For our AI and Voice Recognition Enthusiasts

Reposting from Microsoft's AI Blog, there continue to be exciting developments with voice activated virtual-assistance and intelligent processing of clinical speech and dictation.

We are taking a great first step in moving from dictaphones to Dragon Medical One. We know that Epic will release its "Hey Epic" voice assistant for mobility soon. And we have hope of semantic reporting markup of narrative dictations within a few years.

For those interested:
Thanks to Steven Zachary for this posting.


Identity and Access Management Portal Downtime

An Alberta Netcare Portal (ANP) planned downtime for October 17 evening will impact the Identity & Access Management (IAM) portal for some hours between 2030 on 2019-10-17 and 0100 on 2019-10-18.

During this time, IAM will not be available for capturing network access requests, remote network access requests of updates to AHS users' information profiles. This is important because we've recently posted about use of IAM to check and correct physician information.


Launch Command Structure and Issue Intake Processes

Command Structure (how we are organized to help our users and organizations through the launch process), user supports and issue intake processes are hot topics right now. Most informaticians are involved in one way or another. Many of us seek specifics to help us plan our days in the critical launch window.

The implementation team has produced an excellent presentation that covers all we need to know about the Command Structure and Intake Processes. This continues to evolve, so best to use this link to the latest version, strongly recommended for all informaticians to peruse:


Connect Care Training Progress - and Needs

We continue at peak Training activity while rushing to ensure that physicians are prepared for Wave 1 launch 3 weeks from now.

There are notable accomplishments:
  • 89% of ~3,225 Wave 1 prescribers (physicians, residents, nurse practitioners, etc.) are registered for basic and personalization training.
  • 83% (2,753) have completed basic training and 35% have confirmed proficiency assessment completion (we are aware of many that are complete but not yet credited).
  • 15% of prescribers have already completed personalization training.
  • All medical learners have completed basic training.
  • 54 Area Trainers and 194 Super Users deliver on our commitment to have prescribers train prescribers.
We need help from the medical informatician community with some remaining gaps (please contact ConnectCare.PhysicianTraining@ahs.ca with suggestions):
  • Still looking for Area Trainers in Addiction & Mental Health (1), Inpatient Admitting (5).
  • Still looking for more Super Users in Addiction & Mental Health (11), Cardiology (1), Surgery (5)
A huge thanks to all the training team and all the prescribers who have been generously contributing at odd, and very long, hours.


Demos - Protecting Intellectual Property

Some of our medical informatics leads are producing excellent demonstration videos; a great way to share Connect Care tips with colleagues. These are especially useful when specialty build is not covered in Basic Training or Personalization Workshops.

The CMIO portfolio is eager to support those who wish to contribute in this way. A secure and approved video repository is available at demos.connect-care.ca. The demonstrations stored there can be linked and highlighted other locations and documents. The important thing is that the videos are protected. They cannot be seen without a valid Connect Care userid and password.

Privacy and Property Protection Reminders:

  1. Never make recordings of Production environments. The risk of inadvertently exposing personal health information is high.
  2. Never post demonstrations outside the tools provided by CMIO or Connect Care. Physicians must ONLY use demos.connect-care.ca. At this point, no other posting venue is approved.
Connect Care is committed to protect Epic intellectual property. The CMIO demos site is approved by Epic. Assume that nothing else is approved unless documented in a formal record of understanding with both AHS and Epic.

How to Post Demonstration Videos:

There are some simple tricks to producing demos that are dimensioned and compressed to be useful to most users. The CMIO portfolio arranges short sessions with interested authors to share video editing tips and secure upload process. Committed physicians can become editors on the demonstration site. Get in touch with cmio@ahs.ca


Living Through Go-Live - the Vanderbilt Experience

Vanderbilt University Medical Centre went live in 2017, and took the trouble to capture a fabulous video record of their launch experience. This was a large implementation, with many parallels to ours.

The 10 minute video is visceral. Well worth watching! You'll need to use your Epic UserWeb logon credentials.


First Looks: Serious Adverse Drug Reaction Reporting

The Protecting Canadians from Unsafe Drugs Act, also known as Vanessa's Law, strengthen's Health Canada's ability to collect information and take action when serious health risks are discovered in association with medications. All Canadian health care facilities must implement reporting processes later this year; indeed Alberta Health Services has to have reporting capacity in place the same month as Connect Care's first launch in the Edmonton Zone.

Epic has worked with AHS to develop an embedded serious adverse drug reaction reporting workflow that can work for all Canadian clients. This is ready for a first look, but will continue to be enhanced:


First Looks: Pharmacy Information Network integration

The Alberta Pharmacy Information Network (PIN) offers a fairly complete record of medications that may have been dispensed for a patient from an outpatient pharmacy. The dispensing information is not the same as prescribing (intended) or complying (actually taking) medication lists. It is most accurate for persons over age 65 who are Alberta residents. Still, PIN can be a valuable source of information when doing medication reconciliation.

Connect Care has an interface to the PIN dataset. It is possible to see and review medications that have been dispensed. It is particularly useful to be able to select from those to initiate a patient's medication history during admission or new outpatient review.

A short demonstration shows how PIN information can appear and be reconciled.


Area Trainer Opportunities for Waves 2 and 3

Connect Care will launch at several Calgary and Central zone sites in May 2020, and it is time to get ready!

There are opportunities for new physician Area Trainers, a role that has proven exciting and rewarding to physicians who currently help with Wave 1 preparations. Area Trainers deliver Connect Care training while also promoting transformation and clinical improvement at launch.

We've previously posted about Physician Area Trainers. Interested clinicians benefit from exceptional clinical information system orientation and change management coaching. Stipend-supported, Area Trainers can use the role to supplement their usual clinical activities, play a pivotal role at Connect Care launch and positively impact health care in Alberta. Area Trainers are critical to the success of Connect Care, and will champion the initiative in their teams.  There will be an opportunity to extend the role to subsequent waves of Connect Care in the zone.

For more information:


Key Messages as Launch Looms

As we near the launch of Connect Care in November, interest across the organization is growing. So too is general anxiety about how the launch and transition will go. All clinical informatics protagonists have a role to play in supporting clear messaging about what to expect during and after launch:
  • Together, we’ve been building a much-needed bridge between information, healthcare teams and patients. Thanks to your efforts, patients will be able to access to their AHS medical records through Connect Care’s patient portal, while all healthcare providers across AHS will have a central access point to up-to-date patient information.
  • Connect Care is all about improving patients outcomes and experiences. It provides common decision-making support for clinicians to ensure all our physicians and frontline staff have access to the same clinical standards and best healthcare practices. 
  • Connect Care is complex and so is its rollout. There will be thousands of issues as we transition – some will be urgent; some not. We have plans and supports in place to address these issues and ensure they don’t affect the high-quality care we provide to patients. At the same time, we know there will also be hundreds of thousands of things that go better than expected.  
  • Putting Connect Care in place will take time. We need to be ok with this. Resolution times for issues will vary. Sometimes solutions will require multiple steps and, in the end, won’t be perfect. We will get to where we need to be over the weeks and months ahead. 
  • Stay positive for your teams and our patients. Even in our most frustrating moments, we need to encourage each other and never share our frustrations with our patients. 


Connect Care Mobility Compact - Feedback Requested

Clinicians are free to bring and use personal devices in clinical settings. However, mobile devices also leave clinical settings and are vulnerable to loss, theft, hacking or eavesdropping. Accordingly, while Connect Care Mobility can be convenient for clinicians, it also exposes them and their patients to some extraordinary risks. Ensuring that mobile clinical applications are properly secured relates to Connect Care Mobility Management, as explained in:
Ensuring that mobile applications are used responsibly is a matter of professionalism, commitment and good habit. A "compact" is a clear statement of reciprocal expectations and accountabilities between two groups. Typically short and simple, it can be easier to action than complex legal terms and conditions. The Connect Care Mobility Compact summarizes rights and responsibilities related to health information sharing:
All clinicians who install and use Connect Care Mobility must abide by the Mobility Compact. The current version has been reviewed by a number of stakeholders. We would be most grateful for any additional feedback or suggestions from clinician informaticians.


First Looks: Connect Care Portals Interface Progress

Although the Connect Care patient and provider portals have been in working order for some time now, recent configuration has focused on look-and-feel, including colour schemes and branding that reflects the Connect Care identity.

The Connect Care patient portal should be referred to as "MyAHS Connect" going forward. The Connect Care Provider Portal retains its original name.

More "branding" continues. However, the portals are taking shape and worth a quick, interim, look.

Both demonstrations require an AHS network username and password:


First Looks: Launch Netcare from Connect Care Provider Portal

Physicians who do not use Connect Care can better support their patients by having access to important clinical information managed where Connect Care is the record of care. The Connect Care Provider Portal makes this possible. It complements, not replaces, Alberta's Netcare electronic health record.

It can help to work with both resources, Connect Care and Netcare, when reviewing information that may not be stored in a physician's independent electronic medical record. This is facilitated by being able to launch Netcare (in context, single-sign-on) to the correct patient record when reviewing the corresponding Connect Care record in the provider portal.

A very short demonstration shows how the function works (fictional patient and so no masking).


First Looks: Launch eCLINICIAN from Connect Care

Access to the eCLINICIAN outpatient Electronic Medical Record will be important for Connect Care clinicians in the Edmonton Zone who transition from eCLINICIAN to the Connect Care clinical information system (CIS).

Essential clinical information will transfer from the EMR to CIS as a result of data conversion. However, some information types (such as media manager attachments) do not transfer. If these are needed, in-context launch of the eCLINICIAN Link portal is supported within the CIS patient record.

This function will not be available in pre-production environments, as it depends upon a real patient identifier. A very short demonstration shows how the function works (with appropriate masking).


First looks: Launch Netcare from Connect Care

Our medical informatics community has been eager to see this for some time! Access to the Alberta Netcare Portal (ANP) will be important for Connect Care clinicians, as there remains a wealth of clinical information in the provincial Electronic Health Record (EHR) for years to come.

ANP can be accessed from any chart opened within the Connect Care clinical information system (CIS) by an authorized provider. Although the final details of the user experience continue to be tweaked, the basic idea can be appreciated from a short demonstration video, linked below.

Note that the launch is "single-sign-on" in that the user is not challenged to re-enter logon credentials. The launch is also "in context" because the correct patient chart is loaded and viewed in an activity tab within the open Connect Care chart.

This function will not be available in pre-production environments, as it depends upon an authorized provider ID and a shared patient identifier. Still, coming soon!


Supporting Medical Support Staff

Medical informaticians working to advance Connect Care may be aware of some physician concern about whether their office support staff will be able to continue to do things like surgical case bookings once the clinical information system deploys. Many are not AHS employees. Please see and promote the following messaging about support for support staff.
Access to and use of the Connect Care clinical information system (CIS) is supported wherever, whenever and for whomever Connect Care is the record of care.

Many physicians will serve where Connect Care is the record of care but Alberta Health Services (AHS) is not the provider of care. Some of these physicians work through partner or affiliate organizations and others are members of independent practices or networks.

By now, all Wave 1 physicians should know that they need to join the Connect Care community. Some, however, are concerned about how those who support them will be supported. Medical Office Assistant (MOA) activities include things like facilitating clinical communications, patient preparation, case scheduling and other informational tasks. The activities vary by clinic and specialty.

Just like the physicians they support, MOAs need to register for the training tracks that fit their work. This happens automatically for AHS support staff. The process can be more confusing for support staff working with independent health service organizations or private practices.

Medical Affairs has tried to identify all MOAs who need to be supported for the Wave 1 launch of the Connect Care CIS. All physicians registered for Wave 1 should ensure that all of their MOAs needing CIS access are identified to Medical Affairs, have their job tasks defined, and are allocated to appropriate training tracks.  If in doubt, contact Josephine Amelio (medical affairs) as a matter of urgency.


Medical Informatics Leads - Weekly Highlights

With so much happening so quickly, communicating the right messages to the right people at the right time is even more difficult. We've heard from physician leaders that periodic lists suggested highlight topics could help.

Medical informaticians can continue to find source materials in the physician community blogs. We'll also post weekly about possible theme topics to include in facility and specialty focused communications.

Of interest to the medical informatics community this week:


Connect Care Implementation Timeline Updated

As announced in the general Connect Care physician blog, a decision has been finalized to merge Waves 2 and 3 of our implementation timeline.

The rationale was explained. There are many benefits but also, of course, some logistical challenges to work out.
  • Less travel in difficult winter conditions
  • More post-launch optimization and build
  • More options for training
Medical informaticians may find updated timeline infographics helpful when communicating. Overall project deployment is unchanged.


Update: Reporting Validation Problems

A prior posting about reporting user interface issues still pertains.

Participating informaticians and physicians should work with validation support teams to ensure that design validations, issues, enhancements and requests are recorded in the Connect Care Tracker.

A Connect Care Solution Centre will soon allow all help, bug, suggestion, request and feedback communications to flow through standardized email, telephone, peer and drop-in intake channels. Until then, please continue to send bug reports and interface tweaks to:
Connect Care users can also use the fixes email to report problems until the solution centre becomes available. They can also use monitored email addresses to submit feedback about clinical content (documentation, decision and inquiry supports):
A very simple norm can make it easier to triage reports based on the email subject line, as explained in a resource for Connect Care users:


Patient Movement Day Info for Wave 1 Medical Informatics Leads

A head's up for our clinical informaticians, especially those most affected by Wave 1: Patient Movement Day (PMD) occurs this coming Wednesday September 18, 2019 and is an important readiness event.

The PMD demonstrations in the morning may not cover new ground for folks already trained in things like admission navigators and transfer orders. However, the afternoon demonstrations could benefit from more physician resources. These are important workflows to review and we can help answer questions from participants.

Lots of information, including schedules, has been posted to the general interest Connect Care blog (Bytes) and can be pulled with this link: