AHS Comes of Age

We've oft commented that Connect Care is both a formative and consolidating innovation for Alberta Health Services (AHS). The initiative is possible because the organization has matured as a values-driven healthcare organization. Moreover, the initiative enables continuing transformation as a learning healthcare organization.

A recent publication nicely tallies the many AHS developments that make Connect Care possible and use Connect Care to make the AHS vision possible:


Connect Care Provincial Physician Trainer Opportunity

Alberta Health Services (AHS) is seeking up to 17 Connect Care Provincial Physician Trainers. These clinicians become key members of the office of the Chief Medical Information Officer (CMIO), aiding in the development, support and delivery of a Clinical Information System (CIS) training program for physicians and advanced care providers. The Connect Care initiative will up-skill thousands of CIS users over 3 years of implementations throughout Alberta.  The immediate need is for physician-friendly curriculum development under a clinicians-training-clinicians model.

The Provincial Physician Trainer is an AHS medical leadership position that plans, guides and manages CIS training for all physician and advanced care users in multiple AHS zones, programs, facilities and workflows. In collaboration with the Connect Care learning team, Trainers work closely with Clinical and Operations leaders to define, plan, implement and evaluate curricula that suit different roles and learning styles; while promoting smooth change management and minimal service disruption.

There are multiple Provincial Physician Trainers, each focusing on one or more of the following areas:

  • Inpatient Admitting (including General Internal Medicine; Critical Care; Medicine Subspecialties; Hospitalists; Family Medicine)
  • Surgery (including General Surgery and Surgical subspecialties)
  • Rural Medicine
  • Ambulatory
  • Gastroenterology
  • Pathology
  • Anesthesia
  • Medical Learners
  • Pediatrics
  • Cardiology
  • Obstetrics and Gynaecology
  • Psychiatry
  • Emergency
  • Oncology
  • Radiology
  • Physician Support Roles (e.g. Physician Assistants)

The Provincial Physician Trainer will be an Alberta physician who advocates effectively for AHS strategic information management initiatives, anticipates impacts on stakeholders, identifies issues and helps resolve problems. Experience with adult learning methods is strongly desired.

Applications are welcomed immediately. The posting will renew until all trainers are appointed. To learn more, please visit:


User Group Meeting 2018 #1 - A great community

The annual Epic User Group Meeting (UGM) is a truly impressive gathering! Over 60,000 converge on the Epic campus at Verona, Wisconsin, for 5 days of meetings, councils, presentations, testing and updates. With Alberta Health Services formally announced as a new enterprise community member, a number of our leaders took time to learn during a most exciting and informative week. Some first impressions are summarized in the next series of blogs, with apologies for not properly attributing.

An immediate UGM impression is that one has joined a large, capable and collaborative user community. It spans multiple continents and includes all types of health care organizations. Most clients are driven by goals akin to our Connect Care intent. More importantly, Epic community members are eager to help peers succeed. The AHS UGM presence emphasized connecting with peers, networking, and firming up a support group that includes some of the best health care organizations in the world.

Epic facilitated many meetings around the scheduled program. Short consultations with like-minded Epic clients focused on recent installs or build challenges. Frank conversations opened channels for ongoing conversation and mutual assistance. It was clear that we have a lot to gain from sharing.

We also gained confidence. AHS has undertaken a large and exceptionally complex challenge. Our difficulties are not extraordinary. Our strengths are exemplary. Many complemented us on our preparatory work to discover and reduce unhelpful variation, to unify a large health region and to guide a clinical information system initiative with transformative purpose.


Mandatory Breach Reporting

From Dr. Francois Belanger:

On August 31, 2018, Mandatory Breach reporting will come into effect in Alberta. The new provincial requirements mean Alberta Health Services and all other health custodians must report any privacy breaches to the Office of the Information and Privacy Commissioner (OIPC), the Minister of Health and any affected patient(s).

AHS, through the Information & Privacy Office, has always reported significant breaches to the OIPC. The new requirements serve to remind all of us to continue to report any privacy breaches we may encounter.

To report a breach, you must either fill out the Notification of Privacy Breach Form or e-mail the Information & Privacy Office at privacy@ahs.ca.  The Information & Privacy Office will investigate the incident and will report the breach to the OIPC and Minister of Health. Any individuals affected by the breach will also be notified.

AHS recently implemented a new Privacy Policy that encourages a culture of shared accountability. The policy includes expected behaviours and additional supports to assist all of us in protecting health information and the systems that store it. I encourage everyone to review the new policy and discuss it with your co-workers. 

Just as Albertans trust us with their care, they also trust us with their private health information. Protecting privacy enhances the overall trust in our organization and results in better healthcare and employee engagement.

Information sharing is needed to provide excellence in healthcare but accessing the health or personal information of our friends, co-workers, and other people not in our care is never appropriate.

Please visit the provided links for more information on reporting breaches or the Information & Privacy office.

Thank you for your continued diligence in keeping health information safe.


Adoption & Validation 2 Moves us Further

I again want to personally thank the clinician community for making time out of busy schedules to attend the Connect Care Adoption and Validation sessions this week in Edmonton... and all the colleagues, patients, and families for helping these clinicians be available to share invaluable contributions.

The formal sessions continue to move us forward, helping to guide our build teams as the AHS Connect Care CIS takes shape. It is gratifying to witness how the discussions reflect growing knowledge, strong understanding of our intent, and a firm sense of implementation proximity.

Many groups, including Area Councils, Specialty Workgroups and Committees took opportunity of co-location to tackle complex issues. I personally witnessed and appreciated a number of productive clinical system design workshops. More and more clinical content (documentation, decision and inquiry support) is lined up for build.

We brought together physician leads at various times during the week and on the last day enjoyed a first gathering of all CMIO, ACMIO, design lead, medical informatics lead, directors and support staff in one place at one time! Great energy. Great contributions. We grappled with the complexities of clinical system design and strategies for getting essential clinical content in place by early 2019. We were also pleased to introduce a number of proficiency-development pathways, including both the new clinician builder program and power user program. With profuse thanks to Bart and the IT team, we were thrilled to be able to show a "PLY" environment that medical leads can use to start experiencing, demonstrating and promoting the emerging Connect Care CIS. 

The third and final Adoption and Validation session will take place in Calgary at the BMO Centre, September 25 to 27, 2018. We will soon share more information. 

AHS is most grateful for clinician interest in and support for this transformative project. Please share any feedback or suggestions with your zone ACMIO:

               • Dr. Tim Graham - cmio.ez@ahs.ca (Edmonton Zone)
               • Dr Tom Rich – cmio.caz@ahs.ca (Calgary Zone)
               • Dr. Steven Turner cmio.cez@ahs.ca (Central Zone)
               • Dr. Hendrik van der Watt - cmio.nz@ahs.ca (North Zone)
               • Dr. Aaron Low - cmio.sz@ahs.ca (South Zone)


Dr. Rob Hayward, Chief Medical Information Officer


Connect Care Professional Billing Supports

Many physicians fear that the Alberta Health Services (AHS) Connect Care clinical information system (CIS) will increase screen-time at the expense of patient-time. The concerns are understandable; and Connect Care design is driven by a commitment to decrease total information burdens for clinicians. A fully integrated system spares redundant data entry and, properly implemented, leverages collaboration to cut charting time.

Professional billing is a case in point. Many prescribers track, record and ‘bill’ for services rendered, even when employed or contracted to alternate reimbursement plans. Claims must detail patient diagnoses, co-morbidities, case complexity, related claims and other considerations. To the extent that this chore can be seamlessly integrated with CIS use, hassles decrease and total information burdens are eased. Connect Care can prove a big help to physicians who leverage CIS-integrated professional billing. The options offered are explained in a new Byte.


Connect Care Infrastructure Information

Robust infrastructure provides a sound foundation for the clinical information system (CIS) that will serve Connect Care's transformation goals. Reliable hardware, networks, devices and other technologies need to fit both clinical purpose and CIS capability.

The technology of Connect Care is important to understand. It is also important for clinicians to help guide technology choices toward what will serve Connect Care users best.

A new  section of the Connect Care Insite presence gathers and maintains information about data centres, networks, medical devices and other mission-critical technologies and initiatives.


Smart Stuff for Dummies

The Connect Care clinical information system (CIS) is empowered by Epic Systems software. As we grow more familiar with this robust health information ecosystem, we also appreciate that it's power is continually extended through use of toolkits that allow us to grow and optimize CIS clinical content.

As clinicians guide specialty clinical system design, they get more and more exposure to Epic's toolkits; and the documentation, decision and inquiry supports that can be built. We hear about lots of 'smart' things (SmartTools, SmartText, SmartPhrases, SmartLists, SmartLinks, SmartSets, SmartForms, etc.) ... and may be excused for feeling a bit 'dumb' for not appreciating exactly what these do or how they differ.

The Connect Care eHealth Glossary is recently enhanced with definitions of Epic smart stuff.


Alberta Referral Directory - Authentication-free Access

The Alberta Referral Directory (ARD) is a secure, online listing that provides access to service and consultant demographics, referral guidelines and instructions about how to facilitate efficient and effective referrals, including referral forms.

To remove barriers to access for community clinicians seeking referral information, a read-only view of ARD is now openly available via the Internet without need for a logon user name or password. Full information access, with editing rights, still requires a valid userid and password. The internet address remains easy to remember: www.albertareferraldirectory.ca

With ARD use expanding, all physicians are encouraged to update their referral information, or have responsible clinic staff take care of this for the clinic and all providers.


Reporting Health Informatics is Hard to Do!

Our clinician community can find it hard to understand, let alone explain, the nuanced differences between health information system initiatives in the province of Alberta; especially emerging opportunities for patients to participate more directly in managing their health information. We've previously blogged about Alberta's emerging personal health record (an Alberta Health offering building off of the provincial Netcare electronic health record), the anticipated Connect Care Patient Portal (providing diverse information services tethered to the AHS provincial clinical information system), and diverse patient portal services attached to non-AHS ambulatory care electronic medical records.

Understandably, the news media may also struggle to differentiate. Patient portals are a hot topic right now, possibly triggered by a recent CMAJ editorial calling for wider patient access to digital health records. CBC television recently ran a piece in which AHS was mentioned.

Our clinicians may have picked up a trivial inaccuracy. When discussing the dangers of patients trying to make sense of clinician-to-clinician communications, the example was an oncology report where the patient misunderstood "... NO esophageal carcinoma..." to mean negative, as in "no esophageal cancer." Clinicians would recognize the word in context and read "NO" as "nodes zero" as part of our standard nomenclature for classifying tumour status. The reporter claimed that the term really meant "number". Totally inconsequential error, but clinically entertaining.

A more substantive inaccuracy arose at the end of the segment, when the Netcare personal health record (PHR) was confused with the Connect Care Patient Portal (PP). The reporter was actually talking about the PHR, which indeed had its roll-out stalled for lack of an acceptable mobile interface. The reporter attributed this initiative to Alberta Health Services and used a Connect Care web page screenshot for illustration. In fact, the Connect Care Patient Portal is a different entity, tightly coupled to the CIS, and is not delayed (yet!).