1. AMA dr2dr Secure Messaging
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AMA dr2dr Secure Messaging

2. What is secure messaging?
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What is secure messaging?
Simply put, secure messaging (SM) is a system that enables the exchange of information in a secure fashion  
It is a web-based, secure server approach to protect sensitive data that is sent beyond corporate / clinic / office borders in compliance with industry regulations, such as HIA, FOIP, PIPEDA, PIPA, etc. 

3. Why do we need secure messaging?
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Why do we need secure messaging?
Physicians are limited in their ability to electronically communicate patient information with each other in a secure fashion
OIPC, CPSA and Alberta Health have expressed strong concerns regarding insecure e-communication between providers via facsimile and text messaging
Need to address continuity of care gaps, including those identified in the HQCA report of Dec 19, 2013
Desire to facilitate new modes of coordinated care, enabled by e-communication that is compliant with current privacy legislation and standard of care expectations

4. are secure messaging and secure e-mail the same thing?
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are secure messaging and secure the same thing?
No, secure messaging is not the same as secure
Secure messaging has several important advantages:
No data resides outside of the central server so there is no ability to hack into the information during transport
Confidential and authenticated exchanges can be started immediately. There is no need to install special software or security access devices (e.g. key fobs or fingerprint readers)
It provides a high degree of ‘non-repudiation’, which is proof of the integrity and origin of data as well as highly assured authentication of the identity of the user

5. Attachment 2
Why is the AMA involved?
Need for a simple tool for all physicians to use that complies with required privacy / security practices
Driven by motion passed at the Spring Representatives Forum confirming the value of the AMA engaging in this venture   
Belief that a secure messaging system will deliver unique value for physicians and their patients
Alignment with AMA business plan goals:
Physicians are supported by an integrated health information system
Physicians have solutions for secure exchange of health information to support improved access and quality of care

6. What are the goals OF secure messaging?
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What are the goals OF secure messaging?
To provide secure, seamless, timely sharing of medical information between health care providers
To reduce wait times for access to specialists and requests for consultation
To maximize the coordination of care for Albertans

7. What is the AMA’s secure messaging solution?
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What is the AMA’s secure messaging solution?
The AMA’s secure messaging solution builds on the dr2dr application developed by Microquest (MQ)
AMA is working in partnership with MQ to jointly guide updates and improvements to the application to ensure the initial product adds the most value to Alberta physicians
The long-term plan is to include other providers (e.g., pharmacists, nurse practitioners) and ultimately patients in the secure messaging system

8. Reduces Risk Secure Why should I use it? Collaboration
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Why should I use it?
Protects the physician from privacy risks associated with the exchange of patients’ private medical information
Eliminates the telephone tag and disrupted workflow often associated with follow-up
Provides a central, secure mode of electronic communication for physicians and their staff for use in their professional activities
Facilitates management of opinions around the coordination of patient care
Provides a material record of referral communications
Improves collaboration between physicians and reduces “off the record” patient care communication
Reduces Risk
Protects Privacy
Collaboration
Improved Workflow
Secure

9. Teamwork Useful Address Book Secure Why else should I use it?
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Why else should I use it?
Provides the basis for a common directory of system-user physicians, including their location, services provided, referral information and clinic contacts
No spam. The secure messaging system is designed to provide a single, secure, “professional account” for physicians and staff
Costs will be offset by the ability for referring and referred-to physicians to submit the new e-consult fee codes
Shrinks clinic overhead associated with managing faxing and faxing costs
New e-Codes
Eliminates Faxing
Teamwork
Coordinated Care
No telephone tag
Useful Address Book
Secure
No Spam

10. Attachment 2
HOW WILL IT BE USED?
Secure messaging can be used for many clinical purposes, but there are three primary functions
Rapid exchange of clinical information
Requesting clinical advice quickly and efficiently
Facilitating electronic consultation and referral
Without the hassle of using fax machine or telephone

11. What about privacy and security?
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What about privacy and security?
Protecting privacy and safeguarding clinical information is a cornerstone of the AMA dr2dr system and one of its highest priorities
Only the message generator and authorized receiver(s), have access to the messages
Audit details are available; all users and occasions of use will be logged by date and time
System security will be verified through a third-party security audit
Physicians and other users will be authenticated during the onboarding process
Logging into the application will require two-factor authentication (verification code sent via Google Authenticator or SMS/text sent to your cellphone or via )

12. What makes the data secure?
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What makes the data secure?
Everything is centrally stored
All contained within the dr2dr.ca website
No data stored on outside devices (phones, tablets, computers)
Connections use 256-bit SSL encryption
Bank-level encryption for all “in transit” data
Good enough for Top Secret-level US Government classified documents
All data at rest is also encrypted
Including all messages and attachments

13. How does the AMA’s secure messaging sYSTEM work?
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How does the AMA’s secure messaging sYSTEM work?
Web-based, accessible from anywhere
Supports all modern browsers
Centrally hosted website for secure physician communications
Secure conversations with referenced patient information
Attachments may be added to conversations
Online storage of all messages; no need for server backup
Hosted and maintained system-user address book
Record of conversation can be cut and pasted into patient’s EMR or printed for paper records
Configurable notifications for messages by , text or both
Choose notification frequency: instant, daily or weekly summaries

14. Does the sYSTEM integrate with EMRs?
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Does the sYSTEM integrate with EMRs?
If you have a Healthquest EMR from Microquest, the solution is integrated. If you have a different EMR, not at the moment.
In the short-term, a straightforward Application Program Interface (API) is available to integrate with other EMRs, subject to vendor agreement
In the long-term, the AMA is working on a standards-based strategy to amalgamate secure messaging solutions across the different vendors

15. What is this going to cost?
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What is this going to cost?
Subscription-based model
Monthly or yearly subscription
Charged to credit card
All-inclusive, per-physician price
$34.99 per month (that’s less than a Globe and Mail subscription)
Includes
Unlimited staff accounts *
Unlimited messaging
Unlimited access
Unlimited upgrades
* For clinic or office staff employed by the physician (excludes staff employed by a PCN, AHS, faculty of medicine, etc.)

16. What is the AMA’s timeline for implementing secure messaging?
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What is the AMA’s timeline for implementing secure messaging?
The timeline is as follows:
Dec 2015 – Mar 2016 – Piloting and service development
Apr 2016 – Jun 2016 – Limited roll-out (LR)
Jul Onwards – Full roll-out
For more information: Vic Taylor or Michael or send an to
The AMA and Microquest are currently looking at ways to compress the schedule