Building Capacity in our Physician Community

Building clinical content (decision, documentation and inquiry supports) for Connect Care remains a top priority for committees, councils and specialty workgroups. We strive for an exemplary clinical information system (CIS) that will truly serve our vision of better information for better health. But even a perfect system will disappoint if we lack capacity to adopt it into day to day care, or to continually enhance its application for clinical improvement.

We've been building CIS capacity in the physician community for some time now. Excellent clinical informatics leadership, change management and knowledge translation capabilities have emerged. A few numbers give measure to these accomplishments:
  • Over 70 physician leaders are oriented, trained, supported and mobilized province-wide through the CMIO portfolio, including associate CMIOs (5), design leads (5) and medical informatics leads (61). They serve the Connect Care initiative, their zones and clinical areas and have enduring key roles in leadership, engagement and adoption.
  • 7 physician builders are fully certified, 27 have attended at least one builder course and up to 30 per year can be skilled-up for the next 3 years through the clinician builder program. Builders already accelerate clinical system design and will have pivotal roles in post-implementation optimization.
  • Over 150 physicians have completed CIS basic training, a handful have advanced to become power users and many more will attain super user skills. The resulting awareness has already improved committee and council functions while allowing CIS demonstrations to shift from from vendor to client.
  • Over 60 physician clinical guidance leads empower order set, decision support and other clinical content development.
  • 2 out of the expected 16 provincial physician trainers are already appointed and will guide recruitment of 40 area physician trainers and 6 medical informatics education leads to team with power users and super users supporting physicians transitioning to Connect Care.
  • 6 clinical informatics specialists help knit all these groups together, guided by a strategy for building capacity to adopt and use Connect Care.
Whatever else happens, Connect Care empowers Alberta's physician community to optimize practice in a digitally-enabled healthcare workplace.


Accessing Historical Data after Connect Care Launch

With implementation of Connect Care, Alberta Health Services (AHS) will transition from many health information systems to a single clinical information system (CIS). This ensures that all health data adheres to common definitions, is appropriately linked to health events, providers and decisions, and can be combined in ways that promote better health with better information.

Ideally, the Connect Care CIS would absorb all health data ever assembled by AHS. Unfortunately, such historical data may not adhere to the normal ranges or other properties needed to assure safe use of clinical decision supports, documentation tools and quality improvement. Messy data could clutter or confuse Connect Care. Also, not all data has equal clinical value.

Data conversion is about how historical health information is selected and managed for transfer to Connect Care. Considerations include which information to transfer, how it should be transformed, how much to include and how to make it accessible.

A Connect Care Data Conversion Committee has reached out to physicians, clinicians, leaders and technical experts across Alberta to get input about data conversion strategies and choices. Conversion principles emphasize assessment of clinical need, data quality, compatibility, safety, cost, post-conversion validation and user training.

It has become clear that not all historical data can or should be converted. That does not mean that it will not be available to clinicians and decision-makers. Important information will be readily available for as long as needed to support care. Access options include:
  • The Alberta Netcare Portal electronic health record, which can be launched to a specific patient record from within Connect Care. 
  • Non-Connect Care health information systems maintained in a read-only state for an appropriate time period.
  • Abstracts of high-value information attached to the Connect Care record.
  • Archiving solutions that can be linked to Connect Care.
In any case, legacy health records will be retained as needed for clinical, legal or secondary use. An “Information Disposition and Application Retirement” (IDAR) project will manage archival patient information from retired health information systems.


Physician Readiness Workshop

We are excited to anticipate an in-person gathering of medical and informatics leads in Calgary October 24, 2018. Zone and associate zone medical directors, Associate CMIO, Medical Affairs, Connect Care and other stakeholders will focus on how we can optimally organize for Connect Care implementation.

Topics include physician training, capacity-building, CIS readiness, CIS competency assurance, meaningful CIS use, physician incentives and balancing provincial and zone accountabilities in these topic areas. This work will accelerate a wide range of CIS readiness activities, helping to prepare physician communities for effective CIS uptake and ongoing use. Background information is provided to all participants. Please direct questions to cmio@ahs.ca.


Connect Care Leaders' Toolkit Updated

The Connect Care Leaders' Toolkit gathers and organizes useful resources that can help clinical and operational leaders prepare for clinical information system (CIS) implementation.

The toolkit presently includes downloadable document and presentation materials that give an overview of Connect Care and address frequently asked questions.

The Toolkit is modular. Different sections cover the Who, What, When, Where, Why and How of Connect Care. This makes it easy to organize and deliver communication campaigns.

The toolkit is dynamic. New information and materials are added as the Connect Care journey progresses. Recent updates include "conversation starters" and a preview of the Connect Care Readiness Playbook.


Connect Care Training for Prescribers

A clear and well-resourced training plan is essential for successful Connect Care clinical information system (CIS) implementation. End-user engagement, change management and CIS adoption all hinge on effective training, especially for a large organization with a diverse and dispersed workforce. Connect Care training must additionally recognize the needs of partner organizations, educational institutions and diverse professional groups.

We are particularly sensitive to the difficulties prescribers (including physicians) may face when training to use the Connect Care CIS. Wide consultation has helped shape a prescriber-friendly training strategy that makes the most of AHS experience, best advice from like Epic clients and evidence about physician skill development. Training principles have been devised and ratified, a FAQ initiated (this will continue to grow) and trainer recruitment is well underway.


Connect Care First Anniversary!

Although the Connect Care initiative has been forming for many years, it is almost exactly one year since the AHS contract with Epic Systems was signed and Connect Care began a new phase.

How much has changed! Connect Care has gelled as a truly provincial initiative. Diverse professions, programs, patients and partners have come together to promote a common purpose. The scale of collaboration is extraordinary, possibly a defining event for our decade-young organization.

Here's just a few of the many accomplishments to celebrate:
  • Adopting an innovative provincial oversight strategy, with committees, councils and advisory groups providing governance, advocacy and community connection.
  • Engaging thousands of experts so that Connect Care reflects their needs and aspirations. 
  • Planning and managing six high-impact Direction Setting and Adoption & Validation conferences in just eight months. 
  • Laying the foundation of our new system through extensive design and build work, with many thousands of workflow decisions, and all core clinical system design, already complete. 
  • Preparing for implementation with wireless infrastructure, launch sequencing, data conversion, training strategies, readiness preparations and capacity-building well under way.
  • Supporting over 60 specialty workgroups as they guide customizations for their areas.
  • Certifying over 250 configuration and training staff, plus many physician builders, all contributing to our design and build.
  • Distilling widely divergent scales, measures and flowsheets in to a strong set of validated tools for provincial use.
  • Embraced productive collaboration, not only between clinical, operational, corporate and IT teams, but with a vibrant group of patient advisors embedded at all levels of oversight and guidance.
Profuse thanks to all who have stepped up to put their time and effort into this ground-breaking initiative!

Anniversary highlights are nicely summarized by our CEO:


Results & Reports Routing Workgroup

Closed-loop results & reports routing is about how the outcomes of interventions ordered by prescribers are communicated back to the right person in the right way at the right time, with assurance that the information has been received and managed. A new Connect Care workgroup, co-chaired by Dr. Sid Viner and Dominic Orser, has started work to ensure that Connect Care expresses best possible practice. We will report back about progress and outcomes.


Edmonton Zone: Nov 9 2018 Medical Staff Society lecture about Information Continuity

The next EZ Medical Staff Society Leadership lecture is on November 9, 2018 at 0700 to 0900 in the Bernard Snell Hall, with videoconferencing to all sites in the Edmonton Zone.

There will be a film presentation of The Greg Price Story, followed by a Leadership Round-table.  The film focuses on Greg Price, a 31-year-old Alberta man, who died in 2012 of complications from testicular cancer and his 407-day journey in the health care system.  Greg's death was investigated by the Health Quality Council of Alberta (HQCA). Released in December 2013, its report exposed gaps in health information flows.

Falling Through The Cracks, Greg's Story is a 30 minute film showing what Greg encountered during his fateful journey through the health system.  The Price family produced the film, with Dr. Ward Flemons providing the medical guidance as lead investigator for the HQCA report. Mr. David Price, Greg’s father, and Teri Price, Greg’s sister, will present and discuss the 30-minute film from a family perspective.  A leadership round-table will include Dr. David Zygun, Dr. Mark Joffe, Dr. Francois Belanger, Dr. Owen Heisler, Dr. Shirley Schipper, Dr. Scott McLeod, Dr. Melanie Currie, and Dr. Narmin Kassam.

For more information:


Connect Care Resources for Clinicians

Physicians and other prescribers who want to learn about Connect Care, or follow developments, may find the following one-pager helpful. It lists web pages, handbooks, blogs and email contacts matched to different levels of interest and engagement. The resource list is recently updated.


Second Provincial Physician Informatics Leads Workshop

A big thanks to the many physician leaders who gave so generously of their time and energy to participate in the second provincial Connect Care physician leads meeting (September 27) in Calgary. The half-day session focused on:

  • Connect Care Training - with review and input to physician training principles, curriculum planning, certification and participation plans.
  • Clinical System Design - with updates about immediate specialty customization priorities and strategies for speeding the work of Area Councils and Specialty Workgroups as they grapple with CSD work packages.
  • Orderset Design - with ratification of a strategy for leveraging knowledge leads, knowledge topic leads and clinical informatics leads to accelerate implementation of a modular approach to producing the many order sets that Connect Care will express at implementation.
  • Demonstration Support - with demonstration of processes and methods for accessing and mastering Connect Care online environments that can be used to support design and engagement activities.

A gathering of so many talented clinicians — all readied, committed and attached to Connect Care transformation — is a “tipping point” accomplishment. More important than any number of workflow, design or content decisions, is an organized clinician community that can continue to observe, learn and decide about clinical information system optimization well into the future. Our executive, design, informatics, builder and training physician leadership is established and ready. Networked provincially, this increasingly impactful community is a key to Connect Care success.

Many physician informatics leads helped prepare for, or even deliver, Connect Care Adoption & Validation 3 sessions. Participants remarked at the fundamental shift this represents… we can see ourselves in a system shaped to our purpose.

Physician leaders also continue tireless service to Connect Care committees, councils, specialty workgroups and projects. We are at provincial peak-effort right now and must somehow continue the clinical system design (CSD) sprint through the next 3 months. Getting solid foundational content will pay dividends for decades.