Understanding Connect Care Conversations

As design of the Connect Care clinical information system (CIS) progresses, more and more of us are drawn into conversations about Connect Care tools and how to use these purposefully. Many new terms, acronyms and abbreviations arise.

An "eHealth Glossary" can help.

Canada Health Infoway, a number of Universities, the Centre for Health Evidence and Alberta Health Services have collaborated to maintain a glossary of health informatics terms. This continues to grow, with emphasis on the applications and tools we now encounter in Connect Care.


User Group Meeting 2018 #1 - A great community

The annual Epic User Group Meeting (UGM) is a truly impressive gathering! Over 8,000 converge on the Epic campus at Verona, Wisconsin, for 5 days of meetings, councils, presentations, testing and updates. With Alberta Health Services formally announced as a new enterprise community member, a number of our leaders took time to learn during a most exciting and informative week. Some first impressions are summarized in the next series of blogs, with apologies for not properly attributing.

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

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

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


Connect Care August 24 Newsletter Posted

The August 24, 2018, Connect Care Newsletter is available via the link below; covering clinical benefits, Adoption & Validation 2 experiences, and learning new terms used in Connect Care conversations.

Mandatory Breach Reporting

From Dr. Francois Belanger:

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

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

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

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

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

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

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

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


Adoption & Validation 2 Moves us Further

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

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

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

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

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

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

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


Dr. Rob Hayward, Chief Medical Information Officer


Connect Care August 2018 Calendar

A summary of key Connect Care happenings in August 2018 has been posted to the Alberta Health Services internal Connect Care website, linked below.

A second adoption & validation session in Edmonton continues feedback, demonstration and consultation about how clinical and operational workflows are expressed in the emerging AHS Connect Care clinical information system (CIS). Clinical System Design continues to organize for decision-making through ratification of specialty workgroups and support units associated with Area Councils. Our understanding of options for placement of CIS access points in different workplaces advances with continuing research on non-medical device options and establishment of two simulation centres.


Connect Care August 10 Newsletter Posted

The August 10, 2018, Connect Care Newsletter is available via the link below; covering Adoption & Validation 2 preparations, infrastructure progress and selection of an Enterprise Content Manager partner.


Enterprise Content Services Partner Selected

Managing all the attachments that relate to patient records across the continuum of care is a huge job for Alberta Health Services (AHS). Epic Systems software, a key component of the Connect Care clinical information system (CIS) will do most of the leg work. Additionally, the CIS needs software to help manage the many non-Epic document sources that matter to a fully integrated health record.

An Enterprise Content Services (ECS) solution helps manage chart objects; and information about the objects (like keywords or creation dates). Once Connect Care goes live, the ECS solution will facilitate tasks like document scanning, categorizing and linking to the right part of a health record. The ECS solution will also consolidate information from multiple document management systems and so optimize workflow, access, management, storage and availability of all the artefacts that can arise during the patient’s health journey across the continuum of care.

AHS has now completed an ECS RFP process, selecting Quanum™ Enterprise Content Solutions (formerly known as ChartMaxx), from Quest Diagnostics™. Quest has extensive experience with Epic Systems, and is a 10-time ‘Best in KLAS’ leader in Document Management and Imaging.

This new ECS application will join the CIS fold and support the Connect Care commitment to “one person, one record, one system”. It will implement alongside other key CIS deliverables.


Connect Care Professional Billing Supports

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

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


Connect Care Infrastructure Information

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

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

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


Smart Stuff for Dummies

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

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

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


Alberta Referral Directory - Authentication-free Access

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

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

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


Reporting Health Informatics is Hard to Do!

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

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

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

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


Thank you Connect Care community!


We wanted to send along some words of appreciation and encouragement that we hear on a regular basis from Verna, ELT and our sponsors about the great work we are doing on Connect Care.  It is hard in the middle of everything going on to keep perspective on how far we have come. 

What we are doing is hard.  We are asking people to change what they have done for decades.  We are asking teams to make decisions in a hundredth of the time they are used to.  We are asking Connect Care teams to work at a pace and intensity we are not used to.  We are learning and growing as we do this work.  We are uniting a province in a way we have never done before.  It is not surprising that people are tired or getting snippy. 

Having said that, we have successfully pulled off 4 major conferences in as many months, we have answered over 2,000 questions, we have launched 24 Area Councils and many other work groups, we have established fundamental  or care content that will be used across the province, we have trained hundreds of people in a new tool and had them successfully start to configure it or start developing training materials.  We are helping the organization understand what this means for them, we are working as a team to grapple with any number of important questions.  You did that.  Every one of you should be incredibly proud of the work you are doing. 

We know that measuring progress can be tough on teams.  Know that the leadership in the organization see the progress reporting not as a failure on anyone’s part, but places where we need to provide more support.  There are so many things in play right now, we need to know who needs our support the most to remove roadblocks and help you. 

The organization as a whole is in awe of what you are doing.  We will have good days and bad days, but we are strong as a team, and we will have those together.

We hope you all have some downtime planned this long weekend with family and friends.  Thank you for all you are doing.

Penny, Barb and Rob


Adoption & Validation 2 Sessions August 14-16, 2018

Over 1500 subject matter experts (SMEs) and participants from across Alberta will be meeting in Edmonton at the Shaw Convention Centre from August 14-16 for the second of three Adoption & Validation sessions.

Earlier this year during the Direction Setting Sessions, participants made thousands of decisions that we have used to build parts of the Connect Care clinical information system (CIS). The purpose of Validation & Adoption is to review, validate and adopt how Direction Setting and other decisions are expressed in the emerging CIS. The second session gives opportunity for participants to contribute to  additional choices about how the system can support enhanced workflows.