Connect Care Style Guide

The Connect Care communications team has come up with a nice 2-page summary reminding us about norms for use of abbreviations, logos and corporate identities. This Style Guide, plus file naming, presentation and other tips can be found in the Connect Care Clinician Handbook and the Clinical System Design Handbook.


Specialty Mapping to Areas

In order to build a clinical information system (CIS) that improves patient care, it’s important that clinicians, clinical and operational experts, leaders and patients continue to contribute to the Connect Care Clinical System Design (CSD) process by developing clinical content – the CIS documentation, decision and inquiry support tools.

The Connect Care Executive Committee discussed and was supportive of a CSD mapping guide, which outlines how various CSD tasks are allocated to specific oversight groups. Core CSD affects most clinical areas and is largely handled by clinical documentation and clinical decision support committees. Specialty CSD addresses more specific needs and is mostly handled by Connect Care Area Councils. The mapping guide will evolve as our experience with CSD decisions grows.

The specialty mapping guide, and a wealth of other design information, can be found in the CSD Handbook, available in all committees and councils collaborative workspaces.


Charting by Exception

Charting by ‘exception’ is a clinical documentation practice popularized in the 1980’s to improve the clarity of clinical notes, focus attention on clinically important information, improve signal-to-noise ratios, and reduce clinician information burdens. The record emphasizes significant findings or ‘exceptions’ to a predefined normative state.

To the extent that clinical documentation serves clinical care – thinking instead of scribing – then  exception charting can improve the accuracy of diagnosis, help prevent error and improve the patient experience by ensuring that high-value information is front-of-view.

The prime purpose of Connect Care charting is to support high-quality, safe and efficient health care. Accordingly, technical, procedural and cultural supports for exception charting are important to the design of the Connect Care clinical information system (CIS). Indeed, the design process can help specialty groups define normative datasets and express these in clinical information system charting tools. And the act of ratifying these norms can help establish a safe exception charting culture.
For more information:


Clinical System Design Handbook Initiated

Clinical System Design (CSD) is the process for planning, selecting, designing and building clinical content in the Connect Care clinical information system (CIS). Clinicians, clinical and operations experts, leaders and patients contribute to the prioritization, selection, adaptation and decision-making about Connect Care content. For “core” content, such as the default format for progress notes applicable across all clinical areas, CSD decisions are mostly referred to Content & Standards, Clinical Decision Support, Clinical Documentation and Clinical Improvement Support committees. For “specialty” content, such as how a particular procedure report is formatted, CSD decision-making is the responsibility of Connect Care Area Councils. The councils draw upon diverse subject matter experts, clinical documentation workgroups and CKCM methods experts.

As committees and councils begin work on CSD questions, it is important that common principles, guides, styles and other norms are shared, used and continually improved. To help, a new CSD Handbook gathers key information in one place, available to all Connect Care stakeholders.


Can Medical Scribes Ease Clinical Information System Adoption?

The start of full Connect Care clinical information system (CIS) implementation is no longer a distant prospect.... and it is no surprise that clinicians easily imagine one or more colleagues for whom the prospect of a paper-free workplace seems incompatible with work. Slick order-entry tools may ease the way for some. But there remains a generation for whom keyboards and pointers present an insurmountable barrier to meaningful clinical documentation. Voice recognition and transcription may help. Increasingly, however, medical scribes are promoted not only to smooth the way for the digitally challenged, but generally to improve satisfaction for both clinicians and patients.

A medical scribe is a non-licensed individual specializing in electronic charting under the direction of of licensed clinicians in real time, usually in busy settings like emergency rooms. Scribes can facilitate a wide range of data and order-entry tasks, including chart abstractions. A recent Journal of Family Medicine article describes positive scribe experiences in primary care. A recent Canadian Medical Protective Association article cautions about the accountabilities that clinicians and institutions bear when scribes are employed.

Should Connect Care support workflows for medical scribes? Share what you think by using the linked poll (AHS stakeholders only).


Patient & Family Advisors Needed for Area Councils

One of the ways Alberta Health Services (AHS) is preparing for Connect Care is by working with patients and families to ensure that Connect Care Area Councils (CCACs) effectively advocate for clinical information system (CIS) stakeholder needs.

CCACs provide the clinical and operational leadership to support best possible practices through the design, configuration, customization, implementation and optimization of CIS content. CCACs report to the Connect Care Council, providing advocacy about professional and practice issues specific to major clinical programs, such as surgery, medicine, child health, women’s health, mental health, emergency and cancer care.

Patient and family advisors are needed to bring their healthcare experiences to CCAC deliberations. CCAC members:
  1. Identify clinical priorities for standards and consistent practice across the province
  2. Act as ambassadors and change agents to support implementation
  3. Offer long term support for the ongoing organization and use of Connect Care
  4. Address professional and practice issues specific to clinical service delivery
For more information:


Clinical Knowledge & Content Management serves Clinical System Design

The Alberta Health Services (AHS) Clinical Knowledge & Content Management (CKCM) program was formed to render Alberta’s best clinical content for use in clinical information systems (CIS). Clinical content includes standards (terminologies, lists, etc.), documentation (templates, flowsheets, etc.), decision supports (references, advisories, order sets, etc.) and inquiry supports (performance indicators, quality measures, etc.); all used by a CIS to support best possible health services.

Connect Care clinical content starts with AHS’s extensive experience with order sets, guidelines and standards; including the work of Strategic Clinical Networks, quality improvement initiatives, provincial clinical documentation standards and other sources. CKCM acts as a content “broker”, readying AHS content for Area Council review, adapting Epic’s content to help fill gaps and assuring effective use by Connect Care developers.  Above all, CKCM helps harmonize content across the care continuum provincially.

CKCM is led by a robust team of physicians, clinicians, and clinical support professionals collaborating with stakeholders across the province.  All Connect Care committees and area councils receive CKCM resources to help them answer clinical system design questions and prepare content for use in the CIS. The CKCM annual retreat focused on Choosing Wisely and Clinical Appropriateness initiatives, while formalizing how CKCM supports Connect Care Area Councils.


Connect Care Update Newsletter - March 2018

The Connect Care communications team produces a general-interest Newsletter twice monthly, with one released today. These summarize the latest news and happenings related to the Alberta Health Services Connect Care initiative. The current issue touches upon: Direction Setting, Resources for Health Professionals, and Provincial Clinical Guidance.


Developing eHealth Competencies

eHealth is about how patients and providers use information and communications technologies (including clinical information systems) to improve health and healthcare delivery.

In preparing for Connect Care implementation, AHS is exploring how to best help healthcare providers facing major changes in how they manage information at work. The goal of the AHS eHealth Competence program is to prepare and support healthcare providers when using information and communication technologies anywhere healthcare is delivered. Now that learning pathways are starting to emerge, the program welcomes expression of interest for early testing.


Connect Care Clinician Communication Strategy

The Connect Care 30-60-90 Communications Plan was recently reviewed and approved by Alberta Health Services (AHS) leadership. This recognizes a need to address distinct communication needs of end-user communities. A draft communications strategy for one of those communities, physicians, is now available for review and feedback.

The goal is to explore and ensure effective exchange of questions and information with Connect Care physician communities. Some physicians work within AHS structures. Others see themselves as affiliates. Still others see themselves as independent entities. Even within clinician communities, there are diverse communication preferences. Accordingly, a clinician-oriented communications strategy must addresses challenges of diversity, varied allegiances and even conflicting interests. The ultimate goal is to support engagement with the Connect Care program, to rally clinician input to CIS design and build, and to support beneficial adoption.


Direction Setting 2 Feedback and Session 3 Preparations

The second Connect Care Direction Setting session took place at the Shaw Conference Centre in Edmonton March 13-15, 2018. Even with a lighter schedule than seen in Direction Setting 1, we witness excellent engagement, with some rooms standing room only. Energy and excitement were carried forward through another successful three days.

In just under a month we return to wrap up Direction Setting with three final sessions April 10-12, 2018, in Calgary at the BMO Centre. Detailed session and logistics information will be sent directly to participants.

After the April sessions, there will be a short pause for participants as the Connect Care team works to implement all that has been decided. April is also when Clinical System Design ramps up through Connect Care Area Councils. Once initial configuration steps are complete, a series of Validation & Adoption sessions follow starting early in the summer; when we verify that decisions made have set us on the correct path.

As we prepare for the next direction setting sessions, we remain keen to learn and improve. Participants can help by completing a short online feedback survey.


Direction Setting 1 Consensus Decisions

Through Connect Care Direction Setting sessions, input is gathered from staff, physicians and patient advisors to help guide what will be included in the Connect Care clinical information system (CIS). Direction setting focuses on how commonly used workflows (tasks performed when providing patient care) are complemented by information flows and tools. Participants from across the province, representing programs, care settings, and clinical and operations teams navigate a series of questions about how workflows and processes are designed into the CIS. A high-level summary of decisions arising from the first set of direction setting sessions (mid-March 2018) represents areas of clear consensus. A number of questions and issues uncovered uncertainty or variability requiring further exploration or referral to other Connect Care governance structures (committees, councils, advisory groups) and will be summarized after this work occurs.


Thank you to Direction Setting 2 Participants

A warm thank you to our Alberta Health Services (AHS) clinicians for making time in busy schedules to attend the Connect Care direction setting sessions Tuesday, Wednesday and Thursday of this week. Thanks too to the many colleagues and patients who made accommodations to allow so much protected time from busy physicians.

Direction setting has, again, been a great success. The sessions, demonstrations and discussions have moved us forward, keeping to the Connect Care design and build schedule. As importantly, the many between-session discussions gave invaluable opportunity for just-in-time planning and problem-solving. We’ve changed since direction setting 1! With a clearer sense of purpose, and urgency, we share our growing provincial understanding and sort out a myriad of background issues, making the direction setting sessions more productive.

As with Direction Setting 1, some issues are flagged for further exploration. We’ve already assigned "parking lot" matters to Connect Care Committees, Councils,  and Workgroups. Indeed, both the clinical documentation committee and reporting workgroup took advantage of our time together this week to further explore unresolved workflow and core design questions. This work remains transparent. The Connect Care committee and council workspaces are open to all AHS stakeholders. In addition, we will soon share summaries of decision making session outcomes.


Connect Care Decision Tracker Live

A Connect Care 'Decision Tracker' is up and running on the Connect Care SharePoint site. This workspace helps expose and manage decisions for clinical information system design and build activities.

Many decisions relate to clinical information configuration needs. Others arise during the work of committees, councils and advisory groups. Decisions are assigned to appropriate entities and the outcomes are visible to all stakeholders. The Tracker additionally helps with decision timing and priority setting.


Direction Setting 2 Participation Strong

The second Connect Care direction setting event progresses March 13-15 in Edmonton at the Shaw Convention Centre. Participating physicians received personalized schedules, instructions, and expense instructions, with very positive feedback about logistics. A full complement of clinicians were assembled for all required sessions. In addition to direction setting, half-day workshops were organized for clinical documentation design, analytics reporting requirements, community electronic medical record vendor interoperability, and Alberta Health stakeholder orientations. These too benefited from strong clinician participation and have helped to move Connect Care forward on schedule. The CMIO portfolio will continue to help physicians with any paperwork, credit or expense submissions. Please contact cmio@ahs.ca with questions.
  • Connect Care Direction Setting


A Rose by any other Name

Connect Care stakeholders may struggle with unfamiliar health informatics terms and a host of new names for CIS modules and functions. As Epic Systems Corporation, our technology partner, works closely with all levels of Connect Care contributors, it can help to have an 'Epic-speak' crib-sheet.

For starters, we have enhanced the online eHealth Glossary to include short descriptions of software modules and applications that come up during Connect Care direction setting and clinical system design discussions. The 'CIS' layer of the glossary will be expanded to include other terms important to design and build activities.


Contacting Connect Care Physician Leads

Many have asked for more information about physicians with formal Connect Care leadership roles, perhaps seeking someone with a particular zone, specialty or governance affiliation. Others seek subject matter experts to help with clinical information system development tasks and want information about the larger pool of physicians who have offered to help in various ways.

To address these needs, we have created a contacts list focused on physician leaders in formal roles (ahs-cmio.ca/mdroles) and a registry of physicians volunteering informal contributions (ahs-cmio.ca/mdcontributions). Both are works-in-progress but far enough along to start sharing:


How best to follow Connect Care?

There are so many newsletters, emails, messages and other communications vying for attention that physicians may find it difficult to keep tabs on Connect Care. The challenge is greater when we seek just the bits that matter most to our work day, and preparations for a whole new way of working.

Alberta Health Services Community Engagement & Communications seeks to better understand how to keep you involved and informed.  A short online survey (about 2 minutes) seeks feedback about what works best to get you the information you want and need, when and how you want it.

Responses are anonymous and results will be used to guide the Connect Care communications strategy. Follow-ups will check whether new strategies work for you.

It would be a big help if you could give input via the link:


Connect Care Direction Setting 2 - Information for Physicians

Direction-Setting is one of the major activities occurring during design of the Connect Care clinical information system (CIS). The purpose is to prepare for a CIS foundation build that supports the way we need to work, rather than getting in the way. A first set of sessions occurred mid-February, involved over 2300 participants and gave first exposure to basic CIS functions for many. Consensus was achieved for about 80% of the workflow decisions presented. More importantly, there were many valuable lessons learned about how to present and navigate workflow decisions, with processes steadily improving.  Questions that could not be decided, and many new questions arising, are referred to Connect Care Committees and Area Councils.

The second direction-setting event (DS2) occurs March 13-15 in Edmonton at the Shaw Convention Centre. Participating physicians will be receiving invitations and information about logistics. As with the first event, there are many other ways to help shape the CIS... no worries if an invitation is not received. Only those physicians needed for a smaller set of workflow topics covered in DS2 are pulled in to the March activities.

DS2 has fewer participants than either DS1 or DS3.  This is intentional, because Epic is in the process of upgrading its software to the 2018 version and areas where the upgrade has a big impact on workflow have been moved to DS3.  We have also done our best, based on your feedback, to make the sessions as efficient and condensed as possible.  Some participants may not need to commit more than one or two days. 

Information about the sessions, time commitments and logistics can be found in the physician handbook (handbook.ahs-cis.ca/?=direction-setting). Please contact cmio@ahs.ca with questions, interest, or simply to add your name to the Connect Care registry of physician contributors. Thanks!


Workshop: Evidence-based Practice for Improving Quality

The Canadian EPIQ (Evidence-based Practice for Improving Quality) initiative promotes simple methods that can empower clinical groups interested in pragmatic clinical improvement projects. Emphasis is placed on sustainable quality improvement that fully integrates with clinical practice.

The Edmonton Zone Strategic Clinical Improvement Committee has collaborated with EPIQ to host a 4 hour workshop for teaching process improvement methods. These will surely complement efforts to ready our workplaces to leverage the information management and surveillance capabilities that Connect Care affords.

See the link for more information about the Saturday March 10 workshop from 0830-1300 at the Royal Alexandra Hospital.