2021-10-20

Seeking Physician Design Lead – CMIO Training

Alberta Health Services (AHS) is seeking a passionate leader to fill the role of Physician Design Lead – Chief Medical Information Office (CMIO) Training (PDL). This is a leadership position that demands excellent communication skills, unwavering credibility among peers and experience with clinical operations. The successful candidate would report to the Chief Medical Information Officer and work closely with Clinical Operations and Information Technology partners. Accountabilities include clinical leadership, as well as the implementation and optimization of the provincial clinical information system with a specific focus on the CMIO Training program. 

The PDL will be an established physician within the province of Alberta who understands the complexities of undertaking transformational change, large-scale system integration and continuous quality improvement and innovation to deliver on a commitment to excellent performance.

The posting closes November 18, 2021. 

For more information and to apply:

2021-10-12

UVic Health Information Science Online Open House

The University of Victoria has a highly respected health information science department with an excellent track record supporting clinician career development through advanced training in health informatics at levels from certification through to Masters and PhD degrees. 

The Health Information Science faculty is holding an Open House on Thursday, November 4, 2021 at 17:30 Mountain Time (16:30 Pacific Time) online via Zoom (meeting ID: 899 0589 3451).
  
This is a wonderful opportunity to learn more about the rapidly expanding field of information technology in health care and the rewarding careers HINF graduates experience. 

2021-09-20

Clinical System Design Priorities During Connect Care Wave 4 Launch Pause

From the Connect Care triad (Penny Rae, Debbie Pinter, Jeremy Theal)...


As you know, Connect Care project work has temporarily paused to allow physicians and staff from all areas of AHS to support COVID-19 priorities.

AHS’s approach to Clinical System Design and Build is clinically lead. As Area Council members and our project teams are redeployed to meet COVID-19 priorities, the types of work that we can successfully complete will, by necessity, shift to reflect the availability of clinical and operational subject matter experts. 

Over the next several weeks, our Connect Care design and build teams will prioritize work as follows:

  1. COVID-19 – Teams will continue to prioritize SME time to design and build revised order sets, clinical guidance, decision supports and patient education materials in support of AHS’s COVID-19 response. Build teams will also manage the system changes needed for surge capacity.
  2. Urgent Request (Break Fix) Tickets – Teams will continue to address tickets across all specialties where the issue indicates a potential patient safety or care risk. In all cases, CSD and Build teams will obtain the best available clinical guidance to inform the solution, and will report back to Area Councils for oversight when regular meetings resume.
  3. Future Waves – Teams will continue to prepare for upcoming Waves by addressing design and build items that do not require clinical guidance or where clinical guidance has already been provided. Future Wave work also includes making sure that our analysts complete Epic recertification prior to Wave 4 launch.
  4. CSD Integration – Design and Build teams will work together to integrate design, content and build processes and tracking, including integration of research build processes.
  5. Continuous Improvement Requests – In limited circumstances and only where SME and project team capacity exists, teams may be able to consider design items for previously prioritized continuous improvement requests. If you believe that your Area Council has the capacity to continue this work, please reach out to your CSD Coordinator or Secretariat to discuss.  

We sincerely thank each of you and your committee/council members for your support of AHS’s COVID-19 response.  We know that this means that some anticipated work will be delayed; please rest assured that we remain committed to addressing CSD priorities and look forward to resuming this work with you once COVID-19 pressures ease.


2021-09-16

Documentation Quality Improvement - Progress Report #3

We've previously posted about the Documentation Quality Improvement (DQI) initiative. 

After a few months of testing among early-adopters, a number of fixes and improvements are released mid-September in a continued "soft launch" that makes new tools available to interested users without affecting pre-existing tools or workflows:

  • SmartTool Building Blocks
    • Some documentation building blocks (SmartLinks, SmartPhrases, SmartLists, etc.) used in problem-oriented charting tools have been further improved. In some cases, ways have been found to better format for more skimmable reports. In other cases, options have been added to make it easier for users to bypass documentation components that they do not need for a particular note. The end result is fewer clicks for the user and a faster workflow.
    • The new components, all prose-friendly and complying with common style guides and data formatting standards, are being listed in the Connect Care Manual for the benefit of users wanting to include them in personalized templates or text blocks. 
  • Data-Documentation Integration
    • Enhanced documentation templates and charting views now include more "precision links" to relevant charting tools. If, for example, one selects frailty assessment as part of transition-planning documentation, a link "hot spot" appears in the document draft to facilitate instant access to a pop-up for entering or updating frailty score information. 
  • Adaptable Charting Elements
    • More work has been done to support a "build-your-own-journey" approach to problem-oriented documentation. Templates include optional SmartLists that allow users to pull in the types of information, and level of detail, appropriate to their charting purpose. 
  • Dynamic Charting Elements
    • We have added and tested an ability to display customized summative documentation content when specific patient (e.g., age, health problems), provider (e.g., specialty) or context (e.g., outpatient, inpatient, emergency) conditions are met. The first application of this ability brings some disease management content into discharge summaries when patients are on specific care paths.
  • Hospital Course
    • An improved optional starter text block for the hospital course is implemented with SmartForm support allowing the same data elements to be pulled into appropriate parts of  consult, discharge, operative and transfer summaries.
  • Problem Overviews
    • Support is added for using standardized problem overview elements, with SmartForm support for reusing the data in other documentation objects.
    • Support is added for dynamic problem overviews that bring unique content in for common chronic illnesses.
  • COVID-19 Status
    • A new COVID-19 status text block is included in many templates, bringing swab, serology, immunization and self-reported immunization information together in one place.
  • Sidebar Support
    • The problem-oriented charting sidebar for inpatients has been improved to include more hotspots for rapid updating of structured chart data.
  • Summative Documentation Templates - Instant Access
    • A phase I deliverable for the DQI initiative is a set of summative documentation templates (History & PhysicalConsultDischarge  SummaryTransfer SummaryDeceased Summary, Operative Note).
    • Previously, users would need to know the correct SmartPhrase or SmartText name to use these templates to initiate a summative document. Now, the document types, preloaded with the intended templates, can be initiated with a mouse click from the POC sidebar or the general inpatient sidebar.
  • Next Steps
    • These and other enhancements are implemented in the second week of September, with DQI soft-launch proceeding in the third week.

2021-09-14

Seeking Connect Care Core Trainers

Alberta Health Services (AHS) is seeking Connect Care champions with demonstrated leadership in clinical informatics to fill multiple Connect Care Core Trainer positions, a new role within the Chief Medical Information Office (CMIO). These clinicians will support their colleagues in safe and acceptable Connect Care use, while promoting transformation and clinical improvement. They must be quick to learn how to deliver personalized training materials to suit specific clinical or work contexts, and fluent in delivering classroom and/or virtual training for prescribers, including basic training, personalization and optimization, at a minimum of twice per month.

AHS will be taking applications for multiple positions representing the following Connect Care Training Tracks:

  • Ambulatory
  • AMH
  • Anesthesia
  • Cardiology
  • Critical Care – NICU
  • Critical Care – Peds
  • Emergency Medicine
  • Inpatient Admitting
  • Lumens
  • MOU/Medical Outpatient
  • Obstetrics and Gynecology
  • Oncology – Medical/Supplemental
  • Pathology – Anatomical/Clinical
  • Pediatrics
  • Rural Medicine
  • Surgery

Previous Area Trainer experience during a Connect Care launch wave is required, and the candidate must be eligible for Licensure with the College of Physicians and Surgeons of Alberta.

The posting closes September 30, 2021. 

For more information and to apply: 

2021-09-08

Connect Care Clinical System Design Toolkit Now Available

The “Connect Care CSD Kit” (csdkit.connect-care.ca), an online toolkit for Connect Care Clinical System Design (CSD) stakeholders, is now available in a new eBook online format that resembles the workings of the Connect Care Clinician Manual (manual.connect-care.ca) and Connect Care Builder Handbook (builders.connect-care.ca).

The Connect Care CSD Kit gathers resources (such as templates), work packages and guidance to support CSD activities (such as Continuous Improvement) for Area Councils, Specialty Workgroups and their support units. 

The Connect Care CSD Kit replaces the retired “CSD Support Kit” and it will continue to guide CSD activities going forward.

Questions, requests for additions and corrections, and alerts to any broken links, are welcomed. Please contact the Chief Medical Information Office Editorial Board (cmio-manual@ahs.ca).

2021-08-27

Documentation Quality Improvement - Work Package #4 - Inpatient Sidebar

The Connect Care Documentation Quality Improvement initiative seeks to enhance the appeal, efficiency and utility of structured documentation tools and workflows. Oversight is provided by the Clinical Documentation Quality Improvement Workgroup, reporting to the Clinical Documentation Committee.

An enabling task is to optimize how the sidebar (rightmost panel in charts opened to an inpatient context) serves charting workflows. Enhancements can make it easier to manage problem lists, for example, and pull these into documentation rather than dictating free-text in unstructured notes. It is also important to ratify design principles to guide ongoing sidebar optimizations. 

Any Connect Care user is welcome to learn about the sidebar design and to offer feedback and suggestions. Start by viewing the presentation. 

2021-08-16

Documentation Quality Improvement - Progress Report #2

We've posted previously about the Documentation Quality Improvement initiative. 

Work continues to progress:

  • SmartTool Building Blocks
    • All of the building blocks, or components, needed for documentation quality improvement have been examined, fixed, revised and added, using a series of previously described work packages to group different categories of SmartTools relating to:
      • Provider, Patient and Facility Identity
      • Medications
      • History, Allergies, Surgery, Devices and other structured documentation
      • Transition planning and documentation
      • Test results
      • Goals of care
      • Infection, Isolation and Immunizations
    • The new components, all now prose-friendly and complying with common style guides and data formatting standards, have been in production for a number of months. 
    • Soft-launched, the new work does not affect pre-existing documentation tools. The new elements are needed for new templates. However, they are already enjoying uptake as they solve problems previously reported.
    • The new building blocks are documented in the Builders Handbook and are increasingly promoted to builders for inclusion in all new documentation tools.
  • Problem Oriented Charting
    • Many improvements to problem-oriented charting navigators, editing tools, progress note templates and text automations are completed and stabilized.
    • Use acceptance testing continues until the end of August, when all final tweaks and enhancements will be moved to production.
  • Summative Documentation Templates
    • A phase I deliverable for the Documentation Quality Improvement initiative is a set of summative documentation templates (History & Physical, Consult, Discharge  Summary, Transfer Summary, Deceased Summary, Operative Note) that benefit from extensive stakeholder consultation about how to consistently render concise and clinically helpful summative documents. These are particularly important as they are exchanged with other health information systems, including Netcare.
    • The documentation generation tools and the associated standardized outputs have gone through extensive development, internal and external review. They are now in production for user acceptance testing by a small group of clinicians. 
    • A new release in the first week of September will include all corrections and improvements resulting from user acceptance testing. 
    • A "soft launch" in September will make the new Problem Oriented Charting, progress and summative documentation tools available together with support and training to interested clinician groups, without any requirement for uptake. 
  • Next Steps
    • Work is underway to fully integrate POC tools and innovations with the new Care Path supports emerging in Connect Care.
    • Phase II work begins to apply the POC norms and techniques to outpatient summative documentation and to the needs of different specialty groups.

2021-04-17

Handout Reminder for Wave 3 Supports

For those helping prescribers joining Connect Care at the Wave 3 launch, a business card format (easy to reprint) can be an easy handout. 

2021-04-12

Learning Better Outpatient Workflows with "Efficiency Hour"

"Efficiency Hour" sessions are offered by Epic at multiple times between April 14-22, 2021. These can help physicians become more effective and efficient with in outpatient settings.

  • Session 1: Placing and Managing Outpatient Orders (April 14, multiple times)
  • Session 2: Documentation (April 15, multiple times)
  • Session 3: Reviewing Information (April 21, multiple times)
  • Session 4: Managing In Basket (April 22, multiple times)
The sessions are open to any Connect Care prescriber. Super Users and Medical Informatics Leads are encouraged to take advantage of the sessions, as well as promote the opportunity to clinical colleagues.

2021-04-11

Resources for Super Users and Area Trainers on Launch Support Issues

To access support information on common issues arising post-launch, there are two easy options:

  • Subscribe to the Wave 3 Super User and #bytesblog Slack channels
  • Subscribe to the Connect Care Support and Bytes blog channels
    • New posts are emailed to you as soon as they are published.
    • Support channel has:
      • Hot topics – a list of common issues that have been flagged (e.g., dose ranges, printer mapping), posted daily for the 1st week after launch and then weekly for the remainder of launch support.
        • These posts include links to relevant support information (e.g., Connect Care Manual page, tip sheet, blog post).
      • Alerts on new/fixed/improved Connect Care functions (e.g., new SmartText).
    • Bytes channel has general update posts for Connect Care end users (e.g., downtime notices, launch support changes).
    • To subscribe, go to the blog channel and enter your email address in the ‘Follow (subscribe)’ box, found under the ‘About’ blurb on the right-hand side of the screen. 
      • Note: You have to subscribe to each channel (e.g., Bytes, Support) separately. 
      • Tip: Use your preferred email address to make sure you see new posts when they go up.
    • For further support, also subscribe to the Tips and FAQ channels:
      • Tips channel has daily postings, starting with simple and progressing to more advanced suggestions about how to get more from, and enjoy, Connect Care use (e.g., new series on Problem List management).
      • FAQ channel records issues arising, with suggested workflows, from prescriber use of Connect Care.

2021-04-07

Key Resource for Wave 3 Launch Supporters

Super Users, Medical Informatics Leads and others supporting prescribers at Wave 3 launch will find the "Connect Care Launch Incident Management Branch" (CCLIMB) shared workspace an invaluable resource. Although many entries relate to operations supports (and the Manual launch support page remains a go-to for prescriber supports), the CCLIMB information is particularly useful for discovering meeting and on-call schedules.

2021-03-29

Super User Development Session #10 - User Support Tools

We've previously posted about Super User development sessions offered in the weeks leading up to Connect Care Wave 3 launch.

This week's Wednesday session is facilitated by David Pincock and Pavel Medvedev, focusing on launch supports and tools that Super Users can take leverage to help Wave 3 users.

Participants may want to check some related resources:
Participants may wish to review past presentations, available via:
Questions and requests for Zoom links can be directed to cmio.nz@ahs.ca.

2021-03-24

Provincial Physician Trainer Opportunities

The CMIO is looking to fill three Provincial Physician Trainer positions for the PICU, NICU and Surgery training streams.

Ideally, applicants will already be aware of Connect Care and the work of the CMIO portfolio.

For more information:

2021-03-22

Super User Development Session #9 - Navigators and Complex Workflows

We've previously posted about Super User development sessions offered in the weeks leading up to Connect Care Wave 3 launch.

This week's Wednesday sessions are facilitated by Stuart Rosser and Tim Chan, focusing on complex workflows (esp., referrals and consultation), as well as admission discharge and transfer navigators.

Participants may want to check some related resources:
Participants may wish to review past presentations, available via:
Questions and requests for Zoom links can be directed to cmio.nz@ahs.ca.

2021-03-19

Documentation Quality Improvement - Work Package #3 - Problem Management SmartTools

The Connect Care Documentation Quality Improvement initiative seeks to enhance the utility of summative documentation templates for history & physical, consult, discharge, transfer, deceased and operative notes. Oversight is provided by the Clinical Documentation Quality Improvement Workgroup, reporting to the Clinical Documentation Committee.

An early task is to improve building blocks used by summative document authoring tools, including the Navigators, SmartForms, SmartLists, SmartLinks and SmartPhrases that facilitate problem list management, problem reconciliation and problem-oriented charting... collectively "Problem Management SmartTools". 

While Builders and Analysts are the first work package review participants, any Connect Care user is welcome to learn about the work and offer feedback. Start by viewing the presentation. 

Builders can follow instructions provided in the presentation for working with SmartTool prototypes in the Connect Care POC environments. Users can also use screenshots provided in the  presentation. All can share feedback and suggestions using an online survey.

2021-03-17

Documentation Quality Improvement - Rethinking Problem Lists

The third work package (coming soon) in the Documentation Quality Improvement initiative focuses on tools to support effective Problem List Management, Problem-Oriented Charting and representation of patient problems in summative documentation (e.g., history & physical, consult, discharge summary).

Examining Problem List workflows also gives opportunity to revisit Connect Care's documentation norms, problem list norms and user supports for inpatient and outpatient charting. Recognizing that new guides and tips relate to improvements not yet in production, and there is much work yet to be done, feedback on the emerging descriptions would be most welcome:

2021-03-16

Super User Development Session #8 - Patient Movement and Phases of Care

We've previously posted about Super User development sessions offered in the weeks leading up to Connect Care Wave 3 launch.

This week's Wednesday sessions are facilitated by Alan Sobey, focusing on patient movement and phases of care.

Participants may want to check some related resources:
Participants may wish to review past presentations, available via:
Questions and requests for Zoom links can be directed to cmio.nz@ahs.ca.

2021-03-15

Documentation Quality Improvement - Work Packages #1 and 2 in SUP for Clinical Testing

Documentation Quality Improvement work packages #1 (Medication SmartTools) and #2 (Identity SmartTools) are now in the SUP environment and ready for testing by interested Builders, Super Users and other clinical stakeholders. Testing in SUP is available 09:00-23:00 weekdays this week only.

The last slide in the presentation handout (see the linked work packages) contains instructions for testing. In brief:

  • Medication SmartTools
    • Open patient chart(s), start a documentation note (any type, but progress note is easy for testing) and then try to replicate a post-admission, inpatient, discharge and outpatient context.
    • Inpatient
      • Open a chart from a patient list for current inpatients.
      • To replicate an admission context, consider selecting an ED patient and initiating an admission with the admission navigator. Do admission medication reconciliation, being sure to review home medications. Then test the MedList SmartLinks (use ".DQIMEDLIST") SmartPhrase.
      • To replicate an inpatient context, select any current inpatient.
      • To replicate a discharge context, select any current inpatient and use the discharge navigator to access discharge orders and perform discharge medication reconciliation. Then test the MedRec SmartLinks (use ".DQIMEDREC" SmartPhrase).
      • NOTE: are aware of a problem with medication reconciliation reports where the dose frequency is not specified. This issue is fixed with an update to the Epic software coming in June 2021. The listing of a discharge med list (take home meds) mitigates this problem when combined with the flagging of meds (by name and form) that have changed, stopped, started, continued.
    • Outpatient
      • Open a chart and select an outpatient encounter, which you may need to reopen through the "addend" workflow.
      • Check the current med list, then test the MedList SmartLinks (use ".DQIMEDLIST" SmartPhrase).
    • Provide feedback via: Medication SmartTool Survey.
  • Identity SmartTools
    • Open any chart and then experiment with demographic (patient preferred/affirmed name) and SOGIE SmartForm (accessed by clicking on gender information in StoryBoard) values while using ".DQIIDENTITY" SmartPhrase to test relevant SmartLinks and SmartPhrases. 
    • Note that it will be necessary to switch from the SOGIE form to a different activity (then back again) to refresh the SOGIE values before retesting with DQIIDENTITY by deleting the former note content and re-entering the test SmartPhrase.
    • Provide feedback via: Identity SmartTool Survey.


2021-03-11

Health Evidence Exchange - Information for Builders and Analysts

Clinical content (documentation, decision and inquiry supports) within the Connect Care clinical information system (CIS) can include "resource links". These serve users who, for example, are able to jump to a different section of the chart (internal links) or open an external information resource that explains a new task (Internet links). 

When designers insert Internet links (external URLs) into clinical content, it is important to take advantage of link management tools. The Health Evidence Exchange (HEE, ahs-cis.ca/hee) is used for link management in Connect Care. It makes it possible to insert a standardized link into new content. That link points to the HEE, which in turn redirects to the desired external Internet resource.