Netcare Scheduled Update - April 3, 2020, 00:00-03:00

The Alberta Netcare Portal electronic health record will be taken offline for scheduled maintenance during the early morning of April 3, 2020 (affecting April 2 overnight shifts):

• Friday April 3, 2020, 00:00 (midnight) - 03:00 (AM)

Downtime information is available:

• ANP Downtime Contingency Kit
• AHS Affiliates: 1-877-311-4300
• Community users: 1-877-931-1638

Laboratory and other test results and reports will continue to be available in Connect Care. However, the Connect Care Netcare tab will not work during these time periods.

The update is needed to implement some improvements needed for COVID tracking.

On other Channels...

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

• Blogs
• Training goes Virtual
• Patient Movement Webinars
• Tips
• Remote respiratory distress assessment
• Tippy #26 - COVID Scores and Measures
• Support
• Printing Remotely
• External ER reports in Connect Care
• FAQ
• How is COVID-19 added to Problem Lists?
• Demos
• 
  
• Manual
• Working Remotely
• Virtual Care
• Patient Movement
• Basic Training

Connect Care Training goes Virtual

Although we always planned diverse pathways to Connect Care competency, a fabulous group of innovators have rapidly enabled virtual training for the many physicians now in need of new or expanded clinical information system (CIS) skills.

The Connect Care training teams, supported by AHS MyLearningLink and e-learning teams, have collaborated to design a number of self-directed as well as trainer-facilitated virtual learning modules.  These address an urgent need to on-board physicians, trainees and other clinicians who have no prior Connect Care experience or who are required to learn a new CIS module (e.g., ER, ICU, Inpatient).

Excellent work has been done in an extraordinarily short time! We are most grateful to the MLL and e-Learning experts for pulling out all stops to make good work happen.

The Connect Care Manual is updated to reflect all training options, with linked tip sheets explaining how to use requisite technologies. Physicians needing Connect Care readiness or up-skilling are are identified by Medical Affairs and invited to virtual training.

• Manual: Basic Training

Patient Movement Fundamentals Webinars

Patient movement is about how information flow supports healthcare flow.

A trauma patient can, for example, require task distribution among emergency, critical care, operating room, ward, interventional diagnostics and other care contexts. Each may have focus for a time, with unique orders, measures and workflows. Learning how to manage complex transitions proves one of our most persistent challenges.

A Patient Movement Team has studied tricky-transitions and organized a best practices webinar specifically for physicians, offered on three occasions:

• Tuesday March 31, 2020, 12:00-13:00
• Skype Conference ID: 6281284
• Skype Web Link

• Wednesday April 1, 2020, 12:00-13:00
• Skype Conference ID: 6281284
• Skype Web Link

• Thursday April 2, 2020, 12:00-13:00
• Skype Conference ID: 6281284
• Skype Web Link

Check out resources from the Patient Movement Team:

• Manual: Patient Movement
• Guide: Patient Movement
• Background: Patient Movement

AMA Virtual Care Webinars

The Alberta Medical Association has mobilized a number of resources to help physicians quickly adapt to the provision of virtual care during the COVID-19 pandemic (and beyond).

Two Virtual Care Quick Start Sessions have been organized for Friday, March 27, 2020 (both covering the same content) to address questions about technology choices, privacy protection, professional billing and best practices.

WEBINAR 1: 12:00 P.M.  – 13:15 March 27, 2020

• Zoom Meeting Link: https://albertadoctors.zoom.us/j/321038517
• Zoom Meeting ID: 321 038 517
• Dial in (optional for higher audio quality) +1 647 558 0588 or +1 587 328 1099 or +1 855 703 8985      

WEBINAR 2: 17:00 P.M.  – 18:15 March 27, 2020

• Zoom Meeting Link: https://albertadoctors.zoom.us/j/930810655
• Zoom Meeting ID: 930 810 655
• Dial in (optional for higher audio quality) +1 647 558 0588 or +1 587 328 1099 or +1 855 703 8985      

Presenters: Presenter: Dr. Heidi Fell, Family Physician, AMA Informatics Lead; Dr. Brad Bahler, Family Physician, ACTT Medical Director, Alberta Primary Care Alliance Chair; Norma Shipley, AMA Fees Consultant.

On other Channels...

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

• Blogs
• Working Remotely
• New Billing Codes
• COVID Admission Orders
• Tips
• Virtual Care Assessment of Oxygen Saturation
• Support
• Change to Location of External Orders in Inpatient Contexts
• FAQ
• When is patient consent required for digital communications?
• What admission sets are available for COVID presentations?
• Demos
• Getting Started with Connect Care Training
• Manual
• Remote Access
• Working Remotely
• Virtual Care (see Support Kit link)

COVID-19 and Connect Care #12 - Admission Orders

In a time of need, it is amazing how quickly things can get done!

Last week, a group of dedicated clinical experts, informaticians and analysts came together to assemble current best evidence, derive Alberta-contextualized clinical guidance, and design the first order sets to help support care of patients with COVID-19 presentations.

The Clinical System Design team were able to leverage the work of Strategic Clinical Networks, Area Councils and the Provincial Virology Program to build consensus using Alberta Health Service's Clinical Guidance Repository. This facilitated rapid review, feedback and deliberation, with >65 clinicians participating in a fully transparent process. Facilitated collaboration proved efficient, while  producing a guidance "transform" that informs order set development for all Alberta clinical information systems; as well as paper-based processes. IT teams are able to work with standardized designs to speed build of system-specific decision supports.

Use of the Clinical Guidance Repository improves tracking of ongoing review rounds and iterative production of future versions of COVID Order Sets and Panels. This helps us respond to rapid emergence of new evidence. And accountability is enhanced with one central location for storage and maintenance of system-agnostic, provincially-adjudicated, clinical content.

• FAQ: What COVID-19 Admission Order Sets are Available?

COVID-19 and Connect Care #11 - Professional Billing

The Connect Care Professional Billing team continues work from changes to the Schedule of Medical Benefits that are contemporaneous with the COVID-19 pandemic. A crib-sheet for physicians is updated to reflect the latest Alberta Health directives and Connect Care service code navigator adjustments.

• Crib-Sheet: Pandemic-related Professional Billing Changes
• FAQ: Billing
• Manual: Billing

Physicians Working Remotely

The COVID-19 pandemic changes the way physicians work.

Some are required to self-isolate. All promote social distancing at clinics and facilities. Work needs to continue when remote from offices, clinics or facilities, with implications acknowledged by the College of Physicians and Surgeons of Alberta and others.

We have produced a new guide offering practical advice about how physicians can work remotely while remaining mindful of organizational, legislative and professional obligations:

• Manual: Working Remotely
• Guide: Physicians Working Remotely

IT Grounds Us

The COVID-19 pandemic is "in our face"; totally.

Societal, professional, clinical, business and personal disruption could not be more visible. We see a world of new challenges and appreciate the many responses already in play.

It can be easy to miss what is less visible. Our informational infrastructure is below the surface, but essential to our capacity to respond to new challenges. All IT teams are working flat out, with constant overtime, to ensure that our information systems handle massively increased demands.

Thank you!!!! to help desk, health link, unified communications, patient & provider access and all the other information technology teams working so hard to keep the rest of us working!

On other Channels...

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

• Blogs
• Virtual Care Supports
• Communication Norms Updated
• COVID-19 Clinical System Design
• First Optimization Clinic Series Finishes
• Phishing Alerts
• Support
• Location of External Orders Changes
• FAQ
• How to Bill for COVID-19 Virtual Encounters- UPDATED
• New Billing Codes for Virtual Care
• Are AHS Zoom Videoconferences Secure?
• Demos
• Optimization Clinic Recordings
• Manual
• Virtual Care

Connect Care Optimization Clinics Paused

Optimization clinics are facilitated by peers and focused on challenging use cases. The clinic series has proved popular among clinical informaticians, super users, trainers and medical leaders; all of whom fan-out learnings in their respective areas.

Clinics were scheduled for January, February and March 2020 and, accordingly, are now concluded. A new series will begin at an equivalent time after the next Connect Care launch.

All optimization clinic topics are listed in this blog. Important byproducts include session recordings (in demos.connect-care.ca) and user supports, tips and FAQs added to the Physician Manual and Physician Updates.

COVID-19 and Connect Care #10 - Clinical Content Updates

Clinical information system (CIS) clinical content includes documentation, decision and inquiry best practice supports. Clinical System Design (CSD) is about how we plan, design and build clinical content. We've always asserted that CSD is an ongoing, iterative, way for us to continually improve the CIS while ensuring that it meets our needs.

COVID-19 is our top, iterative, priority. Connect Care CSD resources have been redirected, with new clinical content designed for all AHS systems (including paper). This blog summarizes recent developments.

Appointment Reminders

• Automated telephone and MyAHS Connect (patient portal) appointment reminder scripts have been enhanced to provide alerts about appointment diversion when ILI symptomatic. (Manual)

Travel & Exposure Screening

• A number of enhancements have been made to Travel and Exposure screening (now universally available across all clinical areas and contexts) 
• New Best Practice Advisories using this information to suggest appropriate infection prevention & control measures. (Manual, Tip)

Orders

• A new "COVID-19 NAT" order is now added to relevant preference lists, in addition to always being in the "facility list" within order activities for all modules. (FAQ)

Order Panels

• Physician builders and the most affected clinician groups have developed Order Panels (meaningful clusters of orders that can be shared) that can help with common needs, such as risk stratification and systemic complication tracking. We will promote the best of these to system-wide panels.

Order Sets

• COVID admission order sets (one adult, one peds) are released into production (search in orders using "COVID") and available for use and for personalization.
• COVID ICU admission orders sets (one adult, one peds) also are released into production.
• All order sets have extensive links to guidance and supporting evidence.
• COVID order sets will be continually updated as evidence and provincial protocols change.
• Key steps in the order sets are well annotated to help clinicians know how to make choices for optimal patient care.

Documentation Tools

• SmartPhrases are being developed to assist with rapid documentation of daily progress of COVID-related signs and symptoms. 

Professional Billing

• The re-cycled 03.01AD billing code (professional advice during a pandemic) has been added and is ready for billing.

Connect Care Communication Norms - Update

Connect Care seeks to improve continuity of information, relationships and intent in service of a coherent healthcare experience for patients and providers. Relational continuity is supported by good communication, as previously posted.

Communication Norms are about what Connect Care users expect of one another for effective, efficient, safe and respectful information sharing within and between groups. Although the Norms are now approved by the Connect Care Council, feedback and suggestions are always welcome.

Current public health challenges make our communication best practices doubly important... and difficult. A new section about video conferencing appears in the Norms and a practical guide for physicians has been drafted:

• Norms: Communication
• Guide: Video Conferencing for Collaboration and Care
• Manual: Virtual Care

COVID-19 and Connect Care #9 - Virtual Care Supports

As previously posted, AHS Virtual Health will continue to support physicians and patients who use existing telehealth, Skype or RealPresence tools for Virtual Care. In addition, AHS has extended its Zoom enterprise agreement to support clinicians interacting with one another or with patients.

Collaboration: Video conferencing can help clinicians working remotely from one another or their patients. Videoconferencing for collaboration should continue to use AHS Skype for Business when it is easily usable by all participants. However, physicians work in diverse contexts, often using personal devices, wherein the AHS instance of Skype may struggle. AHS Zoom provides an easy alternative for clinicians willing to (mostly) self-help. The CMIO portfolio, working with Medical Affairs, is organizing help for more complex needs.

Virtual Care: When videoconferencing is needed for virtual care, and telephone or Skype for Business or telehealth suites do not suffice, AHS Zoom can serve as a secure, health-appropriate, alternative. AHS Virtual Health is working to support these uses, initially focusing on the most pressing clinical use-cases.

Please see a new section of the Connect Care Physician Manual about Virtual Care. Links to tips can help physicians get started with AHS Zoom (ahs-cis.ca/zoom). Updated Connect Care Communication Norms offer advice about appropriate use of these tools. This is work in progress so check back from time to time.

We ask for some patience. The extended AHS Zoom service is new. The Manual entries and tip links will evolve as we discover tricks for trouble-free collaboration through Zoom video conferencing:

• Manual: Virtual Care
• Tip: AHS Zoom for Collaboration
• Tip: AHS Zoom for Care
• Tip: AHS Zoom for Mobility
• Guide: Videoconferencing for Collaboration and Care
• Norms: Communication
• FAQ: Billing for Virtual Care
• Insite: AHS Virtual Health
• Queries: AHS Virtual Health (VirtualHealthInfo@ahs.ca)

Practical Paranoia - Even in a Pandemic?

It is heartening to witness how a shared challenge brings out the best in us. It is disheartening to note how the same crisis brings out the worst in some.

While we struggle with COVID-19, it is deeply disappointing to witness an increased frequency of phishing and other cyber-attacks. These try to take advantage of forced work from less secure home networks.

In particular, phishing attacks are on the rise. These appear to come from a trusted source while inviting opening of a document or link. The unwary recipient can expose sensitive information or, worse,  fall prey to information extortion.

Please re-skim our many warnings about 'phishing', brush up on phishing-prevention, and be paranoid about any click-bait.

• Blogs: Practical Paranoia
• Blog: Don't get Caught! 
• Insite Tip: Don't be Scammed by Phishing Emails

New Supports for Virtual Meetings and Care

While Alberta Health Services is known for excellence in telehealth service, we face extraordinary challenges in the face of a COVID-19 pandemic:

• Many physicians are self-isolated and seek the means to continue to participate in outpatient care.
• Patient visits to outpatient facilities (and emergency rooms), risking COVID exposure of patients and providers, can be minimized if some needs can be addressed through telephone or video visits.
• Unfortunately, the use of telehealth suites does not address social distancing needs.

The CMIO portfolio has worked with AHS Communications and Telehealth to test easy-to-use, healthcare appropriate, virtual meeting and patient care tools that can also be fully integrated with the Connect Care clinical information system.  Zoom has been selected and enterprise licensing arranged. 

Zoom will be made available for use by physicians who need to organize consultations, meetings with colleagues or direct interactions with patients. The necessary arrangements are being made, with plans for AHS Virtual Health Services to manage access for clinical purpose and CMIO/Medical Affairs to facilitate account provision for meetings. 

More information will be posted in the coming days. Anyone can set up a free personal account with Zoom.us, possibly allowing time to learn the technology before getting access to the enterprise license. 

Watch this blog for more information!

On other Channels...

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

• Blogs
• Blog Series: COVID-19 and Connect Care
• Blog Reposting: Managing Stress and Anxiety Related to COVID-19
• Optimization Clinic: Simplifying Orders
• Support
• Haiku and Canto issues post-upgrade
• After-Visit-Summary printing post-upgrade
• FAQ
• How to Bill for COVID-19 Virtual Encounters
• How is COVID-19 Testing Ordered?
• Can patients get COVID results in MyAHS Connect?
• Where are COVID results displayed in Connect Care?
• Demos
• Optimization Clinic Recordings
• Manual
• COVID-19 CIS Supports

Adjustments to Waves 2-3 Readiness Activities

A number of adjustments to Waves 2-3 readiness activities are in the works, all the consequence of our decision to focus efforts on COVID needs. Details of the following will be communicated to those affected:

• Connect Care Oversight
• Many user groups, advisory groups, committees and area councils will temporarily suspend or reduce meetings. Some oversight groups most involved in new clinical system design activities may temporarily ramp up in order to respond to rapidly evolving needs. This includes the Coordinating Support Unit and task groups dealing with COVID-related decision, documentation and inquiry (reporting) supports.
• Technical Dress Rehersal
• As this is light on clinician demands, it will proceed as planned so that infrastructure readiness meets milestones that remain important.
• 60 and 30 day Launch Readiness Assessments
• These will be rescheduled
• Non-medical device roadshows
• Also postponed until further notice; although some activities will move to online and other means to continue exposure and awareness.
• Command structures
• These resources shift to COVID planning and support.

COVID-19 and Connect Care #8 - Training

The Connect Care initiative remains focused on supporting physicians, staff and patients across Alberta as the province responds to COVID-19. Over the weekend, AHS leadership announced the formal delay of the launch of Waves 2 and 3 of Connect Care. As a result, all in-class prescriber training sessions for Wave 2-3 are postponed.

The CMIO portfolio is re-focusing on emerging prescriber needs, with top priority given to supporting the provision of best care as efficiently as possible.

COVID-19 affects physician and other prescriber deployments. There is immediate need for just-in-time training for physicians, nurse practitioners, residents and clinical associates/assistants stepping in to cover for shortages or extra needs where Connect Care is the record of care.

CMIO training materials (Basic, Personalization, Optimization) are being moved to online and distance learning supports, allowing us to avoid physician gatherings in small rooms. A team of trainers and physicians has formed to rapidly produce more self-serve demos and mini-tutorials. Early priorities include Emergency, Critical Care, Surgery and Inpatient Medicine/Pediatrics.

If you anticipate service at a Connect Care site as part of the COVID-19 response, your training needs will be flagged through Medical Affairs.  You will receive training instructions via email.   If you have questions about whether you will be needed at a Connect Care site, please contact your medical leader or medical affairs:

• MedicalAffairs.EdmontonZone-PhysicianResources@ahs.ca

Physician training-specific questions can be directed to mip@ahs.ca or cmio@ahs.ca.

If you are a Nurse Practitioner that is being seconded or temporarily re-assigned to support a Wave 1 site as part of the COVID-19 response, your role assignment and training needs will need to be identified through AHS HPSP. Contact advancedpracticenursing@ahs.ca with any questions.

Connect Care Optimization Clinic #12 - Simplifying Ordering

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

A tenth Connect Care Optimization Clinic is offered in a single session at noon on March 18, 2020. All are welcome.

Topic: Did you Want Fries with That?  Simplifying Ordering

• Facilitator: Dr. Darren Hudson
• Date: Wednesday, March 18, 2020
• Time: 1200-1300
• Meeting Link: clinic-b.connect-care.ca
• Calendar (iCal) file: ahs-cis.ca/clinic-b-ical
• Meeting ID: 930 576 272
• Audio: can use computer audio or telephone 
• Canada +1 647 558 0588 (then meeting ID)
• One click: +16475580588,,930576272
• Description:
• How to think about orders, order sets and phases of care.
• How to create order panels.
• How to personalize and share order sets. 
• Preparation:
• If you’ve never used Zoom, the Webinar software used for the clinics, we recommend you do a test call prior to the session here: https://zoom.us/test.
• Short demo videos on how to participate in a call can be found here: https://zoom.us/resources

COVID-19 and Connect Care #7 - CMIO Priorities

Connect Care Physician Update followers may have noticed that we've disabled the Wave 2-3 countdown timer (top left column) and the associated countdown checklist. Yesterday we announced the formal delay of Wave 2-3 launch.

None of this should be taken as indication of Connect Care pause. Rather, the intensity of our work is increased as we respond to a myriad of COVID-19 response needs.

A partial list of current actions and priorities:

• Physician Training
• Basic training for Wave 2-3 physicians is paused and all affected participants have been notified.
• All physician training materials (Basic, Personalization, Stabilization, Optimization) are being moved to online and distance learning supports, allowing us to avoid physician gatherings in small rooms.
• COVID-19 affects physician deployment, necessitating just-in-time training for many physicians who are stepping in to cover for shortages or extra need in areas where Connect Care is the record of care. 
• All trainee training is moved to virtual means.
• A team of trainers and physicians has formed to rapidly produce more online demos and mini-tutorials.
• Early priorities include Emergency, Critical Care, Surgery and Inpatient Medicine/Pediatrics.
• Virtual Care
• There is pressing need for more capacity for specialist and primary care physicians to manage as many ambulatory encounters as possible using virtual care, sparing clinics for urgent needs and minimizing COVID exposures in clinic.
• Connect Care virtual visit types are being enhanced and new support materials produced (keep an eye on the physician manual).
• We are fast-tracking a provincial license for technology to allow physicians to provide secure virtual visit supports to patients at a distance (more news later this week).
• The same technology will support more virtual physician meetings and consultations so that we can tap into the capacity of providers on isolation.
• We are working to promote flexible use of telephone and virtual visit billing codes for physicians.
• Screening and Surveillance
• Standardized travel and exposure screening tools have been optimized and deployed across all contexts and all clinicians. Best Practice Advisories have been tuned to the latest public health recommendations. Isolation flags are likewise tweaked.
• New reports facilitate instant tracking of screening results and patterns.
• Support for release of COVID test results to MyAHS Connect
• Decision Supports
• The Clinical System Design team has struck a new task force to fast-track development of ordersets, alerts, reminders and embedded care guides so that all prescribers have instant access to outcomes of a provincial virology clinical guidance group.
• Documentation Supports
• Work has begun to render text automation (SmartPhrase, SmartText) and other aids to faster documentation for clinicians managing COVID-related illness.
• Community Physician Supports
• We are advocating for faster access of non-Connect Care physicians to the Connect Care Provider Portal.

COVID-19 and Connect Care #6 - Waves 2-3 Delay

An important message from Verna Yiu, Francois Belanger and Sean Chilton:

AHS leadership has carefully weighed the impact of COVID-19 on our health system and has made the decision to temporarily delay our upcoming launch of Waves 2 and 3 of Connect Care.  Given the significantly increasing demands on our frontlines physicians, staff and services, and the increased health risks our patients and healthcare teams are facing due to COVID-19, we do not feel it would be prudent to launch these next waves of Connect Care as originally scheduled.

Connect Care is not being cancelled. The initiative remains one of our highest organizational priorities. A delay of the launch of Waves 2 and 3 allows us to be strategic with our resources and respectful of the demands on our staff and physicians.

We are currently assessing the situation and will adjust our wave rollout plan and sequencing, based on the impact of COVID-19. As this change in timing will affect all future waves, we want to make the sequencing decisions with as clear of a picture as possible. Firm dates for subsequent launches will be communicated once we know more.

We are thankful for all the work done to date in preparation for our next launches by our Connect Care leadership, program team, physicians and staff in Waves 2 and 3. Connect Care preparations will continue as ongoing support for the stabilization and support of Wave1 remains important.  Our immediate priority is to support Alberta’s COVID-19 response.

Thank you for your understanding as we work together to respond to these most immediate needs of Albertans.

COVID-19 and Connect Care #5 - Hot Topics

Connect Care is re-focusing on emerging physician needs that relate to the COVID-19 pandemic.

Existing and new workgroups are building and optimizing clinical content that can help with the care of patients with COVID-related problems. This includes travel and screening tools, ordering tools, ordersets for different presentations, documentation tools and reports.

A new section of the Connect Care Physician Manual highlights clinical system design innovations that can help physicians respond to COVID patient care needs.

• Manual: COVID-19
• Blog: COVID-19
• Questions: COVID-19

COVID-19 and Connect Care #4 - Training

The Connect Care initiative remains focused on supporting physicians, staff and patients across Alberta. Our work is re-focused as the impacts of COVID-19 preparations expand.

The CMIO portfolio is specifically intervening to rapidly enhance the clinical information system to support a new mix of patient care challenges. We recognize that the top priority for our providers is to provide best care as efficiently as possible.

ALERT: In-Person Training Sessions on HOLD

All in-person prescriber training sessions for the next two weeks are cancelled as of this posting. Communications have been sent to affected participants. A final decision about subsequent sessions will be made early next week. The CMIO training group is refocusing on the development and delivery of flexible online, webinar and other modes of training. This includes training that will be needed by physicians cross-covering current Connect Care sites in the coming months.

On other Channels...

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

• Blogs
• March 12 Upgrade (with list of changes)
• Advisories
• Returning AHS Traveler Guidance
• Support
• Watch for possible print misformat with upgrade
• Manual
• Travel and Exposure Screening
• Mobile Hygiene
• FAQ
• How to order COVID-19 testing
• Demos
• Optimization Clinic Recordings

First Connect Care Upgrade - March 12, 2020, 0030-0430 - What's new?

We've previously posted about the upcoming upgrade to Connect Care's clinical information system. Check there for reminders about downtime procedures.

Many have been asked for more detail about what might change. As previously reported, there are no changes with significant workflow or training implications. Many small changes, in aggregate, improve the user experience. Examples include:

• StoryBoard - more information, better organized, for many clinical areas include icon tweaks, procedure information for radiology, clearer patient identifiers, etc.
• Hyperspace - better visual indicators for the application (e.g. ASAP, Inpatient, OpTime) in effect, encounter context and chart locks.
• Applications - Lumens (e.g., difficult procedures) and Beacon (e.g., chemo history) are enhanced functionality.
• SmartText - new SmartLinks and SmartPhrases become available and will be summarized for uers.
• Mobility - user interface improvements for order and chart co-signing, MyAHS Connect messaging, treatment team assignment, and reports.

A full list of all changes (filtered to physician-facing) is available (with screenshots):

• Upgrade: Physician-facing Changes March 12, 2020

COVID-19 and Connect Care #3 - Mobile Device Hygiene

Our mobile devices are continuously with us.  In clinical environments, this means that they can act like a fomite. How can we reduce the risk of a mobile devices transmitting communicable disease?

Apple and other device vendors have updated their screen and keyboard cleaning recommendations. We've added to the Connect Care Physician Manual on this topic and will revise with new information as it becomes available.

• Manual: Mobile Device Hygiene

COVID-19 and Connect Care #2 - Physician Advocacy

The COVID-19 footprint grows... and with it physician concern about social, professional and organizational impacts.

Of course the final months of preparation for Connect Care Wave 2-3 adds another layer of anxiety: how will Connect Care and COVID intersect?

First, the CMIO portfolio has clinician support front of mind. We seek current and practical understanding of the physician experience. This includes reports from a large community of embedded informaticians as well as site visits and direct check-ins.

Second, the CMIO portfolio advocates for physicians throughout Connect Care planning. COVID impacts are reviewed in multiple meetings at multiple levels. Launch plans will be sensitive to our context and launch decisions will be revisited as our context changes.

Our phones, emails and social media are open and listening. Please share so we can work best for you!

• Resources: COVID Physician Information
• Resources: Connect Care Physician Resources (zone emails)
• Web: Connect Care for Physicians (zone contacts)

Connect Care Optimization Clinic #11 - Reports and Dashboards

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

A tenth Connect Care Optimization Clinic is offered in a single session at noon on March 11, 2020. All are welcome.

Topic: Reports and Dashboards

• Facilitator: Dr. Robert Hayward, CMIO
• Date: Wednesday, March 11, 2020
• Time: 1200-1300
• Meeting Link: clinic-b.connect-care.ca
• Calendar (iCal) file: ahs-cis.ca/clinic-b-ical
• Meeting ID: 930 576 272
• Audio: can use computer audio or telephone 
• Canada +1 647 558 0588 (then meeting ID)
• One click: +16475580588,,930576272
• Description:
• Dashboards allow organized display of many different types of information. They can be customized by physicians and can proved a great launchpad for what one most frequently needs to do or know. We'll show how to create or personalize Dashboards.
• Reports can help clinicians answer questions about the patients they see. They are an important aid to clinical inquiry. We'll show how to find, use, save an personalize a few basic reports. 
• Preparation:
• If you’ve never used Zoom, the Webinar software used for the clinics, we recommend you do a test call prior to the session here: https://zoom.us/test.
• Short demo videos on how to participate in a call can be found here: https://zoom.us/resources

All User Bulletin: Daylight Savings Time

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

Daylight Savings Time

On March 8, 2020, clocks turn forward 1 hour at 02:00 to become 03:00.

While ambulatory care is little affected by what happens in the early hours of the morning, emergent, inpatient, surgical and critical care contexts can be sensitive to the loss or gain of small time intervals. The Physician Manual lists key considerations:

• Manual: Daylight Savings Time
• Tip: Daylight Savings Time

Connect Care Scheduled Upgrade - March 12, 2020, 0030-0430

The Connect Care clinical information system will undergo a significant upgrade during the March scheduled downtime on Thursday March 12, 2020 in the early morning hours of (between midnight 00:30 and 04:30).  The various Hyperspace environments will be affected, as well as Mobility apps.

As with all scheduled downtimes, access to "PRDSRO" remains while the main production environment (PRD) is offline. This is a read-only copy of the most recent production (PRD) and allows all patient data to be reviewed. Any urgent orders or documentation that must be completed while PRD is offline can be handled through a combination of paper, eScription (provincial dictation) and Netcare activities.

Any paper ordering or charting will be uploaded by support staff once the downtime finishes. Physicians will want to validate this work.

Essential downtime instruction remains in the Connect Care Physician Manual:

• Manual: Downtime Procedures for Physicians
• Tip: Downtime Essentials for Physicians
• Tip: Downtime Orderset Access
• FAQ: Downtime Procedures for Physicians

Our quarterly update includes many small changes. None require special training or awareness for physicians, as there are no workflow or function changes. However, there are many simplifications and enhancements that collectively make the user experience more intuitive and enjoyable. 

For those seeking details, a comprehensive list of changes is available:

• List: Summary of Connect Care Update Changes March 12, 2020

Countdown Checklist W2-3 L-84: Personal Device

Continuing a list of essential actions for Wave 2-3 physicians readying for Connect Care Launch May 30, 2020...

• Pick Personal Device(s) for Connect Care Use

Many of us will prefer doing some clinical information system (CIS) tasks on mobile or personal computing devices. These are set up to our liking, move with us, and work well in Connect Care facilities. 

This is a good time to check whether what we have is what we'll want to use. Indeed, it may be time to consider purchasing a new mobile device for clinical use, noting that some compensation is available through the AMA CME fund but only if claimed before March 31, 2020. 

The following information can help decide what to procure or prepare:

• Blog: Enterprise Support for Mobile Device Purchases
• Tip: Considerations when Choosing a Mobile Device
• FAQ: Connect Care Mobility

COVID-19 and Connect Care #1 - Clinical Content

With Alberta reporting its first presumptive case of COVID-19, this is a good time to remind our Connect Care clinicians about how the clinical information system has been configured to support risk surveillance and management.

All patients, at all Connect Care encounters, are asked about exposure or symptoms that might indicate risk for epidemic disease. All clinicians can review risk information and access relevant guidance to support decisions and documentation.

Please see an updated section of the Physician Manual and a linked tip illustrating how to view, edit, and document COVID and other exposure risks:

• Manual: Travel and Exposure Screening
• Tip: Travel and Exposure Screening
• Resources: Novel Coronavirus (COVID-19)
• Map: COVID-19 Outbreak Tracker

Great News - New Medicine Chair

We are thrilled to learn that Dr. Narmin Kassam, a Connect Care Area Council co-chair, Super User, Area Trainer and all-round super-innovator and problem-solver becomes the Edmonton Zone chair of medicine starting next month.

We will continue all work to leverage the Connect Care wave 1 beachhead for clinical improvement.

• News: Narmin Kassam to lead Department of Medicine

Connect Care Waves 2-3 90 Day Launch Readiness Assessment

Among many preparations for the Connect Care launch later this year are Launch Readiness Assessments (LRA). These bring together all participants in the Connect Care initiative to  report on progress and to problem-solve impediments. This taking-the-temperature is invaluable for nimble adjustments and collaborative coordination.

An important 90 day LRA occurs today, March 4 2020, via Skype and Telehealth locations in Edmonton and Calgary. Connect Care team members and Wave 2-3 leaders and participants, review all streams of work for progress, risks and launch readiness.

• Insite: Connect Care Readiness Activities
• Edmonton Zone Readiness Resources: edmonton.connect-care.ca
• Calgary Zone Readiness Resources: calgary.connect-care.ca

Countdown Checklist W2-3 L-86: Bookmark Resources

Continuing a list of essential actions for Wave 2-3 physicians readying for Connect Care Launch May 30, 2020...

• Bookmark Connect Care Physician Resources 

While this blogging site (blogs.connect-care.ca), its various channels (see buttons above), and the Connect Care Physician Manual (manual.connect-care.ca) remain the prime Connect Care information sources for physicians, valuable local information is available through other CMIO and zone resources.

Worth bookmarking:

• List: Resources for Physicians (resources.connect-care.ca) 
• Web: General Connect Care Information for Physicians (connect-care.ca)
• Web: Calgary Zone (Wave 2) Information (calgary.connect-care.ca)
• Web: Edmonton Zone (Wave 3) Information (edmonton.connect-care.ca)

Spring Forward

Twice a year we warp time... and frustrate clinical time keeping.

On March 8, 2020, clocks turn forward 1 hour at 02:00 to become 03:00. Then, on November 1, 2020, clocks turn backward 1 hour at 02:00 to become 01:00.

Clinicians need to be aware of these shifts and unique implications for Clinical Information System (CIS) behaviors. While ambulatory care is little affected by what happens in the early hours of the morning, emergent, inpatient, surgical and critical care contexts can be sensitive to the loss or gain of small time intervals.

A new section in the Physician Manual lists key considerations:

• Manual: Daylight Savings Time
• Tip: Daylight Savings Time

Connect Care Champions

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

It is always nice to see a colleague's contributions celebrated. Join us in recognizing the work of Sudhakar Sivapalan, who serves as a Connect Care area trainer in psychiatry!

• Connect Care Champions: Sudhakar Sivapalan 

Connect Care Optimization Clinic #10 - Using In Basket

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

A tenth Connect Care Optimization Clinic is offered in a single session at noon on March 4, 2020. All are welcome.

Topic: Using In Basket

• Facilitator: Dr. Steven Turner, ACMIO, Central Zone & team
• Date: Wednesday, March 4, 2020
• Time: 1200-1300
• Meeting Link: clinic-b.connect-care.ca
• Calendar (iCal) file: ahs-cis.ca/clinic-b-ical
• Meeting ID: 930 576 272
• Audio: can use computer audio or telephone 
• Canada +1 647 558 0588 (then meeting ID)
• One click: +16475580588,,930576272
• Description:
• In Basket is Connect Care’s secure communication hub. Prescribers use it to manage and action tasks, and to communicate with colleagues and patients.
• This session will provide a brief overview of In Basket functions, including:
• Sort/filtering
• Personalizing views 
• Quick actions
• Help reports. 
• The session will also address recent changes to patient messaging. 
• We will also talk about In Basket pool structures. 
• Preparation:
• If you’ve never used Zoom, the Webinar software used for the clinics, we recommend you do a test call prior to the session here: https://zoom.us/test.
• Short demo videos on how to participate in a call can be found here: https://zoom.us/resources