BreastScreen ACT

Information Systems Manual

Version 3 2017

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1. CONTENTS 2. VERSION CONTROL ......................................................................................................................................... 3

3. ACT PATIENT ADMINISTRATION SYSTEM (ACTPAS) ....................................................................................... 4

3.1. OVERVIEW............................................................................................................................................ 4 3.2. PROTOCOLS .......................................................................................................................................... 4 3.3. SECURITY ............................................................................................................................................. 4 3.4. REPORTING SERVICES.............................................................................................................................. 5 3.5. E-HEALTH SUPPORT ............................................................................................................................... 5

4. PICTURE ARCHIVAL COMMUNICATION SYSTEM (PACS) ................................................................................. 5

5. BREASTSCREEN INFORMATION SYSTEM (BIS) ................................................................................................ 6

5.1. TRAINING IN BIS APPLICATION .......................................................................................................... 6 5.2. ADDING A BIS USER ACCOUNT ........................................................................................................... 6 5.3. ADDING A BIS EXAM CODE ................................................................................................................ 8

5.3.1. Adding an Exam Code ................................................................................................................... 8 5.4. ADDING A LABORATORY IN BIS ......................................................................................................... 9

5.4.1. Adding a Laboratory ...................................................................................................................... 9 5.5. ADDING AN EXCLUSION IN BIS ........................................................................................................ 10

5.5.1. Adding an Exclusion .................................................................................................................... 11 5.6. ADDING A NOTE CATEGORY IN BIS .................................................................................................. 13

5.6.1. Adding a Note Category .............................................................................................................. 14 5.7. ADDING A SCREENING MACHINE IN BIS .......................................................................................... 14

5.7.1. Adding a Screening Machine ....................................................................................................... 14 5.8. RUNNING AN AUDIT REPORT .......................................................................................................... 16

6. 6.0 MEETINGS FOR BIS .................................................................................................................................. 19

6.1. BIS POST GO LIVE FORUM MEETING ............................................................................................... 19 6.2. BIS-PACS GOVERNANCE MEETING .................................................................................................. 19 6.3. CLINICAL PORTAL WEEKLY MEETING............................................................................................... 19 6.4. CLINICAL PORTAL SUPPORT FORTNIGHTLY MEETING ..................................................................... 20 6.5. BREASTSCREEN DATA MEETING ...................................................................................................... 20 6.6. BREASTSCREEN MANAGERS, PROMOTION AND QUALITY MEETING .................................................. 20

7. RESOLUTION FOR BIS ISSUES ........................................................................................................................ 21

7.1. SNOW (SERVICE NOW) – E HEALTH ................................................................................................. 21 7.2. SUPPORT TRACKER – ORION HEALTH .............................................................................................. 21

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2. VERSION CONTROL

BREASTSCREEN ACT

INFORMATION SYSTEMS

MANUAL

Effective Date: January 2017 Approval Authority: Executive Director, Cancer, Ambulatory and Community Health Support

Next Review Date: January 2019 Approval Sponsors: Director, BreastScreen ACT, PACS Administrator & BIS System Administrator

Last Updated: January 2017 Version: 3.0

Version

Effective From

Effective To

Change Summary

1.0

October 2012

October 2013

New Manual

2.0

October 2013

February 2016

Revised Manual

3.0

March 2016

March 2018 Revised and updated to align with ACT

Health Directorate Policy and BIS

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3. ACT PATIENT ADMINISTRATION SYSTEM (ACTPAS)

3.1. OVERVIEW ACTPAS is the ACT Patient Administration System. All patients accessing ACT Health and Calvary Health services have one unique ID in ACTPAS. ACTPAS enables: • Patients to be registered once to obtain a holistic view of a patient record. • Users access to up-to-date, accurate patient information, irrespective of where the patient is or when

they last accessed services. • The ability to track data input across all areas of ACT Health. • Reporting capacity and functionality.

3.2. PROTOCOLS • Access to ACTPAS is only provided to trained personnel. • Participants receive a logon and secure password once trained to the required Icons and functionality. • Every action performed in ACTPAS will have the user name attached to it. • Varying access rights are granted, governed by specific client group needs.

3.3. SECURITY • NEVER share passwords. • NEVER leave your PC unattended, always log out. • NEVER provide information to anyone outside of the Health Directorate. • NEVER access your own record or those of friends or relatives.

Refer to the:

ACT Government Acceptable Use of ICT Resources Policy-136

ACT Public Service Code of Conduct

ACT Password Policy WhoG 131

ACT Health Clinical Record Management Policy

ACT Health Standard Operating Procedure for the Release or Sharing of Clinical Records or Personal Health Information

ACT Protective Security Policy and Guidelines

ACT Government Encryption Policy

ACT Government ICT Security Policy

NOTE: SHARING PASSWORDS BREACH – HEALTH DIRECTORATE AND ACT GOVERNMENT ACCEPTABLE USE OF

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ICT POLICY, THE ACT HEALTH RECORDS (PRIVACY AND ACCESS) ACT AND THE FEDERAL PRIVACY AMENDMENT ACT. SECURITY BREACHES ARE TAKEN VERY SERIOUSLY AND CAN RESULT IN DISMISSAL.

3.4. REPORTING SERVICES All data entered into ACTPAS/BreastSceen Information System (BIS) can be extracted as reports and there is a dedicated Reporting Team within the Business Intelligence Unit (BIU) to provide assistance. ACTPAS and Reporting Services work together to allow access to information, including retrospective information, required by management. Authorised users are able to run reports. For non-standard reports, or if access is required, contact E-Health Support.

3.5. E-HEALTH SUPPORT E-Health support provides ACTPAS training and support.

• Telephone: 6205 5064 • Email: E-Health.support@act.gov.au • Web-based resources - Health Directorate intranet • Education and training - Variety of delivery options - face to face, on-line, walk through over the phone • Reporting Services • Core business hours are 8:30 am – 5.00 pm Monday to Friday

4. PICTURE ARCHIVAL COMMUNICATION SYSTEM (PACS)

In 2010 BreastScreen ACT implemented a long-term archival system for image storage - Picture Archival Communication System (PACS).

PACS is a combination of hardware and software dedicated to the short and long term storage, retrieval, management, distribution and presentation of images. PACS main purpose is to replace hard film copies with digital images that can be used and seen by several different medical professionals and different medical automation systems simultaneously.

The PACS system is managed by the PACS Administrator whose role is to:

• Provide application problem support and advice to staff regarding the PACS system; including training and the facilitation of policies and procedures.

• Manage all aspects of system administration functions including management, enhancements, security, configuration, and maintenance.

• Work closely with a multi disciplinary team, including liaison with external and internal Vendors and ICT Services provider.

• Work closely with the BIS System administrator to manage interfacing and connectivity between applications.

• Track and manage outstanding tasks and issues on behalf of users. Escalate as required to Vendors and ICT Services provider.

• Undertake system analysis, business continuity, planning and reporting.

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• Manage daily operations of the Reading Room, including quality assurance procedures and staff supervision.

• Work closely with the Senior Radiographer to ensure all work practices and processes meet business needs and are in compliance with the National Accreditation Standards (NAS) for BreastScreen Australia.

For further information please refer to the following manuals provided by the vendor SECTRA.

WhatsNew IDS7.pdfWhatsNew

IDS7forIDS5Users.pdf

5. BREASTSCREEN INFORMATION SYSTEM (BIS) Breast Screen Information System (BIS) and Picture Archival Communication System (PACS) are an integrated system that will enable the capturing, storage, retrieval and management images and information, including client records relating to BreastScreen ACT. BreastScreen ACT has a strategic goal to deliver a single program of co-ordinated screening services across the service. This program is delivered by BIS and provides:

• A common system with standardised management for BreastScreen ACT, administrative and information reporting requirements.

• Support for operational processes, with improved quality assurance for all aspects of the screening and assessment pathways.

• Data collection and reporting within BreastScreen ACT.

• A centralised booking function within BreastScreen ACT.

The BIS-PACS system is the core business system for BreastScreen ACT, supporting operations from booking through to screening, assessment and reporting.

The BIS go-live date was 01 December 2014.

5.1. TRAINING IN BIS APPLICATION All staff requiring access to the ACT Patient Administration System (ACTPAS) on which BreastScreen data is kept, are required to undergo basic training. Trained staff will then be given a username and password. Passwords will not be displayed and will only be accessible to the authorised person. The level of access a staff member will have will be dependent on their requirements. Staff will log off the database when it is not in use and client information will be removed from the screen when it is not required. This will be reinforced at regular team meetings.

5.2. ADDING A BIS USER ACCOUNT After training has been completed with the BIS Administrator, the BIS Administrator will apply user permission through ACT Health IAM Service Portal.

1. Open ACT Health IAM Service Portal

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2. Click ‘ Security Groups (SGs)’

3. Enter ‘%BSACT% in the ‘Search for’ field

4. Click the magnifying glass (search)

5. The following screen will appear

6. Select the user group the staff member belongs to i.e BSACTClerical

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7. Select tab ‘Members’

8. Add staff members name in the ‘Members to Add’ box

9. Click ‘Ok’

10. Click ‘ Submit’

11. Create a SNOW ticket assigned to Clinical Portal team, requesting the following:

Hi E-Health,

Please forward to Clinical Portal team

BIS - Please provide BIS access to XXX XXXXXX - Radiographer

I have added xxxx to the IAM user group ‘Apps_ClPtl_BSACTRadiographer_IAM-Health’.

XXXXXX completed his/her training with me today from 12pm – 1.30pm.

12. E-Health will advise when they have applied the user role into the Clinical Portal.

13. Send out an email to the staff member with a document of how to log onto BIS and save it to their ‘favourites’ bar in their browser.

Document is located Q:\COMMON\Projects\IM&IT\BreastScreening\BIS Post Go Live\Training\BIS PRODUCTION Cheat Sheet.docx

5.3. MANAGE A BIS EXAM CODE

Exam codes are used in screenings and assessments to track and codify different procedures and types of procedures. The Exam Codes screen lists the current exam codes in Breast Screening.

To display the Exam Codes screen, navigate to Management>Exam Codes:

From this screen you can add an exam code, view or edit the details for an exam code or delete an exam code.

5.3.1. ADDING AN EXAM CODE

To add an exam code:

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1. Enter an alphanumeric identifier for the exam code in the free-text field, then click the Add icon. The Exam Code Details screen is displayed:

2. Enter the exam code details. The following table describes the fields on this screen:

3. Click the Ok button to save the exam code details and display the Exam Codes screen. The exam code is displayed in the list of exam codes.

5.4. MANAGE A LABORATORY IN BIS

In the Needle Biopsy Procedure Details screen, a user can select a Laboratory from the Laboratory drop-down list to associate the needle biopsy results with. This drop-down list is populated from the entries listed on the Laboratories screen.

To display the Laboratories screen, navigate to Management>Laboratories

5.4.1. ADDING A LABORATORY

To add a Laboratory:

1. Enter a name for the laboratory in the free-text field and click the Add icon to display the Laboratory Details screen. For example:

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2. Enter the laboratory details. The following table describes the fields on this screen:

Field Description

Code The code of the laboratory. This is the name you have entered for the laboratory.

Description The description of the laboratory.

Active Indicates whether the laboratory is active or not.

True - the laboratory is active. False - the laboratory is inactive.

3. Click the Save button to save the laboratory details.

Alternatively: • Click the Ok button to save the laboratory details and display the Laboratories screen. • Click the Cancel button to discard the laboratory details and display the Laboratories screen.

5.5. ADDING AN EXCLUSION IN BIS

Exclusion Codes are used to prevent clients from being included in batch bookings and manual bookings, for various reasons. Exclusions may be permanent or temporary. The Exclusion Configuration screen is used to configure exclusion codes in Breast Screening.

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To display the Exclusion Configuration screen, navigate to Management>Exclusion Configuration:

The Exclusion Configuration section lists the exclusions that are mapped to specific workflows.

The Deceased Exclusion and Treatment Exclusion are mapped to the workflows described in the following table:

Exclusion Invoked When...

Deceased Exclusion the user sets a date of death for a client.

Treatment Exclusion a client receives an assessment recommendation of Treatment.

• Whether the exclusion name for these exclusions is read-only is configured in Platform. Refer to Exclusions in the Administration Manual for details.

The exclusion name used for a Previous Mammogram Exclusion, Cleanup Tentative Appointments Exclusion or Cleanup Confirmed Appointments Exclusion can be selected from the drop-down lists.

The Exclusions section lists the existing exclusions in Breast Screening. You can add, edit or deactivate an exclusion.

5.5.1. ADDING AN EXCLUSION

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You can add an exclusion to the default exclusion list. The default list of exclusions is:

• No response • Letter returned • Deceased • Out of area • Male • Unwell • Out of age range • Cancelled By Woman • Cancelled By Program • Did Not attend • Opted out (one round only) • Opted out permanently • Breast cancer • Previous mammogram • Repeat DNA • Repeat DNR

To add an exclusion:

1. Click the Add icon at the bottom of the Exclusions section to display the Add Exclusion screen:

2. Enter the exclusion details. The following table describes the fields on this screen:

Field Description

Code The code for the exclusion. This must be a unique number.

Name The name of the exclusion.

Is Indefinite Specify whether the exclusion is indefinite, that is, it does not expire after a period of time, by selecting one of the following options in the drop-down list:

No - the exclusion is not indefinite. This option is selected by default.

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Not available, unknown, unsure - whether the exclusion is indefinite is not specified.

Yes - the exclusion is indefinite.

Default Exclusion Months

Specify the number of months the exclusion will apply by default, in the free-text field. This value is used to set the Re-eligible Date field on the Client Details screen, when an exclusion is applied.

This field is disabled if Yes is selected in the Is Indefinite field.

Exclusion To Upgrade To

Select an exclusion to upgrade this exclusion to, if required, from the drop-down list of available exclusions. The exclusion will automatically be upgraded to the exclusion selected after a certain number of consecutive repeats have passed. The upgrade will occur when cancelling an appointment or when adding another exclusion on the Client Details screen. If selecting this option, also set the number of consecutive Repeats Before Upgrade.

Repeats Before Upgrade

Specify the number of consecutive repeats that must occur before an exclusion is upgraded to the exclusion selected in the Exclusion to Upgrade To field.

This field is disabled if nothing is selected in the Exclusion to Upgrade To field.

Requires Description If the checkbox is selected, the clinician will be required to enter a reason for applying the exclusion.

Available When Cancelling

If the checkbox is selected, the exclusion will be available for selection when the cancelling a client appointment.

Cannot Create Appointments Manually

If the checkbox is selected, a client with this exclusion cannot be manually booked into an appointment.

3. Click the OK button to save the exclusion details and display the Exclusion Configuration screen. The

exclusion is listed in the Exclusions section

5.6. MANAGE A NOTE CATEGORY IN BIS

Note categories are used on the Client Notes screen. When adding a client note from the Client Notes screen, a user must associate the note with a specific Note Category. Note categories are defined and managed from the Note Categories screen.

To display the Note Categories screen, navigate to Management>Note Categories:

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The default note category in Breast Screening is General Notes. You cannot edit the Category Name of the default note category or change its Status, which is set to Active.

From this screen you can add note categories and edit the details for note categories.

5.6.1. ADDING A NOTE CATEGORY

To add a note category:

1. Enter a name for the note category in the Name free-text field. 2. Enter a description for the note category in the Description free-text field, if required.

3. Click the Add icon. The note category is added to the list of Note Categories and can be associated with a note on the Client Notes screen.

5.7. MANAGE A SCREENING MACHINE IN BIS

The Screening Machine Search screen enables you to view a list of screening machines that have been defined for use at a screening site. Active screening machines are displayed in the Screening Machine drop-down list on the Mammogram Details screen, when recording screening details.

To display the Screening Machine Search screen, navigate to Management>Screening Machine Search:

The Search Results section on the Screening Machine Search screen displays screening machines for all screening sites linked to venues associated with your Service Provider In Focus, by default. Refer to My Details in the User Manual for details about selecting your Service Provider In Focus.

From this screen you can search for a screening machine, add a screening machine and view or edit screening machine details.

5.7.1. ADDING A SCREENING MACHINE

To add a screening machine:

1. Click the Add button to display the Screening Machine Details screen:

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2. Enter the screening machine details. The following table describes the fields on this screen:

Field Description

Screening Machine Name

The name of the screening machine.

This is the name that is shown on the Mammogram Details screen, so it should be a name that clearly identifies the screening machine.

Machine Code The identifying code of the screening machine.

Machine Description A description of the screening machine, if required.

Machine Status Specifies if the screening machine is Active or Inactive.

When adding details of a screening machine in advance, you may want to record it as Inactive until it is ready for use.

Screening Site Select the screening site where the screening machine is located from the drop-down list.

Only screening sites that are linked to venues associated with your Service Provider In Focus are displayed.

Initial EPA Test Information

Select the checkbox to enable the fields below and enter EPA test information for the screening machine.

EPA Test Date Enter the date the screening machine was EPA tested by clicking the Calender icon

and selecting a date.

Test Outcome Select the outcome of the EPA test (Pass or Fail) by selecting an option from the drop-down list.

Performed By Enter the name of the individual who performed the EPA test.

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Field Description

Registration Number Enter the registration number for the screening machine.

Expiry Date Enter the date on which the registration for the screening machine will expire by clicking the Calender icon and selecting a date.

3. Click the Ok button to save the screening machine details and display the Screening Machine Search

screen. The screening machine is added to the list of screening machines.

5.8. RUNNING AN AUDIT REPORT

The Breast Screening Audit Log provides an audit trail for all Breast Screening related activity. The purpose of this report is to identify who has done what to which records.

To display the Breast Screening Audit Log screen, navigate to Audit Reports>cBreastScreening Audit Log:

The search criteria encompass all events available on the system, not only Breast Screening events, so it is important to remember to select cBreastScreening from the Application drop-down list when performing a search for Breast Screening audited events.

If you want to search for audit events at the individual client level, you can also use the Client Audit Log.

To search for audited events in Breast Screening:

1. Enter or select appropriate details in the fields of the Search Criteria section. The following table describes these fields:

Field Description

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Application Select the application whose records are to be searched.

Select cBreastScreening to search for audited events in Breast Screening.

Subject ID Enter the ID for the subject associated with the audit event(s).

User ID Enter the login name of the user who performed the audited event(s).

To search for audited events in the Breast Screening Public Web Module (PWM), enter PWM. This filters the Search Results to only display audited events in the PWM. Refer to PWM Audited Events for details.

Subject Name

Enter the name of the subject associated with the audit event(s).

Terminal ID Enter the ID of the terminal on which the audited event was performed.

Result Select a radio button to specify the status of the audited event(s) to search for:

All - searches for both successful and failed events. Success - only searches for successful events. Fail - only searches for failed events.

All is selected by default.

Session Enter the session in which you want to search for audited events. The period between a user's login and logout is a session and is identifiable by a unique alphanumeric combination.

Date Enter the date range in which the event(s) occurred in the From and To fields.

Click the Calender icon to display an electronic calender, from which you can select a date.

To search for audited events from a certain date up to the current date, enter the date to search from in the From field and leave the To field blank.

Concerto Events

Select the type(s) of Clinical Portal event(s) to search for from the list.

Other Events

Select the type(s) of other event(s) to search for in the application, from the list.

In this case, the list displays Breast Screening events, which you can select to search for in the audit log.

The five free-text fields: Subject ID, User ID, Subject Name, Terminal ID and Session, accept the first part of any value, down to a single digit or letter. For example, a search for 3 in Session returns all sessions whose ID starts with 3; enter 3B to narrow the search, and so on. Similarly,

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enter ra in the User ID field, for example, to find all events performed by users whose login ID starts with ra. Values are case insensitive.

2. Click the Search button to search for the audited events. The search results are displayed in the Search Results section.

Click a column title to reverse the sort-order of the results.

Click the Reset button to reset the search criteria fields to their default state. This will not update the Search Results section.

• If too many results are returned, enter or select further criteria to refine your search. • If the search does not return the audited events, repeat the search with fewer criterions, for example,

with fewer fields specified.

Alternatively, select a favourite search from the drop-down list, or create a new favourite search by performing a search, entering a name for it in the Enter a new favourite search text field, and clicking the

Add Icon The new favourite search is then added to the Select a favourite search drop-down list.

3. The following table describes the columns in the Search Results section:

Column Description

Time The date and time (in 24 hour format) the event occurred.

User ID The login name of the user who performed the event. The user's Service Provider In Focus at the time of the event is displayed in brackets beside the user name.

This column displays PWM for PWM audited events. Refer to PWM Audited Events for details.

Event Type The type of event.

Message Descriptive information that usually expands on the Event Type. This is hard-coded in the application.

Subject ID The ID for the subject associated with the event. If a subject was not associated with the event, this column is blank.

Subject Name

The name of the subject associated with the event. If a subject was not associated with the event, this column is blank.

4. Click anywhere on a row in the search results to display the Audit Event Details dialog for the event, which displays all the information captured about the event in any database connected to the event. For example:

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• Click the Close button to close the Audit Event Details dialog. • Click the Printer friendly Candidate Audit Log link on the Breast Screening Audit Log screen to display a

printable version of the search results in a new dialog, which you can print or save to your computer

6. MEETINGS FOR BIS

6.1. BIS POST GO LIVE FORUM MEETING The BIS Post Go Live Forum meeting meet fortnightly in conjunction with the BreastScreen Data Meeting. Minutes and Agenda items can be found in the following link:

Q:\CH\CY&W\BScreen\BIS\BIS Post go live Progress Form Meeting Minutes

6.2. BIS-PACS GOVERNANCE MEETING The BIS-PACS Governance Meetings are held quarterly, to ensure the ongoing successful implementation of the BIS and ongoing support of PACS. The Committee provides strategic advice to BSACT regarding the prioritisation of issues and solutions to issues. The Committee maintain an ongoing relationship with the BIS product provider (Orion Health) and PACS product provider (Phillips) and other key stakeholders\Vendors. The Committee ensures there is clear governance for the implementation of the BIS and PACS. Minutes and Agenda items can be found in the following link:

Q:\CH\CY&W\BScreen\BIS\BIS-PACS Governance

6.3. CLINICAL PORTAL WEEKLY MEETING

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The Clinical Portal Weekly Meeting is held at Callam Offices, Woden with the Business Systems Support Senior Manager and Health Application Specialist team. This meeting addresses priorities or issues that need attention. Minutes and Agenda items are held on the G: Drive by SSICT.

6.4. CLINICAL PORTAL SUPPORT FORTNIGHTLY MEETING The Clinical Portal Support Fortnightly Meeting is held at Callam Offices, Woden. This meeting is chaired by the Clinical Portal Support Manager who coordinates any issues, updates, upgrades and priorities with the following teams.

• Clinical Portal team

• BIS Administrator

• WIC (Walk in Centre) Administrator

• Integration team

• eOrders Administrator

6.5. BREASTSCREEN DATA MEETING The BreastScreen Data meeting is held weekly to discuss:

• Operational Reports

• NAS Reports

• Electoral Roll/Medicare mail outs

• Lapsed Attendee mail outs

• NSW clients

• Accountability Indicators

• PHIDU (Public Health Information Development Unit)

• Vacancy Rates

• AIHW

• Ad hoc reports

Representatives from the BIU (Business Intelligence Unit) Senior Managers, Promotions, PACS Administrator and BIS Administrator attend these meetings.

6.6. BREASTSCREEN MANAGERS, PROMOTION AND QUALITY MEETING The BreastScreen Managers, Promotion and Quality meeting is coordinated by the Promotions and Quality Manager. These meetings are attended by all Senior Managers, Promotions and Quality Manager, PACS Administrator and the BIS Administrator. Items discussed include:

• Performance of the program - Vacancy Rates, Budget, Staffing, Feedback from the CACHS Executive Director

• BreastScreen Accreditation

• ACT Health Accreditation

• Client Feedback

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• Recruitment activities

• Quality Improvement activities

• Work Health and Safety issues

• Audit processes

• Risk Management

• Policies and Procedures

• BIS/PACS issues

7. RESOLUTION FOR BIS ISSUES

7.1. SNOW (SERVICE NOW) – E HEALTH When an issue is identified at BreastScreen ACT with BIS, the correct procedure is:

• Phone/email the BIS Administrator.

• BIS Administrator will try and work through the issue (standard general questions).

• If the issue cannot be resolved, the BIS Administrator will advise if to contact Help Desk (extension 79000) or will create a ticket on the SSICT SNOW (Service Now) issue reporting system.

• If SSICT cannot resolve the issue, then a Support Tracker (Orion Health) ticket will be created.

7.2. SUPPORT TRACKER – ORION HEALTH Support Tracker is an Orion Health product that tracks issues with BIS that BreastScreen ACT may be experiencing.

The support procedures have been put in place to clearly outline the obligations to BreastScreen ACT and those of the Orion Health Support resources in the resolution of Support Tracker ‘calls’.

Definition of a Call A call requiring support can be defined as one of the following: • Issue Report - a support request reporting that the product is not functioning appropriately or as

designed.

• Technical Question - a support request for clarification of product functionality.

• Enhancement Request - a support request for the product to behave in a manner that is different from the original design.

Supported Environments There are two types of environment supported by Orion Health Support Services: • Non-Production – a customer test environment is one, which is not being used for production purposes.

For example, an environment that the client’s operations team may be using to test the software applications. Efforts with non-production environment are not measured against SLA (Service Level Agreement) by Orion Health Support Services.

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• Production - a live environment is one that the client is using for production purposes of the business operations applications. Orion Health Support Services support this environment.

Priority Levels of Support The priority levels of support, as per the Service Level Agreement, are outlined below: Priority Level 1 – Production Failure (Critical) Critical business impact – problems which, if not fixed will prevent the business form continuing. No work-around possible. E.g. A critical application in unavailable; a majority of the users loose access. Priority Level 2 – Production Degradation (Urgent) Production System Degradation: problems which do not currently stop the business but the consequences could interrupt or stop the business within 24 hours. These may go unnoticed by other groups but can be very serious for the people needing the service that has stopped. For example, the system is still functioning but slow performance is impacting the efficiency of the unit; some users lose access. Performance is severely degraded performance. Priority Level 3 – Functional Impact (Major) Problems causing minor operational impact or people have lost some functionality, but there is a workaround. For example, cannot process a request on an application at one terminal but can at another. Please note: The majority of issues raised should fall into a Level 3 category. Priority Level 4 – No Production Impact (Planned) No impact on production and implementation can wait for a future release. For example, Enhancement / Change Requests

Please note: the majority of Non-Production issues should fall under a Level 4 category.