1. End User Training Presentation
Viewer Training
End User Training Presentation
Site Name
Training Date

2. Agenda Demonstration and Hands-On Learning Introduction
Accessing ConnectingOntario ClinicalViewer (Logging In/Out)
Demonstration and Hands-On Learning
Patient Search
Patient Care Portlets
Timeline
Portlets Overview
Navigation Bar
Medications
Lab and Pathology Results
Consent Management
My Workspace
Next Steps
Remove ‘Hands-On Learning’ if doing demo-style training only
Updates: November 2017 R9.2
Slide 3: Updated language for LHIN home and community services
Slide 9: Statement added that users are limited to a single instance of the ClinicalViewer at any time
Slide 20: Minor edits to language and formatting
View Notes page on this slide for details of updates made to this student guide.

3. Introduction What is the ConnectingOntario ClinicalViewer?
The ConnectingOntario ClinicalViewer displays Ontarians’ personal health information (PHI) from participating healthcare organizations such as hospitals and LHIN home and community care services and provincial repositories
Available information includes:
Discharge Summaries
Hospital Visit/Encounter Details
Consultation Reports
Diagnostic Imaging Reports
Emergency Department Reports
LHIN home and community care service details and assessments
Provincial laboratory information
Medication information (provincial publicly funded drugs and pharmacy services including all monitored drugs and hospital medication information)
With the ConnectingOntario ClinicalViewer, you are able to readily access accurate and up to date electronic patient information that is external to your organization.

4. ConnectingOntario Benefits
3-Feb-16
ConnectingOntario Benefits
Patient, providers, and organizations can realize the following benefits through electronic access to provincial level patient data
Improves the patient experience by:
Enabling faster care decisions
Decreasing the need for patients to repeat their health information
Reducing the need for duplicate testing and procedures
Enhancing communication and collaboration
Enables faster and more informed clinical decision-making by:
Decreasing the time spent chasing information
Enabling faster, more informed decisions
Enhancing communication and collaboration
Increases organizational efficiencies by:
Enabling faster care decisions
Reducing redundancies
Improving resource allocation as providers’ and support staff’s time is freed from administrative tasks
Decreasing administrative costs
Patient
Provider
Organization

5. Accessing the ConnectingOntario ClinicalViewer
Single Sign-On Login
If your organization is using Single Sign-On, update this slide with a screen shot of your organization’s access link to the ConnectingOntario ClinicalViewer
Delete the following 2 slides pertaining to ONE ID Login
Insert Screen shot here
Note: You must only view records for patients for whom you are providing care for the organization you are logged in under (unless permitted otherwise by the organization).

6. Accessing the ConnectingOntario ClinicalViewer
If your organization is using ONE ID to access the viewer, keep this slide and delete the previous slide.
Accessing the ConnectingOntario ClinicalViewer
ONE® ID Login
If your organization is using a shortcut to ONE ID, insert a screen shot here.
To access the ConnectingOntario ClinicalViewer with your ONE® ID credentials:
In your browser, go to URL
Select “ONE ID” from the drop-down list
Click Next
Enter your login ID and password on the ONE ID login page
Click Login

7. If your organization is using ONE ID to access the viewer, keep this slide
ONE ID Login
ConnectingOntario ClinicalViewer opens in a new browser window.
If you are authorized to access the ClinicalViewer under more than one authority and under the same user account (e.g., ONE ID account), a pop-up window will appear prompting you to select an organization. *This window will not appear otherwise.
Click the organization under whose authority you are working
Click Select
Note: You must only view records for patients for whom you are providing care for the organization you are logged in under (unless permitted otherwise by the organization).

8. End User Agreement
The first time you access the viewer and during the first access of a new calendar year, this prompt displays
To accept the End User Agreement:
Click OK
The End User Agreement displays
Scroll through and review the agreement
Click Accept, then click Submit
A privacy reminder will be displayed on your first log in of the day and no more than once every 24 hours
As you previously learned in the Privacy and Security training, you have a legal obligation to protect the privacy of patient information.

9. Close the internet browser
Log Out
Best Practice: Log out after each use of the viewer and before leaving your workstation
To log out of the ConnectingOntario ClinicalViewer:
Click the Logout button in the header of the screen
This is required in order to comply with the Privacy and Security legislation.
Close the internet browser
Note:
You are limited to using a single instance of the ClinicalViewer at any given time

10. ClinicalViewer Demonstration
Remove this slide if doing hands-on learning. Click on graphic for hyperlink to train environment
ClinicalViewer Demonstration
ConnectingOntario ClinicalViewer
Demo will cover what is in the viewer, key features/functions, value to clinicians

11. ClinicalViewer Hands-On Learning
Remove this slide if doing demo-style training only
ClinicalViewer Hands-On Learning
Log in to the training environment:
Select “I already have a training username and password…”
Enter your username and password

12. Medications Portlet Overview of Digital Health Drug Repository
<Slides reflect content from tip sheet: Medications Portlet: Dispensed Medications Guide for Clinical Use and are required content. These can be removed if tip sheet is reviewed during training session with trainee
Medications Portlet
Overview of Digital Health Drug Repository
The Dispensed Medications tab displays information from the Digital Health Drug Repository (DHDR) for Ontarians with an Ontario Health Number. This includes:
Publicly funded drugs and pharmacy services (including monitored drugs)
Reflects information the dispensing pharmacy submits to the Ministry of Health and Long-Term Care for reimbursement
As of May 2017, includes approximately 7 years of information about:
Drugs paid for by the Ontario Drug Benefits (ODB) program. The ODB program includes the Trillium Drug Program (TDP)
Most publicly funded drugs paid for by other public drug programs (e.g. Special Drugs Program - SDP)
Publicly funded pharmacy services (e.g. MedsCheck), some of which are available to all Ontarians, some to ODB program recipients only
Narcotics Monitoring System (NMS) information
As of May 2017, includes approximately 5 years of information about monitored drugs (narcotics and controlled substances), dispensed in Ontario, regardless of payor, when the approved identification used was a valid Ontario Health Number

13. Clinical Use of DHDR Information
Limitations of Data - Considerations
DHDR information is advisory only and is not intended to replace sound clinical judgment
It may not represent a patient’s complete medication history as it may not include
all the current medications a patient is taking at any time, or
all the pharmacy services that a patient has received

14. Clinical Use of DHDR Information
Limitations of Data - Considerations
Key considerations include:
the information should be discussed and confirmed with the patient or other source(s)
the patient may not have picked up their medications or may not be taking them as prescribed
the patient may be taking other medications such as over-the-counter or privately-paid medications (excluding narcotics and controlled substances)
it does not include hospital-dispensed medications
it does not reflect details such as:
whether a prescription is new or a refill
changes to drug therapy (e.g., discontinued, dosage)
current use of medication
instructions for use (e.g., frequency)
Contact the dispensing pharmacy or prescriber for additional information or clarification

15. Clinical Use of DHDR Information
Limitations of Data – Important Term Descriptions
Dispensed Date: transaction date when the prescription drug was dispensed or the pharmacy service was rendered; it does not indicate if the medication was picked up
Strength: strength of the prescription drug dispensed, amount of active ingredient in the drug; for topical and liquid medication it may be shown as a percentage or ratio
Quantity: quantity of medication dispensed; may be the number of items dispensed, or, for topical and liquid medication (e.g., Methadone) it may refer to dose, total volume or volume of drug concentrate
Estimated Days Supply: estimated days of treatment based on the directions for use on the prescription, and/or the pharmacist’s judgment on usage; estimating usage accurately may not be possible for some prescriptions (e.g., PRN)

16. Clinical Use of DHDR Information
Limitations of Data- Clinical Example
DUR information if available is displayed in the Details screen of the Medications portlet
Prescriber and Pharmacy contact information is available in the Details screen of the Medications portlet
Example of Printed Medication List
Use caution extrapolating the frequency from the Quantity and Estimated Days Supply
Based on the example above, 90 tablets of Metoprolol 50 mg was filled for an estimated 30 days supply. (Quantity / Estimated Days Supply) = 3 tablets per day. The instructions may have been 75 mg (1.5 tablets) twice a day, 50 mg (1 tablet) three times a day or another variation. Estimated Days Supply may not be accurately estimated, further compounding the problem

17. Clinical Use of DHDR Information
Limitations of Data- Clinical Example
DUR information if available is displayed in the Details screen of the Medications portlet
Prescriber and Pharmacy contact information is available in the Details screen of the Medications portlet
Example of Printed Medication List
The DHDR does not indicate if a prescriber intended current use of a medication
The patient may have been instructed to take Metoprolol and Verapamil together, stop one and continue the other, or stop both
Changes to medication therapy are not known
The patient may have been given alternate dosing instructions (e.g., to decrease the Metoprolol dose to 25 mg (0.5 tablet) three times a day)

18. Clinical Use of DHDR Information
Limitations of Data- Clinical Example
DUR information if available is displayed in the Details screen of the Medications portlet
Prescriber and Pharmacy contact information is available in the Details screen of the Medications portlet
Example of Printed Medication List
The DHDR reflects an historic record of drug and pharmacy service information. There is no functionality for medications to be marked as discontinued, placed on hold, or to record adverse events or allergies. It cannot be assumed from the appearance of a record that a patient was successfully treated or can tolerate a specific medication

19. Consent Management
Consent Management for all Portlets in ConnectingOntario ClinicalViewer
An express consent override in the ConnectingOntario ClinicalViewer will result in all portlets with a consent directive to be unblocked
Although the data in the Dispensed Medications tab may not be required to provide care, an express consent override in another portlet will also release this data and you must complete the express consent form in addition to the Consent Override Dialogue box
Risk of Harm overrides will not unblock information in the Lab and Pathology Portlet or Dispensed Medications tab

20. Consent Management
Before you perform an express override on any portlet in the ConnectingOntario ClinicalViewer:
Confirm if a block is placed on the Dispensed Medications tab. If it is blocked, you must print a hard-copy express consent form. This can be obtained from the Consent Directive Dialogue Box
Inform patient or substitute decision maker (SDM):
the reason for overriding consent
the override will apply to any other information or portlet where a block has been applied
they may refuse to permit the override
the information will be available:
If the patient agrees to the override and the Dispensed Medications tab is blocked, obtain consent and document the receipt of consent by requesting a signature from the patient or substitute decision maker on the express consent form and complete the Consent Directive Dialogue Box
Data Source
Duration and Users Who May Access
ConnectingOntario Clinical Data Repository (All portlets except Lab and Pathology and Medications-Dispensed Medications)
Up to 11:59pm on the day that the override was initiated to the user that requested the override.
Ontario Laboratories Information System (OLIS) (Lab and Pathology Portlet) and DHDR (Medications-Dispensed Medications)
Available for 4 hours to all users at the organization or practice where the override occurred.

21. Next Steps <Optional Slide>
Live Training on <specific component/feature>: <insert date> Optional, remove if not needed
Resources: <insert list of resources and where they can be found i.e., intranet website, binders etc.>
Contact: <insert name(s) and phone # of site resource(s) /super user(s)>

22. Thank you for your time and attention!
Please hand in your completed training evaluation form