Tippy - Setting In Basket Message Preferences

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

• Setting In Basket Message Preferences

Recent upgrades allow users to opt in/out from many more message types, including auto-delivered summative notes. To set your message preferences, in your In Basket:

1. In the Epic menu at the top, click on "Preferences" and then, in the pop-up window, select the "Message Settings" tab.
2. Click to select or deselect the message types you want or no longer want to receive, and click "Accept" to save.
3. For example, in the sample screenshot (click the camera icon below), deselecting the note type messages under "Notes Automatic Routing" will turn off auto-delivery of these summative note types (e.g., Op Notes). Note that this will suppress all notes of the deselected type, not just those authored by the user.

For more tips on In Basket management, see the CMIO's guide.

• Guide: In Basket Management - CMIO

Tippy - Using QuickActions to Manage In Basket Tasks

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

• Using QuickActions to Manage In Basket Tasks

In Basket QuickActions are a form of personalization that allow users to complete a complex task in a couple clicks. Prescribers may be familiar with the “Not My Result” QuickAction, but the QuickAction tool can also be used to create shortcuts for other frequently performed In Basket actions. Click the below links for more information on each (an Epic UserWeb account will be needed to access the demos):

• Manage misdirected In Basket results:
• Support: How to Manage Misdirected In Basket Results Using the "Not My Result" QuickAction
• Write and route a result note: 
• weLearning Demo: QuickActions - Result Notes  
• Send a routine staff message: 
• weLearning Demo: QuickActions - Sending Staff Messages 
• Forward a message to a pool or medical office assistant:
• weLearning Demo: QuickActions - Replies 

For more information, see the step-by-step guide. And, for additional tips and tricks to make In Basket work better for you, self-register for an In Basket optimization class here.

• Guide: In Basket Best Practices - QuickActions

Tippy - Personalize Chart Activity Tabs

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

• Set Favourite Chart Activity Tabs

Prescribers are presented with a set of "activity tabs" when charts are opened to inpatient, outpatient and other clinical contexts. The displayed tabs reflect default activities configured for a particular logon department, as well as any “favourite” activities selected through personalization. Additional available activities appear in a "More Activities" drop-down menu appearing to the right of the displayed tabs.

Items in the More Activities list can be "pinned" to show among the main activity tabs whenever a chart is opened. The horizontal order of tabs can be adjusted through drag-and-drop actions. And any main activity tab can be moved back to the More Activities list by using a drop menu available within the tab title area.

Iteratively personalizing chart activity tabs can keep most used functions readily available.

• Tip: Workspace Personalization

Tippy - Personalize Start-up Workspace

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

• Set a Favourite Start-up Workspace

Prescribers may work in one context (e.g., inpatient, outpatient, office) for days or even weeks at a time. It can help to have Connect Care open to the most useful workspace at every login.

This is done by selecting the star at the right of the title bar for the selected Workspace tab:

The workspaces available for default vary by specialty, but the personalization method is the same. The favourite can be changed at any time, even more than once in a day.

• Tip: Hyperspace Personalization
• Demo: Hyperspace Personalization

Tippy - Save, Share or Sign an Order?

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

• Save, Share or Sign an Order?

With the exception of some orders that require co-sign before action can be taken, orders are marked for actioning upon signing. When immediate action is not needed or appropriate, orders can be pended or "Saved" for later review by the prescriber or, for example, an attending physician. Consulting services often pend orders with a notation such as “recommended by Infectious Diseases team”.

Inpatient unsigned saved orders are automatically deleted after a specified number of hours depending on the "Save" option chosen, so it is important to be aware of remaining unsigned orders:

• Save, ready for review: When saving orders for consideration by another clinician, the prescriber should mark the planned actions as "ready for review" when prompted. This type of unsigned order will be auto-deleted after 72 hours.
• Save, ready for review, share: This option sets up the saved orders as ready for review while initiating a secure chat (for communication to other prescribers) with the saved orders attached. Again, this type of unsigned order will be auto-deleted after 72 hours.
• Save, not ready for review: Orders saved in a not ready for review state can only be acted upon by the saving prescriber. This type of unsigned order will be auto-deleted after 36 hours.

Unsigned order can easily be tracked by adding the "Unsigned Orders (All)" column to a patient list. To add the column, right-click on the patient list of choice and select properties, search for the column name and add, and rearrange as needed to view.

For more information:

• Manual: Signing, Saving and Sharing Orders

Tippy - Updating Primary Care Provider Associations

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

• Updating a Patient's Primary Care Provider

Connect Care uses information about a patient's primary care provider (PCP) to facilitate a number of automated communications. These can include:

• admission, discharge and death notifications
• consultation and referral tracking
• alerts to key test results, and 
• sending copies of summative documents (e.g., operative reports, discharge summaries) 

Although patients are asked to confirm their primary care provider at every Connect Care registration, changes can occur between the start and end of an encounter. It is important for providers to know how to change the primary care provider name (or clinic) associated with a patient chart.

Editing PCP information is easy. Either select (click on) the Storyboard (leftmost column of any open chart) row where provider names appear, or use chart search to jump to the "Care Team" chart activity. A "Patient Care Team" section has a tool for adding a PCP. 

This is used to identify a PCP when none was previously specified. The same tool is used to enter a new PCP name to replace a previous outdated PCP association.

The current PCP attachment is highlighted in "Transition Planning" reports that appear in the sidebar of inpatient, emergency and outpatient charts, as well as admission and discharge navigators. Selecting the PCP link will open an advanced PCP attachment editor that supports attachment management. Communications can be generated to confirm attachments or request new attachments.

For more information:

• Manual: Patient-Provider Attachments
• Manual: Shared Documents

Tippy - Email Notification of New In Basket Messages

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

• Get Email Notification of New In Basket Messages

Clinicians who are not routinely on Connect Care may wish to be notified by email when new In Basket messages appear, as might happen if there are late-reporting results after an inpatient or emergency encounter has finished. One or more categories of In Basket message (e.g., test results) can be set to trigger email messages indicating availability of new content at user configurable intervals.

• Open the In Basket workspace.
• Select the Preferences activity (wrench icon in In Basket menu bar).
• Within Preferences, select the "Reminder Emails" tab.
• Either indicate that emails should be sent for any new In Basket message or select one or more message types (the best selections for test results are shown in the image).
• Choose the number of days after which new message reminders should be sent.

Most of these settings are also available to Haiku, Canto and Provider Portal users.

• Manual: Email Reminders

Tippy - Separating "My Patients" Lists for Different Facilities

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

• Breaking-out "My Patients" Lists by Facility

When new to Connect Care, clinicians may not have had opportunity to apply Patient List skills to the creation of lists that suit their inpatient workflows. The Manual provides practical advice about how to set up new lists that are based on provincial templates, each optimized for particular work types (e.g., ward rounds, consults, patient management, transition planning).

• Manual: Patient Lists 

Primary care providers often serve patients in more than one facility. They may, for example, have inpatients in a community hospital as well as another set of patients in a long-term care facility. However, the default "My Patients" list will pool all provider-attached patients together.

One can sort a list by facility and room, but it can also help to have separate lists, each with different properties for different facilities (e.g., different columns for LTC patients).

• In the Hyperspace Patient Lists workspace, create a new My List.

• Use the "Copy" button in the new list properties to select one of the provincial templates (e.g., "++ AHS IP MD WARD ROUNDS TEMPLATE) and configure the Advanced properties as desired (see Manual).

• Once the new list is saved, look to the "Available Lists" (system lists) and find the facility of interest and then the "All My Patients" subfolder. Within that, find a relationship of interest (e.g., Attending provider) and drag that list from the Available Lists area to drop onto the newly created My List. The new list will contain an automatically updated list of the assigned patients for the specific facility.

• Manual: Patient Lists
• Demo: Facility-Specific Patient Lists

Tippy - Note to MRHP Replaces "Doctor's Clipboard"

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

• Using Sticky Notes to MRHP

Hospital wards typically maintained a "Doctor's Clipboard" listing tasks best addressed during ward rounds. With the move to Connect Care, the same function can be served by a "digital clipboard" integrated with lists and charts. Using this for communication needs that can wait till the next hospital round can significantly reduce secure messaging and other interruptions to clinician's work.

A "Sticky Note to MRHP" (MRHP = Most Responsible Healthcare Provider") can be added to a patient's chart by care-team members. The same note can be viewed by attending providers on rounds and edited or deleted as tasks are addressed.

MRHP Sticky notes can be highlighted in clinician workflows:

• A MRHP Sticky Note column can be added to patient lists. Hovering reveals the full note and double-clicking allows instant editing without opening the chart.
• The MRHP Sticky Note is displayed on the chart summary tab that shows by default when inpatient charts are opened, and can be personalized so that it displays at the top of an available column.
• The inpatient chart sidebar has an index entry for Sticky Notes that displays the MRHP Sticky Note in the sidebar.
• Vitals and Rapid Rounds discharge planning reports (Ward Rounds and Rapid Rounds patient lists and Transition Plan sidebar) include a display of the MRHP Sticky Note.

Once a task has been addressed, the relevant part of the MRHP Sticky Note should be deleted by the responsible provider.

• Demo: Using MRHP Sticky Notes
• Manual: Sticky Notes
• Crib Sheet: MRHP Sticky Notes

Tippy - Quick Set Primary Provider Team for Inpatients

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

• Set Primary Provider Team from Inpatient Lists

There are a number of Connect Care functions (e.g., reporting) that depend upon knowing which inpatient provider team is considered the "Primary" team attached to an inpatient. Patients can be linked to more than one team but only one can be the designated primary, or home, team.

The fastest way to support consistent attachments is through the use of standardized Connect Care patient lists.

Templates for "ED Consult" and for "IP Management" lists have a column that shows the primary team as well as the inpatient service (specialty) responsible. Double-clicking on one of these values brings up a pop-up editor where quick-buttons allow fast selection of the primary team:

Similar functionality is available wherever inpatient care teams are viewed and edited within an inpatient chart.

Tippy - Cut Down on Patient Blood Draws with Add-on Labs

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

• Reduce blood-draws by using add-on lab tests

Inpatients are typically burdened with one or more repeating blood draws (venipuncture) so that their clinicians can track important developments. Sometimes new information is needed after other blood samples have already been drawn. Wouldn't it be nice if additional information did not incur another poke?

Connect Care makes "add-on" blood testing easy:

• When ordering a new test, note how the order is displayed in the "New Orders" list prior to signing. If the test can be performed on blood already in the lab, a yellow-highlighted question appears:
  
  
  
  
  
• Click on the new order to open the order composer. Note that any recently reported results are shown (maybe the order can be cancelled!) and that an "Add-on" box can be used to add the test to an existing specimen (the date and time of the eligible specimen is provided). 
  
  
  
  
  
• The default option for the Add-on section is "New Collection". Selecting the "Use Existing Specimen" option instead, then signing the order, will prevent a new blood draw for the ordered test. 

Tippy - Compare 2 or More Radiology Images

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

• Comparing Studies with PACS Image Viewer

Clinicians can view diagnostic imaging test results within the Chart Review activity that appears as a main tab in all opened charts. On reviewing study results in the "Imaging" tab in Chart Review, a "PACS Images" section provides links to relevant images. Selecting a link opens the "Xero Viewer" in a pop-up window.

Comparing new to old images for a particular study type (e.g., Chest Xray) helps clinicians recognize important changes. A short demo shows how to do this with ease.

• Demo: Using Image Viewer to Compare Multiple Studies

Tippy - Ordering Repeating Tests

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

• Ordering Repeating Tests

Laboratory technologists do blood draws at roughly standardized times on most inpatient units. To order daily repeat testing that corresponds to morning phlebotomy, the easiest way to set testing intervals is by using the “Frequency” pick list in laboratory test orders. 

 

Sometimes it is important for tests to be drawn at a time other than the default morning slot. The best way to do this is to select “Daily Afternoon” or “Daily Evening” as the frequency, then use the “edit” (pencil icon) tool in the test schedule table to select the days for testing.

• Tip: Ordering Repeating Laboratory Tests
• Manual: Procedure Orders

Tippy - Adding or Updating Referring and Primary Care Providers in Clinic Schedule Lists

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

• Updating a Patient's Referring and Primary Care Providers in Outpatient Lists

Connect Care uses information about a patient's referring and primary care provider (PCP) to facilitate a number of workflows. 

Ensuring that both the referring provider and PCP are correctly identified prior to starting an outpatient encounter is essential to some communications and billing actions. While this information should be entered when visits are scheduled, prescribers should confirm its presence before initiating an actual visit. 

An appointment list column makes this easy to do. 

Note the column with "Ref/PCP Info" in its header. Missing information will be apparent within the column as a blank space. Users can double-click within that blank space to open an editing tool that facilitates rapid entry or revision of the correct referring or PCP provider name.

• Tip: Identifying/Modifying Primary Care and Referring Providers in the Clinic Schedule

Tippy - Fast Prescriber and Team Updates from Patient Lists

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

• Quick Changes to Prescriber and Team Attachments within Patient Lists

Clinicians caring for panels of inpatients often depend upon timely information about which patients are attached to inpatient teams. Many Connect Care system behaviours depend upon correct patient-attending attachments.  

The default workflow is to open a patient chart, go to the "Care Teams" activity, then update information about attending, referring, primary care, consulting or teams of prescribers associated with the patient. 

A faster workflow is to edit patient attachments right within patient lists, avoiding having to open each chart. This is supported when AHS-recommended list templates and columns are used (see Manual link below). 

To change an attending, referring or primary care provider, just double-click on the current (or blank) name. A focused pop-up editor will allow correction of that detail.

To change prescriber-patient attachments for many patients at once, select all (CTRL-A) or multiple (CNTRL plus click on the desired multiple rows) patients, then right click, and select. 

• Manual: Patient Lists
• Manual: Patient Attachments

Tippy - Pend, Share or Sign a Note?

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

• Pend, Share or Sign a Note?

Automated actions can be triggered by the signing of a note. For example, signed summative documents (e.g., discharge summaries) are automatically shared with Netcare and primary care providers when signed. After a document is copied to external systems, additional work is required if the same document needs to be re-shared. It is especially disruptive for community practices to sort through multiple copies of shared documents. 

Best practice makes use of two alternatives to signing:

1. "Pending” a note saves its current state as a draft but does not trigger any automated distributions. The author can return at any time to complete the note. Other authorized prescribers (e.g., attending physician) can take over a pended note by opening it for “Edit”. Pended notes appear within the “Incomplete” tab of the Notes activity within an opened chart.
   
   
2. "Sharing” a note saves the current state as a draft and does not trigger any automated distributions. The author, and other members of the clinical team (e.g., other trainees), can continue to work on the summative report. Authorized prescribers (e.g., attendings) can also take over a shared note by opening it for “Edit”. This workflow allows teams to collaborate in the preparation of summative documents, like discharge summaries.

Pended and shared notes are not available for viewing outside Connect Care, or the current Connect Care patient encounter. Once an authorized prescriber signs a pended or shared note, it becomes finalized, is visible on the appropriate Notes activity tab, and automated distribution actions (e.g., primary care provider copy, Netcare copy) are triggered. Any manual routing should be saved until after the note is signed.

For more information:

• Manual: Shared Documents

Tippy - Completing Consult Orders without Consult Notes

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

• Completing Consult Orders from Patient Lists

Admitting services may elect to complete an admitting H&P note and use this to fulfill documentation requirements for consultation requests from emergency departments. In this case, a Consult note is not prepared and the usual method for closing the consult order is not available. If the consult order is not "completed", the patient remains in the admitting service's unfinished consults list. 

A simple workflow can be used to complete the consultation order from within an inpatient list. This is done by using a "Physician Consults" report when a patient in a list is selected. The report has a link to "complete" the consult (simultaneously removing it from the list of unfinished consults).

• Tip: Completing Consultation Orders from within Patient Lists
• Manual: Consultation Workflows

Tippy - Routing Documents to External Systems When There Is No Primary Care Provider

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

• Sharing when there is no Primary Care Provider

When prescribers see patients in outpatient settings (office, clinic, etc.), a "Communications" workflow and "letter" typically is used to share findings with the primary care provider (PCP) and/or referring provider. The same workflow can be used to copy the communications letter to external systems, including the Netcare electronic health record. 

What if the patient has no PCP? Any of the following actions will result in a Netcare share:

• Emergency Provider
  The patient may have been referred from an emergency encounter, and the emergency provider can be entered as a "referring provider" before the communications activity is initiated. Communications can be routed to referring providers when there are no PCPs.
• Patient has no PCP
  Connect Care allows "Patient has no PCP" to be entered as the PCP for a patient. "Patient has no PCP" can also be selected as a letter recipient even when not set as the patient's PCP. Use of a Netcare letter template will work, but Connect Care will attempt a local print of the letter as well; this is avoidable by selecting "Print to PDF" and then not following through on the "save" part of the printing workflow.
• Copy to self
  Letters can still be routed to Netcare without primary care or referring providers identified. One can send or copy the letter to oneself (use ".ME" SmartLink in the recipients box). The letter will go to Netcare and be copied to the Connect Care prescriber's In Basket. 
  
  
  

When using letter templates that copy the information to Alberta Netcare where a primary care provider is not defined, providers should edit the default cover letter text to make it clear whether they participate in ongoing care or not. For example:

For more information:

• Manual: Shared Documents

Tippy - In Basket Notification for Inpatient Lab Results

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

• Get Notification for Selected Inpatient Test Orders

Results relating to orders placed within an inpatient encounter are, with few exceptions, managed within that encounter. There is no default routing to In Basket or other communication channels. The assumption is that results are routinely reviewed by the inpatient team.

 
Sometimes high-stakes results need clinician attention as soon as available. In such cases, inpatient prescribers can mark specific tests for In Basket notification.

Within an opened inpatient chart, go to the "Orders" activity and find the ordered investigation (e.g., imaging, laboratory test). Hover over the order of interest, looking to the far right of the row holding the order where a pick-list icon (q) will appear. Select this, then the "Notify Me" menu option:

The prescriber selecting the notify option will receive an In Basket message as soon as the requested result is available.

• Manual: Inpatient Results and Reports Routing

Tippy - Optimize Your Screen Resolution

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

• Make Room for More Hyperdrive

Connect Care Hyperdrive can be accessed via AHS facility workstations, laptops-on-wheels and tablets. Hyperdrive can also be accessed via AHS or personal laptops or tablets outside of AHS facilities. 

Sometimes the screen size of a portable computer causes Hyperdrive content to appear crowded, with loss of sidebar space or other useful user-interface features.

When using computers with smaller (LCD) screens, it is best to maximize the screen resolution, and so maximize the amount of Hyperdrive that can be displayed all at once.

• Windows 10 - Changing Screen Resolution
• Windows 11 - Changing Screen Resolution
• Macintosh OS - Changing Screen Resolution