Connect Care January 2019 Calendar

A summary of key Connect Care happenings coming in January 2019 has been posted to the Alberta Health Services (AHS) internal Connect Care website, linked below.

Now that the clinical information system has been configured to fit AHS workflows, build efforts shift to clinical system design. An online training environment will be readied for the end of the month and the first round of system testing will also complete by month's end.

Signalling our shift from content and configuration to testing and training, a Wave 1 Launch event on January 17, 2019, will focus attention on all we must do between now and November 2019.


Alberta Health Personal Health Record Progress

The Alberta Health Personal Health Record project continues to evolve, transitioning to a new phase with new software in the first quarter of 2019. Previously an Internet offering based on the "HealthVault" program, and available to limited pilot-test populations, a new platform will better accommodate the smaller screen sizes of mobile devices.

The re-designed offering, to be launched as "MyHealth Records", provides a secure online digital health portfolio that can be used to gather, manage and track personal health information. MyHealth Records will give adult Albertans the ability to view some of their health data from the Netcare provincial electronic health record. This includes recent medications dispensed from participating Alberta pharmacies, many immunizations administered in Alberta and some common laboratory test results.

Uptake of MyHealth Records can shift how Albertans relate to health information and to their healthcare team. Assistance will be available for users should they have any questions or require help. A call-in line will provide troubleshooting advice and will also connect users to Health Link 811 should users have any questions about health information released on MyHealth Records.

Clinicians can visit the MyHealth Records webpage (myhealth.alberta.ca/mhr-provider) to learn more, and send questions or comments to myhealthrecords@gov.ab.ca.


Identifying Patient Records in Connect Care

As we move toward a single Alberta Health Services (AHS) clinical information system (CIS), the way patients' medical record numbers need to be standardized.

Medical record numbers are used to ensure that an individual's health record remains unique. Currently, patients are assigned different medical record numbers at each care setting they visit. Over time, most Albertans have accrued multiple facility-specific identifiers.

The introduction of the Alberta Unique Lifetime Identifier (ULI) helped, giving one identifier that could be referenced at all sites. However, this Alberta Health maintained ULI does not apply to all patient populations and, for technical reasons, it can take longer to generate than the creation of a health record demands.

The Connect Care CIS adopts a one-patient-one-record-one-system model. A Connect Care provincial medical record number (pMRN) will apply anywhere and anytime AHS facilitates care. It is unique, can occur only once per patient, and is created or retrieved whenever a patient interacts with AHS. Moreover, when the pMRN and ULI are used together, positive patient identification is more efficient and patients are more confidently linked to their Connect Care record.

The new pMRN will apply wherever Connect Care serves as the record of care, including at partner sites such as Covenant Health.


Connect Care Communications Preferences Survey

From Alberta Health Services Community Engagement & Communications:

As work continues on Connect Care, Alberta Health Services (AHS) Community Engagement & Communications wants to make sure you are getting the information you need, in ways that work for you.

Connect Care will transform care in our province and change the way we work. To help us better understand your awareness about Connect Care and the best ways to keep you informed, we invite you to take a short online survey.

It will take about two minutes to complete, and your responses are anonymous. The survey will remain open until end of day, December 15.  Please encourage your teams and colleagues to take the survey as well.
Your feedback will help shape future communications and engagement related to Connect Care. We will repeat this survey regularly to track how we are doing.

We sincerely appreciate your time and valuable input.

Thank you for your help.                   

Colleen Turner
Vice President, Community Engagement & Communications


HIMSS Canadian Prairies Chapter Inaugural Virtual Event

We would like to invite members of the Alberta Health Services health informatics communities to join colleagues from across Manitoba, Saskatchewan and Alberta to celebrate the season and our first HIMSS Canadian Prairies Chapter event – a webinar: HIMSS Canadian Prairies Chapter is Coming to Town. Presenters will reflect on their health IT views and experiences from Alberta, Saskatchewan, Manitoba and HIMSS International.
HIMSS is a global advisor and thought leader supporting the transformation of health through information and technology. As a mission driven non-profit, HIMSS offers a unique depth and breadth of expertise in health innovation, public policy, workforce development, research and analytics to advise global leaders, stakeholders and influencers on best practices in health information and technology.

Chapters represent the grassroots of HIMSS. Canadian Prairies Chapter of HIMSS is the newest of the 57 chapters that serve a valuable role in bringing healthcare system professionals together in a local forum.
We look forward to “seeing” you at this virtual event on December 17th. Please share with your colleagues and within your networks – everyone is invited to attend, whether they are already a HIMSS member, or are just considering it. To register for the event, click here.  


Connect Care Data Conversion

Data conversion is about how historical health information is selected and managed for transfer from legacy information systems to the Connect Care clinical information system (CIS). Considerations include which information to transfer, how it should be transformed, how much to include, and how to make it accessible.

The conversion of data transferred from legacy systems to the CIS started in early 2018 and will be completed by the Wave 1 launch in November 2019, providing physicians and clinicians with the information they need for decision-making and patient care. Connect Care Groundwork and Scoping Recommendations helped set the conversion project scope. Appropriate data types were prioritized into three tiers based on clinical value and conversion effort.
  • Tier 1 includes allergies, encounters (admissions, transfers and discharges), imaging, labs and problem lists. Work on converting these data types has begun.
  • Tier 2 and Tier 3 data types are still being finalized by the conversion team. Details will be released as they become available. 
Based on this analysis, a conversion list describes systems that will be integrated and data types that will be converted. No important clinical data will be lost during the migration to Connect Care.

Before July 2017 several clinical data types were not consistently defined using measures or ranges standardized across Alberta. Accordingly, July 2017 serves as the default start date for data conversion into the Connect Care CIS. Other systems, including Alberta Netcare (launched directly into the right chart) will make historical data accessible to clinicians.

A 1-page ‘Byte’ and a more detailed ‘FAQ’ provide information about Application Integration and Data Conversion, both available on Insite and the Connect Care Clinician Handbook.


Connect Care Application Integration

Clinicians have been asking about how they will access information from health information systems that will be fully integrated into the Connect Care clinical information system (CIS); and how the provincial CIS will work with those few applications that AHS will keep in parallel with the CIS.

The majority of AHS’s health information systems will be integrated into the Connect Care CIS, with functions and databases replaced by a seamless information environment. The integration work will involve data conversion, so that information from replaced systems is transformed to fit CIS data definitions, decision supports and other dependencies. Not all data will be suitable for conversion, leaving some historical material outside of the CIS for a period of time. Clinicians will be able to access this data for as long as it is needed.

While the Connect Care CIS will be a pivotal integrative technology, some external applications are needed to support the whole of AHS' business operations over time. If and how these applications will "talk" to each other (interoperate) is also addressed by the Connect Care Integration strategy.

Integration and interoperation of health data are intensive processes, requiring technical specialists to build transfers and exchanges. A list of integrations to be completed as part of the Connect Care initiative is maintained within Connect Care SharePoint spaces. The list includes all integrations confirmed by the Connect Care Executive Committee (CCEC).

Intensive integration, data conversion and interoperability work anticipates Connect Care launch, in continuity with our earliest scope management principles and processes:


Connect Care Scope Management Progress

Scope management is about how we identify important CIS clinical, functional or safety gaps, prioritize gap-mitigation strategies and select systems that fill gaps while working with the CIS.

We posted about Connect Care scope management over a year ago, emphasizing a principles-based approach to decision-making about which health information systems to integrate into the provincial clinical information system (CIS). We later reported about methods for choosing which data, and how much, to transfer from retiring information systems to Connect Care and later still surfaced options for accessing historical data that may remain in legacy systems. As we get closer to implementation, there is more clarity about which applications are integrated into the CIS and what data can be converted.

The short Byte and Principles, linked below, have been updated. Improved SharePoint resources cover all aspects of scope management, including a list of all integrations to be completed as part of the Connect Care initiative. The presentation gives a reminder about scope management principles and processes. (note that some links will only work on the AHS intranet).


Mea Culpa - Resisters are not Obstructionists

An earlier posting (http://bytesblog.ca/2018/11/25.html) introduced a possible categorization of prescriber responses to clinical information system (CIS) implementation. We wanted to stimulate reflection about how to support change for different CIS-adoption phenotypes, including 'obstructionists', 'minimalists', 'partialists', 'partners' and 'exemplars'.

Some colleagues rightly pointed out that the word 'obstructionist' unfairly brands persons who express genuine concern about how a CIS could affect patient care and professional satisfaction. The scientific literature and popular press abound with reports about negative effects of electronic health records.

A good point is made, and accepted. We will do our best to avoid harm when working with clinician communities to implement Connect Care. However things unfold, some clinicians will (for whatever reason) oppose implementation. Avoidance could be passive or active. The effect is the same.

We have changed the linked backgrounder (and this posting) to refer to "resisters" instead of "obstructionists", as this less judgemental term focuses our attention on the effect of, not the reason for, objecting to CIS implementation.

Please always feel free to comment on postings or linked documents. Connect Care is about learning.


Connect Care December 2018 Calendar

A summary of key Connect Care happenings in December 2018 has been posted to the Alberta Health Services internal Connect Care website, linked below.

Build buckets 1-4 remain a top priority, closely followed by initiation of build for the many specialty clinical system design decisions which have accrued. Training and readiness activities ramp up with substantive new content appearing in Readiness Playbooks, curricula and provider community engagement.


Connect Care Readiness Resources Growing

With more and more attention to Wave 1 (less than a year away!) preparations, Connect Care readiness resources are emerging and maturing. These will continue to grow and consistently discoverable via Connect Care's space on the Alberta Health Services (AHS) internal website (ahs-cis.ca/insite):
  • Training & Learning Resources - with updates about the Connect Care training strategy
  • Readiness Resources - where the Readiness Playbook takes shape and key orientation presentations are added
  • Leader's Toolkit - providing presentation, handout and other materials that can help bring staff up to speed about how Connect Care will affect them
The current internal AHS training and readiness resources have broad applicability. Considerations specific to physicians and prescribers are also gathered and available in the Connect Care Clinician Handbook:


Connect Care November 30 Newsletter Posted

The November 30, 2018, Connect Care Newsletter is available via the link below; covering new readiness resources, reflections from Barb Kathol and Mackenzie Health success with Epic.


Connect Care November 2018 Calendar

A summary of key Connect Care happenings in November 2018 has been posted to the Alberta Health Services internal Connect Care website, linked below.

Multiple parallel priorities continue. Workflow direction and decisions continue to be expressed through build and configuration in Build buckets 1-4, to be completed within another month. Clinical System Design has hit peak activity for decision-making and is shifting attention to facilitation of build activities, all to be completed by February 2019.

Connect Care's first launch, Wave 1 at the University of Alberta Hospital campus, is less that a year away. Recent work has focused on building leadership awareness and planning how non-medical devices will intersect with clinical workspaces.


Innovative new App facilitates Patient-Centred Cancer Care

Cancer Control Alberta and the Alberta Cancer Foundation have partnered to develop, test and release an innovative mobile application that can help patients and families participate in collaborative care.

"My Care Conversations" allows one to use a smart phone (iOS or Android) to record care planning interaction(s) with health care providers. The recording can then be used for review and understanding, or for sharing and discussing with family and trusted friends.

Very well received in pilot testing, this patient-centred support has been shown to reduce anxiety, improve compliance and facilitate more informed decision making.

Strategies for extending this work into Connect Care and patient portal tools are being considered.

For more information:


Minimum Use Norms

Given that improper clinical information system (CIS) use can compromise service and safety, all CIS users have interest in peer-endorsed norms for appropriate and meaningful CIS use. These “minimum use” tasks constitute a subset of practices essential to safe patient care and coordination.

Other CIS practices may be necessary for chronic disease management, integrated care planning and appropriate use of applications, modules, registries, portals and analytics.

CIS minimum use norms are consistent with best practice but should be followed in the spirit of not unfairly increasing information burdens for others contributing to a shared health record.

The Connect Care Council recently endorsed a starter-set of CIS minimum use norms. These are posted to the Connect Care Clinician Handbook, with feedback welcomed via cmio@ahs.ca:


Resisters, Minimalists, Partialists, Partners and Exemplars

The Alberta Health Services (AHS) Connect Care clinical information system (CIS) can facilitate rapid access to health information across the continuum of care. However, the CIS cannot serve if it is not used consistently and effectively by all who share in care. Indeed, the legal record of care is vulnerable to inconsistent or ineffective CIS use. With Wave 1 implementation looming, it is important to anticipate prescriber engagement, adoption and CIS-use patterns.

Inevitably, a few physicians will object to CIS adoption. Whether motivated by principle, workflow concerns, ability or other reasons, the effect will be accept little interaction with the Connect Care record. These ‘resisters’ could be beyond the reach of essential communication, collaboration, decision support and care planning tools.

Other ‘minimalist’ clinicians will do only those CIS tasks absolutely essential to close encounters. Incomplete work on problem lists, medications, allergies, documentation and orders will shift information burdens to others.

Closely related ‘partialist’ phenotypes will use essential CIS features but miss all the efficiency gains to be had from personalization workshops and optimization services.

CIS ‘partners’ will use the CIS safely and collaboratively, while also enjoying decreased information burdens, increased satisfaction and generally improved clinical performance. They will seek and master the personalizations and automations made available through the system.

Finally, CIS ‘exemplars’ will not only master the CIS but additionally develop personalizations and automations to share with colleagues, and so raise the capacity of their clinical community.

As we get ready for CIS testing, training, and implementation, the time is right to look around (and within) to anticipate clinician reactions to Connect Care. We’ll need to manage to these reactions to have any hope of helpful adaptation to massive changes in the clinical workplace.

Backgrounder: Connect Care Prescriber Compliance


Capacity-Building and Compensation

Connect Care provides resources to support physician engagement, adoption and change-management. These are used to build capacity in prescriber communities. Contracted contributions are resourced, and the costs of building training, development and up-skilling programs are covered.

Connect Care investments have yielded excellent results. Over 70 physician leaders are oriented, trained, supported and mobilized. A growing cadre of clinician-builders already empower clinical system design. Hundreds of physicians are positioned for power-user and super-user roles. And knowledge leads prove invaluable to clinical content build.

Capacity-building efforts recognize the importance of compensation. However, ‘compensation’ is framed in terms of opportunity, career advancement, continuing professional development, gaining mandated e-health literacy, and mastering tools needed for clinical improvement, innovation or inquiry. We welcome feedback and input to an emerging Connect Care prescriber compensation strategy, which will continue to develop:


Netcare User Interface Changes Coming

An Alberta Netcare Portal (ANP) update is planned for November 29, 2018. Unlike other updates, this includes user interface changes. Electronic Health Record content and function remains unchanged.

A few quick reads can help clinicians anticipate the changes:
For users accessing ANP within the Alberta Health Services (AHS) intranet (portal.albertanetcare.ca), the FireFox browser works best on both Windows and Apple devices. This update is Internet Explorer 11 compatible (common on AHS Windows devices). Other Internet browsers (Chrome, Safari) are not supported.

For users seeking ANP from outside AHS (access.albertanetcare.ca), access continues via a Citrix Receiver session which can be launched from any Internet browser (Firefox or Chrome recommended).

Those who make frequent use of flowsheets, critical results filters or the quick-search function will want to re-discover how these are accessed, as they are no longer part of the page-top header and require additional click(s) to locate as part of new 'Documents' tab displays.


eHealth Literacy Resources Posted

‘Electronic health,’ also known as ‘eHealth,’ refers to how patients and providers use information and communication technologies (ICT) – including digital health records, portals and mobile apps – to improve health. While many of our staff and clinicians already use ICT effectively, others may not be as comfortable.

eHealth competence is not the same as clinical information system (CIS) competence. Connect Care-specific training – about how to navigate CIS interfaces and get work done – begins a few months before each Wave launch. Now is the time to build general eHealth competence and get ready to care and collaborate in a digitally-enabled workspace. For anyone interested in getting an early start, a new set of resources that can help.

The eHealth Competence program offers tools and resources to help Connect Care stakeholders learn about everything from computer basics to topics like privacy-protection, clinical documentation and information management. Self-assessment tools help choose the best learning pathway for different areas and eHealth comfort levels.

The current resources are optimized for nursing and allied health. Physician and prescriber-optimized resources will be released in the new year, coupled with a scheme for gaining professional development credits.

More information about the eHealth Competence program, self-appraisal tools and aides for managers are now available on Insite. New learning modules become available in early 2019.


Business Continuity Management Partner Selected

AHS is pleased to announce that Recovery Planner has been selected as the software vendor to support the Business Continuity Management (BCM) Program following a request for proposal process. BCM is a process that identifies events that could impact the continuity of services AHS provides. Recovery Planner has been on the forefront of delivering proven cost-effective resiliency solutions since 1999.

The software, named “RPX,” is built on a modern cloud platform and expresses standards and industry best practices. With planning, analysis, and real-time capabilities, RPX will better support the management of continuity and recovery of critical business, facilities, equipment and supplies, as well as staffing and technology services, in the event of a disruption (for example, the Fort McMurray wildfires, IT outages, labour action, or breaks in supply chain management).

Implementation of RPX will also support downtime and recovery objectives for a planned or unplanned Connect Care disruption by providing a platform for plan documentation, storage, access, training and plan activation. The goal is to implement RPX in a manner that supports Connect Care objectives and timelines. The “how” is in development.


When does Clinical System Design stop?

The enthusiasm, energy and productivity of Area Councils (AC) and Specialty Workgroups (SWG) continues to amaze us. Alberta Health Services (AHS) witnesses extraordinary collaboration, reduction of unhelpful variation and informational integration. Indeed, more important than any clinical information system (CIS) configuration may be the principles, relationships, and processes learned through clinical system design (CSD). Growing new ways of designing and optimizing clinical content (documentation, decision and inquiry supports) helps AHS mature as a learning healthcare organization.

ACs and SWGs understand that essential specialty CSD should wrap up as 2018 comes to a close, leaving January 2019 for unfinished or deferred issues. All specialty CSD decisions need to be recorded by a hard deadline of February 8, 2019. This milestone is critical to readying the CIS for testing and training.

So, if specialty CSD must deliver by February 8, 2019 and the value of specialty CSD is as an enduring process, then what becomes of CSD once testing and training start? The short answer is that CSD continues indefinitely. It must. There is no other way to ensure that the CIS grows with AHS, both helping AHS to learn and optimizing what works best.

Appreciating that CSD is a core Connect Care activity, today’s time-boxed work just gets us to a starting line. It allows a basic CIS to be built; enough to illustrate the value of CSD and to teach skills for meaningful use.

The really valuable CSD work begins once the CIS is deployed. Accordingly, we have begun planning systematic processes for tackling all the “parking lot” issues left over from CSD build; and anticipating all the new needs arising post-launch. The appetite for new uses of CSD tools will be great, priorities must be set and design capacity must continue to grow.


In-System Inquiry guided by the Clinical Improvement Lifecycle

We've previously posted about how Connect Care in-system inquiry tools can help AHS grow as a learning healthcare organization.

Key characteristics of a health system that can learn include:

  • Every patient’s characteristics and experience are available for study
  • Best practice knowledge is immediately available to support decisions
  • Improvement is continuous through ongoing study (closed loop)Inquiry happens routinely and economically
  • Curiosity and inquiry is valued and embedded in organizational culture
Connect Care in-system reporting and analytics tools will provide AHS staff with the ability to create and use real time data about patients, populations and the health system as a whole. This data can then be transformed into information that guides evidence-informed decisions in service of continuous clinical improvement.

Clinical information system (CIS) facilitated clinical improvement emulates continuous quality improvement lifecycles. Today’s internal and external evidence generates tomorrow’s ideas which are then critically examined to evaluate the impact of the change and stimulate ideas for further clinical improvement. A simple clinical improvement lifecycle can help guide Connect Care planning for in-system inquiry.


What level of in-system inquiry maturity do we need?

As part of Reporting Content Review, Alberta Health Services (AHS) analysts help clinical information system (CIS) users design reports, dashboards and visualizations that will be deployed through self-serve, in-system, analytics tools supporting decision making. The possibilities are limitless... early configuration work is intimidating to say the least.

It can help to envision a stepwise progression towards the reporting maturity AHS needs to attain HIMSS Level 6 and 7 recognition. Early in-system reports, dashboards and visualizations should focus on gaining insight about user on-boarding and adoption. Soon, data becomes available to support tracking minimum acceptable CIS use. Once use is solid, attention can shift to indicators of meaningful use and charting quality. Thereafter, gaining insight from internal evidence about health processes and outcomes becomes possible. Appreciating this can help prioritization of in-system reporting capabilities for launch and the months that follow.


How does Connect Care align with AHS strategic analytic priorities?

The Strategy for Research, Innovation and Analytics (RIA) lays out Alberta Health Services (AHS) roadmap for becoming an organization skilled at helping its people create, acquire and transfer knowledge to raise the standard of healthcare delivered to all Albertans. Connect Care is a key enabler. The Connect Care clinical information system (CIS) promotes curiosity, inquiry and research with in-system tools for data exploration, practice surveillance and hypothesis testing.

Connect Care aligns directly with the AHS RIA Roadmap by:
  • Making real time data available to care providers and managers
  • Providing front end access to analytics tools
  • Building analytics literacy and frontline interpretive capacity
  • Stimulating curiosity and question formulation
  • Providing effective ways to capture, translate and apply knowledge at the point of care
  • Allowing innovation in care to be introduced with changes in behavior and outcomes measured in real time
AHS builds improvement capacity in the workforce by allowing it to use its own data and identify opportunities to improve; where improvement is about the experience of healthcare as much as patient, organizational and system outcomes.


What is a learning healthcare organization?

A Learning Healthcare System is a system in which, "science, informatics, incentives, and culture are aligned for continuous improvement and innovation, with best practices seamlessly embedded in the delivery process and new knowledge captured as an integral by-product of the delivery experience."
Learning healthcare organizations demonstrate both an ability to use 'external evidence' (arising from the study of populations other than one's own) and an ability to use 'internal evidence' (about what works best in one's own context).  They use this evidence to generate hypotheses, strategically apply change to clinical and operational practices and evaluate the impact of the change on outcomes and behaviours. Characteristics of a health system that can learn include:
  • Every patient's characteristics and experience are available for study
  • Best practice knowledge is immediately available to support decisions
  • Improvement is continuous through ongoing study (closed loop)
  • Inquiry happens routinely and economically
  • Curiosity and inquiry is valued and embedded in organizational culture
Connect Care in-system reporting and analytics tools will provide AHS staff and stakeholders with the ability to create and use real time data about patients, populations and the health system as a whole.  This data can then be transformed into information that guides evidence-informed decisions in service of continuous clinical improvement.


Understanding Connect Care Reporting Tools

Connect Care Area Councils and Specialty Workgroups have begun a new stream of ​specialty clinical system design (CSD) work focusing on 'Reporting Content Review'. The work is covered in detail in the CSD updates blog.

For those not involved in CSD activities, this is still a good time to learn a little of the language and opportunity associated with powerful in-system inquiry support tools to be made available to users.


Mackenzie Health Excels with Epic

It is encouraging to witness successes of other Canadian Epic clients.

Mackenzie Health (Toronto GMA in Ontario) launched just over a year ago, summer of 2017. They have since attained stage 6/7 in most areas and now have reached the coveted 7/7 EMRAM recognition in ER and ICU.

The EMRAM program is run by the Healthcare Information and Management Systems Society (HIMSS). The program scores hospitals around the world on the effectiveness and capabilities of their Electronic Medical Record (EMR) system. Stage 7 certification indicates that the hospital has achieved a near paperless environment and supports optimized patient care through the use of technology.


Connect Care Physician Area Trainers

We have previously posted about Connect Care Provincial Physician Trainers (PPTs) and are thrilled to be screening a number of excellent applicants for these formal physician roles. New PPTs already progress through clinical information system (CIS) and curriculum courses and certifications. A few months from now, recruitment begins for the Area Physician Trainers (APTs) who will focus on the needs of specific clinical areas and specialties under the guidance of PPTs.

Prescriber training is facilitated by prescribers wherever possible. APTs fan out to make this possible across specialties and geographies. They support power users and super users (see informal physician contributions) while also directly helping Connect Care users through the launch and personalization stages of implementation (starting just under a year from now!).

The CMIO office will work with AHS Zones to determine the number of APTs required for successful launch. The APT cohort may include trainers who focus on a few specialties while others focus more on a few waves. Our current APT need estimates range from 25-30 per wave.

Further collaboration and planning with AHS zones will bring precision to the APT plan. Nonetheless, the time is right to think about persons who may be well suited to this role.


Prescriber Training Primer

We have previously described Connect Care's training strategy for prescribers (including physicians).

Work is progressing well. An recent consultation with provincial medical leaders allowed validation of key principles and processes.

A new backgrounder provides an orientation to the emerging Connect Care Prescriber Training Program:


Results & Reports Routing Workgroup Formed

A key Connect Care deliverable is de-fragmentation of AHS-managed health information flows. This includes “closed loop” results and report routing, where investigations and interventions are tracked from ordering to action, with verified delivery of the right information to the right person. Achieving informational continuity within AHS is essential. In addition, the right information needs to be routed to, received by and attested to by practitioners using non-AHS legal records of care.

Again, we have a complex area impacting diverse groups. Accordingly, a workgroup reporting to the Connect Care Portals Committee (which has multi-stakeholder connections) has started work. This will affect both configuration and change management. Sid Viner and Dominic Order co-chair, again with good clinician representation. Query cmio@ahs.ca as needed.


Mobility Workgroup Formed

Recognizing the importance of mobile applications (Haiku for iOS and Android, Canto for iPads, Rover for iOS, Limerick for iWatch) to engagement and adoption, and that impacts cross all clinical and operational groups, Connect Care has established a Mobility Workgroup reporting to the Connect Care Council (cross reporting to Connect Care Infrastructure Committee). Chris White and Bart Mielczarek co-chair, and solid clinician representation has been arranged. The workgroup considers how personal and organizational devices can be best used, and how to optimize mobility application features to fit clinician workflows. Please direct questions to cmio@ahs.ca.


Physician Communication Channels

Finding and growing physician-friendly communication channels is a constant preoccupation. The imperative intensifies as we ramp up readiness work and prepare for wave 1 launch in November 2019.

Many physicians are well served by excellent communications provided for all Alberta Health Services (AHS) staff. However, many other physicians preferentially attend to non-AHS communication channels, such as zone and University clinical department, medical staff society or professional association news. With a first launch looming, now is the time to seek all possible help getting Connect Care communications integrated with stakeholder communications. All suggestions are welcome.

Please promote our current physician-oriented channels to partner organizations, healthcare education, research communities and professional associations!


Where we are at

The herculean work to get essential Connect Care clinical content ready for testing and training has peaked. Area Councils and Specialty Workgroups will get through most clinical system design (CSD) work packages by year end, dealing with any deferred tasks in January, and concluding specialty CSD by February 8, 2019. Thereafter CSD continues but with a view to testing and optimization.

The full attention of our Area Councils will soon shift to readiness. Already the work of training curriculum design is well under way. Recruitment has already brought many clinician trainers into Connect Care, now working through certification. As training, testing and readiness activities ramp up, we’ll shift communications like these to what our stakeholder communities most need to know.


What is Inquiry and Research to Connect Care?

We participate in inquiry when we ask questions about what we do; and perform research when we use systematic approaches to answer those questions.

Connect Care is, at its core, about inquiry and research. The vision is to better healthcare with better information. The means is curiosity, inquiry and research. The Connect Care clinical information system (CIS) supports those means with tools for systematic data exploration, practice surveillance and hypothesis testing.


Patient and Family Centred Care Week

November 5-9 marks Patient and Family Centered Care week, and opportunity to acknowledge the wonderful work of our Connect Care community contributors!

Connect Care is about clinical transformation, with patients and families the intended beneficiaries. Remember who we’re building for: our parents, grandparents, friends, neighbours and colleagues – as well as the thousands of Albertans we’ll never meet.

As defined by the Institute for Patient and Family-Centered Care, “Patient and family-centered care is an approach to the planning, delivery, and evaluation of healthcare that is grounded in mutually beneficial partnerships among healthcare providers, patients, and families.” Core elements include:
  • Respect and Dignity - We listen to and honour patient and family perspectives and choices and include patient and family knowledge, strengths, values, beliefs and cultural backgrounds in the planning and delivery of care.
  • Information Sharing - We communicate with patients and families to ensure they understand and receive timely, complete and accurate information to effectively participate in care and decision making.
  • Participation - We build partnerships with patients and families, and we encourage and support them in the participation  of their care and decision making, at the level they choose.
  • Collaboration - We collaborate with patients and families in policy and program development, implementation and evaluation.
Many Connect Care Patient Advisors have been with us since the first steps of our journey. They serve on committees, councils and advisory groups and have grounded us at all 6 direction setting and adoption & validation sessions. Please join us in celebration of their invaluable work!


Why Doctors Hate Their Computers - 2 - a Surgeon's View

Our re-posting of Atul Gawane's essay, "Why Doctors Hate Their Computers", has generated a lot of discussion about what Connect Care needs to do in order to avoid the harms described. Thanks for the emails! Feel free to use the comment link on postings.

The following came in as 'Thoughts from a Surgeon':

I have gone over the Gawande essay, here are my reflections:

1. It's long piece and, like much of his writing, it meanders a bit and doesn't really reach a firm conclusion or suggest solutions, except to say that the adoption of digital health records may have some unanticipated side-effects that we should guard against.

2. The issue of user burnout related to clinical information system use is real and will probably hit clinic-based docs hardest.

3. It amazes me how much documentation I ignore or skip over in an average day. If I can't skip to the important stuff in a clinical information system (CIS) [Connect Care], my work is going to grind to a halt. The "Revenge of the Ancillaries" is a real risk and could lead to a bloated and unusable system.

4. Ensuring a good user/provider experience is the key to success. How will providers use the system efficiently every day?

5. Proving room for innovation and customization inside the system is also going to be essential.

Here is a detailed list of the actual clinical documentation I do in my own practice:

in clinic space
- see patient, scribble illegible note on health organization paper
- occasionally write a prescription on paper pad

in the office after clinic
- dictate my own detailed letter, copy and paste text into my electronic medical record (EMR)
- complete OR booking form, H&P and pre-op orders in CIS, medical office assistant sends to the OR
- check lab results in EMR
- enter billing codes in EMR

day of surgery
- dictate OR note at end of procedure (unless resident does it)
- resident does post-op note and orders, I rarely do this.

on the ward
- I never write in the chart, residents do all of that
- occasional verbal orders
- dictate discharge summaries which make their way to the provincial electronic health record (EHR)

in endoscopy suite
- scribble illegible note on health organization paper
- dictate my own endoscopy note for attachment to the provincial EHR

At home
- I never do any clinical documentation from home, I don't even have EHR or EMR access and I don't want it!

As you can see, I have developed what I think is a highly-efficient system designed to minimize the time I spend on clinical documentation. I bet most of my colleagues do something similar. I'd love to see what our new workflow will be like in the Connect Care CIS...

Why Doctors Hate Their Computers - 1

To find Atul Gawande's New Yorker essay on "Why Doctors Hate Computers" in my morning newsfeed gives instant jolt. A worrying read.

We took care to capture and characterize clinician fears early in the Connect Care journey. Every one of those fears is explored by Dr Gawande. He gifts Connect Care with a potent reminder of our purpose... to enable better health with better information. Any informational process that gets in the way must be questioned.

The timing could not be better. As we work through the final months of essential clinical system design, our councils and committees navigate more and more demands for mandatory data entry during test ordering, procedural documentation and communications management.  Our Connect Care oversight has strong clinical input. Now more than ever, we need those clinicians present and focused. Their advocacy can keep sensible workflows front of mind while testing design decisions for prospect of making things better, not worse, for our busiest healthcare providers.

The essay is not a short read; but well worth the hour we gained falling back from daylight savings time yesterday. We'll return to each of Dr Gawande's challenges, hoping to avoid the more preventable clinical information system harms, especially those associated with imbalances between administrative and clinical purpose.

And we must invest like never before in preparing clinical communities with the information literacy, norms and professionalism needed for better information to improve both the provision and experience of health care.

Every additional click, screen element or data demand potentially puts Connect Care at risk. We must remember this and continually push for the simplest, leanest and most straightforward configuration possible. There will be ample time later to consider the many decision, documentation and inquiry supports that could make us grow to love Connect Care, if not computers.


Connect Care Lingo - Testing

Even as we accelerate remaining Connect Care clinical content development, enough clinical information system (CIS) build has occurred that testing can begin. This will preoccupy us for most of the next year.

To help make sense of expected communications, we'll keep the eHealth glossary updated with new terms and acronyms.


Falling Back

Twice a year we warp time... and frustrate clinical time keeping. Yes, tonight the clocks fall back an hour as daylight saving time retires for another year.

The DST experiment started about 100 years ago to see if energy consumption (principally coal) would be reduced by bringing more work into daylight. We've learned that the opposite happens. Worker productivity suffers as well.

Whatever our gripes about gaining or losing an hour's sleep, serious information management problems confront those caring for patients when 02:00 becomes 01:00. For example, whether a change in blood glucose occurs over an hour, or a minute, can radically affect insulin drip protocols.

With a clinical information system in play, time distortions also distort medication administration records, clinical decision supports, and countless other digital details; especially if interoperating and interfaced systems handle DST-adjusted timestamps differently.

The biannual DST challenge is not handled consistently by health information systems. We'll need to plan and train for how Connect Care will cope (and vote against DST anytime the opportunity arises!).


Connect Care Privacy Impact Assessment

Information sharing is about how health data is collected, accessed, used, disclosed and exchanged. The Connect Care Clinical Information Sharing Approach (CISA, ahs-cis.ca/cisa) guides Alberta Health Services (AHS) as its provincial clinical information system (CIS) is designed, built and prepared for launch just one year from now.

CISA promotes responsible information sharing to improve health care and the health care system. This includes uses for training, administration, quality improvement, outcomes tracking, research and instruction. As custodian of the Connect Care CIS, AHS bears responsibility for a wide range of processes to ensure that information sharing is both productive and protective.

AHS responsibilities include preparation of a Privacy Impact Assessment (PIA) for submission to the Office of the Information and Privacy Commissioner (OIPC). A PIA demonstrates that AHS, as a custodian of health information under the Health Information Act (HIA), has considered the privacy risks associated with implementing a provincial CIS and has implemented strategies to mitigate those risks.

We highlight this important work now because the first PIA sections are submitted in October 2018.


Alberta Surgery Forum gives focus to Connect Care

The Alberta Surgery Forum is an annual event sponsored by Alberta's Surgery Strategic Clinical Network, this year at the Executive Royal Hotel West Edmonton on November 1 and 2, 2018.

With a broad aim of continuing surgical care improvement in Alberta, this year's event features an exploration of Connect Care fears and hopes. Clinicians will demonstrate the emerging provincial clinical information system with a walk-through of a 'day-in-the-life' for surgical stakeholders at Alberta Health Services facilities. Discussion will centre on preparing for CIS-enabled surgical work and information flows. Skype access is facilitated for surgical team members. Contact surgery.scn@ahs.ca for more information.


CIHR Researcher to Study Connect Care Patient Portal

Follow the link to view a UofA School of Public Health news item about some Patient Portal work of interest to Connect Care...


Connect Care Readiness Playbooks

Implementing the Connect Care clinical information system (CIS) will demand transformation throughout Alberta Health Services (AHS). Individual, unit, program, site, zone and system change is required to effectively adapt to a digitally enabled workplace.

A "Readiness Playbook" gathers recommendations and resources that enable adaptive change. The Connect Care Playbook addresses needs of AHS teams preparing for CIS launch in late 2019, helping them understand the information and actions needed.

Different "chapters" promote change management best practices, while responding to practical suggestions from operational stakeholders (clinical, medical, support, etc.). Recommendations serve and are owned by Connect Care's users. The Playbook will facilitate communication and help align the organizational and individual changes needed to get the most from Connect Care. Practical aids include tools, templates, tips and a monthly task-list. There are five 'chapters':

  • Foundational Readiness
  • Pre-Training Readiness
  • Training Readiness
  • Launch Readiness
  • Optimize and Thrive Readiness

The first chapter will be released in early November, 2018; starting the 52-week countdown to our first launch!


Building Capacity in our Physician Community

Building clinical content (decision, documentation and inquiry supports) for Connect Care remains a top priority for committees, councils and specialty workgroups. We strive for an exemplary clinical information system (CIS) that will truly serve our vision of better information for better health. But even a perfect system will disappoint if we lack capacity to adopt it into day to day care, or to continually enhance its application for clinical improvement.

We've been building CIS capacity in the physician community for some time now. Excellent clinical informatics leadership, change management and knowledge translation capabilities have emerged. A few numbers give measure to these accomplishments:
  • Over 70 physician leaders are oriented, trained, supported and mobilized province-wide through the CMIO portfolio, including associate CMIOs (5), design leads (5) and medical informatics leads (61). They serve the Connect Care initiative, their zones and clinical areas and have enduring key roles in leadership, engagement and adoption.
  • 7 physician builders are fully certified, 27 have attended at least one builder course and up to 30 per year can be skilled-up for the next 3 years through the clinician builder program. Builders already accelerate clinical system design and will have pivotal roles in post-implementation optimization.
  • Over 150 physicians have completed CIS basic training, a handful have advanced to become power users and many more will attain super user skills. The resulting awareness has already improved committee and council functions while allowing CIS demonstrations to shift from from vendor to client.
  • Over 60 physician clinical guidance leads empower order set, decision support and other clinical content development.
  • 2 out of the expected 16 provincial physician trainers are already appointed and will guide recruitment of 40 area physician trainers. Physician trainers and 6 medical informatics education leads to team with power users and super users supporting physicians transitioning to Connect Care.
  • 6 clinical informatics specialists help knit all these groups together, guided by a strategy for building capacity to adopt and use Connect Care.
Connect Care empowers Alberta's physician community to optimize practice in a digitally-enabled healthcare workplace.


Accessing Historical Data after Connect Care Launch

With implementation of Connect Care, Alberta Health Services (AHS) will transition from many health information systems to a single clinical information system (CIS). This ensures that all health data adheres to common definitions, is appropriately linked to health events, and can be combined in ways that promote better health with better information.

Ideally, the Connect Care CIS would absorb all health data ever gathered by AHS. Unfortunately, such historical data may not adhere to normal ranges or other properties needed to assure safe use of clinical decision supports, documentation tools and quality improvement. Messy data could clutter or confuse Connect Care. Also, not all data has equal clinical value.

Data conversion is about how historical health information is selected and managed for transfer to Connect Care. Considerations include which information to transfer, how it should be transformed, how much to include and how to make it accessible.

A Connect Care Data Conversion Committee has reached out to physicians, clinicians, leaders and technical experts across Alberta to get input about data conversion strategies and choices. Conversion principles emphasize assessment of clinical need, data quality, compatibility, safety, cost, post-conversion validation and user training.

It has become clear that not all historical data can or should be converted. That does not mean that it will not be available to clinicians and decision-makers. Important information will be readily available for as long as needed to support care. Access options include:
  • The Alberta Netcare Portal electronic health record, which can be launched to a specific patient record from within Connect Care. 
  • Non-Connect Care health information systems maintained in a read-only state for an appropriate time period.
  • Abstracts of high-value information attached to the Connect Care record.
  • Archiving solutions that can be linked to Connect Care.
In any case, legacy health records will be retained as needed for clinical, legal or secondary use. An “Information Disposition and Application Retirement” (IDAR) project will manage archival patient information from retired health information systems.


Physician Readiness Workshop

We are excited to anticipate an in-person gathering of medical and informatics leads in Calgary October 24, 2018. Zone and associate zone medical directors, Associate CMIO, Medical Affairs, Connect Care and other stakeholders will focus on how we can optimally organize for Connect Care implementation.

Topics include physician training, capacity-building, CIS readiness, CIS competency assurance, meaningful CIS use, physician incentives and balancing provincial and zone accountabilities in these topic areas. This work will accelerate a wide range of CIS readiness activities, helping to prepare physician communities for effective CIS uptake and ongoing use. Background information is provided to all participants. Please direct questions to cmio@ahs.ca.


Connect Care Leaders' Toolkit Updated

The Connect Care Leaders' Toolkit gathers and organizes useful resources that can help clinical and operational leaders prepare for clinical information system (CIS) implementation.

The toolkit presently includes downloadable document and presentation materials that give an overview of Connect Care and address frequently asked questions.

The Toolkit is modular. Different sections cover the Who, What, When, Where, Why and How of Connect Care. This makes it easy to organize and deliver communication campaigns.

The toolkit is dynamic. New information and materials are added as the Connect Care journey progresses. Recent updates include "conversation starters" and a preview of the Connect Care Readiness Playbook.


Connect Care Training for Prescribers

A clear and well-resourced training plan is essential for successful Connect Care clinical information system (CIS) implementation. End-user engagement, change management and CIS adoption all hinge on effective training, especially for a large organization with a diverse and dispersed workforce. Connect Care training must additionally recognize the needs of partner organizations, educational institutions and diverse professional groups.

We are particularly sensitive to the difficulties prescribers (including physicians) may face when training to use the Connect Care CIS. Wide consultation has helped shape a prescriber-friendly training strategy that makes the most of AHS experience, best advice from like Epic clients and evidence about physician skill development. Training principles have been devised and ratified, a FAQ initiated (this will continue to grow) and trainer recruitment is well underway.


Connect Care First Anniversary!

Although the Connect Care initiative has been forming for many years, it is almost exactly one year since the AHS contract with Epic Systems was signed and Connect Care began a new phase.

How much has changed! Connect Care has gelled as a truly provincial initiative. Diverse professions, programs, patients and partners have come together to promote a common purpose. The scale of collaboration is extraordinary, possibly a defining event for our decade-young organization.

Here's just a few of the many accomplishments to celebrate:
  • Adopting an innovative provincial oversight strategy, with committees, councils and advisory groups providing governance, advocacy and community connection.
  • Engaging thousands of experts so that Connect Care reflects their needs and aspirations. 
  • Planning and managing six high-impact Direction Setting and Adoption & Validation conferences in just eight months. 
  • Laying the foundation of our new system through extensive design and build work, with many thousands of workflow decisions, and all core clinical system design, already complete. 
  • Preparing for implementation with wireless infrastructure, launch sequencing, data conversion, training strategies, readiness preparations and capacity-building well under way.
  • Supporting over 60 specialty workgroups as they guide customizations for their areas.
  • Certifying over 250 configuration and training staff, plus many physician builders, all contributing to our design and build.
  • Distilling widely divergent scales, measures and flowsheets in to a strong set of validated tools for provincial use.
  • Embraced productive collaboration, not only between clinical, operational, corporate and IT teams, but with a vibrant group of patient advisors embedded at all levels of oversight and guidance.
Profuse thanks to all who have stepped up to put their time and effort into this ground-breaking initiative!

Anniversary highlights are nicely summarized by our CEO:


What a year it has been!

From the Connect Care Triad (SPO Barb, CIO Penny, CMIO Rob)...

On October 13, 2018, Alberta Health Services (AHS) celebrated its one-year anniversary of signing with its clinical information system (CIS) partner, Epic Systems. What has been accomplished since is quite amazing:

  • >1000 stakeholders assisted with groundwork, introducing AHS and the provincial health care system to Epic.
  • > 3500 others (Subject Matter Experts, physicians, patient advisors, leaders and consultants, and developers) attended Direction Setting and Adoption & Validation sessions, working through over 2500 decisions about workflow;  and configuration teams have completed 50% of the indicated builds.
  • A new Connect Care oversight structure was designed and implemented, including establishing the Connect Care Council and 25 Area Councils (focused on developing provincial content, standards, measures, and improvement supports). 
  • Wireless deployment continues ahead of implementation waves, device selection is underway, and a new datacenter has been created. 
  • Clinical System Design is moving along rapidly. 
  • Training curricula are already taking shape, based on the emergent Connect Care CIS.
  • Device interface integration and data conversion work is underway.

Most importantly, the benefits of transformation already show. The locus of decision making has shifted from local to provincial, reducing unhelpful variation. Clinical stakeholders from zones and programs already build consensus about CIS clinical and operational content, workflows, and practices.

A giant thank you to all who contribute so generously to our Connect Care; as well as those who support and enable contributors. What a year it has been – only to be topped by an even more action-packed year ahead! Hang on!


Results & Reports Routing Workgroup

Closed-loop results & reports routing is about how the outcomes of interventions ordered by prescribers are communicated back to the right person in the right way at the right time, with assurance that the information has been received and managed. A new Connect Care workgroup, co-chaired by Dr. Sid Viner and Dominic Orser, has started work to ensure that Connect Care expresses best possible practice. We will report back about progress and outcomes.


Edmonton Zone: Nov 9 2018 Medical Staff Society lecture about Information Continuity

The next EZ Medical Staff Society Leadership lecture is on November 9, 2018 at 0700 to 0900 in the Bernard Snell Hall, with videoconferencing to all sites in the Edmonton Zone.

There will be a film presentation of The Greg Price Story, followed by a Leadership Round-table.  The film focuses on Greg Price, a 31-year-old Alberta man, who died in 2012 of complications from testicular cancer and his 407-day journey in the health care system.  Greg's death was investigated by the Health Quality Council of Alberta (HQCA). Released in December 2013, its report exposed gaps in health information flows.

Falling Through The Cracks, Greg's Story is a 30 minute film showing what Greg encountered during his fateful journey through the health system.  The Price family produced the film, with Dr. Ward Flemons providing the medical guidance as lead investigator for the HQCA report. Mr. David Price, Greg’s father, and Teri Price, Greg’s sister, will present and discuss the 30-minute film from a family perspective.  A leadership round-table will include Dr. David Zygun, Dr. Mark Joffe, Dr. Francois Belanger, Dr. Owen Heisler, Dr. Shirley Schipper, Dr. Scott McLeod, Dr. Melanie Currie, and Dr. Narmin Kassam.

For more information:


Connect Care October 2018 Calendar

A summary of key Connect Care happenings in October 2018 has been posted to the Alberta Health Services internal Connect Care website, linked below.

With all direction setting and adoption & validation sessions completed and workflow requirements tallied, base configuration work continues in earnest. Clinical System Design has accelerated work on 6 specialty content work packages. Readiness preparations begin with the first surfacing of a playbook and zone resourcing plans.


Connect Care Resources for Clinicians

Physicians and other prescribers who want to learn about Connect Care, or follow developments, may find the following one-pager helpful. It lists web pages, handbooks, blogs and email contacts matched to different levels of interest and engagement. The resource list is recently updated.


Second Provincial Physician Informatics Leads Workshop

A big thanks to the many physician leaders who gave so generously of their time and energy to participate in the second provincial Connect Care physician leads meeting (September 27) in Calgary. The half-day session focused on:

  • Connect Care Training - with review and input to physician training principles, curriculum planning, certification and participation plans.
  • Clinical System Design - with updates about immediate specialty customization priorities and strategies for speeding the work of Area Councils and Specialty Workgroups as they grapple with CSD work packages.
  • Orderset Design - with ratification of a strategy for leveraging knowledge leads, knowledge topic leads and clinical informatics leads to accelerate implementation of a modular approach to producing the many order sets that Connect Care will express at implementation.
  • Demonstration Support - with demonstration of processes and methods for accessing and mastering Connect Care online environments that can be used to support design and engagement activities.

A gathering of so many talented clinicians — all readied, committed and attached to Connect Care transformation — is a “tipping point” accomplishment. More important than any number of workflow, design or content decisions, is an organized clinician community that can continue to observe, learn and decide about clinical information system optimization well into the future. Our executive, design, informatics, builder and training physician leadership is established and ready. Networked provincially, this increasingly impactful community is a key to Connect Care success.

Many physician informatics leads helped prepare for, or even deliver, Connect Care Adoption & Validation 3 sessions. Participants remarked at the fundamental shift this represents… we can see ourselves in a system shaped to our purpose.

Physician leaders also continue tireless service to Connect Care committees, councils, specialty workgroups and projects. We are at provincial peak-effort right now and must somehow continue the clinical system design (CSD) sprint through the next 3 months. Getting solid foundational content will pay dividends for decades.


A fitting close to Adoption & Validation

We thank all those contributing valuable time and energy to Connect Care’s third Adoption & Validation session in Calgary (September 25, 26, 27). This last province-wide gathering continued a series of truly incredible accomplishments! Thousands of participants sustained extraordinary productivity, guiding thousands of decisions through three direction-setting and three adoption & validation sessions.

Connect Care transformation is no longer aspirational; it is our every-day reality. Soon we begin testing a clinical information system fortified with provincially-ratified documentation, decision and inquiry supports… allowing us to express our best intentions as never before. The decisions we’ve made are far from trivial. Even those that seem small, such as patient demographic descriptors, are used for positive transformation.

Adoption & Validation 3 performed good work. It also cemented a remarkable Connect Care “positivism”. Although we were thrilled to see more AHS-led demonstrations, it was the hallway discussions that best reflected how far we’ve come. Conversation about Connect Care has moved from contemplation through acceptance to eager anticipation. Our peers are increasingly aware of coming challenges, but also increasingly motivated by the promise of post-implementation opportunity.

Between now and the end of the year, the race is on to complete essential Connect Care content design and build. We are succeeding already, with every hope for attainment of our best hopes.


AHS Comes of Age

We've oft commented that Connect Care is both a formative and consolidating innovation for Alberta Health Services (AHS). The initiative is possible because the organization has matured as a values-driven healthcare organization. Moreover, the initiative enables continuing transformation as a learning healthcare organization.

A recent publication nicely tallies the many AHS developments that make Connect Care possible and use Connect Care to make the AHS vision possible:


Alberta Health Information Act amendment - mandatory breach reporting

Amendments to Alberta's Health Information Act, in force as of the beginning of September 2018, include important new mandatory breach reporting requirements.

The changes are nicely summarized, highlighting implications for AHS's partners, in a University of Alberta synopsis linked below.


Connect Care Provincial Physician Trainer Opportunity

Alberta Health Services (AHS) is seeking up to 17 Connect Care Provincial Physician Trainers. These clinicians become key members of the office of the Chief Medical Information Officer (CMIO), aiding in the development, support and delivery of a Clinical Information System (CIS) training program for physicians and advanced care providers. The Connect Care initiative will up-skill thousands of CIS users over 3 years of implementations throughout Alberta.  The immediate need is for physician-friendly curriculum development under a clinicians-training-clinicians model.

The Provincial Physician Trainer is an AHS medical leadership position that plans, guides and manages CIS training for all physician and advanced care users in multiple AHS zones, programs, facilities and workflows. In collaboration with the Connect Care learning team, Trainers work closely with Clinical and Operations leaders to define, plan, implement and evaluate curricula that suit different roles and learning styles; while promoting smooth change management and minimal service disruption.

There are multiple Provincial Physician Trainers, each focusing on one or more of the following areas:
  • Inpatient Admitting (including General Internal Medicine; Critical Care; Medicine Subspecialties; Hospitalists; Family Medicine)
  • Surgery (including General Surgery and Surgical subspecialties)
  • Rural Medicine
  • Ambulatory
  • Gastroenterology
  • Pathology
  • Anesthesia
  • Medical Learners
  • Pediatrics
  • Cardiology
  • Obstetrics and Gynaecology
  • Psychiatry
  • Emergency
  • Oncology
  • Radiology
  • Physician Support Roles (e.g. Physician Assistants)
The Provincial Physician Trainer will be an Alberta physician who advocates effectively for AHS strategic information management initiatives, anticipates impacts on stakeholders, identifies issues and helps resolve problems. Experience with adult learning methods is strongly desired.

Applications are welcomed immediately. The posting will renew until all trainers are appointed. To learn more, please visit:


Connect Care September 7 Newsletter Posted

The September 7, 2018, Connect Care Newsletter is available via the link below; covering why we care about Connect Care (#1 Information Access), data conversion plans and assessing non-medical devices.


Connect Care September 2018 Calendar

A summary of key Connect Care happenings in September 2018 has been posted to the Alberta Health Services internal Connect Care website, linked below.

Preparation for the third and final adoption & validation session signifies Connect Care maturation with the majority of sessions presented by trained AHS staff. Many clinicians also perform demonstrations, highlighting that there is, indeed, an Alberta instance of the Epic software system and that it is taking shape guided by workflow decisions. Clinical System Design has adopted a new approach to streamlining the work of specialty content development. Training designers sift through available curriculum components, beginning the design of AHS learning pathways for clinical information system training.


Understanding Connect Care Conversations

As design of the Connect Care clinical information system (CIS) progresses, more and more of us are drawn into conversations about Connect Care tools and how to use these purposefully. Many new terms, acronyms and abbreviations arise.

An "eHealth Glossary" can help.

Canada Health Infoway, a number of Universities, the Centre for Health Evidence and Alberta Health Services have collaborated to maintain a glossary of health informatics terms. This continues to grow, with emphasis on the applications and tools we now encounter in Connect Care.


User Group Meeting 2018 #1 - A great community

The annual Epic User Group Meeting (UGM) is a truly impressive gathering! Over 8,000 converge on the Epic campus at Verona, Wisconsin, for 5 days of meetings, councils, presentations, testing and updates. With Alberta Health Services formally announced as a new enterprise community member, a number of our leaders took time to learn during a most exciting and informative week. Some first impressions are summarized in the next series of blogs, with apologies for not properly attributing.

An immediate UGM impression is that one has joined a large, capable and collaborative user community. It spans multiple continents and includes all types of health care organizations. Most clients are driven by goals akin to our Connect Care intent. More importantly, Epic community members are eager to help peers succeed. The AHS UGM presence emphasized connecting with peers, networking, and firming up a support group that includes some of the best health care organizations in the world.

Epic facilitated many meetings around the scheduled program. Short consultations with like-minded Epic clients focused on recent installs or build challenges. Frank conversations opened channels for ongoing conversation and mutual assistance. It was clear that we have a lot to gain from sharing.

We also gained confidence. AHS has undertaken a large and exceptionally complex challenge. Our difficulties are not extraordinary. Our strengths are exemplary. Many complemented us on our preparatory work to discover and reduce unhelpful variation, to unify a large health region and to guide a clinical information system initiative with transformative purpose.


Connect Care August 24 Newsletter Posted

The August 24, 2018, Connect Care Newsletter is available via the link below; covering clinical benefits, Adoption & Validation 2 experiences, and learning new terms used in Connect Care conversations.

Mandatory Breach Reporting

From Dr. Francois Belanger:

On August 31, 2018, Mandatory Breach reporting will come into effect in Alberta. The new provincial requirements mean Alberta Health Services and all other health custodians must report any privacy breaches to the Office of the Information and Privacy Commissioner (OIPC), the Minister of Health and any affected patient(s).

AHS, through the Information & Privacy Office, has always reported significant breaches to the OIPC. The new requirements serve to remind all of us to continue to report any privacy breaches we may encounter.

To report a breach, you must either fill out the Notification of Privacy Breach Form or e-mail the Information & Privacy Office at privacy@ahs.ca.  The Information & Privacy Office will investigate the incident and will report the breach to the OIPC and Minister of Health. Any individuals affected by the breach will also be notified.

AHS recently implemented a new Privacy Policy that encourages a culture of shared accountability. The policy includes expected behaviours and additional supports to assist all of us in protecting health information and the systems that store it. I encourage everyone to review the new policy and discuss it with your co-workers. 

Just as Albertans trust us with their care, they also trust us with their private health information. Protecting privacy enhances the overall trust in our organization and results in better healthcare and employee engagement.

Information sharing is needed to provide excellence in healthcare but accessing the health or personal information of our friends, co-workers, and other people not in our care is never appropriate.

Please visit the provided links for more information on reporting breaches or the Information & Privacy office.

Thank you for your continued diligence in keeping health information safe.