Build Semantics
The Epic software environment uses a number of terms that overlap clinical and organizational terminology. For example, "Department" has a particular significance as a unit of organization for workflow within the Epic ecosystem but a very different meaning, with different organizational implications, in Alberta Health Services and affiliate organizations.
This section highlights areas where health care words and concepts have different meanings when used to refer to the design and build of Connect Care.
Service
The word "Service" usually refers to a coordinated grouping of health care assets (people and resources) sharing a common clinical purpose. The same word is used in a number of places in Epic and in AHS's Connect Care. Users are confronted with, for example, pick lists and patient lists bearing the name "service" that do not share a common set of available items to choose from. Indeed, these different service listings reflect different underlying concepts.
Hospital (Admitting) Service
The "ADT Service List" (EPT 18886) serves inpatient facilities admitting patients to groups of providers organized to provide a specific clinical service. The options are limited to clinical services that have admitting privileges and beds assigned for use by attending (MRHP) clinicians associated with that service. The admitting hospital service is selected when an admission order is placed (hard stop) but can be revised by bed management staff. It can also be revised if a patient is subsequently moved to a different service through a transfer order. A "patient status" order can be used at any time to make corrections or adjustments to a patient's hospital service.
Contents
Clinical services available within a facility that have capacity to take primary responsibility for a patient in one of the facility beds or other inpatient accommodation resources.
Provided by AHS facilities during preparation for launch.
Terms standardized, as much as possible, so that all services of a particular type share the same name in different facilities.
Context
Patient
Use
Bed allocation, reporting, dashboards, reporting workbench, slicer dicer, work balancing.
Not supported in patient lists.
Display
Can be accessed with "AHSIPSERVICE" SmartLink and appears in provincially standardized documentation templates.
Exposed via hover bubble in StoryBoard and in inpatient sidebar displays (transition planning).
Control
Unit managers, ADT staff and prescribers have access to orders or other tools for updating a patient service allocation.
Present in admission order, transfer order and "update patient status" order.
Not available for editing via SmartForms and not currently supported for editing in navigators or activities, including popup activities.
Oversight
Clinical Service, Clinical Documentation Service, Author Service
A "Clinical Service List" (ECT 34886) is used to categorize documentation (e.g., progress notes, discharge summaries) entered to a patient's chart by providers. This same list is used to align Handoff Reports and the Subjective-Objective and Assessment-Plan note components in problem oriented charting (POC), where each service is able to maintain its own layer of shared documentation objects. This list includes clinical services that may not have facility beds (or admitting privileges) assigned and so is expected to be larger than the Admitting Service list.
Contents
Clinical services available within a facility that can contribute to patient care, either as a primary or contributing (e.g., consulting) care team member.
Provided by AHS facilities and clinical departments during preparation for launch.
Terms standardized, as much as possible, so that all services of a particular type share the same name in different facilities.
Context
Provider
Note (HNO 59)
Use
Documentation, chart filtering, reporting, provider-allocation.
Display
Can be accessed with "AHSIPNOTESERVICE" and "AHSOPNOTESERVICE" SmartLinks and appears in provincially standardized documentation templates.
Exposed in note editors and problem oriented charting navigators.
Control
The inpatient documentation service is entered by the clinician adding content to a patient chart, where a service pick-list appears at the top of the documentation editor (e.g., for a progress note).
Outpatient documentation service is derived from appointment booking attributes and normally cannot be changed by clinicians documenting on that outpatient encounter.
Oversight