chris 2.3.0/hpg 3.1.0 interim release notes...

CHRIS 2.3.0/HPG 3.1.0 Interim Release Notes

V1.0

Organization: Ontario Association of Community Care Access Centers (OACCAC)

Division: Business Technology Solutions

Version: 1.0

Version Date: October 4, 2013

Prepared by: OACCAC

CHRIS 2.3.0/HPG 3.1.0 Version: 1.0

Interim Release Notes Date: October 4, 2013

Revision Log

Version No. Version Date Changed by/Input from Summary of Change

0.1 August 26, 2013 Joan Hill Initial draft, brought forward from published Pre Release Notes

0.2 September 30, 2013 Joan Hill Changes to planned functionality as a result of Functional testing

0.3 October 2, 2013 Joan Hill / OACCAC Business Leads, OACCAC Dev, Louise MacKinnon

Known Issues added

1.0 October 4, 2013 Joan Hill Interim release notes as published to Members Portal for CCAC use

CHRIS 2.3.0/HPG 3.1.0 Interim Release Notes v1.0 i © Ontario Association of Community Care Access Centers



Table of Contents 1. Executive Summary ..................................................................................... 1

1.1 Major Enhancements ................................................................................................ 1 1.2 Other Enhancements ................................................................................................ 2

2. OBP/OBR Phase 2 – Pathway Reporting .................................................... 3 2.1 Business Need .......................................................................................................... 3 2.2 Solution Overview ..................................................................................................... 3 2.3 Functionality .............................................................................................................. 4

3. OBP/OBR Phase 2 – Payment & Pricing Framework .................................. 5 3.1 Business Need .......................................................................................................... 5 3.2 Solution Overview ..................................................................................................... 6 3.3 Functionality .............................................................................................................. 6 3.4 Enhancements .......................................................................................................... 6 3.5 Known Issues............................................................................................................ 7

4. CCAC Referral – eReferral Acute to CCAC ................................................. 8 4.1 Business Need .......................................................................................................... 8 4.2 Solution Overview ..................................................................................................... 8 4.3 Functionality .............................................................................................................. 9

5. CCAC Referral – eReferral to LTC (Minimum Data SetProvincial Referral Standard) ....................................................................................................10 5.1 Business Need ........................................................................................................ 10 5.2 Solution Overview ................................................................................................... 10 5.3 Functionality ............................................................................................................ 11

6. ED Notification (Health Links) .....................................................................12 6.1 Business Need ........................................................................................................ 12 6.2 Solution Overview ................................................................................................... 12 6.3 Functionality ............................................................................................................ 13 6.4 Enhancements ........................................................................................................ 13

7. Connect GTA ..............................................................................................14 7.1 Enhancements ........................................................................................................ 14 7.2 Functionality ............................................................................................................ 14

8. CCAC Configuration of Sharing Authorizations ...........................................15 8.1 Business Need ........................................................................................................ 15 8.2 Solution Overview ................................................................................................... 15 8.3 Background – Overview of Sharing Authorizations ................................................. 16 8.4 Functionality ............................................................................................................ 16

9. CCAC Efficiencies ......................................................................................17 9.1 Client & Referral Management ................................................................................ 17

9.1.1 Defect Resolutions ..................................................................................... 23 9.1.2 Known Issues ............................................................................................ 24

CHRIS 2.3.0/HPG 3.1.0 Interim Release Notes v1.0 ii © Ontario Association of Community Care Access Centers



9.2 Service & Provider Management, E&S ................................................................... 24 9.2.1 Defect Resolutions ..................................................................................... 26

9.3 LTC Placement ....................................................................................................... 26 9.4 eReferral to LTCH, Complex Care/Rehab, Community .......................................... 30 9.5 DMS – Client Document Library .............................................................................. 32

9.5.1 Defect Resolutions ..................................................................................... 32 9.6 HPG / CHP.............................................................................................................. 32

9.6.1 Defect Resolutions ..................................................................................... 32 9.6.2 Known Issues ............................................................................................ 33

9.7 Other Technical Changes ....................................................................................... 34 9.8 Reports ................................................................................................................... 34 9.9 Maintenance ........................................................................................................... 35

10. Provincial Data Updates .............................................................................36 10.1 Allergies .................................................................................................................. 36 10.2 Languages .............................................................................................................. 37 10.3 Note Types.............................................................................................................. 37 10.4 Service Related Table Changes ............................................................................. 37

10.4.1 Functional Centres & MIS Codes ..................................................................... 37 10.4.2 Community Services (for eReferral to Community) .............................................. 38 10.4.3 Purchased Services ..................................................................................... 38

CHRIS 2.3.0/HPG 3.1.0 Interim Release Notes v1.0 iii © Ontario Association of Community Care Access Centers



1. Executive Summary This document provides specific information on the Enhancements and Provincial Data Updates included in CHRIS Release 2.3.0 and HPG Release 3.1.0, scheduled to go live on October 23 November 20, 2013. This section provides an executive summary of the projects / major changes and other enhancements included in R2.3.

Major Enhancements 1.1

R2.3 Project Overview

OBP/OBR Phase 2 – Pathway Reporting

Enhances the existing Pathway Reporting by providers and CCACs with the ability to report expanded pathway and client status information

With the purpose of supporting a more efficient and complete outcome reporting process

OBP/OBR Phase 2 – Payment & Pricing Framework

Implements a new reimbursement model for pathways which are appropriate for outcome based reimbursement

With the purpose of providing fair compensation to providers, based on client outcomes achieved

CCAC Referral – eReferral Acute to CCAC

Automates the sending and receiving of referrals from Acute Hospitals to CCACs, in compliance with the RM&R Acute to CCAC Minimum Data Set Provincial Referral Standard

With the purpose of reducing the time from referral to patient discharge

CCAC Referral – Minimum Data Set Provincial Referral Standard for eReferral to LTC

Builds on the existing eReferral to LTC Homes by meeting the Minimum Data Set Provincial Referral Standard standard for the patient application

With the purpose of providing consistent, complete information when referring clients for LTC

ED Notification for Health Links Builds on the existing ED Notification feature to share an expanded set of client events in hospital with CCACs and Primary Care Team

With the purpose of alerting CCAC and Primary Care providers of changes in client location and status, related to hospital admissions and discharges

cGTA – CCAC Client Viewer Provides CCAC staff with access to connect GTA from a client record in CHRIS

With the purpose of providing a more complete picture of client health and status to CCAC care coordinators

CCAC Efficiencies Provides new and/or increased efficiencies in the CCAC and external partner operation of CHRIS / BBM / HPG / CHP, in the following areas:

• Client Services functionality • LTCH, Hospital & Community Referral Management • CCAC Configuration Management of Sharing Authorizations

for External Health Partners

CHRIS 2.3.0/HPG 3.1.0 Interim Release Notes v1.0 1 © Ontario Association of Community Care Access Centers



Other Enhancements 1.2This release also includes a number of Provincial Data Updates, and a small number of defect corrections across the application.

For a more detailed understanding of these enhancements, please refer to the body of this Release Notes document.




2. OBP/OBR Phase 2 – Pathway Reporting

The enhanced OBR/OBR – Pathway Reporting functionality will be deployed enabled for those CCACs that have an active Outcome Based Service in CHRIS.

Existing OB pathways will be retained as previously for outcome interval reporting; however they will have the new added functionality for reporting and changes to OB management screens in both HPG and CHRIS.

For CCACs that have not enabled Outcome Based Services, this will be available after R2.3 through a planned deployment process

This functionality will be in User Preview only for those CCACs with an active Outcome Based Service in their training environment. An SMA may be required to change notification settings from the default values.

Business Need 2.1With the release of OBP/OBR functionality in CHRIS 2.1, there was an identified need to enhance the present functionality due to:

• Service Provider Organizations required to submit a report that contains several elements that they could not enter into the HPG interval report. This report must be submitted and its information shared with the CCAC outside of the context of the outcome-based pathway interval reporting functionality.

• Elements that were excluded from HPG include; o barriers to achieving outcomes, o variances, o risk factors, o requests for professional or community referrals o changes to a client’s status such as a supervening event

• Certain pathways have outcomes that must be achieved and submitted by Client Services staff. These CCAC only outcomes cannot presently be accommodated by the system.

• SPOs can only submit information through HPG as part of an interval report. If communication between the SPO and the CCAC is necessary prior to an interval report, this communication must occur outside of the system.

• SPO and CCAC users need the ability to view OBP information outside the context of the HPG or CHRIS applications.

Solution Overview 2.2• The ability for SPOs and CCACs to submit and view additional OBP information such as:

o Variances and Risk Factors o Activity Notifications / Requests o Supervening Events

• The ability for Client Services staff to submit CCAC only outcomes and for SPOs to view those outcomes

• The ability for CCACs and SPOs to generate a report that displays OBP information for a client




These enhancements will benefit clients, SPOs and CCACs by:

• Allowing both SPO staff and CCAC staff to communicate information about a client’s care in a timely manner, through the system.

• Providing enhanced notification and tracking for follow-up during the Pathway course of treatment.

Functionality 2.3

For information on the OBP/OBR Phase 2 – Pathway Reporting functionality, please refer to the Members Portal, following the CHRIS R2.3 OBP/OBR Business Functional Overview on July 24, 2013.


https://members.ccac-ont.ca/CHRIS/Pages/BusinessOverview.aspx?RootFolder=%2fCHRIS%2fDocument%20%20Business%20Overview%20%20Reference%20Materials%2fCHRIS%20R2%2e1%20Business%20Documentation&FolderCTID=&View=%7b1A6E30F7%2d1DD4%2d464E%2d8D5D%2d228E7869F8E1%7d



3. OBP/OBR Phase 2 – Payment & Pricing Framework

The new OBP/OBR Payment & Pricing Framework will be deployed enabled for those CCACs that have an active Outcome Based Service in production at R2.3.

Existing OB pathway services will be retained as Fee for Service with authorization of visits/hours billed by the provider. Fee for Service will allow the CCAC to enable ‘frequencies required’ on provider contracts and allow CCAC users to order service on OB billing codes using the Service delivery type override.

Over the next 6 to 8 weeks, a proposed schedule for deployment of OBP/OBR functionality to CCACs and SPOs will be finalized. The current thinking is that some CCACs and SPOs will deploy OBP/OBR in late November and December with the majority of CCACs and SPOs deploying between January and March 2014.

Once the roadmap and dates are finalized and approved by QVHC, each CCAC should submit their requested deployment date to the OACCAC.

For CCACs that have not yet enabled Outcome Based Services, this functionality will be available after R2.3 through a planned deployment process.

This functionality will be available in User Preview only for CCAC who have an Outcome Based Service enabled in training.

Business Need 3.1

The OBP & OBR initiative is being undertaken as part of the Quality and Value in Home Care collaborative which will support health care system funding reform in the home and community care sector by creating value and driving integration in Ontario’s health system, fostering patient-centred positive change and increasing quality of care delivery.

The successful adoption of the outcome-based pathways and OBR will:

• Enable improved patient experience and outcomes

• Incent SPO adherence to evidence-based best practices by reimbursing SPOs through an all-in, fixed price

• Support consistency and evidence-based outcome management by Care Coordinators for specific populations

Work is currently underway to revise the short-stay outcome-based reimbursement framework and to develop OBR pricing for 6 short-stay wound types, and hip and knee replacements. It is expected that the pricing will be available in November 2013.

There are 5 other wound care outcome-based pathways, for which fee-for-service will remain the payment model.

Based on the proof of concepts for wound care and hip/knee replacements, revisions have been made to the outcome-based pathways, and these revisions will be included in CHRIS R2.3.

The ability to have this information in CHRIS will enable a new level of automation to achieve OBP & OBR, as well as the ability to monitor SPO performance, ensure usage of best practices, support CCAC/service provider organization (SPO) billing practices, and allow for efficient and timely service provider reporting.

SPOs and client service users will have access to the patient information received in CHRIS and to automatically update outcome status for reimbursement to the SPO when patient outcomes are met.




Solution Overview 3.2

In order to allow implementation of the payment and pricing framework, the system was enhanced to:

• Release payment to providers upon confirmation of pathway and achievement of payment linked outcomes

• Release payment to providers upon passage of X days, should payment-linked outcomes not be met

• Enable providers to report a fee for service rate for visits provided under an OBP to be used for compensation upon transition of a client to fee for service

• Authorize payment to providers based on fee for service rates upon transition to fee for service

• Commence a warranty period upon achievement of payment-linked outcomes by SPOs

• Remind CCACs to verify that all payment-linked outcomes are achieved at the end of the warranty period

• Release the final payment-linked outcomes to providers upon verification that all payment-linked outcomes are met

• Release the final payment to providers when payment-linked outcomes have been achieved by day x

Patients may not be eligible for an Outcome Based Reimbursement type pathway however best practice indicates that there are benefits to managing and reporting care under an Outcome Based pathway. In this instance the outcome based pathway is still ordered however the reimbursement type will be Fee for Service. The SPO will be compensated on visits/hours provided. The CCAC will have the ability to set frequencies by specific service discipline in order to meet the patient’s needs.

Functionality 3.3

For information on the OBP/OBR Payment & Pricing functionality, please refer to the Members Portal, following the CHRIS R2.3 OBP/OBR Business Functional Overview on July 24, 2013. An updated presentation has been posted to the portal referencing recent functionality changes.

Enhancements 3.4

SMA # OBP/OBR Phase 2 Project

Affects Client Services

Description NEW - 3 OBR/ OPR Canned Reports Removed

With the phase 2 changes, the following reports are no longer needed, and have been removed from CHRIS:

• Outcome-Based Service Client Details Report • Outcome-Based Service Cost Report

• Outcome-Based Service Interval Payment Status Report





Known Issues 3.5


Affects Finance

Description NEW - Export Bundled Payments occasionally fails

The export of OBP/OBR bundled payments occasionally fails if the CCAC has configured teams in a parent – child structure incorrectly. The likelihood of this occurring is very low, and the issue is not being fixed.


Affects Finance, Service Providers

Description NEW - Final Core Payment Denied in Error

When provider submits second interval report with outcomes not met, the system incorrectly creates a Final Core Payment with status = Denied, which is shared with the provider via Outcome Based Remittance Report. This is being fixed for production.


Affects Finance, Service Providers

Description NEW - Statistics reported incorrectly in FSMS Export File when Payments are adjusted

When the system is automatically adjusting Payments as a result of a user or system initiated change, there are errors in the FSMS Export File. Dollars reported are correct, but sometimes statistics are not. This is being fixed for production.




4. CCAC Referral – eReferral Acute to CCAC

The CCAC Referral – eReferral Acute to CCAC project has a two prong deployment. Enhancements to the Intake Search feature will be deployed as part of the CHRIS R2.3 release to all CCACs that have the Intake Search feature enabled. CCACs wanting to enable the enhanced Intake Search after R2.3 are asked to submit an SMA with their request.

The integration for system to system communication of eReferrals from acute hospitals to CCACs, and the new CCAC Referrals feature in CHRIS will be deployed first to a pilot CCAC and pilot hospital, after which it will be available to other CCACs and other hospitals through a planned deployment process.

Business Need 4.1

The CCAC Referral project is being driven by both internal and external business needs. CCACs are looking for a better method of receiving hospital referrals in a timely manner. The Ministry of Health and LHINs are looking to automate the referral process from Acute to CCAC as part of the larger RM&R strategy for the province. The Provincial RM&R Committee is a key partner and stakeholder of this project.

In May 2013, the Provincial RM&R Group agreed on a Minimum Data Set Provincial Referral Standard in an effort to standardize referral information from the Hospitals to the CCAC and Complex Continuing Care / Rehab facilities. In addition, a Minimum Data Set Provincial Referral Standard was also established for referrals from the CCAC to LTCH.

The eReferral to CCAC component of the CCAC Referral project will provide an automated method for (acute) hospitals to refer clients to the CCAC. This project will implement the Minimum Data Set Provincial Referral Standard for hospital to CCAC referrals, as defined by the Provincial RM&R Committee.

CCACs receive requests to assess clients from many sources, including hospitals, primary care, and community support agencies. The receipt of and response to these requests presently occurs through a variety of means, outside of CHRIS. The work that is triggered by these requests (the assessment of clients) is recorded in CHRIS through the client record.

Phase I of the project addresses only the Acute Hospital to CCAC pathway. Future phases will extend the functionality to Primary Care, CSSAs, and other referral sources.


The proposed solution will provide a standard system to system interface to be used by hospitals when referring new patients to their associated CCAC. This standard interface will be used to integrate the incoming referrals from the hospital with CHRIS. The incoming referral information will flow directly into CHRIS where users can manage the incoming hospital referrals.

As a provincial RM&R solution, CHRIS will publish a standard based on the Minimum Data Set Provincial Referral Standard for Referrals to CCAC, which will be used by all hospitals when submitting referral information.

This common interface will be used to integrate incoming referrals with CHRIS which will allow information to flow directly into CHRIS where users can manage these referrals.

As a result, CHRIS will be able to work with any integration partners to receive referral information. CCACs will have the ability to review and process all incoming referrals within CHRIS, create CHRIS referrals and generate outgoing referrals to various facilities/agencies.




Phase 1 of this project will focus on incoming referrals from Hospitals to CCAC only.

This solution will leverage the existing Intake Search functionality. Current functionality only displays CHRIS referrals in pending status. This functionality will be enhanced to include active CHRIS Referrals as well when an e-Referral comes in and has been matched to a CHRIS Client record. These referrals will also be removed from the Intake Search screen once the e-Referral has been processed and marked as Completed or Cancelled.

This solution will benefit the Hospitals and CCACs as follows:

• Improved referral process

• Many methods of communications are standardized into a single process for referring a client to CCAC

• Process is more reliable and is expected to reduce time between referral and admission for service

• Improved CCAC User efficiency

• eliminating duplicate entry of client registration information

• automated workflow to move from hospital referral to creation of CHRIS home care referral

• view and management of hospital referrals for new clients and clients already on service in one place

Phase I functionality will not include Referral Package automation from hospitals to CCACs.

Phase I functionality will only include the communication of the initial referral. No updates from either hospital or CCAC are in scope for phase I.

Functionality 4.3

For detailed information on the Enhanced Intake Search to be deployed with CHRIS R2.3.0, please refer to the CCAC Efficiencies – Client & Referral Management section below in this document.

Also refer to the Members Portal, following the CHRIS R2.3 Business Functional Overview on July 25, 2013.

The details of the eReferral Acute to CCAC functionality and business impact will be presented in a separate Project Functional Overview, after the pilot. The date for this has not yet been determined.





5. CCAC Referral – eReferral to LTC (Minimum Data SetProvincial Referral Standard)

The CCAC Referral - eReferral to LTCH (MDS Provincial Referral Standard) functionality will be implemented as part of the CHRIS R2.3 release, and does not require a separate deployment.

The new fields that were required to comply with the Minimum Data Set LTC Provincial Referral Standard will be deployed and available for all CCACs with R2.3.

For CCACs that have already deployed eReferral to LTC, the expanded application / referral will be available for CCAC users in CHRIS, and for LTC home users in HPG Referral Management, as of the R2.3 deployment.

For CCACs that have not deployed eReferral to LTC, the expanded application will be available for CCAC users only in CHRIS.

Business Need 5.1In May 2013, the Provincial RM&R Group agreed on a Minimum Data Set Provincial Referral Standard in an effort to standardize referral information from the Hospitals to the CCAC and Complex Continuing Care / Rehab facilities. In addition, a Minimum Data Set Provincial Referral Standard was also established for referrals from the CCAC to LTCH.

CHRIS has been recognized as a solution for RM&R by the Provincial RM&R Committee. The business need is to comply with the provincial standard, specifically:

• Identify and collect any information not currently available in CHRIS

• Identify and add information not currently included in the LTC Application / Referral.

A LTCH referral is made up of the client application, and a referral package containing the client assessment and a number of other documents. The Minimum Data Set Provincial Referral Standard for LTC includes a provincial list of documents that will form the Referral Package for LTC.

• CCACs need to have a method to ensure that the documents required by the MDS are sent to the LTC homes as part of the LTC referral package.

• There is intended to be a standard format and content for each document on the provincial list. CCACs have identified these, and are working towards provincial consistency.

The CHRIS LTC application contains MORE information than is specified in the Minimum Data Set LTC Provincial Referral Standard. The Provincial RM&R Committee has agreed that this is fine, given that the additional information is related to the waitlist management aspect of LTC Referral Management.

The Referral to LTC pathway includes all LTC programs: Long Term Placement, Short Stay Interim, Short Stay Convalescent Care and Short Stay Respite. The CHRIS eReferral to LTC solution addresses all LTC programs except Short Stay Respite.

The changes in R2.3 do not include eReferral to LTC for Short Stay Respite: this is out of scope, and will need to be addressed in a future release.

Solution Overview 5.2This project will implement the Minimum Data Set Provincial Referral Standard for LTC referrals. This includes:

• Adding client Ethnocultural Preferences field to CHRIS Add / Edit Choices




• Adding new legal roles for personal contacts in CHRIS

• Prompt the user with the provincial list of documents to be included with an LTC application

• Adding the new CHRIS fields and additional information to the LTC application

• Include the identified document types from the provincial document list in the LTC application, to notify the LTC homes what to expect in the referral package

Functionality 5.3

For information on the CCAC Referral – eReferral to LTC (Minimum Data Set Provincial Referral Standard) functionality, please refer to the Members Portal, following the Business Functional Overview on July 25, 2013.

For information on the enhancement details to be deployed with CHRIS R2.3.0, please refer to the CCAC Efficiencies section below in this document, identified with the project name in the SMA# row.





6. ED Notification (Health Links)

The enhanced ED Notification functionality will be deployed in disabled mode in Release 2.3.0.

New ED Notification functionality will be available for those CCACs with ED Notification currently enabled and whose partner hospital(s) have upgraded their software to extract and send the expanded list of patient events.

CCAC’s will require an SMA to enable/disable the new functionality. The OACCAC will work with the CCAC to onboard a partner hospital to ensure the hospital’s HIS feed is integrated into CHRIS and certified by the CCAC. To support the ED Notification functionality, a Data Sharing Agreement will also need to be signed between the CCAC and the partner hospital.

The enhanced ED Notification functionality in R2.3.0 User Preview will only be available for those CCACs currently with ED Notification enabled.

Business Need 6.1

The ED Notification project is being driven by the Health Links objectives to improve care for 1-5% of Ontario’s population that are responsible for approximately 20B in healthcare system costs.

The Provincial Health Links eHealth Advisory Committee (HLEAC), headed by the MOHLTC, identified the need to notify the Health Link Care Team when the patient presents/admitted/discharged to/from a Hospital Emergency Department. Although it is necessary for the patient’s entire care team to be notified of such occurrences, there has been a heavy emphasize on the importance of notifications to primary care. HLEAC recognized that the OACCAC ED Notification solution along with OMDs HRM (OntarioMD Hospital Report Manager) solution have the foundation in place to be a key enabler to support this business need in the short term.

This approach will allow care providers to better and more efficiently coordinate care for these patients. Two areas where coordination of care can be improved include better communication of ED visits and a patient registry.


Existing Solutions:

ED Notification - The OACCAC has developed an ED Notification solution that a number of CCACs are using receive notifications from Hospitals. The current solution supports the following hospital notifications:

• Patient Presents in the ED

• Patient is Discharged from the ED

• Patient is Admitted to an In-Patient Unit

Ontario MD Hospital Reports Manager – OMDs HRM solution enables Primary Care Practitioners who have adopted the EMR solution to receive hospital reports electronically.

The objectives of this project are:

• Enable direct routing of ED Notifications to Primary Care Clinician’s EMR systems via OntarioMD Hospital Report Manager system. Allow Hospitals to specify Primary Care clinicians that the ED Notification should be routed to and expand this list of recipients using Medical Contact information stored in CHRIS.




• Enable hospitals to include clinical or administrative context information (“observations”) with the ED Notification message. Examples include CTAS Score, LACE Index, or narrative-based Clinical Notes.

• Allow Hospitals to inform notification recipients of health-related “groups” (i.e. HealthLinks) that a patient is known to be associated with. Inform Hospitals of health-related “groups” that are recorded as contacts in the Patient’s CHRIS Client Record if any exist.

• Expand the notification types to include discharges from In-Patient Units

• Expand CHRIS Client queries to determine CCAC Client status at a provincial scope. Upon identifying a CCAC Client, provide an opportunity for each CCAC with that Client’s record to receive a notification.

• Enable CCAC-configurable filtering logic on ED Notifications including Client Age and Client Population.

Functionality 6.3

For information on the ED Notification functionality, please refer to the Members Portal, following the Business Functional Overview.

Enhancements 6.4

SMA # CCAC Request


Description Increase Field Size for Patient Surname and Firstname in ED Notification XML Interface

Hospital patients with long names were failing to match to a client in CHRIS, due to a restriction on the size of the surname and first name fields. An enhancement is being implemented to expand the Surname and Firstname fields in the XML message from 25 characters to 250 characters. Client name search functionality which is used when the hospital patient has no HCN will now search using just the first 25 characters.





7. Connect GTA

The enhanced cGTA functionality will be deployed enabled in R2.3.0 for the 5 participating cGTA CCACs. Access to the UHN cGTA Viewer is expected to be late Fall of 2013.

The enhanced cGTA functionality in R2.3.0 User Preview will only be available for the 5 participating cGTA CCACs. The cGTA Viewer will not be accessible and users will be presented with a cGTA default browser window.

The cGTA initiative is a partnership of the five GTA Local Health Integration Networks (Central, Central East, Central West, Mississauga Halton and Toronto Central), Canada Health Infoway, and eHealth Ontario.

The ConnectingGTA (cGTA) initiative integrates electronic patient information from across the care continuum and makes it available at the point-of-care to improve the patient and clinician experience. Phase I included the data feed from CHRIS to populate the cGTA Clinical Data Repository (CDR) and a Phase 2 Viewer (UHN) that will allow users to view cGTA data as an integrated patient record.

Enhancements 7.1

SMA # ConnectingGTA Initiative for GTA Cluster


Description Link to cGTA Viewer from CHRIS client record

Access to the cGTA Data Viewer will be made available within the CHRIS application from a new choice on the Client Level Action drop-down, called “cGTA Viewer”. Selecting this choice will give the CCAC user access to the GTA wide client information for the client in view. cGTA access will only be available for the 5 participating CCACs that make up the GTA cluster. Only users, authorized for cGTA, will have access to the cGTA Viewer choice.

SMA # ConnectingGTA Initiative for GTA Cluster

Affects Application Admin

Description User Access Control for Link to cGTA Viewer from CHRIS

Access to the cGTA Viewer for CCAC users will be controlled by a distribution group in Active Directory (AD). OACCAC will be responsible for creation and managing of the provincial cGTA Viewer group in AD, which will contain a sub-group for each of the GTA CCACs. Each CCAC will be responsible for identifying which of their users require access to cGTA viewer and for managing the sub-group membership for their particular CCAC.

Functionality 7.2

For information on the cGTA Viewer functionality, please refer to the Members Portal, following the Business Functional Overview on July 25, 2013.





8. CCAC Configuration of Sharing Authorizations

The Sharing Authorizations project will be deployed to all CCACs with R2.3. Sharing authorizations enabled in production will remain in place for all except those for Community Service Agencies and Primary Care Groups:

• CCACs will need to add eReferral Type Sharing Authorizations for CSSAs to be enabled for eReferral

• CCACs will need to add Contact Type Sharing Authorizations for Primary Care Groups to be enabled for CHP

The sharing authorization migration script has been enhanced to now include Primary Care Groups, in addition to Providers, Acute Hospitals, LTCH, and Complex Care & Rehab Hospitals.

This work will need to be done immediately after CHRIS R2.3 deployment, using the new Maintenance function.

Business Need 8.1

CCACs currently share client related information collected in CHRIS with their external health partners through the Health Partner Gateway (HPG). There are two areas in HPG where external health partners have access to CCAC client related information:

• Community Health Portal (CHP) • Referral Management.

An HPG user from an external health partner organization can access information for a specific client if:

• Sharing authorization has been granted and configured for their organization • The user has been granted the necessary HPG Role(s) to access CHP / Referral Management.

Most of the sharing authorizations are currently configured by data script prepared and executed by the OACCAC, at the request of CCACs. This is time consuming, and delays the process of granting sharing authorizations to new external organizations.

The business need is for CCACs to be able to configure sharing authorizations themselves, without needing to involve the OACCAC.

CCACs need to be able to configure client sharing authorizations for external health partners, and also to configure assessment sharing authorizations. The ability to do this needs to be a restricted, application admin function.

CCAC client services users need to be able to see which organizations have been granted access for a specified client. They also need to be able to revoke access as required.


• New functionality will be introduced to the maintenance area of CHRIS that will allow Application Administrators to maintain client sharing authorization templates and assessment sharing authorization templates.

• CHRIS users who have access to the client record will be able to view existing client sharing authorization records for a client. Authorized users will be able to revoke client sharing authorizations for a specific client and organization as required.




Background – Overview of Sharing Authorizations 8.3

CCAC client information is shared with external health partners through two functional areas in the Health Partner Gateway (HPG):

• Client View (also referred to as the Community Health Portal / CHP) • Referral Management.

Access to a specific client in HPG is controlled through sharing authorizations in CHRIS that specify when a CCAC has authorized access to a specific client for a specific organization. If an external HPG user is associated with an organization that has been authorized for access, and they have the necessary user role in HPG, they will be able to view CCAC client information in HPG.

There are four different types of sharing authorizations that control sharing of different client information. These are:

• Client sharing authorizations – controls whether a client is shared or not • Document sharing authorizations – controls whether a client document is shared or not • Note sharing authorizations – controls whether a client note is shared or not • Assessment sharing authorizations – controls whether a client assessment is shared or not

Each type of sharing authorization listed above works independently of each other. However, in the CHP and Referral Management areas in HPG, the user must first access the client record to see any documents, assessments, or notes that have been shared; and this requires the client sharing authorization. As a result, shared documents, notes, or assessments are not accessible through the HPG functionality without the client sharing authorization record.

In CHRIS, sharing authorizations are created and revoked in different ways depending on the type of sharing authorization and the circumstance for which the information is being shared. In general, these can be described in two categories as follows:

Policy driven: Sharing Authorization templates based on business policies are configured by defining the events that trigger when a sharing authorization should be created and revoked for a client for a specific organization. The flow chart below describes the basic flow of an example client sharing authorization that is created and revoked through a client sharing authorization template.

Non-Policy driven: Sharing authorizations are implicitly created when certain client events occur in the system or a user explicitly chooses to share the client information through CHRIS functionality.

Functionality 8.4

For information on the Sharing Authorizations Maintenance functionality, please refer to the Members Portal, following the Business Functional Overview on July 25, 2013.





9. CCAC Efficiencies

Client & Referral Management 9.1

SMA # CCAC Site Visits

Affects Client Services, Health Information Management

Description Spell Check for CHRIS, BBM, HPG !!!

Spell Check and Auto Correct features will now be can be made available to users with work stations running Internet Explorer 10.

If configured, Spell Check will operate on fields defined as text areas in CHRIS, BBM and HPG, and will behave similarly to Spell Check in other applications. Short text fields such as Surname will not have Spell Check.

It will be up to the individual CCACs to determine the strategy to select, deploy and support the dictionaries that form the basis of the Spell Check feature. CCACs will want to consider the benefits of Spell Check, and plan for Spell Check implementation in conjunction with their plan to deploy IE10.

SMA # Provincial Direction re Terminology


Description Change Case Manager title to Care Coordinator

In previous releases, the title for the Case Manager role was changed to Care Coordinator in HPG and on all reports for external recipients. This change completes the work in CHRIS and BBM, and in CHRIS reports for CCAC staff. This includes changing the reference from Case Manager to Care Coordinator in the Consent Script within CHRIS.

SMA # Standardization for Consistency & Application Maintenance, Improved Performance


Description Standardization of Smart Lookup Control in CHRIS

Smart Lookup is a tool used in CHRIS when a user is searching a table of records (organizations, diagnoses, dispositions, etc) for a particular value. The implementation of the Smart Lookup tool has now been standardized across all of CHRIS. Issues of too much space being displayed on Smart Lookup results have been corrected as a result of this work.

SMA # Application Support, Health Information Management

Affects Client Services, Health Records

Description Ability for CCACs to Manage Duplicate Clients in CHRIS CCACs will be able to manage and link duplicate client records in CHRIS, as follows:

• CCACs will be able to mark a client record in CHRIS as a duplicate of another client record (This will replace the client merge data scripts that were done by OACCAC)

• Where multiple client records exist for the same client, CCACs will have to determine which client is the duplicate, and which client is the primary




record going forward. • In order to be marked as a Duplicate, all the information areas within the

duplicate client record must be in a closed state, and the client record must be inactive. E.g. Referrals, Services, Addresses, client & referral Coding, etc.

• Client records marked as a Duplicate will have the text “ – Duplicate” appended to the Client Name on the Client Header.

• On the results of client searches in CHRIS, the status of Duplicate client records will always be displayed as Inactive – Duplicate. This includes Provincial Search.

• Users will be able to view, but not to update a client record marked as Duplicate.

Mark as Duplicate will be a new choice on the client level Action drop-down. It will be available only to HR, HRA and HRRAA roles. If a client has been marked as Duplicate in error, an Undo Duplicate function has also been implemented.

On client records which have been identified as having Duplicate(s), a new Duplicate Clients link will be available under the client Details tab. This is available to all users, and will allow them to see which other clients have been marked as a Duplicate of the Primary client record. The Duplicate Clients link will be present only for client records that HAVE Duplicates.

On the Client Search page, a new display option of Duplicate has been added to the Active | Inactive | All options already in place.



Description Add On Hold Reason to Hold Alert in the client header

When Client is On Hold, the On Hold Reason is now included on the client header, in the format “On Hold – “ On Hold Reason, immediately after the yellow Hold alert symbol.



Description Include hospital phone # when selecting a hospital On Hold Location

Hospital phone # is now displayed when a user is searching for a hospital On Hold Location. The hospital smart lookup results now include the hospital name, hospital type (e.g. acute care hosp), organization type = Hospital and the organization phone #. The hospital phone # is also displayed in the On Hold Location field on the Client On Hold Details page.

SMA # CCAC Site Visits, Primary Care Integration


Description Remove Medical Contacts from Consent Management

Medical contacts are no longer managed from the context of Consent. Medical contacts are now viewed, edited and added from the Medical Contacts link under the Consents/Contacts client tab. The consent related fields have been removed from the Add / Edit / View Medical Contact pages in CHRIS.




The Medical Contacts grid has been removed from the Contacts Overview page. The consent restrictions information for Medical Contacts is not displayed in CHRIS nor shared on any referrals from the CCAC to external partners. As part of this change, additional business rules have been implemented to assist users in dealing with historical consent records WITH consent restrictions and new consent records WITHOUT consent restrictions, as follows:

• Medical contacts that are attached to a consent can no longer be re-activated by removing the end date

• Medical contacts that are attached to a consent cannot be Edited • In order to change any information for a Medical Contact, the contact must

be active. A script will be run as part of R2.3 deployment associated with this change. All Medical Contacts active as of deployment will be ended. For all active medical contacts for active physician / nurse practitioner records, a new medical contact record will be automatically created with the consent restrictions removed.

SMA # Primary Care Integration


Description New Practit ioner Type field for Medical Contacts

The new provincial data source for medical practitioner information will now include Practitioner Type, which will allow for easy identification of physicians vs nurse practitioners. The Practitioner Type field is displayed on the Add / Edit / view Medical Contact pages. Depending on the date when the first feed with this new information is available, this field may not be populated with the R2.3, and will display “- -“.

SMA # 431909 – WW, NE


Description Ability to update Client Contact address when Client Home Address changed

When a user is changing a client’s home address using the Change Address function, and the client has one or more Personal Contact whose address is flagged as Same as Client Address, the user will now be given an option to update the Personal Contact address to the client’s new home address.

The user has the choice to update All or None of the Personal Contacts, reflecting if the whole family is moving to a new location, or just the client is moving.

Edit address is used to correct an error in a client’s recorded address. Edit address will continue to automatically update all Personal Contact addresses that are flagged as Same as Client Address.

Note: At this point, a client home address is never updated automatically by the system as a result of a LTC home admitting a client for long stay placement. If the CCAC records the admission, the CCAC user has an option to Change Home Address, and then they will now be presented with the option to update Personal Contact addresses. In this case, the user should select None, as it is only the client who is moving into the LTC home.




SMA # Usability

Affects Client Services, Application Admin

Description Ability for Language sort order to be configured

CCACs can now identify a subset of frequently used languages that they would like to see at the top of the language pick list, and the order in which they should be displayed. All of the remaining language choices will be displayed AFTER the identified languages in alphabetical order. This change is requested by the CCAC submitting an SMA.

SMA # Consistency


Description Address Validation Improvements

In previous releases, address validation invoked from the Validate button behaved somewhat differently from the Save address button. This logic will now be the same.

SMA # CCAC Referral – eReferral to LTC (Minimum Data Set Provincial Referral Standard)


Description Client Personal Contacts – expanded l ist of Legal Roles

In order to comply with the eReferral to LTC minimum data set Provincial Referral Standard, a number of new Legal Roles choices have been added to CHRIS, as follows:

• Other Legal Oversight • POA – Personal Care (Jointly) • POA – Personal Care (Jointly & Severally) • POA – Finances and Property (Jointly) • POA – Finances and Property (Jointly & Severally)

The existing POA – Personal Care and POA – Finances and Property are still available for selection.

These new roles can be used for any client, and are not restricted to clients with LTC applications.

SMA # OBR/OBR Phase 2 Project

Affects Client Services, Health Records

Description Client Utilization Report changes

Labels on the Outcome Based section of the report have been changed from Outcome Based Services to Outcome Based Reimbursement Costs.

Labels on the Interval Payment have been changes from Interval Payment Status Date to Payment Date.

Labels on the Total lines have been changes correspondingly.




SMA # CCAC Referral – eReferral Acute to CCAC Project, CCAC Site Visits


Description Enhanced Intake Search page

From CCAC Site Visits in 2012, CCACs identified that the Intake Search page was being used primarily by community and placement teams to whom pending referrals had been transferred from a centralized intake team.

When updating the Intake Search function for eReferral Acute to CCAC, enhancements were included to address current limitations in production. The changes made now allow CCAC staff to:

• View referrals in order of due date (determined by Referral Date to CCAC and Assessment Urgency)

• Sort and view referrals by assigned care coordinator

And once CCACs implement eReferral Acute to CCAC with hospital partners, hospital referrals for CCAC clients on service, as well as clients with pending referrals will be included in the Intake queue.

These are the changes to the Intake Search function in R2.3:

Referrals Included:

• Pending CHRIS referrals (of all types) • Incomplete Acute to CCAC eReferrals, that have been matched to a CHRIS

client o New clients for which new client has been registered, and new

Pending Home Care referral has been added to CHRIS o Clients known to the CCAC which were inactive, and new Pending

Home Care referral has been added to CHRIS o Clients active on CCAC Home Care services, and no referral needed

to be added to CHRIS o Clients active on CCAC services other than Home Care, and new

Pending Home Care referral has been added to CHRIS

Changes to Content and Format of Intake Search Results:

• New column named Assessment Due Date added to the right of Assessment Urgency

• Current Team/Case Manager column split into two separate columns o Team o Care Coordinator / Caseload

• Referral Type column will now include Referral Type – Referral Status • Current DMS & Client Notes columns combined into 1 column • BRN & Intake/Assess columns removed

Intended Data Standard and Usage for Intake Search Result fields for Pending CHRIS Referrals is as follows:

Name: • Client Name in CHRIS, with link to Client Overview in client record

Exception for Restricted Clients to which user has no access: “**Restricted** – client #”

• “R” in yellow yield sign: alert that client is Restricted Client, displayed whether or not user has access to client

• “ i ” in yellow yield sign: information alert that client is admitted to other CCAC programs




Presenting Problem: • Text field containing value of Presenting Problem field from referral Intake

page • Can be used to share key information about referral between CCAC staff

throughout the intake process

Assessment Urgency: • Value of Assessment Urgency field from referral Intake page • Blank value indicates that referral has not yet been triaged • Users can sort on Assessment Urgency column to see all referrals waiting

for triage by their team, at the top of the referrals list

Assessment Due Date: • Value calculated for pending referrals as follows:

Assessment Due Date = Referral Date to CCAC + # of days specified by Assessment Urgency

• If referral hasn’t been triaged and Assessment Urgency is blank, then Assessment Due Date will also be blank

Referral Date to CCAC: • Value of Referral Date to CCAC from referral Intake page

Referral Type: • Displayed as Referral Type “ – “ Referral Status • Values from referral Intake page • Link on Referral Type navigates user to Referral Overview in client record

Team:

• Managing Team as assigned on referral Intake page for pending referrals • If Assessing Team is assigned, then value = Assessing Team;

else value = Intake Team

Care Coordinator / Caseload:

• Care Coordinator as assigned on referral Intake page for pending referrals • If Assessing Team is assigned, then value = Assessing Care Coordinator;

else value = Intake Care Coordinator • Blank value indicates that referral has not YET been picked up by Intake

coordinator

DMS / Client Notes:

• Folder icon is link to navigate user to client level Document Library page in the client record

• Notepad icon is link to navigate user to client Notes page in the client record

SMA # Improved Address Management


Description NEW – Change in Edit Address Function

Beginning in R2.3, users will no longer be able to change the location type of an address from the Edit Address function.




9.1.1 Defect Resolutions

SMA # 579135 – SE Affects Client Services

Description Client Summary Report – Community Support note content is missing

For clients with a current Community Support note, the Client Summary Report (selected from Print Client Summary client level Action dropdown) displays the date of the note, but incorrectly says “No data exists”.

The issue has been fixed, and the Note content is now included on the report.

SMA # 561259,561275,561358,561365,561370,561465,561474,561488,561928,567842 – NE; 561489 – CW; 561358 – TC; 561636,562588 – CE; 561333 – WW


Description Add Note & Save – incorrect warning that note not saved

Sometimes after adding and saving a note in CHRIS, a warning message was displayed even though Note had been properly saved:

"You have unsaved work or unsent notifications on this page. Click OK to remain on this page in order to save or send. Click Cancel to exit the page without saving or sending."

The fix that was made in CHRIS R2.2.1 has now been applied permanently in R2.3.0.

SMA # CCAC Site Visits Affects Client Services

Description Intake Search Results – user can’t view all of Presenting Problem

Only the first 50 characters of the Presenting Problem was being displayed.

The issue has been fixed, and the entire content is now displayed.

SMA # Release Testing Affects Client Services

Description Address Validation – organization address saved as Private Dwelling

When a CCAC user is validating a client address, the popup of alternate address choices could include organization addresses having location types that aren’t appropriate for a residential address e.g. Pharmacy, Clinic. This issue has been fixed as follows: non-residential type organization addresses are no longer included in Address Validation choices.

SMA # 546313 - HNHB Affects Client Services

Description NEW - Medical Contacts – system allows user to re-activate inactive physician

The system allowed users to remove the End Date and change the Start Date for a Medical Contact which was associated with an inactive physician / nurse practitioner record.

The issue has been fixed. Medical contacts associated with inactive practitioner records can no longer be re-activated.




9.1.2 Known Issues

SMA # CCAC Referral – Acute to CCAC project Affects Client Services

Description NEW – Intake Search Team selection

The system doesn’t allow user to select multiple teams from the Teams Available box at once, using the Shift key and the down arrow.

Workaround: Multiple teams can be selected using the Shift key and the mouse click. It is suggested that this be included in CCAC R2.3 Education.

SMA # De-coupling of Medical Contacts from Consent Affects Client Services

Description NEW - Consent Restrictions column still in place for Medical Contacts

Even though consent restrictions no longer apply to active Medical Contacts in CHRIS, the Consent Restrictions column is still displayed on the Medical Contacts grid on Client Summary. This will not be fixed for R2.3 production.

Service & Provider Management, E&S 9.2

SMA # 547181 - Cent


Description Remove default Frequency Type on Add Frequency

On Add Frequency page, type of Frequency field now has NO default to reduce errors in recording service frequencies. The user must now select a type of Frequency. The choice of One-Time has been moved to the bottom of the list (to reflect how infrequently it is used).



Description Allow User to Edit Provider End Date when Adding / Editing a Frequency

The Provider End Date field will now be displayed on the Add Frequency and Edit Frequency pages under an assigned Provider. The current value will be displayed, and the user can change it as needed. The system will continue to ensure that the Provider End Date is >= Frequency End Date on ALL of the frequencies for the assigned provider.

SMA # 559222 - HNHB


Description Notify Providers Enhancement

When selecting a provider in the Notify Providers function, the Available Providers and the Selected Providers lists have been made much wider so that users can see the entire provider name.




SMA #

Affects Client Services, Service Providers

Description CHRIS & HPG Service Offer, Service Referral, Frequency Change, Provider OBP/ OBR Reports

The format of all of these service reports has changed to match the new report standard:

• The header now includes the new CCAC logo (already in production) • The title is displayed according to the new report standard • The footer now includes the standard privacy disclaimer

All of the CHRIS reports will now be generated using the XSLT reporting tool (as is used in HPG), rather than in Microsoft Reporting Services (SSRS). As a result, these documents will be displayed in PDF format. CCAC users will no longer be able to export the data to another format as they could with the previous SSRS reports.

SMA # OBP / OBR Project

Affects Client Services, Service Providers

Description NEW - OBP/ OBR Information added to CHRIS & HPG Service Reports

Content of the Service Offer, Service Referral & Frequency Change reports and the corresponding PXML has been updated with new OBP/OBR information: Service Offer:

• Label change on Intervals • Responsible Partner identified for each Interval (CCAC or SPO) • Display of other pathways removed

Service Referral & Frequency Change: • OBP status added (authorized / discontinued • SPO status added (active / inactive) • Reimbursement Type added (OBR or FFS) • Review Date added • Responsible Partner identified for each Interval (CCAC or SPO) • Service Delivery Type (SDT) Override added on Frequencies ordered • End Date for Discontinued Pathways added

Provider Notification:

• All notifications / instructions for a specified client and OBP/OBR Pathway combined into a single notification message

Outcome Based Reconciliation Report: • Report content changed to be compliant with the revised reimbursement

functionality The updated PXML schema specifications for R2.3 will be sent to providers and software vendors upon request to Fiona Williamson, OACCAC HPG Business Lead.





SMA # 579416 - NW Affects Client Services

Description NEW - E&S Data Entry – smart lookup for Requested By field occasionally doesn’t work

When the "Requested by" field (where the user can choose Service Provider or CCAC), the cursor doesn't always appear in the correct spot - it is up slightly. When this happens the user is not able to pull the list up to choose the provider.

The issue has been fixed with the Smart Lookup improvements in R2.3.

LTC Placement 9.3

SMA # 311185 – CE; 537253 - SE

Affects Client Services, Health Records, Health Records Admin

Description Original Eligibility Date - Abil ity to backdate LTC P lacement Eligibility prior to CCAC File

CCACs occasionally need to add / read a LTC placement referral for a client whose placement Eligibility Date is in the date range of a previously closed CCAC File: when this happens, it is usually for a client who has been moving between two CCACs (home – cottage / home – other family member). CHRIS prevented the user (including HRA) from recording the correct Eligibility Date. CCACs would need OACCAC to merge CCAC Files or would document the correct date in Notes, and have to remember when looking at waitlist reports. A new field called Original Eligibility Date has been added to the Referral Management page for LTC Placement. It defaults to blank and will be displayed for all referrals. HRA role is required to edit this field. If this field is specified, choice Waitlist Dates will be validated as being >= Original Eligibility Date, rather than referral Eligibility Date or Initial Referral Date (for Assessed Out of Region = Yes). This new field will allow CCACs to enter these referrals with the correct eligibility and waitlist information, and the clients will be displayed in the correct sequence on waitlist views / reports.

SMA # 542635 - SW


Description LT P lacement Priority 2 - Allow CC and TA roles to record Waitlist Date prior to Eligibility Date

For LT placement choices with Priority 2 – Spouse / Partner Reunification, the client’s Waitlist Date = date their spouse / partner was admitted to the LTC home. This date could be prior to the client’s referral Eligibility Date.

With CHRIS R2.3, CC and TA roles can change the Waitlist Date at the same time as they change the client Priority to 2. Prior to this HRA role was required to set the Waitlist Date prior to the Eligibility Date.




SMA # 534888 – CE


Description LT P lacement Priority Readmission – record correct Waitlist Date

For LT placement choices with Priority Readmission, the client’s Waitlist Date = date they were originally admitted to the LTC home. This date could be prior to the client’s referral Eligibility Date.

With CHRIS R2.3, CC and TA roles can set / change the Waitlist Date to the correct value at the same time as they change the client Priority to READ. The Waitlist Date for Priority READ now follows the same validation rules as Priority 2.

SMA #

Affects Client Services, Health Records, Health Record Admin

Description LTC P lacement - Waitlist Date Validation Enhancement

Choice Waitlist Date is no longer validated against the choice Application Sent Date for Long Term Placement, Short Stay Interim and Short Stay Convalescent Care. Validation against the referral eligibility information was determined to be sufficient.

SMA # LTC Legislation

Affects Client Services, LTC Homes

Description LT P lacement – New Priority for Clients Waiting for Admission from a Specialized Unit

A new long term placement category has been legislated, for clients that are waiting for admission to a LTCH that is NOT their original home. This applies to clients who are in a specialized unit or have been transferred from the specialized unit to a regular bed in the same home. The new category falls between categories 2 (Spouse/Partner Reunification) and 3 (Religious, Ethnic or Linguistic Origin). A new priority has been created in CHRIS:

• Priority Code = 2T • Priority Description = Transition from a Specialized Unit

Continuum of Care consideration does NOT apply to this priority. On Waitlists, 2T is listed in sequence after clients with Priority 2, and before clients with Priority 3A.

SMA # LTC Legislation


Description LT P lacement – New Reason for Client Refuses w ith Exception

When there are no appropriate clients for a bed vacancy in a specialized unit, the bed can be offered to clients that do not require specialized services. The legislation states that these clients are NOT required to accept a bed in a specialized unit, and may Refuse with Exception (with all their choices remaining active).

As a result, a new Reason has been added to the CCAC Update Choice Action of Client Refuses with Exception:

“Client w/o special needs refuses specialized bed offer”




SMA # 393745 - NE


Description BBM Waitlist View for LTC P lacement – Add Unit/ Floor Designation

A new field has been added to the BBM Waitlist View, which is already included in the CHRIS Waitlist Reports and the HPG Waitlist Views. Unit/Floor Designation added between the Accommodation and Match columns on the right side of the grid. For CCACs that have deployed eReferral to LTCH, the Unit/Floor Designation field in CHRIS will contain the information provided by the LTCH in the Secure/Not Secure field when the LTC Accepts Client application.

SMA # Consistency of BBM Waitlist with CHRIS & HPG Waitlists


Description BBM Waitlist View for LT P lacement – Crisis Priority & Continuum of Care

Change the sequence of the BBM Waitlist View for LT Placement, to be compliant with LTC legislation and to be consistent with CHRIS Waitlist Report and HPG Waitlist View:

• For Priority = 3A, 3B, 4A, 4B: clients flagged as Continuum of Care come before clients not flagged with the same priority

• For Priority = 1 (Crisis): all clients have the same sequence #; within Priority, clients listed in Waitlist Date and then Surname, First Name sequence

SMA # CCAC Referral – eReferral to LTCH (MDS Provincial Referral Standard) Project


Description LTC P lacement – new Ethnocultural field

To comply with the minimum data set Provincial Referral Standard for referrals to LTC, a new Ethnocultural Preferences field has been added to Choice Details in CHRIS. This is intended to be used to indicate a client’s eligibility for an Ethnocultural / Language specific home, when a client’s priority is 3A or 3B. It can also be used for other choices to share a client’s Ethnocultural background or Language with LTC homes.



Description LTC P lacement –Provincial Documents to be included w ith referral

To comply with the minimum data set Provincial Referral Standard for Referral to LTC, a new section has been added to the Referral Package page of the Add Choices and Send Updates Wizard in CHRIS. On the Add Choices Wizard, the new Provincial Documents to be included with referral grid will allow users to specify which of the provincially defined list of referral documents apply to the specified client. On the Send Updates Wizard, documents previously selected will display as checked, and the user will be able to check additional documents, uncheck documents or leave the list as is. Checking a document will indicate to the LTC homes that the document should be found in the referral package. For all checked documents, the user will have to select the corresponding Assessment or document from DMS to share with the LTC homes, further down on the Referral Package page. This same grid will also be displayed on the Choice Details page in CHRIS.




This new list only applies to Long Term Placement, Short Stay Interim and Short Stay Convalescent Care referrals.



Description LTC P lacement – expanded LTC Application in CHRIS

To comply with the minimum data set for eReferral to LTC, a number of additions have been made to the LTC Application in CHRIS:

Top section (containing choice and CCAC contact information):

• New field Ethnocultural Preferences • New field Updated On (date and time) • New phone # for Care Coordinator (CCAC phone # displayed) • New value for Priority for Long Stay Placement (2T)

Client Information, Health Profile sections: – no change

• Phone Number moved below Home Address • New - All alternate phone numbers displayed below the Phone Number field

prefixed with the phone type (e.g. Cell: nnn-nnn-nnnn) • New – Province Issuing Health Card displayed below HCN field. If client’s

Home Address Province is NOT “Ontario”, then “- -” is displayed. • Present Location field label renamed “Current Location and Address” • Infection Status field label renamed “Infection Control” • Capacity for Placement field label renamed “Is the Patient Capable to Make

LTC Admission Decisions” (LTC Placement only)

Contacts section

• Relationship/Role/Legal column in the Personal Contacts grid split into 3 separate columns for easier reading, titled “Relationship”, “Non-Legal Role”, “Legal Responsibility”

• New values for Personal Contact Legal Roles (Personal Contacts grid) • If Personal Contact flagged as the Primary Contact, “(Primary)” is appended to

the Contact name • If Personal Contact flagged as an Emergency Contact, Emergency Contact role

is displayed in red text under the Non-Legal Role column • Both Home and Work phone numbers are displayed for Personal Contacts

under the Phone column identified as “H” for home phone, and “W” for work phone

• Contact Restriction Details for Medical Contacts no longer collected, “- -“ displayed

New Referral Documents section

• New Provincial Documents included with Referral grid at bottom of application




eReferral to LTCH, Complex Care/Rehab, Community 9.4

SMA # 561975 – HNHB


Description eReferral Document Selection – Allow user to sort on heading for easier document selection

Document view and user actions within the Referral Package functionality will now look and behave the same for eReferrals to LTCH, Complex Care/Rehab and Community. Changes are:

• Users can sort any column in the Document Library grid, by clicking on the column heading

• Users can sort any column in the Shared Documents grid, by clicking on the column header

• New Folder Level column added to Shared Documents grid • Count of selected documents added after title of Shared Documents grid • User action buttons are labeled Add and Remove

SMA # 507654 - CW

Affects Client Services, LTCH, Hospital & CSSA External Partners using HPG Referral Management

Description eReferral Note to Recipient – Increase size of field

The Notes field for all eReferral streams has been expanded in order to provide CCAC users to share a greater amount of client specific information with the referral recipients. In the Add Choices Wizard for eReferral to LTCH & Complex Care/Rehab, the Application Notes field has been expanded from 30 characters to 230 characters. Application Notes field content is appended to the text “New Referral – “ on the referral received by LTC homes and hospitals. In the Add Agency Wizard for eReferral to Community for all 4 community referral types, the Notes field has been expanded as above. In the Send Updates Wizard for all eReferral streams, the Reason for Update field has been expanded from 30 to 250 characters. Users need to be aware that this is a Transaction based Notes field, and it is not brought forward from one update to the next. It defaults to blank.

SMA # CCAC Referral – eReferral to LTCH (MDS Provincial Referral Standard) project


Description HPG Referral Management - expanded Client Referral for eReferral to LTCH, eReferral to Complex Care & Rehab, eReferral to Community

To comply with the minimum data set Provincial Referral Standard for eReferral to LTC, a number of additions have been made to the Client Referral in HPG Referral Management. To maintain consistency across eReferral functionality, all these changes were applied to all eReferral streams except as noted below.

Updates to the LTCH Provincial Referral Standard (from August 2013) have also been incorporated into the Client Application/Referral for all eReferral streams. These changes are included below.

The changes are as follows: Top section (containing choice and CCAC contact information):




• New field Ethnocultural Preferences (LTC Placement only) • New field Updated On (date and time) • New phone # for Care Coordinator (CCAC phone # displayed) • New value for Priority for Long Stay Placement (2T) (LTC Placement only) • Spelling of Accommodation Type has been corrected (LTC Placement only)

Client Information, Health Profile sections – no change • Phone Number moved below Home Address • New - All alternate phone numbers displayed below the Phone Number field

prefixed with the phone type (e.g. Cell: nnn-nnn-nnnn) • New – Province Issuing Health Card displayed below HCN field. If client’s

Home Address Province is NOT “Ontario”, then “- -” is displayed. • Present Location field label renamed “Current Location and Address” • Infection Status field label renamed “Infection Control” • Capacity for Placement field label renamed “Is the Patient Capable to Make

LTC Admission Decisions” (LTC Placement only)

Contacts section • Relationship/Role/Legal column in the Personal Contacts grid split into 3

separate columns for easier reading, titled “Relationship”, “Non-Legal Role”, “Legal Responsibility”

• New values for Personal Contact Legal Roles (Personal Contacts grid) • If Personal Contact flagged as the Primary Contact, “(Primary)” is appended to

the Contact name • If Personal Contact flagged as an Emergency Contact, Emergency Contact role

is displayed in red text under the Non-Legal Role column • Both Home and Work phone numbers are displayed for Personal Contacts

under the Phone column identified as “H” for home phone, and “W” for work phone

• Contact Restriction Details for Medical Contacts no longer collected, “- -“ displayed

New Referral Documents section (Long Term LTC Placement only) • New Provincial Documents included with Referral grid at bottom of application

SMA # CCAC Referral – eReferral to LTCH (Provincial Referral Standard) Project


Description NEW - HPG Referral Management – new CCAC phone number field

As of R2.3, the CCAC telephone number will be included on the client Application/Referral with all eReferral streams.

The phone number being included is the CCAC phone number from the provincial CCAC Organization records.




DMS – Client Document Library 9.5


SMA # 562210 – HNHB; 561300,561658 – WW; 561587 – CE


Description CHRIS - DMS Integration - Unable to Open Document w ith “/ ” in the Document Type

In CHRIS R2.2, users are unable to open and view any documents that have a “/" (forward slash) in the Document Type. These documents can be found in both Docushare® and CHRIS; but when the CHRIS link is selected, an error message is generated:

Informational Message: No content info.detail.no_content

The fix that was made in CHRIS R2.2.1 has now been applied permanently in R2.3.0.

HPG / CHP 9.6


SMA # 561349 - NSM

Affects Client Services, External Partners using HPG Document Exchange

Description HGP Document Exchange: Add the From User Column to the HPG Sentbox document grid

From User column was removed in the previous release, and has now been added back.

SMA # 562166 – NE; 561441 – NW; 561611 – WW

Affects Client Services, E&S Vendors

Description HPG E&S Purchase Orders – Wrong Order Type on some E&S Orders

Since R2.2.0, in some circumstances, ended equipment rentals were communicated in HPG as New Orders, and new orders were communicated as ended rentals.

The fix that was made in HPG R3.0.1 has now been applied permanently in R3.1.0.

SMA # 571506 - Cent

Affects Client Services, Community Support Service Agencies

Description HPG Referral Management – CSSA cannot accept certain offers

A small number of CSSA’s were receiving the error message “Status Date must not be in the future” when trying to accept a community service referral. This has been fixed.

SMA # 566546 – ESC; 567573 - SW

Affects Hospital and Provider Partners using HPG Client View




Description HPG CHP Client View : Shared Notes content cut off

Shared Notes in HPG Client View were displayed on a single line, and didn’t wrap, resulting in provider and hospital users being unable to read the entire note. This has been fixed.

9.6.2 Known Issues

SMA # De-coupling of Medical Contacts from Consent

Affects Hospital and Provider Partners using HPG Client View

Description NEW - Consent Restrictions column still in place for Medical Contacts

Even though consent restrictions no longer apply to active Medical Contacts in CHRIS, the Consent Restrictions column is still displayed on the Medical Contacts grid on Client View in HPG Community Health Portal. This will not be fixed for R2.3 production.




Other Technical Changes 9.7

SMA # Application Maintenance & Performance


Description Change in Browser Support

CHRIS R2.3.0 is being regarded as a transitional release, to give CCACs time to upgrade from Internet Explorer 8 to Internet Explorer 10. CHRIS, BBM, HPG and DMS applications are being tested under both Internet Explorer 8, and Internet Explorer 10 (IE 10 running in compatibility mode – 32 bit version); but the testing of Internet Explorer 10 is being prioritized. Internet Explorer 9 is not being tested. One of the benefits that comes with IE10 is the built-in Spell Check functionality. It will be up to the individual CCACs to determine the strategy to select, deploy and support the dictionaries that form the basis of the Spell Check feature. It will be the responsibility of each CCAC to plan and execute the rollout of IE10. It is planned that with CHRIS R2.4.0, only Internet Explorer 10 will be supported tested. More details regarding the Internet Explorer 10 upgrade will be provided by OACCAC IT Services.

SMA #

Affects Service Providers, E&S Vendors, and other External Partners

Description NEW – New External CCAC Website

A new system of 14 CCAC external websites are being introduced, which will replace the existing website currently accessible at www.ccac-ont.ca The current website address will be redirected to the new one, which will be healthcareathome.ca Go-live for the new websites is scheduled for the week of November 4, 2013. We will let you know if the schedule changes. As of this date, external partners looking for e-health information related to CCACs, including Release Notes for new CHRIS & HPG releases, will go to the NEW website. When you arrive at the new website, click through to any individual CCAC site, then click on the Partners tab and select Service Provider Portal to access the information you need.

Reports 9.8


Affects Contract Management, Finance, Client Services

Description Service Utilization Report – enhancements for OBP/ OBR

A new section has been added to the Service Utilization Report, titled Outcome Based Reimbursement Costs. The details are outlined in the Functional Overview for OBP/OBR. The existing Purchased Services Costs section is now clearly identified as Fee for Service (FFS).



http://www.ccac-ont.ca/



Affects Contract Management, Application Admin

Description Provider Contract Export – enhancements for Service Delivery Override

Three new columns have been added to the Provider Contract Export report: • SDT Override • FSMS uses SDT Override • FSMS/MIS Reportable.

This information will be included on contracts for both Outcome-Based services, and any other services which have been configured with a service delivery override at the provider billing code level.


Affects Finance

Description New Service Assignment Financial Audit Report

A new report has been developed which provides a detailed list of all adjustments to provider payments for outcome based contracts. This can be found under Provider Contract Reports. More information will be available in the R2.3 OBP/OBR Education sessions.

Maintenance 9.9


Affects Contract Management, Application Admin

Description Service Provider Contract Maintenance

A new validation rule has been implemented when CCAC users are adding new provider billing codes to a provider contract. When the provider billing code being added already exists in CHRIS on another provider contract for the same provider organization, the new provider billing code must have the same Service Delivery Type Override configuration as the existing instance of the provider billing code.




10. Provincial Data Updates

Allergies 10.1

SMA # 543475 - CE; 549006 - CE; 556244 - CW; 571139 - Cent; 556032 - HNHB; 556659 - HNHB; 571974 - NE; 565421 - TC


Description Updates for Allergy Type = Drug:

• Added a new Drug Allergy: Generic Name: Metoclopramide Brand Name: Maxeran

• Added a new Drug Allergy: Generic Name: Mometasone Brand Name: Nasonex

• Added a new Drug Allergy: Generic Name: Rosuvastatin Calcium Brand Name: Crestor

• Added a new Drug Allergy: Generic Name: Barium Sulfate Brand Name: - -

• Added a new Drug Allergy: Generic Name: Nitrazepam Brand Name: Nitrazadon

• Added a new Drug Allergy: Generic Name: Risedronate Soduim Brand Name: Actonel

• Added a new Drug Allergy: Generic Name: Etidronate Disodium/Calcium Carbonate Brand Name: Didrocal

• Added a new Drug Allergy: Generic Name: Perindopril Erbumine Brand Name: Coversyl

Updates for Other Allergy Types: • Added a new Environmental Allergy:

Name: Wound Dressing-OpSite Description: --

• Added a new Food Allergy: Name: Melons Description: - -

• Added a new Food Allergy: Name: Citrus Fruit Description: --




Languages 10.2

SMA # 474949 - Cent; 281497 - NSM

Affects Client Services; All HPG Users

Description Updated Language: • Khmer (Cambodian)

- Formerly: “Khmer” Added new Languages

• Cambodian (Khmer) • Non-Verbal

Note Types 10.3

SMA # Primary Care Integration


Description Added a new Client note-type: • Unattached Patient Support Plan

This note type has been created for the purpose of documenting the plan to support a client until a Primary Care Provider for the client has been identified and has accepted the client.

Service Related Table Changes 10.4

10.4.1 Functional Centres & MIS Codes

SMA # 572413 - MH

Affects Finance

Description Added new Service Functional Centres and corresponding MIS Codes for the community based Complex Wound Consultation service funded by MH CCAC:

• Community Clinics/Program-General - 725 10 20 applies to ET, OT, Dietary Services

• Community Clinics/Programs-Therapy Clinic-Foot Care - 725 10 4020 applies to Chiropody service

SMA # MIS Client Services Working Group

Affects Finance

Description Added new Service Functional Centre and corresponding MIS Code for the Self-Managed Tele Home Care service provided by TC CCAC:

• In-Home Health Care Self-Managed Home Care (TeleHomeCare) - 725 30 4013




SMA # OBP/OBR Project

Affects Finance

Description Added new Service Functional Centres and corresponding MIS Codes for the Outcome Based Wound and Orthopaedic services:

• In Home Wound Care Prof Services Outcome Based - 725 30 4020

• In Home Orthopaedic Care Prof Services Outcome Based - 725 30 4025

10.4.2 Community Services (for eReferral to Community)

SMA # 581224 – Central; DPC PT Transition Project


Description Added two three new Service Types for Community Services Referral service type: • Group Exercises Programs • Falls Prevention Programs

These service types were added between R2.2.1 and R2.3 at the end of July, to support the business process for PT reform. They are for use with the eReferral to Community functionality to refer patients to applicable community services.

• PT Clinic (LHIN funded) This service was added between R2.2.1 and R2.3 at the end of September, to support the business process for PT reform. For use with the eReferral to Community functionality to refer patients to PT clinic service provided by CSSAs.

10.4.3 Purchased Services

New service choices will be deployed as Inactive. Individual CCACs will request specific services / service delivery types be enabled via SMA, as needed for their CCAC. CCACs will notify service providers when new service choices are being deployed.

SMA # CCAC MIS Client Services Working Group

Affects Client Services; Contract Management; Finance; Service Providers

Description Added new Service Type for Other Reimbursed Programs Referral type: • Self-Managed Home Care (TeleHomeCare) • SAF Code = 44 (for provider billing)

Added new Service Type for Home Care Referral type: • Self-Managed Home Care (TeleHomeCare) • SAF Code = 44

Note: No service specific Activity Codes have configured for SAF Code 44; providers will be able to bill using the generic Activity Codes that apply to all services (01 – 09). Added new Service Delivery Types for Self-Managed Home Care (TeleHomeCare)-

Other Reimbursed Programs • Visit - other funding




• Phone - other funding • Hourly - other funding

Service functional assignment is the same for all service delivery types: • Functional Centre: In-Home Health Care Self-Managed Home Care

(TeleHomeCare) • MIS Code: 725 30 4013

Added new Service Delivery Types for Self-Managed Home Care (TeleHomeCare)-

Home Care • Visit • Phone • Hourly

Service functional assignment is the same for all service delivery types: • Functional Centre: In-Home Health Care Self-Managed Home Care

(TeleHomeCare) • MIS Code: 725 30 4013

SMA # 567507 - NW


Description Updated naming of existing Home Care Nurse Practitioner service delivery types, to reflect the service functional centre assignment to Primary Care Practice (725 10 05):

• Hourly Primary Care (formerly: “Hourly”) • Visit Primary Care (formerly: “Visit”)

Added new Service Delivery Types for Service Type ‘Nurse Practitioner’ for Home Care Referral type, consistent with existing types above:

• Phone Primary Care o Functional Centre: Primary Care Practice (725 10 05)

Added new Service Delivery Types for Service Type ‘Nurse Practitioner’ for Home Care Referral type, where service is related to purchased service nursing, rather than NP associated with a primary care office

• Phone Nursing o Functional Centre: In home Nursing Visits (725 30 4011)

• Hourly Nursing o Functional Centre: In home Nursing Visits (725 30 4011)

• Visit Nursing o Functional Centre: In home Nursing Visits (725 30 4011)

Note: all of these Nurse Practitioner service delivery types are distinct than those for the (newer) Nurse Practitioner Integrated Palliative Home Care program. The above service delivery types are for Non-Palliative clients.

SMA # 572413 - MH





Description Complex Wound multi-disciplinary Consultation service added in R2.2. MH has determined that all service delivered under this service should be reported under Community Clinic functional centres, rather than Home Care functional centres. As a result, new service delivery types are being added. Added new Service Delivery Type for Nutritional Services Service Type under Home Care Referral type:

• Hourly Community Clinic

o Functional Centre: Community Clinics/Program-General (725 10 20)

o Location: Therapy Day Clinic

Added new Service Delivery Type for Occupational Therapy Service Type under Home Care Referral type:


o Functional Centre: Community Clinics/Program-General (725 10 20)


Added new Service Delivery Type for Enterostomal Therapy Service Type under Home Care Referral type:


o Functional Centre: Community Clinics/Program-General


Added new Service Delivery Type for Chiropody Service Type under Home Care Referral Service type:

• Hourly Community Footcare Clinic

o Functional Centre: Community Clinics/Programs-Therapy Clinic-Foot Care (725 10 4020)

o Location: Therapy Day Clinic Updated Service Type for Chiropody under Home Care Referral type:

• SAF Code = 45 (formerly: None) Updated Service Delivery Type for Chiropody Service Type under Home Care Referral Service type:

• Visit Community Footcare Clinic (formerly “Visit”) o Functional Centre: Community Clinics/Programs-Therapy Clinic-Foot

Care (formerly: None) o MIS Code: 725 10 4020 o Location: Therapy Day Clinic (formerly: Home)

SMA # DPC PT Transition

Affects Client Services; Contract Management; Service Providers

Description Added three new Service Delivery Types for Service Type Physiotherapy under Referral Service Type Home Care, to support different models for the delivery of Physiotherapy in retirement homes and other congregate settings:

• Visit group (Congregate setting) o Specialty: Group o Location: Home

• Hourly group (Congregate setting)




o Specialty: Group o Location: Home

• Hourly group multi-client billing cap (Congregate setting) o Specialty: Group o Location: Home

Service functional assignment is the same for all service delivery types:

• Functional Centre: In home Physiotherapy • MIS Code: 725 30 4050

SMA # OBP/OBR Project

Affects Client Services; Contract Management; Service Providers

Description Updated Functional Centre for Service Delivery Type Outcome-Based Wound for Service Type Outcome Based Wound under Referral Type Home Care

• Functional Centre: In Home Wound Care Prof Services Outcome Based (formerly: In home Nursing Visits)

• MIS Code: 725 30 4020 (formerly: 725 30 4011)

Updated Functional Centre for Service Delivery Type Outcome-Based Orthopaedic for Service Type Outcome Based Orthopaedic under Referral Type Home Care

• Functional Centre: In Home Orthopaedic Care Prof Services Outcome Based (formerly: In home PT)

• MIS Code: 725 30 4025 (formerly: 725 30 4050)

SMA # 587643 – CW; DPC PT Transition Project

Affects Client Services; Contract Management;

Description At least one CCAC is being funded by their LHIN to act as a Community Support Service Agency and deliver what is usually community based PT services. To record and report this accurately in CHRIS, new services were added under the Other Reimbursed Programs referral, which were then assigned to a CSS MIS service functional centre. Added two new Service Types for Other Reimbursed Programs Referral type:

• Group Exercise Programs-CCAC • Group Falls Prevention Programs-CCAC

Added three new Service Delivery Types for Service Type Group Exercise Programs-CCAC:


• Hourly group (Congregate setting) o Specialty: Group o Location: Home

• Hourly group multi-clt billcap(Congregate setting) o Specialty: Group o Location: Home




Added three new Service Delivery Types for Service Type Group Falls Prevention Programs-CCAC:


• Hourly group (Congregate setting) o Specialty: Group o Location: Home

• Hourly group multi-clt billcap(Congregate setting) o Specialty: Group o Location: Home

Service functional assignment is the same for all service delivery types:

• Functional Centre: Social and Congregate Dining • MIS Code: 725 82 12

These service types were added between R2.2.1 and R2.3 at the end of September, to support the changes in PT service delivery driven by PT reform.
