Why were my discharged patient's lab orders cancelled?

Question: How do I place lab orders for my patient to get after they are discharged from an inpatient unit?

Context: When a patient is discharged, if any lab tests were ordered during that admission but were not performed, those orders get autocancelled within 2 hours of discharge. If existing inpatient lab orders are not converted to after-visit orders or new post-discharge lab orders are not entered, patients arriving at a patient service centre (PSC) for collection may be turned away because they will not have open/pending lab orders available in the system.

Answer: When a patient is discharged from an inpatient unit, any incomplete lab orders are automatically cancelled within 2 hours. To ensure any required lab orders can be collected after discharge, the inpatient lab orders must be reordered or new lab orders entered, through the "External Orders" activity. See the tip sheet for more details on this workflow.

• Tip: Reconciling Inpatient Lab Test Orders at Discharge
• Manual: Order Context - Internal Orders

How do I use an outpatient note authored by a clinical clerk for a letter?

Question: Why is my consult letter blank after pulling in my clinical clerk's outpatient note?

Context: If, when using the "Communication" activity in Connect Care, a supervising physician attempts to send a letter populated with an outpatient (ambulatory clinic) note authored by a clinical clerk, the note will not be incorporated into the letter. Outpatient notes authored by clinical clerks will not upload to Netcare, even after they are signed off by a staff physician. 

Answer: To use an outpatient note authored by a clinical clerk, the supervising physician must either make themselves the author of the note, or create a copy of the note. The latter option uses the "Copy and Create" function to take the text from the note authored by a clinical clerk and make a new note with the supervising physician as the author; see the steps below. Once these steps are followed, the Communication function can then be used to route the outpatient note as a consult letter to Netcare and selected recipients.

1. Click "Edit" on the note authored by the clinical clerk.
2. At the bottom left of the note, click the icon that looks like two overlapping pieces of paper (click the camera icon below to see a screenshot. This button will copy the note text and create a new note with the supervising physician as the author. Then, complete the note:

• Add to the note as necessary. 
• Select "Send to PCP & referring" or, if desired, use the Communications tool in the "Wrap Up" activity to have a consult letter sent to Netcare.
• Click the "Accept" button. 
• Once the visit is signed, the letter will be routed.

Why were my discharged patient's DI orders cancelled?

Question: How do I place diagnostic imaging (DI) orders for my patient to get after they are discharged from the emergency department (ED)/inpatient unit?

Context: When a patient is discharged, if any DI tests were ordered during that admission but were not performed, those orders get autocancelled upon discharge.

Answer: When a patient is discharged from an ED or inpatient unit, any incomplete DI orders are automatically cancelled. To ensure the required imaging is completed in the community, new outpatient orders must be placed. This can be done by placing an After Visit type order from the "Dispo" activity (ED) or Discharge navigator (inpatient). See the tip sheet for more details on this workflow.

• Tip: Reconciling Incomplete DI orders at Discharge
• Manual: Order Context - Internal Orders

How can I send a prescription from Connect Care?

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

Answer: As of July 25, 2023, three options are available for getting (most) outpatient or discharge prescriptions to the patient's preferred pharmacy:

1. New: Send via electronic fax ("eFax") directly from Connect Care to the patient's preferred pharmacy (or pharmacies).
• There are two steps for this option: confirm/enter the patient's preferred pharmacy (or pharmacies); and change the order class to "Fax" (the default is "Print", including for refills) and select the destination pharmacy (or pharmacies). As the screens where these steps occur depend on the context (ambulatory, ED or outpatient), see the tip sheet for further details.
2. Print prescription from Connect Care, add handwritten signature, and manually fax to the patient’s preferred pharmacy.
3. Print prescription from Connect Care, add handwritten signature, and provide to the patient (or patient’s agent) to bring to a pharmacy of choice.

Notes: 

• 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.
• Telephone verbal prescriptions may be okay for some pharmacies, where medications are delivered to a home or continuing care facility. 
• Prescriptions for drugs classified as Type 1 under the Tracked Prescription Program (TPP) cannot be sent by fax and will always be printed.

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 "Class" field at the bottom of the order dialog. If sending via direct electronic fax to a patient’s preferred pharmacy (must already be set in their profile; see tip sheet), select “Fax”; if printing to manually fax or give to the patient to bring to the pharmacy, select "Print":

If printing from the computer and printer originally used to create a prescription: 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.

For more information on the new option of sending prescriptions via direct electronic fax, see the tip sheet and other resources:

• Tip: Direct eFax of Prescriptions from Connect Care to Community Pharmacies
• Manual: Medication Orders
• Resource: ahs.ca/eprescription
• FAQ: eFax FAQs for Community Pharmacists