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1 Manitoba Panorama Provincial Immunization Registry Data Description Document Modified: Manitoba ehealth Document Version: 0.04 Document Status: Document Author: Manitoba Panorama Support Team Document Version Control Document Creation Date: Date Author Version Change Description Penny Klassen 0.01 Document Created and formatted Penny Klassen 0.02 Edits all finalized ready for posting Penny Klassen 0.03 Organization sections expanded Glenn Wright 0.04 Added more details about Panorama s physical database structure. Print Date: Manitoba ehealth Page i

2 Table of Contents Background: Purpose History of Immunization Registry Panorama Overview Important Project Dates: Panorama Interfaces and Data Loads Client Registry Data Load and Interface Claims Processing Data Load DPIN Data Load MIMS Data Load echart Data Interface Organization Model in Panorama Jurisdictional Hierarchy (J-Org) J-Org Hierarchy Root J-Org Provider Organizations J-Org Program Organizations Public Health Units Service Delivery Locations (SDL) Reporting Hierarchy Reporting Hierarchy Root Reporting Organizations Service Delivery Locations School Hierarchy School Hierarchy Root School Division Organizations School Organization Organization Types Client Geographic Assignment Historical MIMS Data Appendix 1: Data Dictionary Print Date: Manitoba ehealth Page ii

3 Background: 1. Purpose The purpose of this document is to provide an overview of the data structure of the immunization registry in Manitoba. It is intended to provide necessary background for researchers and data users to understand how the data is stored and structured in Panorama, and will assist data users in requesting data for analysis. The document includes how Manitoba s initial immunization registry, MIMS, was migrated to Panorama, and provides information on how the current interfaces into the registry function. The document also contains linkages to other relevant information. 2. History of Immunization Registry The Manitoba Immunization Monitoring System (MIMS) is a mainframe registry application with a listing of all immunizations administered to individuals who are registered to receive health care within Manitoba. MIMS was initiated in 1988 for childhood immunizations provided to children born in 1980 or later. Adult records were added in MIMS is populated predominantly via 2 methods: 1 direct manual data entry; and 2 a direct feed from the physicians medical claim information system. MIMS was used in a variety of ways: Data entry of immunization events (new and historical) Inquiry regarding past immunization events Reports for community health offices/regions or schools/divisions of missing or recorded immunizations for a particular subset of the population Reminder letters to parents of children who may be missing recommended immunizations at ages 15 months, 20 months and 5.5 years of age Pneumococcal reminder letter to those 65 years of age who may be missing this recommended immunization Provincial and regional statistical analysis, immunization coverage rates and vaccine doses provided by health care providers (MIMS Annual Report) Provision of funding of specific vaccines for regional health authorities (RHAs) Immunization certificates for children at seven and 18 years of age Reports upon request MIMS was accessed in 189 different sites and by over 1200 authorized MIMS users in the regional health authorities and FNIH sites throughout the province, including public health and other health care providers. Print Date: Manitoba ehealth Page 3

4 3. Panorama Overview Panorama is a Public Health application for disease surveillance and management developed by IBM Canada on behalf of the provinces and territories for implementation across Canada. Post-SARS in 2004, the federal government funded Canada Health Infoway to develop a public health surveillance system across Canada. A large portion of this funding was committed to developing and implementing the Panorama system. Panorama is organized into the following program area modules: 1. Immunization Management Records immunization events; includes tools to create and manage immunization schedules and eligibility; built-in forecaster applies logic to forecast future immunizations that are due; maintains client records, including consent, special considerations, and adverse events following immunization; manages mass immunization clinic events for large groups; reports on coverage rates. 2. Vaccine Inventory Management manages and monitors vaccine inventories; supports cold-chain monitoring during storage and transport; facilitates distribution and sharing in case of an outbreak; supports vaccine recall. 3. Communicable Disease Investigations Management assists public health providers in containing and managing cases and contacts of communicable diseases; provides a longitudinal view of the investigation; 4. Outbreak Management offers support and surveillance tools for investigating, monitoring, managing, analyzing and reporting communicable disease outbreaks. 5. Family Health assists in providing maternal, infant, child, youth and adult health prevention and promotion, as well as the means for planning with individuals, families, and communities. The Manitoba Panorama project was kicked off early in 2013 to implement the Panorama software for Manitoba Public Health and replace MIMS. The goal was to introduce an integrated, electronic public health record developed to improve and support management of communicable diseases, outbreaks, immunizations, and inventory. As of spring 2016, only the immunization and inventory management components of Panorama have been implemented. Print Date: Manitoba ehealth Page 4

5 4. Important Project Dates: September 2014 Data loaded into Panorama release based on Sept 30 th, 2014 extract System Data Type Date Migrated # Records Client Client demographic information from MH Registry ~2.2 M MIMS Immunization data ~11 M MIMS VMS Reference Data: Facility, RHU, RHA, Physician file Catalogue of vaccines available from MDA ~8.5 K ~80 October 2014 November 2014 December 2014 Inventory Manitoba Health and set-up for pilot Pilot sites Immunization management Inventory vaccine warehouse (replacement of Great Plains) and pilot sites February 2015 Catch-up data load from MIMS (Oct 2014 Feb 17, 2015) February 2015 Activation of Interfaces and manual updates to keep MIMS and Panorama in- sync Client Registry to Panorama CR P MIMS to Panorama M P Panorama to MIMS P M February 2015 September 2015 September 2015 October 2015 November 2015 December 2015 January 2016 February 2016 March 2016 October 2016 Roll-out of immunization and inventory modules in public health sites Roll-out of non-public health users of MIMS transitioned to Panorama Activation of Panorama interface to echart (replaces MIMS) Client s default SDL (i.e. public health office) and organization (RHA or FNIH) mapped to their postal code Activation of Claims Processing System (CPS) interface to Panorama Project end and transition to operations Manual reconciliation of data from Panorama to MIMS stopped. MIMS is no longer completely up-to-date. Migration of data from DPIN (Pharmacy) includes pharmacy dispensed immunizations from October 1, 2015 onwards Activation of DPIN interface to Panorama Reminder letters and immunization certificates Adverse Events Following Immunization (AEFI) from January 1, 2016 onwards. Print Date: Manitoba ehealth Page 5

6 5. Panorama Interfaces and Data Loads CLIENT REGISTRY PANORAMA Client Name Address Birth Date Gender PHIN Health Registration Number CPS Client Name Address Birth Date Gender PHIN Health Registration Number Per Immunization Service Date Tariff Code Provider Code MIMS Per Immunization Service Date Tariff Code Provider Code Per Immunization Vaccination Date Agent/Antigen Service Delivery Location DPIN Per Immunization Service Date DIN Pharmacy Code Print Date: Manitoba ehealth Page 6

7 System Direction Frequency Data Elements Notes Client Registry (CR) CR P Daily PHIN, Family Registration Number, Client Name, Address, Birth Date, Gender Uses the Manitoba Health Insured Benefits Registry address. Exception report run weekly and manual updates completed in Panorama by central support staff. Claims Processing System (CPS) CPS P Semi- Monthly PHIN, Service Date, Tariff, Provider Code Drug Processing Information System (DPIN) echart P echart Daily DPIN P Weekly PHIN, Claim Date, DIN, Provider Code MIMS M P Weekly PHIN, Service Date, Tariff, Provider Number P M Immunization records are for all dispensed vaccines. Will be decommissioned after all MIMS users transitioned to Panorama. Manual reconciliation from Panorama to MIMS has been discontinued Client Registry Data Load and Interface Key demographic information from the Client Registry is used: Personal Health Identification Number (PHIN) Manitoba Health Registration Number Client Name Address (street, community, postal code) Birth Date Sex Municipal code is not part of the Panorama data as the maintenance of the collection of the data has not been consistent. Panorama does not capture municipal code as part of the client address. Postal code is part of the migrated address and is used for allocating the associated service delivery location and organization. All the clients from the MB Health member of Client Registry (active and inactive) were loaded into Panorama. The MB Health member of Client Registry was loaded from the MB Health Insurance Registry system and is maintained with daily feeds. The updates from the Registry System also flow through to Panorama to keep the Panorama population up to date. The historical Manitoba Health Family Registration number(s) were not part of the original data load because they get purged from the Client Registry system, but are maintained on an ongoing basis with the operational client registry loads. The associated registration start date, change date(s) and cancellation date are stored in Panorama. Print Date: Manitoba ehealth Page 7

8 Where there are duplicate records identified, the Panorama operations team implements a merge process to ensure that each client has a consolidated record in Panorama Claims Processing Data Load All claims data containing vaccines provided by fee-for-service providers (i.e. physicians, nurse practitioners) is loaded into Panorama. Tariff codes are translated into SNOMED codes used within the Panorama inventory catalog. The SNOMED codes are then translated so that the name of the immunizing agent is displayed. Manitoba Health maintains the list of all pertinent tariff codes. Provider numbers (billing numbers) are translated into a Panorama service delivery location and organization. As the claims system is based on a billing premise, there will be correction and deletion records. Any potential duplicate transactions that may be generated from these transactions are logically deleted by the system to avoid displaying the duplicates. If an immunization record with the same date and agent already exists in Panorama, the claim will not be transferred into Panorama, regardless of whether the provider information is the same or not DPIN Data Load Panorama was populated with data from the Drug Program Information Network (DPIN) with pharmacy dispensed immunizations from October 1, 2015 onwards. It is important to note that these records are for any vaccine dispensed that may or may not be administered by the pharmacist. Therefore, there are records where the vaccine will be administered by a different care provider. In these cases a record for the administration may be entered into Panorama creating an apparent duplicate record. Where these duplicates are identified by public health nurses who have administered the associated vaccine, the DPIN record will be deleted. All other instances of identified duplicates are remaining in Panorama, unless there is a request from a client or provider to delete the pharmacy immunization. The interface into Panorama allows duplicate records if received from DPIN with the same date and agent. The data received from DPIN can have multiple add and delete records for the same immunization event and in some situations we will receive multiple add records in a row before receiving delete records. The add records must all be allowed into Panorama so the follow-up deletes can be processed as well. Based on the testing done prior to implementation, processing all add and delete events keeps Panorama in alignment with DPIN. However, there can be duplicates at some points in the process. For DPIN records, the Drug Identification Number (DIN) is recorded in DPIN for vaccines. Manitoba Health maintains a list of all DINs associated with vaccines and their respective tariff codes, which triggers the interface. DIN s are translated into tariff codes, then to SNOMED codes for the immunizing agent in Panorama MIMS Data Load All immunization data from active clients in MIMS as of October 2014 was migrated. Archived MIMS data from clients inactive prior to April 2012 was not included but will be accessible for Panorama users in Immunization information was transformed for the conversion into Panorama as follows: Tariff codes are translated into SNOMED codes used within the Panorama inventory catalog. The SNOMED codes are then translated so that the name of the immunizing agent is displayed. Manitoba Health maintains the list of all pertinent tariff codes. Print Date: Manitoba ehealth Page 8

9 Public health offices are converted to organizations and service delivery locations. Provider numbers (including physician billing numbers) are translated into a Panorama service delivery location and organization. Comments on individual immunizations were migrated into Panorama as client warnings. The client warning includes the restrict code, tariff code and comments. Other MIMS fields used to include comments on adverse events, consent and contraindications were not transferred to Panorama since these fields were used inconsistently echart Data Interface Panorama is the data source for immunization information in echart, replacing MIMS in September The interface sends all immunization activity (adds, updates and deletes) to echart daily. An XML file is sent to the HIAL where it is translated into HL7 messages. The Panorama SNOMED code is translated into a tariff code in the HIAL and Panorama SDLs are translated into MB Health Provider Numbers. Daily snapshots are taken in Panorama and compared to identify all immunization activity for the period. This approach filters out most of the duplicate DPIN events. If duplicate records are sent to echart (same PHIN, agent and immunization date), duplicate records will overwrite the previous record if one exists. There are some specific add/delete scenarios that result in a client missing an immunization event in echart. Print Date: Manitoba ehealth Page 9

10 6. Organization Model in Panorama The organization model in Panorama is used as the basis for summarizing data in Panorama, and is used extensively for in-application reports. There are two main purposes for utilizing the organization model for reporting: 1. Client associations to organizations for Immunization coverage by geography Reports that focus on immunization coverage use the organization model to assign a client to an organization/geography based on their registered home address (postal code). The client service delivery location (public health office catchment) and region (org) is independent from where they may have received immunization services. 2. Immunization service delivery location association to organizations for provider-based reports Reports that focus on who is delivering immunization services. The focus of these reports is to count the number of doses administered by providers or provider-types to evaluate service delivery programs, and is based on the organization associated to the immunization. The Panorama organization model currently consists of 3 hierarchies: jurisdictional (J-Org), regional health authority, and school. Print Date: Manitoba ehealth Page 10

11 Organization Hierarchy Relationship diagrams are available with further detail under reference documents at Print Date: Manitoba ehealth Page 11

12 The following terms relating to the model are used in this document: Term Hierarchy Organization [ORG] Service Delivery Location [SDL] Association Holding Point Holding Point Location Definition All organizations and service delivery locations are represented in a hierarchy where their relationship is depicted as being above, below, or at the same level as one another (sometimes also referred to as a parent-child relationship). Hierarchies allow for information attributed to the organizations and service delivery locations to be aggregated and reported at varying levels of detail. Panorama consists of at least one hierarchy (the J-Org hierarchy), but can include multiple other hierarchies as may needed. An organization may be thought of as organized group of people with a role in the delivery of public health services either directly (such as public health units) or indirectly (such as schools that provide a physical space in which to deliver immunizations or facilitate the collection of consent for immunization). Organizations may be responsible for one or more service delivery locations, and are represented in a hierarchy structure (such as the J-Org hierarchy or the School hierarchy). Each organization in Panorama has an organizational unit id and a parent organizational unit ID, which establish its location within the J-Org hierarchy. A service delivery location (SDL) represents any place at which a health services, such as immunizations, may be delivered. An SDL may be a bricksand-mortar address-based location such as a health services facility or a school; it could also be a mobile location such as a mobile clinic. SDLs must be owned by an ORG in a defined hierarchy (for example: the J-Org hierarchy). In Manitoba, the definition of an SDL was extended to include providers for the purposes of integrating with systems such as MIMS (Manitoba s preexisting immunization registry), CPS (Manitoba s physician claim system) and echart (Manitoba s electronic health record viewer system). Note: there is no direct database relationship between an individual health care professional provider represented as an SDL and an individual health care professional represented in Panorama s Provider index. An Association is a relationship between two organizations that are contained in different hierarchies. For example: School organizations in the School hierarchy have an association to public health unit organizations in the J-Org hierarchy. The client SDL (local public health office) has an association through its public health organization to the geographical RHA hierarchy, which is defined by its Associated_org_id. Associations are necessary so that information attributed to organizations and service delivery locations in the J-Org hierarchy can be aggregated and reported in a different hierarchical structure. A holding point is an SDL that can hold vaccine inventory; the characteristics of the inventory that can be held are defined through a profile (Holding Point Profile). It must be owned by an organization that will be responsible for immunizations that will draw from that inventory holding point. A holding point location represents the space where vaccine is physically stored (e.g. a fridge or a particular shelf in the fridge, etc.). Multiple holding point locations are defined for a holding point to address storage of vaccines Print Date: Manitoba ehealth Page 12

13 for administration, vaccines that have been quarantined, vaccines that have been set aside for disposal, etc.). ITerm ITerm refers to the repository for standard and customized terminology elements for the application. ITerm contains a reference table, Coded_concept_consolidated, that provides the ability to query the database for concept id s and concept descriptions Jurisdictional Hierarchy (J-Org) The Jurisdictional organization hierarchy forms the core of the overall model implemented in Panorama. It is part of Panorama s security and data access model. The J-Org hierarchy impacts scope of data access and functional behavior, and is also the default reporting hierarchy for selecting and aggregating data. Organizations represent teams of people involved in the delivery of public health services. Important to note that the J-Org does not specifically imply or represent an administrative, political or legal reporting relationship between organizations. Within the J-Org hierarchy: Panorama users belong; Services are attributed; Services are delivered; Investigations are assigned; Clients are associated J-Org Hierarchy Root The root of this hierarchy is a single organization: Manitoba Health. This is the highest level at which information attributed to organizations within the J-Org can be aggregated. It represents all service delivery locations within the province Under normal circumstances, there are no end-user business scenarios that require information to be directly attributed to this organization. This organization is an exception default used when the PC2SDL (postal code to service delivery location) client mapping algorithm is unable to make an SDL assignment J-Org Provider Organizations The major branches of the jurisdictional organization hierarchy represent a logical collection of service delivery organizations. Provider organizations will have associated service delivery locations, although these service delivery locations may be used and associated to any organization on an individual immunization. Contains the parent organizations, which represent RHA s, FNIHB, Manitoba Physicians, Manitoba Pharmacies, Materials Distribution Agency (MDA) and Manitoba Corrections. Manitoba s J-Org has defined the following provider organizations: Print Date: Manitoba ehealth Page 13

14 Manitoba Public Health - represents the provincial government s Public Health Branch and any organizations managed by or affiliated with the Public Health Branch Winnipeg Regional Health Authority - represents the organizations operated by or affiliated with the WRHA Interlake-Eastern Regional Health Authority - represents the organizations operated by or affiliated with the IERHA Prairie Mountain Regional Health Authority - represents the organizations operated by or affiliated with the PMRHA Northern Regional Health Authority - represents the organizations operated by or affiliated with the NRHA Southern Regional Health Authority - represents the organizations operated by or affiliated with the SRHA First Nations and Inuit Health - represents the organizations that deliver public health services in First Nation communities, including public health units operated by FNIHB, WRTC and directly by a First Nation community. First Nations and Inuit Health organizations are structured in the organization hierarchy based on their organizational associations. All First Nation health centers and nursing stations are considered public health locations. Other non-regional providers are represented collectively as top level parent organizations. For example: Private Physicians, Pharmacists, and Corrections. These parent organizations will own service delivery locations that represent the provider s routine place(s) of business. Example: Physician names (based on billing #), Pharmacy clinics Also, the provincial vaccine warehouse, MDA (Materials Distribution Agency) does not have any service delivery locations or organizations associated. It is represented in the org model as staff are associated to this organization for the purposes of vaccine inventory J-Org Program Organizations Each RHA will have a program organization hierarchy representing their regional programs. Organizations at this level include: RHA Public Health Program - aggregates the collection of public health units operated by the public health program within each RHA Other Programs - programs other than Public Health that have a role in the delivery of public health services within an RHA (e.g. Long Term Care, Occupational Health) Print Date: Manitoba ehealth Page 14

15 Public Health Units Organizations at this level are the individual organizations that provide public health services to clients. Organizations at this level include: RHA Public Health Units - the individual public health units operated by the public health program within each RHA FNIHB Public Health Units - the individual public health units (federal nursing stations) operated by FNIHB WRTC Public Health Units - the individual public health units operated by the WRTC Band Public Health Units - the individual public health units operated by a Band Service Delivery Locations (SDL) A service delivery location typically represents a specific physical location (e.g. a public health office). In some instances it is not practical or meaningful for the SDL to represent a single physical location, so the SDL can be used represent a generalized type of location (e.g. clinic delivered at a mall, service delivered at a client s home). An SDL may be used by more than one ORG, so where practical a location should only be represented once Reporting Hierarchy A Regional Health Authority Geographical Hierarchy has been implemented in Manitoba s organization model. The sole purpose of this hierarchy is to be a secondary reporting hierarchy for reporting and aggregating immunization data within RHA geographic boundaries. This hierarchy was required for reporting because all service delivery locations, including First Nation communities, exist physically within RHA geographies, but are not represented within the RHA branches of the J-Org. Reporting is made possible through associations between organizations in the two hierarchies. There are no end-user business scenarios that require client, public health service encounter, or other information to be directly attributed to organizations in this hierarchy Reporting Hierarchy Root The root of this hierarchy is a single organization: Manitoba RHA. This is the highest level at which information attributed to associated organizations within the J-ORG can be aggregated Reporting Organizations Organizations represent the Regional Health Authorities geographical boundaries in Manitoba. The purpose of organizations at this level is to facilitate reporting and aggregating data by RHA geography for immunizations delivered at service delivery locations that fall within an RHA s geographic boundary (i.e. both RHA and FNIH service delivery locations). These organizations have defined associations to Public Health Unit organizations in the J-Org (as they correspond to the RHA geographic boundaries) Service Delivery Locations There are no Service Delivery Locations defined within the Reporting hierarchy. Print Date: Manitoba ehealth Page 15

16 6.3. School Hierarchy A School Organization Hierarchy has been implemented in the organization model. This is a hierarchy whose sole purpose is to be a secondary reporting hierarchy for reporting and aggregating immunization data by school and/or school division. School Division Organizations represent geographic boundaries that differ from health regions. School Organizations will own service delivery locations that represent the schools within a School Division Organization. Individual schools serve as important service delivery locations and may fall within the responsibility of different regional public health jurisdictional organizations. Each school will be associated with the corresponding Regional Public Health Organization that typically provides public health services at school location owned by the school organization. These organizations are not associated with users School Hierarchy Root The root of this hierarchy is a single organization: Manitoba Education. This is the highest level at which information attributed to associated organizations within the J-ORG can be aggregated School Division Organizations School Division Organizations represent the School Divisions in Manitoba. The purpose of organizations at this level is to facilitate reporting and aggregating data by school division for immunizations delivered at schools within the division School Organization The purpose of organizations at this level is to facilitate reporting and aggregating data for immunizations delivered at a particular school. The School organizations are associated to the Public Health Units of the J-Org that are normally responsible for immunization clinics at a particular school Organization Types All organizations have been assigned organization types for the purpose of reports, which allows data users to summarize data based on the organization type (analogous to provider type in MIMS). *A reporting algorithm has been created which defines organization types to allow different organizations to be grouped into categories to summarize the data. These include: Regional/FNIHB Organization Types: Home Care home care program organizations Long Term Care long term care organizations Medical clinics RHA primary care providers who do not submit fee-for-service or shadow billings for immunization. These immunizations are entered directly into Panorama. Occupational Health RHA occupational health organizations. Does not include private occupational health providers. Public Health Public health organizations in RHA s/fnihb. RHA Other Other types of organizations associated with RHA s e.g. Child health, Women s health, ER programs... Note: If an immunization is assigned to the parent RHA/FNIHB organization, it will also be given the following organization types: FN-RHA First Nation organizations where the parent FN organization is selected and not the sub-organizations that fall below it such as a public health unit. Print Date: Manitoba ehealth Page 16

17 MB-RHA Regional health authority organizations where the parent RHA organization is selected and not the sub-organizations that fall below it such as public health, home care, etc. Manitoba Parent Organization Types: Jurisdiction displayed when the organization is unspecified. Medical practitioner providers with a billing number who submit fee-for-service or shadow billings for immunization through the claims processing system. Records are transferred electronically into Panorama from the claims processing system. Immunizations entered into Panorama associated to these providers are also included. Other includes other providers that are not associated to an RHA/FNIHB, such as Manitoba Corrections, or out of province. Pharmacy Includes all pharmacy service delivery locations. 7. Client Geographic Assignment In Panorama, clients are assigned a service delivery location (SDL) to represent where they receive services. In Manitoba, an algorithm is used to map clients based on the postal code of their registered address with Insured Benefits. The client SDL represents the local public health office, and the region is the corresponding RHA or FNIH organization. The client assignment to geographic locations allows inapplication reports at the public health office population level. There are some limitations to this approach since postal codes do not always map uniquely to public health offices, and new postal codes are continually created. Also, this method is dependent upon clients to keep their address up to date with Manitoba Health. The association may be manually updated in Panorama if an error is determined. Manual updates will be allowed in 2017 for public health users to correct allocation to public health offices when postal code geographies overlap office allocations. If addresses are incorrect, clients are encouraged to update their addresses with Manitoba Health. 8. Historical MIMS Data Archives ( ) These are immunization records for individuals that ceased being registered for health insurance with Manitoba Health during the lifetime of MIMS. From 1990 through 2008 the data contains a single record for each individual with all associated immunization events From 2009 through 2012 the record layout follows the historical MIMS monthly data cuts. The Archive data has not been loaded into Panorama s immunization registry, but is accessible through the Panorama database to produce the Archive Immunization Record report in Panorama. Panorama users may choose to manually enter immunization records produced from the archive data if a client will be accessing immunization services in Manitoba, or has returned to Manitoba. Historical MIMS monthly extracts (Jan 2008 to Jan 2016) Monthly snapshot data cuts with all immunization records for individuals actively insured at the time of the snapshot. Print Date: Manitoba ehealth Page 17

18 Both data collections are housed on the Manitoba Health UNIX server and can be accessed through a data request submitted to Epidemiology & Surveillance or Information Management & Analytics. 9. Appendix 1: Data Dictionary Below is a table showing the data element comparison between MIMS & Panorama: FIELD MIMS PANORAMA DESCRIPTION PHIN X X MIMS = scrambled; Panorama = live MH reg number X X 6 character MH registration number birth date X X date of birth on client registry gender X X gender pcode X X postal code on registry old mun X municipality of registration (A-code) pcmun X municipality of postal code client rha X regional health authority of client client ca X community area (Winnipeg clients only) district code X health district code Client Regional Jurisdiction Organization (RHA or X client org FNIH) Client Service Delivery Location (public health office X client sdl catchment) fnind X first nations indicator (based on A-code municipality) band X FN band # of self declaration treaty X FN treaty # of self declaration service date X X service date of immunization tariff X billing tariff code for immunization SNOMED X SNOMED code for immunization vacname/immunizing X X AGENT Generic name label of vaccine received reason X X reason for immunization provider rha X regional health authority of provider provider type X type of provider (public health, physician, etc.) provider code X code identifying specific provider provider organization Service delivery location X X Group of organizations who provide immunization services and whose parent is MB Health. Where the immunization service was delivered dose X dosage of vaccine (public health supplied doses only) Related Link: Data Dictionary and Data Standards Documents Print Date: Manitoba ehealth Page 18