Frequently Asked Questions

What is CDX (Clinical Data eXchange)?

CDX is a clinical document distribution service developed by Interior Health. Northern Health and Interior Health have collaborated to facilitate the sharing of Health Authority clinical documents to EMR systems using this service. This system also allows EMR to EMR exchange.

 

What are the benefits of CDX?    

  • Securely delivers patient reports and results, for the correct provider,
  • Assists in care delivery, through timely and accurate information distributed directly into an EMR,
  • Facilitates care coordination between GPs and Specialists,
  • Save on costs – less toner and paper consumed,
  • Save on time – less scanning, OCR (optical character recognition), attaching, shredding, manual data entry,
  • Save on space – less paper in charts = reduced storage requirements,
  • Ability for one provider to receive results at more than one location.

 

What is delivered via CDX? 

The CDX distribution system will deliver the following clinical information to your EMR:

  • Transcribed reports from the Northern Health Cerner System,
  • Transcribed reports from the Interior Health Meditech System,
  • Lab Results (Chemistry, Hematology, Microbiology, Blood Bank and Pathology) from the Interior Health Meditech System,
  • Lab Results (Chemistry, Hematology, Microbiology, Blood Bank and Pathology) from the Northern Health Cerner System,
  • Medical Imaging reports from the Interior Health Meditech System,
  • Admission and Discharge notifications from the Northern Health Cerner System,
  • EMR to EMR exchange, including referrals, consult letters, etc.

 

What will be delivered via CDX in the future? 

The CDX distribution system has the capacity to expand to distribute additional clinical content in the future. Current plans include delivering the following content:

  • Medical Imaging from Northern Health,
  • EMR to EMR Care Plans,
  • ECGs generated at Interior Health facilities,
  • Location based document distribution,
  • Additional clinical content yet to be defined.

 

How do the Health Authority and EMR systems know to send a provider's reports, results or clinical documents electronically? 

If a provider/clinic is subscribed to the CDX distribution service, the CDX system will automatically send reports, results or clinical documents to that provider, where the provider is specified as a recipient (Family Provider, Most Responsible Provider, Attending Provider, Ordering Provider, cc’d Provider). Providers and their offices/clinics must complete an online subscription form to receive clinical documents through CDX.

 

Are the clinical results, reports (i.e. data) stored that are sent via the CDX system? If so, for how long is the data stored?   

  • Health Authority reports, results and clinical documents that are sent via the CDX system are maintained in a secure data center for 6 months after successful delivery. Audit information is tracked on delivery status and details.
  • EMR to EMR clinical documents that are sent via the CDX system are maintained in a secure data center for 14 days after successful delivery. Audit information is tracked on delivery status and details.

 

Why are the clinical documents, (i.e. results, reports) that are sent via the CDX distribution system stored? 

Temporarily storing the data sent via the CDX distribution system allows the team to investigate any delivery/receipt issues, and re-send messages if necessary.

 

Is the data storage system and the transport of the data secure? 

Yes, all data storage servers are located in a high-security data center environment. As well, the CDX distribution system architecture makes use of several security and authentication layers in transmission, such as 128-bit SSL encryption.

 

Where will I be able to see that a transmission was sent, and when it was received? 

Your EMR system is required to maintain a history for each record sent or received via the CDX distribution system. Check with your EMR vendor for details on how this is handled.

 

How do I know if a clinical document message sent from my EMR system fails? 

If the CDX distribution system is unable to accept a clinical document message sent by your EMR system, a response will be sent back to your EMR system indicating the failed status. Your EMR system should make this information available to you. Check with your EMR vendor for details on how this is handled.

 

What do I do if a clinical document message is sent to my EMR system in error?

The CDX distribution system routes messages only to the provider(s) specified as the intended recipient(s) by the sending provider/clinic. If an error occurs, you will need to contact the sending provider/clinic and let them know that you have received their clinical document message in error. This will allow them to re-send the clinical document message to the correct recipient provider/clinic.

 

Where does the information received via the CDX distribution system appear in my EMR system?

There are subtle differences in how one EMR system handles/displays information compared to another EMR system. Contact your EMR vendor for specific details on how this is handled. In general, you should expect to see information sent via the CDX distribution system appearing in the same areas of the EMR as if you had entered it manually.

 

How will it be indicated in my EMR system that a provider at another clinic is able to receive a clinical document from my EMR system, via the CDX distribution system?

Your EMR system will include functionality that allows you to look up providers/clinics that are subscribed to the CDX distribution system. Contact your EMR vendor for specific details on how this is handled.

  

Which EMR vendors are eligible to take advantage of the CDX distribution service?

Northern Health and Interior Health are committed to delivering results to any EMR vendor that passes CDX conformance testing.

  

Which EMR system do you recommend providers/clinics use?

There are a number of EMR vendors that do business in the province of British Columbia, and we do not recommend or prefer any specific EMR system. Our Northern Health/Interior Health team will work with any EMR vendor that passes CDX conformance testing. Please contact our team to obtain a list of EMR vendors that have passed CDX conformance testing.

  

What if my EMR system is experiencing a service interruption? Is there another way to access the reports and results that the CDX distribution system sends to my EMR?  

  • Providers in Northern Health can access results and transcribed documents remotely from their offices through Cerner Millennium (e.g., PowerChart inbox or patient-specific queries).
  • Providers in Interior Health can access results and transcribed documents remotely from their offices through MEDITECH.
  • If you need assistance to remotely access Cerner or Meditech, please contact the Service Desk at 1-855-242-1300.

 

Why should a provider/clinic subscribe?  

  • More granular/discrete lab results which can be graphed/trended in the EMR system,
  • Additional transcribed document types,
  • Improved distribution functionality,
  • The ability to send/receive clinical documents with attachments,
  • EMR-to-EMR clinical document distribution.

 

Is there a cost for EMR vendors to utilize the service?

Interior Health is providing access to the CDX distribution service free of charge to EMR vendors. Neither Northern Health nor Interior Health charge for distribution of clinical documents or results.

 

How do I participate?  

  • Your clinic needs to have an EMR system and internet access,
  • If you don’t have an EMR system, arrange to have one installed that has passed CDX conformance testing,
  • If a clinic’s EMR system has passed CDX conformance, then the clinic will need to complete the online subscription clinic activation form on this website.

 

Can a provider/clinic continue to receive fax copies of clinical documents and lab results once they are participating in the CDX distribution system?

No, with the exception of INR results from Interior Health and Northern Health transcribed documents, faxed copies of reports will be discontinued after a period of two weeks once a provider/clinic is subscribed to the CDX distribution service.

 

Can a locum provider register to use the service?

Providers who provide locum services are not eligible to register to use the service. However, some EMR systems allow configuration of access. For example, “Provider A” can assign a locum to have temporary access to the EMR system/patient charts under “Provider A’s” name. Contact your EMR vendor for specific details on how locum temporary access is handled.

To ensure that the clinical documents are received by a clinic, always use the CC field to include a provider that is both at the intended destination clinic and subscribed to CDX. 

 

What if a provider leaves a clinic that is participating in the CDX distribution service?

If a provider leaves a subscribed clinic, the clinic will need to fill out the clinic activation form on this website to unsubscribe that provider by selecting the Modify Existing option at the top of the form. Any additional details should be provided in the Comments section.

 

What if a provider or clinic switches to a different EMR system?

If a provider changes EMR systems, the clinic will need to fill out the clinic activation form on this website, being sure to include the updated EMR Vendor Information in the appropriate section of the form. Any additional details should be provided in the Comments section.