information on Cegedim Healthcare Solutions latest Coronavirus guidance see Vision Coronavirus Advice.

  Note - All countries have access to the latest Coronavirus terms using Vision local codes which map to SNOMED CT terms in the background, see Vision Local Codes for details.

The following changes are included in the Vision 3 SIS10600 release:

Vision+ Templates

• New Control in Template Designer - There is now a new control in Template Designer called Template. This enables you to link a user-defined template from another:

  

  See Linking to another User Defined Template for details.

• Non-coded data, for example a questionnaire, that is recorded in the template now displays the date that the responses were recorded:

  

  To clear the previously entered data to add a new response, select Clear . You can now enter new data, this will use the Default Date set:

  

  Note - To undo the data just entered select Undo Last Entry .

• The Clear function has been removed from non-coded controls where no previous data exists:

  

Vision+ Practice Reports - Wales Only

• Vision+ Practice Reports are updated in line with QAIF 38 Business Rules.

Vision+ SNOMED CT

• The latest v32.0.0 SNOMED CT dictionary release is included in SIS 10600, this includes additional Coronavirus concepts. For more information on Cegedim Healthcare Solutions latest Coronavirus guidance see Vision Coronavirus Advice.

  Note - All countries have access to the latest Coronavirus terms using Vision local codes which map to SNOMED CT terms in the background, see Vision Local Codes for details.

Pathway Developer

• Pathway Authors can now pre-set a default value against a Radio Group control.

April 2021

The following changes are included in the Vision+ SIS10590 release:

Vision+ Calculators

• eGFR/Renal Function Calculator - The Renal Function Calculator replaces the previous eGFR Calculator and provides additional functionality when estimating CKD risk.

  The new Renal Function Calculator automatically displays Actual, Ideal or Adjusted Weight based on the patient's BMI for Cockcroft-Gault creatinine clearance calculation:

  

  See Renal Function Calculator for details.

• Framingham CHD/CVD Risk Calculator - Disclaimer added 'The calculator is no longer recommended and NICE recommend using the QRISK calculation'.

  

  See Framingham CHD/CVD Risk Calculator for details.

Vision+ Downloading Web Files

• Download Web Files - You can now view the Pathway descriptions in Download Web Files:

  The Download Web Files screen displays the Short Description under the pathway ID and title.

  

  On selecting Download the Download Confirmation screen displays the full description:

  

  See Downloading Web Files for details.

Vision+ Templates

• Renal Function Calculator - The eGFR Calculator throughout Vision+ is now called the Renal Function Calculator:

  

• Viewing Templates - The template window now has a standard maximise, minimise and restore function.

• Comment Notes - Any comment notes recorded throughout a template will be written back to the patients record:

  

• Filtering Historical Entries - A template can automatically display filtered entries in the history screen by a specific value, this enables users working with specific studies to see the historical data recorded as part of the study. You can switch off the filter by removing the tick and revert back to the full history:

  

• Mandatory Template Entries - The warning message for mandatory template entries has been updated to ensure instructions are clear:

  

• Pathway ID - Templates or calculators now display the Pathway ID on the title bar. This helps to identify the templates for instances such as help desk support:

  

Vision+ SNOMED CT

• The latest v31.5.0 SNOMED CT dictionary release is included in SIS 10590, this includes additional Coronavirus concepts. For more information on Cegedim Healthcare Solutions latest Coronavirus guidance see Vision Coronavirus Advice.

  Note - All countries have access to the latest Coronavirus terms using Vision local codes which map to SNOMED CT terms in the background, see Vision Local Codes for details.

March 2021

The following changes are included in the Vision 3 SIS10580 release:

Outcomes Manager

• Pathway Developer - Pathway Authors can choose from a drop-down of options when creating medication or prescribing code sets, including all types of acute or repeat items:

  

  The drop-down includes the following options:

  • Active Repeats

  • All Drugs

  • Active or Inactive Repeats

  • Acutes

  • Inactive Repeats

Practice Reports

• Viewing Reports by Staff/Staff Role - Vision+ now allows report results to be filtered and sorted by both Staff and/or Staff Role:

  

  See Filtering Data for more information on sorting report results.

• Scheduling Reports - A new scheduler tool allows multiple practice lists to be run at any time in the next 24 hours. This replaces the Scheduler tab in Vision+Settings.

  To schedule a report:

  When you select a Practice or QOF/QAIF List 'Do you want to run this practice list now for the report date dd/mm/yyyy, or schedule it to run in the next 24 hours?' displays:

  

  Select from:

  • Run now - To run the report. The report screen displays with a progress bar.

    Training Tip - To run a report for call and recall invite purposes, you must select Run now.

  • Schedule - To schedule the report in the next 24 hours, the Schedule screen displays, enter a start time in the next 24 hours to run the report:

    Training Tip - This must be set using the 24 hour clock, for example, for 4pm use 16:00.

    

    You can now continue working as usual and the report runs as scheduled. Once a report is complete it displays in the Practice Reports - Last Run screen.

  • Cancel - To exit the confirmation screen.

  See Scheduling a Practice or QOF/QAIF List for more information.

• Viewing Report Information - Practice Reports displays the appropriate information in the Info column, as defined within the report criteria:

  

  For example:

  This patient has a record on 1st July 2020 that relates to this report criteria:

  

  Here is the data in the patient's record:

  

Vision+ SNOMED CT

• The latest v31.3.0 SNOMED CT dictionary release is included in SIS 10580, this includes additional Coronavirus concepts. For more information on Cegedim Healthcare Solutions latest Coronavirus guidance see our Coronavirus (COVID) Guidance Help Centre.

  Note - All countries have access to the latest Coronavirus terms using Vision 3local codes which map to SNOMED CT terms in the background, see Vision 3 Local Codes for details.

January 2021

The following changes are included in the Vision 3 SIS10570 release:

Recording Immunisations using Vision+

• Vision+ now allows for structured data entry for immunisations when recording data in Vision 3. To record immunisations:

  1. From Consultation Manager, select the patient and open a consultation if required.

  2. Record an immunisation either through a template or an alert.

  3. Select Save and Close on the template.

  4. The Immunisations screen displays:

     

  5. Complete the immunisation details as appropriate.

  6. Select OK, the immunisation information is written back to the patient's record.

Outcomes Manager

• Rule Designer - Rule Designer, the tool used by authors to create templates, now displays full codeset descriptions in a tooltip. This only displays when a template includes an Active Repeats control and shows Side Effects. Not all templates have this type of control.

  

Vision+ SNOMED CT

• The latest v31.1.0 SNOMED CT dictionary release is included in SIS 10570, this includes additional Coronavirus concepts. For more information on Cegedim Healthcare Solutions latest Coronavirus guidance see Coronavirus (COVID-19) Guidance Help Centre.

  Note - All countries have access to the latest Coronavirus terms using Vision local codes which map to SNOMED CT terms in the background, see Vision Local Codes for details.

December 2020

The following changes are included in the Vision 3 SIS10560 release:

Vision+ SNOMED CT

The latest v30.2.0 SNOMED CT dictionary release is included in SIS 10560, this includes additional Coronavirus concepts. For more information on Vision’s latest Coronavirus guidance see Coronavirus (COVID-19) Guidance Help Centre.

QAIF - Wales Only

• The issue with the Influenza season date ranges has been addressed in SIS10560:

  • FLU001W - The percentage of the registered population aged 65 years of more who have had influenza immunisation in the preceding 1 August to 31 March.
  • FLU002W - The percentage of patients aged under 65 years included in (any of) the registers for CHD, COPD, Diabetes or Stroke who have had influenza immunisation in the preceding 1 August to 31 March.

Vision+ License Server

• The issue being experienced by some practices without internet access on start up, has been addressed.

Practice Reports - Mail Merge Update

• The issue of the patient patients record not being updated correctly with the appropriate invitation codes following a mail merge on QOF - Extra Indicators has been addressed.

The following changes are included in the SIS 10550 Vision release:

Vision+ SNOMED CT

• The latest SNOMED CT 30.0 dictionary is implemented in SIS 10550.

Vision+ Practice Reports - England Only

• Influenza QOF Lists England - New Influenza category for England only that groups all influenza indicators into one list. Previously practices would invite patients for a flu vaccination using the influenza indicator within each category. With the new influenza category practices can view and invite all qualifying patients under one category. See Influenza QOF Category.
• Vision+ Practice Reports updated in line with QOF45 Business Rules.
• COPD - New indicator for COPD (COPD009MI1) counts the number of patients with a clinical diagnosis of COPD before 1st April 2020. This is for management purposes only.

Calculators

• Updated licence for continual use of QRISK2 CVD Risk Calculator.

INR Results / Warfarin Dosing Calculations

• Due to a SNOMED code mapping issue in Vision 3, previous INR results were not previously stored correctly and therefore may have been lost, causing an incorrect Warfarin dosing calculation in Vision+. This has now been fixed in SIS 10550 and Vision+ will pick up all historical INR results correctly.

SMS Recalls

• Previously when an SMS message is sent to a patient the Read term 9N3G. SMS Text Message Sent to Patient was added to the patient notes however the mail merge screen did not to state that an SMS had been sent. SIS 10550 fixes this issue.

Outcomes Manager

• Rule Designer - Rule Designer within Outcomes Manager (the tool used by Vision authors to create templates), now allows alternative views for Historical Data, Codeset Descriptions, Side Effects and Repeat Usage Control.

The following changes are included in the SIS 10540 Vision release:

Vision+ SNOMED CT

• The latest SNOMED CT 29.3 dictionary is implemented in SIS 10540 and includes additional Coronavirus concepts. For more information on Vision’s latest Coronavirus guidance see - Coronavirus (COVID-19) Guidance Help Centre.

Wales Only

• Quality Assurance and Improvement Framework (QAIF) – Vision+ Reports, Templates and Alerts are now fully compliant with the new Quality Assurance and Improvement Framework (QAIF) Business rules. For an example of the new look QAIF Reports – see QAIF Reports - Wales only.
• Disable QAIF – From Vision+ Settings you can disable QOF prompts and templates. This option is renamed Disable QAIF from SIS 10540. See Vision+ Settings – Disable QAIF Triggers.
• Vision+ Template Designer – From Vision+ Template Designer you can copy QOF Templates and customise them. The templates are renamed QAIF.

QOF England only Vision+

• Smoking (SMOK002) – Vision+ Reports and Alerts now exclude any patients with Asthma under the age of 20.

QAIF – Wales only

Vision+ is now fully compliant with the new Quality Assurance and Improvement Framework (QAIF) Business rules. This includes:

• Vision+ Practice Reports - QAIF replaces QOF reports in Vision+ Reports. See QAIF Reports - Wales only.
• Vision+ Settings – Disable QAIF Triggers - To help manage patient care and optimise QAIF, Vision+ Alerts and Templates automatically display QAIF prompts. From Vision+ Settings you can hide the prompts, if not required. See Vision+ Settings – Disable QAIF Triggers.

Vision+ SNOMED CT

• The latest SNOMED CT 29.2 dictionary is implemented in SIS 10530 and includes additional Coronavirus concepts. For more information on Vision’s latest Coronavirus guidance see - Coronavirus (COVID-19) Guidance Help Centre.

Vision+ SNOMED CT

• The latest SNOMED CT 29.1 dictionary is implemented in SIS 10520 and includes additional Coronavirus concepts. For more information on Vision’s latest Coronavirus guidance see - Coronavirus (COVID-19) Guidance Help Centre.

SMS Text Messaging

• Implied Consent – On receipt of SIS 10520 a new Implied Consent model is available. Patients who do not have a Consent/Declined term recorded in their record are automatically Opted In for SMS Text Messaging. This can now be changed as a practice-wide setting so that the default for your practice is for patients to Opt Out. If you wish to change this please contact the Help Desk who will update the settings on your behalf and ensure Vision+ continues to run. See SMS Text Message Explicit Consent.

• SMS Messages – Previously, if an error occurred during the transmission of SMS messages to a group of patients it was not clear if the text message was sent. From SIS 10520 a record of the message is logged after each message is sent.

Vision Data Entry

• Study Codes – Recording a study clinical term in Vision+, now also records the study reference/code in the correct Structured Data Area (SDA) box. See Study Code.

Vision+ Reports

• QOF Reports – Vision+ Reports now show the correct QOF Version 44 label.

• Last Run – The Last Run option now processes patient records that contain a tilde (~) character in the comments box.

• Temporary Residents – Patients with a registration status of Temporary are automatically removed from Vision+ Reports when their length of stay expires.

Vision+ SNOMED CT

• SNOMED CT - The latest SNOMED CT dictionary is implemented in SIS 10500 and includes the Coronavirus concepts. For more information on Vision's Coronavirus guidance see - Vision Coronavirus guidance

QOF

• QOF England - SIS 10510 removes the restriction to only display sixty SNOMED CT terms in a QOF template.

Vision+ Template Designer

• Codeset Rows - When adding a Codeset row to a template, you can hide the SNOMED CT term/clinical term and description, so it does not display when viewing the template in the patient record. See Hiding the description on a Codeset Row.

• SNOMED CT Browser Search - The SNOMED CT browser within Template Designer now defaults to Terms when searching on a SNOMED CT term.
• SNOMED CT Filter Option - Previously if you entered a SNOMED CT term in the search box, then changed the search options, for example, Hierarchy, the SNOMED CT term was removed and required re-entering. SIS 10510 fixes this issue.

Vision+ Reports

• SNOMED CT Reports - Reports within Practice Lists that include SNOMED CT terms run faster on receipt of SIS 10510.
• Data Extracts - The Data Extract option from Practice Reports enables data to be extracted into a CSV (Comma Separated Value) file and forwarded to HB’s. The issue of extracts being downloaded every night regardless of version number is addressed.
• Contract Manager - The practice list size is now correct when viewing within the Payment Details section of Contract Manager.
• Mail Merge - There was a discrepancy between the All Patient and Individual QOF mail merge lists if a patient had a status of Seen represented by three dots (…). The All Patient list displayed 1st invite instead of the three dots. SIS 10510 resolves this.
• Practice Lists - The issue of some calculators displaying in lists, has been addressed.

Download Web Files

• Pathway ID - Pathway IDs display when downloading a template from Download Web Files.

SNOMED CT

• SNOMED CT - The latest SNOMED CT dictionary is implemented in SIS 10500 and includes the Coronavirus concepts. For more information on Vision's Coronavirus guidance see - Vision Coronavirus guidance.

QOF

• Vision+ England - Vision+ Reports and Templates are updated to QOF Version 44 for practices in England.
• Vision+ Wales - For practices in Wales using QOF Version 37, the reference date has changed from 1st April to 1st October.
• QOF Influenza Wales - The QOF rules relating to Influenza are updated to the latest release to accommodate the new date ranges.
• CHD005 England (Patients taking aspirin, clopidogrel or anti-coagulant) - Previously, when exception coding patients for all three drug areas, the alert prompt and template remained as if it was still outstanding (black text). This is resolved with QOF version 44.
• Hypertension HYP003 and HYP004 England (Patients with a blood pressure 140/90 and 150/90 or less) - The Blood pressure button was missing from the template. This is resolved with QOF Version 44.
• Vision+ Contract Manager England - The Cervical screening indicators CS005 and CS006 within Contract Manager, only showed the maximum threshold required to meet the target on the report. From SIS 10500, the report now displays both the minimum and maximum threshold.

Vision+ Calculators

• eGFR - The eGFR graph is no longer available because it was using the wrong weight for Cockcroft and Gault.

Vision+ Templates

• History tab (additional information) - The history tab within a template now displays additional information.
• History tab (date) - When viewing medication on the history tab within a template, the date the prescription was last issued displays. However, if the prescription had not been issued the date displayed as 30/12/1899. From SIS 10500 the date column is now blank. See Vision+ Templates.
• Smoking - Smoking was missing from some Vision+ templates. This is corrected in SIS 10500.

Vision+ Reports

• electronic Frailty Index (eFI) Calculator - Previously, when running the eFI bulk calculator add option from Practice Reports, an error displayed. This is resolved in SIS 10500.

Vision+ Template Design

• Controls Toolbar - The Controls toolbar within Template Designer includes some extra tools which include current repeats, acutes, repeat usage and problems.

Anticoagulation Manager

• Warfarin Monitoring Reports - The Patient Scan option within the Warfarin monitoring reports now runs a lot faster when identifying patients who need a diagnosis indication.

Outcomes Manager

• Rule Designer - Writing a pathway to search for eGFR>59 did not include eGFR>59 when searching in Vision 3. This is resolved in SIS 10500.

QOF

• Clinical Audit - Clinical Audit is updated to Version 42 QOF Business rules for practices in England. Practices in Northern Ireland and Wales are updated to QOF Version 37.

• Vision+ - Vision+ Reports and Templates are also updated to QOF Version 42 for practices in England and Version 37 for practices in Northern Ireland and Wales.

• QOF Vision+ Template colour coding – Rows in green indicate that QOF data is complete. Rows in black require data to be recorded before QOF year end. Rows in purple indicate no data recorded but it is not relevant for this patient, for example, the electronic frailty index status for a diabetic patient.

• Exception Coding – Vision+ Exception coding and reporting for practices in England has changed and now includes the new Exception Business rules.

Vision+ SNOMED CT

• SNOMED CT - The SNOMED CT June 2019 dictionary is implemented for practices in England.

Vision+ Calculators

• eGFR Calculator – The eGFR Calculator allows for the adjustment for ideal weight to Cockcroft-Gault. It also calculates CCR from Cockcroft-Gault and files this to the patient record.

• eGFR label- The eGFR Cockcroft-Gault screen previously displayed an incorrect label of CR-CL (creatinine clearance). It now shows the correct label of eGFR.

Vision+ Settings

• Exception Reporting – Due to the changes in exception reporting for practices in England, the option to switch on separate Exception searches is removed from Vision+ Settings. The reasoning behind this is that exceptions are no longer reported separately and are part of the main indicators/denominator reports.

Vision+ Reports

• Export Reports to a csv file – Previously, exporting a patient QOF list to a CSV file only displayed the denominator category. The export now also includes indicator data.

Vision+ Mail Merge

• QOF ‘Merge All’ Invite Status – When running the Merge All category option within mail merge, the invite displays with a date and status for each clinical category.

• QOF Merge Fields – Previously, when sending a letter invitation to a patient that included QOF areas, the letter listed all the registers the patient was on, not just those you were inviting the patient in for. From SIS 10490 only the QOF areas selected are merged into the letter.

• QOF Patient Record – Now when performing a mail merge on multiple QOF areas, using the filter option dictates what invite terms are written back to the patient record

• Non QOF Categories – Non-QOF category mail merge options are removed from the mail merge fields.

• QOF Categories with No indicators – Some QOF areas do not contain any indicators within them. For example, Osteoporosis and Epilepsy. Selecting merge category from Vision+ Practice Reports displays the warning message “There are no invite status defined in the QOF Business rules for the Osteoporosis category”.

• Pseudonymised NHS Number Mail Merge Template - Mail merge templates can now include a pseudonymised (encrypted) NHS number. The pseudonymised option was developed for practices who have patients participating in studies/trials. In conjunction with this is a new pseudonymised patient search.

• Mail Merge Filter – Previously, after applying a filter using the All Merge categories you could only sort one column at a time. From SIS 10490 you can sort multiple columns.

Vision+ Contract Manager

• Contract Manager – For practices in Northern Ireland, Scotland and Wales, the option to schedule Contract Manager reports to run are removed from Configuration and Settings in Vision+. Contract Manager now automatically runs overnight and will be up to date as of the day before. You can still select update if you want to run the reports during the day, especially if it is getting near to QOF year-end.

• Contract Manager reports - Some practices experienced error messages when running Contract Manager. This is resolved in SIS 10490.

Anticoagulation Manager

• Anticoagulation Manager Patient Printout - The printout given to a patient is enhanced to include extra information and can be customised.

• Anticoagulation Manager A4 Patient Review – Previously, you could only preview the Anticoagulation Manager printout for a patient on prescription paper. There is now an option to print preview as an A4 report.

• Time in Therapeutic Range Calculator - The default TTR now looks at the last 12 months only. If the TTR is less than 12 months plus 6 weeks, the calculator ignores the first six weeks of results after Warfarin indication and then sets the start date to the first INR after that date.

• Mail Merge – Performing a mail merge in Anticoagulation Manager did not always display the Word document. This is resolved in SIS 10490.

• Warfarin Audit – Previously the Warfarin audit report was displaying zero figures when searching on SNOMED CT terms. This is fixed in SIS 10490.

Outcomes Manager

• Extract Patient Demographic data – Patient demographic data as well as aggregated data is now extracted in Outcomes Manager.

• Rule Designer – Rule Designer within Outcomes Manager (the tool used by Vision authors to create templates), now allows a default value to be set against a SNOMED/clinical term within a template.

• Repeat Count – Rule Designer allows for a repeat count.

SIS 10486 delivers the following Vision+ changes:

Vision+ Calculators

• CHA2DS2-VASc - The CHA2DS2-VASc calculator is re-enabled in Vision+ as it now contains the approved Thromboembolism list of codes.
• QAdmissions - The QAdmission SDK (a SNOMED compliant calculator) updates to the latest license for practices in England.
• QRISK2 - The QRISK2 CVD Risk Calculator (which uses Read terms) updates to the latest license for practices in Northern Ireland, Scotland and Wales.
• QRISK3 - The QRISK3 calculator (which supports the recording of SNOMED CT terms) updates to the latest license for practices in England.
• ABPI - England only, the ABPI Calculator includes the correct SNOMED CT codes.

Vision+ Reports

SIS 10486 introduces the following changes for practices in Northern Ireland, Scotland and Wales. Practices in England received the changes in SIS 10485 release. For more information see SIS 10485 (11/06/2019).

• Contract Manager - The option to schedule Contract Manager reports to run is removed from Configuration and Settings in Vision+. Contract Manager now automatically runs overnight and is up to date as of the day before. You can still select update if you want to run the reports during the day, especially if it is getting near to QOF year-end.
• Points Report - The Learning disability points report in Contract Manager now shows the correct labels.

Outcomes Manager

• Pathways - Pathways cannot be downloaded if they have the same name as a local calculator.
• Web addresses - Internal license URLs now access the new Outcomes Manager server.

SIS 10485 delivers the following Vision+ changes:

Vision+ Templates and Reports

• Vision+ Templates and Reports - Vision+ Templates and Reports are updated to the Version 41 QOF rules for practices in England.

Vision+

SNOMED CT

• SNOMED CT – From SIS 10485, Vision+ is fully SNOMED CT compliant. See SNOMED CT (page 2).
• SNOMED CT Switchover (England Only) – Practices in England are changing to SNOMED CT as the primary coding system in Vision+. The change has minimal impact on the practice, see SNOMED CT Switchover.

Calculators

• QRISK3 - QRISK2 is disabled for practices in England on receipt of SIS 10485 and QRISK3 is enabled. The change is implemented because QRISK3 only supports recording of SNOMED CT terms in the calculator. See QRISK3 (page 33).
• QRISK2 - QRISK2 is still enabled for practices in Northern Ireland, Scotland and Wales because it allows the recording of Read terms (which are mapped to SNOMED CT terms). See QRISK2 (page 35).
• QAdmissions - QAdmissions SDK, a SNOMED CT compliant calculator, used by practices in England, is implemented in SIS 10485.

Reports

• Practice Lists – Individual reports in patient lists have been enhanced to run quicker.
• Contract Manager – The option to schedule Contract Manager reports to run has been removed from Configuration and Settings in Vision+. Contract Manager now automatically runs overnight and is up to date as of the day before. You can still select update if you want to run the reports during the day, especially if it is getting near to QOF year-end.
• Points Reports – The Learning disability points report in Contract Manager now shows the correct labels.

Template Designer

• QRISK3 – The QRISK3 calculator can now be included when designing a screen in Template Designer.

Outcomes Manager Pathways

• Pathway Developer SNOMED CT terms - Pathway developer incorporates SNOMED CT terms. See Pathway Developer (page 35).
• Gemscript – Gemscript therapeutic classes and RDCs are available in Pathway Developer. See Gemscript (page 36).
• Pathway – Pathways cannot be downloaded if they have the same name as a local calculator.

SIS 10481 delivers the following Vision+ changes:

Vision+ Calculators

• CHA2DS2-VASc - On installation of Vision release SIS 10481, the CHA2DS2-VASc Calculator is temporarily disabled. The decision has been made to disable the calculator until such time as it can be redeveloped and implemented to a national standardised specification and codeset once made available by Prof. Gregory Lip who has ownership of and responsibility for producing this (currently no ETA for completion). In the meantime, you are advised to utilise an online version of the calculator (e.g. https://www.mdcalc.com/cha2ds2-vasc-score-atrial-fibrillation-stroke-risk) as an alternative method of calculating CHA2DS2-VASc score for patients

Anticoagulation Manager

• Anticoagulation Manager Recall - Anticoagulation Manager Reports now take into consideration Warfarin recalls up to 84 days into the future.

SIS 10480 delivers the following Vision+ changes:

Clinical Audit

• Clinical Audit - QOF Business Rules v36 is delivered to practices in Northern Ireland and Wales.
• Vision+ Templates and Reports - Vision+ Templates and Reports are also updated to the Version 36 QOF rules for practices in Northern Ireland and Wales.

Vision+

Reporting

• Mail Merge - The Vision+ Mailings screen is enhanced to allow for advanced filters when running Vision+ Reports. See Multi-Disease Registers.

Calculators

• CHA2DS2-VASc - The CHA2DS2-VASc calculator icon was not displaying on the alert toolbar for patients with AF. This is resolved in SIS 10480.
• Edmonton Frail Scale - The Edmonton Frail Scale questionnaire included a textual error within the 'medication use' section on the second page. It now reads "At times, do you forget to take your prescription medications? Yes or No". Patient predicted calculations were still correct.
• COPD Assessment Test (CAT) - The CAT calculator displayed an error when saving to the patient record. SIS 10480 fixes this.

Data Entry

• Inactive User Alert - The warning message "Your staff account is either inactive or has a valid until date in the past. Please edit and restart Vision 3", displays if your account has been inactivated or the valid until date has expired.
• Pneumovax - The correct immunisation type is now recorded for pneumovax in children and adults.

SIS 10478 and SIS 10479 have been combined and are now on general release.

For practices who have already received SIS 10478, you will be automatically updated to SIS 10479. All other practices will be upgraded to SIS 10479.

SIS 10479 contains the following changes to:

Vision+

Anticoagulation Manager

• Warfarin Dose Warning - Diagnosis with a treatment end date now displays a new warning message on the Warfarin Dose screen when recording a dose after the end date. See Warfarin Dosing Tool.
• Warfarin Dose - History Tab - The History tab on the Warfarin dose screen was not displaying the patient's Diagnosis indication, INR history or the patient's weekly Warfarin dose values. This is resolved in SIS 10479.

Vision+ Reporting

• Notes Kept At - For practices licensed as part of a Shared Practice dataset, you can now run individual Practice Reports using the Notes Kept At field.
• Backdated Reports - Backdating Vision+ Practice Reports automatically disables the mail merge options.
• Contract Manager - Some larger practices encountered errors when running Vision+ Contract Manager. SIS 10479 resolves this.

Outcomes Manager Pathway

• Registration Period - Outcomes Manager Pathways can specify a date range to include patients who may now be deducted but were active within the specified date range.

SIS 10478 delivers the following changes:

Vision+

Anticoagulation Manager

• Warfarin Dose Warning - Diagnosis with a treatment end date now displays a new warning message on the Warfarin Dose screen when recording a dose after the end date.
• Warfarin Dose - History Tab - The History tab on the Warfarin dose screen was not displaying the patient's Diagnosis indication, INR history or the patient's weekly Warfarin dose values. This is resolved in SIS 10478.

SIS 10477 delivers the following changes:

Vision+

Calculators

• QRISK2 - On receipt of SIS 10477, the QRISK2 calculator is updated to the 2018 version.
• QAdmissions License - SIS 10477 includes a new license for the QAdmissions calculator.

Vision+ SMS

• Cancellation Settings - Previously, there was an issue with the SMS cancellation period in Settings not working. This is resolved in SIS 10477. SMS Tab

Mail Merge

• Mail Merge Invitation Status - Some practices reported that the invite status in the mail merge screen was not automatically updating on the first attempt when recalling patients. Installation of SIS 10477 resolves this.

SIS 10476 delivers the following changes:

Vision+

Vision+ SMS

• Cancellation settings - There is a new cancellation setting within SMS settings. See SMS Replies Tab.
• Invalid mobile numbers - Mobile numbers containing letters are no longer classified as invalid.
• Patient identification - The patient and appointment ID now display in the appointment reports when processing replies for appointment cancellations. See Appointment Sent SMS Text Message Reports.
• Cancellation time - There can be a delay from the patient sending an SMS text to cancel an appointment and this being processed. Vision+ now uses the time the SMS was sent, not the time it was processed, to determine whether it is cancelled in time. See SMS Replies Tab.
  • Patient name - Vision+ now only cancels a booking if it matches the cancelled patient's name.
  • Memory error - A few practices experienced an out of memory error when loading some large patient records. This is resolved in SIS 10476.

SIS 10471 delivers the following changes:

Clinical Audit

• Clinical Audit - QOF Business Rules v35 are automatically installed for practices in Northern Ireland. In summary:
  • England - QOF Version 36 Business Rules
  • Northern Ireland - QOF Version 35 Business Rules
  • Scotland - QOF Version 32 Business Rules
  • Wales - QOF Business Rules v2017-18 1.0W

• Vision+ Templates and Reports - Vision+ Templates and Reports are also updated to the Version 35 QOF Business rules for practices in Northern Ireland.

Vision+

• Repeat Prescriptions - Repeat masters without an issue were not being counted in Vision+. SIS 10471 fixes this problem.

SIS 10470 delivers the following changes:

Clinical Audit

• Clinical Audit - QOF Business Rules v2017-18 1.0W are automatically installed for practices in Wales. In summary:

  • England - QOF Version 36 Business Rules

  • Northern Ireland - QOF Version 35 Business Rules

  • Scotland - QOF Version 32 Business Rules

  • Wales - QOF Business Rules v2017-18 1.0W

• Vision+ Templates and Reports - Vision+ Templates and Reports are also updated to the Version 36 QOF Business rules for practices in England and Business Rules v2017-18 1.0W for practices in Wales.

Vision+

Vision+ SMS

• SMS Clinical term - Clinical term 9N3G - SMS text message sent to patient is recorded in the patient's record when a SMS text message is sent to a patient from Consultation Manager.
• SMS Scheduled Reminders - From SIS 10470, if SMS messages fail Vision+ performs up to 5 retries and records the failure reason within the appropriate log files. See Log Files.
• SMS Mail Merge Recalls - Previously, when sending SMS messages from the mail merge screen, a failure message sometimes displayed. This message is now ignored the SMS process continues, and a record of the error recorded in the log files. See SMS Message Reports .

Vision+ Template

• Prescribe - You can now prescribe from user-defined Vision+ template created in Template Designer. See Prescribe.

Vision+ Template Designer

• Vision+ Template Distribution - From SIS 10470 you can upload practice created Vision+ templates and download templates created by other GP Practices, Integrated Care Board (ICB) and Health Board (HB) using our bespoke web based Outcomes Manager. See Overview - Creating and Modifying Vision+ Templates.
• Template Rename - You can now rename your template in Vision+ Template Designer. See Renaming your New Template.
• Template Save As - There is a new Save As option in Template Designer which enables you to copy a template and save it as a different name. See Saving the Changes to your New Template.
• Duplicate Template Names - Vision+ now checks for duplicate template names and warns if a template exists with the same name. See Vision+ Template Names.
• Template Status Warning - A new warning message displays if you attempt to upload a Vision+ template where the status is Test or Develop and not Publish. See Changing the Status of Templates.
• Prescribe - Template Designer includes an option to prescribe from a template. See Adding a Prescription Row to the Template.

Vision+ Calculators

• Electronic Frailty Index Calculator (eFI) - The eFI calculator now displays the license agreement. See Introduction - Electronic Frailty Index (eFI).

Vision+ Reports, Templates and Alerts

• Postdated Prescriptions - It has been identified that future dated prescriptions are not being picked up by Vision+. Currently, Vision+ only populates the database with the latest therapy record and if this is in the future, the therapy item is ignored until the date is reached. Consequently, Vision+ reports, templates and alerts were not reporting on this information. This issue is resolved in SIS 10470.

Vision+ Reports

• CKD Contract Manager Reports - The CKD figures within Vision+ Contract Manager previously displayed zero figures. This is resolved in SIS 10470.

Download Web Files

• Download Web Files - Previously, if a newer version of a template required downloading the download checkbox was automatically checked. From SIS 10470 the checkbox is no longer selected. See Additional Templates - Download Web Files.

SIS 10469 delivers the following changes:

Vision+

Calculators

• QRISK2 - On receipt of SIS 10469, the QRISK2 calculator is updated to the 2017 version.
• QAdmissions License - SIS 10469 includes a new license for the QAdmissions calculator.
• Screen Resolution - Due to the amount of data required to perform a calculation, the Electronic Frailty Index (eFI) and QAdmissions calculators are too large to fit on some screen resolutions, resulting in the loss of functionality. Installation of SIS 10469 resolves this.

Vision+ Templates

• Mandatory Comments - Some templates with pre-defined mandatory comments were displaying incorrectly. This is resolved in SIS 10469.

Vision+ Reports

• Influenza Bulk Exception Clinical term - Previously, if performing a bulk exception clinical term on the Vision+ Influenza reporting line an incorrect clinical term was displayed. This is resolved in SIS 10469.

Northern Ireland Only

Vision+ Reports

• QOF DM015NI - The percentage of male patients with diabetes, on the register, with whom erectile dysfunction has been discussed. This reporting line has been updated to take into account the correct time frame.

SIS 10465 delivers the following changes:

Clinical Audit

• Clinical Audit - QOF Version 35 business rules are automatically installed on receipt of SIS 10465 for practices in England. In summary:
  • England - QOF Version 35 Business Rules
  • Northern Ireland - QOF Version 34 Business Rules
  • Scotland - QOF Version 32 Business Rules
  • Wales - QOF Version 34 Business Rules

• Vision+ Templates and Reports - Vision+ Templates and Reports are also updated to the Version 35 QOF Business rules for practices in England.

Vision+

Vision+ SMS

SIS10465 delivers enhancements to My Health/SMS - Text Messaging within Vision+ that provides the following functionality and benefits to your practice and patients:

• Appointments - Allow your patients to Cancel their Appointments via SMS

  Enable your Patients to cancel their appointments by pressing one button, with no practice intervention and a reduction in your DNA rate. See Appointment Cancellation via SMS.

• QOF - Allow your Patients to add Data and Decline Invites via SMS

  Invite your patients for QOF and ask them to answer Questionnaires via SMS, their response is coded into their record. You can access more patients, save administrative time and have more up to date patient data, which increases QOF points. See Decline Chronic Disease Invitation via SMS.

• Questionnaires - Allow Patients to complete Questionnaires via SMS

  Practice, local or national initiatives can be completed in the patient's own time, save administrative time, creating more up to data patient data, which increases QOF points. See Questionnaires via SMS.

Other SMS Changes include:

• Settings - Two new headers within Settings, SMS and SMS Replies contain practice wide options for the new SMS functionality. See Using the Settings Screen.
• Additional merge fields SMS templates - The number of merge fields you can add to SMS messages has been increased. See Creating a New Recall Letter Template.
• Longer SMS messages - You are now prompted when creating longer SMS templates, as changes to the length of SMS templates have been made (a long SMS could cost 2 texts rather than 1).
• SMS from Consultation Manager - You can now Mail, SMS or SMS Question your patient from within Consultation Manager. See SMS Recall/Questionnaire from Consultation Manager.
• Practice defined transmission times - You can now set a time frame for SMS transmissions to be sent and received. See Settings - SMS.
  Important - If you have previously changed any of the SMS settings you must re-configure this information after the installation of SIS 10465, see Settings - SMS.
• Full Audit Trail of SMS Patient Responses - All responses received are recorded and visible within Vision+. See SMS Message Reports and Viewing Sent Messages.
• Valid Mobile Numbers - To reduce the updating of Mobile numbers to a specific format, numbers entered in the format 0000 111 1111 are now validated.

Vision+ Calculators

• Electronic Frailty Index (eFI) calculator – The Electronic Frailty Index (eFI) calculator identifies patients at risk of developing frailty or those patients likely to already have frailty. The calculator assists in the further assessment of a formal diagnosis and potentially reduce the possibility of the hospital admission of a patient with frailty. See Electronic Frailty Index (eFI).
• Predicted Scores - Some of the new calculators now have a predicted button. This allows you to switch between data entry and predicted mode. Predicted mode at the top half of the screen is enabled to allow you to show a patient how a change in their health can affect their score. In predicted mode, the score cannot be saved into the patients records. See Predicted Score.
• Calculator and Questionnaire PDF - All calculator and questionnaire PDF outputs now print correctly; previously some blank pages were printed.
• Time in Therapeutic Range (TTR) - There is no longer a discrepancy when two INR results span the therapeutic range.

Vision+ Data Entry

• Vision+ Drug Select - All Vision+ drug list screens now display Generic only drugs as the default. See Drug Select.

Vision+ Reports

• Reports - Vision+ Practice Reports are quicker to open due to the removal of system groups from patient groups. See Patient Groups.
• Patient Groups - Patient mobile numbers are now validated when sending SMS messages to a group of patients from Vision+ Patient Groups.
• Duplicate Patients - Some patient groups were displaying duplicate patients, this is resolved in SIS 10465.

SIS 10460 delivers the following changes:

Clinical Audit

• Clinical Audit - QOF Version 34 business rules are automatically installed on receipt of SIS 10460 for practices in Northern Ireland. In summary:
  • England - QOF Version 34 Business Rules
  • Northern Ireland - QOF Version 34 Business Rules
  • Scotland - QOF Version 32 Business Rules
  • Wales - QOF Version 34 Business Rules

• Vision+ Templates and Reports - Vision+ Templates and Reports are also updated to the Version 34 QOF Business rules for practices in Northern Ireland.

Vision+

Reporting Changes

• Faster Reports - Designing of reports has changed to enable reports to run quicker.
• Transferred Out Patients - Patients who are Transferred Out are now always ignored in Practice Reports; previously when the date Transferred Out was prior to the date Registration these patients were included.

Mail Merge

• Practice NACS code - There is a new merge field for Practice NACS code.

SIS 10455 (combined with SIS 10450), delivers the following changes:

Clinical Audit

• Clinical Audit - QOF Version 34 business rules are automatically installed on receipt of SIS 10455 for practices in England and Wales. In summary:
  • England - QOF Version 34 Business Rules
  • Northern Ireland - QOF Version 33 Business Rules
  • Scotland - QOF Version 32 Business Rules
  • Wales - QOF Version 34 Business Rules

• Vision+ Templates and Reports - Vision+ Templates and Reports are also updated to the Version 34 QOF Business rules for practices in England and Wales.

Read Dictionary

• Read Quarter 1 Dictionary 2016 - SIS 10455 includes the clinical term Quarter 1 2016 dictionary for Vision+.

Vision+

SMS

• SMS Messages for individual patients - It is now possible to send an SMS text message to an individual patient from Consultation Manager. See - SMS Messages for Individual Patients.
• SMS Messages for a group of patients - You can now send SMS messages to a group of patients. See Working with Patient Groups.
• SMS Text Messaging Report - The SMS Text Message report has been updated so that you now see a processing message. See Sent SMS Text Message Reports.
• SMS EE Messages - If you use EE for text messaging (which allows unlimited text messages), the SMS text remaining message has changed to [EE providing texts].

Vision+ Calculators

• QRISK2 - Changes to the QRISK2 SDK calculator are implemented in SIS 10455. See QRISK2 CVD Risk Calculator.
• QAdmission - For practices in England, the QAdmissions Calculator (2016) is updated in SIS 10455.
  See QAdmissions Calculator.
• eGFR Calculator - Previously when adding an eGFR score to a patient's record after midday, the event date defaulted to the next day. This is fixed in SIS 10455.

Data Entry

• Freetext Comments - The freetext comments box associated with a clinical term has been increased from 255 to 1024 characters.

Vision+ Reports

• Patient Groups - Patient groups now display in Vision+ where you can work with patient lists, perform a mail merge or use the bulk add facility. For more information on working with patient groups. See Working with Data within the Patient Target Lists.
• CVD Primary Prevention - The QOF indicator for CVD Primary Prevention has been updated in Vision+ to incorporate episode type for newly diagnosed Hypertensive patients.
• Mail Merge - If you are using Microsoft Word 2003 an error displays when performing a mail merge. To resolve this error you need convert the document to Microsoft Word 2007. To do this go to a Workstation with Word 2007 (or above) installed and select Vision+ - Practice Reports, then choose Merge Templates. Alternatively, by running a report on a Word 2007 workstation will automatically convert the template.
• Northern Ireland CVD Primary Prevention - The Indicators for CVD-PP001 and CVD-PP002 now display the correct name, for example CVD-PP0011NI and CVD-PP0012NI respectively.
• Report Filters - Practice lists within the SIGN, NICE and Other areas now run correctly.
• Contract Manager buttons - The buttons within Contract Manager now only become enabled once the patient list has finished loading.
• Contract Manager Exception Lists - Previously, exception lists were not showing correctly after reopening Contract Manager. This is fixed in SIS 10455.

Vision+ Settings

• Hiding Indicators - There is no longer a limit to the number of indicators you can suppress from display in the Alert Pop-up screen. For more information on Vision+ settings.

Anticoagulation Manager

• Anticoagulation Manager Patient Print out - The Anticoagulation Manager print out has been updated to exclude advice about when to take medication. See Print, Print Preview and Print A4.
• INR Manual Dose Warning Message - A new warning message displays advising that a manual dose should be recorded if the INR is above eight. See Warfarin Dosing Tool.
• High INR Adjustment - From SIS 10455. If the INR has spiked, a zero dose has previously been recorded, and the middle INR target is less than 3.5, adding a new INR displays a message that the dose cannot be calculated. See Warfarin Dosing Tool.
• Warfarin Monitor Report - Previously, if using the display option from the Warfarin monitor report to alter a patient's therapeutic range, it did not update the abnormal column. This is resolved in SIS 10455. See Warfarin Monitor Report.
• Warfarin Dose Message - Prior to SIS 10455, if the patient's latest dose was zero the dose displayed on the dosing tool was the previous one. This is fixed in SIS 10455.

Clinical Audit

• Clinical Audit - The QOF Version 33 Business Rules for England, Northern Ireland and Wales are automatically installed on receipt of SIS 10440. Practices in Scotland will remain on QOF Version 32 as no new Business rules have been issued. In summary:
  • England - QOF Version 33 Business Rules
  • Northern Ireland - QOF Version 33 Business Rules
  • Scotland - QOF Version 32 Business Rules
  • Wales - QOF Version 33 Business Rules

QOF Reporting

• Northern IrelandQOF Submissions - On installation of SIS 10440, QOF reports for 2015/16 are automatically resubmitted to PCAS.
• COPD and Stroke - The COPD and Stroke audits are corrected on receipt of SIS 10440.

Vision+

• Vision+ Templates and Reports - The Vision+ Templates and Reports are also updated to the appropriate QOF Business rules for practices in England, Northern Ireland and Wales. Vision+ in Scotland will stay on QOF Version 32 Business rules.
  Note - For more information on the changes to the Business Rules, see (QOF Business Rules 2015/16).

Clinical Audit

• Clinical Audit - The QOF Version 32 Business Rules for Northern Ireland are automatically installed on receipt of SIS 10430.

Vision+

• Vision+ Templates and Reports - Vision+ Templates and Reports are also updated to the Version 32 QOF Business rules for practices in Northern Ireland.

Read Dictionary

• Quarter 3 2015 Clinical terms - Vision+ now includes the Quarter 3 2015 Read dictionary.

Vision+ Changes

Practice Reports

• Saved Reports - All Vision+ Reports now automatically save and can be re-opened from the Last Run option. See Last Run button.
• Report Run Date - A run date can now be set for Practices Reports. See Practice Lists View.

Vision+ Merge Indicator/Category Options

• CHA2DS2-VASc Calculator - The CHA2SD2-VASc Calculator can be bulk added to a group of patients. See Adding a Calculator Risk Score to Multiple Patient Records.
• Merge Fields - Vision+ Merge field can be selected from within a Word document. See Creating a New Recall Letter Template.
• Extra Indicators Practice Reports - When running the Extra Indicators Report and performing a mail merge on co-morbidities, the clinical terms are now only written back to the patient's record for the selected categories.
• Rheumatoid Arthritis Invite Status - When inviting a patient for a Rheumatoid Arthritis recall, the following clinical terms are now used instead of the clinical term 9N33.11 - letter encounter.
  • Clinical term 9mM0 - Rheumatoid arthritis monitoring invitation first letter
  • Clinical term 9mM1 - Rheumatoid arthritis monitoring invitation second letter
  • Clinical term 9mM2 - Rheumatoid arthritis monitoring invitation third letter
  • Clinical term 9mM3 - Rheumatoid arthritis monitoring verbal invitation letter
  • Clinical term 9mM4 - Rheumatoid arthritis monitoring telephone invitation

• QOF Flu Invites - When recalling a patient through the Vision+ Flu programme, the QOF category is automatically recorded in the comments and the invite status is updated appropriately.

Template Changes

• Colour Coding - The Vision+ Templates have been updated to match the Alert screen colour scheme. See Colour Coding and Icons.
• CHA2DS2-VASc Calculator History - The CHA2DS2-VASc calculator within a template now displays previous scores.
• Templates not displaying - Previously, If you selected a template from the Vision+ icon in the Windows notification area using the keyboard, the template screen was hidden behind the active window so did not display. This is resolved in SIS 10430.

Vision+ Alerts

• CHD Monitoring - Previously, if you double clicked on the CHD Monitoring indicator on the Alert screen an empty clinical term list displayed. This is fixed in SIS 10430.

Vision+ Calculators

• Time in Therapeutic Range (TTR) Calculator - Vision+ now includes the Time in INR Therapeutic Range calculator (TTR) which assesses a patient's INR control over time. See Time in Therapeutic Range Calculator (TTR).
• Spirometry Calculator - The Spirometry Calculator now records Predicted FEV1 (clinical term 339S) and FEV1/FVC ratio (clinical term 339M) with the correct percentage value.

Data Entry

• Immunisations - The Immunisation status of "Advised" is recognised in Vision+.
• Pneumococcal - Pneumococcal vaccinations now record the correct immunisation and take into account the patient's age, for example either Pneumococcal conjugate vaccine or Pneumococcal conjugate vaccine 13 depending on patients' age.

Anticoagulation Manager

• Time in Therapeutic Range (TTR) Calculator - Vision+ now includes the Time in INR Therapeutic Range calculator (TTR) which assesses a patient's INR control over time. See Time in Therapeutic Range Calculator (TTR).
• Warfarin Monitor Reports - Prior to SIS 10430, if you selected the Mail button in the Warfarin Report, an error message displayed if data was missing from the patient list, such as a missing INR result or Warfarin information. This is fixed in SIS 10430.

Wales

Vision+ Merge Templates

• Preview Mail Merge Template - Some practices in Wales have experienced problems viewing the Mail Merge template within a patient record. This is fixed in SIS 10430.

SIS 10420 delivers the following changes:

Vision+ Changes

New Patients

• New Patients in Vision+ - Patients who are newly registered in Vision are now automatically synchronised with the Vision+ database which means they directly display in Vision+ Reports. (Previously, you had to open a consultation in Consultation Manager in order for the new patient to appear in Vision+).
• Non-Registered Patients - Vision+ Reports can now include patients who have a registration status other than Applied and Permanent, for example patients registered as GP Special Interest, Temporary Patients, Transferred Out.
  Note - INPS or the HB responsible for designing reports define which Registration categories to include.

Vision+ Template Changes

• History Print Option - The History icon at the end of a template line allows you to view historical data and list or graph numerical values. The graph view now includes a new toolbar which enables you to print the data. See History Icon.

New Calculator

• Edmonton Frail Scale - Vision+ now contains the Edmonton Frail Scale which helps identify patients with signs of frailty. The calculator is devised and used by all Healthcare professionals to provide secure and compassionate care for frail older people. See Edmonton Frail Scale.

Calculator Changes

• Christo Questionnaire - The Christo Questionnaire now only shows the OK and Attach button once the questionnaire is completed (previously it also showed the OK button). See Christo Calculator.
• Recovery Plan Questionnaire - The Recovery Plan Questionnaire now restricts the amount of text that can be added to each data entry box. The amount of information recorded is limited to the size of the box. See Recovery Plan Questionnaire.

Practice Reports

• Contract Manager - The reports within Contract Manager have been updated so that they now support AcrobatReader DC.
• Seen by GP - The 'Seen by GP' merge field and column within Practice Reports have been relabelled Usual GP. See Creating and Managing Recalls in Practice Reports.

Template Designer

• Multiple Comment Boxes - You can now have multiple comment boxes on the Codeset and Radio controls within a template. See Adding Multiple Comment Boxes.

Anticoagulation Manager

• Warfarin Monitor Scan Patients Report - The time taken to run a Patient scan within the Warfarin Monitor Reports has been considerably reduced.
• Patients with a Mechanical Valve - Patients with a 'Mechanical Valve Fitted' clinical term recorded in their journal will automatically have their maximum recall period calculated as six weeks. This is regardless of whether this has been selected as the patient's Diagnosis Indication for Warfarin.
• Recall Period - A further two recall periods have been added for ten and twelve weeks to the Recall Maintenance Period. See Recall (Maintenance Period).
• Algorithm Initiation Period - The Initiation period has been removed from the Warfarin module. See Warfarin Dosing Tool.
• Warfarin Dose - The Warfarin Dose screen has been updated to accommodate for patients who stop taking their Warfarin dose then re-start their new weekly dose. See Warfarin Dosing Tool.
• Recall date - The recall date now always prints on the Warfarin Dose report that you can give to the patient.

Scotland

Vision+ - NHS Lothian

• Amber Icon in Templates - Some templates include an amber icon to indicate that information on the template should be reviewed. See Colour Coding and Icons.
• Payment Report - The patient's sex is now included on the Payment Report. See Payment Report (Scotland only).
• Export to CSV - The Payment Report can now be exported to a CSV file. See Payment Report (Scotland only).
• Last Run - The Last Run option can be used to view a previously run Payment Report. See Last Run button.

31/08/2015

SIS 10410 delivers the following changes:

Clinical Audit

• Clinical Audit - The QOF Version 32 Business Rules for England, Scotland and Wales are automatically installed on receipt of SIS 10410. Practices in Northern Ireland remain on QOF Version 30 Business Rules until their specific version is finalised. In summary:
  • England - QOF Version 32 Business Rules
  • Northern Ireland - QOF Version 30 Business Rules
  • Scotland - QOF Version 32 Business Rules
  • Wales - QOF Version 32 Business Rules

Vision+

• Vision+ Templates and Reports - The Vision+ Templates and Reports are also updated to the appropriate QOF Business rules for practices in England, Scotland and Wales. Practices in Northern Ireland will be updated once the QOF rules have been finalised.

Scotland Only

• Contract Manager Percentage Report - The Contract Manager Percentage report was displaying incorrect figures for a retired indicator for practices in Scotland. This has been rectified in SIS 10410.
  Note - For more information on the changes to the Business Rules, see (QOF Business Rules 2015/16).

SIS 10400 delivers the following changes:

Clinical Audit Changes

• QOF Version 31 Business Rules for England - The QOF Version 31 Business Rules for practices in England are installed. Practices in Scotland, Northern Ireland and Wales remain on QOF Version 30 Business Rules until their specific versions are finalised.
• England Manual CQRS Reporting Audits Enhanced Services 2014/15 - The Manual CQRS Reporting Audits for Enhanced Services in England 2014/15 are automatically removed.

Read Quarter 1 2015 Dictionary

• Clinical term Quarter 1 Dictionary 2015 - SIS 10400 includes the clinical term Quarter 1 2015 dictionary for Vision+.

Vision+ Changes

SIS 10400 contains the following Vision+ changes:

Configuration and Settings

• SMS Automated Appointment Reminder Times - It is now possible to set a time frame when sending Automated SMS Appointment Reminders. See Advanced Tab.

Vision+ Reports

• New Look Practice Reports Screen - The Practice Reports screen has been redesigned to incorporate an Office 2013 theme. See Overview - Practice Reports.
• Save a Vision+ List of Patients as a Group - There is a new option to save a patient list from Vision+ Practice Reports as a patient group within Reporting - Patient Groups. See Saving a List of Patients as a Patient Group.
• Payment Reports - Some HB's run Vision+ Payment Reports. From SIS 10400, the Payment Report can be exported to a Central Reporting Dashboard.
• Individual Mail Merge Letters Saved in the Patient Record - From SIS 10400, individual mail merge letters are saved in the patient's record along with the appropriate invite clinical term. See Running a Mail Merge from Patient Target Lists.
  Note - The individual mail merged letters are saved in a P:\attach folder.
• Patient Details Mail Merge Fields - Previously, when merging patient information into a Word document the patient details displayed in upper case and could not be altered. This is changed so that the patient details are name-cased ie display in upper and lower case.
• Mail Merge Fields - Some Vision+ Templates and Reports include documents that merge patient clinical information, for example Care Plans. The number of merge fields has been increased to allow for more clinical data to be incorporated into a merged document. See Running a Mail Merge from Patient Target Lists.
• Mail Merge Confirmation Prompt - The mail merge confirmation prompt now requires you to confirm that your letters have printed before updating the invite status. See Running a Mail Merge from Patient Target Lists.
• Contract Manager - Patient Lists - After running an update within Contract Manager the patient list option now displays as an extra ribbon tab. See Contract Manager.
• Contract Manager Graph Points Corrected - The Vision+ Contract Manager graph shows points against aspiration. Some practices have reported that some graphs were incorrectly displaying the wrong points. This has been addressed in SIS 10400.

Vision+ Templates

• History Tab - The History Tab within Vision+ Templates now prints items you are viewing. See History Icon.
• Save Patient Data - If you have a Vision+ Template open for a patient and select another patient without saving the data on the template. Vision+ now automatically saves this information to avoid any data being lost. See Saving a List of Patients as a Patient Group.

Vision+ Alerts

• Patient Mail Merge - The issue of the mail merge option not being available on the Alert screen if you have Combined Triggers switched on has been addressed. We have also changed it so that if you have exception coded a patient you no longer see the mail merge icon on the Alert Toolbar.

Vision+ Calculators

• CHA2DS2-VASc - For practices in England using the Version 31 QOF Business rules, the CHA2DS2-VASc Calculator is now linked to the new indicator AF006 - The percentage of patients with atrial fibrillation in who stoke risk has been assessed using CHA2DS2-VASc score risk stratification scoring. See CHA2DS2-VASc - AF Stroke Risk Calculator.
• Personal Outcome Plan Questionnaire for Practices in Lothian - Practices in Lothian can access a Personal Outcome Plan Questionnaire from Vision+ Calculators. See Personal Outcome Plan Questionnaire.

Vision+ Northern Ireland Only

• H+C Number - Previously H+C Numbers were listed under the NHS column. Columns are now correctly labelled H+C Number.

Anticoagulation Manager

• INR Practice Screen - The caption 'Mechanical prosthetic heart/Biosprosthetic valve recall always 7 days' has been removed from the INR Practice Screen.

SIS 10390 (19/05/2015) delivers the following changes:

Vision+ SMS Text Messaging

• As part of SIS 10390, we are introducing SMS Text Messaging, a new secure messaging service that enables you to send health care invitations and appointment reminders to patients by SMS text messages. On receipt of SIS 10390 practices in England, Northern Ireland and Scotland automatically have the SMS Text message service enabled but you must purchase a bundle of SMS text messages. Practices in Wales should contact your HB who will activate the SMS service and purchase the SMS Text bundle on your behalf.

  To check you have SIS 10390 installed, from the Vision front screen select Help - About Vision.

  To enquire about purchasing SMS Text bundles, contact the Sales Team on 020 7501 7440 or visit the vStore at: www.inps.co.uk - My Vision - vStore.
  See Appointment SMS Text Messaging Reminders and Creating a Recall SMS Message Template.

Vision+ Changes

Calculator Changes

• Passive Risk Calculations on the Alert Pop-up - It is now possible to see a patient's risk score as a passive calculation on the Vision+ Alert Pop-up.
• QRISK2 and ASSIGN Bulk Add - New functionality is introduced in SIS 10390 to the QRISK2 and ASSIGN calculator. Both calculators are now available from the Calculator Tab within the Vision+ Practice Reports - Mail Merge option.
• Colour Coding and Warnings - The Diabetes Risk, JBS2 and QAdmissions calculators now also show warning colours and messages on the actual score.
• Calculator Data Entry Changes - The Vision+ Calculator screens have been redesigned so that you can easily differentiate between data entry boxes and those that are for information purposes only.
• QAdmissions Episode Prompt for Cancer - You are now prompted to record an episode type if recording a diagnosis of Cancer on the QAdmissions calculator. Without an episode type the Cancer diagnosis will not be included in the calculation.
• QRISK2 and QAdmissions License - SIS 103090 includes a new license for the QAdmissions and QRISK2 calculators.
• QAdmissions Drug Select - The QAdmissions calculator now allows you to see which drugs are included in the calculation, previously no drugs were displaying.
• Changes to Diabetic, QRISK2 and QAdmissions Calculators - Only the previous five years are considered when looking at a patient's Smoking and BMI history.
• Changes to the Diabetes Risk Calculator and QAdmissions Calculator- The BMI box within the 'What If' section of the Diabetes Risk Calculator and QAdmissions Calculator can now be edited.
• Calculator Reset - Previously, if you selected a clinical term on a calculator and clicked Reset to reset the original settings, the clinical term was still recorded in the patient's record. This has been fixed in SIS 10390.
• JBS2 Calculator - The JBS2 calculator has been updated so that a TC:HDL Ratio of three now displays correctly on the graph.

Template Changes

• Retired Indicators - Retired indicators are now always displayed in Templates regardless of whether they are enabled or not in Vision+ Settings. This is to allow for exception coding.
• Clinical term Data Entry Changes - The clinical term data entry box is now blank making it easier to record zero values.

Vision+ Alert

• Extra Indicators Updated to include Stroke - Vision+ Extra Indicators help you monitor QOF disease category recalls and allow call/recall for the purposes of monitoring, assessments and annual reviews. Prior to SIS 10390 the Stroke Extra Indicator option was not displaying. This has been corrected in SIS 10390. For more information on Vision+ Extra Indicators, see http://www.inpshelp.co.uk/DLM480/Visionplus/index.htm#46357.

Vision+ Reports

• Register Check Reports - The Register check report identifies patients who are not on a QOF register but who may be appropriate to place on a register. The wording on the report (and the Alert pop-up and Template) has been updated to provide a better explanation as to why the patient is eligible for being placed on a QOF register.
• Yearly Results - The Yearly Results option in Contract Manager has been updated so that you can still view the results after closing Contract Manager and re-opening it.
• CKD Manager Extract - From SIS 10390, the CKD Manager Reports extract time has been considerably reduced.

Template Design

• Default Code - Previously, if you created a template in Template Designer and included the default clinical term option, the default clinical term was automatically recorded in the patient's record as a priority two. This has been fixed in SIS 10390 so that the clinical term option now defaults to priority three.

Vision+ Scotland Only

• New Payment Report - A new payment report has been created in response to feedback from Health Boards in Scotland.
• Palliative Care (PC002) - Palliative Care (PC002) has been removed from the Vision+ Reports.
• Diabetes (DM018S) - The threshold for the percentage of patients on the Diabetic Register who have had an influenza immunisation now show the correct percentages (50-90%).

Anticoagulation Manager

• Anticoagulation Manager Recall Periods - The default recall periods have been updated within Anticoagulation Manager.

Clinical Audit Update

• Seasonal Flu Audits England - The seasonal flu audits have been updated to fix some reporting errors. The ethnicity details have been updated to look for the LAST ethnicity code recorded only.
• Seasonal Flu Audits England and Scotland - There are new clinical terms added to the Flu audits for England and Scotland.
• Prenatal Pertussis Audits England and Scotland - New clinical terms have been added to the Prenatal Pertussis audits for England and Scotland.

Vision+ SMS Text Messaging

• Vision+ SMS Text Messaging - As part of SIS 10380 we are introducing Vision+ SMS Text Messaging, a new secure messaging service that enables you to send health care invitations and appointment reminders to patients by SMS text messages.

  You can purchase specific text bundles according to your practice requirements via the vStore, create your own message templates and monitor how many messages have been sent and received by patients.

• My Health SMS Text Messaging for practices in Wales - Practices in Wales can use the new secure messaging service for appointment reminders and health care invitations. For more information contact your Health Board.

Vision+

• Quarter 3 2014 Clinical terms - Vision+ now includes the Quarter 3 2014 Read dictionary.
• Patient Date of Birth Display - The patient's date of birth displays throughout Vision+ patient mode.
• Smoking Data Entry - The clinical term data entry screen for smoking has changed so that the Show More option is now a check button to allow the removal of extra clinical terms.
• Automatic Download Web files - Vision+ templates can now be set to automatically download. From, SIS 10380 if a template has been set by INPS to auto-download Vision+ checks Download Web Files and if a newer version of the template is available it downloads it.
• Contract Manager Graph Points Corrected - The Vision+ Contract Manager graphs show points against aspiration. Since SIS 10350, some practices have reported that some graphs were incorrectly displaying the wrong the points. This has been resolved in SIS 10380.
• Retired Indicators - Previously, retired indicators still displayed in Templates even if you had not reactivated them in Vision+ Settings. This has been resolved in SIS 10380.

Calculator Changes

• CHA2DS2-VASc Score for Atrial Fibrillation Stroke Risk - Vision+ now includes the new CHA2DS2-VASc score which calculates stroke risk for patients with atrial fibrillation.
• Diabetes Risk Calculator - The Leicester Practice Diabetes Risk Score is now included in Vision+. The calculator helps identify those patients at risk of having undiagnosed diabetes or being at risk of diabetes in the future.
• Enhancements to Calculators - Vision+ Calculators are being rewritten so that they all conform to the same standard which includes a new style and layout. The JBS 2 CVD Risk Calculator is the first to be redesigned along with the QAdmission Calculator which has been modified. The new Diabetes Risk Calculator is the first of the new calculators to adopt the new standard.
• Spirometry Calculator - The Spirometry Calculator includes a number of changes.
• Calculator Scores filed with the Event date - Previously, if saving a Vision+ Calculator Score the system date was recorded and not the event date. This has been fixed in SIS 10380.
  Note - After upgrading to DLM480 (along with SIS 10380), Vision+ Calculator Attachments will also be saved with the event date and not the system date.
• QAdmission - The QAdmission Calculator has been updated so that it no longer includes patients taking Gabapentin medication with no diagnosis of epilepsy or patients on an inhaler with no diagnosis of Asthma or COPD.
• Christo Calculator - The Christo Calculator questionnaire now prints correctly.

Template Changes

• Care Pathway Icon on the Quick Toolbar - There is a new Care Pathway icon on the quick toolbar within Vision+ Templates. This allows you to view extra guidance for managing patient care.
• Green Tick Icons in Vision+ Templates - The green tick boxes in Templates display if there is a corresponding Alert Pop-up and if the Alert requirements are met.

Mail Merge Changes

• Calculator Tab - From SIS 10380, you can bulk add the JBS 2 CVD Risk Score or the Diabetes Risk Score to a group of patients.
• Bulk Insert Tab - Some of the mail merge options have been moved to a Bulk Insert tab.

Template Designer

• New Calculators in Template Designer - Using the Template Designer module you can add the CHA2DS2-VASc or Diabetes Risk score to any templates you have created or modified.
• Default clinical term option in Template Designer - From SIS 10380, you can set a default clinical term to be entered automatically without having to choose the code from the clinical term data entry screen.

Anticoagulation Manager

• Anticoagulation Manager Planned Duration - In Anticoagulation Manager you can set an end date for the patient's planned duration of treatment.

Vision+ Changes Scotland Only

• CHI Number Merge - When creating a mail merge template in Vision+ the NHS number merge field has been replaced with CHI number.

SIS 10350 (03/10/2014)

nGMS QOF 2014-15

• England - Version 29.001 QOF Business Rules for 2014-15 (Vision+ and Clinical Audit) - SIS 10350 delivers version 29 of the nGMS QOF Audits for England. This is in line with the GPES extraction required for QOF.
• Northern Ireland - Version 28.006 QOF Business Rules 2014-15 - Practices in Northern Ireland will be updated to the version 28.006 Business rules on receipt of SIS 10350.
• Scotland - Version 28.012 QOF Business Rules 2014-15 - Practices in Scotland will be updated to the version 28.012 Business rules on receipt of SIS 10350.
• Wales - Version 28.012 QOF Business Rules 2014-15 - Update to QOF Exception clinical terms - The Version 28 QOF Exception Codes for Wales have been updated since first issued in SIS10330. All practices in Wales must resubmit their QOF reports for 2014-15 with the corrected codes. On receipt of SIS 10350 a re-submission of your QOF audits will automatically be performed - no user intervention is required.

Vision+

• New Warning Message in Consultation Manager - A new warning message displays when you select a patient in Consultation Manager advising that Vision+ is still updating the patient database. Once this message disappears the Alert screen will display.
• Spirometry Calculator - The Spirometry Calculator has changed so that when you record the patient's Spirometry score it now records the clinical term 3396200 - Percentage of Predicted forced vital capacity with the correct % unit of measure rather than L unit of measure.
• Template Design - Recovery Calculator - Previously, if you created a template in Template Designer which included the Recovery Calculator the clinical term in the Codeset was wrong in the picklist. This is resolved in SIS 10350.

Vision+ England Only

• Unplanned Admissions Exporting the Named GP - Previously when you exported a list of patients from the Unplanned Admissions report in Vision+ Reports the CSV (comma separated value) file did not include the named GP. This has been resolved in SIS 10350.

• Anticoagulation Manager - We have created a new Anticoagulation Manager tool that can be purchased and downloaded on receipt of SlS 10330. Anticoagulation Manager consists of Alerts for missing/due data, Templates and Reporting facilities and replaces the previous warfarin management tool. For more information please contact your Account Manager. See Anticoagulation Manager.

Vision+ Changes

• Patient Alert Pop-up Mail Merge Facility - You can now mail merge a letter from the patient's alert screen within Consultation Manager.
• Facility to Save Calculators and Questionnaires in the Patient Record - It is now possible to save Vision+ Calculators and Questionnaires in the patient's record as a PDF file.
• Calculators - Four new calculators have been introduced to the Lifestyle category.
• Icons in Vision+ Templates - Vision+ templates have been enhanced to show new icons at the beginning of each indicator and category line to match the colour scheme used.
• Vision+ Letter Templates - The Vision+ letter template icons and names have changed.
• Merge fields for Mobile number and Email address - You can now merge the patient's mobile number and email address in patient correspondence.
• Vision+ Patient Target Lists include Mobile numbers and Email addresses - Patient lists in Vision+ Reports now include the patient's first mobile number and email address.
• Template Designer Clinical Term Footers - The Template Design module now includes a facility to add a comments box to a template line.
• Mail Merge Invite Status - If performing a mail merge on a QOF category that does not have a specific invite clinical term, the History Entry now includes the QOF category in the comments box.
• Lifestyle Advice Using Scot-PASQ (CVD PP003 Scotland) - For practices in Scotland, you can view CVD PP003 on the Vision+ QOF Template if you have recorded the clinical term 38Q5 - Scottish Physical Activity Screening Questions or clinical term 68L - Exercise status screening. Previously you could only view clinical term 38Q5.
• eGFR Calculator - The eGFR Calculator now includes the option to produce a Linear or Exponential graph.
• Template Designer Default Comments - You can now attach pre-defined comments to a clinical term that displays every time you choose the clinical term in Vision+.
• Template Designer URL - You can now add https URLs to the URL control in Template Designer.
• Rules and Codesets - Some practices experienced speed issues after downloading files from Download Web Files. This has been resolved in SIS 10330.

England

• Unplanned Admissions (DES) Outcomes Manager - In order to assist practices in England with the Unplanned Care Direct Enhanced Service (DES), INPS have created the Unplanned Admissions Outcomes Manager module. Using Vision+ functionality, the Unplanned Admissions Outcome Manager helps practices easily meet the requirements of the DES and includes the following tools:

• Admissions Risk Stratification Reports
• QAdmissions Risk Calculator (if purchased)
• Personalised Care Plan Manager Register and Template
• Personalised Care Plan Manager Reports
  Click here for useful quick reference information detailing how to get started and what you have to do for the Unplanned Admissions DES before 31st July 2014.
  Important - Please contact your INPS Account Manager who will arrange to have the Unplanned Admissions Outcomes Manager enabled ready for you to download.

Vision+ Changes

• Quarter 1 2014 Clinical terms - Vision+ now includes the Quarter 1 2014 Read dictionary.
• QRISK Calculator - The QRISK calculator in Vision+ now considers Diabetes type 1 and 2 within the risk calculation.
• Mini Mental Health State Examination - The Mini Mental Health State Examination (MMSE) has been removed from Vision+ because it is longer licensed.
• Vision+ Alerts Refresh Bug Fix - The Vision+ alerts screen is now immediately refreshed when alert criteria has been met in Consultation Manager.

• Version 27 QOF Business Rules - SIS 10245 brings a new version of the Business Rules v27 for Vision+. This supersedes the previous version 26.0. To check the changes in the Business rules refer to the Clinical Audit on-screen help.
• Undo All Entries - There is a new Undo All option available when adding data to Templates. This allows you to remove all clinical term entries that have been added since accessing the template. See Undo All Entries.
• Scheduler - Vision+ now includes an option to schedule the generation of QOF lists, Contract Manager and Data Extracts within Practice Reports. The scheduler is available for practices with their own server (LAN) practices.
• ABPI Calculator - Vision+ now includes an Ankle Brachial Pressure Index (ABPI) calculator. See ABPI Calculator.
• Warfarin Dosage System - The Warfarin reports have been updated for practices using the existing Vision+ Warfarin Pathway and Anticoagulation Reports.
• Records with End Dates - Patients with an End Date recorded on the History or Problem Structured Data Areas (SDA) are no longer counted by Vision+ as being on a Register. See Add to Register.
• Latest, First and New - Vision+ has been updated so that it now applies the appropriate business rules and takes into account the patient's latest or earliest record.
• Skins - The 'Skins' option within the Vision+ Settings has been removed so that it is no longer possible to change the appearance of Vision+. The default setting is ‘Office2010Silver’. If you have changed the 'Skins' setting you will automatically revert back to the default setting.
• Scot-PASQ Calculator - The Scot-PASQ calculator can now be selected from the Alert screen or from the Calculator section of Vision+.
• Patient Synchronisation - When Vision+ was installed a full synchronisation was performed which synchronised all the patients on Vision, including those patients who are Transferred Out. If a synchronisation is required again (as advised by the Helpdesk), it will only include patients who have Transferred Out within the past 2 years. On installation, SIS10245 will perform a resynchronisation.
• CVD Primary Prevention (CVD PP001) - Vision+ now only looks at the latest entry when looking for patients with a new diagnosis of Hypertension.
• Alert Pop-up Display problems - Some users with admin rights have experienced intermittent problems with the Vision+ alert pop-up displaying then instantly disappearing. This is now resolved.
• Contract Manager - Some larger practices had an error message when running Update Results in Contract Manager. This has been resolved in SIS 10245.
• Temporary Patients - Temporary patients who are registered and removed, for example Transferred Out, on the same day, are no longer included in the Vision+ Recalls.
  Note - Temporary patients registered and deducted on the same date are usually test patients who are used for training purposes
• Discontinued Clinical terms - Discontinued clinical terms are no longer included in Contract Manager, Alerts and Practice Reports.

Vision+ Scotland Only

The following changes are implemented for practices in Scotland:

• CVD Primary Prevention (CVD PP003) - The Contract Manager report now includes patients with a new diagnosis of Hypertension after the 1st April 2009 given advice on increasing activity using the Scot-PASQ (68L, 38Q5) after 1st April 2013.
• Target Threshold change for CVD Primary Prevention (CVD PP003) - The higher target threshold has been updated to the correct value of 90%.
• Medicine Management (MED003) - Medicine Management is now looking back 12 months instead of 15 months.

• ScriptSwitch and Vision+ - ScriptSwitch is now compatible when prescribing from Vision+.
• Prescribing Drug Defaults - If you prescribe a drug from Vision+ the drug defaults are now automatically populated.

England, Wales and Northern Ireland

• Vision+ Changes - As per our recent announcement on the INPS blog, we have made some changes to the way Vision+ is accessed. This is so that we can continue the rollout of scheduled DLM releases and properly address the intermittent freezing and crashing in Vision+ that a minority of practices are experiencing. On receipt of DLM 457, you will notice that the Vision+ menus have been removed from the Vision front screen and there is a new Vision+ floating toolbar in Consultation Manager. We are hoping to reinstate the Vision+ menus in the near future. All Vision+ functionality remains unchanged but please read the following topics to familiarise yourself with this and other minor changes:

• Vision+ In Consultation Manager - Vision+ icon and menu in Consultation Manager is now replaced with a Vision+ floating toolbar where you can access all your Vision+ patient functionality. See Accessing Vision+ .
• Vision+ Module Access - The Vision+ menus have been removed from the Vision front screen ribbons. Vision+ modules are now accessed by right clicking on the Vision+ button in the Windows Notification Area. Your individual Vision+ settings are now only accessible from here. You can also access the Vision+ patient menu from here if you have a patient selected in Consultation Manager. See Accessing Vision+ .
• Vision+ Versioning - Vision+ Versioning details have changed. See Installation and Vision+ Versioning.
• Vision+ Security Settings - From DLM 457, access to Vision+ is no longer determined by Control Panel - Security settings, all Vision users can access all the Vision+ modules. See Security Access to Vision+.
  Note - Unless specifically stated in these release notes, all other aspects of Vision+ Functionality remain unchanged.

Scotland

• Vision+ Integration - DLM 457 introduces a new free of charge QOF management and practice protocol tool called Vision+. This exciting new update to Vision includes real-time alerts for additional QOF points, practice-based protocols and a simple but powerful recall and reporting facility.

  When a patient record is open in Consultation Manager, Vision+ shows missing or incorrect contract information and provides intelligent templates for fast data recording. There are also additional reporting facilities to help with QOF and protocol management.

  Practices can also create their own protocols that alert users to missing information during consultations alongside the existing QOF related alerts.

  Some practices in Scotland may already be familiar with the functionality that Vision+ offers, however, please see Getting Started to recap or familiarise yourself with how Vision+ works within Vision.

• Clinical Audit QOF Reminders - For practices in Scotland on receipt of DLM 457, your QOF reminders in Clinical audit will be disabled. This is because Vision+ will now be the principal tool for QOF alerts and data entry.

• Oxford Calculator - The Oxford Hip and Knee calculators now only calculate the score once all questions have been selected.
• ASSIGN CVD Score - The Vision+ ASSIGN calculator score has been updated so that it now matches the latest algorithm from the ASSIGN Score website (version 1.5, October 2013).
• Read Dictionary Quarter 3 - Vision+ has been updated to incorporate the Quarter 3 2013 Medical clinical terms Release of the Read dictionary.
• Pinning Vision+ Alerts - The Vision+ alert screen can no longer be pinned to task bar on Windows 2008/7 clients. Note this will not remove existing pins, they must be manually unpinned.
• Vision+ Error Reporting - The contents of Vision+ error dialog box has been updated so that it no longer contains patient demographic information.
• Vision+ Letter Template Folder - For hosted practices, Vision+ mail merge now points to the correct letter template folder (p:\visionplus).
• Various behind the scenes fixes are also included in this release.