Countdown Checklist W3 L-82: Check Alberta Referral Directory

Continuing a list of essential actions for Wave 3 physicians readying for Connect Care Launch April 10, 2021...

• Physician Registries - Check ARD 

Alberta has multiple sources of physician information. Connect Care uses these inform a single physician registry. This is a good time for Wave 3 physicians to ensure that provincial databases have current and correct information.

The Alberta Referral Directory (ARD) is one such database. It is a secure, online listing that provides access to consultant demographics, referral guidelines and referral forms.

All physicians are encouraged to update their ARD entry, or have clinic staff take care of this for all clinic providers. ARD is incorporated into Connect Care referral workflows.

• Byte: Alberta Referral Directory
• Guide: Alberta Referral Directory
• Website: Alberta Referral Directory
• Logon: Alberta Referral Directory

Countdown Checklist W3 L-83: Consider Wave 3 Training Options

Continuing a list of essential actions for Wave 3 physicians readying for Connect Care Launch April 10, 2021...

• Consider Connect Care Wave 3 Training Options

While our response to COVID-19 continues across the province, we are carefully moving forward with preparations for the implementation of Connect Care Wave 3. Training activities continue, with appropriate COVID-19 awareness and precautions.

Virtual as well as in-person classes are available. In-person classes have all the necessary measures in place to offer safe training. Contingency plans are in place in the event of facility-level outbreaks. If required, all in-person training can be converted to virtual training. We remain flexible and ready for COVID-19 related change in the weeks and months to come.

Registration for Wave 3 Connect Care training remains open through MyLearningLink (mylearninglink.ahs.ca). Besides completing the training, please remember that completion of the privacy training, On Our Best Behaviours (OOBB), is also mandatory for access to Connect Care. Registration information for Medical Staff is provided by Zone Medical Affairs, and for Nurse Practitioners by Advanced Practice Nursing.

• Physicians:  NZ.Privileging@ahs.ca 
• Nurse Practitioners: advancedpracticenursing@ahs.ca

On Other Channels...

Thank you for continuing to check (...ideally, subscribe to multiple channels; see instructions) the Connect Care Update blog for prescribers. Recent additions to this blog and its various channels:

• COVID and Connect Care
• COVID-19 and Connect Care - New Resources for Prescribers
• COVID-19 and Connect Care - Accessing Public Health Act Forms
• Blogs
• Connect Care - Change in Timing for Wave 3
• All User Bulletin - Immunization Records and Connect Care
• Connect Care Wave 3 Countdown
• Connect Care Wave 3 Countdown Checklist
• Connect Care Scheduled Downtime - January 14, 2021, 00:30-04:30
• Countdown Checklist W3 L-87: Are you in?
• Wave 3 Training Update
• MyHealth Records: More Lab Results Released to Patients via My Personal Records
• It's Official: North Zone Associate Chief Medical Information Officer, Dr. Marc Shaw
• Countdown Checklist W3 L-85: Get Training

• Tips
• Tippy Series
• Questions
• How can documentation be added to a deceased patient's chart?
• Support
• Co-sign Required for Pre-op Orders Placed by Surgical MOAs
• Informatics
• Super User Development Sessions - New Series
• Super User Development Session #1 - Orientation and Resources
• Bridges
• MyHealth Records: More Lab Results for Patients via My Personal Records
• Manual
• COVID-19 - Connect Care Resources
• See What's New (many updates and additions)

COVID-19 and Connect Care - Accessing Public Health Act Forms

We continue to develop a section of the Connect Care Clinician Manual that focuses on workflows supporting care of patients with COVID-19 related illness.

Sometimes physicians need to comply with provisions of the Public Health Act relating to mandatory isolation or testing of non-compliant patients with active COVID-19. Workflows relating to the Mental Health Act are already in place and equivalent orders and flags for COVID-19 public health directives will be available soon.

Until the new orders make it to production, note that the Manual (available in Connect Care from the F1 key or help menu) provides links to instructions and forms:

• Manual: Mandatory Isolation Orders

Countdown Checklist W3 L-85: Get Training

Continuing a list of essential actions for Wave 3 physicians readying for Connect Care Launch April 10, 2021...

• Get Basic Training! 
• Reach out to colleagues who may not be registered.

Physicians will not be allowed access to the Connect Care clinical information system (CIS) unless they have completed basic training. There are no exceptions. Lack of access to the legal record of care means being unable to practice. Privileges are contingent on use of the implemented CIS. 

So, this is important. Colleagues will be inconvenienced if forced to cover for a prescriber who does not have CIS access.

Wave 3 basic training runs from February 16, 2021, to April 9, 2021. Registrations are filling fast. If practicing at a Wave 3 site and still lacking information about how to register or complete basic training, contact:

• Physicians:  NZ.Privileging@ahs.ca 
• Nurse Practitioners: advancedpracticenursing@ahs.ca

It's Official: North Zone Associate Chief Medical Information Officer, Dr. Marc Shaw

Dr. Marc Shaw, ACMIO, North Zone

We are pleased to announce that Dr. Marc Shaw will continue as Associate Chief Medical Information Officer (ACMIO) for Alberta Health Services (AHS) North Zone. Marc has been capably filling this role on an interim basis since September, and it is so nice to make it official.  

Marc has been part of the CMIO office since 2018. His contributions to Connect Care are significant: Provincial Physician Trainer, Surgery, Physician Master Builder, Area Trainer and Super User, Surgery for Wave 1/2. He provided valuable, on-site support for our Wave 1 and 2 Connect Care launches. 

Marc earned his MD at the University of Ottawa and completed his General Surgery Residency at Dalhousie University in Halifax, Nova Scotia. He is pursuing a Health Informatics certificate through Johns Hopkins University. 

Marc has practiced in Grande Prairie since 2006, and is a general surgeon with a special interest in oncoplastic breast cancer surgery. Marc is also an Assistant Clinical Professor in the Faculty of Medicine and Dentistry at the University of Alberta, and was awarded a Certificate of Teaching Excellence from Family Medicine Residents.  He also enjoys racing cars, hiking, and rowing. 

MyHealth Records: More Lab Results Released to Patients via My Personal Records

The following information is provided by Alberta Health respecting some important changes to the My Health Records service:

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In 2021, Albertans will be able to view more laboratory test results in "My Health Records" (MHR), the integrated access point for Albertans’ personal health information. These lab results will be viewable through the "My Personal Records" (MPR) application. This change is being made to provide Albertans with more access to their health information, and as an additional safety net for patient care within the system. These results will be viewable as soon as they are released by laboratory services:

• About 95% of the most commonly-ordered (by volume) lab test results will be viewable by Feb 1, 2021. 
• All remaining lab tests, including more complex results in microbiology, pathology and genetics, will be available in MPR by July 1, 2021.

Lab results ordered from all sites in Alberta, including labs ordered during inpatient and emergency visits will be included in MPR. Once the changes are in place, new users will see an 18-month retrospective view of any lab results slated for release. Existing users will not have labs added retroactively, but they will be able to see the expanded lab results moving forward. 

After the changes, patients will have immediate access to more of their own information. Providers may notice some changes in their patterns of work, and may need to consider giving patients more information about the implications of different results when initially ordering a test. Physicians and other providers will continue to have access to results information through their usual channels, including Alberta Netcare.

To support Albertans, Alberta has created the MyHealth.Alberta.ca Web site, a trusted source of health information, and MyHealth Records Support is available at 1-844-401-4016, 24 hours daily. Technical assistance is available between 8:15 a.m. and 4:30 p.m. (MT), Monday to Friday, but a connection to 811 for health-related inquiries, including test results, is available at all times.

For more information about lab results online, please visit:

• FAQ: MyHealth Records: Lab Results Online via My Personal Records
• List: Additional Test Results Available to MPR 31-01-2021
• Info: MyHealth Records information for Albertans

The Alberta Medical Association and Alberta Health Services will be hosting webinars for providers: 

Webinar: Real Time Release of Labs to Patients: What This Means to Your Practice
Speakers: Dr. Allen Ausford, Dr. Brad Bahler, Dr. Jay Easaw, Dr. Rob Hayward, Dr. Nigel Flook

Date: Wednesday January 20, 2021
Time: 12:00 PM
Moderator: Dr. Heidi Fell, Informatics Chair, Alberta Medical Association
Register: https://albertadoctors.zoom.us/meeting/register/tJEuduqqqjgsGtDTMnZy0HftCmbufOJQlxft

Date: Wednesday January 27, 2021
Time: 5:00 PM
Moderator: Dr. Stuart Rosser, Interim Chief Medical Information Officer, Alberta Health Services
Register: http://ahs-cis.ca/mhrwebinar   

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Wave 3 Training Update

AHS leadership recently announced that Connect Care Wave 3 will now launch in North Zone in former Peace Country Health Region, Fort Vermilion, High Level and La Crete on April 10, 2021. 

Connect Care prescriber training in the North Zone has been rescheduled and new registration dates are now open. Once Wave 3 prescribers register for the new rescheduled Wave 3 classes, they will receive new calendar invitations with the updated information.

Please delete any original calendar invitations if registered in those classes before January 5, 2021. The older invitations will not work for the rescheduled classes, and they cannot be remotely removed from calendars.

Countdown Checklist W3 L-87: Are you in?

Starting a list of essential actions for Wave 3 physicians readying for Connect Care Launch April 10, 2021...

• Are you in Connect Care Wave 3? 

An obvious first checklist task is to determine whether Wave 3 tasks even apply!

For most physicians, that determination is made by Medical Affairs. Lists of clinic physicians, those with hospital privileges, visiting specialists and on-call contributors are used to generate invitations to Wave 3 physicians.

Despite this, it is possible that some physicians with new site responsibilities -- and some physicians who have already trained in Waves 1 or 2 -- might be missed. Physicians should check the clinics and hospitals slated for Wave 3 launch and be sure that they have been invited to participate if they expect to work at those sites:

• Resource: Wave 3 Departments and Facilities

Other online resources can be checked for the latest information:

• Resource: Wave 3 Information for North Zone Physicians
• Resource: Connect Care Wave Sequencing 
• Medical Affairs: NZ.Privileging@ahs.ca

Connect Care Scheduled Downtime - Thursday January 14, 2021, 00:30-04:30

The Connect Care clinical information system needs periodic maintenance. The next scheduled update will occur Thursday January 14, 2021 in the early morning hours (after midnight) between 00:30 and 04:30. On this occasion, Hyperspace, Transfusion (WellSky), Content (Quanum), Dictation (Dragon Medical One), MyAHS Connect and the Link Provider Portal systems are all affected. 

This downtime window will be used to update Connect Care mobility apps (Haiku, Canto) and the Workspace ONE application that AHS uses to manage clinical mobile applications. Haiku and Canto will be unavailable for a period between 00:30 and 08:30. PowerMic Mobile, the dictation application for Dragon Medical One, should be unaffected. It is important for device owners to keep their mobile devices on during the night to allow for the upgrade to download and complete on time.

While Hyperspace PRD is offline, the "North BCA Web" service is available to access patient information. In addition, Netcare remains available.

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 Manual:

• Manual: Downtime Procedures for Physicians
• Status: Connect Care
• Tip: Downtime Essentials for Physicians
• Tip: Downtime Orderset Access
• Flow: Downtime for Physicians
• FAQ: Downtime Procedures for Physicians
• Support: Getting Ready for Downtime

Connect Care Wave 3 Countdown Checklist

Starting a list of essential actions for Wave 3 physicians readying for Connect Care Launch April 10, 2021...

• 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.

• Subscribe: blogs.connect-care.ca
• Bookmark: checklist.connect-care.ca

Connect Care Wave 3 Countdown

Our countdown timer has re-appeared (see top of left column, just above the Search box) again!

After some COVID-19 adjustments, the Connect Care launch schedule resumes with the Wave 3 launch date set for early hours of the morning of Saturday April 10, 2021. This will bring the following sites into the Connect Care fold:

• Peace Country Health Region
• Fort Vermilion
• High Level
• La Crete
  

We are within 90 days from the Wave 3 launch.

Having learned how important it is to avoid a last minute rush, our Countdown Checklist (checklist.connect-care.ca) restarts for Wave 3. This allows physicians to ensure that requirements are met as they progress from registration through training, proficiency, personalization and launch-readiness.

• Link: Countdown Checklist - checklist.connect-care.ca
• Resource: Wave 3 Information for North Zone Physicians
• Resource: Connect Care Wave Sequencing 
• Resource: Wave 3 Departments and Facilities

All User Bulletin - Immunization Records and Connect Care

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

Immunization Records and Connect Care

Immunization data for provincially funded and privately purchased vaccines are recorded in the provincial immunization repository called "ImmARI" (Immunization and Adverse Reaction to Immunization). Authorized healthcare workers use a web app called "IDSM" (Immunization Direct Submission Mechanism) to submit immunization information to ImmARI. 

A letter from Alberta Health was recently sent to some healthcare providers stating that all immunization records need to be entered into ImmARI or IDSM. 

For prescribers who use Connect Care, use of ImmARI or IDSM is not required. Immunization orders for administration of immunizations automatically trigger documentation uploaded to ImmARI – no additional steps are required. 

Questions can be directed to: Health.Imm@gov.ab.ca.

On Other Channels...

Thank you for continuing to check (...ideally, subscribe to multiple channels; see instructions) the Connect Care Update blog for prescribers. Recent additions to this blog and its various channels:

• COVID and Connect Care
• COVID-19 and Connect Care - New Resources for Prescribers
• COVID-19 and Connect Care - Facility-Based Codes Postponed to April 1, 2021
• COVID-19 Tippy - COVID-19 Lab Quick Filter in Chart Review
• COVID-19 Tippy - Finding COVID-19 Tests in Results Review
• COVID-19 Tippy - Finding COVID-19 Results in Inpatient Admission Labs
• COVID-19 Tippy - Quick Discovery of Patient's COVID Experience
• COVID-19 Tippy - Ordering COVID-19 and Respiratory Pathogen Tests
• Blogs
• All User Bulletin - Change to Secure Chat Message Persistence
• All User Bulletin - Netcare Affecting Connect Care

• Tips
• Tippy Series
• Questions
• How can I reprint a discharge prescription?
• How can an inpatient's provider service be changed?
• Manual
• COVID-19 - Connect Care Resources
• See What's New (many updates and additions)

Connect Care - Change in Timing for Wave 3

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The impact of COVID-19 on our health system has been carefully evaluated and a decision made to change the timing and scope of upcoming Connect Care launch waves. Given the increasing demands of COVID-19 on frontline staff, physicians, programs and services, it is prudent to delay the next wave of Connect Care, originally scheduled for February 2021. 

Wave 3 of Connect Care will launch in two parts: 

1. The portion planned for North Zone will launch April 10, 2021
2. The Calgary Zone portion will be further reviewed in consultation with zone leaders and teams. 

AHS remains committed to keeping the full Connect Care implementation within the originally-planned timeframe. Dates for future launches will be communicated as pandemic adjustments are firmed up. 

Despite the change in Wave timing, the bulk of Connect Care preparations continue, including:

• Infrastructure and technology work, including WIFI upgrades, facility preparations, and device deployment and testing
• Continued support for Waves 1 and 2 to aid the stabilization of those sites and programs
• Building and validation work for Waves 3-7
• Building and preparing training support, leadership teams and other roles necessary for upcoming launches.  
  

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All User Bulletin - Netcare Affecting Connect Care

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

Netcare Affecting Connect Care 

The Alberta Netcare electronic health record has experienced some performance issues (freezing in some circumstances) since December 17, 2020, with teams actively implementing fixes.

If Netcare is opened within Connect Care, and Netcare experiences a freeze, some users report that Connect Care can appear to slow-down. Closing Netcare tabs in opened charts appears to help. It is always possible to open Netcare independently, outside of Connect Care.

The reported problems should resolve when Netcare fixes are implemented, as announced on the Netcare logon page (portal.albertanetcare.ca).

Update (2020-12-23, 12:00): Netcare performance has been restored. Any new problems should be reported to the service desk.

COVID-19 and Connect Care - Facility-Based Codes Postponed to April 1, 2021

We previously posted about Connect Care professional billing modifications resulting from Alberta Health policy changes respecting overhead considerations. "Z codes" are a set of 13 facility-based health service codes that physicians use to submit claims for services performed in AHS facilities.

Expected changes are postponed to April 1, 2021.

Clinicians who record and submit professional billings through Connect Care need not make any changes at this time.

All User Bulletin - Change to Secure Chat Message Persistence

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

Change to Secure Chat Message Persistence

Secure Chat is a secure messaging service that allows users to send text and image messages to colleagues in real time. It is the preferred and approved tool for instant messaging within Connect Care. It is an appropriate communication channel for messaging involving personal health information.

To date, messages have been allowed to accrue indefinitely. This presents some users with large message collections. From January 14, 2021, messages older than 30 days will be automatically purged, even if part of a multi-message string. This is appropriate since messages are meant to support short-term communications that do not need to be part of the record of care. Once a message is purged, it cannot be recovered. 

• Manual: Secure Chat

COVID-19 and Connect Care - New Resources for Prescribers

Tippies can be quickly adopted with immediate workflow benefits...

• Connect Care COVID-19 Resources for Prescribers

With prescribers re-assigned to address pandemic surge needs, some find themselves using Connect Care with inpatients for the first time at Wave 1 and 2 facilities in the Edmonton Zone. 

Many Connect Care enhancements have occurred since the pandemic began, with new and continually improving clinical content (e.g., flowsheets, order panels, order sets, documentation tools, navigators).

A new section of the Connect Care Manual organizes tips and guides to match COVID-19 workflows (with frequent additions), and a new series of "Tippies" shares simple actions that speed workflows.

• Manual: COVID-19
• Manual: COVID-19 Workflows
• Updates: COVID-19 (covid.connect-care.ca)
• Tips: COVID-19 Tippies
• FAQ: COVID-19
• Support: COVID-19

On Other Channels...

Thank you for continuing to check (...ideally, subscribe to multiple channels; see instructions) the Connect Care Update blog for prescribers. Recent additions to this blog and its various channels:

• COVID and Connect Care
• COVID-19 and Connect Care - New Posting Series
• COVID-19 and Connect Care - Updates 
• COVID-19 and Connect Care - Clinical Content
• COVID-19 and Connect Care - COVID-19 and Respiratory Pathogen Testing for Inpatients
• COVID-19 and Connect Care - Capacity Prediction
• COVID-19 and Connect Care - Mobile Device Advantage
• COVID-19 and Connect Care - Just-in-Time Training
• COVID Tippy - Using Calculators for COVID-19 Assessments
• Blogs
• All User Bulletin - Consulting for Interventional Neuroradiology Procedures
• All User Bulletin - Ordering Audiology Consults
• Seasons Greetings from the Connect Care Team
• Trainee Bulletin - Change to Supervising Provider Workflow
• All User Bulletin - In Basket Change to "Not My Results" QuickAction
• Connect Care Scheduled Downtime - Dec 10, 2020, 00:30-04:30
• CMIO Optimization Support for Connect Care Users

• Tips
• Tippy Series
• Tippy - Power Chart Searching
• Support
• How to manage mis-directed In Basket results
• Trouble Subscribing to Connect Care Blogs
• Manual
• COVID-19 - Connect Care Resources
• See What's New (many updates and additions)

COVID-19 and Connect Care - Just-in-Time Training

The COVID-19 second wave brings rapidly increasing numbers of patients to our hospitals and critical care units. The Edmonton Zone is particularly hard hit, with most cases going to the University of Alberta Hospital (currently on Connect Care) and the Royal Alexandra Hospital. 

Many healthcare workers help by accepting clinical reassignments to serve COVID-19 inpatient units, or to free up other specialists by covering non-COVID units. Some prescribers are new to Connect Care and others encounter Connect Care modules (e.g., inpatient) that are new to them.  

The following steps are followed for prescribers needing just-in-time basic or additional Connect Care training:

1. Edmonton Zone Medical Affairs is informed of the clinical assignment, confirming that privileges are in place, that training needs are clarified, Connect Care access is provisioned, and training instructions are provided: Edm.MedicalAffairs@ahs.ca.
2. The provider's name is added to a training list and an appropriate pathway is provided for training and certification.
3. Providers new to Connect Care will be contacted by the Edmonton Zone ACMIO team (cmio.ez@ahs.ca) to arrange virtual training.
4. Prescribers who already have Connect Care training, and need to cross-train in another track, can access relevant Independent Learning on MyLearningLink by searching for "Independent". For example, those needing the inpatient tract would:
• Search using "Independent" under "Courses & Registration". 
• Look for "Epic-CMIO Inpatient Admitting Consulting Independent Learning".
• Use the "Register" button to access the course.
• Course elements can be completed at the user's pace and in multiple sittings.
5. Independent learning is currently available for Critical Care, Inpatient, Emergency, Anesthesia, Pediatrics, Addictions and Mental Health, Ambulatory and Personalization.
6. Further help with just-in-time training is available via help.cmio@ahs.ca.

CMIO Optimization Support for Connect Care Users

With over 4,000 professionals having completed Chief Medical Information Office (CMIO) training for Connect Care, the CMIO has developed a four-tier optimization training strategy to foster continuous learning. 

All Connect Care users who fall under the scope of CMIO training will be able to access optimization support via their local leadership. Users can combine facets of optimization from any tier, in any order, to best address their unique needs. 

In Tiers 1 and 3, users can drive their own learning through the available resources and modules; in Tiers 2 and 4, Medical Informatics Leads, Super Users, and Zone Clinical Department Heads will help champion this learning for their colleagues and staff.

For more information, see the new Optimization Training page in the Connect Care Manual.

• Manual: Optimization Training
• Byte: Optimization Training
• Guide: Optimization Training

COVID-19 and Connect Care - Mobile Device Advantage

We've previously warned that personal devices can act like fomites, and that users should take particular care with frequent cleaning. Device vendors have provided COVID-aware screen and keyboard cleaning recommendations.

• Manual: Mobile Device Hygiene

Subsequent postings will look at inpatient workflows for physicians participating in the care of COVID-19 patients. These can change perspectives about the infection control risk of using personal devices relative to shared organizational devices. Use of hospital keyboards can pose personal risk if not cleaned between uses. Assignment of a device to an individual for an entire shift or use of a personal device with appropriate cleaning are alternatives. Indeed, if one can restrict oneself to dictation of quick draft notes on-ward and subsequent completion of notes off-ward, a mobile device can be used safely.

In any case, it is important to be reminded about how to clean personal devices.

Connect Care Scheduled Downtime - Thursday December 10, 2020, 00:30-04:30

The Connect Care clinical information system needs periodic maintenance. The next scheduled update will occur Thursday December 10, 2020 in the early morning hours (after midnight) between 00:30 and 04:30. On this occasion, Hyperspace, Transfusion (WellSky), Content (Quanum), Dictation (Dragon Medical One), MyAHS Connect and the Link Provider Portal systems are all affected.

While PRD is offline, access to "PRDSRO" will be available for the majority of downtime. The "North BCA Web" service is also available to access patient information. In addition, Netcare remains available.

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 Manual:

• Manual: Downtime Procedures for Physicians
• Status: Connect Care
• Tip: Downtime Essentials for Physicians
• Tip: Downtime Orderset Access
• Flow: Downtime for Physicians
• FAQ: Downtime Procedures for Physicians
• Support: Getting Ready for Downtime

All User Bulletin - In Basket Change to "Not My Results" QuickAction

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

In Basket Change to "Not My Results" QuickAction

Sometimes physicians receive In Basket results messages in error. Once a prescriber confirms that the information is indeed inappropriately shared, an In Basket "QuickAction" can be used to flag the error and indicate, if known, to whom the message should be redirected. 

This workflow has been simplified. Previously there were options for "Not My Patient" and "Not My Result". The former is removed. The latter is enhanced with default response text that allows the recipient to quickly indicate why the test might have been misdirected and what action, if any, has been taken.

• Manual: Mis-directed Result Messages
• Support: How to Manage Mis-directed Result Messages

COVID-19 and Connect Care - Capacity Prediction

The prairie provinces, and Alberta in particular, emerge as COVID-19 second wave hotspots. Daily new case records invariably drive hospitalization records a few weeks hence. 

Our ability to compare pandemic phenomena across time and place has greatly improved, with international, national, provincial and organizational datasets proving invaluable for capacity planning. 

We have updated a shortlist of the best of these in the Connect Care Manual:

• Manual: COVID-19 Surveillance

Trainee Bulletin - Change to Supervising Provider Workflow

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

Selecting a Supervising Prescriber no longer required at Login

Prescriber trainees, including medical students, residents and fellows, are supervised by fully licensed prescribers. These are “supervising” or “authorizing” prescribers. Unequivocal identification of the authorizing provider ensures that clinical documentation is appropriately attributed, and that critical and late-reporting results are appropriately routed.

To avoid ambiguity, a requirement for "Supervising Provider" selection at login was introduced for Connect Care trainees in second quarter 2020. This led to practical difficulties for some trainees. The requirement is removed as of noon on December 8, 2020.

Instead, a default authorizing prescriber is specific to each patient and encounter:

• Emergency Departments
1. Attending provider for the patient ED visit
2. Current provider (trainee themselves, if they are an authorizing provider)
• Inpatient Departments
1. Attending provider for the patient admission
2. Current provider (trainee themselves, if they are an authorizing provider)
• Outpatient Departments
1. Encounter provider for the patient visit
2. Current provider (trainee themselves, if they are an authorizing provider)

If the authorizing provider cannot be deduced, then the trainee is prompted to select an authorizing provider at the time of ordering.

The default assignment of an authorizing provider will work most of the time. However, it is important to know how to select an alternate authorizing provider if the default does not fit a specific patient interaction. 

• Manual: Trainee Prescriber Roles
• Tip: Changing an Authorizing Prescriber
• Crib-Sheet: Multi-Supervisor Scenarios

COVID-19 and Connect Care - New Posting Series

Many prescribers find their work changed in Alberta's second wave of the COVID-19 pandemic. Some redeployments require rapid Connect Care training. Most see already-trained prescribers learning new workflows for COVID care.

We resume frequent postings about tips and guidance for optimal use of Connect Care in the pandemic. These can be viewed together by using the COVID category in any of our blogging channels (see left column). A new link, covid.connect-care.ca, lists all the general Connect Care updates that relate to COVID care and is easy to bookmark.

Seasons Greetings from the Connect Care Team

 

All User Bulletin - Ordering Audiology Consults

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

Ordering Audiology Consults

As of Tuesday, December 1, 2020 at noon, specialty audiology exams that were previously available to be searched for and ordered by physicians will only be orderable by Audiology prescribers, who can best select a specific intervention appropriate to the clinical need.  

 

Going forward, physicians seeking specific audiology procedures should place an “Inpatient Consult to Audiology” order for inpatients or "Ambulatory Referral to Audiology" for outpatients. If a specific intervention is wanted, this can be added to the comments section of the consult/referral order. An Audiologist will then place the required procedure order(s) and make appropriate arrangements for assessment.

Entering "hearing" or "audiology" as term in the Order Search will bring up the consult or referral order options. 

All User Bulletin - Consulting for Interventional Neuroradiology Procedures

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

Consulting for Interventional Neuroradiology Procedures

A number of interventional neuroradiology procedures that were previously directly orderable by any prescriber are now ordered specifically by responsible radiologists. The appropriate ordering pathway is to request an interventional radiology referral or consultation. The diagnostic imaging team then confirms the best approach to address the clinical need while taking care of both orders and scheduling.  

Going forward, physicians seeking interventional neuroradiology exams should place a “Consult to Interventional Radiology” order for inpatients or an “Ambulatory Referral to Interventional Radiology” order for outpatients. This includes therapeutic stroke interventions and the following procedures:

• IR Aneurysm Coiling 
• IR Carotid Balloon Test Occlusion
• IR Intracranial AVM Embolization
• IR Head Neck Embolization
• IR Spinal AVM Embolization
• IR Intracranial Tumor Embolization
• IR Spinal Tumor Embolization
• IR Extracranial Stent Placement w Angioplasty
• IR Intracranial Angioplasty
• IR Intracranial Clot Retrieval
• IR Epistaxis Embolization
• IR Kyphoplasty One Level
• IR Kyphoplasty Two or More Levels
• IR Vertebroplasty
• IR Vessel Occlusion Permanent
• IR Nerve Root Ablation
  

The above orders are now treated as synonyms for IR Consult/Referral, which is the suggested order that will appear when searching.

As with all time-sensitive referrals and consultations, it is important to phone interventional radiology at the intended site to share details about the case, the clinical need and urgency considerations.

COVID-19 and Connect Care - COVID-19 and Respiratory Pathogen Testing for Inpatients

Alberta's laboratory medicine services continue spectacular work addressing extraordinary demands associated with the COVID-19 pandemic in its second wave. Strategic decisions are made to ensure that resources are focused on the most efficient way to help physicians diagnose patients presenting with infection-related respiratory symptoms.

Effective December 1, 2020, the COVID-19 and respiratory virus testing algorithm changes to improve test utilization in emergency room and inpatient settings. Key developments include:

• Throat Swabs - Lack sensitivity for detecting non-COVID-19 respiratory viruses, and so will only be processed for COVID-19.
• Nasopharyngeal (NP) Specimens - Can be tested for COVID-19 and other respiratory viruses.
• Influenza Like Illness (ILI) NPs - For ED and inpatients, can be tested for COVID-19, influenza and RSV.
• Full Respiratory Panel (RPP) - Testing should be restricted to patients presenting with ILI and immunocompromised, critical respiratory failure, flaccid paralysis, myocarditis or pericarditis; or for outbreak investigations under the direction of Public Health or Infection Prevention and Control (IPC).
• Bulletin: COVID-19 and other respiratory virus testing changes

COVID-19 and Connect Care - Clinical Content

Clinical information systems (CIS) "content" includes standards (terminologies, lists, etc.), documentation tools (templates, flowsheets, automations, etc.), decision supports (references, advisories, order sets, etc.) and inquiry supports (performance indicators, quality measures, etc.), all designed to support best possible health services.

Connect Care clinical system design (CSD) has been drafting, building and implementing a wide range of clinical content to help clinicians care for patients with COVID-19 illness. We've previously posted about the release and revision of this content.

The burden of COVID-19 on the health care system increases as we struggle with a second wave of infections. The Connect Care updates will give priority to clinical content news, with practical guidance for Connect Care users about how best to use the CIS to reduce information burdens.

• Manual: COVID-19 Clinical Content

COVID-19 and Connect Care - Updates

With rapidly increasing COVID-19 cases, hospitalizations and intensive care admissions, this is a good time to refresh awareness about how Connect Care can make it easier to care for COVID-19 patients.

We will use this blogging channel (blogs.connect-care.ca - please consider subscribing) to update advice from earlier in the pandemic, while adding pointers about subsequent clinical information system (CIS) enhancements.

Connect Care prescribers can also review updates and resources using one or more of the following blogging channel themes. The Connect Care Manual remains a good single starting point, as it provides overviews with links to more detailed information:

• Manual: COVID-19
• General Updates
• Tips
• Frequently Asked Questions
• Support Forum

On Other Channels...

Thank you for continuing to check (...ideally, subscribe to multiple channels; see instructions) the Connect Care Update blog for prescribers. Recent additions to this blog and its various channels:

• Blogs
• Timing and Sequence of Upcoming Connect Care Waves 
• Netcare Scheduled Downtime - Nov 19, 21:00-03:00 Nov 20 
• Connect Care Kudos 
• Practical Paranoia - Pandemic Phishing on the Rise 

• Tips
• Tippy Series
• Support
• Discharge from Leave of Absence Workflow 
• Interfacility Emergency Department (ED) to ED Transfers 
• Bridges
• Important Information for Primary Care and Community Providers related to the impact of Connect Care: Connect Care Identifiers 
• Informatics
• File Naming Norms Updated 
• Manual
• See What's New (many updates and additions)

Practical Paranoia - Pandemic Phishing on the Rise

Hospitals are prime targets for cyberattacks and this is especially true during COVID-19. The consequences not only disrupt patient care but can be lethal. 

Hackers use phishing emails to trick healthcare workers into downloading ransomware, a type of malicious software that attacks computer systems when an infected link or attachment is opened. The ransomware logs out users and shuts off access to critical information until a "ransom" is paid by the organization.

 

Some recent examples:

• Outpatient appointments were postponed in Quebec due to a recent cyberattack targeting health board members.
• A recent ransomware attack in Germany meant that a patient had to be rerouted to a hospital 20 km farther away, delaying care and likely contributing to her death. 
• An early morning cyberattack at Universal Health Services’ US facilities disabled multiple antivirus programs, logged off users and shut down system access. Affected hospitals had to redirect ambulances and relocate patients in need of surgery to other nearby hospitals. Universal Health Services operates in both the US and UK and is similar in size to AHS with more than 400 facilities and more than 90,000 employees providing healthcare services to about 3.5 million patients annually. 

You can help stop these attacks. 

• Take note of AHS’ external email warning message. 
• Don’t open unsolicited email attachments or click on links. 
• Always report suspicious emails using the "Report Phishing" button on Outlook or forward to stop.spam@ahs.ca, then delete.

Learn more about some of the common tricks cybercriminals use to access your information by viewing Don’t be fooled by Scammers and visit InfoCare on AHS Insite for information on all privacy and information security matters.