Physician Access to Digital Records when Patients Complain

​In mid-August 2016, the Office of the Information & Privacy Commissioner of Alberta (OIPC) publicly reported its investigation into the alleged misuse of EHR records by two physicians who were responding to a patient complaint about the quality of their care, in the case Gowrishankar v JK. There have been developments since we last explored possible implications of this case.

The two physicians, with AHS and the AMA as interested parties, appealed the OIPC’s decision.  In January 2018, the Court of Queen’s Bench of Alberta released its decision on the appeal.  It did not change the majority of the OIPC’s findings, but the Court did find that the physicians’ use and disclosure was in compliance with the Alberta Health Information Act.

In February 2018, the patient appealed the decision of the Court of Queen’s Bench of Alberta to the Court of Appeal of Alberta.  While the appeal to the Court of Appeal is outstanding, the AHS policy and procedures related to the use and disclosure of health information remain the same and should be followed.
A backgrounder and FAQ express AHS’ understanding of the information and disclosure processes, along with appropriate documentation, implicated in the case and its appeal.

• OIPC Order: ahs-cmio.ca/oipc201606
• AHS Advice: ahs-cmio/oipc201606advice

Connect Care Validation & Adoption #1 a Success

Adoption & Validation is one of the major activities occurring during design of the Connect Care clinical information system (CIS). The relationships between design and build activities are summarized in an online presentation: How the system is built. The first Adoption & Validation session occurred last week at the Calgary Telus Convention Centre and was a big success.

The formal sessions proved very helpful to those working to shape the AHS CIS. Lots of good discussion tapped expertise and experience from all corners of the province. Many groups, including Area Councils, Specialty Workgroups and Committees took opportunity to meet and tackle complex issues. Indeed, the intensity and productivity of these “un-sessions” reflect how far we’ve come in just over half a year. Connect Care goals are taken for granted. Stakeholders are deeply engaged, and a problem-solving spirit moves us forward more than any leadership team could have hoped for.

Physician leads gathered at various times during the week, including a standing-room-only discussion about mobile solutions. The group resolved to hold similar meets at upcoming sessions, each addressing a theme of particular interest to physicians.

The next Adoption & Validation session will take place in Edmonton, August 14 to 16, 2018.

• Presentation: How the System is Built
• Byte: Adoption & Validation

AHS Recognized for Integration Accomplishments

Befitting our Connect Care ambitions, AHS has recently been cited among the top 5 organizations worldwide for health system integration. And we've only just begun!

• Stoney Plain Reporter News Article

Connect Care June 15 Newsletter Posted

The June 15, 2018, Connect Care Newsletter is available via the link below, covering clinician overview training, how transfusion medicine will be supported in the clinical information system (CIS), and an upcoming Adoption & Validation session in Calgary.

• Connect Care Newsletter - June 15, 2018

Great Presentation about End-user Device Integration with an Enterprise Clinical Information System

Connect Care is at a critical juncture when decisions about workplace reorganization prepare for radically different information flows in busy inpatient workplaces. We continue to carefully consider experiences of other clinical information system implementers.

Dr James King (CMIO, Children's Hospital of Eastern Ontario) describes systematic efforts to understand optimal intersects between devices, applications and clinical work in a superlative recent presentation. Well worth the viewing!

• Canadian Association of Paediatric Health Centres Knowledge Exchange Presentation

Why should nursing care about Connect Care?

Thanks to Tim Graham for relaying this nice tidbit...

The Connect Care initiative was presented at the MEDICINEcares Conference 2018 in Edmonton last week. Attendees participated in a Menti feedback activity, generating a word cloud from the question "What makes you most excited about Connect Care?":

• MEDICINEcares Conference 2018 Information
• Menti Surveys (code 10 22 88)

Artificial Intelligence for Connect Care

Applications of artificial intelligence (AI) and machine learning have moved from theory to practice, with exciting opportunities to improve health care and outcomes. Still, the field is new and mysterious to many. Media controversy can add to the confusion.

As we progress with Connect Care clinical system design (CSD), the AI strengths of Epic Systems and Alberta stakeholders are exposed, with promise of excellent collaboration and exciting possibilities. With system-wide informational integration, we anticipate improved insight about how care is provided, with what results. The Connect Care Clinical Improvement Support Committee already deliberates about implementation of AI-enabled predictive analytics and precision medicine supports.

The time is right for Connect Care stakeholders to build a pragmatic understanding of AI, machine learning, precision medicine and personalized medicine. A recent short Economist piece gives a good starting point:

• Economist Update about AI in Medicine
• Alberta Machine Intelligence Institute
• Machine Learning at the University of Alberta
• Artificial Intelligence in Healthcare (TED)
• Cumming School of Medicine - What is Precision Medicine?

Toronto SickKids Go-Live

We are thrilled to hear that the Toronto SickKids hospital has gone live with the Epic clinical information system enterprise-wide. AHS and SickKids leadership are in close communication, enabling sharing of lessons learned. Great to be in great company!

• SickKids Website
• SickKids MyChart (patient portal) offering

Understanding Training Needs

Before Connect Care training supports can be designed for Alberta Health Services (AHS) clinicians, physicians and staff, their roles, responsibilities and clinical information system dependencies need to be better understood.

Clinical information system training programs will, as much as possible, reflect how new skills can be acquired most efficiently. Among other things, job shadowing is used to get closer to frontline learning styles, and to appreciate how roles and capacities vary across the province. The Connect Care Clinical Operations team is reaching out to program and service leaders to request these and other discovery opportunities.

Connect Care June 1 Newsletter Posted

The June 1, 2018, Connect Care Newsletter is available via the link below, covering new work to understand how workforce roles relate to the clinical information system (CIS), what clinicians who do not use an Alberta Health Services health record can expect from the CIS, and recent refinements to Connect Care communication channels.

• Connect Care Newsletter - June 1, 2018