- New Submitter Column for Cancelled Lab Orders
Connect Care Support Forum
Peer-to-peer support for clinicians using the Connect Care clinical information system.
In Basket Update - Cancelled Lab Orders
Lab Order Update - Frequency Default Time
- Lab Order Frequency Default Time Changed
Therapy Plans - No Show Discontinuation
- New "No Show" Option to Discontinue Therapy Plan
Update - Patient Portal Messages for Mixed-Context Prescribers
- Patient portal messages no longer forwarded to mixed-context prescribers
When IT receives a message sent by a patient via MyAHS Connect that is intended for a mixed-context PCP, IT confirms that it was intended to go to a physician who does not have a department that schedules appointments in Connect Care and therefore does not have a clinical support advice request pool to support message management. IT then responds to the patient, letting them know their physician cannot be reached via MyAHS Connect, and to instead contact the community clinic directly.
Legacy Insulin Order Sets Retiring
- Legacy Insulin Order Sets Retiring
A few insulin administration Order Sets were temporarily made available to Launch 1 users, recognizing that some groups had not completed change management for provincially standardized insulin administration practices. All facilities now have the means to follow evidence-informed, cross disciplinary, insulin administration guidelines. Accordingly, the following two order panels will be retired (exact date TBD).
- "IV Insulin - NPO patients requiring low fluid volumes"
- "IV Insulin - NPO patients requiring regular fluid volumes"
- "Pre-procedure Management of Patients with Diabetes Mellitus, Adult"
- "Post-procedure Management of Patients with Diabetes Mellitus, Adult"
- "Basal Bolus Insulin Therapy (BBIT), Adult"
How to Manage Misdirected In Basket Results
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.
Launch 5 Support Hot Topics - Week 3
- Reminder that outpatient communication is not automatically shared with Netcare. If a communication is appropriate for sharing to Netcare, be sure to pick the template that includes "Netcare" in its name. See this blog post and tip sheet for a summary of how Connect Care to Netcare document sharing works.
- There is also a "quick click" function makes it easy to rapidly route notes to a patient's primary care provider (PCP) and referring provider for outpatient encounters. When selected, a tick box above the note will automatically send your note to Netcare as well as the PCP and referring provider (if known). For more information, see this blog post, demo, and the Shared Documents section of the Connect Care Manual.
- Note: The quick click function does not work for hospital outpatient department encounters (HODs).
- Hours for the Virtual Drop-in Centre are now 10:00-18:00 for all prescribers, until December 2. For oncology prescribers, it opens early Mon–Fri, 08:00–18:00 (regular hours Sat–Sun).
- To access, go to virtualhelp.connect-care.ca using a computer or smartphone, or via the QR code found on the Launch Supports posters up in sites (or launchhelp.connect-care.ca) using a smartphone camera for audio-only help.
- Hours for the In-person Drop-in Centres at FMC and RDRH are 10:00-18:00, up to and including this Thursday, November 24. The In-person Drop-in Centres will then close as of November 25.
- For issues outside of drop-in hours, call the IT Service Desk & Solution Centre at 1-877-311-4300 (#1 for Connect Care). They are able to provide high-level workflow and training support; urgent issues will be escalated to an on-call CMIO training team member.
Launch 5 Support Hot Topics - Week 2
- Observation Bed Request
- Some facilities such as the Foothills Medical Centre have "observation bed" designations. When a patient requires a dedicated observation bed on an inpatient unit in such a facility, an "Observation Bed Requirement" order should be placed, for communication to bed planning and nursing. See the blog post for more information.
- Calgary Zone - Ambulatory Results Management Update
- Starting November 16, some results from outside of the Calgary Zone will be suppressed from In Basket to reduce duplicate reports.
- Prescribers must regularly monitor Connect Care In Basket AND hard copy reports, and follow-up on results as needed.
- To improve the reliability of result delivery to In Basket and reduce hard copy reports, issue Connect Care requisitions to patients.
- For more information, see the memo.
- Computerized Prescriber Order Entry (CPOE) and Allowed Exceptions
- Information on CPOE can be found in a Countdown Checklist post, a general blog post, and the Clinical Ordering Norms section of the Connect Care Manual.
- There will be situations when prescribers cannot be expected to place time-sensitive orders directly and require the assistance of a qualified healthcare professional to transcribe important clinical instructions. Allowed exceptions to prescriber order-entry fall into three categories, each explained and exemplified in FAQ and Order Norms documents: protocolized orders, urgent verbal orders, and urgent telephone orders.
- In ordering – as in all other clinical activities – patient care and safety come first. If there is an urgent or emergent circumstance affecting a patient’s care, verbal or telephone orders may be appropriate and can be allowed. See this memo for further details. For additional information on team collaboration for verbal and telephone orders, see the work package for prescribers and nurses, and, for nurses and allied health professionals, the decision-making guide and paging etiquette guide.
- Consults and Internal vs. External Referrals
- "Consult" requests relate to assessments to be done within the current encounter and are entered from inpatient and emergency orders activities. "Referral" requests relate to assessments that will be done outside or after the current inpatient or emergency encounter and are entered using the "External Orders" tab of orders activities.
- Outpatient services that use Connect Care as the record of care are "internal" referral resources (e.g., a referral from FMC ED to FMC Minor Surgery would follow the internal referral pathway). Outpatient services that are not on Connect Care are "outgoing", or external, referral resources. This status is selected when entering the referral order.
- All referrals originating in Connect Care must be placed as a referral order, regardless of whether or not the referred service provider/clinic is using Connect Care. This ensures that a record of the referral exists in the legal record of care.
- See the Referral Workflows section of the Connect Care Manual for more information, as well as the following resources:
Fix to Identity SmartLinks for Unknown Patients
- Unknown Patient - Fix to Patient Name SmartLinks
- for First name: ".PREFNAMEFIRST"
- for Last name: ".PREFNAMELAST"
- for Full name: ".PREFNAMEFULL"
Patient List Fixes and Tweaks
- Patient List Enhancement Fixes and Tweaks
- Hover bubbles removed from Room/Bed, DOB, Goals of Care and Level of Care columns.
- Double-click simplified for Goals of Care, Room/Bed, Patient Identity columns.
- Visual highlight (background colour) for patients with Alternate Level of Care statuses.
- Better formatting of provider information column to make it easier to skim for attending, referring and primary care details.
- Double-click for co-sign orders column to open main orders activity tab.
- Double-click length of stay column to open Rapid Rounds discharge planning interactive report.
- Default column widths adjusted.
- Discharge readiness column icons enlarged.
- Formatting improvements to discharge goals section of Rapid Rounds report.
For more information:
Launch 5 Support Hot Topics - Day 5
- Non-Standard Medication
- If a medication cannot be found on inpatient facility order lists (be sure to try different spellings and the generic drug name), it is likely non-standard. The ordering prescriber should request the medication by placing a "Non Standard Medication" order. A pharmacist will then review and modify the order to something they can provide, or contact you to suggest an alternative.
- For more information, see the FAQ blog post and Guide.
- Computerized Prescriber Order Entry (CPOE) and Allowed Exceptions
- Information on CPOE can be found in a Countdown Checklist post, a general blog post, and the Clinical Ordering Norms section of the Connect Care Manual.
- There will be situations when prescribers cannot be expected to place time-sensitive orders directly and require the assistance of a qualified healthcare professional to transcribe important clinical instructions. Allowed exceptions to prescriber order-entry fall into three categories, each explained and exemplified in FAQ and Order Norms documents: protocolized orders, urgent verbal orders, and urgent telephone orders.
- In ordering – as in all other clinical activities – patient care and safety come first. If there is an urgent or emergent circumstance affecting a patient’s care, verbal or telephone orders may be appropriate and can be allowed. See this memo for further details. For additional information on team collaboration for verbal and telephone orders, see the work package for prescribers and nurses, and, for nurses and allied health professionals, the decision-making guide and paging etiquette guide.
Launch 5 Support Hot Topics - Day 4
- Wet Signature Prescriptions and E-Prescribing
- The Connect Care team is actively working with the Alberta College of Pharmacy and the College of Physicians and Surgeons of Alberta to specify acceptable standards for direct electronic transmission and authentication of outpatient prescriptions at community pharmacies.
- We recognize that the current state of having to provide wet signatures on outbound prescriptions from Connect Care is not optimal, and appreciate your patience as we obtain the necessary provincial approvals for direct prescribing from Connect Care.
- Ambulatory Outpatient Referrals
- "Consult" requests relate to assessments to be done within the current encounter and are entered from inpatient and emergency orders activities. "Referral" requests relate to assessments that will be done outside or after the current inpatient or emergency encounter and are entered using the "External Orders" tab of orders activities.
- Outpatient services that use Connect Care as the record of care are "internal" referral resources. Outpatient services that are not on Connect Care are "outgoing", or external, referral resources. This status is selected when entering the referral order.
- All referrals originating in Connect Care must be placed as a referral order, regardless of whether or not the referred service provider/clinic is using Connect Care. This ensures that a record of the referral exists in the legal record of care.
- See the Referral Workflows section of the Connect Care Manual for more information, as well as the following resources:
- Secure Chat and Sticky Notes
- The Secure Chat and Sticky Note functions in Connect Care should only be used for non-urgent communication and reminders, not for urgent messages or clinical documentation.
- Secure Chat messages and Sticky Notes are purged after 30 days. Secure Chat messages and Sticky Notes do not form part of the chart.
- See the Secure Chat and Sticky Notes sections of the Connect Care Manual for more information, as well as the Communication Norms.
Launch 5 Support Hot Topics - Day 3
- Patient Movement: Interfacility Transfers (IFTs)
- For transfers to another site (IFTs), remember to use the Interfacility Transfer navigator, located within the Discharge tab. Using the correct navigator will ensure that all steps required for this workflow are completed and orders are available and actionable at the receiving site.
- Note: Every transfer to LTC/Continuing Care is an IFT even if the LTC/Continuing Care is located in the same building.
- The "RAAPID Service Request" order is used to initiate repatriations as well as non-emergent consultation/transfer requests. See the tip sheet.
- For a summary on IFTs, see this Countdown Checklist blog post and this infographic for admitted patients (updated). Further information (including other IFT workflows) is available in the IFT section of the Connect Care Manual.
Launch 5 Support Hot Topics - Day 2
- Patient Movement: Interfacility Transfers (IFTs)
- For transfers to another site (IFTs), remember to use the Interfacility Transfer navigator, located within the Discharge tab. Using the correct navigator will ensure that all steps required for this workflow are completed and orders are available and actionable at the receiving site.
- Calgary Zone is in an interim state for IFTs - see this tip sheet for more information on how to transfer patients within the Calgary Zone, whether to another Connect Care site or a site not yet on Connect Care.
- For a summary on IFTs, see this Countdown Checklist blog post and this infographic. Further information is available in the IFT section of the Connect Care Manual.
- Computerized Prescriber Order Entry (CPOE) and Allowed Exceptions
- Information on CPOE can be found in a Countdown Checklist post, a general blog post, and the Clinical Ordering Norms section of the Connect Care Manual.
- There will be situations when prescribers cannot be expected to place time-sensitive orders directly and require the assistance of a qualified healthcare professional to transcribe important clinical instructions. Allowed exceptions to prescriber order-entry fall into three categories, each explained and exemplified in FAQ and Order Norms documents: protocolized orders, urgent verbal orders, and urgent telephone orders.
- In ordering – as in all other clinical activities – patient care and safety come first. If there is an urgent or emergent circumstance affecting a patient’s care, verbal or telephone orders may be appropriate and can be allowed. See this memo for further details. For additional information on team collaboration for verbal and telephone orders, see the work package for prescribers and nurses, and, for nurses and allied health professionals, the decision-making guide and paging etiquette guide.
- Secure Chat and Sticky Notes
- The Secure Chat and Sticky Note functions in Connect Care should only be used for non-urgent communication and reminders, not for urgent messages or clinical documentation.
- Secure Chat messages and Sticky Notes are purged after 30 days. Sticky Notes do not form part of the chart.
- See the Secure Chat and Sticky Notes Manual sections for more information, as well as the Communication Norms.
New Interventional Radiology and Bedside Order Sets
- New Inpatient Interventional Radiology and Bedside Order Sets
- Bedside Joint Aspiration/Injection
- Image Guided Joint Aspiration/Injection
- Bedside Fluid Aspiration
- Image Guided Fluid Aspiration
- Image Guided Organ/Mass Biopsy
- Image Guided Abscess Drainage
For details on how to find and place any of these order sets, and how to find and release Signed & Held intra- and post-procedure orders, see the tip sheet.
Problems with Citrix Workspace on Personal Computers
Problem: Some Connect Care users who rely on personal computers (especially Apple devices) for remote connection to Epic Hyperspace are reporting problems completing logons.
Context: Citrix Workspace software is used by the Alberta Health Services (AHS) remote access gateway (myapps.albertahealthservices.ca) when prescribers logon to Connect Care on personal computers outside the AHS firewall (extranet).
Some users are reporting that logon efforts are prevented by Epic screens that do not show the expected userid or password fields or are otherwise not functioning.
Citrix released updates to its Workspace software in mid-October and again in the first week of November 2022. The current updates appear to have problems with MyApps or Connect Care. The problems are prevalent with the latest Macintosh updates, especially the new version of Workspace optimized for computers with Apple silicon (M1 and later chips).
Solution: Until further notice, please do not accept Workspace offers to download and update the Citrix Workspace App. If experiencing remote logon problems, and the Citrix Workspace "about" option shows version "2210" or later:
- Uninstall Citrix Workspace
- Reboot computer
- Revert to the September 2022 version (2209 found in "install earlier versions" of Citrix downloads site).
- Reboot computer
- Try logging on via MyApps again.
Launch 5 Support Hot Topics - Day 1
- Test Result Release to Patient Portal (MyAHS Connect)
- Most laboratory result and test report information is released immediately to MyAHS Connect, i.e., as soon as it is reported and available to clinicians (including pathology and genetic results), with DI, cardiology and endoscopy reports released 5 working days after they are available in Connect Care.
- For consideration of what this means for prescribers, see this memo and the MyAHS Connect section of the Connect Care Manual.
- Calgary Zone: NP Clinics Scheduled to Wrong Provider Record
- NPs with concurrent RN roles may have their clinics and scheduling template linked to the incorrect record. The NP will not be able to see appointments nor have NP functionality if appointments are entered from the RN record.
- Mitigation: NPs with .e2 accounts to verify that they can see their schedule. Schedulers and Template Builders to verify and reassign as needed. See the tip sheet for more info.
Connect Care Mobility Install Issues
Problem: Connect Care users trying to install mobile applications (Haiku, Canto, PowerMic) may be unable to complete the enrollment process for their device.
Context: Mobile applications are managed by Alberta Health Services to ensure that connections are secure and privacy is maintained. This involves enrolling new devices in order to check for things like required password protections.
There are new reports of users having difficulty completing new device enrollments. A problem with the associated software (VMWare) has been identified and is being worked on.
Solution: Users experiencing difficulties (“device not allowed” message) should call the Connect Care help desk 1-877-311-4300 or open a ticket via the IT Service Hub (Link: help.connect-care.ca). The device will be manually added. A notice will be posted here when normal device enrollment processes resume.
Update 04-11-2022: This problem has been fixed and no further tickets are coming in. Logs show resumption of successful Haiku initiations.
Repatriation and Consultation/Transfer Update - New RAAPID Service Request Order
- Bundled RAAPID Service Request Order
The bundled "RAAPID Service Request" order can be used to request the following:
- Higher level of care consultation or transfer, if not urgent
- Equal or lower level of care transfer from ED (e.g., capacity move, urgent repatriation)
- Equal or lower level of care transfer from inpatient (i.e., "repatriation")
A tip sheet details the new order fields. For more information on RAAPID, see the Manual.
Second Sign Updates - Requisition Printout
- Second Sign Updates - Requisition Printout
In the Second Sign workflow, once the order has received the second signature by the responsible prescriber, the requisition is often automatically printed off. Non-AHS MOAs are able to submit a ticket to suppress automatic printing of Second Sign orders, and AHS MOAs can submit a ticket to have print settings adjusted if requisitions for Second Signed orders are going to the incorrect printer (see tip sheet).
If the MOA or prescriber is unsure of the requisition print location, or whether the requisition was printed, two new features are available:
- Additional information available in Chart Review: In the "Chart Review" activity, if the requisition was printed, the "Order Parameters >> Sign transmittal event" section now displays the destination printer ("Destination Workstation"), and whether it was a mapped printer or an alternate Virtual Local Printer (VLP) destination (workstation ID would begin with "VLP"). If the requisition was not printed, it will say "This order was not sent to a printer."
- New Reporting Workbench report: In the Reporting Workbench workspace, a new report, "Second Sign Status", can be run that shows existing Second Sign orders. This report will indicate whether a Second Sign has been completed; if completed, an MOA can then find out if a requisition has been printed or not via the Chart Review activity as detailed above. If additional copies of requisitions are needed, MOAs can use "Reprint" from the Chart Review activity.
Facility-to-Facility Medication Reconciliation Streamlined
- Medication Reconciliation Enhancements
When patients present from facilities also using Connect Care (e.g., patient sent from a long-term care facility to an emergency department for assessment), their facility medication list takes the place of a home medication list. In these cases, there is no need to re-build the medication list through a BPMH process. A home medication list should not be populated. Medication reconciliation involves deciding which pre-encounter facility medications should be continued, held or stopped when the patient is admitted to the new facility.
To make this straightforward, the usual "Home Medications" navigator sections are hidden for Connect Care long-term care patients presenting to Connect Care emergency departments. Instead, the pre-encounter facility medications are displayed and a link is provided to a navigator facilitating the selective re-ordering of pre-encounter facility medications.
Suicide Risk Alert Enhancements
- Suicide Risk Alert Enhancements
- Storyboard Alert for High Suicide Risk: Visible across users and encounters.
- High Suicide Risk Best Practice Advisory (BPA): Visible only to the user who documented high suicide risk.
- Moderate Suicide Risk BPA: Visible only to the user who documented moderate suicide risk.
Professional practice respecting when to screen for suicide risk is not impacted by the alert enhancements.
Details regarding suicide risk decision supports, and the underlying guidelines, can be found in the resources below.
Observation Bed Requirement - New Order
- New Observation Bed Requirement Order
The new order should only be used at facilities that support some kind of observation bed designation.
Communications Update - Sensitive Letters
- Confidentiality Feature - Marking Letters as Sensitive
- The patient’s PCP will only receive a letter marked as sensitive if they are specifically selected as one of the recipients.
- In Hyperspace, viewing of the letter contents will only be available to users with the same specialty as the letter author, users logged in to the department of the patient’s encounter, or users logged in to the virtual department that matches the specialty of the encounter department.
Sensitive letters should always be used with discretion and professional judgement, and in a manner that supports access to health information required for continuity of care.
For more information on the use of this feature, see the Confidentiality Practice Guidelines.
Communications Update - Send Notes Buttons
- Renamed and New Send Notes Buttons
Fix for Mobile App Short Time-outs on Android Devices
- Connect Care Mobility for Android Time-out Fix
By default, the screen will lock after one minute of inactivity. This setting has been changed to five minutes of inactivity and can be altered in the Android device settings. For some, the fix may occur automatically. For others, it may be worth checking the mobility settings and increasing the inactivity time-out to five minutes, if desired.
Improvements to Consent Forms Management
- Improvements to Consent Forms Management
- Document Status
When completing an eForm within the Consent Navigator, the document’s completion status can now be updated manually. - Capacity Status
Updates have been made to the Capacity Status section within the Consent Navigator and Advanced Care Planning / Goals of Care Designation Navigator. - Relationships & Alternate Decision-Makers
Revisions have been made to the Relationship options and Alternate Decision-Maker options in the Patient Contact card. - MHA Questions
Second Sign for Clerical/MOA Ambulatory Orders
- Second Sign for Clerical/MOA Ambulatory Orders
With Second Sign, orders are not visible and cannot be carried out until the second signature is obtained electronically from a responsible prescriber. Once the second signature is applied, the affected orders can be acted upon.
Why is this change being made?
- This change was reviewed by eSafety, AHS Legal, CCEC and Zone Medical Leadership, and was determined to be required for patient safety when delegating order entry to unit clerks/MOAs.
- Compared to verbal orders needing co-sign, second sign ensures that orders entered by the ambulatory unit clerk or MOA are reviewed, approved and signed by the authorized prescriber prior to being visible in the patient chart and actionable by other healthcare providers.
- It assists with prescriber and patient care workflow efficiency by allowing clerical staff and non-AHS MOAs, within their scope of practice, to enter certain order types on behalf of the prescriber.
- Use of the second sign order entry workflow allows the order entry process to be transparent and auditable via reporting tools in the reporting workbench.
- When booking urgent cases, prescribers should enter orders themselves.
- Approved exceptions to second sign are as follows:
- Paper orders with a wet signature can be transcribed by unit clerks and MOA’s into Connect Care, provided all order components align from paper to Connect Care format.
- PLEASE NOTE: Providers with Connect Care (CC) access are expected to place orders within CC and orders submitted on paper by these providers will be returned.
- Orders to schedule a procedure may be entered by an ambulatory unit clerk or MOA as an active order, so that scheduling/booking can proceed without need for second sign.
- Second Sign orders can be found in the authorizing prescriber’s "Second Sign Needed" In Basket folder, which can be "favourited" to ensure visibility.
- Order printing:
- Orders with requisitions will not print until the second sign has been completed by the prescriber. Upon second sign, requisitions will print to the location that the current workstation is mapped to; alternatively, prescribers can use Virtual Local Printing (VLP) to choose another destination for the order to print. Information around virtual local printing can be found in the Connect Care Manual.
- MOAs can use Reprint from Chart Review if additional copies of requisitions are needed.
Navigator Update - Discharge as Deceased
- Navigator Update: Discharge as Deceased
The navigator has been streamlined. Some low-value materials have been removed, including the prior "death" and "organ procurement" notes, which were not used consistently. New point-and-click sections allow things like Medical Examiner's review criteria to be quickly documented.
The navigator update is paired with improvements to discharge summary templates for inpatient encounters where patients die in-facility.
Documentation Update - Deceased Note Type Retired
- Deceased Note Type Retired
Inpatient encounters end when patients die in-facility and the appropriate summative documentation is a "Discharge Summary" note type. This note type supports templates for conventional discharges, as well as "Deceased" and "Inter-facility Transfer" templates. A "Deceased" template within a Discharge Summary note type should always be used to to document encounters that include patient death.