2019-10-18

Countdown Checklist L-15

Continuing our list of essential actions for Wave 1 physicians facing Connect Care Launch 15 days from now...
  • Consider a Personal Device for Connect Care Use
Many of us will come to prefer doing common clinical information system (CIS) tasks on mobile or personal computing devices. These are set up to our liking, move with us, and will work well with wireless in Connect Care facilities and clinics. This is a good time to check whether what we have is what we'll want to use. For those interested in new Apple iPads, Macbooks or Macbook Pros, a Connect Care physician purchase portal is now open. The available devices are CIS-appropriate and backed by extended enterprise AppleCare.

Apple Purchase Portal for Connect Care Physicians

We previously posted about things to consider when selecting a personal mobile device for physician use with the Connect Care clinical information system (CIS). We also posted about a new arrangement between Apple and Alberta Health Services to provide enterprise support for clinicians using Apple devices with the CIS.

We are now pleased to confirm availability of a physician purchase portal for Apple devices. The available devices are selected for their fit to rounding and other workflows where personal computing can be most helpful. An exception is iPhones, since both pricing and support is better had through one's mobile phone and wireless services provider.

CIS-ready tablet and notebook computers purchased through the portal are backed by extended enterprise AppleCare support at no additional cost.

2019-10-17

Countdown Checklist L-16

Continuing our list of essential actions for Wave 1 physicians facing Connect Care Launch 16 days from now...
  • Connect to Launch Supports
This is a good time to check that you and clinical colleagues know who the Super Users, Medical Informatics Leads or other peer-resources are for your clinical group, division, subspecialty or clinic. They can facilitate pre-launch personalization activities. They will be present and a great resource during the pressures of launch. 

Clinical groups (divisions, units, clinics, etc.) should plan for their own start and end-of-day meetings to take the pulse of their implementation and flag issues to forward to launch supports.

This is also a good time to note where User Supports are described in the  Connect Care Physician Manual. This information will be updated with more specifics about how to find and use human, online and telephone supports for help with Connect Care on-boarding.

Got your Back!

There is a lot of (anxiety-tinged) excitement as we close in on Connect Care's Wave 1 launch. Everyone is impacted; even those at Zone sites that do not yet implement the clinical information system (CIS). Naturally, we wonder about the who and how of end-user support. We also need to know how unexpected issues will be identified, reported, understood and resolved. 

Medical and Operational Leaders work together in a launch "Command Structure” that coordinates user-supports and problem-solving during launch and for a number of weeks afterwards. This operates 24/7, constantly receiving concerns from clinical groups, managers and leaders. There will be "ears to the ground" everywhere; using rounds, divisional meetings, unit scrums, Super User reports,  and drop-in conversations to capture issues, then channel these to the Connect Care Service Desk & Solution Centre. Throughout the day, diverse Command teams will meet to discuss and resolve issues. Updates will be shared Zone-wide on a regular basis. 

Wave 1 launch deploys the Connect Care CIS to specific facilities and clinics. But the entire Zone monitors clinical impacts, ready to redirect service loads where and when needed.  The Command Structure will dovetail with a Zone Emergency Operations Centre (ZEOC) to ensure an integrated and coordinated approach to addressing service loads, protecting patient safety, and communicating to stakeholders. 

Those putting hands to keyboards (or mouths to microphones!) in early November will have diverse supports:  
  • Super Users will be “at-the-elbow” to guide clinicians (be sure to identify and work with your own Super User, who will help solve problems and log issues and requests). 
  • The CIS Learning Home Dashboards will update guides about how to support workflows with CIS tools.
  • The Connect Care Physician Manual (manual.connect-care.ca) will be updated regularly, reflecting the essential knowledge and skills needed for physicians to make headway with Connect Care.
  • The Connect Care Physician Blogs (blogs.connect-care.ca) have channels for peer-to-peer tips, FAQs and supports. Check daily (or subscribe) for help with unique informational needs of physicians.
Don't be shy! Reach out early and often. A solution or mitigation is likely just a call away.


2019-10-16

Countdown Checklist L-17

Continuing our list of essential actions for Wave 1 physicians facing Connect Care Launch 17 days from now...
  • Buddy-Up and Team-Up
Every clinical group will have members who love, and others who hate, information management. This is a good time to recognize this reality and identify buddies for providers who may struggle. There are valuable human resources to tap. Pre-socialize your Super Users, Medical Informatics Leads, Area Trainers and other specialty, ward or clinic informaticians. Create and share a launch contact list that fits your local group needs.

This is also a good time to identify personalization tasks of great value, but possibly significant effort. Many can be grouped and allocated so that smaller teams do then share work with the larger group.

Consider devoting divisional, section, departmental or extraordinary meetings to developing final team readiness task lists; then divide the work.

Examples of allocatable and sharable personalization tasks are listed in the Connect Care Physician Manual.

Taking Care

Connect Care has taken care to design, build and configure the best possible clinical information system. Now, as a community of users, we need to take care of one another through change and challenge.

As we near the first Wave launch, we can feel the excitement building. We also know that workload and demands increase as preparations progress. We recognize that teams are working very hard and deeply appreciate the efforts.

But even with thorough planning and preparation, implementing what we've collectively built will present unanticipated challenges. Some will be urgent – some will not. We are exploring every eventuality to ensure Connect Care is a success. We have taken our time, considered possibilities, tested and re-tested, and involved staff, physicians and patients at every step of the way. We have resourced to support our people while keeping patient safety and service our top priority.

All preparations aside, our greatest protective is our people. We have surmounted extreme challenge before and will do so again. Connect Care has built a clinical information system that will continually improve. More importantly, Connect Care has grown the people capacity to understand, collaborate and problem-solve informational issues. We have trained and empowered clinical informaticians, super users, trainers and a wealth of other human resources. Now we must leverage that capacity to tackle the challenges to come; leaning on one another to navigate change and seize opportunity.

Connect Care has moved from workgroups to hallways. Let's buddy-up, trust our abilities, take care of one another, and make this work!

2019-10-15

Countdown Checklist L-18

Continuing our list of essential actions for Wave 1 physicians facing Connect Care Launch 18 days from now...
  • Confirm PROVIDER REGISTRY Information
The Connect Care clinical information system (CIS) uses a “provider registry” to store information about clinicians using the CIS. The registry is also a source of information that affects how CIS user roles and permissions are set up, how providers can find and communicate with one another, and how things like preference lists and referrals work. 

It is important that this information be correct and getting ready for Connect Care launch is a perfect time to validate information about oneself. Specific instructions are provided in a Tip: Confirming Provider Registry Information.

Access and identity essentials are described in the Connect Care Physician Manual.

Disaster Recovery Exercise

It is very important that we have a robust and tested disaster recovery plan before Connect Care launch. The processes have been in the works for years, yielding multiple layers of fail-over protection and a resilient infrastructure. Nonetheless, hardware, software and process needs to be tested with fully functional clinical information system (CIS) and support modules.

The Connect Care Disaster Recovery Plan will be put to the test October 16, 2019 after 2200. The exercise will simulate a real disaster. The ability of a downed data centre to fail-over to one of the back-up data centres will be checked together with continuity of CIS functions as the primary data source switches from one urban centre to another.

CIS environments could go down and so the timing avoids interruption of known training events.

2019-10-14

Countdown Checklist L-19

Continuing our list of essential actions for Wave 1 physicians facing Connect Care Launch 19 days from now...
  • Confirm REGISTRATION for PERSONALIZATION
Successful personalization of the Connect Care clinical information system (CIS) has a big impact on physician success at launch. It is very important to take advantage of personalization workshops pre-launch. Make sure that you are already registered or take advantage of self-registration via MyLearningLink (supported on a first-come-first-scheduled basis).

Personalization objectives, pre-requisites and preparation are all described in the Connect Care Physician Manual.

Connect Care Information for Patients

The Connect Care communications team has been hard at work putting together resources to help patients and families understand what is happening at launch. A number of exhibits will be rolled out at Wave 1 sites over the coming weeks:
  • FAQ documents circulated through frontline leaders, staff, information desks and Health Link 811.
  • MyAHS Connect brochures explaining how patients and families can sign up for patient portal access.
  • Postcards banners, tent cards, TV monitor displays, and video kiosk displays raising Connect Care awareness.
  • Decals identifying equipment supporting Connect Care.
  • And many other resources.


2019-10-13

Countdown Checklist L-20

Continuing our list of essential actions for Wave 1 physicians facing Connect Care Launch 20 days from now...
  • Update Your AHS Security Profile
This task anticipates future calls to the Alberta Health Services IT HelpDesk or Connect Care Solution Centre. Among other things, physicians may need help with things like logon credentials or remote access FOBs. Understandably, HelpDesk must confirm the identity of the caller. This is done with a security profile, including special questions and answers, that the physician can set up independently, as explained in the Connect Care Physician Manual

All physicians are asked to update their security profile now:
Upon authenticating to the IAM user section, look for a "Update Security Questions" in the bottom left column. You will set a secret word and answers to a series of security-prompt questions. Remember the answers! (Note - you must have a FOB for external access or do this from within AHS)

Protecting Privacy with NO Privacy

A concerning CBC news report suggests that there is a spike of health care privacy breaches in Alberta:
As the text of the article clarifies, the spike is actually of reports of possible issues that are submitted to the Office of the Information and Privacy Commissioner (OIPC). New legislation mandates reporting all incidents to the OIPC. This, understandably, has increased the number of events that get reported this way (most are already managed). Not all events turn out to be genuine breaches.

This article, like others, can raise public concern about the Connect Care clinical information system (CIS). The CIS will have provincial spread. Are we exposing patients to greater privacy or security risks? 

The evidence says "No". Responsibly managed health information systems dramatically decrease privacy risks over the paper-based systems they replace. Access is more difficult. Audit trails record all chart openings, user activity and attempts to alter the record. Data backups are more robust. Data exchanges are monitored. The encryption and communication tools are vastly more secure than the telephone, fax and printed materials replaced. What does increase is visibility... giving the false impression that privacy threats increase. In fact, true breaches decrease.

What are we doing to ensure the very best protections for our Connect Care patients? 

First, we are making sure that we leverage everything technology can do for us. Connect Care manages security right down to individual chart elements, with more protections, more validations and more accountability than any prior system. 

Second, we are being realistic about technology. The greatest threat to privacy is the grey stuff between two ears... neurons, not networks. No existing technology can fully compensate for privacy illiteracy, negligence or willful access misuse. We have implemented a privacy awareness program that is about understanding, behavior and personal accountability. Everyone must complete this. And we continually reinforce.

Third, we protect patient privacy with lack of physician privacy. Everything physicians do is monitored in Connect Care. The fidelity of auditing is far greater than before. Our capacity to rapidly detect potential problems is enhanced with software that continually monitors patterns and behaviors. This is reasonable. As practitioners, we've never been entitled to hide within legal records of care. 

Again, the evidence is clear. Effective education combined with surveillance, feedback and action has the greatest impact on privacy protection.

2019-10-12

Countdown Checklist L-21

Continuing our list of essential actions for Wave 1 physicians facing Connect Care Launch 21 days from now...
  • Ensure that you have online REMOTE ACCESS
Just 3 weeks to go!

Remote access refers to any use of the clinical information system (CIS) outside of Alberta Health Services (AHS) networks ("intranet"). Will you need this? Some physicians rarely work out-of-AHS. Some will find  remote access through mobility (Haiku, Canto) good enough for results review, communicating, ordering, billing and simple documentation. But many physicians will need full Hyperspace externally. A security FOB is required, as explained in the Connect Care Physician Manual. Existing Netcare FOBs are automatically set up for Connect Care and require no new action. For physicians needing remote Hyperspace, but do not currently have a FOB, apply now (note - must do this from within AHS):
Physicians in Wave 1 are authorized for remote access by Zone Medical Affairs, who should be contacted for support (MedicalAffairs.EdmontonZone-PhysicianResources@ahs.ca).

Visits with Connect Care Teams

This week marks a major milestone for Connect Care: the launch of Wave 1 is less than a month away. Our CEO, Dr. Verna Yiu, visits with teams, taking the pulse of Connect Care.



Other Alberta Health Services leaders express how grateful they are for the work front line teams are doing to prepare for launch, and beyond.

2019-10-11

Countdown Checklist L-22

Continuing our list of essential actions for Wave 1 physicians facing Connect Care Launch 22 days from now...
  • Ensure that you have online ACCESS
This one's easy. It's Friday!

Make sure that you have a working Alberta Health Services "Healthy" network userid and password. These credentials are used to log on to AHS computers, email, Connect Care and many other systems. Your profile needs to be turned on for Connect Care access. Make sure that your user name and password work at:
If you try logging on from outside an AHS facility, you will need to additionally have a security FOB. More about that tomorrow. Checkout the Access section in the Connect Care Physician Manual. Contact AHS IT Service Desk (877-311-4300) if your username and password do not work with myapps.ahs.ca.

Connect Care Weekly Review - October 11, 2019

What a week its been! Lots of action and lots of new information in our various blogging channels. Some highlights:
  • Countdown checklist: daily postings to this blog offer specific steps that can be taken, one at a time, to ensure physician readiness for launch on November 3, 2019. Try to check off the tasks!
  • Physician manual: a Connect Care physician manual summarizes essential information and tips in one simple format that adapts to desktop and mobile devices. This already has a lot of practical information for beginners.
  • Workflow dress rehearsals: started this week, with lots of physician involvement, meaningful system exposure in typical clinical environments, a good test of emerging user supports, and many valuable insights and tweaks now in the works.
  • Over 2,800 physicians have presented for basic training and over 600 are already through personalization training. Personalization training workshops have proved exciting and empowering for participants... already leading to excellent launch preparations.
  • Specialty clinical system design is complete, with all build validated, and >230 ordersets are validated and moving into production, with another 70 to go.
  • Physician users have started to share peer-to-peer tips, supports and answers to questions.
  • A 'First Looks' series of demonstrations shares the look and feel of recent functions to emerge in our Connect Care build.
  • Connect Care Mobility installs are progressing, backed by a new physician mobility compact.
  • Other readiness events: the 30-Day Launch Readiness Assessment, held on October 2, and the Clinical Operations Readiness Day, held on October 3, drew 385 and 505 attendees, respectively. Three quarters believe they are ready for launch. 

2019-10-10

Countdown Checklist L-23

Continuing our list of essential actions for Wave 1 physicians facing Connect Care Launch 23 days from now...
  • Complete InfoCare Privacy Awareness Training
This one applies to everyone. No escape. Every physician must complete an online self-directed eLearning module entitled "InfoCare - On our Best Behavior". This solidifies understanding about responsible behaviors when working with personal health information. 

All prescribers must complete the module. Completion is demonstrated in a final section where commitment to privacy protection is affirmed with a series of statements. Access to Connect Care is not possible without InfoCare completion. Physician AHS privileges are contingent. 

Log on to MyLearningLink.ahs.ca with your AHS username and password. Search the available courses using "InfoCare". Anticipate spending about 20 minutes.

Get in touch with ConnectCare.PhysicianTraining@ahs.ca if you have difficultly getting credit for course completion. Macintosh users: save time by checking our tip sheet first.

Interfacing Clinical Applications

The earliest Connect Care communications defined a clinical information system (CIS), emphasizing that it is not Epic alone, but a composite of interfaced information systems working together as one. The Epic integration engine is fundamental. However, as we approach our first launch, it is important to remember that the Connect Care CIS also includes:
  • Enterprise Content Services
  • Transfusion Medicine
  • Provincial Speech Recognition
  • Barcode Identity Management
... and more. Not all of these have received full attention in training. We will continue to produce just-in-time guides, tip-sheets and online demos to help users understand how to use these non-Epic applications as part of the Connect Care ecosystem.

A new Insite resource summarizes all the applications that are interfaced as part of the CIS:

2019-10-09

Countdown Checklist L-24

Continuing our list of essential actions for Wave 1 physicians facing Connect Care Launch 24 days from now...
  • Clean your eCLINICIAN House
This personal readiness task is relevant to physician users of the eCLINICIAN clinical information system (CIS), but completion will positively affect all Connect Care CIS users.

There are many (tens of thousands) of 'open encounters' accumulated in eCLINICIAN. Many are likely telephone encounters, refills and other minor interactions that simply did not get signed off. However, open outpatient visit encounters could affect the quality of data converted for Connect Care.

Cleaning house is neither hard nor time-consuming. See a short tip about encounter management for clear instructions.

Tell me what to do!

Approaching 3 weeks from launch, there is no shortage of Connect Care awareness... perhaps a surfeit of Connect Care anxiety.

We hear from clinical colleagues that the upcoming change seems overwhelming, even impossible. As Cam Chell reminded us, doing impossible is about just taking the next step!

From now through launch we'll post a short, specific and actionable suggestion about a tangible next step that physicians can take to be ready for a safe launch that we will all be proud to have made possible. You can find the daily checks in this blog, marked with a yellow background, or you can bookmark the series: