DSQ (Dossier Sante Quebec) Installation

The Quebec government is currently rolling out the Dossier Sante Quebec.
This enables any physician to view Lab Results, Medications and Images online.

Requirements:
DSQ Visualizer Software (only for Windows and Internet Explorer)
USB Security Key

Charges for installation are reimbursable by Sogique.

Details at:  http://www.sogique.qc.ca/Accueil—PQADME.aspx

 

Installation notes for Windows Internet Exploder Explorer:

Add gouv.qc.ca to Compatibility View Settings

Add to Trusted sites.  (Tools, Internet Options, Security, Trusted Sites, Sites, Add both Formation & Production)

Make sure the Security certificates are correctly installed.  (Tools, Internet Options, Content, Certificates: Intermediate should list all 4, Trusted Root should list AC Racine, )

Add to Compatibility View does not save?
Options, General, uncheck ‘Delete browsing history on exit’

PDF documents not showing?
Make sure Acrobat Reader X or XI is installed. Some of the free readers are not compatible with the DSQ.

Internet Explorer is not the default browser?
Make a shortcut to Internet Explorer and add the URL to the properties.
“C:\Program Files\Internet Explorer\iexplore.exe” https://visualiseur.forma.dossierdesante.gouv.qc.ca/

 

December Montreal Oscar User Meeting on Tuesday Dec 10th at 19:30

The next (December) Montreal Oscar User Meeting will have a different time, location and format!

Tiny Tots Medical Centre and the Montreal Oscar User Group will be hosting an opportunity for physicians that want to learn more about charting in Oscar.
The evening session will be held at Club Tiny Tots, on Tuesday, December 10th at 19:30.
The clinic is located in Decarie Square, which is near the corner of Decarie and Jean-Talon.
6900 Décarie Suite 3550, Cote-Saint-Luc, QC H3X 2T8
http://www.clubtinytots.ca/
http://goo.gl/maps/S7pl0

The Oscar encounter screen has a lot of information and there are many ways in which it can be used.
This evening is designed to share information about various shortcuts to charting in Oscar.
We will cover eForms, templates, preventions, measurements and prescriptions.
We want to hear from you.  What you find easy and difficult.  What you like and what you think can be improved.
Hopefully, you will find ways to become more efficient Oscar users.
This meeting is primarily for physicians that use Oscar, but everyone is welcome.
Please RSVP
About Tiny Tots Medical Centre:  
Club Tiny Tots is one of the early users of Oscar in Quebec.  Tiny Tots Medical Centres are located in Montreal’s West Island and in the Decarie Square Medical Centre (6900 Decarie, Suite 3550  514-342-9911).
Established in 1985, open 365 days of the year, the team includes 10 Pediatricians, 3 Pediatric Allergists, 2 Pediatric  Respirologists, 26 Family Medicine Doctors specializing in Pediatrics, and 15 Nurses and Physician Assistants.
We have a multidisciplinary approach and have a team of Psychologists, Physiotherapists, Occupational Therapists, Dieticians, and Speech Language Pathologists. With 120,000 patient visits per year, modern facilities, and a web-based electronic medical record, we are popular not only with patients, but also as a training centre for The MUHC and CHUM, accommodating over 30 trainees per year.

We offer SAME DAY appointments for emergencies or consultation and do accept new patients for Primary Care.

Note: The Ontario Oscar User meeting is next week, Friday Nov 29th in Hamilton, Ontario.

The Agenda is here:
This a great opportunity to meet the developers in Hamilton, Ontario and have all (almost) your Oscar questions answered.

Oscar files

Here are the locations of some useful Oscar files (for v12.1):

Language specific files:

/var/lib/tomcat6/webapps/Oscar12_1/WEB-INF/classes/oscarResources_en.properties

 

Monthly Oscar User Group Meeting

The usual monthly meeting* will be on Thursday, November 21st.

The usual location:
GMF Sante Kildare
7005 Kildare, Suite 14. Côte-Saint-Luc (QC) H4W 1C1
514-397-0777
http://goo.gl/maps/9qLno

The usual time: 12:00 to 13:00.
There will be a light lunch.

Please RSVP, so that we have an idea of how many people will be attending.
My email is earlwer@gmail.com

Agenda:

WelchAllyn interface

  • DSQ Deployment in Montreal. All physicians can have access to the DSQ (Dossier Sante Quebec). You sign-up, get a USB key for security, install the software (Windows only) and get $1,800.
  • HL7 Lab update. Yes, we’re getting closer!
  • Billing: I have done some research.  3rd party billing fees in QC range from $0.50 per patient to 1.5% of billing.  There are a number of alternatives being worked on to integrate Oscar and RAMQ billing.
  • Questions?

* Our usual date is the 3rd Thursday of the month. Add it to your calendar now.

Note: The Ontario Oscar User meeting is next week, Friday Nov 29th in Hamilton.
The Agenda is here:
http://oscarcanada.org/agenda-ontario-user-group-meeting-29-nov-2013/view

This a great opportunity to meet the developers in Hamilton, Ontario and have all (almost) your Oscar questions answered.

Next meeting:
The December meeting will have a different date, location and format.

Tiny Tots Medical Centre and the Montreal Oscar User Group will be hosting an opportunity for physicians that want to learn more about charting in Oscar.

The evening session will be held at Club Tiny Tots, on Tuesday, December 10th at 19:30.
The clinic is located in Decarie Square, which is near the corner of Decarie and Jean-Talon.  There is lots of free parking.
6900 Décarie Suite 3550, Cote-Saint-Luc, QC H3X 2T8
http://www.clubtinytots.ca/
http://goo.gl/maps/S7pl0

The Oscar encounter screen has a lot of information and there are many ways in which it can be used.  This evening is designed to share information about various shortcuts to charting in Oscar.  We will cover eForms, templates, preventions, measurements and prescriptions.

We want to hear from you.  What you find easy and difficult.  What you like and what you think can be improved.

Hopefully, you will find ways to become more efficient Oscar users.

This meeting is primarily for physicians that use Oscar.  Family doctors and Specialists are both welcome.  If you have an interest in Oscar charting, don’t hesitate.

About Tiny Tots Medical Centre:  Club Tiny Tots is one of the early users of Oscar in Quebec.  Tiny Tots Medical Centres are located in Montreal’s West Island and in the Decarie Square Medical Centre (6900 Decarie, Suite 3550  514-342-9911).
Established in 1985, open 365 days of the year, the team includes 10 Pediatricians, 3 Pediatric Allergists, 2 Pediatric  Respirologists, 26 Family Medicine Doctors specializing in Pediatrics, and 15 Nurses and Physician Assistants.

We have a multidisciplinary approach and have a team of Psychologists, Physiotherapists, Occupational Therapists, Dieticians, and Speech Language Pathologists. With 120,000 patient visits per year, modern facilities, and a web-based electronic medical record, we are popular not only with patients, but also as a training centre for The MUHC and CHUM, accommodating over 30 trainees per year.

We offer SAME DAY appointments for emergencies or consultation and do accept new patients fro Primary Care.

 

Using Dynamic IPs with Oscar

Many lower cost Internet providers do not provide a static IP address to their clients. That means that you cannot connect remotely without knowing your current IP address. You must either contact someone at the office and ask them for the current IP, or you can install a Dynamic DNS Client. The Dynamic DNS client will allow you to use a domain name like myclinic.dns2go.com and will automatically convert it to your current IP address.

Some companies like dyndns.com or no-ip offer a limited free version which is adequate. I currently use both dyndns and DNS2GO.

There are three (3) places where you can install the Dynamic DNS client. 1) On any single PC 2) In some routers or 3) In the Oscar server.

To use the DNS2Go client with your Oscar server, you have to download the Linux/Debian client into the server (I used /usr/local/bin ) and add a single line to /etc/rc.local.
The line would be something like su -c “/usr/local/bin/dns2go” .
On Oscar 9.06 installations, I added the line at the end of the file (after the python drugref service startup).

 

Email appointment reminders

Adding email appointment reminders to Oscar is easy.

Our current implementation uses a Report by Template (on the Admin, oscarReport menu) that exports patient names and email addresses from the Appointment file. The data is used in an OpenOffice/LibreOffice Mail-merge that sends out the reminders. The following notes describe the process in detail.

The Report Template is:

<report title=”Appointment Reminder Email List” description=”List of Emails for Appointment Reminders” active=”1″>
<query>select dem.email as Email,
DATE_FORMAT(app.appointment_date,’%d/%m/%Y’) as Date, TIME_FORMAT(app.start_time,’%h:%i %p’) as Time, prov.last_name as Doctor,
dem.last_name as Lastname, dem.first_name as Firstname
from appointment app, demographic dem, provider prov
where LOCATE(‘@’, dem.email ) > 2
and appointment_date >= ‘{start}’ and appointment_date <= ‘{finish}’
and app.demographic_no = dem.demographic_no
and app.provider_no = prov.provider_no
order by app.appointment_date, app.provider_no, app.start_time ;
</query>
<param id=”start” type=”date” description=”Start date”> </param>
<param id=”finish” type=”date” description=”Finish date”> </param>
</report>

You can run the query for the following week and save the CSV file to your local PC. The first time you run the mail merge, you will have to setup the CSV as a LibreOffice/OpenOffice database and configure your email account (see below).

The next step is to write your message template and use that as a Mail-merge to Email.
Sample email template:

This is a system generated e-mail reminder.
<<last_name>> <<first_name>> has an appointment with Dr. <<Doctor>> on <<Date>> at <<Time>>.

Should there be a need to reschedule or cancel your appointment, please note we require 24hr notification at (514) 555-1212.
Please note there is a $40 charge for missed appointments.

Ceci est un rappel automatisé par courriel.
<<last_name>> <<first_name>> a un rendez-vous avec Dr. <<Doctor>> le <<Date>> à <<Time>>.

Veuillez nous aviser de tout changement ou cancellation au plus tard 24 heures avant l'heure prévue du rendez-vous au (514)555-1234.
Des frais de $40 seront perçus pour tous les rendez-vous manqués.

This e-mail may be privileged and/or confidential, and the sender does not waive any related rights and obligations. 
Any distribution, use or copying of this e-mail or the information it contains by other than an intended recipient is unauthorized.
 If you received this e-mail in error, please advise us (by return e-mail or otherwise) immediately.
 
Ce courrier électronique est confidentiel et protégé. L'expéditeur ne renonce pas aux droits et obligations qui s'y rapportent.
 Toute diffusion, utilisation ou copie de ce message ou des renseignements qu'il contient par une personne autre que le (les) destinataire(s) désigné(s) est interdite.
 Si vous recevez ce courrier électronique par erreur, veuillez nous en aviser immédiatement, par retour de courrier électronique ou par un autre moyen.

ConsultationRequest bug (v10.12)

If you enter a consultation request without an appointment date and specify that the patient will book their own appointment, the consultation request will not be viewable. This is because the page that displays the consultation requests expects a valid appointment date and time.
The current back-end solution is to plug in a dummy appointment date and time:
update consultationRequests set appointmentDate = ‘1900-01-01′, appointmentTime = ’01:01:01’ where patientWillBook = 1 and appointmentDate is NULL ;

OutOfMemoryError: PermGen space problem

When installing an Oscar v12 demo on my windows laptop, I encountered Java memory problems. I added the following lines to the Tomcat parameters (in Java, Java Options) :
-XX:+CMSClassUnloadingEnabled
-XX:+CMSPermGenSweepingEnabled
-XX:+UseConcMarkSweepGC
-XX:PermSize=128m
-XX:MaxPermSize=512m

Backups

The backup procedure written by Peter Hutton-Czapski works nicely. I’ve added a few lines to sync the backup with a removable USB drive that can be taken home.

The files on the USB drive are encrypted and compressed, so if lost, they are not readable.

To list devices and find out where the USB drive is located:
sudo fdisk -l
should see /dev/sdc1

Create a mount point
sudo mkdir /media/usb_external
Mount the drive
sudo mount -t ntfs-3g /dev/sdc1 /media/usb_external -o force
Edit the backup script.
/usr/local/backups/backup.sh

Add the following lines to the end of the backup script
cp /usr/local/backups/data/2012-06* /media/usb_external/backup/
sudo rsync –delete -dptgoD -e ssh /usr/local/backups/data/ /media/usb_external/backup

if backup files are in /home/mysql
sudo rsync –delete -dptgoD -e ssh /home/mysql/ /media/usb_external/backup
sudo umount /media/usb_external

Some clients have a LOT of scanned documents in Oscar. If a complete set of 30 backups is too large for the existing system, you can replace the lines that delete the month-old backup with the following. This removes any files that end with .gz and are over 7 days old:
find ${DEST} -type f -name “*.gz” -mtime +7 -exec rm {} \;