Home Clinic FAQ

What is a Home Clinic?

A Home Clinic is a patient-centred primary care clinic, registered with Manitoba Health, that serves as a patient’s home base within the health-care system. Home Clinics are primary care clinics that provide patients with timely access to care, coordinate their health care within the health-care system, and manage their health-care records. Having a home base helps support comprehensive and continuous care throughout a patients’ life.

Why are Home Clinics important in Manitoba?

A Home Clinic provides its patients comprehensive, continuous and coordinated care, thereby improving their patients’ health outcomes. Ensuring Manitobans have a Home Clinic, which serves as the home base for the majority of their primary care needs, is a key step towards achieving a longer term vision of a robust, equitable and accessible primary care system. Home Clinics are also considered vital to ensure long-term sustainability of the system.

Refer to the Primary Care website for more information regarding the Home Clinic model.

What is a Most Responsible Provider, and what is their role in a Home Clinic?

Patients are enrolled with the Home Clinic. Within the Home Clinic each enrolled patient is associated with a Most Responsible Provider (MRP).

The MRP is a family physician or nurse practitioner, who has the lead role and medico-legal responsibility for overseeing the patient’s care. The MRP provides ongoing, comprehensive primary care, including ongoing coordination with other health-care providers, monitoring and management of patient condition(s) and patient care plan(s) and ongoing communication with the patient regarding their care.

The relationships between enrolled patients, their Home Clinic and their MRP ensure that Manitobans receive care and support where their health and medical needs and history are known.

The MRP supports the whole patient, not just their illness, and they will focus on wellness, not just treatment. They emphasize health promotion, chronic disease prevention and risk reduction, early detection of health problems, self-care, and evidence-informed chronic disease management, including mental illness. The MRP develops patient-centred strategies to ensure patients can make informed choices and are partners in care planning and management.

What is a My Health Team?

A My Health Team is a collaboration between regional health authorities, fee-for-service primary care practices, and community organizations. The My Health Team collectively and collaboratively plans, develops and provides enhanced primary care services for a specific community area and/or population group. My Health Teams share common and standardized resources, information and responsibilities, providing primary care services to their collective patients in a timely, efficient manner. Home Clinics may be part of My Health Teams.

How are Home Clinics and My Health Teams related and/or different?

Manitoba’s vision for primary care is that all Manitobans will have knowledge of and access to high quality, culturally sensitive and sustainable health care services. Home Clinics and My Health Teams are complementary strategies that have been deployed to achieve that vision. The Home Clinic is the patient’s home base, and the My Health Team is the broader primary care neighbourhood, and may be comprised of several Home Clinics. Home Clinics help their patients navigate the health system including the extended services and supports available from within the My Health Team.

Why are Home Clinics important in Manitoba?

A Home Clinic provides its patients comprehensive, continuous and coordinated care, thereby improving their patients’ health outcomes. Ensuring Manitobans have a Home Clinic, which serves as the home base for the majority of their primary care needs, is a key step towards achieving a longer term vision of a robust, equitable and accessible primary care system. Home Clinics are also considered vital to ensure long-term sustainability of the system.

Refer to the Primary Care website for more information regarding the Home Clinic model.

What are the criteria to be a Home Clinic?

Manitoba’s Home Clinic Criteria include commitments that align with the conditions associated with applicable Family Medicine tariffs (as agreed by Doctors Manitoba and Manitoba Health and Seniors Care), and with the College of Family Physicians of Canada’s The Patient’s Medical Home. We recommend you review all commitments outlined in the Home Clinic Criteria section prior to registering as a Home Clinic.

Does a clinic need to be part of a My Health Team to become a Home Clinic?

There is no requirement for a Home Clinic to be a member of a My Health Team. There are however, benefits that a Home Clinic should consider. At a high level, participating in a My Health Team gives the Home Clinic, and its enrolled patients, access to a broader interprofessional team of care providers and other resources.

What if our clinic is not able to meet all of the criteria at this time?

There is no deadline for registering as a Home Clinic. However, being a registered Home Clinic is a prerequisite to enrolling patients, and, for fee-for-service clinics, to claiming the applicable Family Medicine tariffs.

If you do not meet the Home Clinic Criteria right away, you can work towards meeting the criteria over time, and our team will be here to support your efforts. Contact our Home Clinic team at [email protected] to discuss your challenges in meeting the criteria and how we can help.

How do we become a Home Clinic?

The process is simple, and our dedicated Home Clinic team is here to help.

Step 1: Review Manitoba’s Home Clinic Criteria and confirm your eligibility, ability and willingness to make the required commitments. Feel free to email the Home Clinic team at [email protected] should questions arise during your review.

Step 2: Complete and submit the Initiate Home Clinic Registration form. Within this form, you provide basic information about your Home Clinic (e.g. name, location, contact information). You also identify who within your team will be users of the Home Clinic registration and patient enrolment system. This system is called the Home Clinic Portal. We recommend you identify a primary and a back-up resource to ensure appropriate coverage during any planned and unplanned absences.

Step 3: Shared Health will grant your users’ access to the Home Clinic Portal. One of these users will log in to complete the registration process. This final step requires confirmation of your clinic’s commitment to Manitoba’s Home Clinic Criteria, and identification of the family physicians and nurse practitioners who will be associated with your Home Clinic. These providers will be the Most Responsible Providers for your enrolled patients. Clinics that have not yet successfully submitted a Primary Care Data Extract will also be required to submit a sample for verification.

Note: Primary care clinics that only have dial-up access to the Internet may request a form to complete the process. Email [email protected] to make your request.

What are the benefits of being a Home Clinic?

Becoming a registered Home Clinic offers many benefits to the clinic, the healthcare providers working in your clinic, and to your enrolled patients.

As a registered Home Clinic, you will have access to valuable reports based on data available within Manitoba’s enrolment system. These reports will provide insight into your enrolled patient population, completeness of patient demographic and clinical data, as well as comparative data to other Home Clinics. For example, how your clinic is performing in relation to other Home Clinics, in terms of the Primary Care Quality Indicators.

Fee-for-service family physicians associated with a Home Clinic will be eligible to claim the applicable Family Medicine tariffs for their qualifying enrolled patients.

Home Clinics will have opportunities to expand clinical information sharing and interoperability with Certified EMR Products which will support collaboration and interprofessional care planning between primary care and other parts of the health system for improved patient care

Over time, interested Home Clinics will have opportunities and be supported in their efforts to form or integrate with a My Health Team. Becoming a member of a My Health Team brings considerable value to a Home Clinic. It enables access to the My Health Team resources, supports and services for your Home Clinic team and your enrolled patients. It also enables clinical resources to focus on issues requiring their specific expertise. To learn more about My Health Teams, visit Manitoba’s Primary Care website.

What are the disadvantages for us if we decide not to become a Home Clinic?

Registering as a Home Clinic is not mandatory, and the decision is made by the primary care practice or clinic. If you choose not to become a Home Clinic, you will not be eligible to:

• enrol patients and submit your enrolment data to the provincial enrolment system. Fee-for-service family physicians will not be eligible to claim the applicable Family Medicine tariffs;
• receive important clinical information from episodic care providers who see your enrolled patients. This reduces the continuity of information available to support clinical decision making;
• send enrolment and key clinical information to eChart Manitoba, the provincial electronic health record, in support of continuity of care; and
• leverage operational and analytic reports available only to registered Home Clinics.

What technology must be in place to operate as a Home Clinic?

Home Clinics will require Internet connectivity to access the Home Clinic Portal, and will function well with Firefox, Chrome or version 11 of Internet Explorer. It should be noted that dial-up connectivity is expected to perform poorly.

In addition, Manitoba’s Home Clinic Criteria states that Home Clinics must use an EMR system for management of patient care. The EMR must be able to record patient enrolment information and generate the Primary Care Data Extract (as per Manitoba’s Home Clinic Criteria). Clinics who use a Manitoba Certified EMR have access to a variety of EMR integrations, including sending and receiving of enrolment data and clinical information to support patient care and streamline workflows.

What are the expectations of a Home Clinic now and in the future?

Registered Home Clinics are expected to:

• Provide their enrolled patients with continuous, comprehensive primary care;
• Appropriately record care provided to their enrolled patients in their EMR, and submit the Primary Care Data Extract with regular frequency;
• Improve the quality of the data submitted within the Primary Care Data Extract over time;
• Keep Manitoba Health apprised of changes in their Home Clinic, including basic location and contact information and provider composition; and
• Support their patients, to the best of their ability, during periods where no Most Responsible Provider is associated with the enrolled patients.

What are the workload implications of being a Home Clinic?

Through patient enrolment, a Home Clinic will be better able to clearly define the patient population it serves. This knowledge supports operational activities such as capacity and workload planning.

The patient enrolment process may initially impact the clinic’s workload. For example, Home Clinics will need to prepare for patient enrolment (e.g. identify candidates for enrolment). Our dedicated team is here to help you, and there are various resources available to Home Clinics to support enrolment activities.

Manitoba’s Home Clinic Criteria requires clinics to provide primary-care services consistent with the Primary Care Quality Indicators (Manitoba Primary Care Quality Indicators Guide). Data related to those indicators must be recorded in the right place in the EMR so that it will be included in the Primary Care Data Extract. This may result in additional effort for Home Clinics not familiar with these guidelines or that do not currently capture this data in their EMR.

Does a clinic receive any remuneration for being a Home Clinic or for enroling patients?

Fee-for-service Home Clinics are funded through applicable Family Medicine tariffs available to their family physicians and general practitioners. Home Clinics within Regional Health Authorities are funded through the provision of provider salaries and operational funding.

Our practice has more than one site or location. Should we register as one Home Clinic or as separate Home Clinics?

The choice is yours. You may register as a single Home Clinic or as separate Home Clinics. If registering as a single Home Clinic, all providers at the various locations must share a single EMR instance (i.e. one database). If you choose to register as separate Home Clinics, each location must meet the Home Clinic Criteria.

Our clinic is comprised of family physicians, specialty providers and episodic care providers. Are we eligible to become a Home Clinic?

As long as your clinic meets the Home Clinic Criteria, you are eligible to become a Home Clinic. During your registration process, only family physicians, general practitioners or nurse practitioners would be eligible to be associated with the Home Clinic as Most Responsible Providers.

What are the Primary Care Quality Indicators?

The Primary Care Quality Indicators used in Manitoba are derived from evidence-based indicators and management approaches developed and supported by the Canadian Institute for Health Information (CIHI), with the assistance of clinician experts. They measure recommended screening and chronic disease management processes in the following areas of primary care:

• prevention
• diabetes
• asthma
• congestive heart failure
• hypertension
• coronary artery disease
• osteoporosis
• chronic obstructive pulmonary disease
• mental health and addictions
• sexually transmitted and blood borne infections

What is the Primary Care Data Extract?

The Primary Care Data Extract extracts patient demographic data and data related to the Primary Care Quality Indicators from an EMR. The Primary Care Data Extract is compatible with Manitoba Health’s information systems, and is the submission mechanism referred to in applicable Family Medicine tariffs.

If your EMR product is not able to enrol patients, generate the Primary Care Data Extract, or your clinic is not using an EMR, your clinic is not eligible to be a Home Clinic at this time. Connect with the Primary Care/Community Information Systems (PCIS) Office to learn more about how your clinic could move forward in these areas. The PCIS Office may be reached at 204-926-3482 or [email protected].

Our clinic focuses exclusively on providing episodic care. Can we become a Home Clinic?

No. Home Clinics commit to providing continuous, comprehensive care to their enrolled patients. Clinics, that only provide episodic care, such as fee-for-service walk-in clinics, are not eligible.

What provider types are eligible to be a Most Responsible Provider?

Only family physicians and nurse practitioners are eligible to fulfill the role of Most Responsible Provider within a Home Clinic.

Is there a minimum or maximum number of MRP that may be associated with a Home Clinic?

At least one Most Responsible Provider must be associated with a Home Clinic. There is no limit to the number of MRP that can be associated.

How will I benefit if I am a Most Responsible Provider associated with a Home Clinic?

Clinicians fulfilling the role of Most Responsible Provider for Home Clinics are expected to benefit in a variety of ways. These include:

• Enrolment firms up the relationship not only between a patient and the Home Clinic, but also your relationship to the patient;
• Defining your patient population supports your efforts to better understand the specific needs of that population;
• Participation in future information sharing (refer to Future Direction: Episodic Information Sharing section for more information) will enable improved continuity of information related to your enrolled patients from episodic care providers they visit;
• You will be able to take advantage of valuable reports provided by Manitoba Health.
• If using an EMR product certified to the Primary Care Quality Indicator Reminders and Data Extract specification, you can benefit greatly from the embedded alerts and reminders. They are a valuable asset that helps a provider manage the considerable number of tests and procedures that underpin quality preventative care and chronic disease management for their patients; and
• If you are a fee-for-service family physician, you are eligible to claim applicable Family Medicine tariffs for enrolled and qualifying patients.

Can a Most Responsible Provider be associated with more than one Home Clinic?

Yes. A Most Responsible Provider who practices at multiple clinics may be associated with more than one Home Clinic.

If an episodic provider takes on the responsibility for continuous, comprehensive care for some of their patients, can they be a Most Responsible Provider?

Yes. If a family physician or nurse practitioner takes the lead role and medico-legal responsibility and provides continuous, comprehensive care for any of their patients, they are eligible to fulfil the role of Most Responsible Provider for those patients. They would not be eligible to be the MRP for patients to whom they provide only episodic care.

Who decides which enrolled patients are associated with a Most Responsible Provider?

The association process is managed within the Home Clinic. Enrolment confirms the relationship between a patient and their chosen Home Clinic. Patients should understand the benefits and how it confirms a long-term responsibility for their care as long as they choose to remain enrolled. Best practice is to actively enrol patients, which directly involves the patient in the decision via direct communication (verbal or written). Enrolment and association to a Most Responsible Provider is a key component for eligible fee-for-service physicians to claim applicable Family Medicine tariffs.

Can an enrolled patient be assigned to or associated with more than one MRP?

No. Each enrolled patient may only be associated with one MRP. This ensures that there is a designated provider with the lead role and medico-legal responsibility for overseeing patient care within the Home Clinic and for coordinating care required from healthcare providers outside the Home Clinic. However, this does not preclude patients from seeking episodic care when required.

How do we access information about which patients are enrolled and associated to which MRP?

Home Clinics have access to the Home Clinic Portal application which provides a variety of reports including a list of enrolled patients and their associated MRPs. Review our online Generating a list of enrolled clients quick reference guide for instructions. Home Clinics can reach out to their assigned Home Clinic Liaison for support.

Is there any requirement for the MRP to see the patient at specific intervals, for example, to maintain the MRP relationship?

There are no specific requirements related to enrolment. Frequency of patient and provider interaction should be based on the primary care quality indicator guidelines and the individual patient’s health and medical needs.

Does a fee-for-service family physician need to be associated with a Home Clinic to claim applicable Family Medicine Tariffs for enrolled patients?

Yes. Being associated with a Home Clinic is voluntary, but it is necessary in order for a fee-for-service family physician to enrol patients and subsequently submit applicable Family Medicine tariff claims to Manitoba Health.

How does Manitoba Health know which patients are enrolled?

Patient enrolment is available in the provincial enrolment system. Home Clinics have access to this system via the Home Clinic Portal application and submit enrolment through a variety of methods. Home Clinics using a Manitoba Certified EMR have access to streamlined daily electronic submission of enrolment directly from their EMR via the Home Clinic Enrolment Service.

Can a patient decline being enrolled with a Home Clinic?

Yes. Enrolment is the patient’s choice. Fee-for-service family physicians can only claim applicable Family Medicine tariffs for patients who are enrolled.

Can the MRP sever their relationship to an enrolled patient? If so, what steps should be taken?

The rules and guidelines stipulated by the College of Physicians & Surgeons of Manitoba (CPSM) related to severing a relationship with a patient would apply to patients for whom you are the Most Responsible Provider. If for some reason the Home Clinic or MRP determines it is necessary to change the MRP for a particular patient or group of patients, the Home Clinic should advise the patient(s) of their options.

If changing the MRP for a group of patients, it is recommended that Home Clinics discuss the change in advance with their assigned Home Clinic Liaison to understand the best approach and consider all the impacts related to changing enrolment dates. Enrolment date changes can impact claims for applicable Family Medicine tariffs for fee-for-service providers and should be well understood before making any changes.

What is the impact to me if another MRP associated with my Home Clinic leaves, and we do not have another MRP available to manage their patients?

Managing enrolled patients during these times is not the responsibility of an individual provider. Home Clinics should first evaluate the needs of the enrolled patients with no current MRP association and collaborate with their Regional Health Authority and the Family Doctor Finder Primary Care Connector(s) in the region to determine how best to meet the needs of these patients.

What EMR data is included in the Primary Care Data Extract?

The Primary Care Data Extract (PCDE) extracts data from discrete data fields in the EMR in up to ten categories:

• Patient demographics
• Preventative care and chronic obstructive pulmonary disease management
• Diabetes management
• Asthma management
• Congestive heart failure management
• Hypertension management
• Coronary artery disease management
• Osteoporosis
• Mental health and addictions management
• Sexually transmitted and blood borne infection management

All patients who have a visit documented in the EMR in the last five years are included in the PCDE. A subset of demographic information is submitted to support patient identification along with enrolment start and end dates where applicable. The extract does not include free-form text such as that captured in encounter notes.

How do I know if our EMR can generate the Primary Care Data Extract?

Manitoba Certified EMRs are expected to successfully generate and electronically submit the Primary Care Data Extract when they have achieved certification to the Primary Care Quality Indicator Reminders and Data Extract component. Review the list of Manitoba Certified EMRs on our website.

If you use a non-Certified EMR, talk to your EMR vendor about developing the Primary Care Data Extract. More information can be provided by your assigned Home Clinic Liaison or contact the Home Clinic team at 204-926-6010, 1-866-926-6010 or [email protected].

How often should a Home Clinic submit the Primary Care Data Extract?

Home Clinics using a Manitoba Certified EMR who has achieved certification to the Primary Care Quality Indicator Reminders and Data Extract component submit their PCDE monthly via direct upload to the Home Clinic Portal application.

Home Clinics using a non-Certified EMR or a Manitoba Certified EMR that has not achieved certification to the Primary Care Quality Indicator Reminders and Data Extract component, submit quarterly via an encrypted USB/CD process. To learn more, review our Submitting the Primary Care Data Extract resource and speak with your assigned Home Clinic Liaison or the Home Clinic team at 204-926-6010, 1-866-926-6010 or [email protected].

What happens after I submit the Primary Care Data Extract?

If there are issues with your submission, your clinic will be notified. Action will be required to ensure a successful submission takes place.

After a successful submission, each Home Clinic will receive a report from Manitoba Health that includes information related to demographic data quality. This can support updates that may be required in your EMR to ensure patients are included in the extract.

You will receive a Primary Care Report for Home Clinics quarterly. This report contains specific details for your Home Clinic related to visit history, enrolment, and care completed based on Manitoba’s Primary Care Quality Indicators. To learn more, review the Understanding the Primary Care Report for Home Clinics eLearning video.

For eligible fee-for-service family physicians, submission of the PCDE supports claims for applicable Family Medicine tariffs as outlined in the Physicians Manual. Patients with a visit recorded in the last five years in the EMR are included in the PCDE. Home Clinics should ensure all enrolled patients have visits recorded appropriately in the EMR to ensure information is included to support applicable tariff claims.

What are the ongoing responsibilities of a Home Clinic?

Home Clinics are responsible for keeping all commitments outlined in the Home Clinic Criteria, and made during the registration process. In addition, Home Clinics will:

• Communicate with patients as appropriate regarding Home Clinic and Most Responsible Provider changes;
• Maintain enrolment data within the EMR (e.g. updating de-enrolments, making MRP changes, etc.); and
• Undertake efforts to improve the completeness and quality of the data associated with enrolled patient care.

Your Home Clinic Liaison can help with all of these activities and will ensure that your clinic is aware of the other resources available.

To learn more about managing patient enrolment see the category below.

What enrolment information or reporting is available to Home Clinics?

Registered Home Clinics will have access to a range of reports. Some reports will be based solely on Home Clinic and enrolment data (e.g. number of enrolled patients) and others will require integration of enrolment data with other data sources (e.g. claims data). These reports will be published within the Home Clinic Portal, and are available for viewing, printing and/or exporting by the Home Clinic. These reports will be accessible to authorized users via the Home Clinic Portal. Review our online quick reference guides for more instructions on generating reports including generating a list of enrolled clients.

What supports are available to Home Clinics?

There are a number of resources and supports available to Home Clinics. Each registered Home Clinic is assigned a Home Clinic Liaison who will work with the Home Clinic to support their Home Clinic activities. The Liaison will advise regarding best practices related to EMR use, data quality improvement, patient enrolment and more. Other supports are available on the Shared Health website including, but not limited to:

• The Home Clinic Toolkit, containing the following information:
  • EMR integrations and provincial services available to Home Clinics;
  • EMR Optimization Modules to support EMR data quality improvement;
  • 5-minute eLearning videos on important Home Clinic topics;
  • Templates and worksheets to help with patient communications and quality improvement activities;
  • Quick Reference Guides for the Home Clinic Portal and Tip sheets on Home Clinic processes and workflows;
  • Frequently Asked Questions to help Home Clinics understand the initiative and their operational activities; and
  • Content Matrix to help find the content you need quickly and easily.
  • Operational and analytic reports are available in the Home Clinic Portal, and may be viewed, printed or exported.

If we become a Home Clinic now, can we change our mind in the future?

Yes. A Home Clinic can decide to de-register. Should you consider de-registering as a Home Clinic, contact your Home Clinic Liaison. They will help you fully understand the implications, manage the de-registration process, and communicate appropriately with your enrolled patients about the change.

Who is eligible to enrol with a Home Clinic?

All residents of Manitoba and residents of Canada are eligible to enrol with a registered Home Clinic. As a Home Clinic, you will provide comprehensive, continuous and coordinated care for your enrolled patients. Therefore, you should not enrol episodic patients or visitors to Manitoba. Personal Care Home residents are applicable for enrolment provided they meet the care criteria above and visits/patient care are recorded in the EMR.

How are patients enrolled?

Patients may be enrolled using one of two methods: Active or Passive enrolment.

Active patient enrolment directly involves the patient in the enrolment decision and is the best practice approach. The process involves direct communication with the patient and ensures their understanding of the benefits of Home Clinic enrolment. The communication also clarifies the responsibilities of both parties: the Home Clinic and the enrolled patient. When an active enrolment occurs, and there is an enrolment agreement, the date of the active enrolment is documented in the EMR as the Enrolment Start Date. An active enrolment communication can occur with new or existing patients, and also with patients who were initially passively enrolled.

Passive enrolment does not involve communication with the patient. Candidates for passive enrolment are identified by the Home Clinic through analysis of data within their EMR system. This was common at the initiation of the Home Clinic initiative and is no longer a regular practice.

Can a patient enrol with more than one Home Clinic?

No. Patients may only be enrolled with one Home Clinic at a time. A primary objective of a Home Clinic is to improve the continuity of care and information for a patient. In order to achieve this objective, enrolment must be limited to a single Home Clinic at any one time.

Can a patient decline to enrol with a Home Clinic?

Yes. Enrolment is not mandatory in Manitoba, and patients may choose not to enrol. If so, a fee-for-service family physician would not be able to claim applicable Family Medicine tariffs for that patient. It is our hope that once patients understand the benefits of belonging to Home Clinic, most patients will agree to enrol.

Can the Home Clinic decline to enrol a patient?

A Home Clinic can decline to enrol a patient, but must follow the College of Physicians and Surgeons of Manitoba’s policies and guidelines. For example, a member must not refuse to accept a person as a patient because the medical care required could or will be complex, unless the care the patient requires is beyond the clinical competence of the Home Clinic team or the Most Responsible Provider.

Nurse practitioners are employed by organizations such as Regional Health Authorities. As such, they will adhere to the organization’s relevant policies.

Will any EMR be capable of supporting patient enrolment?

Manitoba Certified EMRs include functionality to support patient enrolment including a direct integration with the provincial enrolment system to efficiently submit and manage enrolment from within the EMR (Home Clinic Enrolment Service). If your EMR is not able to enrol patients or generate the Primary Care Data Extract, your clinic is not eligible to be a Home Clinic at this time. To learn more about how to improve your eligibility, connect with the Home Clinic Team at 204-926-6010, toll-free at 1-866-926-6010, or email [email protected]

How can we submit patient enrolment information?

The majority of Home Clinics submit enrolment data through an EMR integration known as the Home Clinic Enrolment Service. The Enrolment Service is an eHealth_hub interface that provides the ability to enrol patients and manage patient enrolment from within an EMR certified to the Service. This provides Home Clinics with an efficient method to manage client enrolment and submit enrolment data to the provincial enrolment repository in a streamlined and timely fashion right from their EMR. For more information review the Home Clinic Enrolment Service Info sheet.

If your Home Clinic is not using the Enrolment Service, there are other methods to submit enrolment.  If you are using a Manitoba Certified EMR that has achieved certification to the Primary Care Quality Indicator Reminders and Data Extract component, enrolment can be submitted via monthly submission of your Primary Care Data Extract (PCDE). Clinics using this method should regularly monitor the Home Clinic Portal application for enrolment messages, to complete remediation work, and to maintain currency and accuracy of enrolment over time.

If you are a Home Clinic using an EMR that has not achieved certification in Manitoba, or a Certified EMR that has not achieved certification to the Primary Care Quality Indicator Reminders and Data Extract component, you must submit enrolment manually via the Home Clinic Portal application. Clinics using this method should regularly monitor the Home Clinic Portal application for enrolment messages, to complete remediation work, and to maintain currency and accuracy of enrolment over time. 

Home Clinics should speak with their Home Clinic Liaison to understand the method that best aligns with their practice context. The Home Clinic Team can be reached at 204-926-6010, toll-free at 1-866-926-6010 or [email protected].

What is the eHealth_hub Home Clinic Enrolment Service Interface?

The eHealth_hub – Home Clinic Enrolment Service (Enrolment Service) is a service providing users of Certified EMR Products with the ability to submit Home Clinic Enrolment data, receive timely validation of enrolment data submissions, and retrieve up-to-date enrolment remediation messages (e.g. enrolment rejections, de-enrolments, etc.) from within the Certified EMR Product. For more information review the Home Clinic Enrolment Service Info sheet.

Our EMR does not support patient enrolment. Can we still enrol patients?

No. As per Manitoba’s Home Clinic Criteria, your EMR must be able to record patient enrolment in order to become a Home Clinic. For more information, contact the Home Clinic team at 204-926-6010, 1-866-926-6010 or [email protected].

Is there an option that would allow us to enrol multiple patients at one time?

In most cases, enrolment occurs on an individual patient basis. Enrolling multiple patients may be an option when you first become a Home Clinic if you have been recording enrolment in your EMR and can submit the Primary Care Data Extract. Discuss this opportunity with your assigned Home Clinic Liaison or contact the Home Clinic team at 204-926-6010, 1-866-926-6010 or [email protected].

Are all Home Clinics eligible to use the Primary Care Data Extract for bulk enrolment?

Yes. If applicable, a Home Clinic may use the Primary Care Data Extract (PCDE) to submit a one-time bulk enrolment submission. This facilitates initial seeding of the enrolment repository.

Home Clinics using a Certified EMR but who are not using the Enrolment Service are eligible to continue to use their monthly PCDE for ongoing enrolment data submissions (e.g. new enrolments and enrolment updates).

How will enrolment records be processed if more than one Home Clinic submits enrolment information for the same patient?

Active enrolment recognizes the patient’s right to choose, and therefore will supersede any passive enrolment. If the patient chooses to change Home Clinics, a new and more recent active enrolment will supersede a prior active enrolment. Finally, if more than one Home Clinic submits a passive enrolment for the same patient, both Home Clinics will be advised to communicate with the patient to determine the patient’s choice of Home Clinic. Once confirmed, the patient enrolment may be resubmitted as active.

Who is responsible for an enrolled patient when a Most Responsible Provider leaves a Home Clinic?

Patients are enrolled to their Home Clinic. When a Most Responsible Provider, to whom the enrolled patient is associated, leaves a Home Clinic, the patient remains enrolled to the Home Clinic. Home Clinics will, to the best of their ability, work with their Regional Health Authority and the Family Doctor Finder Primary Care Connector(s) in the region to determine how best to meet the needs of these patients.

In some cases, enrolled patients may choose to transition to a new Home Clinic with their previously associated Most Responsible Provider. Transitioning enrolled patients to a new Home Clinic takes consideration, planning and open lines of communication between clinics and Providers to ensure a smooth changeover takes place. Home Clinics and providers should seek guidance well in advance of any transitions to fully understand the impact to enrolment.

What should we do if we inadvertently submit inaccurate enrolment data?

If you submit inaccurate enrolment data, contact your assigned Home Clinic Liaison as soon as possible, or our team at Ph. 204-926-6010, toll-free 1-866-926-6010, or [email protected]. They will help you to determine the best approach for correcting the data.

How will we know if one of our enrolled patients chooses to enrol with another Home Clinic?

If the patient chooses to change Home Clinics, a new and more recent active enrolment will be submitted by the new Home Clinic. That new enrolment will supersede the prior active enrolment submitted by your Home Clinic. You will be notified if this occurs. If your Home Clinic uses the Enrolment Service, you will receive notification in the EMR. If you do not use the Enrolment Service, your Home Clinic should be monitoring the Home Clinic Portal for important notifications to support maintenance of current and accurate enrolment records.

Will our Home Clinic be notified if information related to an enrolled patient changes in other health information systems?

As of January 2022, Home Clinics will be notified when an enrolled patient is deceased. The reason code will provide the clinic with the patient’s deceased date. Patient enrolment details are also available in eChart Manitoba to authorized users with the appropriate access. Enrolment details including Home Clinic name, phone number and enrolment start and end dates will be available as recorded in the Home Clinic Repository, along with the associated main Primary Care Provider (if applicable). Home Clinics that use the Home Clinic Client Summary Service may receive patient validation messages if the demographic information in their EMR does not match the provincial Client Registry system or eChart Manitoba.

Can a Home Clinic sever the relationship with an enrolled patient? If so, what steps must be taken?

If an MRP is associated with the enrolled patient, the same rules and guidelines as per the College of Physicians and Surgeons of Manitoba (CPSM) that currently exist with regards to severing a relationship with a patient would apply.

If no MRP is associated to the enrolled patient, the Home Clinic should, to the best of its ability, seek to meet the needs of the patient. This could include working with their Regional Health Authority and the Family Doctor Finder Primary Care Connector(s) in the region to determine how best to meet the needs of these patients.

Will patient enrolment information be shared with other providers?

Yes. As of January 2019, patient enrolment details are available in eChart Manitoba to authorized users with the appropriate access to the Clinical Documents section. Enrolment details including Home Clinic name, phone number and enrolment start and end dates will be available as recorded in the Home Clinic Repository, along with the associated main Primary Care Provider (if applicable). Home Clinics who have implemented the Client Summary Service are sending clinical information as well as enrolment information to eChart Manitoba. Client Summaries can be accessed from the Primary Care folder in eChart and include the Home Clinic name, phone number and the associated main Primary Care Provider (if applicable).

Sharing patient enrolment information supports improved communication opportunities between episodic care providers and Home Clinics, enabling comprehensive and continuous care for enrolled patients.

We noticed a situation in which enrolment information in eChart Manitoba does not match our EMR. Why would this occur?

Enrolment information in eChart Manitoba comes from the Home Clinic Repository. Please check that your site has completed enrolment remediation in your EMR and that your EMR correctly reflects current patient enrolment.

What information is shared from Home Clinics?

Home Clinic enrolment supports sharing of information between the patient’s Home Clinic and providers of episodic care (e.g., walk-in clinics, emergency departments and others). Patient enrolment information is available in eChart Manitoba. This includes contact information for the patient’s current and previous Home Clinic and main Primary Care Provider (when applicable). In addition, key clinical information about an enrolled patient can be sent from Home Clinics to eChart through the eHealth_hub Home Clinic Client Summary Service.

Home Clinics also share information to Manitoba Health via the Home Clinic Portal and submission of the Primary Care Data Extract. This includes patient information, enrolment details and clinical information according to care guidelines included in Manitoba’s Primary Care Quality Indicators.

Will any EMR be capable of supporting information sharing?

Only EMR products certified by Manitoba against information sharing specifications are able to support sharing of clinical information between Home Clinics and providers of episodic care.

Learn more about Certified EMR Products and the EMR integrations and provincial services available to Home Clinics using Certified EMRs.

.