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:
Prior to Connect Care, clinical charting deficiencies were tracked and enforced through processes managed by Alberta Health Services (AHS) Health Information Management and zone Medical Affairs, with a focus on key summative documents required for all inpatient encounters.
Minimum charting expectations are reinforced for Connect Care users through In Basket reminder messages that reflect Clinical Documentation Norms and Required Documentation. The reminders flag missing or incomplete History & Physical, Discharge, Operative or Emergency Provider notes, along with tools for rapidly addressing or redirecting deficiencies.
Starting mid-January 2022, Connect Care charting deficiency reports are additionally received and acted upon by zone Medical Affairs to ensure compliance with AHS Medical Staff Bylaws & Rules. Privilege curtailment warnings are addressed by each zone’s Medical Affairs office.
As charting deficiency reports include items dating back to the first Connect Care launch, many deficiencies may have accrued for users who have not attended to chart completion In Basket reminders. Prescribers can review and act on Connect Care charting deficiencies via the In Basket chart messages folder.
There will be an upgrade to the Workspace ONE application that AHS uses to manage clinical mobile applications Friday, January 14, 2022, between 00:30 and 04:30.
For more information, please contact the AHS Service Desk at 1-877-311-4300.
Our countdown timer has re-appeared again (see top of left column, just above the Search box)!
The Connect Care Launch 4 date is set for the early hours of Saturday, May 28, 2022. This wave will bring many sites into the Connect Care fold, including the following:Given significantly increasing demands in Alberta Health Services facilities due to COVID-19, and the rapidly spreading Omicron variant, the date for Connect Care Launch 4 is adjusted. This will ensure that frontline and support teams have the time they need to prepare.
There is currently an unplanned outage of the Connect Care User Training (ACE) and Play (PLY) environments, which are used for independent learning and post-training practice. The Connect Care Technical Team is working on the issue, and we will update this notice when the system is fixed.
Update (2021-12-21, 11:25): Some ACE and PLY environments (ACE 11-18, PLY2) are now back online and are operating as expected. The remainder of the environments will be brought up online and worked on operationally throughout the day.
Alberta Netcare Portal will be unavailable Thursday, December 9, 2021 from 21:00 to 03:00 Friday, December 10, 2021. Connect Care will not be able to launch Netcare during this time.
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.
We've previously posted about updates to COVID-19 vaccination orders in Connect Care, reflecting things like changes in eligible populations, dosing intervals and boosters.
Further tweaks to these order sets, now in production, address the needs of newly eligible pediatric populations.
Prescribers providing direct care to COVID-19 patients are requested to participate in a voluntary survey to indicate the COVID-19–related terms that should remain active for Visit and Problem List diagnoses in Connect Care. This survey is open to both Connect Care and non-Connect Care users.
There are approximately 160 COVID-19–related terms for prescriber search and selection of Visit and Problem List diagnoses in Connect Care. A limited clinical review was recently completed under the direction of the Connect Care COVID-19 Working Group to reduce the number of front-facing COVID-19–related terms available to essential terms only. As a result of this review, the terms were grouped into two categories:
Survey responses will be used to determine which of the terms in the "Further clinical review" category will remain active in Connect Care. The terms in the "Essential" category are viewable in the survey for reference only. Terms not selected will be removed from display for all prescribers. Changes will not be retroactive.
The survey is voluntary and takes about 8 to 10 minutes to complete. It will be open until end of day on Sunday, December 12, 2021. If additional terms are required or you have any questions, please contact clinicalterminologies@ahs.ca.
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:
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:
The Connect Care laboratory medicine group seeks feedback about whether and why prescribers might use an available "comments" field when entering orders for laboratory tests in the Connect Care clinical information system. The following survey (closing November 11, 2021) can be used by any prescriber who enters orders for tests:
Survey feedback information will used to help optimize the design and use of order comments.
An important message from Dr. Francois Belanger, Chief Medical Officer, and Sean Chilton, Vice President Health Professions and Practice and Information Technology:
The flu season is soon upon us, with opportunistic immunization important for at-risk patients during hospitalizations.
Previously, the COVID-19 vaccination instructions and documentation suggested that COVID-19 immunization not be considered within 14 days of any other immunization event. The evidence, and guidance, is now clear that co-vaccinations are both safe and appropriate. The Connect Care order set and associated clinician documentation reflects this change.
We've previously posted about how to review COVID-19 immunization information in Netcare and Connect Care and how, if indicated, to add information about an otherwise undocumented vaccination as a historical immunization when patients present with formal documentation of non-Alberta immunizations.
Recent audits have uncovered some inappropriate (even fraudulent) instances of what appear to be formal external documents. Alberta's provincial COVID-19 vaccination validation service is resourced to assess and validate external vaccine documents. It is easily accessed and used by patients online.
Connect Care providers should direct patients to submit their external documents for approval and possible addition to the provincial registry, and should avoid manual entry of historical COVID-19 vaccine administrations into Connect Care. The provincial registry information is automatically copied into Connect Care when validated.
A series of webinars on therapy plans, to be hosted by the CMIO portfolio, had previously been advertised as occurring this fall. With the delay of Wave 4, these supplementary sessions will be deferred to a later date and rescheduled after a launch date is confirmed.
The rescheduled webinars will explain how therapy plans work, how they are used and how prior paper-based plans can be converted in readiness for launch. All Connect Care prescribers are welcome, as many may benefit from a refresher on ordering ongoing therapies.
Watch this space for information on the rescheduled webinars. In the meantime, users can access existing therapy plan resources:
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:
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:
Improvements to the Hyperspace inpatient chart Sidebar include aids for quickly finding, displaying and editing information in either the main (central), Sidebar (right) or pop-up chart spaces. The first set of tools appear by default when the inpatient Sidebar opens to its "Index & checklists" view. These nicely illustrate how the Sidebar can help users quickly access and update chart data that otherwise would require more familiarity with less-used parts of the chart.
The focus of the checklists view is on transition planning, whether that relates to discharge, transfer or a move to a different level of care.
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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:
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:
New patient assessments offer important opportunities to initiate core clinical data in the patient chart. This decreases the work of documentation thereafter, when clinicians can revise or validate information already entered.
Sidebar tools can help clinicians when they review information from other clinical information systems (e.g., Netcare) or from prior unstructured Connect Care documentation (dictated notes that, for example, did not include updated problem lists). The user needs to review and document at the same time, ideally without jumping back and forth between different windows.
The Sidebar can help in two ways, either when used to review information that informs documentation performed with main panel tools, or when used to enter information gleaned from the main panel.
Sidebar views of other clinical information system content are especially helpful when doing problem, adverse reaction or medication reconciliation, as explained in a recent Manual addition.
Users may notice changes to the "Sidebar" (rightmost panel appearing when a patient chart is opened to an inpatient encounter in Hyperspace) starting noon September 30, 2021. The best way to learn about new functions is to select the embedded help link to gain access to a quick overview:
All the same Sidebar information is available. However, many Sidebar views have been enhanced with better clinical summaries. The Sidebar index now uses information about the current provider, patient and clinical setting to conditionally display the most relevant information. In addition, new features make it easier to use the Sidebar to access charting tools that complement what one may be using in Hyperspace's main (centre) panel.
The biggest change relates to how the Sidebar summary index works. The index will always appear at the top of Sidebar views (default "Index" tab) and can be used to jump between different views. Index items have three parts:
Time-saving charting efficiencies become possible with effective use of Sidebar tools. We will post tips and tricks in the Building a Better Health Record series of this blog.
Our Bloat Busters series can help clinicians prevent "note bloat", a digital health record affliction that decreases the signal-to-noise ratio of clinical documentation and frustrates clinical decision-makers.
It can be difficult to break paper-appropriate habits when going paperless. A number of data elements -- such as patient names, birthdates and identifiers -- are important to insert on physical pages because these can be disrupted. Embedded identifying data helps restore pages to the correct chart and location.
Connect Care notes do not get such benefit from embedded identifiers. Clinical information system notes are digitally anchored. More importantly, any act of printing, copying or otherwise moving information causes headers and footers to be generated with unequivocal patient, encounter and event identifiers. This includes the date and time of documentation and other situating information.
No need to replicate!
Our Bloat Busters series can help clinicians prevent "note bloat", a digital health record affliction that decreases the signal-to-noise ratio of clinical documentation and frustrates clinical decision-makers.
The clinical value of progress (non-summative) documentation relates to a ratio of signal (clinically important new information reflecting developments in a patient's experience) to noise (information related to the patient, but not directly relevant to clinical progress) multiplied by interpretation (application of clinical expertise to information to advance understanding and support decision-making):
Digital health records make it easy to amplify noise in progress documentation. Copy-paste of prior documentation and some text automations ("SmartStuff") pull data blocks (e.g., vitals and laboratory flowsheets) into a note, adding signal, but often in company of a lot of noise. Authors can be lulled into thinking that documentation is done, while the note remains lean on clinically helpful interpretation. The reader of a progress note needs to know clearly what the writer thought and did for patient care.
The Connect Care Documentation Quality Improvement initiative ("Building a Better Health Record") introduces a number of new text automations, templates and other documentation aids that can help authors replicate chart data more selectively, while also being explicit about the clinical meaning of observations. Continue to follow this thread as we describe how to use the tools to your advantage.
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:
Our Bloat Busters series can help clinicians prevent "note bloat", a digital health record affliction that decreases the signal-to-noise ratio of clinical documentation and frustrates clinical decision-makers.
Connect Care users have not escaped a big "bloater" – copy-paste excess. On average, about a quarter of all notes contain content copied from elsewhere (other notes), with about a fifth of all note content duplicating other documentation. Understandable, since clinicians may think that, as with paper-based records, it is a service to use a progress note like a scrapbook, sparing the reader from having to flip through dense records.
Unfortunately, digital notes laden with copied-forward, then saved or edited, content make it unnecessarily difficult for the clinical reader to figure out what's new, current, trending or important. Connect Care documentation norms promote referencing prior documentation in preference to copying into current documentation. The current note should highlight, not obfuscate, change.
There is a workflow that helps! Progress notes can refer to prior notes (being specific about the note type, service and date; e.g., "see GIM Consult from 2021-09-20"). Even better is the ability to create an automated link to the prior documentation that will allow users to quickly see it in context.
Our Bloat Busters series can help clinicians prevent "note bloat", a digital health record affliction that decreases the signal-to-noise ratio of clinical documentation and frustrates clinical decision-makers.
Clinicians reviewing the clinical documentation of others may not always appreciate who authored the parts used to assemble the note, or how those parts were generated. It can be important to know, for example, that content was facilitated by text automations (e.g., SmartPhrases).
There is a documentation tool that helps!
When a documentation object (e.g., progress note) is open for review, look to the top right of the note display to find a hovering option menu with checkboxes for "Hide copied text" and "Hover for details":
Our Bloat Busters series can help clinicians prevent "note bloat", a digital health record affliction that decreases the signal-to-noise ratio of clinical documentation and frustrates clinical decision-makers.
Clinicians reviewing the clinical documentation of others may not always appreciate how much of it is copied from elsewhere and how much is original to the current note. The author may have copied-forward a prior note and then edited it to reflect current state and saved it as a new note. But the reader's interest may be less in a note as a snapshot for a point in time, and more in how the patient's condition is changing or progressing.
There is a documentation tool that helps!
When a documentation object (e.g., progress note) is open for review, look to the top right of the note display to find a hovering option menu with checkboxes for "Hide copied text" and "Hover for details":
Select the "Hide copied text" checkbox and note how content copied from elsewhere is greyed. This helps the reader get a quick sense of what is newly authored in the current note. The personalization icon can be used to have this feature persistently enabled.