Integrated Assessment
Record (IAR)
IAR Tool Train-the-Trainer
Agenda
• Objectives
• Viewer Manual Review
• What is IAR?
• Health Information Network Providers (HINPs)
• Benefits of IAR
• IAR Consent
• Demonstration
• “Hands-On”
2
Objectives
• By the end of this session, IAR viewers will be
able to:
– Describe how IAR works
– Describe the HSP consent model for IAR to a client
– Navigate IAR to view assessments
3
What is the Integrated Assessment
Record (IAR)?
The IAR is an application that allows assessment
information to move with the client from one health
service provider to another.
Health service providers (HSPs)
Community Care
can use the IAR to view
Access Centres
timely client assessment
information:
Community
• electronically
• securely
Long-Term
Care Homes
Support
Services
Others
Inpatient
Mental Health
Addictions
• accurately
Community Mental
Health
4
IAR Supported Assessments
5
Assessment
Sector
Ontario Common Assessment of Need
(OCAN)
Community Mental Health
Resident Assessment Instrument –
Mental Health (RAI-MH)
Inpatient Mental Health
Resident Assessment Instrument –
Minimum Data Set (RAI-MDS 2.0)
Long-Term Care Homes
interRAI Community Health Assessment
(interRAI CHA)
Community Support Services
interRAI Contact Assessment
(interRAI-CA)
Community Care Access
Centres
Resident Assessment Instrument –
Home Care (RAI-HC)
Community Care Access
Centres
Admission Discharge and Assessment
Tools (ADAT)
Addictions
Health Information
Network Providers
(HINPs)
LHINs:
1. Erie St. Clair
2. South West
3. Waterloo Wellington
4. Hamilton Niagara Haldimand Brant
5. Central West
6. Mississauga Halton
7. Toronto Central
8. Central
9. Central East
10. South East
11. Champlain
12. North Simcoe Muskoka
13. North East
14. North West
14
13
13
11
12
10
9
8
3
2
Clusters:
•
•
•
6
North Eastern Cluster – Health Sciences North
South Western Cluster – Consolidated Health Information Services (CHIS)
GTA Cluster – William Osler Health System
4
1
5
6
7
Health Information Network Providers
Health Information Network Provider
North Eastern Cluster – Health Sciences North
IAR
Clinical
Viewer
Clinical
Data
Repository
Health Information Network Provider
South Western Cluster – CHIS
Enterprise
Master
Patient Index
Reporting
Repository
Health Information Network Provider
GTA Cluster – William Osler Health System
IAR
Clinical
Viewer
7
Clinical
Data
Repository
IAR
Clinical
Viewer
Clinical
Data
Repository
Main Tasks to Use the IAR
Assess Clients,
Gather Consent
Ax
Ax
Ax
Enter
Assessments
Submit Data
Regularly
Monitor IAR
Integrity & Usage
Use the IAR in
Care Provision
Assessment
Software
HINP
HINP
Upload
Assessments
View
Assessments
HINP
Assessment
Software
Business and Permissions Roles
HSP A
Options for assessment entry:
• Local software installations
• Shared software used by
multiple HSPs
8
Two upload methods:
• Manual uploads
• Automated web
services uploads
• Work with your
vendor to set up your
system to ensure
regular uploads
HSP responsibilities:
• Manage user access
• Review audit logs
• Leverage reports
• Clarify client records (EMPI)
• Advise HINP of HSP
changes
• Manage privacy, security
and consent
HSP B
HSP C
Include IAR into processes to:
• Support client-centric approach
to care
• Enhance and inform care
planning
• Ensure secure transfer of
personal health information
(PHI)
IAR Benefits
•
•
•
•
•
•
•
•
9
Supports client-centric approach to care
Provides historical context
Enhances and informs service/care planning
Ensures secure transfer of personal
health information (PHI)
Ensures accountability in assessment sharing
Promotes collaboration
Reduces workload
Increases reliability of information
IAR User Privacy & Security
Requirements
10
IAR Consent Model
There are two ways to manage consent in IAR:
1. HSP-level consent directives
– Consent directives that are applied to the
assessments collected by your organization
2. IAR-level consent directives
– IAR-level consent applies to ALL assessments
stored in IAR
•
11
Clients can withdraw their consent for sharing
ANY assessments through IAR, regardless of
which HSP conducted the assessment
IAR Consent Model
There are two ways to manage consent in IAR:
1. HSP-level Consent Directives – applied to the assessments
collected by the individual HSP
2. IAR-level Consent Directives – applied to all assessments
in IAR relating to a client
– Consent to share in the IAR means all of the client’s assessments
across HSPs will be shared with participating HSPs that provide care to
the client
– If consent is withheld in the IAR, all of the client’s assessments already
in the IAR, and uploaded in the future, will be locked and participating
HSPs will not be able to view them
– Clients who feel at risk having their demographic information viewable in
IAR even if their assessment is blocked can opt for complete PI
Suppression
• Clients can withdraw their consent for sharing ANY assessments
through IAR, regardless of which HSP conducted the assessment
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How Consent Works in IAR
HSP-A
HSP Level
Consent
Directive
Assessment A1
Yes
HSP-B
Assessment A2
Assessment B1
Yes
No
Assessment B2
No
IAR
Assessment A1
Client
IAR Level
Consent
Directive
Yes
Assessment A2
No
Yes
IAR Level Consent Directive - YES
Clinician
13
Assessment B1
Assessment B2
No
How Consent Works in IAR (Cont’d)
HSP-A
HSP Level
Consent
Directive
Assessment A1
Yes
HSP-B
Assessment A2
Yes
No
Option 1 – Client’s
assessments not
viewable
Assessment A1
Assessment A2
Yes
Yes
Assessment B1
No
IAR Level Consent Directive - No
Option 2 – Client’s
basic identifying info
also not viewable
IAR Viewers
14
Assessment B2
No
IAR
Client
IAR Level
Consent Directive
Assessment B1
Assessment B2
No
IAR Privacy and Security User
Requirements
• Sign and understand the user agreement
• IAR only needs to be accessed when you are
providing services to a client
– All actions in IAR are logged
•
•
•
•
15
Choose a strong password and keep it safe
Inform clients and manage consent
Support client privacy rights
Report incidents
Responsibilities for Managing Consent
• Inform the client so that they understand what
they are consenting to
• Obtain the consent
• Register and record the consent
16
How to Inform Clients
In order for the client to understand what they are
consenting to, they must be properly informed. We
inform clients by:
•<<Insert informing method A>>
•<<Insert informing method B>>
•<<Insert informing method C>>
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What to Include When Informing Clients
• <<Insert information about WHY you are collecting,
using and disclosing their information>
• <<Insert information about WHAT types of information
you are collecting (e.g., psychiatric history, legal status,
etc.)>>
• <<Insert information about the types of HSPs you
disclose to and how you disclose assessment data in
general>>
• <<Insert information about what it may mean to the client
to have this information collected and used and shared,
including positive or negative consequences>>
• <<Insert how your staff should tell the client that it is their
choice to give or withhold consent>>
18
How to Obtain Consent
• <<Insert the steps that your HSP takes to obtain
consent >>
• <<If your HSP uses implied consent, insert
where and how staff should note that they
informed the client and, hearing no objections,
assumed consent>>
• <<If your HSP uses express consent, insert
where and how staff should specifically ask for
consent>>
19
Recording and Registering Consent
• <<Insert the steps that your HSP takes to record
consent in a central location.>>
• <<Insert the steps that your HSP takes to
register consent along with the assessment.>>
20
Assisting the Client with IAR-Level
Consent
• If the client requests your assistance in
withdrawing consent for sharing all assessments
through IAR, you should:
– Provide the client with the toll-free number for the IAR
Consent Management Call Centre.
– Explain to the client the implication of a consent
directive in IAR (willing to share or not willing to share
their assessments or basic identifying information)
– Remind the client that he/she can always change
his/her mind about his/her consent directives by
calling the toll-free number
21
Client’s Right to Access
• The client can:
– Make a request to you or your organization to obtain
a copy of their assessment record
– Make a request to you or your organization to change
their assessment record
– File a complaint about the privacy practice of your
organization
• Alert your Privacy Officer if you receive these
requests
22
Your Responsibilities in Managing Client
Privacy Rights
• <<Insert steps that staff should take if client asks
to see assessment>>
• <<Insert steps that staff should take if client asks
for a correction>>
• <<Insert steps that staff should take if client
wishes to make a complaint>>
23
Incident Management
Examples of Incidents
• Printed client assessment information is left in a public area
(e.g., coffee shop)
• A client’s assessment is faxed to the wrong number
• Theft, loss, damage, unauthorized destruction or modification of
client records
• Inappropriate access to client information by unauthorized
users
• Large amount of IAR records accessed by a single individual in
a short period of time (out of the ordinary)
• User account and password was compromised
• Network infrastructure affected by malicious users
• Violation of joint security and privacy policies or procedures
24
Reporting Incidents
If you see or recognize an incident…
Example: You found printed assessment records left on a table
at the Tim Horton's downstairs
…Report it to your Privacy and Security Lead
immediately!
• <Name:>
• <Phone:>
• <Email:>
25
Contact Information
Issues
26
Contact
Request or update
an IAR user account
<<insert user
coordinator name>>
Report an IAR
incident
<<insert privacy
officer name or their
delegate>>
Privacy issues with
client/patient
<<insert privacy
officer name or their
delegate>>
Login account or
general IAR issues
IAR Support Centre
Client decides to
block their
assessments on IAR
IAR Consent Call Centre
Phone
Email
1-866-909-5600
iar@ccim.on.ca
1-855-585-5279
& TTY for the
hearing impaired
1-855-973-4445
iar@ccim.on.ca
Additional Resources
•
• e-learning: 4 modules
–
–
–
–
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Basic Privacy and Client Privacy Rights
Informed Consent
IAR Privacy and Security
IAR Consent
Integrating IAR into Business Processes
• Business process mapping will assist you
in determining:
–
–
–
–
Potential streamlining opportunities as a result of the IAR
Which roles and responsibilities will be affected by the IAR
Where and how information and work will flow with the IAR
Any changes, gaps or bottlenecks that may require attention
• For example, you may want to
consider how IAR will affect:
–
–
–
–
–
28
Intake
Referrals
Care/service planning
Reassessment
Transfers
Intake Using IAR
• <<Insert steps that assessors should take at
intake to integrate IAR into the intake business
process>>
29
Transfers Using IAR
• <<Insert steps that assessors should take to use
IAR when a client is transferred from your care
to the care of another care provider or HSP>>
• <<Insert steps that assessors should take to use
IAR when a client is transferred to your care to
the care of another care provider or HSP>>
30
Developing a Care/Service Plan
• <<Insert steps that assessors should take at
intake to integrate IAR into the care/service
planning business process>>
31
Integrating IAR into Other Business
Processes
• <<List other processes within your organization
that may be affected by the introduction of the
IAR>>
32
Main Tasks to Implement the IAR
Assign Roles
Attend IAR
Training
Review
Processes
Prepare
Technology
Submit
Paperwork, Get
Credentials
Assessment
Software
Change
Team
Upload
Assessments
HINP
Business &
Permissions
Roles
Designate those who
will work on the IAR:
• Assign Change
Team roles
• Assign IAR
Permissions and
Business roles
33
Exec
Lead
Attend sessions and
apply at your HSP:
• Kick-off
• DSA Workshop
• Privacy, Security &
Consent Management Training
• Technical Kick-off
• Technical Training
• Tool Train-theTrainer
Ensure IAR is
integrated:
• Review privacy and
security processes
• Review business
(e.g., intake)
processes
• Implement
processes
Preparing IT generally Submit forms as required:
• Change Team Contact
involves:
List Form
• Engaging your
• UA/UC Form
vendor
• HSP Account Creation
• Validating and
Form
testing the IAR feed
• Data Sharing
• Ensuring you have
Agreement
an external IP
address in place
Receive credentials
Logging In and My Details
•
•
•
•
•
•
•
34
Login
Disclaimer
Home Page
My Details
Set Secret Question
Reset Password
Inactivity Timeout
Logging in to IAR
• The IAR login screen is shown below. A username and password are
required to gain access to the application.
• A default password will be assigned when the account is first set up.
Once the user has entered the username and default password the
system will prompt the user to change the password.
35
First Time Login
36
First Time Login
37
Disclaimer
•
38
When your log in attempt is successful, you will come to the disclaimer
below. Review and accept the disclaimer in order to move forward to a
person search.
Home Page
•
39
When your log in attempt is successful and you have accepted the
disclaimer the first page you will see is your home page.
My Details
40
•
My Details is located in the Common tab of the menu bar.
•
It allows individuals assigned to the Viewer role to change their passwords,
set a secret question in case they forget their password, set inactivity
timeout, customize time zone settings, set the time that important message
notification messages will display, view roles and groups, and view
information in the My Attributes section.
Set Secret Question
•
41
In the event that a password has been forgotten the secret question will be
used to authenticate the user.
Reset Password
•
•
•
•
42
Upon initial log in to IAR, the user will be required to change their password.
Every 90 days, a user will be required to reset their password.
The password is case sensitive and is a minimum of 8 characters in length.
The same password may not be reused.
Inactivity Timeout
•
•
•
43
IAR will log out the user automatically after defined time period.
Default setting of inactivity is set to 30 minutes.
Each user can define their inactivity timeout to less than 30 minutes.
Hands On
44
Hands-On
•
•
•
•
Person Search
Search Results
Document Tree
Timeline Bar
and Assessment List
• Assessment Views
–
–
–
–
45
Summary
Detail
Outcomes
Jump To
•
•
•
•
Consent Levels
Messaging
Printing
Worklists
Help
•
•
46
Your first point of help should be the appropriate lead within your
organization.
If you need further assistance, you can click the Help button located in the
menu or you can contact the IAR team via the Support Centre desk:
 Tel: 1.866.909.5600, Option 8
 Fax: 416.314.1585
 Email: iar@ccim.on.ca
Next Steps
• Collaborate with your Privacy and Security Lead to deliver training to
viewers
• Review your processes:
– When will you do a person search?
– Where does consent fit into the assessment process?
• Prepare your technology
• Determine who in your HSP requires training
• Submit your paperwork
– Data Sharing Agreement
– HSP Account Creation
– UA/UC Form
•
•
•
•
47
Receive credentials
Go live
Upload assessments and use the IAR to inform service / care plans
Monitor IAR integrity and usage
Quiz
Thank You!
Project Support Centre
Tel: 1.866.909.5600, Option 8
Fax: 416.314.1585
Email: iar@ccim.on.ca
Appendix
Community Care Information Management (CCIM)
Local Health Integration Networks (LHINs)
Assessment
Projects
CCAC
CSS
Common Intake
Assessment
Tool
interRAI
Community
Health
Assessment
Long Stay
Assessment
Software
interRAI
Preliminary
Screener
CMH&A
LTCH
Ontario
Common
Assessment
of Need
Resident
Assessment
Instrument
MDS 2.0
CHC
SCCH
Integrated Assessment Record
Integrated Data Strategy
Business
Systems
Management
Information
Systems
(OHRS/Software)
Management
Information
Systems
(OHRS/Software)
Management
Information
Systems
(OHRS/Software)
Ontario
Healthcare
Reporting
Standards OHRS
Ontario
Healthcare
Reporting
Standards
Management
Information
Systems
(Software)
Human
Resources
Information
Systems
Human
Resources
Information
Systems
Human
Resources
Information
Systems
Management
Information
Systems
(Software)
Management
Information
Systems
(Software)
Human
Resources
Information
Systems
Infrastructure & Operations
IT Implementation & Support
Initiation stage
CCAC = Community Care Access Centres
LTCH = Long-Term Care Homes
51
Security, Privacy & Risk Management
Currently rolling out
CSS = Community Support Services
SCCH = Small & Complex Continuing Care Hospitals
Transition
Completed and/or transitioned
CMH&A = Community Mental Health and Addictions
CHC = Community Health Centres
Information Flows with the Client
CCAC
CSS
care
providers
support
workers
LTCH
CLIENT
Inpatient
Providing
coordinated
care and
support
RAI-MDS 2.0
CMH
interRAI CHA
RAI-HC
interRAI CA
RAI-MH©
HINP
Viewing
health service
provider
52
Addictions
OCAN
ADAT