How can I send a Prescription from Connect Care?

Question: How can I send a prescription from the Connect Care clinical information system?

Answer: It depends upon what is intended by "Send". Assuming the question relates to outpatient contexts, one could:
  1. Print prescribed medication(s), then sign and provide to the patient to independently 'send' to a pharmacy of choice.
  2. One may want to 'send' a prescription directly to a preferred pharmacy by fax.
  3. One may fantasize about 'sending' a prescription electronically to an external pharmacy information system.
Working backwards, the third option is an aspiration. We await pharmacy information system adoption of standards-based protocols for receiving and reconciling electronic prescriptions. A Canada Health Infoway initiative called "PrescribeIT" addresses the need for standards, currently piloted in Alberta. Connect Care plans to work with this protocol when tested and ready.

The second option is not possible as a matter of policy. Prescriptions must be signed and electronic signatures are not yet accepted in Alberta for the same reasons that option 3 is not tenable now. It may be okay to print, sign, then fax the printed and signed prescription to a pharmacy; or telephone verbal prescription instructions to some pharmacies, where medications are delivered to a home or continuing care facility. 

So, until outpatient pharmacy information systems are able to interoperate with clinical information systems, we are left with printing. One must print medication prescriptions, sign them and provide to the patient or patient's agent.

If the patient requires a reprint or refill at a later date, consider opening an "Orders Only" or "Prescription Refill" encounter. Order or renew one or more meds, taking care to look to the bottom of the order dialog and select the "Class" as "Print":

If printing from the original computer and printer... Note that an orders review icon appears just to the left of the "Sign Encounter" at the bottom right. Clicking on this lists the meds for potential printing and provides icons for printing individual or all prescriptions:

If printing from a different computer or personal device and locally installed printer... From an open chart, go to Chart Review, Select the Meds tab, then either double-click on the medication to be reprinted or right-click to display the medication information in a side bar. Scroll to the bottom of the medication information (report) and note a link for generating a new prescription printout (1). Click on this, then the print icon (2), then select the correct local printer and generate the paper prescription for signing.

How can I print a note or letter?

Question: When I open the "Notes" activity (inpatient) and then view and try to print the note of interest, I find the top-right "Print" menu greyed out. How can I print a specific note?

Answer: Printing is disabled in a number of activities and views. This may be because the information object does not have clear boundaries or is not set for an acceptable print layout. The "Notes" activity is one of these areas. The Print menu (top right of Hyperspace) will be "ghosted" to indicate that it is not available.

It is possible to print notes, letters and other chart objects. The best place for this is the "Chart Review" activity (inpatient and outpatient). This has a tab for Notes and a display area that shows the note content when selected. The button bar of this display area, as well as the top-right print menu, are active for printing.

Look for similar functionality for just about anything else that can be found through the various tabs of Chart Review.

How can I generate a report of recent professional billings?

Professional billing reports are available through the Reporting Workbench workspace. A generic report can be accessed and run. It can also be saved as one or more personal favourite reports. These can be tuned to focus on specific time intervals, contexts (e.g. inpatient, outpatient) or even billing codes.

Do Connect Care Users have an Information Manager Agreement?

Question: How should physicians respond when asked about an information manager agreement for use of a electronic record?

Answer: It's that time of year again. College of Physicians & Surgeons of Alberta (CPSA) practice permit renewals are due in just over a month. Many physicians will be completing their annual surveys. A survey section entitled "medical records" asks if the respondent shares patient information with other physicians and if an Information Sharing Agreement (ISA) is in place. Connect Care users may not know how to respond. We suggest:

Unfortunately, the CPSA standard respecting Information Sharing Agreements dates back to 2009 and has not been updated to reflect the advent of clinical information systems (CIS) capable of supporting the record of care across a continuum of care. The CPSA is aware and will be updating its annual survey for the next cycle.

Know that the CPSA participated in the development of the Clinical Information Sharing Approach (CISA) for Connect Care. This meets CPSA requirements and is an accepted surrogate for an ISA. CISA includes an Information Sharing Compact that all participating physicians must uphold.

Information Sharing Agreement: When asked if an ISA exists, say "Yes".

Custody of Patient Records: When asked if a written agreement exists to maintain custody and control of your patient records, you can answer "Yes" since this is provided for in Connect Care business continuity and most specialty group arrangements.

EMR Use: When asked if you currently use an Electronic Medical Record (EMR), select "Yes" and pick "Clinical Information Systems" as the type of EMR.

Level of EMR Use: When asked "What is the level of your EMR use?", you can select Level 5 as Connect Care is designed for shared care and has a full patient portal.

Control over EMR Use: When asked "How much control do you have over the EMR?", you can select the second option "Shared Custody and Control" since physicians actively customize Connect Care through Area Councils, Specialty Workgroups and User Groups. In addition, there are extensive personalization controls available to physician users.

Level of Netcare Use: When asked "What is the level of your Netcare use?", you can select Level 3 because Netcare PIN data can be imported and integrated into Connect Care and Connect Care shares summative information back to Netcare.

How can I change what MyAHS Connect says about me?

Question: Physicians appreciate that patients are entitled to their full name and practice address. However, there may be situations where a physician might wish to share a name variant (e.g. without middle name) that differs from the official information stored in the Connect Care provider registry. How can this be done?

Answer: The MyAHS Connect patient portal shares information about a patient's physician and possibly other members of a ongoing health care team. Physicians can adjust how their name and other information (e.g. biosketch, interests, research, etc.) appears to patients.

Do this by seeing the "About Me" submenu item from the "My Settings" menu within the main Epic drop-down menu. This can also be found by entering "About Me" in the general search box at the top right of Hyperspace.

Why is my Provider Contact Information Wrong?

Question: Some providers express concern about how their name, and possibly some address information, appears in After Visit Summaries and other Connect Care communications. How can this be changed?

Answer: Basic identification and contact information for Connect Care prescribers comes from the clinical information system provider registry. Drawn from Medical Affairs and Licensing Organization databases, this information may be out of date. Indeed, some physicians provided a home address for professional communications. This may not be what is wanted for Connect Care.

It is easy to check how Connect Care describes a provider, as this information appears in the "Phone Book", available to all authorized users. See the Identity, Roles and Contact Information section of the Physician Manual. In particular, note the tip sheet and its instruction about how to submit a provider information change request.

Why does my Pulse Dashboard seem off?

Question: As we move into our second week of Connect Care use, the physician 'Pulse' and other clinical dashboards draw attention but seem to have odd values for the available metrics? Are these ready for attention?

Answer: Any Dashboards, and especially any minimum use metrics, will be questionable in the first week or two of Connect Care use. Types and amounts of data in the system are in a state of rapid change. Anything that relates to the performance of the initiative overall (e.g. CPOE rates) are being independently analyzed. Know that work will continue for at least 6 weeks to carefully validate the information being fed back to clinicians. Take anything appearing in physician feedback reports with a grain of salt until given the signal that we have credible numerators, denominators and measures.

How can Patients Indicate Willingness to be Invited to Studies?

Question: How can patients consent or otherwise indicate a willingness to be approached about research studies?

Answer: The Connect Care clinical information system supports clinical inquiry in a number of ways. One important capability relates to identification of patients who are willing to be approached for possible participation in research studies.

There are two ways for patients to indicate a willingness to be approached for potential participation in research studies. The first is simplest but requires patient access to MyAHS Connect. Patient portal users can register research preferences as described in the Connect Care Physician Manual and the tip below. The second method involves explicit consent to inclusion in specific research initiatives, is handled through the Consent Navigator.

Can Haiku, Canto or Rover be used to capture patient signatures?

Question: The Consent Navigator (accessed via StoryBoard) is a powerful tool for streamlining consistent consent processes, but struggles with the patient/provider/witness signature capture. Can eSignature capture happen with mobility (Haiku, Canto, Rover)?

Answer: That would be nice! Epic has heard the need and has this on the list for updates to mobility (~summer 2020). In the meantime, we need to use touchscreens, mouse-sig and signature pads. We have increased the number of pads assigned to ER. We have also published tips to the Connect Care Physician Manual to clarify some workflows and emphasize use of alternatives to pads.

Which Physicians use Connect Care for Professional Billing?

Question: Most physicians who are required to enter billing claims in Connect Care know who they are, especially those in alternative reimbursement plans and service contracts with Alberta Health Services. But there may be uncertainty about grey areas, like fee-for-service physicians on time-limited contracts with group plans.

Answer: See a 1-pager summarizing how professional billing is supported in Connect Care. For the most part, physicians who have billed through eCLINICIAN will shift to billing through Connect Care. All physicians working through clinical and academic ARPs (AMHSP) will have been informed about whether their plan has arranged to shadow bill through Connect Care.

Those arrangements include the locum and fee-for-service physicians seconded or contracted to the ARP to fill clinical service gaps. They are expected to bill through Connect Care.

Physicians who have an independent billing service are able to take advantage of Connect Care for claim capture, then generating a report for provision to their billing service.

How long will eCLINICIAN In-Basket messages persist?

Question: In supplement to our earlier posting about access to In-Basket, Media Tab and other eCLINICIAN content after the launch of Connect Care, we receive a question about how long eCLINICIAN In-Basket messages will remain before being erased.

Answer: eCLINICIAN In-Basket messages will not be erased. They can be viewed by launching eCLINICIAN from within a Connect Care chart. As has always been the case, completed ("Doned") In-Basket tasks or communications are automatically archived after 60 days of inactivity. Items that have not been marked "Done" remain indefinitely.

Is it okay for trainees to follow up on patient results after leaving a service?

Question: Residents and students can (and should) be copied on results associated with the orders they enter to the Connect Care clinical information system. Some orders do not get resulted until after the patient has left the hospital or the trainee has left the clinical service. Are we prohibited from accessing health information if not continuing as the patient's treatment physician?

Answer: Trainees may have concerns about a 2016 Alberta administrative law case (with clearer results on appeal); and the more recent Saskatchewan privacy commissioner reaction to ER physician access to charts of emergency patients that they had treated.

Health privacy legislation can differ in detail and interpretation from province to province. Alberta’s understanding of "circle of care" is not narrowly constrained by time or location alone. Need, role, purpose and accountability are important considerations.

For purposes of education (following up on a case), clinical feedback (seeing how one’s clinical decisions affected outcomes), quality control, practice audit and safety reviews, one remains in the circle of care "purpose". It can be important for authorized trainees to access, learn from, and possibly help improve results associated with the interventions they ordered in the care episode they participated in. Indeed, it could be argued that they should be particularly attentive to learning from their actions, as that was a key attribute of their role in the circle of care.

What is not okay is to access the record of a patient one has previously seen for a purpose unrelated to the specific care one participated in. For example, to explore other domains of care or types of information.

The Clinical Information Sharing Approach addresses questions like this.

How is eCLINICIAN opened within Connect Care?

Question: Has the method for accessing eCLINICIAN legacy information from within Connect Care locked in?

Answer: Yes. We are happy with how this has turned out. The eCLINICIAN access method will also serve for access to Netcare and to other legacy AHS information systems (e.g., Meditech, Sunrise Clinical Manager) in future. Best demonstrated, not described. We've updated a very short video:

How does faxing work in Connect Care?

Question: Sending and receiving faxes, in any way that is integrated with a health information system, has been a challenge to Alberta Health Services. What will Connect Care do about fax communications?

Answer: However much we wish for fax technology to be allowed a quiet demise, this communication habit remains relatively common among the settings that Connect Care interacts with. Outgoing faxing is automated and relatively simple. It is integrated within Connect Care. Incoming faxes will continue to be handled by clinical groups in the way they have managed in the past. The technology will be replaced as quickly as possible. For more information, see the Physician Manual entry.

Who Supports Medical Office Assistants

Question: Connect Care Wave 1 includes some independently run clinics where medical office assistants are not employed by Alberta Health Services. What supports can they expect?

Answer: All medical office assistants (MOA) enjoy the same online (, IT, help desk, training and peer supports, irrespective of who employs them or under what business arrangement they work. All content development, engagement, readiness, training and other Connect Care design, build and optimization activities are employer-agnostic.

Some supports are organized through end-user groups. These may differ by business arrangements. Super Users, for example, are recruited and have their time protected through user organizations. Non-AHS MOAs will not see Super Users resident in their external organizations unless they have appointed, protected and put their own staff forward for training. However, when non-AHS MOAs appear in AHS facilities as part of their clinic activities, they have full access to the AHS Super Users supporting that AHS clinic space.

Will eCLINICIAN InBasket Messages be Accessible post-Transition?

Question: Given that eCLINICIAN moves to a read-only state after Connect Care launches, and eCLINICIAN In-Basket tasks and messages do not transfer (data convert) to Connect Care, how can one access eCLINICIAN In-Basket archival content?

Answer: The eCLINICIAN legacy clinical information system is replaced by Connect Care and so, at launch of Connect Care, eCLINICIAN changes to a read-only state.

"eCLINICIAN Link" can be launched from within a Connect Care patient record. By this means, all past chart content is available for review in Connect Care. Most eCLINICIAN content will have been converted to become part of the full Connect Care chart. However, some categories of information are not automatically transferred. These include In-Basket content (tasks, messages, result notices, etc.) and material added to the "Media" section of a patient's chart.

Opening eCLINICIAN within Connect Care is seamless. There is no additional logon or patient lookup required. Important past InBasket notes can be copied and pasted. Media tab content can also be copied and pasted.

Over time, important Media tab content is brought to Connect Care as part of its enterprise content management functions.

How do physicians participate in referral triage and prioritization?

Question: Once a referral order is placed, what do physicians in the target service need to do respecting the review and prioritization (triage) of incoming referrals? I understand there are all sorts of rules about responding in a timely manner etc? How are those being managed during the “soft launch” of schegistration?

Answer:  Our pre-launch training emphasis for physicians focuses on getting referral (outpatient) orders placed the right way so they get to the right destination with the right information. But there is a lot more to the process!

After an outpatient referral order is placed, the next steps could be relatively simple, with support staff managing an incoming referral work queue and scheduling appointments according to pre-set protocols (each specialty has its own, worked out as part of ARD or Path-to-Care or eReferral). More complicated processes do involve physician review, triage and priority setting at one or more steps.

Most of the Connect Care referral destinations (outpatient) are former eCLINICIAN sites. They already have referral processes in place, admittedly with a lot of variation between specialties. And eCLINICIAN upgraded to referral work queues, so there are no major workflow changes in Connect Care.

Those groups that use physician triage steps already know who they are. Some use physicians assigned to consult rotations. Presumably, they will maintain current process in Connect Care. But there is opportunity to do more to centralize, standardize and use the new closed loop visibility of Connect Care to improve efficiency. Our post-launch optimization work should involve learning from the best practices of the most experienced referral-management groups.

How Many Mobile Devices can I install on?

Question: My clinical group has acquired some iPads for rounding use and is blocked from Connect Care mobility installs after the first few are configured. What's happening?

Answer: Prescribers can install Connect Care mobile applications (Haiku, Canto) on up to two personal devices. Installation of Limerick (Apple Watch app) with Haiku (iPhone) is considered a single install.

Device numbers are controlled through the mobility management software used for installations. Personal devices can be any combination of smartphones or tablets. So, it is okay to install on an iPhone and an iPad, or on two different iPads, for example, but installation on an iPhone and two iPads would not be supported.

If it is necessary to replace a device, uninstall from the old device before attempting installation on the new device.

There may be special arrangements where a clinical group has purchased multiple mobile devices and need one person to do Haiku and/or Canto installs on all of these. For more information:

Does Connect Care Mobile Device Management Conflict with other Mobile Management Solutions

Question: I work at a health care organization that has its own system for distributing and protecting mobile applications... and I'm having trouble installing Connect Care mobility. What could be happening?

Answer: Some prescribers belong to organizations that have their own mobility management systems and policies. It is possible that the software used by the non-AHS organization will conflict with Workspace ONE. Please bring potential challenges to the attention of AHS mobility. In the case of iOS devices, it is sometimes possible to alternate between different organizational connections, but not use both at the same time. See “Settings >> General >> Profiles & Device Management” for details.

For more questions and answers:

What happens to eCLINICIAN access with Connect Care launch?

Question: A Connect Care FAQ document says that eCLINICIAN is being replaced by Connect Care. How does this work, logistically, for the community physicians, academic physicians at other sites, and researchers with studies that use eCLINICIAN? Once a transition occurs, will eCLINICIAN still be accessible for those who have relied upon it?

Answer: It is true that the eCLINICIAN clinical information system (CIS) is being replaced by the Connect Care CIS. But it is not true that there will be discontinuity, loss of data or lack of ongoing support for those who have relied upon eCLINICIAN.

Connect Care replaces eCLINICIAN, like-for-like. Everyone who uses eCLINICIAN as the record of care (or the scheduling facilitator of care) is aware of the change and supported in the move to Connect Care. This includes all outpatient areas where eCLINICIAN has been used, many outside the University Health Sciences campus. Research protocols are moved to Connect Care, where there are superior research information management tools.

Most of the clinical content of eCLINICIAN is automatically moved (data converted) to Connect Care. There are some things that cannot be safely moved. Personalizations, for example, have to be manually copied by physicians from one Epic platform to the next. And some scanned content will take a while to migrate to the new Connect Care enterprise content management system. All eCLINICIAN stakeholders retain read-only access to eCLINICIAN after Connect Care launches.