2020-01-31

Allen Ausford Presents Alberta's Experience with Interoperation

The Canadian Health Care Technology "Sharing Health Information Success Stories" series features Dr. Allen Ausford, a Connect Care Medical Informatics Lead (and co-chair of the Clinical Decision Support Committee) for its January webinar.

Allen speaks about Alberta's experience with the Netcare health information exchange. This pulls information from diverse sources so that clinicians can view key health information about patients they serve.

The 45 minute presentation is recorded with the help of Orion Health:

2020-01-30

Wave 2-3 Workflow Walkthrough February 5, 2020

With the Connect Care Wave 2-3 launch (May 30, 2020) getting closer, there are more opportunities to validate how the clinical information system (CIS) will support workflows at new launch sites.

"Workflow Walkthroughs" allow clinicians to see how Connect Care can support clinical work. A Walkthrough event includes demonstration of one or more high-risk, high-complexity, multidisciplinary or high-volume workflows. Patient journey videos are interspersed with feedback and discussion opportunities. The goal is to discover what more we need to do to get the system attuned to specific site challenges.

The Wave 2-3 Walkthrough event will be held February 5, 2020, at a variety of locations, including online, supported by Skype teleconferencing. The Workflow Walkthrough videos are available on Insite (links below).

  • 08:15 - Welcome and Introductions
  • 08:30 - End-to-end Patient Journey
  • 09:00 - Scheduling and Registration Demonstration
  • 09:50 - Rural Nursing Workflow
  • 11:00 - Long Term Care 
  • 12:35 - Ambulatory Care
  • 13:10 - Labour and Delivery
  • 14:10 - Surgical Workflows

Although all interested physicians are encouraged to contribute, the Walkthrough event spans an entire workday. Only some parts will pertain. Please take a look at the agenda and consider whether any of the blocks offer an important feedback opportunity. Session recordings will be posted on Insite afterwards.

2020-01-29

Connect Care Champions

We continue to marvel at the energy and enthusiasm of our physician informaticians. They give backbone to physician engagement and adoption.

It is always nice to see a colleague's contributions celebrated. Join us in recognizing the work of Eddie Bolster who serves as a medical informatics lead, area trainer, super user and physician builder!

2020-01-28

Automated Patient Appointment Reminders go Live

Connect Care ambulatory care clinics can leverage the efficiency of automated appointment reminders for patients with upcoming clinic, day surgery, therapy or investigation visits.

The system was integrated with the clinical information system (CIS) January 27, 2020, supporting appointments from January 30, 2020 forward. Ultimately, the system will facilitate the over 25,000 reminders daily handled by legacy processes.

The automated reminder system supplements information and instructions that are sent out via mail or MyAHS Connect (patient portal), with prospect for fewer missed appointments and improved patient choice. However, it is important for physicians to ensure that their clinic has made the necessary arrangements, scheduling staff are ready, and that patient education materials are in-clinic.

The following resources can help physicians answer patients' questions:

2020-01-27

Connect Care Waves 2-3 - Timeline

As Connect Care wave 1 continues to stabilize, preparations accelerate for the combined waves 2 & 3 launch in May 2020.
We've previously posted about wave sequence adjustments. While work continues to further adjust for the opening of a new hospital in the North Zone, the next launch is locked-in. A timeline with key milestones can help participants and stakeholders to pace preparations:

2020-01-26

Downtime Resources for Physicians

Connect Care has its next scheduled downtime overnight (early hours of Tuesday January 28, 2020 sometime between 00:01-0400).

Straightforward instructions for physicians (which complement the more detailed Connect Care Downtime Resources at ahs-cis.ca/downtime) have been updated and streamlined:

2020-01-25

Connect Care Scheduled Downtime - January 28, 2020

The Connect Care production environment (PRD) needs periodic maintenance. This allows system fixes and updates to be installed without risking database content.

The next scheduled update will occur Tuesday January 28, 2020 in the early morning hours of (between midnight 00:01 and 0400).  PRD  and both provider and patient portals will be affected.

While PRD is offline, access to "PRDSRO" remains. This is a read-only copy of the most recent production (PRD) and allows all patient data to be reviewed. Any urgent orders or documentation that must be completed while PRD is offline can be handled through a combination of paper, eScription (provincial dictation) and Netcare activities. Try to postpone and avoid use of paper, as PRD is likely to be restored quickly.

Any paper ordering or charting will be uploaded by support staff once the downtime finishes. Physicians will want to validate this work. Charting deficiency notifications may appear later in In-Basket but can be addressed with the smartphrase ".DOWNTIME".

Additional instruction remains available in the Connect Care Physician Manual:

2020-01-24

Alberta Netcare Portal Scheduled Downtime - Feb 6, 27, 2020

The Alberta Netcare Portal electronic health record will be taken offline for scheduled maintenance during one or both of the following periods:
  • Thursday February 6, 2020, 21:00-03:00
  • Thursday February 27, 2020, 21:00-03:00
Downtime information is available:
Laboratory and other test results and reports will continue to be available in Connect Care. However, the Connect Care Netcare tab will not work during these time periods.

2020-01-23

Connect Care Optimization Clinic #6 - Speedy Orders

Optimization clinics are facilitated by peers and focused on challenging use cases. A short presentation is followed by questions, discussion and suggestions from participants. User supports are updated in the Physician Manual and Physician Updates.

A sixth Connect Care Optimization Clinic is offered at two times of day (duplicate clinics) to fit clinical schedules. All are welcome. Please complete a short pre-clinic survey to share information about your needs.
  • Topic: Speedy Orders
  • Facilitator: Rob Hayward
  • Date: Wednesday, January 29, 2020
  • Pre-clinic Needs Survey: ahs-cis.ca/clinic-6-survey
  • Time #1: 0700-0800
  • Time #2: 1200-1300
  • Description:
    • Ordering interventions (labs, meds, procedures, care, etc.) can be time-consuming, especially at admission to hospital and other transfers of care. 
    • Ordering personalizations and automations can have a big impact on prescriber efficiency, productivity and satisfaction. 
    • We will share tricks that can speed ordering workflows, with attention to both surgical and non-surgical perspectives.
  • Preparation:
    • If you’ve never used Zoom, the Webinar software used for the clinics, we recommend you do a test call prior to the session here: https://zoom.us/test.
    • Short demo videos on how to participate in a call can be found here: https://zoom.us/resources

2020-01-21

Connect Care Professional Billing Progress

There are 3 professional billing relationships that physicians can enter into with Connect Care, based upon how service claims are documented and how they are managed:
  1. Independent Charge Capture & Independent Claims Management - where physicians track and record their charges outside of Connect Care and use a third-party billing service to submit claims and manage responses.
  2. Connect Care Charge Capture & Independent Claims Management - where physicians use CIS tools to capture information to support professional billing claims, generate a report or export of the data, then use a third-party billing service to submit claims and manage responses.
  3. Connect Care Charge Capture & Connect Care Claims Management - where physicians capture charges using CIS tools and rely on the CIS and AHS billing services to take care of claims submissions and response management.
Option 3 affects many wave 1 physicians, as it applies to those employed by Alberta Health Services or contracted through alternate reimbursement plans. Both physicians, who have moved from paper to digital service documentation, and AHS, which has rapidly expanded and upskilled a central billing management service, have experienced a lot of change! Overall, uptake of Connect Care professional billing has been remarkably rapid, effective and efficient.

Of the ~400 physicians adopting option 3, 94% are already using the full Connect Care billing functionality (the remaining physicians are not active users yet). Over 115,000 claims have been entered with the majority requiring no further intervention from the physician. And information burdens steadily decrease as physicians get better at automating inclusion of needed information (like a referring physician for many billing codes).

2020-01-20

This Week in Optimization - Professional Billing

Wave 1 post-launch optimization training progresses through weekly themes; with Manual, Tip, Demo and Clinic interventions keyed to each theme.

This week's optimization theme is about Professional Billing workflows. We've learned that a few tips and personalizations can dramatically speed and ease this work. We will review billing tricks that work best in inpatient and in outpatient environments and how physicians can check the claims they have submitted.

Please take the short professional billing survey to share issues we should be aware of and address.

This week's optimization clinics (Wednesday Jan 22 at 0700 and 1200) are used to share a few tips and to learn about common issues or challenges at this stage post-launch. New or improved supports appear in physician resources throughout the week:

2020-01-19

Connect Care Optimization Review - Referral Workflows

Last week's optimization theme was about Referral and Consultation workflows. While Connect Care supports closed loop referral, we remain in an interim state as long as some services use Connect Care and others rely on fax, eReferral or other intake processes. 

An optimization clinic (Wednesday Jan 15, 2020) explored the difference between internal and external outpatient referrals. The presentation and demonstration elements were recorded and are available via a protected (AHS userid/password) link:
Participants raised a number of questions. These are addressed in updated online physician supports:
For those prescribers needing more detail, specific tip sheets and details about things like referral use of In-Basket pools, the "Referrals Guides" section of Connect Care learning home dashboards (LHD, all CMIO variants) have a wealth of practical information.

In general, those who refer can optimize workflows by skimming succinct resources in the Manual and Updates. Those participating in incoming referral management may need to avail themselves of additional LHD resources.

2020-01-18

Prescriber Workstation Preferences - Please Respond

We are eager to learn more about physician non-medical device preferences.

The Connect Care non-medical device plan includes estimates of the number of fixed (desktop, wall-mount, counter, etc.) and mobile (Workstation on Wheels [WOW], Laptop on Wheels [LOW], etc.) computers to install in different clinical environments. The Wave 1 experience suggests that prescribers have welcomed mobile workstations. This could influence future device re-distribution.

If you are a prescriber (physician, trainee, medical student, nurse practitioner, etc.) with at least ONE week of experience using the Connect Care clinical information system, please take a few moments to complete an anonymous survey about your device experience:

2020-01-17

Connect Care Oversight Refresh

Connect Care's committees, councils and advisory groups proved instrumental to a successful first launch in November 2019.

With multiple new launch waves occurring in rapid succession over the next 2 years, the time is right to review and adjust the terms of reference and membership of Connect Care oversight groups. Where CIS design, build and validation were top priorities pre-launch, matters of adoption, meaningful use and change management are top priorities going forward.

All Connect Care oversight groups participate in this refresh in the first two months of 2020:

2020-01-16

Connect Care Optimization Clinic #5 - Professional Billing

Optimization clinics are facilitated by peers and focused on challenging use cases. A short presentation is followed by questions, discussion and suggestions from participants. User supports are updated in the Physician Manual and Physician Updates.

A fifth Connect Care Optimization Clinic is offered at two times of day (duplicate clinics) to fit clinical schedules. All are welcome. Please complete a short pre-clinic survey to share information about your needs.
  • Topic: Professional Billing
  • Facilitator: Rob Hayward
  • Date: Wednesday, January 22, 2020
  • Pre-clinic Needs Survey: ahs-cis.ca/clinic-5-survey
  • Time #1: 0700-0800
  • Time #2: 1200-1300
  • Description:
    • Many physicians now use Connect Care to record professional billing claims for submission to Alberta Health. We've learned that a few tips and personalizations can dramatically speed and ease this work.
    • We will review billing tricks that work best in inpatient and in outpatient environments.
    • How to access billing reports will be demonstrated
  • Preparation:
    • If you’ve never used Zoom, the Webinar software used for the clinics, we recommend you do a test call prior to the session here: https://zoom.us/test.
    • Short demo videos on how to participate in a call can be found here: https://zoom.us/resources

2020-01-15

Connect Care Optimization Clinics - Jan/Feb 2020 Themes

Optimization training can help physicians to progress from adequate to proficient use of our new clinical information system. Our priority for the first months of 2020 is post-launch optimization, with each week focusing on a different optimization theme.

To date, themes have included "Orders Hygiene", "Tricky Transitions", "Patient Lists", and "Referrals". Upcoming themes include "Professional Billing", "Care Transfers", "Communications", "Speedy Documentation" and "Reports & Dashboards".

To help with planning, we would like to know about other themes and questions that Connect Care physicians might like addressed through optimization clinics, tips, FAQs, training or other interventions. Please contribute by completing a very short (2 question) online survey:

2020-01-14

Connect Care Waves 2-3 120 Day Launch Readiness Assessment

Among many preparations for the next Connect Care launches are Launch Readiness Assessments (LRA). These bring stakeholders together to assess progress and mitigate impediments.

Launch waves 2 and 3 occur May 2020, with tomorrow the 120 day LRA. Wave readiness representatives meet (Skype invites sent) to share information and contribute suggestions.

For more information:

2020-01-13

This week in Optimization - Referral & Consultation

Connect Care physician training occurs in three phases:
  1. Basic training covers essential skills for logging on, navigating Hyperspace and using common functions safely. 
  2. Personalization training teaches how to adapt the CIS environment for a more satisfying experience. 
  3. Optimization training explores workflow improvement for productivity. 
While personalization has the biggest impact on efficiency and satisfaction, optimization training can troubleshoot complex workflows that challenge many physicians. Workgroups have helped to define difficulties, suggest clinical information system optimizations and identify opportunities for end-user skill enhancement. 

Wave 1 post-launch optimization training progresses through weekly themes; with Manual, Tip, Demo and Clinic interventions keyed to each theme. 

This week's optimization theme is about Referral and Consultation workflows. While Connect Care offers prospect for seamless closed loop referral, we remain in an interim state with some services using Connect Care as the record of care and others still reliant on fax, eReferral or other intake processes. 

This week's optimization clinics (Wednesday Jan 15 at 0800 and 1200) explore the difference between internal and external outpatient referrals. New or improved supports appear in physician resources throughout the week:

2020-01-12

Practical Paranoia - PLEASE don't trust links in e-mails!

Cyber-threats just keep getting worse!

Last week Saskatchewan health was hit by disruptive malware that proved very expensive to recover from. Alberta Health Services, like all big organizations, fends off thousands of attacks daily.

The hackers' windfall remains the unwary insider with access to protected networks and temptation to click on links in emails. We've managed to contain a few more of these lately, but affected users face extended downtimes and work is lost when damaged files are replaced by older copies.

Please re-skim our many warnings about 'phishing', brush up on phishing-prevention, and be paranoid about anything inviting your click.

2020-01-11

Connect Care Wave Adjustments - Who's when?

We've previously posted about adjustments to the sequencing and membership of the remaining Connect Care launch waves. While Waves 2 and 3 continue to work to a May 2020 launch date, the involved sites were modified as a result of some learnings and tough choices required at the end of 2019, as previously posted.

Wave sequencing work continues, as new dependencies or needs emerge. The best way to review current plans is through a regularly updated online resource (note the need to select a wave of interest in order to view affected locations and clinical groups) :

2020-01-09

Wave 1 Post Launch Visits

The Connect Care initiative remains committed to meaningful user support through stabilization, optimization and remediation. Delivering on this commitment requires ongoing direct observation as part of systematic surveillance. Post Launch Visits (PLV) are one form of direct observation.

The first PLVs occured this week, touching over 2000 participants through over 230 hours of meetings, observations and evaluations. The work has been remarkably informative. Key issues are identified, summarized, prioritized and escalated for attention.

Some physician highlights from today's PLV debrief:
  • Need for more training and change-management support for optimal use of CIS navigators to support efficient workflows.
  • Complex transitions (ER <--> OR <--> ICU <--> IP <--> OP) and order management (save, pend, phase of care) require continued work to streamline, simplify and achieve consistent compliance.
  • Time to hyperspace access remains a challenge in high-volume ambulatory settings, needing further remediation for faster access (touch-n-go, thin-client, etc.).
  • Timely laboratory result routing remains a multi-factorial challenge and will continue to receive attention to provider IDs and other correctives.
  • Need for continuing training support to help users understand build released since basic training and workflow hot-spots identified post-launch. 
  • Condense ordersets to show only what is essential and so facilitate faster navigation.
Plans and (near-term) dates are set for addressing these and other issues.

2020-01-08

Connect Care Optimization Clinic #4 - Referral Orders

Optimization clinics are delivered by peers, usually a clinician informatician or super user, with focus on challenging use cases. A short presentation is followed by questions, discussion and suggestions from participants. Any new tips are posted to the Physician Manual or Physician Updates.

A fourth Connect Care Optimization Clinic is offered at two times of day (duplicate clinics) to fit clinical schedules. All are welcome. Please try the meeting link ahead of time to ensure that your computer is ready before the session.
  • Topic: Consultation & Referral Orders
  • Facilitator: Stuart Rosser
  • Date: Wednesday, January 15, 2020
  • Time #1: 0700-0800
  • Time #2: 1200-1300
  • Description:
    • Inpatient consultation and outpatient clinic referrals have been slow to stabilize after wave 1 launch. A workgroup has considered the issues and produced helpful guidance about optimizing consultation and referral orders. Best practices will be demonstrated.
    • Referral reception processes will be outlined so that referring prescribers can improve their ordering practices for different specialty services.

2020-01-07

With gratitude!

As we return from a short respite, Connect Care reasserts its demands. It may help to draw strength from many astounding accomplishments that will stabilize and spread in the coming year.

Clinical Content - relates to the inquiry, decision and documentation supports designed, built and implemented with Area Council oversight to facilitate effective and efficient workflows:
  • Inpatient decision supports are customized to the needs of different clinical areas with best-practice aids that include 600+ order panels, 310+ order sets, 350+ cancer protocols, 100+ best practice advisories and 600+ ambulatory aids (SmartSets, therapy plans, order panels, order preferences).
  • An innovative StoryBoard reflects specialty needs while adhering to standards for alerts, demographics, care teams and other patient information summarized the same way across the continuum of care.
  • Dashboards (100+), chronic disease registries (5), clinical performance metrics, predictive analytics models and reporting templates are among the many clinical inquiry supports (2000+) activated at launch, with ongoing clinical validation.
  • Active clinical research protocols at launch sites (350+) are supported by Connect Care research information management tools.
  • Progress notes, consult letters, discharge summaries, admission histories, emergency visit reports and other key clinical documentation for inpatient and outpatient sites have consistent formatting and are delivered to community electronic medical records and the Netcare electronic health record.
  • Flowsheets, functional status questionnaires and patient preference surveys are simplified, standardized and integrated to inform patient-centred care, including direct patient interaction through the MyAHS Connect portal. 
  • Provincially normalized catalogues for laboratory tests, medications, procedures, imaging and other interventions are implemented for provincial spread.
Prescriber Adoption - relates to the leadership, engagement, training, personalization and optimization capacity built in physician and trainee user communities:
  • Hundreds of clinical informaticians, including medical informatics leads, power users, super users and physician builders were readied pre-launch and played a definitive role in wave 1 launch success.
  • 3,250+ prescribers (physicians, residents, nurse practitioners, etc.) were trained for Connect Care launch, then supported through stabilization.
  • 2,250+ physician mobile devices were configured for Connect Care mobility, with rapid update of smartphone and tablet interfaces to the point that 1 in 5 logons are via mobile devices.
  • In-system dictation for clinical documentation (Dragon Medical One) enjoyed viral uptake, rapidly overtaking use of provincial transcription services (in a ratio of 25:1).
There are many more accomplishments to celebrate. Most important are the 2020 opportunities made possible by the foothold Connect Care gained in 2019. We will ensure that no-one has been left behind, that users regain and surpass past productivity, and that the Connect Care experience promotes excellence.

2020-01-06

Connect Care Mobility Update Today

Connect Care Mobility supports prescriber interaction with the clinical information system (CIS) using smartphones (Haiku) and iPads (Canto) inside and outside AHS networks. Alberta Health Services (AHS) provides mobility management software ("Hub") to keep the CIS mobile apps updated and appropriately configured for Connect Care.

Mobile Apps have proved a quick win for clinicians. Uptake at Wave 1 launch was rapid and usage continues to rise. Nonetheless, some minor problems have been reported, most fixed in an update ready to deploy.

The Hub application will be updated today (January 6, 2020) at 1030.

Mobility users may receive a prompt to accept the update. Please do this to refresh with the currently supported version of Connect Care mobility management.

2020-01-05

Connect Care Optimization Clinic #3 - Lists, Rounds and Handoffs

Optimization clinics are delivered by peers, usually a clinician informatician or super user, with focus on challenging use cases. A short presentation is followed by questions, discussion and suggestions from participants. Any new tips are posted to the Physician Manual or Physician Updates.

A third Connect Care Optimization Clinic is offered a two times of day (duplicate clinics) to fit different clinical schedules. All are welcome. Please try the meeting link ahead of time to ensure that your computer is ready before the session.
  • Topic: Patient Lists, Rounds & Handoffs
  • Facilitator: Rob Hayward
  • Date: January 8, 2020
  • Time #1: 0700-0800
    • Meeting Link: clinic-a.connect-care.ca
    • Meeting ID: 258 320 762
    • Audio: can use computer audio or telephone 
      • Canada +1 647 558 0588 (then meeting ID)
      • One click: +16475580588,,258320762
  • Time #2: 1200-1300
    • Meeting Link: clinic-b.connect-care.ca
    • Meeting ID: 930 576 272
    • Audio: can use computer audio or telephone 
      • Canada +1 647 558 0588 (then meeting ID)
      • One click: +16475580588,,930576272
  • Description:
    • The Patient Lists toolkit provides clinicians with powerful tools to facilitate better team management, consult tracking, multidisciplinary rounds, ward rounds and end-of-shift handovers.
    • We will remind about how custom Patient Lists can be created, edited and shared; using illustrative examples to show how specialty notes, handoff report fields and other elements can be used to fit lists to different clinical needs.

2020-01-03

Connect Care January 2020 Calendar

A summary of key Connect Care happenings in January 2020 has been posted to the Alberta Health Services (AHS) internal Connect Care website, linked below.