2020-12-22

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

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

Expected changes are postponed to April 1, 2021.

Clinicians who record and submit professional billings through Connect Care need not make any changes at this time.
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2020-12-21

All User Bulletin - Change to Secure Chat Message Persistence

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

Change to Secure Chat Message Persistence

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

To date, messages have been allowed to accrue indefinitely. This presents some users with large message collections. From January 14, 2021, messages older than 30 days will be automatically purged, even if part of a multi-message string. This is appropriate since messages are meant to support short-term communications that do not need to be part of the record of care. Once a message is purged, it cannot be recovered. 
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2020-12-13

COVID-19 and Connect Care - New Resources for Prescribers

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

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

A new section of the Connect Care Manual organizes tips and guides to match COVID-19 workflows (with frequent additions), and a new series of "Tippies" shares simple actions that speed workflows.
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2020-12-11

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:

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2020-12-10

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

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

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

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

  1. Edmonton Zone Medical Affairs is informed of the clinical assignment, confirming that privileges are in place, that training needs are clarified, Connect Care access is provisioned, and training instructions are provided: Edm.MedicalAffairs@ahs.ca.
  2. The provider's name is added to a training list and an appropriate pathway is provided for training and certification.
  3. Providers new to Connect Care will be contacted by the Edmonton Zone ACMIO team (cmio.ez@ahs.ca) to arrange virtual training.
  4. Prescribers who already have Connect Care training, and need to cross-train in another track, can access relevant Independent Learning on MyLearningLink by searching for "Independent". For example, those needing the inpatient tract would:
    • Search using "Independent" under "Courses & Registration". 
    • Look for "Epic-CMIO Inpatient Admitting Consulting Independent Learning".
    • Use the "Register" button to access the course.
    • Course elements can be completed at the user's pace and in multiple sittings.
  5. Independent learning is currently available for Critical Care, Inpatient, Emergency, Anesthesia, Pediatrics, Addictions and Mental Health, Ambulatory and Personalization.
  6. Further help with just-in-time training is available via help.cmio@ahs.ca.
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2020-12-08

COVID-19 and Connect Care - Mobile Device Advantage

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

In any case, it is important to be reminded about how to clean personal devices.
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2020-12-06

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

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

In Basket Change to "Not My Results" QuickAction

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

This workflow has been simplified. Previously there were options for "Not My Patient" and "Not My Result". The former is removed. The latter is enhanced with default response text that allows the recipient to quickly indicate why the test might have been misdirected and what action, if any, has been taken.
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2020-12-05

COVID-19 and Connect Care - Capacity Prediction

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

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

We have updated a shortlist of the best of these in the Connect Care Manual:
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2020-12-04

Trainee Bulletin - Change to Supervising Provider Workflow

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

Selecting a Supervising Prescriber no longer required at Login

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

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

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

The default assignment of an authorizing provider will work most of the time. However, it is important to know how to select an alternate authorizing provider if the default does not fit a specific patient interaction.
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2020-12-03

COVID-19 and Connect Care - New Posting Series

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

We resume frequent postings about tips and guidance for optimal use of Connect Care in the pandemic. These can be viewed together by using the COVID category in any of our blogging channels (see left column). A new link, covid.connect-care.ca, lists all the general Connect Care updates that relate to COVID care and is easy to bookmark.
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2020-12-02

Seasons Greetings from the Connect Care Team

 


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2020-12-01

All User Bulletin - Ordering Audiology Consults

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

Ordering Audiology Consults

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

Entering "hearing" or "audiology" as term in the Order Search will bring up the consult or referral order options. 
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2020-11-30

All User Bulletin - Consulting for Interventional Neuroradiology Procedures

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

Consulting for Interventional Neuroradiology Procedures

A number of interventional neuroradiology procedures that were previously directly orderable by any prescriber are now ordered specifically by responsible radiologists. The appropriate ordering pathway is to request an interventional radiology referral or consultation. The diagnostic imaging team then confirms the best approach to address the clinical need while taking care of both orders and scheduling.  

Going forward, physicians seeking interventional neuroradiology exams should place a “Consult to Interventional Radiology” order for inpatients or an “Ambulatory Referral to Interventional Radiology” order for outpatients. This includes therapeutic stroke interventions and the following procedures:

  • IR Aneurysm Coiling 
  • IR Carotid Balloon Test Occlusion
  • IR Intracranial AVM Embolization
  • IR Head Neck Embolization
  • IR Spinal AVM Embolization
  • IR Intracranial Tumor Embolization
  • IR Spinal Tumor Embolization
  • IR Extracranial Stent Placement w Angioplasty
  • IR Intracranial Angioplasty
  • IR Intracranial Clot Retrieval
  • IR Epistaxis Embolization
  • IR Kyphoplasty One Level
  • IR Kyphoplasty Two or More Levels
  • IR Vertebroplasty
  • IR Vessel Occlusion Permanent
  • IR Nerve Root Ablation
The above orders are now treated as synonyms for IR Consult/Referral, which is the suggested order that will appear when searching.

As with all time-sensitive referrals and consultations, it is important to phone interventional radiology at the intended site to share details about the case, the clinical need and urgency considerations.

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2020-11-29

COVID-19 and Connect Care - COVID-19 and Respiratory Pathogen Testing for Inpatients

Alberta's laboratory medicine services continue spectacular work addressing extraordinary demands associated with the COVID-19 pandemic in its second wave. Strategic decisions are made to ensure that resources are focused on the most efficient way to help physicians diagnose patients presenting with infection-related respiratory symptoms.

Effective December 1, 2020, the COVID-19 and respiratory virus testing algorithm changes to improve test utilization in emergency room and inpatient settings. Key developments include:
  • Throat Swabs - Lack sensitivity for detecting non-COVID-19 respiratory viruses, and so will only be processed for COVID-19.
  • Nasopharyngeal (NP) Specimens - Can be tested for COVID-19 and other respiratory viruses.
  • Influenza Like Illness (ILI) NPs - For ED and inpatients, can be tested for COVID-19, influenza and RSV.
  • Full Respiratory Panel (RPP) - Testing should be restricted to patients presenting with ILI and immunocompromised, critical respiratory failure, flaccid paralysis, myocarditis or pericarditis; or for outbreak investigations under the direction of Public Health or Infection Prevention and Control (IPC).
  • Bulletin: COVID-19 and other respiratory virus testing changes
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2020-11-28

COVID-19 and Connect Care - Clinical Content

Clinical information systems (CIS) "content" includes standards (terminologies, lists, etc.), documentation tools (templates, flowsheets, automations, etc.), decision supports (references, advisories, order sets, etc.) and inquiry supports (performance indicators, quality measures, etc.), all designed to support best possible health services.

Connect Care clinical system design (CSD) has been drafting, building and implementing a wide range of clinical content to help clinicians care for patients with COVID-19 illness. We've previously posted about the release and revision of this content.

The burden of COVID-19 on the health care system increases as we struggle with a second wave of infections. The Connect Care updates will give priority to clinical content news, with practical guidance for Connect Care users about how best to use the CIS to reduce information burdens.

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2020-11-27

COVID-19 and Connect Care - Updates

With rapidly increasing COVID-19 cases, hospitalizations and intensive care admissions, this is a good time to refresh awareness about how Connect Care can make it easier to care for COVID-19 patients.

We will use this blogging channel (blogs.connect-care.ca - please consider subscribing) to update advice from earlier in the pandemic, while adding pointers about subsequent clinical information system (CIS) enhancements.

Connect Care prescribers can also review updates and resources using one or more of the following blogging channel themes. The Connect Care Manual remains a good single starting point, as it provides overviews with links to more detailed information:

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2020-11-26

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:

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2020-11-21

Practical Paranoia - Pandemic Phishing on the Rise

Hospitals are prime targets for cyberattacks and this is especially true during COVID-19. The consequences not only disrupt patient care but can be lethal. 


Hackers use phishing emails to trick healthcare workers into downloading ransomware, a type of malicious software that attacks computer systems when an infected link or attachment is opened. The ransomware logs out users and shuts off access to critical information until a "ransom" is paid by the organization.
 
Some recent examples:
  • Outpatient appointments were postponed in Quebec due to a recent cyberattack targeting health board members.
  • A recent ransomware attack in Germany meant that a patient had to be rerouted to a hospital 20 km farther away, delaying care and likely contributing to her death. 
  • An early morning cyberattack at Universal Health Services’ US facilities disabled multiple antivirus programs, logged off users and shut down system access. Affected hospitals had to redirect ambulances and relocate patients in need of surgery to other nearby hospitals. Universal Health Services operates in both the US and UK and is similar in size to AHS with more than 400 facilities and more than 90,000 employees providing healthcare services to about 3.5 million patients annually. 
You can help stop these attacks. 
  • Take note of AHS’ external email warning message. 
  • Don’t open unsolicited email attachments or click on links. 
  • Always report suspicious emails using the "Report Phishing" button on Outlook or forward to stop.spam@ahs.ca, then delete.
Learn more about some of the common tricks cybercriminals use to access your information by viewing Don’t be fooled by Scammers and visit InfoCare on AHS Insite for information on all privacy and information security matters.
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2020-11-20

Connect Care Kudos

From our Chief Medical Officer...

Connect Care Kudos

Following the roll out of Wave 2 on October 23, there have been many messages of thanks to the teams. We’d like to share a few to recognize the teams and tremendous work that went into a successful implementation of Wave 2 Connect Care.
 
Thank You Wave 2 Users: To the new Wave 2 Connect Care users, ​we want to thank you for all that you have done for this successful rollout of Wave 2. As part of this launch, you and your colleagues helped us achieve a 4/5 rating from Epic on the Wave 2 implementation. Under normal conditions this would be an extremely great achievement, never mind doing it under the current circumstances. Keep up the good work. ~ ​The AHS Board
 
Kudos to UAH Dialysis: I was a super user for Wave 1, and I must congratulate all individuals on the dialysis unit at UAH that were involved with the implementation of Wave 2. Staff are functioning at a week three level; they are very confident in opening the chart of the outpatients on dialysis, they calmly navigate through the record when looking for patient information.
 
Lessons learned and recommendation from Wave 1 have been implemented. The patients were well aware of the changes that were occurring; it's obvious the changes were shared with them. Physicians were present to support the staff. The therapy plans are complete, it is evident the success is due to a lot of hard work from all staff involved. I have been very impressed with the calm atmosphere: a real collaborative atmosphere!
 
Congratulations and Thank You: A huge congratulations and thank you to all the staff who have worked so hard on preparing for the Wave 2 launch! The use of Connect Care will positively impact your clinical practice for years to come. The preparation efforts that you have all made while responding to the pandemic at the same time are so incredibly impressive. Thank you!
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2020-11-16

Timing and Sequence of Upcoming Connect Care Waves

A message from Dr. Verna Yiu and Dr. Laura McDougall:

With the successful launch of Connect Care’s second wave on October 24, we are starting to look ahead to our next launches. We know each launch of Connect Care involves thousands of people and hours of preparation. We want to acknowledge the efforts you are making to make Connect Care a reality in your waves, zones and sites, especially with the added pressures of COVID-19.  

Wave 3 will launch on February 27, 2021, at 5 a.m. Teams are heavily involved in training and preparation for that launch, which will take place at 38 locations, including acute and combined acute/long-term care sites across the Calgary and North zones, and urgent care sites in Calgary Zone. This wave also includes related pharmacy and diagnostic imaging services, and Alberta Precision Labs (North Zone sites only) associated with these programs and services. The details of which sites are launching in Wave 3 can be found here. 

Recently, the Connect Care Executive Committee approved the launch timing for Waves 4 and 5, as follows:

  • Wave 4 will launch Saturday, June 5, 2021, at 5 a.m. in Calgary and Edmonton Zones, including:
    • the Alberta Children’s Hospital, Peter Lougheed Hospital, Glenrose Rehabilitation Hospital, Lois Hole Hospital for Women, Royal Alexandra Hospital and many Addiction and Mental Health programs and services in the Edmonton Zone. 
    • It incorporates related clinical support programs, including pharmacy, diagnostic imaging services, Alberta Precision Labs associated with these programs and services (Edmonton Zone sites only, plus genetics labs at Alberta Children’s Hospital), Health Information Management, Nutrition and Food Services, and other support areas.  

  • Wave 5 will launch Sunday, November 7, 2021, at 4 a.m. in various locations in all five zones. Major sites include:
    • the Foothills Medical Centre, Richmond Road Diagnostic and Treatment Centre, acute and combined acute/long-term care sites in Central Zone, the Centennial Centre for Mental Health and Brain Injury in Ponoka, Sylvan Lake Advanced Ambulatory Care Centre, Cancer Care, Screen Test and Alberta Kidney Care (Central, Calgary and South zones). 
    • It also incorporates all of the related clinical support programs, including pharmacy, diagnostic imaging services, and Alberta Precision Labs (Central Zone sites only) associated with some of these programs and services, Health Information Management, Nutrition and Food Services, and other programs.

Connect Care remains one of AHS’ highest priorities. It will give patients and their healthcare team a more complete picture of their health history, improved access to consistent information on best practices, and other resources at their fingertips. It will facilitate communication between patients and their healthcare providers, and among members of the healthcare team. 

Connect Care is being introduced to all AHS programs, facilities and many AHS partners in phases, which started in 2019 and will continue through 2023. The full implementation timelines and sequencing are available, here. 

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2020-11-13

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:

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2020-11-12

Wave 2 Stabilizing

The Connect Care Wave 2 launch continues to stabilize after a remarkably smooth and collaborative transition. Most problems have been resolved and a few ongoing issues are explored by teams working to better match a few workflows to clinical information system capabilities.

As the comfort and experience of users increases, twice daily physician huddles have been reduced to twice weekly. Rapid-response clinical system design and other task groups remain active, but switching from daily to ad hoc meetings as required. Accordingly, our Support Update postings retire and we resume communications in all blogging channels for prescribers in all Waves. 

Renewed thanks to all Wave 2 teams for their incredible work and resourcefulness through the launch period!

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2020-11-05

Results and Reports Routing - Updated Information

Prescribers (including physicians, medical trainees, nurse practitioners, clinical assistants and other health care professionals) order laboratory tests, imaging and other diagnostic interventions in the course of health care. Results or reports related to these interventions are returned to the prescriber for consideration. 

The recent Wave 2 launch has added many prescribers who serve where Connect Care is the record of care as well as where Connect Care is not the record of care. Some new resources can help address questions about results routing in these mixed contexts:

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2020-11-04

Netcare - eDelivery Adjustments

Connect Care's Wave 2 launch has onboarded a number of physicians who manage "hybrid" health record experiences. Some work (e.g., inpatient or emergency) is at sites where the Connect Care clinical information system (CIS) is the record of care and other work (e.g., office visits) is at locations where an electronic medical record is used.

Results and report delivery considerations can be complex during transitional periods. All routable test results and reports for work at a Connect Care venue deliver to In Basket. If the physician has requested eDelivery to their external Electronic Medical Record (EMR), there may be duplicative results routing. There are strategies to manage this, which we will re-post in the coming days.

In addition to laboratory test results and diagnostic imaging reports, providers may receive eDelivery of "summative" reports relating to their patients. These include admission histories, inpatient consults, operative reports, discharge summaries, labour & delivery reports and emergency room reports. 

Some providers have also received eDelivered inpatient progress notes that they authored for their patients in Connect Care. The automated eDelivery of non-summative documentation has been halted. As of November 4, 2020, only summative inpatient Connect Care documentation is eDelivered to external EMRs.

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2020-11-02

Happy Birthday Connect Care!

A year ago today, we were biting nails in anticipation of Connect Care's first launch at Wave 1 sites. 


So much has happened since! Most importantly, the Connect Care community has continued to grow in numbers and capacity. These strengths have enabled a successful Wave 2 launch and, no doubt, many launches to come!

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2020-10-31

On Other Channels...

Thank you for continuing to check (... ideally, subscribe to multiple channels; see instructions) the Connect Care Update blog for prescribers. One week into Wave 2 launch, there are many recent additions to this blog and its various channels to note:

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2020-10-30

Thanks for a great Wave 2 start!

A message of thanks from our Connect Care Triad:



Barb Kathol, Senior Program Officer, Connect Care; Penny Rae, Chief Information Officer; Stuart Rosser, Interim Chief Medical Information Officer
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2020-10-28

All Prescriber Bulletin - Test Patients in PRD

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

Keep Play in the Sandbox!

Demonstration patients are provided in the Production (PRD) environment to facilitate prescriber personalizations pre-launch. It is very important to limit use of these charts.

Never sign an order, communication or other action when working with a test patient. Strictly limit use to prepping order or documentation favourites or preferences. All system personalizations can be done without the use of test charts.

If practice with signing workflows is needed, do so in the PLY (play sandbox) environment.
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MyAHS Connect (Patient Portal) Virtual Office Hours - November

We've previously posted about why this is the right time to promote Connect Care's patient portal, MyAHS Connect.

Although it is possible for physicians to initiate the patient activation process, it is bests for team members to collaborate taking advantage of every clinic or ER visit and every hospitalization. 

Clinics and wards working to improve patient participation in care can take advantage of virtual office hours focusing on portal activation processes:

Resources are available to help with clinic and team preparations, with current topics:
  • Activation workflows
  • Staff and provider roles in activation
  • Patient tasks and responsibilities
  • Proxy access processes
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2020-10-27

Reminder: Personalization Power

Personalization is important for successful CIS adoption. Many groups benefit from having a few members create and share more advanced personalizations. Multiple pathways to proficiency are available:

Personalization Guides and Tips

The personalization section of the Clinician Manual gives a quick overview of key personalization tasks, opportunities and links. A number of enhancements are made to the Personalization Tips subsection to provide layered and specialty-aware advice about how to grow personalization skills.

Personalization Independent Learning

An online self-directed course, available via MyLearningLink (search for courses using "CMIO Personalization" keyword), covers a number of high-value personalizations for prescribers.

Power Personalization Workshops

A series of workshops are offered to help Connect Care prescribers leverage the power of personalization. Anyone is welcome. The focus will be on some of the more advanced adjustments that can dramatically speed up workflows. 

Personalization workshops are offered through the CMIO Virtual Drop-in Centre, repeated four times in the coming week:

  • October 27, 2020, 17:00-19:00 
  • October 29, 2020, 17:00-19:00 
  • November 3, 2020, 17:00-19:00 
  • November 5, 2020, 17:00-19:00 
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Getting More From Your Dragon

"If you want to conquer the world, you best have dragons."
George R.R. Martin, A Dance with Dragons, Game of Thrones

Looking to be slicker and faster (and happier!) with "Dragon Medical One" (DMO)?

Connect Care's in-system dictation solution consistently proves to be a physician's best friend. Dragon users can document with ease and automate repetitive workflows.

All Connect Care prescribers (current and previous waves) are encouraged to benefit from a DMO optimization session. These go beyond the basics, teaching how to do more with custom commands, hotkey shortcuts and dictation-triggered SmartText. 

All DMO optimization sessions are delivered via Zoom. This makes sessions easy to attend, and multiple time slots are available to choose from. Registration is requested, as group sizes are limited for a better learning experience. To register:
  • Visit My Learning Link (MLL)
  • Search for courses using “DMO Optimization” keyword
  • Select a session from among the available dates and times
    • Location: Zoom
    • Duration: 1 hour
    • Dates: November 3, 4, 5, 10, 10, 12
    • Times: 0700-0800, 1200-1300, 1700-1800
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2020-10-25

Smooth Wave 2 Launch

A huge thanks to all who worked so well together to achieve an exceptionally smooth cutover from legacy systems (and paper!) to Connect Care at Wave 2 sites yesterday. Emergency, medical, surgical and obstetrical care have ramped up in the new system.

Launch occurred on time with clinical work progressing well at all Wave 2 sites. Indeed, ambulance diversions are ending.

Physician "huddles" occur twice a day. Any significant issues are rapidly characterized, assigned and sorted. Physicians can track this problem-solving through daily postings in the Support channel (support.connect-care.ca).  

All in all, a great launch!

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2020-10-24

Connect Care Wave 2 Launch - Support Hot Topics

New daily postings in the Support channel (support.connect-care.ca) flag high-priority needs raised in physicians huddles, usually with links to helpful solutions. 

A day's post can be updated many times as new needs emerge. Super Users and other prescriber supporters may want to subscribe to receive Support postings via email.

Also note that new "Tippies" appear daily in the Tips channel (tips.connect-care.ca).

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Wave 2: We are GO!

All interfaces and all other dependencies have cleared. We've launched on time at 0500!


Onward to better health, powered by information!

Today we welcome many colleagues to the Connect Care community, including Sturgeon Community Hospital, Fort Saskatchewan Hospital, Devon General Hospital, Leduc Community Hospital, Northeast Community Health Centre, Strathcona Community Hospital, Westview Health Centre, Gibbons Health Unit, Morinville Clinic Building, Redwater Health Centre, University of Alberta Hospital Dialysis, Plaza 124 Building, Seventh Street Plaza.

A welcome from our CEO:



Physicians, please make use of the drop-in centre and other launch supports (launchhelp.connect-care.ca). We have pulled in extra resources to deal with any access or role problems.
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2020-10-23

Introducing Wave 2

The Connect Care community is thrilled to welcome Wave 2 colleagues, who have excelled at getting ready for launch in the early hours of Saturday morning. Some facts to introduce the Wave 2 cohort...

Wave 2 launches at suburban sites in the Edmonton Zone:

  • Sturgeon Community Hospital
  • Fort Saskatchewan Hospital
  • Devon General Hospital
  • Leduc Community Hospital
  • Northeast Community Health Centre
  • Strathcona Community Hospital
  • Westview Health Centre

Other locations will have some partial launches:

  • Plaza 124 Building
  • Seventh Street Plaza
  • University of Alberta dialysis 

There are 4,875 staff and over 1,100 prescribers (physicians, nurse practitioners, physician assistants, and dentists):

  • 1,066 physicians
  • 33 nurse practitioners
  • 2 nurse practitioner students
  • 15 clinical assistants
  • 3 physician assistants

Other Wave 2 providers include:

  • 456 inpatient nurses
  • 319 rural nurses
  • 35 pharmacists
  • 75 respiratory therapists  
  • 23 midwives

With Waves 1 and 2 combined, there will be 27,000 staff and prescribers using Connect Care.

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2020-10-22

Extra Personalization Support

Personalization is important for successful CIS adoption. Many groups benefit from having a few members create and share more advanced personalizations. 

Connect Care Physician Builders offer focused support for prescriber personalization questions through the Virtual Drop-in Centre during the following times:

  • October 27, 2020, 17:00-19:00 
  • October 29, 2020, 17:00-19:00 
  • November 3, 2020, 17:00-19:00 
  • November 5, 2020, 17:00-19:00 

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On Other Channels...

Thank you for continuing to check (... ideally, subscribe to multiple channels; see instructions) the Connect Care Update blog for prescribers. On the eve of Wave 2 launch, there are many recent additions to this blog and its various channels to note:

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2020-10-21

Connect Care Wave 2 - Why Now?

Connect Care Wave 2 launches in just a few days. Site physicians new to Connect Care, as well as those shouldering re-directed work, may question the wisdom of adding informational stress to pandemic pressure. These concerns are taken seriously. The risks and benefits of clinical information system (CIS) launch are weighed, and re-weighed.

COVID Pressures

Unfortunately, pandemic pressures are unlikely to change anytime soon. Indeed, we will continue to adapt for years to come. 

One of our most effective adaptations is Connect Care. The CIS, where implemented, has enabled more flexible practice, safer workflows, better integration with laboratory and virtual health services, and rapid deployment of new guidelines and decision supports. The more sites we have on Connect Care, the smoother we transition COVID patients to the level and location of care they need. 

On balance, pandemic pressures are easier to manage on Connect Care than off (also a factor in launch decisions by other large sites). 

No Good Time

The lead up to a launch date is complex and effortful. Training, technology, people and processes are all readied and aligned. There are so many interdependencies that any launch deferral would be to a much later date, with no assurance that conditions would have improved by then. We are in a strong position now, with excellent Super User, leader, drop-in and other supports already in play. 

Site Success Is a Zone Accountability

Wave 2 sites do not work alone. They are surrounded by groups already using a stable and strong Connect Care CIS, sites that help shoulder launch burdens. Readiness includes zonal redirection and other supports integrated with pandemic emergency response planning. The time is right.

Weekend Launch

A weekend launch date is best because there are minimal ambulatory appointments or elective surgeries, and the inpatient census is easier to contain. Furthermore, fewer diagnostic tests are scheduled and inter-facility transfers for procedures are limited. 

Safety Valve

Connect Care has proven its value at our Wave 1 sites over the last year, where it has stabilized and continually improved. Wave 2 sites will benefit from greater system maturity, and they will benefit even more from the accumulated experience of a large population of proficient users. 

We have great confidence in the leadership, staff and clinicians at all sites that will be implementing Connect Care, and expect that these will return to near-normal throughput sooner than imagined. 

That said, go-no-go decisions are revisited frequently... right up to the final launch hour. Wave 2 clinicians can trust that their CIS benefit/risk balance is a matter of constant, vigilant attention. Be sure to keep your leaders updated with any new developments or concerns.


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2020-10-20

Connect Care Wave 2 is On

 From Francois Belanger and Sean Chilton...

In just under one week, we will reach another very important milestone in healthcare in Alberta: Wave 2 of Connect Care is set to launch at 5:00 a.m. on October 24 in the Edmonton Zone. We know that you have all been involved in months and even years of preparation to bring us to this point on the Connect Care journey.
 
Our patients have been our focus every step of the way. Connect Care will transform how patient information flows between patients and their healthcare providers, eventually creating a central access point for current and accurate patient information across AHS. The whole healthcare team, including patients, will have the best possible information throughout their care journey.
 
We’ve prepared a video message to thank Wave 2 teams for all you have done at your sites and programs to get ready to launch. You are changing healthcare for Albertans and you should be proud of all you have accomplished, even before we launch.
 


We know that with increased pressure from the pandemic and our ongoing daily work challenges, this has been an intense process. We also know that launching will result in new issues that we will need to work through. We are prepared for this and have ensured that throughout the launch period, Wave 2 teams will have resources and supports available in-person and virtually.
 
We also want to share a documentary video about our Wave 1 launch, which happened almost one year ago. The video captured the experience of the actual launch, as well as a look at the months after Connect Care was put in place. It will give you a sense of the challenges and successes that are part of this massive undertaking. Thank you to our Wave 1 teams for paving the way.
 
If you have questions, or need support, please visit Connect Care launch support – there are resources there to help you.
 
Once again, we want to thank everyone, and especially our Connect Care teams, for your commitment to healthcare in this province. Thank you for your collaboration and support of one another. Thank you for your amazing work to make Connect Care a reality in Wave 2.
 
The countdown is on!
 
Dr. Francois Belanger
Chief Medical Officer
Executive Co-sponsor of Connect Care
 
Sean Chilton
Vice President Health Professions and Practice and Information Technology
Executive Co-sponsor of Connect Care
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2020-10-19

Connect Care - A Year In

Alberta Health Services (AHS) continues to "Connect Care" for patients and families through a continuum of care clinical information system enabling better health powered by information.

The following documentary shares highlights from Connect Care's first launch, November 3, 2019, at Wave 1 sites about a year ago:


Even with a pandemic surge, we are stronger moving into our second wave launch. Good to remember where we've been!

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2020-10-16

Connect Care Wave 2 Launch - Panel Discussion

Alberta Health Services (AHS) continues to "Connect Care" for patients and families through a continuum of care clinical information system enabling better health powered by information.

This "Conversations with Yiu" video discusses preparations and readiness for the second Connect Care launch wave:


Panelists include:

  • Heather Durstling, Executive Director, Suburban Hospitals Edmonton Zone
  • Judith Hockney, Senior Operating Officer, Royal Alexandra Hospital, Lois Hole Hospital for Women and Sturgeon Community Hospitals
  • Barb Kathol, Senior Program Officer, Connect Care
  • Stuart Rosser, Interim Chief Medical Information Officer

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Clinical Inquiry Cases - Grand Rounds Oct 23, 2020

Connect Care Clinical Inquiry Clinics, now Clinical Inquiry Cases, explore user-submitted data report and visualization needs for match to in-system self-serve inquiry tools. The case analysis is shared, and participants can adapt resulting templates to their needs. The first "clinics" were offered as scheduled sessions, then continued as case consultations posted online via a clinical inquiry blog theme. 

Part of the clinical inquiry support initiative will be a medical grand rounds session October 23, 2020 from 0800-0900. All Edmonton Zone department of medicine members receive email invitations. Others who may want to join the Zoom session can request registration.

  • Title: Connecting Care with Inquiry
  • Time: October 23, 2020, 0800-0900
  • Venue: Zoom by invitation and registration
  • Objectives:
    • Recognize how the Connect Care clinical information system (CIS) can support clinical improvement.
    • Appreciate how the Clinical Information Sharing Approach (CISA) promotes CIS-enabled inquiry.
    • Consider how in-system clinical inquiry supports and services can facilitate personal and group improvement projects.
We continue to welcome suggestions for future inquiry case consultations:
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On Other Channels...

Thank you for continuing to check (... ideally, subscribe to multiple channels; see instructions) the Connect Care Update blog for prescribers. The pace of communications has picked up with the Wave 2 launch soon upon us, so we post more frequently about recent additions to this blog and its various channels:

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2020-10-15

Trillium Joins the Canadian Epic Family

We've previously posted about the growing number of Canadian health care enterprises adopting the Epic Systems Corporation software at the core of the Connect Care clinical information system. 

We've also appreciated a mutual share-and-support culture within the Canadian Epic collaborative, and the larger world-wide community. AHS learns from the guidance, tools (e.g., order sets) and processes of others and we energetically share-forward our assets and learnings.

Trillium Health Partners went live with their Epic-based system on October 10. We congratulate them and welcome them to the collaborative!

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2020-10-14

Connect Care Trainer Recognized for Mentorship

A big congratulations to Dr. Vanessa Maclean, Physician Design Lead and trainer extraordinaire for the Alberta Health Services (AHS) Chief Medical Information Officer (CMIO) training program, who has won the distinguished May Cohen Award for Women Mentors. Vanessa's accomplishments were recognized in last week's message to all AHS staff.

From Dr. Verna Yiu, AHS President and CEO, and Dr. Laura McDougall, AHS Senior Medical Officer of Health:

Former South Zone Medical Director Recognized for Mentoring

We’d like to congratulate longtime Lethbridge physician Dr. Vanessa Maclean - a former medical director in the South Zone of Alberta Health Services - for receiving the May Cohen Award for Women Mentors. The award is presented to a female physician and Canadian Medical Association member who has demonstrated outstanding mentoring. 
 
Starting as a family physician in Lethbridge in 1987, she later became an emergency department doctor, then medical director for the zone. Dr. Maclean retired from that position in 2016 but remains active in the medical community. 
 
As medical director, she kept an eye out for promising young physicians with big ideas, making sure they had a chance to be heard, and made herself available when they needed advice or support. In 2017, she conducted a review of the experience of female physician leaders in Alberta; it found women are under-represented in leadership positions in healthcare and encounter barriers to achieving those positions.
 
Today, Dr. Maclean’s work focuses primarily on the establishment of Connect Care, and she is still actively mentoring women and other emerging leaders.

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All Prescriber Bulletin - In Basket Notifications re Cancelled Tests

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

New In Basket Messages - Test Cancellations

Starting October 13, 2020, Connect Care prescribers receive In Basket notifications when some laboratory tests are cancelled; in both inpatient and outpatient care contexts. Cancellation notifications are suppressed when not clinically significant, as might happen when duplicate orders are detected and managed. Notifications are sent when testing cannot be performed because the needed specimen cannot be collected, the collected specimen is inadequate to purpose, or the test request is declined in compliance with guidelines.

Cancellation messages include links to the relevant patient chart and encounter, as well as details of the affected prescriber order.
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2020-10-13

All Prescriber Bulletin - New Inter-Facility Transfer Navigator

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

New Inter-facility Transfer Navigator

A new consolidated Inter-Facility Transfer (IFT) navigator appears in Connect Care starting October 13, 2020. This addresses concerns of both sending and receiving sites, improving the quality of communication and documentation. It will also be easier for transferring and receiving prescribers.

The prior "IFT to Connect Care Site" and "IFT to Non-Connect Care Site" navigators are combined to a single IFT navigator. This provides a consistent experience while guiding providers about the specific orders documentation required for different transfer scenarios. In particular, medication reconciliation and recommended orders are summarized in a standardized IFT Note for receiving non-Connect Care sites.

The new navigator has embedded instructions. Additional guidance is in the following Tips and Demos, which should be referred to the first few times that a prescriber uses the new IFT workflow:
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2020-10-12

Clinical Inquiry Clinics - Change of Pace

We've previously posted about this being a good time to explore Connect Care's metric, report, visualization, dashboard and other inquiry support tools. Excellent reporting training opportunities continue to be available via MyLearningLink.

Connect Care "Clinical Inquiry Clinics" explore user-submitted cases for match to in-system tools. Resources are provided, casework is shared, and participants can adapt resulting templates to their needs. The first three clinics were offered during at noon Tuesdays and Thursdays. These times have not proved practical for interested clinicians.

The "Clinics" will change to "Consultations". Instead of scheduled sessions, we will consider cases submitted through an online intake form. Consultations are accepted if available Connect Care tools can be used to advantage with available data. The work-up, interventions and outcomes are shared, together with templates and crib-sheets, to allow adaptation to similar needs experienced by others.
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2020-10-11

On Other Channels...

Thank you for continuing to check (... ideally, subscribe to; see right sidebar instructions) the Connect Care Update blog for prescribers. Some recent additions to this blog and its various channels:

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2020-10-09

Connect Care Champions

Thrilled to see one of the CMIO medical informatics education leads recognized for outstanding accomplishment!

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2020-10-08

Clinical Inquiry Case #3 - Recordings - Clinical Productivity

Those who cannot make the Connect Care Inquiry Clinics scheduled times can access related recordings:

Participants are encouraged to check the Manual section on Reporting Workbench for background information, additional tips, e-learnings and guides. 

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2020-10-07

MyAHS Connect (Patient Portal) Virtual Office Hours

We've previously posted about why this is the right time to promote Connect Care's patient portal, MyAHS Connect.

Although it is possible for physicians to initiate the patient activation process, it is bests for team members to collaborate taking advantage of every clinic or ER visit and every hospitalization. 

Clinics and wards working to improve patient participation in care can take advantage of virtual office hours focusing on portal activation processes:

Resources are available to help with clinic and team preparations, with current topics:
  • Activation workflows
  • Staff and provider roles in activation
  • Patient tasks and responsibilities
  • Proxy access processes

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2020-10-04

Connect Care Wave 3 Training Registration... NOW

Registration is now open for training of Wave 3 physicians, nurse practitioners, clinical assistants and other prescribers who are new to Connect Care and anticipating launch, February 27, 2021.

Email notifications have gone out from Calgary Zone and North Zone Medical Affairs to all affected physicians. Separate notifications have gone out from Advanced Practice Nursing. Prescribers are invited to register for training with instructions about how to do this through MyLearningLink  (mylearninglink.ahs.ca).

Prescriber training is offered in three modes:
  • In-classroom training (COVID prevention precautions in place)
  • Virtual training (via Zoom)
  • Online training through independent learning modules
The best mix is determined for each trainee, covering key Connect Care skills for the user's clinical context.  Super Users will fan out to assist with training while building relationships with the user groups they will support at launch.

Prescribers who expect but have not received a training invitation should contact:
For more information about Medical Staff training, please visit:
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2020-10-03

Clinical Inquiry Clinics - Case #3: Professional Productivity

We've previously posted about this being a good time to explore Connect Care's measure, report, visualization, dashboard and other inquiry support tools. Excellent reporting training opportunities continue to be available via MyLearningLink.

Connect Care Inquiry Clinics explore user-submitted cases, considering the best match of problem to in-system reporting, analytic or visualization tools. Resources are provided, casework is shared, and participants are encouraged to adapt learnings to their needs. Case referrals are accepted where available Connect Care tools can be used to advantage with data already available (rob.hayward@ahs.ca).

Inquiry Clinics occur approximately weekly via Zoom Thursdays at noon. We no longer support the Tuesday session as this did not fit well with participant schedules:
  • Thursday noon (12:00-13:00)
The third clinic is scheduled for October 8, 2020. This week's cases explore how to use Reporting Workbench ('My Reports') to generate lists reflecting clinical productivity. This sort of information can help inform physician annual reporting.
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2020-09-30

AHS eMail Migration - Check your Junk Mail

We've previously posted about migration of AHS email services to Outlook 365 for many Connect Care physicians.

A few months in, we are hearing surprise from some users checking their "Junk Email" folder to find a proportion of the content clearly not Junk.

Microsoft defines Junk as "...spam, which are unsolicited and universally unwanted messages (when identified correctly)". 

Office 365 servers use Microsoft's "Exchange Online Protection (EOP)" to spare us from phishing, spam and other inappropriate messages. In addition, machine learning is used to further filter messages that may be benign but unwanted.

It appears that the move to a new communications service has triggered some re-learning. 

What to do? Keep a closer eye on your Junk Email folder in Outlook 365, at least for the next few months. When a non-Junk message is found, either right-click and select "Mark as Not Junk" or use a different right-click command to add the sender to one's contacts. Outlook should not flag mail from contacts as junk (unless discovered to be malicious). Outlook will (re)learn and the false-positive rate should go down.

Junk Email settings are configured by AHS. It is not possible for users to opt-out through user preferences. This makes sense because EOP prevents hacking (especially phishing) as well as spam.
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2020-09-29

Clinical Inquiry Clinics - Case #2 Recordings

The Connect Care Inquiry Clinics continue Tuesday and Thursday at noon. Those who cannot make the scheduled times can access related recordings:

Participants are encouraged to check the Manual section on Reporting Workbench for background information, additional tips, e-learnings and guides. 

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2020-09-28

Connect Care Wave 2 Workflow Dress Rehearsals - Physician Participation

An important Wave 2 Connect Care readiness event is soon upon us. A series of "Workflow Dress Rehearsals" (WDR) occur between October 5-6 and 13-14 in outpatient and inpatient settings respectively.

Workflow Dress Rehearsals (WDR) provide clinicians with opportunity for hands-on practice using the Connect Care clinical information system (CIS) in simulated workflows. The current CIS build is exposed for testing in real clinical contexts, usually with the computers and devices that will be used at Wave 2 launch. Physicians, nurses, other clinicians, managers and the project team work together to identify any issues and find solutions pre-launch.

The WDR events (at each Wave 2 facility) promote end-user confidence, give teams a chance to check that workflows work as intended, demonstrate that end-users can successfully complete Connect Care and facilitate end-user understanding of downstream effects of their actions.

Physician participation (and help with demonstration) is very important!

For more information and to sign up for participation or observation (physician roles are listed in the schedules):
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2020-09-27

On Other Channels...

Thank you for continuing to check (... ideally, subscribe to; see right sidebar instructions) the Connect Care Update blog for prescribers. Some recent additions to this blog and other channels:

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2020-09-26

Clinical Inquiry Clinics - Case #2 - Patient Safety & Med Exposure

We've previously posted about this being a good time to explore Connect Care's measure, report, visualization, dashboard and other inquiry support tools. Excellent reporting training opportunities continue to be available via MyLearningLink.

Connect Care Inquiry Clinics explore user-submitted cases, considering the best match of problem to in-system reporting, analytic or visualization tools. Resources are provided, casework is shared, and participants are encouraged to adapt learnings to their needs. Case referrals are accepted where available Connect Care tools can be used to advantage with data already available (rob.hayward@ahs.ca).

Inquiry Clinics occur approximately weekly via Zoom and are repeated to accommodate participant schedules:
  • Tuesday noon (12:00-13:00)
  • Thursday noon (12:00-13:00) repeat
The second clinic is scheduled for September 29 and October 1, 2020. This week's cases explore how to use Reporting Workbench ('My Reports') for some example patient safety queries.
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