Connect Care Builders - External Link Norms

External Link Norms

Connect Care clinical system design (CSD) principles emphasize "transparent" clinical content, where clinical guidance (guidelines, protocols, studies, evidence, etc.) is readily available to users within their workflows.

Although it may be tempting to embed narrative instruction in order sets, for example, excessive explanatory material adds to the length, complexity and clutter of tools that prescribers need to navigate efficiently. Accordingly, embedded information should be limited to the minimum text essential for safe use by most clinicians. Additional supporting evidence should be made available via external links. These allow users to access support materials if and when needed.

This section addresses key considerations when deciding whether to embed external resource links within clinical content, and how such links should be configured. Other sections deal with link management techniques, link naming conventions and the complexities of internal (EpicACT) links.

External Link Anchors

The text, button or other user-interface element that is used to activate an external link can be referred to as the link "trigger" or "anchor". Whenever possible, trigger text should comply with Connect Care's link naming convention. This helps users to anticipate what will happen, and what information they will be able to access, when a link is selected. It also helps users avoid inefficiencies associated with clicking on links in order to discover what information is on offer.

In general, link triggers should identify the type of information expected followed by a title reflecting the information content; using "type: content" syntax (e.g., Handbook: EpicACT Links):

Handbook: Link Naming Conventions

External Link Markup

External links are inserted within SmartText, SmartPhrases, Order Composers and other user interface elements by using the "hyperlink" menu or toolbar tool (🔗) found within object editors. Some text fields (e.g., flowsheet row descriptions/instructions) do not include editor tools for marking-up trigger text as a hyperlink. There are two options that builders can try in order to insert hyperlinks in such areas:

Copy/Paste
Create the anchor text and hyperlink in a different editor (e.g., SmartPhrase editor), then copy the text/link block and paste it in the text field where the hyperlink is desired.
XML Markup
Some Epic text boxes support use of XLM markup coding. Use the following syntax:<ELINK>http://www.epic.com/<ENAME>Click here to Epic site</ELINK>

External Link Types

External links, and the associated target displays, are "unmanaged" or "managed":

Unmanaged External Links
are usually a simple URL (internet address) added to documentation, decision or inquiry supports using default text-editor, order-composer or dashboard-design tools. Hyperspace takes care of how the internet resource (web page) is displayed. The words "Alberta Health Services" appearing in a letterhead, for example, may be hyperlinked to the "https://ahs.ca" internet address. The linked information may appear in a popup window, in a hyperspace workspace or within a chart activity, under Epic's control and reflecting what usually works best.
Managed External links
make use of EpicACT links to provide builders with additional controls over where (popup, sidebar, activity, workspace, etc.) information is displayed, how it is displayed (e.g., viewer dimensions), and what capabilities are provided to users (e.g., whether printing is enabled).

Managed External Links

Managed external links are inserted in the same places as unmanaged links, most commonly as hyperlinks within SmartText that is, in turn, used in navigators, templates and other clinical content. The difference is that managed links do not start with "http://" or "https://". Instead, they use one of the following "EpicACT:" links. The target "URL" (e.g., http://, https://, mailto:, etc.) is specified as a parameter of the EpicACT link. The parameter (URL) portion of the EpicACT link should comply with Health Evidence Exchange link management guidelines. The activity portion of the EpicACT link should be chosen from the options below to optimally display the intended content in the intended place.

Hyperdrive update:

The following Activities, offering different formatting options for the display of external links, do not work as intended in Hyperdrive. When viewed in Hyperdrive, the Activities will automatically redirect to a standard Microsoft Edge external browser window.

Help Popup - External Link to Help or Support Resources

Activity: AC_SUPPORT_BROWSER
Link Format: "EpicACT:AC_SUPPORT_BROWSER,RunParams:URL"
Example: "EpicACT:AC_SUPPORT_BROWSER,RunParams:https://manual.connect-care.ca/support/Downtime-Procedures"
Display:
- Popup window with 4:3 horizontal aspect appearing superimposed on current workspace with "Connect Care Support" in titlebar.
- Uses Epic internalized (Internet Explorer ActiveX Control) browser technology.
- Provides home button such that users can navigate back to the initial help link. Forward/backward navigation enabled.
- No internet address field.
- Suppresses internet page scripting error messages.
- Minimalist toolbar, no menus, with print disabled.
Usage:
- Best for display of user help topics, usually as links to content in the Connect Care Clinician Manual.
- Some URLs may include special characters (e.g., "#", "@"). If links to these resources do not initially work, consider first creating a managed link using the Health Evidence Exchange. Alternately, substitute "RunParamsURLEncoded" for "RunParams" and use an ASCII escape code for the special character(s) in the URL.

Guidance Popup - External Link to Clinical Guidance or Supporting Evidence

Activity: AC_GUIDANCE_BROWSER
Link Format: "EpicACT:AC_GUIDANCE_BROWSER,RunParams:URL"
Example: "EpicACT:AC_GUIDANCE_BROWSER,RunParams:https://ahsweb.ca/HEE/Practical-Tips-HFrEF-ARNI"
Display:
- Popup window with 3:4 vertical aspect appearing superimposed on current workspace with "Clinical Guidance" in the titlebar.
- Uses Epic internalized (Internet Explorer ActiveX Control) browser technology.
- Provides home button such that users can navigate back to the initial help link. Forward/backward navigation enabled.
- No internet address field.
- Suppresses internet page scripting error messages.
- Minimalist toolbar, no menus, with print enabled.
Usage:
- Best for display of clinical evidence or guidance, usually as Health Evidence Exchange links.
- Especially useful for display of pdf document types, as layout resembles the printed page.
- Some URLs may include special characters (e.g., "#", "@"). If links to these resources do not initially work, consider first creating a managed link using the Health Evidence Exchange. Alternately, substitute "RunParamsURLEncoded" for "RunParams" and use an ASCII escape code for the special character(s) in the URL.

Resource Popup - External Link to Other Resources

Activity: AC_RESOURCE_BROWSER
Link Format: "EpicACT:AC_RESOURCE_BROWSER,RunParams:URL"
Example: "EpicACT:AC_RESOURCE_ BROWSER,RunParams:https://status.connect-care.ca"
Display:
- Popup window with square aspect appearing superimposed on current workspace with "Connect Care Resource" in titlebar.
- Uses Epic internalized (Internet Explorer ActiveX Control) browser technology.
- Provides home button such that users can navigate back to the initial help link. Forward/backward navigation enabled.
- No internet address field.
- Suppresses internet page scripting error messages.
- Minimalist toolbar, no menus, with print enabled.
Usage:
- Can be tried for general purpose documents, usually as Health Evidence Exchange links.
- Note that this browser control does not suppress scripting errors within web pages and so Internet Explorer minor incompatibilities may become apparent (and annoying) to the user.
- Some URLs may include special characters (e.g., "#", "@"). If links to these resources do not initially work, consider first creating a managed link using the Health Evidence Exchange. Alternately, substitute "RunParamsURLEncoded" for "RunParams" and use an ASCII escape code for the special character(s) in the URL.

Browser Popup - External Link to Other Resources in full Internet Browser Window

Activity: AC_EXTERNAL_BROWSER
Link Format: "EpicACT:AC_EXTERNAL_BROWSER,RunParams:URL"
Example: "EpicACT:AC_EXTERNAL_ BROWSER,RunParams:https://help.connect-care.ca"
Display:
- Uses full instance of Internet browser, with version reflecting what is installed on same instance of Citrix Workspace that Epic Hyperspace runs on.
- Menus, toolbars and features as configured for IE in Citrix Workspace (enterprise security constraints may limit available features)
Usage:
- Can be tried for general purpose documents, usually as Health Evidence Exchange links.
- Best used when other links (as above) generate errors or malformed web pages.
- Some URLs may include special characters (e.g., "#", "@"). If links to these resources do not initially work, consider first creating a managed link using the Health Evidence Exchange. Alternately, substitute "RunParamsURLEncoded" for "RunParams" and use an ASCII escape code for the special character(s) in the URL.

Browser Popup with Options - External Link to Resources Optionally Appearing in a new Instance of Internet Browser

Activity: ED_FLOATING_BROWSER
Link Format: "EpicACT:ED_FLOATING_BROWSER,RunParams:URL|Options1|Option2"
Example: "EpicACT:ED_FLOATING_BROWSER,RunParamsURLencoded:https://connect-care.ca%7Credirectcontent"
Options:
- redirectcontent - if used, this redirects the URL to an instance of Internet browser (full browser, not ActiveX control embedded within Epic Hyperspace) outside of Epic where the instance is the one installed in the same Citrix workspace (virtual machine) that Epic hyperspace launches within.
- showtoolbar/hidetoolbar - controls whether Internet browser toolbar is available or not
- printenabled/printdisabled - controls whether printing is enabled from the popup browser
- homedisabled/homeenabled - controls whether home button is present or not
- silent - attempts to suppress Internet browser scripting errors (version incompatibilities for more modern web pages); not relevant if redirectcontent is used
- showiemenu/hideiemenu - controls whether Internet browser menus are suppressed or not
- showvscroll/hidevscroll - controls whether vertical scrollbar is shown or not
Display:
- Popup full Internet browser browser superimposed on current workspace.
- Floating - can be moved to a separate monitor.
- Uses Epic internalized (Internet Explorer ActiveX Control) browser technology unless "redirectcontent" option is specified, in which case the Internet browsere version available to citrix workspace is used.
- Options allow specific control over whether things like home button and printing are supported.
Usage:
- Can be tried for general purpose documents, usually as Health Evidence Exchange links.
- Best use for when it is important (usually for web page compatibility reasons) to bypass the Internet Explorer ActiveX control (and version) embedded in Epic Hyperspace.
- Some URLs may include special characters (e.g., "#", "@"). If links to these resources do not initially work, consider first creating a managed link using the Health Evidence Exchange. Alternately, substitute "RunParamsURLEncoded" for "RunParams" and use an ASCII escape code for the special character(s) in the URL.

Chart Sidebar - External Link to Resources Appearing in the Sidebar in Open Charts

Activity: AHS_IP_WEB_VIEWER_SIDEBAR
Link Format: "EpicACT:AHS_IP_WEB_VIEWER_SIDEBAR,RunParams:URL"
Example: "EpicACT:AHS_IP_WEB_VIEWER_SIDEBAR,RunParams:https://blogs.connect-care.ca/?m=1"
Display:
- Web page displays within the (right) sidebar available within an opened patient chart.
- Uses Epic internalized (Internet Explorer ActiveX Control) browser technology.
- Does not suppress internet page scripting error messages.
- No toolbar or other navigation controls with page navigation supports and print enabled.
Usage:
- Can be tried for general purpose documents, usually as Health Evidence Exchange links.
- Important to limit to documents those that can automatically format (dynamically resize) to fit within a narrow-width display area and avoid documents that rely on additional hyperlinks for meaning, as these may go to resources that do not format optimally for the narrower display of a sidebar.
- Use with care because the link will only resolve (open) if the trigger (link anchor) is presented within an opened chart. This link will NOT display information in a patient list, schedule or In Basket sidebar.
- Note that this browser control does not suppress scripting errors within web pages and so Internet Explorer incompatibilities may become apparent (and annoying) to the user.
- Some URLs may include special characters (e.g., "#", "@"). If links to these resources do not initially work, consider first creating a managed link using the Health Evidence Exchange. Alternately, substitute "RunParamsURLEncoded" for "RunParams" and use an ASCII escape code for the special character(s) in the URL.

Chart Activity - External Link to Resources Appearing within an Activity Tab in Open Charts

Activity: IP_BLANK_BROWSER
Link Format: "EpicACT:IP_BLANK_BROWSER,RunParams:URL"
Example: "EpicACT:IP_BLANK_BROWSER,RunParams:https://www.dynamed.com/"
Display:
- Web page displays within a new activity (tab) within an opened patient chart.
- Uses Epic internalized (Internet Explorer ActiveX Control) browser technology.
- Does not suppress internet page scripting error messages.
- No toolbar, menu, page navigation supports and print disabled.
Usage:
- Can be tried for general purpose documents, usually as Health Evidence Exchange links.
- Use with care because the link will only resolve (open) if the trigger (link anchor) is presented within an opened chart. This link will NOT display information in a patient list, schedule or dashboard.
- Avoid resources or web pages that may need home, navigation, print or other browser tools.
- Note that this browser control does not suppress scripting errors within web pages and so Internet Explorer minor incompatibilities may become apparent (and annoying) to the user.
- Some URLs may include special characters (e.g., "#", "@"). If links to these resources do not initially work, consider first creating a managed link using the Health Evidence Exchange. Alternately, substitute "RunParamsURLEncoded" for "RunParams" and use an ASCII escape code for the special character(s) in the URL.

HyperSpace Workspace - External Link to Resources Appearing in a New Workspace Tab

Activity: WM_WEB_BROWSER
Link Format: "EpicACT:WM_WEB_BROWSER,RunParams:URL"
Example: "EpicACT:WM_WEB_BROWSER,RunParams:https://www.dynamed.com/"
Display:
- Web page displays within a new workspace (tab) in Hyperspace, outside of any opened charts.
- Uses Epic internalized (Internet Explorer ActiveX Control) browser technology.
- Does not suppress internet page scripting error messages.
- No toolbar, menu, page navigation supports and print disabled.
Usage:
- Can be tried for general purpose documents, usually as Health Evidence Exchange links.
- Use with care because the user will have to navigate back and forth between the new workspace tab and any opened charts, with a small risk of error if more than one chart(s) are open at the same time.
- Note that this browser control does not suppress scripting errors within web pages and so Internet Explorer minor incompatibilities may become apparent (and annoying) to the user.
- Some URLs may include special characters (e.g., "#", "@"). If links to these resources do not initially work, consider first creating a managed link using the Health Evidence Exchange. Alternately, substitute "RunParamsURLEncoded" for "RunParams" and use an ASCII escape code for the special character(s) in the URL.

Reporting Workbench - External Link to Resources Appearing in a New Reporting Workbench Tab

Activity: AC_RW_WEB_BROWSER
Link Format: "EpicACT:AC_RW_WEB_BROWSER,RunParams:URL"
Example: "EpicACT:AC_RW_WEB_BROWSER,RunParamsURLencoded:https://manual.connect-care.ca/norms/minimum-use-norms/minimum-use-norms-dashboard%7Csilent"
Display:
- Web page displays within a new tab in the Reporting Workbench, outside of any opened charts.
- Uses Epic internalized (Internet Explorer ActiveX Control) browser technology.
- Does not suppress internet page scripting error messages.
- No toolbar, menu, page navigation supports and print disabled.
Usage:
- Can be tried for general purpose documents, usually as Health Evidence Exchange links.
- Use with care because the user will have to navigate back and forth between the new workspace tab and any opened charts, with a small risk of error if more than one chart(s) are open at the same time.
- Note that this browser control does not suppress scripting errors within web pages and so Internet Explorer minor incompatibilities may become apparent (and annoying) to the user.
- Some URLs may include special characters (e.g., "#", "@"). If links to these resources do not initially work, consider first creating a managed link using the Health Evidence Exchange. Alternately, substitute "RunParamsURLEncoded" for "RunParams" and use an ASCII escape code for the special character(s) in the URL.