Overview of a CHC’s Clinical Management System Roohullah Shabon

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Overview of a CHC’s Clinical Management System : 

Overview of a CHC’s Clinical Management System Software components are required for the Community Health Centre’s (CHC) Clinical Management System (CMS)

What is a CMS? : 

What is a CMS? A Clinical Management System (CMS) is a software application that combines the clinical and administrative aspects of practice management into an integrated electronic record. The CMS encompasses and manages all aspects of practice management and patient care – from appointment scheduling and billing to clinical encounter notes, medications, test results and a cumulative patient profile.

1. Purkinje-Practice Management (PM) : 

1. Purkinje-Practice Management (PM) Registration Scheduler

2. Purkinje-Dossier : 

2. Purkinje-Dossier Dashboard Prescriber (eMeds) e-Documents (Scan + View) Order/Results (eLabs)

3. Data Extraction (DE) System Mandexin Technologies : 

3. Data Extraction (DE) System Mandexin Technologies This system, developed by the Ministry, captures data generated at the front-end of the Purkinje System (i.e. via PM and Dossier), loads the generated data into the CHC’s Local MIS (CHC LMIS), and creates a ‘Transfer File’. This Transfer File is then used to transmit the CHC’s extracted data to the Ministry’s MIS (i.e. the MOHLTC MIS). The transmission is done using a Virtual Private Network (VPN) that is set up and configured on the CHC’s special Data Extraction workstation. The system first checks the ‘Transfer File’ to identify any data that requires correction and subsequently creates ‘Error Log’ files to record data errors. All ‘Error Log’ files are stored (at c:\chc_ym\log) and available on the CHC’s Data Extraction workstation. Use of the DE System is usually done by the CHC’s Data Management Coordinator (DMC) or Resident Expert (RE). Please be aware that the DE System captures specific data in accordance with the CHC Evaluation Framework. All information sent to the Ministry’s MIS does not contain any personal identifiers of clients (e.g. their name, address, health card number, etc).

4. Hummingbird BI Reporting Tool : 

4. Hummingbird BI Reporting Tool This Reporting Tool is based on the Hummingbird Business Intelligence (BI) software which is an enterprise-strength Decision Support System (DSS) tool that is used for query, analysis, and reporting purposes. Users can also create their own ad-hoc queries and reports. The user interface shows data models for both the Purkinje Database and the CHC’s Local MIS. It also has a number of built-in queries, reports, and cubes.

5. OMA Incentives/’Shadow Billing’ & Client Enrolment : 

5. OMA Incentives/’Shadow Billing’ & Client Enrolment As part of developing a final solution for the CHC Primary Care Incentives/’Shadow Billing’ & Client Enrolment Project, we have developed the following two User Guides--‘How to Record Primary Care/OMA Incentives – Manual 1 (for Front-Line Staff) and Manual 2 (for CHC Providers). Each guide provides instructions on how to record and capture Primary Care/OMA bonus payments within the Purkinje|Dossier system (v.4.30).

Site Preparation / Hardware & Software : 

Site Preparation / Hardware & Software providing specifications on the required hardware and software for implementing the current CMS; ensuring that CHCs have set up their computer systems and environments in accordance with Purkinje-defined requirements and parameters for workstations and servers; ordering, preparing, and configuring all newly purchased Purkinje servers; ordering and purchasing all required workstations and printers; ensuring that CHCs have received, set up, and tested all received workstations prior to software installation; ensuring that CHCs have access to suitable and secure physical locations for installing these new servers; ensuring that two workstations (i.e. a ‘primary’ and a ‘backup’) are installed, tested, and ready for use by the Lab Module; and, ensuring that all required printers are received, set up, and tested for either a ‘client-server’ or ‘thin-client’ computing environment (as determined by the new CHC site); providing the DMC (or designated alternate) with narrative descriptions of the various modules to the Purkinje CMS--Practice Management (PM), Dossier (of Clinical Information), Lab Module, Alerts Module, the Data Extraction System, the Local MIS, Transfer Files, the Ministry MIS, and the Hummingbird BI Reporting Tool; providing licensing details for both servers and new workstations to the DMC (or designated alternate); acquiring all required Server licenses and Client Access Licenses (CALs) for the implementation at the new CHC site; and, ensuring all system software is installed, configured, tested, and approved for use by the new CHC site.

The following acceptances will be required of the new CHC site: : 

The following acceptances will be required of the new CHC site: Workstations Data Conversion (if applicable); Lab Module; Data Extraction System; Hummingbird BI Tool; OMA Incentive Primary Care/’Shadow Billing’ & Client Enrolment scripts; and, Overall System.

New CHC site staff will require training on the following topics: : 

New CHC site staff will require training on the following topics: Model of Primary Care CHC Evaluation Framework Data Quality Management Purkinje Practice Management Purkinje DOSSIER Purkinje Medication/Lab Module System Administration functions

Slide 11: 

The CHC ISS Service Desk, in coordination with the AOHC Training Lead, will call the designated CHC contact to discuss and schedule the provision of the following courses (when appropriate): - Data Extraction System, Local MIS, Transfer Files, and MOHLTC MIS; - Hummingbird BI Reporting Tool; and, - OMA Incentive Primary Care/’Shadow Billing’ and Client Enrolment scripts.

Assumptions regarding the use of a CMS by CHCs. : 

Assumptions regarding the use of a CMS by CHCs. There are a number of key assumptions regarding the use of a CMS by Ontario’s CHCs. These assumptions are reflected in the CHC functional requirements and contribute to an understanding of how these requirements need to be performed to address the CHC model of care. These assumptions include the following: the CMS adopts a single chart concept that enables providers to view all information entered for a single client within a one chart and allows for the merging of multiple charts that represent the same client, where applicable; multiple providers are able to enter information within the client chart that enables actions to be attributed to a specific provider or care team; the CHC model of care is both collaborative and interdisciplinary; CHC clients are more diverse than many other health care providers and organizations, which is reflected in the demographic information included in the CMS, as well as the scope of services provided; CHC clients are not required to have an OHIP number and may be registered as ‘anonymous’ within the CMS; many CHC clients have complex health care needs; it is typical for a client to see multiple providers in one visit to a CHC in order to address complex care requirements for a single issue (e.g. diabetes) or to receive services regarding multiple issues; clients may be referred to a single provider, multiple providers, a care team, and/or a personal development group(s) that is either internal or external to the CHC; encounters are not restricted to a the physical location of the CHC and may be conducted outside the CHC (e.g. at a shelter) or over the telephone; and reporting requirements are more extensive than other primary care providers, and as a result, CMS data standards are of increased importance.

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