Clinical Information System (CIS) / Connect Care Implementation
Clinical Information System (CIS) / Connect Care Implementation: The intervention (exposure) is the implementation of the Connect Care Clinical Information System (CIS) across Alberta Health Services (AHS) acute-care facilities. Connect Care integrates comprehensive electronic health records, clinician communication tools, pharmacy dispensing data, laboratory and diagnostic imaging results, standardized medication reconciliation, and electronic discharge summaries. It supports coordination across hospital, specialty, and primary care settings and includes a patient-facing portal allowing access to personal health information. The CIS rollout occurred at multiple sites with staggered launch dates and represents one of the largest Epic deployments.
Study summary
This is a retrospective, observational study using routinely collected information collected by Alberta Health Services. The study will identify patients with chronic disease, defined by one or more of the following conditions; diabetes mellitus, heart failure, coronary artery disease, chronic kidney disease, or chronic lung disease. Adult residents of Alberta with a chronic disease of interest present upon hospital admission and who survive to hospital discharge will be included in the study cohort. The primary outcome will be the composite of hospital readmission or death within 30 days of discharge. Secondary outcomes will include components of the composite, length of stay, patient experiences related to their hospital to home transition of care, and processes of care. Multi-level interrupted time series analysis will be used to compare outcomes before versus after implementation of the Connect Care CIS.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
* Adults aged 18 years or older at the time of hospital admission.
* Residents of Alberta eligible to receive acute-care services in AHS facilities.
* Hospitalized for any cause during the study period (5 years pre-implementation and 2 years post-implementation of the CIS).
* Meet the validated case definition for one or more of the five key NCDs (diabetes mellitus, chronic kidney disease, coronary artery disease, heart failure, or chronic lung disease) based on ICD codes, laboratory measures, or pharmacy records during standardized lookback periods (up to 5 years for diagnoses; up to 1 year for labs/pharmacy).
* Have a qualifying date for the NCD(s) that occurs prior to or during the index hospital admission.
* Eligible for inclusion in the primary and patient experience outcomes if they survive to hospital discharge.
* May enter multiple sub-cohorts if more than one NCD is present.
Exclusion Criteria:
* Individuals younger than 18 years at the time of hospital admission.
* Non-residents of Alberta or individuals not eligible for care within AHS facilities.
* Hospitalizations that end in death (excluded from analyses of the primary outcome and patient experience measures).
* Patients without evidence of any of the five key NCDs during the lookback period or at the index hospital admission.
* Admissions outside the study period or admissions for which necessary administrative, laboratory, or pharmacy data are unavailable.
Primary outcome measure(s)
All-cause unplanned hospital readmission or death within 30 days after hospital discharge — Within 30 days after hospital discharge This primary outcome captures whether a patient experiences either (1) the unplanned hospital readmission for any cause or (2) death from any cause within 30 days following discharge from an acute-care hospitalization. The outcome is restricted to patients who survived to hospital discharge. Analyses will also be stratified by the presence of each of the five key NCDs (diabetes, CKD, CAD, heart failure, chronic lung disease) and by multimorbidity (two or more of the NCDs).
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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