Provider Teams Live!

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

Provider Teams Launched

On the evening of Tuesday, June 30, 2020, an enhanced "Provider Teams" function was added to Connect Care. This adds flexibility, simplicity and power to the creation and management of facility patient lists.

The upgrade is complete and all inpatients are moved from the old "Provider Groups" to the matching "Provider Teams/Treatment Team". Selection of the designation Provider team for all admissions, consults and transfers is now part of relevant orders or order sets.

Please refer to the Manual and Tips for more information.

• Tip: Managing Provider Teams
• Manual: Patient Lists
• Crib-Sheet: Provider Team Names

Welcome new Trainees!

Connect Care continues its implementation, wave by wave, until the clinical information system (CIS) is province-wide 2 years from now. But not all newcomers on-board at wave launches. There is a steady stream of newly appointed physicians, elective trainees and rotating trainees, with July 1 bringing a wave of new residents to Connect Care.

This year, we are pleased to welcome incoming residents to a stabilized CIS rich with order sets and other clinical content ready to personalize.

Getting to know a new CIS can be challenging. Lean on experienced peers, picking up on content they share to speed the path to proficiency.

Connect Care provides other ways to share. Most important are the update (blogging) channels at blogs.connect-care.ca and the physician manual manual.connect-care.ca. All are mobile-friendly.

Some parts of the Blogs and Manual are useful for tapping into Connect Care street-smarts:

• Tippies - a stream within the Tips channel, these list simple time-saving tricks.
• Countdown Checklist - now cued to the Oct 24 launch, this thread has a lot of practical guidance
• FAQs - user questions and answers for common newcomer issues.
• Support - solutions and work-arounds for common problems.
• Manual - Connect Care Physician Manual (focus on the Personalization section)
• Resources - full listing of Connect Care resources for physicians.

Connect Care All-in-One

We've celebrated how Connect Care makes it easier to understand our patients' experience with health problems. But many may not appreciate how Connect Care also eases access to information about how to manage health problems.

There are a variety of ways to use clinical references, guidelines, websites and tools embedded in Connect Care:

• Resource Links - A top toolbar button called "Resource Links" lists a number of immediately useful clinical resources, including:
• AHS Clinical Guidance 
• AHS COVID-19 
• Point-of-Care Clinical Decision Supports :
• Dynamed - clinical handbook with evidence-based summaries about management of clinical conditions
• Lippincott Advisor - nursing & allied health clinical guidance and patient education
• Lippincott Procedures - instructions about a wide range of bedside procedures, including patient education handouts.
• Bugs and Drugs - evidence-based antimicrobial guidance
• Lexicomp - drug prescribing guidance and patient handouts
• Micromedex - detailed information about pharmaceutical agents and therapies, including POISINDEX and other toxicology information.
• AHS Emerging Pathogens - sensitivity and resistance surveillance.
• APL and Dynalife Laboratory Test Directories - information about available tests and sample collection requirements.
• General and Clinical calculator collections - wide range of conversion, formulae, and other clinical assists.
• AHS Knowledge Resource Service 
• AHS Insite 
• Dashboards - available as the "Dashboards" activity (tab) in Hyperspace
• Learning Home Dashboards - often include links to clinically useful resources
• Specialty Dashboards - are curated by Connect Care Area Councils and increasingly provide access to online resources of particular interest to clinical programs.

Some point-of-care resources are additionally "deep-linked" within ordering and documentation workflows, facilitating just-in-time access to relevant drug information, clinical guidance or patient handouts.

• Manual: Finding Knowledge

All-Prescriber Bulletin: Provider Teams and Patient Lists

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

Provider Teams - Simplified Patient List Management

On the evening of Tuesday, June 30, 2020, an enhanced "Provider Teams" function will be appear in Connect Care. This adds flexibility, simplicity and power to the creation and management of facility patient lists.

Previously, care teams (e.g., inpatient ward and consult services) would need to manually add patients to "Provider Group" lists, which could help track inpatients that a particular team might be accountable for.

The new "Provider Teams" will activate automatically on July 1, with the prior "Provider Group" listings transferred over. Of course, it is wise to confirm that nothing was missed in the cutover.

Going forward, all admitting, transfer and consultation workflows include assignment of patients to the correct inpatient and consulting teams. This is part of the ordering process and is mandatory. Thereafter, clinicians can further adjust Provider Team panels as needed. It's easily done using the care teams activity within a chart (click on the provider name in any chart Storyboard) or by right-clicking on a patient name in any patient list and using "Assign Teams" or "Remove Teams" popup menu options.

Impacts on Connect Care users? Prescribers and trainees will need to select a responsible Provider Team when admitting, consulting or transferring patients. In addition, some admission Order Set personalizations may need to be adjusted.

• Tip: Managing Provider Teams
• Manual: Patient Lists
• Crib-Sheet: Provider Team Names

Connect Care Off-Boarding

Prescribers may change or leave a clinical practice. Typical reasons include a move to a different jurisdiction with a different record of care, promotion, retirement or death. Indeed, many trainees transition to new roles and locations at this time of year.

For those leaving the Connect Care clinical record, off-boarding protocols must be followed. Clinical privileges are handled through Zone Medical Affairs Intake. In addition, specific Connect Care off-boarding tasks require prescriber attention. These include ensuring that In-Basket is assigned to a responsible provider or group, that Provider Team relationships are updated, the Phone Book (provider registry) is corrected and that Secure Chat settings are updated.

A new tip sheet covers the basics:

• Tip: Connect Care Off-Boarding for Prescribers
• Manual: Leaving Connect Care

Improved Support for Workers' Compensation Board Billing

Services performed as part of Workers’ Compensation Board (WCB) assessments can be submitted with Connect Care professional billing tools. However, the claim will not be satisfied unless the provider completes a form containing all information required by WCB.

Starting July 1, 2020, Connect Care is enhanced to ease compliance with WCB reporting requirements, both within scheduled WCB visits and for other visits where WCB assessments arise. Although any prescriber can use the new tools, only those who bill through Connect Care can expect that the claim and report will be submitted to WCB (and tracked) for them.

• Manual: Charge Capture

Design for Inclusion

Alberta Health Services promotes toleration, inclusivity and respect throughout a patient-focused health system that is accessible and sustainable for all Albertans. Early in the Connect Care experience, we committed to protecting sexual and gender identity by addressing patients by their affirmed (preferred) name... and we expressed this with affirmed names in all user interfaces (e.g., Patient Storyboard, Chart Review Snapshot, etc.).

Post-launch, we discovered some Smart Tools (e.g., SmartLinks found in some SmartPhrases) defaulting to legal rather than affirmed name. Work is underway to close this gap. SmartTool stakeholders are encouraged to participate:

• Instructions: Patient Name SmartTool Cleanup
• Submissions: ConnectCare.SOGI@ahs.ca
• Sponsor: Connect Care Sexual Orientation and Gender Identity Expression (SOGIE) Working Group

Virtual Care - Telephone Encounters

Although telephone calls with patients are commonplace, they increasingly support virtual care.  Telephone-facilitated assessment, follow-up, education and care planning is familiar to patients and easily supported with existing infrastructure.

A telephone encounter is suitable when in-person interaction is not required, video is not needed, and the patient’s hearing, speaking and cognition are adequate. A few tips can help clinicians help patients get the most out of telephone encounters:

• Tip: Telephone Encounters for Virtual Care
• Manual: Telephone Encounters

Connect Care Clinical Inquiry Supports - SlicerDicer Use Cases

We participate in clinical inquiry when we ask questions about what we do; and facilitate improvement when we use answers to do better.

Connect Care is, at its core, about inquiry. The vision is to better healthcare with better information. The clinical information system (CIS) supports this with tools enabling clinical data exploration, practice surveillance, hypothesis generation and continuing clinical improvement.

Now over 6 months after the first Connect Care launch, the time has come to expand use of Connect Care's inquiry-support tools. One tool is "SlicerDicer". This allows clinicians to interact with clinical data visualizations while asking and tweaking clinical questions. Examples include:

    Which patients have been exposed to a medication subject to a Health Canada alert?
    Which patients continue to follow assigned care paths?
    Which patients with a particular chronic illness have specific laboratory test results?
    Which patients are following recommended health maintenance guidelines?

We hope all physicians will be able to work with tools like SlicerDicer, including an ability to find and work with patients meeting specific search criteria. Please help us describe the importance of such functionality by offering your own use cases:

• Survey: SlicerDicer Use Cases

Connect Care Communication Norms Evolve

We've previously posted about Communication Norms, which express what Connect Care users expect of one another for efficient, safe and respectful information sharing within groups. Feedback and suggestions continue, with adjustments reflecting new learnings.

Connect Care's many communication tools can be a boon to teams, especially in the face of pandemic physical distancing. But the same tools can also prove frustrating, even unsafe, when used inappropriately or inconsistently. Unfortunately, there is no one definition for "appropriate". Some teams, for example, use secure messaging to great advantage, while other teams struggle and risk missed communications.

The single most important "norm" is for teams to be aware of the clinical information tools provided, and to jointly commit to a "communications pact". This spells out mutual expectations respecting the use of paging, telephone, secure messaging, In-Basket and other tools.

• Norms: Communication
• Manual: Communications

Connect Care Summative Documents to Netcare... Ensuring Success

We've previously posted about an expanded range of summative clinical documents flowing from Connect Care to the Netcare electronic health record. Later, we clarified the eligible document types. Now that a required upgrade has successfully completed, Netcare is able to accept summative documentation generated by Connect Care for sharing.

There is a slight workflow change that Connect Care physicians need to be aware of for outpatient consult and procedure communications.

When generating an outpatient communication -- such as a letter to the referring physician or a report about an outpatient procedure -- the selected "template" determines whether the report will go to Netcare or not. There are new template options. If the communication is appropriate for sharing to Netcare, be sure to pick a template that includes "Netcare" in its name.

• Manual: Shared Documents
• Tip: Sharing Outpatient Documents with Netcare

Connect Care Wave 2 Countdown!

Our countdown timer has re-appeared (see top of left column, just above the Search box) again!

After some COVID-19 distractions, the Connect Care launch schedule has resumed, with the Wave 2 launch date set for early hours of the morning of Saturday October 24, 2020. This will bring the following sites into the Connect Care fold:

• Devon General Hospital
• Fort Saskatchewan Community Hospital
• Leduc Community Hospital
• Gibbons Health unit, Redwater Health Centre, Morinville Clinic (labs only, no physicians)
• Westview Health Centre
• Sturgeon Community Hospital
• Strathcona Community Hospital
• North East Community Health Centre (except Family Practice Clinic)

We are approaching 100 days from the Wave 2 launch.

Having learned how important it is to avoid a last minute rush, our Countdown Checklist (checklist.connect-care.ca) also resumes. This allows physicians to pace tasks and ensure that requirements are met as they progress from registration through training, proficiency, personalization and launch-readiness.

• Link: Countdown Checklist - checklist.connect-care.ca
• Infographic: Wave scope and sequencing 
• Infographic: Wave 2 Physician Timelines

Connect Care Clinical Content Continuing Improvement

As other pre-pandemic activities resume across Alberta Health Services, Connect Care wave implementation activities also resume.  Connect Care Area Councils and their Specialty Working Groups and Support Units are re-engaging by reviewing requests for clinical content improvements, including decision, documentation and inquiry supports. A "Continuing Improvement Prioritization" work package offers a structured approach to defining, categorizing, prioritizing and allocating ongoing Clinical System Design (CSD) tasks.

Connect Care users generate improvement requests and have a keen interest in how they are handled. We'll provide high-level updates in this blog, with more detail for clinical informaticians and clinical system design participants in their respective channels:

• Blog: informatics.connect-care.ca
• Blog: csd.connect-care.ca

Post COVID Pulmonary Clinic Referrals

Current Connect Care users (wave 1) can refer recovering patients with COVID-19 respiratory symptoms to a new specialty clinic service.

A post-COVID Pulmonary Outpatient Clinic focuses on the detection and treatment of respiratory complications for patients hospitalized or treated in the community for COVID-related syndromes. The service is available for all physicians who would normally refer to or within the AHS Edmonton Zone and patients need to be able to travel to Kaye Edmonton Clinic or use AHS virtual health services.

• Outpatient Connect Care Referral: 
• Service - Pulmonary
• Provider - Drs. Giovanni Ferrara or Ronald Damant
• Reason - "COVID Follow-up" or "post-COVID Specialist Evaluation"

Connect Care Resumes Implementations

A Message from Dr. Francois Belanger & Sean Chilton: 

June 9, 2020

Dear staff, physicians and volunteers,

Along with re-launching other pre-pandemic activities across AHS, we are now re-launching Connect Care planning and implementation work for our next waves.

Waves 2 and 3 of Connect Care were temporarily delayed in March, given the significantly increased demands on our frontline physicians, staff and services, and the increased health risks our patients and healthcare teams faced due to COVID-19. While our response to COVID-19 continues, we are ready to resume the preparations for the upcoming waves. Those preparations were well underway before we paused this work.

Connect Care remains one of our highest organizational priorities. The delay of Connect Care allowed us to be strategic and align with the requirements of the public health measures and the demands on our staff and physicians for preparing and having the ability to respond to COVID-19.
As the pandemic demands increased, Wave 1 sites and programs were able to use Connect Care to support COVID-19 care. Connect Care was adapted to meet the needs of patients, staff and medical staff, including expanding our virtual care options, such as telephone and video visits for patients and families, adding travel screening and COVID-19 diagnosis areas to patient charts, and adapting a variety of other elements to support the COVID-19 response.

As we look to re-launch across Alberta, we know that the pandemic is not over and that we will need to maintain our ability to remain ready for COVID-19 patients in the foreseeable future. We have carefully assessed the situation and have adjusted our wave rollout plan and sequencing, based on the impact of COVID-19. Work also continued behind the scenes over the past months to lay the groundwork and put systems in place for new waves of Connect Care. Like so much of our work that has changed as a result of the pandemic, Connect Care’s re-launch will also include adaptations to how we prepare for the next waves – training and implementation will be modified from the models we used in Wave 1. The launch dates for waves 2, 3, and 4 are as follows:

• Wave 2: Launch date - Saturday, October 24, 2020
• Wave 3: Launch date - Saturday, February 27, 2021
• Wave 4: Launch date - Saturday, June 5, 2021

Details about which sites and programs are included in these launches can be found on the wave scope and sequencing diagram.

As we move forward with the plans for these waves, and Wave 2 in particular, we are taking into consideration that COVID-19 will continue to have some impact on our health system and that we will need to be adaptable in accordance with the COVID-19 viral activity and utilization of AHS facilities.  We will continue to assess the impacts of COVID-19 and other factors that may impact our re-launch strategy throughout the coming months, so we can adapt as necessary.

Starting this week, you will see activities to prepare for Connect Care increasing in Wave 2, 3 and 4 sites, including work on the physical infrastructure, data collection, training and other work to get us ready for these Connect Care launches.

We look forward to getting Connect Care in place across Alberta. Learning new systems and work flows can be challenging, and we want you to know you will be supported throughout the process. We have learned much from our launch of Wave 1 and the experiences of our staff and physicians who paved the way. As we embark on these next waves, it is good to remember our long-term goals for Connect Care:

• 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 frontline staff have access to the same clinical standards and best healthcare practices
• Allow all patients across Alberta to have access to their health information through the patient portal, MyAHS Connect
• Implement more consistent and standardized clinical and business processes
• Reduce the number of information systems which support clinical care

Ultimately, Connect Care means that the whole AHS healthcare team, including patients, will have the best possible information throughout their care journey.

Thank you for your ongoing support as we put this system in place to provide better healthcare to Albertans.

Dr. Francois Belanger
VP Quality and Chief Medical Officer

Sean Chilton
VP Health Professions and Practice and Information Technology

New Opportunity to Help with Connect Care User Supports

The AHS CMIO portfolio Editorial Board oversees a wide range of resources, references, training and other supports for prescriber users of the Connect Care clinical information system. Consider joining our team!

With the next waves of implementation approaching, we are renewing existing assets (Manual, Glossary, Handbook, Blogging, Twitter and other social media), and building new ones to serve growing numbers of users, trainers, super users, power users and builders.

An exciting opportunity awaits someone with technical writing, digital media and communications flair. Please check the position description and pass along to persons who might enjoy this work while joining a dynamic Connect Care team:

• Position: Digital Content Advisor