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How to choose a software vendor for your interRAI implementation

How to choose a software vendor for your interRAI implementation kathschach

This section will help you choose a software vendor for your interRAI implementation.

The vendor software you use to collect and submit data needs to meet your business requirements for collection and integration with other systems.

Understand everyone’s role

Explore the different roles and responsibilities for interRAI, CIHI, your software vendor and your organization for choosing a vendor. 

Assess IT capacity

Recommendations to assess IT capacity when choosing a software vendor for IRRS and interRAI implementation.
 

Review vendor requirements

Guidance on requirements and considerations to discuss with a software vendor prior to implementing interRAI and IRRS.

Prepare your RFP

Criteria to consider in your request for proposals (RFPs) to vendors for interRAI assessments. 

Prepare your contract

Questions to help guide organizations with vendor contract negotiations regarding interRAI assessments.

Integrate into EHR

Choose vendor software that can help efficiently and accurately integrate your interRAI assessment data into electronic health records.

The importance of data quality

Data quality is a collaborative effort and is part of the process every step of the way. Consider incorporating some of these data quality tools into your vendor software to assist with initiatives at your organization:

  • Current Canadian interRAI standard
  • Clinical audit flags
  • Assessment scheduler
  • Data quality audits

How CIHI can help

  • CIHI provides data submission requirements and supporting documents for the interRAI data standard to licensed CIHI vendors.
  • CIHI offers expertise in testing the proposals and submissions you receive from vendors to ensure that they comply with specifications.
  • CIHI provides additional information on acquiring a non-commercial vendor licence for organizations interested in becoming a non-commercial vendor.

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Understand everyone’s role in choosing a vendor

Understand everyone’s role in choosing a vendor kathschach

interRAI, CIHI, your software vendor and your organization all have roles and responsibilities when it comes to system implementation. 

interRAI 

Develops and owns the intellectual property in the interRAI assessment system

Provides a licence to users, including

  • Commercial software vendors
  • Non-commercial users that wish to adopt interRAI tools

CIHI

Maintains Canadian standards and specifications and distributes them to licensed

  • Commercial vendors
  • Organizations

Vendor

Becomes licensed with CIHI and interRAI

Provides and supports the contracted software solution at your organization

Your organization

Defines requirements that will meet organizational and jurisdictional business processes for

  • Data collection
  • Reporting
  • Submission to CIHI

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Find an interRAI assessment system licensed vendor

Find an interRAI assessment system licensed vendor kathschach

Many of the products and services we produce are closely connected with CIHI data holdings. 

To protect these holdings and the integrity of CIHI products, we have developed a vendor licensing process. This process provides vendors with the CIHI products they need to develop and support their software to meet the electronic submission requirements for our data holdings.

Cost

Organizations do not incur any software costs from CIHI. Software/licensing fees are vendor-specific. Organizations should contact individual vendors for pricing information.

Vendor fees may depend on the number of licences that need to be purchased to accommodate staff who require access to the software.

Vendor testing requirements

Prior to the start of a fiscal year, CIHI distributes data submission requirements to software vendors. Vendors are then required to make changes to their software.

CIHI requires software vendors to test annually. The vendor testing process provides vendors with the opportunity to validate their systems prior to updating their applications.

Vendors must successfully complete the testing process before their clients can begin data submission to CIHI for a new fiscal year.

Access a list of commercial vendors that have successfully passed CIHI testing and that support the Integrated interRAI Reporting System (IRRS)

Additional information about requirements and related processes is available on the health information software vendors page of CIHI’s website.
 

Relationship with commercial vendors

Establish a collaborative relationship with your software vendor and/or software developer. Clarify your organization’s requirements for software vendor solutions and build them into the contract with the vendor/developer. For example, 

  • The vendor must have an agreement with interRAI for use of the interRAI assessment. 
  • The vendor must have a Health Information Standards and Specifications Agreement (HISSA) with CIHI and access to the IRRS specifications. 
  • The vendor must build the solution to meet IRRS specifications. 
  • The vendor is required to pass IRRS vendor conformance testing prior to its clients submitting data to CIHI. 

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For more information on vendor testing, request a vendor test process document by sending an email to

help@cihi.ca

Assess IT capacity for the interRAI assessment

Assess IT capacity for the interRAI assessment kathschach

When it comes to choosing a software vendor to help you implement the interRAI assessment system, your decision will partly depend on your organization’s existing IT infrastructure and staff.

Consider the following questions when assessing the capacity of your IT services.

  • Can your organization’s IT department perform all the tasks required in terms of skills, tools, processes and management capabilities? 
  • Has your organization successfully executed a project of comparable scope and size? 
  • What are some initial start-up costs? Remember to include potential upgrades to hardware or software, additional staffing and capital purchases, such as
    • Equipment
    • Systems
    • Software required for submission
  • Are there any conflicting IT projects (e.g., electronic health record [EHR] implementation, hardware upgrades) that could potentially affect this project?
  • Are additional resources (e.g., staff) required for data collection and submission?
    • Note that resource requirements will vary depending on the scope and volume of data submitted
  • What are the ongoing operational costs?

When choosing a software vendor for this project, consider its ability to efficiently integrate the interRAI assessment system into an EHR.

Understanding the requirements for this integration will assist in decision-making at clinical, organizational and system levels. 
 

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Vendor solution considerations

Vendor solution considerations kathschach

After selecting a software vendor, it is important to understand their project plan, including the timeline for completing Integrated interRAI Reporting System (IRRS) conformance testing to become a licensed vendor with CIHI, and to align this with your overall project plan. 

Make sure to clearly document the requirements and needs of your jurisdiction for the vendor software solution and incorporate them into the contract to avoid additional costs and delays.

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Ensure the vendor is using the Canadian version of the interRAI standard and determine how specification updates will be reflected in the vendor software solution (including frequency, timelines for incorporating changes and whether changes are included in the contract or are an additional cost). 

Outline the reports that are required to meet your business needs. Ensure that the vendor can manage the process for reporting and extracting data based on CIHI’s submission specifications.

There is a subset of data available through the query functionality in IRRS. It is recommended that jurisdictions build data quality reports that use the query data to meet their business needs. This includes the following types of reports:

  • A report that lists which validations have been triggered and how often. Use this information to enhance or modify training for assessors on coding.
  • A report that lists which assessment data has not yet been submitted to IRRS. This enables your jurisdiction to identify unsubmitted assessment data and investigate the reason (e.g., incomplete data, error triggered during initial submission and not fixed).
  • A report that flags missing longitudinal records (i.e., no assessment or discharge information for a person for a specified period).
     

Consider any additional data elements you may be interested in collecting outside the interRAI assessments; there may be an additional cost if this is not included in your vendor contract. 

For additional functionality, consider the following: 

  • The ability to retrieve metadata from IRRS for previously submitted assessments and the ability to delete submitted data by using CIHI-issued resource identifiers. This is particularly useful when trying to reconcile submissions and when performing system migrations.
  • Inclusion of local validations and reporting to meet business needs.
     

It is recommended that the selected software vendor build in local validations so that data is validated prior to submission to IRRS. These local validations might include hard edits or warnings to prevent incomplete or inaccurate data submissions to IRRS. 

It is recommended that the vendor software solution include an offline option for data collection and validation. This is so that the system will still function in times of poor connectivity or lack of internet access.

Confirm that the vendor software solution has local validation checks that allow the assessor to make corrections in real time as opposed to needing to address errors upon reconnection. 

Ensure that the outputs (e.g., Clinical Assessment Protocols, outcome scales, quality indicators, resource allocation, screening and risk algorithms) are included in your vendor solution package. 

Discuss the ability to retrieve metadata for previously submitted assessments from IRRS and the ability to delete submitted data by using CIHI-issued resource identifiers. This is particularly useful when trying to reconcile submissions and when performing system migrations. 

Note: The above considerations also apply when developing your non-commercial data collection and submission solution rather than using a commercial software vendor. If you are considering this option, contact us to discuss the best approach.

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Prepare your interRAI assessment request for proposals

Prepare your interRAI assessment request for proposals kathschach

As you prepare a request for proposals (RFP), review vendor solution considerations to make sure your selected vendor will be able to provide everything you need.

Other points for consideration in creating an RFP may include

  • Negotiating software licence fees, system maintenance expenses and software updates
  • Providing staff training on the software, as well as ongoing support
  • Conducting clinical/data quality audits
  • Managing the process for reporting and extracting data based on CIHI’s submission specifications
  • Linking your organization’s information system (e.g., registration) to other data collection systems
  • Integrating and streamlining clinical documentation and organizational requirements
  • Developing a schedule for installation and testing

You might also want to think about

  • Retention of your own data
    • For example, if you change your vendor software, you need to be able to maintain historical data. The interRAI reporting systems at CIHI are longitudinal databases, so it is critical that unique identifiers for existing persons and records remain the same to avoid any impact on data submissions.
  • Other system requirements, including customized needs and specific workflow/business processes

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Prepare your interRAI assessment system contract with the vendor

Prepare your interRAI assessment system contract with the vendor kathschach

Once you have selected a vendor, review vendor solution considerations and these questions to help guide contract negotiations. 

The review will help ensure that the vendor solution will meet your organization’s business needs for data collection, reporting and submission to CIHI.

Consider the following questions when creating your contract:

  • What determines the software price?
  • What types of services (on site and virtual) are included in the purchase?
  • What is the timeline to build software and test all requirements?
  • What ongoing training is offered?
  • Is real-time client support available?
  • What standard is being supported?
  • How often do program updates go out, and are clients notified when they do?
  • What is the turnaround time for getting bugs fixed?
  • How customizable is the system? Will it meet business needs? Are there additional costs for maintenance?
  • Can jurisdiction- or organization-specific mandatory reporting requirements be integrated into the system?
  • Is the software integrated or stand-alone? Is it available for online and/or offline use? Can it be used remotely with mobile devices (e.g., tablets, laptops, smartphones)?
  • Can the solution link to other organizational information systems?
  • What are the contract term commitments, termination clauses, discounts and hidden fees?

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Integrate your interRAI assessment data into an electronic health record

Integrate your interRAI assessment data into an electronic health record kathschach

It’s important to choose a vendor software that can help you efficiently and accurately integrate your interRAI assessment data into an electronic health record (EHR).

interRAI assessments electronically capture standardized information across different health and social service settings. They share a common language and refer to the same clinical concepts in the same way across assessments. 

This commonality enables continuity of care as part of an integrated health system. The ability for authorized clinicians to connect, share and use health information across different health care systems, when and where that is needed, is vital for quality of care for Canadians.

A key component of this integrated system is the EHR. EHRs help improve Canadians’ access to health services, enhance quality and safety of care, and help health care systems become more efficient.

Understanding how to integrate interRAI assessment information into an EHR will help support decision-making at clinical, organizational and system levels.

Integrating your interRAI assessment data with an EHR

What’s the difference between an EHR and an electronic medical record (EMR)?

  • An EHR is a longitudinal collection of the electronic health information of a person or population and can serve as an information source for an EMR.
  • An EMR is a partial patient record. It is provider- or organization-centric and can serve as an information source for an EHR.

Before you begin integrating your interRAI assessment data into an EHR, you need to answer 6 questions:

  1. How would systems (EMR, EHR, etc.) share data and assessment information?
  2. What data sharing standard will be used to move the information among systems? Some examples of data sharing standards include
  3. Where would the data and assessment information be stored? For example, is the information stored in a centralized repository similar to the Acute and Community Care Clinical Data Repository in Ontario?
  4. Which components of the EHR are available to use in your jurisdiction?
    • Client registry: For client demographics
    • Provider registry: For provider demographics
    • Consent registry: For consent information
    • Drug information system (DIS): For drugs/medication history
    • Panorama/public health surveillance: For immunization history
    • Jurisdictional laboratory information system (JLIS): For laboratory results
    • Shared health record (SHR): For observations/health conditions (e.g., allergies, diagnoses, social behaviours, social history, treatments, procedures)
  5. What client demographic data from an EHR can be used to autopopulate an interRAI assessment (e.g., information from the client registry)?
  6. What data from interRAI assessments can be used to populate EHR components (e.g., outcome scales such as Pain Scale, Depression Rating Scale)?
     

Workflow design and business processes

These tools can support workflow design and help determine business processes.

Single sign-in

Having identity management tools/platforms simplifies access to client information and removes the need for separate login credentials for each system. 

With a single sign-in process, a user logs in once and can access a range of applications through multiple channels without having to log in again during that session.
 

Security and privacy policies

The security and privacy needs for delivering interdisciplinary health care services across and between care settings, organizations and disciplines can be complex. Clearly defined security and privacy policies need to be in place in the areas of

  • Accountability for personal health information
  • Identifying purposes for the collection, use and disclosure of personal health information
  • Consent
  • Accuracy of personal health information
  • Safeguards for the protection of personal health information
  • Individual access to personal health information

More information can be found in Canada Health Infoway’s Privacy and Security Requirements and Considerations for Digital Health Solutions.
 

Clinical and specification requirements

Online tools such as InfoScribe from Canada Health Infoway are available to help you develop your clinical and specification requirements.

Terminology and classification standards

Terminology and classification standards allow information to be captured, retrieved, aggregated, analyzed and shared across health care settings in a consistent, safe and reliable manner.

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