For the Alberta Health Services (AHS) Connect Care initiative to succeed, patients, providers and support staff must integrate informational supports into workflows. This happens best when clinical information system (CIS) users have meaningful input into the decisions that affect their CIS experience. A robust oversight strategy with clear governance principles has helped guide Connect Care by purpose and principles.
Sustaining success requires nimble ways to tap into what is happening on the front lines, while monitoring for unanticipated problems. Community-aware calibration requires purposeful consultation with both advisory groups and user groups, tapping into organizational wisdom and end-user pragmatism. As we ready for first launch late this year, advisory group activity ramps up while user groups start to get established.
The Connect Care Stakeholder Advisory Group has its first meeting this week, a good reminder to refresh our shared understanding of how Connect Care oversight works.
2019-01-06
Connect Care Inquiry & Research Support Webinars
We’ve previously posted about how the Connect Care clinical information system (CIS) will support clinical inquiry. Connect Care, at its core, is about inquiry and research – learning from the care we deliver to Albertans. We initiate inquiry when we ask questions about what we do and we participate in research when using systematic approaches to answering those questions.
Connect Care affords us powerful tools for inquiry and research support. As these take shape, there is growing interest in what is possible and when it will be available. The Connect Care Clinical Inquiry and Research Team helps by hosting a series of monthly demonstrations showcasing research capabilities and workflows. The webinars also give opportunity to put questions to the Connect Care team.
Upcoming inquiry & research management webinars are planned as follows:
Connect Care affords us powerful tools for inquiry and research support. As these take shape, there is growing interest in what is possible and when it will be available. The Connect Care Clinical Inquiry and Research Team helps by hosting a series of monthly demonstrations showcasing research capabilities and workflows. The webinars also give opportunity to put questions to the Connect Care team.
Upcoming inquiry & research management webinars are planned as follows:
- Monday Jan 21st, 2019 12 PM-1PM
- Tues Feb 19th, 2019 12 PM-1 PM
- Mon Mar 18th, 2019 12 PM-1 PM
- Mon Apr 15th, 2019 12 PM-1PM
2019-01-05
Re-jigging Communications in the New Year
This year (2019) brings Connect Care to its first launch, Wave 1 in the Edmonton Zone on November 2. Where 2018 focused on scope, workflow, configuration and clinical content design, the new year emphasis continues build while starting testing, training, change management and implementation.
Most Connect Care participants continue invaluable contributions, building on all that has been learned since we started our journey. The many new participants pulled into readiness prep need help building a Connect Care awareness sufficient to their needs.
Both Connect Care newcomers and veterans can benefit from reinforcement of key concepts and re-connection with key communication channels. We'll use this blog to help followers re-cycle and re-invigorate.
For starters:
Most Connect Care participants continue invaluable contributions, building on all that has been learned since we started our journey. The many new participants pulled into readiness prep need help building a Connect Care awareness sufficient to their needs.
Both Connect Care newcomers and veterans can benefit from reinforcement of key concepts and re-connection with key communication channels. We'll use this blog to help followers re-cycle and re-invigorate.
For starters:
2019-01-04
School for Change Agents - Free Webinar Opportunities
Alberta Health Services has enjoyed innovative input from Helen Bevan (@helenbevan) on more than one occasion. A thought-leader in healthcare engagement, adoption and change management, she has helped initiate a "School for Change Agents" through the National Health Service in Britain.
A series of free online 5 webinars start later this year. International participants are welcomed.
With 2019 bringing transformation through Connect Care implementation, most of us can benefit from new ideas about change awareness, support and management. Please consider registering, as below.
A series of free online 5 webinars start later this year. International participants are welcomed.
With 2019 bringing transformation through Connect Care implementation, most of us can benefit from new ideas about change awareness, support and management. Please consider registering, as below.
2019-01-03
Connect Care Wave 1 Launch Event
In collaboration with the University of Alberta and Stollery Hospital Medical Staff Society, Alberta Health Services presents in the leadership lecture series about:
"Connect Care: Learning to Love your Clinical Information System"
January 17, 2019, 1600-1800, Bernard Snell Hall, Walter C Mackenzie Centre, Edmonton,
with videoconferencing widely available.
A wine and cheese reception will follow in the foyer.
The presenting panel includes Rob Hayward (CMIO), Tim Graham (Associate CMIO), Stuart Rosser (Physician Design Lead), Stewart Hamilton (Senior Medical Advisor), Jacques Lovely (Senior Leader Clinical Operations) and local Connect Care leaders.
Session objectives:
"Connect Care: Learning to Love your Clinical Information System"
January 17, 2019, 1600-1800, Bernard Snell Hall, Walter C Mackenzie Centre, Edmonton,
with videoconferencing widely available.
A wine and cheese reception will follow in the foyer.
The presenting panel includes Rob Hayward (CMIO), Tim Graham (Associate CMIO), Stuart Rosser (Physician Design Lead), Stewart Hamilton (Senior Medical Advisor), Jacques Lovely (Senior Leader Clinical Operations) and local Connect Care leaders.
Session objectives:
- Share updates about Connect Care status and launch timelines
- Understand Connect Care conditions for success
- Explore clinician fears and hopes
We hope to see as many clinicians as possible at this kick-off event for the first wave launch (November 2019).
2019-01-02
Why Doctors Love Their Computers - 1
We previously posted about an influential piece by Dr. Atul Gawande: "Why Doctors Hate Their Computers". The New Yorker article has attracted a lot of attention, upping our clinicians' angst about the Connect Care clinical information system (CIS) launch later this year.
The Gawande article, and many others like it, raises important considerations for us as we move from system design through testing, adoption, training and readiness. Harms reduction is, unequivocally, the biggest chunk of change management.
However, Dr. Gawande's concerns reflect (roughly) just one dimension of our prospects. Many of his concerns do not, exactly, apply to our situation. Other challenges need to be exposed, explored, and mitigated. More importantly, there is a huge upside for physicians that we also need to understand, plan for, and realize.
BytesBlog will devote the first postings of 2019 to an exploration of how we can move from "why doctors hate their computers" to "why doctors love their computers." I have no doubt that we will come to love the Connect Care achievement. But we have a lot of stormy transformation to navigate first. Please use BytesBlog comments and email links to contribute your thoughts, helping us broaden the discussion and prepare together to take ownership of CIS use... for success!
Obviously, we are not alone in these discussions. A recent HealthcareITNews article references a report about how vendors (specifically Epic) are connecting with physicians to better understand the information management problems they need to solve. A related American Medical Association initiative, the "Digital Health Implementation PlayBook" captures practical steps clinicians can take to benefit from eHealth, while avoiding harms.
The Gawande article, and many others like it, raises important considerations for us as we move from system design through testing, adoption, training and readiness. Harms reduction is, unequivocally, the biggest chunk of change management.
However, Dr. Gawande's concerns reflect (roughly) just one dimension of our prospects. Many of his concerns do not, exactly, apply to our situation. Other challenges need to be exposed, explored, and mitigated. More importantly, there is a huge upside for physicians that we also need to understand, plan for, and realize.
BytesBlog will devote the first postings of 2019 to an exploration of how we can move from "why doctors hate their computers" to "why doctors love their computers." I have no doubt that we will come to love the Connect Care achievement. But we have a lot of stormy transformation to navigate first. Please use BytesBlog comments and email links to contribute your thoughts, helping us broaden the discussion and prepare together to take ownership of CIS use... for success!
Obviously, we are not alone in these discussions. A recent HealthcareITNews article references a report about how vendors (specifically Epic) are connecting with physicians to better understand the information management problems they need to solve. A related American Medical Association initiative, the "Digital Health Implementation PlayBook" captures practical steps clinicians can take to benefit from eHealth, while avoiding harms.
2019-01-01
What a year, going and coming!
What a year its been... and what a year to come!
Congratulations to the Connect Care build team, who worked to a December 31 deadline for build buckets 1-4... and made it! Thanks also to the many committees, workgroups, experts, advisors and validators who worked the deliberations guiding design. The outcome is a Connect Care clinical information system (CIS) environment with AHS workflows, preferences and needs expressed; a major milestone in an incredibly big and complex venture!
The outcome is important, but so too is the process. We've built effective oversight, support, design and configuration capacity. Diverse stakeholders have learned how to work efficiently, forging a provincial perspective on how a digitally-enabled healthcare workplace should emerge and evolve.
The New Year begins with another deadline rush. All essential clinical system design (CSD) decisions need to be set by February 8, 2019. We are about 75% there, moving at a pace that should close the gap on time. Parallel CSD build continues, providing us with the documentation, decision and inquiry supports that will allow Connect Care to support clinical improvement.
Moving forward, our focus shifts from design and build to testing, training and readiness. The wave 1 first launch is a mere 10 months away. A lot of tough work coming in 2019! But we continue our Connect Care journey with confidence born of tremendous accomplishment already to hand.
Congratulations to the Connect Care build team, who worked to a December 31 deadline for build buckets 1-4... and made it! Thanks also to the many committees, workgroups, experts, advisors and validators who worked the deliberations guiding design. The outcome is a Connect Care clinical information system (CIS) environment with AHS workflows, preferences and needs expressed; a major milestone in an incredibly big and complex venture!
The outcome is important, but so too is the process. We've built effective oversight, support, design and configuration capacity. Diverse stakeholders have learned how to work efficiently, forging a provincial perspective on how a digitally-enabled healthcare workplace should emerge and evolve.
The New Year begins with another deadline rush. All essential clinical system design (CSD) decisions need to be set by February 8, 2019. We are about 75% there, moving at a pace that should close the gap on time. Parallel CSD build continues, providing us with the documentation, decision and inquiry supports that will allow Connect Care to support clinical improvement.
Moving forward, our focus shifts from design and build to testing, training and readiness. The wave 1 first launch is a mere 10 months away. A lot of tough work coming in 2019! But we continue our Connect Care journey with confidence born of tremendous accomplishment already to hand.
2018-12-31
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.
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.
2018-12-14
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.
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.
2018-12-13
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.
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.
2018-12-10
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
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
2018-12-06
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.
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.
2018-12-05
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.
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.
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.
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.
2018-12-04
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:
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:
2018-12-03
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).
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).
- Glossary: Integration and Conversion
- Byte: Connect Care Scope Management
- Concept: Integration-Interoperation-Interfacing
- Presentation: Connect Care Scope Management
- Principles: Connect Care Scope Management
- Resource: Connect Care Integration
- Resource: Connect Care Scope Management (Applications Ins and Outs)
2018-12-02
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.
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.
2018-12-01
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.
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.
2018-11-30
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:
2018-11-29
Connect Care November 30 Newsletter Posted
2018-11-28
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.
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.
2018-11-27
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:
"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:
2018-11-26
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:
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:
2018-11-25
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
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
2018-11-24
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:
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:
2018-11-23
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:
A few quick reads can help clinicians anticipate the changes:
- Simple (1-page) visual highlighting changes in menus and navigation
- Short video illustrating layout 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.
2018-11-22
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.
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.
2018-11-21
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.
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.
2018-11-20
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.
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.
2018-11-19
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:
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.
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
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.
2018-11-18
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.
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.
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