Netcare is evolving. Connect Care is moving forward. Community Information Integration (CII)/Central Patient Attachment Registry (CPAR) implementation is underway. These initiatives are intended to provide a more comprehensive patient record and give physicians and other health care providers more information upon which to make patient-care decisions.

Technology is only as good at the practices surrounding its use. The Alberta Medical Association believes that with the current investment in information integration, there are several opportunities over the short and medium term to improve how information flows between these systems.

“Over the next two to three years, there are opportunities to significantly improve information exchange by leveraging existing zone-based best practice at a provincial level,” says Dr. Heidi Fell, Chair, AMA Informatics Committee. “The goal is to support coordinated care by moving forward with integration; we don’t want to create stand-alone solutions or lose any of the progress that has been made.”

How a new Clinical Information System will help Albertans
Short-term priorities

Here is an overview of the improvements that could be made in the next two to three years:

  • Share standard Connect Care Emergency Department (ED) summaries by sending the summaries to Netcare to replace the sometimes inconsistent format and availability of zonal ED summaries sent today. In addition, enable integration of Connect Care ED summaries to electronic medical records (EMRs) used by the patient’s medical home.
  • Close the gaps in sharing standard specialist consult reports by sending the Connect Care Specialist Consults to Netcare from all locations and routing Connect Care Specialist Consults to EMRs.
  • Ensure community-based specialist consults are available to Alberta Health Services (AHS) providers using Connect Care as CII/CPAR implementation progresses. CPAR/CII ensures these consults are available in Netcare.
  • Explore ways to share patient-summary-level information collected from community physicians in the CII hub to AHS providers using Connect Care.
  • Share other standardized reports as Connect Care replaces existing disparate solutions across the province. This could include sending standard Connect Care reports to Netcare from all AHS locations and routing them to EMRs.
  • Use CPAR panels to improve coordination of patient care and facilitate better transitions between the community providers and AHS.

Medium-term priorities

The following priorities have more considerations when designing an integration solution. It’s important to assess the risks associated with making processes more complex by adding steps. It’s equally important that current functionality and integration are not removed.

  • Explore the long-term strategic direction to improve care coordination and transitions associated with the patient referral/consultation process, especially between community and AHS care settings. Advantages might include improved access to advice, which could alleviate the need for a full referral and reduce wait times, or the physical transfer of patients between care settings. Implementation would need to consider the effect on the existing referral process, workflow design, patient engagement and notification. 
  • Improve the exchange of diagnostic ordering between community providers using EMRs and organizations performing diagnostic services. Integration with the Connect Care Lab System could enable closed order and result tracking within the EMR while reducing the potential for data entry errors. While there is not a single diagnostic imaging system to integrate, there is an opportunity to align some processes and streamline orders. 
  • Look for a viable solution to provide secure clinical messaging between providers and between patients and providers. While secure messaging solutions exist, they lack the ability to communicate with existing solutions, which creates complexity in workflow and maintaining the legal record of care.

“We’ve been looking at solutions to close certain gaps in information sharing, but to date, they have not been feasible,” explains Dr. Fell. “With the introduction of Connect Care and CII, there is the potential for new and cost-effective solutions for better integration.”

The goal with all information integration priorities is to improve patient care while minimizing complicated workflows. The AMA continues to work with its stakeholders to look for opportunities to improve Alberta’s electronic health record landscape.

Community Information Integration (CII) is a system that transfers select patient information between community electronic medical records and other members of the patient’s care team through Alberta Netcare, including community specialist consultation reports and specific information from the primary care chart.

Connect Care is the Alberta Health Services provincial care transformation initiative. It is powered by a common provincial clinical information system that will replace most of the more than 1,300 existing systems across AHS.