2020-02-16

On other Channels...

Thank you for continuing to check (... ideally, subscribe to; see right sidebar instructions) the Connect Care Updates blog for physicians. Some recent postings from other channels of general interest:

2020-02-15

Connect Care Waves 2-3 Countdown Checklist

Starting a list of essential actions for Wave 2-3 physicians readying for Connect Care Launch May 30, 2020...
  • Bookmark Connect Care Countdown Checklist 
A countdown checklist can help physicians to get ready for their Connect Care launch by breaking a complex undertaking into a series of simple tasks. The order is important; starting with the actions needed to do future work without hassle.

Each checklist item includes brief explanatory notes plus links to relevant tips, demonstrations, resources or guides.

Please subscribe to this blogging channel, where all checklist items are posted. You can also bookmark the checklist-only link and check-in periodically.

2020-02-14

Physician Resources Editorial Board

The Connect Care updates (blogs.connect-care.ca), physician manual (manual.connect-care.ca), web pages (connect-care.ca) and other supports for physicians increasingly balance the stabilization needs of Wave 1 with the readiness needs of Waves 2-3. Tips and guides are tweaked to reflect first launch learnings, while ensuring that these address upcoming launch contexts.

A CMIO editorial board was established in late 2019. It meets weekly now, busy with the work of ensuring that training, news, social media and other communications are consistent, physician-aware,  and optimized for the current state of our Connect Care journey.

We hope that users will find fewer gaps in the Manual; with guidance consolidated in fewer points of access. Indeed, the Manual is a gateway to all other resources.

2020-02-13

Connect Care Reporting Content Certification

With the Wave 1 launch behind us, we are working to ensure the Connect Care in-system dashboards, metrics and reports are working as expected.

We know that many measures (e.g., lab utilization, minimum use norms compliance, etc.) will take months to stabilize. The clinical information system will not have solid metric denominators until at least the six month mark. In addition, we need to confirm that what is measured adequately represents what is supposed to be measured. This will be an iterative process. We are not hiding reports, but we need to be transparent about which measures have been tweaked sufficiently to be trustworthy. To accomplish this, we are using a certification process with easy-to-recognize visual data quality markers.

Why are we verifying reporting measures now, after the Wave 1 launch?
Prior to the Wave 1 launch, all reporting content was carefully validated. But this had to use test data, as there were no real patients in the system. Now we verify the validated measures using the data that Connect Care has captured and stored. The verification process is called certification.

How will I know if a measure or report has been certified?
Once a given dashboard or report is certified, a ribbon icon will appear on the screen in Connect Care. A blue ribbon appears on certified Dashboards, a purple ribbon appears on certified Reporting Workbench reports and an orange ribbon indicates certified Crystal reports.

What if the content I need has not been certified yet?
All reporting content should be used with caution, as there may be variation and inaccuracies until certification is complete. Even then, one must always apply clinical common sense; alert to possible anomalies in how source information is entered, for what purpose, and with what consistency.

Will prescriber-identifiable information be visible?
No. AHS is committed to not expose identifiable data about prescribers (physicians and others). Should you encounter any examples of physician-identifiable information, please report it to the Clinical Inquiry Support Unit at cisu@ahs.ca.

Which measures are priority for early certification?
Our first focus is on measures that support real-time clinical and operational decision-making about health service delivery. Five areas receive early attention: Emergency Departments, Operating Rooms, Capacity Management, Patient Safety and Launch Dashboards.

Where can I get more information?
If you are a Wave 1 user with questions about content certification, contact us at ConnectCare.WMCImplementationTeam@ahs.ca.

2020-02-12

Connect Care Optimization Clinic #9 - Clinical Communications

Optimization clinics are facilitated by peers and focused on challenging use cases. A short presentation is followed by questions, discussion and suggestions from participants. User supports are updated in the Physician Manual and Physician Updates.

A ninth Connect Care Optimization Clinic is offered in a single session at noon on February 19. All are welcome.

Topic: Clinical Communications
  • Facilitator: Rob Hayward & team
  • Date: Wednesday, February 19, 2020
  • Time: 1200-1300
  • Description:
    • Connect Care offers a number of communication tools that clinicians can take advantage of when coordinating care. These include commenting, messaging, tasking and secure chat capabilities.
    • This session will distinguish the different categories of communication tools, highlighting matching communication needs.
    • Demonstrations include 5 types of sticky notes, different In-Basket mailings, In-Basket reminders and secure chat.
    • New Connect Care communication norms will be introduced
  • Preparation:
    • If you’ve never used Zoom, the Webinar software used for the clinics, we recommend you do a test call prior to the session here: https://zoom.us/test.
    • Short demo videos on how to participate in a call can be found here: https://zoom.us/resources

2020-02-11

All-User Bulletin: Professional Billing with Mobile Apps

All-user-bulletins highlight stumbling blocks that all physicians need to be aware of when using the Connect Care clinical information system.

Professional Billing with Mobile Apps
Connect Care applications for smartphones (Haiku) and iPads (Canto) support rapid charge recording for physicians who use Connect Care for professional billing documentation and/or claims submissions.

Unfortunately, instances have been discovered where the mobile billing function does not filter viewable claims to those of the currently signed-on user. The mobile filtering problem proves more complicated than any quick fix can solve. Epic is working on the problem.

A multi-stakeholder group has arrived at the difficult decision to turn off professional billing in Connect Care mobile applications (Haiku and Canto) until the charge filter problem is fixed. Full functionality remains in Hyperspace and no personalizations or existing submissions are affected. 

2020-02-10

Connect Care February 2020 Calendar

A summary of key Connect Care happenings in February 2020 has been posted to the Alberta Health Services (AHS) internal Connect Care website, linked below.

2020-02-09

On other channels...

Thank you for continuing to check (... ideally, subscribe to; see right sidebar instructions) the Connect Care Updates blog for physicians. Visiting periodically is sufficient to keep up with key developments as Connect Care progresses from first launch to deployment throughout Alberta.

This blog is complemented by a number of "channels", each accessed via one of the navigation buttons above or a link in the list below:
Some recent postings from other channels of general interest:

2020-02-08

Connect Care Wave Sequencing Update


Following extensive consultation, it proves necessary to shift the timing for Waves 4 and 5 of the ongoing province-wide roll out of Connect Care. Patient care and safety, as always, were the prime considerations.  Other factors include:
  • New Grande Prairie Regional Hospital (GPRH): Connect Care must be deployed at the existing Queen Elizabeth II hospital, so that staff and physicians are fully trained and stabilized begin to serve patients in the new facility designed for digital records. With a commissioning date now set, it is necessary to move up launch for affected sites and services in North Zone.
  • Reducing the length of high risk transitional states: large hospitals in the Edmonton Zone are in an interim state between Connect Care rollouts, with particular challenges because needed support systems are retiring and results are hard to route appropriately. 
As a result of this sequencing adjustments:
  • Some sites and services in the North Zone (which currently use the Meditech clinical information system) move from Wave 5 to Wave 4. This includes the Queen Elizabeth II hospital. 
  • Some sites and services in the Central Zone (which currently use the Meditech clinical information system) will, by necessity, move from Wave 4 to Wave 5. 
This decision was not taken lightly and is considered the best approach based on new developments.  And further adjustments may be needed. Many changes can influence dependencies within zones and waves. We will continue to be nimble and flexible as we move forward, adapting to needs of patients, staff and physicians.



The usual Connect Care sequencing resources are kept current:

2020-02-07

Join Patient Access 2022!

Myth: Digital health is just for health care providers.

Fact: 50% of Canadians now report they can access at least one health service online, such as viewing their health information, making an appointment with a physician and consulting with a health care provider.

Providing patients with timely access to their health information is an important part of patient engagement and empowerment, which are linked to improved chronic disease management. In fact, engaged patients use less urgent and after hour services.



2020-02-06

Practical Paranoia - Celebrating our Cybersecurity Team

We've oft posted about alert fatigue and physician burnout. Despite our best efforts to design the Connect Care clinical information system for efficient interaction, we continually seek ways to reduce clinicians' total informational burdens.

A recent CHIME newsletter article describes how alert fatigue is not just for clinicians! Fascinating to read about the struggles of our cybersecurity teams, who are constantly bombarded by alerts to possible new security threats. Their work is high-stakes-high-stress. Health care organizations crippled by hackers suffer great financial, reputational and health care losses.

2020-02-05

Connect Care Optimization Clinic #8 - Patient Communications

Optimization clinics are facilitated by peers and focused on challenging use cases. A short presentation is followed by questions, discussion and suggestions from participants. User supports are updated in the Physician Manual and Physician Updates.

An eighth Connect Care Optimization Clinic is offered at two times of day (duplicate clinics) to fit clinical schedules. All are welcome. Please complete a short pre-clinic survey to share information about your needs.
  • Topic: Patient Portal Tips
  • Facilitator: Rob Hayward & team
  • Date: Wednesday, February 12, 2020
  • Pre-clinic Needs Survey: ahs-cis.ca/clinic-8-survey
  • Time #1: 0700-0800
  • Time #2: 1200-1300
  • Description:
    • The MyAHS Connect patient portal launched with Wave 1 on November 3, 2019. Although some functions (e.g. self-scheduling) are only available to requesting clinics, features like secure communications have been turned on for all clinics.
    • It is important for prescribers to understand how patient messaging works, how messages can be attached to test results, and what happens when patients initiate a message to a clinician. 
    • We will highlight preparations that clinics need in order to use patient messaging safely.
  • Preparation:
    • If you’ve never used Zoom, the Webinar software used for the clinics, we recommend you do a test call prior to the session here: https://zoom.us/test.
    • Short demo videos on how to participate in a call can be found here: https://zoom.us/resources

2020-02-04

Connect Care Scheduled Downtime - Thursday February 13, 2020, 00:30-04:30

The Connect Care production environment (PRD) needs periodic maintenance. This allows system fixes and updates to be installed without risking database content. Updates will be more frequent this spring as we ready for a quarterly upgrade.

The next scheduled update will occur Thursday February 13, 2020 in the early morning hours of (between midnight 00:30 and 04:30).  PRD  and the provider portals will be affected.

While PRD is offline, access to "PRDSRO" remains. This is a read-only copy of the most recent production (PRD) and allows all patient data to be reviewed. Any urgent orders or documentation that must be completed while PRD is offline can be handled through a combination of paper, eScription (provincial dictation) and Netcare activities. Try to postpone and avoid use of paper, as PRD is likely to be restored quickly.

Any paper ordering or charting will be uploaded by support staff once the downtime finishes. Physicians will want to validate this work. Charting deficiency notifications may appear later in In-Basket but can be addressed with the smartphrase ".DOWNTIME".

Additional instruction remains available in the Connect Care Physician Manual:

2020-02-03

Alberta Health Services Performance Review Released

Alberta Health contracted Ernst and Young to conduct a performance review during 2019. The review recommendations are now available and subject of intense work to see how opportunities for improvement can be actioned.

While the Connect Care initiative was not in scope for this review (there is a separate external review looking at health information systems provincially), the report highlights a number of benefits that the provincial clinical information system can help realize. In general, the report is positive about Alberta Health Services achievements and prospects.

For more information:

2020-02-02

Connect Care Optimization Clinic #7 - Intra-facility Transitions

Optimization clinics are facilitated by peers and focused on challenging use cases. A short presentation is followed by questions, discussion and suggestions from participants. User supports are updated in the Physician Manual and Physician Updates.

A seventh Connect Care Optimization Clinic is offered at two times of day (duplicate clinics) to fit clinical schedules. All are welcome. Please complete a short pre-clinic survey to share information about your needs.
  • Topic: Intra-facility Transitions
  • Facilitator: Tim Chan
  • Date: Wednesday, February 5, 2020
  • Pre-clinic Needs Survey: ahs-cis.ca/clinic-7-survey
  • Time #1: 0700-0800
  • Time #2: 1200-1300
  • Description:
    • Transitions of care (from one provider, team or site to another) can occur within (intra) or between (inter) facilities. This session explores workflows when physicians hand over patient care to other providers, patients move from one service to another (intra-facility) or from one context to another (e.g., ICU to ward). 
    • We will highlight gaps to avoid and tricks for efficient transitions.
  • Preparation:
    • If you’ve never used Zoom, the Webinar software used for the clinics, we recommend you do a test call prior to the session here: https://zoom.us/test.
    • Short demo videos on how to participate in a call can be found here: https://zoom.us/resources

2020-02-01

Epic top of Klas yet again!

Epic System's electronic health record software, the centrepiece of Connect Care's clinical information system (CIS), continues to excel in the 'Best in KLAS' awards... for a 10th straight year!

The 2020 awards, based on an annual survey of health information system users (including opinions of physicians and other health care decision-makers from >4,500 hospitals and >2,500 clinics), go to Epic in the categories of Inpatient (Acute Care), Outpatient, Application Hosting, Practice Management and Patient Portals.

We are happy to work with such a strong technology partner!

2020-01-31

Allen Ausford Presents Alberta's Experience with Interoperation

The Canadian Health Care Technology "Sharing Health Information Success Stories" series features Dr. Allen Ausford, a Connect Care Medical Informatics Lead (and co-chair of the Clinical Decision Support Committee) for its January webinar.

Allen speaks about Alberta's experience with the Netcare health information exchange. This pulls information from diverse sources so that clinicians can view key health information about patients they serve.

The 45 minute presentation is recorded with the help of Orion Health:

2020-01-30

Wave 2-3 Workflow Walkthrough February 5, 2020

With the Connect Care Wave 2-3 launch (May 30, 2020) getting closer, there are more opportunities to validate how the clinical information system (CIS) will support workflows at new launch sites.

"Workflow Walkthroughs" allow clinicians to see how Connect Care can support clinical work. A Walkthrough event includes demonstration of one or more high-risk, high-complexity, multidisciplinary or high-volume workflows. Patient journey videos are interspersed with feedback and discussion opportunities. The goal is to discover what more we need to do to get the system attuned to specific site challenges.

The Wave 2-3 Walkthrough event will be held February 5, 2020, at a variety of locations, including online, supported by Skype teleconferencing. The Workflow Walkthrough videos are available on Insite (links below).

  • 08:15 - Welcome and Introductions
  • 08:30 - End-to-end Patient Journey
  • 09:00 - Scheduling and Registration Demonstration
  • 09:50 - Rural Nursing Workflow
  • 11:00 - Long Term Care 
  • 12:35 - Ambulatory Care
  • 13:10 - Labour and Delivery
  • 14:10 - Surgical Workflows

Although all interested physicians are encouraged to contribute, the Walkthrough event spans an entire workday. Only some parts will pertain. Please take a look at the agenda and consider whether any of the blocks offer an important feedback opportunity. Session recordings will be posted on Insite afterwards.

2020-01-29

Connect Care Champions

We continue to marvel at the energy and enthusiasm of our physician informaticians. They give backbone to physician engagement and adoption.

It is always nice to see a colleague's contributions celebrated. Join us in recognizing the work of Eddie Bolster who serves as a medical informatics lead, area trainer, super user and physician builder!

2020-01-28

Automated Patient Appointment Reminders go Live

Connect Care ambulatory care clinics can leverage the efficiency of automated appointment reminders for patients with upcoming clinic, day surgery, therapy or investigation visits.

The system was integrated with the clinical information system (CIS) January 27, 2020, supporting appointments from January 30, 2020 forward. Ultimately, the system will facilitate the over 25,000 reminders daily handled by legacy processes.

The automated reminder system supplements information and instructions that are sent out via mail or MyAHS Connect (patient portal), with prospect for fewer missed appointments and improved patient choice. However, it is important for physicians to ensure that their clinic has made the necessary arrangements, scheduling staff are ready, and that patient education materials are in-clinic.

The following resources can help physicians answer patients' questions:

2020-01-27

Connect Care Waves 2-3 - Timeline

As Connect Care wave 1 continues to stabilize, preparations accelerate for the combined waves 2 & 3 launch in May 2020.
We've previously posted about wave sequence adjustments. While work continues to further adjust for the opening of a new hospital in the North Zone, the next launch is locked-in. A timeline with key milestones can help participants and stakeholders to pace preparations:

2020-01-26

Downtime Resources for Physicians

Connect Care has its next scheduled downtime overnight (early hours of Tuesday January 28, 2020 sometime between 00:01-0400).

Straightforward instructions for physicians (which complement the more detailed Connect Care Downtime Resources at ahs-cis.ca/downtime) have been updated and streamlined:

2020-01-25

Connect Care Scheduled Downtime - January 28, 2020

The Connect Care production environment (PRD) needs periodic maintenance. This allows system fixes and updates to be installed without risking database content.

The next scheduled update will occur Tuesday January 28, 2020 in the early morning hours of (between midnight 00:01 and 0400).  PRD  and both provider and patient portals will be affected.

While PRD is offline, access to "PRDSRO" remains. This is a read-only copy of the most recent production (PRD) and allows all patient data to be reviewed. Any urgent orders or documentation that must be completed while PRD is offline can be handled through a combination of paper, eScription (provincial dictation) and Netcare activities. Try to postpone and avoid use of paper, as PRD is likely to be restored quickly.

Any paper ordering or charting will be uploaded by support staff once the downtime finishes. Physicians will want to validate this work. Charting deficiency notifications may appear later in In-Basket but can be addressed with the smartphrase ".DOWNTIME".

Additional instruction remains available in the Connect Care Physician Manual:

2020-01-24

Alberta Netcare Portal Scheduled Downtime - Feb 6, 27, 2020

The Alberta Netcare Portal electronic health record will be taken offline for scheduled maintenance during one or both of the following periods:

  • Thursday February 6, 2020, 21:00-03:00
  • Thursday February 27, 2020, 21:00-03:00
Downtime information is available:
Laboratory and other test results and reports will continue to be available in Connect Care. However, the Connect Care Netcare tab will not work during these time periods.

2020-01-23

Connect Care Optimization Clinic #6 - Speedy Orders

Optimization clinics are facilitated by peers and focused on challenging use cases. A short presentation is followed by questions, discussion and suggestions from participants. User supports are updated in the Physician Manual and Physician Updates.

A sixth Connect Care Optimization Clinic is offered at two times of day (duplicate clinics) to fit clinical schedules. All are welcome. Please complete a short pre-clinic survey to share information about your needs.
  • Topic: Speedy Orders
  • Facilitator: Rob Hayward
  • Date: Wednesday, January 29, 2020
  • Pre-clinic Needs Survey: ahs-cis.ca/clinic-6-survey
  • Time #1: 0700-0800
  • Time #2: 1200-1300
  • Description:
    • Ordering interventions (labs, meds, procedures, care, etc.) can be time-consuming, especially at admission to hospital and other transfers of care. 
    • Ordering personalizations and automations can have a big impact on prescriber efficiency, productivity and satisfaction. 
    • We will share tricks that can speed ordering workflows, with attention to both surgical and non-surgical perspectives.
  • Preparation:
    • If you’ve never used Zoom, the Webinar software used for the clinics, we recommend you do a test call prior to the session here: https://zoom.us/test.
    • Short demo videos on how to participate in a call can be found here: https://zoom.us/resources

2020-01-21

Connect Care Professional Billing Progress

There are 3 professional billing relationships that physicians can enter into with Connect Care, based upon how service claims are documented and how they are managed:
  1. Independent Charge Capture & Independent Claims Management - where physicians track and record their charges outside of Connect Care and use a third-party billing service to submit claims and manage responses.
  2. Connect Care Charge Capture & Independent Claims Management - where physicians use CIS tools to capture information to support professional billing claims, generate a report or export of the data, then use a third-party billing service to submit claims and manage responses.
  3. Connect Care Charge Capture & Connect Care Claims Management - where physicians capture charges using CIS tools and rely on the CIS and AHS billing services to take care of claims submissions and response management.
Option 3 affects many wave 1 physicians, as it applies to those employed by Alberta Health Services or contracted through alternate reimbursement plans. Both physicians, who have moved from paper to digital service documentation, and AHS, which has rapidly expanded and upskilled a central billing management service, have experienced a lot of change! Overall, uptake of Connect Care professional billing has been remarkably rapid, effective and efficient.

Of the ~400 physicians adopting option 3, 94% are already using the full Connect Care billing functionality (the remaining physicians are not active users yet). Over 115,000 claims have been entered with the majority requiring no further intervention from the physician. And information burdens steadily decrease as physicians get better at automating inclusion of needed information (like a referring physician for many billing codes).

2020-01-20

This Week in Optimization - Professional Billing

Wave 1 post-launch optimization training progresses through weekly themes; with Manual, Tip, Demo and Clinic interventions keyed to each theme.

This week's optimization theme is about Professional Billing workflows. We've learned that a few tips and personalizations can dramatically speed and ease this work. We will review billing tricks that work best in inpatient and in outpatient environments and how physicians can check the claims they have submitted.

Please take the short professional billing survey to share issues we should be aware of and address.

This week's optimization clinics (Wednesday Jan 22 at 0700 and 1200) are used to share a few tips and to learn about common issues or challenges at this stage post-launch. New or improved supports appear in physician resources throughout the week:

2020-01-19

Connect Care Optimization Review - Referral Workflows

Last week's optimization theme was about Referral and Consultation workflows. While Connect Care supports closed loop referral, we remain in an interim state as long as some services use Connect Care and others rely on fax, eReferral or other intake processes. 

An optimization clinic (Wednesday Jan 15, 2020) explored the difference between internal and external outpatient referrals. The presentation and demonstration elements were recorded and are available via a protected (AHS userid/password) link:
Participants raised a number of questions. These are addressed in updated online physician supports:
For those prescribers needing more detail, specific tip sheets and details about things like referral use of In-Basket pools, the "Referrals Guides" section of Connect Care learning home dashboards (LHD, all CMIO variants) have a wealth of practical information.

In general, those who refer can optimize workflows by skimming succinct resources in the Manual and Updates. Those participating in incoming referral management may need to avail themselves of additional LHD resources.

2020-01-18

Prescriber Workstation Preferences - Please Respond

We are eager to learn more about physician non-medical device preferences.

The Connect Care non-medical device plan includes estimates of the number of fixed (desktop, wall-mount, counter, etc.) and mobile (Workstation on Wheels [WOW], Laptop on Wheels [LOW], etc.) computers to install in different clinical environments. The Wave 1 experience suggests that prescribers have welcomed mobile workstations. This could influence future device re-distribution.

If you are a prescriber (physician, trainee, medical student, nurse practitioner, etc.) with at least ONE week of experience using the Connect Care clinical information system, please take a few moments to complete an anonymous survey about your device experience:

2020-01-17

Connect Care Oversight Refresh

Connect Care's committees, councils and advisory groups proved instrumental to a successful first launch in November 2019.

With multiple new launch waves occurring in rapid succession over the next 2 years, the time is right to review and adjust the terms of reference and membership of Connect Care oversight groups. Where CIS design, build and validation were top priorities pre-launch, matters of adoption, meaningful use and change management are top priorities going forward.

All Connect Care oversight groups participate in this refresh in the first two months of 2020: