1. Welcome to Panorama January 2015

2. This presentation can be modified as you need: Part 1 – Overview of Panorama Contains information about when Panorama will be implemented, differences between Panorama and MIMS and how data was initially migrated into Panorama. It also outlines how Panorama interfaces work. Part 2 – Key Navigation Terms Contains information about Panorama the software application. There are tips and tricks for navigating Panorama and moving around the interface Part 3 - How to Use Quick Reference Cards Describes the why the project team decided to develop QRCs and how to read and use QRCs

3. Agenda Part 1  What is Panorama?  Differences between MIMS and Panorama  When will Panorama be implemented?  Panorama Data  Initial data uploads  MIMS data conversion issues  Interfaces Part 2  Panorama Navigation Key Concepts Part 3  Panorama Quick Reference Cards

4. What is Panorama? Panorama is the electronic public health record that will be used to manage information for: immunizations vaccine inventory communicable diseases/investigation outbreaks Will be used by all public health providers in: Regional health authorities, Manitoba Health, Nursing stations and Community health centres Replaces the current provincial immunization registry (MIMS) and other paper based systems 4

5. Differences between MIMS and Panorama MIMS is an immunization registry that contains immunization records and has been in use for over 30 years in Manitoba – The privacy and security requirements were consistent with requirements of the time – Disclosure directives not available is an electronic public health record that will contain immunization and communicable disease management information for all Manitobans – The privacy and security requirements reflect current legislative and health requirements and practice – Disclosure directives are available for clients who request them Panorama

6. Differences between MIMS and Panorama MIMS users received hands on trained on the production environment using real clients and viewing real data Panorama users will be trained in a training environment using fake clients and data – It is appropriate to provide coaching or support to new Panorama users in the production environment so long as the client information accessed is appropriate. E.g. looking up clients scheduled for clinic to preview immunization history, etc. MIMSPanorama

7. Differences between MIMS and Panorama Panorama will be used as an electronic public health record for immunizations and managing communicable diseases and outbreaks  Users must sign a Terms of Use agreement  Manitoba Health will have the ability to audit or track use in Panorama MIMSPanorama Some public health practitioners used MIMS for non-immunization record management  Users did not sign a Terms of Use Agreement  There was no audit trail in MIMS

8. When will Panorama be implemented?

9. Initial Data Load into Panorama When Panorama goes live in the fall of 2014 it will be pre-populated with data from: SystemData type Date Migrated # Records Client RegistryClient demographic information from the MBH Registry System 2014-10-01~2.2 M MIMS Immunization data: entered by MIMS users uploaded from Physician Billing 2014-10-01~11 M MIMS Reference Data: Facility, RHU, RHA, Physician file 2014-10-01 ~8.5 K VMS Catalogue of vaccines available from MDA 2014-10-01~80 Great Plains Holding Point information

10. Initial data load into Panorama details  Client Name  Address  Birthdate  Sex  PHIN  Family Number C LIENT R EGISTRY Per Immunization  Date  Tariff Code  Provider Number  Provider Type M IMS P ANORAMA  Client Name  Address  Birthdate  Gender  PHIN  Family Number Per Immunization  Date  Agent/Antigen  Provider  Service Delivery Location Catalogue  Agent  Antigens  Dose size Per Immunization  Date  Tariff Code  Physician Code P HYSICIAN B ILLING Vaccine Inventory  Agents  Antigens  Doses size VMS

11. MIMS data- exceptions Comments Comments on individual immunizations were migrated into Panorama as client warnings. The client warning includes the restrict code; tariff code and comment x Restrictions in MIMS were not migrated Any reason a vaccine was not given x Clients are coded into region of residence in MIMS. This is used for reminder letters and immunization certificate. In Panorama clients are not attached to any region or organization. Also any data that is unique to MIMS is not being migrated including addresses and phone numbers in MIMS

12. Clinical Implications of MIMS data not migrated into Panorama Some regions have used the other MIMS fields to include comments on adverse events, consent and contraindications. However, since these fields were used inconsistently, they could not be transferred to Panorama Immunization certificates and reminder letters will be sent from MIMS until a Panorama solution for them is developed later in the project

13. Interfaces to/from Panorama When Panorama is fully functional for immunization and inventory the following interfaces will keep Panorama and MIMS up-to-date Client Registry > Panorama  One way interface to upload new clients to Panorama  Frequency: weekly MIMS Panorama  Two way interface to synchronize immunization information in each system  Frequency: weekly Physician Billing > MIMS  Physician billing one way interface to upload immunization information to MIMS  Frequency: monthly but dependent on Physicians’ submitting

14. Data Synchronization There will not be an interface between Panorama and MIMS during the initial pilot period. We expect the interface to be ready by February 2, 2015 During the pilot period:  immunization data entered into Panorama or into MIMS will not be synchronized into the other system until the interface is active.  No new clients will be uploaded from the Client Registry

15. Panorama Navigation Key Concepts Navigation Panes Recent work Hiding and showing information using the chevrons Fields Embedded finds Factory Table Set in Context Panorama Quirks  Back button  Save  Timeout  Type ahead

16. Navigation Panes Left Navigation Top Navigation Return to the left nav when you get lost or want to start again

17. Recent Work  Displays links to client records that you have recently worked on

18. Show and Hide  The Show Option indicates there is more detail to be displayed  The Hide Option indicates that the detail is being displayed Contains Data  Indicates that the form contains data even though the details are hidden from view

19. Fields Type Ahead Fields  As text is typed the data is searched a character at a time Text Fields  As text is typed no data is displayed to select from

20. Embedded Find  Find features that are located in different parts of the Panorama application

21. Factory Tables  Can contain nothing or several records of details on that item (i.e. Address, Name, Identifier...) Factory Tables Factory Table

22. Set in Context  Identifying the Client that is to be worked on  Places the client into “context” so several updates can be made for that client at one time Client Set in Context

23. Panorama Quirks ×Do not use the back button

24. Panorama Quirks Use the save button

25. Panorama Quirks Timeout:  Panorama will timeout after 20 minutes. Remember to save your work often Type ahead fields and selecting from dropdowns  Panorama will try to match your entry with data from the list. Make sure you double click on the entry to select it. Sometimes this feature is finicky.

26. Panorama Quick Reference Cards What are Quick Reference Cards Why we developed Quick Reference Cards How to use Quick Reference Cards For Trainers: Why you need to include a commercial about QRCs in your training program.

27. What are Quick Reference Cards? Mostly one page workflow documents that outline the steps required to complete a Panorama activity Do not contain screen shots Best Practice advice and tips are included in a section at the bottom Created for most immunization steps Numbered based on their functional area:  0 – set up  1 – Managing Client Records  2 – Individual Immunizations  3 - Mass immunizations  4 – inventory

28. Why? Advice from other jurisdictions to keep training materials simple and free from screen shots since the system can change QRCs were well received in Ontario Able to include many steps on a single page  Instructions with screenshots would be 10 – 20 times longer Expect that users will refer to them as a reminder

30. How to Read/Use the QRCs Start in the upper left hand corner Follow the arrows Note the different shapes and their meaning: Entry or activity in Panorama Decision What Panorama Displays

31. Questions