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Data Sharing Agreement (DSA)

Community Pharmacy in New Brunswick& Community Pharmacy Incident Reporting (CPhIR) Platform

Dear New Brunswick Participating Pharmacy,

Thank you for selecting the Community Pharmacy Incident Reporting (CPhIR) platform for your pharmacy's medication incident reporting and learning. CPhIR meets the Mandatory Medication Incident Reporting Practice Directive of the New Brunswick College of Pharmacists for contributing incident data to the National Incident Data Repository for Community Pharmacies (NIDR).

The Institute for Safe Medication Practices Canada (ISMP Canada) houses the National Incident Data Repository for Community Pharmacies (NIDR); a database of standardized data on medication incidents reported by community pharmacies and a component of the Canadian Medication Incident Reporting and Prevention System (CMIRPS).

ISMP Canada is an independent, not-for-profit corporation continued under the Canada Not-for-profit Corporations Act by Articles of Continuance dated October 3, 2014, with a mandate to analyze medication incident reports and develop recommendations for enhancing patient safety. The activities to support this mandate are conducted in accordance with ISMP Canada's goals and purpose, as set out in the ISMP Canada Vision and Strategic Plan. Personal health information, as it is defined in the federal Personal Health Information Protection Act, 2004, is not collected.

The data is collected through a secure transfer protocol for the purpose of analysis and shared learning to advance medication safety in all health care settings in Canada. The following categories of information are received by ISMP Canada from pharmacies:

  • Date of incident
  • Type of incident (e.g., incorrect drug, incorrect strength/concentration)
  • Discoverer of incident (e.g., pharmacist, technician, patient)
  • Medication system stages involved in the incident (e.g., order entry, dispensing, administration)
  • Medication(s) involved (e.g., medication name, strength)
  • Degree of harm to patient due to incident (e.g., no harm, harm)
  • Description of the incident
  • Gender, and age range of patient (optional)
  • Incident background information (optional)
  • Contributing factors of the incident (e.g., miscommunication of drug order) (optional)

A reminder that we do not collect incident data that may identify an individual or an organization. Pharmacies submitting incident data must ensure that all identifying information is removed before submission. ISMP Canada has a privacy program to guide handling of information by its employees. As part of the program, we have completed a privacy impact assessment (PIA). Our Privacy Policy is available at www.ismpcanada.ca/about/#privacy. In accordance with our policy, the data is used by ISMP Canada only for the purposes of analysis, recommended actions to improve medication safety, and shared learning.

The reporter will be provided with login credentials that allow for viewing individual pharmacy data and aggregate data from the CPhIR incident database. Such aggregate data is for your information only and cannot be published without written permission from ISMP Canada. ISMP Canada reserves all rights in the use of the CPhIR platform. ISMP Canada may from time to time implement updates to the reporting and submission processes. All pharmacies will be provided with notice of any changes.

There is an annual fee of $340 that includes a $70 NIDR data processing fee and complimentary use of the Community Pharmacy Medication Safety Self Assessment (MSSA). The fee schedule is outlined in the CPhIR Pricing Page.

This Data Sharing Agreement shall remain in effect until (i) ISMP Canada is notified by the pharmacy that the agreement has been cancelled; or (ii) ISMP Canada notifies the pharmacy of a change in the agreement. ISMP Canada will periodically conduct a reconciliation process with the New Brunswick College of Pharmacists to ensure all licensed pharmacies have a valid signed Data Sharing Agreement.

If you have any questions, please do not hesitate to contact the CPhIR team at ISMP Canada by email cphir@ismpcanada.ca, or phone 416-733-3131 or 1-866-544-7672.

Thank-you,

Carolyn Hoffman, CEO
Institute for Safe Medication Practices Canada info@ismpcanada.ca www.ismpcanada.ca
4711 Yonge St, Suite 706, Toronto, Ontario M2N 6K8,
416-733-3131 or 1-866-544-7672 Fax: 416-733-1146

Cc:
Enna Aujla, ISMP Canada
Sylvia Hyland, ISMP Canada

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Enter your Pharmacy Information

I acknowledge that I have read and understood the above and agree to submit de-identified medication incident data to the ISMP Canada Community Pharmacy Incident Reporting (CPhIR) Program.

Pharmacy Manager's Signature

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Please select the appropriate box.

Note: If you are a new CPhIR user, please select the first option

Once the form is submitted, you will be contacted by ISMP Canada to arrange payment.

The registration information, a copy of the completed DSA, and the account username and password will be sent to the email address on your account registration once it has been reviewed by ISMP Canada.