New Referral Reject Reason - Collateral Visit

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• New Referral Reject Reason - "Collateral Visit Provided"

As previously posted, "Collateral Visits" are visits with a person other than the patient (e.g., parent, partner, caregiver, provider, multidisciplinary team) regarding the health care of the patient. The appointment is scheduled to the patient but attended by the collateral person, and the encounter is on the patient’s health record. These visit types should not be used to link referrals to. 

As of August 7, 2025, to support proper workflows for referrals, if a referral request is actioned by the referred-to provider through a Collateral Visit, when the referral is triaged it will be rejected with the new reason of "Collateral Visit Provided" and the referral record will show as closed. If the referring provider has follow-up questions about the Collateral Visit, they should communicate with the referred-to provider who provided the Collateral Visit. 

For more information on Collateral Visits and referrals, see:

• Guide: Collateral Visit
• Manual: Referral Workflows

Change to Ambulatory Referral to Continuing Care Access and Home Care Order

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• Change to Ambulatory Referral to Continuing Care Access and Home Care Order

All Home Care referrals must be triaged through the Continuing Care Access (CCA) departments, and so CCA is pre-filled in the "To Department Specialty" field of the Ambulatory Referral to Continuing Care Access and Home Care order. Previously, however, some referral orders have been signed with that field changed, causing delays in the requests being processed. 

To ensure the CCA is not bypassed, as of July 8, 2025, users will not be able to change the "To Department Specialty" field on the Ambulatory Referral to Continuing Care Access and Home Care order. This is noted in the "Process Instructions" at the top of the order (click the left camera icon to see a screenshot). If the pre-filled field is changed, an error message will appear, indicating that a CCA department must be chosen before the order can be signed (right camera icon).

 

Ambulatory Referrals Update - No Editing After Signing

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• Ambulatory Referrals Update - No Editing After Signing

When changes are made in Connect Care to a signed referral order on the ordering side, the referred to department is not notified. To avoid any issues caused by this, as of June 10, 2025, users will no longer be able to edit ambulatory referral orders that have already been signed.

If any updates are needed to a signed referral order, call and/or fax the referred to provider or clinic. If the referral has not yet been assigned, Centralized Access and Triage (CAT) can be called and/or faxed. 

• Manual: Referral Workflows - Updates to Referrals

Prehabilitation (Prehab) Program Referral Order

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• Prehabilitation (Prehab) Program Referral Order 

The AHS Prehabilitation (Prehab) Program provides prehabilitation services for Albertans 18 years and older who are waiting for surgery. As of May 6, 2025, a new "Prehab Program" section will be added to eleven Preprocedure Adult order sets in Connect Care, so prescribers (or their MOAs) can easily place an ambulatory referral to prehabilitation. The addition of this section will have no impact to personalization of the affected order sets. 

To place an order for referral to prehabilitation using a Connect Care pre-op order set:

• Open Prep for Procedure and find the patient.
• In the order set, under the "General" section, find the new "Prehab Program" section. Click "Ambulatory Referral to Rehabilitation" (click the camera icon below to see a screenshot).

• In the Ambulatory Referral to Rehabilitation order that opens:
• The "To Department" field will be prefilled with "AHS PROV PREHABILITATION" and the "Reason" field with "Prehabilitation". Leave these as is.
• In the "Comments" field, enter "prehab" or "prehabilitation" (this is a hardstop).
• Sign the orders.

For more information on the Prehab Program, visit ahs.ca/Prehab. Patient handouts and posters can be requested by submitting the Prehab Order Form. If you have questions, please email Prehab@ahs.ca or call 1-888-852-3383. 

Change to Availability of Endoscopy/ Bronchoscopy Procedure Orders

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• Change to Availability of Endoscopy/Bronchoscopy Procedure Orders 

To avoid procedural orders being inappropriately ordered in Connect Care instead of a referral or consult, as of April 21, 2025, endoscopy and bronchoscopy procedures (all except for motility and video capsule endoscopy) will be removed from preference and facility lists. Prescribers without any Lumens training will no longer be able to search for the removed procedural orders; instead, when the prescriber searches for the removed procedural orders, the Ambulatory Referral or Inpatient Consult to the relevant specialty will appear. 

Note that prescribers with a GI or General Surgery profile will still have access to the endoscopy and bronchoscopy procedural orders.

• Manual: Referral and Consultation Workflows

Update to Ambulatory Referral to Rehabilitation and Speech Therapy Orders

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• Update to Ambulatory Referral to Rehabilitation and Speech Therapy Orders 

Provincial stakeholders have been working over the last several months to make improvements to the "Ambulatory Referral to Rehabilitation" and "Ambulatory Referral to Speech Therapy" orders, as higher than expected rates of missing information have been delaying patient access to these specialty care areas.

As part of this work, starting April 1, 2025, instead of an authorization question in the orders, an authorization statement will appear after selecting “Eating/Feeding/Swallowing” as the functional problem the patient is experiencing (click the camera icon below for a screenshot). This change will streamline the process when referrals are submitted to Ambulatory clinics who perform Instrumental Swallowing Assessments (Videofluoroscopic Swallow Study [VFSS] and Flexible Endoscopic Evaluation of Swallowing [FEES]). 

If you have personalized a referral where you have selected "Eating/Feeding/Swallowing" as a functional problem, you will need to re-personalize the Referral order from the facility list, and within your order sets and SmartSets.

New Ambulatory Referral to Oncofertility

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• New Ambulatory Referral to Oncofertility

As of January 15, 2025, the implementation of a new Oncofertility Pathway brings changes to how oncology prescribers will be able to refer to fertility services. The new "Ambulatory Referral to Oncofertility" order will streamline the referral process for connecting cancer patients with fertility clinics. The referral is available to all oncology prescribers (Cancer Care Alberta [CCA] and non-CCA) and will facilitate electronic referral requests being sent to one of the three fertility clinics in Alberta who provide fertility preservation services for cancer patients.

For more information on the referral workflow, see the Quick Start Guide:

• Guide: Oncofertility Quick Start Guide 

Referral Order Pop-up in Personalized Referral Orders

Personalized referral orders have been impacted by the recent referral order update. If you are using a personalized referral order, you may see a pop-up titled "Change Order Class" or "Change Referred to Department" that asks to replace the order's "Comments" field with SmartText. To stop this pop-up from occurring, please delete and resave the referral order to your preference list. See below for additional details.

  

Context: As previously posted, the updates made to the referral order composer on October 27, 2023 have made the Comments field a hard stop, and the field is now pre-populated with a prompt to remind the prescriber to enter details ("Please describe in detail, the reason for referral or the clinical question you would like answered", with the wildcard ***). As Personal Preference Lists were not changed as part of this update, if Comments field personalizations were created before this update, they will have to be re-created.

The above pop-ups are triggered for users who are using a referral order they had saved to their Personal Preference List prior to the October update, and are making a change either to the order "Class" field (first screenshot above) or to the "Referral To dept" field (second screenshot above). If the "Yes" button in the pop-up is clicked and you had previously personalized the Comments field, that personalized text will be replaced with the new automatic prompt. However, clicking "Yes" will not disable the pop-up, and it will appear each time you change the "Class" or "Referral To dept" field in your saved referral order. 

Solution: The pop-up will go away only if you remove and re-add the order to your Personal Preference List. Before doing so, ensure you record any personalized comments you want to keep first, so you can re-create that personalization in the updated order.

Referral Workflow Updates

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• Referral Workflow Updates

As of October 27, 2023, prescribers using referral orders for outpatient (ambulatory) consultation will notice a few changes. There are enhancements to the referral order composer for prescribers, and to the tools specialty services use for referral triage via In Basket. 

Changes to the Referral Order Composer

• The "Comments" field, where information important for triage and consultation is entered, is now a required field (hard stop). SmartLinks can be used to pull chart information into the comments and SmartPhrases can be used to record frequently used referral indications. 
• Note: Previously saved Comments field personalizations will need to be re-entered and re-saved after October 27, 2023. 
• Following this update, if you are using a personalized referral order, you may see a pop-up. See this blog post for more details on how to manage.
• A reason for the referral must be selected (from the list or via speed button) in the "Reason" field.
• FAST (Facilitated Access to Specialized Treatment) referral orders will now be entered using the specialty-specific order (e.g., urology) and then indicating in the order that it is for FAST, rather than using a customized FAST referral for each specialty.
• For outgoing referrals, the "To loc/pos" (location/place of service) field is now a recommended field.  
• Referral orders now contain a link to the Referrals section of the Connect Care Manual, in the "Reference Links" section.

Note: given the changes to the referral order composer, any personalizations of Order Sets or Smart Sets containing referral orders will have to be re-entered after the update. Order preference lists will not be affected.

Changes to the Referral Triage In Basket Message Report

• The referral triage In Basket message report is now available from the In Basket Message as well as the Referral Sidebar.
• A "Notes" section has been created to display specialty comments and referral attachments.
• A "Messages" section has been added.
• Referral notifications have been moved to a separate tab ("Notifications").
• The referral reason ("Rfl Reason") has been added to the message preview. 
• An "Order Information" section, including a hyperlink to the Ordering Encounter Summary and Appointment Request, has been added.

For screenshots and a walkthrough of each change, see the tip sheet and demo video.

• Tip: Referral Updates
• Demo: Referral Updates
• Manual: Referral Workflows
• Support: Referral Order Pop-up in Personalized Referral Orders

Removal of Ambulatory Clinical Letters

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• Removal of Two Ambulatory Clinical Letters 

As of March 29, 2022, the following two ambulatory clinical letters will be removed from Connect Care, to ensure the correct referral workflow is being used for generating a referral in an ambulatory context to a specialty:

• AHS AMB PRIMARY CARE RFL SIMPLE
• AHS AMB PRIMARY CARE RFL DETAILED

Referrals from Connect Care providers should not be managed with letters in the communications activity. Instead, all outgoing referrals should be managed in Connect Care using referral orders. Doing so ensures that the referral becomes part of the patient's chart and is properly managed by the receiving department. A referral order facilitates Closed Loop Referral Management communications for both referring providers and patients. This applies for both internal referrals to services where Connect Care is the record of care, and external referrals to services using a different information system.

 For more information:

• Manual: Referral Norms 
• Manual: Referral Workflows

Referral Routing SmartPhrase

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• Referral Routing SmartPhrase

All referrals and consultations must be ordered within Connect Care where Connect Care is the record of care. Using the correct workflow ensures that consults and referrals are identified, tracked and completed in a timely manner. Clinicians who receive consult requests from other Connect Care clinicians through informal channels should remind the requesting provider that the desired consult or referral must be entered in Connect Care. 

A simple SmartPhrase can be used to generate reminders for colleagues when responding to In Basket requests that do not use the recommended referral order workflow:

• Use ".REFERRALROUTING" or ".REFROUTE" in the body of the In Basket response message.

The new SmartPhrase will pull in text instructions for the appropriate referral order workflow.

• Manual: Referral and Consultation 

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:

• Manual: Referral Norms
• Manual: Referral Workflows

Change to location of 'External' Orders

Problem: When ordering interventions (e.g., referral) in an inpatient context, physicians need to remember to open a specific "External Orders" activity to access orders applicable in an outpatient context. This proved confusing and forced exit from one ordering workflow (inpatient) to find a different ordering workflow.

Solution: Connect Care has been enhanced to bring all ordering within the same workflow. Now "External Orders" appears as a tab within the Inpatient Orders activity when a patient chart is open in an inpatient context. Prescribers are alerted to use this tab only for referrals or other post-discharge interventions.

Who can help Specialty Services adapt Referral processes for Connect Care?

Problem: Specialty outpatient clinics may use Connect Care as their record of care without fully implementing referral management processes that use the clinical information system. This is a problem if the clinic has indicated that it is "internal" for referrals but has not set up intake messaging pools, assigned staff to work-queue monitoring, or coordinated staff and physician contributions. Referring prescribers will generate referral orders that do not achieve the intended result.

Solution: Outpatient speciality services that use Connect Care as the record of care are "internal" referral resources. It is important that they have "receptor capacity" with appropriate use of referral intake messaging pools, work-queue tracking and triage processes. These clinics should reach out to the Connect Care Patient Access Team (ClinicalOperations-Patient.Access@ahs.ca) to confirm that they are referral-orders-ready.