Integrated Assessment Record (IAR)

IAR Tool Train-the-Trainer

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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

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What is the Integrated Assessment Record (IAR)?

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Long-Term Care Homes(RAI-MDS 2.0)

Community Mental Health(OCAN)

Inpatient Mental Health(RAI-MH)

Community Care Access Centers(interRAI CA, RAI-HC)

Community Support Services(interRAI PS, InterRAI CHA)

A tool that provides a central repository for data collected from multiple assessments for clients and allows health service providers within the circle of care to view a client’s previous assessment information from other care providers.

HSPs can use IAR to electronically view timely client assessment information in a secure manner, improving information management and enabling collaborative care planning.

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IAR Supported Assessments

Assessment SectorOntario 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 Preliminary Screener for Primary and Community Care Settings (Screener)

Community Support Services

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

Health Information Network Providers (HINPs)

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• South Western Cluster • TransForm Shared Services Ontario

(TSSO)• Central Ontario (GTA) Cluster

• William Osler Health System (WOHS)• North Eastern Cluster

• Health Sciences North (HSN)

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W

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Enterprise Master Patient Index (EMPI)

TReporting Repository

Assessment Entry Module (AEM)

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

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Using the IAR

Assess Clients, Gather Consent

Submit Data Regularly

Use the IAR in Care Provision

HSP responsibilities:• Manage user access• Review audit logs• Leverage reports • Clarify client records (EMPI)• Advise HINP of HSP

changes • Manage privacy, security

and consent

AxAx

Assessment Software

Enter Assessments

AxAx AxAx

Monitor IAR Integrity & Usage

Upload Assessments

Assessment Software

HINP

HINP

View Assessments

HSP A HSP B HSP C

HINP

Include IAR into processes to enhance and inform care planning:

• Ensure secure transfer of personal health information (PHI)

• Support “Patients First Action Plan for Health Care” by enabling access to assessment information that provides holistic understanding of the client’s health care needs.

Business and Permissions Roles

Two upload methods: • Automated web

services uploads• Manual uploads

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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:– Intake– Referrals– Care/service planning– Reassessment– Transfers

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Top 10 Benefits of the Integrated Assessment Record

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Supports “Patient’s First Action Plan for Health Care” by enabling access to assessment information that provides a holistic understanding of the client’s health care needs

Facilitates a collaborative approach to care through the sharing of information that can improve client outcomes

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Enables Health Service Providers to share client assessment information in a secure and timely manner leading to more efficient care planning

Provides reporting capabilities for HSPs to identify the needs of client populations and measure outcomes for service planning

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Eliminates the need for assessment duplication Assessment data from the IAR can support the development of indictors and inform MOHLTC policy development

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Improves workflow and reduces the dependency on paper-based systems

Ensures fewer gaps in client information by tracking assessment history over time as they move between hospital, community service providers, and long-term care settings.

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Promotes standard person centered experience in all locations across the province

Assessment Data from the IAR can support MOHLTC compliance activities

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IAR User Privacy & Security Requirements

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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

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How Consent Works in IAR

HSP Level Consent Directive

Client

HSP-A

Assessment A1 Assessment A2

Yes Yes

HSP-B

Assessment B1 Assessment B2

No No

IAR

Assessment A1 Assessment A2

Yes Yes

Assessment B1 Assessment B2

No No

IAR Level Consent Directive - YES

IAR Level Consent Directive

Clinician

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How Consent Works in IAR (Cont’d)

HSP Level Consent Directive

HSP-A

Assessment A1 Assessment A2

Yes Yes

HSP-B

Assessment B1 Assessment B2

No No

IAR

Assessment A1 Assessment A2

Yes Yes

Assessment B1 Assessment B2

No No

IAR Level Consent Directive - No

IAR Viewers

Client

IAR Level Consent Directive

Option 1 – Client’s assessments not

viewable

Option 2 – Client’s basic identifying info

also not viewable

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IAR Consent Model: Summary

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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Responsibilities for Managing Consent

• Develop policies for the use of your consent methods ranging from:

Express to implied consent

– Establish how staff:o Informs clients so that they understand what they

are consenting too Obtains the consent and what constitutes consento Registers and records the consent

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What to Include When Informing Clients

• WHY you are collecting, using and disclosing their information

• WHAT – types of information you are collecting (e.g., psychiatric

history, legal status, etc.)– it may mean to the client to have this information collected

and used and shared, including positive or negative consequences

• WHO you disclose to and how you disclose assessment data in general

• HOW your staff should ask for consent

It is always the client’s choice to give or withhold consent

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Other 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

• Choose a strong password and keep it safe• Inform clients and manage consent• Support client privacy rights• Report incidents

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Incident ManagementExamples 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

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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

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Contact Information

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Issues Contact Phone Email

Request or update an IAR user account

<<insert user coordinator name>>

   

Report an IAR incident

Contact your Privacy Officer to Report IAR incidents

   

Privacy issues with client/patient

Contact your Privacy Officer to Report IAR privacy issues with client/patients

   

Login account or general IAR issues

CCIM Service Desk 1-866-909-5600 Option 8

iar@ccim.on.ca

Client decides to block their assessments on IAR

IAR Consent Call Centre 1-855-585-5279 & TTY for the hearing impaired 1-855-973-4445

iar@ccim.on.ca

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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

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Demo

Activity 1 – Logging in to IAR

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Logging in to IAR

• 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

• When the user enters the username and default password for the first time, the system will prompt the user to change the password

• Usernames and passwords are case-sensitive

• Passwords must be at least 8 characters in length, will expire after 90 days and must be reset at that time

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To log in to IAR:1.Enter User ID2.Enter Password3.Click Login button or press Enter

Output:The Terms of Use disclaimer screen will appear each time you log in

Logging in to IAR (continued)

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First Time Login

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First Time Login

Password Considerations

• Passwords are case-sensitive, must be at least 8 characters in length, and contain the following:– At least one upper-case character– At least one numeric character– At least one special character ($ / ! / ?)

• Passwords will expire after 90 days and must be reset at that time• If a user forgets their password, they may select the Forgot Your Password? link

on the Login screen to reset the password– Note: This will only work if the user has previously defined a secret question

• After three (3) failed attempts to enter a correct password, user accounts will automatically be disabled for 24 hours. Users will have to contact their User Coordinator for assistance with resetting their password

• In this session: Do NOT change your password

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My Details – Setting My Secret QuestionTo set a secret question:

1.Click the Set button beside Set my secret question

2.Select a question from the Secret Question dropdown menu

3.Type your answer

4.Type your password

5.Click OK

6.Click Save

Output:

The secret question will appear if you need to reset your password

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Accepting the Terms of Use

To accept the Terms of Use:1.Read the Terms of Use

2.Click Accept button to proceed

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• When a user logs in to IAR, a Terms of Use disclaimer screen appears. The user must click the Accept button to proceed

• If you do not accept the Terms of Use, click on the return to the login screen link to return to the Login screen without accessing the system

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Homepage

Output:

The Homepage automatically appears upon log inIt contains the following components:1.Menu Bar2.Person Search3.Recent Persons

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Menu Bar

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Menu bar features:1.Autohide – hide menu bar2.Help - access online help3.Home – return to Homepage4.Logout – end session5.Common - My Details / Worklists6.Messaging – secure message other users7.Worklists – manage worklists8.Person Search – search for clients

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Activity 2 – Managing My Details

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My Details

My Details allows users to configure user-based system settings

1.Change my password

2.Set my secret question

3.Set inactivity timeout duration

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My Details – Inactivity TimeoutTo set the inactivity timeout duration:

1.Click the drop-down menu beside Inactivity Timeout

2.Select the desired duration

3.Click Save or OK

Output:

The inactivity timeout is changed

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Person Search

Enter all or some of the following search criteria and click Search:

1.Ontario Health Card Number

or

2.Last Name, First Name and Date of Birth (if unknown an estimated date of birth must be provided)

3.Other demographics can be included to further ‘narrow’ search results

When Search Results appear :

Click on the desired person record to go to person summary view.

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Helpful Links

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Resource(English and French)

Material Link

Education and Training IAR eLearning Modules•Viewing records and verifying uploads•Privacy and Security

Training Documents•IAR Tool Train the Trainer•Privacy, Security & Consent Management•IAR Technical Training

Link to IAR Education and Training

IAR Forms and Guides Operational Forms•IAR Business Sustainment Role Request Form•HSP and User Access Request Form•HSP IAR Reports Recipient Form

Link to IAR Forms and Guides

Privacy and Security Common Privacy FrameworkPrivacy Processes•Audit Log Review Standards•Client Privacy Rights Support Process•EMPI HSP Process•Integrated Consent Management Process•Integrated Incident Management Process•Self-Assessment Checklist•User Account Management Process

Link to IAR Privacy and Security Material

There are many additional resources on the CCIM website: www.ccim.on.ca

Thank You!

Please contact the IAR Team if you have any questions or need assistance:

CCIM Service DeskTel: 1.866.909.5600, Option 8

Fax: 416.314.1585Email: iar@ccim.on.ca