Hyperspace - Paradigm Change Coming

Epic has been working on a fundamental change to its workstation user-interface. Indeed, this is already in production for clients already adopting the May 2022 version. Connect Care will catch this update sometime in the next year.

The shift from a Window-based to a Web-based application opens up many more opportunities for innovation and enhancement. 

For now, a short video explains a bit more about why the change is important and some early features that users may notice:

• Epic: Here's Why... Hyperspace Updates

Invitation - Physician Usability Feedback

Epic seeks help from inpatient and outpatient physicians as it evaluates usability of upcoming enhancements and features. The process is virtual, requiring no travel.

Super Users and Medical Informatics Leads can help by participating, if interested, or recruiting colleagues. Those relatively new to clinical information systems can provide valuable perspectives.

• Invitation: Meaningful Use Usability Testing

Inclusive SmartTool Design

Alberta Health Services promotes toleration, inclusivity and respect throughout a patient-focused health system that is accessible and sustainable for all Albertans. Early in the Connect Care experience, we committed to protecting sexual and gender identity by addressing patients by their affirmed (preferred) name... and we expressed this with affirmed names in all user interfaces (e.g., Patient Storyboard, Chart Review Snapshot, etc.).

Post-launch, we discovered some Smart Tools (e.g., SmartLinks found in some SmartPhrases) defaulting to legal rather than affirmed name. Work is underway to close this gap.

Smart Tool stakeholders are asked to help identify any small subset of SmartText records where, for regulatory or other compelling reasons, the legal name should be displayed alongside an affirmed name. Such records, appropriately justified, must be identified and submitted by August 14, 2020.

• Instructions: Patient Name SmartTool Cleanup
• Submissions: ConnectCare.SOGI@ahs.ca

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:

• Demo: Serious Adverse Drug Reaction Reporting

Invitation to Participate in User Acceptance Testing - Connect Care to Netcare

In anticipation of Connect Care launch this fall, the Alberta Netcare Portal (Netcare) will be updated to ensure that:

• Laboratory and diagnostic imaging tests ordered and resulted in Connect Care will be viewable in Netcare
• Approved care summaries (e.g., discharge reports, consultation letters, some progress notes) generated in Connect Care are shared and viewable in Netcare
• Health care events (e.g., emergency visits, admissions) occurring where Connect Care is the record of care are included among events listed in Netcare

These functions will undergo robust technical testing, assuring completeness and accuracy. In addition, clinicians need to know that the right information is displayed in the right way in the right place.

We seek physician volunteers willing to participate in User Acceptance Testing (UAT) sometime between August 19 to 30, 2019. Testing involves following a script at a time and place convenient to the physician, with an expectation of about 30 minutes time investment. UAT participants are given clear instructions about how to access the testing system, suggested scenarios to guide testing, and means to record and report any issues encountered.

Physicians with interest or questions please contact:

• kamal.karki@ahs.ca

Non-Medical Device Workflows

The Connect Care communications team has produced a nice video illustrating how clinicians can interact with non-medical devices (computers, mobility, etc.) in inpatient environments.

Dragon Medical One and Hyperspace

As discussed at the April provincial medical informatics lead (MIL) retreat, we are very happy to have begun testing "Dragon Medical One" (DMO, Nuance's voice recognition and digital transcription solution for the cloud) within the Connect Care implementation of Epic Systems software.

Please get in touch with cmio@ahs.ca if you are a MIL and would like to participate in the testing. We have applied to free up as many preview licenses as possible for this group. A tip sheet is in the works to help you get started and an intake email for problem reports is coming soon.

DMO works in conjunction with Hyperspace to facilitate easy voice recognition for dictation, user interface navigation, activity commands and text automations. All require some user-investment in recording personal preferences and text-hotkey-command sequences.

A different Nuance product brings additional functionality to the Haiku mobile environment. "Epic Voice Assistant" works a lot like Siri (Apple devices) or Alexa (Android devices). The user can ask questions, such as "who is my next patient" and the assistant will line up both an answer and the best mobile activity for taking next steps.

For more information:

• Video: Nuance demonstration of DMO
• Video: CMIO demonstration of some DMO features
• Video: Epic Voice Assistant

Connect Care Bridging Solution Presentation Materials Domesticated

We previously posted about updates to presentation materials (in the presentation repository) about Patient and Provider Bridges (portals). As of today, these are further updated to include screenshots with Connect Care colour and branding; as the source is now the AHS configuration instead of Epic Foundation Hosted.

New Portal Information and Handouts

We have updated backgrounders, bytes and overviews that describe Connect Care patient and provider portals.

There are sensitivities about the relative positioning of Netcare and Connect Care portal offerings. While strategic planning continues, we suggest referring to the Connect Care portal functions as "bridging" services. The idea of a bridge is more consistent with Connect Care visual metaphors. It also encompasses a broader range of capabilities and more clearly grounds the services as part of clinical relationships enabled by a clinical information system.

Content changes clarify what the bridges are configured to support, without committing to what we will be supported to deploy.

Please use the following, remember to work from the online versions, and retire any older handouts:

• Byte: Connect Care Patient Bridge
• Overview: Connect Care Patient Bridge
• Backgrounder: Connect Care Patient Bridge
• Presentation: Connect Care Patient Bridge
• Byte: Connect Care Provider Bridge
• Overview: Connect Care Provider Bridge
• Presentation: Connect Care Provider Bridge

Hey Epic!

We saw a preview of this at the Epic User Group Meeting in autumn 2018... an intelligent voice assistant supporting conversations with a clinical information system. As with Siri (Apple) and Alexa (Android), one can hail ("Hey, Epic") the Epicare software and ask for information using plain language. Common tasks, such as recording vitals, are also possible.

An article describes early adopter evaluations at Vanderbilt:

• HealthcareIT News: Vanderbilt combines AI and Smart on FHIR in an EHR voice assistant

StoryBoard User Interface Enhancements

'StoryBoard' (previously referred to as 'StoryLine') refers to a set of user interface enhancements appearing in Epic's February 2019 software update. Connect Care has elected to fast-track this upgrade, as it affects training scripts presently under development. Accordingly, all those involved in design, configuration, testing and training need a quick re-orientation to the Hyperspace (desktop) Epicare experience.

StoryBoard has been under development for years. Extensive testing with other clients shows that common user requests have been addressed. Workspace screens are easier to recognize and navigate, fewer clicks are required to complete common information flows, and screen real estate is used more efficiently.

StoryBoard represents a fundamental change to the clinical information system (CIS) user experience. The former workspace 'header' moves to a more functional left column and the former left-sided activity tabs move to the top of the screen, automatically sorted by frequency of use. The StoryBoard (new leftmost column) highlights, in a consistent way, who the patient is, what the encounter is about, what has happened recently and which actions might be most relevant. Mouse-overs bring the next layer of information to the foreground, allowing much of chart review and action to happen without switching screens.

A short (3 minute) video clip (Epic) highlights three goals: 1. tell the patient story, 2. avoid screen jumps, 3. make better use of space. A short UserWeb (Epic) article explains the rationale. Our own demonstration further illustrates the user experience.

• Presentation: StoryBoard Overview (Epic, 3 min)
• Article: The Story of StoryBoard (Epic, UserWeb)
• Demo: Key StoryBoard Functions (AHS, 6 min)