HOSPITAL REPORT MANAGER Fax Deactivation RequestREQUEST FOR DEACTIVATION OF FAXING/HARD COPY REPORT DISTRIBUTION FOR ESC LHIN HOSPITALS
In adherence to the HRM Project, we, the undersigned, hereby consent to the deactivation of faxed/hard copy report distribution for all report types that are included in the scope of the Hospital Report Manager interface. As a component of the interface validation, we have used the faxed/hard copy reports received to complete an evaluation of the reports received via HRM. We have verified the receipt of appropriate report types and ensured the content is accurate.
We, the undersigned, acknowledge that we will cease to receive faxing/paper copies of the reports outlined below from the 5 hospitals in the Erie St. Clair LHIN (BWH, WRH, WRHO, CKHA, & LDMH)
Transcribed Reports (Discharge Summaries, Clinic Notes, Consults, Etc.)
Diagnostic Imaging Reports (MRIs, CT Scans, Ultra-Sounds, Etc.)
We further understand that reports that are NOT in scope of the HRM interface will continue to be delivered via faxing/hard copy report distribution. Examples of these reports include:
Cardiology Reports some
Hand Written Notes
Any report containing an image, graph, or table
Certain Pre-opt reports
CLINIC INFORMATION
Lead Physician/administrative user
clinic name:
signature:
clinic address:
print name:
clinic phone:
date:
I, the undersigned, agree that the Hospital Report Manager interface is functional and reliable in the transmission of the specified reports to the EMR supporting my practice. My signature demonstrates my full adoption of the Hospital Report Manager Program.
Surname
First Name
OHIP #
CPSO/CNO #
clinic name
fax number
Signature
Submission Guidelines:
Please return the completed document to the cSWO Change Management team via email to [email protected]. It is strongly encouraged to deactivate the faxing/hard copy report distribution within 90 days of your HRM implementation.
*** The deactivation of faxing/hard copy report distribution may be completed on a per provider basis.***
NOTE: Not all report types will be deactivated at the same time. The process of deactivating the faxing/hard copy report distribution occurs within several departments and across the 5 participating hospitals. Once this form is processed, the deactivation for all report types will be completed within 72 business hours. A Change Management Site Coordinator (CMSC) will be in contact with the clinic to provide further information regarding specific timelines.
Thank you for your participation in the Hospital Report Manager Project!
