eChart Manitoba Services
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eChart Manitoba Services Handbookforhealth-careproviders Version 11 February 2021
Transcript of eChart Manitoba Services
eChart Manitoba Services Handbookforhealth-careproviders
Version 11 February 2021
Contact Information
eChart Manitoba Services The eChart Manitoba Services team provides support and assistance from Shared health for eChart Manitoba. Contact us with questions or concerns (see below).
Shared Health Service Desk The Shared Health Service Desk is available 24 hours a day, seven days a week to help with issues using eChart Manitoba. Phone: (204) 940-8500 Phone (toll-free): 1-866-999-9698 Email: [email protected]
For more information General inquiries Web: www.echartmanitoba.ca Email: [email protected] Phone (toll-free): 1-855-203-4528 Fax: (204) 926-9148
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Table of Contents Contact Information .......................................................... 2
eChart Manitoba Services Shared Health Service Desk For more information
General Information .......................................................... 4 Introducing eChart Manitoba
Communications ............................................................... 5 Communicating to patients about eChart Manitoba How eChart Manitoba communicates with
authorized users Patient Forms ................................................................... 6
Providing access to an individual’s personal health information
Implementation and Training ............................................. 7 Implementation of eChart Manitoba Future training opportunities Training new staff
Privacy and Security .......................................................... 8 Privacy and security overview
User Accounts .................................................................. 9 Site responsibilities regarding user accounts Setting up new user’s eChart access Available user roles (access level)
Access Role Matrix ........................................................... 12 Selecting appropriate eChart Manitoba roles Pathway for determining level of user access
User Reports for Authorized Sponsors ................................ 13 eChart Manitoba Active User Report for
eChart Manitoba User Account Management Report for Authorized Sponsors
Launching eChart Manitoba ............................................... 13 Logging in to eChart Manitoba
Terms of Use for eChart Manitoba ...................................... 14 Support ............................................................................. 15
Connecting with support services Glossary of acronyms
Support
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Privacy & Security
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Communications
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Authorized
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General Information
Introducing eChart Manitoba eChart Manitoba provides authorized health- care providers with key health information in the right place at the right time, improving access to information, safety and quality of care. eChart Manitoba is being made available to health care locations across Manitoba. Over time, eChart Manitoba will be available to all locations that require access and the system will continue to expand in the amount and type of key health information. System components eChart Manitoba provides authorized health-care providers with viewable, searchable and printable access to: • Provincial Client Registry/Registration Systems-
Personal identifying information including name, address, date of birth, personal health identification number (PHIN).
• Immunizations recorded in and provided by the Manitoba Immunization Monitoring System (MIMS) and the Provincial Health Information Management System (PHIMS). Information is derived from physician billing claims and from public health provided immunizations.
• Prescriptions filled at retail pharmacies provided through the Drug Programs Information Network (DPIN).
• Laboratory test results from Diagnostic Services, Shared Health locations (Winnipeg sites December 2010 and rural sites added since 2013).
• Historical laboratory test results from Unicity Laboratory.
• Laboratory test results from Dynacare. • Laboratory test results from Cadham Provincial
Laboratory.
• Diagnostic image reports from Manitoba’s
Radiology Information Systems (RIS). • Diagnostic image reports from the Prairie
Mountain Health region. • Encounter information from connected provincial
ADT EPR sources. Provides administrative information regarding a visit to the hospital (eg. admission date, type of visit, discharge date).
• Direct link to PACS Web Viewer. • Enrolment status for Home Clinic Repository. • Home Clinic Client Summary What are the benefits to patients? • Improved quality and timeliness of care • Increased access to information by health-care
providers • Reduced duplicate and unnecessary tests What are the benefits to clinicians? • Reduced time spent searching for information,
allowing more time for patient care • Improved access to patient information that was
available in separate clinical systems (i.e. DPIN, CR)
• Improved information sharing and collaboration between authorized health-care providers
Note: Additional lab results and other clinical information is anticipated to be added to eChart Manitoba over time.
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Communications
Communicating to patients about eChart Manitoba As awareness of eChart Manitoba continues to build across the province, health-care providers may receive inquiries from patients about the safety, security and privacy of their personal health information. Patients can request to view or receive a copy of their personal health information in eChart, see who has accessed their eChart record, and limit the disclosure of information within eChart. Website To ensure patients receive accurate and current information about eChart Manitoba, sites are encouraged to direct individuals to the eChart Manitoba website at echartmanitoba.ca.
Provincial public information All health-care facilities across the province with access to eChart Manitoba will receive materials to educate patients and create awareness about eChart Manitoba. Public inquiries can also be referred directly to contact a representative at eChart Manitoba Services (see the contact information on page two).
How eChart Manitoba communicates with authorized users eChart Manitoba internet The Shared Health internet site is designed to give health-care providers access to new and noteworthy information about all of our programs. The eChart Manitoba section can be found under “Our Programs” and contains frequently asked questions (FAQs), the most recent versions of all documents and forms, and is a repository for training material, information for communications and notifications for users. Go to: echartmanitoba.ca.
Encourage patients to visit echartmanitoba.ca for more information.
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Patient Forms
Forms can be
found online at echartmanitoba.ca
Providing access to an individual’s personal health information To provide access to an individual’s personal health information in eChart Manitoba: • Encourage individuals to discuss their personal
health information with their health-care provider, who can provide a view of their personal health information in eChart Manitoba
• Provide forms available from the eChart website and other educational materials such as the eChart brochure
• Assist, as necessary, to complete and send the forms to eChart Manitoba Services
Where applicable, the site privacy officer or designate can assist with providing access to an individual’s personal health information and related requests. Currently only sites using eChart Manitoba can offer a view or print-out of personal health information; however, eChart Manitoba Services can also provide copies of an individual’s personal health information upon request. The health-care provider may provide the appropriate forms or refer the requestor to eChart Manitoba Services. Access to personal health information Individuals can see or receive a copy of their personal health information in eChart Manitoba by filling out the Request to access your personal health information in eChart Manitoba form and returning it to eChart Manitoba by mail or fax. A record of user activity Individuals can receive a copy of who has viewed their personal health information in eChart Manitoba by filling out the Request record of user activity in eChart Manitoba form and returning it to eChart Manitoba Services by mail or fax. Disclosure Directives Individuals can request to add or remove a Disclosure Directive to prevent health-care providers from viewing their personal health information in eChart Manitoba. A Disclosure Directive limits all authorized health-care providers from seeing an individual’s clinical information. Identifying information, including name, date of birth, gender, address and personal health identification number
(PHIN) will still be viewable to the health-care provider but the clinical information (e.g. lab results, medications, immunizations) will not be viewable unless the user has the ability to override the Disclosure Directive (page 10). Individuals can add or remove a Disclosure Directive at any time by completing the Add or remove a Disclosure Directive in eChart Manitoba form and returning it to eChart Manitoba Services.
Making changes to records eChart Manitoba is comprised of information from existing electronic clinical systems. If there are errors in the information, any changes to this information in eChart Manitoba must come from the system of the source organization (e.g. the laboratory). This is the same way changes are currently made to lab results for example in the paper-based chart (e.g. a lab result is in error). The source systems for eChart are responsible to ensure the information they provide is correct, current and complete (as per The Personal Health Information Act (PHIA)). • If information corrections and updates are
required, the changes will appear in eChart once the source has sent the correction or update
• eChart does not notify users directly when changes or corrections occur to the information held in eChart
• The health-care provider may provide the appropriate forms to request a correction from a source such as a lab or refer the requestor to eChart Manitoba Services
• eChart Manitoba Services can facilitate a request for a correction with the source system but has no ability to change the information directly
If an individual requests to make a correction to his/ her personal health information in eChart Manitoba, the health-care provider may wish to contact the Shared Health Service Desk for any necessary assistance in the process. The Service Desk will put the provider in touch with a member of the eChart Manitoba Services team.
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Implementation and Training
Implementation of eChart Manitoba Implementation of eChart Manitoba generally follows a four-step approach to prepare authorized health- care providers to use the system. Step one - Foundation and readiness Approximately four weeks before activation An introduction to the implementation process will outline what is involved prior to activation of eChart Manitoba. This will include an overview of key roles and responsibilities, account provisioning process and a schedule of activities. More information about the implementation process will be communicated as each site’s implementation date draws near. Step two - Planning and preparation Detailed training schedules are developed with the site coordinator prior to activation. Orientation sessions and account requests are also completed during this step. Training for Privacy Officers must be completed before a site go-live.
Step three - Training and user activation Week of implementation The implementation team may deliver on-site training of the eChart Fundamentals Course. User training will take approximately two hours, depending on an individual’s role and access required. Training and activation are concurrent events for the first users at a site. All users are expected to complete the eChart Fundamentals Course prior to accessing the live system. The eChart Fundamentals course helps users: • understand what clinical data is included in
eChart and how it is arranged • learn how to search and filter the information • understand privacy, confidentiality and security
within the context of eChart • learn about supporting patients’ rights regarding
their personal health information Training is completed using a variety of methods including traditional classroom, eLearning or personalized training. Distance learning tools such as Virtual Solutions are also available. The implementation team works closely with each site to tailor the delivery of training based on the individual needs of each site. After the training session, each user will receive a unique username and password. Users will be encouraged to use the live system in their clinical practice immediately after training is complete. Step four - Post-implementation support and evaluation The implementation will conclude with the following activities: • Assessment of the success of the
implementation, and identify areas for improvement
• Review of short-term and long-term benefits and evaluate trends in the use of the system
• Gauging acceptance and adoption of the system • Identification and collection of anecdotal
feedback • Management of issues, address questions and
concerns
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Implementation and Training
Future training opportunities As the system continues to evolve, future training topics and opportunities may be offered based on user feedback.
Training new staff The eChart Manitoba eLearning courseware is available to support training for new staff. New users can access eLearning: eChart Fundamentals on the Shared Health internet. We recommend that sites support new users by providing them with opportunities for peer-to- peer learning with individuals who have experience using eChart Manitoba. It is important that all users receive training before being granted an eChart Manitoba account. Users must understand their responsibilities regarding the PHIA in the context of eChart Manitoba and that they should only access information that is required to
perform their role. Users must also be aware that all activity is audited and logged in the system, and that this ID represents their online, digital professional identity. The training material also informs users about the information available in eChart so that it can be used appropriately and safely as an adjunct to the clinical information they already have available to provide care at their site. eChart Manitoba Services will not typically provide training services for new users following site activation of eChart Manitoba. Exceptions may apply when there is a significant intake of new staff in a region at one time (e.g. a large number of medical students start at the same time in the same facility).
Privacy and Security
To report a breach,
contact the Shared Health Service Desk
immediately.
eChart Manitoba should never be used to look
up your own information or that of your friends, co-workers, colleagues
or others of personal interest to you. Did you
know that new legislation in Manitoba will include unauthorized access by
a user as an offence under PHIA for which a user can be prosecuted and, if found guilty by a
court, could result in a significant fine
Privacy and security overview eChart Manitoba abides by all existing regulatory and legislative standards in Manitoba related to the protection of personal health information, including The Personal Health Information Act (PHIA). Privacy reminder Access to an individual’s personal health information in eChart Manitoba is restricted to: A) When a health-care provider is in a care relationship with an individual and requires access to the individual’s information for: • the provision of health care or • to arrange for the provision of health care The information must be related to and necessary for the current session of care. B) When information is required to fulfill administrative responsibilities and duties related to supporting the provision of health care. All actions taken on eChart Manitoba under each user’s username and password are captured, logged and attributed to that particular user. Access to eChart Manitoba will be audited on a random
basis and will be audited if a breach is reported or suspected. Site representatives will be requested by the eChart Manitoba Services privacy analyst to assist with user audits periodically to confirm that users at a site are accessing eChart Manitoba appropriately. Unauthorized access may have professional, employment, and legal and financial consequences. For example, unauthorized access can result in disciplinary action up to and including dismissal and/ or where applicable, a report to the user’s health profession regulatory body as well as sanctions or fines.
EChart is not to be used for research study purposes, chart audits or to obtain information regarding individuals for whom you are not supporting care. Access to eChart for such purposes is unauthorized and is a misuse of the system. Reporting a suspected breach To report a suspected breach, contact the Shared Health Service Desk immediately and notify the privacy officer at your site.
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User Accounts
Site responsibilities regarding user accounts Each site must identify an Authorized Sponsor (AS) and an Authorized Account Requestor (AAR). One of the roles of the AS and AAR is to identify users that require access to eChart, identify the users’ access role, as well as submit any changes for the users (e.g. name change, change in role, disable eChart access). The eChart Manitoba Account and Access Request form can be completed and submitted to the Shared Health Service Desk.
The site is responsible for notifying eChart Manitoba Services of any of the following role changes: AS, AAR, Privacy Designate, Outage Designate or IT Resource by completing the eChart Site Contacts Update form and submitting to Service Desk. Authorized Sponsor (AS) The AS is the person at the site who has the authority to determine who needs access to eChart Manitoba in order to perform his/her role. Generally, the AS is a person in a management role. They may also be contacted in the event of an audit of user activity at the site. See instructions below for “Setting up new user’s eChart access”. Authorized Account Requestor (AAR) The AAR is the person at the site who assists the AS and submits the approved account requests, received from the AS, to the Shared Health Service Desk. See instructions below for “Setting up new user’s eChart access”.
Setting up new user’s eChart access Setting up new user access To request eChart Manitoba access for a new user, the Authorized Sponsor must complete the following steps: 1. Fill out the eChart Manitoba Account and Access
Request Form. 2. Confirm the status of the individual (i.e.
has a current employment contract with the organization and requires access to eChart Manitoba in order to perform his/her duties).
3. Validate the individual’s identity as per current site practices.
4. Confirm that the user has completed PHIA training and signed a PHIA Pledge of Confidentiality.
5. Determine the eChart role required (see
Selecting appropriate eChart roles on page 10). 6. Confirm whether or not the user has a Shared
Health network identification (i.e. confirm if he/ she has an existing WRHA network ID and/or an eChart, eReferral and/or RIS or PACS ID).
7. Have the user complete the challenge questions on the Authentication Questions and Answers form and submit directly to the service desk.
8. Approve and email the completed eChart Manitoba Account and Access Request Form to the AAR.
The Authorized Account Requestor will: 1. Ensure all details have been filled out on the
form. 2. Email the approved eChart Manitoba Account
and Access Request Form to the Service Desk at [email protected]
3. Receive the username and temporary password from the Service Desk and provide it to the new eChart Manitoba user once they have completed their training.
Important note: Maintain the username and temporary password in a confidential location until it can be provided to the new user. Destroy all record of the username and temporary password when passed to the user. User changes their password immediately once they receive notification of their account from the AAR. Changing a user’s profile information If a user’s account, name, eChart Manitoba role or labour classification needs to change, the Authorized Sponsor and Authorized Account Requestor will: Fill out the eChart Manitoba Account and Access Request Form, indicating the required changes. Email the completed form with approval to Shared Health Service Desk. Disabling a user’s eChart Manitoba access Should a user no longer require access to eChart Manitoba a request to disable the user’s account should be submitted as soon as possible. To disable access, the Authorized Account Requestor must complete the following steps:
A current list of Authorized Sponsors and Authorized Account Requestors is maintained at Shared Health and account requests will only be accepted for eChart Manitoba from individuals noted on the listing.
The Authorized Sponsor ensures the individual needs access and that all forms are complete and approves request.
The Authorized Account Requestor submits the request to Shared Health.
Shared health provides a username and password for the new user.
User changes his/her password.
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A decision to assign a role in eChart Manitoba must be made considering theseprinciples: • The individual requires access to eChart Manitoba
to perform his/herjob. • The individual is affiliated with a regulatory body
directly or is under the direct supervision of such an individual.
• The individual agrees, through formal agreements with his/her employer, to exhibit conduct within the constraints of PHIA and related regulatory legislation where applicable.
• Any access to information, regardless of user role, is restricted to the minimum amount and on a need-to-know basis.
The agreement between Shared Health and the trustee organization, as well as the Terms of Use, outlines the monitoring and review of user activity as well as the application of sanctions should inappropriate access occur.
User Accounts
Access requests will NOT be accepted by
phone. All eChart Manitoba Account and Access Request Forms
must be emailed.
Clinical view with override is limited to users who meet the criteria on the
pathway on page 11.
1. Fill out the eChart Manitoba Account and Access
Request Form. 2. Validate the user’s details, disabling eChart
access on the account. 3. Email the completed form to Shared Health
Service Desk. If an individual is moving to another site and needs to maintain access to eChart Manitoba, the AS/AAR will need to request the user’s account be disabled at the first site; and the AS/AAR at the user’s new site will need to request an account be created identifying their access level in their new position. Immediate deactivation of accounts For immediate deactivation of an account (e.g. for suspected breaches or short notice employment terminations) call the Shared Health Service Desk, providing the individual’s user details (i.e. full name and location), and request account termination.
Available user roles (access level) In all cases, clinicians are limited by policy to access information only to the extent it is needed for direct individual patient care. Clinical View with Images & Override Clinical View with Images & Override is granted to individuals who are members of a regulated health-care profession and who also have the ability to prescribe in a clinical setting (emergent or non-emergent). An individual with access to Clinical View with Images & Override is authorized to access all clinical and demographic views, and launch PACS Web Viewer. They also have the ability to override a patient’s Disclosure Directive where circumstances warrant thisstep. Clinical View with Images An individual with Clinical View with Images is authorized to access all clinical and demographic views and launch PACS Web Viewer. There is no ability to override a patient’s Disclosure Directive. Clinical View An individual with Clinical View is authorized to access all clinical and demographic views. There is no ability to override a patient’s Disclosure Directive. Laboratory and Reports View The Laboratory and Reports View provides an authorized user with access to laboratory results and diagnostic imaging reports as well as all documents under the clinical documents tab. At this time, the clinical documents tab includes microbiology and diagnostic imaging reports. The
individual also has access to demographic information. Medication View An individual with access to Medication View is authorized to view medication information and demographic information. Immunization View An individual with access to Immunization View is authorized to view immunization information and demographic information. Demographic View An individual with the Demographic View role is authorized to view demographic information (name, address, date of birth, PHIN and gender). The role of demographic view is required to complete a patient search.
Selecting appropriate eChart Manitoba roles The pathway for determining level of user roles (on page 11) assists eChart Manitoba sites to determine appropriate user access roles. Provisioning of roles is a process unique to the duties, responsibilities and workflow of individuals, not to their professional designation. The exception to this is the highest level of access, Clinical View with Images and Override, which is limited to users who have the ability to prescribe in a clinical setting.
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Account request denied
Does the individual maintain memberships or work under the direct supervision of a designated regulated health-care professional?
Account request denied
Medication View is granted
Pathway for determining level of user access When access to eChart Manitoba is requested, follow these steps to determine the role level of access that individual should be granted.
Yes
Yes
Yes
No
Yes
No
No
No
No For information on determining roles for privacy officers, please see the Handbook for Site Privacy Officers.
Yes
Is the individual a member of a regulated health profession providing care? Do they have the ability to prescribe in a clinical setting (emergent or non-emergent), where the inability to access history would substantially compromise providing assessment, diagnosis and care?
Account request denied
Does the individual’s role require access to all or a combination of a patient’s information in eChart Manitoba?
Clinical View is granted
Does the individual’s role require access to a patient’s immunization information only?
Immunization View is granted
Does the individual’s role require access to a patient’s laboratory and/or diagnostic imaging information only?
Laboratory and Reports View is granted
Account request denied
Clinical View with Images & Override is granted
Does the individual’s role require access to a patient’s medication information only?
Demographic View is granted
Does the individual support direct care and treatment in their practice setting?
Does the individual currently require access to a patient’s demographic information only to fulfill their role?
Has the individual completed PHIA training and signed a PHIA Pledge of Confidentiality?
Account request denied
Clinical View with Images is granted
Does the individual’s role require access to all or a combination of a patient’s information in eChart Manitoba and access to DI images?
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Access Role Matrix
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User Reports for Authorized Sponsors
eChart Manitoba user reports are sent out automatically at specific times and on request. The reports can also be sent to other individuals with site responsibilities if requested by the Authorized Sponsor.
eChart Manitoba Site and User Management Report This report is sent out monthly and provides the names of all users sponsored at the site, their eChart access roles and how they have accessed eChart within the past month. The report displays the total number of system logins, patients searched, and the type of clinical information accessed (e.g. laboratory, medication, immunization).
The report also lists all individuals who have been assigned eChart site responsibilities by Authorized Sponsors, like Privacy Officers (PO) or Authorized Account Requestors (AAR). The purpose of this report is for Authorized Sponsors to determine if any changes are required to authorized eChart Users or other individuals with site responsibilities for eChart. It is important for sponsors to ensure that only users who require access to eChart in order to perform their roles continue to have access to the system. Sponsors are asked to review this report and use it to identify and communicate required changes, encourage eChart adoption at the site and identify requirements for eChart end user training when appropriate.
Launching eChart Manitoba
Logging in to eChart Manitoba Logging in Users will be given a username and temporary password by the Authorized Sponsor (AS) or Authorized Account Requestor (AAR). See site responsibilities regarding access (page 9) to determine who the AS or AAR are for the site. Each user is required to change their password and will be prompted to read and accept the eChart Terms of Use (see page 14 for the Terms of Use, current - at the time of publication) prior to
accessing the system for the first time. Your eChart Implementation Coordinator will provide you with a reference sheet with step by step instructions to help users with this process. Changing eChart Manitoba password The system will prompt each user to change their password after 90 days. Please refer to the Change My Password bulletin on the Shared Health intranet for instructions.
Shared Health Service Desk: (204) 940-8500 servicedesk@ sharedhealthmb.ca
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Use only the minimum amount of information on a need to know basis
Do not look up your own information
Activity will be monitored, tracked and subject to auditing
Note: Users must electronically accept the Terms of Use for eChart Manitoba when they log in for the first time. This copy of the Terms of Use for eChart Manitoba is provided so that users know what to expect when they log on electronically. All users must agree to the Terms of Use before they are allowed access into the system. The most current copy of the Terms of Use is available for review any time on the Shared Health internet at: eChartmanitoba.ca
Terms of Use for eChart Manitoba
Terms of use for accessing eChart Manitoba is your commitment to protect the privacy of information when accessing eChart Manitoba
Measures are taken to ensure privacy and confidentiality of information • Information is transmitted and stored securely • Information access and acceptable use policies are required. For example, PHIA pledges and Terms of User (TOU) • Standards of professional practice are in place • System checks and balances are enforced such as audits, reviews and disciplinary actions
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Support
Connecting with support services Shared Health Service Desk The Shared Health Service Desk is a single point of contact for all eChart Manitoba issues and a service desk analyst will help to troubleshoot. If the analyst cannot resolve the issue during the initial call, it may be transferred to a Clinical Informatics Specialist for further review. A Clinical Informatics Specialist is a clinician who has advanced training in eChart Manitoba and understands clinical practice and information systems. After each call to the Shared Health Service Desk, users will receive an email with the incident number of the call. Keep this number in case you need to refer to the incident in the future.
Contacting support: Shared Health Service Desk: Phone: (204) 940-8500 Phone (toll-free): 1-866-999-9698 Email: [email protected] Available 24 hours a day, seven days a week Consult the eChart Manitoba training materials and FAQ section on the eChart Manitoba internet at: eChartmanitoba.ca.
A hard copy of the Quick Reference Guide will be provided to users in training. Site coordinators will receive an electronic copy.
Glossary of acronyms The following is a list of the acronyms mentioned throughout implementation: Acronym Description AAR Authorized Account Requestor AS Authorized Sponsor CPL Cadham Provincial Laboratory CR Manitoba Provincial Client Registry DPIN Drug Program Information Network EMR Electronic medical record EPR Electronic patient record IT Information technology LIS Laboratory Information System LMS Learning Management System MIMS Manitoba Immunization Monitoring
System PHIMS Public Information Management
System
PACS Picture Archiving and Communication System
PDN Provincial data network PHIA Personal Health Information Act PHIN Personal Health Information Number PWV PACS Web Viewer RHA Regional health authority RIS Radiology Information System TCP/IP Transmission control protocol /
Internet protocol
For more information Web: www.echartmanitoba.ca Email: [email protected] Phone (toll-free): 1-855-203-4528 Fax: (204) 926-9148
