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Applying for membership... In the upstart phase of this project membership including the processing of the POSP Service Agreements, Enrolment Forms and direction of funding was handled by the POSP (Physicians Office Service Program). MDERA members who have yet to complete forms should supply these to the POSP Office as soon as possible. You can access your forms by clicking on the following hyperlink: In the near future membership will be handled directly by the MDERA office. Your signature on the Service Agreement assigns your POSP Funding to MDERA which in turn supports the project. Phase 2 of POSP funding is complete, and Phase 3 is now underway and will be available only until the end of March 2008. Further funding information will be posted on this website as it is available. Please call the MDERA office (403-220-7893) for information about completing these forms. April-May 2009 Note: All of these forms and/or letter may be accessed using Adobe Reader.
The advantages of membership... To manage the EMR system, the custodians are forming a not for profit corporation – MEDICAL DOCTORS ELECTRONIC RECORD ASSOCIATION OF SOUTHERN ALBERTA (MDERA). This corporation will enter into agreements with:
· EMR Vendor for purchase, licensing and maintenance of the software required to operate the system. · Calgary Health Region for the maintenance of the system, including hosting the data servers, leasing hardware, network management, data management and business resumption services. · University of Calgary for provision of transcription services and long term storage of billing data. · Microquest Inc. (through the University of Calgary) to act as the billing agent and AH&W submitter for members.
The corporation will adopt a privacy policy and provide a common set of minimum standards and procedures which all members must agree to follow. Members may adopt more stringent standards and procedures if they wish to do so.
MDERA members will disclose identifying and/or non-identifying health information, according to the process outlined in the Information Sharing Agreement between MDERA and the Calgary Health Region, to enable that custodian to carry out its obligations with regard to monitoring, administering and reporting on ambulatory care encounters in its facilities.
This may include:
Patient Demographic Information - general information about an individual patient that is not specifically related to the Health Care Services received by that patient. Patient Demographic Information includes an individual patient’s name, address, phone number, age, date of birth, ULI, postal code, health care number and similar information.
Health Services Provider Information - information about the individual physician members of MDERA who use the EMR. Health Services Provider Information may include a physician’s name, address, phone number (and other contact information), specialty/profession, accreditations, privileges, provider number, date of birth and other similar information.
Clinical Patient Information - information relating to the health of a patient and the health care services provided to a patient. Clinical Patient Information includes notes, case histories and examinations performed by a physician or other providers of Health Care Services, consultations, letters, procedure reports, drug and pharmacy information including known allergic reactions and diagnostic information such as diagnostic imaging and laboratory reports .
The EMR will track patient encounters and report registration information to CHR. Patient information will also be extracted from the CHR Enterprise Master Patient Index (EMPI) and MDERA members will provide updated demographic information for that EMPI as encounters occur in clinics. Once the details of how this information will be reported (in both directions) a PIA will be completed by CHR to assess the risks.
Billing Procedure
Many physician members have a contract through the University of Calgary Medical Group (UCMG) with Microquest Inc. for processing and submitting claims to Alberta Health and Wellness. This contract has been in place since before April 2001.
With the introduction of the EMR, each individual custodian will continue to be responsible for compressing a billing submission file regularly and transmitting it via secure FTP process to Microquest Inc. in Edmonton. Microquest will, in turn, continue to transmit the assessment and reconciliation data back to the custodian as it has done previously, as well as to the University of Calgary.
The University of Calgary stores both the billing submissions and the assessment file in an Oracle database housed in the main university data centre. The data base has been in existence since before 1994 and has not been purged since 1995. No significant change has been made to the operation since 2000 when the contract between the University of Calgary and Microquest was signed.
This data base is accessible by the UCMG system administrator, 3 UCMG accounting services staff and the MedIT Help Desk, as well as by Microquest Inc. personnel. Access to the data base is by VPN and the data resides behind the university's firewall.
The data base consists of health service provider information of the UCMG physicians including name, practitioner ID, business contact information and all financial information related to billings; registration information of all patients seen by UCMG physicians, including PHN and demographic information; Hlink data fields. The demographic information of patients is organized so that an individual patient can be linked to all physicians who have seen that patient. The data base is used to manage UCMG operations and provide statistical reporting on utilization and operations. The information is not used for research, nor for reporting of information in identifying form.
The security requirements and access permissions for this data base will be described in an Information Manager Agreement with the University of Calgary.
Transcription Procedure (UCMG Members)
Currently physicians dictate reports from any touch tone telephone to a voice server in the Faculty of Medicine. The transcription staff then retrieves the report as an audio wave file, retrieve letter templates and physician addresses from a data base in a file server and create the letters. The letters are stored on the file servers and are printed, sent to the physicians and mailed from the physician office. The file servers are housed in the Faculty of Medicine, within the University of Calgary’s managed data centre.
The security requirements and access permissions for this data base will be described in an Information Manager Agreement with the University of Calgary – following is a summary:
· Access to file servers is limited to system administrators and Dictaphone support and is controlled by User ID/strong password protection. · Access to the application is controlled by User ID/password protection and physicians have a PIN for access to dictation. · Home transcriptionists access the application either via VPN or branch to branch tunnel using 2 factor authentication. · Additional security is being placed on home transcriptionists to ensure that data is encrypted on home computers and strong passwords are required for access. · Transcription documents are backed up nightly to Dept of Medicine “group share” data base and that in turn is backed up nightly to the University’s TSM Archive system. · Transcription servers are housed in a locked room with limited key access. · Transcription file servers are protected by a firewall that restricts traffic as follows: o Local Transcriptionists o Branch office tunnels: · subnet 172 · home transcriptionists · Software VPN Access · home transcriptionists · other accounts
Server Security
Calgary Health Region will host the data server in its Telus Internet Data Centre. The following physical security measures are in place for this Data Centre:
· Card access locks, with card access strictly limited to those employees whose functions require them to enter the data centre. · 24 hour operator supervision. · On-site security staff. · Security cameras. · Intrusion detection system. · Sign-in/sign-out log book for systematic identification / supervision of authorized guests. · Uninterruptible power supply (UPS), which instantly provides a temporary supply of electrical to all computers in the centre in the event of power failure, allowing for a seamless switch to emergency generator power. UPS also “conditions” the power supply to the computers, eliminating power surges and depressions. · Halon fire suppression system. · Raised flooring, allowing for isolation of electrical and data wiring, sufficient air circulation and temperature control, flood protection, and protection from dust which might accumulate on the sub-floor.
The EMIS server resides on the Region’s Wide Area Network (WAN). In order to protect the WAN from unauthorized access or corruption of data, the Region’s IT Services has established security processes and procedures which match or exceed the standards of ISO 17799 / BS 7799. IT Services has also established a number of internal policies and standards, such as an Internet Firewall Policy, a Virus Protection and Prevention Policy, and a System Management Security Policy. These and other IT Security policies are available in the Calgary Health Region’s Organizational Privacy Management PIA.
System Configuration
MDERA has chosen EMIS Canada Inc. to be its EMR vendor. EMIS Canada is a wholly owned subsidiary of EMIS Ltd, a U.K. Electronic Medical Record Systems supplier that has been in business for 18 years. EMIS has passed the VCUR testing and will install EMIS PCS, Patch 2360 as a local installation. MDERA will be using the scheduling and charting functions and extracting the needed data for its billing submitter, Microquest Inc.
EMIS is designed as a web-based system incorporating two factor authentication – a unique password and a fob-based authentication. MDERA members and their affiliates will be able to access the EMR from any of the clinic or office sites, the University of Calgary, their home computers or any remote computer in another health region or clinic outside of Calgary. When accessing the EMR from a Calgary Health Region site, and using one of the desk top workstations authorized to access the EMR, only userID and password authentication will be required. A FOB will be required for any access from outside the Calgary Health Region’s secure zone.
Please read MDERA’s Society Bylaws |
