Connect Care was supposed to revolutionize Alberta Health Services. Then came the pandemic

In 2016, Alberta's then-NDP provincial government announced a $1.6 billion, five-year project to replace thousands of separate systems tracking and storing patient information within Alberta Health Services. Six years later we wanted to check in on what is happening and where the project is at. Here is what we know.

What is Connect Care?

Connect Care is a new digital filing system for AHS, or what's known as a clinical information system. Rather than the current method of recording, tracking and storing patient information across more than a thousand systems, Connect Care implements a model of "one patient, one record" — at least within AHS.

AHS initially declined to comment for this story, but after publication spokesperson Kerry Williamson reached out to add that Connect Care "is supported by a comprehensive integrated medical record across AHS and our partners."

It sounds complicated.

It's certainly a major undertaking to overhaul the digital infrastructure of the largest integrated provincial health-care system in Canada.

But it's actually intended to be simplified compared to the current AHS system, which is really sort of a hodgepodge of more than 1,000 different systems and repositories stitched together.

How did things get to be such a mess?

That's a complicated question, but it's partly a result of the formerly federated system of regional health authorities in Alberta, as well a messy transition from paper records to digital. It was only in 2009 that the nine previous regional health boards were consolidated into AHS.

Who came up with Connect Care?

"Connect Care is the culmination of international leadership of the province of Alberta in digital health care," says Daniel Baumgart, professor of gastroenterology and computing science at the University of Alberta.

He points to the Electronic Health Record Information System, introduced in 1997, as an important predecessor to the new system.

The idea of a unifying province-wide system has been around for quite a while. But this specific project dates back to 2016, when the provincial government, under Rachel Notley, announced a $1.6 billion, five-year project to replace most of the 1,300 separate systems within AHS.

The government contributed $400 million in new funding, while the remainder is to be made up from cost-saving efficiencies created by the new system.

The actual technology behind Connect Care is a customized version of a software system developed by an American company called EPIC, a decision applauded by Baumgart.

"Alberta has wisely not chosen to deploy the out-of-the-box version, but has actually invested greatly into adapting the system to the needs of Albertans," he says, noting that health care delivery in the U.S. is considerably different from the Canadian context.

So it's been in the works for a long time. How far along is it?

This being a massive project with many moving parts, the strategy has been a nine-stage piecemeal rollout rather than one huge disruption to the entire healthcare sector. The initial introduction of the system was in November 2019 at the University of Alberta Hospital.

But the plan has itself been disrupted by the COVID-19 pandemic since then. Wave 4 of the rollout took place in May 2022, nearly a full year behind schedule. Wave 5, slated for next month, was previously planned for Fall 2021.

In the meantime, training thousands of doctors, nurses and other health-care workers to use the new system at a time when those workers are already stretched thin due to the pandemic has been a contentious challenge.

"Not only are AUPE members receiving training on Connect Care, we are often the ones providing that training," AUPE vice president Susan Slade said in a statement. "What we ask is that AHS provide the proper time for all staff to receive training while adjusting schedules so that already burned-out hospital staff are not overworked further."

When will the rollout be finished?

The current plan has the final rollout happening in fall 2024.

But the new government under Danielle Smith has promised significant changes at AHS, and has not said whether the existing plan for Connect Care will proceed unaltered.

Nate Glubish, now Minister of Technology and Innovation, recently announced a fact-finding trip to Denmark to "learn more about the Scandinavian nation's approach to managing health data and how it can improve outcomes for Albertans."

Melissa Crane, Glubish's press secretary, said in a statement to CBC News that "Minister Glubish will share his findings with his cabinet and caucus colleagues, including the Minister of Health."

She noted that Connect Care is still being rolled out.

"Once fully implemented, AHS will need time to evaluate its efficacy and if it is functioning as intended."

What will the new system mean for Albertans?

From a patient perspective, you'll have increased access to your digital health-care information. But it also impacts the patient experience indirectly, in that it simplifies the sharing of information for health-care providers.

The "one patient, one record" model means that your medical history is kept in one place for all providers under the AHS umbrella. However, that doesn't include primary care providers like your family doctor, who are private business owners. Instead, they will have indirect access to the system through the existing Netcare system, which will have some integration with Connect Care.

Baumgart points to future potential developments of the system. Computerized decision-making support in the form of artificial intelligence could, for example, alert a patient or their health-care provider about a clinical trial for their rare condition taking place in another part of the province. Or it could alert a physician about a drug interaction before prescribing new medication.

Some decision-making support is already active in Connect Care. But Baumgart imagines such a system growing in scale and sophistication comparable to the computerized system for pilots in an aircraft.

"A computer can keep track of many things that a human might not be able to," he says.

For now, however, Connect Care is just intended to keep track of medical records — if it can ever get fully off the ground.