A string of letters and numbers that is generated in the system for a patient or a proxy to use to gain initial access to the patient portal web page.
ADT stands for the admission, discharge, and transfer processes involved when tracking inpatient visits.
Faculty and staff members of advisory groups provide input and guidance on operational-level decisions related to CareConnect; escalate issues to appropriate leadership entities, as needed; and assist in providing an ongoing two-way communication channel between the health system and the CareConnect team.
The after visit summary (AVS) is a report summarizing such things as orders, diagnoses, and notes for an encounter that you can print and send home with a patient.
On the patient portal home page, alerts will inform patients of important things such as an upcoming appointment. If a patient clicks on the alert, the related page is opened.
The ambulatory rollout schedule details when the clinical applications and the patient portal will be implemented at the more than 150 patient-care clinics at UCLA Health throughout Southern California. The clinic go-lives are occurring in waves from June 2013 through February 2014.
Applications refer to different modules of software in CareConnect that perform specific functions. For example, the Cadence application contains all the scheduling workflows, ASAP covers emergency department workflows, and Beacon enables users to perform workflows related to oncology.
Application testing refers to testing all the modules within CareConnect. Testing was done to make sure the processes and workflows contained within it work as designed to enable faculty and staff members to use the system to do their jobs. Teams used scripts, or scenarios, such as admitting a patient or scheduling a patient, to make sure the applications perform properly. Application testing is the first stage of testing. (See Integration Testing below.)
At-elbow support is individual help in using CareConnect provided by super users at go-live and in the weeks following go-live. Super users will also provide in-class support to end users during training.
Everyone will need basic computer skills -- how to use a keyboard and a mouse -- to access CareConnect. A 15-minute tutorial accessible through CareConnect's website will help users gain an understanding of those basics. Click here to access the tutorial.
Care Everywhere is an application that provides access at the point-of-care to the patient's medical records from other organizations.
CareConnect Lite – a version of CareConnect designed specifically to replicate the functionality of cView and ClinDoc – serves as a bridge for physicians, other providers, and staff members until CareConnect’s documentation and Computerized Provider Order Entry (CPOE) are implemented in their clinics. The full version of CareConnect (EpicCare Ambulatory) is being rolled out to clinics in waves over nine months from June 2013 through February 2014.
CareConnect Lite provides:
Classroom training on using CareConnect Lite is mandatory.
Chart review is a function in CareConnect by which users can view reports about a patient's encounters, labs requests and results, imaging orders, procedures, medications, and more.
Clinic readiness refers to how prepared a clinic is to receive CareConnect. Determination of clinic readiness includes the evaluation of: physician and practice leadership desire to implement CareConnect; geography for support; size/staffing of clinic for training and go-live support; and dependencies/grouping across clinics and other go-live timing.
Clinical content is the core of CareConnect. Clinical content provides the "what" for patient assessments, care plans, and patient education tools. Content will be tailored to clinical departments. It is being developed separately from workflows in CareConnect. For more information, see the entry below on Specialty Specific Clinical Content SME Work Groups.
Clinical documentation refers to the electronic capture of clinical notes and flowsheets; patient assessments; and clinical information such as medication administration records in CareConnect.
A centralized location that serves as a base of operations during go-lives and installs.
CPOE stands for Computerized Provider Order Entry, a function of CareConnect that allows care providers to manage and communicate orders.
Credentialed trainers will serve as CareConnect experts in their assigned application. After receiving specialized training and becoming credentialed for CareConnect training, they will conduct end-user classroom training for all users.
The xDR is the enterprise data warehouse that UCLA Health is implementing to serve as the source for all secondary uses of clinical data, including quality improvement and research.
CareConnect offered previews of the system through demonstrations and informal cyber cafes at various locations throughout the health system. These demonstrations were targeted to specific roles and workflows. They gave faculty and staff members the opportunity to see how CareConnect will help them do their jobs, ask questions, and provide feedback to the CareConnect team.
Some of clinical devices were integrated with CareConnect so that the clinical information flows automatically into the electronic medical record. Examples are ventilators, anesthesia machines, and cardiac monitors.
Disaster recovery includes the policies and procedures associated with preparing for recovery or continuation of technology infrastructure in the midst of disruptive events. CareConnect's comprehensive disaster recovery plan provides multiple levels of redundancy within and across two duplicate data centers to ensure that the system continues to run in the event of a server or power failure or any disaster.
Dragon is voice-recognition software that helps clinicians navigate and dictate information directly into a patient's electronic record. CareConnect is investigating the implementation of Dragon. Learn more about Dragon Naturally Speaking.
Dress rehearsals provide opportunities for departments to do a "dry run" of a typical patient encounter using CareConnect for the first time. This testing allows the care team to have a first-hand experience prior to go-live and the project team to solidify workflows and resolve any outstanding issues. Dress rehearsals are held in the two months preceding go-live.
Enterprise-wide refers to all the UCLA Health facilities: Ronald Reagan UCLA Medical Center, Mattel Children's Hospital UCLA, Resnick Neuropsychiatric Hospital, UCLA Medical Center, Santa Monica, and 150-plus outpatient practices throughout Southern California.
An Electronic Health Record (EHR) is a longitudinal electronic record of patient health information generated by one or more encounters in any care-delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data, and radiology reports. The EHR automates and streamlines the clinician's workflow. The EHR has the ability to generate a complete record of a clinical patient encounter (as well as supporting other care-related activities directly or indirectly via interface) including evidence-based decision support, quality management, and outcomes reporting.
eMAR stands for electronic medication administration record, which monitors and documents the administration of medications.
EpicCare Ambulatory refers to the clinical applications -- documentation and orders -- in outpatient settings.
EpicCare Inpatient refers to the clinical applications -- documentation and orders -- in inpatient settings.
EpicCare Link is the web application that allows providers at an affiliate organization to view a patient's clinical data from CareConnect using the Internet. This product was implemented for the March 1, 2013 go-live.
Epic Systems Corp. is a company based in Verona, Wis., that makes software for mid-size and large medical groups, hospitals, and integrated health care organizations – working with customers that include community hospitals, academic facilities, children's organizations, safety net providers, and multi-hospital systems. Epic Systems Corp. supplies the software that provides the foundation for CareConnect.
An episode is a patient condition that spans several encounters such as pregnancy, back pain, or worker's compensation. The encounters can be linked for easier review and reporting. It is used primarily in ambulatory clinics and in hospital outpatient departments.
Leaders from across UCLA Health and the David Geffen School of Medicine were selected to form an Executive Oversight Board (EOB) responsible for providing direction and oversight for all CareConnect activities, enforcing CareConnect's Guiding Principles, and acting as sponsors and advocates of CareConnect.
The date when faculty and staff members begin using CareConnect is called a "go-live." Much of CareConnect was implemented simultaneously in a single go-live in March 2013 for:
March 1, 2013: Much of CareConnect's functionality was rolled out in a single day:
Scheduling, registration, billing, ADT, HIM, and health plan management at all hospitals (Ronald Reagan UCLA Medical Center, Resnick Neuropsychiatric Hospital at UCLA, and UCLA Medical Center, Santa Monica)
Scheduling, registration, referrals, and authorizations for UCLA managed care members at all clinics
Clinical applications - pharmacy, Computerized Provider Order Entry (CPOE), documentation, radiology, rounding lists - at all hospitals
Computerized Provider Order Entry (CPOE) and documentation at a group of clinics and procedure areas in our hospitals (Wave 0)
CareConnect Lite as a replacement for cView at all clinics (except those in Wave 0)
Health education is made up of patient education materials concerning clinical topics. It allows users to search for particular information about clinical topics, print related articles, and send the materials to an external email address.
Health information management (HIM) is the practice of maintenance and care of health records by traditional (paper-based) and electronic means in hospitals, physician's office clinics, health departments, health insurance companies, and other facilities that provide health care or maintenance of health records. With the widespread computerization of health records and other information sources, including hospital administration functions and health and human resources information, health informatics and health information technology are being increasingly utilized in information management practices in the health care sector. The HIM suite in CareConnect includes chart tracking, deficiency tracking, release of information, and coding and abstracting functions.
A hospital outpatient department is a specialty department that provides outpatient care to patients who may or may not be admitted to another department in the hospital. These departments often use a combination of clinical documentation tools from both EpicCare Ambulatory and EpicCare Inpatient.
Hyperspace is the integrated platform that hosts most of CareConnect's applications.
Implementation is an itemized plan that includes the steps needed to install the system and the estimated number of months it will take.
The InBasket is the electronic messaging system used within CareConnect.
Inpatient documentation refers to the notes, records of medication administrations, and other information entered into a patient's hospital chart.
After confirmation that CareConnect software works as it's supposed to through application testing (see glossary item for application testing above), integrated testing begins to ensure that CareConnect will communicate properly with existing systems at UCLA Health System.
Meaningful use is a government incentive program run by the Centers for Medicare & Medicaid Services to reward investment in electronic health records. CMS has developed a set of objectives (such as maintaining a medication list for each patient or providing patients with electronic copies of their records) and quality measures (such as appropriate management of patients with diabetes) to guide adoption of electronic health records. To receive meaningful use incentives, providers and hospitals need to demonstrate meeting these set of objectives and quality measures.
Medical informaticists are clinicians engaged in all aspects of understanding and promoting effective organization, analysis, management, and use of clinical information in CareConnect.
Medical Information Technology Services (MITS) develops and maintains the central technology infrastructure and provides services and applications to more than 20,000 people comprising the UCLA Health, UCLA Faculty Practice Group, and the David Geffen School of Medicine at UCLA.
The "Model System" is Epic Systems Corp.'s out-of-the-box electronic health record system. It is a set of common configurations, workflows, and content based on common practices, real-world content, and configurations gathered from dozens of health care organizations across the country that have successfully implemented the company's electronic health records.
Notes refers to the area where clinicians can type in information to add to a patient's chart. The clinician can also view previously added notes in this section.
Optimization is an ongoing process that begins after go-live. It involves refining CareConnect to work as effectively as possible based on lessons learned through our everyday use of it.
Order entry refers to the activity of placing medication and procedure orders for a patient.
An order set is a preconfigured group of orders that is commonly ordered together for a specific problem or diagnosis. Order sets can be suggested based on entries in your patient's problem list. Order sets used most frequently can be identified as favorites.
Patient-service kiosks are interactive computer stations, which perform self-service tasks such as patient check-in, collection of co-payments, and wayfinding. They can speed processes for patients and take some of the workload from registration personnel, who are then freed up to help patients with more complicated registration or payment needs. They were not used as part of the first implementation.
PlanLink is an Epic Systems software component that allows external providers who are contracted with UCLA Medical Group to check eligibility, view referrals, submit referrals, and work with claims in CareConnect.
The playground is a replica of CareConnect containing fictitious patient information that enables faculty and staff members to practice their skills in using the system once they've been trained.
Practice management includes the processes of scheduling, admission-registration, hospital and professional billing, discharge, and transfer.
A set of frequently used orders. Providers may maintain their own personal preference list to include orders they have pre-configured based on their preferences.
CareConnect has more than a dozen principal trainers who create and maintain lesson plans, develop curriculum, and other training materials for future users of the program. The principal trainers work with assigned process teams to make sure the training curriculum is up-to-date and provide training to credentialed trainers and super users.
After training in CareConnect, all users must demonstrate proficiency in using CareConnect to do their jobs before receiving a log-in and password to the system.
The term "readiness" refers to two different aspects of the implementation:
Readiness assessments occurred at 30, 60, 90, 120, and 150 days before go-live to evaluate all factors contributing to go-live in preparation for the implementation of CareConnect. They included examination of planning, hardware, system build, and end-user training.
In the spring of 2012, CareConnect enlisted managers to serve as “readiness leads” for their work areas /departments. Readiness leads from throughout the health system will play key roles in ensuring a smooth implementation. They will work closely with the CareConnect team to prepare for go-live, tracking and reporting their area’s progress on readiness tasks.
Ready users are members of the faculty or staff who have both the will and the skill to be able to use CareConnect effectively and efficiently to do their jobs.
Scanning refers to the process of turning paper medical records into an electronic format for viewing and archiving in CareConnect.
Scope refers to departments, processes, and systems that will be included in CareConnect. (View CareConnect's scope.)
Scope of practice defines the procedures, actions, and processes that can be performed by licensed or certified faculty and staff members in CareConnect - by law for specific education and experience, and demonstrated competency. Future users of CareConnect will perform work at the highest level authorized by their licensure or certification as defined by scope of practice standards.
Site visits are the first step in the implementation process. Teams of staff from our software vendor, Epic Systems Corp., paired with UCLA staff, visited different areas of our hospitals and clinics. Their goal was to gain a general understanding of our operational workflows and how our existing systems fit into them. In contrast to validation sessions, these were very "light touch" events.
SmartLink is a SmartTool that pulls or links information from the patient record directly into your documentation. For example, if you enter .name, the patient's name is pulled in.
SmartList is a SmartTool that allows you to choose from a list of preconfigured choices in a SmartText or SmartPhrase. These can be single- or multiple-response lists.
SmartPhrase is a SmartTool that allows you to type a few characters into your documentation which automatically expands into a longer phrase or block of text. For example, .pt will come up as patient.
A SmartSet is a documentation template which displays groups of orders and other elements, such as notes, chief complaints, SmartGroups, and levels of service – that are commonly used together to document a specific type of visit.
A text template for charting that can include text, SmartPhrases, SmartLists, and SmartzLinks which is frequently used in progress notes.
SMEs, or Subject Matter Experts, are members of the faculty or staff with expertise in a specific area. SMEs (often pronounced "smees") inform all aspects of CareConnect's development by reviewing and validating Epic System Corp.'s Model System; providing input about workflow design, system configuration, interface functionality, training, go-live, etc.; and serve as liaisons/advocates with eventual CareConnect users.
Sneak Peeks give faculty and staff members a chance to see CareConnect after the design and build have been largely completed and to offer feedback on technical features and work processes before training begins. Using realistic patient-care or patient business services scenarios, Sneak Peeks also validate that end-to-end workflows perform as they should and that data from one setting to another within CareConnect flow correctly across the health system.
Learn more about Sneak Peeks.
Specialty-Specific Clinical Content SME (subject-matter expert) Work Groups composed of physicians, nurses, pharmacists, and other subject matter experts were tasked with reviewing and validating existing UCLA clinical content; recommending clinical content design to address gaps; representing specific specialties across UCLA to reach consensus on all content design; and serving as liaisons/advocates with eventual CareConnect users.
Super users are eventual CareConnect end users who are respected by peers and trained to: assist in adoption pre-go-live, support peers during training, provide dedicated support to peers at go-live, serve as ongoing "go-to" people for peers, and act as liaisons to the CareConnect team. CareConnect's program involved about 2,000 faculty and staff members serving as super users to assist end users in their own areas of expertise.
Technical readiness refers to how prepared a clinic is to receive CareConnect from a technological standpoint. Determination of a clinic's technical readiness includes an evaluation of the following criteria: end-user devices, network connectivity, and complexity of devices to integrate and contract obligations to other systems. A "CareConnect Technology Requirements" document details the requisite technology standards and policies to create a robust technology environment capable of supporting the implementation and adoption of CareConnect. (See the full document here.)
Test scenarios, or sets of instructions performed in CareConnect – such as transferring a patient or issuing a refund – were tested individually to ensure that they function properly on their own. Individual application modules in CareConnect are made up of dozens of test scripts.
Validation sessions were held to examine workflows in Epic’s Model System to ensure that faculty and staff will be able to use all the workflows incorporated into CareConnect to perform their jobs. Hundreds of faculty and staff from across UCLA Health and the David Geffen School of Medicine began meeting in May 2011 through October 2011, to review workflows pertinent to their areas of expertise. Model system workflows that required modification to meet our business and clinical needs wereevaluated in subsequent validation sessions or examined by work groups, advisory groups, and executive-level decision-making groups, as needed.
Web peeks are online demos with audio descriptions of selected CareConnect functions and tools. These 6- to 10-minute web peeks offer a quick way to learn more about CareConnect before training. Launch available Web Peeks.
A workflow in CareConnect walks a user through the steps needed to do their job. CareConnect started with workflows offered in Epic's Model System, asked hundreds of faculty and staff members to validate the workflows, and then modified them to accommodate the way we work at UCLA Health System.
Faculty and staff members of work groups provide subject-matter expertise. They review and validate Epic’s Model System and provide input regarding workflow design, system configuration, interface functionality, training, and more.