Connect Care Support Forum

Communications Update - Sensitive Letters

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

Confidentiality Feature - Marking Letters as Sensitive

As of September 16, 2022, letters (like notes) can now be marked as "Sensitive". When a letter is marked sensitive, it will only be routed to the selected recipient(s) of the letter and will be excluded from Netcare and automated eDelivery to the patient's Primary Care Provider (PCP).

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.

A letter can be marked as "Sensitive" by selecting the "Sensitive" button appearing in the communications workflow. The "Sensitive" property can then be removed by selecting the "Addendum" option in the identified letter and unchecking the "Sensitive" designation. Only the author of the letter can adjust the sensitive properties of the letter.

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

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

Renamed and New Send Notes Buttons

As of June 7, 2022, in the Communications section for ambulatory encounters, the "Send Notes" button has been renamed "Send Last MD/NP Note". An additional "Send All Notes" button has also been added, which captures all progress notes or telephone notes for the current encounter.

Fix for Mobile App Short Time-outs on Android Devices

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

Connect Care Mobility for Android Time-out Fix

Mobility application (PowerMic Mobile, Haiku) users on Android devices can increase the amount of inactivity time before the device screen locks.

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.

Launch 4 Support Hot Topics - Week 3

This posting lists a few new or persisting issues raised in prescriber huddles during the third week of launch support, with links to support information. Consider looking back at previous Hot Topics posts.

Provider Care Team Lists

Reports from multiple zones have identified an issue with providers dropping off of Provider Care Team lists for unknown reasons. The issue is currently being investigated by IT.
Until the issue is resolved, it is recommended to print your patient list for cross-reference. Ensure you log a ticket if you notice this behaviour as we continue to try and find out why this is happening.

Computerized Prescriber Order Entry (CPOE), Verbal/Telephone Orders, and Mobility Apps

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.
As mobility apps are not required and not all prescribers have them, mobility apps should not be considered part of the ordering workflow.

Death Certification - Paper Process

Reminder that death certification is one of the few tasks that can only be completed on paper, as the Province of Alberta does not yet support digital death certification.
See the blog post for more information.

Virtual Drop-In Support

The In-person Drop-in Centres are closed for the weekend, June 18-19.
The Virtual Drop-in Centre remains available, to both end users and Super Users requiring additional support, 08:00-21:00 until June 26. 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.

Launch 4 Support Hot Topics - Week 2

This combined posting is updated throughout the second week of launch support, accumulating needs raised in prescriber huddles, with links to support information. Consider looking back each day.

(Note: Emails from our subscription service show the original version of the post,

and so will not show any updates made in the body of the email - click the link in the email to see the up-to-date web version.)

Calgary Zone – Add-on Labs

Add-on labs cannot be ordered in Calgary Zone through Connect Care.
Inpatient clinicians should continue using the legacy process of calling the Lab Information Centre to request add-on tests to existing specimens.

Calgary Zone – Endocrinology Central Access & Triage (CAT) Workflows

There were concerns around CAT workflows due to some incorrect messaging. The original issue was determined to be an isolated event specific to end-user behaviour.
The CAT workflows are performing as designed, but users are encouraged to submit a ticket if investigation is needed.
See a memo for further details.

Delivery of Summative Notes and Results to Community Providers

With Launch 4, there have been changes to how Connect Care summative notes and results are distributed to community providers, including those who work both within AHS and at community-based or private practices (“mixed-context” providers).
A memo summarizes how these changes affect mixed-context providers, whether they are identified as the Primary Care Provider (PCP) or are the authoring provider.

Mixed-Context Prescribers - Diagnostic Imaging (DI) Report Delivery

For prescribers who work both within AHS and at community-based or private practices (“mixed-context” providers), some DI reports will be received twice - both in their Connect Care In Basket AND at a community/private clinic.
See this memo for more information.

Ambulatory Clinic Consult Notes

In addition to the communications workflow taught during training (selecting template that goes to Netcare and AHS referring provider), a new simplified "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).
Note the quick click function does not work for hospital outpatient department encounters (HODs).
For more information on this quick click function, see this blog post, demo, and the Shared Documents 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.

Emergency/Urgent Care - Ordering Acetylcysteine for Acetaminophen Overdose

Please note when ordering acetylcysteine for acetaminophen overdose, there are order sets to support ordering the appropriate infusions. Recommended order sets for ED:

Overdose / Toxic Ingestions (Acetaminophen, Salicylates, Toxic Alcohols) Adult ED/UCC
Overdose Acetaminophen ED/UCC Pediatric

The "Acetylcysteine Infusion (Pediatric/Adult)" order does not follow the protocol to treat acetaminophen overdose, it only orders a continuous infusion.

New Inpatient Consult to Pediatric Respirology

A new inpatient consult to Pediatric Respirology has been created that replaces "Inpatient Consult to Pediatric Pulmonology" and "Pediatric Respiratory Medicine".
The new order is available in production, and Order Sets and system preference lists have also been updated. Please update in your personalized ordering tools and preference lists as needed.
If you have questions, please reach out to terri.mcneill@ahs.ca.

Calgary Zone - Microbiology Antibiotic Susceptibilities not Matching the Organism

An intermittent issue has been identified with microbiology antibiotic susceptibilities either being delayed or mapping to the incorrect organism since launch in the Calgary Zone sites.
The laboratory will continue to call positive cultures and susceptibility results from blood cultures and sterile sites. In the event of a discrepancy between that verbal notification and the results in Connect Care, Netcare should be used as confirmation of the accurate results and for confirmation for cultures from all non-sterile sites.
Lab is continuing to monitor and fix the issues as they are found, and will have provided notice to those prescribers who may have had errors.

Referrals to External Clinics

"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 are not on Connect Care are "outgoing", or external, referral resources.
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:

Intra-facility Direct Admit

Updated tip sheets are now available for direct admit, one for Ambulatory Clinic to Inpatient (IP) and one for Hospital Outpatient Department (HOD) to IP. Both tip sheets are linked to from the Direct Admissions section of the Connect Care Manual.

Interfacility Transfers (IFTs) - Connect Care to Connect Care Sites

Reminder that all users should now be using the IFT workflow when moving patients from a Connect Care site to another Connect Care site. See the Connect Care Manual section for more information.

OR Scheduling and MOA Workflows

There has been some lack of clarity between OR scheduling workflows and MOA workflows. A memo has been communicated.

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.

Astraia and Connect Care Integration

Astraia is a specialized perinatal documentation system used in conjunction with Connect Care to provide comprehensive Maternal Fetal Medicine (MFM) assessment and consultation.
Challenges with the Astraia interface to Netcare and Connect Care impacted prescribers and staff this past week.
Due to the efforts of the MFM team working together with the Astraia vendor and AHS IT, all results from Astraia are now successfully flowing into Netcare and Connect Care.

Virtual Drop-In Support

The Virtual Drop-in Centre is available, to both end users and Super Users requiring additional support, 24/7 until June 10. 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.

Launch 4 Support Hot Topics - Day 7

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.
See the IFT section of the Connect Care Manual for more information, which includes a number of resources such as the below tip sheets:

Calgary Zone - Results Management

Reminder to Calgary Zone prescribers to check legacy systems and processes for lab results for one week post-cutover. See this tip sheet for more information.

Virtual Drop-In Support

The Virtual Drop-in Centre is available, to both end users and Super Users requiring additional support, 24/7 until June 10. 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.

Printing Tips

Some printing tasks in Connect Care are driven by system settings (e.g., label printing), while other tasks use printers mapped to the current workstation in a way that the user may be able to modify.
For help with printing issues, see the Printing Tips section of the Connect Care Manual. The section links to a number of resources such as a tip sheet on Virtual Local Printing (VLP), which allows users to select the preferred printer and retain it for all future printing.

Launch 4 Support Hot Topics - Day 6

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.
See the IFT section of the Connect Care Manual for more information, which includes a number of resources such as the below tip sheets:

Calgary Zone - Results Management

Reminder to Calgary Zone prescribers to check legacy systems and processes for lab results for one week post-cutover. See this tip sheet for more information.

Virtual Drop-In Support

The Virtual Drop-in Centre is available, to both end users and Super Users requiring additional support, 24/7 until June 10. 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.

Printing Tips

Some printing tasks in Connect Care are driven by system settings (e.g., label printing), while other tasks use printers mapped to the current workstation in a way that the user may be able to modify.
For help with printing issues, see the Printing Tips section of the Connect Care Manual. The section links to a number of resources such as a tip sheet on Virtual Local Printing (VLP), which allows users to select the preferred printer and retain it for all future printing.

Launch 4 Support Hot Topics - Day 5

Virtual Drop-In Support

The Virtual Drop-in Centre is available, to both end users and Super Users requiring additional support, 24/7 until June 10. 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.

Medication Start Times and Scheduling

A bulletin reminds inpatient prescribers to take note of medication order start times and the resulting anticipated initial schedule of dose times, to confirm that it fits clinical need.
Tips regarding standardized medication administration times (SMAT) and medication scheduling are covered in a tip sheet.

Calgary Zone - Results Management

Reminder to Calgary Zone prescribers to check legacy systems and processes for lab results for one week post-cutover. See this tip sheet for more information.

Attaching Media (documents, images) to Patient Charts

See the Connect Care Manual entry for information on attaching documents/objects to patient charts, including prescriber-friendly workflows for scanning, importing or otherwise working with Media Manager. A Tippy also gathers key resources.

Connect Care to Netcare

See this blog post for a summary of how Connect Care to Netcare document sharing works.

Printing Tips

Some printing tasks in Connect Care are driven by system settings (e.g., label printing), while other tasks use printers mapped to the current workstation in a way that the user may be able to modify.
For help with printing issues, see the Printing Tips section of the Connect Care Manual. The section links to a number of resources such as a tip sheet on Virtual Local Printing (VLP), which allows users to select the preferred printer and retain it for all future printing.

Launch 4 Support Hot Topics - Day 4

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.

Calgary Zone - Results Management

Reminder to Calgary Zone prescribers to check legacy systems and processes for lab results for one week post-cutover. See this tip sheet for more information.

Calgary Zone - Accessing External Patient Info

See this tip sheet for more information on how to access external patient info while Calgary Zone transitions from Sunrise Clinical Manager (SCM) to Connect Care. (An Insite page covers other interim state workflows for Calgary Zone.)

Printing Tips

Some printing tasks in Connect Care are driven by system settings (e.g., label printing), while other tasks use printers mapped to the current workstation in a way that the user may be able to modify.
For help with printing issues, see the Printing Tips section of the Connect Care Manual. The section links to a number of resources such as a tip sheet on Virtual Local Printing (VLP), which allows users to select the preferred printer and retain it for all future printing.

Launch 4 Support Hot Topics - Day 3

Daily postings on this channel address needs raised in prescriber huddles, with links to support information. Content is published around 17:00; any additional hot topics after this time will be posted the following day. Consider looking back at the previous day's posting. (Note: Emails from our subscription service show the original version of the post, and so will not show any updates made in the body of the email - click the link in the email to see the up-to-date web version.)

Documenting Allergies

Allergy documentation is important to the provision of safe patient care. When entering a new allergen, the system completes a search of common allergens. If the allergen cannot be found, clinicians should check off "Full Search" to access the extended list of all allergens available in the database, before selecting “Other”. When “Other” allergen is selected, the system cannot complete interaction checking and allergies are not communicated to other applications.
Food allergens: In order to find common food allergens in Connect Care, make sure that "Full Search" is checked off. If food allergies cannot be found using Full Search, choose "Other Food" and then enter the food in the comments section. Food allergies entered under “Other” will not be communicated to Patient Food Services, while food allergies entered under "Other Food" will be reported to Patient Food services and interface with CBORD.
For more information on documenting allergies, see the Adverse Reaction (Allergy) Documentation Norms section of the Connect Care Manual and tip sheet.

Patient Movement - Interfacility Transfers (IFTs)

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. If you need a consultation for advice or for transfer of care, contact RAAPID South. (An Insite page covers other interim state workflows for the Sunrise Clinical Manager [SCM] to Connect Care transition.)
Further information on IFTs for all zones is gathered in this Countdown Checklist post.

Verbal Communication

Connect Care clinical communication norms detail the importance of verbal communication for urgent care matters and issues impacting patient disposition. See the Communication Norms section in the Connect Care Manual and today's blog post for more information.

Printing Tips

Some printing tasks in Connect Care are driven by system settings (e.g., label printing), while other tasks use printers mapped to the current workstation in a way that the user may be able to modify.
For help with printing issues, see the Printing Tips section of the Connect Care Manual. The section links to a number of resources such as a tip sheet on Virtual Local Printing (VLP), which allows users to select the preferred printer and retain it for all future printing.

Launch 4 Support Hot Topics - Day 2

Daily postings on this channel address needs raised in prescriber huddles, with links to support information. Content may be added throughout the day, and is locked in around 17:00; any additional hot topics after this time will be posted separately. Consider looking back at the previous day's posting(s).

Provider Care Team (PCT) and Specialty Service - For prescribers with inpatients in hospital during cutover transition

PCTs and Specialty Service are used for prescribers to track their patients. Due to the cutover process, some PCT lists are currently not populating correctly. In an effort to fix this, in some cases individual users have been manually creating lists or adding “Admit to Inpatient” Orders on top of the “Cutover Admit Order”, resulting in unexpected system behaviour including patients dropping off of PCT lists, or appearing on different PCT lists. See the memo for more details.
Prescribers should stop trying to add an “Admit to Inpatient” order in addition to the “Cutover Admit Order”, since this creates a duplicate bed request and impacts patient lists. Prescribers should also pause creating manual lists, as they will continue to be unstable as we address these issues over the next 24 hours. Nursing staff will be asked to validate the Patient Care Team and Specialty Service for the patients they are caring for, and if an issue is identified, call a team involving a prescriber to help resolve.
We will continue to monitor the issue.
NOTE: All newly admitted patients should follow the standard admission navigator workflow.

Verbal Communication

Connect Care clinical communication norms detail the importance of verbal communication for urgent care matters and issues impacting patient disposition. See the Communication Norms section in the Connect Care Manual for more information.

Printing Tips

Some printing tasks in Connect Care are driven by system settings (e.g., label printing), while other tasks use printers mapped to the current workstation in a way that the user may be able to modify.
For help with printing issues, see the Printing Tips section of the Connect Care Manual. The section links to a number of resources such as a tip sheet on Virtual Local Printing (VLP), which allows users to select the preferred printer and retain it for all future printing.

Finding the Chart of an Unborn Baby

When a laboring mother is admitted, a “pended baby” chart is created that can have orders applicable once the baby arrives. Prescriber orders on pended baby charts are signed and held, and can be released when the baby is born.
A tip sheet provides additional instructions on the Newborn Nursery Workflow.

Launch 4 Support Hot Topics - Day 1

Daily postings on this channel address needs raised in prescriber huddles, with links to support information. Content is locked in around 17:00, and any additional hot topics after this time will be posted separately. Consider looking back at the previous day's posting(s).

Provider Care Team (PCT) - For prescribers with inpatients in hospital during cutover transition

PCTs are used for prescribers to track their patients. Due to the cutover process, some PCT lists are currently not populating correctly. This is impacting a proportion of patients across all Launch 4 sites.
A tip sheet is being created to assist clinicians in correcting the issue. Lessons Learned will be documented to apply to future Connect Care launches.

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 FAQ addresses the previous practice of using generic logins, and a bulletin details logging off/tapping out.

Lab Result Component Information (Calgary Launch 4 Sites Only)

There may be some areas in Connect Care where a lab result component will not appear if it’s coming from the legacy lab system in Calgary (Millennium). Examples of areas in the system being analyzed are Best Practice Advisories (BPAs), graphs, flowsheets, SmartTools and reports.
Until all build is analyzed and updated, clinicians should utilize the "Chart Review" activity as part of their workflow to review these lab results.
If a prescriber sees an area in the system where they expect a value and it does not appear, please log a ticket.
The Millennium interface is working as expected. Patient lab results coming from this interface are routing as expected and will be available in Chart Review and Netcare.

Launch 4 Support Hot Topics - Pre-Launch Week

This combined posting is updated throughout the week leading up to launch day, accumulating any pre-launch issues that have been identified, with links to support information.

A daily Hot Topics post will begin May 28, 2022.

Cutover Prescriber Tasks

Non-medication orders - Prescribers need to complete a Cutover Non-Medication Orders paper form listing cutover non-medication orders. This form must be reviewed and signed by the prescriber, regardless if it is completed manually or is a report printed from Sunrise Clinical Manager (SCM).
Best Possible Medication History (BPMH) - Prescribers must review/complete and sign the current paper Admission BPMH/Medication Reconciliation form if this was not already completed on admission, in order for nursing to transcribe it through launch.

Lab Result Component Information (Calgary Launch 4 Sites Only)

There may be some areas in Connect Care where a lab result component will not appear if it’s coming from the legacy lab system in Calgary (Millennium). Examples of areas in the system being analyzed are Best Practice Advisories (BPAs), graphs, flowsheets, SmartTools and reports.
Until all build is analyzed and updated, clinicians should utilize the "Chart Review" activity as part of their workflow to review these lab results.
If a prescriber sees an area in the system where they expect a value and it does not appear, please log a ticket.
The Millennium interface is working as expected. Patient lab results coming from this interface are routing as expected and will be available in Chart Review and Netcare.

Mixed-Context Providers

Prescribers with "mixed-context" practices need to be aware of a situation where results might route to both their Connect Care and external EMR systems.

Improvements to Consent Forms Management

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

Improvements to Consent Forms Management

Some recent Connect Care updates address user requests for improvements to patient consent workflows:

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.

Tip: Consent 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

ConnectCare.Consent@ahs.ca

Second Sign for Clerical/MOA Ambulatory Orders

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

Second Sign for Clerical/MOA Ambulatory Orders

As of April 28, 2022, orders placed in ambulatory settings by AHS clerical staff and non-AHS Medical Office Assistants (MOAs) for medications, procedures, laboratory testing, diagnostic imaging, and cardiology and surgical procedures (with some exceptions listed below) must be "Second Signed".

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.

What else you need to know

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.

For more information:

Navigator Update - Discharge as Deceased

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

Navigator Update: Discharge as Deceased

As of April 21, 2022, there are changes to the "Discharge as Deceased" navigator within the "Discharge" activity available to patient charts opened to an inpatient encounter.

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

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

Deceased Note Type Retired

As of April 21, 2022, the "Deceased" note type will no longer be available when generating new notes in Connect Care charts opened to an inpatient encounter. These note types were being used inconsistently (e.g., as a record of bedside death pronouncement), often with inappropriate information going to Netcare.

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.

Manual: Deceased Documentation

Quick Click Update for Ambulatory Encounters

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

'Quick Click' Update for Ambulatory Encounters

As of April 21, 2022, new functionality has been enabled for outpatient encounters to make it easier to rapidly route notes to the patient's primary care provider (PCP) and referring provider. The Quick Click communication function does not work for hospital outpatient department encounters (HODs; e.g., Rehabilitation Medicine).

Clinical observations (consultation or updates) can be documented in the progress note associated with an outpatient encounter. When prescribers use this note to record all pertinent clinical observations, assessments and plans, the progress note can then be incorporated into a standardized "letter" that goes out (e.g., to PCP, referring provider, copied provider) via the "communications" part of an outpatient navigator. A new shortcut allows this workflow to be automated.
To send an outpatient progress note to the patient's PCP and referring provider, click the "Send to PCP & referring" checkbox appearing at the top-right of the note editor.

The PCP and referring provider fields must be populated in the patient's chart for this checkbox to appear. If one of these fields are not filled in, the checkbox will be named "Send to PCP" or "Send to referring". If neither field is populated, "Send notes" will appear.
The outpatient communication letter will be routed using the receiving providers' default communication method.

Note that this workflow also sends the communication to Netcare (and, later this year, to community EMRs that have updated to receive such letters via eDelivery) and should be used only when this is appropriate.
To edit the communication before it is sent, including adding additional recipients (e.g., copying yourself), click the "Communications" link to the right of the checkbox or use the communications section of the "wrap up" navigator.

If there is no PCP or referring provider indicated in the chart, they can be added in the communications tool.

In addition to the new functionality, the content of the relevant letter templates (AHS TO REFPROV + NETCARE CONSULT, PRESCRIBER PROGRESS NOTES [Consult/Netcare Notes] and AHS TO REFPROV + NETCARE PROCEDURE, PRESCRIBER PROCEDURE NOTES [Proc/Netcare Notes]) has been simplified:

Modified content: "Please find below select notes from the Connect Care medical record for @FNAME@ @LNAME@."
Previous content: "Thank you for referring @FNAME@ @LNAME@ to me for evaluation. Below are my notes for this consultations. If you have questions, please do not hesitate to call me."

For more information:

Mental Health Act Flag Order - Update

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

Improvement to Mental Health Act Order

The Mental Health Act (MHA) order, Flag Patient as Certified (Mental Health Act), is used as a communication tool, to display an alert in the patient's Storyboard based on the information in the order. As of April 21, 2022, new required questions will be seen when the prescriber places this order:

In the "Certificate" section of the order window, which MHA Form the patient is being certified on must be chosen.
Based on the Form selected, required cascading questions will appear where date and time of issuance or triage date and time must be specified (backdating is possible). This time will then be visible in the Storyboard.

Relevant to this update is the recent Bill 17 (Mental Health Amendment Act), which has expanded the scope of practice for nurse practitioners (NPs), enabling the ability to issue admission certificates, renewal certificates and community treatment orders. NPs should be familiar with their legislated scope of practice and which MHA Forms they are able to complete. For more support, please refer to Bill 17 Summary of Changes or contact advancedpracticenursing@ahs.ca.

MHA eForms will continue to be developed when the Connect Care Teams have capacity to work on continuous improvement items; in the meantime, MHA Forms must be manually completed and scanned into Connect Care.

Urine Culture Orders - Clinical Indication Required

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

Clinical Indication Needed for Urine Culture Orders

(Edit: Change date has been moved from April 11 to April 8.) As of April 8, 2022, entry of a clinical indication when placing a urine culture order is required. Requiring provision of an indication is part of a provincial effort to reduce unnecessary urine culture ordering and treatment of asymptomatic bacteriuria.

To complete a urine culture order, the ordering provider must select the appropriate indication within the "Indications" section. If none of the options are relevant, select "Other" and enter the reason in the "Other Indications details" free-text field.

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:

RAAPID Intake Encounter Charge Filing

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

RAAPID Intake Encounter Charge Filing

Charges dropped in Intake encounters (used in the RAAPID workflow) will now file automatically upon acceptance by the clinician, with no change to the RAAPID workflow.

When these charges are accepted, clinicians will immediately see the status change to "Filed". Any charges entered in error can still be removed after filing.

Clinical Terminology Update: Sexual Orientation, Gender Identity and Expression (SOGIE)

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

SOGIE Problem List & Diagnosis Terminology

As of February 10, 2022, outdated clinical terminology related to sexual orientation, gender, identity and expression (SOGIE) in Connect Care is modified or replaced in pick-lists. Prescribers will find that these changes better align with the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5).

Where do the enhancements apply?

Standardized medical terminology is used when entering health conditions in problem lists, identifying the "chief complaint" associated with an encounter and selecting admission, visit or discharge diagnoses.

What terms have changed?

The following terms have changed. When searching for appropriate terms for problems or diagnoses, older terms will be recognized as synonyms for new terms which will be presented for selection (e.g., prescribers will be able to search for “Transsexualism” or “Gender identity disorder” and be led to “Gender dysphoria”).

Sex, gender and orientation identifiers:

“Anorgasmia of male” and “Anorgasmia of female” has been replaced by “Anorgasmia”
“Male erectile disorder” has been replaced by “Erectile disorder”
“Female orgasmic disorder” has been replaced by “Orgasmic disorder”

“Gender dysphoria” has replaced the following terms:

“Gender identity disorder”
“Transsexualism”

The term “reassignment” has been replaced by “confirmation:”

“Trans-sexualism, status post gender reassignment surgery” has been removed; users are encouraged to use “Gender dysphoria, status post gender reassignment surgery”

What happens to prior terminology selections?

The changes are not retroactive and so old problem lists and diagnoses will remain as originally entered. However, when problem lists are reviewed and updated (problem list reconciliation), prescribers are provided with an opportunity to substitute equivalent current terms.

More information

Installing Mobility on Apple Devices

Problem: Due to some updates to the Intelligent Hub app, some users may have experienced trouble installing or reinstalling Connect Care Mobility apps on their Apple device.

Solution: Process instructions have been updated in the Connect Care Manual and tip sheet.

Patient-Entered Flowsheet - POC Blood Glucose

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

Patient-Reported POC Blood Glucose

The MyAHS Connect (MAC) patient portal includes tools that clinicians can use to improve chronic disease management, functional status assessment and health maintenance. Some involve direct patient data capture (e.g., answers to questionnaires or entries to flowsheets) while others involve indirect data capture via interfaces to patients' medical devices (e.g., glucometers). A few questionnaires and flowsheets are provided to patients by default, while others are explicitly "ordered" for activation within a particular patient's MAC experience.

As of January 20, 2022, a patient-entered flowsheet will be available for patients to self-report their point-of-care (POC) blood glucose levels via their MAC account. To activate this flowsheet, (1) the patient must have an active MAC account and (2) prescribers must place an order for the flowsheet.

Use "flowsheet" as a search term within the order search tool, in the "Facility List" or "Database" tab.
Select "MYCHART GLUCOSE FLOWSHEET", click the "Accept" button, and sign the order.
The patient will receive a message in their MAC account about the newly available flowsheet.

Patient-entered clinical data can appear in a few places in the Connect Care chart, including the "Glucose Management" inpatient activity, "MYCHART" glucose flowsheets in the "Flowsheets" activity and in the "Episodes of Care" activity. For more information, see the tip sheet.

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

After Visit Summary Enhancement - Video Viewing Instructions

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

Adding Video Viewing Instructions to an AVS

As of January 20, 2022, prescribers can incorporate patient education video viewing instructions within patients' After Visit Summaries (AVS). Previously, only text instructions could be included. This enhancement gives prescribers the ability to leverage a broader range of health education supports for patients as part of their AVS.

Similar to the workflow for finding text handouts, there are three ways (tabs) to discover and select video viewing instructions. All use the "Go to Clinical References" link in the Patient Instructions section found in "Wrap-Up" (ambulatory encounters), "Discharge Navigator" (inpatient encounters) or "Disposition" activities (emergency encounters) in an opened patient chart.

Relevant Documents
Selectable video viewing instructions, automatically offered based on the patient's problem list or diagnosis, can be selected before clicking "Add to Patient Instructions".
Additional Search
Both patient and video viewing instructions can be sought (look for "Video" at the end of the titles in search results) and optionally selected by clicking "Add to Patient Instructions".
Master Index
Search alphabetically or by category, or click on the "Videos" link under "Content Types" to see all available video viewing instructions.

After selecting one or more text or video patient education resources, clinicians can optionally add further comment that will appear when the AVS is printed. Frequently used comments can be saved as a SmartPhrase.

Tip: Video Viewing Enhancement to Patient Instruction Export
Help or feedback: feedback@myhealth.alberta.ca

PICC Insertion Order

Problem: Some clinicians may see their peripherally inserted central catheter (PICC) line insertion orders cancelled or changed, possibly delaying the requested intervention.

Context: PICC line insertions are often performed by Diagnostic Imaging (DI) in Alberta Health Services facilities as an interventional radiology (IR) procedure. However, there are also circumstances (e.g., some critical care settings) where IR does not do the procedure. Two orders are available to prescribers: one for IR-facilitated insertions and one for other insertions. It is important to select the right order when DI is asked to place the PICC.

Solution: To avoid delay in DI receiving and processing the intervention request, search for "Insert PICC" when ordering, look to the "Procedures" grouping of search results, and choose "IR PICC Line Insertion" for procedures to be facilitated by DI.

Accessing Legacy Records

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

Accessing Legacy Records

As of January 1, 2022, legacy medical record content for inpatients that was scanned into Connect Care during cutover can be accessed more easily.

Previously, access to scanned legacy materials required use of a special "ECT-Pt" button.

Now, these records can be accessed within Chart Review using the familiar "Media" tab:

The "Document Type" column will indicate "Clinical Document".
The "Description" column will indicate "Patient Cutover Record".

Legacy records captured during future launches will also be accessed this way when available.

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).

Status: Connect Care

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