AIDS Regional Information and Evaluation System

1. AIDS Regional Information and Evaluation System California Department of Public Health Office of AIDS

2. You can’t hide from me! It’s time to turn in your report! Please! No more downloads!

3. But it worked just fine yesterday!

5. Overview: • ARIES History • ARIES Defined • ARIES Benefits • ARIES Features • Business Flow • ARIES Security • Implementation Requirements • ARIES Client – Blueprint • Tab and Subtab Structure • Role Based Permissions • Data Elements Design: Agenda

6. General Information: • Policies • Help / Technical Assistance • Questions/Discussion • Hands-On Training Agenda

7. ARIES Overview

8. ARIES History

9. In 1998, the California Department of Health Services (CDHS), Office of AIDS (OA) began discussions on developing a consolidated database for OA care and treatment programs. • Other Title I EMAs also began internal discussions on developing a consolidated care services database. • In March 2000, OA met with other government agencies interested in building an HIV/AIDS care and treatment client system. • After a year of discussions, a partnership was formed between CA/OA, San Diego County, San Bernardino County, and the State of Texas Department of Public Health, Title II Grantee. History

10. ARIES Defined

11. ARIES – the AIDS Regional Information and Evaluation System – is a real time system. • It is an Internet browser-based client case management information system that will fulfill administration and reporting needs for HIV/AIDS care. • It facilitates the delivery and tracking of effective, efficient, appropriate, timely, and desired care and treatment services to people with HIV/AIDS. Defined

12. Programs Included in ARIES: • RWCA Parts A, B, C & D (formerly Titles I, II, II & IV)* • Case Management Program (CMP) • Medi-Cal Waiver Program (MCWP) • Early Intervention Program (EIP), Bridge, Positive Changes, and Life • Care Services Program (CSP/Part B)* • Housing Opportunities for Persons with AIDS Program (HOPWA)* • Health Insurance Premium Payment Program (CARE/HIPP) • Certain aspects of the Therapeutic Monitoring Program (TMP)* *These programs are not required to use ARIES; Part A areas (Title I) who receive CSP funds will be required to import their data into ARIES in the designated format. Defined

13. ARIES Benefits

14. Clients: • (When they choose to share their data with other providers) • Need to register only once, thus initiating the “single point of entry;” • Quicker access to services; • May receive better care since providers have a better overall picture of the services provided; • Easier referral tracking for additional services; and • Provides a “data home” for clients who move around a lot. Benefits

15. Providers: • Better global picture of the services provided; • Easier to track client outcomes and effectiveness of treatment alternatives; • Easier to plan and organize client care plans; • May help stretch scarce resources as it will be more difficult for clients to receive duplicate services at different agencies; Benefits

16. Providers (continued): • Elimination of duplicate data entry for an agency with multiple funded care & treatment programs; • Better quality data; • Ability to easily analyze client data using canned reports and the crosstab wizard; • Ability to conduct complex analyses using the ad-hoc reporting feature; Benefits

17. Providers (continued): • Simplified monthly reporting (no longer necessary to send monthly disks to OA); • Elimination of software updates and patches on individual provider computers; updates will be made to the ARIES server by an ARIES administrator. • Providers can use ARIES to track all of their HIV/AIDS clients regardless of funding source. Benefits

18. RWCA Grantees (Parts A, C & D): • Unduplicates clients across ARIES providers; • Provides reliable client-level data; • Consolidates and updates client and service tracking tools; • Allows a grantee to administer each of its contracted providers and produce consolidated reports; • Allows for easier reporting to HRSA (Care Act Data Report (CADR), Women, Infant, Children Youth (WICY) Report; Benefits

19. RWCA Grantees (Parts A, C & D): • Provides relevant data to meet HRSA’s quality management mandate; • Provides data for program monitoring and outcome evaluations; • Allows the grantee to provide data reports back to its providers and/or its Planning Council; and • Shifts the responsibility for implementing software patches and upgrades to OA. Benefits

20. ARIES Features

21. Needs Assessments • Track Referrals and Referral Outcomes • Care Plans • Case Notes • Comprehensive Assessment Tools (includes psychosocial, functional status/quality of life, and behavioral risk) • Outcome Tracking and Quality Management Indicators • Canned Reports and a Crosstab Feature (simple reports) • A Custom Report Module (more sophisticated reports) • Store Custom Reports (written by either the help desk or other agency users) • Client Flow Sheet • On-Line Help Manual (Press F-1 key) Features

22. Agencies who currently use COMPIS, Carebase or CAREWare will have their data converted into ARIES before they begin to use the system. • OA will provide the data conversion for these programs and will convert all active clients who had a service in 2005/06/07. Data conversion will include most of the data necessary to complete the 2007 CARE Act Data Report (CADR) for HRSA as well as historical CD4 and Viral Load counts. Features

23. ARIES Business Flow

24. ARIES will potentially change the way you do business! • Agencies will need to decide how to implement ARIES in their agency. • ARIES is a real-time system. How often are you going to enter data (daily, weekly, every two weeks)? • Will you use ARIES real-time or use forms and enter the data at a later time? • If you use forms, will each user fill out their own forms and enter the data themselves or will they fill out the forms and give them to a data entry person? • What sections of ARIES will the user fill out? Will one person enter intake information while another enters service data? • Will Case Managers only be responsible for entering in their case notes? Business Flow

25. Potential Business Changes – (continued): • Administrative: • Providers must determine how ARIES will affect physical and electronic client charts: • May impact how agencies maintain existing physical charts. Providers need not print and file everything in ARIES for the clients. • Aries will probably not replace existing Electronic Medical Records Systems. Business Flow

26. Potential Business Changes (continued): User: ARIES is a real-time system; data you enter can be immediately seen by other providers in your network (if the client has agreed to share their data). Enter data more frequently if real-time data entry is not possible. Current data entry ensures that the providers in your network are getting the most current information on your client to better serve their needs. Business Flow

27. Potential Business Changes (continued): • Client: • To unlock their record at each agency (when share status is designated), the client must give the exact same information to each agency: • First name • Middle initial • Last name • Date of birth • Gender • Mother’s maiden name • *Clients may use the information on their driver’s license or their California ID card (if applicable) to ensure name consistencies between providers. Business Flow

28. ARIES Security

29. Security ~ ARIES Forefront: • Security of confidential client data has been of primary concern throughout the entire life cycle of the ARIES project. • Revisions and discussions on additional security enhancements continue to occur between the partners. Security

30. Security Measures in ARIES: ARIES is divided into four separate applications: ARIES Client Users must have the appropriate authorization to access each of the four areas. This requires a separate digital certificate for each application. This division was motivated by security precautions and limiting access to data.

31. Digital Certificate Process: Fill out the ARIES User Registration Form. Fax it: Attention: Bill Hunter at the Office of AIDS (916-449-5858). Bill or another OA staff person will contact you to provide instructions on how to install your digital certificate. Security

32. Digital Certificate Process (continued): • The OA ARIES administrator will be able to revoke any digital certificate if necessary. • The agency Technical Lead will be able to delete a user password immediately if necessary. Security

33. Security Measures in ARIES (continued): • ARIES encrypts client personal identifiers in the database using a polyalphabetic cipher utilizing shared keys stored in the middle tier. The vendor has stated that the polyalphabetic cipher used in ARIES is roughly equivalent in strength to the 64-bit DES encryption standard. • ARIES uses a three tier hardware architecture, protected with multiple firewalls and intrusion detection tools. Security

35. Security Measures in ARIES (continued): Encryption is used in ARIES to: 1) secure communication over the network; 2) secure files used by SQL server; 3) secure the ARIES user password; 4) secure database connection strings stored on the web server; 5) secure the ARIES client ID; and 6) secure client identifiers in the database. Security

36. Security Measures in ARIES (continued): • ARIES uses dual factor authentication: 1) user logins and passwords and 2) computers must have digital user certificates for each application. ARIES will configure these certificates for both the user and the machine. • Within ARIES, there are set permissions to determine which screens and data elements users can view and edit. In other words, users will only be granted permission to view and edit the screens that they need. This is implemented through a configurable role-based security mechanism. Security

37. Security Measures in ARIES (continued): • ARIES contains a “client share status” option. This option gives clients control as to whether their information is shared across multiple service providers. For clients opting to share, a provider will be able to view relevant information on their clients that were entered by other ARIES providers serving the same clients. Because clients must give providers the “keys” to unlock their ARIES record, providers will only have access to information on clients they serve. For clients opting not to share, providers will only see the information entered by their staff. Security

38. Health Insurance Portability and Accountability Act – HIPAA: • ARIES contains protected health information (PHI) and as such, each provider needs to take and/or continue appropriate actions to ensure compliance with HIPAA. • Users are required to sign the ARIES User Registration Form which stipulates that they are aware of the confidentiality requirements for PHI and agree to follow their agency’s guidelines pertaining to patient confidentiality and HIPAA. Security

40. ARIES Design

41. ARIES Requirements

42. Minimum User Requirements: • IBM compatible computer; • Internet Explorer (IE) 6.0 (the system can accommodate any future IE releases as they become available); • Windows 2000, XP, Vista operating system or higher if one becomes available; and • 56k modem.* *ARIES will work more efficiently if the user is accessing the system through DSL, cable, or satellite connection. Requirements

43. Minimum User Requirements (continued): • Java Script and cookies must be enabled. • To access the help screens, the pop up blocker needs to be disabled for the ARIES website. • Login ID must be a minimum of 7 characters. • Passwords must be a minimum of 6 characters, one must be a capital letter, one must be a number, and some of the characters must be lower case. • Passwords expire every 60 days. The system will prompt you when its time to change your password. Requirements

44. ARIES Client-Blueprint

45. Major Tab Blueprint Subtabs Major Tab Subtabs

46. Major Tab Subtabs Blueprint Subtabs • *For CSP, collect all asterisk marked fields (*) as well as those indicated in the CSP minimum dataset document.

47. Major Tab Subtabs Blueprint Subtabs

48. Major Tab Blueprint Subtabs Major tabs with no subtabs

49. ARIES Read-Only Screen

50. ARIES Edit Screen