Problem: When ordering point of care test (POCT) blood gases, prescribers may be confused by the available options (arterial, venous, capillary) being listed with a "Type" of "Nursing". Although these test requests are sometimes fulfilled by nurses, they are often handled by other clinicians such as registered respiratory therapists (RRTs). Some prescribers have been selecting inappropriate Blood Gas POCT orders.Context: The below screenshot includes orders primarily handled by respiratory services. Though all orders are listed as a "Nursing" type order, and though they may be drawn by nursing or other disciplines, they are still managed by respiratory services. Therefore, for example, "Blood Gas Arterial POCT, Type - Nursing" is the correct order for an Arterial Blood Gas to be drawn and run by an RRT.
Problem: Prescribers using a smartphone with the Android 11 operating system (OS) may be unable to connect to the "AHSRestrict" wireless network in AHS facilities.
Context: The AHSRestrict wireless network allows mobile (e.g., smartphones, tablets) and portable (e.g., laptops) computing devices to connect to the AHS intranet. The "HealthSpot" wireless network is also available in AHS facilities, providing public access akin to connecting from outside AHS. Both networks can be used to access Connect Care and otherwise stay connected, even in places where cellular signals are weak.
Some users report difficulties connecting to AHSRestrict when using the latest version of Google’s Android 11 OS.
Solution: The AHS IT network and mobility teams continue to investigate a feasible solution so that all Android devices are able to join the AHSRestrict wireless network.
HealthSpot wireless network connections are not affected and so can be used as a short-term alternative until a solution has been confirmed. To report issues with network access, please contact the IT Service Desk & Solution Centre (1-877-311-4300).
Problem: Volume-related delays in access to the MyHealth Records login portal can affect access to the Connect Care patient portal (MyAHS Connect, MAC), preventing patients from using MAC to initiate telehealth visits by that means.Context: Connect Care supports secure virtual visits for patients through its patient portal (MAC) where patients select an appointment and activate the associated video visit from within the appointment encounter. If patients are unable to log in to MAC, they may have difficulty joining a virtual visit. Connect Care Hyperspace tools for clinician participation in virtual visits are not affected.
Solution: Clinic staff (and prescribers) can call patients directly to provide an alternate means of accessing their upcoming Connect Care video visit if MAC access is compromised.
- Within an outpatient encounter "Pre-Charting" activity, use the "Start the Visit" button to make the "Rooming" activity available.
- Within the Rooming activity, find the "Connect" section and use the "Email Link to..." button to generate an email with the needed Zoom link to send to the patient.
- If the "Email Link to..." button is not available, use the "Demographics" activity (chart search) to add the patient's email to the chart.
Problem: Users of Connect Care mobility (Haiku, Canto) may receive messages that the mobile application ("app") cannot establish a network connection, possibly after a system upgrade.
Context: The Connect Care mobile apps (Haiku for smartphones and Canto for iPads) are managed by another application called "Workspace One" from vmWare. This includes a "Tunnel" app that takes care of establishing a secure virtual private network (VPN) for clinical apps to use when communicating with their server.
The Tunnel app may update automatically, and an update may include a new copyright or privacy notice. Users who are unaware of this may try to use Connect Care mobile apps without realizing that the VPN is not activated. The mobile app will fail to logon, giving a message to the effect that a network connection to its server cannot be established.
The Tunnel VPN may also fail if the user's device is already connected to a personal or enterprise VPN, as there can be a conflict.
Solution: When confronted with a network connection error message when trying to login to Haiku or Canto, be sure to open the Tunnel app and take care of any alerts or messages there. Also consider whether an independent VPN service needs to be turned off in order for the Connect Care VPN to activate.
Considerations: In Basket messages that link to patient health information should relate to patients with whom the receiving prescriber has, has had, or will have an approved relationship (circle of care, quality or research).
- a member of the patient’s Care Team and configured to receive results,
- signed into a results review message pool,
- supervising a medical learner, or
- the most responsible provider at the time of discharge for results reporting after the time of discharge.
Solution: The Connect Care In Basket has a "QuickActions" tool that allows prescribers to manage results received in error.
- Not My Result
- Use this action if the result was misdirected and should not have been routed to the recipient's In Basket, even if the provider has participated in the patient's care at some point.
- The Result Note window will open and the provider will be required to complete two SmartLists (use F2 to find and use pick-list) to indicate why the result is being marked as received in error and what, if any, steps have been taken to remediate.
- If none of the available pick-list options fit, select "other" and provide a brief comment to better explain the issue and what has been or should be done.
- Upon completing the two SmartLists and accepting the message, the result note will be re-routed to an internal results routing error pool for review and action.
- The associated In Basket message will disappear.
Problem: Some inpatients at Wave 2 sites were admitted before Wave 2 launch. Key information was transferred to Connect Care charts as part of a cutover process. This information was then validated by prescribers immediately after launch. If an admission order was missed, or medication reconciliation was not completed, efforts to discharge the patient post-launch can be blocked.
Context: When experiencing discharge challenges, an important first check should be for a valid admission order. Next, confirm that medication reconciliation has been completed. Patient transfers and discharges require a completed medication reconciliation so that accurate medication information follows the patient. Unattended admission order or MedRec work will be flagged in the "Sidebar Summary" that appears in the right sidebar of an open chart.
Solution: Attending to the following two checks should resolve most discharge blocks:
- Check for an Admission Order by looking in the "Order History" section of the "Orders" activity, and add an admission order if found missing.
- Open the Admission navigator (tab) with the chart open in the current inpatient encounter.
- Select the "Admission Orders" section (bottom of the navigator left column).
- Select "Review Home Medications":
- Ensure this list includes all medications that the patient was taking prior to admission.
- This step may already have been completed by nursing or pharmacy, as indicated by the "Med List Status" at the bottom of the listing.
- Select "Reconcile Home Medications" (must be done by prescriber):
- Complete documentation of reconciliation decisions by selecting "Don't Order" for any medications that were already ordered as part of cutover.
- If all home medications listed were already ordered for cutover, use the "Mark unreconciled Don't Order" button at the top of the screen for convenience.
- Review the new reconciliation actions and then Sign at the bottom of the right sidebar.
- Active Orders: Go to the "Orders" activity and hover over an order in the "Active Orders" tab to get an order report icon (📃) at the top right of the row for that order. Click on this icon to get a popup with information about the order. The order number is in brackets or parentheses.
- External Orders: Note the list of external orders at the bottom of the "External Orders" tab, and click on an order of interest to get a popup that includes the order number (in parentheses).
- Encounter Orders: If encounter orders have been signed, click on the order icon (📋) just to the left of the bottom right "Sign Encounter" button. Then, click on the individual order of interest, and note the order number in the Order Report.
- All contexts
- With a patient's chart open, use the Search function (top right of hyperspace or within StoryBoard) to find the "Order Review" activity.
- This can be used to list all orders for a specified time period (default is last 72 hours).
- Clicking on an order will reveal the Order Report (usually bottom half of screen) with the order number in it.