What is a CIS "Environment"?

It is exciting to get ever more exposure to what the Connect Care clinical information system (CIS) will look like at launch. Along the way, we are called upon to work in a variety of CIS "environments". Each has a specific purpose, and properties suited to that purpose.

Our eHealth Glossary has been updated to include definitions of all the CIS environments that may be encountered by clinical informaticians. Each acronym (e.g., PRD, SBX, PLY, etc.) is defined together with information about the groups who have access, and under what conditions. The following link pulls environment definitions from the glossary:

• Environment definitions: glossary.connect-care.ca/?=environments

How will current eHealth initiatives enhance continuity of care?

[repost from AMA MD Scope]

Continuity of care is about a patient and provider health care experience that is coherent, connected, coordinated and consistent with patient goals.

Connect Care, community EMRs, Netcare, and the Community Information Integration (CII) and Central Patient Attachment Registry (CPAR) will build connectivity to defragment the health information space and increase access to it; bringing continuity to Albertans' experience of health care.

• News article: Alberta Medical Association MD Scope

How can Connect Care connect with you?

In November 2019, Connect Care will begin launching at Wave 1 sites and programs, with the rest of Alberta Health Services (AHS) and its partners launching by the end of 2022.

Connect Care is becoming very real, very quickly, for all those clinicians not yet directly involved. This is a large and busy group. We want to make sure that all stakeholders are able to get the information they need via the channels that work best. Can you help us make sure you are getting the information you want, when and how you want it?

AHS Community Engagement and Communications wants to better understand the best ways to keep clinicians involved and informed about Connect Care. A short online survey (<2 min) remains open until 11:59 p.m. Sept. 3, 2019.

And, as always, please feel free to share feedback directly or through your physician informatics leads.

• Survey: Connect Care Communication Needs
• Feedback: connectcare@ahs.ca
• Physician Contacts: CMIO portfolio

Wave 1 Patient Movement Day - September 18, 2019

Patient Movement Day (PMD) offers a unique opportunity for clinicians to take a practical look at what in-patient journeys will look like in Connect Care.

All physicians, prescribers, nurses, allied health and other staff are encouraged to attend. They can see and learn about how complex patient movements are coordinated with clinical information system (CIS) tools and workflows. Morning demonstrations illustrate how Connect Care will facilitate the sequence of events that must occur for patients to flow safely and efficiently from emergency to ward, critical care, surgery, diagnostic imaging and other investigation and intervention venues. In the afternoon, drop-in practice centers (including a physician practice center) allow participants to dig deeper, view more specific workflows, ask questions and practice different patient movement scenarios.

Wave 1 Patient Movement Day occurs Wednesday September 18, 2019 from 08:30 to 16:00, with scenario explorations and demonstrations in the morning and practice activities in the afternoon. A more detailed agenda will follow, allowing physicians to focus on the transitions most relevant to their practice.

• Byte: Patient Movement Day

Training Milestone - First MD Cohort Completes Basic Training

We are delighted to see the first group of Wave-1 physicians complete their basic training!

12 paediatricians worked with a physician trainer and 2 physician super users to progress through a curriculum customized to their typical workday, work setting and clinical tasks. The training environment worked well and everyone was able to progress through the planned tasks. All participants were appropriately allocated the right Connect Care applications. And it was clear that physicians training physicians is appreciated.

Of course, we noted ways in which the experience could be improved. The trainers' learnings are summarized, shared and used to tweak the next set of training sessions.

In particular, we are very aware of some challenges with the MyLearningLink learning management system. The recommended self-directed modules are not filtering correctly, with the result that physicians see all possible modules when checking "Required Courses", not the ones that pertain to their track. We are putting together supplementary QuickStart guides to help the next wave of trainees to pick out what matters most.

Huge thanks to our first participants, and to the Connect Care training team. We're finding our stride!

Connect Care Clinical Inquiry Newsletter

We've previously posted about how Connect Care in-system inquiry tools can help AHS grow as a learning healthcare organization.

The Connect Care Clinical Inquiry Newsletter offers an excellent way for those interested to keep updated about developing capabilities, supports and processes related to clinical inquiry. There are many applications, including personal practice reviews, quality assurance, quality improvement, clinical research and process optimization.

The Newsletter releases monthly. For those interested in the same content via shorter but more frequent communications, subscribe the Clinical Inquiry Blog. 

With our current emphasis on training, change management and readiness, the Newsletter is full of great information about courses, webinars and emerging key contacts.

Physician Resources Listing Updated

Befitting the size and complexity of Connect Care, the volume and variety of communications grows exponentially as launch grows closer. Not all are of direct relevance to prescribers.

This (bytes.connect-care.ca) and other Connect Care communication channels for physicians can help. We highlight new and important topics, briefly, daily. Those who want to know more can link-out to single-page summaries ("Byte") and, from there, more detailed resources.

Not all physicians have the same Connect Care needs. Focused communication channels can help. Accordingly, we have started messaging for different listening styles and contexts. One new channel focuses on the needs of physicians who will not be using Connect Care as their record of care. Another focuses on physicians pursuing informatics opportunities.

A user-to-user peer support forum is part of our launch plans. We've set this up and are figuring out how to make it work well for those who value that kind of interaction. And we continue to work on a new physician manual to make key user-oriented documents readily available on mobile platforms. The physician handbook will focus on the more detailed information needs of super users, trainers, power users, builders and designers.

We will continue to summarize current and emerging links at resources.connect-care.ca (recently updated).

Connect Care for outside Connect Care

The Connect Care "Non-AHS Community Physician Advisory Group" gathers together stakeholders interested in Connect Care but not anticipating using Connect Care as their record of care. NACPAG has been active for a number of months and has already facilitated impactful analyses, consultations and recommendations. Above all, they have worked to improve communications about how Connect Care links with diverse provincial health informatics initiatives.

NACPAG supports its own blogging channel (bridges.connect-care.ca), where a newsletter series has been initiated. We encourage interested physicians to subscribe by following the instructions linked on the blog home page.

• Blog: Connect Care Bridges
• Newsletter: Connect Care Community Provider Update (August 2019)
• FAQ: Connect Care outside Connect Care
• Web: Connect Care Community Provider Resources

Medical Error - How big is the problem?

We approach the 10 year anniversary of publication of the Institute of Medicine's report, "To Err is Human: Building a Safer Health System," with growing awareness that health information systems can both prevent and contribute to medical error.

Where Safety relates to freedom from unacceptable risk, eSafety relates to freedom from unacceptable risk associated with the development, implementation and use of health information systems.

There have been great advances in our understanding of health safety, with many Canadian Patient Safety Institute facilitated initiatives now protective in health care facilities. We are also more measured in our understanding of patient safety, even recognizing that we may have over-estimated some risks. A recent healthydebate article explores the thinking.

What is Connect Care doing about patient safety and eSafety?

• eSafety Framework
• Clinical System Design (CSD) is informed by an eSafety Framework developed and adopted at the beginning of Connect Care. 
• User Interface Review
• Emerging clinical content is tested against an eSafety Checklist to avoid known interface and informational risks. Experienced human factors specialists facilitate this work.
• Workflow Review
• Human Factors also facilitates a detailed, click-by-click, review of common and complex workflows to ensure that no new interface, information or interaction flaws increase risks.
• Safety Incident Reporting
• The AHS safety reporting system is integrated with Connect Care, enabling users to report near-misses and other events without breaking workflows.
• eSafety Tracking
• Safety incident reporting and tracking now includes specific characterizations for errors directly or indirectly related to information system use.
• Embedded Problem Reporting
• Users are able to report, from within Connect Care information flows, aspects of their Connect Care experience that might contribute to error or safety.

We'll share more specifics as clinicians make their way through training and enhance our eSafety vigilance.