This resource has been created to provide guidance for trainees who are new to using Connect Care. 

Table of Contents

• Login

• Outpatient Configuration

• Inpatient Configuration

• Personalize Patient Lists

• Personalize Documentation

• Avoiding Note Bloat

• Problem List 

• Medical History

Configure Outpatient Schedule 🗓️

The Schedule activity is where you find the Schedule for Outpatient (Ambulatory) clinics

• Schedule shows the patients that are scheduled to be seen today by you. But as a trainee patients are, typically, not scheduled to be seen by you they are scheduled to a physician.

The steps below can be used to see the schedule for the physician(s) you are working with.

• from the schedule activity click on your name, where it appears in the top left corner

• click the pushpin to pin this view

• click the ➕ create button

• name the new schedule view

• click configuration tab

• click Provider radio button

• enter the name of the physician you are working with

• click Accept

The schedule for that physican will now appear and be available for you to select each time you login.

Admitted Patients

As a trainee you will be, primarily, interacting with patients that are admitted to the hospital or scheduled for an outpatient office visit.

• DO NOT USE Patient Lookup to find patients who is scheduled for an outpatient visit or is admitted to the hospital, this includes  patients in the Emerg.

• There are examples of when you would use patient lookup to search for a person who is no longer admitted to the hospital. That is functionality that you will learn as you have spent more time in connect care.

Patient Lists 🧍

There are a different ways to find a patient, or patients.

Add a Supervising Physician

The most helpful way to populate My Patients is to add the patients of your supervising physician(s). To do this: 

• Right click on the title My Patients and select Edit Criteria 

• The top of the window that appears is titled Add Providers 

• Make sure there is a checkbox next to Admitting, Attending, and Treatment Team 

• In the provider search field enter the name of your supervising physician. 

• Click Accept 

• The list will update to show the seven patients associated with that physician  

Add Provider Team

• Using Available Lists, bottom left corner, find the name of your facility

• The facilities are organized by community and then the name of the facility

• After clicking on the facility name scroll through the list of subfolders to find Provider Teams 

• Each hospital has a unique list of provider teams, scroll down to the team you are working with 

• Right click select Send To → My Patients

Add by Unit 🛏️

• Go back to the top level for your facility

• Click on the folder titled Units

• Scroll down to find the unit that your patients are admitted to, 

• Right click, select Send To → My Patients

Configure the Consult list

• go back to EMD WMC University of Alberta Hospital

• scroll down to New Consults - Physician

• in that folder scroll down to find the service you are working on e.g., Internal Medicine

• right click select Send To → My Consults

Finding Patients – Surgical Cases

Surgical cases will appear in the schedule for the OR where the case has been requested or booked. Status Board is the best way for Trainees (residents and fellows) to see the schedule of surgical cases.

Snapboard provides a view of the scheduled cases in the ORs are your facility. To access snapboard for OR procedures you first have to login to the appropriate zone department i.e., Edmonton Zone Gen Surg, Calgary Zone Surgery, etc.

Surgical Job and Department

To access SnapBoard you have to ensure you are logged in to the surgery job and a surgical department:

1. Select the job Resident - Surgery

2.  Select a surgical department i.e., Edmonton Zone General Surgery, Calgary Zone Pediatric Surgery, etc.

Access SnapBoard

Snapboard does not appear by default, to access is

• Click EPIC menu at the top left of the hyperspace window

• • find the Reports menu

  • Hover over SnapBoard

  • notice the pushpin icon that appears, click the pushpin

  • select "add to toolbar" to have snapboard appear at the top of the hyperspace window.

Run Snapboard

When you first launch snapboard you have to identify what facility you want to run it for. 

• When you are logged in to a Surgery Department each facility in your zone will be listed

• Select the appropriate facility name

• Click the Run button (lower right corner)

the Chart

Chart Review is all history for this patient that is in Connect Care, for real patients there should be a lot of information here

• Summary is just this admission

• The search tool in the storyboard will search the current admission (summary) and historic information (chart review)

Navigators 🧭

IMPORTANT

As a trainee you will be interacting with navigators related to ADT, Admission, Discharge, Transfer

If you are involved in a patient going through one of these transitions you MUST use the appropriate navigator. It is not correct to simply write an admission order using the orders activity tab, that will NOT result in an appropriate/complete admission

For an admission the actions that are completed in the admission navigator are: update the Problem List, write the H&P note, complete the Admission Orders actions (which includes home medication reconciliation).

Notes 🗒️

Trainees are supervised by fully licensed prescribers who must co-sign or attest to many trainee activities in the Connect Care clinical information system (CIS).

• One activity where co-signs are required relates to discharge documentation.

• Discharge, transfer, deceased, operative and consult reports are Connect Care summative documentation types that also flow to Netcare. Without a co-sign, the summative document will post to Netcare under the trainee's name (as opposed to the attending prescriber), which in turn provides an inaccurate reflection of the record of care and can impact follow-up efforts.

• When authoring a note that requires a co-sign check off the co-sign box, enter the name of the supervisor who will be cosigning your note.

• That person will receive a message to their InBasket that links to the note so it can be reviewed and signed.

Note Templates

The following note templates have been incorporated in to Connect Care to provide standardized documentation by typing the "dot phrase" shown: 

• Progress note ".ahsipheadingsProgress"

• H&P Admission note  ".ahsipbasicAdmit "

• Consult note  ".ahsipbasicConsult "

• Discharge Summary  ".ahsipbasicDCSummary "

Orders

As a trainee you have the authority to sign orders, but you may be asked to have your orders reviewed before signing, or have them signed by others. This may be true when starting to work in a new area as part of an elective or off-service rotation and/or for complex sets of orders such as for an admission.

• Save work → Not Ready - orders are hidden from all other Connect Care users

• Save work → Ready - your orders can be seen by all other prescribers in connect care

• Confirm with the team, who they want you to inform when you have orders that are ready, and HOW you want you to c

PERSONALIZATION

Customizing Patient Lists  

Add Provider Team(s) to My Patients

When you start a new clinical rotation ask for the name of the Provider Team(s) that patients from your service are admitted to. 

Add a Provider Team to your Patient list

• Lower left corner all the hospitals will be listed

• Find your hospital in the Available Lists,

• After clicking on the hospital name scroll down to find the folder called Provider Teams.

• In this folder you can find a list of teams.

• Find the name of your team

• Add it to your Patient’s list by

• right clicking on the name of the list and

  • selecting Send To … My Patients

  • select the list to add it to.

Add Consult Service(s) to My Consults

When you start on a new clinical service confirm with your colleagues the name of the service to add.

To add a consult service to My Consults

• Find your hospital in the Available Lists,

• After clicking on the hospital name a list of folders will appear.

• New Consults – Physician is the folder you are looking for

• Open this folder.

• Scroll down to find the name of the appropriate list of New Consults.

• Add it to your My Consults list by

  • right clicking and selecting

  • Send To … My Consults

City Wide Call – Consult Service for Multiple Locations

Some specialties will respond to consult orders from more than one hospital. To manage these consults, it is suggested to make a new patient list separate from My Consults and My Patients.

To create a new patient list:

• Locate the wrench icon that appears Above My Consults which is labelled “Edit List”

• After clicking on that icon select Create My List

• In the new window that appears enter a name for this list

• Use the Available Columns section to add at least one column (The next section of this document outlines how to add, remove, and apply column templates.)

• After adding columns click Accept

• Add the appropriate specialty service from New Consult – Physician for each of the hospitals you will be covering when on call.

Configuring Patient List Columns

You will find it helpful to update the configuration of columns that appear in your patients list.

Add Columns

You can add, and remove, individual columns from the default configuration, such as adding a column to show Attending.

• Right click on the name of the list and select properties

• The screen that appears shows Available Columns

• Scroll down or use the search function to find Attending

• Select the column with your mouse, then click the Add Column button.

• Add additional columns as you wish

• When finished click Accept.

Apply a Column Template

The easiest way to configure patient list columns is to apply a template which updates all columns. Below are names of column templates that have been created for AHS providers that you can apply to existing Patient Lists, or make new lists for specific purposes such as Discharge Planning

To apply a template to a patient list:

• Right click on the name of the list, select properties

• In the window that opens find the Copy button (half way down on right side)

• After clicking that Copy button scroll down to find the template

• Select the one you want to use, then click Accept.

Column Template Names

• AHS MD SERVICE MANAGEMENT – works well with the My Patients list

• AHS MD WARD CONSULTS TEMPLATE – consult information apply to My Consults list

• AHS MD WARD ROUNDS – apply to My Patients or make a copy of My Patients specific to Rounding.

• AHS MD DISCHARGE MANAGEMENT – Discharge planning specific information, could create a specific discharge planning list and use this template.

Order Preferences 🌟

TERMINOLOGY- epic uses the term preferences when talking about orders. A preferred order can also be called a favourite you may see both terms when working with orders

• Personalization prefix - a good prefix should have at least 3 characters and be something you will never forget. We suggest people to use their initials as you will never forget your initials.

• The green ➕New will take you to see your favourites  when you click the “Only Favourites” it displays the items that you have made a favourite.

• You can create a favourite order by clicking the ⭐ that appears in the name of the item in the shopping cart.

• Create Panel allows you to group 3 or more items together so that you can order multiple items in one preferred order

  • Options → Create Panel

  • Name your panel, using your prefix

Order Sets

To customize an order set type the name of the orderset in the order panel e.g., “Gen Med Admit”

• ✏️ can be used to customise a particular item of the orderset

• Order sets personalised by others can be found by going to the 🔧Personalize in the red banner and selecting User Smartsets

Copying Favourite Orders from Another User

Go to 🔧 My Tools, found at the top of the hyperspace sceen

• Click Preference List Composer (your second choice)

• Click the Copy User Lists button that appears at the bottom of this screen

• Enter name of person you are copying from in the From User field

• Put a check mark next to the order group you want to copy i.e., Orders Outpatient or Orders Inpatient

• Click the ✔️Copy button to copy all those orders over to your favourite orders

• Click Close to go back to the first screen and show you that you now have have those orders in your favourites, double click on the Outpatient order line and it will show you the name and information of all the orders you copied

Notes

SmartPhrases and SmartLinks

SmartPhrases are note templates that are made from a combination of text, smartlinks, and smartlists. SmartLinks are short codes that pull information from a patient’s chart. For example when “.ALGP” is typed in a note it will insert a list of the patient’s adverse reactions (allergies).

How to add a SmartPhrase to a note

• Typing the name of the smartphrase, with a “.” in front will insert that smartphrase

• For example .ahsipbasicconsult will insert a standard consult template

System SmartPhrases

Below are some standard SmartPhrases that have been developed for AHS providers. These can be used as the basis for notes you author.

• Progress note                         .AHSIPheadingsPROGRESS

• Consult note                               .AHSIPbasicCONSULT

• Admission History & Physical  .AHSIPbasicADMIT

• Discharge note                           .AHSIPbasicDISCHARGESUMMARY

How to Access Your SmartPhrases

Find the MyTools menu, top and middle of the Hyperspace screen. Select My SmartPhrases, fifth down. From here you can create your own smart phrases, or access those created by other users.

How to Copy SmartPhrases from another user

• Go to My SmartPhrases, using the steps above

• In the middle towards the top of the screen your name will appear

• Change the name to another user

• Look at the description to find a SmartPhrase you are interested in

• Double click on the name to open it

• Copy the SmartPhrase by clicking Copy bottom right corner

• Name it, starting with your initials

• Make changes as appropriate

Avoiding Note Bloat

Key steps in reducing note bloat are to make “what changed” easy to find and to interpret, rather than replicate, clinical information.

Write Lean

Write for change and lead with what has changed since the last note and the decision/action it drives. Interpretation of information, if you include data, add what it means and what you’ll do, rather than populating notes with a lot of data 

Lab Result Table in Notes

It is common for note templates to be configured to load recent lab results into the note, which can lead to note bloat and make progress documentation difficult to read.

In some cases, the lab table is incorporated into the note template to make it easy for the author to review recent lab results, for the author’s not the reader’s benefit.

• Interpretation not replication: if you include data, add what it means and what you’ll do, rather than populating note with a lot of data for the reader to interpret.

Link, Don’t Copy

Linking to previous documentation is more effective than copying and pasting into a note. For example, if a patient has a report from a procedure or consult that can be linked in to documentation for those that want to review it.

To link a note, procedure, or test result

• Go to Chart Review

• Select the appropriate subsection (cardiology, notes, etc.)

• Right click on the one you want and select Copy Links

• Paste this link into the note.

Avoid Duplication and Clutter

When a patient is admitted and a consult note has been authored for the patient, it is possible to use the Interval H&P workflow, so the existing consult note is used to satisfy the requirement for an admission note.

• This is found in the Documentation section of the Admission Navigator.

Adding the patient’s name, date of birth, MRN, etc. is not necessary in progress documentation.

• Provincial summative note templates include this information automatically, reducint the need to type the information in.

Use Prose Smart Links

Smartlinks are a useful way to add information from the chart to notes. In some cases, smart links will add information in a table that can contribute to note bloat.  Most smartlinks have a prose version that is easier for the reader. For example, when adding vital signs to a new use .VSP rather than .VITALS.

Below are some common prose smartlinks that you will find helpful

• Hospital Medications .MEDLISTIPP

• Home Medications     .MEDLISTEDHMP

• Medical History           .PMHP 

• Surgical Hx                    .SURGICALHXP

• Family History              .FAMHXP       

• Hospital Problems       .HPROBP

• Last Vital Signs             .VITALSO2P

Problem List and Hospital Course

A list of active health conditions (“Problem List”) appears in all Connect Care charts. The list flags diseases, disorders, injuries or health conditions that have an impact on, or could be impacted by, a patient’s current care. Gaining proficiency in problem list management is an essential skill.

Problem List Etiquette

Connect Care is a shared health record, with collaboratively maintained problems, allergies, history, medication, and other lists. All are entitled, indeed expected, to contribute to keeping lists relevant and succinct. All changes are recorded, and there is always a way to backtrack from a change. 

Hospital Course 

The hospital course section is accessible from the Problem List chart activity. It is used to provide a high-level, concise, summary of key developments during the inpatient or emergency department encounter.

Hospital course is a collaborative activity, allowing multiple providers to record key developments occurring during a patient’s admission, which is then incorporated into the Discharge Note. This allows for important elements of the Discharge Note to be started at the beginning of, and updated throughout, their admission. 

History 

History is a condition that no longer impacts or is impacted by a patient’s current care. Included in the Problem List Activity is the patient’s medical history, appearing immediately after the Hospital Course. Medical history includes substance use, family history, and surgical history. 

Updating history in this section ensures this information is available to everyone that accesses the patient’s chart and allows for ease of entering this information into current and future documentation.