Why is there a delay in being able to view diagnostic images if the exam was completed at a Connect Care site?

Question: Why is there sometimes a delay between completion of an imaging investigation or intervention ordered in Connect Care and availability of associated images for viewing in Connect Care? 

Context: Diagnostic images are not instantly available to the ordering provider when an imaging exam is marked complete in Connect Care by a Technologist. The imaging workflow involves a number of steps that may not be apparent to all users:

  1. A Technologist facilitating the intervention or investigation completes their documentation in Connect Care.
  2. "Picture Archive and Communications System" (PACS) receives an "End Exam" message from Connect Care and generates a unique identifier for the exam.
  3. The identifier initializes archiving of the diagnostic images and data to a storage system ("Impax Data Center", IDC).
  4. IDC generates a message when all of the images for that diagnostic imaging procedure have been received, which then makes the images available to be viewed in Connect Care and Netcare.

Answer: A number of steps occur behind the scenes once an imaging investigation or intervention is marked complete in Connect Care by the performing Technologist. These steps are usually fast but can trigger a perceptible delay when a diagnostic imaging procedure generates many images, large images or image transfers when network traffic is high. These variables are outside of the control of the Technologist. 

If diagnostic images are taking longer than expected to appear for clinical use, or if the images are critical to provide urgent patient care, please call the IT Service Desk (1-877-311-4300) to report a high priority ticket, or email Imaging Apps Support (ImagingAppsSupport@ahs.ca; available Monday–Friday, 07:45–16:00). In critical situations, the images can be viewed in the imaging department if there is an unexpected delay with image transmission to Connect Care.

Do I use a Recommendation or Referral to send a patient to an allied health provider?

Question: Is entering a Referral order appropriate to send my patient to physiotherapy or another allied health provider?

Context: If a provider does not require closed loop referral management (i.e., confirmation that the patient was seen by the specified allied health provider and the outcome of that appointment), this is considered to be a Recommendation rather than a Referral. If a Referral is instead placed in such a situation, the provincial standard agreed upon is to confirm with the ordering provider that the Referral was intended to be a Recommendation rather than a Referral order. A comment can then be added in the Communication section summarizing the discussion, and the referral can then be closed with the "non-clinical flag". 

Answer: If a provider does not require closed loop referral management, a Referral order should not be entered. Instead, a Recommendation can be made via a Communication letter, or, if a prescription is required by insurance, it can also be made via a Patient Care Order. See the tip sheet for further details and screenshots.

How can I review and edit key patient preferences?

Question: Can key patient preferences be viewed and managed with a unified Connect Care tool?

Context: The Alberta Health Services (AHS) "Shared Commitments" initiative aims to improve healthcare experiences for patients, families and healthcare providers through inclusive approaches to learning about, respecting and promoting patient agency. One shared commitment is to ask about and respond to identity, language, religious, spiritual and other support interests in a compassionate and confidential manner. 

Answer: While patients' identity and preferences are captured and used throughout the Connect Care information space, key indicators are gathered in a "patient preferences" patient list template that can be used to configure any "My List" patient list.

The list columns are "active", providing extra information on hovering and relevant editing tools on double-clicks. They include representations of: 

  • Patient identity, preferred name and preferred pronouns
  • Patient goals for the encounter
  • Spoken and written language preferences, including any translation or interpreter requirements
  • Self-reported relationship and religious affiliations, plus spiritual support requests
  • Indication of whether a consent to release of personal information has been filed
  • Indication of whether AHS Shared Commitments teaching has occurred
  • Communication preferences
  • Patient portal status

This patient preferences list functionality can be replicated in ED trackboards, L&D greaseboards and outpatient schedules. Reporting Workbench (My Reports) templates (under the same "patient preferences" title) can facilitate quality improvement efforts for facilities, services or departments.

    How do I reorder parenteral nutrition (PN) to ensure the order stays active?

    Question: Why are the PN orders for my patient no longer visible in active orders?

    Context: Recently there have been a few tickets related to PN orders no longer being visible as active orders. This appears to be due to the Order Frequency not being changed as needed when a PN reorder is placed. The PN Order Frequency determines when and how long the order will be active for; if the Order Frequency is not changed, the field will default to the number of doses/days for which the previous order was active. There is currently no technical solution to prevent this from happening but can be prevented by following the workflow.

    Answer: Each time PN is reordered, review the Order Frequency field. If it is not changed, the field will default to the number of doses/days for which the previous order was active, which may not be appropriate for the reorder.

    • If you anticipate updating the PN prescription daily, use a frequency of "1 day". This will populate a start time of 18:00 and an end time of 17:59. The reorder button will appear to easily update the next order’s prescription. 
    • If you anticipate updating the PN prescription less frequently (i.e., stable patient), consider entering the PN order with a frequency for a specific duration (i.e., 7 days).
    For more information, see the Quick Start Guide (page 9).

    How is COVID-19 Testing Ordered? - UPDATED

    Question: How can a prescriber order COVID-19 laboratory testing in Connect Care?

    Answer: Ordering of rapid COVID-19 PCR occurs using the "Respiratory Infection (incl. COVID-19) NAT" order. Connect Care prescribers can enter "COVID" when searching for an order in ER, outpatient or inpatient contexts. Any physician can order the test. If the "Respiratory Infection (incl. COVID-19) NAT" test does not immediately appear in one's department preference list, be sure to click on the "Facility List" tab to find the order. This order is also used to order rapid influenza/RSV PCR and the respiratory pathogen panel (RPP); rapid COVID-19 testing will be automatically selected by default.

    Be sure to indicate the reason for testing (symptomatic, infection control screen or pre-transplant testing) and then patient location/disposition (not required for outpatient orders). As resources for rapid on-site testing are limited, answering accurately whether the patient is admitted or is likely to be admitted is very important to ensure the sustainability of the rapid COVID-19 testing program.

    For more information, see the tip sheet and lab bulletin.

    Can I get tap-badge access for Connect Care as a consulting prescriber to EDs?

    Question: Can consulting prescribers in the Emergency Department get tap-badge access to Connect Care like other ED prescribers?

    Context: Tap-badge technology supports faster network access to computing devices by eliminating the need to manually enter a username and password. As the use of Imprivata tap-badge technology (i.e., tap-badge access for Connect Care) requires a user license, only select AHS departments have been approved for deployment of this technology.

    Recognizing the need for consulting prescribers in the ED to have more rapid access to Connect Care, any physician, physician assistant, resident, fellow or nurse practitioner who logs into any AHS ED computer at least 15 times per month is eligible to request Imprivata access.

    Please note that obtaining Imprivata access for EDs will not enable tap-badge access for workstations on other clinical units where tap-badge readers are not available.

    Answer: Yes, any physician, physician assistant, resident, fellow or nurse practitioner who logs into any AHS ED computer at least 15 times per month is eligible to request Imprivata, including consulting prescribers. See the tip sheet for instructions on how to request Imprivata access.

    How do I manage orders for Long-Term Care/Supportive Living patients on dialysis?

    Question: How do I manage orders in Connect Care for Long-Term Care (LTC) and Supportive Living (SL) residents requiring hemodialysis (HD), peritoneal dialysis (PD), or an Alberta Kidney Care (AKC) clinic appointment?

    Context: If an LTC/SL resident requires HD/PD or an AKC clinic appointment, there is a specific workflow that needs to be followed so that information flows appropriately through Connect Care. This will allow medication orders to work correctly and help to mitigate patient safety concerns. The specific workflow is dependent on whether the facility is on Connect Care, and, if it is, whether the facility has an on-site pharmacy (e.g., CareWest or Capital Care facilities) or uses a contracted/community pharmacy.

    Answer: For HD, PD, or AKC clinic appointments, the LTC/DSL Prescriber and Nephrologist must follow the workflow specific to the whether the facility is on Connect Care (as this will determine whether the resident is considered an outpatient or an inpatient) and whether the facility has an onsite vs. contracted/community pharmacy, with the following considerations in mind: 

    • Connect Care facilities with on-site pharmacy: Medications are ordered in the inpatient "Orders" activity.
    • Connect Care facilities with a contracted/community pharmacy: Medications are ordered in the "External Orders Community" tab.
    • For HD: Ordered via the Hemodialysis Therapy Plan, with any changes to be made by the Nephrologist. The "Dialysis Treatment Orders", "Hemodialysis-Anemia Management Protocol" and "Hemodialysis-Intradialytic Anticoagulation Protocol" medications are already included in the Hemodialysis Therapy Plan. It is important for the LTC/DSL Prescriber to ensure there are not duplicative orders for medications, as duplicative orders may lead to patient safety concerns. 
    • For PD: Ordered via the Adult Peritoneal Dialysis Order Sets, with any changes to be made by the Nephrologist.  

    Please see the memo and tip sheet for further details. 

    Can I suppress or filter a medication warning?

    Question: Is it possible to suppress or filter a particular Medication Warning?

    Context: Alert/pop-up fatigue is a concern for prescribers. While some alerts such as Best Practice Advisories (BPAs) are important to fire each time and cannot be turned off, Medication Warnings can be suppressed or filtered, if a prescriber does not think it is necessary to see the warning again for their patient(s).

    Answer: To suppress a particular warning, when it fires, click "Don’t Show This Warning Again" (click on first camera icon below for screenshot), and then choose to suppress it for just that patient or for all your patients (click on second camera icon for screenshot).

      

    FAQ Blog - Maintenance Complete

    Many thanks for your patience while maintenance of this blog channel was performed. All posts have now been restored. 

    You will notice that Connect Care screenshots are now behind an icon. Whenever you see the below camera icon in other blog posts on this channel (or any of our other blog channels), this indicates that there is an accompanying screenshot. When you click on the icon, it will take you to an Insite page with the relevant screenshot.

    Which Encounter Type should be used for Specialty Outreach Services?

    Question: Which ad hoc (unscheduled) outpatient encounter type best fits the needs of patient visits (virtual or in-person) that are part of a specialty outreach service?

    Context: Specialty health services may be based in an organization using Connect Care as the record of care, yet provide consultative services to community or facility locations elsewhere. Services might include telephone consultative support to clinicians at other (usually rural) facilities, telehealth virtual visits, or drop-in in-person visits to assist with the care of selected patients; all as part of outreach from the central service requiring service documentation in Connect Care.

    Outreach appointments may be scheduled or otherwise organized by the remote location (e.g., primary care network) and so not involve Connect Care support staff for appointment management. In such cases, ad hoc (unscheduled) outpatient visits are needed and clinicians may wonder which visit type to select when creating a new encounter in their specialty department.

    Answer: If Connect Care is the record of care for part, but not all, of an integrated health service program, it may be appropriate to use Connect Care integrative charting tools (e.g., therapy plans, care paths, disease management documentation, SmartSets) to manage and document related care. A "Documentation" visit can be created if the outreach support need is limited to generating and sharing a consultation letter. More commonly, the "Telemedicine" visit type works best for outreach services because it benefits from specialty-specific visit, order and documentation tools in Connect Care.

    How do I manage orders for admitted patients on dialysis?

    Question: How do I manage orders in Connect Care for admitted patients on hemodialysis (HD) or peritoneal dialysis (PD)?

    Context: If an admitted patient requires HD/PD, there is a specific workflow that needs to be followed so that information flows appropriately through Connect Care. This will allow medication orders to work correctly and help to mitigate patient safety concerns. (Note: There is a separate blog post for managing orders for Long-Term Care/Supportive Living patients on dialysis.)

    Patients receiving dialysis have their dialysis treatment and associated intradialytic medications ordered via the Hemodialysis Therapy Plan or Peritoneal Dialysis Therapy Plan. When a patient with a Hemodialysis/Peritoneal Dialysis Therapy Plan is admitted to the hospital, the Therapy Plan is automatically placed on hold so that the Nephrology team can adjust the prescription and intradialytic medication orders. Once the prescription and orders have been adjusted, the Therapy Plan is available for the duration of the admission.

    Answer: For HD and PD, to ensure information flows correctly and medication and blood product orders function properly in Connect Care, a non-nephrologist admitting prescriber should first place a consult order to Nephrology. Then there are specific workflows for medication and blood product ordering, including (but not limited to) the below: 

    • For HD: The dialysis treatment prescription, anemia and intradialytic medications are already included in the Hemodialysis Therapy Plan, and changes are to be made by the Nephrologist. It is important to ensure there are not duplicative orders for medications, as duplicative orders may lead to patient safety concerns. 
    • For PD: All PD treatments and medication orders are ordered via the Peritoneal Dialysis Adult Order set and inpatient orders by the Nephrologist. 
    Please see the memo and tip sheet for further details. 

    How can I refer a patient to the FAST program?

    Question: How do I refer a patient to the Facilitated Access to Specialized Treatment (FAST) program?

    Context: As part of the Alberta Surgical Initiative (ASI), a central access and intake program called Facilitated Access to Specialized Treatment (FAST) has been implemented across Alberta. The FAST program is responsible for reviewing referrals for completeness and assigning them to a next available provider with the shortest waitlist, a specific provider, clinic or site, or an out-of-zone provider. 

    Not all specialties have implemented FAST. Previously, a customized FAST referral order was available for each relevant specialty. Now, to both accommodate a growing number of specialties using FAST and reduce confusion, FAST referrals are placed via the standard specialty-specific referral order. If that specialty uses FAST, a question will be available in the order where the prescriber can indicate that the referral should be directed to FAST and include any FAST specialty-specific questions that may need to be answered. 

    Answer: To submit a FAST referral, search for the standard specialty-specific referral order (e.g., "Referral to Orthopedics"), and then add a specialty reason of FAST. Searching for "FAST" referral orders will bring up specialties that are FAST-eligible. 

    How can clinicians control whether patients can contact them via secure messaging?

    Question: How can a clinician determine whether, and for how long, a patient can send them messages via MyAHS Connect (Connect Care patient portal)?

    Context: Patients who have activated MyAHS Connect are able to securely communicate with healthcare providers via Connect Care. This does not mean that they can initiate communication with any provider. Four tests determine whether a patient is able to send a message to a Connect Care clinician:
    1. Recipient - If a provider initiates a secure patient message to an individual active on MyAHS Connect, that patient will be able to respond to the sending provider.
    2. PCP - If the patient's primary care provider (PCP) uses Connect Care as their record of primary care services, then that provider can be messaged directly (if so configured by the provider) or via a clinic-managed message pool.
    3. Consultant - If the patient has been seen by a consulting (specialist) clinician within the prior 90 days in a facility where Connect Care is the record of care, then the patient can send a message to the clinician (if configured to accept personal-direct messages) and/or the clinic patient message pool.
    4. Clinic - If the patient's clinic (primary care or specialty) has a patient message pool configured, and the patient was seen in that clinic within the last 90 days, then appointment request and some other message types can be initiated with the clinic via its managed message pool.
    Patients are offered three options when generating a new message:


    If the "Ask a medical question" option is selected, additional options appear. These will be seen by receiving clinician(s) as patient messages categorized by the request reason.


    If there is no active patient-clinician messaging relationship for the option selected, the patient is immediately informed that there are no providers assigned for that type of question, and they are directed to contact their clinic for assistance.


    Most Connect Care outpatient clinics are configured by default to route incoming patient messages to a clinic message pool for monitoring, screening and forwarding. This can help shield physicians from excess In Basket messages, or delays in answering messages when physicians are busy. However, sometimes physicians will want to send and receive a patient message without anyone else being part of the communication loop.
    Answer: Patients with active MyAHS Connect accounts can receive and respond to patient messages sent directly from any clinician. Patients can also use the patient portal to communicate with their primary care provider, or with a provider seen in a Connect Care clinic within the last 90 days, but in most cases the messages will go to a clinic message pool for screening and review before possible redirection to the individual provider.

    If a provider does not want to receive messages from one or more patients, the following options should be explored:
    • Outpatient clinic messaging protocol - Work with clinic colleagues to confirm an agreement respecting whether the clinic maintains an incoming patient message screening process and ensure that the responsible support staff know that the particular provider does not accept patient messages.
    • Patient-provider relationship - If a provider will not participate in any ongoing care of the patient, or will not offer any further post-visit communications, then the "Care Team" activity can be opened in Connect Care and the provider can "end" any existing primary or specialty care relationship, thus removing the provider from communication availability.
    • Direct communication - Clinicians can always respond (or have their messaging pool respond) to a patient message with a request to not use MyAHS Connect for communications with a particular provider.
    For more information:

    How can I resend a prescription via direct electronic fax to a community pharmacy?

    Question: How can I “reprint” or refax a prescription that was originally sent via direct electronic fax?

    Context: Prescriptions sent directly from Connect Care via electronic fax to a community pharmacy are handled by the RightFax application. In the “My Printouts” activity, the “Printer Used” column will show “RIGHTFAX”.

    If the initial fax fails, the RightFax application will attempt to send the fax a total of five times, every 5 minutes. After that, the message goes into a failure queue in the RightFax application. Similar to community EMRs that fax prescriptions, the pharmacy or patient would need to request a reprint from the prescriber if the fax does not come through.

    If a prescriber receives such a reprint request, or if the original pharmacy information was incorrect, there are a few different ways to reprint/resend, depending on the context. Note that the usual method for reprinting prescriptions, via the My Printouts activity, will not work, and the only option in some cases will be to print, sign, and manually fax.

    Answer: For ambulatory encounters, the following options can be used to resend/reprint a prescription that was originally sent via direct electronic fax:

    • If the patient’s preferred pharmacy is still the same, from the relevant encounter, the prescription can be resent via direct electronic fax using the “Reprint Meds” link.

    • If the original electronic fax was sent to an incorrect pharmacy/fax number, contact the pharmacy that was sent the prescription in error to cancel the original prescription, and then either:
      • Print on paper by going to Chart Review >> Meds, selecting the medication, scrolling down to “Reprint Prescription”, and clicking the link. Then sign and manually fax to the correct number. 
      • Cancel the original order and reorder with the correct pharmacy information. Follow the steps in the tip sheet to send via direct electronic fax.
    For inpatient encounters, the following options can be used to resend/reprint a prescription that was originally sent via direct electronic fax:
    • Print via one of the below methods, then sign and manually fax:
      • In the “After Visit Summary” section of the Discharge Navigator, click the add icon ("+") found beside "Discharge Medications". 
      • In the “Discharge Status” section of the Discharge Navigator, click the “Reprint” link next to the relevant medication. 
    • If the original electronic fax was sent to an incorrect pharmacy/fax number, contact the pharmacy that was sent the prescription in error to cancel the original prescription, and then either:
      • Print on paper by going to Chart Review >> Meds, selecting the medication, scrolling down to “Reprint Prescription”, and clicking the link. Then sign and manually fax to the correct number.
      • In Discharge Med Rec, click on the pencil icon next to the medication and modify/reorder with the correct pharmacy information entered for the patient’s preferred pharmacy. If “Fax” is selected for the order class (as detailed in the tip sheet), it should send via direct electronic fax.


    Information on reprinting discharge prescriptions that were originally printed out can be found in this FAQ.

    Can I use Z-codes to change the status of a patient to Alternate Level of Care?

    Question: Can I enter Z-codes to indicate the barriers to discharge that cause my patient to remain in hospital as an Alternate Level of Care (ALC) patient?

    Context: When inpatients no longer need the intensity of care or level of service provided by their admitting acute care facility, it is important for the Most Responsible Provider (MRP, usually the attending prescriber) to change their "patient status" to "Alternate Level of Care" (ALC). The ALC designation effectively stops the clock measuring a patient's actual length of stay (LOS). Recognizing when medical management has finished and switching to ALC status is among meaningful use norms expected of prescribers.

    The easiest way to make changes to the inpatient status is to use the "Level of Care" column in patient lists. This is built-in to the Rapid Rounds patient list template. Double-clicking on the LOC row value for a patient opens a pop-up editing tool where the "ALC - TBD" button should be used.

    Prescribers can also initiate an ALC status using the "Orders" activity, by using an "Initiate ALC" order or a "Patient Status" order, then using the "ALC - TBD" speed button. 

    It is important that prescribers ONLY select "ALC - TBD" and not Z-codes. Transition coordinators and/or nursing staff take care of more detailed (Z-code) ALC statuses. Selecting Z-codes too early can trigger direct charges to the patient.

    • Note: If a patient already has an ALC status and an "Initiate ALC" order is entered with "ALC - TBD" selected, any Z-codes assigned to that patient will be overwritten.

    Answer: To change the status of a patient to Alternate Level of Care, the MRP should use the "Level of Care" patient list column or enter an "Initiate ALC" order. Either way, it is important to use the "ALC - TBD" quick-button, and to NOT select ALC statuses with Z-codes. Prescribers can document barriers to discharge using the Expected Date of Discharge (EDD) comment field and the Discharge Planning report built-in to the inpatient sidebar.

    For more information:

    What happens when a Restricted Medication Therapy Plan has a date change?

    Question: Why do I need to re-sign a Restricted Medication Therapy Plan when only the date has been changed?

    Context: Therapy Plans can be entered in advance and expected dates may change. While nursing can make changes to Therapy Plans, plans with Restricted Medications cannot be signed by nurses. Therefore, if there is a date change to a Restricted Medication Therapy Plan, the plan will then have to be re-signed by the prescriber. (Note that Connect Care is continuing to look at options to reduce this workload on prescribers.)

    Answer: If a date has been changed in a Restricted Medication Therapy Plan, you will receive a notice in your In Basket indicating that review and re-sign is required.

    1. In the "Recurring Treatments" folder of your In Basket, select the relevant patient.
    2. Click on the 3 dots icon above the message and select "Open Plan" from the dropdown menu that appears.
    3. Review and edit, if necessary. 
    4. Sign the plan.

    For more information:

    What happens to patient messages sent via MyAHS Connect to their physician?

    Question: My patient indicated that when they tried to send me a message via MyAHS Connect, they received a reply indicating that direct messaging is not available. Why did it not go to my In Basket, and why are patients able to send these messages?

    Context: While patients can send messages via MyAHS Connect to their physicians who are on Connect Care, whether those messages are able to reach a physician’s In Basket is determined by whether that physician is in a department that schedules appointments in Connect Care. If they are, the message will route to the clinical support In Basket pool of that physician’s department, and can then be forwarded by the clinical support pool staff to the physician; these messages can be found in the “Pt. Advice Requests” folder. 

    A physician working in a mixed context (i.e., working in an AHS facility as well as at a private clinic/office in the community) may be added to a patient’s care team in Connect Care as a Primary Care Provider (PCP) for a patient receiving services with AHS; however, their role as PCP is related to the community clinic. Patient messages sent in this case would not be related to their care with AHS nor to the work the physician does in AHS. As there are no pools or structure to support these messages, the messages are routed to an IT team error pool instead of to the intended physician.  

    Answer: When IT receives a message sent by a patient via MyAHS Connect that is intended for a mixed-context PCP, IT will confirm that it was intended to go to a physician who does not have a department that schedules appointments in Connect Care and therefore does not have a clinical support advice request pool to support message management. IT will then respond to the patient, letting them know their physician cannot be reached via MyAHS Connect, and to instead contact the community clinic directly. IT will no longer forward these messages to the physician. Connect Care is working on a technical solution to prevent patients from being able to send messages to physicians on their care team who do not have an associated pool structure to support them.

    How are triplicate (duplicate) prescriptions handled in Connect Care?

    Question: How should prescribers handle tracked (triplicate or duplicate) prescriptions required for outpatient use of controlled substances?

    Context: The Alberta Tracked Prescription Program (TPP, tppalberta.ca) monitors use of prescription drugs prone to abuse. It does this by ensuring that such prescriptions are handwritten to prescription pads with security features and copies. Unfortunately, the program has yet to take advantage of the additional security and surveillance made possible by digital health records. It is hoped that the emergence of e-prescribing (PrescribeIT) will avoid paper workflows in the future. Please note that the new Connect Care workflow for sending prescriptions directly to community pharmacies via electronic fax ("eFax") cannot be used for prescriptions for drugs classified as Type 1 under the TPP; these prescriptions still require the use of a paper TPP secure prescription form.

    Prescribers must follow TPP requirements for managing tracked prescription copies and records:

    How, exactly, are Connect Care prescribers to keep a copy of a triplicate (duplicate) prescription?

    Answer: Connect Care made application to the Alberta TPP program for workflow adaptations appropriate to Connect Care, as a fully integrated clinical information system, like Connect Care. A TPP decision was made (July 2019) to the effect that Connect Care prescribers do not need to scan a copy of the TPP paper form for attaching to the digital chart. The acceptable workflow is as follows:

    • Order all prescriptions in Connect Care, including TPP specified Type 1 controlled substances.
    • Write out a manual (handwritten) TPP prescription (3-part or newer 2-part TPP pad) for specified Type 1 controlled substances.
    • Record the TPP prescription identification number (unique to each prescription) in Connect Care (ideally in the comments field of the actual order).
    • Do ONE of the following with the original (paper) pharmacy/TPP prescription (see guide):
      • Option 1: Provide to patient and do not fax to pharmacy.
      • Option 2: Fax to the patient's one chosen pharmacy, marking "FAXED" on the prescription and do not provide to the patient.
    • Continue to protect the TPP (duplicate or triplicate) pad with its copy of the hand-written original.
    • Destroy any leftover copies or artefacts. 
    The Connect Care tracked prescription order constitutes the official record. It is NOT necessary to scan or otherwise copy the paper TPP prescription to attach to the Connect Care digital record.

    How did I get that test order wrong?

    Question: Having ordered what seems like the right test, a result is not returned or the test is declined with a request to order differently. How does this happen and how can it be avoided? 

    Context: Those new to Connect Care may fumble with the occasional test or procedure order. The is more likely with tests based on samples (e.g., aspirates) that can be collected in different ways in different contexts. Possible reasons for delays or declines include:
    • Wrong Test
      • A vast number of tests are available to request via Connect Care, including all possible orderables for an entire province.
      • Different tests can have similar names. It is important to consider possible alternative test names, check the "Facility List" if nothing familiar appears on the "Preference List", and chose the most specific test description to fit your intent.
    • Wrong Sample
      • Test orderables can have similar names but relate to different clinical needs. 
      • If ordering a pH, for example, be sure to select the test appropriate to the fluid being sampled (e.g., venous, arterial, pleural).
    • Wrong Details
      • Orders for similar investigations may have specific required details for samples collected during specific workflows (e.g., surgical operation).
    • Wrong Location
      • An increasing number of assays can be performed using Point of Care Testing (POCT), with rapid result availability. However, the instrumentation needs to be available in-facility, as well as the test kits for the desired assay, with staff certified to use the equipment.
      • Local variation in POCT availability is inevitable. Be sure to check with colleagues, or laboratory services, that the POCT orderable found in Connect Care is available on site.
    • Wrong Permission
      • In some cases, special assays require special permission in order to be performed. This will usually be communicated to the ordering prescriber.
    Answer: Just as has always been the case, prescribers need to build an awareness of the laboratory services available at a particular facility. If in doubt, ask. Local laboratory services will know what can be ordered, and how. In addition, Connect Care "Resource Links" (top menu in Hyperspace) are provided for:

    How can I add patient information or instructions to the After Visit Summary (AVS)?

    Question: How can prescribers add instructions, information or education materials to the After Visit Summary (AVS) provided to patients at the end of encounters?

    Context: Encounter overviews (emergency, inpatient and outpatient) are routinely shared with patients as "After Visit Summaries" (AVS). These include information about key events, educational materials, medications, follow-up appointments and discharge instructions. The AVS is automatically sent to the MyAHS Connect patient portal. Additionally, patients are provided with a printed AVS at discharge and at the close of most outpatient visits.

    Prescribers can use the "Discharge" navigator (inpatient encounters) or "Wrap-Up" navigator (outpatient encounters) to add instructions and/or educational handouts before the AVS is printed.

    Answer: Instructions and handouts can be added to the AVS for emergency, inpatient and outpatient encounters, with slight variations in how this is done.

        Inpatient

    • Open the Discharge navigator and note the "Other Instructions" section in the navigator menu. Select this to open an edit box in the navigator where prescriber instructions for inclusion in the AVS can be entered.
    • Note that additional instructions can be attached to any outpatient appointments set up in the Discharge navigator.
    • One or more educational handouts, with patient-specific comments added by the prescriber, can be attached to the AVS. To do this, select the "References" menu item within the Discharge navigator. This opens a section for looking up and adding educational attachments. Individual attachments can be edited to make them maximally applicable to the patient, and overall comments can be added by the prescriber.

        Outpatient and Emergency

    • Open the Wrap-Up navigator (or the Dispo tab in emergency contexts) and note the top-left "Patient Instructions" section. This includes a lookup tool for optionally selecting one or more educational handouts for attachment to the AVS. Educational handouts can be edited to customize to particular patient needs. There is also provision for general instructions or comments that will be included in the AVS.
    • Just above the Patient Instructions section are icons that can be used to preview or (re)print the AVS.