Integrated Assessment Record (IAR) IAR Tool Train-the-Trainer

2 Objectives By the end of this session, IAR viewers will be able to: –Describe how IAR works –Describe the HSP consent model for IAR to a client –Navigate IAR to view assessments

3 What is the Integrated Assessment Record (IAR)? 3 Long-Term Care Homes (RAI-MDS 2.0) Community Mental Health (OCAN) Inpatient Mental Health (RAI-MH) Community Care Access Centers (interRAI CA, RAI-HC) Community Support Services (interRAI PS, InterRAI CHA) A tool that provides a central repository for data collected from multiple assessments for clients and allows health service providers within the circle of care to view a client’s previous assessment information from other care providers. HSPs can use IAR to electronically view timely client assessment information in a secure manner, improving information management and enabling collaborative care planning.

4 IAR Supported Assessments AssessmentSector Ontario Common Assessment of Need (OCAN) Community Mental Health Resident Assessment Instrument – Mental Health (RAI-MH) Inpatient Mental Health Resident Assessment Instrument – Minimum Data Set (RAI-MDS 2.0) Long-Term Care Homes interRAI Preliminary Screener for Primary and Community Care Settings (Screener) Community Support Services interRAI Community Health Assessment (interRAI CHA) Community Support Services interRAI Contact Assessment (interRAI-CA) Community Care Access Centres Resident Assessment Instrument – Home Care (RAI-HC) Community Care Access Centres

Health Information Network Providers (HINPs) 5 South Western Cluster TransForm Shared Services Ontario (TSSO) Central Ontario (GTA) Cluster William Osler Health System (WOHS) North Eastern Cluster Health Sciences North (HSN) T W W H H Enterprise Master Patient Index (EMPI) T Reporting Repository Assessment Entry Module (AEM) LHINs: 1. Erie St. Clair 2. South West 3. Waterloo Wellington 4. Hamilton Niagara Haldimand Brant 5. Central West 6. Mississauga Halton 7. Toronto Central 8. Central 9. Central East 10. South East 11. Champlain 12. North Simcoe Muskoka 13. North East 14. North West

6 Using the IAR Assess Clients, Gather Consent Submit Data Regularly Use the IAR in Care Provision HSP responsibilities: Manage user access Review audit logs Leverage reports Clarify client records (EMPI) Advise HINP of HSP changes Manage privacy, security and consent Ax Assessment Software Enter Assessments Ax Monitor IAR Integrity & Usage Upload Assessments Assessment Software HINP View Assessments HSP AHSP BHSP C HINP Include IAR into processes to enhance and inform care planning: Ensure secure transfer of personal health information (PHI) Support “Patients First Action Plan for Health Care” by enabling access to assessment information that provides holistic understanding of the client’s health care needs. Business and Permissions Roles Two upload methods: Automated web services uploads Manual uploads

7 Integrating IAR into Business Processes Business process mapping will assist you in determining: –Potential streamlining opportunities as a result of the IAR –Which roles and responsibilities will be affected by the IAR –Where and how information and work will flow with the IAR –Any changes, gaps or bottlenecks that may require attention For example, you may want to consider how IAR will affect: –Intake –Referrals –Care/service planning –Reassessment –Transfers

8 Top 10 Benefits of the Integrated Assessment Record 1 6 Supports “Patient’s First Action Plan for Health Care” by enabling access to assessment information that provides a holistic understanding of the client’s health care needs Facilitates a collaborative approach to care through the sharing of information that can improve client outcomes 2 7 Enables Health Service Providers to share client assessment information in a secure and timely manner leading to more efficient care planning Provides reporting capabilities for HSPs to identify the needs of client populations and measure outcomes for service planning 38 Eliminates the need for assessment duplication Assessment data from the IAR can support the development of indictors and inform MOHLTC policy development 4 9 Improves workflow and reduces the dependency on paper-based systems Ensures fewer gaps in client information by tracking assessment history over time as they move between hospital, community service providers, and long-term care settings. 510 Promotes standard person centered experience in all locations across the province Assessment Data from the IAR can support MOHLTC compliance activities

99 IAR User Privacy & Security Requirements

10 IAR Consent Model There are two ways to manage consent in IAR: 1.HSP-level consent directives –Consent directives that are applied to the assessments collected by your organization 2.IAR-level consent directives –IAR-level consent applies to ALL assessments stored in IAR

11 How Consent Works in IAR HSP Level Consent Directive Client HSP-A Assessment A1 Assessment A2 Yes HSP-B Assessment B1Assessment B2 No IAR Assessment A1Assessment A2 Yes Assessment B1Assessment B2 No IAR Level Consent Directive - YES IAR Level Consent Directive Clinician

12 How Consent Works in IAR (Cont’d) HSP Level Consent Directive HSP-A Assessment A1 Assessment A2 Yes HSP-B Assessment B1Assessment B2 No IAR Assessment A1Assessment A2 Yes Assessment B1Assessment B2 No IAR Level Consent Directive - No IAR Viewers Client IAR Level Consent Directive Option 1 – Client’s assessments not viewable Option 2 – Client’s basic identifying info also not viewable 12

13 IAR Consent Model: Summary There are two ways to manage consent in IAR: 1.HSP-level Consent Directives – applied to the assessments collected by the individual HSP 2. IAR-level Consent Directives – applied to all assessments in IAR relating to a client –Consent to share in the IAR means all of the client’s assessments across HSPs will be shared with participating HSPs that provide care to the client –If consent is withheld in the IAR, all of the client’s assessments already in the IAR, and uploaded in the future, will be locked and participating HSPs will not be able to view them –Clients who feel at risk having their demographic information viewable in IAR even if their assessment is blocked can opt for complete PI Suppression Clients can withdraw their consent for sharing ANY assessments through IAR, regardless of which HSP conducted the assessment

14 Responsibilities for Managing Consent Develop policies for the use of your consent methods ranging from: Express to implied consent –Establish how staff: o Informs clients so that they understand what they are consenting to o Obtains the consent and what constitutes consent o Registers and records the consent

15 What to Include When Informing Clients WHY you are collecting, using and disclosing their information WHAT –types of information you are collecting (e.g., psychiatric history, legal status, etc.) –it may mean to the client to have this information collected and used and shared, including positive or negative consequences WHO you disclose to and how you disclose assessment data in general HOW your staff should ask for consent It is always the client’s choice to give or withhold consent

16 Other IAR Privacy and Security User Requirements Sign and understand the user agreement IAR only needs to be accessed when you are providing services to a client –All actions in IAR are logged Choose a strong password and keep it safe Inform clients and manage consent Support client privacy rights Report incidents

17 Incident Management Examples of Incidents Printed client assessment information is left in a public area (e.g., coffee shop) A client’s assessment is faxed to the wrong number Theft, loss, damage, unauthorized destruction or modification of client records Inappropriate access to client information by unauthorized users Large amount of IAR records accessed by a single individual in a short period of time (out of the ordinary) User account and password was compromised Network infrastructure affected by malicious users Violation of joint security and privacy policies or procedures

18 Assisting the Client with IAR-Level Consent If the client requests your assistance in withdrawing consent for sharing all assessments through IAR, you should: –Provide the client with the toll-free number for the IAR Consent Management Call Centre. –Explain to the client the implication of a consent directive in IAR (willing to share or not willing to share their assessments or basic identifying information) –Remind the client that he/she can always change his/her mind about his/her consent directives by calling the toll-free number

19 Contact Information 19 IssuesContactPhone Request or update an IAR user account > Report an IAR incident Contact your Privacy Officer to Report IAR incidents Privacy issues with client/patient Contact your Privacy Officer to Report IAR privacy issues with client/patients Login account or general IAR issues CCIM Service Desk Option 8 Client decides to block their assessments on IAR IAR Consent Call Centre & TTY for the hearing impaired

20 Client’s Right to Access The client can: –Make a request to you or your organization to obtain a copy of their assessment record –Make a request to you or your organization to change their assessment record –File a complaint about the privacy practice of your organization Alert your Privacy Officer if you receive these requests

21 Demo

Activity 1 – Logging in to IAR 22

Logging in to IAR A username and password are required to gain access to the application A default password will be assigned when the account is first set up When the user enters the username and default password for the first time, the system will prompt the user to change the password Usernames and passwords are case-sensitive Passwords must be at least 8 characters in length, will expire after 90 days and must be reset at that time 23

To log in to IAR: 1.Enter User ID 2.Enter Password 3.Click Login button or press Enter Output: The Terms of Use disclaimer screen will appear each time you log in Logging in to IAR (continued) 2 1 3

25 First Time Login

26 First Time Login

Password Considerations Passwords are case-sensitive, must be at least 8 characters in length, and contain the following: –At least one upper-case character –At least one numeric character –At least one special character ($ / ! / ?) Passwords will expire after 90 days and must be reset at that time If a user forgets their password, they may select the Forgot Your Password? link on the Login screen to reset the password –Note: This will only work if the user has previously defined a secret question After three (3) failed attempts to enter a correct password, user accounts will automatically be disabled for 24 hours. Users will have to contact their User Coordinator for assistance with resetting their password In this session : Do NOT change your password 27

My Details – Setting My Secret Question To set a secret question: 1.Click the Set button beside Set my secret question 2.Select a question from the Secret Question dropdown menu 3.Type your answer 4.Type your password 5.Click OK 6.Click Save Output: The secret question will appear if you need to reset your password

Accepting the Terms of Use To accept the Terms of Use: 1.Read the Terms of Use 2.Click Accept button to proceed 2 1 When a user logs in to IAR, a Terms of Use disclaimer screen appears. The user must click the Accept button to proceed If you do not accept the Terms of Use, click on the return to the login screen link to return to the Login screen without accessing the system 29

Homepage Output: The Homepage automatically appears upon log in It contains the following components: 1.Menu Bar 2.Person Search 3.Recent Persons 1 30

Menu Bar Menu bar features: 1. Autohide – hide menu bar 2. Help - access online help 3. Home – return to Homepage 4. Logout – end session 5. Common - My Details / Worklists 6. Messaging – secure message other users 7. Worklists – manage worklists 8. Person Search – search for clients 31

Activity 2 – Managing My Details 32

My Details My Details allows users to configure user- based system settings 1.Change my password 2.Set my secret question 3.Set inactivity timeout duration

My Details – Inactivity Timeout To set the inactivity timeout duration: 1.Click the drop- down menu beside Inactivity Timeout 2.Select the desired duration 3.Click Save or OK Output: The inactivity timeout is changed

35 Person Search Enter all or some of the following search criteria and click Search: 1.Ontario Health Card Number or 2.Last Name, First Name and Date of Birth (if unknown an estimated date of birth must be provided) 3.Other demographics can be included to further ‘narrow’ search results When Search Results appear : Click on the desired person record to go to person summary view. 1 23

36 Helpful Links 36 Resource (English and French) MaterialLink Education and TrainingIAR eLearning Modules Viewing records and verifying uploads Privacy and Security Training Documents IAR Tool Train the Trainer Privacy, Security & Consent Management IAR Technical Training Link to IAR Education and Training IAR Forms and Guides Operational Forms IAR Business Sustainment Role Request Form HSP and User Access Request Form HSP IAR Reports Recipient Form Link to IAR Forms and Guides Privacy and SecurityCommon Privacy Framework Privacy Processes Audit Log Review Standards Client Privacy Rights Support Process EMPI HSP Process Integrated Consent Management Process Integrated Incident Management Process Self-Assessment Checklist User Account Management Process Link to IAR Privacy and Security Material There are many additional resources on the CCIM website:

Thank You! Please contact the IAR Team if you have any questions or need assistance: CCIM Service Desk Tel: , Option 8 Fax: