COVID-19 and Connect Care - Facility-Based Codes Postponed to April 1, 2021

We previously posted about Connect Care professional billing modifications resulting from Alberta Health policy changes respecting overhead considerations. "Z codes" are a set of 13 facility-based health service codes that physicians use to submit claims for services performed in AHS facilities.

Expected changes are postponed to April 1, 2021.

Clinicians who record and submit professional billings through Connect Care need not make any changes at this time.


All User Bulletin - Change to Secure Chat Message Persistence

All-user-bulletins highlight stumbling blocks that all physicians need to be aware of when using the Connect Care clinical information system.

Change to Secure Chat Message Persistence

Secure Chat is a secure messaging service that allows users to send text and image messages to colleagues in real time. It is the preferred and approved tool for instant messaging within Connect Care. It is an appropriate communication channel for messaging involving personal health information.

To date, messages have been allowed to accrue indefinitely. This presents some users with large message collections. From January 14, 2021, messages older than 30 days will be automatically purged, even if part of a multi-message string. This is appropriate since messages are meant to support short-term communications that do not need to be part of the record of care. Once a message is purged, it cannot be recovered. 


COVID-19 and Connect Care - New Resources for Prescribers

Tippies can be quickly adopted with immediate workflow benefits...
  • Connect Care COVID-19 Resources for Prescribers
With prescribers re-assigned to address pandemic surge needs, some find themselves using Connect Care with inpatients for the first time at Wave 1 and 2 facilities in the Edmonton Zone. 

Many Connect Care enhancements have occurred since the pandemic began, with new and continually improving clinical content (e.g., flowsheets, order panels, order sets, documentation tools, navigators).

A new section of the Connect Care Manual organizes tips and guides to match COVID-19 workflows (with frequent additions), and a new series of "Tippies" shares simple actions that speed workflows.


COVID-19 and Connect Care - Just-in-Time Training

The COVID-19 second wave brings rapidly increasing numbers of patients to our hospitals and critical care units. The Edmonton Zone is particularly hard hit, with most cases going to the University of Alberta Hospital (currently on Connect Care) and the Royal Alexandra Hospital. 

Many healthcare workers help by accepting clinical reassignments to serve COVID-19 inpatient units, or to free up other specialists by covering non-COVID units. Some prescribers are new to Connect Care and others encounter Connect Care modules (e.g., inpatient) that are new to them.  

The following steps are followed for prescribers needing just-in-time basic or additional Connect Care training:

  1. Edmonton Zone Medical Affairs is informed of the clinical assignment, confirming that privileges are in place, that training needs are clarified, Connect Care access is provisioned, and training instructions are provided: Edm.MedicalAffairs@ahs.ca.
  2. The provider's name is added to a training list and an appropriate pathway is provided for training and certification.
  3. Providers new to Connect Care will be contacted by the Edmonton Zone ACMIO team (cmio.ez@ahs.ca) to arrange virtual training.
  4. Prescribers who already have Connect Care training, and need to cross-train in another track, can access relevant Independent Learning on MyLearningLink by searching for "Independent". For example, those needing the inpatient tract would:
    • Search using "Independent" under "Courses & Registration". 
    • Look for "Epic-CMIO Inpatient Admitting Consulting Independent Learning".
    • Use the "Register" button to access the course.
    • Course elements can be completed at the user's pace and in multiple sittings.
  5. Independent learning is currently available for Critical Care, Inpatient, Emergency, Anesthesia, Pediatrics, Addictions and Mental Health, Ambulatory and Personalization.
  6. Further help with just-in-time training is available via help.cmio@ahs.ca.


COVID-19 and Connect Care - Mobile Device Advantage

We've previously warned that personal devices can act like fomites, and that users should take particular care with frequent cleaning. Device vendors have provided COVID-aware screen and keyboard cleaning recommendations.
Subsequent postings will look at inpatient workflows for physicians participating in the care of COVID-19 patients. These can change perspectives about the infection control risk of using personal devices relative to shared organizational devices. Use of hospital keyboards can pose personal risk if not cleaned between uses. Assignment of a device to an individual for an entire shift or use of a personal device with appropriate cleaning are alternatives. Indeed, if one can restrict oneself to dictation of quick draft notes on-ward and subsequent completion of notes off-ward, a mobile device can be used safely.

In any case, it is important to be reminded about how to clean personal devices.


All User Bulletin - In Basket Change to "Not My Results" QuickAction

All-user-bulletins highlight stumbling blocks that all physicians need to be aware of when using the Connect Care clinical information system.

In Basket Change to "Not My Results" QuickAction

Sometimes physicians receive In Basket results messages in error. Once a prescriber confirms that the information is indeed inappropriately shared, an In Basket "QuickAction" can be used to flag the error and indicate, if known, to whom the message should be redirected. 

This workflow has been simplified. Previously there were options for "Not My Patient" and "Not My Result". The former is removed. The latter is enhanced with default response text that allows the recipient to quickly indicate why the test might have been misdirected and what action, if any, has been taken.


COVID-19 and Connect Care - Capacity Prediction

The prairie provinces, and Alberta in particular, emerge as COVID-19 second wave hotspots. Daily new case records invariably drive hospitalization records a few weeks hence. 

Our ability to compare pandemic phenomena across time and place has greatly improved, with international, national, provincial and organizational datasets proving invaluable for capacity planning. 

We have updated a shortlist of the best of these in the Connect Care Manual:


Trainee Bulletin - Change to Supervising Provider Workflow

All-user-bulletins highlight developments physicians need to be aware of when using the Connect Care clinical information system.

Selecting a Supervising Prescriber no longer required at Login

Prescriber trainees, including medical students, residents and fellows, are supervised by fully licensed prescribers. These are “supervising” or “authorizing” prescribers. Unequivocal identification of the authorizing provider ensures that clinical documentation is appropriately attributed, and that critical and late-reporting results are appropriately routed. 

To avoid ambiguity, a requirement for "Supervising Provider" selection at login was introduced for Connect Care trainees in second quarter 2020. This led to practical difficulties for some trainees. The requirement is removed as of noon on December 8, 2020. 

Instead, a default authorizing prescriber is specific to each patient and encounter:
  • Emergency Departments
    1. Attending provider for the patient ED visit
    2. Current provider (trainee themselves, if they are an authorizing provider)
  • Inpatient Departments
    1. Attending provider for the patient admission
    2. Current provider (trainee themselves, if they are an authorizing provider)
  • Outpatient Departments
    1. Encounter provider for the patient visit
    2. Current provider (trainee themselves, if they are an authorizing provider)
If the authorizing provider cannot be deduced, then the trainee is prompted to select an authorizing provider at the time of ordering. 

The default assignment of an authorizing provider will work most of the time. However, it is important to know how to select an alternate authorizing provider if the default does not fit a specific patient interaction.


COVID-19 and Connect Care - New Posting Series

Many prescribers find their work changed in Alberta's second wave of the COVID-19 pandemic. Some redeployments require rapid Connect Care training. Most see already-trained prescribers learning new workflows for COVID care.

We resume frequent postings about tips and guidance for optimal use of Connect Care in the pandemic. These can be viewed together by using the COVID category in any of our blogging channels (see left column). A new link, covid.connect-care.ca, lists all the general Connect Care updates that relate to COVID care and is easy to bookmark.


All User Bulletin - Ordering Audiology Consults

All-user-bulletins highlight stumbling blocks that all physicians need to be aware of when using the Connect Care clinical information system.

Ordering Audiology Consults

As of Tuesday, December 1, 2020 at noon, specialty audiology exams that were previously available to be searched for and ordered by physicians will only be orderable by Audiology prescribers, who can best select a specific intervention appropriate to the clinical need.  
Going forward, physicians seeking specific audiology procedures should place an “Inpatient Consult to Audiology” order for inpatients or "Ambulatory Referral to Audiology" for outpatients. If a specific intervention is wanted, this can be added to the comments section of the consult/referral order. An Audiologist will then place the required procedure order(s) and make appropriate arrangements for assessment.

Entering "hearing" or "audiology" as term in the Order Search will bring up the consult or referral order options.