New User Request Form

Overview

HealthInfoNet’s participants may request Clinical Portal access for individuals serving their organization. The following sections describe the process by which participants can choose to request new user accounts.

Process Requirements

During Initial Onboarding

In order for participants' Account Authorizers to request new user accounts for their organization during the initial technical onboarding process to connect to the Clinical Portal, they must follow these steps:

Obtain access to the appropriate version of the Clinical Portal New User Request Form based on their organization's configured secure connection option (i.e., virtual private network (VPN) or two-factor authentication (2FA)).
Populate the form with the desired new user attributes, per the Field Requirements section below.
Save the form:
1. as an Excel .xlsx file
2. with a file name of “Clinical Portal New User Request Form: [organization_description] [today’s date: mmddyyyy]” (e.g., “Clinical Portal New User Request Form: Acme Facility 03062023”)
Share the populated form via email with HealthInfoNet’s Customer Care team for account creation.

Following Initial Onboarding

Participants Accessing the Clinical Portal via VPN Connection

When initially connected to the Clinical Portal, participants' Account Authorizers will be credentialed as Help Desk users. This user role provides Account Authorizers with the necessary self-service functionality to create and manage user accounts for their organization’s authorized end users on an ongoing basis. To learn more, visit the section on the New User Request Function.

Should Account Authorizers opt not to leverage the Help Desk user role to perform user management, they must continue to complete the Clinical Portal New User Request Form (VPN) for all new user requests. Please refer to the section above for a full overview of the steps involved in requesting new user accounts through HealthInfoNet’s Customer Care team.

Participants Accessing the Clinical Portal via 2FA Connection

At this time, the Clinical Portal does not support a Help Desk user role for participants accessing the system via 2FA connection. For that reason, Account Authorizers must continue to complete the Clinical Portal New User Request Form (VIP) for all new user requests. Please refer to the section above for a full overview of the steps involved in requesting new user accounts through HealthInfoNet’s Customer Care team.

File Field Requirements

The following table outlines the fields included in each version of the Clinical Portal New User Request Form template, and each field’s requirements.

Clinical Portal New User Request Form (VPN)

Field Name	Field Description	Required
request_dt	The date when the Account Authorizer requested the new user’s Clinical Portal account.	Y
user_fname	The first name of the requested new user.	Y
user_lname	The last name of the requested new user.	Y
user_email_address	The email address of the requested new user.	Y
user_job_title	The job title of the requested new user.	Y
user_credential_1	The primary medical credential of the requested new user.	N
user_credential_2	The secondary medical credential of the requested new user.	N
user_npi	The National Provider Identifier (NPI) value of either (a) the user or (b) the provider who the user is a delegate of for the purposes of the Prescription Monitoring Program (PMP).	N
user_dea	The Drug Enforcement Administration (DEA) value of either (a) the user or (b) the provider who the user is a delegate of for the purposes of the Prescription Monitoring Program (PMP).	N
user_organization	The name of the organization to which the new user should be associated for system auditing purposes.	Y
user_clinical_portal_id	The desired Clinical Portal User ID of the requested new user. This may not be the user’s email address.	N
user_clinical_portal_role	The desired Clinical Portal User Role of the requested new user. Valid values include: Clinician - This user role provides clinical staff with functionality to look up and retrieve patients' electronic health records, as well as to subscribe to real-time, event-based notifications for defined patient panels. For more information about the features and functionality available with this role, visit the section on Clinician Features. Auditor - This user role provides self-service reporting functionality required by privacy/compliance officers and/or support staff to review patient health record accesses and activities by their organization’s authorized end users. For more information about the features and functionality available with this role, visit the section on Auditor Features. Help Desk - This user role provides self-service functionality required by help desk personnel and IT support teams to create and manage user accounts for their organization’s authorized end users. For more information about the features and functionality available with this role, visit the section on Help Desk Features.	Y
welcome_email_address	The email address to which the new user account information should be sent.	Y
cc_welcome_email_address	The additional “cc’d” email address to which the new user account information should be sent.	N

Clinical Portal New User Request Form (2FA)

Field Name	Field Description	Required
request_dt	The date when the Account Authorizer requested the new user’s Clinical Portal account.	Y
user_fname	The first name of the requested new user.	Y
user_lname	The last name of the requested new user.	Y
user_email_address	The email address of the requested new user.	Y
user_job_title	The job title of the requested new user.	Y
user_credential_1	The primary medical credential of the requested new user.	N
user_credential_2	The secondary medical credential of the requested new user.	N
user_npi	The National Provider Identifier (NPI) value of either (a) the user or (b) the provider who the user is a delegate of for the purposes of the Prescription Monitoring Program (PMP).	N
user_dea	The Drug Enforcement Administration (DEA) value of either (a) the user or (b) the provider who the user is a delegate of for the purposes of the Prescription Monitoring Program (PMP).	N
user_organization	The name of the organization to which the new user should be associated for system auditing purposes.	Y
user_clinical_portal_id	The desired Clinical Portal User ID of the requested new user. This may not be the user’s email address.	N
user_clinical_portal_role	The desired Clinical Portal User Role of the requested new user. Valid values include: Clinician - This user role provides clinical staff with functionality to look up and retrieve patients' electronic health records, as well as to subscribe to real-time, event-based notifications for defined patient panels. For more information about the features and functionality available with this role, visit the section on Clinician Features. Auditor - This user role provides self-service reporting functionality required by privacy/compliance officers and/or support staff to review patient health record accesses and activities by their organization’s authorized end users. For more information about the features and functionality available with this role, visit the section on Auditor Features. Help Desk - This user role provides self-service functionality required by help desk personnel and IT support teams to create and manage user accounts for their organization’s authorized end users. For more information about the features and functionality available with this role, visit the section on Help Desk Features.	Y
user_2fa_id	The Credential ID stored in the user’s Symantec 2FA application(s). Additional Notes: If a user has installed the Symantec 2FA application on multiple operating devices in order to access the Clinical Portal from each of their workstations, the Credential ID will be specific to each installed application. For that reason, the Account Authorizer must provide each of the Credential IDs across all of the user’s installed applications to ensure seamless access. If a user has replaced an operating device that previously had the Symantec 2FA application installed, and the user chooses to re-install the application on the new device, the Credential ID will change with the new install. For that reason, the Account Authorizer must provide the new Credential ID for the user.	Y
welcome_email_address	The email address to which the new user account information should be sent.	Y
cc_welcome_email_address	The additional “cc’d” email address to which the new user account information should be sent.	N