FAQ

Frequently Asked Questions

HRM Deployment


HRM Reference Site


HRM Requirements


Answers

How will EMR vendors be informed of new hospitals or specialty clinics connecting to HRM?

OntarioMD will provide EMR vendors with information about the HRM Schedule of Sending Facilities in addition to vendor-specific progress to facilitate EMR vendor planning of HRM release deployment and client implementation of HRM.

A monthly email will be distributed to the EMR vendors updating them about which hospitals and specialty clinics are connected to HRM. Additional information will be made available on the HRM section of the OntarioMD website.

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Will EMR vendors receive information about which clients are interested in connecting to HRM?

All practices must be notified by their EMR vendor in writing (email is acceptable) that the HRM release is Generally Available and the vendor must schedule the upgrade date in consultation with the practice.

OntarioMD will provide EMR vendors, by email, with a list of priority practices interested in those which are ready to connect to HRM.

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Is the Reference Site required to have a test environment?

OntarioMD recommends having a test environment, however the Reference Site is not required to have a test environment. When the Reference Site does not have a test environment, all activities will be conducted in the Reference Site's production environment using test data.

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Does the Reference Site have to use a certified EMR offering?

Yes, the HRM Reference Site must use a certified EMR offering in order to proceed with HRM.

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What assistance can OntarioMD provide to identify potential Reference Sites?

OntarioMD will provide all EMR vendors with a list of practices that could be potential Reference Sites based on alignment with HRM sending facilities.

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What agreements are required to implement HRM at a Reference Site?

EMR ASP vendors are required to sign the ASP Value Add Agreement before connecting the Reference Site to the HRM production environment.

The Reference Site is required to complete the following agreements to implement HRM in the production environment at the Reference Site (outlined in section 4.2 in the HRM EMR Vendor Planning Guide):

  • Technical Information Sharing Agreement (TISA) - makes up the HRM Subscription Agreement;
  • HRM Subscription Agreement - signed by the practice
  • HRM End User Agreement - signed by each clinician enrolling in HRM.

Note: The HRM Subscription Agreement must be signed before the Reference Site can connect to the HRM production environment.

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How does a Reference Site connect to the HRM test environment or the HRM production environment?

Connecting to the HRM Test Environment:
OntarioMD will send the HRM Reference Site instructions on how to connect to the HRM test environment once the Reference Site has completed the following precondition(s):

  • The EMR vendor must successfully complete technical validation with OntarioMD.
  • The EMR vendor must receive Conditional Approval for the HRM Requirements under the Ontario EMR Specification 4.1(including Ontario EMR Specification Amendment 4.1A).

Connecting to the HRM Production Environment:
OntarioMD will send the HRM Reference Site instructions on how to connect to the HRM production environment once the Reference Site has completed the following precondition(s):

  • The practice has completed end user testing. Please refer to the HRM Site End User Testing Phase document.
  • The Reference Site has signed the HRM Subscription Agreement and completed the Technical Information Sharing Agreement.


Once all preconditions are met, OntarioMD will send the instructions on how to connect to the HRM test or production environment as well as the security keys and certificates to the Reference Site.

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What is the estimated schedule of activities for completing the Reference Site phase?

The schedule of activities for completing the Reference Site phase is outlined in section 1.3.1 in the HRM Reference Site Phasedocument. 
The schedule of activities is:

  • Select a Reference Site running a certified EMR offering
  • Provide OntarioMD with:
    • Release notes for the release that includes HRM functionality
    • EMR vendor's training plan and materials for HRM
    • Reference Site training schedule
    • Mapping table of the site-specific HRM report categorization
  • Upgrade the Reference Site test environment certified EMR offering to include HRM functionality
  • Connect the Reference Site test environment to the HRM test environment
  • Upgrade the EMR production environment at the Reference Site with HRM functionality
  • Connect the EMR production environment at the Reference Site to the HRM production environment
  • Maintain a four (4) week stabilization period during the HRM production validation phase
  • Participate in the HRM Reference Site validation session.

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What are the requirements during the HRM production validation phase at the Reference Site?

EMR vendors must pass the checkpoint before entering the production validation phase (ASP EMR vendors have signed the ASP Value Add Agreement).

The requirements during the HRM production validation phase are as follows (see section 1.2 in the HRM Reference Site Phasedocument):

  • The Reference Site production environment must have a connection to the HRM production environment.
  • The Reference Site must go through a four (4) week stabilization period during which the practice will receive live patient reports in their EMR production environment.
  • A pre-reference site validation checkpoint meeting will take place one week before the HRM Reference Site validation session.
  • The HRM Reference Site validation session will take place at the end of the four (4) week stabilization period (outlined in section 4.4 in the HRM EMR Vendor Planning Guide document).
  • The HRM Reference Site validation session will be remotely conducted by the OntarioMD Validation Authority (OntarioMD VA).

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What is required from the EMR vendor before the Reference Site validation session can take place?

The requirements before the Reference Site validation session are:

  • The Reference Site, along with the EMR vendor, must have gone through a validation checkpoint meeting.
  • The EMR vendor must upgrade the certified EMR offering production environment at the Reference Site with HRM functionality.
  • The Reference Site production environment must be connected to the HRM production environment for a four (4) week stabilization period.
  • The EMR vendor must ensure that there are no outstanding issues or bugs with the upgraded certified EMR offering.
  • EMR vendors will work with the Reference Site to identify five (5) patients that meet the required criteria (outlined in section 1.3.1 B in the HRM Reference Site Phase document).
  • The EMR vendor must be prepared to validate the export of the HRM report against the CDS-XSD Schema (can use XML Spy).
  • The EMR vendor must provide training to the Reference Site so they are able to respond to the sample list of questions available in Attachment A: Reference Site Question Outline of the HRM Reference Site Phase document.

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When can the EMR vendor upgrade the test and production environments at the Reference Site with HRM functionality?

Upgrading the Reference Site Test Environment:
Once the certified EMR offering has received Conditional Approval, EMR vendors may upgrade the test environment at the Reference Site with the HRM functionality.

Note: Once the Reference Site test environment has been upgraded to include the HRM functionality, the Reference Site can then proceed to connect to the HRM test environment.

Upgrading the Reference Site Production Environment:
Once the certified EMR offering has received Conditional Approval, EMR vendors may upgrade the production environment at the Reference Site with the HRM functionality.

Note: Once the Reference Site production environment has been upgraded to include the HRM functionality, the Reference Site can then proceed to connect to the HRM production environment.

If an EMR vendor does not have a test environment at their Reference Site, the EMR vendor can upgrade the Reference Site's production environment with the HRM functionality. Refer to FAQ "Is the EMR vendor's Reference Site required to have a test environment?" for more information to support the situation.

Refer to the FAQ "How does a Reference Site connect to the HRM Test Environment or the HRM Production Environment?" for instructions on how to connect in the test and production environments.

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What types of hospital reports will the Reference Site receive during the HRM end user testing phase?

During the HRM end user testing phase, the Reference Site will receive test reports that have been generated by a sending facility (i.e., hospital or specialty clinic).

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Is the Reference Site required to complete report categorization before receiving reports in their production environment at the Reference Site?

Yes, the HRM Reference Site is required to set up their specific categories for HRM report class and sub-class/accompanying subclass before clinical use. This will ensure that mapped HRM reports received during the clinical use period will be categorized automatically.

During the Reference Site validation checkpoint, the mapping table of the site specific HRM report categorization will be reviewed by the OntarioMD VA.

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Will EMR vendors be required to support the change in length in CNO number to 8 digits?

All vendors are required to accommodate the change to support the 8 digit College of Nurses of Ontario (CNO) number. Please refer to Appendix F - Hospital Report Manager Requirements of the Ontario EMR Specification 4.1 document.

The HRM XSD Schema can be used to verify support of the 8 digit CNO number. The affected areas relate to a metadata rule change in the DeliverToUserId tag, with an increase to a maximum length of 9 from 8. The HRM XSD Schema is available and will be provided to the EMR vendors.

As OntarioMD moves forward with the HRM across the province, it is expected that practices will roster Registered Nurse Practitioners. If vendors do not take the necessary action to implement this update, then Registered Nurse Practitioners will not be able to access hospital reports through a certified EMR offering that is connected to HRM.

EMR vendors will be contacted individually by OntarioMD to review and schedule a time to demonstrate that their certified EMRs are able to accommodate the change in CNO number to 8 digits.

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What are the main differences between Ontario EMR Specification 4.1 and Ontario EMR Specification Amendment 4.1A that relate to the HRM requirements?

The differences between Ontario EMR Specification 4.1 and the Ontario EMR Specification Amendment 4.1A are outlined in the document EMR Specification 4.1A Amendments - Summary of Changes available on the OntarioMD website.

Ontario EMR Spec Amendment 4.1A includes the following:

  1. Supports the delivery of binary based reports;
  2. Supports distribution of reports to nurse practitioners;
  3. Accommodates a change in Message Unique ID length and sub-components;
  4. Updates to the schema definition files;
  5. Provision of security key and certificate maintenance management.

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Will OntarioMD update its website to indicate that the vendor has achieved HRM functionality under the Ontario EMR Specification 4.1?

EMR vendors will be able to update Schedule H - Offerings Profiles schedule to reflect updates to their profile on the OntarioMD website that includes approval of HRM functionality under the Ontario EMR Specification 4.1 (including Ontario EMR Specification Amendment 4.1A).

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