Workstations on Wheels (WOWs) Issues

Problem: Some users have been experiencing issues logging in to some Workstations on Wheels (WOWs).

Solution: If there is an issue with logging in to a WOW, please restart the computer. If the issue does not resolve after restarting, call the IT Service Desk & Solution Centre (1-877-311-4300). 

In Basket - Attachments for Patient Messages

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...
  • Adding Attachments to In Basket Patient Messages 
As of November 4, 2021, attaching documents to a patient message in In Basket has been simplified. 

To attach a document to an In Basket patient message, initiate a patient message from its menu item (available only for patients with an activated MyAHS Connect patient portal service), then in the "Patient Message" screen:
  1. Select the "+Add" button in the "Attachment" row of the "Tasks & Attachments" section.
  2. From the "Media Selector" window that opens, select the desired document to be attached:
    • Attaching a Connect Care document: In the "Detailed View" tab, the "All Media" list shows all media available in Connect Care for that patient (including scanned/imported files), with document types and descriptions. Select the desired document and click the "Accept" button.
    • Attaching a document from your device: Click the "Browse" tab (to the right of "Detailed View"). In the "Open" window that pops up, click "This PC", select the desired document, and click the "Open" button. Add a description in the "Description" field (note: the patient will see this description). 
      • The document type will automatically fill in as "Provider Attachment".
For more information:

WCB and Connect Care - Updates

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...
  • WCB Form Submission and New Reports
As of October 19, 2021, a Workers' Compensation Board (WCB) form can be completed within Connect Care and submitted to WCB directly from Connect Care. 

The new WCB SmartForm replaces an existing WCB SmartLink available in the "Wrap-Up" tab for ambulatory charts (last section), and can be found in the "Dispo" tab for emergency charts. The "WCB Form" can be completed in steps, with a final validation step confirming presence of all required information as well as the type of submission (direct or via third party). 

Current and previously completed WCB forms, related to any ambulatory or emergency visit, can 
be viewed in Chart Review under the "Encounters" tab, and easily found by filtering for “WCB Visits”.

There are also two new WCB reports found in "Print Documents", as well as a third-party billing report in the reporting workbench.

For more information, new tip sheets are provided for ambulatory and emergency department contexts.

How To Respond to a Connect Care Login Password Warning

Problem: Connect Care users may receive a message at login about a need to change their password, but may not know how to take action.


Context: Connect Care is accessed with the same username and password required for other Alberta Health Services (AHS) information resources, including wireless networks, intranet resources and clinical systems. These "Healthy" network credentials have security protections, including a requirement for periodic password changes. Many Connect Care users will come up for a password change in the coming months and may not remember where or how to change AHS passwords.

Solution: AHS Healthy network credentials can be managed, with an easy tool for password updates, through the Integrated Access Management (IAM) website, as explained in the Connect Care Manual:

Charting Deficiencies Fix - Death Notes

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...
  • Correction to Charting Deficiency Checks
As of October 7, 2021, Connect Care charting deficiency checks are corrected to better reflect documentation requirements in the event of an inpatient death.

Previously, an in-facility death ending an inpatient encounter triggered a check for the presence of a signed discharge summary. However, Connect Care documentation norms indicate that a "deceased note" document type should be used in such circumstances. Now the presence of either document type will satisfy charting completion requirements and the deficiency check algorithms have been corrected accordingly.

New Mobility Feature - Monitor Activity

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...
  • Connect Care Mobility "Monitor" Activity
As of October 6, 2021, Connect Care mobility apps (Haiku for smartphones and Canto for iPads) gain a new activity (view) for use within opened patient charts.

The "Monitor" activity is well suited to inpatient, emergency and critical care contexts, where a clean, simple, aggregated view of key information supports a quick gestalt of clinical trending. There are sections for vitals, input/output, respiratory status, lines/drips, etc.


Look to the activity/view icons at the bottom of a mobility display within an opened patient chart. The Monitor activity can be set as a default view (first to be shown upon opening a chart) at the user's discretion (use the Haiku or Canto "Initial Patient Activity" configuration in device settings).

Home Medications History

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...
  • Home Medication List Changes
As of October 5, 2021, nursing will have access to complete a patient's Best Possible Medication History (BPMH) within a Connect Care chart, including the ability to remove (discontinue) outpatient or "home" medications that the patient is no longer taking. Previously, only prescribers had the ability to remove medications, and any changes made by nursing were not retained unless reviewed by a prescriber in the same encounter. It is expected that this access will also be extended to pharmacy technicians in the near future. Note that both nursing and prescribers will continue to have the option of flagging medication history for prescriber review.

Along with this access change, the "Medication Documentation Review Audit" report has been expanded, to pull in information from the previous five medication reviews. By reviewing this report, prescribers can see what home medication changes were made, e.g., by nursing in Pre-Admission Clinic (PAC) clinics or by pharmacy technicians. 

To access the history report, in the "Review Home Medications" section of Admission Documentation, click the "History" link beside the "Mark as Reviewed" button.
 

New Public Health Act Order and Flag

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...
  • New Inpatient Order - Public Health Act Certification
A prior posting drew attention to a Manual section explaining how enforced assessments are managed in Connect Care, including how certification is indicated through placement of an order that places an appropriate flag on the patient chart.

A recent order enhancement makes it easy to access and act upon all requirements relating to enforced detention, assessment, isolation or treatment under provisions of the Public Health Act (PHA). 
  1. Within a patient chart opened to an inpatient encounter, open the Orders activity and use "certified" to look up the "Flag Patient as Certified (Public Health Act)" order.
  2. Select the order to edit its properties, noting that instructions are provided about requirements that must be met to activate the provisions of the PHA.
  3. The order contains links to the required forms, which can be completed electronically, printed and scanned to the chart using Media Manager. (Note that the Section 39 and 44 and Notification of Patient Rights Forms must be printed off and given to the patient and those who need a copy of it. Please refer to the Process document hyperlink for specific details.)
  4. Action links in the order enable the generation of required notification letters, which can be composed and sent from within Connect Care.
  5. Signing the order will place a flag on the patient's Storyboard, a visual indicator that a patient is certified.
  6. Discontinuing the order (found in the "Precautions" section of the active orders list) will remove the certification flag. Modifying the order will provide access to useful links, including ones for generating letters to be used when discontinuing the certification order.

Choosing the Correct Blood Gas POCT Order

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.


Solution: The "Type" classification cannot be changed to display the expected "Respiratory" or "Respiratory/Nursing", for a variety of reasons. However, once the correct Blood Gas POCT order is found, it can be saved as a favourite.

Android 11 OS Users - Unable to Connect to AHSRestrict Wireless Network

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).

Managing Virtual Visits Without MyAHS Connect

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. 

Connect Care automatically generates a Zoom link that can be sent to the patient outside of MAC. Email can be used as follows:
  1. Within an outpatient encounter "Pre-Charting" activity, use the "Start the Visit" button to make the "Rooming" activity available.
  2. 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.
  3. If the "Email Link to..." button is not available, use the "Demographics" activity (chart search) to add the patient's email to the chart.

Prescriber Trainee Login and Authorizing Provider Updates

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...
  • Trainee Login Job Consolidation 
  • Resident Authorizing Provider Changes
As of noon on August 17, 2021, two changes go live that affect prescriber trainees:
  • Trainee login job consolidation
    • Recent work in consolidating jobs with similar functionality has simplified and reduced the number of choices presented at login. 
    • Those trainees who have multiple Connect Care roles (typically PGY1 and PGY2 residents) will see an updated list of jobs when they login to Connect Care on or after August 17. 
    • For a summary of the changes and more information, see the Manual:
  • Resident authorizing provider changes
    • The "Authorizing Provider" button is now front-facing and easier to find for all users. It will also still be available from the "Options" drop-down menu.
    • For patients in the Emergency Department, when orders are being signed, the Authorizing Provider selection screen will appear automatically. 
    • For more information on Authorizing Providers, see the Manual:

PFT Discrete Data in Results Review

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...
  • Pulmonary Function Testing discrete data now in Results Review

As of July 5, 2021, the "Results Review" activity, available in Connect Care Hyperspace for charts opened to inpatient encounters, contains Pulmonary Function Testing (PFT) discrete data obtained from AHS Pulmonary Function Labs using the Sentry Suite PFT information system.

Presentation of values for measures like FVC and FEV1 will allow for trending of PFT discreet data. Also, PFT data becomes easier to access for a wider range of users.

A PFT synopsis view is also newly available. "Synopsis" is an activity that streamlines the presentation of quantitative clinical data. The activity can be selected from any patient chart opened to an inpatient or outpatient encounter. 

Connect Care Mobility Cannot Find a Network Connection

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.

Spinal Precautions Order Panel

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...
  • Spinal Precautions now ordered via Spinal Precautions Panel
As of June 29, 2021, spinal precautions are ordered exclusively through the Spinal Precautions Panel:
  • To order, with the patient's chart open, in the "Orders" activity, search for "spinal" and select "Spinal Precautions Panel". Relevant linked patient care orders can be selected within this panel. 
  • To clear spinal precautions, two steps are needed:
    1. Discontinue the order: In the "Orders" activity, under "Active Orders">>"Precautions & Restraints">>"Spinal Precautions", click "Discontinue".
    2. Document the clearance: In the "Notes" activity, create a new note and indicate the "Type" as "Spinal Clearance" (search for "spinal") to bring up the Spinal Clearance Documentation SmartText.
      • Note: Recently cleared precautions can be seen in the "Summary">>"Overview" activity tab.
For more information, see the new tip sheet:

Inpatient Consult Order Minor Changes

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...
  • Change to Inpatient Consult Orders
A minor change to the order composer for inpatient consult requests is part of the Connect Care Spring 2021 Upgrade. This impacts no features or functions, but involves a slight layout adjustment that users will notice. Inpatient consult order entry workflows do not change. 

Previously, contact particulars for the requesting (from) and receiving (to) provider were accessed via an icon:


Presently, contact particulars appear in an information field to the right of the selected provider:


Typically, inpatient consultation requests go to a particular inpatient provider team. This continues to be the most important field as it ensures that the consult request appears in the patient list for the desired service.

If a specific consultant is desired, the "To Provider" field should be completed. The address information helps confirm that the appropriate location was chosen for providers attached to more than one facility.

Wave 3 Launch Support Hot Topics - Week 2

While this channel has highlighted post-launch needs identified in physician huddles, the launch has gone well and things have stabilized. This combined Wave 3 Week 2 posting is updated throughout the week, accumulating any new issues while also indicating issue resolution. 

  
  • Clarify Options for Reflecting On-call Coverage in Connect Care
    • Responding to user requests, new supports have been developed to highlight how Connect Care tools can be used to reflect changes in attending and on-call prescriber status, with a new Manual section, Tip sheet and FAQ.
  • Documenting COVID-19 Immunizations
    • As the order build for COVID-19 immunizations is currently in progress, documentation in Connect Care is not yet automatic. 
    • On the process for manually recording past vaccinations not captured in Connect Care, see a new bulletintip, and Manual section.
  • Mobility Apps: Haiku and Canto
    • The Haiku app on Android mobile devices lacks some of the functionality available on iOS mobile devices, particularly for inpatient quick order tools. Also, ordering from iOS devices is limited to preference lists. See this FAQ for considerations when selecting a mobile device that will best fit your clinical needs.
    • The job type you can log in to in Hyperspace can be affected by whether there is a simultaneously open Haiku or Canto session, as explained in a new FAQ.
    • Not all lab results are available to Haiku or Canto. A default lookback period (2 years for outpatient labs; 1 week for inpatient labs) ensures that the apps remain quickly responsive, even on slow networks, while not consuming too much of a user's mobile data allowance. A working group is investigating whether the lookback periods should be modified post-Wave 3, as explained in a FAQ and a general blog.
  • Virtual Drop-in Centre Hours
    • Now that we're in the second week, launch support via the Virtual Drop-in Centre is scaled back to daytime hours.
    • The schedule and information about after-hours CMIO support is available in a post and in the Manual.
  • Handoff Tool
    • Resources are being developed to highlight how Connect Care's Handoff tool is used to support patient handovers between providers.
  • Requesting Therapy Plans in Other Facilities
    • For a prescriber to request a therapy plan at a facility where they do not have privileges (especially in EDs that may not have appointment scheduling capacity or a clear most responsible provider), there needs to be direct communication between the prescriber and responsible provider at the facility that will enact a therapy plan.
    • Facility-specific workflows may be determined in collaboration with a Zone Medical Director.
    • Planning is underway for longer-term (post-Wave 3) solutions to accommodate variances in where and by whom therapy plans can be ordered and enacted.
  • Taking Care When Ordering Tests
    • Some prescribers may struggle when finding the right test for a specific clinical purpose, while being mindful of what may be locally available.
    • A new FAQ offers some advice.
  • Pocket Card Handouts for CMIO User Supports
    • A handout-ready card has been prepared that Super Users, Medical Informatics Leads, Trainers and others can use to remind Wave 3 initiates about where to get help.
  • Results Routing at Discharge
    • Specific questions are raised about how results for tests ordered at discharge, where the intent is that the test be performed AFTER discharge. A Manual section is updated.
  • Medication Start Times
    • A bulletin has been posted to remind inpatient prescribers of the importance of medication start times.
  • Patient Lists
    • An updated list of Provider Teams has been added to the Manual, organized by Wave.

Dragon Medical One Upgrades

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...
  • Dragon Medical One upgrades
A recent Dragon Medical One (DMO) upgrade brings in a few new features:
  • Dynamic microphone selection: You no longer need to exit and relaunch DMO to choose a new audio input. To switch microphones while using DMO, use the Dragon "flame" menu. 


  • Access online learning videos within DMO: Using the verbal command "open training" or "show training" will bring up a catalogue of short demonstration videos. Topics include:
    • Getting Started
    • Increasing Productivity
    • Additional Features
    • Administrative Tools
  • Spelling mode: Following the use of the verbal command "spell out", users can then spell unusual terms or acronyms, uncommon names, or special characters. The characters can be spoken using either standard letter pronunciation or the NATO phonetic alphabet (e.g., Alpha, Bravo).

For more information:

Wave 3 Launch Support Hot Topics - Day 7

Daily postings on this channel address needs raised in physician huddles, with links to support information. Content is locked in at 16:00, and any additional hot topics after this time will be posted separately. Consider looking back at the previous day's posting(s).

  
  • Keep Calm and Navigate
    • Navigators help prescribers navigate multi-step workflows where it is otherwise easy to forget key requirements. Admission, transfer and discharge navigators are particularly important.
    • Using the Discharge Navigator simplifies prescriber work, ensuring that orders, medication reconciliation, documentation and follow-up tasks are coordinated.
    •  A Manual page gives a brief orientation to navigators, including tip sheets that are being updated.
  • Start Times for Med Orders
    • If a med order is entered without a start time, the default (standardized medication administration time, SMAT) can lead to inadvertent timing of dose administration.
    • Super Users and other Wave 3 supports for prescribers are encouraged to reinforce awareness of this, and a posting will be prepared for weekend release.
  • Control Over Print Location for Discharge Prescriptions
    • Earlier this week, physicians expressed frustration with lack of control over the print location for discharge medication prescriptions generated when using the discharge navigator and discharge order. We posted a workaround.
    • Build work was reviewed and approved today by the Clinical Documentation Committee to add discharge prescription reprinting (with print location control) to the other printable discharge documents. This should get into production early next week.
  • Special Mobility Considerations for Multi-job Prescribers
    • Some prescribers have multiple roles ("Jobs", e.g., emergency physician and rural family physician) that they select from when logging in to Connect Care. This ensures that they see the correct module (e.g., ASAP) and tools. 
    • Connect Care is designed to ensure that the same user is not logged in to Connect Care in the same way at two different devices simultaneously... with the exception of mobile devices (which can be open while Hyperspace is open).
    • The catch is that a prescriber who has a mobile session (e.g., Haiku) open under one job cannot then open Hyperspace under another job. It is essential that multi-job prescribers take care to fully log off of mobility (Haiku or Canto) before logging on to Hyperspace in a different job. Otherwise, a session lock can be encountered.
    • Communications and Manual support will be developed to address this situation.

Wave 3 Launch Support Hot Topics - Day 6

Daily postings on this channel address needs raised in physician huddles, with links to support information. Content is locked in at 16:00, and any additional hot topics after this time will be posted separately. Consider looking back at the previous day's posting(s).

  • Nursing Communication Orders for Rapid Response
    • Some Wave 3 sites continue to work out how their Rapid Response nursing protocols can reflect most responsible provider engagement and endorsement.
    • While the processes need to be worked out as matters of norms and change management, this situation illustrates a possible use of "communication orders" to support initiation of protocolized actions. 
    • A new Manual section and FAQ relate.  
  • Finding Upcoming Encounters
    • Some prescribers have reported difficulty finding encounters of interest. 
    • tip is developed, a FAQ posted and both and linked to comments newly added to the Manual.
  • Setting Up a My Consults List
    • Some users do not have a "My Consults" patient list in the personal lists area of the Patient Lists activity. A method used to set up a custom list was not working.
    • Instructions are posted respecting the safest way to track one's patient attachments of the "consult" type... and to set up a My Consults folder.
    • The Patient Lists section of the Manual is updated.
  • Prescription Refill Workflows
    • There are frustrations in the early days post-launch for outpatient prescribers managing large volumes of prescription refill requests from pharmacies.
    • Prior guidance about the need to record a prescription refill in Connect Care is reinforced, while posting a FAQ reassuring that pharmacy-provided refill forms can be signed and returned (avoiding a print-sign-scan-fax workflow).
  • Need for Local Scanner/PDF-Attach Support in Consent Navigator
    • Some surgical office assistants have struggled with remote addition of scanned consent documents to the chart. 
    • A meeting of stakeholders was held to illustrate any challenges. The technology is working but there are opportunities to emphasize a few tips that will address challenges. Training is aware.
  • Attaching Media (documents, images) to Patient Charts
    • A related user request sought simple prescriber-friendly guidance about how to capture and attach documents to patient charts, or insert clinical images directly into notes.
    • The Manual entry for attaching documents/objects to patient charts is updated to highlight prescriber-friendly workflows for scanning, importing or otherwise working with Media Manager. A relevant Tippy is updated and re-posted.
  • Generating Reports Specific to a Provider's Activities During a Defined Period
    • Already Wave 3 users express interest in how they might use Connect Care to generate a report of their patient-related activities for a defined period.
    • We may turn specific request(s) into examples that others can emulate.
    • For now, a section of the Manual has been updated.
  • Results Routing for Locum Prescribers
    • Challenges with different options for locum prescribers to receive or delegate test results related to a specific work assignment are being explored, with intent to produce a simplified summary of issues and options.
  • Orders for Specific Rapid COVID-19 Testing
    • Some Wave 3 prescribers wish to order a new Rapid-testing assay newly available but not on their facility list. 
    • The Components committee is looking at options for extending the current integrated testing order panel.

Wave 3 Launch Support Hot Topics - Day 5

Daily postings on this channel address needs raised in physician huddles, with links to support information. Content is locked in at 16:00, and any additional hot topics after this time will be posted separately. Consider looking back at the previous day's posting(s).

  • Login for Shared Clinical Workstations
    • It is very important to ALWAYS log in to an AHS computer workstation (and then Connect Care) with one's own unique credentials (user name and password), and then to log off of both Connect Care and the workstation before leaving the device. This prevents "session stealing" and other information system challenges. "Generic" logins should not be used. 
    • An updated FAQ addresses the previous practice of using generic logins, and a bulletin details logging off/tapping out.  
  • Post-Admission Alerts when ED organizes Admission
    • Workflows for emergency physicians who organize and implement admissions (more common at Wave 3 sites) expressed concern about intrusive alerts.
    • The associated workflow is being simplified to avoid a superfluous popup.
  • Admitting vs. Attending vs. Authorizing Prescriber
    • Wave 3 inpatient services are getting used to a variety of admission workflows, including those where an ED prescriber does an admission overnight that a hospitalist takes responsibility for in the morning.
    • It is important to recognize the primary importance of the "Attending" (Most Responsible Healthcare Provider) prescriber attachment to a patient and to firm-up processes for ensuring that this status is updated as clinicians handover. An enhanced Manual section is released today along with a linked tip.
  • Finding Upcoming Encounters
    • Some prescribers have reported difficulty finding past encounters of interest. 
    • A tip is developed and linked to comments newly added to the Manual.
  • Sticky Notes
    • Reminder that Sticky Notes do not form part of the chart and should not be used for orders or care notes/documentation. They can be very useful for multidisciplinary team, most responsible provider and specialty reminders.
    • See yesterday's posting on communication norms for more information and note the Manual section about Sticky Notes.
  • Virtual Drop-In Support
    • The Virtual Drop-in Centre is available, to both end users and Super Users requiring additional support, 24/7 for the first post-launch week. To access, go to virtualhelp.connect-care.ca using a computer or smartphone or via the QR code found on the Launch Supports poster up in sites (or the Manual) using a smartphone camera for audio-only help. 
  • Connect Care to Netcare
    • Some Wave 3 users have asked about how to tell if a Connect Care documentation object (e.g., progress note) will be shared with Netcare.
    • A general blog posting reminds about how Connect Care to Netcare document sharing works.

Wave 3 Launch Support Hot Topics - Day 4

Daily postings on this channel address needs raised in physician huddles, with links to support information. Content is locked in at 16:00, and any additional hot topics after this time will be posted separately. Consider looking back at the previous day's posting(s).

  • Ordering Therapy Plan Treatments in EDs
    • Therapy plan treatments may require visits scheduled in emergency departments (EDs), a workflow more common Wave 3. However, the best way to facilitate scheduling differs from site to site.
    • A tip sheet has been published, linked to an addition to the Manual and a new FAQ posting.
  • Virtual Drop-In Support
    • The Virtual Drop-in Centre is available, to both end users and Super Users requiring additional support, 24/7 for the first post-launch week. To access, go to virtualhelp.connect-care.ca using a computer or smartphone or via the QR code found on the Launch Supports poster up in sites (or the Manual) using a smartphone camera for audio-only help. 
  • Entering Orders on Behalf of Another Provider
    • If a provider must enter an order on behalf of the Ordering Provider, the correct Authorizing Provider must be selected via the Options >> Providers drop-down menu (in the Orders sidebar) to avoid incorrect results routing.
    • Note that entering an order for another provider is not recommended as a routine practice, particularly if the providers have different login departments. 
    • New FAQ posted.
  • ED Prescriber Admitting to a Different Site
  • Tweaks to Discharge Report for Community Pharmacy
  • Ordering Norms
  • Communication Norms
    • A new blog posting emphasizes that secure messaging should not be used as a surrogate for order entry. If one can secure-message, one can and should do CPOE. Secure messaging is not an appropriate communications tool for "verbal" orders.
  • Connect Care to Netcare
    • Some Wave 3 users have asked about how to tell if a Connect Care documentation object (e.g., progress note) will be shared with Netcare.
    • The April 14 general blog posting reminds about how Connect Care to Netcare document sharing works.
  • Connect Care to Community EMR
    • Wave 3 users have also asked about whether and how Connect Care documentation can be shared with Community Electronic Medical Records served by "eDelivery".
    • This is an area where important new capabilities are soon to be released. What and how to communicate is under consideration. Prior messaging needs to be updated.

Wave 3 Launch Support Hot Topics - Day 3

Daily postings on this channel address needs raised in physician huddles, with links to support information. Content is locked in at 16:00, and any additional hot topics after this time will be posted separately. Consider looking back at the previous day's posting(s).

  • ED Prescriber Admitting to a Different Site
    • An emerging Wave 3 workflow involves a prescriber assessing a patient at an ED at one facility (without inpatient beds) and admitting to another facility where the prescriber may continue or handover care. The best way to handle this is being worked out and may involve an addition to the Patient Movement section of the Manual. 
  • ED Prescribers Entering Inpatient Orders
    • Another workflow emerging as Connect Care encompasses more rural sites involves a prescriber working in an ED context admitting a patient to the same facility (possibly as an emergency inpatient) where the ED prescriber is also the inpatient attending. Connect Care orders, navigators and documentation tools tend to be anchored to specific contexts (i.e., inpatient, ED, critical care, outpatient) and so generate alerts if a prescriber logged in to one context tries to take actions for the same patient in a different context. Best practice supports are being enhanced.
  • Controlled Printing of Prescriptions at Discharge
    • Upon signing a patient discharge order, important documents are automatically printed at the relevant patient's hospital location (ward). These include an after visit summary (AVS), medication reconciliation report for community pharmacy and any new physician prescriptions. The printing location is tied to the patient location, under system control.
    • Pandemic and rural workflows may involve responsible physicians off-site at the moment of discharge. Yet the printed prescriptions need to be signed and faxed or otherwise delivered to the preferred pharmacy.
    • Enhancement requests are submitted to improve options for reprinting (under manual control) physician prescriptions, just as it is possible to re-print AVS and pharmacy forms.
    • A workaround for physicians is communicated, hoping that this will decrease temptation to (inappropriately) use signed pharmacy MedRec reports (which can be printed to local devices).
  • Provider Teams
    • Continued progress is made capturing few remaining provider team needs and setting up the associated lists.
    • A summary listing of all Wave 3 provider teams will be linked to the Manual towards the end of the week.
  • Ordering Norms
    • As happens with each Wave launch, prescribers and their supports struggle with situations where it may be difficult for physicians to enter orders directly to Connect Care. 100% CPOE (computerized provider order entry) is the goal, for many reasons, but there are some clearly defined exceptions described.
    • There are many ways (including use of mobile apps) for prescribers to order from a distance without distancing themselves from decision supports.
    • All clinicians are reminded to follow Connect Care Ordering Norms and the heads-up provided in the Wave 3 countdown checklist.
  • Communication Norms
    • Also shared with prior launch Waves is the need for prescribers and healthcare teams to consider appropriate uses of the new secure clinical communication options made possible by Connect Care. Professionalism must guide sensible tool use.
    • All clinicians are reminded to follow Connect Care Communication Norms, especially to devise and adhere to communication pacts among teams. The Norms recognize that different teams may need to use particular tools in different ways. But all must have a clear understanding of which tools to use for different levels of urgency and response timeliness. 

Wave 3 Launch Support Hot Topics - Day 2

Daily postings on this channel address needs raised in physician huddles, with links to support information. Content is locked in at 16:00, and any additional hot topics after this time will be posted separately. Consider looking back at the previous day's posting(s).
  • Blood Product Information System
  • Dose Ranges in Medication Orders
    • Pharmacy has noted difficulty fulfilling some PRN orders containing instructions for dosing within pre-defined ranges. Dose ranges that are too wide create dispensing challenges when the range exceeds what can be covered within a particular medication concentration (strength).
    • Prescriber best practices, highlighted in the Manual, are re-emphasized.
  • Printer Mapping
    • A common early post-launch challenge relates to ensuring that all clinical workstations are mapped to appropriate local printers. This work continues as problems are discovered.
    • Prescribers are reminded about the difference between printing tasks that are subject to system-set printer mappings versus other tasks where the user can control the print location.
  • Provider Teams
    • Post-launch, a need for some additional inpatient provider teams (important to Patient Lists) has been identified and the needed teams are being created.
  • Therapy Plans and Departments
    • Some NZ departments are not available in relevant pick-lists within therapy plans.
    • A rapid configuration tweak is underway.
  • Cardioversion Information Flows
    • An opportunity for additional training and change-management support has been identified, without need for Connect Care build changes or optimizations.
  • Medical Scribes
    • As in prior waves, questions are raised about ordering norms and how they apply to situations where there may be a duty to accommodate.
    • Related questions about the possible use of "medical scribes" provide opportunity to remind prescribers that any exceptions to Connect Care ordering norms must be formally requested and approved, and that substitute ordering can only be done in a pre-approved way where the involved extended-role non-prescribers are appropriately trained and AHS-certified.
  • Problem List Management
    • Team members have commented about the number of Wave 3 charts that lack problem lists reflecting patients' health conditions.
    • Problem list management is very important to do, but a bit daunting early in one's Connect Care experience.
    • A new series of Problem Power Tips is started in the Connect Care Tips channel. 

Wave 3 Launch Support Hot Topics - Day 1

Daily postings on this channel address needs raised in physician huddles, with links to support information. Content is locked in at 16:00, and any additional hot topics after this time will be posted separately. Consider looking back at the previous day's posting(s).
  • WellSky Blood Product System Downtime
    • A planned downtime for the WellSky blood product management information system had to be extended when interfaces to core Connect Care information systems did not restore as expected.
    • Prescribers have continued downtime procedures as reminded in an all-user bulletin and login alerts.
  • Drop-in Centre Move
    • As of Sunday morning, April 11, the in-person Drop-In Centre at the Grande Prairie Queen Elizabeth II Hospital is being moved to a more convenient location: room 2509-2510 (previously called 2-2 North), located just outside the physicians' lounge.
  • Goals of Care Management

Wound Treatment Orders Can Be Linked to a Specific Wound

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...
  • Change to Wound Orders
As requested by surgical specialties, wound care orders can now be linked to a specific wound site by selecting from a list of documented wounds at the time of order entry.


IVIg Therapy Plan Changes

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...
  • Change to Therapy Plan for IVIg
As requested by a number of specialties, intravenous immunoglobulin G (IVIg) can now be ordered through its own Therapy Plan. Previously it was necessary to work through a transfusion (Blood Administration) Therapy Plan to order recurring treatments with IVIg.

The IVIg Transfusion (ADULT) Therapy Plan includes two series of appointment requests and two sets of Prepare, Dispense and Immune Globulin orders for divided doses.

New SmartText Available for Declined Inpatient Co-signs

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...
  • New Declined Co-sign SmartText
Sometimes prescribers receive In Basket messages reminding/requesting a co-sign for an inpatient order where the receiving physician did not supervise the ordering trainee, or otherwise was not accountable for the action.

A new SmartText can facilitate a quick response, clearing the message (and request) from one's In Basket. The returned text reminds to suggest the appropriate co-signing provider. To retrieve the SmartText, type "cosign" in the SmartText lookup box above the response message edit area:

Simpler Connect Care Referral Orders

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...
  • Change to Connect Care Referral Orders - Internal/External
Connect Care is making some changes to referral workflows, to ensure that closed loop communication is maintained. Prescribers will see some minor changes to referral (to ambulatory services) order composers starting January 21, 2021.

Previously, an "internal state" workflow was available to address situations in zones where some services are on Connect Care and others are not. This workflow is eliminated. It is simpler to think of just two workflows, one for referrals that are "internal" because both the order (request) and the response (outpatient service) occur where Connect Care is the record of care; and another for referrals that are "outgoing" because the receiving service is not on Connect Care. 

If the "Internal Referral" button is selected, the order composer adjusts to show only those services currently using Connect Care (no future wave sites). If the user does not find the desired service there, then the "Outgoing Referral" button can be selected to expose options for sending the referral to an external service.

Referral norms and processes are covered in the Connect Care Physician Manual:

Co-sign Required for Pre-op Orders Placed by Surgical MOAs

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...
  • Second Signature for Pre-op Orders entered by Medical Office Assistants
In compliance with decisions made by Zone executive committees, a Connect Care delegated ordering workflow has been enhanced to assure surgeon validation of pre-operative orders entered by medical office assistants (MOAs), with the process summarized in the Connect Care Physician Manual: