ConnectingOntario ClinicalViewer Release 9.2 Changes - Viewing November 2017

Release 9.2 Changes Viewing Integration of ConnectingOntario and Provincial Client Registry Patient Search Patient List Pre-Admit Documentation Graph Trending in Lab and Pathology Results Portlet User Interface Changes Multiple Concurrent Views into the ClinicalViewer Release 9.2 Fixes

Integration of ConnectingOntario and Provincial Client Registry (PCR) Integration of Provincial Client Registry (PCR) with ConnectingOntario will enhance patient searches and provide current, accurate and trustworthy health care client identity information PCR is a provincial repository of patient identifier and demographic information, forming the patient identity backbone of the provincial electronic health record PCR links individual records from disparate systems to create a client’s ‘golden record’ ConnectingOntario ClinicalViewer will use PCR to query and retrieve patient demographic and identifier data in support of patient search and resolution

Integration with Provincial Client Registry (PCR) Benefits: Allows for more accurate patient searches and more sophisticated client matching resolving duplicates Provide current, accurate and trustworthy patient identity information A patient record is viewable even when the patient information has not been added to the ConnectingOntario Clinical Data Repository by a contributing organization (i.e., hospitals and LHINs) Patient Search Results and Patient Banner display a patient’s ‘golden record’ from PCR Data is updated through daily reports received from MOHLTC and in near real-time from hospitals and other sources

The Search button becomes available when the HCN has been entered Patient Search Search by HCN Patient Search has been changed to support the integration of ConnectingOntario to the Provincial Client Registry (PCR) Search by HCN no longer includes the Gender and Last Name fields Health Card Number field remains mandatory and still requires the correct number format (version code is not required) The Search button becomes available when the HCN has been entered

Either DoB or Street Address and City must be entered Patient Search Advanced Search Advanced Search now requires: Last Name and First Name Enter as much information as possible to ensure a patient match is achieved Full spelling of last name and first name are recommended And at least one of: DoB (date of birth) Street Address and City Organization field has been removed Either DoB or Street Address and City must be entered The Search button becomes available when the minimum combination of fields has been filled

Patient Search Because of the matching formula used by PCR, the patient search results may be different than what would have appeared previously Patient demographic information may also be different from your organization’s demographic record for a patient Cell phone has been replaced with Other Phone number Other Phone will display cell phone number as available ‘Other’ phone number also appears on the patient banner Email is not available in PCR and will not display

Patient Search Patient Search Results The search results display the top five best matching results from your query The prompt to refine the search criteria will no longer display if more than five patients are matched to the search criteria. Enter more information if your patient’s name does not display in the top five results When a minimum threshold of matching to the entered search criteria does not occur, a “No patient for these criteria” displays in the results window. You will need to enter more information in the search criteria

Patients List Pre-Release Preparations for My Workspace Patients who do not have a valid Ontario Health Card Number (HCN) in the Provincial Client Registry will be removed from My Patients List and My Recent Patients with the migration from R9.1 to R9.2 The first time searching for these patients after R9.2, it will be necessary to search for these patients again using Search by MRN (recommended) or Advanced Search. They can then be re-added to My Patients List and will appear there normally going forward. This action is required only ONCE after the migration to R9.2

Patient Not Found Following integration with the PCR, you may encounter a rare scenario in which a patient selected from My Patients List or My Recent Patients is not found: In this scenario, you should be able to view the patient by selecting the patient through a Search by HCN or Advanced Search In order to avoid this scenario in the future, it is advised that you delete the patient from the patient list and (if desired) re-add them after searching for the patient and selecting the patient’s record This is due to scenario where the hospital MRN is from hospital that is not contributing to CDR

Patient Information Not Found Pre-admit documentation A very small portion of patients will not have their hospital pre-admission information (e.g., lab results, pre-surgical consultation notes) display from the CDR until they have been admitted and had an MRN assigned Applies to patients who have not made a prior visit to the same hospital (have an existing MRN) Applies to pre-admission information in the CDR only During the pre-admit phase, other information for the patient may be viewable including: Lab and pathology results (OLIS) Dispensed Medications (DHDR) CDR information from other sites (excluding any information linked to the patient’s MRN in pre-admit status) Once the patient has been admitted, the pre-admit info will be available for viewing

Graph Trending in the Lab and Pathology Portlet A graphing functionality has been added to the Lab and Pathology Results portlet to allow for trending results over time for test types that can be viewed on the Flowsheet An end-user selects test types for graphing on the Flowsheet tab. A Graph tab is generated which displays a graph(s) of the selected result(s) for the period selected on the timeline

Graph Trending in the Lab Portlet Select one or more results, then click the Graph button Only numeric values can be displayed as a graph (no dates or alphabetic values) Each selected test type is displayed in a separate graph on the Graph tab Blue dots are normal results, red dots are abnormal

Graph Trending in the Lab Portlet From the Graph tab, select the options as needed The results can be viewed as a line graph Blue bars are normal results, red bars are abnormal The results can also be viewed as a bar graph The system initially displays a line graph by default; then, in subsequent sessions, it defaults to the graph type you last used

Graph Trending in the Lab Portlet Zoom in on particular sections of the graph by drawing a rectangle around them. Reset to the default view by clicking Reset Zoom

Graph Trending in the Lab Portlet Show Data Labels button displays in Graph tool bar when data point values are hidden Hide or show the data point labels for all displayed results: Hover over a data point to see the details for the test: Note: To avoid cluttering up a graph with many results, only the most significant values are labelled. A significant value is: A value that differs by at least 5% of the total results range from the previous point Occurs a significant time after the previous measurement with a visible label (at least 1/10 of the time frame away from the last labeled point)

Graph Trending in the Lab Portlet Save the graph view to store the selected test type(s) for future graphing When graphs have been saved, they are saved to the specific view you are in (i.e., Summary List View or individual Lab and Pathology Portlet view). The Graph tab will be available in that view for future sessions. Selecting it will display graphs of the saved test types for any selected patient and timeline Remove a graph from the saved view by clicking the Remove Graph icon Note: Graphs cannot be printed

User Interface Changes Portlet Continuous Scrolling The pagination on patient information has been removed from all portlets. Information can be viewed by using the vertical scroll bar in each portlet The size of each portlet is set and predefined The ability to set user preferences for the number of rows in a portlet has been removed Use continuous scrolling in both small and full size portlets

Portlet Continuous Scrolling Because the amount of retrieved data can be large, data is loaded in chunks and is sorted as it is displayed (for lab results, the maximum number of lab results displayed is approximately1000; refer to Release 8 changes) A ‘loading more data’ message appears until all data for the selected date range has been retrieved (as per current behaviour in the Lab and Pathology Results and Medications portlets) When all data has been loaded, the green circle is displayed with the total number of results

Multiple Concurrent Views into ConnectingOntario ClinicalViewer In Release 9.1 and prior, it was possible for a single user, using any of a number of techniques, to launch and use multiple instances of the ClinicalViewer at the same time With Release 9.2, this is no longer possible. A user is limited to using a single instance of the ClinicalViewer at any given time, including across different browsers, different devices/workstations, or launching from a hospital information system (HIS) If a user attempts to open a second instance of the ClinicalViewer when they already have one open, the pre-existing instance of the ClinicalViewer will be inactivated

Release 9.2 Fixes R9.2 contains a number of fixes. These include but are not limited to: Consent Override Fixes Overriding consent should now always result in a refresh of the ClinicalViewer and the immediate display of previously blocked data Portlets will no longer display the Consent Directive warning indicating that there are blocked records after consent has been overridden for portlets when no records were returned Lab and Pathology Results Portlet “Group By” sorting feature will now display all possible results Details screen can be viewed prior to all results loading The patient's date of birth in the document viewer is now displayed in dd/mmm/yyyy rather than mm/dd/yyyy Issue is corrected where the ‘from’ and ‘to’ dates initially displayed in the custom time interval dialog may not match the current timeline Refer to “Release 9.2 Fixes” for list of other fixes (to be posted)

For more information Visit ConnectingOntario ClinicalViewer support pages at www.ehealthontario.on.ca under Client Support menu Documents/Release 9.2 folder/Resources Training/ConnectingOntario ClinicalViewer Training/ End User Toolkit Questions? Email: connecting.ontario@ehealthontario.on.ca