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:

• General
• Referral Management in Connect Care
• End of Support for iOS 12 as of June 16, 2021
• Easier and More Flexible (Re-)Printing of Discharge Prescriptions
• Improved Goals of Care Designation Order
• Connect Care CMIO Refresher Training
• Netcare Scheduled Outage - June 17, 2021, 21:00-03:00 June 18, 2021
• Changes to Available Lab Results in MyHealth Records/My Personal Records
• Connect Care Transparent Lockdown - June 18, 2021 12:00-04:30 June 24, 2021
• COVID and Connect Care
• COVID-19 and Connect Care - Outpatient Vaccination Orders
• Acute Care COVID-19 Vaccinations Order Set Updated
• COVID-19 Tippy - Placing COVID Vaccination Orders
• Tips
• Tippy Series
• Questions
• How can I reprint a discharge prescription?
• Manual
• COVID-19 - Connect Care Resources
• See What's New (many updates and additions)

Connect Care Transparent Lockdown - June 18, 2021 12:00-04:30 June 24, 2021

Connect Care anticipates a significant upgrade in the early hours of June 24, 2021 (post with details important for prescribers to come). Connect Care uses a "transparent lockdown" process during upgrades to help prepare the system and reduce the upgrade workload, resulting in a shortened downtime window. The transparent lockdown period for the upcoming upgrade is from Friday, June 18, 2021 at 12:00 to Thursday, June 24, 2021 at 04:30.  

The lockdown does not affect system performance, existing workflows, or the activities of most users (thus "transparent"). Physicians and other prescribers will have access to their personalized orders, tools and templates during the lockdown; however, there will be no ability to create new personalizations during the lockdown period. For more details:

• Alert: June Upgrade Transparent Lockdown

Changes to Available Lab Results in MyHealth Records/My Personal Records

Effective June 15, 2021, lab tests for microbiology and blood bank will be released immediately to Alberta Health’s MyHealth Records, in the My Personal Records (MPR) application. This change is part of Alberta Health’s rollout of expanded result release, which began in February 2021, to provide Albertans with more access to their health information.

Once the changes are in place, new MPR users will see an 18-month retrospective view of any lab results slated for release. Existing MPR users will not have labs added retroactively, but they will be able to see the expanded lab results moving forward. 

As is the standard practice, Connect Care releases these lab test results to MyAHS Connect. What’s new is that, as of June 15, 2021, these specific lab test results will be released immediately to MyAHS Connect, instead of being delayed by five days as they were previously. This means that patients will have immediate access to more of their own lab results and may have questions for their healthcare providers about them. As part of the overall rollout plan, Alberta Health is planning to release additional lab test results to MPR in the coming months. We will provide more details regarding the next planned release as we have them. MyAHS Connect result release will change to immediate for results being released in MPR as they become available. 

Alberta Health is providing support to Albertans through the MyHealth.Alberta.ca website and a 24-hour telephone line at 1-844-401-4016. Albertans can also call HealthLink at 811 for health-related inquiries.

Netcare Scheduled Outage - Thursday June 17, 2021, 21:00-03:00 Friday June 18, 2021

Alberta Netcare Portal will be unavailable between June 17, 2021 21:00 and 03:00 June 18, 2021, to accommodate system upgrades. 

Users who are logged in during this time will be disconnected and will need to re-authenticate following the outage period. 

If urgent access to results is anticipated during these periods, please refer to and complete the ANP Downtime Contingency Kit in advance of the maintenance. 

For any questions or concerns, AHS employees please contact 1-877-311-4300, while Community Alberta Netcare users (outside AHS) can contact the Provincial Helpdesk at 1-877-931-1638.

Connect Care CMIO Refresher Training

Some Connect Care users trained in the earliest waves, particularly those who only occasionally use the system, may find it beneficial to have some refresher training to ensure they continue to have a positive user experience.

CMIO refresher training for Waves 1 and 2 CMIO users in the Edmonton Zone can be accessed in one of two ways:

• Register for Independent Learning on MyLearningLink, available for the following tracks (more tracks to be added, see below*):
• Epic – CMIO Addiction and Mental Health 
• Epic – CMIO Ambulatory 
• Epic – CMIO Anesthesia
• Epic – CMIO Cardiology 
• Epic – CMIO Critical Care Adult
• Epic – CMIO Diagnostic Imaging
• Epic – CMIO Emergency Medicine 
• Epic – CMIO Inpatient Admitting and Consulting
• Epic – CMIO Obstetrics and Gynecology 
• Epic – CMIO Pediatrics
• Epic – CMIO Rural
• Epic – CMIO Surgery
• Epic – CMIO Personalization (note: users need to complete their EUPA prior to registering)

OR

• Register for EZ Wave Basic or Personalization Instructor Led Training (ILT) on MyLearningLink 

There is no time limit to access refresher training through the Independent Learning option, and users can pick and choose what they would like to review. While Independent Learning takes approximately 1.5-2 hours to complete, the total time refresher training via this option would take depends on how much the user would like to review.

Refresher training via the Instructor Led Training option runs from August 30 to October 31, and is a repeat of users' original basic or personalization training. In-person and virtual options are available. Basic Instructor Led Training for most tracks takes approximately 6 hours, and personalization Instructor Led Training takes approximately 4 hours. 

For any questions or if your track is not listed, please email CMIO.EZ@ahs.ca.

*Independent Learning for NICU and Lumens will be available by September, and Independent Learning for all tracks will be available by the start of Wave 4 (November 7). Another notice with an updated list will be posted when available.

• Manual: Refresher Training

Acute Care COVID-19 Vaccinations Order Set Updated

Changing COVID-19 vaccine availability, paired with a constant imperative to immunize, makes it possible to offer vaccination to patients in AHS emergency and inpatient facilities, without some of the restrictions previously applied (e.g., 21-day stay).

The Connect Care inpatient (also available in ED) COVID-19 vaccine order set is updated to reflect changes in guidance about eligible patients and choice of second vaccine type.

• Manual: Hospital COVID-19 Vaccination Orders
• Byte: COVID-19 Vaccination (Inpatient)
• Byte: COVID-19 Vaccination (Outpatient)

Improved Goals of Care Designation Order

We've previously posted about how goals of care designations can be viewed, modified and maintained in Connect Care.

The order composer used to record a goals of care designation (GCD) has been enhanced (now available in all Connect Care modules).

1. Embedded summaries about the attributes of a particular GCD are more consistent and informative.
2. Links are provided to clinician-friendly GCD definitions as well as to guidance about goals of care workflows.
3. Clinicians can select more than one participant for GCD decisions, as appropriate.
4. A goals of care tracking record entry can be generated from a link embedded in the GCD order.

Goals of Care Designations persist across encounters, but need to be re-validated at the beginning of in-patient encounters.

• Manual: Goals of Care Management
• Manual: Goals of Care Designations

Easier and More Flexible (Re-)Printing of Discharge Prescriptions

An enhancement was added to the Connect Care production environment today to make it easier for prescribers to reprint discharge prescriptions at locations or devices other than the nursing unit that the patient is discharged from. This can be useful when a new or corrected prescription needs to be generated after the prescriber has left the unit, or if the prescriber is facilitating information transfer to a pharmacy from, for example, the prescriber's office.

• FAQ: How can I reprint a discharge prescription?
• Manual: Printing Discharge Documents

End of Support for iOS 12 as of June 16, 2021

On Wednesday, June 16, 2021, Mobility Services will start blocking new enrolments for Apple mobile devices running iOS version 12. Mobile devices currently enrolled into Workspace ONE with iOS 12 will have a grace period of 90 days to be upgraded to one of the currently supported iOS versions (iOS 13 or 14).

As previously posted, iOS 12 support has already been dropped by some of the application vendors that AHS currently uses, and so these applications are not able to be installed or upgraded on devices running iOS 12. AHS mobile policy also requires that mobile device operating systems be kept up to date, to ensure that AHS data and resources remain secure for all devices connecting to an AHS environment. 

What to expect:

• As of June 16, any Bring Your Own Device (BYOD) program users who try to enrol a device running iOS 12 will get an "enrolment blocked" message and the enrolment will fail.
• Starting June 16, BYOD users with enrolled devices that are running iOS 12 will get emails and/or Workspace ONE Hub notices indicating the need to update to a later version within 90 days. 
• If a device is not upgraded to a supported iOS version in the 90-day grace period, it will automatically be unenrolled on the 91st day. Once unenrolled, all access to AHS data and resources will be removed from the device.
• During this grace period, support for devices running iOS 12 will be on a best effort, with a direction for users to upgrade to a later iOS version. 

For more information or assistance, please contact the AHS Service Desk at 1-877-311-4300.

COVID-19 and Connect Care - Outpatient Vaccination Orders

A previous posting explained a unique order-documentation workflow used for inpatients who might meet criteria for administration of a COVID-19 vaccination during a hospital encounter.

Primary and specialty care clinics that use Connect Care as the record of care can now order and administer COVID-19 vaccinations in outpatient settings. 

Each clinic will be aware of the specific vaccine type available within the clinic. There are orders available for each of these vaccine types. The clinic workflow is the same (with the same patient informing and consenting norms) as that used for other clinic vaccinations (e.g., influenza vaccine).

Use the order search tool with "covid v" to find these new orderables.

• Tip: Placing COVID-19 Vaccination Orders

Referral Management in Connect Care

Effective referral management is key to safe and efficient patient care. Alberta Health Services (AHS), and the Connect Care initiative, continue work to optimize referral processes.

Connect Care introduces standardized ordering, triaging and communicating in support of "closed loop management", in compliance with College of Physicians and Surgeons of Alberta (CPSA) practice standards and AHS QuRE referral guides. Using the correct Connect Care workflow ensures that consults and referrals are identified, tracked and completed in a timely manner.  

As always, if an issue is time-sensitive, there is no substitute for direct provider-to-provider communication. This supplements, but cannot replace, placing the requisite Connect Care referral (outpatient) or consult (inpatient) order. Bypassing Connect Care orders by means of hallway conversations, In Basket messages or chart copies does not meet CPSA requirements, can inconvenience colleagues, and risks referral loss. 

Clinicians who receive consult requests through informal channels should remind the requesting provider that the desired consult or referral must be entered in Connect Care. The onus rests with the requesting – not the accepting – physician. A simple SmartPhrase can be used to document such reminders.

• Manual: Referral and Consultation
• CribSheet: Referral or Consult Order Reminder SmartPhrase

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:

• General
• Mobility Apps Outage - May 13, 2021, 00:30-04:30
• Non-Medical Device Assessments: What Prescribers Need to Know
• CMIO Optimization Support for Connect Care Users
• COVID and Connect Care
• COVID-19 and Connect Care - New Resources for Prescribers
• COVID-19 and Connect Care - Guidance for VITT
• COVID-19 and Connect Care - Inpatient Vaccination Orders
• COVID-19 Tippy - Finding COVID-19 Vaccination Information
• FAQ: Why is COVID-19 vaccination information missing in Connect Care?
• Tips
• Tippy Series
• Manual
• COVID-19 - Connect Care Resources
• See What's New (many updates and additions)

CMIO Optimization Support for Connect Care Users

With over 4,500 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 for those in Waves 1, 2 and 3. 

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 Optimization Training page in the Connect Care Manual.

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

Non-Medical Device Assessments: What Prescribers Need to Know

Non-Medical Devices (NMDs) are computing and related devices that enable interaction with Connect Care. These include computer workstations, printers, document scanners, e-signature pads and track boards, among other things. 

AHS provisions and supports NMDs in clinical areas in order to match peak staff and workflow needs. To better estimate site-specific needs, NMD Assessments are completed prior to each Connect Care launch. The assessments are collaborative, facilitated by visiting teams working with site managers and prescribers. AHS NMD standards help set expectations for the quantity, types and locations of devices that can be deployed to sites. Information about NMDs and the NMD Standards can be found on Insite. 

Prescriber participation in NMD Assessments is important for ensuring that device type and location support physician workflows. For example, a printer placed in the wrong location can add significant burden to a physician’s workflow if inconvenient for retrieving printed prescriptions or outpatient laboratory test requisitions. 

Prescribers are encouraged to attend the first 30 minutes of NMD Assessment sessions at their sites. North Zone Wave 7 NMD Assessments begin May 17, 2021 and run until October 1, 2021. Dates will be emailed to site Medical Leadership directly. If you have questions about NMD Assessments in your Zone, please contact your Zone's CMIO supports:

• North Zone: cmio.nz@ahs.ca
• Edmonton Zone: cmio.ez@ahs.ca
• Central Zone: cmio.cez@ahs.ca
• Calgary Zone: cmio.caz@ahs.ca
• South Zone: cmio.sz@ahs.ca

Mobility Apps Outage - Thursday May 13, 2021, 00:30-04:30

As previously posted, a scheduled upgrade to the Connect Care Mobility apps (Haiku, Canto, Limerick) will occur Thursday May 13, 2021, between 00:30-04:30, in preparation for a general Connect Care upgrade occurring in June. No other Connect Care systems will be affected during this outage, and Hyperspace and other Connect Care systems can be used as usual. 

Users may see an action request to allow the upgrade for each affected mobile device, based on device type. Failure to accept the upgrade will require a manual upgrade before the June Connect Care upgrade in order for the mobility apps to continue interacting with Connect Care servers.

• iOS, iPadOS and watchOS devices: 
• Once the mobile app upgrade window begins (00:30 on May 13), iOS devices will get a prompt to upgrade. For devices powered off during the window, iOS devices will receive the prompt to upgrade shortly after power on. 
• Please accept this prompt to continue to use the Connect Care mobility with the coming June upgrade. 
• Android devices: Users may need to upgrade the apps manually by re-selecting from the from the Workspace One (vmware airwatch) Catalog.

The PowerMic Mobile dictation application for Dragon Medical One is not affected by these updates. 

In case of difficulties, please contact the AHS Service Desk (1-877-311-4300).

COVID-19 and Connect Care - Inpatient Vaccination Orders

Alberta Health Services (AHS) and Covenant Health support COVID-19 immunization of eligible acute care patients who anticipate a long hospital stay, are unable to access community immunization programs and wish to be immunized while in hospital. 

Connect Care offers an integrated workflow for ordering inpatient vaccination, documenting compliance with requirements, documenting vaccine administration, updating a patient’s vaccination history and communicating key information to provincial programs. Components supporting this workflow go into production Monday May 17, 2021. 

Affected clinicians should check new tip and Manual content:

• Tip: COVID-19 Inpatient Vaccination
• Manual: COVID-19 Hospital Vaccination Orders

COVID-19 and Connect Care - Guidance for VITT

We have previously posted about testing for Vaccine-induced Immune Thrombotic Thrombocytopenia (VITT). As experience grows, guidance for clinicians is firmed up.

• Guidance: Management of Symptomatic Persons who have received Viral Vector COVID-19 Vaccine

Connect Care prescribers should remain alert to patient presentations that might indicate emerging or established VITT 4 to 28 days post-immunization:

• a persistent and severe headache
• focal neurological symptoms or visual changes, including blurred or double vision, or episodes suspicious for seizure
• shortness of breath
• abdominal or chest pain
• swelling, pain and/or redness in a limb
• pallor and coldness in a limb
• unusual bleeding, multiple small bruises, reddish or purplish spots or blood blisters under the skin

The most important Connect Care action is to place an urgent order for a hematology consult (inpatient) or referral (outpatient) together with direct personal contact with a hematologist on call (RAAPID) who will guide initial investigations.

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:

• General
• Connect Care Mobility Apps Need Device Operating System Updates
• Mobility Apps Upgrade (May 13, 2021)
• COVID and Connect Care
• COVID-19 and Connect Care - New Resources for Prescribers
• COVID-19 Tippy - Ordering COVID-19 and Respiratory Pathogen Tests
• COVID-19 Tippy - Finding COVID-19 Tests in Results Review
• COVID-19 Tippy - Finding COVID-19 Results in Inpatient Admission Labs
• COVID-19 Tippy - COVID-19 Lab Quick Filter in Chart Review
• COVID-19 Tippy - Quick View of a Patient's COVID-19 Experience
• Tips
• Tippy Series
• Tippy - Quick Launch Dragon Medical One
• Tippy - Easy Dictation within Mobile Apps
• Manual
• COVID-19 - Connect Care Resources
• See What's New (many updates and additions)

Mobility Apps Upgrade (May 13, 2021)

On Thursday May 13, 2021, between 00:30-04:30, the Connect Care Mobility apps (Haiku, Canto, Limerick) will be upgraded in preparation for a general Connect Care upgrade occurring in June. Users may see an action request to allow the upgrade for each affected mobile device, based on device type. Failure to accept the upgrade will require a manual upgrade before the June Connect Care upgrade in order for the mobility apps to continue interacting with Connect Care servers.

• iOS, iPadOS and watchOS devices: 
• Once the mobile app upgrade window begins (00:30 on May 13), iOS devices will get a prompt to upgrade. For devices powered off during the window, iOS devices will receive the prompt to upgrade shortly after power on. 
• Please accept this prompt to continue to use the Connect Care mobility with the coming June upgrade. 
• Android devices: Users may need to upgrade the apps manually by re-selecting from the from the Workspace One (vmware airwatch) Catalog.

The PowerMic Mobile dictation application for Dragon Medical One is not affected by these updates. 

In case of difficulties, please contact the AHS Service Desk (1-877-311-4300).

Connect Care Mobility Apps Need Device Operating System Updates

Most of us keep our mobile devices (smartphones, tablets, watches) in sync with the latest operating system updates. Among other things, this ensures that important security patches are in place to protect the device from intrusion. While Connect Care mobility applications (Haiku, Canto, Limerick) have robust app security, it is important that they work with safe operating systems.

A Connect Care mobility update is anticipated May 13, 2021. The fresh instances of Canto (for iPads), Limerick (for Apple Watches) and the iOS (Apple) version of Haiku will require recent versions of iOS/iPadOS (13.0 or later) and watchOS (version 6.0 or later). Those who keep up with updates have no worries, as the current version of iOS is 14.5 and watchOS is 7.4.

We recommend taking this opportunity to check the update status of any mobile device used for Haiku, Canto or Limerick.  Perform any possible updates before May 13.

There are some older devices that cannot support iOS/iPadOS 13 or later and so will not work with Connect Care mobility apps.

• Reference: iOS version support by device

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:

• General
• COVID-19 and Connect Care - Testing for VITT
• Results Management for Emergency Departments
• Using RAAPID for Interfacility Transfers
• Digital Dictation Optimization Sessions
• Growing Awareness and Attention for Mixed-Context Prescribers
• Attaching and Sharing Clinical Objects via Connect Care Charts
• Printing in a Paperless System?
• Tips
• Tippy Series
• Tippy - Time-Mark from StoryBoard
• Tippy - Time-Mark for Notes
• Tippy - Equals Sign in Lookups
• Tippy - Set Start-up Activity
• Tippy - Personalized Toolbar
• Tippy - Fast Menu Buttons
• Questions
• How can I report a Serious Adverse Drug Reaction?
• How can I report an Adverse Effect Following Immunization?
• Does Connect Care In Basket or Secure Chat support attachments?
• Support
• Wave 3 Launch Support Hot Topics
• COVID and Connect Care
• COVID-19 and Connect Care - New Resources for Prescribers
• Manual
• COVID-19 - Connect Care Resources
• See What's New (many updates and additions)

Printing Requisitions in a Paperless Clinical Information System?

One of Connect Care's expected benefits is freedom from paper; and all the associated supply, mail, fax and storage costs. We've made progress! Already by Wave 3, paper-related expenses are dramatically reduced.

Connect Care clinicians may wonder why outpatient laboratory requisitions are printed when the Connect Care clinical information system supports both the clinician requesting a test and the laboratory performing the test.

In time, we hope to dispense with printed lab reqs altogether. However, until all sites have transitioned to  Connect Care, the following considerations can help prescribers ordering outpatient laboratory tests:

• Labs not using Connect Care
• Patients can present to any laboratory in Alberta to have samples drawn and tests performed. Some labs may currently use the Connect Care CIS while others may not. 
• Printed reqs provided to outpatients can be considered a protective for patient choice until all labs use Connect Care.
• Labs using Connect Care
• If a patient presents to a laboratory collection site already using the Connect Care CIS, a printed requisition for Connect Care ordered tests is not absolutely necessary. 
• With the patient's identity confirmed with government issued identification, laboratory staff can check Connect Care for open laboratory test orders.
• A printed requisition can still be useful because it confirms patient awareness of the tests to be performed at a specific time (note that patients using MyAHS Connect see pending tests in a section called "Upcoming Tests and Procedures").

Attaching and Sharing Clinical Objects via Connect Care Charts

The Connect Care one-patient-one-record-one-system goal will be achieved when all clinicians participating in a patient's care have access to the same record of care. Until then, clinicians may need to attach external "objects" (e.g., documents, images, scans) from external systems to the Connect Care chart. These, as well as images of clinical findings, can be selected for the attention of other users when linked to communications (In Basket or Secure Chat).

Connect Care users seek tips about how to capture and attach documents or media, then share with colleagues. We have updated relevant sections of the Manual and its links:

• Manual: Attaching Media (Objects) to Charts
• Tip: Importing Objects from a Local Computer
• FAQ: Sharing Attached Chart Objects

Growing Awareness and Attention for "Mixed-Context" Prescribers

Prescribers who work where the Connect Care clinical information system (CIS) is the record of care and also work in at least one setting where the CIS is not the record of care (inside or outside of AHS facilities supported by paper or electronic medical records) are said to be working in a "mixed context". Connect Care's Wave 3 launch has brought more mixed-context providers to the CIS, with impacts on how results or reports ("results") may route to their non-Connect Care contexts. 

A detailed explanation of changes to result routing (lab and DI results) is available in Result Routing for Mixed-Context Prescribers. Additional resources related to result routing are available in the Clinician Manual sections on Mixed Contexts and Results Management. 

Routing of reports and communications (consultations, letters, etc.) is also impacted. Regardless of where a patient is seen (Connect Care or non-Connect Care context), some messages must route to the CIS In Basket for all Connect Care users. This lowers the risk of a privacy breach and allows reports to be correctly directed to the correct provider, even when the report does not contain information identifying a precise routing destination. 

All users with Connect Care CIS access will need to regularly monitor their In Basket for tasks, communications, results or reports that pertain to their work within Connect Care contexts, as well as for the same related to patients seen where Connect Care is not the record of care. Connect Care can be personalized to support email alerts, out of contact and other functions to help prescribers know when new In Basket content is ready for review, or to delegate some In Basket tasks to others (see Manual: Mixed Contexts).

Result and/or report routing to In Basket may not be ideal for some providers. A working group is working on further solutions to improve the routing of important messages and reports to a prescriber's preferred system. Additionally, new mitigations for mixed-context prescribers and their clinics are being created.  

In Basket is a core function of Connect Care. If a prescriber uses Connect Care in any capacity, regular In Basket review and management is required. 

• Manual: Mixed Contexts
• Manual: Results Management
• FAQ: Results Routing for Mixed-Context Prescribers
• Guide: In Basket Best Practices

Digital Dictation Optimization Sessions

Please join the digital dictation team to explore advanced Dragon Medical One functions that are available in Connect Care. 

These Zoom-delivered optimization sessions will include:

• Step-by-step commands
• Autotext vs. SmartPhrases
• Manage vocabulary 
• Anchor and release speech focus
• Bring your questions and let us know what you’d like help with!

To register for a session on one of the dates below, click the relevant link:

• Tuesday, April 27, 2021 – 6:00 to 7:30 p.m.
• Thursday, April 29, 2021 – 6:00 to 7:30 p.m. 
• Thursday, May 6, 2021 – 6:00 to 7:30 p.m. 

More information:

• Contact: help.cmio@ahs.ca 
• Manual: Dictation

Using RAAPID for Interfacility Transfers

Connect Care supports for the “Referral, Access, Advice, Placement, Information & Destination" (RAAPID) service facilitate prescriber actions for patients who may need transfer between sites or consultative advice about care at a current site. 

Use of RAAPID to coordinate interfacility transfers (IFTs) is not mandatory, but use of Connect Care functions is strongly encouraged as it helps to automate workflows and increase visibility for the transfers within the system. Specific circumstances under which prescribers should consider using RAAPID-specific workflows include:

• Transfers to a higher level of care
  Consultation with a potentially receiving consultant is initiated with a RAAPID call. 
• Transfers to a lower level of care
  Arrangements are facilitated by a "RAAPID Repatriation" order entered into Connect Care. 
• Transfers for emergency care
  All ED to ED transfers must involve RAAPID. 

The benefits of using Connect Care with RAAPID include:

• A pending admission at the receiving site is automatically generated, setting up the patient for immediate arrival and access to the Connect Care chart. 
• RAAPID can send documents to involved providers, allowing for information transfer between care locations and seamless patient transitions.
• RAAPID can document the patient’s transportation needs and arrangements (i.e., EMS) together with estimated arrival time, allowing the receiving site to better prepare.
• From the RAAPID Patient Lists in Connect Care, all clinicians (e.g., Bed Planning, Managers, Charge Nurses) can track the progress details of a patient transfer, including physician acceptance, bed availability and patient appropriateness at/for the receiving site.

Further information about IFT workflows using RAAPID is available in the Clinician Manual.

Results Management for Emergency Departments

A number of prescribers spend at least some time contributing to emergency department (ED) services, where department-specific test result routing considerations may apply. These are summarized in a new section of the Connect Care Clinician Manual, with links to practical details in process and tip documents.

• Manual: Emergency Department Results and Reports Routing
• Process: Emergency Department Results Routing Pool Management
• Tip: In Basket Results Pool

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:

• Support
• Wave 3 Launch Support Hot Topics
• Dragon Medical One Upgrades
• Blogs
• All Prescriber Bulletin - Med Order Start Times
• Virtual Drop-in Centre Hours
• Connect Care's Wave 1 Wins Health Quality Award
• Connect Care Mobility - Managing Expectations
  
• All Prescriber Bulletin - COVID-19 Vaccination Records
• Tips
• Tippy Series
• Tippy - Fast Sorting
• Tippy - MD Notifications in Patient Lists
• Tippy - Simple Patient List Reports
• Tippy - Custom Schedules
• Tippy - Provider Name Tweak in Schedule Lists
• Tippy - Right-Click Powers
• Tippy - Hover to Discover
• Tippy - Time Mark for Results
• Problem Power - A New Tips Series
• Informatics
• Handout Reminder for Wave 3 Supports
• Questions
• How can on-call coverage arrangements be reflected in Connect Care?
• Why are some lab results missing from Connect Care mobile apps?
• How did I get that test order wrong?
• Are there limits to Connect Care Mobility supports for Orders?
• Why can't I log in to my job type?
• COVID and Connect Care
• COVID-19 and Connect Care - New Resources for Prescribers
• Manual
• COVID-19 - Connect Care Resources
• See What's New (many updates and additions)

COVID-19 and Connect Care - Testing for VITT

Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT) is an extraordinarily rare hematologic complication associated with COVID-19 vaccination. Symptoms may include persistent and severe headache, focal neurological findings, seizures, blurred vision, shortness of breath, chest or abdominal pain, swelling and redness in a limb or pallor and coldness in a limb. Onset may occur between 4-28 days after immunization (first or second vaccine). Laboratory findings may include thrombocytopenia, elevated D-dimer or imaging evidence of thrombosis.

In general, suspected VITT should be referred to a consulting Hematologist or Thrombosis physician who will oversee collection of required specimens in appropriate tubes, complete special laboratory requisitions and communicate with relevant reference laboratories. The consultant will take care of Connect Care orders (or will give the requesting physician specific instructions about which tests to order and how). 

In sum, the important action for Connect Care prescribers is to order a Hematology consult and speak directly with the consultant.

• APL: VITT Instructions for Hematologists and Thrombosis Physicians
• ISTH: VITT Diagnostic Flow Chart

All Prescriber Bulletin - COVID-19 Vaccination Records

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

Documenting COVID-19 Immunizations in Connect Care

We've previously posted about how provincial immunization information systems interface to Connect Care, where the health record includes a patient's immunization history. 

There can be gaps. Patients may receive vaccinations at clinics, offices or other provinces that do not send data to Alberta's provincial records. In addition, if Connect Care does not yet have an order for a new vaccine (as is the case for COVID-19 for a period of time), documentation is not automatic.

Prescribers can use a simple manual process to record past patient vaccinations that have not been captured in Connect Care (be careful to work from an official record of administration, select the correct COVID-19 vaccine type, and note that in-hospital vaccination events will be independently recorded by vaccination staff):

• Manual: Documenting Immunizations
• Tip: Documenting Immunizations
• Insite: COVID-19 Immunization Information

Connect Care Mobility - Managing Expectations

Connect Care mobility continues to prove very popular with prescribers. As with Waves 1 and 2, uptake of speech recognition (Dragon Medical One for in-system dictation) has been almost instantaneous in Wave 3. Mobile applications that provide access to the health record (Haiku for smartphones and Canto for iPads) have also enjoyed rapid adoption.

While the enthusiasm is great, a bit of expectation management might be timely. 

We've posted some updates to the Manual, FAQs and Tips to remind about care needed when prescribers with multiple jobs use mobile apps, limits to the number of lab results accessible via mobile apps, and important differences between what the iOS and Android versions of Haiku are capable of:

• Manual: Mobility
• Manual: Mobile Devices
• Tip: Considerations when selecting a mobile device
• FAQ: Why can't I log on to my job type?
• FAQ: Are there limits to mobility supports for orders?
• FAQ: Why are some lab results missing from mobility?