Richer medication and indication tags

Touchdose now displays every tag that is relevant to the screen you are on, rather than only a fixed set of tags. This includes a new group of typed tags that can convey clinically meaningful information at a glance — for example that a medication is a controlled drug, that it is subject to a prescribing restriction, which line of therapy an option represents, or that relevant guidance applies.

Tags that apply to a medication are shown next to the medication name, and tags that apply to a particular indication are shown alongside that indication, next to the source. Touchdose no longer decides which tags to show based on their type; the system returns only the tags that are pertinent to each screen, and all of them are displayed. Clicking a tag continues to reveal any additional detail or link exactly as before.

🔧 Maintenance​

Reliability and security improvements

This release includes a range of behind-the-scenes improvements to the SMART-on-FHIR application and RxConnect, including more reliable SMART and CDS Hooks launches, hardened authentication, updated core dependencies, and infrastructure changes to improve performance and resilience.

📘 Documentation​

The Instructions for Use document has been updated to reflect the new tag handling. Highlights:

• The Tags sections on the Select medication, Select indication, Search by indication, Select dose recommendation and Medication order pages now explain that every tag relevant to the screen is displayed.
• The guidance now describes where tags appear: tags relevant to the medication are shown next to the medication, and tags relevant to an indication are shown alongside that indication, next to the source.
• Tag examples have been updated to reflect the new typed tags (such as a controlled drug or a prescribing restriction) in place of the previous fixed set.

Adjusted body weight support in obesity-related dosing workflows

Touchdose now supports adjusted body weight (AdjBW) where the underlying formulary instructs its use for obese patients. This means obesity-related dose calculations and smart alerts can now refer to either ideal body weight (IBW) or AdjBW, depending on the formulary content and the patient context.

Where relevant, the patient header also now shows adjusted body weight as a derived patient parameter, alongside the method used to calculate it.

Clearer handling of medication-context launch failures

In medication-context launch workflows, Touchdose now more clearly depends on successful medication lookup before the prescribing flow can continue. If the incoming medication cannot be resolved from the launch context, the user cannot proceed into indication selection for that launch.

Blocking order writeback where it cannot be performed safely

Order writeback can now be deliberately blocked for orders that cannot be safely or correctly transferred into the EP System's order form — for example a continuous infusion, whose dose is expressed as a rate that the order form cannot represent. When writeback is blocked for an order, the Add order button remains disabled even when all decisions within Touchdose have been completed, in the same way it does when a required decision is still outstanding. The clinician completes the order using the standard EP System order form, exactly as they would when viewing dose recommendations outside the ordering workflow.

This behaviour is controlled per client through the localisation mapping configuration, so which orders are blocked is determined by each organisation's setup. It is distinct from the existing case where an individual field simply has no equivalent in the EP System: there, the order is still written back with that one field left blank, whereas a blocked order is not written back at all.

For full details, see Limitations relating to order writeback into the EP System and Adding the order to the EP System.

🔧 Maintenance​

Order writeback field mapping updates

Order writeback mappings have been updated to better support separate strength-based and volume-based dose fields where required by the integration.

📘 Documentation​

The Instructions for Use document has been updated to reflect the changes in this release. Highlights:

• Dosing weight guidance updated to reflect support for both IBW and AdjBW in obese patients where required by the formulary.
• Derived patient parameters updated with a dedicated AdjBW section and patient-header display details.
• Smart alert guidance updated so obesity alerts can describe either IBW or AdjBW.
• Glossary updated with the AdjBW definition.
• Medication-context launch guidance clarified in line with medication lookup requirements.
• Adding the order to the EP System on the Medication order page now explains that the Add order button can remain disabled for orders that cannot be safely written back, with the clinician completing the order manually on the EP System order form.
• The Limitations relating to order writeback into the EP System section now distinguishes a blocked order (not written back at all) from a single unmapped field (written back with that field left blank).

Analytics for the order writeback workflow

New analytics have been added to capture key events within the in-order writeback workflow introduced in v2.2.3-1.0.0. These provide visibility into how the Add order action is being used end-to-end, supporting ongoing monitoring and improvement of the writeback experience.

Updated dependencies

Updated core dependencies to improve performance and security.

Order writeback into the EP System

Touchdose can now transfer the dose recommendation built within the application directly into the EP System's pre-signature order form. Where supported by the integration and the launch context (typically an in-order launch, in which Touchdose is launched with a medication context already set), an Add order button is shown on the medication order screen. Once all decisions within Touchdose have been completed, clicking Add order populates the EP System's order form; Touchdose then closes and the order form opens for the clinician to review, complete any unpopulated fields, and sign.

The fields typically populated by order writeback include medication, indication, brand, dose quantity, dose unit, frequency, duration, duration unit, route of administration, formulation, special administration instructions, and PRN status. Not every order will contain values for all of these, and some values may not be transferable to the EP System and will be left blank.

The clinician retains full responsibility for the resulting order. Existing clinical decision support in the EP System — such as duplicate checks and interaction alerts — continues to operate as normal and is not bypassed by the use of Touchdose.

For full details, see Limitations relating to order writeback into the EP System and Adding the order to the EP System.

Additional Touchdose fields written back to the EP System

Three new fields are now written back to the EP System as do-not-display fields, intended for downstream comparison and traceability rather than for clinician review on the order form:

• Touchdose dosing weight — the dosing weight used by Touchdose when generating the dose recommendation. If ideal body weight (IBW) was used, the value is appended with "IBW". A dosing weight is returned whenever Touchdose has a weight available, even if it was not used in a dose calculation.
• Touchdose dose recommendation string — a textual representation of the dose recommendation that Touchdose presented. This allows the order ultimately placed in the EP System to be compared against what Touchdose originally recommended, surfacing any manual adjustments made by the clinician in the order form.
• Touchdose SMART tracking number — a UUID identifying the Touchdose session.

Max Dose/Time now always included in administration information

Max Dose/Time information is now included in the administration information on the order form for all relevant orders. Previously this was only included when the order was marked as PRN.

Localisation and Datacomposition in the About panel

The localisation property has been added to the information resource and is now visible from the About panel. Datacomposition information is also now displayed in the same place.

🔧 Maintenance​

Performance improvements

A range of performance improvements have been made across the application.

Security improvements

A range of security improvements have been made across the application.

📘 Documentation​

The Instructions for Use document has been substantially updated to reflect the changes in this release. Highlights:

• New section Adding the order to the EP System on the Medication order page describing the Add order button and the order writeback workflow.
• New Limitations relating to order writeback into the EP System subsection covering availability, field coverage, and opt-in use.
• Order writeback referenced in Intended use, Warnings, and Contraindications, with clinician responsibility for the resulting order called out at each touchpoint.
• Technical overview restructured into Deployment configurations (Standalone vs Integrated) and Launch contexts (patient-context launch and in-order launch as examples).
• New Observation writeback subsection in Patient inputs distinguishing the existing weight/height EHR-update behaviour from the new order writeback.
• New glossary terms: In-order launch, Patient-context launch, Order writeback, Observation writeback, Standalone, EHR.
• "Integrated workflow" renamed to In-order launch throughout, with breadcrumb behaviour clarified on the affected prescribing journey pages (the medication is fixed for the duration of the flow and the breadcrumbs do not allow navigation back to a medication selection step).
• Patient header section moved earlier in the sidebar so it precedes the prescribing journey.
• A range of clarity, terminology, link, and typo fixes across the document.

Range dose rounding

Fixed an issue where range-based doses with divisions were not correctly applying rounding calculations.

Brand name on indication screen

Fixed brand name not appearing on indication screens.

🔧 Maintenance​

Improved internal checks

Enhanced validation and reliability across the application.

Updated dependencies

Updated core dependencies to improve performance and security.

Smarter rounding for range doses

We now provide intelligent rounding suggestions for range-based doses. These appear as quick-select buttons alongside the existing Minimum and Maximum dose values, making dose selection faster and more accurate.

When a rounding suggestion is shown, we clearly display the percentage deviation from the original calculated value, so users always understand the impact of the rounding.

Introducing Tags

We’ve introduced a new Tag system that appears across all key screens in the user journey. Tags can be linked to a medication or a condition and are designed to surface important contextual information at a glance—such as funding status, whether something is a high-cost drug, inclusion in a NICE TA, and other relevant classifications.

Many tags are also interactive: they can be tapped to reveal additional detail or used as direct links to external sources for deeper reference.

In this release, we've introduced a refreshed UI design. While the UI functionality remains the same as the previous version, our goal has been to keep the interface as familiar as possible while improving clarity and usability.

Dose resolution screen​

The final screen for the dose flow has been updated to allow users to select the desired value when multiple options are present for route of administration, medication formulation, duration, frequency, or dose. This provides a clearer dose recommendation once all selections have been made.

In this release, we’ve introduced a new design system. While the UI remains almost identical to the previous design system, you may notice subtle changes in certain design elements. Our goal has been to keep the interface as familiar as possible, while improving clarity and usability.

Patient header layout​

The patient name is now displayed in line with other patient details rather than at the top of the header. This change frees up vertical space, addressing the screen space constraints some users experienced in Cerner.

Link-out icons for sources​

Sources with an underlying link now display a link-out icon. This makes it clearer that these sources are clickable and helps distinguish them from non-linked sources.

Improved indication search results​

When searching by indication, conditions are now grouped under a single medication entry rather than repeating the medication name for each matching condition. This reduces visual clutter and makes it quicker to scan through medications and find the right condition–medication pairing.

Analytics Fix​

Resolved an issue where some analytics data was missing.

Screen Size Adjustment​

Fixed a layout problem where the bottom of the screen was being compressed.

Indications Search​

• Fixed: Resolved an intermittent issue where the application would become unresponsive during indication searches

Dose Resolver​

• Fixed: Corrected dose story display logic where division was incorrectly shown in specific scenarios
  • The default story now properly handles division display rules
• Fixed: Resolved frequency deselection behavior
  • Deselecting frequency now correctly resets the dose story to the default state as expected

Fewer Clicks, Faster Workflow​

Selecting your desired dose recommendation is now quicker — simply choose your option without needing to click “Proceed.”

Expanded Support for Routes and Units​

We’ve added support for new routes of administration and measurement units.

Feedback form​

You can now share your thoughts with us using our new feedback form. Just click the feedback button located in the top-right corner of the screen—above the search bar and below the patient header. We welcome and appreciate all feedback.

Creatinine and eGFR​

Touchdose can now retrieve creatinine levels for children and display the patient-specific reference range. If the value falls outside this range, it will be clearly highlighted. We also check the recency of creatinine results—if a value is outdated, it will not be shown in the patient header. However, you can still access the value and its date by clicking on the out-of-date symbol.

If the patient’s height is available, Touchdose calculates an estimated glomerular filtration rate (eGFR) using the Modified Bedside Schwartz equation and categorises it according to KDIGO guidelines. A renal caution is triggered if the patient’s eGFR is below 45 mL/min/1.73m² or if height is unavailable—preventing eGFR calculation—but the creatinine level is elevated.

It’s important to note that Touchdose does not factor creatinine or eGFR into dosing recommendations. Adjustments based on this information remain the prescriber’s responsibility. This data is displayed in the patient header under a section labelled “For information only.”

Rounding​

When Touchdose performs dose calculations based on a relative formulary dose, it suggests rounding options above and below the calculated value within a 5% tolerance. The system prioritises rounding to the fewest significant figures within this range.

Depending on the scenario, Touchdose may present only a rounding-down option, only a rounding-up option, or no rounding suggestion at all. Rounding is not provided for dose ranges, rates, or values explicitly defined in the formulary, nor when constrained by a maximum or minimum dose. Where rounding options are available, Touchdose displays the rounding deviations as a percentage for reference.

Formulary Dose Hover Feature Now Available​

In the Suggested Dose section, the dose and frequency are now underlined, allowing you to hover over them to display a pop-up. This pop-up provides additional details from the underlying formulary, including:

• Dose
• Frequency
• Divided doses
• Dose limits
• Patient group information

These details help explain how the patient-specific dose was determined.

Handling of Relative vs. Exact Doses​

If the underlying dose is not relative (i.e., not based on weight or other patient factors), the formulary dose will be identical to the patient-specific dose.

• If the underlying dose is relative, the pop-up will display:
• The relative formulary dose
• Any minimum or maximum dose limits specified in the formulary

This feature allows users to:

• Check any calculations performed during dose selection.
• Assess whether the patient’s dose is near the boundaries of the recommended dosing range.

The hover feature is available both during the Selecting a dose recommendation stage and at the final step when confirming dose recommendations. For an example, refer to the Formulary dose hover feature in the IFU.

Simplification of the Dose Selection Page​

Previously, when multiple routes of administration, forms, or divided dose options were available, they each generated separate suggested doses, sometimes leading to overwhelming repetition. To streamline this, some decisions are now resolved in the final step, reducing duplication and simplifying dose selection.

Key improvements:​

Divided Doses

• If a divided dose is specified in the formulary, it is now presented as a total dose with divisions rather than being immediately broken down into a dose and frequency.
• In the final phase of prescribing, after selecting a dose recommendation, the system will resolve the total dose into a frequency and quantity per dose.
• If the formulary provides a range of divided dose frequencies, you will be prompted to select a frequency, after which the system will calculate the quantity per dose accordingly.
• For more details, see Handling of divided doses and Frequency selection.

Routes of Administration

• Routes of administration are now grouped together. You will select your preferred route only during the final phase of prescribing, after selecting a dose recommendation and clicking Proceed. See Route / Method selection for details.

Forms

• Different formulations of a medication are now grouped together. You will choose the preferred form during the final phase of prescribing, after selecting a dose recommendation. See Form selection for more information.

Changes to Smart Alerts​

• There have also been changes to how smart alerts are presented. See the Smart alert section for details.
  • When selecting a dose recommendation, only ideal body weight (IBW) smart alerts are displayed.
  • In the final phase of prescribing, after all decisions have been resolved, all relevant smart alerts are shown.

• Ability to configure different zoom settings for each client.

• Enhanced analytics functionality.

• When "Not Obese" is selected, this choice is now applied to dose recommendations for other drugs and conditions.

• A "Not Obese" tag is added to the patient header, allowing you to click for additional details or to reset the selection.

• Dose units are now displayed with enhanced clarity.
• The validation range for children's weight, height, and BMI has been extended from the 0.05th–99.95th percentile to the 0.01st–99.9th percentile, following analytics that showed some children fell outside the previous range.
• Improved error handling allows users to input missing values when required.
• Enhanced error and resolution messages for better user experience.
• Bug fix: Outdated or incorrect unit observations are now properly discarded.
• Percentiles are now displayed to one decimal place if they are over the 99th percentile or below the 1st percentile.
• The obesity modal has been redesigned to present information more clearly, making it easier to resolve issues.
• Improved error messaging for invalid number entries, with an added information button that provides a tooltip explaining how to resolve the error.
• The header popover now requires a click to open, preventing it from closing when the mouse moves away.

• Introduced new analytics features.

• Enhanced performance to reduce initial load time.

• Added a dynamic load screen to keep users informed of the loading stages.

• Support Months as a duration unit

• Support Liquid as a form

• Support for the following new dose units:

  • inhalation(s)
  • pessary(ies)
  • enema(s)
  • inch(es)

• Updated dependencies

• Bug fix when pushing
• Improved analytics

• Fixed an issue with the analytics.