The Connect Care clinical information system (CIS) includes powerful tools for accessing, personalizing, building and sharing patient lists. Some contexts, such as those for emergency and surgical prescribers, have highly specialized lists. All prescribers can access a Patient Lists activity where groups of patients can be defined, tracked and shared.
The "My Lists" section of Patient Lists groups patient lists of personal significance to the signed-on provider. The default "My Patients" list contains all patients associated with the current provider by virtue of an attending, team or assigned responsibility. The user can copy any existing list to make a personalized derivative. It is also possible to create custom personal lists from scratch.
Other lists may be shared by colleagues. This allows inpatient groups to create and share lists that serve a specific purpose, such as quality rounds cases.
Patients can be moved between lists, assigned, de-assigned, or removed.
Inpatient lists found in the "Available Lists" area are particularly powerful, as they can leverage “system" information to pre-populate lists with patients associated with particular locations, groups, services, consultations and activities. Prescribers can use these to help initiate personal, team and shared lists.
System lists categorize patients by characteristics that span multiple facilities.
Facility lists group patients by current facility nursing unit, support service area (e.g., diagnostic imaging), clinical service, or functions like incoming consult requests.
Most health care facilities group inpatient beds, providers and services in ways that simplify consultation, bed-assignment, and multi-provider cross-coverage arrangements. Within a general surgery service, for example, there may be teams that take turns admitting patients, other teams focused on tasks like consulting, and others focusing on specific types of care (e.g., trauma service).
Connect Care expresses clinically meaningful groupings through an inpatient "Provider Teams" functionality. A folder listing all available Provider Teams appears within each facility folder within System Lists. Note that "Treatment Teams" and "Provider Teams" are synonymous, and both terms can be used in different places with in Epic user interfaces.
All admitting, transfer and consulting workflows require selection of the accountable Provider Team, with the result that most Provider Team lists are automatically populated. The Care Teams (within a chart) and Patient Lists activities make it easy to move patients between teams. A Patient List right-click popup menu has options for assigning and removing from the available Provider Teams.
Similar terms are used in Epic to refer to different types of patient-provider attachments. It is important to appreciate the difference between, for example, a "Provider Team" and a "Patient Care Team". This is easiest to appreciate through the "Care Teams" activity, which can be accessed with global search (within a chart) or via the patient's Storyboard or SnapShot.
The "Patient Storyboard" appears as the leftmost column when patient charts are opened in any Connect Care module. Just below the chart search box, the current patient's most responsible provider is identified. Hovering or clicking on this brings up a "Care Teams" activity displaying all providers and teams in a formal care relationship with the patient. The attachments can be added, edited or removed. There are up to four sections:
- Attending Provider - appears for inpatients and reflects the most responsible provider while admitted.
- Treatment Team - appears for inpatients, listing all providers and provider teams associated with the patient while admitted.
- Patient Care Team - appears for all patients, listing providers and teams that have an enduring relationship spanning multiple encounters, including the patient's Primary Care Provider (PCP).
- Referring Provider - appears for inpatients, Emergency Room encounters and some outpatient encounters where a referral for service pertains (this relationship can also be set in the Service Code Navigator activity).