MedMail User Manual. Contents. 1.0 Introduction. 2.0 Installing the system. 3.0 Program operation

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1 MedMail User Manual Contents 1.0 Introduction 1.1 Program functions 1.2 Security 2.0 Installing the system 2.1 Software installation 2.2 Initial Setup by a Supervisor Site description Folders Printer Users 3.0 Program operation 3.1 Selecting recipients 3.2 Sending the message 3.3 Retrieving messages 4.0 Digital signatures 5.0 EMR Interfaces 5.1 WinRx

2 1.0 Introduction 1.1 Program functions Most confidential medical information is sent between medical practitioners via fax. This involves considerable work, is slow, consumes large quantities of paper, and is not secure by any reasonable standard. There are a few electronic methods of transferring information, government and private, but these always lack general interface capability, are expensive, and do not employ the most easy to use and efficient security technology. MedMail provides a superior way to electronically transfer private medical information between medical practitioners (physicians, pharmacists, nurses, etc.) 1.3 Security All users are identified by their College licence number and College code e.g. P1 for pharmacists, 91 for doctors, 93 for dentists, etc. The location where they practise (pharmacy or clinic) is identified by either a phone number or a combination of their licence number and college e.g P1. This location identifier, a network id, is used to identify where data is coming from and where it is sent. Pharmacists can only send and receive data from a pharmacy with a net id identifying the pharmacy, usually a phone number. Other practitioners may send and receive data from a clinic identified by a site net id or from a location associated with their licence number. Data, however, is always associated with an author, always an individual practitioner. Only individual practitioners may digitally sign documents. Data is sent encrypted from the sender's location to a central MedMail server via SSL and from the server, upon a request to receive data, to a recipient, again via SSL. The information is stored encrypted at the server until it is sent to a recipient. Digital signatures may be applied to Word, Excel, or Adobe PDF transmitted files to verify the author and ensure the document has not been altered. Sending and receiving messages and files via MedMail is free unless, in the case of documents being sent, a digital signature is required. In that case, the author must have a digital signature certificate, available for a small annual fee. This allows the author, however, to very quickly sign documents conforming with the highest security standards available. In the near future, recipients who have not yet installed MedMail may have a MedMail transmitted file automatically faxed to them but, again, there is a small charge to the author if this option is selected. Hopefully this will be a work around of short duration.

3 2.0 Installing the system 2.1 Software installation To install the software on a computer, go to the arirx.ca website and double click the MedMail link to Run it. Before it installs, you will be prompted to enter the location of the folder where the programs are to reside on your disk. The default will be in 'c:\medmail'. If you are a pharmacy using WinRx, change this to 'c:\winrx'. The software will then be installed on your computer (there are no registry changes) and an icon to start MedMail will appear on your desktop. 2.2 Initial setup by a Supervisor At each clinic or pharmacy where MedMail is to be used, there is one person designated to be a Supervisor. This person cannot send or receive mail but is responsible for defining who the users will be and other setup attributes. After MedMail is installed, the supervisor should start the program. They will be prompted to contact MedMail support (the phone number is on the login page) in order to register the net id to be used and receive a supervisor id and initial password to use with that net id. After doing this, the supervisor enters the id and password they have been given and will receive the registration screen shown below.

4 2.2.1 Site Description The first tab in the registration form contains information need to identify the site when messages are sent access the registration screen and the password necessary to allow the supervisor subsequent access to the registration screen - - the initial password provided expires quickly. The name field may contain a clinic, pharmacy, or practitioner name - - how you wish the site to be identified when mail is sent. If the supervisor has registered a phone number as the site net id, this will be put in the Network ID field. If a site in the form #####.xx has been registered, the user will log in with id ##### but will enter the full network id, complete with hyphen and college. The password should be changed at this point as the original one provided by support will expire. If MedMail will be interfaced to an EMR, this should be selected from the list of EMR systems integrated with the program Folders Medmail needs separate folders to store inbox, attachments, and general data information. The second tab allows the supervisor to select where those folders are located. If MedMail is installed on a network, these folders should be shared and pointed to in the MedMail folder install done on each machine.

5 2.2.3 Printers The third tab on the registration form allows the supervisor to select where printing is done from MedMail when it is requested Users The supervisor is the only one who can designate the practitioners who will be using MedMail at the site. This is done via the Users tab. The user licence number will be used by the user to log into MedMail. The supervisor sets the initial password to be used by the user but the user will change that to one of their own choosing the first time they log in. 3.0 Log in procedure When a user logs in with his college id and password, they will be presented with the Medmail transmit/receive form above. Before the form displays, the program will populate the Inbox with any mail that was waiting at the server to be delivered. If MedMail is interfaced to an EMR, MedMail can be started automatically when a report is generated. In that case the subject, attached file, and recipient(s) fields can be auto populated. All the user has to do in that case is sign the document, if appropriate, and hit the Send button.

6 3.1 Selecting recipients Recipients can be selected from the Contacts list maintained in the program or, if MedMail is interfaced to an EMR, by selecting a practitioner from the local doctor file or a pharmacy from the local pharmacy table. When creating a contact, be sure to specify the network id properly i.e. a phone number of a store or clinic where the practitioner's mail is to be addressed or the practitioner net id in the form #####-xx where ##### is the practitioners licence number and xx is a college designation. A contact must have a net id specified and either a clinic/store name or a surname, if the practitioner receives information personally. If the recipient list is auto populated by an EMR, you may not wish to send the message to some of the practitioners identified as the patient's physicians. Items with check in the check box on the recipient line identify the practitioners who will receive the message. 3.2 Sending messages When the Send button is struck, the message will be sent to each selected recipient, as shown by the check beside their name. If the message is received correctly by the server, the recipient line will be set to the color green. If an error occurs, a network failure or message sent to a practitioner not registered with MedMail, then an error message indicating the nature of the problem will be displayed. In such cases, the message may be saved as a draft and, after the problem has been corrected, resent. 3.3 Receiving messages Any messages retrieved will be displayed in the inbox. The server is queried for new mail each time a user logs in or when WinMail is started automatically by an EMR. New messages appear in the inbox with a light blue background. 4.0 Digital Signatures A user may digitally sign a document before sending it to the recipient(s) or when they receive it. After a document is signed, it may not be altered and, to do so, causes the document to become unsigned. Currently only pdf, Office Excel (2007 or later), and Word (2007 or later) documents may be signed. A user can only use a digital signature by contacting MedMail support and providing basic demographic information. Installation certificates and instructions will be provided at that time. There is an annual fee for use of the CA provided digital signature certificate.

7 5.0 EMR Interfaces 5.1 WinRX Currently the College of Pharmacists requires all documents transmitted to physicians to be digitally signed. Treatment plan(from EMR), adaptation, narcotic missed dose, and rx transfer reports are sent via MedMail to the appropriate physicians. Reports sent automatically to other practitioners may be accessed by hitting the 'documents' button for the patient, either in WinRx or the WinEMR module. In either case, the WinRx scanning module is invoked (licensed automatically) to view the information. To install MedMail using WinRx, the medmail install extract should be placed in the winrx folder on each computer using WinRx. When signing pdf documnts, if a jpg file named #####.jpg (where ##### is the user's diploma number), that image will serve as a background for the pdf signature on the document.