HRM

The Ontario Hospital Report Manager electronically delivers e-Notifications of admissions and discharges, text-based Medical Record reports, (e.g. Discharge Summary), and transcribed Diagnostic Imaging (excluding image) reports from sending facilities directly into patients' chart, within OSCAR 15.

Preface

HRM is an eHealth solution that enables clinicians using an OntarioMD-certified EMR to securely receive patient reports electronically from participating sending facilities. These instructions allow for connecting OSCAR 15 to HRM.

Document Version History

• v1.0 – initial OSCAR 15 version published to oscarmanual.org – Mar 17, 2016
• v1.1 – added step by step instructions – April 12, 2016

HRM from scratch

The HRM User Acceptance Test

1. If you use a certified EMR from OntarioMD contact the OntarioMD Practice Advisor for your area directly or via report.manager@ontariomd.com
2. Your OntarioMD Practice Advisor may schedule a meeting with you at which time you will review the HRM Welcome Package.
3. Fill out the HRM Information Sheet and return to your Practice Advisor who in turn will send you the additional agreements for signatures.
4. Sign the Subscription Agreement, Technical Information Sharing Agreement and User Acceptance Testing for your site.
5. You will also need a End User Agreement signed for each clinician who will be using HRM (usually MD's and NP's).
6. Once they process those agreements you will receive an an email which contains
• The "Receiving Facility Onboarding Roadmap" (Roadmap) which is a 11 page procedure for testing your installation
• email with your 3 keys that will be labelled <username>T.ppk  <username>V.ppk and <username>P.ppk
• and an encrypted AES decryption key in 7z format 
7.  Take the INITIAL settings particularly for IP and Decryption Key that are provided in section "3.2.2 Setting up and testing a connection" of the Roadmap and enter them in the /usr/share/tomcat7/oscar.properties file

# Ontario MD HRM properties
OMD_HRM_USER=13HAILEYBUL001T
OMD_HRM_IP=206.172.45.41
OMD_HRM_PORT=22
OMD_HRM_AUTH_KEY_FILENAME=13HAILEYBUL001T.ppk
OMD_HRM_REMOTE_DIR=Test
OMD_HRM_DECRYPTION_KEY=1111111111111

# All the following paths will generate if you set BASE_DOCUMENT_DIR
#BASE_DOCUMENT_DIR=/usr/share/oscar-emr/OscarDocument/
# alternately you can set them individually to existing directories

OMD_hrm=/usr/share/oscar-emr/OscarDocument/oscar/hrm/
OMD_directory=/usr/share/oscar-emr/OscarDocument/oscar/hrm/OMD/
OMD_log_directory=/usr/share/oscar-emr/OscarDocument/oscar/hrm/logs/
OMD_stored=/usr/share/oscar-emr/OscarDocument/oscar/hrm/stored/
OMD_downloads=/usr/share/oscar-emr/OscarDocument/oscar/hrm/sftp_downloads/

1. Place your key files into the OMD directory
   

   sudo cp 13HAILEYBUL001T.ppk /usr/share/oscar-emr/OscarDocument/oscar/hrm/OMD/13HAILEYBUL001T.ppk
   sudo cp 13HAILEYBUL001V.ppk /usr/share/oscar-emr/OscarDocument/oscar/hrm/OMD/13HAILEYBUL001V.ppk
   sudo cp 13HAILEYBUL001P.ppk /usr/share/oscar-emr/OscarDocument/oscar/hrm/OMD/13HAILEYBUL001P.ppk

2. Place the parsing files into the OMD directory (get them from https://source.oscartools.org:8080/#/c/12243/)

sudo cp report_manager_dt.xsd /usr/share/oscar-emr/OscarDocument/oscar/hrm/OMD/report_manager_dt.xsd
sudo cp report_manager_cds.xsd /usr/share/oscar-emr/OscarDocument/oscar/hrm/OMD/report_manager_cds.xsd
sudo cp ontariomd_cds_dt.xsd /usr/share/oscar-emr/OscarDocument/oscar/hrm/OMD/ontariomd_cds_dt.xsd

1. Restart tomcat

   sudo service tomcat7 restart

2. Test your system with these settings to ensure that things are correctly configured and you are getting files into OSCAR.  

Smoke Test Setup

Once you pass the UAT test you are ready to reconfigure for verification against the HRM server.  You just have to change the settings in the properties file.  First you need to obtain the production decryption key. You have to pass this "smoke test" prior to connecting to the production HRM system.

1. Get the 7zip program

sudo apt-get install p7zip-full

1. Decrypt the AES key file you received supplying the encryption password that OntarioMD faxed you.  If you supply the correct password you will be able to extract the AESDecryption.txt file that contains your production decryption key.  This is used both for the smoke test and for production use.

7z x AESDecryption_Haileybury\ FHT\ -\ 95\ Meridian\ Ave.7z

1. Check against section 3.3.2 of the Roadmap. Use these New settings to change your settings from the ones for Test to the Verification ones

# For Verification Testing you need to change to new property settings
OMD_HRM_IP=sft.ver.hrm.prod.ehealthontario.ca
OMD_HRM_USER=13HAILEYBUL001V
OMD_HRM_AUTH_KEY_FILENAME=13HAILEYBUL001V.ppk
OMD_HRM_REMOTE_DIR=Test
OMD_HRM_DECRYPTION_KEY=222222222222222222222222

1. Restart tomcat

sudo service tomcat7 restart

Production Setup

Once you pass the "smoke test" you are ready to reconfigure for production use.  You have to again change the settings in the properties file.

1. Check against section 3.3.3 of the Roadmap. Use these New settings to change your settings from the ones for Test to the Production ones

# For Production use you need to change to new property settings
OMD_HRM_IP=sft.hrm.prod.ehealthontario.ca
OMD_HRM_USER=13HAILEYBUL001P
OMD_HRM_AUTH_KEY_FILENAME=13HAILEYBUL001P.ppk
OMD_HRM_REMOTE_DIR=Production
OMD_HRM_DECRYPTION_KEY=222222222222222222222222

1. Finally set HRM to poll every 30 minutes (the default) by adding the HRM to the ModuleNames list in oscar.properties

#Add HRM to the comma delineated list of services
ModuleNames=REST,HRM

1. Restart tomcat

sudo service tomcat7 restart

Gotcha's courtesy Keith Chung

Password:

We were emailed an encrypted file by OntarioMD.   The password to this file was supposed to be faxed to us.  When the password came, we wasted a fair amount of time trying to decrypt the file using the faxed password.  Turns out the faxed password was the actual decrypted version of the file.   We ultimately could just ignore the encrypted file that they emailed us.

Test Files:

When we tried to perform the “smoke test”, everything seemed to connect fine, there were no errors in the log, but nothing happened.   We spent a while troubleshooting, before giving up.  Turns out OntarioMD had not put any test files into our folder, so there was nothing to download.

XSD Files:

We were lucky to have seen the thread referencing the additional files that Hagir provided.   Without coming across this email, we likely would have gotten stuck at this step.  Thanks! [note these updated files are source for 12_1 build 509 and newer, but are missing in OSCAR 15]

Cached Server Address:

After everything seemed to work with the verification, we changed OSCAR’s configuration to point to OntarioMD’s production server, and restarted the server.  OntarioMD reported that we were still polling their verification server though, and not their production server.  We needed to perform a manual fetch using the HRM button in the GUI for OSCAR to start polling the production server.

Polling:

It took us a while to figure out why we weren't polling.  Turns out, according to this - http://oscarmcmaster.16.x6.nabble.com/HRM-setup-td5005226.html - we needed to add ModuleNames=HRM into the properties file.   The most frustrating thing is that even when this field hadn't been added into our properties file, and so our instance was presumably not actually polling, OntarioMD told us that we did poll the verification server.  On a close review of the logs, this was likely not the case, and so OntarioMD telling us that our instance was previously polling and stopped wasted a few hours of our time time troubleshooting as we went down a completely different troubleshooting path.