Alberta Health and Wellness Alberta Ambulance Information ... · Accreditation Process Alberta...

Alberta Health and Wellness Alberta Ambulance Information Management System

Accreditation Process

Version 2.6

June 2008

Alberta Ambulance Information Management System


Table of Contents 1 INTRODUCTION............................................................................................................................................. 3

1.1 ABOUT THIS DOCUMENT............................................................................................................................... 3 2 ACCREDITATION PROCESS....................................................................................................................... 4

2.1 ACCREDITATION PROCESS STEPS FOR THIRD PARTY SOFTWARE DEVELOPERS ........................................... 4 2.2 ACCREDITATION PROCESS STEPS FOR THIRD PARTY DATA SUBMITTERS .................................................... 6

3 TECHNICAL REQUIREMENTS................................................................................................................... 7 3.1 SOFTWARE REQUIREMENTS ......................................................................................................................... 7 3.2 RECOMMENDED HARDWARE REQUIREMENTS.............................................................................................. 7

4 THIRD PARTY DATA SUBMITTER ACCREDITATION RESPONSIBILITIES .................................. 8 4.1 DOCUMENTS/COMMUNICATION ................................................................................................................... 8 4.2 DATA ........................................................................................................................................................... 8 4.3 FREQUENCIES AND VOLUMES ...................................................................................................................... 8 4.4 SECURITY..................................................................................................................................................... 8 4.5 CHARGES AND COSTS .................................................................................................................................. 9 4.6 TERMINATION .............................................................................................................................................. 9

5 AMBULANCE OPERATOR ACCREDITATION RESPONSIBILITIES ............................................... 10 5.1 DOCUMENTS/COMMUNICATION ................................................................................................................. 10 5.2 DATA ......................................................................................................................................................... 10 5.3 VOLUMES................................................................................................................................................... 11 5.4 SECURITY................................................................................................................................................... 11 5.5 AUDIT ........................................................................................................................................................ 11

6 ALBERTA HEALTH AND WELLNESS ACCREDITATION RESPONSIBILITIES ........................... 12 6.1 CONTACTS ................................................................................................................................................. 12 6.2 NOTIFICATION............................................................................................................................................ 12 6.3 SECURITY................................................................................................................................................... 13 6.4 AUDIT ........................................................................................................................................................ 13

APPENDIX A..................................................................................................................................................... 14 APPLICATION FOR THIRD PARTY SUBMITTER ACCREDITATION ROLE.............................................................. 14 THIRD PARTY SUBMITTER/CLIENT RELATIONSHIP FORM ................................................................................ 15 EXTERNAL USER ID APPLICATION FORM ........................................................................................................ 16

APPENDIX B ..................................................................................................................................................... 19 THIRD PARTY SOFTWARE ACCREDITATION ..................................................................................................... 19 CRITERIA FOR GROUND PCR SUBMISSION ....................................................................................................... 19 TABLE 1 – GROUND PCR SUBMISSION CALL TYPES & NO TRANSPORT REASONS .......................................... 23



1 Introduction

1.1 About this document Alberta Ambulance Information Management System (AAIMS) is a web-based application that collects patient care reporting data. This document describes the accreditation process for Third Party Software Developers and Third Party Data Submitters. Third Party Software Developers develop software used by ambulance operators or Third Party Data Submitters to submit patient care report (PCR) data to AAIMS via the batch submission process. Third Party Software Developers do not submit data unless they wish to be accredited as a Third Party Data Submitter. Third Party Data Submitters are the groups contracted by some Ambulance Operators to submit PCR data to AAIMS through either the AAIMS online function or the batch submission process. Ambulance operators who develop in-house batch submission software for their exclusive use are not considered Third Party Data Submitters. If submitted through the batch submission process, PCR data must be submitted in the specified format to meet technical specifications explained in detail in the AAIMS Batch - Data Submission Guidelines document that has already been distributed to Third Party Software Developers. Alberta Health and Wellness (AH&W) is the main contact for any initial communication regarding the submission process and the testing of the batch submission file from Third Party Software Developers.

Alberta Health and Wellness System Information and Planning Unit

Application Maintenance and Data Services Team 14th Floor Telus Plaza North Tower

10025 – Jasper Ave Edmonton, AB T5J 1S6

AAIMS Help Desk Phone #: 780-422-9087

E-mail Address: [email protected]



2 Accreditation Process

2.1 Accreditation Process Steps for Third Party Software Developers Third Party Software Developers develop software used by some Ambulance Operators or Third Party Data Submitters to submit Patient Care Report (PCR) data to AAIMS via the batch submission process. Ambulance Operators or Third Party Data Submitters need to know that the batch software will be able to submit PCR data to AAIMS.

- Third Party Software Developers ensure their software can make batch submissions to AAIMS as per the specifications in the AAIMS Batch - Data Submission Guidelines document. Third Party Software is accredited by AH&W after it meets the PCR submission criteria as defined in Appendix B of this document.

- AH&W Analyst provides required PCR core data to the Third Party Software

Developer prior to sending the XML test file.

- Third Party Software Developers send the XML test file to AH&W, System Information and Planning Unit, Application Maintenance & Data Services Team. A disk containing the XML test file could be sent via mail or e-mail (the AAIMS Help Desk mail and e-mail addresses are provided earlier in this document). Evidence showing the use of the software being accredited must also accompany the XML test files. The evidence can include system audit logs and screen prints showing the use of data entry screens and the creation of the test XML file. Accreditation will not be performed on software that is still under development.

- Once the AH&W Application Maintenance & Data Services Team analyst receives

the file and supporting documentation, a confirmation e-mail will be sent to the Third Party Software Developer.

- The AH&W Application Maintenance & Data Services Team analyst will review the

file & use-of-software evidence and perform the test by submitting the XML test file in the AAIMS UAT environment using the AAIMS ‘Submit PCR Batches’ function.

- The AH&W Application Maintenance & Data Services Team analyst will then check

the results of the submission. The results will be communicated with the Third Party Software Developer.

- If the test is not successful, the AH&W Analyst will communicate the error details

with the Third Party Software Developer. The Third Party Software Developer will need to eliminate the identified issues and schedule a software retest with AH&W



analyst. This process will continue until the successful test is performed. The AH&W analyst will stop the accreditation process if:

o more than 7 level-1 edit errors are encountered (XML File Structure) o more than 7 level-2 edit errors are encountered (XML File Header/Footer

errors) o more than 25 level-3 edit errors are encountered (business rules)

If any of the above thresholds are reached, the Third Party Software Developer must revisit their software and take appropriate steps to reduce the number of errors being submitted. The AH&W analyst will inform the Third Party Software Developer when they may resume the accreditation process. A minimum of 30 days will be allotted to provide the Third Party Software Developers sufficient time to ensure they resolve their issues without involving Alberta Health and Wellness.

- Once the AH&W Application Maintenance & Data Services Team analyst confirms

the software test is successful, they will send an e-mail with a letter of confirmation to the Third Party Software Developer that its software is ready to be used by prospective Ambulance Operators or Third Party Data Submitters for the electronic PCR data submission.



2.2 Accreditation Process Steps for Third Party Data Submitters A Third Party Data Submitter is the group contracted by the Ambulance Operator to submit PCR data to AAIMS. This can be done via the AAIMS online function or the batch submission process. They may use third party software or have in-house software. A prospective Third Party Data Submitter must apply for the submitter role in order to be granted access to the electronic submission. Prior to being granted a submitter role, the applicant must meet the minimum criteria requirements and pass an accreditation check. The accreditation process is the responsibility of AH&W. An application for accreditation will be reviewed by the System Information and Planning Unit, Application Maintenance & Data Services Team according to predetermined accreditation requirements. The prospective Third Party Data Submitter should contact AH&W System Information and Planning Unit, Application Maintenance & Data Services Team via mail or email for information and the application forms.

Note: The following application forms need to be filled out and sent to AH&W by the prospective Third Party Data Submitter:

1. Application for Third Party Submitter Accreditation Role 2. Third Party Submitter Client Relationship Form

The Third Party Data Submitter will need to fill out and submit to AH&W the External User ID Application form in order to get the proper access to the AAIMS application. This is a requirement of the Third Party Submitter Accreditation. Both applications (Data Submitter and External ID) can be submitted at the same time. Please refer to the Appendix A for “Application for Third Party Submitter Accreditation Role” form, “Third Party Submitter/Client Relationship Form”, and “External User ID Application” form. These forms are used during the AAIMS Deployment Phase. The process flow is as follows:

- AH&W analyst provides the required forms to the prospective Third Party Data Submitter.

- The prospective Third Party Data Submitter completes the forms and returns

them to AH&W as per instructions stated on the actual forms.

- AH&W will then review the forms for completeness, and inform the applicant regarding any possible discrepancies or missing information.

- Once the forms are complete and accurate, AH&W will initiate Third Party Data

Submitter AAIMS security accreditation/access process.



- Once the process is complete, AH&W will establish the Third Party Data Submitter in the AAIMS Production environment.

3 Technical requirements Alberta Health and Wellness does not charge accredited submitters for using AAIMS. However, accredited submitters are responsible for the cost of acquiring hardware, software and all related set-up and usage charges. To effectively communicate with Alberta Health and Wellness, the following technical specifications should be followed:

3.1 Software Requirements

- Web browser Internet Explorer 5.5 or greater - Windows Me, 2000, XP Professional, Windows NT or Windows Vista. Not

recommended for Windows XP Home or Mac Emulation

3.2 Recommended Hardware Requirements - Pentium personal computer (450 megahertz) with Windows Me (minimum) - Minimum of 32mb RAM for Windows Me - Minimum of 64mb RAM for any other acceptable operating system stated above - A Hayes compatible modem with a baud line speed of 56.6 KBPS or High-speed

Internet Connection - A security fob issued by Alberta Health and Wellness and used for logging in to

the AH&W network - Telephone line, ADSL, or Cable



4 Third Party Data Submitter Accreditation Responsibilities

4.1 Documents/Communication

- Third Party Data Submitter must provide AH&W, System Information and Planning Unit, Application Maintenance & Data Services Team with at least three weeks notice of the termination of their role as a submitter for an Ambulance Operator.

4.2 Data

- Third Party Data Submitter must NOT alter an original data received from an Ambulance Operator unless authorized by the Ambulance Operator.

- Third Party Data Submitter must NOT create the “original” data.

- Third Party Data Submitter acknowledges that all data and associated

documentation is the property of AH&W.

- Third Party Data Submitter must return all PCR files and reports to the Ambulance Operator unless a written agreement is reached with the Ambulance Operator.

4.3 Frequencies and Volumes

- PCR records must be submitted no later than 30 days from the date of service. Therefore, the minimum submission frequency is at least once per month. - The maximum number of PCR records per submission is 5000 or file size of 5mb.

Note: For more detailed information about the volume and frequency of data submission, please refer to AAIMS Batch Data – Submission Guidelines.

4.4 Security

- Third Party Data Submitter must protect the confidentiality and security of any data handled on behalf of Ambulance Operators.

- Third Party Data Submitter must not release any information to outside parties

without written permission from the Ambulance Operator(s) concerned and AH&W.



- Third Party Data Submitter must not divulge, share or compromise the password and User ID assigned by AH&W.

- Third Party Data Submitter requesting access to the AH&W AAIMS application

must complete the necessary security forms.

4.5 Charges and Costs

- Third Party Data Submitter acknowledges that operational charges incurred by the Third Party Data Submitter or Ambulance Operator as a result of legislative, policy or other changes will not be covered by AH&W.

- Third Party Data Submitter will charge a fee to Ambulance Operators for

accredited submitter services as per the written service agreement between the Third Party Data Submitter and their Ambulance Operator.

- Third Party Data Submitter acknowledges that all costs associated with Internet

connectivity are the responsibility of the Third Party Data Submitter or Ambulance Operator.

4.6 Termination

- Third Party Data Submitter acknowledges that any breach or non-compliance of any terms may result in immediate and unconditional withdrawal of accreditation privileges by AH&W.

- Third Party Data Submitter must inform AH&W of any violations by the

Ambulance Operator(s) of the PCR electronic submission requirements or of the Ambulance Services Act and Regulations.

- Third Party Data Submitter must return the security fob(s) to Alberta Health and

Wellness upon termination of submission activities.



5 Ambulance Operator Accreditation Responsibilities The Ambulance Operator utilizing the accredited Third Party Data Submitter must comply with the following:

5.1 Documents/Communication

- Ambulance Operator must file with AH&W a completed Third Party Submitter Client Relationship Application form.

- Ambulance Operator must advise AH&W at least two weeks in advance of any

change from one Third Party Data Submitter vendor to another or of the use of any additional Third Party Data Submitters. A new Third Party Submitter Client Relationship Application form must be filed if the additional Submitter is contracted.

- Ambulance Operator must advise their Third Party Data Submitter vendor in

writing when they no longer wish to retain their services. A copy of this notice must be forwarded to Alberta Health and Wellness.

5.2 Data

- Ambulance Operator must ensure that data submitted through the accredited Third Party Data Submitter is in accordance with the Ambulance Services Act and Regulations.

- Ambulance Operator is responsible for submitting PCR data in accordance with

the Ambulance Services Act until the Third Party Data Submitter has been accredited to submit on the operator’s behalf.

- Ambulance Operator must ensure that the Third Party Data Submitter keeps

confidential and secure any data received from AH&W or any data processed on their behalf. No information may be compiled or released by the Third Party Data Submitter to any third party without written permission from the Ambulance Operator(s) concerned and AH&W.

- Ambulance Operator acknowledges all documentation and data used in the

submission of Patient Care Reports are the property of the Ambulance Operator and/or AH&W.



5.3 Volumes

- PCR records must be submitted no later than 30 days from the date of service. Therefore, the minimum submission frequency is at least once per month. - The maximum number of PCR records per submission is 5000 or file size of 5mb.

Note: For more detailed information about the volume and frequency of data submission, please refer to AAIMS Batch Data – Submission Guidelines.

5.4 Security

- Ambulance Operator must maintain security, validity and accuracy of all PCR submissions to AAIMS. As part of this responsibility, the Ambulance Operator must ensure the Third Party Data Submitter has adequate processes and procedures in place to record, protect and recreate, if necessary, any data submitted on their behalf.

- Ambulance Operator must inform AH&W of any violations or inconsistencies by

the Third Party Data Submitter.

5.5 Audit

- Ambulance Operators must retain all original documents and records as per the Ambulance Services Act and Regulations.

- Ambulance Operators must acknowledge that all costs for providing data required

in the course of an examination of records, are the responsibility of the Ambulance Operator and/or accredited Third Party Data Submitter.



6 Alberta Health and Wellness Accreditation Responsibilities Alberta Health and Wellness must comply with the following:

6.1 Contacts

- AH&W must accredit new Third Party Data Submitters to submit patient care report data based on their ability to meet the accreditation criteria specified in this document.

- AH&W must monitor Third Party Data Submitters transmissions to ensure

accreditation requirements are maintained. Any problems identified through the accreditation process by AH&W will be brought to the attention of the Third Party Data Submitters and/or Third Party Software Developers.

- AH&W must provide specifications, security key fobs, and password granting the

accreditation to new Third Party Data Submitters.

- AH&W must provide a standard set of test data to the software vendor. This data includes the Operator ID, License Number, List of Stations, Ambulance Units, Facilities, Ambulance Attendants and a list of Alberta resident patients. AH&W will also provide a range of PCR numbers to be used for testing. This data is provided in an effort to avoid violations of the Freedom of Information and Privacy Act and the Health Information Act.

- AH&W must provide testing and submission results information to the Third Party

Software Developers through the View/Download Batch Results report link in AAIMS.

6.2 Notification

- AH&W will inform stakeholders of any operational changes as far in advance as possible.

- AH&W must provide confirmation to the stakeholders (Third Party Data

Submitters and Third Party Software Developers) when the accreditation is granted.

- AH&W must inform the affected Third Party Data Submitters, Third Party

Software Developers, and/or Ambulance Operators of any operational problems during the accreditation period or while in production.



6.3 Security - AH&W must keep confidential information captured on the Accreditation Application

forms.

6.4 Audit

- AH&W must notify the affected Third Party Submitter and/or the Ambulance Operators in writing two weeks in advance, if accreditation privileges are being withdrawn.

- AH&W reserves the right to place Third Party Submitter accreditation privileges

under probation for a period of one year, if either the Third Party Submitter or the Ambulance Operator fails to comply with the accreditation responsibilities listed in this document. Any repeated or additional failures to comply with accreditation responsibilities during the probationary period by either the Third Party Submitter or the Ambulance Operator will result in termination of accreditation privileges.

- The reasons under which AH&W will terminate accreditation are as follows:

o Alteration of original data was detected and not substantiated with an

audit trail showing evidence of Ambulance Operator approval. o Repeated or flagrant violation of security/confidentiality o Evidence of fraudulent collusion between Third Party Submitter and

Ambulance Operator(s).



Appendix A

Application for Third Party Submitter Accreditation Role



Third Party Submitter/Client Relationship Form



External User ID Application Form



Note: The Access Administrator Authorization section of the External User ID Application for the Third Party Data Submitters needs to be filled out and signed by the Access Administrator of the Ambulance Operator that has contracted the Third Party Data Submitter.



Appendix B

Third Party Software Accreditation

Criteria for Ground PCR submission

The provided xml file has to contain at least 20 PCR records* that will record different PCR information, depend on the type of call as stated below:

1. Emergency response on a scene (patient is Alberta resident) o Incident Information o Attendant Information o Patient Information o Times Information o Vitals (multiple vital signs) o Skilled Interventions (multiple treatments/medications) o Observation Information o Trip Information

2. Emergency response on a scene (patient resides outside of Alberta)

o Incident Information o Attendant Information o Patient Information o Times Information o Vitals (multiple vital signs) o Skilled Interventions (multiple treatments/medications) o Observation Information o Trip Information

3. Rendezvous

o Incident Information o Attendant Information o Patient Information o Times Information o Vitals o Skilled Interventions o Observation Information o Trip Information



4. Unscheduled transfer within a region (RHA) o Incident Information (Responded To/Transported To Facility included) o Attendant Information o Patient Information o Times Information o Vitals (optional) o Skilled Interventions (optional) o Observation Information o Trip Information

5. Unscheduled transfer between regions

o Incident Information (Responded To/Transported To Facility included) o Attendant Information o Patient Information o Times Information o Vitals (optional) o Skilled Interventions (optional) o Observation Information o Trip Information

6. Scheduled transfer within a region

o Incident Information (Responded To/Transported To Facility included) o Attendant Information o Patient Information (Patient out of province) o Times Information o Vitals (optional) o Skilled Interventions (optional) o Observation Information o Trip Information

7. Scheduled transfer between regions

o Incident Information (Responded To/Transported To Facility included) o Attendant Information o Patient Information o Times Information o Vitals (optional) o Skilled Interventions (optional) o Observation Information o Trip Information

8. Air ambulance support

o Incident Information (Responded To/Transported To Facility included) o Attendant Information o Patient Information o Times Information o Vitals o Skilled Interventions o Observation Information o Trip Information



9. Return to residence o Incident Information (Responded To/Transported To Facility included) o Attendant Information o Patient Information o Times Information o Observation Information o Trip Information

10. Emergency call - No patient found (No transport involved)

o Incident Information o Attendant Information o Times Information o Trip Information (Response Type only)

11. Transfer care to other EMS agency (No transport involved)

o Incident Information o Attendant Information o Patient Information o Times Information o Observation Information o Trip Information (Response Type only)

12. Emergency call - Patient treated and released (No transport involved)


13. Emergency call - No treatment required (No transport involved)


14. Emergency call - Refused care (No transport involved)




15. Emergency call - Dead at scene (No transport involved) o Incident Information o Attendant Information o Patient Information o Times Information o Observation Information o Trip Information (Response Type only)

16. Emergency call - Trip cancelled (No transport involved)

o Incident Information o Attendant Information o Times Information o Trip Information (Response Type only)

17. Emergency call - Provided assistance only (No transport involved)


18. Emergency response on a scene (patient is Alberta resident) o Incident Information o Attendant Information o Patient Information o Times Information – Time Received prior to midnight, Unit Responded

after midnight o Vitals (multiple vital signs – PHI & GCS blank) o Skilled Interventions (multiple treatments/medications) o Observation Information o Trip Information

19. Scheduled transfer within a region o Incident Information (Responded To/Transported To Facility included) o Attendant Information o Patient Information (Patient in province or out of province) o Times Information – Time Received prior to midnight, Unit Responded

after midnight o Vitals (optional) o Skilled Interventions (optional) o Observation Information o Trip Information

* The first xml file will contain 1 PCR to validate the file structure and data format. This PCR can be any one of the scenarios listed above.



Table 1 – Ground PCR Submission Call Types & No Transport Reasons

Scenario Description Call Type No Transport Reason

1 Emergency Response on Scene – Alberta Resident

C1 n/a

2 Emergency Response on Scene – non-Alberta Resident

C1 n/a

3 Rendezvous C2 n/a 4 Unscheduled Transfer Within RHA C4 n/a 5 Unscheduled Transfer Between RHA C3 n/a 6 Scheduled Transfer Within RHA C6 n/a 7 Scheduled Transfer Between RHA C5 n/a 8 Air Ambulance Support C7 n/a 9 Return to Residence C8 n/a 10 Emergency Call – No Patient Found C1 N1 11 Transfer Care to other EMS C1 N2 12 Emergency Call – Treat & Release C1 N3 13 Emergency Call – No Treatment Required C1 N4 14 Emergency Call – Refused Care C1 N5 15 Emergency Call – Dead at Scene C1 N6 16 Emergency Call – Trip Cancelled C1 N7 17 Emergency Call – Assistance Only C1 N8 18 File Structure/Data Format 19 Emergency Response on Scene – Alberta

Resident (Time Rec’d < 12:00 a.m., Unit Responded > 12:00 a.m.)

C1 n/a

20 Scheduled Transfer Within RHA (Time Rec’d < 12:00 a.m., Unit Responded > 12:00 a.m.)

C6 n/a

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