2018-01-22

Clinical Telehealth becomes Virtual Health Services

​The Alberta Health Service (AHS) Clinical Telehealth program is newly reorganized as "Virtual Health Services" (VHS) under the dyad leadership of Dr. Jonathan Choy (medical) and Catherine Keenan (operational), with oversight through the Chief Medical Office portfolio.
VHS is responsible for the introduction, adoption, promotion and monitoring of processes and technology enabling high quality and effective patient care anywhere. Services include traditional video conferencing, as well as electronic consultations, store and forward, secure messaging and remote patient monitoring. The vision for VHS is closely coupled with that for Connect Care and will leverage the many tools and processes afforded by a fully integrated digital health record.
A new, Connect Care aware, VHS strategy is in the works. Interested stakeholders are encouraged to assist with direction setting. Contact Jonathan (jonathan.choy@ahs.ca) or Catherine (catherine.keenan@ahs.ca) for more information.
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2018-01-21

Epic Announces Option for Small Practices and Facilities

First described at the 2017 Epic User Group meeting attended by some of our physician leads, Epic has formally announced 'Sonnet', a stripped down variant of its digital health record software optimized for small hospitals, clinics and physician practices. It's workflows are streamlined and standardized, coupled with a quick-install methodology and ready-to-use designs.

In is uncertain how long before this kind of offering might become available in Canada. Sonnet could bring affordable options to smaller practices wanting to connect with fully integrated clinical information systems.


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2018-01-19

Epicare 2017 Software now in-Province for further Development

​We are thrilled to learn that all 6 non-production Epic 2017 environments are now installed and functioning in Alberta in support of Connect Care! This is a key milestone, timed exactly right (and on time), as we prepare clinicians and support staff for intense direction-setting and design activities over the next months.
The foundation build will be upgraded to Epic's 2018 software in March. This will be the environment that most trainees, designers, deveopers and testers work with. Important clinical repository interfacing can now proceed with key databases and codesets up and running.
Connect care has the first elements of its technology foundation!
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2018-01-17

Connect Care Physician Information Resources

As Connect Care ramps up and speeds up, communications increase exponentially. It can be difficult for stakeholders to track what affects them the most. The AHS CMIO will continue to advocate for clinician interests and will work with physician and other practitioner groups to customize and optimize communication strategies.
For now, general Connect Care information is readily available via an open public website (see links). Focused project information is available to Connect Care participants via an internal AHS website and comprehensive Connect Care activity supports are managed via an internal SharePoint site (see links).

Physician users of Connect Care services can also access a Connect Care Physician Handbook. This handbook provides guides and tips, largely prepared by clinicians for clinicians. The Handbook is intended as a form of peer-to-peer mentoring and support. It can be accessed directly with its web link or as part of the Clinical Improvement Collaboratory.
If you believe you should be able to access one of these sites, but are unable to do so, please contact cmio@ahs.ca.
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2018-01-16

US Regulatory Agency Rules on Use of Clinical Text Messaging

​The Centers for Medicare and Medicaid Services (CMS) in the United States may have brought some clarity to whether text messaging can be used to communicate clinical information supporting health care. CMS has confirmed that in order to be compliant with conditions for reimbursement coverage, providers must use messaging systems that are secure, encrypted and maintained for privacy and confidentiality protections. Messaging integral to a Clinical Information System would comply. Separate non-integrated systems must meet discrete security standards. This reinforces our commitment to enable unified and integrated secure clinical messaging as an integral part of the Connect Care ecosystem.
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2018-01-15

New Connect Care Physician Design Lead

​Dr. Alan Sobey joins Connect Care as its new Physician Design Lead. Dr. Sobey brings over 20 years of experience to the role, highly regarded as a surgeon and intensivist. He received his MD from the University of Alberta and will soon complete his Masters of Science in Health Information Science at the University of Victoria. In addition to his Design Lead role, Dr. Sobey will continue contributions as a Clinical Knowledge Lead, and remains clinically grounded in the Department of Critical Care at the University of Alberta. Dr. Sobey is the proud father of three and grandfather of two. He loves to cook, read, cycle and swim and has started to play the guitar (no tours in the offing!).
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2018-01-11

Alberta Clinical Trials Registry Online

Alberta’s universities, working with Alberta Health Services and the Northern Alberta Clinical Trials and Research Centre, now support an online database of clinical trials registered or active in Alberta. “Be The Cure” intends value for patients seeking information about possible new treatments, and for researchers planning new studies or recruiting for ongoing studies. Follow the link for more information. The link has also been added to the Clinical Improvement Collaboratory (clinicalimprovement.ca).​
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2018-01-04

Connect Care - Giving Direction

For clinical improvement to follow Connect Care (CC) implementation, it is vitally important that physicians integrate new informational tools into daily workflows in a meaningful way. For this to happen, they must also be directly involved in decisions about how the CC Clinical Information System (CIS) is designed and configured. A system adapted to Alberta’s front-line opportunities and constraints has the best chance of success.

A key first opportunity for input comes during “Direction-Setting” sessions scheduled for early 2018. These tap into clinician perspectives to guide basic choices about how common workflows will be supported by Connect Care. Physicians participating in Direction-Setting will:
  • review groundwork information about common workflows and practices;
  • guide translation of optimized processes into Connect Care workflows;
  • ensure that proposed workflows align with AHS goals and policies.
We need your help! Please check out the FAQ link: 
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2018-01-02

Recognizing AHS Secure Emails

The AHS Connect Care initiative will support unified clinical communications, all securely integrated with the legal record of care. Until Connect Care is deployed, Alberta Health services (AHS) provides health care providers with the opportunity to transmit clinical information via secure email, including encrypted email to external addresses. This is enbled with an add-on to AHS Microsoft Exchange email services. Clinicians receiving encrypted emails sent to non-AHS email addresses may not recognize the source or type of communication; and might rightly suspect a phishing or hacking attempt. Emails from an AHS address that contain “You have received an email message secured by Private Post” in the body, and bear an “Encrypted_Message.htm” attachment, are okay to open and review.​
Clinical Secure Messaging:
stq.ahs-cis.ca/?=12153
AHS Secure Email Guide:handbook.ahs-cis.ca/?=12164
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2017-10-16

What do Clinicians want from Connect Care?

The Alberta Health Services (AHS) Connect Care initiative aspires to improved health outcomes through use of a one-person-one-record-one-system support for clinical improvement. For improvement to follow implementation, it is vitally important that pCIS users integrate new informational supports into daily workflows in a meaningful way. And that requires meaningful engagement.
Engagement is facilitated when stakeholders understand the purpose of Connect Care, what it means for patients, what benefits users can expect, and how AHS can collaborate with users to promote benefits and avoid harms. The mission, values, goals and core principles of the initiative must make sense, be easily understand, and be compelling.
Users must also be highly motivated. They must be able to see, in a very practical way, how Connect Care will help them to do their work. These are matters of detail, often intimate, and inseparable from the messiness of frontline practice.
So, what do clinicians want from Connect Care? We have summarized impressions gained from interviews, meetings and focus. Follow the link to learn how users prioritize matters of convenience, connection, adaptation, integration and agency.
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2017-10-05

Connect Care Technology Partner Confirmed

Alberta Health Services and Epic Systems Corporation have finalized and signed a contract engaging Epic as the technology partner for AHS’s Connect Care initiative. Effective the beginning of October, 2017, this clears the final hurdle to embarking on a transformative journey that will integrate health information systems across all AHS lines of service and the continuum of care.
Work begins in earnest to align AHS preparations with Epic’s approach for bringing large complex projects like Connect Care to successful implementation.

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2017-10-03

Meeting Less, Doing More

Among many preparations for the formal kick-off to Alberta Health Services’ (AHS) Provincial Clinical Information System (CIS) has been establishing effective governance and oversight. New committees are struck, terms of reference are approved, meetings are scheduled and day timers filled. The need to rationalize old and new structures is the subject an upcoming governance workshop that will try to resolve issues of overlap and accountability.
Emergence of a systematic approach to formal governance matters to Connect Care stakeholders. We also need, and are working on, an approach to informal channels of influence, oversight and accountability; including User Group coordination and collaboration.
Is this our opportunity for a re-think? A recent Guardian editorial (see link) summarizes evidence that typical organizational meetings accomplish little, kill productivity and are even a health hazard. We can’t escape meetings, but maybe we can moderate their quantity and maximize their quality.
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2017-08-28

Harmonizing Clinical Documentation

Clinical documentation is about how we build health records. It is also a requirement of all who serve patients. Whether in electronic or written format, proper documentation is mandated by professional, regulatory, legal, accreditation and Alberta Health Services (AHS) expectations. More importantly, it enables inter-professional communication, care coordination, service continuity and outcome monitoring. 
The Clinical Knowledge & Content Management (CKCM) team coordinates program-specific multi-disciplinary clinical documentation working groups. Work is underway to promote best practices, build consensus about documentation norms, expose clinically essential documentation elements, and reduce unhelpful program-to-program variation.
Bringing consistency and efficiency to clinical documentation can reduce health practitioners’ total information burden, streamline complex medical records, speed recovery of clinically important data, and focus caregivers on the communication needs of patients and families. Follow the links to learn more about harmonizing clinical documentation in AHS and how you can get involved.

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2017-07-25

AHS CIS Information Sharing Approach

​Information sharing is about how health data is collected, accessed, used, disclosed, and exchanged. Connect Care, as a continuum-of-care one-patient-one-record-one-system initiative, will challenge traditional ways of thinking about information sharing. To the extent that Clinical Information Systems (CIS) integrate across domains with different legislation (e.g. Health Information Act, Hospitals Act, Health Professions Act), regulations (e.g. CPSA charting standards) and policies (e.g., medical staff bylaws), a new and integrative approach to information sharing needs to work for all stakeholders in all settings. As clinicians move from independent to shared digital records, this touches the core of health care professionalism.
Diverse stakeholders have worked to develop a new "Information Sharing Approach" applicable to all AHS CISs, all participating health care providers and all settings. Shared rights, responsibilities and accountabilities are endorsed and embraced to build trust and protect the privacy, confidentiality, security and integrity of health information in all AHS CISs.
Learn more about the approach from the links provided and please provide feedback. The goal is to firm-up new arrangements in fourth quarter 2017.
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2017-07-24

What’s in a name? – Clinical Decision Support

​As design and build of the AHS Provincial Clinical Information System (CIS) starts, we are reminded that we are NOT building a digital health record. Rather, we are growing a system that supports coordinated care, best practice and clinical improvement. The magic sauce… helping users made good decisions.

Digitizing health information, and delivering it to clinical decision-makers, does not necessarily improve health care. Informed choice is facilitated when information about health is connected with information about how to improve health. Accordingly, "meaningful use" of the CIS is more likely when connections between observations and knowledge serve better processes, outcomes and satisfaction for patients, providers and policy-makers. This is what Clinical Decision Support (CDS) is about. 

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2017-07-23

Getting Ready - Current State Assessment

As part of our preparation for Connect Care, the AHS Provincial CIS team meets with clinical teams across the province to document what services AHS provides and how technology is used by healthcare providers in their daily work. Right now, AHS supports clinical care with over 1,300 different information systems. This fragments Albertans’ information, also making it harder for clinicians to provide comprehensive care.

Current state assessment teams have already engaged with many clinical teams to learn how the services we deliver interact with technology. Through this work we have already heard from over 800 clinical staff and physicians from across the province, across specialties and across diverse care settings.

We are moving through this process sequentially. As the current state assessments home in on critical clinical workflows, given the size and diverse needs of the organization, intersects with teams focus on smaller segments.  One of our early observations is that we deliver very similar services provincially, with largely the same high level processes. And there is widespread recognition of need for more consistency in how these services are supported with technology. This is great news as we move forward.

Follow the link to view an infographic that illustrates the current areas of work under Connect Care current assessment. We recognize that we have yet to touch all areas within AHS, but be assured that we are working our way through the organization and eventually will meet with representatives from all clinical areas impacted by Connect Care.

Through these initial meetings we have developed a high-level understanding and received good feedback about the process.  As we work with your teams to prepare for Connect Care, we will continue to enhance our understanding of how care is delivered, and where the CIS can have the most positive impacts.

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2017-07-17

Soft Security Tokens for AHS CIS & AH Netcare Remote Access

​Alberta Health Services (AHS) staff and affiliate clinicians may be authorized to access Clinical Information System (CIS), Netcare or other health information systems remotely from locations outside AHS network firewalls. This remote access requires two-factor authentication; such that the user 1) knows something (username and password) and has something (a Token or other securely recognized device).  Two-factor authentication reduces the risk of a security breach due to loss or theft of any one piece of information.

Some users requiring frequent or varied remote access find a physical security Token inconvenient; and unavailable when needed. These same users may have a smartphone always available and appreciate use of a "soft token" that works as an application. Replacing a "hard token" with "soft token" technology is fairly straightforward. Follow the link provided and work through the instructions starting on page 14.
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2017-07-14

No Secret Plan

​Connect Care is a significant investment in the future of healthcare in Alberta. This large-scale project will take time to put in place. As the Connect Care team continues to delve into preparations for this initiative, we are undertaking a thorough process to understand how all the pieces fit together.

You will start to see more communications as we work toward the design and build phase of the project. In the meantime, we will continue to collaborate and share our progress with you.

Please visit ahs.ca/connectcare or contact connectcare@ahs.ca with questions.
AHS_CIS_No-Secrets.png
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2017-07-12

Connect Care Technology Partner

​After almost a year of evaluation – and consultation involving hundreds of clinicians, staff and patients – Alberta Health Services (AHS) has announced that Epic is the chosen vendor responding to a Request for Proposal (RFP) to help build the AHS Provincial Clinical Information System (CIS). The CIS provides the technology platform to enable Connect Care, an AHS-led initiative to transform healthcare delivery in the province. 

The RFP process was thorough and conducted with fastidious care. A first phase narrowed the field to 3 vendors felt most able to address the full range of AHS integration needs, with capacity to implement sustainably for an entire province. The second phase engaged hundreds more evaluators, site visits, reference reports and financial analyses to complement a deep dive examination of 24 functional domains and 4 areas. The results were consistent and clear, with strong agreement across domains, areas, regions, disciplines and experiences.

Epic started in 1979 and has grown to serve as the largest continuum-of-care digital health record provider for complex health care organizations like ours. Epic develops software to help people get well, stay well and prepare future generations to be healthier. 

Now that Epic has been selected as the preferred vendor, contract negotiations proceed while comparing an emerging understanding of our current state with a detailed assessment of what Epic has ready to go. The gap analysis will be informed by readiness assessments, strategic transformation analyses and listings of CIS capabilities prioritized for early attention. All this helps prepare for collaborative design and build, which begins fall 2017.

The Connect Care integration goal remains to migrate the majority of AHS clinical systems to the AHS Provincial CIS over the next 4-6 years. Existing systems will be kept functioning and current until ready for transition. Transitions will be guided cost-effectively, with support for AHS teams to safely prepare for changes.

Keep a close eye on the Connect Care web and SharePoint sites for the latest news.

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2017-07-11

Connect Care Information Gateways

Alberta Health Services has opened a new website that can help stakeholders learn about Connect Care, follow developments, ask questions and discover why Connect Care matters. There are views optimized for patients and families, and others focused on the information needs of health care professionals. An intranet (Insite) page is open to all of AHS. Connect and find out why you should Care!
An internal AHS site (SharePoint) is used by teams working on Connect Care. It offers a single point of contact for finding detailed information about progress, projects, resources and governance. Optimized to support a community of practice, there are discussion boards, blogs, team tools, calendars and progress dashboards. If you are not able to connect, and are an involved AHS staff member, please send a request to the connect care email intake.
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2017-07-06

“Connect Care” is our CIS Initiative

Connect Care encompasses all the work being done to transform the way we provide care at AHS, and empower change with information. The initiative attends to information gaps that can frustrate integration of health services across the continuum of care. Connect Care will enable use of the AHS Provincial Clinical Information System (CIS) to support the work we do and enhance the quality of care we provide. 


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2017-06-05

Meet the CISU

The Clinical Inquiry Support Unit (CISU) supports clinicians to use Clinical Information Systems to drive clinical change.  We design, implement and evaluate clinical decision support tools and optimize CIS functionality for clinical inquiry use. We are part of a larger CIS Analytics Community of Practice and are committed to helping clinicians identify and use the right tool to produce reliable data products that meet clinical improvement needs. We are also a key stakeholder in the overall AHS Analytics Strategy, identifying opportunities to integrate AHS data outputs with the CIS and feeding CIS data to the analytics community for their use.
CISU delivers:
  • Clinical Decision Support Surveillance
  • CIS Use Surveillance
  • Research Protocol Registration and Initial Configuration
  • Clinical Metric Design and Configuration& Clinician Dashboard Templates
  • Reporting Workbench Templating
  • Disease Registry Design and Configuration
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2017-05-23

Internet-aware File Naming Conventions

File naming conventions have evolved from systems optimized for paper or index cards to ones attuned to computer file managers and, most recently, natural language processors. Current best practices build names in ways that are internet-safe, file-system optimized, and easiest to search and browse in disk directories, website management systems, online databases and internet search engines. Please see and consider the linked file naming guide, which draws upon international (ISO) standards, Internet best practices, AHS CIS guides, and AHS Health Information Management procedures to improve the usefulness of shared digital file collections for all stakeholders.
File naming norms: ahs-cis.ca/filenames
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2017-05-18

AHS e-Mail File Attachment Size Limit Increase

Email can fail if attachments are too large. We are pleased to learn that the allowed size is increased to 50 megabytes (MB).

AHS Email norms: li.ahs-cmio.ca/emailnorms​
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2017-05-17

Protecting Important Credentials

AHS staff were recently advised to change any AppleID passwords they may have. This was in reaction to a news report about a hacker group claiming to have the ability to delete millions of Apple customer credentials. The threat did not materialize. Perhaps more important is the fact that genuine risks are unlikely to hit the news and often result from users willingly giving their credentials to ‘phishers’… one can’t always know when it might be important to change a password. Another approach is to implement ‘2-factor’ authentication, with the result is that, even if one’s credentials are discovered, it is not possible to log on to an account if the hacker does not also have a second factor; such as a smart phone, smart watch or authentication device. Typically, users are alerted to suspect logon attempts. Please consider turning this on for Apple, Google and other online services you commonly use.
Phishing description: li.ahs-cmio.ca/2ff
2-factor description: li.ahs-cmio.ca/2fw
Google instructions: li.ahs-cmio.ca/2fg
LinkedIn instructions: li.ahs-cmio.ca/2fl
Apple instructions: li.ahs-cmio.ca/cismd​
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2017-05-14

Towards a Caring Information System – Connecting Care

As AHS embarks on its Connect Care journey, we are reminded of gaps that can be bridged with a comprehensive, continuum of care, integrated, clinical information system. Information gaps can fragment care in a frustrating, if not dangerous, way for patients. A compelling personal testimonial can be found in Eric Dishman’s talk about the need for team-work powered by information.
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2017-05-10

Netcare BPMH Forms and eSafety

The “Best Possible Medication History” (BPMH) form, which can be generated from the Alberta Netcare Electronic Health Record, can help practitioners gain an appreciation of medications that a patient should be taking, and actually is taking. However the form has limitations. It can be used safely if practitioners are aware of these limitations and take care to protect against error. 
​Netcare BPMH safety tips: li.ahs-cmio.ca/bpmhtips
Med Rec info: li.ahs-cmio.ca/bpmhinfo
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2017-04-13

CMIO April Appointments

​We are delighted to have Stephanie Ladouceur join the Chief Medical Information Office as its executive associate. Formerly an acting business manager and team support coordinator at AHS Supportive Living, Stephanie brings a wealth of experience and enthusiasm to a challenging role. A quick study, already she helps smooth our way to the AHS Provincial Clinical Information System.
David Meurer also started with the CMIO in April 2017, bringing many years of experience with clinical guidance development and coordination in the Emergency Medicine Strategic Clinical Network. David serves as Program Director Provincial eQuality and eSafety, a role critical to preparations for the provincial CIS.
·   Stephanie Ladouceur, Executive Associate
·   David Meurer, Program Director
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2017-04-05

AHS Clinical Telehealth Vision Presentation

​Clinical Telehealth helps clinicians deliver health services, share expertise and exchange information – anytime and anywhere – when clinician and client cannot be in the same place. Given Alberta’s broad geography, telehealth tools, skills and supports are increasingly instrumental for provision of equitable, patient-focused, and high-quality care. Advent of a provincial clinical information system, and rapid emergence of “lean” telehealth tools, assures rapid expansion of Clinical Telehealth in diverse AHS lines of service. Dr. Jonathan Choy, our AHS Telehealth Medical Director, will be presenting about Clinical Telehealth successes and aspirations. Join him May 6 from 0800-0900 in the Edmonton Zone Walter Mackenzie Health Sciences Centre, Classroom D, or via teleconference by registering using the link provided.
Register for videoconf: li.ahs-cmio.ca/cthrounds
Clinical telehealth on insite: li.ahs-cmio.ca/cth
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2017-04-03

Strategic Transformation Progressing with 3 Streams of Work

Adoption of a seamlessly integrated Clinical Information System (CIS) gives opportunity to improve outcomes, control costs, and support caregivers.  But first we have to simplify and streamline our everyday work. The AHS Provincial CIS Strategic Transformation Initiative promotes collaborative answering of questions about how to transform CIS-sensitive health care policies, processes and norms.
The work of transformation is ramping up; with three pathways yielding results:
Technical: managing our infrastructure (wires and things) and infostructure (software and systems) to take advantage of communications, coordination and other capabilities a CIS can provide.
Capacity: harmonizing and improving existing operations, services and processes so they work best in an integrated continuum-of-care system.
Transformative: rethinking strategies and reshaping how we operate, especially when practices vary without good reason, or we have not figured out how to do something a CIS depends upon.
With a number of strategic transformation questions coming to fruition, there are now regular presentations to executive so that the associated work packages are reviewed, endorsed and allocated.
STQ Catalogue: stq.ahs-cis.ca
STQ Resources: ahs-cmio.ca/stqresources
STQ Collaboratory: ahs-cmio.ca/stqcollaboratory
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