Dragon Medical One is Freezing

Problem: Dragon Medical One (DMO) is the software, integrated with the Connect Care clinical information system (CIS) that enables speech recognition and in-system dictation. We are receiving sporadic reports of the DMO software freezing within Hyperspace sessions. The DMO session is rendered temporarily unusable. This is an emerging issue. Alberta Health Services Provincial Speech Recognition (PSR) team is working with the vendor (Nuance) to resolve this issue.

Cause: Although a conflict between the DMO software and the Citrix container which it works within is suspected, all potential root causes are being explored. This includes possible network issues. Specialists are onsite to observe and gather diagnostic data.

Solution: There is no fix at this time. Progress will be communicated. The best mitigation appears to be to force closure of both Epic Hyperspace and DMO, completely close the browser and Citrix, then re-initiate a logon.

Lost Access to Connect Care Icon in MyApps

Problem: Some physicians have reported that one or more Connect Care environment icons (e.g., Connect Care PLY, Connect Care PRD) have recently disappeared when they log on to the Unified Access Portal (UAP) at myapps.ahs.ca.

Cause: The Connect Care initiative has triggered a major clean-up of Medical Affairs, Active Directory and Provider Registry content. Common standards are being applied across Alberta Health Services for things like password expiration dates. As part of this work, some physician application permissions were inadvertently reset (when applying the account standards). About 600 physician accounts are affected. The physicians retain access to the UAP but may have lost access to Connect Care production (something they gained in personalization workshops).

Solution: First, make sure that you really have "lost" an icon. Check the full list of "Apps", as it is possible that the Connect Care application is available but somehow no longer marked as one of your favourites. If the PRD icon still cannot be found, then know that all disrupted accounts will have been batch-fixed by Monday October 21. If PRD access is needed before that time, please request a correction via ConnectCare.SupportTeam.Security@ahs.ca. They know the physician permissions and can do a quick manual fix. More information available in Connect Care Physician Manual.

Function keys not working on Mac Computers

Problem: The Connect Care clinical information system (CIS) relies on a lot of desktop (non-mobile) computer tasks. The Keyboard is key to these interactions. Shortcuts can speed workflows and many are anchored to Function or "F" keys normally arranged as the top row of a keyboard. When some users are logged on to the CIS Hyperspace on a desktop computer, the function keys don't seem to work.

Cause: Keyboard function keys may be "mapped" to functions specific to a particular software product, like a word processor. These mappings may not be understood by the Citrix workspace that sits between Connect Care and the user. And some computers (e.g. Macintosh) have flexible function keys that come up on a "TouchBar" that can be configured.

Solution: A tip sheet explains (see last section) how to force a TouchBar or function keys to always send the intended shortcut to Connect Care.

• Tip: Keyboard Tweaks for Citrix Workspace and MacOS

Should I be Worried: Mobility Management seems to want to Control my Device?

Problem: Knowing that Connect Care mobility (Haiku, Canto, PowerMic Mobile) is important for personalization workshops, participants are encouraged to pre-install. But setting up the secure "bubble" that the clinical apps are installed into can be scary. Some Apple warnings seem to imply that one forfeits all control of one's device!

Cause: In an abundance of caution, Apple posts worst-case warnings. But Connect Care's use of mobility management is very limited, affecting only AHS clinical applications stored a sandboxed virtual space created on the mobile device. This allows those apps, including Haiku, Canto and PowerMic Mobile, to be automatically configured, updated, maintained and protected. They can be deleted in the event of device loss or theft. It is okay to tap "Install". One's personal apps, settings and device are untouched; and not monitored.

Solution: The rationale for, and benefits of, clinical mobile app management are explained in a Connect Care Mobility FAQ provided with installation tip sheets. Have a quick skim to understand what the install process does.... and definitely does not do.

Why does Connect Care access fail after upgrading to MacOS Catalina?

Problem: Some of our early-adopter colleagues have installed the Catalina MacOS upgrade on Apple's Macintosh computers. Understandable, as there are a number of great new features. However, connections to the Unified Access Portal for Connect Care (myapps.ahs.ca) fail. Citrix Workspace, the software that facilitates the connection, throws a security certificate error.

Cause: The method by which MacOS checks the certificates that enable encrypted connections from client to & from the server changed. All versions of Citrix Workspace for Mac prior to today's release (October 8, 2019 version 19.10.0.18.1910) fail. The fix from Citrix is new.

Solution: We advise Mac users to wait at least another few weeks so that the Catalina-compatible Citrix Workspace version can be more fully tested. For those who already upgraded to Catalina, we suggest installing the very latest version of Citrix Workspace. Please report back to cmio@ahs.ca with your experience so we can learn more about this problem.

• Citrix Workspace 1910 for Mac

Why are keystrokes on my Mac Computer generating the wrong Character in Hyperspace?

Problem: A few users have reported that keys typed on their Macintosh (Apple) computer generate the wrong (unintended) character in Epic Hyperspace when logged on to the Connect Care clinical information system (CIS). Special characters are affected (e.g., @#$%^&). Indeed, this can occur at the Hyperspace logon page and cause one's password to be misread (and so cannot log on).

Cause: CIS access on desktop, workstation, notebook,  or laptop computers occurs via the Alberta Health Services Unified Access Portal (UAP) at myapps.ahs.ca. This causes the Epic Hyperspace software to be viewed within a “virtual machine” that is running on an AHS server. The viewer software is called Citrix Workspace (or Viewer or Receiver).

Problems can occur if the client’s (user’s) keyboard maps keys to different characters than the host (Citrix, then Epic) expects. This happens rarely but affects special characters important to SmartPhrases and SmartLinks.

Solution: A work-around involves forcing the Macintosh computer to interpret all keystroke input as coming from a standard American (US) input device. The Citrix server is already set to US keyboard input and cannot be changed. Simple steps for making this fix are outlined in a tip:

• Tip: Keyboard Tweaks for Citrix Workspace with MacOS

Why is the Playground available only 2 days a week?

Problem: We've heard concern from some users that a "Playground" for testing and practicing learnings is only open 2 days a week. But basic training participants are asked to practice with homework exercises; anytime and anywhere.

Cause: There is a misunderstanding based upon multiple uses of the term "Playground". There is a drop-in centre that is "open" in the 4th floor atrium of the Walter Mackenzie Health Sciences Centre Tuesdays and Thursdays. This is a venue where clinicians can use workstations to try things out and ask questions. The emphasis is on dabbling with different computer and device user interfaces.

But this drop-in centre is not the "PLY" (Play) environment that clinicians can access to practice lessons from basic training. Once registered for training, clinicians should expect to find PLY among the clinical information system "environments" that they can launch from their unified access portal (see Manual for easy access instructions) at myapps.ahs.ca.

Solution: Clinicians should work on post-basic practice exercises using the online PLY environment provided. If this does not appear in one's myapps.ahs.ca applications, contact ConnectCare.PhysicianTraining@ahs.ca to report and get a fix.

Why has my Mobile Device Screen Idle Timeout changed?

Problem: Some users have reported shortening of the time that their mobile device screen remains open while inactive (screen time-out), reducing to 1 minute. This is inadequate for dictation and other clinical uses.

Cause: An early version of Connect Care Mobility Management incorrectly altered screen time-out settings. This has been fixed.

Solution: It should be possible to visit the device setting controls and re-configure the device to the screen time-out of preference. It may be necessary to re-install Workspace ONE (see tips in physician manual).

Why do I get a procedure task-list when logging on?

Problem: Early personalization labs, where users start their access to the production version of the Connect Care clinical information system (CIS), revealed some logon problems for some users. Upon entering username/password, then department, a screen would appear listing procedures to be done or reviewed. But this had no relevance to the user. The screen had to be 'cancelled' in order to proceed.

Cause: It turns out there was an error in the setup of some physician user profiles. A 'Diagnostics Intervention Review' role sub-template was inadvertently attached to over 400 physicians.

Solution: The rogue sub-template is being removed from the affected physician templates. There is nothing for users to do. The fix should to be completed by end of September 2019. Please inform ConnectCare.Fixes@ahs.ca if an unexpected task management tool appears between logon and hyperspace load after that date.

Why Don't I have Access to the Play (PLY) Environment?

Problem: Some prescribers do not find the PLY (Play or Playground) environment when they expect it. This can limit one's ability to do self-study exercises after basic training or to practice some of the skills shown in MyLearningLink eLearning modules.

Cause: Prescribers have been assigned PLY access to time with completion of their scheduled basic training session. However, there have been last-minute changes in schedules and there have been some delays in assignments. Not everyone has PLY when they need it.

Solution: The CMIO portfolio is working with Zone Medical Affairs to get every prescriber registered for training activated for PLY. This will soon be active irrespective of the scheduled date of basic training. Access to full "production" (PRD) Connect Care is provided when prescribers appear for their personalization workshops pre-launch.

If you do not have access, but think you should, please contact ConnectCare.PhysicianTraining@ahs.ca. For more information, see the Connect Care Physician Manual.

Why is Haiku failing for lack of a 'profile'?

Problem: "I followed the instructions for installing Connect Care mobility management on my personal devices, then for installing Haiku and Canto, but when I click on Haiku on my iPhone or Canto on my iPad I get: 'No environments configured' and nothing further happens."

Cause: It sounds like you were able to install the mobile clinical information system (CIS) apps from the Workspace One Catalogue (see image), but the apps subsequently did not receive their configuration settings from the mobility management system. This can happen if you did not wait long enough, changed networks before configuration completed, or turned off your device before configuration completed. Note that the app will appear on your device well before the configuration finishes.

Solution: Even though the apps are downloaded, you can "re-install" from the Catalogue (even though the Catalogue shows the app already installed). Tap the "installed" green button to the right of Haiku or Canto in the Catalogue (see image). Carefully observe an allow prompts asking you to install the app and to allow management of the app. You must allow management in order for the configuration settings to be downloaded and installed.

Resources:

• Tip: Connect Care Mobility for Android Devices
• Tip: Connect Care Mobility for Apple Devices

Am I in the right (Connect Care) Training Track?

Problem: Some physicians follow instructions received in their Connect Care training track invitation, log on to MyLearningLink, view their "Required Courses", but find eLearning modules that do not fit their specialty or practice. For example, an emergency physician finds inpatient  medicine modules, not ER (ASAP-oriented) modules.

Cause: Physicians are allocated to training tracks based upon information received from Alberta Health Services (AHS) Zone Medical Affairs. Sometimes the physician specialty is not current or correct. Sometimes a physician has more than one specialty or practice type (inpatient, outpatient, etc.) and the wrong one is identified as primary. Sometimes the physician does not answer registration questions carefully.

Solution:

• First, send a clarification request to ConnectCare.PhysicianTraining@ahs.ca to indicate what you find in MLL and what you would expect to find. 
• Second, do a search for courses using "Epic". Scan the search results to seek eLearning modules that seem relevant to your specialty. Note the code starting the title of those courses (e.g., "Epic - ER..."). Search again using that code and register for those courses. Your MLL settings will get corrected but this way you can get started on pertinent courses while waiting.

Why is Dragon Medical One taking so long to initiate?

Problem: After opening a Connect Care clinical information system (CIS) Hyperspace session, then clicking on the top left button bar item to launch Dragon Medical One (DMO), the DMO loading screen (see image) gets stuck for 2 minutes or more with a spinning circle.

Cause: A system configuration change was made on Sept 19 that appears to have caused problems where DMO cannot find specific dictation hardware attached to the computer where it loads. Computers that have that hardware work well but all other computers have a painfully slow DMO logon.

Solution: This is a system configuration error. It is being worked on, with expectation of normal DMO load times later this week.

How can I get MyLearningLink to Record Course Completion on a Mac?

Problem: Some users, especially physicians doing coursework on personal computing devices outside of Alberta Health Services networks, report completing courses but not getting credited with completion. The course remains in a list of "required courses", without moving over to the "completed courses" section of MyLearningLink (MLL). Completing courses is important for getting continuing professional development credits.

Cause: Most eLearning modules posted to the MLL system are in "SCORM" format. This depends upon the course web page noting when all content has been viewed and then sending a signal back to MLL to the effect that the current user has finished the current course. This communication can fail.

Solution: We recommend using the Chrome Internet Browser on personal computers, especially Apple computers. There is a trick for forcing the Chrome window holding an eLearning module to "send" information "home":

• Ensure that your MLL session has not timed out (you can test this by doing a browser page refresh of the browser window that MLL is running in). Log on again if needed.
• Work your way to the very end of the course screens. Make sure that the course outline shows all sections checked off. You may need to click on the last section and scroll to the end again.
• Position the cursor (mouse pointer) over the top right area of the browser title bar that the course link appears in (see image). There will be nothing in that space initially. Click if needed. A small computer icon will appear, possibly with the text "send" next to it. Click on this. Click twice for good measure! This should force sending course completion data to MLL.

Tips for physicians have been updated:

• Tip: MyLearningLink for Connect Care

If, despite following the tip, a training track EUPA does not get credited or appropriately assessed as “pass”, contact the MyLearningLink Support Centre (HelpMyLearningLink@ahs.ca) immediately with the Subject Line: “EUPA Move to Pass”. In the body of the message, provide your name, email address, course name (EUPA), session number and final grade.

For physicians who need additional Connect Care Training support while using personal computers, contact:

• ConnectCare.PhysicianTraining@ahs.ca 

Getting Help - Takes Patience

While planning for "Command Centre", "Solution Centre", "Drop-in Centres" and just plain "Help Desk" to get us through launch, we are reminded of a bit of help desk history.