Showing posts with label Decision Supports. Show all posts
Showing posts with label Decision Supports. Show all posts

What are Care Gaps/Health Maintenance Reminders?

Question: “Care Gap” alerts appear in my patient’s Storyboard, sometimes related to care I do not provide. What are these and how do I respond to them?

Context: Care Gaps and Health Maintenance Reminders are clinical decision supports in Connect Care that monitor patient characteristics and experiences, then match them to evidence-based preventive care or chronic disease management guidelines in order to recommend actions that may improve care. The underlying algorithms have been adapted to and validated for Albertans. 

Care Gap alerts can appear in the patient’s Storyboard (leftward column in an opened chart, “Care Gaps” section), in the Plan of Care tab of the "Chart Review" activity, or in the "Health Maintenance" activity (global search for "maint" works well). 

  • Example: A diabetic patient's demographics and history trigger an alert indicating that a diabetic foot exam is due (Alberta guidelines call for yearly foot exams for those on the diabetes register).
A Care Gap alert flags possible mismatches between evidence-informed care and a patient's current experience. Connect Care chart content is compared to patient-specific health maintenance plans. Missing or inaccurate information (e.g., incomplete problem, medication or lab results) can lead to false positive, or false negative, alerts.

Answer: Connect Care clinical oversight elected to make Care Gap information available to all providers, irrespective of specialty or context (e.g., outpatient vs. inpatient). This promotes opportunistic preventive care, where important gaps (e.g., immunization needs) can be addressed wherever patients interact with the health care system. Patients most in need of preventive care may not, for example, have a primary care provider.

When a possible Care Gap is identified, providers have several options to address it. The alerts are "passive" and can be left for other providers to attend to. Alerts can be acknowledged but deferred (e.g., adding completion date, Postpone, Discontinue, or entering a date for Follow-Up). Finally, patient's health maintenance plans can be adjusted or deactivated (e.g., not applicable for reason of compassionate care).

How can a Scale or Score be Requested for use in Connect Care?

Question: How can addition of a clinical scale or score be requested for the Connect Care clinical information system?

Context: Clinical Scales Scores and Tools (CSST) offer valuable decision supports for estimating risks for and effects of health conditions.  Connect Care provides access to a wide range of common clinical measures, most in forms that allow trending observations over time.

The Connect Care Clinical System Design program ensures that deployed CSST are based on provincially validated instruments that are carefully evaluated for use in Alberta, avoid unhelpful duplication, and have use permissions secured from authors or owners.

Answer: First check to see if a desired CSST is already available in Connect Care as a calculator, advanced flowsheet or SmartForm (see relevant parts of the Manual).

If a case is to be made for a new CSST, there is a process to follow. Complete and submit a CSST Clinical Requirements Form to provide background information about the tool, design details and clinical use cases. This is reviewed by an appropriate Connect Care Area Council. Priorities are established before build work can begin, including securing copyright or licensing arrangements. We ask that applicants do not directly contact copyright owners. AHS legal has developed a process for  that manages risks for AHS and clinicians alike. Any useful contacts can be specified in the requirements form.

How can Special Medication Approvals be Flagged in Patient Charts?

Question: How can patients with special approvals for medication access be flagged within Connect Care?

Context: Patient chart flags (FYIs) are short visual markers and notes associated with a patient record to signify considerations important to patient care. Some health care interventions, usually medications, are available for patient care only given special approvals. Examples include Compassionate Supply, Special Access Program (SAP), and Short Term Exceptional Drug Therapy (STEDT) programs. It can be useful to have a visual indicator on a patient’s chart to signify such approval status, facilitating more efficient pharmacy review of med orders.

Answer: A "Special Medication Approval Status" flag type is available to visually indicate patients accessing interventions under special approvals. Use of this can speed things like pharmacy order review and medication release.