2021-11-04

Prescriber Feedback: Use of Comments Within Laboratory Test Orders

The Connect Care laboratory medicine group seeks feedback about whether and why prescribers might use an available "comments" field when entering orders for laboratory tests in the Connect Care clinical information system. The following survey (closing November 11, 2021) can be used by any prescriber who enters orders for tests:

Survey feedback information will used to help optimize the design and use of order comments.  

2021-11-03

Connect Care Waves 4 and 5 - Updated Launch Timelines

An important message from Dr. Francois Belanger, Chief Medical Officer, and Sean Chilton, Vice President Health Professions and Practice and Information Technology:


In September 2021, we made the difficult decision to delay the planned launch of Connect Care’s Wave 4 and subsequent waves, in order to support patients and healthcare teams as we faced an overwhelming wave four of the pandemic in Alberta. We thank all of you for your patience over this period of time, for your ongoing work to keep preparing for Connect Care, where it was possible, and for being redeployed into areas which desperately needed your help. 
 
Despite this recent delay, Connect Care remains an organizational priority. We promised we would update you with new timelines for launches as soon as we could. We feel we can now revisit Connect Care planning given there has been some reduction of pressure on the health system. Over the past weeks, Connect Care leaders collaborated with zone, provincial and executive leadership to determine our best path forward for the remaining six launches of Connect Care. 
 
The new plans for Connect Care have shifted the existing sequencing and scope for each wave six months into the future. This has extended the overall timelines for Connect Care, which will now be complete in 2024; however, the content of each wave remains the same. The next two waves are outlined below.
 
Wave 4: May 14, 2022

With 57 sites in the Edmonton and Calgary Zones, Wave 4 will be our biggest launch to date. It includes:
  • Calgary Zone
    • Alberta Children’s Hospital, Peter Lougheed Centre, Southern Alberta Forensic Psychiatric Centre (and associated forensic services), Calgary Correctional Centre, Calgary Tuberculosis Clinic
    • Urgent Care Centres: Sheldon M. Chumir Health Centre, South Calgary Health Centre, Airdrie, Okotoks and Cochrane, including Addictions and Mental Health Urgent Care sites and rural ambulatory clinics
    • Calgary Zone rural and acute care combined sites, including Airdrie Community Health Centre and Provincial Building, Banff Community Health Centre, Mineral Springs Hospital (Banff), Canmore General Hospital, Claresholm General Hospital, Willow Creek Continuing Care Centre (Claresholm), Chestermere Health Centre, Cochrane Community Health Centre, Didsbury District Health Services, High River General Hospital, Lake Louise Medical Clinic, Nanton Community Health Centre, Oilfields General Hospital (Black Diamond), Okotoks Health and Wellness Centre, Strathmore District Health Centre, Vulcan Community Hospital  
  • Edmonton Zone: Glenrose Rehabilitation Hospital, Lois Hole Hospital for Women, Royal Alexandra Hospital, Addictions and Mental Health Addictions and Residential programs
  • Pharmacy and Diagnostic Imaging: Sites in Calgary and Edmonton, including Central Production Pharmacy
  • Alberta Precision Labs: Alberta Children’s Hospital Genetics Services South Lab, Edmonton, including Glenrose Rehabilitation Hospital, Royal Alexandra Hospital, Grey Nuns Hospital and Misericordia Community Hospital
Wave 5: November 6, 2022
  • Calgary Zone: Foothills Medical Centre (including associated clinics at Richmond Road Diagnostic and Treatment Centre)
  • Central Zone: Acute and combined acute and long-term care sites from the former David Thompson Health Region, including the Centennial Centre for Mental Health and Brain Injury, Sylvan Lake Advanced Ambulatory Care Service, Addictions and Mental Health services in the former David Thompson Health Region, Continuing Care (intake and transition services)
  • North Zone: Addictions and Mental Health ambulatory sites from the former Peace County Health Region, Fort Vermillion, High Level, La Crete, Paddle Prairie and Rainbow Lake
  • Provincial Programs: CancerCare Alberta North and South, Kidney Care South
  • Pharmacy and Diagnostic Imaging: Sites in Calgary and the former David Thompson Health Region
  • Alberta Precision Labs: Sites in the former David Thompson Health Region
For more details on launch sequencing, please visit Insite.
 
As we move forward, Connect Care teams will be working with site and zone operational leaders to schedule required training in early to late November. The training will commence in January 2022. 
 
Connect Care team members redeployed to support the pandemic response will be released from those roles as capacity and demand decreases across the organization. We expect these team members will be returned to their Connect Care roles no later than the beginning of January.  
 
We are thankful for all the work done to prepare us for these next launches by teams across the organization. Your work has set us up for success as we move forward.  
 
We also want to thank you for your patience as we altered our plans to address the urgent needs of Albertans and the healthcare system. 
 
We look forward to these upcoming launches and continuing to improve the care we provide to Albertans through Connect Care. 

2021-10-30

COVID-19 and Connect Care - Hospital Co-vaccinations

The flu season is soon upon us, with opportunistic immunization important for at-risk patients during hospitalizations.

Previously, the COVID-19 vaccination instructions and documentation suggested that COVID-19 immunization not be considered within 14 days of any other immunization event. The evidence, and guidance, is now clear that co-vaccinations are both safe and appropriate. The Connect Care order set and associated clinician documentation reflects this change.

2021-10-29

COVID-19 and Connect Care - Documenting Historical Vaccinations

We've previously posted about how to review COVID-19 immunization information in Netcare and Connect Care and how, if indicated, to add information about an otherwise undocumented vaccination as a historical immunization when patients present with formal documentation of non-Alberta immunizations.

Recent audits have uncovered some inappropriate (even fraudulent) instances of what appear to be formal external documents. Alberta's provincial COVID-19 vaccination validation service is resourced to assess and validate external vaccine documents. It is easily accessed and used by patients online.

Connect Care providers should direct patients to submit their external documents for approval and possible addition to the provincial registry, and should avoid manual entry of historical COVID-19 vaccine administrations into Connect Care. The provincial registry information is automatically copied into Connect Care when validated.

2021-10-11

BBHR: Charting Efficiencies - Sidebar Aids for Transition Planning

Building a Better Health Record (BBHR)
Charting Efficiencies - Sidebar Aids for Transition Planning

Improvements to the Hyperspace inpatient chart Sidebar include aids for quickly finding, displaying and editing information in either the main (central), Sidebar (right) or pop-up chart spaces. The first set of tools appear by default when the inpatient Sidebar opens to its "Index & checklists" view. These nicely illustrate how the Sidebar can help users quickly access and update chart data that otherwise would require more familiarity with less-used parts of the chart.

The focus of the checklists view is on transition planning, whether that relates to discharge, transfer or a move to a different level of care (click on icon to view screenshot; numbers below refer to numbers in screenshot). 

  1. If not already displayed, select the top-left "Index & checklists" link to display the "Checklists" and "Transition Planning" Sidebar tools.
  2. Daily, Admission and Discharge Checklists are presented. These function like task managers, reflecting important unfinished tasks and changing to completion status when the relevant work is done. The few highlighted tasks closely match Connect Care minimum use norms.
  3. Checklist items are "active". When selected, the user is taken to a relevant documentation or ordering tool directly relevant to the listed task.
  4. The Transition Planning section summarizes relevant information, including expected transition and discharge dates, social supports, community care needs and patient goals. Where information is missing or incomplete, the title or bracketing text appears in a (dark) blue font, indicating that it can be selected to activate data entry tools in-context where the associated information can be updated. Use the Sidebar "refresh" icon (top left of Sidebar) to update the display if this does not happen automatically.

2021-10-08

2021-09-30

BBHR: Charting Efficiencies - Other Clinical Systems Sidebar Views

Building a Better Health Record (BBHR)
Charting Efficiencies - Using Other Clinical Systems Sidebar Views

New patient assessments offer important opportunities to initiate core clinical data in the patient chart. This decreases the work of documentation thereafter, when clinicians can revise or validate information already entered. 

Sidebar tools can help clinicians when they review information from other clinical information systems (e.g., Netcare) or from prior unstructured Connect Care documentation (dictated notes that, for example, did not include updated problem lists). The user needs to review and document at the same time, ideally without jumping back and forth between different windows. 

The Sidebar can help in two ways, either when used to review information that informs documentation performed with main panel tools, or when used to enter information gleaned from the main panel. 

Sidebar views of other clinical information system content are especially helpful when doing problem, adverse reaction or medication reconciliation, as explained in a recent Manual addition.

2021-09-29

All User Bulletin - Inpatient Sidebar Enhancements

All-user-bulletins highlight information that all prescribers can benefit from when using the Connect Care clinical information system.

Inpatient Hyperspace Sidebar Enhancements

Users may notice changes to the "Sidebar" (rightmost panel appearing when a patient chart is opened to an inpatient encounter in Hyperspace) starting noon September 30, 2021. The best way to learn about new functions is to select the embedded help link to gain access to a quick overview.

All the same Sidebar information is available. However, many Sidebar views have been enhanced with better clinical summaries. The Sidebar index now uses information about the current provider, patient and clinical setting to conditionally display the most relevant information. In addition, new features make it easier to use the Sidebar to access charting tools that complement what one may be using in Hyperspace's main (centre) panel. 

The biggest change relates to how the Sidebar summary index works. The index will always appear at the top of Sidebar views (default "Index" tab) and can be used to jump between different views. Index items have three parts:

  1. Clicking on a left arrow will open relevant information in the main Hyperspace panel.
  2. Clicking on the index title will open a Sidebar summary view with information matching the title topic.
  3. Clicking on a right arrow (when present) will open a charting tool (with data-entry capabilities) in the Sidebar itself.
The enhanced Sidebar better supports a number of charting needs, including:
  • Quickly find a tool not among one's defaults (and so not having to seek in menus).
  • Enter and update problem lists within the Sidebar while reviewing past notes in the main Hyperspace panel.
  • Gain rapid access to discharge planning tools.
  • Find and use supports for problem-oriented charting.

Time-saving charting efficiencies become possible with effective use of Sidebar tools. We will post tips and tricks in the Building a Better Health Record series of this blog.

2021-09-25

Next Connect Care Scheduled Downtime Window Will NOT Be Used

The September 30th downtime for Connect Care will not be taken as scheduled.
 
The decision was made with Clinical Leadership based on the significant capacity issues the frontline is currently facing with COVID-19 workloads.
 
A new date for scheduled Connect Care system maintenance has not been confirmed but will be communicated well in advance.

2021-09-10

On Other Channels...

Thank you for continuing to check (...ideally, subscribe to multiple channels; see instructions) the Connect Care update blog for prescribers. Recent additions to this blog and its various channels:

2021-09-03

COVID-19 and Connect Care - Waves 4-5 Delay

An important message from Dr. Francois Belanger, Chief Medical Officer, and Sean Chilton, Vice President Health Professions and Practice and Information Technology:


Our healthcare teams and patients come first in every decision we make. Given the significantly increasing demands on acute and critical care areas, frontline staff, physicians, programs and services, and the increased health risks our patient and healthcare teams are facing due to COVID-19, we do not feel it would be prudent to launch the next wave of Connect Care in November 2021.

Our immediate priority is to support Alberta’s on-going COVID-19 response. We know that each Connect Care launch requires significant training and preparation by frontline teams, those who support behind the scenes and leadership. Delaying our Connect Care launches helps ensure our staff, physicians and leaders are able to focus on delivering care to patients who need acute and critical care at this time. 

We are currently assessing the situation in order to determine our new wave rollout plan. Firm dates for subsequent launches will be shared as we have them.

To be very clear, Connect Care is not being cancelled: Connect Care continues to be one of our highest organizational priorities. In fact, even with this delay to the upcoming launches, some Connect Care work will still continue to support the needs of the organization, the pandemic, and to prepare for the next launches. Work that can still continue because it is less impacted by COVID-19 includes:
  • Infrastructure and technology work, including WIFI upgrades, facility preparations, and device deployment and testing
  • Continued support for Waves 1, 2 and 3 to aid the stabilization of those sites and programs
  • Building and validation work for Waves 4-7
  • Building and preparing training support, leadership teams and other roles necessary for future launches. 
We are thankful for all the work done to launch our three previous waves so successfully, including the incredible support from the Edmonton and North zones, and from sites and programs across the province. We also want to recognize the preparations undertaken for our next launches by Connect Care teams, site and program teams and our leadership. 

When it is safe and prudent to move ahead with our future launches, we will be ready. In the meantime, making these changes means we can be strategic with resources and respectful of the demands on our staff and physicians, as they continue to protect the people of this province.  

2021-09-02

COVID-19 and Connect Care - Additional Dose and Moderna Changes

As of September 1, 2021, an additional (third or booster) dose of the COVID-19 vaccine is available for eligible groups:

  • immunocompromised individuals 12 years of age and older with specific conditions, 8 weeks after their second dose; 
  • residents of seniors’ supportive living facilities, 5 months after their second dose; and 
  • travelers to jurisdictions where AstraZeneca/Covishield or mixed doses are not recognized, 4 weeks after their second dose.
Also as of September 1, 2021, the Moderna (COVMODmRNA) vaccination has been approved for ages 12 years and older.

To support the expanded criteria for vaccinations, the COVID-19 vaccine inpatient order set is enhanced in Connect Care:

  • An "Additional Dose" section has been added to the order set to support those eligible for additional doses (as described above).
  • Moderna (COVMODmRNA) is now available for everyone born 2009 and earlier.

For more information:

2021-08-22

Reminder: Connect Care 180-Day Inactive Access Account Disabling

As previously posted, the Alberta Health Services Identity & Access Management (AHS IAM) team has activated a security practice for Connect Care whereby Connect Care user accounts that have not been accessed for 180 consecutive days will be inactivated. Users with inactive accounts will not be able to log in to Connect Care. The first day access to inactive accounts may be lost is Wednesday, August 25, 2021.

  • Anyone at risk of Connect Care account inactivation (no log ins for 150 days) is sent automated email notifications from “Identity Management”, the AHS IAM system.
    • Email notifications are sent both to the user and to the user's "Authorized Approver" (manager), with repeat notices 30, 15 and 2 days prior to the inactivation date. 
    • Email notifications identify the upcoming inactivation date and actions that can be taken to maintain access.
    • Prescribers may also receive additional email notifications from Provincial Medical Affairs.
  • If the Connect Care user fails to log in despite warnings, the account is switched to inactive status on the previously identified inactivation date. 
  • Inactive accounts can be reactivated if and when users return to active clinical work in Connect Care settings. Managers will work with the affected end user to determine the best pathway to renewed Connect Care access, including any training or other remediation that may be required.  

This inactivation protocol helps ensure that Connect Care users remain available for system alerts, information about new or changed features, and important clinical notifications. The protocol applies to all AHS employees, members of the medical and midwifery teams, students, volunteers, and other persons acting on behalf of AHS (including contracted service providers).

More information:

2021-08-21

All Prescriber Bulletin - Ensure Documentation Files to Correct Record of Care

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

File Documentation to the Correct Record of Care

As the Connect Care clinical information system (CIS) continues to spread throughout Alberta, situations emerge where a program or facility has areas launched in Connect Care and others awaiting launch. Temporary "hybrid" contexts occur when part of a patient's experience is captured in Connect Care and other part(s) in legacy systems. 

Clinicians trained in Connect Care workflows may find themselves attracted to the convenience of in-system dictation, speech recognition or text automations when providing service in contexts where the CIS has yet to launch. Nonetheless all clinical documentation must be rendered and entered to the correct legal record of care.

The Connect Care Manual describes how to print material that needs to be added to a paper chart:

2021-08-20

On Other Channels...

Thank you for continuing to check (...ideally, subscribe to multiple channels; see instructions) the Connect Care update blog for prescribers. Recent additions to this blog and its various channels:

2021-08-18

BBHR: Minimum Use for Maximum Utility - Adverse Reaction Documentation

Building a Better Health Record (BBHR)
Minimum Use for Maximum Utility - Allergies and Adverse Reactions

Connect Care Minimum Use Norms highlight a few essential activities that all clinicians must share in order to promote patient safety, improve charting efficiency and minimize any one clinician's information burdens.

One norm relates to validating a patient's list of allergies and adverse reactions at appropriate intervals. We've noticed room for improvement.

Prescriber supports have been improved to clarify how allergy reconciliation can occur with minimum fuss and maximum benefit. Emerging problem oriented charting tools reward minimum use compliance with easier preparation of standardized clinical documentation.

2021-08-17

Rural Cardiogram Scheduled Downtime - Example of secondary system downtimes

Most Connect Care users are familiar with planned Connect Care downtimes that are periodically scheduled to allow for system updates and technology maintenance. Primary downtime procedures for prescribers, including access to backup systems, are described in the Clinician Manual. 

Most clinical information system maintenance, including non-Epic systems integrated with Connect Care, can be scheduled during planned Connect Care downtimes. However, as Connect Care grows throughout Alberta, there may be times when focused secondary downtimes are needed.

Secondary health information systems provide Connect Care with important clinical data through information interfaces. They can be taken offline for short periods without affecting core Connect Care functionality. Examples include medical devices, such as electrocardiogram recorders, that use interface software to upload information that Connect Care incorporates into the patient chart. Such support systems may require periodic maintenance, possibly affecting just one facility or zone. To further the example, the rural interfaces for Holter monitor and electrocardiogram uploads will be down for one hour (20:00-21:00) on August 24, 2021 for scheduled maintenance.

Instructions specific to support system scheduled and unscheduled downtimes are included in Connect Care downtime resources for clinicians.

2021-08-16

Webinar: Complex Lab Results in Patient Portals

As previously posted, more lab test results were made available last February in My Personal Records (MPR), found in MyHealth Records (MHR), the single access point for Albertans’ personal health information. These lab results are viewable through the MPR application. Making more results available online provides Albertans with more access to their health information and acts as an additional safety net for patient care within the system.

Through a series of rollouts, additional results are being added to MPR through to September. To date, the following results are now viewable as soon as they are released by the lab:

  • About 95% of the most commonly ordered (by volume) lab test results were viewable as of February 1. 
  • More complex results in pathology and other areas are being included in MPR on August 23.

Providers may notice some changes in their patterns of work, and may wish to consider giving patients more information about the implications of different results at the time of ordering a test. Physicians and other providers will continue to have access to results through their usual delivery channels.

For more information about the August 23 rollout, AHS will be hosting a 1-hour information webinar on Zoom: 

  • To register
    • Wednesday, August 18, 2021, 10:00-11:00
    • Please add this link to your calendars and join the Zoom meeting.
      • Dial by your location:  1 587 328 1099
      • Meeting ID: 980 6212 9635
      • Passcode: 884504
For more information about laboratory result release via portals:

2021-08-10

Leave of Absence Workflow Improvements

When admitted patients leave an inpatient setting with expectation of return, they enter a "leave of absence" (LOA) status. Special provisions may be needed, including for things like medications to be taken while on leave. 

A LOA navigator (usually found within the Discharge activity in Hyperspace) helps clinicians take care of everything needed for a LOA. This now has a new section, “LOA Orders for Procedures”, to be used to continue all required inpatient medications when sending a patient to another site for a procedure.

If medications are not required during transfer, then the only requirement is placing an LOA order for the procedure in the Orders section.

The Clinician Manual, with attached tip sheets, has been updated:

2021-07-30

AHS CMIO Portfolio Leadership

A big welcome to Dr. Jeremy Theal who assumes leadership of the Alberta Health Services (AHS) Chief Medical Information Officer (CMIO) portfolio next month!

From Dr. Francois Belanger, AHS Chief Medical Officer & Vice President Quality:


I am very pleased to announce Dr. Jeremy Theal will assume the role of Chief Medical Information Officer (CMIO) for AHS, effective August 30, 2021.

I would like to sincerely thank Dr. Stuart Rosser for providing interim coverage for the Chief Medical Information Officer role over the last year. His familiarity with the Connect Care design, build, and implementation provided the context and continuity, which were imperative to this transition period, and I am grateful for his leadership and support during this time. Dr. Rosser will continue to benefit the Connect Care Project and will return to his role of Physician Design Lead.   

The CMIO plays a key part in the AHS senior leadership team. Reporting directly to the Vice President Quality & Chief Medical Officer of AHS and forming a triad with the Chief Information Officer (CIO), and the Senior Program Officer – Connect Care, the CMIO co-leads the development of a steady-state clinical IT and informatics strategy, as well as represent and communicate project and operational issues to clinical business leaders and clinicians within AHS, all while promoting clinical improvement and innovation. The CMIO directs and oversees engagement of physician communities in the five AHS zones, building awareness and opportunities for meaningful physician CIS adoption.

Dr. Theal graduated from the University of Toronto, Faculty of Medicine in 1999 in addition to completing an internship in Clinical Informatics at the Harvard Medical School during the summer of 1998. In 2003, Dr. Theal completed his Fellowship in Internal Medicine followed by a Fujisawa Fellowship in Hepatobiliary Disease and ERCP in 2005, an AstraZeneca Fellowship in Endoscopic Ultrasound in 2005 and a Fellowship in Gastroenterology in 2006. Dr. Theal is currently Staff Gastroenterologist at the North York General Hospital in Toronto, Ontario since 2006.  

Over the past 15 years, Dr. Theal has held several key health informatics leadership roles at the hospital, provincial and national level. As the Chief Medical Information Officer at North York General Hospital, he was the physician lead of a multi-award winning clinical information system implementation that built evidence into daily care workflows and significantly reduced inpatient mortality. He founded and led the innovative Clinical Systems Benefits and Adoption Team, which was funded by the Ontario Ministry of Health and provided peer-to-peer coaching in clinical systems implementation to over 80 hospitals across Ontario, resulting in reduced project costs and improved system outcomes. At Canada Health Infoway, he led several projects including the Canadian CPOE Toolkit, a digital network that freely shared a library of over 1,500 evidence-based electronic order sets among publicly-funded hospitals and long-term care facilities nationwide. For his efforts in improving patient care with clinical systems, Dr. Theal received the Ontario Minister's Medal Honouring Excellence in Health Quality and Safety. In 2020, he completed a one year program in Safety, Quality, Informatics and Leadership at Harvard.

Dr. Theal is an experienced physician leader with proven results in transforming care at an organizational, provincial and national level through design, implementation and data-driven improvement of clinical information systems. This previous experience combined with his passion for improving quality and safety of care will bring a wealth of experience and knowledge to Alberta Health Services in his role as Chief Medical Information Officer.  

Please join me in giving a warm welcome to Dr. Theal in his new role.  

2021-07-22

Connect Care 180-Day Inactive Access Account Disabling

As of July 22, 2021, the Alberta Health Services Identity & Access Management (AHS IAM) team activates an anticipated security practice for Connect Care. In short, Connect Care user accounts that are not accessed for 180 consecutive days will be inactivated. Users with inactive accounts will not be able to log in to Connect Care.   

  • Anyone at risk of Connect Care account inactivation (no log ins for 150 days) will be sent automated email notifications from “Identity Management”, the AHS IAM system.
    • Email notifications are sent both to the user and to the user's "Authorized Approver" (manager), with repeat notices 30, 15 and 2 days prior to the inactivation date. 
    • Email notifications identify the upcoming inactivation date and actions that can be taken to maintain access.
    • Prescribers may also receive additional email notifications from Provincial Medical Affairs.
  • If the Connect Care user fails to log in despite warnings, the account will be switched to inactive status on the previously identified inactivation date. 
  • Inactive accounts can be reactivated if and when users return to active clinical work in Connect Care settings. Managers will work with the affected end user to determine the best pathway to renewed Connect Care access, including any training or other remediation that may be required.  

The previously described inactive user protocol comes into force Tuesday, August 24, 2021. The process helps ensure that Connect Care users remain available for system alerts, information about new or changed features, and important clinical notifications. 

Managers may want to attend Zoom Virtual Office Hours (to be recorded) to explore their role and the inactivation protocol in more detail:  

This inactivation protocol applies to all AHS employees, members of the medical and midwifery teams, students, volunteers, and other persons acting on behalf of AHS (including contracted service providers).

More information: