Metamorphosis Conference 2007 Working Together for Change

1. Metamorphosis Conference 2007Working Together for Change Management Information Systems (MIS) Continuing Care e-Health Enabling One Person One Record

2. MIS: The Current Scenario Management Information Systems (MIS): • Were established to create standards for gathering, and processing, financial and statistical data related to the daily operations of health care facilities, ultimately, to facilitate reporting • Apply these standards to support organizational goals, and the decision-making process • Adhere to the Ontario Healthcare Reporting Standards (OHRS) • National MIS Standards were originally implemented by the Canadian Institute for Health Information (CIHI) MIS is currently in place within: • Community Care Access Centres • Community Mental Health and Addiction (CMH&A) 100% of CCACs are reporting in MIS 99% of CMH&A agencies are reporting in MIS Continuing Care e-Health Enabling One Person One Record

3. MIS/OHRS Benefits MIS/OHRS facilitates reporting financial and statistical data by creating standardized and consistent: • Financial and statistical records • Staffing levels • Data for analysis of business processes MIS/OHRS implements, controls, and monitors plans, strategies, and tactics by providing data which helps: • Develop cost reduction strategies • Alert organizations to changes • Maintain up-to-date and accurate data Continuing Care e-Health Enabling One Person One Record

4. Working Together for Change Community Support Service Providers are committed to responding to the needs of the client by building a system that: • Improves access to needed services, helps reduce wait times across the health care system, and establishes standards of practice • Helps more clients remain in their own homes • Provides a safe and secure environment within communities • Has tools in place to collect information and measure the quality of services provided Based on the successful introduction of MIS in other healthcare sectors, Community Support Services (CSS), in partnership with the e-Health Council, has requested implementation of MIS standards in the sector. Continuing Care e-Health Enabling One Person One Record

5. MIS/OHRS and the CSS Vision In accordance with the vision to serve Ontario with a well-funded continuum of quality community support services, delivered by the not-for-profit sector, MIS/OHRS implementation in the CSS sector will: • Implement accrual accounting-based standards • Create benchmarking in the sector • Provide complete reporting and standardization of data • Permit timely data (most recent sector data is from 2004) Timely data and reports will: • Increase productivity • Increase efficient resource utilization • Substantiate operating plans • Improve back office efficiency Continuing Care e-Health Enabling One Person One Record

6. Benefits of Business Systems in CSS Financial Accountability • Improved accountability through tested and accepted reporting standards. • Provide data for evidence-based decision making for the ministry and LHIN stakeholders to understand the true costs and complexities of sector. • Permit comparability and benchmarking within LHINs, and across LHINs. • Provide ministry with balance sheet data indicators of business viability. • Produce data revealing financial outcomes to help improve efficiencies, accountability, and client outcomes. Comparable Information for the LHINs Process Improvements Sector Efficiency including: Decreased Costs and Increased Productivity Improved Client Outcomes Continuing Care e-Health Enabling One Person One Record

7. MIS/OHRS Trial Project Trial Project was conducted to: 1) Identify and evaluate the development, infrastructure and operational requirements, and considerations, associated with establishing a centralized financial and statistical management and reporting system, for the CSS organizations across Ontario. 2) Demonstrate: limited financial and statistical functions, the ease of learning, the usability of the software, the ability to implement the MIS standards and to identify potential issues in the trial submission method. 3) Determine the effectiveness of the education delivery method, and the readability of the printed education materials, as well as to identify potential issues in the various educational delivery methods. Continuing Care e-Health Enabling One Person One Record

8. Trial Outcome Ten (10) CSS organizations volunteered for the trial project, which was conducted from March to May 2007. Two (2) organizations were unable to complete the trail scenario process and work required, citing: lack of internal recourses, year end reporting requirements and other internal organizational timing constraints. The project trial team were able to achieve all three main objectives and move to the full Request for Proposal (RFP). Continuing Care e-Health Enabling One Person One Record

9. Project RFP On June 15, 2007 the CSS MIS RFP team solicited an RFP. The objectives for the RFP was: to contract with qualified and experienced vendors, to provide the Financial and Statistical software and associated services, and to successfully implement the CSS MIS/OHRS reporting system for Community Support Services organizations with the Province of Ontario. To ensure RFP objectives were met, the RFP included eight (8) rated evaluation criteria as follows: (1) Software Functionality; (2) MIS/OHRS Standards-Based Reporting; (3) Technical Infrastructure and Capacity; (4) Design, Installation and Configuration; (5) User and Software Support; (6) Training and Documentation; (7) Administration and Management; (8) Proponent’s Business Experience and Experience in the CSS sector. Continuing Care e-Health Enabling One Person One Record

10. RFP Evaluation Firstly, the proposals were evaluated on whether or not they met all mandatory requirements of the RFP. A scoring and weight system of evaluation was outlined in the RFP and used to evaluate the Proposals. Secondly, upon completion of the evaluated rated requirements, it was determined that five (5) Proponents would be invited to attend the demonstration and presentation sessions. Price Bids were opened on August 16, 2007 and the scoring system of evaluation, identified in the RFP, was used to evaluate the Price Bids. At the Steering Committee meeting on August 22 , the evaluation team presented the recommendation for contract award and achieved unanimous support to award the contract to BDO Dunwoody LLP representing Microsoft Dynamics GP. Continuing Care e-Health Enabling One Person One Record

11. MIS/OHRS Training • MIS/OHRS Information Sessions • Chart of Account (CoA) Mapping Sessions • Budget Submission Sessions • Trial Balance (TB) Submission and Ontario Healthcare Financial & Statistical (OHFS) Reporting sessions (TB and OHFS sessions) Continuing Care e-Health Enabling One Person One Record

12. 1. MIS/OHRS Information Session Overview • The session describes the Management Information System (MIS) and Ontario Healthcare Reporting Standards (OHRS), and explains why OHRS is being implemented in the CSS sector, and what benefits they provide. • Participants develop an understanding of the CSS MIS Project and learn how to become part of the project. • The material familiarizes participants with the framework of the OHRS standards (i.e. the structure of financial and statistical accounts). • The volunteers have a greater understanding of the processes and the necessary steps to becoming MIS/OHRS ready.

13. 2. CoA Mapping Sessions: Account Types Account Types can be primary or secondary accounts. Primary accounts can be Balance Sheet items, Functional Centres, or Accounting Centres. Secondary accounts can be financial or statistical accounts. Balance Sheet accounts have no accompanying secondary accounts. Continuing Care e-Health Enabling One Person One Record

14. CoA Mapping Sessions: Account Types Functional Centres and Accounting Centres have secondary Financial and Statistical accounts. Tracking Financial and Statistical data under theses accounts, allows organizational expenditures to be linked to their companion services; this permits better performance monitoring, planning and budgeting. Both individual General Ledger (GL) accounts are captured, as well as broader GL account groupings. Continuing Care e-Health Enabling One Person One Record

15. CoA Mapping Sessions: Account Structure The coding structure for account types is hierarchical in nature, so the roll-up definition is embedded in the number system. The chart of accounts (CoA) provides a complete hierarchy of aggregated or “rolled-up” accounts; collectively, the CoA embodies both the Balance Sheet, and Profit and Loss (or Income Statement), financial statements, as well as statistical information. All organizations within the same sector are not required to report at the same level of detail, but each sector has determined the minimum level of reporting for overall comparative purposes. Continuing Care e-Health Enabling One Person One Record

16. CoA Mapping Sessions: Key Reporting Rules OHRS key reporting rules • Matching Principle • Functional Centres • Accounting Centres • Balance Sheet Accounts • Revenue/Recovery • Expense • 80/20 Rule • Administrative Expenses Continuing Care e-Health Enabling One Person One Record

17. 3. Budget Submission Sessions The objective of the Trial Balance & OHFS Submission Training Session is to prepare Healthcare Service Providers (HSPs) to submit their financial and statistical quarterly data, through the Ontario Healthcare Financial and Statistical database (OHFS) website. The course includes how to populate the Trial Balance Submission Template with HSP financial and statistical data. Other topics covered are how to register on the OHFS website and submit their trial balance. Participants will also learn how to edit their trial balance using an error report generated from the OHFS website.

18. 4. TB and OHFS Submission Sessions The Web-enabled Ontario Healthcare Financial and Statistical System (OHFS) enables Healthcare Service Providers (HSPs) to submit their Trial Balance Report on-line. The OHFS processes the trail balance submission by going through EDIT RULES to verify the correctness of submitted data prior to the TB being accepted. The TB Report Template: • Is completed at Q2,Q3, and year-end • Must contain only actual data • Is reported cumulatively i.e. using year-to-date figures Continuing Care e-Health Enabling One Person One Record

19. TB and OHFS Sessions: Key Accounts Revenue accounts for CSS services, that are used to capture funding: • F.11006: Funding – LHIN is used to capture funding for LHIN Managed Programs/Services • F.11010: Funding – Provincial MOHLTC is used to capture funding for Ministry Managed Programs/Services Continuing Care e-Health Enabling One Person One Record

20. TB and OHFS Sessions: Excel Template • Download TB Submission Template from FIM Website • Complete Template • Convert to ASCII file • Upload the ASCUII file to OHFS • FIX Edit Errors • Submit / re-submit until accepted Continuing Care e-Health Enabling One Person One Record

21. Chapter 10 • Functional List of Accounts • Full Financial List of Accounts • Statistical List of Accounts • Full Balance Sheet List of Accounts • Balance Sheet Accounts • Functional/Accounting Centres • Financial Secondary Accounts • Statistical Secondary Accounts Continuing Care e-Health Enabling One Person One Record

22. Software Solution Training Microsoft Dynamics Great Plains 10 is provided at no cost to users, who will have access to the hosting environment through an internet connection. Accounting programs provided within this solution are: • General Ledger • Accounts Receivable • Accounts Payable • Reporting/ Stats Magt(FRx) • Momentum MIS.OHRS • Microsoft Electronic Fund Transfer • Microsoft Fixed Assets • Microsoft Integration Manager( to enable data imports) • Mekorma Voucher Pay Select • Momentum Materials Management Continuing Care e-Health Enabling One Person One Record

23. Software Solution Education Software training will be provided for organizations who wish to move to the hosted solution. Phase 1 organizations will received training late 2007. Phase 2 and 3 organizations will receive training after the MIS/OHRS training has been completed. Continuing Care e-Health Enabling One Person One Record

24. MIS/OHRS Project: Next Steps Identify Phase 2 Organizations for the MIS/OHRS Project. Information sessions to begin Spring, 2008. Mapping sessions to begin Spring,2008. How do I become a Phase 2 volunteer CSS organization?

25. CSS MIS/OHRS Project Team Contact us using the following email address: ohrscss.moh@ontario.ca