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

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​

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​

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.

• ​TED Talk Online: li.ahs-cmio.ca/ted001
• ​Connect Care website:  ahs.ca/connectcare

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

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

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

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

e-Health Policy Symposium – Towards Person-Centred Integrated Health in Alberta

Wide-area integrated digital health records crossing the continuum of care are emerging in Alberta and other provinces. Primed by our experience of a province-wide Electronic Health Record (Netcare), we will soon grapple with information sharing implications of an AHS Clinical Information System, where there are no borders between inpatient, outpatient, community and other healthcare contexts. Added to this paradigm change is the prospect of direct patient access through portals and personal health records. While these developments open extraordinary opportunity for improving personal and population health, a shared health record also stretches understandings of patient-provider privilege, professionalism and informational accountability.

The O’Brien Institute for Public Health and the Institute of Health Economics, in collaboration with Alberta Health, are co-hosting an invitational meeting to allow key stakeholders and informants to consider how best to promote information sharing to the advantage of patients, populations and health care.  Provocative presentations set the stage during an open morning session, followed by an invitational afternoon session that considers strategies to enable a seamless flow of health information across the continuum of care.

Check out the link for more information and registration particulars.

   February 14, 2017
Westin Edmonton
10135 100 Street NW

Information & Registration: li.ahs-cmio.ca/symposium

Integrated Health Records – Improving Patient Care for Albertans​

​Collaboratively brought to you by the Alberta Network for Health Information Exchange (ANHIX) and Canada’s Health Informatics Association (COACH), this conference features public and private sector experts sharing insights about health information system integration. Alberta’s initiatives and impacts are explored as they relate to clinical practice, service quality and patient outcomes; highlighting objectives for an AHS provincial Clinical Information System. Check ​​ out the link to see the latest speaker and session line up, and to register to join what promises to be a very engaging discussion!

February 8, 2017
Delta Calgary South
Calgary, Alberta 

 Information & Registration: li.ahs-cmio.ca/anhix

CMIO Director Analytics and Special Projects

Leahann Mcelveen joins the Chief Medical Information Office (CMIO) as Program Director for Analytics and Special Projects, transitioning from her current role as Information Stewardship Office (ISO) director. Leahann has provided exceptional service and exemplary oversight while leading complex inter-organizational supports for the provincial Electronic Medical Record Information Sharing Framework.  Prior to joining the ISO in 2012, Leahann was a senior portfolio officer with the Office of the Information and Privacy Commissioner (OIPC) and a lead instructor for the University of Alberta’s Information Access & Protection of Privacy program.

Leahann will report to the CMIO, working closely with AHS Research & Analytics, the AHS Provincial CIS initiative, and strategic transformation efforts.  She will guide the development of structures, processes and controls necessary facilitate information sharing within and between clinical information systems to promote clinical improvement, inquiry and instruction.

 AHS CMIO: ahs.ca/cmio

                    insite.ahs.ca/cmio.asp

Clinical Improvement Clinician Handbook

​A wealth of clinical informatics information, and Clinical Information System (CIS) specifics, can be found on internal and external AHS websites, SharePoint spaces, and policy and procedure databases. A common lament of busy clinicians is that these materials may not be well suited to their more practical questions or to the kinds of devices they use in diverse workplaces; or may be too technical or detailed.  Accordingly, a “CI Clinician Handbook” supports sharing of brief guides and tips, largely prepared by clinicians for clinicians; as a form of peer-to-peer mentoring and support. The handbook is part of the Clinical Improvement Collaboratory.

CIS public website: ahs-cis.ca/public

CIS AHS Insite: ahs-cis.ca/private

CI Clinician Handbook: handbook.ahs-cis.ca

CI Collaboratory: clinicalimprovement.ca

Clinical Information Systems – Key Concepts

​The work of evaluating a technology platform for the Alberta Health Services Provincial Clinical Information System (CIS) continues, with expectation of selection within a matter of months. Accordingly, preparations for design and build are well underway. This involves pulling together diverse groups in AHS, understanding (multiple variants of) prevailing workflows, and transforming practice to align with best guidance and CIS-enabled optimization. With critically important discussions and documents unfolding, it becomes clear that information management terms are not always jointly understood. Happily, stakeholders have agreed to collaboratively define “CIS Key Concepts,” then stick to a common interpretation as work continues.

CIS Key Concepts: handbook.ahs-cis.ca?=concepts 

Alberta Health Personal Health Record – Release Immanent

Alberta Health and Alberta Health Services will launch the first phase of the Personal Health Record (PHR) on MyHealth.Alberta.ca by the end of January 2017. The PHR offers a secure online space where Albertans can enter and manage their own health information. The content can be shared with health care teams through printed summaries or personal device displays.  

The first phase of the initiative focuses on information gathered from and managed by individuals. There are tools for recording health measurements, documenting health histories, and setting health and wellness goals. Other tools allow capture of health data from medical devices and smartphones connected to Windows-compatible computers. The only information captured from the Alberta Netcare EHR will be dispensed medications. Future phases will bring selected laboratory test results, transcribed reports and immunization records into the PHP.

MyHealth: myhealth.alberta.ca

PHR Access: myhealth.alberta.ca/myaccount

CBC News article: news.ahs-cis.ca/php-cbc

AHS Provincial CIS – Senior Program Officer Appointed

​Barbara Kathol joins the AHS Provincial CIS team as its new Senior Program Officer starting January 16, 2017, completing the CIS leadership triad with Rob Hayward (CMIO) and Penny Rae (CIO). Most recently serving as an executive director at the Foothills Medical Centre, Barb brings extensive experience with enterprise information system implementations, information technology governance and clinical operations leadership. Moving forward, she will serve all zones and programs as they transform while getting ready for the CIS and the many process optimizations it will enable.

 CIS governance: ahs-cis.ca/cisgov

 CIS project overview: ahs-cis.ca/cisproj

CPSA Electronic Patient Record RoadMap

​In September 2016, the College of Physicians and Surgeons of Alberta approved a roadmap to move the profession decisively toward use of integrated electronic patient records. This important document clearly positions information sharing and collaborative record keeping as matters of professionalism. Indeed, the roadmap includes commitment to standardized charting protocols that support information sharing; and new norms to share for patient advantage.

CPSA Roadmap News: ahs-cmio.ca/cpsanews

CPSA Roadmap Document: ahs-cmio.ca/cpsaroadmap

Digital Professionalism

​Wide-area digital health record initiatives, like the Alberta Netcare Electronic Health Record and the Alberta Health Services Provincial Clinical Information System, give hope for better coordination of care across generations, geographies and services. However, experience shows that clinical improvement is more a matter of people and processes than products or technologies. Our true paradigm change, and great opportunity, occurs when we move from sequestered to shared health records. Doing this brings all health professions into new and unfamiliar information ecosystems. Indeed, a new professionalism is required to facilitate collaborative documentation, care planning, communication and shared decision-making. The Alberta Health Information Executive Committee has commissioned and endorsed a White Paper about health information exchange and the need for innovative norms, standards and expectations of all health professions. This is an important read.

HIEC White Paper: evidence.ahs-cis.ca?=12290

Feedback to: doreen.rabi@ahs.ca

Physician Concerns about Accessing Digital Records for Quality Assurance

​In mid-August 2016, the Office of the Information & Privacy Commissioner of Alberta (OPIC) publicly reported its investigation into alleged misuse of electronic health records by two physicians responding to a patient complaint. AHS and the physicians appealed the OIPC’s decision to the Court of Queen’s Bench of Alberta, suspending the OIPC order until the Court renders a final decision in 2018. College of Physicians and Surgeons of Alberta (CPSA) newsletters have drawn attention to the Order, offering advice about how to access records when responding to complaints. AHS-affiliated physicians have many questions. The CMO, CMIO, Legal and Privacy have prepared a short memo and FAQ.

OIPC Order: ahs-cmio.ca/oipc201606

CPSA News: CPSA Newsletter

AHS Advice: ahs-cmio/oipc201606advice

AHS Provincial CIS RFP Progress

​Recently, an important milestone for the AHS Provincial Clinical Information System (CIS) program was achieved. The first stage of the Request for Proposal (RFP) process is complete. The RFP solicited proposals from the entire marketplace, with the aim of selecting proponents best suited to address AHS needs. Following a well-coordinated and intensive process, AHS has confirmed a shortlist of proponents. An exceptional evaluation panel achieved clear consensus. The second stage engages a much larger group of clinicians and other staff to carefully examine 24 specific domains of functionality.

 What’s happening at CIS: ahs-cis.ca/news

AHS Provincial CIS info (public): ahs-cis.ca/info

AHS Provincial CIS info (Insite): ahs-cis.ca/insiteinfo

What is Digital Health?

​Canada Health Infoway now promotes use of the term “digital health,” with a view to reinvigorating conversations with Canadians about positive uses of digital health records.  The concept encompasses efficient clinician access to information supporting better decisions, patient and family access to their own information online, and collaborative maintenance of care plans shared by all members of a patient’s health care team. The intent is a more connected health care system always open to patient participation.

It may be wise to promote more inclusive language, avoiding terms that compartmentalize by institution, health sector, discipline or patient/provider access. Calling for a fresh start to digital health record planning may also be shrewd; given significant negative press (and literature) about adverse effects of large scale electronic medical record initiatives; especially impacts on patient and physician experiences.  Check out the links to explore making the case for Digital Health.

Digital Health description: li.ahs-cmio.ca/dh

Canada Health Infoway: infoway-inforoute.ca

Digital Health Week

​Digital Health Week, sponsored by Canada Health Infoway and affiliate healthcare organizations, takes place November 14-20, 2016. Canadians are invited to join discussion about how digital health technology is being used by patients and their health care providers. Conversations, stories and experiences emphasize transitions from engagement as patients to partners in managing health care. Check out the links to learn more about patient-centred eHealth, eHealth literacy learning resources, public expectations of health informatics, and how digital health is expected to positively change the experience of health care. Implications for clinical information systems abound.

Digital Health Week overview: li.ahs-cmio.ca/dhw

Digital health experience poll: li.ahs-cmio.ca/dhwpoll

Alberta stories: li.ahs-cmio.ca/dhab

Clinical Improvement Collaboratory

Alberta Health Service’s efforts in quality improvement, patient safety and operational best practices are complemented by partner commitments to systematic clinical improvement. The Edmonton Zone clinical department of medicine (AHS and University) has established, as one of its top three governance committees, a “Strategic Clinical Improvement Committee”. Already the SCIC helps to define key performance indicators, quality report formats and many other initiatives. The healthcare enterprise and academe work in close partnership.

One shared initiative involves support for a “Clinical Improvement Collaboratory”; an online integrated environment where clinician innovators can access and share information about improvement projects, learning programs, initiatives, and directories of helpful internet resources. Although the CI Collaboratory is largely fueled by volunteerism, we hope that it will offer a practical gateway to resources and opportunities for some time to come. Interested clinicians and improvement advocates can register for access.

Registration and log-on: clinicalimprovement.ca

AH–AMA Agreement Good for Clinical Improvement

​Alberta Health, Alberta Health Services and the Alberta Medical Association (AMA) announced mid-October 2016 that the province’s physicians have ratified amendments to a medical services contract running through 2018. The new deal includes commitments to better distribution of physician services, new models for patient attachment and medical services compensation reform. Of importance to the work of the CMIO, the agreement includes provision for a new “Appropriateness and Evidence-based Initiatives Committee” which will advise about opportunities for healthcare improvement. Establishment of a province-wide best guidance viewer, a Clinical Information System Content Repository (for clinical decision supports) and building eHealth literacy are timely and compatible AHS efforts.

Agreement backgrounder: li.ahs-cmio.ca/ama2016

Recognizing Clinical Improvement

Alberta Health Services (AHS), Alberta Health and partner University strategic plans call for capacity-building in quality improvement, quality assurance, patient safety, clinical informatics, health information analytics and other domains collectively referred to as “clinical improvement science.” Key recommendations include organizational commitment, supportive governance, enabling information services, and faculty development and recognition.

Unfortunately, the contributions of clinician innovators may not be as well understood as work typically presented by “clinician educators” or “clinician researchers.” The Chief Medical Information Office (CMIO) hosts a number of programs where clinicians excel at innovation. We promote career advancement by facilitating preparation of contribution reports that align with the principles, frameworks and language of clinical improvement. See the linked guide for more information.

Clinical Improvement Career: ahs-cmio.ca/career

Operational Best Practices align with Strategic Transformation

​Operational Best Practice (OBP) is an organization-wide AHS effort to promote clinical and administrative efficiencies at all levels of AHS. The goal is to maintain or improve quality and safety of care, at lower cost. Savings have already been realized by heeding front-line insights about what works best. Harmonized development of decision supports for use in AHS Clinical Information Systems can help sustain innovation and progress.

OBP FAQ: ahs-cis.ca/obpfaq

OBP overview: ahs-cis.ca/obp

Senior Provincial Director – AHS Provincial CIS

David van Heerden will be joining the AHS executive team as Senior Provincial Director for the AHS Provincial CIS starting November 1, 2016.

David has over 25 years of extensive senior leadership experience in technology business optimization; with specific focus on information technology application, systems development and implementation. His expertise covers the health care sector as well as complex wide-area information system implementations.

David will be accountable to a CIS leadership triad, including the AHS CIO, CMIO and CIS Clinical Operations Leader.

Alberta Health Services Privacy Officer Appointed

​Linda French, with decades of legal experience in the private and public sector, has accepted the position of Chief Privacy Officer (CPO) with Alberta Health Services. Linda's diverse background in law, change management, leadership development and process optimization will be an asset to the Legal & Privacy department. The CMIO works closely with Privacy; strong collaboration helping to mitigagte information sharing challenges raised by widening adoption of enterprise-wide shared health records. Dawn Lake is acknowledged for her tremendous contributions as acting CPO since February 2016.

AHS Privacy: li.ahs-cmio.ca/ahsprivacy

AHS Privacy queries: privacy@ahs.ca

What does it mean for the AHS Provincial CIS to be “business-led”?

​With AHS now firmly on the path to a provincial clinical information system (CIS), we face major transformative challenges. We cannot succeed unless both executive and clinician (user) engagement is rock-solid. Indeed, we have committed to run a project that is “business-led”. Our user engagement strategy very much depends upon what we mean by “business-led”. The CMIO team, in collaboration with the CIO, CIS Project, Organizational Change Management, Communications and other stakeholders, seeks a better understanding of what AHS leadership, information technologies, and other stakeholders understand by business leadership, clinician engagement, empowerment and accountability. The aim is to expose core principles that can inform the next stage of clinician engagement planning. More to follow!

AHS Provincial CIS Leadership Opportunity

​AHS is looking for a Senior Program Officer (SPO) for the Provincial Clinical Information System (CIS) Program to co-lead the most significant transformation in provincial healthcare to date. Reporting directly to the VP, Quality and Chief Medical Officer, the CIS SPO will work in a triad partnership with the CMIO and Chief Information Officer (CIO). The successful candidate will provide overall leadership to care transformation, planning, development and change management required for the deployment of a single continuum-of-care provincial CIS. The SPO will co-lead CIS design, build, implementation, optimization and operation, with particular focus on clinical design. A business-focused thought leader, with in-depth understanding of clinical operations, the SPO will have strong communication, liaison and coordination skills that will ensure the successful transfer of knowledge to clinical teams and affected employees.

SCO Recruitment Posting: ahs-cis.ca/SPO

AHS Provincial CIS RFP Progresses to Second Phase

​Alberta Health Services (AHS) has just completed the first stage of its Request For Proposal (RFP) process for an AHS Provincial Clinical Information System (CIS). This proved a complicated logistical and technical process requiring significant coordination. Shortlisted Proponents will be invited to a more in-depth review as part of the second stage of the RFP. This will include a requirement to demonstrate detailed functionality to 250 clinicians, staff and patients in early 2017. A final decision on the successful bid will be made in mid-2017 and will be shared with staff and the public.

The aim of the CIS is to improve patient experiences and the quality and safety of patient care by supporting standardized information management across the continuum of health care.

AHS CIS Facts: ahs-cis.ca/facts

AHS CIS Website: ahs-cis.ca/public

AHS CIS InSite: ahs-cis.ca/private

AHS CIS Queries: provincialcisprogram@ahs.ca