2022-12-19

Connect Care Benefits - Prescriber Perspective

Prescribers were polled about how Connect Care affects the care they provide. The following slideshow summarizes key points...

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2022-12-09

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2022-12-05

Results Management for Emergency Departments

A number of prescribers spend at least some time contributing to emergency department (ED) services, where department-specific test result routing considerations may apply. These are summarized in a section of the Connect Care Manual, with links to practical details in process and tip documents. Key to note is that ED prescribers participating in an ED Results Pool should ensure they are signed into the pool while on shift in the ED so they can monitor the messages and manage the results in the pool.
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2022-12-02

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2022-11-25

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2022-11-18

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2022-11-16

Calgary Zone Bulletin - Ambulatory Results Management Update

User bulletins highlight stumbling blocks that all affected prescribers need to be aware of when using the Connect Care clinical information system.

Ambulatory Results Management Update

Starting November 16, 2022, some results from outside of the Calgary Zone will be suppressed from In Basket to reduce duplicate reports related to Calgary Zone patients. This is an interim state and will revert at some future date.

  • A hard copy (paper or fax) of results may be sent. Prescribers must regularly monitor Connect Care In Basket AND hard copy reports, and follow-up on results as needed.
  • All results are available in Netcare and the Connect Care patient chart.
  • To improve the reliability of result delivery to In Basket and reduce hard copy reports, be sure to use Connect Care requisitions when arranging for patients' laboratory testing.

For more information, see the memo.

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2022-11-11

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2022-11-09

No More Tweets

Although these Connect Care blog postings have been linked to Twitter notifications for a number of years, few of our target viewers use those feeds for following Bytes and related CMIO blogging channels.

The time seems right to leave the Twitter platform. Accordingly, all repostings are stopped and the associated Twitter accounts have been deleted.

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2022-11-06

Launch 5: We are GO!

All Connect Care systems activated on time at 05:00! 

Today, Connect Care welcomes 135 sites from across the province into the family, including Cancer Care Alberta and Alberta Kidney Care South. The first few days will be intense, but with lots of help at hand we are confident that progress will be fast. 

Prescribers, please make use of the drop-in centres and other launch supports (launchhelp.connect-care.ca). Watch this channel for any updates, as well as the Support channel for information on "hot topic" common issues that have been flagged for Launch 5 prescribers.

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2022-11-04

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2022-10-28

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BBHR: Interactive Patient Lists

Building a Better Health Record (BBHR)

As part of our documentation quality improvement initiative, we promote practical ways for clinicians to comply with minimum use norms.

Interactive Patient Lists

The Connect Care clinical information system (CIS) includes powerful tools for accessing, personalizing, building and sharing patient lists.

Those working on inpatient ward, consult or service teams can benefit from the creation of one or more personalized lists. Unfortunately, it can be daunting to know which columns (often with many similarly named options to choose from) to line up for a specific clinical need. 

A clinician-led working group has established standards for Patient List design and has used those to produce a growing set of high-performing, validated and clinician-recommended list columns (easy to recognize as descriptors start with "[AHS]"). In addition, a set of 6 patient list templates can help users initiate personal lists with preferred columns.

To start or adapt a "My List" personal list:

  • Use the "Edit List" menu (top left of Patient Lists activity) to pick the "Properties" submenu.
  • Look for a "Copy" button at the bottom left of the "Available Columns" section in the list editor. Click this.
  • Note the list templates with names that start with "++AHS IP MD..." (near the top of the pick-list) and select a template fitting the clinical workflow (e.g., ward rounds, ward consults, emergency consults).
  • Either use the patient list configuration as is, or add/remove columns to personalize. Columns that have descriptors starting with "[AHS]" are preferred.

A number of enhancements respond to user requests:

  • Content - Columns display succinct information that is formatted to comply with AHS standards.
  • Hover - Hovering over columns within patient rows triggers pop-up displays of relevant information.
  • Double-click - Activating a column within a patient row will either open a relevant editing tool within the list or will open the patient chart to a relevant activity.
  • Sorting - This is optimized for clinical use case.
  • Report - Again defaulted to best fit the clinical use case.
A number of Patient Lists resources have been updated:

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2022-10-27

BBHR: RAPID Rounds Report Consolidates Transition Planning Information

Building a Better Health Record (BBHR)

As part of our documentation quality improvement initiative, we promote practical ways for clinicians to provide clear and actionable communication at transitions of care.

RAPID Rounds Report

When a patient (row) is selected in a Rapid Rounds patient list, a "report" displays either below or to the side of the list (user preference). The default report for Rapid Rounds is a transition planning report. The same report can be viewed as a pop-up by double-clicking within the Room/Bed or Length of Stay (LOS) columns in the patient list. And the report is always available from inpatient chart sidebars.

The new report functions like a planning dashboard. It gathers in one place all information that might be needed when preparing for discharge or transfer. More importantly, the report is interactive. The displayed information can be selected (click or tap) to view deeper layers of related information. And the data (e.g., pre-admission community supports) can be edited in-place, allowing work to be done in patient lists without having to open individual charts.

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2022-10-26

BBHR: RAPID Rounds Patient List Supports Multidisciplinary Discharge Planning

Building a Better Health Record (BBHR)

As part of our documentation quality improvement initiative, we promote practical ways for clinicians to provide clear and actionable communication at transitions of care.

RAPID Rounds Patient List

"RAPID" (Review, Assess, Plan for Imminent Discharge) Rounds is a CoACT Collaborative Care activity that fosters communication within and between care team members, including patients and families. It facilitates timely coordination of care and decreases overall lengths of stay.

Connect Care provides a number of informational supports for Rapid Rounds, including:

  • Rapid Rounds Patient List - For use during multidisciplinary discharge planning rounds, this allows quick information access and documentation while reviewing a panel of inpatients.
  • Rapid Rounds Report - Provides a compressed summary of discharge planning information together with interactive tools for updating key data and multidisciplinary discharge readiness "traffic lights".
  • Transition Planning Sidebar - For use when a chart is opened to an inpatient encounter, replicating much of the information found in the Rapid Rounds report while speeding access to information best updated during day-to-day care.
Connect Care's patient lists serve as a gateway to inpatient workflows. A uniquely interactive list has been developed to support RAPID Rounds. This exposes information needed for discharge planning while allowing much of it to be updated without leaving the patient list.

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2022-10-24

BBHR: Introducing the Connect Care Transition Planning Package

Building a Better Health Record (BBHR)

As part of our documentation quality improvement initiative, we promote practical ways for clinicians to provide clear and actionable communication at transitions of care.

Connect Care Transition Planning Package

Preparing for discharge begins at admission. Some admissions are straightforward, with dates and dispositions unfolding as expected. Others are complex and require coordinated multidisciplinary planning to facilitate safe transitions. 

Connect Care provides a new set of integrated supports that can help clinicians with complex discharges, while improving communication with healthcare providers for all discharges. These tools comprise a "transitions planning package" that includes:

  • Improved Admission and Discharge Navigators
  • Expected Discharge Date (EDD Management) tools
  • Daily Checklists
  • Rapid Rounds Lists and Reports
  • Transition Planning Sidebars
  • Transition Planning Documentation blocks
  • LACE Readmission Index calculations and recommendations
  • Provincial Standardized Discharge and Transfer Summaries
  • Communications to Electronic Health Record (Netcare) and Electronic Medical Records (eDelivery)

The next series of BBHR postings will focus on transition planning tools, highlighting how they work with tips, guides and demonstrations. 

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2022-10-14

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2022-10-05

eCLINICIAN Viewer Launching October 7, 2022

With the launch of Connect Care in November 2019, the eCLINICIAN clinical information system has been maintained in read-only state to ensure that legacy clinical information remained accessible while plans for full decommissioning were being developed. As of October 7, 2022, the eCLINICIAN patient record access in Connect Care (via the “Other Clinical Systems” link in Storyboard or Sidebar) will be removed and replaced by an eCLINICIAN "Viewer." This will continue to provide access to key clinical information from the legacy system.

How does this impact me? 

The ability to access legacy clinical information will continue, but the access method may change:

  • Key clinical information required for continuity of care will be available in real time via the eCLINICIAN Viewer. Connect Care prescribers will be able to access this Viewer. 
  • eCLINICIAN Letters, Notes and Communications (encounters before July 1, 2017) can be found in the Viewer, but not in the original formatting. Images that were embedded in Progress Notes will not display in the Viewer.
  • The entire eCLINICIAN database has been added to the AHS Enterprise content management system ("Solix") which can recover and generate reports from legacy data.

Requests by Connect Care prescribers for information not available in the eCLINICIAN Viewer, or for purposes outside of continuity of care, can be submitted as follows:

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2022-09-30

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2022-09-16

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2022-09-02

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2022-08-31

LACE Index for Readmission Risk

Plentiful evidence shows that patients with multiple comorbidities, frequent emergency room visits or other frailty indicators are more likely to present for readmission to hospital within a short time following their last discharge. Many of these readmissions are preventable, mostly through anticipation, communication and provision of post-discharge supports. 

AHS uses the "LACE readmission risk index" to stratify patients into those who are at low, moderate or high risk for early readmission. The index considers the patient's length of stay, admission type, comorbidities and frequency of emergency room visits. 

Most of the information needed to calculate a LACE Index is available to Connect Care in-system, and does not need to be entered by prescribers. An automatically calculated LACE Index has been developed for Connect Care and has been tested during summer 2022. It is now in production, continually updated for all inpatients. 

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2022-08-30

All User Bulletin - Cognitive Assessment Tools

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

Change in Embedded Cognitive Assessment Tools

Connect Care provides access to a wide range of clinical scores, scales, calculations and assessment tools. These are described in the Clinician Manual.

Alberta Health Services (AHS) takes care to ensure that permission is obtained from copyright holders for any scores, scales or tools embedded in the Connect Care clinical information system.

The copyright contract for two popular cognitive assessment tools will expire August 31, 2022: the Standardized Mini-Mental State Examination (SMMSE) and the Montreal Cognitive Assessment (MoCA). AHS has carefully reviewed evidence-based alternatives and has elected to obtain permissions for a panel of these in Connect Care. 
Prescribers can find cognitive assessment tools via the Flowsheets activity within an opened chart. They are also available in a clinician-friendly format in both a "Scores and Scales" navigator (use chart search for "score" and select "jump to Scores and Scales") and the inpatient chart sidebar (use the sidebar index to navigate to a "Scores" view). Both the navigator and the sidebar have groupings for AHS approved cognitive assessment tools. 

The sidebar tools are interactive, in that any score can be selected to update its data then closed with the refreshed data showing in the sidebar. The Sidebar also provides links to the Navigator as well as other clinically useful quantitative tools.

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2022-08-26

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2022-08-12

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2022-07-29

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Unique Workflows During Interim States

Connect Care is a fully integrated clinical information system. Nonetheless, it may depend upon other health information systems for core data while implementation progresses, launch-by-launch, across Alberta. 

Interim states occur when Connect Care interoperates with an external health information system (e.g., laboratory services, pharmacy services) that will be replaced by Connect Care functionality later. The (temporary) dependency may require workflows different from where Connect Care is fully deployed.

Considerations for prescribers are now linked in the Connect Care Clinician Manual:

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2022-07-28

Connect Care Summative Documents - Mindful Signing

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

Mindful Signing of Summative Documents

Connect Care automatically shares key summative documents with the Alberta Netcare Portal electronic health record and with eDelivery-compatible electronic medical records (EMRs).

Automated sharing is triggered when an eligible note is signed (co-signed in the case of trainee-authored notes). If the same note is later edited and re-signed, a new copy is distributed to external systems. This can create a lot of work for providers using external EMRs. It is especially disruptive for community practices to sort through multiple copies of shared documents to determine which is definitive and what has changed. 

Summative document contributors should “pend” or “share” their work, saving "signing" for the most responsible prescriber after all reviews are complete. A document should be signed just once; and so shared just once.

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2022-07-27

Connect Care to Netcare: Summative Document Sharing Update

Summative documents are high-value clinical notes that organize observations and offer goal-directed assessments and plans. Included are admission history and physicals, discharge summaries, consultation reports (inpatient and outpatient), operative reports, transfer summaries and emergency provider notes. 

Connect Care inpatient summative documents are automatically copied to the Netcare electronic health record, as well as compatible external electronic medical records via eDelivery. Outpatient communications are also copied to external systems if the author selects a Netcare-destined document template. 

Progress documents (which depend upon the rest of the chart for context) are not automatically shared with external systems.

A few best practices can help reduce incoming document management burdens for receiving providers:
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2022-07-11

All User Bulletin: ED Provider Note Not Auto-copied to Author EMRs

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

ED Provider Notes No Longer Automatically Copied to External EMR of Authoring Providers

Connect Care prescribers may provide services where Connect Care is the record of care, and additionally provide follow-up services where a community electronic medical record (EMR) is the record of care. Physicians working in emergency departments, for example, may find themselves subject to "mixed-context" workflows. When these prescribers author summative documentation in Connect Care, copies are sent to their external EMR if it supports this type of eDelivery. 

Emergency Department Provider Notes are an exception. These are no longer copied to compatible external EMRs of authoring prescribers. Mixed-context prescribers who use these reports as part of externally managed (non-Connect Care) billing workflows can adopt other strategies for tracking billable ED events, as described in the following bulletin:

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2022-07-05

All User Bulletin - Update: Ultrasound Reports for Referring Providers

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

Ultrasound Reports for Referring Providers via Astraia

[This post originally appeared in June, with subsequent updates indicated with strikeout and dark red font below.]

Astraia, a third-party specialized perinatal documentation system that is used in conjunction with Connect Care to provide comprehensive Maternal Fetal Medicine (MFM) assessment and consultation, provides highly specialized, in-depth MFM ultrasound reporting. Astraia generates detailed ultrasound reports for referring healthcare providers; these reports are available in Connect Care in text-only and full PDF versions:

  • Text-only: The text portion of the ultrasound report contains the consulting MFM physician’s summary, recommendations but does NOT contain the specific ultrasound measurements, anatomical assessments and graphs which includes fetal and maternal assessments. Currently the text-only report does not provide all fetal measurements and assessments. Critical results will be communicated to referring providers via a telephone call and facsimile of the full report. The text-only portion is displayed in Connect Care, and is also faxed to the referring healthcare provider. 
  • Full report: The complete report that includes specific ultrasound measurements, anatomical assessments and graphs is available as a PDF. Referring providers can find the PDF in the Chart Review activity:
    • Click the "Imaging" section. Select the target ultrasound, scroll down below the text to the section entitled "Order-Level Documents", and click on the hyperlink. 
    • Tip: To move the "Order-Level Documents" section to the top of your viewing screen, use the wrench tools on the top-right corner of the report window and drag this section to the top of the list.
                               
    • Note: The complete report PDF can also be found in Netcare (click the diagnostic imaging section and find the target ultrasound report by date).

As of June 7, 2022, all text-only reports issued by Connect Care will contain the following statement to direct healthcare providers to the full PDF report:

“This is the text portion (Consultation) of the Maternal Fetal Medicine ultrasound report. At the present time, Connect Care, Millennium, SCM and Impax are unable to accept the graphics portion of the report. For the entire report including graphs, please view this ultrasound report through the Alberta Netcare Portal (for access go to http://www.albertanetcare.ca/) or view through Connect Care by clicking on the Order-Level Documents PDF link found in the section below the imaging text result.”  

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2022-06-30

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2022-06-28

Experience MyAHS Connect to Promote MyAHS Connect

We've previously posted about increasing uptake of Connect Care's patient portal, MyAHS Connect. With a critical mass of engaged patients, Connect Care prescribers have growing opportunity to improve information gathering and sharing with patients, including during inpatient encounters. 

But it can be hard to promote a service that one has little experience of!

A new initiative enables Connect Care prescribers to activate their own MyAHS Connect accounts. They can experience firsthand the benefits of a full-feature patient portal. Personal access can also help clinicians help patients who ask questions about patient portal functions.

This opportunity is offered to prescribers activated for Connect Care use as part of past and current launches. Some clinicians may already have MyAHS Connect access by virtue of their own experiences as patients. Others can complete a self sign-up request. 

Application instructions are provided on the AHS intranet. Note that the links will only work when logged on to an intranet (within AHS) location. It is also possible to open the Clinician Manual from within Connect Care (F1 key for pop-up help, then Clinician Manual link at top of middle column), go to the Patient Portal page, then follow the sign-up link from there:

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2022-06-27

Care Path Launch – Heart Failure and COPD

The Heart Failure and Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) Care Paths will launch in Connect Care on July 11, 2022. 

Who is the Care Path for?

Any patient admitted to hospital with a principal diagnosis of Heart Failure or COPD. While a patient can be placed on a Care Path at any point during the hospital stay, it is recommended to begin the Care Path on admission.

What is a Care Path and why use it?

    A Care Path is an advanced clinical decision support tool in Connect Care which summarizes relevant patient information, incorporates evidence, and builds multidisciplinary care into a single workflow path based on the patient’s primary diagnosis. Advantages include:
    • Automatically integrates evidence into care – Care Paths help providers to see summaries of diagnosis-specific care evidence in context of a patient’s relevant health information, enabling personalization of care decisions to optimize quality and safety of care.
    • Improves efficiency by summarizing relevant information – The Care Path Summary page consolidates patient information specific to the primary diagnosis into one view with quick links to relevant assessments, labs, vitals, medications, rapid rounds, expected date of discharge (EDD), and problem-oriented charting.
    • Provides specific guidance for phases of care – Care Paths includes imbedded Order Sets for hospital admission, as well as workflows to support managing day-to-day hospital care. Care paths also help to guide coordinated transitions between acute, primary and community-based care.
    Is there evidence to support Care Path use?
      Yes! The use of standard order sets and clinical pathways have been associated with improved patient outcomes including decreased length of stay, reduced hospital readmission rates, improved adherence to evidence, reduced healthcare costs, and even substantially reduced patient mortality. 

      What do you need to do?

      Care Paths are launching on July 11, 2022. Prior to that date, please watch the training video(s) below in My Learning Link (MLL). Benefits: learn how to use Care Paths efficiently to save time, and earn CME credits!

      • Unaccredited summary course: EPIC - Care Paths - Prescribers (20 min)
        • Note: This course is also inserted into the accredited modules listed below. 

      or 

      • Accredited course (Care Path-specific):
        • Heart Failure Disease Care Path Integration: Evidenced-Based Guideline Recommended Best Care 
          • RCPSC MOC 3 – SAP 1.5 hrs 
          • CFPC Mainpro+ 3-credits-per-hour for 1.5 hrs (4.5 credits)
        • Acute Exacerbation of Chronic Obstructive Pulmonary Disease Care Path Integration - Evidenced-Based Guideline Recommended Best Care 
          • RCPSC MOC 3 – SAP 1.0 hr 
          • CFPC Mainpro+ 3-credits-per-hour for 1.0 hr (3.0 credits) 

      For more information, see the updated Care Paths section of the Manual.

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      2022-06-24

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      2022-06-16

      Death Certification Still a Paper Process

      While it is great to see so many Connect Care users enjoying digital documentation -- and release from fussy forms -- there are some tasks that can only be completed on paper.

      One of these is death certification.

      The Province of Alberta is working on, but does not yet support, digital death certification. At this time, responsible physicians must complete a formal (paper) death certificate in the event of a patient death. These can be found at Emergency or Nursing Station forms stores. They can also be obtained from the facility admitting department and must be returned to medical records before a body can be released.

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      2022-06-13

      Dictated Textual Radiology Results Issue - Resolved

      On the afternoon of Sunday June 12, 2022, there was an issue preventing flow of newly dictated textual radiology results to Connect Care. During this time, critical results were reported verbally. The flow of results was disrupted for approximately three hours, from 12:47 until 15:48, and was in effect province-wide. The issue is now resolved, and all textual results have been posted to Connect Care. There is no further action required at this time. 

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      2022-06-10

      Connect Care Launch 4 - Electronic Documents and Results Delivery to Community Providers

      AHS uses a system called "eDelivery" to electronically deliver patient information to providers and physicians at their private community practices. With Connect Care Launch 4, there have been changes to the information distributed to providers. Providers who work at AHS facilities using Connect Care as well as at private clinics/offices in the community will want to understand these changes. 

      These changes affect the six types of Connect Care summative notes as well as results for lab, diagnostic imaging (DI) and other investigations. A memo summarizes the changes for the delivery of this information from Connect Care to community providers; the key messages are:

      • All providers will receive copies of summative notes in their external electronic medical record (EMR) when they are identified as the Primary Care Provider (PCP) for a patient; sometimes you may receive information for a patient not associated with you or your clinic – you can follow up with AHS to remediate this situation. 
      • Authoring providers in Connect Care will receive copies of summative notes they author at AHS facilities in their external EMR. 
      • Mixed-context providers (working in AHS facilities as well as at private clinics/offices in the community) may receive some community DI reports twice (in their Connect Care In Basket as well as at their non-AHS locations).
        • Additional information specific to DI report delivery for mixed-context providers is available in an earlier memo.
      • All summative notes and results are available in Netcare.

      For more information, please review the full memo:

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      2022-05-31

      Launch 4 Progress - A Great Start!

      Connect Care Launch 4 continues to progress well after a remarkably smooth weekend. Most early problems are resolved and a few ongoing issues are explored by teams working to fine tune some of the more complex workflows.

      Twice-daily prescriber huddles continue to triage any prescriber issues identified to Super Users, Medical Informatics Leads or the ticketing process. Rapid-response clinical system design and other task groups receive and work on issues during the day. Highlights of what is being worked on appear in a daily prescriber Support Hot Topics. 

      Learning curves remain steep in the first week. New users are encouraged to continue to consult with Super Users, check the Connect Care Manual (manual.connect-care.ca), and identify where new supports or clarifications could help (cmio-manual@ahs.ca). In addition, blog postings focus on the more common questions and challenges that we hear about:

      Renewed thanks to all Launch 4 teams for their incredible work and resourcefulness through the launch period!

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      2022-05-28

      Launch 4: We are GO!

      All Connect Care systems activated on time at 05:00! 

      Today, Connect Care welcomes 57 Edmonton and Calgary sites into the family. The first few days will be intense, but with lots of help at hand we are confident that progress will be fast. 

      Prescribers, please make use of the drop-in centre and other launch supports (launchhelp.connect-care.ca).

      A message to Connect Care Launch 4 teams from Interim President and CEO Mauro Chies:


      The Alberta Medical Association (AMA) published a letter from the President advocating for physician and patient interests during the Launch 4 Connect Care rollout:


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      2022-05-27

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