ConnectingOntario ClinicalViewer Release 9.2 Changes - Contribution November 2017

Release 9.2 Changes Contribution Integration of ConnectingOntario and Provincial Client Registry PCR Integration and Merged Patients Admin Portal Changes Post R9.2 Testing

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 allows for more accurate patient searches and more sophisticated client matching resolving duplicates ConnectingOntario contribution processes will change for sites in flight for contribution implementation

PCR Golden Record Each record from a given source is stored in the PCR as a distinct record (member) Based on a matching algorithm and supporting business processes, PCR links these source records into a distinct person (entity) which is assigned a PCR managed Enterprise Client ID (ECID) The ‘Golden Record’ is a virtual record assembled in real-time for a given person entity, returning the latest demographics based on the date and time updated for a given attribute across sources

Provincial Client Registry (PCR) What is contained in PCR and available in ConnectingOntario ClinicalViewer? Patient Information from PCR Where displayed in ClinicalViewer Health Card Number (HCN) – Ontario My Workspace Patient Search Patient Banner Medical Record Number (MRN) Legal Name (First, Middle, Last) Patient Search Results Gender Date of Birth (DoB) Home Address – displays under Address Home Phone Cell Phone - displays under Other Phone if available in PCR; most sites contribute only one phone number Patient Search Results and the Patient Banner display information from PCR Data is updated through daily reports received from MOHLTC and in near real-time from hospitals and other sources Other phone number will likely not be available Email is not available in PCR and will not display

PCR Integration and Merged Patients When a patient is merged in the PCR, the query for the surviving MRN will return both surviving and non-surviving MRNs When multiple MRNs are returned from the PCR, the ConnectingOntario ClinicalViewer will display all results relating to all retrieved MRNs The merge workaround that is presently in place will no longer be required, but will not result in complications Important Note: If the workaround is in place for merges, a reciprocal workaround will need to be in place for unmerges otherwise documents and visits which have been moved to the previously surviving MRN will remain on that MRN

R9.2 Admin Portal Changes A number of enhancements in Admin Portal will facilitate site monitoring and handling of errors DLQ/EQ Viewer is renamed to Error Viewer

R9.2 Admin Portal Changes Updated Error Viewer Fields : Dead Letter Queue and Error Searches Search results display the Error code/Description/Error list columns instead of the Transaction ID/Source System ID/Sender ID. It is no longer necessary to use the magnifying glass to view the error details The following columns are available in the error viewer search results for Dead Letter and Error searches: Sending System Message ID MRN Message Type Severity Error code Description Error List Timestamp ER7 string Resolved Flag Related to

R9.2 Admin Portal Changes Resolved flag added to the Error Viewer Enables users to identify which errors have already been addressed. It is available as a search parameter, and the default search is for errors that are Not Resolved Search Query Search Result

R9.2 Admin Portal Changes ‘Related to’ field added to the Error Viewer A free-text field entitled 'Related to' has been added to the Error Viewer This enables a site to identify other related issues against an error Free text entered in the “Related to” field is not searchable

R9.2 Admin Portal Changes Updated Error Viewer Fields: Suspend Errors Suspend errors: unknown or generic exceptions that require further investigation to determine the root cause of the issue, and subsequent corrective actions The following columns are available in the error viewer search results for Suspend searches: Severity Error code Description Error List Error List Sending System Message ID Message Type Timestamp ER7 string MRN Diverted Messages

R9.2 Admin Portal Changes Updated Error Viewer Fields: Diverted Messages Diverted Messages: messages associated with the suspended patient message.  The first message is suspended and subsequent messages for that patient are diverted to the suspended queue The following information is displayed for the diverted messages: Timestamp Message ID Message Type Sending System Message Content

R9.2 Admin Portal Changes Export Site/Solution Administrators with access to the Error Viewer can now perform their own error handling and remediation processes more easily by exporting data into reports which contain the following fields: Message ID Timestamp HL7 Message Type Severity Error Code Description Source System Name

R9.2 Admin Portal Changes Date no longer required to search for a specific Message ID It is no longer necessary to specify a date when searching for a specific Message ID using the Error Viewer Removal of Date Range Restrictions Prior to release 9.1 the DL/EQ Viewers were limited to retrieving messages received within the previous 2 days The revised Error Queue viewer supports specifying an arbitrary date range for messages to review PCR for testing of not live sites. Admin portal is for all sites - live sites and non-live sites doing testing

Post R9.2 Testing eHealth Ontario is performing it’s own testing of the iCR/PCR transition iCR/PCR transition regression testing is not required by current contributing sites to both PCR and CDR

Post R9.2 Testing Site Testing of CDR after Release 9.2 To facilitate testing of CDR after R9.2 when PCR is integrated, a site needs to be conformant with and contributing to PCR prior to CDR contribution Conformance Testing: Sites will need to point any test systems to feed test ADT data to the PCR lower environment, using their existing PCR interface design over the existing MPN connection Clinical Validation: No impact as a result of PCR integration Each site is expected to support an ongoing (or existing) ADT feed to PCR, as well as the clinical feed to CDR

Post R9.2 Testing Test patient/Test data post R9.2 The PCR and the ConnectingOntario Clinical Data Repository (CDR) are supported by independent environments for both production and non-production needs Test patient/test data sent to the CDR today will not auto-populate the PCR lower environment To perform conformance testing Post 9.2, any test data/test patients will need to be contributed to both the CDR PST environment and PCR “PST” equivalent environment Sites that are already contributing to PCR today should already have a connection to the lower PCR environment, using the existing PCR interface configuration used by the site today to send their ADT data to eHealth Ontario Data source sites have to send 2 distinct feeds; one to PCR over a managed private network (MPN) as many hospitals currently do today, and the other data feed to the CDR. All but a small number of hospitals in the province are already contributing ADT data to the PCR, using a separate specification and interface configuration

Post R9.2 Testing Conformance testing and test patients in PST CDR (iCR) Currently, there are no plans to migrate data from the iCR lower environments to the PCR lower environments. Conformance testing approach recommended for sites scheduled for testing during this time is defer their conformance testing post R9.2, or complete conformance testing prior to R9.2 to avoid having to resend test patient data, or send test data to both CDR PST environment as well as PCR CONF environment concurrently, to ensure test patients are available in both environments

For more information Questions? Email: connecting.ontario@ehealthontario.on.ca