1. ConnectingOntario ClinicalViewer
Release 9.2 Changes - Viewing
November 2017

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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
is not available in PCR and will not display

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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)

17. 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

18. 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

19. 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

20. 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

21. 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)

22. For more information
Visit ConnectingOntario ClinicalViewer support pages at under Client Support menu
Documents/Release 9.2 folder/Resources
Training/ConnectingOntario ClinicalViewer Training/ End User Toolkit
Questions?