2018-05-29

Connect Care June 2018 Calendar

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

With completion of Core Clinical System Design, Area Councils ramp up to begin the work of Specialty Clinical System Design. A first Adoption & Validation session will take place June 19-21 at the Calgary Telus Convention Centre, when Build Bucket 1 (ending June 15) configuration work will be reviewed. June is also when plans for the Connect Care data centre are finalized and an end-user device framework brings forth guides and plans for approval.

2018-05-28

Connect Care Overview Training - few Spots Remain

Overview training offers an overall introduction to the Connect Care clinical information system (CIS) and how it supports best possible practice. The one-day curriculum gives hands-on exposure to Epic systems, overall CIS architecture, and how documentation, order entry, communications and handoffs work. This training is invaluable for clinicians participating in Connect Care Area Councils, clinical system design, validation and adoption activities. Registration is required.

All Calgary sessions are fully booked (June 5, 6, 7). Some spots remain on each of the scheduled Edmonton sessions (May 29, 30, 31, June 1, 2018). A Byte has information about registration, sites and curricula:

2018-05-18

Latest Connect Care Newsletter Posted

The May 18, 2018, Connect Care Newsletter is available via the link below, covering the upcoming Adoption & Validation sessions, Patient Advisor Recruitment, and Information Technology Infrastructure developments.

2018-05-15

Connect Care for the Rest of Us

Complements to Dr. Wes Jackson who contributed a very thoughtful and informative article to the Alberta Medical Association Doctors' Digest.

While Alberta Health Services (AHS) strives to consolidate and integrate the many health information systems under its direct control (the AHS "legal record of care") in a single clinical information system (CIS), many care venues remain outside the reach of the Connect Care record of care. These may operate independent electronic medical records (EMRs).

As Dr. Jackson observes, deployment of an advanced, standards-based, CIS could simplify the work of providers seeking to understand their patients' AHS experience. Provider and patient portals are key.

In addition, a lot of important work prepares for helpful system-to-system and application-to-application connections between the Connect Care record and the other health information systems that will continue to be used in Alberta. Information about many of these initiatives can be found via informative links at the end of the article. A good read!

2018-05-10

Connect Care Design Management Principles

“Configuration,” “Customization” and “Personalization” relate to the manner, degree and frequency with which a clinical information system (CIS) is modified to address the business needs of specific users or user groups. Getting the right balance is key to user satisfaction; as well as build effort, update resilience and e-safety.

CIS design management is about how sustainable CIS configuration, acceptable specialty customization, and safe personalizations are achieved. A transparent approach to design management can also build confidence in how build resources are allocated.


    2018-05-08

    Alberta Referral Directory More Accessible

    The Alberta Referral Directory (ARD) is a secure, online listing that provides access to service and consultant demographics, referral guidelines and instructions about how to facilitate efficient and effective referrals, including referral forms. The ARD centralizes referral information for Alberta Health Services (AHS) consulting physicians and AHS scheduled ambulatory services.

    To date, ARD content has been viewable only to persons with a registered user name and password. Soon this logon barrier will be removed. ARD information will be openly available via the Internet, recognizing that the contained information is already in the public domain but fragmented and sometimes difficult to access. Full information access, with editing rights, still requires a valid userid and password.

    With ARD use expanding, all physicians are encouraged to update their referral information, or have responsible clinic staff take care of this for the clinic and all providers. AHS consulting clinicians can use the guide for help accessing the ARD and updating or correcting information found there.

    2018-05-07

    Connect Care Validation & Adoption

    Validation & Adoption is one of the major activities occurring during design of the Connect Care clinical information system (CIS). Other activities include Groundwork, Direction Setting and Clinical System Design. Where Groundwork helps the Epic team learn about Alberta Health Services (AHS), Direction Setting explores how AHS does its work, Clinical System Design builds the content that helps us work better and Validation & Adoption checks that the emerging CIS will work for AHS. The relationships between design and build activities are summarized in an online presentation: How the system is built.

    The purpose of Validation & Adoption is to review, validate and adopt how Direction Setting and other decisions are expressed in the emerging CIS. With the AHS foundation build of Epic Systems 2018 software up and running in Alberta, we can see how certified AHS staff are working with stakeholders to build to our need and purpose. Demonstrations more closely match what we will use, allowing us to see and imagine how Connect Care can be further configured to support our work.



    2018-05-04

    Connect Care Scope Management Principles

    A core Connect Care ambition is to consolidate diverse health information systems into a seamlessly integrated clinical information system (CIS) that de-fragments information, relationships and health care. Working the integration mandate forces challenges as continuity and best-of-breed trade-offs are negotiated.

    A transparent, principles-based, scope management approach can help. 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. The linked presentation gives an overview of current scope management principles and processes.

    2018-05-03

    World Password Day

    Happy (and anxious?) world password day!

    Identity theft has become common place, hurting individuals in profound ways. Health care organizations also suffer. Hacks analogous to identity theft hurt the organization and all dependent professionals, patients and populations.

    The most damaging attacks succeed because individuals are fooled into releasing credentials, or are lulled into using patterned credentials stolen outside the organization, then used within the organization. A curious coincidence... on World Password Day, Twitter announces that their password store may have been exposed. How many of us style our passwords for clinical apps like we do for our social apps?

    2018-04-23

    How does Clinical System Design happen?

    Clinical System Design (CSD) is about how we plan, design and build clinical content. Check out the online presentation to learn about how we are organizing the CSD processes to serve the Connect Care Needs.

    2018-04-20

    How is Clinical Content Built?

    Clinical information system (CIS) clinical content includes documentation, decision and inquiry support tools that are built into the CIS to support best possible practice and Clinical System Design (CSD) is about how we plan, design and build clinical content. Check out the online presentation for a simple way to understand and classify content and CSD.

    2018-04-19

    Building the Connect Care Clinical Information System

    Building the Connect Care clinical information system is our 'main event' now and for months to come. Diverse activities must be coordinated for design and build to progress as needed. The names of these -- Scope-setting, Groundwork, Foundation, Direction-Setting, Clinical System Design, Configuration, Build, etc. -- may be unfamiliar to many. Check out the latest clinician update video blog for a short presentation that likens Connect Care design and build to stages of construction.

    2018-04-18

    Connect Care Milestone Acheived

    With high-level completion of Scoping, Groundwork, Direction-Setting, Technical Training and much of core Clinical System Design, the Connect Care initiative has substantially passed, on time, all milestones needed before starting build of the Alberta Health Services (AHS) clinical information system (CIS).

    Our preparatory work of the last 3 years has proved a big help. As important has been the remarkably fast, adaptive and intense mobilization of Connect Care stakeholders since October 2017 when a contract was signed with Epic Systems, our prime technology partner.

    Now begins the next phase of our journey. We will rely more and more on AHS staff trained to build and configure the Alberta foundation system. At the same time, we support our committees and councils as they move even faster to decide about CIS clinical content (decision supports, documentation supports and inquiry supports) to be built and validated over the next 10 months.

    Thank you to all who have worked so hard, with so much good-spirited and creative adaptation, to get us ready for the next stage of the Connect Care journey.

    2018-04-11

    Subscribing for Blog Alerts

    Blogs and Vlogs (video blogs) can be a useful way to provide interested stakeholders with updates about Connect Care and its various activities, especially in areas where change is rapid.

    With so much happening in Connect Care, so quickly, clinicians are offered a number of blogs suiting different interests and needs. Blogs can be open (no sign-in authentication required) or may require Alberta Health Services (AHS) intranet (HEALTHY domain) username and password credentials.
    Updates can fan-out to stakeholders via preferred communications channels. This works best when stakeholders make use of blog subscription or newsreader features. A short tip sheet explains how this works for both open and AHS blogging platforms.

    2018-04-10

    Navigating Connect Care Committee Workspaces

    Connect Care committees, councils and advisory groups are supported with Alberta Health Services (AHS) SharePoint workspaces. These keep important materials in one place, limiting the need to attach large files (which may later be updated) to emails and calendars. With few exceptions, collaborative workspaces are open to all AHS staff, while editing rights are restricted to co-chairs and secretariat or support staff. All committee, councils and advisory group workspaces can be found via one root location, which may request a valid AHS (HEALTHY) network user name and password in order to proceed. The workspaces all have the same structure and functions. Learning how to navigate one will make it easier to navigate any other oversight group of interest.

    SharePoint has some unique behaviours, giving some users trouble with screen-to-screen navigation. A new Connect Care collaborative workspace tip sheet can ease the way.



    2018-04-09

    Direction Setting 2 - Key Decisions

    Through Connect Care Direction Setting sessions, input is gathered from staff, physicians and patient advisors to help guide what will be included in the Connect Care clinical information system (CIS). Direction setting focuses on how commonly used workflows (tasks performed when providing patient care) are complemented by information flows and tools.

    A high-level summary of decisions arising from the second set of direction setting sessions (mid-April 2018) represents areas of clear consensus. Areas of uncertainty or variability requiring further exploration are referred to Connect Care governance structures (committees, councils, advisory groups).

    2018-04-03

    Clinical System Design Decision Viewer

    Connect Care scoping, groundwork, direction-setting and clinical system design decisions set an important context, and sometimes limits, that clinical content development groups need to be aware of when doing clinical system design (CSD) work. Some decisions, for example, determine principles or styles applicable to categories of design activities. Stakeholders need a way to quickly browse or search for simple statements of relevant approved decisions, together with any important context or implications.

    A Connect Care CSD ‘Decision Viewer’ is linked to all committee and council workspaces. This online collection synopsizes decisions of broad import. The Viewer does not replace or conflict with the Connect Care Decision Tracker, which is the source of truth for decision management. Instead, the viewer can assist committee, council and advisory group members appreciate key decisions that new design work may depend upon.

    2018-04-02

    Provincial Provider Registry Integration Success

    The Alberta Provincial Provider Registry holds in one place a definitive list of healthcare providers licensed to practice in Alberta and eligible for access to provincial health information systems. Previously, distinct databases were maintained by Alberta Health (AH) and Alberta Health Services (AHS). AHS registry information was further compartmentalized for provider information management in different clinical information systems (CIS).

    The current single registry, used by both AH and AHS, supports the provincial electronic health record (Alberta Netcare). This registry is now also successfully established as the source of truth for the eCLINICIAN AHS CIS. As eCLINICIAN and Connect Care are both based on Epic Systems software, this bodes well for our upcoming Connect Care deployment. We anticipate Connect Care use of provincial registry services for providers, patients and facilities. The registry integration work also relates to patient attachment registry and physician self-serve registry initiatives.

    2018-03-30

    Connect Care Style Guide

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

    2018-03-29

    Specialty Mapping to Areas

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

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

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



    2018-03-28

    Charting by Exception

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

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

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

    2018-03-27

    Clinical System Design Handbook Initiated

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

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

    2018-03-26

    Can Medical Scribes Ease Clinical Information System Adoption?

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

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

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

    2018-03-24

    Clinical Knowledge & Content Management serves Clinical System Design

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

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

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

    2018-03-23

    Connect Care Update Newsletter - March 2018

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

    2018-03-22

    Developing eHealth Competencies

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

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

    2018-03-19

    Connect Care Clinician Communication Strategy

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

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

    2018-03-17

    Direction Setting 2 Feedback and Session 3 Preparations

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

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

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

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




    2018-03-16

    Direction Setting 1 Consensus Decisions

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

    2018-03-15

    Thank you to Direction Setting 2 Participants

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

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

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