CareConnect: Provincial eHealth Viewer - Squarespace · PDF fileCareConnect: Provincial eHealth Viewer An orientation to British Columbia’s integrated electronic health records solution

CareConnect: Provincial eHealth Viewer An orientation to British Columbia’s integrated electronic health records solution.

Revision Date: October 6, 2015

Document Version: 5.3

This document contains fictional data only.

Table of Contents

2

Slide Introduction 4 What’s Available in the eHealth Viewer 5

eHealth Viewer (CareConnect) Overview 6 Privacy & Confidentiality 7 – 8 System Messages 9 Patient Search 10 – 12 Confirmation of Clinical Relationship 13 Patient Summary 14 – 17 Encounters 18 – 22 Labs 23 – 25 Labs - Provincial - Standard & Secondary Filters 26 – 29 Labs - Disclosure Directive 30 – 31 Labs - Powell River Hospital 32 – 34 Labs - VCHA Historical 35 – 37 Imaging 38 – 41

Table of Contents

3

Slide Documents 42 – 45 Community Summaries 46 – 48 Contacts 49 Registration Info 50 – 51 Preferences 52 – 53 Conclusion 54 Appendices 55 – 72

Introduction

The Provincial eHealth Viewer (CareConnect) is a secure, view-only Electronic

Health Record (EHR) that delivers patient-centric information required to

support healthcare providers in their delivery of patient care. The Provincial

eHealth Viewer (CareConnect) offers authorized care providers 24/7 access to

an integrated, provincial view of clinical information.

• Registration Information

• Encounters

• Documents

• Provincial Laboratories Information Solution (PLIS)

• Provincial Diagnostic Information Viewer (PDIV)

• Community Summaries

4

What’s Available in the eHealth Viewer

5

The eHealth Viewer (CareConnect) Overview

The eHealth Viewer (CareConnect) contributes to the provision

of safe, high quality patient care by providing users with the following:

• Ability to quickly obtain:

o consolidated view of visits/encounters from across Health

Authorities

o details of care (diagnostic images and reports, transcribed reports,

lab results, etc.)

• Supports the continuity of care as patients move across programs and

services

• Enhances the flow of information across the care team

• Reduces the need to phone for reports and results

• Reduces the number of duplicate diagnostic requests

• Improves clinical decision-making

• Increases efficiency by saving time for providers

6

Privacy & Confidentiality

7

Protecting patient

privacy is a top

priority.

Security measures

and privacy

policies and

procedures, are

designed to ensure

only authorized

providers have

access to clinical

information in the

eHealth Viewer

(CareConnect).

This privacy, Confidentiality and Acceptable Use Acknowledgement must be accepted:

• When you login to the eHealth Viewer (CareConnect) for the first time.

• Again once annually for the duration of eHealth Viewer (CareConnect) access.

Privacy & Confidentiality

8

• Please contact your local Service Desk to get in touch

with the Health Authority Privacy Office.

• For more information about eHealth, visit the BC

Ministry of Health’s eHealth website at:

http://www2.gov.bc.ca/gov/topic.page?id=2F9FDDD8

CE5040F0A09872FE5BF1BBE3

System Messages

9

Communication updates about the eHealth Viewer (CareConnect) are posted in the

Message Centre.

• Maintenance – these are messages about system maintenance and downtimes.

• What’s New – these are messages informing users of upcoming changes and

important alerts in the eHealth Viewer (i.e. new data, functionality, etc.).

Patient Search

10

The eHealth Viewer (CareConnect) uses the Provincial Role-Based Access

Model to ensure two fundamental principles:

• Need to Know

• Least Privilege

As such, not all users will gain access to the above patient information within the eHealth

Viewer (CareConnect).

The Enterprise Master Patient Index (EMPI), a registry containing patient demographic

information, returns patient search results. The EMPI is maintained by the Ministry of

Health.

Based on the patient search criteria you entered, you will be presented with 1 patient name

or a list of possible matches to your name search.

Ensure you have correctly identified the patient, based on the basic demographics provided

in the Search Results, before going further.

Patient Search

11

There are three ways to search for a patient:

• Search by PHN

• Search by MRN (VCHA only)

• Search by Name (restricted access based on user’s permissions, as per the

provincial access model)

Enter appropriate

digits and click GO

Patient Search

12

• The ability to search by name is restricted to services/programs that regularly see

patients who do not have a PHN.

• This is not a search option for most users.

• Note: A birth date is also required to search by name.

Enter the Patient’s birth date

(YYYY-MM-DD). You can also put

in an approximate birthdate (i.e.

1940 01 01).

Enter the patients

first name OR first

initial, and Last Name

Confirmation of Clinical Relationship

13

Confirm that you have a legitimate

need to access this patient’s

information by clicking ACCEPT. All

access is audited in compliance with

privacy requirements.

Patient Summary

14

Patient Summary – Demographics

15

• Demographic information is obtained from the Ministry of Health’s (MoH) Enterprise

Master Patient Index (EMPI).

• It is the most current demographic information available for the patient.

• The information may differ from the information contained in Health Authority

clinical systems.

Patient Summary – Alerts

16

The Alerts icon is

viewable in every

data domain -

Click to view Alert

details

• VCHA-PCIS alerts for MRSA and VRE appear in this section

of Patient Summary if they exist for the patient record.

• MRSA and VRE alerts displayed include the system the

alert was entered into (e.g. PHC PCIS, VCH PCIS).

Patient Summary – Encounters

17

• The patient’s three most recent encounters will be displayed.

• If there is no discharged date, the patient may still be receiving care, or the field

has not been updated in the clinical information system.

Encounters

18

The Encounters tab displays information about a specific patient encounter. Encounters are episodes of care and

they are known as:

• “Accounts” at Vancouver Acute / Richmond Health Service

• “Referrals” at Vancouver-Richmond Community

Note: British Columbia Cancer Agency (BCCA) CAIS has no concept of Encounters or Episodes of Care as BCCA

provides life-long care to their patients. To address this, the eHealth Viewer (CareConnect) creates an encounter

upon first admission. All BCCA CAIS patient information and documents are connected to this one unique

encounter. For more information, see the help files within the Encounters tab.

If there are document(s) related to an

encounter, the total number of

documents available will be shown in

the “Documents Available” column

Click to learn

more about

encounters

available.

Encounters

19

3. Select which options to filter.

Options displayed are specific to

the patient being viewed.

4. Click Apply Filters

to show results.

2. Use the Then By dropdown to filter

encounters by Facilities, Services, Patient

Types, Providers, or Source Systems.

1. Use the Filter By dropdown to filter by

date range or the last (number) of records

Encounters – with NavTrack

20

Bolded font and blue “brick” (left side

vertical bar) indicates you have NOT

viewed that specific encounter

Regular font and NO blue “brick”

(left side vertical bar) indicates the

encounter has been viewed

NOTE: NavTrack is also available in other data domains, such as Labs, Imaging and Documents

Click “Reset Viewed” to

reset all rows as NOT viewed

Encounters – with NavTrack

21

NOTE: NavTrack is also available in other data domains, such as Labs, Imaging and Documents

Anchor Row (light blue)

- indicates where you

have last clicked

Focus Row (dark blue) -

moves dynamically with your

mouse pointer

Encounters - Details

22

Highlight the desired

document and click to

display document details

• Additional encounter details appear after selecting the encounter.

• There may be documents (dictated-transcribed reports) attached to an encounter.

Labs

The Labs tab contains results from the following data sources:

1. Provincial lab results from:

• Vancouver Coastal Health

• Providence Health Care

• Provincial Health Services Authority

• Fraser Health Authority

• Interior Health Authority

• Island Health Authority

• Northern Health Authority

• Community (LifeLabs, BC BioMedical, Valley Medical)

• Canadian Blood Services – Diagnostic Services

2. Powell River Hospital results from October 31, 2000 to present for Chemistry,

Microbiology, Hematology and Blood Bank

3. VCHA Historical results prior to March 28, 2012 for Chemistry, Microbiology and

Hematology

23

Labs

24

Information found within the PLIS tab is not exhaustive and cannot be relied upon

as complete, while data is still being added to the Provincial Repository by the various

Health Authorities.

The use of this information is not intended as a substitute for professional judgment.

For more information, see the help files within the Labs tab.

Labs

25

Click to learn

more about

labs available.

Click here to select a

different data source.

• When you navigate to the Labs section, the Provincial (PLIS) data source is displayed

by default.

• Other data sources available are Powell River Hospital and VCHA Historical (prior to

2012 Mar 28).

Labs – Provincial – Standard Filter

26

Results can be sorted by clicking on the appropriate header:

• Collection Date

• Test Type

• Specimen

• Out-of-Range

• Ordering Provider

• Reporting Lab

• Test Status

3. Click on the row

to view a lab report.

1. Standard Filter displays by default:

Use the Filter By dropdown to filter

results by date range or the last

(number) of records.


to show results.

Tip: If the list of results appear greyed out, remember to

click Apply Filters to show results.

27

Labs – Provincial – Standard Filter

4. To print the report,

click the printer icon.

Click to return to the

previous screen.

Labs – Provincial – Secondary Filters

28

4. (optional) Select the checkbox to

display only out-of-range results.

• Selected filter options stay persistent as you navigate through the patient’s record.

• You can combine several filter options to drill down and find the specific result(s).

• Results displayed are based on the selected filter criteria.

1. Select Secondary Filters.


to show results.

2. Use the Then By dropdown to

filter results by Test Types or

Reporting Labs.

3. Select which test types to filter.

Test types displayed in the

Secondary Filters box are specific

to the patient being viewed.

Labs – Provincial – Standard & Secondary Filters • Standard Filter

• CareConnect displays lab results using the standard filter by default.

• Use this option to filter for lab results by Date Range, or the last 15, 30, or 50

records.

• Secondary Filters

• In addition to the Standard Filter, combine additional filter options to filter for lab

results by Test Types or Reporting Labs.

• By choosing this option, the clinician is using a snapshot of lab results that were

available at the time the clinical relationship attestation was confirmed. This

snapshot expires in 60 minutes.

• During this 60-minute window, the same snapshot of lab results is used.

• After 60 minutes have passed, the snapshot is refreshed when the clinical

relationship attestation is confirmed again, or if the clinician returns to Labs.

• This snapshot may not be inclusive of all lab results available in PLIS (i.e. results

that become available within 60 minutes after the noted timestamp are not

viewable).

29

Labs – Disclosure Directive

30

• Patients have the option to place an electronic ‘mask’ called a Disclosure

Directive on their PLIS information.

• If a Disclosure Directive exists, you will be required to enter the patient’s

keyword before accessing this portion of the EHR record and the mask will be

temporarily lifted.

• Some eHealth Viewer (CareConnect) users are provided the option to “override”

the disclosure directive without consent (i.e. not using the keyword).

• The “override” option is only to be used in urgent or emergent care situations.

If you are permitted to override without consent, you will see the option on the

disclosure directive screen.

• Labs (PLIS) Secondary Filters are not available for patient records with

Disclosure Directive.

Labs – Disclosure Directive

31

Option 2: Override

without Consent

Select reason for

Override and click

SUBMIT OVERRIDE

WITHOUT CONSENT.

Option 1: Override with

Consent

Enter the Keyword and

click SUBMIT KEYWORD.

The record will remain

available until

• another patient record

is viewed

• Logs off

• Sessions times out

Labs - Powell River Hospital

32

The Powell River Hospital Labs section displays hematology, chemistry

microbiology and Blood Bank results.

For more information, see the help files within the Powell River Hospital

Labs section.

33

4. Click to

view a lab

report.


1. Use the Filter By dropdown

to filter results by date range

or the last (number) of records.

3. (optional) Select the

checkbox to display only

out-of-range results.

2. Select which

test types to filter.

34

All labs tests associated with the order will appear in the report.




Click to return to

the previous screen.

Labs - VCHA Historical

35

The VCHA Historical Labs section displays hematology, chemistry and

microbiology lab results prior to March 28th, 2012.

Results from:

• Vancouver Coastal Health

• Providence Health Care

For more information, see the help files within the VCHA Historical Labs

section.


36

4. Click to

view a lab

report.

1. Click to filter

labs by date range.

3. (optional) Select the

checkbox to display only

out-of-range results.

2. Select which

test types to filter.


37

All labs tests associated with the order will appear in the report.



Click to return to

the previous screen.

Imaging

38

Imaging results within CareConnect offer healthcare providers access to

Diagnostic Imaging and reports available from the Provincial Diagnostic

Imaging Viewer (PDIV):

• Provincial Health Services Authority (PHSA)

• Vancouver Coastal Health / Providence Health Care (VCH/PHC)

• Fraser Health Authority (FHA)

• Interior Health Authority (IHA)

• Island Health Authority (VIHA)

• Northern Health Authority (NHA)

• Some private clinics within IHA boundaries

For more information, see the help files within the Imaging tab.

Imaging

39

Click to view

navigating tips for

iSite Image Viewer.

Click to learn

more about

images available.


• Exam Date Modality

• Procedure Description Organization

• Body Part Status

Tip: BCCA imaging reports can be viewed along with the images by

clicking the “image” icon.

Imaging

40

1. Use the Filter By dropdown to

filter results by date range or

the last (number) of records.


to show results.

The image will display

in another window.

3. Click on the icons

to view the report or

the image

Imaging – Report

41

The client demographic

information in the header is

retrieved from the Enterprise

Master Person Index (EMPI),using

the most current data from the

provincial EMPI database.

The client

demographic

information from

the Patient

Known at

Radiology as

section is

retrieved from

the radiology

source system

(i.e. iSite).



Documents

42

Dictated/Transcribed reports are clinical reports such as consultations, discharge summaries,

operative reports, history & physical reports, transfer summaries, etc., which are dictated by

physicians and other clinicians.

The Documents tab displays dictated/transcribed reports from:

• The SoftMed and M*Modal systems for Vancouver Coastal Health Authority and PHSA – Children’s & Women’s Health Centre

of BC. Documents excluded are

• Emergency Department Discharge Summaries

• Radiology reports

• Anatomic Pathology reports

• Reports dictated using private dictation services or systems other than SoftMed and M*Modal

• In addition, certain types of dictated/transcribed reports are not currently included in eHealth Viewer

(CareConnect) for patient privacy reasons (i.e. psychiatric consults, sexual assault reports and therapeutic abortion

reports).

• CAIS for PHSA - BC Cancer Agency (Southern Interior, Vancouver Centre, Fraser Valley Centre, Vancouver Island Centre,

Abbotsford Centre and Centre for the North). Documents include:

• History & Physical

• Transfer Summary

• Progress Note

• Consultation

• Anesthetic Consultation • Discharge Summary

• Operative Report

• Treatment Note

• Letter

• Outpatient Clinic Note

• Televisit

• Diagnostic Report – PET Scan

Documents

43


• Date Facility

• Document Type Source System

Click to learn more

about documents

available.

Documents

44

5. Click on the

row to view a

document.

2. Use the Then By dropdown to filter

documents by Facilities, Document

Types, or Source Systems.

1. Select an option to filter

documents by date range or

the last (number) of records.

3. Select which options to filter.

Options displayed are specific to

the patient being viewed. 4. Click Apply Filters

to show results.

Documents - Report

45

Click to return to

the previous screen. 6. To print the report, click

here to open the printable

version, then click the

printer icon.

Community Summaries

46

The Community Summaries tab displays a select set of data that was identified to

provide the most clinical value, from the following instances of PARIS (Primary Access

Regional Information System) - Vancouver Coastal Health Authority.

The data represented in the Community Summary is a subset of information available

via PARIS. Community Summary information is not available in the eHealth Viewer

(CareConnect) if a patient does not have associated information as indicated by this

subset/list.

If a patient record has a privacy “block” at the PARIS end, the records are not made

available in the eHealth Viewer (CareConnect). Also note that the application generates

the Community Summary in real-time upon request, displaying the most up to date

information.

Community Summaries

47

1. Click to view a community

summary report.

This date reflects the last update

to the patient’s record in PARIS.

Community Summaries - Report

48

The client demographic information

in the header is retrieved from the

Enterprise Master Person Index

(EMPI),using the most current data

from the provincial EMPI database.

The client demographic information from

the DEMOGRAPHICS (FROM PARIS)

section is retrieved from PARIS.



Contacts

49

The Contacts section displays the most current contact person (i.e. emergency

contact / next of kin) from the most recently updated encounter.

Note: To view all contacts for the patient, go to Registration Info. Please note

that contact information from CAIS (BCCA) and Cerner (C&W and St. Mary’s) are

currently not available.

For more information, see the help files (‘?’) within the Contacts tab.

Registration Info

50

The Registration Info tab displays patient demographic and contact information from all of the

individual Clinical Information Systems (CIS) that provide patient data to the eHealth Viewer

(CareConnect):

Patient information may be different across systems – this tab can be used to clarify contradictory

information between the EMPI and the CIS. For example, if a patient’s address has changed since

a visit to St. Paul’s Hospital, the EMPI may list a more recent address.

For more information, see the help files within the Registration Info section.

Health Authority HSDA / Agency CIS Acronym Displayed

Vancouver Coastal Health Authority (VCHA)

Vancouver Acute Richmond Health Services

GE CareCast VA-RHS

Providence Health Care Eclipsys Sunrise Care Manager

PHC

Coastal McKesson Star Coastal Vancouver/Richmond Community PARIS PARIS St. Mary’s Hospital Cerner VA-SM

Provincial Health Services Authority (PHSA)

BC Children Hospital and BC Women’s Hospital & Health Centre

Cerner BC-C&W

BC Cancer Agency CAIS BCCA

Registration Info

51

Information in this tab is taken from Registration systems at facilities in

health authorities where the patient has presented for care.

CIS patient demographic and

contact information displays here.

Preferences

52

You can personalize the way you view information in CareConnect. To set preferences, click

on the Cog icon in the top right-hand corner:

To access user preferences:

Preferences

53

Click on the dropdown menu to

select your own default screen. For

example, you can choose the Labs

screen to be the first screen you see

every time you search a patient

Viewed History (NavTrack) is

ON by default. If you do not

wish to use Viewed History,

select OFF. This applies to all

data domains.

Click on the

dropdown menu to

set the default

filter in each data

domain

The domains available to set preferences are

viewable according to the permissions allowed

within your assigned CareConnect business role

Reset all preferences to the System

Default:

• Default screen = Patient Summary

• Viewed History = ON

• Filter for: Encounters, Documents,

Imaging = past 1 year

• Filter for Labs:

Provincial = past 3 months

Powell River = past 3 months

VCHA Historical = 1 year

Click “Save” to apply

your preference

changes

Conclusion

This slide concludes the orientation.

To obtain additional information or support, please

contact your Health Authority Service Desk, or your

Health Authority eHealth team.

54

Questions?

Appendices

1. CareConnect Account Management

2. Login

• Personal Workstation

• Shared Workstation

3. CC Linking to PCIS and SCM (Single Log On)

4. Clinical Environments

• PCIS

• SCM

5. Excelleris

• Access

• Patient Search

55

CareConnect Account Management

56

Do you need to get first-time CareConnect access or modify an existing

CareConnect account?

Do you need to get first-time CareConnect access or modify an existing

CareConnect account?

Submit your access request by going to:

https://enrol-careconnect.healthbc.org

If you are located at Sechelt Hospital (formerly St. Mary’s Hospital),

please continue to submit the “Cerner and eHealth Viewer” request

form via the Service Catalogue

http://servicecatalogue.healthbc.org/Pages/default.aspx

https://enrol-careconnect.healthbc.org/




http://servicecatalogue.healthbc.org/Pages/default.aspx

Login - Personal Workstation

57

Service Area Location Icon

Vancouver Community inside the VCH

Applications folder

Vancouver Acute inside the Novell

Applications icon / NAL

Window

General In the START Menu

program list

1. Log onto your workstation with your network

account (i.e. vch\jsmith). This is usually the same as your Window account or webmail.

2. Look for the Application Secure Access (ASA) icon:

jsmith2 VCH

Login – Shared Workstation

58

Service Area Location Icon

Vancouver Community inside the VCH

Applications folder

Vancouver Acute inside the Novell

Applications icon / NAL

Window

General In the START Menu

program list

1. Log onto your workstation with your network

account (i.e. vch\jsmith). This is usually the same as your Window account or

webmail.

2. Look for the Application Secure Access (ASA) icon:

3. Enter your username, password and domain (VCH, VRHB or INFOSYS).

4. Select either: CareConnect Clinical Environment, or CareConnect eHealth

Viewer

Login – Shared Workstation

59

This window

appears only if a

shared log on for

the workstation

is being used.

• Synchronizing your PCIS and/or SCM account with your eHealth Viewer

(CareConnect) account means you will not have to enter your username

and password each time you access PCIS/SCM via the eHealth Viewer (CareConnect).

• Single log on is applicable to those who meeting the following criteria:

o Has access to a PCIS and/or SCM

o Has access to the eHealth Viewer (CareConnect)

• Note: Functionality remains the same when accessing PCIS and/or SCM through the

eHealth Viewer (CareConnect).

Synchronizing PCIS and/or SCM with CC

60

• To synchronize the PCIS/SCM account(s) with the eHealth Viewer

(CareConnect) account, steps are as follows:

1. Log on to the eHealth Viewer (CareConnect)

2. Click on the appropriate PCIS/SCM tab

3. Enter your PCIS/SCM username and password (ensure successful login)

4. Select Ctrl + Alt + Delete

5. Click Change Password

6. Change password

7. Click OK

• This completes the synchronization of PCIS/SCM accounts with the eHealth Viewer

(CareConnect) account, and means that both passwords are now the same.

• Note: the password synchronization process takes approximately 15 minutes to take effect.

• If you are ever prompted to change your PCIS/SCM password in the future, press CT Ctrl + Alt

+ Delete and click Change Password. Both your eHealth Viewer (CareConnect) (network

account) password and PCIS/SCM passwords will be changed.

CC Linking to PCIS and SCM - Single Log On

61

Clinical Environment - PCIS

62

This icon shows

that the patient

is linked.

You will notice the name of the patient you had

been working with in the eHealth Viewer

(CareConnect) automatically displays if a record

exists for this patient in PCIS. This is referred to as

patient linking.

If you are editing patient information make sure you

return to your home screen to ensure information is

saved. If you do not, the link could break.

Use the tabs to access different PCIS throughout Vancouver Coastal Health Authority (i.e. VA –

RHS, VA – PACS, PHC-PCIS).

Clinical Environment - SCM

63

This icon shows

that the patient is

linked.

Note that, if working in a patient record in

the eHealth Viewer (CareConnect) and if

the patient has a record in PCIS, the

patient name will automatically display.

To break the link,

click Clinical Link

and then click on

Break Clinical Link.

Clinical Environment - SCM

64

This icon shows that the patient is

broken between the link between

Sunrise Clinical Manager (SCM) and

the eHealth Viewer (CareConnect).

Excelleris

65

• Excelleris is the provider of PharmaNet data

• If you have been authorized for Excelleris use in the eHealth Viewer

(CareConnect) you can access the application from the Excelleris tab

• Your Excelleris username and password is not the same as your eHealth

Viewer (CareConnect) account

• Excelleris maintains a separate username and a password that must be

changed every 42 days in accordance with Ministry of Health standards

Excelleris - Access

66

Excelleris PharmaNet medication profiles can be accessed in several ways

by authorized end-users:

1. From the CareConnect Clinical Environment icon -

• Excelleris launchpad – after logging into the eHealth Viewer

(CareConnect), click on the tab labelled Excelleris at the top of

the page

2. From within the ASA icon:

• Excelleris launchpad - click on the icon labelled Excelleris.

Excelleris - Access

67

Enter the Excelleris User ID that was

provided to you. This is different from

your eHealth Viewer (CareConnect)

username. Usually it is your first initial,

last name, plus a number (i.e. jsmith8).

Enter the temporary password

that was provided to you or

your own password.

This slide and the next few slides illustrates access to Excelleris

via the CareConnect Clinical Environment.

Excelleris - Access

68

Enter the temporary password that was

provided to you in the Current Password field.

Choose a new password and enter it twice.

This password prompt will exist when logging in for the first time

only.

Excelleris – Access

69

As a private company, Excelleris

has its own conditions of use.

Read and agree to the Excelleris

Launchpad Terms of Use.

Excelleris - Patient Search

70

Select a physician, reason and

enter a PHN to search for a

patient

Excelleris - Patient Search

71

The patient’s medication profile

appears

Click the

Print button

Excelleris – Setting User Preferences

72

Set user preferences by

selecting options

available