Connect Care Tips: COVID

Showing posts with label COVID. Show all posts

COVID-19 Tippy - Problem Overviews

Tippies can be quickly adopted with immediate workflow benefits...

COVID-19 Problem Overviews

A prior tip describes how standardized problem overviews can facilitate improved capture and use of key clinical indicators in chronic disease management. This feature is now available for COVID-19 care.

As soon as a COVID-19-related problem is added or activated in a patient's problem list, a link becomes available just below the overview edit box ("Problem Overview Data - COVID-19"). This is used to enter structured data for a standardized problem overview.

Alternately, when the ".OVERVIEWCOVID" SmartPhrase is used in the Problem Overview (or anywhere else), interactive text appears. This summarizes key illness information. Clicking within the text brings up a form for editing the underlying data. The same structured text is used in the COVID-19 Sidebar and in standardized summary documentation.

COVID-19 Tippy - COVID Status SmartPhrase Available

Tippies can be quickly adopted with immediate workflow benefits...

COVID-19 Status SmartPhrase

A prior tip highlighted a SmartLink that can bring Connect Care COVID-19 vaccination information into notes.

More recently, AHS communicable disease screening includes checks for self-reported vaccination events. This covers situations where immunizations may have occurred in other jurisdictions, or in some pharmacies, and data is not automatically added to provincial databases.

A new ".COVID19STATUS" SmartPhrase is available to Connect Care users, with inclusion of the most recent diagnostic swab result, Connect Care immunization records and any self-reported COVID-19 vaccination information. Embedded "hotspot" links allow clinicians to jump to tools for further review and editing of the data included in the SmartPhrase.

COVID-19 Tippy - Placing COVID Vaccination Orders

Tippies can be quickly adopted with immediate workflow benefits...

Placing COVID-19 Vaccination Orders

A prior tip explains how to record a vaccination (administered elsewhere) in a patient's vaccination history. When vaccines are administered in a setting where Connect Care is the record of care, the correct workflow starts with an order for the vaccine, just like workflows for any other immunization. The order automatically facilitates the generation of a vaccine administration record, which automatically appears in the patient's Connect Care chart.

Outpatient vaccination workflows are straightforward. The clinic will know which vaccine is available and so will know which specific COVID-19 vaccine to enter in the order search box. The resulting order composer is simple.

Inpatient vaccination workflows are more complex because a number of orders must accumulate before there are sufficient patients to immunize without wasting available vaccine vials. The required order, criteria check and verbal consent documentation are all linked, as explained in the clinician Manual:

Manual: Inpatient COVID-19 Vaccination Orders

COVID-19 Tippy - Inserting Recent COVID-19 Vaccination Information into Notes

Tippies can be quickly adopted with immediate workflow benefits...

COVID-19 Vaccination SmartLink

Increasingly, patients receive first or second COVID-19 vaccinations during an inpatient or outpatient encounter where Connect Care is the record of care. Clinicians may want to document this intervention in a consult, discharge or transfer note. A new SmartLink makes this easier. Use the usual SmartPhrase/SmartLink syntax when pulling into a note (dot followed by token):

".IMMCOVIDP" pulls in recent COVID-19 vaccination information in a prose-friendly format

Manual: Inpatient COVID-19 Vaccination Orders

COVID-19 Tippy - Finding COVID-19 Vaccination Information

Tippies can be quickly adopted with immediate workflow benefits...

Finding COVID-19 Immunization Histories

The Connect Care health record includes an immunization history activity. This supports automated documentation of all immunizations ordered and administered through Connect Care. Other immunization data is acquired from provincial information systems through interfaces. Finally, any clinician can add one or more missing immunization records to complete a patient's history.

NOTE: For a variety of reasons, Connect Care COVID-19 immunization history information may be missing or incomplete (see FAQ).

As always, ask the patient!
Many patients will have an official vaccination record that can be used as a valid source for updating the immunization history.
Check Netcare
Netcare immunization histories draw from many sources and are updated more frequently (and, for now, completely) with COVID-19 immunization administration data.

Use Chart Search to find a "jump to" link and open the "Immunizations" activity in a patient chart. Alternately, jump to the Immunizations activity by clicking on the "Immunizations" section of the patient SnapShot in the Chart Review activity.

Once opened, the Immunizations activity can be used to review information, add missing information and produce immunization reports.

Recorded immunizations are listed in the "Administration History" section, grouped by type.
One or more missing immunizations can be added by selecting from the "Historical Admins" menu.
A formal immunization record can be printed (for provision to the patient) using the "Immunization Report" button.

The same immunization history information appears to patients in the MyChart patient portal.

COVID-19 Tippy - Quick View of a Patient's COVID-19 Experience

Tippies can be quickly adopted with immediate workflow benefits...

COVID-19 Quick Review

Connect Care's global search function (CTRL+space keyboard shortcut, or top right of any screen) can speed Hyperspace exploration ("Jump to" links):

The same Chart Search function is available in the Storyboard (leftmost column) of any open chart:

Chart Search offers a great way to quickly find anything in a patient's chart. With "covid" as a search term, the results will include relevant tests, interventions, problems, documentation and other content, organized by encounter and time. Hovering over a result brings up more information about that search result.

... a very fast support for quick review of chart content relevant to COVID-19.

COVID-19 Tippy - COVID-19 Lab Quick Filter in Chart Review

Tippies can be quickly adopted with immediate workflow benefits...

COVID-19 Quick Filter in Chart Review Labs

The "Chart Review" activity is available in all Connect Care Hyperspace configurations, usually the leftmost activity at the top of an opened chart. Chart Review includes a "Labs" tab that defaults to a list of all available laboratory results, sorted chronologically.

This is a good place to check for current, recent or past COVID-19 test results. A "Quick Filter" is easily created so that a single click instantly displays COVID-19 test results any time a chart is opened to the labs review.

Click on the "Filters" button within Chart Review >> Labs.
Select the "Order" filter type if not selected by default.
Enter "COVID-19" in the "Order contains..." search box. It is important to match the spelling and capitalization as it would appear in a results list. All COVID-19 test results should appear in the results list area.
Look to the bottom of the Filter column and select "Save as New Filter" to see a pop-up offering to create a new filter that will pull test results that have "COVID-19" in the test name.
Give the new custom filter a name like "COVID-19 Tests".
A checkbox will appear in the Filters row just above listed lab results. Selecting this will filter out just the COVID-19 results. This can be used for any patient to quickly review present and past testing.
If a Quick Filter is active, you can use the above steps to change its parameters (e.g., add in other lab tests that are helpful assessing the severity of COVID-19 illness to produce a filter that focuses attention on what is most relevant to COVID-19 prognostication).
An existing Quick Filter can be removed by selecting the personalization icon (wrench) at the top-right of the Chart Review activity, then the "Manage Quick Filters" command.

Of course, this tip can be applied to other clusters of lab tests commonly sought in one's work... with efficiency dividends!

COVID-19 Tippy - Finding COVID-19 Results in Inpatient Admission Labs

Tippies can be quickly adopted with immediate workflow benefits...

COVID-19 Test Search in Admission Labs

The "Labs" tab in the inpatient chart "Summary" activity is useful when doing ward rounds, as the flowsheet focuses on tests ordered during the current admission.

One may want to quickly find COVID-19 rows in the admission labs flowsheet. A "Find text within the current report" tool is activated by clicking on the binoculars icon (or using the Ctrl+F keystroke combination, just like searching within web pages). Enter "covid" as a search term and, if found, jump to the relevant flowsheet row.

Note that this Find-in-Report function only searches data presently displayed and will not include results from outside the present admission or the currently displayed date range.

COVID-19 Tippy - Finding COVID-19 Tests in Results Review

Tippies can be quickly adopted with immediate workflow benefits...

COVID-19 Test Selection in Inpatient Results Review

The "Results Review" activity is available in Connect Care Hyperspace for inpatients. It nicely organizes test results in clinical categories, explored using a multilevel outline.

Inpatients can have large numbers of laboratory test results. To rapidly home-in on a specific result, it is faster to use the provided "Search" tool. Entering "covid" as a search keyword will completion-match on "COVID-19 Test" and limit the displayed results accordingly.

Given that COVID-19 tests only became available in early 2020, be sure to set the "Date Range Wizard" to "All Data".

COVID-19 Tippy - Quick Discovery of Patient's COVID Experience

Tippies can be quickly adopted with immediate workflow benefits...

COVID Chart Search

The fastest way to get a bird's-eye view of a patient's experience with COVID-19 is to use Chart Search (top-right of Hyperspace, middle of Story Board, or Ctrl+Space keystroke combination) with "covid" as a search term.

Connect Care will return a chronological list of tests, notes, problems and other chart content relating to COVID. A button bar can be used to home-in on chart subsections, such as labs and notes.

COVID-19 Tippy - Using Calculators for COVID-19 Assessments

Tippies can be quickly adopted with immediate workflow benefits...

Finding COVID-19 Calculator Aids

A number of metrics, measures and decision-rules are emerging to help recognize, prognosticate and triage COVID-19 syndromes.

An excellent COVID-19 measures compendium is available within all Connect Care contexts. Interactive calculators can be used to generate scores for care planning and documentation:

From within Hyperspace, go to the "Resource Links" top-level toolbar, click to expose the options, then select "MDCalc".
When the MD+Calc website opens, look to the top-right and select the "COVID-19 Resource Center" link.
This will open a page giving access to CURB-65, SCAP, SOFA, SIRS, 4C and other scores. All walk you through online assessments.

The "Resource Links" toolbar button gives access to many point-of-care knowledge resources.

COVID Tip: Remote Assessment in Primary Care

The Connect Care Clinical System Design (CSD) team is mobilizing clinical content (decision, documentation and inquiry supports) for emergency, inpatient and critical care management of patients with moderate to severe COVID-19 illness.

However, the most prevalent COVID-19 syndromes constitute mild disease that can be managed in the community. A recent BMJ article nicely describes how this can be facilitated with virtual care processes:

Article: COVID-19 Remote Assessment in Primary Care

COVID Tip: Virtual Care Assessment of Oxygen Saturation

UPDATE ALERT 2020-04-02: EMERGING EXPERIENCE SUGGESTS THAT THIS ROTH SCORE IS _NOT_ VALID FOR COVID-19 PATIENTS.

Although there are no validated tests for assessing breathlessness via telephone or video conference, a potentially promising test, the Roth Score, is creating some buzz.

This is nicely demonstrated by a Welsh physician via Twitter:

Blogs