Connect Care December 20, 2019, Newsletter

The December 20, 2019, Connect Care Newsletter is available via the link below; covering 1) Connect Care sequencing, 2) Wave 1 Unit Story, 3) Reporting Content Certification, 4) Champions:


Connect Care Physician Supports during Holiday Period

Escalations of physician help requests have become relatively rare, which is reassuring as we enter the winter holiday season and reduced support staffing.

The CMIO portfolio has organized to ensure that clinical informatics and medical informatics resources are available on-call over this time. User support methods remain the same (see the Support section of the Connect Care Physician Manual) with the CMIO resources available if Help Desk is not able to resolve a problem.


Connect Care Wave Adjustments

With the launch of Connect Care’s Wave 1 in November almost behind us, we are now looking ahead to the next launches, occurring in waves over the next few years.

Following extensive discussion, senior leaders have adjusted the timing and scope of Connect Care’s Waves 2 and 3, and modified the scope of Waves 4 and 5. Wave 1 launched in November 2019 successfully and we want to align upcoming launch plans with lessons learned.

Patient care and safety, along with the needs of staff and physicians, is at the forefront of all of planning decisions, including this one. While mindful of healthcare funding constraints, the Connect Care initiative continues to be fully resourced to achieve its original completion targets. This includes working to resolve outstanding issues and challenges. We want to optimize timing so that staff and physicians within future waves are ready and supported at their launch dates.

Here is a summary of the modified Connect Care wave sequencing and timing:
  • Waves 2 and 3 (launching in May 2020) will include Calgary Zone rural and urgent care sites and the clinics and services aligned with those, and Edmonton Zone suburban sites. 
    • All of the Central Zone rollout, initially planned for Wave 2, will be moved to Wave 4. 
  • Waves 4 and 5 have scope and timelines recalibrated to ensure they are not too compressed by the delay of Central Zone’s rollout. The wave implementation schedule remains the same.  
    • Wave 4 (launching November 2020) will include the Royal Alexandra and Glenrose Hospitals in Edmonton Zone, all of Central Zone and Alberta Children’s Hospital in Calgary Zone.
    • Wave 5 (launching May 2021) includes Peace Country and Grande Prairie hospitals) in North Zone, the Foothills Medical Centre and South Health Campus hospitals in Calgary Zone, cancer programs in the north and south, and the coinciding rural labs.
  • The scope and sequencing of Waves 6, 7, 8 and 9 are being reviewed and details about any changes or updates to those waves will be available in the coming weeks. 
  • The timing for the rollout of Connect Care within Kidney Care North and South is still being determined.   
  • Wave 1 launched in November, 2019 and included the University, Mazankowski and Stollery hosptials, outpatient clinics across Edmonton Zone, the East Edmonton Health Centre, Pharmacy and Diagnostic Imaging sites in the Edmonton Zone, Alberta Public Labs sites in Edmonton and the North Zone, DynaLIFE sites across Alberta and the lab at the Cross Cancer Institute.
For more details about these changes, please refer to the updated Implementation Timeline.

The current plan reflects the best information available today.  We may need to make future adjustments as we continue to learn from, and adapt to, each Connect Care launch. We’ll also continue to be responsive to the needs of patients, families, staff and physicians.


Reminder: Tricky Transitions Tomorrow (optimization clinic)

Complex patient movements can affect how Connect Care orders are placed, when they are activated and how they are approved for action. The second Connect Care Optimization Clinic will seek input from participants about the types of "patient movement" challenges they may have experienced with orders. We will share a flow diagram highlighting key "tricky transitions" and the orders choices that can navigate them successfully.
We continue to experiment with webinar technologies that can serve prescribers joining virtual clinics from inside and outside AHS networks and using different personal computing configurations. Tomorrow, "Zoom" will be the platform in use. Please use the links provided below to try connecting well ahead of time. This will allow for any downloads or other adjustments needed to participate.
Note that there are two (duplicate) sessions. The morning session may better suit surgeon schedules.
Session #1 - December 18, 2019, 0700-0800
  • Meeting ID: 843 908 198
  • Audio: can use computer audio or telephone (647 558 0588 then meeting ID or one-click +16475580588,,843908198)
Session #2 - December 18, 2019, 1200-1300
  • Meeting ID: 359 904 795
  • Audio: can use computer audio or telephone (647 558 0588 then meeting ID or one-click +16475580588,,359904795


Connect Care December 2019 Calendar

A summary of key Connect Care happenings in December 2019 has been posted to the Alberta Health Services (AHS) internal Connect Care website, linked below.


Pharmacy Information Network Connect Care Interface Update

We previously posted about early efforts to interface Alberta's Pharmacy Information Network (PIN) with Connect Care medication reconciliation workflows, including an "outside information" function for PIN medication reconciliation.

This did not work as well as hoped. The function was removed so that PIN reconciliation reminders would not interfere with workflows. Of safety concern, the laborious task of importing medications from PIN did not benefit from clinical decision supports.

Connect Care users may not appreciate that it remains possible to review PIN dispensing information, even though one is no longer prompted to reconcile "outside" PIN medications. A full PIN list remains available in Netcare. This can be displayed in-context and allows a full history of (eligible) medication dispenses to be reviewed.

Some confusion may relate to orphan PIN medication reconciliation flags "left over" from the early Connect Care launch period. These should not be relied upon. No updates have occurred since early November. It is wise, and easy, to remove these flags:


New Inpatient Consults: Spiritual Care, Indigenous Health

Inpatient referrals to spiritual care and indigenous health services are now supported in Connect Care. Search for "Inpatient Consult to Spiritual Care" or "Inpatient Consult to Indigenous Health" to complete a request, entering contextual information in the usual fashion.

Connect Care Optimization Clinic #2 - Tricky Transitions

Optimization clinics are delivered by peers, usually a clinician informatician or super user, with focus on challenging use cases. A short presentation is followed by questions, discussion and suggestions from participants. Any new tips are posted to the Physician Manual or Physician Updates.

A second Connect Care Optimization Clinic is offered a two times of day (duplicate clinics) to better fit physician schedules. All are welcome. Please try the meeting link ahead of time to ensure that your computer is ready before the session.
  • Topic: Tricky Transitions
  • Facilitators: Rob Hayward, Alan Sobey
  • Date: December 18, 2019
  • Time #1: 0700-0800
    • Meeting Link: clinic-a.connect-care.ca
    • Meeting ID: 843 908 198
    • Audio: can use computer audio or telephone 
      • Canada +1 647 558 0588 (then meeting ID)
      • One click: +16475580588,,843908198
  • Time #2: 1200-1300
    • Meeting Link: clinic-b.connect-care.ca
    • Meeting ID: 359 904 795
    • Audio: can use computer audio or telephone 
      • Canada +1 647 558 0588 (then meeting ID)
      • One click: +16475580588,,359904795
  • Description:
    • Complex patient movements can affect how Connect Care orders are placed, when they are activated and how they are approved. Our focus will be on the sorts of problems that may arise when patients transition to settings or phases along a care pathway. 
    • We’ll demonstrate and discuss how Connect Care physicians can take corrective action, with a focus on Orders clean-up.


Connect Care System Update - December 12, 2019

A scheduled downtime in the early hours of December 12, 2019 allows Connect Care production servers to be updated with a number of enhancements.

Mostly, these relate to change-needs arising from our early post-launch experience. Some updates reflect our commitment to keep Connect Care current with Epic's latest enhancements. For example, improvements will be noticed by physicians using the Android version of Haiku.

The downtime window will also be used for updates and fixes to Dragon Medical One, including correction of microphone persistence and voice command issues.

A complete list of changes, keyed to Epic modules, includes notes about what users may notice:

Downtime Resources for Physicians

Connect Care has its first scheduled downtime overnight (early hours of Thursday Dec 12, 2019 sometime between 0030-0430).

Straightforward instructions for physicians (which complement the more detailed Connect Care Downtime Resources at ahs-cis.ca/downtime) have been updated and streamlined:


All-User Bulletin: Connect Care Service Interruption

All-user-bulletins highlight stumbling blocks, and solutions, that all physicians need to be aware of when starting to use the Connect Care clinical information system.

Service Interruption Dec 10, 10:10 - what to do
While preparing for a system update Thursday morning (see post), the Internet servers that support Connect Care Hyperspace were being prepared and a few encountered a brief outage.

This affected some Hyperspace users who may have noticed error messages or loss of access to patient charts. Although the unplanned, unscheduled, interruption lasted only minutes, some workstation sessions may remain ineffective. The solution is to simply re-boot the workstation.

Mobility remained active during this time, a reminder that Canto, Haiku and Rover are alternate ways to get into a chart.

The incident has been analyzed and this kind of server adjustment will not be attempted again in this way.


Connect Care Scheduled Downtime

The Connect Care production environment (PRD) needs periodic maintenance. This allows system fixes to be installed without risking database content and also gives opportunity to install quarterly software updates.

The first scheduled update will occur Thursday December 12, 2019, sometime between 0030-0430 in the early morning hours. While access to PRD is taken offline, access to "PRDSRO" remains. 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 and Netcare activities. Try to postpone and avoid use of paper, as PRD is likely to be restored quickly.

Any paper ordering or charting will be uploaded by support staff once the downtime finishes. Physicians will want to validate this work. Charting deficiency notifications may appear later in In-Basket but can be addressed with the smartphrase ".DOWNTIME".

Additional instruction remains available in the Connect Care Physician Manual:


Connect Care December 6, 2019, Newsletter Posted

The December 6, 2019, Connect Care Newsletter is available via the link below; covering 1) Connect Care's first month, 2) eHealth, 3) Champions:


All Physician Bulletin - In-System Dictation Downtime

All-physician-bulletins highlight stumbling blocks, and solutions, that all physicians need to be aware of when starting to use the Connect Care clinical information system.

Dragon Medical One brief Downtime Dec 06, 0100-0200...
There is a scheduled Dragon Medical One (DMO) outage set for December 6 sometime between 0100 and 0200 (overnight). The vendor hopes it may be complete in <10 mins.
During this time, physicians will receive an error message if they try to start a new in-system dictation using DMO. Any dictation initiated before the downtime will be saved, but users will not be able to start another dictation session until the upgrade is complete.

Of course all other methods of documentation remain available within Connect Care. Users who strongly prefer DMO can record a few text notes and return later to delete and dictate or supplement and dictate.


One Month of Connect Care

A Message from Dr. Verna Yiu, AHS President and CEO 

Dear staff, physicians and volunteers,

We now have one month officially behind us in our Wave 1 Connect Care journey.  Congratulations to all of our sites and teams across AHS who have provided strong support for our Wave 1 colleagues as they pave the way for Connect Care across the province. For the past 30 days, teams have been working around the clock to provide support and help resolve issues. We are so proud of your collaborative spirit.

As we work together to become more comfortable and confident using Connect Care, we know there will be challenges along the way. Learning new systems and work flows can be difficult, and there have been issues as we figure it out. It is good to remember the long-term goals. 

Connect Care will:
  • House all AHS, partner and affiliate medical records to support care wherever Connect Care is in place.
  • Provide common decision-making tools and resources for clinicians, to ensure all our physicians and staff have access to the same clinical standards and best healthcare practices.
  • Eventually allow all patients across Alberta to have access to their health information through the patient portal, MyAHS Connect.
Ultimately, Connect Care means  the whole healthcare team, including patients, will have the best possible information throughout their care journey. 

Our healthcare providers and supporting teams are at the heart of all we do. We’ve taken some time to talk to several staff, physicians and patients involved in Wave 1 about what this month-long experience has meant to them.

Thank you for such a successful launch. Thank you for your patience and resilience. Because of you, we have accomplished so much in these last 30 days. I also want to thank and encourage those working on the combined Waves 2 and 3. There is much to learn from the first implementation and I appreciate all your efforts to get us ready for the next step.


Dr. Verna Yiu
AHS President and CEO