1. ConnectingOntario ClinicalViewer
Release 9.2 Changes - Contribution
November 2017

2. Release 9.2 Changes Contribution
Integration of ConnectingOntario and Provincial Client Registry
PCR Integration and Merged Patients
Admin Portal Changes
Post R9.2 Testing

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
Integration allows for more accurate patient searches and more sophisticated client matching resolving duplicates
ConnectingOntario contribution processes will change for sites in flight for contribution implementation

4. PCR Golden Record
Each record from a given source is stored in the PCR as a distinct record (member)
Based on a matching algorithm and supporting business processes, PCR links these source records into a distinct person (entity) which is assigned a PCR managed Enterprise Client ID (ECID)
The ‘Golden Record’ is a virtual record assembled in real-time for a given person entity, returning the latest demographics based on the date and time updated for a given attribute across sources

5. Provincial Client Registry (PCR)
What is contained in PCR and available in ConnectingOntario ClinicalViewer?
Patient Information from PCR
Where displayed in ClinicalViewer
Health Card Number (HCN) – Ontario
My Workspace
Patient Search
Patient Banner
Medical Record Number (MRN)
Legal Name (First, Middle, Last)
Patient Search Results
Gender
Date of Birth (DoB)
Home Address – displays under Address
Home Phone
Cell Phone - displays under Other Phone if available in PCR; most sites contribute only one phone number
Patient Search Results and the Patient Banner display information from PCR
Data is updated through daily reports received from MOHLTC and in near real-time from hospitals and other sources
Other phone number will likely not be available
is not available in PCR and will not display

6. PCR Integration and Merged Patients
When a patient is merged in the PCR, the query for the surviving MRN will return both surviving and non-surviving MRNs
When multiple MRNs are returned from the PCR, the ConnectingOntario ClinicalViewer will display all results relating to all retrieved MRNs
The merge workaround that is presently in place will no longer be required, but will not result in complications
Important Note: If the workaround is in place for merges, a reciprocal workaround will need to be in place for unmerges otherwise documents and visits which have been moved to the previously surviving MRN will remain on that MRN

7. R9.2 Admin Portal Changes
A number of enhancements in Admin Portal will facilitate site monitoring and handling of errors
DLQ/EQ Viewer is renamed to Error Viewer

8. R9.2 Admin Portal Changes
Updated Error Viewer Fields : Dead Letter Queue and Error Searches
Search results display the Error code/Description/Error list columns instead of the Transaction ID/Source System ID/Sender ID. It is no longer necessary to use the magnifying glass to view the error details
The following columns are available in the error viewer search results for Dead Letter and Error searches:
Sending System
Message ID
MRN
Message Type
Severity
Error code
Description
Error List
Timestamp
ER7 string
Resolved Flag
Related to

9. R9.2 Admin Portal Changes Resolved flag added to the Error Viewer
Enables users to identify which errors have already been addressed. It is available as a search parameter, and the default search is for errors that are Not Resolved
Search Query
Search Result

10. R9.2 Admin Portal Changes ‘Related to’ field added to the Error Viewer
A free-text field entitled 'Related to' has been added to the Error Viewer
This enables a site to identify other related issues against an error
Free text entered in the “Related to” field is not searchable

11. R9.2 Admin Portal Changes Updated Error Viewer Fields: Suspend Errors
Suspend errors: unknown or generic exceptions that require further investigation to determine the root cause of the issue, and subsequent corrective actions
The following columns are available in the error viewer search results for Suspend searches:
Severity
Error code
Description
Error List
Error List
Sending System
Message ID
Message Type
Timestamp
ER7 string
MRN
Diverted Messages

12. R9.2 Admin Portal Changes
Updated Error Viewer Fields: Diverted Messages
Diverted Messages: messages associated with the suspended patient message.  The first message is suspended and subsequent messages for that patient are diverted to the suspended queue
The following information is displayed for the diverted messages:
Timestamp
Message ID
Message Type
Sending System
Message Content

13. R9.2 Admin Portal Changes Export
Site/Solution Administrators with access to the Error Viewer can now perform their own error handling and remediation processes more easily by exporting data into reports which contain the following fields:
Message ID
Timestamp
HL7 Message Type
Severity
Error Code
Description
Source System Name

14. R9.2 Admin Portal Changes
Date no longer required to search for a specific Message ID
It is no longer necessary to specify a date when searching for a specific Message ID using the Error Viewer
Removal of Date Range Restrictions
Prior to release 9.1 the DL/EQ Viewers were limited to retrieving messages received within the previous 2 days
The revised Error Queue viewer supports specifying an arbitrary date range for messages to review
PCR for testing of not live sites.
Admin portal is for all sites - live sites and non-live sites doing testing

15. Post R9.2 Testing
eHealth Ontario is performing it’s own testing of the iCR/PCR transition
iCR/PCR transition regression testing is not required by current contributing sites to both PCR and CDR

16. Post R9.2 Testing Site Testing of CDR after Release 9.2
To facilitate testing of CDR after R9.2 when PCR is integrated, a site needs to be conformant with and contributing to PCR prior to CDR contribution
Conformance Testing:
Sites will need to point any test systems to feed test ADT data to the PCR lower environment, using their existing PCR interface design over the existing MPN connection
Clinical Validation:
No impact as a result of PCR integration
Each site is expected to support an ongoing (or existing) ADT feed to PCR, as well as the clinical feed to CDR

17. Post R9.2 Testing Test patient/Test data post R9.2
The PCR and the ConnectingOntario Clinical Data Repository (CDR) are supported by independent environments for both production and non-production needs
Test patient/test data sent to the CDR today will not auto-populate the PCR lower environment
To perform conformance testing Post 9.2, any test data/test patients will need to be contributed to both the CDR PST environment and PCR “PST” equivalent environment
Sites that are already contributing to PCR today should already have a connection to the lower PCR environment, using the existing PCR interface configuration used by the site today to send their ADT data to eHealth Ontario
Data source sites have to send 2 distinct feeds; one to PCR over a managed private network (MPN) as many hospitals currently do today, and the other data feed to the CDR. All but a small number of hospitals in the province are already contributing ADT data to the PCR, using a separate specification and interface configuration

18. Post R9.2 Testing
Conformance testing and test patients in PST CDR (iCR)
Currently, there are no plans to migrate data from the iCR lower environments to the PCR lower environments.
Conformance testing approach recommended for sites scheduled for testing during this time is
defer their conformance testing post R9.2, or
complete conformance testing prior to R9.2 to avoid having to resend test patient data, or
send test data to both CDR PST environment as well as PCR CONF environment concurrently, to ensure test patients are available in both environments

19. For more information
Questions?